Background
Due to their impact on premature mortality and long-term disabilities, a better understanding of health risk behavior (HRB) determinants among college students is crucial in order to build ...the most appropriate prevention tools. Although self-esteem appears to be a relevant candidate, a clear picture summarizing its multiple links with HRB is lacking to guide clinicians and researchers. This study aims to provide a systematic review of the associations between health risk behavior and self-esteem among college students.
Methods
This search was performed in several databases on 02/02/17. Study eligibility criteria were original articles in peer-reviewed journals, in English; observational quantitative studies; among college students; and investigated the association between self-esteem and HRB. The PRISMA statements were complied with.
Results
One hundred fifteen articles were included: 46 on substance use, 35 on sexual behavior, 11 on nutritional habits, 27 on physical activity, and 5 on other HRB. Most studies reported an association between higher self-esteem and healthier behavior. For alcohol consumption and number of sexual partners, both negative and positive associations have been reported. Directionality was investigated in a few studies suggesting potential bidirectional effects.
Conclusions
This review points out the need for consensus for the definition of self-esteem and HRB. There was high heterogeneity in (1) the measurement of self-esteem either in the concept measured (global vs. domain) or in the way to implement validated tools; and (2) the definition of HRB. Self-esteem seems to be a relevant target to intervene on HRB, especially alcohol abuse and physical activity.
Trial Registration
Registration number: PROSPERO (ID = CRD42017056599).
The closure of bars and lockdowns related to the Covid-19 pandemic changed alcohol use levels in France during the spring of 2020. We wondered whether this sudden cessation of social interactions ...impacted students more than non-students and what factors specific to students would explain the increase in alcohol misuse. The aims of this study were to compare self-reported changes in alcohol misuse (alcohol intake and binge-drinking frequency) during the first Covid-19 lockdown from March 17 to May 10, 2020, between French students and non-students and describe factors associated with this alcohol misuse in each subgroup.
Data collected in the Confins study from April 8 to May 10, 2020, were used in cross-sectional analyses stratified by student status. Multiple logistic regression was performed to estimate the association between self-reported increase in alcohol intake or binge-drinking frequency (at least six drinks of alcohol on one occasion) and demographic, socioeconomic, and clinical factors, as well as conditions associated with the Covid-19 pandemic. The population-attributable fraction was then used to estimate the contribution of identified risk factors to increased alcohol misuse in students and non-students.
Among both students and non-students, a self-reported decrease or no change in alcohol intake or binge-drinking was more common than an increase. However, the risk factors explaining an increase in alcohol intake differed among students (≥ 25 years old, not working or studying in the health field, and having suicidal ideation during the last 7 days) and non-students (having a medical diagnosis of mental disorders). The risk factors explaining an increase in binge-drinking frequency were similar in the two subgroups (being a tobacco smoker before lockdown and not practicing any physical activity during the last 7 days), except suicidal thoughts, which was a risk factor for alcohol misuse specific to students.
These results highlight the vulnerability of certain French students to alcohol misuse and the necessity of combining both mental health and substance use-related screening in the student population.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
ObjectivesTo estimate the effect of student status on mental health condition during COVID-19 general lockdown in France.DesignCross-sectional analysis comparing students and non-students recruited ...in the same study.SettingParticipants of the web-based CONFINS study implemented during the general lockdown in France in spring 2020.Participants2260 participants (78% women) including 1335 students (59%).Primary and secondary outcome measuresThrough an online questionnaire, participants declared if they have experienced suicidal thoughts, coded their perceived stress on a 10-points scale and completed validated mental health scales (Patient Health Questionnaire-9 for depressive symptoms, Generalised Anxiety Disorder-7 for anxiety symptoms) during the last 7 days. The effect of college student status on each mental health condition was estimated using multivariate logistic regression analyses. Stratified models for students and non-students were performed to identify population-specific factors.ResultsStudent status was associated with a higher frequency of depressive symptoms (adjusted OR (aOR)=1.58; 95% CI 1.17 to 2.14), anxiety symptoms (aOR=1.51; 95% CI 1.10 to 2.07), perceived stress (n=1919, aOR=1.70, 95% CI 1.26 to 2.29) and suicidal thoughts (n=1919, aOR=1.57, 95% CI 0.97 to 2.53). Lockdown conditions that could be potentially aggravating on mental health like isolation had a higher impact on students than on non-students.ConclusionsCollege students were at higher risk of mental health disturbances during lockdown than non-students, even after taking into account several potential confounding factors. A close follow-up and monitoring of students’ mental health status is warranted during lockdown periods in this vulnerable population.
ObjectivesThe aim of the study was to estimate the association between self-esteem and subsequent self-rated health during college years, taking into account a wide range of potential ...confounders.DesignProspective longitudinal study.SettingThe French i-Share cohort.ParticipantsThe sample consisted of 1011 college students.Primary and secondary outcome measuresThe association between self-esteem and later self-rated health was evaluated using multivariate modelling.Data regarding self-rated health, global self-esteem and demographic, educational, social, behavioural, environmental and financial characteristics were collected through an internet-based questionnaire.ResultsThe 1011 participants had a median age of 21.9 years and 79% (795/1011) were females. Self-rated health was assessed a median of 8 months after the self-esteem measurement. Twenty per cent of the students declared average to very poor health (203/1011). Students with higher levels of self-esteem were more likely to declare good or very good self-rated health (adjusted OR=1.40, 95% CI 1.15 to 1.72, p value=0.001). Other factors associated with good or very good self-rated health were low body mass index, a comfortable financial situation during childhood and three personality traits (low persistence and harm avoidance and high cooperativeness).ConclusionsThis study offers novel findings on the impact of self-esteem on self-rated health among college students. Interventions targeting self-esteem should be experimented during university years in order to improve health outcomes.
