The Post-Secondary Student Stressors Index: Proof of concept and implications for use

Recent stressful life events and identity development in emerging adults: An examination of within-person effects

OBJECTIVE

To examine longitudinal associations among stressful life events and identity processess in emerging adults while accounting for within-person and between-person effects.

BACKGROUND

Theoretical perspectives suggest that stressful life events may impact one's identity (i.e., coherent sense of self), but few studies have considered how changes in stressful life events are associated with changes within an individual's identity development over time (within-person effects).

METHODS

 Recent stressful life events (i.e., academic problems, friendship problems, romantic problems, and time pressure) and the processes through which identity develops (e.g., exploring in breadth and depth) were examined longitudinally (T1-T3) in a sample of emerging adults (N = 1125, Mage = 17.96 years).

RESULTS

Random-intercept cross-lagged modeling demonstrated that at the between-person level, emerging adults with greater academic and friendship problems, as well as more time pressures (relative to their counterparts), tended to engage in greater ruminative exploration. Further, those with more academic problems tended to demonstrate weaker commitment-making and exploration in breadth and depth (relative to their counterparts). Within-person increases in romantic problems predicted lower commitment-making and higher ruminative exploration over time.

CONCLUSION

Findings suggest that romantic problems may predict within-person changes in identity processes, whereas academic problems, friendship problems, and time pressure may be more concurrently related to identity development.

Canada's Student Mental Health Network: Protocol for a Comprehensive Program Evaluation

BACKGROUND

Prevalence estimates for mental health-related problems, including above-average stress, psychological distress, and symptoms of mental illnesses have increased significantly among Canadian postsecondary students. As demand for downstream mental treatment has surpassed many institutions' abilities to deliver timely care, there is a need for innovative upstream supports that foster mental health promotion and mental illness prevention among this population.

OBJECTIVE

Supported by an extensive network of student volunteers, Canada's Student Mental Health Network is a virtual, one-stop shop for centralized mental health education and evidence-based resources tailored to postsecondary students. This article describes a protocol for the comprehensive evaluation of the Network.

METHODS

Development of the Network was developed using a participatory action research framework. Network content is created and curated by students and reviewed by subject matter experts. The proposed program evaluation will include both a formative process evaluation and a summative impact assessment to determine the feasibility, acceptability, and utility of the Network in addition to assessing change in the 3 primary outcomes of interest: mental health literacy, perceived social support, and help-seeking behavior. Participants will be recruited directly from the Network website using a "rolling" recruitment approach to allow for continuous data collection and evaluation. A combination of qualitative (ie, interviews) and quantitative (ie, surveys) methods of data collection will be used.

RESULTS

The process of evaluation of the Network will begin in September 2022, collecting data for 1 year. In September 2023, the impact evaluation will begin using the same follow-up schedule. Data collection will then remain ongoing to facilitate the continued evaluation of the Network. Reports detailing evaluation data will be released annually.

CONCLUSIONS

The Network is a novel and innovative method of delivering universal mental health promotion to Canadian postsecondary students by providing centralized and freely accessible mental health education and resources, created by students and validated by subject matter experts. The continued creation and curation of resources for the Network will be ongoing to meet the evolving needs of the target population.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/41521.

Stressors and resilience are associated with well-being in young adult college students

Objective: The purposes were to describe stressors and resilience behaviors of college students and examine the relationships among stressors, resilience, and well-being. Hypothesis: Resilience will modify the relationship between stressors and well-being. Participants: The sample included 1,010 college students, ages 18-26, from an urban Midwestern university. Methods: A secondary analysis of cross-sectional data from an anonymous survey was conducted using multiple regression and simple slopes analysis. Results: Resilience did not modify the relationship between stressors and well-being. Stressors (β = -.44, p < .0001) and resilience (β = .33, p < .0001) accounted for 42% of the variance in well-being (adjusted R² = .42, F_2,999 = 365.98, p < .0001). The most frequently endorsed stressors were sleep problems, anxiety, and relationships. Conclusions: Stressors and resilience warrant special attention in the allocation of resources and development of programs to improve student well-being.

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

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

Further evidence in support of the validity of the post-secondary student stressors index using a nationwide, cross-sectional sample of Canadian university students

The Post-Secondary Student Stressors Index (PSSI) was created to facilitate improved evaluation of the sources of post-secondary student stress. This study reports evidence in support of the validity of the tool using a large, nationwide cross-sectional sample of students attending universities across Canada during the 2020-2021 academic year. We provide additional evidence for the construct validation of the PSSI, including internal structure evidence and relations to other variables by estimating multiple-indicator, multiple-cause models and investigating Spearman's rho correlation coefficients between the PSSI and like constructs. Based on index validation guidelines, results provide further support for the internal structure of the PSSI, demonstrating hypothesized relationships with like constructs and manifest variables, as well as acceptable goodness-of-fit statistics. Similarly, correlation coefficients were statistically significant and in line with directionality hypotheses. The results of this research provide further evidence for the validity of the PSSI among varied university student populations in Canada and addresses several of the limitations identified in earlier preliminary psychometric work on the instrument.

