Contextualizing public stigma: Endorsed mental health treatment stigma on college and university campuses

Why does local identity influence mental health among university students in Hawai'i?

Objective: This study examines local identity and mental health at one of the most ethnically diverse universities in the United States to move beyond the dichotomy between international and domestic students. Participants: Undergraduate students (N = 1,098) attending a university in Hawai'i completed anonymous surveys during class. Results: Self-identified local students who were born and/or raised in Hawai'i had lower levels of depressive symptoms than non-local students, over and above their nativity status, gender, age, race/ethnicity, multiracial status, and socioeconomic background. Sobel tests further confirmed significant mediators, which suggested that locals were less psychologically distressed than non-locals because of their stronger familiarity with the "aloha spirit," rooted in Native Hawaiian culture, and their lower risk of discrimination. Conclusions: These new findings can inform mental health services and interventions to better target non-local (international and out-of-state domestic) students by considering the stress of discrimination and the protective role of cultural values.

Associations Between Psychopathological Symptom Severity Amid the Pandemic and the Childhood Sociodemographic Environment

It is well-documented that childhood socioeconomic status (SES) is associated with various health conditions in adulthood. Here, we examine the extent to which childhood SES is associated with COVID-19 pandemic anxiety and depression. Participants (n = 212), recruited from Amazon Mechanical Turk, were assessed for depression and anxiety in February 2022 for both the current context and retrospective self-perceived early pandemic depression and anxiety (April 2020). Participants also reported childhood SES and current demographics. Consistent with predated findings, we show a strong, positive correlation between depression and anxiety under both conditions. Paternal unemployment in childhood was associated with increased anxiety, while maternal occupation was not. High household education in childhood was generally associated with greater anxiety and depression, similar to past studies examining education levels and depression. However, the shift from high school to post-secondary degrees (trade school and associate's) was associated with decreased anxiety and depression, which may reflect "essential work" careers, therefore indicating a dualism. Growing up in crowded, de-individualized spaces was associated with lower anxiety and depression, suggesting better conditioning for the imposition of COVID-19 quarantines. Pandemic-related unemployment was associated with an increase in anxiety and depression. Strong political views, regardless of ideology, were associated with increased anxiety. Finally, participants in our cohort perceived their mental health to be worse in the early pandemic for anxiety and depression, up 6.6% and 7.9%, respectively. Our work suggests a complex relationship between SES, demographics, and anxiety and depression during the pandemic. These findings emphasize the importance of exploring the dynamics between early SES and mental health in adulthood, particularly during extended societal stressors.

Involving Persons With Lived Experience to Improve Vocational Students' Stigmatizing Attitudes Toward Mental Disorders: A Quasi-Experimental Study

BACKGROUND

Mental health problems are estimated to affect one in six individuals in the European Union. Fifty percent of mental disorders start in adolescence, around the age of 14. The stigma associated with having a mental health problem is one of the main barriers to seeking help for psychiatric and psychological disorders among adolescents and young adults. Interventions to reduce social stigma could contribute to increased help-seeking behavior in this population. AIMS: To assess the effectiveness of a direct contact intervention in the classroom by persons with lived experience to reduce vocational students' stigmatizing attitudes. METHOD: One person with lived experience and one first-degree relative implemented a classroom intervention lasting 90 min. Its effectiveness was measured using a quasi-experimental study with a pretest-posttest design and within-subject control. RESULTS: A total of 128 students from three different Vocational and Technical Schools from Spain participated in the study. After the intervention, statistically significant differences were observed in the scores of 11 of the 13 dimensions measured with the Spanish Mental Illness Stigma Attribution Questionnaire (AQ-27-E) and the Community Attitudes toward Mental Illness (CAMI) questionnaires. No differences associated with gender or familiarity with the mental disorder were observed. CONCLUSION: Vocational students' negative attitudes and emotions can be improved through a direct contact intervention in the classroom involving people who have experienced a mental disorder themselves. The age range for optimal results with this type of intervention appears to be 18 to 20 years.

