A Review of Psychological Distress Among University Students: Pervasiveness, Implications and Potential Points of Intervention

The mediating effect of nomophobia in the relationship between problematic social media use/problematic smartphone use and psychological distress among university students

As smartphones and social media become more common, the psychological impact on university students has garnered increasing research attention. The present study examined nomophobia as the mediator in the relatioship between problematic social media use (PSMU)/ problematic smartphone use (PSU), and psychological distress among university students during the COVID-19 pandemic. Of the 622 Malaysian university students recruited through online survey, socio-demographic information, Bergen Social Media Addiction Scale (BSMAS), Smartphone Application-Based Addiction Scale (SABAS), Nomophobia Questionnaire (NMPQ) and Depression, Anxiety and Stress Scale-21 (DASS-21) were completed. To analyze mediation effects, partial least squares structural equation modelling (PLS-SEM) was used. PSMU, PSU and psychological distress were found to be positively related to nomophobia. Nomophobia was a significant mediator between PSMU/PSU and psychological distress. Findings appear to highlight the importance of nomophobia in increasing psychological distress among young adults. Future research could examine these relationships longitudinally to better understand the relationship for effective interventions for the improvement of psychological well-being of young adults navigating the challenges of modern technology.

Psychological Problems and Academic Motivation in University Students: A Cross-Sectional Study One Year after the COVID-19 Lockdown in Italy

This study was aimed at exploring students' psychological condition (operationalized through psychological distress and perceived loneliness) one year after the COVID-19 lockdown and testing its role in predicting academic motivation. The possible mediating role of emotional regulation in this relationship was also investigated. A non-random sample of university students completed a cross-sectional online survey assessing their psychological distress, feelings of loneliness, emotion regulation strategies, and academic motivation. Structural equation modeling multi-group analysis was used to examine the relation between variables. The final sample comprised 479 students (62.8% female, Mage = 22.16 ± 2.79 years) from several degree courses attending Italian universities. Of these, 56.6% and 41.5% of the participants showed high levels of psychological distress and perceived loneliness, respectively. Psychological distress and loneliness were positively associated with problems with emotion-regulation abilities and negatively associated with academic motivation. The lack of emotional awareness, in turn, reduced their academic motivation levels. Analysis of the indirect effects showed that psychological distress affected academic motivation via awareness (β = -.02, p < .05 and β = -.03, p < .05 in males and females, respectively). Overall, the model was able to predict academic motivation in university students, explaining a reasonable percentage of the variance (14% for males and 17% for females). These results indicate a meaningful effect of students' psychological condition on academic motivation. Implications for the definition and implementation of actions to support students in managing psychological problems and feelings of loneliness and to foster students' psychological health in university settings are discussed.

Containment Measures and Alcohol Consumption Among Drinking Higher Education Students Before and During the COVID-19 Pandemic: A Multilevel Analysis in 25 Countries

Hazardous alcohol use tends to be more prominent among higher education students. The COVID-19 pandemic severely altered student life, raising questions on its impact on students' alcohol use patterns. The current study examined cross-country variations in drinking behaviors (weekly drinking and binge drinking), and the extent to which these variations were associated with containment measures implemented during the first wave of the COVID-19 pandemic. Data were obtained from the COVID-19 International Student Well-being Study, covering students in 25 middle- and upper-high income countries. Data on government responses were retrieved from the Oxford COVID-19 Government Response Tracker. Multilevel multinomial logistic regression analyses were performed on weekly drinking (n = 44,212) and binge drinking (n = 32,785). Considerable cross-country variation existed for weekly drinking and binge drinking. In the majority of countries, a self-reported decrease in weekly drinking and a substantial self-reported decrease in binge drinking were observed. Closings of schools were associated with decreases in weekly drinking, while limitations on social gatherings were associated with increases in weekly drinking. The stringency index was associated with reporting decreased binge drinking. The study findings demonstrate a number of small yet significant associations between containment measures and changes in student drinking behaviors. Future studies are required to uncover why some students increased their alcohol consumption, particularly in countries with stricter limitations on social gatherings.

Evaluation of curricular mindfulness micro-interventions to support college student resilience: a pilot study

Objective: This study addressed two research questions: (1) What is the feasibility of embedding curricular resilience micro-interventions across campus at a small university? (2) How do students and faculty describe their experiences of participating in resilience micro-interventions? Participants: 12 faculty, 267 students. Methods: Mixed-methods, quasi-experimental design. Faculty were randomly assigned to either implement curricular micro-interventions (the experimental group) or not (the control group). Student participants completed three surveys: pre-, mid-, and post-test. Six experimental group faculty completed a post-study focus group. Results: Qualitative data indicated micro-interventions are feasible to implement (RQ1), and students responded well and perceived a positive impact on their lives (RQ2). Conclusions: Resilience micro-interventions are feasible to implement in the classroom and show promise for supporting student resilience and well-being. Future research directions include studying their long-term impact, scalability, and effectiveness in diverse educational contexts.

How Do University Students Navigate Distress? An Examination of Determinants, Coping Strategies, and Support Systems Through the Lens of Self-Determination Theory

Entrance to university is marked by significant changes and challenges that can impact mental health and well-being. This study investigated the determinants of psychological distress, coping strategies used, and the availability of support systems among university students in a non-Western country through the lenses of self-determination theory. The thematic analysis of 16 in-depth interviews revealed several academic, socio-demographic, and situational factors crucial in facilitating or impeding university students' sense of self-determination and, consequently, their psychological distress. The study uncovered students' relative preference for avoidance coping mechanisms, the limited presence of perceived formal support systems in higher education institutions, and a clear reliance of students on informal sources of support to buffer the effects of distress. Moreover, it was evident that students perceived their higher education settings as leaning toward being controlling rather than autonomy-supportive. Implications for promoting well-being among university students are discussed.

A systematic review of first-generation college students' mental health

Objective: To synthesize peer-reviewed research on first-generation college students' mental health. Methods: Systematic searches were conducted in 4 databases through 2022 to identify empirical, peer-reviewed, and published articles on first-generation college student anxiety, depression, stress and mental health. Results: Across 62 papers, first-generation college students appeared to experience heightened anxiety, depression and stress when academic activities and social relationships conflicted rather than aligned with interdependent norms. Importantly however, when these negative mental health outcomes were measured generally - without reference to a specific domain (i.e., academic or social) - nearly all papers found no significant differences between first- and continuing-generation students. Conclusions: The findings further emphasized the need for understanding mental health within specific contexts.

Changes in physical activity, diet, sleep, and mental well-being when starting university: A qualitative exploration of Australian student experiences

Objective: To explore young adult's experiences of how starting university influenced their physical activity, diet, sleep, and mental well-being, and barriers and enablers to health behavior change. Participants: University students aged 18-25 years. Methods: Three focus groups were conducted in November 2019. Inductive thematic approach was utilized to identify themes. Results: Students (female: n = 13, male: n = 2, other gender identity: n = 1, 21.2 (1.6) years) reported mental well-being, physical activity levels, diet quality and sleep health were negatively affected. Stress, study demands, university timetabling, not prioritizing physical activity, cost and availability of healthy foods, and difficulty falling asleep were key barriers. Health behavior change interventions aiming to support mental well-being need to include both information and support features. Conclusions: There is a significant opportunity to improve the transition to university for young adults. Findings highlight areas to target in future interventions to improve physical activity, diet, and sleep of university students.

Psychological distress among students in Egypt and Jordan during the initial months of the Gaza war

BACKGROUND

Psychological distress has significantly impacted students in Egypt and Jordan. These countries have faced many challenges, including the COVID-19 pandemic, the fallout from the conflict in Syria, and the war in Ukraine. These crises have had far-reaching consequences, affecting the economy, food security, and energy supplies, particularly with the increased number of refugees in these countries. Amid these existing complexities, the ongoing war in Gaza further exacerbates the situation, compounding mental health challenges. Therefore, this study aimed to analyze how the war in Gaza impacted the mental health of students in Egypt and Jordan.

METHODS

We conducted a cross-sectional study involving students from Egypt and Jordan between December 2023 and January 2024. The questionnaire incorporated the Brief Symptom Inventory 18 (BSI-18) to assess the overall general distress score, as well as the domains of anxiety, somatization, and depression.

