Chinese college freshmen's mental health problems and their subsequent help-seeking behaviors: A cohort design (2005-2011)

Analysis of the Effect of Emotional Intelligence and Coping Strategies on the Anxiety, Stress and Depression Levels of University Students

The present study examines the direct and indirect effects of trait emotional intelligence (trait EI) on levels of stress, anxiety and depression, and whether these are moderated by coping strategies. To this end, the Wong and Law Emotional Intelligence Scale, Coping Strategies Inventory and Depression Anxiety Stress Scales were administered to 567 university students. The findings point to a direct relationship between EI and the levels of anxiety, depression and stress. EI directly explained the university students' levels of anxiety, depression and stress, and it indirectly explained such levels through coping strategies. The article concludes by pointing out practical implications for university education and the improvement of students' socio-emotional well-being.

Correlation between mental status and prevalence of asthenopia in Chinese college students

BACKGROUND

The purpose of this study was to identify the possible association between mental status and the risk of self-reported asthenopia among college students in China.

METHODS

Ten thousand students were randomly assessed in the study using a self-reported asthenopia questionnaire. Their demographic characteristics and mental status were recorded. Univariate analysis was performed to preliminarily select potential risk and protective factors. Then, multivariate logistic regression was used to estimate odds ratios for the selected risk factors of interest.

RESULTS

Among the 8370 students who completed the survey, the prevalence of asthenopia was 61.0%. Multivariate analysis revealed a significant relationship between asthenopia and depressive symptoms (OR 1.511 95% CI: 1.350-1.691), obsessive-compulsive symptoms (OR 1.477, 95% CI: 1.338-1.632), gender and study load. The place college students spent their off-hours (OR 0.841, 95% CI: 0.784-0.902) was found to be the strongest factor for decreasing the occurrence of asthenopia complaints.

CONCLUSION

Asthenopia appears common in Chinese college students. In addition to depressive symptoms, we should pay attention to obsessive-compulsive symptoms when considering means of preventing asthenopia. Harmonious social relationships, outdoor off-hour activities and exercising more than three times per week are crucial to relieving visual fatigue. Further study is still needed in this area.

Chinese university students' help-seeking behaviors when faced with mental health challenges

BACKGROUND

Mental illnesses and mental health challenges have become increasingly pervasive among Chinese university students. However, the utilization rate of mental health services is low among students.

AIMS

We aimed to explore Chinese university students' help-seeking behaviors to understand how they deal with mental health challenges and use the results to inform the development of effective mental health promotion initiatives.

METHODS

In this study, we conducted 13 focus group interviews with students in six universities in Jinan, China, including 91 (62%) female students and 56 (38%) male students. We drew on the Theory of Planned Behaviors to guide our thematic analysis to gain a contextual understanding of participants' accounts on help-seeking.

RESULTS

Our results have depicted the help-seeking patterns of Chinese university students and show that there are four major behaviors which are self-reliance, seeking support from peers and families, seeking professional support, and accessing virtual mental health care.

CONCLUSION

Results from this study can be used to inform the development of mental health literacy programming for students in universities that share similar contexts, and the study has also opened up a new space for using qualitative approaches to study mental health needs and access to care in diverse populations.

Substitutions of physical activity and sedentary behavior with negative emotions and sex difference among college students

BACKGROUND

A growing number of studies have found that physical activity (PA) benefits mental health, and sedentary behavior (SB) increases the risk of psychological symptoms, but it remains unclear whether substituting the duration of different activities may affect the association, and whether sex difference exists among college students.

METHODS

A longitudinal survey was conducted in three colleges in Anhui province, China. A total of 8049 participants validly answered the questionnaire, which included demographic variables, PA, SB and negative emotions (depressive, anxiety, and stress symptoms).

RESULTS

Substituting 30 min per day of SB with equivalent walking was associated with lower scores of depressive symptoms. Stress symptoms were reduced when SB was substituted by moderate intensity PA (MPA) and walking. Substituting 30 min per day of MPA in place of walking and SB was associated with an amelioration of depressive and stress symptoms in females, and a reallocation of 30 min walking was associated with lower depressive and stress symptom scores when SB was replaced in males.

CONCLUSIONS

Replacing SB with walking and MPA ameliorates the depressive and stress symptoms in young adults. The results suggest a reallocation of time from SB or walking to MPA in females while from SB to walking in males may markedly reduce the depressive and stress symptoms in college population.

The comorbid network characteristics of anxiety and depressive symptoms among Chinese college freshmen

BACKGROUND

This study aimed to investigate the interplay between anxiety and depressive symptoms in Chinese college freshmen using the causal system perspective (CSP), which differs from the traditional common cause perspective (CCP) by providing an alternative explanation by attributing comorbidity to direct interactions among symptoms.

METHODS

A convenience sample of 2,082 Chinese college freshmen (39.51% male, Mage = 18.61) from a normal university completed the Generalized Anxiety Disorder 7-Item Scale (GAD-7) and the Patient Health Questionnaire (PHQ-9). Network analysis was conducted and evaluated as to centrality, stability, node predictability, and bridging features. Moreover, the moderated network model (MNM) was utilized to detect the moderation effects of gender in the comorbidity network.

RESULTS

The network of anxiety and depressive symptoms exhibited stability, characterized by the core symptoms of "restlessness", "lack of energy", and "excessive worry about control", as well as the bridging symptoms of "fearfulness", "sad mood", and "irritability". Notably, the nodes representing "uncontrollable worry" and "difficulty in relaxation" demonstrated the highest predictive power. Gender did not exert any moderating effects on the anxiety and depressive symptom network.

CONCLUSION

These results reinforce that certain anxiety or depressive symptoms are more central than others, and thus play a more vital role in the comorbid network. These findings highlight underlying potential targeting symptoms to consider in future interventions.

The effects of a multimedia intervention on help-seeking process with a Chinese college student sample

Little is known about encouraging help-seeking in non-English speaking settings and relatively little research has been directed to facilitate help-seeking among Chinese-speaking people. This study examined the effects of a multimedia intervention on barriers, attitudes, and intentions for seeking counseling in China. The multimedia intervention was informed by prior empirical research on models of help-seeking for counseling. A total of 200 participants were randomly assigned to one of the two conditions: (1) a help-seeking media-exposed intervention group and (2) a control group, who watched a hospital advertisement that was unrelated to mental health help-seeking. Results indicated that the intervention was effective at increasing both positive attitudes toward therapy and intentions to seek therapy. The intervention also improved participants' perceptions about treatment accessibility. This intervention is available and can be a resource for Chinese language populations (both within China and other countries), especially for immigrants, rural, and persons who might benefit from mental health treatments such as psychotherapy.

Maternal and paternal emotion expression and youths' negative emotions: The moderation of resting respiratory sinus arrhythmia

OBJECTIVE

We investigated whether college students' resting Respiratory Sinus Arrhythmia (RSA) would moderate the association between parental negative dominant and submissive emotion expression and their negative emotions.

METHODS

Participants were 97 Chinese college students (28.87% male, Mage = 19.11, SD =.89). Participants reported their perceived maternal and paternal emotion expression, as well as their negative emotions. Resting RSA was assessed during a laboratory visit.

RESULTS

Parental negative dominant emotion expression was positively related to students' negative emotions. Additionally, the association between paternal negative dominant emotion expression and negative emotions was stronger among students with low (versus high) levels of resting RSA. Nonetheless, no similar association was found in maternal negative emotion expression.

CONCLUSIONS

Our findings contribute important information regarding the different roles of maternal and paternal negative emotion expression in college students' emotional outcomes, and signify the interaction between parental socialization and individual characteristics in human developmental process.

