Article

Mental disorders among college students in the WHO World Mental Health Surveys

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Abstract

Background. Although mental disorders are significant predictors of educational attainment throughout the entire educational career, most research on mental disorders among students has focused on the primary and secondary school years. Methods. The World Health Organization World Mental Health Surveys were used to examine the associations of mental disorders with college entry and attrition by comparing college students (n = 1,572) and nonstudents in the same age range (18-22; n = 4,178), including nonstudents who recently left college without graduating (n = 702) based on surveys in 21 countries (4 low/lower-middle income, 5 upper middle-income, 1 lower-middle or upper-middle at the times of two different surveys, and 11 high income). Lifetime and 12-month prevalence and age-of-onset of DSM-IV anxiety, mood, behavioural and substance disorders were assessed with the Composite International Diagnostic Interview. Results. One-fifth (20.3%) of college students had 12-month DSM-IV/CIDI disorders. 83.1% of these cases had pre-matriculation onsets. Disorders with pre-matriculation onsets were more important than those with post-matriculation onsets in predicting subsequent college attrition, with substance disorders and, among women, major depression the most important such disorders. Only 16.4% of students with 12-month disorders received any 12-month healthcare treatment for their mental disorders. Conclusions. Mental disorders are common among college students, have onsets that mostly occur prior to college entry, in the case of pre-matriculation disorders are associated with college attrition, and are typically untreated. Detection and effective treatment of these disorders early in the college career might reduce attrition and improve educational and psychosocial functioning.

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... Reliable epidemiological data are needed to plan effective campus-based interventions, formulate context-sensitive policies, and establish priorities, especially in austere environments like sub-Saharan Africa where limited resources need to be allocated carefully to interventions that yield maximum benefit. However, literature on the epidemiology of student mental health comes predominantly from high-income countries (Auerbach et al., 2016), with comparatively little data on the approximately 7.4 million university students in sub-Saharan Africa (Calderon, 2018). For a range of socioeconomic and political reasons (including poverty, income inequality, a history of colonization and civil wars, political instability, and gender inequality) the epidemiology of student mental health in sub-Saharan Africa may differ substantially from that of high income, industrialized, western countries. ...
... There is growing concern worldwide about the mental health of university students (Duffy et al., 2019;Lipson et al., 2018;Liu et al., 2019), with one multinational study across 19 colleges in 8 countries reporting lifetime and 12-month prevalence estimates for CMDs of 35 % and 31 %, respectively . Anxiety and mood disorders were the most common problems reported by students in those studies and have been the focus of much of the research in this area (Auerbach et al., 2016;Peltzer and Pengpid, 2017), but attention difficulties, hazardous substance use, and eating disorders are also not uncommon (Cranford et al., 2009;Harrer et al., 2020;Pedrelli et al., 2015;Peltzer and Pengpid, 2016a;Yi et al., 2017). In SA, CMDs appear to be more prevalent among university students than the general population, although this finding is based on very few studies typically conducted with small samples from single institutions, focused on one or two mental disorders (Bantjes et al., 2019;Makhubela, 2021). ...
... Groups of students that appear to be at somewhat higher increased risk include Black students attending HWIs, and female, gender non-conforming and sexual minority (i.e., LGBTQ+) students. Overall, the 30-day prevalence estimates for GAD (10.9 %), MDE (15.4 %), and bipolar spectrum disorder (1.8 %) are consistent with other international (Auerbach et al., 2016 and local (Bantjes et al., 2019) student studies, but higher than in the country's general population (Herman et al., 2009). Likewise, the 30-day prevalence of alcohol use disorder (2.5 %) and drug use disorder (5.1 %) are congruent with studies among students globally , and broadly aligned with patterns of substance use disorders in SA's general population (Herman et al., 2009). ...
Article
Background We estimate 30-day prevalence of 11 common mental disorders among a representative sample of university students in South Africa and explore disparities in student mental health across historically segregated institutions and marginalised groups. Methods Cross-sectional data collected in self-report surveys of students (n = 28,268) from 17 universities were weighted to adjust for differences in survey responses. Poisson regression was used to estimate risk ratios (RRs). Results Prevalence estimates were highest (21.0–24.5 %) for two anxiety disorders (social anxiety disorder, PTSD) and two disruptive behavior disorders (eating disorder, ADHD). Prevalence estimates were higher for any anxiety disorder (37.1 %) and any disruptive behavior disorder (38.7 %) than for any mood disorder (16.3 %) or any substance use disorder (6.6 %). Prevalence estimates varied significantly by historical segregation status of institutions (F3 = 221.6, p < .001), with prevalence consistently highest in Historically White Institutions (HWIs). Across all institutions, risk of any disorder was lower among oldest than younger students (RR = 0.7, 95%CI = 0.7–0.8), and elevated among gender non-conforming (RR = 1.3, 95%CI = 1.1–1.4), female (RR = 1.2, 95%CI = 1.1–1.2), and sexual minority (RR = 1.2, 95%CI = 1.2–1.3) students. Black students attending HWIs had elevated risk of any disorder relative to White students. Limitations Reliance on self-report measures together with relatively low and variable response rates across institutions limit generalizability of results. Conclusions Modest risks associated with sociodemographic factors suggest a need to focus on mental health of female, gender nonconforming and sexual minority students at all universities along with Black students attending HWIs.
... This age range corresponds to the prime years for the onset of mental health and substance use disorders (Martin, 2010;Storrie et al., 2010). In global surveys, 20-30% of university students met the diagnostic criteria for a mood disorder, substance use disorder, anxiety disorder, panic disorder or bipolar disorder, with most having pre-entrance onset (Auerbach et al., 2016;Auerbach et al., 2018). A few small-scale surveys in New Zealand found that just under 20% of students scored significantly on depression and anxiety scales (Samaranayake et al., 2014), while the 12-month prevalence of self-harming was reported as 13% (Fitzgerald & Curtis, 2017). ...
... Despite the high prevalence of mental health challenges, students underutilise the counselling services available on campus (Auerbach et al., 2016;Sharp & Theiler, 2018). A lack of awareness and under-resourced services pose barriers to access (Stallman, 2012;van Ommen & Nazari, 2019). ...
Thesis
In New Zealand, the COVID-19 pandemic arrived soon after the 2020 academic year began, posing additional challenges for first-year students navigating the transition to university while adapting to the pandemic. This thesis explores the experience of first-year students as they navigate this dual challenge. Using Interpretative Phenomenological Analysis (IPA), three participants from Massey University Albany Campus were interviewed to describe the pandemic's impact on their wellbeing using the Te Whare Tapa Whā model, and its impact on their university experience and day-today learning. Analysis revealed four themes. In Disruption, the participants struggled with the very concept of a pandemic, causing intangible losses and grief. Wellbeing focussed on the pandemic's impact on participants' physical and mental health. The participants demonstrated divergent pathways to mental ill-health over time. Lockdown with Others highlighted how lockdown brought the household members' different lifestyle needs into conflict and created distractions to the participants' studies. Lastly, Studying during the Pandemic covers the participants' initial adjustment to the university and their experience during Auckland's two lockdowns. The participants reported less collaboration with others and reduced motivation when studying online. This thesis is the first to examine the collision of the pandemic and first-year university experience in New Zealand. The results highlight the pandemic's lasting impact on the participants' worldview. As with other research, the participants had unrealistic expectations of university. They attributed the failure to experience their idealised university life to the pandemic, perceiving their university experience as not a genuine one. Particular findings of note include the unintended impact of the university's grade-adjustment policy reducing student motivation for learning; the impact of sleeping patterns during the lockdown on 2 household dynamics; and the participants' framing of physical exercise during the lockdown as a space-claiming action. Practice recommendations based on these findings include clear communication of academic expectations at university to first-year students; incorporating independent learning into the core first-year curriculum; and avoiding technology solutionism in online learning by positioning authentic relationships between faculty and students, and between the students, as the basis of the student experience.
... University students are at an age that transitions them from being adolescents to being young adults, who not only encounter major changes in many aspects of their lives (i.e., social life, friends, study patterns), but are also not fully mature [1]. Previous studies have found that mental problems are common among college students, at about one in five to one in two [2][3][4][5], including stress, anxiety, and depressive disorders [6][7][8], leading to worsening of learning outcomes [3]. These problems cause not only short-term but also long-term impacts, including on emotional health, physical health [9], and relationships [10]. ...
... As shown in Table 3, after adjustment for sex [2,8,11], faculty, student year [7,8], and domicile of the students [8], the severity of the problems reported by the students was associated with communication failures in the family (AOR = 3.30 (95% CI: [1.14-9.52], p = 0.027). ...
Article
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Mental health problems are common among university students. Specific type of family background is one of the important factors contributing to these problems. This study aimed to evaluate the proportion of severe mental health problems and the associations between severity and types of problems and family backgrounds. This was a cross-sectional descriptive study. We reviewed the database and medical records of 125 university students aged over 18 years who attended the mental health consultation clinic for university students, 123 Primary Care Unit, Khon Kaen University, between 1 January and 31 December 2018. The characteristics of the participants were summarized using descriptive statistics. We performed an analysis using logistic regression to obtain the crude and adjusted odds ratio. The proportion of severe mental health problems was 50.4%. The most common problem was learning problems (54.4%). The severity of the problems reported by the students was associated with communication failure in the family (AOR = 3.30 [95% CI: 1.14–9.52], p = 0.027). All students who experienced domestic violence in their family had severe mental health problems. This study re-appraised the utility of the context of the family as a predictor of current problems of university students.
... Recent research has indicated that the onset of psychological disorders often occurs prior to the commencement of college [7,12,14]. The transition into higher education and adjustment to a less structured learning environment, new social networks and increased academic demands can cause considerable stress and anxiety [15][16][17] which may exacerbate pre-existing mental illness and correlates with the development of mood disorders in students [18]. ...
... The high prevalence of mental illness, suicidality and transitional risk are not the only worrisome trends globally. Research has also revealed rates of treatment-seeking as low as 11%-16% within the student population [14,19]. The reluctance towards treatment-seeking may be partially attributable to stigma, fears that treatment-seeking will impact future career goals, poor symptom recognition and a preference for self-reliance [7,20,21]. ...
