Mental health problems in college freshmen: Prevalence and academic functioning

Exploring mental health stigma among Indonesian healthcare students towards individuals with mental illnesses: a qualitative study

BACKGROUND

The social disapproval or stigma surrounding mental illness contributes to the postponement of individuals seeking assistance and frequently undermines therapeutic alliances between mental illness sufferers and health care professionals.

AIMS

This study explored perceptions and attitudes towards individuals with mental illness among college healthcare students in Indonesia.

METHODS

This study used a qualitative method. Twenty five students enrolled in six healthcare programs were interviewed using a semi structured format. The data analysis adopted a thematic analysis.

RESULTS

Our thematic analysis generated four main themes: (1) general perceptions of mental health and mental illness; (2) knowledge about mental illness; (3) mental health stigma; and (4) mental health stigma campaigns.

CONCLUSIONS

The participants exhibited positive perceptions of mentally ill people. Students understood mental health, and they exhibited positive attitudes toward mentally ill people. Some students have stigma and lack of confidence to assist those who have mental illness. Further efforts are required to acquaint students with mental health issues and facilitate their interaction with mentally ill individuals. Anti-stigma campaigns are required to combat the pervasive stigmatization of individuals with mental illness. It is recommended to conduct a more extensive study about the stigma that students encounter in relation to mentally ill individuals.

Academic self-efficacy and cognitive strategy use in college students with and without depression or anxiety

OBJECTIVE

This study examined whether college students with and without depression or anxiety differed in subjective cognitive concerns, academic self-efficacy, and cognitive strategy use.

PARTICIPANTS

Participants included 582 college students (M = 19.0 ± 1.0 years-old, 79.4% women, 81.9% White).

METHODS

Participants completed online self-report questionnaires on subjective cognitive functioning, academic self-efficacy, cognitive strategy use, and depression and anxiety symptoms, which were used to categorize participants as having anxiety or depression based on established clinical cutoffs.

RESULTS

Participants with anxiety or depression reported greater subjective cognitive concerns and lower academic self-efficacy compared to participants without anxiety or depression, but these groups differed only modestly in cognitive strategy use.

CONCLUSIONS

Despite greater cognitive concerns, participants with anxiety or depression reported only modestly greater cognitive strategy use. Future research should evaluate interventions to increase strategy use among college students with anxiety or depression, tailoring these interventions for modern students by incorporating telehealth approaches and smartphone use.

Exploring the effects of COVID-19-related traumatic events on the mental health of university students in Brazil: A cross-sectional investigation

University students are vulnerable to mental health issues during their academic lives. During the COVID-19 pandemic, university students faced mental distress due to lockdowns and the transition to e-learning. However, it is not known whether these students were also affected specifically by COVID-19-related traumatic events. This study examined the impact of COVID-19-related traumatic events on 2277 university students from two federal institutions of higher education in Brazil. The university students completed an online questionnaire covering demographics, lifestyle habits, health characteristics, COVID-19-related traumatic events, and depression, anxiety, and stress symptoms. The results showed that an increased intensity of COVID-19-related traumatic events was positively associated with stress, anxiety, and depressive symptoms, and each specific type of event was associated with these symptoms. In addition, we found a negative association between these symptoms and male sex and age and a positive association with having or having had a history of cardiovascular, respiratory, neurological, or mental disorders or another disease diagnosed by a physician. In conclusion, this study emphasizes the heightened risk of mental health issues in university students in the face of COVID-19-related traumatic events. Women, young people and people who have or have had a history of disease were the most vulnerable to mental health issues during the COVID-19 pandemic.

Therapeutic Assessment in a University Counseling Center: A Replicated Single-Case Time-Series Pilot Study

In this study, we pilot tested Therapeutic Assessment (TA) in a university counseling center using a replicated single-case design to generate hypotheses on the effectiveness and applicability for this setting and population. We aimed to see whether TA could be an effective brief intervention to address students' presenting mental health concerns. Further, we explored whether different types of presenting concerns were associated with differential symptomatic improvement during the intervention. An independent clinician interviewed participants before the baseline period to develop individualized rating scales pertaining to their presenting concerns. Eight consecutive students accessing the counseling center enrolled in the study and rated their presenting problems across baseline, intervention, and follow-up periods. The intervention involved five TA sessions. The results suggested that TA is associated with statistically significant reductions in clients' symptoms in the context of a university counseling center. Idiographic trajectory analysis of participant data who experienced significant and insignificant change was used to test whether changes were associated with the onset of TA. The findings suggest TA might be more effective for certain presenting concerns than for others. The implications for the implementation of TA in university counseling centers is discussed.

Nursing student perspectives on improving mental health support services at university in Saudi Arabia - a qualitative study

BACKGROUND

University students' needs for mental health (MH) services are an important aspect of academic success or failure. Nursing students enrolled at Saudi Arabian universities in need of MH care encounter obstacles in accessing this type of care.

AIMS

The present work explores students' views and suggestions about the existing problems surrounding university students' MH and well-being support services.

METHODS

Twenty students enrolled in a Master of Nursing program were recruited as research participants. Individual interviews of students' perceptions of the needs and availability of MH services during their studies provided inductive data. These data were analysed through a constructivist thematic method.

FINDINGS

Three major themes and sub-themes regarding the issues and possibilities of MH services were distinguished from the research data, namely, social implications, access and opportunity, and ways to improve care. Participants emphasised a need for a university-wide approach to reforming MH services to provide students with the required support and alleviate service demand by qualified professionals.

CONCLUSION

The present work underscores the need for provision of good quality MH care for university students and health promotion which strives to reduce stigma related to MH care.

Did childhood adversity increase the vulnerability of university students to the negative mental health impact of the COVID-19 pandemic?

OBJECTIVE

To examine a potential synergistic effect of history of childhood adversity and COVID-19 pandemic exposure on the association with mental health concerns in undergraduate students. Participants: We used U-Flourish Survey data from 2019 (pre-pandemic) and 2020 (during-pandemic) first-year cohorts (n = 3,149) identified at entry to a major Canadian University.

METHODS

Interactions between childhood adversity (physical and sexual abuse, and peer bullying) and COVID-19 pandemic exposure regarding mental health concern (depressive and anxiety symptoms, suicidality, and non-suicidal self-harm) were examined on an additive scale.

RESULTS

We found a positive additive interaction between physical abuse and pandemic exposure in relation to suicidality (combined effect was greater than additive effect (risk difference 0.54 vs. 0.36)). Conversely, less than additive interactions between peer bullying and pandemic regarding depression and anxiety were observed.

CONCLUSIONS

Childhood adversities have diverse reactions to adult stressor depending on the nature of the childhood adversity and the mental health outcomes.

User Experiences of Well-Being Chatbots

OBJECTIVE

The current paper conducted two parallel studies to explore user experiences of well-being conversational agents (CAs) and identify important features for engagement.

BACKGROUND

Students transitioning into university life take on greater responsibility, yet tend to sacrifice healthy behaviors to strive for academic and financial gain. Additionally, students faced an unprecedented pandemic, leading to remote courses and reduced access to healthcare services. One tool designed to improve healthcare accessibility is well-being CAs. CAs have addressed mental health support in the general population but have yet to address physical well-being support and accessibility to those in disadvantaged socio-economic backgrounds where healthcare access is further limited.

METHOD

Study One comprised a thematic analysis of mental health applications featuring CAs from the public forum, Reddit. Study Two explored emerging usability themes of an SMS-based CA designed to improve accessibility to well-being services alongside a commercially available CA, Woebot.

