Many college students experience racism and discrimination, which negatively impacts their mental health. As COVID-19 has brought about increased reliance on virtual spaces, increased online racial discrimination (ORD) has also become a more prevalent issue. ORD may be defined as online behaviors that demean or marginalize individuals or groups based on race. It may occur on social media, through text messaging, online videos/games, and/or online chat rooms. Research has shown that direct ORD predicted mental health difficulties, but the link between vicarious ORD and mental health was less consistent. Therefore, it is imperative to investigate how direct or vicarious ORD impacts student mental health. This study aims to examine the relationships between direct and vicarious ORD and college student mental health (depression, anxiety, flourishing, and health-related quality of life) and compare the relationships between White students and students of color. Data were collected from a sample of 617 undergraduate students (Mage = 19.5 years, SD = 1.9, 71.6% female) from two large, urban universities in the Mid-Atlantic region of the USA during COVID-19 from October to December 2021. Our findings revealed that both direct and vicarious ORD predicted depression and anxiety among students of color. However, this was not the case among White students. We also found that social support was a significant buffer on the relation between vicarious ORD and anxiety and flourishing. Social support was a buffer on the relation between direct ORD and health-related quality of life for students of color, but only at low levels of direct ORD. Our findings have implications for future intervention development.

Objective: To examine international student-athletes' (ISAs) rates of depression, perceived stress, problematic drinking, and sleep disturbance. Participants: 509 ISAs (Mage = 20.39 years, women = 63.1%) from over 80 NCAA institutions. Methods: Survey data were collected in April/May 2020. Results: Overall, 27.9% and 9.2% endorsed clinical and high levels of depression and stress, respectively; 2.4% (n = 12) reported severe sleep disturbances and 12.4% (n = 63) problematic drinking. Except problematic drinking, being a woman ISA was associated with significantly higher levels of disturbance. Year in school interacted with gender for perceived stress; men ISAs in their 2nd year or higher reported the lowest levels. Conclusions: Large numbers of ISAs endorsed clinical/severe levels of psychological concerns at onset of COVID-19, likely due to the unique stressors experienced by this international college population. Athletic departments, like universities in general, must provide culturally-sensitive mental health services for their ISAs.

As mental health issues are prevalent among athletes, research is warranted to examine athletes' help-seeking for mental health concerns. This study examined the relationship between social norms and college athletes' mental health help-seeking intentions. Analysis of cross-sectional survey data from 290 college athletes in the United States and Canada revealed that after accounting for key control variables, descriptive norms from parents (i.e., perceptions that parents would seek help) were positively associated with athletes' help-seeking intentions. Descriptive norms from coaches, teammates, and friends were not associated with help-seeking intentions. Relationships between descriptive norms and help-seeking intentions were not moderated by social identity or injunctive norms. The findings suggest that descriptive norms may have a small, but meaningful relationship with intentions to seek help for mental health concerns, depending on the person from whom the social norms originate.

The COVID-19 pandemic has exacerbated mental health challenges of university students, staff, and faculty alike. We used linear mixed models to examine demographic predictors of, and change over time in, self-reported depression and anxiety symptoms of a cohort of university students and staff/faculty between surveys administered in August-November 2021 and December 2021-March 2022.

Students who identified as "other" race/ethnicity, Lesbian Gay Bisexual or Queer, and female, reported high baseline levels of both depression and anxiety. The disparity in self-reported depression among students who identify as "other" race/ethnicity compared to White students widened between surveys. Staff/faculty in younger age groups and Trans/Non-Binary staff reported high baseline levels of both depression and anxiety.

Mental health challenges have continued well into the pandemic, however there are disproportionate impacts on sexual and gender and racial/ethnic minorities. University administrations should prioritize mental health services and resources accordingly.

Objective: This study examines how mental health and health behaviors evolved among college students nationwide before and during the onset of the COVID-19 pandemic. Participants: Data collected from college students across various campuses in Fall 2019 (N = 33,372) and Fall 2020 (N = 34,168) as part of the Healthy Minds Study. Methods: The online survey was delivered via Qualtrics. Data was analyzed through an unpaired two-samples T-test and a two-proportion Z-test. Results: The results show a significant difference of depression and anxiety symptoms in college students during Fall 2020 compared to Fall 2019. Sleep patterns significantly shifted during the pandemic. Substance use, perceived need for counseling, and the amount of time students spent exercising all significantly differed during the COVID-19 pandemic. Conclusion: In the context of declines in mental health among college students, college campuses should implement mental health support models addressing students' individual health risk and lifestyle behaviors.

Black adults experience depression that is more severe than that of their White counterparts, yet they are less likely to receive treatment from a mental health professional. This study aimed to examine the relationships between medical mistrust or trust and the willingness to seek mental health care.

The authors conducted an online cross-sectional survey of 1,043 Black adults in the United States. The primary variables of interest were medical mistrust (measured via the 12-item Group-Based Medical Mistrust Scale; GBMMS) and a single item, derived from the General Help-Seeking Questionnaire, that assessed willingness to seek mental health care. The authors hypothesized that mistrust would have a negative correlation with willingness to seek help from a mental health professional. To estimate the association between level of mistrust and willingness to seek care, gamma regression models were fitted with a log link, and the analyses were adjusted for age, ethnic identity or origin, education, insurance status, personal income, citizenship status, and length of time in the United States.

At low levels of medical mistrust (GBMMS scores ≤3), an increase in mistrust was significantly associated with an increase in the probability of seeking mental health care (rate ratio [RR]=1.55, p<0.001). At high levels of medical mistrust (GBMMS scores >3), an increase in mistrust was associated with a decrease in care seeking (RR=0.74, p<0.001). Similar patterns were observed for medical trust.

At low levels of medical mistrust among Black adults, each unit increase in mistrust was counterintuitively associated with an increase in willingness to seek care from a mental health professional.

Objective: The study analyzes e-health message content shared by university health centers and determines college students' engagement with those messages. Method: Using the Reasoned Action Approach (RAA) framework, the current study content analyzed the RAA components (target behavior, attitudes/expectancies, social norms, and efficacy) within Instagram messages that were shared by official university health services accounts to promote health behaviors among college students. Results: Results showed that university health services are often using RAA-informed message strategies, with just under half of all posts containing at least one RAA component. Also, students are more likely to engage with university health services content that includes positive expectancies-specifically, improved academic performance and general efficacy. Conclusion: The present research will help university health services tailor their theory-driven messaging to improve student engagement with their e-health content.

