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.     

1993至2016年医学生心理健康变迁的横断历史研究

为考察我国医学生心理健康水平随年代的变迁趋势, 运用横断历史研究的方法, 对1993至2016年间181篇采用90项症状自评量表(SCL-90)测量医学生心理健康水平的研究报告(被试为129613名医学生)进行元分析。研究发现：(1)除恐怖因子外, SCL-90其余8个因子均与年代呈显著负相关, 这说明, 我国医学生的心理健康水平在逐年提升。(2)当年和5年前的2个社会指标(卫生总费用和注册医师数)与SCL-90的8个因子均值呈显著负相关, 说明这些社会指标可能是预测医学生心理健康水平的重要因素。(3)与男生相比, 女生心理健康水平的上升趋势更为明显, 但心理健康水平的性别差异并不显著。(4)医学新生心理健康水平的上升趋势要比非新生更明显和全面。     

Judgments and definitions of sexual harassment by high school students

This study considers how high school students perceive incidents of possible sexual harassment toward students and how they define sexual harassment. Thirty-five male and 38 female high school seniors (44% Asian-American; 40% white, non-Hispanic; 6% Indian-American; 4% African-American; 3% Hispanic; and 3% other ethnic groups) evaluated scenarios that varied the type of sexual harassment, the status of the initiator (either teacher or student), and the gender composition of the dyad (either male toward female or female toward male). As predicted, type of harassment influenced ratings of severity. Compared to male respondents, female respondents rated the scenarios as more severe. Teachers were judged more critically than students. Differences in status were more apparent at less severe levels of harassment. In defining harassment, students relied on four factors: the behavior itself, the target's reaction to the behavior, the perpetrator's intentions, and the relationship that existed between the two people. Overall, the findings underline the importance of examining high schools as a locale for harassment.This study was originally conducted by the first author as a Westinghouse Science project at Stuyvesant High School, with the guidance of the second and third authors.     

Medical Ethics Education: A Survey of Opinion of Medical Students in a Nigerian University

In Nigeria, medical education remains focused on the traditional clinical and basic medical science components, leaving students to develop moral attitudes passively through observation and intuition. In order to ascertain the adequacy of this method of moral formations, we studied the opinions of medical students in a Nigerian university towards medical ethics training. Self administered semi-structured questionnaires were completed by final year medical students of the College of Medicine, University of Ibadan, Nigeria. There were 82 (64.1%) male and 44 (34.4%) female respondents. The median age was 26 years. Most students (80.5%) responded that they did not receive enough training in medical ethics. The ethics instructions they received did not sufficiently prepare them for the ethical challenges they came across as medical students. Though inadequate, the few hours of lecture and discussion on human values and professional etiquette which they received positively influenced their moral reasoning. They identified end-of-life issues, dealing with financial issues and handling socio-cultural beliefs of patients and relations as some challenges that medical doctors are ill-prepared for by their current training. Most, 85.9% believed that formal medical ethics education would be worthwhile as it would enhance the making of complete and better doctors. They recommended incorporating bioethics as a course in the medical school curriculum. Nigerian medical students encounter ethical challenges for which they have not been adequately trained to resolve. They recommended formal medical ethics training in their curriculum and a uniform bioethics programme in the country.     

Further Validation of the Social and Emotional Health Survey for High School Students

The Social Emotional Health Survey (SEHS) was developed with the aim of assessing core cognitive dispositions associated with adolescents’ positive psychosocial development. Using a new sample, the present study sought to extend previous SEHS research by coadministering it with the Behavioral Emotional Screening System (BESS). The sample included 2,240 students in Grades 9-12 from two comprehensive high schools located in a major west coast USA city. A majority of the students were of Latino/a heritage (72 %) and had experienced disadvantaged economic circumstances (80 % at school 1 and 68 % at school 2). Confirmatory factor analyses supported the original SEHS factor structure composed of the first-order constructs of belief-in-self, belief-in-others, emotional competence, and engaged living, which parsimoniously mapped on to a second-order “covitality” factor. Complete factorial invariance was found across four groups formed by crossing gender (male, female) and age (ages 13–15, ages 16–18). Latent means analysis found several small to moderate effects size differences, primarily for the belief-in-self and belief-in-others first-order latent traits. A SEM analysis found that the SEHS measurement model, including covitality was a significant negative predictor of psychological distress as measured by the BESS and was positively associated with students’ end-of-semester grade point average. The discussion focuses on implications for conceptualizing the core psychological components of adolescents’ positive quality of life and how schools can use the SEHS as part of a whole-school procedure to screen for students’ complete mental health.     

