The psychophysiology of combat-induced post-traumatic stress disorder in Vietnam veterans

The psychophysiological responses of heart rate (HR), systolic and diastolic blood pressure, skin conductance level and forehead electromyogram were compared during: rest, mental arithmetic and combat sounds of gradually increasing intensity for five groups of Ss: Vietnam veterans with post-traumatic stress disorder (PTSD); Vietnam veterans without PTSD but with comparable levels of combat experience; Vietnam veterans with other psychiatric disorders; Vietnam-era veterans; and nonveteran phobics. HR response to low-intensity combat sounds provided good discrimination between veterans with PTSD and the other groups and seems to resemble a conditioned emotional response.     

Towards an evidence‐base for student wellbeing and mental health: Definitions,developmental transitions and data sets

Against a background of huge changes in the world of university and college students since the turn of the millennium, together with a multitude of reports on student mental health/wellbeing, this article argues that the field of student mental health is hampered by the imprecise use of terms, a rush to action by universities in the absence of a robust evidence‐base, and a lack of overall coordination and collaboration in the collection and use of data. In response, we argue for clearer and more consistent use of definitions of, as well as differentiations between, student wellbeing and mental health, for a longitudinal approach to the student body that captures their developmental transitions to and through university, and a strategic and systematic approach to the use of bona fide measures in the collection of data on wellbeing and on the process of outcomes in embedded university counselling services. Such a coordinated approach will provide the necessary evidence‐base upon which to develop and deliver appropriate support and interventions to underpin and enhance the quality of students’ lives and learning while at university or college.     

Positive mental imagery and mental health amongst university students in Pakistan

Mental health problems amongst university students pose a major public health challenge, and this is particularly the case in Pakistan. Alongside broader societal and cultural pressures, cognitive factors likely also play a role in the development of and resilience to mental health problems and may provide a feasible target for interventions. The current study built on previous research in primarily European samples investigating the relationship between one cognitive factor, positive future-oriented mental imagery, and mental health, extending this to a sample of university students in Pakistan (N = 1838). In a cross-sectional design, higher vividness of positive future-oriented mental imagery was associated with lower levels of depressive symptoms and higher levels of positive mental health amongst participants completing questionnaire measures on paper (N = 1430) or online (N = 408). In the sample completing the measures on paper, these relationships remained statistically significant even when controlling for socio-demographic and mental health-related variables. The results provide a foundation for further investigating positive mental imagery as a potential mechanism of mental health and intervention target amongst university students in Pakistan.     

Prevalence of mental health problems in Australian university health services

General practice patients report greater mental health problems than the general population, and students attending one university health service have reported greater prevalence rates at the end of the academic year. This study assessed the overall prevalence rate of mental health problems in university students using a cross‐sectional survey design of 1,168 students from three large, predominantly urban, Australian university health services. Approximately half of the students attending university health services reported elevated levels of psychological distress. The majority of severely distressed students had not sought any professional assistance for mental health problems. While there is scope for general practitioners to take a lead role in the identification of mental health problems in tertiary students, adequate treatment pathways need to be available. Implications for the role of universities in prevention work are discussed.     

Psychological distress and help-seeking among Taiwanese college students: role of gender and student status

This study investigated the relationship between psychological distress and attitudes toward seeking professional help and whether the relationship was moderated by gender and student status (traditional vs. non-traditional) among Chinese college students in Taiwan. 961 first-year university students completed standardised measures of depression, anxiety, attitudes toward seeking professional psychological help, and a demographic questionnaire. Results from the multiple regression analysis found that while higher levels of depression were adversely correlated with help-seeking attitudes, gender was positively correlated with help-seeking attitudes. Chinese female students held more favourable attitudes toward seeking psychological help than their male counterparts. Additionally, gender interacted with depression and anxiety in affecting attitudes toward help-seeking. These results were discussed within the Chinese cultural context and recommendations were given for student outreach programme aimed at increasing utilisation of mental health services on campus.     

University Counselling Services in Australia and New Zealand: Activities,Changes, and Challenges

The high prevalence of stress and psychological distress in university students highlights the need for adequate support services to enable students to achieve their goals. This study aimed to describe counselling services available to university students in Australia and New Zealand and to benchmark them against international services. Participants were five Australian and three New Zealand Counselling Services. Results showed that counselling services are using a variety of formats and e‐technologies to deliver services to students, but are hampered by limited resources compared with their international counterparts. These include very high counsellor student ratios, lower average number of consultations per student, and lower mental health qualifications of counsellors. This has even greater implications in the context of higher education reform in Australia that may further widen the gap between needs of students and available counselling services. Inadequate counselling support can negatively impact on students, universities, and the community through lost potential.     

