{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T14:16:00Z","timestamp":1763388960334,"version":"3.45.0"},"reference-count":107,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T00:00:00Z","timestamp":1763164800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The COVID-19 pandemic was responsible for an unprecedented increase in psychological problems among post-secondary students worldwide. Drawing on data from a repeated cross-sectional (RCS) project, this study investigated changes in psychological symptoms, emotional regulation (cognitive reappraisal and emotional suppression), and academic, social, and personal\u2013emotional college adjustment, and associations between these variables among students in two countries during the phases of lockdown (2021), lifting of restrictions (2022), and the endemic phase (2023). University students in Canada (n = 1014) and Spain (n = 447) completed online surveys during these periods. Students in both countries reported significant declines in perceived COVID-19 stress across the pandemic phases. In comparison with pre-pandemic rates, elevated psychological symptoms remained constant. There were some country differences, but sex differences were consistent. Psychological symptoms mediated the association between cognitive reappraisal and the adjustment measures among Canadian students during each pandemic period. Alternatively, they mediated the linkages of maladaptive emotional suppression with academic, social, and personal\u2013emotional functioning of Spanish students at every phase, but only during the lifting of restrictions and the endemic phase for Canadian students. The results indicate the complexity of country and context in the role of emotional regulation during uncontrollable conditions and provide directions for intervention in stressful situations, including adjustment to university and future disastrous environmental events.<\/jats:p>","DOI":"10.3390\/ijerph22111731","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T14:04:07Z","timestamp":1763388247000},"page":"1731","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-Term Effects of the COVID-19 Pandemic: Emotional Regulation, Psychological Symptoms, and College Adjustment"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3216-7310","authenticated-orcid":false,"given":"Barbara M.","family":"Gfellner","sequence":"first","affiliation":[{"name":"Department of Psychology, Brandon University, Brandon, MB R7A 6A9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9855-1174","authenticated-orcid":false,"given":"Ana I.","family":"Cordoba","sequence":"additional","affiliation":[{"name":"Faculty of Psychology, University of Valencia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,15]]},"reference":[{"key":"ref_1","unstructured":"WHO (2021, January 10). WHO Director-General\u2019s Opening Remarks at the Media Briefing on COVID-19. Available online: https:\/\/www.who.int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1001\/jama.2020.9740","article-title":"Psychological distress and loneliness reported by US adults in 2018 and April 2020","volume":"324","author":"McGinty","year":"2020","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/S2215-0366(20)30308-4","article-title":"Mental health before and during the COVID-19 pandemic: A longitudinal probability sample survey of the UK population","volume":"7","author":"Pierce","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1027\/1016-9040\/a000465","article-title":"Mental health in times of the COVID-19 pandemic: Current knowledge and implications from a European perspective","volume":"26","author":"Wirkner","year":"2021","journal-title":"Eur. Psychol."},{"key":"ref_5","unstructured":"World Health Statistics (2020). World Health Statistics 2020: Monitoring Health for the SDGs, Sustainable Development Goals, World Health Organization. [1st ed.]."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2851","DOI":"10.1097\/JS9.0000000000000513","article-title":"The WHO declares COVID-19 is no longer a public health emergency of international concern: Benefits, challenges, and necessary precautions to come back to normal life","volume":"109","author":"Sarker","year":"2023","journal-title":"Int. J. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"4308","DOI":"10.4103\/jfmpc.jfmpc_313_24","article-title":"Post-Covid pandemic: The new normal and aftermath","volume":"13","author":"Selvam","year":"2024","journal-title":"J. Fam. Med. Prim. Health Care"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1002\/wps.20768","article-title":"Addressing mental health needs: An integral part of COVID-19 response","volume":"19","author":"Ghebreyesus","year":"2020","journal-title":"World Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S2215-0366(20)30168-1","article-title":"Multidisciplinary research priorities for the COVID-19 pandemic: A call for action for mental health service","volume":"7","author":"Holmes","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/s12992-020-00589-w","article-title":"Prevalence of stress, anxiety, depression among the general population during the COVID-pandemic: A systematic review and meta-analysis","volume":"16","author":"Salari","year":"2020","journal-title":"Glob. Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/S2215-0366(20)30240-6","article-title":"Addressing the public mental health challenge of COVID-19","volume":"7","author":"Campion","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1007\/s11469-021-00577-0","article-title":"The impact of COVID-19 stressors on mental health: Is COVID-10 a new type of Trauma type?","volume":"21","author":"Kira","year":"2023","journal-title":"Int. J. Ment. Health Addict."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Patel, V., Fancourt, D., Furukawa, T.A., and Kola, L. (2023). Reimagining the journey to recovery: The COVID-19 pandemic and global mental health. PLoS Med., 20.","DOI":"10.1371\/journal.pmed.1004224"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/S2215-0366(14)00080-7","article-title":"The new life stage of emerging adulthood at ages 18-29 years: Implications for mental health","volume":"1","author":"Arnett","year":"2014","journal-title":"Lancet Psychiatry"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1177\/17456916211029964","article-title":"Mental health during the first year of the COVID-19 pandemic: A review and recommendations for moving forward","volume":"17","author":"Aknin","year":"2022","journal-title":"Perspect. Psychol. Sci. A J. Assoc. Psychol. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"112977","DOI":"10.1016\/j.psychres.2020.112977","article-title":"Impact of Sars-Cov-2 and its reverberation in global higher education and mental health","volume":"288","author":"Araujo","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1002\/da.23109","article-title":"Exposure to COVID-19 pandemic stress: Associations with depression and anxiety in emerging adults in the United States","volume":"37","author":"Kujawa","year":"2020","journal-title":"Depress. Anxiety"},{"key":"ref_18","first-page":"14","article-title":"More than inconvenienced: The unique needs of U.S. college students during the COVID-19 pandemic","volume":"48","author":"Lederer","year":"2021","journal-title":"Health Educ. Behav. Off. Publ. Soc. Public Health Educ."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1476","DOI":"10.1177\/21676968231198908","article-title":"Perceived COVID-19 threat, psychological distress, and increases in alcohol and cannabis use at the onset of the pandemic in racially diverse emerging adults","volume":"11","author":"Marks","year":"2023","journal-title":"Emerg. Adulthood"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1037\/pspp0000459","article-title":"The impact of the early stages of the COVID-19 on mental health in the United States, Germany, and the United Kingdom","volume":"124","author":"Muller","year":"2023","journal-title":"J. Personal. Soc. Psychol."},{"key":"ref_21","doi-asserted-by":"crossref","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":"ref_22","doi-asserted-by":"crossref","unstructured":"Varma, P., Junge, M., Meaklim, H., and Jackson, M.L. (2021). Younger people are more vulnerable to stress, anxiety, and depression during COVID-19 pandemic: A global cross-sectional survey. Prog. Neuropharmacol. Biol. Psychiatry, 109.","DOI":"10.1016\/j.pnpbp.2020.110236"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1007\/s40596-015-0390-1","article-title":"College mental health: A vulnerable population in an environment with systematic deficiencies","volume":"39","author":"Balon","year":"2015","journal-title":"Acad. Psychiatry"},{"key":"ref_24","doi-asserted-by":"crossref","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":"ref_25","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1037\/hea0001259","article-title":"A global meta-analysis of depression, anxiety, and stress before and during COVID-19","volume":"42","author":"Daniali","year":"2023","journal-title":"Health Psychol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1177\/21676968211058516","article-title":"Changes in college student depression and anxiety from pre- to during- COVID-19: Perceived stress, academic challenges, loneliness, and positive perceptions","volume":"10","author":"Haikalis","year":"2022","journal-title":"Emerg. Adulthood"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1016\/j.jad.2020.09.018","article-title":"Longitudinal evaluation of the impact of the COVID-19 crisis in Spain","volume":"277","author":"Irurtia","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/j.jad.2021.09.098","article-title":"A systematic review and meta-analysis of longitudinal cohort studies comparing mental health before versus during the COVID-19 pandemic","volume":"296","author":"Robinson","year":"2022","journal-title":"J. Affect. Disord."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e074224","DOI":"10.1136\/bmj-2022-074224","article-title":"Comparison pf mental health symptoms before and during the acute phase of the COVID pandemic: Evidence from a systematic review and meta-analysis of 134 cohorts","volume":"8","author":"Sun","year":"2023","journal-title":"BMJ"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1111\/jora.12781","article-title":"Longitudinal change in adolescent depression and anxiety symptoms from before to during the COVID-19 pandemic: An international collaborative of 12 samples","volume":"33","author":"Barendse","year":"2023","journal-title":"J. Res. Adolesc."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.jad.2022.05.025","article-title":"Psychological distress associated with the second COVID-10 wave: Prospective evidence from the UK Household Longitudinal Study","volume":"310","author":"Daly","year":"2022","journal-title":"J. Affect. Disord."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1177\/21676968231185171","article-title":"How psychological symptoms mediate perceived COVID-19 stress with identity distress in emerging adults","volume":"11","author":"Gfellner","year":"2023","journal-title":"Emerg. Adulthood"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Cavicchioli, M., Ferrucci, R., Guidetti, M., Canevini, M.P., Prevettoni, G., and Galli, F. (2021). What will be the impact of the COVID-19 quarantine on psychological distress? Considerations based on a systematic review of pandemic outbreaks. Healthcare, 9.","DOI":"10.3390\/healthcare9010101"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1080\/07448481.2021.1942009","article-title":"Association between COVID-19-related loneliness or worry and symptoms of anxiety and depression among first-year college students","volume":"71","author":"Mehus","year":"2023","journal-title":"J. Am. Coll. Health"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1016\/j.jadohealth.2020.10.030","article-title":"Constant stress has become the new normal: Stress and anxiety inequalities among U.S. college students in the time of COVID-19","volume":"68","author":"Hoyt","year":"2021","journal-title":"J. Adolesc. Health"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2955","DOI":"10.1017\/S0033291716001665","article-title":"Mental disorders among college students in the World Health Organization World Mental Health Surveys","volume":"46","author":"Auerbach","year":"2016","journal-title":"Psychol. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1037\/abn0000362","article-title":"WHO World Mental Health Surveys International College Student Project: Prevalence and distribution of mental disorders","volume":"127","author":"Auerbach","year":"2018","journal-title":"J. Abnorm. Psychol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"277","DOI":"10.24095\/hpcdp.45.6.02","article-title":"Sex specific estimates of positive mental health among youth before and during the COVID-19 pandemic in Canada","volume":"45","author":"Ooi","year":"2025","journal-title":"Health Promot. Chronic Dis. Prev. Can."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1186\/s13690-023-01211-2","article-title":"An international comparison of gender differences in mental health among higher education students duringthe first wave of the COVID-19 pandemic: A multilevel design","volume":"81","author":"Jacobs","year":"2023","journal-title":"Arch. Public Health"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1037\/amp0001237","article-title":"Emotion regulation strategies and psychological health across cultures","volume":"79","author":"Tamir","year":"2024","journal-title":"Am. Psychol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.copsyc.2014.12.004","article-title":"Culture and emotion regulation","volume":"3","author":"Ford","year":"2015","journal-title":"Curr. Opin. Psychol."},{"key":"ref_42","first-page":"201","article-title":"Differences in psychological distress, resilience, and cognitive emotional regulation strategies in adults during the Coronavirus pandemic: A cross-cultural study of Poland and Spain","volume":"38","author":"Palomera","year":"2022","journal-title":"Ann. Psychol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Rothenberg, W.A., Landsford, J.E., Skinner, A.T., Chang, L., Deater-Deckard, K., Di Giunta, L., Dodge, K.A., Gurdal, S., Junla, D., and Liu, Q. (2024). Investigating longitudinal trajectories of COVID-19 disruption: Methodological challenges and recommendations. Prev. Sci.","DOI":"10.1007\/s11121-024-01726-2"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1037\/0022-3514.85.2.348","article-title":"Individual differences in two emotional regulation processes: Implications for affect, relationships, and well-being","volume":"85","author":"Gross","year":"2003","journal-title":"J. Personal. Soc. Psychol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1146\/annurev-clinpsy-032511-143109","article-title":"Emotion regulation and psychopathology: The role of gender","volume":"8","year":"2012","journal-title":"Annu. Rev. Clin. Psychol."},{"key":"ref_46","unstructured":"Gross, J.J., and Ford, B. (2024). Handbook of Emotion Regulation, Guilford Press. [3rd ed.]."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1111\/j.1469-8986.2011.01191.x","article-title":"The temporal dynamics of two response-focused forms of emotion regulation: Experiential, expressive, and autonomic consequences","volume":"48","author":"Gross","year":"2011","journal-title":"Psychophysiology"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.cpr.2009.11.004","article-title":"Emotion regulation strategies across psychopathology: A meta-analytic review","volume":"30","author":"Aldao","year":"2010","journal-title":"Clin. Psychol. Rev."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1037\/bul0000110","article-title":"Coping, emotion regulation, and psychopathology in childhood and adolescence: A meta-analysis and narrative review","volume":"143","author":"Compass","year":"2017","journal-title":"Psychol. Bull."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.cpr.2018.07.004","article-title":"Emotional regulation in social anxiety and depression: A systematic review of expressive suppression and cognitive reappraisal","volume":"65","author":"Dryman","year":"2018","journal-title":"Clin. Psychol. Rev."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"341","DOI":"10.2466\/03.20.PR0.114k22w4","article-title":"Relation between emotion regulation and mental health: A meta-analysis review","volume":"114","author":"Hu","year":"2014","journal-title":"Psychol. Rep."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Keskiner, E.S., Sahin, E., Topkaya, N., and Yigit, Z. (2024). Behavioral emotion regulation strategies and symptoms of psychological distress among Turkish university students. Behav. Sci., 15.","DOI":"10.3390\/bs15010006"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1038\/s44159-022-00040-4","article-title":"The role of emotion regulation in the characterization, development, and treatment of psychopathology","volume":"1","author":"Lincoln","year":"2022","journal-title":"Nat. Rev. Psychol."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Castillo-Gualda, R., and Ramos-Cejudo, J. (2025). Beyond Individual Differences in Affective Symptomatology: The Distinct Contributions of Emotional Competence and Rumination in a Nationally Representative Sample. Behav. Sci., 15.","DOI":"10.3390\/bs15030318"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Germani, A., Buratta l Delvecchio, E., and Mazzeschi, C. (2020). Emerging adults and COVID-19: The role of individualism-collectivism on perceived risks and psychological mechanisms. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17103497"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Krifa, I., van Zyl, L.E., Braham, A., Ben Nasar, S., and Shankland, R. (2022). Mental health during the COVID-19 pandemic: The role of optimism and emotional regulation. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19031413"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"19","DOI":"10.17241\/smr.2023.01963","article-title":"Psychological distress during COVID-19: Its association with stress, emotion regulation, and sleep","volume":"15","author":"Amaral","year":"2024","journal-title":"Sleep Med. Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e3274","DOI":"10.1002\/smi.3274","article-title":"Emotion regulation styles and adolescent adjustment following a COVID-19 lockdown","volume":"40","author":"Scharf","year":"2024","journal-title":"Stress Health"},{"key":"ref_59","first-page":"41","article-title":"Correlation between emotion regulation and mental well-being among university students during COVID-19","volume":"36","author":"Shah","year":"2022","journal-title":"J. Psikol. Malays."},{"key":"ref_60","first-page":"14823","article-title":"Psychological distress among university students: The role of mindfulness, decentering, reappraisal, and emotional regulation","volume":"42","year":"2022","journal-title":"Curr. Psychol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"20211","DOI":"10.1007\/s12144-021-02623-5","article-title":"Emotion regulation in times of COVID-19: A person-centered approach based on self-determination theory","volume":"42","author":"Waterschoot","year":"2023","journal-title":"Curr. Psychol."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Xiao, M., Wang, Y., Zhuang, Y., Yier, L., Liu, L., Lin, Y., Gao, D., and Xu, J. (2025). Emotion regulation strategies and mental wellbeing among Chinese college students during COVID-19: The moderating roles of confinement and attentional bias. Front. Psychol., 16.","DOI":"10.3389\/fpsyg.2025.1571275"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.adolescence.2020.09.009","article-title":"Development of emotional regulation across the first two years of college","volume":"84","author":"Park","year":"2020","journal-title":"J. Adolesc."},{"key":"ref_64","first-page":"259","article-title":"Italian university students\u2019 resilienceduring COVID-19 lockdown\u2014A structural equation model about the relationship between resilience, emtion regulation, and well-being","volume":"13","author":"Renati","year":"2023","journal-title":"Eur. J. Investig. Health Psychol. Educ."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Skinner, A.T., Ciftci, L., Jones, S., Klotz, E., Ondruskova, T., Langford, J.E., Alampay, L.P., Al-Hassan, S.M., Bacchini, D., and Bornstein, M.H. (2022). Adolescent positivity and future orientation, parental psychological control, and young adult internalizing behaviours in nine countries. Soc. Sci., 11.","DOI":"10.3390\/socsci11020075"},{"key":"ref_66","unstructured":"Hofstede, G. (2021, March 15). Country Comparisons Graph. Available online: https:\/\/geerthofstede.com\/country-comparison-graphs\/."},{"key":"ref_67","first-page":"411","article-title":"Is emotional suppression always bad? A matter of flexibility and gender differences","volume":"38","author":"Rogier","year":"2019","journal-title":"Curr. Psychol. A J. Divers. Perspect. Divers. Psychol. Issues"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1177\/0022022116673910","article-title":"Differences in empathetic concern and perspective taking in 63 countries","volume":"48","author":"Chopik","year":"2017","journal-title":"J. Cross Cult. Psychol."},{"key":"ref_69","unstructured":"Damon, W., Lerner, R.M., and Lerner, R.M. (2006). The bioecological model of human development. Handbook of Child Psychology: Vol. 1. Theoretical Models of Human Development, Wiley."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1080\/15283488.2016.1268961","article-title":"Identity problems, ego strengths, perceived stress, and adjustment during contextual changes at university","volume":"17","author":"Gfellner","year":"2017","journal-title":"Identity"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1111\/sjop.12625","article-title":"The interface of identity distress and psychological problems in students adjustment to university","volume":"61","author":"Gfellner","year":"2020","journal-title":"Scand. J. Psychol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1080\/15283488.2020.1810044","article-title":"A closer look at economic context in identity distress, identity development, and adjustment to university","volume":"20","author":"Gfellner","year":"2020","journal-title":"Identity"},{"key":"ref_73","unstructured":"Hofstede, G., Hofstede, G.J., and Minkov, M. (2010). Cultures and Organizations: Software of the Mind, McGraw-Hill. [3rd ed.]."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1111\/1467-6494.696169","article-title":"Individualism-collectivism and personality","volume":"69","author":"Triandis","year":"2001","journal-title":"J. Personal."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1177\/0956797616642596","article-title":"Fear of ebola: The influence of collectivism on xenophobic threat responses","volume":"27","author":"Kim","year":"2016","journal-title":"Psychol. Sci."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Xiao, W.S. (2021). The Role of Collectivism\u2013Individualism in attitudes toward compliance and psychological responses during the COVID-19 pandemic. Front. Psychol., 12.","DOI":"10.3389\/fpsyg.2021.600826"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/s10648-011-9184-5","article-title":"Adjustment to college as measured by the Student Adaptation to College Questionnaire: A quantitative review of its structure and relationships with correlates and consequences","volume":"24","author":"Niehorster","year":"2012","journal-title":"Educ. Psychol. Rev."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Preece, D.A., Ditzer, J., and Gross, J.J. (2025). Emotion Regulation. Oxf. Res. Encycl. Psychol.","DOI":"10.1093\/acrefore\/9780190236557.013.923"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1027\/1015-5759\/a000150","article-title":"A Spanish adaptation of the Emotion Regulation Questionnaire","volume":"29","author":"Cabello","year":"2013","journal-title":"Eur. J. Psychol. Assess."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1037\/a0021282","article-title":"Development of the Counseling Center Assessment of Psychological Symptoms-62 (CCAPS-62)","volume":"58","author":"Locke","year":"2011","journal-title":"J. Couns. Psychol."},{"key":"ref_81","first-page":"151","article-title":"Development and initial validation of the Counseling Centre Assessment of Psychological Symptoms-34 (CCAPS-34)","volume":"45","author":"Locke","year":"2012","journal-title":"J. Couns. Psychol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1037\/pst0000029","article-title":"The Counseling Center Assessment of Psychological Symptoms (CCAPS): Merging Clinical Practice, Training, and Research","volume":"52","author":"Youn","year":"2015","journal-title":"Psychotherapy"},{"key":"ref_83","unstructured":"Center for Collegiate Mental Health (CCMH) (2015). CCAPS User Manual, CCMH."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1037\/a0029855","article-title":"Clinical validity of the Counseling Center Assessment of Psychological Symptoms-62 (CCAPS-62): Further evaluation and clinical applications","volume":"59","author":"McAleavey","year":"2012","journal-title":"J. Couns. Psychol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1080\/07481756.2020.1843971","article-title":"Psychometric analysis of CCAPS-34 scores with a large university sample","volume":"54","author":"Sherman","year":"2020","journal-title":"Meas. Eval. Couns. Dev."},{"key":"ref_86","unstructured":"Baker, R., and Siryk, B. (1999). Student Adjustment to College Manual, Western Psychological Services."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1080\/15283488.2011.540740","article-title":"Identity Distress, Psychosocial Maturity and Adaptive Functioning among University Students","volume":"11","author":"Gfellner","year":"2011","journal-title":"Identity"},{"key":"ref_88","first-page":"624","article-title":"The Student Adaptation to College Questionnaire (SACQ) for use with Spanish Students","volume":"11","author":"Tinajero","year":"2012","journal-title":"Psychol. Rep."},{"key":"ref_89","unstructured":"Hayes, A.F. (2018). Introduction to Mediation, Moderation, and Conditional Process Analysis, The Guilford Press. [2nd ed.]."},{"key":"ref_90","first-page":"2583","article-title":"The Evolution of Psychological Distress Levels in University Students in Spain during Different Stages of the COVID-19 Pandemic: Risk and Protective Factors","volume":"13","author":"Matud","year":"2023","journal-title":"Eur. J. Investig. Health Psychol. Educ."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"e32","DOI":"10.1192\/j.eurpsy.2020.35","article-title":"The consequences of the COVID 19 pandemic on mental health and implications for clinical practice","volume":"63","author":"Fiorillo","year":"2020","journal-title":"Eur. Psychiatry J. Assoc. Eur. Psychiatr."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/S2215-0366(22)00152-3","article-title":"Pathways to depressive and anxiety disorders during and after the COVID-19 pandemic","volume":"9","author":"Lokman","year":"2022","journal-title":"Lancet Psychiatry"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1016\/j.jad.2020.04.050","article-title":"VMental disorders in Spanish university students: Prevalence, age-of-onset, severe role impairment, and mental health treatment","volume":"273","author":"Ballester","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1679","DOI":"10.1007\/s10964-022-01648-8","article-title":"Living with COVID-19: Subjective well-being in the second phase of the pandemic","volume":"51","author":"Henseke","year":"2022","journal-title":"J. Youth Adolesc."