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Effects of the COID-19 Pandemic on Anhedonia, Reward Exposure and Responsiveness, and Sleep in College Students

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Title: Effects of the COID-19 Pandemic on Anhedonia, Reward Exposure and Responsiveness, and Sleep in College Students
Language: English
Authors: Sarah T. Wieman (ORCID 0000-0001-5768-0092), Jessica S. Fields, Kimberly A. Arditte Hall (ORCID 0000-0002-3095-1099), Helen Z. MacDonald (ORCID 0000-0002-7902-4237), Gabrielle I. Liverant (ORCID 0000-0003-4515-3046)
Source: Journal of American College Health. 2024 72(2):351-355.
Availability: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 5
Publication Date: 2024
Document Type: Journal Articles
Reports - Research
Education Level: Higher Education
Postsecondary Education
Descriptors: Undergraduate Students, COVID-19, Social Isolation, Mental Health, Psychological Patterns, Physical Environment, Environmental Influences, Patterned Responses, Rewards, Sleep
DOI: 10.1080/07448481.2022.2047705
ISSN: 0744-8481
1940-3208
Abstract: Objective: The COVID-19 pandemic's effects on college student mental health and its underlying mechanisms are not fully understood. Although necessary, physical distancing abruptly restricts interaction with environmental rewards and disrupts sleep patterns, both of which may contribute to psychological symptoms (eg, depression and anhedonia). This study explored differences in psychological symptoms, reward exposure and responsiveness, and sleep before versus during the pandemic. Methods: Eighty-seven college students completed baseline questionnaires and a one-week daily diary paradigm. The sample was divided into two groups based on data collection before (pre-) or after (post-COVID-19) implementation of state-wide COVID-19 physical distancing measures. Results: Findings highlight higher anhedonia, decrements in exposure to social, professional, and exercise related rewards, lower anticipatory reward responsiveness, and lower sleep efficiency among college students during the initial months of the pandemic. Conclusions: Findings suggest anhedonia, reward system functioning, and sleep may be important targets to mitigate against college student mental health sequelae during COVID-19.
Abstractor: As Provided
Entry Date: 2024
Accession Number: EJ1419065
Database: ERIC
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  Value: <anid>AN0176405461;acl01feb.24;2024Apr05.04:37;v2.2.500</anid> <title id="AN0176405461-1">Effects of the COVID-19 pandemic on anhedonia, reward exposure and responsiveness, and sleep in college students </title> <p>Objective: The COVID-19 pandemic's effects on college student mental health and its underlying mechanisms are not fully understood. Although necessary, physical distancing abruptly restricts interaction with environmental rewards and disrupts sleep patterns, both of which may contribute to psychological symptoms (eg, depression and anhedonia). This study explored differences in psychological symptoms, reward exposure and responsiveness, and sleep before versus during the pandemic. Methods: Eighty-seven college students completed baseline questionnaires and a one-week daily diary paradigm. The sample was divided into two groups based on data collection before (pre-) or after (post-COVID-19) implementation of state-wide COVID-19 physical distancing measures. Results: Findings highlight higher anhedonia, decrements in exposure to social, professional, and exercise related rewards, lower aniticipatory reward responsiveness, and lower sleep efficiency among college students during the initial months of the pandemic. Conclusions: Findings suggest anhedonia, reward system functioning, and sleep may be important targets to mitigate against college student mental health sequelae during COVID-19.</p> <p>Keywords: Anhedonia; COVID-19; reward exposure; reward responsiveness; sleep</p> <hd id="AN0176405461-2">Introduction</hd> <p>The outbreak of the novel coronavirus disease (COVID-19) has spread globally and was declared a pandemic by the World Health Organization in March, 2020.[<reflink idref="bib1" id="ref1">1</reflink>] Physical distancing measures to curtail the spread of COVID-19 led to profound changes for college students as campuses closed and classes moved online.[<reflink idref="bib2" id="ref2">2</reflink>],[<reflink idref="bib3" id="ref3">3</reflink>] Initial research suggests that the COVID-19 pandemic and associated public health restrictions have had detrimental effects on college student mental health, including increased stress, anxiety, and depression.