Exploring poor sleep, mental health, and help‐seeking intention in university students

Cognitive behavior therapy for insomnia in university students delivered via videoconferencing groups: A pilot study

INTRODUCTION

Sleep difficulties are common amongst university students and are associated with mental illness and reduced wellbeing. This paper reports a pilot study of Cognitive Behavior Therapy for Insomnia (CBT-I) tailored specifically for university students. It was hypothesized that the intervention would be feasible, acceptable, and improve sleep, anxiety, depression, and wellbeing.

METHOD

Students aged 18-25 participated via videoconferencing small group sessions of CBT-I. Feasibility was assessed through sign-up, consent rates, and study attrition, while acceptability was assessed using intervention adherence and a measure of intervention acceptability. Outcome measures included sleep quality, insomnia, suicidal ideation, symptoms of depression, anxiety, and wellbeing, and were assessed at baseline and post-intervention.

RESULTS

Participants were 44 students (M = 21.8 years). Feasibility was confirmed by sign-up and consent rates (80% of the students who expressed interest agreed to participate); overall study attrition was 48%, comprised largely of participants not commencing treatment (27%). Participants perceived the program as effective and logical and made use of the skills suggested. In terms of adherence, 82% of the participants who engaged with treatment attended two or more sessions and 63% attended all four sessions; and 92% were either very satisfied or mostly satisfied. Sleep quality, insomnia, depression, anxiety, and wellbeing all significantly improved from pre- to post-intervention.

DISCUSSION

There was evidence that the CBT-I intervention tailored for university students was acceptable to participants and could be feasible to deliver. Sleep quality, depression, anxiety, and wellbeing improved significantly. These findings suggest that the intervention is suitable for evaluation in a fully powered randomized controlled trial.

The relationship between university student help-seeking intentions and well-being outcomes

University represents a time of both great uncertainty and change as well as a time of opportunity and learning. University students represent a population both at a higher risk of experiencing poor mental health and diagnosis and a population with relatively greater access and communication of both mental health literacy resources and mental health support services. Despite this, we consistently see low intention of help-seeking for mental health services or health services, with a clear preference shown for personal contacts such as friends or parents. To understand help-seeking intentions and their relationship with well-being, the current study explored two core hypotheses, when assessing a broad range of help-seeking options, the likelihood of seeking support from a range of sources will cluster together to create help-seeking groupings that can be further explored (1) and that across these help-seeking factors, there would be difference in intention score across students who fall within "at-risk," "low," or "normal to high" well-being groupings (2). Through a series of exploratory factor analysis (EFA) on a subsample (N = 178) and final confirmatory factor analysis (N = 1597) identified five help-seeking factors: Intimate Partner (single item), Personal Relations (friends, parents, and other relatives), External Health Service (external mental health provider and health provider), University Health Service (university mental health and health provider), and Digital and Distal Professional (digital apps, websites or forums, telehealth, religious leaders, and phone or online emergency services). To address hypothesis 2, a multivariate analysis of covariance was run to assess help-seeking intentions across factors between students with "at-risk" (N = 453), "low" (N = 484), or "normal to high" (N = 563) well-being scores. Although significant differences were found between groups on almost all help-seeking factors (except External Health Service), the differences between groups were small. However, consistently those with "normal to high" well-being demonstrated higher intention to seek help compared to "low" and "at-risk" groups. Across all groups, Personal Relations demonstrated the highest average help-seeking intention score and, in addition to supporting findings in previous literature, represents a potential "lowest hanging fruit" of help-seeking source for university students.

Australian men's help-seeking intentions for anxiety symptoms: The impact of masculine norm conformity and gender role conflict

Research highlights a discrepancy between the number of men experiencing mental illness and those seeking professional help, particularly for anxiety. Conformity to masculine norms (CMN) and gender role conflict (GRC) have been recognised as barriers to men's mental health help-seeking, but few studies have examined these relationships for anxiety. This study aimed to examine the relationship between anxiety severity and help-seeking intentions in Australian men, and the additional impact of CMN and GRC. A total of 610 Australians aged 18-89 years (M = 46.02, SD = 17.14) participated in an online survey, which included demographic information and four standardised questionnaires measuring anxiety, help-seeking intentions, CMN, and GRC. CMN but not GRC was found to fully mediate the relationship between anxiety severity and anxiety-related help-seeking intentions. The results have theoretical implications for the study of masculinity and clinical implications for therapeutic approaches for men with anxiety symptoms.

