Investigating the relationship between family support and psychological distress mediated by psychological flexibility in high school students in online classes

Document Type : Research Paper

Authors

1 Iran - Kurdistan - University of Kurdistan - Faculty of Humanities and Social Sciences - Department of Counseling.

2 University of Kurdistan

Abstract

Introduction: Serious concerns about the mental health of adolescents during the pandemic related quarantine and school closures and entering online education have been raised. The aim of this study was to investigate the mediating role of psychological flexibility in the relationship between family support and psychological distress in high school students in the context of online classes.
Materials and Methods: The method of the present study is (correlation and structural equation modeling). The population of the study includes all junior and senior high school male students who were studying in online classes. The sample consisted of 644 male students (383 junior high school students and 261 senior high school students) who were selected by cluster random sampling method and assigned to answer the Depression, Anxiety and Stress Scale (DASS-21), Multidimensional scale of perceived Social Support Questionnaire - Family Dimension (MSPSS-Family) and Acceptance and Action Questionnaire 2 (AAQ-II).
Findings: Data analysis showed that the structural model of the study has a good fit. Also, this model showed that family support is negatively related to psychological distress and positively related to psychological flexibility, and psychological flexibility is also negatively related to psychological distress.
Discussion and Conclusion: By acknowledging the mediating role of psychological flexibility and the effective role of family support in reducing psychological distress and increasing adolescent flexibility, one can make better planning for family participation and awareness in adolescent students' psychological issues in the future.

Keywords


References

1- Alqahtani AY. Rajkhan AA. E-learning critical success factors during the covid-19 pandemic: A comprehensive analysis of e-learning managerial perspectives. Education sciences, 2020. 10(9): p. 216. [DOI:10.3390/educsci10090216]

2- Misirli O, Ergulec F. Emergency remote teaching during the COVID-19 pandemic: Parents experiences and perspectives. Education and information technologies, 2021. 26(6): p. 6699-6718. [https://doi.org/10.1007/s10639-021-10520-4]

3- Aldhafeeri FM, Khan BH. Teachers’ and students’ views on e-learning readiness in Kuwait’s secondary public schools. Journal of Educational Technology Systems, 2016. 45(2): p. 202-235. [DOI:10.1177/0047239516646747]

4- Armitage R, Nellums LB. Considering inequalities in the school closure response to COVID-19. The Lancet Global Health, 2020. 8(5): p. e644. [DOI: 10.1016/s2214-109x (20)30116ـ9]

5- Lee J. Mental health effects of school closures during COVID-19. The Lancet Child & Adolescent Health, 2020. 4(6): p. 421. [DOI: 10.1016/S2352ـ4642 (20)30109ـ7]

6- Drapeau A, M.A., Beauli-Prévost D, Epidemiology of psychological distress. In Luciano L’Abate (Ed.) Mental Illnesses ـ Understanding, Prediction and Control. Rijeka. 2012, Intech: Janeza Trdine 9, 51000 Rijeka, Croatia. [DOI:10.5772/29413]

7- Mirowsky J, Ross CE. Social causes of psychological distress. 2017: Routledge.

8- Ohayashi H. Psychological distress: symptoms, causes, and coping. 2012: Nova Science Publishers.

9- Davis CP. Medical definition of stress. 2021  [cited Reviewed 2021 March; Available from: https://www.medicinenet.com/stress/definition.htm.

10- Association AP. What Is Depression? . 2020  [cited 2020 October]; Available from: from https://psychiatry.org/patients-families/depression/what-is-depression.

11- Association AP. What are Anxiety Disorders? 2021 [cited 2021 June]; Available from: From https://psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders.

12- Sheeber L, et al. Family support and conflict: Prospective relations to adolescent depression. Journal of abnormal child psychology, 1997. 25(4): p. 333-344. [DOI: 10.1023/a:1025768504415.]