The Stride program: Feasibility and pre-to-post program change of an exercise service for university students experiencing mental distress

Rates of mental illness are disproportionately high for young adult and higher education (e.g., university student) populations. As such, universities and tertiary institutions often devote significant efforts to services and programs that support and treat mental illness and/or mental distress. However, within that portfolio of treatment approaches, structured exercise has been relatively underutilised and greater research attention is needed to develop this evidence base. The Stride program is a structured 12-week exercise service for students experiencing mental distress. We aimed to explore the feasibility of the program and assess pre- and post-program change, through assessments of student health, lifestyle, and wellbeing outcomes. Drawing from feasibility and effectiveness-implementation hybrid design literatures, we conducted a non-randomised feasibility trial of the Stride program. Participants were recruited from the Stride program (N = 114, M_age = 24.21 years). Feasibility results indicated the program was perceived as acceptable and that participants reported positive perceptions of program components, personnel, and sessions. Participants’ pre-to-post program change in depressive symptomatology, physical activity levels, mental health-related quality of life, and various behavioural outcomes were found to be desirable. Our results provide support for the feasibility of the Stride program, and more broadly for the delivery and potential effectiveness of structured exercise programs to support university students experiencing mental distress.     

Perceptions concerning college student suicide: data from four universities

The issue of suicide, including prevention, intervention, and postvention, continues to be a problem on college campuses. For this study, data concerning a variety of issues related to college student suicide were collected from 1,865 students at four different universities. Incidence, risk factors, and potential solutions are described, as well as implications for mental health professionals in university settings.     

The relation of depression and anxiety to life‐stress and achievement in students

Objectives: An apparent increase in seriously disturbed students consulting student health services in the UK has led to concern that increasing financial difficulties and other outside pressures may affect student mental health and academic performance. The current research investigated whether student anxiety and depression increases after college entry, the extent to which adverse life experiences contribute to any increases, and the impact of adversity, anxiety and depression on exam performance. Method: 351 UK‐domiciled undergraduates completed questionnaires one month before university entry and mid‐course. The Hospital Anxiety and Depression Scale (HADS: Zigmond & Snaith, 1983) was administered at both time points and a modified List of Threatening Experiences (Brugha, Bebbington, Tennant, & Hurry, 1985) was administered mid‐course. Results: By mid‐course 9% of previously symptom‐free students became depressed and 20% became anxious at a clinically significant level. Of those previously anxious or depressed 36% had recovered. After adjusting for pre‐entry symptoms, financial difficulties made a significant independent contribution to depression and relationship difficulties independently predicted anxiety. Depression and financial difficulties mid‐course predicted a decrease in exam performance from first to second year. Conclusions: This is the first study to confirm empirically that financial and other difficulties can increase British students' levels of anxiety and depression and that financial difficulties and depression can affect academic performance. However, university life may also have a beneficial effect for some students with pre‐existing conditions. With widening participation in higher education, the results have important implications for educational and health policies.     

Mental Health Risk and Social Ecological Variables Associated with Educational Attainment for Gulf War Veterans: Implications for Veterans Returning to Civilian Life

This study examines how post-secondary educational attainment among young veterans of the first gulf war affects their mental health status. The all-volunteer military attracts recruits by offering them veterans’ educational benefits. Education should help veterans adjust to civilian life. Few studies have shown whether education following military service helps improve veterans’ mental health, however. Viewing resiliency, life span and life course, and social geography theories through the lens of social ecology, it is hypothesized that selected contextual factors in the personal, interpersonal, and organizational domains could mediate or moderate the relationship between education and veterans’ mental health. Informational social networks showed an association with obtaining mental illness treatment. Recent treatment for post-traumatic stress disorder (PTSD) showed an association with use of veterans’ educational benefits. Residing with a small nuclear family in conjunction with having higher levels of health and educational benefits and a higher family income was associated with higher educational attainment.     