Article
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Background: Elevated levels of suicidality, ADHD, mental ill-health and substance disorders are reported among college students globally, yet few receive treatment. Some faculties and courses appear to have more at-risk students than others. The current study aimed to determine if students commencing college in different academic disciplines were at a heightened risk for psychopathology, substance use disorders and suicidal behaviour, and examined variations in help-seeking behaviour. Materials and methods: The study utilised data collected from 1,829 first-year undergraduate students as part of the Student Psychological Intervention Trial (SPIT) which commenced in September 2019 across four Ulster University campuses in Northern Ireland and an Institute of Technology, in the North-West of Ireland. The SPIT study is part of the World Mental Health International College Student Initiative (WMH-ICS) which uses the WMH-CIDI to identify 12-month and lifetime disorders. Results: Students from Life and Health Sciences reported the lowest rates of a range of psychological problems in the year prior to commencing college, while participants studying Arts and Humanities displayed the highest levels (e.g. depression 20.6%; social anxiety 38.8%). However, within faculty variations were found. For example, psychology students reported high rates, while nursing students reported low rates. Variations in help seeking behaviour were also revealed, with male students less likely to seek help. Conclusions: Detecting specific cohorts at risk of psychological disorders and suicidality is challenging. This study revealed that some academic disciplines have more vulnerable students than others, with many reluctant to seek help for their problems. It is important for educators to be aware of such issues and for colleges to provide information and support to students at risk. Tailored interventions and prevention strategies may be beneficial to address the needs of students from different disciplines.
... Nearly one quarter of incoming college students reported 12-month suicidal ideation and one out of six suicidal plans. These findings are similar to what has been reported in other countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain and United States) with 17.6 % of 12-month ideation and 9.2 % of 12-month suicide plan in WMH-ICS data (Auerbach et al., 2016). These rates are, however, considerably higher than what has been reported in the general population of France, with 4.7 % of adults reporting 12-month suicidal ideation (Léon et al., 2019). ...
... Taken together, the present findings combine with population attributable risk proportions associated with CAs estimated to range from 62.6 % to 84.7 % (Mortier et al., 2021), confirm the importance of CAs on suicidal ideation earlier in life and support the need for early detection of mental health problems as well as prevention. Furthermore, the use of specialized services for mental health problems is known to be insufficient among college students (Auerbach et al., 2016;Eisenberg et al., 2007Eisenberg et al., , 2011. In a recent study, only one out of four college students with 12-month suicidal ideation used mental health services in the past year (Janota et al., 2022). ...
Article
Background Exposure to childhood adversities (CAs) is known to be associated with the onset of suicidal ideation and plans. However, little is known regarding the contribution of CAs to their persistence. Aims The study aims to examine the type, number and frequency of CA exposure on the persistence of suicidal ideation and plans at one-year. Method Data were drawn from the French portion of the World Mental Health International College Student survey. At baseline (n = 2661, response rate = 7,58 %), exposure to 12 types of CAs prior to age 18, lifetime mental disorders, lifetime and 12-month suicidal ideation and plans were assessed. At one-year follow-up (n = 1221), 12-month mental disorders, suicidal ideation and plans were assessed. Among those with a prior history of suicidal ideation, logistic regressions were performed to examine the role of CAs on the persistence of ideation and plans at one-year. Results At baseline, frequency and number of CAs were associated with 12-month suicidal ideation and plans. Among lifetime ideators, 49.6 % reported 12-month suicidal ideation at follow-up. Physical abuse was associated with an increased risk of suicidal ideation and plan persistence at one year in univariate analyses. However, CAs were not associated with the persistence of suicidal ideation and plans at one-year in multivariate analyses. Limitations Retrospective report of CA exposure, and low baseline response rate. Conclusions Using a fine-grained operationalization of CA exposure, CAs were not involved in the persistence of suicidal ideation or plans, their deleterious effect more likely to occur early in the course of psychopathology.
... 11 Globally, universities have been increasingly concerned about the prevalence of common mental disorders and suicidal behaviour among undergraduate students even before COVID-19. [12][13][14] One pre-COVID-19 survey of students from 19 universities across eight countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, USA) reported 12-month prevalence rates of 35% for at least one common mental disorder among first-year students 15 , and 12-month prevalence rates for suicidal ideation, plan, and attempt of 17.2%, 8.8%, and 1.0%, respectively 13 . The prevalence of psychopathology among undergraduate students is partly attributed to psychosocial stressors associated with this developmental period (i.e. ...
Article
COVID-19 has had far-reaching economic, social and health consequences, with vulnerable groups disproportionally affected. Even before the COVID-19 pandemic, concern was expressed about university students’ mental health, with global data suggesting students are more vulnerable than the general population to mental disorders. Yet, it is unclear what the pandemic’s impact has been on the mental health of students in South Africa. We examined the impact of COVID-19 on first-year students at two universities in South Africa by analysing changes in the prevalence and age-of-onset of three common mental disorders (namely major depressive episode, generalised anxiety disorder, and suicidal ideation) before and during the pandemic, and comparing these to changes between 2015 and 2017. Our analysis of cross-sectional survey data collected in 2015, 2017 and 2020 shows no clear or consistent pattern of increases in prevalence of common mental disorders following the start of the pandemic. Lifetime prevalence rates of common mental disorders among students have been steadily increasing since 2015, and where increases before and during COVID-19 were observed, they are not consistently larger than increases between 2015 and 2020. No significant changes were observed in the 12-month prevalence of common mental disorders before and during COVID-19, except for an increase in prevalence of depression at one institution, and a decrease in suicidal ideation at the other. Findings suggest that in the context of ongoing adversity and disruptions on South African university campuses in recent years, COVID-19 may be just one more stressor local students face and that its impact on student mental health may not have been as marked in South Africa compared to other regions. Significance: • This study is the first to explore COVID-19’s impact on university students’ mental health in South Africa, using data collected before and during the pandemic. • High rates of psychopathology confirm the need for sustainable campus-based interventions to support student well-being. • Rates of mental disorders among students have been increasing since 2015, and increases observed in 2020 were no larger than those observed in prior years. • In the context of disruptions on university campuses in recent years, COVID-19 is just one more stressor for students, and its impact may not have been as marked in South Africa compared to other regions.
... Higher education (HE) students in general have been identified as a vulnerable population for developing stress and mental health problems (Auerbach et al. 2016;Sharp and Theiler 2018). More specifically, especially the transition to HE is recognized as being challenging for new students, as they face changes both on an academic and a social level (Conley et al. 2020;Sharp and Theiler 2018;Tholen et al. 2022). ...
Article
Full-text available
Background: The COVID-19 pandemic caused disruptions in numerous fields, including higher education. New students have been identified as a vulnerable sub-population experiencing stress and mental health problems due to the pandemic. Little research, however, explores how and why they are particularly vulnerable. We aimed to answer (1) how new students experienced their academic and social integration process during the pandemic and (2) how these changing conditions might affect their mental well-being. Methods: The researchers performed five focus group discussions with 23 new students (i.e., first-year students, international students, and students from a bridging program) from several faculties. Focus groups were coded and analyzed by two researchers. An abductive analytical perspective was used, building on the integration and emerging adulthood literature. Results: Three main processes were identified: (1) academic and social integration, formerly intertwined, have become two separate goals; (2) integration increasingly became the students' responsibility; and (3) COVID-19 measures and emerging adulthood expectations clashed: increasing social connection, exploration, and carefree living were replaced by, respectively, social isolation, lingering monotony, and increasing worries. Conclusion: COVID-19 measures presented students with a dichotomy in which they were pushed faster into adulthood by taking up increasing responsibilities and at the same time remained socially stuck in adolescence by not living up to emerging adulthood expectations.
... tiriamųjų. Tik labai maža dalis šios amžiaus grupės tiriamųjų kreipiasi į specialistus [33]. Universiteto studentų turimų psichikos sveikatos sutrikimų bei jų simptomatikos nesuvokimas ir manymas, kad jie neturi laiko kreiptis pagalbos, gali būti kreipimosi į psichikos sveikatos specialistus kliūtis, rodanti žemą studentų psichikos sveikatos raštingumo lygį net ir tuomet, kai jaunesnis amžius yra nustatytas kaip veiksnys, darantis teigiamą įtaką aukštesniam PSR suvokimui [34]. ...
Article
Įvadas. Psichikos sveikatos raštingumas (PSR) – tai psichikos sveikatos būklių supratimas, padedantis jų prevencijai, atpažinimui ir gydymui. Dėl nepakankamo visuomenės išmanymo apie psichikos sutrikimus, jų atpažinimas, kreipimasis pagalbos ir gydymas vėluoja. Pavyzdžiui, JAV depresiją atpažįsta <50 proc. paauglių ir koledžo studentų [16]. Buvo nustatyta keletas skirtingų sociodemografinių veiksnių, turinčių įtakos psichikos sveikatos raštingumo lygiui, įskaitant lytį, amžių, išsilavinimą ir žmogaus asmenybę. PSR bendroje pop­uliacijoje išlieka itin žemo lygio. Būtina skubiai didinti moderniosios visuomenės informuotumą apie psichikos ligas, sutrikimus ir psichikos sveikatos raštingumą. Reikia atlikti kuo daugiau informatyvių PSR tobulinimo tyrimų [37] ir geros kokybės mokslinių tyrimų, įvertinti visuomenės PSR lygį ir parengti visuomenės PSR ger­inimo metodikas. Šios priemonės, didindamos ankstyvo psichikos sutrikimų nustatymo ir gydymo galimybę, gerintų visuomenės gyvenimo kokybę. 1997 m. A. Jorm pirmą kartą pavartojo psichikos sveikatos raštingumo (PSR) terminą, kad apibūdintų „žinias ir gebėjimus, padedančius atpažinti psichikos sutrikimus, juos val­dyti ar užkirsti kelią“ [14]. Iki šiol atlikti PSR tyrimai parodė, kad daugelis žmonių nesikreipia pagalbos arba ją atideda dėl įvairių asmeninių ir struktūrinių kliūčių, tokių kaip baimė dėl stigmos ir diskriminacijos, susiju­sios su depresija; negeba atpažinti problemos simptomų, neturi žinių apie pagalbos prieinamumą, neieško tinkamų atsakymų bei pagalbos tiek iš šeimos, tiek iš draugų [15]. Šioje literatūros apžvalgoje aptariama psichikos sveikatos raštingumo apibrėžtis, PSR svarba visuomenei bei ryšys su sociodemografiniais veiksniais. Tikslas − išanalizuoti psichikos sveikatos raštingumo apibrėžtį, jo svarbą visuomenei, kylančias problemas bei ryšį su sociodemografiniais veiksniais. Tyrimo medžiaga ir metodai. Mokslinių šaltinių paieška, apžvalga bei analizė. Publikacijų paieška buvo vyk­doma tarptautinėje medicinos duomenų bazėje PubMed. Paieška buvo atliekama pasitelkiant raktinius žodžius ir jų derinius: psichikos sveikatos raštingumas, sociodemo­grafiniai veiksniai, pagalba sergant psichikos sutrikimu, psichikos sveikatos raštingumo svarba visuomenei. Rezultatai. Taikant teorinės analizės metodus, buvo surasta 100 publikacijų, atitinkančių įtraukimo kriterijus. 65 publikacijos buvo atmestos, nes neatitiko įtraukimo kriterijų. Išvados. Psichikos sveikatos raštingumas labai svarbus ankstyvam psichikos sutrikimų atpažinimui ir interven­cijai. Žemesnio išsilavinimo moterų, vyresnio amžiaus ir žemas mėnesines pajamas gaunančių žmonių psichikos sveikatos raštingumas yra žemesnis. Didinant psichikos sveikatos raštingumą, tikimasi formuoti palankų požiūrį į psichikos sveikatą, ugdyti psichikos sveikatos problemų suvokimą, akcentuoti kreipimosi pagalbos svarbą ir pamokyti ją rasti, pagerinti profesionalios pagalbos prieinamumą pirmuosius simptomus pajutusiems as­menims.
