Alcohol and drug use in UK university students

A game-based learning approach to sleep hygiene education: a pilot investigation

Introduction

Sleep hygiene education (SHE) consists of environmental and behavioral practices primarily intended to reduce sleep problems. Currently considered ineffective as a stand-alone treatment, the manner in which the education is typically delivered may be ineffective for the acquisition of new knowledge. The purpose of this study was to determine if a more engaging teaching medium may improve the efficacy of sleep hygiene education. This study examined the use of game-based learning to teach SHE to individuals with sleep problems.

Methods

35 participants played the SHE games for 30 days. Differences in pre- and post-state anxiety and sleep quality measures were examined.

Results

Participants had significant improvements in sleep quality and state anxiety after using the app for 30 days, although scores for the majority of patients remained elevated.

Discussion

This pilot investigation provides initial evidence for the efficacy of a game-based approach to SHE.

Reflective and non-reflective influences on cannabis use among undergraduate students: A qualitative study

OBJECTIVE

Around 40% of US university students use cannabis, 25% of whom present with cannabis use disorder, which endangers health. We investigated the concurrent contribution of reflective processes, which generate action via conscious deliberation, and non-reflective processes, which prompt behavior automatically, to undergraduates' cannabis consumption.

PARTICIPANTS

Eighteen UK undergraduates who regularly consume cannabis (11 female, 7 male; mean age 20 y).

METHODS

Semi-structured interviews explored cannabis motives, routines, cues, and decision points. Thematic analysis identified themes, in each of which reflective and non-reflective dimensions were coded.

RESULTS

Four themes were identified: cannabis use for relaxation, social bonding, and symbolic-affective significance, and contexts and triggers. Some influences guided cannabis use reflectively in some settings, and non-reflectively in others. Even when cannabis use was consciously driven, non-reflective processes were deployed to execute subservient acts, such as rolling joints.

CONCLUSIONS

Findings highlight specific processes and pathways that might be targeted to reduce cannabis-related harm.

Early Family Experiences, Drug Use, and Psychosocial Adjustment across the Life Span: Is Parental Strictness Always a Protective Factor?

Objective: This study analyzes whether parental strictness, which is shared by authoritative parenting (strictness and warmth) and authoritarian parenting (strictness without warmth) styles, always acts as a main protective factor against drug use and psychosocial maladjustment in children. This conclusion has already been stated in numerous classic studies, though emergent research suggests that there are benefits to parental warmth regardless of whether strictness is present or not. Method: Sample were 2,095 Spanish participants (1,227 females, 58.6%), 581 adolescent children (aged 12-18 years, 27.7%) and 1,514 adult children (72.3%). The measures were the main parenting style dimensions (warmth and strictness), drug use, and a set of indicators of psychosocial adjustment. A 4 × 2 × 4 MANOVA was applied for all outcomes with parenting style, sex, and age as independent variables. Results: Indulgent parenting (warmth without strictness) was related to less drug use than parenting without warmth (authoritarian and neglectful). Additionally, indulgent and authoritative parenting styles were related to better scores on psychosocial adjustment than authoritarian and neglectful styles, although the indulgent parenting was the only style related to the optimal scores being equal or even more effective than the authoritative style. Conclusion: Contrary to classical studies, present findings suggest that it is the parental warmth instead of the parental strictness that seems to be effective in protecting against drug use and psychosocial maladjustment.

Prevalence of anxiety, depression, mania, insomnia, stress, suicidal ideation, psychotic experiences, & loneliness in UK university students

Despite existing wellbeing services, university students remain particularly vulnerable to mental health difficulties. Therefore, this study was designed to provide a comprehensive assessment of the prevalence of psychiatric symptoms by using well validated scales with robust psychometric properties. More specifically, the current data provides crucial information concerning the prevalence of anxiety, depression, mania, insomnia, stress, suicidal ideation, psychotic experiences and loneliness amongst a sample of N = 1408 UK university students. A cross-sectional online questionnaire-based study was implemented. Online recruitment for this dataset began on September 17th, 2018, and ended on the 30th July 2019. Eight validated measures were used: Generalized Anxiety Disorder Scale; Patient Health Questionnaire; The Mood Disorder Questionnaire; The Sleep Condition Indicator; The Perceived Stress Scale; Suicidal Behaviours Questionnaire-Revised; The Prodromal Questionnaire 16 (PQ-16); and the University of California Loneliness Scale. The dataset is available to other researchers and is provided on figshare. Information concerning the data records, usage notes, code availability and technical validation are presented. Finally, we present demographic information concerning psychiatric symptom prevalence.

Alcohol use disorder among healthcare professional students: a structural equation model describing its effect on depression, anxiety, and risky sexual behavior

BACKGROUND

Mental health problems such as depression, anxiety and alcohol use disorders are among the leading causes of disability worldwide. Among university students, alcohol use and poor mental health are associated with risky sexual behavior. Given the syndemic occurrence of these disorders most especially in young adults, we describe the relationship between them so as to guide and intensify current interventions on reducing their burden in this population.

METHODS

This was a cross-sectional study based on an online survey among healthcare professional university students that captured sociodemographic characteristics, risky sexual behavior, alcohol use disorder, generalized anxiety disorder, and depression. Structural equation modelling was used to describe the relationship between these variables using RStudio.

RESULTS

We enrolled a total of 351 participants of which 11% (37/351) had Alcohol Use Disorder, 33% (117/351) had depressive symptoms and 32% (111/351) had symptoms of anxiety. A model describing the relationship between these variables was found to fit well both descriptively and statistically [χ² = 44.437, df = 21, p-value = 0.01, CFI = 0.989, TFI = 0.980, RMSEA = 0.056]. All observed variables were found to fit significantly and positively onto their respective latent factors (AUD, anxiety, depression and risky sexual behavior). AUD was found to be significantly associated with risky sexual behavior (β = 0.381, P < 0.001), depression (β = 0.152, P = 0.004), and anxiety (β = 0.137, P = 0.001).

CONCLUSION

AUD, depression and anxiety are a significant burden in this health professional student population and there's need to consider screening for anxiety and depression in students reporting with AUD so as to ensure appropriate interventions. A lot of attention and efforts should be focused on the effect of AUD on risky sexual behavior and continued health education is still required even among health professional students.

Frequency and Factors of Sleep Paralysis Among Medical Students of Karachi

INTRODUCTION

Sleep paralysis is a prevalent phenomenon characterized by suffocation, immobility, and hallucinations. Its causes remain unknown, although the neurotransmitter imbalance is suggested as a potential factor. This condition is closely associated with hallucinations and a sense of intrusion, often observed in patients with narcolepsy, hypertension, and seizures.

METHODS

A cross-sectional study was conducted in various medical colleges in Karachi, involving 297 participants aged 18 to 30 years. The participants were divided into groups based on gender and year of study. They were surveyed about the frequency of sleep paralysis episodes, their beliefs about the phenomenon, sleep routines, and academic impacts.

RESULTS

Among the respondents, a significant number of females (n=209, 70.3%) reported experiencing sleep paralysis. The overall mean age was 20±2.0 years. Correlation analysis revealed an insignificant relationship between depression and mental anxiety (p=0.147). Similarly, no significant association was found when comparing the occurrence of sleep paralysis (p=0.16). However, a notable finding was the significant link between sleep paralysis and its impact on academics (p=0.043).

CONCLUSION

This study highlighted the frequency of sleep paralysis among medical students, particularly among females. Furthermore, it emphasizes the diverse beliefs held by individuals regarding these frightening episodes. To address this neglected issue, it is essential to conduct awareness sessions aimed at understanding and alleviating sleep paralysis in individuals' lives.