[[<reflink idref="bib4" id="ref4">4</reflink>], [<reflink idref="bib6" id="ref5">6</reflink>]] Findings further suggest that college students have experienced greater sleep disturbance during the pandemic.[<reflink idref="bib7" id="ref6">7</reflink>],[<reflink idref="bib8" id="ref7">8</reflink>] However, potential mechanisms that contribute to these symptom changes during COVID-19 are not well understood.</p> <p>While physical distancing measures, including campus closure, quarantine, and gathering limits, are necessary to control the virus, they also abruptly restricted interaction with reinforcers. This alteration in environmental rewards may be important as reduced reward exposure has been implicated in the onset and maintenance of depression and anhedonia.[<reflink idref="bib9" id="ref8">9</reflink>],[<reflink idref="bib10" id="ref9">10</reflink>] In addition, depression and anhedonia have been associated with impairments in reward responsiveness.[<reflink idref="bib11" id="ref10">11</reflink>] Reward responsiveness is a multifaceted construct that is divided into distinct temporal components, including anticipatory ('wanting') and consummatory ('liking'), with differential associations with motivation and behavior.[<reflink idref="bib12" id="ref11">12</reflink>] Recent theory highlights interrelated etiological roles for reward system dysfunction and sleep disturbance in the development of depression/anhedonia.[<reflink idref="bib13" id="ref12">13</reflink>] Thus, alterations in reward exposure and responsiveness and increased sleep disturbance are clinically relevant phenomena, which may contribute to mental health symptoms among college students during COVID-19. However, to date, no studies have examined associations between the pandemic and associated physical distancing and <emph>in vivo</emph> interaction with environmental rewards and reward responsiveness (ie, both prior to and following reward occurrence).</p> <p>This research examined differences in psychological symptoms (ie, depression, anhedonia, stress, and anxiety) between two groups of college students: one recruited before the COVID-19 pandemic and one recruited following statewide and local physical distancing measures during the start of the pandemic. This investigation was the first to explore differences in: frequency of environmental rewards, anticipatory and consummatory reward responsiveness, and sleep before versus during COVID-19 using both questionnaires and a daily diary paradigm. We predicted greater depression, anhedonia, insomnia, and sleep disturbance, lower environmental rewards, and diminished anticipatory and consummatory reward responsiveness among college students experiencing physical distancing restrictions.</p> <hd id="AN0176405461-3">Material and methods</hd> <p></p> <hd id="AN0176405461-4">Study design and participants</hd> <p>From Novermber 2019 to May 2020, 87 undergraduate students (<emph>N</emph> = 87; <emph>n</emph> = 33 pre-COVID-19, <emph>n</emph> = 54 post-COVID-19) were recruited from a college in the Northeastern United States. Participants were required to be: 1) enrolled in college, 2) ≥ 18 years old, 3) comfortable reading/writing in English, and 4) have a smartphone with texting and Internet capabilities. The sample was 87.4% female, 74.7% white, with an average age of 19.09 years (<emph>SD</emph> = 1.03).</p> <p>The study was conducted online using Qualtrics software.[<reflink idref="bib14" id="ref13">14</reflink>] Participants provided informed consent, completed questionnaires, and then completed daily diary measures three times per day for seven days at 8:00 AM, 2:00 PM, and 8:00 PM. All procedures were conducted in compliance with the college's institutional review board.</p> <hd id="AN0176405461-5">Baseline questionnaires</hd> <p></p> <hd id="AN0176405461-6">Psychological symptoms</hd> <p>The 21-item Depression Anxiety Stress Scale (DASS-21) consists of three 7-item subscales rated on a 4-point Likert scale that measure: depression, anxiety, and stress.[<reflink idref="bib15" id="ref14">15</reflink>] Higher scores indexed greater symptoms. Internal consistency was good (Depression: α =.91; Anxiety: α =.83; Stress: α =.86).</p> <p>The 22-item Anhedonia Depression subscale of the Mood and Anxiety Symptom Questionnaire (MASQ-AD) assessed anhedonia.[<reflink idref="bib16" id="ref15">16</reflink>] Items were rated on a 5-point Likert scale; higher scores represented elevated anhedonia. Internal consistency was acceptable (α =.74).</p> <hd id="AN0176405461-7">Sleep measures</hd> <p>The 7-item Insomnia Severity Index (ISI) measured insomnia.