Relationship Between Freshmen's Psychological Health and Family Economic Status in Chinese Universities: A Latent Profile Analysis

Purpose

With the rapid social changes, psychological health problems among freshmen in universities have become increasingly serious. Many researchers have studied the psychological health status of college freshmen using quantitative methods. However, most researchers have studied the psychological health of college freshmen by treating variables as the central concept and analysis unit, which has limitations on the variable-centered research method. Therefore, this study aims to explore the impact of family economic status and demographic variables on the psychological health of college freshmen, as well as the potential types of psychological health among college freshmen.

Methods

Based on the SCL-90 and the self-evaluation of the family economic status of college freshmen, latent profile analysis (LPA) was used to analyze the psychological health of 1497 college freshmen selected through a whole-group sampling method. Freshmen completed the questionnaire from October 18 to October 20, 2022. Then, multinomial logistic regression analysis and variance analysis were conducted using SPSS 25.0 to analyze the impact of family economic status and demographic variables on different psychological health subtypes of college freshmen from a university in Eastern China.

Results

There is obvious heterogeneity in the psychological health of college freshmen, which can be divided into three groups: psychological health group (69.54%), psychological distress group (24.65%), and psychological risk group (5.81%). The latent categories of psychological health among college freshmen differ by gender and family economic status. The psychological health status of female students is significantly better than that of male students. In addition, the lower the self-evaluation of family economic status of college freshmen, the lower their psychological health level.

Conclusion

Three categories of mental health exist for college freshmen, with significant group heterogeneity. Gender and family economic status significantly influenced mental health outcomes with female students faring better. The study's significance lies in providing useful recommendations for educational administrators and developing targeted interventions for college freshmen. Given the practical realities of mental health education efforts, personalized strategies that utilize peer support, counseling, and psychological services can be adopted to assist freshmen in acclimating to university life and maintaining mental wellness. The findings suggest considering the role of family economic status and gender in promoting mental health and the need for further research to develop comprehensive and effective interventions.

A therapist-guided internet-based cognitive behavioral therapy program for Hong Kong university students with psychological distress: A study protocol for a randomized controlled trial

Background

University students are at high risk of various mental health problems due to high levels of psychological distress. However, university counseling services are often inadequate to meet their mental health needs due to shortage of mental health professionals, especially in Hong Kong. Internet-based cognitive behavioral therapy (iCBT) has shown similar effects as those of face-to-face CBT in addressing these mental health concerns, but few iCBT programs have been developed for Hong Kong university students.

Objective

This study protocol aims to develop and evaluate a culturally and linguistically appropriate iCBT program called "REST Online" to reduce the psychological distress and improve the mental health of Chinese university students in Hong Kong in a randomized controlled trial (RCT).

Method

The contents and functionality of the "REST Online" program which includes both web- and app-based versions, are described. A blended mode of service delivery is adopted, with 8 online modules and 2 counseling sessions. Therapist support will be provided by a CBT therapist. A total of 338 Chinese university students with mild to moderate levels of psychological distress will be openly recruited and randomized to three groups: the (1) web-based and (2) app-based "REST Online" groups, and (3) waitlist control group. The program effectiveness is evaluated in psychological distress, depression and anxiety symptoms, and positive and negative emotions and positive and negative thoughts at pre-, post- and 3-month follow-up tests. Linear mixed effect models will be conducted for data analysis.

Discussion

The "REST Online" program is among the first of its kind to address the mental health needs of Hong Kong university students by an internet intervention. Theoretically, this study will provide some empirical evidence for the effectiveness of this iCBT program in the Hong Kong context for Chinese clients. Practically, if proven effective, this program can be provided to local university counselors as an option for service delivery. Strengths and limitations are also discussed.

Prevalence of mental health symptoms in children and adolescents during the COVID-19 pandemic: A meta-analysis

The COVID-19 pandemic and its accompanying infection control measures introduced sudden and significant disruptions to the lives of children and adolescents around the world. Given the potential for negative impacts on the mental health of youths as a result of these changes, we conducted a systematic review and meta-analysis to examine the prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances in children and adolescents during the pandemic. We searched major literature databases for relevant cross-sectional or longitudinal studies that included primary and secondary school students or children and adolescents ≤18 years of age. Prevalence values were extracted, logit-transformed, and pooled. Based on 191 included studies with 1,389,447 children and adolescents, we found the pooled prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances to be 31%, 31%, and 42%, respectively. Age, grade levels, education levels, gender, geographical regions, and electronics use were correlated with the prevalence of mental health symptoms. The prevalence of mental health symptoms also increased with time, although signs of recovery and stabilization were also observed. Overall, the results from this review demonstrate the need for increased mental health research, monitoring, and intervention for children and adolescents during the current and future pandemics.

University students' use of mental health services: a systematic review and meta-analysis

BACKGROUND

International estimates suggest around a third of students arrives at university with symptoms indicative of a common mental disorder, many in late adolescence at a developmentally high-risk period for the emergence of mental disorder. Universities, as settings, represent an opportunity to contribute to the improvement of population mental health. We sought to understand what is known about the management of student mental health, and asked: (1) What proportion of students use mental health services when experiencing psychological distress? (2) Does use by students differ across health service types?

METHODS

A systematic review was conducted following PRISMA guidelines using a Context, Condition, Population framework (CoCoPop) with a protocol preregistered on Prospero (CRD42021238273). Electronic database searches in Medline, Embase, PsycINFO, ERIC and CINAHL Plus, key authors were contacted, citation searches were conducted, and the reference list of the WHO World Mental Health International College Student Initiative (WMH-ICS) was searched. Data extraction was performed using a pre-defined framework, and quality appraisal using the Joanna Briggs Institute tool. Data were synthesised narratively and meta-analyses at both the study and estimate level.

RESULTS

7789 records were identified through the search strategies, with a total of 44 studies meeting inclusion criteria. The majority of included studies from the USA (n = 36), with remaining studies from Bangladesh, Brazil, Canada, China, Ethiopia and Italy. Overall, studies contained 123 estimates of mental health service use associated with a heterogeneous range of services, taking highly variable numbers of students across a variety of settings.

DISCUSSION

This is the first systematic quantitative survey of student mental health service use. The empirical literature to date is very limited in terms of a small number of international studies outside of the USA; studies of how services link together, and of student access. The significant variation we found in the proportions of students using services within and between studies across different settings and populations suggests the current services described in the literature are not meeting the needs of all students.

Psychological well-being amongst students in a Malaysian medical college one year into the COVID-19 pandemic: a cross-sectional study

Background

The frequent disruption to the delivery of education and the switch to online learning amidst the COVID-19 pandemic affected students’ mental health. The objectives of the study were to explore the levels of anxiety, depression, somatic symptoms, and stress among students during the COVID-19 pandemic and their associations with sociodemographic status, clinical teaching, and concerns about COVID-19.

Methods

A cross-sectional study was conducted using convenience sampling via an online self-administered questionnaire-based survey with 285 participants. The survey included questionnaires on sociodemographics, anxiety, depression, somatic symptoms, and stress levels using a validated questionnaire. Data was analyzed using Spearman’s correlation test and ordinal logistic regression to identify correlations between psychological well-being and the effectiveness of e-learning.

