Suicidal Behavior and Psychological Distress in University Students: A 12-nation Study

Psychosocial factors and physical function in higher education students with musculoskeletal pain attending direct access physiotherapy: An observational longitudinal study

INTRODUCTION

Musculoskeletal pain and mental health problems commonly coexist in students, potentially impacting physical function. However, there is a lack of follow-up studies investigating the relationship between changes in psychosocial stress and physical function among higher education students.

OBJECTIVE

We examined whether psychosocial factors at baseline or the change in psychosocial profile over 3 months were associated with physical function at a 3-month follow-up in higher education students with musculoskeletal pain.

METHODS

Participants were students attending direct access physiotherapy due to musculoskeletal pain (n = 133). Psychosocial factors were measured with the Short Form of the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ-SF), and with the Mental Health Index (MHI-5). Physical function was measured using the Patient-Specific Functional Scale. The associations were analyzed using linear regression analysis adjusted for gender and age.

RESULTS

A higher load of psychosocial factors, measured by the ÖMPSQ-SF at baseline, was associated with lower physical function at the 3-month follow-up, regression coefficient beta (ß) -0.557, 95% confidence interval (CI) [-1.04, -0.08]. No association was found between physical function and the MHI-5. The median of the ÖMPSQ-SF score decreased seven points (p < .001) between the baseline (32, interquartile range (IQR) 25-42) and 3-month follow-up (25, IQR 17-38). A reduction in the ÖMPSQ-SF score was associated with better physical function at 3 months (ß -0.332; CI 95% -0.50 to -0.16).

CONCLUSION

A reduced psychosocial load over three months is associated with better physical function in students with musculoskeletal pain. Addressing psychosocial factors appears to be important in direct access physiotherapy for patients with reduced physical function.

Social media utilization, mindfulness practice, and psychological distress of nonprofit workers in China: mediation effects of positive and negative affect

Introduction

In the contemporary landscape, the intersection of technology and human behavior has given rise to transformative trends, prominently featuring the emergence of social media. Nevertheless, studies show that adults who heavily depend on these platforms may affect their psychological distress. Conversely, a growing body of research indicates that engaging in mindfulness practices can regulate emotional reactions and contribute to enhanced mental health, resulting in a reduction of psychological distress.

Methods

In this investigation, a cross-sectional survey involving 318 adult nonprofit employees in China was conducted to explore the impact of social media utilization and mindfulness practice on psychological distress. The study specifically aimed to examine whether positive and negative affect mediate the relationships between these variables. Structural Equation Modeling was employed to analyze both the direct and indirect effects of social media utilization and mindfulness practice on psychological distress through positive affect (PA) and negative affect (NA).

Results

Social media utilization positively influenced positive affect (PA) (β = 0.15, p < 0.01) but showed no significant impact on negative affect (NA). Mindfulness practice displayed a positive effect on PA (β = 0.30, p < 0.001) and a negative effect on NA (β = -0.10, p < 0.10). PA exhibited a negative effect on psychological distress (β = -0.12, p < 0.01), whereas NA had a positive effect on psychological distress (β = 0.75, p < 0.001). The total effect of mindfulness practice on psychological distress was -0.11 (p < 0.01), while social media utilization did not have a significant effect on distress.

Discussions

The results indicated that participating in mindfulness practice boosts PA and simultaneously diminishes NA and psychological distress. Despite social media utilization being linked to heightened PA, it did not demonstrate significant effects in mitigating NA or psychological distress. This study underscores the significance of advocating for mindfulness practice as a public health strategy to alleviate NA and psychological distress, while also fostering PA among adults in China.

Do Social Support, Perceived Stress, and Psychological Distress Mediate the Relationship Between Social Problem-Solving and Suicidality in People With Gender Dysphoria?

Individuals with gender dysphoria (GD) often exhibit suicidal inclinations. In the present study, we investigated the scope of suicidal ideation and attempts and the roles of perceived social support, stress, and psychological distress in mediating social problem-solving and suicidality in individuals with GD. Two hundred and five adults with GD (110 GD assigned female at birth [AFAB]; 95 GD assigned male at birth [AMAB]) completed a self-report survey including questions about suicide ideation and attempts, as well as the General Health Questionnaire (GHQ-12), Multidimensional Scale of Perceived Social Support (MSPSS), Perceived Stress Scale (PSS), and Social Problem-Solving Inventory-Revised (SPSI-R). We utilized correlation, regression, and mediation analyses to assess models. Overall, both suicidal ideation (for AFAB = 61.8%; for AMAB = 61.1%; p = 0.91) and suicide attempts (for AFAB = 43.6%; for AMAB = 37.9%; p = 0.41) were common in individuals with GD. The two groups did not differ in GHQ-12, PSS, and SPSI-R total scale scores, but AMAB scored lower on the MSPSS total score. Perceived social support, perceived stress, and psychological distress partially mediated social problem-solving and suicidal ideation, whereas perceived stress and psychological distress fully mediated social problem-solving and suicide attempts. There is a need to develop interventions to improve the psychological well-being of people with GD. Current results suggest that problem-solving therapy may effectively suit the need to manage suicidality in people with GD.

Suicidal Behavior in University Students in Spain: a Network Analysis

INTRODUCTION

Suicidal behavior is a significant mental health concern among university students, yet it remains underexplored through a network approach. Traditional methods often overlook the complex interplay of psychological factors influencing suicidal behavior. This study addresses this gap by (a) examining suicidal behavior using network analysis and (b) identifying the psychological network of suicidal behavior along with protective and risk factors among university students.

METHOD

The sample consisted of a total of 1048 Spanish university students (M = 20.5 years; SD = 2.5; 58.2% women) from various universities. Several instruments were used to measure suicidal behavior, emotional and behavioral difficulties, prosocial behavior, subjective well-being, emotional intelligence, self-esteem, empathy, affect (both positive and negative), and emotional regulation. Data were analyzed using network analysis to understand the relationships among these variables.

RESULTS

A total of 21.5% of the participants had experienced suicidal thoughts, 26.3% had wished to be dead or not wake up, 15% had considered specific suicide methods or made plans, and 5.8% had attempted suicide at least once. In addition, 18% had engaged in non-suicidal self-injury (NSSI) at least once. Network analysis revealed that suicidal behavior was highly interconnected with other psychological factors, with "considered taking own life" as the most influential node. Key factors included depressive symptoms, positive affect, and emotional intelligence. Suicidal behavior showed a positive connection with depressive symptoms and negative affect and a negative connection with self-esteem and positive affect. Stability analysis confirmed the accuracy of the network estimations, indicating reliable insights into the psychological interconnections.

CONCLUSIONS

These findings indicate that suicidal behavior in university students is a complex, dynamic system shaped by cognitive, emotional, and affective factors. Network analysis, through advanced psychopathological and psychometric models, offers valuable insights into suicidal behavior, improving risk and protective factor assessment. This highlights the need for targeted and comprehensive prevention strategies in educational settings.

The effect of social media use on suicidal ideation in college students: Mediation by daytime sleepiness and sleep quality

BACKGROUND

Social media use and daytime sleepiness are common among university students and have significant implications for their mental health. The aim of this study was to examine the effects of social media use on suicidal ideation among university students and to analyse the mediating effects of daytime sleepiness and sleep quality.

METHODS

A total of 5899 full-time undergraduate students were included in this study. Questionnaires were distributed and collected using the QuestionStar platform. Logistic regression analysis was used to examine the association between social media use, daytime sleepiness and sleep quality, and suicidal ideation among college students. The mediation model was tested using the bias-corrected percentile bootstrap method.

RESULTS

Among 4835 students, 612 (12.66 %) reported having had suicidal ideation. Regression analysis revealed that social media use (OR = 1.09, 1.05-1.12), daytime sleepiness (OR = 1.09, 1.06-1.11), general and poor sleep quality (OR = 1.89, 1.56-2.28; OR = 4.82, 3.76-6.18) were all significantly and positively associated with suicidal ideation. Furthermore, there was a chain-mediated effect of daytime sleepiness and sleep quality on the relationship between social media use and suicidal ideation.

LIMITATIONS

Causality could not be explored by cross-sectional studies, and future cohort studies are needed.

