Psychosocial Adjustment of U.S. College Students in the Early Months of the COVID-19 Pandemic
Saved in:
| Title: | Psychosocial Adjustment of U.S. College Students in the Early Months of the COVID-19 Pandemic |
|---|---|
| Language: | English |
| Authors: | Okado, Yuko, Scaramella, Courtney, Nguyen, Ha M., Mendoza, Benjamin, Watarastaporn, Tanya |
| Source: | Journal of American College Health. 2023 71(4):1281-1292. |
| Availability: | Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals |
| Peer Reviewed: | Y |
| Page Count: | 12 |
| Publication Date: | 2023 |
| Document Type: | Journal Articles Reports - Research |
| Education Level: | Higher Education Postsecondary Education |
| Descriptors: | Psychological Patterns, College Students, COVID-19, Pandemics, Stress Variables, Anxiety, Depression (Psychology) |
| DOI: | 10.1080/07448481.2021.1926268 |
| ISSN: | 0744-8481 1940-3208 |
| Abstract: | Objective: Examine the psychosocial adjustment of U.S. college and university students during the early months of the COVID-19 pandemic. Participants: Higher education students in the U.S. (N = 228), recruited between March 2020 and May 2020. Methods: Participants completed self-report measures regarding their psychosocial functioning online. Qualitative and quantitative methods were used to explore participants' psychosocial adjustment. Results: Participants reported increased concerns about such stressors as academics, job loss, health, and social isolation. They reported significantly elevated symptoms of depression, anxiety, perceived stress, and somatization, and prior history of psychological counseling was associated with greater levels of distress. Approximately one-third of participants reported inadequate perceived social support, which in turn was linked to psychosocial adjustment. Conclusions: College students reported experiencing a wide range of stressors related to the pandemic. Increasing access to mental health services and providing supportive services in such areas as social connection and employment are encouraged. |
| Abstractor: | As Provided |
| Entry Date: | 2023 |
| Accession Number: | EJ1389492 |
| Database: | ERIC |
|
Full text is not displayed to guests.
Login for full access.
|
|
| FullText | Links: – Type: pdflink Url: https://content.ebscohost.com/cds/retrieve?content=AQICAHj0k_4E0hTGH8RJwT4gCJyBsGNe_WN95AvKlDbXJGqwxwFxzEoIgjS_RxlfS1oLupMLAAAA4zCB4AYJKoZIhvcNAQcGoIHSMIHPAgEAMIHJBgkqhkiG9w0BBwEwHgYJYIZIAWUDBAEuMBEEDGcPSKsi8oxRW7CMRQIBEICBm7RRFmFycz2sqO2ti4wtqJNdagReUSy6Dzou65ixiNqHGEXUPXCDoZhYdHd6g1r41pPf5FFBDMzbElP9lA67QHCs51DOInOjDbzJX3D3kZGZXoUSXsJtDdsmxkqRy_ZeKGDOuDd-3TJaR3B-KM7-9AwVf8LME6lzYivF--OkzTOEcse0_5InKxpz2dLV2-YbOiXx7nXQ57Pc_YRk Text: Availability: 1 Value: <anid>AN0164011030;acl01may.23;2023Jun02.06:31;v2.2.500</anid> <title id="AN0164011030-1">Psychosocial adjustment of U.S. college students in the early months of the COVID-19 pandemic </title> <p>Objective: Examine the psychosocial adjustment of U.S. college and university students during the early months of the COVID-19 pandemic. Participants: Higher education students in the U.S. (N = 228), recruited between March 2020 and May 2020. Methods: Participants completed self-report measures regarding their psychosocial functioning online. Qualitative and quantitative methods were used to explore participants' psychosocial adjustment. Results: Participants reported increased concerns about such stressors as academics, job loss, health, and social isolation. They reported significantly elevated symptoms of depression, anxiety, perceived stress, and somatization, and prior history of psychological counseling was associated with greater levels of distress. Approximately one-third of participants reported inadequate perceived social support, which in turn was linked to psychosocial adjustment. Conclusions: College students reported experiencing a wide range of stressors related to the pandemic. Increasing access to mental health services and providing supportive services in such areas as social connection and employment are encouraged.</p> <p>Keywords: College; COVID-19; mental health; stress</p> <p>The coronavirus (COVID-19) pandemic has posed unprecedented psychosocial changes and challenges to individuals across the globe. Empirical studies and data regarding the mental health impact of COVID-19 in the U.S. are emerging rapidly in the literature and suggest that adults in the U.S. are experiencing greater levels of emotional distress and mental illness, including depression, anxiety, perceived stress, and sleep disturbances,[[<reflink idref="bib1" id="ref1">1</reflink>], [<reflink idref="bib3" id="ref2">3</reflink>]] exacerbated by such factors as intensified health concerns, economic hardship, restricted personal freedom, prolonged social isolation, and conflicting or confusing public health messages from authorities.[[<reflink idref="bib4" id="ref3">4</reflink>], [<reflink idref="bib6" id="ref4">6</reflink>]] Indeed, a study based on national surveys administered by the U.S. Census Bureau has found that adults in the U.S. were more than three times as likely to positively screen for depressive disorder, anxiety disorder, or both in April to May of 2020 compared to the first half of 2019, with 35.9% of adults screening positive for one or both types of disorders in 2020.[<reflink idref="bib3" id="ref5">3</reflink>]</p> <p>Students in higher education may be particularly vulnerable to increased psychological distress during the pandemic, given the relatively high prevalence of mental illness in this population even prior to the pandemic.[<reflink idref="bib7" id="ref6">7</reflink>] Previous estimates claim that around 17% or more of U.S. college students are affected by serious psychological distress.[<reflink idref="bib8" id="ref7">8</reflink>] Another study with an international sample found that 20.3% of college students had a Diagnostic and Statistical Manual of Mental Disorders-IV/Composite International Diagnostic Interview disorder, of which 83.1% arose prior to matriculation.[<reflink idref="bib9" id="ref8">9</reflink>] Such diathesis combined with such stressors as sudden changes, disruptions, and restrictions to their primary responsibilities (e.g., courses moving online; loss of opportunities for training; sudden loss of or change in routine; relocation; loss of job, shelter, or food security; loss of childcare) and fear of infection can be expected to increase the number of students that report clinical levels of distress.[[<reflink idref="bib10" id="ref9">10</reflink>], [<reflink idref="bib12" id="ref10">12</reflink>]]</p> <p>Indeed, colleges and universities have introduced major changes and challenges to their students' psychosocial and academic functioning as a result of COVID-19. On March 6, 2020, the University of Washington became the first major institution of higher education to cancel in-person classes and exams in response to the COVID-19 pandemic. Over the next few weeks, more than 1,100 additional colleges and universities across all 50 states canceled face-to-face instruction and rapidly shifted their courses to an online modality.[<reflink idref="bib13" id="ref11">13</reflink>] This sudden and unexpected transition to virtual learning required students to quickly adapt to the online learning environment, even if they did not have the requisite technology, technological skills, or preparation. As colleges and universities were forced to continue limiting their on-campus offerings of courses, resources, and services, students have faced serious challenges to their coping, with the sudden loss of access to secure housing in college dorms, consistent meals at dining halls, and a steady source of income through work-study programs.[<reflink idref="bib13" id="ref12">13</reflink>] Moreover, changes in instructional methods and workload, as well as uncertainty regarding course expectations, have been cited in a large single-campus study as some of the greatest sources of frustration related to academics.[<reflink idref="bib11" id="ref13">11</reflink>]</p> <p>In addition to the potential financial and educational stress posed by the COVID-19 pandemic, the transition from studying and possibly residing on campus to being sheltered at home may lead many students to be removed from crucial social and emotional supports or increase caretaking responsibilities, further exacerbating their psychological distress.[<reflink idref="bib14" id="ref14">14</reflink>] A literature review conducted by Brooks et al.[<reflink idref="bib15" id="ref15">15</reflink>] highlighted several studies in which individuals that have experienced forced quarantines suffered from distressing emotional states, due to factors such as separation from friends and loved ones, disease status uncertainty, excessive boredom, and general loss of freedom. Thus, the effects of stay-at-home orders may be deleterious for college students' mental well-being. For those students that receive mental health services on campus, the inability to access those essential services in person may further exacerbate their psychological symptoms and increase some students' risk for substance abuse and suicide.[<reflink idref="bib12" id="ref16">12</reflink>] Although data for American students are still emerging in the literature, one study of Dartmouth College students found that self-reported symptoms of depression and anxiety spiked noticeably after students were asked to leave campus and plan for the switch to remote learning, compared to the previous two years,[<reflink idref="bib16" id="ref17">16</reflink>] and another study at the University of Southern Mississippi found an increase in symptoms of depression, anger, and mania in Spring 2020 compared to Fall 2019.[<reflink idref="bib17" id="ref18">17</reflink>] Studies on other campuses have documented elevated levels of mental health symptoms and distress as well.[<reflink idref="bib11" id="ref19">11</reflink>],[<reflink idref="bib18" id="ref20">18</reflink>] Relocation due to COVID-19 has been linked to increased loneliness, generalized anxiety symptoms, or increased psychosocial distress in large national samples of college students.[<reflink idref="bib14" id="ref21">14</reflink>],[<reflink idref="bib19" id="ref22">19</reflink>] Similar effects have been found abroad as well.[<reflink idref="bib20" id="ref23">20</reflink>],[<reflink idref="bib21" id="ref24">21</reflink>]</p> <p>In addition to the psychosocial stressors mentioned above, perceived social support and certain aspects of the student's demographic background, for example those associated with underserved academic status (e.g., low-income; first-generation to attend college; racial or ethnic minority), may also impact students' adjustment. With regard to social support, previous studies have linked higher levels of perceived social support to better mental health and more benign interpretations of stressors.