Suicidal Thoughts and Behaviors Among First-Year College Students: Results From the WMH-ICS Project

Caregiver-Youth intergeneration acculturation conflict moderates the relationship between depression severity and suicidality among female Mexican-Descent college students

OBJECTIVE

Suicide is the second leading cause of death among college-age students in the U.S., with disparities in suicide ideation and attempts among Latinas. The current study aims to examine if depression severity predicts suicide ideation and attempts and to examine if caregiver intergeneration acculturation conflict (IAC) moderates this link.

PARTICIPANTS

A sample of 246 Mexican-descent female college students.

METHODS

Self-reported measures for depression severity, male and female caregiver IAC, and suicide ideation and attempts in the previous 12-months were ascertained.

RESULTS

In our sample, 31.1% endorsed suicide ideation and 15.9% suicide attempts. Controlling for age, both male and female caregiver IAC moderated the relationship between depression severity and suicide ideation. A similar moderation pattern emerged for the suicide attempts outcome.

CONCLUSIONS

Understanding this exacerbating contextual factor can help inform prevention/intervention efforts targeting Mexican-descent college students who are experiencing depressive symptoms by focusing on decreasing IAC with both caregivers.Suicide is the second leading cause of death among emerging adults, defined as 18-29-year-olds,1 in the United States (U.S.) and is responsible for more deaths than any single major medical illness.2 Significant gender and ethnic/racial disparities have been well-documented and highlight that Latina emerging adults experience some of the highest rates of suicide ideation (SI) and suicide attempts (SA) and the greatest increases in SA over time, when compared to non-Latinx White, female emerging adults.3,4 In fact, recent research suggests that Latina college students report a 1.7% prevalence rate of suicide attempts compared to 1.2% among non-Latina White college students and data trends report a nearly double increase in the percent of suicide attempts from 2011 to 2015 (from 0.9% to 1.7%) for Latinas versus a minimal change (from 1.1% to 1.2%) among non-Latina White college students.4 Key research examining this disparity have cited that elevated depressive symptoms, which are also experienced at higher levels among Latinx groups in the U.S.,5 are strongly linked to SI and SA among Latinx college students and emerging adults.6,7 Developmentally, the highest risk period for the onset of SI and SA is during late adolescence or emerging adulthood8 and deaths due to suicide increase as adolescents move into emerging adulthood.2,9 Emerging adulthood is an even riskier developmental period for minoritized college students, like Latinx college students, because this period is marked by identity formation processes that are exacerbated by intercultural interactions on college campuses and cultural expectations at home.10 These data underscore the significance of detecting how unique contextual factors may interact with elevated depressive symptoms, and importantly, how these factors are associated with the increased suicide risk among Latinx college-age youth, as they represent a high-risk developmental and ethnic group.

Screen Time and Mental Health in Canadian Youth: An Examination of Nationally Representative Data

As screens have become ubiquitous in modern-day society, investigating the effects of high screen time on mental health is highly warranted. In the past decade, many studies have determined that higher levels of screen time engagement are associated with adverse mental health outcomes like anxiety and depression. However, the nature of the relationship between screen time and mental health requires further investigation to gain a better understanding of its mechanisms and properties. The purpose of this study is to utilize a nationally representative data set to (1) examine how factors like sex, age, and socioeconomic status moderate the relationship between screen time and mental health in Canadian youth and (2) determine whether this relationship supports the Goldilocks hypothesis or an exposure-response curve. It was hypothesized that (1) young, female, lower socioeconomic status individuals will be more strongly associated with poor mental health, and that (2) mental health will peak at low screen time usage, therefore, supporting an exposure-response curve. A series of moderation analyses concluded that young, male, lower socioeconomic status individuals strongly moderated the relationship between screen time and poor mental health compared to their counterparts. Furthermore, three out of the four mental health (presence of mood disorder, presence of anxiety disorder, and depression severity) measures peaked at an average of 12 hours and 19 minutes of screen time per week, hence, supporting the exposure-response curve.

The initiation or continuation of mental health services in the transition to college

Objective: To examine what factors impact college students in the United States who are deciding to initiate or continue mental health services. Participants: Spring 2021 undergraduate students (N = 453) at a large urban university. Methods: Online, cross-sectional survey with mental health service experience as the independent variable and social support, accessibility, attitudes toward mental health, mental health literacy, and trust of mental health professionals as the dependent variables, as well as thematic analysis of reasons to discontinue services. Results: Individuals with lower levels of social support and higher levels of mental health literacy were more likely to have received therapy. Participants tended to discontinue services because of negative experiences, accessibility problems, negative attitudes toward services, or they felt better. Conclusions: Mental health literacy, social support, and accessibility are significant predictors of college student service use and should be taken into consideration by university administration.

Improving responsible Media Reporting on Student Suicide to Reduce Negative Public Opinion: Text Mining Based on Sina Weibo in China

The aims of this study were to explore whether student suicide reporting is consistent with media recommendations for suicide reporting; analyze public opinion and sentiments toward student suicide reports. A keyword search was performed on the WeiboReach platform. This study included 113 student suicide report posts and 176,262 readers' comments on suicide news reports. Hierarchical generalized linear modeling was used to analyze the relationships between adherence to reporting recommendations and negative emotions in readers' comments. None of the media reporting of student suicide was consistent with all of the media recommendations for suicide reporting. Netizens were less likely to post negative comments when the reports describe the suicide method used (OR 1.169, 95% CI 1.022∼1.337), and not specifying the cause of suicide was a protective factor for public negative emotion (OR 0.799, 95% CI 0.707, 0.905). The findings suggest improving responsible media reporting on student suicide to reduce negative public emotion.

Discrepancies in prevalence estimates of suicidal ideation and attempts in 18- to 22-year-old US college students: a comparison of three surveys

PURPOSE

Suicidal thoughts and behaviors (STB) have been increasing among US college students. Accurate measurement of STB is key to understanding trends and guiding suicide prevention efforts. We aimed to compare the prevalence estimates of STB among college students from two campus-based surveys (the National College Health Assessment [NCHA] and the Healthy Minds Study [HMS]) and one general population study (the National Survey on Drug Use and Health [NSDUH]).

METHODS

Estimates were generated from the three surveys for past year suicidal ideation (PYSI) and past year suicide attempts (PYSA) among 18- to 22-year-old full-time college students. Data were combined from each survey to develop bivariate and multivariate regression models for odds of PYSI and PYSA.

RESULTS

Estimates for PYSI varied between the three surveys: 34.3% for NCHA, 15.0% for HMS, and 10.7% for NSDUH. Estimates for PYSA were 2.6% for NCHA, 1.6% for HMS, and 1.7% for NSDUH. After adjusting for demographic and educational characteristics, odds of PYSI remained significantly lower for HMS participants (aOR 0.31, 95% CI 0.29-0.33) and NSDUH participants (aOR 0.19, 95% CI 0.19-0.30) compared to NCHA participants. The odds of PYSA for HMS participants were lower than those for NCHA participants (aOR 0.63, 95% CI 0.54-0.73).

