Associations among trauma,depression, and alcohol use profiles and treatment motivation and engagement in college students

ABSTRACT

Objective: This study examined how profiles of alcohol use and symptoms of common mental health disorders (depression and posttraumatic stress disorder [PTSD]) influenced the perceived need for and actual seeking of different types of treatment (for alcohol versus psychological distress) in college student drinkers. Participants: Undergraduate students (n = 164) were assessed between September 2009 and August 2015. Methods: We classified students into different symptom profiles using model-based clustering and compared these profiles on a variety of variables. Results: The cluster model yielded three profiles: Low Risk (n = 66), Concomitant (n = 35), and Heavy Drinking (n = 63). Students in these profiles significantly differed in alcohol consumption, alcohol-related cognitions and problems, and perceptions of need and prior engagement in treatment. Conclusion: A variety of strategies can be used to engage students experiencing heavy drinking and/or mental health problems into treatment on campus.     

Civic engagement among student veterans

Abstract

Objective: The purpose of this study was to assess participation rates in civic volunteering among service member and veteran students. Participants: Data for the present cross-sectional study were obtained from the American College Health Association’s (ACHA) 2011–2014 National College Health Assessment II (NCHA). Methods: Demographic characteristics of the study sample were explored by calculating frequencies and percentages by military service status. Research questions were explored with either Fisher’s exact test or maximum likelihood multiple logistic regression. Results: Service member and veteran students were more likely to engage in volunteerism than their non-veteran counterparts. Additionally, student veterans and non-veteran students reported that engagement in volunteer efforts both reduces their feelings of depression and increases their use of mental health services. Conclusion: The findings of this research suggest that the promotion of civic engagement and participation in volunteerism for service member and veteran students on college campuses might contribute to successful reintegration outcomes.     

Does the Andersen Behavioral Model of Health Services Use predict college students’ use of on-campus mental health services?

Abstract

Objective: 10–50% of college students meet the diagnostic criteria for one or more mental illnesses; unfortunately, less than half seek treatment. This study assessed the predictive power of specific variables on students’ use of on-campus mental health resources using the American College Health Association’s National College Health Assessment (ACHA-NCHA) II. Participants: Respondents included undergraduate and graduate students ages 18–35?years (n?=?96,121). Methods: We analyzed data from the ACHA-NCHA II Fall 2014 and Spring 2015. Andersen’s Behavioral Model of Health Services Use enabled selection of predisposing, enabling, and need predictor variables; these were analyzed individually and collectively. Results: Predisposing, enabling, and need variables accounted for 9%, 2.3%, and 17% of the overall variance. Significant variables associated with a student’s decision to access on-campus mental health services accounted for 23% of variance total. Conclusions: This insight could allow universities to better recognize students at-risk for needing but not accessing mental health services.     

Examining the Relationships Between Resilience,Mental Health,and Academic Persistence in Undergraduate College Students

Abstract

Objective: In this study, the relationships between measures of interpersonal resilience, intrapersonal resilience, and mental health were examined with respect to academic and social integration, key determinants of academic persistence. Participants: A sample (n = 605) of undergraduate students was recruited from 2 midwestern universities during the 2007–2008 academic year. Methods: Hierarchal (or sequential) regression analysis examined whether the inter- and intrapersonal resilience and mental health measures contributed to explaining variance in the response variables of university cumulative grade point average (GPA) and university sense of belonging. Results: The intrapersonal resilience factors contributed to explaining variance in cumulative GPA in addition to aptitude and achievement. Furthermore, there was a strong statistical correlation between the inter- and intrapersonal resilience factors and mental health. Conclusions: The demands in college are significant and there is a need for more research on the concept of resilience as it relates to college health and academic persistence.     

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.     

