Stress, Emotional Eating and Food Choices Among University Students During the Covid-19
Keywords:
stress, emotional eating, eating behaviour, university students, Covid-19
Abstract
The Covid-19 pandemic has had a huge impact on stress and eating behaviours. This study aims to determine the relationship between stress, emotional eating, and food choices among university students during the Covid-19. A total of 273 university students participated in this cross-sectional study. Online self-administered questionnaires were used to determine the stress intensity, emotional eating, and eating behaviours. All statistical analyses were performed using Statistical Package for the Social Sciences (SPSS). Almost half (49.8%) of the participants experienced high stress. In males, the high-stress group consumed sweets or sugars more frequently than the low-stress group (p<0.05). In females, the high-stress group consumed more sweets or sugar and cakes or cookies but less milk products and fresh fruits than the low-stress group (p<0.05). Students with higher negative emotion scores consumed less cooked vegetables (r=-0.133; p<0.05) whereas students with higher positive emotion scores consumed more fast food (r=0.208; p<0.001), sweets or sugar (r=0.139; p<0.05) and cakes or cookies (r=0.139; p<0.05). Body Mass Index (BMI) was positively correlated with negative emotions (r=0.134; p<0.05), negative situations (r=0.161; p<0.01), and total negative Emotional Appetite Questionnaire (EMAQ) scores (r=0.168; p<0.01). In conclusion, Covid-19 brings negative impact on stress. University students shifted food preferences from healthy foods to palatable foods and this could result in adverse health outcomes. Therefore, stress management interventions and nutrition education should be implemented to reduce stress and overcome stress-induced eating behaviour among private university students during the Covid-19.
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References
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Aristovnik, A., Keržič, D., Ravšelj, D., Tomaževič, N., Umek, L. (2020). Impacts of the COVID-19 Pandemic on Life of Higher Education Students: A Global Perspective. Sustainability , 12, 8438.
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Bayram, N. & Bilgel, N. (2008) The Prevalence And Socio-Demographic Correlations Of Depression, Anxiety And Stress Among A Group Of University Students. Soc Psychiatry Psychiatr Epidemiol, 43, 667-72.
Biasi, V. & Bonaiuto, P. (2014) Negative Emotions And Defence Mechanisms In Obese People. Psychology, 5(18), 1979-1988.
Bilici, S., Ayhan, B., Karabudak, E. & Koksal, E. (2020) Factors Affecting Emotional Eating And Eating Palatable Food In Adults. Nutrition Research And Practice, 14, 70.
Cao,W., Fang, Z., Hou, G., Han, M., Xu, X., Dong, J., Zheng, J. (2020) The psychological impact of the COVID-19 epidemic on college students in China. J. Psychiatry Res. 287, 112934.
Cardi, V., Leppanen, J. & Treasure, J. (2015) The Effects Of Negative And Positive Mood Induction On Eating Behaviour: A Meta-Analysis Of Laboratory Studies In The Healthy Population And Eating And Weight Disorders. Neuroscience & Biobehavioral Reviews, 57, 299-309.
Cheng, S. H. & Kamil, M. (2020) Stress And Food Intake Among University Students - Is There A Relationship? Sains Malaysiana, 49, 121-128.
Cohen, S. (1988) Perceived Stress In A Probability Sample Of The United States. The Social Psychology Of Health. Thousand Oaks, Ca, Us: Sage Publications, Inc.
El Ansari, W. & Berg-Beckhoff, G. (2015) Nutritional Correlates Of Perceived Stress Among University Students In Egypt. Int J Environ Res Public Health, 12, 14164-76.
Elshurbjy, A. & Ellulu, M. S. (2017) Association Between Stress And Dietary Behaviors Among University Students: Mini-Review. Medical And Clinical Archives, 1.
Evers, C., Adriaanse, M., Ridder, D. & Huberts, J. (2013) Good Mood Food: Positive Emotion As A Neglected Trigger For Food Intake. Appetite, 68.
Ganley, R. M. (1989) Emotion And Eating In Obesity: A Review Of The Literature. International Journal Of Eating Disorders, 8, 343-361.
Geliebter, A. & Aversa, A. (2003) Emotional Eating In Overweight, Normal Weight, And Underweight Individuals. Eating Behaviors, 3, 341-347.
