Leaving home for college: A potentially stressful event for adolescents with preoccupied attachment patterns

Impact of Medical School on the Relationship between Nutritional Knowledge and Sleep Quality-A Longitudinal Study of Students at Wroclaw Medical University in Poland

The aim of this study was to investigate the impact of the first year of medical school on the relationship between nutritional knowledge and sleep. To achieve this, first-year medical students at Wroclaw Medical University were invited to participate in the study during both the initial and final months of their first academic year. The study included 570 students in the initial period and 705 in the latter. The research questionnaire comprised the KomPAN, assessing nutritional knowledge, and the Pittsburgh Sleep Quality Index (PSQI), evaluating sleep quality. The majority of students demonstrated at least sufficient nutritional knowledge, while approximately two-thirds of students experienced poor sleep in both periods. Notably, sleep quality further deteriorated in the second period (PSQI total score: 6.86 vs. 7.38, p = 0.0157). This change was influenced mainly by a decrease in sleep duration and an increase in the use of sleep medications (both p < 0.0001). The significant difference in overall sleep quality between different nutritional knowledge levels emerged only in the second semester, where students with the highest nutritional knowledge slept the best, while those with the lowest slept the worst (p = 0.0001). Crucially, in both periods, the use of sleep medications was highest among individuals with insufficient nutritional knowledge. Throughout the academic year, the usage increased for all except those with the highest nutritional knowledge, who exhibited the best sleep (p < 0.0001). The escalating use of sleep medications among medical students warrants greater attention, and leveraging the relationship between nutritional knowledge and sleep could prove beneficial, as positive habits in one domain may positively influence the other.

Mindfulness among lebanese university students and its indirect effect between mental health and wellbeing

BACKGROUND

University students are a high-risk population for developing mental health issues. Mindfulness, the non-judgmental awareness of the present moment, has an effective role in numerous psychological contexts among students. However, no previous studies have investigated the association between mindfulness, mental health and wellbeing among Lebanese university students. Therefore, this study aimed to assess the mediating effect of mindfulness in the association between mental health and wellbeing in this population.

METHODS

This cross-sectional study enrolled 363 Lebanese university students recruited through convenience sampling (July-September 2021). The Wellbeing Index Scale, Lebanese Anxiety Scale, Patient Health Questionnaire and Freiburg Mindfulness Inventory were used to assess subjective well-being, anxiety, depression and mindfulness respectively.

RESULTS

Our findings showed that higher mindfulness (Beta = 0.18; p < 0.001) was significantly correlated with a higher wellbeing, whereas more depression (Beta=-0.36; p < 0.001) was significantly associated with a lower wellbeing. The results of the indirect effect analysis showed that mindfulness mediated the association between anxiety and wellbeing and between depression and wellbeing. Higher anxiety/depression were significantly associated with lower mindfulness and a lower wellbeing (direct effect). Moreover, higher mindfulness was significantly associated with a higher wellbeing.

CONCLUSION

Mindfulness is associated with improved wellbeing and plays an indirect role between mental health issues and wellbeing. Our results suggest that mindfulness presents an adaptive approach and coping method associated with improved students' wellbeing.

Health Literacy, Health Behaviors, and Body Mass Index Impacts on Quality of Life: Cross-Sectional Study of University Students in Surabaya, Indonesia

University student life is an important transformation stage with many potential factors that can impact negatively on the Quality of Life (QOL) and the adoption of unhealthy behaviors. Health literacy (HL), Health Behaviors (HBs), and Body Mass Index (BMI) have been found to be essential components in influencing QOL, in addition to socioeconomic determinants. To identify the influential factors of QOL, we performed a cross-sectional survey in a university, and 955 undergraduate students were enrolled as respondents. We measured two different aspects of HL, i.e., Comprehensive Health Literacy (CHL) and Functional Health Literacy (FHL). Overall, QOL scores in four domains did not differ, regarded as medium with averages ranging from 57.00–63.98, and no significant difference between male and female students. In multivariate analysis, CHL had a significant positive influence on all domains, while FHL only affected the psychological and environmental domains with negative associations. Academic performance had a significant positive association with physical and psychological domains. Students from education majors had higher QOL in the psychological and social domains. Moreover, students with normal or underweight BMI status had better psychological QOL, and physical exercise had a positive association with the social relationship and environmental domains. The findings confirmed that CHL and FHL had significant associations with QOL domains in different ways that should be addressed accordingly. Public health practitioners should carefully empower students to use both CHL and FHL as decision-making skills by incorporating them into related curricula.

