Abstract

BackgroundThe year 2020 has been challenging for many, particularly for young adults who have been adversely affected by the COVID-19 pandemic. Emerging adulthood is a developmental phase with significant changes in the patterns of daily living; it is a risky phase for the onset of major mental illness. College students during the pandemic face significant risk, potentially losing several protective factors (eg, housing, routine, social support, job, and financial security) that are stabilizing for mental health and physical well-being. Individualized multiple assessments of mental health, referred to as multimodal personal chronicles, present an opportunity to examine indicators of health in an ongoing and personalized way using mobile sensing devices and wearable internet of things.ObjectiveTo assess the feasibility and provide an in-depth examination of the impact of the COVID-19 pandemic on college students through multimodal personal chronicles, we present a case study of an individual monitored using a longitudinal subjective and objective assessment approach over a 9-month period throughout 2020, spanning the prepandemic period of January through September.MethodsThe individual, referred to as Lee, completed psychological assessments measuring depression, anxiety, and loneliness across 4 time points in January, April, June, and September. We used the data emerging from the multimodal personal chronicles (ie, heart rate, sleep, physical activity, affect, behaviors) in relation to psychological assessments to understand patterns that help to explicate changes in the individual’s psychological well-being across the pandemic.ResultsOver the course of the pandemic, Lee’s depression severity was highest in April, shortly after shelter-in-place orders were mandated. His depression severity remained mildly severe throughout the rest of the months. Associations in positive and negative affect, physiology, sleep, and physical activity patterns varied across time periods. Lee’s positive affect and negative affect were positively correlated in April (r=0.53, P=.04) whereas they were negatively correlated in September (r=–0.57, P=.03). Only in the month of January was sleep negatively associated with negative affect (r=–0.58, P=.03) and diurnal beats per minute (r=–0.54, P=.04), and then positively associated with heart rate variability (resting root mean square of successive differences between normal heartbeats) (r=0.54, P=.04). When looking at his available contextual data, Lee noted certain situations as supportive coping factors and other situations as potential stressors.ConclusionsWe observed more pandemic concerns in April and noticed other contextual events relating to this individual’s well-being, reflecting how college students continue to experience life events during the pandemic. The rich monitoring data alongside contextual data may be beneficial for clinicians to understand client experiences and offer personalized treatment plans. We discuss benefits as well as future directions of this system, and the conclusions we can draw regarding the links between the COVID-19 pandemic and college student mental health.

Highlights

  • Emerging Adulthood and CollegeYoung adults between the ages of 18-25 years report greater feelings of loneliness than other age groups [1]

  • In the month of January was sleep negatively associated with negative affect (r=–0.58, P=.03) and diurnal beats per minute (r=–0.54, P=.04), and positively associated with heart rate variability (r=0.54, P=.04)

  • We focused on heart rate (BPM), heart rate variability (RMSSD), sleep quality, step count, and affect for this case study

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Summary

Introduction

Emerging Adulthood and CollegeYoung adults between the ages of 18-25 years report greater feelings of loneliness than other age groups [1]. Emerging adulthood is a developmental period marked by tremendous growth and opportunity and by significant risk [2,3]. It is during this phase that the majority of major disease processes have their onset [4,5,6,7]; this is a time when emerging adults develop habits for adaptive ways of managing stress and help-seeking behaviors [8]. College students during the pandemic face significant risk, potentially losing several protective factors (eg, housing, routine, social support, job, and financial security) that are stabilizing for mental health and physical well-being. Individualized multiple assessments of mental health, referred to as multimodal personal chronicles, present an opportunity to examine indicators of health in an ongoing and personalized way using mobile sensing devices and wearable internet of things

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