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Open AccessOriginal Article

The COVID-19 International Student Well-Being Study (C-19 ISWS)

The Case of Cyprus

Published Online:https://doi.org/10.1024/2673-8627/a000014

Abstract

Abstract. The COVID-19 pandemic has had a great impact on the mental health and well-being of different populations including young adults. This study replicates and extends previous research by evaluating the impact of the COVID-19 pandemic on the well-being of college students in Cyprus, a Mediterranean island with unique sociocultural and genetic characteristics, and to identify risk factors related to the poor mental health of university students. Behavioral changes in the students before and during the quarantine period were also examined. A total of 387 university students completed an online survey coordinated by the Young Universities of Europe (YUFE) network. Results indicated that most of the sample (89.3%) reported depressive symptoms. Academic stress and academic satisfaction were associated with depressive symptoms and loneliness. Specifically, students with greater academic stress and lower academic satisfaction reported more symptoms of depression and felt lonelier. Younger students with poorer economic capital were more likely to feel depressed, and younger college students with higher academic stress were more likely to feel lonely. The results of t-test analyses indicated that quarantine affected students’ time and type of study turning to online studies and to moderate physical activities. The present study’s findings add to the existing literature and support the development of new measures to support students, both financially as well as psychologically.

As the COVID-19 pandemic spread around the world, a wave of growing literature has shed light on the psychological impact the pandemic had on different population groups. It is well known that uncertainty (Lee & You, 2020), imposition of multiple precautionary measures to prevent the spread of the disease (Solomou & Constantinidou, 2020), the worry of being infected or infecting a loved one (Brooks et al., 2020; Serafini et al., 2020), the emergence of conspiracy theories and circulation of misinformation (Constantinou, Gloster & Karekla, 2021), disruptions of routine and social isolation (Gloster et al., 2020) became some of the major stressors disrupting the daily life of people around the globe over the past 18 months. Several studies pointed out the psychological burden of the pandemic with increased symptoms of depression and posttraumatic stress in specific populations. Previous research implicated different factors in the psychological burden of the pandemic, including virus-related fear, enforced quarantine and isolation, inadequate knowledge and misinformation, financial loss as well as stigma (Brooks et al., 2020). In fact, greater impact was reported among young females in the general population as well as in other vulnerable populations such as those with a prior psychiatric history, the unemployed, and with frequent exposure to social media (Gloster et al, 2020; Serafini et al., 2020; Solomou & Constantinidou, 2020; Xiong et al., 2020). In addition, loneliness and limited access to mental health services were identified as key factors associated with depression and even self-harm (Holmes et al., 2020).

Thus, different risk factors influence the risk of developing mental health symptoms because of COVID-19 in different populations. Besides the impact on mental health, behavioral changes were also reported because of the COVID-19. Specifically, there was a negative effect on the intensity of psychical activity, increased seating time, and amount of food consumption (Ammar et al, 2020).

Another population heavily impacted by the pandemic are university/college students, who exhibit many of the above-mentioned risk factors. University students were faced with major disruptions in their lives and college experiences, including uncertainty possibly resulting in multiple complications and psychological effects, which can have long-term effects. Thus, the mental health of university students during the COVID-19 outbreak has gained interest (Aristovnik et al., 2020; Browning et al., 2021; Cao et al., 2020; Elmer et al., 2020; Son et al., 2020; Wang et al., 2020). Immediately after the outbreak, most universities and colleges switched from traditional face-to-face teaching to online-education platforms. Though this was aimed to decrease disruptions in learning, in fact, it resulted in great challenges for students, including having to deal with technical and technological issues, concerns about grading and privacy, and other difficulties surrounding distance learning (Son et al., 2020). Moreover, according to prior research, e-learning results in negative reactions by university students who prefer face-to-face learning (Mann & Henneberry, 2014).

Shifting from physical learning to distance learning made it more difficult for students to maintain their focus, while worries about their academic performance flourished (Wang et al., 2020). One study conducted in the US indicated gender differences, with women reporting higher levels of both depression and anxiety symptomatology than men (Wang et al., 2020). Furthermore, the severity of anxiety and depression symptoms was greater for undergraduate students compared to Masters and doctoral students (Solomou & Constantinidou, 2020).

