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      A Study on the Psychological Wound of COVID-19 in University Students

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          Abstract

          An increasing number of studies have addressed the psychological impact of the COVID-19 crisis on the general population. Nevertheless, far less is known about the impact on specific populations such as university students, whose psychological vulnerability has been shown in previous research. This study sought to examine different indicators of mental health in university students during the Spanish lockdown; we also analyzed the main sources of stress perceived by students in relation to the COVID-19 crisis, and the coping strategies adopted when faced with the situation. Data was collected from 932 students (704 women) through a web-based platform. Measures of anxiety (i.e., GAD-7), depression (PHQ-9), irritability, and self-perceived change in mental health were administered, as well as ad hoc measures of stressors and coping strategies. Results indicated that students experienced considerable psychological problems during the confinement, with higher rates of emotional difficulties in women and undergraduate students than in men and postgraduates, respectively. Psychological distress was mainly related to several specific domains of stressors, as perceived by the participants: academic future, task overload, worsening of interpersonal conflicts, and restrictions in pleasant social contact; and far less related to the spread of the disease and its consequences for physical health. As regards coping strategies, both reframing skills and daily routines were shown to be the most effective. A path-analysis model integrating stressors, coping, and mental health revealed that coping strategies partially mediated the effect of stressors on psychological health. In general, results suggest that students’ psychological health was substantially affected by the COVID-19 situation and that the academic and relational changes were the most notable sources of stress. This study reinforces the need to monitor and promote mental health in university students to boost resilience in times of crisis. Our results on effective coping strategies may inform preventive programs aimed at helping students to deal with challenges like the COVID-19 pandemic.

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          Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives

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            A brief measure for assessing generalized anxiety disorder: the GAD-7.

            Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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              The PHQ-9: validity of a brief depression severity measure.

              While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
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                Author and article information

                Contributors
                Journal
                Front Psychol
                Front Psychol
                Front. Psychol.
                Frontiers in Psychology
                Frontiers Media S.A.
                1664-1078
                26 January 2021
                2021
                26 January 2021
                : 12
                : 589927
                Affiliations
                [1] 1Cognitive Processes & Behavior Research Group, Department of Social Psychology, Basic Psychology, and Methodology, University of Santiago de Compostela , Santiago de Compostela, Spain
                [2] 2Department of Social, Psychology, Basic Psychology, and Methodology, University of Santiago de Compostela , Santiago de Compostela, Spain
                [3] 3UNDERISK, Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela , Santiago de Compostela, Spain
                Author notes

                Edited by: Eduard Brandstätter, Johannes Kepler University Linz, Austria

                Reviewed by: Ceymi Doenyas, Koç University, Turkey; Brigitte Lueger-Schuster, University of Vienna, Austria

                *Correspondence: Estrella Romero, estrella.romero@ 123456usc.es

                This article was submitted to Personality and Social Psychology, a section of the journal Frontiers in Psychology

                Article
                10.3389/fpsyg.2021.589927
                7870473
                33574786
                67b724ef-cd49-4331-8274-74d8cacc4d17
                Copyright © 2021 Padrón, Fraga, Vieitez, Montes and Romero.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 31 July 2020
                : 04 January 2021
                Page count
                Figures: 1, Tables: 7, Equations: 0, References: 83, Pages: 15, Words: 0
                Funding
                Funded by: Consellería de Cultura, Educación e Ordenación Universitaria, Xunta de Galicia 10.13039/501100008425
                Categories
                Psychology
                Original Research

                Clinical Psychology & Psychiatry
                university students,psychological impact,covid-19,stressors,coping,convida-20

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