CONCLUSIONS

There was a chain-mediated effect between daytime sleepiness and sleep quality in the relationship between social media use and suicidal ideation. Therefore, it is recommended that students reduce their use of social media to improve their sleep quality and mental health.

The impact of canine-assisted intervention on stress reduction among university students in Thailand

Stress negatively impacts university students, leading to adverse outcomes. While canine-assisted intervention (CAI) has been shown to reduce self-reported stress, no studies have investigated stress levels and associated biomarkers in dogs and students simultaneously. This study examined salivary cortisol, blood pressure, and pulse rate in 122 university students experiencing self-reported moderate to high stress before an encounter with a dog (T1), immediately before meeting a dog (T2), and after spending 15 minutes interacting with a dog (T3). Participants assessed their stress level using a visual analog scale, and blood pressure and pulse rate were measured at three time points. Salivary cortisol was also measured at T1 and T3. Six privately owned dogs, all in good health and comfortable with strangers, participated in the intervention sessions. Salivary and fecal cortisol samples from the dogs were collected in the morning before commencing activities, at noon, and in the evening after human interactions ended. The results showed that the expectation of interacting with dogs reduces self-reported stress, pulse rate, and salivary cortisol, which remained significantly lower after the interaction. Salivary cortisol concentrations in dogs did not differ throughout the day. By contrast, fecal glucocorticoid metabolite concentrations during the week dogs interacted with students were higher (P =  0.0012) than those during the week post-experiment, which, based on behavior, appeared to indicate positive stimulation. These findings highlight the potential of integrating CAI into university stress management programs. Future research could explore extending these benefits to community dogs, long-term effects, and enhancing accessibility to this form of stress relief.

A Comprehensive Review of Psychosocial, Academic, and Psychological Issues Faced by University Students in India

Background

University students confront a wide range of issues during their pursuit of education. Understanding these issues is essential for developing effective treatments and support systems.

Purpose

This study aims to delineate the landscape of scholarly literature pertaining to psychosocial, academic, and psychological issues among university students. It further identifies key journals and publishing trends within the fields, thereby significantly contributing to this domain. Additionally, this study outlines the scientific field networks that offer theoretical and conceptual foundations for exploring the psychosocial, academic, and psychological challenges faced by university students. Furthermore, it also intends to systematically categorise various types of problems encountered by university students in India.

Methods

To systematically gather and investigate the problems encountered by students in higher education, this study utilises bibliometric analysis, highlighting topics related to mental health. Data were extracted from Scopus and Web of Sciences databases.

Results

The analysis of the literature yielded 12 overarching categories related to challenges faced by university students: stress, academic stress, depression, anxiety, internet/ smartphone addiction/ gaming disorder, low self-esteem, loneliness, insomnia, suicidal ideations, eating disorders, drug addiction, adjustment issues.

Conclusion

Academic institutions should prioritise student mental health, as it affects academic performance and can lead to psychological disorders. Universities need Guidance and Counselling Cells staffed with professionals to help students manage psychosocial, academic, and psychological challenges.

Grit and the Relationships among Psychological Distress and Suicidality in Female Patients with Breast Cancer

PURPOSE

The risk of suicide is approximately two times higher in patients with breast cancer compared to the general population. Suicide risk factors are widely investigated but research on the protective factors is lacking. We investigated whether each subscale of grit, consistency of interest, and perseverance of effort, could serve as a protective factor against suicidality.

MATERIALS AND METHODS

Participants were recruited at the Stress Clinic for Cancer Patients, a psycho-oncology clinic at Asan Medical Center from May 2019 to March 2021. A total of 140 female patients with breast cancer completed self-administered questionnaires including Grit scale, Distress thermometer, and Mini International Neuropsychiatric Interview (MINI) suicidality module. We used PROCESS macro for analyzing the mediation model to identify the protective factors for suicidality.

RESULTS

Our findings showed that perseverance of effort showed statistically non-significant associations with psychological distress (p=0.403) and suicidality (p=0.945), however, consistency of interest decreased suicidality through psychological distress (β=-0.015; 95% confidence interval, -0.035 to -0.002).

CONCLUSION

The result shows that consistency of interest can be a protective factor against suicidality by reducing psychological distress.

Stress Reactivity, Wellbeing and Functioning in University Students: A Role for Autonomic Activity During Sleep

Sleep is a key biological mechanism in promoting wellbeing and resilience to stress. This cross-sectional study examined connections between sleep, autonomic function, wellbeing, and stress reactivity in healthy individuals. Demographic, lifestyle, sleep, and psychological well-being information were collected from 85 healthy university students. These variables were analysed in conjunction with indices of cardiac autonomic activity, including heart rate and high frequency heart rate variability (HF HRV, an indicator of parasympathetic vagal tone) recorded during nocturnal sleep onset and in response to a cognitive stressor. Correlational analyses revealed that unrefreshing and fragmented sleep was strongly associated with lower HF HRV at sleep onset, suggestive of poorer autonomic de-arousal. Further, those with minimal increases in HF HRV from wakefulness to sleep reported worse sleep quality and greater challenges in daily activities compared to those with significant increases. This same group also demonstrated significantly greater reactivity and slower recovery when faced with a stressor the next day, as evidenced by comparison of heart rate values. Our findings suggest an association between autonomic hypervigilance and aspects of sleep quality, with potential implications for wellbeing and stress responses.

Suicidal behavior among Turkish physicians: Associations with negative life-events, psychological distress, and attitudes towards suicide

BACKGROUND

Suicidal behavior among physicians is a significant concern globally, with various factors contributing to increased risk. Physicians in Türkiye are a group facing significant psychological distress due to challenging work conditions, economic instability, and violence in the healthcare system. Understanding the specific risk factors and attitudes contributing to this elevated suicidal behavior can inform the development of targeted interventions and support mechanisms for improving the well-being of physicians in Türkiye. This study aims to investigate suicidal behavior among Turkish physicians and its associations with adverse life events, psychological distress, and attitudes toward suicide.

METHOD

In the present study, 512 Turkish physicians from diverse demographics and professional backgrounds participated. Suicidal behavior, psychological distress, stressful life events, and attitudes toward suicide were explored through tailored instruments. Logistic regression analysis was conducted to identify independent risk factors for suicidal behavior.

RESULTS

The results demonstrated that among Turkish physicians, psychological distress and suicidal behavior were frequent. One in five individuals (22.3%) reported experiencing one of the suicidal behaviors within the past month. Nearly one in ten (8.6%) have attempted suicide at some point in their lives. The average number of suicidal behaviors reported was .48 (SD = 1.1), and the average severity score for suicidal ideation was .51 (SD = 1.2). Young age, single marital status, low social support, psychological distress, the number of stressful life events, and the acceptability of suicide were identified as independent risk factors for suicidal behavior. Having a diagnosis of a psychiatric disorder and the number of stressful life events were factors associated with suicide attempts.

CONCLUSION

The intricate associations between several factors that influence suicidal behavior among Turkish physicians are elucidated by this study. The results highlight the critical need for focused interventions and systems of support within the Turkish healthcare system to deal with this serious public health concern. Future studies and therapeutic practices can better meet the mental health requirements of this vulnerable demographic by considering the complex nature of suicidal behavior among physicians.

Problem Gambling and Suicidal Behaviours in Young Adult men in Ghana: A Moderated Mediation Model of Psychological Distress and Social Support : Journal of Gambling Studies

Problem gambling has been recognised as an important public health issue because of its harmful consequences at the personal, interpersonal, and societal levels. There is a proliferation of gambling activities in Ghana owing to increased access to the internet, soaring smartphone penetration, and an influx of sports betting companies. Yet, very little research has addressed the harm associated with problem gambling in Ghana. This study assessed if the effect of problem gambling severity on suicidal behaviours (ideation, planning, and attempts) through psychological distress is contingent on the level of perceived social support. A total of 350 young adult men in the Greater Accra Region of Ghana provided the data for the current analysis. The data were analysed using a moderated mediation approach. The results showed that psychological distress is an important intervening mechanism through which problem gambling severity influences suicidality. In addition, the positive association between psychological distress and suicidal behaviours was found to be conditional on the levels of perceived social support. In other words, our results showed that problem gambling may first trigger episodes of psychological distress, which, in turn, can lead to suicidality among problem gamblers who report low to moderate levels of perceived social support. Our findings suggest that young adult problem gamblers require higher levels of social support from family, friends, and significant others to prevent those experiencing psychological distress from engaging in suicidal behaviours.