Goldschmidt, A. B., Crosby, R. D., Engel, S. G. et al. (2014) Affect And Eating Behavior In Obese Adults With And Without Elevated Depression Symptoms. Int J Eat Disord, 47, 281-6.
Halboub, E., Alhajj, M. N., Alkhairat, A. M., Sahaqi, A.-A. M. & Quadri, M. F. A. (2018) Perceived Stress Among Undergraduate Dental Students In Relation To Gender, Clinical Training And Academic Performance. Acta Stomatologica Croatica, 52, 37-45.
Jansen, A., Vanreyten, A., van Balveren, T., Roefs, A., Nederkoorn, C. & Havermans, R. (2008) Negative Affect And Cue-Induced Overeating In Non-Eating Disordered Obesity. Appetite, 51, 556-62.
Jarman, M., Lawrence, W., Ntani, G. et al. (2012) Low Levels Of Food Involvement And Negative Affect Reduce The Quality Of Diet In Women Of Lower Educational Attainment. J Hum Nutr Diet, 25, 444-52.
Kandiah, J., Yake, M., Jones, J. & Meyer, M. (2006) Stress Influences Appetite And Comfort Food Preferences In College Women. Nutrition Research, 26, 118-123.
Khubchandani, J., Kandiah, J., Saiki, D. (2020) The COVID-19 Pandemic, Stress, and Eating Practices in the United States. Eur. J. Investig. Health Psychol. Educ. 10, 950-956.
Laitinen, J., Ek, E. & Sovio, U. (2002) Stress-Related Eating And Drinking Behavior And Body Mass Index And Predictors Of This Behavior. Prev Med, 34, 29-39.
Lindeman, M. & Stark, K. (2001) Emotional Eating And Eating Disorder Psychopathology. Eat Disord, 9, 251-9.
Macht, M. (1999) Characteristics Of Eating In Anger, Fear, Sadness And Joy. Appetite, 33 (1), 129-139.
Macht, M., Roth, S. & Ellgring, H. (2002) Chocolate Eating In Healthy Men During Experimentally Induced Sadness And Joy. Appetite, 39, 147-58.
Macht, M. & Simons, G. (2000) Emotions And Eating In Everyday Life. Appetite, 35, 65-71.
Maurer, J., Taren, D. L., Teixeira, P. J. et al. (2006) The Psychosocial And Behavioral Characteristics Related To Energy Misreporting. Nutrition Reviews, 64, 53-66.
Mikolajczyk, R. T., El Ansari, W. & Maxwell, A. E. (2009) Food Consumption Frequency And Perceived Stress And Depressive Symptoms Among Students In Three European Countries. Nutrition Journal, 8, 31.
Monroe, S. M. & Cummins, L. F. (2015) Stress: Psychological Perspectives. In: Wright, J. D. (Ed.) International Encyclopedia Of The Social & Behavioral Sciences (Second Edition). Oxford: Elsevier.
Muna, S. & Atinkut, Z. (2018) Prevalence And Associated Factors Of Stress Among Undergraduate Students In Ambo University: Implication For Intervention. International Journal Of Psychology And Counselling, 10, 29-39.
Nelson, M. C., Story, M., Larson, N. I., Neumark-Sztainer, D. & Lytle, L. A. (2008) Emerging Adulthood And College-Aged Youth: An Overlooked Age For Weight-Related Behavior Change. Obesity (Silver Spring), 16, 2205-11.
Nguyen-Michel, S. T., Unger, J. B. & Spruijt-Metz, D. (2007) Dietary Correlates Of Emotional Eating In Adolescence. Appetite, 49, 494-499.
Nolan, L. J., Halperin, L. B. & Geliebter, A. (2010) Emotional Appetite Questionnaire. Construct Validity And Relationship With BMI. Appetite, 54, 314-9.
Nolen-Hoeksema, S., Larson, J. & Grayson, C. (1999) Explaining The Gender Difference In Depressive Symptoms. J Pers Soc Psychol, 77, 1061-72.
Oh, Y., Hass, N. C. & Lim, S.-L. (2016) Body Weight Can Change How Your Emotions Are Perceived. PloS One, 11(11), e0166753.
Oliver, G. & Wardle, J. (1999) Perceived Effects Of Stress On Food Choice. Physiology & Behavior, 66, 511-515.