CONCLUSION

Estimates of PYSI and PYSA vary between leading sources of data on college student mental health. The differences are likely related to question wording, survey implementation, as well as institutional and individual representation. Accounting for these differences when interpreting estimates of STB can help guide suicide prevention efforts.

Potential suicide risk among the college student population: machine learning approaches for identifying predictors and different students' risk profiles

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.

Suicidal ideation risk among LGB Spanish university students: The role of childhood and adolescence adversities and mental disorders

BACKGROUND

Childhood/adolescence adversities and mental disorders are higher among LGB youths.

AIMS

To evaluate the role of childhood maltreatment, bullying, and mental disorders on the association between sexual orientation and suicidal ideation (SI); and the role of mental disorders on the association between sexual orientation discrimination and SI.

METHODS

Baseline and 12-month follow-up online surveys of Spanish first-year university students (18-24-year-olds). Multivariable logistic regression models assessed the effects of childhood/adolescence adversities and mental disorders in the relationship between sexual orientation, discrimination and SI.

RESULTS

A total of 1224 students were included (16.4 % LGBs). Risk factors of lifetime SI were sexual orientation (OR 2.4), any bullying (OR 2.4), any childhood maltreatment (OR 4.0), and any mental disorders (OR 3.8). Final model Area Under the Curve (AUC) 0.78. Among homosexual and bisexual students, discrimination showed increased risk of 12-month SI (OR 2.2), but this effect was no longer statistically significant when any 12-month mental disorder was added (OR 7.8). Final model AUC 0.72.

LIMITATIONS

Sample of interest was relatively small. But it was similar to comparable studies and statistical adjustments have been performed. Assessment of mental disorders and SI was not based on clinical assessment. However, validated scales showing good diagnostic agreement with clinical judgement were used.

CONCLUSIONS

Childhood/adolescence adversities and mental disorders interact in the association between sexual orientation and SI. Mental disorders may mediate the association between sexual orientation discrimination and SI. Further research using larger samples and causal modelling approach assessing the mediators of SI risk among LGBs is needed.

Association between Current Substance Use, Healthy Behaviors, and Depression among Ukrainian College Students

Depression is a pervasive issue among college students worldwide, yet there is a significant gap in the literature regarding its prevalence and coping strategies in the Ukrainian context. The present study aims to fill this gap by investigating how substance use and health-promoting behaviors relate to depressive symptoms among Ukrainian college students. Health-promoting behaviors are an important strategy to prevent depression, whereas substance use can contribute to depression or make it harder to manage. Given the substantial psychosocial problems and stressors related to the ongoing war in Ukraine and the limited availability of mental health services for college students, it is important to understand how we can encourage college students to keep themselves mentally healthy. A cross-sectional study was conducted among college students on 10 campuses in 2018. Almost 16% of participants met a cut-off for depression. Female students and those who were older reported significantly higher depressive symptoms. Participants were more likely to report depressive symptoms if they were more often involved with alcohol and cannabis use, were older, and engaged in fewer health-promoting behaviors. Tobacco use was not significantly associated with depressive symptoms. Our findings suggest a moderate prevalence of depressive symptoms in our study population. We recommend implementing balanced public health interventions that address risk factors (such as substance use) while also promoting protective behaviors and can be tailored to the specific cultural and environmental context of the region.

Relationship of compassion for self and others to sense of well-being of college students

Objective: The mental health issues among college students have increased significantly in recent years. The primary purpose of this study was to explore and describe the relationship between self-compassion, compassion for others, and a sense of well-being among undergraduate college students. Participants: This study surveyed N = 651 college students aged 18-24 years at an urban university in the Northeast. Methods: Students completed an online survey through Survey Monkey that was comprised of questions about their selfcompassion, compassion for others, and overall sense of well-being. Results: The results indicate that self-compassion, compassion for others, and sense of well-being are positively related. Exploratory tests for sex differences showed that females reported having significantly higher compassion for others while males reported having substantially higher self-compassion. Conclusion: The authors discuss the implications of the results and suggest a need for more compassion education programs at institutions of higher education. Suggestions are made for future experimental research that measures the impact of self-compassion and compassion for others, especially after the COVID-19 pandemic that impacted many college students' education, economy, relationships, and job prospects.

Adolescent suicide risk factors and the integration of social-emotional skills in school-based prevention programs

Adolescents are considered one of the most vulnerable groups affected by suicide. Rapid changes in adolescents' physical and mental states, as well as in their lives, significantly and undeniably increase the risk of suicide. Psychological, social, family, individual, and environmental factors are important risk factors for suicidal behavior among teenagers and may contribute to suicide risk through various direct, indirect, or combined pathways. Social-emotional learning is considered a powerful intervention measure for addressing the crisis of adolescent suicide. When deliberately cultivated, fostered, and enhanced, self-awareness, self-management, social awareness, interpersonal skills, and responsible decision-making, as the five core competencies of social-emotional learning, can be used to effectively target various risk factors for adolescent suicide and provide necessary mental and interpersonal support. Among numerous suicide intervention methods, school-based interventions based on social-emotional competence have shown great potential in preventing and addressing suicide risk factors in adolescents. The characteristics of school-based interventions based on social-emotional competence, including their appropriateness, necessity, cost-effectiveness, comprehensiveness, and effectiveness, make these interventions an important means of addressing the crisis of adolescent suicide. To further determine the potential of school-based interventions based on social-emotional competence and better address the issue of adolescent suicide, additional financial support should be provided, the combination of social-emotional learning and other suicide prevention programs within schools should be fully leveraged, and cooperation between schools and families, society, and other environments should be maximized. These efforts should be considered future research directions.

Exploring suicide ideation in university students: sleep quality, social media, self-esteem, and barriers to seeking psychological help

The purpose of the current study is to analyze how variations in suicidal ideation scores can relate to sleep quality, social media consumption, self-esteem, and perceived barriers to seeking psychological help in a sample of university students in Honduras. A quantitative cross-sectional design was used. Self-reported data was collected from a non-random sample of 910 university students in Honduras; their average age was 24.03 years (SD=6.05). Most respondents were women (67%) with men accounting for 33% of the sample. Measurements included item 9 of the Patient Health Questionnaire-9, the Single-Item Sleep Quality Scale, Rosenberg's Self-Esteem Scale, Barriers to Seeking Psychological Help Scale for College Students, and a self-reported questionnaire on social media. In response to the query, "Over the past two weeks, how frequently have you experienced thoughts that you would be better off dead or of hurting yourself?" 54% (n=495) of participants indicated "not at all" 18% (n=168) reported "several days" 14% (n=129) responded "more than half of the days" and 13% (n=118) stated "nearly every day". The results from the ordinal logistic regression model indicate that sleep quality and self-esteem serve as protective factors associated with decreased suicide ideation. At the same time, a higher number of social media platforms used per week and perceived barriers to seeking psychological help increase suicide ideation. Altogether, these variables explained 19% of the variance in suicidal ideation scores. Suicidal ideation is highly prevalent among the sampled university students.

