The Developmental Trajectory of a Decade of Research on Mental Health and Well-Being amongst Graduate Students: A Bibliometric Analysis

Assessing factors that influence graduate student burnout in health professions education and identifying recommendations to support their well-being

BACKGROUND

While well-being has become increasingly important in graduate education, limited information exists regarding factors contributing towards burnout and well-being in Pharmaceutical Sciences Doctor of Philosophy (PhD) students. This exploratory story aimed to identify factors influencing well-being and burnout in these students as well as identify recommendations to support their well-being.

METHODS

A two-stage sampling approach was used: (1) purpose sample of Pharmaceutical Sciences PhD students at a public university were invited to participate in a semi-structured focus group or interview to explore factors contributing to PhD student burnout and well-being as well as solicit suggestions for strategies to improve their well-being; (2) Stratified sampling was used to assign participants into focus groups by All-But-Dissertation (ABD) status (i.e., pre-ABD candidates, ABD candidates) to explore experiences that may be unique to these students. Inductive coding and thematic analysis were used.

RESULTS

Six PhD candidates participated in three sessions: three Pre-ABD candidates in one focus group, two ABD candidates in one focus group, and one ABD candidate in one interview. Participants identified relationships and aspects of curriculum and research (i.e., program design, completing milestones) as factors influencing their well-being. Factors influencing participants' burnout included curriculum and research stressors (e.g., cumulative exams, competing academic and research responsibilities), working overtime, unrealistic expectations, lack of work life balance, and financial burden. While relationships and curriculum and research were factors in both subgroups, unique aspects within these themes emerged between Pre-ABD and ABD participants. Participant recommendations to foster PhD student well-being included improving financial support and encouraging PhD connections.

CONCLUSIONS

This study advances knowledge on factors influencing PhD student well-being and burnout, providing suggestions to improve their well-being. Findings highlight curriculum and research factors as well as relationship dynamics influence graduate student burnout and well-being. Findings contribute to broader conversations aimed to support student wellness and reduce burnout in higher education, informing the academy of focused areas and strategies to improve PhD student well-being.

Changes in stress-related outcomes among graduate students following the Mindfulness Ambassador Program: A pilot study

OBJECTIVES

Graduate students face numerous demands, high stress levels, and associated challenges to intra- and inter-personal relationships. Mindfulness may help to ease such challenging experiences. The Mindfulness Ambassador Program (MAP) is a promising group-based program that has not yet been studied among graduate students. The primary objectives of this study were to: (1) explore graduate students' perceptions of stress, and their relationships with themselves and meaningful others; (2) explore graduate students' perspectives of and satisfaction with the MAP; and (3) investigate if participation in the MAP elicited changes in graduate students' perceived levels of stress, self-awareness, interpersonal skills, and/or social connectedness.

METHODS

In this one-group, pre/post mixed-methods pilot study, nine participants completed pre-post questionnaires and participated in a semi-structured interview post-intervention. Data were analyzed using descriptive statistics, thematic analysis, and paired t-tests.

RESULTS

Pre-intervention, qualitative themes included participants experiencing moderate-to-high stress levels, intrapersonal conflict, interpersonal relationship challenges, and seeing oneself as a work in progress. Post-intervention themes included better stress management, increased consideration for oneself and others, feelings of connection with others, and overall satisfaction with the MAP. Statistically significant improvements were found from pre- to post-intervention in mean score differences for perceived stress (p = .043), private self-awareness (p = .006), awareness of immediate surroundings (p = .044), and social connectedness (p = .006).

CONCLUSIONS

Participants reported several benefits from their positive experience participating in the MAP. These findings may be used to inform future mindfulness-based programming for graduate students.

The Well-Being of Doctoral Students in Education: An Ecological Systems Perspective

This study aims to explore the factors that influence the well-being situation of doctoral students in education from a qualitative perspective and draws on the ecological systems theory as an overarching framework. A total of 18 doctoral students in education from 3 universities in Hong Kong were interviewed. In line with the ecological systems theory, individual influential factors may embed and interact with all layers of systems (i.e., the microsystem, the mesosystem, the exosystem, the macrosystem, and the chronosystem) surrounding the doctoral students that hinder or boost their well-being, respectively. These six main areas of concern were identified from a thematic analysis of participants' responses. The study highlighted several salient influential factors of doctoral students' well-being, such as coping strategies, social relations, and their living and cultural environment. An interactive effect among specific factors, such as the COVID-19 pandemic and social movements, was also identified. Findings provide theoretical insights and offer recommendations for improving doctoral students' well-being.

