Symptoms and health complaints and their association with perceived stress: students from seven universities in England, Wales and Northern Ireland

Medically unexplained symptoms and experiences with healthcare among emerging adults exposed to multiple types of potentially traumatic events

Experiencing multiple types of traumatic events can increase the risk of developing somatic and posttraumatic stress symptoms (PTSS). Medically unexplained symptoms (MUS), or somatic symptoms that lack a distinct medical explanation, often coexist with PTSS in emerging adults and may be due to common underlying mechanisms. Coping strategies have been associated with PTSS, but have not been studied in trauma-exposed individuals with MUS. The current study examined the relationship between the number of types of potentially traumatic events experienced and MUS among emerging adults, considering the influence of PTSS and engagement and disengagement coping. A sample of 363 emerging adults (Mean = 18.91) completed self-report measures of trauma history, PTSS, MUS, experiences with healthcare providers, and coping strategies. Dissatisfaction with healthcare providers was reported by 11.3% of participants reporting MUS, with over half (52.8%) feeling their concerns were dismissed. Hierarchical linear regression showed that the number of types of traumatic events experienced did not predict MUS after accounting for PTSS. Moderation hypotheses linking traumatic events and coping strategies were not supported. Results suggest that PTSS explains the relationship between exposure to different traumatic events and MUS. Findings may have diagnostic and treatment implications for healthcare providers working with emerging adults who have experienced trauma.

Factors that influence mental health of university and college students in the UK: a systematic review

Background

Worsening mental health of students in higher education is a public policy concern and the impact of measures to reduce transmission of COVID-19 has heightened awareness of this issue. Preventing poor mental health and supporting positive mental wellbeing needs to be based on an evidence informed understanding what factors influence the mental health of students.

Objectives

To identify factors associated with mental health of students in higher education.

Methods

We undertook a systematic review of observational studies that measured factors associated with student mental wellbeing and poor mental health. Extensive searches were undertaken across five databases. We included studies undertaken in the UK and published within the last decade (2010–2020). Due to heterogeneity of factors, and diversity of outcomes used to measure wellbeing and poor mental health the findings were analysed and described narratively.

Findings

We included 31 studies, most of which were cross sectional in design. Those factors most strongly and consistently associated with increased risk of developing poor mental health included students with experiences of trauma in childhood, those that identify as LGBTQ and students with autism. Factors that promote wellbeing include developing strong and supportive social networks. Students who are prepared and able to adjust to the changes that moving into higher education presents also experience better mental health. Some behaviours that are associated with poor mental health include lack of engagement both with learning and leisure activities and poor mental health literacy.

Conclusion

Improved knowledge of factors associated with poor mental health and also those that increase mental wellbeing can provide a foundation for designing strategies and specific interventions that can prevent poor mental health and ensuring targeted support is available for students at increased risk.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13943-x.

Is Achieving the Guidelines of Four Forms of Physical Activity Associated with Less Self-Reported Health Complaints? Cross-Sectional Study of Undergraduates at the University of Turku, Finland

Very little research has assessed the physical activity (PA) of university students in in Finland, and their associations with self-reported health complaints (HCs), whilst simultaneously accounting for a range of other potential confounders. Students at the University of Turku (1177) completed an online health and wellbeing questionnaire that assessed 22 physical and somatic HCs, and students' achievement of the international guidelines of four forms of PA (moderate, vigorous, moderate-to-vigorous and muscle strengthening PA; MPA, VPA, MVPA, MSPA respectively). We also explored the associations between HCs and PA, controlling for sociodemographic and health confounders (age, sex, year of study, marital status, accommodation during semesters, health awareness). Factor analysis reduced the HCs into three factors (psychological, pains/aches, circulatory/breathing). Bivariate relationships (no controlling for confounders) between these 3 factors and four forms of PA guideline achievement showed significant effects of achieving the PA guidelines against various groups of HCs, where more strenuous PA was associated with significantly less HCs in a step-ladder pattern. Multiple regression analyses (controlling for confounders) showed that achievement of PA guidelines was significantly independently associated with self-reported HCs scores in most cases. Psychological HCs were negatively associated with achieving any type of PA; pains/aches were negatively associated with achieving two types of PA or with achieving MSPA guidelines; and circulatory/breathing HCs were negatively associated with achieving the VPA guidelines only. This is the first study in Finland to examine such relationships, and highlights the critical role of PA for the health of these young adults. Programs and policies to strengthen and improve the PA of university students would be beneficial, recognizing the benefits of instilling life-long PA habits among this group of young adults.