13- Stice E, Ragan J, Randall P. Prospective relations between social support and depression: Differential direction of effects for parent and peer support? Journal of abnormal psychology, 2004. 113(1): p. 155. [DOI:10.1037/0021-843X.113.1.155 ]

14- Campos B, et al. Familism and psychological health: the intervening role of closeness and social support. Cultural Diversity and Ethnic Minority Psychology, 2014. 20(2): p. 191. [DOI: 10.1037/a0034094]

15- Shaw BA, et al. Emotional support from parents early in life, aging, and health. Psychology and aging, 2004. 19(1): p. 4. [DOI:10.1037/0882ـ7974.19.1.4]

16- Kimiaee S, et al. Develop and Study of Preliminary Psychometric and Validation Characteristic of Iranian Family Psychological Function Scale. Journal of Modern Psychological Researches, 2012. 7(27): p. 145-182. [Persian]

17- Cardol M, et al. Shared help seeking behaviour within families: a retrospective cohort study. Bmj, 2005. 330(7496): p. 882. [DOI:10.1136/bmj.38411.378229.E0]

18- Lai CC. Ma CM. The mediating role of social support in the relationship between psychological well-being and health-risk behaviors among Chinese university students. Health psychology open, 2016. 3(2): p. 2055102916678106. [DOI:10.1177/2055102916678106]

19-Fledderus M, et al, The role of psychological flexibility in a self-help acceptance and commitment therapy intervention for psychological distress in a randomized controlled trial. Behaviour research and therapy, 2013. 51(3): p. 142-151.[DOI: 10.1016/j.brat.2012.11.007]

20- Hayes SC, et al, Acceptance and commitment therapy: Model, processes and outcomes. Behaviour research and therapy, 2006. 44(1): p. 1-25. [DOI:10.1016/j.brat.2005.06.006]

21- Williams KE, Ciarrochi J. Heaven PC. Inflexible parents, inflexible kids: A 6-year longitudinal study of parenting style and the development of psychological flexibility in adolescents. Journal of youth and adolescence, 2012. 41(8): p. 1053-1066. [DOI:10.1007/s10964ـ012ـ9744ـ0]

22- Raimundi MJ, et al, Family functioning profiles and character strengths in young elite athletes from Argentina. International Journal of Sport and Exercise Psychology, 2019. 17(1): p. 32-51. [DOI:10.1080/1612197x.2016.1189949]

23- Berryhill MB, Hayes A, Lloyd K. Chaotic-enmeshment and anxiety: the mediating role of psychological flexibility and self-compassion. Contemporary Family Therapy, 2018. 40(4): p. 326-337. [DOI:10.1007/s10591ـ018ـ9461ـ2]

24- Arias-de la Torre J, et al, Psychological distress, family support and employment status in first-year university students in Spain. International journal of environmental research and public health, 2019. 16(7): p. 1209. [DOI:10.3390/ijerph16071209]

25- Parker J, et al, Family support and psychological distress among commuter college students. Journal of American college health, 2021: p. 1-10. [DOI:10.1080/07448481.2021.1895805]

26- Boudreault-Bouchard A-M, et al., Impact of parental emotional support and coercive control on adolescents' self-esteem and psychological distress: Results of a four-year longitudinal study. Journal of adolescence, 2013. 36(4): p. 695-704. [DOI:10.1016/j.adolescence.2013.05.002]

27- Zhu L. A multi-level analysis on school connectedness, family support, and adolescent depression: Evidence from the National Longitudinal Study of Adolescent Health, 1995–1996. Social Sciences, 2018. 7(5): p. 72. [DOI:10.3390/socsci7050072]

28- Roche KM, Bingenheimer JB, Ghazarian SR. The dynamic interdependence between family support and depressive symptoms among adolescents in Ghana. International journal of public health, 2016. 61(4): p. 487-494. [DOI:10.1007/s00038ـ015ـ0781ـ9]

29- Maleki Pirbazari M, Nouri R, Sarami G. Social support and depression symptoms: The mediating role of self-efficacy. Contemporary Psychology, Biannual Journal of the Iranian Psychological Association, 2012. 6(2): p. 26-34. [https://bjcp.ir/browse.php?a_id=33&sid=1&slc_lang=en]. [Persian]

30- Masuda A, Tully EC. The role of mindfulness and psychological flexibility in somatization, depression, anxiety, and general psychological distress in a nonclinical college sample. Journal of Evidence-Based Complementary & Alternative Medicine, 2012. 17(1): p. 66-71. [DOI:10.1177/2156587211423400]

31- Azadeh SM, Kazemi-Zahrani H, Besharat MA. Effectiveness of acceptance and commitment therapy on interpersonal problemsand psychological flexibility in female high school students with social anxiety disorder. Global journal of health science, 2016. 8(3): p. 131. [DOI:10.5539/gjhs.v8n3p131]

