A pragmatic clinical trial examining the impact of a resilience program on college student mental health

Mediating roles of sleep quality and resilience in the relationships between chronotypes and mental health symptoms

Sleep and mental health are intrinsically intertwined, but not every individual with problems sleeping develops a mental health disorder. This study examined the association among chronotypes, resilience, sleep quality and mental health symptoms amongst otherwise healthy individuals. Two hundred adults (Mage = 27.75 ± 5.11, 68% female) with no previous diagnosis of mental illness were recruited and filled in a set of questionnaires measuring chronotypes, sleep quality, depression and anxiety symptoms. The findings from the path analysis showed that the morning type had a statistically significant direct effect on a range of sleep quality indices. These included better subjective sleep quality, shortened sleep latency, and fewer daytime dysfunctions, as well as a higher level of resilience. However, it did not significantly affect depression and anxiety symptoms. In addition, the morning type had statistically significant indirect effects on a higher level of resilience and fewer depression and anxiety symptoms through the mediating effect of sleep quality indices. Findings from this study support that morning type is associated with better resilience and psychological health, which is mediated through better sleep quality.

Assessing the efficacy of a resilience training intervention for long-term improvements in well-being and resilience

This article has two aims: (1) to assess the impacts of a novel training intervention for individual well-being and (2) to measure the trajectory of resilience over the training period dependent on reported significant life events. Using a randomised controlled trial with a diverse German sample with the majority drawn from a student population, we measure the effects of the intervention to provide insight into its impacts and act as a proof of concept for the training. We find that the training intervention boosts resilience and other related well-being measures with a high effect size in comparison with a control group and compared with existing resilience training studies.

Types of Digital Mindfulness: Improving Mental Health Among College Students - A Scoping Review

The pressure of learning on students causes mental health problems in students. This can disrupt the student's academic process. The previous review still focused on the impact of digital mindfulness on students, but did not describe the various types of digital mindfulness on students' mental health. A digital image of mindfulness is needed to be a reference for health workers in providing health services to students. The purpose of this study is to describe types of digital-based mindfulness method to improve mental health in university students. The method used in this study was a scoping review. The databases used were CINAHL, PubMed, and Scopus. Search strategy used PRISMA for Scoping Review with keywords namely mindfulness, digital, mental health, and students. The inclusion criteria in this study were student samples, digital-based mindfulness therapy, randomized control trial and quasi-experiment designs, and publication year in the last 10 years (2014-2023). We found that 11 articles about digital-based mindfulness therapy is effective in improving mental health in college students. The types of digital mindfulness carried out are education, counseling, and meditation. Range of samples are 54-561 university students. In addition, there are also counseling services and therapy training guided by facilitators. Information is presented through video and audio that can be accessed at any time by students. Application development is needed by adding monitoring and evaluation features to monitor student compliance in conducting mindfulness therapy and counseling schedules. Then, the role of health workers through holistic mental health services by involving families can improve the process of developing services for students optimally.

Potential resilience treatments for orangutans (Pongo spp.): Lessons from a scoping review of interventions in humans and other animals

Wild orangutans (Pongo spp.) rescued from human-wildlife conflict must be adequately rehabilitated before being returned to the wild. It is essential that released orangutans are able to cope with stressful challenges such as food scarcity, navigating unfamiliar environments, and regaining independence from human support. Although practical skills are taught to orangutans in rehabilitation centres, post-release survival rates are low. Psychological resilience, or the ability to 'bounce back' from stress, may be a key missing piece of the puzzle. However, there is very little knowledge about species-appropriate interventions which could help captive orangutans increase resilience to stress. This scoping review summarises and critically analyses existing human and non-human animal resilience literature and provides suggestions for the development of interventions for orangutans in rehabilitation. Three scientific databases were searched in 2021 and 2023, resulting in 63 human studies and 266 non-human animal studies. The first section brings together human resilience interventions, identifying common themes and assessing the applicability of human interventions to orangutans in rehabilitation. The second section groups animal interventions into categories of direct stress, separation stress, environmental conditions, social stress, and exercise. In each category, interventions are critically analysed to evaluate their potential for orangutans in rehabilitation. The results show that mild and manageable forms of intervention have the greatest potential benefit with the least amount of risk. The study concludes by emphasising the need for further investigation and experimentation, to develop appropriate interventions and measure their effect on the post-release survival rate of orangutans.

Increasing resiliency and reducing mental illness stigma in post-secondary students: A meta-analytic evaluation of the inquiring mind program

Objective: Worsening student mental health, along with more complex mental illness presentation and increased access to campus mental health services, has led to a mental health "crisis" on campuses. One way to address student mental health needs may be through mental health programs which have been found to increase resiliency and help-seeking, and reduce stigma. Participants: The effectiveness of The Inquiring Mind (TIM), a mental health promotion and mental illness stigma reduction program, was examined in 810 students from 16 Canadian post-secondary institutions. Methods and Results: Using a meta-analytic approach, TIM improved resiliency and decreased stigmatizing attitudes from pre to post, with medium effect sizes (d > .50). Analyses with those that completed the follow-up (about one-third of the sample) showed that effects were mostly retained at three months. Other outcomes also point to the program's effectiveness. Conclusion: TIM appears to be an effective program for post-secondary students. However, additional research, including randomized control trials, is needed to address study limitations.

Resilience resources, coping, and health outcomes in college students during the Covid-19 pandemic

Background: Resilience resources are predispositions that promote individuals' abilities to cope with stress. Objective: The current cross-sectional study used path analysis with parallel multiple mediators to test whether coping behaviors mediated associations between resilience resources and somatic, depression, and anxiety symptoms during the Covid-19 pandemic. Method: Undergraduates at a small Northeastern college (n = 193) completed online surveys assessing resilience resources, coping, and symptoms. Results: Results support significant indirect effects from resilience resources to somatic symptoms through positive reinterpretation and growth, mental disengagement, and substance use. Total indirect effects for depressive symptoms were driven by mental disengagement and substance use, with a direct effect of resilience resources. The effect of resilience resources on anxiety symptoms was mediated by mental disengagement, and there was a direct effect of resilience resources. Conclusions: Findings demonstrate that some coping strategies link resilience resources to better outcomes, potentially informing interventions for adaptive coping during public health crises.

