Do Addictive Behaviors Matter for College Students’ Depression and Suicidal Ideation?

New form of addiction: An emerging hazardous addiction problem of milk tea among youths

BACKGROUND

Milk tea has experienced tremendous growth in popularity in China, especially among youths. The primary objective of this study is to investigate whether milk tea addiction may have a detrimental impact on youths' mental health, such as anxiety, depression, and suicidal ideation. Additionally, we aim to explore its potential role in influencing various mental health outcomes.

METHODS

A large-scale, cross-sectional study was conducted from 5281 college students in Beijing, China. Participants self-reported depressive, anxiety symptoms, suicidal ideation, and milk tea addiction symptoms including milk tea consumption, dependence, guilty feelings, withdrawal, tolerance, unable to stop, craving, and intention to stop.

RESULTS

Nearly 77 % of participants consumed milk tea at least 6-11 cups in the last year. The confirmatory factor analysis (CFA) supported the one-factor structure of the milk tea addiction scale, developed according to DSM-5 substance use guidelines. Moreover, we found that a higher level of milk tea addiction was significantly associated with a higher risk of depression (b = 0.24, p < 0.001), anxiety (b = 0.21, p < 0.001), and suicidal ideation (b = 0.06, p < 0.001), respectively, after controlling confounding variables, among youths consuming milk tea. The possible mediating role of milk tea addiction between loneliness feelings and mental health outcomes was further addressed.

CONCLUSIONS AND IMPLICATIONS

Our findings highlighted that milk tea consumption might lead to addiction, and it is associated with depression, anxiety, and suicidal ideation. Current findings can assist policymakers in developing regulations such as restricting advertising, providing psycho-education, establishing food hygiene standards for such a prosperous youth-dominant consumption industry while protecting their mental health.

Impact of resilience on college student mental health during COVID-19

OBJECTIVE

The aim of this study was to investigate how the COVID-19 pandemic impacted college student mental health and alcohol use and to determine how resilience could alleviate negative outcomes.

PARTICIPANTS

Students attending an Appalachian university during spring 2020 were surveyed shortly after on-campus activities stopped.

METHODS

Survey items included resilience, demographics, self-rated health, and depression symptoms, anxiety symptoms, and alcohol use before and since COVID-19.

RESULTS

There was a significant increase in prevalence of severe depression, severe anxiety, and high stress, and a significant decrease in prevalence high risk for problem drinking before and since COVID-19. Four separate standard least squares regression models were conducted with each of the dependent variables. Self-rated health was the strongest predictor for changes in depression, anxiety, and stress in each of the models, displaying a negative relationship.

CONCLUSIONS

Universities should prepare students using resilience training and provide employment and other resources to mitigate effects of stressful situations.

Early life influences on the development of food addiction in college attending young adults

PURPOSE

There is little investigation into the causes of food addiction. The aim of this study was to determine the impact of early life influences on the development of food addiction in college-attending young adults aged 18-29.

METHODS

This study utilized a sequential explanatory mixed-methods research design. College-attending young adults were invited to complete an online survey measuring Adverse Childhood Experiences (ACEs), food addiction, depression, anxiety, stress, and demographic information. Correlations between food addiction and the other variables were analyzed and significant variables were placed into a nominal logistic regression model to predict the development of food addiction. Participants who met the criteria for food addiction were invited to participate in interviews to examine their childhood eating environment and when their symptoms emerged. Interviews were transcribed and thematically analyzed. Quantitative analysis was conducted using JMP Pro Version 16.0 and qualitative analysis was conducted using NVIVO Software Version 12.0.

RESULTS

Survey respondents (n = 1645) had an overall 21.9% prevalence of food addiction. Significant correlations were observed between food addiction and ACEs, depression, anxiety, stress, and sex (p < .01 for all). Depression was the only significant predictor of the development of food addiction (OR = 3.33 95% CI 2.19, 5.05). The most common eating environment described by interview participants (n = 36) was an emphasis on diet culture, ideal body image, and restrictive environments. Symptoms frequently emerged after transitioning into college and having the ability to make their own food choices.

CONCLUSION

These results show the impact of early life eating environments and young adulthood mental health on the development of food addiction. These findings contribute to the understanding of underlying causes of food addiction.

LEVEL OF EVIDENCE

Level V, Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Exploring the association of addiction-related genetic factors with non-suicidal self-injury in adolescents

Background

Non-suicidal self-injury (NSSI) is self-injurious behavior without suicidal intent commonly seen in the adolescent population and poses a serious threat to the life safety of adolescents. Related researches suggest a possible correlation between addiction and the occurrence of NSSI. This study aimed to explore the correlation between addiction and NSSI from a molecular biological perspective by analyzing the differential expression of addiction-related genes in NSSI patients.

