Zhao SX, Han T, Bi WZ, Fei LL, Han LL, Wang YL, Ping ZG, Wang CJ, Hao CF, Xin YJ. Emotion regulation habits and emotional states of college students during lockdown: A cross-sectional survey. World J Psychiatry 2026; 16(1): 111778 [DOI: 10.5498/wjp.v16.i1.111778]
Corresponding Author of This Article
Yong-Juan Xin, PhD, Assistant Professor, Department of Child and Adolescent Health, School of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou 450001, Henan Province, China. yjxin@zzu.edu.cn
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Psychology
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Observational Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 19, 2026 (publication date) through Dec 31, 2025
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World Journal of Psychiatry
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Zhao SX, Han T, Bi WZ, Fei LL, Han LL, Wang YL, Ping ZG, Wang CJ, Hao CF, Xin YJ. Emotion regulation habits and emotional states of college students during lockdown: A cross-sectional survey. World J Psychiatry 2026; 16(1): 111778 [DOI: 10.5498/wjp.v16.i1.111778]
Shu-Xin Zhao, Tao Han, Wei-Zhi Bi, Le-Le Fei, Lu-Luan Han, Yu-Lin Wang, Chang-Fu Hao, Yong-Juan Xin, Department of Child and Adolescent Health, School of Public Health, Zhengzhou University, Zhengzhou 450001, Henan Province, China
Yu-Lin Wang, Department of Gynaecology, The Second People’s Hospital of Yibin, Yibin 644000, Sichuan Province, China
Zhi-Guang Ping, Chong-Jian Wang, Department of Epidemiology and Biostatistics, Zhengzhou University, Zhengzhou 450001, Henan Province, China
Author contributions: Zhao SX was responsible for formal analysis, methodology; Han T handled data curation, investigation; Zhao SX and Han T wrote the original draft, they contributed equally to this article, they are the co-first authors of this manuscript; Bi WZ, Fei LL, Han LL, and Wang YL participated in writing the draft; Ping ZG, Wang CJ, and Hao CF took charge of supervision, methodology; Xin YJ was in charge of conceptualization, project administration, supervision; Ping ZG, Wang CJ, Hao CF, and Xin YJ wrote, reviewed, and edited; and all authors thoroughly reviewed and endorsed the final manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Zhengzhou University Life Science Ethics, approval No. ZZUIRB2024-216.
Informed consent statement: All study participants, or their legal guardian, provided informed online consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: All data generated or used during the study are shown to be available through the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong-Juan Xin, PhD, Assistant Professor, Department of Child and Adolescent Health, School of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou 450001, Henan Province, China. yjxin@zzu.edu.cn
Received: July 10, 2025 Revised: July 30, 2025 Accepted: October 15, 2025 Published online: January 19, 2026 Processing time: 174 Days and 21.7 Hours
Abstract
BACKGROUND
The prevalence of negative emotional states, such as anxiety and depression, has increased annually. Although personal habits are known to influence emotional regulation, the precise mechanisms underlying this relationship remain unclear.
AIM
To investigate emotion regulation habits impact on students negative emotions during lockdown, using the coronavirus disease 2019 pandemic as a case example.
METHODS
During the coronavirus disease 2019 lockdown, an online cross-sectional survey was conducted at a Chinese university. Emotional states were assessed using the Depression, Anxiety, and Stress Scale-21 (DASS-21), while demographic data and emotion regulation habits were collected concurrently. Data analysis was performed using SPSS version 27.0 and included χ2-tests for intergroup comparisons, Spearman’s rank-order correlation coefficient analysis to examine associations, and stepwise linear regression modeling to explore the relationships between emotion regulation habits and emotional states. Statistical significance was set at α = 0.05.
RESULTS
Among the 494 valid questionnaires analyzed, the prevalence rates of negative emotional states were as follows: Depression (65.0%), anxiety (69.4%), and stress (50.8%). DASS-21 scores (mean ± SD) demonstrated significant symptomatology: Total (48.77 ± 34.88), depression (16.21 ± 12.18), anxiety (14.90 ± 11.91), and stress (17.64 ± 12.07). Significant positive intercorrelations were observed among all DASS-21 subscales (P < 0.01). Regression analysis identified key predictors of negative emotions (P < 0.05): Risk factors included late-night frequency and academic pressure, while protective factors were the frequency of parental contact and the number of same-gender friends. Additionally, compensatory spending and binge eating positively predicted all negative emotion scores (β > 0, P < 0.01), whereas appropriate recreational activities negatively predicted these scores (β < 0, P < 0.01).
