A preliminary assessment of adjustment disorder among first-year college students

Is nature relatedness associated with better mental health? An exploratory study on Vietnamese university students

OBJECTIVE

This study aims to examine the relationship between nature relatedness (NR) on subjective positive well-being (life satisfaction) and mental disorders (depression, stress, and anxiety) in Vietnamese university students.

PARTICIPANTS

340 Hue University students voluntarily took part in the survey.

METHODS

The Nature Relatedness Scale, Depression, Anxiety, and Stress Scale and Satisfaction with Life Scale were used. Bivariate correlation, single regression, and moderation analysis were conducted to investigate the relationship between NR and the mental health of university students and the moderating role of NR.

RESULTS

Higher levels of NR significantly predicted higher levels of life satisfaction but did not significantly predict fewer symptoms of depression, anxiety, and stress. NR significantly moderated the link between life satisfaction and depression, anxiety, and stress.

CONCLUSIONS

The findings of this study imply that efforts to enhance students' mental health should include efforts to promote their NR.

Hostile attribution bias's role in perceived stress among college freshman students: A latent growth modelling approach

This study's objective was to examine the growth trajectories of freshman students' perceived stress and whether hostile attribution bias predicts the pattern of perceived stress change using latent growth analyses. A longitudinal dataset with fourth measurement points was gathered from a total of 1109 college students enrolled at a university in Guizhou Province in the first 3 months after college freshmen enrollment. The freshman students' levels of perceived stress tend to show a piecewise linear decline during the transition period, which manifests as a faster decline in the first stage (within the first month) than in the second stage (after the first month). Moreover, hostile attribution bias not only positively predicted the initial level of perceived stress but also positively predicted the slope of perceived stress in the first and second stages. In addition, there was a significant sex difference in the initial level of perceived stress where the initial level of perceived stress was higher in females than in males, but there was no significant sex difference in the rate of perceived stress decline. These results highlight the longitudinal relationship between hostile attribution bias and perceived stress and have implications for improving freshmen' college adaptation.

Effectiveness and mediators of change of an online CBT intervention for students with adjustment disorder-study protocol for a randomized controlled trial

BACKGROUND

Adjustment problems and disorders are highly prevalent among university students worldwide. These problems can cause significant interference in academic and social functioning and increase vulnerability to other mental health disorders. Unfortunately, only half of students in need receive psychological help. Furthermore, few studies have evaluated psychological interventions for adjustment disorders in students. New, more scalable forms of treatment for students with an adjustment disorder need to be developed, evaluated, and implemented. The study aims to determine the effectiveness of an online transdiagnostic cognitive behavioural intervention for students experiencing adjustment disorder and to assess mediators of change.

METHOD/DESIGN

In this three-arm randomized controlled trial, we plan to recruit 214 Polish students diagnosed with an adjustment disorder. Participants who meet initial eligibility criteria will be randomly assigned to one of three 6-week conditions: (1) online cognitive behavioural therapy intervention based on an existing, empirically supported transdiagnostic protocol, the unified protocol; (2) online progressive muscle relaxation training as an active control group; or (3) waiting-list control group. Both interventions are asynchronous, interactive, and include minimal amount of therapist support. Assessments will consist of self-report questionnaires, daily diary measures, and neurocognitive tasks for evaluating cognitive functioning. These will be conducted at baseline, post-treatment, and 1-month follow-up. Daily diary measures will be taken during the first and last week of treatment (or waitlist period). Primary outcome measures will include adjustment disorder severity; secondary outcome measures will consist of other negative (psychopathology: depression, anxiety, and stress) and positive (life satisfaction) indexes of mental health as well as process measures (e.g. mindfulness, experiential avoidance, cognitive fusion).

DISCUSSION

To our knowledge, the current study is the first to evaluate the effectiveness of a psychological intervention for students with adjustment disorder. Therefore, it may have important practical implications for students with this disorder. It can potentially guide the development of a scalable, validated treatment option.

TRIAL REGISTRATION

Clinical Trials, NCT05768308, registered 14 March 2023, https://www.

CLINICALTRIALS

gov/ct2/show/NCT05768308.

Adjustment disorder among first year medical students at King Saud University, Riyadh, Saudi Arabia, in 2020

BACKGROUND

The general health and well-being of medical students has become a matter of concern, as medical students have higher levels of stress than their nonmedical peers. Long-standing stress may lead to serious outcomes, such as depression, anxiety, poor quality of life, or adjustment disorders. This study aimed to estimate the proportion of first year medical students who have adjustment disorder and explore possible risk factors.

