Sarah Ketchen Lipson

Eating disorder symptoms among undergraduate and graduate students at 12 U.S. colleges and universities.

OBJECTIVES We sought to estimate the prevalence of eating disorder symptoms in a large sample of U.S. college students and variations therein across student characteristics. METHODS Participants were 9713 students from 12 colleges and universities participating in the Healthy Bodies Study. We used gender-stratified logistic regression to estimate bivariate correlates of elevated eating disorder symptoms, past-month objective binge eating, and past-month compensatory behaviors across student characteristics including age, degree-level, sexual orientation, race/ethnicity, first-generation status, citizenship, academic and extracurricular characteristics, and weight status. Eating disorder outcomes were based on the Eating Disorder Examination Questionnaire. RESULTS We observed higher prevalence of objective binge eating among females relative to males (49% versus 30%, p<0.001), but similar prevalence of compensatory behaviors (31% versus 29%). Weight status was the most consistent predictor of eating disorder risk with significantly more symptoms seen among individuals with overweight and obesity. When compared to individuals with a healthy weight, those with overweight had greater eating disorder risk (males OR=3.5; females OR=2.0), binge eating (males OR=2.1; females OR=1.9), and use of compensatory behaviors (males OR=1.5; females OR=1.3). CONCLUSIONS This study suggests smaller gender difference in prevalence of eating disorder symptoms than previously reported and identifies students with overweight/obesity as salient targets for campus-based eating disorder screening and early intervention efforts.

Variations in Student Mental Health and Treatment Utilization Across US Colleges and Universities

Abstract Objective: On US college campuses, mental health problems are highly prevalent, appear to be increasing, and are often untreated. Concerns about student mental health are well documented, but little is known about potential variations across the diversity of institutions of higher education. Participants: Participants were 43,210 undergraduates at 72 campuses that participated in the Healthy Minds Study from 2007 to 2013. Methods: Multivariable logistic regressions focus on associations between institutional characteristics and student mental health and treatment utilization. Results: The following institutional characteristics are associated with worse mental health: doctoral-granting, public, large enrollment, nonresidential, less competitive, and lower graduation rates. Among students with apparent mental health problems, treatment utilization is higher at doctorate-granting institutions, baccalaureate colleges, institutions with small enrollments, and schools with strong residential systems. Conclusions: Although high rates of mental health problems and low treatment utilization are major concerns at all types of institutions of higher education, substantial variation occurs across campuses.

Major Differences: Variations in Undergraduate and Graduate Student Mental Health and Treatment Utilization Across Academic Disciplines

ABSTRACT This article explores variations in mental health and service utilization across academic disciplines using a random sample of undergraduate and graduate students (N = 64,519) at 81 colleges and universities. We report prevalence of depression, anxiety, suicidality, and self-injury, and rates of help-seeking across disciplines, including results from multivariate logistic regressions. We find significant variations: Students in humanities and art and design are significantly more likely to have mental health problems; and for students with apparent mental health problems, treatment rates are lowest among those in business and engineering. Noting these variations could enhance efforts to promote student mental health, particularly within academic departments.

Increased emergency department use by adolescents and young adults with eating disorders.

OBJECTIVE This study describes patterns of emergency department (ED) utilization by patients who screen positive for eating disorders. METHOD ED patients aged 14-20 years (n = 1,920) completed a computerized questionnaire. The analyses compared the rates of ED use between patients who screened positive for an eating disorder and those who did not and examined the reasons for ED use amongst patients with eating disorders. RESULTS ED patients who screened positive for eating disorders were significantly more likely to have previously visited the ED and, on average, utilized the ED at a rate 1.6 times higher than patients who screen negative for eating disorders. The most common chief complaints among patients who screen positive for eating disorders were abdominal pain and other gastrointestinal-related problems. DISCUSSION Patients with eating disorders utilize the ED more frequently than those without and commonly present for complaints seemingly unrelated to their eating disorder.