Internalizing psychopathology and its links to suicidal ideation, dysfunctional attitudes, and help-seeking readiness in a national sample of college students

BACKGROUND

Recent evidence suggests that multiple emotional disorders may be better assessed using dimensional models of psychopathology. The current study utilized a cross-sectional population survey of college students (N = 8613 participants) to examine the extent to which broad psychopathology factors accounted for specific associations between emotional problems and clinical and behavioral validators: suicidality, dysfunctional attitudes, and treatment seeking.

METHODS

Confirmatory factor models were estimated to identify the best structure of psychopathology. Models were then estimated to examine the broad and specific associations between each psychopathology indicator and the clinical and behavioral validators.

RESULTS

The hierarchical model of psychopathology with internalizing problems at the top, fear, and distress at the second level, and five specific symptom dimensions at the third level evidenced the best fit. The associations between symptom indicators of psychopathology and clinical and behavioral validators were relatively small and inconsistent. Instead, much of the association between clinical and behavioral validators and emotional problems operated at a higher-order level.

LIMITATIONS

The cross-sectional nature of the survey precludes the ability to make conclusions regarding causality.

CONCLUSIONS

Researchers should focus on investigating the shared or common components across emotional disorders, particularly concerning individuals presenting with higher rates of suicidal ideation dysfunctional attitudes, and help-seeking behavior. Using higher-order dimensions of psychopathology could simplify the complex presentation of multiple co-occurring disorders and suggest valid constructs for future investigations.

Predicting stress in first-year college students using sleep data from wearable devices

Consumer wearables have been successful at measuring sleep and may be useful in predicting changes in mental health measures such as stress. A key challenge remains in quantifying the relationship between sleep measures associated with physiologic stress and a user's experience of stress. Students from a public university enrolled in the Lived Experiences Measured Using Rings Study (LEMURS) provided continuous biometric data and answered weekly surveys during their first semester of college between October-December 2022. We analyzed weekly associations between estimated sleep measures and perceived stress for participants (N = 525). Through mixed-effects regression models, we identified consistent associations between perceived stress scores and average nightly total sleep time (TST), resting heart rate (RHR), heart rate variability (HRV), and respiratory rate (ARR). These effects persisted after controlling for gender and week of the semester. Specifically, for every additional hour of TST, the odds of experiencing moderate-to-high stress decreased by 0.617 or by 38.3% (p<0.01). For each 1 beat per minute increase in RHR, the odds of experiencing moderate-to-high stress increased by 1.036 or by 3.6% (p<0.01). For each 1 millisecond increase in HRV, the odds of experiencing moderate-to-high stress decreased by 0.988 or by 1.2% (p<0.05). For each additional breath per minute increase in ARR, the odds of experiencing moderate-to-high stress increased by 1.230 or by 23.0% (p<0.01). Consistent with previous research, participants who did not identify as male (i.e., female, nonbinary, and transgender participants) had significantly higher self-reported stress throughout the study. The week of the semester was also a significant predictor of stress. Sleep data from wearable devices may help us understand and to better predict stress, a strong signal of the ongoing mental health epidemic among college students.

Development and evaluation of a predictive algorithm and telehealth intervention to reduce suicidal behavior among university students

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.

Impact of Bullying Victimization on Chinese College Students' Suicidal Tendency: The Moderating Effect of Teachers' Emotional Support and Family Support

Objective

To explore the influence of bully victims on the suicidal tendencies of college students, and the moderating role of teacher emotional support and family support in the relationship between bully victims and college students' suicidal tendencies, in order to provide a reference for the effective intervention of college students' suicide behavior.

Methods

Based on a survey of 15,560 college students. Multiple stepwise regression and Interaction analysis explore the impact of the bully victimization on college students' suicidal tendencies and the moderating role of family support and teacher emotional support in the relationship between the bully victim and college students' suicidal tendencies.

Results

This study found that the Suicidal Tendencies score of college students was 19.79 points, indicating that some college students have a risk of suicidal tendencies; secondly, verbal bullying (β = 0.084, P <0.001), physical bullying (β = 0.222, P <0.001) and social relationship bullying (β = 0.122, P <0.001) have a positive and significant impact on the suicidal tendencies of college students; in addition, family support and teacher emotional support have a significant regulatory effect on the bully victim and college students Suicidal Tendencies and family support. The regulating effect was significantly higher than that of teacher emotional support.

Conclusion

Chinese college students have the risk of suicidal tendencies; peer bullying victimization is an important reason for affecting college students' suicidal tendencies, teacher emotional support is a protective factor for bully victims to affect college students' suicidal tendencies, and family support has a significant moderating effect on the bully victim and college students' suicidal tendencies. Therefore, it is necessary to actively adopt home-school linkage and home-school communication to reduce campus violence and increase the psychological resilience of college students.

Student mental health during the COVID-19 pandemic: Are international students more affected?

Background: The psychological well-being of students may be especially affected by the COVID-19 pandemic; international students can lack local support systems and represent a higher risk subgroup. Methods: Self-reported depressive symptoms, suicidal ideation, anxiety, post-traumatic stress disorder (PTSD), insomnia, alcohol use, academic stress, and loneliness were examined in two cohorts of university students (March 2020 n = 207, March 2021 n = 142). We investigated differences i) between 2020 and 2021, ii) between domestic and international students, and ii) whether differences between the two cohorts were moderated by student status. Results: More depressive symptoms, academic stress, and loneliness were reported in 2021. International students reported more depressive symptoms, suicidal ideation, anxiety, PTSD, academic stress, and loneliness. The main effect of cohort was not moderated by student status. Conclusions: International students had worse mental health outcomes overall, but were not affected more by the COVID-19 pandemic than domestic students.

Suicidal Ideation and Behavior Among Mexican University Students Before and During the COVID-19 Pandemic

OBJECTIVE

The COVID-19 pandemic has affected the mental health of populations around the world, but few longitudinal studies of its impact on suicidal thoughts and behaviors have been published especially from low- and middle-income countries.

METHODS

This is a prospective cohort study of 1,385 first-year students from 5 Universities in Mexico followed-up for 1 year. We report 1-year cumulative incidence of suicidal thoughts and behaviors before (September 19, 2019-March 29, 2020) and during the COVID-19 period (March 30, 2020-June 30, 2020), focusing on those in the COVID-19 period with risk conditions and positive coping strategies during the pandemic.