RESULTS

Study One identified several themes, including accessibility and availability, communication style, and anthropomorphism as important features. Study Two identified themes such as user response modality, perceived CA role, question specificity, and conversation flow control as critical for user engagement.

CONCLUSION

Various themes emerged from individuals' experiences regarding CA features, functionality, and responses. The mixed experiences relevant to the communication and conversational styles between the CA and the user suggest varied motivations for using CAs for mental and physical well-being.

APPLICATION

Practical recommendations to encourage continued use include providing dynamic response modalities, anthropomorphizing the chatbot, and calibrating expectations early.

Differences in mental health problems in LGBT+ first year college students in Chile during the pandemic

PURPOSE

To examine the differences in mental health problems by sexual orientation and gender identity in first-year university students in Chile during the pandemic.

METHODS

7,213 first-year students aged 18 years and older from five universities participated as part of the World Mental Health - International College Student initiative in Chile. Students completed an online self-report survey between 2020 and 2021 that included measures of lifetime and 12-month major depressive episode, generalized anxiety disorder, panic disorder, bipolar disorder, drug abuse/dependence, alcohol dependence, non-suicidal self-injuries, and suicidal risk. Prevalence of mental health problems were estimated and the differences by sexual orientation and gender identity were examined using logistic and multinomial logistic regression models.

RESULTS

Between 84.1% and 98% of lesbian, gay, bisexual, trans, and other sexual and gender minority (LGBT+) students screened positive for at least one lifetime mental health problem and between 67.6% and 90.6% for two or more problems. For most outcomes, non-heterosexual (Odds Ratio [OR] between 1.25 and 7.00) and trans and gender nonconforming students (OR between 1.72 and 5.81) had significantly higher odds of positive screening for lifetime mental health problems than heterosexual and cisgender students, respectively. Similar results were observed for 12-month mental health problems.

CONCLUSION

The results show differences in the prevalence of mental health problems in LGBT+ university students in Chile, which are consistent with those found in other countries. These results may be useful for planning interventions to improve the mental health of LGBT+ students.

Public Health Challenges for Post-secondary Students During COVID-19: A Scoping Review

Research about public health impacts of COVID-19 on post-secondary students is slowly beginning to emerge. This scoping review identified common public health challenges among post-secondary students in higher-income countries during the COVID-19 pandemic. Five databases were searched to find relevant peer-reviewed literature up to March 2022. Results were categorized according to reported public health challenges and relevant socio-economic variables. After screening, 53 articles were reviewed. Most articles were from the USA (39/53). The seven main public health challenges identified were mental health (35/53), financial instability (25/53), physical health (13/53), food insecurity (12/53), social well-being (8/53), digital access (7/53), and housing or relocation (6/53). Students with low socioeconomic status experienced heightened public health challenges. This review offers insight and opportunities for the development of longitudinal tools to support social determinants of health in post-secondary populations in high-income countries and may offer insight into similar experiences for students in other settings.

Emotion Dynamics among Late Adolescents and Emerging Adults: The Role of Maternal Privacy Invasion Perceptions

Prior research suggests that youth experience immediate emotional distress following privacy invasion, but it is unclear whether and how persistent privacy invasion over longer periods destabilizes the intrapersonal emotional regulatory functions that privacy serves. This study investigated whether late adolescents and emerging adults who reported different patterns of maternal privacy invasion over a full academic year showed differences in emotion regulation, as reflected by the frequency and lability of negative and positive emotional experiences. Participants were first-year university students (n = 349; 60.2% female) in Hong Kong, aged 17 to 24 (MT1 = 18.20, SDT1 = 1.10). They self-reported maternal privacy invasion perceptions and negative and positive emotions 16 times, at bi-weekly intervals. Latent class growth analyses divided participants into a Higher Invasion Perceptions group (24.9%), a Moderate Invasion Perceptions group (46.4%), and a Lower Invasion Perceptions group (28.7%). A one-way MANCOVA examined potential differences in negative and positive emotion dynamics across groups, indexed by frequency (means) and instability (mean square of successive differences and probability of acute change). In line with predictions, both the Higher Invasion and Moderate Invasion groups reported higher negative emotion frequency and instability, compared to the Lower Invasion group. However, groups showed no significant differences regarding positive emotion frequency and instability. The findings indicate that perceptions of maternal privacy invasion predict youth's negative emotion regulation processes over their first collegiate year. Prolonged, higher levels of maternal privacy invasion may disrupt the intrapersonal regulatory functions that privacy serves over time.

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.

A feasibility study on indoor therapeutic horticulture to alleviate sleep and anxiety problems: The impact of plants and activity choice on its therapeutic effect

INTRODUCTION

Therapeutic horticulture (TH) is increasingly being applied for sub-health or patient mental health care. Whether plant and activity type will affect TH's effectiveness is unclear.

AIM

To evaluate the feasibility of an indoor TH for alleviating the anxiety symptoms and sleeping problems of people with poor sleep quality, and explore the potential affection of plant and activity type on health benefits.

METHOD

Thirty subjects (all with sleep problems and half with anxiety problems) were randomly assigned to three groups to do horticultural activities with ornamental plants, general aromatic plants, or aromatic plants with reported mental health functions, respectively. Six indoor TH activities were then held sequentially within two weeks. Psychological scales, subjective feedback questionnaires, and physiological indicators were used as evaluation indexes before and after horticulture activities.

RESULTS

The TH relieved subjects' sleep and anxiety problems and was particularly effective in alleviating anxiety among people with high anxiety levels. Using ornamental plants was more effective in relieving stress while functional aromatic plants performed better in sleep improvement and satisfaction to TH. Each horticultural activity could improve mood state but showed different effects on the vitality of the participants.

CONCLUSION

The above findings provided some basis for the potential benefits of selecting plants and activities based on psychological care needs in the development of TH plans. Future research that expands upon the current project is warranted. A larger sample size is beneficial for obtaining more powerful statistical results.

Substitutions of physical activity and sedentary behavior with negative emotions and sex difference among college students

BACKGROUND

A growing number of studies have found that physical activity (PA) benefits mental health, and sedentary behavior (SB) increases the risk of psychological symptoms, but it remains unclear whether substituting the duration of different activities may affect the association, and whether sex difference exists among college students.

METHODS

A longitudinal survey was conducted in three colleges in Anhui province, China. A total of 8049 participants validly answered the questionnaire, which included demographic variables, PA, SB and negative emotions (depressive, anxiety, and stress symptoms).

RESULTS

Substituting 30 min per day of SB with equivalent walking was associated with lower scores of depressive symptoms. Stress symptoms were reduced when SB was substituted by moderate intensity PA (MPA) and walking. Substituting 30 min per day of MPA in place of walking and SB was associated with an amelioration of depressive and stress symptoms in females, and a reallocation of 30 min walking was associated with lower depressive and stress symptom scores when SB was replaced in males.

CONCLUSIONS

Replacing SB with walking and MPA ameliorates the depressive and stress symptoms in young adults. The results suggest a reallocation of time from SB or walking to MPA in females while from SB to walking in males may markedly reduce the depressive and stress symptoms in college population.

The comorbid network characteristics of anxiety and depressive symptoms among Chinese college freshmen

BACKGROUND

This study aimed to investigate the interplay between anxiety and depressive symptoms in Chinese college freshmen using the causal system perspective (CSP), which differs from the traditional common cause perspective (CCP) by providing an alternative explanation by attributing comorbidity to direct interactions among symptoms.