[<reflink idref="bib22" id="ref25">22</reflink>] Moreover, perceived social support has been shown predict symptoms related to depression, anxiety, stress and life satisfaction, in expected directions.[<reflink idref="bib23" id="ref26">23</reflink>],[<reflink idref="bib24" id="ref27">24</reflink>]</p> <p>Furthermore, demographic factors associated with underserved student status, such as having a low-income background, being a first-generation college student, and being a racial or ethnic minority have also been associated with increased risk of psychological distress among college students.[[<reflink idref="bib25" id="ref28">25</reflink>], [<reflink idref="bib27" id="ref29">27</reflink>]] However, as not all studies find the impact of such demographic characteristics on mental health symptoms,[<reflink idref="bib28" id="ref30">28</reflink>] and how they interact with psychosocial stressors introduced by the COVID-19 pandemic is unclear. This study aimed to fill such gaps by exploring these factors.</p> <p>In sum, based on existing literature, it would be anticipated that college students adapting to the period of rapid transition to online learning, stay-at-home orders, and other changes introduced by the COVID-19 pandemic during Spring of 2020 would report elevations in stress-related psychological symptoms, including anxiety, depression, and somatization. Accordingly, this study explored the psychosocial challenges experienced by college students in the U.S. during the transition to remote instruction (specifically, between March 19, 2020 and May 20, 2020) and their impact on mental health. For brevity, we will use the term "college students" to refer to those pursuing postsecondary education at American colleges and universities at all levels, including undergraduate and graduate students.</p> <p>The present study took a primarily exploratory approach and utilized qualitative and quantitative data to: (a) describe the main psychosocial challenges experienced by college students during the COVID-19 pandemic and their transition to remote instruction between March 2020 and May 2020, (b) describe stress-related psychological symptoms (e.g., depression, anxiety, perceived stress, and somatization) reported by college students and identify demographic and psychosocial correlates, and (c) explore the changes in perceived social support and their correlates. Although the aim of the study was largely exploratory, it was hypothesized that: (a) elevated symptoms of anxiety, depression, and stress will be reported among college students, compared to national norms reported for the measures, and (b) perceived adequacy of social support will be negatively associated with psychological symptoms.</p> <hd id="AN0164011030-2">Method</hd> <p></p> <hd id="AN0164011030-3">Participants</hd> <p>College and university students (<emph>N</emph> = 228) studying at an institution of higher education in the United States were recruited for the study using postings on online bulletin boards, snowball sampling, word-of-mouth, and the authors' home institution's psychology department subject pool. Inclusion criteria included being at least 18 years of age and attending an American college or university while the academic term was still ongoing. Approximately two-thirds (<emph>n =</emph> 142; 62.3%) attended California State University, Fullerton (CSUF), and the remainder attended other institutions of higher education (<emph>n</emph> = 85; 37.3%). One participant did not indicate their institution.</p> <p>Demographic data for 17 participants (7.5%) that did not complete the survey were largely unavailable, as demographic data were collected at the end of the survey. Of the 211 participants that finished the survey, 32.7% were male (<emph>n</emph> = 69), 65.4% were female (<emph>n</emph> = 138), 1.4% were transgender (<emph>n</emph> = 3), and one participant selected "other" to indicate their gender. Majority (<emph>n</emph> = 187; 88.6%) reported being single, only eight participants (3.8%) reported having children, and approximately half reported being employed (41.2% part-time, 7.6% full-time). Participants' mean age was 21.29 years (<emph>SD</emph> = 4.67, <emph>Mdn</emph> = 20.00, range = 18–66), and most participants (96.7%) were below 30 years of age. Approximately one-third reported being the first to attend college (<emph>n</emph> = 73, 34.8%), and approximately one-quarter (<emph>n</emph> = 60, 28.4%) reported being financially independent. The sample was approximately one-third White (<emph>n</emph> = 73, 34.8%), one-fifth Asian (<emph>n</emph> = 45, 21.4%), one-fifth Hispanic but not Latinx (<emph>n</emph> = 43, 20.5%), and one-sixth Latinx (<emph>n</emph> = 35, 16.7%), with limited representation of Black or African-American (<emph>n</emph> = 6, 2.9%) and American Indian or Alaskan Native (<emph>n</emph> = 5, 2.4%) students (<emph>n</emph> = 3, 1.4%, endorsed "Other" for their racial or ethnic information). Vast majority of participants (91.2%) reported being an undergraduate student, with six Master's students and ten doctoral students (four declined to report their academic status). Approximately one-third of the participants (<emph>n</emph> = 83; 36.4%) reported majoring in Psychology.</p> <p>As with most anonymous online surveys, we had concerns about the quality of data provided by participants. Multiple metrics drawn from existing studies were used to identify cases with potentially invalid data due to random, careless, or insufficient effort in responding, including failure to pass either of the attention check items (e.g., "Please click on Moderately Inadequate"), unusually low response time, uniform responding that created obvious inconsistencies across items or measures, and examination of the Mahalanobis distance on quantitative dependent measures to identify multivariate outliers (<emph>n</emph> = 1).[<reflink idref="bib29" id="ref31">29</reflink>] All of the cases identified using these metrics were checked by the first author to determine whether their responses were actually invalid rather than simply unusual. Seven (3.1%) participants were identified as having submitted invalid data and were removed from analyses.</p> <hd id="AN0164011030-4">Procedure</hd> <p>As mentioned above, participants were recruited through online announcements and snowball sampling. Once they provided informed consent by indicating agreement on an online cover letter, participants were asked to create an anonymous user ID and to provide an email address, so that the participants could receive email communication regarding the study. To ensure that participants were eligible for the study, participants were required to provide a valid email address affiliated with an ".edu" domain. Following these procedures, participants completed a survey that contained both qualitative (write-in short answer) questions and self-report questionnaires. Once the participants completed the survey, they were shown a message encouraging them to share the study with other interested individuals. Data collection occurred between March 19, 2020 and May 20, 2020. For participating, those from the CSUF psychology department subject pool received participation credit, and a subset of non-research pool participants (<emph>n =</emph> 35) received a $10 gift card upon completion of additional follow-up measures. All procedures were approved by the Institutional Review Board (IRB) at authors' home institution.</p> <hd id="AN0164011030-5">Measures</hd> <p>As detailed below, psychosocial challenges and social support experienced by the participant were assessed using measures created for the study. In addition, Depression Anxiety Stress Scales short form (DASS-21) and Patient Health Questionnaire-15 (PHQ-15) were administered to assess participant symptoms of depression, anxiety, perceived stress, and somatization. Demographic information was also assessed using a questionnaire created for the study.</p> <hd id="AN0164011030-6">Qualitative data: Psychosocial challenges</hd> <p>At the very beginning of the survey, the participants were asked the following question and invited to respond with a write-in answer: <emph>What are the main changes and challenges you have experienced as a result of this outbreak? Please describe below.</emph></p> <p>Of the 221 participants with valid data, all but one provided a written response. Most responses were approximately one paragraph long. To code the data, two coders (first and fourth authors) closely examined a subset (<emph>n</emph> = 30) of written responses first to identify potential codes. Those codes were then organized by theme, and a codebook was drafted to help standardize the subsequent rounds of coding. Two coders and the principal investigator (first author) then engaged in three iterative rounds of coding, such that coders were trained for accuracy and fidelity, the codebook was revised for clarity and to address potential sources of confusion or disagreement, and coders were trained to sufficient agreement (96.4% agreement). Ultimately, a total of 40 codes organized under four main themes (Daily Life, Economic, Health, and Academic) were identified, with no code showing positive valence (i.e., positive change). In the final round of coding, the two coders evaluated the presence of each code (0 = absent; 1 = present) for each written response. They demonstrated excellent consistency (<emph>K</emph> =.95), and instances of disagreement (54 out of 9040; 0.6%) were resolved by the first author so that any coder error was corrected and instances of coder disagreement due to differences in interpretation were dropped from analysis.</p> <p>In addition, there were two sets of items created for the study that probed the participants' main areas of concern. Participants were asked the following question: "<emph>How worried or concerned have you been about the following? Please rate how much you have been worried or concerned about the topics below, before the coronavirus outbreak and currently.</emph>" They then used a 5-point Likert scale ranging from 1 (<emph>Not at all</emph>) to 5 (<emph>Extremely</emph>) to indicate the extent to which they were concerned or worried about the following nine domains: participant's physical health, participant's mental health, others' physical health, others' mental health, academics, access to necessities, children/parenting, employment/income, and finances. Separate ratings were requested for before the COVID-19 outbreak and for the present. Perceived changes in level of worry or concern for the stressor domains were calculated by subtracting the pre-COVID ratings from the "currently" ratings.</p> <p>Participants were also presented with a list of eleven areas of concern (e.g., academics; access to necessities; children/child care/parenting; employment/work; health of others) and asked to rank their top three areas of concern. They indicated the most, second most, and third most "concerning, stressful, or worrying" areas from the list by dragging and dropping their responses to the appropriate boxes.