CONCLUSION
High negative emotion prevalence occurred among confined students. Recreational activities were protective, while compensatory spending and binge eating were risk factors, necessitating guided emotion regulation.
Core Tip: Mental health issues are increasingly prevalent among college students. Negative emotions, such as depression, anxiety, and stress, can significantly impact this population, especially in closed environments. A clear example was seen during coronavirus disease 2019 lockdowns, when prolonged isolation at home or on campus led to information blockage, disrupted education, and social isolation. To investigate the impact of lockdowns on college students’ mental health, we conducted an online survey at a Chinese university using the Depression, Anxiety, and Stress Scale-21. We found a high prevalence of negative emotions among confined students. Recreational activities helped mitigate distress, while compensatory spending and binge eating worsened mental health. In all, Proactive measures should be implemented to guide healthy emotion regulation habits among college students, particularly in high-stress environments.
Citation: Zhao SX, Han T, Bi WZ, Fei LL, Han LL, Wang YL, Ping ZG, Wang CJ, Hao CF, Xin YJ. Emotion regulation habits and emotional states of college students during lockdown: A cross-sectional survey. World J Psychiatry 2026; 16(1): 111778
The incidence of mental health disorders continues to rise, with depression and anxiety being among the most prevalent conditions. According to the World Health Organization in 2022, depression affects approximately 280 million people worldwide, with a prevalence of 3.8%, and is projected to rise to the top of the global burden of disease by 2030, constituting a significant public health burden[1]. The 2019 China Mental Health Survey reported a depression prevalence of 2.1% and an anxiety disorder prevalence of 4.98%, totaling approximately 7.0%[2]. Additionally, the co-occurrence of anxiety and depression is particularly common among specific groups, such as college students. A cross-sectional survey of 1074 students from Spanish universities indicated that 22.5% experienced two co-morbid psychological disorders, while 9.7% reported simultaneous symptoms of depression, anxiety, and stress[3]. Similarly, research involving 8500 college students from Shanghai, Hubei Province, and Jiangxi Province, China, found a co-prevalence rate of 23.15% for anxiety and depression[4].
Negative emotions, including depression, anxiety, and stress, represent a class of distressing psychological experiences with a particularly significant impact on the college population[5]. These emotional states not only reduce learning efficiency but also hinder the development of mental health and social functioning, especially among students prone to internal friction[6] or experiencing intense academic pressure[7]. Stress is a key trigger of negative emotional responses and can severely disrupt mood, attention, and behavioral regulation[8]. Prolonged exposure to elevated stress levels may result in irritability, low mood, anxiety, or depression. Anxiety and depression are characterized by excessive worry, nervousness, irritability, low mood, loss of interest, fatigue, and impaired concentration. These symptoms may lead to multiple developmental challenges, including interpersonal alienation due to social anxiety, endocrine disruptions related to sleep disorders, diminished self-worth stemming from low self-esteem, and a heightened risk of extreme behaviors associated with worsening depressive tendencies[9]. In severe cases, anxiety and depression can contribute to physical illnesses such as hypertension and cardiovascular disease[10]. Prolonged exposure to negative emotional states may alter brain structure and function[11], contributing to cognitive decline, including reduced concentration, memory impairment, and weakened decision-making abilities, as well as adverse physical health outcomes, such as cardiovascular disease and disruptions to normal endocrine function. These conditions can disrupt daily functioning, evidenced by impaired social interaction, increased loneliness, and reduced self-efficacy, particularly during lockdown.