RESULTS

A total of 1509 Jordanian and Egyptian students were included in the study, of which 66% were female. Approximately 18% of the students had an elevation (≥ 50) in their BSI-18 total score. Females scored significantly higher in general distress [30 (18-44.25) vs. 24 (11-41), p < 0.001], and all three dimensions. The univariate predictors for elevated general distress (≥ 50) were being Egyptian (OR 1.49, 95% CI 1.08 to 2.08, p = 0.014), watching social media multiple times a day (OR 3.04, 95% CI 1.97 to 4.69, p < 0.001), and having a Palestinian connection (friend, neighbor, colleague, or relative) (OR 1.63, 95% CI 1.23 to 2.16, p < 0.001). These three predictors were retained in the backward stepwise multivariate regression analysis model. The univariate predictors for moderate and marked general distress (≥ 57) were watching social media multiple times a day (OR 3.26, 95% CI 1.78 to 5.99, p < 0.001) and having a Palestinian connection (OR 1.49, 95% CI 1.05 to 2.14, p = 0.026). Only the former was retained in the backward stepwise multivariate regression analysis.

CONCLUSION

General distress has increased among students in Egypt and Jordan throughout the War in Gaza. Mental, psychological, and social support activities are necessary for these students, particularly those watching social media multiple times daily. The development of coping skills to manage the additional stressors of war and socioeconomic status necessitates further research within this group of students.

Sociodemographic, economic, and academic factors linked with resilience in university students during covid-19 pandemic: a Brazilian cross-sectional study

BACKGROUND

Resilience is a crucial factor in students' mental health, playing an important role in their successful adaptation to the academic environment. However, there is a lack of understanding about resilience and its associated factors in students from different undergraduate courses. This study aimed to describe the resilience profile of undergraduate students from various courses in Brazil and identify sociodemographic, economic, and academic factors associated with resilience.

METHODS

This study has data from a cross-sectional multicenter study involving undergraduate students from eight Federal Institutions of Higher Education in Minas Gerais, Brazil. The dependent variable was resilience, measured using the Connor-Davidson Resilience Scale (CD-RISC) 10-item version, with sociodemographic, economic, and academic factors considered independent variables. Data was collected virtually via a self-administered questionnaire between October 2021 and February 2022 (during the covid-19 pandemic). Independent samples t-tests and ANOVAs were conducted to compare resilience scores between independent variables, and Tukey's post-hoc test was performed when necessary. Multiple linear regression was performed to create three models.

RESULTS

8,650 undergraduate students were included in this study. The average score on the resilience scale was 19.86 ± 8.15, with a normal distribution. The respondents ranged from 18 to 71 years old, averaging 23.9 ± 6.33. Being female, not having a religious belief, having low per capita family income, having had a decrease in the family income, not being heterosexual, or having the head of the family with a low education level were the main factors associated, individually, with low resilience scores in the sociodemographic and economic multiple linear regression model constructed. Being from linguistics, letters and arts courses, being enrolled in fewer subjects, or being from UFMG were the main factors associated, individually, with low resilience scores in the academic multiple linear regression model constructed.

CONCLUSIONS

The study's findings revealed that sociodemographic, economic, and academic variables were significantly associated with resilience scores in undergraduates from Minas Gerais during the covid-19 pandemic. These findings can help universities develop target strategies to promote students' resilience and reduce the risk of poor mental health among this population.

Mental Health Among First-Year Students Transitioning to University in Australia: A Longitudinal Study

Objectives: Young people attending university for the first time may be at heightened risk of experiencing mental health problems. However, limited research has examined the mental health experiences of this cohort using longitudinal methods. This study aimed to examine mental health symptoms prior to commencing university, estimate changes in symptoms over the course of the first semester of study, and identify factors associated with initial symptom levels and changes. Methods: Australian first-year undergraduate students (N = 340) were recruited via social media and participated in a four-wave online longitudinal study conducted between February and June 2021. Symptoms of depression, anxiety, and psychological distress were assessed at each wave, along with psychosocial and lifestyle factors. Demographic characteristics were assessed at baseline. Results: Latent growth curve models indicated no significant linear change over time for depression (p = .26) or anxiety (p = .83) symptoms. However, a significant effect of time was observed for psychological distress (p = .03), indicating higher distress levels at wave 3 compared to baseline (p = .004). Financial stress, pressure to succeed, difficulty coping, greater loneliness, and more negative social interactions were each significantly associated with higher baseline depression, anxiety, and distress scores. Only greater loneliness and more negative social interactions were found to be associated with a greater increase in depression over time. Conclusion: The findings indicate that transition to university was not generally associated with an increase in poor mental health. However, several factors were associated with poorer mental health immediately prior to university commencement. Assisting students to manage financial distress, facilitating the development of social connections among students with limited social networks and skills training targeting coping and the development of realistic academic expectations may help support student mental health and promote improved wellbeing during transition to university.

Mental distress and associated factors among undergraduate students: evidence from a cross-sectional study at the University of Dodoma, Tanzania

Mental distress is a common health problem facing university students worldwide. It manifests with varying levels of depression, anxiety, and somatic symptoms such as headache, backache, sleeping problems, and fatigue. University students are a high-risk group for mental distress than the general population. This study aimed to assess knowledge, the prevalence of mental distress, and its associated factors among undergraduate students. A cross-sectional study was conducted among undergraduate students at the University of Dodoma in Tanzania. Data were collected using pre-tested and self-administered questionnaires. Bivariate and multivariable logistic regression models were used to identify factors associated with mental distress. A total of 224 undergraduate students gave a complete response, of which the majority were aware of the common symptoms of mental distress. Self-reported mental distress experience was reported among 116/224 (51.8%) students. Multivariable logistic analysis showed that only alcohol consumption (aPR = 1.61, 95% CI 1.22-2.11, p = 0.001) was independently associated with mental distress among students. The findings of this study revealed that undergraduate students had adequate knowledge of the symptoms of mental distress. Our results show that the prevalence of self-reported mental distress was moderately high among undergraduate students. Furthermore, the study indicates a significant association between alcohol consumption and self-reported mental distress among these students. These results suggest that interventions aimed at reducing alcohol consumption may be beneficial in mitigating mental health issues among undergraduate students in Tanzania.

The prevalence of mental health conditions and effectiveness of psychological interventions among university students in Italy: A systematic literature review

The aim of this review was to synthesize extant literature concerning the prevalence of mental health problems among Italian university students seeking psychological help in university counseling services (UCS) and the effectiveness of these interventions. A systematic search was conducted on main scientific databases following the PRISMA guidelines. Using the PICO method, the study included research on college students seeking psychological help through UCS (P), focusing on psychological interventions delivered by UCS (I), examining the prevalence of psychological problems and/or the effect of UCS intervention on symptoms of mental health issues as (primary or secondary) outcome (O). Class comparisons (C) did not apply to this study. Studies excluded consisted of non-peer-reviewed journal articles, qualitative studies, or publications that reported only descriptive or not fully relevant information. The systematic search was conducted on the PsycInfo, PsycArticles, PsycCRITIQUES, PubMed, Web of Science and Scopus databases up to December 17, 2023. The data was organized in a narrative synthesis. Finally, the review was registered on OSF (osf.io/t2y9q). Study quality was assessed using a modified Newcastle-Ottawa Scale. Thirty-six studies were found to meet the inclusion criteria for a total of 7,432 participants (5,390 female, 6,625 accessing UCS). Most studies (n = 21) had a pre-post intervention design, followed by cross-sectional (n = 12) and case-control (n = 3) designs. Data from the period between 1983 and 2022 were collected (n = 7 studies focused specifically on the COVID-19 pandemic period), primarily using self-report measures. Students attending UCS exhibited significant psychological distress (63.2-92.7 %), various psychopathological symptoms, and poor psychological functioning, including depressive symptoms (9-30 % up to 48.9 %) and anxiety symptoms (11.2-36 %). Studies (n = 21) testing the effectiveness of counseling intervention showed that treatment was helpful in improving students' mental health, regardless of the approach employed. Limitations in the examined studies' design (e.g., heterogeneity in studies outcomes and measures, small sample size, self-reported data, low methodological quality) should be addressed in future research to obtain a more comprehensive picture on the topic under investigation. The high levels of psychological problems and psychopathological symptoms found in students attending UCS support the need of mental-health promotion activities. Counseling interventions seems to be an effective first-line service for university students experiencing psychological problems.

Impact of music learning on students' psychological development with mediating role of self-efficacy and self-esteem

Professionals and academics have recently placed a greater emphasis on comprehending the elements that go into improving students' psychological wellbeing. Students frequently face major obstacles as a result of the rigorous nature of academic life, which can result in problems like tension, depression and other psychological health concerns. These complications have a long-lasting influence on their future aspirations in addition to affecting their academic achievement. This study determined the effects of music learning on students' academic performance and psychological well-being. The mediating role of self-efficacy and self-esteem are also examined in this study. The data is collected from 326 students in Chinese universities and applied structural equation modeling for empirical analysis. The findings show that music education improves the students' psychological well-being, which in turn improves their academic performance. Additionally, psychological health is a major factor in improving the academic performance. There is significant mediating impact of self-efficacy and self-esteem in relationship between mental well-being and music education. To improve students' psychological health, it is suggested that policy makers should consider the integration of music education into academic settings.