MATERIALS AND METHODS

This cross-sectional study was conducted among all first-year medical students at King Saud University, College of Medicine, Saudi Arabia. The adjustment disorder-new model 20 (ADNM-20) was used to assess adjustment disorder with the stressor and item lists. The item list scores were summed and a cutoff point >47.5 was designated as a high risk of developing the disorder. Descriptive analysis included computing mean and standard deviation for continuous variable while frequency and percentages for categorical variables. Chi-square test and logistic regression analysis determined risk factors for having an adjustment disorder and the stress of attending a medical school.

RESULTS

The study enrolled 267 students but only 128 completed the ADNM-20 survey. Out of 267 students, the most commonly reported recent stressor was too much/too little work, and 52.8% reported having difficulty in meeting deadlines. The most common core symptom expressed by the medical students was avoidance behavior with a mean score of 10.91 ± 3.12, followed by preoccupation with stressors with a mean score of 10.66 ± 3.10. The factors significantly associated with having adjustment disorder were being female, younger age, recent illness of a loved one, having family conflicts, and having too much or too little work.

CONCLUSION

First year medical students are at increased risk of adjustment disorder. Screening and awareness programs may be considered for preventing adjustment disorder. Increased student-staff interactions may provide support to adapt to their new environment and help reduce social adjustment difficulties.

Does attending elite colleges matter in the relationship between self-esteem and general self-efficacy of students in China?

This study analyzed the reciprocal relationship between self-esteem and general self-efficacy among students from both the elite and non-elite universities in China. Descriptive statistics showed that the levels of general self-efficacy remained stable among Chinese college students albeit with minor fluctuations, while their self-esteem continuously declined during the four academic years; students from elite universities had higher self-esteem than their counterparts from non-elite universities. Moreover, the general self-efficacy of students was significantly and positively correlated with their self-esteem at college. Using a four-wave cross-lagged model, we found that the self-esteem and general self-efficacy among elite university students reinforced each other from the freshman to the junior years, whereas the self-esteem of their equivalents from non-elite universities monodirectionally predicted their subsequent general self-efficacy levels from the sophomore to the senior years. The study adds to the literature by (1) exploring the directionality of the relationship between self-esteem and generalized self-efficacy with four-wave panel data, and (2) discussing the heterogeneity of the relationship among sub-groups of the college students. The study proposed that institutions of different tiers should take targeted interventions to boost students' self-esteem and general self-efficacy.

Effects of Stress in Adaptation to Undergraduate Life on Psychiatric Morbidity: Mediating Effects of Early Trauma and Adverse Family Factors

PURPOSE

University students experience high levels of stress, and the prevalence of depression is higher than in the general population. The reason is not clear. More effective interventions and better prevention are needed.

METHODS

We did annual cross-sectional surveys of Chinese undergraduates 2014-2018 (mean age 18.7 [SD 2.1], N = 39,573). We measured adaptation to university life using the Adolescent Self-rating Life Events Checklist (ASLEC) and common mental disorders using standardized self-report instruments. Regression analyses identified associations between childhood maltreatment, current family problems, stress in adaptation to undergraduate life, and psychiatric morbidity. Mediation analyses further tested relationships between these factors.

RESULTS

Childhood maltreatment, current family problems, stress in adaptation, and psychiatric morbidity were all significantly associated with each other. The strongest association between childhood experiences and psychiatric morbidity was for sexual abuse and depression (OR = 3.39, 95%CI: 2.38-4.83, p < 0.001) and between stress from adaptation and somatic disorder (OR = 4.54, 95%CI: 3.62-5.68, p < 0.001). Associations between childhood maltreatment and stress from university life were partly mediated by psychiatric morbidity. Associations between family problems and psychiatric morbidity were mediated by stress from university life.

CONCLUSIONS

Stress from adaptation to university life and pressures from academic study exert stronger effects on psychiatric morbidity among students than childhood traumatic experiences and current family problems, although these factors are closely interrelated. Mental health services for students should focus on adaptation to university life and pressures from academic study as well as external factors of childhood trauma and family problems.

Prevalence and predicting factors of perceived stress among Bangladeshi university students using machine learning algorithms

Background

Stress-related mental health problems are one of the most common causes of the burden in university students worldwide. Many studies have been conducted to predict the prevalence of stress among university students, however most of these analyses were predominantly performed using the basic logistic regression (LR) model. As an alternative, we used the advanced machine learning (ML) approaches for detecting significant risk factors and to predict the prevalence of stress among Bangladeshi university students.

