Effects of Stress in Adaptation to Undergraduate Life on Psychiatric Morbidity: Mediating Effects of Early Trauma and Adverse Family Factors

Yingzhe Zhang; Jeremy Coid; Xiang Liu; Yamin Zhang; Huan Sun; Xiaojing Li; Wanjie Tang; Qiang Wang; Wei Deng; Liansheng Zhao; Xiaohong Ma; Yajing Meng; Mingli Li; Huiyao Wang; Ting Chen; Qiuyue Lv; Wanjun Guo; Tao Li

doi:10.3389/fpsyt.2022.538200

Effects of Stress in Adaptation to Undergraduate Life on Psychiatric Morbidity: Mediating Effects of Early Trauma and Adverse Family Factors

Front Psychiatry. 2022 Apr 8:13:538200. doi: 10.3389/fpsyt.2022.538200. eCollection 2022.

Authors

Yingzhe Zhang^{1

2

3

4}, Jeremy Coid^{1

2

3}, Xiang Liu⁴, Yamin Zhang^{1

2

3}, Huan Sun^{1

2

3}, Xiaojing Li^{1

2

3}, Wanjie Tang⁵, Qiang Wang^{1

2

3}, Wei Deng^{1

2

3}, Liansheng Zhao^{1

2

3}, Xiaohong Ma^{1

2

3}, Yajing Meng^{1

2

3}, Mingli Li^{1

2

3}, Huiyao Wang^{1

2

3}, Ting Chen¹, Qiuyue Lv^{1

2

3}, Wanjun Guo^{1

2

3}, Tao Li^{1

2

3

5

6}

Affiliations

¹ Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.
² West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China.
³ Mental Health Education Center, Sichuan University, Chengdu, China.
⁴ West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
⁵ Centre for Psychology Education and Consultation, Sichuan University, Chengdu, China.
⁶ Hangzhou Seventh People's Hospital and Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, China.

Abstract

Purpose: University students experience high levels of stress, and the prevalence of depression is higher than in the general population. The reason is not clear. More effective interventions and better prevention are needed.

Methods: We did annual cross-sectional surveys of Chinese undergraduates 2014-2018 (mean age 18.7 [SD 2.1], N = 39,573). We measured adaptation to university life using the Adolescent Self-rating Life Events Checklist (ASLEC) and common mental disorders using standardized self-report instruments. Regression analyses identified associations between childhood maltreatment, current family problems, stress in adaptation to undergraduate life, and psychiatric morbidity. Mediation analyses further tested relationships between these factors.

Results: Childhood maltreatment, current family problems, stress in adaptation, and psychiatric morbidity were all significantly associated with each other. The strongest association between childhood experiences and psychiatric morbidity was for sexual abuse and depression (OR = 3.39, 95%CI: 2.38-4.83, p < 0.001) and between stress from adaptation and somatic disorder (OR = 4.54, 95%CI: 3.62-5.68, p < 0.001). Associations between childhood maltreatment and stress from university life were partly mediated by psychiatric morbidity. Associations between family problems and psychiatric morbidity were mediated by stress from university life.

Conclusions: Stress from adaptation to university life and pressures from academic study exert stronger effects on psychiatric morbidity among students than childhood traumatic experiences and current family problems, although these factors are closely interrelated. Mental health services for students should focus on adaptation to university life and pressures from academic study as well as external factors of childhood trauma and family problems.

Keywords: adaptation; childhood maltreatment; common mental health disorders; stress; undergraduate students.