[<reflink idref="bib17" id="ref16">17</reflink>] Items were rated on a 5-point Likert scale; higher scores indicated increased insomnia. Internal consistency was good (α =.87).</p> <hd id="AN0176405461-8">COVID-19 enrollment status</hd> <p>Enrollment status pre- or post-COVID-19 was based on data collection before/after the shift to online learning on March 18, 2020 during a statewide State of Emergency issued due to the pandemic.</p> <hd id="AN0176405461-9">Daily diary questionnaires</hd> <p></p> <hd id="AN0176405461-10">Consensus Sleep Diary</hd> <p>The Consensus Sleep Diary (CSD) measured sleep quality, duration, latency, and efficiency at each morning timepoint.[<reflink idref="bib18" id="ref17">18</reflink>] Sleep quality was rated on a 5-point Likert scale; lower scores indicated poorer sleep quality. Sleep latency represents time to fall asleep in minutes, and sleep efficiency is defined as the percentage of time in bed spent asleep.</p> <hd id="AN0176405461-11">Reward responsiveness and affect measure</hd> <p>At each timepoint, participants reported on rewarding experiences they had since the last assessment and rewarding experiences they anticipated occurring in the next six hours. They specified the rewarding experience(s) by selecting from the following categories: (<reflink idref="bib1" id="ref18">1</reflink>) work/school activity, (<reflink idref="bib2" id="ref19">2</reflink>) watching TV/listening to music/reading something enjoyable, (<reflink idref="bib3" id="ref20">3</reflink>) exercise, (<reflink idref="bib4" id="ref21">4</reflink>) completing chores, (<reflink idref="bib5" id="ref22">5</reflink>) engagement in social activity, (<reflink idref="bib6" id="ref23">6</reflink>) sleeping, (<reflink idref="bib7" id="ref24">7</reflink>) eating, and (<reflink idref="bib8" id="ref25">8</reflink>) sexual activity.[<reflink idref="bib19" id="ref26">19</reflink>] Total number of rewards per category was calculated by summing participant ratings of anticipating/experiencing a type of reward over the entire the week.</p> <p>For each reward anticipated, participants rated how motivated, interested, and enjoyable they predicted the reward would be on a 5-point Likert scale.[<reflink idref="bib19" id="ref27">19</reflink>] For each reward experienced, participants rated how much they enjoyed and were interested in the reward on a 5-point Likert scale.[<reflink idref="bib19" id="ref28">19</reflink>] Separate anticipatory and consummatory reward responsiveness scores were calculated by averaging ratings across all future or past rewarding experiences identified; higher scores indicated greater reward responsiveness.</p> <p>Positive affect (PA) ratings indexed state hedonia/anhedonia. Participants rated how much they were experiencing (<reflink idref="bib1" id="ref29">1</reflink>) enthusiasm, (<reflink idref="bib2" id="ref30">2</reflink>) happiness, (<reflink idref="bib3" id="ref31">3</reflink>) relaxation, and (<reflink idref="bib4" id="ref32">4</reflink>) contentedness on a 5-point Likert scale.[<reflink idref="bib20" id="ref33">20</reflink>] Total PA scores were calculated by summing the four PA items per timepoint and then averaging across timepoints. Lower scores indicated greater anhedonia. The scale had good internal consistency (α =.84).</p> <p>Reward responsiveness and affect measures have been previously validated for use in Ecological Momentary Assessment and experience sampling studies.[<reflink idref="bib19" id="ref34">19</reflink>],[<reflink idref="bib20" id="ref35">20</reflink>]</p> <hd id="AN0176405461-12">Data analysis</hd> <p>Analyses were performed using SPSS software (version 25.0.0.0).[<reflink idref="bib21" id="ref36">21</reflink>] Independent samples <emph>t-</emph>tests were used to examine differences between pre- versus post-COVID-19 enrollment groups. Complete data were available for 76.3% of data points, consistent with rates for similar studies examining sleep and affect.[<reflink idref="bib22" id="ref37">22</reflink>],[<reflink idref="bib23" id="ref38">23</reflink>] A corrected significance level of <emph>p</emph> <.028 was used to interpret the statistical significance of results (see footnote[<reflink idref="bib1" id="ref39">1</reflink>]).[<reflink idref="bib24" id="ref40">24</reflink>]</p> <hd id="AN0176405461-13">Results</hd> <p></p> <hd id="AN0176405461-14">Demographics</hd> <p>There were no differences between groups on demographic variables including age, gender, race, and ethnicity.