Depression,anxiety, and tobacco use: Overlapping impediments to sleep in a national sample of college students

ABSTRACT

Objectives: To examine how tobacco use and depression/anxiety disorders are related to disturbed sleep in college students. Participants: 85,138 undergraduate respondents (66.3% female, 74.5% white, non-Hispanic, ages 18–25) from the Spring 2011 American College Health Association–National College Health Assessment II database. Methods: Multivariate analyses of tobacco use (none, intermediate, daily) and mental health (diagnosed and/or symptomatic depression or anxiety) were used to predict sleep disturbance. Results: Daily tobacco use was associated with more sleep problems than binge drinking, illegal drug use, obesity, gender, and working >20 hours/week. Students with depression or anxiety reported more sleep disturbances than individuals without either disorder, and tobacco use in this population was associated with the most sleep problems. Conclusions: Tobacco use and depression/anxiety disorders are both independently associated with more sleep problems in college students. Students with depression and/or anxiety are more likely to be daily tobacco users, which likely exacerbates their sleep problems.     

Mental Health Among College Students: Do Those Who Need Services Know About and Use Them?

Objective: The objective of this study was to examine connections between university students' mental health and their knowledge and use of campus mental health services. Participants and Methods: In March 2001, a sample of undergraduate students (N = 266) completed a Web-based questionnaire, providing information related to their mental health, knowledge of mental health services, and use of those services. Results: Students who were mentally distressed were more likely to know about and use services; however, some students who reported to be mentally distressed either did not know about services or knew about services but did not use them. Living off campus, identifying as male, and having fewer years in college were related to less knowledge of campus mental health services. In addition, female sex and number of years in college were predictive of higher service use. Conclusions: With the high prevalence rates and severity of mental health problems, university mental health providers must continue to make strategic efforts to disseminate knowledge about mental health services to all students.     

Body image,self-esteem,and behavioral risk for chronic disease among college students: Additional evidence for integrated prevention

Abstract

Objective: To examine associations between two body image constructs (body appreciation and body satisfaction) and five health behaviors (diet, physical activity, weight management, tobacco exposure, and alcohol intake) associated with risk for chronic disease, controlling for self-esteem. Participants: Three hundred and forty-four college students enrolled at a large, public university in the southeastern US. Methods: Students completed an online survey composed of measures of body appreciation, body satisfaction, self-esteem, and frequency of engagement in preventive health behaviors. Hierarchical linear regression models were used to assess relationships between constructs. Results: Body appreciation, but not body satisfaction or self-esteem, significantly and positively predicted engagement in diet-, physical activity-, and weight-related health behaviors. No associations were found for substance use outcomes. Conclusions: Results illuminate health risks among college students and provide additional evidence to support the development of holistic preventive interventions that simultaneously address aspects of mental and physical health among college students.     

Transactional sexual activity among university students: Prevalence and clinical correlates

Abstract

Objectives: This study examined the prevalence and mental health correlates of transactional sexual activity (sex for compensation) in a university sample. Methods: A 156-item anonymous survey was distributed via random email generation to 9,449 university students. Results: The prevalence of transactional sex was 2.1%. Respondents who had sold sex (n?=?30) reported significantly higher rates of risky sexual behavior and mental health problems than those who had not sold sex (n?=?1,405). Conclusions: Transactional sex in our sample of university students was associated with a range of impulsive or compulsive behaviors that may affect students’ health and well-being.     

The intersection of nonsuicidal self-injury and suicide-related behavior: Patterns of elevated risk and implications for college mental health

Objective: To analyze the overlap of nonsuicidal self-injury (NSSI) and suicide-related behaviors (SRB) among college students with regard to demographics, mental health, and coping styles. Participants: Respondents were 572 undergraduate students at a southwestern public university. Methods: Data were collected in 2015. Respondents completed a demographic survey and assessments of NSSI, SRB, internalizing symptoms (ie, anxiety, stress, and depression), aggression, and negative coping strategies. The survey was administered via a Web-based procedure. Results: Women reported more frequent cutting behaviors than men. Endorsement of NSSI was also associated with an increased likelihood of lifetime SRB. A subgroup of students endorsing both NSSI and SRB demonstrated poorer mental health, more negative coping, and self-reported female sex. Conclusions: College healthcare providers may benefit from competency-based training in techniques for the combination treatment of NSSI and SRB, as well as culturally based models of suicide.     

