Social Media Discussions Predict Mental Health Consultations on College Campuses.

The mental health of college students is a growing concern, and gauging the mental health needs of college students is difficult to assess in real-time and in scale. To address this gap, researchers and practitioners have encouraged the use of passive technologies. Social media is one such "passive sensor" that has shown potential as a viable "passive sensor" of mental health. However, the construct validity and in-practice reliability of computational assessments of mental health constructs with social media data remain largely unexplored. Towards this goal, we study how assessing the mental health of college students using social media data correspond with ground-truth data of on-campus mental health consultations. For a large U.S. public university, we obtained ground-truth data of on-campus mental health consultations between 2011-2016, and collected 66,000 posts from the university's Reddit community. We adopted machine learning and natural language methodologies to measure symptomatic mental health expressions of depression, anxiety, stress, suicidal ideation, and psychosis on the social media data. Seasonal auto-regressive integrated moving average (SARIMA) models of forecasting on-campus mental health consultations showed that incorporating social media data led to predictions with r = 0.86 and SMAPE = 13.30, outperforming models without social media data by 41%. Our language analyses revealed that social media discussions during high mental health consultations months consisted of discussions on academics and career, whereas months of low mental health consultations saliently show expressions of positive affect, collective identity, and socialization. This study reveals that social media data can improve our understanding of college students' mental health, particularly their mental health treatment needs.

Dynamic changes in generalized anxiety and depression during counseling.

Comorbidity of generalized anxiety and depression is common in clinical populations. Understanding how change in generalized anxiety and depression are related during counseling may help improve treatment. College student data (N = 51,922) from university and college counseling centers across the United States were used to examine relationships between change in generalized anxiety and depression across 12 counseling sessions using bivariate dual change score models. Results suggested greater improvement in depression was related to greater improvement in generalized anxiety across sessions, but greater improvement in generalized anxiety was related to less improvement in depression across sessions. This same pattern of results generalized to individuals who attended counseling with concerns in anxiety only, depression only, and both anxiety and depression. Although there were general improvements in generalized anxiety and depression across counseling sessions, greater improvement in depression at earlier sessions appeared to be a leading indicator of greater improvement in generalized anxiety at later sessions. Implications and future directions are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Incidence of seizure exacerbation and injury related to football participation in people with epilepsy.

INTRODUCTION: There is scant evidence to quantify the risk of contact sports such as football to patients with epilepsy. This retrospective review was performed to evaluate the incidence of injuries or seizure exacerbation related to football participation in patients with epilepsy. METHODS: Between the years 1994 and 2004, 157,709 consecutive clinic notes were searched for mention of "football" and "epilepsy" or "seizure". Resulting notes were reviewed to quantify the number of seizure exacerbations and the number of injuries in this cohort. RESULTS: Seven of 44 subjects with epilepsy (15.9%) experienced injury while playing football. Four of 32 (12.5%) patients experienced seizure exacerbation during a time when they were concurrently participating in football though 3 of these patients stopped taking or were weaned off of their antiepileptic drugs (AEDs). One in 32 patients with epilepsy (3.1%) had an exacerbation of seizures while playing football and consistently taking AEDs. CONCLUSION: The risk of injury and seizure exacerbation due to participation in football for patients with epilepsy is low. Clinicians should use their best judgment in deciding whether contact sports increase risks for a particular patient based on individual seizure frequency, concurrent neurological and medical issues, and medication adverse effects.

Suicide among college students in psychotherapy: Individual predictors and latent classes.

This study sought to identify predictors of suicidal behavior among college students who are psychotherapy clients, as well as to determine underlying classes of clients with suicidal ideation. Data were gathered from 101,570 clients, 391 of whom engaged in suicide behavior during treatment. Regression analyses revealed that suicide behavior was positively associated with 3 pretreatment variables: depression, prior suicide behavior, and prior nonsuicidal self-injury. Four latent classes of clients with suicidal ideation were identified that were named "prior ideation," "extensive risk," "prior treatment," and "circumscribed depression." The number of clients in each class varied widely, as did the relative risk of suicide behavior. Implications for treatment, suicide assessment, and suicide prevention are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The effect of implementing the partners for change outcome management system in a nationwide student counseling service.