Oliver, G., Wardle, J. & Gibson, E. L. (2000) Stress And Food Choice: A Laboratory Study. Psychosomatic Medicine, 62, 853-865.
Ozier, A. D., Kendrick, O. W., Leeper, J. D., Knol, L. L., Perko, M. & Burnham, J. (2008) Overweight And Obesity Are Associated With Emotion- And Stress-Related Eating As Measured By The Eating And Appraisal Due To Emotions And Stress Questionnaire. J Am Diet Assoc, 108, 49-56.
Pfefferbaum, B.& North, C.S. (2020) Mental Health and the Covid-19 Pandemic. N. Engl. J. Med., 383, 510–512.
Polivy, J. & Herman, C. P. (1993) Etiology Of Binge Eating: Psychological Mechanisms. Binge Eating: Nature, Assessment, And Treatment. New York, Ny, US: Guilford Press.
Misigo, B. L. (2015) Gender Difference In The Perceived Level Of Stress And Coping Strategies Among University Students In Kenya: A Case Of Public Universities. International Academic Journal Of Social Sciences And Education, 1, 44-52.
Muharrani, N. P., Achmad, E. & Sudiarti, T. (2018) Effects Of Restrained, External, And Emotional Eating Styles On Weight Gain Among Female Students At Faculty Of Public Health, Universitas Indonesia. Kne Life Sciences, 4, 8.
Reddy, K., Menon, K. R. & Thattil, A. (2018) Academic Stress And Its Sources Among University Students. Biomedical And Pharmacology Journal, 11, 531-537.
Sinha, R. & Jastreboff, A. M. (2013) Stress As A Common Risk Factor For Obesity And Addiction. Biol Psychiatry, 73, 827-35.
Smith, K. E., Mason, T. B., Crosby, R. D. et al. (2018) State And Trait Positive And Negative Affectivity In Relation To Restraint Intention And Binge Eating Among Adults With Obesity. Appetite, 120, 327-334.
Solomon, M. R. (2001) Eating As Both Coping And Stressor In Overweight Control. J Adv Nurs, 36, 563-72.
Thompson, S. (2015) Gender And Racial Differences In Emotional Eating, Food Addiction Symptoms, And Body Weight Satisfaction Among Undergraduates. Journal Of Diabetes And Obesity, 2, 1-6.
Torres, S. J. & Nowson, C. A. (2007) Relationship Between Stress, Eating Behavior, And Obesity. Nutrition, 23, 887-894.
Ulrich-Lai, Y. M. (2016) Self-Medication With Sucrose. Current Opinion In Behavioral Sciences, 9, 78-83.
van Strien, T. (2018) Causes Of Emotional Eating And Matched Treatment Of Obesity. Current Diabetes Reports, 18, 35-35.
van Strien, T., Donker, M. H. & Ouwens, M. A. (2016) Is Desire To Eat In Response To Positive Emotions An ‘Obese’ Eating Style: Is Kummerspeck For Some People A Misnomer? Appetite, 100, 225-235.
Vollrath, M. (2001) Personality And Stress. Scandinavian Journal Of Psychology, 42, 335-347.
Wallis, D. J. & Hetherington, M. M. (2004) Stress And Eating: The Effects Of Ego-Threat And Cognitive Demand On Food Intake In Restrained And Emotional Eaters. Appetite, 43, 39-46.
Wardle, J., Steptoe, A., Oliver, G. & Lipsey, Z. (2000) Stress, Dietary Restraint And Food Intake. Journal Of Psychosomatic Research, 48, 195-202.
White, B. A., Horwath, C. C. & Conner, T. S. (2013) Many Apples A Day Keep The Blues Away--Daily Experiences Of Negative And Positive Affect And Food Consumption In Young Adults. Br J Health Psychol, 18, 782-98.
Wong, J. G. W. S., Cheung, E. P. T., Chan, K. K. C., Ma, K. K. M. & Tang, S. W. (2006) Web-Based Survey Of Depression, Anxiety And Stress In First-Year Tertiary Education Students In Hong Kong. Australian & New Zealand Journal Of Psychiatry, 40, 777-782.
World Health Organization. (2004) Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet, 363, 157-163.