... Young adults entering college are a population at risk of IGD because they spend large amounts of time using computers for learning, peer communication, and leisure [8]. Because those starting college also face stress from a new, demanding learning environment, they are also at risk of mental disorders [9]. Few epidemiological studies are available for IGD among college students, and only a handful are follow-up studies that would enable one to determine the role of IGD in the onset of mental disorders [10]. ...
Article
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We seek to evaluate whether Internet Gaming Disorder (IGD) among university students in Mexico during their first year at university predicts a long list of mental disorders a year later, controlling for baseline mental health disorders as well as demographics. This is a prospective cohort study with a one-year follow-up period conducted during the 2018–2019 academic year and followed up during the 2019–2020 academic year at six Mexican universities. Participants were first-year university students (n = 1741) who reported symptoms compatible with an IGD diagnosis at entry (baseline). Outcomes are seven mental disorders (mania, hypomania, and major depressive episodes; generalized anxiety disorder and panic disorder; alcohol use disorder and drug use disorder), and three groups of mental disorders (mood, anxiety, and substance use disorders) at the end of the one-year follow-up. Fully adjusted models, that included baseline controls for groups of mental disorders, rendered all associations null. The association between baseline IGD and all disorders and groups of disorders at follow-up was close to one, suggesting a lack of longitudinal impact of IGD on mental disorders. Conflicting results from available longitudinal studies on the role of IGD in the development of mental disorders warrant further research.
... The persistence of symptoms of depression and anxiety among young adults was also highlighted before the outbreak of the COVID-19 pandemic [18][19][20]. As early as 2007, Eisenberg et al. [21] found depressive-anxiety symptoms in nearly 16% of the students surveyed, and two years later Zivin et al. [18] confirmed the existence of these symptoms in as many as 60% of people in the aforementioned study group. ...
Article
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Abstract: Background: Mental health deterioration in young adults in the aftermath of the COVID-19 pandemic is being increasingly studied. It is clear that the psychological consequences of the pandemic will be evident for many years, especially among the younger generation, who did not have time to acquire adaptive coping strategies before the outbreak of COVID-19. The purpose of this study was to assess the condition of the mental health of students at Polish universities after two years of the pandemic. The types of coping strategies used by the respondents to deal with stress were also evaluated in order to establish which of them could have a beneficial effect on the psyche of young people. Methods: This study included 721 participants (age [years]: M = 25.7, SD = 5.3; 269 (37.2%) males) recruited using snowball sampling from students at two universities in Lodz, Poland, and full-time doctoral students from across Poland (phase I of the study was conducted in March 2019 (N = 352); phase II of the study was conducted in April 2022 (N = 369)). The following tools were used in this study: The General Health Questionnaire (GHQ-28) by D. Goldberg, the Perceived Stress Scale (PSS-10), and the Inventory for Measuring Coping with Stress (Mini-COPE) by Carver et al. Pearson's chi-square test and multivariate logistic regression were used in the statistical analysis. Results: The results detailing the condition of the mental health of the subjects, as measured using GHQ-28, were significantly worse in the group surveyed after two years of the pandemic than the results of the survey conducted in March 2019 (adjusted odds ratio for GHQ-28 ≥ 5: 3.66, 95%CI 2.12-6.30, p < 0.001). Statistically significant differences were seen for each of the subscales of the GHQ-28 questionnaire. Most often, the subjects complained of anxiety symptoms and sleep disorders, in addition to somatic symptoms. The risk factors for worsening mental health included female (odds ratio 1.70, 95%CI 1.20-2.40, p = 0.003) and professional inactivity (odds ratio 1.55, 95%CI 1.04-2.31, p = 0.031). On the other hand, the ages of the people surveyed, their relationship status, whether they had children, or the type of university they attended all proved to be insignificant. The following coping strategies had a positive impact on the mental health of the respondents: positive reframing (Z = −2.951; p = 0.003) and seeking emotional support (Z = −2.351; p = 0.019). In contrast, strategies such as self-distraction (Z = 2.785; p = 0.005), denial (Z = 2.948; p = 0.003), venting (Z = 2.337; p = 0.019), self-blame (Z = 5.511; p < 0.001) and behavioral disengagement (Z = 4.004; p < 0.001) were associated with poorer mental health among the respondents. Conclusions: 1. Of the students surveyed, 33% reported elevated stress levels after two years of the COVID-19 pandemic. 2. The overall mental health of students at Polish universities, as measured by GHQ-28, was significantly worse in the group evaluated after two years of the COVID-19 pandemic, mainly in respect of anxiety symptoms and sleep disorders. 3. Female gender and professional inactivity appeared to be risk factors for the students' worsening mental health, which may be an indication of the need for further research and planning of psychotherapeutic interventions.
... Fear of COVID-19 has led to a decline in individual mental health and an increase in negative emotions such as depression and anxiety . Undergraduates are in adolescence, their psychological development is not very mature, and they are prone to psychological problems due to the pressure of learning and employment (Auerbach et al., 2016(Auerbach et al., , 2018. Fear of COVID-19 has made the psychological problems of undergraduates who lack social experience and coping measures more serious (Pierce et al., 2020;Son et al., 2020). ...
Article
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Objective Explore the influence of fear of COVID-19 on depression, with anxiety as a mediator and perceived social support and stress perception as moderates. Methods From February to March 2020, 1,196 valid data were collected online through questionnaire by cluster sampling method. Fear of COVID-19 Questionnaire, the Patient Health Questionnaire 9-Item Scale (PHQ-9), the Generalized Anxiety Disorder 7-Item Scale (GAD-7), the Perceived Social Support Scale (PSSS) and the10-item Perceived Stress Scale (PSS-10) were used as the survey instrument, and the participants were female undergraduates from a liberal arts college of a Chinese university. Common method bias was assessed using Harman’s single-factor test in SPSS and confirmatory factor analysis in AMOS. The levels of participants’ anxiety, depression and perceived social support were described using frequency and percentage, Pearson Correlation test was used to measure the correlation between the variables. The PROCESS macro for SPSS (Model 1, Model 4, and Model 21) were applied to examine the mediating effect and moderating effect of the model. Results Fear of COVID-19 can positively influence depression, anxiety plays a mediating role between fear of COVID-19 and depression, perceived social support negatively moderates the relationship between fear of COVID-19 and anxiety, and stress perception positively moderates the relationship between anxiety and depression. These five variables can form a moderated mediating effect model. Conclusion Fear of COVID-19, anxiety and stress perception are risk factors for depression, perceived social support is a protective factor for depression. Reducing the fear of COVID-19, anxiety and stress perception and enhancing perceived social support are beneficial to reduce the level of depression.
... Hormonal changes, major life decisions, peer and familial pressure, separation from home, academic and societal expectations, and exposure to digital technology were among the negative factors that placed college students under extreme mental and emotional duress. (Auerbach, 2016.) Philippine state and private higher education institutions have taken laudable steps to provide the broadest access to their college students' mental health care services. ...
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The issue of psychological wellbeing among pre-service teachers had received heightened attention as a research platform at this time of global health emergency. A marked increase in mental health researches undertaken globally in recent years attests to this. In the Philippines, before the pandemic onset, universities in Manila known for their robust Behavioral Science curricular offerings have conducted comparative studies. This research determined the pre-service teachers' psychological profile was a trailblazing initiative to place Bicol University among the lead institutions heeding the urgent call for research that identified maladaptive behaviors within cognitive, affective, social, and occupational spheres. Students who reported moderate to significant psychological distress further participated in small focus groups. They shared narratives during childhood and adolescence they considered as precursors of their current psychological-emotional difficulties. Quantitative scores from the BPI instrument and qualitative data obtained from focus group discussions served as the basis for crafting policy recommendations and program proposals to improve mental health services delivery in the university, upgrade the current curriculum for teacher education and promote the professional development needs of teachers in the realm of mental health literacy, given that they perform a critical role in handling social-emotional and cognitive health issues in the classroom. The outcome is a developed, context-specific, holistic mental health and resilience program for pre-service teachers of Bicol University for psychological maladjustment, improving stress-coping skills, cultivating self-management, emotional regulation, and pro-social behavior.
... The prevalence of mental disorders and generalised psychological distress in university students is high globally. For example, an international study of 14,000 students spanning 19 universities and eight countries found that 35% of students met the diagnostic criteria for one or more mental disorders [6]. A 2016 Australian study by Farrer et al. [7] found that the prevalence of major depressive disorder and generalised anxiety disorder in university students was 7.9% and 17.5%, respectively. ...
Article
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Students transitioning from secondary school to university may experience unique issues that impact their mental health. There is limited research, however, on what drives first year students to seek professional help for mental health problems. There is also a current lack of knowledge about the factors that may be associated with engagement with university life in students transitioning to university, and how engagement may be related to help seeking attitudes and behaviours in a first year university population. Data (N = 165) were drawn from two waves (Wave 1, February 2021, and Wave 4, June 2021) of a longitudinal study of Australian university students commencing study for the first time, which included measures of engagement, belonging, stigma and help seeking intentions and behaviours. The results showed that students with higher levels of depression stigma prior to commencing university at Wave 1 had less positive attitudes towards help seeking at Wave 4. Students had increased odds of seeking help for a mental health problem in Wave 4 if they had moved away for university, reported higher levels of mental health literacy or willingness to disclose, had lower levels of engagement with university life and were experiencing higher levels of general psychological distress. Students experiencing higher thwarted belongingness were also found to have lower levels of engagement with university at Wave 4. Both thwarted belongingness and stigma were found to be associated with engagement with university and help seeking behaviours and should be examined further.
... Studies about the need and role of cognitive strategies and their relationships to EF and daily functioning were conducted mainly among populations with learning or attention difficulties [14] and traumatic brain injury [5]. Despite demonstrated associations between EF and daily performance, little of the literature addresses the role of cognitive strategies in moderating these relationships [15,16]. ...
Article
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Whereas prior studies have addressed relationships between cognitive strategies and learning and achievement, very few dealt with their connection to daily functioning. This study examines the moderation effect of the frequency of compensatory cognitive strategy use within that relationship among university students. A sample of 336 students (18–36 years; 180 women, 156 men) answered the Dysexecutive Questionnaire (DEX; executive function components), Time Organization and Participation Scale (TOPS; daily functioning), and Compensatory Cognitive Strategies Scale (CCSS; strategy use). The results showed significant correlations between the DEX and TOPS for three CCSS levels (−1.0, −1.0 to 1.0, and 1.0 SD from average); the higher the frequency of cognitive strategy use, the stronger the association between the DEX and TOPS. The findings suggest that more frequently use of cognitive strategies can strengthen efficient daily functioning.
