Suicide is a leading cause of death among college students, but inconsistent data and a lack of meta-analysis make it difficult to identify and recognize the risk factors for suicidal ideation, planning, and attempts in this group. To gain a comprehensive understanding of previous research, this study summarized risk factors for suicidal ideation, planning, and attempts among college students through a review and meta-analysis.

We systematically searched six electronic databases from inception to May 18, 2024, to identify longitudinal studies of factors associated with suicidal ideation, planning, and attempts among college students. The effect sizes of the risk factors were pooled using a random effects model. Based on the results of the meta-analysis, we developed a risk prediction model for suicidal ideation among college students.

Thirty-three studies involving 193,517 college students were included. This study identified 18 risk factors, such as sexual orientation and traumatic experiences, and identified two protective factors, namely, social support and positive coping. Suicidal ideation is considered an important precursor to suicide. This study developed a predictive model for suicidal ideation with the results of the meta-analysis.

This review demonstrated the importance of several risk and protective factors for suicidal ideation, planning, and attempts among college students. A predictive model was developed based on the results of this meta-analysis, thus providing novel insights for translating evidence into clinical practice.

Few studies have examined the effects of brief focused breathing techniques. This study investigated the impact of brief slow-paced breathing (SPB) with a longer exhalation on working memory and perceived mood, stress, and arousal.

Between-subjects experimental design.

Participants (139 undergraduates, 69% female) were randomized to a one-time SPB session or a mind-wandering active control condition. The participants completed the OSPAN working memory task and state measures of mood, stress, and arousal at three time points: baseline, post-manipulation, and post-task.

OSPAN performance improved in the experimental group. Mood improved in the experimental group but decreased in the control group from baseline to post-manipulation and then decreased in both conditions after completing the OSPAN task. Stress decreased in the experimental group from baseline to post-manipulation and was significantly different from the control group at the post-manipulation time point. Stress then increased from post-manipulation to post-task in both conditions. Arousal decreased in both conditions from baseline to post-manipulation but then increased from post-manipulation to post-task.

The current results demonstrate that a brief SPB session with longer exhalation improved working memory and temporarily improved mood and stress thus providing a just-in-time intervention to help individuals cope with stress-inducing conditions.

This study aimed to assess the relationship between mental health, health behaviors, and food security in young adults in a university environment. Young adults (N = 536) at two United States universities completed a survey assessing health behaviors and characteristics. Logistic regression determined the odds of anxiety and/or depression based on gender identity, body mass index (BMI), food security status (FSS), and sleep restfulness. Over one-third of students were food insecure (36.7%), and almost all reported anxiety (57%) and/or depression (39.1%). Students who identified as female, reported very low FSS, poor sleep, and had higher BMI were at greater odds for the prevalence of depression. Students with poor sleep and low FSS were more likely to report mental health challenges. Universities should focus on priorities and interventions among at-risk students.

Mental health disorders and limited care access are global challenges. In Italy, the Psychological Bonus (PB) aims to increase access to psychological care. As part of the PsyCARE project, this study explores the characteristics of the PB's participants, using a person-centered approach to investigate patients' psychopathological and transdiagnostic profiles. Cross-sectional data from 2261 patients were analyzed, focusing on clinical characteristics, treatment reasons, and differences between patients already in therapy and new patients. Latent Profile Analysis (LPA) identified psychological profiles based on symptoms and transdiagnostic factors (emotion regulation and epistemic trust). Anxiety and depressive disorders were the most common diagnoses. Patients already in treatment were more likely to be on medication, have a history of non-suicidal self-injury, and have experienced hospitalization for psychological problems. LPA identified four profiles: Profile 1 (19.79 %) with the highest distress, poor emotion regulation, and significant interpersonal difficulties; Profile 2 (28.89 %) and Profile 3 (22.82 %) with above-average distress but varying emotion regulation behaviors and interpersonal dispositions; and Profile 4 (28.50 %) with the lowest distress, adaptive emotion regulation, and more adaptive interpersonal dispositions. Significant Sex and age differences were observed across profiles, but no differences between patients already in therapy and new patients. This study emphasizes the value of integrating transdiagnostic elements into psychological assessment beyond symptom-focused approaches. While different profiles presented similar levels of psychological distress, they differed substantially in emotion regulation strategies and interpersonal dispositions. These findings underscore the need for tailored interventions addressing symptomatology and the transdiagnostic mechanisms that shape individuals' psychological functioning.

Psychological distress is a growing concern among university students, yet the role of Psychological Capital (PsyCap) components in mitigating distress remains unclear. This study examines the protective roles of self-efficacy, optimism, hope, and resilience on psychological distress among Malaysian university students. A total of 547 students aged 18 to 24 years (M = 21.23, SD = 1.82) participated in this cross-sectional correlational study. Using SmartPLS software, the regression analysis showed that self-efficacy and optimism were significant negative predictors of psychological distress, whereas pessimism and succumbing were significant positive predictors. However, hope and resilience did not exhibit significant predictive effects. These findings highlight the protective roles of self-efficacy and optimism in reducing distress, while acknowledging the detrimental impact of pessimism and succumbing. Outcomes of the study support Psychological Distress Theory and partially validate PsyCap, highlighting the distinct contributions of its components on psychological distress. Addressing these negative psychological constructs through targeted interventions such as self-efficacy enhancement workshops and cognitive-behavioural programs may help reduce pessimistic thoughts and psychological distress among university students.

We review the published literature on common presentations, unique challenges, existing models of care, and best practices regarding college student psychiatric emergencies.

College students who are in psychiatric crisis experience a range of responses and support. The diversity of institutions of higher education (IHEs), geography, resources, and the demographics of college students themselves means that no two psychiatric emergency responses are alike. Population health approaches to these crises are generally lacking even though the literature is clear that some students have unique and elevated risk. New models of care have emerged at some IHEs but have not yet been sufficiently evaluated. There are diverse responses and models of care for college student psychiatric emergencies. Recent guidelines reflect novel approaches to care and support.

A high frequency of mental issues has been reported amongst dental students in recent years. The aim of this study was to explore the frequency of depression, stress, and anxiety amongst undergraduate dental students in a developing country and identify factors which may contribute to the poor mental health of dental students.

After obtaining ethical approval, undergraduate dental students from 14 dental institutions were invited to participate in an online study. Data were collected using two globally validated scales for screening mental health. The survey inventory also included two open-ended items and was administered using Google forms.