Yau, Y. H. C. & Potenza, M. N. (2013) Stress And Eating Behaviors. Minerva Endocrinologica, 38, 255-267.
Zellner, D.A., Loaiza, S., Gonzalez Z., Pita, J., Morales, J., Pecora, D. and Wolf, A. (2006) Food Selection Changes Under Stress. Physiology & Behaviour, 87(4), 789-93.
Aristovnik, A., Keržič, D., Ravšelj, D., Tomaževič, N., Umek, L. (2020). Impacts of the COVID-19 Pandemic on Life of Higher Education Students: A Global Perspective. Sustainability , 12, 8438.
Arnow, B., Kenardy, J. & Agras, W. S. (1995) The Emotional Eating Scale: The Development Of A Measure To Assess Coping With Negative Affect By Eating. International Journal Of Eating Disorders, 18, 79-90.
Barrington, W. E., Beresford, S. A. A., Mcgregor, B. A. & White, E. (2014) Perceived Stress And Eating Behaviors By Sex, Obesity Status, And Stress Vulnerability: Findings From The Vitamins And Lifestyle (Vital) Study. Journal Of The Academy Of Nutrition And Dietetics, 114, 1791-1799.
Bayram, N. & Bilgel, N. (2008) The Prevalence And Socio-Demographic Correlations Of Depression, Anxiety And Stress Among A Group Of University Students. Soc Psychiatry Psychiatr Epidemiol, 43, 667-72.
Biasi, V. & Bonaiuto, P. (2014) Negative Emotions And Defence Mechanisms In Obese People. Psychology, 5(18), 1979-1988.
Bilici, S., Ayhan, B., Karabudak, E. & Koksal, E. (2020) Factors Affecting Emotional Eating And Eating Palatable Food In Adults. Nutrition Research And Practice, 14, 70.
Cao,W., Fang, Z., Hou, G., Han, M., Xu, X., Dong, J., Zheng, J. (2020) The psychological impact of the COVID-19 epidemic on college students in China. J. Psychiatry Res. 287, 112934.
Cardi, V., Leppanen, J. & Treasure, J. (2015) The Effects Of Negative And Positive Mood Induction On Eating Behaviour: A Meta-Analysis Of Laboratory Studies In The Healthy Population And Eating And Weight Disorders. Neuroscience & Biobehavioral Reviews, 57, 299-309.
Cheng, S. H. & Kamil, M. (2020) Stress And Food Intake Among University Students - Is There A Relationship? Sains Malaysiana, 49, 121-128.
Cohen, S. (1988) Perceived Stress In A Probability Sample Of The United States. The Social Psychology Of Health. Thousand Oaks, Ca, Us: Sage Publications, Inc.
El Ansari, W. & Berg-Beckhoff, G. (2015) Nutritional Correlates Of Perceived Stress Among University Students In Egypt. Int J Environ Res Public Health, 12, 14164-76.
Elshurbjy, A. & Ellulu, M. S. (2017) Association Between Stress And Dietary Behaviors Among University Students: Mini-Review. Medical And Clinical Archives, 1.
Evers, C., Adriaanse, M., Ridder, D. & Huberts, J. (2013) Good Mood Food: Positive Emotion As A Neglected Trigger For Food Intake. Appetite, 68.
Ganley, R. M. (1989) Emotion And Eating In Obesity: A Review Of The Literature. International Journal Of Eating Disorders, 8, 343-361.
Geliebter, A. & Aversa, A. (2003) Emotional Eating In Overweight, Normal Weight, And Underweight Individuals. Eating Behaviors, 3, 341-347.
Goldschmidt, A. B., Crosby, R. D., Engel, S. G. et al. (2014) Affect And Eating Behavior In Obese Adults With And Without Elevated Depression Symptoms. Int J Eat Disord, 47, 281-6.
Halboub, E., Alhajj, M. N., Alkhairat, A. M., Sahaqi, A.-A. M. & Quadri, M. F. A. (2018) Perceived Stress Among Undergraduate Dental Students In Relation To Gender, Clinical Training And Academic Performance. Acta Stomatologica Croatica, 52, 37-45.
Jansen, A., Vanreyten, A., van Balveren, T., Roefs, A., Nederkoorn, C. & Havermans, R. (2008) Negative Affect And Cue-Induced Overeating In Non-Eating Disordered Obesity. Appetite, 51, 556-62.