Passive sensing data predicts stress in university students: a supervised machine learning method for digital phenotyping

Introduction

University students are particularly susceptible to developing high levels of stress, which occur when environmental demands outweigh an individual's ability to cope. The growing advent of mental health smartphone apps has led to a surge in use by university students seeking ways to help them cope with stress. Use of these apps has afforded researchers the unique ability to collect extensive amounts of passive sensing data including GPS and step detection. Despite this, little is known about the relationship between passive sensing data and stress. Further, there are no established methodologies or tools to predict stress from passive sensing data in this group.

Methods

In this study, we establish a clear machine learning-based methodological pipeline for processing passive sensing data and extracting features that may be relevant in the context of mental health.

Results

We then use this methodology to determine the relationship between passive sensing data and stress in university students.

Discussion

In doing so, we offer the first proof-of-principle data for the utility of our methodological pipeline and highlight that passive sensing data can indeed digitally phenotype stress in university students.

Clinical trial registration

Australia New Zealand Clinical Trials Registry (ANZCTR), identifier ACTRN12621001223820.

Psychological distress among Canadian postsecondary students: a repeated cross-sectional analysis of the Canadian Campus Wellbeing Survey (CCWS) between spring 2020-2023

Objective: To examine trends in self-reported psychological distress among Canadian postsecondary students between 2020 and 2023. Participants and Methods: Using data collected from postsecondary students (n = 103,936) through the Canadian Campus Wellbeing Survey (CCWS), multilevel regression models were fitted to determine how distress levels, as measured by the Kessler Psychological Distress Scale, differed across six-time points of the CCWS. Results: Across the cycles, students reported high levels of distress (mean across cycles = 26.16, SD = 8.61). Considering the impact of time on distress, when compared to pre-COVID-19 pandemic, Fall 2020 (β = 1.4, p < .001), Spring 2021 (β = 1.2, p < .001), Spring 2022 (β = 1.6, p < .001), and Spring 2023 (β = 0.80, p < .017) had significantly higher levels of distress. Distress levels were associated with ancestry, age, gender, and sexual orientation. Conclusion: It is imperative to develop strategies and allocate resources to address the high levels of psychological distress among Canadian postsecondary students.

The interplay of psychological resilience and adolescent mobile phone addiction in Henan province, China: insights from latent class analysis

Background

The aim of this study was to classify distinct subgroups of adolescents based on the severity levels of their mobile phone addiction and to investigate how these groups differed in terms of their psychosocial characteristics. We surveyed a total of 2,230 adolescents using three different questionnaires to assess the severity of their mobile phone addiction, stress, anxiety, depression, psychological resilience, and personality. Latent class analysis was employed to identify the subgroups, and we utilized Receiver Operating Characteristic (ROC) curves and multinomial logistic regression for statistical analysis. All data analyses were conducted using SPSS 26.0 and Mplus 8.5.

Methods

We classified the subjects into subgroups based on their mobile phone addiction severity, and the results revealed a clear pattern with a three-class model based on the likelihood level of mobile phone addiction (p < 0.05). We examined common trends in psychosocial traits such as age, grade at school, parental education level, anxiety levels, and resilience. ROC analysis of sensitivity versus 1-specificity for various mobile phone addiction index (MPAI) scores yielded an area under the curve (AUC) of 0.893 (95% CI, 0.879 to 0.905, p < 0.001). We also determined diagnostic value indices for potential cutoff points ranging from 8 to 40. The optimal cutoff value for MPAI was found to be >14, which corresponded to the maximum Youden index (Youden index = 0.751).

Results

The latent classification process in this research confirmed the existence of three distinct mobile phone user groups. We also examined the psychosocial characteristics that varied in relation to the severity levels of addiction.

Conclusion

This study provides valuable insights into the categorization of adolescents based on the severity of mobile phone addiction and sheds light on the psychosocial characteristics associated with different addiction levels. These findings are expected to enhance our understanding of mobile phone addiction traits and stimulate further research in this area.

A cross-sectional analysis of psychological distress among higher education students in Ireland

OBJECTIVES

To examine levels of psychological distress among higher education students in Ireland overall and across a range of personal, higher education, and socioeconomic characteristics, prior to the COVID-19 pandemic.

METHODS

A cross-sectional online survey of college students in Ireland was undertaken in 2018. Data on 5201 students from 13 higher education institutions (HEIs) were analyzed. Stress, anxiety, and depression symptom scores based on the Depression, Anxiety and Stress Scale (DASS-21) were calculated and reported, with statistical testing used to compare across groups.

RESULTS

Overall, 29.6% and 19.1% of respondents were classified in the mild to moderate and severe to extremely severe range for depression respectively. The corresponding proportions were 25.9% and 20.7% for anxiety, and 24.5% and 14.8% for stress. Differences across groups included higher levels of psychological distress for transgender and female students compared to males (p < 0.01), for gay/lesbian/bisexual students compared to heterosexuals (p < 0.01), for undergraduates compared to postgraduates (p < 0.01), for students from intermediate/technical/service/unskilled social classes compared to professional/self-employed social classes (p < 0.01), and for those with financial difficulties compared to those without financial difficulties (p < 0.01).

CONCLUSIONS

Rates of psychological distress were high amongst college students in Ireland prior to the COVID-19 pandemic, with substantial differences across groups. Due to study limitations, such as possible selection bias, the findings need replication. Further research is needed to determine the impact of the pandemic on the prevalence of mental illness in this population.

Effects of a mindfulness-based program on the occupational balance and mental health of university students. Protocol for a randomized controlled trial

OBJECTIVE

The aim is to examine whether the addition of Virtual Reality (VR) meditation training to a standard 8-week Mindfulness-Based Health Care Program (MBHC-VR) results in a significantly increased improvement in occupational, mental health, and psychological functioning versus MBHC-only in university students.

MATERIALS AND METHODS

A randomized controlled clinical trial with three arms (MBHC, MBHC-VR, Control Group), four assessment time points (pre-intervention, inter-session, post-intervention, and 3-month follow-up), and mixed methodology will be proposed. University students (undergraduate, master, or doctoral) interested in participating and who meet the inclusion/exclusion criteria will be included over two years. Data will be collected from different ad hoc questionnaires, several standardized tests, and an Ecological Momentary Assessment. We will use R software to carry out descriptive analyses (univariate and bivariate), multilevel modeling, and structural equation models to respond to the proposed objective. The qualitative analysis will be carried out using the MAXQDA program and the technique of focus groups.

DISCUSSION

It is expected that with the proposed intervention university students will learn to relate in a healthier way with their mental processes, so as to improve their occupational balance (OB) and their psychological well-being.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier NCT05929430.

Emotional Exhaustion Scale (ECE): Psychometric Properties in a Sample of Portuguese University Students

Academic emotional exhaustion is the first stage of academic burnout syndrome, and it is necessary to assess it and intervene early, as the consequences can lead to harmful effects on psychological well-being. The main objectives of this study were to explore the psychometric properties of the Emotional Exhaustion Scale (ECE); to assess the association with suffering and positive well-being, using the MHI-5 Inventory; and to provide information on its validity and to compare it with these constructs. A total sample of 526 university students (81% female and 19% male) aged between 17 and 62 (M = 21.42 years and SD = 5.78) took part in this study. Exploratory and confirmatory factor analyses were carried out. In the internal consistency assessment, the ECE was 0.89 and the MHI-5 was 0.81 (Cronbach's alpha). Exploratory factor analysis was carried out with Varimax rotation and confirmatory analysis, obtaining the factor that explains 50.5% of the variance. The results indicated that the ECE has adequate psychometric properties for use with higher education students in Portugal. Its use by mental health professionals in higher education institutions could be very relevant for screening for emotional exhaustion and thus preventing possible serious pathologies.

Are health behaviors associated with academic performance among tertiary education students? A systematic review of cohort studies

OBJECTIVE

To evaluate the association between health behaviors with academic performance among tertiary education students.

METHODS

Six databases were searched until July 2020 for prospective cohort studies evaluating the association between health behavior(s) (dietary intake, physical activity, sedentary behavior, alcohol intake, sleep, smoking or illicit drug use) and academic performance.

