Flourishing: Exploring Predictors of Mental Health Within the College Environment

Abstract

Objective: To explore the predictive factors of student mental health within the college environment. Participants: Students enrolled at 7 unique universities during years 2008 (n = 1,161) and 2009 (n = 1,459). Methods: Participants completed survey measures of mental health, consequences of alcohol use, and engagement in the college environment. Results: In addition to replicating previous findings related to Keyes’ Mental Health Continuum, multiple regression analysis revealed several predictors of college student mental health, including supportive college environments, students’ sense of belonging, professional confidence, and civic engagement. However, multiple measures of engaged learning were not found to predict mental health. Conclusions: Results suggest that supportive college environments foster student flourishing. Implications for promoting mental health across campus are discussed. Future research should build on exploratory findings and test confirmatory models to better understand relationships between the college environment and student flourishing.     

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.     

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.     

Help Seeking and Treatment Use Among Suicidal College Students

Abstract

Objectives: Many suicidal college students do not receive mental health treatment, and the reasons for this are not fully understood. This study examines how attitudes, beliefs, and social network factors relate to help seeking among suicidal students. Participants: A random sample of 8,487 undergraduate and graduate students from 15 US universities participated. Methods: A Web-based survey administered in spring 2009 examined correlates of mental health service utilization among students reporting serious thoughts of suicide in the previous year (n = 543). Results: Correlates of treatment use included perceived need, beliefs that treatment is effective, contact with service users, lower personal stigma, higher perceived stigma, fewer positive relationships, and sexual minority or Caucasian identity. Conclusions: Help seeking among suicidal students is associated with a range of personal and social network factors. Campus strategies to enhance help seeking should be tailored to address identified facilitators and barriers to treatment use among target populations.     

Illness uncertainty and illness intrusiveness as predictors of depressive and anxious symptomology in college students with chronic illnesses

Objective: To examine predictors of psychological functioning in college students with chronic illnesses. Participants: Participants (N = 1413) included 364 students with self-reported diagnoses of asthma or allergies, 148 students with other chronic illnesses (eg, epilepsy, type 1 diabetes), and 901 healthy students. Data were collected between November 2013 and May 2015. Methods: Participants completed online measures of psychosocial functioning, including illness uncertainty, illness intrusiveness, depression, and anxiety. Results: Students with chronic illnesses other than asthma or allergies evidenced the greatest levels of anxious (p <. 05), but not depressive symptomology. Additionally, this group reported greater illness uncertainty and intrusiveness (p <. 05) compared to their peers. Uncertainty and intrusiveness independently predicted depressive and anxious symptoms for students in both illness groups. Conclusions: Compared to peers with asthma or allergies, college students with other chronic illnesses reported higher levels of anxious symptoms. Illness uncertainty and intrusiveness appear to be predictors of psychological distress, regardless of illness.     

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.     

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.     

The Community College Nurse as an Occupational Health Nurse

Abstract

Objective: This multisite study assessed college student's perceptions and practices regarding carrying concealed handguns on campus. Participants: Undergraduate students from 15 public midwestern universities were surveyed (N = 1,800). Methods: Faculty members distributed the questionnaire to students in general education classes or classes broadly representative of undergraduate students. Results: Useable questionnaires were returned by 1,649 students (92%). The majority (78%) of students was not supportive of concealed handguns on campuses, and 78% claimed that they would not obtain a permit to carry a handgun on campus, if it were legal. Those who perceived more disadvantages to carrying handguns on campus were females, who did not own firearms, did not have a firearm in the home growing up, and were not concerned with becoming a victim of crime. Conclusions: The majority of students was not supportive of concealed handguns on campus and claimed that they would not feel safer if students and faculty carried concealed handguns.     

Evaluating College Student Interest in Pet Therapy

The first year of college can be extremely stressful, especially for students residing on campus. Objective: The authors obtained information from college freshmen about their relationships with pets and investigated interest in a pet therapy program as social support for transient stressful periods. Participants: As part of a university orientation program, 246 college freshman attended 1 of 5 health issues sessions offered during the 2006-2007 academic year. Approximately 50 freshmen attended each session. Method: Participants completed a questionnaire at the beginning of the session, followed by a 20-minute presentation about pet therapy that ended with pet therapy visitation. Results: Students identified that visits with certified pet therapy dogs could be beneficial to college freshman during their first year away from home. Conclusions: These students indicated that a pet therapy program could temporarily fill the absence of previous support systems and be a catalyst for establishing new social relationships.     

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.     

Understanding Weight Management Perceptions in First-Year College Students Using the Health Belief Model

Abstract

Objective: To examine weight management barriers, using the Health Belief Model, in first-year college students. Participants: First-year college students (n = 45), with data collected in April, May, and November 2013. Methods: Nominal group technique sessions (n = 8) were conducted. Results: First-year students recognize benefits to weight management beyond physical attractiveness to quality-of-life domains, including social (eg, bonding opportunities and energy to socially engage) and mental health (eg, stress management). Men believe that weight management is important for career/financial reasons, whereas women voiced that it will allow them to live a full, independent life with a high level of multitasking. Men believed that their barriers were external (eg, campus resources/programs), whereas females perceived their barriers to be internal (eg, poor time management). Conclusions: College students are challenged by weight management and want the institution to provide resources, including curriculum, to help them manage their physical activity and nutrition behaviors.     

