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Avdimiotis S, Konstantinidis I, Stalidis G, Stamovlasis D. Coping with Examination Stress: An Emotion Analysis. SENSORS (BASEL, SWITZERLAND) 2024; 24:4297. [PMID: 39001079 PMCID: PMC11243834 DOI: 10.3390/s24134297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 06/26/2024] [Accepted: 06/28/2024] [Indexed: 07/16/2024]
Abstract
Stress is an important factor affecting human behavior, with recent works in the literature distinguishing it as either productive or destructive. The present study investigated how the primary emotion of stress is correlated with engagement, focus, interest, excitement, and relaxation during university students' examination processes. Given that examinations are highly stressful processes, twenty-six postgraduate students participated in a four-phase experiment (rest, written examination, oral examination, and rest) conducted at the International Hellenic University (IHU) using a modified Trier protocol. Network analysis with a focus on centralities was employed for data processing. The results highlight the important role of stress in the examination process; correlate stress with other emotions, such as interest, engagement, enthusiasm, relaxation, and concentration; and, finally, suggest ways to control and creatively utilize stress.
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Affiliation(s)
- Spyros Avdimiotis
- Department of Organizations Management and Tourism, Faculty of Economy and Management, International Hellenic University, 57001 Thessaloniki, Greece; (S.A.); (G.S.)
| | - Ioannis Konstantinidis
- Department of Organizations Management and Tourism, Faculty of Economy and Management, International Hellenic University, 57001 Thessaloniki, Greece; (S.A.); (G.S.)
| | - George Stalidis
- Department of Organizations Management and Tourism, Faculty of Economy and Management, International Hellenic University, 57001 Thessaloniki, Greece; (S.A.); (G.S.)
| | - Dimitrios Stamovlasis
- Department of Philosophy and Education, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
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Siteneski A, de la Cruz-Velez M, Montes-Escobar K, Duran-Ospina JP, Fonseca-Restrepo C, Barreiro-Linzán MD, Campos García GA, Gil-Mohapel J. Effects of Transition from Remote to In-Person Learning in University Students: A Longitudinal Study. Eur J Investig Health Psychol Educ 2024; 14:1786-1802. [PMID: 38921084 PMCID: PMC11202480 DOI: 10.3390/ejihpe14060118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/12/2024] [Accepted: 06/18/2024] [Indexed: 06/27/2024] Open
Abstract
Previous studies have shown that the transition from the University environment to remote learning impacted student mental health. Our study aimed to investigate the effects of university environment on anxiety and depressive symptoms in health sciences students. Students at the Technical University of Manabí, Ecuador, with 6-10 in-person semesters, who shifted to remote learning and then returned to face-to-face learning were selected. Students responded to the General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). In addition, questions regarding social interaction, physical exercise, mood and sleep habits were also asked. This longitudinal study tracked 323 students during the return to in-person classes and term end. The results showed similar rates of anxiety (GAD-7, p = 0.011-p = 0.002) and depression (PHQ-9 p = 0.001-p = 0.032) among students at week 1 and week 15. Previous diagnosis of depression (OR, 0.171; CI 0.050-0.579, p < 0.005) was shown to correlate with depression levels in week 1, with no changes seen at follow-up. Anxiety levels were shown to be associated with a previous diagnosis of the disorder at week 1, but not at follow-up (OR 0.233; CI 0.085-0.643, p < 0.005). The return to in-person learning among university students maintained levels of anxiety and depressive symptoms, underscoring ongoing vulnerabilities to mental health disorders in this group.
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Affiliation(s)
- Aline Siteneski
- School of Medicine, Faculty of Health Sciences, Universidad Técnica de Manabí, Portoviejo 130102, Ecuador; (M.d.l.C.-V.)
- Research Institute, Universidad Técnica de Manabí, Portoviejo 130105, Ecuador
| | - Melina de la Cruz-Velez
- School of Medicine, Faculty of Health Sciences, Universidad Técnica de Manabí, Portoviejo 130102, Ecuador; (M.d.l.C.-V.)
| | - Karime Montes-Escobar
- Department of Mathematics and Statistics, Institute of Basic Sciences, Technical University of Manabí, Portoviejo 130105, Ecuador; (K.M.-E.); (M.D.B.-L.)
- Statistics Department, University of Salamanca, 37007 Salamanca, Spain
| | | | - Carolina Fonseca-Restrepo
- Departamento de Medicina Veterinaria, Facultad de Ciencias Veterinarias, Universidad Técnica de Manabí, Portoviejo 130105, Ecuador;
| | - Mónica Daniela Barreiro-Linzán
- Department of Mathematics and Statistics, Institute of Basic Sciences, Technical University of Manabí, Portoviejo 130105, Ecuador; (K.M.-E.); (M.D.B.-L.)
| | - Gusdanis Alberto Campos García
- School of Medicine, Faculty of Health Sciences, Universidad Técnica de Manabí, Portoviejo 130102, Ecuador; (M.d.l.C.-V.)
| | - Joana Gil-Mohapel
- Island Medical Program, Faculty of Medicine, University of British Columbia, Victoria, BC V8P 5C2, Canada;
- Division of Medical Sciences, University of Victoria, Victoria, BC V8P 5C2, Canada
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Koelen J, Klein A, Wolters N, Bol E, De Koning L, Roetink S, Van Blom J, Boutin B, Schaaf J, Grasman R, Van der Heijde CM, Salemink E, Riper H, Karyotaki E, Cuijpers P, Schneider S, Rapee R, Vonk P, Wiers R. Web-Based, Human-Guided, or Computer-Guided Transdiagnostic Cognitive Behavioral Therapy in University Students With Anxiety and Depression: Randomized Controlled Trial. JMIR Ment Health 2024; 11:e50503. [PMID: 38896474 PMCID: PMC11222767 DOI: 10.2196/50503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 01/23/2024] [Accepted: 01/28/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Internet-based cognitive behavioral interventions (iCBTs) are efficacious treatments for depression and anxiety. However, it is unknown whether adding human guidance is feasible and beneficial within a large educational setting. OBJECTIVE This study aims to potentially demonstrate the superiority of 2 variants of a transdiagnostic iCBT program (human-guided and computer-guided iCBT) over care as usual (CAU) in a large sample of university students and the superiority of human-guided iCBT over computer-guided iCBT. METHODS A total of 801 students with elevated levels of anxiety, depression, or both from a large university in the Netherlands were recruited as participants and randomized to 1 of 3 conditions: human-guided iCBT, computer-guided iCBT, and CAU. The primary outcome measures were depression (Patient Health Questionnaire) and anxiety (Generalized Anxiety Disorder scale). Secondary outcomes included substance use-related problems (Alcohol Use Disorder Identification Test and Drug Abuse Screening Test-10 items). Linear mixed models were used to estimate the effects of time, treatment group, and their interactions (slopes). The primary research question was whether the 3 conditions differed in improvement over 3 time points (baseline, midtreatment, and after treatment) in terms of depression and anxiety symptoms. Results were analyzed according to the intention-to-treat principle using multiple imputation. Patients were followed exploratively from baseline to 6 and 12 months. RESULTS In both short-term and long-term analyses, the slopes for the 3 conditions did not differ significantly in terms of depression and anxiety, although both web-based interventions were marginally more efficacious than CAU over 6 months (P values between .02 and .03). All groups showed significant improvement over time (P<.001). For the secondary outcomes, only significant improvements over time (across and not between groups) were found for drug use (P<.001). Significant differences were found in terms of adherence, indicating that participants in the human-guided condition did more sessions than those in the computer-guided condition (P=.002). CONCLUSIONS The transdiagnostic iCBT program offers a practical, feasible, and efficacious alternative to usual care to tackle mental health problems in a large university setting. There is no indication that human guidance should be preferred over technological guidance. The potential preference of human support also depends on the scale of implementation and cost-effectiveness, which need to be addressed in future trials. TRIAL REGISTRATION International Clinical Trials Registry Platform NL7328/NTR7544; https://trialsearch.who.int/Trial2.aspx?TrialID=NL-OMON26795.
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Affiliation(s)
- Jurrijn Koelen
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Anke Klein
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Nine Wolters
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Eline Bol
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Lisa De Koning
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Samantha Roetink
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Jorien Van Blom
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Bruno Boutin
- Technical Support Psychology Department, University of Amsterdam, Amsterdam, Netherlands
| | - Jessica Schaaf
- Cognitive Neuroscience Department, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Raoul Grasman
- Department of Psychological Methods, University of Amsterdam, Amsterdam, Netherlands
| | - Claudia Maria Van der Heijde
- Department of Research, Development and Prevention, Student Health Service, University of Amsterdam, Amsterdam, Netherlands
| | - Elske Salemink
- Experimental Psychopathology and Clinical Psychology Lab, Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands
| | - Heleen Riper
- Amsterdam Public Health Research Institute, Department of Clinical Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands
| | - Eirini Karyotaki
- Amsterdam Public Health Research Institute, Department of Clinical Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands
| | - Pim Cuijpers
- Amsterdam Public Health Research Institute, Department of Clinical Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands
| | - Silvia Schneider
- Mental Health Research and Treatment Center, Department of Clinical Child and Adolescent Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Ronald Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Peter Vonk
- Department of Research, Development and Prevention, Student Health Service, University of Amsterdam, Amsterdam, Netherlands
| | - Reinout Wiers
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands
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Pei J, Amanvermez Y, Vigo D, Puyat J, Kessler RC, Mortier P, Bruffaerts R, Rankin O, Chua SN, Martínez V, Rapsey C, Fodor LA, David OA, Garcia C, Cuijpers P. Sociodemographic Correlates of Mental Health Treatment Seeking Among College Students: A Systematic Review and Meta-Analysis. Psychiatr Serv 2024; 75:556-569. [PMID: 38291886 DOI: 10.1176/appi.ps.20230414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
OBJECTIVE College students have high rates of mental health problems and low rates of treatment. Although sociodemographic disparities in student mental health treatment seeking have been reported, findings have not been synthesized and quantified. The extent to which differences in perceived need for treatment contribute to overall disparities remains unclear. METHODS A systematic search of PubMed, PsycInfo, and Embase was conducted. Studies published between 2007 and 2022 were included if they reported treatment rates among college students with mental health problems, stratified by sex, gender, race-ethnicity, sexual orientation, student type, student year, or student status. Random-effects models were used to calculate pooled prevalence ratios (PRs) of having a perceived need for treatment and of receiving treatment for each sociodemographic subgroup. RESULTS Twenty-one studies qualified for inclusion. Among students experiencing mental health problems, consistent and significant sociodemographic differences were identified in perceived need for treatment and treatment receipt. Students from racial-ethnic minority groups (in particular, Asian students [PR=0.49]) and international students (PR=0.63) reported lower rates of treatment receipt than White students and domestic students, respectively. Students identifying as female (sex) or as women (gender) (combined PR=1.33) reported higher rates of treatment receipt than students identifying as male or as men. Differences in perceived need appeared to contribute to some disparities; in particular, students identifying as male or as men reported considerably lower rates of perceived need than students identifying as female or as women. CONCLUSIONS Findings highlight the need for policy makers to address barriers throughout the treatment-seeking pathway and to tailor efforts to student subgroups to reduce treatment disparities.
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Affiliation(s)
- Julia Pei
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Yagmur Amanvermez
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Daniel Vigo
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Joseph Puyat
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Ronald C Kessler
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Philippe Mortier
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Ronny Bruffaerts
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Osiris Rankin
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Sook Ning Chua
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Vania Martínez
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Charlene Rapsey
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Liviu A Fodor
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Oana A David
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Claudia Garcia
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Pim Cuijpers
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
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Dagani J, Buizza C, Ferrari C, Ghilardi A. Potential suicide risk among the college student population: machine learning approaches for identifying predictors and different students' risk profiles. PSICOLOGIA-REFLEXAO E CRITICA 2024; 37:19. [PMID: 38758421 PMCID: PMC11101401 DOI: 10.1186/s41155-024-00301-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 05/02/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Suicide is one of the leading causes of death among young people and university students. Research has identified numerous socio-demographic, relational, and clinical factors as potential predictors of suicide risk, and machine learning techniques have emerged as promising ways to improve risk assessment. OBJECTIVE This cross-sectional observational study aimed at identifying predictors and college student profiles associated with suicide risk through a machine learning approach. METHODS A total of 3102 students were surveyed regarding potential suicide risk, socio-demographic characteristics, academic career, and physical/mental health and well-being. The classification tree technique and the multiple correspondence analysis were applied to define students' profiles in terms of suicide risk and to detect the main predictors of such a risk. RESULTS Among the participating students, 7% showed high potential suicide risk and 3.8% had a history of suicide attempts. Psychological distress and use of alcohol/substance were prominent predictors of suicide risk contributing to define the profile of high risk of suicide: students with significant psychological distress, and with medium/high-risk use of alcohol and psychoactive substances. Conversely, low psychological distress and low-risk use of alcohol and substances, together with religious practice, represented the profile of students with low risk of suicide. CONCLUSIONS Machine learning techniques could hold promise for assessing suicide risk in college students, potentially leading to the development of more effective prevention programs. These programs should address both risk and protective factors and be tailored to students' needs and to the different categories of risk.
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Affiliation(s)
- Jessica Dagani
- Department of Clinical and Experimental Sciences, Section of Clinical and Dynamic Psychology, University of Brescia, Viale Europa, 11, 25123, Brescia, Italy.
| | - Chiara Buizza
- Department of Clinical and Experimental Sciences, Section of Clinical and Dynamic Psychology, University of Brescia, Viale Europa, 11, 25123, Brescia, Italy
| | - Clarissa Ferrari
- Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati, 57, 25124, Brescia, Italy
| | - Alberto Ghilardi
- Department of Clinical and Experimental Sciences, Section of Clinical and Dynamic Psychology, University of Brescia, Viale Europa, 11, 25123, Brescia, Italy
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6
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Dagani J, Buizza C, Cela H, Sbravati G, Rainieri G, Ghilardi A. The Interplay of Sleep Quality, Mental Health, and Sociodemographic and Clinical Factors among Italian College Freshmen. J Clin Med 2024; 13:2626. [PMID: 38731154 PMCID: PMC11084360 DOI: 10.3390/jcm13092626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 04/25/2024] [Accepted: 04/27/2024] [Indexed: 05/13/2024] Open
Abstract
Background/Objectives: Sleep and mental health are closely linked, with sleep deprivation increasing the risk of mental health problems in college students. This study aimed to analyze the role of sleep in the mental health status of a sample of Italian freshmen, considering various mental health outcomes and potential interactions between sleep and other relevant factors, such as sociodemographic characteristics, academic experiences, and mental health history. Methods: All freshmen from a medium-sized Italian university were invited to participate in a multidimensional online survey (n = 3756). Sleep quality was assessed through questions on average hours of sleep per night and on satisfaction of perceived sleep quality. Mental health outcomes included psychophysical well-being, psychological distress, substance use, and problematic internet use. Statistical analysis involved multivariate analysis of variance, followed by pairwise comparisons. Results: The sample (n = 721) exhibited low levels of well-being and a high prevalence of psychological distress (52.1%). Approximately one-third of students (n = 258) were dissatisfied with their sleep quality, and one-fourth (n = 186) reported inadequate sleep (less than 7 h per night). More specifically, 24.4% of students slept on average six hours per night, and 1.4% slept five hours or less. Satisfaction with perceived sleep quality significantly influenced well-being, psychological distress, and cannabis use (ηp2 = 0.02). Interaction effects were observed between satisfaction with sleep quality and drop-out intentions (ηp2 = 0.01), as well as between satisfaction with sleep quality and history of mental health diagnosis (ηp2 = 0.02), both of which were significant for psychological distress and cannabis use. Conclusions: This study highlights the influence of perceived sleep quality on academic distress among college freshmen, particularly those with higher intentions of leaving university and with a history of mental health diagnosis.