The efficacy of the "Talk-to-Me" suicide prevention and mental health education program for tertiary students: a crossover randomised control trial

Despite suicide ideation being one of the most frequently reported health issues impacting tertiary students, there is a paucity of research evaluating the efficacy of preventive interventions aimed at improving mental health outcomes for students studying at two tertiary institutes. The current study evaluated the efficacy of the "Talk-to-Me" Mass Open Online Course (MOOC) in improving tertiary students' abilities to support the mental health of themselves and their peers via a randomised controlled trial design, comparing them to a waitlist control group. Overall, 129 tertiary students (M = 25.22 years, SD = 7.43; 80% female) undertaking a health science or education course at two Western Australian universities were randomly allocated to either "Talk-to-Me" (n = 66) or waitlist control (n = 63) groups. The participants' responses to suicidal statements (primary outcome), knowledge of mental health, generalised self-efficacy, coping skills, and overall utility of the program (secondary outcomes) were collected at three timepoints (baseline 10-weeks and 24-weeks from baseline). Assessment time and group interaction were explored using a random-effects regression model, examining changes in the primary and secondary outcomes. Intention-to-treat analysis (N = 129) at 10-weeks demonstrated a significant improvement in generalised self-efficacy for "Talk-to-Me" compared to the control group (ES = 0.36, p = .04), with only the "Talk-to-Me" participants reporting increased knowledge in responding to suicidal ideation (primary outcome). This change was sustained for 24 weeks. Findings provide preliminary evidence suggesting that the "Talk-to-Me" MOOC can effectively improve tertiary students' mental health and knowledge of how to support themselves and others in distress. ACTRN12619000630112, registered 18-03-2019, anzctr.org.au.

Exploring participants' experiences of mental health and stigma in American colleges

Objective: Mental illness is a growing public concern, particularly for persons in higher education. This research aims to distinguish mental health and stigma experiences between three academic communities: undergraduate students, graduate students, and faculty members. Methods: The researchers conducted semi-structured interviews with nineteen individuals who self-identified as a member of one or more of these groups. Findings and discussion: Participants reported experiencing a variety of mental health conditions (e.g., depression, anxiety, and post-traumatic stress), and described having diverse cognitive, affective, and behavioral responses to internally and externally derived stigma. The findings of this study also provide insights into the ways that academic communities observe and interpret on-campus communication about mental health, and participants offered impressions about ways to improve intervention and awareness messaging. Implications of the findings are discussed.

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.

Factors Affecting Anxiety-Related Symptoms, Diagnosis, and Treatment Among Collegiate Student-Athletes in the National College Health Assessment

CONTEXT

Increased attention continues to be placed on best practices for assisting student-athletes who show symptoms of a mental health illness. One of the most common mental health concerns for student-athletes is feeling overwhelmed or anxious. Early recognition of these symptoms can help student-athletes find early intervention.

OBJECTIVE

To elucidate specific attributes associated with an increased likelihood of anxiety symptoms and treatment avoidance to help athletic trainers and other practitioners better identify and assist high-risk individuals.

DESIGN

Cross-sectional study.

SETTING

Colleges and universities in the United States.

PATIENTS OR OTHER PARTICIPANTS

A total of 51 882 varsity athletes who completed the National College Health Assessment between 2011 and 2019.

MAIN OUTCOME MEASURE(S)

Survey responses (self-report) to questions related to anxiety symptoms and disorders cross-sectioned into 9 predictors: year in school, gender, sexual orientation, race and ethnicity, international student status, school type, received information on stress reduction or depression or anxiety, anxiety about impeding academic performance, and history of mental health treatment in the last year.

RESULTS

More than three-fourths (82.9%, n = 43 016) of student-athletes reported feeling overwhelmed because of all that they had to do in their daily activities, whereas only half (47.5%, n = 24 645) of student-athletes described overwhelming anxiety as a symptom. Gender, sexual orientation, race and ethnicity, school type, and previous mental health treatment had large effects on these 2 symptoms. However, of the student-athletes who reported overwhelming anxiety as a symptom, only one-fourth (22.9%, n = 5649) indicated they received a diagnosis of anxiety with or without treatment.

CONCLUSIONS

Factors such as the year in school and availability of mental health information appeared to have little effect on the experience of anxiety-related symptoms and the propensity to seek treatment. However, other factors, including gender, sexual orientation, race and ethnicity, school type, and previous mental health treatment, did have important effects. Our study provides additional evidence that the stresses placed on collegiate student-athletes frequently led to feelings of being overwhelmed and, eventually, anxiety disorder diagnoses. However, most student-athletes experiencing anxiety-related symptoms still did not seek a diagnosis with or without treatment.