Complete responses were received from 639 participants, which included 71.67% (n = 458) females and 28.33% (n = 181) males. The overall response rate was 43%. The modal age group was 18-21-year-olds (63.54%, n = 406), followed by 22-25-year-olds (35.52%, n = 227). The mean score on PHQ-9 was 10.37 (SD ± 6.13) and 48.67% of participants showed moderate to severe depression. The mean DASS-21 score was 20.81 (SD ± 14.64) and 48.21% of participants were screened positively for moderate to extremely severe depression, 49.30% for moderate to extremely severe anxiety, and 30.36% of participants showed features of moderate to extremely severe stress. Significantly positive correlations were observed for the whole sample and demographic factors for participant scores on PHQ-9 for Depression, and Depression, Anxiety, and Stress scores on DASS-21. Academic workload, social interactions, personal factors, academic environment, and financial difficulties were reported as the main causes of poor mental health.

This study shows a high prevalence of depression, anxiety, and stress amongst undergraduate dental students in a country with a unique socio-cultural landscape. The study also identified underlying factors which adversely affect the mental health of dental students and provides recommendations to address these challenges.

Background: Veterinary students experience high levels of mental health issues. Objectives: To analyze substance use, internet consumption, and mental health factors among students and academic staff of the Faculty of Veterinary Medicine of the University of Las Palmas de Gran Canaria, identifying factors associated with well-being and dissatisfaction. Methods: A total of 226 respondents participated, including 177 students (78.3%) and 49 staff members (21.7%). Data were collected between 30 October 2024 and 14 January 2025 using an adapted EDADES-based survey assessing substance use (alcohol, tobacco, electronic nicotine delivery systems (ENDSs), anxiolytics, and illicit drugs), internet habits, and psychological well-being among participants. Binary logistic regression was applied to identify factors associated with dissatisfaction. Results: Students exhibited higher binge drinking rates, greater ENDS consumption, and more problematic internet use than staff. Significant gender differences were observed, with females reporting greater emotional distress and a higher need for psychological support. Water pipe use (OR = 2.79, 95% CI = 1.45-5.38), anxiolytic consumption (OR = 2.31, 95% CI = 1.08-4.92), and excessive internet use (OR = 4.83, 95% CI = 1.66-14.1) were associated with lower overall satisfaction. Age was inversely associated with dissatisfaction (OR = 0.96, 95% CI = 0.94-0.98), and females were significantly more likely to report dissatisfaction (OR = 2.79, 95% CI = 1.45-5.38). Conclusions: Veterinary students exhibited higher psychological distress than teaching staff. Implementing targeted interventions to address substance use and internet habits is needed in order to enhance psychological well-being.

This study aims to develop and validate a Physical Fitness Test Anxiety Scale (FTAS) for Chinese college students and assess its scientificity and applicability through reliability and validity testing.

The initial scale was constructed through literature analysis and semi-structured interviews, followed by item analysis and factor analysis to optimize the scale structure. Multiple statistical methods were used to test the scale's reliability and validity.

The final scale consists of 12 items, covering two dimensions: cognitive anxiety and somatic anxiety. The model fit was good (χ 2/df = 2.29, RMSEA = 0.051, IFI, CFI, TLI, GFI, AGFI >0.90). The internal consistency coefficients for the total scale and the two dimensions ranged from 0.903 to 0.928, with split-half reliability between 0.804 and 0.899. The average variance extracted (AVE) ranged from 0.575 to 0.667, and the composite reliability (CR) ranged from 0.904 to 0.950.

The Physical Fitness Test Anxiety Scale for college students has good reliability and validity and is suitable for assessing the physical fitness test anxiety levels of college students.

Diathesis-stress theory of depression is well known, which stresses that stressor is an inducing factor for depression in general population. High altitude, a combination of variety of stressors, is a special environment that may cultivate more depression. However, how different types of stressors contribute to depression and its underlying mechanisms in high-altitude populations remain unrevealed. The study aimed to reveal the effect of different stressors on depressive mood among long-term high-altitude workers in China and further explore the mediation of emotion regulation and moderation of parent-child alienation.

2065 Chinese workers at altitude of approximate 4200 m completed a cross-sectional survey with the Baker Depression Inventory-II scale, the Emotional Regulation scale, the Parent-child Alienation scale, and the Stressors scale (i.e., environmental factors, low social support, working challenges, accommodation, personal affairs, and cognitive factors).

Correlation analysis showed positive correlations between stressors and depressive mood (r = 0.05-0.94, p < 0.05). Regression analysis indicated that low social support stressor was the strongest predictor of depressive mood (β = 0.21), while working challenges, personal affairs, and cognitive factors also positively predicted depressive mood. The mediating model showed that expression inhibition played a partial mediating (promoting) role between stressors and depressive mood, accounting for 3.13% of total variance. The moderating model showed that parent-child alienation played a moderating role in the model (β = 0.01, p < 0.001); a lower level of parent-child alienation effectively alleviated the impacts of stressors on depressive mood.

Stressors (working challenges, personal affairs, cognitive factors, and especially low social support) positively predict the depressive mood of long-term high-altitude workers in China. Expression inhibition plays a promoting mediation in the relationship between stressors and depressive mood. A good parent-child relationship alleviates the negative impact of stressors on depressive mood. Findings provide new empirical support for diathesis-stress theory and attract further attention to less expression inhibition and better parent-child relationships in depression prevention.

University non-continuation, also termed as university dropout in literature, is a concern for institutions. Elevated stress levels, mental distress, and psychiatric issues affect academic performance and thus may contribute to non-continuation. There is a lack of systematic reviews exploring the link between mental health and university non-continuation.

This systematic review aims to bridge this gap, by investigating the prevalence of non-continuation and mental health conditions among university students, and the impact of mental health on university non-continuation.

Following PRISMA guidelines this review synthesized data from 67 studies, utilising both narrative synthesis and meta-analytic techniques.

The results revealed that the included studies reported a range of university non-continuation rates (5.9% to 43.6%) with a pooled prevalence of 17.9%, 95% CI [14.2%, 22.3%]. The prevalence of mental health concerns among students varied widely (2.2% to 83.6%), with a pooled prevalence of 26.3%, 95% CI [16.0%, 40.0%]. Depression, OR = 1.143 (95% CI [1.086, 1.203] p<.001), stress, OR = 1.413 (95% CI [1.106, 1.805], p=.006), and other mental health conditions, OR = 1.266 (95% CI [1.133, 1.414], p<.001), were associated with higher non-continuation.