The strength of pursuing your values: Valued living as a path to resilience among college students

Although stressful life events (SLEs) frequently relate to negative outcomes, many individuals demonstrate resilience by positively adapting to stressors without significant impairment. Valued living, a key process in the theory underpinning acceptance and commitment therapy is a response style characterized by daily purposeful actions that are linked to important values and may promote resilience in college students. This study examined the main and interactive effects of SLEs and valued living in the prediction of a multidimensional measure of resilience. Results supported a strong positive relationship between resilience and valued living. Further, valued living moderated the association between SLE negative impact scores and resilience (but not the association between cumulative prior year SLEs and resilience). Although SLE negative impact scores were negatively associated with resilience at lower levels of valued living, there was no demonstrated relationship at higher levels of valued living. Implications related to promoting valued living among college students in the service of increasing resilience are discussed.

Role of perceived social support in depressive and somatic symptoms experienced by Bedouin Arab and Jewish Israeli undergraduates

Elevated levels of depressive and somatic symptoms have been documented among college students. Over the past two decades, there has been an increase in the number of Bedouin Arab students studying at institutions of higher education in southern Israel. To date, research on coping and mental health problems among students who are members of this ethnic minority has been limited. This study examined the role of three aspects of perceived social support - availability, satisfaction, and the ability to get emotional support - in predicting depressive and somatic symptoms among Jewish Israeli and Bedouin Arab college students. A total of 89 Bedouin and 101 Jewish first-year students participated in this study, which involved two assessment waves 12 to 14 months apart. Participants completed questionnaires assessing depressive symptoms, somatic complaints, three aspects of perceived social support, and demographics. At Time 1, Bedouin students exhibited higher levels of depressive and somatic symptoms and lower levels of all three aspects of social support. Regression analyses showed that level of emotional support was a prospective predictor of somatization at Time 2. Moreover, when levels of emotional support were low, ethnic group predicted depression at Time 2; emotional support predicted depression only among Bedouin Arabs. The present study highlights the importance of the use of emotional support in predicting somatic complaints and depressive symptoms specifically among Bedouin Arab students. Clinical implications on intervention programs for ethnic minority students will be discussed.

Comparison of Subjective Health Complaints between Chinese and German University Students: A Cross-Sectional Study

High rates of health complaints (HCs) with substantial variation are reported in different university populations, which can be linked to socio-demographic, lifestyle-related factors, and cultural differences. HCs can be categorized into distinct components. This study aimed to identify and compare underlying dimensions of HCs (HC components); to access and compare HC prevalence, and the associations between HC components, socio-demographic, lifestyle-related factors, and perceived stress in German and Chinese university students. Two health surveys were conducted among 5159 university students (1853 Chinese, 3306 German). Factor analysis and logistic regression were applied. The prevalence of HC ranged from 4.6% to 40.2% over the two countries. Germans reported at least three HCs more often (47.2% vs. 35.8%). Chinese students more often reported gastrointestinal complaints. Perceived stress was positively associated with all three HC components in both countries (OR = 1.03–1.50) with stronger associations among Germans. Women more often reported HCs (OR = 1.32–2.43) with stronger associations among the Germans. Having a father with a low educational level was associated with high psychological symptoms among the Chinese (OR = 1.51), but with low gastrointestinal complaints among the Germans (OR = 0.79). The high prevalence of HCs in students requires country-specific interventions.

Role of virtues and perceived life stress in affecting psychological symptoms among Chinese college students

OBJECTIVE

This study explored the relationship among virtues, self-perceived life stress, and psychological symptoms.

PARTICIPANTS

A total of 235 undergraduates participated in the study in March 2013.

METHODS

The participants were recruited to complete the Life Stress Rating Scale for College Students, the Chinese Virtues Questionnaire that measures 3 virtues (relationship, vitality, and conscientiousness), and the Symptom Checklist-90.

RESULTS

Regression analyses indicated that the perceived stress from minor events explained approximately 35.00% of the variance of psychological symptoms. Both vitality and conscientiousness contributed to another 6.00% of psychological symptoms. Perceived stress from minor events mediated the relationship between vitality and psychological symptoms, whereas conscientiousness directly affected psychological symptoms regardless of the perceived stress level.

CONCLUSION

This study clarified the positive role of virtues in stressful situations among Chinese undergraduates. The results benefit the college health professionals in attending strengths of their clients in practice both in Eastern and Western countries.

