*3.4. Analysis of the Significance of Factors*

A one-way within subject analysis of variance (ANOVA) was applied to assess the significance of each factor such as the gender, residence and annual household income, as shown in Tables 4–6. Table 4 demonstrates that the F values of the ANOVA were below 3.0 and the *p* values were above 0.05. Hence, it could be said that there was no difference in regard to the residence. Thus, Hypothesis 1 was not supported.


**Table 4.** The difference in psychological symptoms across the residences.

F, test statistic; *p*, probability value.

**Table 5.** The impact of the risk level of the residence on anxiety.


Anxiety 2.32 ± 0.65 2.33 ± 0.64 0.071 0.790

**Table 6.** The impact of the risk level of the residence on fear.


The impact of the risk level of the residence on the anxiety variation of participants is demonstrated in Table 5. It was found that 8.73% lived in a high risk level region; 58.30% and 32.96% were in the regions of medium and low risk levels. At the same time, the participants who lived in the medium and high risk level regions had greater anxiety than those of the low risk level regions. In addition, most of the participants appeared in the mild level of anxiety in this study.

Similar to the case of anxiety, the participants located in the safer regions experienced less fear, as shown in Table 6. The fear level of most of the participants was normal and mild. The safer areas had fewer restrictions and the participants could have more social interactions, physical activities and supplies, which was of benefit for good emotions.

According to Table 7, the F values of all psychological symptoms were below 3.0 and the *p* values were also above 0.05. Hence, it can be said that there was no obvious difference in regard to the gender so Hypothesis 2 was not supported.


**Table 7.** The difference in psychological symptoms across the genders.

F, test statistic; *p*, probability value.

Table 8 demonstrates that there were no significant differences in invulnerability, conformity, fear, bravado, rebelliousness and anxiety in regard to the annual household income so Hypothesis 3 was not supported. However, the economical level of the family had an obvious influence on insensitivity during the epidemic period (F = 3.668, *p* = 0.033). The students with a medium annual household income had a high level of psychological symptoms such as invulnerability, conformity, fear, rebelliousness and insensitivity and the participants who had the highest annual household income had the highest level of anxiety.


**Table 8.** The difference in psychological symptoms across the annual household income.

F, test statistic; *p*, probability value; \* *p* < 0.05.

#### **4. Discussions**

In this survey, over half of all college students surveyed had psychological symptoms of fear and anxiety during the epidemic of COVID-19. In the early epidemic stage, the origin, transmission routes and suitable medicines were unknown. A lot of negative information and rumors about the virus emerged in the media or on the internet and governments had no time to debunk them. At the same time, college students were isolated in the home and spent a lot of time browsing the internet; thus, a greater number of negative psychological symptoms appeared [25]. College students are in the later stage of adolescence and their mental states can be more easily affected by the information from the internet or media [26]. Thus, the college students surveyed suffered from fear, anxiety, invulnerability, conformity, bravado, rebelliousness and insensitivity symptoms.

In this survey, 62.64% students had anxiety symptoms during the epidemic. Batra et al. assessed the psychological impact of COVID-19 among college students and found that the prevalence of anxiety in China was 25.5% compared with 58.7% in other regions [27]. The government strengthened the management of information released, the frequency of news release conferences increased and information or knowledge acquisition methods were also added. Thus, college students could know more information about COVID-19 and the cognition of COVID-19 was rebuilt. The level of the psychological symptoms appearing in college students gradually decreased [26].

In addition, the high grade students experienced more anxiety. The emotion variation was related to the worry of being infected, social support, income and academic delay [28]. The freshmen would not consider the graduation, employment and practice course [21], which would relieve part of the stress and anxiety [29]. Moreover, the higher grade students had greater academic pressure [21].

According to the results of Li et al., the risk level of the community had a linear relationship with the psychological symptoms of the residents (Severe ≥ 10,000 confirmed cases: Hubei province; Moderate = 1000–9999 confirmed cases: Guangdong, Henan, Hunan and Zhejiang provinces; Mild ≤ 1000 confirmed cases: all other provinces) [30]. Budimir et al. also thought that the risk level of the epidemic had a significant influence on mental health, e.g., depression, anxiety and insomnia [31]. In this survey, it was revealed that about 0.6% respondents had infected relatives, which had a negative effect on the emotional state of the students. However, Moghanibashi-Mansourieh claimed that belief was rebuilt after the relatives recovered from COVID-19 and the infected relatives had a positive influence on anxiety and stress reduction [32].