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Affiliation(s)
- Jessica Dagani
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy; (J.D.); (C.B.); (G.S.); (G.R.)
| | - Chiara Buizza
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy; (J.D.); (C.B.); (G.S.); (G.R.)
| | - Herald Cela
- Department of Psychology, University of Graz, Universitätsplatz 2, 8010 Graz, Austria
| | - Giulio Sbravati
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy; (J.D.); (C.B.); (G.S.); (G.R.)
| | - Giuseppe Rainieri
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy; (J.D.); (C.B.); (G.S.); (G.R.)
| | - Alberto Ghilardi
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy; (J.D.); (C.B.); (G.S.); (G.R.)
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Howlader S, Abedin S, Rahman MM. Social support, distress, stress, anxiety, and depression as predictors of suicidal thoughts among selected university students in Bangladesh. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002924. [PMID: 38626087 PMCID: PMC11020522 DOI: 10.1371/journal.pgph.0002924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 03/15/2024] [Indexed: 04/18/2024]
Abstract
This study examines the association of perceived social support with suicidal thoughts among a young adult sample of university students and estimates the degree to which perceived stress, distress, anxiety, and depression may explain the association. A cross-sectional survey was conducted from June to September 2022 among 642 students, selected using the probability proportional to size procedure, at a large university in Bangladesh. We used the Multidimensional Scale of Perceived Social Support (MSPSS) to measure support. The Impact of Events Scale-Revised (IES-R), the Perceived Stress Scale (PSS-10), the Generalized Anxiety Disorders (GAD-7) scale, and the Patient Health Questionnaire (PHQ-9) were used to assess distress, stress, anxiety, and depression. The association between social support and suicidal thoughts was examined using multivariable logistic regression models. Mediation analyses were carried out using the Karlson, Holm, and Breen (KHB) method. We found that perceived social support was associated with lower odds of suicidal thoughts after controlling for other variables (adjusted odds ratio = 0.94; 95% confidence interval = 0.92-0.96). Mediation analysis showed that, after adjusting for potential confounders, the mediating effects among the total effect of perceived social support on suicidal thoughts were 56.1%, 20.8%, 22.5%, 38.8%, and 50.9% for all mental disorders together and four specific adverse mental health outcomes, i.e., perceived distress, stress, anxiety, and depression, respectively. This study demonstrates that perceived social support reduces the likelihood of suicidal thoughts among university students, and mental disorders have a partial mediating effect on the association. Suicide prevention and mental health promotion efforts among university students should consider encouraging students to build and strengthen a strong social support network.
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Affiliation(s)
- Sihab Howlader
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Sumaiya Abedin
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Md. Mosfequr Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
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Hasking PA, Robinson K, McEvoy P, Melvin G, Bruffaerts R, Boyes ME, Auerbach RP, Hendrie D, Nock MK, Preece DA, Rees C, Kessler RC. Development and evaluation of a predictive algorithm and telehealth intervention to reduce suicidal behavior among university students. Psychol Med 2024; 54:971-979. [PMID: 37732419 PMCID: PMC10939946 DOI: 10.1017/s0033291723002714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
BACKGROUND Suicidal behaviors are prevalent among college students; however, students remain reluctant to seek support. We developed a predictive algorithm to identify students at risk of suicidal behavior and used telehealth to reduce subsequent risk. METHODS Data come from several waves of a prospective cohort study (2016-2022) of college students (n = 5454). All first-year students were invited to participate as volunteers. (Response rates range: 16.00-19.93%). A stepped-care approach was implemented: (i) all students received a comprehensive list of services; (ii) those reporting past 12-month suicidal ideation were directed to a safety planning application; (iii) those identified as high risk of suicidal behavior by the algorithm or reporting 12-month suicide attempt were contacted via telephone within 24-h of survey completion. Intervention focused on support/safety-planning, and referral to services for this high-risk group. RESULTS 5454 students ranging in age from 17-36 (s.d. = 5.346) participated; 65% female. The algorithm identified 77% of students reporting subsequent suicidal behavior in the top 15% of predicted probabilities (Sensitivity = 26.26 [95% CI 17.93-36.07]; Specificity = 97.46 [95% CI 96.21-98.38], PPV = 53.06 [95% CI 40.16-65.56]; AUC range: 0.895 [95% CIs 0.872-0.917] to 0.966 [95% CIs 0.939-0.994]). High-risk students in the Intervention Cohort showed a 41.7% reduction in probability of suicidal behavior at 12-month follow-up compared to high-risk students in the Control Cohort. CONCLUSIONS Predictive risk algorithms embedded into universal screening, coupled with telehealth intervention, offer significant potential as a suicide prevention approach for students.
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Affiliation(s)
- Penelope A Hasking
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Faculty of Health Sciences, enAble Institute, Curtin University, Perth, Australia
| | - Kealagh Robinson
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Faculty of Health Sciences, enAble Institute, Curtin University, Perth, Australia
| | - Peter McEvoy
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Faculty of Health Sciences, enAble Institute, Curtin University, Perth, Australia
- Centre for Clinical Interventions, Perth, Australia
| | - Glenn Melvin
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
| | | | - Mark E Boyes
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Faculty of Health Sciences, enAble Institute, Curtin University, Perth, Australia
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, USA
- Division of Clinical Developmental Neuroscience, Sackler Institute, New York, USA
| | - Delia Hendrie
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, USA
| | - David A Preece
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Faculty of Health Sciences, enAble Institute, Curtin University, Perth, Australia
| | - Clare Rees
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, USA
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9
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Gandarillas MA, Elvira-Zorzo MN, Rodríguez-Vera M. The impact of parenting practices and family economy on psychological wellbeing and learning patterns in higher education students. PSICOLOGIA-REFLEXAO E CRITICA 2024; 37:8. [PMID: 38446334 PMCID: PMC10917719 DOI: 10.1186/s41155-024-00291-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/09/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND There is a large literature on the significant impact of rearing factors in the psychological development of different child's learning patterns and wellbeing in elementary and secondary schools, but there is a scarcity of studies on to what extent those influences remain stable up to higher education. OBJECTIVE In this study, parenting practices and family status were analyzed as predictors of the different learning styles, psychological difficulties, mental health factors, and academic performance, comprising the psychosocial diversity in learning (DinL) at the university classroom. METHODS Using a cross-sectional design, a questionnaire was administered to a sample of 2522 students at the Complutense University of Madrid (Spain). It included a DinL scale measuring five psychological learning dimensions (coping with difficulties, effort, autonomy, Social/Physical Context, and understanding/career interest), plus several items on retrospective parenting practices, family, and sociodemographic variables. Multiple regressions and analyses of variance were conducted with the family factors as independent variables and the learning factors as dependent variables. RESULTS Results showed parenting variables, parents' education, and family economy as having a significant impact on psychological learning dimensions, academic performance, and especially on the students' wellbeing and mental health status, being an important contributors to explain the DinL in the university classroom. CONCLUSION The results bring interesting conclusions for developmental and health psychologists when working with parents aimed at fostering wellbeing and learning strategies related to academic inclusion and achievement.
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Affiliation(s)
- M A Gandarillas
- Department of Social, Work and Differential Psychology, School of Psychology, Universidad Complutense de Madrid (UCM), Campus de Somosagua, Ctra. de Húmera, s/n, 28223, Pozuelo de Alarcón, Spain.
| | - M N Elvira-Zorzo
- Department of Social Psychology and Anthropology, School of Psychology, University of Salamanca (USAL), Campus Ciudad Jardín. Avda. de la Merced 109-131, 37005, Salamanca, Spain
| | - M Rodríguez-Vera
- Facultad de Odontología y Ciencias de La Rehabilitación, Universidad San Sebastián (USS), Concepción, Chile
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Berman AH, Topooco N, Lindfors P, Bendtsen M, Lindner P, Molander O, Kraepelien M, Sundström C, Talebizadeh N, Engström K, Vlaescu G, Andersson G, Andersson C. Transdiagnostic and tailored internet intervention to improve mental health among university students: Research protocol for a randomized controlled trial. Trials 2024; 25:158. [PMID: 38429834 PMCID: PMC10908025 DOI: 10.1186/s13063-024-07986-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 02/15/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Emerging adulthood is often associated with mental health problems. About one in three university students report symptoms of depression and anxiety that can negatively affect their developmental trajectory concerning work, intimate relationships, and health. This can interfere with academic performance, as mood and anxiety disorders are key predictors of dropout from higher education. A treatment gap exists, where a considerable proportion of students do not seek help for mood and anxiety symptoms. Offering internet interventions to students with mental health problems could reduce the treatment gap, increase mental health, and improve academic performance. A meta-analysis on internet interventions for university students showed small effects for depression and none for anxiety. Larger trials are recommended to further explore effects of guidance, transdiagnostic approaches, and individual treatment components. METHODS This study will offer 1200 university students in Sweden participation in a three-armed randomized controlled trial (RCT) evaluating a guided or unguided transdiagnostic internet intervention for mild to moderate depression and anxiety, where the waitlist control group accesses the intervention at 6-month follow-up. Students reporting suicidal ideation/behaviors will be excluded and referred to treatment within the existing healthcare system. An embedded study within the trial (SWAT) will assess at week 3 of 8 whether participants in the guided and unguided groups are at higher risk of failing to benefit from treatment. Those at risk will be randomized to an adaptive treatment strategy, or to continue the treatment as originally randomized. Primary outcomes are symptoms of depression and anxiety. Follow-ups will occur at post-treatment and at 6-, 12-, and 24-month post-randomization. Between-group outcome analyses will be reported, and qualitative interviews about treatment experiences are planned. DISCUSSION This study investigates the effects of a transdiagnostic internet intervention among university students in Sweden, with an adaptive treatment strategy employed during the course of treatment to minimize the risk of treatment failure. The study will contribute knowledge about longitudinal trajectories of mental health and well-being following treatment, taking into account possible gender differences in responsiveness to treatment. With time, effective internet interventions could make treatment for mental health issues more widely accessible to the student group.
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Affiliation(s)
- Anne H Berman
- Department of Psychology, Uppsala University, Uppsala, Sweden.
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
| | - Naira Topooco
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Petra Lindfors
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Marcus Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Philip Lindner
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Olof Molander
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Martin Kraepelien
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Christopher Sundström
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | | | - Karin Engström
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - George Vlaescu
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Gerhard Andersson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Claes Andersson
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Department of Criminology, Malmö University, Malmö, Sweden
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Özer Ö, Köksal B, Altinok A. Understanding university students' attitudes and preferences for internet-based mental health interventions. Internet Interv 2024; 35:100722. [PMID: 38356613 PMCID: PMC10864831 DOI: 10.1016/j.invent.2024.100722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/04/2024] [Accepted: 01/31/2024] [Indexed: 02/16/2024] Open
Abstract
Internet-based interventions are recognised as a practical approach to address mental health issues. The acceptance and utilisation of such interventions are closely linked to user attitudes and preferences. This study aims to examine the predictors of university students' attitudes towards internet-based interventions. Additionally, it seeks to elucidate students' preferences regarding crucial features of these interventions, such as the format, delivery mode, content type, and structural components, to understand better what makes these interventions appealing and practical for university students. A total of 273 university students (comprising 68 % females and 32 % males) participated in the study. The data collection instruments employed were the Personal Information Form, Internet-Based Intervention Preference Survey, E-therapy Attitude Measure (ETAM), Digital Literacy Scale, Patient Health Questionnaire-9, and the Generalized Anxiety Disorder-7 (GAD-7). The data were analysed utilising descriptive statistics, Pearson correlation analysis, and multiple linear regression analysis. The multiple regression analysis revealed digital literacy as a predictive factor for attitudes towards internet-based interventions. Demographic variables, such as age and gender, and psychological variables, such as depression and anxiety levels, were found not to be associated with attitudes towards these interventions. While students are actively seeking mental health information online, a significant majority remain unaware of internet-based interventions. They show a preference for interventions offering greater human interaction, including face-to-face guidance and video content featuring people. Participants favour completing one or two sessions of the intervention weekly. Desired features of internet-based interventions include self-assessment scales, relatable characters, voice relaxation exercises, practical daily life activity tasks, and weekly reminders throughout the process. In conclusion, initiatives aimed at enhancing digital literacy levels could foster more positive attitudes towards internet-based interventions among students. Developers creating Internet-Based Interventions (IBI) for university students should consider these preferences.
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Affiliation(s)
- Ömer Özer
- Department of Social Work and Consultancy, Open Education Faculty, Anadolu University, Eskisehir, Turkiye
| | - Burak Köksal
- Counseling and Guidance Center, Gaziosmanpaşa University, Tokat, Turkiye
| | - Ahmet Altinok
- Department of Psychology, Experimental Psychology, University of Groningen, Groningen, the Netherlands
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Osborn TG, Town R, Bawendi M, Stapley E, Saunders R, Fonagy P. University students' access to mental health services: A qualitative study of the experiences of health service professionals through the lens of candidacy in England. J Health Serv Res Policy 2024:13558196241235877. [PMID: 38414282 DOI: 10.1177/13558196241235877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
OBJECTIVES In order to develop a better understanding of students' access to mental health services, we explored the experiences of health care professionals interacting with university students with mental health problems. METHODS We interviewed 23 professionals working across university advice and counselling services, NHS general practice, crisis, and psychological services in North and East London between June 2022 and January 2023. Our approach drew on reflexive thematic analysis and the principles of abductive analysis. The notion of candidacy - that is, how different needs are deemed deserving of health service attention - was particularly helpful to our understanding of the ongoing phenomenon of interest in the data. RESULTS Each student's access to mental health support was highly contingent on the student's dynamic social context and the pressures and organisation of the local health system. Professionals described how different students viewed different needs as deserving of health service attention. Which students reached the professional's service depended on the resources and relationships a student could draw upon, and the service's relative permeability. Once there, what action professionals took was strongly influenced by the professional's service expertise, resource constraints, the relationships the professional's service had with other organisations, the students' wishes, and whether students regarded treatment offers as acceptable. CONCLUSIONS Candidacy offers a useful lens to view university students' access to mental health support. Access appears to be an increasingly intricate task for students, given the fragmented service landscape, surging demand for mental health care and challenges of emerging adulthood. Our findings suggest that policy goals to increase use of mental health services are unlikely to improve outcomes for students without policy makers and health systems giving holistic consideration of inter-service relationships and available resources.