Peer,social media,and alcohol marketing influences on college student drinking

Objective: To investigate how alcohol marketing and peers may promote college students' alcohol use through social media. Participants: College students (N = 682) aged 18 to 22 years from a large Southern university completed paper surveys in April 2014. Methods: Structural equation modeling was used to investigate relationships among variables as well as moderation by gender and race. Results: Drinking behavior was directly related to perceived norms and attitudes toward alcohol that develop, in part, from direct and indirect interactions with their online and offline peers, as well as engagement with alcohol-related content on social media. Gender and ethnicity moderated some effects. Conclusions: College student drinking is influenced by friends' alcohol-related content posted on social networking sites and by greater engagement with traditional and online alcohol marketing. College campus alcohol misuse interventions should include components to counter peer influences and alcohol marketing on social media.     

American College Health Association-National College Health Assessment Spring 2008 Reference Group Data Report (Abridged): The American College Health Association

Objective: Assessing and understanding the health needs and capacities of college students is paramount to creating healthy campus communities. The American College Health Association-National College Health Assessment (ACHA-NCHA) is a survey that ACHA developed in 1998 to assist institutions of higher education in achieving this goal. The ACHA-NCHA contains approximately 300 questions assessing student health status and health problems, risk and protective behaviors, and impediments to academic performance. Participants: The spring 2008 reference group includes ACHA-NCHA data from 80,121 students at 106 institutions of higher education. Methods: Officials at participating institutions administered the ACHA-NCHA to all students, randomly selected students, or students in randomly selected classrooms. ACHA collected data between January and May 2008. Results: Results from the spring 2008 reference group (N = 80,121) are presented. Conclusions: These data expand the understanding of the health needs and capacities of college students.     

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.     

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.     

Who is willing to come back? College students' willingness to seek help after using campus mental health services

Objective: To examine characteristics of college students who have previously received mental health (MH) services on campus and are willing to seek help again in the future. Participants: Spring 2015 ACHA-NCHA II (N = 12,501) undergraduate respondents who had previously used MH services on their current campus. Methods: Binary logistic regression with willingness to seek MH services in the future as the dependent variable. Results: Among students who had already utilized campus MH services, significant predictors for future help-seeking were: female, white, gay/lesbian, those not working for pay, having the college/university health insurance plan, and not currently/previously serving in the military (p < .05). Conclusions: The predictors for willingness to use services in the future were consistent with the existing literature related to initial use. Colleges and universities need to consider factors that influence openness to MH services after a previous experience in addition to initiating care. Implications for college MH professionals are provided.     

The Role of a Psychiatric Pharmacist in College Health

Abstract

Published evidence indicates there is a growing prevalence of psychiatric illnesses on college campuses, and that approximately one quarter of students may be taking psychotropic medications. But attracting and retaining experienced mental health care professionals to college health settings is a challenging task. The psychiatric pharmacist is one professional resource that can serve as both a clinical and educational consultant for college mental health services. A pilot psychiatric pharmacist service project is described.     

American College Health Association-National College Health Assessment Spring 2007 Reference Group Data Report (Abridged)

Objective: Assessing and understanding the health needs and capacities of college students is paramount to creating healthy campus communities. The American College Health Association-National College Health Assessment (ACHA-NCHA) is a survey that ACHA developed in 1998 to assist institutions of higher education in achieving this goal. The ACHA-NCHA contains approximately 300 questions assessing student health status and health problems, risk and protective behaviors, and impediments to academic performance. Participants: The spring 2007 reference group includes ACHA-NCHA data from 71, 860 students at 107 institutions of higher education. Methods: Officials at participating institutions administered the ACHA-NCHA to all students, to randomly selected students, or to students in randomly selected classrooms. ACHA collected data between January and May 2007. Results: Results from the spring 2007 reference group (N= 71, 860) are presented. Conclusions: These data expand the understanding of the health needs and capacities of college students.     

Victimization and Microaggressions Targeting LGBTQ College Students: Gender Identity As a Moderator of Psychological Distress

ABSTRACT

Lesbian, gay, bisexual, transgender, and queer and questioning (LGBTQ) discrimination continues to be common on college campuses. While a number of studies have examined blatant victimization among students, little attention has been given to LGBTQ microaggressions. In this study, we examine both blatant victimization and microaggressions and their association with psychological distress among LGBTQ college students (N = 497) and look at whether gender identity moderates these relationships. Both forms of discrimination are associated with lower self-esteem and greater stress and anxiety. Victimization is more negatively associated with self-esteem among trans* students. Our findings emphasize the importance of addressing both blatant and subtle forms of discrimination targeting LGBTQ college students.