The Interpersonal Psychological Theory of Suicide in Italian University Students: Validation of the INQ-15 and the ACSS-FAD

In the frame of the interpersonal psychological theory of suicide (IPTS), Interpersonal Needs Questionnaire (INQ-15) assesses thwarted belongingness (TB) and perceived burdensomeness (PB), related to suicidal ideation (SI); Acquired Capability for Suicide Scale-Fearlessness About Death (ACSS-FAD) measures this component which contributes to lethal self-harm. The objective was to evaluate the psychometric properties of INQ-15 and ACSS-FAD in a population of Italian university students. Since the Italian INQ-15 was already validated, we translated ACSS-FAD through a multistage procedure and administered both to 1,665 Italian university students. Factor analysis confirmed a two-factor-related model of INQ-15, one factor of ACSS-FAD, and good reliability for both. We proved the association between INQ-15 and current SI and between ACSS-FAD and lifetime suicidal planning and/or suicide attempt. The convergent and discriminant validities were in line with those of previous studies. Both tools are valid and reliable to assess the constructs associated with suicide outcomes according to IPTS.

Situation Analysis of Suicide and Self-Harm in the WHO Eastern Mediterranean Region

OBJECTIVE

An estimated 41,000 lives are lost to suicide each year in World Health Organization Eastern Mediterranean Region Office (WHO EMRO) countries. The objective of this study was to conduct a situation analysis for suicide and self-harm in the WHO EMRO region.

METHODS

Data on suicide were obtained from the WHO Global Health Estimates for the years 2000-2019. Information on risk groups efforts to prevent self-harm and suicide in the EMRO region were retrieved through scientific studies, grey literature, and public websites.

RESULTS

During 2000-2019, the age-standardized suicide rate was 6.7 per 100,000 inhabitants, albeit there are concerns regarding data quality. Self-harm and suicide remain criminal acts in more than half of the countries. Few countries have a national plan for prevention of suicide. Toxic agents, such as pesticides and black henna, are easily available and frequently used for suicide in some areas, as are firearms and self-immolation. Successful prevention measures include means restriction and psychosocial interventions after self-harm.

CONCLUSION

Many WHO EMRO countries remain underserved in terms of mental health care. Decriminalization of suicide and means restriction might be further promoted. Online-based tools for mental health literacy and psychosocial therapy are other options to explore.

Does Psychological Flourishing Have the Potential to Mitigate Self-Injurious Thoughts and Behaviors? A Preliminary Analysis of the Protective Influence of Flourishing

AIM

The purpose of this article was to examine whether psychological flourishing, a multi-dimensional construct of well-being, has the potential to play a preventative role in suicidal and nonsuicidal thoughts and actions.

METHODS

This two-part study utilized cross-sectional survey data from college students across the United States, assessing levels of psychological distress, loneliness, and psychological flourishing. Frequencies of suicidal ideation, intent, previous suicidal attempts, and nonsuicidal self-injury (NSSI) were also assessed. Data collected in 2019 were used for Study 1 (n = 38,679) and data collected in 2020 were used for Study 2 (n = 50,307).

RESULTS

Psychological flourishing is significantly inversely related to suicide and NSSI risk when controlling for loneliness and psychological distress. There were two-way interactions between flourishing and distress, whereby under conditions of high distress, the inverse effect of flourishing on suicidal ideation, intent, and attempts and NSSI was more pronounced. These results were consistent across both studies. Subgroup analyses revealed similar results regardless of participants' race, sexual orientation, and gender identity.

CONCLUSION

Inverse associations between flourishing and self-injurious thoughts and behaviors suggest that flourishing may buffer risk of suicide and NSSI, and these findings may have important implications for developing evidence-based therapeutic interventions. Additional research, including longitudinal and clinical work, is warranted.

Longitudinal Impact of Perfectionism on Suicidal Ideation among Chinese College Students with Perceived Academic Failure: The Roles of Rumination and Depression

OBJECTIVE

Suicide has become a nonnegligible cause of death among emerging adults, and academic performance is one of the most significant factors in Chinese college students' suicidal ideation. Based on this, we examined the risk and protective sides of perfectionism on suicidal ideation among college students with perceived academic failure experiences.

METHOD

In the current study, a total of 674 Chinese college students (63.6% females, Mage = 19.96, SD = 1.31) with perceived academic failure in the past six months participated in a survey and completed self-report measures assessing perfectionism, rumination, depression, and suicidal ideation twice with a six-month interval.

RESULTS

Negative perfectionism was a risk factor for suicidal ideation, while positive perfectionism had an opposite effect. In addition, intrusive rumination, deliberate rumination, and depression serially mediated the association between positive/negative perfectionism and suicidal ideation.

CONCLUSION

The results indicated perfectionism has both positive and negative sides to suicidal ideation. Clinicians might be aware of the risk and protective components of perfectionism when intervening with suicidal ideation among college students with perceived academic failure experiences.

Group-format, peer-facilitated mental health promotion interventions for students in higher education settings: a scoping review protocol

INTRODUCTION

Young people in higher education face various stressors that can make them vulnerable to mental ill-health. Mental health promotion in this group therefore has important potential benefits. Peer-facilitated and group-format interventions may be feasible and sustainable. The scoping review outlined in this protocol aims to map the literature on group-format, peer-facilitated, in-person interventions for mental health promotion for higher education students attending courses on campuses in high and low/middle-income countries.

METHODS AND ANALYSIS

Relevant studies will be identified through conducting searches of electronic databases, including Medline, CINAHL, Scopus, ERIC and PsycINFO. Searches will be conducted using Boolean operators (AND, OR, NOT) and truncation functions appropriate for each database. We will include a grey literature search. We will include articles from student participants of any gender, and published in peer-reviewed journals between 2008 and 2023. We will include English-language studies and all study types including randomised controlled trials, pilot studies and descriptive studies of intervention development. A draft charting table has been developed, which includes the fields: author, publication date, country/countries, aims, population and sample size, demographics, methods, intervention type, comparisons, peer training, number of sessions/duration of intervention, outcomes and details of measures.

ETHICS AND DISSEMINATION

No primary data will be collected from research participants to produce this review so ethics committee approval is not required. All data will be collated from published peer-reviewed studies already in the public domain. We will publish the review in an open-access, peer-reviewed journal accessible to researchers in low/middle-income countries. This protocol is registered on Open Science Framework (https://osf.io/agbfj/).

Rethinking students' mental health assessment through GHQ-12: evidence from the IRT approach

BACKGROUND

The General Health Questionnaire-12 (GHQ-12) is a widely used screening tool for mental health assessment however its traditional scoring methods and cutoffs may not adequately capture the mental health complexities of younger populations.

METHODS

This study explores GHQ-12 responses from a sample of university students. Possible differences in means scores considering gender, age, academic field and degree course were assessed through t-test or one-way ANOVA as appropriate. To deeper understanding different levels of severity and individual item impact on general distress measurement, we applied Item-Response-Theory (IRT) techniques (two-parameters logistic model). We compared students' population with a population of workers who underwent a similar psychological evaluation.

RESULTS

A total of 3834 university students participated in the study. Results showed that a significant proportion (79%) of students reported psychological distress. Females and younger students obtained significantly higher average scores compared to others. IRT analysis found item-specific variations in mental distress levels, with more indicative items for short-term fluctuations and potential severe mental health concerns. Latent class analysis identified three distinct subgroups among students (including 20%, 37%, 43% of the participants respectively) with different levels of psychological distress severity. Comparison with a population of adults showed that students reported significantly higher scores with differences in the scale behavior.

CONCLUSION

Our results highlighted the unique mental health challenges faced by students, suggesting a reevaluation of GHQ-12 applicability and cutoff scores for younger populations, emphasizing the need for accurate instruments in mental health evaluation.