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1007\/s10964-022-01573-w","article-title":"Young adult adaptability to the social challenges of the COVID 19 pandemic: The protective role of friendships","volume":"51","author":"Juvonen","year":"2022","journal-title":"J. Youth Adolesc."},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Fruehwirth, J.C., Biswas, S., and Perriera, K.M. (2021). The COVID-19 pandemic and mental health of first-year college students: Examining the effect of COVID-19 stressors using longitudinal data. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0247999"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1016\/j.jad.2021.12.086","article-title":"Longitudinal trajectories of depression and anxiety among adolescents during COVID-19 lockdown in China","volume":"299","author":"Wang","year":"2022","journal-title":"J. Affect. Disord."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1038\/s44220-024-00290-6","article-title":"Depressive symptoms and sex differences in the risk of post-COVID-19 persistent symptoms: A prospective population-based cohort study","volume":"2","author":"Matta","year":"2024","journal-title":"Nat. Ment. Health"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1037\/1528-3542.7.1.30","article-title":"Emotion regulation and culture: Are social consequences of emotion suppression culture-specific?","volume":"7","author":"Butler","year":"2007","journal-title":"Emotion"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1037\/a0023340","article-title":"Is expressive suppression always associated with por psychological functioning? A cross-cultural comparison between European Americans and Hong Kong Chinese","volume":"11","author":"Soto","year":"2011","journal-title":"Emotion"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"e12373","DOI":"10.1111\/spc3.12373","article-title":"Culture, emotion suppression and disclosure, and health","volume":"12","author":"Tsai","year":"2018","journal-title":"Soc. Personal. Psychol. Compass"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1080\/02699931.2021.1997924","article-title":"Regulation of positive and negative emotions across cultures: Does culture moderate associations between emotional regulation and mental health?","volume":"36","author":"Schunk","year":"2022","journal-title":"Cogn. Emot."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1177\/0146167218796793","article-title":"Lonely alone and lonely together? A cultural psychological examination of individualism-collectivism and loneliness in five European countries","volume":"45","author":"Heu","year":"2019","journal-title":"Personal. Soc. Psychol. Bull."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.euroneuro.2021.10.864","article-title":"The impact of the prolonged COVID-19 pandemic on stress resilience and mental health: A critical review across waves","volume":"55","author":"Manchia","year":"2022","journal-title":"Eur. Neuropsychopharmacol."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1037\/pas0001048","article-title":"Comparing responses in repeated cross-sectional and panel studies: Results across eight weeks during the first COVID-19 lockdown in Denmark","volume":"13","author":"Zetter","year":"2021","journal-title":"Psychol. Assess."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1037\/amp0000958","article-title":"Psychopathology and resilience following strict COVID-19 lockdowns in Hubei, China: Examining person- and context-level predictors for longitudinal trajectories","volume":"77","author":"Chen","year":"2022","journal-title":"Am. Psychol."},{"key":"ref_107","doi-asserted-by":"crossref","unstructured":"Salkind, J. (2010). Encyclopedia of Research Design, Sage.","DOI":"10.4135\/9781412961288"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/11\/1731\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T14:07:35Z","timestamp":1763388455000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/11\/1731"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,15]]},"references-count":107,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["ijerph22111731"],"URL":"https:\/\/doi.org\/10.3390\/ijerph22111731","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2025,11,15]]}}}