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Affiliation(s)
- Tom G Osborn
- ARC Research Assistant, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Rosa Town
- Digital Community Manager, The Tavistock and Portman NHS Foundation Trust, London, UK
| | - Majeed Bawendi
- MBBS Student, UCL Medical School, University College London, London, UK
| | - Emily Stapley
- Senior Research Fellow, Evidence Based Practice Unit, University College London, London, UK
| | - Rob Saunders
- Associate Professor, CORE Data Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Peter Fonagy
- Professor, Division of Psychology and Language Sciences, University College London, London, UK
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Kählke F, Hasking P, Küchler AM, Baumeister H. Mental health services for German university students: acceptance of intervention targets and preference for delivery modes. Front Digit Health 2024; 6:1284661. [PMID: 38426046 PMCID: PMC10903098 DOI: 10.3389/fdgth.2024.1284661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/22/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction Most university students with mental disorders remain untreated. Evaluating the acceptance of intervention targets in mental health treatment, promotion, and prevention, as well as mental health service delivery modes is crucial for reducing potential barriers, increasing healthcare utilization, and efficiently allocating resources in healthcare services. Aim The study aimed to evaluate the acceptance of various intervention targets and delivery modes of mental health care services in German first-year university students. Methods In total, 1,376 first-year students from two German universities from the 2017-2018 multi-center cross-sectional cohort of the StudiCare project, the German arm of the World Mental Health International College Student Survey initiative, completed a web-based survey assessing their mental health. Mental disorder status was based on self-reported data fulfilling the DSM-IV criteria. We report frequencies of accepted delivery modes [categories: group or in-person therapy with on or off campus services, self-help internet- or mobile-based intervention (IMI) with or without coaching, or a combination of a in-person and IMI (blended)]. In a multinomial logistic regression, we estimate correlates of the preference for in-person vs. IMI vs. a combination of both modes (blended) modalities. Additionally, we report frequencies of intervention targets (disorder specific: e.g., social phobia, depressive mood; study-related: test anxiety, procrastination; general well-being: sleep quality, resilience) their association with mental disorders and sex, and optimal combinations of treatment targets for each mental illness. Results German university students' acceptance is high for in-person (71%-76%), moderate for internet- and mobile-based (45%-55%), and low for group delivery modes (31%-36%). In-person treatment (72%) was preferred over IMI (19%) and blended modalities (9%). Having a mental disorder [odds ratio (OR): 1.56], believing that digital treatments are effective (OR: 3.2), and showing no intention to use services (OR: 2.8) were associated with a preference for IMI compared to in-person modes. Students with prior treatment experience preferred in-person modes (OR: 0.46). In general, treatment targets acceptance was higher among female students and students with mental disorders. However, this was not true for targets with the highest (i.e., procrastination) and the lowest (i.e., substance-use disorder) acceptance. If only two intervention targets were offered, a combination of study-related targets (i.e., procrastination, stress, time management) would reach 85%-88% of the students. Conclusion In-person services are preferred, yet half of the students consider using IMI, preferably aiming for a combination of at least two study-related intervention targets. Student mental health care services should offer a combination of accepted targets in different delivery modes to maximize service utilization.
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Affiliation(s)
- Fanny Kählke
- TUM School of Medicine and Health, Professorship Psychology & Digital Mental Health Care, Technische Universität München, Munich, Germany
| | - Penelope Hasking
- Curtin enAble Institute, Curtin University, Perth, WA, Australia
| | - Ann-Marie Küchler
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
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Tickell A, Fonagy P, Hajdú K, Obradović S, Pilling S. 'Am I really the priority here?': help-seeking experiences of university students who self-harmed. BJPsych Open 2024; 10:e40. [PMID: 38297500 PMCID: PMC10897682 DOI: 10.1192/bjo.2023.652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Self-harm is a significant problem in university students because of its association with emotional distress, physical harm, broader mental health issues and potential suicidality. Research suggests that fewer than half of students who have self-harmed seek professional help when at university. AIMS This study aimed to explore the help-seeking journeys of university students who had engaged in self-harm, to identify perceived facilitators and barriers to securing both formal and informal support. METHOD Participants comprised 12 students who had self-harmed during their university tenure. Engaging in two semi-structured interviews over the academic year, they shared insights into their help-seeking behaviours and proposed enhancements to local services. Data underwent reflexive thematic analysis within a critical realist framework. RESULTS The analysis identified four themes: 'The initial university phase poses the greatest challenge', 'Perceived criteria for "valid" mental health problems', 'Evading external judgements, concerns and consequences' and 'The pivotal role of treatment options and flexibility in recovery'. CONCLUSIONS Students felt isolated and misunderstood, which amplified self-harming tendencies and diminished inclinations for help-seeking. A prevalent belief was that for self-harm to be deemed 'valid', it must manifest with a certain severity; however, concurrent fears existed around the ramifications of perceived excessive severity. Participants expressed a desire for streamlined pathways to mental health resources, encompassing both university and external mental health services. Insights from this study could guide future research and inform current service paradigms within academic and healthcare systems.
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Affiliation(s)
- Alice Tickell
- Department of Clinical, Educational and Health Psychology, University College London, UK
| | - Peter Fonagy
- Department of Clinical, Educational and Health Psychology, University College London, UK
| | - Katalin Hajdú
- Department of Clinical, Educational and Health Psychology, University College London, UK
| | - Sandra Obradović
- School of Psychology and Counselling, Faculty of Arts and Social Sciences, The Open University, UK
| | - Stephen Pilling
- Department of Clinical, Educational and Health Psychology, University College London, UK
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da Conceição V, Mesquita E, Gusmão R. Effects of a stigma reduction intervention on help-seeking behaviors in university students: A 2019-2021 randomized controlled trial. Psychiatry Res 2024; 331:115673. [PMID: 38113809 DOI: 10.1016/j.psychres.2023.115673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION Stigma is one of the most frequently identified help-seeking barriers, but there is a lack of research on the effects of stigma reduction interventions on actual mental health help-seeking behaviors during crucial academic years. This research explores the effects of stigma on university students' mental health care help-seeking behaviors before and during the pandemic. METHODS A randomized control trial spanned from 2019 to 2021 at the University of Porto, along five evaluation moments, with students into one control group and two intervention groups-the interventions aimed to reduce depression stigma. RESULTS Among the 702 participants (mean age 18.87, 59.4 % female), the intervention groups significantly increased help-seeking behaviors. In 2020, the intervention groups, having reduced stigma, continued to demonstrate to be more prompt to seek mental health help. In 2021, 22 months, the effects of the intervention on help-seeking were no longer significant; however, participants in the intervention groups showed less severe symptomatology. CONCLUSION Stigma reduction interventions have a pronounced effect on enhancing help-seeking behaviors among university students, even during times of crisis. This study advocates for prioritizing stigma reduction in academic settings, highlighting its value in promoting mental health access during crucial academic and life challenges.
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Affiliation(s)
- Virgínia da Conceição
- EPIUnit - Institute of Public Health, University of Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.
| | - Edgar Mesquita
- EPIUnit - Institute of Public Health, University of Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Ricardo Gusmão
- EPIUnit - Institute of Public Health, University of Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Portugal
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Wittevrongel E, van Winkel R, Jackers M, Colman L, Versyck M, Camp E, Everaert G, Vrijens M, Baeyens D, Danckaerts M. How to make mental health services more youth-friendly? A Delphi study involving young adults, parents and professionals. Health Expect 2023; 26:2532-2548. [PMID: 37608557 PMCID: PMC10632649 DOI: 10.1111/hex.13832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/15/2023] [Accepted: 07/20/2023] [Indexed: 08/24/2023] Open
Abstract
INTRODUCTION Although youth-friendly service characteristics have been previously identified, consensus among a representative group of stakeholders about which of these characteristics are truly relevant to the youth-friendliness of services is currently lacking. In our study, young adults, parents and professionals were consulted on this topic to reveal existing (dis)agreement. In addition, (dis)agreement on feasibility for implementation in clinical practice was also assessed. METHODS A mixed-method Delphi approach was used with three online questionnaire rounds and a physical meeting. Young adults (18-26 years) and parents were part of a public panel and professionals were allocated to the professional panel. In the rounds, participants were asked to rate the importance and feasibility of each item. Subsequently, the percentage agreement (% of participants giving a score of 7 or above on a 9-point Likert scale) within and across panels was calculated. Consensus was assumed to have been reached when at least 70% agreement was achieved. A thematic analysis of the qualitative data, obtained in the rounds and the physical meeting, was performed to identify overarching themes and characteristics of relevance to the youth-friendliness of services. RESULTS For 65% of the items included in the Delphi questionnaire, consensus on importance was reached within both panels. Participants showed more insecurity about the feasibility of these items, however. Our thematic analysis revealed reasons for disagreement between and within the panels. CONCLUSIONS Our study revealed substantial between- and within-panel agreement on youth-friendly service characteristics. We recommend that the items for which consensus was reached should be used as a checklist in terms of youth mental health service development, design and delivery. The characteristics for which there was disagreement between and within the panels should inspire an ongoing trialogue between young adults, parents and professionals both on the individual level and the service level. PATIENT OR PUBLIC CONTRIBUTION In this study, (parents of) young adults with lived experience were included as experts, including one of the coauthors. This coauthor contributed to the manuscript by having a final say about the included quotes.
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Affiliation(s)
- Eline Wittevrongel
- Department of Neurosciences, Research Group Psychiatry, Center for Clinical PsychiatryKU LeuvenLeuvenBelgium
- University Psychiatric Center (UPC) KU LeuvenLeuvenBelgium
| | - Ruud van Winkel
- Department of Neurosciences, Research Group Psychiatry, Center for Clinical PsychiatryKU LeuvenLeuvenBelgium
- University Psychiatric Center (UPC) KU LeuvenLeuvenBelgium
| | - Maarten Jackers
- Department of Neurosciences, Research Group Psychiatry, Center for Clinical PsychiatryKU LeuvenLeuvenBelgium
| | | | - Melina Versyck
- Faculty of MedicineKU LeuvenLeuvenBelgium
- mArquee Multiversum Psychiatric HospitalAntwerpenBelgium
| | - Eline Camp
- Faculty of MedicineKU LeuvenLeuvenBelgium
| | - Geert Everaert
- Neuro‐Psychiatric Clinic Saint Joseph V.Z.W.PittemBelgium
| | - May Vrijens
- Asster Psychiatric HospitalSint‐TruidenBelgium
| | - Dieter Baeyens
- Faculty of Psychology and Educational Sciences, Parenting and Special EducationKU LeuvenLeuvenBelgium
| | - Marina Danckaerts
- University Psychiatric Center (UPC) KU LeuvenLeuvenBelgium
- Department of Neurosciences, Research Group Psychiatry, Center for Developmental PsychiatryKU LeuvenLeuvenBelgium
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Bantjes J, Kessler MJ, Hunt X, Stein DJ, Kessler RC. Treatment rates and barriers to mental health service utilisation among university students in South Africa. Int J Ment Health Syst 2023; 17:38. [PMID: 37946243 PMCID: PMC10633973 DOI: 10.1186/s13033-023-00605-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 09/27/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Mental health problems are common and impairing among university students, yet only a minority of students with psychological disorders access treatment. Understanding barriers to treatment is integral to planning services, especially in resource constrained settings like South Africa (SA). METHODS Data collected across 17 institutions in the online SA National Student Mental Health Survey were used to: (1) estimate 12-month prevalence of common mental health problems and self-harm; (2) estimate the proportion of students receiving treatments for the various mental health problems; (3) explore barriers to treatment; and (4) investigate sociodemographic predictors of treatment mediated through the various barriers endorsed by students with mental health problems. Prevalence analyses were carried out using cross-tabulations and prediction analyses using modified Poisson regression models. RESULTS Prevalence of clinically significant mental health problems is high relative to international comparisons, with the prevalence of severe, mild and moderate symptoms of any disorder and/or self-harm of 24.8% (SD = 0.3), 18.8% (SD = 0.3) and 27.6% (SD = 0.4) respectively. Treatment rates were 35.2% (S.E. = 0.6) among students with mental health problems who perceived need for treatment and 21.3% (S.E. = 0.4) irrespective of perceived need. Treatment rates were highest for mood disorders (29.9%, S.E. = 0.6) and lowest for externalising disorders (23.8%, S.E. = 0.5). Treatment rates were much less variable across disorder types among students with perceived need than irrespective of perceived need, indicating that perceived need mediated the associations of disorder types with received treatment. Adjusting for disorder profile, probability of obtaining treatment was significantly and positively associated with older age, female gender, study beyond the first year, traditional sexual orientation, and diverse indicators of social advantage (full-time study, high parent education, and attending Historically White Institutions). Among students with mental health problems, numerous barriers to treatment were reported adjusting for disorder profile, including lack of perceived need (39.5%, S.E. = 0.5) and, conditional on perceived need, psychological (54.4%, S.E. = 1.0), practical (77.3%, S.E. = 1.1), and other (79.1%, S.E. = 1.1) barriers. Typically, students reported multiple barriers to treatment. Differences in perceived need explained the gender difference in treatment, whereas practical barriers were most important in accounting for the other predictors of treatment. CONCLUSION Mental health problems are highly prevalent but seldom treated among SA university students. Although many barriers were reported, practical barriers were especially important in accounting for the associations of social disadvantage with low rates of treatment. Many of these practical barriers are however addressable.
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Affiliation(s)
- Jason Bantjes
- Mental Health, Alcohol, Substance Use and Tobacco (MAST) Research Unit, South African Medical Research Council, Cape Town, South Africa.
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
| | | | - Xanthe Hunt
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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Bower E, Ramsey E, Seiler S. Alcohol and cannabis use among rural university students: A quantitative analysis of barriers to care, student resilience, and school climate. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-12. [PMID: 37910656 DOI: 10.1080/07448481.2023.2272198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 10/09/2023] [Indexed: 11/03/2023]
Abstract
Objective: This article examines impacts of student resilience, school climate, and barriers to mental health care on problematic drinking behavior and cannabis use among rural university students. Participants: A total of 948 students from a public university in a southeastern state that completed the 2019-2020 Healthy Minds Study. Methods: Cross-tabulations and multivariate logistic regression analyses were employed to test study hypotheses. Results: Students who binge drink are more likely to engage in problematic drinking behaviors than students who do not binge drink; students who engage in problematic drinking are more likely to use cannabis than those who do not engage in problematic drinking. As students face more barriers to mental health care, they are more likely to engage in problematic drinking and cannabis use; students who are more resilient are less likely to engage in problematic drinking. Conclusions: To promote health and wellbeing, universities must understand factors that impact substance use among students.
