Mental health problems, especially anxiety and depression, during the pandemic caused by Omicron variant have aroused a great concern. The drastic change in daily routine leads to a higher level of life stress. Since postgraduate students usually have worse mental health problems, they could be vulnerable to life stress. Social support would be a protective factor against depression and anxiety, and might play a moderating role between life stress and these mental health indices.
This study is to explore the relationship between life stress and mental health, and how social support alleviates such relationship.
A set of online questionnaires, including (1) items of 11 points visual analog scale (VAS) to measure postgraduate students' current life stress and social support, (2) Generalized Anxiety Disorder (GAD-7), (3) Patient Health Questionnaire (PHQ), was handed out to postgraduate students from several universities in Shanghai. Data of 110 postgraduate students were collected and analyzed. Pearson correlations and mediate effect tests were conducted to verify the potential relationship.
(1) Life stress was positively correlated with the level of anxiety and depression. Social support was negatively correlated with life stress and the level of anxiety and depression. (2) The interaction between social support level and life stress played a significant role in predicting anxiety level (β = –0.020, p = 0.044). The interaction between social support level and life stress also predicted the level of depression (β = –0.025, p = 0.009).
High-level social support had effectively mitigated the steep slope between the restrained life stress and mental health, which indicated that more available social support would be promising to alleviate the risk of anxiety and depression during the static management period.
Kunzler, A. M., Röthke, N., Günthner, L., Stoffers-Winterling, J., Tüscher, O., Coenen, M., Rehfuess, E., Schwarzer, G., Binder, H., Schmucker, C. et al. Mental burden and its risk and protective factors during the early phase of the SARS-CoV-2 pandemic: Systematic review and meta-analyses. Globalization and Health, 2021, 17(1): 34.
Ju, Y., Zhang, Y., Wang, X., Li, W., Ng, R. M. K., Li, L. China's mental health support in response to COVID-19: Progression, challenges and reflection. Global Health, 2020, 16(1): 102.
Necho, M., Tsehay, M., Birkie, M., Biset, G., Tadesse, E. Prevalence of anxiety, depression, and psychological distress among the general population during the COVID-19 pandemic: A systematic review and meta-analysis. International Journal of Socical Psychiatry, 2021, 67(7): 892–906.
Zhang, J., Lu, H., Zeng, H., Zhang, S., Du, Q., Jiang, T., Du, B. The differential psychological distress of populations affected by the COVID-19 pandemic. Brain, Behavior, and Immunity, 2020, 87: 49–50.
O'Toole, Á., Scher, E., Underwood, A., Jackson, B., Hill, V., McCrone, J. T., Colquhoun, R., Ruis, C., Abu-Dahab, K., Taylor, B. et al. Assignment of epidemiological lineages in an emerging pandemic using the pangolin tool. Virus Evolution, 2021, 7(2): veab064.
Tang, S., Xiang, M., Cheung, T., Xiang, Y. T. Mental health and its correlates among children and adolescents during COVID-19 school closure: The importance of parent-child discussion. Journal of Affective Disorders, 2021, 279: 353–360.
Wathelet, M., Duhem, S., Vaiva, G., Baubet, T., Habran, E., Veerapa, E., Debien, C., Molenda, S., Horn, M., Grandgenèvre, P. et al. Factors associated with mental health disorders among university students in France confined during the COVID-19 pandemic. JAMA Network Open, 2020, 3(10): e2025591.
Grolli, R. E., Mingoti, M. E. D., Bertollo, A. G., Luzardo, A. R., Quevedo, J., Réus, G. Z., Ignácio, Z. M. Impact of COVID-19 in the mental health in elderly: Psychological and biological updates. Molecular Neurobiology, 2021, 58(5): 1905–1916.
Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., McIntyre, R. S., Choo, F. N., Tran, B., Ho, R., Sharma, V. K. et al. A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain, Behavior, and Immunity, 2020, 87: 40–48.
Toews, J. A., Lockyer, J. M., Dobson, D. J., Simpson, E., Brownell, A. K., Brenneis, F., MacPherson, K. M., Cohen, G. S. Analysis of stress levels among medical students, residents, and graduate students at four Canadian schools of medicine. Academic Medicine, 1997, 72(11): 997–1002.
Gloster, A. T., Lamnisos, D., Lubenko, J., Presti, G., Squatrito, V., Constantinou, M., Nicolaou, C., Papacostas, S., Aydın, G., Chong, Y. Y. et al. Impact of COVID-19 pandemic on mental health: An international study. PLoS One, 2020, 15(12): e0244809.
Czaja, S. J., Boot, W. R., Charness, N., Rogers, W. A., Sharit, J. Improving social support for older adults through technology: Findings from the PRISM randomized controlled trial. The Gerontologist, 2017, 58(3): 467–477.
Spitzer, R. L., Kroenke, K., Williams, J. B., Löwe, B. A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 2006, 166(10): 1092–1097.
Löwe, B., Decker, O., Müller, S., Brähler, E., Schellberg, D., Herzog, W., Herzberg, P. Y. Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population. Medical Care, 2008, 46(3): 266–274.
Dear, B. F., Titov, N., Sunderland, M., McMillan, D., Anderson, T., Lorian, C., Robinson, E. Psychometric comparison of the generalized anxiety disorder scale-7 and the Penn state worry questionnaire for measuring response during treatment of generalised anxiety disorder. Cognitive Behaviour Therapy, 2011, 40(3): 216–227.
Zeng, Q. -Z., He, Y. -L., Liu, H., Miao, J. -M., Chen, J. -X., Xu, H. -N., Wang, J. -Y. Reliability and validity of Chinese version of the Generalized Anxiety Disorder 7-item(GAD-7) scale in screening anxiety disorders in outpatients from traditional Chinese internal department. Chinese Mental Health Journal, 2013, 27(3): 163–168. (in Chinese)
Kroenke, K. Enhancing the clinical utility of depression screening. Cmaj, 2012, 184(3): 281–282.
Martin, A., Rief, W., Klaiberg, A., Braehler, E. Validity of the Brief Patient Health Questionnaire Mood Scale (PHQ-9) in the general population. General Hospital Psychiatry, 2006, 28(1): 71–77.
Wang, W., Bian, Q., Zhao, Y., Li, X., Wang, W., Du, J., Zhang, G., Zhou, Q., Zhao, M. Reliability and validity of the Chinese version of the Patient Health Questionnaire (PHQ-9) in the general population. General Hospital Psychiatry, 2014, 36(5): 539–544.
Finlay-Jones, R., Brown, G. W. Types of stressful life event and the onset of anxiety and depressive disorders. Journal of the American College of Clinical Pharmacy, 1981, 11(4): 803–815.
Monroe, S. M., Simons, A. D. Diathesis-stress theories in the context of life stress research: Implications for the depressive disorders. Psychological Bulletin, 1991, 110(3): 406–425.
Marin, M. F., Lord, C., Andrews, J., Juster, R. P., Sindi, S., Arsenault-Lapierre, G., Fiocco, A. J., Lupien, S. J. Chronic stress, cognitive functioning and mental health. Neurobiology of Learning and Memory, 2011, 96(4): 583–595.
Alegría, M., NeMoyer, A., Falgàs Bagué, I., Wang, Y., Alvarez, K. Social determinants of mental health: Where we are and where we need to go. Current Psychiatry Reports, 2018, 20(11): 1–13.
The authors thank Huiting Cai and Di Zhao for their help in designing the experiment.
Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attributtion-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission.