thesis about anxiety of students

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The impact of COVID-19 on students’ anxiety and its clarification: a systematic review

1 Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia

2 School of Physical Health, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China

3 School of Sports Science, Nantong University, Nantong, Jiangsu, China

4 Dafang County No. 7 Middle School, Bijie, Guizhou, China

Mohamad Najmi Masri

5 Faculty of Bioengineering and Technology, Universiti Malaysia Kelantan, Kota Bharu, Kelantan, Malaysia

Abdulwali Sabo

6 Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia

Yee Cheng Kueh

Associated data.

The datasets presented in this study can be found in online repositories. The names of the repository/repositories and accession number(s) can be found in the article/supplementary material.

Introduction

Since the emergence of COVID-19 in 2019, every country in the world has been affected to varying degrees. Long-term psychological pressure and anxiety will inevitably damage the physical and mental health of students. This study aimed to examine the effects of the COVID-19 pandemic on students who experienced stress and anxiety and to clarify which intervention was more effective.

A comprehensive literature search was conducted between January 2020 and December 2022 using online databases such as PubMed, Web of Science, Scopus, and Google Scholar by using the following keywords in combination: “COVID-19,” “stress,” “anxiety,” “depression,” and “intervention.” The retrieved literature was screened and reviewed.

A total of 2,924 articles were retrieved using subject and keyword searches. After screening through the titles and abstracts, 18 related studies were retained. Their review revealed that: (1) most studies did not use medication to control stress and anxiety; (2) the standard methods used to reduce stress and anxiety were religion, psychological counseling, learning more about COVID-19 through the media, online mindfulness courses, improving sleep quality, and physical exercise; (3) the most effective interventions were physical activity and raising awareness about COVID-19 through the media and online mindfulness programs. However, some studies show that physical activity cannot directly relieve psychological stress and anxiety.

Limited interventions are effective, but learning more about COVID-19 and using active coping strategies may help reduce stress and anxiety. The implications of COVID-19 are also discussed.

Since the COVID-19 outbreak in December 2019, the virus has maintained exceptionally high transmission rates, and countries around the world have been greatly affected. According to the World Health Organization’s (WHO) COVID-19 Dashboard (2022), the cumulative number of confirmed cases worldwide exceeded 600 million as of September of that same year. Due to the continuous mutation of COVID-19, the number of confirmed and suspected cases remains high, and people are forced to live with the virus for a long time, which creates a lot of psychological anxiety and stress and seriously affects the normal lives of people around the world ( Peteet, 2020 ).

Although the severity of COVID-19 has decreased over time and the current level of prevention and control of the epidemic in the world has also decreased, COVID-19 has not been eliminated and still poses a threat to humanity ( World Health Organization, 2023a , b ). As noted in the WHO’s most recent official COVID-19 policy brief, the pandemic appears to be in transition after more than 3 years. However, the COVID-19 pandemic remains an acute global emergency, with the risk of the emergence of new variants and future surges remaining real ( World Health Organization, 2023a , b ).

According to data released by the WHO COVID-19 Dashboard of 2023, as of 7 June, there had been 6,941,095 deaths and 767,750,853 confirmed cases of COVID-19 worldwide. Furthermore, according to the WHO Coronavirus (COVID-19) Dashboard, the COVID-19 outbreak has shown unpredictable volatility in terms of weekly changes in the number of confirmed cases worldwide every week since the outbreak began, with the most recent large-scale outbreak appearing in December 2022. In just 4 weeks, the outbreak increased the number of cases worldwide by 97,976,070 ( World Health Organization, 2022a , b ).

It is clear from these findings that COVID-19 remains a threat to humans. To deal with the possibility of a recurrence of the virus pandemic in the future, we need to understand the various effects of COVID-19 on people’s psychological states and develop effective responses.

Many psychological effects have been examined during the virus outbreak at the personal, national, and even international levels ( Fawaz et al., 2023 ). On a personal level, people are more likely to experience fear of getting sick or dying, feeling helpless, and being stereotyped by others ( Salari et al., 2020 ). Mental health can contribute to serious psychological crises. In fact, COVID-19 affected the mental health of medical workers and also the general population ( Chakraborty and Chatterjee, 2020 ; Khatatbeh et al., 2021 ; Chen et al., 2022 ). For healthcare workers, the sudden increase in workload has led to a surge in work stress ( Tabur et al., 2022 ), and the risk of infection at any time has had a negative impact on their psychology ( Wu et al., 2020 ). Witnessing the suffering and death of patients can also have a profound impact on their mental health ( Mosheva et al., 2021 ). In addition, the uncertainty and rapid change of the COVID-19 pandemic mean that they must constantly adapt to new job requirements, changing work processes, and protective measures, and the stress caused by this uncertainty may also increase their anxiety levels ( Deliktas Demirci et al., 2021 ). For the general population, COVID-19 may increase health anxiety and panic, and concern over the risk of infection may cause people to over-interpret common physiological responses ( Marra et al., 2020 ). Reduced human interaction due to fear of infection can also lead to depression and anxiety ( Haider et al., 2020 ). In addition, financial stress and work stress also contribute to a decline in mental health ( Halliburton et al., 2021 ). The WHO has also reported that the COVID-19 pandemic triggered a 25% increase in the prevalence of anxiety and depression worldwide ( World Health Organization, 2022a , b ).

University students face certain peculiarities compared to working adults. They will show emotional instability under pressure. Their psychological characteristics differ from those of the general public or even ordinary young people, and they are high-risk groups for psychological problems ( Kontoangelos et al., 2020 ; Fusar-Poli et al., 2021 ). Under the influence of an external environment, psychological problems such as anxiety, depression, and post-traumatic stress disorder (PTSD) are more likely to occur ( Bruffaerts et al., 2018 ). They face greater academic pressures and challenges, and their worries about academic performance and work prospects are more intense ( Son et al., 2020 ). Compared with adults, they are more susceptible to the adverse effects of distance learning due to their lack of experience in time management ( Singh et al., 2020 ). Most of the students social and interpersonal relationships exist on campus, and COVID-19 isolation has cut off most of their social ties, increased their loneliness, and led to a decline in mental health. This will last for a period of time and will not disappear quickly with the end of the epidemic ( Garris and Fleck, 2022 ). In addition, in terms of independence and social identity, COVID-19 can also have a negative impact on independence and social identity and last for a long time ( Sharaievska et al., 2022 ).

How to deal with the psychological problems faced by university students due to the COVID-19 epidemic has become a crucial research topic at this stage ( González-Sanguino et al., 2020 ). The purpose of this article is to review articles on the different interventions applied to reduce the psychological impact of COVID-19 and to discuss solutions among students. First of all, such research has a long-term and global impact. A large number of studies have confirmed that COVID-19 has broad psychological effects on university students worldwide. Understanding the long-term impact of COVID-19 on the mental health of university students and adaptation strategies can provide experience and lessons for similar emergencies in the future ( De Girolamo et al., 2020 ). Second, by evaluating the effectiveness of different mental health intervention strategies, we can determine which interventions have a positive impact on alleviating mental distress and improving the mental health of university students, which can help guide mental health professionals and policymakers in choosing appropriate intervention strategies to better support their mental health. In addition, by focusing on the mental health of college students, it is helpful to increase public awareness and attention to the mental health of college students and promote overall societal attention to mental health ( Hunt and Eisenberg, 2010 ). There are three problems to be solved in this study: (a) To summarize the effects of COVID-19 on the psychological status of students; (b) To compare the impact of different interventions; (c) To discuss the findings and recommendations for future research in this area.

Methodology

Search strategy.

A literature search was conducted using major computerized databases (e.g., PubMed, Web of Science, Scopus, and Google Scholar) and library holdings for English-language peer-reviewed articles and was reviewed by two additional co-authors. When searching the database, the selected studies were those published from the beginning of January 2020 to December 2022 (because the outbreak of COVID-19 began in December 2019, this study only looked at studies over a three-year period, from January 2020 to December 2022, when searching the databases). The keywords used in this review were “COVID-19,” “anxiety,” “stress,” “student,” and “intervention.” A manual search of the reference lists of relevant studies found in the computerized search was also performed.

Inclusion and exclusion criteria

The inclusion of articles followed a three-phase approach ( Figure 1 ) using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines ( Moher et al., 2015 ). In the first phase, a total of 3,101 records were initially obtained through an extensive database search. A total of 178 duplicates were identified and removed in this phase. In the second phase, the titles of 2,923 records were screened, and the following records were removed: (a) those that did not refer to the terms “COVID-19” or “anxiety” or “stress” or “student”; (b) all types of literature reviews and guidelines; and (c) those that were not written in English. This process resulted in the removal of 2,496 records. In the third phase, the abstracts or full texts of the remaining 427 records were examined. Records that met the inclusion criteria were studies with an interventional design. Only 18 studies met the inclusion criteria, and the authors and co-authors assessed the quality of these 18 studies and found them to be of good quality for a systematic review and were therefore included in this review.

Flow diagram from identification to inclusion of studies.

Categorization of studies

The impact of covid-19 on the psychological status of students, research on the psychological status of medical college students.

Early in the COVID-19 outbreak, the Association of American Medical Colleges recommended pausing all student clinical rotations while the in-person curriculum moved to virtual modalities. Medical students also reported higher levels of anxiety, stress, and exhaustion, with female students experiencing this more than male students ( Mittal et al., 2021 ). At the College of Medicine of King Saud University, Riyad, Saudi Arabia, a total of 234 medical students found that quarantine caused them to feel emotionally detached from family, colleagues, and friends and reduced their overall work performance and study time. The findings also showed that a quarter of the medical students who participated in the study felt disheartened during the quarantine period ( Meo et al., 2020 ). In a study of 217 undergraduate medical students at a medical college in Chennai, India, there was a significant increase in both the prevalence and level of anxiety and stress ( Saraswathi et al., 2020 ). In an Indonesian study of 1,027 medical students, 44.6% were found to be stressed, 47.8% had anxiety, and 18.6% had depression ( Natalia and Syakurah, 2021 ).

Research on the mental state of the general student population

The psychological state of the general student population has also been a focus of researchers during the COVID-19 pandemic. A study of Bangladesh university students aged 18 to 29 years (59.5% men; mean age 21.4 ± 2 years) revealed that the estimated prevalence of depression, anxiety, and stress was 76.1, 71.5, and 70.1% for at least mild symptoms, 62.9, 63.6, and 58.6% for at least moderate symptoms, 35.2, 40.3, and 37.7% for at least severe symptoms, and 19.7, 27.5, and 16.5% for at least very severe symptoms, respectively. These data are significantly higher than before the COVID-19 pandemic ( Islam et al., 2020 ). In a cross-sectional survey of different populations in Jordan, anxiety was highest among college students during the COVID-19 pandemic, at 21.5%, and college students were found to be at higher risk for depression ( Naser et al., 2020 ). In another study of 69,054 high school students in France, the prevalence of suicidal thoughts, severe distress, high levels of perceived stress, severe depression, and high levels of anxiety were 11.4% (7,891 students), 22.4% (15,463 students), 24.7% (17,093 students), 16.1% (11,133 students), and 27.5% (18,970 students), respectively ( Wathelet et al., 2020 ). Similarly, a study of 1,224 high school students in Brazil reported that the majority of undergraduates presented with symptoms of depression (60.5%), anxiety (52.5%), and stress (57.5%). These data indicated a high prevalence of symptoms of depression, anxiety, and stress in students ( Lopes and Nihei, 2021 ). In summary, numerous studies have reported on the mental health of students during the COVID-19 pandemic, and the results show that the pandemic has caused varying degrees of mental health problems among students, indicating that the presence of COVID-19 has indeed increased psychological stress and anxiety among the student population around the world.

The effects of the different interventions

Since the outbreak of COVID-19, some research studies have tried various ways to reduce people’s stress and anxiety. By collating the existing literature, the primary approaches for reducing stress and anxiety include religious practice, psychological counseling, learning more about COVID-19 through the media, mindfulness online programs, increasing the quality of sleep, and physical activity. Some of the most effective interventions include watching brief Dialectical Behavior Therapy (DBT) skill videos, regular web-based physical education to increase students’ understanding of COVID-19 through social media, and about 2,500 METs of physical activity per week ( Deng et al., 2020 ; Zhang et al., 2020 ; Kheirallah et al., 2021 ; Rizvi et al., 2022 ). Although the effect of some intervention methods is not significant, they play a role as effective mediating factors. These methods include: middle- and long-distance running, boosting satisfaction with distance learning, strengthening psychological resilience, enhancing social support, improving sleep quality, reducing incorrect smartphone use, and catalyzing academic satisfaction ( Franzen et al., 2021 ; Li and Peng, 2021 ; Lin et al., 2021 ; Liu et al., 2021 ; Gabrovec et al., 2022 ; Song et al., 2022 ). The intervention had positive results, and effective alternatives to conventional psychotherapy included behavioral therapy and online mindfulness programs ( Liang et al., 2021 ; Simonsson et al., 2021 ). Some studies have suggested that positive approach coping strategies for COVID-19 are better than negative avoidance coping strategies in improving stress and anxiety ( Banstola et al., 2021 ; Chan et al., 2022 ). A review of the literature identified 18 articles related to COVID-19, anxiety, stress, and the effects of different interventions (all studies are summarized in Table 1 ).

Literature on different interventions evaluated in this study.

Of the 18 articles included, four showed significant effects on students’ stress and anxiety after the intervention ( Deng et al., 2020 ; Zhang et al., 2020 ; Kheirallah et al., 2021 ; Rizvi et al., 2022 ). In a randomized clinical trial, 153 undergraduate students from a large public university in the United States completed three phases of pre-assessment, intervention, and post-assessment over six weeks during the COVID-19 pandemic. During the intervention, participants were randomized to receive animated videos of DBT skills for 14 consecutive days. All participants received ecological momentary assessments of mood, emotion management self-efficacy, and emotional tolerance four times a day. The study found that negative emotions significantly decreased and positive emotions significantly increased before and after watching the videos. There was a significant interaction between time and conditions in the development of emotional tolerance. Compared to the first two weeks, participants in the control group rated their emotions as more intolerable in the third and fourth weeks, whereas participants in the intervention group did not rate their emotions as more intolerable ( Rizvi et al., 2022 ). This proved that DBT techniques can help college students avoid a decline in mental health and that this simple, highly scalable intervention could expand the scope of available mental health treatment.

In a Chinese study, 1,607 college students in Wuhan were asked about their mental health, exercise-related lifestyle, and other issues. The Depression, Anxiety, and Stress Scale (DASS-21) was used to evaluate their mental health. The results showed that lower DASS-21 scores were significantly associated with regular exercise, maintaining exercise habits during the COVID-19 pandemic, exercising more than 1–2 times per week, exercising for ≥1 h, and taking ≥2,000 steps ( Deng et al., 2020 ). This proved that mental status is significantly related to regular exercise and adequate exercise time. In a similar article, a longitudinal survey of 66 college students during the peak of the COVID-19 epidemic in China showed that COVID-19 had a direct negative impact on general sleep quality. In contrast, COVID-19 mediated general negative emotions, stress, anxiety, and sleep quality. In addition, physical activity directly alleviated general negative emotions, with the greatest effect when physical activity was approximately 2,500 METs per week ( Zhang et al., 2020 ).

In a study of all medical students in Jordan, participants self-reported increased levels of negative emotions, such as anxiety, and decreased levels of positive emotions. Nearly half of the participants reported that social media was the primary source of COVID-19 information, with a significant reduction in emotional distress after long-term use of social media for COVID-19 information ( Kheirallah et al., 2021 ). This was evidence that social media has a potentially positive effect on mitigating negative emotions.

Of the 18 included studies, three suggested that improving sleep quality could indirectly improve stress and anxiety in students during COVID-19 ( Zhang et al., 2020 ; Liu et al., 2021 ; Song et al., 2022 ). In a study examining the relationship between perceived stress and depression in medical students during the COVID-19 pandemic and the mediating role of insomnia in this relationship, researchers used the Perceived Stress Scale (PSS), Insomnia Severity Index (ISI), and Patient Health Questionnaire 9 (PHQ-9) to measure perceived stress, insomnia, and depression levels. Results showed that perceived stress was significantly associated with depression. Insomnia mediated the relationship between perceived stress and depression. The indirect effect of insomnia on perceived stress was significant ( Liu et al., 2021 ). This demonstrates that depression in medical students can be effectively reduced by improving sleep quality and relieving perceived stress. In a similar study of 666 medical students in China, anxiety was significantly associated with problematic smartphone use and sleep disturbances during the COVID-19 pandemic. Problematic smartphone use not only directly affected anxiety but also had a significant indirect effect on anxiety through sleep disturbance. Using sleep disturbance as a mediator, a significant reduction in the path coefficient of problematic smartphone use on anxiety was observed. The importance of promoting sleep health to reduce anxiety should be emphasized ( Song et al., 2022 ).

HP Lovecraft, in “Supernatural Horror in Literature” (1927), H.P. Lovecraft wrote: “The oldest and strongest emotion of mankind is fear, and the oldest and strongest kind of fear is fear of the unknown” ( Joshi and Schultz, 2001 ; p. 255). Therefore, among the 18 included studies, five were of the opinion that we should actively face COVID-19 and that increasing its understanding through various means would help reduce students’ stress and anxiety ( Banstola et al., 2021 ; Kheirallah et al., 2021 ; Simegn et al., 2021 ; Yildirim et al., 2021 ; Chan et al., 2022 ).

The study of 202 medical students in Hong Kong about their mental health status, stress coping strategies, and their relationship proved that respondents who adopted an approach strategy had higher Ryff scores than those with avoidant coping strategies, suggesting that approach strategies are more effective in stress management than the more dysfunctional avoidant strategies ( Chan et al., 2022 ). Similarly, Banstola et al. (2021) suggested that adopting adaptive coping strategies helps reduce pandemic-related mental health problems. Kheirallah et al. (2021) suggested that students’ use of social media to increase access to COVID-19 information had a significant effect on reducing emotional distress. Simegn et al. (2021) found that the mental health situation can be improved by the provision of adequate and accurate information and by increasing the self-efficacy of students. Yildirim et al. (2021) indicated that this would be an effective method to provide training to nursing students, to change their negative attitudes, increase their awareness of COVID-19-related death anxiety, improve their coping skills for dealing with death anxiety, and reduce the burden of anxiety. Table 2 provides a summary of the studies included in this review. Across all works, data were derived from assessments of 44,014 participants. Of these, 14,790 were men (33.60%), 26,547 were women (60.32%), and 2,677 were undetermined (6.08%). The number of participants ranged from 40 to 29,663. The studies included 32,973 medical students and 11,041 non-medical students.

Summary of this systematic review.

The research included in this review covers three years (01/2020–12/2022). The participants in these studies were college students. According to the country distribution of the participants, Asia (11), the Americas (2), Europe (4), Australia (0), and Africa (1). From the perspective of the interventions used, the most common effective interventions were sustained physical exercise at a certain intensity for a period of time, maintaining good sleep quality, improving understanding of COVID-19 through multimedia, and facing COVID-19 with more positive attitudes and behaviors. In addition, regular watching of DBT skill videos may help college students avoid mental health issues.

The COVID-19 pandemic has resulted in substantial global mental health challenges, such as increased levels of anxiety and depression symptoms ( Brooks et al., 2020 ; Holmes et al., 2020 ), along with significant variation in anxiety and depression symptoms among residents of different countries ( Ding et al., 2021a , b ). In this review, 18 studies on anxiety and stress levels among students during the COVID-19 pandemic were identified, while also listing the effects of different interventions. The 11 studies that did not explicitly report anxiety among participants all reported higher rates of anxiety among participants; in the seven studies where anxiety was explicitly reported, the average anxiety rate was 77.99%. Hence, this shows the high level of anxiety among students due to COVID-19.

Studies have shown that students’ anxiety about COVID-19 stems not only from concerns about their health but also from the health of those around them ( Al-Kumaim et al., 2021 ). In addition, academic pressure and employment prospects during this period are also major causes of anxiety for students ( Sundarasen et al., 2020 ). In particular, female, rural, low-income, and academically underperforming students are more likely to suffer from psychological distress ( Lee et al., 2021 ). These key findings are of great concern given that mental health is strongly linked to student well-being, academic performance, and employment rates. During the pandemic, student mental health is in crisis and necessitates increased attention and intervention.

The primary focus of this study was to identify more effective interventions. Four of the 18 included studies reported significant reductions in student stress and anxiety. The selected interventions included: (1) Watching DBT skill videos. The results of this study showed that the simple animated DBT skill videos were easily accepted by most of the participants; the intervention showed promising results in reducing negative emotions at the time and preventing students from experiencing increased distress (i.e., finding their emotions more unbearable) as the semester progressed. This intervention is also very easy to implement ( Rizvi et al., 2022 ). (2) 2,500 METs of physical activity per week. The results of this study showed that the persistence of COVID-19 may reduce people’s sleep quality, thereby significantly increasing their negative emotions; maintaining regular exercise can help alleviate this state of mind, and engaging in physical activity (PA) of 2,500 METs per week is the most effective optimal load ( Zhang et al., 2020 ). (3) Extending the use of social media to gain a better understanding of COVID-19 has been shown to reduce students’ fear of COVID-19 and improve their negative mental state ( Deng et al., 2020 ; Kheirallah et al., 2021 ).

Three of the 18 selected studies showed that due to the persistence of COVID-19, students have experienced sleep disturbance or insomnia, and the continuation of this phenomenon will lead to stress and anxiety. Improving sleep quality can indirectly help with these symptoms ( Zhang et al., 2020 ; Liu et al., 2021 ; Song et al., 2022 ). In addition, increasing physical activity is not only beneficial in improving stress and anxiety caused by COVID-19, but it also happens to be an effective way to improve sleep quality ( Piercy et al., 2018 Zhang et al., 2020 ). There is now a consensus that appropriately heightened physical activity can help relieve stress and anxiety, promote blood circulation, relax muscles, and improve sleep quality; multi-component exercise has a significant effect on improving people’s sleep quality and physical fitness ( Yang, 2019 Ai et al., 2022 ).

By synthesizing the results of previous studies, we have drawn a comprehensive summary that includes effective intervention methods and combined these with the current situation. Therefore, we have been able to clearly identify the most effective intervention measures. At this stage, COVID-19 is no longer an unfamiliar disease. As a result, simply getting more information about COVID-19 through social media no longer seems to be an effective way to reduce the resulting stress and anxiety. Although watching DBT skill videos is considered an effective intervention, due to the relatively small number of similar studies, it is not yet possible to provide sufficiently strong evidence. After a comprehensive comparison, it can be found that appropriate physical activity can not only directly reduce the stress and anxiety caused by COVID-19 but can also indirectly relieve these by improving sleep quality. Therefore, this can be regarded as the most effective means of intervention at this stage. Proper physical exercise can also help improve our body’s immune system, increase the speed of antibody production, and improve the ability to resist viral attacks ( Atzrodt et al., 2020 ). Therefore, more research in the future can address the need to improve sleep quality through physical activity to alleviate the perceived stress caused by COVID-19 and effectively reduce students’ anxiety.

The main focus of this paper is to examine the effects of various intervention methods applied during the COVID-19 pandemic. However, there are still some limitations. Firstly, many of the included studies in the literature were cross-sectional studies, meaning that a temporal causal relationship between mental health and stress-coping strategies could not be established. The reason for this is that, although there is a large amount of research on psychological problems caused by COVID-19 at this stage, fewer articles can be retrieved with the inclusion of the keywords “student” and “intervention.” Therefore, future research should focus more on the impact of COVID-19 on students’ mental states and potential solutions. Second, all included studies used self-report methods to assess anxiety and depression scores, and mental health counselors were not asked to evaluate the psychological status of the participants as a form of third-party verification. Although this method simplifies the difficulty of obtaining data on the mental state of subjects, it is highly subjective and may be affected by social desirability bias. However, since all papers considered found a higher rate of anxiety in the study groups, the results are generally reliable. In addition, the participants included in the literature are all college students, so it is impossible to conclude whether the interventions applicable to college students are also applicable to students in other age groups. Similarly, the research subjects included in the literature are mostly medical students. Since these students have medical knowledge and skills, in addition to certain characteristics, it is impossible to conclude whether the interventions applicable to medical students are also applicable to non-medical students.

This study provides a comprehensive look at solutions to student anxiety during COVID-19. By comparing different interventions, we found that appropriate physical activity has unique benefits that not only directly reduce the stress and anxiety caused by COVID-19 but also further alleviate these feelings by improving sleep quality. Currently, the persistence and impact of COVID-19 on daily life present students with unprecedented psychological challenges. Appropriate physical activity, as a comprehensive intervention that provides both a physical and mental health response, was found to be the most effective intervention for students. Of course, we must also acknowledge the limitations of this study and recognize that physical activity, while effective, is not the only solution. A combination of other interventions is also critical when dealing with the stress and anxiety of COVID-19. Therefore, in the future response to the epidemic, we should continue to explore, research, and promote the combination of more targeted physical activities and other interventions to better help students cope with the challenges they may face during COVID-19.

Data availability statement

Author contributions.

JW, GK, HL, and YK conceptualized and designed the original study, from which the data for the analyses presented here were obtained. JW, GK, and YK completed data collection, data analysis, and initial writing. JW, GK, HL, XH, MM, AS, and YK participated in writing and commenting on the manuscript and drafted, edited, and approved its final version. All authors read and agreed to the published version of the manuscript.