Negative emotions may arise from a variety of factors. Genetically, abnormalities in specific genes account for approximately 40%-50% of the risk for depression, making it a significant contributor to its onset[12]. A family history of depression or other mental disorders can influence brain structure and function, affecting physiological processes such as neurotransmitter regulation and neural development. These alterations may increase sensitivity to negative emotions and notably elevate the risk of developing depression. Within the social environment, social support and sociocultural factors play critical roles. The family is a crucial social support system; family conflicts and disputes can lead to emotional problems. Additionally, social discrimination, such as racial and gender-based discrimination, can exert harmful effects on emotional well-being. Personal lifestyle also exerts an influence on mental health. Unhealthy eating habits, such as high-sugar dietary patterns, can lead to blood sugar fluctuations, emotional instability, and disruptions in insulin signaling. Physical inactivity reduces endorphin secretion, increases levels of stress hormones such as cortisol, and limits opportunities for social interaction. Sleep disturbance, including insomnia, may disrupt circadian rhythms, heighten stress responses, and lead to insufficient blood supply to the brain, leading to irritability and fatigue. Excessive use of electronic devices can contribute to social isolation, information overload, and negative self-comparison, ultimately resulting in diminished self-esteem and low mood. Changes in the external living environment also influence mental health[13]. Specific situations that may trigger the onset of mood disorders include high-pressure work environments, workplace interpersonal conflicts, family changes, social fears, social rejections, and lockdown conditions such as coronavirus disease 2019 (COVID-19). All of these can impose significant psychological stress on the individual.
Lockdown environments typically refer to settings characterized by spatial isolation and limited communication with the outside world, such as prolonged home confinement or restricted access to workplaces and educational institutions[14]. These environments are characterized by confined physical spaces, reduced social interaction, and limited information flow, which may, over time, lead to loneliness, anxiety, and other negative emotional states in individuals[15]. They can also trigger cognitive decline and interpersonal alienation. During the COVID-19 lockdown, college students experienced extended periods of isolation at home or on campus, facing challenges such as limited contact with friends and family, a drastic reduction in opportunities for social interaction, and strain on family relationships. Additionally, during this period, students may encounter information barriers, educational disruptions, and social isolation. In some regions, they also face economic pressures and limited access to medical resources, all of which may act as triggers for stress, anxiety, and depression[16,17].
Personal habits refer to behavioral patterns in daily life that considerably impact an individual’s health and well-being. These habits include lifestyle routines, dietary behaviors, and exercise practices. Studies have identified several personal habits that influence mental health, such as protective factors: Physical exercise, regular social rhythms, and high frequency of mental activities[18]; risk factors: Unhealthy dietary habits[19], less social support, negative coping strategies[20]. Furthermore, inequalities and differences in social determinants of health, including income level, social status, occupational environment, parental education, and access to healthcare, can further contribute to the development of psychological distress among college students during lockdowns, such as the COVID-19 pandemic[21]. Although personal habits are known to influence emotional regulation, the precise mechanisms underlying this relationship remain unclear.
The primary objective of this study is to examine the relationship between emotion regulation habits and the prevalence of negative emotions among university students during lockdowns. The COVID-19 pandemic presents a distinct and relevant context for this investigation, as students encountered unprecedented challenges, including social isolation, routine disruption, and heightened uncertainty, all of which significantly affected their mental health. This study explores how various emotion regulation strategies adopted by students during such periods influenced their experiences of negative emotions, including depression, anxiety, and stress. By analyzing specific habits and coping mechanisms used by students, this study aims to identify which strategies were most effective in mitigating psychological distress and which may have contributed to its intensification. The findings may offer valuable insights for developing targeted interventions to support the mental well-being of university students in future crisis scenarios.
MATERIALS AND METHODS
Participants
A cross-sectional study was conducted among university students in Zhengzhou, Henan Province, China, using a convenience sampling method. In October 2022, 532 online questionnaires were distributed, and 494 valid responses were collected, yielding an effective response rate of 92.86%. The sample included 205 male and 289 female students. For academic year, 67 students were in grade 22, 101 in grade 21, 275 in grade 20, and 51 in grade 19. Regarding academic disciplines, 84 were from science, 148 from the humanities, 150 from engineering, and 112 from medicine. Informed consent was obtained from all participants.
Measures
Basic information: A self-administered demographic questionnaire was used to collect basic participant information, including gender, academic grade, home address, household composition, family economic status, and academic major. It also gathered data on the weekly frequency of late-night sleeping and contact with parents, levels of academic stress, number of friends, and emotion regulation habits.