... College students can be subject to stressful situations. The pressures of establishing a career path, academic demands, the transition from adolescence to adulthood, peer pressures, and many other factors affect their general well-being and mental health [6]. Before the pandemic, there was a significant number of reports showing that the increase in stress, depression, and reduction in the overall well-being amongst college students was prevalent, and was the subject of different interventions from the public health system ...
Article
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College students face unique challenges that the consequences of COVID-19 might aggravate. To explore the pandemic’s consequences on college students’ well-being, we conducted an online survey with 634 students from a private university in Cali, Colombia. The study sought to assess students’ well-being due to COVID-19, and to explore the mediating effects of optimism, gratitude, and emotional closeness on college students’ well-being. Results showed that COVID-19 affected students’ mental health and well-being. Being optimistic and grateful mediated with life satisfaction and happiness. Optimism, emotional closeness, and gratitude also mediated the negative effect of fear of infection and the pandemic’s impact on students’ academic performance. The results of this analysis will promote discussion of the implementation of coping strategies to help students thrive, promote resilience, and contribute to students’ well-being and better mental health.
... People in their late teens and twenties, including university students, are at a relatively higher risk of experiencing mental health impairments such as depression (American Psychiatric Association, 2013). It was reported that about one-fifth of university students experienced mental illness within 12 months of the survey and mental health problems were common among them (Auerbach et al., 2016). Moreover, since adolescence and young adulthood are periods of taking on responsibilities and frequently rebelling against them (Jurewicz, 2015), it may also be a period of high risk for mental health problems. ...
Article
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Objectives It is understood that individuals with autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) are likely to have other mental health issues. However, there is a subset of the population who have ASD traits but are below the diagnostic threshold. Nevertheless, in this population, there is an increased risk of psychiatric comorbidities including depression and other symptoms. Therefore, this study aims to examine whether university students in the general population with both higher ASD and ADHD traits had a more severe risk of developing emotional problems.Method An online survey was conducted with Japanese university students in June and July 2021. Using data from 313 Japanese university students, this study examined whether higher ASD and ADHD traits were related to emotional problems. The survey measured ASD traits with the Autism spectrum Quotient; ADHD traits were measured with the Adult ADHD Self-Report Scale, and emotional problems were evaluated using the Kessler scale.ResultsResults showed that ADHD traits moderated the association between higher ASD traits and higher emotional problems, which indicated students with both higher ASD and ADHD traits, had a severe risk of developing emotional problems.Conclusions This study highlights that it is important to focus on subthreshold ASD traits and ADHD traits in university students for their better subsequent mental health.
... The period of college, which represents an important stage of development straddling the adolescent and young adulthood life stages, is the peak for the onset of many common psychiatric illnesses, particularly depression, anxiety ( Sheaves et al. 2016). However, while timely and effective treatment is important, a number of students in need of treatment for these disorders receive no pharmaceutical or traditional psychological treatment from college mental health care services, resulting in a substantial unmet need for the treatment of mental disorders among college-going students (Auerbach et al. 2016(Auerbach et al. , 2018Beiter et al. 2015). The majority of current interventions for psychiatric illnesses mainly focus on psychotherapy and medication, and therapy that emphasizes the mind-body connection is seemingly undervalued (Weerdmeester et al. 2020). ...
Preprint
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Background Biofeedback therapy is mainly based on the analysis of physiological features to improve an individual’s affective state. There are insufficient objective indicators to assess symptom improvement after biofeedback. In addition to psychological and physiological features, speech features can precisely convey information about emotions. The use of speech features can improve the objectivity of psychiatric assessments. Therefore, biofeedback based on subjective symptom scales, objective speech, and physiological features to evaluate efficacy provides a new approach for early screening and treatment of emotional problems in college students. Methods A four-week, randomized, controlled, parallel biofeedback therapy study was conducted with college students with symptoms of anxiety or depression. Speech samples, physiological samples, and clinical symptoms were collected at baseline and at the end of treatment, and the extracted speech features and physiological features were used for between-group comparisons and correlation analyses between the biofeedback and wait-list groups. Based on the speech features with differences between the biofeedback intervention and wait-list groups, an artificial neural network was used to predict the therapeutic effect and response after biofeedback therapy. Results Through biofeedback therapy, improvements in depression (p = 0.001), anxiety (P = 0.001), insomnia(P = 0.013), and stress(P = 0.004) severity were observed in college-going students (n = 52). The speech and physiological features in the biofeedback group also changed significantly compared to the waitlist group (n = 52) and were related to the change in symptoms. The energy parameters and Mel-Frequency Cepstral Coefficients (MFCC) of speech features can predict whether biofeedback intervention effectively improves anxiety and insomnia symptoms and treatment response. The accuracy of the classification model built using the artificial neural network (ANN) for treatment response and non-response was approximately 60%. Conclusions The results of this study provide valuable information about biofeedback in improving the mental health of college-going students. The study identified speech features, such as the energy parameters, and MFCC as more accurate and objective indicators for tracking biofeedback therapy response and predicting efficacy. Trial Registration ClinicalTrials.gov ChiCTR2100045542
... Student mental health is a factor analyzed by [10], [29]- [31], and proves significant relevance between these factors and student persistence in their educational institution. ...
Article
The dropout of Brazilian students from higher education is a subject that has been well explored, where high rates of students who drop out are verified. However, despite the vast literature, the problems arising from student's dropout still have no solution since dropout itself is an unsolved problem. This research aims to present a classification via decision trees to predict the evasion of Engineering course students in Brazil. To reach this objective, exploratory field research was conducted, where data was collected employing surveys directed to the students, enabling the elaboration of a classificatory decision tree with the C4.5 algorithm. The survey sample consisted of 91 valid answers. The results were analyzed with the RapidMiner tool and presented a decision tree with 86.81% accuracy. Among the main factors preventing dropout is interaction with professors, the course curriculum, and issues related to mental well-being.
... The World Health Organization World Mental Health Survey Initiative found emerging adults aged 18-22 to have a 12-month prevalence of any mental disorder of between 20.3% to 25.0%, with 11.7% to 14.7% expressing anxiety disorders (e.g., Generalized Anxiety Disorder; Post-Traumatic Stress Disorder), and 6.0% to 9.9% experiencing mood disorders (e.g., Major Depressive Disorder; Auerbach et al., 2016). Although emerging adults exhibit elevated prevalence of mental disorders compared to other age groups, little support is available to them. ...
Article
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PurposeDue to shifts in societal and educational expectations alongside the COVID-19 pandemic, many emerging adults live with their family of origin for extended periods of time. Little is known about patterns of parent-perpetrated maltreatment in emerging adulthood. Therefore, this study evaluates the relation between forms of parent-perpetrated maltreatment, including economic abuse, and COVID stress, on symptoms of depression, anxiety, and traumatic stress.Method423 emerging adults who were enrolled in college in the United States in March of 2020 were recruited via MTurk to complete an online survey. An age-related COVID questionnaire and six empirically validated measures assess levels of COVID-19 exposure, lifetime maltreatment, economic abuse, and mental health status.Results13.0% of participants reported maltreatment that most recently occurred over the age of 18 in their household of origin. Mean COVID stress level was found to be significantly higher in the Maltreated Over 18 group compared to the Never Maltreated group (t(345) = -3.03, p = 0.003), and in the Maltreated Under 18 group compared to the Never Maltreated group (t(346) = -3.20, p = 0.002). In accounting for the contribution of demographic variables, maltreatment chronicity, economic abuse, and COVID stress, our model predicted 38.6% of variance in depression symptoms, 37.2% of variance in anxiety symptoms, and 42.9% of variance in traumatic stress.Conclusions Findings indicate need for increased maltreatment screenings within the emerging adult population and calls for age-specific interventions to address the mental health disparities experienced by emerging adults with maltreatment histories.
... Even before the onset of the pandemic, college students experienced high levels of depression, anxiety, and stress [10][11][12][13]. According to the American college health association-National college health assessment III in 2019, more than one-third of students reported at least one mental health symptom [14]. ...
Article
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The COVID-19 pandemic not only had detrimental effects on physical health but also had adverse effects on college students’ mental health. This paper begins to fill a gap in knowledge related to the contextual factors that impacted college students’ mental health during COVID. Using in-depth interviews with a diverse sample of 33 college students at a Midwestern university, during Spring 2021, we highlight the pandemic’s role in shaping college students’ mental health and their outlook of the future. Thematic analysis revealed student reports of mental health decline during the pandemic attributed to campus closures and social distancing policies implemented by the institution to reduce the spread of COVID-19. Students shared that the pandemic created uncertainties about their future opportunities for education, career fulfillment, and employment. However, the interviews also suggested a general sense of adaptation to the pandemic’s impact which was students achieved via a combination of active and passive coping strategies. Expanding institution-based mental health services to include a variety of modalities and off-line toolkits for students can help students cope with mental health challenges, whether in ‘normal times’ or during national crises. Future research should focus on identifying strategies for promoting mental wellness among college students and exploring post-pandemic mental health wellbeing.
... Many mental health issues emerge during late adolescence and early emerging adulthood, including anxiety, insomnia, and depression [2,3]. Despite the added stressors and transitions during college, students often avoid seeking professional help [4]. ...
Article
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This study examined the association between the degree of religiosity, combined with cultural beliefs, social stigmas, and attitudes towards mental-health treatment in two groups, who, despite having similar cultural and religious affiliation, have experienced different socio-political contexts: Palestinian Muslim college students living in the Occupied Palestinian Territory (OPT) and Israel. The study was guided by Tanhan and Young’s (2021) conceptual framework. Methods: A snowball recruitment strategy was applied, using a cross-sectional survey. A total sample size was 214 students, 105 from the OPT and 109 from Israel. Results indicate that students from the OPT (n = 105) did not differ from those living in Israel (n = 109) on religiosity using the Islamic Belief scale, or Attitudes Towards Mental Health treatment (F(1, 189) = 1.07, p = 0.30). However, students from the OPT had higher confidence in mental-health professionals (M = 15.33) than their counterparts (M = 14.59), and women had higher confidence (M = 16.03) than men (M = 13.90). The reliance on traditions for Muslim students over Western mental-health approaches is a critical factor in predicting the attitudes towards students’ mental problems and their chosen treatment. Sociopolitical context played a significant role in shaping attitudes toward mental-health providers.
... Mental health problems in higher education students have been associated with negative impacts on young people's development Auerbach et al., 2016), poorer academic performance and higher dropout rates (Reavley & Jorm, 2019), and a negative impact on later functioning in the labor market (Ashwood et al., 2016;Goldman-Mellor et al., 2014;Niederkrotenthaler et al., 2014). ...