Potential suicide risk among the college student population: machine learning approaches for identifying predictors and different students' risk profiles

BACKGROUND

Suicide is one of the leading causes of death among young people and university students. Research has identified numerous socio-demographic, relational, and clinical factors as potential predictors of suicide risk, and machine learning techniques have emerged as promising ways to improve risk assessment.

OBJECTIVE

This cross-sectional observational study aimed at identifying predictors and college student profiles associated with suicide risk through a machine learning approach.

METHODS

A total of 3102 students were surveyed regarding potential suicide risk, socio-demographic characteristics, academic career, and physical/mental health and well-being. The classification tree technique and the multiple correspondence analysis were applied to define students' profiles in terms of suicide risk and to detect the main predictors of such a risk.

RESULTS

Among the participating students, 7% showed high potential suicide risk and 3.8% had a history of suicide attempts. Psychological distress and use of alcohol/substance were prominent predictors of suicide risk contributing to define the profile of high risk of suicide: students with significant psychological distress, and with medium/high-risk use of alcohol and psychoactive substances. Conversely, low psychological distress and low-risk use of alcohol and substances, together with religious practice, represented the profile of students with low risk of suicide.

CONCLUSIONS

Machine learning techniques could hold promise for assessing suicide risk in college students, potentially leading to the development of more effective prevention programs. These programs should address both risk and protective factors and be tailored to students' needs and to the different categories of risk.

Clustering of lifestyle risk factors in relation to suicidal thoughts and behaviors in young adolescents: a cross-national study of 45 low- and middle-income countries

BACKGROUND

Prior research has reaffirmed lifestyle risk behaviors to cluster among adolescents. However, the lifestyle cluster effect on suicidal thoughts and behaviors (STBs) was unclear among adolescents in low- and middle-income countries (LMICs). No comparison of such associations was conducted across nations.

METHODS

Data from 45 LMICs were obtained from the Global School-based Student Health Survey (GSHS) between 2009 and 2019. Lifestyle behavior factors were collected through a structured questionnaire. Suicidal ideation, plan, and attempt were ascertained by three single-item questions. Lifestyle risk scores were calculated via a sufficient dimension reduction technique, and lifestyle risk clusters were constructed using a latent class analysis. Generalized linear mixed models with odds ratio (OR) and 95% confidence interval (CI) were used to estimate the lifestyle-STB associations.

RESULTS

A total of 229,041 adolescents were included in the final analysis. The weighted prevalence of suicidal ideation, plan, and attempt was 7.37%, 5.81%, and 4.59%, respectively. Compared with the favorable lifestyle group, the unfavorable group had 1.48-, 1.53-, and 3.11-fold greater odds of suicidal ideation (OR = 1.48, 95%CI: 1.30-1.69), plan (OR = 1.53, 95%CI 1.34-1.75), and attempt (OR = 3.11, 95%CI 2.64-3.65). Four clusters of lifestyle risk behaviors were identified, namely healthy lifestyles (H-L), insufficient intake of vegetables and fruit (V-F), frequent consumption of soft drinks and fast food (D-F), and tobacco smoking and alcohol drinking (S-A) clusters. Compared with H-L cluster, V-F cluster was associated with 43% and 42% higher odds of suicidal ideation and plan, followed by S-A cluster (26% for ideation and 20% for plan), but not significant in D-F cluster (P > 0.05). D-F cluster was associated with 2.85-fold increased odds of suicidal attempt, followed by V-F cluster (2.43-fold) and S-A cluster (1.18-fold).

CONCLUSIONS

Clustering of lifestyle risk behaviors is informative for risk stratification of STBs in resource-poor settings. Lifestyle-oriented suicide prevention efforts should be initiated among school-attending adolescents in LMICs.

Associations between Sleep Disturbance and Suicidal Ideation Severity in Iranian University Students: Evaluating Emotion Regulation Difficulties and Distress Tolerance

AIM

Although sleep disturbance is associated with suicide ideation, underlying cognitive-affective mechanisms that may explain this association are not well understood. The aim of the present study was to concurrently evaluate whether emotion regulation difficulties and distress tolerance explain this association among Iranian university students.

METHOD

A total of 679 Iranian university students (66.42% females; Mage = 24.34 years, SD = 4.86) completed a battery of online self-report questionnaire. Structural equation modeling was used to empirically explore the relations among variables.

RESULTS

Sleep disturbance was positively associated with suicide ideation. Higher sleep disturbance symptoms were associated with higher levels of suicide ideation. Sleep disturbance was indirectly related to suicide ideation through both emotion regulation difficulties and distress tolerance.

CONCLUSION

Findings expand knowledge of cognitive-emotional processes that may explain the sleep disturbance-suicide ideation association among Iranian university students. Iranian students experiencing sleep disturbance may benefit from intervention strategies targeting emotion regulation skills and distress tolerance to reduce suicide ideation.

Efficacy of BrighterSide, a Self-Guided App for Suicidal Ideation: Randomized Controlled Trial

Background

Self-guided digital interventions can reduce the severity of suicidal ideation, although there remain relatively few rigorously evaluated smartphone apps targeting suicidality.

Objective

This trial evaluated whether the BrighterSide smartphone app intervention was superior to a waitlist control group at reducing the severity of suicidal ideation.

Methods

A total of 550 adults aged 18 to 65 years with recent suicidal ideation were recruited from the Australian community. In this randomized controlled trial, participants were randomly assigned to receive either the BrighterSide app or to a waitlist control group that received treatment as usual. The app was self-guided, and participants could use the app at their own pace for the duration of the study period. Self-report measures were collected at baseline, 6 weeks, and 12 weeks. The primary outcome was severity and frequency of suicidal ideation, and secondary outcomes included psychological distress and functioning and recovery. Additional data were collected on app engagement and participant feedback.

Results

Suicidal ideation reduced over time for all participants, but there was no significant interaction between group and time. Similar improvements were observed for self-harm, functioning and recovery, days out of role, and coping. Psychological distress was significantly lower in the intervention group at the 6-week follow-up, but this was not maintained at 12 weeks.

Conclusions

The BrighterSide app did not lead to a significant improvement in suicidal ideation relative to a waitlist control group. Possible reasons for this null finding are discussed.

Psychological distress among individuals with a suicide attempt or suicidal ideation and suicide attempts patterns: first two years of the pandemic

BACKGROUND

The COVID-19 pandemic and related restrictions may have led to increased stress, particularly in people with mental health problems. Since stress factors play important role in the emergence of suicide attempts (SA) and suicidal ideation (SI), they may have been exacerbated by the pandemic, which could have led to an increased number of suicide attempts. Thus, we first investigated whether the pandemic affected personal stress experiences and appraisal of coping potential in individuals with and without SA and SI. In a second step, we analyzed the frequency and dynamics of SAs by patients admitted to a psychiatric university clinic over a period of four years.

METHODS

We examined stress experiences and appraisal of coping resources of inpatients recruited between March 2021 and February 2022 with SA (n=38), SI (n=27), and with mood disorder without SA or SI (n=45). In the second study, we investigated the time course of prospectively recorded patients with a suicide attempt (n=399) between January 1st 2018 and December 31st 2021 using interrupted time-series Poisson regression models.

RESULTS

There was a significant main effect of group (F[2,107]=6.58, p=0.002) regarding psychological stress levels, which was significantly higher in the SA and SI groups than in the psychiatric control group. No significant differences were found in the appraisal of coping resources or in the frequency of SAs before and during pandemic. However, the pandemic had a significant impact on the seasonal pattern of SAs.

CONCLUSIONS

The pandemic increased psychological stress levels in individuals with SA and SI, which may be related to SI and do not necessarily result in SA. The pandemic did not affect the overall frequency of SA between March 2020 and December 2021, but interfered with the seasonal pattern of SA occurrence. Effective intervention strategies during a pandemic should include programs to strengthen the psychological resilience of people who are susceptible to mental health problems.