Illicit drug use in university students in the UK and Ireland: a PRISMA-guided scoping review

BACKGROUND

Interest in the health and well-being of university students has increased in the UK and Ireland in the past two decades as their numbers have grown. Recent high-profile deaths of students after using illicit drugs have highlighted the importance of the topic for policy makers. This scoping review maps the state of the existing literature evaluating use of illicit drugs in university students in the UK and Ireland. It aims to highlight research gaps and inform policy.

METHOD

We conducted a systematic search of papers related to psychoactive drug use in university students in the UK and Ireland published before August 2021. The 18 extracted study characteristics included author(s); year of publication; journal; location of data collection; study design; delivery method (e.g., online survey, in-person, postal survey); number of participants; response rate; participant course of study, year of study, degree level (i.e., undergraduate, postgraduate), gender and age; time-period assessed (e.g., lifetime, current use, past 12 months); primary aim; primary outcome; ethical approval; and funding source.

RESULTS

The PRISMA-guided search strategy identified 1583 papers for abstract review; of 110 papers retained for full-text review, 54 studies met criteria for inclusion for this paper. Primary outcomes were coded into five groups: prevalence and patterns of drug use; factors associated with drug use; attitudes and knowledge about, and motivation for, drug use; supply of drugs; consequences of drug use. The results show that there is no coherent body of research in this area. The prevalence of reported drug use has crept up and the range of substances reported has broadened over time, and attitudes to drugs on average have normalised. However, there are significant methodological limitations that limit the utility of these findings. There was little evidence of published work on prevention of, or intervention to reduce, drug-related harms.

CONCLUSION

The domains identified offer a framework for university administrators, researchers and policy makers to understand the potential response to drug use in university students in the UK and Ireland. Recommendations are made to fill the gaps in the research evidence base.

Prevalence and Psychiatric Correlates of Illicit Substance Use in UK Undergraduate Students

This study examined the prevalence of illegal drug use in UK students and motivators behind such behavior. Additionally, we explored possible relationships between substance use, psychosocial motivators, and psychiatric distress. A group (n = 543) of students completed online measures of substance use, anxiety, depression, perceived stress, and insomnia. A series of reasons behind their use were ranked based on importance. Reported cannabis, cocaine, nitrous oxide, ketamine, and MDMA use were most prevalent based on lifetime, past year, and month assessments. The experience of anxiety, depression, perceived stress, and insomnia were related to increased reports of substance use. Poor self-confidence and self-medication were key motivators of illicit drug use in those presenting greater psychiatric distress. These outcomes add to the sparse body of literature concerning illicit substance use in relation to psychiatric distress amongst UK students. Furthermore, we provided novel insight into the psychosocial motivators of such use.

Estimating the prevalence of high-risk behaviors using network scale-up method in medical university students

BACKGROUND

There is not much information about high-risk behaviors in young groups, especially students. This study was conducted to estimate the prevalence of high-risk behaviors in students of universities of medical sciences in West Azerbaijan Province, Iran, by network scale-up (NSU) method.

MATERIALS AND METHODS

This cross-sectional study was performed on 450 students from the universities of medical sciences. A researcher-developed checklist was used to collect the data. We considered number 16 for the social network size of students according to a previous study. Based on the response of individuals to each of the high-risk behaviors (including cigarette smoking, hookah use, opium consumption, alcohol drinking, tramadol/ecstasy taking, and extramarital sex) in their social network, the prevalence of these behaviors was estimated. The required calculations were performed using the NSU method. Furthermore, 95% uncertainty interval (UI) was calculated using the bootstrap method.

RESULTS

Totally, 196 (44%) participants were male. The mean age (standard deviation) of the participants was 22 ± 2 years. Results showed that hookah use (20% 95% UI [18.9-21.1]) and opium consumption (0.4% 95% UI [0.24-0.6]) had the highest and lowest frequencies, respectively. Cigarette smoking (17% 95% UI [15.8-18]), alcohol use (8.3% 95% UI [7.5-9.1]), extramarital sex (8.2% 95% UI [7.4-9]), and tramadol/ecstasy taking (4% 95% UI [6.4-4.6]) were the next most common high-risk behaviors, respectively.

CONCLUSIONS

Given that hookah use and cigarette smoking are the most common high-risk behaviors in students, especially males, appropriate cultural activities and educational programs should be employed by relevant authorities to reduce these behaviors.

Patterns of Alcohol Consumption and Use of Health Services in Spanish University Students: UniHcos Project

The aim of the study was to examine the association of alcohol consumption patterns (hazardous alcohol use and binge drinking) and the use of emergency services and primary care consultations in university students. An observational, descriptive, cross-sectional study was conducted at eleven Spanish universities collaborating within the uniHcos Project. University students completed an online questionnaire that assessed hazardous alcohol use and binge drinking using the AUDIT questionnaire and evaluated the use of emergency services and primary care. A descriptive analysis of the data was performed, as well as the chi-squared test and Student’s t-test and nonconditional logistic regression models to examine this association. Results: There were 10,167 participants who completed the questionnaire. The prevalence of hazardous alcohol use was 16.9% (95% CI: 16.2−17.6), while the prevalence of binge drinking was 48.8% (95% CI: 47.9−49.8). There were significant differences in the use of emergency services in those surveyed with hazardous alcohol use (p < 0.001) or binge drinking pattern (p < 0.001). However, no significant differences were observed in terms of attendance during primary care visits in individuals with hazardous alcohol use (p = 0.367) or binge drinking pattern (p = 0.755). The current study shows the association between university students with a pattern of hazardous alcohol use or binge drinking and greater use of emergency services. However, no significant association was observed between the said consumption patterns and the use of primary care services.

Sleep quality and its correlates among undergraduate medical students in Nepal: A cross-sectional study

Poor sleep quality has been found to affect students' learning abilities, academic performance, and interpersonal relationships. However, little is known about this issue in Nepal. This study aimed to identify the factors associated with poor sleep quality among undergraduate medical students in Nepal. A web-based survey was conducted in March 2021 among 212 undergraduate medical students at the Institute of Medicine, Kathmandu, Nepal. Sleep quality was measured using a 19-item Pittsburgh Sleep Quality Index (PSQI). Multivariable logistic regression analysis was done to assess the factors associated with sleep quality. In the study participants, 38.2% of the students were identified as poor sleepers. Factors like being depressed (AOR = 4.5, 95% CI; 1.2-5.4), current alcohol use (AOR = 2.5, 95% CI; 1.8-10.8), poor academic achievement (AOR = 3.4, 95% CI; 1.1-10.9), and being a fourth-year student (AOR = 3.6, 95% CI; 1.1-11.8) were significantly associated with poor sleep quality. Poor sleep quality was common among undergraduate medical students. Routine screening of sleep quality and depressive symptoms is necessary to mitigate their impact among medical students. Medical students of the fourth year, current alcohol users, and those who did not have good academic achievement had poor sleep quality. Special attention on these population subgroups is thus needed to enhance sleep quality.

Asociación entre alteraciones en el sueño y problemas de salud mental en los estudiantes de Medicina durante la pandemia de la COVID-19

Introduction

Medical students are a population vulnerable to poor sleep quality and sleep deprivation; these problems were accentuated during the COVID-19 pandemic. The objective was to evaluate the association between sleep disturbances and the presence of depression and anxiety in medical students during the pandemic.