Disrupted resting-state functional connectivity of frontal network in opium use disorder

Opioid use disorder (OUD) as a chronic relapsing disorder is initially driven by dysfunction of brain reward networks and associated with several psychiatric disorders. Resting-state EEG was recorded in 24 healthy participants as well as 31 patients with OUD. Healthy participants do not meet OUD criteria. After pre-processing of the raw EEG, functional connectivity in the frontal network using eLORETA and all networks using graph analysis method were calculated. Patients with OUD had higher electrical neuronal activity compared to healthy participants in higher frequency bands. The statistical analysis revealed that patients with OUD had significantly decreased phase synchronization in β1 and β2 frequency bands compared with the healthy group in the frontal network. Regarding global network topology, we found a significant decrease in the characteristic path length and an increase in global efficiency, clustering coefficient, and transitivity in patients compared with the healthy group. These changes indicated that local specialization and global integration of the brain were disrupted in OUD and it suggests a tendency toward random network configuration of functional brain networks in patients with OUD. Disturbances in EEG-based brain network indices might reflect an altered cortical functional network in OUD. These findings might provide useful biomarkers to understand cortical brain pathology in opium use disorder.

Trends in Collegiate Student-Athlete Mental Health in the National College Health Assessment, 2011-2019

CONTEXT

Recently, the athletic training community has paid increased attention to collegiate student-athlete mental health, mental health treatment-seeking behavior, and the effects of mental health factors on athletic and academic performance. Ongoing efforts to better educate and equip athletic trainers to help student-athletes in this regard should result in improved mental health-related outcomes.

OBJECTIVE

To examine changes in the mental health of student-athletes over the past decade compared with that of nonathlete students.

DESIGN

Cross-sectional study.

SETTING

Colleges and universities in the United States.

PATIENTS OR OTHER PARTICIPANTS

Varsity athletes (athletes; n = 54 479) and nonathlete students (nonathletes; n = 448 301) who completed the National College Health Assessment between 2011 and 2019.

MAIN OUTCOME MEASURE(S)

Surveys included responses (self-reported) to questions in 5 mental health-related categories: recent mental health symptoms, recent mental health diagnosis, mental health treatment-seeking behavior, receiving mental health information from the institution, and the recent effect of mental health factors on academic performance.

RESULTS

Athletes consistently described lower symptom and diagnosis rates compared with nonathletes, except for attempted suicide, substance abuse, and eating disorders. Rates of diagnosis increased over time in both groups but remained lower in athletes. Treatment-seeking behavior and openness to future treatment increased over time in both groups but remained lower in athletes. Athletes received more information on stress reduction, substance abuse, eating disorders, and handling distress or violence compared with nonathletes. Both groups received information more frequently over time. Athletes reported fewer academic effects, especially for depression and anxiety, but these effects grew over time in both groups. The effects of injuries and extracurricular activities on academic performance were greater in athletes than in nonathletes.

CONCLUSIONS

Athletes described overall lower levels of mental health symptoms, diagnoses, and academic effects compared with nonathletes. Whereas the rates in nonathletes climbed over the past decade, the rates in athletes broadly remained flat or climbed less rapidly. Increasingly positive attitudes toward treatment were encouraging, but the deficit in athletes relative to nonathletes persisted. Ongoing efforts of athletic trainers to educate athletes and guide them to mental health resources are needed to continue, or better yet to accelerate, the observed positive trends in information dissemination and treatment-seeking behavior.

The Mediating Effect of Stress between Extracurricular Activities and Suicidal Ideation in Chinese College Students

OBJECTIVE

The objective of this study was to explore the relationship between extracurricular activities, stress, and suicidal ideation and to examine the mediating effect of stress between extracurricular activities and suicidal ideation in Chinese college students.

METHOD

A total of 6446 college students were surveyed with a web-based online data collection system using the self-made demographic questionnaire, Suicidal Behaviors Questionnaire-Revised (SBQ-R), and the 21-Item Depression Anxiety Stress Scales (DASS-21). SPSS 24.0 was used for descriptive statistics and correlation analysis, and the bootstrap method in the process procedure for SPSS Version 3.4.1 was used to construct the mediating effect model.