College Counselors’ Perceptions and Practices Regarding Anticipatory Guidance on Firearms

Abstract

Objectives: This study assessed college counselors’ anticipatory guidance on firearms for student clients. Participants: The membership of the Association for University and College Counseling Center Directors was used to identify a national random sample of counseling centers (n = 361). One counselor from each center was selected to survey. Methods: In the winter of 2008, a 3-wave mailing procedure was used to maximize the response rate. Completed surveys served as consent (as approved by the University Human Subjects Committee). Results: A total of 213 counselors (59%) responded. They were unlikely to provide anticipatory guidance (6%), chart/keep records on client ownership/access to firearms (17%), or to counsel the majority of clients from various diagnostic categories on firearms. Conclusions: University personnel are likely to refer students with suspected mental health problems to university counseling centers. The findings indicate that few counseling centers will address firearm issues with students.     

An examination of ecological predictors of health literacy in black college students

Objective: Health literacy is a determinant of health, but disparities in health literacy persist. This study examined the influence of ecological factors on college students’ health literacy. Participants: During January 2016 a nonrandom sample of black undergraduate students (n = 298) aged 18–24 were recruited from enrollment lists at two urban universities in the Southeastern United States. Methods: Information on health literacy as well as numerous intrapersonal, social, and cultural-environment factors was obtained using an electronic questionnaire and then statistically modeled. Results: Ecological factors accounted for 28.7% of the variance in health literacy. In particular, reappraisal (B = 0.323, p < .001), suppression (B = ?0.289, p < .001), campus health education (B = 0.192, p < .05), campus tobacco culture (B = ?0.174, p < .05), and perceived norms (B = ?0.153, p < .05) directly predicted health literacy. Conclusions: Although intrapersonal factors influence health literacy, the sociocultural environment of college can also foster or hinder college students’ health literacy.     

Development and Initial Validation of the Symptoms and Assets Screening Scale

Abstract

Objective: To develop and test a screening measure of mental health symptoms and well-being in college students, the Symptoms and Assets Screening Scale (SASS). Participants: Participants were 758 college students at 2 universities in the Northwest sampled between October 2009 and April 2011. Methods: Participants completed the SASS, as well as measures of depressive symptoms, anxiety symptoms, substance problems, and eating problems in 1 session. A subset of participants (n = 259) completed the SASS 1 to 2 weeks later to allow an examination of test–retest stability. Results: The SASS demonstrated good reliability and validity and appears to assess similar constructs as well-established measures in college students. Fifty-nine percent of the sample reported having problems with their thoughts, behaviors, or emotions, whereas only 9.7% reported currently receiving treatment. Conclusions: The SASS is a brief instrument that has the potential to effectively screen for the most prevalent mental health problems in college students.     

A Comparative Study of Campus Experiences of College Students With Mental Illnesses Versus a General College Sample

Abstract

Objective: Examine campus experiences and relationships of college students with mental illnesses compared to general student norms using the College Student Experiences Questionnaire to understand potential sources of distress and retention issues. Participants: Responses were obtained from 449 former and current students with mental illnesses from more than 300 colleges and universities around the country. Methods: Participants completed an online survey available from July 2005 to July 2006. Results: Multivariate analysis of variance and t test results indicate that college students with mental illnesses report less engagement on campus and poorer relationships, and that these factors were associated with lower graduation rates. Students reporting they were treated differently “most of the time” because of a mental illness had the lowest levels of engagement and poorest relationships. Conclusions: More attention is needed to developing interventions that enhance social functioning and engagement and address stigma on campus in order to reduce distress and enhance retention.     

Undergraduate students survey their peers on mental health: Perspectives and strategies for improving college counseling center outreach

Abstract

Objective: The purpose of the study was to examine student perspectives about college mental health including the primary mental health issues affecting students, common college student stressors, student awareness of campus mental health resources, and mental health topics students want more information about. Participants: Participants were 822 undergraduate and graduate students enrolled in a private university. The study was conducted during September 2016. Methods: As part of a public health course in program planning, undergraduate students surveyed their peers about their experience with mental health and mental health resources. Results: Stress was perceived as the largest mental health issue. Students most wanted more information about school/work/life balance followed by stress management. Electronic newsletters, social media, and on-campus seminars were the top strategies that students suggested as ways to reach them. Conclusions: The results provide student perspectives on mental health that may be useful in developing effective outreach efforts.     