Materials and methods

Cross-sectional, analytical study in medical students of a private university in Peru. Data were collected from May 22 to June 14, 2020, after 3 months of mandatory social isolation. The Patient Health Questionnaire (PHQ-9; ≥ 10), the Generalized Anxiety Disorder (GAD-7; ≥ 10) scale and the Insomnia Severity Index (ISI; ≥ 8) were used to assess depression, anxiety and insomnia, respectively. Poisson regressions with robust variance were used to calculate prevalence ratios.

Results

The prevalence of depression, anxiety and insomnia was 28.5%, 29.5% and 60.1% respectively. It was found that those who had short sleep (RPa: 1.40, CI: 1.05-1.87, p: 0.024), who slept after 2:00 hours (RPa: 2.24, CI: 1.31-3.83, p: 0.003) and who presented insomnia (RPa: 7.12, CI: 3.70-13.73, p: < 0.001) had a higher prevalence of anxiety. Likewise, those who slept after 2:00 hours (RPa: 2.13, CI: 1.24-3.64, p: 0.006) and those who presented insomnia (RP: 8.82, CI: 4.17-18.68, p: < 0.001) had a higher prevalence of depression.

Conclusions

Short sleep, bedtime and insomnia are factors associated with the prevalence of depression and anxiety.

Addictive profiles of Lebanese university students in terms of smoking, alcohol, and illegal drug use

The Lebanese economic crisis, financial crisis, and USD shortage were conducive to an increased drug addiction especially for students who feel that their future in Lebanon is not safe, as well as the psychological fragility of the Lebanese people, and the more permissive sociocultural context. Our study aimed to assess the addiction levels and profiles of university students in Lebanon, and thus to evaluate the rapid rising in dependence regarding smoking, alcohol, and illegal drug use during this crisis. This cross-sectional study was carried out between February and September 2020. A total of 467 participants (315 females, 152 males; Mage = 23.48 ± 6.03) were recruited through convenience sampling through several universities in Lebanon's governorates. Participants received the online link to the survey. Students were divided into three clusters as follows: cluster 1, which corresponds to students with moderate addictions; cluster 2, which corresponds to students with high addictions; and cluster 3, which corresponds to students with low addictions. When comparing cluster 1 to cluster 3, the results of the multinomial regression showed that older age (aOR=1.08) and having a high monthly income compared to no income (aOR=2.78) were significantly associated with higher odds of being in cluster 1 compared to cluster 3. When comparing cluster 2 to cluster 3, the results of the multinomial regression showed that female gender (aOR=0.19) was significantly associated with lower odds of being in cluster 2 compared to cluster 3, whereas having a dead (aOR=16.38) or divorced parent (aOR=6.54) and having a low (aOR=3.93) or intermediate income compared to zero income (aOR=4.71) were significantly associated with higher odds of being in cluster 2 compared to cluster 3. The results of our study revealed a considerable prevalence of addiction to alcohol, illicit drugs, and specially to smoking, among Lebanese university students. These findings emphasize the need to implement firm policies and rules in an attempt to minimize the tendency of the young population to engage in such addictions.

Educational attainment and drinking behaviors: Mendelian randomization study in UK Biobank

Educational attainment has been associated with drinking behaviors in observation studies. We performed Mendelian randomization analysis to determine whether educational attainment causally affected drinking behaviors, including amount of alcohol intakes (in total and various types), drinking frequency, and drinking with or without meals among 334,507 white British participants from the UK Biobank cohort. We found that genetically instrumented higher education (1 additional year) was significantly related to higher total amount of alcohol intake (inverse-variance weighted method (IVW): beta = 0.44, 95% confidence interval (CI) 0.40-0.49, P = 1.57E-93). The causal relations with total amount and frequency of alcohol drinking were more evident among women. In analyses of different types of alcohol, higher educational attainment showed the strongest causal relation with more consumption of red wine (IVW beta = 0.34, 95% CI 0.32-0.36, P = 2.65E-247), followed by white wine/champagne, in a gender-specific manner. An inverse association was found for beer/cider and spirits. In addition, we found that 1 additional year of educational attainment was causally related to higher drinking frequency (IVW beta = 0.54, 95% CI 0.51-0.57, P = 4.87E-230) and a higher likelihood to take alcohol with meals (IVW: odds ratio (OR) = 3.10, 95% CI 2.93-3.29, P = 0.00E + 00). The results indicate causal relations of higher education with intake of more total alcohol especially red wine, and less beer/cider and spirits, more frequent drinking, and drinking with meals, suggesting the importance of improving drinking behaviors, especially among people with higher education.

Comparing Theoretical Models for the Understanding of Health-Risk Behaviour: Towards an Integrative Model of Adolescent Alcohol Consumption

The aim of the present manuscript is to test and compare the theory of reasoned action (TRA), theory of planned behaviour (TPB) and prototype-willingness model (PWM) in predicting risky alcohol consumption among adolescents and to build an integrative model to get a more comprehensive understanding of such risky behaviour. A total sample of 518 adolescents (55% females; 13-19 aged) recruited from Italian schools (7th to 12th grade) participated in a cross-sectional research study and completed an online questionnaire. Risky alcohol use assessed through the AUDIT-C was the dependent variable; whereas, variables from the TRA, TPB, and PWM (i.e. attitude, subjective norms, perceived behavioural control, intention, prototype favourability and similarity, and willingness to alcohol use) were used as predictors. Data were analysed using structural equation modelling (SEM). The findings show that the integrative model had greater explanatory power and provided a better fit to the data, compared to the TRA, TPB, and PWM, indicating attitudes and subjective norms as the best predictors. In conclusion, perceived social approval from significant others and the volitional component have a central role in understanding adolescents’ alcohol consumption.

Risk factors for hazardous drinking in university students from South Africa and Belgium: a cross-cultural comparison study

Background

Previous studies have associated certain risk factors with hazardous drinking in students. However, big cultural and geographical differences exist regarding alcohol use.

Objectives

To determine whether or not there was a difference in hazardous drinking between Belgian and South African university students and to establish the risk factors that contribute to hazardous drinking in university students (calculated using the AUDIT-C) from a developing country (South Africa) and a developed country (Belgium).

Methods

An online survey assessing hazardous drinking among university students in South Africa (University of KwaZulu-Natal, UKZN) and Belgium (University of Antwerp, UoA) was conducted, using the shortened version of the Alcohol Use Disorder Identification Test (AUDIT-C). Risk factors in males and females for hazardous drinking were explored using multivariate logistic regression analysis.

Results

In total, 499 students were included in the study (250 UoA and 249 UKZN students). A significant higher amount of male (94.8%) as well as female (92.4%) UoA students drank alcohol in the last year compared to the male (66.2%) and female (67.8%) UKZN students (p<0.001). Additionally, a significant higher amount of UoA students were hazardous drinkers, compared to the UKZN students (p<0.001). Multivaiate analysis showed that male UoA students were almost 6 times more likely to be hazardous drinkers than male UKZN students (OR=5.611, p=0.005). Female UoA students were more than twice as likely to be hazardous drinkers than female UKZN students (OR=2.371, p=0.016).

Conclusion

This study found a significant difference in hazardous drinking between Belgian and South African university students.

Sleepiness, sleep deprivation, quality of life, mental symptoms and perception of academic environment in medical students

BACKGROUND

It has been previously shown that a high percentage of medical students have sleep problems that interfere with academic performance and mental health.

METHODS

To study the impact of sleep quality, daytime somnolence, and sleep deprivation on medical students, we analyzed data from a multicenter study with medical students in Brazil (22 medical schools, 1350 randomized medical students). We applied questionnaires of daytime sleepiness, quality of sleep, quality of life, anxiety and depression symptoms and perception of educational environment.