Objective: Previous research has suggested that autistic college students experience lower degree completion, along with social and mental health challenges. Other recent work has shown similar outcomes between autistic and non-autistic students. Participants: Participants in this study were autistic college students. Methods: We implemented a mixed methods approach including thematic analysis of interviews conducted at the end of the semester, along with weekly surveys, capturing autistic students' college experiences in real time. Qualitative findings were integrated with quantitative analysis of standardized measures of campus connectedness, student satisfaction and student adjustment to college. Results: Weekly surveys were generally positive with most not reporting any challenges. End of semester interviews reflected similar results. Feelings of belonging on campus and college satisfaction were high. Conclusion: Gathering first-hand accounts on a weekly basis provided a unique account of autistic students' experiences, and while not the case for all, many were successfully navigating the demands of college life.

Past work has provided support for the relevance of personality traits and emotional dysregulation (ED), individually, for characterizing ADHD phenotypes beyond symptoms in college-aged populations. Yet, no studies have attempted to integrate these constructs into current ADHD conceptualizations within the context of one another. The current study thus sought to determine whether personality traits and ED dimensions, together, could facilitate meaningful differentiation of college students meeting symptom and impairment criteria for ADHD.

Participants included 1,858 college students aged 18 to 29 years (M = 19.4 years, 70.4% female) with either self-reported ADHD diagnoses and/or clinical levels of symptoms and impairment.

Latent profile analyses provided support for a three-profile solution comprised of a Primarily Inattentive/ED Present/Emotionally Unstable profile, a Moderate ADHD Severity/ED Absent/Normative Personality Traits profile, and a High ADHD Severity/ED Absent/Normative Personality Traits profile. Consideration of ED dimensions and personality traits, namely Emotional Stability, meaningfully enriched profiles beyond ADHD sum scores. Concurrent validation of profiles suggested significant differences with respect to impairment domains and internalizing problems.

Additional work is needed to characterize the integration of personality and ED into ADHD conceptualizations to inform more comprehensive assessment and treatment practices.

We review the published literature on common presentations, unique challenges, existing models of care, and best practices regarding college student psychiatric emergencies.

College students who are in psychiatric crisis experience a range of responses and support. The diversity of institutions of higher education (IHEs), geography, resources, and the demographics of college students themselves means that no two psychiatric emergency responses are alike. Population health approaches to these crises are generally lacking even though the literature is clear that some students have unique and elevated risk. New models of care have emerged at some IHEs but have not yet been sufficiently evaluated. There are diverse responses and models of care for college student psychiatric emergencies. Recent guidelines reflect novel approaches to care and support.

Vegan and vegetarian diets are increasingly popular, though there is concern that disordered eating can drive, emerge, or intensify from the choice to adopt dietary restrictions.

We sought to ascertain whether disordered eating or weight-control behaviors are associated with newly adopting a vegetarian/vegan diet during college and to assess symptom awareness and treatment utilization.

Data came from 11,503 students in the Healthy Minds Study spanning 2015-2021. We examined associations between (i) the SCOFF eating disorder screener and (ii) symptom-specific items from the Eating Disorder Examination Questionnaire, and recent adoption of a vegan/vegetarian diet. Participants' knowledge of eating disorder symptoms and experiences with treatment utilization were also assessed.

Five-hundred thirty-two participants (∼5 %) reported adopting a vegan/vegetarian diet. Compared to students who did not change eating patterns, those who adopted vegetarianism/veganism had higher past-month prevalence of binge eating (25 % vs, 16 %), compulsive exercise (18 % vs. 9 %), and fasting (12 % vs. 8 %). Each behavior was significantly associated with greater odds of having recently adopted a vegetarian/vegan diet. A positive SCOFF screen (2+ items) was associated with 1.79-times (95 % CI: 1.48, 2.16) greater odds of newly adopting a vegetarian/vegan diet. There were no observed differences between groups with respect to knowledge of eating disorder symptoms or treatment-seeking attitudes and behaviors.

Disordered eating or weight-control behaviors were prevalent in this population of young adults and were associated with adopting a vegetarian/vegan diet, though awareness and help-seeking were not elevated among those with higher eating disorder risk.

Over the past decade, mental health problems have disproportionately increased among U.S. ethnoracially minoritized college students, though explanations for this disparity remain understudied. In the present study, we examined the direct and indirect associations between online racial/ethnic discrimination, suicidal ideation (SI), and alcohol misuse. We also investigated whether internalized racism helps explain the association between online racial/ethnic discrimination (i.e., individual or vicarious exposures) and SI and alcohol misuse. Lastly, we examined the moderating role of ethnic identity dimensions (i.e., exploration and commitment) in this indirect association. Participants included 494 ethnoracially minoritized college students ages 18-30 years (M = 19.62, SD = 2.08; 79% female; 60% Latine; 83% U.S.-born) from the U.S. who completed an online survey. Findings revealed that online racial/ethnic discrimination (i.e., individual and vicarious exposures) was directly associated with increased SI and alcohol misuse. The indirect association of online racial/ethnic discrimination (i.e., individual and vicarious) on SI via internalized racism was statistically significant. These indirect associations, however, were not observed with alcohol misuse. Ethnic identity commitment moderated the indirect association of vicarious, though not individual, online racial/ethnic discrimination on SI via internalized racism. These findings underscore the impact of online racial/ethnic discrimination on ethnoracially minoritized college students' mental health, identify internalized racism as a potential pathway through which this type of discrimination may confer risk for SI, as well as ethnic identity commitment as a potential protective factor that may buffer these harmful effects.

Objective: The current study compares the health behaviors and outcomes of students with three types of invisible disabilities-autism, ADHD or learning disabilities, and mental health conditions-to neurotypical students. Gender differences are also examined. Participants: Undergraduate college students (n = 2,822) at ten postsecondary institutions in Indiana. Methods: Students completed an online survey in spring 2021. Differences in health behaviors and outcomes based on disability status were estimated using linear and logistic regression models. Results: College students with invisible disabilities reported worse health than neurotypical students across a range of health behaviors and outcomes, for both physical and mental health. Students with mental health conditions reported worse health most consistently. There were few gender differences. Conclusions: Health-related programming targeted to students with invisible disabilities has received little attention in research on college student health. As this population grows, we recommend that institutions develop programs to address their specific health-related challenges and needs.

Loneliness and insomnia are endemic in college students, and emotion regulation is strongly related to both. Starting with a biopsychosocial framework, the present study tested a model in which emotional repair mediated the relationship between loneliness and insomnia, with the goal of using a potential mechanism of action to address loneliness. Participants were undergraduate students (N=1,513) in the United States who completed a survey including the Trait Meta-Mood Scale, Sleep Condition Indicator, and UCLA Loneliness Scale, amongst other measures. Insomnia had a significant total negative effect on loneliness, B = -0.46, 95% CI [-0.54, -0.39]. Emotional repair partially mediated this relationship, with an indirect effect of B = 0.015, 95% CI [-0.19, -0.12]. Participants with better sleep were more able to regulate their emotions, and thus tended to experience lower levels of loneliness. Treating insomnia (e.g., CBT-I) or skills associated with emotional repair and regulation (e.g., transdiagnostic approaches to emotion regulation) could reduce overall loneliness.

