Latent Profiles and Transitions of Bedtime Procrastination Among Chinese College Students: The Predictive Roles of Anxiety, Depression, Problematic Smartphone Use and Self-Control.

Background: Bedtime procrastination (BP) has become an important factor affecting individual well-being. This study aimed to assess the stability and changes in BP and examine risk and protective factors. Methods: The study recruited 1423 respondents. Latent profile analysis was used to identify subgroups of BP and latent transition analysis to determine transition probabilities for each subgroup. Logistic regression examined associations between identified classes and related factors. Results: Three subgroups of BP were identified. In terms of stability and changes, the moderate bedtime procrastination group showed the highest stability (66%), followed by the severe bedtime procrastination group (62.4%), and the mild bedtime procrastination group had a 52% probability of switching to moderate bedtime procrastination. In terms of influencing factors, more problematic phone use (PSU) (OR: 1.08; 95% CI = 1.05-1.12), more depression (OR: 1.17; 95% CI = 1.06-1.29) and anxiety (OR: 1.16; 95% CI = 1.05-1.28) are all factors that aggravate the transition from mild to moderate sleep procrastination. Similarly, PSU (OR: 1.15; 95% CI = 1.12-1.19), anxiety (OR: 1.10; 95% CI = 1.06-1.14), and depression (OR: 1.10; 95% CI = 1.06-1.14) increased the risk of severe bedtime procrastination. Self-control emerged as a protective factor against BP. Conclusion: This study identified three subgroups of BP at two time points and the rule of transition for each subgroup. Our findings indicate that BP were relatively stable, with some changes over time. The results also highlight the important function that PSU, depression, anxiety, and self-control can play in preventing and intervening in BP.

Prospective relationships between college adjustment, self-esteem, and mental health status among Chinese undergraduates.

Objective: This three-wave longitudinal study tested the prospective relationships between college adjustment, self-esteem, and mental health status (ie, subjective well-being, anxiety, and depression). Participants: The study recruited 265 Chinese undergraduate students. Methods: Demographic, college adjustment, self-esteem, and mental health status data were collected. Results: College adjustment and self-esteem were moderate in magnitude and maintained a reasonable stability over time. College adjustment and self-esteem at Year 1 and Year 2, and mental health status at Year 3, were significantly correlated with each other. College adjustment at Year 1 and Year 2, and self-esteem at Year 1 significantly predicted mental health status at Year 3. Conclusions: Interventions to improve self-esteem and college adjustment may benefit long-term mental health outcomes.

Do Attitudes, Mental Health Status, and Interpersonal Factors Predict COVID-19 Vaccine Hesitancy at the Early Phase of the Pandemic? A Longitudinal Study in Chinese College Students.

Purpose: The present study examined whether and how attitudes toward the COVID-19 vaccine (i.e., safety, efficacy, and price), mental health statuses (i.e., perceived stress and depression), and interpersonal factors (i.e., online social support, perceived social support) would predict COVID-19 vaccine hesitancy. Patients and methods: The two-wave longitudinal surveys were conducted in December 2019 and 2020 in Chinese medical college students (N = 194). Well- validated measures were used, including the Perceived Stress Scale, the Center for Epidemiologic Studies Depression Scale, the Online Social Support Questionnaire, and the Perceived Social Support Scale. Perceived safety, efficacy, price of COVID-19 vaccine, vaccine hesitancy, and actual intake were also measured. Results: Only 2.1% of participants had been vaccinated against COVID-19 in the early stages of the pandemic; 13.4% intended to get vaccinated in the next 3 months, and 66% intended to have it in the next 12 months upon follow-up. Multiple regression analyses revealed that perceived stress (ßm = -0.15, p < 0.05) and depression (ßm = -0.15, p < 0.05) were risk factors for positive attitudes toward the COVID-19 vaccine; online social support (ORm = 1.41, p < 0.01) and positive attitudes toward the COVID-19 vaccine (ORm = 1.83, p < 0.01) were protective factors of intention to get vaccinated in future. Conclusion: Findings suggest that intervention efforts should be made to reduce negative attitudes toward the COVID-19 vaccine among people with poor mental health and enhance online social support to promote COVID-19 vaccination.

The role of illness representations of internet gaming disorder (IGD) in help-seeking intention among undergraduates: A longitudinal study.