RESULTS

There was an increase in the incidence of suicidal ideation during the COVID-19 period compared to the pre-COVID-19 period (RR 1.65, 95%CI 1.08-2.50). This increase was mostly found among students with heightened sense of vulnerability (RR 1.95), any poor coping behavior (RR 2.40) and a prior mental disorder (RR 2.41). While we found no evidence of an increased risk of suicidal planning or attempts, there was evidence that those without lifetime mental health disorders were at greater risk of suicidal plans than those with these disorders especially if they had poor coping strategies (RR 3.14).

CONCLUSION

In the short term, how students deal with the pandemic, being at high risk and having poor coping behavior, increased the new occurrence of suicidal thoughts and behaviors. Studies with longer follow-up and interventions to reduce or enhance these behaviors are needed.HIGHLIGHTSSuicidal ideation increased during the COVID-19 periodThose with heightened sense of vulnerability and poor coping were more affectedStudies with longer follow-up are needed.

Clinical characteristics of suicidal behavior in first hospitalization and drug-naïve patients with major depressive disorder

BACKGROUND

Major depressive disorder (MDD) is a major and common cause of suicide. The purpose of this article is to report the clinical characteristics and patterns of co-morbid suicidal behavior (SB) in first hospitalized and drug-naïve MDD patients.

METHODS

A total of 345 patients with first hospitalization and drug-naïve MDD with SB were included in this study, while 183 patients without SB were included as a control group. We collected socio-demographic, general clinical data and common biochemical indicators of all participants and assessed their clinical symptoms.

RESULTS

Compared to patients without SB, MDD with SB had more severe clinical symptoms and worse metabolic indicators. Duration of disease, depressive symptom scores, and thyroid stimulating hormone (TSH) levels was risk factors for SB and its number.

CONCLUSIONS

MDD patients with SB suffered more severe clinical symptoms and worse metabolic indicators, and risk factors for SB in this population were identified, which may provide beneficial insight and reference for clinical prevention and intervention of SB in MDD patients.

Treatment rates and barriers to mental health service utilisation among university students in South Africa

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.

Investigating the co-occurrence of marijuana use and prescription opioid misuse with multiple suicide attempts among adolescents with a history of suicidal ideation

This study investigated the co-occurrent association of marijuana use and prescription opioid misuse with multiple suicide attempts among adolescents with a history of suicidal ideation. Data came from the 2019 Youth Risk Behavior Survey. The sample was comprised of adolescents ages 14-18 who reported suicidal ideation during the past year (n = 2,562). Multinomial logistic regression was used to examine the co-occurring association of marijuana use and prescription opioid misuse with multiple suicide attempts. Of the 2,562 adolescents who experienced suicidal ideation, 19.2 % also attempted suicide multiple times during the past year and 19.0 % reported ever using marijuana and misusing prescription opioids, 8.8 % misused prescription opioids only, and 33.3 % used marijuana only. In the multivariate model, for adolescents who used marijuana and misused prescription opioid, the risk of attempting suicide once was 1.77 times higher (RRR = 1.77, 95 % CI = 1.22-2.59) and the risk of multiple suicide attempts was 3.23 times higher (RRR = 3.23, 95 % CI = 1.95-5.33) when compared to adolescents who had never used marijuana nor misused prescription opioid. The risk of multiple suicide attempts was greater for bisexual and racial/ethnic minority adolescents and adolescents who felt sad or hopeless. Interventions that prevent prescription opioid misuse among adolescents may be effective in mitigating suicide attempts.

Impact of the COVID-19 pandemic on college students' mental health and lifestyle factors

Objective: This study examines how mental health and health behaviors evolved among college students nationwide before and during the onset of the COVID-19 pandemic. Participants: Data collected from college students across various campuses in Fall 2019 (N = 33,372) and Fall 2020 (N = 34,168) as part of the Healthy Minds Study. Methods: The online survey was delivered via Qualtrics. Data was analyzed through an unpaired two-samples T-test and a two-proportion Z-test. Results: The results show a significant difference of depression and anxiety symptoms in college students during Fall 2020 compared to Fall 2019. Sleep patterns significantly shifted during the pandemic. Substance use, perceived need for counseling, and the amount of time students spent exercising all significantly differed during the COVID-19 pandemic. Conclusion: In the context of declines in mental health among college students, college campuses should implement mental health support models addressing students' individual health risk and lifestyle behaviors.

An example of implementing a safety protocol in remote intervention and survey research with college students

INTRODUCTION

This article draws attention to the need for open evaluation and reporting on safety protocols in survey and intervention research. We describe a protocol for responding to those who indicate increased risk of self-harm (i.e. suicidality or potentially lethal alcohol use) as an example and report on the outcome of our procedures.

METHODS

Participants were first-year college students (n = 891) participating in an intervention trial for binge drinking. We describe the protocol, provide descriptive outcomes, and examine whether participant sex, attrition, or study intervention condition were related to endorsing items that indicated risk for suicidality or potentially lethal alcohol use.

RESULTS

Of the 891 participants, 167 (18.7%) were identified as being at risk in one or more study wave. Of those, we were able to successfully contact 100 (59.9%), 76 (45.5%) by phone, and 24 (14.4%) by email. Of those 100, 78 accepted mental health resources as a result of outreach. Participant sex, attrition, and intervention condition were not related to risk.

DISCUSSION

This article may aid other research teams in developing similar protocols. Strategies to reach an even greater proportion of high-risk participants are needed. A body of literature documenting published safety protocols in research and the associated outcomes would help to identify opportunities for improvement.

Sexual Assault, Posttraumatic Stress, Alcohol Use, and Suicidality Among Diverse College Students

Suicide is the second leading cause of death among college-aged populations. This study examined the association of demographics (sexual orientation, gender identity, age, and race), sexual assault, posttraumatic stress symptoms (PTSS), and alcohol use with suicidality, current urge to self-harm, and current suicidal intent among a diverse sample of college students (n = 2,160) from two universities. Over half of participants reported any suicidality (63.5%), 12% reported current urge to harm themselves, and 5% reported current suicidal intent. A linear regression indicated that participants who identified as a sexual minority, gender minority, consumed more drinks per week, and had more severe PTSS reported higher levels of suicidality. University also was associated with suicidality. A negative binomial regression demonstrated that participants who identified as a sexual minority and had more severe PTSS had more current urge to harm themselves. Further, a negative binomial regression demonstrated that first-generation college students, students with more severe sexual assault histories, and students with more severe PTSS had higher current suicidal intent. Findings suggest that risk factors may differ for college students' general suicidality, self-harm urges, and suicidal intent, suggesting that these may be separate constructs. More comprehensive models, incorporating multiple risk factors and multiple ways of assessing suicidality, are needed to better understand the range of college student suicidal behavior and risks.

A machine learning analysis of risk and protective factors of suicidal thoughts and behaviors in college students

OBJECTIVE

To identify robust and reproducible factors associated with suicidal thoughts and behaviors (STBs) in college students.

