Increasing utilization of student mental health services on a college campus: Eight actionable tips.

Undergraduate and graduate students have a higher risk of mental illness than the general population. Multiple barriers may contribute to decreased help-seeking, including mental health stigma, lack of awareness of available resources, lack of prioritization of self-care, busy class schedules, and different preferences in communication styles. Over the past six years, we have increased the utilization of our Student and Resident Mental Health Clinic on the University of Colorado Anschutz Medial Campus by more than 100%. This viewpoint article highlights eight initiatives that address some of the barriers that mental health clinics on undergraduate and graduate campuses may face. These initiatives include involving students to reduce stigma and increase engagement, matching capacity of clinic services to demand, using technology, being as visible as possible, modeling vulnerability and self-care, adapting services to your audience needs, providing food (other than pizza!), and building a team and promoting collegiality.

A deeper understanding of depression and suicidality among medical students.

Prevalence rates for depression among medical students are three times higher than the prevalence rates of depression in the general population. In order to understand these high prevalence rates, the authors discuss the underlying psychodynamics of a subset of medical students who seek therapy for depression and suicidality during their medical school years. Does medical school screen for people who are more prone to depression or does medical school cause high depression rates? The authors describe students with the combination of harsh/critical aspects from their early family life coupled with emotional misattunement of caregivers. The authors then discuss how the medical school environment may lead to reeexperiencing of these dynamics, triggering depression and suicidal ideation. The article provides recommendations for identifying these students and referring them to mental health services.

Common factors affecting psychotherapy outcomes: some implications for teaching psychotherapy.

The number of psychotherapies classified as "empirically supported treatments" has increased significantly. As the number and scope of empirically supported treatments multiply, it has become impossible to train therapists in all of these specific modalities. Although the current Accreditation Council for Graduate Medical Education requirements for psychiatric residents follow an approach based on specific schools of psychotherapy (emphasizing competency in cognitive-behavioral therapy, psychodynamic therapy, and supportive treatments), evidence suggests that we are failing even in these efforts. In developing a specialized Psychotherapy Scholars Track in the residency program at the University of Colorado School of Medicine, we opted to focus initially on teaching the common factors in psychotherapy that positively affect psychotherapy outcomes. This article reviews 6 such broad common factors.

Investigating the genetic and environmental structure of Cloninger's personality dimensions in adolescence.

In this study we examined the genetic and environmental structure of four dimensions from Cloninger's personality system: novelty-seeking (NS), harm-avoidance (HA), reward-dependence (RD), and persistence (PS). Although adult twin studies suggest that these personality dimensions are moderately heritable, this is the first twin study of Cloninger's personality dimensions in adolescence--a period marked by significant physiological and social changes. Study participants included 1851 adolescent twins between the ages of 11 and 18 years; 878 complete twin pairs and 95 singleton-responding twins. Subjects were participants in two community-based samples of twins residing in the state of Colorado. Results indicated that cross-sectional mean levels for NS, HA and RD tended to show modest increases across the adolescent years, while PS showed modest mean decreases. Consistent sex differences in means were found only for RD. Univariate biometrical twin models were used to decompose trait variance into genetic and environmental sources. Results indicated that for NS, HA and RD additive genetic influences and unique environmental effects were sufficient to explain the data. PS, however, could be explained by unique and common environmental effects only, with different patterns of common environmental effects for males and females. We found moderate heritability estimates for NS, HA and RD ranging from .28 to .36--with no evidence for sex-limitation in those influences.

Investigating age differences in the genetic and environmental structure of the tridimensional personality questionnaire in later adulthood.

In this study we examined cross-sectional age differences in means, phenotypic covariance structure, and the underlying genetic and environmental structure of four personality constructs from Cloninger's personality system: Novelty Seeking (NS), Harm Avoidance (HA), Reward Dependence (RD), and Persistence (PS). Study participants were same-sex female twins between the ages of 50 and 96, drawn from the American Association of Retired Persons (AARP) twin sample. We examined age differences by comparing younger (age 50-65) and older (age 661) cohorts (based on a median split of the sample) and by estimating biometrical model parameters as linear and quadratic functions of continuous age. Results indicated modest, but significant, mean-level declines across this age range for NS, RD, and PS. HA showed no significant mean differences. We found moderate heritability estimates for all of the TPQ higher-order personality dimensions, ranging from 0.16 to 0.62. No significant age differences in the proportion of genetic and environmental influences on the TPQ dimensions were found. For HA, RD, and PS there were no significant age-related differences in total variance. However, for NS we observed a decline in total phenotypic variance across age cohorts.