The prevalence and correlations of medical student burnout in the pre-clinical years: a cross-sectional study

Burnout is a psychological syndrome of emotional exhaustion, depersonalization, and impaired personal accomplishment induced by repeated workplace stressors. Current research suggests that physician burnout may have its origins in medical school. The consequences of medical student burnout include both personal and professional distress, loss of empathy, and poor health. We hypothesized that burnout occurs prior to the initiation of the clinical years of medical education. This was a cross-sectional survey administered to third-year medical students at the Mount Sinai School of Medicine (MSSM) in New York, New York (a traditional-style medical school with a marked division between pre-clinical and clinical training occurring at the beginning of the third year). Survey included an instrument used to measure job burnout, a sleep deprivation screen, and questions related to demographic information, current rotation, psychiatric history, time spent working/studying, participation in extracurricular activities, social support network, autonomy and isolation. Of the 86 medical students who participated, 71% met criteria for burnout. Burnt out students were significantly more likely to suffer from sleep deprivation (p?=?0.0359). They were also more likely to disagree with the following statements: "I have control over my daily schedule" (p?=?0.0286) and "I am confident that I will have the knowledge and skills necessary to become an intern when I graduate" (p?=?0.0263). Our findings show that burnout is present at the beginning of the third year of medical school, prior to the initiation of the clinical years of medical training. Medical student burnout is quite common, and early efforts should be made to empower medical students to both build the knowledge and skills necessary to become capable physicians, as well as withstand the emotional, mental, and physical challenges inherent to medical school.     

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.     

Religious Affiliation Influences on the Health Status and Behaviours of Students Attending Seventh-Day Adventist Schools in Australia

Students attending Seventh-day Adventist (Adventist) schools in Australia have been shown to have better health status and behaviours compared to secular norms, yet these schools cater for a high percentage of non-Adventist students. The purpose of this study was to investigate the influence of religious affiliation (Adventist/non-Adventist) on the health status and behaviours of students attending Adventist secondary schools in Australia. The sample included 1734 students who responded to a health and lifestyle survey that captured demographic details, self-reported height and weight, self-reported health status, mental health and select health behaviours. Students who identified themselves as Adventist reported significantly better health behaviours than the non-Adventist students in several behavioural domains, especially among the male students. However, this did not translate to a difference in health status. Further research is needed to understand the causal mechanisms responsible for the potential health advantage of Adventist students, which may include family or church religious influences.     

大学生心理健康变迁的横断历史研究

自恢复高考至今, 中国的高等教育取得了巨大进步, 这一历史时期大学生整体的心理健康水平如何变化呢？本研究对1986至2010年间237项采用90项症状自评量表(SCL-90)的研究报告进行了横断历史的元分析, 以考察这些研究(被试为30多万名大学生)所测心理问题的9个因子得分随年代的变化趋势。结果表明：(1)SCL-90各因子均值与年代之间均呈负相关, 年代可以解释9个因子4%至36%的变异; 25年来9个因子均值分别下降了1%至13%, 其中偏执、人际关系、抑郁、敌对因子变化较明显。这说明25年来大学生的心理问题逐渐减少, 即大学生心理健康的整体水平逐步提高。(2)25年来大学生心理健康水平的提高, 主要体现在大学一年级以上的学生上, 而且重点大学学生(较之非重点大学)、城市生源学生(较之农村)、男生(较之女生)的心理健康改善更快。     

Developing the Good Physician: Spirituality affects the development of virtues and moral intuitions in medical students

The Project on the Good Physician is a national longitudinal study of moral and professional formation of American physicians over the course of medical training. The purpose of this paper is to examine the processes by which spirituality influences the development of three virtues (mindfulness, empathic compassion, and generosity) in medical students as mediated by the moral intuition to care/harm, as well as make predictions as to how this type of study could be generalizable to other populations. Study participants were 563 medical students recruited by the University of Chicago from 24 medical schools across the U.S. (54.7% male, 57% white) who completed measures assessing virtue formation 9 months apart. Path analysis of a cascade model showed that spirituality (but not religiousness) was directly and indirectly related to change in the virtue empathic compassion, and also indirectly related to change in the virtue generosity. Moreover, the moral intuition to care/harm partially mediated the association between spirituality and the virtues of empathic compassion and generosity (but not mindfulness).     

