Associations Between Academic Stress and Depressive Symptoms Mediated by Anxiety Symptoms and Hopelessness Among Chinese College Students

References

• James SL, Abate D, Abate KH, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the global burden of disease study 2017. Lancet. 2018;392(10159):1789–1858.
   PubMed Web of Science ®Google Scholar
• Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3(11):e442. doi:10.1371/journal.pmed.0030442
   PubMed Web of Science ®Google Scholar
• Lattie EG, Adkins EC, Winquist N, Stiles-Shields C, Wafford QE, Graham AK. Digital mental health interventions for depression, anxiety, and enhancement of psychological well-being among college students: systematic review. J Med Internet Res. 2019;21(7):e12869. doi:10.2196/12869
   PubMed Web of Science ®Google Scholar
• Mendelson T, Tandon SD. Prevention of depression in childhood and adolescence. Child Adolesc Psychiatr Clin N Am. 2016;25(2):201–218. doi:10.1016/j.chc.2015.11.005
   PubMed Web of Science ®Google Scholar
• Feng Q, Zhang QL, Du Y, Ye YL, He QQ. Associations of physical activity, screen time with depression, anxiety and sleep quality among Chinese college freshmen. PLoS One. 2014;9(6):e100914. doi:10.1371/journal.pone.0100914
   PubMed Web of Science ®Google Scholar
• Eisenberg D, Gollust SE, Golberstein E, Hefner JL. Prevalence and correlates of depression, anxiety, and suicidality among university students. Am J OrthoPsychiatry. 2007;77(4):534–542. doi:10.1037/0002-9432.77.4.534
   PubMed Web of Science ®Google Scholar
• Wang M, Liu J, Wu X, et al. The prevalence of depression among students in Chinese universities over the past decade: a meta-analysis. J Hainan Med Univ. 2020;9:44–50.
   Google Scholar
• Ibrahim AK, Kelly SJ, Adams CE, Glazebrook C. A systematic review of studies of depression prevalence in university students. J Psychiatr Res. 2013;47(3):391–400. doi:10.1016/j.jpsychires.2012.11.015
   PubMed Web of Science ®Google Scholar
• Jayanthi P, Thirunavukarasu M, Rajkumar R. Academic stress and depression among adolescents: a cross-sectional study. Indian Pediatr. 2015;52(3):217–219. doi:10.1007/s13312-015-0609-y
   PubMed Web of Science ®Google Scholar
• Emond M, ten Eycke K, Kosmerly S, Robinson AL, Stillar A, van Blyderveen S. The effect of academic stress and attachment stress on stress-eaters and stress-undereaters. Appetite. 2016;100:210–215. doi:10.1016/j.appet.2016.01.035
   PubMed Web of Science ®Google Scholar
• Verma S, Gupta J. Some aspects of high academic stress and symptoms. J Pers Clin Stud. 1990;6(1):7–12.
   Google Scholar
• Jinghua L, Xiaoli F, Songli M, Dongliang Y. Investigation of study pressure effects on mental health of junior school students in Changchun. Med Soc. 2007;20(2):56–57.
   Google Scholar
• Beiter R, Nash R, McCrady M, et al. The prevalence and correlates of depression, anxiety, and stress in a sample of college students. J Affect Disord. 2015;173:90–96. doi:10.1016/j.jad.2014.10.054
   PubMed Web of Science ®Google Scholar
• Leung GSM, Yeung KC, Wong DFK. Academic stressors and anxiety in children: the role of paternal support. J Child Fam Stud. 2010;19(1):90–100. doi:10.1007/s10826-009-9288-4
   Web of Science ®Google Scholar
• Fawzy M, Hamed SA. Prevalence of psychological stress, depression and anxiety among medical students in Egypt. Psychiatry Res. 2017;255:186–194. doi:10.1016/j.psychres.2017.05.027
   PubMed Web of Science ®Google Scholar
• Kouzma NM, Kennedy GA. Self-reported sources of stress in senior high school students. Psychol Rep. 2004;94(1):314–316. doi:10.2466/pr0.94.1.314-316
   PubMed Web of Science ®Google Scholar
• Azad N, Shahid A, Abbas N, Shaheen A, Munir N. Anxiety and depression in medical students of a private medical college. J Ayub Med Coll Abbottabad. 2017;29(1):123–127.