Objective: The objective of the study was to improve models of mental health outcomes for Asian American and Native Hawaiian/Other Pacific Islander (NHOPI) undergraduates (n = 48,516). Participants: Participants were Asian American, NHOPI, and White undergraduate adult students in the United States. Methods: Using data from the national 2018-2019 Healthy Minds Study,1 depression, anxiety and psychological well-being were analyzed using multivariate logistic and linear regression models. Both additive and interactive model assumptions for race and gender were tested. Results: 1) Compared to White students, Asian Americans experienced depression and psychological well-being disparities and NHOPIs experienced marginal depression disparities; 2) Asian American and NHOPI students experienced different health inequities compared to Whites, and 3) modeling race and gender using interactions did not significantly improve model fit for depression, anxiety, or psychological well-being. Conclusions: Mental health disparities among Asian American and NHOPI undergraduates should be further studied to facilitate mental health promotion and prevention.

Intersectional stigma of mental illness and race/ethnicity is a persistent determinant of the growing mental health care disparities among students in the United States. It is also the foundation on which concerns of inclusion and belonging are experienced, warranting scholarship on intersectional stigma and occupational engagement.

To examine intersectional stigma and its relationship with occupational engagement among racialized higher education students.

This study used a qualitative descriptive design with interview methodology, and thematic analysis was used for data analysis. Transcript checks, peer debriefings, and multiple analysts helped strengthen the rigor of the study. Theoretical frameworks included the principle of gradient rationality to examine stigma and the moral economics of occupations framework to examine occupational engagement.

Higher education institution. Participants Thirteen racialized students with mental illness were recruited via purposive sampling.

Four themes emerged: identities and their negotiations, mental health journey, intersectional stigma of mental illness and race/ethnicity, and occupational engagement (mental health care and community participation).

Findings highlight that intersectional stigma and racial/ethnic identity construction are fluid processes instead of fixed attributes and guide occupational engagement. Future research will help occupational therapy practitioners and leaders in efforts to address the growing public mental health crisis. Plain-Language Summary: This study highlights that concerns related to belonging and inclusion among racialized students with mental illness are experienced through the intersectional stigma of mental illness and race/ethnicity. Understanding intersectional stigma also allows practitioners and scholars to better inform and implement culturally sensitive care within mental health care settings. Positionality Statement: This research was conducted by a team of interdisciplinary multiracial researchers. This research was initiated by Nikhil Tomar, an immigrant scholar of color with a professional background in occupational therapy. The team included researchers from clinical psychology, social work, and sociology. The team included a Black scholar with expertise in race/ethnic identity, a Biracial scholar with expertise in stigma and global mental health, and a White scholar with expertise in children and adolescent mental health. The interdisciplinary nature of this research allowed the authors to challenge conventional wisdom in their respective fields and conduct research in a critical manner. Tomar has expertise in interview methodology and mental health research, which helped him conduct interviews by balancing the needs for participant safety and data collection.

The ongoing global student mental health crisis indicates the urgent need for updated research specifically targeting nursing students. Considering their anticipated transition into healthcare professions, their mental well-being is critical, not only for their academic performance but also for the quality of care they will deliver in their professional roles.

To estimate the prevalence of mental health issues among nursing students by synthesizing data from systematic reviews and meta-analyses.

An umbrella review of published prevalence meta-analyses.

Publication records were retrieved from four databases-PubMed, CINAHL, PsycINFO, and Scopus-up to September 2024. The methodological quality of each meta-analysis was assessed using the A Measurement Tool for the Assessment of Multiple Systematic Reviews (AMSTAR-2). Assessment followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline checklist. A random-effects model was used for the meta-analysis, and the I2 index was employed to assess between-study heterogeneity. Additionally, the Risk of Bias in Systematic Reviews tool was used to assess review quality, including calculation of overlap between primary studies and adherence to GRADE criteria.

Twenty-five meta-analyses, comprising 375 primary studies and a total of 171,828 nursing students, were included, revealing an overall prevalence of mental health issues at 27 % (95 % CI: 25 % - 30 %). Sleep disturbances were the most prevalent at 50 % (95 % CI: 28 % - 72 %), followed by fear at 41 % (95 % CI: 7 % - 75 %), burnout at 32 % (95 % CI: 25 % - 38 %), and depression at 29 % (95 % CI: 21 % - 38 %). Nomophobia/smartphone addiction had a prevalence of 30 % (95 % CI: 12 % - 49 %), anxiety 29 % (95 % CI: 17 % - 40 %), and stress 27 % (95 % CI: 17 % - 37 %). Lower prevalence rates were observed for smoking, eating disorders, post-traumatic stress disorder, and suicidal ideation/attempts. Significant heterogeneity was noted, particularly in the meta-analyses for anxiety, nomophobia/smartphone addiction, and stress.

Our review identified eleven prevalent mental health issues among nursing students, with sleep disturbances, anxiety, depression, and burnout being the most common. Behavioral issues, such as nomophobia, are also rising concerns. These findings indicate the need for targeted interventions and further research into causal factors (e.g., geographical and cultural contexts), gender disparities (as most studies focused on female students), and resilience-building strategies.

The study protocol was uploaded to the Open Science Framework (OSF) at https://doi.org/10.17605/OSF.IO/EN7UX (registered on 28/10/23).

Among nursing students, overall mental health issues are at 27 %. Key concerns include sleep disturbances, burnout, anxiety, and depression. Nomophobia prevalence also warrants further study.

Purpose: The study's purpose was to assess: (1) Students' perceptions toward mindfulness interventions, and (2) Instructors' perceptions in implementing mindfulness interventions in their classes. Study design: Descriptive study. Methods: A total of 96 students from the second-degree option and BSN programs in the host institution participated in a mindfulness intervention prior to course activities. The four mindfulness interventions utilized in this study included: music, meditation, guided breathing, and positive affirmation. The data were analyzed using descriptive statistics on postintervention surveys. Findings: The mindfulness intervention was overwhelmingly received by the students and faculty as reflected in the result of the confidential postsurveys. The majority of the students and faculty felt that this mindfulness intervention was worth implementing in their course. Conclusion: The mindfulness intervention can promote students' feelings of "at ease" and confidence prior to a nursing course activity.