</p> <hd id="AN0164011030-7">Depression, anxiety, and stress</hd> <p>The shortened, 21-item version of the Depression Anxiety Stress Scales (DASS-21) was developed by Henry and Crawford[<reflink idref="bib30" id="ref32">30</reflink>] based on a 42-item self-report questionnaire created by Lovibond and Lovibond.[<reflink idref="bib31" id="ref33">31</reflink>] The measure has three subscales measuring depression, anxiety, and stress, each being measured using 7 items. Each item was rated on a 4-point scale ranging from 0 (<emph>Did not apply to me at all</emph>) to 3 (<emph>Applied to me very much, or most of the time</emph>), corresponding to the extent of symptoms experienced in the past week. The DASS-21 was scored by summing the scores for each subscale, with higher scores indicating greater symptom severity. Internal consistencies for the present study were α =.85 for the anxiety subscale, α =.87 for the stress subscale, and α =.88 for the depression subscale, which are similar to those found in validation samples.[<reflink idref="bib30" id="ref34">30</reflink>],[<reflink idref="bib32" id="ref35">32</reflink>] All subscales display good convergent and discrimination validity.[<reflink idref="bib30" id="ref36">30</reflink>]</p> <hd id="AN0164011030-8">Somatization</hd> <p>Symptoms of somatization were assessed using the Patient Health Questionnaire-15 (PHQ-15), which contains 15 items related to common physical symptoms.[<reflink idref="bib33" id="ref37">33</reflink>] Each item was rated on a 3-point scale (0 = <emph>not bothered at all</emph>; 1 = <emph>bothered a little</emph>; 2 = <emph>bothered a lot</emph>), indicating how much the participant had been bothered by each symptom in the past month. A total score was calculated by summing all items, with higher scores suggesting greater severity of somatic symptoms. PHQ-15 displays good internal reliability and criterion validity,[<reflink idref="bib33" id="ref38">33</reflink>] with Cronbach's α =.82 for the present study.</p> <hd id="AN0164011030-9">Social support</hd> <p>Methods of obtaining social support and perceived adequacy of social support were assessed using brief items created for this study. Participants were asked to report the frequency with which they obtained social support through five different methods (face-to-face contact; real-time phone contact; text or other instant messaging; online; other), ranging from 1 (<emph>less than weekly</emph>) to 5 (<emph>more than once a day</emph>), and they were asked to provide ratings separately for before the coronavirus outbreak and currently. For each source of social support (e.g., face-to-face contact), a difference score was calculated by subtracting the rating for before the pandemic from the current rating, such that a positive difference score indicated a perceived increase during the pandemic and a negative difference score indicated a perceived decrease. Additionally, perceived adequacy of social support was measured using the item, "Overall, how adequate has your social support been in the past week?" on a 7-point scale ranging from −3 (<emph>extremely inadequate)</emph> to 3 (<emph>extremely adequate)</emph>.</p> <hd id="AN0164011030-10">Analytic plan</hd> <p>First, descriptive analyses were run to examine the study variables. Qualitative data on main challenges were coded using the procedures described above and were treated as dichotomous variables. Chi-square tests of independence were used to examine their association with demographic variables. Moreover, Pearson correlations were run to examine the association between difference scores in perceived level of worry or concern for stressors and psychological symptoms.</p> <p>For the quantitative outcome variables (DASS-21 subscales and PHQ-15), Pearson correlations were also run to examine relationships among them, and one-sample t-tests were run to compare the present sample against existing norms. Univariate outliers were removed from these analyses (<emph>n</emph> = 6 for DASS-21 anxiety; <emph>n</emph> = 5 for PHQ-15 somatization). Multivariate analysis of variance (MANOVA) was used to examine these outcomes' association with demographic and psychosocial factors. For the MANOVAs, Tukey's Honestly Significant Difference (HSD) post-hoc tests were used where applicable to probe significant differences. Age was the only demographic factor that was not categorical, and its association with DASS-21 and PHQ-15 were examined using Pearson correlations.</p> <p>Social support was examined using multiple analyses. Perceived adequacy of social support, assessed using an item rated on a 7-point Likert scale, was treated as a continuous variable. Pearson correlations were used to examine its association with changes in methods of obtaining social support during the pandemic, and multivariate regression was used to determine its association with psychological symptoms. Finally, Pearson correlations were used to explore the relationship between changes in methods of obtaining social support and psychological symptoms.</p> <hd id="AN0164011030-11">Results</hd> <p></p> <hd id="AN0164011030-12">Psychosocial stressors</hd> <p>Table 1 summarizes the codes and themes that emerged from the write-in data provided by participants describing the main changes and challenges they had faced as a result of the COVID-19 pandemic. The most frequently mentioned change or challenge was the transition to remote instruction (<emph>n</emph> = 93; 42.47%), followed by social isolation (30.32%), observing stay-at-home directives (26.36%), and job loss or reduction (24.66%).</p> <p>Table 1. Frequency of the main changes and challenges spontaneously identified by respondents.</p> <p> <ephtml> &lt;table&gt;&lt;thead&gt;&lt;tr&gt;&lt;td&gt;Category&lt;/td&gt;&lt;td&gt;Code&lt;/td&gt;&lt;td&gt;&lt;italic&gt;n&lt;/italic&gt; (%)&lt;/td&gt;&lt;/tr&gt;&lt;/thead&gt;&lt;tbody valign="top"&gt;&lt;tr&gt;&lt;td&gt;&lt;bold&gt;Daily life&lt;/bold&gt;&lt;/td&gt;&lt;td char="."&gt;160 (72.4%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Social isolation&lt;/td&gt;&lt;td char="."&gt;67 (30.3%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Staying home&lt;xref ref-type="table-fn" rid="tfn1"&gt;a&lt;/xref&gt;&lt;/td&gt;&lt;td char="."&gt;58 (26.4%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Mental health&lt;xref ref-type="table-fn" rid="tfn1"&gt;a&lt;/xref&gt;&lt;/td&gt;&lt;td char="."&gt;33 (15%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Relocation&lt;xref ref-type="table-fn" rid="tfn1"&gt;a&lt;/xref&gt;&lt;/td&gt;&lt;td char="."&gt;30 (13.6%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Access to shopping&lt;xref ref-type="table-fn" rid="tfn2"&gt;b&lt;/xref&gt;&lt;/td&gt;&lt;td char="."&gt;15 (6.8%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Routine disruption&lt;xref ref-type="table-fn" rid="tfn1"&gt;a&lt;/xref&gt;&lt;/td&gt;&lt;td char="."&gt;15 (6.8%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Access to outdoors&lt;/td&gt;&lt;td char="."&gt;14 (6.3%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Family obligations&lt;/td&gt;&lt;td char="."&gt;11 (5%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Access to health care&lt;/td&gt;&lt;td char="."&gt;6 (2.7%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Boredom&lt;/td&gt;&lt;td char="."&gt;6 (2.7%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Physical activity&lt;/td&gt;&lt;td char="."&gt;6 (2.7%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Eating&lt;/td&gt;&lt;td char="."&gt;5 (2.3%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Sleep&lt;/td&gt;&lt;td char="."&gt;5 (2.3%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Family stress&lt;xref ref-type="table-fn" rid="tfn1"&gt;a&lt;/xref&gt;&lt;/td&gt;&lt;td char="."&gt;4 (1.8%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Privacy/space&lt;/td&gt;&lt;td char="."&gt;2 (0.9%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td&gt;&lt;bold&gt;Economic&lt;/bold&gt;&lt;/td&gt;&lt;td char="."&gt;70 (31.7%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Job loss/reduction&lt;xref ref-type="table-fn" rid="tfn2"&gt;b&lt;/xref&gt;&lt;/td&gt;&lt;td char="."&gt;54 (24.4%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Income&lt;/td&gt;&lt;td char="."&gt;29 (13.1%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Food insecurity&lt;/td&gt;&lt;td char="."&gt;3 (1.4%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Housing insecurity&lt;/td&gt;&lt;td char="."&gt;1 (0.5%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Work stress&lt;/td&gt;&lt;td char="."&gt;1 (0.5%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td /&gt;&lt;td /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td&gt;&lt;bold&gt;Health&lt;/bold&gt;&lt;/td&gt;&lt;td char="."&gt;38 (17.2%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Infection concerns&lt;/td&gt;&lt;td char="."&gt;15 (6.8%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Disinfection/hygiene&lt;xref ref-type="table-fn" rid="tfn1"&gt;a&lt;/xref&gt;&lt;/td&gt;&lt;td char="."&gt;13 (5.9%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Social changes&lt;/td&gt;&lt;td char="."&gt;10 (4.5%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Health concerns about others&lt;/td&gt;&lt;td char="."&gt;6 (2.7%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Health concerns about self&lt;/td&gt;&lt;td char="."&gt;4 (1.8%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Stress concerning COVID&lt;/td&gt;&lt;td char="."&gt;3 (1.4%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td&gt;&lt;bold&gt;Academic&lt;/bold&gt;&lt;/td&gt;&lt;td char="."&gt;125 (56.6%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Remote instruction&lt;xref ref-type="table-fn" rid="tfn2"&gt;b&lt;/xref&gt;&lt;/td&gt;&lt;td char="."&gt;93 (42.5%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Motivation&lt;xref ref-type="table-fn" rid="tfn1"&gt;a&lt;/xref&gt;&lt;/td&gt;&lt;td char="."&gt;27 (12.3%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Focus&lt;/td&gt;&lt;td char="."&gt;14 (6.3%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Access to academic resources&lt;/td&gt;&lt;td char="."&gt;13 (5.9%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Study environment&lt;/td&gt;&lt;td char="."&gt;10 (4.5%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Instructional format&lt;/td&gt;&lt;td char="."&gt;9 (4.1%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Organization/tracking&lt;xref ref-type="table-fn" rid="tfn2"&gt;b&lt;/xref&gt;&lt;/td&gt;&lt;td char="."&gt;9 (4.1%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Learning&lt;/td&gt;&lt;td char="."