Methods

This prevalence study surveyed 355 students from twenty-eight different Bangladeshi universities using questions concerning anthropometric measurements, academic, lifestyles, and health-related information, which referred to the perceived stress status of the respondents (yes or no). Boruta algorithm was used in determining the significant prognostic factors of the prevalence of stress. Prediction models were built using decision tree (DT), random forest (RF), support vector machine (SVM), and LR, and their performances were evaluated using parameters of confusion matrix, receiver operating characteristics (ROC) curves, and k-fold cross-validation techniques.

Results

One-third of university students reported stress within the last 12 months. Students’ pulse rate, systolic and diastolic blood pressures, sleep status, smoking status, and academic background were selected as the important features for predicting the prevalence of stress. Evaluated performance revealed that the highest performance observed from RF (accuracy = 0.8972, precision = 0.9241, sensitivity = 0.9250, specificity = 0.8148, area under the ROC curve (AUC) = 0.8715, k-fold accuracy = 0.8983) and the lowest from LR (accuracy = 0.7476, precision = 0.8354, sensitivity = 0.8250, specificity = 0.5185, AUC = 0.7822, k-fold accuracy = 07713) and SVM with polynomial kernel of degree 2 (accuracy = 0.7570, precision = 0.7975, sensitivity = 0.8630, specificity = 0.5294, AUC = 0.7717, k-fold accuracy = 0.7855). Overall, the RF model performs better and authentically predicted stress compared with other ML techniques, including individual and interaction effects of predictors.

Conclusion

The machine learning framework can be detected the significant prognostic factors and predicted this psychological problem more accurately, thereby helping the policy-makers, stakeholders, and families to understand and prevent this serious crisis by improving policy-making strategies, mental health promotion, and establishing effective university counseling services.

Prevalence of anxiety, depression and suicidal behaviors among Brazilian undergraduate students: A systematic review and meta-analysis

BACKGROUND

The university context can be an overwhelming background, being especially harmful to undergraduates' mental health. Considering that several studies have reported on the prevalence of psychological distress among Brazilian undergraduate students, this study aimed to conduct a systematic review and meta-analysis of the prevalence and associated factors of anxiety, depression and suicidal behavior in this population.

METHODS

Studies reporting on the prevalence of anxiety, depression and suicidal behavior and its associated factors among Brazilian undergraduate students were systematically searched in scientific electronic databases. Pooled prevalence was calculated using a random-effects meta-analysis. Individual associated factors were summarized, and study characteristics associated with outcome prevalence were tested through meta-regression analysis.

RESULTS

Forty-seven articles were included, of which 44 were meta-analyzed (37,486 undergraduates). The pooled prevalence estimates of anxiety, depression and suicidal behavior were 37.75%, 28.51%, and 9.10%, respectively. Meta-regression analysis showed that investigations with probabilistic samples presented a higher prevalence of anxiety and that studies conducted within public institutions and with samples of exclusively medical students presented higher frequencies of depression.

LIMITATIONS

Cross-sectional data do not allow the establishment of temporality and causal inference. Furthermore, the high heterogeneity of the included studies may also constitute a weakness of this review.

CONCLUSIONS

The prevalence of anxiety, depression and suicidal behavior among Brazilian undergraduates was high. These results have scientific and practical implications, the former regarding the need for the standardization of the methodology of studies and the latter regarding the need for comprehensive mental health care for Brazilian undergraduates.

Relationship Between Dispositional Mindfulness and Living Condition and the Well-eing of First-ear University Students in Japan

The present study was conducted to examine how dispositional mindfulness and living conditions are related to well-being among first-year university students in Japan. Participants were 262 Japanese first-year students (156 females and 106 males; M_age = 18.77 years, SD_age = 0.85). Dispositional mindfulness was measured using the Mindful Attention Awareness Scale (MAAS), and living condition was operationalized as living at home or living alone after having left their home. Hierarchical multivariate regression analysis was used to analyze whether the factors of living condition and dispositional mindfulness had predictive effects on well-being. The results showed that dispositional mindfulness positively correlated with well-being in first-year university students; however, living condition had no significant correlation. On the other hand, the interaction between living condition and dispositional mindfulness significantly correlated with well-being. Simple slope analysis revealed that higher levels of dispositional mindfulness had a protective effect in the relationship between living condition and well-being. These results suggest that an intervention to promote dispositional mindfulness could be effective in protecting the well-being of first-year university students, especially for those who have left their home and are living alone. Further research will be necessary to examine, longitudinally, how mental health changes depending on the level of dispositional mindfulness of first-year university students.