RESULTS

Gender, school grades, living area, and family income status were influencing factors for suicidal ideation, stress, and extracurricular activities. Extracurricular activities were negatively correlated with stress (r = -0.083, p < 0.001) and suicidal ideation (r = -0.039, p < 0.01). Extracurricular activities had no direct predictive effect on college students' suicidal ideation (c = -0.198, CI: -0.418, 0.023), while stress had a mediating effect between extracurricular activities and suicidal ideation; the indirect mediating effect was 0.159.

CONCLUSIONS

Extracurricular activities indirectly predict college students' suicidal ideation through stress. A variety of extracurricular activities can decrease the stress and suicidal ideation of college students and benefit their mental health.

Psychiatric comorbidities among undergraduate and graduate students attending spiritual-mind-body interventions

OBJECTIVE

This study examined rates of positive screens for depression and posttraumatic stress and their comorbidity among undergraduate (N = 77) and graduate (N = 136) students who participated in on-campus Spiritual-Mind-Body (SMB) wellness interventions.

METHODS

Participants completed the PHQ-9 and the PCL-C before starting an 8-week in-person SMB wellness intervention. Elevated depression was indicated by a score of ≥10 on the PHQ-9; elevated posttraumatic stress (PTS) was indicated by a score of ≥30 on the PCL-C.

RESULTS

There were unexpectedly high rates of posttraumatic stress among both undergraduate (39%) and graduate (32%) students without the presence of comorbid depression. A small minority of students experienced depression apart from elevated PTS symptoms. Overall, students reported high levels of clinically relevant psychopathology.

CONCLUSION

On-campus wellness centers may offer an appropriate setting for the screening of trauma-related distress and depression and their comorbidity to address the psychiatric concerns of SMB wellness-seeking students.

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.

Reducing stigma associated with mental health problems among university students in the Asia-Pacific: A video content analysis of student-driven proposals

INTRODUCTION

Studies have demonstrated that mental health problems among university students may be increasing in both prevalence and severity. This study aimed to identify ways to reduce stigma and improve students' utilization of mental health services.

METHODS

We performed a content analysis on video proposals to address stigma and mental health at universities, submitted by 15 teams from nine Asian-Pacific countries as part of a case competition. We examined five domains: (1) tone; (2) cultural context; (3) mental health issue of focus; (4) prevention versus secondary prevention; and (5) main intervention strategies.

RESULTS

Five main intervention strategies emerged: (1) educational campaigns; (2) peer interaction and support; (3) counseling; (4) screening; and (5) self-management. The results suggest that mental health literacy is low among students. Educational campaigns and events to increase awareness and reduce stigma were the most commonly incorporated strategy, through film screenings, mental health days, and social media. Building empathy through personal stories from celebrities and other students was also highly recommended. Second, counseling was incorporated in 80% of proposals, with a preference for peers and staff support, and web-based therapy over professional counselors, except in severe cases. Programs to increase social contact were the third most common strategy, suggesting students may feel isolated and disconnected. Creating common spaces for students to interact and pairing of students with and without mental health issues were widely suggested. The use of technology was recommended for self-management of mental health and for mandatory mental health screening, which was generally only recommended for incoming students.

CONCLUSIONS

Our analysis provides insight into student-generated intervention approaches to prevent and address stigma associated with mental health issues among students. A greater university commitment is needed to provide a range of resources, including education and counseling, to leverage technology, and to foster stronger support networks among students.

Mental health stigma among college students: misperceptions of perceived and personal stigmas

ObjectiveThe purpose of this study was to assess the relationship between college student perceived and personal mental health stigmas. Participants: A sample of 352 undergraduate college students from two large Universities in the Eastern United States was utilized. Methodology: A self-report anonymous online survey was utilized. The survey contained demographics as well as questions to assess participant levels of perceived stigma, personal stigma, and social desirability.ResultsResults revealed that college student perceived stigma was significantly greater than personal stigma, and that perceived stigma and personal stigma were significantly and positively correlated. Conclusions: Overall findings suggest a misperception of campus mental health stigma levels. Based upon these student misperceptions of stigma, best practices for addressing stigma within the clinical setting are discussed. Overall implications for college counseling centers are presented, including campus outreach strategies.

