Countering the Troubling Increase in Mental Health Symptoms Among U.S. College Students

A small area analysis of acute exposure to temperatures and mental health in North Carolina

Increasing evidence suggests that temperatures adversely impact mental and behavioral disorders (MBD). This study explores the effects of temperatures on mental health outcomes using over 5.9 million MBD-related emergency department (ED) visits across three geographical regions of North Carolina (i.e., Mountains, Piedmont, and Coast) from 2016 to 2019. A distributed lag non-linear model (DLNM) with a generalized linear model and quasi-Poisson distribution adjusted for humidity, long-term seasonal time trends, and day of the week examined the acute impact (i.e., 7-day) of temperature on daily MBD-related ED visits at zip code tabulation area (ZCTA) locations. Results were pooled at the region and state levels and reported in reference to the median temperature using a case-time series design for the analysis of small-area data. Stratified analyses were conducted for age, sex, and specific mental-health related ED visits (substance use, mood disorders, anxiety disorders). At the state level, we found significant positive associations between high temperatures (97.5th percentile) and an increase in relative risk (RR) for total MBDs (RR:1.04, 95% CI,1.03-1.05) and psychoactive substance use (RR:1.04, 95% CI, 1.02-1.06). Low air temperatures (2.5th percentile) only increased risk for the elderly (i.e., 65 and older) and predominantly white communities (RR: 1.03, CI: 1.03-1.05). During high temperatures (97.5th percentile), majority-white communities (RR:1.06, CI: 1.01-1.10) and low-income communities had the highest risk for MBDs (RR: 1.05, CI: 1.03-1.07). Our findings suggest there is a positive association between exposure to high temperatures and increased MBD-related ED visits, modified by patient age and place-based sociodemographic (ie., race and income) context.

Trends in Mental Health Outcomes of College Students Amid the Pandemic (Roadmap mHealth App): Longitudinal Observational Study

BACKGROUND

The mental health crisis among college students intensified amid the COVID-19 pandemic, suggesting an urgent need for innovative solutions to support them. Previous efforts to address mental health concerns have been constrained, often due to the underuse or shortage of services. Mobile health (mHealth) technology holds significant potential for providing resilience-building support and enhancing access to mental health care.

OBJECTIVE

This study aimed to examine the trends in mental health and well-being outcomes over 3 years among college students, with an exploratory aim to assess the potential impact of the Roadmap mHealth app on these outcomes.

METHODS

A fully automated longitudinal observational study was conducted remotely from a large public academic institution in the Midwestern United States, evaluating mental health and well-being outcomes among college students using the Roadmap mHealth app over 3 fall semesters from 2020 to 2022. The study enrolled 2164 college students in Year I, with 1128 and 1033 students returning in Years II and III, respectively. Participants completed various self-reported measures, including the Patient Health Questionnaire-9 for depression, Generalized Anxiety Disorder-7 for anxiety, and additional metrics for coping, flourishing, and loneliness.

RESULTS

The findings indicated an evolving trajectory in students' mental health. In Year I, depression and anxiety levels were higher compared with levels reported between 2014 and 2019, remaining stable into Year II. However, significant decreases were noted by Year III for both depression (Year I mean 7.78, SD 5.65 vs Year III mean 6.21, SD 4.68; t108=-2.90; P=.01) and anxiety (Year I mean 6.61, SD 4.91 vs Year III mean 5.62, SD 4.58; t116=-2.02; P=.046). Problem-focused coping decreased initially from Year I (mean 2.46, SD 0.58) to Year II (mean 2.36, SD 0.60; t1073=-5.87; P<.001), then increased by Year III (mean 2.40, SD 0.63; t706=2.26; P=.02). Emotion-focused (Year I mean 2.33, SD 0.41 vs Year III mean 2.22, SD 0.47; t994=-7.47; P<.001) and avoidant coping (Year I mean 1.76, SD 0.37 vs Year III mean 1.65, SD 0.38; t997=-8.53; P=.02) consistently decreased. Loneliness significantly decreased from Year I (mean 5.79, SD 1.74) to Year III (mean 5.17, SD 1.78; t1013=-10.74; P<.001), accompanied by an increase in flourishing from Year I (mean 63.78, SD 14.76) to Year III (mean 66.98, SD 15.06; t994=7.22; P<.001). Analysis of app usage indicated that the positive piggy bank and gratitude journal were the favored activities. Greater engagement with the app was positively correlated with enhanced flourishing, even after adjusting for demographic and sociobehavioral factors (β=.04, SE .016; t3974=2.17; P=.03).

