Evidence map›Paper›PMID 41649989›Full record

ArticlePloS one2026

Exploring the influence of COVID-19 stress on mental health among international undergraduate and graduate students: A mixed-methods approach.

Chinyere N Reid, Jason W Beckstead, Abraham A Salinas-Miranda

Abstract read
In one paragraph

Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Chinyere N ReidUniversity of South Florida, College of Public Health, Community Health Sciences Department, Tampa, Florida, United States of America.ORCID https://orcid.org/0000-0002-2133-4005
Jason W BecksteadUniversity of South Florida, College of Public Health, Community Health Sciences Department, Tampa, Florida, United States of America.
Abraham A Salinas-MirandaUniversity of South Florida, College of Public Health, Community Health Sciences Department, Tampa, Florida, United States of America.ORCID https://orcid.org/0000-0001-7749-6110

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

International college students in the United States are at increased risk of developing mental health disorders and are less likely to seek mental health services. However, little is known about the effects of stress during the COVID-19 pandemic on the mental health of international undergraduate students compared to their graduate counterparts studying in the US. This study examined the associations between COVID-19 stress, anxiety, and depression and whether education level moderates these associations in international undergraduate and graduate students. A cross-sectional online survey containing psychometric scales and open-ended questions was completed by 219 international undergraduate and graduate students. Validated psychometric scales used included the Depression, Anxiety, and Stress Scale (DASS-21), COVID-19 Stress Scale (CSS), and Perceived Stress Scale 4 (PSS-4). Path analysis was used to assess whether education level moderated the relationships between COVID-19 stress and anxiety and depression. Applied thematic analysis was conducted to qualitatively determine COVID-19-related stressors affecting students' mental health. We found that COVID-19 stress was significantly associated with students' anxiety and depression, and education level moderated the relationship between COVID-19 stress and anxiety, but not depression. Major themes of COVID-19-related stressors affecting mental health included academic performance, financial difficulties, travel constraints, social isolation, and grief. Findings highlighted the influence of stress during the COVID-19 pandemic on the mental health of international students studying in the US. Graduates and undergraduates experienced stress differently, particularly related to anxiety. Additionally, pandemic-related stressors were multifaceted in nature. Adequate mental health interventions and support tailored for graduates and undergraduates are needed to address students affected during global crises.

Indexed as

COVID-19Mental HealthStress, PsychologicalStudentsAdultAnxietyCross-Sectional StudiesDepressionFemaleHumansMalePandemicsPsychometricsSARS-CoV-2Subjective StressSurveys and Questionnaires

Identifiers

PMID41649989
PMCPMC12880682

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.