A Lifespan Development Theory of Insecure Attachment and Internalizing Symptoms: Integrating Meta-Analytic Evidence via a Testable Evolutionary Mis/Match Hypothesis

Attachment scholars have long argued that insecure attachment patterns are associated with vulnerability to internalizing symptoms, such as depression and anxiety symptoms. However, accumulating evidence from the past four decades, summarized in four large meta-analyses evaluating the link between insecure attachment subtypes and internalizing symptoms, provide divergent evidence for this claim. This divergent evidence may be accounted for, at least in part, by the developmental period under examination. Specifically, children with histories of deactivating (i.e., insecure/avoidant) but not hyperactivating (i.e., insecure/resistant) attachment patterns in infancy and early childhood showed elevated internalizing symptoms. In contrast, adolescents and adults with hyperactivating (i.e., insecure/preoccupied) but not deactivating (i.e., insecure/dismissing) attachment classifications showed elevated internalizing symptoms. In this paper, we summarize findings from four large meta-analyses and highlight the divergent meta-analytic findings that emerge across different developmental periods. We first present several potential methodological issues that may have contributed to these divergent findings. Then, we leverage clinical, developmental, and evolutionary perspectives to propose a testable lifespan development theory of attachment and internalizing symptoms that integrates findings across meta-analyses. According to this theory, subtypes of insecure attachment patterns may be differentially linked to internalizing symptoms depending on their mis/match with the developmentally appropriate orientation tendency toward caregivers (in childhood) or away from them (i.e., toward greater independence in post-childhood). Lastly, we offer future research directions to test this theory.

Relationship Between Dispositional Mindfulness and Living Condition and the Well-eing of First-ear University Students in Japan

The present study was conducted to examine how dispositional mindfulness and living conditions are related to well-being among first-year university students in Japan. Participants were 262 Japanese first-year students (156 females and 106 males; M_age = 18.77 years, SD_age = 0.85). Dispositional mindfulness was measured using the Mindful Attention Awareness Scale (MAAS), and living condition was operationalized as living at home or living alone after having left their home. Hierarchical multivariate regression analysis was used to analyze whether the factors of living condition and dispositional mindfulness had predictive effects on well-being. The results showed that dispositional mindfulness positively correlated with well-being in first-year university students; however, living condition had no significant correlation. On the other hand, the interaction between living condition and dispositional mindfulness significantly correlated with well-being. Simple slope analysis revealed that higher levels of dispositional mindfulness had a protective effect in the relationship between living condition and well-being. These results suggest that an intervention to promote dispositional mindfulness could be effective in protecting the well-being of first-year university students, especially for those who have left their home and are living alone. Further research will be necessary to examine, longitudinally, how mental health changes depending on the level of dispositional mindfulness of first-year university students.

The role of cognitive biases in short-term psychodynamic psychotherapy

The concept of biased thinking - or cognitive biases - is relevant to psychotherapy research and clinical conceptualization, beyond cognitive theories. The present naturalistic study aimed to examine the changes in biased thinking over the course of a short-term dynamic psychotherapy (STDP) and to discover potential links between these changes and symptomatic improvement. This study focuses on 32 self-referred patients consulting for Adjustment Disorder according to DSM-IV-TR. The therapists were experienced psychodynamically oriented psychiatrists and psychotherapists. Coding of cognitive biases (using the Cognitive Errors Rating Scale; CERS) was made by external raters based on transcripts of interviews of psychotherapy; the reliability of these ratings on a randomly chosen 24% of all sessions was established. Based on the Symptom Check List SCL-90-R given before and after, the Reliable Change Index (RCI) was used. The assessment of cognitive errors was done at three time points: early (session 4-7), mid-treatment (session 12-17), and close to the end (after session 20) of the treatment. The results showed that the total frequency of cognitive biases was stable over time (p = .20), which was true both for positive and for negative cognitive biases. In exploring the three main subscales of the CERS, we found a decrease in selective abstraction (p = .02) and an increase in personalization (p = .05). A significant link between RCI scores (outcome) and frequency of positive cognitive biases was found, suggesting that biases towards the positive might have a protective function in psychotherapy.

PRACTITIONER POINTS

Therapists may be attentive to changes in biased thinking across short-term dynamic psychotherapy for adjustment disorder. Therapists may foster the emergence of positive cognitive biases at mid-treatment for adjustment disorder.