Symptoms and health complaints and their association with perceived stressors among students at nine Libyan universities

University students are exposed to many stressors. We assessed the associations between two stressors (educational related and general overall), socio-demographic characteristics (five variables), health behaviours/lifestyle factors (six variables), as well as religiosity and quality of life as independent variables, with self-reported symptoms/health complaints as dependent variables (eight health complaints). A sample of 2100 undergraduate students from nine institutions (six universities, three colleges) located in seven cities in Libya completed a general health questionnaire. The most prevalent symptoms were headaches, depressive mood, difficulties to concentrate and sleep disorder/insomnia that have been reported by 50%-60% of the students. The majority of students (62%) reported having had three or more symptoms sometimes or very often in the last 12 months. There was a positive association between perceived stressors and health symptoms, which remained significant after adjustment for gender and many other relevant factors for headache (OR 1.52; 95% CI 1.15-2.02), depressive mood (OR 2.20; 95% CI 1.64-2.94) and sleep disorder/ insomnia (OR 1.55, 95% CI 1.19-2.03). Other factors independently associated with most health symptoms were female gender and poor self-perceived health. Stress management programmes and a reduction of educational related stressors might help to prevent stress-related symptoms and health complaints in this student population.

Physical activity and gender differences: correlates of compliance with recommended levels of five forms of physical activity among students at nine universities in Libya

AIMS

This cross-sectional survey assessed and compared by gender the levels and correlates of achieving the international guidelines recommendations on five forms of physical activity (PA) (walking, moderate PA, vigorous PA, moderate or vigorous PA- MVPA, and muscle-strengthening PA). We examined the associations between achieving the international guidelines recommendations on five forms of PA and a variety of sociodemographic, health and academic performance variables.

METHODS

Data was collected across nine Libyan universities (2008-2009, representative sample of 1,300 undergraduates). A self-administered questionnaire assessed frequency and duration of PA/week for each form of PA. Cut-offs for recommended guidelines were set according to the American Heart Association.

RESULTS

About 43.7% of students achieved the guidelines for muscle strengthening PA, 20.7% for walking, 11.2% for vigorous PA, 28.5% for MVPA, and 4.8% for moderate PA (excluding walking). Binary logistic regression showed that except for walking, males were consistently associated with achieving the guidelines recommendations for all other forms of PA. Students with higher health awareness were more likely to achieve the guidelines for vigorous PA and muscle strengthening PA. Better academic performance was associated with higher levels of muscle strengthening PA. Students at institutions in the East of Libya were less likely to achieve the guidelines for walking, vigorous PA or muscle strengthening PA as compared to students from the North. Students from the West of Libya were also less likely to walk or to engage in moderate PA than their peers from the North.

CONCLUSIONS

Overall, relatively low proportions of students achieved the recommended guidelines of PA. Female students were particularly at risk for low level of PA. Attention is required to national policies that promote active living, along with addressing the cultural, geographic and other barriers to engagement of young adult males and females in PA.

Are students' symptoms and health complaints associated with perceived stress at university? Perspectives from the United Kingdom and Egypt

This cross-sectional survey assessed and compared by country, the levels and correlates of 21 self-reported symptoms/health complaints. We examined the associations between self-reported symptoms and perceived stress. Data was collected from universities in the United Kingdom and Egypt (N = 3706 and 3271 undergraduates, respectively). A self-administered questionnaire assessed a range of self-reported symptoms, perceived stress, sociodemographic (gender, age, marital status, year of study, living arrangements during semester, income sufficiency), lifestyle (tobacco smoking, illicit drug/s use, alcohol consumption frequency), and health variables (subjective health status, health awareness, BMI), along with religiosity, and quality of life. Factor analysis categorized the 21 self-reported symptoms into four components. Correlation analysis and linear regression tested the associations between the self-reported symptoms and stress. Factor analysis of the health symptoms generated four symptom groups for each of the UK and Egypt (psychological; circulatory/breathing; gastrointestinal; and, pains/aches), and factor loadings were quite similar for both countries. Whilst the two samples showed similarities as to the kind of symptoms most frequently reported by students, the Egyptian sample had significantly higher frequency than the UK for every symptom. Frequent complaints (both countries) included difficulties to concentrate, fatigue, headaches, nervousness/anxiety, and back pain (UK) and mood swings (Egypt). Significantly more Egyptian students reported ≥4 symptoms over the past year than the UK. For each of the UK and Egypt, across each of the four symptom groups, there was a stepladder appearance whereby the frequency of symptoms increased with increasing quartiles of perceived stress. Not controlling for other variables, for both countries, there were significant positive correlations between each of the four symptom groups and stress; the highest correlation was for psychological symptoms. After controlling for sex, age country, and other symptom groups, stress was highly and significantly associated with psychological symptoms and also with pain & aches symptoms in both countries. UK students were generally less stressed than their counterparts in Egypt. Age and female gender were also associated with stress; the younger the student was the more likely to suffer from stress. Interactions were not significant. Across both countries, the levels of stress among students and the associations between perceived stress and health complaints suggest the need for a multiple approaches in order to understand the sources of stress; how college students experience stress; and, the coping mechanisms that different students employ to mitigate stress. Interventions aimed at both preventing, treating and caring for students’ distress, and also preventive strategies to help minimize the impact of stressful situations are required. Strategies that address both physical and psychological complaints may be beneficial for this population.