Results

More than half of the students reported anxiety (57.2%), depression (58.6%), somatic symptoms (54.4%) and moderate to high stress (79.7%) during the pandemic. Students who stated that online role players were not helpful had increased anxiety levels (rho=-0.18, P=0.005). However, somatic symptoms were reduced among students who found campus role players helpful (rho=0.16, P=0.012). More than half the participants (55.8%) felt that they were supported by the university during the COVID-19 pandemic, although most students (91.6%) sought clear information and prompt updates from the university. We found that students with psychological distress experiencing anxiety (OR=2.47, 95% confidence interval, CI=1.49-4.08), depression (OR=3.22, 95% CI=1.94-5.34), somatic symptoms (OR=2.94, 95% CI=1.76-4.91, P<0.001), and stress (OR=3.08, 95% CI=1.76-5.41) would value more mental health support from the university.

Conclusions

The university should consider increasing campus role-play sessions and providing prompt updates and mental health resources to help students cope better psychologically during the pandemic.

Construction and Analysis of Emotion Recognition and Psychotherapy System of College Students under Convolutional Neural Network and Interactive Technology

This study's aim is to effectively establish a psychological intervention and treatment system for college students and discover and correct their psychological problems encountered in a timely manner. From the perspectives of pedagogy and psychology, the college students majoring in physical education are selected as the research objects, and an interactive college student emotion recognition and psychological intervention system is established based on convolutional neural network (CNN). The system takes face recognition as the data source, adopts feature recognition algorithms to effectively classify the different students, and designs a psychological intervention platform based on interactive technology, and it is compared with existing systems and models to further verify its effectiveness. The results show that the deep learning CNN has better ability to recognize student emotions than backpropagation neural network (BPNN) and decision tree (DT) algorithm. The recognition accuracy (ACC) can be as high as 89.32%. Support vector machine (SVM) algorithm is adopted to classify the emotions, and the recognition ACC is increased by 20%. When the system's K value is 5 and d value is 8, the ACC of the model can reach 92.35%. The use of this system for psychotherapy has a significant effect, and 45% of the students are very satisfied with the human-computer interaction of the system. This study aims to guess the psychology of students through emotion recognition and reduce human participation based on the human-computer interaction, which can provide a new research idea for college psychotherapy. At present, the mental health problems of college students cannot be ignored; especially every year, there will be news reports of college students' extreme behaviors due to depression and other psychological problems. An interactive college student emotion recognition and psychological intervention system based on convolutional neural network (CNN) is established. This system uses face recognition as the basic support technology and uses feature recognition algorithms to effectively classify different students. An interaction technology-based psychological intervention platform is designed and compared with existing systems and models to further verify the effectiveness of the proposed system. The results show that deep learning has better student emotion recognition ability than backpropagation neural network (BPNN) and decision tree algorithm. The recognition accuracy is up to 89.32%. Support vector machine algorithm is employed to classify emotions, and the recognition acceptability rate increases by 20%. When K is 5 and d is 8, the acceptability rate of the model can reach 92.35%. The effect of this system in psychotherapy is remarkable, and 45% of students are very satisfied with the human-computer interaction of this system. This work aims to speculate students' psychology through emotion recognition, reduce people's participation via human-computer interaction, and provide a new research idea for university psychotherapy.

Assessing Prevalence and Unique Risk Factors of Suicidal Ideation among First-Year University Students in China Using a Unique Multidimensional University Personality Inventor

BACKGROUND

University students with suicidal ideation are at high risk of suicide, which constitutes a significant social and public health problem in China. However, little is known about the prevalence and associated risk factors of suicidal ideation among first-year university students in China, especially during the COVID-19 pandemic.

OBJECTIVES

To investigate the prevalence of suicidal ideation and its factors in first-year Chinese university students from a vocational college in Zhejiang during the COVID-19 pandemic.

METHODS

Using a cluster sampling technique, a university-wide survey was conducted of 686 first-year university students from Hangzhou in March 2020 using University Personality Inventory (UPI). UPI includes an assessment for suicidal ideation and possible risk factors. Suicidal ideation prevalence was calculated for males and females. Univariate analysis and multivariable logistic regression models were conducted, adjusting for age and sex. Analyses were carried out using the SPSS version 22.0 software.

RESULTS

The prevalence of 12-month suicidal ideation among first-year university students during March 2020 was 5.2%, and there was no significant difference between males and females (4.8% vs. 6.0%, x2 = 0.28, p = 0.597). Multivariable logistic regression analysis identified social avoidance (B = 0.78, OR = 2.17, p < 0.001) and emotional vulnerability (B = 0.71, OR = 2.02, p < 0.001) as positively associated with suicidal ideation.

CONCLUSIONS

Social avoidance and emotional vulnerabilities are unique factors associated with greater suicidal ideation among first-year university students during the COVID-19 pandemic. UPI serves as a validated tool to screen suicide risks among Chinese university students. Encouraging social engagement and improving emotional regulation skills are promising targets to reduce suicidal ideation among first-year university students.

The relationship between resilience, anxiety, and depression in Chinese collegiate athletes

Anxiety disorder is becoming increasingly prevalent across college campuses, particularly among collegiate athletes who face different stressors and challenges than their non-athlete peers. Anxiety and depression are well documented comorbidities. Furthermore, the number of Chinese collegiate athletes suffering from anxiety and depression is increasing. Psychologists have recently begun to take a more prophylactic approach to defend against these disorders through resilience education. Resilience education focuses on developing greater capacity to cope when mental and emotional challenges arise. The purpose of this study was to analyze the relationship between resilience, depression, and anxiety in Chinese collegiate athletes. This study provides additional evidence of the value of incorporating an effective resilience educational module amongst collegiate athletes.

Research design

The study employed a survey research design to explore the complex relationship between depression, anxiety, and resilience for collegiate student athletes.

Data analysis strategy

Structural Equation Modeling (SEM) was employed to account for any measurement error between the observed items (responses on the instruments) and the latent variables (anxiety, depression, and resilience). The theoretical hypothesized relationship for this study is an inverse relationship between anxiety and depression, on the one hand, and resilience on the other hand. The SEM statistical analysis from this study supported this theoretical model.

Effective sample size

599 collegiate athletes from six different universities in the province of Guangdong, China P.R. participated in this study.

Chinese University Students' Perspectives on Help-Seeking and Mental Health Counseling

Psychological distress and mental illness have become increasingly pervasive among Chinese university students. However, many university students who need mental health treatment or psychological support do not actively seek help from professional counselors or service providers, which could lead to poor mental health outcomes. To promote help-seeking, we undertook a qualitative study to understand Chinese university students' perspectives on help-seeking and mental health counseling. We conducted 13 focus group interviews with students in six universities in Jinan, China, and altogether 91 (62%) female students, and 56 (38%) male students participated in the study. Our results indicate that students' misconception and distrust of on-campus counseling, stigma of mental illness, low mental health literacy, and hard-to-access mental health services are the major barriers that impede students help-seeking behaviors. Internal struggles and systematic and organizational barriers are identified to shed light on future work to promote mental health literacy among Chinese university students.

Comparison of Two Approaches to Enhance Self-Esteem and Self-Acceptance in Chinese College Students: Psychoeducational Lecture vs. Group Intervention

Objective

Self-esteem and self-acceptance are not only basic features but also influential factors of mental health. The present study aimed at assessing the effects of psychoeducational lecture and group intervention on self-esteem and self-acceptance in Chinese college students.

Methods

A total of 149 Chinese college students who participated in a mental health course were randomly class-based assigned into the psychoeducational lecture group (n = 62) and the self-focused intervention group (n = 87). The lecture group received 6-session psychoeducational lectures on overview of mental health, campus adaptation, stress adjustment, self-understanding, emotion management, and interpersonal relationships. The self-focused intervention group was treated with self-related group activities involving aspects of self-knowledge, self-feeling, and self-regulation for six sessions. Pre- and post-intervention measurements were taken with Rosenberg Self-Esteem Scale and Self-Acceptance Questionnaire for both groups.