METHODS

A convenience sample of 2,082 Chinese college freshmen (39.51% male, Mage = 18.61) from a normal university completed the Generalized Anxiety Disorder 7-Item Scale (GAD-7) and the Patient Health Questionnaire (PHQ-9). Network analysis was conducted and evaluated as to centrality, stability, node predictability, and bridging features. Moreover, the moderated network model (MNM) was utilized to detect the moderation effects of gender in the comorbidity network.

RESULTS

The network of anxiety and depressive symptoms exhibited stability, characterized by the core symptoms of "restlessness", "lack of energy", and "excessive worry about control", as well as the bridging symptoms of "fearfulness", "sad mood", and "irritability". Notably, the nodes representing "uncontrollable worry" and "difficulty in relaxation" demonstrated the highest predictive power. Gender did not exert any moderating effects on the anxiety and depressive symptom network.

CONCLUSION

These results reinforce that certain anxiety or depressive symptoms are more central than others, and thus play a more vital role in the comorbid network. These findings highlight underlying potential targeting symptoms to consider in future interventions.

Barriers to mental health service utilisation among medical students in Saudi Arabia

Introduction

Medical students experience high levels of stress, often due to academic demands, which can adversely affect their mental health. However, they frequently hesitate to seek and underutilise available mental health services. This study aimed to assess the perceived need for mental health services and identify the barriers to seeking help among undergraduate medical students.

Materials and methods

This cross-sectional study recruited 480 undergraduate medical students from two main universities in the Eastern Province of Saudi Arabia. Data were collected through an online, self-administered questionnaire that encompassed sections on sociodemographic details, the Patient Health Questionnaire (PHQ-9), perceptions about the necessity for professional mental health care, service utilisation over the past year, and the Barriers to Access to Care Evaluation (BACE-III).

Results

The study found that 33.6% of the participants showed signs of depression. Even though 42.5% expressed a perceived need for mental health services, only 16.2% actually utilised these services in the previous 12 months. In terms of barriers, attitudinal-related barriers received the highest mean score, followed by stigma- and instrumental-related barriers. Notably, students who had previously experienced academic failure and those who had sought mental health services were more inclined to report stigma- and instrumental-related barriers.

Conclusion

Mental health challenges are notably prevalent among undergraduate medical students. Although there is a significant perceived need for professional mental health intervention, the actual utilisation rate remains low. The primary obstacles to seeking assistance are attitudinal and stigma-related barriers.

Relationship between Psychosocial Factors and Physical Activity among Undergraduate Students from a South African University

Psychosocial factors such as mental health, motivation, and social support are key determinants of behavior that play a significant role in physical activity participation. Limited studies have investigated the relationship between psychosocial factors and physical activity among university students in Africa. The aim of this study was to determine the relationship between psychosocial factors and physical activity participation among undergraduate university students at a historically disadvantaged university (HDU) in South Africa. This was a cross-sectional study that used convenience sampling (n = 534, majority female, 53.6% with a mean age of 20.69). The study was conducted through an online, self-administered, and hard-copy, valid questionnaire in September 2022. Data on sociodemographic information were collected. Psychosocial factors were assessed using the Depression, Anxiety, and Stress-21 Scale for mental health, the Physical Activity and Leisure Motivation Scale for motivation, and the Perceived Social Support Scale for social support. Physical activity (calculated as MET-min/week) was assessed using the international physical activity questionnaire in short form. Results revealed that almost a third (29%) of undergraduate students were physically inactive, 31.1% were minimally active, and 39.9% were in the health-enhancing category. Physical activity was positively related to stress (r = 0.11, p < 0.05) and anxiety (r = 0.10, p < 0.05). Motivational factors were positively related to psychological condition and others' expectations (r = 0.10, p < 0.05), and depression and others' expectations (r = 0.11, p < 0.05). Results from this study highlighted that psychosocial factors were related to physical activity participation among undergraduate university students. Psychosocial factors should be considered a coping mechanism when implementing health-promoting strategies.

The mental and physical health correlates of psychotic experiences among US college students: Findings from the Healthy Mind Study 2020

BACKGROUND

Psychotic experiences have been framed as a marker of mental and physical health status; however, more research is needed to confirm these associations in university populations.

METHODS

We analyzed data from the Healthy Minds Survey (Fall Semester Cohort 2020), which is a non-probability sample of students attending one of 28 universities in the United States, who completed an online survey (September 2020-December 2020). We used multivariable logistic regression to examine the associations between several mental and physical health conditions and psychotic experiences, adjusting for age, gender, sexual orientation race/ethnicity, and international student status.

RESULTS

In terms of mental health, all conditions were associated with greater odds of having lifetime psychotic experiences. Having at least one mental health condition was associated with 2.18 times greater odds of having lifetime psychotic experiences (aOR: 2.18; 95% CI: 1.96-2.42). In terms of physical health, having at least one physical health condition was associated with 1.37 times greater odds of having lifetime psychotic experiences (aOR: 1.37; 95% CI: 1.22-1.53), but only four conditions were associated with greater odds of lifetime psychotic experiences, which were: asthma, gastrointestinal disease, HIV/AIDS, and other chronic disease. The counts of mental and physical health conditions were associated with greater odds of lifetime psychotic experiences in a dose-dependent fashion.

CONCLUSION

Psychotic experiences appear to be an indicator for mental health problems and some physical health problems. More research is needed to determine whether assessing for psychotic experiences broadly can help identify at-risk individuals in university settings who may benefit from targeted preventive interventions.

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.

Long-term effects of combined mindfulness intervention and app intervention compared to single interventions during the COVID-19 pandemic: a randomized controlled trial

Objectives

The study examines the short-, middle-, and long-term effects of a combined intervention (face-to-face mindfulness intervention plus the mindfulness app 7Mind), compared to single interventions (face-to-face mindfulness intervention alone and an intervention via app 7Mind alone). The subgroups were compared with an active control group on mindfulness, mindful characteristics, mental health, emotion regulation, and attentional abilities during the COVID-19 pandemic. Additionally, the study explores whether students' engagement with the app and their formal mindfulness practice at home improves intervention outcomes.

Methods

The study employs a randomized controlled trial approach involving three intervention groups and an active control group, with two follow-ups conducted over 12 months. The study included 177 university students who were randomly assigned to a mindfulness group (n = 42), a mindfulness app group (7Mind app, n = 44), a mindfulness + app group (n = 45), and an active control group (n = 46). The duration of the interventions was 4 weeks. The outcome variables were assessed at pre- and post-intervention, at 4 and 12 months post-intervention.

Results

At post-intervention and during both follow-ups, students in the combined mindfulness intervention did not demonstrate better outcomes compared to students in the single interventions or the active control group across all measures. Additionally, no statistically significant difference was observed between all interventions and the active control groups on any of the measures. However, it is noteworthy that all intervention groups and the active control group exhibited improvement in mindfulness, body awareness, emotion regulation, stress, and attentional abilities over the short, medium, and long term. Moreover, higher app usage in the app groups was significantly associated with increased body awareness. However, greater app use was also correlated with higher stress.

Conclusion

The results suggest that the mindfulness intervention and the mindfulness app were similar to the active control condition (communication training) on the investigated variables in the short, medium, and long term. Furthermore, an increased use of a mindfulness app can negatively affect stress.

Implementation of a computerized tool to address barriers to academic success among college students

OBJECTIVE

Academic assistance professionals work with college students to address barriers to academic success, although few assessment tools exist. This feasibility study examined the results of implementing a computerized tool for academic assistance professionals to help students. The Measure of Obstacles to Succeeding Academically in College (MOSAIC) is a 31-item risk assessment tool used to characterize academic barriers. It utilizes a tailored computer algorithm on a mobile device to match students with resources to address academic barriers.