Parental Rejection and Mental Health Problems in College Students: Mediating Role of Interpersonal Difficulties

College students are said to have an increasing trend of mental health problems that lead to various negative academic, personal and social outcomes. The current study aimed to determine the mediating role of interpersonal difficulties between parental rejection and mental health problems of college students. A total of 321 college students selected through purposive sampling aged 15to 20 years provided self-report data on EMBU-A (Gerlsma, Arrindell, Van der Veen, & Emmelkamp, 1991), Urdu version of Depression Anxiety Stress Scale (DASS; Aslam, 2007) and Interpersonal Difficulties Scale (IDS; Saleem, Ihsan, & Mahmood, 2014). Pearson Correlation was used to ensure that parental rejection, mental health problems and interpersonal difficulties are related. Results of path analysis revealed that parental rejection has an indirect effect on mental health through interpersonal difficulties. Implications for counselling services are discussed.

Attitudes toward disabilities among students in college settings: A multidimensional scaling analysis with biplot

We investigated attitudes toward 10 specific groups of individuals with disabilities among students in college settings. These groups comprised major depression, substance use disorder (SUD), anxiety disorder, autism spectrum disorder (ASD), cerebral palsy, hearing impairment, learning disability, visual impairment, spinal cord injury, and cancer survivor. The multidimensional scaling (MDS) analysis revealed a two-dimension space representing participants’ attitudes toward those disabilities. The MDS biplot further indicated higher levels of perceived dangerousness from the groups with SUD, major depression, anxiety disorder, and ASD. The hierarchical cluster analysis revealed that cluster A (SUD and major depression) was rated as having the highest level of social distance (i.e., negative attitudes). The implications for research and practice in rehabilitation counseling were discussed.

Prevalence of Adjustment Problem and Its Predictors among First-Year Undergraduate Students in Ethiopian University: A Cross-Sectional Institution Based Study

Background

Being in a university for the first time is an unpleasant event and time of heavy pressure relating to social things and dissatisfaction for several new faculty students. Adjustment difficulties are the foremost common issues among freshman students; World Health Organization area unit researched a full-of-life adjustment innovation in universities. Despite this reality, there is a few literature that identifies prevalence and factors related to the adjustment downside among university/college students.

Methods

Institutional based quantitative cross-sectional study style was conducted from May to June 2016. A total of 537 haphazardly elite students concerned within the study. The result adjustment downside was explained with Student Adjustment to College Questionnaire (SACQ). Data was described using descriptive analysis; logistic regression was used to assess the relation between adjustment downside and associated factors. An odds quantitative relation 95% confidence interval was used to point out the strength of association. Applied mathematics significance was declared as a p value less than 0.05.

Result

A total of 537 respondents participate with a response rate of eighty-five percent. the prevalence of adjustment downside among the respondents was 228 ( 42.5%). Of the respondents, 327 (60.9%) were male and therefore the mean (sd) age was 19 (+- 1) years. Being away from home and homesickness (AOR=4.15,95% CI: 2.46,2,99 and AOR=5. 9,95% CI: 2.35,14.76) and difficulties in socializing or making friends (AOR=3.99,95% CI:2.29,6.98) and difficulties in managing time and study skill (AOR=3.02,95% CI: 1.3,7.02) were abundant associated factors with adjustment downside.

Conclusion

The study confirms that freshman students joining university do face problems in adjusting themselves at the university. Homesickness, difficulties in socializing or making friends, and difficulties in managing time and study skill were found to be significant factors in adjustment downside.

Managing the Transition: The Role of Optimism and Self-Efficacy for First-Year Australian University Students

Students making the transition from high school to university often encounter many stressors and new experiences. Many students adjust successfully to university; however, some students do not, often resulting in attrition from the university and mental health issues. The primary aim of the current study was to examine the effects that optimism, self-efficacy, depression, and anxiety have on an individual's life stress and adaptation to university. Eighty-four first-year, full-time students from the Queensland University of Technology (60 female, 24 male) who had entered university straight from high school completed the study. Participants completed a questionnaire assessing their levels of optimism, self-efficacy, depression, anxiety, perceived level of life stress and adaptation to university. In line with predictions, results showed that optimism, depression, and anxiety each had a significant relationship with students’ perceived level of stress. Furthermore, self-efficacy and depression had a significant relationship with adaptation to university. We conclude that students with high levels of optimism and low levels of depression and anxiety will adapt better when making the transition from high school to university. In addition, students with high levels of self-efficacy and low levels of depression will experience less life stress in their commencement year of university. The implications of this study are outlined.

