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ORIGINAL ARTICLE
Year : 2022  |  Volume : 15  |  Issue : 10  |  Page : 451-460

Posttraumatic stress symptom trajectories of Chinese university students during the first eight months of the COVID-19 pandemic and their association with cognitive reappraisal, expressive suppression, and posttraumatic growth


1 The First Affiliated Hospital of Hainan Medical University, Haikou 571199, China
2 Student Affairs Office, Hainan Medical University, Haikou 571199, China; Centre for Research in Psychology and Human Well-Being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
3 Affiliated Hainan Hospital, Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou, 571199; Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510275, China
4 Affiliated Maternal and Child Health Hospital/Affiliated Children's Hospital; Key Laboratory of Brain Science Research & Transformation in Tropical Environment of Hainan Province, Hainan Medical University, Haikou 571199, China

Correspondence Address:
Jiang Nan
Student Affairs Office, Hainan Medical University, Haikou 571199, China; Centre for Research in Psychology and Human Well-Being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia

Juan Yang
Affiliated Maternal and Child Health Hospital/Affiliated Children's Hospital; Key Laboratory of Brain Science Research & Transformation in Tropical Environment of Hainan Province, Hainan Medical University, Haikou 571199, China
China
Zhi-yue Lv
Affiliated Hainan Hospital, Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou, 571199; Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510275, China
China
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Source of Support: This work was supported by Hainan Provincial Natural Science Foundation of China (grant number 821RC1124), the Education Department of Hainan Province (grant number Hnjgzc2022-22), the Hainan Medical University (grant numbers XGZX2020003, HYPY2020028, and HYYB202131), and Hainan Province Clinical Medical Center (QWYH202175), Conflict of Interest: None


DOI: 10.4103/1995-7645.359786

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Objective: To identify the moderating effects of cognitive reappraisal (CR) and expressive suppression (ES) on the relationship between posttraumatic stress (PTS) symptoms and posttraumatic growth (PTG) in university students. Methods: The survey included 1 987 Chinese university students who completed questionnaires on PTS symptoms in February 2020, with three follow-up surveys at two-month intervals until August 2020. We assessed CR and ES at February 2020 and PTG at August 2020. Growth mixture modeling was used to classify the PTS symptom trajectories. Multinomial logistic regression was used to recognize the predictors of class membership. The relationships among PTS symptoms, CR, ES, and PTG were examined using multi-group path analysis. Results: Sex, SARS-CoV-2 infection of a family member or friend, number of siblings, CR, and ES were significantly associated with PTS symptoms. Three latent classes were identified: ‘Increasing PTS’ (n=205, 10.0%) who had rapid deterioration of PTS symptoms, ‘Moderate PTS’ (n=149, 8.0%) who had a high level of PTS symptoms at the beginning and slightly increasing, and ‘Persistent Minimal PTS’ (n=1 633, 82.0%), who had slow resolution of PTS symptoms over time. Male, SARS-CoV-2 infection of a family member or friend, and having a lower CR and a higher ES, were more likely to have ‘Increasing PTS’. PTS at February 2020 predicted PTG only in ‘Increasing PTS’ class, and both CR and ES had moderating effects on the conversion between them. Conclusions: Most students recovered from posttraumatic stress of COVID-19 pandemic, but a small proportion expeienced increasing PTS symptoms, and those with this condition may benefit from emotional regulation intervention.


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