Changes in Mental Health among Japanese University Students during the COVID-19 Era: Differences by College Department, Graduate Level, Sex, and Academic Year

This study compared the effects of academic year, college department, and undergraduate or graduate status on Japanese students' mental health during the COVID-19 pandemic. From 2021-2023, an online survey was conducted using the Counseling Center Assessment of Psychological Systems-Japanese (CCAPS-Japanese) to evaluate students' mental health; 9395 undergraduate students (4623 female, 4772 male) and 1169 graduate students (380 female, 789 male) responded. Undergraduate students in medicine had lower levels of depression, generalized anxiety, and social anxiety than those in other departments. Engineering students exhibited the highest level of academic distress. First-year students had the highest levels of generalized and social anxiety but the lowest level of academic distress. Second-year students had the lowest level of depression, and third-year students had the highest level of academic distress. Among graduate students, first-year students had higher levels of depression, generalized anxiety, social anxiety, academic distress, and hostility than second-year students. Undergraduates had poorer mental health than graduate students. Females had higher levels of eating concerns than males among undergraduate students. This study revealed that the mental health of university students was affected by various factors. These findings demonstrate the characteristics of university students requiring early support.

Bibliometric Analysis of Research Papers on Academic Stress (1989-2023)

This extensive study provides a comprehensive overview of the contemporary research landscape about academic stress, emphasizing on identifying the most relevant contributors and understanding prevalent trends. The analysis included 5,375 results from the PubMed database and revealed a consistent upward trajectory with fluctuations in research paper publications over the years. Network analysis and visualization were performed using the Biblioshiny app and VOSviewer software. The analysis identified that the University of Oslo has published the highest number of research papers related to academic stress. In contrast, the Netherlands, the USA, and Australia demonstrated the highest frequency of collaboration. Analysis of keywords and their co-occurrence provides an overview of the research focus and the areas associated with psychological stress due to academics. Thematic evaluation and topic trend analysis provided insights into the evolving nature of research in academic stress. The thematic map depicts two categories of themes - motor themes, including psychological stress, its epidemiology, the influence of the COVID-19 pandemic, and the mental health of university students, particularly those in medical programs; and emerging themes, including oxidative stress and risk factors, indicated evolving areas of interest. A notable observation was the scarcity of research on primary school students, signaling a gap in the existing academic stress literature. Citation analysis identified the most cited authors, countries, universities, and sources. This multifaceted examination provides a nuanced understanding of academic stress research's current state and dynamics, offering valuable insights into trends, collaborations, and thematic shifts that will guide future research in this critical field.

Experience of irreproducibility as a risk factor for poor mental health in biomedical science doctoral students: A survey and interview-based study

High rates of irreproducibility and of poor mental health in graduate students have been reported in the biomedical sciences in the past ten years, but to date, little research has investigated whether these two trends interact. In this study, we ask whether the experience of failing to replicate an expected finding impacts graduate students' mental health. Using an online survey paired with semi-structured qualitative interviews, we examined how often biomedical science doctoral students at a large American public university experienced events that could be interpreted as failures to replicate and how they responded to these experiences. We found that almost all participants had experience with irreproducibility: 84% had failed to replicate their own results, 70% had failed to replicate a colleague's finding, and 58% had failed to replicate a result from the published literature. Participants reported feelings of self-doubt, frustration, and depression while experiencing irreproducibility, and in 24% of cases, these emotional responses were strong enough to interfere with participants' eating, sleeping, or ability to work. A majority (82%) of participants initially believed that the anomalous results could be attributed to their own error. However, after further experimentation, most participants concluded that the original result was wrong (38%), that there was a key difference between the original experiment and their own (17%), or that there was a problem with the protocol (17%). These results suggest that biomedical science graduate students may be biased towards initially interpreting failures to replicate as indicative of a lack of skill, which may trigger or perpetuate feelings of anxiety, depression, or impostorism.

Acceptability and Feasibility of Online Support Groups for Mental Health Promotion in Brazilian Graduate Students During the COVID-19 Pandemic: Longitudinal Observational Study

BACKGROUND

The outbreak of the COVID-19 pandemic in 2020 aggravated already existing difficulties and added new challenges for students. Owing to the gap between needed and available psychological services, group interventions may offer a helpful strategy for student mental health promotion.