</p> <hd id="AN0176405461-15">Psychological symptoms and sleep indices</hd> <p>No significant differences were found on the MASQ-AD, DASS-21, or ISI. Among the daily diary, PA and sleep efficiency were significantly lower post-COVID-19 (Table 1).</p> <p>Table 1. Differences in psychological symptoms, sleep variables, and reward responsiveness and exposure pre- and post-COVID-19.</p> <p> <ephtml> <table><thead><tr><td /><td>Pre-Covid (<italic>n</italic> = 33)</td><td>Post-Covid (<italic>n</italic> = 54)</td><td /><td /><td /><td /></tr><tr><td /><td>M (SD)</td><td>M (SD)</td><td><italic>t</italic></td><td>df</td><td><italic>p</italic></td><td><italic>g</italic></td></tr></thead><tbody valign="top"><tr><td>DASS depression</td><td char=".">12.80 (10.76)</td><td char=".">13.56 (11.18)</td><td>−0.35</td><td char=".">85</td><td char=".">.723</td><td char=".">0.07</td></tr><tr><td>DASS anxiety</td><td char=".">12.42 (10.63)</td><td char=".">9.07 (8.06)</td><td>1.66</td><td char=".">85</td><td char=".">.100</td><td char=".">0.37</td></tr><tr><td>DASS stress</td><td char=".">15.63(11.96)</td><td char=".">14.11 (8.60)</td><td>0.52</td><td char=".">85</td><td char=".">.492</td><td char=".">0.17</td></tr><tr><td>MASQ-AD</td><td char=".">62.81 (15.52)</td><td char=".">70.19 (15.85)</td><td>−2.35</td><td char=".">85</td><td char=".">.037</td><td char=".">0.47</td></tr><tr><td>ISI total</td><td char=".">11.06 (7.07)</td><td char=".">9.33 (5.18)</td><td>0.89</td><td char=".">85</td><td char=".">.194</td><td char=".">0.29</td></tr><tr><td>DDQ positive affect</td><td char=".">10.78 (4.39)</td><td char=".">10.13 (3.40)</td><td>2.76</td><td char=".">1239</td><td char=".">.006</td><td char=".">0.17</td></tr><tr><td>DDQ sleep quality</td><td char=".">3.45 (1.14)</td><td char=".">3.51 (0.92)</td><td>−0.58</td><td char=".">428</td><td char=".">.563</td><td char=".">0.06</td></tr><tr><td>DDQ sleep duration</td><td char=".">460.60 (130.58)</td><td char=".">462.08 (113.47)</td><td>−0.11</td><td char=".">359</td><td char=".">.913</td><td char=".">0.01</td></tr><tr><td>DDQ sleep latency</td><td char=".">24.81 (29.92)</td><td char=".">28.01 (35.81)</td><td>−0.85</td><td char=".">412</td><td char=".">.395</td><td char=".">0.09</td></tr><tr><td>DDQ sleep efficiency</td><td char=".">83.17 (15.40)</td><td char=".">76.12 (17.05)</td><td>3.66</td><td char=".">344</td><td char=".">.000</td><td char=".">0.43</td></tr><tr><td>Anticipatory reward responsivness</td><td char=".">3.52 (0.89)</td><td char=".">3.26 (0.77)</td><td>4.81</td><td char=".">1135</td><td char=".">.000</td><td char=".">0.32</td></tr><tr><td>Consummatory reward responsiveness</td><td char=".">3.53 (0.89)</td><td char=".">3.41 (0.83)</td><td>2.17</td><td char=".">1150</td><td char=".">.030</td><td char=".">0.14</td></tr><tr><td>Total anticipated rewards</td><td char=".">2.80 (1.71)</td><td char=".">2.61 (1.51)</td><td>1.83</td><td char=".">1242</td><td char=".">.068</td><td char=".">0.12</td></tr><tr><td>Total consumed rewards</td><td char=".">2.75 (1.57)</td><td char=".">2.49 (1.43)</td><td>2.82</td><td char=".">1250</td><td char=".">.005</td><td char=".">0.18</td></tr><tr><td>Social anticipated</td><td char=".">6.05 (5.13)</td><td char=".">4.19 (5.17)</td><td>5.69</td><td char=".">1250</td><td char=".">.000</td><td char=".">0.36</td></tr><tr><td>Social experienced</td><td char=".">7.08 (4.76)</td><td char=".">5.02 (4.96)</td><td>6.66</td><td char=".">1250</td><td char=".">.000</td><td char=".">0.42</td></tr><tr><td>Eating anticipated</td><td char=".">8.76 (4.42)</td><td char=".">10.92 (3.93)</td><td>−8.39</td><td char=".">1250</td><td char=".">.000</td><td char=".">0.52</td></tr><tr><td>Eating experienced</td><td char=".">9.62 (4.72)</td><td char=".">10.61 (3.57)</td><td>−3.97</td><td char=".">1250</td><td char=".">.000</td><td char=".">0.24</td></tr><tr><td>TV/music/read anticipated</td><td char=".">8.37 (5.06)</td><td char=".">11.97 (6.03)</td><td>−9.84</td><td char=".">1250</td><td char=".">.000</td><td char=".">0.63</td></tr><tr><td>TV/music/read experienced</td><td char=".">7.98 (4.69)</td><td char=".">9.76 (4.86)</td><td>−5.85</td><td char=".">1251</td><td char=".">.000</td><td char=".">0.37</td></tr><tr><td>Chores anticipated</td><td char=".">1.66 (2.74)</td><td char=".">2.43 (3.04)</td><td>−4.12</td><td char=".">1250</td><td char=".">.000</td><td char=".">0.26</td></tr><tr><td>Chores experienced</td><td char=".">1.56 (1.71)</td><td char=".">2.48 (2.46)</td><td>−6.35</td><td char=".">1251</td><td char=".">.000</td><td char=".">0.41</td></tr><tr><td>Work/school anticipated</td><td char=".">8.66 (5.09)</td><td char=".">9.54 (4.88)</td><td>2.07</td><td char=".">1252</td><td char=".">.039</td><td char=".">0.18</td></tr><tr><td>Work/school