32- salehzadeh Einabad Z, et al., Investigation of the relationship among acceptance, control, avoidance and anxiety and gender differences in anxiety. Rooyesh-e-Ravanshenasi Journal(RRJ), 2018. 7(5): p. 129-146. [http://frooyesh.ir/article-1-390-en.html]. [Persian]

33- Akbari M, Seydavi M, Zamani E. The mediating role of personalized psychological flexibility in the association between distress intolerance and psychological distress: A national survey during the fourth waves of COVID‐19 pandemic in Iran. Clinical Psychology & Psychotherapy, 2021. 28(6): p. 1416-1426. [https://doi.org/10.1002/cpp.2685]

34- Huang C, et al., Is psychological flexibility a mediator between perceived stress and general anxiety or depression among suspected patients of the 2019 coronavirus disease (COVID-19)? Personality and Individual Differences, 2021. 183: p. 111132. [DOI:10.1016/j.paid.2021.111132]

35- Bibi A, et al., Impact of Parenting Styles on Psychological Flexibility Among Adolescents of Pakistan: A Cross-Sectional Study. Child and Adolescent Social Work Journal, 2022. 39(3): p. 313-322. [DOI:10.1007/s10560ـ021ـ00754ـz]

36- Golberstein E, Wen H, Miller BF. Coronavirus disease 2019 (COVID-19) and mental health for children and adolescents. JAMA pediatrics, 2020. 174(9): p. 819-820. [DOI:10.1001/jamapediatrics.2020.1456]

37- Scott, S.R., et al., “I Hate This”: A Qualitative Analysis of Adolescents' Self-Reported Challenges During the COVID-19 Pandemic. Journal of Adolescent Health, 2021. 68(2): p. 262-269. [DOI:10.1016/j.jadohealth.2020.11.010]

38- Lovibond PF, Lovibond S.H. The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour research and therapy, 1995. 33(3): p. 335-343. [DOI:10.1016/0005ـ7967 (94)00075ـu]

39- Aazami Y, KhanjaniM, Sader M.M. Confirmatory factor structure of depression, anxiety and stress scale in students. Journal of Mazandaran University of Medical Sciences, 2017. 27(154): p. 94-106. [http://jmums.mazums.ac.ir/article-1-9617-en.html]. [Persian]

40- Zimet GD, et al., The multidimensional scale of perceived social support. Journal of personality assessment, 1988. 52(1): p. 30-41. [DOI:10.1207/s15327752jpa5201ـ2]

41- Edwards LM, Measuring perceived social support in Mexican American youth: Psychometric properties of the multidimensional scale of perceived social support. Hispanic journal of behavioral sciences, 2004. 26(2): p. 187-194. [DOI:10.1177/0739986304264374]

42- ALIPOUR A, et al., Relationship between perceived social support and adherence of treatment in Diabetes mellitus type 2: mediating role of resillency and hope. 2016. [http://rph.khu.ac.ir/article-1-2679-en.html]. [Persian]

43- Bond FW, et al., Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behavior therapy, 2011. 42(4): p. 676-688. [DOI:10.1016/j.beth.2011.03.007]

44- Imani M, Evaluation of the factor structure of the psychological flexibility questionnaire in students. . Teaching and Learning Studies, 2016. 8(1): p. 162-181. [DOI:10.22099 / jsli.2016.3830]. [Persian]

45- Hooper D, Coughlan J, Mullen MR. Structural equation modelling: Guidelines for determining model fit. Electronic journal of business research methods, 2008. 6(1): p. pp53‑60-pp53‑60. [DOI:10.21427/D7CF7R]

46- Arbuckle JL. Wothke W. AMOS user’s guide 7.0. Spring House, PA: AMOS Development Corporation, 2006.