METHODS

The MOSAIC was customized and administered at seven universities around the United States. Student responses were analyzed in Microsoft Excel. Academic assistance professionals were asked about implementation in unstructured interviews.

RESULTS

Stress and study skill concerns were the most reported barriers. The MOSAIC was well received, especially among students experiencing academic difficulties, but integration into routine workflow was an obstacle to sustained implementation.

CONCLUSIONS

The MOSAIC holds promise in addressing issues impeding academic success.

Prevalence of suicidal thoughts and behaviors among young adults between 2000 and 2021: Results from six national representative surveys in France

The study examines the prevalence of 12-month suicidal thoughts and lifetime suicide behaviors among young adults between 2000 and 2021. Data were drawn from the Health Barometer survey, a cross-sectional survey on a French national representative sample. The 2000, 2005, 2010, 2014, 2017, and 2021 survey waves were pooled to examine time trends in 12-month suicidal thoughts and lifetime suicidal behaviors among respondents aged 18 to 25 (n = 13,326), categorized based on sex and on their occupational status: students, those employed, and those who are neither in employment, education or training (NEETs). The 12-month prevalence of suicidal ideation among young adults in 2021 (6.8 %) is no different from that of 2000 (7.0 %), despite a U-shape curve in between. In contrast, the overall prevalence of lifetime suicide attempts was significantly higher in 2021 as compared to what was observed on average in the previous 21 years. In multivariate models, females and NEETs were overall at greatest risk for suicidal ideation and suicidal behaviors. Additional attention and prevention efforts are needed to reach young adults who are neither in employment, education or training.

Transdiagnostic and tailored internet intervention to improve mental health among university students: Research protocol for a randomized controlled trial

BACKGROUND

Emerging adulthood is often associated with mental health problems. About one in three university students report symptoms of depression and anxiety that can negatively affect their developmental trajectory concerning work, intimate relationships, and health. This can interfere with academic performance, as mood and anxiety disorders are key predictors of dropout from higher education. A treatment gap exists, where a considerable proportion of students do not seek help for mood and anxiety symptoms. Offering internet interventions to students with mental health problems could reduce the treatment gap, increase mental health, and improve academic performance. A meta-analysis on internet interventions for university students showed small effects for depression and none for anxiety. Larger trials are recommended to further explore effects of guidance, transdiagnostic approaches, and individual treatment components.

METHODS

This study will offer 1200 university students in Sweden participation in a three-armed randomized controlled trial (RCT) evaluating a guided or unguided transdiagnostic internet intervention for mild to moderate depression and anxiety, where the waitlist control group accesses the intervention at 6-month follow-up. Students reporting suicidal ideation/behaviors will be excluded and referred to treatment within the existing healthcare system. An embedded study within the trial (SWAT) will assess at week 3 of 8 whether participants in the guided and unguided groups are at higher risk of failing to benefit from treatment. Those at risk will be randomized to an adaptive treatment strategy, or to continue the treatment as originally randomized. Primary outcomes are symptoms of depression and anxiety. Follow-ups will occur at post-treatment and at 6-, 12-, and 24-month post-randomization. Between-group outcome analyses will be reported, and qualitative interviews about treatment experiences are planned.

DISCUSSION

This study investigates the effects of a transdiagnostic internet intervention among university students in Sweden, with an adaptive treatment strategy employed during the course of treatment to minimize the risk of treatment failure. The study will contribute knowledge about longitudinal trajectories of mental health and well-being following treatment, taking into account possible gender differences in responsiveness to treatment. With time, effective internet interventions could make treatment for mental health issues more widely accessible to the student group.

Associations of mental well-being with higher education-related stress and orientation of the academic goals among nursing students: A cross-sectional study

To investigate the association between the mental health of nursing students, the stress of higher education, and academic goal orientation. At a medical college, 1170 nursing students volunteered for this cross-sectional survey. The Warwick-Edinburgh Well-being Scale, the Higher Education Stress Scale, and the Academic Goal Orientation Questionnaire were utilised to collect data. Descriptive statistics, ANOVA, and Pearson correlation analysis were all performed to evaluate the data. The significance level for all statistical tests was p < 0.05. A total of 1126 valid samples, with a 96.23% effective recovery rate. The Higher Education Stress Scale score for nursing students was (38.31 ± 8.29), the Academic Goal Orientation Questionnaire result was (49.32 ± 9.62), and the Mental Health Scale value was (31.24 ± 14.00). Overall, there was a strong relationship between the stress associated with higher education, academic goal orientation, and the mental health of nursing students. Therefore, in future interventions, the Chinese government and its relevant educational authorities can enhance nursing students' ability to reasonably regulate stress related to higher education and set clear academic goals by adjusting the strategies for regulating nursing students' academic stress and increasing the number of academic goal-oriented courses to improve their mental health.

Mental and physical health among students at a private university that held in-person classes during the COVID-19 pandemic

OBJECTIVE

The COVID-19 pandemic is expected to have serious negative consequences on mental and physical health, which may disproportionally affect young adults. The aim of this study was to understand short-term impacts on a population of students at a college that held in-person classes during the pandemic.

PARTICIPANTS

This study was conducted at a moderately-sized private university in the southeastern United States where approximately 75% of students were enrolled in undergraduate degree programs and 25% in graduate degree programs.

METHODS

A survey was created to assess anxiety and depression symptoms, psychotherapeutic medication use, healthy living, and coping skills. Links to the electronic form were distributed to students via email in Spring 2020 and Fall 2020. Participation was completely voluntary and responses were collected anonymously.

RESULTS

The rate of anxiety symptoms in the study cohort was higher than the national average (31%) and increased between Spring 2020 (39%) and Fall 2020 (50%). Rates of psychotherapeutic medication use also rose, with benzodiazepine use increasing from 6% to 11% and antidepressant use increasing from 16% to 20%. Compared to the national average, fewer students in the study cohort rated their overall health as "good" or better (72-76% vs. 82%). Physical exercise, nutrition, and alcohol use worsened between Spring and Fall 2020. Problem-focused engagement was associated with significantly fewer anxiety and depression symptoms. Demographic factors such as gender, race, and sexual orientation interacted with several outcomes studied.

CONCLUSIONS

Students at a private university that held in-person classes during the COVID-19 pandemic reported high rates of anxiety that increased between Spring and Fall 2020. Self-reported physical health was below average in Spring 2020 but improved in Fall 2020. Appropriate identification and management of the effects of pandemic-related stressors is critical during this uncertain time.

Supplemental data for this article can be accessed online at https://doi.org/10.1080/07448481.2022.2052074 .

Unlocking the power of physical activity in easing psychological distress

The severity of the current global mental health situation and the importance of maintaining psychological well-being call for more powerful, convenient, and efficient solutions for addressing psychological issues and relieving mental stress. Physical activity not only effectively improves physical fitness and reduces negative emotions such as anxiety and depression but also increases the improvement of psychological health and sense of well-being. At the same time, physical activity interventions for mental health have unique advantages, including reducing the side effects of psychological interventions and increasing necessity, convenience, and cost-effectiveness, as well as flexible adaptability across multiple methods, groups, and age ranges, providing stronger support for relieving psychological stress and addressing psychological issues. Although physical activity is an important intervention measure in relieving psychological stress, its value and role in mental health care seem to have not yet received sufficient attention, and its potential remains to be further revealed. Given the significant advantages and effectiveness of physical activity in mental health intervention practices, it is necessary to stimulate its potential in relieving psychological stress through various means in future studies to better safeguard the public's physical and mental health. Developing guidelines for physical activity for improved mental health, enhancing organic integration with other inter-vention measures, and providing necessary respect, encouragement, and support are important directions to consider.