Mindful self-care and resilience in first-year undergraduate students

OBJECTIVE

Post-secondary students experience elevated levels of academic stress. The objective of the current study is to examine the relationship between a three factor model of resilience (ie, mastery, emotionality reactivity, and relatedness), mindful self-care and flourishing in first-year undergraduate students.

PARTICIPANTS

A sample (n = 177) of first-year undergraduates were recruited from a large urban university in Alberta during the 2019-2020 academic year.

METHOD

A multiple regression analysis was utilized to examine whether the three-factor model of resilience and mindful self-care predicted flourishing in undergraduate students.

RESULTS

Self-reported resilience significantly predicted flourishing. Specifically, a sense of mastery and a sense of relatedness was positively associated with flourishing. Additionally, mindful self-care significantly predicted flourishing. Specifically, supportive relationships and supportive structure.

CONCLUSIONS

University demands are significant and academic stress reduction interventions should be offered to support students entering post-secondary education.

Impact of resilience on college student mental health during COVID-19

OBJECTIVE

The aim of this study was to investigate how the COVID-19 pandemic impacted college student mental health and alcohol use and to determine how resilience could alleviate negative outcomes.

PARTICIPANTS

Students attending an Appalachian university during spring 2020 were surveyed shortly after on-campus activities stopped.

METHODS

Survey items included resilience, demographics, self-rated health, and depression symptoms, anxiety symptoms, and alcohol use before and since COVID-19.

RESULTS

There was a significant increase in prevalence of severe depression, severe anxiety, and high stress, and a significant decrease in prevalence high risk for problem drinking before and since COVID-19. Four separate standard least squares regression models were conducted with each of the dependent variables. Self-rated health was the strongest predictor for changes in depression, anxiety, and stress in each of the models, displaying a negative relationship.

CONCLUSIONS

Universities should prepare students using resilience training and provide employment and other resources to mitigate effects of stressful situations.

A machine learning analysis of risk and protective factors of suicidal thoughts and behaviors in college students

OBJECTIVE

To identify robust and reproducible factors associated with suicidal thoughts and behaviors (STBs) in college students.

METHODS

356 first-year university students completed a large battery of demographic and clinically-relevant self-report measures during the first semester of college and end-of-year (n = 228). Suicide Behaviors Questionnaire-Revised (SBQ-R) assessed STBs. A machine learning (ML) pipeline using stacking and nested cross-validation examined correlates of SBQ-R scores.

RESULTS

9.6% of students were identified at significant STBs risk by the SBQ-R. The ML algorithm explained 28.3% of variance (95%CI: 28-28.5%) in baseline SBQ-R scores, with depression severity, social isolation, meaning and purpose in life, and positive affect among the most important factors. There was a significant reduction in STBs at end-of-year with only 1.8% of students identified at significant risk.

CONCLUSION

Analyses replicated known factors associated with STBs during the first semester of college and identified novel, potentially modifiable factors including positive affect and social connectedness.

Digital Therapy: Alleviating Anxiety and Depression in Adolescent Students During COVID-19 Online Learning - A Scoping Review

The learning method has changed from offline to online since Coronavirus Disease 2019 pandemic cause mental health problems in students such as stress, anxiety, and even depression. Interventions to reduce mental health problems in adolescents need to be carried out digitally to reduce the transmission of Coronavirus Disease 2019. The purpose of this study is to explore methods of digital therapy to reduce symptoms of anxiety and depression among students during the Coronavirus Disease 2019. A scoping review study design was used in this study. Database the study from CINAHL, PubMed, and Scopus databases. This study used PRISMA Extension for Scoping Reviews (PRISMA-ScR) and for quality appraisal used JBI Quality Appraisal. The inclusion criteria for articles in this study are full text, randomized control trial or quasi-experiment research design, English language, students sample, and the publication period during COVID-19 pandemic (2019-2022). There were found 13 articles discussing digital therapy and it was found that the digital therapy model to reduce anxiety and depression includes directions through digital modules, directions via video, and asynchronous discussions via online meeting. The sample range in this study is 37-1986 students. Most of the articles come from developed countries. Delivery services of digital therapy consist of three phases, namely psycho-education, problem-solving, and implementation of problem-solving strategies. The authors found that there are four digital therapy methods, namely Improving psychological abilities, Bias-modification intervention, Self-help intervention, and Mindfulness intervention. The implementation of digital therapy must still pay attention to various aspects that affect students, so that therapists need to pay attention to physical, psychological, spiritual, and cultural aspects. Here we highlight, digital therapy interventions are proven for improving mental health by reducing depression and anxiety levels among students during the COVID-19 pandemic by paying attention to all aspects that affect students.

Mindfulness Intervention for Improving Psychological Wellbeing Among Students During COVID-19 Pandemic: A Scoping Review

The COVID-19 pandemic can cause mental health problems such as stress, social anxiety, depression, and decrease social life on students. Mental health problems need to be taken seriously to develop the stage of development and improve the psychological well-being of students on learning in the school. The aim of this study was to explore mindfulness interventions to improve psychological well-being among students. This study used the Scoping Review method. Literature from CINAHL, PubMed, and Scopus databases. The keywords used in English are psychological wellbeing, students, and mindfulness. The inclusion criteria were full text, study design randomized control trial or quasi-experimental, English language, population and sample were students, and the publication period is the last 10 years (2013-2022). From 2194 articles based on initial research, we found 10 articles were analyzed related to mindfulness interventions consisting of several methods, namely internet-based mindfulness, mindfulness-based intervention, and mindfulness-based stress reduction. Most of samples the study from the United States with the range samples were 20-166 students. Mindfulness interventions can be carried out improve the psychological well-being of students. Mindfulness therapy is done by fully concentrating the mind in meditation so that it can improve psychological health. Providing mindfulness therapy involves health workers such as nurses and psychologists to provide comprehensive therapy covering both physical and psychological aspects.

