U.S. undergraduate college students who attended online-only classes during the COVID-19 pandemic experienced higher levels of psychological distress than those who took a mix of online and in-person classes, according to a report published today in JAMA Network Open.
“Although online classes may be simpler logistically and may minimize the risk of COVID-19 transmission, they also may increase the risk of negative mental health sequelae that should not be ignored,” wrote Abdelrahman ElTohamy, M.D., of Brigham and Women’s Hospital in Boston and colleagues. “These results are particularly relevant to mental health professionals within educational settings. Knowing that a student is attending classes fully online may provide insight that informs therapeutic approaches and suggestions for recovery.”
The researchers analyzed data from the 2021 American College Health Association–National College Health Assessment III, a biannual survey administered to students in higher educational institutions across the United States. The spring 2021 survey, administered from January to early June 2021, was entirely web-based and included demographic data, psychometric scales, and COVID-19–related questions.
As part of the survey, students were asked about the way they were participating in courses that term (response options were as follows: “entirely in-person,” “entirely online,” or “a mix of in-person and online classes”). The students also completed the Kessler Screening Scale for Psychological Distress, which asked them to report how often over the past 30 days they felt “nervous,” “hopeless,” “restless or fidgety,” “so sad nothing could cheer you up,” “that everything was an effort,” and “worthless.”
Of the 59,250 participants in the study sample, 3.5% attended fully in-person classes, 61.2% attended fully online classes, and 35.3% attended a mixed format of in-person and online classes. Compared with the students attending mixed-format classes, those who attended fully online classes were more likely to report psychological distress. This association remained significant regardless of geographic region, year in school, gender, race and ethnicity, food security, current anxiety and/or depressive disorders, COVID-19 concerns, whether students were living on or off campus, and time spent socializing with friends.
“Socializing with friends was likely more challenging for those who attended classes only online, as such engagement requires greater intentionality and effort,” the researchers wrote. “In contrast, a mixed format still afforded at least some in-person experiences that students were accustomed to, with informal opportunities for social interaction.”
For related information, see the Psychiatric News article “College Students Struggle Amid Pandemic’s Uncertainty.”
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