&gt;6 (2.7%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Access to academic technology&lt;xref ref-type="table-fn" rid="tfn1"&gt;a&lt;/xref&gt;&lt;/td&gt;&lt;td char="."&gt;4 (1.8%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Class cancelation&lt;/td&gt;&lt;td char="."&gt;4 (1.8%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Academic stress&lt;xref ref-type="table-fn" rid="tfn3"&gt;c&lt;/xref&gt;&lt;/td&gt;&lt;td char="."&gt;3 (1.4%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Procrastination&lt;/td&gt;&lt;td char="."&gt;3 (1.4%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Communication&lt;/td&gt;&lt;td char="."&gt;2 (0.9%)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;Instructional quality&lt;/td&gt;&lt;td char="."&gt;2 (0.9%)&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt; </ephtml> </p> <p>1 <emph>Note. N</emph> = 221. Frequencies in rows with category names reflect the total number of participants with responses that met any code for that category.</p> <ulist> <item>2 <emph>n</emph> = 220.</item> <item>3 <emph>n</emph> = 219.</item> <item>4 <emph>n</emph> = 218.</item> </ulist> <p>By and large, demographic factors did not appear to be associated with these reported challenges. However, female participants identified job loss or reduction as a main change or challenge (29.4%) more frequently than non-female participants (14.3%), χ<sups>2</sups>(<reflink idref="bib2" id="ref39">2</reflink>, _I_N_i_ = 203) = 6.678, <emph>p</emph> =.035. First-generation college students also identified family obligations as a challenge (2.94%) at a higher rate than non-first-generation students (1.47%), χ<sups>2</sups>(<reflink idref="bib1" id="ref40">1</reflink>, _I_N_i_ = 204) = 4.537, <emph>p</emph> =.033. In contrast, fewer first-generation college students identified challenges involving social isolation (6.86%), χ<sups>2</sups>(<reflink idref="bib1" id="ref41">1</reflink>, _I_N_i_ = 204) = 4.596, <emph>p</emph> =.032, staying home (4.93%), χ<sups>2</sups>(<reflink idref="bib1" id="ref42">1</reflink>, _I_N_i_ = 203) = 6.891, <emph>p</emph> =.009, and study environment (0.00%), χ<sups>2</sups>(<reflink idref="bib1" id="ref43">1</reflink>, _I_N_i_ = 204) = 4.812, <emph>p</emph> =.028, compared to non-first-generation students (26.96%, 28.57%, and 4.41%, respectively).</p> <p>Differences in participant ratings of concern or worry for nine domains pre-COVID and at assessment are summarized in Figure 1. On average, participants reported higher level of concern or worry for all nine domains at the time of assessment compared to prior to the pandemic. Greatest differences were seen in concerns related to access to necessities (<emph>M</emph><subs>Δ</subs> = 1.493, <emph>SD</emph> = 1.435), others' physical health (<emph>M</emph><subs>Δ</subs> = 1.231, <emph>SD</emph> = 1.186), and employment or income (<emph>M</emph><subs>Δ</subs> = 1.208, <emph>SD</emph> = 1.425). Smallest changes, albeit still increases, were reported for children or parenting (<emph>M</emph><subs>Δ</subs> = 0.577, <emph>SD</emph> = 1.055), academics (<emph>M</emph><subs>Δ</subs> = 0.710, <emph>SD</emph> = 1.194), and one's own mental health (<emph>M</emph><subs>Δ</subs> = 0.950, <emph>SD</emph> = 1.145). Perceived increase in concerns about one's physical health was associated with higher symptoms of stress, <emph>r</emph>(<reflink idref="bib204" id="ref44">204</reflink>) =.149, <emph>p</emph> =.033, whereas perceived increase in concerns related to children or parenting was associated with greater somatization symptoms, <emph>r</emph>(<reflink idref="bib203" id="ref45">203</reflink>) =.148, <emph>p</emph> =.035. Otherwise, perceived increases in concerns or worry about the nine domains were not significantly associated with psychological symptoms.</p> <p>Graph: Figure 1. Ratings of concern or worry associated with stressors, pre-pandemic and currently. Note. Participants rated how worried or concerned they are about each domain. They provided separate ratings for "before the coronavirus outbreak" (darker bars) and "currently" (lighter bars).</p> <p>Ratings for the respondents' three most "concerning, stressful, or worrying" areas are summarized in Figure 2. Consistent with qualitative write-in data, academics was the most common area of concern, followed by such categories as health, finances, and social relationships. These categories were more evenly distributed when examining their endorsement as their third most stressful issue. These categories did not show any associations with psychological symptoms, thus categories identified as the respondents' top, second most, and third most concerning area did not show systematic relationships with distress.</p> <p>Graph: Figure 2. Most "concerning, worrying, and stressful" issues ranked by students. Note. Numbers on bars represent the number of respondents endorsing that category.</p> <hd id="AN0164011030-13">Psychological symptoms</hd> <p>The descriptive statistics and Pearson correlations for DASS-21 and PHQ-15 are shown in Table 2. Significant positive correlations were found across all four outcome variables, ranging from <emph>r</emph> =.491 to <emph>r</emph> =.770. All but one coefficient, which was between DASS-21 depression and PHQ-15 somatization, were large in magnitude (<emph>r</emph> &gt;.50).</p> <p>Table 2. Pearson correlations among psychosocial outcomes.</p> <p> <ephtml> &lt;table&gt;&lt;thead&gt;&lt;tr&gt;&lt;td&gt;Outcome&lt;/td&gt;&lt;td&gt;&lt;italic&gt;M&lt;/italic&gt; (&lt;italic&gt;SD&lt;/italic&gt;)&lt;/td&gt;&lt;td char="."&gt;1&lt;/td&gt;&lt;td char="."&gt;2&lt;/td&gt;&lt;td char="."&gt;3&lt;/td&gt;&lt;td char="."&gt;4&lt;/td&gt;&lt;td char="."&gt;5&lt;/td&gt;&lt;/tr&gt;&lt;/thead&gt;&lt;tbody valign="top"&gt;&lt;tr&gt;&lt;td char="."&gt;1. DASS-21 Depression&lt;/td&gt;&lt;td char="."&gt;8.583 (5.392)&lt;/td&gt;&lt;td&gt;&amp;#8211;&lt;/td&gt;&lt;td /&gt;&lt;td /&gt;&lt;td /&gt;&lt;td /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td char="."&gt;2. DASS-21 Anxiety&lt;/td&gt;&lt;td char="."&gt;4.762 (4.62)&lt;/td&gt;&lt;td char="."&gt;.645**&lt;/td&gt;&lt;td&gt;&amp;#8211;&lt;/td&gt;&lt;td /&gt;&lt;td /&gt;&lt;td /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td char="."&gt;3. DASS-21 Stress&lt;/td&gt;&lt;td char="."&gt;8.442 (5.202)&lt;/td&gt;&lt;td char="."&gt;.752**&lt;/td&gt;&lt;td char="."&gt;.770**&lt;/td&gt;&lt;td&gt;&amp;#8211;&lt;/td&gt;&lt;td /&gt;&lt;td /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td char="."&gt;4. PHQ-15 Somatization&lt;/td&gt;&lt;td char="."&gt;8.733 (5.193)&lt;/td&gt;&lt;td char="."&gt;.491**&lt;/td&gt;&lt;td char="."&gt;.603**&lt;/td&gt;&lt;td char="."&gt;.617**&lt;/td&gt;&lt;td&gt;&amp;#8211;&lt;/td&gt;&lt;td /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td char="."&gt;5. Perceived Social Support&lt;/td&gt;&lt;td char="."&gt;0.416 (1.584)&lt;/td&gt;&lt;td&gt;&amp;#8211;.416**&lt;/td&gt;&lt;td&gt;&amp;#8211;.362**&lt;/td&gt;&lt;td&gt;&amp;#8211;.350**&lt;/td&gt;&lt;td&gt;&amp;#8211;.150*&lt;/td&gt;&lt;td&gt;&amp;#8211;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt; </ephtml> </p> <ulist> <item>5 <emph>Note. N</emph> = 206. DASS-21 = Depression Anxiety Stress Scale-21; PHQ-15 = Patient Health Questionnaire-15.</item> <item>6 * p &lt;.05. ** <emph>p</emph> &lt;.01.</item> </ulist> <p>One-sample t-tests comparing our sample means with another national college sample collected by Osman et al.[<reflink idref="bib34" id="ref46">34</reflink>] indicated that our sample was consistently elevated in all three subscales of the DASS-21, including stress, <emph>t</emph>(<reflink idref="bib204" id="ref47">204</reflink>) = 7.919, <emph>p</emph> &lt;.001, <emph>d</emph> =.553, anxiety, <emph>t</emph>(<reflink idref="bib198" id="ref48">198</reflink>) = 4.133, <emph>p</emph> &lt;.001, <emph>d</emph> =.293, and depression, <emph>t</emph>(<reflink idref="bib204" id="ref49">204</reflink>) = 12.478, <emph>p</emph> &lt;.001, <emph>d</emph> =.871. However, when compared to a non-clinical sample of adults by Sinclair et al.,[<reflink idref="bib32" id="ref50">32</reflink>] the present sample was higher only in depression, <emph>t</emph>(<reflink idref="bib204" id="ref51">204</reflink>) = 7.630, <emph>p</emph> &lt;.001, <emph>d</emph> =.533. Of note, using scoring cutoffs for the DASS,[<reflink idref="bib35" id="ref52">35</reflink>] 21.8% (<emph>n</emph> = 45) of the sample scored in the "severe" range or higher in stress, 24.8% (<emph>n</emph> = 51) did so in anxiety, and 40.8% (<emph>n</emph> = 84) did so in depression subscales.</p> <p>Similarly, our sample scored higher than a comparison college sample by Coiro et al.[<reflink idref="bib36" id="ref53">36</reflink>] on PHQ-15, <emph>t</emph>(<reflink idref="bib199" id="ref54">199</reflink>) = 4.328, <emph>p</emph> &lt;.001, <emph>d</emph> =.3059. This was the case when scores were examined separately for males (<emph>M</emph> = 6.57<emph>, SD</emph> = 4.110), <emph>t</emph>(<reflink idref="bib62" id="ref55">62</reflink>) = 4.058, <emph>p</emph> &lt;.001, <emph>d</emph> =.511, and females (<emph>M</emph> = 9.19, <emph>SD</emph> = 4.658), <emph>t</emph>(<reflink idref="bib131" id="ref56">131</reflink>) = 3.526, <emph>p</emph> =.001, <emph>d</emph> =.307. Approximately one-third (<emph>n</emph> = 77; 37.4%) of the sample scored 10 or above, which is recommended as a clinical cutoff and represents symptoms in the moderate range or higher,[<reflink idref="bib33" id="ref57">33</reflink>] and 11.7% (<emph>n</emph> = 24) scored in the severe range or higher (a score of 15 or above).</p> <hd id="AN0164011030-14">Association between psychological symptoms and demographic or psychosocial factors</hd> <p>Multivariate Analysis of Variance (MANOVA) tests were performed to further investigate the associations between psychological symptoms as measured by the DASS-21 and the PHQ-15 and demographic and social factors. No significant differences were found between students at the authors' home institution and those at other institutions, or based on employment status, being a first generation student, mother's level of education, father's level of education, race and ethnicity, or their identified top three stressor categories. Additionally, physical health, as measured by whether they were currently seeing a doctor for any health concerns, did not prove to be significant (<emph>p</emph> =.398). Age was correlated with only the PHQ-15 ratings, <emph>r</emph>(<reflink idref="bib202" id="ref58">202</reflink>) =.142, <emph>p</emph> =.042.