Besides learning difficulties, college students faced economic difficulties, and their social lives were greatly impacted because of the social restrictions/lockdowns implemented by state authorities to control the pandemic (Xiong et al., 2020). As the pandemic was unfolding, students had to rapidly adapt to changes in their academic as well as personal lives (e.g., moving from dormitories to their parental housing) and social lives. Students had to adjust to these changes and incorporate them into their academic schedules, which added to their mental health burden (Son et al., 2020; Wang et al., 2020). Most students mentioned high levels of stress and anxiety caused by the pandemic (Son et al., 2020; Wang et al., 2020).

The stress resulting from the COVID-19 pandemic is in line with research investigating student mental health in other epidemics such as the SARS epidemic (Main et al., 2011; Wong et al., 2007). Interestingly, one of the studies found that less than half of the students in their sample were able to cope with this level of stress (Wang et al., 2020). A considerable proportion of students also reported having depressive thoughts because of COVID-19, while a small number presented suicidal ideation (Son et al., 2020; Wang et al., 2020). Reasons proposed to influence depressive symptoms and suicidal ideation include loneliness caused by social isolation and distancing, powerlessness, financial uncertainty (Son et al., 2020; Wang et al., 2020), and loss of major reinforcers in life (Gloster et al, 2020). Finally, university students experienced worry not only about their own health but also about the health of their loved ones (Son et al., 2020; Wang et al., 2020).

Despite the impact of this pandemic on the mental health of students, this population group was among the ones least likely to adhere to precautionary measures (Solomou & Constantinidou, 2020). Specifically, compliance with precautionary measures was heavily impacted by age, with people over 30 constituting the most engaged age group (Solomou & Constantinidou, 2020). Especially among younger age groups, increases in stress levels were associated with a rise in conspiracy theory beliefs, which in turn predicted science mistrust and unwillingness to adhere to public health measures (Constantinou et al., 2020; Constantinou et al., 2021), a phenomenon observed across various continents (Pizarro et al., 2020).

The Present Study

Although several studies used a broad set of the variables mentioned above to predict their outcomes, most studies were conducted in the general population (Alzueta et al., 2021; Islam et al., 2021; Zhang et al., 2020). Previous research indeed provided information on the relationship between several demographic variables, academic factors, and COVID-19-related stressors, with depression symptoms and loneliness during the COVID-19 pandemic among student populations. Specifically, in the context of Cyprus, studies focused on mental health outcomes in the general population (Solomou & Constantinidou, 2020, Papageorgiou et al., 2021) or special populations such as health professionals (Chatzittofis et al., 2021, Nicolaou et al., 2021), but not specifically on college students, a population faced with particular stressors related to the pandemic as outlined above. The few studies in Cyprus that included college students focused on specific aspects of the impact of the pandemic and on specific groups of university students (i.e., medical students), or they had very small sample sizes not representative of the university population in Cyprus. A study investigating the role of social factors in perceived stress reported that college students perceived high levels of stress during the lockdown, and that preexisting social skills as well as concurrent family support were significant predictors of perceived stress during the lockdown. The ability to manage interpersonal conflicts and effectively resolve disagreements was inversely related to perceived stress (Panteli et al., 2021). In addition, Panayiotou et al. (2021) reported a decrease in the quality of life of college students compared to prepandemic levels and identified the difficulty describing feelings and accessing emotion regulation strategies as predictors of decreases in quality of life. Positive correlations between distance learning, employment, and stress levels of college students were also reported in a study investigating students’ adjustment to distance learning. Still, the above-mentioned study included only 80 participants from a private university in Cyprus (Demetriou et al., 2021). Finally, a study on student burnout (Zis et al., 2021), although reporting that the burnout prevalence did not differ before and during the COVID-19 period, reported a significant decrease in emotional exhaustion in 4th-year medical students and an increase in emotional exhaustion of 6th-year students as well as an increase in students’ cynicism from all years. However, this study included only medical students. This might be because students closer to graduation were under the stressful scenario of being called to serve in hospitals because of the COVID-19 crisis.

Thus, to our knowledge, no published study has yet to use different variables (demographic, behavior, academic factors, COVID-19-related stressors, depression symptoms, and loneliness) to build predictive models among students and particularly among college students’ in Cyprus, a country that had among the strictest of lockdowns during the first and second waves of the pandemic. We hypothesized that demographics dominantly predict the outcome of interest followed by the academic, and COVID-19-related factors.

The present study took place in Cyprus and is part of an international study coordinated by the Young Universities of Europe (YUFE) network. Thus, this cross-sectional study aimed to contribute by replicating and extending the existing literature on how the pandemic impacted the well-being of university students, with a focus on a European island country with unique social-cultural characteristics. Another important aim was to detect risk factors that predispose students to disrupt their mental health using hierarchical regression analyses, while a further objective of this body of work lay in detecting changes in the way students behaved (e.g., studying, physical activity, smoking, etc.) before and during the quarantine period of the pandemic (Van de Velde et al., 2021).

Methods

Sample and Data Collection Procedure

A total of 387 questionnaires were received from 3 to 26 June 2020. 275 respondents completed the survey, whereas 112 respondents left one or more items incomplete. Incomplete data were treated as missing values using listwise deletion. Participants were 17 years of age or older and university students from any educational institution in Cyprus (Cyprus has three public universities and four private universities). An email with the survey information and the link for participation was sent to students on 3 June and again on 24 June 2020. The survey took place a few weeks after the end of the lockdown period on 21 May and when the country was still in a good place epidemiologically; as of 23 May 2020 there were 0 new infections since the beginning of the pandemic in early March. The survey was conducted online to maximize reach and ensure anonymity. Participation was voluntary.

Survey Development and Measures

This study is part of the COVID-19 International Student Well-Being Study (C19 ISWS), which is the result of a study design, protocol, and questionnaire developed by a team at the University of Antwerp in collaboration with the University of Ghent, Belgium (Van de Velde et al., 2021). Cyprus participated in this survey, along with educational institutes from 26 different countries including many European countries, Canada, the United States, and South Africa. The core questionnaire was translated into Greek through a committee approach, i.e., a team of a minimum of two translators fluent in Greek and English. However, the participants had the option to complete the survey in Greek or in English since both questionnaires were inserted into the Qualtrics survey tool by the coordinating team (Van de Velde et al., 2021).

The questionnaire consisted of five major sections: (1) sociodemographic variables, (2) study-related information, (3) daily activities/behaviors before and during the COVID-19 outbreak, (4) COVID-19-related perceived worries, and (5) mental well-being questions. Before we distributed the survey among the students, a sample of two students completed the survey to ensure its proper technical functioning, understandability of questions, and completion within the desirable timeframe (10 minutes maximum). The questionnaire is published with the study protocol (Van de Velde et al., 2021).

Participants submitted their informed consent for participation in the study over a web-based platform (Qualtrics). The study protocol was approved by the National Bioethics Committee of Cyprus (Protocol number: 2020.01.20).

Sociodemographic Variables

Sociodemographic variables included information about sex, age, relationship status, migration status, parents’ educational level, and resources (e.g., social support and economic capital).

Study-Related Information

Study-related information included information about the academic program students were currently enrolled in, whether they were in their first year in higher education, the status of the student in Cyprus, the importance of the studies for the student, academic stress experienced, and academic satisfaction.

Daily Activities/Behaviors Before and During the COVID-19 Outbreak

Changes in living conditions because of COVID-19 included questions about the frequency of students’ engagement in specific behaviors before and after a lockdown, such as study, courses, physical activities (moderate physical activity was defined as exercises like easy cycling or walking for at least 30 minutes), smoking, alcohol consumption, and employment.

COVID-19-Related Perceived Worries

COVID-19 related perceived worries included questions about the perceived risk of personal infection, perceived risk of personal severely illness, perceived risk of infection of the personal network, perceived risk of COVID-19 illness severity among their personal network, compliance with the government’s precautionary measures (rated on a scale ranging from 0 to 10, where 10 indicated very strict adherence), and whether they know someone infected with COVID-19.

Mental Well-Being Measures

Mental health status was measured using the 8-item Center for Epidemiological Studies Depression Scale (CES-D8) for depression (Radloff, 1977). The Cronbach’s α for the entire sample was 0.85, indicating excellent internal consistency. Response options were none or almost none of the time, some of the time, most of the time, and all or almost all of the time, scored as 0, 1, 2, and 3, respectively. Scale scores for the CES-D8 were the sum of the items (score range 0 to 24), with higher scores indicating a higher frequency of depressive complaints (Radloff, 1977).

To assess loneliness, we used a 3-item scale (how much of the time during the quarantine you felt lonely, lacked companionship, or felt isolated from others). Two of the three questions were extracted from UCLA’s Loneliness Scale (RULS-8). Cronbach’s α for the entire sample was 0.81, indicating excellent internal consistency. Loneliness was defined as the feeling that arises when the actual quality of a person’s social relationships is lower than their expected quality. Response options were none or almost none of the time, some of the time, most of the time and all or almost all of the time, scored as 0, 1, 2, and 3, respectively. The scale’s score scale ranged between 0 and 9, where 9 indicates higher negative feelings (Roberts et al., 1993).

Data Analysis

The data were exported to the statistical program SPSS Statistics 25.0. Descriptive statistics were used to describe the sample sociodemographic characteristics and study-related information. We also used correlation matrix analysis to assess the bivariate relationships between sociodemographic, study-related, and COVID-19-related variables with the two scales, CES-D8 and Loneliness. Two hierarchical stepwise multiple linear regressions were conducted with Depression and Loneliness as the outcome variables, where step 1 included the sociodemographic variables, step 2 the study-related information, and step 3 the COVID-19-related information. Each step served as a statistical control of the variables, to see whether adding variables significantly improved the model’s ability to predict the outcome of interest. This enabled the estimation of the incremental variance explained by predictor variables on outcomes of interest. Finally, for the last analysis, we used a paired-sample t-test to identify significant differences in behavior before and during the first wave of the COVID-19 outbreak.

Results

Sociodemographic Characteristics

The sociodemographic characteristics and study-related information are presented in Table 1. Most of the respondents were women (73.1%), between the ages of 19 to 20 years old (31.5%) and approximately half of the sample was single or not in a relationship (51.9%). Most of the respondents’ parents had completed a middle-educational level (50.6%), while 41.3% reported having at least one parent with a higher educational diploma. Majority of the sample (46.0%) reported being able to easily borrow EUR 500 from five or more people, showing that they had a strong social and economic capital (see Table 1).

Table 1 Summary of participants demographic characteristics and study-related Information

Regarding study-related information, most students were enrolled in a bachelor’s program (72.9%) and had completed their first year of studies (68.2%). Furthermore, most respondents were Cypriot citizens (65.1%), while 16.0% were permanent residents with a migrant background, and a smaller percentage (7.5%) declared as temporary residents with more than 1-year permit to reside in Cyprus. Finally, about half of the sample (50.1%) rated the importance of their studies as being equally important as other activities (see Table 1).

Depression and Loneliness Levels

Depressive symptoms, measured using CES-D8, presented a sample mean score of 9.04 (SD = 4.75), range = 0 to 24. Only 10.3% of the respondents were considered to have a normal score while most of the sample (89.7%) were considered to have depressive symptoms.

The mean Loneliness score was 3.07 (SD = 2.48), range = 0 to 9. This score corresponds to feeling lonely some of the time.

In the correlation matrix, increased Depression and Loneliness scores were associated with younger age (CESD-8: −.20; Loneliness: −.29; p < .01) and having a poorer social and economic capital (see Table 2). Moreover, both variables were positively associated with academic stress (CESD-8: .42; Loneliness: .38; p < .01) and negatively correlated with academic satisfaction (CESD-8: −.29; Loneliness: −.28; p < .01), (see Table 3). Depression was positively correlated with Perceived risk of personal infection (CESD-8: .13; p < .05), Perceived risk of personal severe illness (CESD-8: −15; p < .05) and Perceived risk of severe illness in the personal network (CESD-8: .16; p < .05), (see Table 4).

Table 2 Correlation matrix among demographic variables and depression and loneliness
Table 3 Correlation matrix among study related variables and Depression and Loneliness
Table 4 Correlation matrix among COVID-19 related perceived worries and Depression and Loneliness

Hierarchical Multiple Regression Analyses

Predictors of Depressive Symptoms

The first research goal was to examine the relationship between CES-D8 and 18 potential predictors. We partitioned the predictors into sociodemographic variables (sex, age group, relationship status, migration status, parents’ educational level, and support system), study-related factors (academic satisfaction, academic stress, program currently enrolled, first year in higher education, status in Cyprus, and studies importance compared to other activities) and COVID-19-related perceived worries (knowing someone with infected COVID-19, perceived risk of personal infection, perceived risk of personal illness, perceived risk of infection of the personal network, perceived risk of illness of personal network, and compliance to government’s precautionary measures).

Our original intention was to test a hierarchical linear regression model in which sociodemographic predictors were entered in Step 1, study-related predictors in Step 2, and COVID-19-related perceived worries in Step 3. We calculated Pearson and Spearman correlations between CES-D8 and potential predictors; Table 2 presents the results. Predictors that were not significantly correlated with CES-D8 were dropped from the regression model. The sample size was deemed adequate, given the seven independent variables to be included in the analysis and assumption of singularity was also met. Hierarchical linear regression assumptions of linearity, normality, homoscedasticity, and collinearity had been met.

Table 5 shows the full details of each step of the analysis. In the first step, both age and social and economic capital added statistically significant to the prediction model, R2 = 0.06, F(2, 272) = 8.98, p < .001. Relative to the patterns in the correlation matrix, younger age, and poor social and economic capital were associated with more depressive symptoms.

Table 5 Hierarchical multiple regression analysis predicting depression from sociodemographic, study related factors, and COVID-19 related factors (N = 275)

In the second step, after including study-related factors, academic stress (β = 0.341, p < .001) emerged as the only study-related factor that was a significant predictor, with the overall model being still statistically significant, R2 = 0.21, F(4, 270) = 17.49, p < .001. In the third step, the three COVID-19-related perceived worries factors (perceived risk of personal infection, perceived risk of personal severe illness because of COVID-19, and perceived risk of severe illness in one’s personal network because of COVID-19) were entered into the regression equation. None of them were statistically significant as independent variables. The full model of sociodemographic variables, study-related factors, and COVID-19-related factors was statistically significant, R2 = 0.224, F(7, 267) = 11.04, p < .001.

Predictors for Loneliness

The second research goal was to examine the relationship between Loneliness and the same 18 potential predictors partitioned into groups as before and entered in separate steps into a hierarchical linear regression model. We calculated the Pearson and Spearman correlations between Loneliness and potential predictors; Table 3 presents the results. Predictors that were significantly correlated with Loneliness were included in the regression model. The sample size was deemed adequate, given the four independent variables included in the analysis. The scatterplot of standardized predicted values against standardized residuals values showed no evidence of violations of the regression assumptions of linearity, normality, and homoscedasticity. Collinearity assumption was also met.

Table 6 presents the results of this second regression analysis. In step 1, age groups (β = −0.276, p < .001) emerged as the only sociodemographic statistically significant predictor to the regression model, R2 = 0.09, F(2, 273) = 13.89, p < .001. In step 2, when study-related factors were included, age group (β = −0.157, p < .01) was still a significant predictor, whereas academic stress (β = 0.252, p < .001) emerged as the only study-related factor that was a significant predictor with the overall model still being statistically significant, R2 = 0.21, F(4, 270) = 17.49, p < .001. Regarding the full model of sociodemographic variable, study-related factors such as COVID-19-related factors were statistically significant, R2 = 0.18, F(4, 71) = 15.32, p < .001.

Table 6 Hierarchical multiple regression analysis predicting Loneliness from sociodemographic and study related factors (N = 276)

Changes in Daily Activities/Behaviors Before and During the COVID-19 Outbreak

To investigate changes in the frequency of students’ daily activities before and during the COVID-19 Outbreak, we conducted a paired-sample t-test. The results indicated a statistically significant reduction of hours spent in offline courses during the COVID-19 outbreak (M = 5.14, SD = 16.76) compared to before (M = 16.75, SD = 25.904), t(262) = 6.99, p < .001 . At the same time, there was a significant difference in the hours spent in online courses before (M = 9.73, SD = 17.11) vs. during the lockdown (M = 19.09, SD = 26.73), t(242) = −2.82, p < .05. The results further indicated a statistically significant increase in the frequency of engagement in moderate physical activities during the lockdown (M = 3.03, SD = 1.477) compared to before (M = 2.82, SD = 1.51), t(283) = −2.171, p < .05. t-test results were not significant for the rest of the daily activities (see Table 7).

