Suicidal Behavior and Psychological Distress in University Students: A 12-nation Study

Suicidal behavior among Turkish physicians: Associations with negative life-events, psychological distress, and attitudes towards suicide

BACKGROUND

Suicidal behavior among physicians is a significant concern globally, with various factors contributing to increased risk. Physicians in Türkiye are a group facing significant psychological distress due to challenging work conditions, economic instability, and violence in the healthcare system. Understanding the specific risk factors and attitudes contributing to this elevated suicidal behavior can inform the development of targeted interventions and support mechanisms for improving the well-being of physicians in Türkiye. This study aims to investigate suicidal behavior among Turkish physicians and its associations with adverse life events, psychological distress, and attitudes toward suicide.

METHOD

In the present study, 512 Turkish physicians from diverse demographics and professional backgrounds participated. Suicidal behavior, psychological distress, stressful life events, and attitudes toward suicide were explored through tailored instruments. Logistic regression analysis was conducted to identify independent risk factors for suicidal behavior.

RESULTS

The results demonstrated that among Turkish physicians, psychological distress and suicidal behavior were frequent. One in five individuals (22.3%) reported experiencing one of the suicidal behaviors within the past month. Nearly one in ten (8.6%) have attempted suicide at some point in their lives. The average number of suicidal behaviors reported was .48 (SD = 1.1), and the average severity score for suicidal ideation was .51 (SD = 1.2). Young age, single marital status, low social support, psychological distress, the number of stressful life events, and the acceptability of suicide were identified as independent risk factors for suicidal behavior. Having a diagnosis of a psychiatric disorder and the number of stressful life events were factors associated with suicide attempts.

CONCLUSION

The intricate associations between several factors that influence suicidal behavior among Turkish physicians are elucidated by this study. The results highlight the critical need for focused interventions and systems of support within the Turkish healthcare system to deal with this serious public health concern. Future studies and therapeutic practices can better meet the mental health requirements of this vulnerable demographic by considering the complex nature of suicidal behavior among physicians.

Problem Gambling and Suicidal Behaviours in Young Adult men in Ghana: A Moderated Mediation Model of Psychological Distress and Social Support : Journal of Gambling Studies

Problem gambling has been recognised as an important public health issue because of its harmful consequences at the personal, interpersonal, and societal levels. There is a proliferation of gambling activities in Ghana owing to increased access to the internet, soaring smartphone penetration, and an influx of sports betting companies. Yet, very little research has addressed the harm associated with problem gambling in Ghana. This study assessed if the effect of problem gambling severity on suicidal behaviours (ideation, planning, and attempts) through psychological distress is contingent on the level of perceived social support. A total of 350 young adult men in the Greater Accra Region of Ghana provided the data for the current analysis. The data were analysed using a moderated mediation approach. The results showed that psychological distress is an important intervening mechanism through which problem gambling severity influences suicidality. In addition, the positive association between psychological distress and suicidal behaviours was found to be conditional on the levels of perceived social support. In other words, our results showed that problem gambling may first trigger episodes of psychological distress, which, in turn, can lead to suicidality among problem gamblers who report low to moderate levels of perceived social support. Our findings suggest that young adult problem gamblers require higher levels of social support from family, friends, and significant others to prevent those experiencing psychological distress from engaging in suicidal behaviours.

The Interpersonal Psychological Theory of Suicide in Italian University Students: Validation of the INQ-15 and the ACSS-FAD

In the frame of the interpersonal psychological theory of suicide (IPTS), Interpersonal Needs Questionnaire (INQ-15) assesses thwarted belongingness (TB) and perceived burdensomeness (PB), related to suicidal ideation (SI); Acquired Capability for Suicide Scale-Fearlessness About Death (ACSS-FAD) measures this component which contributes to lethal self-harm. The objective was to evaluate the psychometric properties of INQ-15 and ACSS-FAD in a population of Italian university students. Since the Italian INQ-15 was already validated, we translated ACSS-FAD through a multistage procedure and administered both to 1,665 Italian university students. Factor analysis confirmed a two-factor-related model of INQ-15, one factor of ACSS-FAD, and good reliability for both. We proved the association between INQ-15 and current SI and between ACSS-FAD and lifetime suicidal planning and/or suicide attempt. The convergent and discriminant validities were in line with those of previous studies. Both tools are valid and reliable to assess the constructs associated with suicide outcomes according to IPTS.

Situation Analysis of Suicide and Self-Harm in the WHO Eastern Mediterranean Region

OBJECTIVE

An estimated 41,000 lives are lost to suicide each year in World Health Organization Eastern Mediterranean Region Office (WHO EMRO) countries. The objective of this study was to conduct a situation analysis for suicide and self-harm in the WHO EMRO region.

METHODS

Data on suicide were obtained from the WHO Global Health Estimates for the years 2000-2019. Information on risk groups efforts to prevent self-harm and suicide in the EMRO region were retrieved through scientific studies, grey literature, and public websites.

RESULTS

During 2000-2019, the age-standardized suicide rate was 6.7 per 100,000 inhabitants, albeit there are concerns regarding data quality. Self-harm and suicide remain criminal acts in more than half of the countries. Few countries have a national plan for prevention of suicide. Toxic agents, such as pesticides and black henna, are easily available and frequently used for suicide in some areas, as are firearms and self-immolation. Successful prevention measures include means restriction and psychosocial interventions after self-harm.

CONCLUSION

Many WHO EMRO countries remain underserved in terms of mental health care. Decriminalization of suicide and means restriction might be further promoted. Online-based tools for mental health literacy and psychosocial therapy are other options to explore.

Does Psychological Flourishing Have the Potential to Mitigate Self-Injurious Thoughts and Behaviors? A Preliminary Analysis of the Protective Influence of Flourishing

AIM

The purpose of this article was to examine whether psychological flourishing, a multi-dimensional construct of well-being, has the potential to play a preventative role in suicidal and nonsuicidal thoughts and actions.

METHODS

This two-part study utilized cross-sectional survey data from college students across the United States, assessing levels of psychological distress, loneliness, and psychological flourishing. Frequencies of suicidal ideation, intent, previous suicidal attempts, and nonsuicidal self-injury (NSSI) were also assessed. Data collected in 2019 were used for Study 1 (n = 38,679) and data collected in 2020 were used for Study 2 (n = 50,307).

RESULTS

Psychological flourishing is significantly inversely related to suicide and NSSI risk when controlling for loneliness and psychological distress. There were two-way interactions between flourishing and distress, whereby under conditions of high distress, the inverse effect of flourishing on suicidal ideation, intent, and attempts and NSSI was more pronounced. These results were consistent across both studies. Subgroup analyses revealed similar results regardless of participants' race, sexual orientation, and gender identity.

CONCLUSION

Inverse associations between flourishing and self-injurious thoughts and behaviors suggest that flourishing may buffer risk of suicide and NSSI, and these findings may have important implications for developing evidence-based therapeutic interventions. Additional research, including longitudinal and clinical work, is warranted.

Longitudinal Impact of Perfectionism on Suicidal Ideation among Chinese College Students with Perceived Academic Failure: The Roles of Rumination and Depression

OBJECTIVE

Suicide has become a nonnegligible cause of death among emerging adults, and academic performance is one of the most significant factors in Chinese college students' suicidal ideation. Based on this, we examined the risk and protective sides of perfectionism on suicidal ideation among college students with perceived academic failure experiences.