Some mental health conditions elevate non-continuation risks, and addressing mental health may enhance student retention in higher education.

In recent years, post-secondary students' mental health has become an important public health concern. However, studies examining protective factors of mental health among students and during challenging times are limited. Guided by the strength-based Resilience Portfolio Model and following a group of undergraduates (N = 1004) throughout the 2020/2021 academic year, this study examined multiple domains of resilience internal assets and external resources and simultaneously tested multiple protective mechanisms for student mental health using structural equation modelling. Results provided support for insulating effects: both internal assets such as emotion regulation and external recourses such as social network supportiveness and cultural fit in university (i.e., perceived congruity between students' personal and cultural selves and their university environment) were associated with reducing academic stress which in turn promoted student mental health at the end of the academic year. There was also support for additive effects: greater cultural fit in university was also directly related to better end-of-year student mental health. As cultural fit in university was associated both directly and indirectly with student mental health, creating an inclusive university community may help reduce student academic stress, lower student psychological distress and improve student subjective well-being.

To assess the prevalence of technology-facilitated sexual harassment (TFSH) and its relationships to adverse mental health issues among young adult female students in Bangladesh.

We collected data for this cross-sectional study from July to September 2022 from 455 female students at a large university in Bangladesh. The prevalence of TFSH, self-reported distress, stress, anxiety, depression, and suicidal thoughts was assessed. Multivariable logistic regressions were used to assess the identified relationships.

This study found that nearly half of the respondents (46.1%) reported having experienced TFSH. The prevalence of suicidal thoughts, moderate to severe distress, stress, anxiety, and depression was 34.9%, 47.7%, 78.2%, 36.9%, and 59.8%, respectively. Results also reported that, compared to the respondents who did not experience TFSH, those who experienced it were more likely to report adverse mental health issues with higher odds. For example, after controlling for sociodemographic variables, the odds of moderate to severe distress (Adjusted odds ratio [AOR]: 3.70; 95% confidence interval [CI]: 2.36-5.78), stress (AOR: 2.09; 95% CI: 1.25-3.49), anxiety (AOR: 3.80; 95% CI: 2.40-6.03), depression (AOR: 3.32; 95% CI: 2.12-5.18), and having suicidal thoughts (AOR: 4.86; 95% CI: 2.29-7.89) were higher among female students experiencing TFSH than those who did not experience it.

TFSH harassment among young adult female students is common and significantly associated with different adverse mental health issues. Attempts at primary intervention for improving mental health status are required to take TFSH into consideration.

Objective: Examine predictors of alcohol misuse among university students amid the COVID-19 pandemic. Participants: University students who completed the National College Health Assessment III before, during, and after the pandemic lockdown. Methods: Using multivariable logistic regression, we examined associations between psychological functioning, time spent with family and friends, and problematic alcohol use. Results: Alcohol use decreased, and psychological functioning was poorest one year after COVID-19-related university closures. While indicators of psychological functioning started to improve in the second year after the school closures, alcohol use started to increase. Overall stress, spending more time with friends, and fraternity/sorority residence significantly predicted moderate to high risk for alcohol dependence and binge drinking two years post-pandemic. Severe psychological distress (OR= 1.36, CI = 1.22, 1.52, p < 0.001) predicted moderate to high risk for alcohol dependence but not binge drinking. Conclusion: Innovative mental health interventions are needed to reduce alcohol misuse among university students.

Mental health problems seemed to have increased among university students during the COVID-19 pandemic. To deepen our understanding of the pandemic's effects in this population, we conducted qualitative research to investigate any perceived changes in students during the pandemic, differentiating the sample based on the presence or absence of current suicidal ideation (SI).

A wide sample of Italian university students (n = 1,214) completed an online questionnaire during the COVID-19 pandemic, March 2020-June 2021. We conducted a computer-assisted content analysis of an open-ended question about the perceived changes that occurred to them during the pandemic.

(1) Four thematic clusters were identified: "The psychological impact of the pandemic," "New ties and new loneliness," "An uncertain forethought" and "Discovering the value of relationships." (2) In subjects characterized by severe SI, the state of confinement at home was related to the most intense emotional states and worries. (3) Students with severe SI were different from the others, in particular using the lemma "panic," which was the only psychological state specifically associated with this group.

Students with current severe SI experienced higher level of psychological distress and suffering compared to the other groups during the pandemic.

Background: Young adulthood is a demanding developmental stage, in that individuals are often faced with making major and long-lasting decisions related to career and family. This is also a heightened time of mental health difficulties. There is recent evidence that cognitive disengagement syndrome (CDS; previously sluggish cognitive tempo) may also be more prevalent in young adults and associated with poorer functioning. However, the relation between CDS symptoms and anxiety, depression, stress, and insomnia remains insufficiently investigated among young adults. Given this, the aims of the present study were as follows: (1) to investigate the associations between CDS and symptoms of depression, anxiety, stress, and insomnia; (2) to investigate if and which dimensions of ill-being were more robustly related to higher CDS scores; (3) to explore if stress scores moderated the associations between CDS symptoms and insomnia; and (4) to explore if higher insomnia categories were associated with higher CDS scores. Methods: A total of 246 young adult students in Switzerland (mean age = 22.62; 56.3% females) completed a booklet of questionnaires covering socio-demographic information, cognitive disengagement syndrome (Adult Concentration Inventory; ACI), and symptoms of depression, anxiety, stress, and insomnia as part of this cross-sectional study. Results: Higher CDS scores on the ACI were associated with higher scores for depression, anxiety, stress, and insomnia. Depression, anxiety, stress, and insomnia were independently associated with higher scores for CDS. Higher categories of stress moderated the associations between higher CDS scores and higher insomnia. Higher insomnia categories were related to higher CDS scores. Conclusions: The present data showed that among a small sample of young adult students, higher CDS scores were associated with higher psychological ill-being (depression, anxiety, stress, and insomnia). If we consider CDS as a trait, specific performance-enhancing medication or psychotherapeutic interventions might favorably influence dimensions of psychological ill-being such as depression, anxiety, stress, and insomnia.