Trends in mental health service utilization among LGB+ college students

OBJECTIVES

1) Compare service utilization among LGB+ and straight-identified students. 2) Assess rates of mental health concerns among LGB+ students only. Participants: Undergraduates (N = 675) reported on their sexual orientation, mental health conditions, and past service providers. Methods: Logistic regression was used for aim 1 and descriptive statistics for aim 2. Results: LGB+ students were more likely than straight-identified students to seek services for anxiety (odds ratio [OR] = 2.051; p < .01) or depression (OR = 3.058; p < .001) and from a counselor/therapist/psychologist (OR = 2.937; p < .001) or their university's counseling/health services (OR = 1.933; p < .01). Bisexual students utilized the most services. Conclusions: Colleges must ensure that programing, outreach, and overall support for the mental health needs of their LGB+ students are being met so that this vulnerable population continues to seek services.

The Evaluation Model of College Students' Mental Health in the Environment of Independent Entrepreneurship Using Neural Network Technology

In recent years, the employment of college students is becoming more and more prominent; no matter for the society, universities, college students themselves, and their families have formed a huge pressure, in the current situation, the success rate of college students to start their own business is not high; one of the important reasons is that college students generally have defects in entrepreneurial psychology. Therefore, effective evaluation of college students' mental health under the environment of independent entrepreneurship is conducive to comprehensively improving the quality of talent training in colleges and universities. In this paper, we propose a novel three-channel multifeature fusion network based on neural network technology to identify and predict college students' mental health problems in the self-entrepreneurship environment. Specifically, we first extract the behavior characteristics, visual characteristics, and social relations as a three-channel network input. Second, in view of the behavior characteristic, we use the length of the memory deep context dependent on network access. In view of visual features, we use the convolution neural network to face emotional characteristics and characteristics of social relations. The feature concat strategy is used for feature fusion. The experimental results on real datasets show that the method in this paper is effective, and it is expected to propose a new solution for college students' mental health assessment.

Stigmatizing Attitudes Toward Depression Among Male and Female, Medical and Non-medical Major College Students

Background: Stigma is often reported to be a barrier to the treatment and rehabilitation of depression. However, little is known about stigma toward people with depression among college students in China.

Methods: Using a questionnaire with a case vignette describing depression, a total of 1,056 students from nine colleges/universities in Hunan Province of China were included in this study. The questionnaire addressed the attitudes toward depression and the desire for keeping a distance from depressed individuals. The current study explored the stigma attitudes of college students toward people with depression and the desire for social distancing, as well as the gender (male and female) and major (medical and non-medical) differences.

Results: Over half of the respondents agreed that people described in the vignette were “dangerous” (60.7%) and “could snap out of the problem” (58.7%). Compared with female students, males were more likely to agree that “If I had this problem, I would not tell anyone” (7.0 vs. 13.2%, p = 0.001); compared with non-medical students, medical students were more likely to agree that “The problem is a sign of personal weakness” (38.0 vs. 50.0%, p < 0.001). A lot of respondents would be unwilling to “marry into the family of people with depression” (71.1%) or “work closely with them” (45.1%). Compared with male students, females were more unwilling to “work closely with them” (40.3 vs. 47.5%, p = 0.026).

Conclusion: This study found that a high proportion of Chinese college students showed stigma toward and desire for social distancing from people with depression, male students and medical major students showed higher stigma in some subscale items toward people with depression. The present results suggest that more anti-stigma interventions should be applied for Chinese college students to help prevent or reduce stigma attitudes toward people with depression.

Advancing Mental Health Supports for Autistic Postsecondary Students: A Call for Research

Research has documented elevated rates of co-occurring depression and anxiety in autistic adults, with some noting particularly high rates for autistic students enrolled in postsecondary education. Difficulty coping with the stressors that accompany daily life as they navigate college campuses may contribute to development or exacerbation of co-occurring conditions. Autistic students have reported that depression, anxiety and stress interfere with their success in college, but that they have difficulty identifying and accessing the supports that they need. Though many postsecondary institutions have established programs that provide academic supports to autistic students, few programs directly support mental health and wellness. Recently, stakeholders have advocated for mental health to be prioritized in adult autism research. We suggest that a specific focus on autistic students in postsecondary education is warranted and provide a brief overview of the relatively limited literature in this area. To inform development of mental health services and supports that will be both accessible and acceptable to the range of autistic students attending postsecondary education, research is recommended in four areas: factors positively and negatively affecting mental health; types of supports; outreach; on-campus training and education. It will be essential for researchers to establish community partnerships with autistic individuals to inform study design and specific research questions. This will ensure that autistic voices guide development of supports that will foster positive mental health in postsecondary education and beyond.

