Ruth “Topsy” Staten

The Relationship among Young Adult College Students’ Depression, Anxiety, Stress, Demographics, Life Satisfaction, and Coping Styles

Recent research indicates that young adult college students experience increased levels of depression, anxiety, and stress. It is less clear what strategies college health care providers might use to assist students in decreasing these mental health concerns. In this paper, we examine the relative importance of coping style, life satisfaction, and selected demographics in predicting undergraduates’ depression, anxiety, and stress. A total of 508 full-time undergraduate students aged 18–24 years completed the study measures and a short demographics information questionnaire. Coping strategies and life satisfaction were assessed using the Brief COPE Inventory and an adapted version of the Brief Students’ Multidimensional Life Satisfaction Scale. Depression, anxiety, and stress were measured using the Depression Anxiety and Stress Scale-21 (DASS-21). Multiple regression analyses were used to examine the relative influence of each of the independent variables on depression, anxiety, and stress. Maladaptive coping was the main predictor of depression, anxiety, and stress. Adaptive coping was not a significant predictor of any of the three outcome variables. Reducing maladaptive coping behaviors may have the most positive impact on reducing depression, anxiety, and stress in this population.

Strategies Used by Advanced Practice Psychiatric Nurses in Treating Adults With Depression

PURPOSE Strategies used by psychiatric advanced practice registered nurses (APRNs) in treating clients with depression are described to explore their effectiveness. DESIGN AND METHODS Ten APRNs participated in semistructured individual interviews for this qualitative descriptive study. The use of either a symptom severity scale or symptom reduction checklist was used to measure the effectiveness of the strategies used. FINDINGS APRNs identified a biopsychosocial approach as the primary component of their treatment of clients with depression. Other strategies identified include psychopharmacology, cognitive-behavioral therapy, and partnering with the client. PRACTICE IMPLICATIONS Treatment of depression can be enhanced with the incorporation of the biopsychosocial strategies along with standard treatment modalities.

IOM Releases Report on Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities

• Negative self-image • Apathy • Anxiety • Dysthymia • Insecure attachment • Poor social skills: impulsive, aggressive, passive, and withdrawn • Poor social problem-solving skills • Shyness • Poor impulse control • Sensation-seeking • Lack of behavioral self-control • Impulsivity • Early persistent behavior problems • Attention deficit/hyperactivity disorder • Anxiety • Depression • Antisocial behavior • Head injury • Self-reported psychotic symptoms

When Trauma Doesn’t End...

With the observation of the first anniversary of the September 11, 2001 (9/11) World Trade Center and Pentagon tragedies, we commemorated a disaster that, similar to the attack on Pearl Harbor on December 7, 1941, shook Americans’ sense of safety. In the past year, much healing has indeed taken place in New York, Washington D.C., Pennsylvania, and nationwide, but there are hundreds of thousands of people for whom the sequelae of trauma continue.

Advanced Practice Psychiatric Nurses' Outcomes of Care: A Pilot Study

This pilot study evaluated the effectiveness of the Advanced Practice Psychiatric Nurse (APPN) in improving clinical outcomes of depressed clients and measured their clients’ level of satisfaction with APPN care. A longitudinal study design using repeated measures was conducted to evaluate clinical outcomes and satisfaction with care of depressed clients treated by APPNs. The findings suggest that APPNs are highly effective in treating clients with depression and that clients are very satisfied with the care they receive from APPNs.

Student and Principal Perceptions of School Tobacco Policy

Abstract Background: Enforcement of no-tobacco policies is critical to providing a safe, healthy environment for students. Purpose: The purposes of the study were to: (1) describe and compare student and principal perceptions of enforcement of school tobacco policy in a school district with a tobacco-free policy, and (2) explore perceived barriers to enforcement and factors related to enforcement beliefs and perception of smoking. Methods: Students (N = 774) in five high schools in a southeastern city completed a survey. Administrators from those schools were interviewed. Results: Student and principal perceptions varied dramatically concerning tobacco policy enforcement. Only 8% of students said students followed the rules about smoking all/most of the time. Many students reported problems with secondhand smoke. The percentage of smokers was overestimated by nearly three-quarters of students (73%). Predictors of beliefs about number of tobacco rules were: smoking status, number of places students were seen smoking and number of problems reported with smoking. Barriers identified by principals included lack of supervisory help and that tobacco is physically addicting. Discussion: Student perception of how well tobacco policies are enforced should not be ignored by administrators because it is related to smoking behavior. Teachers, students, staff, administrators and parents must be enlisted to help enforce tobacco policy. Translation to Health Education Practice: To change the culture in schools, teachers, students, staff, administrators and parents must be educated about the tobacco policy, and tobacco rules must be consistently enforced.