METHOD

In the current study, a total of 674 Chinese college students (63.6% females, Mage = 19.96, SD = 1.31) with perceived academic failure in the past six months participated in a survey and completed self-report measures assessing perfectionism, rumination, depression, and suicidal ideation twice with a six-month interval.

RESULTS

Negative perfectionism was a risk factor for suicidal ideation, while positive perfectionism had an opposite effect. In addition, intrusive rumination, deliberate rumination, and depression serially mediated the association between positive/negative perfectionism and suicidal ideation.

CONCLUSION

The results indicated perfectionism has both positive and negative sides to suicidal ideation. Clinicians might be aware of the risk and protective components of perfectionism when intervening with suicidal ideation among college students with perceived academic failure experiences.

Group-format, peer-facilitated mental health promotion interventions for students in higher education settings: a scoping review protocol

INTRODUCTION

Young people in higher education face various stressors that can make them vulnerable to mental ill-health. Mental health promotion in this group therefore has important potential benefits. Peer-facilitated and group-format interventions may be feasible and sustainable. The scoping review outlined in this protocol aims to map the literature on group-format, peer-facilitated, in-person interventions for mental health promotion for higher education students attending courses on campuses in high and low/middle-income countries.

METHODS AND ANALYSIS

Relevant studies will be identified through conducting searches of electronic databases, including Medline, CINAHL, Scopus, ERIC and PsycINFO. Searches will be conducted using Boolean operators (AND, OR, NOT) and truncation functions appropriate for each database. We will include a grey literature search. We will include articles from student participants of any gender, and published in peer-reviewed journals between 2008 and 2023. We will include English-language studies and all study types including randomised controlled trials, pilot studies and descriptive studies of intervention development. A draft charting table has been developed, which includes the fields: author, publication date, country/countries, aims, population and sample size, demographics, methods, intervention type, comparisons, peer training, number of sessions/duration of intervention, outcomes and details of measures.

ETHICS AND DISSEMINATION

No primary data will be collected from research participants to produce this review so ethics committee approval is not required. All data will be collated from published peer-reviewed studies already in the public domain. We will publish the review in an open-access, peer-reviewed journal accessible to researchers in low/middle-income countries. This protocol is registered on Open Science Framework (https://osf.io/agbfj/).

Rethinking students' mental health assessment through GHQ-12: evidence from the IRT approach

BACKGROUND

The General Health Questionnaire-12 (GHQ-12) is a widely used screening tool for mental health assessment however its traditional scoring methods and cutoffs may not adequately capture the mental health complexities of younger populations.

METHODS

This study explores GHQ-12 responses from a sample of university students. Possible differences in means scores considering gender, age, academic field and degree course were assessed through t-test or one-way ANOVA as appropriate. To deeper understanding different levels of severity and individual item impact on general distress measurement, we applied Item-Response-Theory (IRT) techniques (two-parameters logistic model). We compared students' population with a population of workers who underwent a similar psychological evaluation.

RESULTS

A total of 3834 university students participated in the study. Results showed that a significant proportion (79%) of students reported psychological distress. Females and younger students obtained significantly higher average scores compared to others. IRT analysis found item-specific variations in mental distress levels, with more indicative items for short-term fluctuations and potential severe mental health concerns. Latent class analysis identified three distinct subgroups among students (including 20%, 37%, 43% of the participants respectively) with different levels of psychological distress severity. Comparison with a population of adults showed that students reported significantly higher scores with differences in the scale behavior.

CONCLUSION

Our results highlighted the unique mental health challenges faced by students, suggesting a reevaluation of GHQ-12 applicability and cutoff scores for younger populations, emphasizing the need for accurate instruments in mental health evaluation.

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.

Associations between Sleep Disturbance and Suicidal Ideation Severity in Iranian University Students: Evaluating Emotion Regulation Difficulties and Distress Tolerance

AIM

Although sleep disturbance is associated with suicide ideation, underlying cognitive-affective mechanisms that may explain this association are not well understood. The aim of the present study was to concurrently evaluate whether emotion regulation difficulties and distress tolerance explain this association among Iranian university students.

METHOD

A total of 679 Iranian university students (66.42% females; Mage = 24.34 years, SD = 4.86) completed a battery of online self-report questionnaire. Structural equation modeling was used to empirically explore the relations among variables.

RESULTS

Sleep disturbance was positively associated with suicide ideation. Higher sleep disturbance symptoms were associated with higher levels of suicide ideation. Sleep disturbance was indirectly related to suicide ideation through both emotion regulation difficulties and distress tolerance.

CONCLUSION

Findings expand knowledge of cognitive-emotional processes that may explain the sleep disturbance-suicide ideation association among Iranian university students. Iranian students experiencing sleep disturbance may benefit from intervention strategies targeting emotion regulation skills and distress tolerance to reduce suicide ideation.

Efficacy of BrighterSide, a Self-Guided App for Suicidal Ideation: Randomized Controlled Trial

Background

Self-guided digital interventions can reduce the severity of suicidal ideation, although there remain relatively few rigorously evaluated smartphone apps targeting suicidality.

Objective

This trial evaluated whether the BrighterSide smartphone app intervention was superior to a waitlist control group at reducing the severity of suicidal ideation.

Methods

A total of 550 adults aged 18 to 65 years with recent suicidal ideation were recruited from the Australian community. In this randomized controlled trial, participants were randomly assigned to receive either the BrighterSide app or to a waitlist control group that received treatment as usual. The app was self-guided, and participants could use the app at their own pace for the duration of the study period. Self-report measures were collected at baseline, 6 weeks, and 12 weeks. The primary outcome was severity and frequency of suicidal ideation, and secondary outcomes included psychological distress and functioning and recovery. Additional data were collected on app engagement and participant feedback.

Results

Suicidal ideation reduced over time for all participants, but there was no significant interaction between group and time. Similar improvements were observed for self-harm, functioning and recovery, days out of role, and coping. Psychological distress was significantly lower in the intervention group at the 6-week follow-up, but this was not maintained at 12 weeks.

Conclusions

The BrighterSide app did not lead to a significant improvement in suicidal ideation relative to a waitlist control group. Possible reasons for this null finding are discussed.

The impact of different neurobehavioral symptoms on suicidal ideation and perceived likelihood of future suicidality

Existing literature suggests that psychological and functional impairment, independent of head injury severity, can increase suicide risk. This study explores the impacts of self-perceived dysfunction within four neurobehavioral symptom clusters-vestibular (e.g., dizziness, balance), somatosensory (e.g., headaches, nausea, vision), affective (e.g., anxious, irritable mood), and cognitive (e.g., concentration, memory, indecision)-on current suicidal ideation and the perceived likelihood of future suicidal ideation and attempts. Community participants (n = 309; Mage = 36.88; 51.6% female; 79.6% White) completed the Neurobehavioral Symptom Inventory (NSI) and the Self-Injurious Thoughts and Behaviors-Short Form (SITBI-SF). Quantile regression analysis was used to explore the effects of the four neurobehavioral symptom clusters at different levels of suicidal ideation intensity, perceived likelihood of future suicidal ideation, and self-perceived likelihood of future suicide attempt. Controlling for past head injuries and suicide attempts, affective symptoms were significantly associated with a moderate and high average intensity of current suicidal ideation. Somatosensory symptoms were significantly associated with a moderate perceived likelihood of future suicidal ideation. Finally, vestibular symptoms were significantly associated with a moderate perceived likelihood of a future suicide attempt. These findings highlight the critical need to consider a broader spectrum of symptoms, including chronic physical symptoms, when assessing suicide risk. Furthermore, they underscore the need to expand beyond affective symptoms as an explanation for increased suicidality and examine additional mechanisms through which chronic physical symptoms can increase suicide risk.