Depression, anxiety and stress in different subgroups of first-year university students from 4-year cohort data

BACKGROUND

Limited studies have been conducted to investigate the mental health status of subgroups of university students. This study hypothesized that there would be differences among student subgroups in the prevalence of depression, anxiety and stress; and association of age, gender, academic performance and mental health status.

METHODS

This was a cross-sectional survey study. Since 2014, first-year university students in a university in Hong Kong were invited to complete the Depression Anxiety Stress Scale (DASS-21) before the commencement of their study. These DASS data were then merged with objectively measured data from university records. 9,479 students completed the DASS survey, this being 56.5% of the total student population in the records. Kruskal-Wallis Tests were applied to compare the differences among student subgroups.

RESULTS

Community college transfer (CCT) students were the highest-risk group for depression, anxiety and stress, and their study load was the highest as well. Unexpectedly, mainstream students ranked after the CCT students in the prevalence and levels of depression, anxiety and stress. Student athletes had the highest prevalence of depression. Although there were declining trends for depression, anxiety and stress, it was only a slight drop. Overall, age, gender, study load and academic performance were associated with the mental health profile (p<0.05).

LIMITATIONS

After admission, students' mental health conditions could have changed. Further studies are needed to measure mental health during their study.

CONCLUSIONS

Mental health problems were not distributed evenly across different student subgroups, psychological support should be designed according to the needs of each student subgroup.

Enhancing big data in the social sciences with crowdsourcing: Data augmentation practices, techniques, and opportunities

Proponents of big data claim it will fuel a social research revolution, but skeptics challenge its reliability and decontextualization. The largest subset of big data is not designed for social research. Data augmentation–systematic assessment of measurement against known quantities and expansion of extant data with new information–is an important tool to maximize such data's validity and research value. Using trained research assistants or specialized algorithms are common approaches to augmentation but may not scale to big data or appease skeptics. We consider a third alternative: data augmentation with online crowdsourcing. Three empirical cases illustrate strengths and limitations of crowdsourcing, using Amazon Mechanical Turk to verify automated coding, link online databases, and gather data on online resources. Using these, we develop best practice guidelines and a reporting template to enhance reproducibility. Carefully designed, correctly applied, and rigorously documented crowdsourcing help address concerns about big data's usefulness for social research.

Association between perceived public stigma and suicidal behaviors among college students of color in the U.S

BACKGROUND

Suicide is the 2^nd leading cause of death among college students and 10 to 34-year-olds in the U.S. While rates of suicide among young people of color have increased, less is known about factors that contribute to suicidality among racial minority students who are sorely underrepresented within existing research. Thus, we sought to explore the association between perceived public stigma of receiving mental health treatment and suicidality among Black, Asian Domestic, Asian International, Latinx, Multiracial, Arab/Arab American, American Indian/Alaska Native, and White college students.

METHODS

We analyzed cross-sectional survey responses from racially diverse sample of 153, 635 college students who participated in the Healthy Minds Study from years 2007-2018. Multivariable logistic regression was used to examine associations between perceived public stigma and suicide ideation, suicide planning, and suicide attempt.

RESULTS

Perceived public stigma was significantly associated with greater odds of suicide ideation, planning, and attempt. Odds of having attempted suicide within the past year were significantly greater among Asian International and Black college students. Sexual minority students broadly, and bisexual students specifically, were also at elevated risk for suicidal behavior.

LIMITATIONS

Cross-sectional survey responses were assessed and causality cannot be determined.

CONCLUSIONS

Students who endorsed more perceived public stigma also reported significantly greater odds of having experienced suicide ideation, planning, and attempt within the past 12 months. Subsequent interventions should account for concerns surrounding public perceptions of stigma when working to prevent suicide among students of color.

The impact of opioid use disorder on levels of educational attainment: Perceived benefits and consequences

BACKGROUND/AIMS

Adolescents and young adults have the highest rates of opioid use, and despite shared risk-factors such as mental health and social pressures, there is little information on the relationship between education and opioid use disorder. In this study, we sought to assess differences in educational attainment between opioid users and the general population, and the impact of opioid use on one's education.

