A Randomized Controlled Trial of Internet-Based Self-Help for Stress During the COVID-19 Pandemic.

PURPOSE: The COVID-19 pandemic has heightened the need for mental healthcare that can be delivered remotely and at scale to college students. This study evaluated the efficacy of online self-help for stress among students during the pandemic. METHOD: College students with moderate or higher stress (N = 585) were recruited between November 2020 and February 2021, when COVID-19 had a major impact on colleges. Participants were randomly assigned to receive either online self-help using cognitive-behavioral therapy and positive psychology principles to support resilience and coping with pandemic-related stressors (n = 301) or referral to usual care (n = 284). Stress (primary outcome), depression, and anxiety (secondary outcomes) were assessed at pretreatment, one-month post-treatment, and three-month follow-up. RESULTS: Participants in the online self-help condition experienced significantly larger reductions in stress (d = -0.18, p = .035) and depression (d = -0.20, p = .018) from pretreatment to post-treatment than participants in the referral group. Reductions in stress from pretreatment to follow-up were also larger in the treatment versus referral group (d = -0.23, p = .005). Groups did not differ in change in anxiety. More time using the self-help program predicted greater improvement in depression at post-treatment (d = -0.41, p = .001) and follow-up (d = -0.32, p = .007), although usage was unrelated to change in stress or anxiety. CONCLUSION: Online self-help targeting resilience and coping during the pandemic appears efficacious for long-term alleviation of stress and short-term alleviation of depression symptoms among the college students. REGISTRATION: ClinicalTrials.gov (NCT04762173).

College Mental Health Before and During the COVID-19 Pandemic: Results From a Nationwide Survey.

Background: The COVID-19 pandemic could affect college students' mental health. We examined screening rates for psychological disorders before and during the pandemic. Methods: Undergraduates were surveyed before (n = 3643) or during the pandemic (n = 4970). Logistic regression adjusting for participant demographics was conducted. Results: Frequencies of depression [OR 1.32, 95% CI (1.17, 1.48)], alcohol use disorder [OR 1.70, 95% CI (1.50, 1.93)], bulimia nervosa/binge-eating disorder [OR 1.54, 95% CI (1.28, 1.85)], and comorbidity [OR 1.19, 95% CI (1.04, 1.35)] were greater during (vs. before) the pandemic. Frequencies of posttraumatic stress disorder were lower during the pandemic [OR 0.86, 95% CI (0.75, 0.98)]. The upward trend in alcohol use disorder was stronger among women than men [OR 1.47, 95% CI (1.18, 1.83)]. The upward trend in depression was stronger among Black students than White students [OR 1.72, 95% CI (1.19, 2.49)]. Anxiety disorders, insomnia, anorexia nervosa, and suicidality showed no significant trends. Conclusions: Depression, alcohol use disorder, bulimia nervosa/binge-eating disorder, and comorbidity were higher, whereas posttraumatic stress disorder was lower during the pandemic. Women and Black students could face especially heightened risk for alcohol use disorder and depression, respectively, during the pandemic.

More Than Inconvenienced: The Unique Needs of U.S. College Students During the COVID-19 Pandemic.

U.S. college students are a distinct population facing major challenges due to the COVID-19 pandemic. Before the pandemic, students were already experiencing substantial mental health concerns, putting both their health and academic success in jeopardy. College students now face increasing housing and food insecurity, financial hardships, a lack of social connectedness and sense of belonging, uncertainty about the future, and access issues that impede their academic performance and well-being. There is also reason to believe that COVID-19 is exacerbating inequalities for students of color and low-income students. We provide several recommendations for institutions of higher education to mitigate these obstacles, including engaging in data-driven decision making, delivering clear and informative messaging to students, prioritizing and expanding student support services, and using an equity framework to guide all processes.