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Affiliation(s)
- Erica Bower
- The Crime and Justice Institute, A Division of Community Resources for Justice, Boston, Massachusetts, USA
| | - Elizabeth Ramsey
- School of Human Ecology, Tennessee Tech University, Cookeville, Tennessee, USA
| | - Steven Seiler
- Department of Sociology & Political Science, Tennessee Tech University, Cookeville, Tennessee, USA
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Guenthner L, Baldofski S, Kohls E, Schuhr J, Brock T, Rummel-Kluge C. Differences in Help-Seeking Behavior among University Students during the COVID-19 Pandemic Depending on Mental Health Status: Results from a Cross-Sectional Survey. Behav Sci (Basel) 2023; 13:885. [PMID: 37998632 PMCID: PMC10669357 DOI: 10.3390/bs13110885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/21/2023] [Accepted: 10/23/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Current evidence suggests that a significant proportion of university students are affected by mental disorders and suicidal ideation. Despite this, a treatment gap exists. Therefore, the present study assessed students' knowledge and past use of on- and off-campus mental health services and help-seeking intentions. Furthermore, resilience was investigated as a potential barrier to help-seeking behavior. METHODS Data were collected between April and May 2022 from N = 5510 students from Saxony, Germany. To compare dependent variables, subgroups were computed according to students' mental health status. Variables were assessed using standardized questionnaires. Chi-square tests were used for comparisons between groups. Multiple regression models were used to investigate the influence of resilience on help-seeking behavior. RESULTS Between 34 and 38% (depending on the subgroup) of participants indicated that they were not aware of their universities' psychosocial counseling services. Furthermore, between 17 and 19% of participants indicated that they were not willing to seek help from professional mental health services. Finally, the previously found negative effect of resilience on help-seeking behavior was confirmed. CONCLUSION The results showed a lack of awareness regarding universities' mental health services and a treatment gap among university students. Universities and healthcare providers need to educate students about mental health services and how to access them. Further research is needed to elucidate the differential impact of resilience on mental health and help-seeking.
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Affiliation(s)
- Lukas Guenthner
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, 04103 Leipzig, Germany; (L.G.); (S.B.); (E.K.)
| | - Sabrina Baldofski
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, 04103 Leipzig, Germany; (L.G.); (S.B.); (E.K.)
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, 04103 Leipzig, Germany; (L.G.); (S.B.); (E.K.)
- Department of Psychiatry and Psychotherapy, University Leipzig Medical Center, Leipzig University, 04103 Leipzig, Germany
| | - Jan Schuhr
- Centre for Research, Further Education and Consulting, University of Applied Sciences for Social Work, Education and Nursing, 01307 Dresden, Germany; (J.S.); (T.B.)
| | - Tanja Brock
- Centre for Research, Further Education and Consulting, University of Applied Sciences for Social Work, Education and Nursing, 01307 Dresden, Germany; (J.S.); (T.B.)
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, 04103 Leipzig, Germany; (L.G.); (S.B.); (E.K.)
- Department of Psychiatry and Psychotherapy, University Leipzig Medical Center, Leipzig University, 04103 Leipzig, Germany
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20
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Yao ZY, Wang T, Yu YK, Li R, Sang X, Fu YN, Gong XJ, Sun WJ, Liu JJW, Wong JPH, Fung KPL, Jia CX. Mental health literacy and suicidal ideation among Chinese college students: The mediating role of depressive symptoms and anxiety symptoms. J Affect Disord 2023; 339:293-301. [PMID: 37437723 DOI: 10.1016/j.jad.2023.07.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/03/2023] [Accepted: 07/08/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Mental health literacy (MHL) is essential to mental health. Symptoms of depression and anxiety are significant antecedents and closely related to suicide among college students. Few studies have explored the mediating role of depressive and anxiety symptoms between MHL and suicidal ideation. METHODS 5578 college students were included in the analysis. The online Wenjuanxing platform was used to collect data from November 2020 to March 2021. The bootstrapping method was used to test the mediating role of depressive and anxiety symptoms in the links between MHL and suicidal ideation. RESULTS Approximately 18.8 % of Chinese college students in our study reported having suicidal ideation. MHL exhibited a significant and negative correlation with depressive symptoms, anxiety symptoms, and suicidal ideation, whereas depressive and anxiety symptoms correlated significantly and positively with suicidal ideation. Compared with the lowest MHL quartile, the 3rd and 4th quartiles of MHL were associated with a significantly lower risk of suicidal ideation after adjusting for various confounding factors. Depressive and anxiety symptoms partially mediated the relationship between MHL and suicidal ideation, and the mediating effect of depressive symptoms was significantly greater than that of anxiety symptoms. LIMITATIONS This study was a cross-sectional survey. Future longitudinal studies on this relation are needed. CONCLUSIONS Depressive and anxiety symptoms mediate the relationship between MHL and suicidal ideation. Comprehensive school-based specific psychological education programs are needed to improve college students' MHL and change their attitudes toward mental health services.
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Affiliation(s)
- Zhi-Ying Yao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Tao Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Yao-Kun Yu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Ran Li
- Center of Students' mental health and Consultation, Liaocheng University, Liaocheng 252000, China
| | - Xiao Sang
- Student Mental Health Education Center, Shandong Jianzhu University, Jinan 250101, China
| | - Yi-Na Fu
- School of Management, Shandong University, Jinan 250100, China
| | - Xiao-Jie Gong
- Department of Sociology, School of Political Science and Law, University of Jinan, Jinan 250022, China
| | - Wen-Jun Sun
- Student Work Office, College of Textile and Clothing, Qingdao University, Qingdao 266071, China
| | - Jenny Jing-Wen Liu
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada; Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Josephine Pui-Hing Wong
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada
| | - Kenneth Po-Lun Fung
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
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Hamza CA, Robinson K, Hasking PA, Heath NL, Lewis SP, Lloyd-Richardson E, Whitlock J, Wilson MS. Educational stakeholders' attitudes and knowledge about nonsuicidal self-injury among university students: A cross-national study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2140-2150. [PMID: 34380005 DOI: 10.1080/07448481.2021.1961782] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 06/15/2021] [Accepted: 07/22/2021] [Indexed: 06/13/2023]
Abstract
Nonsuicidal self-injury (NSSI) is a commonly occurring, yet historically poorly understood, mental health concern among post-secondary students. The present study sought to identify the current knowledge needs of university stakeholders to inform training efforts around effective NSSI response and student support on university campuses. Participants were 1,762 university students, staff, and student-staff (77% female) from seven universities in Canada, the USA, New Zealand, and Australia. Participants completed an online survey about their attitudes and knowledge of both general mental health and NSSI. University stakeholders reported significantly greater stigma toward NSSI than mental illness in general. Student-staff reported greater perceived knowledge and comfort, and demonstrated greater knowledge of NSSI, than students and staff. Findings underscore the need for additional training and resources to reduce stigma and increase knowledge about NSSI on university campuses internationally.
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Affiliation(s)
- Chloe A Hamza
- Applied Psychology and Human Development, University of Toronto Ontario Institute for Studies in Education, Toronto, Ontario, Canada
| | - Kealagh Robinson
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
| | - Penny A Hasking
- Health Sciences, School of Psychology, Curtin University, Perth, Australia
| | - Nancy L Heath
- Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Stephen P Lewis
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | | | - Janis Whitlock
- Family Life Development Center, Cornell University, Ithaca, New York, USA
| | - Marc S Wilson
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
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Al-Dajani N, Czyz EK, Eisenberg D, Zheng K, King CA. A latent profile analysis of at-risk first-year undergraduate students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-8. [PMID: 37722880 PMCID: PMC10947455 DOI: 10.1080/07448481.2023.2252909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/20/2023] [Indexed: 09/20/2023]
Abstract
Objective: We examined whether meaningful subgroups of self-injurious behaviors (SIBs) would emerge within a pool of first-year college students already deemed at elevated risk. Participants: First-year undergraduates (N = 1,068) recruited in 2015-2018 Fall terms. Methods: Past-year nonsuicidal self-injury (NSSI) frequency, past-year number of NSSI methods used, lifetime suicide attempt (SA) history, and recency of SA were included in a latent profile analysis. Results: Four subgroups emerged: low SIB (n = 558, 52%), high NSSI only (n = 182, 17%), high SIB (n = 141, 13%), and high SA only (n = 187, 18%). Students in the high SIB group reported higher levels of suicidal ideation at baseline and follow-up in comparison to all groups. Those in the high NSSI only or high SIB groups had relatively higher levels of NSSI at baseline and follow-up. Conclusions: Findings highlight the amount of heterogeneity within a high-risk group, along with the importance of considering distal and proximal SIBs in university screening efforts.
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Affiliation(s)
| | - Ewa K. Czyz
- Department of Psychiatry, University of Michigan
| | - Daniel Eisenberg
- Department of Health Management and Policy, School of Public Health, University of Michigan
| | - Kai Zheng
- Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California, Irvine
| | - Cheryl A. King
- Department of Psychiatry, University of Michigan
- Depression Center, University of Michigan
- Injury Prevention Center, University of Michigan
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Wallace GT, Henry KL, Barrett KC, Conner BT. Personality and emotion dysregulation profiles predict differential engagement in a wide range of health-risk behaviors. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1740-1752. [PMID: 34243687 DOI: 10.1080/07448481.2021.1947302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 03/13/2021] [Accepted: 06/08/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Health-risk behaviors have an unclear etiology and college students have elevated risk for engagement. Emotion dysregulation and several personality dimensions have been implicated in health-risk behaviors, but these constructs have rarely been studied together. Further, it is unknown if different types of health-risk behaviors have distinct etiologies. PARTICIPANTS 2077 college students completed a cross-sectional survey. METHODS Latent profile analysis discerned classes of participants from emotion dysregulation and personality dimensions. Differential engagement in self-injury, suicidality, disordered eating, substance misuse, and unprotected sex was evaluated across classes. RESULTS Three classes were identified, which were primarily distinguished by emotion dysregulation, urgency, and neuroticism. Health-risk behaviors generally increased across classes with increasing emotion-related constructs. Self-injury and suicidality demonstrated different patterns than other health-risk behaviors. CONCLUSIONS Results elucidate heterogeneity in health-risk behavior engagement. Focusing on emotional difficulties may be more important for reducing self-injury and suicidality than disordered eating, substance misuse, and risky sex.
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Affiliation(s)
- Gemma T Wallace
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Kimberly L Henry
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Karen C Barrett
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Bradley T Conner
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
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Benjet C, Zainal NH, Albor Y, Alvis-Barranco L, Carrasco-Tapias N, Contreras-Ibáñez CC, Cudris-Torres L, de la Peña FR, González N, Guerrero-López JB, Gutierrez-Garcia RA, Jiménez-Peréz AL, Medina-Mora ME, Patiño P, Cuijpers P, Gildea SM, Kazdin AE, Kennedy CJ, Luedtke A, Sampson NA, Petukhova MV, Kessler RC. A Precision Treatment Model for Internet-Delivered Cognitive Behavioral Therapy for Anxiety and Depression Among University Students: A Secondary Analysis of a Randomized Clinical Trial. JAMA Psychiatry 2023; 80:768-777. [PMID: 37285133 PMCID: PMC10248814 DOI: 10.1001/jamapsychiatry.2023.1675] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 04/10/2023] [Indexed: 06/08/2023]
Abstract
Importance Guided internet-delivered cognitive behavioral therapy (i-CBT) is a low-cost way to address high unmet need for anxiety and depression treatment. Scalability could be increased if some patients were helped as much by self-guided i-CBT as guided i-CBT. Objective To develop an individualized treatment rule using machine learning methods for guided i-CBT vs self-guided i-CBT based on a rich set of baseline predictors. Design, Setting, and Participants This prespecified secondary analysis of an assessor-blinded, multisite randomized clinical trial of guided i-CBT, self-guided i-CBT, and treatment as usual included students in Colombia and Mexico who were seeking treatment for anxiety (defined as a 7-item Generalized Anxiety Disorder [GAD-7] score of ≥10) and/or depression (defined as a 9-item Patient Health Questionnaire [PHQ-9] score of ≥10). Study recruitment was from March 1 to October 26, 2021. Initial data analysis was conducted from May 23 to October 26, 2022. Interventions Participants were randomized to a culturally adapted transdiagnostic i-CBT that was guided (n = 445), self-guided (n = 439), or treatment as usual (n = 435). Main Outcomes and Measures Remission of anxiety (GAD-7 scores of ≤4) and depression (PHQ-9 scores of ≤4) 3 months after baseline. Results The study included 1319 participants (mean [SD] age, 21.4 [3.2] years; 1038 women [78.7%]; 725 participants [55.0%] came from Mexico). A total of 1210 participants (91.7%) had significantly higher mean (SE) probabilities of joint remission of anxiety and depression with guided i-CBT (51.8% [3.0%]) than with self-guided i-CBT (37.8% [3.0%]; P = .003) or treatment as usual (40.0% [2.7%]; P = .001). The remaining 109 participants (8.3%) had low mean (SE) probabilities of joint remission of anxiety and depression across all groups (guided i-CBT: 24.5% [9.1%]; P = .007; self-guided i-CBT: 25.4% [8.8%]; P = .004; treatment as usual: 31.0% [9.4%]; P = .001). All participants with baseline anxiety had nonsignificantly higher mean (SE) probabilities of anxiety remission with guided i-CBT (62.7% [5.9%]) than the other 2 groups (self-guided i-CBT: 50.2% [6.2%]; P = .14; treatment as usual: 53.0% [6.0%]; P = .25). A total of 841 of 1177 participants (71.5%) with baseline depression had significantly higher mean (SE) probabilities of depression remission with guided i-CBT (61.5% [3.6%]) than the other 2 groups (self-guided i-CBT: 44.3% [3.7%]; P = .001; treatment as usual: 41.8% [3.2%]; P < .001). The other 336 participants (28.5%) with baseline depression had nonsignificantly higher mean (SE) probabilities of depression remission with self-guided i-CBT (54.4% [6.0%]) than guided i-CBT (39.8% [5.4%]; P = .07). Conclusions and Relevance Guided i-CBT yielded the highest probabilities of remission of anxiety and depression for most participants; however, these differences were nonsignificant for anxiety. Some participants had the highest probabilities of remission of depression with self-guided i-CBT. Information about this variation could be used to optimize allocation of guided and self-guided i-CBT in resource-constrained settings. Trial Registration ClinicalTrials.gov Identifier: NCT04780542.