Background: Sleep disturbances and mental health disorders represent a significant public health concern. Medical students, in particular, experience intense academic pressure, long study hours, irregular schedules, and the emotional burden of clinical training, all of which may contribute to the development of sleep disturbances and mental health issues. This study aims to assess sleep quality and the prevalence of symptoms of depression, anxiety, and stress among medical students, as well as their interrelationships. Methods: This multicentric cross-sectional study was conducted in January and February 2025 among medical students from two medical faculties in Croatia. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), while symptoms of depression, anxiety, and stress were evaluated using Depression, Anxiety, and Stress Scale-21 (DASS-21). Results: The study included 386 participants, of whom 96 were male and 290 were female students. It was found that 67.9% of students had poor sleep quality, while symptoms of depression, anxiety, and stress were reported by 38.8%, 45.3%, and 40.4% of participants, respectively. Female students exhibited higher PSQI scores (U = 10,205, p < 0.001), as well as higher levels of depression (U = 10,372, p < 0.001), anxiety (U = 10,328, p < 0.001), and stress scores (U = 10,560, p < 0.001). Additionally, significant moderate positive correlations were observed between the total PSQI score and depression (ρ = 0.566, p < 0.001), anxiety (ρ = 0.489, p < 0.001), and stress scores (ρ = 0.503, p < 0.001). Moreover, an increase in depression (β = 0.178, p < 0.001) and anxiety scores (β = 0.141, p < 0.001) contributed to a higher total PSQI score, indicating poorer sleep quality. Conclusions: A high prevalence of poor sleep quality and symptoms of depression, anxiety, and stress was observed among medical students, with female students exhibiting higher levels of these variables. Furthermore, poorer sleep quality was associated with higher levels of depression, anxiety, and stress.

This study employs a network analysis approach to explore the interconnections between anxiety, depression, and sleep problems and smartphone addiction among college students using network analysis, offering a new perspective on these prevalent mental health issues.

A cross-sectional study was conducted among art students at a public university in the province of Fujian, China. Data were collected using the Generalized Anxiety Disorder Scale-7, Patient Health Questionnaire-9, Pittsburgh Sleep Quality Index, and Mobile Phone Addiction Index. The R package was used in the analysis for statistical analysis, and information was collected using multi-stage sampling as well as stratified sampling. Network analysis was utilized to identify bivariate associations between symptoms, core components, co-occurring patterns, and key nodes within the network. Network stability and accuracy were assessed using the bootstrap method, and network comparisons were conducted across subgroups based on gender, residential condition, and sibling status.

The study included 2,057 participants. The network analysis revealed uncontrollable worry as the most central symptom, with low energy and excessive worry also identified as key symptoms within the network. Bridge symptoms such as daytime dysfunction, self-harm or suicidal ideation, abnormal behavior and speech, and sensory fear were found to be critical in linking anxiety, depression, and sleep problems. The network of comorbid symptoms and smartphone addiction highlighted inefficiency and loss of control as central factors influencing mental health. No significant differences in network characteristics were found across the subgroups, suggesting the universality of the identified network structure.

This study delineates the intricate network of anxiety, depression, sleep problems, and smartphone addiction among college students, identifying key symptomatic intersections and their implications for mental health.

Objective: We examined how mentorship, remote participation, and COVID-19 challenges were associated with the mental health of college students participating in summer research programs. Participants: Participants were students participating in 78 National Science Foundation (NSF) Research Experiences for Undergraduate (REU) Sites during Summer 2022 (n = 516 students). Methods: We used multivariable generalized estimating equations that account for clustering by REU Site. Results: Students with more competent mentors had reduced depression severity. Students who spent ≥25% of their time doing remote research or ≥25% of their time in remote meetings and workshops had greater depression severity. Remote research was also associated with anxiety severity. Having a COVID-19 challenge that impacted students' research experience was associated with increases in depression and anxiety severity. Conclusions: Results suggest potential interventions: implement strategies to boost mentor competency and scaffold a support system into summer research programs to enhance student wellbeing. Additional research on remote engagement is needed.

Physical activity and experiencing bullying is a protective and risk factor for mental health, respectively. Adolescents who suffer from bullying tend to be trapped in rumination, leading to mental health problem. However, the interaction among them from the perspective of increasing protective factors and reducing risk factors is unclear. This study explored whether rumination mediated the association between experiencing bullying and mental health problems and the moderating role of physical activity.

This study investigated 13,983 students from high school in Jiangxi Province, China, and assessed for experiencing bullying, rumination, mental health problems (depressive, anxiety, and insomnia symptoms), and physical activity. Moderated mediation analysis was conducted using R software (version 4.1.1).

Significant differences were observed in rumination, physical activity and mental health problems between adolescents who have experienced bullying and those who have not (p < 0.001). Rumination mediated the relationship between experiencing bullying and depressive symptoms (β= 0.45, 95 % CI [0.42, 0.48]), anxiety symptoms (β= 0.37, 95 % CI [0.35, 0.39]), and insomnia symptoms (β= 0.36, 95 % CI [0.33, 0.38]). Moreover, physical activity moderated the relationship between rumination and depressive symptoms (coeff = -0.03, p < 0.001), anxiety symptoms (coeff = -0.02, p < 0.001), and insomnia symptoms (coeff = -0.01, p < 0.001).

Rumination and physical activity mediated and moderated, respectively, the relationship between experiencing bullying and adolescents' mental health problems. These findings indicate that schools and society should establish a campus bullying early warning system, pay attention to bullying incidents and promote physical activity.

Graduate students face higher depression rates worldwide, which were further exacerbated during the COVID-19 pandemic. This study employed a machine learning approach to predict depressive symptoms using academic-related stressors.

We surveyed students across four graduate programs at a Federal University in Brazil between October 15, 2021, and March 26, 2022, when most activities were restricted to taking place online due to the pandemic. Through an online self-reported screening, participants rated ten academic stressors and completed the Patient Health Questionnaire (PHQ-9). Machine learning analysis tested whether the stressors would predict depressive symptoms. Gender, age, and race and ethnicity were used as covariates in the predictive model.

Participants (n=172), 67.4 % women, mean age: 28.0 (SD: 4.53) fully completed the online questionnaires. The machine learning approach, employing an epsilon-insensitive support vector regression (Ɛ-SVR) with a k-fold (k=5) cross-validation strategy, effectively predicted depressive symptoms (r=0.51; R2=0.26; NMSE=0.79; all p=0.001). Among the academic stressors, those that made the greatest contribution to the predictive model were "fear and worry about academic performance", "financial difficulties", "fear and worry about academic progress and plans", and "fear and worry about academic deadlines".