Jarman, M., Lawrence, W., Ntani, G. et al. (2012) Low Levels Of Food Involvement And Negative Affect Reduce The Quality Of Diet In Women Of Lower Educational Attainment. J Hum Nutr Diet, 25, 444-52.
Kandiah, J., Yake, M., Jones, J. & Meyer, M. (2006) Stress Influences Appetite And Comfort Food Preferences In College Women. Nutrition Research, 26, 118-123.
Khubchandani, J., Kandiah, J., Saiki, D. (2020) The COVID-19 Pandemic, Stress, and Eating Practices in the United States. Eur. J. Investig. Health Psychol. Educ. 10, 950-956.
Laitinen, J., Ek, E. & Sovio, U. (2002) Stress-Related Eating And Drinking Behavior And Body Mass Index And Predictors Of This Behavior. Prev Med, 34, 29-39.
Lindeman, M. & Stark, K. (2001) Emotional Eating And Eating Disorder Psychopathology. Eat Disord, 9, 251-9.
Macht, M. (1999) Characteristics Of Eating In Anger, Fear, Sadness And Joy. Appetite, 33 (1), 129-139.
Macht, M., Roth, S. & Ellgring, H. (2002) Chocolate Eating In Healthy Men During Experimentally Induced Sadness And Joy. Appetite, 39, 147-58.
Macht, M. & Simons, G. (2000) Emotions And Eating In Everyday Life. Appetite, 35, 65-71.
Maurer, J., Taren, D. L., Teixeira, P. J. et al. (2006) The Psychosocial And Behavioral Characteristics Related To Energy Misreporting. Nutrition Reviews, 64, 53-66.
Mikolajczyk, R. T., El Ansari, W. & Maxwell, A. E. (2009) Food Consumption Frequency And Perceived Stress And Depressive Symptoms Among Students In Three European Countries. Nutrition Journal, 8, 31.
Monroe, S. M. & Cummins, L. F. (2015) Stress: Psychological Perspectives. In: Wright, J. D. (Ed.) International Encyclopedia Of The Social & Behavioral Sciences (Second Edition). Oxford: Elsevier.
Muna, S. & Atinkut, Z. (2018) Prevalence And Associated Factors Of Stress Among Undergraduate Students In Ambo University: Implication For Intervention. International Journal Of Psychology And Counselling, 10, 29-39.
Nelson, M. C., Story, M., Larson, N. I., Neumark-Sztainer, D. & Lytle, L. A. (2008) Emerging Adulthood And College-Aged Youth: An Overlooked Age For Weight-Related Behavior Change. Obesity (Silver Spring), 16, 2205-11.
Nguyen-Michel, S. T., Unger, J. B. & Spruijt-Metz, D. (2007) Dietary Correlates Of Emotional Eating In Adolescence. Appetite, 49, 494-499.
Nolan, L. J., Halperin, L. B. & Geliebter, A. (2010) Emotional Appetite Questionnaire. Construct Validity And Relationship With BMI. Appetite, 54, 314-9.
Nolen-Hoeksema, S., Larson, J. & Grayson, C. (1999) Explaining The Gender Difference In Depressive Symptoms. J Pers Soc Psychol, 77, 1061-72.
Oh, Y., Hass, N. C. & Lim, S.-L. (2016) Body Weight Can Change How Your Emotions Are Perceived. PloS One, 11(11), e0166753.
Oliver, G. & Wardle, J. (1999) Perceived Effects Of Stress On Food Choice. Physiology & Behavior, 66, 511-515.
Oliver, G., Wardle, J. & Gibson, E. L. (2000) Stress And Food Choice: A Laboratory Study. Psychosomatic Medicine, 62, 853-865.
Ozier, A. D., Kendrick, O. W., Leeper, J. D., Knol, L. L., Perko, M. & Burnham, J. (2008) Overweight And Obesity Are Associated With Emotion- And Stress-Related Eating As Measured By The Eating And Appraisal Due To Emotions And Stress Questionnaire. J Am Diet Assoc, 108, 49-56.
Pfefferbaum, B.& North, C.S. (2020) Mental Health and the Covid-19 Pandemic. N. Engl. J. Med., 383, 510–512.