A motivational approach to understanding problematic smartphone use and negative outcomes in university students

Considering the rising integration of smartphones into classrooms, the purpose of this research was to explore the relationship between problematic smartphone use (PSU) and negative outcomes through the lens of self-determination theory. This study examined 1,039 students' reported academic motivation, PSU, anxiety, insomnia, and perceived stress. The first objective of this study was to examine how motivational orientations could predict PSU. Then, we examined how motivational orientations and PSU, when used as a mediating variable, could be modeled to predict negative student mental health outcomes (anxiety, insomnia, and perceived stress). As predicted, statistically significant results suggested that autonomous academic motivation was associated with less PSU (β = -0.16), as well as less anxiety (β = -0.12), insomnia (β = -0.16), and stress (β = -0.10). In contrast, higher levels of controlled academic motivation were associated with more PSU (β = 0.37), as well as higher levels of anxiety (β = 0.49) and insomnia (β = 0.41). Amotivation was also positively related to PSU (β = 0.17), anxiety (β = 0.36), insomnia (β = 0.62), and stress (β = 0.22). All indirect effects (mediation effects) were statistically significant and in the predicted direction: the impact of autonomous motivation on negative outcomes was mediated by lower levels of PSU while controlled motivation and amotivation were mediated by higher levels of PSU. Overall, this study advanced the understanding of PSU in university classrooms by demonstrating a link with academic motivation and mental health outcomes.

The effect of fear of contagion/being contagious on depression, anxiety and stress levels of university students during the COVID-19 pandemic

BACKGROUND

University students are generally quite active in social life. It is thought that their fear of contagion/being contagious will affect their depression, anxiety and stress levels due to the removal of restrictions and the increase in individual responsibilities. This study aims to determine the effect of fear of contagion/being contagious on depression, anxiety and stress levels of university students during the COVID-19 pandemic.

METHODS

This study, descriptive and cross-sectional. Quantitative data were collected using the Demographic Information Form, the Fear of Contagion/Transmission Scale and the Depression-Anxiety-Stress Scale. The sample included 3500 participants. Descriptive statistics were used for the presentation of the results. The STROBE checklist for cross-sectional studies was used in this study.

RESULTS

This study revealed that the depression, anxiety and stress levels of university students were above normal, and these results were mostly associated with females, those with a chronic disease and high fear of contagion/being contagious.

CONCLUSION

The findings of this study may be useful for precautionary plans to support the psychological health of university students after the COVID-19 pandemic and in the fight against possible new pandemics. Considering the findings of our study, educational programs should be planned for youth in general and university students in particular to deal with depression, anxiety, stress and fears.

RELEVANCE TO CLINICAL PRACTICE

The depression, anxiety and stress levels of university students were above normal. As the fear of contamination and contagion increases, the level of depression, anxiety and stress increases. Those with chronic diseases have high levels of depression, anxiety and stress.

PATIENT OR PUBLIC CONTRIBUTION

Research data were collected through an online questionnaire. Data collection tools were prepared on Google Forms, and then, links were shared with student groups over social media. Students shared the link on their social platforms, allowing it to reach wider audiences.

Perceived stress and resilience among college students: The roles of self-compassion and anxiety symptomatology

OBJECTIVE

The current study explored the role of self-compassion on the relationship between perceived stress and resilience among college students experiencing different levels of anxiety symptomatology.

PARTICIPANTS

Three hundred and forty-five undergraduate students (Mage= 19.66; 74.8% female) were recruited from a public university in the northeastern United States.

METHODS

Participants completed self-report measures assessing perceived stress, self-compassion, anxiety symptomatology, and resilience.

RESULTS

Self-compassion was found to indirectly affect the association between perceived stress and resilience at both low (b = -0.06, 95% CI [-0.08, -0.04]) and high levels (b = -0.03, 95% CI [-0.05, -0.01]) of anxiety symptomatology. The index of moderated mediation was significant (b = 0.005, 95% CI [0.001, 0.01]).

CONCLUSIONS

Results of the present study suggest that interventions to enhance resilience should incorporate strategies aimed at managing stress and anxiety and increasing self-compassion.

The relationship between life events, life satisfaction, and coping style of college students

We aimed to investigate the life events, life satisfaction, and coping style of college students, and to assess the relationship between them by performing mediating effect analysis. Our findings may provide a scientific basis for promoting the mental health of college students. Students in a medical college were selected using grade-stratified cluster sampling, and administered a standardized questionnaire survey. Out of 2,000 participants, 1827 participants provided valid questionnaires (response rate: 91.4%). The mean scores of life satisfaction and life events were 181.39 ± 30.28 and 19.32 ± 15.62, respectively. The mean score of coping style was 14.34 ± 7.54, which reflected positive coping style. Analysis of life satisfaction, life events, and factor scores showed that different grades, sibling status (whether the respondent was the only child in the family or not), family location, and life events had a significant association with life satisfaction (p < 0.001). There were significant differences in coping style between male and female students, and between students in different grades (p < 0.001). Positive coping style was found to play a partial mediating role between life events and life satisfaction, and the mediating effect accounted for 33.2% of the total effect. These results suggest that both life events and coping styles are related to college students' life satisfaction. The impact of life events on life satisfaction can be adjusted by psychological interventions to develop coping styles that can help promote the mental health of college students.

Interventions for Strengthening General Self-Efficacy Beliefs in College Students: An Integrative Review

OBJECTIVE

To assess the evidence regarding the effectiveness of interventions aimed at strengthening self-efficacy beliefs in college students.

METHODS

Integrative Review conducted on the Lilacs, PubMed, CinahL, Cochrane Collaboration Databases, Scopus, and PsycInfo databases. The methodological quality of the studies was assessed using tools proposed by the Joanna Briggs Institute, and the results were analyzed descriptively.

RESULTS

Out of the 10 selected studies, six demonstrated that interventions aimed at strengthening self-efficacy were effective (Levels of Evidence II and III), and four revealed contrary results (Levels of Evidence I and II). Programs aimed at enhancing self-efficacy should include content on positive mental health, psychoeducation strategies, cover a period of eight to twelve weeks, and consider the completion of homework assignments.

CONCLUSION

The synthesis of evidence pointed to pathways for building an effective self-efficacy strengthening program to be implemented in universities.

Psychological well-being, stressors, coping strategies and support of undergraduate healthcare students amid COVID-19

Background

Students function better academically when psychologically well. The COVID-19 pandemic proved a new challenge to the mental wellness of undergraduate healthcare students. Students were not only faced with academic changes but also had to complete clinical practice in healthcare facilities amid the COVID-19 pandemic.

Aim

This study investigated the psychological well-being, stressors, coping strategies and support of undergraduate healthcare students amid COVID-19.

Setting

A South African university's faculty of health sciences.

Methods

A survey design through a cross-sectional descriptive approach was used to collect data from the population of 1529 undergraduate healthcare students. One hundred and ninety-six (n = 196) students responded to the online survey.

Results

Participants reported a variety of stressors influencing their psychological well-being. Participants chose mostly adaptive coping strategies to deal with stressors. They gave feedback on the support they received from the faculty and institution. Most of the participants indicated they prefer weekly online communication from the higher education institution.