Web-Based Physical Activity Interventions to Promote Resilience and Mindfulness Amid the COVID-19 Pandemic: A Pilot Study

College students faced unique challenges during the COVID-19 pandemic. Implementing a physical activity intervention can help support the physical and mental health of college students. The purpose of this study was to examine the effectiveness of an aerobic-strength training exercise intervention (WeActive) and a mindful exercise intervention (WeMindful) in improving resilience and mindfulness among college students. Seventy-two students from a major public university in the Midwest participated in a two-arm experimental study over the course of ten weeks. One week before and after the 8-week interventions, participants completed the Five-Facet Mindfulness Questionnaire (FFMQ-15), Connor Davidson Resilience Scale (CD-RISC-10), and demographic and background questionnaire via Qualtrics. Both groups also participated in bi-weekly Peer Coaching sessions, which utilized reflective journaling and goal-setting exercises. ANCOVA showed a significant main effect of time for total mindfulness score (F = 5.177, p < 0.05, η² = 0.070), mindfulness Acting with Awareness (F = 7.321, p < 0.05, η² = 0.096), and mindfulness Non-Judging of Inner Experience (F = 5.467, p < 0.05, η² = 0.073). No significant main effect of group and interaction effects of time with group were observed for the total mindfulness and the five facets of mindfulness as well as resilience. In addition, no significant main effect of time for resilience was found. We conclude that aerobic-strength exercises and mindful yoga exercises, together with reflective journaling, may be effective in increasing mindfulness in the college population.

Cognitive Behavior Therapy by Nurses in Reducing Symptoms of Post-Traumatic Stress Disorder on Children as Victims of Violence: A Scoping Review

Violence against children can cause psychological problems such as post-traumatic syndrome disorder (PTSD). The negative impact of violence on children is psychological and physical problems and risk of suicide. Nurses have a role to provide comprehensive nursing care such as cognitive behavior therapy for reducing PTSD symptoms. The purpose of this study was to describe the methods of cognitive behavior therapy to reduce symptoms of PTSD in children who are victims of violence. This study used the scoping review method. The databases use for the literature review in this study were CINAHL, PubMed, and Scopus. The keywords used in English were "cognitive behavioral therapy OR CBT" AND "violence OR abuse" AND "post-traumatic stress disorder OR PTSD" AND "child OR children". The inclusion criteria were full text, randomized control trial or quasi-experimental research design, English language, the sample was children, and the publication period was for the last 10 years (2013-2022). We found 10 articles discussing CBT intervention on children who experienced victim abuse to reduce symptoms of PTSD. Most of the articles in this study used randomized control trial design. Several samples in this study are from the USA. The total sample was 47-320 respondents. This study showed three methods of CBT, namely psychoeducation, self-management, and coping strategies. CBT interventions can be carried out face-to-face or online. The activities carried out by the participants were relaxing, participating in training, counseling, problem-solving discussions, and therapy to improve sleep quality. Cognitive behavioral therapy is an intervention that can be carried out to reduce the traumatic impact on child victims of violence by taking into account the characteristics and development of the children.

Effects of Mobile Mindfulness Meditation on the Mental Health of University Students: Systematic Review and Meta-analysis

BACKGROUND

Mobile mindfulness meditation (MMM) is a mindfulness meditation intervention implemented using mobile devices such as smartphones and apps. MMM has been used to help manage the mental health of university students.

OBJECTIVE

This study aims to evaluate the effectiveness of MMM on the mental health of university students in the areas of stress, anxiety, depression, mindfulness, well-being, and resilience.

METHODS

We conducted a systematic review and meta-analysis of the effectiveness of MMM on the mental health of university students. This study followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. An electronic literature search was performed on PubMed, Web of Science, EBSCO, Cochrane Library, and Embase databases, from inception to July 16, 2021. This study was conducted to identify studies that reported the effects of MMM on the primary outcomes including stress, anxiety, and depression, and on the secondary outcomes including mindfulness, well-being, and resilience. Two reviewers retrieved articles, evaluated quality, and extracted data independently. The methodological quality of the selected studies was determined using the Cochrane criteria for risk-of-bias assessment. Standardized mean differences (SMDs) for continuous outcomes and risk ratios for dichotomous outcomes were calculated. Sensitivity analyses and subgroup analyses were performed for results with high heterogeneity. The RevMan version 5.3 was used to perform meta-analysis.

RESULTS

A total of 10 studies, including 958 university students, were selected for this meta-analysis. Results of the primary outcome showed that the MMM groups were more effective than the control groups in decreasing stress (SMD -0.41, 95% CI -0.59 to -0.23; P<.001) and alleviating anxiety (SMD -0.29, 95% CI -0.50 to -0.09; P=.004). However, there was no difference between the MMM groups and the control groups in depression (SMD -0.14, 95% CI -0.30 to 0.03; P=.11). The use of either waitlist control or traditional face-to-face intervention in the control group was identified as the source of heterogeneity. Specifically, the waitlist control subgroup (SMD -0.33, 95% CI -0.53 to -0.13; P=.002) was superior when compared with the face-to-face subgroup (SMD 0.29, 95% CI -0.01 to 0.59; P=.06). Results of the secondary outcome showed that the MMM groups were more effective than the control groups in enhancing well-being (SMD 0.30, 95% CI 0.11-0.50; P=.003) and improving mindfulness (SMD 2.66, 95% CI 0.77-4.55; P=.006). Whether commercial sponsorship was obtained was considered as the source of heterogeneity. The "without company support" group (SMD 17.60, 95% CI 11.32-23.87; P<.001) was superior to the "with company support" group (SMD 1.17, 95% CI -0.82 to 3.15; P=.25) in raising the level of mindfulness. However, there was no difference between the MMM and control groups in resilience (SMD -0.06, 95% CI -0.26 to 0.15; P=.59). The evidence level of the results from the 10 studies was determined to be moderate to low.