The impact of different neurobehavioral symptoms on suicidal ideation and perceived likelihood of future suicidality

Existing literature suggests that psychological and functional impairment, independent of head injury severity, can increase suicide risk. This study explores the impacts of self-perceived dysfunction within four neurobehavioral symptom clusters-vestibular (e.g., dizziness, balance), somatosensory (e.g., headaches, nausea, vision), affective (e.g., anxious, irritable mood), and cognitive (e.g., concentration, memory, indecision)-on current suicidal ideation and the perceived likelihood of future suicidal ideation and attempts. Community participants (n = 309; Mage = 36.88; 51.6% female; 79.6% White) completed the Neurobehavioral Symptom Inventory (NSI) and the Self-Injurious Thoughts and Behaviors-Short Form (SITBI-SF). Quantile regression analysis was used to explore the effects of the four neurobehavioral symptom clusters at different levels of suicidal ideation intensity, perceived likelihood of future suicidal ideation, and self-perceived likelihood of future suicide attempt. Controlling for past head injuries and suicide attempts, affective symptoms were significantly associated with a moderate and high average intensity of current suicidal ideation. Somatosensory symptoms were significantly associated with a moderate perceived likelihood of future suicidal ideation. Finally, vestibular symptoms were significantly associated with a moderate perceived likelihood of a future suicide attempt. These findings highlight the critical need to consider a broader spectrum of symptoms, including chronic physical symptoms, when assessing suicide risk. Furthermore, they underscore the need to expand beyond affective symptoms as an explanation for increased suicidality and examine additional mechanisms through which chronic physical symptoms can increase suicide risk.

Gender difference in emotional distress among nursing and health science college students: An online survey

This cross-sectional study investigates the self-reported emotional distress of medical, nursing, dental, pharmacy, and public health students and identifies gender-related differences through an online survey. The data of 364 students were analyzed using Pearson correlation coefficients and multiple logistic regression. Emotional distress was more prevalent among female respondents (11.7 %) than male (3.8 %) respondents. The stigma, isolation, and depression experienced by female respondents influenced their emotional distress, whereas only the depression of male respondents influenced their emotional distress. Our findings suggest that mental health professionals should consider gender-specific factors when developing interventions for the study population to minimize emotional distress.

Supports for university counselors impacted by student suicide: A systematic review and thematic synthesis

The purpose of this systematic review and thematic synthesis was to identify and consolidate research on the support needs of impacted Higher Education (HE) counselors that have experienced a student suicide death. When exposed to a student suicide death, counselors are often extensively involved in a postvention response. This systematic review synthesized four qualitative papers that explored the experiences of staff impacted by student suicide. Thematic synthesis revealed three core themes: The unknown, responding, and the known, and six subthemes: Gaps in knowledge of individual experience, gaps in knowledge of organizational impact, extrospective responding, introspective responding, the needs of impacted counselors, the degree of impact, and the support processes that arise from needs. The results provide a summary of the current supports available to impacted HE counselors and considerations relevant to their postvention needs.

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

OBJECTIVE

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

PARTICIPANTS

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

University students' intentions to seek psychological counseling, attitudes toward seeking psychological help, and stigma

BACKGROUND

Mental health problems are prevalent among university students worldwide. Studies have shown that most students do not disclose and do not get the psychological help and support they need.

OBJECTIVES

This survey aims to investigate the intentions to seek psychological counseling (ISC) among university students, their attitudes toward seeking professional psychological help (ATSPPH), and the predictors of those intentions and attitudes including stigma.

DESIGN AND METHODS

a cross-sectional survey was conducted among 420 students at the American University of Beirut (AUB).

RESULTS

Depression, test anxiety, and difficulty sleeping are the three main reasons students would seek psychological help. The source the students most preferred to ask for help was one's family followed by psychologists and psychiatrists. Students' ATSPPH is a positive predictor of their ISC, while students' self-stigma of seeking help (SSOSH) is a negative predictor of their ATSPPH. Moreover, students' awareness of the psychological help system available on campus, free of charge, is a positive predictor for both ISC and ATSPPH.

CONCLUSION

Different interventions are needed to reduce stigma and enhance students' mental health literacy and awareness of the available professional psychological help on campus.

Suicide literacy mediates the path from religiosity to suicide stigma among Muslim community adults: Cross-sectional data from four Arab countries

BACKGROUND

The majority of research attention has been devoted to the link between religiosity and suicide risk, and a considerable amount of studies has been carried out on how stigma impacts individuals with mental health problems of different kinds. However, the interplay between religiosity, suicide literacy and suicide stigma has seldom been empirically researched, especially quantitatively. We sought through this study to redress the imbalance of research attention by examining the relationship between religiosity and suicide stigma; and the indirect and moderating effects of suicide literacy on this relationship.

METHOD

A cross-sectional web-based survey was conducted among Arab-Muslim adults originating from four Arab countries (Egypt: N = 1029, Kuwait: N = 2182, Lebanon N = 781, Tunisia N = 2343; Total sample: N = 6335). The outcome measures included the Arabic Religiosity Scale which taps into variation in the degree of religiosity, the Stigma of Suicide Scale-short form to the solicit degree of stigma related to suicide, and the Literacy of Suicide Scale explores knowledge and understanding of suicide.

RESULTS

Our Mediation analyses findings showed that literacy of suicide partially mediated the association between religiosity and stigmatizing attitude toward suicide. Higher religiosity was significantly associated with less literacy of suicide; higher literacy of suicide was significantly associated with less stigma of suicide. Finally, higher religiosity was directly and significantly associated with more stigmatization attitude toward suicide.

CONCLUSION

We contribute the literature by showing, for the first time, that suicide literacy plays a mediating role in the association between religiosity and suicide stigma in a sample of Arab-Muslim community adults. This preliminarily suggests that the effects of religiosity on suicide stigma can be modifiable through improving suicide literacy. This implies that interventions targeting highly religious individuals should pay dual attention to increasing suicide literacy and lowering suicide stigma.

Suicidality among university students in the Eastern Mediterranean region: A systematic review

The prevalence of suicide attempts and suicidal ideation among university students is a global concern. Cultural values, social determinants, religion, and especially growing stress all play an important role in this. This systematic review aimed to identify potential protective and risk factors thought to be associated with suicidal ideation among students in the Eastern Mediterranean region and highlight the importance of developing an effective health care response. MEDLINE, CINAHL, Embase, PsycINFO, WHO Global Health Library, IMEMR, Web of Science Core Collections and Farsi and Arabic databases were searched for papers in English, Farsi, and Arabic. A combination of validated filters, free text keywords, and Mesh and Non-Mesh terms were used to retrieve relevant literature. A total of 2774 papers were found after the search, 257 selected for full-text review, and 72 papers included in the final review. Family and peer support play a potential protective role in the development of suicidal ideation among university students, while adverse life events, bullying, depression, anxiety, and other mental health conditions were identified as risk factors. Suicidality was likely under-reported due to stigma around social and cultural factors. Factors involving religion and culture may act as both protective and risk factors and require more in-depth investigation. The student population in the Eastern Mediterranean region face many challenges. The common theme of suicidality emerged as an indicator of an imbalance of resources and stress, which needs to be addressed proactively, given a most likely underreporting of suicidal ideation and attempts due to stigma.

Perfect people, happier lives? When the quest for perfection compromises happiness: the roles played by substance use and internet addiction

Building on the Conservation of Resources Theory and the Stress-Coping Model, the present study explored the relationship between perfectionism (rigid, self-critical, narcissistic) and subjective happiness among youth. In this relationship, we also examined the mediating roles of substance use (i.e., drinking and smoking) and Internet addiction symptoms. Our sample comprised 431 Romanian university students aged 18-25 (M = 20.50, SD = 1.58), and most of them were females (79.81%, self-reported gender). Participants completed self-reported anonymous scales through a web-based survey at the beginning of 2023. Correlation analysis results indicated that all forms of perfectionism were associated with Internet addiction symptoms. Self-critical and narcissistic perfectionism and drinking, smoking, and Internet addiction symptoms were negatively associated with subjective happiness. Path analysis suggested that health-risk behaviors completely mediated the effect of perfectionism on subjective happiness. High levels of perfectionism were associated with high levels of health-risk behaviors, and high levels of addictive behaviors were associated with low levels of subjective happiness. We discuss the present findings considering their practical use regarding students' subjective happiness.