This research was supported by the Ministry of Higher Education Malaysia for the Fundamental Research Grant Scheme (FRGS) with project code: FRGS/1/2020/SKK06/USM/03/13.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Home > Student Works > GRADUATE_WORKS > ETD > 51

Electronic Theses and Dissertations

The effect of anxiety and depression on college students’ academic performance: exploring social support as a moderator.

Katherine H. Bisson , Abilene Christian University Follow

Campus Location

Abilene Campus (Residential)

Date of Award

Spring 5-2017

Document Type

Social Work

Degree Name

Master of Science

Committee Chair or Primary Advisor

Kyeonghee Jang

Second Committee Member or Secondary Advisor

Rachel Slaymaker

Third Committee Member or Committee Reader

Shannon Kaczmarek

The purpose of this study is to explore how social support is related to the overall well-being of college students. Literature suggests social support buffers a negative effect of distress on academic performance. This study attempts to provide practical information for a program called Student Opportunities, Advocacy, and Resources (SOAR) at Abilene Christian University (ACU), which assists students and connects them to resources available to support their path to success. A multiple linear regression was conducted to examine the association between anxiety, depression, social support, and academic performance using a sample of 93 students enrolled in this program in Fall of 2016. Some findings were not congruent with the literature. Although social support had a significant moderating effect, it did not necessarily buffer the negative influence of depression on academic performance. Surprisingly, among the group who reported having low social support, depression had a positive relationship with academic performance. After eliminating an insignificant moderating effect of social support on the relationship between anxiety and academic performance, the total effect of anxiety on academic performance was not significant. The findings show gender was the strongest predictor; females performed higher than males. Past academic performance had a positive effect on current academic performance. The implication of the findings is not to disregard mental health issues; rather, it is possible that these students are more difficult to reach due to less visible symptoms and/or succeeding academically. Knowing that this population could be silently suffering makes it imperative for college campuses to implement programs such as SOAR that reaches out to students who may not seek support or show signs that they are experiencing difficulties due to various stressors during this developmental transition. Considering limitations of this study, further investigation is needed to validate these findings

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Bisson, Katherine H., "The Effect of Anxiety and Depression on College Students’ Academic Performance: Exploring Social Support as a Moderator" (2017). Digital Commons @ ACU, Electronic Theses and Dissertations. Paper 51. https://digitalcommons.acu.edu/etd/51

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Management of Stress and Anxiety Among PhD Students During Thesis Writing: A Qualitative Study

Affiliation.

• 1 Author Affiliations: Department of Medical Education, Medical Education Research Center, University of Medical Sciences, Isfahan (Drs Bazrafkan, Yousefi, and Yamani); and Applied Linguistics, Shiraz University of Medical Sciences (Dr Shokrpour), Shiraz, Iran.
• PMID: 27455365
• DOI: 10.1097/HCM.0000000000000120

Today, postgraduate students experience a variety of stresses and anxiety in different situations of academic cycle. Stress and anxiety have been defined as a syndrome shown by emotional exhaustion and reduced personal goal achievement. This article addresses the causes and different strategies of coping with this phenomena by PhD students at Iranian Universities of Medical Sciences. The study was conducted by a qualitative method using conventional content analysis approach. Through purposive sampling, 16 postgraduate medical sciences PhD students were selected on the basis of theoretical sampling. Data were gathered through semistructured interviews and field observations. Six hundred fifty-four initial codes were summarized and classified into 4 main categories and 11 subcategories on the thematic coding stage dependent on conceptual similarities and differences. The obtained codes were categorized under 4 themes including "thesis as a major source of stress," "supervisor relationship," "socioeconomic problem," and "coping with stress and anxiety." It was concluded that PhD students experience stress and anxiety from a variety of sources and apply different methods of coping in effective and ineffective ways. Purposeful supervision and guidance can reduce the cause of stress and anxiety; in addition, coping strategy must be in a thoughtful approach, as recommended in this study.

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The Effect of Anxiety and Depression on College Students’ Academic Performance: Exploring Social Support as a Moderator

The purpose of this study is to explore how social support is related to the overall well-being of college students. Literature suggests social support buffers a negative effect of distress on academic performance. This study attempts to provide practical information for a program called Student Opportunities, Advocacy, and Resources (SOAR) at Abilene Christian University (ACU), which assists students and connects them to resources available to support their path to success. A multiple linear regression was conducted to examine the association between anxiety, depression, social support, and academic performance using a sample of 93 students enrolled in this program in Fall of 2016. Some findings were not congruent with the literature. Although social support had a significant moderating effect, it did not necessarily buffer the negative influence of depression on academic performance. Surprisingly, among the group who reported having low social support, depression had a positive re...

Related Papers

samra salamat

This study was conducted to examine the relationship between social support and psychological problems i.e. depression, anxiety, and stress. 120 undergraduate university students were involved in this study. They were selected using purposive sampling technique. The Social Support Behaviour (SSB) scale was used to measure the level of social support among students and the Depression Anxiety Stress Scale (DASS) was used to measure the level of depression, anxiety, and stress among students. Correlation coefficient was used to measure the relationship between social support and psychological problems. The findings of this study revealed that there were significant negative relationship between social support and psychological problems suggesting that the higher the social support, the lower is the psychological problem. The findings of the study will be useful in assisting educators, counsellors, psychologist, and researchers to develop strategies to enhance student psychological well-being.

Prashant Talwar

Background and objectives: The omnipresence of stress and depression among university students is a cause for concern, as it can have adverse consequences on all aspects of their life. Understanding the role of social support as a protective factor within this context, may well be vital to the enhancement of overall wellbeing among students. The main aim of the present study was to examine the moderating effect of perceived social support on the relationship between stress and depression. Methods: A cross-sectional survey was conducted to garner data from 254 university students for hierarchical multiple regression and structural equation modeling analysis. Results: Firstly, the present study replicated the frequently reported positive relationship between stress and depression. Secondly, an inverse association between social support and depression was also depicted. Finally, the results also supported an interaction between perceived social support and stress in predicting depression among students. Conclusion: In sum, the results of the current study may well augment our understanding of the role of perceived social support in combating stress and depression among students, and thereby convey important implications for intervention strategies tailored to this demographic group.