Depression Anxiety Stress Scale-21 Items: Depression, Anxiety, and Stress Scale-21 (DASS-21) was developed by Lovibond[22] and adapted into Chinese by Gong et al[23] was employed to assess participants’ levels of depression, anxiety, and stress. This scale comprises 21 items, divided into three subscales: Depression, anxiety, and stress, each with seven items. Each item was rated on a 4-point Likert scale (ranging from 0 to 3). The final score for each sub-subscale is multiplied by two and then evaluated according to the severity rating index, which ranges from 0 to 42. The total score of the scale, calculated as the sum of all subscales’ scores, ranges from 0 to 126, with higher scores indicating more severe negative emotional symptoms. Depression, anxiety, and stress levels were categorized into five severity categories. For depression: ≤ 9 (normal), 10-13 (mild), 14-20 (moderate), 21-27 (severe), and ≥ 28 (extremely severe). For anxiety: ≤ 7 (normal), 8-9 (mild), 10-14 (moderate), 15-19 (severe), and ≥ 20 (extremely severe). For stress: ≤ 14 (normal), 15-18 (mild), 19-25 (moderate), 26-33 (severe), and ≥ 34 (extremely severe).
Quality control
A web-based questionnaire was used, and anonymous responses were collected through the online platform Wenjuanxing. Before data collection, unified training was conducted for all surveyors to ensure a clear understanding of the questionnaire’s purpose and content. Before answering the questionnaire, respondents were informed of the study’s purpose and significance, assured of data confidentiality, and provided informed consent. Questionnaires completed in less than 5 minutes or containing garbled responses were excluded from the analysis. Additionally, responses with missing data were removed, and erroneous data were either corrected or excluded based on the actual circumstances.
Statistical analysis
The study was analyzed using the SPSS 27.0. The general characteristics of the participants were statistically described. For continuous variables (scores from depression, anxiety, and stress scales), central tendency and dispersion were reported using mean ± SD. For categorical variables (gender, major, grade level), distribution patterns were presented using frequency (n) and percentage (%). The χ2 test to compare intergroup differences and assess the statistical significance of associations among categorical variables. Fisher’s exact test was employed instead when expected frequencies were less than 5. Post hoc comparisons with Bonferroni adjustments were used when an overall statistical significance was observed in χ2-tests. To explore the linear associations among the scores of depression, anxiety, and stress, Spearman’s rank-order correlation coefficient analysis was performed, with results reported as correlation coefficients (r) and two-tailed significance levels (P). To evaluate the predictive effect of emotion regulation habits on depression/anxiety/stress scores, stepwise linear regression was employed, with independent variables selected as emotion regulation habits that exhibited significant intergroup differences. The entry P ≤ 0.05 and removal P ≥ 0.10 criteria are standard in stepwise regression. Subsequently, for each dependent variable (depression/anxiety/stress), demographic variables that yielded significant results in χ2-tests (P < 0.05) were chosen as confounding factors: For depression: Gender, home address, household, family economic situation, frequency of sleeping late/ week, frequency of contact with parents/week, academic stress, and same-sex friends; for anxiety: Frequency of sleeping late/week, Academic stress, same-sex friends, and opposite-sex friends; For stress: Family economic situation, frequency of sleeping late/week, academic stress, and same-sex friends. These confounding factors were incorporated into the model as covariates to control for their effects on the dependent variables, thereby minimizing biases induced by confounding. Additionally, a multicollinearity test was conducted to assess collinearity among independent variables, condition index ≤ 30, variance proportion < 0.5 and combined with variance inflation factor < 5, considered indicative of no significant collinearity - this was done to avoid coefficient estimation biases arising from collinearity. Statistical significance was set at α = 0.05.