Table 7 Students daily activities frequency pre and during COVID-19 outbreak

Discussion

The COVID-19 pandemic affected the general population’s mental health around the globe, with college students being a population heavily impacted by the pandemic aftereffects and considered a vulnerable population regarding mental health concerns (Browning et al., 2021; Cao et al., 2020; Elmer et al., 2020; Son et al., 2020; Wang et al., 2020). In the present study, more than half of the sample (89.7%) reported either mild, moderate, or severe symptoms of depression, whereas the scores on the Loneliness scale indicated that most students felt lonely during the study period. These prevalence ranges appear to be slightly higher than those reported by previous studies with the general population in Cyprus (Papageorgiou et al., 2021) and thus add to the existing literature on the increased rates of mental health concerns among college students reported in previous studies in Cyprus and internationally (Cao et al., 2020; Drissi et al., 2020; Patsali et al., 2020; Solomou & Constantinidou, 2020; Son et al., 2020; Wang et al., 2020). The depression scores in this study also resemble those of other national studies (Belgium, France, and Greece) included in the international consortium, where the present study is included (De Man et al., 2021; Tavolacci et al., 2021; Stathopoulou et al., 2020). Because the methodology of these studies is the same, it increases the validity and generalization of the results. All previous studies, including the present study, provide cross-sectional data from various phases of the COVID-19 pandemic. The prevalence of depressive symptoms among the present cohort was much higher than the 30.6% prevalence reported under prepandemic conditions (Ibrahim et al., 2013). Moreover, in line with our findings about loneliness, a study with students in Switzerland reported that, because of the decrease of social interaction, students reported higher levels of stress, anxiety, and loneliness (Elmer et al., 2020). It is also possible that younger students did not have the time to fully develop a social supporting network compared to older students with established social life as university students. It is also a transitional period for younger students and carries the extra burden of adjusting from high school to university. Social support is important and predicts well-being in general and during the pandemic (Gloster et al., 2020; Nicolaou et al., 2021).

Another main finding of the present study was that academic stress and academic satisfaction were associated with depressive symptoms and loneliness. Specifically, students with greater academic stress and lower academic satisfaction reported more symptoms of depression and felt lonelier. Most importantly, the Belgian study, included in the same international consortium as the present study, reported that academic stress was associated with substantially higher depressive symptoms severity scores (De Man et al., 2021). A similar study that examined the experiences of students in 62 countries indicated that students expressed great concerns about their academic and professional careers, leading them to feel frustration and anxiety (Aristovnik et al., 2020). In a very short time, students around the globe had to cope with a new reality in their academic, social and personal environment. They were faced with multiple challenges and needed to develop new skills, learn new electronic platforms, study in isolation and online, at home, etc. Students expressing dissatisfaction with the transition to online learning are more vulnerable to feelings of frustration and stress with regard to their academic obligations (Aristovnik et al., 2020).

Based on the first hierarchical linear regression, younger students with poorer economic capital systems were more likely to feel depressed. This is not surprising as it is well documented in the literature that limitations in financial resources are strongly associated with an increase in stress and depressive symptomatology (Aristovnik et al., 2020; Butterworth et al., 2009; Lorant et al., 2007). It was also found that younger students may be at a greater risk than older ones, because, contrary to older students, younger ones appear to be more concerned about their studies and financial obligations (Aristovnik et al., 2020). Second, during the pandemic, younger students spent more time on social media platforms than older students (Elhai et al., 2020; Hunt & Eisenberg, 2010). Thus, their increased exposure to news relating to COVID-19 amplifies the possibility of being exposed to risk-elevating messages that could contribute to anxiety and pose a threat to their mental health (Browning et al., 2021).