   PubMedGoogle Scholar
• Dyson R, Renk K. Freshmen adaptation to university life: depressive symptoms, stress, and coping. J Clin Psychol. 2006;62(10):1231–1244. doi:10.1002/jclp.20295
   PubMed Web of Science ®Google Scholar
• Shao R, He P, Ling B, et al. Prevalence of depression and anxiety and correlations between depression, anxiety, family functioning, social support and coping styles among Chinese medical students. BMC Psychol. 2020;8(1):38. doi:10.1186/s40359-020-00402-8
   PubMed Web of Science ®Google Scholar
• Beck AT, Weissman A, Lester D, Trexler L. The measurement of pessimism: the hopelessness scale. J Consult Clin Psychol. 1974;42(6):861–865. doi:10.1037/h0037562
   PubMed Web of Science ®Google Scholar
• Landis D, Gaylord-Harden NK, Malinowski SL, Grant KE, Carleton RA, Ford RE. Urban adolescent stress and hopelessness. J Adolesc. 2007;30(6):1051–1070. doi:10.1016/j.adolescence.2007.02.001
   PubMed Web of Science ®Google Scholar
• Lew B, Huen J, Yu P, et al. Associations between depression, anxiety, stress, hopelessness, subjective well-being, coping styles and suicide in Chinese university students. PLoS One. 2019;14(7):e0217372. doi:10.1371/journal.pone.0217372
   PubMed Web of Science ®Google Scholar
• Alloy LB, Clements CM. Hopelessness theory of depression: tests of the symptom component. Cognit Ther Res. 1998;22(4):303–335. doi:10.1023/A:1018753028007
   Web of Science ®Google Scholar
• Alloy LB, Kelly KA, Mineka S, Clements CM. Comorbidity of anxiety and depressive disorders: a helplessness-hopelessness perspective. In: Comorbidity of Mood and Anxiety Disorders. 1990:499–543.
   Google Scholar
• Starr LR, Davila J. Responding to anxiety with rumination and hopelessness: mechanism of anxiety-depression symptom co-occurrence? Cognit Ther Res. 2012;36(4):321–337. doi:10.1007/s10608-011-9363-1
   PubMed Web of Science ®Google Scholar
• Kohn JP, Frazer GH. An academic stress scale: identification and rated importance of academic stressors. Psychol Rep. 1986;59(2, Pt 1):415–426. doi:10.2466/pr0.1986.59.2.415
   Web of Science ®Google Scholar
• Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–1097. doi:10.1001/archinte.166.10.1092
   PubMed Web of Science ®Google Scholar
• Xianyan H, Chunbo L, Jie Q, Haisong C, Wenyuan W. Reliability and validity of a generalized anxiety disorder scale in general Hospital outpatients. Shanghai Arch Psychiatry. 2010;22(4):200–203.
   Google Scholar
• Yuanyuan K, Jie Z, Shuhua J, Li Z. Reliability and validity of the Beck hopelessness scale for adolescent. Chin Mental Health J. 2007;21(10):686–689.
   Google Scholar
• Rush AJ, Trivedi MH, Ibrahim HM, et al. The 16-item quick inventory of depressive symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression. Biol Psychiatry. 2003;54(5):573–583. doi:10.1016/S0006-3223(02)01866-8
   PubMed Web of Science ®Google Scholar
• Reilly TJ, MacGillivray SA, Reid IC, Cameron IM. Psychometric properties of the 16-item quick inventory of depressive symptomatology: a systematic review and meta-analysis. J Psychiatr Res. 2015;60:132–140. doi:10.1016/j.jpsychires.2014.09.008
   PubMed Web of Science ®Google Scholar
• Liu J, Xiang YT, Wang G, et al. Psychometric properties of the Chinese versions of the quick inventory of depressive symptomatology - clinician rating (C-QIDS-C) and self-report (C-QIDS-SR). J Affect Disord. 2013;147(1–3):421–424. doi:10.1016/j.jad.2012.08.035
   PubMed Web of Science ®Google Scholar
• Edwards JR, Lambert LS. Methods for integrating moderation and mediation: a general analytical framework using moderated path analysis. Psychol Methods. 2007;12(1):1–22. doi:10.1037/1082-989X.12.1.1
   PubMed Web of Science ®Google Scholar
• Hayes AF. Introduction to Mediation, Moderation, and Conditional Process Analysis. 2nd ed. Guilford Press; 2018.
   Google Scholar
• Chen L, Wang L, Qiu XH, et al. Depression among Chinese university students: prevalence and socio-demographic correlates. PLoS One. 2013;8(3):e58379. doi:10.1371/journal.pone.0058379
   PubMed Web of Science ®Google Scholar
• Zuo B, Zhang X, Wen FF, Zhao Y. The influence of stressful life events on depression among Chinese university students: multiple mediating roles of fatalism and core self-evaluations. J Affect Disord. 2020;260:84–90. doi:10.1016/j.jad.2019.08.083
   PubMed Web of Science ®Google Scholar
• Liu X, Ping S, Gao W. Changes in undergraduate students’ psychological well-being as they experience university life. Int J Environ Res Public Health. 2019;16(16):2864.
