Examining enduring effects of COVID-19 on college students' internalizing and externalizing problems: A four-year longitudinal analysis.

BACKGROUND: College students' mental health has been a vital concern for researchers, policymakers, administrators, and educators since before the pandemic, and it is crucial to identify the extent to which the pandemic affected college students' mental health. METHODS: The current study utilized data repeatedly collected over more than four years (2017-2022) from N = 355 students enrolled at a large public research university in the Midwestern US. The data collection period coincided with the COVID-19 pandemic's onset, facilitating systematic examination of whether and how college students' trajectories (i.e., level and slopes) of depressive symptoms, social anxiety, general disinhibition, callous aggression, and problematic alcohol use changed as the pandemic progressed. Across seven waves, surveys assessed multiple outcome and predictor domains. Multilevel growth curve modeling was used to analyze all outcomes. RESULTS: Depression symptoms peaked mid-pandemic, whereas social anxiety first declined then continued rising. General disinhibition and callous aggression showed non-significant changes in trajectories. Problematic alcohol use decreased continuously with no significant pandemic-associated effects in the best-fitting model. LIMITATIONS: An important limitation is reliance on a sample from a single campus utilizing self-reported, non-clinical assessments. Another important limitation is the lack of location information from participants during the acute COVID-19 phase. CONCLUSIONS: Reported longitudinal analyses expand upon findings from previous limited repeated-measures and cross-sectional studies. In terms of clinical significance, some of the most harmful COVID-19 effects to mental health may be long-lasting and cumulative, making them difficult to detect in shorter-term or cross-sectional studies. Altogether, findings demonstrate complex changes in students' mental health that may have ongoing effects on well-being during key developmental stages.

College students' sense of belonging in times of disruption: Prospective changes from before to during the COVID-19 pandemic.

The current study examined whether college students' sense of belonging changed following the onset of the COVID-19 pandemic. Participants were 252 (66.7% female) first- and second-year college students at a large public university in the United States. It was hypothesized that students would report a decrease in their sense of belonging from before to during the pandemic. It was also hypothesized that female students and racial-ethnic minority students, respectively, would report steeper declines in their sense of belonging compared to their male peers and to their White, non-Hispanic peers. Repeated-measures data were analyzed using a multilevel modeling framework to test for mean differences in students' levels of belonging from pre-COVID to during-COVID periods. No direct change in students' sense of belonging was detected. Moderation results indicated that sense of belonging decreased significantly over time for racial-ethnic minority students but not for White, non-Hispanic students. The findings encourage higher education researchers and practitioners to consider the unique experiences of racial-ethnic minority college students during the COVID-19 pandemic and beyond.

Comparing Reported Prescription Drug Misuse between Ecological Momentary Assessment versus Timeline Follow-Back among College Students.

Background: Accurate assessment of prescription drug misuse (PDM) is critical among young-adult college students, a particularly high-risk group for this substance behavior. No studies have compared assessments of college students' reports of PDM obtained from their reporting in daily life (via ecological momentary assessment; EMA) to their retrospective accounts of PDM over the same period (via timeline follow-back interview; TLFB), an approach that is commonly used in substance use research. Purpose/Objectives: To determine day-level agreement and person-level agreement in college student reports of PDM in EMA versus TLFB methods. Methods: Participants were 297 college freshmen and sophomores (69% female) recruited based on misuse behavior in the past three months. PDM behaviors were captured in daily life using EMA for 28 days and TLFB administered during an in-person lab visit. Agreement was assessed at the person level (any PDM during the 28 days) and day level (PDM on a given day) using Cohen's kappa and percent agreement. Results: PDM was reported more frequently using TLFB compared to EMA. Person-level agreement between the two methods was good (k = 0.62, 95% CI: 0.53, 0.70), whereas day-level agreement was fair (k = 0.23, 95% CI: 0.19, 0.28). Agreement in stimulant misuse reported across methods was more consistent compared to reports of other medication classes. Conclusions: Findings offer implications for the assessment of college student PDM data in substance use research.

Academic factors associated with college students' prescription stimulant misuse in daily life: An ecological analysis of multiple levels.

ObjectiveTo identify academic factors pertaining to college students, calendar timing, and particular moments that are uniquely associated with elevated likelihood of prescription stimulant misuse (intentions and actual behavior) in daily life. Participants: Participants were 297 freshmen and sophomores at a large public university in the United States in 2017-2019. Methods: Participants completed survey measures during lab visits and ecological momentary assessment procedures in daily life. Hypotheses were tested using multilevel models that accounted for the nested data and demographic covariates. Results: Student, calendar-based, and momentary academic factors were uniquely associated with stimulant misuse intentions in daily life. Real-time academic events, beyond the proportion of academic events experienced, emerged as a robust predictor of misuse behavior. Within-person links between real-time momentary predictors and misuse behavior were moderated by finals week timing. Conclusions: Findings offer implications for prevention and intervention strategies for college students at risk for prescription drug misuse.

Real-time momentary mood as a predictor of college students' prescription drug misuse in daily life: Direct links and the moderating role of background mental health.