CONCLUSIONS

MMM was an effective method to reduce stress and anxiety, and to increase the well-being and mindfulness of university students. However, further studies are needed to confirm our findings.

TRIAL REGISTRATION

PROSPERO International Prospective Register of Systematic Reviews CRD42022303585; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=303585.

The Effect of Child Trauma on the Relation between Psychological Well-Being and Depressive Symptoms in Chilean University Students

(1) Background: There is consistent evidence of the impact of early adverse experiences on mental health in adulthood, especially as a risk factor for depression. However, their influence on positive aspects of mental health such as well-being has been less extensively studied. Therefore, this study aims to investigate the effect of traumatic childhood experiences on the relationship between depression and psychological well-being in a sample of university students. (2) Methods: The Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Beck Depression Inventory (BDI-IA), and Ryff's psychological well-being scale were administered to 700 Chilean university students. Several regression models were used to analyze the interaction between variables, with multivariate SEM being applied to hierarchize the relationships found. (3) Results: Emotional Neglect and Abuse stand out as the types of maltreatment with the greatest impact on mental health, associated first with a decrease in the self-acceptance dimension of psychological well-being and then with depressive symptomatology in adulthood. (4) Conclusions: Results provide evidence that early trauma has an important impact on mental health, increasing the risk of depression, however, its impact is greater on positive aspects of health, such as self-acceptance, a fundamental element in the construction of psychological well-being.

College Student Resilience During COVID-19: Examining the Roles of Mindfulness, Compassion, and Prosocial Behavior

The present study examined factors associated with resilience in college students during the COVID-19 pandemic. Participants were undergraduates at a large Midwestern university in the USA (N = 848). Hierarchical linear regression analyses examined self-reported pandemic-related adversity, community COVID-19 case rates, mindfulness, compassion, and prosocialness to determine the strongest associates of resilience. Findings demonstrated that mindfulness was the only psychological process of interest significantly associated with resilience, so specific facets were further explored in a regression analysis. Specifically, higher levels of the following mindfulness skills were associated with greater resilience: ability to describe internal experiences, to remain aware while engaging in action, and to take a nonreactive stance toward internal experiences. Mindfulness-based interventions may be appropriate for promoting resilience in college students during the COVID-19 pandemic.

The relationship between psychological resilience, neuroticism, attentional bias, and depressive symptoms in college Chinese students

In recent years, the incidence of depressive symptoms among Chinese college students has been increasing. Studies have shown that depressive symptoms are related to a variety of psychosocial factors, among which neuroticism, resilience, and attention bias are most notably related, but the correlation among the three is not clear. This study aimed to investigate the influence mechanisms of different degrees of resilience, attentional bias, and neuroticism in the formation of depressive symptoms. The college freshmen of this study were selected through stratified multi-stage cluster sampling. Students provided informed consent and then completed a general situation questionnaire and four scales: the Chinese version of the Connor–Davidson Resilience Scale, the Attention to Positive and Negative Information Scale, the Eysenck Personality Questionnaire, and the Zung Self-Rating Depressive Symptoms Scale. In total, 1,493 freshmen participated in the research group. Our results showed that low resilience, negative attention bias, and high neuroticism jointly increased the risk of depressive symptoms. There is a significant correlation between these three factors and depressive symptoms. Additionally, strength, tenacity, and attention bias all had more significant effects on the occurrence of depressive symptoms. These findings indicate that there may be an important psychological mechanism for the occurrence, development, and poor prognosis of depressive symptoms.

A scoping review and evaluation of instruments used to measure resilience among post-secondary students

As mental health problems continue to increase among post-secondary populations, the need to develop effective initiatives designed to bolster students’ resilience has increasingly been identified as a priority. Therefore, access to valid tools with which to measure the efficacy of these interventions is imperative. To date, a comprehensive assessment of existing instruments used to evaluate the construct of resilience among post-secondary student populations has not been conducted. The purpose of this study was to fill this gap by conducting a scoping review of literature detailing the use of resilience instruments and evaluating their quality based on suitability for use in the post-secondary setting and associated psychometric evidence. We identified a total of 78 records published between 2010 and 2022, extracting a total of 12 instruments. Using detailed criteria frameworks, each instrument was assessed in terms of suitability and quality of associated psychometric evidence for validity and reliability. The results of our study suggest that many of the instruments currently being used to assess resilience among post-secondary students may not be appropriate. The majority of the instruments included in our review were developed for use among general adult populations and not specifically designed for use in the post-secondary setting. Most instruments did not assess resilience in a comprehensive, holistic matter that addressed the ability to bounce back from adversity by drawing upon psychological, social, cultural, and environmental resources, as defined by recent research. Further, no instruments included in our review had published evidence in support of a complete psychometric analysis. The results of our evaluation suggest that the Connor-Davidson Resilience Scale (CD-RISC) is the most suitable instrument for measuring resilience among post-secondary populations due to its suitability, comprehensive assessment of the construct of resilience, and demonstrably strong psychometric properties for both the 25- and 10-item versions of the tool.

•

There is a need for access to valid and appropriate tools with which to measure post-secondary students’ resilience.

•

We identified a total of 12 instruments evaluating resilience among post-secondary student populations.

•

The majority of the instruments were not designed for use in the post-secondary setting and were not comprehensive· We recommend the CD-RISC as the most suitable.

•

We recommend the CD-RISC as the most suitable instrument for measuring resilience among post-secondary students.