Chapter
The promotion and protection of the emotional well-being of older adults is a relevant challenge, given the increase in life expectancy and demographic changes. Although many older adults experience “successful aging” and positive emotional well-being, biological, psychological, and social factors may favor the development of depressive disorders, one of the frequent and disabling diagnoses of mental health in this age group. The prevention of depressive episodes in older adults is, thus, an important line of action to support their well-being and quality of life. This includes actions at various levels to reduce risk factors and enhance protective ones. This chapter offers a broad perspective of the available findings regarding the prevention and early intervention of depression in older adults. The first section analyzes the consequences and main risk factors of this health concern. The second section covers the general characteristics of the prevention of depression in this age group. The third describes the results of efficacy studies of specific psychosocial preventive programs based on different components (physical exercise, mind-body connection, psychological, and multicomponent approaches), while the fourth and final section comments on the background presented and outlines future challenges.
... 3 Currently, CMDs are a public health concern and evidence indicates that the occurrence becomes higher among younger age groups, including students across the globe. 4 The WHO reports that one in seven people worldwide develops mental health problems, and 10.7% of those people have lived with such conditions. 5 The initial onset of CMDs can be in adolescence, and usually severe mental disorders are typically preceded by less severe events as a prodromal phase, and giving early intervention helps to prevent the persistence of illness. ...
Article
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Background Common mental disorders include anxiety, depression and somatic symptoms. These pose significant public health problems because of their serious effects on personal well-being, social and occupational functions. They also can affect the health and quality of life of people in adolescence, because this age group has been vulnerable to different factors. According to the American Psychiatry Association, more than 60% of adolescents fulfil the criteria for at least one common mental disorder. Despite the high burden of the disorders, there are limited studies in Ethiopia; therefore, this study provided the prevalence of common mental disorders among students in Ethiopia. Methods From 5 May to 30 May 2021, an institutional-based cross-sectional study was undertaken. Simple random sampling was used to select study participants from each class level across all high schools. A self-administered survey was used that included Self-Reporting Questionnaire 20, Oslo Social Support Scale-3 and other semistructured instruments for the screening of common mental disorders. Data were checked, coded and entered into Epi-Data V.4.6.0, then exported to SPSS V.20 for analysis. Bivariable and multivariable logistic regression analyses were done to identify factors associated with common mental disorders. Adjusted ORs with 95% CIs were calculated and variables with a p value of <0.05 were considered as significantly associated with common mental disorders. Results A total of 600 high school students were recruited with a response rate of 93.2%. The overall prevalence of common mental disorders among the participants was 181 (32.4%). Being female (adjusted OR (AOR)=1.93; 95% CI: 1.27 to 2.99), a family history of mental illness (AOR=2.23; 95% CI: 1.15 to 4.35), poor social support (AOR=3.14; 95% CI: 1.51 to 6.54), a history of non-physical sexual abuse (AOR=2.09; 95% CI: 1.21 to 3.62) and a history of physical sexual abuse (AOR=2.43; 95% CI: 1.29 to 4.59) were significantly associated with common mental disorders. Conclusion and recommendation The prevalence of common mental disorders was 32.4% among students; therefore, it is recommended facilitating institutional-based intervention services in the school to decrease the contributing factors for the common mental disorders.
... Beyond simply the workload, some students felt strong pressure to perform and live up to the "honours" status of the programme. With concerns over mental health of students rising (Auerbach et al. 2016), it may be warranted to further explore how novel educational forms can be implemented in a way that better take into account mental health concerns. One option may be to replace rather than add extra work on top of existing programmes. ...
Article
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Despite the growing consensus that academic curricula should play a crucial role in addressing wicked problems, academic curriculum designers often find themselves entering uncharted waters. This impact study addresses a number of challenges in the search for how innovative ways of learning affect students’ ability to deal with wicked problems. The empirical research focuses on the case study of the Honours Programme of Wageningen University and draws on interviews with early career alumni. The concepts “agency” and “boundary spanning” are considered guiding principles to prepare students to cope with complexity and uncertainty, unreliable information, conflicting interpretations and non-transparent cause–effect relationships. This study finds that participation in the Honours Programme resulted in students developing agency in (1) ownership; (2) self-reflexivity and (3) shaping focus and boundary spanning between (1) disciplines; (2) people and (3) theory & practice. The study concludes that innovative education characterized by freedom, long-term projects, and real-life challenges can contribute to students developing agency and boundary spanning capacities.
Chapter
Für die gesellschaftliche Entwicklung insgesamt sowie den Innovations-, Wissens- und Wirtschaftsstandort Deutschland stellen Studierende eine wesentliche Ressource dar. Der Anteil derjenigen eines Jahrgangs, die sich für ein Studium entscheiden, ist in den vergangenen Jahrzehnten deutlich gestiegen. Waren es im Jahr 2000 noch 33 % betrug der Anteil ab 2011 regelmäßig über 50 % (Statista 2020).
Article
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The COVID-19 pandemic caused extensive disruption to higher education, highlighting the negative impacts of emergency shift to online instruction. As a result, advantages of intentionally designed, online programs in higher education were overshadowed during the pandemic. Furthermore, socioeconomic disparities were exacerbated during the pandemic which extended to STEM undergraduate transfer students, who are more likely to be low-income, from historically underrepresented groups, older, and first generation in their family to attend college. To better understand the impact of the pandemic on STEM undergraduates, including those in an intentionally designed online program, ordinal regression analysis of 352 student survey respondents enrolled in a life sciences major at a large, R1 institution in the United States spring 2020 through fall 2021 was performed. Three student types are compared: on-campus, first-time in college (FTIC); on-campus transfer (OC-TR); and online transfer (ONL-TR) students. The latter group receives all course delivery online, whereas on-campus student groups received predominately in-person course delivery prior to the pandemic. ONL-TR students were over six times less likely to report negative educational impact compared to on-campus students, FTIC and OC-TR, while controlling for parent education, income, gender, race/ethnicity, and GPA. Additional survey items further explored this result and were validated with academic records and thematic analysis of students’ text responses. A pre−/post-pandemic comparison revealed that students maintained a similar course load and GPA, despite increased perceptions of a lower GPA during the pandemic. OC-TR students were over two times more likely to express increased concern related to delayed graduation and higher frequency of feeling stress compared to FTIC and ONL-TR students. Meanwhile, low-income students were more likely to report stressors due to the pandemic’s impact on daily life, independent of student type. Taken together, students in this intentionally designed online program were more resilient to the educational and emotional impacts of the pandemic compared to on-campus students. The differences between student groups warn against generalization of student impacts and suggest further research into the positive role of online learning, not just for delivery of educational content and expanding access, but for academic and emotional stability for different student populations.
Article
High scores on Harm Avoidance (HA) on Cloniger’s Temperament and Character Inventory (TCI) have been identified as a risk factor for depression. Group cognitive-behavioral therapy (GCBT) has been found effective in preventing depression and improving depressive symptoms among university students. However, no randomized controlled trials of GCBT have been conducted with university students with high HA. Although we initiated a randomized controlled trial in this study, some participants submitted incomplete questionnaires at baseline interfering with assured randomization; therefore, we report this study as a non-randomized controlled trial. We evaluated whether a GCBT intervention would be effective at reducing HA and, thereby, preventing depression in university students with high HA. We performed final analysis of data on 59 participants in the intervention group and 60 in a control group. We used scores on the Beck Depression Inventory-II (BDI-II) as the primary outcome measure and analysis of covariance to assess group differences on mean BDI-II change scores before the intervention and at six months and one year after the intervention. The intervention group had lower BDI-II scores than the control group at six months after the intervention. GCBT may have facilitated cognitive modification in individuals with high HA, or GCBT may have fostered mutual modeling by group participants. Thus, GCBT may contribute to reducing depressive symptoms in university students with high HA, and associated risk for developing depression.
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Background There are growing concerns about the mental health of university students in Australia and internationally, with universities, governments and other stakeholders actively developing new policies and practices. Previous research suggests that many students experience poor mental health while at university, and that the risk may be heightened for international students. Mental health-related knowledge, attitudes and behaviours are modifiable determinants of mental health and thus suitable targets for intervention. This study assessed the mental health-related knowledge, stigmatising attitudes, helping behaviours, and self-reported experiences of mental health problems in the student population of a large multi-campus Australian university, and conducted a comparative assessment of international and domestic students. Methods Participants were 883 international and 2,852 domestic students (overall response rate 7.1%) who completed an anonymous voluntary online survey that was sent to all enrolled students in July 2019 (n = ~ 52,341). Various measures of mental health-related knowledge, attitudes and helping behaviours were assessed. A comparative analysis of international and domestic students was conducted, including adjustment for age and sex. Results Overall, there was evidence of improvements in mental health-related knowledge, attitudes and behaviours relative to previous studies, including higher depression recognition, intentions to seek help, and reported help-seeking behaviour. Comparative analysis indicated that international students scored predominantly lower on a range of indicators (e.g., depression recognition, awareness of evidence-based forms of help); however, differences were narrower difference between the two groups compared to what has been reported previously. Finally, some indicators were more favourable among international students, such as higher help-seeking intentions, and lower prevalence of self-reported mental health problems compared to domestic students. Conclusion Though there were some important differences between domestic and international students in this study, differences were narrower than observed in previous studies. Study findings are informing the on-going implementation and refinement of this university’s student mental health strategy, and may be used to inform evolving policy and practice in the university sector.
Article
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To examine the prevalence of 12-month mood disorders and receipt of mental health treatment among a volunteer sample of higher education students during the 2nd and 3rd COVID-19 wave in the Flanders region. Web-based self-report surveys were obtained from 9101 students in higher education in the Flemish College Surveys (FLeCS) in Flanders, Belgium. As part of the World Health Organization's World Mental Health–International College Student Initiative, we screened for 12-month mood disorders (major depressive episode (MDE), mania/hypomania), and service use. We used poststratification weights to generate population-representative data on key socio-demographic characteristics. 50.6% of the respondents screened positive for 12-month mood disorders (46.8% MDE, of which 22.9% with very severe impact). Use of services was very low, with estimates of 35.4% for MDE, 31.7% for mania, and 25.5% for hypomania. Even among students with very severe disorders, treatment rates were never higher than 48.3%. Most common barriers for not using services were: the preference to handle the problem alone (83.4%) and not knowing where to seek professional help (79.8%). We found a high unmet need for mood problems among college students; though caution is needed in interpreting these findings given the volunteer nature of the sample. A reallocation of treatment resources for higher education students should be considered, particulary services that focus on innovative, low-threshold, and scalable interventions.