The present study addressed calls for research to identify real-time predictors of prescription drug misuse (Schepis et al., 2020) by testing young adults' momentary reports of their negative mood and positive mood as predictors of event-level misuse in daily life. We implemented a 28-day ecological momentary assessment (EMA) procedure that collected individuals' mood and other contextual experiences in moments preceding prescription drug misuse. Consistent with models of problematic substance use as a means to reduce negativity (Khantzian, 1997), results from hierarchical generalized linear modeling (HGLM) indicated within-person links between higher than usual negative mood and greater likelihood of prescription misuse in daily life. Contrary to the hypothesis, misuse was also more likely when preceded by elevated positive mood. We found consistent support for the hypothesized between-person effects, with prescription misuse in daily life associated with higher average levels of negative mood, and lower average levels of positive mood, across the reporting period. We further predicted that individuals reporting greater levels of social anxiety, depression, and externalizing symptoms would evidence stronger links between their momentary negative mood and prescription misuse. Partial support for this moderation hypothesis was found, with the positive within-person link between negative mood and prescription misuse significantly stronger among individuals higher (vs. lower) on social anxiety and depression. Results provide support for intricate connections between young adults' momentary mood, mental health symptoms, and prescription drug misuse. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Development and Acceptability of a Method to Investigate Prescription Drug Misuse in Daily Life: Ecological Momentary Assessment Study.

BACKGROUND: Prescription drug misuse and abuse is an established public health challenge, and young adults are particularly affected. There is a striking lack of real-time, naturalistic data collection assessing intentions to misuse and other precipitating factors at the time of actual misuse, leaving the conditions under which individuals are most likely to misuse prescription medications unknown. Ecological momentary assessment (EMA) apps and protocols designed to capture this information would accelerate and expand the knowledge base and could directly contribute to prevention and treatment efforts. OBJECTIVE: The objectives of this study are to describe the development and administration of a mobile app and the EMA protocol designed to collect real-time factors associated with college students' prescription drug misuse intentions and behaviors in daily life; present completion rates, compliance, acceptability, and reactivity associated with the EMA protocol for participants who endorsed recent prescription drug misuse at screening (ie, risk group; n=300) and those who did not (ie, nonrisk group; n=55); and establish initial construct validity by linking the reports of misuse behaviors in daily life collected via the EMA app to prescription drug misuse reported on a standard survey. METHODS: An EMA data collection app and protocol were designed specifically to capture hypothesized contextual factors along with prescription drug misuse intentions and behaviors in daily life. Using this protocol, young adult college students (N=352) completed signal- and event-contingent reports over a 28-day period. When the intention to misuse a prescription drug was endorsed, a brief follow-up prompt was sent 15 min later to collect participants' indications of whether or not misuse had occurred. RESULTS: Risk-group participants were significantly more likely than nonrisk counterparts to endorse any prescription drug misuse intentions in daily life (P<.001), to complete one or more follow-up reports (P<.001), and to endorse any prescription drug misuse behavior in daily life on the follow-ups (P<.001). Overall, participants demonstrated consistent engagement with the EMA procedures and returned an average of 74.5 (SD 23.82; range 10-122) reports. Participants in the risk and nonrisk groups did not differ in the number of reports they completed (P=.12), the number of their reporting days (P=.32), or their average completion rates (P=.14). The results indicated some evidence of reactivity to the momentary reporting procedure. Participants reported uniformly positive experiences and remained highly engaged throughout the reporting protocol and broader study. CONCLUSIONS: The novel EMA app and protocol provide an effective way to assess real-time factors associated with prescription drug misuse intentions and behaviors in daily life. The resulting investigations offer the potential to provide highly translatable information for research and prevention efforts.

How High Schools Become Empowering Communities: A Mixed-Method Explanatory Inquiry into Youth-Adult Partnership and School Engagement.

Educational reform efforts emphasize empowerment and engagement, but these concepts are rarely translated into policy or classroom practice. This inquiry explores how schools can become places where students take ownership over their own learning. Phase 1 of this inquiry, a survey of students from diverse high schools, examines pathways to school engagement. Results indicated that youth voice in decision-making, particularly when the experience is situated within supportive adult relationships and a sense of safety, significantly predicts emotional and cognitive engagement. Phase 2, a case study of an exemplary high school, sought to explain these pathways. Grounded in the theoretical perspectives of "empowered community settings" and "youth-adult partnership," analyses highlighted the importance of a shared belief system and core instructional activities that were student-centered, affirmative, and strength-based. Within this context, the opportunity role structure allowed students to exercise voice in creating their own educational program. The relational environment offered partnership and safety for academic risk-taking. Teachers broke down traditional roles and power hierarchies in ways that helped students discover their own sources of engagement. The article identifies ways that community psychologists, as policy framers and as researchers, can help schools become places of empowerment and engagement.

Empowerment and Social Support: Implications for Practice and Programming Among Minority Women with Substance Abuse and Criminal Justice Histories.

Programs for women with substance abuse and criminal justice histories often incorporate empowerment and social support into service delivery systems. Women's empowerment research has focused on the relationship between women's personal identities and the larger sociopolitical context, with an emphasis on how community-based resources are critical for promoting well-being. Social support often protects against negative outcomes for individuals who live with chronic stress. However, few studies have evaluated community resource knowledge and empowerment among marginalized women or how social support might strengthen or weaken this relationship. This study investigated resource knowledge, social support, and empowerment among 200 minority women in substance abuse recovery who had recent criminal justice involvement. Results indicated that resource knowledge was related to empowerment and belonging social support marginally moderated this relationship. In addition, education level increased and current involvement in the criminal justice system decreased empowerment. Implications for research, practice, and policy are discussed.