RESULTS
Negative emotional detection rates among students
A total of 532 questionnaires were distributed, with 494 deemed valid, yielding a validity rate of 92.86%. The sample comprised 205 male and 289 female students. By academic year level, 67 students were in grade 22, 101 in grade 21, 275 in grade 20, and 51 in grade 19. by discipline, 84 students were from science, 148 from humanities, 150 from engineering, and 112 from medicine. Geographically, 281 students were from urban areas and 213 from rural areas. Regarding family economic status, 8 students reported superior, 108 well-off, 291 average, and 87 poor conditions. Additional data were collected on the weekly frequency of late-night sleeping, parental contact, academic stress levels, and number of friends. Detailed information is presented in Table 1. Overall, 321 students reported depressive symptoms (65.0%), 343 experienced anxiety (69.4%), and 251 students reported stress (50.8%). The χ2-test was applied to compare the detection rates of stress, anxiety, and depression across students with varying characteristics. The detection rates of depression, anxiety, and stress were found to be associated with different demographic variables, respectively. In all, among all demographic factors examined, family economic situation, the frequency of staying up late each week, perceived academic stress, and the size of same-sex friend networks emerge as the strongest factors of negative emotions which merit particularly close attention.
Table 1 Comparison of negative emotion detection rates of students with different characteristics.
Descriptive statistics and correlation analysis of DASS-21 scores
Table 2 presents the descriptive statistics for students’ depression, anxiety, stress, and total DASS-21 scores. The total DASS-21 scores for the participants ranged from 2 to 126, with a mean of 48.77 ± 34.88. The mean scores for depression, anxiety, and stress were 16.21 ± 12.18, 14.90 ± 11.91, and 17.64 ± 12.07, respectively. These results indicated varying levels of depression, anxiety, and stress among students. Spearman’s rank correlation analysis revealed positive correlations among depression, anxiety, stress, and total DASS-21 scores (P < 0.001), with correlation coefficients (r) ranging from 0.865 to 0.961. This finding highlights the interconnected nature of these emotional conditions, suggesting a tendency for co-occurrence and mutual reinforcement in students.
Table 2 Correlation of depression, anxiety, stress and Depression, Anxiety, and Stress Scale-21.
Key emotional regulation habits and detection rates of negative emotions among college students
The questionnaire results indicated significant associations between various emotional regulation habits and the detection rates of depression, anxiety, and stress among college students. Habits such as revenge consumption and binge eating were linked to higher detection rates of negative emotional states (P < 0.001). In contrast, maintaining emotional interactions with friends and family, engaging in leisure activities, and participating in regular physical activity were associated with lower detection rates of negative emotional states (P < 0.001). Notably, students with no emotional regulation habits exhibited higher detection rates of negative emotions (P < 0.05), as detailed in Table 3, emphasizing the importance of healthy emotional regulation habits in reducing emotional distress. In summary, students can protect their emotional health by using positive regulation strategies and avoiding negative ones.
Table 3 Emotional regulation habits and the detection rate of negative emotion among students.
Multiple linear regression model of emotional regulation habits and negative emotions in college students
Stepwise linear regression analysis was performed with emotional regulation habits, including revenge consumption, binge eating, emotional interaction, leisure activities, physical activity, and absence of emotional regulation habits, as independent variables and depression, anxiety, and stress scale scores as dependent variables. After adjusting for confounders, results indicated that “Compensatory Spending” and “Binge Eating” were positive predictors of depression, anxiety, and stress scores [β = 0.13, 95% confidence interval (CI): 1.54-6.77, β = 0.16, 95%CI: 2.43-7.65, β = 0.15, 95%CI: 1.94-7.26; β = 0.19, 95%CI: 3.05-7.76, β = 0.14, 95%CI: 1.70-6.42, β = 0.16, 95%CI: 2.21-7.04]. In contrast, “Appropriate Recreational Activities” were negatively associated with depression, anxiety, and stress scores (β = -0.30, 95%CI: -9.28 to -5.53; β = -0.28, 95%CI: -8.66 to -4.88; β = -0.25, 95%CI: -8.14 to -4.28). All associations were statistically significant (P < 0.01), as presented in Table 4. These findings provide direction for the prevention and intervention of negative emotions.
Table 4 Multiple linear regression of different emotional regulation habits and negative emotion in college students (n = 494).
