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Trends in Mood and Anxiety Symptoms and Suicide-Related Outcomes Among U.S. Undergraduates, 2007–2018: Evidence From Two National Surveys
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Purpose Past work has evidenced increased utilization of mental health services on college campuses, as well as rising rates of mood and suicide-related pathology in adolescents and young adults in recent years. We examined whether such findings are reflective of large-scale, nationwide trends in college student mental health in the past decade.Methods We examined trends in mood, anxiety, and suicide-related outcomes among U.S. college students from 2007 to 2018 across two large national datasets: (1) the National College Health Assessment (n = 610,543; mean age = 21.25 years; 67.7% female; and 72.0% white) and (2) the Healthy Minds Study (n = 177,692; 86% students aged 18-22 years; 57% female; and 74% white). Participants, randomly selected by their educational institution, completed self-report measures of past-year mood, anxiety, nonsuicidal self-injury, and suicidal thoughts and behaviors.Results In both samples, rates of depression, anxiety, nonsuicidal self-injury, suicidal ideation, and suicide attempts markedly increased over the assessed years, with rates doubling over the period in many cases. Anger, low flourishing, and suicide plans, each assessed in only one dataset, also exhibited upward trends.Conclusions Findings demonstrate a broad worsening of mental health among U.S. college students over the past decade, a concerning result meriting further attention and intervention.
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“Layered atop these well-known developmental trajectories, a series of new findings indicate that rates of these adolescent-emergent mental health problems (depressive and anxiety disorders, NSSI, and suicidal thoughts and behaviors) have been increasing worldwide -- especially over the past decade, and most notably amongst girls.(2,20–23)”
From Puberty Initiates Cascading Relationships Between Neurodevelopmental, Social, and Internalizing Processes Across Adolescence (2021) · cites this paper as [22]
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“Women appear to have a greater tendency toward emotional disorders, which could incur more suicide-related outcomes across the life course [ 83 ].”
From Anxiety and Depression Symptoms among Youth Survivors of Childhood Sexual Abuse: A Network Analysis (2023) · cites this paper as [83]
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“Over the last decade, college student depression, anxiety, and suicidal ideation has been increasing (Duffy et al., 2019; Lipson et al., 2019).”
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“including future mood and anxiety pathology and increased risk of suicidal thoughts and behaviors.(1) College student-athletes are not immune to these mental”
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Sleep irregularity and nonsuicidal self-injurious urges and behaviors
Burke, T. A., Hamilton, J. L., Seigel, D., Kautz, M. M., Liu, R. T., Alloy, L. B., & Barker, D. (2022) · SLEEP · doi:10.1093/sleep/zsac084 · Cited by 37
Hirshberg, M. J., Colaianne, B. A., Greenberg, M. T., Inkelas, K. K., Davidson, R. J., Germano, D., Dunne, J. D., & Roeser, R. W. (2022) · Mindfulness · doi:10.1007/s12671-022-01952-1 · Cited by 41
COVID-19 stressful life events and mental health: Personality and coping styles as moderators
Wang, C., Havewala, M., & Zhu, Q. (2022) · Journal of American College Health · doi:10.1080/07448481.2022.2066977 · Cited by 34
Anxiety and suicidality in the college student population
Moskow, D. M., Lipson, S. K., & Tompson, M. C. (2022) · Journal of American College Health · doi:10.1080/07448481.2022.2060042 · Cited by 33
“16 These findings underscore the importance of focusing on the college student population to be able to better prioritize and focus intervention and treatment.”
BackgroundThe Role of TikTok in Students’ Health and Wellbeing
Ramsden, E., & Talbot, C. V. (2024) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-023-01224-6 · Cited by 58
Bogardus, J., Blackinton, M. T., Litwin, B. A., Nelson, T. M., & Mitchell, K. (2021) · Journal of Physical Therapy Education · doi:10.1097/jte.0000000000000185 · Cited by 31
Suffoletto, B., Goldstein, T., Gotkiewicz, D., Gotkiewicz, E., George, B., & Brent, D. (2021) · JMIR Formative Research · doi:10.2196/32271 · Cited by 29
“Nationally, 31% of US college students report having a mental health diagnosis [2], and rates of mental health disorders in young adults have been increasing [3].”