This survey revealed that there were no significant differences in gender, residence and annual household income and all hypotheses were not supported although there were significant differences of economy, infrastructure and policy of the central government between the rural and urban regions in China. In general, the economic situation in the rural regions was usually lower than in the urban region. At the same time, college students had to complete their study online and the internet in the rural regions was worse than in the urban regions [33]. Moreover, the urban regions had more hospitals and the patients could be promptly treated [28]. Food and medical supplies were also preferentially provided. However, rural regions usually have a low population density and the risk level was lower than that of urban regions. Hence, the limits of COVID-19 prevention in urban regions were stricter than those of the rural regions. Thus, there was no significant difference in the psychological symptoms with regard to the residence.

Insensitivity symptoms seemed to have a significant difference in the annual household income. The participants with a 0.2–0.4 Chinese Yuan (RMB) million annual household income had the highest level of insensitivity symptoms due to the middle-class family having no financial pressures. Rossell et al. reported that people under economic stress experience more negative emotions [34]. At the same time, the parents of the middle-class families had more time to accompany the children. The participants who had the highest household income had the highest anxiety because they were worried about their business.

Although females were more sensitive and emotional to the environment due to biological factors and females experienced greater anxiety and fear in the disaster [35], the present study also discovered that both female and male college students had similar negative psychological symptoms during the epidemic of COVID-19. This conclusion was consistent with previous studies [21,28].

In general, half of the participants had negative psychological symptoms. Suitable intervening methods or strategies such as online psychological counseling and online mental health education courses as well as opportunities for talking with classmates, friends or teachers should be provided, which could be useful for building a positive attitude and effectively reducing the stress or psychological symptoms. Social support was also important in maintaining the psychology of college students. In addition, the psychological resilience of college students played an important role in safeguarding their mental health [12]. Shorter studying hours, a reduced workload, keeping enough sleep time and regular eating of healthy food were should be considered to improve the resilient mentality [36].

#### **5. Limitation**

This study had a few limitations, which limited the application of this finding in other epidemics. Firstly, the study had a limited response of 1168 and all respondents came from one university located in Wuhan city. The generalizability of this finding was insufficient. Secondly, this study was undertaken between April and June, which was the medium stage of COVID-19; the views could not represent the final view such as the influence of infected relatives on the psychological symptoms of students. A secondary survey was necessary and the dynamic variations of the psychological symptoms should be tracked. Thirdly, the respondents were not equally distributed with regard to gender, grade and residence. Lastly, all data from the survey were obtained by self-reporting.

Although there were a few shortcomings, this study gave the psychological symptoms of college students in the COVID-19 epidemic, which was useful for choosing a suitable method of psychological intervention.

### **6. Future Direction**

This survey investigated the dependence of psychological symptoms such as fear, anxiety, conformity, invulnerability, insensitivity and rebelliousness on the gender, residence and annual household income during the epidemic of COVID-19. A longitudinal study of the psychological symptoms during and after the epidemic is necessary and the severity of psychological symptoms can be understood. In addition, the relationship between psychological symptoms and academic study also should be considered. Lastly, it is also worth considering the influence of the suggested intervention methods on psychological symptoms.

#### **7. Conclusions**

In general, all members of society have had a huge stress due to the high fatality rate of COVID-19. Especially for relatives or friends who were infected by or exposed to COVID-19, stress levels sharply increased. Thus, the body shows stress responses such as the variation of emotions, biology, behavior and cognition. In this study, it was revealed that half of the participants had obvious psychological symptoms during the epidemic of COVID-19. The psychological symptoms of the college students were anxiety (61.64%), fear (58.39%), conformity (49.49%), invulnerability (26.11%), insensitivity (21.49%) and rebelliousness (12.41%). In addition, about 6.16% students had insomnia and 2.83% had the symptoms of in-appetite.

Moreover, the results of the survey also presented that psychological symptoms had no significant difference with regard to the gender, residence and annual household income while the financial level of the family had an obvious influence on insensitivity symptoms during the epidemic period. The survey also revealed that the senior students experienced more fear and anxiety than the freshmen due to the worry about the academic study delay and practice courses, graduation and employment.

**Author Contributions:** Conceptualization, J.H.; methodology, Y.L.; software, L.Q.; investigation, Y.S.; writing—original draft preparation, Y.L.; writing—review and editing, J.H. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research was funded by Teaching Reform Research Project of Hubei Province, grant number 2018245. The APC was funded by Teaching Reform Research Project of Hubei Province.

**Institutional Review Board Statement:** The study was conducted according to the guidelines of the Declaration of Helsinki and approved by Ethics Committee of Wuhan University of Science and Technology (protocol code 20200407, 4 February 2021).

**Informed Consent Statement:** Informed consent was obtained from all subjects involved in the study.

**Data Availability Statement:** The data presented in this study are available on request from the corresponding author.

**Conflicts of Interest:** The authors declare no conflict of interest.