This study found high detection rates of depression (65.0%), anxiety (69.4%), and stress (50.8%) among college students during lockdown, all exceeding 50%, as presented in Table 1. Notably, anxiety exhibited the highest scores and detection rates compared to depression and stress, indicating that anxiety has become the most prominent mental health concern among college students. These findings are consistent with previous research by Basudan et al[24], and Daso et al[25] and exhibit higher detection rates of stress, anxiety, and depression than those reported by Li et al[26]. Furthermore, the results align with Chen et al[27], who observed a recent upward trend in the detection rates of anxiety and depression among college students. This phenomenon is not limited to university students during lockdown. Supporting this, a cross-sectional study by Wang et al[28] of 19372 people under lockdown conditions in China found that confinement generates interpersonal isolation, leading to increased prevalence of psychological disturbances, such as anxiety and depression and sleep disturbances including insomnia. Women, young people, and individuals living alone were identified as particularly vulnerable groups.
Univariate analysis results indicated that the frequency of sleeping late, academic stress, and the number of same-sex friends were common influencing factors for depression, anxiety, and stress. These findings are consistent with those reported by Zhu et al[4], Gu et al[29], and Steare et al[30]. These results suggest that sleep quality may be a critical factor in mental health. Sleep deprivation may affect mental well-being through various mechanisms, including elevated inflammatory markers and increased levels of stress hormones such as cortisol. Academic stress is also a significant factor, as prolonged exposure can reduce self-efficacy and hinder effective coping strategies, particularly in the absence of adequate relaxation time. Furthermore, friends can provide emotional support and enhance mental resilience, thereby helping to alleviate negative emotions.
In addition, gender, home address, household composition, family economic status, and frequency of contact with parents are significant determinants of depression. These findings are consistent with those by Li et al[31]and Quan et al[32]. Students residing in rural areas or with lower socioeconomic status often face limited family income, restricted access to social resources, and inadequate mental health services compared to those in urban areas, where access to adequate healthcare is readily available. Economic factors influence mental health broadly across populations. Evidence from a cohort study involving 333017 adults demonstrates that low socioeconomic status groups experience a higher cumulative burden of chronic stress and life stressors. This burden, in turn, elevates their risk of depression and anxiety[33].
In contrast to a previous study indicating that females typically exhibit poorer psychological conditions than males[34], this study found higher detection rates of various negative emotions among male students. This discrepancy may be attributed to the specific research setting. COVID-19 lockdowns forced universities into closed-campus rules, sharply cutting offline sports and group activities. For male students, the sudden loss of these key social outlets blocked a primary way to meet peer-interaction needs, creating marked frustration. Compounding this, traditional Chinese norms that “real men stay strong” discouraged them from voicing distress, unspoken emotions accumulated and later surfaced as higher depression-screening rates. Female students, who more often employ emotion-focused coping and readily seek social support, experienced the same restrictions yet showed lower detection rates. Besides, research has demonstrated that chronic stress and subchronic stress disrupt the blood-brain barrier in emotion-related brain regions of female mice. In particular, blood-brain barrier dysfunction in the prefrontal cortex of female mice induces anxiety and depression behaviors. Evidence from the wider college population shows that chronic stress follows sex-specific pathways. Intense, persistent stress most often drives depression and anxiety in women, while moderate yet sustained stress more strongly forecasts suicidal thoughts in men and younger students[33]. Although our study finds more male students screening positive for negative emotions, this does not lessen the urgency of monitoring female students. Instead, it highlights the need for equal vigilance across genders, because the level of stress that triggers harm and the way that harm is expressed differ between men and women. These findings suggest that prolonged depressive behaviors may exert greater harm to females[35], underscoring the importance of monitoring the mental health of female college students. Enhancing sleep duration and quality also plays a crucial role in improving emotional well-being[36].
Depression, anxiety, and stress are positively correlated, consistent with the findings of Ooi et al[37] and Gu et al[29], whose studies have also identified a strong positive correlation among these psychological conditions. This correlation indicates mutual influence and the presence of shared psychological or physiological mechanisms. It also reflects the high comorbidity among depression, anxiety, and stress, emphasizing significant mental health concerns. For instance, individuals experiencing high levels of stress may develop anxiety in response to the perceived threats or challenges posed by stressors. If stress and anxiety persist without appropriate intervention, they can contribute to the onset of depressive symptoms. This sequential effect highlights the complex interaction among these psychological states, where each can exacerbate or trigger the onset of another. A large cohort study of 36795 adults has confirmed that depression and anxiety frequently co-occur with sleep disturbances[38]. Because these conditions share underlying neurobiological pathways and mutually reinforce one another, untangling their interrelationship is a prerequisite for designing integrated interventions that can simultaneously improve mental well-being and mitigate associated physical-health risks.