Article
Objectives University students represent a vulnerable population to mental health and wellbeing issues. However, young people are likely to delay or fail to engage in help-seeking behaviours. Embedding mental health learning opportunities in curriculum design may improve the mental health and wellbeing of students, but there are challenges to embedding this material in non-health disciplines where students’ intrinsic interests may not align with mental health–themed coursework. To explore this challenge, the present study involved embedding mental health literacy learning into an Event Management course through an experiential learning opportunity. Design A quasi-experimental design involving university students divided into intervention groups ( n = 40) and control groups ( n = 83). Setting Students in the intervention groups managed events across campuses of a major Australian university in support of a University Mental Health and Wellbeing Day. Students in the control groups managed non-mental health events. Method Pre- and post-event surveys compared students’ perceptions of experiential learning, of the effectiveness of student-led events in promoting mental health literacy and help-seeking behaviours in themselves and peers, and of embedding mental health learning into an experiential learning framework. Results Results suggest that experiential learning opportunities that contain mental health literacy content in addition to course content can be valuable without interruption to core learning aims. Conclusion This study is one of the first to evaluate the impact of innovative curriculum designs that embed mental health literacy in non-health disciplines, highlighting the opportunities for creative approaches to improving mental health education in universities.
Article
Objective: College students' psychological health has been negatively impacted by the COVID-19 pandemic (e.g., 1). We investigated whether students' psychological health was related to their orientation toward the future and mindfulness while considering previously-identified correlates of psychological health such as perceived risks of COVID-19. Participants: Participants were 278 college students at a mid-Atlantic US university in November and December 2020. Method: Using a self-report survey, we measured three aspects of psychological health (depression, anxiety, and stress) and future orientation, mindfulness, perceptions of risk, and the personal impact of COVID-19 on students' lives. Results: Multiple linear regression analyses showed that greater mindfulness and focusing less on a limited future were related to less depression, anxiety, and stress. Conclusions: Encouraging students to be mindful and focus on the present instead of focusing on a limited future may be beneficial for their psychological well-being during the COVID-19 pandemic.
Article
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Bu çalışmada sağlık yüksekokuluna başlayan öğrencilerin depresyon, anksiyete ve stres düzeyleri çeşitli değişkenlere göre incelenmiştir. Veriler kişisel bilgi formu ile Depresyon Anksiyete Stres Ölçeği kullanılarak yüz yüze toplanmıştır. Verilerin analizinde yüzde ve frekans değerleri ile Bağımsız Grup T Testi, Tek Yönlü Varyans Analizi (ANOVA) ve Post-hoc testlerden Tukey testi kullanılmıştır. Araştırmaya katılan öğrencilerin yaşları 17 ile 35 arasındadır (19,51±1,80) ve çoğunluğu kadındır (%66,4). Katılımcıların %89,6’sının kronik hastalığı bulunmamaktadır. Sağlık yüksekokuluna başlayan öğrencilerde gelir durumu, sigara içme, kronik hastalık durumu, bölümü istemeden seçme gibi bazı faktörlerin öğrencilerde depresyon anksiyete ve stres ile ilişkili olduğu saptanmıştır. Öğrencilerde cinsiyet, medeni, durum, aile tipi, en çok yaşadığı yer ve beden kitle indeksi gibi değişkenler ile depresyon anksiyete ve stres puanları arasında anlamlı fark bulunamamıştır.
Article
Introduction: Depression is considered a multiproblematic disorder that leads to impairment in interpersonal, academic, social, and occupational functioning. Untreated depression can lead to suicide, which is the second leading cause of death among adolescents and young adults. Antidepressants and psychotherapy have limited effectiveness and are not available worldwide. Alternative and complementary treatments, such as online mindfulness-based interventions (MBIs), are growing. Objective: We examined the effects of online MBIs on depressive symptoms in college and university students and explored the moderating effects of participant, methods, and intervention characteristics. Methods: We systematically searched nine databases from their inception through August 2022 without date restrictions. We included primary studies evaluating MBIs with college and university students with depression measured as an outcome, a comparison group, that were written in English. We used random-effects model to compute effect sizes (ESs) using Hedges' g, a forest plot, and Q and I2 statistics as measures of heterogeneity; we also examined moderator analyses. Results: Fifteen studies included 1886 participants (22.6 ± 3.2 years old). Overall, online MBIs showed significantly improved depression (g = 0.18, 95% confidence interval 0.02 to 0.34, I2 = 61%) compared with controls. With regard to moderators, when depression was measured further from the end of the intervention, there was less reduction in depressive symptoms (β = -0.012, Qmodel = 3.81, p = 0.051). Researchers who reported higher attrition reported less beneficial effects on depressive symptoms (β = -0.013, Qmodel = 9.85, p = 0.001). Researchers who used intention-to-treat reported lower ESs (g = -0.15) compared with not using intention-to-treat (g = 0.32, p < 0.001). No other quality indicators moderated the effects of online MBIs on depression. Conclusions: Online MBIs improved depressive symptoms in college and university students. Thus, it might be used as one treatment in their tool kit for college and university students.
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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.
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Background The purposes of this study were to assess the current status of perceived social support and COVID-19 impact on quality of life, to investigate the association of perceived social support with the COVID-19 impact on quality of life, and to examine differences in perceived social support between better and worse COVID-19 impact on quality of life for the total sample and by gender. Methods Participants included 1296 university students (399 male, 871 female, 22 transgender, non-binary, or other) with a mean age of 21.5 (SD = 2.6 years) from a large public university in the Midwest region of the US. Students voluntarily completed two questionnaires and demographic information via Qualtrics based on a cross-sectional study design. The Multidimensional Scale of Perceived Social Support (MSPSS) is a 12-item survey used to assess an individual’s perception of social support from significant others, friends, and family. The COVID-19-Impact on Quality of Life scale (COVID-19 QoL) is a 6-item scale used to assess the impact of COVID-19 on quality of life. Data was analyzed using descriptive statistics, multiple linear regression, independent t-tests, and ANCOVA. Results Multiple linear regression showed that perceived social support from family was a significant predictor of COVID-19 QoL (F = 35.154, p < .01) for the total sample. Further, t-test demonstrated significant differences between males and females on perceived social support (t = −2.184, p < .05) as well as COVID-19 QoL (t = −5.542, p < .01). Results of ANCOVA demonstrated a significant group effect on perceived social support for both males (F = 10.054, p < .01, η² = .025) and females (F = 5.978, p < .05, η² = 0.007), indicating that the better quality of life group scored higher on perceived social support than low quality of life. Conclusions Social support from family may act as a key buffer for quality of life during the fall semester of 2020, amid the COVID-19 pandemic in college students. With social interactions restricted during COVID-19, maintained access to social support is highly important. • KEY MESSAGES • Social support is a crucial contributing factor to the impact of COVID-19 on quality of life, and support from social relationships may buffer these challenging and unpredictable times. • The COVID-19 pandemic may have impacted the quality of life of males and females differently.
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The high rates of depression, anxiety, suicide, and other mental health disorders among collegiate student-athletes have resulted in the need for appropriate mental health services. The National Collegiate Athletic Association (NCAA) has released a best practices guide for mental health in college sport that includes licensed psychologists (LP), licensed clinical social workers (LCSW), and licensed professional counselors (LPC) as competent to provide mental health services to student-athletes. However, an examination of the differences between these three licenses is absent from the literature. This essay offers an overview on these differences to clarify the purview of each license as there is confusion surrounding the different types of professionals that can provide mental health services. A detailed description of what is means to hold an LP, LCSW, and LPC distinction is provided, followed by a discussion of the difference between mental health licensure and certification as a certified mental performance consultant (CMPC). This will assist administrators, athletic administrators, and student-athletes in making informed decisions about mental health care.
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Background When experiencing mental distress, many university students seek support from their peers. In schools and mental health services, formalised peer support interventions have demonstrated some success but implementation challenges have been reported. This study aimed to assess the feasibility, acceptability and safety of a novel manualized peer support intervention and associated data collection processes. Methods A longitudinal mixed methods study was conducted following the pilot of a peer support intervention at a large London university between June 2021 and May 2022. The study utilised data routinely recorded on all students who booked a peer support session, focus groups with nine peer workers and five staff members implementing the intervention, pre-post intervention surveys with 13 students and qualitative interviews with 10 of those students. Results 169 bookings were made during the pilot, of which 130 (77%) were attended, with November the peak month. Staff and peer workers described strong motivation and commitment to implement the intervention, noting that the peer support model and peer worker role addressed previously unmet needs at the university. However, students described implementation problems relating to the coherence of the intervention and the burden of participation. While students mostly described acceptable experiences, there were examples where acceptability was lower. No adverse events were reported during the pilot. Conclusion The training and supervision of peer workers, and the provision of one-to-one peer support to students was found to be feasible, mostly acceptable, and safe. However, sustained implementation difficulties were observed. These pose challenges to the scalability of peer support in universities. We make recommendations to improve implementation of peer support including improving reach, greater clarity about the intervention, and fuller involvement of students throughout.
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Objective Examine time trends in suicidal ideation in post-secondary students over the first three waves of the COVID-19 pandemic in Canada and identify subpopulations of students with increased risk. Method We analysed 14 months of data collected through repeated cross-sectional deployment of the World Health Organization (WHO) World Mental Health-International College Student (WMH-ICS) survey at the University of British Columbia. Estimated log odds weekly trends of 30-day suicidal ideation (yes/no) were plotted against time with adjustments for demographics using binary logistic generalized additive model (GAM). Risk factors for 30-day suicidal ideation frequency (four categories) were examined using the ordered logistic GAM, with a cubic smoothing spline for modelling time trend in obervation weeks and accounting for demographics. Results Nearly one-fifth (18.9%) of students experienced suicidal ideation in the previous 30 days. While the estimated log odds suggested that binary suicidal ideation was relatively stable across the course of the pandemic, an initial drop followed by an increasing trend was observed. Risk factors for suicidal ideation frequency during the pandemic included identifying as Chinese or as another non-Indigenous ethnic minority; experiencing current symptoms of depression or anxiety; having a history of suicidal planning or attempts; and feeling overwhelmed but unable to get help as a result of COVID-19. Older age was identified as a protective factor. Conclusions The general university student population in our study was relatively resilient with respect to suicidal ideation during the first three waves of the pandemic, but trends indicate the possibility of delayed impact. Specific sub-populations were found to be at increased risk and should be considered for targeted support. Further analyses should be undertaken to continue monitoring suicidality trends throughout the remainder of the pandemic and beyond.
Chapter
Most students in higher education are in the so-called “emerging adulthood” period, which is a critical phase that coincides with the age of onset of most mental disorders. Mental health problems in higher education students have been associated with negative impacts on youth development, poorer academic performance, and higher dropout rates, as well as a negative impact on subsequent functioning in the labor market. Although higher education institutions have developed specific strategies to address the mental health of their students, there is still a significant gap in prevention and early treatment. Moreover, given the high prevalence of mental health problems in higher education students, these institutions are unlikely to have sufficient resources to meet the needs for mental health services. Internet-based interventions may be particularly beneficial in overcoming logistical and financial barriers to health services and hold promise for low-cost interventions with positive outcomes. These interventions allow flexible use of available resources, without time and location constraints, enabling rapid scale-up of prevention and treatment programs, in contrast to face-to-face care. In addition, their relative anonymity and privacy reduce the stigma of receiving treatment for depression. Although the accumulating evidence on the use of these technologies to prevent or treat depression in higher education students shows promising results, significant challenges remain.