Personality Risk Factors for Vape Use amongst Young Adults and Its Consequences for Sleep and Mental Health

(1) Background: The surge in vape (e-cigarette) use among young adults is concerning, as there is limited knowledge about risk factors and health consequences. This study explores the personality traits linked to vape use, and associations between vaping and chronotype, sleep quality, and mental health, among young adults. (2) Methods: 316 participants, aged 18-25, completed measurements of mindfulness, rumination, self-compassion, anxiety/depression, chronotype, and sleep quality. (3) Results: the vape user group scored significantly lower on mindfulness, higher on rumination, and lower on self-compassion. Vape users were more likely to be evening types and had significantly lower sleep quality and higher anxiety symptoms, as well as higher alcohol use and loneliness (at trend) (4) Conclusions: These novel findings enhance our understanding of what might predispose young adults to vaping and the potential impact on their mental health and sleep quality. Findings point to specific cognitive/personality traits as vaping risk factors, which could inform intervention strategies.

The effect of Pilates exercises on sleep quality and fatigue among female students dormitory residents

BACKGROUND

This study aims to investigate the effect of Pilates exercises on sleep and fatigue among female college students residing in the dormitory.

METHODS

This quasi-experimental study, two parallel groups was performed on 80 single female college students (40 per group), between 18 to 26 years old who lived in the two dormitories. One dormitory was considered as the intervention group and another as the control group. The Pilates group received three one-hour Pilates exercise sessions per week for eight weeks and the control group maintained their routine activities. The Pittsburgh Sleep Quality Index (PSQI) and the Multidimensional Fatigue Inventory (MFI-20) were used respectively to assess sleep quality and fatigue levels, at three time points: baseline, end of week four, and eight follow-ups. Fisher's exact, Chi-square, independent sample t-test and repeated measurements were used.

RESULTS

Overall, 66 participants completed the study (32 and 35 participants in the Pilates and control groups, respectively). After four and eight weeks of intervention, the overall mean score of sleep quality improved significantly (p < 0.001). At week four of the intervention, the Pilates group had a significantly lower mean score for subjective sleep quality and daytime dysfunction than the control group (p < 0.001 and p < 0.002, respectively), although sleep duration and habitual sleep efficiency improved after eight weeks of intervention (p < 0.04 and p < 0.034, respectively). Additionally, the overall mean score of fatigue and its dimensions in weeks four and eight of the intervention in the Pilates group were significantly lower compared to the control group (p < 0.001).

CONCLUSION

After eight weeks of Pilates exercises implementation, most components of sleep quality significantly improved; however, the effect of Pilates exercises on fatigue was evident from week four onward. Trial registration This trial was registered on 2/6/2015 in the Iranian Registry of Clinical Trials with the IRCT ID: IRCT201412282324N15. URL of registry: https://www.irct.ir/trial/1970 .

Monitoring sleep using smartphone data in a population of college students

Sleep is fundamental to all health, especially mental health. Monitoring sleep is thus critical to delivering effective healthcare. However, measuring sleep in a scalable way remains a clinical challenge because wearable sleep-monitoring devices are not affordable or accessible to the majority of the population. However, as consumer devices like smartphones become increasingly powerful and accessible in the United States, monitoring sleep using smartphone patterns offers a feasible and scalable alternative to wearable devices. In this study, we analyze the sleep behavior of 67 college students with elevated levels of stress over 28 days. While using the open-source mindLAMP smartphone app to complete daily and weekly sleep and mental health surveys, these participants also passively collected phone sensor data. We used these passive sensor data streams to estimate sleep duration. These sensor-based sleep duration estimates, when averaged for each participant, were correlated with self-reported sleep duration (r = 0.83). We later constructed a simple predictive model using both sensor-based sleep duration estimates and surveys as predictor variables. This model demonstrated the ability to predict survey-reported Pittsburgh Sleep Quality Index (PSQI) scores within 1 point. Overall, our results suggest that smartphone-derived sleep duration estimates offer practical results for estimating sleep duration and can also serve useful functions in the process of digital phenotyping.

