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1. Neural Mixed Effects for Nonlinear Personalized Predictions

Author

Wörtwein, Torsten, Allen, Nicholas, Sheeber, Lisa B., Auerbach, Randy P., Cohn, Jeffrey F., and Morency, Louis-Philippe

Subjects
Computer Science - Machine Learning, Computer Science - Artificial Intelligence
Abstract

Personalized prediction is a machine learning approach that predicts a person's future observations based on their past labeled observations and is typically used for sequential tasks, e.g., to predict daily mood ratings. When making personalized predictions, a model can combine two types of trends: (a) trends shared across people, i.e., person-generic trends, such as being happier on weekends, and (b) unique trends for each person, i.e., person-specific trends, such as a stressful weekly meeting. Mixed effect models are popular statistical models to study both trends by combining person-generic and person-specific parameters. Though linear mixed effect models are gaining popularity in machine learning by integrating them with neural networks, these integrations are currently limited to linear person-specific parameters: ruling out nonlinear person-specific trends. In this paper, we propose Neural Mixed Effect (NME) models to optimize nonlinear person-specific parameters anywhere in a neural network in a scalable manner. NME combines the efficiency of neural network optimization with nonlinear mixed effects modeling. Empirically, we observe that NME improves performance across six unimodal and multimodal datasets, including a smartphone dataset to predict daily mood and a mother-adolescent dataset to predict affective state sequences where half the mothers experience at least moderate symptoms of depression. Furthermore, we evaluate NME for two model architectures, including for neural conditional random fields (CRF) to predict affective state sequences where the CRF learns nonlinear person-specific temporal transitions between affective states. Analysis of these person-specific transitions on the mother-adolescent dataset shows interpretable trends related to the mother's depression symptoms., Comment: camera-ready version

Published
2023
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5. Quantifying & Modeling Multimodal Interactions: An Information Decomposition Framework

Author

Liang, Paul Pu, Cheng, Yun, Fan, Xiang, Ling, Chun Kai, Nie, Suzanne, Chen, Richard, Deng, Zihao, Allen, Nicholas, Auerbach, Randy, Mahmood, Faisal, Salakhutdinov, Ruslan, and Morency, Louis-Philippe

Subjects
Computer Science - Machine Learning, Computer Science - Artificial Intelligence, Computer Science - Computation and Language, Computer Science - Computer Vision and Pattern Recognition, Computer Science - Information Theory
Abstract

The recent explosion of interest in multimodal applications has resulted in a wide selection of datasets and methods for representing and integrating information from different modalities. Despite these empirical advances, there remain fundamental research questions: How can we quantify the interactions that are necessary to solve a multimodal task? Subsequently, what are the most suitable multimodal models to capture these interactions? To answer these questions, we propose an information-theoretic approach to quantify the degree of redundancy, uniqueness, and synergy relating input modalities with an output task. We term these three measures as the PID statistics of a multimodal distribution (or PID for short), and introduce two new estimators for these PID statistics that scale to high-dimensional distributions. To validate PID estimation, we conduct extensive experiments on both synthetic datasets where the PID is known and on large-scale multimodal benchmarks where PID estimations are compared with human annotations. Finally, we demonstrate their usefulness in (1) quantifying interactions within multimodal datasets, (2) quantifying interactions captured by multimodal models, (3) principled approaches for model selection, and (4) three real-world case studies engaging with domain experts in pathology, mood prediction, and robotic perception where our framework helps to recommend strong multimodal models for each application., Comment: NeurIPS 2023. Code available at: https://github.com/pliang279/PID

Published
2023

6. Mindfulness-based real-time fMRI neurofeedback: a randomized controlled trial to optimize dosing for depressed adolescents

Author

Bloom, Paul A., Pagliaccio, David, Zhang, Jiahe, Bauer, Clemens C. C., Kyler, Mia, Greene, Keara D., Treves, Isaac, Morfini, Francesca, Durham, Katherine, Cherner, Rachel, Bajwa, Zia, Wool, Emma, Olafsson, Valur, Lee, Ray F., Bidmead, Fred, Cardona, Jonathan, Kirshenbaum, Jaclyn S., Ghosh, Satrajit, Hinds, Oliver, Wighton, Paul, Galfalvy, Hanga, Simpson, H. Blair, Whitfield-Gabrieli, Susan, and Auerbach, Randy P.

Published
2023
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7. Learning Language and Multimodal Privacy-Preserving Markers of Mood from Mobile Data

Author

Liang, Paul Pu, Liu, Terrance, Cai, Anna, Muszynski, Michal, Ishii, Ryo, Allen, Nicholas, Auerbach, Randy, Brent, David, Salakhutdinov, Ruslan, and Morency, Louis-Philippe

Subjects
Computer Science - Machine Learning, Computer Science - Artificial Intelligence, Computer Science - Computation and Language, Computer Science - Human-Computer Interaction
Abstract

Mental health conditions remain underdiagnosed even in countries with common access to advanced medical care. The ability to accurately and efficiently predict mood from easily collectible data has several important implications for the early detection, intervention, and treatment of mental health disorders. One promising data source to help monitor human behavior is daily smartphone usage. However, care must be taken to summarize behaviors without identifying the user through personal (e.g., personally identifiable information) or protected (e.g., race, gender) attributes. In this paper, we study behavioral markers of daily mood using a recent dataset of mobile behaviors from adolescent populations at high risk of suicidal behaviors. Using computational models, we find that language and multimodal representations of mobile typed text (spanning typed characters, words, keystroke timings, and app usage) are predictive of daily mood. However, we find that models trained to predict mood often also capture private user identities in their intermediate representations. To tackle this problem, we evaluate approaches that obfuscate user identity while remaining predictive. By combining multimodal representations with privacy-preserving learning, we are able to push forward the performance-privacy frontier., Comment: ACL 2021. arXiv admin note: substantial text overlap with arXiv:2012.02359

Published
2021

8. Multimodal Privacy-preserving Mood Prediction from Mobile Data: A Preliminary Study

Author

Liu, Terrance, Liang, Paul Pu, Muszynski, Michal, Ishii, Ryo, Brent, David, Auerbach, Randy, Allen, Nicholas, and Morency, Louis-Philippe

Subjects
Computer Science - Machine Learning, Computer Science - Computers and Society, Statistics - Applications
Abstract

Mental health conditions remain under-diagnosed even in countries with common access to advanced medical care. The ability to accurately and efficiently predict mood from easily collectible data has several important implications towards the early detection and intervention of mental health disorders. One promising data source to help monitor human behavior is from daily smartphone usage. However, care must be taken to summarize behaviors without identifying the user through personal (e.g., personally identifiable information) or protected attributes (e.g., race, gender). In this paper, we study behavioral markers or daily mood using a recent dataset of mobile behaviors from high-risk adolescent populations. Using computational models, we find that multimodal modeling of both text and app usage features is highly predictive of daily mood over each modality alone. Furthermore, we evaluate approaches that reliably obfuscate user identity while remaining predictive of daily mood. By combining multimodal representations with privacy-preserving learning, we are able to push forward the performance-privacy frontier as compared to unimodal approaches.

Published
2020

9. Think Locally, Act Globally: Federated Learning with Local and Global Representations

Author

Liang, Paul Pu, Liu, Terrance, Ziyin, Liu, Allen, Nicholas B., Auerbach, Randy P., Brent, David, Salakhutdinov, Ruslan, and Morency, Louis-Philippe

Subjects
Computer Science - Machine Learning, Computer Science - Distributed, Parallel, and Cluster Computing, Statistics - Machine Learning
Abstract

Federated learning is a method of training models on private data distributed over multiple devices. To keep device data private, the global model is trained by only communicating parameters and updates which poses scalability challenges for large models. To this end, we propose a new federated learning algorithm that jointly learns compact local representations on each device and a global model across all devices. As a result, the global model can be smaller since it only operates on local representations, reducing the number of communicated parameters. Theoretically, we provide a generalization analysis which shows that a combination of local and global models reduces both variance in the data as well as variance across device distributions. Empirically, we demonstrate that local models enable communication-efficient training while retaining performance. We also evaluate on the task of personalized mood prediction from real-world mobile data where privacy is key. Finally, local models handle heterogeneous data from new devices, and learn fair representations that obfuscate protected attributes such as race, age, and gender., Comment: NeurIPS 2019 Workshop on Federated Learning distinguished student paper award. Code: https://github.com/pliang279/LG-FedAvg

Published
2020

14. Impulsivity and Suicidality in Adolescent Inpatients

Author

Auerbach, Randy P, Stewart, Jeremy G, and Johnson, Sheri L

Subjects
Prevention, Clinical Research, Depression, Serious Mental Illness, Suicide Prevention, Suicide, Behavioral and Social Science, Mental Health, Pediatric, 2.3 Psychological, social and economic factors, Aetiology, Mental health, Good Health and Well Being, Adolescent, Adolescent Behavior, Adult, Female, Humans, Impulsive Behavior, Inpatients, Male, Suicidal Ideation, Suicide, Attempted, Young Adult, Adolescents, Suicide attempts, Suicide ideation, Suicide plans, Impulsivity
Abstract