Gender difference in emotional distress among nursing and health science college students: An online survey

This cross-sectional study investigates the self-reported emotional distress of medical, nursing, dental, pharmacy, and public health students and identifies gender-related differences through an online survey. The data of 364 students were analyzed using Pearson correlation coefficients and multiple logistic regression. Emotional distress was more prevalent among female respondents (11.7 %) than male (3.8 %) respondents. The stigma, isolation, and depression experienced by female respondents influenced their emotional distress, whereas only the depression of male respondents influenced their emotional distress. Our findings suggest that mental health professionals should consider gender-specific factors when developing interventions for the study population to minimize emotional distress.

Supports for university counselors impacted by student suicide: A systematic review and thematic synthesis

The purpose of this systematic review and thematic synthesis was to identify and consolidate research on the support needs of impacted Higher Education (HE) counselors that have experienced a student suicide death. When exposed to a student suicide death, counselors are often extensively involved in a postvention response. This systematic review synthesized four qualitative papers that explored the experiences of staff impacted by student suicide. Thematic synthesis revealed three core themes: The unknown, responding, and the known, and six subthemes: Gaps in knowledge of individual experience, gaps in knowledge of organizational impact, extrospective responding, introspective responding, the needs of impacted counselors, the degree of impact, and the support processes that arise from needs. The results provide a summary of the current supports available to impacted HE counselors and considerations relevant to their postvention needs.

Mental health and adherence to Mediterranean diet among university students: an Italian cross-sectional study

OBJECTIVE

This study is aimed to explore severe mental illness (SMI), mental well-being (MWB), and Mediterranean Diet adherence (MedDiet) among university students.

PARTICIPANTS

University students in Northern Italy (sample size = 502).

METHODS

Cross-sectional survey was conducted in 2019. The questionnaires included Warwick-Edinburgh Mental Well-Being Scale for MWB, K6 for SMI, Mediterranean Diet Adherence Screener for MedDiet. Multivariable regressions were mainly performed (p < .05 as significant).

RESULTS

MWB was high in 3.93% of the participants and low in 23.97%. SMI was probable in 21.87%. MedDiet adherence was high in 2.19% and low in 35.06%. Mainly, poor/very poor perceived health, Economics/Legal/Strategic Sciences courses, and not being on time with exams showed associations with both lower MWB and probable SMI. Gender and some lifestyle, dietary, and university factors predicted MedDiet. MWB and MedDiet were positively associated.

CONCLUSIONS

This study found high levels of mental issues and low MedDiet. Modifiable factors at university level should be investigated to design preventive interventions.

University students' intentions to seek psychological counseling, attitudes toward seeking psychological help, and stigma

BACKGROUND

Mental health problems are prevalent among university students worldwide. Studies have shown that most students do not disclose and do not get the psychological help and support they need.

OBJECTIVES

This survey aims to investigate the intentions to seek psychological counseling (ISC) among university students, their attitudes toward seeking professional psychological help (ATSPPH), and the predictors of those intentions and attitudes including stigma.

DESIGN AND METHODS

a cross-sectional survey was conducted among 420 students at the American University of Beirut (AUB).

RESULTS

Depression, test anxiety, and difficulty sleeping are the three main reasons students would seek psychological help. The source the students most preferred to ask for help was one's family followed by psychologists and psychiatrists. Students' ATSPPH is a positive predictor of their ISC, while students' self-stigma of seeking help (SSOSH) is a negative predictor of their ATSPPH. Moreover, students' awareness of the psychological help system available on campus, free of charge, is a positive predictor for both ISC and ATSPPH.

CONCLUSION

Different interventions are needed to reduce stigma and enhance students' mental health literacy and awareness of the available professional psychological help on campus.

Suicide literacy mediates the path from religiosity to suicide stigma among Muslim community adults: Cross-sectional data from four Arab countries

BACKGROUND

The majority of research attention has been devoted to the link between religiosity and suicide risk, and a considerable amount of studies has been carried out on how stigma impacts individuals with mental health problems of different kinds. However, the interplay between religiosity, suicide literacy and suicide stigma has seldom been empirically researched, especially quantitatively. We sought through this study to redress the imbalance of research attention by examining the relationship between religiosity and suicide stigma; and the indirect and moderating effects of suicide literacy on this relationship.

METHOD

A cross-sectional web-based survey was conducted among Arab-Muslim adults originating from four Arab countries (Egypt: N = 1029, Kuwait: N = 2182, Lebanon N = 781, Tunisia N = 2343; Total sample: N = 6335). The outcome measures included the Arabic Religiosity Scale which taps into variation in the degree of religiosity, the Stigma of Suicide Scale-short form to the solicit degree of stigma related to suicide, and the Literacy of Suicide Scale explores knowledge and understanding of suicide.

RESULTS

Our Mediation analyses findings showed that literacy of suicide partially mediated the association between religiosity and stigmatizing attitude toward suicide. Higher religiosity was significantly associated with less literacy of suicide; higher literacy of suicide was significantly associated with less stigma of suicide. Finally, higher religiosity was directly and significantly associated with more stigmatization attitude toward suicide.

CONCLUSION

We contribute the literature by showing, for the first time, that suicide literacy plays a mediating role in the association between religiosity and suicide stigma in a sample of Arab-Muslim community adults. This preliminarily suggests that the effects of religiosity on suicide stigma can be modifiable through improving suicide literacy. This implies that interventions targeting highly religious individuals should pay dual attention to increasing suicide literacy and lowering suicide stigma.

Suicidality among university students in the Eastern Mediterranean region: A systematic review

The prevalence of suicide attempts and suicidal ideation among university students is a global concern. Cultural values, social determinants, religion, and especially growing stress all play an important role in this. This systematic review aimed to identify potential protective and risk factors thought to be associated with suicidal ideation among students in the Eastern Mediterranean region and highlight the importance of developing an effective health care response. MEDLINE, CINAHL, Embase, PsycINFO, WHO Global Health Library, IMEMR, Web of Science Core Collections and Farsi and Arabic databases were searched for papers in English, Farsi, and Arabic. A combination of validated filters, free text keywords, and Mesh and Non-Mesh terms were used to retrieve relevant literature. A total of 2774 papers were found after the search, 257 selected for full-text review, and 72 papers included in the final review. Family and peer support play a potential protective role in the development of suicidal ideation among university students, while adverse life events, bullying, depression, anxiety, and other mental health conditions were identified as risk factors. Suicidality was likely under-reported due to stigma around social and cultural factors. Factors involving religion and culture may act as both protective and risk factors and require more in-depth investigation. The student population in the Eastern Mediterranean region face many challenges. The common theme of suicidality emerged as an indicator of an imbalance of resources and stress, which needs to be addressed proactively, given a most likely underreporting of suicidal ideation and attempts due to stigma.