</p> <p>Three factors were found to be associated with the outcome variables. First, a significant main effect was found for history of mental health treatment, <emph>F</emph>(<reflink idref="bib4" id="ref59">4</reflink>, 199) = 7.657, <emph>p &lt;</emph>.001, <emph>Wilk's Λ =</emph>.867, <emph>partial η<sups>2</sups> =</emph>.133. Participants who had previously received counseling scored significantly higher than those without such history on all outcome measures, including PHQ-15, <emph>F</emph>(<reflink idref="bib1" id="ref60">1</reflink>, 202) <emph>=</emph> 20.885, <emph>p &lt;</emph>.001, as well as DASS-21 depression, <emph>F</emph>(<reflink idref="bib1" id="ref61">1</reflink>, 202) <emph>=</emph> 22.937, <emph>p &lt;</emph>.001, anxiety, <emph>F</emph>(<reflink idref="bib1" id="ref62">1</reflink>, 202) <emph>=</emph> 18.366, <emph>p &lt;</emph>.001, and stress subscales, <emph>F</emph>(<reflink idref="bib1" id="ref63">1</reflink>, 202) <emph>=</emph> 22.062, <emph>p &lt;</emph>.001.</p> <p>There was also a significant main effect for gender, <emph>F</emph>(<reflink idref="bib8" id="ref64">8</reflink>, 394) = 20.885, <emph>p =</emph>.002, <emph>Wilk's Λ =</emph>.882, <emph>partial η<sups>2</sups> =</emph>.029. PHQ-15 was the only measure on which there was a significant difference between males and females, <emph>F</emph>(<reflink idref="bib2" id="ref65">2</reflink>, 201) = 445.333, <emph>p &lt;</emph>.001, such that females reported more severe symptoms than males.</p> <p>Finally, there was a significant main effect of family income level, which was classified into three groups (less than $20,000; $20,000 to under $40,000; $40,000 or above), <emph>F</emph>(<reflink idref="bib8" id="ref66">8</reflink>, 394) = 2.439, <emph>p =</emph>.014, <emph>Wilk's Λ =</emph>.908, <emph>partial η<sups>2</sups> =</emph>.047. Only anxiety showed significant differences by family income level, <emph>F</emph>(<reflink idref="bib2" id="ref67">2</reflink>, 200) <emph>=</emph> 153.685, <emph>p =</emph>.028. Tukey's HSD post-hoc tests indicated that those with family income above $40,000 reported significantly higher levels of anxiety (<emph>M =</emph> 9.00, <emph>SD =</emph> 6.07) than those with family income below $20,000 (<emph>M =</emph> 4.68, <emph>SD =</emph> 4.48) or between $20,000 and $40,000 (<emph>M =</emph> 4.16, <emph>SD =</emph> 4.81).</p> <hd id="AN0164011030-15">Social support</hd> <p>Approximately one-third of participants (33.9%) indicated that their social support levels in the past week have been inadequate, providing a rating ranging from extremely inadequate (<emph>n</emph> = 6; 2.7%) to slightly inadequate (<emph>n</emph> = 47, 21.3%). There was a modest positive relationship between perceived adequacy of social support and difference in the amount of face-to-face social support received, <emph>r</emph>(<reflink idref="bib219" id="ref68">219</reflink>) =.217, <emph>p</emph> =.001, such that those experiencing more face-to-face social support during the pandemic relative to before the pandemic reported receiving more adequate social support. Otherwise, perceived adequacy of social support was not associated with perceived differences in social support received through other methods (e.g., online; texts).</p> <p>Perceived adequacy of social support was significantly associated with all four types of psychological symptoms, <emph>F</emph>(<reflink idref="bib4" id="ref69">4</reflink>, 201) = 12.912, <emph>p &lt;</emph>.001, <emph>Wilk's Λ =</emph>.796, <emph>partial η<sups>2</sups> =</emph>.204. Inverse associations were found between perceived adequacy of social support and stress, <emph>β =</emph> −0.350, <emph>t</emph>(<reflink idref="bib204" id="ref70">204</reflink>) = −5.340, <emph>p</emph> &lt;.001, anxiety, <emph>β =</emph> −0.362, <emph>t</emph>(<reflink idref="bib204" id="ref71">204</reflink>) = −5.546, <emph>p</emph> &lt;.001, depression, <emph>β =</emph> −0.416, <emph>t</emph>(<reflink idref="bib204" id="ref72">204</reflink>) = −6.532, <emph>p</emph> &lt;.001, and somatization, <emph>β =</emph> −0.150, <emph>t</emph>(<reflink idref="bib204" id="ref73">204</reflink>) = −2.170, <emph>p</emph> =.031.</p> <p>Additionally, some associations between DASS-21 scores and changes in the amount of social support gained through face-to-face contact, text or other instant messaging, and online contact were found. There were inverse relationships between perceived changes in face-to-face contact and depression symptoms, <emph>r</emph>(<reflink idref="bib204" id="ref74">204</reflink>) = −.170, <emph>p</emph> =.014, between changes in social contact via text or other instant messaging and stress symptoms, <emph>r</emph>(<reflink idref="bib204" id="ref75">204</reflink>) = −.142, <emph>p</emph> =.041, and anxiety symptoms, <emph>r</emph>(<reflink idref="bib204" id="ref76">204</reflink>) = −.165, <emph>p</emph> =.018, and between changes in online social support and stress symptoms, <emph>r</emph>(<reflink idref="bib204" id="ref77">204</reflink>) = −.144, <emph>p</emph> =.038, such that decreases in social support obtained from these varied sources were associated with higher levels of distress.</p> <hd id="AN0164011030-16">Discussion</hd> <p>The present study examined the psychosocial challenges and difficulties reported by a large sample of students attending an institution of higher education in the United States during Spring of 2020. For all participants, this period was marked by a transition to online instruction, and the majority of participants identified academics as the domain about which they most felt concerned or worried.</p> <p>Our study used a mixed-methods design and sampled from multiple institutions across the country. By doing so, we were able to explore the potential reasons as to why our sample expressed greater levels of depression, anxiety, stress, and somatization symptoms than were previously found in other college student and non-clinical sample of adults.[<reflink idref="bib32" id="ref78">32</reflink>],[<reflink idref="bib34" id="ref79">34</reflink>] When asked to identify the three most stressful domains of concerns in a list provided, academics and health concerns, both for others and self, were the most commonly identified concerns. However, when participants rated their level of concern regarding potential stressors, retrospectively for prior to the pandemic and at assessment, the areas that showed the greatest differences were economic in nature (access to necessities and employment or income), along with others' health. Arguably, these domains were the ones in which participants perceived greatest changes due to the pandemic, whereas some other areas such as academics were already a major area of concern prior to the pandemic and thus did not result in as large of a perceived difference. Overall, students reported grappling with a wide range of stressors and changes during Spring 2020.</p> <p>Participants' responses to an open-ended question provided further insight into their struggles. The transition to remote instruction was identified as a major challenge for over 40% of the participants. Students reported struggling with the sudden absence of structure and resources that are associated with on-campus instruction, cited difficulties with motivation and focus, and indicated that they lacked access to important campus resources such as tutoring services and the library. In addition, a substantial number of students reported struggling with social isolation, stay-at-home measures, and their own mental health. These findings are consistent with other studies on college students' descriptions of stressors during the early months of the COVID-19 pandemic.[<reflink idref="bib14" id="ref80">14</reflink>],[<reflink idref="bib18" id="ref81">18</reflink>],[<reflink idref="bib37" id="ref82">37</reflink>],[<reflink idref="bib38" id="ref83">38</reflink>]</p> <p>Given that college students are already at elevated risk for psychopathology,[<reflink idref="bib7" id="ref84">7</reflink>] increased social isolation and limited access to outside resources based on public health directives to shelter at home were expected to exacerbate their stress and distress. Indeed, some students noted that staying at home is not beneficial to their well-being (e.g., "My household is not a very healthy environment, and it's a struggle being here longer than strictly necessary"; "Feeling trapped and pent up in the house<emph>"</emph>) and reported longing for social contact (e.g., "I have maybe 1–2 face to face interactions with people per week and feel very lonely"; "The deprivation from social contact with friends has lead [sic] to an emotional rollercoaster with a lack of escape"). In addition, nearly a quarter of participants reported that loss or reduction in employment was a challenge, and another thirteen percent cited concerns about income. Of note, most participants did not spontaneously identify concerns regarding COVID infection and other health-related considerations as their main challenges.</p> <p>As social isolation was a major concern identified in the study, and interpersonal relationships and social support might be expected to influence college students' mental well-being,[<reflink idref="bib39" id="ref85">39</reflink>] perceived adequacy of social support and methods of obtaining social support were both examined. Surprisingly, only one-third of the participants indicated that the social support received in the previous week was inadequate. Reported reduction in face-to-face social support, but not perceived changes in any other method of obtaining social support (e.g., online, phone call, text, etc.), was associated with perceptions of inadequate social support. Moreover, there was an inverse relationship between perceived adequacy of social support and psychological symptoms, especially depression, anxiety, and stress. Thus, difficulties with obtaining adequate social support may accompany, or even contribute to, internalizing symptoms among college students. In particular, perceived reduction in opportunities for social support through face-to-face contact, texting, or online contact compared to their availability prior to the COVID-19 pandemic appear to be associated with increased distress and warrant continued attention and exploration.