RESULTS

37.8% of medical students presented mild values of daytime sleepiness (Epworth Sleepiness Scale - ESS) and 8.7% presented moderate/severe values. The percentage of female medical students that presented ESS values high or very high was significantly greater than male medical students (p <  0.05). Students with lower ESS scores presented significantly greater scores of quality of life and perception of educational environment and lower scores of depression and anxiety symptoms, and these relationships showed a dose-effect pattern. Medical students reporting more sleep deprivation showed significantly greater odds ratios of presenting anxiety and depression symptoms and lower odds of good quality of life or perception of educational environment.

CONCLUSIONS

There is a significant association between sleep deprivation and daytime sleepiness with the perception of quality of life and educational environment in medical students.

Why Switch? - Motivations for Self-Substitution of Illegal Drugs

Self-substitution is the conscious switch from one drug to another for reasons such as price, availability, desired effect, or perceived benefit of the substitute drug. Purpose/Objectives: This study aimed to describe drug use patterns and motivations associated with substitution. We examined correlates of lifetime substitution among individuals with substance use disorder. Methods: A cross-sectional study of 771 treatment-enrolled individuals. We used self-report for determining the lifetime prevalence, correlates, and motivations for substitution. Results: Of the 771 respondents, 570 (73.9%) reported ever substituting their preferred substance. The main incentives for substitution were availability (23.7%) and curiosity (20.2%). Among heroin or cannabis preferers, improved effects or less adverse effects of the substitute drug, self-medication, and managing withdrawal symptoms were significant substitution incentives. Increased odds for substitution were observed for past 12 months use of cannabis (OR = 1.51, CI = 1.06-4.52), prescription opioids (OR = 2.86, CI = 1.81-4.52), novel psychoactive substances (OR = 2.68, CI = 1.64-4.36), and repeated admission (OR = 1.50, CI = 1.05-2.14). Older age at onset-of-use was negatively associated with substitution (OR = 0.95, CI = 0.93-0.98). Conclusions: Self-substitution of one substance for another is a highly prevalent behavior among treatment-enrolled patients with substance use disorder. Clinicians caring for substance use disorder patients should be aware of substitution patterns involving the use of highly potent substances, which constitutes a risk to patients. Results underscore the benefit of substitution patterns analyses, as they reveal important information on the characteristics of persons who use drugs and their motivations.

Salivary free light chains as a new biomarker to measure psychological stress: the impact of a university exam period on salivary immunoglobulins, cortisol, DHEA and symptoms of infection

INTRODUCTION

Measurement of immunoglobulin free light chains (FLCs) in saliva can serve as a non-invasive biomarker in health and behavioural research. FLCs have been explored in relation to physiological stress but FLC responses to psychological stress and their relationship with infections remain unknown. This study aimed to investigate the impact of exam period stress on salivary FLCs alongside other established biomarkers of stress and whether FLCs relate to symptoms of infection.

METHODS

58 healthy adults studying at university completed saliva samples and questionnaires in a period without exams (baseline), and again prior to the start of an exam period. Saliva samples were assessed for FLCs, IgA, cortisol and dehydroepiandrosterone (DHEA). Measures of life events stress, perceived stress, anxiety and depression were completed. Students also reported incidence and severity of symptoms of infection and rated general well-being at baseline, prior to, during and after the exam period. Exercise, sleep and alcohol consumption were also assessed at both timepoints.

RESULTS

FLCs secretion rates were significantly lower at the exam period compared to baseline (p < .01), with reductions of 26% and 25% for κ FLC and λ FLC, respectively. In agreement, salivary IgA secretion rate was lower at exams (non-significant trend, p = .07). Cortisol concentration significantly increased at exams (p < .05) while DHEA did not change, leading to an increase in the cortisol:DHEA ratio (p = .06). Depression (p < .05) and anxiety increased from baseline to exams and life stress reported in the build up to the exam period was higher compared with baseline (p < .001). Well-being significantly decreased from baseline to exams (p < .01). The proportion of participants reporting infection symptoms (70%) was unchanged between baseline and prior to exams. No significant relationships were found between FLCs or other saliva parameters and infection symptoms, well-being or stress/psychological measures. Changes in saliva parameters between timepoints were independent of health behaviours.

CONCLUSIONS

Salivary FLCs are responsive to life events stress and corroborate with IgA. This preliminary study highlights the potential utility of FLCs as a new salivary biomarker in stress research.

The quality of sleep and daytime sleepiness and their association with academic achievement of medical students in the eastern province of Saudi Arabia

BACKGROUND:

Sleep is often challenging for medical students because of the considerable amount of learning they have to do. The aim of this study was to identify the patterns of sleep quality and daytime sleepiness among medical students in Saudi Arabia and to identify the possible factors associated with poor quality of sleep and daytime sleepiness.

MATERIALS AND METHODS:

This cross-sectional questionnaire-based study was conducted at College of Medicine, Imam Abdulrahman Bin Faisal University, Saudi Arabia. The questionnaire included the prevalidated Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality and the Epworth Sleepiness Scale (ESS) to measure daytime sleepiness. Covariates included sociodemographic characteristics and academic performance. Bivariate and multivariate logistic regression analyses were used to obtain adjusted and unadjusted odds ratios (ORs).

RESULTS:

The sampled population comprised 36.7% males and 63.30% females. The mean global PSQI score was (standard deviation (SD)=4.66), while the mean global ESS score was 8.03 (SD=4.66). Further analysis showed that 80.60% had poor sleep quality and 37.80% of the students suffered from excessive daytime sleepiness. Multivariate regression showed that poor sleep quality was significantly associated with poor academic achievement (adjusted OR = 3.33, 95% confidence interval [CI] = 1.28–8.63). Furthermore, excessive sleepiness significantly increased the odds of poor academic performance (adjusted OR = 4.58, 95% CI = 1.09–20.81).

CONCLUSIONS:

The results on daytime sleepiness were found to be within the ranges reported worldwide; poor sleep quality was found to be among the highest ever reported. Both sleep quality and daytime sleepiness significantly affect academic achievement.

Developing and validating a new multi-dimensional scale for anti-social behavior in a higher education setting

The purpose of this research is to construct and validate a multi-dimensional scale of Anti-social Behavior (hereafter ASB) in a Western higher education context (i.e., USA). To achieve this, four studies, each with a different sample, were performed. Study 1 (n = 150) followed an exploratory design to generate a pool of potential items measuring ASB. Study 2 (n = 254) explored the dimensionality of the items produced in Study 1 using exploratory factor analysis (EFA) and reliability measures. Study 3 (n = 654) confirmed the factorial structure from Study 2 and assessed the measurement model invariance using structural equation modeling (SEM). Finally, Study 4 (n = 287) assessed the predictive validity of the ASB measure through testing a hypothetical path model linking ASB to narcissism and Machiavellianism via an SEM procedure. In total, our research findings conclude that the ASB measurement model is a two-factor multi-dimensional structure comprising: Interpersonal Antagonistic Behavior (six items) as well as Indirect Distractive Behavior (four items). The research and practical implications for universities are thereafter discussed.

My own personal hell: approaching and exceeding thresholds of too much alcohol

Objectives: Government guidelines aim to promote sensible alcohol consumption but such advice is disconnected from people's lived experiences. This research investigated how people construct personal thresholds of 'too much' alcohol. Design and measures: One hundred fifty drinkers completed an online survey (M_age = 23.29(5.51); 64.7% female). Participants were asked whether they had an intuitive sense of what constitutes too much alcohol. They wrote open-ended descriptions of how that threshold had been established and how it felt to approach/exceed it. These qualitative accounts were coded using thematic analysis and interpreted with an experiential theoretical framework. Results: Personal thresholds were based on previously experienced embodied states rather than guidelines, or health concerns. Describing the approach to their threshold, 75% of participants fell into two distinct groups. Group 1's approach was an entirely negative embodied experience (nausea/anxiety) and Group 2's approach was an entirely positive, embodied experience (relaxed/pleasurable). These groups differed significantly in awareness of alcohol's effects, agency and self-perceptions, but not on alcohol consumption. Exceeding their threshold was an entirely negative embodied experience for all. Conclusion: These findings illustrate that people are guided by experientially grounded conceptions of consumption. Interventions could target different groups of drinker according to their embodied experience during the approach to 'too much' alcohol.