Perfect people, happier lives? When the quest for perfection compromises happiness: the roles played by substance use and internet addiction

Building on the Conservation of Resources Theory and the Stress-Coping Model, the present study explored the relationship between perfectionism (rigid, self-critical, narcissistic) and subjective happiness among youth. In this relationship, we also examined the mediating roles of substance use (i.e., drinking and smoking) and Internet addiction symptoms. Our sample comprised 431 Romanian university students aged 18-25 (M = 20.50, SD = 1.58), and most of them were females (79.81%, self-reported gender). Participants completed self-reported anonymous scales through a web-based survey at the beginning of 2023. Correlation analysis results indicated that all forms of perfectionism were associated with Internet addiction symptoms. Self-critical and narcissistic perfectionism and drinking, smoking, and Internet addiction symptoms were negatively associated with subjective happiness. Path analysis suggested that health-risk behaviors completely mediated the effect of perfectionism on subjective happiness. High levels of perfectionism were associated with high levels of health-risk behaviors, and high levels of addictive behaviors were associated with low levels of subjective happiness. We discuss the present findings considering their practical use regarding students' subjective happiness.

A 2-year follow-up of the effects of combined binge drinking and cannabis consumption on academic performance and adjustment in Spanish third-year university students

Introduction

The study was based on 2-year follow-up of the effects of binge drinking and cannabis co-consumption on academic performance and adjustment in Spanish Third-Year University Students and to further explore the impact of academic adjustment on this relationship.

Methods

A total of 144 students (aged 19-20 years) enrolled in the third year of university completed the study. The students were recruited during in first academic year (T1) via a survey that included items regarding the use of alcohol (AUDIT-C), cannabis and other drugs and demographic variables. Then, participants meeting the study criteria were then selected and invited by e-mail to a clinical (face-to face) structured interview. The participants completed a calendar of alcohol consumption during the 6 months prior to the interview (Alcohol Timeline Follow back), and recorded cannabis consumption in 3 months prior to the interview. To examine the effects of alcohol and cannabis co-consumption on the outcome variables, we categorized participants into three consumption groups (i.e., control, BD, and BDCA) based on the number of BD days and cannabis unit scores.

Results

Binge drinking and cannabis co-consumption in first-year students was significantly associated with poor academic performance and adjustment after 2 years of undergraduate study. Relative to controls, co-consumers (BDCA) reported significantly lower academic and personal-emotional adjustment to university as well as poorer performance. Mediation analysis showed that academic adjustment explains the mechanism by which BDCAs perform less well, mediating the relationship between co-consumption and academic performance, with an indirect effect representing 64.61% of the total effect. Furthermore, the mediating effect of academic adjustment was maintained after controlling for academic adjustment and baseline grade point average (T1).

Conclusion

This prospective follow-up study helps to further our knowledge of how combined binge drinking and cannabis consumption may affect university adjustment and academic success in Spanish university students Overall, the study results should encourage health professionals, educational psychologists and academic institutions to take ownership of the need for support and involvement in prevention, as well as for provision of guidelines for implementing appropriate intervention strategies.

Prevalence and factors associated with depression and suicidal ideation among French students in 2016: A national study

Depression is one of the leading causes of morbidity worldwide and increases the risk of suicide. Students are known as a population at risk for depression. This study aimed to evaluate the prevalence of 12 months major depressive episode (MDE) and suicidal thoughts in French students and investigate associated factors. A questionnaire was sent by email to a representative sample of the French student population between April 28th and June 27th 2016. MDE was assessed using the Composite International Diagnostic Interview Short Form (CIDI-SF). The response rate was 18.7% (N= 18,875). Prevalence of 12 months MDE was 15.8%, and suicidal thoughts was 9%. Factors associated with MDE were being a woman, study field (law/eco, human/social sciences, and medical), having failed midterms exams or dropout, refusal or stop social scholarship, and subjective financial difficulties. Factors associated with suicidal thoughts were study field (human/social sciences), having failed midterms exams or dropout, and important subjective financial difficulties. The use of CIDI-SF allows comparison with the 2017 French national study, and showed more MDE in students than in the general population. This is the only national study on French students before COVID 19 pandemic.

Mental health trajectories in university students across the COVID-19 pandemic: findings from the Student Wellbeing at Northern England Universities prospective cohort study

Introduction

Psychological wellbeing in university students is receiving increased focus. However, to date, few longitudinal studies in this population have been conducted. As such, in 2019, we established the Student Wellbeing At Northern England Universities (SWANS) cohort at the University of York, United Kingdom aiming to measure student mental health and wellbeing every six months. Furthermore, the study period included the COVID-19 pandemic, giving an opportunity to track student wellbeing over time, including over the pandemic.

Methods

Eligible participants were invited to participate via email. Data were collected, using Qualtrics, from September 2019 to April 2021, across five waves (W1 to W5). In total, n = 4,622 students participated in at least one wave of the survey. Data collection included sociodemographic, educational, personality measures, and mental health and wellbeing. Latent profile analyses were performed, exploring trajectories of student wellbeing over the study period for those who had completed at least three of the five waves of the survey (n = 765), as measured by the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS).

Results

Five latent profile trajectories of student wellbeing were identified. Of these, the two latent classes with initially higher wellbeing scores had broadly stable wellbeing across time (total n = 505, 66%). Two classes had lower initial scores, which lowered further across time (total n = 227, 30%). Additionally, a fifth class of students was identified who improved substantially over the study period, from a mean WEMWBS of 30.4 at W1, to 49.4 at W5 (n = 33, 4%). Risk factors for having less favourable wellbeing trajectories generally included identifying as LGBT+, self-declaring a disability, or previously being diagnosed with a mental health condition.

Conclusion

Our findings suggest a mixed picture of the effect of the COVID-19 pandemic on student wellbeing, with a majority showing broadly consistent levels of wellbeing across time, a smaller but still substantial group showing a worsening of wellbeing, and a small group that showed a very marked improvement in wellbeing. Those from groups traditionally underrepresented in higher education were most at risk of poorer wellbeing. This raises questions as to whether future support for wellbeing should target specific student subpopulations.

Why the belief in one's equal rights matters: Self-respect, depressive symptoms, and suicidal ideation in Western and non-Western countries

The present research investigated the relationship between self-respect (i.e., a person's belief of possessing the same rights as others) and depressive symptoms. Based on earlier longitudinal findings that self-respect fosters assertiveness and that assertiveness negatively predicts depressive symptoms, we tested these relationships in Western and non-Western countries. Additionally, we explored associations with suicidal ideation. Across seven countries (N = 2408) we found that self-respect and depressive symptoms were negatively correlated. In addition, we found evidence for an indirect path via assertiveness as well as negative correlations with suicidal ideation in countries with available measures. Finally, within-manuscript meta-analyses confirmed the main path between self-respect and depressive symptoms across all seven countries. This research presents the first evidence for the negative association between self-respect (feeling equal to others) and depressive symptoms and highlights new directions for linking self and self-regard to mental health.

Mediating role of psychological distress in the associations between medical errors, adverse events, suicidal ideation and plan among operating room nurses in China: a cross-sectional study

OBJECTIVES

Medical errors (MEs) and adverse events (AEs) both had long-term impacts on healthcare professionals. Studies investigated the associations between MEs, AEs, psychological distress and suicidal behaviours among healthcare professionals. The aim of the current study was to explore the mediating role of psychological distress in the relationship between MEs/AEs and suicidal ideation/suicide plan among operating room nurses in China.

DESIGN

A cross-sectional study.

SETTING

The survey was conducted between December 2021 and January 2022 in China.

PARTICIPANTS

A total of 787 operating room nurses completed the questionnaires in China.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome measures were MEs and AEs. Secondary outcome measures were psychological distress and suicidal behaviours.

