Negative life events, inadequate mental health literacy, and emotional symptoms among Chinese college students: a school-based longitudinal prospective study.

Abstract

Background: Emotional symptoms have emerged as a major public health concern, affecting the mental and physical well-being of college students worldwide. Negative life events and mental health literacy are commonly recognized as significant predictors of emotional symptoms. However, research on their combined effects remains limited, particularly in longitudinal studies. This study aimed to investigate the interaction between negative life events and mental health literacy in relation to emotional symptoms among college students.

Methods: A longitudinal study was conducted from November 2021 to June 2022 to assess negative life events, mental health literacy, and emotional symptoms among college students. A total of 3,210 students (mean age: 19.49 ± 0.87 years) were selected using a cluster sampling method in Anhui Province, China. Multivariate logistic regression models were employed to evaluate the combined effects of negative life events and mental health literacy on emotional symptoms.

Results: The prevalence of depressive symptoms, anxiety symptoms, and stress symptoms was 15.3%, 19.7%, and 4.2%, respectively. Negative life events were significantly associated with an increased risk of depressive symptoms (RR = 1.568, 95%CI: 1.282-1.918), anxiety symptoms (RR = 1.603, 95%CI: 1.338-1.919), and stress symptoms (RR = 1.717, 95%CI: 1.194-2.470). Additionally, students with inadequate mental health literacy exhibited a higher incidence of depressive symptoms (RR = 1.286, 95%CI: 1.035-1.597) and anxiety symptoms (RR = 1.343, 95%CI: 1.105-1.632) compared to those with adequate mental health literacy. Furthermore, students who experienced high levels of negative life events and had inadequate mental health literacy were at the highest risk of developing depressive symptoms (RR = 2.447, 95%CI: 1.709-3.504) and anxiety symptoms (RR = 2.466, 95%CI: 1.802-3.375).

Conclusion: This study did not confirm a direct correlation between mental health literacy and general psychological health. Moreover, due to contextual differences across societies, the generalizability of these findings should be approached with caution. Nonetheless, the results highlight that negative life events and mental health literacy jointly influence emotional symptoms. These findings underscore the importance of interventions aimed at improving college students' mental health literacy and enhancing their ability to cope with negative life events.