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Affiliation(s)
- Corina Benjet
- Center for Global Mental Health, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Nur Hani Zainal
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Yesica Albor
- Center for Global Mental Health, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | | | | | | | - Lorena Cudris-Torres
- Programa de Psicología, Fundación Universitaria del Area Andina, Valledupar, Colombia
| | - Francisco R. de la Peña
- Unidad de Fomento a la Investigacion, Direccion de Servicios Clínicos, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Noé González
- Center for Global Mental Health, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | | | | | - Ana Lucía Jiménez-Peréz
- Facultad de Ciencias Administrativas y Sociales, Universidad Autónoma de Baja California, Ensenada, Mexico
| | - Maria Elena Medina-Mora
- Center for Global Mental Health, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Pamela Patiño
- Center for Global Mental Health, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Pim Cuijpers
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | - Sarah M. Gildea
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Alan E. Kazdin
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Chris J. Kennedy
- Center for Precision Psychiatry, Department of Psychiatry, Massachusetts General Hospital, Boston
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Alex Luedtke
- Department of Statistics, University of Washington, Seattle
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Maria V. Petukhova
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
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Vasiliadis HM, Léon C, du Roscoät E, Husky MM. Suicidal ideation and mental health care: Predisposing, enabling and need factors associated with general and specialist mental health service use in France. Int J Soc Psychiatry 2023; 69:1285-1292. [PMID: 36905113 DOI: 10.1177/00207640231159020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
BACKGROUND Population-based studies have shown that less than one in two individuals reporting suicidal ideation also report past-year mental health service use. Only a few studies have looked at different types of providers consulted. There is a need to better understand the factors associated with different provider combinations of mental health service use in representative samples of individuals with suicidal ideation. AIMS The aim of the current study is to assess, using Andersen's model of healthcare seeking behaviors, the predisposing, enabling and need factors associated with type of mental health service use in adults with past-year suicidal ideation. METHODS Data were drawn from the 2017 Health Barometer survey, a representative sample of the general population aged 18 to 75 years, among whom 1,128 respondents had reported suicidal ideation in the past year were analyzed. Past-year outpatient mental health service use (MHSU) was categorized into mutually exclusive groups as no use, general practitioner (GP) only; mental health professional (MHP) only; and both GP and MHP. Multinomial regression analyses were used to model mental health service use as a function of predisposing, enabling and need factors. RESULTS Overall, 44.3% reported past-year MHSU and this was higher in females than males (49.0% vs. 37.6%). Prevalence of GP only use in the overall sample was 8.7%, consulting with GP and MHP was 21.3%, consulting with MHP only was 14.3%. Higher education was associated with increased MHP use. Residing in a rural area was associated with increased GP only use. Presence of a suicide attempt within the year, a major depressive episode and role impairment were associated with consulting a GP and MHP, and MHP only, but not GP only. CONCLUSIONS When controlling for need and predisposing factors, socio-economic factors related to employment and income were associated with higher levels of consulting with mental health professionals.
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Affiliation(s)
- Helen-Maria Vasiliadis
- Département des sciences de la santé communautaire, Université de Sherbrooke, QC, Canada
- Centre de recherche Charles-Le Moyne, Campus de Longueuil Université de Sherbrooke, QC, Canada
| | | | - Enguerrand du Roscoät
- Santé publique France, Saint-Maurice, France
- Laboratoire Parisien de Psychologie Sociale (LAPPS), EA 4386, Université Paris Nanterre, France
| | - Mathilde M Husky
- Equipe ACTIVE, Bordeaux Population Health Research Center, INSERM U1219, Université de Bordeaux, France
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Hunt X, Jivan DC, Naslund JA, Breet E, Bantjes J. South African university students' experiences of online group cognitive behavioural therapy: Implications for delivering digital mental health interventions to young people. Glob Ment Health (Camb) 2023; 10:e45. [PMID: 37854416 PMCID: PMC10579664 DOI: 10.1017/gmh.2023.39] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 06/17/2023] [Accepted: 07/21/2023] [Indexed: 10/20/2023] Open
Abstract
Mental disorders are common among university students. In the face of a large treatment gap, resource constraints and low uptake of traditional in-person psychotherapy services by students, there has been interest in the role that digital mental health solutions could play in meeting students' mental health needs. This study is a cross-sectional, qualitative inquiry into university students' experiences of an online group cognitive behavioural therapy (GCBT) intervention. A total of 125 respondents who had participated in an online GCBT intervention completed a qualitative questionnaire, and 12 participated in in-depth interviews. The findings provide insights into how the context in which the intervention took place, students' need for and expectations about the intervention; and the online format impacted their engagement and perception of its utility. The findings of this study also suggest that, while online GCBT can capitalise on some of the strengths of both digital and in-person approaches to mental health programming, it also suffers from some of the weaknesses of both digital delivery and those associated with in-person therapies.
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Affiliation(s)
- Xanthe Hunt
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Dionne C. Jivan
- Department of Psychology, Faculty of Arts and Social Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - John A. Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Elsie Breet
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Jason Bantjes
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Alcohol, Tobacco and Other Drugs Research Unit, South African Medical Research Council, Cape Town, South Africa
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27
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Jones LB, Vereschagin M, Wang AY, Munthali RJ, Pei J, Richardson CG, Halli P, Xie H, Rush B, Yatham L, Gadermann AM, Pendakur K, Prescivalli AP, Munro L, Bruffaerts R, Auerbach RP, Mortier P, Vigo DV. Suicidal Ideation Amongst University Students During the COVID-19 Pandemic: Time Trends and Risk Factors. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:531-546. [PMID: 36475311 PMCID: PMC9732498 DOI: 10.1177/07067437221140375] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Examine time trends in suicidal ideation in post-secondary students over the first three waves of the COVID-19 pandemic in Canada and identify subpopulations of students with increased risk. METHOD We analysed 14 months of data collected through repeated cross-sectional deployment of the World Health Organization (WHO) World Mental Health-International College Student (WMH-ICS) survey at the University of British Columbia. Estimated log odds weekly trends of 30-day suicidal ideation (yes/no) were plotted against time with adjustments for demographics using binary logistic generalized additive model (GAM). Risk factors for 30-day suicidal ideation frequency (four categories) were examined using the ordered logistic GAM, with a cubic smoothing spline for modelling time trend in obervation weeks and accounting for demographics. RESULTS Nearly one-fifth (18.9%) of students experienced suicidal ideation in the previous 30 days. While the estimated log odds suggested that binary suicidal ideation was relatively stable across the course of the pandemic, an initial drop followed by an increasing trend was observed. Risk factors for suicidal ideation frequency during the pandemic included identifying as Chinese or as another non-Indigenous ethnic minority; experiencing current symptoms of depression or anxiety; having a history of suicidal planning or attempts; and feeling overwhelmed but unable to get help as a result of COVID-19. Older age was identified as a protective factor. CONCLUSIONS The general university student population in our study was relatively resilient with respect to suicidal ideation during the first three waves of the pandemic, but trends indicate the possibility of delayed impact. Specific sub-populations were found to be at increased risk and should be considered for targeted support. Further analyses should be undertaken to continue monitoring suicidality trends throughout the remainder of the pandemic and beyond.
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Affiliation(s)
- Laura B. Jones
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Melissa Vereschagin
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Angel Y. Wang
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Richard J. Munthali
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Julia Pei
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Chris G. Richardson
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Priyanka Halli
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Hui Xie
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Brian Rush
- Department of Psychiatry & School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Lakshmi Yatham
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Anne M. Gadermann
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Krishna Pendakur
- Department of Economics, Simon Fraser University, Burnaby, BC, Canada
| | - Ana Paula Prescivalli
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Lonna Munro
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Ronny Bruffaerts
- Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
| | | | - Philippe Mortier
- Health Services Research Unit, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Daniel V. Vigo
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Küchler AM, Kählke F, Bantleon L, Terhorst Y, Ebert DD, Baumeister H. Moderators and mediators of change of an internet-based mindfulness intervention for college students: secondary analysis from a randomized controlled trial. Front Digit Health 2023; 5:1179216. [PMID: 37441226 PMCID: PMC10333756 DOI: 10.3389/fdgth.2023.1179216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 06/07/2023] [Indexed: 07/15/2023] Open
Abstract
Background Existing evidence suggests internet- and mobile-based interventions (IMIs) improve depressive symptoms in college students effectively. However, there is far less knowledge about the potential mechanisms of change of mindfulness-based IMIs, which could contribute to optimizing target groups and interventions. Hence, within this secondary analysis of data from a randomized controlled trial (RCT), potential moderators and mediators of the effectiveness of the IMI StudiCare Mindfulness were investigated. Methods Moderation and mediation analyses were based on secondary data from a RCT that examined the effectiveness of the 7-module IMI StudiCare Mindfulness in a sample of college students (intervention group: n = 217; waitlist control group: n = 127). Assessments were collected before (t0; baseline), 4 weeks after (t1; during intervention), and 8 weeks after (t2; post-intervention) randomization. Longitudinal mediation analyses using structural equation modeling were employed, with depressive symptom severity as the dependent variable. For moderation analyses, bilinear interaction models were calculated with depressive symptom severity and mindfulness at t2 as dependent variables. All data-analyses were performed on an intention-to-treat basis. Results Mediation analyses showed a significant, full mediation of the intervention effect on depressive symptom severity through mindfulness (indirect effect, a*b = 0.153, p < 0.01). Only the number of semesters (interaction: β = 0.24, p = 0.035) was found to moderate the intervention's effectiveness on depressive symptom severity at t2, and only baseline mindfulness (interaction: β = -0.20, p = 0.047) and baseline self-efficacy (interaction: β = -0.27, p = 0.012) were found to be significant moderators of the intervention effect on mindfulness at t2. Conclusion Our results suggest a mediating role of mindfulness. Moderation analyses demonstrated that the intervention improved depressive symptom severity and mindfulness independent of most examined baseline characteristics. Future confirmatory trials will need to support these findings. Clinical Trial Registration The trial was registered a priori at the WHO International Clinical Trials Registry Platform via the German Clinical Studies Trial Register (TRN: DRKS00014774; registration date: 18 May 2018).
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Affiliation(s)
- Ann-Marie Küchler
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Fanny Kählke
- Department for Sport and Health Sciences, Professorship for Psychology & Digital Mental Health Care, Technical University of Munich, Munich, Germany
| | - Leandra Bantleon
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Yannik Terhorst
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - David Daniel Ebert
- Department for Sport and Health Sciences, Professorship for Psychology & Digital Mental Health Care, Technical University of Munich, Munich, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
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Allie SLN, Bantjes J, Andriessen K. Suicide postvention for staff and students on university campuses: a scoping review. BMJ Open 2023; 13:e068730. [PMID: 37328183 PMCID: PMC10277115 DOI: 10.1136/bmjopen-2022-068730] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 05/22/2023] [Indexed: 06/18/2023] Open
Abstract
OBJECTIVE To examine current knowledge about suicide bereavement and postvention interventions for university staff and students. DESIGN Scoping review. DATA SOURCES AND ELIGIBILITY We conducted systematic searches in 12 electronic databases (PubMed, PsycINFO, MEDLINE, CINAHL, Africa-Wide Information, PsycARTICLES, Health Source: Nursing/Academic Edition, Academic Search Premier, SocINDEX through the EBSCOHOST platform; Cochrane Library, Web of Science, SCOPUS), hand searched lists of references of included articles and consulted with library experts during September 2021 and June 2022. Eligible studies were screened against the inclusion criteria independently by two reviewers. Only studies published in English were included. DATA EXTRACTION AND SYNTHESIS Screening was conducted by two independent reviewers following a three-step article screening process. Biographical data and study characteristics were extracted using a data extraction form and synthesised. RESULTS Our search strategy identified 7691 records from which 3170 abstracts were screened. We assessed 29 full texts and included 17 articles for the scoping review. All studies were from high-income countries (USA, Canada, UK). The review identified no postvention intervention studies on university campuses. Study designs were mostly descriptive quantitative or mixed methods. Data collection and sampling were heterogeneous. CONCLUSION Staff and students require support measures due to the impact of suicide bereavement and the unique nature of the university context. There is a need for further research to move from descriptive studies to focus on intervention studies, particularly at universities in low-income and middle-income countries.
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Affiliation(s)
| | - Jason Bantjes
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit (MASTRU), South African Medical Research Council, Tygerberg, Western Cape, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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Futch W, Gordon NS, Gerdes AC. Student wellness: Interest and program ideas & pilot of a student wellness program. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-9. [PMID: 37289966 DOI: 10.1080/07448481.2023.2214241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 03/30/2023] [Accepted: 05/03/2023] [Indexed: 06/10/2023]
Abstract
Objective: To increase our knowledge related to student wellness programs, the current studies examined interest in wellness and wellness programs among university students and piloted a newly developed wellness program targeting students in higher education. Participants/Methods: In Study 1, 93 undergraduate students answered questions related to their wellness and mental health (e.g. psychological wellbeing, satisfaction with life, optimism, and stress) and to wellness programs (e.g. interest, barriers, duration, and topics). In Study 2, 13 undergraduate and graduate students participated in a 9-week pilot wellness program focused on specific wellness topics (e.g. relaxation, yoga, gratitude and self-compassion, and emotion regulation). Results/Conclusions: Study 1 results support a strong interest in wellness and wellness programs among undergraduate students. Study 2 results suggest that students who participated in an on-campus wellness program reported higher levels of overall psychological wellbeing and optimism and lower levels of mental health issues relative to baseline.
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Affiliation(s)
- Will Futch
- Psychology Department, Marquette University, Milwaukee, Wisconsin, USA
| | - Nakia S Gordon
- Psychology Department, Marquette University, Milwaukee, Wisconsin, USA
| | - Alyson C Gerdes
- Psychology Department, Marquette University, Milwaukee, Wisconsin, USA
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Dagani J, Buizza C, Ferrari C, Ghilardi A. The role of psychological distress, stigma and coping strategies on help-seeking intentions in a sample of Italian college students. BMC Psychol 2023; 11:177. [PMID: 37280661 DOI: 10.1186/s40359-023-01171-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 04/17/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Mental health issues are common among university students, but the latter are unlikely to seek professional help even when mental health services are available. Coping strategies, stigma and psychological distress are often considered as factors that can affect help-seeking intentions in university students. METHODS This study aimed to determine the role of coping strategies, stigma and psychological distress on the intentions to seek professional help for psychological problems. All students (N = 13,886) from an Italian medium-sized university were asked to participate in a multidimensional online survey and 3754 (27.1%) agreed to participate. A Structural Equation Modelling approach was applied to explore the simultaneous direct and indirect effects of distress, stigma and coping strategies on professional help-seeking intentions. RESULTS Results showed that students were not very likely to seek professional help and, through the Structural Equation Model, psychological distress was found to be positively correlated with coping strategies, which in turn was negatively associated with the stigma of seeking help. The latter was negatively associated with professional help-seeking intentions. These effects suggest that students with significant psychological distress use coping strategies to face the stigma of seeking help: the lower the stigma of seeking help, the higher the chance of developing intentions to seek professional help. CONCLUSIONS This study suggests the importance of implementing programs to encourage college students to seek help, including measures that foster a stigma-free environment, reduce psychological distress and promote the use of adaptive coping strategies. Interventions should be focused firstly on self-stigma and secondly on perceived stigma, taking into consideration the level of psychological distress and social stereotypes associated with mental disorders and help seeking behaviours. Programs about coping are also essential and should focus on promoting emotion-focused strategies and problem-focused strategies.