This study highlights the vulnerability of graduate students to depressive symptoms caused by academic-related stressors during the COVID-19 pandemic through an artificial intelligence methodology. These findings have the potential to guide policy development to create intervention programs and public health initiatives targeted towards graduate students.

The social identity model of identity change (SIMIC) posits that social group memberships protect well-being during transitional periods, such as the transition to university, via two pathways - maintaining previously held social group memberships (social identity continuity) and gaining new social group memberships (social identity gain). Breaking new ground, this study investigates how these processes can influence an important biomarker of stress - cortisol awakening response (CAR). A total of 153 first year undergraduate students (69.3% female) completed measures (group memberships, depression, life satisfaction) at the beginning of the academic year (October, time 1; T1), of which 67 provided a saliva sample for CAR assessment. Seventy-nine students completed the time 2 (February, T2) measures 4 months later (41 provided saliva). Academic performance was assessed objectively through end-of-academic year university grade data (June, T3). At T1, students who maintained and gained social group memberships reported lower depressive symptoms and greater life satisfaction. Across the academic year, social identity gain was associated with a larger post-awakening cortisol response at T2, indicative of a better ability to cope with stress. Thus, gaining new social group memberships during the transition to university was associated with a better ability to cope with stress.

Increasing mental health problems among university students highlight the need for scalable, effective solutions. We have developed a transdiagnostic mobile intervention called ROOM, promoting adaptive emotion regulation (ER) skills among university students. Understanding how the intervention works and optimising content and delivery is essential for creating an effective and adaptive system. Therefore, this study aimed to optimise ROOM through a sequential explanatory mixed-methods design, combining a Micro-Randomized Trial (MRT), evaluating within-person effects using repeated randomisation, with user experience interviews. 161 university students (82% females) participated in a 3-week MRT to assess the intervention proximal outcomes, that is, participants' positive and negative emotional states after completing intervention exercises. Additionally, we evaluated impact on distal outcomes (i.e., distress symptoms and ER skills), and user experience by combining objective (e.g., exercise completion rates) and subjective (e.g., exercise likability and helpfulness ratings) engagement patterns with insights from the semi-structured interviews (n = 18). Upon receiving the intervention, positive emotional states increased and negative ones decreased. The effect on positive emotional states gradually decreased over time while the effect on negative emotional states remained stable throughout the 3-week intervention period. Distress symptoms and ER skills either remained stable or improved over the 3 weeks, which indicated the intervention's safety. Overall, engagement patterns and interview data show that the intervention was well received, students enjoyed this study design and found context-sensitive content recommendations highly relevant.

Mental health problems in university students are associated with many negative outcomes, yet there is a gap between need and timely access to help. Single-session interventions (SSIs) are designed to be scalable and accessible, delivering core evidence-based intervention components within a one-off encounter.

COMET (Common Elements Toolbox) is an online self-help SSI that includes behavioral activation, cognitive restructuring, gratitude, and self-compassion. COMET has previously been evaluated in India, Kenya, and the United States with promising results. This study tests the acceptability, appropriateness, perceived utility, and efficacy of COMET among UK university students during the peripandemic period.

We conducted a randomized controlled trial evaluating the efficacy of COMET compared with a control group, with 2- and 4-week follow-ups. Outcome variables were subjective well-being, depression severity, anxiety severity, positive affect, negative affect, and perceived stress. We also measured intervention satisfaction immediately after completion of COMET. All UK university students with access to the internet were eligible to participate and were informed of the study online. The data were analyzed using linear mixed models and reported in accordance with the CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile Health Applications and Online Telehealth) checklist.

Of the 831 people screened, 468 participants were randomized to a condition, 407 completed the postintervention survey, 147 returned the 2-week follow-up survey, 118 returned the 4-week follow-up survey, and 89 returned both. Of the 239 randomized, 212 completed COMET. Significant between-group differences in favor of the COMET intervention were observed at 2-week follow-ups for subjective well-being (Warwick-Edinburgh Mental Well-Being Scale; mean difference [MD] 1.39, 95% CI 0.19-2.61; P=.03), depression severity (9-item Patient Health Questionnaire; MD -1.31, 95% CI -2.51 to -0.12; P=.03), and perceived stress (4-item Perceived Stress Scale; MD -1.33, 95% CI -2.10 to -0.57; P<.001). Overall, participants were satisfied with COMET, with the majority endorsing the intervention and its modules as acceptable, appropriate, and exhibiting high utility. The self-compassion module was most often reported as the participants' favorite module and the behavioral activation module was their least favorite. Qualitative analysis revealed that participants found COMET generally accessible, but too long, and experienced immediate and long-term beneficial effects.

This study demonstrated high engagement with the COMET intervention, along with preliminary short-term efficacy. Almost all participants completed the intervention, but study attrition was high. Participant feedback indicated a high level of overall satisfaction with the intervention, with perceived accessibility, immediate benefits, and potential long-term impact being notable findings. These findings support the potential value of COMET as a mental health intervention and highlight important areas for further improvement.

ClinicalTrials.gov NCT05718141; https://clinicaltrials.gov/ct2/show/NCT05718141.

Motivation for the study. College students are exposed to numerous stressful events, which predispose them to problems such as depression and anxiety, leading to increased consumption of psychotropic medications. Main findings. The use of psychotropic medications was reported by 12.0% of students, being higher among those with access to health insurance and diagnosed with depression and anxiety, as well as among those who reported using illicit drugs and who were dissatisfied with their academic performance. We found lower consumption of psychotropic drugs among women who consumed alcoholic beverages. Implications. The evidence from this study may support actions to promote not only rational drug use campaigns, but also measures to minimize and help students with the stress of academic life.

To analyze the consumption of psychotropic drugs and their associated factors in university students, stratified by sex.

We conducted a cross-sectional study with undergraduate students of a public university in Brazil. The instrument was an online self-administered questionnaire. The outcome variable was the use of psychotropic drugs, based on the Anatomical Therapeutic Chemical (ATC) classification system, and the exposure variables were socio-demographic, academic and health-related. The association between the exposure variables and the outcome was verified by calculating prevalence ratios and their 95% confidence intervals.

We found that 12.2% (n=396) of the 3238 participants used psychotropic drugs; most were women (78.3%). The prevalence of psychotropic drug use was higher among students with access to health insurance, diagnosis of depression and diagnosis of anxiety. It was also higher in the group of women who reported using illicit drugs in the last three months and in the group of men who reported being dissatisfied or very dissatisfied with their academic performance. We detected low frequency of psychotropic drug use among women who consume alcohol on a weekly basis.