Methods

(1) The association between addiction and non-suicidal self-injury in a Chinese adolescent population was verified with the help of questionnaires on substance and non-substance addictions and non-suicidal self-injury among 1,329 adolescents in China, (2) Screening for key genes associated with addiction by bioinformatics analysis, and (3) RT-qPCR experiment was performed to validate key genes and Receiver Operating Characteristic curves were plotted for target genes.

Results

(1) Substance and non-substance addictions were all significantly correlated with non-suicidal self-injury, (2) Four target genes: SERPINA3, SLC14A1, RPS6 and RPS3A were screened by bioinformatics technique, and (3) Relative quantitative analysis by RT-qPCR revealed that the expression levels of SLC14A1 (p < 0.01), RPS6 (p < 0.05) and RPS3A (p < 0.01) were significantly higher in NSSI patients than in healthy controls.

Conclusion

(1) The significant association between addiction and NSSI exists in the Chinese adolescent population and (2) Addiction-related genes SLC14A1, RPS6, and RPS3A are differentially expressed in adolescents with NSSI. The genes have the potential to become biological markers for the diagnosis of NSSI.

Blind box over-engagement and suicide risk among adolescents and young adults: Results of a large-scale survey

BACKGROUND

Gambling appears to be an independent risk factor for suicide among the young population worldwide. Blind boxes are collectable toys packed randomly in the box, which share certain similarities with gambling and are popular among the young population. This is the first study that examined the association between blind box engagement and suicide risk in the young population, the leading consumption group of blind boxes.

METHODS

This study is part of a large-scale, cross-sectional study using convenience sampling conducted Oct 26 to Nov 18, 2021, which covered all the university and college students in the Jilin province, China. A total of 73,206 participants completed the survey with valid data for the current study (male: N = 28,762; female: N = 44,444; Mean age = 19·59). Participants' blind box engagement, suicide risk, depression, anxiety, alcohol use, smoking habit, and sociodemographic characteristics were assessed. First, we used univariate and multivariable binary logistic regression models to examine the relationship between blind box engagement and suicide risk in all participants. Second, we tested whether depression and anxiety would mediate the association between blind box engagement and suicide risk. Third, we analysed the association between "Frequency (i.e., frequency of blind box engagement)," "Bet (i.e., expenditure on the blind box that exceeds affordability)," "Tolerance (i.e., level of addiction)," "Borrowed (i.e., the amount of money borrowed for blind box engagement)," and suicide risk in the group with blind box engagement history.

FINDINGS

4,195 participants (5·73%) have engaged in blind boxes, with 3,255 females (77·59%) and 940 males (22·41%). In the univariate models, binary logistic regression showed that blind box engagement was associated with suicide risk in both male and female participants (male: OR = 2·21, 95% CI = 1·86-2·63; female: OR = 1·64, 95% CI = 1·50-1·78). In the multivariable models, after controlling age, subjective socioeconomic status, per capita disposable income, alcohol use, and smoking habit, blind box engagement still was associated with suicide risk across genders (male: OR = 2·25, 95% CI = 1·89-2·68; female: OR = 1·58, 95% CI = 1·45-1·73). Depression (male: indirect effect = 0·31, SE = 0·04, p < 0·001; female: indirect effect = 0·20, SE = 0·02, p < 0·001) and anxiety (male: indirect effect = 0·26, SE = 0·03, p < 0·001; female: indirect effect = 0·13, SE = 0·02, p < 0·001) mediate the association between blind box engagement and suicide risk. Within the blind box engagement group, forward binary logistic regression revealed that "Tolerance" was associated with participants' suicide risk in both males (p = 0·001) and females (p < 0·001); "Borrowed" (p = 0·019) alone was associated with the male participants' suicide risk.

INTERPRETATION

Our findings showed that blind box over-engagement is positively associated with suicide risk in both young males and females, and this association persisted after adjusting for influencing factors. In spite of the limitations in this study (e.g., cross-sectional, convenience sampling), current findings can assist policymakers in developing regulations for such a prosperous youth-dominant consumption industry while protecting youth's mental health worldwide.

FUNDING

None.