Suicide is the second leading cause of death among adolescents, and impulsivity has emerged as a promising marker of risk. The present study tested whether distinct domains of impulsivity are differentially associated with suicide ideation, plans, and attempts. Adolescents (n = 381; boys = 106, girls = 275) aged 13-19 years (M = 15.62, SD = 1.41) were recruited from an acute, residential treatment program. Within 48 h of admission to the hospital, participants were administered structured clinical interviews assessing mental health disorders and suicidality. Following these interviews, participants completed self-report questionnaires assessing symptom severity and impulsivity. Consistent with past research, an exploratory factor analysis of our 90-item impulsivity instrument resulted in a three-factor solution: Pervasive Influence of Feelings, Feelings Trigger Action, and Lack of Follow-Through. Concurrent analysis of these factors confirmed hypotheses of unique associations with suicide ideation and attempts in the past month. Specifically, whereas Pervasive Influence of Feelings (i.e., tendency for emotions to shape thoughts about the self and the future) is uniquely associated with greater suicidal ideation, Feelings Trigger Action (i.e., impulsive behavioral reactivity to emotions) is uniquely associated with the occurrence of suicide attempts, even after controlling for current psychiatric diagnoses and symptoms. Exploratory gender analyses revealed that these effects were significant in female but not male adolescents. These findings provide new insight about how specific domains of impulsivity differentially increase risk for suicide ideation and attempts. Implications for early identification and prevention of youth suicide are discussed.

Published
2017

16. Cognitive Vulnerability to Depression in Canadian and Chinese Adolescents

Author

Auerbach, Randy P., Eberhart, Nicole K., and Abela, John R.

Subjects
Psychology, Child and School Psychology, Depression, Cognitive vulnerability, Diathesis-stress, Stress generation, Adolescence, China
Abstract

The goal of the current study was to compare diathesis-stress and transactional models of cognitive vulnerability to depression in samples of Canadian (n = 118) and Chinese (n = 405) adolescents. We utilized a six-month multi-wave, longitudinal design in order to examine whether (a) perceived control moderated the association between the occurrence of dependent interpersonal stressors and subsequent increases in depressive symptoms (i.e., a diathesis-stress perspective) and (b) dependent interpersonal stressors mediated the association between perceived control and subsequent increases in depressive symptoms (i.e., a transactional perspective). Results from idiographic, time-lagged, hierarchical linear modeling analyses indicated that for Canadian adolescents both diathesis-stress and transactional models were significant predictors of depressive symptomology. When examining the diathesis-stress model, boys, but not girls, who reported lower perceived control, reported higher levels of depressive symptoms following the occurrence of dependent interpersonal stress. Gender differences, however, were not present in the transactional model. In contrast, transactional, but not diathesis-stress, models were significant in Chinese adolescents, and gender differences did not emerge. Overall, these results may reflect culturally-relevant differences in the etiology of depression in Canadian and Chinese adolescents.

Published
2010

18. Mood disorders in higher education in Flanders during the 2nd and 3rd COVID-19 wave: Prevalence and help-seeking: Findings from the Flemish College Surveys (FLeCS)

Author

Bootsma, Erik, Jansen, Leontien, Kiekens, Glenn, Voorpoels, Wouter, Mortier, Philippe, Proost, Sebastian, vande Poel, Ilse, Jacobs, Karen, Demyttenaere, Koen, Alonso, Jordi, Kessler, Ronald C., Cuijpers, Pim, Auerbach, Randy P., Bruffaerts, Ronny, Bootsma, Erik, Jansen, Leontien, Kiekens, Glenn, Voorpoels, Wouter, Mortier, Philippe, Proost, Sebastian, vande Poel, Ilse, Jacobs, Karen, Demyttenaere, Koen, Alonso, Jordi, Kessler, Ronald C., Cuijpers, Pim, Auerbach, Randy P., and Bruffaerts, Ronny

Abstract

To examine the prevalence of 12-month mood disorders and receipt of mental health treatment among a volunteer sample of higher education students during the 2nd and 3rd COVID-19 wave in the Flanders region. Web-based self-report surveys were obtained from 9101 students in higher education in the Flemish College Surveys (FLeCS) in Flanders, Belgium. As part of the World Health Organization's World Mental Health–International College Student Initiative, we screened for 12-month mood disorders (major depressive episode (MDE), mania/hypomania), and service use. We used poststratification weights to generate population-representative data on key socio-demographic characteristics. 50.6% of the respondents screened positive for 12-month mood disorders (46.8% MDE, of which 22.9% with very severe impact). Use of services was very low, with estimates of 35.4% for MDE, 31.7% for mania, and 25.5% for hypomania. Even among students with very severe disorders, treatment rates were never higher than 48.3%. Most common barriers for not using services were: the preference to handle the problem alone (83.4%) and not knowing where to seek professional help (79.8%). We found a high unmet need for mood problems among college students; though caution is needed in interpreting these findings given the volunteer nature of the sample. A reallocation of treatment resources for higher education students should be considered, particulary services that focus on innovative, low-threshold, and scalable interventions.

Published
2023
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19. Childhood adversities and mental disorders in first-year college students: Results from the World Mental Health International College Student Initiative

Author

Husky, Mathilde M., Sadikova, Ekaterina, Lee, Sue, Alonso, Jordi, Auerbach, Randy P., Bantjes, Jason, Bruffaerts, Ronny, Cuijpers, Pim, Ebert, David D., Garcia, Raùl Gutiérrez, Hasking, Penelope, Mak, Arthur, McLafferty, Margaret, Sampson, Nancy A., Stein, Dan J., Kessler, Ronald C., Husky, Mathilde M., Sadikova, Ekaterina, Lee, Sue, Alonso, Jordi, Auerbach, Randy P., Bantjes, Jason, Bruffaerts, Ronny, Cuijpers, Pim, Ebert, David D., Garcia, Raùl Gutiérrez, Hasking, Penelope, Mak, Arthur, McLafferty, Margaret, Sampson, Nancy A., Stein, Dan J., and Kessler, Ronald C.

Abstract

Background This study investigates associations of several dimensions of childhood adversities (CAs) with lifetime mental disorders, 12-month disorder persistence, and impairment among incoming college students. Methods Data come from the World Mental Health International College Student Initiative (WMH-ICS). Web-based surveys conducted in nine countries (n = 20 427) assessed lifetime and 12-month mental disorders, 12-month role impairment, and seven types of CAs occurring before the age of 18: parental psychopathology, emotional, physical, and sexual abuse, neglect, bullying victimization, and dating violence. Poisson regressions estimated associations using three dimensions of CA exposure: type, number, and frequency. Results Overall, 75.8% of students reported exposure to at least one CA. In multivariate regression models, lifetime onset and 12-month mood, anxiety, and substance use disorders were all associated with either the type, number, or frequency of CAs. In contrast, none of these associations was significant when predicting disorder persistence. Of the three CA dimensions examined, only frequency was associated with severe role impairment among students with 12-month disorders. Population-attributable risk simulations suggest that 18.7-57.5% of 12-month disorders and 16.3% of severe role impairment among those with disorders were associated with these CAs. Conclusion CAs are associated with an elevated risk of onset and impairment among 12-month cases of diverse mental disorders but are not involved in disorder persistence. Future research on the associations of CAs with psychopathology should include fine-grained assessments of CA exposure and attempt to trace out modifiable intervention targets linked to mechanisms of associations with lifetime psychopathology and burden of 12-month mental disorders.

Published
2023
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21. Childhood adversities and mental disorders in first-year college students: results from the World Mental Health International College Student Initiative

Author

Husky, Mathilde M., Sadikova, Ekaterina, Lee, Sue, Alonso Caballero, Jordi, Auerbach, Randy P., Bantjes, Jason, Bruffaerts, Ronny, Cuijpers, Pim, Ebert, David Daniel, Gutiérrez Garcia, Raùl, Hasking, Penelope, Mak, Arthur, McLafferty, Margaret, Sampson, Nancy A., Stein, Dan J., Kessler, Ronald C., and WHO WMH‐ICS Collaborators

Subjects
impairment, Psychiatry and Mental health, Impairment, substance use disorders, Depression, depression, college students, childhood adversities, Childhood adversities, College students, Anxiety, Substance use disorders, Applied Psychology
Abstract

Background This study investigates associations of several dimensions of childhood adversities (CAs) with lifetime mental disorders, 12-month disorder persistence, and impairment among incoming college students. Methods Data come from the World Mental Health International College Student Initiative (WMH-ICS). Web-based surveys conducted in nine countries (n = 20 427) assessed lifetime and 12-month mental disorders, 12-month role impairment, and seven types of CAs occurring before the age of 18: parental psychopathology, emotional, physical, and sexual abuse, neglect, bullying victimization, and dating violence. Poisson regressions estimated associations using three dimensions of CA exposure: type, number, and frequency. Results Overall, 75.8% of students reported exposure to at least one CA. In multivariate regression models, lifetime onset and 12-month mood, anxiety, and substance use disorders were all associated with either the type, number, or frequency of CAs. In contrast, none of these associations was significant when predicting disorder persistence. Of the three CA dimensions examined, only frequency was associated with severe role impairment among students with 12-month disorders. Population-attributable risk simulations suggest that 18.7–57.5% of 12-month disorders and 16.3% of severe role impairment among those with disorders were associated with these CAs. Conclusion CAs are associated with an elevated risk of onset and impairment among 12-month cases of diverse mental disorders but are not involved in disorder persistence. Future research on the associations of CAs with psychopathology should include fine-grained assessments of CA exposure and attempt to trace out modifiable intervention targets linked to mechanisms of associations with lifetime psychopathology and burden of 12-month mental disorders.