The aims of the present study were to investigate the effect of implementing the Partners for Change Outcome Management System (PCOMS) in the Danish Student Counseling Service and to explore both between-condition moderators and within-condition predictors of outcomes. The study was a nonrandomized controlled study, comparing the outcome of individual and group student counseling for 634 PCOMS clients to that of 740 clients having started treatment as usual (TAU) 2 years before the PCOMS data collection began. The primary outcome measure was the Global Severity Index on the Symptom Checklist 90-Revised. Main analyses were conducted with multilevel models on the intention-to-treat sample. The results demonstrated no effect of the PCOMS compared with the TAU condition, neither for the primary outcome nor for the number of dropouts or clients experiencing deterioration. The PCOMS effect was not predicted by the counselors' adherence to the PCOMS protocol. Because the counselor level explained less than 1% of the variance in outcome, the counselor factors (i.e., attitude to feedback, reactions to negative feedback, and deliberate practice) were not analyzed as predictors. In conclusion, this study does not align with previous studies finding a positive effect of the PCOMS in counseling settings. However, all previous studies relied on the PCOMS Outcome Rating Scale as the only measure of outcome, maybe indicating a measure-specific effect. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

College students' barriers to seeking mental health counseling: Scale development and psychometric evaluation.

This article reports the development and psychometric properties of the 27-item Barriers to Seeking Mental Health Counseling (BMHC) scale, which assesses perceived help-seeking barriers among college-aged students. Across 2 studies involving ethnically diverse samples (e.g., Latinx majority students), the authors provided evidence for this new measure's validity and reliability. Exploratory and confirmatory factor analyses (including a bifactor analysis) provided support for the BMHC scale's multidimensionality reflecting 6 barriers: Negative Perceived Value, Discomfort with Emotions, Ingroup Stigma, Lack of Knowledge, Lack of Access, and Cultural Barriers. Evidence for criterion-related validity was shown through significant but differential correlations with self-stigma, emotional control, and the 4 components of Ajzen's (1991) Theory of Planned Behavior model-attitude, subjective norm of social stigma, perceived behavioral control, and mental health help-seeking intention. Discriminant evidence of validity was established through nonsignificant or small correlations between BMHC subscales and 2 measures of socially desirable responding. The authors also found evidence for incremental validity and measurement invariance across race, and evidence for internal reliability and temporal stability of the BMHC subscales. Findings are discussed in light of the conceptual, methodological, and clinical contributions of the BMHC scale. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Investigating the impact of early alliance on predicting subjective change at posttreatment: An evidence-based souvenir of overlooked clinical perspectives.

[Correction Notice: An Erratum for this article was reported in Vol 66(5) of Journal of Counseling Psychology (see record 2019-58882-002). In the article, a portion, +γ40ERit, was omitted in the Model 3 formula. The corrected formula is presented in the erratum. All versions of this article have been corrected.] Despite meta-analytic evidence showing that alliance is associated with posttreatment outcomes, several open questions still remain regarding this relation. First, we investigate whether (or not) the progressive aggregation of early alliance assessments increases the alliance-outcome relation across 2 distress and 4 subjective change measures. Second, we investigate whether the alliance-outcome relations using subjective change measures are independent from intake distress and early response. Third, we explore whether the progressive aggregation of the alliance on outcomes becomes particularly apparent between or within therapists again investigating these six outcome measures. Data were drawn from N = 430 patients treated by N = 151 therapists. Patient ratings of early alliance were assessed after Session 1 to 6. For outcome, 2 commonly used distress measures at intake and at posttreatment and 4 measures of retrospectively evaluated subjective change at posttreatment are integrated into a series of multilevel models. The proportion of variance in outcome predicted by alliance scores varied considerably depending on the number of alliance assessments which were aggregated, as well as on the type of outcome assessment (distress vs. subjective change measures) explaining up to 15% of outcome variance. Improvements in the strength of prediction with aggregated alliance assessments were most pronounced for subjective change measures for between-therapist components of the alliance. Examining associations with subjective change measures provides an additional, patient-centered perspective of the relation between early alliance and treatment outcomes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Predictors of post-concussion symptom severity in a university-based concussion clinic.