METHODS

Patients (N = 14,349) entering opioid treatment programs across the United States were surveyed on educational attainment from 2010 to 2018. Data were compared to estimates from an annual survey administered by the US Census. A follow-up sub-set of opioid users (N = 240) was interviewed to add context and expand on the structured survey.

RESULTS

Nearly one-third (32.2%) of the US population is estimated to have earned a bachelor's/advanced degree, compared to just 7.8% of treatment-seeking opioid users. Over half of follow-up respondents (57.5%) reported initiating regular opioid use while attending an educational institution. The majority (68.0%) also indicated opioids negatively impacted their education, with drug-seeking behavior prioritized over attendance and academic performance. Perceived benefits included cognitive enhancement and therapeutic value for anxiety/depression.

CONCLUSIONS

Our data suggest that opioid users achieve lower levels of education, which may result in both individual and economic costs. Prevention programs need to not only include education-specific risk factors (e.g., social norms), but underlying precipitators such as mental health, stigma, and the myth of risk-free cognitive enhancement. Opioid specific services should be available and disseminated to student populations, including certification of campus physicians to provide buprenorphine maintenance.

Unhealthy weight control behaviors and substance use among adolescent girls: The harms of weight stigma

RATIONALE

Unhealthy weight control behaviors (UWCBs) often predict future substance use, resulting in a comorbidity that predicts later health consequences.

OBJECTIVE

The current study aimed to examine whether weight stigma and its associated harms magnify or attenuate the effect of UWCBs at baseline on substance use at 10-year follow-up among girls and to elucidate factors related to the perceived harms of weight stigma.

METHODS

Data from 1147 adolescent girls from Project EAT (Eating and Activity in Teens and Young Adults) were analyzed at baseline and 10-year follow-up. Participants were split into three groups at baseline: no weight stigma; weight stigma only (being teased by peers or parents); and weight stigma with perceived harms (e.g., being bothered by teasing). Moderation and stratified regression analyses examined the role of weight stigma and its perceived harms on the relationship between UWCBs and substance use. ANOVA models aimed to elucidate factors related to the perceived harms of weight stigma.

RESULTS

Moderation analyses revealed marginally significant effects of group membership on the effect of UWCB on substance use (p = .08). Stratified regression results indicated that UWCBs at baseline predicted substance use at 10-year follow-up among girls in the weight stigma with perceived harms group (p = .005), but not in the no weight stigma or weight stigma only groups. Girls in the weight stigma with perceived harms group reported higher weight concern, depressive symptoms and BMIs than girls who report no weight stigma or weight stigma only.

CONCLUSIONS

Health initiatives should seek to reduce weight stigma and its associated harms to prevent substance use in girls and women. Clinicians working with adolescent girls with UWCB should inquire about experiences with weight stigma with its harms to assess substance use risk. Due to the marginally significant moderation, results should be interpreted with caution.

CONCLUSIONS

Health initiatives should seek to reduce weight stigma and its associated harms to prevent substance use in girls and women. Clinicians working with adolescent girls with UWCB should inquire about experiences with weight stigma with its harms to assess substance use risk. Due to the marginally significant moderation, results should be interpreted with caution.

Regional differences in mental health stigma-Analysis of nationally representative data from the Health Survey for England, 2014

Background

Mental health stigma persists despite coordinated and widely-evaluated interventions. Socioeconomic, structural, and regional context may be important in shaping attitudes to mental illness, and response to stigma interventions. Regional differences in attitudes towards mental illness could be relevant for intervention, but have not been systematically explored. We evaluated regional variation in mental health stigma using nationally representative data from England, the Health Survey for England (HSE), from 2014.

Methods

A previously derived scale for mental health-related attitudes with 2 factors (i. tolerance and support, ii. prejudice and exclusion), and overall attitudes, were outcomes. Weighted linear regressions estimated contribution of individual characteristics and region of residence to inter-individual variability in mental health-related attitudes.

Results

London and southern regions tended to have more negative mental health-related attitudes. These differences were not fully or consistently explained by individual sociodemographic characteristics, or personal familiarity with mental illness.

Conclusions

Stigma policies could require refinements based on geographic setting. Regions may be in particular need of stigma interventions, or be more resistant to them. Regional differences might be related to media coverage of mental illness, funding differences, service availability, or accessibility of educational opportunities. Greater geographic detail is necessary to examine reasons for regional variation in stigmatizing attitudes towards people with mental illness, for example through multilevel analysis.