METHODS

356 first-year university students completed a large battery of demographic and clinically-relevant self-report measures during the first semester of college and end-of-year (n = 228). Suicide Behaviors Questionnaire-Revised (SBQ-R) assessed STBs. A machine learning (ML) pipeline using stacking and nested cross-validation examined correlates of SBQ-R scores.

RESULTS

9.6% of students were identified at significant STBs risk by the SBQ-R. The ML algorithm explained 28.3% of variance (95%CI: 28-28.5%) in baseline SBQ-R scores, with depression severity, social isolation, meaning and purpose in life, and positive affect among the most important factors. There was a significant reduction in STBs at end-of-year with only 1.8% of students identified at significant risk.

CONCLUSION

Analyses replicated known factors associated with STBs during the first semester of college and identified novel, potentially modifiable factors including positive affect and social connectedness.

Non-lethal suicidal behavior in university students of Spain during COVID-19

Background

Suicide is the fourth external cause of death in the world, in persons between the ages of l5 and 29. The objectives of this study were to measure the prevalence of suicidal behavior in university students and analyze the relationship of suicide risk with psychological distress, resilience, and family and social support.

Methods

An observational and transversal study wherein the students at the University of Malaga (Spain) completed an online questionnaire which included items from different scales, sociodemographic and academic questions, and the subjective impact of the COVID-19 pandemic. Descriptive analyses and prevalence rates of suicidal behavior were calculated, and bivariate analyses, multiple linear regression, and a mediation and moderation analyses were conducted.

Results

A total of 2,212 students completed the questionnaire. The prevalence of the last 6 months was 30.4% wishing for death, 14.7% suicidal ideation, 5% self-harm injuries, and 0.5% suicide attempts. Psychological distress, family and social support were linked to the risk of suicide. Lastly, resilience and family support measure and moderate the relation between psychological stress and suicide risk.

Conclusion

Psychological distress is a risk factor for suicidal behavior, while resilience and family and social support are linked to a lower risk of suicide.

Exploring the Safety of a General Digital Mental Health Intervention to Effect Symptom Reduction among Individuals with and without Suicidal Ideation: A Secondary Analysis

Trials of digital mental health interventions (DMHIs) often exclude individuals with suicide-related thoughts and behaviors precluding an understanding of whether DMHIs for affective disorders are safe for, and perform similarly within, this high-risk group. We explore the safety and performance of a DMHI for depression in participants with and without suicidal ideation (SI) at baseline. Three hundred and one participants were included in this secondary data analysis from a trial of an 8-week DMHI comprising 14 smartphone apps. We found that SI decreased across the study among participants with baseline SI and that baseline SI status did not attenuate depression treatment effects. Through a case study of the IntelliCare platform, we find that DMHIs for general affective disorders can be safe.

Suicidal Ideation Amongst University Students During the COVID-19 Pandemic: Time Trends and Risk Factors

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.

Suicide postvention for staff and students on university campuses: a scoping review

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.

Predictors of digital technology-based mental health programs in young adults for mental health support

Technology-based platforms are widely used to deliver mental health support. The aim of this study was to explore factors associated with the use of technology-based mental health platforms by students who may be vulnerable to develop a mental health condition in an Australian psychology student sample. Participants were 1146 students (18-30 years) at an Australian university who completed a survey regarding their current mental health symptoms and lifetime use of technology-based platforms. The student's country of birth, having a previous mental health diagnosis, having a family member with a mental illness and greater stress scores predicted any type of online/technology-use. Greater symptoms correlated with lower helpfulness of online mental health programs and websites. Apps were perceived as more helpful by those with a mental illness history and associated with higher stress scores. The use of any type of technology-based platform was high in the sample overall. Further research may clarify why mental health programs are less popular, and how these platforms may be utilised to support mental health outcomes.

Associations between psychological distress and facets of mindfulness: Implications for campus-based university wellness services

OBJECTIVES

To investigate associations between components of psychological distress and five facets of mindfulness (i.e. observing; describing; acting with awareness; non-reactivity; non-judging).

PARTICIPANTS

Students from a university in South Africa (n = 174).

METHODS

This cross-sectional study assessed psychological distress and mindfulness using the K10 and Five Facet Mindfulness Questionnaire. Multivariate regression analysis identified associations between psychological distress and facets of mindfulness, controlling for demographics.

RESULTS

Prevalence of psychological distress was 56.9% (95% CI 49.2%-64.4%). Acting with awareness, non-reactivity, and non-judging predicted significantly lower psychological distress, whereas observing and describing did not. Acting with awareness was the only facet of mindfulness that consistently predicted lower levels of negative affect, fatigue, nervousness, and agitation.

CONCLUSIONS

Acting with awareness appears to be a key component of psychological wellbeing. To advance theory and practice, future research should consider why and how various facets of mindfulness predict lower psychological distress and its components among university students.

Gender differences in the predictive effect of depression and aggression on suicide risk among first-year college students

BACKGROUND

Depression and aggression are related to the risk of suicide. Previous studies have associated different characteristics with depression and aggression in separate gender groups. The main aim of this study was to investigate the gender differences in the predictive effect of depression and aggression on suicide risk among first-year college students.

METHODS

A total of 2004 first-year undergraduates (80.5 % female, mean age = 19.4 ± 0.8 years) were surveyed by a battery of questionnaires that contained the Chinese version of the Beck scale for Suicide Ideation, the Chinese version of the 12-item Aggression Questionnaire, and the Center for Epidemiologic Studies Depression scale.

RESULTS

(1) Depression severity was significantly associated with the suicidality risk (r = 0.090, p < 0.01). (2) Suicide risk correlated positively with physical aggression, verbal aggression, anger, and hostility in the aggression questionnaire (r = 0.308, 0.227, 0.284, 0.277, p < 0.01). (3) A possible gender difference was noted for suicide risk in that depression degree was a significant risk factor for females but not males (R2 = 0.095, F = 41.554, p < 0.01), whereas anger was a significant predictor of suicide risk for males but not for females (R2 = 0.21, F = 25.75, p < 0.01).

CONCLUSIONS

Gender differences exist in the predictive effect of depression and aggression on suicide risk among first-year college students.

Interpersonal and intrapersonal predictors of suicidal thoughts and actions in first-year college students

OBJECTIVE

The aim was to determine the unique predictors of suicide risk in first-year college students.

PARTICIPANTS

First-year students (N = 665) at a Midwestern university participated.

METHODS

An online survey assessed Joiner's interpersonal factors (i.e., thwarted belongingness, perceived burdensomeness, and acquired capability) as well as intrapersonal factors (i.e., perfectionism, self-compassion, emotional intelligence/reactivity, and growth mindset) often associated with suicidal thoughts and actions.

RESULTS

Linear regression indicated that the factor set significantly predicted thoughts, F (12, 632) = 114.90, p < .000, R² = .680, and actions, F (12, 632) = 58.42, p < .000, R² = .526. Perceived burdensomeness, acquired capability, and underrepresented sexual orientation were positive predictors of both thoughts and actions, whereas growth mindset was a negative predictor of thoughts and stressful life events was a positive predictor of actions.