Further, during the quarantine, students needed to adjust their social lives according to the situation, all while living in already highly diverse environments. Their mental health during this period relied greatly on how much of their routines they had changed and on the support they were receiving both socially and financially (Ma & Miller, 2020). This observation leads us to the second hierarchical linear regression that suggests that younger college students with higher academic stress were more likely to feel lonely. By maintaining a strong economic capital, students had the feeling of being supported in situations like these and were thus better protected from the vulnerability of feeling lonely.

Without a doubt, economic capital emerged as a very important risk factor for disturbance in the students’ mental health. Entities such as the government and the university must recognize how students belong to vulnerable populations. Thus, new measures regarding dealing with the pandemic should consider the mental health and needs of college students and aim at lessening the stress of this population to improve their mental health. Special emphasis should be put on socioeconomic aspects, with measures focusing on helping with financial aspects such as rent, public transport, student loan payments, etc., as well as enriching their social support opportunities.

A not-so-surprising finding of the present study is that the COVID-19 pandemic and governmental containment measures contributed to other behavioral life changes too, such as an increase of time spent at online courses and a decrease in time spent in physical presence in courses. Undoubtedly, the pandemic challenged higher-education institutions tremendously. Universities had to adapt promptly by shifting to online learning rather than physical learning, resulting in more hours of lectures, conferences, practical work, and seminars. Students also had to rapidly adapt, which raised many concerns and worries about their academic issues and their future careers in the workplace (Aristovnik et al., 2020). Another behavioral change observed in the present study is that students in Cyprus turned to moderate physical activities, which agrees with the results from the Greek study of this consortium reporting increasing physical activity among female students (Stathopoulou et al., 2020). However, these results differ from the findings on students in other regions such as the United States (Wilson et al., 2021). Also, contrary to our results, the French study, included in the same international consortium as the present study, reported a decrease in physical activity (Tavolacci et al., 2021). Therefore, it is important to investigate how students in different parts of the world respond differently to the same crisis.

The findings should be interpreted with caution because of several limitations. First, the cross-sectional nature of the study limits the ability to make causality claims. Should the research be repeated in the future, it would be better to collect longitudinal data. Second, while the survey asked students about their behaviors and emotions during the lockdown, the data collection took place a few weeks after the lockdown period. Because of the retrospective nature of the study, participants might have had difficulty accurately remembering their past attitudes and feelings or exhibited prior psychopathology that could not be accounted for in this study. Third, regarding the sample, we cannot overlook the possibility of a selection bias among the participants as well as the fact that the sample mainly consisted of young females, both of which can affect the generalizability of the results. However, the sample of this study was very close to the investigating population regarding pregraduate vs. postgraduate status, though there was an overrepresentation of first-year students. Fourth, recruitment through online surveying can also be a limitation for the data quality. Because participation was anonymous, we assume that participants completed the survey only once and with complete honesty. Moreover, we used self-report measures, which is a common survey study limitation. Fifth and last, while the selection of specific variables included in the models was based on the correlation analysis, variables that may have enabled additional insight into the outcomes of interest may have been excluded. It is also possible that the relationship between variables is bidirectional, the example being academic stress and depression. However, because the aim of the present study was to identify predictors for depression, we chose the present model. Further, longitudinal studies are needed to evaluate the possible long-standing effects of the COVID-19 pandemic on the mental health of university students.

The present study contributes to a growing body of research on the long-lasting psychological impacts of the COVID-19 pandemic on college students in Europe. The negative psychological effects on university students were previously reported during the height of the first wave and lockdown with its severe restrictions in movement (Solomou & Constantinidou, 2020). In the present study, we demonstrated that these effects continue with a different cohort of university students, once restrictions in movement were lifted and the epidemiological picture of Cyprus was optimal.

Conclusion

In a period of just a few months, the COVID-19 pandemic caused by a novel coronavirus radically transformed the lives of masses of people around the globe, including students of higher education. Participants in this study also expressed stress and depression associated with changes in educational mode during the pandemic. During the lockdown, students primarily raised concerns about their studies and were mainly bored, anxious, and frustrated. They also changed some of their behavioral activities. Our findings add to the existing literature and support the development of new measures to support students especially financially and psychologically. Institutions and policymakers can influence students’ well-being and are advised to implement measures focusing on the higher-education context that will aid students to more effectively deal with the pandemic situation and its aftereffects. Finally, these measures should focus especially on younger students who experience more academic stress.

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