OBJECTIVE: To investigate potential predictors of acute post-concussion symptom severity in a university population. METHODS: Data were obtained from the University of Florida Student Health Care Center Concussion Databank. Symptom severity, measured by the Sport Concussion Assessment Tool - third edition Symptom Evaluation (S3SE), was analyzed at 0-3 (n = 99) and 7-14 days (n = 56) post-concussion. Participants were 99 (56 females; age range: 18-30) students from the University of Florida who had been referred to the center's Concussion Clinic. Independent samples t-test and Mann-Whitney U were used to assess group differences in overall and domain-specific symptom severity, respectively. Hierarchical regressions were used to assess predictors of symptom severity at 0-3 and 7-14 days, as well as residual symptom change between time points. RESULTS: Female sex (ß = .293; p = .002) and history of ADHD (ß = .312; p = .001) predicted greater symptom severity at 0-3 days. History of motion sickness predicted lower symptom severity (ß = -.199; p = .033). ADHD (ß = .284; p = .009) and higher 0-3-day physical symptoms (ß = .552; p < .001) predicted greater symptom severity at 7-14 days. ADHD predicted residual symptom severity change between time points (ß = .433; p = .001). CONCLUSION: ADHD, female sex, and acute physical symptoms (0-3 days) represent risk factors for greater symptom severity in the first two weeks post-concussion among college students.

Cultural concealment and therapy outcomes.

Therapy is predicated on the need for clients to share intimate details about their lives, including their cultural values, attitudes, and beliefs. Previous studies have found that clients conceal certain aspects of their lives including, but not limited to their symptoms and their feelings about the therapy process. To date, there has not been an investigation focused on whether clients conceal aspects of their cultural identities, whether some therapists are more likely to have clients conceal aspects of their cultural identities, and if cultural concealment is associated with therapy outcomes. The present study attempted to do so utilizing the caseloads of 37 therapists who treated a total of 233 clients in a university counseling center setting. Client data were collected at the end of treatment utilizing the Patient's Estimate of Improvement (PEI; Hatcher & Barends, 1996), a measure that assesses client change on domains including general functioning, symptom related distress, intimate and social relationships, work or school, feelings about oneself, behavior, control of life, and tolerance for and ability to share painful feelings. Cultural concealment was assessed via 5 items regarding the amount and circumstances under which clients withheld cultural identity based information in therapy. Results indicated that within therapists' caseloads, client's ratings of cultural concealment were negatively associated with therapy outcomes. Additionally, therapists whose clients rated more cultural concealment on average had clients with worse therapy outcomes. Lastly, there was a significant contextual effect indicating that within and between therapist cultural concealment were statistically different from one another. (PsycINFO Database Record

Perspectives of University Students with Autism Spectrum Disorder.

Students with autism spectrum disorder (ASD) are at heightened risk of post-secondary educational failure and account for approximately 1% of students in post-secondary education. Findings from an on-line survey of students with ASD attending university in Australian are reported in this study. Respondents indicated high rates of academic and non-academic difficulties but low usage of supports. Ratings for supports were idiosyncratic, and some students indicated discomfort from using supports or disclosing their disability. Those students who delayed their disclosure accessed fewer supports and reported a poorer overall university experience. Recommendations were made including the need for better transition support and alternative strengths based approaches that use more flexible and individualised curriculum designs.

Autism and Accommodations in Higher Education: Insights from the Autism Community.