Table 3 presents evidence that compensatory spending, binge eating, maintaining emotional interaction, recreational activities, physical activity, and a lack of emotional coping strategies influence levels of depression, anxiety, and stress. Among these, negative emotions are more prevalent in individuals who engaged in compensatory spending, binge eating, and lacked emotional coping strategies, aligning with previous findings[39]. Binge eating is caused by emotional eating, wherein individuals unsatisfied with their bodies may use food as a coping mechanism. Stress is a known trigger for emotional eating. During lockdowns, perceived loss of control and restrictions on normal consumption behaviors may contribute to retaliatory consumption, which serves as a means of regaining control and relieving stress. Furthermore, the absence of emotional coping strategies can result in a prolonged inability to regulate emotions, placing students in a persistent state of psychological distress and increasing the risk of depression and anxiety disorders. A lower prevalence of negative emotions was observed among individuals who engaged in emotional interaction, recreational activities, and physical exercise. This finding is consistent with the conclusions drawn by Zhang et al[40]and Lei et al[41]. Regardless of the exercise type, increased physical activity improves mental health potentially through mechanisms such as reduced cortisol levels and increased dopamine secretion[42].
As indicated in Table 4, regression analyses revealed that compensatory spending, binge eating, and levels of depression, anxiety, and stress were positively correlated and considerably predicted scale scores. In contrast, engagement in leisure activities can negatively predict scale scores. The regression analysis regarding binge eating indicated that unhealthy eating habits, such as overeating, are also associated with college students’ mental health. Excessive consumption of sugary beverages and high-calorie foods may temporarily satisfy emotional needs but is also associated with poor mental health among college students[43]. This behavior can trigger a stress response, increase the risk of obesity, and contribute to symptoms of depression or anxiety[44]. Additionally, individuals who engage in binge eating experience heightened social anxiety[45]. Recent studies suggest that gut microbiota may interact with the host brain and play a key role in the pathogenesis of neuropsychiatric disorders[46], potentially by regulating neurotransmitter synthesis and release, such as g-aminobutyric acid or through vagus nerve signaling[47], which influences emotional regulation. Consequently, modifying intestinal probiotics through proper dietary interventions may help restore normal brain function.
Compensatory spending refers to the phenomenon wherein, following extended periods of suppressed consumption, such as during pandemics or unexpected crises, individuals engage in concentrated spending during the recovery phase. This behavior reflects a psychological overcompensation and is often employed as a form of emotional regulation, particularly when individuals experience anxiety or depression[48]. It is considered a “compensatory mechanism” aimed at alleviating negative emotions. However, the temporary pleasure and perceived control associated with this short-term emotional response may quickly diminish, potentially leading to more severe negative emotions. Although the concept has been widely discussed since 2020, empirical research on this behavioral pattern and its emotional implications remains limited. The present study offers direction for future research.
Appropriate Recreational activities, when appropriately structured, can stabilize mood and reduce levels of depression, anxiety, and stress. This positive effect has been confirmed in a previous study involving 14767 Chinese university students by Lei et al[41]. Additionally, research has indicated that engaging in more than three sessions of moderate-intensity exercise per week is more effective in alleviating symptoms of depression, anxiety, and stress[49]. Exercise contributes to mental health through several mechanisms, including synaptic transmission[50], stimulation of endorphin release, increased dopamine production[51], and activation of the parasympathetic nervous system[52]. These effects help alleviate symptoms of mental disorders. Furthermore, physical activity can improve self-efficacy and psychological resilience. Under lockdown conditions, moderate exercise is indispensable for regulating negative emotions. Universities should encourage students to incorporate regular physical activity including outdoor activities to support emotional well-being and maintain structured schedules[53]. While the negative emotional states of students have been frequently discussed, this study specifically emphasizes the demographic characteristics associated with negative emotions; the linear association of negative emotional scores; the relationship between emotional regulation habits and the incidence of negative emotions, as well as the predictive factors of negative emotions.