Journal of paramedical sciences

Hamid Gilasi

Psychological disorders are universally common problems. Social support contributes much to the health of individuals. Focusing upon social support and upon vicissitudes of life can help prevent the depression-induced disorders. The present paper investigated the relationship between perceived social support, depression and perceived stress in university students. The descriptive-analytical study was carried out on 390 students living in Shahid Beheshti University of Medical Sceince campus, whom were selected based on a simple random selection method. The related questionnaires of multidimensional scales of perceived social support, Beck’s depression, and perceived stress then were distributed during midterm among students to collect the necessary data. Data was fed into SPSS 16 and analysed using ANOVA, Pearson correlation coefficient, independent t-test, Chisquare, and Fisher exact test. Our results indicated that 49.7 per cent of students suffered from specific degrees of depress...

The relationship between social support that students perceived from their friends and families and their depression and anxiety levels is investigated in this study. The study is conducted with 325 students (200 females 125 males aged between 18 and 21, mean age = 20.41) attending to different universities in the 2002-2003 academic year. Three scales were used in the study to measure perceived social support, depression and anxiety levels: the Social Support Perceived from the Family and Friends, adapted to the Turkish by Eskin, “the Beck Depression Scale” adapted to the Turkish by Tegin and “the State and Trait Anxiety Inventory” adapted to the Turkish by Öner. These three scales were administered simultaneously to the students participating in the study and the relations among them were calculated. As a result, there found to be a positive significant relationship between trait anxiety and depression scores (p<.01) and a negative relationship between social support perceived from the friends (p<.01) and family (p<.05) and depression scores.

Journal of College Counseling

Jonathan Mattanah

Journal of Human Sciences and Extension

Anthony J Ferraro

Guided by the Relationships Motivation Theory, this short-term longitudinal study examined associations between social support (i.e., relatedness), depression, and stress in the form of task overload among emerging adult, university students (N = 184 at time one; N = 105 at time two; 69.2% female). Results from a series of path models indicated a significant relationship between decreased perceptions of social support over time and an increase in perceived task overload with significant mediating effects through depressive symptomology. Implications for counseling services as well as intervention and awareness points for university professionals are discussed.

Psychology in The Schools

Michelle Demaray

Perceived Social Support predicts Psychological Problems among University Students

Binte Afzal

Background: psychological problems are prevailing among university students, which need the attention of university management, government, social workers, and counsellors as well. Aims

When first-year students enter university, they experience many changes and challenges that require adjustment and adaptation. Previous studies have suggested that social support is one factor related to college adjustment. However, scientific support for the relationship between these variables in Indonesia is limited. This study aimed to investigate the relationship between social support and college adjustment in the Indonesian university context. We used the adapted version of the Student Adjustment to College Questionnaire (SACQ) and the Multidimensional Scale of Perceived Social Support (MSPSS) to measure college adjustment and social support in 281 first-year students enrolled in Universitas Indonesia. The social supports measured in this study include peer support and family support. Our analysis confirmed that social support was positively correlated with college adjustment (r = 0.468, p &lt; 0.001, one-tailed). The results suggest that social networks, including family and...

Franklin Glozah

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STUDENTS’ SPEAKING ANXIETY IN AN EFL CLASSROOM

Mayangta, Tesalonika (2013) STUDENTS’ SPEAKING ANXIETY IN AN EFL CLASSROOM. S1 thesis, Universitas Pendidikan Indonesia.

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This research was designed to investigate students’ speaking anxiety in EFL classroom in a junior high school. There were 32 students of a junior high school in Bandung who participated in this research. This qualitative research investigated the levels of students’ anxiety, the sources of their speaking anxiety and their anxiety coping strategies. The data were collected using Foreign Language Classroom Anxiety Scale (designed by Horwitz et al., 1986) and an open-ended questionnaire. The research found most of the students were mildly anxious (43.8%). In addition, there were three very anxious students (9.4%), seven anxious students (21.9%) and eight relaxed students (25%). The findings show that the sources of students’ anxiety in speaking English were personal and interpersonal anxiety, learner’s beliefs about language learning, instructor-learner interactions, classroom procedures and perceived levels of English proficiency. Most of the students applied positive thinking strategy followed by preparation, relaxation and resignation strategy. The findings show that anxiety affects students’ performance in learning English, especially in speaking. Thus, it is important to pay attention and reduce it. Therefore, further research on speaking anxiety and its solutions are needed to help EFL students to learn English better. Key words: speaking, speaking anxiety

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How Uncertainty Builds Anxiety

• by Andy Fell
• June 25, 2024

Alfred Hitchcock observed that “There is no terror in the bang, only in the anticipation of it.” A common way to build suspense in a movie scene is for the audience to know something bad is going to happen, but not when it is going to happen. But how does uncertainty work to ratchet up our anxiety? In a recent paper in the journal Computational Psychiatry, researchers at the University of California, Davis, Department of Psychology take a deeper look into what builds fear.

Not knowing when something will happen can cause anxiety, but until now we didn’t have any idea why, said Drew Fox, associate professor of psychology at UC Davis. The first step in addressing this problem is being more precise about how we define “uncertainty,” he said.

Fox and graduate student Dan Holley realized that when you are anticipating that a bad thing is going to happen, depending on how the scenario is set up, there can be big differences in the perception of hazard at different times, even if the probability of the bad thing happening is the same.  

For example, if there is a 10 second countdown to an electric shock, the hazard rate is low until the countdown ends. But if the shock could occur at any time in those 10 seconds, the hazard rate should go up, they calculated.

“If you know something is going to happen, as time goes on the hazard rate goes up because you know it didn’t happen earlier,” Fox said. “The hazard rate is always going to be higher if you don’t know when it is going to happen.” 

Hazard rate rising over time

Holley and Fox, working with Professor Erie Boorman and graduate student Erica Varga, set up an experiment to test their idea. Volunteers received a small cash incentive (1 cent per second) to stay in a virtual environment but could also get a mild electric shock at some point unless they opted to leave first. 

They found that as expected, the hazard rate rather than the actual probability of getting a shock drives anxiety. 

“At each experimental time point, the threat hazard rate mapped almost perfectly to our participants’ behavior, whereas the momentary threat probabilities had no predictive value whatsoever,” Holley said. The volunteers also reported feeling significantly more anxious in the higher hazard rate environment.

Our brains have likely evolved to track rising hazard rates, Holley said. 

“Imagine a gazelle on the Serengeti,” he said. “As a matter of survival, it could keep its head down and graze a little longer, but the tradeoff is that it’s a bit more likely to be attacked by a lion.” 

The longer the gazelle grazes, the more the hazard rate increases. 