Polivy, J. & Herman, C. P. (1993) Etiology Of Binge Eating: Psychological Mechanisms. Binge Eating: Nature, Assessment, And Treatment. New York, Ny, US: Guilford Press.
Misigo, B. L. (2015) Gender Difference In The Perceived Level Of Stress And Coping Strategies Among University Students In Kenya: A Case Of Public Universities. International Academic Journal Of Social Sciences And Education, 1, 44-52.
Muharrani, N. P., Achmad, E. & Sudiarti, T. (2018) Effects Of Restrained, External, And Emotional Eating Styles On Weight Gain Among Female Students At Faculty Of Public Health, Universitas Indonesia. Kne Life Sciences, 4, 8.
Reddy, K., Menon, K. R. & Thattil, A. (2018) Academic Stress And Its Sources Among University Students. Biomedical And Pharmacology Journal, 11, 531-537.
Sinha, R. & Jastreboff, A. M. (2013) Stress As A Common Risk Factor For Obesity And Addiction. Biol Psychiatry, 73, 827-35.
Smith, K. E., Mason, T. B., Crosby, R. D. et al. (2018) State And Trait Positive And Negative Affectivity In Relation To Restraint Intention And Binge Eating Among Adults With Obesity. Appetite, 120, 327-334.
Solomon, M. R. (2001) Eating As Both Coping And Stressor In Overweight Control. J Adv Nurs, 36, 563-72.
Thompson, S. (2015) Gender And Racial Differences In Emotional Eating, Food Addiction Symptoms, And Body Weight Satisfaction Among Undergraduates. Journal Of Diabetes And Obesity, 2, 1-6.
Torres, S. J. & Nowson, C. A. (2007) Relationship Between Stress, Eating Behavior, And Obesity. Nutrition, 23, 887-894.
Ulrich-Lai, Y. M. (2016) Self-Medication With Sucrose. Current Opinion In Behavioral Sciences, 9, 78-83.
van Strien, T. (2018) Causes Of Emotional Eating And Matched Treatment Of Obesity. Current Diabetes Reports, 18, 35-35.
van Strien, T., Donker, M. H. & Ouwens, M. A. (2016) Is Desire To Eat In Response To Positive Emotions An ‘Obese’ Eating Style: Is Kummerspeck For Some People A Misnomer? Appetite, 100, 225-235.
Vollrath, M. (2001) Personality And Stress. Scandinavian Journal Of Psychology, 42, 335-347.
Wallis, D. J. & Hetherington, M. M. (2004) Stress And Eating: The Effects Of Ego-Threat And Cognitive Demand On Food Intake In Restrained And Emotional Eaters. Appetite, 43, 39-46.
Wardle, J., Steptoe, A., Oliver, G. & Lipsey, Z. (2000) Stress, Dietary Restraint And Food Intake. Journal Of Psychosomatic Research, 48, 195-202.
White, B. A., Horwath, C. C. & Conner, T. S. (2013) Many Apples A Day Keep The Blues Away--Daily Experiences Of Negative And Positive Affect And Food Consumption In Young Adults. Br J Health Psychol, 18, 782-98.
Wong, J. G. W. S., Cheung, E. P. T., Chan, K. K. C., Ma, K. K. M. & Tang, S. W. (2006) Web-Based Survey Of Depression, Anxiety And Stress In First-Year Tertiary Education Students In Hong Kong. Australian & New Zealand Journal Of Psychiatry, 40, 777-782.
World Health Organization. (2004) Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet, 363, 157-163.
Yau, Y. H. C. & Potenza, M. N. (2013) Stress And Eating Behaviors. Minerva Endocrinologica, 38, 255-267.
Zellner, D.A., Loaiza, S., Gonzalez Z., Pita, J., Morales, J., Pecora, D. and Wolf, A. (2006) Food Selection Changes Under Stress. Physiology & Behaviour, 87(4), 789-93.
Published
2021-09-10
How to Cite
Cheng, S.-H. and Wong, S. E. (2021) “Stress, Emotional Eating and Food Choices Among University Students During the Covid-19”, Malaysian Journal of Social Sciences and Humanities (MJSSH), 6(9), pp. 335 - 346. doi: 10.47405/mjssh.v6i9.983.
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