   PubMed Web of Science ®Google Scholar
• Ramón-Arbués E, Gea-Caballero V, Granada-López JM, Juárez-Vela R, Pellicer-García B, Antón-Solanas I. The prevalence of depression, anxiety and stress and their associated factors in college students. Int J Environ Res Public Health. 2020;17(19):7001. doi:10.3390/ijerph17197001
   PubMed Web of Science ®Google Scholar
• Lester D. Hopelessness in undergraduate students around the world: a review. J Affect Disord. 2013;150(3):1204–1208. doi:10.1016/j.jad.2013.04.055
   PubMed Web of Science ®Google Scholar
• Aloufi MA, Jarden RJ, Gerdtz MF, Kapp S. Reducing stress, anxiety and depression in undergraduate nursing students: systematic review. Nurse Educ Today. 2021;102:104877. doi:10.1016/j.nedt.2021.104877
   PubMed Web of Science ®Google Scholar
• Leung JTY. Perceived parental sacrifice, filial piety and hopelessness among Chinese adolescents: a cross-lagged panel study. J Adolesc. 2020;81:39–51. doi:10.1016/j.adolescence.2020.04.005
   PubMed Web of Science ®Google Scholar
• Shek DTL, Lee TY. Hopelessness in Chinese adolescents in Hong Kong: demographic and family correlates. Int J Adolesc Med Health. 2005;17(3):279–290. doi:10.1515/IJAMH.2005.17.3.275
   PubMedGoogle Scholar
• Iqbal S, Gupta S, Venkatarao E. Stress, anxiety and depression among medical undergraduate students and their socio-demographic correlates. Indian J Med Res. 2015;141(3):354–357. doi:10.4103/0971-5916.156571
   PubMed Web of Science ®Google Scholar
• Rana S, Lall G, Mishra A, Nandinee D, Vincent K. Hopelessness during emerging adulthood: contributions of anxiety. Int J Health Allied Sci. 2014;3(4):273–277. doi:10.4103/2278-344X.143074
   Google Scholar
• Coskun O, Ocalan A, Ocbe C, Semiz H, Budakoglu I. Depression and hopelessness in pre-Clinical medical students. Clin Teach. 2019;16:345–351. doi:10.1111/tct.13073
   PubMed Web of Science ®Google Scholar
• Iliceto P, Pompili M, Lester D, et al. Relationship between temperament, depression, anxiety, and hopelessness in adolescents: a structural equation model. Depress Res Treat. 2011;2011:160175. doi:10.1155/2011/160175
   PubMedGoogle Scholar
• Gulec Oyekcin D, Sahin EM, Aldemir E. Mental health, suicidality and hopelessness among university students in Turkey. Asian J Psychiatr. 2017;29:185–189. doi:10.1016/j.ajp.2017.06.007
   PubMed Web of Science ®Google Scholar
• Ribeiro JD, Huang X, Fox KR, Franklin JC. Depression and hopelessness as risk factors for suicide ideation, attempts and death: meta-analysis of longitudinal studies. Br j psychiatry. 2018;212(5):279–286. doi:10.1192/bjp.2018.27
   PubMed Web of Science ®Google Scholar
• Bouma EMC, Ormel J, Verhulst FC, Oldehinkel AJ. Stressful life events and depressive problems in early adolescent boys and girls: the influence of parental depression, temperament and family environment. J Affect Disord. 2008;105(1–3):185–193. doi:10.1016/j.jad.2007.05.007
   PubMed Web of Science ®Google Scholar
• Sharma B, Wavare R. Academic stress due to depression among medical and paramedical students in an Indian medical college: health initiatives cross sectional study. J Health Sci. 2013;3(5):29–38.
   Google Scholar
• Reinherz HZ, Giaconia RM, Pakiz B, Silverman AB, Frost AK, Lefkowitz ES. Psychosocial risks for major depression in late adolescence: a longitudinal community study. J Am Acad Child Adolesc Psychiatry. 1993;32(6):1155–1163. doi:10.1097/00004583-199311000-00007
   PubMed Web of Science ®Google Scholar
• Reinherz HZ, Stewart-Berghauer G, Pakiz B, Frost AK, Moeykens BA, Holmes WM. The relationship of early risk and current mediators to depressive symptomatology in adolescence. J Am Acad Child Adolesc Psychiatry. 1989;28(6):942–947. doi:10.1097/00004583-198911000-00021
   PubMed Web of Science ®Google Scholar
• Falsafi N. A randomized controlled trial of mindfulness versus yoga: effects on depression and/or anxiety in college students. J Am Psychiatr Nurses Assoc. 2016;22(6):483–497. doi:10.1177/1078390316663307
   PubMed Web of Science ®Google Scholar
• Lemay V, Hoolahan J, Buchanan A. Impact of a yoga and meditation intervention on students’ stress and anxiety levels. Am J Pharm Educ. 2019;83(5):7001. doi:10.5688/ajpe7001
   PubMed Web of Science ®Google Scholar
• Nekanda-Trepka CJ, Bishop S, Blackburn IM. Hopelessness and depression. Br J Clin Psychol. 1983;22(Pt 1):49–60. doi:10.1111/j.2044-8260.1983.tb00578.x
   PubMed Web of Science ®Google Scholar
• Pössel P, Smith E. Integrating Beck’s cognitive theory of depression and the hopelessness model in an adolescent sample. J Abnorm Child Psychol. 2020;48(3):435–451. doi:10.1007/s10802-019-00604-8
   PubMed Web of Science ®Google Scholar