RESULTS

Thirty-four studies were included (18 assessed sleep, 16 alcohol intake, 12 illicit drug use, 10 physical activity, 8 diet, 4 smoking, 2 sedentary behavior). A consistent negative association with academic performance was demonstrated for sleep (12/18 studies), alcohol intake (13/16) and illicit drug use (9/12). Most (7/10) studies found no association between physical activity and academic performance.

CONCLUSION

Findings suggest interventions to mitigate the influence of poor sleep, high alcohol intake, and illicit drug use on academic performance may be needed. Further research of other health behaviors, along with their co-occurrence, with academic performance, is required.

Academic stress, mindfulness-related skills and mental health in international university students

This study investigated the relationships between academic stress, mindfulness-related constructs (ie, mindfulness, self-compassion and psychological flexibility) and anxiety and depressive symptoms in a sample of 190 international university students. Participants filled in an online questionnaire. Multiple Regression Analyses showed that anxiety and depressive symptoms were significantly related to higher levels of perceived academic stress, and to lower levels of acting with (mindful) awareness, lower self-compassion and lower psychological flexibility. None of the mindfulness-related constructs was found to moderate the relationship between perceived academic stress and anxiety and depressive symptoms. The results provide possible targets for mental health interventions in international university students. Especially the training of mindfulness-related skills could be a promising path.

Self-Reported Mood and Lifestyle-Related Physical Activity of Young Adults With Major Depressive Disorder

We investigated whether mood and lifestyle-related indicators of physical health are differentially expressed according to self-reported levels of depressive symptoms among young adults with a current episode of major depression. In a cross-sectional study, we recruited 94 young adults (females = 67, 71.3%; males = 27, 28.7%; aged 18-35 years) with a current episode of major depression. We assessed their mood with the Profile of Mood States (POMS), and Beck Anxiety Inventory-(BAI), sleep with the Pittsburgh Sleep Quality Index (PSQI), physical activity with the Simple Physical Activity Questionnaire (SIMPAQ), and their cardiorespiratory fitness. Participants' depression levels were classified as follows using established cut-points: (a) Mild Depressive Symptoms (MIDS, BDI-II 14-19 points, n = 17), (b) Moderate Depressive Symptoms (MODS, BDI-II 20-28 points, n = 37) or (c) Severe Depressive Symptoms (SEDS, BDI-II 29-63 points, n = 40). As expected, we found that young adults with SEDS, when compared to those with MODS and MIDS, showed higher depressive mood on the POMS, and they exhibited greater anxiety symptoms, lower reported 'vigor' on physical activity measures, worse sleep quality as expressed by their global score sleep; daytime dysfunction; and sleep disturbance, and they showed lower cardiorespiratory fitness. Those with moderate depressive symptoms only differed from those with mild symptoms with respect to hostility, fatigue and mood disturbance. Although there was a gradient whereby worse mental and physical health indicators were more closely related to the SEDS depression categorization, while healthier indicators were associated with the MIDS category, some parameters were not different between the MDD severity groups, particularly when comparing MIDS and MODS. Clinicians treating patients with MDD should consider these factors when designing lifestyle-based interventions.

Is the Association Between Alcohol Consumption and Mental Well-Being in University Students Linear, Curvilinear or Absent?

Background: Both alcohol consumption and mental well-being problems have been found to be prevalent in higher educated students and often have severe consequences. However, previous findings of the association between these constructs are mixed, possibly because often linear models are fitted, while some theories suggest a curvilinear association between the two concepts. Objectives: To clarify previously mixed findings, the current study compared curvilinear and linear models for the relationship between alcohol consumption and mental well-being in university students. Because of potential gender differences in this relationship, these models were explored for females and males separately. Data from the first cross-sectional online survey wave of the Healthy Student Life project including 2,631 female and 998 male students was used. The Alcohol Use Disorders Identification Test-consumption was used to measure alcohol consumption. Mental well-being was assessed by six sub-concepts (i.e., depressive symptoms, anxiety, stress, life satisfaction, happiness, and self-rated mental health). Results: For females both linear (for anxiety, life satisfaction, and self-rated mental health) and curvilinear (for depression, stress, and happiness) associations were found, while for males no support for either curvilinear or linear models was found. Conclusions: Results should be interpreted with caution due to the small effect sizes in the relationships for females but may suggest that testing the curvilinear association between alcohol consumption and mental well-being is an important future endeavor.

Physical activity habits prevent psychological distress in female academic students: The multiple mediating role of physical and psychosocial parameters

Background

Psychological distress is recognised as the most common mental health difficulty in emerging adult (18-to-24-year-old) female academic students. This study aimed to test a novel model positing physical activity habits as a protective factor for psychological distress through the mediating role of physical and psychological parameters. Adherence to the Mediterranean diet and self-reported physical health status were included as physical parameters. Self-reported psychological health status and time spent on leisure activities were the psychological parameters considered.

Method

Data were collected between April and May 2021. Correlation analyses and a multiple mediation model were computed on 411 online questionnaires filled out by 18-to-24-year-old female students from the University of blind (Italy).

Results

The multiple indirect effects were significant (β = -0.088; p < 0.001). This means that physical activity habits reduce psychological distress through high adherence to the Mediterranean diet, a good self-assessment of one's physical and psychological health status, and more time spent on leisure activities outdoors, with friends, and with family members.

Conclusions

Results show that academic policies should be adopted so as to design physical activity programmes that may improve the students' healthy behaviours and social interactions, which, in turn, mitigate the detrimental effects of psychological distress.

Exercise Prescription Practices Among Mental Health Professionals on College Campuses: Testing the Information-Motivation-Behavioral Skills Model

BACKGROUND

The co-occurrence of physical inactivity and poor mental health in the college student population can lead to chronic health issues that have negative short-term effects (e.g., academic success). Poor mental health is associated with long-term conditions (e.g., obesity, serious mental illness) that are linked to premature mortality. The purpose of this study was to examine the information-motivation-behavioral (IMB) skills model and evaluate its ability to explain the variance in the use of exercise prescription in mental health treatment.

METHOD

Mental health professionals (MHPs) (n = 255) were recruited from college counseling centers in the USA. Structural equation modeling was used to examine the relationship between the predictor variables of information (exercise knowledge and benefits of exercise), motivation (personal beliefs, perceived barriers, and organizational support), and behavioral skills (self-efficacy), and the outcome variable of exercise prescription (i.e., brief counseling and referral for exercise).

RESULTS

The predictors accounted for 23% of the variance in exercise prescription (p = .001). Organizational support had a significant direct effect on exercise prescription (β = 0.27, p = .05). Personal beliefs (β = 0.96, p = .05) and organizational support (β = 0.31, p = .04) had significant direct effects on self-efficacy for prescribing exercise. MHP personal exercise behavior was associated with exercise prescription.

CONCLUSION

MHPs may be willing to support physical activity promotion and exercise prescription, but organizational structures are critical to enhance and sustain the delivery of this adjunctive therapy. The personal exercise history of MHPs may be an important consideration for behavior change interventions. The development and validation of scales are important considerations for future intervention study design.

A Quasi-Experimental Study Investigating the Impact of a Lifestyle Redesign Program on the Well-Being of Korean University Students

Background

Korean university students (KUS) face numerous challenges that can jeopardize their well-being, including academic stress, peer pressure, irregular sleep patterns, unhealthy eating habits, lack of physical exercise, and difficulties in time management, resulting in unhealthy habits and fluctuations in lifestyle. Consequently, there is a growing need for interventions tailored to this population.

Aim

This study explored the effects of a Lifestyle Redesign (LR) intervention on Korean university students' well-being including occupational participation, satisfaction, perceived stress levels, and quality of life.

Method

A quasi-experimental study with 33 KUS (17 intervention, 16 control) assessed the effects of a 10-week LR intervention on well-being of the students. Pre- and postintervention changes were measured using Canadian Occupational Performance Measure (COPM), Stress Response Inventory (SRI), and World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF). The intervention, delivered by trained OTs, comprised of individual and group sessions.

Results

Statistically significant improvement was observed in occupational performance. While statistical significance was not consistently achieved in the rest of other areas, the LR group displayed positive trends. The LR group exhibited higher COPM satisfaction scores, lower SRI scores (indicating reduced stress), and elevated WHOQOL-BREF scores compared to the control group.

Conclusion

This study contributes to the understanding of the importance of addressing lifestyle changes and habits in the well-being of university students, especially in the context of academic stress and peer pressure. Future research with larger, more diverse samples and extended intervention periods may offer further insights into the benefits of LR programs in university settings.