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Affiliation(s)
- Jessica Dagani
- Department of Clinical and Experimental Sciences, Section of Clinical and Dynamic Psychology, University of Brescia, Viale Europa, 11, 25123, Brescia, Italy.
| | - Chiara Buizza
- Department of Clinical and Experimental Sciences, Section of Clinical and Dynamic Psychology, University of Brescia, Viale Europa, 11, 25123, Brescia, Italy
| | - Clarissa Ferrari
- Service of Statistics, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Via Pilastroni, 4, 25125, Brescia, Italy
| | - Alberto Ghilardi
- Department of Clinical and Experimental Sciences, Section of Clinical and Dynamic Psychology, University of Brescia, Viale Europa, 11, 25123, Brescia, Italy
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Castro-Ramirez F, Paz-Pérez MA, McGuire TC, Rankin O, Alfaro MCG, Audirac AM, Campuzano MLG, Coady P, Núñez-Delgado M, Manana J, Hernández-de la Rosa C, Tambedou T, Vergara GA, Barranco LA, Cudris-Torres L, Nock MK, Naslund JA, Benjet C. A Qualitative Examination of the Impact of Suicidal Thoughts and Behavior on Help-Seeking Among University Students in Colombia and Mexico. JOURNAL OF BEHAVIORAL AND COGNITIVE THERAPY 2023; 33:67-80. [PMID: 37680902 PMCID: PMC10482072 DOI: 10.1016/j.jbct.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
This study examined descriptions of suicidal thoughts and behavior (STB) to identify risk and protective factors that may present in clinical settings among university students from Latin America. Our focus was on answering the following key questions: How are suicidal thoughts and behavior described? What are reasons for wanting to die and for living? What impact do STBs have on motivations to seek or avoid psychological treatment? To this end, 55 qualitative interviews were completed with university students from Colombia and Mexico who recently endorsed emotional difficulties in the World Mental Health International College Student (WMH-ICS) surveys. Interviews were coded to identify themes specific to STBs. Findings revealed insight on symptom presentations and consequences of STBs. Participants described uncontrollable somatic symptoms during periods of high suicide risk, which serves as a relevant clinical marker for health providers. An important reason for living was to avoid suffering for family, which was protective against suicide and motivates familial involvement in treatment planning. Participants sought solutions to emotional problems after experiencing STBs, including psychological treatment. Cultural stigma of mental illness induced feelings of shame and burden, which led to avolition, avoidance, and nondisclosure of symptom severity. This study provides insight into the utility of evaluating cultural context in (a) detecting antecedents to STBs frequently reported as somatic symptoms, (b) identifying protective factors against suicide, and (c) recognizing how stigma of mental illness and suicide, shame avoidance, and familism might influence personal motivations to seek or avoid help for emotional distress.
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Affiliation(s)
| | | | | | - Osiris Rankin
- Department of Psychology, Harvard University, United States
| | | | | | | | - Parker Coady
- Department of Psychology, Harvard University, United States
| | | | | | | | - Tida Tambedou
- Department of Psychology, Harvard University, United States
| | | | | | | | - Matthew K Nock
- Department of Psychology, Harvard University, United States
| | - John A Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, United States
| | - Corina Benjet
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, México City, México
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Husky MM, Sadikova E, Lee S, Alonso J, Auerbach RP, Bantjes J, Bruffaerts R, Cuijpers P, Ebert DD, Garcia RG, Hasking P, Mak A, McLafferty M, Sampson NA, Stein DJ, Kessler RC. Childhood adversities and mental disorders in first-year college students: results from the World Mental Health International College Student Initiative. Psychol Med 2023; 53:2963-2973. [PMID: 37449483 PMCID: PMC10349206 DOI: 10.1017/s0033291721004980] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND This study investigates associations of several dimensions of childhood adversities (CAs) with lifetime mental disorders, 12-month disorder persistence, and impairment among incoming college students. METHODS Data come from the World Mental Health International College Student Initiative (WMH-ICS). Web-based surveys conducted in nine countries (n = 20 427) assessed lifetime and 12-month mental disorders, 12-month role impairment, and seven types of CAs occurring before the age of 18: parental psychopathology, emotional, physical, and sexual abuse, neglect, bullying victimization, and dating violence. Poisson regressions estimated associations using three dimensions of CA exposure: type, number, and frequency. RESULTS Overall, 75.8% of students reported exposure to at least one CA. In multivariate regression models, lifetime onset and 12-month mood, anxiety, and substance use disorders were all associated with either the type, number, or frequency of CAs. In contrast, none of these associations was significant when predicting disorder persistence. Of the three CA dimensions examined, only frequency was associated with severe role impairment among students with 12-month disorders. Population-attributable risk simulations suggest that 18.7-57.5% of 12-month disorders and 16.3% of severe role impairment among those with disorders were associated with these CAs. CONCLUSION CAs are associated with an elevated risk of onset and impairment among 12-month cases of diverse mental disorders but are not involved in disorder persistence. Future research on the associations of CAs with psychopathology should include fine-grained assessments of CA exposure and attempt to trace out modifiable intervention targets linked to mechanisms of associations with lifetime psychopathology and burden of 12-month mental disorders.
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Affiliation(s)
- Mathilde M. Husky
- Laboratoire de Psychologie EA4139, Université de Bordeaux, Bordeaux, France
| | - Ekaterina Sadikova
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, US
| | - Sue Lee
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute; Pompeu Fabra University (UPF); and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Randy P. Auerbach
- Department of Psychiatry, Columbia University, New York, New York, USA
| | - Jason Bantjes
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, South Africa
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - David D. Ebert
- Department for Sport and Health Sciences, Chair for Psychology & Digital Mental Health Care, Technical University Munich, Germany
| | - Raùl Gutiérrez Garcia
- Department of Social Sciences and Humanities, De La Salle Bajio University, Salamanca, Guanajuato, Mexico
| | - Penelope Hasking
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Arthur Mak
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR
| | | | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Dan J. Stein
- Department of Psychiatry & Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, Republic of South Africa
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
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Prado ADS, Kohls E, Baldofski S, Bianchi AS, Trindade LIP, Freitas JDL, Rummel-Kluge C. How are Brazilian university students coping with the COVID-19 pandemic? Results of an online survey on psychosocial well-being, perceived burdens, and attitudes toward social distancing and vaccination. PLoS One 2023; 18:e0284190. [PMID: 37099492 PMCID: PMC10132549 DOI: 10.1371/journal.pone.0284190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 03/24/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic caused significant disruption to education systems worldwide, increasing pre-existing concerns regarding university students' mental health. Brazil was among the countries most affected by COVID-19 cases and deaths and was considered a pandemic epicenter. This study aimed to investigate Brazilian university students' mental health status and perceived burdens during the COVID-19 pandemic. MATERIAL AND METHODS From November 2021 to March 2022, a cross-sectional and anonymous online survey was conducted among students of a Brazilian federal university. Mental health status (depressive symptoms, alcohol and drug consumption) and social and emotional aspects in the pandemic context (social support, perceived stress, loneliness, resilience, and self-efficacy) were assessed with standardized measures. Students' attitudes toward the COVID-19 pandemic and vaccination and perceived burdens of the pandemic were also investigated. RESULTS A total of N = 2,437 students completed the online survey. The PHQ-9 mean sum score was 12.85 (SD = 7.40), while n = 1,488 (61.10%) participants reported a sum score of 10 or more, indicating clinically relevant depressive symptoms. Further, n = 808 (33.1%) of the total sample reported suicidal thoughts. Levels of depressive symptoms, perceived stress, and loneliness were higher among undergraduate/bachelor students than doctoral students. Almost all participants (97.3%) reported being fully vaccinated against COVID-19. Multiple regression analyses showed that being single, having an income decreased during the pandemic, having a previous mental illness, having a chronic somatic condition, not finding positive aspects in the pandemic, lower self-efficacy, lower social support, lower resilience, and higher experienced loneliness were significantly associated with higher levels of depression. CONCLUSIONS The study showed high levels of depressive symptoms and suicidal ideation among Federal University of Parana students. Therefore, health care providers and universities need to recognize and address mental health issues; psychosocial policies must be enhanced to mitigate the impact of the pandemic on students' mental health and wellbeing.
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Affiliation(s)
- Aneliana da Silva Prado
- Faculty of Life Sciences, Wilhelm Wundt Institute for Psychology, Leipzig University, Leipzig, Sachsen, Germany
- Department of Psychology, Federal University of Parana, Curitiba, Parana, Brazil
- Campus Curitiba, Federal Institute of Education, Science and Technology of Parana, Curitiba, Parana, Brazil
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Sachsen, Germany
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Sachsen, Germany
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Sachsen, Germany
| | - Sabrina Baldofski
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Sachsen, Germany
| | | | | | | | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Sachsen, Germany
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Sachsen, Germany
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Elledge DK, Lee SC, Stewart SM, Pop R, Trivedi MH, Hughes JL. Examining a Resilience Mental Health App in Adolescents: Acceptability and Feasibility Study. JMIR Form Res 2023; 7:e38042. [PMID: 36947113 PMCID: PMC10132019 DOI: 10.2196/38042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 01/12/2023] [Accepted: 01/29/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Resilience is defined as the ability to rely on internal characteristics and external strengths to adapt to adverse events. Although universal resilience-enhancing programs are effective for adolescents, there is a need for interventions that are more easily accessible and can be customized for individual teens. Phone apps are easy to use, can be tailored to individuals, and have demonstrated positive effects for mental health outcomes. OBJECTIVE This study aimed to examine the feasibility and acceptability of a resilience app for adolescents. This app aimed to enhance resilience through modules focused on depression prevention, stress management, and healthy lifestyle approaches containing videos, measures, and practice suggestions. Furthermore, the study aimed to evaluate the effect of short-term app use on changes in resilience. METHODS In study 1, individual interviews and focus groups were conducted with adolescents, parents, teachers, and clinicians to discuss possible incentives for using a mental health app, the benefits of app use, and concerns associated with app use. Feedback from study 1 led to ideas for the prototype. In study 2, individual interviews and focus groups were conducted with adolescents, parents, teachers, and clinicians to gather feedback about the resilience app prototype. Feedback from study 2 led to changes in the prototype, although not all suggestions could be implemented. In study 3, 40 adolescents used the app for 30 days to determine feasibility and acceptability. Additionally, resilience and secondary mental health outcomes were measured before and after app use. Dependent samples 2-tailed t tests were conducted to determine whether there were changes in resilience and secondary mental health outcomes among the adolescents before and after app use. RESULTS Multiple themes were identified through study 1 individual interviews and focus groups, including app content, features, engagement, benefits, concerns, and improvement. Specifically, the adolescents provided helpful suggestions for making the prototype more appealing and functional for teen users. Study 2 adolescents and adults reported that the prototype was feasible and acceptable through the Computer System Usability Questionnaire (mean 6.30, SD 1.03) and Mobile App Rating Scale (mean 4.08, SD 0.61). In study 2, there were no significant differences in resilience and mental health outcomes after using the app for 30 days. There was variation between the participants in the extent to which they used the app, which may have led to variation in the results. The users appeared to prefer the depression module and survey sections, which provided mental health feedback. CONCLUSIONS Qualitative and quantitative data provide evidence that youth are interested in a resilience mental health app and that the current prototype is feasible. Although there were no significant mental health changes in study 3 users, practical implications and future directions are discussed for mental health app research.
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Affiliation(s)
| | - Simon Craddock Lee
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Sunita M Stewart
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
- Children's Medical Center, Dallas, TX, United States
| | - Radu Pop
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Madhukar H Trivedi
- Center for Depression Research and Clinical Care, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
- Peter O'Donnell Jr Brain Institute, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Jennifer L Hughes
- Nationwide Children's Hospital, Columbus, OH, United States
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, United States
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Bantjes J, Hunt X, Stein DJ. Anxious, Depressed, and Suicidal: Crisis Narratives in University Student Mental Health and the Need for a Balanced Approach to Student Wellness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4859. [PMID: 36981766 PMCID: PMC10049682 DOI: 10.3390/ijerph20064859] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
There is growing global awareness of the poor mental health of university students, as well as the need to improve students' access to services and expand the range of available evidence-based interventions. However, a crisis narrative is emerging, particularly in the wake of the COVID-19 pandemic, that runs the risk of positioning all students as potential patients in need of formal psychiatric interventions. Our aim in this commentary is to critically present the evidence that supports increased attention to student mental health, while also raising a concern that the crisis narrative may itself have unintended harmful consequences. We highlight some of the potential dangers of overtly medicalizing and thus pathologizing students' experiences of everyday distress, inadequacies of formal diagnostic categories, limitations of focusing narrowly on psychotherapeutic and psychiatric interventions, and the short-sightedness of downplaying key social determinants of students' distress. We argue for an integrative and balanced public health approach that draws on the rigor of psychiatric epidemiology and the advances that have been made to identify evidence-based interventions for students, while simultaneously being mindful of the shortcomings and potential dangers of working narrowly within the paradigm of diagnostic labels and psychotherapeutic interventions.
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Affiliation(s)
- Jason Bantjes
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town 7505, South Africa
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch 7602, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town 7700, South Africa
| | - Xanthe Hunt
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch 7602, South Africa
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town 7700, South Africa
- SAMRC Unit on Risk and Resilience in Mental Disorders, Stellenbosch University, Stellenbosch 7602, South Africa
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Bootsma E, Jansen L, Kiekens G, Voorpoels W, Mortier P, Proost S, Vande Poel I, Jacobs K, Demyttenaere K, Alonso J, Kessler RC, Cuijpers P, Auerbach RP, Bruffaerts R. Mood disorders in higher education in Flanders during the 2 nd and 3 rd COVID-19 wave: Prevalence and help-seeking: Findings from the Flemish College Surveys (FLeCS). J Psychiatr Res 2023; 159:33-41. [PMID: 36657312 DOI: 10.1016/j.jpsychires.2023.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 11/21/2022] [Accepted: 01/09/2023] [Indexed: 01/13/2023]
Abstract
To examine the prevalence of 12-month mood disorders and receipt of mental health treatment among a volunteer sample of higher education students during the 2nd and 3rd COVID-19 wave in the Flanders region. Web-based self-report surveys were obtained from 9101 students in higher education in the Flemish College Surveys (FLeCS) in Flanders, Belgium. As part of the World Health Organization's World Mental Health-International College Student Initiative, we screened for 12-month mood disorders (major depressive episode (MDE), mania/hypomania), and service use. We used poststratification weights to generate population-representative data on key socio-demographic characteristics. 50.6% of the respondents screened positive for 12-month mood disorders (46.8% MDE, of which 22.9% with very severe impact). Use of services was very low, with estimates of 35.4% for MDE, 31.7% for mania, and 25.5% for hypomania. Even among students with very severe disorders, treatment rates were never higher than 48.3%. Most common barriers for not using services were: the preference to handle the problem alone (83.4%) and not knowing where to seek professional help (79.8%). We found a high unmet need for mood problems among college students; though caution is needed in interpreting these findings given the volunteer nature of the sample. A reallocation of treatment resources for higher education students should be considered, particulary services that focus on innovative, low-threshold, and scalable interventions.