Mental health and academic attitudes and expectations in university populations: results from the healthy minds study

Abstract Background: Mental health problems are highly prevalent in university populations and have been shown to impair academic performance. Yet little is known about the ways in which mental health influences academic outcomes in higher education. Aims: This study seeks to offer new insight into the relationship between mental health and academic performance, focusing on students’ academic experience and expectations as interrelated mechanisms. Method: Data come from 3556 students at four campuses that participated in the Healthy Minds Study. We explore unadjusted and multivariable relationships between mental health and academic experiences, expectations and impairment. Results: We find significant differences by mental health status, including that one-in-four students with symptoms are dissatisfied with their academic experience, relative to one-in-ten without (p < 0.001). Approximately 30% with symptoms doubt whether higher education is worth their time, money and effort, compared to 15% without (p < 0.001). In multivariable models, mental health problems were a significant predictor of academic dissatisfaction and drop out intentions, while positive mental health was a significant predictor of satisfaction and persistence. Conclusions: This descriptive study offers further evidence of the importance of mental health for university success, identifying pathways related to students’ experiences and expectations that may help to explain this relationship.

Competition, Anxiety, and Depression in the College Classroom: Variations by Student Identity and Field of Study

Abstract:In light of rising academic stress and an increase in diagnosed mental illnesses among adolescents and young adults, this article offers the first comprehensive analysis of relationships between perceived competition and depression/anxiety among college students. Analyses were conducted by using clinically validated instruments for depression and anxiety and a diverse, national sample of 40,350 undergraduates from 70 institutions. Multivariate logistic regressions reveal that high levels of perceived competition in one’s classes are associated with increased risks of depression and anxiety, especially among queer, first-generation, Black, and Latino/a students. Discrimination and peer support moderate these relationships, suggesting avenues for future research and educational interventions.

Mental Health Disparities Among College Students of Color

PURPOSE Understanding the mental health needs of students of color is a growing priority on college and university campuses nationwide. This study aims to capture the state of mental health among students of color, including the prevalence of mental health problems and treatment utilization. METHODS The sample is comprised of 43,375 undergraduate and graduate students at 60 institutions that participated in the survey-based Healthy Minds Study from 2012 to 2015. These data include over 13,000 students of color; we look separately at African-American, Latinx, Asian/Asian American, and Arab/Arab American students. Data are analyzed at the individual level using bivariate and multivariate modeling to elucidate variations across race/ethnicity. We examine symptom prevalence (measured by validated screens such as the Patient Health Questionnaire-9 for depression), help-seeking behaviors, and related factors (including knowledge and stigma). RESULTS Across race/ethnicity, we find modest variation in symptom prevalence and larger variation in service utilization. Overall, treatment use is lower among students of color relative to white students, even when controlling for other variables in regression models. Asian/Asian American students have the lowest prevalence of treatment, at only 20% among those with apparent mental health conditions. Attitudes related to mental health treatment also vary significantly and help to explain the primary findings. CONCLUSIONS College students of color represent a disparities population based on greater levels of unmet mental health needs relative to white students. This paper takes an important step toward understanding these needs and points to implications for future research and practice.

Be True to Our Schools—Models of Care in College Mental Health

Purpose of ReviewTo review and synthesize the previous, current, and proposed models of care in college mental health in order to identify best practices that will address the mental health needs of today’s students. To highlight data that supports existing or proposed models and describe areas where more data is needed.Recent FindingsDespite the potentially appealing attributes of integrated care, empirical evidence supporting these systems and structures in campus settings is mixed. Recent surveys show less than half of campuses have an integrated mental health care model. Overall, there is only partial consensus on optimal models of campus mental health care.SummaryMental health needs in college student populations are greater and more complex than ever. While the resources available are vast and varied, there is limited evidence to support which models and programs can best meet students’ needs.

Do Resident Advisors Serve as Mental Health Gatekeepers?: Evidence from a Natural Experiment on College Campuses

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