Effects of Physical Activity and COVID-19 on Healthy Student Strengths in the University System: Implications for Post-Pandemic Management

The COVID-19 pandemic has profoundly affected the physical, mental, and social well-being of millions worldwide. It has also brought about abrupt disruptions to the entire university system, whose students form a crucial segment of society. The pandemic's effects on student education and well-being have been particularly significant. One of the primary consequences has been a drastic reduction in physical activity levels among students, leading to mental and physical health problems. Despite the rapid growth in the literature exploring student experiences during the pandemic, there is a paucity of research on how this decline in physical activity has affected the five strengths of the healthy student: optimism, self-efficacy, resilience, engagement, and hope. Therefore, the aim of this investigation is to examine the relationship between physical activity levels and the five strengths of the healthy student at two different time points (pre-COVID-19 and COVID-19) through the International Physical Activity Questionnaire (IPAQ) and the Healthy Student Questionnaire. The study involved 897 participants, with 290 participating in the pre-COVID-19 phase and 607 participating in the COVID-19 phase. The results revealed significant differences in the five strengths between the two periods. Students who engaged in physical activity exhibited significantly higher optimism scores in the pre-COVID-19 phase. During the COVID-19 phase, physically active students demonstrated significantly higher scores in optimism, resilience, and self-efficacy. These findings provide clear guidance for university administrators seeking to enhance student well-being in a post-pandemic world and in the face of future disruptions. Universities should consider implementing physical exercise programs for their students to promote psychosocial well-being and provide training and resources to equip faculty members with new skills to better understand and support students' perceptions.

The role of physical literacy and mindfulness on health-related quality of life among college students during the COVID-19 pandemic

This study aimed to examine the role played by the physical literacy and mindfulness in the health-related quality of life (QoL) of college students. In early 2022, 24,236 college students from three universities in southern China were recruited in the study. R software and the lavvan package was utilized to build the structural equation model. The measurement model was composed of three latent factors (physical literacy, mindfulness, and quality of life) and 16 observed variables in total. The results of the measurement model indicated goodness fit with p > .05 in Chi-square result, and GFI = .92. In addition, the comparative fit index (.92), Tucker-Lewis index (.91), root-mean-square error of approximation (.07), and root of mean square residual (.11) were in accord with the cutoff model-fit criteria. The results confirm that physical literacy and mindfulness can play a significant and positive role in the structural equation model of quality of life. In addition, this study provides initial evidence that mindfulness and physical literacy could potentially buffer declines in student QoL during the COVID-19 pandemic. Moreover, this study is the first to develop a structural equation model of QoL with multiple indicators, making it a strong addition to existing research on QoL during a pandemic.

A motivational approach to understanding problematic smartphone use and negative outcomes in university students

Considering the rising integration of smartphones into classrooms, the purpose of this research was to explore the relationship between problematic smartphone use (PSU) and negative outcomes through the lens of self-determination theory. This study examined 1,039 students' reported academic motivation, PSU, anxiety, insomnia, and perceived stress. The first objective of this study was to examine how motivational orientations could predict PSU. Then, we examined how motivational orientations and PSU, when used as a mediating variable, could be modeled to predict negative student mental health outcomes (anxiety, insomnia, and perceived stress). As predicted, statistically significant results suggested that autonomous academic motivation was associated with less PSU (β = -0.16), as well as less anxiety (β = -0.12), insomnia (β = -0.16), and stress (β = -0.10). In contrast, higher levels of controlled academic motivation were associated with more PSU (β = 0.37), as well as higher levels of anxiety (β = 0.49) and insomnia (β = 0.41). Amotivation was also positively related to PSU (β = 0.17), anxiety (β = 0.36), insomnia (β = 0.62), and stress (β = 0.22). All indirect effects (mediation effects) were statistically significant and in the predicted direction: the impact of autonomous motivation on negative outcomes was mediated by lower levels of PSU while controlled motivation and amotivation were mediated by higher levels of PSU. Overall, this study advanced the understanding of PSU in university classrooms by demonstrating a link with academic motivation and mental health outcomes.

Experiential learning spaces and student wellbeing: a mixed-methods study of students at three research intensive UK universities

There is clear evidence that university students are experiencing significant mental health difficulties, further exacerbated by the temporary closure of university campuses during the height of the COVID-19 pandemic. Against this backdrop, our study - Student Wellbeing and Experiential Learning Spaces (SWELS) - explored the role of experiential learning spaces in supporting student wellbeing. We adopted a mixed-methods approach, consisting of an online survey and interviews with students from three research intensive UK Universities. The survey results revealed that compared to the national average of 16-25-year-olds from the UK Office for National Statistics' (ONS) wellbeing questionnaire, the sampled students exhibited significantly lower levels of life satisfaction, happiness, perceived worthwhileness and higher levels of anxiety. The qualitative results further confirmed that students perceived their wellbeing to be affected by their university experience and the COVID pandemic. However, the results also suggest that experiential learning spaces (such as museums, collections, libraries, and gardens) hold strong potential to support student mental health. Accordingly, the study indicates that diversifying module content and conscientiously considering both physical and digital learning spaces can positively impact students. In short, curricula that are cognisant of the physical learning environment and embed a focus on wellbeing into their content might help to bolster student wellbeing.

Mental health and adherence to Mediterranean diet among university students: an Italian cross-sectional study

OBJECTIVE

This study is aimed to explore severe mental illness (SMI), mental well-being (MWB), and Mediterranean Diet adherence (MedDiet) among university students.

PARTICIPANTS

University students in Northern Italy (sample size = 502).

METHODS

Cross-sectional survey was conducted in 2019. The questionnaires included Warwick-Edinburgh Mental Well-Being Scale for MWB, K6 for SMI, Mediterranean Diet Adherence Screener for MedDiet. Multivariable regressions were mainly performed (p < .05 as significant).

RESULTS

MWB was high in 3.93% of the participants and low in 23.97%. SMI was probable in 21.87%. MedDiet adherence was high in 2.19% and low in 35.06%. Mainly, poor/very poor perceived health, Economics/Legal/Strategic Sciences courses, and not being on time with exams showed associations with both lower MWB and probable SMI. Gender and some lifestyle, dietary, and university factors predicted MedDiet. MWB and MedDiet were positively associated.

CONCLUSIONS

This study found high levels of mental issues and low MedDiet. Modifiable factors at university level should be investigated to design preventive interventions.

Relationship Between Freshmen's Psychological Health and Family Economic Status in Chinese Universities: A Latent Profile Analysis

Purpose

With the rapid social changes, psychological health problems among freshmen in universities have become increasingly serious. Many researchers have studied the psychological health status of college freshmen using quantitative methods. However, most researchers have studied the psychological health of college freshmen by treating variables as the central concept and analysis unit, which has limitations on the variable-centered research method. Therefore, this study aims to explore the impact of family economic status and demographic variables on the psychological health of college freshmen, as well as the potential types of psychological health among college freshmen.

Methods

Based on the SCL-90 and the self-evaluation of the family economic status of college freshmen, latent profile analysis (LPA) was used to analyze the psychological health of 1497 college freshmen selected through a whole-group sampling method. Freshmen completed the questionnaire from October 18 to October 20, 2022. Then, multinomial logistic regression analysis and variance analysis were conducted using SPSS 25.0 to analyze the impact of family economic status and demographic variables on different psychological health subtypes of college freshmen from a university in Eastern China.

Results

There is obvious heterogeneity in the psychological health of college freshmen, which can be divided into three groups: psychological health group (69.54%), psychological distress group (24.65%), and psychological risk group (5.81%). The latent categories of psychological health among college freshmen differ by gender and family economic status. The psychological health status of female students is significantly better than that of male students. In addition, the lower the self-evaluation of family economic status of college freshmen, the lower their psychological health level.

Conclusion

Three categories of mental health exist for college freshmen, with significant group heterogeneity. Gender and family economic status significantly influenced mental health outcomes with female students faring better. The study's significance lies in providing useful recommendations for educational administrators and developing targeted interventions for college freshmen. Given the practical realities of mental health education efforts, personalized strategies that utilize peer support, counseling, and psychological services can be adopted to assist freshmen in acclimating to university life and maintaining mental wellness. The findings suggest considering the role of family economic status and gender in promoting mental health and the need for further research to develop comprehensive and effective interventions.

Effectiveness of attachment-based compassion therapy to reduce psychological distress in university students: a randomised controlled trial protocol

Introduction

Higher education, particularly university, is a challenge for many students that can lead to their mental health being seriously affected. The stress to which they are subject throughout their time at university can lead to anxiety and depression. "Third wave" psychotherapies, including compassion-based therapy, have been used to improve psychological outcomes, such as stress, anxiety, emotional distress and well-being. There are some signs that third wave psychotherapies reduce psychological distress in university students, but more and higher-quality studies are needed. In this randomised controlled trial (RCT), we hypothesise that the provision of attachment-based compassion therapy (ABCT) will be more effective than an active control group based on relaxation therapy for improving psychological distress in university students.