Results

Self-esteem significantly increased in both groups after six sessions. However, the enhancement of self-acceptance was more robust for the self-focused intervention group than the psychoeducational lecture group.

Conclusion

The psychoeducational lecture and self-focused intervention were effective approaches to improve self-esteem for Chinese college students. With respect to self-acceptance, self-focused group intervention might have a more prominent effect.

Developmental Trajectory of Depressive Symptoms in Chinese College Students: Latent Classes and Gender Effect

Depressive symptoms are prevalent in Chinese college students, but little is known about the heterogeneity in the developmental trajectory of depressive symptoms in China. This study examined heterogeneity in the development of depressive symptoms and examined the effect of gender on the developmental trajectories over a 14-month period among Chinese college students (N = 1163, mean age 20.18, 80.31% female). Three different trajectories, moderate-increasing, high-stable and low-stable, captured the heterogeneity in the development of depressive symptoms. Gender showed significant influence on class membership. Relative to the moderate-increasing class, males emerged as significantly more likely than females to be found in the low-stable class (odds ratio (OR) = 2.73, 95% CI = (1.21, 6.13), p = 0.015) and the high-stable class (OR = 5.10, 95% CI = (1.12, 23.18), p = 0.035). The results provide additional evidence for the conclusion that the trajectories of depressive symptoms are heterogeneous with Chinese samples. Moreover, cultural difference should be paid more attention to when examining the effect of gender and other predictors of the trajectories of depressive symptoms.

Prevalence of anxiety, depression, and stress among students of Jahangirnagar University in Bangladesh

Background and Aims

Anxiety and depression, as well as stress, are well-known problems observed across the world, particularly among students. This study intends to identify the level of anxiety, depression, and stress among university students and determine its association with their sociodemographic characteristics.

Methods

The primary data were collected from 351 students with the help of a self-administrated questionnaire consisting of sociodemographic information and contains the Depression, Anxiety and Stress Scale-21 Items (DASS-21) instrument over the period December 8, 2019-January 23, 2020. The χ 2 test is employed to find the association between the status of stress, anxiety, and depression level with selected sociodemographic variables, and confirmatory factor analysis is used to find interrelationships between DASS items.

Results

The results illustrate that no students have an extremely severe level of stress. However, the majority have a mild or moderate level of stress and it is associated with sex and residence (urban or rural). More than 40% of students have extremely severe anxiety. Results reveal that gender, residence (urban or rural), and family type of the students are linked with the anxiety level. The results also suggest that the type of accommodation of the students, their family type, and birth order are related to their depression level at a 5% level of significance. The findings also disclose that female students have more levels of depression, stress, and anxiety than their counterparts.

Conclusion

Considering the finding, the authors think that the university authority should pay a need for greater interest to the mental well-being of students to enhance their quality of life. Given the harmful impacts of stress on academic performance and health, university administrators should be incorporating anxiety, stress, and depression management training in orientation activities.

Association Between Online Self-Directed Learning Ability and Negative Emotions Among College Students During the COVID-19 Pandemic: A Cross-Sectional Study in Anhui Province, East China

Background: This study investigated the correlation between depression, anxiety, and stress among college students engaged in online learning during the coronavirus disease 2019 (COVID-19) pandemic and self-directed learning (SDL) ability, which could provide a scientific basis for mental health education of the college students. Methods: A cross-sectional study was conducted among 5,558 students from two universities in Anhui province, East China. The Depression, Anxiety, and Stress Scale-21 (DASS-21) and the Self-directed Learning Ability Scale were used to conduct an online questionnaire survey. Results: A total of 35.15, 36.32, and 17.24% of college students reported symptoms of depression, anxiety, and stress, respectively. Males and nonmedical students were at higher risks to suffer from depression, anxiety, and stress. In adjusted model, compared with Q1 of self-management ability, the odds ratio (OR) of the Q2, Q3, and Q4 were as follows: 0.635 (0.531-0.759), 0.504 (0.415-0.611), and 0.312 (0.248-0.392) for depression; 0.639 (0.535-0.764), 0.653 (0.540-0.789), and 0.421 (0.338-0.525) for anxiety; and 0.649 (0.523-0.805), 0.579 (0.457-0.733), and 0.482 (0.364-0.637) for stress. For information capability, decrease in risk was even more pronounced: Q2 (0.654, 0.540-0.794), Q3 (0.560, 0.454-0.690), and Q4 (0.233, 0.181-0.301) for depression; Q2 (0.781, 0.646-0.945), Q3 (0.616, 0.501-0.757), and Q4 (0.276, 0.216-0.353) for anxiety; and Q2 (0.444, 0.357-0.553), Q3 (0.454, 0.357-0.578), and Q4 (0.272, 0.202-0.368) for stress. Compared with the Q2 group of cooperation learning ability, cooperation learning ability quartiles were positively associated with depression (Q1: 1.382, 95% CI: 1.138-1.678), anxiety (Q4: 1.260, 95% CI: 1.008-1.576), and stress (Q1: 2.002, 95% CI: 1.583-2.532; Q3: 1.600, 95% CI: 1.252-2.044; Q4: 1.674, 95% CI: 1.243-2.255). Conclusion: The prevalence of depression, anxiety, and stress among college students was high for those studying online at home during the COVID-19 pandemic, especially among nonmedical students and males. SDL ability was negatively associated with negative emotions of the college students during this period of online learning.

Anxiety among nursing students during the Covid-19 pandemic: A web-based cross-sectional survey

Objective

The objective of this study was to assess levels of anxiety and ways of coping among nursing students in The School of Nursing, University of Riau during the COVID-19 Outbreak.

Method

This study was conducted among 247 students through the web-based cross-sectional survey.

Results

The findings show that more than one in three students 87 (35.3%) had mild to severe anxiety. Many students experienced anxiety when doing activities outside, having no use personal protection equipment (PPE), worrying about being infected if they have a cough, fever, or sore throat. The top three ways of coping to reduce student's anxiety are implemented healthy lifestyle behaviors (46.56%), staying at home and doing activities together with family (44.94%), and doing positive activities (22.67%).

Conclusions

The school should give attention to the mental health of students by providing psychological support to reduce student's anxiety.

Mental health of college students and associated factors in Hubei of China

Background

Although many studies have analyzed mental health problems in college students in China, the associations of mental health with individual and family circumstances, academic performance, and social support were rarely discussed.

Objectives

The study aimed to determine the mental health status and its associated factors among college students in China.

Methods

An online survey was conducted on 300 students selected through a cluster sampling strategy in a university in Hubei, China, tapping into sociodemographic characteristics of the participants, their mental health status measured by the modified Symptom Checklist-90 (SCL-90), and social support measured by the Social Support Rating Scale. Multivariate linear regression models were established to identify predictors of the SCL-90 scores.

Results

Mental health disorders were found in 8% of the respondents, with obsessive compulsive, interpersonal sensitivity and depression as the top three reported problems. Compared with the national population norms of university students in 2014, our study participants had higher scores in SCL-90. There were statistically significant difference in the Global Severity index (GSI) and all nine subscales scores (p<0.05). Poorer self-rated health, higher study pressure, and lower social support were significant predictors of higher SCL-90 scores (p<0.05) after adjustment for variations in other variables.

Conclusions

College students in Hubei, China may experience a range of different mental health problems, which are associated with their individual, study, and social circumstances.