Published
2022

24. Suicidal Ideation Amongst University Students During the COVID-19 Pandemic: Time Trends and Risk Factors.

Author

Jones, Laura B., Vereschagin, Melissa, Wang, Angel Y., Munthali, Richard J., Pei, Julia, Richardson, Chris G., Halli, Priyanka, Xie, Hui, Rush, Brian, Yatham, Lakshmi, Gadermann, Anne M., Pendakur, Krishna, Prescivalli, Ana Paula, Munro, Lonna, Bruffaerts, Ronny, Auerbach, Randy P., Mortier, Philippe, and Vigo, Daniel V.

Subjects
COVID-19 pandemic, SUICIDAL ideation, COLLEGE students, MENTAL depression, AT-risk students, WORD frequency
Abstract

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2023
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25. Suicidal Ideation Amongst University Students During the COVID-19 Pandemic: Time Trends and Risk Factors

Author

Jones, Laura B., primary, Vereschagin, Melissa, additional, Wang, Angel Y., additional, Munthali, Richard J., additional, Pei, Julia, additional, Richardson, Chris G., additional, Halli, Priyanka, additional, Xie, Hui, additional, Rush, Brian, additional, Yatham, Lakshmi, additional, Gadermann, Anne M., additional, Pendakur, Krishna, additional, Prescivalli, Ana Paula, additional, Munro, Lonna, additional, Bruffaerts, Ronny, additional, Auerbach, Randy P., additional, Mortier, Philippe, additional, and Vigo, Daniel V., additional

Published
2022
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26. The World Mental Health International College Student Survey in Canada: Protocol for a Mental Health and Substance Use Trend Study

Author

Jones, Laura B, primary, Judkowicz, Carolina, additional, Hudec, Kristen L, additional, Munthali, Richard J, additional, Prescivalli, Ana Paula, additional, Wang, Angel Y, additional, Munro, Lonna, additional, Xie, Hui, additional, Pendakur, Krishna, additional, Rush, Brian, additional, Gillett, James, additional, Young, Marisa, additional, Singh, Diana, additional, Todorova, Antoaneta A, additional, Auerbach, Randy P, additional, Bruffaerts, Ronny, additional, Gildea, Sarah M, additional, McKechnie, Irene, additional, Gadermann, Anne, additional, Richardson, Chris G, additional, Sampson, Nancy A, additional, Kessler, Ronald C, additional, and Vigo, Daniel V, additional

Published
2022
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27. ADHD Comorbidity Structure and Impairment: Results of the WHO World Mental Health Surveys International College Student Project (WMH-ICS)

Author

Mak, Arthur D.P., Lee, Sue, Sampson, Nancy A., Albor, Yesica, Alonso, Jordi, Auerbach, Randy P., Baumeister, Harald, Benjet, Corina, Bruffaerts, Ronny, Cuijpers, Pim, Ebert, David D., Gutierrez-Garcia, Raúl A., Hasking, Penelope, Lapsley, Coral, Lochner, Christine, Kessler, Ronald C., Mak, Arthur D.P., Lee, Sue, Sampson, Nancy A., Albor, Yesica, Alonso, Jordi, Auerbach, Randy P., Baumeister, Harald, Benjet, Corina, Bruffaerts, Ronny, Cuijpers, Pim, Ebert, David D., Gutierrez-Garcia, Raúl A., Hasking, Penelope, Lapsley, Coral, Lochner, Christine, and Kessler, Ronald C.

Abstract

Objective: To examine the prevalence of ADHD and the association of comorbid disorders, and multivariate disorder classes with role impairment in college students. Method: About 15,991 freshmen (24 colleges, 9 countries, WMH-ICS) (response rate = 45.6%) completed online WMH-CIDI-SC surveys for 6-month ADHD and six 12-month DSM-IV disorders. We examined multivariate disorder classes using latent class analysis (LCA) and simulated a population attributable risk proportions (PARPs) of ADHD-related impairment. Results: About 15.9% had ADHD, of which 58.4% had comorbidities. LCA classified ADHD respondents to pure (42.9%), internalizing (36.0%), bipolar comorbidities (11.3%), and externalizing disorder classes (9.8%). ADHD, comorbidities, and multivariate disorder classes independently predicted severe impairment. PARPs: eliminating ADHD hypothetically reduced severe impairment by 19.2%, 10.1% adjusted for comorbidities, 9.5% for multivariate disorder classes. Conclusions: ADHD and comorbid disorders are common and impairing in college students. Personalized transdiagnostic interventions guided by multivariate disorder classes should be explored.

Published
2022
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28. Guided internet-based transdiagnostic individually tailored Cognitive Behavioral Therapy for symptoms of depression and/or anxiety in college students: A randomized controlled trial

Author

Leerstoel Baar, Development and Treatment of Psychosocial Problems, Sub Molecular Microbiology, Karyotaki, Eirini, Klein, Anke M, Ciharova, Marketa, Bolinski, Felix, Krijnen, Lisa, de Koning, Lisa, de Wit, Leonore, van der Heijde, Claudia M, Ebert, David D, Riper, Heleen, Batelaan, Neeltje, Vonk, Peter, Auerbach, Randy P, Kessler, Ronald C, Bruffaerts, Ronny, Struijs, Sascha, Wiers, Reinout W, Cuijpers, Pim, Leerstoel Baar, Development and Treatment of Psychosocial Problems, Sub Molecular Microbiology, Karyotaki, Eirini, Klein, Anke M, Ciharova, Marketa, Bolinski, Felix, Krijnen, Lisa, de Koning, Lisa, de Wit, Leonore, van der Heijde, Claudia M, Ebert, David D, Riper, Heleen, Batelaan, Neeltje, Vonk, Peter, Auerbach, Randy P, Kessler, Ronald C, Bruffaerts, Ronny, Struijs, Sascha, Wiers, Reinout W, and Cuijpers, Pim

Published
2022

30. Guided internet-based transdiagnostic individually tailored Cognitive Behavioral Therapy for symptoms of depression and/or anxiety in college students: A randomized controlled trial

Author

Karyotaki, Eirini, Klein, Anke M, Ciharova, Marketa, Bolinski, Felix, Krijnen, Lisa, de Koning, Lisa, de Wit, Leonore, van der Heijde, Claudia M, Ebert, David D, Riper, Heleen, Batelaan, Neeltje, Vonk, Peter, Auerbach, Randy P, Kessler, Ronald C, Bruffaerts, Ronny, Struijs, Sascha, Wiers, Reinout W, Cuijpers, Pim, Leerstoel Baar, Development and Treatment of Psychosocial Problems, Sub Molecular Microbiology, Research of the Student Medical Service, Psychology Other Research (FMG), Ontwikkelingspsychologie (Psychologie, FMG), Psychiatry, APH - Global Health, APH - Mental Health, Leerstoel Baar, Development and Treatment of Psychosocial Problems, and Sub Molecular Microbiology

Subjects
Adult, DISORDER, Internet-based CBT, Adolescent, NETWORK METAANALYSIS, education, Psychology, Clinical, QUESTIONNAIRE, Social Sciences, Experimental and Cognitive Psychology, Depression/therapy, Anxiety, PSYCHOTHERAPY, Humans, Psychology, College students, VALIDITY, Students, Transdiagnostic, Internet, Cognitive Behavioral Therapy, Depression, Anxiety/therapy, PSYCHOLOGICAL TREATMENT, Students/psychology, INTERVIEW, Psychiatry and Mental health, Clinical Psychology, Treatment Outcome, RELIABILITY, Quality of Life, e-health, MENTAL-HEALTH, Internet-Based Intervention, INTERVENTIONS
Abstract