The Relationship Between College Students' Interpersonal Relationship and Mental Health: Multiple Mediating Effect of Safety Awareness and College Planning

Purpose

The research intends to find the internal influence mechanism of interpersonal relationship on college students' mental health. College students have many mental health problems, which can easily lead to extreme events. It is of great research value to explore the relationship among interpersonal relationship, safety awareness, college planning, and mental health.

Participants and Methods

GHQ, WHOQOL-BREF, SWBS-CC, LSIB, and TSCS scales were used, revised questionnaire for cluster sampling of college students, 1661 valid samples. SPSS 26.0 and PROCESS V4.1 were used for analysis, and nonparametric Bootstrap method was used to test the significance level of the mediating effect.

Results

There are significant differences in interpersonal relationship, safety awareness, and college planning between high mental health group and low mental health group. There are differences in safety awareness between genders. There is a positive correlation among interpersonal relationship, safety awareness, college planning, and mental health. Interpersonal relationship has a positive predictive effect on mental health. There are three mediating pathways of interpersonal relationship on mental health: independent mediating effect pathway of safety awareness, independent mediating effect pathway of college planning, and chain mediating effect pathway through safety awareness and college planning.

Conclusion

This study reveals the Influence mechanism of interpersonal relationships on college students' mental health. The relationship between interpersonal relationship and mental health is affected by the multiple mediating effects of safety awareness and college planning. It provides a new perspective for preventing and intervening mental health problems. College students' personality has plasticity, which can be interfered by mediating mechanism. The present findings could help college students actively participate in interpersonal communication, improve safety awareness, and make a good college planning, so as to enhance the mental health level of college students.

What matters most? Network analysis of mental health, recovery experiences, sleep, and fatigue among career firefighters

Firefighters exhibit a higher prevalence of mental health issues than other occupations because they often directly or indirectly experience potentially traumatic events. Previous research has suggested that recovery experiences, sleep, and fatigue may be protective or risk factors for firefighters' mental health. This study conducted regularised partial correlation network analysis to investigate and visualise the complex relationships between these variables. We collected data through an online survey, and 3144 career firefighters from a large east-coast city in China, were included in the analyses. The results of the network analysis showed that: (1) only relaxation and mastery experiences directly correlated with one dimension of the mental health scale, namely, life/social functioning; (2) sleep quality had stronger correlations with mental health issues than sleep quantity; and (3) mental health issues were central nodes of the network. These results indicated that firefighters' mental health was close to other variables in the network and acted as a bridge linking other variables. Therefore, more attention should be paid to the mental health of firefighters to prevent comorbidities. The study's results also indicated that recovery experiences and sleep may be protective factors for firefighters' mental health.

Indirect contact with nature, lifestyle, and mental health outcomes during mandatory hotel quarantine in Hong Kong

BACKGROUND

During the pandemic of COVID-19 Hong Kong lead one of the world's longest and most stringent quarantine measures.

AIMS

To examine cross-sectionally (i) the relationship between the duration of mandatory hotel quarantine and mental health outcomes; (ii) whether indirect contact with nature and lifestyle factors (i.e. diet, sleep, exercises, social support, and sense of meaning), mitigated this relationship.

METHODS

A group of 248 participants under 14 or 21-d mandatory hotel quarantine in Hong Kong completed an online questionnaire that included quarantine and lifestyle-related questions, as well as mental health outcome measures.

RESULTS

For those under a 21-d quarantine, there was a significant effect of the week of quarantine on the level of depressive symptoms (Patient Health Questionnaire-4), which peaked in Week 2. Worse quality of sleep, a lower sense of meaning, and a longer set (but not completed) duration of quarantine were predictors of worse mental health outcomes. The positive relationship between the day of quarantine and the level of perceived stress was moderated by the indirect contact with nature.

CONCLUSION

The results shed light on the potential negative impact of prolonged periods of quarantine on mental health outcomes and the possible protective factors.

Changes in the comorbidity patterns of negative emotional symptoms and Internet addiction over time among the first-year senior high school students: A one-year longitudinal study

BACKGROUND

The comorbidity of psychiatric disorders and Internet addiction (IA) has been widely documented. However, changes and instability of the comorbidity between negative emotional symptoms and IA over time are not fully understood.