BackgroundDescriptive Analysis of Mental and Physical Wellness in Collegiate Dancers
Michaels, C., Holman, A., Teramoto, M., Bellendir, T., Krautgasser-Tolman, S., & Willick, S. E. (2023) · Journal of Dance Medicine & Science · doi:10.1177/1089313x231178091 · Cited by 30
Mediating effects of negative cognitive bias and negative affect on neuroticism and depression
Pang, Y. T., & Wu, S. (2021) · Current Psychology · doi:10.1007/s12144-021-02052-4 · Cited by 31
The Associations of Common Psychological Problems With Mental Disorders Among College Students
Cuijpers, P. J., Smit, F., Aalten, P., Batelaan, N. M., Klein, A. M., Salemink, E., Spinhoven, P., Struijs, S. Y., Vonk, P., Wiers, R. W. H. J., et al. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.573637 · Cited by 43
Anxiety and Depression Symptoms among Youth Survivors of Childhood Sexual Abuse: A Network Analysis
Li, J., Jin, Y., Xu, S., Luo, X., Wilson, A., Li, H., Wang, X., Sun, X., & Wang, Y. (2023) · BMC Psychology · doi:10.1186/s40359-023-01275-3 · Cited by 29
“Women appear to have a greater tendency toward emotional disorders, which could incur more suicide-related outcomes across the life course [83].”
BackgroundMiller, R., Blakeslee, J., & Ison, C. (2020) · Children and Youth Services Review · doi:10.1016/j.childyouth.2020.104992 · Cited by 29
A Novel Peer-to-Peer Coaching Program to Support Digital Mental Health: Design and Implementation
Rosenberg, B. M., Kodish, T., Cohen, Z. D., Gong-Guy, E., & Craske, M. G. (2021) · JMIR Mental Health · doi:10.2196/32430 · Cited by 35
Digital Methods for the Spiritual and Mental Health of Generation Z: Scoping Review
Park, S. Y., Do, B., Yourell, J., Hermer, J., & Huberty, J. (2024) · Interactive Journal of Medical Research · doi:10.2196/48929 · Cited by 28
“In addition, only 1 article administered a valid measure to assess mental health, spirituality, or spiritual well-being (ie, Generalized Anxiety Disorder-7 [GAD-7]) [26].”
Castro, E. M., Dull, B. D., Hoyt, L. T., & Cohen, A. K. (2021) · Journal of Community Psychology · doi:10.1002/jcop.22678 · Cited by 33
“Importantly, anxiety was on the rise in college populations prepandemic (Duffy et al., 2019), and has further increased during the COVID‐19 pandemic (Hoyt et al., 2021; Huckins et al., 2020), due to myriad factors, including fears of the virus and social distancing mandates (Son et al.,2020).”
BackgroundMethodInfluentialJuul, L., Brorsen, E., Gøtzsche, K., Nielsen, B. L., & Fjorback, L. O. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.722771 · Cited by 28
Mental Health in the College Classroom: Best Practices for Instructors
Coleman, M. E. (2022) · Teaching sociology · doi:10.1177/0092055x221080433 · Cited by 20
“mental health, mental illness, COVID-19, inequality, best practices suicide attempts more than doubled among U.S. undergraduates (Duffy, Twenge, and Joiner 2019).”
BackgroundTrends in the epidemiology of depression and comorbidities from 2000 to 2019 in Belgium
Walrave, R., Beerten, S. G., Mamouris, P., Coteur, K., Nuland, M. V., Pottelbergh, G. V., Casas, L., & Vaes, B. (2022) · BMC Family Practice · doi:10.1186/s12875-022-01769-w · Cited by 32
Vitagliano, L. A., Wester, K. L., Jones, C. T., Wyrick, D. L., & Vermeesch, A. L. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20021451 · Cited by 38
“The number of students pursuing campus mental health resources has increased over the years [7,8]; however, college students may underutilize mental health services due to lack of information on campus resources, limited time due to busy schedules, and the stigma associated with disclosing mental health issues [9,10].”