CONCLUSION

The results offer direction for evidence-informed interventions aimed at reducing suicide risk in first-year college students.

Suicidal Thoughts and Behaviors Among Adolescent Psychiatric Inpatients

BACKGROUND

Given low base rates of suicidal thoughts and behaviors (STBs) in national samples of adolescents, clarifying the sociodemographic and clinical correlates among psychiatric inpatients may afford insights into potential risk factors that predict STBs onset.

METHOD

Adolescents (N = 970; ages 12-19 years) admitted for acute, psychiatric inpatient care completed baseline clinical interviews and self-report measures assessing demographics and early life adversity. Lifetime and 12-month STBs prevalence were obtained, allowing for the estimate of STBs persistence (i.e., rates of those with both current and past STBs) and transition rates (i.e., proportion of ideators that transition to plans or attempts). Univariate and multivariate logistic regression tested sociodemographic and clinical correlates of STBs.

RESULTS

Age-of-onset for STBs occurred in early adolescence. Most patients reported suicide ideation with nearly half of patients making a plan and one-third a suicide attempt. Although relatively modest, the strongest correlates of lifetime attempts were depressive disorders, physical abuse, and non-suicidal self-injury. Knowing a peer that had attempted suicide also increased the likelihood of a suicide attempt, especially among attempters who transitioned from ideation to planned attempts.

CONCLUSION

STBs are highly prevalent among adolescents admitted for acute psychiatric inpatient treatment. The modest effects suggest that correlates, particularly those related to suicide attempts, are widely distributed. As a history of physical abuse and knowing a peer with a suicide attempt history are related to transitioning from ideation to action, these may be critical factors to target in the deployment of future suicide prevention and treatment programs. HIGHLIGHTSOne-third of adolescent inpatients report a lifetime history of suicide attempts.Approximately 65% of adolescent inpatients with a lifetime plan attempt suicide.Knowing peers who attempt suicide may facilitate the transition from ideation to action.

First-year undergraduate students: depressed, distressed, and drained? Influence of depressive symptoms on markers of psychological well-being, sleep, and physical activity

Objective: This study examined depressive symptomatology (DS) across the academic year in first-year undergraduate students and the influence of DS on anxiety, stress, body esteem, physical activity, and sleep. Participants: Participants were first-year undergraduate students (N= 164). Methods: Participants completed validated self-report measures each quarter. A repeated measures ANCOVA was conducted to examine changes in DS over time. Students were categorized as reporting subclinical (SCD) or clinical (CD) depressive symptoms. A repeated measures MANCOVA was conducted to examine the effect of time and DS groups on primary outcomes. Results: No significant main effects of time were observed for outcomes. Significant between-subjects effects were observed with CD participants reporting significantly higher anxiety and stress and lower sleep than SCD participants. Conclusions: First-year undergraduates with CD may have increased risk for negative markers of psychological and physical health outcomes. Universities should prioritize the psychological and physical health of their first-year students.

A Person-Centered Investigation Into the Co-Development of Perceived Stress and Internalizing Symptoms Among Post-Secondary Students

The early post-secondary years are regarded as a period of heightened vulnerability for stress and internalizing symptoms among emerging adults. However, there is a lack of research examining variability in stress and internalizing symptoms among students, the co-occurrence of stress and internalizing symptoms, or predictors of distinct profiles of stress and internalizing symptoms. To address these gaps in the literature, 1125 ethnically diverse first-year students (71% female; Mage = 17.96 years, SD = 0.69; 55% East or South Asian, 21% Caucasian, 24% other ethnicity) were surveyed three times across the first year of university. Latent growth mixture models revealed four distinct profiles (i.e., high distress, moderate increasing distress, low distress, high decreasing distress), in which patterns of perceived stress and internalizing symptoms co-occurred. Higher levels of exposure to stressful life events, identifying as female and/or LGBQ+ were associated with increasing and high distress profiles. The findings underscore variability in distress among students, as well as the strong associations between stressful experiences, perceived stress, and internalizing symptoms.

Anxious, Depressed, and Suicidal: Crisis Narratives in University Student Mental Health and the Need for a Balanced Approach to Student Wellness

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.

Prevalence and correlates of 30-day suicidal ideation and intent: Results of the South African National Student Mental Health Survey

Background. Although suicide prevention is recognised as a priority among university students in South Africa (SA), it is unclear whatproportion of students require urgent indicated interventions and what the characteristics are of these students.Objective. To assess the prevalence and sociodemographic correlates of 30-day suicidal ideation, frequency of ideation and self-reported intention to act on ideation in the next year among a national sample of SA university students.Methods. Self-report cross-sectional data were collected online from students (N=28 268) at 17 universities across SA as part of the national student mental health survey. Students reported suicidal ideation in the past 30 days, frequency of ideation and intention to act on ideation in the next year. Data were weighted within institutions by gender and population group, and across the four main types of universities (historically white, historically disadvantaged, technical and distance learning) to correct for response rate discrepancies. Prevalence was estimated with these weighted in the total sample and across types of universities. Poisson regression with robust error variances was used to investigate associations of sociodemographic characteristics with ideation and intention to act on suicidal ideation. Results are reported as relative risks (RRs) with design-based 95% confidence intervals (CIs).Results. Thirty-day prevalence of suicidal ideation was 24.4% (standard error (SE) 0.3), with 2.1% (SE 0.1) and 4.1% (SE 0.1), respectively,reporting suicidal ideation all/almost all the time, or most of the time. A total of 1.5% (SE 0.1) of respondents reported being very likely to act on their suicidal ideation, while 3.9% (SE 0.2) were somewhat likely, 8.7% (SE 0.2) were not very likely and 85.8 (SE 0.5) either reported no suicidal ideation or that they were not at all likely to act on this ideation. Risk of suicidal ideation with high intent in the total sample was elevated among females (RR 1.9, 95% CI 1.3 - 2.7) and gender non-conforming students (RR 4.3, 95% CI 1.4 - 13.0) relative to males, black African students compared with white students (RR 3.6, 95% CI 1.9 - 7.1), students whose parents did not progress to secondary school compared with students whose parents had a university education (RR 1.6, 95% CI 1.0 - 2.5) and sexual minority students compared with heterosexual students (RR 1.9, 95% CI 1.3 - 2.6). Among students with 30-day ideation (controlling for frequency of ideation), only two of these predictors of high intent remained significant: identifying as black African (RR 2.7, 95% CI 1.4 - 5.1), and having parents with less than secondary education (RR 1.5, 95% CI 1.0 - 2.1).Conclusion. Scalable suicide prevention interventions are needed to reach the large number of SA students who report suicidal ideation with intent.