RESULTS

The results showed that 22.1% of operating room nurses were involved in MEs, while 13.9% of operating room nurses were involved in AEs. The associations between suicidal ideation (OR=1.10, p<0.001), suicide plan (OR=1.07, p<0.01) and psychological distress were significant. The associations between suicidal ideation (OR=2.76, 95% CI=1.53 to 4.97, p<0.01), suicide plan (OR=2.80, 95% CI=1.20 to 6.56, p<0.05) and MEs were significant. The associations between suicidal ideation (OR=2.27, 95% CI=1.17 to 4.40, p<0.05), suicide plan (OR=2.92, 95% CI=1.19 to 7.18, p<0.05) and AEs were significant. The psychological distress mediated the relationship between MEs/AEs and suicidal ideation/suicide plan.

CONCLUSION

There were positive associations between MEs, AEs and psychological distress. Moreover, MEs and AEs were also positively associated with suicidal ideation and suicide plan. As expected, psychological distress played an important role in the relationship between MEs/AEs and suicidal ideation/suicide plan.

Suicide ideation among Brazilian college students: Relationship with academic factors, mental health, and sexual abuse

BACKGROUND

Suicide is one of the leading causes of death among youth and its occurrence among college students is a matter of great concern. Challenges of transitional adulting and mental illness increase the likelihood of suicidal cognition in students. The objective of present study was to investigate the prevalence of suicide ideation and associated factors in a representative sample of Brazilian college students (n = 12,245).

METHODS

Data were drawn from a nationwide survey and further subjected to estimate the prevalence of suicide ideation and its association with socio-demographic and academic characteristics. We performed logistic regression analyses upon a conceptual framework, considering individual and academic factors.

RESULTS

The point-prevalence of suicide ideation among college students was 5.9 % (SE = 0.37). In the final regression model, variables associated with the likelihood of suicide ideation were psychopathology, sexual abuse, and academic variables, such as dissatisfaction with the chosen undergraduate course (OR = 1.86; IC95 % 1.43-2.41) and low academic performance (OR = 3.56; IC95 % 1.69-7.48). Having children and religious affiliation were inversely associated with the likelihood of suicide ideation.

LIMITATIONS

Participants were recruited from state capitals, which limited data generalizability to non-urban college students.

CONCLUSIONS

The impact of academic life on the mental health of students should be carefully monitored in in-campus pedagogical and health services. Early identification of poor-performance students with social disadvantages could indicate vulnerable ones who are much in need of psycho-social support.

Self-harm in university students: A comparative analysis of data from the Multicentre Study of Self-harm in England

BACKGROUND

Increases in poor mental health and suicide have been identified among university students in the UK. However, little is known about self-harm in this group.

AIMS

To describe and identify care needs of university aged-students who self-harm via comparisons with an age-equivalent non-student group who self-harm.

METHODS

Observational cohort data from The Multicentre Study of Self-harm in England were used to investigate students aged 18 to 24 years who presented to emergency departments for self-harm, 2003 to 2016. Data were collected via clinician reports and medical records from five hospitals in three English regions. Characteristics, rates, repetition, and mortality outcomes were investigated.

RESULTS

The student sample included 3491 individuals (983, 28.2 % men; 2507, 71.8 % women; 1 unknown) compared to 7807 (3342, 42.8 % men; 4465, 57.2 % women) non-students. Self-harm increased over time in students (IRR 1.08, 95%CI 1.06-1.10, p < 0.01) but not in non-students (IRR 1.01, 95%CI 1.00-1.02, p = 0.15). There were differences in monthly distribution of self-harm with more presentations by students in October, November, and February. Characteristics were broadly similar, but students reported more problems with studying and mental health. Repetition (HR 0.78, 95%CI 0.71-0.86, p < 0.01) and mortality (HR 0.51, 95%CI 0.33-0.80, p < 0.01) were lower in students than non-students.

CONCLUSIONS

Self-harm in students may be directly related the student experience, such as academic pressure, relocation, and the transition to independent living. Wellbeing initiatives targeting these factors, alongside mental health awareness training for academic and non-academic staff may help to support students at risk.

Designing and determining the effectiveness of a suicide intervention package for psychologists working in the primary health care system

Aims

Suicide is a major public health problem around the world. The present study aimed to design and determine the effectiveness of a suicide intervention package for psychologists working in the primary health care system in Hormozgan Province.

Materials and Methods

This study was conducted in two phases: qualitative and quantitative phases. In the qualitative phase, it was a thematic analysis type, and in the quantitative phase, it was quasi-experimental type with pretest-posttest in two groups of intervention and comparison. To standardize the suicide intervention package, Delphi method was used, and for quantitative content validity, content validity index (CVI) and content validity ratio (CVR) were used. In the quantitative phase of the study, the statistical population of the study included 270 people who had suicidal ideations and had no history of suicide attempt. Among them, 135 people were included in the intervention group and 135 people were included in the comparison group using a convenience sampling method. They were selected among those referred to eight comprehensive rural and urban health service centers in eight cities of Hormozgan Province. The results were analyzed by MANCOVA statistical test.

Results

CVR was more than 0.75 and CVI was more than 0.87. In the quantitative phase, the results showed a significant difference between the means before and after the intervention for the variables of psychological distress, suicidal ideation, and hopelessness (P < 0.01).

Conclusion

It seems that psychological suicide preventive interventions in the primary health care system are effective in reducing psychological distress,suicidal thoughts and hopelessness.

The Mental Imagery for Suicidality in Students Trial (MISST): study protocol for a feasibility randomised controlled trial of broad-minded affective coping (BMAC) plus risk assessment and signposting versus risk assessment and signposting alone

BACKGROUND

Going to university is an important milestone in many people's lives. It can also be a time of significant challenge and stress. There are growing concerns about mental health amongst student populations including suicide risk. Student mental health and counselling services have the potential to prevent suicide, but evidence-based therapies are required that fit these service contexts. The Broad-Minded Affective Coping intervention (BMAC) is a brief (6 sessions), positive imagery-based intervention that aims to enhance students access to past positive experiences and associated emotions and cognitions. Pilot data provides preliminary support for the BMAC for students struggling with suicidal thoughts and behaviours, but this intervention has not yet been evaluated in the context of a randomised controlled trial (RCT). The Mental Imagery for Suicidality in Students Trial (MISST) is a feasibility RCT that aims to determine the acceptability and feasibility of evaluating the BMAC as an intervention for university students at risk of suicide within a larger efficacy trial. Key feasibility uncertainties have been identified relating to recruitment, retention, and missing data. Intervention acceptability and safety will also be evaluated.

METHOD

MISST is a feasibility randomised controlled trial design, with 1:1 allocation to risk assessment and signposting plus BMAC or risk assessment and signposting alone. Participants will be university students who self-report experiences of suicidal ideation or behaviour in the past 3 months. Assessments take place at baseline, 8, 16, and 24 weeks. The target sample size is 66 participants. A subset of up to 20 participants will be invited to take part in semi-structured qualitative interviews to obtain further data concerning the acceptability of the intervention.

DISCUSSION

The BMAC intervention may provide an effective, brief talking therapy to help university students struggling with suicidal thoughts that could be readily implemented into university student counselling services. Depending on the results of MISST, the next step would be to undertake a larger-scale efficacy trial.

TRIAL REGISTRATION

The trial was preregistered (17 December 2021) on ISRCTN (ISRCTN13621293) and ClinicalTrials.gov (NCT05296538).

