Trends in self-reported psychological distress among college and university students from 2010 to 2018
Open accessAbstract
Background: An increase in reported psychological distress, particularly among adolescent girls, is observed across a range of countries. Whether a similar trend exists among students in higher education remains unknown. The aim of the current study was to describe trends in self-reported psychological distress among Norwegian college and university students from 2010 to 2018. Methods: We employed data from the Students' Health and Wellbeing Study (SHoT), a nationwide survey for higher education in Norway including full-time students aged 18–34. Numbers of participants (participation rates) were n = 6065 (23%) in 2010, n = 13 663 (29%) in 2014 and n = 49 321 (31%) in 2018. Psychological distress was measured using the Hopkins Symptom Checklist-25 (HSCL-25). Results: Overall, a statistically significant increase in self-reported psychological distress was observed over time across gender and age-groups. HSCL-25 scores were markedly higher for women than for men at all time-points. Effect-size of the mean change was also stronger for women (time-by-gender interaction: χ 2 = 70.02, df = 2, p < 0.001): in women, mean HSCL-25 score increased from 1.62 in 2010 to 1.82 in 2018, yielding a mean change effect-size of 0.40. The corresponding change in men was from 1.42 in 2010 to 1.53 in 2018, giving an effect-size of 0.26. Conclusions: Both the level and increase in self-reported psychological distress among Norwegian students in higher education are potentially worrying. Several mechanisms may contribute to the observed trend, including changes in response style and actual increase in distress. The relative low response rates in SHoT warrant caution when interpreting and generalising the findings.
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The increase in mental health problems was notably stronger from 2018 to 2021 than in earlier periods.
“especially from 2018 (men: 27%/women: 45%) to 2021 (men: 41%/women: 62%, p <0.001)”
From Changes in mental health problems and suicidal behaviour in students and their associations with COVID-19-related restrictions in Norway: a national repeated cross-sectional analysis (2022) · cites this paper as [20]
The Results section, “Trends in HSCL-25 score across survey years” (page unavailable), reports increasing psychological distress through 2018 and a 2018 figure of 26.8% for men. The paper examines surveys from 2010, 2014 and 2018; it provides no 2021 figures or comparison showing that the increase after 2018 was stronger than in earlier periods. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe authors do not consider it likely that a pre-existing pattern of worsening self-reported mental health among students could account for the sudden sharp drop in mental health and increase in suicidal thoughts over just 3 years.
“we do not consider it likely that this could account for the sudden sharp drop in mental health and increase in suicidal thoughts over just 3 years.”
From Changes in mental health problems and suicidal behaviour in students and their associations with COVID-19-related restrictions in Norway: a national repeated cross-sectional analysis (2022) · cites this paper as [20]
The Results section, under ‘Trends in HSCL-25 score across survey years’ (page unavailable), documents worsening self-reported psychological distress among students from 2010 to 2018. The paper does not assess whether that earlier trend could explain a sharp change over three years or report a three-year increase in suicidal thoughts. The ‘we do not consider it likely’ judgment in the citing sentence is the citing authors’ own, not a conclusion established by this source. (LLM, conf=0.84)
Experimental — accuracy not yet measuredMeasurement invariance of HSCL-25 across time has been previously confirmed.
“We have previously confirmed measurement invariance of HSCL-25 across time.20”
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Cites
Putnick, D. L., & Bornstein, M. H. (2016) · Developmental Review · doi:10.1016/j.dr.2016.06.004 · Cited by 4,369 · cited 3× · see citing works
“Overall, the 1-factor model yielded a satisfactory fit (RMSEA = 0.077, CFI = 0.938, TLI = 0.932).”
MethodInfluentialDepression, chronic diseases, and decrements in health: results from the World Health Surveys
Moussavi, S., Chatterji, S., Verdes, E., Tandon, A., Patel, V., & Ustun, B. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61415-9 · Cited by 4,070 · see citing works
Auerbach, R. P., Collaborators, W. W.-I., Mortier, P., Bruffaerts, R., Alonso, J., Benjet, C., Cuijpers, P., Demyttenaere, K., Ebert, D. D., Green, J. G., et al. (2018) · Journal of Abnormal Psychology · doi:10.1037/abn0000362 · Cited by 2,522 · cited 1× · see citing works
“Another cross-national WHO survey, using web-based self-report questionnaires, showed that as many as one-third of first-year college students reported at least one DSM-IV anxiety, mood or substance disorder (Auerbach et al., 2018).”