Prevalence and Psychiatric Correlates of Illicit Substance Use in UK Undergraduate Students

This study examined the prevalence of illegal drug use in UK students and motivators behind such behavior. Additionally, we explored possible relationships between substance use, psychosocial motivators, and psychiatric distress. A group (n = 543) of students completed online measures of substance use, anxiety, depression, perceived stress, and insomnia. A series of reasons behind their use were ranked based on importance. Reported cannabis, cocaine, nitrous oxide, ketamine, and MDMA use were most prevalent based on lifetime, past year, and month assessments. The experience of anxiety, depression, perceived stress, and insomnia were related to increased reports of substance use. Poor self-confidence and self-medication were key motivators of illicit drug use in those presenting greater psychiatric distress. These outcomes add to the sparse body of literature concerning illicit substance use in relation to psychiatric distress amongst UK students. Furthermore, we provided novel insight into the psychosocial motivators of such use.

The effect of childhood adversities on the persistence of suicidal ideation and plans among college students: A longitudinal study

BACKGROUND

Exposure to childhood adversities (CAs) is known to be associated with the onset of suicidal ideation and plans. However, little is known regarding the contribution of CAs to their persistence.

AIMS

The study aims to examine the type, number and frequency of CA exposure on the persistence of suicidal ideation and plans at one-year.

METHOD

Data were drawn from the French portion of the World Mental Health International College Student survey. At baseline (n = 2661, response rate = 7,58 %), exposure to 12 types of CAs prior to age 18, lifetime mental disorders, lifetime and 12-month suicidal ideation and plans were assessed. At one-year follow-up (n = 1221), 12-month mental disorders, suicidal ideation and plans were assessed. Among those with a prior history of suicidal ideation, logistic regressions were performed to examine the role of CAs on the persistence of ideation and plans at one-year.

RESULTS

At baseline, frequency and number of CAs were associated with 12-month suicidal ideation and plans. Among lifetime ideators, 49.6 % reported 12-month suicidal ideation at follow-up. Physical abuse was associated with an increased risk of suicidal ideation and plan persistence at one year in univariate analyses. However, CAs were not associated with the persistence of suicidal ideation and plans at one-year in multivariate analyses.

LIMITATIONS

Retrospective report of CA exposure, and low baseline response rate.

CONCLUSIONS

Using a fine-grained operationalization of CA exposure, CAs were not involved in the persistence of suicidal ideation or plans, their deleterious effect more likely to occur early in the course of psychopathology.

Predictive Factors of Suicidal Ideation in Spanish University Students: A Health, Preventive, Social, and Cultural Approach

Suicide, as the ultimate expression of suicidal ideation, has accompanied human beings throughout history within specific social and cultural contexts. However, in recent decades the increase in suicides, especially in developed countries after the Second Demographic Transition and the rise of postmaterialist values, has been increasing in the youth population. This study is created from a quantitative perspective and aims to determine the predictors of suicidal ideation in university students in Spain. The fieldwork was carried out in a large sample of Spanish universities over several weeks in 2022, with the participation of hundreds of university students (n = 1472). The predictors of suicidal ideation were gender, types of social relationships, history of bullying, health status, taking antidepressant medication, increased anxiety after COVID-19, economic difficulties in continuing studies, and perspective on their future. The results highlight the need for the greater involvement of universities by establishing programs for preventing, detecting, and treating suicidal ideation, always in coordination with health systems to prevent further suicides in their university community.

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

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.

"Managing emotion": Open label trial and waitlist controlled trial of an emotion regulation program for university students

Background: More than one-third of university students meet diagnostic criteria for a mental disorder, and three quarters experience role impairment in some aspect of their life. One determinant of whether young adults will experience mental health difficulties is their ability to regulate emotion. We conducted two pilot trials of a brief online program designed to teach emotion regulation skills to university students. Methods: In Study 1, we conducted an open-label trial (n = 104). In Study 2, we conducted a waitlist controlled trial (n = 167). In both studies, pre- and post-assessment of emotion regulation, psychological distress, and self-compassion were conducted. Results: In both trials, we observed improvements in emotion regulation, and reductions in symptoms of psychological distress. Acceptability and feasibility were also satisfactory. Conclusion: An online emotion regulation program may offer promise in improving emotion regulation and subsequent mental health concerns among university students. (ACTRN12620000390987; ACTRN12620000839909).

Mental Health of Students at Polish Universities after Two Years of the Outbreak of COVID-19

BACKGROUND

Mental health deterioration in young adults in the aftermath of the COVID-19 pandemic is being increasingly studied. It is clear that the psychological consequences of the pandemic will be evident for many years, especially among the younger generation, who did not have time to acquire adaptive coping strategies before the outbreak of COVID-19. The purpose of this study was to assess the condition of the mental health of students at Polish universities after two years of the pandemic. The types of coping strategies used by the respondents to deal with stress were also evaluated in order to establish which of them could have a beneficial effect on the psyche of young people.

METHODS

This study included 721 participants (age [years]: M = 25.7, SD = 5.3; 269 (37.2%) males) recruited using snowball sampling from students at two universities in Lodz, Poland, and full-time doctoral students from across Poland (phase I of the study was conducted in March 2019 (N = 352); phase II of the study was conducted in April 2022 (N = 369)). The following tools were used in this study: The General Health Questionnaire (GHQ-28) by D. Goldberg, the Perceived Stress Scale (PSS-10), and the Inventory for Measuring Coping with Stress (Mini-COPE) by Carver et al. Pearson's chi-square test and multivariate logistic regression were used in the statistical analysis.

RESULTS

The results detailing the condition of the mental health of the subjects, as measured using GHQ-28, were significantly worse in the group surveyed after two years of the pandemic than the results of the survey conducted in March 2019 (adjusted odds ratio for GHQ-28 ≥ 5: 3.66, 95%CI 2.12-6.30, p < 0.001). Statistically significant differences were seen for each of the subscales of the GHQ-28 questionnaire. Most often, the subjects complained of anxiety symptoms and sleep disorders, in addition to somatic symptoms. The risk factors for worsening mental health included female (odds ratio 1.70, 95%CI 1.20-2.40, p = 0.003) and professional inactivity (odds ratio 1.55, 95%CI 1.04-2.31, p = 0.031). On the other hand, the ages of the people surveyed, their relationship status, whether they had children, or the type of university they attended all proved to be insignificant. The following coping strategies had a positive impact on the mental health of the respondents: positive reframing (Z = -2.951; p = 0.003) and seeking emotional support (Z = -2.351; p = 0.019). In contrast, strategies such as self-distraction (Z = 2.785; p = 0.005), denial (Z = 2.948; p = 0.003), venting (Z = 2.337; p = 0.019), self-blame (Z = 5.511; p < 0.001) and behavioral disengagement (Z = 4.004; p < 0.001) were associated with poorer mental health among the respondents.