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Purpose of Review Provide a critical overview of recent global advances in student mental health from a public health perspective, highlighting key challenges and gaps in the literature. Recent Findings Mental disorders and suicidality are common among university students globally. However, there is a signifcant treatment gap even though evidence-based treatments are available. To overcome barriers to treatment, public health interventions should be conceptualized within a developmental paradigm that takes cognizance of the developmental tasks of young adulthood. Summary Traditional one-on-one treatment approaches will not be a cost-efective or sustainable way to close the treatment gap among students. A range of evidence-based interventions is available to promote students’ mental health; however, novel approaches are needed to scale up services and adapt intervention delivery to suit student specifc contexts. Digital interventions and peer-to-peer interventions could be a cost-efective way to scale-up and expand the range of services.
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Objectives: Dental hygiene students adapt to new environments while learning technical skills and providing clinical care during their education. Understanding how stress affects students in their professional healthcare program warrants exploration. This study assessed stress among dental hygiene students in two educational settings in the Southeastern United States. Methods: First and second-year dental hygiene students (N=136) from a community college setting (n=67) and a university setting (n=69) were invited to complete an anonymous online survey on mental health in fall 2019. Validated surveys on depression, anxiety, social support, and burnout were included. Data analysis included chi-square and Mantel Haenszel statistics, depending on the scale of measurement, with the level of significance set at 0.05 for all analyses. Results: Participants included 54 dental hygiene students from a community college (Response Rate=80.6%) and 69 dental hygiene students from a university (RR=100%). There was a statistically significant difference in the proportion of students reporting moderately severe or severe anxiety (P=0.007), with 56% (n=30) of the community college respondents and 36% (n=24) of the university reporting these anxiety levels. Students attending a community college were also more likely to express feelings of worry (n=34) compared to students in a university setting (P=0.005). There was no statistically significant difference in depression (P=0.07) or suicidal thoughts (P=0.41). Conclusion: Dental hygiene students enrolled in these two programs reported high levels of self-reported stress, mental and emotional concerns that may increase suicidal tendencies.
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The severe impact of COVID-19 in the United States has forced many students to replace in-person socialization with online digital contact. In this study, we investigate the mental health impacts associated with this shift by examining properties of online interactions that may affect loneliness and perceived social support. Students were surveyed (N=827) across 97 universities across the US during their first full semester impacted by the COVID-19 pandemic (Fall 2020). Private online interactions (messaging, phone call, video call) were found to have a comparable correlation to social support as face-to-face interactions, but public online interactions (social media) were associated with more negative outcomes. Among private platforms, messaging had the strongest correlation with social support; and daily self-disclosure over messaging yielded social support levels that were 1.21x higher than rarely or never disclosing over this platform. We speculate that factors such as the level of privacy and peoples' feelings of control contributed to disclosure and perceived social support in online platforms.
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The main objective of this study was to examine the moderating or buffering effect of social support (SS) perceived by university students on the psychological impact of lockdown on mental health. Specifically, a total of 826 participants (622 women) completed an online survey that included standardized measures of anxiety (Generalised Anxiety Disorder-7), depression (Patient Health Questionnaire-9), and irritability (Brief Irritability Test), as well as measures of stressors, perceived SS, and self-perceived change in mental health. The results of hierarchical regression analyses suggest that SS contributes toward attenuating the negative impact of academic stressors, general overload, and interpersonal conflict on the indicators of psychological well-being; however, moderation analysis only confirms the buffering effect for symptoms of anxiety. In conclusion, it is suggested that SS networks need to be strengthened as a basic means of protecting health and well-being during unexpected disasters.
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Objective Describe the profile of students in the health and exact undergraduate courses of a public university in the Midwest region of Brazil, determine the prevalence of Common Mental Disorders (CMD) among these students, and verify the sociodemographic and course-related factors associated with their occurrence. Method A cross-sectional and relational study was carried out from May to September 2020 with a sample of 493 students who answered a survey on sociodemographic variables and the Self-reporting Questionnaire (SRQ 20). We conducted descriptive analyses of the variables and logistic regression, using the Statistical Package for Social Sciences (SPSS), version 21.0. A cutoff point ≥7 was adopted in the SRQ-20 for suspected CMD. Results The prevalence of CMD in the sample was 66.1%. Comparison between the groups (with or without CMD) showed that the highest prevalence rates were linked to the female gender (p<0.001) and undergoing health care treatment (p<0.001). Regression analysis indicated significant predictors for CMD being female (p<0.001) and being enrolled in exact science courses (p=0.050). Conclusion The high prevalence of CMD reinforces the need to invest in the creation of care spaces that pay special attention to women and exact sciences students, in addition to discussing student assistance policies aimed at promoting the health, well-being, and care of university students.
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Objective: Describe the profile of students in the health and exact undergraduate courses of a public university in the Midwest region of Brazil, determine the prevalence of Common Mental Disorders (CMD) among these students, and verify the sociodemographic and course-related factors associated with their occurrence. Method: A cross-sectional and relational study was carried out from May to September 2020 with a sample of 493 students who answered a survey on sociodemographic variables and the Self-reporting Questionnaire (SRQ 20). We conducted descriptive analyses of the variables and logistic regression, using the Statistical Package for Social Sciences (SPSS), version 21.0. A cutoff point ≥7 was adopted in the SRQ-20 for suspected CMD. Results: The prevalence of CMD in the sample was 66.1%. Comparison between the groups (with or without CMD) showed that the highest prevalence rates were linked to the female gender (p
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Purpose: The aim of this study was to investigate the association between interpersonal relationships and the risk of MDD in freshmen. Methods: 6,947 participants without baseline MDD (lifetime) completed the 1-year follow-up survey in 2019. Demographic information, interpersonal relationship scores measured by the Chinese version of Interpersonal Relationship Comprehensive Scale, depression severity at baseline screened with Patient Health Questionnaire-9, lifetime severe traumatic events and MDD at baseline and follow-up survey screened via the Composite International Diagnostic Interview 3.0 were collected. Logistic regression was performed to quantify the associations between interpersonal relationships and the new-onset of MDD. Results: The baseline total relationship score (9 to 14, mild relationship distress) and the dimension score of dealing with people were positively associated with MDD incidence, respectively (OR total score=1.68, 95%CI: 1.16-2.43; OR dealing with people=1.39, 95%CI: 1.10-1.75). Interpersonal relationship score was not associated with MDD in participants without baseline depressive symptoms. However, it was positively associated with MDD (OR=2.10, 95%CI: 1.40-3.15) among participants with baseline depressive symptoms. There was a statistically significant interactions between dealing with people and baseline PHQ-9 score for the risk of MDD. Conclusions: Interpersonal relationship perplex can increase the risk of MDD in college students. College students suffering from depressive symptoms without MDD yet who have interpersonal disorder deserve more attention in terms of prevention against MDD.
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Almost half (46%) of people will experience a mental health issue in their lifetime and all nurses need mental health knowledge and skills regardless of their area of specialization. Little is known, however, about student attitudes toward people with mental illness on entry to pre-registration nursing programs. The aims were to investigate Australian pre-registration nursing students’ attitudes toward, and prior experience with, people with mental illness on program commencement. This cross-sectional study used the Community Attitudes Toward Mental Illness (CAMI) scale with pre-registration nursing students, and questions on students’ prior experience with mental illness (self, family, friends). There were n = 311 (271 female/40 male) first year, first semester Bachelor of Nursing students at a national Australian university. Students reported prior experience with mental illness with family (49.5%/n = 154) and friends (61.4%/n = 191). Self-reported (36.3% /n = 113) mental illness, particularly anxiety and depression, significantly exceeded national averages. Most students held accepting attitudes toward people with mental illness, except for perceptions of dangerousness. This study provides new findings on nursing student attitudes and experience with people with mental illness on program entry. The high self-reported prevalence of anxiety and depression at program entry indicates a pressing need for early intervention and mental wellbeing strategies for students from commencement of their tertiary education. Fear-reducing education which challenges perceptions of dangerousness in relation to people with mental illness, and supportive mental health clinical placements during their program, may help improve students’ attitudes and reduce fear and mental health stigma.
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Starting college is a major life transition. This study aims to characterize patterns of substance use across a variety of substances across the first year of college and identify associated factors. We used data from the first cohort (N=2056, 1240 females) of the "Spit for Science" sample, a study of incoming freshmen at a large urban university. Latent transition analysis was applied to alcohol, tobacco, cannabis, and other illicit drug uses measured at the beginning of the fall semester and midway through the spring semester. Covariates across multiple domains - including personality, drinking motivations and expectancy, high school delinquency, peer deviance, stressful events, and symptoms of depression and anxiety - were included to predict the patterns of substance use and transitions between patterns across the first year. At both the fall and spring semesters, we identified three subgroups of participants with patterns of substance use characterized as: 1) use of all four substances; 2) alcohol, tobacco, and cannabis use; and 3) overall low substance use. Patterns of substance use were highly stable across the first year of college: most students maintained their class membership from fall to spring, with just 7% of participants in the initial low substance users transitioning to spring alcohol, tobacco, and cannabis users. Most of the included covariates were predictive of the initial pattern of use, but covariates related to experiences across the first year of college were more predictive of the transition from the low to alcohol, tobacco, and cannabis user groups. Our results suggest that while there is an overall increase in alcohol use across all students, college students largely maintain their patterns of substance use across the first year. Risk factors experienced during the first year may be effective targets for preventing increases in substance use.
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Importance The inverse social gradient in mental disorders is a well-established research finding with important implications for causal models and policy. This research has used traditional objective social status (OSS) measures, such as educational level, income, and occupation. Recently, subjective social status (SSS) measurement has been advocated to capture the perception of relative social status, but to our knowledge, there have been no studies of associations between SSS and mental disorders.Objectives To estimate associations of SSS with DSM-IV mental disorders in multiple countries and to investigate whether the associations persist after comprehensive adjustment of OSS.Design, Setting, and Participants Face-to-face cross-sectional household surveys of community-dwelling adults in 18 countries in Asia, South Pacific, the Americas, Europe, and the Middle East (N = 56 085). Subjective social status was assessed with a self-anchoring scale reflecting respondent evaluations of their place in the social hierarchies of their countries in terms of income, educational level, and occupation. Scores on the 1 to 10 SSS scale were categorized into 4 categories: low (scores 1-3), low-mid (scores 4-5), high-mid (scores 6-7), and high (scores 8-10). Objective social status was assessed with a wide range of fine-grained objective indicators of income, educational level, and occupation.Main Outcomes and Measures The Composite International Diagnostic Interview assessed the 12-month prevalence of 16 DSM-IV mood, anxiety, and impulse control disorders.Results The weighted mean survey response rate was 75.2% (range, 55.1%-97.2%). Graded inverse associations were found between SSS and all 16 mental disorders. Gross odds ratios (lowest vs highest SSS categories) in the range of 1.8 to 9.0 were attenuated but remained significant for all 16 disorders (odds ratio, 1.4-4.9) after adjusting for OSS indicators. This pattern of inverse association between SSS and mental disorders was significant in 14 of 18 individual countries, and in low-, middle-, and high-income country groups but was significantly stronger in high- vs lower-income countries.Conclusions and Relevance Significant inverse associations between SSS and numerous DSM-IV mental disorders exist across a wide range of countries even after comprehensive adjustment for OSS. Although it is unclear whether these associations are the result of social selection, social causation, or both, these results document clearly that research relying exclusively on standard OSS measures underestimates the steepness of the social gradient in mental disorders.