“Something in its mind must be tracking the hazard rate and guiding its behavior accordingly,” Holley said. 

By breaking down the concept of “uncertainty” in anxiety-inducing situations, the researchers hope to get a better understanding of the mechanisms behind fear and anxiety, including ways to treat the millions of people who suffer from extreme anxiety disorders.   

The work was supported in part by grants from the National Institutes of Health. 

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Read the paper (Computational Psychiatry)

Media Contacts:

• Drew Fox, Psychology, [email protected]
• Andy Fell, News and Media Relations, 530-304-8888, [email protected]

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Presentation Master's Thesis - Stijne de Winter - Developmental Psychology

Roeterseilandcampus - Gebouw G, Straat: Nieuwe Achtergracht 129-B, Ruimte: GS.11

The current study examined the relationship between Disconnection/Rejection early maladaptive schemas (EMS: D/R) and social anxiety (SA), between EMS: D/R and depression, and the moderating role of depression in the relation between EMS: D/R and SA. This study is done with young adults because it was found that young adults are more vulnerable to developing SA and depression compared to adults (Cámara & Calvete, 2011). The results showed that EMS: D/R significantly predicted SA and significantly predicted depression. The interaction term (EMS: D/R * SA) was not significant, indicating that depression does not moderate the relationship between EMS: D/R and SA. The findings suggest that higher levels of EMS: D/R are associated with higher levels of social anxiety and higher levels of depression in young adults. They also indicate that there is no influence of depression on the strength of the relationship between EMS: D/R and SA in young adults. This study contributes to the knowledge of the relationship between EMS: D/R, SA, and depression in young adults. Further research should examine the relationship between these variables with longitudinal research and possibly other moderators like resilience, coping, and social support. 

8 Steps to Reduce Anxiety Over Summer Break

Evidence-based strategies to reduce anxiety for college students..

Posted June 27, 2024 | Reviewed by Tyler Woods

• What Is Anxiety?
• Find counselling to overcome anxiety
• Summer break is an opportunity to reduce anxiety.
• Work on getting physically and emotionally fit.
• Plan for the future while also attending to interests, work, and a social life.

Summer break never comes soon enough and never lasts long enough. It’s a much-anticipated time for college students, offering a chance to relax and step away from academic pressures. However, for many, the transition from a busy semester to a relatively unstructured break can bring its own set of anxieties. Whether it’s concerns about internships, future plans, or simply managing downtime effectively, summer break can sometimes be more stressful than expected. This blog post explores evidence-based strategies for college students to reduce anxiety and make the most of their summer break.

1. Nail Down a Routine: While it’s tempting to sleep in and take each day as it comes, maintaining a loose routine can provide a sense of stability. It also helps your brain have some amount of predictability (which reduces anxiety). Plan your day with a balance of activities, including exercise, hobbies, and social time. Also, set small, achievable goals for the summer. These can range from reading a certain number of books to learning a new skill. Goals provide a sense of purpose and accomplishment. I think physical fitness, reading, or even cooking goals lend themselves to measurable outcomes that can be easily tracked and very satisfying.

2. Get Fit: Physical activity is the number one evidence-based way to reduce anxiety. Aim for at least 30 minutes of exercise a day, whether it’s a morning run, yoga session, or playing a sport with friends. This also helps with sleep. Pay attention to your diet . Eating a diet full of fruits, vegetables, and whole grains can improve mood and energy levels. Avoid excessive caffeine (don’t consume after 11:00 am) and sugar, which can exacerbate anxiety (and actually make you feel more tired).

3. Learn How to Chill Out: Mindfulness and meditation practices can significantly reduce anxiety with few side effects. Several apps offer guided meditations that are perfect for beginners. Simple deep breathing exercises can help manage stress in the moment. Practice techniques like the 4-7-8 breathing method or box breathing to calm your mind and body.

4. Stay Connected: Maintain social connections with friends and family. Regular social interaction can provide emotional support and reduce feelings of isolation. No, it doesn’t count if you’re on Snapchat or Instagram —they are actually designed to increase your anxiety. It’s also not the same as being physically around people and interacting face-to-face. Maybe it’s a bit corny, but consider joining a summer group or club that aligns with your interests. This can be a great way to meet new people and stay engaged. I love the idea of college students joining a running club or performance group. They're challenging, social, and get you out of the house.

5. Practice Playing Again: Use the summer break to lean into hobbies you’ve pushed off during the semester. Whether it’s painting, playing an instrument, or gardening, engaging in activities you love can be therapeutic while also helping you to practice using your time without a device. Try challenging yourself to learn something new. This could be a new language, cooking, or a craft. Learning new skills can boost confidence and provide a sense of accomplishment.

6. Prep for the Future: If you’re anxious about your career , use the summer to gain experience. Internships, part-time jobs, or volunteer work can be valuable for your resume and give you a sense of direction. The days are long, so there’s plenty of time to really load up your day with a job, volunteering, fitness, and time with friends. It’s also a great time to reflect on your career goals and plan steps to achieve them. Research potential career paths, network with professionals, and consider your next steps. I especially love the idea of using summer break for informational interviews with family friends who can provide insight into job hunting and preparing for the career landscape.

7. Get Help: When anxiety becomes overwhelming, don’t hesitate to seek professional help. Summer is the time to get comfortable with a therapist. Many colleges offer counseling services during the summer, and there are also numerous online therapy options available. A great way to learn more about anxiety and how to mitigate it is by joining a support group for anxiety. Sharing experiences with other college students facing similar challenges can provide comfort and practical coping strategies.

8. Get Outside: Nature has a calming effect on the mind. Just seeing the color green reduces peoples anxiety and depression . Spend time hiking, biking, or simply walking in a park. If possible, plan a weekend getaway to a park, beach, or lake. Camping, beach trips, or mountain retreats can offer a refreshing break from daily routines and activate other senses and parts of the brain you may not use as often.

Summer break is a valuable opportunity for college students to relax, recharge, and reduce anxiety. By establishing a routine, focusing on physical and mental health, staying connected, engaging in hobbies, planning for the future, seeking professional help if needed, and enjoying nature, students can make the most of their summer break. It’s not about balance but about attending to each of these areas to reduce anxiety and increase satisfaction. Remember, the goal is to find an authentic structure that works for you and allows you to return to the next semester refreshed and ready to tackle new challenges.

To find a therapist, visit the Psychology Today Therapy Directory .

Liu Kexiu, Mohamed Elsadek, Binyi Liu, et al (2021). Foliage colors improve relaxation and emotional status of university students from different countries. Heliyon. Cell Press.