Common mental disorders, such as depression and anxiety, often emerge in college students during the transition into early adulthood. Mental health problems can seriously impact students' functioning, interpersonal relationships, and academic achievement. Actively reaching out to college students with mental health problems and offering them internet-based interventions may be a promising way of providing low-threshold access to evidence-based treatment in colleges. This randomized controlled trial aimed to assess the effectiveness of a guided web-based transdiagnostic individually tailored Cognitive Behavioral Therapy (iCBT) in treating college students with depression and/or anxiety symptoms. Through an online survey that screened college students' mental health, we recruited 100 college students aged ≥18 years who reported mild to moderate depression and/or anxiety symptoms and were attending colleges in the Netherlands. Participants were randomly allocated to guided iCBT (n = 48) or treatment as usual (TAU) control (n = 52). Primary outcomes were symptoms of depression and anxiety measured at post-treatment (7 weeks post-randomization). We also measured all outcomes at 6- and 12-months post-randomization. All analyses were based on the intention-to-treat principle and were repeated using the complete-case sample. We found no evidence of a difference between the effects of guided iCBT and TAU in any of the examined outcomes (i.e., symptoms of depression and anxiety, quality of life, educational achievement, and college dropout) across all time points (p > .05). There was no evidence that effects of iCBT were associated with treatment satisfaction and adherence. More research into transdiagnostic individually tailored iCBT is necessary. Further, future studies should recruit larger samples to investigate possible smaller but clinically relevant effects of internet-based interventions for college students with depression and/or anxiety. ispartof: BEHAVIOUR RESEARCH AND THERAPY vol:150 ispartof: location:England status: published

Published
2022

31. Attention-deficit/hyperactivity disorder (ADHD) comorbidity structure and impairment: Results of the WHO World Mental Health Surveys International College Student Project (WMH-ICS)

Author

Mak, Arthur D.P., Lee, Sue, Sampson, Nancy A., Albor, Yesica, Alonso, Jordi, Auerbach, Randy P., Baumeister, Harald, Benjet, Corina, Bruffaerts, Ronny, Cuijpers, Pim, Ebert, David D., Gutierrez-Garcia, Raúl A., Hasking, Penelope, Lapsley, Coral, Lochner, Christine, and Kessler, Ronald C.

Subjects
Diagnostic and Statistical Manual of Mental Disorders, Attention Deficit Disorder with Hyperactivity, Mental Disorders, Surveys and Questionnaires, Humans, Comorbidity, Students, World Health Organization, Health Surveys, Article
Abstract

OBJECTIVE: To examine the prevalence of attention-deficit/hyperactivity disorder (ADHD) and the association of comorbid disorders, and multivariate disorder classes with role impairment in college students. METHOD: 15,991 freshmen (24 colleges, 9 countries, WMH-ICS) (response rate = 45.6%) completed online WMH-CIDI-SC surveys for 6-month ADHD and six 12-month DSM-IV disorders. We examined multivariate disorder classes using latent class analysis (LCA) and simulated population attributable risk proportions (PARPs) of ADHD-related impairment. RESULTS: 15.9% had ADHD, of which 58.4% had comorbidities. LCA classified ADHD respondents to pure (42.9%), internalizing (36.0%), bipolar comorbidities (11.3%) and externalizing disorder classes (9.8%). ADHD, comorbidities and multivariate disorder classes independently predicted severe impairment. PARPs: eliminating ADHD hypothetically reduced severe impairment by 19.2%, 10.1% adjusted for comorbidities, 9.5% for multivariate disorder classes. CONCLUSIONS: ADHD and comorbid disorders are common and impairing in college students. Personalized transdiagnostic interventions guided by multivariate disorder classes should be explored.

Published
2021

32. Lifetime and 12-month treatment for mental disorders and suicidal thoughts and behaviors among first year college students

Author

Bruffaerts, Ronny, Mortier, Philippe, Auerbach, Randy P, Alonso, Jordi, Hermosillo De la Torre, Alicia E, Cuijpers, Pim, Demyttenaere, Koen, Ebert, David D, Green, Jennifer Greif, Hasking, Penelope, Stein, Dan J, Ennis, Edel, Nock, Matthew K, Pinder-Amaker, Stephanie, Sampson, Nancy A, Vilagut, Gemma, Zaslavsky, Alan M, Kessler, Ronald C, Boyes, Mark, Kiekens, Glenn, Bootsma, Erik, Husky, Mathilde, Kovess-Masfety, Viviane, Berking, Matthias, Franke, Marvin, Kaehlke, Fanny, Baumeister, Harald, Kuechler, Ann-Marie, Mak, Arthur, Siu-Oi-Ling, Benjet, Corina, Borges, Guilherme, Elena Medina-Mora, Maria, Abrego Ramirez, Adrian, Covarrubias Diaz, Anabell, Socorro Duran, Ma, Perez Tarango, Gustavo, Zavala Berbena, Maria Alicia, Gonzalez Gonzalez, Rogaciano, Gutierrez-Garcia, Raul A, Hermosillo De la Torre, Alicia Edith, Martinez Martinez, Kalina Isela, Martinez Ruiz, Sinead, Karyotaki, Eirini, O'Neill, Siobhan, Bjourson, Tony, Murray, Elaine, Lochner, Christine, Roos, Janine, Taljaard, Lian, Bantjes, Jason, Saal, Wylene, Alayo, Itxaso, Ballester, Laura, Jesus Blasco, Gabriela Barbaglia Maria, Castellvi, Pere, Isabel Cebria, Ana, Garcia-Forero, Carlos, Miranda-Mendizabal, Andrea, Pares-Badell, Oleguer, Almenara, Jose, Lagares, Carolina, Echeburua, Enrique, Gabilondo, Andrea, Iruin, Alvaro, Teresa Perez-Vazquez, Maria, Antonio Piqueras, Jose, Soto-Sanz, Victoria, Rodriguez-Marin, Jesus, Roca, Miquel, Gili, Margarida, Vives, Margarida, Green, Jennifer G, Clinical, Neuro- & Developmental Psychology, APH - Global Health, and APH - Mental Health

Subjects
Male, HELP-SEEKING, affective disorders, Psychological intervention, Health services, 0302 clinical medicine, Risk Factors, Surveys and Questionnaires, Prevalence, health service, Receipt, Psychiatry, RISK, Mental Disorders, ALCOHOL-USE DISORDERS, DEPRESSION, anxiety, Mental health treatment, PREVALENCE, Psychiatry and Mental health, Anxiety, Female, medicine.symptom, Life Sciences & Biomedicine, medicine.medical_specialty, Universities, education, ORGANIZATION, World health, Special Issues, Unmet needs, Suicidal Ideation, IDENTIFICATION TEST AUDIT, 03 medical and health sciences, Young Adult, SDG 3 - Good Health and Well-being, medicine, PLANS, Humans, HEALTH-SERVICE UTILIZATION, IDEATION, Students, suicide, Health Services Needs and Demand, Science & Technology, business.industry, college students, 030227 psychiatry, business, 030217 neurology & neurosurgery
Abstract

OBJECTIVES: Mental disorders and suicidal thoughts and behaviors (STB) are common and burdensome among college students. Although available evidence suggests that only a small proportion of the students with these conditions receive treatment, broad-based data on patterns of treatment are lacking. The aim of this study is to examine the receipt of mental health treatment among college students cross-nationally. METHODS: Web-based self-report surveys were obtained from 13,984 first year students from 19 colleges in eight countries across the world as part of the World Health Organization's World Mental Health-International College Student Initiative. The survey assessed lifetime and 12-month common mental disorders/STB and treatment of these conditions. RESULTS: Lifetime and 12-month treatment rates were very low, with estimates of 25.3-36.3% for mental disorders and 29.5-36.1% for STB. Treatment was positively associated with STB severity. However, even among severe cases, lifetime and 12-month treatment rates were never higher than 60.0% and 45.1%, respectively. CONCLUSIONS: High unmet need for treatment of mental disorders and STB exists among college students. In order to resolve the problem of high unmet need, a reallocation of resources may focus on innovative, low-threshold, inexpensive, and scalable interventions. ispartof: INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH vol:28 issue:2 ispartof: location:United States status: published