The aim of this study was to examine academic resilience and its relationship with psychological resilience, self-efficacy, and psychological well-being in Chinese undergraduate students compared with an Australian cohort of nursing students.

Evidence suggests that resilience acts as a protective factor against the adverse effects of stress, including psychological distress. Academic resilience, which specifically focuses on resilience in the face of academic adversity, remains largely unexplored in nursing students.

A correlational cross-sectional study.

Using validated self-reported questionnaires, we aimed to increase the understanding of academic resilience in undergraduate students across two diverse international locations. Data were collected in three universities, one in Hong Kong and two in Australia, between November 2021 and January 2022 and socio-demographic information via the online Qualtrics survey platform.

Across the three recruitment sites questionnaires were distributed to 956 students and 477 participated, giving a response rate of 49.9 %. Nursing students in Hong Kong showed lower academic resilience (100.8 vs 102.9; p = 0.009), lower psychological resilience (30.6 vs 36.4; p < 0.001) and lower self-efficacy (26.8 vs 30.6; p < 0.001) than their Australian counterparts. Hong Kong participants showed higher levels of psychological distress (28.6 vs 25.1; p < 0.001).

From a cross-cultural perspective, our study illustrates differences in levels of academic resilience, psychological resilience, and self-efficacy between nursing students in Hong Kong and Australia. Our findings highlight the importance of incorporating resilience-building educational interventions within undergraduate nurse education; teaching academic resilience may provide a valuable attribute to help nursing students overcome issues of academic adversity. Reporting guideline: We adhered to STROBE reporting guidelines.

Suicide is the second leading cause of death for Asian American (AA) young adults, yet few studies have focused on AA college students. This study examines the link between suicidal behaviors, psychological stressors, and substance use among AA men, women, and transgender and gender nonconforming (TGNC) college students. Data from the Healthy Minds Study (HMS) between September 2020 and May 2023 (n = 28,856) were analyzed to estimate the three-year weighted prevalences of suicidal behaviors among AA students. Adjusted multivariable logistic regression assessed the odds of suicidal behaviors in relation to psychosocial stressors and substance use. Social isolation significantly increased the odds of suicidal ideation and planning among AA women, while sexual assault significantly increased the odds of suicide attempts. For AA men, social isolation was the only significant predictor of suicidal ideation. Addressing social isolation and sexual violence is crucial for suicide prevention among AA women. Further mixed methods, culturally grounded research is needed to improve mental health interventions on campuses.

Data show that the detection rate of anxiety symptoms among college students has risen from 16.6 to 34.8% over the past 10 years, and that college students are gradually becoming a high prevalence group for anxiety symptoms.This study aims to investigate the relationship between physical activity, behavioral inhibition and activation, and anxiety symptoms in college students. Specifically, it seeks to identify the mediating role of individual subcomponents of behavioral inhibition and activation in the association between physical activity and anxiety symptoms. A total of 5125 college students were recruited to participate in the study. Participants completed the Physical Activity Rating Scale-3, the Behavioral Inhibition/Activation System Scale, and the Generalized Anxiety Disorder-7 (GAD-7) scale. ANOVA, linear regression analysis and structural equation modelling were used to analyse the data and subcomponents of each variable (physical activity, anxiety symptoms, BIS/BAS) were analysed. Anxious college students demonstrated significantly lower scores in reward responsiveness, drive, and fun seeking, while exhibiting higher scores in behavioral inhibition. Additionally, these students engaged in physical activity at lower intensities, for shorter times, with reduced frequency, and overall less total exercise (all p < 0.001). Furthermore, a significant negative correlation was observed between levels of physical activity and anxiety (r= - 0.145, p < 0.001), while a weak correlation was identified between physical activity levels and the behavioral inhibition system (r= - 0.020, p = 0.156). Conversely, physical activity levels were significantly positively correlated with the behavioral activation subcomponents of reward responsiveness (r = 0.062, p < 0.001), drive (r = 0.122, p < 0.001), and fun seeking (r = 0.067, p < 0.001). Physical activity, behavioral inhibition, and behavioral activation were significant predictors of anxiety symptoms among university students. Among male students, exercise intensity (Beta= - 0.088, p = 0.001) and reward responsiveness (Beta= - 0.255, p < 0.001) showed the strongest correlations with anxiety levels, while among female students, exercise time (Beta = - 0.084, p < 0.001) and behavioral inhibition (Beta = 0.291, p < 0.001) were the most highly correlated. Physical activity levels had a direct effect of 84.37% on reducing anxiety symptoms (Beta= - 0.286, p < 0.001), with 15.63% of the effect mediated by the behavioral inhibition and activation system (Beta= - 0.053, p < 0.001). The mediating effects of the behavioral inhibition and activation system were stronger in females (29.92%, Beta= - 0.076, p = 0.001) compared to males (15.76%, Beta= - 0.061, p < 0.001). Factor loadings indicated that exercise time (male: 1.81, female: 2.71) and drive (male: 1.01, female: 1.04) were more effective in alleviating anxiety symptoms, particularly in the dimensions of uncontrollable worrying (1.07), worry too much (1.03), trouble relaxing (1.00), and nervousness (1.00). Physical activity exerts a direct influence on anxiety, with its anxiolytic effects partially mediated by the behavioral inhibition and activation system. This mediating effect is most pronounced in the female college student population.

The mental health of college students significantly impacts their life, academic performance, and even employment prospects. Research indicates that physical exercise can promote mental health, but the pathways of its influence require further exploration. This study investigates the relationship between physical exercise and psychological capital in college students, focusing on the mediating roles of perceived social support and self-control.

This study seeks to investigate the relationship between physical exercise and psychological capital among university students, with a further in-depth analysis of the mediating roles played by perceived social support and self-control within this dynamic.

Using cluster sampling, we surveyed 898 college students from five universities in Xinxiang, Henan Province, employing the Physical Activity Rating Scale (PARS-3), the Perceived Social Support Scale (PSSS), the Revised Self-Control Scale (SCS), and the Psychological Capital Questionnaire (PCQ). Data were analyzed using SPSS 26.0 and Amos 23.0, and common method bias was tested using Harman's single-factor test. The significance of the mediation effects was tested using the bootstrap sampling method.

(1) Physical exercise is significantly correlated with psychological capital (r = 0.786, p < 0.01); (2) Perceived social support and self-control mediate the relationship between physical exercise and psychological capital; (3) The mediation effect consists of two indirect effects: physical exercise → perceived social support → psychological capital (β = 0.404, 95% CI: 0.336-0.473) and physical exercise → self-control → psychological capital (β = 0.158, 95% CI: 0.067-0.242).