OBJECTIVE

This study aimed to investigate the acceptability and feasibility of a 4-week online support group program designed for mental health promotion tailored to graduate students at a Brazilian public university in the context of the COVID-19 pandemic (May 2022 to June 2022).

METHODS

Participants in the program took part in online support groups based on a pilot group facilitated by a trained clinical psychologist. Self-administered, standardized web-based questionnaires were assessed at the baseline (T0; before the intervention), postintervention (T2), and follow-up (T3; after 4-6 weeks) time points. We measured sociodemographic variables, treatment credibility and expectancy (Credibility and Expectancy Questionnaire), satisfaction (Client Satisfaction Questionnaire), negative effects of the intervention (Negative Effects Questionnaire), depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]), and participants' quality of life (abbreviated World Health Organization Quality of Life assessment). A 9-answer option questionnaire and open-ended questions also assessed the group's perceived positive and negative outcomes.

RESULTS

The total sample comprised 32 participants. Most (23/32, 72%) were doctoral students. Credibility and expectancy scores were high. Participants' satisfaction (Client Satisfaction Questionnaire) with the program was high at the postintervention (T2) and follow-up (T3) evaluations (T2: mean 28.66, SD 3.02; T3: mean 27.91, SD 3.02). Most participants reported that they could learn from other participants' experiences (T2: 29/32, 91%; T3: 27/32, 84%) and felt encouraged to take better care of themselves (T2: 22/32, 69%; T3: 24/32, 75%). None of the participants reported that they had no benefits from the program. The PHQ-9 scores showed mild to moderate depressive symptoms (mean 9.59, SD 6.34), whereas the answers of 9% (3/32) of the participants to the PHQ-9 item 9 indicated suicidality at baseline (T0). Finally, the 4 domains of quality of life (physical: P=.01; psychological: P=.004; social: P=.02; and environmental: P<.001) showed a slight and statistically significant improvement at the postintervention evaluation (T0: mean 57.03, SD 15.39 to 59.64, SD 17.21; T2: mean 64.32, SD 11.97 to 68.75, SD 8.87).

CONCLUSIONS

Online support groups for the mental health promotion of graduate students are feasible and can be especially useful for universities with students allocated to different cities. They are also satisfactory and may positively influence participants' quality of life. Therefore, they can be considered a helpful mental health promotion strategy in the educational context. Further studies could evaluate these (or similar) programs under nonpandemic circumstances.

Understanding and Fostering Mental Health and Well-Being among University Faculty: A Narrative Review

In recent years, there has been increasing recognition of mental health concerns in academia, with stress, burnout, anxiety, and depression being reported among faculty members. The demanding work environment, the need to balance personal and professional duties, and the constant pressure of productivity while navigating multiple tasks of teaching, research, mentorship, professional development, and service all impact the mental health and overall well-being of faculty. Higher education institutions have structurally changed as has the research landscape. These changes as well as faculty-specific and student-specific factors coupled to the effect of the COVID-19 pandemic have led to profound effects on the mental health of academics. This paper is a narrative review of the pertinent literature describing faculty mental health and well-being. It summarizes the available evidence on factors influencing faculty mental health and shows the prevalence of anxiety, depression, stress, and burnout among faculty from various academic fields and along the whole academic ladder. Using a suggested framework that collates the efforts of leaders and faculty, the paper concludes by exploring strategies that promote work-life balance among academics and suggesting effective interventions to improve their mental health outcomes.

Mental Health Problems Among Graduate Students in Turkey: a Cross-Sectional Study

In this study, depression/anxiety and academic distress were investigated among graduate students in Turkey. The study sample comprised 459 graduate students who voluntarily completed an online survey (294 women, 64%). Independent t-tests and multivariate analyses were performed to examine group differences. The results confirmed that depression/anxiety and academic distress scores varied according to sociodemographic variables. Whereas depression/anxiety and academic distress did not show significant differences in terms of gender and place of residence, students who had previously sought psychological help had higher levels of depression/anxiety and academic distress. Younger age, being a master's student, and being single increased the risk of having higher levels of depression/anxiety and academic distress. University counseling centers may benefit from these findings in efforts to identify graduate students at risk and apply appropriate prevention and intervention strategies.