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

Introduction

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

Methods

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

Results

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

Conclusion

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

Prevalence and factors associated with depression and suicidal ideation among French students in 2016: A national study

Depression is one of the leading causes of morbidity worldwide and increases the risk of suicide. Students are known as a population at risk for depression. This study aimed to evaluate the prevalence of 12 months major depressive episode (MDE) and suicidal thoughts in French students and investigate associated factors. A questionnaire was sent by email to a representative sample of the French student population between April 28th and June 27th 2016. MDE was assessed using the Composite International Diagnostic Interview Short Form (CIDI-SF). The response rate was 18.7% (N= 18,875). Prevalence of 12 months MDE was 15.8%, and suicidal thoughts was 9%. Factors associated with MDE were being a woman, study field (law/eco, human/social sciences, and medical), having failed midterms exams or dropout, refusal or stop social scholarship, and subjective financial difficulties. Factors associated with suicidal thoughts were study field (human/social sciences), having failed midterms exams or dropout, and important subjective financial difficulties. The use of CIDI-SF allows comparison with the 2017 French national study, and showed more MDE in students than in the general population. This is the only national study on French students before COVID 19 pandemic.

Mental health trajectories in university students across the COVID-19 pandemic: findings from the Student Wellbeing at Northern England Universities prospective cohort study

Introduction

Psychological wellbeing in university students is receiving increased focus. However, to date, few longitudinal studies in this population have been conducted. As such, in 2019, we established the Student Wellbeing At Northern England Universities (SWANS) cohort at the University of York, United Kingdom aiming to measure student mental health and wellbeing every six months. Furthermore, the study period included the COVID-19 pandemic, giving an opportunity to track student wellbeing over time, including over the pandemic.

Methods

Eligible participants were invited to participate via email. Data were collected, using Qualtrics, from September 2019 to April 2021, across five waves (W1 to W5). In total, n = 4,622 students participated in at least one wave of the survey. Data collection included sociodemographic, educational, personality measures, and mental health and wellbeing. Latent profile analyses were performed, exploring trajectories of student wellbeing over the study period for those who had completed at least three of the five waves of the survey (n = 765), as measured by the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS).

Results

Five latent profile trajectories of student wellbeing were identified. Of these, the two latent classes with initially higher wellbeing scores had broadly stable wellbeing across time (total n = 505, 66%). Two classes had lower initial scores, which lowered further across time (total n = 227, 30%). Additionally, a fifth class of students was identified who improved substantially over the study period, from a mean WEMWBS of 30.4 at W1, to 49.4 at W5 (n = 33, 4%). Risk factors for having less favourable wellbeing trajectories generally included identifying as LGBT+, self-declaring a disability, or previously being diagnosed with a mental health condition.

Conclusion

Our findings suggest a mixed picture of the effect of the COVID-19 pandemic on student wellbeing, with a majority showing broadly consistent levels of wellbeing across time, a smaller but still substantial group showing a worsening of wellbeing, and a small group that showed a very marked improvement in wellbeing. Those from groups traditionally underrepresented in higher education were most at risk of poorer wellbeing. This raises questions as to whether future support for wellbeing should target specific student subpopulations.

Why the belief in one's equal rights matters: Self-respect, depressive symptoms, and suicidal ideation in Western and non-Western countries

The present research investigated the relationship between self-respect (i.e., a person's belief of possessing the same rights as others) and depressive symptoms. Based on earlier longitudinal findings that self-respect fosters assertiveness and that assertiveness negatively predicts depressive symptoms, we tested these relationships in Western and non-Western countries. Additionally, we explored associations with suicidal ideation. Across seven countries (N = 2408) we found that self-respect and depressive symptoms were negatively correlated. In addition, we found evidence for an indirect path via assertiveness as well as negative correlations with suicidal ideation in countries with available measures. Finally, within-manuscript meta-analyses confirmed the main path between self-respect and depressive symptoms across all seven countries. This research presents the first evidence for the negative association between self-respect (feeling equal to others) and depressive symptoms and highlights new directions for linking self and self-regard to mental health.

Mediating role of psychological distress in the associations between medical errors, adverse events, suicidal ideation and plan among operating room nurses in China: a cross-sectional study

OBJECTIVES

Medical errors (MEs) and adverse events (AEs) both had long-term impacts on healthcare professionals. Studies investigated the associations between MEs, AEs, psychological distress and suicidal behaviours among healthcare professionals. The aim of the current study was to explore the mediating role of psychological distress in the relationship between MEs/AEs and suicidal ideation/suicide plan among operating room nurses in China.

DESIGN

A cross-sectional study.

SETTING

The survey was conducted between December 2021 and January 2022 in China.

PARTICIPANTS

A total of 787 operating room nurses completed the questionnaires in China.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome measures were MEs and AEs. Secondary outcome measures were psychological distress and suicidal behaviours.

RESULTS

The results showed that 22.1% of operating room nurses were involved in MEs, while 13.9% of operating room nurses were involved in AEs. The associations between suicidal ideation (OR=1.10, p<0.001), suicide plan (OR=1.07, p<0.01) and psychological distress were significant. The associations between suicidal ideation (OR=2.76, 95% CI=1.53 to 4.97, p<0.01), suicide plan (OR=2.80, 95% CI=1.20 to 6.56, p<0.05) and MEs were significant. The associations between suicidal ideation (OR=2.27, 95% CI=1.17 to 4.40, p<0.05), suicide plan (OR=2.92, 95% CI=1.19 to 7.18, p<0.05) and AEs were significant. The psychological distress mediated the relationship between MEs/AEs and suicidal ideation/suicide plan.

CONCLUSION

There were positive associations between MEs, AEs and psychological distress. Moreover, MEs and AEs were also positively associated with suicidal ideation and suicide plan. As expected, psychological distress played an important role in the relationship between MEs/AEs and suicidal ideation/suicide plan.

Suicide ideation among Brazilian college students: Relationship with academic factors, mental health, and sexual abuse

BACKGROUND

Suicide is one of the leading causes of death among youth and its occurrence among college students is a matter of great concern. Challenges of transitional adulting and mental illness increase the likelihood of suicidal cognition in students. The objective of present study was to investigate the prevalence of suicide ideation and associated factors in a representative sample of Brazilian college students (n = 12,245).

METHODS

Data were drawn from a nationwide survey and further subjected to estimate the prevalence of suicide ideation and its association with socio-demographic and academic characteristics. We performed logistic regression analyses upon a conceptual framework, considering individual and academic factors.

RESULTS

The point-prevalence of suicide ideation among college students was 5.9 % (SE = 0.37). In the final regression model, variables associated with the likelihood of suicide ideation were psychopathology, sexual abuse, and academic variables, such as dissatisfaction with the chosen undergraduate course (OR = 1.86; IC95 % 1.43-2.41) and low academic performance (OR = 3.56; IC95 % 1.69-7.48). Having children and religious affiliation were inversely associated with the likelihood of suicide ideation.

LIMITATIONS

Participants were recruited from state capitals, which limited data generalizability to non-urban college students.

CONCLUSIONS

The impact of academic life on the mental health of students should be carefully monitored in in-campus pedagogical and health services. Early identification of poor-performance students with social disadvantages could indicate vulnerable ones who are much in need of psycho-social support.

Self-harm in university students: A comparative analysis of data from the Multicentre Study of Self-harm in England

BACKGROUND

Increases in poor mental health and suicide have been identified among university students in the UK. However, little is known about self-harm in this group.

AIMS

To describe and identify care needs of university aged-students who self-harm via comparisons with an age-equivalent non-student group who self-harm.

METHODS

Observational cohort data from The Multicentre Study of Self-harm in England were used to investigate students aged 18 to 24 years who presented to emergency departments for self-harm, 2003 to 2016. Data were collected via clinician reports and medical records from five hospitals in three English regions. Characteristics, rates, repetition, and mortality outcomes were investigated.