experienced</td><td char=".">7.92 (4.80)</td><td char=".">7.36 (4.04)</td><td>−2.79</td><td char=".">1250</td><td char=".">.005</td><td char=".">0.13</td></tr><tr><td>Exercise anticipated</td><td char=".">2.32 (2.47)</td><td char=".">3.18 (3.40)</td><td>−4.28</td><td char=".">1250</td><td char=".">.000</td><td char=".">0.28</td></tr><tr><td>Exercise experienced</td><td char=".">2.42 (2.10)</td><td char=".">2.08 (1.94)</td><td>2.7</td><td char=".">1251</td><td char=".">.007</td><td char=".">0.17</td></tr><tr><td>Sleep anticipated</td><td char=".">5.62 (2.87)</td><td char=".">4.71 (2.50)</td><td>5.52</td><td char=".">1250</td><td char=".">.000</td><td char=".">0.34</td></tr><tr><td>Sleep experienced</td><td char=".">5.78 (2.13)</td><td char=".">6.63 (2.59)</td><td>−5.44</td><td char=".">1250</td><td char=".">.000</td><td char=".">0.35</td></tr><tr><td>Sexual activity anticipated</td><td char=".">0.42 (0.69)</td><td char=".">0.35 (0.81)</td><td>1.33</td><td char=".">1250</td><td char=".">.183</td><td char=".">0.09</td></tr><tr><td>Sexual activity experienced</td><td char=".">0.61 (0.86)</td><td char=".">0.57 (1.00)</td><td>0.75</td><td char=".">1250</td><td char=".">.454</td><td char=".">0.04</td></tr></tbody></table> </ephtml> </p> <p>1 <emph>Note.</emph> DASS = Depression and Anxity Stress Scale; MASQ-AD = Mood and Anxiety Symptom Questionnaire-Anhedonic Depression Subscale, DDQ = Daily Diary Questionnaire; ISI = Insomnia Severity Index.</p> <hd id="AN0176405461-16">Number of rewards and reward responsiveness</hd> <p>Participants engaged in significantly fewer rewarding activities post-COVID-19 (Table 1). Results suggest that the differences in participants' anticipation of and engagement in rewarding activities prior to versus during the pandemic differed based on the type of activity. The total number of social rewards anticipated and engaged in was significantly lower for participants post-COVID-19 than prior (Table 1). In contrast, participants both anticipated and engaged in significantly more eating, watching TV/music/reading, and completing chores post-COVID-19 than before. While participants anticipated significantly more exercising post-COVID-19, they actually engaged in significantly less exercise and engaged in fewer work/school activities, as well. In contrast, participants anticipated less sleep post-COVID-19, but actually engaged in significantly more sleep post-COVID-19. In addition, anticipatory, but not consummatory, reward responsiveness was significantly diminished in the post-COVID-19 group (Table 1).</p> <hd id="AN0176405461-17">Discussion</hd> <p>Findings extend preliminary research showing the COVID-19 pandemic and associated public health restrictions are linked to mental health symptoms and sleep disturbance among college students.[<reflink idref="bib4" id="ref41">4</reflink>],[<reflink idref="bib7" id="ref42">7</reflink>] Specifically, our findings highlight anhedonia, as indexed by lower daily diary positive affect, and sleep efficiency as uniquely affected in the initial two months of the pandemic following the implementation of physical distancing. Unlike previous studies, we did not find differences in depression, anxiety, stress, or other indices of sleep disturbance before versus during the pandemic.[<reflink idref="bib4" id="ref43">4</reflink>],[<reflink idref="bib5" id="ref44">5</reflink>],[<reflink idref="bib7" id="ref45">7</reflink>]</p> <p>This was the first study to examine differences in exposure to environmental rewards, reward responsiveness, and sleep during versus before the COVID-19 pandemic. Critically, changes in all three domains would be expected to contribute to the experience of anhedonia, specifically.[<reflink idref="bib13" id="ref46">13</reflink>],[<reflink idref="bib25" id="ref47">25</reflink>] Results demonstrated lower social, school/work, and exercise rewards following physical distancing, while engagement in other rewarding activities remained the same (ie, sexual activity) or increased (ie, TV/reading/music, chores, sleep, and eating). Thus, it is possible that reduced interaction with certain rewards, such as in-person social contact or exercise, associated with physical distancing, had specific impacts on anhedonia/positive affect symptoms and reward responsiveness. This interpretation is supported by neurobiological and behavioral studies highlighting social rewards and exercise as mechanisms for decreasing psychological symptoms and promoting well-being.