Conclusion

The COVID-19 pandemic influenced the psychological well-being of undergraduate healthcare students. The psychological well-being of these students is a collective responsibility between students and higher education institutions to enable academic success and positive patient outcomes.

Contribution

This study found that undergraduate healthcare students had academic, psychological, financial and other stressors during the COVID-19 pandemic. Higher education institutions, especially those involved in training undergraduate healthcare professionals, in collaboration with students, need to provide students with targeted continued support and training to use healthy coping behaviours to manage various stressors.

Prevalence of co-occurring severe depression and psychotic symptoms in college students and its relationship with childhood maltreatment

BACKGROUND

It has been demonstrated that childhood maltreatment (CM) is associated with an increased risk of depression and psychotic symptoms. However, there is still a lack of studies on the prevalence of co-occurring severe depression and psychotic symptoms (CSDPS) and the association between CM and CSDPS among college students.

OBJECTIVE

We aim to investigate the prevalence and demographic distribution of CSDPS among Chinese college students and to examine its relationship with CM.

PARTICIPANTS AND SETTING

A total of 7351 college students aged 18 and above completed the survey. Finally, 6854 valid questionnaires were included for further analysis.

METHODS

The Childhood Trauma Questionnaire and the item for witnessing domestic violence were used to assess the CM. The Prodromal Questionnaire-16 and the depression subscale of the Depression Anxiety and Stress-21 scale were used to assess psychotic symptoms and depressive symptoms.

RESULTS

The prevalence of CSDPS was 1.47 % among the college students. The multivariate logistic regression analysis showed that emotional abuse and emotional neglect were associated with an increased risk of CSDPS (all p < 0.05). The risk of CSDPS was dramatically increased for individuals who had experienced ≥3 types of CM (OR = 22.929, p < 0.001), as compared to those who had experienced 1-2 types of CM (OR = 4.452, p < 0.001) and those without the experience of CM.

CONCLUSION

CM was found to be associated with an increased risk of CSDPS among the college students. Notably, experiencing more types of CM was also associated with a higher risk of CSDPS.

Internet interventions for perfectionism: a meta-analysis and proposals for the college setting

ObjectiveSuh et al (2019) found that treatments for perfectionism, even online, reduce perfectionism and concomitant psychopathology. This meta-analysis investigated the efficacy of Internet interventions and psychotherapeutic interventions for perfectionism as potential tools for overburdened college counseling centers where perfectionism is particularly prevalent. Method: PubMed, MEDLINE, and PsycINFO were searched for relevant treatment studies. Comprehensive Meta-analysis V3 was used to compute and pool effect sizes for perfectionism and concomitant psychopathology. Results: Psychological interventions (N = 18) for perfectionism yielded significant reductions in perfectionistic strivings (g = .394; n = 16), concerns (g = .603; n = 17), and clinical perfectionism (g = .960; n = 8). Effect sizes were small-to-medium for depression (g = .601; n = 12), anxiety (g = .399; n = 13), and eating disorder symptoms (g = .477; n = 7). Effect sizes were similar for Internet-mediated and non-Internet-mediated interventions. Most interventions used 8-10-session cognitive-behavioral therapy of perfectionism. Conclusion: Internet interventions for perfectionism reduce perfectionism and concomitant psychopathology. College counseling centers could eventually use them to reduce demand for in-person services.

Mental health during COVID-19: College students' need for structure

Objective: College students made the unprecedented shift to remote learning during the COVID-19 pandemic, potentially contributing to escalating anxiety, depression, and suicide. This loss of structure may be a driving factor in students' distress. We examined the relationship between students' mental health, perceived need for structure, and five stressors related to COVID-19. Participants: Students (N = 1319, 76.3% female, 79.8% White) at a southeastern university responded to a survey in spring 2020. Methods: Participants answered questions about global anxiety and depression, suicide, perceived need for structure, and COVID-19 related stressors. Results: Participants reported increased anxiety and depression and elevated suicidality compared to previous studies of student mental health. Findings indicated that the stressors and lack of structure added unique variance toward predicting anxiety and depression. Conclusions: As COVID-19's consequences persist, counseling centers and other stakeholders are urged to work together in providing support for students' mental wellness and stress management.

A Randomized Controlled Trial of the Effects of a Web-Based Intervention on Perceived Stress and Diet Quality Among First-Year University Students

Background

e-Health interventions can potentially improve health care. My Viva Plan® (MVP) is a web-based program that focuses on mindfulness, nutrition, and physical fitness. The aim of this study was to evaluate the effects of this platform on stress indicators and diet quality among first-year university students.

Methods

Ninety-seven university students were enrolled in a randomized, controlled clinical trial. Participants were randomized into control (n = 49) and MVP (n = 48) groups. Perceived stress was measured using the self-report Stress Indicator Questionnaire. Diet quality was assessed by the nutrient-rich foods index, and body composition was assessed by a hand-to-foot, multifrequency, bioelectrical impedance analysis.

Results

There were no differences in physical, sleep, behavioral, emotional, and personal habit indicators between groups. Diet quality and body composition were similar between groups, except among women in the MVP group with decreased body fat (-1.2 ± 2.6 kg, p < 0.05). Participant engagement was low: 50% of the MVP group did not access the platform.

Conclusions

The MVP web-based intervention was not associated with improvements in stress indicators, diet quality, and body composition, likely due to the characteristics of our cohort of healthy young individuals. Future studies should focus on enhancing motivational approaches to explore the potential of e-health interventions that improve health behavior.

Clinical Trial Registration number: NCT03579264A.

College instructors' experiences with undergraduate students who have mental health symptoms: systematic review

OBJECTIVE

to synthesize peer-reviewed research exploring postsecondary instructors' experiences with undergraduate students with mental health (MH) symptoms.

METHODS

English-language, peer-reviewed primary research articles published between 2010 and 2021 were included. Themes and subthemes were analyzed.

RESULTS

Ten articles met criteria. Three themes emerged: Instructor Actions in the Moment, with subthemes Talking with Students, Making Referrals, and Doing Nothing; Processing the Complex Emotional Impact, with subthemes Caring and Confidence, Powerlessness and Apprehension, Struggle with Boundaries, and Worry about Safety; and Needs Unmet by the Institution, with subthemes Wanted Disclosure, Wanted MH Training, Wanted Clear Policies, Wanted Institutional Support, and Wanted Robust Campus Counseling Services. Lack of resources was the major reported impediment.

CONCLUSIONS

Several implications for institutions emerge. MH education should be provided for instructors. Institutions should ensure MH policies are clear and easily accessible. Institutions should acknowledge instructors' efforts with students. Finally, training on applicable laws surrounding student MH should be available.

Mental health literacy and suicidal ideation among Chinese college students: The mediating role of depressive symptoms and anxiety symptoms

BACKGROUND

Mental health literacy (MHL) is essential to mental health. Symptoms of depression and anxiety are significant antecedents and closely related to suicide among college students. Few studies have explored the mediating role of depressive and anxiety symptoms between MHL and suicidal ideation.

METHODS

5578 college students were included in the analysis. The online Wenjuanxing platform was used to collect data from November 2020 to March 2021. The bootstrapping method was used to test the mediating role of depressive and anxiety symptoms in the links between MHL and suicidal ideation.