RESULTS

The student sample included 3491 individuals (983, 28.2 % men; 2507, 71.8 % women; 1 unknown) compared to 7807 (3342, 42.8 % men; 4465, 57.2 % women) non-students. Self-harm increased over time in students (IRR 1.08, 95%CI 1.06-1.10, p < 0.01) but not in non-students (IRR 1.01, 95%CI 1.00-1.02, p = 0.15). There were differences in monthly distribution of self-harm with more presentations by students in October, November, and February. Characteristics were broadly similar, but students reported more problems with studying and mental health. Repetition (HR 0.78, 95%CI 0.71-0.86, p < 0.01) and mortality (HR 0.51, 95%CI 0.33-0.80, p < 0.01) were lower in students than non-students.

CONCLUSIONS

Self-harm in students may be directly related the student experience, such as academic pressure, relocation, and the transition to independent living. Wellbeing initiatives targeting these factors, alongside mental health awareness training for academic and non-academic staff may help to support students at risk.

Designing and determining the effectiveness of a suicide intervention package for psychologists working in the primary health care system

Aims

Suicide is a major public health problem around the world. The present study aimed to design and determine the effectiveness of a suicide intervention package for psychologists working in the primary health care system in Hormozgan Province.

Materials and Methods

This study was conducted in two phases: qualitative and quantitative phases. In the qualitative phase, it was a thematic analysis type, and in the quantitative phase, it was quasi-experimental type with pretest-posttest in two groups of intervention and comparison. To standardize the suicide intervention package, Delphi method was used, and for quantitative content validity, content validity index (CVI) and content validity ratio (CVR) were used. In the quantitative phase of the study, the statistical population of the study included 270 people who had suicidal ideations and had no history of suicide attempt. Among them, 135 people were included in the intervention group and 135 people were included in the comparison group using a convenience sampling method. They were selected among those referred to eight comprehensive rural and urban health service centers in eight cities of Hormozgan Province. The results were analyzed by MANCOVA statistical test.

Results

CVR was more than 0.75 and CVI was more than 0.87. In the quantitative phase, the results showed a significant difference between the means before and after the intervention for the variables of psychological distress, suicidal ideation, and hopelessness (P < 0.01).

Conclusion

It seems that psychological suicide preventive interventions in the primary health care system are effective in reducing psychological distress,suicidal thoughts and hopelessness.

Prevalence of suicidal behaviour among students living in Muslim-majority countries: systematic review and meta-analysis

BACKGROUND

Assessing suicidal behaviours among students would help to understand the burden and enhance suicide prevention.

AIMS

We aimed to determine the prevalence of suicidal behaviour among students living in Muslim-majority countries.

METHOD

We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic search was conducted in Medline, EMBASE and PsycINFO. Meta-analyses were performed to pool the lifetime, 1-year and point prevalence rates for suicidal ideation, plans and attempts.

RESULTS

From 80 studies, 98 separate samples were included in this analysis. The majority (n = 49) were from the Eastern Mediterranean, and 61 samples were of university students. The pooled prevalence of suicidal ideation was 21.9% (95% CI 17.4%-27.1%) for lifetime, 13.4% (95% CI 11.1%-16.1%) for the past year and 6.4% (95% CI 4.5%-9%) for current. The pooled prevalence of suicide plans was 6.4% (95% CI 3.7%-11%) for lifetime, 10.7% (95% CI 9.1%-12.4%) for the past year and 4.1% (95% CI 2.7%-6.2%) for current. The pooled prevalence of suicide attempts was 6.6% (95% CI 5.4%-8%) for lifetime and 4.9% (95% CI 3.6%-6.5%) for the past year. The lifetime prevalence of suicidal ideation was highest (46.2%) in South-East Asia, but the 12-month prevalence was highest (16.8%) in the Eastern Mediterranean.

CONCLUSIONS

The study revealed notably high rates of suicidal behaviours among students living in Muslim-majority countries. However, the quality of studies, differences in regional and cultural factors, stages of studentship and methods of measurement should be considered when generalising the study results.

The Mental Imagery for Suicidality in Students Trial (MISST): study protocol for a feasibility randomised controlled trial of broad-minded affective coping (BMAC) plus risk assessment and signposting versus risk assessment and signposting alone

BACKGROUND

Going to university is an important milestone in many people's lives. It can also be a time of significant challenge and stress. There are growing concerns about mental health amongst student populations including suicide risk. Student mental health and counselling services have the potential to prevent suicide, but evidence-based therapies are required that fit these service contexts. The Broad-Minded Affective Coping intervention (BMAC) is a brief (6 sessions), positive imagery-based intervention that aims to enhance students access to past positive experiences and associated emotions and cognitions. Pilot data provides preliminary support for the BMAC for students struggling with suicidal thoughts and behaviours, but this intervention has not yet been evaluated in the context of a randomised controlled trial (RCT). The Mental Imagery for Suicidality in Students Trial (MISST) is a feasibility RCT that aims to determine the acceptability and feasibility of evaluating the BMAC as an intervention for university students at risk of suicide within a larger efficacy trial. Key feasibility uncertainties have been identified relating to recruitment, retention, and missing data. Intervention acceptability and safety will also be evaluated.

METHOD

MISST is a feasibility randomised controlled trial design, with 1:1 allocation to risk assessment and signposting plus BMAC or risk assessment and signposting alone. Participants will be university students who self-report experiences of suicidal ideation or behaviour in the past 3 months. Assessments take place at baseline, 8, 16, and 24 weeks. The target sample size is 66 participants. A subset of up to 20 participants will be invited to take part in semi-structured qualitative interviews to obtain further data concerning the acceptability of the intervention.

DISCUSSION

The BMAC intervention may provide an effective, brief talking therapy to help university students struggling with suicidal thoughts that could be readily implemented into university student counselling services. Depending on the results of MISST, the next step would be to undertake a larger-scale efficacy trial.

TRIAL REGISTRATION

The trial was preregistered (17 December 2021) on ISRCTN (ISRCTN13621293) and ClinicalTrials.gov (NCT05296538).

The Impact of Campus-Based Therapy Dogs on the Mood and Affect of University Students

University students experience a high level of stress, which could potentially affect how they manage stressful situations beyond university, such as when entering the workforce. Although universities offer counseling services and various health promotion programs, there is reluctance and negative perceptions about utilizing these from students. Further research is needed to explore the effectiveness of therapy dog interventions in human interactions that is quantifiable and embraces the elements of health promotion. This study aimed to investigate the impact of therapy dog interventions on students' moods across a multi-campus university during a 2-week final examination period. Two hundred and sixty-five students participated in the study involving a multi-campus university. The intervention group and control group completed a questionnaire involving the positive affect negative affect schedule (PANAS), a 20-item scale that measures a person's affect at the time. The intervention group (n = 170) had a higher average of total PANAS scores (mean = 77.63, standard deviation = 10.975) compared to the control group (n = 95) (mean = 69.41, standard deviation = 13.442). The results were statistically significant (mean difference = 8.219, 95% CI = 5.213-11.224, p < 0.05) with a t-score of 5.385. Students who engaged with therapy dogs on campus during the examination period were more likely to have a more positive affect. The results suggest that universities should include therapy dog programs within their health promotion programs for students, as these may help improve their mood and reduce the stress associated with university examinations.

General Health Questionnaire (GHQ12): new evidence of construct validity

This study aimed to gather evidence on the adequacy of the General Health Questionnaire (GHQ-12) in Brazil, considering a random sample of Brazilian physicians. Specifically aimed: (1) to test the GHQ-12 bifactor structure compared to alternative models, (2) to check its factorial invariance regarding to gender and the diagnosis of mental and behavioral disorders, and (3) to know the association of this measure with indicators of poor health (e.g., suicidal thoughts, decreased libido, medication use). The study included 1,085 physicians with a mean age of 45.7 (SD = 10.6), mostly male (61.5%), married (72.6%) and Catholic (59.2%). They answered the GHQ-12, the Positive and Negative Suicidal Ideation Inventory, and demographic questions. The best fit model was the bifactor structure composed of anxiety and depression, in addition to a general dimension, which presented Cronbach's alpha, McDonald's ω and composite reliability higher than 0.70 just for a general fact. Psychological distress scores correlated with suicidal ideation and indicators of health and sexual satisfaction. This is a psychometrically suitable instrument that can be used in terms of its total, but its specific factors need to be used with caution.

