http://www-personal.umich.edu/~daneis/symposium/2012/readings/Hunt_Eisenberg2010.pdf

Mental Health Problems and Help-Seeking Behavior Among College Students

Context Although young adulthood is often characterized by rapid intellectual and social development, college-aged individuals are also commonly exposed to circumstances that place them at risk for psychiatric disorders. Objectives To assess the 12-month prevalence of psychiatric disorders, sociodemographic correlates, and rates of treatment among individuals attending college and their non–college-attending peers in the United States. Design, Setting, and Participants Face-to-face interviews were conducted in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (N = 43 093). Analyses were done for the subsample of college-aged individuals, defined as those aged 19 to 25 years who were both attending (n = 2188) and not attending (n = 2904) college in the previous year. Main Outcome Measures Sociodemographic correlates and prevalence of 12-month DSM-IV psychiatric disorders, substance use, and treatment seeking among college-attending individuals and their non–college-attending peers. Results Almost half of college-aged individuals had a psychiatric disorder in the past year. The overall rate of psychiatric disorders was not different between college-attending individuals and their non–college-attending peers. The unadjusted risk of alcohol use disorders was significantly greater for college students than for their non–college-attending peers (odds ratio = 1.25; 95% confidence interval, 1.04-1.50), although not after adjusting for background sociodemographic characteristics (adjusted odds ratio = 1.19; 95% confidence interval, 0.98-1.44). College students were significantly less likely (unadjusted and adjusted) to have a diagnosis of drug use disorder or nicotine dependence or to have used tobacco than their non–college-attending peers. Bipolar disorder was less common in individuals attending college. College students were significantly less likely to receive past-year treatment for alcohol or drug use disorders than their non–college-attending peers. Conclusions Psychiatric disorders, particularly alcohol use disorders, are common in the college-aged population. Although treatment rates varied across disorders, overall fewer than 25% of individuals with a mental disorder sought treatment in the year prior to the survey. These findings underscore the importance of treatment and prevention interventions among college-aged individuals.

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Mental health of college students and their non-college-attending peers: results from the National Epidemiologic Study on Alcohol and Related Conditions.

With the increased popularity of qualitative research, researchers in counseling psychology are expanding their methodologies to include mixed methods designs. These designs involve the collection, analysis, and integration of quantitative and qualitative data in a single or multiphase study. This article presents an overview of mixed methods research designs. It defines mixed methods research, discusses its origins and philosophical basis, advances steps and procedures used in these designs, and identifies 6 different types of designs. Important design features are illustrated using studies published in the counseling literature. Finally, the article ends with recommendations for designing, implementing, and reporting mixed methods studies in the literature and for discussing their viability and continued usefulness in the field of counseling psychology.

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Mixed Methods Research Designs in Counseling Psychology.

http://sites.psu.edu/clair333/wp-content/uploads/sites/22671/2015/02/The-prevalence-and-correlates-of-depression-anxiety-and-stress-in-a-sample-of-college-students.pdf

The prevalence and correlates of depression, anxiety, and stress in a sample of college students.

Although the therapeutic alliance is a consistent predictor of psychotherapy outcomes, research has not distinguished between the roles of patient and therapist variability in the alliance. Multilevel models were used to explore the relative importance of patient and therapist variability in the alliance as they relate to outcome among 331 patients seen by 80 therapists (therapist average caseload was 4.1). Patients rated both the alliance and outcome and all models adjusted for baseline psychological functioning. The results indicated that therapist variability in the alliance predicted outcome, whereas patient variability in the alliance was unrelated to outcome. Reasons why therapist variability as opposed to patient variability predicted outcome are discussed. Clinical implications include therapists monitoring their contribution to the alliance, clinics providing feedback to therapists about their alliances, and therapists receiving training to develop and maintain strong alliances.

Untangling the alliance-outcome correlation: exploring the relative importance of therapist and patient variability in the alliance.

Are perceived increases in symptom severity in college counseling center clients real or imagined? Counseling center staff, retrospectively, reported that client problems are more severe now than in the past. Yet studies examining client distress levels at intake have found no significant increases. This study examined counseling center client problems across 13 years from the perspective of the treating therapist at the time of case closure. Increases were found for 14 of 19 client problem areas, whereas other areas retained stable levels, and 2 problem areas had a quadratic trend over time. These changes directly affect counseling service practices. Across several years, counseling center staff (Robbins, May, & Corazzini, 1985) and directors (Gallagher, Gill, & Sysco, 2000; O’Malley, Wheeler, Murphey, O’Connell, & Waldo, 1990) have perceived increases in levels of psychopathology and symptom severity among counseling center client populations. In these studies, therapists’ and directors’ responses were retrospective, reflecting their speculations about changes in client problems over the previous years. However, researchers who have attempted to examine this issue with more objective data, such as client-perceived distress scores at intake, have found no differences across 6 – 8 years (Cornish, Kominars, Riva, McIntosh, & Henderson, 2000; Pledge, Lapan, Heppner, Kivlighan, & Roehlke, 1998). How can one explain the discrepancy between therapists’ and directors’ post hoc subjective impressions and client-perceived distress scores? What increases in symptom severity might therapists and directors perceive that are not reflected in measures of client distress levels at intake? This study attempted to lend some clarity to these questions by providing data from another perspective. We analyzed client case descriptors, completed by therapists at case closure, for each case across a 13-year period. Several researchers have relied on retrospective survey data, asking counselors and directors to recall their impressions regarding changes in symptom severity over time. For example, Robbins et al. (1985) surveyed 200 college counseling center staffs and found that most respondents reported an increase in the emotional and behavioral problems of their clients over 3 years. Gallagher et

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Changes in counseling center client problems across 13 years.