RESULTS

Approximately 18.8 % of Chinese college students in our study reported having suicidal ideation. MHL exhibited a significant and negative correlation with depressive symptoms, anxiety symptoms, and suicidal ideation, whereas depressive and anxiety symptoms correlated significantly and positively with suicidal ideation. Compared with the lowest MHL quartile, the 3rd and 4th quartiles of MHL were associated with a significantly lower risk of suicidal ideation after adjusting for various confounding factors. Depressive and anxiety symptoms partially mediated the relationship between MHL and suicidal ideation, and the mediating effect of depressive symptoms was significantly greater than that of anxiety symptoms.

LIMITATIONS

This study was a cross-sectional survey. Future longitudinal studies on this relation are needed.

CONCLUSIONS

Depressive and anxiety symptoms mediate the relationship between MHL and suicidal ideation. Comprehensive school-based specific psychological education programs are needed to improve college students' MHL and change their attitudes toward mental health services.

Association Between Combinations of 24-Hour Movement Behaviors and Depression Among Adolescents - Inner Mongolia Autonomous Region, China, 2019-2021

What is already known about this topic?

In recent years, there has been growing concern regarding the escalating rates of depression among adolescents. While certain individual behaviors have been suggested as potential protective factors for mental health, there is a scarcity of research examining the collective influence of 24-hour movement behaviors.

What is added by this report?

This research documented the prevalence of adolescent depression, along with the rates of adherence to 24-hour movement behavior guidelines encompassing moderate to vigorous physical activity, screen time, and sleep time, in the years 2019, 2020, and 2021. A significant correlation was observed between levels of depression and combined health behaviors. Of particular note was the finding that adherence to the "screen+sleep time" recommendation was linked with the lowest risk of depression.

What are the implications for public health practice?

A comprehensive intervention that targets three 24-hour movement behaviors should be accentuated, with the combination of "sleep and screen time" potentially offering the most effective approach to managing depression.

Association between Body Image Flexibility and Intermittent Fasting in Chinese Medical Students: A Cross-Sectional Study

Unhealthy dietary behaviors and body dissatisfaction are becoming increasingly common among college students. Understanding the association between body image flexibility and intermittent fasting is particularly meaningful, especially for medical college students. This study aimed to investigate the association between body image flexibility and intermittent fasting among medical students. We conducted a cross-sectional study with 5138 medical college students at Jitang College of North China University of Science and Technology. Univariate and multivariate logistic regression were used to evaluate the association between body image flexibility and intermittent fasting. Subgroup analysis and interaction tests were further used to examine the possible interaction between body image flexibility and intermittent fasting. In this study, 1329 (25.87%) students had intermittent fasting behavior. After adjustment for confounding factors, there was a negative association between body image flexibility and intermittent fasting (OR = 0.94, 95%CI = 0.93 to 0.95, p < 0.001). A significant interaction between body image flexibility and intermittent fasting was found in gender, academic year, major, and monthly living expenses (p for interaction < 0.05). E-value analysis suggested there was unlikely to be an unmeasured confounding. This association could contribute to the establishment of personalized health intervention strategies and provide recommendations for promoting the physical and mental health of medical students.

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.

COVID-19, stress and mental health: What students expect from academic institutions during a pandemic

Objectives: To learn about the mental health of students, the tools they use to cope with stress, and their perceptions toward the assistance they receive from their academic institutions during the COVID-19 pandemic. Participants: 593 students from two University of California campuses. Methods: The link to an anonymous survey was included in a mass email that was sent to students. Results: 87% of students expressed that their mental health has been negatively impacted by the pandemic, especially in students who already had diminished levels of self-reported mental health. Students articulated the need for increased financial, academic, and mental health support and that they want to have a voice in discussions that will lead to decisions that would impact them. Conclusion: Students reported that the pandemic has negatively impacted their mental health and that they wanted academic institutions to include them in the decision-making processes that would contribute to their health.

COVID-19 Related Stressors, Parent-Child Relationship, and Alcohol Use and Mental Health Profiles Among White and Hispanic/Latinx First-Year College Students

Transitioning to college during the novel coronavirus disease 2019 (COVID-19) pandemic may increase risk for alcohol use and mental health problems. We examined how COVID-19 related stressors and parent-child relationships are independently and interactively associated with alcohol use and mental health profiles in a sample of first-year college students (N = 425, 34.8% Hispanic/Latinx; 74.9% female) who completed an online survey in October 2020. Latent profile analysis identified four profiles: well-adjusted (53.2%), mental health problems only (21.6%), alcohol use only (17.4%), and comorbid (7.8%). COVID-19 related stressful events increased risk of being in the alcohol use only and comorbid profiles, whereas COVID-19 related worries increased risk of being in the mental health problems only profile. Parent-child relationship quality lowered risk of being in the mental health problems only and the comorbid profiles. In addition, parent-child relationship quality moderated the role of COVID-19 related worries such that COVID-19 related worries were associated with lower odds of being in the comorbid profile when parent-child relationship quality was high but not when parent-child relationship quality was low. Strengthening parent-child relationship quality appears important for promoting college students' well-being.

A longitudinal investigation of non-suicidal self-injury persistence patterns, risk factors, and clinical outcomes during the college period

BACKGROUND

Although non-suicidal self-injury (NSSI) is known typically to begin in adolescence, longitudinal information is lacking about patterns, predictors, and clinical outcomes of NSSI persistence among emerging adults. The present study was designed to (1) estimate NSSI persistence during the college period, (2) identify risk factors and high-risk students for NSSI persistence patterns, and (3) evaluate the association with future mental disorders and suicidal thoughts and behaviors (STB).

METHODS

Using prospective cohorts from the Leuven College Surveys (n = 5915), part of the World Mental Health International College Student Initiative, web-based surveys assessed mental health and psychosocial problems at college entrance and three annual follow-up assessments.

RESULTS

Approximately one in five (20.4%) students reported lifetime NSSI at college entrance. NSSI persistence was estimated at 56.4%, with 15.6% reporting a high-frequency repetitive pattern (≥five times yearly). Many hypothesized risk factors were associated with repetitive NSSI persistence, with the most potent effects observed for pre-college NSSI characteristics. Multivariate models suggest that an intervention focusing on the 10-20% at the highest predicted risk could effectively reach 34.9-56.7% of students with high-frequency repetitive NSSI persistence (PPV = 81.8-93.4, AUC = 0.88-0.91). Repetitive NSSI persistence during the first two college years predicted 12-month mental disorders, role impairment, and STB during the third college year, including suicide attempts.

CONCLUSIONS

Most emerging adults with a history of NSSI report persistent self-injury during their college years. Web-based screening may be a promising approach for detecting students at risk for a highly persistent NSSI pattern characterized by subsequent adverse outcomes.

Freshmen anxiety and COVID-19: Practical implications from an online intervention for supporting students affected by health inequities

OBJECTIVE

This study explored how college freshmen, particularly those affected by health inequities, are affected by COVID-19 and whether they would use a university-created online wellness intervention for help.

PARTICIPANTS

Nine-hundred and eighty-nine freshmen at a large southeastern university.

METHOD

Students responded to an online survey regarding their anxiety, worry, number of life disruptions, perceived resilience and their use of the online intervention during the pandemic (June to mid-September 2020).

RESULTS

During COVID-19, Latinx, Black, women and non-heterosexual students reported significantly greater worry, daily life disruptions than their non-Latinx, white, male and heterosexual counterparts. Women and non-heterosexual students also reported greater anxiety and less resilience. Additionally, Latinx students reported using the university's online intervention for help during COVID-19 more than others. Overall, freshmen, especially Black and women students, reported the online intervention would help them with struggles.