This article builds on the growing body of research on higher education for autistic students by soliciting input from autistic adults on their higher education experiences and suggestions on making these experiences more 'autism-friendly'. Sixty-six individuals participated in a national exploratory survey and thirty-one participated in follow-up, online focus groups. The article reviews the accommodations individuals received and the accommodations they would have liked to receive. Concrete strategies are provided for institutes of higher education to address the social and sensory needs of autistic students, areas many participants reported being neglected in their academic experience, such as mentors and a neurodiverse space. These suggestions are intended to complement traditional academic accommodations to improve the outcomes of autistic students.

The development of an in-house dispensary in a college health center.

BACKGROUND AND PURPOSE: A small college health center discovered that students perceived obtaining prescribed medication was a barrier to adherence to short-term antibiotic therapy. To address this specific barrier, an in-house dispensary was developed and modified over the past several years to meet the needs of students. Partnering with a local pharmacy has made the process of obtaining prescriptions easier for the students. DATA SOURCES: Data were extracted from the electronic health records at Student Health Services for the academic year 2014-2015. A total of 910 prescriptions were filled in-house during that time, compared to 102 prescriptions written for purchase elsewhere. CONCLUSIONS: Students are utilizing the in-house dispensary more often than taking a prescription to a pharmacy and generally regard the service as convenient. Despite challenges in changing drug prices and other factors that influence medication adherence, dispensing a small number of drugs in the clinic has been feasible and well received. IMPLICATIONS FOR NURSE PRACTITIONERS: Nurse practitioners must be aware of specific perceived barriers for their practice population and develop interventions to overcome them. The evaluation of such interventions is imperative for modifications and sustainability.

Nivel de conocimiento y utilización de métodos anticonceptivos que posee un grupo de estudiantes de primer y quinto año de medicina de la Facultad de Ciencias Médicas de la Universidad Nacional de Córdoba

Las prácticas anticonceptivas (PAC) revisten un interés fundamental dentro de la Salud Publica en general y de la Salud Sexual y Reproductiva (SSyR) en particular. Integran asimismo la estructura de los derechos sexuales y de reproducción de las personas. Básicamente, reflejan el derecho de hombres y mujeres a tener o no descendencia. Los adolescentes y adultos jóvenes constituyen una franja poblacional con actividad sexual intensa pero con dispar conocimiento de PAC y de medidas de prevención de enfermedades de trasmisión sexual (ETS). Los estudiantes de Medicina ingresan a la carrera en la Universidad Nacional de Córdoba siendo adolescentes tardíos y egresan como adultos jóvenes, en su mayoría. Es de suponer que estos jóvenes egresados, al finalizar su formación profesional de grado, han adquirido un conocimiento suficiente sobre PAC muy superior al demostrado por los estudiantes recién ingresados. Esta investigación se planteó el objetivo de identificar y analizar el nivel de conocimiento y de utilización de los métodos anticonceptivos que poseen los estudiantes de primero y quinto año de la Carrera de Medicina de la Facultad de Ciencias Médicas de la Universidad Nacional de Córdoba

SUMMARY: Contraceptive practices (CP) are truly impotent in terms of Public Health in general and Reproductive Health (RH) in particular. They are germane to sexual and reproductive rights, reflecting the right of people (men and women) to generate offspring. Both adolescents and young adults belong to a population group dwelling into full sexual activity, yet their knowledge about CP far from ideal including prevention of sexually transmitted diseases (STI). By age definition standards freshmen medical students starting their career at the Medical School of Cordoba National University are either late adolescents, and most graduate as young adults. Allegedly, these graduating students should possess a more than adequate knowledge of CP, as compared with just admitted ones. The goal of this research is to identify and analyze the degree og knowledge and usage of CP in both first (initiated) and fifth (last) year medical students at Cordoba National University School of Medicine

Reciprocal influence model of working alliance and therapeutic outcome over individual therapy course.

A reciprocal influence model of the working alliance and the therapeutic outcome was examined in a sample of clients (n = 638) seen by novice therapists. Past researchers have found a relation between the working alliance and symptom improvement and this relation has been interpreted as the alliance leading to such symptom change. The current study was an examination of whether the alliance does indeed lead to symptom change, or whether symptom change leads to subsequent alliance change, or whether each is related to the other in a reciprocal way over time. By modeling the longitudinal development of the working alliance and the symptomatic severity over the individual therapy course, we found support for the reciprocal model being superior to the unidirectional models. The ideas of relationship as strategy and relationship as outcome along with the reciprocal pattern revealed in the findings were discussed with respect to the theoretical and clinical implications. We also discussed the limitations of the study and provided suggestions for future research.