Physical exercise can directly enhance the psychological capital of college students and can indirectly influence psychological capital through perceived social support or self-control. The mediating effect of perceived social support is stronger than that of self-control.

Anti-racism efforts are imperative for campus communities, yet little is known about whether perceiving their presence on campuses relates to a range of mental health outcomes among students.

We analyzed data from the Healthy Minds Study 2020-2021 (N = 110,203). Using multivariable logistic regression, we examined the associations between perceptions of anti-racism efforts and several mental health outcomes.

Individuals who disagreed that their schools combatted racism in their campus communities had significantly greater odds of mental health problems (depression, anxiety, psychotic experiences, suicidal ideation, suicide plan, suicide attempt, perceived need for help, and loneliness), and lower odds of flourishing when compared with those who strongly agreed with the statement. For most outcomes, we observed an apparent dose-response association.

Perceiving the presence of anti-racism efforts on campuses was inversely associated with mental health problems, calling for more research to test the effects of anti-racism efforts on mental health.

American Indian and Alaskan Native (AIAN) populations have the highest rate of alcohol use disorder (AUD). Binge drinking is a known predecessor of AUD and is prevalent in college-attending populations. However, little is known about the prevalence and risk factors related to AIAN college student binge drinking. The current study examines prevalence of binge drinking and association with socio-demographic features, other substance use, exposure to discrimination and feelings of belonging within collegiate institutions.

Data were collected by the Healthy Minds Study. Present analyses were restricted to 2- and 4-year college attending students in the 2021-2022 academic year who identified as AIAN (n = 1383). We used descriptive, bivariate and multivariate Poisson weighted models to evaluate distributions and associations of binge drinking, age, gender, socioeconomic status, degree program, military experience, substance use, sexual assault, discrimination, and feelings of belonging within the institution.

In the prior 2 weeks, 26.3% of AIAN students reported binge drinking. Binge drinking commonly overlapped with other substance use. AIAN students aged 21-34 reported the highest rates of binge drinking, as did students pursuing bachelor's degrees. AIAN students who identified as trans or queer gender were less likely to report binge drinking, while across gender identities those reporting sexual assault or racial discrimination were more likely to report binge drinking in multivariate analyses.

There are multiple factors associated with binge drinking, representing individual and contextual influences on AIAN students. Developing prevention and intervention activities to address overlap in substance use and high concurrence of sexual assault and binge drinking are critical. Additionally, colleges must make concerted efforts to reduce racial discrimination and be more inclusive of AIAN students to reduce institutional-based features that exacerbate risk.

The study objective was to assess the effects of a five-week compassionate mind training for university students regarding symptoms of depression, anxiety and stress, and self-compassion compared with an active control group. Swedish university students were randomized to a compassionate mind training group or to an active control group. The outcome measures were. the Hospital Anxiety and Depression scale, the Perceived Stress Scale 14, and the Self-Compassion Scale - Short Form. All outcomes were measured pre- and post-intervention. Data were analyzed with linear mixed-effects models. The only statistically significant difference between the groups were depression symptoms (p = 0.02, d = -0.40) corresponding to a slight clinically relevant improvement. The study's results are consistent with prior research suggesting that compassionate mind training may be beneficial for alleviating depression symptoms. However, the low baseline depression levels in this sample and the short duration of the intervention may limit the generalizability and the magnitude of the findings. The small sample size and relatively homogenous group, also point to the need for larger and more diverse samples.

To study how COVID-19 stress-related factors and changes in psychosocial resources during the pandemic contributed to changes in mental health symptoms among first-year college students during the pandemic.

Using data on 339 first-year students (ages 18-20) at a large public university in North Carolina, we evaluated changes in anxiety and depression symptoms from before to early and later stages of the COVID-19 pandemic. Additionally, we estimated longitudinal associations of chronic stress, COVID-19 stress/stressors and psychosocial resources with anxiety and depression symptoms using a first-difference model.

We found that mental health symptoms increased significantly 4 months into the pandemic. Eighteen months into the pandemic, depression symptoms had returned to prepandemic levels, but anxiety symptoms had not. Chronic stress, social isolation, and distanced learning were significant risk factors; resilience was significantly protective. Results varied by the presence/absence of moderate-severe anxiety/depression symptoms prepandemic.

Mental health symptoms for first-year college students were at already high levels prepandemic and have not improved 18 months into the pandemic. Colleges may help address this growing mental health crisis through bolstering social connectedness and resilience.

Objective: We studied current psychotherapy utilization rates among college students with mental health problems and identified characteristics associated with differential utilization. Participants: Nationwide online survey of students screening positive for at least one clinical mental health problem (N = 18,435). Methods: Rates and correlates of psychotherapy utilization were analyzed descriptively and with logistic regression. Results: Sample-wide, 19% reported receiving psychotherapy. Being male (vs. female), being Asian, Black or African American, or Multiracial (vs. White), greater financial difficulty, lower parent education, lower year in school, and attending a public (vs. private) institution were associated with lower utilization. Holding a gender minority (vs. female) identity and holding a sexual minority (vs. heterosexual) identity were associated with higher utilization. Utilization fell from Fall 2019 to Spring 2020, early during the COVID-19 pandemic, and subsequently rebounded. Conclusions: This study estimates current psychotherapy utilization among students with mental health problems and identifies possibly underserved populations.

The COVID-19 pandemic may have exacerbated mental health conditions by introducing and/or modifying stressors, particularly in university populations. We examined longitudinal patterns, time-varying predictors, and contemporaneous correlates of moderate-severe psychological distress (MS-PD) among college students. During 2020-2021, participants completed self-administered questionnaires quarterly (T1 = 562, T2 = 334, T3 = 221, and T4 = 169). MS-PD reflected Kessler-6 scores ≥ 8. At T1 (baseline), most participants were cisgender women [96% vs. 4% transgender/gender non-conforming (TGNC)]. MS-PD prevalence was over 50% at all timepoints. MS-PD predictors included low self-rated health and perceptions of local pandemic control, verbal/physical violence experience, food insecurity, cohabitation dynamics, geographic location, and loneliness. Unique MS-PD correlates encompassed drug use and TGNC identity. Trajectories comprised Persistently (40%), Highly (24% MS-PD twice/thrice), Minimally (15% MS-PD once), and Never (21%) Distressed. Persistently Distressed students had low social support and self-rated health; high food insecurity, drug use, physical/verbal violence experience, need-based financial aid, and TGNC representation; and fluctuating self-rated health amid increasing COVID-19 symptomatology. In this sample, MS-PD prevalence was high, persistent, and associated with financial, behavioral, structural, experiential, and intra- and inter-personal factors. Given its complexity, improving and preserving college students' mental health necessitates comprehensive, multi-component activities to change adjustable stressors while attenuating the adverse effects of immutable influences.