The State of Sleep Among College Students at a Large Public University

Abstract

Objective: Data about college student sleep were collected and used to develop an education campaign to improve sleep. Participants: On-campus residents at a large state university were surveyed on 4 occasions, October 2005 to April 2007. Sample size was 675 to 1,823 students. Fall 2005 mean age = 18.5 years, SD = 1.03 (range 18–30) years. Initial survey included 935 males and 1,859 females (2005–2006). Matched pairs data (2006–2007) included 91 males and 107 females. Twenty-six males and 22 females participated in interviews. Methods: A survey administered online included the Pittsburgh Sleep Quality Index, along with an 8-question in-person interview. Results: Poor sleep interacted with academics and mental health, and an education campaign positively affected student sleep. Conclusions: Teaching students how to effectively manage sleep can improve their well-being. Sleep may also be a gateway topic for health care professionals to address sensitive health issues such as depression.     

The Association Between Mental Health and Acute Infectious Illness Among a National Sample of 18- to 24-Year-Old College Students

Poor mental health is associated with physical illness, but this association is poorly characterized among college students. Objective and Participants: Using American College Health Association-National College Health Assessment data, the authors characterized poor mental health (depression, anxiety, negative affect) and examined the relationship between poor mental health and acute infectious illnesses (bronchitis, ear infection, sinusitis, strep throat) among 47,202 US college students. Methods: The authors used frequency and cross-tabulation analyses to characterize mental health and determine univariate associations among variables. They used binary logistic regression to determine the association between poor mental health and acute infectious illness, controlling for research-derived covariates. Results: The prevalence of acute infectious illness ranged from 8% to 29%. The prevalence of anxiety and depression ranged from 12% to 20%, respectively. Depression, anxiety, and exhaustion were associated with acute infectious illness across all dependent measures, with odds ratios ranging from .56 to .91. Conclusions: Poor mental health is associated with acute infectious illness among college students.     

Perceived Discrimination and Its Associations With Mental Health and Substance Use Among Asian American and Pacific Islander Undergraduate and Graduate Students

Abstract

Objectives: Racial discrimination experiences can negatively affect health. This study examined perceived discrimination and its relationship with mental health and substance use among Asian American and Pacific Islander (API) undergraduate and graduate students. Participants: A total of 113 API students aged 18–35 completed the study during February–June, 2011. Methods: The authors conducted a cross-sectional, anonymous survey online. Dependent variables included mental health (depressive, anxiety, and somatic symptoms) and substance use (alcohol problems, use of tobacco, marijuana or hashish, and other illegal drugs). Results: Students’ perceived discrimination were significantly, positively associated with depressive, anxiety, and somatic symptoms, but not with substance use. Ethnic identity moderated the relationship between perceived discrimination and somatic symptoms, but not depressive or anxiety symptoms. Conclusions: These findings suggested the negative effect of racial discrimination on API students’ mental health. The buffering effect of ethnic identity may increase resilience in these students when they face racial discrimination.     

Characteristics of university students who mix alcohol and energy drinks

Objective: Research has identified correlates (eg, drug use, risky sex, smoking) of using alcohol mixed with energy drinks (AMEDs). Few studies have investigated common mental health-related concerns (eg, depression, sleep). Participants: Alcohol-using college students (n = 380 never used AMEDs, n = 180 used AMEDs) were recruited in the study during the fall 2011 semester. Methods: The study examined demographics, substance use, depressive symptoms, and sleep problems in association with AMED use. Results: Multivariable logistic regression indicated that alcohol use severity (AOR = 1.24; 95% CI = 1.14+1.34), drug use severity (AOR = 1.20; 95% CI = 1.04–1.39), depressive symptoms (AOR = 1.06; 95% CI = 1.01–1.12), and smoking (AOR = 2.12; 95% CI = 1.22–3.68) were independently associated with AMED use; sleep problems were non-significant. Conclusions: Administrators may consider policies regarding energy drink availability on campus, and campus health personnel may increase screening and education surrounding AMED use to reduce risks among students.     

College students coping with interpersonal stress: Examining a control-based model of coping

Objective: The ways that college students cope with stress, particularly interpersonal stress, may be a critical factor in determining which students are at risk for impairing mental health disorders. Using a control-based model of coping, the present study examined associations between interpersonal stress, coping strategies, and symptoms. Participants: A total of 135 undergraduate students from 2 universities. Methods: Interpersonal stress, coping strategies, depression, anxiety, and somatization were assessed via self-report. Results: Students reporting more interpersonal stress reported more depression, anxiety, and somatization, and they reported less use of engagement coping strategies and greater use of disengagement coping strategies. Engagement coping strategies accounted for a significant portion of the association between interpersonal stress and mental health symptoms. Unexpectedly, coping strategies did not moderate the association between stress and mental health symptoms. Conclusion: Interventions designed to improve students' coping strategies may be an effective way to reduce mental health problems on college campuses.     