METHODS

A sample of 453 first-year senior high school students completed all measures three times across one-year period and were included in the current study. The sample consisted of 163 (36.0%) males and 290 (64.0%) females. At the baseline, the mean age of the participants was 15.07 ± 0.46 (range: 12-16) years old. Latent class analysis was used to identify the latent class pattern. Multinomial logistic regression analysis was utilized to examine the association between covariates and latent classes at baseline. Latent transition analysis was applied to explore the changes in latent classes of individuals over time.

RESULTS

Three subgroups of negative emotional symptoms, IA and their comorbidity were identified at all the three time points. Being Internet gamers, high average time of Internet use every day, peer exclusion, verbal and physical bullying experience, and poor self-rated health were found to be significant predictors of the high comorbidity symptom. Students were more likely to remain the same class rather than moving between the latent classes across time.

CONCLUSIONS

A better understanding of change characteristics in latent classes across time contributes to confirm an appropriate time for intervention targeted on students who converted from low symptom class to the high class.

The Status of Chinese National Theoretical Discourse System and Its Correlation With Psychological Education of College Students

In recent years, in the face of new situations and problems in society, the discourse system, academic concepts, and related research perspectives of Chinese national theory have been strongly impacted by Western thought, making the discourse mode of western national theory become the second discourse system outside the traditional Chinese national theory. In order to further promote the construction of the Chinese national discourse system in college students' mental health education systems, the study first starts with the concept of national theory and discourse system and then uses the literature method to consult the development status of the Chinese national theoretical discourse system and the mental health education of college students. The results show that students' grade is directly proportional to the satisfaction of students with mental health education, that is, with the increase of grade, students are more and more satisfied with mental health education. The attendance rates of college students, high school students, junior middle school students, and primary school students are about 98, 87, 81, and 78%, respectively. In addition, students who are willing to actively accept psychological education account for about 38% of the total number of students, those who do not refuse account for 51% of the total number of students, and those who are unwilling to accept account for 11% of the total number of students. Among these students, their acceptance of mental health education will not be affected by other factors. Furthermore, the satisfaction score of college students with mental health education is about 4.1, the satisfaction score of high school students is about 3.6, the satisfaction score of junior middle school students is about 2.9, and the satisfaction score of primary school students is about 2.1. It reveals that the degree of satisfaction with mental health education is also related to grade. While taking mental health education courses, students not only realize a comprehensive understanding of the theory of the Chinese nation, but also greatly improve their national self-confidence and psychological quality. Moreover, it also strengthened by disseminating the theoretical discourse of the Chinese nation. Therefore, the exploration is of great significance to the development of the Chinese national theoretical discourse system in the psychological education of college students.

COVID-19 Specific Risk Markers for Intimate Partner Violence Perpetration

Intimate partner violence (IPV) rates have grown alongside the sweeping changes, challenges, and transitions necessitated by the onset of COVID-19. The goal of this exploratory study was to examine COVID-19 related risk markers for IPV perpetration. Data were collected from a national sample of 365 U.S. individuals who were in a relationship during August 2020, in the midst of the COVID-19 epidemic. Unadjusted odds ratios were calculated for 27 unique risk markers related to lifestyle changes due to COVID-19, mental health, isolation, financial impacts, and COVID-19 diagnoses. The strongest risk markers for IPV perpetration were feelings of loneliness, followed by anxiety symptoms, perceived stress, fear, boredom, substance use and lifestyle changes. Understanding risk markers associated with an increase in IPV perpetration can aid helping professionals identify individuals who may be at risk for IPV, or target these factors to aid in IPV prevention and intervention efforts.

Effect of Inadequate Sleep on Frequent Mental Distress

INTRODUCTION

One-third of US adults report sleeping less than the recommended amount, and approximately 20% live with a mental illness. The objective of our study was to examine the association between inadequate sleep and frequent mental distress in a population-based sample of US adults.

METHODS

We conducted a cross-sectional study by using 2018 Behavioral Risk Factor Surveillance System (BRFSS) data that included 273,695 US adults aged 18 to 64. Inadequate sleep was defined as 6 hours or less in a given night, and frequent mental distress was defined as self-reporting 14 days of mental health status as "not good" within the last month. We used weighted logistic regression to calculate odds ratios (ORs) and 95% CIs.