Published
2019

33. Image acquisition and quality assurance in the Boston Adolescent Neuroimaging of Depression and Anxiety study

Author

Massachusetts Institute of Technology. Department of Brain and Cognitive Sciences, Harvard University--MIT Division of Health Sciences and Technology, Martinos Imaging Center (McGovern Institute for Brain Research at MIT), McGovern Institute for Brain Research at MIT, Siless, Viviana, Hubbard, Nicholas A, Jones, Robert, Wang, Jonathan, Lo, Nicole, Bauer, Clemens CC, Goncalves, Mathias, Frosch, Isabelle, Norton, Daniel, Vergara, Genesis, Conroy, Kristina, De Souza, Flavia Vaz, Rosso, Isabelle M, Wickham, Aleena Hay, Cosby, Elizabeth Ann, Pinaire, Megan, Hirshfeld-Becker, Dina, Pizzagalli, Diego A, Henin, Aude, Hofmann, Stefan G, Auerbach, Randy P, Ghosh, Satrajit, Gabrieli, John, Whitfield-Gabrieli, Susan, Yendiki, Anastasia, Massachusetts Institute of Technology. Department of Brain and Cognitive Sciences, Harvard University--MIT Division of Health Sciences and Technology, Martinos Imaging Center (McGovern Institute for Brain Research at MIT), McGovern Institute for Brain Research at MIT, Siless, Viviana, Hubbard, Nicholas A, Jones, Robert, Wang, Jonathan, Lo, Nicole, Bauer, Clemens CC, Goncalves, Mathias, Frosch, Isabelle, Norton, Daniel, Vergara, Genesis, Conroy, Kristina, De Souza, Flavia Vaz, Rosso, Isabelle M, Wickham, Aleena Hay, Cosby, Elizabeth Ann, Pinaire, Megan, Hirshfeld-Becker, Dina, Pizzagalli, Diego A, Henin, Aude, Hofmann, Stefan G, Auerbach, Randy P, Ghosh, Satrajit, Gabrieli, John, Whitfield-Gabrieli, Susan, and Yendiki, Anastasia

Abstract

© 2020 The Authors The Connectomes Related to Human Diseases (CRHD) initiative was developed with the Human Connectome Project (HCP) to provide high-resolution, open-access, multi-modal MRI data to better understand the neural correlates of human disease. Here, we present an introduction to a CRHD project, the Boston Adolescent Neuroimaging of Depression and Anxiety (BANDA) study, which is collecting multimodal neuroimaging, clinical, and neuropsychological data from 225 adolescents (ages 14–17), 150 of whom are expected to have a diagnosis of depression and/or anxiety. Our transdiagnostic recruitment approach samples the full spectrum of depressed/anxious symptoms and their comorbidity, consistent with NIMH Research Domain Criteria (RDoC). We focused on an age range that is critical for brain development and for the onset of mental illness. This project sought to harmonize imaging sequences, hardware, and functional tasks with other HCP studies, although some changes were made to canonical HCP methods to accommodate our study population and questions. We present a thorough overview of our imaging sequences, hardware, and scanning protocol. We detail similarities and differences between this study and other HCP studies. We evaluate structural-, diffusion-, and functional-image-quality measures that may be influenced by clinical factors (e.g., disorder, symptomatology). Signal-to-noise and motion estimates from the first 140 adolescents suggest minimal influence of clinical factors on image quality. We anticipate enrollment of an additional 85 participants, most of whom are expected to have a diagnosis of anxiety and/or depression. Clinical and neuropsychological data from the first 140 participants are currently freely available through the National Institute of Mental Health Data Archive (NDA).

Published
2021

34. Investigating the effect of COVID-19 dissemination on symptoms of anxiety and depression among university students

Author

Vigo, Daniel, primary, Jones, Laura, additional, Munthali, Richard, additional, Pei, Julia, additional, Westenberg, Jean, additional, Munro, Lonna, additional, Judkowicz, Carolina, additional, Wang, Angel Y., additional, Van den Adel, Brianna, additional, Dulai, Joshun, additional, Krausz, Michael, additional, Auerbach, Randy P., additional, Bruffaerts, Ronny, additional, Yatham, Lakshmi, additional, Gadermann, Anne, additional, Rush, Brian, additional, Xie, Hui, additional, Pendakur, Krishna, additional, and Richardson, Chris, additional

Published
2021
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35. The importance of physical and mental health in explaining health-related academic role impairment among college students

Author

Wilks, Chelsey R., Auerbach, Randy P., Alonso, Jordi, Benjet, Corina, Bruffaerts, Ronny, Cuijpers, Pim, Ebert, David D., Green, Jennifer G., Mellins, Claude A., Mortier, Philippe, Sadikova, Ekaterina, Sampson, Nancy A., Kessler, Ronald C., Wilks, Chelsey R., Auerbach, Randy P., Alonso, Jordi, Benjet, Corina, Bruffaerts, Ronny, Cuijpers, Pim, Ebert, David D., Green, Jennifer G., Mellins, Claude A., Mortier, Philippe, Sadikova, Ekaterina, Sampson, Nancy A., and Kessler, Ronald C.

Abstract

Research consistently documents high rates of mental health problems among college students and strong associations of these problems with academic role impairment. Less is known, though, about prevalence and effects of physical health problems in relation to mental health problems. The current report investigates this by examining associations of summary physical and mental health scores from the widely-used Short-Form 12 (SF-12) Health Survey with self-reported academic role functioning in a self-report survey of 3,855 first-year students from five universities in the northeastern United States (US; mean age 18.5; 53.0% female). The mean SF-12 physical component summary (PCS) score (55.1) was half a standard deviation above the benchmark US adult population mean. The mean SF-12 mental component summary (MCS) score (38.2) was more than a full standard deviation below the US adult population mean. Two-thirds of students (67.1%) reported at least mild and 10.5% severe health-related academic role impairment on a modified version of the Sheehan Disability Scale. Both PCS and MCS scores were significantly and inversely related to these impairment scores, but with nonlinearities and interactions and much stronger associations involving MCS than PCS. Simulation suggests that an intervention that improved the mental health of all students with scores below the MCS median to be at the median would result in a 61.3% reduction in the proportion of students who experienced severe health-related academic role impairment. Although low-cost scalable interventions exist to address student mental health problems, pragmatic trials are needed to evaluate the effectiveness of these interventions in reducing academic role impairment.

Published
2020
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36. Binge eating and purging in first-year college students: Prevalence, psychiatric comorbidity, and academic performance

Author

Serra, Riccardo, Kiekens, Glenn, Vanderlinden, Johan, Vrieze, Elske, Auerbach, Randy P., Benjet, Corina, Claes, Laurence, Cuijpers, Pim, Demyttenaere, Koen, Ebert, David D., Tarsitani, Lorenzo, Green, Jennifer Greif, Kessler, Ronald C., Nock, Matthew K., Mortier, Phillippe, Bruffaerts, Ronny, Serra, Riccardo, Kiekens, Glenn, Vanderlinden, Johan, Vrieze, Elske, Auerbach, Randy P., Benjet, Corina, Claes, Laurence, Cuijpers, Pim, Demyttenaere, Koen, Ebert, David D., Tarsitani, Lorenzo, Green, Jennifer Greif, Kessler, Ronald C., Nock, Matthew K., Mortier, Phillippe, and Bruffaerts, Ronny

Abstract

Background: Binge eating and purging behaviors (BPB) are common among college students, but evidence is scant on prevalence and associations of BPB with mental health problems and objective academic performance. This study aims to investigate: (a) 12-month prevalence of BPB among college first-year students, (b) comorbidity patterns of BPB with various mental health problems, and (c) the association of BPB with objective academic functioning. Methods: Using data from the Leuven College Surveys (Belgium), as part of the World Mental Health Surveys International College Student initiative, we cross-sectionally assessed 12-month BPB and mental health problems among college first-year students (n = 4,889; response rate = 73.2%) at the beginning of the academic year. Objective measures of academic functioning (final grades, expressed in academic year percentage “AYP” [0–100%] and academic failure) were obtained from administrative records at the end of the academic year. Results: Twelve-month prevalence of BPB was 7.6% (7.3%binge eating and 1.0%purging), with higher rates among females than males. Bivariate models showed an association between BPB and numerous mental health problems (ORs = 3.4–18.4). Multivariate models showed associations with non-suicidal self-injury, post-traumatic stress, internalizing/externalizing problems and suicidal ideation. After controlling for sociodemographic characteristics and comorbid mental health problems, BPB were still associated with lower AYP (−4.1 to −11.2% range) and elevated odds of academic year failure (ORs = 1.4–4.2). Conclusions: BPB (especially binge eating) are relatively common and associated with mental health problems, comparatively low academic performance, and higher risk of academic failure among college first-year students. Further study is needed to examine the causal dynamics underlying these associations.