Objective: Grounded in the Social Rank Theory, this study examined the levels and associations of subjective social status (SSS), depressive symptoms (DEP), and suicidal ideation (SI). Participants: Participants included 956 U.S. college students (Mage = 19.94, SDage = 2.78; 75% females [n = 716], 24% males [n = 228], 41% Whites [n = 395], 59% students of color [n = 561]. Methods: Participants completed a questionnaire including their SSS, DEP, and SI. Results: Females scored significantly higher than males on DEP and SI. There was a significant, negative SSS-DEP correlation in males, females, Whites, students of color, males and females of color. A significant, negative SSS-DEP correlation was found in males, females, Whites, students of color, and females of color, except in males of color. The negative SSS-DEP and SSS-SI links were stronger in students of color than Whites. Conclusion: Study contributions, limitations, and practical implications are discussed.

To determine the prevalence of period poverty in university students and if experiencing period poverty is associated with poor mental health outcomes.

Participants were n = 311 females assigned at birth attending a university in the northeast US. Seven items assessed period poverty. Participants were also screened for depression, anxiety, and suicide ideation. Logistic regression models assessed main effects after adjusting for gender, sexual orientation, race, age, ethnicity, disability status, and income.

Overall, 18.3% experienced period poverty, with higher odds occurring in students identifying as trans-gender/nonconforming (OR[95%CI] = 3.34 [1.22,9.15]), LGB+ (OR[95%CI] = 1.94 [1.01,3.74]), and Black/African American (OR[95%CI] = 3.61 [1.30,10.0]). Period poverty was associated with higher odds of screening positive for depression (OR[95%CI] = 6.21 [2.45,15.7]), anxiety (OR[95%CI] = 4.01 [2.09,7.68]), and suicide ideation (OR[95%CI] = 2.85 [1.26,6.44]).

Period poverty is prevalent and is associated with adverse mental health outcomes in university students. Government agencies and universities should consider providing free period products to reduce health inequities.

This study sought to understand how young adults (age 18-25) with histories of mental health disorders are coping with disrupted transitions to adulthood during the COVID-19 pandemic. A cross-sectional web survey was conducted in March-June 2021 of 967 US young adults with pre-pandemic psychiatric disability to assess their current psychiatric status, interrupted transitions, and associations with social determinants including income, community participation, and social context. Mental health was assessed with the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and PTSD Checklist-Civilian Version. Social determinants were identified with the Epidemic-Pandemic Impacts Inventory. Interrupted transitions were measured with the Young Adult Disrupted Transitions Assessment. Multivariable logistic regression models predicted four types of transition disruptions and associations with current mental health, social determinants, and demographic factors. Disruptions were reported by 81.1% including interrupted education completion (38.3%), employment careers (37.6%), residential independence (27.7%), and intimate partner relationships (22.9%). Many screened positive for major depressive disorder (81.7%), PTSD (85.5%), or GAD (58.6%). Disruption in establishing intimate partner relationships was associated with depression, anxiety, and PTSD. Interrupted residential independence was associated with anxiety. Interrupted education completion was associated with PTSD. Interrupted employment was associated with anxiety. Social determinants significant in these models included social connections, community participation, income, and racial/ethnic identification. Results illuminate ways that current mental health and social determinants affect transition interruptions during the pandemic. Findings suggest the need for interdisciplinary approaches, integrated models of care, and assistance accessing treatment, rehabilitation, and community support services from adult service systems.

College students are at higher risk for problematic substance use and disordered eating. Few studies have examined the comorbid risks associated with OCD despite the increased prevalence of OCD among young adults. This study examined substance use and disordered eating risk associated with OCD conditions among college students and how this association may vary by sex/gender.

Data were from 92,757 undergraduate students aged 18-24 enrolled in 216 colleges between Fall 2021 and Fall 2022, from the American College Health Association-National College Health Assessment III. Regression models were used to estimate alcohol, cannabis, tobacco, and disordered eating risk among those with OCD related conditions compared to those without conditions, overall and by sex/gender, while adjusting for covariates and school clustering.

Students with OCD conditions displayed a higher prevalence of substance use and disordered eating risks. In adjusted models, OCD conditions were associated with increased odds of moderate/high tobacco (aOR = 1.12, 95% CI 1.05, 1.21), cannabis (aOR = 1.11, 95% CI 1.04, 1.18), alcohol (aOR = 1.14, 95% CI 1.05, 1.24) and disordered eating risk (aOR = 2.28, 95% CI 2.13, 2.43). Analyses stratified by gender revealed cis-female students with OCD conditions were at increased risk for moderate/high risk alcohol (aOR = 1.18, 95% CI 1.08, 1.29), tobacco (aOR = 1.12, 95% CI 1.03, 1.22), cannabis (aOR = 1.13, 95% CI 1.06, 1.23) and disordered eating (aOR = 2.30, 9%% CI 2.14, 2.47). Among TGNC students, OCD conditions were associated with increased risk for moderate/high tobacco risk (aOR = 1.24, 95% CI 1.05, 1.48) and disordered eating (aOR = 2.14, 95% CI 1.85, 2.47). OCD conditions was only associated with disordered eating among male students (aOR = 2.34, 95% CI 1.93, 2.83).

Young adult college students with OCD conditions exhibit a higher prevalence of medium/high risk alcohol, tobacco, and cannabis use and disordered eating compared to their counterparts without such conditions, even after adjusting for stress, depression, and anxiety.

Chatbots' rapid advancements raise the possibility that they can be used to deliver mental health support. However, public utilization of and opinions toward chatbots for mental health support are poorly understood.

Survey study of 428 U.S. university students who participated in early 2024, just over one year after the release of ChatGPT. Descriptive analyses examined utilization of and attitudes toward both traditional mental health services (i.e. psychotherapy, counseling, or medication) and chatbot-delivered mental health support.

Nearly half (49%) of participants reported having used a chatbot for any purpose, yet only 5% reported seeking mental health support from a chatbot (8% when only considering participants with probable depression or generalized anxiety disorder). Attitudes toward traditional mental health services were broadly positive, and attitudes toward chatbot-delivered support were neutral and significantly less positive (d = 1.18, p < .001). Participants reported lack of need and doubts about helpfulness as barriers to using chatbot-delivered support more frequently than they reported them as barriers to traditional services. Cost, time, and stigma barriers were less frequently reported for chatbot-delivered support than for traditional services. Attitudes were generally consistent as a function of mental health status.

Among U.S. students, utilization of chatbots for mental health support is uncommon. Chatbots are perceived as less likely to be beneficial, yet also less affected by cost, time, and stigma barriers than traditional services. Rigorous outcome research may increase public trust in and utilization of chatbots for mental health support.