How Do Students Source and Supply Drugs? Characteristics of the University Illegal Drug Trade

Background: It is widely known that a proportion of university students use drugs. However, much less is known about how they source and supply their drugs. Objectives: In this article, we investigate student drug trading activity, including how they obtained their drugs, whether they sold drugs, and the extent to which their drug trading might be described as a form of "social supply". Methods: A survey was conducted of all students across seven of the nine universities of Wales. In total, 7855 students submitted a questionnaire and 1877 of these reported drug use in the current academic year. All students who reported using one or more illegal drugs in the current academic year were asked how they obtained their drugs, how they funded their drug use, whether they had sold, traded or given away illegal drugs, along with their motives for drug trading. Results: The results showed that about half of users obtained drugs solely from friends and associates and one-fifth obtained them solely from external dealers. One-quarter used friends and associates as well as external markets. In many cases, supplying drugs amounted to sharing them or giving them away. However, over one-third of students said that they had sold drugs. Conclusions: Overall, the methods of sourcing and supplying drug among university students shares features of both "social supply" and "traditional" drug markets. We conclude that the student drug market investigated is best described as a "hybrid" combination of both.

Responding to excessive alcohol consumption in third-level (REACT): a study protocol

BACKGROUND

Problem alcohol use is an ongoing, worldwide phenomenon of considerable concern. Throughout the past 20 years, national policies have noted the importance of students when tackling alcohol consumption. Considering alcohol is a multifaceted issue, a multi-component response is required to combat its excessive use. This protocol sets out the approach used for developing, implementing and evaluating the REACT (Responding to Excessive Alcohol Consumption in Third-level) Programme.

METHODS/DESIGN

This evaluation will provide the evidence base for programme development, implementation and improvement. Stage one involved defining the multi-component intervention. This was developed following a systematic review of existing literature and a Delphi-consensus workshop involving university students, staff and relevant stakeholders. Following this, the programme is being implemented across the Higher Education sector in Ireland. A number of Higher Education Institutes have declined the invitation to participate in the programme. These institutions will act as control sites. Each intervention site will have a steering committee whose membership will include a mix of students and academic and student service staff. This steering committee will report to the REACT research team on the implementation of mandatory and optional action points at local sites. An online cross-sectional study at baseline and two-years post intervention will be utilised to determine the impact of the REACT programme. The impact assessment will focus on (1) whether the intervention has reduced alcohol consumption among third-level students (2); whether the programme altered students attitudes toward alcohol and (3) whether the programme has decreased the second-hand effects associated with excessive consumption. Finally, qualitative research will focus on factors influencing the take-up and implementation of this programme as well as students' views on the initiative.

DISCUSSION

Alcohol consumption has remained on the policy agenda at both national and international level over recent decades. Students are regularly among the highest alcohol consumers, yet university management and public policymakers struggle to tackle this burgeoning issue. The REACT Programme provides a structure to translate policy into practice for those seeking to reduce hazardous alcohol consumption and related harms among third-level students.

Motivations for reducing alcohol consumption: An international survey exploring experiences that may lead to a change in drinking habits

AIMS

Brief interventions delivered by doctors and other healthcare practitioners might be meaningfully enhanced by understanding what individual experiences might lead patients to cut down. The aim of the current paper was to explore the experiences that might lead people to reduce their alcohol consumption and to compare these findings between respondents from 21 different countries.

METHODS

Global Drug Survey is an online cross sectional, opportunistic anonymous survey. This paper includes 72,209 respondents from 21 counties with over 250 respondents (60.8% male).

RESULTS

Almost a third (32.9%) of participants reported that they would like to drink less alcohol over the next 12months, and a third thought their GP would tell them to cut down if they were honest about their drinking. The primary experiences that were rated as most likely to lead to a change in behaviour were related to physical health, sexual assault and having to seek emergency medical treatment. Respondents from Germany were more likely to select embarrassment as a motivation to reduce drinking than those from other counties. Females were more likely to report indicate motivations related to sexual regret, sexual assault or seeking treatment. Older participants and those in the low risk audit category were more likely to report embarrassment or forgetfulness as potential motivation for change.

CONCLUSION

Understanding the different motivations that may lead individuals to change their drinking behaviours can be used to inform targeted brief interventions and targeted public health guidance.

Health assessment of French university students and risk factors associated with mental health disorders

Objective

The first year of university is a particularly stressful period and can impact academic performance and students’ health. The aim of this study was to evaluate the health and lifestyle of undergraduates and assess risk factors associated with psychiatric symptoms.

Materials and methods

Between September 2012 and June 2013, we included all undergraduate students who underwent compulsory a medical visit at the university medical service in Nice (France) during which they were screened for potential diseases during a diagnostic interview. Data were collected prospectively in the CALCIUM database (Consultations Assistés par Logiciel pour les Centres Inter-Universitaire de Médecine) and included information about the students’ lifestyle (living conditions, dietary behavior, physical activity, use of recreational drugs). The prevalence of psychiatric symptoms related to depression, anxiety and panic attacks was assessed and risk factors for these symptoms were analyzed using logistic regression.

Results

A total of 4,184 undergraduates were included. Prevalence for depression, anxiety and panic attacks were 12.6%, 7.6% and 1.0%, respectively. During the 30 days preceding the evaluation, 0.6% of the students regularly drank alcohol, 6.3% were frequent-to-heavy tobacco smokers, and 10.0% smoked marijuana. Dealing with financial difficulties and having learning disabilities were associated with psychiatric symptoms. Students who were dissatisfied with their living conditions and those with poor dietary behavior were at risk of depression. Being a woman and living alone were associated with anxiety. Students who screened positively for any psychiatric disorder assessed were at a higher risk of having another psychiatric disorder concomitantly.

Conclusion

The prevalence of psychiatric disorders in undergraduate students is low but the rate of students at risk of developing chronic disease is far from being negligible. Understanding predictors for these symptoms may improve students’ health by implementing targeted prevention campaigns. Further research in other French universities is necessary to confirm our results.

Alcohol and other substance use among medical and law students at a UK university: a cross-sectional questionnaire survey

PURPOSE OF THE STUDY

To examine the use of alcohol and other substances among medical and law students at a UK university.

STUDY DESIGN

Anonymous cross-sectional questionnaire survey of first, second and final year medical and law students at a single UK university.

RESULTS

1242 of 1577 (78.8%) eligible students completed the questionnaire. Over half of first and second year medical students (first year 53.1%, second year 59.7%, final year 35.9%) had an Alcohol Use Disorders Identification Test (AUDIT) score suggestive of an alcohol use disorder (AUDIT≥8), compared with over two-thirds of first and second year law students (first year 67.2%, second year 69.5%, final year 47.3%). Approximately one-quarter of medical students (first year 26.4%, second year 28.4%, final year 23.7%) and over one-third of first and second year law students (first year 39.1%, second year 42.4%, final year 18.9%) reported other substance use within the past year. Over one-third of medical students (first year 34.4%, second year 35.6%, final year 46.3%) and approximately half or more of law students (first year 47.2%, second year 52.7%, final year 59.5%) had a Hospital Anxiety and Depression Scale anxiety score suggestive of a possible anxiety disorder.

