Psychological problems like procrastination, perfectionism, low self-esteem, test anxiety and stress are common among college students. There are evidence-based interventions available for these... Show morePsychological problems like procrastination, perfectionism, low self-esteem, test anxiety and stress are common among college students. There are evidence-based interventions available for these problems that not only have direct effects on these problems, but also indirect effects on mental disorders such as depression and anxiety disorders. Targeting these psychological problems may offer new opportunities to prevent and treat mental disorders in a way that is less stigmatizing to students. In this study we examined the association of five psychological problems with five common mental disorders (panic, generalized anxiety, bipolar, major depressive, and substance use disorder) in a sample of 2,449 students from two Dutch universities. Psychological problems were measured with one item for each problem and mental disorders were measured with the Composite International Diagnostic Interview Screening Scales. Associations were examined with Poisson regression models as relative risks (RR) of the disorders as a function of the psychological problems. The population attributable fraction (PAF) indicates by what percentage the prevalence of the mental disorder would be reduced if the psychological problem was addressed successfully by an intervention. Especially generalized anxiety disorder was strongly associated with psychological problems (strong associations with stress and low self-esteem and moderately with test anxiety). The group with three or more psychological problems had a strongly increased risk for generalized anxiety (RR = 11.25; 95% CI: 7.51-16.85), and a moderately increase risk for major depression (RR = 3.22; 95% CI: 2.63-3.95), panic disorder (RR = 3.19; 95% CI: 1.96-5.20) and bipolar disorder (RR = 3.66; 95% CI: 2.40-5.58). The PAFs for having any of the psychological problems (one or more) were considerable, especially for generalized anxiety (60.8%), but also for panic disorder (35.1%), bipolar disorder (30.6%) and major depression (34.0%). We conclude that common psychological problems are associated with mental disorders and with each other. After adjustment, psychological problems are associated with different patterns of mental disorders. If the impact of the psychological problems could be taken away, the prevalence of several mental disorders would be reduced considerably. The psychological problems may provide a promising target to indirectly prevent and intervene in psychopathology in hard to reach college students with mental disorders. Show less
Cuijpers, P.; Miguel, C.; Ciharova, M.; Aalten, P.; Batelaan, N.; Salemink, E.; ... ; Karyotaki, E. 2021
We conducted an umbrella review of 31 meta-analyses with 608 primary studies, examining the effects of psychological interventions for prevention and treatment of mental and psychological problems... Show moreWe conducted an umbrella review of 31 meta-analyses with 608 primary studies, examining the effects of psychological interventions for prevention and treatment of mental and psychological problems in college students. The proportion of unique primary studies included in the meta-analyses ranged from 6 to 100%. For problems like depression, anxiety, and stress, effective universal, indicated, and treatment interventions are available. For alcohol problems effects are small and it is not clear if these are clinically relevant. Effective interventions have been developed for smoking cessation, test-anxiety, internet addiction, procrastination, and bystander sexual assault prevention programs. The quality of most metaanalyses and almost all primary studies was suboptimal. Therefore, all findings have to be considered with caution. Show less
Furukawa, T.A.; Luenen, S. van; Garnefski, N.; Kraaij, V.; Cuijpers, P. 2021
More than half of university students have high levels of stress. Stress management programs can help students improve coping skills and prevent psychological distress. However, studies have... Show moreMore than half of university students have high levels of stress. Stress management programs can help students improve coping skills and prevent psychological distress. However, studies have generally targeted all university students regardless of whether they experience high levels of stress or not, and thus more studies are needed to examine the feasibility and acceptability of e-health interventions for students with elevated stress. The present open trial aims to examine the feasibility and acceptability of a guided internet-based stress management program for university students with high levels of stress. In this study, participants are recruited via e-mail, newsletters, and flyers from four universities in the Netherlands to participate in a guided internet-based stress management program. Guidance is delivered by e-coaches who provide weekly asynchronous text-based motivational feedback after each module is completed. Primary outcomes are satisfaction with the intervention, assessed by the Client Satisfaction Scale (CSQ-8), and usability, assessed by the System Usability Scale (SUS-10). Secondary outcomes are perceived stress, quality of life, and depression, assessed by the Perceived Stress Scale (PSS-10), the EuroQol- 5 Dimension- 5 Level Scale (EQ- 5D- 5L), and the Patient Health Questionnaire (PHQ-9) respectively. Adherence rates to the program are assessed by examining the number of completed modules, time spent on the platform, and completed exercises. The Caring Universities Project was funded in (September 2019). In June 2020, the project was officially announced to the students and recruitment began immediately. As of October 2020, recruitment continues. The expected date of the publication of the results is in 2021. It is expected that the results of the proposed study will be informative for designing and implementing e-health interventions in higher education. Moreover, it is assumed that the findings will contribute to the growing literature on internet interventions by yielding preliminary evidence related to the feasibility and acceptability of an online stress management program.Trial registration: Netherlands Trial Register NL8686; https://www.trialregister.nl/trial/8686 Show less
It is not clear if treatments for anxiety specifically targeting repetitive negative thinking (RNT: rumination, worry, and content-independent perseverative thinking) have a specific effect on RNT... Show moreIt is not clear if treatments for anxiety specifically targeting repetitive negative thinking (RNT: rumination, worry, and content-independent perseverative thinking) have a specific effect on RNT resulting in better outcomes than other psychological and nonpsychological treatments. We conducted a systematic search of randomized controlled trials comparing RNT-focused and non-RNT-focused psychological treatments, as well as nonpsychological treatments for anxiety with control groups and reporting outcomes on RNT. Inclusion criteria were met by 46 studies with a total of 3,194 participants. RNT-focused and non-RNT-focused psychological treatments had comparable effects on RNT, and level of anxiety and changes in RNT and anxiety were highly associated across treatments. Further mediation and mechanistic studies to test whether reductions in RNT during RNT-focused cognitive behavioral therapy predict subsequent reductions in anxiety are called for. Show less
It is not clear if treatments for depression targeting repetitive negative thinking (RNT: rumination, worry and content-independent perseverative thinking) have a specific effect on RNT resulting... Show moreIt is not clear if treatments for depression targeting repetitive negative thinking (RNT: rumination, worry and content-independent perseverative thinking) have a specific effect on RNT resulting in better outcomes than treatments that do not specifically target rumination. We conducted a systematic search of PsycINFO, PubMed, Embase and the Cochrane library for randomized trials in adolescents, adults and older adults comparing CBT treatments for (previous) depression with control groups or with other treatments and reporting outcomes on RNT. Inclusion criteria were met by 36 studies with a total of 3307 participants. At post-test we found a medium-sized effect of any treatment compared to control groups on RNT (g = 0.48; 95% CI: 0.37–0.59). Rumination-focused CBT: g = 0.76, <0.01; Cognitive Control Training: g = 0.62, p < .01; CBT: g = 0.57, p < .01; Concreteness training: g = 0.53, p < .05; and Mindfulness-based Cognitive Therapy: g = 0.42, p < .05 had medium sized and significantly larger effect sizes than other types of treatment (i.e., anti-depressant medication, light therapy, engagement counseling, life review, expressive writing, yoga) (g = 0.14) compared to control groups. Effects on RNT at post-test were strongly associated with the effects on depression severity and this association was only significant in RNT-focused CBT. Our results suggest that in particular RNT-focused CBT may have a more pronounced effect on RNT than other types of interventions. Further mediation and mechanistic studies to test the predictive value of reductions in RNT following RNT-focused CBT for subsequent depression outcomes are called for. Show less