Examine center- and therapist-level factors that may impact suicide ideation outcomes for college students with minoritized identities.

Data were drawn from a 2015-2017 data set collected from 136 university counseling centers that were part of the Center for Collegiate Mental Health. This study used a three-level model in hierarchical linear modeling with clients (Level 1; N = 122,212), clients nested in therapists (Level 2; N = 2,574), and therapists nested in counseling centers (Level 3; N = 120).

Racially/ethnically minoritized students were 20%, LGBQ + students were 100% more likely, and women students were 20% less likely to have suicidal ideation at the first session, compared to White, male, heterosexual domestic students. LGBQ + students were 20%, and international students were 50% more likely to have suicidal ideation in the last session, compared to White, male, heterosexual domestic students. Cross-level interactions revealed that when therapists had a higher percentage of international students on their caseload, international students had decreased suicidal ideation. Similarly, when therapists had a higher percentage of male students on their caseload, their male students had decreased suicidal ideation.

Findings from this study support the importance of experience and competence in working with minoritized students, as therapists who had more international and men students on their caseload fared better in decreasing the suicide ideation of respective students. This suggests that continued exposure to the unique challenges faced by particular minoritized groups of college students can enhance the quality of care delivered by therapists.

Studies indicate that mental health literacy (MHL) is low among college students. Previous studies report that male college students score lower on MHL than female college students. MHL is connected to mental health help-seeking behavior. Black male college students are shown to be at higher risk for mental health problems such as depression, anxiety, and post-traumatic stress disorder, yet are less likely to seek help for these problems compared with other racial groups. Challenges with mental health can lead to significant negative consequences, such as poor academic performance, social isolation, and even suicide attempts. Stigma has been identified as an important factor that can influence the help-seeking behavior of male college students. Previous research has indicated that Black male college students in predominantly White institutions (PWIs) often struggle with seeking mental health compared with those in Historically Black Universities and Colleges (HBCUs). The purpose of the descriptive cross-sectional study was to investigate the relationships among MHL, stigma, and help-seeking behavior among Black males at HBCUs. The results indicate that having better mental health knowledge is linked to seeking help more often, stressing the need to enhance mental health understanding for better support-seeking. Seeking help was positively associated with reduced stigma. The implications for practitioners, policymakers, and administrators were explored, emphasizing the need for targeted, culturally sensitive interventions for young Black men in higher education. This study underscores the importance of addressing their specific challenges to enhance mental health and academic outcomes.

College students are amid a mental health crisis with campuses seeing the highest rates of mental health disorders in over a decade. College nursing students stand out as particularly affected, experiencing elevated levels of anxiety, stress, and depression compared to the general student population. At the forefront of addressing this issue are college faculty, especially nursing faculty, who play a unique role in identifying and referring students with mental health needs due to their close interactions in smaller teaching-learning settings such as clinicals, simulations, and one-on-one validations.

This study evaluated the perceived competency, knowledge, engagement, and fear levels of nursing faculty in supporting the mental health of Bachelor of Science in Nursing students. Additionally, the study explored whether faculty members with prior MH training differed in these levels.

Survey data from 63 faculty members employed across six prominent nursing schools in the southeast region of the United States, all offering Bachelor of Science in Nursing programs, were analyzed. Employing a cross-sectional design, the study utilized the "College Mental Health Perceived Competency Scale" (CMHPCS) to assess faculty's competence, knowledge, engagement and fear in supporting student mental health.

Among the 63 participants, significant differences were observed in engagement levels between nursing faculty with and without prior mental health training (p < .012). Overall, the surveyed nursing faculty demonstrated high levels of competence, engagement and knowledge and low levels of fear in supporting the nursing student's mental health.

The results prompt recommendations for future research aimed at developing a comprehensive approach to equip nursing faculty with effective mental health training and interventions. Such efforts seek to empower student nurses with the tools necessary to support their own mental health, enabling them to competently care for patients and communities.

Objective: We examined the role of personal identity vis-à-vis COVID-related outcomes among college students from seven U.S. campuses during spring/summer 2021. Participants: The present sample consisted of 1,688 students (74.5% female, age range 18-29). The sample was ethnically diverse, and 57.3% were first-generation students. Procedures: Students completed an online survey assessing personal identity synthesis and confusion, COVID-related worries, general internalizing symptoms, positive adaptation, and general well-being. Results: Personal identity synthesis was negatively related to COVID-related worries and general internalizing symptoms, and positively related to positive adaptation, both directly and indirectly through life satisfaction and psychological well-being. Personal identity confusion evidenced an opposing set of direct and indirect associations with outcome variables. Conclusions: Personal identity may potentially be protective against pandemic-related distress among college students, in part through its association with well-being. Reducing identity confusion and promoting identity synthesis are essential among college students during this and future pandemics.

Objective: Empathic concern (EC) for others may be related to COVID-19 pandemic responses. Participants and methods: The purpose of this survey study was to examine differences in pandemic responses in 1,778 college students rated as low (LE) versus high (HE) on the EC subscale of the Interpersonal Reactivity Index. Results: HE participants reported greater concerns in numerous pandemic-related domains, including acquiring COVID-19; access to COVID-19 treatment; number of COVID-19 cases, hospitalizations, and deaths reported; staying employed; and being isolated for long periods of time. Generalized anxiety symptoms, depressive symptoms, and perceived stress scores were significantly higher for individuals in the HE group compared to the LE group. The HE group reported being significantly more adherent to health and safety recommendations than the LE group. Conclusions: Empathic concern for others is important for promoting college student prosocial behavior but is associated with anxiety and depression symptomatology during times of traumatic stress.

A systematic evaluation and network meta-analysis (NMA) using randomized controlled trials (RCTs) was conducted to investigate the effects of different exercise intensities and dosages on the mental health of college students.

A systematic search of eight electronic databases of RCTs involving mental health exercise interventions for college students was conducted, which included data from the inception of the databases through July 2024. Two independent reviewers assessed the quality of the literature. Pairwise, network, and dose‒response meta-analyses were conducted via random-effects models to analyze the effects of exercise on college students' mental health.

A total of 48 RCTs (3951 patients) were included. Light, moderate, and vigorous exercise were all significantly effective at reducing symptoms of depression, anxiety and stress, whereas very light exercise was only effective at reducing symptoms of depression and stress. Surface under the cumulative ranking curve (SUCRA) probability ranking revealed that vigorous exercise had the highest probability of being the best intervention intensity to improve depression and stress symptoms, and the best exercise intensity to improve anxiety symptoms was moderate. The minimum threshold for overall exercise intervention for depressive symptoms was 150 METs-min per week, the benefits provided after doses above 1300 METs-min per week were less pronounced, and the predicted maximum significant response dose was 860 METs-min per week, which was the same as the predicted data for moderate exercise.