The Effect of College Students' Physical Activity Level on Depression and Personal Relationships

Background: Physical activity greatly affects human physical and mental health. This study investigated the effect of college students’ physical activity levels on depression and personal relationships. Methods: Participants were 525 college students from five Korean cities. The International Physical Activity Questionnaire, Beck’s Depression Inventory, and Leary’s interpersonal orientation paper test measured physical activity volume, depression, and interpersonal relationships, respectively. Data were analyzed using descriptive statistics, reliability analysis, one-way analysis of variance (ANOVA), and Pearson’s correlation analysis. Results: The results revealed significant differences among emotional, cognitive, and synchronous symptoms of depression across activity level groups. Regarding interpersonal relationships according to physical activity, for the sociometric disposition, there were differences between groups in the sympathetic-acceptable and sociable-friendliness factors and, for the expressive disposition, in the competitive-aggressive and rebellious-distrustful factors. Conclusions: There were statistical correlations between the physical activity volume and depression and the physical activity and interpersonal relationships. Subsequent research should examine college students’ physical activities and causal relationships among various psychological variables.

Prevalence of depressive symptoms among Chinese university students amid the COVID-19 pandemic: a systematic review and meta-analysis

AIMS

Chinese university students are at high risk for depressive symptoms and the ongoing coronavirus disease 2019 (COVID-19) pandemic may have exacerbated the mental health of university students. However, existing studies on depressive symptoms in Chinese university students during the COVID-19 pandemic reported a wide range of prevalence estimates, making mental health planning for this population difficult. The objective of this study was to conduct a systematic review and meta-analysis of surveys that assessed the prevalence of depressive symptoms in Chinese university students amid the COVID-19 pandemic.

METHODS

Major Chinese (CNKI, Wanfang, VIP) and English (PubMed, Embase, PsycInfo) databases and preprint platforms were searched to identify cross-sectional studies containing data on the prevalence of depressive symptoms in Chinese university students during the pandemic. Two authors independently retrieved the literature, evaluated the eligibility of potential studies, assessed the risk of bias (RoB) of included studies, and extracted data. RoB was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data.

RESULTS

In total, 1177 records were retrieved, and 84 studies involving 1 292 811 Chinese university students during the pandemic were included. None of the included studies were rated as completely low RoB. Statistically significant heterogeneity in the prevalence estimates of included studies was detected (I2 = 99.9%, p < 0.001). The pooled prevalence of depressive symptoms was 26.0% (95%CI: 23.3-28.9%), which was significantly higher in female than in male students (30.8% v. 28.6%, p < 0.001), in postgraduates than in undergraduates (29.3% v. 22.9%, p < 0.001), in students living inside than in those living outside the COVID-19 epicentre (27.5% v. 22.3%, P < 0.001), in students from universities at the epicentre than in those from universities outside the epicentre (26.2% v. 23.1%, p < 0.001), in students who had close contact with COVID-19 than in those who did not (46.0% v. 25.0%, p < 0.001), and in students who had acquaintances or relatives infected with COVID-19 (39.7% v. 24.0%, p < 0.001) than in those who did not. Five sources of heterogeneity were identified from the subgroup analysis: survey period, % of males among the survey sample, scale of depressive symptoms, cutoff score of the scale and level of RoB.

CONCLUSIONS

Over one-fourth of Chinese university students experienced depressive symptoms during the COVID-19 pandemic. Mental health services for this population should include periodic evaluation of depressive symptoms, expanded social support and psychiatric assessment and treatment when necessary. It is also necessary to design depression prevention programmes that target higher-risk cohorts of university students.

The clash of culture and cuisine: A qualitative exploration of cultural tensions and attitudes toward food and body in Chinese young adult women

OBJECTIVE

Accumulating evidence suggests that the prevalence of eating disorders among Chinese women is a public health concern. Prior studies have drawn linkages between conflicting cultural values, identity confusion, and eating disorder symptomatology, which may be relevant for understanding the rise of eating disorders amidst China's rapid economic and sociocultural transformation. Here, we explore how women's experiences with traditional eating norms and modernizing norms of femininity may shape their food and body attitudes.

METHOD

Chinese young adult women (N = 34; aged 18-22 years) participated in semi-structured interviews focusing on experiences with norms surrounding eating and ideal feminine appearance, perceived conflict between these norms, and their responses to perceived conflict. Interviews were conducted via email (n = 27) or via Skype (n = 7). Participants were not asked about past or present diagnoses of eating disorders. Analysis of responses was guided by the principles of thematic analysis.

RESULTS

Women reported encounters with cultural eating norms and feminine appearance norms, and described factors that motivated continued or discontinued adherence to these norms. Women reported strategies of conflict resolution, which resulted in different emotional and behavioral outcomes including eating disorder symptoms.

DISCUSSION

Women's experiences with norms surrounding eating and appearance indicate the centrality of these encounters in the formation of individual and interpersonal values. Our findings suggest the importance for clinicians to assist clients in exploring the meanings behind internalized attitudes toward food and body, and to help clients balance interpersonal and individual needs.

Relationship Among Physical Literacy, Mental Health, and Resilience in College Students

Objectives: The objective of the study is to examine the relationship among physical literacy, mental health, and resilience in college students. Methods: The study is a cross-sectional study. Participants (N = 5,265; 46.6% males) completed perceived physical literacy instruments, mental health continuum short forms, and the 12-item child and youth resilience measures. Mediation models were applied to explore the association among three concepts. Results: Physical literacy, resilience, and mental health were significantly linked with each other. In the mediation model, the direct effect of physical literacy on mental health was 0.49. The indirect effect of physical literacy on mental health through the mediation of resilience was 0.97. The mediating effect of resilience accounts for 66.30% of the total effect, indicating the partial mediating effect of resilience in the relationship between physical literacy and mental health. In more detailed models, resilience was found to mediate the relationship between physical literacy and social and psychological wellbeing, accounting for 61.02% and 56.92% of the total effect, respectively. In addition, resilience acted as full mediator in the relationship between physical literacy and emotional wellbeing (>100%). These findings suggest that physical literacy increases mental health by improving resilience. Conclusions: This is the first time to connect physical literacy with mind factors. The mediating effect of resilience on the relationship between physical literacy and mental health was found. Our findings support the development of physical literacy in universities as part of a holistic approach to supporting the wellbeing and mental health of undergraduates. This study provides a new perspective for the development of large-scale interventions in the health of body and mind in college students.

Translation and Validation of the Mindful Self-Care Scale—Chinese Version: A Pilot Study

(1) Background: Numerous research studies have investigated and identified the high prevalence of poor mental health status among the Chinese population, for example suffering from a high level of anxiety and depression. Moreover, the Chinese population are shown to have a conservative attitude towards mental health problems and a passive help-seeking behaviour when suffering from psychological distress. Therefore, it is important to assess the levels of self-care among the Chinese population, which is considered as the basis for tackling psychological well-being issues by the World Health Organization (WHO). Self-care was conceptualised and measured by the Mindful Self-Care Scale (MSCS), but without being translated and adapted to the Chinese population. The purpose of this study is to translate the scale into Chinese and to conduct a pilot test to validate the scale among the Chinese population. (2) Methods: Participants (N = 161), with 96 females and 65 males, with an age range from 18 to 62, mage = 26.1 (SD = 6.64), were recruited from Hong Kong (n = 63), Taiwan (n = 44), and mainland China (n = 54) using convenience sampling. (3) Results: The results show a satisfying internal consistency (Cronbach’s α = 0.915) without items that need to be deleted as well as an adequate validity, with Kaiser–Mayer–Olkin (KMO) value of 0.856 and significant correlation between self-care and the two variables: self-compassion and well-being (r = 0.403, r = 0.172, p < 0.001). (4) Conclusions: The results preliminarily indicate that the Chinese version of MSCS is reliable and valid. However, test–retest reliability and confirmatory factor analysis should be performed with a larger sample size for further validation.