</p> <p>Given that college students in our sample reported significantly higher levels of depression, anxiety, perceived stress, and somatization symptoms than comparison college or normative adult samples, it was important to explore potential factors associated with their elevated distress. Surprisingly, in contrast to some other studies that have found differences based on such demographic factors as gender, race or ethnicity, and age,[<reflink idref="bib6" id="ref86">6</reflink>],[<reflink idref="bib14" id="ref87">14</reflink>],[<reflink idref="bib17" id="ref88">17</reflink>],[<reflink idref="bib37" id="ref89">37</reflink>],[<reflink idref="bib40" id="ref90">40</reflink>] only a few demographic and psychosocial factors were associated with psychological symptoms in the present study. Perhaps unsurprisingly, students with prior history of psychological counseling reported greater levels of distress than those without such history. Thus, those with a prior mental health treatment history may be at elevated risk for exacerbation or relapse in symptoms during young adulthood,[<reflink idref="bib7" id="ref91">7</reflink>],[<reflink idref="bib41" id="ref92">41</reflink>] potentially triggered by the stress of sudden transitions and restrictions to social interactions posed by the pandemic. They may also be more strongly impacted by the limitations in face-to-face social contact and counseling posed by the transition to remote instruction. Given that available counseling resources may be eclipsed by student needs and demand,[<reflink idref="bib42" id="ref93">42</reflink>] further resources and support are needed for improvements in service provision. Of note, existing literature suggests that there is an increasing awareness of college students' mental health needs,[<reflink idref="bib10" id="ref94">10</reflink>],[<reflink idref="bib12" id="ref95">12</reflink>],[<reflink idref="bib43" id="ref96">43</reflink>] and efforts by colleges and college counseling centers are underway to help meet this need, for example through the use of telehealth and public health messages made available on their websites.[<reflink idref="bib44" id="ref97">44</reflink>] Additionally, as stressors related to COVID-19 may elevate suicidal risk,[<reflink idref="bib45" id="ref98">45</reflink>] ensuring that students are made aware of and encouraged to contact free crisis resources may be warranted.</p> <p>Finally, as mentioned above, a few differences were found based on such demographic factors as gender and household income. Surprisingly, we found significant differences between males and females only in somatization. Although gender differences in somatization has been previously found in other studies,[<reflink idref="bib46" id="ref99">46</reflink>] existing literature also indicates that women are twice as likely to develop depression and/or anxiety disorders than men.[<reflink idref="bib47" id="ref100">47</reflink>] Women may be particularly susceptible to such psychosocial factors as lack of social support and negative life events.[<reflink idref="bib48" id="ref101">48</reflink>],[<reflink idref="bib49" id="ref102">49</reflink>] It may be that the impact of the pandemic has been sufficiently strong to increase distress across the board; however, further research is needed to understand the absence of gender differences.</p> <p>With regard to income, although students from lower-income families may be at increased risk for mental health difficulties and financial stress,[<reflink idref="bib50" id="ref103">50</reflink>] it was found that only anxiety showed significant differences by respondents' household income level. Moreover, contrary to expectations, those with the highest household income (above $40,000) reported significantly higher levels of anxiety than those with lower levels of household income. It is possible that those with higher household income are experiencing greater reductions in employment or income, or have stronger concerns to that effect. One potential explanation may be that, compared to low-income households that might qualify for public assistance and programs, lower middle-income families may be unable to obtain adequate state assistance to help cover future expenses.[<reflink idref="bib51" id="ref104">51</reflink>] Furthermore, consistent with our findings, a survey of unemployed American adults conducted by the Pew Research Center during the COVID-19 pandemic has found that unemployed adults with higher socioeconomic status (SES) report higher rates of distress compared to those with lower SES.[<reflink idref="bib52" id="ref105">52</reflink>]</p> <p>Finally, of note, approximately one-third of the sample reported being the first to attend college. Such first-generation status may pose risk for increased psychosocial and academic difficulties.[<reflink idref="bib26" id="ref106">26</reflink>] Despite such risk, we did not find significant differences between first-generation and non-first generation students in their adjustment. However, a significantly greater proportion of first-generation students spontaneously identified family obligations as a main challenge. This may be associated with added family obligations and responsibilities that come from being the "golden child" of the family,[<reflink idref="bib53" id="ref107">53</reflink>] often experienced by first-generation students. In contrast, fewer first-generation college students identified challenges involving social isolation, staying home, and study environment compared to non-first-generation students. This may be because first-generation students are more likely to have prior experience with stressors noted in the study, such as difficulties with finances or peer relations and a sense of obligation to their families.[<reflink idref="bib54" id="ref108">54</reflink>] While these situations might have been initially stressful, they may have helped the first-generation students become more resilient by building more skills and resources to address those stressors or by developing a thicker skin.[<reflink idref="bib54" id="ref109">54</reflink>] Also, first-generation students may be more likely to come from family systems or cultures requiring high levels of family contact or have a stronger desire to stay home and connect with family,[<reflink idref="bib55" id="ref110">55</reflink>] and thus, their adjustment to the pandemic may have been less jarring in those three areas mentioned.</p> <hd id="AN0164011030-17">Limitations and future directions</hd> <p>The study has several limitations. First, due to its cross-sectional design, the data collected represent a snapshot in time. Longitudinal studies are needed to ascertain the sustained effects of the COVID-19 pandemic on college students. In addition, the present study assessed for perceived differences in worry or concern about stressors and in the format of social support obtained (e.g., face-to-face contact), before the pandemic and during the pandemic ('currently' at the time of participation), using retrospective reports for the pre-pandemic ratings. Thus, these reports should be interpreted with caution, as the difference scores do not reflect actual change over time, and retrospective reports are likely influenced by participants' ongoing experience.</p> <p>Furthermore, our sampling methods over-sampled from CSUF (approximately two-thirds), largely due to the use of its psychology subject pool. This led to a sample with a high proportion of psychology majors (36.4%) that skewed female (65.4%). Thus, although no significant differences were found between data from CSUF students and those from non-CSUF students, results should be interpreted with caution, and findings need to be compared with those from more representative samples.</p> <p>Additionally, several measures, including those assessing psychosocial challenges and social support, were created for the study. This was due to the absence of validated measures for constructs of interest (e.g., perceived amount of social support received through different methods of contact), need for qualitative data (e.g., main challenge experienced during the pandemic), and space limitations, further research with validated measures of constructs examined in the study, especially of social support, is encouraged to corroborate the findings. Finally, as only self-report data were collected, shared method variance likely contributed to the associations among constructs examined in this study, and collection of observational or behavioral data would have strengthened the study.</p> <p>Despite the limitations mentioned above, our data provide important insight into potential influence of the COVID-19 pandemic on college students' adjustment as they moved to online learning and worked to complete the Spring 2020 semester. Continued comparisons of the present findings with those of other studies on college students' adjustment during the pandemic, including of other U.S. samples and of data collected at other points during the pandemic, are encouraged.</p> <hd id="AN0164011030-18">Conclusion</hd> <p>College students in the United States reported experiencing elevated psychosocial distress and a wide range of stressors associated with the COVID-19 pandemic (e.g., transition to remote instruction, observing stay-at-home orders, negative effects on income or employment, concerns about others' and one's own health) between mid-March 2020 and mid-May 2020. Interestingly, academic concerns, social isolation and stay-at-home restrictions, and job loss or reduction were identified more often by students as their main challenges compared to infection-related and health-related concerns. The findings indicate the importance of proactively making supports and mental health services available to college students. Moreover, interventions related to helping students adapt to the online learning environment, connect and socialize with others, and obtain financial assistance or employment may be important additional avenues for alleviating distress among students. Continued research on the impact of the COVID-19 pandemic on psychosocial adjustment among college students, as well as on effects of mental health and additional university-based support services, is strongly encouraged.</p> <hd id="AN0164011030-19">Acknowledgments</hd> <p>We are very grateful to the study participants for sharing their experiences and providing invaluable data during such a challenging time. For methodology-related consultation, we thank Drs. Lucia Alcalá and William Marelich. For research assistance, we thank Chelsea Proctor, Ashley Park, Jackie Chang, Marlon Gamez, Amir Sherkat, and Angelica Aguirre.</p> <hd id="AN0164011030-20">Conflict of interest disclosure</hd> <p>The authors have no conflicts of interest to report. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of United States of America and received approval from the Institutional Review Board of California State University, Fullerton.</p> <hd id="AN0164011030-21">Funding</hd> <p>No funding was used to support this research and/or the preparation of the manuscript.</p> <ref id="AN0164011030-22"> <title> References </title> <blist> <bibl id="bib1" idref="ref1" type="bt">1</bibl> <bibtext> Rajkumar RP. COVID-19 and mental health: a review of the existing literature. Asian J Psychiatr. 2020; 52 : 102066. doi: 10.1016/j.ajp.2020.102066.</bibtext> </blist> <blist> <bibl id="bib2" idref="ref39" type="bt">2</bibl> <bibtext> Cameron EE, Joyce KM, Delaquis CP, Reynolds K, Protudjer JLP, Roos LE. Maternal psychological distress &amp; mental health service use during the COVID-19 pandemic. J Affect Disord. 2020; 276 : 765 – 774. doi: 10.1016/j.jad.2020.07.081.</bibtext> </blist> <blist> <bibl id="bib3" idref="ref2" type="bt">3</bibl> <bibtext> Twenge JM, Joiner TUS. Census Bureau-assessed prevalence of anxiety and depressive symptoms in 2019 and during the 2020 COVID-19 pandemic. Depress Anxiety. 