The Impact of Campus-Based Therapy Dogs on the Mood and Affect of University Students

University students experience a high level of stress, which could potentially affect how they manage stressful situations beyond university, such as when entering the workforce. Although universities offer counseling services and various health promotion programs, there is reluctance and negative perceptions about utilizing these from students. Further research is needed to explore the effectiveness of therapy dog interventions in human interactions that is quantifiable and embraces the elements of health promotion. This study aimed to investigate the impact of therapy dog interventions on students' moods across a multi-campus university during a 2-week final examination period. Two hundred and sixty-five students participated in the study involving a multi-campus university. The intervention group and control group completed a questionnaire involving the positive affect negative affect schedule (PANAS), a 20-item scale that measures a person's affect at the time. The intervention group (n = 170) had a higher average of total PANAS scores (mean = 77.63, standard deviation = 10.975) compared to the control group (n = 95) (mean = 69.41, standard deviation = 13.442). The results were statistically significant (mean difference = 8.219, 95% CI = 5.213-11.224, p < 0.05) with a t-score of 5.385. Students who engaged with therapy dogs on campus during the examination period were more likely to have a more positive affect. The results suggest that universities should include therapy dog programs within their health promotion programs for students, as these may help improve their mood and reduce the stress associated with university examinations.

General Health Questionnaire (GHQ12): new evidence of construct validity

This study aimed to gather evidence on the adequacy of the General Health Questionnaire (GHQ-12) in Brazil, considering a random sample of Brazilian physicians. Specifically aimed: (1) to test the GHQ-12 bifactor structure compared to alternative models, (2) to check its factorial invariance regarding to gender and the diagnosis of mental and behavioral disorders, and (3) to know the association of this measure with indicators of poor health (e.g., suicidal thoughts, decreased libido, medication use). The study included 1,085 physicians with a mean age of 45.7 (SD = 10.6), mostly male (61.5%), married (72.6%) and Catholic (59.2%). They answered the GHQ-12, the Positive and Negative Suicidal Ideation Inventory, and demographic questions. The best fit model was the bifactor structure composed of anxiety and depression, in addition to a general dimension, which presented Cronbach's alpha, McDonald's ω and composite reliability higher than 0.70 just for a general fact. Psychological distress scores correlated with suicidal ideation and indicators of health and sexual satisfaction. This is a psychometrically suitable instrument that can be used in terms of its total, but its specific factors need to be used with caution.

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.

Trajectory of suicidal ideation among medical students during the COVID-19 pandemic: the role of childhood trauma

BACKGROUND

The aim of this study was to understand the longitudinal trajectory of suicidal ideation (SI) among Chinese medical students and the role of childhood trauma (CT).

METHODS

Using a whole-group sampling method, we assessed SI in 2192 (male = 834, female = 1358) medical students on three occasions over a period of one year. The Suicidal Ideation Self-Assessment Scale (SISAS) and the Childhood Trauma Questionnaire-Short Form (CTQ-SF) were used to assess SI and CT. The growth mixture modeling (GMM) was used to classify the developmental trajectory of SI.

RESULTS

A greater number of medical students were experiencing suicidal ideation during the COVID-19 pandemic. The trajectory of SI among medical students was divided into two groups: a low risk, slowly rising group and a high risk, continuous group. The low risk, slowly rising group had a significant time effect (B = 1.57, p < 0.001) and showed a slowly increasing trend. Emotional neglect (EN), physical neglect (PN), emotional abuse (EA) and physical abuse (PA) all had significant positive predictive effects for the high risk, continuous group (B = 0.18-0.65, P < 0.01).

CONCLUSION

The trajectory of SI among medical students can be divided into a low risk, slowly rising group and a high risk, continuous group; the more EN, PN, EA and PA experienced during childhood, the more likely medical students are to develop a high risk, continuous state of SI.

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

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

Supervision Effects on Negative Affect and Psychological Distress: Evidence from Social Workers in China

Supervision is an imperative practice within the social work field. It provides social workers with support systems, ensures that social workers are adhering to professional standards, and protects clients. Research has also shown that quality supervision can improve social workers' professional capacity and reduce work stress. However, most of this research has been confined to social workers' experiences within Western countries and has been largely qualitative in nature. Thus, this study aims to examine the experience of 489 social workers based in Guangzhou, China to understand how supervision affects their negative affect and psychological distress. The findings indicate that supervision not only reduces negative affect and psychological distress amongst Chinese social workers, but also is especially effective for social workers with high job demands. When job demands are high, social workers who receive both individual and group supervision also appear to have lower negative affect and psychological distress as compared to social workers who only receive individual supervision. These findings emphasize the significance of supervision as a buffer factor to reduce negative affect and psychological distress amongst Chinese social workers who face high job demands.

Instability of emotional relationships and suicide among youth: a qualitative study

BACKGROUND

Interpersonal problems are one of the factors for understanding the complex issues that result in suicide attempts and self-injury by poisoning. The quality of familial relationships is a predictor of the occurrence and outcome of suicide attempts. This study aimed to explore motives for self-poisoning suicide attempts amongst young adults.

METHOD

This research was a qualitative study conducted using semi-structured interviews in 2019 in Kermanshah Province, Iran. Eighteen participants who had attempted suicide by self-poisoning were interviewed, and information was collected until data saturation was achieved. The interviews were recorded and transcribed, and the data were analyzed through content analysis.

RESULTS

The results included the category of instability in emotional relationships with the three sub-categories of 1- Emotional failure, 2- Emotional trauma, and 3- Loss of emotional resilience (caused by emotional failure and emotional trauma within the previous few months). Instability in emotional relationships creates feelings of disgrace, humiliation, burdensomeness, worthlessness, and insignificance, which increases the chances of attempting suicide.

CONCLUSION

The study results provided an in-depth understanding of romantic, and unstable familial relationships as a significant factor in suicide attempts, demonstrating the role of emotional stress in attempting suicide. The present study provided information on the risk factors and warning signs for psychiatrists and nurses dealing with suicidal patients to take effective measures to prevent suicide through social support.

Mental health disorder symptom prevalence and rates of help-seeking among University-Enrolled, emerging adults

Objective. Examine mental health symptom prevalence and rates of campus services utilization among Black male, White male and Black female college students. Participants. 2500 students from an ongoing, student survey at a public university; launched in 2011. Methods. Measures included data for anxiety and depressive symptoms and utilization of campus health services (counseling center, health services, etc.). Descriptive analyses determined prevalence and utilization rates. Mann Whitney U tests compared prevalence. Chi-squared tests compared utilization rates. Results. Anxiety prevalence: greater than 60% of students from each ethnic group reported symptoms; reporting rates decreased significantly for Black men (49.6%); p < 0.001. Depression prevalence: greater than 80% reported symptoms; there were significant differences in reporting between Black men and Black women (72.7% vs. 87.1%, p < 0.001). Utilization: Black men utilized counseling services less than White men (20.4% vs. 37.8%, p = 0.024). Conclusion. Black men report depressive and anxiety symptoms but underutilize campus health resources.