Elizabeth A. Hoge, Eric Bui, Luana Marques, et al. (2013). Randomized Controlled Trial of Mindfulness Meditation for Generalized Anxiety Disorder: Effects on Anxiety and Stress Reactivity. Journal of Clinical Psychiatry.

Elizabeth Aylett, Nicola Small, and Peter Bower. (2018). Exercise in the treatment of clinical anxiety in general practice – a systematic review and meta-analysis. BMC Health Services Research.

Fengxia Lai, Lihong Wang, and Jiyin Zhang, et al. (2021). Relationship between Social Media Use and Social Anxiety in College Students: Mediation Effect of Communication Capacity. International Journal of Environmental Research and Public Health.

Rob Danzman is a licensed professional counselor and mental health counselor and founder of Motivate Counseling in Bloomington, Indiana.

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At any moment, someone’s aggravating behavior or our own bad luck can set us off on an emotional spiral that could derail our entire day. Here’s how we can face triggers with less reactivity and get on with our lives.

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Report Card Anxiety: 5 Tips to Help Students Improve Their Grades

Research findings indicate that approximately 64% of parents consider report cards to be a crucial indicator of their child's progress. As students are still struggling to catch up post-pandemic, there is a pressing need to address this issue and explore steps that can be taken to improve performance and ease the anxiety that comes along with receiving lower grades.

Encouraging a positive mindset and resilience can help students navigate challenges and setbacks more effectively, leading to improved academic performance and confidence overall.

Here are five ways to help students improve their grades and avoid report card anxiety in the future.

Set realistic goals

Setting achievable goals involves students and parents working together to define clear targets that align with the student's abilities and ambitions, often far beyond grades. Students can track their progress more effectively and stay motivated by breaking down larger goals into smaller, manageable steps. For example, instead of aiming to improve all subjects simultaneously, they can focus on one subject at a time, setting targets for each grading period.

Implement effective study strategies

Not all students learn or process information in the same way. Experimenting with various study techniques and time management methods is crucial for finding what works best for each student. Additionally, understanding different learning styles and customizing learning experiences can significantly improve their ability to absorb information. Some students may benefit from traditional methods like note-taking and flashcards, while others prefer more interactive approaches such as group discussions or teaching the material to someone else.

Encourage active learning

Active learning promotes deeper engagement and understanding by involving students in interactive activities such as discussions and problem-solving. Students develop a stronger grasp of the subject matter by participating in group activities with their peers. Additionally, immediate feedback in active learning environments helps identify areas for improvement, ultimately contributing to improved grades and academic success.

Seek out external support

External support can come in many forms, such as tutoring services , study groups, or online resources. Seeking additional help outside the classroom can provide students with new perspectives, reinforce concepts, and offer guidance for individual needs. Whether joining a learning center for assistance or forming a study group to work with peers, external support can complement classroom learning and provide valuable resources for improving grades.

Have discussions with teachers

Open communication between students, parents, and teachers is essential for addressing academic challenges and finding practical solutions. Encouraging students to initiate discussions with their teachers about areas of difficulty, clarification on concepts, or strategies for improvement creates a supportive learning environment. Teachers can provide valuable insights, guidance, and resources to help students overcome obstacles and succeed academically.

By implementing these strategies, parents can support their children in developing confidence across multiple subjects, reigniting their enthusiasm for learning. Acknowledging and tackling challenges encountered in the classroom pave the pathway to academic success, enhancing self-esteem and ultimately leading to improved grades.

Author: John Bianchette , Vice President of Education and Training of Mathnasium – responsible for developing the curriculum of mathematics that is being taught across the globe in over 1,100 learning centers.

Source: https://www.todaysparent.com/family/education/report-card-anxiety-tips-to-improve-student-grades/ .

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Effectiveness of psychobiotic bifidobacterium breve bb05 in managing psychosomatic diarrhea in college students by regulating gut microbiota: a randomized, double-blind, placebo-controlled trial.

Graphical Abstract

1. Introduction

2. materials and methods, 2.1. study design and ethical approval, 2.2. randomization and masking, 2.3. intervention procedure and management, 2.4. questionnaires, 2.5. enzyme-linked immunosorbent assay (elisa), 2.6. dna extraction and 16s rrna sequencing, 2.7. sample size, 2.8. statistical analysis, 3.1. diarrhea affects mental health and gut microbiota on college students (observational experiment), 3.1.1. baseline characteristics and scales results of participants in the observational experiment, 3.1.2. diarrhea and perturbance in gut microbial diversity and composition in college students, 3.2. b. breve bb05 intervention improves gut dysbiosis and mental health in diarrheal college students (intervention experiment), 3.2.1. baseline characteristics and the impact of b. breve bb05 on diarrhea symptoms and associated anxiety and depression, 3.2.2. b. breve bb05 supplement enriches and improves the compromised gut microbiota in diarrheal students, 3.3. correlation analysis among phenotypes, gut microbiota, and related fecal neurotransmitters, 4. discussion, 5. conclusions, author contributions, institutional review board statement, informed consent statement, data availability statement, conflicts of interest.

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Share and Cite

Wang, Y.; Wang, Y.; Ding, K.; Liu, Y.; Liu, D.; Chen, W.; Zhang, X.; Luo, C.; Zhang, H.; Xu, T.; et al. Effectiveness of Psychobiotic Bifidobacterium breve BB05 in Managing Psychosomatic Diarrhea in College Students by Regulating Gut Microbiota: A Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients 2024 , 16 , 1989. https://doi.org/10.3390/nu16131989

Wang Y, Wang Y, Ding K, Liu Y, Liu D, Chen W, Zhang X, Luo C, Zhang H, Xu T, et al. Effectiveness of Psychobiotic Bifidobacterium breve BB05 in Managing Psychosomatic Diarrhea in College Students by Regulating Gut Microbiota: A Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients . 2024; 16(13):1989. https://doi.org/10.3390/nu16131989

Wang, Yufan, Yufei Wang, Kunpeng Ding, Yuhan Liu, Dingming Liu, Weijun Chen, Xinyi Zhang, Chuanlin Luo, Hongyan Zhang, Tangchang Xu, and et al. 2024. "Effectiveness of Psychobiotic Bifidobacterium breve BB05 in Managing Psychosomatic Diarrhea in College Students by Regulating Gut Microbiota: A Randomized, Double-Blind, Placebo-Controlled Trial" Nutrients 16, no. 13: 1989. https://doi.org/10.3390/nu16131989

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