HEARTSMAP-U: Adapting a Psychosocial Self-Screening and Resource Navigation Support Tool for Use by Post-secondary Students

BACKGROUND

Mental health challenges are highly prevalent in the post-secondary educational setting. Screening instruments have been shown to improve early detection and intervention. However, these tools often focus on specific diagnosable conditions, are not always designed with students in mind, and lack resource navigational support.

OBJECTIVE

The aim of this study was to describe the adaptation of existing psychosocial assessment (HEARTSMAP) tools into a version that is fit-for-purpose for post-secondary students, called HEARTSMAP-U.

METHODS

We underwent a three-phase, multi-method tool adaptation process. First, a diverse study team proposed a preliminary version of HEARTSMAP-U and its conceptual framework. Second, we conducted a cross-sectional expert review study with Canadian mental health professionals (N = 28), to evaluate the clinical validity of tool content. Third, we conducted an iterative series of six focus groups with diverse post-secondary students (N = 54), to refine tool content and language, and ensure comprehensibility and relevance to end-users.

RESULTS

The adaptation process resulted in the HEARTSMAP-U self-assessment and resource navigational support tool, which evaluates psychosocial challenges across 10 sections. In Phase two, clinician experts expressed that HEARTSMAP-U's content aligned with their own professional experiences working with students. In Phase three, students identified multiple opportunities to improve the tool's end-user relevance by calling for more "common language," such as including examples, definitions, and avoiding technical jargon.

CONCLUSIONS

The HEARTSMAP-U tool is well-positioned for further studies of its quantitative psychometric properties and clinical utility in the post-secondary educational setting.

Cross-Canada Release of the Post-Secondary Student Stressors Index (PSSI): Protocol for a Cross-sectional, Repeated Measures Study

Background

The prevalence of mental health–related problems, including stress, psychological distress, and symptoms of mental illnesses, continues to increase among Canadian postsecondary student populations. Excessive stress in this population has been linked to a number of negative academic and health outcomes. Despite attempts to improve mental health at postsecondary institutions, a persistent gap exists in the evaluation of the specific sources of stress for students within the postsecondary setting.

Objective

The purpose of this paper is to report the study protocol for a cross-Canada, multisite launch of the Post-Secondary Student Stressors Index (PSSI), which will engage postsecondary institutions across the country as partners and facilitate improved measurement of the sources of student stress, in addition to contributing toward improved tailoring of upstream mental health services and support.

Methods

Created in collaboration with students, the PSSI is a validated 46-item tool assessing stressors across five domains: academics, learning environment, campus culture, interpersonal, and personal stressors. The tool is designed to be applicable to students at all years, levels, and areas of study. Data will be collected longitudinally at multiple time points over the course of each academic year.

Results

We recruited 15 postsecondary institutions across Canada for the first year, inviting students to participate in an online survey including questions concerning sociodemographic characteristics, stress, mental health, and resiliency. Analyses, including appropriate data visualization, will be conducted to determine the impact of specific stressors on mental health, linking responses over time to allow for the observation of changes in trends.

Conclusions

The PSSI is an intuitive and evidence-informed tool that can aid postsecondary institutions in evaluating the sources of student stress on their campuses. This multisite project will make a substantial contribution to the current literature regarding postsecondary student stress and allow institutions across the country to improve the tailoring of upstream mental health services in order to directly support the unique needs of their student body. Opportunities for knowledge translation and exchange are discussed.

International Registered Report Identifier (IRRID)

DERR1-10.2196/27713

Cross-sectional trend analysis of the NCHA II survey data on Canadian post-secondary student mental health and wellbeing from 2013 to 2019

Background

Canadian post-secondary students are considered to be at risk for chronic stress and languishing mental health, but there has been no longitudinal analysis of the available population-level data. The purpose of this study was to examine trends in the overall and sex-specific prevalence of self-reported stress, distress, mental illness, and help seeking behaviours among Canadian post-secondary students over the past several years.

Methods

Using the 2013, 2016, and 2019 iterations of the National College Health Assessment II Canadian Reference data, we conducted a trend analysis for each variable of interest, stratified by sex. The significance and magnitude of the changes were modelled using cumulative linked ordinal regression models and log binomial regression models.

Results

With few exceptions, we observed significant increases over time in the proportion of students reporting symptoms of psychological distress, mental illness diagnoses, and help seeking for mental health related challenges. Female students reported a higher level of stress than male students, with a statistically significant increase in the stress level reported by female students observed over time. In all cases, larger proportions of female students were observed compared to male students, with the proportion of female students who self-reported mental illness diagnoses nearly doubling that of males.

Conclusions

Our analysis indicated that the proportion of students self-reporting mental health related challenges, including stress, psychological distress, and diagnosed mental illnesses increased between the 2013, 2016 and 2019 iterations of the NCHA II conducted among Canadian post-secondary students.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10622-1.