Factors Associated With the Psychological Well-Being and Distress of University Students

Objective: Because of the serious nature of psychiatric illness and related problems, the authors attempted to identify demographic, individual, and behavioral factors linked to university students' psychological health. Participants: They surveyed 353 (60.9% female) predominately Caucasian (88.7%) university students attending a large public university. Methods: The authors used a self-report questionnaire including valid and reliable psychometric instruments for all study variables. They conducted multiple regression analyses to examine associations among study variables using a cross-sectional design. Results: More favorable health states (ie, greater psychological well-being and less distress) were positively associated with optimism, health values, and religiousness and were negatively associated with spirituality and number of sexual partners. Conclusions: Results demonstrated that multiple protective and risk factors contribute to the psychological well-being and distress of university students. Health promotion practitioners should adopt strategies that strengthen the personality characteristics and values associated with university students' psychological health.     

Relationship of sleep quality and attention deficit hyperactivity disorder symptoms with quality of life in college students

Abstract

Objective: Attention deficit hyperactivity disorder (ADHD) negatively influences various aspects of life such as social relations, adaptive skills, and occupation. In addition, many university students experience sleep problems, academic failure, and low quality of life (QOL). We investigated the relationship among ADHD symptoms, sleep quality, and QOL of college students, and identified the factors related to their QOL. Participants and Methods: Using a survey questionnaire, data were collected from 195 students from March–May 2017. Results: QOL of students was related to ADHD symptoms and sleep quality. Factors significantly associated with better QOL were fewer ADHD symptoms, good sleep quality, male sex, high academic performance, and high economic status. The explanatory power of these variables on QOL was 32.0%. Conclusion: To improve the QOL of college students, a multifaceted approach that includes assessment of ADHD symptoms and sleep quality is needed.     

Typologies of Childhood Exposure to Violence: Associations With College Student Mental Health

Abstract

Objective: This study examined typologies of childhood violence exposure (CVE) and the associations of profiles with current demographic characteristics and mental health in emerging adulthood. Participants: The study evaluated a sample of college students from 2 US geographic regions (Midwest, n = 195; Southeast, n = 200). Methods: An online questionnaire (collected 2013–2014) assessed CVE and current mental health. Latent class analysis was used to identify typologies of CVE. Follow-up analyses were conducted to distinguish differences between typologies in demographic characteristics and mental health. Results: Four distinct profiles emerged: High-Exposed, Domestic-Exposed, Community-Exposed, and Low-Exposed. High- and Domestic-Exposed groups were more likely to be first-generation college students and to experience symptoms of psychopathology. Conclusions: This study offers a unique presentation of CVE profiles and a nuanced interpretation of their differential relationship to current demographic characteristics and mental health. It may befit university mental health initiatives to engage first-generation students and utilize comprehensive assessments of previous victimization.     

A Study on the Sleep Patterns and Problems of University Business Students in Hong Kong

Abstract

Objective: To investigate sleep patterns and problems of university business students. Participants: Undergraduate Chinese business students in Hong Kong. Methods: Self-reported questionnaires were completed during class lectures and through online system. Results: Of the 620 participating students (mean age 19.9 years), sleep duration was significantly shorter during weekdays (6.9 hours) than weekends (8.6 hours). Two thirds of students reported sleep deprivation. The following factors were associated with being a “poor sleeper” (Pittsburgh Sleep Quality Index > 5): attending early morning lectures (odds ratio [OR] = 1.90), living on-campus (OR = 1.89), Sleep Sufficiency Index less than 0.8 (OR = 2.55), sleep debt (differences of total time-in-bed between weekday and weekend ≥ 75 minutes) (OR = 1.58), and minor psychiatric disturbances (OR = 2.82). Conclusions: Poor sleep quality and sleep deprivation were prevalent in university business students in Hong Kong, especially for those attending early morning lectures and living on-campus. Systemic education on the importance of sleep and stress and time management is needed for university students.     

A multivariate analysis of adverse childhood experiences and health behaviors and outcomes among college students

Objective: This study investigated associations between adverse childhood experiences (ACE) prior to age 18 years and multiple health behaviors (eg, cigarette and other substance use) and outcomes (eg, obesity, depression) for a large college sample. Participants: 2,969 college students from seven universities in the state of Georgia were included in the analysis. Methods: Web-based surveys were completed by students (45–60 minutes) during the spring semester, 2015. Results: Findings indicate that more ACEs are associated with higher levels of depressive symptoms, ADHD symptoms, cigarette use, alcohol use, marijuana use, and BMI, in addition to lower levels of fruit and vegetable intake, and sleep. Conclusion: ACEs may carry forward in the lifespan to influence a range of unhealthy outcomes among college students. College intervention programs may benefit by recognizing the pervasiveness of ACEs and their associations with health behaviors and outcomes, and include interventions across more than one health behavior.     