47- Ramezankhani A, et al., Perceived social support, depression, and perceived stress in university students. Archives of Advances in Biosciences, 2013. 4(4). [https://doi.org/10.22037/jps.v4i4.4846]

48- Rathakrishnan B, et al., Homesickness and socio-cultural adaptation towards perceived stress among international students of a public university in Sabah: an exploration study for social sustainability. Sustainability, 2021. 13(9): p. 4924. [https://doi.org/10.3390/su14063250]

49- Tian X, et al., The positive effect of social support on psychological distress among Chinese lung cancer patients: The mediating role of self‐esteem. Nursing open, 2021. 8(4): p. 1642-1651. [DOI:10.1002/nop2.793]

50- Temel M, Atalay A.A. The relationship between perceived maternal parenting and psychological distress: Mediator role of self-compassion. Current Psychology, 2020. 39(6): p. 2203-2210. [https://doi.org/10.1007/s12144-018-9904-9]

51- Anderson SF, Sladek M.R. Doane LD. Negative affect reactivity to stress and internalizing symptoms over the transition to college for Latinx adolescents: Buffering role of family support. Development and psychopathology, 2021. 33(4): p. 1322-1337. [https://doi.org/10.1017/S095457942000053X]

52- Marroquín B, Interpersonal emotion regulation as a mechanism of social support in depression. Clinical psychology review, 2011. 31(8): p. 1276-1290. [DOI:10.1016/j.cpr.2011.09.005]

53- Chao RCL. Managing stress and maintaining well‐being: Social support, problem‐focused coping, and avoidant coping. Journal of Counseling & Development, 2011. 89(3): p. 338-348. [https://doi.org/10.1002/j.1556-6678.2011.tb00098.x]

54- Ma Y, The Roles of Mindfulness and Family Emotional Climate on Chinese Adolescents' Emotion Regulation and Psychological Distress: A Mixed-method Study. 2017: The Chinese University of Hong Kong (Hong Kong).

55- Scanlon NM, Epkins C.C. Aspects of mothers’ parenting: Independent and specific relations to children’s depression, anxiety, and social anxiety symptoms. Journal of Child and Family Studies, 2015. 24(2): p. 249-263. [https://psycnet.apa.org/doi/10.1007/s10826-013-9831-1]

56- Shin H, et al., Students’ perceptions of parental bonding styles and their academic burnout. Asia Pacific Education Review, 2012. 13(3): p. 509-517. [DOI:10.1007/s12564ـ012ـ9218ـ9]

57- Nunes Baptista M, et al., Soporte social, familiar y autoconcepto: relación entre los constructos. Psicología desde el Caribe, 2012. 29(1): p. 1-18.[ http://www.scielo.org.co/pdf/psdc/v29n1/v29n1a02.pdf]

58- Campos EP. Suporte social e família. Doença e família, 2004: p. 141-161.

59- Cummings EM, Cheung RY, Davies PT. Prospective relations between parental depression, negative expressiveness, emotional insecurity, and children’s internalizing symptoms. Child Psychiatry & Human Development, 2013. 44(6): p. 698-708. [DOI:10.1007/s10578-013-0362-1]

60- Maarefvand A, Shafiabady A. The role of emotional regulation, self-belief, and psychological flexibility in predicting social anxiety and depression among female high school students; the mediating role of social functioning. Rooyesh-e-Ravanshenasi Journal (RRJ), 2021. 9(11): p. 97-110. [http://frooyesh.ir/article-1-2348-en.html]. [Persian]

61- Gloster AT, Meyer A.H. Lieb R. Psychological flexibility as a malleable public health target: Evidence from a representative sample. Journal of Contextual Behavioral Science, 2017. 6(2): p. 166-171. [DOI:10.1016/j.jcbs.2017.02.003]

62- Hayes SC, Sanford BT. Cooperation came first: Evolution and human cognition. Journal of the Experimental Analysis of Behavior, 2014. 101(1): p. 112-129. [DOI:10.1002/jeab.64]

63- Kashdan TB, Rottenberg J. Psychological flexibility as a fundamental aspect of health. Clinical psychology review, 2010. 30(7): p. 865-878. [DOI:10.1016/j.cpr.2010.03.001]

64-Kafetsios K, Sideridis G.D. Attachment, social support and well-being in young and older adults. Journal of health psychology, 2006. 11(6): p. 863-875. [DOI:10.1177/1359105306069084]

65- Collins NL, Feeney B.C. A safe haven: an attachment theory perspective on support seeking and caregiving in intimate relationships. Journal of personality and social psychology, 2000. 78(6): p. 1053. [DOI:10.1037/0022ـ3514.78.6.1053]