The differences in symptom networks of depression, anxiety, and sleep in college students with different stress levels

Abstract Background Stress is closely related to depression, anxiety, and sleep problems. However, few studies have explored the complex symptom-level relationships among these variables at different stress levels among college students. Methods From March to April 2024, a survey was conducted using...

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Main Authors: Wei Li, Shuhui Huo, Fei Yin, Zhengyu Wu, Xueqi Zhang, Zhengjun Wang, Jianqin Cao
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-024-21161-w
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author Wei Li
Shuhui Huo
Fei Yin
Zhengyu Wu
Xueqi Zhang
Zhengjun Wang
Jianqin Cao
author_facet Wei Li
Shuhui Huo
Fei Yin
Zhengyu Wu
Xueqi Zhang
Zhengjun Wang
Jianqin Cao
author_sort Wei Li
collection DOAJ
description Abstract Background Stress is closely related to depression, anxiety, and sleep problems. However, few studies have explored the complex symptom-level relationships among these variables at different stress levels among college students. Methods From March to April 2024, a survey was conducted using a convenience sampling method in three universities in Daqing City, Heilongjiang Province. A total of 7,845 participants (2,447 males and 5,398 females) were assessed using the Psychological Stress Tolerance Index (PSTR), the General Health Questionnaire-20 (GHQ-20), and the Self-Rating Scale of Sleep (SRSS). Based on the GHQ-20 scores, college students were categorized into low, medium, and high-stress levels. Non-parametric tests and Post-hoc tests were conducted to explore the impact of stress levels on depression, anxiety, and sleep. Network analysis methods were used to reveal the differences in the symptom networks of depression, anxiety, and sleep among college students at different stress levels. Results Non-parametric test results indicate significant differences in depression, anxiety, and sleep scores among high, medium, and low-stress groups. Post-hoc tests reveal that the high-stress group scores significantly higher in depression, anxiety, and sleep than the medium and low-stress groups. The medium-stress group scored significantly higher than the low-stress group. Network analysis shows that the core symptoms in the low-stress group are “Difficulty falling asleep”, “Anxious and restless”, and “Taking sleeping pills”, with bridging symptoms including “Hopeless future”, “Feeling useless”, “Life is a battlefield”, and “Anxious and restless”. For the medium-stress group, the core symptoms are “Difficulty falling asleep”, “Easily awakened after sleeping”, and “Life is hopeless”, with bridging symptoms including “Feeling useless”, “Life is a battlefield”, “Anxious and restless”, and “Taking sleeping pills”. In the high-stress group, the core symptoms are “Difficulty falling asleep”, “Feeling useless”, and “Anxious and resless”, with bridging symptoms including “Feeling useless”, “Life is a battlefield”, “Anxious and restless”, and “Stress hinders tasks”. Conclusion Stress exacerbates depression, anxiety, and sleep problems among college students, with differences in core symptoms and bridging symptoms of depression, anxiety, and sleep disturbances at varying levels of stress. Therefore, precise interventions can be implemented based on the core and bridge symptoms of the three networks, further improving university students’ physical and mental health.
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spelling doaj-art-96be9fc72a254a2a984482fc4211bd912025-01-05T12:49:05ZengBMCBMC Public Health1471-24582024-12-0124111310.1186/s12889-024-21161-wThe differences in symptom networks of depression, anxiety, and sleep in college students with different stress levelsWei Li0Shuhui Huo1Fei Yin2Zhengyu Wu3Xueqi Zhang4Zhengjun Wang5Jianqin Cao6School of Nursing, Harbin Medical University (Daqing)School of Nursing, Harbin Medical University (Daqing)School of Nursing, Harbin Medical University (Daqing)School of Nursing, Harbin Medical University (Daqing)School of Nursing, Harbin Medical University (Daqing)School of Nursing, Harbin Medical University (Daqing)School of Nursing, Harbin Medical University (Daqing)Abstract Background Stress is closely related to depression, anxiety, and sleep problems. However, few studies have explored the complex symptom-level relationships among these variables at different stress levels among college students. Methods From March to April 2024, a survey was conducted using a convenience sampling method in three universities in Daqing City, Heilongjiang Province. A total of 7,845 participants (2,447 males and 5,398 females) were assessed using the Psychological Stress Tolerance Index (PSTR), the General Health Questionnaire-20 (GHQ-20), and the Self-Rating Scale of Sleep (SRSS). Based on the GHQ-20 scores, college students were categorized into low, medium, and high-stress levels. Non-parametric tests and Post-hoc tests were conducted to explore the impact of stress levels on depression, anxiety, and sleep. Network analysis methods were used to reveal the differences in the symptom networks of depression, anxiety, and sleep among college students at different stress levels. Results Non-parametric test results indicate significant differences in depression, anxiety, and sleep scores among high, medium, and low-stress groups. Post-hoc tests reveal that the high-stress group scores significantly higher in depression, anxiety, and sleep than the medium and low-stress groups. The medium-stress group scored significantly higher than the low-stress group. Network analysis shows that the core symptoms in the low-stress group are “Difficulty falling asleep”, “Anxious and restless”, and “Taking sleeping pills”, with bridging symptoms including “Hopeless future”, “Feeling useless”, “Life is a battlefield”, and “Anxious and restless”. For the medium-stress group, the core symptoms are “Difficulty falling asleep”, “Easily awakened after sleeping”, and “Life is hopeless”, with bridging symptoms including “Feeling useless”, “Life is a battlefield”, “Anxious and restless”, and “Taking sleeping pills”. In the high-stress group, the core symptoms are “Difficulty falling asleep”, “Feeling useless”, and “Anxious and resless”, with bridging symptoms including “Feeling useless”, “Life is a battlefield”, “Anxious and restless”, and “Stress hinders tasks”. Conclusion Stress exacerbates depression, anxiety, and sleep problems among college students, with differences in core symptoms and bridging symptoms of depression, anxiety, and sleep disturbances at varying levels of stress. Therefore, precise interventions can be implemented based on the core and bridge symptoms of the three networks, further improving university students’ physical and mental health.https://doi.org/10.1186/s12889-024-21161-wCollege studentStressDepressionAnxietySleepNetwork analysis
spellingShingle Wei Li
Shuhui Huo
Fei Yin
Zhengyu Wu
Xueqi Zhang
Zhengjun Wang
Jianqin Cao
The differences in symptom networks of depression, anxiety, and sleep in college students with different stress levels
BMC Public Health
College student
Stress
Depression
Anxiety
Sleep
Network analysis
title The differences in symptom networks of depression, anxiety, and sleep in college students with different stress levels
title_full The differences in symptom networks of depression, anxiety, and sleep in college students with different stress levels
title_fullStr The differences in symptom networks of depression, anxiety, and sleep in college students with different stress levels
title_full_unstemmed The differences in symptom networks of depression, anxiety, and sleep in college students with different stress levels
title_short The differences in symptom networks of depression, anxiety, and sleep in college students with different stress levels
title_sort differences in symptom networks of depression anxiety and sleep in college students with different stress levels
topic College student
Stress
Depression
Anxiety
Sleep
Network analysis
url https://doi.org/10.1186/s12889-024-21161-w
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