Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.
Mental Health Education and Counseling Center, Guangzhou Academy of Fine Arts, Guangzhou, China.
BMC Psychiatry. 2023 Apr 12;23(1):244. doi: 10.1186/s12888-023-04717-9.
During the COVID-19 pandemic, college students were required to stay at home and maintain social distance for the entire spring semester of 2020. There is little research on how family functioning influenced mental health problems and how coping styles moderated the relationship between family functioning and mental health problems among college students during their stay-at-home period.
A total of 13,462 college students (age = 16-29 years) completed four online surveys between February and October 2020, namely the outbreak phase, remission phase, online study phase, and school reopening phase in Guangdong Province, China. Family functioning was assessed by the Family APGAR; coping styles were assessed by the Simplified Coping Style Questionnaire (SCSQ), depression symptoms and anxiety symptoms were evaluated by the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7) respectively. Generalized estimating equations were used to assess associations between variables, the logit link function was used to estimate the odds ratio of different subgroups, the Newton-Raphson method was used to estimate parameters, and the Wald test was used to test the main effect and the interaction effect.
The incidence rates of depression increased during the stay-at-home period from 33.87%, 95% CI (29.88%, 38.10%) to 40.08% 95% CI (35.76%, 44.55%) after schools reopened, χ = 193.68, p < 0.001. The incidence rates of anxiety increased from 17.45%, 95% CI (14.59%, 20.73%) to 26.53%, 95% CI (16.94%, 23.67%) over the entire period, χ = 195.74, p < 0.001. The percentages of students with highly functional, moderately dysfunctional and severely dysfunctional family functioning were 48.23%, 43.91 and 7.86% at T1 and 46.20%, 45.28%, and 8.52 at T4, respectively. The percentage of subjects with active coping style was 23.9%, negative coping style was 17.4%, strong response coping was 26.9%, and weak response coping was 31.7%. The incidence rate of depression and anxiety for different family functioning groups varied at different time points, and the interaction effect was significant (χ2 = 52.97, p < 0.001 and χ2 = 51.25, p < 0.001, respectively). The incidence rate of depression and anxiety for different family functioning groups with different coping styles also varied at different time points, the interaction effect was likewise significant (χ2 = 862.09, p < 0.001 and χ2 = 583.29, p < 0.001, respectively).
Having a severely dysfunctional family and a negative coping style increase the incidence rates of depression and anxiety. These findings highlight the importance of paying special attention to college students' family functioning and promoting appropriate coping strategies during and after COVID-19.
在 2020 年新冠疫情期间，大学生整个春季学期都被要求待在家中并保持社交距离。关于家庭功能如何影响心理健康问题，以及在大学生居家期间，应对方式如何调节家庭功能与心理健康问题之间的关系，研究甚少。
2020 年 2 月至 10 月，共有 13462 名大学生（年龄 16-29 岁）完成了四次在线调查，分别是广东省疫情爆发期、缓解期、线上学习期和学校复课期。家庭功能采用家庭适应度评估问卷（APGAR）进行评估；应对方式采用简易应对方式问卷（SCSQ）进行评估；抑郁症状和焦虑症状分别采用患者健康问卷（PHQ-9）和广泛性焦虑障碍量表（GAD-7）进行评估。采用广义估计方程评估变量之间的关联，使用对数链接函数估计不同亚组的优势比，使用牛顿-拉普森法估计参数，使用 Wald 检验测试主要效应和交互效应。
居家期间，抑郁的发生率从开学前的 33.87%（95%CI：29.88%，38.10%）增加至 40.08%（95%CI：35.76%，44.55%），χ2=193.68，p<0.001。焦虑的发生率从开学前的 17.45%（95%CI：14.59%，20.73%）增加至整个时期的 26.53%（95%CI：16.94%，23.67%），χ2=195.74，p<0.001。居家期间，家庭功能高度、中度和重度功能障碍的学生比例分别为 T1 时的 48.23%、43.91%和 7.86%，T4 时的 46.20%、45.28%和 8.52%。积极应对方式的学生比例为 23.9%，消极应对方式的学生比例为 17.4%，强反应应对方式的学生比例为 26.9%，弱反应应对方式的学生比例为 31.7%。不同家庭功能组的抑郁和焦虑发生率在不同时间点有所不同，交互效应显著（χ2=52.97，p<0.001 和 χ2=51.25，p<0.001）。不同应对方式的不同家庭功能组的抑郁和焦虑发生率在不同时间点也有所不同，交互效应同样显著（χ2=862.09，p<0.001 和 χ2=583.29，p<0.001）。
家庭功能严重障碍和消极应对方式会增加抑郁和焦虑的发生率。这些发现强调了在新冠疫情期间和之后，特别关注大学生家庭功能并促进适当应对策略的重要性。