BACKGROUND AND AIMS: The Common-Sense Model asserts that illness representations of a health threat affect coping and behavioral reactions to it. Internet gaming disorder (IGD) is a newly defined mental disorder and leads to various health consequences. Little is known about illness representations of IGD and help-seeking for IGD among young adults who are at particular risk of IGD. OBJECTIVE: This study investigated the roles of illness representations in intention to seek help from professionals and important others (families and friends) for IGD in college students in China. METHODS: A two-wave longitudinal study was conducted with a convenience sample of college students in China (N = 591, 57.9% females, Meanage = 19.10). Descriptive analyses and logistic regression analyses were conducted. RESULTS: Approximately 10% of participants were classified as having probable IGD. However, over 70% endorsed self-diagnosed IGD. Less than 40% perceived resources of help-seeking, and most perceived shame for help-seeking. Less than 40% intended to seek help from professionals, and 26% from family and friends. Significant predictors of intention to seek professional help included probable IGD, perceived resources of help-seeking for IGD, consequence, timeline, and treatment. Significant predictors of intention to seek help from family and friends included probable IGD, self-diagnosed IGD, perceived resources of help-seeking for IGD, shame for help-seeking for IGD, timeline, treatment control, identity, concern, and emotional response. Females were more likely to seek both types of help. DISCUSSION AND CONCLUSIONS: Perceptions of IGD and help-seeking play significant roles in help-seeking intentions. These modifiable factors can be used to guide the development of health promotion and behavioral change programs to promote help-seeking for IGD.

Longitudinal relationships among perceived stress, suicidal ideation and sleep quality in Chinese undergraduates: A cross-lagged model.

BACKGROUND: Sleep quality is an important indicator of quality of life. It is of importance to investigate the risk factors and potential consequences of poor sleep quality, such as perceived stress and suicidal ideation. We therefore investigated the longitudinal and reciprocal relationships among perceived stress, suicidal ideation, and sleep quality. METHODS: A three-wave longitudinal survey was conducted from June 2019 to June 2020 at six-month intervals in undergraduate students (N = 197, 58.9% female) in China. The participants completed self-report questionnaires in classroom settings. RESULTS: While the levels of perceived stress were stable, levels of suicidal ideation and sleep quality fluctuated significantly over time. There were significant reciprocal relationships between perceived stress and suicidal ideation from T1 to T3. In addition, the reciprocal relationships between suicidal ideation and sleep quality from T1 to T2 were also significant. Suicidal ideation at T2 partially mediated the relationship between perceived stress at T1 and sleep quality at T3 (indirect effect: ß=0.06, 95% CI: 0.04 to 0.10, p<0.001), and suicidal ideation at T2 fully mediated the relationship between sleep quality at T1 and perceived stress at T3 (indirect effect: ß=0.48, 95% CI: 0.30, 0.70, p<0.001). LIMITATIONS: The subjects' educational background is single, and the measurement method is self-report measures. CONCLUSIONS: Suicidal ideation may play a significant role in explaining the longitudinal relationships between perceived stress and sleep quality. And suggest the importance of early identification and treatment of suicidal ideation among Chinese undergraduates.

Longitudinal Effects of Stressful Life Events on Problematic Smartphone Use and the Mediating Roles of Mental Health Problems in Chinese Undergraduate Students.

Background and Aims: This three-wave longitudinal study investigated the effects of stressful life events on problematic smartphone use and the mediating roles of mental health problems (i.e., depressive symptoms, poor sleep quality, and suicidal ideation) in Chinese undergraduate students. Methods: A total of 197 undergraduate students completed the three-wave surveys. Their severity of stressful life events, mental health problems, and problematic smartphone use were assessed. Results: Regression analyses revealed that stressful life events at T1 was significantly associated with problematic smartphone use at T3. Mediation analyses showed that mental health problems (i.e., depressive symptoms, poor sleep quality, and suicidal ideation) at T2 fully mediated the association between stressful life events at T1 and problematic smartphone use at T3 (B = 0.042, 0.034, and 0.022, respectively). Conclusions: The present study revealed that stressful life events and mental health problems (i.e., depressive symptoms, poor sleep quality, and suicidal ideation) are predictors of problematic smartphone use in Chinese college students.

Relationship Between Illness Representations and Symptoms of Internet Gaming Disorder Among Young People: Cross-Lagged Model.

BACKGROUND: The common-sense model of illness suggests that mental representations of health threats may affect one's behavioral reactions to them and health status. Internet gaming disorder is a newly defined mental disorder. Illness representations of internet gaming disorder may affect one's risk of internet gaming disorder. In turn, symptoms of internet gaming disorder may affect one's perceptions of the disorder. OBJECTIVE: This study aimed to investigate the relationships between illness representations and symptoms of internet gaming disorder in college students. METHODS: A 1-year longitudinal study was conducted with a convenience sample of Chinese college students (n=591; 342/591, 57.9% female). RESULTS: Of the participants, 10.1% (60/591) and 9.1% (54/591) were classified as having probable internet gaming disorder at baseline (T1) and follow-up (T2), respectively. The correlations between some dimensions of illness representations regarding internet gaming disorder (ie, consequence, timeline, personal control, treatment control, and concern) at T1 and symptoms of internet gaming disorder at T2 and between symptoms of internet gaming disorder at T1 and the dimensions of illness representations at T2 (ie, consequence, timeline, personal control, and emotional response) were statistically significant. The cross-lagged model fit the data well ((χ2/df=2.28, comparative fit index=.95, root mean square error of approximation=.06) and showed that internet gaming disorder at T1 was positively associated with unfavorable illness representations at T2. CONCLUSIONS: Individuals with more severe symptoms of internet gaming disorder had more pessimistic perceptions about the disorder. Such cognitive perceptions may affect one's emotional and behavioral reactions towards the disorder (eg, greater levels of depression and low self-control intention) and should be modified by educational programs and psychological interventions.

