Evidence map›Paper›PMID 42104478›Full record

ArticleBMC psychology2026

Contextual stressors and multidimensional mental health among university students during the COVID-19 period: a construct-level network analysis.

Zhenti Cui, Shujuan Wu, Haoyang Ma, Yi Zhang, Xiaoxiao Lin, Xiaojie Hou, Yuan Ren, Yaru Feng, Yingdong Cao

Abstract read
In one paragraph

Article in BMC psychology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Zhenti CuiSchool of Medicine, Sias University, Zhengzhou, China. Zhenti.cui@sias.edu.cn.
Shujuan WuSchool of Medicine, Sias University, Zhengzhou, China.
Haoyang MaSchool of Medicine, Sias University, Zhengzhou, China.
Yi ZhangSchool of Medicine, Sias University, Zhengzhou, China.
Xiaoxiao LinSchool of Medicine, Sias University, Zhengzhou, China.
Xiaojie HouSchool of Medicine, Sias University, Zhengzhou, China.
Yuan RenSchool of Medicine, Sias University, Zhengzhou, China.
Yaru FengSchool of Medicine, Sias University, Zhengzhou, China.
Yingdong CaoSchool of Medicine, Sias University, Zhengzhou, China. 11021@sias.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMental health problems among university students predated COVID-19, but pandemic-period conditions coincided with changes in how academic, relational, behavioral, and internalizing difficulties co-occurred. Prior studies often modeled single outcomes or symptom clusters separately. This secondary analysis used a construct-level network to describe conditional associations among contextual stressors, adaptive-functioning indicators, and multidimensional mental health indicators in one archived student dataset.

methodsWe analyzed cross-sectional survey data from 10,745 students collected January 13-March 26, 2021. Fourteen nodes were included: media time, online adaptation, learning efficiency, family conflict, friendship change, epidemic attitude, epidemic attention, exercise, perceived stress, anxiety, depression, sleep problems, loneliness, and resilience. After correcting exercise-frequency coding and anxiety-score derivation errors, we estimated an EBICglasso-regularized partial-correlation network using Spearman correlations. Expected influence, bridge expected influence, and nodewise R2 were interpreted as descriptive, model-dependent indices. We examined edge accuracy, centrality stability, bridge stability, edge-weight differences, data-quality exclusions, alternative estimators, community definitions, and counterintuitive partial edges.

resultsThe fitted network retained 53 of 91 possible edges (density = 0.582). In this specification, depression, perceived stress, and anxiety had the highest expected-influence values (1.428, 1.064, and 0.782). The strongest absolute partial-correlation edges linked sleep problems with depression (0.736), depression with anxiety (0.668), anxiety with perceived stress (0.459), and sleep problems with anxiety (-0.423). Under the prespecified two-community partition, bridge expected influence was largest for perceived stress (0.461), loneliness (0.343), family conflict (0.233), epidemic attitude (0.184), and learning efficiency (0.126). Expected influence and bridge expected influence showed high case-dropping stability within this analytic specification (CS = 0.75). Data-quality exclusions and an ordinal/mixed-correlation EBICglasso model yielded estimates very similar to the primary network, whereas an unsigned-weight mixed graphical model yielded different centrality rankings.

conclusionsThe findings describe a construct-level snapshot of conditional associations among students from one institutional context during a specific COVID-19 period. Perceived stress showed the highest and most stable bridge expected-influence value across the tested community specifications, while other bridge rankings and centrality values were specification-dependent. The results are hypothesis-generating, not evidence of causal pathways, intervention targets, or population-representative student mental health structure.

Indexed as

COVID-19Mental HealthStress, PsychologicalStudentsAdaptation, PsychologicalAdolescentAdultAnxietyCross-Sectional StudiesDepressionFemaleHumansLonelinessMaleSubjective StressUniversitiesAnxietyCOVID-19DepressionLonelinessNetwork analysisPerceived stressUniversity students

Identifiers

PMID42104478
PMCPMC13295187

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LicenceCC BY-NC-ND
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Registered trials

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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.