The association between depressive symptoms and self-rated health among university students: a cross-sectional study in France and Japan

BACKGROUND

Depressive disorders in University students have risen dramatically in the past few decades to the extent that students' mental health has become a current global public health priority. Obtaining information from University students about their mental health is challenging because of potential embarrassment of disclosing one's concerns and fear of stigmatization. Self-rated health might be a good solution to evaluate mental health state by a simple and neutral indicator. The aim of the study is to investigate the association between depressive symptoms and self-rated health by sex among University students in France and Japan.

METHODS

A cross-sectional study was conducted by using two large cohorts of students aged ≥18 years (n = 5655 in Bordeaux, France and n = 17,148 in Kyoto, Japan). Depressive symptoms (PHQ-2 scale), Likert scale of self-rated health, socio-demographic characteristics and health habits were collected through self-administered questionnaires. Multivariate logistic regression models were performed to describe the association between depressive symptoms and other variables including self-rated health, stratified by sex.

RESULTS

A high score of PHQ-2 (high depressive symptoms) was associated with poor self-rated health in both cohorts independently of all other variables (OR 2.82, 95%CI 1.99-4.01 in France, OR 7.10, 95%CI 5.76-8.74 in Japan). Although the prevalence of depressive symptoms between sexes was different in French students (males 15.4%, females 25.0%, p < 0.001), it was similar in Japanese students (males 3.5%, females 3.3%, p = 0.466), who reported less depressive symptoms than French students. The association between depressive symptoms and poor self-rated health was greater in Japanese females (OR 12.40, 95%CI 7.74-20.00) than in males (OR 6.30, 95%CI 4.99-7.95), whereas the strength of the association was almost similar in French students (OR 2.17, 95%CI 0.86-5.47 in males, OR 2.98, 95%CI 2.03-4.38 in females).

CONCLUSIONS

Depressive symptoms were associated with self-rated health among University students in both countries with slightly differences in sex. Self-rated health would be a simple, reliable and universal indicator for healthcare professionals and University staff to identify students at risk of depression.

The Impacts of Air Pollution on Mental Health: Evidence from the Chinese University Students

A growing number of developing countries have experienced worsening air pollution, which has been shown to cause significant health problems. However, few studies have explored the impact of air pollution on the mental health of university students, particularly in the Chinese context. In order to address this gap, through a large-scale cross-sectional survey, this study aims to examine the effects of air pollution on final-year Chinese university undergraduates' (due to graduate in 2020) mental health by employing multivariable logistic regression. Our findings show that, first, although normal air quality is not strongly associated with lower levels of negative mental health, there is a strong link between poor air quality and higher levels of negative mental health. More specifically, life satisfaction hedonic unhappiness and depression measured by the Centre for Epidemiological Studies' Depression scale (CES-D) are statistically associated with air pollution. In addition, we also found that gender is a significant factor, as males had more than 1.6 times greater odds of increased mental health problems compared to their female counterparts. Place of birth also plays a significant role in participants' mental health. Moreover, undergraduates with urban household registration experienced significant levels of hedonic unhappiness and depression on the CES-D scale. Finally, we found that there is an association between respondents' economic situation and their mental health too. Overall, this study contributes to the research on air pollution management and mental health intervention, particularly in relation to student groups. The undergraduate curriculum should provide more guidance and suggestions on promoting mental health and establishing positive attitudes to life and academic study of the final year students, under the context of air pollution in China.

Poorer sleep quality correlated with mental health problems in college students: A longitudinal observational study among 686 males

OBJECTIVE

Poor sleep quality and mental health problems are common in college students. The objective of this study is to examine whether sleep quality predicts the risk of future mental health problems, and vice versa.

METHODS

The sleep quality and mental health status of 686 male college students were estimated, and 582 of them were followed up a year later. Subjective sleep quality and mental health problems were measured with the Pittsburgh Sleep Quality Index (PSQI) and the Depression Anxiety Stress Scale-21 (DASS-21), respectively.

RESULTS

Either at baseline or during follow-up, the PSQI global score was positively associated with scores for depression, anxiety, and stress on the DASS-21 (p's < 0.001). Longitudinal analyses revealed that DASS-21 total score increased in line with increased of PSQI global score during the year (p < .001). More importantly, the cross-lagged analysis showed that (i) PSQI global score at baseline was positively related to depression (β = 0.261), anxiety (β = 0.321), and stress (β = 0.311) scores a year later (p's < 0.001) and (ii) depression (β = 0.259), stress (β = 0.245) and anxiety (β = 0.292) scores at baseline were related to PSQI global score a year later (p's < 0.001). Finally, we further found that among those without mental health problems at baseline, poorer baseline sleep quality predicted a higher risk of anxiety symptoms a year later (RR 3.07, 95% CI 1.36-6.97, p = .007).

CONCLUSIONS

These data may suggest a bidirectionally relationship between sleep quality and mental health problems.

Psychological resilience and positive coping styles among Chinese undergraduate students: a cross-sectional study

Background

Psychological resilience and coping strategies have been found to be related to various psychological and mental health problems. Evaluations of the relationship between resilience and coping style among university students are important for developing effective health promotion strategies focused on resilience intervention to benefit students’ health and well-being. The relationship between psychological resilience and coping styles has usually been examined among adults and patients. Very few studies have investigated the relationship between resilience and coping style in university students. The present study aimed to investigate the associations between psychological resilience, students’ characteristics (gender, major and grade) and coping styles among undergraduate students.

Methods

A cross-sectional survey was conducted among undergraduate students in Shandong Province, China. Undergraduate students were randomly selected from 6 universities in 3 cities of the province using a stratified random sampling method. The questionnaire included questions on the participants’ demographic information, including gender, grade and major, measures of psychological resilience and coping style. Coping style was measured by the Simplified Coping Style Questionnaire (SCSQ). The Asian Resilience Scale (ARS) was applied to evaluate undergraduates’ psychological resilience. Multivariable regression analysis was used to examine the relationships between resilience, students’ characteristics and positive coping styles.

Results

A sample of 1743 undergraduates was analysed. The mean psychological resilience score was 70.41. The mean score for positive coping style was 24.72. Multiple regression analysis showed that three factors of psychological resilience, mood control, self-plasticity and coping flexibility, were all significant factors for positive coping styles (regression coefficient = 0.34, 0.35, 0.14, p < 0.01 for the three factors, respectively). Medical students and females had higher scores for positive coping styles than non-medical students and males (p < 0.01).

Conclusions

The research revealed that females and medical students are more likely than males and non-medical students to adopt positive coping styles. Higher psychological resilience is associated with a better positive coping style. The findings suggest that psychological education and health promotion programmes that target strengthening psychological resilience among undergraduate students may help foster positive coping styles to benefit their mental health and psychological well-being.

Shame and Suicidal Ideation among Undergraduates in China: The Mediating Effect of Thwarted Belongingness and Perceived Burdensomeness

Undergraduate students with shame are more likely to experience suicidal ideation, but there remains a lack of research investigating the factors underlying this relationship. The interpersonal theory of suicide posits that suicidal ideation is influenced by the simultaneous presence of thwarted belongingness and perceived burdensomeness. We examined the prevalence of suicidal ideation among undergraduate students in China and examined the association between shame and suicidal ideation mediated by perceived burdensomeness and thwarted belongingness. A survey was conducted in July 2018 involving 2320 undergraduate students, and the twelve-month prevalence of suicidal ideation was 8.95%. Shame played a crucial role in predicting suicidal ideation, and the mediating effects of perceived burdensomeness and thwarted belongingness between shame and suicidal ideation were significant. Suicidal ideation is common among undergraduate students in China and merits greater attention. Shame, perceived burdensomeness, and thwarted belongingness may be important factors to assess among undergraduate students in suicide risk assessment and psychological intervention.