2020; 37 (10): 954 – 956. doi: 10.1002/da.23077.</bibtext> </blist> <blist> <bibl id="bib4" idref="ref3" type="bt">4</bibl> <bibtext> Dubey S, Biswas P, Ghosh R, et al. Psychosocial impact of COVID-19. Diabetes Metab Syndr. 2020; 14 (5): 779 – 788. doi: 10.1016/j.dsx.2020.05.035.</bibtext> </blist> <blist> <bibl id="bib5" type="bt">5</bibl> <bibtext> Pfefferbaum B, North CS. Mental health and the COVID-19 pandemic. N Engl J Med. 2020;383(6): 510 – 512. doi: 10.1056/NEJMp2008017.</bibtext> </blist> <blist> <bibl id="bib6" idref="ref4" type="bt">6</bibl> <bibtext> Fitzpatrick KM, Harris C, Drawve G. Living in the midst of fear: depressive symptomatology among US adults during the COVID-19 pandemic. Depress Anxiety. 2020; 37 (10): 957 – 964. doi: 10.1002/da.23080.</bibtext> </blist> <blist> <bibl id="bib7" idref="ref6" type="bt">7</bibl> <bibtext> Pedrelli P, Nyer M, Yeung A, Zulauf C, Wilens T. College students: mental health problems and treatment considerations. Acad Psychiatry. 2015; 39 (5): 503 – 511. doi: 10.1007/s40596-014-0205-9.</bibtext> </blist> <blist> <bibl id="bib8" idref="ref7" type="bt">8</bibl> <bibtext> Sontag-Padilla L, Woodbridge MW, Mendelsohn J, et al. Factors affecting mental health service utilization among California public college and university students. Psychiatr Serv. 2016; 67 (8): 890 – 897. doi: 10.1176/appi.ps.201500307.</bibtext> </blist> <blist> <bibl id="bib9" idref="ref8" type="bt">9</bibl> <bibtext> Auerbach RP, Alonso J, Axinn WG, et al. Mental disorders among college students in the World Health Organization world mental health surveys. Psychol Med. 2016; 46 (14): 2955 – 2970. doi: 10.1017/S0033291716001665.</bibtext> </blist> <blist> <bibtext> Lederer AM, Hoban MT, Lipson SK, Zhou S, Eisenberg D. More than inconvenienced: the unique needs of U.S. College students during the COVID-19 pandemic. Health Educ Behav. 2021; 48 (1): 14 – 19. doi: 10.1177/1090198120969372.</bibtext> </blist> <blist> <bibtext> Tasso AF, Hisli Sahin N, San Roman GJ. COVID-19 disruption on college students: academic and socioemotional implications. Psychol Trauma. 2021; 13 (1): 9 – 15. doi: 10.1037/tra0000996.</bibtext> </blist> <blist> <bibtext> Zhai Y, Du X. Addressing collegiate mental health amid COVID-19 pandemic. Psychiatry Res. 2020; 288 : 113003. doi: 10.1016/j.psychres.2020.113003.</bibtext> </blist> <blist> <bibtext> Smalley A. Higher education responses to coronavirus (COVID-19). 2020, July 27. https://<ulink href="http://www.ncsl.org/research/education/higher-education-responses-to-coronavirus-covid-19.aspx">www.ncsl.org/research/education/higher-education-responses-to-coronavirus-covid-19.aspx</ulink>. Updated March 15, 2021. Accessed March 16, 2021.</bibtext> </blist> <blist> <bibtext> Hoyt LT, Cohen AK, Dull B, Maker Castro E, Yazdani N. Constant stress has become the new normal: stress and anxiety inequalities among U.S. college students in the time of COVID-19. J Adolesc Health. 2021; 68 (2): 270 – 276. doi: 10.1016/j.jadohealth.2020.10.030.</bibtext> </blist> <blist> <bibtext> Brooks SK, Webster RK, Smith LE, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020; 395 (10227): 912 – 920. doi: 10.1016/S0140-6736(20)30460-8.</bibtext> </blist> <blist> <bibtext> Huckins JF, daSilva AW, Wang W, et al. Mental health and behavior of college students during the early phases of the COVID-19 pandemic: longitudinal smartphone and ecological momentary assessment study. J Med Internet R. 2020; 22 (6): 20185.</bibtext> </blist> <blist> <bibtext> Charles NE, Strong SJ, Burns LC, Bullerjahn MR, Serafine KM. Increased mood disorder symptoms, perceived stress, and alcohol use among college students during the COVID-19 pandemic. Psychiatry Res. 2021; 296 : 113706. doi: 10.1016/j.psychres.2021.113706.</bibtext> </blist> <blist> <bibtext> Wang X, Hegde S, Son C, Keller B, Smith A, Sasangohar F. Investigating mental health of us college students during the COVID-19 pandemic: cross-sectional survey study. J Med Internet R. 2020; 22 (9): 22817.</bibtext> </blist> <blist> <bibtext> Conrad RC, Hahm HC, Koire A, Pinder-Amaker S, Liu CH. College student mental health risks during the COVID-19 pandemic: implications of campus relocation. J Psychiatr Res. 2021; 136 : 117 – 126. doi: 10.1016/j.jpsychires.2021.01.054.</bibtext> </blist> <blist> <bibtext> Cao W, Fang Z, Hou G, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res. 2020; 287 : 112934 – 112934. doi: 10.1016/j.psychres.2020.112934.</bibtext> </blist> <blist> <bibtext> Husky MM, Kovess-Masfety V, Swendsen JD. Stress and anxiety among university students in France during COVID-19 mandatory confinement. Compr Psychiatry. 2020; 102 : 152191. doi: 10.1016/j.comppsych.2020.152191.</bibtext> </blist> <blist> <bibtext> Watkins K, Hill EM. The role of stress in the social support–mental health relationship. J Coll Couns. 2018; 21 (2): 153 – 164. doi: 10.1002/jocc.12094.</bibtext> </blist> <blist> <bibtext> Shelton AJ, Wang CDC, Zhu W. Perceived social support and mental health: cultural orientations as moderators. J Coll Couns. 2017; 20 (3): 194 – 207. doi: 10.1002/jocc.12062.</bibtext> </blist> <blist> <bibtext> Rankin JA, Paisley CA, Mulla MM, Tomeny TS. Unmet social support needs among college students: relations between social support discrepancy and depressive and anxiety symptoms. J Couns Psychol. 2018; 65 (4): 474 – 489. doi: 10.1037/cou0000269.</bibtext> </blist> <blist> <bibtext> Smith KM, Chesin MS, Jeglic EL. Minority college student mental health: does majority status matter? Implications for college counseling services. J Multicult Couns Devel. 2014; 42 (2): 77 – 92. doi: 10.1002/j.2161-1912.2014.00046.x.</bibtext> </blist> <blist> <bibtext> Tate KA, Fouad NA, Marks LR, Young G, Guzman E, Williams EG. Underrepresented first-generation, low-income college students' pursuit of a graduate education: investigating the influence of self-efficacy, coping efficacy, and family influence. J Career Assess. 2015; 23 (3): 427 – 441. doi: 10.1177/1069072714547498.</bibtext> </blist> <blist> <bibtext> Jenkins S, Belanger A, Connally M, Boals A, Durón K. First-generation undergraduate students' social support, depression, and life satisfaction. J Coll Couns. 2013; 16 : 129 – 142.</bibtext> </blist> <blist> <bibtext> House LA, Neal C, Kolb J. Supporting the mental health needs of first generation college students. J Coll Stud Psychother. 2020; 34 (2): 157 – 167. doi: 10.1080/87568225.2019.1578940.</bibtext> </blist> <blist> <bibtext> Huang JL, Curran PG, Keeney J, Poposki EM, DeShon RP. Detecting and deterring insufficient effort responding to surveys. J Bus Psychol. 2012; 27 (1): 99 – 114. doi: 10.1007/s10869-011-9231-8.</bibtext> </blist> <blist> <bibtext> Henry JD, Crawford JR. The short-form version of the Depression Anxiety Stress Scales (DASS-21): construct validity and normative data in a large non-clinical sample. Br J Clin Psychol. 2005; 44 (2): 227 – 239. doi: 10.1348/014466505X29657.</bibtext> </blist> <blist> <bibtext> Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995; 33 (3): 335 – 343. doi: 10.1016/0005-7967(94)00075-U.</bibtext> </blist> <blist> <bibtext> Sinclair SJ, Siefert CJ, Slavin-Mulford JM, Stein MB, Renna M, Blais MA. Psychometric evaluation and normative data for the Depression, Anxiety, and Stress Scales-21 (DASS-21) in a nonclinical sample of US adults. Eval Health Prof. 2012; 35 (3): 259 – 279. doi: 10.1177/0163278711424282.</bibtext> </blist> <blist> <bibtext> Kroenke K, Spitzer RL, Williams JBW, Löwe B. The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review. Gen Hosp Psychiatry. 2010; 32 (4): 345 – 359. doi: 10.1016/j.genhosppsych.2010.03.006.</bibtext> </blist> <blist> <bibtext> Osman A, Wong JL, Bagge CL, Freedenthal S, Gutierrez PM, Lozano G. The Depression Anxiety Stress Scales-21 (DASS-21): further examination of dimensions, scale reliability, and correlates. J Clin Psychol. 2012; 68 (12): 1322 – 1338. doi: 10.1002/jclp.21908.</bibtext> </blist> <blist> <bibtext> Lovibond SH, Lovibond PF. Manual for the Depression Anxiety Stress Scales. 2nd ed. Sydney, Australia : Psychology Foundation; 1995.</bibtext> </blist> <blist> <bibtext> Coiro MJ, Bettis AH, Compas BE. College students coping with interpersonal stress: examining a control-based model of coping. J Am Coll Health. 2017; 65 (3): 177 – 186. doi: 10.1080/07448481.2016.1266641.</bibtext> </blist> <blist> <bibtext> Browning MHEM, Larson LR, Sharaievska I, et al. Psychological impacts from COVID-19 among university students: Risk factors across seven states in the United States. PLoS One. 2021; 16 (1): e0245327. doi: 10.1371/journal.pone.0245327.</bibtext> </blist> <blist> <bibtext> Son C, Hegde S, Smith A, Wang X, Sasangohar F. Effects of COVID-19 on college students' mental health in the United States: interview survey study. J Med Internet Res. 2020; 22 (9): e21279. doi: 10.2196/21279.</bibtext> </blist> <blist> <bibtext> Hefner J, Eisenberg D. Social support and mental health among college students. Am J Orthopsychiatry. 2009; 79 (4): 491 – 499. doi: 10.1037/a0016918.</bibtext> </blist> <blist> <bibtext> Sánchez-Teruel D, Robles-Bello MA, Valencia-Naranjo N. Do psychological strengths protect college students confined by COVID-19 to emotional distress? The role of gender. Pers Individ Dif. 2021; 171 : 110507. doi: 10.1016/j.paid.2020.110507.</bibtext> </blist> <blist> <bibtext> Hart AB, Craighead WE, Craighead LW. Predicting recurrence of major depressive disorder in young adults: a prospective study. J Abnorm Psychol. 2001; 110 (4): 633 – 643. doi: 10.1037/0021-843X.110.4.633.</bibtext> </blist> <blist> <bibtext> Locke B, Wallace D, Brunner J. Emerging issues and models in college mental health services. New Dir Stud Serv. 2016; 2016 (156): 19 – 30. doi: 10.1002/ss.20188.</bibtext> </blist> <blist> <bibtext> Part 1 of 5: COVID-19's impact on college student mental health. Center for Collegiate Mental Health Web site. https://ccmh.psu.edu/assets/BlogPDFs/Part%201%20of%205%20COVID%20Blog%5fStudent%20Mental%20Health.pdf. Updated February 2, 2021. Accessed February 18, 2021.</bibtext> </blist> <blist> <bibtext> Seidel EJ, Mohlman J, Basch CH, Fera J, Cosgrove A, Ethan D. Communicating mental health support to college students during COVID-19: an exploration of website messaging. J Community Health. 2020; 45 (6): 1259 – 1262. doi: 10.1007/s10900-020-00905-w.</bibtext> </blist> <blist> <bibtext> Thakur V, Jain A. COVID 2019-suicides: a global psychological pandemic. Brain Behav Immun. 2020; 88 : 952 – 953. doi: 10.1016/j.bbi.2020.04.062.</bibtext> </blist> <blist> <bibtext> Ballering AV, Bonvanie IJ, Olde Hartman TC, Monden R, Rosmalen JGM. Gender and sex independently associate with common somatic symptoms and lifetime prevalence of chronic disease. Soc Sci Med. 2020; 253 : 112968. doi: 10.1016/j.socscimed.2020.112968.