[[<reflink idref="bib26" id="ref48">26</reflink>], [<reflink idref="bib28" id="ref49">28</reflink>]]</p> <p>In addition, findings revealed decrements in anticipatory, but not consummatory, reward responsiveness during physical distancing. This may suggest that students may be less motivated to seek out rewards (ie, anticipatory reward responsiveness), but that the rewards they experience remain as enjoyable (ie, consummatory reward responsiveness). Results underscore the importance of continued investigation into the effects of the pandemic and physical distancing measures on reward system functioning. This is important given established links between reward system dysfunction, especially anticipatory reward responsiveness, and anhedonia and depression.[<reflink idref="bib30" id="ref50">30</reflink>] Results also may support the use of interventions (eg, behavioral activation) targeting the reward system during COVID-19.[<reflink idref="bib31" id="ref51">31</reflink>] Specifically, increased exposure to social rewards (via distanced technology) and/or engagement in home-based exercise may be important treatment goals in college populations while restrictions remain.[<reflink idref="bib32" id="ref52">32</reflink>]</p> <p>In addition, sleep efficiency (the ratio of sleep duration to time in bed) is a marker and risk factor for insomnia that was significantly lower post-COVID-19.[<reflink idref="bib33" id="ref53">33</reflink>] Daily diary findings suggest that sleep efficiency was lower because participants spent more time awake in bed (versus sleeping less) post-COVID-19. This contributes to insomnia because it weakens associations between the sleep environment and sleep, reducing the likelihood that getting into bed will evoke a sleep response.[<reflink idref="bib33" id="ref54">33</reflink>],[<reflink idref="bib34" id="ref55">34</reflink>] Thus, sleep efficiency may represent an important intervention target among college students during this and future pandemics to mitigate against the development of insomnia and associated mental health symptoms.</p> <p>Daily diary sleep efficiency results are consistent with established relationships between sleep disturbance and two domains negatively affected by COVID-19 in this study: reward system functioning and anhedonia.[<reflink idref="bib13" id="ref56">13</reflink>],[<reflink idref="bib35" id="ref57">35</reflink>] Importantly, decreased reward exposure and increased sleep disturbance are risk factors for subsequent depression/anhedonia.[<reflink idref="bib10" id="ref58">10</reflink>],[<reflink idref="bib35" id="ref59">35</reflink>] In contrast to existing research, results did not show increased depressive symptoms during the pandemic in college students.[<reflink idref="bib7" id="ref60">7</reflink>],[<reflink idref="bib8" id="ref61">8</reflink>],[<reflink idref="bib36" id="ref62">36</reflink>] Nevertheless, our results highlight reward system dysfunction and sleep disturbance as important prevention targets with the potential to mitigate against the future development of mental health symptoms among college students.</p> <p>Similar to depression symptoms, baseline insomnia severity (ISI) and anhedonia (MASQ-AD) were not significantly different between the groups. Importantly, daily diary assessment of sleep and anhedonia, via positive affect, may better capture acute symptom differences associated with the pandemic given the repeated measurements over one week (vs. retrospective assessment of global symptoms over the previous 1–2 weeks).</p> <p>Despite study contributions, a number of limitations should be noted. Due to study sample size and composition, caution should be used when generalizing findings to more diverse, non-college-aged populations and individuals who identify as male. This study used a between-subjects, cross-sectional design to explore the differences pre- and post-COVID-19 during a 2-month period immediately following the onset of the pandemic and implementation of physical distancing. However, longitudinal within-subjects research over longer periods is needed to fully characterize the effects of COVID-19 and associated restrictions on mental health. Future research exploring changes in these constructs following the lifting of restrictions will enhance our understanding of these relationships. In addition, although participants were subject to the same social distancing mandates, adherence to them was not examined. Lastly, the study relied on self-report, and future studies should utilize additional assessments of reward exposure and responsiveness and sleep (eg, neurobiological indices, behavioral tasks, actigraphy).