Emotion Management for College Students: Effectiveness of a Mindfulness-Based Emotion Management Intervention on Emotional Regulation and Resilience of College Students

ABSTRACT

The discovery of psychological healing methods that are easy to master and can be developed by the individual as a means of improving students' self-psychological adjustment ability is of great practical value. This study is a randomized control trial intended to investigate the effectiveness of mindfulness-based emotion management interventions and to test their effects on the mood state and resilience of college students. A total of 72 students were recruited and randomly divided into an intervention group and a control group. Thirty-six students in the intervention group received a modified mindfulness-based emotion management intervention once per week for 4 weeks, with each intervention having a duration of 80 minutes. Participants were assessed by questionnaires to measure mindfulness level, emotion, and resilience before and after intervention. There were significant interaction effects on mindfulness level (F = 97.76, p < 0.00), mood state (F = 353.52, p < 0.00), and resilience (F = 178.99, p < 0.00) scores. A modified 4-week mindfulness-based emotion management intervention can improve the mindfulness level and resilience of college students and is an innovative and feasible strategy for enhancing mental health in college students.

Striatal reactivity during emotion and reward relates to approach-avoidance conflict behaviour and is altered in adults with anxiety or depression

BACKGROUND

We have previously reported activation in reward, salience and executive control regions during functional MRI (fMRI) using an approach-avoidance conflict (AAC) decision-making task with healthy adults. Further investigations into how anxiety and depressive disorders relate to differences in neural responses during AAC can inform their understanding and treatment. We tested the hypothesis that people with anxiety or depression have altered neural activation during AAC.

METHODS

We compared 118 treatment-seeking adults with anxiety or depression and 58 healthy adults using linear mixed-effects models to examine group-level differences in neural activation (fMRI) during AAC decision-making. Correlational analyses examined relationships between behavioural and neural measures.

RESULTS

Adults with anxiety or depression had greater striatal engagement when reacting to affective stimuli (p = 0.008, d = 0.31) regardless of valence, and weaker striatal engagement during reward feedback (p = 0.046, d = -0.27) regardless of the presence of monetary reward. They also had blunted amygdala activity during decision-making (p = 0.023, d = -0.32) regardless of the presence of conflict. Across groups, approach behaviour during conflict decision-making was inversely correlated with striatal activation during affective stimuli (p < 0.001, r = -0.28) and positively related to striatal activation during reward feedback (p < 0.001, r = 0.27).

LIMITATIONS

Our transdiagnostic approach did not allow for comparisons between specific anxiety disorders, and our cross-sectional approach did not allow for causal inference.

CONCLUSION

Anxiety and depression were associated with altered neural responses to AAC. Findings were consistent with the role of the striatum in action selection and reward responsivity, and they point toward striatal reactivity as a future treatment target. Blunting of amygdala activity in anxiety or depression may indicate a compensatory response to inhibit affective salience and maintain approach.

Disparities in the prevalence, frequency and trajectories of substance use and disordered eating across first-year university in sexual minority undergraduates

Objective. To compare the prevalence and trajectories of risky health behaviors in sexual minority (SM; lesbian/gay/bisexual/questioning/asexual) versus heterosexual undergraduates across their first year of post-secondary. Participants. First-year undergraduates (N = 704, Mage=17.97 years, 24% SM) from a midsized Canadian university. Methods. Students completed monthly (September-April) online questionnaires assessing substance use (binge drinking, tobacco, cannabis, illicit drug use) and disordered eating (binge eating, fasting, purging). Results. At the outset of the academic year, SM students endorsed more frequent cannabis use, illicit drug use, fasting, and binge eating, but less frequent tobacco use, versus heterosexual students. Over the year, SM students' binge drinking frequency declined less than that of heterosexual students, but their illicit drug use decreased while that of their heterosexual peers increased, and all students reported declining disordered eating frequency. Conclusions. Campus wellness initiatives for SM students should offer prevention and harm-reduction strategies prior to or shortly after their arrival on campus.

Active coping strategies and less pre-pandemic alcohol use relate to college student mental health during the COVID-19 pandemic

Objective

To further delineate risk and resilience factors contributing to trajectories of mental health symptoms experienced by college students through the pandemic.

Participants

n = 183 college students (67.2% female).

Methods

Linear mixed models examined time effects on depression and anxiety. Propensity-matched subgroups exhibiting "increased" versus "low and stable" depression symptoms from before to after the pandemic-onset were compared on pre-pandemic demographic and psychological factors and COVID-related experiences and coping strategies.

Results

Students experienced worsening of mental health symptoms throughout the pandemic, particularly during Fall 2020 compared with Fall 2019 (Depression scale d = -0.43 [95% CI: -0.65 to -0.21]). The propensity-matched subgroup exhibiting relative resilience ("low and stable" symptoms) reported less alcohol use prior to the pandemic, greater use of active coping strategies, and less of an impact on their college progress.

Conclusions

Results point to several potential targets of screening and intervention to decrease residual impacts of the pandemic.

First-onset major depression during the COVID-19 pandemic: A predictive machine learning model

BACKGROUND

This study longitudinally evaluated first-onset major depression rates during the pandemic in Italian adults without any current clinician-diagnosed psychiatric disorder and created a predictive machine learning model (MLM) to evaluate subsequent independent samples.

METHODS

An online, self-reported survey was released during two pandemic periods (May to June and September to October 2020). Provisional diagnoses of major depressive disorder (PMDD) were determined using a diagnostic algorithm based on the DSM criteria of the Patient Health Questionnaire-9 to maximize specificity. Gradient-boosted decision trees and the SHapley Additive exPlanations technique created the MLM and estimated each variable's predictive contribution.

RESULTS

There were 3532 participants in the study. The final sample included 633 participants in the first wave (FW) survey and 290 in the second (SW). First-onset PMDD was found in 7.4% of FW participants and 7.2% of the SW. The final MLM, trained on the FW, displayed a sensitivity of 76.5% and a specificity of 77.8% when tested on the SW. The main factors identified in the MLM were low resilience, being an undergraduate student, being stressed by pandemic-related conditions, and low satisfaction with usual sleep before the pandemic and support from relatives. Current smoking and taking medication for medical conditions also contributed, albeit to a lesser extent.

LIMITATIONS

Small sample size; self-report assessment; data covering 2020 only.

CONCLUSIONS

Rates of first-onset PMDD among Italians during the first phases of the pandemic were considerable. Our MLM displayed a good predictive performance, suggesting potential goals for depression-preventive interventions during public health crises.