Health attitudes and suicidal ideation among university students

ABSTRACT

Objective: The purpose of this study was to examine whether positive health attitudes are associated with suicidal ideation among university students after accounting for other health risk factors linked to suicidal ideation. Participants: Participants were 690 undergraduates from a large midwestern university during fall semester 2011. Methods: Participants reported demographics and health characteristics. Regression models compared individuals who reported suicidal ideation and those who did not. Results: In unadjusted models, suicidal ideation was significantly negatively associated with positive health attitudes, and positively associated with depression, drug use problems, sleep problems, and being overweight. In adjusted models, more positive health attitudes continued to be significantly negatively associated with suicidal ideation. Conclusions: This study suggests a link between positive health attitudes and lower probability of suicidal ideation. Additional research is needed to assess enhancing general health attitudes as a suicide prevention effort.     

Promoting healthy transition to college through mindfulness training with first-year college students: Pilot randomized controlled trial

Objective: Given the importance of developmental transitions on young adults' lives and the high rates of mental health issues among U.S. college students, first-year college students can be particularly vulnerable to stress and adversity. This pilot study evaluated the effectiveness and feasibility of mindfulness training aiming to promote first-year college students' health and wellbeing. Participants: 109 freshmen were recruited from residential halls (50% Caucasian, 66% female). Data collection was completed in November 2014. Methods: A randomized control trial was conducted utilizing the Learning to BREATHE (L2B) program, a universal mindfulness program adapted to match the developmental tasks of college transition. Results: Participation in the pilot intervention was associated with significant increase in students' life satisfaction, and significant decrease in depression and anxiety. Marginally significant decrease was found for sleep issues and alcohol consequences. Conclusions: Mindfulness-based programs may be an effective strategy to enhance a healthy transition into college.     

The Connections of Mental Health Problems,Violent Life Experiences,and the Social Milieu of the “Stroll” with the HIV Risk Behaviors of Female Street Sex Workers

Abstract

This paper examines the connections of mental health, victimization, and sexual risk behaviors among a sample of 278 street-based female sex workers in Miami. Using targeted sampling strategies, drug-using sex workers were recruited into an HIV prevention research program. Data were collected by trained interviewers, and focused on drug use and sexual risk for HIV, childhood abuse, recent victimization, and mental health. More than half of the participants reported histories of physical (51.1%) or sexual (53.1%) abuse as children, 37.4% were classified with moderate or severe anxiety symptoms, and 52.9% had symptoms of moderate or severe depression. Logistic regression analyses demonstrated significant associations between mental health issues and engagement in recent unprotected vaginal and oral sex. The program development and policy implications of these findings are discussed.     

Predictors of well-being among college students

ABSTRACT

Objectives: Identification of health-related risk behaviors associated with well-being in college students is essential to guide the development of health promotion strategies for this population. The purposes were to evaluate well-being among undergraduate students and to identify health-related risk behaviors that predict well-being in this population. Methods: A cross-sectional Web-based survey of undergraduate students was conducted at a metropolitan university in the Southeast United States. A total of 568 students responded (response rate 14.2%). Data were collected on health-related risk behaviors using the National College Health Assessment II. Results: Controlling demographic characteristics, the best predictive model included physical activity, current tobacco user, depression, ever received mental health services, and sleep quality, which was the strongest predictor (β = .45, p < .001). This model explained 35% of the variance in well-being. Conclusions: Interventions that promote sleep quality among college students may be most beneficial in improving well-being.     

Variations in Student Mental Health and Treatment Utilization Across US Colleges and Universities

Abstract

Objective: On US college campuses, mental health problems are highly prevalent, appear to be increasing, and are often untreated. Concerns about student mental health are well documented, but little is known about potential variations across the diversity of institutions of higher education. Participants: Participants were 43,210 undergraduates at 72 campuses that participated in the Healthy Minds Study from 2007 to 2013. Methods: Multivariable logistic regressions focus on associations between institutional characteristics and student mental health and treatment utilization. Results: The following institutional characteristics are associated with worse mental health: doctoral-granting, public, large enrollment, nonresidential, less competitive, and lower graduation rates. Among students with apparent mental health problems, treatment utilization is higher at doctorate-granting institutions, baccalaureate colleges, institutions with small enrollments, and schools with strong residential systems. Conclusions: Although high rates of mental health problems and low treatment utilization are major concerns at all types of institutions of higher education, substantial variation occurs across campuses.