Methods and analysis

A two-arm RCT will be conducted involving 140 university undergraduate and postgraduate students from the University of Zaragoza and the National University of Distance Education (UNED) who reside in the autonomous community of Aragon, Spain. Interventions with either ABCT or relaxation therapy will be implemented, with an allocation ratio of 1:1 between groups. Both interventions will last six weeks and consist of six weekly group sessions lasting 1.5 h each. Data will be collected before and after the intervention, and there will be a follow-up at six months. The primary outcome will be psychological distress at post-intervention. Secondary outcomes will be depression, anxiety, stress and burnout symptoms, affectivity and emotional regulation. Attachment style, experiential avoidance, compassion (for others/oneself) and mindfulness skills will be measured as potential mechanistic variables. Intention-to-treat analysis will be performed using linear mixed regression models. The clinical significance of improvements will be calculated. Potential side effects will be monitored by an independent clinical psychologist.

Ethics and dissemination

This study was approved by the Clinical Research Ethics Committee of Aragón. Participant data will remain anonymous, and results will be submitted to peer-reviewed open-access journals and disseminated via conferences.

Clinical Trial Registration

ClinicalTrials.gov, identifier NCT05197595.

Investigating Relationships Among Self-Efficacy, Mood, and Anxiety Using Digital Technologies: Randomized Controlled Trial

BACKGROUND

Digital tools assessing momentary parameters and offering interventions in people's daily lives play an increasingly important role in mental health research and treatment. Ecological momentary assessment (EMA) makes it possible to assess transient mental health states and their parameters. Ecological momentary interventions (EMIs) offer mental health interventions that fit well into individuals' daily lives and routines. Self-efficacy is a transdiagnostic construct that is commonly associated with positive mental health outcomes.

OBJECTIVE

The aim of our study assessing mood, specific self-efficacy, and other parameters using EMA was 2-fold. First, we wanted to determine the effects of daily assessed moods and dissatisfaction with social contacts as well as the effects of baseline variables, such as depression, on specific self-efficacy in the training group (TG). Second, we aimed to explore which variables influenced both groups' positive and negative moods during the 7-day study period.

METHODS

In this randomized controlled trial, we applied digital self-efficacy training (EMI) to 93 university students with elevated self-reported stress levels and daily collected different parameters, such as mood, dissatisfaction with social contacts, and specific self-efficacy, using EMA. Participants were randomized to either the TG, where they completed the self-efficacy training combined with EMA, or the control group, where they completed EMA only.

RESULTS

In total, 93 university students participated in the trial. Positive momentary mood was associated with higher specific self-efficacy in the evening of the same day (b=0.15, SE 0.05, P=.005). Higher self-efficacy at baseline was associated with reduced negative mood during study participation (b=-0.61, SE 0.30, P=.04), while we could not determine an effect on positive mood. Baseline depression severity was significantly associated with lower specific self-efficacy over the week of the training (b=-0.92, SE 0.35, P=.004). Associations between higher baseline anxiety with higher mean negative mood (state anxiety: b=0.78, SE 0.38, P=.04; trait anxiety: b=0.73, SE 0.33, P=.03) and lower mean positive mood (b=-0.64, SE 0.28, P=.02) during study participation were found. Emotional flexibility was significantly enhanced in the TG. Additionally, dissatisfaction with social contacts was associated with both a decreased positive mood (b=-0.56, SE 0.15, P<.001) and an increased negative mood (b=0.45, SE 0.12, P<.001).

CONCLUSIONS

This study showed several significant associations between mood and self-efficacy as well as those between mood and anxiety in students with elevated stress levels, for example, suggesting that improving mood in people with low mood could enhance the effects of digital self-efficacy training. In addition, engaging in 1-week self-efficacy training was associated with increased emotional flexibility. Future work is needed to replicate and investigate the training's effects in other groups and settings.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05617248; https://clinicaltrials.gov/study/NCT05617248.

A 2-year follow-up of the effects of combined binge drinking and cannabis consumption on academic performance and adjustment in Spanish third-year university students

Introduction

The study was based on 2-year follow-up of the effects of binge drinking and cannabis co-consumption on academic performance and adjustment in Spanish Third-Year University Students and to further explore the impact of academic adjustment on this relationship.

Methods

A total of 144 students (aged 19-20 years) enrolled in the third year of university completed the study. The students were recruited during in first academic year (T1) via a survey that included items regarding the use of alcohol (AUDIT-C), cannabis and other drugs and demographic variables. Then, participants meeting the study criteria were then selected and invited by e-mail to a clinical (face-to face) structured interview. The participants completed a calendar of alcohol consumption during the 6 months prior to the interview (Alcohol Timeline Follow back), and recorded cannabis consumption in 3 months prior to the interview. To examine the effects of alcohol and cannabis co-consumption on the outcome variables, we categorized participants into three consumption groups (i.e., control, BD, and BDCA) based on the number of BD days and cannabis unit scores.

Results

Binge drinking and cannabis co-consumption in first-year students was significantly associated with poor academic performance and adjustment after 2 years of undergraduate study. Relative to controls, co-consumers (BDCA) reported significantly lower academic and personal-emotional adjustment to university as well as poorer performance. Mediation analysis showed that academic adjustment explains the mechanism by which BDCAs perform less well, mediating the relationship between co-consumption and academic performance, with an indirect effect representing 64.61% of the total effect. Furthermore, the mediating effect of academic adjustment was maintained after controlling for academic adjustment and baseline grade point average (T1).

Conclusion

This prospective follow-up study helps to further our knowledge of how combined binge drinking and cannabis consumption may affect university adjustment and academic success in Spanish university students Overall, the study results should encourage health professionals, educational psychologists and academic institutions to take ownership of the need for support and involvement in prevention, as well as for provision of guidelines for implementing appropriate intervention strategies.

Post-Traumatic Stress Disorder and Mental Health in Chinese College Athletes during and after the COVID-19 Pandemic: The Multiple Mediating Effects of Basic Psychological Needs and Generalized Anxiety Disorder

Psychological issues have a complex and multidimensional impact on a college athlete's training and performance. As the reserve talent of competitive sports, it is very important to investigate the psychological health of athletes. This study aims to explore the association between generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), basic psychological needs (BPN), and mental health (MH) among Chinese college athletes. Chinese college athletes who were willing to participate in the study, had participated in national competitions, and had a Chinese athlete rating certificate were included in this study. Participants completed the Kessler Psychological Distress Scale (K10), the Generalized Anxiety Disorder Scale (GAD-7), the Impact of Event Scale-Revised (IES-R), and the Basic Needs Satisfaction in General Scale (BNSG-S). The study involved 665 college athletes (415 males and 250 females), with an average age of 20.43 years (SD = 1.68). We performed descriptive statistics, correlation analyses, and moderated chain mediation analyses using SPSS 22.0 and Hayes' PROCESS macro. The results of the final model showed that basic psychological needs were positively correlated with mental health (r = 0.443, p < 0.001), while PTSD (r = -0.346, p < 0.001) and generalized anxiety disorder (r = -0.527, p < 0.001) were negatively correlated with mental health among college athletes. There were significant indirect impacts. According to the bootstrapping results, basic psychological needs and generalized anxiety disorder played a mediating role in 22.54% and 50.29% of the total effects of PTSD on mental health, respectively. Meanwhile, the chain mediating effect of basic psychological needs and generalized anxiety disorder (7.23%) was also significant. The study's findings advance our understanding of the connections between PTSD and mental health and highlight the significant roles played by basic psychological needs and generalized anxiety disorder in that link among Chinese college athletes.

Protocol for a bandit-based response adaptive trial to evaluate the effectiveness of brief self-guided digital interventions for reducing psychological distress in university students: the Vibe Up study

INTRODUCTION

Meta-analytical evidence confirms a range of interventions, including mindfulness, physical activity and sleep hygiene, can reduce psychological distress in university students. However, it is unclear which intervention is most effective. Artificial intelligence (AI)-driven adaptive trials may be an efficient method to determine what works best and for whom. The primary purpose of the study is to rank the effectiveness of mindfulness, physical activity, sleep hygiene and an active control on reducing distress, using a multiarm contextual bandit-based AI-adaptive trial method. Furthermore, the study will explore which interventions have the largest effect for students with different levels of baseline distress severity.