CONCLUSIONS

Study participants had high levels of substance misuse and anxiety. Some students' fitness to practice may be impaired as a result of their substance misuse or symptoms of psychological distress. Further efforts are needed to reduce substance misuse and to improve the mental well-being of students.

Sleep Duration and Sleep Patterns in Chinese University Students: A Comprehensive Meta-Analysis

STUDY OBJECTIVES

This meta-analysis aimed to determine duration and patterns of sleep in Chinese university students.

METHODS

English (PubMed, PsycINFO, Embase) and Chinese (SinoMed, Wan Fang Database, and Chinese National Knowledge Infrastructure) databases were systematically and independently searched from their inception until August 16, 2016. Data on sleep duration and sleep patterns of tertiary student population in eligible studies were extracted and pooled using random-effects models.

RESULTS

A total of 57 studies with 82,055 university students were included in the meta-analysis. Pooled mean sleep duration was 7.08 h/d (95% confidence interval [CI]: 6.84 to 7.32 h/d). The percentage of students with sleep duration shorter than 6 h/d and 7 h/d (short sleep) was 8.4% (95% CI: 5.7% to 12.3%) and 43.9% (95% CI: 36.9% to 51.1%), respectively. In contrast, the percentage of students with sleep duration longer than 8 hours and 9 hours (long sleep) was 18.3% and 5.7%, respectively. The pooled mean bedtime was at 12:51 am. The percentage of university students who fall asleep after midnight was 23.8%. The percentage of students with sleep latency more than 30 minutes was 25.5%. The pooled mean wake-up time was at 8:04 am on weekdays and on weekends.

CONCLUSIONS

Short sleep duration and unhealthy sleep patterns were found to be common among Chinese university students.

Utilizing community and voluntary sector partnerships to survey and compare the health outcomes of hard-to- reach groups to the wider community-the EURO- URHIS 2 Hard-to-Reach Project

Background

This article describes the Hard-to-Reach (HtR) Project that was developed to capture health and lifestyle data from groups who are HtR by postal surveys within the larger EURO-URHIS 2 project. By collaborating with partner organizations, data were collected using standard survey tools, allowing for comparison with the wider population. Following a scoping exercise to determine which groups were HtR in Greater Manchester, black and minority ethnic (BME) groups and students were selected. BME groups were surveyed through partnership with Community and Voluntary Sector Organizations (CVSOs). Language barriers were addressed through the recruitment of volunteer interpreters. Students were surveyed by accessing university premises. Fifteen survey visits took place at nine CVSOs and five visits to University facilities. In total, 144 eligible surveys were collected. There were significant differences for both HtR groups, compared with Greater Manchester and the EURO-URHIS 2 mean. Both HtR groups had worse outcomes than both Greater Manchester and EURO-URHIS 2 for psychological problems. In addition, students had worse outcomes for passive smoking, binge drinking, use of cannabis, lack of access to green spaces, less sense of belonging and social cohesion and damp or mildewed homes, and better outcomes for self-perceived health and overweight and obesity. BME had in addition worse outcomes than both Greater Manchester and EURO-URHIS 2 for long-standing restrictive illness. Despite the limitations of this study, the development of this methodology allowed for the collection of comparable data, showing up statistically significant differences between the HtR populations and the wider population which merits further investigation.

Prevalence of alcohol use disorders among under- and post-graduate healthcare students in Italy

A cross-sectional study was carried out on 641 medical students, 359 students attending a degree course in the healthcare professions, and 500 resident physicians, all undergoing health surveillance at the ambulatory of the Division of Occupational Medicine, Second University of Naples, Italy. 76.1% of the participants drank alcohol, with 85.5% of medical students, 77.4% of resident physicians, and 63% of healthcare-professions students reporting regular alcohol use. In the whole sample, the mean Audit-C score was 1.6 for men and 1.1 for women; only 5.5% of men and 7.1% of women had a hazardous alcohol consumption with an Audit-C score of respectively ≥4 and ≥3. Multivariate regression modeling revealed that regular alcohol use was more likely in individuals who were men, were younger, had a lower body-mass index, were active smokers, were habitual coffee drinkers, and who were resident physicians or medical students rather than healthcare-professions students. This finding identifies a need to assess alcohol use in medical-profession workers in order to identify risky behavior early on and to carry out rapidly effective preventive and curative interventions.

Additive Effects of Former Methylenedioxymethamphetamine and Cannabis Use on Subclinical Psychotic Symptoms

INTRODUCTION

Methylenedioxymethamphetamine (MDMA) is an amphetamine-derived psychostimulant, usually known as "ecstasy." The long-term neuropsychological effects of MDMA are examined in several studies with conflicting results. The most common findings reported are depression, anxiety, and memory and attention deficits. In addition to acute psychotic reactions observed after MDMA use, serotonergic and dopaminergic toxicities may increase the psychosis risk in the long-term. Cannabis usage among MDMA users is very high. The aim of this study was, therefore, to examine the additive effects of cannabis and MDMA on subclinical psychotic symptoms (SPS).

METHODS

Here, 131 healthy controls (hC), 54 former cannabis and MDMA users (C&M), and 46 former cannabis users (C) were evaluated for SPS. The definition of former user was based on the Munich Composite International Diagnostic Interview. The SPS scores were assessed by using the Schizotypal Personality Questionnaire (SPQ). The relationship between substance-free periods and total MDMA exposure with SPS was also examined.

RESULTS

The C&M group had higher levels of SPS than both C and hC groups. This is true not only for the total SPQ scores but both positive and negative schizotypy scores as well as cognitive-perceptual, disorganized, and interpersonal schizotypy scores aligned hierarchically in the 3 study groups (C&M>C>hC). The total MDMA exposure was positively correlated and MDMA-free period was negatively correlated with the SPS score.

CONCLUSION

We found that the former use of cannabis and MDMA is associated with marked elevation in SPS. Moreover, the exposure amount of MDMA and MDMA-free periods are important determinants of SPS. The longer the cannabis and ecstasy free periods, the larger is the waning of SPS.

Substance abuse amongst the medical graduate students in a developing country

Background & objectives:

Substance abuse is found worldwide including among students. We carried out this study to estimate the prevalence of substance abuse among medical student studying in a medical college in north India.

Methods:

Using a validated questionnaire a cross-sectional survey was conducted among 230 undergraduate and postgraduate medical students in a private medical college.

Results:

The prevalence of substance abuse was 20.43 per cent (47/230) among medical students. An increase in substance abuse was observed in the latter years of medical education. A total of 43 of 47 (91.7%) students using these substances were aware of the ill effects. The most common reasons for substance use were relief from psychological stress (34/47, 72.4%) and occasional celebration (34/47, 72.4%). Of the 47 substance users, 28 (59.6%) made past attempts to quit the substance abuse.

Interpretation & conclusions:

Nearly one-fifth of medical students abuse at least one substance despite knowing the ill effects with the main predisposing factor being the psychological stress.

Promoting mental health in students: is there a role for sleep?

Independently both the role of being a student and reporting insufficient or unsatisfactory sleep have been shown to have deleterious consequences on mental health. However, few studies have examined the combined relationship between students’ sleep patterns specifically with mental health in mind, and how individual psychological characteristics and situational factors can influence this relationship.