Published
2020
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37. Functional Alterations in Cerebellar Functional Connectivity in Anxiety Disorders

Author

Massachusetts Institute of Technology. Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research at MIT, Lee, Yoon Ji, Guell, Xavier, Hubbard, Nicholas, Siless, Viviana, Frosch, Isabelle, Goncalves, Mathias, Lo, Nicole, Nair, Atira, Ghosh, Satrajit S., Hofmann, Stefan G., Auerbach, Randy P., Pizzagalli, Diego A., Yendiki, Anastasia, Gabrieli, John D. E., Whitfield-Gabrieli, Susan, Anteraper, Sheeba Arnold, Massachusetts Institute of Technology. Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research at MIT, Lee, Yoon Ji, Guell, Xavier, Hubbard, Nicholas, Siless, Viviana, Frosch, Isabelle, Goncalves, Mathias, Lo, Nicole, Nair, Atira, Ghosh, Satrajit S., Hofmann, Stefan G., Auerbach, Randy P., Pizzagalli, Diego A., Yendiki, Anastasia, Gabrieli, John D. E., Whitfield-Gabrieli, Susan, and Anteraper, Sheeba Arnold

Abstract

Adolescents with anxiety disorders exhibit excessive emotional and somatic arousal. Neuroimaging studies have shown abnormal cerebral cortical activation and connectivity in this patient population. The specific role of cerebellar output circuitry, specifically the dentate nuclei (DN), in adolescent anxiety disorders remains largely unexplored. Resting-state functional connectivity analyses have parcellated the DN, the major output nuclei of the cerebellum, into three functional territories (FTs) that include default-mode, salience-motor, and visual networks. The objective of this study was to understand whether FTs of the DN are implicated in adolescent anxiety disorders. Forty-one adolescents (mean age 15.19 ± 0.82, 26 females) with one or more anxiety disorders and 55 age- and gender-matched healthy controls completed resting-state fMRI scans and a self-report survey on anxiety symptoms. Seed-to-voxel functional connectivity analyses were performed using the FTs from DN parcellation. Brain connectivity metrics were then correlated with State-Trait Anxiety Inventory (STAI) measures within each group. Adolescents with an anxiety disorder showed significant hyperconnectivity between salience-motor DN FT and cerebral cortical salience-motor regions compared to controls. Salience-motor FT connectivity with cerebral cortical sensorimotor regions was significantly correlated with STAI-trait scores in HC (R2 = 0.41). Here, we report DN functional connectivity differences in adolescents diagnosed with anxiety, as well as in HC with variable degrees of anxiety traits. These observations highlight the relevance of DN as a potential clinical and sub-clinical marker of anxiety., National Institute of Mental Health (Grant U01MH108168), NAH (Grant F32MH114525), NAH (Grant F32MH114525, R01EB021265, U01EB026996, R37MH068376, R01MH101521, R01MH119771, R56MH121426, R01EB020740, P41EB019936, R01AT007257, and R01MH099021)

Published
2020

38. Sources of Stress and Their Associations With Mental Disorders Among College Students: Results of the World Health Organization World Mental Health Surveys International College Student Initiative

Author

Karyotaki, Eirini, primary, Cuijpers, Pim, additional, Albor, Yesica, additional, Alonso, Jordi, additional, Auerbach, Randy P., additional, Bantjes, Jason, additional, Bruffaerts, Ronny, additional, Ebert, David D., additional, Hasking, Penelope, additional, Kiekens, Glenn, additional, Lee, Sue, additional, McLafferty, Margaret, additional, Mak, Arthur, additional, Mortier, Philippe, additional, Sampson, Nancy A., additional, Stein, Dan J., additional, Vilagut, Gemma, additional, and Kessler, Ronald C., additional

Published
2020
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39. Image acquisition and quality assurance in the Boston Adolescent Neuroimaging of Depression and Anxiety study

Author

Siless, Viviana, primary, Hubbard, Nicholas A., additional, Jones, Robert, additional, Wang, Jonathan, additional, Lo, Nicole, additional, Bauer, Clemens C.C., additional, Goncalves, Mathias, additional, Frosch, Isabelle, additional, Norton, Daniel, additional, Vergara, Genesis, additional, Conroy, Kristina, additional, De Souza, Flavia Vaz, additional, Rosso, Isabelle M., additional, Wickham, Aleena Hay, additional, Cosby, Elizabeth Ann, additional, Pinaire, Megan, additional, Hirshfeld-Becker, Dina, additional, Pizzagalli, Diego A., additional, Henin, Aude, additional, Hofmann, Stefan G., additional, Auerbach, Randy P., additional, Ghosh, Satrajit, additional, Gabrieli, John, additional, Whitfield-Gabrieli, Susan, additional, and Yendiki, Anastasia, additional

Published
2020
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41. Efficacy and cost-effectiveness of an unguided, internet-based self-help intervention for social anxiety disorder in university students:Protocol of a randomized controlled trial

Author

Kählke, Fanny, Berger, Thomas, Schulz, Ava, Baumeister, Harald, Berking, Matthias, Cuijpers, Pim, Bruffaerts, Ronny, Auerbach, Randy P., Kessler, Ronald C., Ebert, David Daniel, Clinical, Neuro- & Developmental Psychology, APH - Global Health, and APH - Mental Health

Subjects
Adult, Male, Universities, lcsh:RC435-571, STRESS-MANAGEMENT, Cost-Benefit Analysis, POSITIVE EVALUATION, 610 Medicine & health, Internet-based treatment, Philosophische Fakultät und Fachbereich Theologie, Self-help, Study Protocol, ddc:150, QUALITY-OF-LIFE, lcsh:Psychiatry, Humans, PHOBIA, Students, Social anxiety disorder, Psychiatry, Internet, Science & Technology, Unguided self-help, Phobia, Social, COGNITIVE-BEHAVIOR THERAPY, Economic evaluation, PUBLIC SPEAKING, University students, Self Care, PSYCHOMETRIC PROPERTIES, Treatment Outcome, ECONOMIC EVALUATIONS, Randomized controlled trial, Therapy, Computer-Assisted, Female, 150 Psychology, Social phobia, Life Sciences & Biomedicine, MENTAL-HEALTH, 1ST ONSET
Abstract

BACKGROUND: Social anxiety disorder (SAD) is highly prevalent among university students, but the majority of affected students remain untreated. Internet- and mobile-based self-help interventions (IMIs) may be a promising strategy to address this unmet need. This study aims to investigate the efficacy and cost-effectiveness of an unguided internet-based treatment for SAD among university students. The intervention is optimized for the treatment of university students and includes one module targeting fear of positive evaluations that is a neglected aspect of SAD treatment. METHODS: The study is a two arm randomized controlled trial in which 200 university students with a primary diagnosis of SAD will be assigned randomly to either a wait-list control group (WLC) or the intervention group (IG). The intervention consists of 9 sessions of an internet-based cognitive-behavioral treatment, which also includes a module on fear of positive evaluation (FPE). Guidance is delivered only on the basis of standardized automatic messages, consisting of positive reinforcements for session completion, reminders, and motivational messages in response to non-adherence. All participants will additionally have full access to treatment as usual. Diagnostic status will be assessed through Structured Clinical Interviews for DSM Disorders (SCID). Assessments will be completed at baseline, 10 weeks and 6-month follow-up. The primary outcome will be SAD symptoms at post-treatment, assessed via the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS). Secondary outcomes will include diagnostic status, depression, quality of life and fear of positive evaluation. Cost-effectiveness and cost-utility analyses will be evaluated from a societal and health provider perspective. DISCUSSION: Results of this study will contribute to growing evidence for the efficacy and cost-effectiveness of unguided IMIs for the treatment of SAD in university students. Consequently, this trial may provide valuable information for policy makers and clinicians regarding the allocation of limited treatment resources to such interventions. TRIAL REGISTRATION: DRKS00011424 (German Clinical Trials Register (DRKS)) Registered 14/12/2016. ispartof: BMC PSYCHIATRY vol:19 issue:1 ispartof: location:England status: published

Published
2019

43. Accuracy of online survey assessment of mental disorders and suicidal thoughts and behaviors in Spanish university students. Results of the WHO World Mental Health- International College Student initiative

Author

Ballester, Laura, Alayo, Itxaso, Vilagut, Gemma, Almenara, Jose, Isabel Cebria, Ana, Echeburua, Enrique, Gabilondo, Andrea, Gili, Margalida, Lagares, Carolina, Antonio Piqueras, Jose, Roca, Miquel, Soto-Sanz, Victoria, Jesus Blasco, Maria, Castellvi, Pere, Forero, Carlos G., Bruffaerts, Ronny, Mortier, Philippe, Auerbach, Randy P., Nock, Matthew K., Sampson, Nancy, Kessler, Ronald C., Alonso, Jordi, UNIVERSAL Study Grp, and Biomedicina, Biotecnología y Salud Pública

Subjects
Male, Diagnóstico clínico, Social Sciences, Mental disorders, Anxiety, Global Health, neuropsychiatric interview mini, 0302 clinical medicine, Surveys and Questionnaires, evaluación de riesgos, Psychology, Estudiants universitaris -- Salut mental, estudios de cohortes, Suicidal ideation, Salut mental, psychiatric-disorder, Depression, adulto, adulto joven, Suicide, Mental illness, Physical Sciences, Medicine, Science & Technology - Other Topics, Estudiants universitaris -- Conducta suïcida, Generalized anxiety disorder, Universities, Science, cribado sistemático, education, universidades, Neuropsychiatric Disorders, diagnostic-tests, World Health Organization, Risk Assessment, 03 medical and health sciences, Humans, Students, 1st onset, Mass screening, Survey Research, Science & Technology, Mood Disorders, Biology and Life Sciences, medicine.disease, Diagnòstic clínic, 030227 psychiatry, Mood disorders, Depressió, Mathematics, validity, Emotions, humanos, College students -- Mental health, adolescente, Surveys, Cohort Studies, sistemas en línea, screening scales, Depresión, Medicine and Health Sciences, Mass Screening, ideación suicida, 030212 general & internal medicine, Major depressive episode, Multidisciplinary, Applied Mathematics, Simulation and Modeling, face-to-face, Clinical diagnosis, Diagnostic and Statistical Manual of Mental Disorders, Multidisciplinary Sciences, Behavioral disorders, Research Design, Trastornos mentales, Female, Mental health, medicine.symptom, Algorithms, Research Article, Clinical psychology, Adult, Adolescent, Models, Psychological, Research and Analysis Methods, Neuroses, Online Systems, Suicidal Ideation, Salud mental, Young Adult, algoritmos, Mental Health and Psychiatry, College students -- Suicidal behavior, medicine, business.industry, Panic disorder, global burden, dsm-iv, Diagnostic medicine, Hypomania, Trastorns mentals, estudiantes, business, Malalties mentals, Anxiety disorders
Abstract