METHODS AND ANALYSIS

The Vibe Up study is a pragmatically oriented, decentralised AI-adaptive group sequential randomised controlled trial comparing the effectiveness of one of three brief, 2-week digital self-guided interventions (mindfulness, physical activity or sleep hygiene) or active control (ecological momentary assessment) in reducing self-reported psychological distress in Australian university students. The adaptive trial methodology involves up to 12 sequential mini-trials that allow for the optimisation of allocation ratios. The primary outcome is change in psychological distress (Depression, Anxiety and Stress Scale, 21-item version, DASS-21 total score) from preintervention to postintervention. Secondary outcomes include change in physical activity, sleep quality and mindfulness from preintervention to postintervention. Planned contrasts will compare the four groups (ie, the three intervention and control) using self-reported psychological distress at prespecified time points for interim analyses. The study aims to determine the best performing intervention, as well as ranking of other interventions.

ETHICS AND DISSEMINATION

Ethical approval was sought and obtained from the UNSW Sydney Human Research Ethics Committee (HREC A, HC200466). A trial protocol adhering to the requirements of the Guideline for Good Clinical Practice was prepared for and approved by the Sponsor, UNSW Sydney (Protocol number: HC200466_CTP).

TRIAL REGISTRATION NUMBER

ACTRN12621001223820.

Student well-being in times of COVID-19 in the Netherlands: basic psychological need satisfaction and frustration within the academic learning environment

The COVID-19 pandemic affected student well-being through measures such as closing educational institutions and social distancing, which forced universities to adapt the student learning environment. Previous research has demonstrated that the learning environment influences student well-being by satisfying their basic psychological needs of autonomy, competence, and relatedness. The present study therefore aimed to investigate, against the background of the pandemic, (1) how the basic psychological needs related to student well-being, (2) how students perceived interaction within the academic system, and (3) how they would like the “new educational normal” to look. To address these aims, we implemented a cross-sectional survey which included both quantitative measures and qualitative open-ended questions and distributed it at a Dutch university (n = 653). To identify the predictive strength of need satisfaction and frustration, we ran multiple regressions. We found that need satisfaction and frustration were significantly related to the well-being measures, of which relatedness was only weakly related to student well-being. Moreover, students reported restricted interactions with their teachers and fellow students, leading to feelings of disconnectedness, as well as struggles to establish or maintain relationships. In contrast with the quantitative findings, students highlighted relatedness as an essential, currently lacking part of their experience. They suggested a potential hybrid learning environment with a focus on social cohesion. This study emphasizes the relevance of interpersonal connections within higher education and provides practical ideas for post-pandemic academic structures. These insights can support systemic investments of universities in student well-being and creating a healthier learning environment for the future.

The Impact of COVID-19 Confinement on Substance Use and Mental Health in Portuguese Higher Education Students

The mental health of higher education students is a constant concern, and the pandemic situation caused by COVID-19 has intensified this concern. The social measures imposed to control and minimize the disease have led, among other things, to the reconfiguration of higher education students' academic life habits, which has naturally altered their emotional balance, mental health, and substance abuse. This cross-sectional, descriptive, and correlational study assesses the influence of higher education students' personal characteristics on their (self-reported) use of addictive substances (alcohol, tobacco, drugs, and pharmaceutical drugs) before and during their first compulsory confinement in Portugal, as well as its relationship with mental health. An online questionnaire was applied between 15 April and 20 May 2020, to students from various study cycles of higher education institutions in one region of Portugal (northern area of Alentejo), which included the Mental Health Inventory in its reduced version (MHI-5) and questions (constructed by the authors) on personal characterization and on the use of addictive substances before and during confinement. The convenience sample included 329 mostly female health care students between the ages of 18 and 24. In our results, we found a statistically significant decrease in tobacco, alcohol, and drug use; however, there was an increase in tobacco use among older students and an increase in anxiolytic use among students with higher academic achievement and among students who exhibited more active social behavior in the period prior to confinement. Students who took anxiolytics during confinement had higher MHI-5 scores and students who used the most addictive substances during confinement had lower MHI-5 scores than the other students.

How mindfulness, self-compassion, and experiential avoidance are related to perceived stress in a sample of university students

University students constitute a population that is highly vulnerable to developing mental health problems, such as distress. The role of different variables associated with the development of states of stress has been studied in order to identify potential risk and protective factors. This study explored whether mindfulness, self-compassion, and experiential avoidance, while controlling for specific sociodemographic and academic variables, were potential significant protective or risk factors explaining perceived stress in a sample of 589 Spanish university students (81.2% female, age range 18-48 years). A hierarchical multiple regression analysis was performed using an exploratory cross-sectional design. Higher experiential avoidance, lower self-compassion, lower mindfulness, not perceiving family support, higher total study hours per week, having a partner (vs. being single), being female (vs. being male), and being older were significantly associated with higher levels of perceived stress. In conclusion, perceived stress in our sample was positively associated with experiential avoidance, which could be regarded as a potential psychological risk variable. In contrast, perceived stress was negatively correlated with self-compassion and mindfulness, which, in turn, could be seen as protective factors. Accordingly, it is concluded that programmes aimed at reducing stress and at improving well-being among university students should include experiential avoidance, self-compassion, and mindfulness as therapeutic targets.

The association between smartphone use and sleep quality, psychological distress, and loneliness among health care students and workers in Saudi Arabia

BACKGROUND

The use of smartphones among the general public and health care practitioners, in particular, is ubiquitous. The aim of this study was to investigate the relationship between smartphone addiction and sleep quality, psychological distress, and loneliness among health care students and workers in Saudi Arabia.

METHODS

This cross-sectional study used an online questionnaire to collect data on smartphone addiction, sleep quality, psychological distress, and loneliness as well as demographic information.

RESULTS

A total of 773 health care students and workers participated in the study, with an average age of 25.95 ± 8.35, and 59.6% female participants. The study found a positive significant association between smartphone addiction and psychological distress (F(1,771) = 140.8, P < 0.001) and emotional loneliness (F(1,771) = 26.70, P < 0.001). Additionally, a significant negative association between smartphone addiction and sleep quality was found (F(1,771) = 4.208, P = 0.041). However, there was no significant relationship between smartphone addiction and social loneliness (F (1,771) = 0.544, P < 0.461).

CONCLUSION

These findings suggest that smartphone addiction has a negative impact on psychological distress, sleep quality, and emotional loneliness among health care students and workers. It is important to promote strategies to reduce smartphone dependency in order to avoid the harmful consequences of smartphone addiction.

Towards a health promoting university: descriptive findings on health, wellbeing and academic performance amongst university students in Australia

BACKGROUND

Universities are increasingly recognised as institutions where health and wellbeing can be promoted to maximise academic outcomes, career transitions, and lifelong positive health behaviours. There is concern about the mental health of university students and other factors which affect academic outcomes particularly for subgroups such as international students. There are few cohort studies of the breadth of issues that can impact on mental health and academic outcomes for both local and international students. We conducted a baseline prevalence survey of students at a large Australian university covering health, academic, and social determinants of wellbeing. The purpose was to inform the university's new student health and wellbeing framework with a view to follow-up to determine predictors of mental ill-health and academic outcomes in the subsequent year. In this paper we present the baseline prevalence data and report on selected mental health and health care access issues for local and international students.

METHODS

The entire university population as of April 2019 of over 56,375 students aged 18 or above were invited to complete the online survey. Questions explored eight domains: demographic characteristics, general health and wellbeing, mental health, risk taking behaviours, psychosocial stressors, learning and academic factors, social and cultural environment, and awareness of and access to health and wellbeing services. Records of academic results were also accessed and matched with survey data for a large subset of students providing consent.

RESULTS

Fourteen thousand eight hundred eighty (26.4%) students commenced our survey and were representative of the entire student population on demographic characteristics. Three quarters were aged between 18 to 25 years and one third were international students. Eighty-five percent consented to access of their academic records. Similar proportions of local and international students experienced symptoms of a depression or anxiety disorder, however international students were less aware of and less likely to access available health services both inside and external to the university. We also reported on the prevalence of: general lifestyle factors (diet, exercise, amount of daily sleep); risk-taking behaviours (including alcohol, tobacco and other drug use; unprotected sexual activity); psychosocial stressors (financial, intimate partner violence, discrimination, academic stressors, acculturative stress); subjects failed; resilience; social supports; social media use; and health services accessed online.

CONCLUSIONS

This rigorous and comprehensive examination of the health status of local and international students in an Australian university student population establishes the prevalence of mental health issues and other psychosocial determinants of health and wellbeing, along with academic performance. This study will inform a university-wide student wellbeing framework to guide health and wellbeing promotion and is a baseline for a 12-month follow-up of the cohort in 2020 during the COVID-19 pandemic.