CONCLUSIONS

In this study, students' mental health and well-being improved, with notable reductions in depression, anxiety, and loneliness, associated with an increase in flourishing. The app did not appear to worsen students' mental health. Based on the usage pattern, it is possible the app enhanced positive psychology-based practices. Future research should explore the efficacy of mHealth interventions through randomized controlled trials to further understand their impact on college students' mental health outcomes.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04766788; https://clinicaltrials.gov/ct2/show/NCT04766788.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/29561.

Behavioral Emotion Regulation Strategies and Symptoms of Psychological Distress Among Turkish University Students

The purpose of this study was to examine the association between behavioral emotion regulation strategies and symptoms of depression, anxiety, and stress among Turkish university students. Participants consisted of 633 students continuing their university education in two different universities in Türkiye. Participants completed a data collection tool comprising a Sociodemographic Information Form, the Behavioral Emotion Regulation Questionnaire, and the Depression Anxiety Stress Scales-21. Data were analyzed using descriptive statistics, Pearson's product-moment correlation coefficient analysis, and multivariate multiple regression analysis. The results of this study revealed that seeking distraction was negatively associated with symptoms of depression, anxiety, and stress, whereas withdrawal, seeking social support, and ignoring were positively associated with symptoms of depression, anxiety, and stress among university students. Additionally, actively approaching was negatively associated with depressive symptoms. Overall, the findings demonstrate that university students who use maladaptive behavioral emotion regulation strategies (e.g., withdrawal, ignoring) tend to have higher levels of psychological distress, whereas university students who use adaptive emotion regulation strategies (e.g., distraction) tend to have lower levels of psychological distress. However, contrary to expectations, seeking social support was positively associated with symptoms of psychological distress. Given the paucity of research on the relationship between behavioral emotion regulation strategies and psychological distress in the Turkish cultural context, this study may contribute to identifying both universal and culturally specific strategies associated with depressive, anxiety, and stress symptoms among Turkish university students.

Insomnia partially mediates the relationship between anxiogenic and depressogenic traits and state anxiety and depression in college students

OBJECTIVE

Insomnia, anxiety, and depression are common and co-morbid amongst college students. The mechanisms by which trait factors like intolerance of uncertainty and anxiety sensitivity connect to state anxiety and depression is unclear, but insomnia may mediate that relationship.

PARTICIPANTS

College students (N = 439) were recruited from national and local sources.

METHODS

Participants completed the Sleep Condition Indicator (SCI), Depression, Anxiety and Stress Scale (DASS), Anxiety Sensitivity Index (ASI), and Intolerance of Uncertainty Scales (IUS).

RESULTS

All models predicted a significant amount of variability in state anxiety and depression (R2 between 0.24 and 0.32). Mediation analyses revealed that the relationship between anxiogenic and depressogenic traits and state anxiety and depression is significantly mediated by insomnia.

CONCLUSIONS

Our findings support the role of insomnia in the expression of anxiety and depression in at-risk college students. Clinical sleep intervention, either reactive or prophylactic, may help reduce mental health burden on campus.

Declines in social-emotional skills in college students during the COVID-19 pandemic

Introduction

The present study investigated whether social-emotional skills in first year college students differed before and after the coronavirus disease (COVID-19) lockdowns.

Methods

Participants (N = 1,685) consisted of first year college students (mean age 18.53 years) selected from a broader cohort enrolled in a longitudinal study on college mental health at liberal arts colleges in the United States. In a cohort-sequential design, participants completed an online survey assessing social-emotional skills in January of 2018, 2019, 2020, and 2022. Using analysis of covariance, we examined mean differences in social-emotional skills between students who were first years before (January 2018-2020) and after the lockdowns (January 2022), controlling for sociodemographic variables.