Private psychotherapy training in Italy: A systematic analysis

This paper examines the results of a systematic analysis, organised by the Italian Ministry of Education, University and Research, of private psychotherapy training in Italy. Since 1989, training in psychotherapy in Italy has been governed by a national law which recognises both public and private institutions. While the public system usually comprises approximately 150 students, the private system has grown significantly over time, registering thousands of students in hundreds of schools (for example, 19,123 students in 212 schools in 2011). Systematic analysis variables included geographical distribution, theoretical approaches, training methods, student and teacher characteristics, student’s personal psychotherapy, supervision and apprenticeships. Data were obtained from 92% of the schools. The primary issues discussed in this paper are as follows: the uneven geographical distribution of the schools; the disorderly amalgamation of traditional scientific paradigms; programmes which concentrate on theory and fail to meet international guidelines. One key issue is the excess supply with regard to demand, meaning that recently graduated psychotherapists (especially women) risk underemployment and financial hardship. Student enrolment is also increasingly problematic. This is the first paper to present an in-depth analysis of one European country’s situation in this field. The authors believe it will foster comparison and discussion internationally.     

大中学生英语阅读的元认知策略发展及其民族差异比较

采用英语阅读的元认知意识问卷对云南省大学生,昆明汉族、丽江地区的纳西族和彝族中学生进行测查。结果表明：(1)大中学生英语阅读的元认知策略水平随着年级的升高呈现出提高的趋势,从中学到大学是元认知策略水平快速发展的时期;(2)男女大中学生英语阅读的元认知策略水平整体上具有一致性,但在中学阶段却呈现出女生略优于男生的趋势,到了大学,男女两性发展基本平衡;(3)汉族与纳西族中学生英语阅读的元认知策略水平整体上具有一致性,彝族中学生英语阅读的元认知策略水平呈现出优于汉族和纳西族的趋势。     

课间缓解学习疲劳的一项探索性研究

学习疲劳是影响学生心理健康和学习效率的重要因素。学生课间心理保健操是根据我国大、中、小学生的生理、心理特点,参考Jacobson的渐进放松技术编制而成的,一般在学生学习最疲劳的课间组织实施。经过8所大、中、小学921名被试的实验研究,结果显示:学生课间心理保健操对大、中、小学生都有作用,能够有效地缓解学生的学习疲劳,恢复认知水平,特别是注意水平;对男生和女生普遍适用。适合大面积推广。     

Experience of a Lifetime: Study Abroad,Trauma, and Institutional Betrayal

This study is the first to expand the investigation of study-abroad risks to include a range of traumatic experiences for male and female students and to examine effects of institutional betrayal (i.e., an institution’s failure to prevent trauma or support survivors). In an online survey of 173 university students who had studied abroad, many respondents (45.44%, n = 79) reported exposure to at least 1 traumatic experience while abroad, most frequently natural disasters, sexual assault, and unwanted sexual experiences. Of students exposed to potentially traumatic events, more than one third (35.44%, n = 28) also reported at least 1 form of related institutional betrayal, which uniquely correlated with posttraumatic distress in some participants, when controlling for lifetime trauma history.     