RESULTS

Thirteen percent of study participants experienced inadequate sleep, and 14.1% experienced frequent mental distress. Participants who averaged 6 hours or less of sleep per night were about 2.5 times more likely to have frequent mental distress when controlling for confounders (OR, 2.52; 95% CI, 2.32-2.73) than those who slept more than 6 hours.

CONCLUSION

Inadequate sleep was associated with significantly increased odds of frequent mental distress. Our findings suggest that further research is necessary to evaluate the temporal relationship between inadequate sleep and frequent mental distress.

Dysfunctional beliefs, sleep hygiene and sleep quality in university students

ISSUE ADDRESSED

Poor sleep quality is common among university students and can have negative implications for physical, emotional, cognitive and academic wellbeing. Previous research has identified that sleep beliefs and sleep behaviours are associated with poor sleep quality. However, few studies have examined these variables simultaneously. This study explored associations between dysfunctional beliefs about sleep, sleep hygiene and sleep quality in a sample of university students.

METHODS

Participants were recruited from a pool of undergraduate psychology students and included 120 male students and 145 female students with an average age of 20 years (SD = 5.10). Participants completed an online survey including the Pittsburgh Sleep Quality Index, Dysfunctional Beliefs and Attitudes About Sleep Scale, Sleep Hygiene Index and demographic items.

RESULTS

Overall 60.4% of participants (59.4% of women, 40.6% of men) had poor sleep quality. Logistic regression indicated a significant positive association between sleep hygiene and sleep quality, OR = 1.16, P >.001, 95% CI (1.10, 1.23), and no significant relationship between dysfunctional beliefs about sleep and sleep quality, OR = 1.03, P > .79, 95% CI (0.84, 1.26), after adjusting for covariates.

CONCLUSIONS

Sleep interventions for university students are needed and could focus on common hygiene components, such as using the bed for activities other than sleeping, engaging in arousing activities before bed and how to manage thinking and worrying before bed. So What? The results of the study demonstrate poor sleep quality is common among university students and indicates that sleep interventions are warranted. The positive association found between sleep hygiene and sleep quality highlights that interventions should focus on behavioural components of sleep.

Natural or Urban Campus Walks and Vitality in University Students: Exploratory Qualitative Findings from a Pilot Randomised Controlled Study

Despite extensive evidence of the restorative effects of nature, the potential vitalizing effects of connecting with nature are yet understudied, particularly in higher education settings. University students face high levels of stress and anxiety, and may benefit from nature-based interventions that enhance positive states such as vitality. Using preliminary data from a pilot randomized controlled study with qualitative interviews, we explored the psychological experiences associated with a brief walk either in nature or an urban environment in a sample of 13 university students. The qualitative thematic analysis revealed that walking in nature was a more energizing and vitalizing experience than the urban walk. The nature walk was also found to have both affective and cognitive enhancing effects on participants. Our study highlights the usefulness of exploring subjective psychological experiences of interacting with nature, as well as supporting its restorative potential. Implications for further research and interventions are discussed.

Associations Between Cyberbullying Perpetration, Sleep Quality, and Emotional Distress Among Adolescents: A Two-Wave Cross-Lagged Analysis

ABSTRACT

Previous studies demonstrate that cyberbullying perpetration and sleep quality likely have vital linkages to each other and to emotional distress. In this article, we examine the bidirectional association between cyberbullying perpetration, sleep quality, and emotional distress in a longitudinal data set with two waves of data collection (T1 and T2, 8 months apart). The participants included 661 Chinese junior high school students (n = 661; mean age, 14.02; 61.4% male) who filled out the Revised Cyber Bullying Inventory-Cyberbullying Subscale, Pittsburgh Sleep Quality Index, and Depression Anxiety Stress Scales. Results revealed that cyberbullying and sleep quality would predict each other over time, and significant bidirectional relationships were found between sleep quality and emotional distress across T1 and T2. Cyberbullying at T1 would not predict the emotional distress at T2, whereas emotional distress at T1 was associated with cyberbullying at T2.

