Impact of family functioning on mental health problems of college students in China during COVID-19 pandemic and moderating role of coping style: a longitudinal study

Abstract

Background 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. Methods 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. Results 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, χ2 = 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, χ2 = 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). Conclusions 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.

Pain intensity and self‐perceived burden mediate the relationship between family functioning and pain catastrophizing in patients with neuropathic pain

“…Patients with NP not only have severe pain and poor health but also have a long duration of the disease (Bouhassira et al, 2008;Smith et al, 2020); in this case, the family may be the most accessible source of long-term care (Liu et al, 2023;Wang et al, 2021). Family functioning measures the quality of the family system.…”

“…Neuropathic pain (NP) refers to the pain caused by a lesion or disease of the somatosensory system (Jensen et al, 2011), presumably affecting more than 90 million people in China (van Hecke et al, 2014). Patients with NP not only have severe pain and poor health but also have a long duration of the disease (Bouhassira et al, 2008; Smith et al, 2020); in this case, the family may be the most accessible source of long‐term care (Liu et al, 2023; Wang et al, 2021). Family functioning measures the quality of the family system.…”

Depression and academic engagement among college students: the role of sense of security and psychological impact of COVID-19

“…It often disrupts people's mental states and leads to an array of difficulties in their studies and lives, with severe cases resulting in self-harm and other harmful consequences (13). As an unprecedented public health crisis, the pandemic caused an incalculable disruption to students' lives and studies, coupled with increased uncertainty about their future, which increased their susceptibility to depression (14). For students with a predisposition to depression or a history of illness, the pandemic undoubtedly acted as an adverse stimulus, potentially leading to heightened feelings of despair and sorrow (15).…”