A Student-to-Student Dental Outreach Program

Abstract

Objective: This study investigates the individual, interpersonal, and institutional level factors that are associated with overall mental health among college students. Participants: Data are from an online cross-sectional survey of 2,203 students currently enrolled at a large public university. Methods: Mental health was ascertained using a subcomponent of the RAND Medical Outcomes Study functioning and well-being measures developed by the RAND corporation. Stepwise regression was used to determine if self-reported measures of individual (ie, coping abilities), interpersonal (ie, intergroup awareness), and institutional (ie, campus climate/tension) level factors were associated with overall mental health, after controlling for demographic characteristics. Results: The combined effects of both individual and institutional level measures were associated with student mental health. In particular, limited coping abilities and a perceived racially tense campus climate contributed to the psychological distress of college students. Conclusions: Simultaneously addressing the individual and institutional level influences on mental health offers the most promising help for students.     

Alcohol Use in Students Seeking Primary Care Treatment at University Health Services

Abstract

Objective: Given the high rate of at-risk drinking in college students, the authors examined drinking behaviors and associated factors in students being seen in student health services for primary care visits from October 30, 2004, to February 15, 2007. Methods: Analyses were based on a Health Screening Survey completed by 10,234 college students seeking general medical treatment. Results: Alcohol use was similar to other studies with 57% (n = 5,840) meeting the National Institute on Alcohol Abuse and Alcoholism criteria for at-risk drinking. Twenty-six percent of the students reported smoking at least once in the last 3 months. Risk factors for at-risk drinking included young age, white males, drinking at a fraternity/sorority house, and use of tobacco. Conclusions: These findings support the widespread implementation of alcohol screening and intervention in university health services.     

Does ethno-cultural betrayal in trauma affect Asian American/Pacific Islander college students' mental health outcomes? An exploratory study

Objectives: Interpersonal trauma has deleterious effects on mental health, with college students experiencing relatively high rates of lifetime trauma. Asian American/Pacific Islanders (AAPIs) have the lowest rate of mental healthcare utilization. According to cultural betrayal trauma theory, societal inequality may impact within-group violence in minority populations, thus having implications for mental health. In the current exploratory study, between-group (interracial) and within-group (ethno-cultural betrayal) trauma and mental health outcomes were examined in AAPI college students. Participants: Participants (N = 108) were AAPI college students from a predominantly white university. Data collection concluded in December 2015. Methods: Participants completed online self-report measures. Results: A multivariate analysis of variance revealed that when controlling for interracial trauma, ethno-cultural betrayal trauma significantly impacted dissociation, hallucinations, posttraumatic stress symptoms, and hypervigilance. Conclusions: The results have implications for incorporating identity, discrimination, and ethno-cultural betrayal trauma victimization into assessments and case conceptualizations in therapy.     

Self-esteem,Self-focused Attention,and the Mediating Role of Fear of Negative Evaluation in College Students With and Without Asthma

Abstract

Objective: The current study investigated the mediating role of fear of negative evaluation on the relationship between self-focused attention and self-esteem among college students with and without asthma. Participants: Young adults with (n = 148) and without (n = 530) childhood-onset asthma were recruited from a college student population. Methods: Self-focused attention and fear of negative evaluation measures were completed. Participants also answered questions about inclusion in a social activity. Results: Higher levels of self-focused attention and fear of negative evaluation were associated with lower self-esteem in both groups within the context of social activity participation. Fear of negative evaluation mediated the relationship between self-consciousness and self-esteem. No significant differences were found between groups. Conclusions: Findings indicate significant relationships among self-focused attention, fear of negative evaluation, and self-esteem in the context of social activity participation. Further examination of self-esteem regarding participation in social activities among college students appears warranted.     