The purpose of this research was to examine the relationship between sleep functioning and students’ levels of perceived stress over the course of an exam period. Additionally, the influence of perfectionism (as an individual characteristic) and daytime sleep-related intrusive thoughts (sleep catastrophising) on sleep functioning and stress were also examined. Two assumptions were tested. Firstly, that stress would increase between baseline and the morning of the exam and secondly, that this relationship would be moderated by poor sleep functioning, sleep catastrophising and levels of perfectionism.

Levels of stress, sleep functioning and sleep catastrophising were examined over a seven-day period in 48 Access to Higher Education students about to take an exam and 44 non-exam taking controls. For the exam group, levels of stress and sleep catastrophising increased between time-points. At baseline higher reported perfectionism predicted stress scores. Conversely, low perfectionism predicted high stress on the morning of the exam. Additionally, going to bed later and high levels of sleep catastrophising were also related to stress levels the morning of the exam. The results suggest an association between perfectionism and pre-exam stress, and are discussed in terms of mental health promotion for higher education students.

Alcohol consumption among university students: a Sino-German comparison demonstrates a much lower consumption of alcohol in Chinese students

BACKGROUND

Alcohol use is reported in university students with discrepancy between countries. The study objectives were to assess prevalence and associated factors of alcohol consumption among university students in Germany and China.

METHODS

Data used were from 1853 Chinese and 3306 German university students. Alcohol consumption frequency was measured by a question "How often did you drink alcohol in the last three months?" with six possible responses, which were later collapsed into three categories of "At least once a week", "Less than once a week" and "Never". Problem drinking was measured by the CAGE test and defined as a CAGE score of two or more (four as the maximum). Simple and multivariable logistic regressions were used for association analyses.

RESULTS

German students reported more often "At least once a week" drinking (59.8 vs. 9.0 %). Among Germans, women drank less often "At least once a week" (OR = 0.40, 0.30-0.53). Among Chinese, a higher BMI was associated with drinking "At least once a week" (OR = 1.09, 1.02-1.18). Age revealed a positive association with "At least once a week" drinking in Chinese (1.33, 1.21-1.46) but a negative association in Germans (OR = 0.97, 0.94-0.99). Having a father with high educational level was positively related to "At least once a week" drinking in both countries (OR = 4.25, 2.67-6.78 for Chinese; OR = 1.32, 1.01-1.72 for Germans). Doing less than once a week physical exercise was negatively associated with "At least once a week" drinking in Chinese and German students (OR = 0.27, 0.15-0.48 for Chinese; OR = 0.69, 0.49-0.96 for Germans). Among the German students, 20.3 % reported problem drinking. Being a female (OR = 0.32, 0.26-0.40) and performing less than once a week physical activity (OR = 0.73, 0.56-0.95) were negatively associated with problem drinking, while having a father with high educational level (OR = 1.32, 1.09-1.60) and experiencing higher level of perceived stress (OR = 1.08, 1.04-1.13) were positively related to problem drinking.

CONCLUSIONS

Country-specific strategies for reducing alcohol consumption, e.g. educational awareness programmes of alcohol use on Chinese campuses and alcohol prevention schemes among German youth before entering university, are sensible.

Anxiety symptom interpretation: A potential mechanism explaining the cardiorespiratory fitness-anxiety relationship

BACKGROUND

Higher cardiorespiratory fitness is associated with lower trait anxiety, but research has not examined whether fitness is associated with state anxiety levels and the interpretation of these symptoms. The aim of this paper was to (1) reexamine the association between cardiorespiratory fitness and general anxiety and (2) examine anxiety intensity and perceptions of these symptoms prior to an acute psychological stress task.

METHODS

Participants (N=185; 81% female; Mage=18.04, SD=0.43 years) completed a 10-minute Paced Serial Addition Test. General anxiety was assessed using the anxiety subscale of the Hospital Anxiety Depression Scale. Cognitive and somatic anxiety intensity and perceptions of symptoms was assessed immediately prior to the acute psychological stress task using the Immediate Anxiety Measures Scale. Cardiorespiratory fitness was calculated using a validated standardized formula.

RESULTS

Higher levels of cardiorespiratory fitness were associated with lower levels of general anxiety. Path analysis supported a model whereby perceptions of anxiety symptoms mediated the relationship between cardiorespiratory fitness and levels of anxiety experienced during the stress task; results remained significant after adjusting for general anxiety levels. Specifically, higher levels of cardiorespiratory fitness were positively associated with more positive perceptions of anxiety symptoms and lower levels of state anxiety.

LIMITATIONS

A standard formula rather than maximal testing was used to assess cardiorespiratory fitness, self-report questionnaires were used to assess anxiety, and the study was cross-sectional in design.

CONCLUSIONS

Results suggest a potential mechanism explaining how cardiorespiratory fitness can reduce anxiety levels.

Tobacco, Alcohol and Drug Use among Dental Undergraduates at One UK University in 2015

The aim of this study was determine the prevalence of tobacco, alcohol and illicit substance use among dental undergraduates at one UK university in 2015. A cross-sectional survey of all 344 dental undergraduates using an anonymous self-report questionnaire was carried out. The response rate was 77%, of which 29% were male and 71% female. Tobacco smoking was reported by 23.6% of males and 12.2% of females, with only 1.6% of females reporting to smoke ≥10 cigarettes per day. Alcohol consumption was reported by 85.5% of males and 84% of females, and reported levels of alcohol consumption increased since becoming undergraduates. Binge drinking was reported by 35.3% of males and 41% of female students. Only 2.6% of males and 0.5% of females reported to be current regular users of cannabis. The vast majority of respondents claimed to have never used any illicit substance. The only other reported regularly used substances by males was Ecstasy (1.3%) and by females were LSD (0.5%), Ecstasy (1.5%), Cocaine (0.5%), Inhalants (0.5%) and Ketamine (0.5%). These results are encouraging. Fewer students reported smoking than in the general population, levels of binge drinking were considerably lower than previously reported figures, as were the numbers of regular users of cannabis and other illicit substances.

The emergence of health inequalities in early adulthood: evidence on timing and mechanisms from a West of Scotland cohort

Background

Evidence is inconsistent as to whether or not there are health inequalities in adolescence according to socio-economic position (SEP) and whether or when they emerge in early adulthood. Despite the large health inequalities literature, few studies have simultaneously compared the relative importance of ‘health selection’ versus ‘social causation’ at this life-stage. This study followed a cohort through the youth-adult transition to: (1) determine whether, and if so, when, health inequalities became evident according to both class of origin and current SEP; (2) compare the importance of health selection and social causation mechanisms; and (3) investigate whether these phenomena vary by gender.

Methods

Data are from a West-of-Scotland cohort, surveyed five times between age 15 (in 1987, N=1,515, response=85%) and 36. Self-reported physical and mental health were obtained at each survey. SEP was based on parental occupational class at 15, a combination of own education or occupational status at 18 and own occupational class (with an additional non-employment category) at older ages. In respect of when inequalities emerged, we used the relative index of inequality to examine associations between both parental and own current SEP and health at each age. In respect of mechanisms, path models, including SEP and health at each age, investigated both inter and intra-generational paths from SEP to health (‘causation’) and from health to SEP (‘selection’). Analyses were conducted separately for physical and mental health, and stratified by gender.

Results

Associations between both physical and mental health and parental SEP were non-significant at every age. Inequalities according to own SEP emerged for physical health at 24 and for mental health at 30. There was no evidence of selection based on physical health, but some evidence of associations between mental health in early adulthood and later SEP (intra-generational selection). Paths indicated intra-generational (males) and inter-generational (females) social causation of physical health inequalities, and intra-generational (males and females) and inter-generational (females) social causation of mental health inequalities.

Conclusions

The results suggest complex and reciprocal relationships between SEP and health and highlight adolescence and early adulthood as a sensitive period for this process, impacting on future life-chances and health.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-015-2674-5) contains supplementary material, which is available to authorized users.