Results

The post-lockdown group scored significantly lower on emotional control and expressivity and marginally higher on social sensitivity compared to the pre-lockdown group. No group differences in social/emotional expressivity or social control were detected.

Discussion

These findings indicate that the COVID-19 lockdowns impaired some, but not all, social-emotional skills in first year college students. Addressing social-emotional skills in college may help to reduce the COVID-19 mental health burden.

A mixed methods investigation of college student mental health during the first year of the COVID-19 pandemic

OBJECTIVE

Researchers collaborated with undergraduate minority students to quantitatively and qualitatively investigate college students' mental health during the first year of the COVID-19 pandemic.

PARTICIPANTS

Participants were two convenience samples of diverse college students surveyed in June (n = 128; M age = 21.7, SD = 1.7) and December (n = 242; M age = 20.3, SD = 1.7) of 2020.

METHODS

This study administered items from the California Health Interview Survey and open-ended qualitative items via Qualtrics.

RESULTS

Across both waves, students reported significant mental health challenges and psychological distress. Students surveyed in December were three to four times more likely to report depression and anxiety. Female and older students reported heightened odds of mental health challenges. Qualitative findings elaborated on contributing factors.

CONCLUSION

During the pandemic, college students have experienced pronounced mental health challenges, potentially exacerbated by academic, professional, relational, and environmental stressors and uncertainty.

College students' motivations for using fitness related technology

Objective: The purpose was to understand college students' motivations for the use and discontinued use of fitness related technology (FRT) in relation to their physical activity behaviors. Participants: Participants were undergraduate students (n = 22) who were eligible if they were between 18-24 years of age (emerging adulthood) and current or previous users of FRT. Methods: Qualitative descriptive design was used with semi-structured interviews conducted virtually. Thematic analysis was used to analyze the data. Results: Participants discussed four themes; (1) Motivations for physical activity, (2) Motivations for using FRT, (3) Social connection improves accountability for physical activity, and (4) The ups and downs of FRT goal setting and data display. Conclusions: Best practice guidelines need to be established for the use of FRT along with approaches to promote physical activity among this population. Additional research is needed to identify reasons for discontinuation of use and to develop potential interventions to promote sustained engagement with FRT.

The mental and physical health correlates of psychotic experiences among US college students: Findings from the Healthy Mind Study 2020

BACKGROUND

Psychotic experiences have been framed as a marker of mental and physical health status; however, more research is needed to confirm these associations in university populations.

METHODS

We analyzed data from the Healthy Minds Survey (Fall Semester Cohort 2020), which is a non-probability sample of students attending one of 28 universities in the United States, who completed an online survey (September 2020-December 2020). We used multivariable logistic regression to examine the associations between several mental and physical health conditions and psychotic experiences, adjusting for age, gender, sexual orientation race/ethnicity, and international student status.

RESULTS

In terms of mental health, all conditions were associated with greater odds of having lifetime psychotic experiences. Having at least one mental health condition was associated with 2.18 times greater odds of having lifetime psychotic experiences (aOR: 2.18; 95% CI: 1.96-2.42). In terms of physical health, having at least one physical health condition was associated with 1.37 times greater odds of having lifetime psychotic experiences (aOR: 1.37; 95% CI: 1.22-1.53), but only four conditions were associated with greater odds of lifetime psychotic experiences, which were: asthma, gastrointestinal disease, HIV/AIDS, and other chronic disease. The counts of mental and physical health conditions were associated with greater odds of lifetime psychotic experiences in a dose-dependent fashion.

CONCLUSION

Psychotic experiences appear to be an indicator for mental health problems and some physical health problems. More research is needed to determine whether assessing for psychotic experiences broadly can help identify at-risk individuals in university settings who may benefit from targeted preventive interventions.