The Mediating Role of Visual Stimuli From Media Use at Bedtime on Psychological Distress and Fatigue in College Students: Cross-Sectional Study

BACKGROUND

Empirical research has linked psychological distress with fatigue. However, few studies have analyzed the factors (eg, stimuli from bedtime media use) that affect the relationship between psychological distress and fatigue.

OBJECTIVE

The aim of this study was to examine whether visual stimuli from bedtime media use mediate the relationship between psychological distress and fatigue among college students.

METHODS

The sample included 394 participants (92 males, 302 females) with a mean age of 19.98 years (SD 1.43 years), all of whom were Chinese college students at an occupational university in Sichuan Province, China. Data were collected using a paper-based questionnaire that addressed psychological distress, stimuli from bedtime media use, and fatigue. Mediation analysis was conducted using the PROCESS macro version 2.16.2 for SPSS 22, which provided the 95% CIs.

RESULTS

Both psychological distress (r=.43, P<.001) and visual stimuli from bedtime media use (r=.16, P<.001) were positively related to fatigue. The association between auditory stimuli from bedtime media use and fatigue was not significant (r=.09, P=.08). The relationship between psychological distress and fatigue was partially mediated by visual stimuli from bedtime media use (beta=.01, SE 0.01, 95% CI 0.0023-0.0253).

CONCLUSIONS

The findings imply that psychological distress has an indirect effect on fatigue via visual stimuli from bedtime media use. In contrast, auditory stimuli from bedtime media use did not have the same effect. We suggest that college students should reduce bedtime media use, and this could be achieved as part of an overall strategy to improve health. Mobile health apps could be an option to improving young students' health in daily life.

Association between Breakfast Consumption and Depressive Symptoms among Chinese College Students: A Cross-Sectional and Prospective Cohort Study

Skipping breakfast has been suggested to increase the risk of depressive symptoms, but there is no information regarding young adults. We aimed to investigate the relationship between the frequency of breakfast consumption and the risk of depressive symptoms among Chinese college students. We investigated a cross-sectional (n = 1060) and one-year prospective (n = 757) relationship between the frequency of breakfast consumption and the risk of depressive symptoms. The frequency of breakfast consumption was categorized into “≤1 time/week”, “2–5 times/week”, or “≥6 times/week”. Depressive symptoms were assessed using the 20-item Zung self-rating depression scale (SDS) with an SDS score of ≥50 to indicate moderate to severe depressive symptoms. In the cross-sectional analysis, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of depressive symptoms related with the breakfast consumption categories were 1.00 (reference) for ≥6 times/week, 1.761 (95% CI: 1.131, 2.742) for 2–5 times/week, and 3.780 (95% CI: 1.719, 8.311) for ≤1 time/week (p for trend: <0.001) after adjusting for these potential confounders. Similarly, in the one-year prospective analysis, we found that 10.2% of participants was classified as having moderate to severe depressive symptoms. Multivariate logistic regressions analysis revealed a significant negative relationship between the frequency of breakfast consumption and the risk of depressive symptoms. The ORs (95% CI) for depressive symptoms with decreasing breakfast consumption frequency were 1.00 (reference) for ≥6 times/week, 2.045 (1.198, 3.491) for 2–5 times/week, and 2.722 (0.941, 7.872) for ≤1 time/week (p for trend: 0.005). This one-year prospective cohort study showed that skipping breakfast is related to increased risk of depressive symptoms among Chinese college students. Future research using interventional or experimental studies is required to explore the causal relationship between the effects of breakfast consumption and depressive symptoms.

Different patterns of perceived barriers to psychological treatment among Chinese depressed college students: Preliminary findings

OBJECTIVES

This study aimed to (a) identify the different patterns of perceived barriers to psychological treatment in Chinese college students with depression and (b) determine whether self-compassion and depression severity distinguished individuals with different patterns.

METHODS

This study included 338 college students with depression. The perceived barriers to psychological treatment scale were used. Latent profile analysis (LPA) was performed to identify the differential patterns.

RESULTS

Results of LPA indicated four patterns of perceived barriers, which differed with respect to levels and patterns, namely, "low barriers" (31%, n = 105), "moderate barriers" (45%, n = 153), "attitudinal and availability barriers" (18%, n = 61), and "high barriers" (6%, n = 19). Self-compassion (particularly, negative self-compassion) and depression severity distinguished participants with the four patterns.

CONCLUSIONS

A small number of participants reporting high levels across different types of barriers deserve special attention because they would be less likely to seek professional help.

An Investigation of a Cultural Help-Seeking Model for Professional Psychological Services With U.S. and Chinese Samples

Help-seeking processes for participants in the People’s Republic of China and the United States were modeled in the present study. The decision to seek professional services for mental health problems (e.g., psychotherapy) has been primarily studied by applying principles from the theory of planned behavior and reasoned action (TPB). Application of the TPB has commonly been used with a three-level empirical model of help-seeking, whereby expectations/barriers to help-seeking predict attitudes toward therapy, which in turn predicts intentions and behaviors to seek professional help. Informed by the TPB, the present study added a cultural-contextual level to the model to account for the role of cultural identity variables, which included independent and interdependent self-construal as well as gender. The resulting four-level model, the cultural help-seeking (CHS) model, was compared with the conventional three-level help-seeking model using data collected from 296 college students from Mainland China and 334 college students from the United States. Separate analyses were conducted for the Chinese group and American group. Chinese versions of the questionnaires were developed for the present study using translation and back-translation procedures. Using structural regression modeling, the four-level CHS model provided a better fit than the three-level traditional model for both the U.S. and Chinese samples. However, the specific decisional pathways within this four-level model were structurally different for the U.S. and Chinese samples. Findings suggest that including cultural-contextual variables as a first level of the professional help-seeking model is supported by both samples.

Lifetime and 12-month treatment for mental disorders and suicidal thoughts and behaviors among first year college students

OBJECTIVES

Mental disorders and suicidal thoughts and behaviors (STB) are common and burdensome among college students. Although available evidence suggests that only a small proportion of the students with these conditions receive treatment, broad-based data on patterns of treatment are lacking. The aim of this study is to examine the receipt of mental health treatment among college students cross-nationally.

METHODS

Web-based self-report surveys were obtained from 13,984 first year students from 19 colleges in eight countries across the world as part of the World Health Organization's World Mental Health-International College Student Initiative. The survey assessed lifetime and 12-month common mental disorders/STB and treatment of these conditions.

RESULTS

Lifetime and 12-month treatment rates were very low, with estimates of 25.3-36.3% for mental disorders and 29.5-36.1% for STB. Treatment was positively associated with STB severity. However, even among severe cases, lifetime and 12-month treatment rates were never higher than 60.0% and 45.1%, respectively.

CONCLUSIONS

High unmet need for treatment of mental disorders and STB exists among college students. In order to resolve the problem of high unmet need, a reallocation of resources may focus on innovative, low-threshold, inexpensive, and scalable interventions.

ACCESS Open Minds at the University of Alberta: Transforming student mental health services in a large Canadian post-secondary educational institution

AIM

Demands for mental health services in post-secondary institutions are increasing. This paper describes key features of a response to these needs: ACCESS Open Minds University of Alberta (ACCESS OM UA) is focused on improving mental health services for first-year students, as youth transition to university and adulthood.

METHODS

The core transformation activities at ACCESS OM UA are described, including early case identification, rapid access, appropriate and timely connections to follow-up care and engagement of students and families/carers. In addition, we depict local experiences of transforming existing services around these objectives.