Dyslexia and Substance Use in a University Undergraduate Population

BACKGROUND

A number of cognitive deficits are associated with dyslexia. However, only a limited amount of research has been performed exploring a putative link between dyslexia and substance use. As substance use is thought to involve a cognitive component, it is possible that the pattern of substance use would be different for dyslexic participants, when compared to nondyslexic controls. During the current study, a guiding hypothesis was that people with dyslexia would demonstrate less substance use than nondyslexic controls. Theories of memory activation, automaticity, and attentional bias in substance use suggest that cognitive components of substance use are important in the development and maintenance of continued substance use and it is thought that, at least some of these components, would be impaired in a dyslexic population.

OBJECTIVES

If the cognitive deficits displayed by dyslexics somehow impair the development of cognitive components of substance use, substance use for dyslexic participants may be less pronounced. This paper therefore examines this hypothesis by comparing substance use within dyslexic and nondyslexic participants, from an undergraduate population.

METHODS

This was an exploratory questionnaire-based study. Dyslexic participants (n = 35) were compared to control participants (n = 62) on a series of questions designed to measure their substance use history.

RESULTS

The results provided preliminary evidence of a difference between dyslexic and nondyslexic substance use. Dyslexics reported a substance use history that was significantly lower than nondyslexic controls.

CONCLUSIONS/IMPORTANCE

These results are interpreted in terms of cognitive deficits within dyslexia and with reference to the cognitive model of substance use.

The influence of medical student gender and drug use on the detection of addiction in patients

Little is known about medical students' interest in their training on drug addiction, their personal experience of consumption, and whether these aspects influence the detection of addiction in patients. Eighty-eight and one half percent considered that drug dependence issues are important to their professional future. The students report consuming alcohol (69%), cigarettes (19.5%), and illegal drugs (15.8%). Female students consumed fewer illegal drugs than the men (p =.022). Male students consumed more illegal drugs more frequently (p =.005), knew more consumers (p =.023), and those who drink alcohol consumed more illegal drugs than women who drink alcohol (p <.005). Drug and alcohol consumption among medical students may serve to normalize consumption and thus, may prevent the detection of addicts. It is important to educate and raise awareness about drugs and alcohol use, as this may influence detection. The focus should be particularly on the male group.

Internet-delivered cognitive behavior therapy for anxiety and insomnia in a higher education context

BACKGROUND AND OBJECTIVES

Anxiety and insomnia can be treated with internet-delivered Cognitive Behavioral Therapy (iCBT). iCBT may be well-suited to students who are known to be poor help-seekers and suffer these symptoms. iCBT can offer easy access to treatment and increase service availability. The aim of this study was to evaluate the efficacy of anxiety and insomnia iCBT programs in students.

DESIGN

A randomized, controlled study.

METHODS

Students were randomly allocated to intervention ("Anxiety Relief": n = 43; "Insomnia Relief": n = 48; control: n = 47). Interventions lasted six weeks. Outcome measures were the State-Trait Anxiety Inventory and the Pittsburgh Sleep Quality Index.

RESULTS

Significant within-group reductions in anxiety (t(31) = 2.00, p = .03) with moderate between-groups (compared to control) effect size (d = .64) and increases in sleep quality (t(31) = 3.46, p = .002) with a moderate between-groups effect size (d = .55) were found for completers of the anxiety program from pre- to post-intervention. Significant within-group increases in sleep quality were found for completers of the insomnia program from pre- to post-intervention (t(35) = 4.28, p > .001) with a moderate between-groups effect size (d = .51).

CONCLUSIONS

Findings support the use of iCBT for anxiety and insomnia in students, and indicate that further research is needed.

Drinking Outcome Expectancies and Normative Perceptions of Students Engaged in University Sport in England

This study examined whether students engaged in university sport have different drinking outcome expectancies and normative beliefs than students who are not engaged in university sport. A cross-sectional survey of university students in England in 2008–2009 was undertaken. A questionnaire battery, including the Drinking Expectancies Questionnaire (DEQ) and a measure of normative beliefs, was completed by 770 students from seven universities across England. Responses from 638 students who were not abstaining from alcohol were analyzed. Students engaged in university sport have significantly higher drinking expectancies of assertion compared with students not engaged in university sport. Moreover, students engaged in university sport consistently report higher personal alcohol consumption and higher perceptions of consumption in those around them than students not engaged in university sport. Both assertion and the perception that students around them drink heavily provide only a partial explanation for why students engaged in university sport drink more than those not engaged in university sport. Further research is required to identify the reasons for heavy drinking among students involved in university sport in England.

Substance use and sexual behaviour among female students in Nigerian universities

Substance use continues to constitute social and health problems, more so among adolescents and young adults. One consequence is risky sexual behavior, a major problem in sub-Saharan Africa already facing the synergistic problems of poverty and HIV/AIDS. This study of female students aged ≥ 18 years in two universities in Nigeria uses a multi-stage stratified random sampling method, and each subject that gave consent to the study was administered with a structured questionnaire by trained interviewers; 2,408 female students were studied (1,854 from the University of Ibadan and 554 from the Bayero University, Kano). The mean age of the respondents was 21.6 (SD = 2.9), and about two-thirds (65.7%) were aged between 20-24, with 2,204 (91.5%) being single and 4.3% married. In all, 23.4% of the subjects used one form of substance. Alcoholic drinks of palm wine, alcoholic wine, and beer were the most common of substances used (22.7%), followed by tobacco (2%) and cannabis (1%). Substance use was significantly associated with religious affiliation of the students (p < 0.001), as the prevalence of substance use was least among Muslim students (11.7%) and highest among those who professed traditional religion (39.4%). Alcohol use was also positively associated with sexual activity (p < 0.001). Among the 547 students who used alcohol, 147 (26.9%) had sex in the 4 weeks prior to the survey, while among the 1,861 non-users, only 8.9% did so. The practice of unprotected sex was found not to be associated with substance use: a slightly lower proportion (29.5% vs. 36.6%) of substance users engaged in unprotected sex in their last encounter compared to non-users. There is need to scale up public health education on the dangers of substance use and its associated sexual risk behavior.

Hazardous alcohol consumption among university students in Ireland: a cross-sectional study

OBJECTIVE

There is considerable evidence of a cultural shift towards heavier alcohol consumption among university students, especially women. The aim of this study is to investigate the prevalence and correlates of hazardous alcohol consumption (HAC) among university students with particular reference to gender and to compare different modes of data collection in this population.

SETTING

A large Irish university.

DESIGN

A cross-sectional study using a classroom distributed paper questionnaire.

PARTICIPANTS

A total of 2275 undergraduates completed the classroom survey, 84% of those in class and 51% of those registered for the relevant module.

MAIN OUTCOME MEASURES

Prevalence of HAC measured using the Alcohol Use Disorders Identification Test for Consumption (AUDIT-C) and the proportion of university students reporting 1 or more of 13 adverse consequences linked to HAC. HAC was defined as an AUDIT-C score of 6 or more among males and 5 or more among females.

RESULTS

In the classroom sample, 66.4% (95% CI 64.4 to 68.3) reported HAC (65.2% men and 67.3% women). In women, 57.4% met HAC thresholds for men. Similar patterns of adverse consequences were observed among men and women. Students with a hazardous consumption pattern were more likely to report smoking, illicit drug use and being sexually active.

CONCLUSIONS

The findings highlight the high prevalence of HAC among university students relative to the general population. Public policy measures require review to tackle the short-term and long-term risks to physical, mental and social health and well-being.