Our results show a higher frequency of psychotropic medication use in females, as well as in students with access to health insurance, diagnosis of depression and diagnosis of anxiety, regardless of sex.

Objective: This secondary analysis examined the feasibility and acceptability of a novel peer coaching model designed to improve adherence to an online self-help program based on Acceptance and Commitment Therapy (ACT), called ACT Guide. Participants: All participants (N = 152) and peer coaches were undergraduate students attending the same university. Methods: Participants were instructed to use ACT Guide for 10 wk and were randomly assigned to receive weekly peer coaching through either phone calls or text messaging. Results: We found our peer coaching model to be feasible for delivery via phone and text, however acceptability varied widely. Phone coaching performed significantly better than the text format. Conclusions: Our results support the feasibility of using peer coaching with a college student population, particularly when delivered through phone calls. However, peer coaching was only acceptable to a subset of students, potentially due to differences in level of need and individual preferences.

Suicide is a public health problem worldwide, being the fourth leading cause of death in young adult population (15-29 years). Therefore, it is important to identify its risk and protective factors, and how they interact to develop more effective interventions. The present study aims to analyze the relation between depressive symptoms, hopelessness (risk factors) with reasons for living (protective factors) and suicidal ideation in young adults with and without previous suicide attempts.

A sample of 845 Portuguese young adults answered an online form which assessed suicidal ideation, hopelessness, depressive symptoms, and reasons for living. Mean comparisons, correlations, and moderated mediation analysis were computed.

Individuals with a history of suicide attempt showed higher mean levels in risk factors, compared to individuals without suicide attempt. When no history of suicide attempt was present, ideation was positively and significantly correlated to depression and hopelessness, and negatively correlated to the reasons for living. Higher levels of depressive symptomatology predict lower levels of reasons for living. Mediation and moderation relations were assessed in a model and the history of suicide attempts showed a relevant role.

The evidence found in this study reinforce that reasons for living may play a preponderant role in suicidal ideation, that is as a negative mediator and therefore it can act as a protective factor.

This study sought to explore the relationship between sociodemographic-, mental health-, knowledge-, attitudinal-, and conformity to masculine norms variables with suicide literacy, suicide stigma, and help-seeking attitudes among men in a university setting (n = 471) in Ireland. Multiple linear regression with backward elimination was used to determine the independent variables associated with suicide literacy, suicide stigma, and help-seeking attitudes. Lower suicide literacy was associated with an ethnic minority background, living in a rural community, postgraduate students compared to undergraduate students, no depression symptoms in the past year, decreasing loneliness, greater suicide stigma, more negative help-seeking attitudes, lower resilience, greater conformity to the masculine norm power over women and lower conformity to the masculine norm emotional control. Greater suicide stigma was associated with a non-ethnic minority background, all departments of study compared to health and sports science, lower suicide literacy, more negative help-seeking attitudes, and greater conformity to the masculine norms of power over women, dominance, and heterosexual self-presentation. More negative help-seeking attitudes were associated with no generalized anxiety disorder symptoms in the past year, depression symptoms in the past year, greater suicide risk, lower suicide literacy, greater suicide stigma, greater resilience, and greater conformity to the masculine norms emotional control, self-reliance, violence, and heterosexual self-presentation. Findings highlight a need for gender-responsive psychoeducational programmes to target suicide literacy, suicide stigma, and/or help-seeking attitudes among men in university settings. They also highlight that such initiatives need to be co-produced alongside ethnic minority and rural-dwelling men to ensure they are culturally sensitive and acceptable.

The Maslach Burnout Inventory-Student Survey (MBI-SS) is a widely used instrument to assess burnout levels, which provides valuable insight into their psychological well-being. Accurate measurement of burnout is crucial for developing interventions aimed at reducing stress and promoting mental health among students. This study aims to validate the MBI-SS when applied among Thai university students and to examine whether the psychometric properties of the scale are consistent with the original conceptual framework. A total of 413 undergraduate students from Thailand participated in the study, with 57.63% females and 42.37% males, and a mean age 21.75 years (SD = 2.40). The MBI-SS was translated into Thai by following rigorous procedures to maintain accuracy and cultural relevance. The factorial structure of the MBI-SS Thai version was evaluated using confirmatory factor analysis (CFA) for both a three-factor model and second-order factor model. The Thai version of the MBI-SS demonstrated a three-dimensional structure consistent with the original inventory, with excellent model fit indices. All item factor loadings exceeded the recommended threshold, and the instrument showed high internal consistency, establishing it a valuable tool for future research and practical application in educational settings aimed at addressing and reducing student burnout.

Addressing the effects of non-compliance with health-related recommendations in pandemics is needed for informed decision-making. This longitudinal study investigated the effects of non-compliance on mental health and academic self-efficacy among university students in Sweden.

Baseline assessments were conducted in May 2020, with follow-ups after 5 and 10 months. Students (n = 3123) from 19 universities completed online questionnaires covering compliance, mental health, and academic self-efficacy. Effects of non-compliance were estimated using causal inference and multilevel multinomial regression.

Non-compliant students constituted a minority, but their proportion increased over time. Regarding mental health and academic self-efficacy, few differences were observed between compliant and non-compliant students. When differences were identified, non-compliant students experienced fewer negative effects on mental health and academic self-efficacy than compliant students.

The findings may suggest that non-compliance may have involved a trade-off between increased individual freedom and mitigating negative outcomes. Addressing the research gap on non-compliance effects is crucial for informed decision-making and promoting the common good. This may guide strategies balancing individual autonomy and collective well-being during future pandemics.

Center for Open Science (OSF), https://accounts.osf.io/login?service=https://osf.io/37dhm/ .

Background: Asian American (AA) young adults, including AA college students, may experience more suicidal thoughts and behaviors (STBs) compared to other racial and ethnic groups of the same age. To the best of our knowledge, this study is the first systematic review of the risk and protective factors for STBs with a focus on AA young adults. Methods: Informed by the social-ecological perspective and the cultural model and theory of suicide, this study systematically reviews the risk and protective factors for STBs among AA young adults. Based on 22 research articles published between 1998 and 2023, we analyzed and discussed the effects of 37 risk and 15 protective factors at the individual, relationship, community, societal, and cultural levels. Results: Most risk factors are at the individual level (e.g., depressive symptoms and hopelessness), followed by factors at the cultural level (e.g., acculturation and acculturative stress), the relationship level (e.g., family problems and romantic relationship problems), the community level (e.g., verbal threats on campus), and the societal level (e.g., public stigma about mental health). Also, most protective factors are at the individual level (e.g., self-reliance and fear of suicide), followed by the relationship level (e.g., social support and family responsibilities), the community level (e.g., religious affiliations), and the cultural level (desire not to burden others). Conclusions: This systematic review emphasizes the need for future research to explore cultural factors, subgroup differences, and longitudinal designs, while advocating for culturally specific prevention and intervention strategies to improve mental health outcomes for AAYAs.