</bibtext> </blist> <blist> <bibtext> Karger A. Geschlechtsspezifische aspekte bei depressiven erkrankungen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2014; 57 (9): 1092 – 1098. doi: 10.1007/s00103-014-2019-z.</bibtext> </blist> <blist> <bibtext> Beeber LS. Testing an explanatory model of the development of depressive symptoms in young women during a life transition. J Am Coll Health. 1999; 47 (5): 227 – 234. doi: 10.1080/07448489909595652.</bibtext> </blist> <blist> <bibtext> Peden AR, Hall LA, Rayens MK, Beebe L. Negative thinking mediates the effect of self-esteem on depressive symptoms in college women. Nurs Res. 2000; 49 (4): 201 – 207. doi: 10.1097/00006199-200007000-00003.</bibtext> </blist> <blist> <bibtext> Cadaret M, Bennett S. College students' reported financial stress and its relationship to psychological distress. J Coll Couns. 2018; 22 : 225 –239.</bibtext> </blist> <blist> <bibtext> Cox N, Ganong P, Noel P, et al. Initial impacts of the pandemic on consumer behavior: evidence from linked income, spending, and savings data. Paper presented at: The Brookings Papers on Economic Activity; June 25, 2020.</bibtext> </blist> <blist> <bibtext> Parker K, Igielnik R, Kochhar R. Unemployed Americans are feeling the emotional strain of job loss; most have considered changing occupations. Pew Research Center. https://<ulink href="http://www.pewresearch.org/fact-tank/2021/02/10/unemployed-americans-are-feeling-the-emotional-strain-of-job-loss-most-have-considered-changing-occupations/">www.pewresearch.org/fact-tank/2021/02/10/unemployed-americans-are-feeling-the-emotional-strain-of-job-loss-most-have-considered-changing-occupations/</ulink>. Updated February 2, 2021. Accessed March 16, 2021.</bibtext> </blist> <blist> <bibtext> Hand C, Payne EM. First-generation college students: A study of Appalachian student success. J Dev Educ. 2008; 32 (1): 4.</bibtext> </blist> <blist> <bibtext> Alvarado A, Spatariu A, Woodbury C. Resilience &amp; emotional intelligence between first generation college students and non-first generation college students. Focus Coll Univ Sch. 2017; 11 (1): 1 – 10.</bibtext> </blist> <blist> <bibtext> Covarrubias R, Valle I, Laiduc G, Azmitia M. You never become fully independent": family roles and independence in first-generation college students. J Adolesc Res. 2019; 34 (4): 381 – 410. doi: 10.1177/0743558418788402.</bibtext> </blist> </ref> <aug> <p>By Yuko Okado; Courtney Scaramella; Ha M. Nguyen; Benjamin Mendoza and Tanya Watarastaporn</p> <p>Reported by Author; Author; Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib10" firstref="ref9"></nolink> <nolink nlid="nl2" bibid="bib12" firstref="ref10"></nolink> <nolink nlid="nl3" bibid="bib13" firstref="ref11"></nolink> <nolink nlid="nl4" bibid="bib11" firstref="ref13"></nolink> <nolink nlid="nl5" bibid="bib14" firstref="ref14"></nolink> <nolink nlid="nl6" bibid="bib15" firstref="ref15"></nolink> <nolink nlid="nl7" bibid="bib16" firstref="ref17"></nolink> <nolink nlid="nl8" bibid="bib17" firstref="ref18"></nolink> <nolink nlid="nl9" bibid="bib18" firstref="ref20"></nolink> <nolink nlid="nl10" bibid="bib19" firstref="ref22"></nolink> <nolink nlid="nl11" bibid="bib20" firstref="ref23"></nolink> <nolink nlid="nl12" bibid="bib21" firstref="ref24"></nolink> <nolink nlid="nl13" bibid="bib22" firstref="ref25"></nolink> <nolink nlid="nl14" bibid="bib23" firstref="ref26"></nolink> <nolink nlid="nl15" bibid="bib24" firstref="ref27"></nolink> <nolink nlid="nl16" bibid="bib25" firstref="ref28"></nolink> <nolink nlid="nl17" bibid="bib27" firstref="ref29"></nolink> <nolink nlid="nl18" bibid="bib28" firstref="ref30"></nolink> <nolink nlid="nl19" bibid="bib29" firstref="ref31"></nolink> <nolink nlid="nl20" bibid="bib30" firstref="ref32"></nolink> <nolink nlid="nl21" bibid="bib31" firstref="ref33"></nolink> <nolink nlid="nl22" bibid="bib32" firstref="ref35"></nolink> <nolink nlid="nl23" bibid="bib33" firstref="ref37"></nolink> <nolink nlid="nl24" bibid="bib204" firstref="ref44"></nolink> <nolink nlid="nl25" bibid="bib203" firstref="ref45"></nolink> <nolink nlid="nl26" bibid="bib34" firstref="ref46"></nolink> <nolink nlid="nl27" bibid="bib198" firstref="ref48"></nolink> <nolink nlid="nl28" bibid="bib35" firstref="ref52"></nolink> <nolink nlid="nl29" bibid="bib36" firstref="ref53"></nolink> <nolink nlid="nl30" bibid="bib199" firstref="ref54"></nolink> <nolink nlid="nl31" bibid="bib62" firstref="ref55"></nolink> <nolink nlid="nl32" bibid="bib131" firstref="ref56"></nolink> <nolink nlid="nl33" bibid="bib202" firstref="ref58"></nolink> <nolink nlid="nl34" bibid="bib219" firstref="ref68"></nolink> <nolink nlid="nl35" bibid="bib37" firstref="ref82"></nolink> <nolink nlid="nl36" bibid="bib38" firstref="ref83"></nolink> <nolink nlid="nl37" bibid="bib39" firstref="ref85"></nolink> <nolink nlid="nl38" bibid="bib40" firstref="ref90"></nolink> <nolink nlid="nl39" bibid="bib41" firstref="ref92"></nolink> <nolink nlid="nl40" bibid="bib42" firstref="ref93"></nolink> <nolink nlid="nl41" bibid="bib43" firstref="ref96"></nolink> <nolink nlid="nl42" bibid="bib44" firstref="ref97"></nolink> <nolink nlid="nl43" bibid="bib45" firstref="ref98"></nolink> <nolink nlid="nl44" bibid="bib46" firstref="ref99"></nolink> <nolink nlid="nl45" bibid="bib47" firstref="ref100"></nolink> <nolink nlid="nl46" bibid="bib48" firstref="ref101"></nolink> <nolink nlid="nl47" bibid="bib49" firstref="ref102"></nolink> <nolink nlid="nl48" bibid="bib50" firstref="ref103"></nolink> <nolink nlid="nl49" bibid="bib51" firstref="ref104"></nolink> <nolink nlid="nl50" bibid="bib52" firstref="ref105"></nolink> <nolink nlid="nl51" bibid="bib26" firstref="ref106"></nolink> <nolink nlid="nl52" bibid="bib53" firstref="ref107"></nolink> <nolink nlid="nl53" bibid="bib54" firstref="ref108"></nolink> <nolink nlid="nl54" bibid="bib55" firstref="ref110"></nolink> |
|---|---|
| Header | DbId: eric DbLabel: ERIC An: EJ1389492 AccessLevel: 3 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
| IllustrationInfo | |
| Items | – Name: Title Label: Title Group: Ti Data: Psychosocial Adjustment of U.S. College Students in the Early Months of the COVID-19 Pandemic – Name: Language Label: Language Group: Lang Data: English – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Okado%2C+Yuko%22">Okado, Yuko</searchLink><br /><searchLink fieldCode="AR" term="%22Scaramella%2C+Courtney%22">Scaramella, Courtney</searchLink><br /><searchLink fieldCode="AR" term="%22Nguyen%2C+Ha+M%2E%22">Nguyen, Ha M.</searchLink><br /><searchLink fieldCode="AR" term="%22Mendoza%2C+Benjamin%22">Mendoza, Benjamin</searchLink><br /><searchLink fieldCode="AR" term="%22Watarastaporn%2C+Tanya%22">Watarastaporn, Tanya</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="SO" term="%22Journal+of+American+College+Health%22"><i>Journal of American College Health</i></searchLink>. 2023 71(4):1281-1292. – Name: Avail Label: Availability Group: Avail Data: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals – Name: PeerReviewed Label: Peer Reviewed Group: SrcInfo Data: Y – Name: Pages Label: Page Count Group: Src Data: 12 – Name: DatePubCY Label: Publication Date Group: Date Data: 2023 – Name: TypeDocument Label: Document Type Group: TypDoc Data: Journal Articles<br />Reports - Research – Name: Audience Label: Education Level Group: Audnce Data: <searchLink fieldCode="EL" term="%22Higher+Education%22">Higher Education</searchLink><br /><searchLink fieldCode="EL" term="%22Postsecondary+Education%22">Postsecondary Education</searchLink> – Name: Subject Label: Descriptors Group: Su Data: <searchLink fieldCode="DE" term="%22Psychological+Patterns%22">Psychological Patterns</searchLink><br /><searchLink fieldCode="DE" term="%22College+Students%22">College Students</searchLink><br /><searchLink fieldCode="DE" term="%22COVID-19%22">COVID-19</searchLink><br /><searchLink fieldCode="DE" term="%22Pandemics%22">Pandemics</searchLink><br /><searchLink fieldCode="DE" term="%22Stress+Variables%22">Stress Variables</searchLink><br /><searchLink fieldCode="DE" term="%22Anxiety%22">Anxiety</searchLink><br /><searchLink fieldCode="DE" term="%22Depression+%28Psychology%29%22">Depression (Psychology)</searchLink> – Name: DOI Label: DOI Group: ID Data: 10.1080/07448481.2021.1926268 – Name: ISSN Label: ISSN Group: ISSN Data: 0744-8481<br />1940-3208 – Name: Abstract Label: Abstract Group: Ab Data: Objective: Examine the psychosocial adjustment of U.S. college and university students during the early months of the COVID-19 pandemic. Participants: Higher education students in the U.S. (N = 228), recruited between March 2020 and May 2020. Methods: Participants completed self-report measures regarding their psychosocial functioning online. Qualitative and quantitative methods were used to explore participants' psychosocial adjustment. Results: Participants reported increased concerns about such stressors as academics, job loss, health, and social isolation. They reported significantly elevated symptoms of depression, anxiety, perceived stress, and somatization, and prior history of psychological counseling was associated with greater levels of distress. Approximately one-third of participants reported inadequate perceived social support, which in turn was linked to psychosocial adjustment. Conclusions: College students reported experiencing a wide range of stressors related to the pandemic. Increasing access to mental health services and providing supportive services in such areas as social connection and employment are encouraged. – Name: AbstractInfo Label: Abstractor Group: Ab Data: As Provided – Name: DateEntry Label: Entry Date Group: Date Data: 2023 – Name: AN Label: Accession Number Group: ID Data: EJ1389492 |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1389492 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1080/07448481.2021.1926268 Languages: – Text: English PhysicalDescription: Pagination: PageCount: 12 StartPage: 1281 Subjects: – SubjectFull: Psychological Patterns Type: general – SubjectFull: College Students Type: general – SubjectFull: COVID-19 Type: general – SubjectFull: Pandemics Type: general – SubjectFull: Stress Variables Type: general – SubjectFull: Anxiety Type: general – SubjectFull: Depression (Psychology) Type: general Titles: – TitleFull: Psychosocial Adjustment of U.S. College Students in the Early Months of the COVID-19 Pandemic Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Okado, Yuko – PersonEntity: Name: NameFull: Scaramella, Courtney – PersonEntity: Name: NameFull: Nguyen, Ha M. – PersonEntity: Name: NameFull: Mendoza, Benjamin – PersonEntity: Name: NameFull: Watarastaporn, Tanya IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 01 Type: published Y: 2023 Identifiers: – Type: issn-print Value: 0744-8481 – Type: issn-electronic Value: 1940-3208 Numbering: – Type: volume Value: 71 – Type: issue Value: 4 Titles: – TitleFull: Journal of American College Health Type: main |
| ResultId | 1 |
