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College students' mental health has been a vital concern for researchers, policymakers, administrators, and educators since before the pandemic, and it is crucial to identify the extent to which the pandemic affected college students' mental health. The current study utilized data repeatedly collected over more than four years (2017–2022) from N = 355 students enrolled at a large public research university in the Midwestern US. The data collection period coincided with the COVID-19 pandemic's onset, facilitating systematic examination of whether and how college students' trajectories (i.e., level and slopes) of depressive symptoms, social anxiety, general disinhibition, callous aggression, and problematic alcohol use changed as the pandemic progressed. Across seven waves, surveys assessed multiple outcome and predictor domains. Multilevel growth curve modeling was used to analyze all outcomes. Depression symptoms peaked mid-pandemic, whereas social anxiety first declined then continued rising. General disinhibition and callous aggression showed non-significant changes in trajectories. Problematic alcohol use decreased continuously with no significant pandemic-associated effects in the best-fitting model. An important limitation is reliance on a sample from a single campus utilizing self-reported, non-clinical assessments. Another important limitation is the lack of location information from participants during the acute COVID-19 phase. Reported longitudinal analyses expand upon findings from previous limited repeated-measures and cross-sectional studies. In terms of clinical significance, some of the most harmful COVID-19 effects to mental health may be long-lasting and cumulative, making them difficult to detect in shorter-term or cross-sectional studies. Altogether, findings demonstrate complex changes in students' mental health that may have ongoing effects on well-being during key developmental stages. • Findings demonstrate complex changes in students' mental health. • Depression symptoms peaked mid-pandemic in January 2021. • Social anxiety first declined then continued rising. • Externalizing spectrum issues showed non-significant changes in trajectories. • Problematic alcohol use decreased continuously with no pandemic-associated effects. [ABSTRACT FROM AUTHOR]

Objective To identify academic factors pertaining to college students, calendar timing, and particular moments that are uniquely associated with elevated likelihood of prescription stimulant misuse (intentions and actual behavior) in daily life. Participants: Participants were 297 freshmen and sophomores at a large public university in the United States in 2017–2019. Methods: Participants completed survey measures during lab visits and ecological momentary assessment procedures in daily life. Hypotheses were tested using multilevel models that accounted for the nested data and demographic covariates. Results: Student, calendar-based, and momentary academic factors were uniquely associated with stimulant misuse intentions in daily life. Real-time academic events, beyond the proportion of academic events experienced, emerged as a robust predictor of misuse behavior. Within-person links between real-time momentary predictors and misuse behavior were moderated by finals week timing. Conclusions: Findings offer implications for prevention and intervention strategies for college students at risk for prescription drug misuse. [ABSTRACT FROM AUTHOR]

Background: Accurate assessment of prescription drug misuse (PDM) is critical among young-adult college students, a particularly high-risk group for this substance behavior. No studies have compared assessments of college students' reports of PDM obtained from their reporting in daily life (via ecological momentary assessment; EMA) to their retrospective accounts of PDM over the same period (via timeline follow-back interview; TLFB), an approach that is commonly used in substance use research. Purpose/Objectives: To determine day-level agreement and person-level agreement in college student reports of PDM in EMA versus TLFB methods. Methods: Participants were 297 college freshmen and sophomores (69% female) recruited based on misuse behavior in the past three months. PDM behaviors were captured in daily life using EMA for 28 days and TLFB administered during an in-person lab visit. Agreement was assessed at the person level (any PDM during the 28 days) and day level (PDM on a given day) using Cohen's kappa and percent agreement. Results: PDM was reported more frequently using TLFB compared to EMA. Person-level agreement between the two methods was good (k = 0.62, 95% CI: 0.53, 0.70), whereas day-level agreement was fair (k = 0.23, 95% CI: 0.19, 0.28). Agreement in stimulant misuse reported across methods was more consistent compared to reports of other medication classes. Conclusions: Findings offer implications for the assessment of college student PDM data in substance use research. [ABSTRACT FROM AUTHOR]