In daily life, a lockdown environment typically refers to isolated settings with limited external communication, such as those experienced in boarding schools or during periods of social isolation. Lockdown status can also be referred to as a form of social relationship lockdown, characterized by a reduction in social interaction frequency, increased interpersonal distance, decreased sense of real-life engagement, and excessive engagement in online life. The psychological and emotional distress associated with this condition is analogous to the psychological distress experienced in a lockdown environment. Both can have negative impacts on mood, cognition, and behavior, such as anxiety, loneliness, and emotional depression, rigid thinking, decreased creativity, and impulsive behaviors coupled with self-damage.
Given the unique characteristics of the college student population, including sleep disturbances associated with communal dormitory living, interpersonal difficulties in navigating relationships with peers and teachers, academic pressure from examinations and grade expectations, and uncertainty about prospects, psychological stress levels remain high. Moreover, the psychological demands of identity formation, autonomy development, and self-efficacy challenges increase susceptibility to anxiety and depressive symptoms, leading to emotional dysregulation. Inadequate access to mental health services during lockdowns directly contributes to increased rates of depression and anxiety. This underscores the necessity of not only addressing the mental health of college students during lockdowns but also prioritizing ongoing mental health maintenance in their daily lives, timely psychological interventions when problems are identified[38]. Through sustained psychological support services, mental health education initiatives, and cultivating a mental wellness-oriented campus culture, colleges can empower students to better cope with stress, regulate negative emotions, develop psychological resilience, and enhance overall mental well-being.
Limitations and future directions
This study has some limitations. Firstly, as a cross-sectional design, it cannot allow for the determination of causal relationships between depression, anxiety, stress, and emotional processing styles. Secondly, the data here were collected through a self-reported questionnaire to assess emotional states. Their accuracy is influenced by individual factors, which may introduce information bias and affect the reliability of the results. Thirdly, the sample in this study was limited to students from a single university. this demographic or school characteristics may reduce the generalizability of the findings.
Future studies could employ prospective cohort studies to ascertain the temporal sequence and the strength of the association between emotional regulation habits and emotional states, through multiple data collections at baseline and during follow-up visits. And should incorporate objective measures combined with subjective indicators to enhance data accuracy during the data collection, for example, monitoring cortisol levels through blood, saliva, urine or physiological signals, assessment of motor activity testing or sleep disorder testing, via smart bracelet behavioral changes or sleep changes due to depression, anxiety, or stress. Furthermore, conducting randomized controlled trials that cover all age groups, not just college students, can help to identify effective intervention strategies for negative emotions such as depression, anxiety, and stress, thereby providing a scientific basis for generalizing the results to different age groups. At the same time, investigating the synergistic effects of emotional regulation habits with other interventions like dietary adjustments and exercise, may offer new strategies for improving emotional health across the entire population. Beyond common research variables such as depression, anxiety, and stress, future studies should incorporate investigations of related psychological factors including coping strategies and sleep quality by first exploring the associations between these factors and negative emotions among college students under lockdown conditions, then validating the generalizability of these associations through population-based studies, and thereby extending the research conclusions to populations across different age groups and living scenarios.
CONCLUSION
A high prevalence of negative emotions was identified among students during lockdown. Recreational activities served as protective factors, while compensatory spending and binge eating were associated with increased psychological risk. Proactive strategies should be implemented to promote effective emotion regulation habits among college students. Regular mental health monitoring and timely interventions are essential for supporting student well-being.
Footnotes
Provenance and peer review: Invited article; Externally peer reviewed.
Peer-review model: Single blind
Specialty type: Psychology
Country of origin: China
Peer-review report’s classification
Scientific Quality: Grade B
Novelty: Grade C
Creativity or Innovation: Grade C
Scientific Significance: Grade B
P-Reviewer: Wang S, MD, Assistant Professor, China S-Editor: Bai Y L-Editor: A P-Editor: Lei YY
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