Very light, light, moderate, and vigorous exercise are all potentially effective exercise intensities for improving the mental health of college students, with no significant difference in effectiveness across the four exercise intensities. SUCRA rankings revealed that vigorous exercise is the most effective intervention for depression and stress and that moderate exercise is the most effective intervention for anxiety. Exercise interventions for depressive symptoms have a low dosage threshold, are simple and easy to administer, and are good treatments for psychological problems in college students.

Preventing anxiety and depression among college students is a pressing public health need. Recent meta-analyses have examined mobile mindfulness interventions in adult populations; however, college students are in a unique developmental stage and institutional setting.

We conducted a systematic literature review and meta-analysis of published and unpublished studies in English language on the acceptability, usage, and efficacy of mindfulness training apps on mental health among non-clinical samples of college students. Out of 167 reviewed studies, 47 were included in the narrative review. Additionally, we summarized effects from 19 stress, 12 anxiety, 13 depression, and 8 emotional well-being trials (total N = 2974) using robust variance estimation meta-regression and evaluated certainty of evidence with the GRADE approach.

Apps were acceptable, with usage levels varying. They reduced stress by 0.435 standard deviation units, 95 % CI (-0.615,-0.255), and increased emotional well-being by 0.431 (0.162,0.7) approaching medium effect sizes. The apps had small effects on depression (B = -0.219 (-0.374, -0.065)) and anxiety (B = -0.218 (-0.42, -0.016)). Certainty of evidence was moderate for stress, depression, and well-being; and low-to-moderate for anxiety. Distressed participants had larger improvements in all outcomes except depression.

Small sample sizes in the original studies and small numbers of studies limit the precision of our effect estimates. The small number of studies with objective usage data impedes our ability to characterize the optimal dose.

With moderate certainty of evidence, mindfulness training apps may improve student mental health with similar or larger effect sizes than in the general adult population. However, sustained usage may be a challenge, and more research is needed on the optimal implementation strategy, dose, and equity.

The COVID-19 pandemic has underscored the health benefits of green spaces, yet research on how specific elements of natural infrastructure affect well-being during the pandemic has been limited.

This study, conducted at Sichuan Agricultural University with 300 students in 2022, investigated how urban natural infrastructure impacts physical and psychological well-being during the pandemic. Different aspects of natural infrastructure, such as thermal comfort, air quality (negative ion concentration), and noise and light levels, varied in their positive effects on students' health.

The findings revealed that 65.6% of university students felt reduced stress when engaging with outdoor spaces, and 72.8% of them renewed recognized the therapeutic value of nature.

The study emphasizes the importance of incorporating natural elements into urban planning to enhance outdoor activity and well-being, especially in post-pandemic settings. Recommendations are provided for future urban design to address the therapeutic needs of specific populations.

Stress is a major problem among students, threatening their health and well-being. The aim of the research is to analyze the sources of stress in students and to investigate whether there are gender differences and differences between university and non-university students in stress, coping styles, mental symptoms and well-being. A second aim is to know the relevance of age, education, stress, coping styles, self-esteem and social support on mental symptoms, psychological well-being and life satisfaction of boys and girls.

The study was cross-sectional. The sample consisted of 1,426 students between the ages of 16 and 26.

The results of the ANOVAs showed that although there were some gender differences, being a university student or not explained more variance than gender. University students had more chronic stress than non-university students. However, they were more satisfied with their studies, had healthier coping styles, fewer mental symptoms, and greater well-being. For both genders, the main predictor of more mental symptoms was a higher emotional coping style. This was followed by lower self-esteem, a higher number of stressful life events, and higher chronic stress. Higher study dissatisfaction was associated with lower psychological well-being and lower life satisfaction. Higher chronic stress was associated with lower life satisfaction. It is concluded that stress and coping styles are relevant to students' mental health. The results of this study are relevant to the design of policies, strategies, and programs to improve students' mental health and well-being.

The use of ecological momentary assessment (EMA) designs has been on the rise in mental health epidemiology. However, there is a lack of knowledge of the determinants of participation in and compliance with EMA studies, reliability of measures, and underreporting of methodological details and data quality indicators.

This study aims to evaluate the quality of EMA data in a large sample of university students by estimating participation rate and mean compliance, identifying predictors of individual-level participation and compliance, evaluating between- and within-person reliability of measures of negative and positive affect, and identifying potential careless responding.

A total of 1259 university students were invited to participate in a 15-day EMA study on mental health problems. Logistic and Poisson regressions were used to investigate the associations between sociodemographic factors, lifetime adverse experiences, stressful events in the previous 12 months, and mental disorder screens and EMA participation and compliance. Multilevel reliability and intraclass correlation coefficients were obtained for positive and negative affect measures. Careless responders were identified based on low compliance or individual reliability coefficients.

Of those invited, 62.1% (782/1259) participated in the EMA study, with a mean compliance of 76.9% (SD 27.7%). Participation was higher among female individuals (odds ratio [OR] 1.41, 95% CI 1.06-1.87) and lower among those aged ≥30 years (OR 0.20, 95% CI 0.08-0.43 vs those aged 18-21 years) and those who had experienced the death of a friend or family member in the previous 12 months (OR 0.73, 95% CI 0.57-0.94) or had a suicide attempt in the previous 12 months (OR 0.26, 95% CI 0.10-0.64). Compliance was particularly low among those exposed to sexual abuse before the age of 18 years (exponential of β=0.87) or to sexual assault or rape in the previous year (exponential of β=0.80) and among those with 12-month positive alcohol use disorder screens (exponential of β=0.89). Between-person reliability of negative and positive affect was strong (RkRn>0.97), whereas within-person reliability was fair to moderate (Rcn>0.43). Of all answered assessments, 0.86% (291/33,626) were flagged as careless responses because the response time per item was <1 second or the participants gave the same response to all items. Of the participants, 17.5% (137/782) could be considered careless responders due to low compliance (<25/56, 45%) or very low to null individual reliability (raw Cronbach α<0.11) for either negative or positive affect.

Data quality assessments should be carried out in EMA studies in a standardized manner to provide robust conclusions to advance the field. Future EMA research should implement strategies to mitigate nonresponse bias as well as conduct sensitivity analyses to assess possible exclusion of careless responders.

To identify social determinants of mental health embedded within college students' living and learning conditions.

Participants included 215 mostly undergraduate (95%) business students at a diverse, urban west coast public university (48% women; mean age 24).