College health service capacity to support youth with chronic medical conditions.

BACKGROUND AND OBJECTIVE: Twenty percent of US youth have a chronic medical condition and many attend college. Guidelines for transition from pediatric to adult care do not address college health services, and little is known about their capacity to identify, support, and provide care for these youth. The objective of this study was to describe college health center policies, practices, and resources for youth with chronic medical conditions (YCMC). METHODS: Survey of medical directors from health centers of a representative sample of 200 4-year US colleges with ≥ 400 enrolled undergraduate students. Patterns of identification, management, and support for youth with a general chronic medical condition and with asthma, diabetes, and depression, were investigated; χ(2) and Fisher exact tests were used to ascertain differences by institutional demographics. RESULTS: Directors at 153 institutions completed the survey (76.5% response rate). Overall, 42% of schools had no system to identify YCMC. However, almost a third (31%) did identify and add to a registry of incoming YCMC on review of medical history, more likely in private (P < .001) and small (<5000 students, P = .002) colleges; 24% of health centers contacted YCMC to check-in/make initial appointments. Most institutions could manage asthma and depression (83% and 69%, respectively); 51% could manage diabetes on campus. CONCLUSIONS: Relatively few US colleges have health systems to identify and contact YCMC, although many centers have capacity to provide primary care and management of some conditions. Guidelines for transition should address policy and practices for pediatricians and colleges to enhance comanagement of affected youth.

Heavy drinking and alcohol-related injuries in college students / Consumo intensivo y lesiones relacionadas con el alcohol en estudiantes universitarios

Objective. The main objective of this study is to evaluate the effect of heavy drinking on alcohol-related injuries. Material and methods. We carried out an open cohort study among university students in Spain (n = 1,382). Heavy drinking and alcohol-related injuries were measured by administrating AUDIT questionnaires to every participant at the ages of 18, 20, 22 and 24. For data analysis we used a Multilevel Logistic Regression for repeated measures adjusting for consumption of alcohol and cannabis. Results. The response rate at the beginning of the study was 99.6% (1,369 students). The incidence rate of alcohol-related injuries was 3.2 per 100 students year. After adjusting for alcohol consumption and cannabis use, the multivariate model revealed that a high frequency of heavy drinking was a risk factor for alcohol-related injuries (Odds Ratio = 3.89 [95%CI: 2.16 - 6.99]). The proportion of alcohol-related injuries in exposed subjects attributable to heavy drinking was 59.78% [95%CI: 32.75 - 75.94] while the population attributable fraction was 45.48% [95%CI: 24.91 - 57.77]. Conclusion. We can conclude that heavy drinking leads to an increase of alcohol-related injuries. This shows a new dimension on the consequences of this public concern already related with a variety of health and social problems. Furthermore, our results allow us to suggest that about half of alcohol-related injuries could be avoided by removing this consumption pattern (AU)