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Affiliation(s)
- Erik Bootsma
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Belgium; The KU Leuven - VIB Center for Microbiology, Leuven, Belgium.
| | - Leontien Jansen
- Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium
| | - Glenn Kiekens
- Faculty of Psychology and Educational Sciences, Clinical Psychology, KU Leuven, Leuven, Belgium; Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | | | - Philippe Mortier
- Health Services Research Unit, IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Sebastian Proost
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Belgium; The KU Leuven - VIB Center for Microbiology, Leuven, Belgium
| | - Ilse Vande Poel
- Knowledge and Innovation Center FOOD, University Colleges Leuven-Limburg, Leuven, Belgium
| | - Karen Jacobs
- Knowledge and Innovation Center FOOD, University Colleges Leuven-Limburg, Leuven, Belgium
| | - Koen Demyttenaere
- Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium; Campus Gasthuisberg, Universitair Psychiatrisch Centrum KU Leuven (UPC-KUL), Leuven, Belgium
| | - Jordi Alonso
- Health Services Research Unit, IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, MA, USA
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, USA; Division of Clinical Developmental Neuroscience, Sackler Institute, New York, USA
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium; Campus Gasthuisberg, Universitair Psychiatrisch Centrum KU Leuven (UPC-KUL), Leuven, Belgium
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Oliveira C, Pacheco M, Borges J, Meira L, Santos A. Internet-delivered cognitive behavioral therapy for anxiety among university students: A systematic review and meta-analysis. Internet Interv 2023; 31:100609. [PMID: 36873307 PMCID: PMC9982642 DOI: 10.1016/j.invent.2023.100609] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 02/14/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
University years are marked by multiple stressors. Consequently, university students often report anxiety symptoms or disorders, but most remain untreated. Internet-delivered cognitive behavioral therapy (ICBT) has been proposed as an alternative to address known help-seeking barriers, which were aggravated during the COVID-19 pandemic. This meta-analysis aims to evaluate the efficacy of ICBT for university students with anxiety. A systematic search on three databases, EBSCOhost, PubMed, and Web of Science, and a manual search were performed. Fifteen studies were identified, including a total of 1619 participants. Seven studies evaluated ICBT treatment for both anxiety and depression, three for social anxiety, two for generalized anxiety, while the remaining (k = 3) only targeted anxiety, test anxiety, and comorbidity between anxiety and insomnia. Analyses were performed based on a random-effects model using the metafor package in R. The results indicated that ICBT had a significant and positive effect on university students with anxiety compared to controls at post-test (g = -0.48; 95 % CI: -0.63, -0.27; p < .001, I 2 = 67.30 %). Nevertheless, more research is required to determine the intervention components that are more relevant for therapeutic change, how much guidance is required to produce better outcomes, and how patient engagement can be improved.
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Affiliation(s)
- Cláudia Oliveira
- University of Maia, Av. Carlos Oliveira Campos, 4475-690 Maia, Portugal.,Center for Psychology at University of Porto, 4200-135 Porto, Portugal
| | - Mara Pacheco
- University of Maia, Av. Carlos Oliveira Campos, 4475-690 Maia, Portugal
| | - Janete Borges
- University of Maia, Av. Carlos Oliveira Campos, 4475-690 Maia, Portugal
| | - Liliana Meira
- University of Maia, Av. Carlos Oliveira Campos, 4475-690 Maia, Portugal.,Center for Psychology at University of Porto, 4200-135 Porto, Portugal
| | - Anita Santos
- University of Maia, Av. Carlos Oliveira Campos, 4475-690 Maia, Portugal.,Center for Psychology at University of Porto, 4200-135 Porto, Portugal
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Mavragani A, Mestroni G, Hunt C, Glozier N. Personalized Help-Seeking Web Application for Chinese-Speaking International University Students: Development and Usability Study. JMIR Form Res 2023; 7:e35659. [PMID: 36800231 PMCID: PMC9985004 DOI: 10.2196/35659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 12/03/2022] [Accepted: 12/19/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The mental health of international students is a growing concern for education providers, students, and their families. Chinese international students have low rates of help seeking owing to language, stigma, and mental health literacy barriers. Web-based help-seeking interventions may improve the rate of help seeking among Chinese international students. OBJECTIVE This study aimed to describe the development of a mental well-being web app providing personalized feedback and tailored psychoeducation and resources to support help seeking among international university students whose first language is Chinese and test the web application's uptake and engagement. METHODS The bilingual MindYourHead web application contains 6 in-app assessments for various areas of mental health, and users are provided with personalized feedback on symptom severity, psychoeducation tailored to the person's symptoms and information about relevant interventions, and tailored links to external resources and mental health services. A feasibility study was conducted within a school at the University of Sydney to examine the uptake and engagement of the web application among Chinese international students and any demographic characteristics or help-seeking attitudes or intentions that were associated with its engagement. RESULTS A total of 130 Chinese international students signed up on the web application. There was an uptake of 13.4% (122/908) in the schools' Chinese student enrollment. Most participants (76/130, 58.5%) preferred to use the web application in Chinese and used informal but not formal help for their mental health. There was considerable attrition owing to a design issue, and only 46 students gained access to the full content of the web application. Of these, 67% (31/46) of participants completed 1 or more of the in-app mental well-being assessments. The most commonly engaged in-app assessments were distress (23/31, 74%), stress (17/31, 55%), and sleep (15/31, 48%), with the majority scoring within the moderate- or high-risk level of the score range. In total, 10% (9/81) of the completed in-app assessments led to clicks to external resources or services. No demographic or help-seeking intentions or attitudes were associated with web-application engagement. CONCLUSIONS There were promising levels of demand, uptake, and engagement with the MindYourHead web application. The web application appears to attract students who wished to access mental health information in their native language, those who had poor mental health in the past but relied on informal support, and those who were at moderate or high risk of poor mental well-being. Further research is required to explore ways to improve uptake and engagement and to test the efficacy of the web application on Chinese international students' mental health literacy, stigma, and help seeking.
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Affiliation(s)
| | - Gemma Mestroni
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia.,Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Caroline Hunt
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia.,Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Nick Glozier
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.,Australian Research Council Centre of Excellence for Children and Families Over the Life Course, Sydney, Australia
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Küchler AM, Schultchen D, Dretzler T, Moshagen M, Ebert DD, Baumeister H. A Three-Armed Randomized Controlled Trial to Evaluate the Effectiveness, Acceptance, and Negative Effects of StudiCare Mindfulness, an Internet- and Mobile-Based Intervention for College Students with No and "On Demand" Guidance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3208. [PMID: 36833903 PMCID: PMC9965996 DOI: 10.3390/ijerph20043208] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
The college years can be accompanied by mental distress. Internet- and mobile-based interventions (IMIs) have the potential to improve mental health but adherence is problematic. Psychological guidance might promote adherence but is resource intensive. In this three-armed randomized controlled trial, "guidance on demand" (GoD) and unguided (UG) adherence-promoting versions of the seven-module IMI StudiCare Mindfulness were compared with a waitlist control group and each other. The GoD participants could ask for guidance as needed. A total of 387 students with moderate/low mindfulness were recruited. Follow-up assessments took place after 1 (t1), 2 (t2), and 6 (t3) months. Post-intervention (t2), both versions significantly improved the primary outcome of mindfulness (d = 0.91-1.06, 95% CI 0.66-1.32) and most other mental health outcomes (d = 0.25-0.69, 95% CI 0.00-0.94) compared with WL, with effects generally persisting after 6 months. Exploratory comparisons between UG and GoD were mostly non-significant. Adherence was low but significantly higher in GoD (39%) vs. UG (28%) at the 6-month follow-up. Across versions, 15% of participants experienced negative effects, which were mostly mild. Both versions effectively promoted mental health in college students. Overall, GoD was not associated with substantial gains in effectiveness or adherence compared with UG. Future studies should investigate persuasive design to improve adherence.
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Affiliation(s)
- Ann-Marie Küchler
- Department of Clinical Psychology and Psychotherapy, Ulm University, 89081 Ulm, Germany
| | - Dana Schultchen
- Department of Clinical and Health Psychology, Ulm University, 89081 Ulm, Germany
| | - Tim Dretzler
- Department of Clinical Psychology and Psychotherapy, Ulm University, 89081 Ulm, Germany
| | - Morten Moshagen
- Department of Quantitative Methods in Psychology, Ulm University, 89081 Ulm, Germany
| | - David D. Ebert
- Department for Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Ulm University, 89081 Ulm, Germany
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Kiekens G, Hasking P, Bruffaerts R, Alonso J, Auerbach RP, Bantjes J, Benjet C, Boyes M, Chiu WT, Claes L, Cuijpers P, Ebert DD, Mak A, Mortier P, O’Neill S, Sampson NA, Stein DJ, Vilagut G, Nock MK, Kessler RC. Non-suicidal self-injury among first-year college students and its association with mental disorders: results from the World Mental Health International College Student (WMH-ICS) initiative. Psychol Med 2023; 53:875-886. [PMID: 34140062 PMCID: PMC8683565 DOI: 10.1017/s0033291721002245] [Citation(s) in RCA: 43] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Although non-suicidal self-injury (NSSI) is an issue of major concern to colleges worldwide, we lack detailed information about the epidemiology of NSSI among college students. The objectives of this study were to present the first cross-national data on the prevalence of NSSI and NSSI disorder among first-year college students and its association with mental disorders. METHODS Data come from a survey of the entering class in 24 colleges across nine countries participating in the World Mental Health International College Student (WMH-ICS) initiative assessed in web-based self-report surveys (20 842 first-year students). Using retrospective age-of-onset reports, we investigated time-ordered associations between NSSI and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-IV) mood (major depressive and bipolar disorder), anxiety (generalized anxiety and panic disorder), and substance use disorders (alcohol and drug use disorder). RESULTS NSSI lifetime and 12-month prevalence were 17.7% and 8.4%. A positive screen of 12-month DSM-5 NSSI disorder was 2.3%. Of those with lifetime NSSI, 59.6% met the criteria for at least one mental disorder. Temporally primary lifetime mental disorders predicted subsequent onset of NSSI [median odds ratio (OR) 2.4], but these primary lifetime disorders did not consistently predict 12-month NSSI among respondents with lifetime NSSI. Conversely, even after controlling for pre-existing mental disorders, NSSI consistently predicted later onset of mental disorders (median OR 1.8) as well as 12-month persistence of mental disorders among students with a generalized anxiety disorder (OR 1.6) and bipolar disorder (OR 4.6). CONCLUSIONS NSSI is common among first-year college students and is a behavioral marker of various common mental disorders.
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Affiliation(s)
- Glenn Kiekens
- Center for Public Health Psychiatry, KU Leuven, Belgium
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Penelope Hasking
- School of Population Health, Curtin University, Perth, Australia
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, KU Leuven, Belgium
- Institute for Social Research, Population Studies Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Jordi Alonso
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública, Madrid, Spain
- Pompeu Fabra University, Barcelona, Spain
| | | | - Jason Bantjes
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences Stellenbosch University, South Africa
| | - Corina Benjet
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Mark Boyes
- School of Population Health, Curtin University, Perth, Australia
| | - Wai Tat Chiu
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - David D. Ebert
- Department for Sport and Health Sciences, Chair for Psychology & Digital Mental Health Care, Technical University Munich, Germany
| | - Arthur Mak
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Philippe Mortier
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Siobhan O’Neill
- School of Biomedical Sciences, Ulster University, Derry-Londonderry, Northern Ireland
| | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Dan J. Stein
- Department of Psychiatry and Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Gemma Vilagut
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Matthew K. Nock
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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Kohls E, Guenthner L, Baldofski S, Brock T, Schuhr J, Rummel-Kluge C. Two years COVID-19 pandemic: Development of university students' mental health 2020-2022. Front Psychiatry 2023; 14:1122256. [PMID: 37091715 PMCID: PMC10117945 DOI: 10.3389/fpsyt.2023.1122256] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/21/2023] [Indexed: 04/25/2023] Open
Abstract
Background The literature indicates a negative impact on the mental health of university students during the COVID-19 pandemic. It remains unclear if this negative impact persists even after lockdown measures are lifted. The current study therefore investigates the mental health status of students by drawing on two previous studies the present study seeks to investigate differences in the mental health status across three time points. Methods A cross-sectional, anonymous online survey among students of six universities was conducted between April and May 2022 (N = 5,510). Symptoms of depression, anxiety, hazardous alcohol use and eating disorders as well as social and emotional variables were assessed utilizing standardized instruments. Risk- and protective factors for severity of depressive and anxiety symptoms were investigated using multiple regression models. Differences in e.g., symptoms of depression across three time points were assessed with one-way analysis of variance. Results More than one third of students exhibited clinically relevant symptoms of depression (35.5%), hazardous alcohol use (33.0-35.5% depending on gender) or anxiety disorder (31.1%). Taken together, almost two out of three (61.4%) students reported clinically relevant symptoms in at least one of the aforementioned symptom patterns, while almost one fifth of students reported suicidal ideation or thoughts of self-harm (19.6%). Higher perceived stress and loneliness significantly predicted higher levels of depressive symptoms, while resilience and social support were identified as protective factors. Compared to 2020 and 2021, levels of depressive symptoms were significantly reduced in 2022, levels of hazardous alcohol consumption showed a small but significant increase from 2021 to 2022. Worryingly, prevalence of suicidal ideation was the highest yet, being significantly higher than in 2020 (14.5%) and 2021 (16.5%). Conclusion These results confirm previous results that the pandemic had and still has a negative impact on the mental health of university students. The present study broadens this view by the fact that some areas seem to recover quicker, while others seem to increase worryingly. Especially the persistent rise in suicidal ideation from 2020 to 2021 and to 2022, a constant reduction in reported social support and associated perceived loneliness is concerning. The claim for low-threshold and accessible mental health support for university students remains the same as in the beginning of the pandemic.
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Affiliation(s)
- Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University Leipzig Medical Center, Leipzig University, Leipzig, Germany
| | - Lukas Guenthner
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Sabrina Baldofski
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Tanja Brock
- Centre for Research, Further Education and Consulting, University of Applied Sciences for Social Work, Education and Nursing Dresden, Dresden, Germany
| | - Jan Schuhr
- Centre for Research, Further Education and Consulting, University of Applied Sciences for Social Work, Education and Nursing Dresden, Dresden, Germany
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University Leipzig Medical Center, Leipzig University, Leipzig, Germany
- *Correspondence: Christine Rummel-Kluge
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Hoeflich CC, Nutley S, Striley CW, Miller L, Riba MB, Morris MR. Current psychiatric treatment for college students with depression only, anxiety only, or comorbid depression & anxiety (2013-2019). J Affect Disord 2023; 320:348-352. [PMID: 36183823 PMCID: PMC9675714 DOI: 10.1016/j.jad.2022.09.133] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 09/20/2022] [Accepted: 09/27/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND This epidemiological study described changes in the estimated prevalence of current pharmacological and/or psychotherapy-based treatment utilization among college students with depression only, anxiety only, or comorbid depression & anxiety. METHODS A sample of 190,500 weighted responses was collected through the 2013-2019 Healthy Minds Study questionnaires. Annual prevalence estimates of depression only, anxiety only, or comorbid depression & anxiety were computed. Current use of therapy, pharmacological services, or dual treatment among students with depression and/or anxiety were examined via descriptive statistics. RESULTS Estimated prevalence of college students who screened positive for depression only, anxiety only, and comorbid depression & anxiety escalated from 2013 to 2018-2019. When assessed individually, rates of currently using any psychiatric medication, participating in therapy, and engaging in concurrent medication & therapy services significantly rose among students with depression and/or anxiety. However, temporal trends in the current use of specific classes of psychiatric medications among young adults with depression only, anxiety only, or comorbid depression & anxiety differed by medication class. LIMITATIONS This study was unable to assess psychiatric prescribing practices, depression or anxiety diagnoses, and prior mental health treatment. CONCLUSIONS An increasing proportion of college students are reporting depression and/or anxiety symptoms as well as pharmacological and/or psychotherapy service utilization when comparing rates from 2013 to 2018-19. Although this may indicate increasing acceptability to disclose and seek treatment for problematic symptomology, continued surveillance of college populations is needed to identify students at risk for adverse psychiatric health outcomes, especially during the coronavirus disease 2019 pandemic.
