Does the severity of psychopathology of Italian students receiving counselling services increase over time? A 5-year analysis and a comparison with a clinical and non-clinical sample

Supporting students with empathy: the association between empathy and coping strategies in pre-clinical medical students

How medical students cope with stress predicts their mental health and academic/clinical performances, making the promotion of functional copy strategies a relevant outcome for medical educators. Empathy has been reported to be connected with coping. This study wanted to explore the most used coping strategies and whether gender differences existed, and to investigate whether and to what extent empathy affected coping in a sample of pre-clinical medical students. In a cross-sectional study design, the Interpersonal Reactivity Index (IRI) and the Coping Orientations to the Problems Experienced - New Italian Version (COPE-NIV) were administered to 398 (53% females) Italian second-year medical students. T-tests and multiple regression analyses were used to explore gender differences and the association between IRI and COPE-NIV scores, respectively. Problem Orientation obtained the highest mean score, whereas Avoidance the lowest one. Females outscored males on Social Support (t = 4.95, p < .001) and Transcendent Orientation (t = 4.04, p < .001). After controlling for gender, Empathic Concern was positively associated with Social Support (β = 0.223, p = .001) and Transcendent Orientation (β = 0.234, p = .001). Perspective Taking was positively and negatively associated with Positive Attitude (β = 0.248, p < .001) and Transcendent Orientation (β = − 0.180, p = .008), respectively. Personal Distress was negatively related to Problem Orientation (β = − 0.250, p < .001). Educational and psychological counselling interventions targeting empathy should be implemented in the pre-clinical years to equip medical students to cope functionally with the emotional distress linked to medical school.

Effect of online counselling on emotional outcomes during the COVID‐19 pandemic: An innovative group intervention for university students using the Brain Wave Modulation Technique

Young people's mental health problems are a matter of concern during the COVID‐19 pandemic. Counselling services for university students by means of telemental support can help them to deal with psychological issues that they may be facing due to the pandemic. The present study investigated the effects of four once‐weekly online counselling sessions based on a mind‐body technique (the Brain Wave Modulation Technique; BWM‐T) on enhancing positive affect and on reducing negative affect and anxiety in a sample of 54 university students (96.3% females; M_age = 21.31 years, SD = 2.09). An experimental design was conducted: the participants were randomly assigned to the intervention group, which received 15 min of a guided online BWM‐T session, or to the control group, which watched a 15‐min video on how to sustain their psychological well‐being. The results of a two‐factor mixed‐design analysis of variance (ANOVA) showed that the participants in the intervention group reported a significant increase in positive affect and a decrease in negative affect over time compared to those in the control group. They also reported a slight decrease in state anxiety compared to the control group, although this was just short of statistical significance. The information provided by this study, regarding emotional outcomes among university students after four brief online counselling sessions, suggests that such interventions could be an effective and sustainable way to reinforce young people's mental health during the COVID‐19 pandemic, as well as later in their university careers and adult lives.

The role of difficulties in emotion regulation in predicting empathy and patient-centeredness in pre-clinical medical students: a cross-sectional study

While empathy and patient-centeredness (PC) are considered core variables in high-quality healthcare education and care, research suggests that empathy and PC decrease during the clinical years of study and that impairments in empathy and PC may be related to difficulties in emotion regulation. There is a growing interest in identifying the psycho-social variables that sustain and foster empathy and PC in medical students throughout their education. This study explored whether and to what extent emotion dysregulation predicted empathy and PC in medical students controlling for gender. Three hundred ninety-eight pre-clinical medical students enrolled at a university in northern Italy completed the Difficulties in Emotion Regulation Scale (DERS), the Interpersonal Reactivity Index (IRI) and the Patient-Practitioner Orientation Scale - 8 Items - Italian version (PPOS-8-IT). All statistically significant correlation coefficients between DERS, IRI and PPOS-8-IT scores were negative (rs from -.130 to -.336, ps ≤ 01), except for IRI Personal Distress and IRI Fantasy Scale that were mainly positively related to DERS scores (rs from .130 to .305, ps ≤ .01). Hierarchical multiple-regression analyses showed that DERS scores accounted for a significant amount of additional variance in both IRI and PPOS-8-IT components above and beyond gender. Emotion dysregulation was positively associated with Personal Distress (βs from .135 to .250, ps ≤ .007), whereas Empathic Concern, Perspective Taking, and the PC components were negatively predicted by emotion regulation difficulties (βs from -.131 to -.309, ps ≤ .005). Female students showed higher levels of all empathy and PC measures than males (ts from -3.49 to -5.54, ps ≤ 001) except for Perspective Taking. Tailored educational approaches that provide medical students with emotion regulation strategies implemented along the pre-clinical curriculum may sustain empathy and PC and equip students to appropriately and functionally face the emotional and interpersonal aspects of the clinical internship experience.