Developing and validating a university needs instrument to measure the psychosocial needs of university students

BACKGROUND

University students are four times more likely to experience elevated levels of psychological distress compared to their peers. The psychosocial needs of university students are associated with high psychological distress, stressful life events, and academic performance. Our study focuses on developing a measure to help universities identify these psychosocial needs.

AIMS

The study aimed to develop and validate the factor structure of the University Needs Instrument and identify the relationship between psychosocial needs, psychological distress and academic performance among university students.

SAMPLE

Undergraduate university students (N = 511) currently studying at university.

METHOD

Participants completed demographic questions, the University Needs Instrument and the Kessler-10 Psychological Distress scale. The University Needs Instrument comprises 30 items within six psychosocial factors (academic support, financial support, support from family, support from friends, practical support and emotional support), each consisting of five items.

RESULTS

Confirmatory factor analysis showed that all items significantly loaded on the six hypothesized factors. The hypothesized model was supported by the data displaying excellent model fit and psychometric properties. Our analysis determined that the UNI has strong internal consistency. The results also confirmed that university students' high levels of psychological distress and their academic performance may be affected by their psychosocial needs.

CONCLUSIONS

Our findings have provided an initial validation of the UNI to help screen and identify the psychosocial needs of university students. This scale can be used to identify the appropriate psychosocial support that can be offered to students and in turn could help reduce their psychological distress, improve their psychosocial well-being and increase academic performance.

Educational contexts that nurture students' psychological needs predict low distress and healthy lifestyle through facilitated self-control

Psychological distress and unhealthy lifestyle behaviors are highly prevalent among undergraduate students. Importantly, numerous longitudinal studies show that these phenomena rise significantly during the first months of college and remain high thereafter. However, research identifying theory-driven mechanisms to explain these phenomena is lacking. Using two complementary statistical approaches (person- and variable-centered), this study assesses basic psychological needs (BPNs) and self-control as possible explanatory factors underlying the association between student's educational experience and multiple health-related outcomes. A total of 2450 Canadian undergraduates participated in this study study involving two time points (12 months apart; NTime1 = 1783; NTime2 = 1053), of which 386 participated at both measurement occasions. First, results from person-centered analyses (i.e., latent profile and transition analyses) revealed three profiles of need-satisfaction and frustration in students that were replicated at both time points. Need-supportive conditions within college generally predicted membership in the most adaptive profile. In turn, more adaptive profiles predicted higher self-control, lower levels of psychological distress (anxiety, depression), and healthier lifestyle behaviors (physical activity, fruit and vegetable consumption). Second, results from variable-centered analyses (i.e., structural equation modeling) showed that the association between students' BPNs and health-related outcomes was mediated by self-control. In other words, high need satisfaction and low need frustration were associated with higher self-regulatory performance at Time 1, which in turn predicted a more adaptive functioning at Time 2. Overall, these findings help clarify the mechanisms underlying the association between college educational climate and students' health-related functioning.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-04019-5.

The Consequences of the Pandemic on Medical Students’ Depressive Symptoms and Perceived Stress: A Repeated Cross-Sectional Survey with a Nested Longitudinal Subsample

This study aimed to explore the impact of the pandemic on medical students’ mental health in Italy using a repeated cross-sectional survey with a nested longitudinal subsample (first timepoint: 2018; second: 2020/2021). Three research questions (RQs) were investigated. Study 1 (longitudinal sub-sample) explored whether medical students had higher levels of depressive symptoms and stress during the pandemic compared with a pre-pandemic period (RQ1) and what variables were associated with these conditions during the pandemic adjusting for baseline levels (RQ2). Study 2 (repeated cross-sectional data) aimed to examine whether medical students had higher levels of these conditions during the pandemic compared with their same-year peers during a pre-pandemic period (RQ3). In Study 1, higher levels of depressive symptoms and stress were shown during the pandemic (RQ1). Multivariable models highlighted associations between poor mental health and worsening of the judgment of medical school choice, worsened psychological condition due to the pandemic, economic repercussions due to the pandemic, and baseline levels of symptoms (RQ2). In Study 2, our findings reported higher levels of depressive symptoms and stress during the pandemic, also adjusting for other variables (RQ3). In conclusion, depressive symptoms and stress were greater during the pandemic. The most relevant variables were pandemic-related items and medical school choice judgment.

Development and Evaluation: A Behavioral Activation Mobile Application for Self-Management of Stress for College Students

College students are at a high risk of mental health problems due to continuous exposure to considerable stress as they transition into adulthood. It is necessary to reflect on young people’s needs and provide brief, personalized support interventions via mobile applications. This study aimed to (1) describe the co-design development process of a behavioral activation (BA) mobile health application called MEndorphins to help youth manage stress; and (2) evaluate the ease of use and quality of the application and its effects on psychological distress. College students aged 18–25 in South Korea participated as co-designers throughout the MEndorphins development process, which involved prototyping workshops. Thirty-five students also evaluated the application’s ease of use and quality, as well as its effects on psychological distress, using a self-reported online questionnaire. In the pilot evaluation, ease of use scored 74.21 out of 100 and quality 3.72 out of 5. There were statistically significant decreases in depression, anxiety, and stress after using MEndorphins (p ≤ 0.001 for depression and anxiety, p = 0.001 for stress) for 7 days. In this developed BA based mobile application, participants could monitor their mood, plan stress self-management strategies, and gain motivation by sharing experiences.

Mental Health Study from the Perspective of Behavior Preference under the Environment of Internet Media: Based on China's Data Analysis

To prevent the mental health problems of college preference students effectively, this paper analyzes the influence of college students' internet media use behaviors on their mental health in the information age. We make an empirical study on the above problems by using metrology models under the condition of controlling individual factors. The result shows that the mental health of college students is significantly affected by different internet media use behaviors and shows obvious heterogeneity. Preference for games and soap operas or films has a significant negative relationship with the mental health of college students, while the preference for science, education programs, and the preference to obtain current political news comments through official media have a positive impact on the psychological security of college students. Meanwhile, the mental health of college students is also significantly influenced by individual factors. The education level, family income, and social satisfaction show a significant positive correlation with the mental health of college students.

The Effectiveness of a Leadership Subject Using a Hybrid Teaching Mode during the Pandemic: Objective Outcome and Subjective Outcome Evaluation

Positive youth development (PYD) is an innovative approach to protect students from mental health problems and promote their positive and holistic development. Although there are many studies on the beneficial effects of PYD programs on youth in high school and community contexts, it is not clear whether subjects adopting PYD principles can promote positive development for university students. Moreover, it is unclear whether such subjects are effective under COVID-19, where subjects are commonly taught via the "hybrid" mode (i.e., face-to-face plus online teaching). The present study examined students' changes in the PYD, wellbeing, and desired graduate attributes after they had taken a leadership subject utilizing PYD principles taught by the "hybrid" mode (N = 630). Adopting the one-group pre-test and post-test design (i.e., objective outcome evaluation), we found that students showed significant positive improvement in PYD indicators, wellbeing, as well as desired graduate attributes. Additionally, students had high satisfaction with the course design and teaching staff, and perceived many benefits from this subject based on the subjective outcome evaluation conducted at the end of the subject. Results also showed that students' satisfaction with the curriculum significantly and positively predicted their positive change in PYD indicators, indicating the convergence of subjective outcome evaluation and objective outcome evaluation. The results highlight the positive impacts of the hybrid mode leadership subject with PYD principles in higher education.

Changes in College Students Mental Health and Lifestyle During the COVID-19 Pandemic: A Systematic Review of Longitudinal Studies

College students have poorer mental health than their peers. Their poorer health conditions seem to be caused by the greater number of stressors to which they are exposed, which can increase the risk of the onset of mental disorders. The pandemic has been an additional stressor that may have further compromised the mental health of college students and changed their lifestyles with important consequences for their well-being. Although research has recognized the impact of COVID-19 on college students, only longitudinal studies can improve knowledge on this topic. This review summarizes the data from 17 longitudinal studies examining changes in mental health and lifestyle among college students during the COVID-19 pandemic, in order to improve understanding of the effects of the outbreak on this population. Following PRISMA statements, the following databases were searched PubMed, EBSCO, SCOPUS and Web of Science. The overall sample included 20,108 students. The results show an increase in anxiety, mood disorders, alcohol use, sedentary behavior, and Internet use and a decrease in physical activity. Female students and sexual and gender minority youth reported poorer mental health conditions. Further research is needed to clarify the impact of the COVID-19 pandemic on vulnerable subgroups of college students.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40894-022-00192-7.