BackgroundFreichel, R., & O’Shea, B. A. (2023) · Translational Psychiatry · doi:10.1038/s41398-023-02434-1 · Cited by 35
“It is beyond the scope of the current work to explain the worsening trends; however, various explanatory factors have been put forward [6].”
BackgroundMinichiello, A., Lawanto, O., Goodridge, W., Iqbal, A., & Asghar, M. (2022) · Project Leadership and Society · doi:10.1016/j.plas.2022.100043 · Cited by 28
“These results come at a time when recent reports describe increasing depression, anxiety, and suicidal ideation among college students (Danowitz and Beddoes, 2020; Duffy et al., 2019).”
Suicidal Mental Imagery: Investigating a Novel Marker of Suicide Risk
Lawrence, H. R., Nesi, J. L., & Schwartz‐Mette, R. A. (2021) · Emerging Adulthood · doi:10.1177/21676968211001593 · Cited by 26
“suicidal mental imagery, suicidal verbal thoughts, suicide plan, suicide, attempt, suicidal behavior Suicidal ideation and behavior are common and increasing among emerging adults (Duffy et al., 2019; Mortier et al., 2018).”
BackgroundForte, A. M., Orri, M., Brandizzi, M., Iannaco, C., Venturini, P., Liberato, D., Battaglia, C., Nöthen-Garunja, I., Vulcan, M., Brusìc, A., et al. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18147638 · Cited by 34
“This might be, in part, explained by the fact that girls are generally more prone to internalizing-spectrum symptoms [27], while boys might be more likely to show externalizing behaviors and underreport internalizing emotions [28].”
BackgroundAbelson, S., Lipson, S. K., & Eisenberg, D. (2021) · Higher education · doi:10.1007/978-3-030-66959-1_6-1 · Cited by 38
Anxiety and Food Addiction in Men and Women: Results From the Longitudinal LIFE-Adult-Study
Hussenoeder, F. S., Pabst, A., Conrad, I., Löbner, M., Engel, C., Zeynalova, S., Reyes, N., Glaesmer, H., Hinz, A., Witte, A. V., et al. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.914358 · Cited by 26
Athlete Identity and Mental Health of Student Athletes during COVID-19
Antoniak, K. S., Tucker, C. P., Rizzone, K. H., Wren, T. A. L., & Edison, B. R. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192417062 · Cited by 28
“Suicide, which is associated with depression [36], is the second leading cause of death in young adults in the United States [37].”
BackgroundBrunette, M. F., Erlich, M. D., Edwards, M. L., Adler, D. A., Berlant, J., Dixon, L., First, M. B., Oslin, D. W., Siris, S. G., & Talley, R. M. (2023) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0000000000001734 · Cited by 26
Metadata
- Authors
- Duffy, M. E., Twenge, J. M., & Joiner, T. E.
- Affiliations
- Florida State University (US)
- San Diego State University (US)
- Corresponding author
- Duffy, Mary E.
- Venue
- Journal of Adolescent Health
- Publisher
- Elsevier BV
- Published
- 2019-11
- Volume
- 65
- Issue
- 5
- Pages
- 590-598
- ISSN
- 1054-139X (ISSN-L)
- OpenAlex
- W2953777207
- Cited by
- 579
- References
- 34
- Citations by year
- 2026: 58 · 2025: 87 · 2024: 98 · 2023: 104 · 2022: 108 · 2021: 87 · 2020: 34 · 2019: 3
- FWCI
- 67.81
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Adolescent Health (acceptedVersion)
- PubMed (publishedVersion)
- Funders
- National Science Foundation (NSF 1449440)
- U.S. Department of Defense (W81XWH-16-2-0003)
- National Institute of Mental Health
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
- Keywords
- college student mental health, mood disorders, depression, anxiety, non-suicidal self-injury, suicidal ideation, suicide attempts, suicide planning, anger, eudaimonia, temporal trends, National College Health Assessment, Healthy Minds Study
- MeSH terms
- Adolescent, Affect, Anger, Anxiety, Cross-Sectional Studies, Depression, Female, Health Surveys, Humans, Male, Students, Suicide, Attempted, United States, Universities, Self-Injurious Behavior, Young Adult, Suicidal Ideation, Datasets as Topic
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