College Students: Mental Health Problems and Treatment Considerations

Proximal Influences on the Trajectory of Suicidal Behaviors and Suicide during the Transition from Adolescence to Young Adulthood

Youth transitioning to adulthood have unique developmental tasks that make them vulnerable to suicide. Brain development, life stressors, and psychological adjustments during the transition contribute to a high rate of suicidal gestures. To reduce the incidence of self-harm in this age group, a public health approach that identifies and reduces risk factors and enhances protective factors should be used. Institutions and employment arenas should consider structural supports to facilitate this transition of youth into adulthood, with a particular focus on youth with self-harm thoughts, and should provide education about suicide, evidence-based resources, and intervention programs to encourage help seeking.

Elevated salivary IgA, decreased anxiety, and an altered oral microbiota are associated with active participation on an undergraduate athletic team

BACKGROUND

Previous reports indicate that regular, but not excessive, exercise can moderate the response to anxiety and alter the immune response, therefore we hypothesized that college student athletes who were actively participating on an NCAA Division III athletics team ("in-season") would have lower levels of anxiety and higher salivary IgA levels than similar college athletes who were in their "off-season". NCAA Division III athletes participate in athletics at a level of intensity that is more moderate compared to other NCAA divisions. Alterations in the microbiome have been associated with alterations in psychosocial well-being and with exercise. Therefore, we also proposed that the oral microbiota would be different in "in-season" versus "off-season" athletes.

METHOD

In this pilot study, nineteen female students participating on a NCAA Division III athletic team (hockey="in-season"; soccer="off-season") were compared for level of fitness (modified Balke test of VO₂ max), salivary IgA levels by immunoassay, anxiety (using a GAD-7 survey), salivary cortisol levels by immunoassay, and numbers of culturable bacteria by growth of CFU/ml on blood agar, mitis salivarius agar and Staphylococcus 110 agar.

RESULTS

The proportion of subjects reporting "severe anxiety" on an anxiety scale (GAD-7) were significantly greater in the "off-season" group compared to the "in-season" group (p=0.047, Chi-squared test). "In-season" athletes had significantly higher salivary IgA/total protein levels than "off-season" athletes (one-sided Student's t-test; p=0.03). Cortisol levels were not significantly different in the two groups. The total culturable bacteria counts were higher among "in-season" athletes (p=0.0455, Wilcoxon Rank Sum test), as measured by CFUs on blood agar plates, an estimate of total culturable bacteria, including pathogenic and non-pathogenic bacteria. In contrast, there was a decrease in the growth of bacteria from the oral cavity of the "in-season" athletes, when the growth of bacteria on mitis salivarius agar (primarily oral streptococcus) was measured (p=0.0006, Wilcoxon Rank Sum test). There was a negative correlation (Spearman Rank correlation coefficient=-0.651, p=0.0018 one-sided) between high IgA levels and the growth of bacteria on mitis salivarius agar in the combined group of "in-season" and "off-season" athletes, suggesting a protective response of high IgA levels to the typical oral pathogenic bacteria. Anxiety levels (GAD-7) in the "in-season" group were positively correlated with growth of oral bacteria on blood agar (Spearman Rank correlation coefficient of 0.622 for "in-season", p value=0.033 one-sided) and mitis salivarius agar (Spearman Rank correlation coefficient=0.671 for "in-season, p value=0.021 one-sided), and negatively correlated in "off-season" athletes on blood agar (-0.689 for "off-season", p value=0.028 one-sided), supporting the hypothesis that the microbiota are distinct in "in-season" and "off-season" athletes and may be associated with anxiety levels.

CONCLUSION

These findings are supportive of the hypothesis that participation in college level athletics has a positive effect on student-athlete health, specifically enhanced protective oral immunity, reduced anxiety, and alterations in oral microbial populations.

Alcohol use and depression during adolescence and young adulthood: a summary and interpretation of mixed findings

Alcohol Use Disorder (AUD) and alcohol misuse are common among adolescents and young adults and are associated with significant personal and societal problems. Similarly, Major Depressive Disorder (MDD) and depressive symptoms are prevalent in this population and when they co-occur with alcohol misuse lead to even more severe consequences. Numerous studies have investigated the association between depressive symptoms, AUD and various drinking behaviors presenting an unclear picture. In this review we summarize studies among adolescents and young adults that have examined these relationships. From this review it emerges that several factors affect results, including study design (cross-sectional vs longitudinal), participants' age (adolescents vs young adults), severity of problems considered (AUD vs heavy drinking; MDD vs depressive symptoms), and gender. Adolescents with AUD are at higher risk for MDD in particular at a younger age. During adolescence, several drinking behaviors, including weekly alcohol use and heavy drinking, increase the risk for depressive symptoms and MDD, while during young adulthood primarily AUD, but not other drinking behaviors, is associated with increased risk for MDD. Gender may have an effect on the association between depression and drinking behaviors but its role is still unclear. Some evidence suggests that the association between AUD and MDD is bidirectional such that mood problems contribute to the onset of alcohol problems and vice-versa. More longitudinal studies are needed to examine these associations in young adults and to clarify the effect of gender on these associations. To date, findings suggest the critical need to reduce any alcohol use at a young age and to treat both depressive symptoms and AUD to prevent the occurrence of comorbid disorders.