RESULTS

The ACCESS OM UA Network has brought together staff with diverse backgrounds in order to address the unique needs of students. Together with the addition of ACCESS Clinicians these elements represent a systematic effort to support not just mental health, but the student as a whole. Key learnings include the importance of community mapping to developing networks and partnerships, and engaging stakeholders from design through to implementation for transformation to be sustainable.

CONCLUSIONS

Service transformation grounded in principles of community-based research allows for incorporation of local knowledge, expertise and opportunities. This approach requires ample time to consult, develop rapport between staff and stakeholders across diverse units and develop processes in keeping with local opportunities and constraints. Ongoing efforts will continue to monitor changing student needs and to evaluate and adapt the transformations outlined in this paper to reflect those needs.

Proactive Suicide Prevention Online (PSPO): Machine Identification and Crisis Management for Chinese Social Media Users With Suicidal Thoughts and Behaviors

Background

Suicide is a great public health challenge. Two hundred million people attempt suicide in China annually. Existing suicide prevention programs require the help-seeking initiative of suicidal individuals, but many of them have a low motivation to seek the required help. We propose that a proactive and targeted suicide prevention strategy can prompt more people with suicidal thoughts and behaviors to seek help.

Objective

The goal of the research was to test the feasibility and acceptability of Proactive Suicide Prevention Online (PSPO), a new approach based on social media that combines proactive identification of suicide-prone individuals with specialized crisis management.

Methods

We first located a microblog group online. Their comments on a suicide note were analyzed by experts to provide a training set for the machine learning models for suicide identification. The best-performing model was used to automatically identify posts that suggested suicidal thoughts and behaviors. Next, a microblog direct message containing crisis management information, including measures that covered suicide-related issues, depression, help-seeking behavior and an acceptability test, was sent to users who had been identified by the model to be at risk of suicide. For those who replied to the message, trained counselors provided tailored crisis management. The Simplified Chinese Linguistic Inquiry and Word Count was also used to analyze the users’ psycholinguistic texts in 1-month time slots prior to and postconsultation.

Results

A total of 27,007 comments made in April 2017 were analyzed. Among these, 2786 (10.32%) were classified as indicative of suicidal thoughts and behaviors. The performance of the detection model was good, with high precision (.86), recall (.78), F-measure (.86), and accuracy (.88). Between July 3, 2017, and July 3, 2018, we sent out a total of 24,727 direct messages to 12,486 social media users, and 5542 (44.39%) responded. Over one-third of the users who were contacted completed the questionnaires included in the direct message. Of the valid responses, 89.73% (1259/1403) reported suicidal ideation, but more than half (725/1403, 51.67%) reported that they had not sought help. The 9-Item Patient Health Questionnaire (PHQ-9) mean score was 17.40 (SD 5.98). More than two-thirds of the participants (968/1403, 69.00%) thought the PSPO approach was acceptable. Moreover, 2321 users replied to the direct message. In a comparison of the frequency of word usage in their microblog posts 1-month before and after the consultation, we found that the frequency of death-oriented words significantly declined while the frequency of future-oriented words significantly increased.

Conclusions

The PSPO model is suitable for identifying populations that are at risk of suicide. When followed up with proactive crisis management, it may be a useful supplement to existing prevention programs because it has the potential to increase the accessibility of antisuicide information to people with suicidal thoughts and behaviors but a low motivation to seek help.

The effect of Imaginary Working Qigong on the psychological well-being of college students: Study protocol for a randomized controlled trial

INTRODUCTION

College students are special populations that are particularly prone to have significantly high level of psychological distress than their community peers. Apparently, the best way to manage stress and mental state is through self-care. The characteristic of Qigong is self-directed and self-healing, which is a traditional Chinese mind-body exercise, which has the potential as a stress management intervention. Imaginary Working Qigong, as a kind of static Qigong, is more perception-oriented and can bring about benign sensations of mind and body so as to eliminate stress completely and induce physiological and mental relaxation. In this study protocol, we will systematically examine the feasibility and acceptability of Imaginary Working Qigong on psychological outcomes of the college students and deeply explore molecular biological mechanisms underlying the effects of mind adjustment induced Imaginary Working Qigong.

METHODS/DESIGNS

We will conduct a randomized, assessor and statistician-blinded, parallel-controlled trial exploring the beneficial mind adjustment of Imaginary Working Qigong in college students.A total of 80 eligible college students from Beijing University of Chinese Medicine will be recruited and randomly allocated into Imaginary Working Qigong training or unaltered lifestyle control group according 1:1 allocation ratio with allocation concealment. Imaginary Working Qigong training will last 8 weeks. The study period is 12 weeks including a 4-week supervised training, 4-week independence training, and a 4-week follow-up. Relevant psychological outcomes measurement will take place at baseline, 5 weeks (at the end of supervised training), 9 weeks (at the end of independence training), and 13 weeks (after the 4-week follow-up period) by blinded independent outcome assessors.

CONCLUSION

This is the first randomized controlled trial protocol from the perspective of Qigong connotation to systematically evaluate the effects and relevant molecular mechanism of Imaginary Working Qigong for the mental health of a college student population. If our study demonstrates a significant intervention effect, this would provide preliminary higher-quality evidence and establish a further guidance for the application of Imaginary Working Qigong program among a college student population.

ETHICS AND DISSEMINATION

The study protocol and consent forms have been approved by the medical and animal experiment ethic committee of BUCM (approval number: BJZYYDX-LL2014005).

Suboptimal health status and psychological symptoms among Chinese college students: a perspective of predictive, preventive and personalised health

Background

Suboptimal health status (SHS) is an intermediate health status between health and illness, a syndrome characterised by the perception of health complaints, general weakness and low energy. This study aimed to investigate the prevalence of SHS and the correlation between SHS and psychological symptoms among Chinese college students and to identify the SHS-related risk factors from the perspective of predictive, preventive and personalised medicine (PPPM).

Methods

A cross-sectional study was conducted among 4119 college students who were enrolled from Taishan Medical University and Baoji Vocational and Technical College in the eastern and western areas of China. SHS levels of the participants were measured by an established self-reporting Suboptimal Health Status Questionnaire-25 (SHSQ-25). Psychosomatic conditions were estimated by the self-rating Symptom Checklist-90 (SCL-90) scale. Spearman correlation analysis was applied to analyse the relationship between SHSQ-25 scores and SCL-90 estimates. Logistic regression analysis was applied for multivariate analysis.

Results

The prevalence of SHS was 21.0% (864/4119), with 23.3% (701/3005) for female students and 14.6% (163/1114) for male students. The prevalence of general positive psychological symptom was 14.2% (586/4119), with 15.6% (470/3005) for female students and 10.4% (116/1114) for male students. A strong correlation was identified between SHS score and SCL-90 estimates, with the correlation coefficient (r) of 0.719. Logistic regression showed that variables significantly associated with SHS were somatisation (adjusted odds ratio (aOR) = 3.185, 95% confidence interval [CI] = 2.048-4.953), obsessive-compulsive (aOR = 3.518, 95% CI = 2.834-4.368), interpersonal sensitivity (aOR = 1.883, 95% CI = 1.439-2.463) and depression (aOR = 1.847, 95% CI = 1.335-2.554).

Conclusions

Our findings confirm that there is a high prevalence of SHS among college students and there is a strong association between SHS and psychological symptoms among Chinese college students. High susceptibility of SHS occurs particularly in vulnerable groups: female students, sophomore students, medical students and students from rural area. Identification of SHS and prompt application of personalised psychological health-supporting activities will promote college students' health status.