An Exploratory Cross-Sectional Study on the Relationship between Dispositional Mindfulness and Empathy in Undergraduate Medical Students

There is a growing interest in identifying the psychological variables that promote and sustain empathy in medical students during their studies. Dispositional mindfulness has been shown to be empirically associated with socio-demographic characteristics and empathy among the general population. This research aimed to assess dispositional mindfulness in a sample of undergraduate medical students and to investigate its association with gender, age, and empathy. Hypotheses: It is hypothesized that male medical students would show, on average, higher dispositional mindfulness than their female counterparts, and that older students would exhibit higher dispositional mindfulness than younger ones. Dispositional mindfulness was also expected to be positively associated with the ability to feel compassion for others and to adopt their perspective, and negatively associated with the personal distress in tense interpersonal settings. Method: An exploratory cross-sectional study was conducted. Data were gathered from a large sample (N = 933) of Italian non-meditating second- and fifth-year medical students. Dispositional mindfulness and empathy were assessed using the Five-Facet Mindfulness Questionnaire and the Interpersonal Reactivity Index, respectively. Gender and age differences in dispositional mindfulness scores were calculated by analyses of variance, whereas hierarchical multiple regression models were used to assess the association between dispositional mindfulness and empathy scores. RESULTS Female medical students were more able to Act with Awareness than males, whereas males had higher levels than females of Describing and Nonreactivity to their feelings. When compared to their older counterparts, younger students scored higher on Observing and lower on Nonreactivity facets. Dispositional mindfulness facets correlated differently with both emotional and cognitive empathy dimensions, beyond the effects of gender and age. Medical students who displayed higher dispositional mindfulness appeared to be less emotionally distressed in tense interpersonal settings and more able to take others' cognitive perspective. Conclusions: The findings support the notion that dispositional mindfulness is related to empathy and may have implications for the design of mindfulness-based training for use in the medical educational setting. Tailored interventions that cultivate specific dispositional mindfulness facets may be implemented along the medical curriculum to prevent the emotional distress in tense interpersonal settings and to sustain the cognitive capability to take others' viewpoints among medical students.

Personal values as early predictors of emotional and cognitive empathy among medical students

The present study contributes to the literature by examining the association between personal values (PVs), assessed with the Schwartz’s Portrait Values Questionnaire, and empathy, assessed with the Davis’ Interpersonal Reactivity Index, in a sample of first-year medical students. We also examined medical students’ PVs profile and gender differences in terms of PVs. All participants (N = 398) were Italian, young (average age = 19.62 years, SD = 1.22), and unmarried; none had children. Zero-order correlations and hierarchical multiple regression models were performed to verify the association between PVs and empathy; in contrast, t-tests were run to explore gender differences in scoring on PVs. Benevolence and Universalism correlated positively with both the emotional and cognitive dimensions of empathy, whereas Power, Achievement, Hedonism, and Security were negatively associated with empathy. The three most important PVs in the whole sample were Benevolence, Self-Direction, and Universalism. Male medical students outscored their female counterparts on Power, Achievement, and Hedonism, whereas female students outscored the males on Benevolence, Universalism, Conformity, and Tradition. Our findings highlight the importance of fostering self-transcending PVs and discouraging self-enhancing PVs in medical students during the early years of medical school, as a means of supporting other-oriented responses such as empathy in future doctors.

The challenges and mental health issues of academic trainees

In the last decade, mental health issues have come to the foreground in academia. Literature surrounding student mental health continues to grow as universities try to implement wellness services and study the mental health of their students. Studies vary greatly in terms of measurement tools, timeframe, sample demographics, as well as the chosen threshold of symptom severity for diagnosis. This review attempts to summarize, contextualize and synthesize papers that pertain to the challenges faced by academic trainees at the undergraduate, graduate and post-graduate level. The evidence for, and against, the common claim of increasing prevalence of mental health issues among students in recent years is discussed. While some studies support this claim, it is difficult to reach a definitive conclusion due to numerous confounding factors such as increased help-seeking behaviour, greater awareness of mental health issues and weak methodology. The prevalence of depression, anxiety, suicidal and self-injurious behaviour, distress and general mental illness diagnoses are discussed. Other issues known to influence mental health, such as sexual assault and bullying, are briefly addressed. Finally, select studies on a few wellness strategies that may improve mental health of trainees, such as mindfulness, are summarised, along with diverse recommendations for individual students, universities, and academia as a whole.

Analytical psychodrama with college students suffering from mental health problems: Preliminary outcomes

The aim of this work was to assess the therapeutic efficacy of analytical psychodrama groups for college students with psychological problems. Analytical psychodrama, as a form of group psychotherapy, is an integral part of the program of treatment of young adults in the Counselling Center of the University of Bologna, which provides a free service for its students, aimed at delivering psychological support. Thirty patients (22 females) from 20 to 26 years old (mean age 22.33, standard deviation±1.75), suffering from mental health problems, who completed one year of psychodrama, were assessed before and after group psychotherapy. The Italian validation of Clinical Outcomes in Routine Evaluation - Outcome Measure was used as test-retest questionnaire for clinical outcome evaluation. The results demonstrated the efficacy of the treatment in terms of symptom decrease and improvement of patients' well being. After the treatment (40 sessions, once a week), patients showed a statistically significant reduction in clinical outcomes scores compared with pre-treatment scores. Moreover, the analyses of Reliable and Clinical Significant Change index showed that about 30% of patients improved, and this improvement was reliable and/or clinically significant. Our preliminary findings revealed that analytical psychodrama is a suitable treatment for college students, as it actually reduces young adults' symptoms. These results contribute to the topic of the validity of psychodrama interventions to encourage research regarding the specific psychotherapeutic effects of its method.