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Mental health services embedded within school systems can create a continuum of integrative care that improves both mental health and educational attainment for children. To strengthen this continuum, and for optimum child development, a reconfiguration of education and mental health systems to aid implementation of evidence-based practice might be needed. Integrative strategies that combine classroom-level and student-level interventions have much potential. A robust research agenda is needed that focuses on system-level implementation and maintenance of interventions over time. Both ethical and scientific justifications exist for integration of mental health and education: integration democratises access to services and, if coupled with use of evidence-based practices, can promote the healthy development of children.
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Mental health problems represent a potentially important but relatively unexplored factor in explaining human capital accumulation during college. We conduct the first study, to our knowledge, of how mental health predicts academic success during college in a random longitudinal sample of students. We find that depression is a significant predictor of lower GPA and higher probability of dropping out, particularly among students who also have a positive screen for an anxiety disorder. In within-person estimates using our longitudinal sample, we find again that co-occurring depression and anxiety are associated with lower GPA, and we find that symptoms of eating disorders are also associated with lower GPA. This descriptive study suggests potentially large economic returns from programs to prevent and treat mental health problems among college students, and highlights the policy relevance of evaluating the impact of such programs on academic outcomes using randomized trials.
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This article provides a review of the magnitude of mental disorders in children and adolescents from recent community surveys across the world. Although there is substantial variation in the results depending upon the methodological characteristics of the studies, the findings converge in demonstrating that approximately one fourth of youth experience a mental disorder during the past year, and about one third across their lifetimes. Anxiety disorders are the most frequent conditions in children, followed by behavior disorders, mood disorders, and substance use disorders. Fewer than half of youth with current mental disorders receive mental health specialty treatment. However, those with the most severe disorders tend to receive mental health services. Current issues that are now being identified in the field of child psychiatric epidemiology include: refinement of classification and assessment, inclusion of young children in epidemiologic surveys, integration of child and adult psychiatric epidemiology, and evaluation of both mental and physical disorders in children.
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Studies of the impact of mental disorders on educational attainment are rare in both high-income and low- and middle-income (LAMI) countries. To examine the association between early-onset mental disorder and subsequent termination of education. Sixteen countries taking part in the World Health Organization World Mental Health Survey Initiative were surveyed with the Composite International Diagnostic Interview (n=41 688). Survival models were used to estimate associations between DSM-IV mental disorders and subsequent non-attainment of educational milestones. In high-income countries, prior substance use disorders were associated with non-completion at all stages of education (OR 1.4-15.2). Anxiety disorders (OR=1.3), mood disorders (OR=1.4) and impulse control disorders (OR=2.2) were associated with early termination of secondary education. In LAMI countries, impulse control disorders (OR=1.3) and substance use disorders (OR=1.5) were associated with early termination of secondary education. Onset of mental disorder and subsequent non-completion of education are consistently associated in both high-income and LAMI countries.
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Although young adulthood is often characterized by rapid intellectual and social development, college-aged individuals are also commonly exposed to circumstances that place them at risk for psychiatric disorders. To assess the 12-month prevalence of psychiatric disorders, sociodemographic correlates, and rates of treatment among individuals attending college and their non-college-attending peers in the United States. Face-to-face interviews were conducted in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (N = 43,093). Analyses were done for the subsample of college-aged individuals, defined as those aged 19 to 25 years who were both attending (n = 2188) and not attending (n = 2904) college in the previous year. Sociodemographic correlates and prevalence of 12-month DSM-IV psychiatric disorders, substance use, and treatment seeking among college-attending individuals and their non-college-attending peers. Almost half of college-aged individuals had a psychiatric disorder in the past year. The overall rate of psychiatric disorders was not different between college-attending individuals and their non-college-attending peers. The unadjusted risk of alcohol use disorders was significantly greater for college students than for their non-college-attending peers (odds ratio = 1.25; 95% confidence interval, 1.04-1.50), although not after adjusting for background sociodemographic characteristics (adjusted odds ratio = 1.19; 95% confidence interval, 0.98-1.44). College students were significantly less likely (unadjusted and adjusted) to have a diagnosis of drug use disorder or nicotine dependence or to have used tobacco than their non-college-attending peers. Bipolar disorder was less common in individuals attending college. College students were significantly less likely to receive past-year treatment for alcohol or drug use disorders than their non-college-attending peers. Psychiatric disorders, particularly alcohol use disorders, are common in the college-aged population. Although treatment rates varied across disorders, overall fewer than 25% of individuals with a mental disorder sought treatment in the year prior to the survey. These findings underscore the importance of treatment and prevention interventions among college-aged individuals.
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The purpose of this study was to evaluate the independent associations between DSM-IV psychiatric disorders and the failure to complete college among college entrants. Data were from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The sample included 15,800 adults, aged 22 years and older, who at least entered college. Diagnoses were made with the NESARC survey instrument, the Alcohol Use Disorder and Associated Disability Interview Schedule-DSM-IV Version. The large sample permitted analysis of multiple psychiatric disorders in the same multivariable logistic regression models. Given the frequent comorbidity of these disorders, this approach is an important step toward disentangling the independent roles of disorders in postsecondary educational outcomes. Evaluation of the independent associations between specific psychiatric disorders and postsecondary educational attainment showed that five diagnoses were positively and significantly associated with the failure to graduate from college. Four were axis I diagnoses: bipolar I disorder, marijuana use disorder, amphetamine use disorder, and cocaine use disorder. One was an axis II diagnosis: antisocial personality disorder. This study provides new data on DSM-IV diagnoses associated with the failure to complete postsecondary education. The findings suggest that psychiatric factors play a significant role in college academic performance, and the benefits of prevention, detection, and treatment of psychiatric illness may therefore include higher college graduation rates.
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This paper describes a series of questions designed to improve the accuracy of age-of-onset reports in the US National Comorbidity Survey (NCS) and empirically evaluates the impact of these questions on reports about age of onset of major depressive episodes. The logic underlying the series of question is traced to cognitive psychological research on autobiographical memory. Data are presented showing that the new question series yielded more substantively plausible age-of-onset reports than those obtained a decade earlier in the Epidemiologic Catchment Area (ECA) Study. The test–retest consistency of age-of-onset reports was also higher in the NCS than the ECA. Despite these improvements, considerable inconsistency in age-of-onset reports remains in the NCS test-retest data. The paper closes with a discussion of potentially promising future directions to improve retrospective age-of-onset reports in new psychiatric epidemiological surveys. Copyright © 1999 Whurr Publishers, Ltd. Peer Reviewed http://deepblue.lib.umich.edu/bitstream/2027.42/34219/1/55_ftp.pdf
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This is the first in a series of investigations of the social consequences of psychiatric disorders based on the National Comorbidity Survey. Data on the relationship between preexisting psychiatric disorders and subsequent educational attainment are presented. The National Comorbidity Survey is a nationally representative survey of 8,098 respondents in the age range 15-54 years. A subsample of 5,877 respondents completed a structured psychiatric interview and a detailed risk factor battery. Diagnoses of DSM-III-R anxiety disorders, mood disorders, substance use disorders, and conduct disorder were generated, and survival analyses were used to project data on school terminations to the total U.S. population. Early-onset psychiatric disorders are present in more than 3.5 million people in the age range of the National Comorbidity Survey who did not complete high school and close to 4.3 million who did not complete college. The most important disorders are conduct disorder among men and anxiety disorders among women. The proportion of school dropouts with psychiatric disorders has increased dramatically in recent cohorts, and persons with psychiatric disorders currently account for 14.2% of high school dropouts and 4.7% of college dropouts. Early-onset psychiatric disorders probably have a variety of adverse consequences. The results presented here show that truncated educational attainment is one of them. Debate concerning whether society can afford universal insurance coverage for the treatment of mental disorders needs to take these consequences into consideration.
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In this article we summarize our current understanding of depression in older (14-18 years old) adolescents based on our program of research (the Oregon Adolescent Depression Project). Specifically, we address the following factors regarding adolescent depression: (a) phenomenology (e.g., occurrence of specific symptoms, gender and age effects, community versus clinic samples); (b) epidemiology (e.g., prevalence, incidence, duration, onset age); (c) comorbidity with other mental and physical disorders; (d) psychosocial characteristics associated with being, becoming, and having been depressed; (e) recommended methods of assessment and screening; and (f) the efficacy of a treatment intervention developed for adolescent depression, the Adolescent Coping With Depression course. We conclude by providing a set of summary statements and recommendations for clinicians.
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Social causation theory and social selection theory have been put forth to explain the finding that low socioeconomic status (SES) is associated with risk for psychiatric disorders. The predictions of both theories were investigated using data from a community-based longitudinal study. Psychosocial interviews were administered to 736 families from 2 counties in New York State in 1975, 1983, 1985-1986, and 1991-1993. Results indicated that (a) low family SES was associated with risk for offspring anxiety, depressive, disruptive, and personality disorders after offspring IQ and parental psychopathology were controlled, and (b) offspring disruptive and substance use disorders were associated with risk for poor educational attainment after offspring IQ and parental psychopathology were controlled. These findings indicate that social causation and social selection processes vary in importance among different categories of psychiatric disorders.
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This study examined associations between the extent of anxiety disorder in adolescence (14-16 years) and young people's later risks of a range of mental health, educational, and social role outcomes (16-21 years). Data were gathered over the course of a 21-year longitudinal study of a birth cohort of 1,265 New Zealand children. Measures collected included (1) an assessment of DSM-III-R anxiety disorders between the ages of 14 and 16 years; (2) assessments of mental health, educational achievement, and social functioning between the ages of 16 and 21 years; and (3) measures of potentially confounding social, family, and individual factors. Significant linear associations were found between the number of anxiety disorders reported in adolescence and later risks of anxiety disorder; major depression; nicotine, alcohol, and illicit drug dependence; suicidal behavior; educational underachievement; and early parenthood. Associations between the extent of adolescent anxiety disorder and later risks of anxiety disorder, depression, illicit drug dependence, and failure to attend university were shown to persist after