This study made use of a model of college success that involves students achieving academic goals and life satisfaction. Hierarchical regressions examined the role of six psychosocial factors for college success among 579 first-year college students. Academic self-efficacy and organization and attention to study were predictive of first semester grade point average (GPA) when controlling relevant demographic factors. Academic self-efficacy was even predictive of end-of-year GPA when controlling previous, first-semester GPA. Mediation analyses revealed that first-semester GPA was an important mediator between these two psychosocial variables and end-of-year GPA. Additional psychosocial variables were predictive of college students' life satisfaction: stress and time management, involvement with college activity, and emotional satisfaction with academics. We explore how formulating interventions on the basis of psychosocial factors offers an avenue for students to address specific attitudes, emotions, and behaviors that relate to college success.

/pdf/psychosocial-factors-predicting-first-year-college-student-1wcokgapm2.pdf

Psychosocial Factors Predicting First-Year College Student Success

Objective: This study explored the relationships between college student gender, alcohol use, protective strategies and harmful drinking consequences. Method: A derivation sample (N = 3,851; 54% women) and a replication sample (N = 4,151; 55% women) of undergraduate students completed the Campus Alcohol Survey (CAS) in classroom settings. Results: Although women drank less than men and were less likely to experience harmful consequences, they were more likely to use protective strategies. Hierarchical regression analyses revealed that students who consumed at least six drinks when they partied--especially men-were less likely to experience more common consequences (e.g., poor academic performance, property damage, unconsciousness, riding in a vehicle with others who have been drinking) if they engaged in self-protective strategies. Such strategies also helped students who exceeded the median number of drinks to moderate the effect of drinking on less common consequences (e.g., vehicular accidents, class f...

College student protective strategies and drinking consequences.

How and why some international students experience their study abroad lives in positive ways is largely ignored in existing research. In this study, two international students were interviewed for their perception of the sources of well-being during their study abroad experience. A grounded theory analysis showed that they related strategies for well-being most strongly to tactics for gaining general well-being and coping skills for adjusting to study abroad life from the perspective of their study abroad goals. This study built a model of how international students exercise possible ways to maintain well-being through their study abroad experience. Furthermore, the process of the qualitative approach itself provided for a better understanding of international students and an implication for future research. ********** The international student population has increased dramatically over the past fifty years. Today, the United States has the highest number of international students in the world. In the 2000-01 academic year, there were 547,867 international students studying in the United States (American Council on Education, 2000; Institute of International Education, 2001). Educators in higher education display a great interest in developing a better understanding of how international students differ from their American counterparts and in determining ways to assist these students in adjusting to the host culture. Researchers have devoted a great deal of effort to the study of adjustment problems and issues of international students (Cheng, 1999; Han, 1996; Kaczmarek, Matlock, Merta, Ames, & Ross, 1994; Lin & Yi, 1997; Ying & Liese, 1994). Specifically, the key adjustment problems faced by international students include the following four major categories: (1) general living adjustment, such as adjusting to American food, living/housing environment and transportation, adaptation to a new climate (weather), dealing with financial problems and health care concerns; (2) academic adjustment, such as lack of proficiency in the English language, lack of understanding of the American educational system, and lack of effective learning skills for gaining academic success; (3) socio-cultural adjustment, for example, experiencing culture shock, cultural fatigue, or racial discrimination, having difficulties in adjusting to new social/cultural customs, norms and regulations, differences in intercultural contacts/social activities, and encountering conflicts between American host standards (or values, world views, life styles) and those of home country; and (4) personal psychological adjustment, such as experiencing homesickness, loneliness, depression, frustration, or feeling alienation, isolation, the loss of status or identity, and feelings of worthlessness. The research, previously noted, has focused on problems that impact international student adjustment. What is largely ignored in these studies is an explanation of how and why some international students experience their study abroad life in positive ways. Although numerous theories of well-being have been conducted with domestic students, these studies seldom select international students as research participants. From the perspective of international students, it leaves gaps at two levels: what constitutes and determines their well-being and how they understand and manage their well-being. The goal of this present study was to examine the determinants of international students' well-being, and discern their strategies for attaining well-being. A qualitative design of grounded theory was used as a framework to explore international students' definition of well-being and then to discern their strategies for enhancing their well-being while studying abroad. Grounded theory, first discussed by Glaser and Strauss (1967), utilizes techniques to analyze and interpret actions and experience of the respondent, develop and refine analytic interpretations of empirical data, and, finally, construct a representative theoretical model of respondent's experience. …

Fred B. Newton

Papers

Changes in counseling center client problems across 13 years.

Psychosocial Factors Predicting First-Year College Student Success

College student protective strategies and drinking consequences.

International Students' Strategies for Well-Being

Students Helping Students: A Guide for Peer Educators on College Campuses. First Edition. The Jossey-Bass Higher and Adult Education Series.