The Mediating Effect of Stress between Extracurricular Activities and Suicidal Ideation in Chinese College Students

OBJECTIVE

The objective of this study was to explore the relationship between extracurricular activities, stress, and suicidal ideation and to examine the mediating effect of stress between extracurricular activities and suicidal ideation in Chinese college students.

METHOD

A total of 6446 college students were surveyed with a web-based online data collection system using the self-made demographic questionnaire, Suicidal Behaviors Questionnaire-Revised (SBQ-R), and the 21-Item Depression Anxiety Stress Scales (DASS-21). SPSS 24.0 was used for descriptive statistics and correlation analysis, and the bootstrap method in the process procedure for SPSS Version 3.4.1 was used to construct the mediating effect model.

RESULTS

Gender, school grades, living area, and family income status were influencing factors for suicidal ideation, stress, and extracurricular activities. Extracurricular activities were negatively correlated with stress (r = -0.083, p < 0.001) and suicidal ideation (r = -0.039, p < 0.01). Extracurricular activities had no direct predictive effect on college students' suicidal ideation (c = -0.198, CI: -0.418, 0.023), while stress had a mediating effect between extracurricular activities and suicidal ideation; the indirect mediating effect was 0.159.

CONCLUSIONS

Extracurricular activities indirectly predict college students' suicidal ideation through stress. A variety of extracurricular activities can decrease the stress and suicidal ideation of college students and benefit their mental health.

Trajectory of suicidal ideation among medical students during the COVID-19 pandemic: the role of childhood trauma

BACKGROUND

The aim of this study was to understand the longitudinal trajectory of suicidal ideation (SI) among Chinese medical students and the role of childhood trauma (CT).

METHODS

Using a whole-group sampling method, we assessed SI in 2192 (male = 834, female = 1358) medical students on three occasions over a period of one year. The Suicidal Ideation Self-Assessment Scale (SISAS) and the Childhood Trauma Questionnaire-Short Form (CTQ-SF) were used to assess SI and CT. The growth mixture modeling (GMM) was used to classify the developmental trajectory of SI.

RESULTS

A greater number of medical students were experiencing suicidal ideation during the COVID-19 pandemic. The trajectory of SI among medical students was divided into two groups: a low risk, slowly rising group and a high risk, continuous group. The low risk, slowly rising group had a significant time effect (B = 1.57, p < 0.001) and showed a slowly increasing trend. Emotional neglect (EN), physical neglect (PN), emotional abuse (EA) and physical abuse (PA) all had significant positive predictive effects for the high risk, continuous group (B = 0.18-0.65, P < 0.01).

CONCLUSION

The trajectory of SI among medical students can be divided into a low risk, slowly rising group and a high risk, continuous group; the more EN, PN, EA and PA experienced during childhood, the more likely medical students are to develop a high risk, continuous state of SI.

Predictive Factors of Suicidal Ideation in Spanish University Students: A Health, Preventive, Social, and Cultural Approach

Suicide, as the ultimate expression of suicidal ideation, has accompanied human beings throughout history within specific social and cultural contexts. However, in recent decades the increase in suicides, especially in developed countries after the Second Demographic Transition and the rise of postmaterialist values, has been increasing in the youth population. This study is created from a quantitative perspective and aims to determine the predictors of suicidal ideation in university students in Spain. The fieldwork was carried out in a large sample of Spanish universities over several weeks in 2022, with the participation of hundreds of university students (n = 1472). The predictors of suicidal ideation were gender, types of social relationships, history of bullying, health status, taking antidepressant medication, increased anxiety after COVID-19, economic difficulties in continuing studies, and perspective on their future. The results highlight the need for the greater involvement of universities by establishing programs for preventing, detecting, and treating suicidal ideation, always in coordination with health systems to prevent further suicides in their university community.

Supervision Effects on Negative Affect and Psychological Distress: Evidence from Social Workers in China

Supervision is an imperative practice within the social work field. It provides social workers with support systems, ensures that social workers are adhering to professional standards, and protects clients. Research has also shown that quality supervision can improve social workers' professional capacity and reduce work stress. However, most of this research has been confined to social workers' experiences within Western countries and has been largely qualitative in nature. Thus, this study aims to examine the experience of 489 social workers based in Guangzhou, China to understand how supervision affects their negative affect and psychological distress. The findings indicate that supervision not only reduces negative affect and psychological distress amongst Chinese social workers, but also is especially effective for social workers with high job demands. When job demands are high, social workers who receive both individual and group supervision also appear to have lower negative affect and psychological distress as compared to social workers who only receive individual supervision. These findings emphasize the significance of supervision as a buffer factor to reduce negative affect and psychological distress amongst Chinese social workers who face high job demands.

Instability of emotional relationships and suicide among youth: a qualitative study

BACKGROUND

Interpersonal problems are one of the factors for understanding the complex issues that result in suicide attempts and self-injury by poisoning. The quality of familial relationships is a predictor of the occurrence and outcome of suicide attempts. This study aimed to explore motives for self-poisoning suicide attempts amongst young adults.

METHOD

This research was a qualitative study conducted using semi-structured interviews in 2019 in Kermanshah Province, Iran. Eighteen participants who had attempted suicide by self-poisoning were interviewed, and information was collected until data saturation was achieved. The interviews were recorded and transcribed, and the data were analyzed through content analysis.

RESULTS

The results included the category of instability in emotional relationships with the three sub-categories of 1- Emotional failure, 2- Emotional trauma, and 3- Loss of emotional resilience (caused by emotional failure and emotional trauma within the previous few months). Instability in emotional relationships creates feelings of disgrace, humiliation, burdensomeness, worthlessness, and insignificance, which increases the chances of attempting suicide.

CONCLUSION

The study results provided an in-depth understanding of romantic, and unstable familial relationships as a significant factor in suicide attempts, demonstrating the role of emotional stress in attempting suicide. The present study provided information on the risk factors and warning signs for psychiatrists and nurses dealing with suicidal patients to take effective measures to prevent suicide through social support.

Mental health disorder symptom prevalence and rates of help-seeking among University-Enrolled, emerging adults

Objective. Examine mental health symptom prevalence and rates of campus services utilization among Black male, White male and Black female college students. Participants. 2500 students from an ongoing, student survey at a public university; launched in 2011. Methods. Measures included data for anxiety and depressive symptoms and utilization of campus health services (counseling center, health services, etc.). Descriptive analyses determined prevalence and utilization rates. Mann Whitney U tests compared prevalence. Chi-squared tests compared utilization rates. Results. Anxiety prevalence: greater than 60% of students from each ethnic group reported symptoms; reporting rates decreased significantly for Black men (49.6%); p < 0.001. Depression prevalence: greater than 80% reported symptoms; there were significant differences in reporting between Black men and Black women (72.7% vs. 87.1%, p < 0.001). Utilization: Black men utilized counseling services less than White men (20.4% vs. 37.8%, p = 0.024). Conclusion. Black men report depressive and anxiety symptoms but underutilize campus health resources.

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

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

Supplementary Information

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

Bending not breaking: coping among Filipino University students experiencing psychological distress during the Global Health Crisis

The impact of the global health crisis on students' mental health has been well documented. While most of the studies looked into the psychological impact of the coronavirus disease, the process of coping with psychological distress as experienced by university students in the Philippines remains unexamined. Cognizant of the dearth in literature, this grounded theory study purports to investigate and understand the coping processes among 20 Filipino university students. A comprehensive model highlights Filipino university students' coping techniques with psychological distress through vertical and horizontal analysis of the field text, open, axial, and selective coding. To ensure the trustworthiness and truthfulness of the theory and for refinement and consistency, triangulation, peer debriefing, and member checking validation strategies were likewise employed. The novel and distinct B.E.N.D. Model of Coping with Psychological Distress illustrates a substantive four-phased process symbolic of the challenges that a bamboo tree underwent, namely: (1) Befuddling Phase, (2) Enduring Phase, (3) Navigating Phase, and (4) Developing Phase. The phases that emerged had the advanced appreciable understanding of the university students' coping processes that may provide evidence-based information in crafting programs and specific interventions to support and safeguard students' mental health.