{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T21:29:09Z","timestamp":1792445349424,"version":"4.5.0"},"reference-count":62,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:00:00Z","timestamp":1714003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Various psychological theories suggest that a supportive family environment protects the mental health of young adults during stressful life events. However, evidence is limited regarding the protective role of family support during a major public health crisis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the role of family functioning on mental health among Chinese college students during first stage of the COVID-19 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between January\u2013March 2020, 1,555 college students (44% female, on average 19\u2009years old) from five Chinese universities participated. Participants rated their family functioning on the Family APGAR Index and their mental health on the Psychological Questionnaires for Emergent Events of Public Health, measuring depression, neurasthenia, fear, obsessive-anxiety and hypochondriasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Better family functioning was associated with having fewer psychological symptoms. In addition, we identified three mental health profiles related to the severity across the psychological symptoms: Low-level, medium-level and high-level symptom clusters. Latent profile analysis showed that as family function improved, students were, respectively, 16 to 24% more likely to be in the low-level symptom group, compared to being in the medium symptom group or the high-level symptom group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These results support the notion that family support may act as a psychological buffer for young adults during a large-scale public health crisis like the COVID-19 pandemic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2024.1383399","type":"journal-article","created":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:43:26Z","timestamp":1714005806000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Chinese college students\u2019 mental health during the first three months of the COVID-19 pandemic: the protective role of family functioning"],"prefix":"10.3389","volume":"12","author":[{"given":"Zihao","family":"Zeng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Holtmaat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irma M.","family":"Verdonck-de Leeuw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sander L.","family":"Koole","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,4,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.1177\/1359105320937053","article-title":"Health behaviour changes during COVID-19 and the potential consequences: a mini-review","volume":"25","author":"Arora","year":"2020","journal-title":"J Health Psychol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1177\/0020764020915212","article-title":"The outbreak of COVID-19 coronavirus and its impact on global mental health","volume":"66","author":"Torales","year":"2020","journal-title":"Int J Soc Psychiatry"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1002\/pnp.666","article-title":"The COVID-19 pandemic and its impact on mental health","volume":"24","author":"Chakraborty","year":"2020","journal-title":"Prog Neurol Psychiatry"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1007\/s10826-022-02490-z","article-title":"Associations between work\u2013family balance, parenting stress, and marital conflicts during COVID-19 pandemic in Singapore","volume":"32","author":"Chung","year":"2023","journal-title":"J Child Fam Stud"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1177\/10783903211072222","article-title":"COVID-19 experiences and mental health among graduate and undergraduate nursing students in Los Angeles","volume":"30","author":"Jardon","year":"2024","journal-title":"J Am Psychiatr Nurses Assoc"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/02699931.2022.2027702","article-title":"Coping with COVID-19: insights from cognition and emotion research","volume":"36","author":"Koole","year":"2022","journal-title":"Cognit Emot"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"3222","DOI":"10.1017\/S0033291720005358","article-title":"Increases in depression and anxiety symptoms in adolescents and young adults during the COVID-19 pandemic","volume":"52","author":"Hawes","year":"2022","journal-title":"Psychol Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"113172","DOI":"10.1016\/j.psychres.2020.113172","article-title":"Factors associated with depression, anxiety, and PTSD symptomatology during the COVID-19 pandemic: clinical implications for US young adult mental health","volume":"290","author":"Liu","year":"2020","journal-title":"Psychiatry Res"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.annepidem.2018.10.002","article-title":"Oral contraceptive use and depression among adolescents","volume":"29","author":"McKetta","year":"2019","journal-title":"Ann Epidemiol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1037\/bul0000365","article-title":"Personality stability and change: a meta-analysis of longitudinal studies","volume":"148","author":"Bleidorn","year":"2022","journal-title":"Psychol Bull"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13034-020-00329-3","article-title":"Challenges and burden of the coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: a narrative review to highlight clinical and research needs in the acute phase and the long return to normality","volume":"14","author":"Fegert","year":"2020","journal-title":"Child Adolesc Psychiatry Ment Health"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1037\/amp0000707","article-title":"Mental health and clinical psychological science in the time of COVID-19: challenges, opportunities, and a call to action","volume":"76","author":"Gruber","year":"2021","journal-title":"Am Psychol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"103228","DOI":"10.1016\/j.nepr.2021.103228","article-title":"Prevalence of mental health problems and sleep disturbances in nursing students during the COVID-19 pandemic: a systematic review and meta-analysis","volume":"57","author":"Mulyadi","year":"2021","journal-title":"Nurse Educ Pract"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1037\/tra0000996","article-title":"COVID-19 disruption on college students: academic and socioemotional implications","volume":"13","author":"Tasso","year":"2021","journal-title":"Psychol Trauma Theory Res Pract Policy"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"171","DOI":"10.12122\/j.issn.1673-4254.2020.02.06","article-title":"Mental health status and its influencing factors among college students during the epidemic of COVID-19","volume":"40","author":"Chang","year":"2020","journal-title":"Nan Fang Yi Ke Da Xue Xue Bao"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1016\/j.jpain.2010.04.005","article-title":"Systematic review of family functioning in families of children and adolescents with chronic pain","volume":"11","author":"Lewandowski","year":"2010","journal-title":"J Pain"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1016\/j.cpr.2005.08.001","article-title":"Family issues in child anxiety: attachment, family functioning, parental rearing and beliefs","volume":"26","author":"B\u00f6gels","year":"2006","journal-title":"Clin Psychol Rev"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"57","DOI":"10.4324\/9781351153683-3","article-title":"The need to belong: desire for interpersonal attachments as a fundamental human motivation","volume":"3","author":"Baumeister","year":"2017","journal-title":"Interper Dev"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1016\/j.sbspro.2014.12.412","article-title":"The relationship between bullying, family functions, perceived social support among high school students","volume":"159","author":"E\u015fkisu","year":"2014","journal-title":"Procedia Soc Behav Sci"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1111\/ajsp.12393","article-title":"Seeking harmony in Chinese families: a dyadic analysis on Chinese parent\u2013child relations","volume":"23","author":"Cheung","year":"2020","journal-title":"Asian J Soc Psychol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1080\/00221329809596160","article-title":"A longitudinal study of Hong Kong adolescents' and parents' perceptions of family functioning and well-being","volume":"159","author":"Shek","year":"1998","journal-title":"J Genet Psychol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1186\/s12875-017-0630-4","article-title":"The effects of family structure and function on mental health during China\u2019s transition: a cross-sectional analysis","volume":"18","author":"Cheng","year":"2017","journal-title":"BMC Fam Pract"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.ejcnurse.2005.10.002","article-title":"Family functioning assessed by family members in Finnish families of heart patients","volume":"5","author":"Paavilainen","year":"2006","journal-title":"Eur J Cardiovasc Nurs"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1111\/1467-6427.00146","article-title":"Family assessment measure and process model of family functioning","volume":"22","author":"Skinner","year":"2000","journal-title":"J Fam Ther"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1278","DOI":"10.3390\/ijerph16071278","article-title":"Family functioning and psychological health of children with mentally ill parents","volume":"16","author":"Wiegand-Grefe","year":"2019","journal-title":"Int J Environ Res Public Health"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12889-021-12403-2","article-title":"Family aspects, physical fitness, and physical activity associated with mental-health indicators in adolescents","volume":"21","author":"Lema-G\u00f3mez","year":"2021","journal-title":"BMC Public Health"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"3151","DOI":"10.1177\/15248380221126182","article-title":"Family function and post-traumatic stress disorder in children and adolescents: a meta-analysis","volume":"24","author":"Ye","year":"2023","journal-title":"Trauma Violence Abuse"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11920-016-0691-4","article-title":"The role of parents, parenting and the family environment in children\u2019s post-disaster mental health","volume":"18","author":"Cobham","year":"2016","journal-title":"Curr Psychiatry Rep"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1080\/15374416.2022.2158838","article-title":"Resilience in the time of COVID-19: familial processes, coping, and mental health in Latinx adolescents","volume":"53","author":"Stein","year":"2024","journal-title":"J Clin Child Adolesc Psychol"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1080\/15374416.2024.2301775","article-title":"Mental health among Puerto Rican adolescents living in the United States during the COVID-19 pandemic","volume":"53","author":"Capielo Rosario","year":"2024","journal-title":"J Clin Child Adolesc Psychol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"703899","DOI":"10.3389\/fpubh.2021.703899","article-title":"Family cohesion and stress consequences among Chinese college students during COVID-19 pandemic: a moderated mediation model","volume":"9","author":"Zeng","year":"2021","journal-title":"Front Public Health"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"701945","DOI":"10.3389\/fpsyg.2021.701945","article-title":"The influence of family function on state anxiety of Chinese college students during the epidemic of COVID-19","volume":"12","author":"Yang","year":"2021","journal-title":"Front Psychol"},{"key":"ref33","first-page":"143","article-title":"Latent class analysis and latent profile analysis","volume-title":"Handbook of methodological approaches to community-based research: Qualitative, quantitative, and mixed methods","author":"Williams","year":"2016"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1136\/bmj.39339.610000.BE","article-title":"The declaration of Helsinki","volume":"335","author":"Goodyear","year":"2007","journal-title":"BMJ"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"221","DOI":"10.15585\/mmwr.mm6509a1","article-title":"Health care, family, and community factors associated with mental, behavioral, and developmental disorders in early childhood\u2014United States, 2011\u20132012","volume":"65","author":"Bitsko","year":"2016","journal-title":"Morb Mortal Wkly Rep"},{"key":"ref36","first-page":"267","article-title":"Handbook of behavioral medicine scale (CD-ROM version with book attached)","volume":"16","year":"2007","journal-title":"Chin Behav Med Sci"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"1353718","DOI":"10.3389\/fpsyt.2023.1353718","article-title":"Assessing and evaluating the psychosocial impact of the COVID-19 pandemic on anxiety and stress: perspectives from East Asia","volume":"14","author":"Zhou","year":"2024","journal-title":"Front Psych"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"645938","DOI":"10.3389\/fpsyt.2021.645938","article-title":"Mental health status of the elderly Chinese population during COVID-19: an online cross-sectional study","volume":"12","author":"Zhou","year":"2021","journal-title":"Front Psych"},{"key":"ref39","first-page":"1231","article-title":"The family APGAR: a proposal for a family function test and its use by physicians","volume":"6","author":"Smilkstein","year":"1978","journal-title":"J Fam Pract"},{"key":"ref40","volume-title":"Behavioral medicine scale manual","author":"Zhang","year":"2005"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1016\/j.jad.2023.01.110","article-title":"Intolerance of uncertainty and anxiety among college students during the re-emergence of COVID-19: mediation effects of cognitive emotion regulation and moderation effects of family function","volume":"327","author":"Huang","year":"2023","journal-title":"J Affect Disord"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1016\/j.jad.2020.11.109","article-title":"Mental health among college students during the COVID-19 pandemic in China: a 2-wave longitudinal survey","volume":"281","author":"Li","year":"2021","journal-title":"J Affect Disord"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1177\/0312896219871976","article-title":"Common method bias in applied settings: the dilemma of researching in organizations","volume":"45","author":"Jordan","year":"2020","journal-title":"Aust J Manag"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1080\/10705510709336735","article-title":"Performance of factor mixture models as a function of model size, covariate effects, and class-specific parameters","volume":"14","author":"Lubke","year":"2007","journal-title":"Struct Equ Model"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1080\/10705510701575396","article-title":"Deciding on the number of classes in latent class analysis and growth mixture modeling: a Monte Carlo simulation study","volume":"14","author":"Nylund","year":"2007","journal-title":"Struct Equ Model Multidiscip J"},{"key":"ref46","volume-title":"Growth modeling with latent variable using Mplus: advanced growth models, survival analysis and missing data","author":"Muth\u00e9n","year":"2010"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1186\/s12912-023-01563-8","article-title":"Insomnia and anxiety among COVID-19 patients in China: the chain mediating effect of psychological capital and self-esteem","volume":"23","author":"Du","year":"2024","journal-title":"BMC Nurs"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1164\/rccm.202305-0806OC","article-title":"Resilience and mental-health symptoms in ICU healthcare professionals facing repeated COVID-19 waves","volume":"209","author":"Azoulay","year":"2024","journal-title":"Am J Respir Crit Care Med"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1016\/j.jadohealth.2023.09.011","article-title":"Perceived epidemic impacts and mental symptom trajectories in adolescents Back to school after COVID-19 restriction: a longitudinal latent class analysis","volume":"74","author":"Rong","year":"2024","journal-title":"J Adolesc Health"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"e0297937","DOI":"10.1371\/journal.pone.0297937","article-title":"Self-care interventions to assist family physicians with mental health care of older patients during the COVID-19 pandemic: feasibility, acceptability, and outcomes of a pilot randomized controlled trial","volume":"19","author":"Yaffe","year":"2024","journal-title":"PLoS One"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"e0269802","DOI":"10.1371\/journal.pone.0269802","article-title":"Stigma towards mental illness and help-seeking behaviors among adult and child psychiatrists in Hungary: a cross-sectional study","volume":"17","author":"\u0150ri","year":"2022","journal-title":"PLoS One"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"e144533","DOI":"10.5812\/intjssh-144533","article-title":"The impact of aerobic exercise on athletic performance in recovered and uninfected COVID-19 athletes during post-COVID-19 period","volume":"6","author":"Ezdini","year":"2023","journal-title":"Int J Sport Stud Health"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1186\/s40798-023-00653-w","article-title":"Comparative study of the long-term impact of the COVID-19 pandemic on mental health and nutritional practices among international elite and sub-elite athletes: a sample of 1420 participants from 14 countries","volume":"9","author":"Taheri","year":"2023","journal-title":"Sports Med Open"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"38","DOI":"10.61838\/kman.hn.1.3.5","article-title":"Mind and body in sync: the fascinating field of psychophysiology in sports","volume":"1","author":"Navabinejad","year":"2023","journal-title":"Health Nexus"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"S55","DOI":"10.1037\/tra0000703","article-title":"Loneliness, isolation, and social support factors in post-COVID-19 mental health","volume":"12","author":"Saltzman","year":"2020","journal-title":"Psychol Trauma Theory Res Pract Policy"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/07448481.2022.2053689","article-title":"Fear of COVID-19, anxiety, and social support among college students","volume":"72","author":"Mauer","year":"2022","journal-title":"J Am Coll Heal"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1111\/famp.12089","article-title":"Taking it to the streets: family therapy and family-centered services","volume":"53","author":"Madsen","year":"2014","journal-title":"Fam Process"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"1680","DOI":"10.1002\/cam4.1393","article-title":"Impact of pediatric cancer on family relationships","volume":"7","author":"Erker","year":"2018","journal-title":"Cancer Med"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"1055819","DOI":"10.3389\/fpubh.2022.1055819","article-title":"The changes in family functioning and family happiness during the COVID-19 pandemic: the situation in Thailand","volume":"10","author":"Limsuwan","year":"2022","journal-title":"Front Public Health"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1111\/famp.12730","article-title":"Building long-term family resilience through universal prevention: 10-year parent and child outcomes during the covid-19 pandemic","volume":"61","author":"Feinberg","year":"2022","journal-title":"Fam Process"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1177\/02724316211036744","article-title":"COVID-19 life events spill-over on family functioning and adolescent adjustment","volume":"42","author":"Hussong","year":"2022","journal-title":"J Early Adolesc"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"1693","DOI":"10.1037\/dev0001206","article-title":"Shocks to the system: the influence of COVID-19\u2013related stressors on coparental and family functioning","volume":"57","author":"Peltz","year":"2021","journal-title":"Dev Psychol"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2024.1383399\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:44:47Z","timestamp":1714005887000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2024.1383399\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,25]]},"references-count":62,"alternative-id":["10.3389\/fpubh.2024.1383399"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2024.1383399","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,25]]},"article-number":"1383399"}}