Effects of Online Social Support and Perceived Social Support on the Relationship Between Perceived Stress and Problematic Smartphone Usage Among Chinese Undergraduates.

PURPOSE: Recent research has identified a relationship between perceived stress and problematic smartphone usage. However, little is known about the underlying mediating and moderating mechanisms. The present study aimed to test the relationship between perceived stress and problematic smartphone usage as well as the mediating role of online social support and the moderating role of perceived social support among Chinese undergraduates. PATIENTS AND METHODS: A sample of 1123 college students participated in the study. The Perceived Stress Scale, Mobile Phone Addiction Index Scale, Online Social Support Questionnaire, and Perceived Social Support Scale were used. RESULTS: Perceived stress was significantly and positively associated with problematic smartphone usage, and online social support partially mediated the relationship between perceived stress and problematic smartphone usage. Moderated mediation analysis suggested that perceived social support moderated the association between perceived stress and online social support. This relationship became stronger for college students with lower levels of perceived social support. CONCLUSION: The results of this study can contribute to a better understanding of how perceived stress increases the risk of problematic smartphone usage. The importance of reducing online social support and enhancing perceived social support in preventing undergraduates' problematic smartphone usage is highlighted. The findings should be taken with caution given the convenience sampling and cross-sectional study design.

A longitudinal study of changes in smart phone addiction and depressive symptoms and potential risk factors among Chinese college students.

BACKGROUND: The current study aims to track the changes in the levels of smart phone addiction (SPA) and depressive symptoms between pre and during COVID-19 and potential risk factors of among Chinese college students in a four-wave longitudinal study. METHODS: The participants were recruited from a Chinese university (n = 195; 58.5% females). The first three-wave surveys were conducted before COVID-19 (during December of Year 1, June of Year 1, and December of Year 2 of their college study; Time 1, Time 2, Time 3), while the fourth survey (Time 4; during June of Year 2 of their college study) was conducted in June 2020 during COVID-19. COVID-19-related factors, including quarantine, lockdown, boredom, emotional loneliness, and social loneliness, were investigated. RESULTS: The results showed a significant increase in the levels of depressive symptoms and prevalence of probable depression during COVID-19 (69.2%) compared to those 18 months, 12 months and 6 months before COVID-19 (41.5, 45.6, 48.2%) but non-significant changes in SPA. Boredom and emotional loneliness were positively associated with both SPA and depressive symptoms during COVID-19. Social loneliness was also positively associated with depressive symptoms during COVID-19. Quarantine and lockdown were not significantly associated with SPA or depressive symptoms. DISCUSSION AND CONCLUSIONS: The results highlight that the study population may be a high risk group of probable depression. Future studies should continue to track these mental and behavioral status with the progression of the epidemic. The identified emotional factors could be used to reduce depressive symptoms during COVID-19 and prevent the potential risk of SPA.

Prospective relationships between mobile phone dependence and mental health status among Chinese undergraduate students with college adjustment as a mediator.

BACKGROUND: This 3-year longitudinal study investigated the prospective relationships between mobile phone dependence and mental health status (i.e., subjective well-being, anxiety and depression) and the mediating role of college adjustment among Chinese undergraduate students. METHODS: The study recruited 265 first-year undergraduate students from a university (mean age = 18.95 years, SD = 0.72) in Wenzhou, China. A baseline survey and two follow-up surveys were conducted between November 2013 and December 2015 (the response rate was 76.4%). The validated Mobile Phone Addiction Tendency Scale (MPATS), Chinese College Student Adjustment Scale (CCSAS), Index of Well-being, Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS) were used for assessments. RESULTS: The prevalence of anxiety and depression at Year 3 was 7.5% and 9.4%, respectively. Correlation analyses showed that mobile phone dependence at Year 1, college adjustment at Year 2, and mental health status at Year 3 were significantly correlated with each other. Structural equation modeling analyses showed that mobile phone dependence at Year 1 significantly predicted poor mental health status at Year 3. College adjustment at Year 2 significantly mediated the effect of mobile phone dependence at Year 1 on mental health status at Year 3. CONCLUSIONS: Interventions both on reduction of mobile phone dependency and improvement of college adjustment (especially among those with mobile phone dependence) are possible and needed among new college students to prevent their future depression and anxiety. Such interventions should be incorporated into regular education programs in universities.