Educational contexts that nurture students' psychological needs predict low distress and healthy lifestyle through facilitated self-control

Psychological distress and unhealthy lifestyle behaviors are highly prevalent among undergraduate students. Importantly, numerous longitudinal studies show that these phenomena rise significantly during the first months of college and remain high thereafter. However, research identifying theory-driven mechanisms to explain these phenomena is lacking. Using two complementary statistical approaches (person- and variable-centered), this study assesses basic psychological needs (BPNs) and self-control as possible explanatory factors underlying the association between student's educational experience and multiple health-related outcomes. A total of 2450 Canadian undergraduates participated in this study study involving two time points (12 months apart; NTime1 = 1783; NTime2 = 1053), of which 386 participated at both measurement occasions. First, results from person-centered analyses (i.e., latent profile and transition analyses) revealed three profiles of need-satisfaction and frustration in students that were replicated at both time points. Need-supportive conditions within college generally predicted membership in the most adaptive profile. In turn, more adaptive profiles predicted higher self-control, lower levels of psychological distress (anxiety, depression), and healthier lifestyle behaviors (physical activity, fruit and vegetable consumption). Second, results from variable-centered analyses (i.e., structural equation modeling) showed that the association between students' BPNs and health-related outcomes was mediated by self-control. In other words, high need satisfaction and low need frustration were associated with higher self-regulatory performance at Time 1, which in turn predicted a more adaptive functioning at Time 2. Overall, these findings help clarify the mechanisms underlying the association between college educational climate and students' health-related functioning.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-04019-5.

College students’ screening early warning factors in identification of suicide risk

This study aimed to explore the main influencing factors of suicide risk among Chinese students and establish an early warning model to provide interventions for high-risk students. We conducted surveys of students in their first and third years from a cohort study at Jining Medical College. Logistic regression models were used to screen the early warning factors, and four machine learning models were used to establish early warning models. There were 8 factors related to suicide risk that were eventually obtained through screening, including age, having a rough father, and CES-D, OHQ, ASLEC-4, BFI-Neuroticism, BFI-Openness, and MMC-AF-C scores. A random forest model with SMOTE was adopted, and it verified that these 8 early warning signs, for suicide risk can effectively predict suicide risk within 2 years with an AUC score of 0.947. Among the factors, we constructed a model that indicated that different personality traits affected suicide risk by different paths. Moreover, the factors obtained by screening can be used to identify college students in the same year with a high risk of suicide, with an AUC score that reached 0.953. Based on this study, we suggested some interventions to prevent students going high suicide risk.

Bending not breaking: coping among Filipino University students experiencing psychological distress during the Global Health Crisis

The impact of the global health crisis on students' mental health has been well documented. While most of the studies looked into the psychological impact of the coronavirus disease, the process of coping with psychological distress as experienced by university students in the Philippines remains unexamined. Cognizant of the dearth in literature, this grounded theory study purports to investigate and understand the coping processes among 20 Filipino university students. A comprehensive model highlights Filipino university students' coping techniques with psychological distress through vertical and horizontal analysis of the field text, open, axial, and selective coding. To ensure the trustworthiness and truthfulness of the theory and for refinement and consistency, triangulation, peer debriefing, and member checking validation strategies were likewise employed. The novel and distinct B.E.N.D. Model of Coping with Psychological Distress illustrates a substantive four-phased process symbolic of the challenges that a bamboo tree underwent, namely: (1) Befuddling Phase, (2) Enduring Phase, (3) Navigating Phase, and (4) Developing Phase. The phases that emerged had the advanced appreciable understanding of the university students' coping processes that may provide evidence-based information in crafting programs and specific interventions to support and safeguard students' mental health.

Study of suicidal thoughts and intentions with regard to job stress among female medical students living in dormitory with a mental health promotion approach

BACKGROUND

Medical students are exposed to stresses which have irreversible consequences, such as suicidal ideation. The present study aimed to investigate the level of occupational stress in medical students and its relationship with the prevalence of suicidal ideation and attention among them and then provide mental health promotion approaches.

MATERIALS AND METHODS

This cross-sectional descriptive study was performed on 325 undergraduate medical students residing at the dormitory of Shahid Beheshti University of Medical Sciences. The sample size was determined by the census method. Osipow and Suicide Behaviors Questionnaires were used to measure job stress and suicidal ideation, respectively. The condition of entry into the study was living in the dormitory and spent at least one semester. Linear regression and logistic regression were used to examine the relationship between variables.

RESULTS

The mean score of occupational stress among students with a mean age of 21 (±2.18) years was 158.84 (±27.07) and 60% (n = 180) of students had high levels of stress. There was a significant relationship between age and educational level with stress level and suicidal ideation (P < 0.05). They had the highest effect on stress (P = 0.031) and suicidal ideation (P = 0.001), respectively, among students. High level of stress was 11.829 times more likely to have suicidal thoughts than low-stress level (P < 0.001).

CONCLUSIONS

Stress and suicidal ideation are much higher in students of lower semesters and lower ages than students with higher semesters. Students should learn how and with what approach to control and manage exposure to stressors. Measures such as holding stress management training courses as well as managing stressful situations are among the effective measures in improving mental health and reducing stress levels and its effects.

Being able to enjoy normal day to day activities separates suicidal ideation from attempted suicide in a nationwide population-based health examination study of adults aged 18 to 28 years

PURPOSE

A higher total score on the General Health Questionnaire (GHQ-12) is associated with a higher likelihood of having suicidal ideation as well as having suicide attempt. The association of GHQ-12 with suicide attempts item by item has not been analyzed earlier.

MATERIALS AND METHODS

In a population-based sample, aged 18 to 28 years, mental illness was assessed as self-reported during the interview. Participants were also asked to score on two specific questions concerning suicidal ideation as well as attempted suicide. The GHQ-12 total score and each of the 12 item scores of the GHQ-12 were analyzed with regression models to explain suicidality (n = 679).

RESULTS

The total score of GHQ-12 differed by suicidality (Bonferroni-corrected p < 0.001). The item 6 (Felt that could not overcome difficulties) and the item 11 (Feeling oneself worthless) were associated with suicidal ideation (OR = 1.66, 95% CI = 1.12-2.47, p = 0.01 and OR = 1.58, 95% CI = 1.04-2.39, p = 0.03, respectively) as well as with suicide attempts (OR = 2.82, 95% CI = 1.54-5.16, p = 0.001 and OR = 3.10, 95% CI = 1.64-5.85, p < 0.001, respectively). The item 7 (Able to enjoy normal day to day activities) was associated with suicide attempts (OR = 0.28, 95% CI = 0.12-0.64, p = 0.003) and made the item-specific difference between those with suicidal ideation w/o suicide attempt (OR = 0.35, 95% CI = 0.14-0.89, p = 0.03).

CONCLUSION

Being able to enjoy normal activities day to day made a difference between suicidal ideation and attempted suicide.

The Mediating Roles of Mental Health and Substance Use on Suicidal Behavior Among Undergraduate Students With ADHD

OBJECTIVE

To evaluate the prevalence of suicidal ideation (SI), plans and attempts, and non-suicidal self-injury (NSSI) among students with attention deficit hyperactivity disorder (ADHD). Furthermore, we explored the mediating effects of depression, anxiety, alcohol and substance use on the association between ADHD and suicidal behaviors and NSSI.

METHOD

Participants were first-year undergraduate students (n = 1,829) recruited as part of the World Mental Health International College Student Initiative. Participants completed validated clinical measures online.

RESULTS

The prevalence of suicide behaviors and NSSI were significantly higher among students with ADHD than those without. Mediation analyses indicated that ADHD directly and indirectly increased suicidal behaviors and NSSI. While ADHD increased suicidal behaviors and NSSI through depression, ADHD and the co-variates age and gender also had indirect effects on suicidal behaviors via substance use.