CONCLUSIONS

Universities should identify unique worries faced by students during a health crisis and provide institutional support. Practical implications are discussed.

Examining social activity, need to belong, and depression among college students

OBJECTIVE

Prior research suggests that social connectedness is associated with lower levels of depression among college students. The aim of this exploratory study was to determine if an association existed between social activity, need to belong, and depression. Variations in study measures by race, gender, and student status were also explored.

PARTICIPANTS

Data was collected from students attending a large university in the southeastern United States during the Spring 2019 academic semester (N = 299).

METHODS

Participants completed an anonymous self-administered survey, which was offered in both electronic and paper formats.

RESULTS

Need to belong significantly predicted depression among college students even when accounting for social activity and response bias. Study measures varied significantly based on race, gender, and student status.

CONCLUSION

Belonging and social connectedness may be utilized by collegiate stakeholders to increase student and university outcomes.

Understanding the utility of "Talk-to-Me" an online suicide prevention program for Australian university students

BACKGROUND

Australian university students are at risk of experiencing poor mental health, being vulnerable to self-harm and suicidal ideation.

AIM

"Talk-to-Me" is a suicide ideation prevention Massive open online course (MOOC) previously showing it can support Western Australian university students' knowledge of identifying and responding to suicide ideation in themselves and others.

METHODS

A multi-site one-group pre-test/post-test design with a 12-week follow-up explored the efficacy of "Talk-to-Me" for university students Australia-wide, evaluating the influence of COVID-19 and location. Overall, 217 students (55% female; mage  = 24.93 years [18, 60]) enrolled in this study from 2020 to 2021. Participants' responses to suicidal statements, mental health literacy, generalized self-efficacy, help-seeking behavior, and overall utility of the program were collected at baseline, post-MOOC (10 weeks from baseline) and 12-week follow-up. The effect of time and location interaction was explored using a random-effects regression model.

RESULTS

Findings indicated significant improvement in participants' knowledge of positive mental health support strategies (ES = 0.42, p < 0.001) and recognizing appropriate responses to suicidal statements (ES = 0.37, p < 0.001) at 10-weeks, with further improvement at 12 weeks follow-up (ES = 0.47 and 0.46, p < 0.001). Students reported higher generalized self-efficacy at the 12-week follow-up compared to baseline (ES = 0.19, p = 0.03) and an increased tendency to seek professional help for mental health issues (ES = 0.22, p = 0.02).

CONCLUSION

These findings provide preliminary evidence of the efficacy of the "Talk-to-Me" program in supporting ‎university students across Australia to increase their suicide-related knowledge and skills, ‎general self-efficacy, and overall mental fitness.

Suicide Risk among University Students in Spain: Implications for Social Work

Suicide is a phenomenon that affects university students all over the world, and although vulnerability has been revealed in universities, there are still few studies that include large populations, a large number of universities and students pursuing different degrees. The study presented here aims to detect the risk of suicide in Spanish university students pursuing different areas of study. A total of 2,025 students from 16 Spanish universities and 17 degree programs completed an online questionnaire assessing support and suicide risk factors. The results indicate that 29.2 percent of the university students had experienced suicidal ideation in their lifetime. Logistic regression analysis showed that this risk was associated with depressive symptomatology and having suffered sexual violence. In contrast, self-esteem, life satisfaction, and perceived support were shown to be protective factors. Suicide risk affects one in three students. The present study includes particular implications for decision makers in the university community and other related governmental bodies, as well as for social work.

Psychological Counseling among University Students Worldwide: A Systematic Review

University counseling services (UCSs) are actively involved in mental health assessment and in supplying interventions aimed at preventing, facing and possibly overcoming psychological problems. However, we do not have a global overview of psychological counseling among universities. This systematic review aims at reviewing the literature on university psychological counseling, including articles documenting: (1) mental health and attitudes regarding help-seeking behaviors and UCSs among university students or counselors, (2) the description of protocols/services among UCSs, (3) the efficacy of psychological counseling/interventions among university students (both face-to-face and internet-delivered interventions). The study followed PRISMA guidelines and was registered on PROSPERO. After defining inclusion and exclusion criteria, a literature search was conducted, identifying 7085 records. Finally, 152 articles met the review eligibility criteria and were included in the qualitative synthesis. Results are divided into seven thematic topics that emerged during the analysis of the literature. The results mainly showed that face-to-face and web-based counseling/psychological interventions improve university students' mental health. Cross-sectional studies showed that many biases exist toward help-seeking behaviors, especially among international students. Both students and counselors must strive to overcome cultural barriers. Available resources for UCSs are scarce and need to be strengthened, as well as efficacy studies through randomized clinical trials.

Impact of mental disorders during education on work participation: a register-based longitudinal study on young adults with 10 years follow-up

BACKGROUND

Mental disorders are a leading cause of disability and a major threat to work participation in young adults. This register-based longitudinal study aims to investigate the influence of mental disorders on entering and exiting paid employment among young graduates and to explore differences across socioeconomic groups.

METHODS

Register information on sociodemographics (age, sex, migration background) and employment status of 2 346 393 young adults who graduated from secondary vocational (n=1 004 395) and higher vocational education or university (n=1 341 998) in the period 2010-2019 was provided by Statistics Netherlands. This information was enriched with register information on the prescription of nervous system medication for mental disorders in the year before graduation as a proxy for having a mental disorder. Cox proportional hazards regression models were used to estimate the influence of mental disorders on (A) entering paid employment among all graduates and (B) exiting from paid employment among graduates who had entered paid employment.

RESULTS

Individuals with mental disorders were less likely to enter (HR 0.69-0.70) and more likely to exit paid employment (HR 1.41-1.42). Individuals using antipsychotics were the least likely to enter (HR 0.44) and the most likely to exit paid employment (HR 1.82-1.91), followed by those using hypnotics and sedatives. The association between mental disorders and work participation was found across socioeconomic subgroups (ie, educational level, sex and migration background).

DISCUSSION

Young adults with mental disorders are less likely to enter and maintain paid employment. These results ask for prevention of mental disorders and for a more inclusive labour market.

The Barriers to Seeking Mental Health Services at King Saud Bin Abdulaziz University for Health Sciences

BACKGROUND

The mental health of college students, especially medical students, is a major issue worldwide. Depression and anxiety are among the top causes of death among people aged 15-29 years old. Mental health disorders, especially mood disorders such as depression and anxiety, are common among university students. Psychological problems can negatively impact academic performance and life satisfaction. The earlier mental illness is detected, the better the treatment and outcome. The aim of this study is to determine the barriers among students to seeking mental health services.

METHODS

This cross-sectional questionnaire-based study was carried out at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia The cross-sectional questionnaire-based study involved 434 students: 72.1% men and 27.9% women. This study had a response rate of 28.5% and responses were gathered in May 2023.

RESULTS

The top three barriers identified in this study were "Feeling that my problems are not important," "Concern that no one will understand my problems," and "Difficulty with access to care." The majority of students reported feeling "I feel reluctance a little" to use mental health services; 31.4% chose "I need it a little" when asked whether they needed to use mental health services. Furthermore, 34.8% of students reported having mild anxiety, and 34.1% reported having mild depression.

CONCLUSION

Mental illness is a serious issue, which is why medical students should be aware of it to improve their quality of life and reduce the stress and obstacles they face. Medical schools should address awareness of mental illness and how to approach a clinic. This is important for students to succeed and overcome the psychological difficulties that might affect academic performance. In addition, recognizing the barriers will help achieve better outcomes in seeking help and utilizing existing services.