INFLUENCE OF PHYSICAL EDUCATION ON THE MENTAL HEALTH OF COLLEGE STUDENTS

ABSTRACT Under the influence of the special education system in China, after entering the free and open college environment from a tightly-controlled high school, many students suffer psychologically from a “weaning period”. During the students’ initial contacts with society, they can simultaneously experience confusion and psychological conflicts in interpersonal communication, perception, emotions, and free will. If these problems persist, they can cause psychological problems. Through field investigation, this paper found that physical exercise can not only improve the intelligence level of students, but also have a positive impact on their emotional and psychological states and their interpersonal skills. Evidence Level I; Systematic review.

Influencing factors, prediction and prevention of depression in college students: A literature review

The high prevalence of depression among college students has a strong negative impact on individual physical and mental health, academic development, and interpersonal communication. This paper reviewed the extant literature by identifying nonpathological factors related to college students' depression, investigating the methods of predicting depression, and exploring nonpharmaceutical interventions for college students' depression. The influencing factors of college students' depression mainly fell into four categories: biological factors, personality and psychological state, college experience, and lifestyle. The outbreak of coronavirus disease 2019 has exacerbated the severity of depression among college students worldwide and poses grave challenges to the prevention and treatment of depression, given that the coronavirus has spread quickly with high infection rates, and the pandemic has changed the daily routines of college life. To predict and measure mental health, more advanced methods, such as machine algorithms and artificial intelligence, have emerged in recent years apart from the traditional commonly used psychological scales. Regarding nonpharmaceutical prevention measures, both general measures and professional measures for the prevention and treatment of college students' depression were examined in this study. Students who experience depressive disorders need family support and personalized interventions at college, which should also be supplemented by professional interventions such as cognitive behavioral therapy and online therapy. Through this literature review, we insist that the technology of identification, prediction, and prevention of depression among college students based on big data platforms will be extensively used in the future. Higher education institutions should understand the potential risk factors related to college students' depression and make more accurate screening and prevention available with the help of advanced technologies.

An Examination of Factors Associated With Student Resiliency

BACKGROUND

Student resiliency, success, and retention are top priorities for nursing programs.

PURPOSE

The purpose of the cross-sectional descriptive study was to identify factors associated with the resiliency level and physical and mental health of nursing students.

METHODS

A cross-sectional descriptive study design was used with a convenience sample of 199 nursing students from organizations that comprise the Community Patient Safety Coalition Nursing Research Consortium. Resiliency was measured with the Connor Davidson Resiliency Scale. Physical and mental health was measured with the Patient Reported Outcomes Measurement Information System Global Health Short Form.

RESULTS

Most of the nursing students in the sample were female (92%), White (94%), and in BSN programs (74.4%). Students had low resiliency (P < .0001) and low physical and mental health (P < .0001) compared with the general population.

CONCLUSIONS

Student resilience was positively correlated to self-perception of physical and mental health.

Prospective Association Between Problematic Mobile Phone Use and Eating Disorder Symptoms and the Mediating Effect of Resilience in Chinese College Students: A 1-Year Longitudinal Study

A previous cross-sectional study found that problematic mobile phone use (PMPU) was associated with students' eating disorder symptoms. However, since the cross-sectional study cannot infer the causality and the direction of effect, the longitudinal relationship between the two and the mechanism behind this relationship are unclear. Therefore, the present study explores the prospective association between PMPU and eating disorder symptoms and related mediation mechanisms using a 1-year longitudinal study of 1,181 college students (from December 2019 [T1] to December 2020 [T2]). Survey tools used include the Mobile Phone Addiction Tendency Scale, the 10-item Connor-Davidson resilience scale, and the 12 item Short Form of the Eating Disorder Examination Questionnaire. The longitudinal relationship between PMPU and eating disorder symptoms and the mediating effect of resilience was analyzed using a cross-lagged model. The results showed that PMPU (β = 0.086, P < 0.01) and resilience (β = -0.145, P < 0.01) at T1 predicted eating disorder symptoms at T2, but not vice versa. PMPU was bidirectionally associated with resilience, and the prediction effect of PMPU at T1 to resilience at T2 (β = -0.151, P < 0.001) was higher than the prediction effect of resilience at T1 to PMPU at T2 (β = -0.134, P < 0.001). The standardized indirect effect of PMPU at T1 on eating disorder symptoms at T2 via resilience was significant (β = 0.022, 95% CI = 0.010~0.040, P < 0.001). Therefore, PMPU and resilience were predictive for eating disorder symptoms in college students, and resilience may play a mediating role in the prospective association between PMPU and eating disorder symptoms. This study provides new ideas and higher-level evidence for the development of prevention and intervention measures for college students' eating disorder symptoms.

The Developmental Trajectory of a Decade of Research on Mental Health and Well-Being amongst Graduate Students: A Bibliometric Analysis

The journey of graduate students through academia can be a difficult road plagued with several roadblocks due to several intersectional factors. These difficulties often impact the students’ mental health with severe consequences on their well-being and personal and academic achievements. There is a critical need for researchers to conduct studies in response to the positive mental well-being for this group of trainees, considering their peculiar role in the scholarly environment. This study aimed to explore the scientific research on the health and well-being of graduate students; typify the scientific landscape and development trajectory, cooperation networks, and fundamental research areas; and identify areas of needed research in this field. A bibliometric analysis of articles indexed in Scopus and published in the past decade (2012 to 2021) was undertaken. The results revealed that the research on graduate students’ mental health and well-being has increased over the years, significantly in the past two years, probably owing to the incidence of the COVID-19 pandemic and concerns around remote learning. The highest number of publications was from the United Kingdom (U.K.) and United States (U.S.), while the organizational affiliations were mainly from universities. The most prominent source type of publications was journal articles. The result also shows a weak collaboration across countries and organizations. The study identifies other areas of useful research, collaboration, intervention strategies, and policy review.