Undergraduate students are often impacted by depression, anxiety, and stress. In this context, machine learning may support mental health assessment. Based on the following research question: "How do machine learning models perform in the detection of depression, anxiety, and stress among undergraduate students?", we aimed to evaluate the performance of these models. PubMed, Embase, PsycINFO, and Web of Science databases were searched, aiming at studies meeting the following criteria: publication in English; targeting undergraduate university students; empirical studies; having been published in a scientific journal; and predicting anxiety, depression, or stress outcomes via machine learning. The certainty of evidence was analyzed using the GRADE. As of January 2024, 2,304 articles were found, and 48 studies met the inclusion criteria. Different types of data were identified, including behavioral, physiological, internet usage, neurocerebral, blood markers, mixed data, as well as demographic and mobility data. Among the 33 studies that provided accuracy assessment, 30 reported values that exceeded 70%. Accuracy in detecting stress ranged from 63% to 100%, anxiety from 53.69% to 97.9%, and depression from 73.5% to 99.1%. Although most models present adequate performance, it should be noted that 47 of them only performed internal validation, which may overstate the performance data. Moreover, the GRADE checklist suggested that the quality of the evidence was very low. These findings indicate that machine learning algorithms hold promise in Public Health; however, it is crucial to scrutinize their practical applicability. Further studies should invest mainly in external validation of the machine learning models.

Accumulating research on mental health emphasizes the general factor of psychopathology (p-factor) that unites various mental health issues. This study develops a psychopathological vulnerability assessment for youths, evaluating its psychometric properties and clinical utility. An umbrella review conceptualized multifactor psychopathological vulnerability, leading to a 57-item pool. A total of 11,224 individuals participated in this study. The resulting 22-item psychopathological vulnerability index (PVI) fitted the unidimensional Rasch model, demonstrating a person separation reliability of 0.78 and a Cronbach's alpha of 0.84. Cut-off points of 11 and 5, derived from latent class analysis, were used to distinguish vulnerable and high-protection populations. The PVI's concurrent and predictive hit rates ranged from 36.00% to 53.57% in clinical samples. The PVI concretized the vulnerability-stress model for identifying at-risk youths and may facilitate universal interventions by integrating the theoretical foundations of bifactor S-1 models with key symptoms from network models for theoretically grounded approaches.

The purpose of this paper is to describe a bibliotherapy-based wellness initiative that was developed at the health science library at Canadian Memorial Chiropractic College.

A comprehensive literature review and consultations with stakeholders were completed. A bibliotherapy program, which included the practice of using books and reading to promote mental health, well-being, and resilience for chiropractic students, was developed and launched in January 2020. The program included shared reading, reflection, and a guided group discussion. Short readings of various genres (i.e., poetry, fiction, nonfiction) were tailored specifically to address psychological, emotional, and social challenges facing students.

The program participant feedback showed that shared reading helped students cope with anxiety, worries, and loneliness and isolation caused by the pandemic, as consistent with bibliotherapy research.

The bibliotherapy program at this 1 location seemed to be well-received by chiropractic students. The program was recognized by faculty and college administrators as a valuable addition to other mental health and wellness support services available on campus. These findings suggest future research to evaluate the potential efficacy of bibliotherapy for the mental health, well-being, and resilience of chiropractic students.

Universities worldwide are witnessing a surge in mental health problems among students, particularly in anxiety and depression. The Hopkins Symptom Checklist (HSCL) is a popular screening tool, but its reliability in identifying mental disorders remains debated. The aim of this study was to evaluate the criterion validity of the HSCL-25, HSCL-10, and HSCL-5 using 30-day prevalence of major depressive episode (MDE) and generalized anxiety disorder (GAD) from a self-administered electronic version of the Composite International Diagnostic Interview, fifth version (CIDI 5.0), as the benchmark.

Data stem from a national survey targeting students in higher education in Norway. In a 2023 follow-up study on mental disorders, 5,568 participants completed both the HSCL-25 and the CIDI. Sex-specific optimal thresholds for all HSCL versions in relation to MDE and GAD (from CIDI) were determined using the Youden Index maximization.

The optimal cut-off values for detecting MDE or GAD with the HSCL-25 were 1.96 for males and 2.20 for females, displaying a good balance between sensitivity and specificity. Similar high and balanced sensitivity and specificity patterns were found for both the HSCL-10 and HSCL-5. However, all HSCL versions overestimated prevalence rates compared to the self-administered CIDI.

All three HSCL versions showed high criterion validity. The data indicate that HSCL may be better as a screening tool than for precise estimation of MDE and GAD prevalence. For improved diagnostic accuracy, future HSCL versions should incorporate functional impairment assessment. This update would bring the HSCL into closer alignment with clinical diagnostic standards.

Common mental health problems (CMHP) are prevalent among junior doctors and medical students, and the COVID-19 pandemic has brought challenging situations with education disruptions, early graduations, and front-line work. CMHPs can have detrimental consequences on clinical safety and healthcare colleagues; thus, it is vital to assess the overall prevalence and available interventions to provide institutional-level support.

This overview summarises the prevalence of CMHPs from existing published systematic reviews and informs public health prevention and early intervention practice.

Four electronic databases were searched from 2012 to identify systematic reviews on the prevalence of CMHPs and/or interventions to tackle them.

Thirty-six reviews were included: 25 assessing prevalence and 11 assessing interventions. Across systematic reviews, the prevalence of anxiety ranged from 7.04 to 88.30%, burnout from 7.0 to 86.0%, depression from 11.0 to 66.5%, stress from 29.6 to 49.9%, suicidal ideation from 3.0 to 53.9% and one obsessive-compulsive disorder review reported a prevalence of 3.8%. Mindfulness-based interventions were included in all reviews, with mixed findings for each CMHP.