Self-rated Health in Relation to Rape and Mental Health Disorders in a National Sample of College Women

Abstract

Objective: The purpose of this study was to employ a multivariate approach to examine the correlates of self-rated health in a college sample of women, with particular emphasis on sexual assault history and related mental health outcomes. Participants: A national sample of 2,000 female college students participated in a structured phone interview between January and June 2006. Methods: Interview modules assessed demographics, posttraumatic stress disorder, major depressive episode, substance use, rape experiences, and physical health. Results: Logistic regression analyses showed that poor self-rated health was associated with low income (odds ratio [OR] = 2.70), lifetime posttraumatic stress disorder (OR = 2.47), lifetime major depressive episode (OR = 2.56), past year illicit drug use (OR = 2.48), and multiple rape history (OR = 2.25). Conclusions: These findings highlight the need for university mental health and medical service providers to assess for rape history, and to diagnose and treat related psychiatric problems in order to reduce physical morbidity.     

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.     

The Theory of Planned Behavior as it predicts potential intention to seek mental health services for depression among college students

ABSTRACT

Background: Between 9.5% and 31.3% of college students suffer from depression (American college health association national college health assessment II: reference group executive summary spring 2013. Amer. Coll. Health Assoc. 2013; Eagan K, Stolzenberg EB, Ramirez JJ, Aragon, MC, Suchard, RS, Hurtado S. The American freshman: national norms fall 2014. Higher Educ. Res. Inst.; 2015). Universities need to understand the factors that relate to care-seeking behavior. Objective: Across 3 studies, to relate attitudes, social norms, and perceived behavioral control to intention to seek mental health services, and to investigate barriers to care-seeking. Participants: University college students (N = 845, 64% female, 26% male, and 10% unspecified). Methods: New measures were created in Studies 1 and 2, and were examined using structural equation modeling in Study 3. Results: Partially consistent with the Theory of Planned Behavior (Ajzen, I, Fishbein, M. Understanding Attitudes and Predicting Social Behavior. Englewood Cliffs, NJ: Prentice-Hall; 1980), a model with an excellent fit revealed that more positive attitudes about care and higher perceived behavioral control directly predicted higher intention to seek mental health services. Conclusions: Educating college students about mental health disorders and treatments, enhancing knowledge about available services, and addressing limited access to long-term care might improve treatment rates for students suffering from depression.     

College Health Professionals and Academic Librarians: Collaboration for Student Health

College health professionals must find new ways of educating students on finding and evaluating consumer health information, specifically in the online environment. Librarians are trained as information professionals; however, librarians at general academic libraries are not taking a lead role in providing consumer health information. Objective: The authors' purpose in this research was to determine the health information resource needs of college and university students and provide a model for collaboration between college health professionals and academic librarians. Participants and Methods: The authors compared data from a national survey on college health (N = 54,111) with their own results from a survey of general academic librarians (N = 17) to create recommendations for synching students' reported health information needs with librarians' resources. Results: Although the Internet was students' second most-often consulted health information source, they ranked the believability of online health information above only television. In the librarian survey, although 12 respondents indicated that health information provision is a library's responsibility, the majority (n = 11) believed their library's consumer health outreach to be passive. Conclusions: The authors offer recommendations for partnerships between college healthcare professionals and academic librarians to better provide this information to students.     

Anthropometric and Behavioral Measures Related to Mindfulness in College Students

Abstract

Objective: To determine whether mindfulness is associated with physical and behavioral measures in first semester college students. Participants: Male and female first year college students (n = 75) from the University of Rhode Island. Methods: Height, weight, waist circumference (WC), and blood pressure were assessed and online questionnaires were completed. Independent t tests and Pearson correlations were utilized for analysis. Results: The less mindful group had a higher WC than the more mindful group. Correlations were seen between mindfulness and weight-related behaviors. Conclusions: Mindfulness can impact health status of first year college students, particularly with behavioral measures that have been found to effect weight status. However, additional research is needed focusing on mindfulness as a potential weight gain prevention technique for first year college students in order to decrease chronic disease prevalence.