Strategies to develop student support mechanisms in medical radiation sciences clinical education

Clinical placement experience is an important component of medical radiation science (MRS) education, equipping students to safely transition into complex healthcare environments. This commentary draws on evidence from the literature that reports challenges allied health students face in clinical environments. As several factors are implicated that could result in a higher prevalence of psychological distress and mental ill-health in MRS students, there is a need to re-emphasize the importance of developing strategies to support students in clinical education. A key recommendation is to identify associated risk factors early as they can impact on the quality of education and in severe cases be detrimental to students' psychological well-being. This requires an understanding of the full extent and nature of the challenges through partnered approaches between professional organisations, clinical departments, academics and students. Developing evidence-based strategies for improving students' well-being in clinical environments is also essential.

The Restorative Effect of the Natural Environment on University Students' Psychological Health

The present study evaluated the effect of a three-week intervention aimed at improving psychological health in university students. Participants included 200 Australian students randomly assigned to an experimental or waitlist control group, with 42 adhering to intervention instructions. Participants in the experimental group read a story about someone who used the natural environment to decrease stress and burnout levels and to increase their perceived satisfaction with life. They were then instructed to spend 20 minutes each week, for three weeks, in any chosen natural environment. Waitlist control participants received intervention instructions three weeks later. Restorativeness was positively associated with life satisfaction and negatively related to stress and burnout. Experimental participants, compared to waitlist control participants, experienced a significant decrease in stress; however, the intervention had no effect on life satisfaction or burnout. More research is still needed to determine the practical significance of nature exposure on university students' psychological health.

A Cluster Analysis of Sleep Quality, Self-Care Behaviors, and Mental Health Risk in Australian University Students

Background: University students have high levels of poor sleep quality (SQ) and mental health, and low adherence to healthy nutrition and physical activity (PA). Objective: This study examined what clusters of self-care behaviors (SCB) were associated with SQ and mental health in Australian university students. Method: 355 Australian university students, ranging in age from 18 to 24 years (M = 20, SD = 1.5, 286 females) completed surveys relating to fruit and vegetable consumption, alcohol binge behavior, PA, mental health measured by the Depression Anxiety Stress Scales 21, and SQ measured by the Pittsburgh SQ Index (PSQI). Fruit and vegetable consumption, alcohol binge behavior, and PA were assessed according to current Australian guidelines. Results: Almost two thirds of participants (62.0%) met the criteria for poor SQ. Good SQ was significantly associated with meeting PA guideline levels (r_b = .14) and inversely associated with higher levels of depression (r_pb = -.34), anxiety (r_pb = -.36), and stress levels (r_pb = -.42). Four distinct SCB and mental health risk clusters were created. The "healthiest SCB" cluster had 1.6 times better SQ than the average. This cluster had higher levels of moderate and vigorous PA, higher levels of fruit consumption, and less binge drinking, the least sedentary behavior, and the lowest levels of depression, anxiety, and stress compared to the other clusters. Conclusion: This research corroborates with previous literature on the importance of regular vigorous PA as a lifestyle intervention to facilitate better sleep outcomes and improved mental health outcomes in university students.

Sex-specific associations between sleep and mental health in university students: a large cross-sectional study

Objective: To examine the associations between sleep problems and mental health dimensions in university students, and the effect of sex on these associations. Participants: Self-reported survey data from 3,483 students aged 18-30 years was drawn from a larger web-based study (i-Share) conducted in France in the years 2013-2017. Methods: We performed logistic regression analyses stratified by sex using insufficient sleep duration, poor sleep quality, difficulty initiating sleep and excessive daytime sleepiness, in relation with stress, self-esteem, depression and anxiety. Results: All sleep problems were strongly associated with all mental health dimensions, particularly anxiety, in female students. Sleep and mental health problems were also associated in male students, with the exception of low self-esteem, but odds ratios were lower than for female students. Conclusions: Present findings warrant attention to propose early interventions targeting sleep and mental health in the university setting taking sex into account.

Readiness to change and barriers to treatment seeking in college students with a mental disorder

BACKGROUND

College students have high prevalence of mental disorders and suicidal thoughts and behaviours, and low rates of treatment uptake. This study assesses treatment access, intentions to seek help, and perceived barriers to help-seeking, considering gender and suicidal thoughts or behaviours (STBs) as predictors.