Meanings of Living in Lodgings During Senior High School

Studies show that senior high school students living in lodgings (away from home) when attending high school are vulnerable to stress and mental health problems. Moving away from home at the age of 15-16 is a transition that might affect adolescents' well-being. The aim of this study is to explore the experience of living in lodgings during senior high school. In-depth interviews were conducted with 21 Norwegian lodgers of both genders between the ages of 16-18. Interviews were analyzed according to a phenomenological hermeneutical approach. Four main themes were identified: (a) striving between controlling time and being controlled by time, (b) striving between finding comfort in being alone and feeling left alone, (c) striving between being independent and being taken care of, and (d) striving between leaving and finding home. The findings illuminate many challenges experienced by lodgers. A raised awareness and preventive initiatives from school nurses are recommended.

The Young and the Stressed: Stress, Impulse Control, and Health in College Students

High levels of stress are common among young adults, particularly those enrolled in college. These degrees of stress have shown numerous deleterious effects across both academic and health variables. Findings regarding the role of stress in the presentation of impulse control disorders, particular among college students, are limited. This study examined potential associations between perceived stress, academic achievement, physical/mental health, and impulse control disorders in young adults. A total of 1805 students completed an online survey and were included in the analysis. Responders were grouped by their overall score on the Perceived Stress Scale into mild, moderate, or severe. Severe perceived stress was associated with worse academic achievement and worse physical health, as well as higher rates of psychiatric and impulsive disorders. These findings may suggest associations between stress and numerous aspects of mental/physical health in young adults, which could be an important consideration for individuals working with college students.

Refining the assessment of internal working models: the Attachment Multiple Model Interview

The Attachment Multiple Model Interview (AMMI) was developed to assess internal working models (IWMs) of specific relationships in adulthood (e.g., with mother, father, and romantic partner). In an initial effort to validate the AMMI, the interview was administered to participants who were followed from age 4 to 23. ANOVA and contrast tests confirmed the AMMI's capacity to discriminate between mother, father, and partner IWMs. AMMI security with each parent was correlated with coherence according to the Adult Attachment Interview, and AMMI disorganization with mother with unresolved trauma (N = 53). AMMI dimensions of security, deactivation, and hyperactivation with the mother were associated with cumulative lifetime scores of security (N = 23), avoidance, and resistance (N = 34), respectively. Intercorrelations between these AMMI scales were also theory-consistent. Associations with the AAI and between AMMI security scores of different relationships are consistent with previous findings suggesting a contribution from both parents in the development of a state of mind, but a more important role of the mother for representations of the partner.

Individuation in Slovene emerging adults: its associations with demographics, transitional markers, achieved criteria for adulthood, and life satisfaction

The study investigated associations of Slovene emerging adults' age, gender, living situation, romantic relationship, and employment status with aspects of individuation in relation to mother and father. Controlling for demographic variables and transitional markers of adulthood, we further explored the contribution of individuation measures to individuals' perceptions of achieved criteria for adulthood and life satisfaction. The participants provided self-reports on the Individuation Test for Emerging Adults, the Satisfaction With Life Scale, and the list of Achieved Criteria for Adulthood. Age and living out of parental home were positively associated with self-reliance in relation to both parents, whereas female gender was related to higher levels of connectedness and seeking parental support. Along with age and involvement in a romantic relationship, connectedness and self-reliance predicted adulthood criteria attainment and life satisfaction. The results support the models of individuation that emphasize growing autonomy and retaining connectedness to parents as pathways towards personal adjustments.

Heterogeneous patterns of stress over the four years of college: associations with anxious attachment and ego-resiliency

OBJECTIVE

A growing body of literature suggests that college students display alarming rates of psychological distress. However, studies of responses to significant life stressors in other contexts have found that people respond in heterogeneous ways and that attachment style and ego-resiliency mitigate the effects of stressors on mental health.

METHOD

Individual differences in distress among a cohort of students (N = 157; Mean age = 18.8 years, 62.6% female) across the four years of college were analyzed using latent class growth analysis. Trajectories were then regressed on levels of anxious and avoidant attachment and ego-resiliency.

RESULTS

Four discrete patterns emerged characterized by healthy and maladaptive patterns of stress response, indicating that students respond to college in heterogeneous ways. Several patterns showed significant variability in distress by semester. Low levels of anxious but not avoidant attachment predicted membership in the stable-low distress or resilient class while ego-resiliency predicted membership in both the resilient and moderate distress classes.