Dominant Cultural and Personal Stigma Beliefs and the Utilization of Mental Health Services: A Cross-National Comparison

Purpose: The detrimental impact of stigma on the utilization of mental health services is a well-established finding. Nevertheless, most studies consider only the personal or interactional dimensions of stigma. This contribution makes a distinction between the dominant beliefs about stigma within a culture and the personal beliefs of individuals with regard to stigma. We hypothesize that both have an impact on professional-care seeking within the field of mental health. Methods: A multi-level research design is used to estimate the effects of both types of stigma beliefs on the likelihood of consulting general and specialized health professionals about mental health problems in 28 European countries (N of individuals = 24,881, Eurobarometer 248, 2005-2006). Results: In countries where stigmatizing beliefs are dominant, the likelihood of seeking help from specialized mental health professionals is constrained, and individuals refrain from contacting general practitioners when in need of formal support, regardless of their own personal stigma beliefs. Conclusion: The present study signals the importance of stigma beliefs as shared cultural phenomena, and of personal stigma beliefs to the likelihood of seeking professional care for mental health problems. We therefore propose that most studies on stigma and formal-care seeking underestimate the pervasive effects of stigma beliefs, due to methodological individualism.

Surviving and Thriving During Stress: A Randomized Clinical Trial Comparing a Brief Web-Based Therapist-Assisted Acceptance-Based Behavioral Intervention Versus Waitlist Control for College Students

The high rates of anxiety in college students and the many barriers to accessing evidence-based care in communities and on campuses indicate a clear need to explore ways to increase access to evidence-based treatments. Web-based interventions and preventions are one way to bridge this gap; they hold the potential to decrease mental health disparities and enhance student functioning. The current RCT examined the acceptability and efficacy of a 3-session web-based therapist-assisted acceptance-based behavioral intervention targeting anxiety (Surviving and Thriving During Stress) for college students versus a waitlist (WL) control condition, in a sample of racially and ethnically diverse college students. Overall, participants rated the program as helpful and acceptable. Mixed-effects regression models (MRMs) were run in SPSS to examine the effects of time, condition, and Condition × Time on outcomes and hypothesized mechanisms. Significant Condition × Time interactions for general anxiety, depression, and quality of life (QOL) emerged, suggesting that SATDS participants reported significantly greater changes on these outcomes from pre- to posttreatment versus WL. However, interaction effects were nonsignificant for anxious arousal and social anxiety. MRMs examining hypothesized mechanisms revealed significant Condition × Time interactions for experiential avoidance, decentering, and values-based living. However, interaction effects were nonsignificant for mindfulness. All significant gains were maintained at 1-month follow-up, with the exception of QOL. Results contribute to the growing literature on the acceptability and efficacy of web-based approaches, and suggest these approaches can be effective for diverse college students, and may provide a unique platform to increase access to evidence-based care.

Parental recognition of preadolescent mental health problems: Does stigma matter?

RATIONALE

Parents are one of several key gatekeepers to mental health (MH) services for adolescents with MH problems. Parental MH stigma is a significant barrier to treatment, yet little is known about how stigma may bias parental recognition of mental illness in youth.

OBJECTIVE

This study examines how stigma influences a critical and early stage of the help-seeking process-the recognition of MH problems in preadolescents by their parents.

METHOD

Parents from a school-based anti-stigma intervention study were analyzed. Logistic regressions examined the association of stigma with parental recognition of MH problems in their preadolescent child (10-12 years old) and that of two preadolescent vignette characters described as having bipolar disorder and social anxiety disorder.

RESULTS

The more parents desired their preadolescent child to avoid interaction with individuals with a mental illness-that is, to be more socially distant-the less likely these parents believed their child had a MH problem, controlling for parent-reported MH symptoms and other covariates. This pattern was prominent among parents who reported high symptoms in their child. Social distance had no bearing on whether parents recognized the vignette characters as having a problem. Avoidance of individuals with a mental illness and knowledge/positive MH attitudes were not associated with problem recognition.

CONCLUSION

Stigmatizing attitudes of parents may be detrimental when trying to understand the psychopathology of their own preadolescent children but not preadolescents outside their family. Stigma may present itself as a barrier to problem recognition because it may impose a significant personal cost on the family, thereby affecting the help-seeking process earlier than considered by previous work.