</p> <p>Overall, this study adds to the emerging literature suggesting that the COVID-19 pandemic and associated restrictions negatively affected college student mental health, highlighting key impacts on anhedonia/positive affect, frequency of certain environmental rewards, anticipatory reward responsiveness, and sleep efficiency. Although additional research is needed, results may point to reward system functioning and sleep as key targets in college students to prevent mental health sequelae associated with COVID-19 and future pandemics.</p> <hd id="AN0176405461-18">Conflict of interest disclosure</hd> <p>The authors have no conflicts of interest to report. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of the United States of America and received approval from the Committee for the Protection of Human Participants in Research of Emmanuel College.</p> <hd id="AN0176405461-19">Funding</hd> <p>This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.</p> <ref id="AN0176405461-20"> <title> References </title> <blist> <bibl id="bib1" idref="ref1" type="bt">1</bibl> <bibtext> Oosterhoff B, Palmer CA, Wilson J, Shook N. 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J Med Internet Res. 2020; 22 (9): e22817. doi: 10.2196/22817.</bibtext> </blist> </ref> <ref id="AN0176405461-21"> <title> Footnotes </title> <blist> <bibtext> Given that 30 <emph>t</emph>-tests were conducted, we accounted for increased risk of Type 1 error by using a Benjamini-Hochberg corrected <emph>p</emph>-value. Compared to the Bonferroni correction, the Benjamini-Hochberg correction is better suited for detecting true small to medium effects because it is more powerful.<sups>24</sups> The Benjamini-Hochberg correction involves rank ordering observed <emph>p</emph>-values and then comparing each <emph>p</emph> value to its Benjamini-Hochberg critical value, which is calculated as (<emph>i/m</emph>)<emph>Q.</emph> In this calculation, <emph>i</emph> represents the rank of the observed <emph>p</emph>-value, <emph>m</emph> is the total number of tests, and <emph>Q</emph> is the false discovery rate, which was set to.05 for these analyses.</bibtext> </blist> </ref> <aug> <p>By Sarah T. Wieman; Jessica S. Fields; Kimberly A. Arditte Hall; Helen Z. MacDonald and Gabrielle I. Liverant</p> <p>Reported by Author; Author; Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib10" firstref="ref9"></nolink> <nolink nlid="nl2" bibid="bib11" firstref="ref10"></nolink> <nolink nlid="nl3" bibid="bib12" firstref="ref11"></nolink> <nolink nlid="nl4" bibid="bib13" firstref="ref12"></nolink> <nolink nlid="nl5" bibid="bib14" firstref="ref13"></nolink> <nolink nlid="nl6" bibid="bib15" firstref="ref14"></nolink> <nolink nlid="nl7" bibid="bib16" firstref="ref15"></nolink> <nolink nlid="nl8" bibid="bib17" firstref="ref16"></nolink> <nolink nlid="nl9" bibid="bib18" firstref="ref17"></nolink> <nolink nlid="nl10" bibid="bib19" firstref="ref26"></nolink> <nolink nlid="nl11" bibid="bib20" firstref="ref33"></nolink> <nolink nlid="nl12" bibid="bib21" firstref="ref36"></nolink> <nolink nlid="nl13" bibid="bib22" firstref="ref37"></nolink> <nolink nlid="nl14" bibid="bib23" firstref="ref38"></nolink> <nolink nlid="nl15" bibid="bib24" firstref="ref40"></nolink> <nolink nlid="nl16" bibid="bib25" firstref="ref47"></nolink> <nolink nlid="nl17" bibid="bib26" firstref="ref48"></nolink> <nolink nlid="nl18" bibid="bib28" firstref="ref49"></nolink> <nolink nlid="nl19" bibid="bib30" firstref="ref50"></nolink> <nolink nlid="nl20" bibid="bib31" firstref="ref51"></nolink> <nolink nlid="nl21" bibid="bib32" firstref="ref52"></nolink> <nolink nlid="nl22" bibid="bib33" firstref="ref53"></nolink> <nolink nlid="nl23" bibid="bib34" firstref="ref55"></nolink> <nolink nlid="nl24" bibid="bib35" firstref="ref57"></nolink> <nolink nlid="nl25" bibid="bib36" firstref="ref62"></nolink>
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  Data: Effects of the COID-19 Pandemic on Anhedonia, Reward Exposure and Responsiveness, and Sleep in College Students
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  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Sarah+T%2E+Wieman%22">Sarah T. Wieman</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-5768-0092">0000-0001-5768-0092</externalLink>)<br /><searchLink fieldCode="AR" term="%22Jessica+S%2E+Fields%22">Jessica S. Fields</searchLink><br /><searchLink fieldCode="AR" term="%22Kimberly+A%2E+Arditte+Hall%22">Kimberly A. Arditte Hall</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-3095-1099">0000-0002-3095-1099</externalLink>)<br /><searchLink fieldCode="AR" term="%22Helen+Z%2E+MacDonald%22">Helen Z. MacDonald</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-7902-4237">0000-0002-7902-4237</externalLink>)<br /><searchLink fieldCode="AR" term="%22Gabrielle+I%2E+Liverant%22">Gabrielle I. Liverant</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-4515-3046">0000-0003-4515-3046</externalLink>)