Objective: To estimate the association between ADHD symptoms and suicidal ideation in college students, and to test mediation by depressive symptoms or self-esteem. Method: Based on the i-Share ...cohort (prospective cohort of 2,331 college students in France). Self-reported measures included ADHD symptoms at baseline, self-esteem and depressive symptoms at 3 months, and suicidal ideation at 1-year follow-up. We conducted path analysis to estimate total, direct, and indirect effect. Results: Participants with high ADHD symptoms were more likely to report suicidal ideation 1 year later (p < .0001). Indirect effects through depressive symptoms (p < .0001) and self-esteem (p < .0001) explained 44% and 25% of this association, respectively. An indirect pathway via a combination of self-esteem, then depressive symptoms, was also identified (p < .0001), explaining 19% of the total effect. The direct effect was not significant (p = .524). Conclusion: ADHD symptoms seem to have no direct but indirect effect through both self-esteem and depressive symptoms on suicidal ideation.
•ADHD increases the risk of suicidal ideation among students of France.•Perceived stress partially accounts for the association between ADHD and suicidal ideation.•ADHD and perceived stress were also ...independently associated with suicidal ideation.
The association between Attention Deficit Hyperactivity Disorder (ADHD) and suicidal ideation has been the focus of recent research interest among youths and young adults. However, the role perceived stress plays in this association is unclear. We investigated whether perceived stress accounts for the association between ADHD and subsequent suicidal ideation among French students enrolled in the i-Share cohort. The associations between ADHD symptoms, perceived stress at baseline, and suicidal ideation during follow-up were investigated using logistic regression models, and Structural Equation Modeling was used to estimate the indirect effect via perceived stress. In total 4333 participants (median age: 20.3 years; interquartile range: 18.7-21.8) were included in the main analyses. ADHD was associated with suicidal ideation (adjusted Odds Ratio = 1.15 95% Confidence Interval: 1.04-1.26). Perceived stress partially accounts for the association between ADHD and suicidal ideation (proportion explained 49%). Our study suggests that ADHD and perceived stress represent mental health targets for suicide prevention programs.
Abstract
Background
Cannabis use in university students is associated with academic achievement failure and health issues. The objective of the study was to evaluate the association between attention ...deficit hyperactivity disorder (ADHD) symptoms and cannabis use after 1 year among students according to previous cannabis use.
Methods
Students in France were recruited from February 2013 to July 2020 in the i-Share cohort. 4,270 participants were included (2,135 who never used cannabis at inclusion and 2,135 who did). The Adult ADHD Self-Report Scale (ASRS) was used to assess ADHD symptoms at inclusion. Cannabis use frequency was evaluated 1 year after inclusion. Multinomial regressions were conducted to assess the association between inclusion ADHD symptoms and cannabis use after 1 year.
Results
Increase in ASRS scores was linked with a greater probability to use cannabis after 1 year and to have a higher cannabis use frequency (once a year—once a month adjusted odds ratio OR: 1.24 (1.15–1.34), more than once a month adjusted OR: 1.43 (1.27–1.61)). Among participants who never used cannabis at inclusion, this association disappeared (once a year—once a month adjusted OR: 1.15 (0.95–1.39), more than once a month adjusted OR: 1.16 (0.67–2)) but remained in participants who ever used cannabis at inclusion (once a year—once a month adjusted OR: 1.17 (1.06–1.29), more than once a month adjusted OR: 1.35 (1.18–1.55)).
Conclusions
High levels of ADHD symptoms in students could lead to continued cannabis use rather than new initiations.
The aim of the present study was to investigate self-esteem associated factors related to childhood/adolescence or young-adulthood in male and female college students. Based on the i-Share cohort, ...childhood/adolescence and young-adulthood related factors were collected at study enrolment. Three months later, global self-esteem was evaluated through the Rosenberg Self-esteem Scale. Linear regression models were performed for the different time period factors (childhood/adolescence factors, young-adulthood factors) and R-squared were computed for each model. Among the 6602 college students included, 78.8 % were female with a mean age of 20.7 (SD = 2.2) and mean self-esteem score of 27.6 (SD = 5.7) for females and 30.3 (SD = 5.7) for males. Low self-esteem was associated with factors related to childhood/adolescence (weak parental support, life events, parents with depression or anxiety problems) and young adulthood (freshmen year, high BMI, dissatisfaction with social life, not practicing sports or extra-university activities). Factors related to young adulthood seem to explain more variability among males than factors related to childhood/adolescence (9 % versus 5 %), whereas the opposite was observed for females (5 % versus 7 %). Interventions targeting self-esteem should address several factors that consider period of life and gender to intervene efficiently (during childhood/adolescence for females and young-adulthood for males).
•Childhood/adolescence and young adulthood factors explained self-esteem independently from mental health conditions•Childhood/adolescence factors explained more variability in females whereas this were young-adulthood factors in males•Higher effects of parental support and economic situation during childhood on female self-esteem rather than male•Higher effects of sports practice and social life during young-adulthood on male self-esteem rather than female•Gender differences regarding period of life should guide interventional research to promote college students’ self-esteem
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