Prevention Approaches in Child Mental Health Disorders

If the health of children is to be improved, systems of care for youth must organize and collaborate around an emphasis toward promotion of health and prevention of mental illness. This approach demands an understanding of the complex interplay of genes, environment, risk, and protective factors that influence the manifestation of behavior problems. The focus of this article is prevention efforts aimed at processes thought to be involved in the development of mental illnesses. A particular emphasis is on prevention strategies that reduce risk prior to the onset of an identifiable mental disorder. Included are interventions appropriate to nurses who deal with children in schools, pediatric primary care, and specialty mental health care.

A novel text message-based motivational interviewing intervention for college students who smoke cigarettes

INTRODUCTION Tobacco use disorder is critical among people aged 16 to 25 years. College campuses are prime locations for smoking cessation interventions for young adults. The vast majority of the smoking research with college students has been epidemiological in nature. This study examined a novel motivational interviewing intervention designed for college students, and explored predictors of smoking behavior change. METHODS A quasi-experimental one group pretest-posttest design with repeated measures was used to evaluate a novel text message-based brief motivational interviewing intervention. The data were collected from undergraduate students (N=33) who smoked cigarettes in Fall 2015. RESULTS Students’ level of autonomy and relatedness needs satisfaction, autonomous motivation, and smoking cessation self-efficacy increased (p < 0.05), and their rate of daily smoking declined (p <0 .05) over time. However, competence need satisfaction, readiness to quit smoking and severity of nicotine addiction remained unchanged. Smoking cessation self-efficacy was the strongest predictor of smoking behavior change in college students. CONCLUSIONS This study adds to the knowledge on smoking behavior among college students. Preliminary evidence indicates that text message-based motivational interviewing and smoking cessation self-efficacy may help guide successful smoking behavior interventions for college students.

Prevention Column—Adverse Childhood Experiences Study Offers Insight Into Lasting Effects

It has been 15 years since Felitti et al. (1998) published the landmark research on the relationship of adverse childhood experiences and adult health status. This study supported what many had suspected, that growing up in difficult family environments was linked to lasting adult health problems. Since then, additional research has connected 10 adverse childhood experiences to a multitude of problems children experience throughout childhood, adolescence, young adulthood, and beyond. Communities, school, social services groups, and other organizations have taken this knowledge and developed programs that reframe the question from “what is wrong with you” to “what happened to you.” This reframe has led to changes in the way school personnel, healthcare providers, community responders, and others treat those for whom they are responsible. This is a two-part column on adverse childhood experiences, the first presenting the research foundation and the second on application of the research to individual, family, and community care. Dr. Felitti was influenced by the clinical knowledge that those needing to and trying to change unhealthy behaviors had experienced adverse childhood experiences that contributed to their health problems and difficulty in changing and maintaining healthy behaviors (Felitti, 2002). Ten childhood experiences have been identified as having a negative impact on mental and physical health and contributing to social problems encountered in our culture. These 10 events include verbal abuse, physical abuse or threatening, sexual abuse, feeling unloved or not supported, not having enough basic care or a parent who was too high or drunk to provide basic care, parents separated or divorced, physically threatened or mistreated by a mother or stepmother, living with someone with alcohol problem or used street drugs or who was depressed or mentally ill or attempted suicide, or was in prison. As the scores go up, so do the difficulties related to health and well-being. In this study of 17,000 HMO participants, two thirds of participants reported experiencing at least one adverse childhood experience and 20% reported three or more adverse childhood experiences. Two main findings are that the adverse childhood experiences are more prevalent than previously acknowledged and the effects are long lasting even 50 years after the experiences occurred. In a discussion of the meaning of the study to current healthcare delivery, Dr. Felliti shares that clients in an obesity clinic were aware of the connection between their weight gain and sexual trauma, but had not been asked by health professions about childhood traumas. Additionally, this research program documents the likelihood that if one experiences one adverse event, there is an 80% likelihood that there will be other events with increasing numbers of experiences leading to increased health problems throughout adulthood. These childhood experiences have led to development of unhealthy behaviors including smoking, intravenous drug use, and attempted suicide (Felitti, 2002). Even controlling for unhealthy behaviors, persons who experienced adverse childhood experiences, and as the number increases, are more likely to have health problems throughout adulthood. Dr. Felliti and colleagues make a strong case for the cost of these childhood experiences not only to the individuals, families, and communities, but the financial cost in terms of health care and social supports for these individuals. This body of research gives strong credibility to what we have long known: that children growing up in difficult environments do experience lifelong consequences. Dr. Felliti and colleagues brought this awareness and need for change in the questions that are asked by primary care providers and specialists and to change how they care for individuals with these experiences. Their research supports the effort to destigmatize mental health problems, obesity, and other unhealthy behaviors that leave individuals judged rather than helped. They give a compelling plea that we find ways to prevent these experiences from happening and to support healthy development of families and children. Take time to read about this research and prepare to apply this knowledge to individuals, families, and communities. Programs are being developed and lives are being changed. Read about these in the next Prevention Column. For more information visit these websites: http://www.acestudy.org Health Presentations: The Adverse Childhood Experiences Study http://www.cdc.gov/ace Center for Disease Control and Prevention, The Adverse Childhood Experiences Study