METHODS

Data is from the Ulster University Student Wellbeing study (2015) conducted in Northern Ireland (NI), as part of the WHO World Mental Health Surveys International College Student Project. Participants are 392 new college entrants (162 males (41.3%)/230 females (58.7%)), who all reported some lifetime mental disorder or STBs.

RESULTS

Receipt of treatment was low (37.8%), particularly among males and those with no STBs. Males were less likely to intend to access external professional services and were less likely than females to rate embarrassment (OR = 0.60) or worry about being treated differently (OR = 0.63) as important reasons for not seeking treatment. Those with STBs rated wanting to handle things on their own as a more important barrier those with no STBs (OR = 0.55 for non STBs group) and rated being unsure where to go as a less important barrier than those with no STBs (OR = 1.80 for non STBs group).

LIMITATIONS

Data is correlational and concerns lifetime criteria for mental disorder, with no consideration of current mental status nor disorder type.

CONCLUSIONS

These findings have implications for the active screening and intervention for vulnerable college students, particularly males and those with mental disorders but no STBs.

Internationalization and Its Discontents: Help-Seeking Behaviors of Students in a Multicultural Environment Regarding Acculturative Stress and Depression

Stress and depression can be seen as the major obstacles for sustained education and attainment of foreign students, and in turn, the sustainability of an education system as a whole. However, the mainstream consideration following Berry’s model on acculturation does not take into account whether students of the host countries are immune to these problems. This study aims to examine the prevalence and predictors of help-seeking behaviors among international and domestic students in a multicultural environment by employing ANOVA and polynomial regression. Some significant results from this study are: (1) Informal sources were the most prevalent sources of help-seeking among international and domestic students, while formal help-seeking was not popular; (2) international students were more likely to overcome emotional difficulties alone and seek help on the Internet than domestic students; (3) acculturative stress was a positive predictor of formal, informal, and miscellaneous help-seeking behaviors among international students and informal help-seeking behaviors or among domestic students; and (4) depression was negatively correlated with the willingness of international students to seek help from informal sources. The findings hint at the risk of acculturative stress faced by domestic students in a multicultural environment being overlooked and the lack of help-seeking sources for international students. The study also provides empirical evidence for policy-planners to design a sustainable education system better at supporting students dealing with depression and acculturative stress.

Help-seeking behavior of Jimma university students with common mental disorders: A cross-sectional study

BACKGROUND

Globally, the mental health help-seeking behavior of university students is reported to be poor; less than one-third of university students with common mental disorders (CMDs) report having sought help from formal sources. Failure to seek treatment is associated with prolonged disability and poor mental health outcomes, including suicide. In Ethiopia, little is known about the help-seeking behavior of university students for CMDs.

OBJECTIVE

This study aimed to assess the prevalence and determinants of help seeking, and sources of help sought by Jimma University undergraduate students with CMDs.

METHOD

Seven hundred and sixty students were selected to participate in this cross-sectional study using multi-stage sampling. Sources of help were identified using the Actual Help-Seeking Questionnaire. CMDs were assessed using the 10-item Kessler Psychological Distress Scale. Binary logistic regression analysis was used for both univariate and multivariable analysis.

RESULTS

Of the sampled students, 58.4% were found to have current CMDs. Of those with current CMDs, 78.4% had sought help for their problems. The majority (83.8%) of participants who sought help did so from informal sources. Compared to students who had 'very good' overall levels of satisfaction with life, those who had 'good', 'fair', and 'poor or very poor' overall level of satisfaction with life were less likely to seek help (p-value = 0.021, 0.014, and 0.011, respectively). Lastly, having no previous history of help-seeking was significantly associated with seeking help for CMDs (p-value<0.001).

CONCLUSION

More than half of Jimma University students were found to have a high risk of CMDs and the majority of those with CMDs sought help from informal sources. Future studies are needed to explore the barriers of seeking help from formal resources, and the effects of not receiving help from formal sources for CMDs symptoms.

Schizophrenia literacy: the effects of an educational intervention on populations with and without prior health education

BACKGROUND

Mental health literacy is an important predictor of appropriate help-seeking behaviour.