CONCLUSIONS

Specific predictors of risk were identified for students with ADHD which may inform the development of more targeted mental health and suicide prevention strategies across campuses.

The protective role of sense of community and access to resources on college student stress and COVID-19-related daily life disruptions

The aim of our study was to understand more about how college students have been impacted by the pandemic and how their universities can better support them by emphasizing protective factors that build resilience. The protective factors we explored were sense of community, perceived adequacy of resources, and perceived social support.We conducted an online survey, which was administered to 296 (70.4% female and Mage = 20.34) students from a private Northeastern University in the United States. There were gender and class year differences found after analysis. In addition, sense of community and perceived adequacy were found to be statistically significant. There were gender and class year differences found after analysis. In addition, sense of community and perceived adequacy were found to be statistically significant. Overall, our findings highlight the importance of sense of community and access to resources as protective factors in mitigating stress and coronavirus disease 2019-related disruptions to daily life among college students, particularly for female students who report more adverse outcomes.

Psychological distress among first-year health science students in Taiwan

Background

Objective

Methods

Results

Conclusion

•

Some first-year health science students are at risk of psychological distress.

•

Anxiety and self-harm are common among first-year health science students.

•

Students in four-year programs are more likely to experience mental health challenges.

Are Nonfatal Suicide Attempts Instrumental in Achieving Personal and Interpersonal Goals?

This study focused on the well-being of the survivors of suicide attempts and the well-being of their interpersonal relationships after the attempt. The data came from a sample of 392 college students from 10 Muslim majority countries who reported having attempted suicide in the last 4 years. Suicide was conceptualized as a goal-directed behavior embedded in a sociocultural context and motivated by personal or interpersonal goals. We tested a process that linked culturally shaped self-construal to the postsuicidal personal and interpersonal well-being. We posited that this process would operate through the attitudes towards suicide, motives for suicide, the strength of the intention to die. Our model indicated that the acceptability of suicide was positively associated with escape motives, and this association was even stronger for the individuals with interdependent self-construals. Escape motives were negatively associated with postsuicidal personal and interpersonal well-being, but communication motives were not associated with these outcomes. We also found evidence that having an interdependent self-construal might be beneficial for postsuicidal personal and interpersonal well-being. Our results further suggested that the postsuicidal personal and interpersonal well-being of highly interdependent individuals may depend on the interpretation of their act of suicide by their close others.

Suicidal Thoughts, Depression, Post-Traumatic Stress, and Harmful Alcohol Use Associated with Intimate Partner Violence and Rape Exposures among Female Students in South Africa

While ample evidence from high-income country settings indicates the prevalence and risk factors for multiple mental ill-health symptoms in student populations, evidence from low- and middle-income higher education settings remains limited. We determined the frequency, associations, and structural pathways between mental health outcomes and possible risk factors among a sample of 1292 predominantly Black African and female students ages 18-30 years, enrolled at nine purposefully selected public universities and Technical Vocational Education and Training (TVET) campuses. We measured and created a mental ill-health latent outcome consisting of depressive symptoms, post-traumatic stress disorder (PTSD), and suicidal thoughts. We also measured traumatic exposures including childhood trauma, recent intimate partner violence (IPV), non-partner rape, and other life traumatic events. We used structural equation modelling to analyse data. We found that 50% of the surveyed students binge drank, 43% reported depressive symptoms, 9% reported PTSD symptoms, and 21% had suicidal thoughts. Students' experiences of childhood trauma, food insecurity, other traumatic events, non-partner rape, and IPV impacted the mental ill-health latent. IPV experiences mediated the relationships between experiences of childhood trauma or other trauma and the mental ill-health latent, and the relationship between binge drinking and other life traumatic events. Non-partner rape mediated the relationship between food insecurity and the mental ill-health latent. Binge drinking directly impacted non-partner rape experience. The findings substantiate the need for campus-based mental health promotion, psychosocial services and treatments, and implementation of combined interventions that address the intersections of violence against women and mental health among students in South Africa.

COVID-19 Pandemic Psychological Impact and Volunteering Experience Perceptions of Medical Students after 2 Years

Undergraduate healthcare students were mobilized to support healthcare systems during the COVID-19 pandemic, but we have scarce information regarding their experience and its impact on their wellbeing. An anonymous online survey was conducted among undergraduate students and recently graduated physicians of a medical university in Spain, regarding their symptoms and volunteering experience during the initial months of the Spanish COVID-19 pandemic. Respondents showed a high prevalence of perceived stress, anxiety, and depressive symptoms, measured by the PHQ-9 and GAD-7. 14.5% reported healthcare-related volunteering tasks. Volunteering was a satisfactory experience for most of the respondents and the majority felt ready to do volunteering tasks (66.6%). Yet, 16.6% acknowledged not getting appropriate specific-task education before starting, 20.8% reported not having appropriate supervision, and 33.3% feel they did not have proper protective equipment. More than half of volunteers feared getting infected, more than 70% feared infecting their relatives or friends, and 54.2% reported stigmatization. Volunteers showed significantly higher stress, anxiety, and depression scores than the rest of the respondents, and 32% reported a highly traumatic event during volunteering, with high scores on the IES-R in the 16% of volunteers. Our results should help guide future potential volunteering processes in emergencies, enhance academic programs at medical schools and provide valuable data for psychological support services.

Socio-demographic, economic and mental health problems were risk factors for suicidal ideation among Kenyan students aged 15 plus

BACKGROUND

About a third of youth with suicidal ideation develop suicidal plans and about 60% of youth with suicidal plans make suicidal attempts. This study aimed to study different types of suicidal ideation and the risk factors in Kenyan youth.

METHODS

We studied a total of 9742 high school, college and university students using following self-administered instruments: - a researcher design socio-demographic questionnaire, Psychiatric Diagnostic Screening Questionnaire (PDSQ) to document psychiatric disorders and various types of suicidal ideas in previous two weeks, Washington Early Recognition Center Affectivity and Psychosis tool to assess stress, affectivity and psychosis, Wealth index questionnaire to document economic indicators based on household items for the families of the students. We used descriptive statistics, univariate analysis, bivariate logistic regression analysis and variables with a p-value of less than <.05 were entered into generalized linear models using logit links to identify independent predictors.

RESULTS

The overall prevalence of different types of suicidal ideation was (22.6%), major depression was found in 20.0%, affectivity, psychosis and stress was found in 10.4%, 8.7% and 26.0% respectively. Female gender, major depression, stress, affectivity and psychosis and being in high school were significant (p < 0.05) predictors of suicidal ideation.

LIMITATIONS

This was a cross sectional study that focused only on suicidal ideas and associated economic factors and mental health disorders. It did not study suicidal behavior.

CONCLUSION

Future studies are needed to study the progression from suicidal ideas to suicidal attempts and the factors associated with that progression.

Prevalence and Factors Associated with Suicidal Ideation Among University Students in Bangladesh

This study aimed to determine the prevalence of and factors associated with suicidal ideation among university students in Bangladesh. We collected cross-sectional data from 407 students aged between 18 and 27 years at Jahangirnagar University (Dhaka, Bangladesh), using a convenience sampling technique. Of the total sample, 13.8% reported having suicidal ideation during the past 12 months. In multiple logistic regression analysis, being female, being a fifth-year student, lower socioeconomic status, exposure to traumatic events, family suicide history, and depression were associated with suicidal ideation. The findings emphasize the need for appropriate support services for university students with a focus on mental health wellbeing and suicide prevention.