Objetivo. El objetivo principal del estudio es evaluar el efecto del consumo intensivo de alcohol sobre las lesiones relacionadas con esta droga. Material y métodos. Se ha realizado un estudio de cohorte abierta entre universitarios en España (n = 1.382). El consumo intensivo y las lesiones relacionadas con el alcohol se midieron mediante la administración del cuestionario AUDIT a cada uno de los participantes a las edades de 18, 20, 22 y 24 años. Para analizar los datos se utilizó la Regresión Logística Multinivel para medidas repetidas ajustando por consumo de alcohol y de cannabis. Resultados. La tasa de respuesta al comienzo del estudio fue 99,6% (1.369 estudiantes). La tasa de incidencia de lesiones relacionadas con el alcohol fue de 3,2 por 100 estudiantes año-1. Tras ajustar por consumo de alcohol y de cannabis, el modelo multivariante revela que la alta frecuencia de consumo intensivo fue un factor de riesgo para las lesiones relacionadas con el alcohol (Odds Ratio = 3,89[95%CI:2,16 - 6,99]). La proporción de lesiones relacionadas con el alcohol en expuestos atribuible al consumo intensivo fue 59.78% [95%CI: 32.75 - 75.94] mientras que la fracción atribuible poblacional fue 45.48% [95%CI: 24.91 - 57.77]. Conclusión. Podemos concluir que el consumo intensivo conduce a un aumento de las lesiones relacionadas con el alcohol. Esto muestra una nueva dimensión de las consecuencias de esta preocupación social que ya se ha relacionado con variedad de problemas sociales y de salud. Además los resultados nos permiten sugerir que aproximadamente la mitad de las lesiones relacionadas con el alcohol podrían evitarse eliminando este patrón de consumo (AU)

A quality improvement project to increase influenza vaccination in healthcare personnel at a university health center.

PURPOSE: The purpose of this quality improvement project was to increase the healthcare personnel (HCP) influenza vaccine uptake at a university student health center. DATA SOURCES: A descriptive design was used. A preintervention survey identified facilitators and barriers to HCP's uptake of influenza vaccine. Based on the results of this survey, four interventions were implemented. The postintervention survey was administered to assess for intervention effectiveness. CONCLUSIONS: The most common facilitators for influenza vaccination uptake on the preintervention survey were as follows: (a) protect self/family, (b) free vaccine, (c) recommended by experts, and (d) convenient vaccination process. The most common barrier was concern about vaccine side effects. Postintervention, the vaccination uptake increased from 71% in 2008-2009 to 77% in 2009-2010. Free vaccine and convenient vaccination process were rated as the most effective interventions. Education and the declination form used for the project were rated less favorably. IMPLICATIONS FOR PRACTICE: Factors influencing vaccine uptake may be different across practice settings. It is important to identify facilitators and barriers that are unique to health centers to better plan and implement interventions to improve vaccination rates. Furthermore, at a time when resources are limited, it is critical to identify the most effective strategies to maximize outcomes.

Experiencias traumáticas y trastorno por estrés postraumático en universitarios españoles / Traumatic experiences and posttraumatic stress disorder in Spanish university students

El presente estudio se propuso estudiar en universitarios la ocurrencia de diferentes eventos traumáticos y el riesgo condicional y pre-valencia actual de probable trastorno por estrés postraumático (TEPT). Cuatrocientos treinta y dos universitarios contestaron un cuestionario de eventos traumáticos y una escala de TEPT. El 60.6% de la muestra había experimentado algún evento traumático. El evento más frecuente fue la muerte violenta o inesperada de alguien cercano. Los peores eventos fueron la muerte de seres queridos y el padecimiento de violencia física o sexual. El riesgo condicional de probable TEPT fue 8.6% y la prevalencia actual, 5.2%. Estos datos son, con toda probabilidad, una sobrestimación de los verdaderos valores, debido probablemente al hecho de haber utilizado cuestionarios en vez de una entrevista estructurada, pero indican que aunque la experiencia de eventos traumáticos es frecuente, la inmensa mayoría de las personas que los padecen se sobreponen a los mismos (AU)

The aim of this study was to analyze in college students the occurrence of different traumatic events, as well as the conditional risk and current prevalence of probable posttraumatic stress disorder (PTSD). Four hundred and thirty two college students completed a questionnaire concerning traumatic experiences, as well as a scale of PTSD. Of the sample, 60.6% had experienced a traumatic event. The most common was the violent or unexpected death of loved ones. The death of loved ones and suffering from physical or sexual violence were the worst events. The conditional risk of probable PTSD was 8.6% and the current prevalence, 5.2%. These data are probably an overestimate of the true values, probably due to having used questionnaires rather than a structured interview, but indicate that although the experience of traumatic events is common, the vast majority of people exposed to these events overcome them (AU)