Objective To assess the accuracy of WMH-ICS online screening scales for evaluating four common mental disorders (Major Depressive Episode[MDE], Mania/Hypomania[M/H], Panic Disorder[PD], Generalized Anxiety Disorder[GAD]) and suicidal thoughts and behaviors[STB] used in the UNIVERSAL project. Methods Clinical diagnostic reappraisal was carried out on a subsample of the UNIVERSAL project, a longitudinal online survey of first year Spanish students (18-24 years old), part of the WHO World Mental Health-International College Student (WMH-ICS) initiative. Lifetime and 12month prevalence of MDE, M/H, PD, GAD and STB were assessed with the Composite International Diagnostic Interview-Screening Scales [CIDI-SC], the Self-Injurious Thoughts and Behaviors Interview [SITBI] and the Columbia-Suicide Severity Rating Scale [C-SSRS]. Trained clinical psychologists, blinded to responses in the initial survey, administered via telephone the Mini-International Neuropsychiatric Interview [MINI]. Measures of diagnostic accuracy and McNemar chi(2) test were calculated. Sensitivity analyses were conducted to maximize diagnostic capacity. Results A total of 287 students were included in the clinical reappraisal study. For 12-month and lifetime mood disorders, sensitivity/specificity were 67%/88.6% and 65%/73.3%, respectively. For 12-month and lifetime anxiety disorders, these were 76.8%/86.5% and 59.6%/71.1%, and for 12-month and lifetime STB, 75.9%/94.8% and 87.2%/86.3%. For 12-month and lifetime mood disorders, anxiety disorders and STB, positive predictive values were in the range of 18.1-55.1% and negative predictive values 90.2-99.0%; likelihood ratios positive were in the range of 2.1-14.6 and likelihood ratios negative 0.1-0.6. All outcomes showed adequate areas under the curve [AUCs] (AUC> 0.7), except M/H and PD (AUC = 0.6). Post hoc analyses to select optimal diagnostic thresholds led to improved concordance for all diagnoses (AUCs> 0.8). Conclusion The WMS-ICS survey showed reasonable concordance with the MINI telephone interviews performed by mental health professionals, when utilizing optimized cut-off scores. The current study provides initial evidence that the WMS-ICS survey might be useful for screening purposes., This project was supported by: Fondo de Investigacion Sanitaria, Instituto de Salud Carlos III FEDER (PI13/00343); Ministerio de Sanidad, Servicios Sociales e Igualdad, Plan Nacional Sobre Drogas PNSD (exp.2015I015); and from the DIUE of the Generalitat de Catalunya (2017SGR452). L. Ballester was supported by FPU grant (FPU15/05728); M. J. Blasco was supported byRio Hortega grant (CM14/00125); P. Castellvi and P. Mortier were supported by a Sara Borrell grant (CD12/00440, and CD18/00049, resp.). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Published
2019

44. WHO World Mental Health Surveys International College Student Project: Prevalence and Distribution of Mental Disorders

Author

Auerbach, Randy P, Mortier, Philippe, Bruffaerts, Ronny, Alonso, Jordi, Benjet, Corina, Cuijpers, Pim, Demyttenaere, Koen, Ebert, David D, Green, Jennifer Greif, Hasking, Penelope, Murray, Elaine, Nock, Matthew K, Pinder-Amaker, Stephanie, Sampson, Nancy A, Stein, Dan J, Vilagut, Gemma, Zaslavsky, Alan M, Kessler, Ronald C, Boyes, Mark, Kiekens, Glenn, Baumeister, Harald, Kaehlke, Fanny, Berking, Matthias, Ramirez, Adrian Abrego, Borges, Guilherme, Diaz, Anabell Covarrubias, Duran, Ma Socorro, Gonzalez, Rogaciano, Gutierrez-Garcia, Raul A, de la Torre, Alicia Edith Hermosillo, Martinez, Kalina Isela Martinez, Medina-Mora, Maria Elena, Zarazua, Humberto Mejia, Tarango, Gustavo Perez, Berbena, Maria Alicia Zavala, O'Neill, Siobhan, Bjourson, Tony, Lochner, Christine, Roos, Janine, Taljaard, Lian, Bantjes, Jason, Saal, Wylene, Alayo, Itxaso, Almenara, Jose, Ballester, Laura, Barbaglia, Gabriela, Blasco, Maria Jesus, Castellvi, Pere, Cebria, Ana Isabel, Echeburua, Enrique, Gabilondo, Andrea, Garcia-Forero, Carlos, Iruin, Alvaro, Lagares, Carolina, Miranda-Mendizabal, Andrea, Pares-Badell, Oleguer, Perez-Vazquez, Maria Teresa, Piqueras, Jose Antonio, Roca, Miquel, Rodriguez-Marin, Jesus, Gili, Margalida, Soto-Sanz, Victoria, Vives, Margarida, Clinical, Neuro- & Developmental Psychology, APH - Mental Health, and APH - Global Health

Subjects
Male, Psychology, Clinical, college, Social Sciences, Alcohol use disorder, ALCOHOL-USE, 0302 clinical medicine, lifetime prevalence, Prevalence, Psychology, 030212 general & internal medicine, Response rate (survey), Psychiatry, MAJOR DEPRESSIVE DISORDER, AGE-OF-ONSET, LIFETIME PREVALENCE, SEXUAL ORIENTATION, COGNITIVE-BEHAVIOR THERAPY, Substance abuse, Diagnostic and Statistical Manual of Mental Disorders, Clinical Psychology, Psychiatry and Mental health, Mental Health, Female, medicine.symptom, SDG 4 - Quality Education, Life Sciences & Biomedicine, Adult, Mental Health Services, medicine.medical_specialty, Generalized anxiety disorder, Adolescent, World Health Organization, Article, IDENTIFICATION TEST AUDIT, 03 medical and health sciences, Young Adult, INTERVIEW SCREENING SCALES, medicine, Humans, Students, Socioeconomic status, Biological Psychiatry, Science & Technology, Panic disorder, SUICIDAL THOUGHTS, medicine.disease, Mental health, Health Surveys, SUBTHRESHOLD DEPRESSION, 030227 psychiatry, mental disorders, Hypomania, 12-month prevalence
Abstract

Increasingly, colleges across the world are contending with rising rates of mental disorders, and in many cases, the demand for services on campus far exceeds the available resources. The present study reports initial results from the first stage of the WHO World Mental Health International College Student project, in which a series of surveys in 19 colleges across 8 countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States) were carried out with the aim of estimating prevalence and basic sociodemographic correlates of common mental disorders among first-year college students. Web-based self-report questionnaires administered to incoming first-year students (45.5% pooled response rate) screened for six common lifetime and 12-month DSM-IV mental disorders: major depression, mania/hypomania, generalized anxiety disorder, panic disorder, alcohol use disorder, and substance use disorder. We focus on the 13,984 respondents who were full-time students: 35% of whom screened positive for at least one of the common lifetime disorders assessed and 31% screened positive for at least one 12-month disorder. Syndromes typically had onsets in early to middle adolescence and persisted into the year of the survey. Although relatively modest, the strongest correlates of screening positive were older age, female sex, unmarried-deceased parents, no religious affiliation, nonheterosexual identification and behavior, low secondary school ranking, and extrinsic motivation for college enrollment. The weakness of these associations means that the syndromes considered are widely distributed with respect to these variables in the student population. Although the extent to which cost-effective treatment would reduce these risks is unclear, the high level of need for mental health services implied by these results represents a major challenge to institutions of higher education and governments. (PsycINFO Database Record (c) 2018 APA, all rights reserved). ispartof: JOURNAL OF ABNORMAL PSYCHOLOGY vol:127 issue:7 pages:623-638 ispartof: location:United States status: published

Published
2018

45. Accuracy of online survey assessment of mental disorders and suicidal thoughts and behaviors in Spanish university students. Results of the WHO World Mental Health- International College Student initiative