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Affiliation(s)
- Carolin C Hoeflich
- Department of Epidemiology, College of Public Health & Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA.
| | - Sara Nutley
- Department of Epidemiology, College of Public Health & Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Catherine W Striley
- Department of Epidemiology, College of Public Health & Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Leslie Miller
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Michelle B Riba
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Marcia R Morris
- Department of Psychiatry, College of Medicine, University of Florida, Gainesville, FL, USA
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Van Der Poll R, Coetzee B, Bantjes J. Willing and unwilling digital cyborg assemblages: University students talk about mental health apps. Digit Health 2023; 9:20552076231210658. [PMID: 37915793 PMCID: PMC10617263 DOI: 10.1177/20552076231210658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/12/2023] [Indexed: 11/03/2023] Open
Abstract
Objective Explore how students talk about mental health mobile applications (i.e., apps). Methods Data collected in focus group interviews with 51 students (all self-identifying as having mental health problems) and analysed using inductive thematic content analysis. Results Participants describe mental health apps as an anti-dote to the loss of control, vulnerability, helplessness, impotence, isolation, conspicuousness, and shame which characterise their experience of mental illness. They describe the on-campus clinic as inaccessible and associated with "serious" problems, while configuring psychologists and psychotherapy as out of reach, scarce, formal, structured and anxiety provoking. In contrast, they imagine mental health apps as informal, relaxed, inviting, and accessible. Participants expressed openness and optimism about using apps to improve their mental health. They idealise technology as a means to connect effortlessly, anonymously, and informally, as well as learn skills, assert agency, and act responsibly. They also articulate reluctance to trust technology, show cognisance of participating in a capitalist economy, demonstrate scepticism about the legitimacy of mental health apps, and call for regulation, thereby resisting the position of responsible neoliberal subjects. Conclusion Participants express ambivalence towards mental health apps without surrendering to either technophobia or technophilia. They express faith in technologies' potential to support mental health while questioning the implicit assumption that people are competent to manage their own mental health. In talking about mental health apps students reproduce broader cultural discourses (including techno-optimism, techno-solutionism, somatopiamism, neo-liberalism, responsibilisationism, technoscepticism, and discourses about neuroplasticity and self-help) thus presenting themselves as both willing and unwilling digital cyborgs.
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Affiliation(s)
- Ryan Van Der Poll
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Bronwyne Coetzee
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Jason Bantjes
- Mental Health, Alcohol, Substance use and Tobacco (MAST) Research Unit, South African Medical Research Council, Cae Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Rondebosch, South Africa
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Hu H, Yang X, Mo PKH, Zhao C, Kuang B, Zhang G, Lin G. How mobile phone addiction is associated with suicidal ideation in university students in China: Roles of depression and online social support. Front Psychol 2022; 13:1001280. [PMID: 36619077 PMCID: PMC9816797 DOI: 10.3389/fpsyg.2022.1001280] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Background Recent studies have highlighted mobile phone addiction (MPA) as a potential risk of suicidal ideation. However, the mechanisms underlying that association require attention. Objective This investigation aims to examine whether the relationship between MPA and suicidal ideation would be mediated by depression, and buffered by online social support (OSS) in university students. Methods A convenient sample of 1,042 Chinese university students completed the measures of mobile phone addiction, depression, suicidal ideation, OSS in classroom settings. Moderated mediation analyses were performed to test the roles of depression and OSS in the association between MPA and suicidal ideation. Results MPA was positively associated with suicidal ideation through depression (indirect effect =. 23, 95% CI: 0.18, 0.28, p < 0.001); OSS moderated the association between depression and suicidal ideation (B = - 0.09, 95% CI: -0.13, -0.04, p < 0.001). Specifically, the effect of depression on suicidal ideation was weaker in individuals with high (versus low) OSS. OSS moderated the association between MPA and suicidal ideation (B = 0.06, 95% CI: 0.02, 0.10, p = 0.001). The influence of MPA on suicidal ideation was non-significant among individuals with high OSS but negatively significant among students with low OSS. Conclusion The results enrich the understanding of how MPA may increase suicidal ideation, and highlight the potential importance of reducing depression and enhancing OSS to prevent suicidal ideation in university students.
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Affiliation(s)
- Huahua Hu
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, China
| | - Xue Yang
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, China,The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China
| | - Phoenix K. H. Mo
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, China,The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China
| | - Chengjia Zhao
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Beibei Kuang
- College of International Relation, National University of Defense Technology, Nanjing, China
| | - Guohua Zhang
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou, China,The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China,*Correspondence: Guohua Zhang,
| | - Guangyao Lin
- The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China,Guangyao Lin,
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Validity of Adult Psychopathology Model Using Psychiatric Patient Sample from a Developing Country: Confirmatory Factor Analysis. Ment Illn 2022. [DOI: 10.1155/2022/9594914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objectives. This study is aimed at testing and validating the two-factor measurement model of the Millon Clinical Multiaxial Inventory (MCMI). Specifically, this paper reported construct validity, particularly focusing on convergent and discriminant validities of the internalizing-externalizing MCMI model of adult psychopathology using a psychiatric sample from a developing country, the Republic of Yemen. Methods. MCMI was distributed among 232 outpatients from the Hospital of Taiz City and two private psychiatry clinics in Yemen; data were collected using structured interviews over four months. We used exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to explore and confirm the latent structure MCMI and verify the evidence of convergent and discriminant validity. Results. The CFA results indicated that MCMI was a good fit for the internalizing-externalizing two-factor model of adult psychopathology, comparative fit index
, and
. The results of the CFA provide evidence of convergent and discriminant validity characterized by MCMI with the internalizing-externalizing model. Conclusion. The adult psychopathology of internalizing-externalizing is a valid measurement model of MCMI with ten personality disorders and eight clinical syndromes.
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University students' use of mental health services: a systematic review and meta-analysis. Int J Ment Health Syst 2022; 16:57. [PMID: 36527036 PMCID: PMC9758037 DOI: 10.1186/s13033-022-00569-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND International estimates suggest around a third of students arrives at university with symptoms indicative of a common mental disorder, many in late adolescence at a developmentally high-risk period for the emergence of mental disorder. Universities, as settings, represent an opportunity to contribute to the improvement of population mental health. We sought to understand what is known about the management of student mental health, and asked: (1) What proportion of students use mental health services when experiencing psychological distress? (2) Does use by students differ across health service types? METHODS A systematic review was conducted following PRISMA guidelines using a Context, Condition, Population framework (CoCoPop) with a protocol preregistered on Prospero (CRD42021238273). Electronic database searches in Medline, Embase, PsycINFO, ERIC and CINAHL Plus, key authors were contacted, citation searches were conducted, and the reference list of the WHO World Mental Health International College Student Initiative (WMH-ICS) was searched. Data extraction was performed using a pre-defined framework, and quality appraisal using the Joanna Briggs Institute tool. Data were synthesised narratively and meta-analyses at both the study and estimate level. RESULTS 7789 records were identified through the search strategies, with a total of 44 studies meeting inclusion criteria. The majority of included studies from the USA (n = 36), with remaining studies from Bangladesh, Brazil, Canada, China, Ethiopia and Italy. Overall, studies contained 123 estimates of mental health service use associated with a heterogeneous range of services, taking highly variable numbers of students across a variety of settings. DISCUSSION This is the first systematic quantitative survey of student mental health service use. The empirical literature to date is very limited in terms of a small number of international studies outside of the USA; studies of how services link together, and of student access. The significant variation we found in the proportions of students using services within and between studies across different settings and populations suggests the current services described in the literature are not meeting the needs of all students.
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Vasiliadis HM, Léon C, du Roscoät E, Husky MM. Predisposing, enabling and need factors associated with past-year health service use for mental health reasons in adults with suicidal ideation in France. J Affect Disord 2022; 319:62-69. [PMID: 36126787 DOI: 10.1016/j.jad.2022.09.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 09/12/2022] [Accepted: 09/15/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND We aimed to determine the prevalence of past-year health service use for mental health reasons in a French representative sample of adults overall and in those reporting suicidal ideation in the past year and assess the factors associated with health service use according Andersen's model of healthcare seeking behaviors. METHODS Data were drawn from the 2017 Health Barometer survey a large computer-assisted telephone survey on a representative sample of the general population aged 18-75 years living in France (n = 25,319). Logistic regression analyses were used to study past-year health service use for mental health reasons as a function of predisposing, enabling and need factors. Analyses were stratified according to suicidal ideation and sex. RESULTS Among individuals with suicidal ideation, 45.1 % of adults, 50.4 % of females and 37.6 % of males, reported past-year health service use for a mental health reason. Increased odds of health service use were observed regarding predisposing (female sex, younger age, higher education), enabling (income level), and need factors (prior suicide attempts, role impairment and major depression). Among males, the only significant factors included age 65-75 (aOR = 0.16, 95%CI = 0.03-0.84) and major depression (aOR = 2.79, 95%CI = 1.79-4.36). LIMITATIONS Self-reported service utilization. Cross-sectional survey. CONCLUSIONS In a country with a high level of medical coverage, further research is needed to identify sex-specific socio-demographic, economic and clinical differences in the use of different types of health services as well as perceived need for care, structural and attitudinal barriers to treatment.
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Affiliation(s)
- Helen-Maria Vasiliadis
- Département des sciences de la santé communautaire, Université de Sherbrooke, Canada; Centre de recherche Charles-Le Moyne, Campus de Longueuil Université de Sherbrooke, Canada
| | | | - Enguerrand du Roscoät
- Santé publique France, Saint-Maurice, France; Laboratoire Parisien de Psychologie Sociale (LAPPS), EA 4386, Université Paris Nanterre, France
| | - Mathilde M Husky
- Laboratoire de psychologie EA4139, Université de Bordeaux, Bordeaux, France.
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Osborn T, Town R, Ellis R, Buckman J, Saunders R, Fonagy P. Implementing peer support in higher education: A feasibility study. SSM - MENTAL HEALTH 2022; 2:100175. [PMID: 37916032 PMCID: PMC10616816 DOI: 10.1016/j.ssmmh.2022.100175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/23/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022] Open
Abstract
Background When experiencing mental distress, many university students seek support from their peers. In schools and mental health services, formalised peer support interventions have demonstrated some success but implementation challenges have been reported. This study aimed to assess the feasibility, acceptability and safety of a novel manualized peer support intervention and associated data collection processes. Methods A longitudinal mixed methods study was conducted following the pilot of a peer support intervention at a large London university between June 2021 and May 2022. The study utilised data routinely recorded on all students who booked a peer support session, focus groups with nine peer workers and five staff members implementing the intervention, pre-post intervention surveys with 13 students and qualitative interviews with 10 of those students. Results 169 bookings were made during the pilot, of which 130 (77%) were attended, with November the peak month. Staff and peer workers described strong motivation and commitment to implement the intervention, noting that the peer support model and peer worker role addressed previously unmet needs at the university. However, students described implementation problems relating to the coherence of the intervention and the burden of participation. While students mostly described acceptable experiences, there were examples where acceptability was lower. No adverse events were reported during the pilot. Conclusion The training and supervision of peer workers, and the provision of one-to-one peer support to students was found to be feasible, mostly acceptable, and safe. However, sustained implementation difficulties were observed. These pose challenges to the scalability of peer support in universities. We make recommendations to improve implementation of peer support including improving reach, greater clarity about the intervention, and fuller involvement of students throughout.
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Affiliation(s)
- T.G. Osborn
- Division of Psychology and Language Sciences, Faculty of Brain Sciences, UCL, 26 Bedford Way, London, WC1H 0AP, UK
| | - R. Town
- Division of Psychology and Language Sciences, Faculty of Brain Sciences, UCL, 26 Bedford Way, London, WC1H 0AP, UK
- Evidence Based Practice Unit, 4-8 Rodney Street, University College London, London, N1 9JH, UK
| | - R. Ellis
- Division of Psychology and Language Sciences, Faculty of Brain Sciences, UCL, 26 Bedford Way, London, WC1H 0AP, UK
- PsychUP for Wellbeing, Division of Psychology and Language Sciences, Faculty of Brain Sciences, UCL, 26 Bedford Way, London, WC1H 0AP, UK
| | - J.E.J. Buckman
- Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical Educational & Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- iCope – Camden & Islington NHS Foundation Trust, St Pancras Hospital, London, NW1 0PE, UK
- UCL University Clinic, Research Department of Clinical Educational & Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - R. Saunders
- Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical Educational & Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - P. Fonagy
- Division of Psychology and Language Sciences, Faculty of Brain Sciences, UCL, 26 Bedford Way, London, WC1H 0AP, UK
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Bantjes J, Hunt X, Stein DJ. Public Health Approaches to Promoting University Students' Mental Health: A Global Perspective. Curr Psychiatry Rep 2022; 24:809-818. [PMID: 36399235 DOI: 10.1007/s11920-022-01387-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/24/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE OF REVIEW Provide a critical overview of recent global advances in student mental health from a public health perspective, highlighting key challenges and gaps in the literature. RECENT FINDINGS Mental disorders and suicidality are common among university students globally. However, there is a significant treatment gap even though evidence-based treatments are available. To overcome barriers to treatment, public health interventions should be conceptualized within a developmental paradigm that takes cognizance of the developmental tasks of young adulthood. Traditional one-on-one treatment approaches will not be a cost-effective or sustainable way to close the treatment gap among students. A range of evidence-based interventions is available to promote students' mental health; however, novel approaches are needed to scale up services and adapt intervention delivery to suit student specific contexts. Digital interventions and peer-to-peer interventions could be a cost-effective way to scale-up and expand the range of services.
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Affiliation(s)
- Jason Bantjes
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa.,Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | - Xanthe Hunt
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | - Dan J Stein
- SAMRC Unit on Risk and Resilience in Mental Disorders, Stellenbosch University, Stellenbosch, South Africa. .,Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
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