Relação entre Perfil, Hábitos, Vivências Acadêmicas e Resiliência de Universitários

Resumo A falta de recursos para lidar com situações desafiadoras pode dificultar o ajuste do estudante à universidade e aumentar o risco de fracasso acadêmico. Pensando nisso, o objetivo deste estudo foi verificar se há relação entre o perfil, os hábitos de vida, as vivências acadêmicas e a resiliência de graduandos das áreas da saúde e Psicologia. Trata-se de um estudo transversal e inferencial. Participaram 361 graduandos dos cursos de Biomedicina, Educação Física, Enfermagem, Farmácia, Fisioterapia, Medicina, Nutrição, Terapia Ocupacional e Psicologia, matriculados em três instituições federais de Ensino Superior do interior de Minas Gerais. Utilizou-se um questionário sociodemográfico e de hábitos de vida, a Escala de Resiliência e o Questionário de Vivências Acadêmicas - versão reduzida -, respondidos de forma on-line pelos universitários, bem como análises descritivas e correlacionais. Os resultados mostraram resiliência média para a maioria dos universitários e boa adaptação ao contexto universitário, além de relações entre a resiliência e o período cursado, estar em psicoterapia, avaliar positivamente a própria saúde e todas as dimensões das vivências acadêmicas. Conclui-se que a resiliência é uma capacidade importante para enfrentar as demandas da graduação e que é possível desenvolvê-la, especialmente durante o começo da graduação e com a adoção de intervenções focadas no autoconhecimento, na autoeficácia e em boas estratégias de enfrentamento. Desenvolver a resiliência nos estudantes pode colaborar para a promoção da saúde desta população e a redução da evasão no Ensino Superior.

The Resilience Journal: Exploring the Potential of Journal Interventions to Promote Resilience in University Students

Given the prevalence of mental health issues among university students, they must be regarded as a vulnerable population. Resilience interventions offer one potential means of strengthening students' capacity to overcome academic challenges and external threats. This is all the more urgent in light of the additional difficulties caused by the current COVID-19 pandemic, such as the demands of remote learning. The present study is a first step toward designing and evaluating an appropriate dynamic resilience intervention for students. The design of the Resilience Journal intervention draws on insights from expressive writing and positive writing research and focuses on reflection on daily challenges. In this online intervention, 100 business school students (66% female, M age = 23.74) at a German university were randomly assigned to two groups and completed two different versions of the Resilience Journal for 5 days. The two versions focused, respectively on broadening attention to challenges and priming attention to mastered challenges. In a pre-post design, two resilience measures and one measure of life satisfaction were used to assess intervention outcomes. Additionally, a newly developed rating scale was used for daily monitoring of dynamic resilience. While both groups showed a significant increase in resilience as measured by the Brief Resilience Scale, that increase could not be attributed directly to the intervention, as there were no group differences, and the design did not include a control group. The other resilience and life satisfaction measures showed no significant change. This first implementation confirms the potential of the Resilience Journal and indicates directions for the development of dynamic resilience interventions and measures in future studies. To further study the potential of such a positive psychology intervention, future research necessitates the inclusion of control groups.

Neural contributors to trauma resilience: a review of longitudinal neuroimaging studies

Resilience in the face of major life stressors is changeable over time and with experience. Accordingly, differing sets of neurobiological factors may contribute to an adaptive stress response before, during, and after the stressor. Longitudinal studies are therefore particularly effective in answering questions about the determinants of resilience. Here we provide an overview of the rapidly-growing body of longitudinal neuroimaging research on stress resilience. Despite lingering gaps and limitations, these studies are beginning to reveal individual differences in neural circuit structure and function that appear protective against the emergence of future psychopathology following a major life stressor. Here we outline a neural circuit model of resilience to trauma. Specifically, pre-trauma biomarkers of resilience show that an ability to modulate activity within threat and salience networks predicts fewer stress-related symptoms. In contrast, early post-trauma biomarkers of subsequent resilience or recovery show a more complex pattern, spanning a number of major circuits including attention and cognitive control networks as well as primary sensory cortices. This novel synthesis suggests stress resilience may be scaffolded by stable individual differences in the processing of threat cues, and further buttressed by post-trauma adaptations to the stressor that encompass multiple mechanisms and circuits. More attention and resources supporting this work will inform the targets and timing of mechanistic resilience-boosting interventions.

Lifestyle Changes among Polish University Students during the COVID-19 Pandemic

Students worldwide have been impacted by nationwide safety closures due to the COVID-19 pandemic, creating an environment with loss of interaction with colleagues, social isolation, boredom, and economic uncertainty. Since university students were considered uniquely vulnerable to mental health problems even before the pandemic, this study aimed to investigate lifestyle and behavioral changes experienced by this population due to the epidemiological situation and their effect on their mental health. Data were collected via an online survey conducted among university students across Poland. The survey addressed recent lifestyle changes that were a result of the pandemic as well as psychological distress, symptoms of insomnia and symptoms of post-traumatic stress. The results indicate that protective factors include maintaining a daily routine, staying physically active, following a usual eating pattern and taking care of sleep hygiene. Changes in behavior contributing to poorer mental health included giving up a daily routine, neglecting meals, tidiness, hygiene as well as social relationships, changes in food intake, sleeping schedule, a decrease in physical activity and the onset of sexual dysfunctions. A history of psychiatric treatment and an increase in self-harm as well as an increase in alcohol and tobacco consumption were also found to be associated with psychological distress. Experienced lifestyle and behavioral changes and their impact on mental health were apparent throughout the obtained data, highlighting the need for psychological support in the studied population. Based on the results we were able to establish a list of protective and risk factors influencing the everyday life and psychological wellbeing of students amidst the COVID-19 pandemic, which could also be translated into life skills.