Sexual Minority Status and Psychotic Experiences Among Young Adult College Students in the United States

2020-2021 Healthy Minds Study, and used multivariable logistic regression to examine the associations between sexual minority status and psychotic experiences, adjusting for age, gender, and race/ethnicity. We then tested whether psychosocial factors accounted for the association. Sexual minority status was associated with 1.87 times greater odds of having psychotic experiences over the past 12 months (aOR: 1.87; 95% CI: 1.77-1.99; N = 110,551). Several factors mediated the association between sexual orientation and psychotic experiences such as loneliness (26.93%), anxiety (30.90%), depression (33.18%), and marijuana use (13.95%); all factors together accounted for 59.01% of the association between sexual minority status and psychotic experiences. Food insecurity, recent abuse, and discrimination did not significantly mediate the association. Findings should raise clinical awareness that psychotic experiences are more common among sexual minorities than among heterosexuals, which is largely explained by mental health factors, calling for targeted outreach and intervention.

Advancing Understanding on Greenspace and Mental Health in Young People

Mental distress among young people has increased in recent years. Research suggests that greenspace may benefit mental health. The objective of this exploratory study is to further understanding of place-based differences (i.e., urbanity) in the greenspace-mental health association. We leverage publicly available greenspace data sets to operationalize greenspace quantity, quality, and accessibility metrics at the community-level. Emergency department visits for young people (ages 24 and under) were coded for: anxiety, depression, mood disorders, mental and behavioral disorders, and substance use disorders. Generalized linear models investigated the association between greenspace metrics and community-level mental health burden; results are reported as prevalence rate ratios (PRR). Urban and suburban communities with the lowest quantities of greenspace had the highest prevalence of poor mental health outcomes, particularly for mood disorders in urban areas (PRR: 1.19, 95% CI: 1.16-1.21), and substance use disorders in suburban areas (PRR: 1.35, 95% CI: 1.28-1.43). In urban, micropolitan, and rural/isolated areas further distance to greenspace was associated with a higher prevalence of poor mental health outcomes; this association was most pronounced for substance use disorders (PRRUrban: 1.31, 95% CI: 1.29-1.32; PRRMicropolitan: 1.47, 95% CI: 1.43-1.51; PRRRural 2.38: 95% CI: 2.19-2.58). In small towns and rural/isolated communities, poor mental health outcomes were more prevalent in communities with the worst greenspace quality; this association was most pronounced for mental and behavioral disorders in small towns (PRR: 1.29, 95% CI: 1.24-1.35), and for anxiety disorders in rural/isolated communities (PRR: 1.61, 95% CI: 1.43-1.82). The association between greenspace metrics and mental health outcomes among young people is place-based with variations across the rural-urban continuum.

Associations between college students' personal experience with mental health issues and their mental health literacy: a strengths-based perspective

BACKGROUND

Mental health literacy (MHL) programs are a promising approach to help prevent mental health issues (MHI) among college students; however, there is an increasing need to understand individual factors that influence the development of students' MHL.

AIMS

Following a strengths-based approach, we examined if college students' individual characteristics and MHI experience were associated with students' MHL.

METHODS

Using two vastly different college samples (Sample 1, N = 617; Sample 2, N = 306), we used the Mental Health Awareness and Advocacy framework, guided by the health belief model and social-cognitive theory, to investigate associations between students' mental health literacy, demographic factors, and their previous experience with MHI.

RESULTS

Results from nested regression analyses suggest that personal experiences with MHI are associated with higher MHL (knowledge, self-efficacy, and behaviors), even after controlling for key individual characteristics. Prior experience with having an MHI and receiving therapy appeared to be most important in explaining MHL behaviors.

CONCLUSIONS

Students with personal experience with an MHI may be one of the most valuable resources for increasing MHL and utilization of mental health resources on college campuses. Additional implications and future research directions are offered.

Stop Asian hate: The mental health impact of racial discrimination among Asian Pacific Islander young and emerging adults during COVID-19

BACKGROUND

The rapid surge in anti-API discrimination and assault during the COVID-19 pandemic has the potential to exacerbate mental health disparities already pervasive among API populations. The primary of this study was to understand the impact of the pandemic and COVID-related discrimination on API college and university student mental health.

METHODS

Secondary data was used from three administrations (Fall 2019, Spring 2020, and Fall 2020) of the Healthy Minds Study (HMS). We conducted Chi-square analyses to analyze differences in mental health symptoms across the three academic semesters. Cross-sectional multivariable logistic regression models were utilized to examine the association between COVID-related discrimination and mental health symptoms and help-seeking behavior during Spring 2020 and Fall 2020.