CONCLUSIONS

Findings indicate that low levels of anxious attachment and the ability to flexibly cope with adversity may be associated with better mental health throughout college. Implications from stress response and developmental perspectives are discussed.

Integration of the brief behavioral activation treatment for depression (BATD) into a college orientation program: depression and alcohol outcomes

College freshmen face a variety of academic and social challenges as they adjust to college life that can place them at risk for a number of negative outcomes, including depression and alcohol-related problems. Orientation classes that focus on teaching incoming students how to better cope with college-oriented stress may provide an opportunity to prevent the development of these adjustment problems. This article outlines a program based on behavioral activation that can be integrated into college orientation programs to provide a more comprehensive orientation experience. Data are presented from an initial pilot study in which 71 first-semester freshman at the University of Maryland participated in a 15-week, 2 hr per week orientation class (n = 37 in the behavioral activation-enhanced orientation classes and n = 34 in the control orientation as usual classes). Students' depression and alcohol use were evaluated at the beginning, middle, and end of the course. Results indicated a Time × Group interaction such that problem drinking (but not consumption) was significantly reduced across assessments in the behavioral activation classes and largely unchanged in the standard classes. No difference was observed in depression scores; however, fairly low depression scores across the 3 time points may have limited the opportunity to observe any meaningful impact of the orientation classes on depression. The authors conclude with a discussion of the implications of their findings for preventing adjustment problems among incoming college students and future directions.

The structure of parental involvement and relations to disease management for youth with type 1 diabetes

OBJECTIVE

To test structural models of parental involvement in type 1 diabetes and to examine associations of parental involvement with adherence and metabolic control.

METHODS

Two hundred and fifty-two young adolescents (10-14 years) completed reports of adherence and parents' involvement: acceptance, independence encouragement, communication, general and diabetes-specific monitoring, frequency of help, and intrusive support. HbA(1c) values came from medical records.

RESULTS

A model of relationship quality, behavioral involvement, and monitoring as three separate yet interrelated factors best fit the data. Higher reports of mothers' and fathers' monitoring and fathers' relationship quality uniquely related to better adherence, whereas higher reports of fathers' behavioral involvement uniquely related to poorer adherence. Higher reports of paternal monitoring were related to lower HbA(1c).

CONCLUSIONS

Adolescent perceptions of components of parental involvement are interrelated, yet separate constructs for both mothers and fathers. Parental monitoring was an important predictor of management of type 1 diabetes during adolescence.

Attachment organization and patterns of conflict resolution in friendships predicting adolescents' depressive symptoms over time

The current study examined the moderating effects of observed conflict management styles with friends on the link between adolescents' preoccupied attachment organization and changing levels of depressive symptoms from age 13 to age 18 years. Adolescents and their close friends were observed during a revealed differences task, and friends' behaviors were coded for both conflict avoidance and overpersonalizing attacks. Results indicated that preoccupied adolescents showed greater relative increases in depressive symptoms when their friends demonstrated overpersonalizing behaviors, vs. greater relative decreases in depressive symptoms when their friends avoided conflict by deferring to them. Results suggest the exquisite sensitivity of preoccupied adolescents to qualities of peer relationships as predictors of future levels of psychological functioning.

A preliminary assessment of adjustment disorder among first-year college students

Using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (American Psychiatric Association, 2000) criteria, we investigated whether the diagnosis adjustment disorder (AD) described first-year college students' adjustment problems. We found that a substantial portion of students experienced a set of adjustment symptoms meeting the AD criteria. Another portion of students reported adjustment concerns that were problematic but did not meet the AD diagnosis threshold. Female students tended to report more symptoms than do male students. College counseling implications are presented.

Leaving home or still in the nest? Parent-child relationships and psychological health as predictors of different leaving home patterns

In this study, the author examines the patterns of leaving home in a sample of 93 participants and their parents. The quality of parent-child relationships, psychological symptomatology in adolescence and young adulthood, and attachment representation were assessed longitudinally from mid-adolescence to young adulthood. Attachment representation, adolescent autonomy, and parent-adolescent conflict were found to be important predictors of the timing of leaving home. In-time leavers were more securely attached and had been granted high autonomy during adolescence, compared with participants who had left home later or had returned to reside in the family home. Young adults with nonnormative leaving home patterns also showed higher percentages of insecure attachment representations and lower percentages of involvement with a romantic partner. Participants residing with their parents were, according to their parents' perceptions, less psychologically healthy.