Intolerance of uncertainty and COVID-19-related post-traumatic stress disorder symptoms in US and Korean college students: serial mediation by COVID-19 concerns and loneliness
Abstract Background This cross-national study aims to identify risk factors and mechanisms for developing COVID-19-related post-traumatic stress disorder (PTSD) symptoms in college students from the US and Korea. Given the prevalence of traumatic stress reactions during the pandemic, PTSD symptoms s...
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| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-07-01
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| Series: | BMC Psychology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40359-025-03027-x |
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| Summary: | Abstract Background This cross-national study aims to identify risk factors and mechanisms for developing COVID-19-related post-traumatic stress disorder (PTSD) symptoms in college students from the US and Korea. Given the prevalence of traumatic stress reactions during the pandemic, PTSD symptoms serve as an important indicator of psychological maladjustment. College students, identified as a vulnerable population, are the focus of this research. To address the lack of cross-national studies on PTSD symptoms and related psychological factors, we recruited participants from the US and Korea—two countries with distinct cultural orientations (e.g., individualism vs. collectivism) and pandemic contexts. This sampling approach allowed us to test whether the same psychological pathways would be observed across culturally different contexts. Specifically, the study examines intolerance of uncertainty as a risk factor and investigates the mediating effects of COVID-19 concerns and loneliness on the relationship between intolerance of uncertainty and COVID-19-related PTSD symptoms. Methods The study included 448 college students from the US and 674 college students from Korea, aged 18 to 29, who completed an online survey measuring intolerance of uncertainty, COVID-19 concerns, loneliness, and COVID-19-related PTSD symptoms. Data were collected from September 2020 to May 2021 in the US and in August 2021 in Korea. Mediation analyses were used to assess the indirect effects of intolerance of uncertainty on COVID-19-related PTSD symptoms through COVID-19 concerns and loneliness. We assessed the significance of indirect effects using bootstrap analyses with 5,000 resamples and 95% confidence intervals. Furthermore, we compared the differences in indirect effects between US and Korean students in each mediation model using a likelihood ratio test. Results Preliminary analyses showed that US college students reported significantly higher levels of PTSD symptoms, loneliness, whereas Korean students reported greater COVID-19 concerns. Simple mediation analyses showed that COVID-19 concerns and loneliness were significant mediators in the relationship between intolerance of uncertainty and COVID-19-related PTSD symptoms in both samples. Additionally, COVID-19 concerns and loneliness had significant serial mediating effects on the relationship between intolerance of uncertainty and COVID-19-related PTSD symptoms in both samples. Lastly, the indirect effect of intolerance of uncertainty on COVID-19-related PTSD symptoms mediated by COVID-19 concerns was significantly higher among college students in the US. Conclusions This study provides comprehensive insights into the mechanisms underlying COVID-19-related PTSD symptoms in college students from the US and Korea, emphasizing the roles of intolerance of uncertainty, COVID-19 concerns, and loneliness, which have implications for designing effective interventions and support strategies during the pandemic. |
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| ISSN: | 2050-7283 |