RESULTS

Comparing Fall 2019 to Fall 2020, we found that API students reported a 17 % increase in severe depression and a 30 % increase in severe anxiety. Mental health treatment utilization among those experiencing clinically-significant mental health problems decreased by 26 % between Fall 2019 and Spring 2020. COVID-related discrimination was associated with greater odds of severe depression in both Spring 2020.

LIMITATIONS

HMS does not include a random sample of campuses as schools themselves elect to participate. Analyses rely on self-report data.

CONCLUSIONS

Throughout the COVID-19 pandemic, API students reported significant increases in clinically-significant mental health symptoms and decreases in treatment utilization. Our analyses also suggest that COVID-related discrimination is correlated with greater odds of clinically-significant mental health symptoms, including severe depression and severe anxiety, as well as lower odds of treatment utilization.

Food insecurity and mental health among young adult college students in the United States

BACKGROUND

Food insecurity is prevalent among college students in the United States and has been associated with mental health problems. However, the literature is not entirely consistent and is missing key aspects of mental health.

METHODS

Using cross-sectional data from the Health Minds Study (N = 96,379; September 2020-June 2021), we used multivariable logistic regression to examine associations between food insecurity and several aspects of mental health (i.e., depression, anxiety, languishing, perceived need, loneliness, self-injurious behaviors), adjusting for age, gender, race/ethnicity, financial distress, and parental education.

RESULTS

Food insecurity was associated with greater odds of having depression, anxiety, languishing, perceived need for help, loneliness, and self-injurious behaviors, adjusting for sociodemographic characteristics and markers of socioeconomic status.

CONCLUSION

This study found evidence to suggest that food insecurity is related to poor mental health in a large sample of young adult college students in the United States, calling for targeted interventions.

Risk Factors for COVID-19 in College Students Identified by Physical, Mental, and Social Health Reported During the Fall 2020 Semester: Observational Study Using the Roadmap App and Fitbit Wearable Sensors

BACKGROUND

The COVID-19 pandemic triggered a seismic shift in education to web-based learning. With nearly 20 million students enrolled in colleges across the United States, the long-simmering mental health crisis in college students was likely further exacerbated by the pandemic.

OBJECTIVE

This study leveraged mobile health (mHealth) technology and sought to (1) characterize self-reported outcomes of physical, mental, and social health by COVID-19 status; (2) assess physical activity through consumer-grade wearable sensors (Fitbit); and (3) identify risk factors associated with COVID-19 positivity in a population of college students prior to release of the vaccine.

METHODS

After completing a baseline assessment (ie, at Time 0 [T0]) of demographics, mental, and social health constructs through the Roadmap 2.0 app, participants were instructed to use the app freely, wear the Fitbit, and complete subsequent assessments at T1, T2, and T3, followed by a COVID-19 assessment of history and timing of COVID-19 testing and diagnosis (T4: ~14 days after T3). Continuous measures were described using mean (SD) values, while categorical measures were summarized as n (%) values. Formal comparisons were made on the basis of COVID-19 status. The multivariate model was determined by entering all statistically significant variables (P<.05) in univariable associations at once and then removing one variable at a time through backward selection until the optimal model was obtained.

RESULTS

During the fall 2020 semester, 1997 participants consented, enrolled, and met criteria for data analyses. There was a high prevalence of anxiety, as assessed by the State Trait Anxiety Index, with moderate and severe levels in 465 (24%) and 970 (49%) students, respectively. Approximately one-third of students reported having a mental health disorder (n=656, 33%). The average daily steps recorded in this student population was approximately 6500 (mean 6474, SD 3371). Neither reported mental health nor step count were significant based on COVID-19 status (P=.52). Our analyses revealed significant associations of COVID-19 positivity with the use of marijuana and alcohol (P=.02 and P=.046, respectively) and with lower belief in public health measures (P=.003). In addition, graduate students were less likely and those with ≥20 roommates were more likely to report a COVID-19 diagnosis (P=.009).

CONCLUSIONS

Mental health problems were common in this student population. Several factors, including substance use, were associated with the risk of COVID-19. These data highlight important areas for further attention, such as prioritizing innovative strategies that address health and well-being, considering the potential long-term effects of COVID-19 on college students.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04766788; https://clinicaltrials.gov/ct2/show/NCT04766788.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/29561.

