Relationship between self-efficacy, social rhythm, and mental health among college students: a 3-year longitudinal study

Although many empirical studies have aimed to find variances in positive mental health among different groups and the relationship between mental health and other variables, few studies examined the developmental trend of mental health levels and the cross-lagged relationship between self-efficacy, social rhythm, and mental health. Furthermore, few of them explored the interrelationship between self-efficacy and social rhythm among college students over time. This study thus aimed to clarify the longitudinal cross-lagged relationship between self-efficacy, social rhythm, and positive mental health among college students. A total of 764 students (627 females, mean age 21.03 ± 0.84 years at T1) participated in a 3-year-long study (T1, T2, T3) and were asked to complete the General Self-Efficacy, the Brief Social Rhythm, and the Positive Mental Health Scales. The results indicate that the development of positive mental health among college students showed an upward trend during those 3 years. There was a significant relationship between positive mental health, social rhythm, and self-efficacy. Positive mental health and social rhythm significantly predicted self-efficacy in the following year. Positive mental health in T2 could predict both T3 social rhythm marginally and T3 self-efficacy significantly. However, T1 social rhythm was not indirectly associated with T3 mental health via T2 self-efficacy, and T1 self-efficacy was not indirectly associated with T3 mental health via T2 social rhythm. This finding clarified the relationship between positive mental health, self-efficacy, and social rhythm, and provided evidence that positive mental health is the basis for self-efficacy and social rhythm among young adults. Therefore, school psychologists in universities should pay close attention to the positive mental health of young adults to form high levels of self-efficacy and social rhythm.

The associations between illness perceptions and social rhythm stability on mood symptoms among patients with bipolar disorder

BACKGROUND

The association between illness perceptions and the effectiveness of patients' illness-management strategies has been supported across a range of medical and psychiatric disorders. Few studies have examined these variables or their association in bipolar disorder (BD). This study examined the main and interactive associations between illness perceptions and one important illness management strategy - social rhythms stability on mood symptom severity in adults with BD.

METHODS

A cross-sectional study with 131 patients with BD in Taiwan was conducted using clinician- and patient-rated mood symptoms, self-reported illness perceptions, and a measure of daily and nightly social rhythms.

RESULTS

Illness perceptions were associated with mood symptom severity, but social rhythms were not. Unfavorable illness perceptions (e.g., beliefs of experiencing more BD symptoms, having stronger emotional responses to the illness) were associated with more severe mood symptoms. Favorable illness perceptions (e.g., beliefs of being able to understand and control the illness) were associated with less severe mood symptoms, with personal control as the strongest correlate of mood symptom severity. Finally, social rhythm stability moderated the relationship between unfavorable illness perceptions and clinician-rated manic symptoms.

LIMITATIONS

The cross-sectional design limits our ability to make causal conclusions. Also, the effects pertain to patients in remission and may not generalize to more severely ill or hospitalized bipolar patients.

CONCLUSIONS

This study indicates that in patients with BD, illness perceptions are associated with symptom severity. Interventions to enhance favorable IPs and reduce unfavorable IPs may improve mood outcomes, particularly when patients have adopted regular social rhythms.

Sleep and Circadian Rhythm Disorder in Bipolar Affective Disorder

Symptoms of affective disorders encompass a range of changes to biological processes such as sleep and appetite. These processes are regulated over a 24-h cycle known as the circadian rhythm. Sleep is a particularly useful marker of this rhythm as it is readily measurable and functionally significant. Sleep disturbance is common in bipolar affective disorder and may act as a marker, and precipitant, of relapse. Circadian rhythms are modulated by environmental and social cues and have been shown to be influenced by treatment in BPAD. As such understanding of circadian rhythms may lead to a better understanding of the pathophysiology of BPAD and its treatment. This chapter will explore the neurobiology of the circadian clock and the putative role of circadian rhythm dysregulation in the pathophysiology and treatment of bipolar affective disorder (BPAD).

Lifestyle choices and mental health: a longitudinal survey with German and Chinese students

BACKGROUND

A healthy lifestyle can be beneficial for one's mental health. Thus, identifying healthy lifestyle choices that promote psychological well-being and reduce mental problems is useful to prevent mental disorders. The aim of this longitudinal study was to evaluate the predictive values of a broad range of lifestyle choices for positive mental health (PMH) and mental health problems (MHP) in German and Chinese students.