Emotional Abuse: Correlates to Abuse Among College Students

Emotional abuse, also known as psychological maltreatment, is a significant health problem. Long-term outcomes of emotional abuse are quite negative and include physical and mental health disorders. The present study examined emotional abuse and correlates to such abuse among college students. The American College Health Association–National College Health Assessment II was completed by study participants at one urban, Midwestern university. A total of 777 students participated in the survey. Greater than one in 10 (10.7%) students reported being emotionally abused in the past year. The final logistic regression model found being female, being an older student, recent marijuana use, and being so depressed it was difficult to function were significant predictors of emotional abuse. Study findings suggest it may be important to screen high-risk students for emotional abuse as part of mental health treatment or other medical screenings. Given that one in 10 students experienced past year emotional abuse, it may also be crucial to raise awareness of emotional abuse on college campuses.     

The impact of psychological distress and university counselling on academic outcomes: Analysis of a routine practice-based dataset

Whole university approaches to student mental health and well-being increasingly involve university counselling and mental health services (UCMHSs) as key stakeholders in higher education and the fulfilment of good academic outcomes. However, previous research using routine outcome measures has focussed on psychological distress only. Research is needed to demonstrate the value of university counselling on academic outcomes. This study aimed at profiling the psychological distress of a student sample according to the Clinical Outcomes in Routine Evaluation—Outcome Measure (CORE-OM); measuring the change in perceived impact of problems on academic outcomes, and measuring the perceived impact of counselling on academic outcomes. Students from two UK university counselling services completed the CORE-OM and the Counselling Impact on Academic Outcomes (CIAO) questionnaire as part of routine practice. After counselling, 67.4% (n = 323) of students with planned endings to counselling showed at least reliable improvement on the CORE-OM. Significant reductions in the perceived impact of problems on all academic outcomes were also found. On average, 83% (n = 398) of students found counselling helpful for academic outcomes to at least a limited extent. University counselling was found to reduce psychological distress and the impact of problems on academic outcomes. Psychometric examination of the CIAO tool is warranted to strengthen its use. The need for robust data across UCMHSs is demonstrated by both the strengths and limitations of this study.     

我国大学生心理健康教育研究的现状与展望

大学生心理健康教育研究已经成为我国心理学研究的一项重要课题。只有对大学生心理健康教育研究的现状有所了解,才能够更好地进行大学生心理健康教育。文章从理论研究和实证研究两方面阐述了当前我国大学生心理健康教育研究的现状,其中理论研究包含了大学生心理健康教育的内容、途径、模式研究;实证研究则包括了大学生心理健康状况的研究、大学生心理健康与自我概念相关的研究以及大学生心理健康教育研究方法的研究。最后展望了我国大学生心理健康教育研究的趋势。     

Psychological distress in university students: A comparison with general population data

Objective: While the mental health of university students is recognised internationally as an important public health issue, more epidemiological data are needed that allows benchmarking with general population data. Methods: All enrolled students from two large Australian universities were invited to complete a web‐based survey. Anxiety‐mood disorders were assessed using the Kessler 10. A total of 6,479 students participated in the study with sociodemographics generally consistent with the university population. Results: The estimated prevalence for mental health problems was 19.2% with 67.4% reporting subsyndromal symptoms. These rates were significantly higher than the general population. Psychological distress was associated with disability and lower academic achievement. Predictors of distress included: full‐time status, financial stress, being aged between and 18 and 34 years, being female, and in a subsequent undergraduate year of their degree. Conclusions: The extremely high prevalence of mental health problems in university students provides evidence for this being an at‐risk population. Implications: The results highlight the need for universal early interventions to prevent the development of severe mental illness in university students.     

Student mental health: how can psychiatrists better support the work of university medical centres and university counselling services?

Student psychiatric morbidity is rising. Whilst the influence of university counselling services is widely reported, NHS involvement by psychiatrists and general practitioners is not so well described. Counselling and mental health service providers for students at the University of Leeds were approached for numerical data and a university Group on Student Mental Health discussed the findings. The Student Counselling Centre, the University Medical Practice and a dedicated student psychiatric clinic have all seen a rise in referral rates. The University Medical Practice has also seen a rise in the prescribing of psychoactive medication. Collaborative links at the University of Leeds are explored and options for the future discussed. These include self-help over the internet, a research project to assess student mental health needs and the provision of a dedicated NHS psychiatric team for the university.     