Impact of COVID-19 on college student diet quality and physical activity

Background: The COVID-19 pandemic can cause in increase in stress experienced by college students and consequently, potentially adversely affect their health behaviours. Aims: The aim of this study was to investigate how COVID-19 impacted college-attending young adults diet quality and physical activity. Methods: Students attending an Appalachian university in spring 2020 participated in this cross-sectional study. Participants were surveyed on their eating habits, diet quality, and physical activity before and since COVID-19. Frequencies of responses were analyzed and Bowker's test was used to determine differences in responses before and since COVID-19. Alpha was set at 0.05. Results: Almost one third (32.6%) of students reported eating somewhat more since COVID-19 and 67.9% of these students stated it was due to boredom. Students showed a significant increase in frequency of eating and in consumption of almost every food group. The number of students engaging in low physical activity increased from 27.8% to 51.9% and the number of students engaging in high physical activity decreased from 59.5% to 34.0% (p < .0001) and many switched to the use of at-home workouts. Conclusion: Results indicate the effects of campus closure on college student's lifestyles and the risk of developing health problems due to the COVID-19 pandemic, potentially inhibiting their academic progress and well-being.

Predictors of suicide attempts in male UK gamblers seeking residential treatment

BACKGROUND

Disordered gambling can have serious negative consequences for the individual and those around them. Previous research has indicated that disordered gamblers are at an increased risk of suicidal thoughts, ideation and attempts. The current study sought to utilise data from a clinical sample to identify factors that are associated with prior suicide attempts.

METHODS

The sample included 621 patients entering a gambling-specific residential facility in the UK. A series of Chi-Square analyses and binary logistic regressions were run to identify clinical and sociodemographic variables associated with suicide attempts.

RESULTS

Of the 20 variables analysed using Chi-square statistics, five were significantly associated with the outcome variable (lifetime attempted suicide): loss of family relationships, loss of home, prior depression, prior suicidal thoughts, and medication use. Regression analysis showed that individuals were more likely to have reported suicide attempts if they had experienced loss of family relationships (1.65 times), loss of a home (1.87 times), prior depression (3.2 times), prior suicidal thoughts (6.14 times), or were taking medication (1.95 times) compared to those not reporting such individual events.

CONCLUSIONS

Disordered gamblers are vulnerable to suicide; a number of factors have been identified in the current study that predict an increased likelihood of attempted suicide. The factors mainly revolve around loss: not financial loss, but rather disintegration of an individual's support network and deterioration in the individual's mental health. Findings indicate that isolation and negative affect associated with gambling are most influential in attempted suicide and should therefore be more strongly considered when creating and providing the legislative, educational and treatment environments for those experiencing gambling related harm.

Suicidality and gambling among young adults in Great Britain: results from a cross-sectional online survey

BACKGROUND

Suicide rates in young people have increased in England and Wales since 2010. There are a range of possible explanations for this increase, and problem gambling has been suggested as a potential risk factor. We aimed to examine the association between suicidality (suicidal thoughts and suicide attempts) and problem gambling specifically for young adults in Great Britain, where gambling has become more widely available and normalised in the past two decades.

METHODS

We analysed data from the Emerging Adults Gambling Survey: a cross-sectional, online, non-probability sample survey of young adults aged 16-24 years living in Great Britain, who were selected from a YouGov online panel. Participants were eligible if they had not taken part in any other YouGov survey on gambling in the past year. We examined associations between problem gambling (defined as a score of 8 or higher on the Problem Gambling Severity Index [PGSI]) and suicidal thoughts and suicide attempts in the year before survey completion in a series of regression models, with and without adjustment for sociodemographic factors, alcohol use, video gaming, anxiety, loneliness, and impulsivity.

FINDINGS

3549 eligible participants completed the survey between June 25 and Aug 16, 2019. 24 (37·0% [95% CI 25·6-50·2]) of 62 men who had attempted suicide in the past year had survey scores that were indicative of problem gambling, compared with 38 (3·6% [2·6-5·0]) of 1077 men who had not attempted suicide or had suicidal thoughts in the past year. 13 (14·5% [8·5-23·6]) of 85 women who had attempted suicide in the past year had survey scores that were indicative of problem gambling, compared with 25 (2·0% [1·4-3·0]) of 1184 women who had not attempted suicide or had suicidal thoughts in the past year. The adjusted odds ratio for attempted suicide was 9·0 (4·1-19·7) in men with scores that indicated problem gambling and 4·9 (2·0-12·0) in women with scores that indicated problem gambling, compared with participants of the same gender with PGSI scores of 0.

INTERPRETATION

Problem gambling appears to be associated with suicide attempts in both young men and young women. This association persisted after adjusting for anxiety, impulsivity, life satisfaction, and other factors, which suggests that other mechanisms, such as the severity and multiplicity of harms experienced, or gambling to cope with life stressors, might underpin this relationship. Young people with problem-gambling behaviours should be considered at risk for suicidality.

FUNDING

Wellcome Trust.