Health-related Quality of Life, Marital Satisfaction, and Social Support in Medical Staff in Iran

Quality of life is a subjective and multidimensional concept that includes all aspects of an individual’s life. Many investigations indicate that marital satisfaction is an important determinant of quality of life and social support affects both marital satisfaction and quality of life. Since medical staff face job stressors in their everyday life, in the present cross-sectional study, the relationships between quality of life, marital satisfaction, and social support in medical staff in Tehran were analyzed. Data collection was performed in 653 medical staff using socio-demographic questions, the SF-36 questionnaire, the ENRICH Marital Satisfaction Inventory, and the Social Support Questionnaire. The results revealed that men reported significantly higher quality of life and marital satisfaction than women, but there was no gender difference in social support. The quality of life and marital satisfaction domains were found to be differentially correlated among male and female participants. All domains of marital satisfaction were found to be significantly associated with the “vitality” and “mental health” domains among females and “physical functioning” domain in the male. Also, social support was associated with almost all quality of life domains in both sexes. The multiple regression analyses indicated that all the study variables combined with socio-demographic factors can explain between 12 % and 28 % of the variance in quality of life domains. Therefore, focusing on these factors could be an effective approach to improve quality of life in medical staff as a group with a stressful job.     

Expanding Mental Health Services to Older High-Utilizing HMO Patients: A Pilot Study

Background: Expanded mental health benefits were offered to older HMO patients who were high medical utilizers. Outcomes of interest were use of services, subjective well-being, and psychopathology. Methods: Sixty-nine (25 male, 44 female) patients age 55 or above seeking frequent outpatient medical care completed the SF-36 health survey and the revised Symptom Check List (SCL-90-R). Patients were assigned to usual care, health education, or expanded mental health benefit conditions. Results: Patients showed high initial levels of psychopathology and distress. Over the 6 months of the study, patients in the expanded benefits group made a mean of 11.5 visits to mental health professionals versus a mean of 3.4 visits by usual care patients. Patients in the expanded benefits group showed significant improvement in SF-36 General Health and Mental Health well-being scores. Patients in the health education group showed no improvement. Patients in the usual care group showed improvements in Vitality scores. Psychopathology summary scores showed improvement for both usual care and enhanced benefit groups. Conclusions: Mental health treatment may improve well-being and reduce psychopathology in older high-utilizing patients. Creativity will be needed in expanding access to mental health services for this population.     

Primary care providers' views regarding assessing and treating suicidal patients

Primary care providers (PCPs) usually do not explore patient suicidality during routine visits. Factors that predict PCP attitudes toward the assessment and treatment of suicidality were examined via an online survey of 195 practicing PCPs affiliated with medical schools in the United States. PCPs who perceived themselves as competent to work with suicidal patients were more willing to assess and more willing to treat suicidal patients, with the perception of competency fully explaining the relationship between training and willingness to treat. Female gender predicted lower self-perceived competency, while in-office access to professional mental health (MH) consultation predicted greater self-perceived competency. Higher self-perceived general competence predicted lower subjective valuation of access to MH consultation. Multiple linear regression analysis indicated a three-way interaction between training, gender, and valuation of MH consultation as predictors of perceived competency, with training generally being associated with greater perceived competency to treat suicidality. Relative to their male counterparts, female PCPs have lower confidence in assessing and treating suicidality. Perceived competence in risk assessment should be given more attention in medical training because of its role in PCPs' willingness to treat suicidality.     

Social Support,Economic Hardship and Psychological Distress in Spanish and Portuguese At-Risk Families

Individuals with low socioeconomic status generally have worse mental health outcomes than their wealthier counterparts; a tendency that is exacerbated during financial crises. However, social support might buffer the effects of stress on mental health. In this study, we tested whether social support mitigated the effects of economic hardship on psychological distress on an at-risk sample from two of the European countries most affected by the 2008 economic downturn: Spain and Portugal. Participants were 249 caregivers enrolled in Child Welfare Services (73.0% women). Results showed that economic hardship and a negative indicator of social support (network dysfunctionality) were significant predictors of belonging to the psychological distress clinical group (OR: 2.35 and 1.80, respectively). However, no significant interaction effects were observed, thereby refuting the buffering effect hypothesis. When we conducted an in depth analysis of the clinical group, a significant moderation effect emerged. Our results suggest that, for at-risk populations, the detrimental effects of dysfunctional networks on mental health can outweigh the benefits of positive assistance and that social support is a potential stress buffer only for individuals in the clinical spectrum. These findings indicate that the protective effect of social support during circumstances of intense economic adversity is limited.