Using Relational-Cultural Theory to Conceptualize International Student Transitions

ABSTRACT

In this article, Relational-Cultural Theory (RCT) is applied to international student transition experiences. The purpose of this phenomenological study was to describe the lived experiences of international students transitioning to college life in the rural United States using the principles of RCT. Five women and four men enrolled at a mid-sized university agreed to participate in the study. In the data analysis phase, four components of RCT emerged as themes. The authors provide implications for campus-based mental health professionals (e.g., college counselors).     

Psychological Functioning of Partners of Australian Combat Veterans: Contribution of Veterans' PTSD Symptoms and Partners' Caregiving Distress

Previous research has found posttraumatic stress disorder (PTSD) symptoms in combat veterans to be associated with impaired psychological functioning in their partners. However, little is known about possible mediators of this association. The present study investigated the mediational properties of six dimensions of the revised Partners of Veterans' Distress Scale (MacDonell, Marsh, Hine, & Bhullar, 2010). Participants were 181 female partners of Australian combat veterans, age ranging from 43 and 83 years (M = 60.47, SD = 4.96), who completed measures assessing their caregiving distress levels, dyadic adjustment, mental health, and satisfaction with life. The combat veterans also completed a scale measuring their PTSD symptoms. Our results indicated that higher scores of veterans' PTSD were associated with lower levels of dyadic adjustment, mental health, and satisfaction with life in their partners. Partners reported that distress related to exhaustion and intimacy problems significantly mediated the relationship between veterans' PTSD symptoms and their partners' satisfaction with life, whereas partners' distress associated with intimacy problems was the sole significant mediator for their dyadic adjustment, and exhaustion was the only significant mediator for partners' mental health. Implications for programmes designed to address the significant needs of the partners of combat veterans are discussed.     

大学生心理健康教育教学模式的构建与实践研究

采用自然教学实验法,探索提高大学生心理健康水平的有效途径与教学模式。结果表明（1）开设心理健康教育课程并辅以心理咨询是眼下提高大学生心理健康水平的有效措施之一;（2）不同系科心理健康教育的效果不同,心理健康教育课程应根据学生的个别差异有针对性地进行;（3）大学生心理健康教育课程的教学模式为“面上集中释疑,线上互相解疑,点上个别辅导”。     

A follow-up study of new users of a university counselling service

For many students the demands of a university course, often coupled with financial and relationship difficulties, create circumstances where counselling or specialist psychiatric support are needed. Few published studies exist of these services. A follow-up study of new users of the University of Cambridge Counselling Service during the course of the 1993/94 academic year is reported. The study aimed to describe morbidity levels and to identify the determinants of change in students' mental health status. Data were obtained from two initial questionnaires: one completed by each student at the time of their initial consultation; the second by the counsellor completing an assessment consultation. About one year following their first assessment, students were asked to complete a further questionnaire. The clear demonstration in this study of depression and anxiety symptoms, as dominant features for many students at their assessment consultation, suggests that training to improve counsellor recognition of such symptoms and of their knowledge of the effectiveness of available therapeutic approaches would be valuable. Such training should also provide guidance on when to refer students to other professionals.     

Improving Mental Health Treatment Utilization in Military Veterans: Examining the Effects of Perceived Need for Care and Social Support

Many veterans with mental health problems do not adequately utilize needed care. Research has focused on identifying barriers to mental health care in veterans. The current study adds to existing literature by examining whether perceived need for treatment and social support affect treatment utilization in a national longitudinal survey of Iraq and Afghanistan veterans (n = 1,090). The Health Beliefs Model (HBM) postulates that a key reason why patients fail to obtain needed care is their belief “it’s up to me to handle my own problems.” This view was endorsed by 42% in the current national sample of veterans and was found in multivariate analysis to predict less treatment seeking in the next year. Mediation analysis revealed that veterans with higher ratings of social support were less likely to believe they needed to solve mental health problems on their own, indirectly equating to higher odds of treatment use. Simultaneously, findings indicated that posttraumatic stress disorder (PTSD) had a direct effect on more mental health visits but was also associated with higher endorsement that one needed to handle one’s own problems and thus had an indirect effect of reducing mental health visits. Both social support and PTSD affected veterans’ perceptions of needing to solve one’s own problems, significantly predicted follow-up with mental health care. As a result, the findings indicate that clinicians’ should explore veterans’ belief systems about perceived treatment need as well as investigate the role of social support to improve mental health treatment utilization.