AIMS

This study investigated (a) the effects of an educational intervention on schizophrenia mental health literacy, beliefs about causes, discrimination, treatment, and attitudes that promote recognition, and (b) whether schizophrenia literacy would be higher in people with prior education in a health-related area than people without such education.

METHOD

A randomised control design tested the effects of an educational intervention on schizophrenia literacy relative to a control group. Participants (N = 260; mean age = 31.18 years, SD = 11.43, female = 78.8%) answered a mental health literacy questionnaire, based on a vignette of a person with schizophrenia, before and after watching either an educational video on schizophrenia or a control video.

RESULTS

The intervention significantly increased schizophrenia identification and literacy, reduced personal stigma, and increased perceived discrimination in society. The health background group reported significantly greater schizophrenia identification than the no health background group. Participants thought help should be sought from health care professionals and through psychotherapy, close friends and physical activity.

CONCLUSIONS

Targeted education can significantly improve the ability to identify schizophrenia which may have positive implications for reducing the time individuals take to seek help.

A Mobile Sleep-Management Learning System for Improving Students' Sleeping Habits by Integrating a Self-Regulated Learning Strategy: Randomized Controlled Trial

Background

Insomnia can significantly affect students’ learning performance. Researchers have indicated the importance and challenge of coping with insomnia using nondrug treatments, such as cognitive behavioral therapy (CBT) for insomnia. However, it is easy for the traditional CBT for insomnia to be interrupted owing to the overly lengthy period of sleep therapy. Self-regulated learning (SRL) strategies are known to be an effective approach for helping students improve their time management, as well as their ability to set learning goals and adopt learning strategies.

Objective

The objective of this study was to propose a mobile sleep-management learning system integrated with SRL strategies and CBT.

Methods

A total of 18 undergraduate students from a university in northern Taiwan participated in the 2-week experiment of using this sleep-management system.

Results

The experimental results showed that the proposed approach was useful and easy for students to use. In addition, the number of students with insomnia significantly decreased; that is, the proposed approach could help students improve their sleep quality and cultivate better sleeping habits, which is important for them to enhance their learning efficiency.

Conclusions

With the assistance of this proposed approach, students can plan their daily life by setting goals, applying strategies, monitoring their life habits process, and modifying strategies to cultivate good learning and healthy lifestyle habits.

Trial Registration

Government Research Bulletin MOST104-3011-E038-001; https://www.grb.gov.tw/search/planDetail? id=11568383&docId=467988 (Archived by WebCite at http://www.webcitation.org/73MnPHNri)

Predicting intentions to seek help for depression among undergraduates in Sri Lanka

BACKGROUND

Studies have found that although there are high rates of depression among university students, their help-seeking practices are poor. It is important to identify students who are less likely to seek the necessary help, to encourage better help-seeking among them. This study, which was conducted among undergraduates in Sri Lanka, examined the associations between personal characteristics of the undergraduates and their intentions to seek help for depression.

METHODS

This was a cross-sectional study in which 4461 undergraduates (Male: n = 1358, 30.4%, Female: n = 3099, 69.5%; Mean age = 22.18; SD = 1.47) indicated their intentions to seek help if personally affected by depression, which was described in a hypothetical vignette about a peer experiencing depression symptomatology. The predictors of the undergraduates' help-seeking intentions, including their sociodemographic characteristics, prior exposure to and recognition of the problem, and their stigma towards those with depression were examined using binary logistic regression analyses models.

RESULTS

The undergraduates' ability to recognise the problem was one of the strongest predictors of their intentions to seek professional help. Those with higher levels of stigma were less likely to seek both professional and informal help. While females were less likely to consider professional help, they were more likely to consider the help of informal help-providers and to consider religious strategies. Medical undergraduates and those who had sought help for personal experiences of the problem were also more likely to consider informal help. However, all these associations resulted in small effect sizes, except for those between recognition of the problem and the undergraduates' intentions to seek professional help, where medium to very large effect sizes were observed in the case of some the associations examined.

CONCLUSIONS

Improvement of problem-recognition may be a key strategy for improving help-seeking among these undergraduates. Reduction of stigma may also be associated with better depression-related help-seeking of undergraduates. Females and medical undergraduates need to be educated about the importance of seeking appropriate types of help, and their informal social networks must be educated about how best to help them.