METHOD

Data were assessed at baseline and at 1-year follow-up. Samples included 2991 German (Mage = 21.69, SD = 4.07) and 12,405 Chinese (Mage = 20.59, SD = 1.58) university students. Lifestyle choices were body mass index, frequency of physical and mental activities, frequency of alcohol consumption, smoking, vegetarian diet, and social rhythm irregularity. PMH and MHP were measured with the Positive Mental Health Scale and a 21-item version of the Depression Anxiety and Stress Scale. The predictive values of lifestyle choices for PMH and MHP at baseline and follow-up were assessed with single-group and multi-group path analyses.

RESULTS

Better mental health (higher PMH and fewer MHP) at baseline was predicted by a lower body mass index, a higher frequency of physical and mental activities, non-smoking, a non-vegetarian diet, and a more regular social rhythm. When controlling for baseline mental health, age, and gender, physical activity was a positive predictor of PMH, smoking was a positive predictor of MHP, and a more irregular social rhythm was a positive predictor of PMH and a negative predictor of MHP at follow-up. The good fit of a multi-group model indicated that most lifestyle choices predict mental health comparably across samples. Some country-specific effects emerged: frequency of alcohol consumption, for example, predicted better mental health in German and poorer mental health in Chinese students.

CONCLUSIONS

Our findings underline the importance of healthy lifestyle choices for improved psychological well-being and fewer mental health difficulties. Effects of lifestyle on mental health are comparable in German and Chinese students. Some healthy lifestyle choices (i.e., more frequent physical activity, non-smoking, regular social rhythm) are related to improvements in mental health over a 1-year period.

Biological dysrhythm in remitted bipolar I disorder

BACKGROUND

Recent treatment guidelines support treatment of biological rhythm abnormalities as a part of treatment of bipolar disorder, but still, literature examining various domains (Sleep, Activity, Social, and Eating) of biological rhythm and its clinical predictors are less.

OBJECTIVES

The main aim of our study is to compare various domains of biological rhythm among remitted bipolar I subjects and healthy controls. We also explored for any association between clinical variables and biological rhythm among bipolar subjects.

METHODS

40 subjects with Bipolar I disorder and 40 healthy controls who met inclusion and exclusion criteria were recruited for the study. Diagnoses were ascertained by a qualified psychiatrist using MINI 5.0. Sociodemographic details, biological rhythm (BRIAN-Biological Rhythm Interview of assessment in Neuropsychiatry) and Sleep functioning (PSQI- Pittsburgh Sleep Quality Index) were assessed in all subjects.

RESULTS

Mean age of the Bipolar subjects and controls were 41.25±11.84years and 38.25±11.25 years respectively. Bipolar subjects experienced more biological rhythm disturbance when compared to healthy controls (total BRIAN score being 34.25±9.36 vs 28.2±6.53) (p=0.002). Subsyndromal depressive symptoms (HDRS) had significant positive correlation with BRIAN global scores(r=0.368, p=0.02). Linear regression analysis showed that number of episodes which required hospitalization (β=0.601, t=3.106, P=0.004), PSQI (β=0.394, t=2.609, p=0.014), HDRS (β=0.376, t=2.34, t=0.036) explained 31% of variance in BRIAN scores in remitted bipolar subjects.

CONCLUSION

Biological rhythm disturbances seem to persist even after clinical remission of bipolar illness. More studies to look into the impact of subsyndromal depressive symptoms on biological rhythm are needed.

Social Rhythm Therapies for Mood Disorders: an Update

Social rhythms are patterns of habitual daily behaviors that may impact the timing of the circadian system directly or indirectly through light exposure. According to the social rhythm hypothesis of depression, depressed individuals possess a vulnerability in the circadian timing system that inhibits natural recovery after disrupting life events. Social rhythm therapies (SRTs) support the implementation of regular, daily patterns of activity in order to facilitate recovery of circadian biological processes and also to improve mood. The majority of SRT research has examined interpersonal and social rhythm therapy (IPSRT) for bipolar disorder. Recent studies have examined IPSRT in inpatient settings, using alternative modes of delivery (group, combined individual and group, internet-based applications) and with brief timeframes. New forms of SRTs are developing that target mood in individuals who have experienced specific types of stressful life events. This manuscript reviews the theoretical and biological bases of SRTs and current literature on SRT outcomes.