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  Label: Source
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  Data: <searchLink fieldCode="SO" term="%22Journal+of+American+College+Health%22"><i>Journal of American College Health</i></searchLink>. 2024 72(2):351-355.
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  Data: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
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  Data: Y
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  Data: 5
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  Label: Publication Date
  Group: Date
  Data: 2024
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  Label: Document Type
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  Data: Journal Articles<br />Reports - Research
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  Label: Education Level
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  Data: <searchLink fieldCode="EL" term="%22Higher+Education%22">Higher Education</searchLink><br /><searchLink fieldCode="EL" term="%22Postsecondary+Education%22">Postsecondary Education</searchLink>
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Undergraduate+Students%22">Undergraduate Students</searchLink><br /><searchLink fieldCode="DE" term="%22COVID-19%22">COVID-19</searchLink><br /><searchLink fieldCode="DE" term="%22Social+Isolation%22">Social Isolation</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+Health%22">Mental Health</searchLink><br /><searchLink fieldCode="DE" term="%22Psychological+Patterns%22">Psychological Patterns</searchLink><br /><searchLink fieldCode="DE" term="%22Physical+Environment%22">Physical Environment</searchLink><br /><searchLink fieldCode="DE" term="%22Environmental+Influences%22">Environmental Influences</searchLink><br /><searchLink fieldCode="DE" term="%22Patterned+Responses%22">Patterned Responses</searchLink><br /><searchLink fieldCode="DE" term="%22Rewards%22">Rewards</searchLink><br /><searchLink fieldCode="DE" term="%22Sleep%22">Sleep</searchLink>
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  Label: DOI
  Group: ID
  Data: 10.1080/07448481.2022.2047705
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  Label: ISSN
  Group: ISSN
  Data: 0744-8481<br />1940-3208
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: The COVID-19 pandemic's effects on college student mental health and its underlying mechanisms are not fully understood. Although necessary, physical distancing abruptly restricts interaction with environmental rewards and disrupts sleep patterns, both of which may contribute to psychological symptoms (eg, depression and anhedonia). This study explored differences in psychological symptoms, reward exposure and responsiveness, and sleep before versus during the pandemic. Methods: Eighty-seven college students completed baseline questionnaires and a one-week daily diary paradigm. The sample was divided into two groups based on data collection before (pre-) or after (post-COVID-19) implementation of state-wide COVID-19 physical distancing measures. Results: Findings highlight higher anhedonia, decrements in exposure to social, professional, and exercise related rewards, lower anticipatory reward responsiveness, and lower sleep efficiency among college students during the initial months of the pandemic. Conclusions: Findings suggest anhedonia, reward system functioning, and sleep may be important targets to mitigate against college student mental health sequelae during COVID-19.
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  Data: 2024
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  Data: EJ1419065
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        PageCount: 5
        StartPage: 351
    Subjects:
      – SubjectFull: Undergraduate Students
        Type: general
      – SubjectFull: COVID-19
        Type: general
      – SubjectFull: Social Isolation
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      – SubjectFull: Mental Health
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      – SubjectFull: Rewards
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      – SubjectFull: Sleep
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      – TitleFull: Effects of the COID-19 Pandemic on Anhedonia, Reward Exposure and Responsiveness, and Sleep in College Students
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