Author

Personalidad, evaluación y tratamiento psicológico, Nortasuna, balioespena eta psikologia tratamendua, Ballester, Laura, Alayo, Itxaso, Vilagut, Gemma, Almenara, José, Cebrià, Ana Isabel, Echeburúa Odriozola, Enrique, Gabilondo, Andrea, Gili, Margalida, Lagares, Carolina, Piqueras, José Antonio, Roca, Miquel, Soto Sanz, Victoria, Blasco, Maria Jesús, Castellví, Pere, Forero, Carlos G., Bruffaerts, Ronny, Mortier, Philippe, Auerbach, Randy P., Nock, Matthew K., Sampson, Nancy, Kessler, Ronald C., Alonso, Jordi, UNIVERSAL study group, Personalidad, evaluación y tratamiento psicológico, Nortasuna, balioespena eta psikologia tratamendua, Ballester, Laura, Alayo, Itxaso, Vilagut, Gemma, Almenara, José, Cebrià, Ana Isabel, Echeburúa Odriozola, Enrique, Gabilondo, Andrea, Gili, Margalida, Lagares, Carolina, Piqueras, José Antonio, Roca, Miquel, Soto Sanz, Victoria, Blasco, Maria Jesús, Castellví, Pere, Forero, Carlos G., Bruffaerts, Ronny, Mortier, Philippe, Auerbach, Randy P., Nock, Matthew K., Sampson, Nancy, Kessler, Ronald C., Alonso, Jordi, and UNIVERSAL study group

Abstract

Objective To assess the accuracy of WMH-ICS online screening scales for evaluating four common mental disorders (Major Depressive Episode[MDE], Mania/Hypomania[M/H], Panic Disorder[PD], Generalized Anxiety Disorder[GAD]) and suicidal thoughts and behaviors[STB] used in the UNIVERSAL project. Methods Clinical diagnostic reappraisal was carried out on a subsample of the UNIVERSAL project, a longitudinal online survey of first year Spanish students (18-24 years old), part of the WHO World Mental Health-International College Student (WMH-ICS) initiative. Lifetime and 12month prevalence of MDE, M/H, PD, GAD and STB were assessed with the Composite International Diagnostic Interview-Screening Scales [CIDI-SC], the Self-Injurious Thoughts and Behaviors Interview [SITBI] and the Columbia-Suicide Severity Rating Scale [C-SSRS]. Trained clinical psychologists, blinded to responses in the initial survey, administered via telephone the Mini-International Neuropsychiatric Interview [MINI]. Measures of diagnostic accuracy and McNemar chi(2) test were calculated. Sensitivity analyses were conducted to maximize diagnostic capacity. Results A total of 287 students were included in the clinical reappraisal study. For 12-month and lifetime mood disorders, sensitivity/specificity were 67%/88.6% and 65%/73.3%, respectively. For 12-month and lifetime anxiety disorders, these were 76.8%/86.5% and 59.6%/71.1%, and for 12-month and lifetime STB, 75.9%/94.8% and 87.2%/86.3%. For 12-month and lifetime mood disorders, anxiety disorders and STB, positive predictive values were in the range of 18.1-55.1% and negative predictive values 90.2-99.0%; likelihood ratios positive were in the range of 2.1-14.6 and likelihood ratios negative 0.1-0.6. All outcomes showed adequate areas under the curve [AUCs] (AUC> 0.7), except M/H and PD (AUC = 0.6). Post hoc analyses to select optimal diagnostic thresholds led to improved concordance for all diagnoses (AUCs> 0.8). Conclusion The WMS-ICS survey showed rea

Published
2019

46. Internet interventions for mental health in university students: A systematic review and meta-analysis

Author

Harrer, Mathias, Adam, Sophia H., Baumeister, Harald, Cuijpers, Pim, Karyotaki, Eirini, Auerbach, Randy P., Kessler, Ronald C., Bruffaerts, Ronny, Berking, Matthias, Ebert, David D., Harrer, Mathias, Adam, Sophia H., Baumeister, Harald, Cuijpers, Pim, Karyotaki, Eirini, Auerbach, Randy P., Kessler, Ronald C., Bruffaerts, Ronny, Berking, Matthias, and Ebert, David D.

Abstract

OBJECTIVES: Mental health disorders are highly prevalent among university students. Universities could be an optimal setting to provide evidence-based care through the Internet. As part of the World Mental Health International College Student initiative, this systematic review and meta-analysis synthesizes data on the efficacy of Internet-based interventions for university students' mental health.METHOD: A systematic literature search of bibliographical databases (CENTRAL, MEDLINE, and PsycINFO) for randomized trials examining psychological interventions for the mental health (depression, anxiety, stress, sleep problems, and eating disorder symptoms), well-being, and functioning of university students was performed through April 30, 2018.RESULTS: Forty-eight studies were included. Twenty-three studies (48%) were rated to have low risk of bias. Small intervention effects were found on depression (g = 0.18, 95% confidence interval [CI; 0.08, 0.27]), anxiety (g = 0.27, 95% CI [0.13, 0.40]), and stress (g = 0.20, 95% CI [0.02, 0.38]). Moderate effects were found on eating disorder symptoms (g = 0.52, 95% CI [0.22-0.83]) and role functioning (g = 0.41, 95% CI [0.26, 0.56]). Effects on well-being were non-significant (g = 0.15, 95% CI [-0.20, 0.50]). Heterogeneity was moderate to substantial in many analyses. After adjusting for publication bias, effects on anxiety were not significant anymore.DISCUSSION: Internet interventions for university students' mental health can have significant small-to-moderate effects on a range of conditions. However, more research is needed to determine student subsets for which Internet-based interventions are most effective and to explore ways to increase treatment effectiveness.© 2018 John Wiley & Sons, Ltd.KEYWORDS: Internet; college; mental disorders; meta-analysis; psychotherapy

Published
2019
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47. Development and psychometric properties of the health-risk behavior inventory for Chinese adolescents

Author

Wang Mengcheng, Yi Jinyao, Cai Lin, Hu Muli, Zhu Xiongzhao, Yao Shuqiao, and Auerbach Randy P

Subjects
Adolescent, Health-Risk behavior, Reliability, Validity, Medicine (General), R5-920
Abstract

Abstract Background There is a growing body of research investigating adolescent risk behaviors in China, however, a comprehensive measure that evaluates the full spectrum of relevant risk behaviors is lacking. In order to address this important gap, the current study sought to develop and validate a comprehensive tool: the Health-Risk Behavior Inventory for Chinese Adolescents (HBICA). Methods Adolescents, ages 14–19 years (n = 6,633), were recruited from high schools across 10 cities in mainland China. In addition, a clinical sample, which included 326 adolescents meeting DSM-IV criteria for Conduct Disorder, was used to evaluate predictive validity of the HBICA. Psychometric properties including internal consistency (Cronbach’s alpha), test-retest reliability, convergent validity, and predictive validity were analyzed. Results Based upon item analysis and exploratory factor analysis, we retained 33 items, and 5 factors explained 51.75% of the total variance: Suicide and Self-Injurious Behaviors (SS), Aggression and Violence (AV), Rule Breaking (RB), Substance Use (SU), and Unprotected Sex (US). Cronbach’s alphas were good, from 0.77 (RB) to 0.86 (US) for boys, and from 0.74 (SD) to 0.83(SS) for girls. The 8 weeks test–retest reliabilities were moderate, ranged from 0.66 (AV) to 0.76 (SD). External validities was strong, with Barratt Impulsiveness Scale-11 was 0.35 (p p p d = 0.79 – 2.96). Conclusions These results provide initial support for the reliability and validity of the Health-Risk Behavior Inventory for Chinese Adolescents (HBICA) as a comprehensive and developmentally appropriate assessment instrument for risk behaviors in Chinese adolescents.

Published
2012
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48. Examining the effectiveness of a web-based intervention for symptoms of depression and anxiety in college students: study protocol of a randomised controlled trial

Author

Karyotaki, Eirini, primary, Klein, Anke M, additional, Riper, Heleen, additional, Wit, Leonore de, additional, Krijnen, Lisa, additional, Bol, Eline, additional, Bolinski, Felix, additional, Burger, Simone, additional, Ebert, David D, additional, Auerbach, Randy P, additional, Kessler, Ronald C, additional, Bruffaerts, Ronny, additional, Batelaan, Neeltje, additional, van der Heijde, Claudia M, additional, Vonk, Peter, additional, Kleiboer, Annet, additional, Wiers, Reinout W, additional, and Cuijpers, Pim, additional

Published
2019
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49. Efficacy of an unguided internet‐based self‐help intervention for social anxiety disorder in university students: A randomized controlled trial

Author

Kählke, Fanny, primary, Berger, Thomas, additional, Schulz, Ava, additional, Baumeister, Harald, additional, Berking, Matthias, additional, Auerbach, Randy P., additional, Bruffaerts, Ronny, additional, Cuijpers, Pim, additional, Kessler, Ronald C., additional, and Ebert, David Daniel, additional

Published
2019
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