Increasing mental health issues in college students from 2016-2019: Assessing the intersections of race/ethnicity, gender, and sexual orientation.

BACKGROUND: This study aimed to evaluate how trends in mental health (e.g., diagnosis/treatment of depression, anxiety, suicidal ideation) varied across intersections of gender, race/ethnicity, and sexual orientation in a large, national sample of undergraduate students. METHODS: Data from the American College Health Association, and National College Health Assessment II: 2016-2019 were analyzed (N = 228,640 undergraduate students from 442 campuses, ages 18-24; 67.8 % female, 40.4 % BIPOC, 3.0 % non-binary (trans/non-conforming), 19.4 % LGBQ+). We used logistic regression to predict each mental health indicator; covariates included year, gender, BIPOC, LGBQ+ status, and their interactions, as well as other covariate controls (e.g., region, year in school). RESULTS: There were significant and steady increases in the odds of each mental health indicator by year (ORs = 1.12-1.13), which were significantly greater in magnitude for LGBQ+ students (ORs = 1.20-1.23). Increases did not vary by gender, race/ethnicity, or intersections between these groups and LGBQ+ status. There were significant interactions between identity groups that aligned with intersectional and minority stress theories (which did not vary by year). Non-Hispanic White students had significantly greater odds of past-year treatment/diagnosis of depression and anxiety compared to BIPOC students; however, BIPOC students had significantly greater odds of past-year suicidal ideation and this was pronounced for BIPOC women. Being non-binary x LGBQ+ was associated with significantly greater odds of each indicator. DISCUSSION: Results affirm the importance of promoting mental health among college students, with a particular focus on how to better serve and support BIPOC, non-binary, and LGBQ+ students.

Microaggressions, perceptions of campus climate, mental health, and alcohol use among first-year college students of color.

Depressive and anxiety symptoms are increasingly common, and problematic alcohol use remains prevalent in college. To expand on prior research on mostly white samples, we surveyed first-year students of color from our predominately white university (Southeastern US) to identify risk factors for mental health symptoms and potentially co-occurring problematic alcohol use. Results showed significant associations between microaggressions and poor campus climate (hypothetical predictors) with depressive, anxiety, somatic symptoms (hypothetical outcomes) that were indirectly linked through perceived stress, poor sleep, and academic burnout (hypothetical mediators). Poor campus climate, academic burnout, and using alcohol to cope were the most relevant to alcohol use disorder symptoms. Results support efforts to address and reduce racial microaggressions and promote a positive campus climate for all.

Predictors of persistent alcohol use disorder and co-occurring depressive symptoms: Insights from the longitudinal college experiences study.

INTRODUCTION: Problematic alcohol use and depression are prevalent in the college student population. The purpose of this study was to identify how personality and social-contextual factors in the first year of college work together to predict stable and potentially co-occurring alcohol use disorder (AUD) and depressive symptoms over a period of approximately 4 years. METHODS: Participants were first-year college students from the Southeastern United States (N = 209, 90% white, 62% female). Baseline data were collected in the first year of college and follow-up assessments were completed ~1 and ~4 years later (retention rates: 80%+, average ages ~19, 20, and 23 years, respectively). At each assessment, participants completed a comprehensive online survey assessing mental health and substance use, as well as personality, social support, stress, sleep, and other features of peer and romantic partner affiliations. RESULTS: Results from our random-intercept cross-lagged panel model indicated AUD and depressive symptoms were more likely to co-occur in the transition out of rather than into college. Significant predictors of stable AUD symptoms across the ~4-year period included greater alcohol quantity, marijuana frequency, affiliation with antisocial/substance-using peers, and frequency of drinking with romantic partner in the first year of college. Significant predictors of stable depressive symptoms included greater constraint, greater negative emotionality, lower positive emotionality, greater stress, and less weekday sleep. CONCLUSIONS: Findings suggest that personality factors, stress, and sleep in the first year of college may be useful targets to screen for in efforts to reduce long-term depressive symptoms in the college context. Disrupting affiliation with antisocial/substance-using peers and romantic partners and reducing the high quantity of alcohol and frequency of marijuana may be more relevant to reducing long-term problematic alcohol use. Implications for incorporating individually-tailored approaches to prevention/intervention are addressed.