Social isolation and psychological distress among southern U.S. college students in the era of COVID-19

BACKGROUND

College students are at heightened risk for negative psychological outcomes due to COVID-19. We examined the prevalence of psychological distress and its association with social isolation among public university students in the southern United States.

METHODS

A cross-sectional survey was emailed to all University of North Carolina-Chapel Hill students in June 2020 and was open for two weeks. Students self-reported if they were self-isolating none, some, most, or all of the time. Validated screening instruments were used to assess clinically significant symptoms of depression, loneliness, and increased perceived stress. The data was weighted to the complete student population.

RESULTS

7,012 completed surveys were included. Almost two-thirds (64%) of the students reported clinically significant depressive symptoms and 65% were categorized as lonely. An estimated 64% of students reported self-isolating most or all of the time. Compared to those self-isolating none of the time, students self-isolating some of the time were 1.78 (95% CI 1.37, 2.30) times as likely to report clinically significant depressive symptoms, and students self-isolating most or all of the time were 2.12 (95% CI 1.64, 2.74) and 2.27 (95% CI 1.75, 2.94) times as likely to report clinically significant depressive symptoms, respectively. Similar associations between self-isolation and loneliness and perceived stress were observed.

CONCLUSIONS

The prevalence of adverse mental health indicators among this sample of university students in June 2020 was exceptionally high. University responses to the COVID-19 pandemic should prioritize student mental health and prepare a range of support services to mitigate mental health consequences as the pandemic continues to evolve.

Abuse and suicide risk among college students in the United States: Findings from the 2019 Healthy Minds Study

BACKGROUND

Suicide has increased among American youth, and remains a concern on college campuses where students have reported increasing levels of psychological distress, alcohol use, social isolation, and loneliness. Abuse is known to be a risk factor for suicide, but more research is needed to understand whether current specific types of abuse and their co-occurrence are related to current suicidal thoughts and behaviors among young adults in college.

METHODS

We analyzed data from the 2019 wave of the Healthy Minds Study, a cross-sectional, web-based survey administered to undergraduate and graduate students. Using multivariable logistic regression, we examined the associations between abuse and suicidal thoughts and behaviors, adjusting for sociodemographic and mental health covariates.

RESULTS

In the past 12 months, 12.56% of the sample reported suicidal ideation, 5.70% reported making a suicide plan, and 1.28% reported making a suicide attempt. Over a third of the sample reported at least one type of abuse over the past 12 months. Emotional, physical, and sexual abuse were all associated with greater odds of all suicide outcomes, adjusting for sociodemographic characteristics and mental health. Endorsing multiple types of abuses was associated with greater odds of suicide outcomes in a dose-response fashion.

LIMITATIONS

Data were cross-sectional and the response rate for this survey was 16%.

CONCLUSIONS

Universities can implement a multi-pronged approach that covers screening for types of abuse, initiating awareness campaigns around abuse and suicide, and training faculty and staff to make appropriate referrals. Student services must also be equipped to address students who perpetrate abuse.

Mental Distress, Help Seeking, and Use of Health Services Among University Students. The SHoT-Study 2018, Norway

Background: Existing studies have documented high levels of mental distress in University and college students, complemented with poor help-seeking behavior. Colleges and universities offer a unique setting to address mental health problems that might overcome some of the most prominent barriers to help-seeking. Objective: We aim to describe the use of campus-based health care services and health services available in the near-by community among students in Norwegian student welfare organizations. We compare health care service use between non-local (in-movers) and local students, students at large and small welfare organizations, and students with severe and medium-low levels of mental distress. Methods: Data stem from the SHoT study (Students' Health and Well-being Study), a national survey from 2018 of all students aged 18-35 undertaking higher education in Norway. Mental distress was assessed using the Hopkins Symptom Checklist-25 (HSCL-25), and we also obtained self-report data on use of health care services. Data on health care services offered at Norwegian student welfare organizations was obtained from semi-structural telephone interviews. Results: Non-local students used health care services that are low threshold, easily accessible and close to campus (health clinics and services organized by the student welfare organization) to a larger extent than local students. Students with symptoms of severe mental distress used almost all types of health services more than other students. We found big differences in reported use of health services in large and small organizations, yet these differences mirrored services available, and not necessarily student demand and preferences. Conclusion: Services offered by the student welfare organizations seem to play a particularly important role for non-local students and students reporting symptoms of severe mental distress.