Sleep quality as a mediator between technology-related sleep quality, depression, and anxiety

This study examines (a) relations among technology use during sleep time, sleep quality, and depression/anxiety and (b) time awake due to technology use. Two hundred thirty-six college students completed self-report questionnaires and week-long sleep diaries. Results revealed that 47 percent of students reported night-time waking to answer text messages and 40 percent to answer phone calls. Regression analyses indicated that higher levels of technology use after the onset of sleep predicted poorer sleep quality, and poorer sleep quality predicted symptoms of depression/anxiety. Finally, sleep quality is a mediator between technology use after the onset of sleep and depression/anxiety. College students who have difficulty setting boundaries around technology use may be at increased risk for psychological health concerns.

Higher Reported Levels of Depression, Stress, and Anxiety Are Associated With Increased Endorsement of ADHD Symptoms by Postsecondary Students

This study examined the extent to which postsecondary students endorse symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) and whether experienced level of stress, depression, or anxiety are associated with higher reporting of ADHD symptoms. Students attending a combined health and counseling service completed the Conners Adult ADHD Rating Scale (CAARS), the Depression Anxiety and Stress Scale (DASS), and the Life Experiences Survey (LES). A subset also completed the Brown Attention Deficit Disorder Scale (BADDS). Findings demonstrate that the BADDS had weak specificity; 35% of never-diagnosed postsecondary students were classified as probably or very probably having ADHD based on their BAADS score. Lower false positive rates were found on the CAARS. Misdiagnosis of ADHD seems especially likely in students experiencing high levels of stress, depression, or anxiety, as these psychological conditions were associated with elevated reporting of ADHD symptoms; such conditions must therefore be considered when assessing for possible ADHD in young adults.

Executive functions, depressive symptoms, and college adjustment in women

Many students have difficulty adjusting to college, and the contribution of academic and relational factors have been considered in previous research. In particular, depression commonly emerges among college women at this time and could be related to poor adjustment to college. This study examined the relationship between executive functions, depressive symptoms, and college adjustment in college women. Seventy-seven female participants from a midsize urban university completed the Wechsler Abbreviated Scale of Intelligence, College Adjustment Scale, Beck Depression Inventory-Second Edition, Behavior Rating Inventory of Executive Function-Adult Version, and four subtests from the Delis-Kaplan Executive Function System: the Trail-Making Test, Design Fluency Test, Verbal Fluency Test, and Color-Word Interference Test. After controlling for IQ score, hierarchical regression analyses showed that subjective and objective measures of executive functioning and depressive symptoms were significantly related to college adjustment problems in academic, relational, and psychological areas. The current study provides evidence for a relationship between cognitive abilities, psychiatric symptoms, and college adjustment.

Cognitive responses to stress, depression, and anxiety and their relationship to ADHD symptoms in first year psychology students

OBJECTIVE

To explore the relationship between levels of reported depression, anxiety, and stress with scores on the Conners's Adult ADHD Rating Scale (CAARS).

METHOD

Information was obtained from 84 1st-year psychology students using the CAARS, the Depression Anxiety and Stress Scale (DASS), and the Life Experiences Survey (LES).

RESULTS

Approximately 23%, 18%, and 12% of students scored above critical values on the Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV) Inattention Symptoms, the DSM-IV ADHD Symptoms Total, and the Inattention/Restlessness subscales, respectively. CAARS scores were positively related to reported levels of depression, anxiety, and stress, which accounted for significant variance among the three subscales. Only 5% of participants scored above recommended critical values on the ADHD index; however, a significant amount of the variance on this measure was also attributable to the DASS.

CONCLUSION

Mood symptoms such as depression, anxiety, and stress may obscure correct attribution of cause in those being evaluated for ADHD.

Integration of the brief behavioral activation treatment for depression (BATD) into a college orientation program: depression and alcohol outcomes

College freshmen face a variety of academic and social challenges as they adjust to college life that can place them at risk for a number of negative outcomes, including depression and alcohol-related problems. Orientation classes that focus on teaching incoming students how to better cope with college-oriented stress may provide an opportunity to prevent the development of these adjustment problems. This article outlines a program based on behavioral activation that can be integrated into college orientation programs to provide a more comprehensive orientation experience. Data are presented from an initial pilot study in which 71 first-semester freshman at the University of Maryland participated in a 15-week, 2 hr per week orientation class (n = 37 in the behavioral activation-enhanced orientation classes and n = 34 in the control orientation as usual classes). Students' depression and alcohol use were evaluated at the beginning, middle, and end of the course. Results indicated a Time × Group interaction such that problem drinking (but not consumption) was significantly reduced across assessments in the behavioral activation classes and largely unchanged in the standard classes. No difference was observed in depression scores; however, fairly low depression scores across the 3 time points may have limited the opportunity to observe any meaningful impact of the orientation classes on depression. The authors conclude with a discussion of the implications of their findings for preventing adjustment problems among incoming college students and future directions.