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Insufficient Coping Behavior under Chronic Stress and Mental Health Problems

Epidemiological Background

Epidemiological data indicate that 75% of subjects suffering from major psychiatric disorders or with a previous history of psychiatric disorders have had their onset of the illness between 17 and 24 years of age. This is exactly the time when college and university students receive their higher education, thereby experiencing significant levels of chronic stress over several years. Chronic stress, however, can lead to serious health problems and can affect nearly every system of the human body, as suggested by physical, cognitive, affective and behavioral symptoms. Indeed, for a certain percentage of the general population, chronic stress raises blood pressure, increases the risk of heart attack and stroke, suppresses the immune system, and increases the vulnerability to psychiatric disorders, such as anxiety, depression, or schizophrenia.

Psychological Distress among College Students

Results from general health surveys of college students are qualitatively very similar across study sites: Typically 50% of students report psychological distress (compared to only 11% of age-matched controls of the general population) and some 30% say that chronic stress significantly affects their academic performance. Among those reporting reduced academic performance, the stress-induced burden appeared to be closely related to a pronounced lack of coping skills which obviously can let things escalating on the long run.

Mental Health Problems under Chronic Stress

In consequence, almost 50% of these students show elevated alcohol consumption, 12% report suicidal thoughts, and 11% have already been treated for mental health problems. As to physical activity, nearly half of those students do not meet the "Recommendation for Adults" of the American Heart Association with respect to moderate-intensity cardio or aerobic exercise. Given these facts, it is not really surprising that (1) 35-50% of drop-outs among students appear to be related to insufficient coping skills, and (2) 85% of students who receive a diagnosis of major psychiatric disorder withdraw from college/university prior to completion of their education.

Empirical Study with Freshman Students

We aimed at developing standardized means for the "early" identification of freshman students with insufficient coping skills under chronic stress and at risk for mental health problems. Specifically, our study addressed the following questions: (1) inter-relationship of coping behavior with the factors "regular exercises", "consumption behavior", "impaired physical health", "psychosomatic disturbances", and "impaired mental health"; (2) how to draw a line between risk and non-risk cases; (3) extent to which insufficient coping skills are influenced by socio-cultural factors.

References

Mohr C, Braun S, Bridler R, Chmetz F, Delfino JP, Kluckner VJ, Lott P, Schrag Y, Seifritz E, Stassen HH: Insufficient Coping Behavior under Chronic Stress and Vulnerability to Psychiatric Disorders. Psychopathology 2014; 47: 235-243
students UZH
Fig. 6: Analysis of the academic performance of UZH students for the years 1995-2010 showed an almost constant percentage of students per year who completed their education with a masterís degree (70%), despite major changes in the demographic characteristics of the student population (UZH: University of Zurich, Switzerland).
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