Problematic internet use/computer gaming among US college students: Prevalence and correlates with mental health symptoms

BACKGROUND

Despite widespread internet use and computer gaming, as well as concerns about online addiction, little is known regarding the relationship between problematic internet use/computer gaming and mental health (MH) symptomatology among US college students. To address this gap, the present study examines a large, nation-wide sample of US college students to assess the rate of problematic internet use/computer gaming and its association with MH symptoms.

METHODS

Using data from 43,003 undergraduates participating in the 2017 American College Health Association-National College Health Assessment, we examined rates of problematic internet use/computer gaming, defined as self-reported internet use/computer gaming that negatively affected academic performance. Logistic regression using a generalized estimating equations approach to adjust for clustering by school examined whether rates of MH symptomatology differed among students who reported problematic versus nonproblematic internet use and computer gaming.

RESULTS

Ten percent of students reported problematic internet use/computer gaming that had negatively impacted academic performance. Adjusting for a range of covariates, students reporting problematic internet use/computer gaming had higher rates of all 11 MH indicators examined, with odds ratios ranging from 1.42 ("ever attempted suicide") to 3.90 ("ever felt overwhelmed by all you had to do").

CONCLUSIONS

Problematic internet use/computer gaming is reported by 10% of undergraduate students and represents a significant correlate of MH symptomatology. These findings suggest that problematic internet use/computer gaming will be an important public health focus for college campuses.

Smartphone Apps for College Mental Health: A Concern for Privacy and Quality of Current Offerings

OBJECTIVE

The expanding need for mental health services on college campuses has increased interest in smartphone apps for mental health. Although apps can be effective tools, they can also present risks regarding privacy and lack of efficacy, and little is known about the nature or quality of mental health apps that colleges are recommending to students. This study sought to fill that knowledge gap.

METHODS

Sixty college counseling center Web sites were examined for suggested mobile apps offered as resources for students. The features of each app were assessed, including date of last update, privacy policy, and whether any research had been published in peer-reviewed journals.

RESULTS

Twenty-six college counseling centers suggested a total of 218 unique apps. Of these, 28% were no longer available for download. Of the 158 remaining apps, only 44% had been updated in the past 6 months, and 39% had no privacy policy. Of the 97 existing apps with privacy policies, 88% collected user's data and 49% shared users' data with third parties. Efficacy studies had been published in peer-reviewed journals for only 16% of existing apps.

CONCLUSIONS

College counseling centers are not suggesting safe or up-to-date mobile apps. There is an urgent need to help centers identify, curate, and recommend more appropriate apps. The authors suggest that centers use the American Psychiatric Association's app evaluation framework; develop an app review process, with input from clinicians and students; or employ a digital navigator to select apps and help connect students to the appropriate app.

Social support and self-esteem on the association between stressful life events and mental health outcomes among college students

The purpose of this research is to determine whether social support (informal and formal) and self-esteem can moderate the associations between life stress and mental health among college students. The research questions for the study are as follows: i) Does life stress affect mental health among college students? ii) Do social support (informal and formal) and self-esteem predict this association? iii) What are the characteristics of students predicting life stress, social support and self-esteem? Using a survey design (n = 184), respondents were asked about stressful life events, formal and informal social support, self-esteem, depression, anxiety, and baseline characteristics (age, sexual orientation, post graduate status, family size, income, employment status, participation in activities at school, and previous mental health diagnoses). Regression analysis found that students who experienced more stressful life events reported higher depression and anxiety. Informal social support and self-esteem significantly enhanced positive mental health. However, formal social support was not found to impact students' mental health. Younger students tend to have lower self-esteem and higher mental health problems. Students who worked part-time and participated in extra curriculum activities used more forma social services. Students who had previous mental health diagnoses had higher mental health problems.