CONCLUSIONS

1. Of the students surveyed, 33% reported elevated stress levels after two years of the COVID-19 pandemic. 2. The overall mental health of students at Polish universities, as measured by GHQ-28, was significantly worse in the group evaluated after two years of the COVID-19 pandemic, mainly in respect of anxiety symptoms and sleep disorders. 3. Female gender and professional inactivity appeared to be risk factors for the students' worsening mental health, which may be an indication of the need for further research and planning of psychotherapeutic interventions.

Willing and unwilling digital cyborg assemblages: University students talk about mental health apps

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.

One-year incidence, predictors, and accuracy of prediction of suicidal thoughts and behaviors from the first to second year of university

BACKGROUND

Research is scarce on the prospective predictors of first onset suicidal thoughts and behaviors (STB) and the accuracy of these predictors in university students, particularly in low-and-middle income countries. Therefore, we assessed the 1-year incidence of STB among first-year students, a broad range of prospective predictors of STB incidence, and evaluated the prediction accuracy of a baseline multivariate risk prediction model to identify students at highest risk for STB onset over the subsequent 12 months.

METHODS

Students (n = 3238) from 13 universities in Mexico completed an online survey developed for the World Mental Health International College Student Surveys in their first year and again 12 months after. We ran generalized linear models and receiver operator curves.

RESULTS

The 1-year incidence of suicidal ideation, plan and attempt was 8.53%, 3.75%, and 1.16%, respectively. Predictors in final models were female sex (ideation only), minority sexual orientation (ideation only), depression, eating disorders, ADHD (ideation and plan), ongoing arguments or breakup with a romantic partner (ideation only), emotional abuse (ideation only), parental death (ideation, plan), not Catholic/Christian (ideation, plan), not having someone to rely on, psychotic experiences (plan only), and insufficient sleep (attempt only). Prediction accuracy for ideation, plan and attempt was area under the curve = 0.76, 0.81 and 0.78, respectively. Targeting the top 10% of students at highest risk could reduce STB in the subsequent year up to 36%.

CONCLUSIONS

By assessing these risk/protective factors in incoming students we identified students at greatest risk for developing STB to whom suicide prevention strategies could be targeted.

The Impact of Ashwagandha on Stress, Sleep Quality, and Food Cravings in College Students: Quantitative Analysis of a Double-Blind Randomized Control Trial

The purpose of this study was to examine the impact of ashwagandha (ASH) (Withania somnifera) on sleep, perceived stress, and cravings in a college student population. Sixty healthy students were screened/enrolled into a 30-day double-blinded placebo (PLA)-controlled intervention (700 mg daily, full spectrum extract of ASH root). Anthropometrics, demographics, and validated questionnaires assessing physical activity, restorative sleep, perceived stress, and food cravings were assessed before and after the study. Descriptive statistics, Pearson's correlations, and point biserial correlations were used to screen the data. For sleep and stress, a nonsignificant mixed (group × time) multivariate analysis of variance (MANOVA) was followed by one-way MANOVA (time on sleep/stress) and one-way multivariate analysis of covariance (MANCOVA) (group on sleep/stress, using initial sleep as a covariate) as follow-up tests. Further follow-up tests for this MANCOVA showed group membership affected final sleep (58.4 ± 12.4 vs. 48.2 ± 15.0 ASH vs. PLA respectively, P < .05) using initial sleep as a covariate. Initial sleep (confounder) affected final stress, but not final sleep. Mixed analysis of variance (group × time) showed an interaction effect on food cravings, where the ASH group experienced lower cravings than the PLA group over time at end of study. The 30-day intervention was shorter than most other studies where more pronounced stress differences were seen at six weeks, indicating ASH may need the longer time period to show more pronounced stress relieving differences. ASH can be an effective safe intervention in young adult populations to help manage stress and its detrimental impacts on sleep and satiety in as little as 30 days. Clinical Trial Registration number-NCT05430685.

Understanding Aotearoa New Zealand University Students Intentions to Seek Help If Experiencing Mental Distress: A Comparison of Naturalistic and Interventional Findings

University students globally are consistently identified as a vulnerable group for mental distress and suicide. Despite this, students report low engagement in help-seeking behaviours. This series of studies aimed to assess barriers to help-seeking for students and the impact of an intervention that sought to increase support-seeking intentions. In Study 1, 373 undergraduate psychology students completed items related to depression, anxiety, suicidal ideation, stigma, and help-seeking intentions. In Study 2, 133 undergraduate psychology students were randomly allocated into one of three intervention groups (control, infographic, video) and completed measures as used in Study 1. Despite experiencing clinically relevant symptoms and recent suicidal ideation, students in Study 1 tended to report low intentionality to seek help, citing perceptions that their distress was not serious enough or a desire to handle their issues independently. In Study 2, an infographic about different support services increased student's intentions to access support services and reduced their perception that their issues were not serious enough. Overall, Aotearoa New Zealand students endorsed similar barriers to help-seeking as students in other countries. Importantly, we demonstrated that a simple infographic intervention reduced perceptions regarding these common barriers and may increase students' knowledge about when to seek help.

Association of parental death and illness with offspring suicidal ideation: cross-sectional study in a large cohort of university students

PURPOSE

The aim of this study was to (1) investigate the association of parental death and illness with suicidal ideation using a large sample of university students and (2) test whether associations were moderated by perceived family support.

METHODS

We used data from N = 15,008 French university students enrolled in the i-Share cohort (mean age, 20.5 years; 77% women). Students self-reported information on parental death, including the cause, parental illness (cardiovascular, stroke, cancer, depression/anxiety, alcohol abuse), and perceived family support during childhood/adolescence. Twelve-month suicidal ideation was self-reported and categorized into no, occasional, and frequent ideation.

RESULTS

Occasional and frequent suicidal ideation were, respectively, reported by 2692 (17.5%) and 699 (4.6%) students. After adjustment for age, gender, and parental education, we found associations between parental death and risk of occasional and frequent suicidal ideation (respectively, RR = 1.98 [1.81-2.17] and RR = 2.73 [2.30-3.24]). Parental deaths from illness, accidents, and suicides had the strongest associations. We also found associations for parental depression/anxiety (occasional, RR = 1.98 [1.81-2.17]; frequent, RR = 2.73 [2.30-3.24]), alcohol use problems (occasional, RR = 1.71 [1.5-1.94]; frequent, RR = 2.33 [1.89-2.87]), and cardiovascular diseases (occasional, RR = 1.22 [1.06-1.40]; frequent, RR = 1.83 [1.47-2.27]). For participants who experienced parental death and stroke, associations with occasional and frequent suicidal ideation (respectively) increased as perceived family support increased (Ps_interaction ≤ 0.005).

CONCLUSIONS

Students who experienced parental death and common parental illnesses were at risk of reporting suicidal ideation, especially if their family were perceived as an important source of support. As information on parental death or illness can be routinely collected during health visits, attention should be paid to students reporting such experiences.