The prevalence of CMHPs is high among junior doctors and medical students, with anxiety remaining relatively stable and depression slightly increasing during the COVID-19 pandemic. Future research on mindfulness-based interventions is required for a resilient and healthy future workforce.

the researchers have followed PRISMA guidance. This overview was not registered with PROSPERO as it was conducted as part of an MSc research project.

Promoting inclusive student communities and a sense of belonging is essential for university students' well-being and mental health. Our aim in this study was to explore how universities can enhance student well-being by facilitating interactions that contribute to a sense of belonging within the university environment.

Through thematic analysis of 309 written narratives collected from students at the Norwegian University of Science and Technology (NTNU), we explored significant events related to their studies, social lives, or personal experiences.

Introduction Week is important for students' well-being, providing a key opportunity to form initial social connections and foster a sense of belonging. However, its impact is inconsistent, and building lasting relationships requires continued effort throughout the academic journey. Recognizing and addressing potential challenges when expectations are unmet is essential for enhancing student belonging.

Our findings suggest that while Introduction Week plays an essential role in breaking social barriers and ensuring immediate social inclusion, the greatest challenge lies in establishing structures that facilitate belonging and relationships throughout the entire period of studies. Recognizing the diverse needs of students, universities should offer a variety of platforms for engagement and connection to enhance student well-being.

Cognitive reappraisal, an effective emotion regulation strategy, is influenced by various individual factors. Although previous studies have established a link between negative emotion differentiation (NED) and cognitive reappraisal, the underlying neural mechanisms remain largely unknown. Using electroencephalography, this study investigates the influence and neural basis of NED in cognitive reappraisal by integrating aspects of event-related potentials, neural oscillation rhythms, and cross-frequency coupling. The findings revealed that individuals with high NED demonstrated a significant decrease in parietal late positive potential amplitudes during cognitive reappraisal, suggesting enhanced cognitive reappraisal abilities. Moreover, high NED individuals displayed increased γ synchronization, parietal α-γ coupling, and frontal θ-γ coupling when reappraising negative emotions than those with low emotion differentiation ability. Machine learning analysis of these neural indicators highlighted the superior classification and predictive accuracy of multimodal indicators for NED as opposed to unimodal indicators. Overall, this multimodal evidence provides a comprehensive interpretation of the neurophysiological mechanisms through which NED influences cognitive reappraisal and provides preliminary empirical support for personalized cognitive reappraisal interventions to alleviate emotional problems.

To investigate the effects of a 16-week Baduanjin exercise programme on the psychological status and heart rate variability (HRV) of college students in a sports-disadvantaged group, offering a theoretical basis for the potential of Baduanjin exercise to improve mental health.

This prospective study enrolled 93 college students from Wuyi University, exempt from the National Standards for Students' Physical Health due to illness or disability. The participants were divided into a control group (n = 47) and an experimental group (n = 46). Over 16 weeks, the experimental group engaged in the Baduanjin exercise, whereas the control group did not participate in regular physical training.

We assessed the Symptom Checklist-90-Revised (SCL-90-R, the primary outcome) scores and HRV (time domain and frequency domain indices, the secondary outcomes) of all participants both before and after the 16-week programme.

(1) Post-16 weeks of Baduanjin exercise, a statistically significant difference was observed in the SCL-90-R scores between the control and experimental groups (P < 0.01, P < 0.05). Notably, the scores for interpersonal sensitivity, depression, anxiety, psychoticism, and other factors (predominantly relating to sleep and diet) were significantly lower in the experimental group (t = 4.234, 2.616, 3.450, 2.226, 3.980, P < 0.01, P < 0.05). (2) Following the exercise regimen, the experimental group showed a substantial decrease in heart rate, low-frequency (LF) power, and the LF/high-frequency ratio (LF/HF ratio), and a significant increase in HF compared with the control group (t = 2.358, 4.528, - 2.595, P < 0.05 P < 0.01).

Sixteen weeks of Baduanjin exercise may substantially enhance HRV, potentially aiding in balancing sympathetic-vagal nerve activity and thus contributing to the regulation of mental health.

to evaluate of the validity of the Brazilian version of the Kessler Psychological Distress Scale, based on its internal structure, concurrent validity, and predictive validity, for the screening of psychological distress among higher education students.

methodological study with 1,034 participants, using the Kessler Psychological Distress Scale as well as the Self-Reporting Questionnaire. An analysis of the internal structure was conducted using a two-factor confirmatory factor analysis, which evaluated fit indices and hierarchical omega reliability coefficients. A Pearson's correlation test was used to assess concurrent validity, while sensitivity, specificity, areas under the ROC curve and 95% confidence intervals were used to assess predictive validity.

the bifactor model demonstrated excellent fit indices (CFI=1.000; TLI=0.999; SRMR=0.019; RMSEA=0.028; 95%CI: 0.015 - 0.041) as well as high reliability (ωH=0.886). It was observed that there was a strong correlation between the K10 and the SRQ (r=0.813; 95%CI: 0.784 - 0.837). The ideal cut-off point for screening was identified as being higher than 21, with a sensitivity of 85.2% and a specificity of 82.9%.

the structure composed of a general factor, psychological distress, demonstrated a high level of reliability. The scale demonstrated concurrent and predictive validity for the assessment of psychological distress among university students.

To date, a number of intra- and interpersonal functions of non-suicidal self-injury (NSSI) have been identified. Yet, their association with persistence of NSSI and suicide risk remains unknown. The study aimed to investigate which functions of NSSI are associated with its persistence and suicide risk in university students using a network analysis.

Altogether, 830 university students reporting a lifetime history of NSSI were enrolled. The persistence of NSSI was defined as its presence over preceding 12 months.

Persistent NSSI was directly connected to the nodes representing two functions of NSSI: affect regulation and self-punishment. Suicide risk was directly connected to the anti-suicide function of NSSI. The shortest pathway from persistent NSSI to suicide risk led through depressive symptoms. Other likely pathways (three mediating nodes) led through the functions of NSSI (affect regulation or self-punishment, anti-dissociation, and anti-suicide). Depressive symptoms had the highest centrality. However, it did not differ significantly compared to some functions of NSSI (marking distress, anti-dissociation, toughness, and affect regulation).

In university students, persistent NSSI might be directly associated with its functions related to affect regulation and self-punishment, while suicide risk might be directly associated with the anti-suicide function. The observations posit a role of intrapersonal functions in shaping the outcomes of NSSI. Depressive symptoms and some NSSI functions might be the most promising targets for interventions in this population.