Gamification as an approach to improve resilience and reduce attrition in mobile mental health interventions: A randomized controlled trial

Forty percent of all general-practitioner appointments are related to mental illness, although less than 35% of individuals have access to therapy and psychological care, indicating a pressing need for accessible and affordable therapy tools. The ubiquity of smartphones offers a delivery platform for such tools. Previous research suggests that gamification-turning intervention content into a game format-could increase engagement with prevention and early-stage mobile interventions. This study aimed to explore the effects of a gamified mobile mental health intervention on improvements in resilience, in comparison with active and inactive control conditions. Differences between conditions on changes in personal growth, anxiety and psychological wellbeing, as well as differences in attrition rates, were also assessed. The eQuoo app was developed and published on all leading mobile platforms. The app educates users about psychological concepts including emotional bids, generalization, and reciprocity through psychoeducation, storytelling, and gamification. In total, 358 participants completed in a 5-week, 3-armed (eQuoo, "treatment as usual" cognitive behavioral therapy journal app, no-intervention waitlist) randomized controlled trial. Relevant scales were administered to all participants on days 1, 17, and 35. Repeated-measures ANOVA revealed statistically significant increases in resilience in the test group compared with both control groups over 5 weeks. The app also significantly increased personal growth, positive relations with others, and anxiety. With 90% adherence, eQuoo retained 21% more participants than the control or waitlist groups. Intervention delivered via eQuoo significantly raised mental well-being and decreased self-reported anxiety while enhancing adherence in comparison with the control conditions. Mobile apps using gamification can be a valuable and effective platform for well-being and mental health interventions and may enhance motivation and reduce attrition. Future research should measure eQuoo's effect on anxiety with a more sensitive tool and examine the impact of eQuoo on a clinical population.

Wellness and resilience for college and beyond: protocol for a quasi-experimental pilot study investigating a dialectical behaviour therapy skill-infused college course

INTRODUCTION

College students' mental health problems and suicidal behaviour are serious, persistent and prevalent public health issues. With the need for mental health support greatly exceeding the availability of on-campus treatment, a recent trend on college campuses is to offer courses designed to teach students strategies for developing mental health or resilience. While these courses are exceptionally popular among students, a paucity of research investigates the health outcomes associated with participation. The purpose of this study is to investigate the acceptability, appropriateness, feasibility and preliminary effectiveness of a college course grounded in skills from dialectical behaviour therapy (DBT) titled, 'Wellness and Resilience for College and Beyond'.

METHODS AND ANALYSIS

During the spring and fall 2020 semesters, the course will be offered on five campuses in Southwestern Pennsylvania and West Virginia. The course consists of 15 weekly 2.5-hour lessons, weekly homework assignments and a final examination with content drawn from DBT, acceptance and commitment therapy and positive psychology. Undergraduate students aged 18-24 will self-select into the course and control subjects receiving 'university as usual' will be recruited to serve as a comparison group. Students who receive the course will complete measures of course acceptability, appropriateness and feasibility. All study participants will complete measures of adaptive coping skills use, emotion dysregulation and suicidality.

ETHICS AND DISSEMINATION

All of the study procedures were approved as an exempt protocol for evaluation of educational curricula by the University of Pittsburgh Human Research Protections Office (HRPO); the study was approved as a research study by the institutional review board (IRB) of the fifth study site. The University of Pittsburgh HRPO served as the IRB of record for all except one study site, which required standard IRB review. Data from this study will be disseminated via conference presentations, peer-reviewed publications and via our online stakeholder learning collaborative.

TRIAL REGISTRATION NUMBER

NCT04338256.

Visual cortical regions show sufficient test-retest reliability while salience regions are unreliable during emotional face processing

Functional magnetic resonance imaging studies frequently use emotional face processing tasks to probe neural circuitry related to psychiatric disorders and treatments with an emphasis on regions within the salience network (e.g., amygdala). Findings across previous test-retest reliability studies of emotional face processing have shown high variability, potentially due to differences in data analytic approaches. The present study comprehensively examined the test-retest reliability of an emotional faces task utilizing multiple approaches to region of interest (ROI) analysis and by examining voxel-wise reliability across the entire brain for both neural activation and functional connectivity. Analyses included 42 healthy adult participants who completed an fMRI scan concurrent with an emotional faces task on two separate days with an average of 25.52 days between scans. Intraclass correlation coefficients (ICCs) were calculated for the 'FACES-SHAPES' and 'FACES' (compared to implicit baseline) contrasts across the following: anatomical ROIs identified from a publicly available brain atlas (i.e., Brainnetome), functional ROIs consisting of 5-mm spheres centered on peak voxels from a publicly available meta-analytic database (i.e., Neurosynth), and whole-brain, voxel-wise analysis. Whole-brain, voxel-wise analyses of functional connectivity were also conducted using both anatomical and functional seed ROIs. While group-averaged neural activation maps were consistent across time, only one anatomical ROI and two functional ROIs showed good or excellent individual-level reliability for neural activation. The anatomical ROI was the right medioventral fusiform gyrus for the FACES contrast (ICC ​= ​0.60). The functional ROIs were the left and the right fusiform face area (FFA) for both FACES-SHAPES and FACES (Left FFA ICCs ​= ​0.69 & 0.79; Right FFA ICCs ​= ​0.68 & 0.66). Poor reliability (ICCs ​< ​0.4) was identified for almost all other anatomical and functional ROIs, with some exceptions showing fair reliability (ICCs ​= ​0.4-0.59). Whole-brain voxel-wise analysis of neural activation identified voxels with good (ICCs ​= ​0.6-0.74) to excellent reliability (ICCs ​> ​0.75) that were primarily located in visual cortex, with several clusters in bilateral dorsal lateral prefrontal cortex (DLPFC). Whole-brain voxel-wise analyses of functional connectivity for amygdala and fusiform gyrus identified very few voxels with good to excellent reliability using both anatomical and functional seed ROIs. Exceptions included clusters in right cerebellum and right DLPFC that showed reliable connectivity with left amygdala (ICCs ​> ​0.6). In conclusion, results indicate that visual cortical regions demonstrate good reliability at the individual level for neural activation, but reliability is generally poor for salience regions often focused on within psychiatric research (e.g., amygdala). Given these findings, future clinical neuroimaging studies using emotional faces tasks to examine individual differences might instead focus on visual regions and their role in psychiatric disorders.