BackgroundMental health problems and help-seeking behavior among college students
Hunt, J., & Eisenberg, D. (2010) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2009.08.008 · Cited by 1,949 · see citing works
Prevalence and correlates of depression, anxiety, and suicidality among university students
Eisenberg, D., Gollust, S. E., Golberstein, E., & Hefner, J. L. (2007) · American Journal of Orthopsychiatry · doi:10.1037/0002-9432.77.4.534 · Cited by 1,592 · see citing works
Blanco, C., Okuda, M., Wright, C., Hasin, D. S., Grant, B. F., Liu, S.-M., & Olfson, M. (2008) · Archives of General Psychiatry · doi:10.1001/archpsyc.65.12.1429 · Cited by 1,582 · see citing works
Psychological distress in university students: A comparison with general population data
Stallman, H. M. (2010) · Australian Psychologist · doi:10.1080/00050067.2010.482109 · Cited by 1,372 · see citing works
Mental Illness and Mental Health: The Two Continua Model Across the Lifespan
Westerhof, G. J., & Keyes, C. L. M. (2010) · Journal of Adult Development · doi:10.1007/s10804-009-9082-y · Cited by 1,345 · see citing works
Annual Research Review: Secular trends in child and adolescent mental health
Collishaw, S. (2015) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12372 · Cited by 788 · see citing works
Perfectionism is increasing over time: A meta-analysis of birth cohort differences from 1989 to 2016
Curran, T., & Hill, A. P. (2019) · Psychological Bulletin · doi:10.1037/bul0000138 · Cited by 780 · see citing works
Mental Health Service Utilization Among College Students in the United States
Eisenberg, D., Hunt, J., Speer, N., & Zivin, K. (2011) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0b013e3182175123 · Cited by 633 · see citing works
The prevalence of suicidal thoughts and behaviours among college students: a meta-analysis
Mortier, P., Cuijpers, P., Kiekens, G., Auerbach, R. P., Demyttenaere, K., Green, J. G., Kessler, R. C., Nock, M. K., & Bruffaerts, R. (2018) · Psychological Medicine · doi:10.1017/s0033291717002215 · Cited by 572 · see citing works
Baxter, A. J., Scott, K. M., Ferrari, A. J., Norman, R. E., Vos, T., & Whiteford, H. A. (2014) · Depression and Anxiety · doi:10.1002/da.22230 · Cited by 403 · see citing works
Symptoms of Emotional Distress in a Family Planning Service: Stability over a Four-Week Period
Winokur, A., Winokur, D. F., Rickels, K., & Cox, D. S. (1984) · British Journal of Psychiatry · doi:10.1192/bjp.144.4.395 · Cited by 390 · see citing works
The Health Status of Nonparticipants in a Population-based Health Study: The Hordaland Health Study
Knudsen, A. K., Hotopf, M., Skogen, J. C., Overland, S., & Mykletun, A. (2010) · American Journal of Epidemiology · doi:10.1093/aje/kwq257 · Cited by 322 · see citing works
Self-citationNettelbladt, P., Hansson, L., Stefansson, C. G., Borgquist, L., & Nordstr�m, G. (1993) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/bf00801743 · Cited by 269 · see citing works
Thombs, B. D., Kwakkenbos, L., Levis, A. W., & Benedetti, A. (2018) · Canadian Medical Association Journal · doi:10.1503/cmaj.170691 · Cited by 231 · see citing works
Mojtabai, R., Stuart, E. A., Hwang, I., Eaton, W. W., Sampson, N., & Kessler, R. C. (2015) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-015-1083-5 · Cited by 215 · see citing works
Alonso, J., Mortier, P., Auerbach, R. P., Bruffaerts, R., Vilagut, G., Cuijpers, P., Demyttenaere, K., Ebert, D. D., Ennis, E., Gutiérrez-García, R. A., et al. (2018) · Depression and Anxiety · doi:10.1002/da.22778 · Cited by 205 · see citing works
Salzer, M. S. (2012) · Journal of American College Health · doi:10.1080/07448481.2011.552537 · Cited by 191 · see citing works
Ventevogel, P., De Vries, G., Scholte, W. F., Shinwari, N. R., Faiz, H., Nassery, R., van den Brink, W., & Olff, M. (2007) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-007-0161-8 · Cited by 179 · see citing works
Sivertsen, B., Råkil, H., Munkvik, E., & Lønning, K. J. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-025200 · Cited by 97 · see citing works
Self-citationGHQ increases among Scottish 15 year olds 1987–2006
Sweeting, H., Young, R., & West, P. (2009) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-008-0462-6 · Cited by 83 · see citing works
Flagged first, then by citations
Research works printed but not linked: 29
- Arria A. M., Winick E. R., Garnier-Dykstra L. M., Vincent K. B., Caldeira K. M., Wilcox H. C., & O'Grady K. E. (2011). Help seeking and mental health service utilization among college students with a history of suicide ideation. Psychiatric Services, 62(12), 1510– 1513. doi: 10.1176/appi.ps.005562010. 22193801 PMC3246367 · DOI
- Auerbach R. P., Alonso J., Axinn W. G., Cuijpers P., Ebert D. D., Green J. G., & Bruffaerts R. (2016). Mental disorders among college students in the World Health Organization world mental health surveys. Psychological Medicine, 46(14), 2955– 2970. doi: 10.1017/S0033291716001665. 27484622 PMC5129654 · DOI · Paper page
- Batterham P. J., Sunderland M., Slade T., Calear A. L., & Carragher N. (2018). Assessing distress in the community: psychometric properties and crosswalk comparison of eight measures of psychological distress. Psychological Medicine, 48(8), 1316– 1324. doi: 10.1017/s0033291717002835. 28967345 · DOI
- Bernhardsdottir J., & Vilhjalmsson R. (2013). Psychological distress among university female students and their need for mental health services. Journal of Psychiatric and Mental Health Nursing, 20(8), 672– 678. doi: 10.1111/jpm.12002. 22988953 · DOI
- Bor W., Dean A. J., Najman J., & Hayatbakhsh R. (2014). Are child and adolescent mental health problems increasing in the 21st century? A systematic review. Australian and New Zealand Journal of Psychiatry, 48(7), 606– 616. doi: 10.1177/0004867414533834. 24829198 · DOI · Paper page
- Burton W. N., Pransky G., Conti D. J., Chen C.-Y., & Edington D. W. (2004). The association of medical conditions and presenteeism. Journal of Occupational and Environmental Medicine, 46(6), S38– S45. doi: 10.1097/01.jom.0000126687.49652.44. 15194894 · DOI
- Cvetkovski S., Jorm A. F., & Mackinnon A. J. (2019). An analysis of the mental health trajectories of university students compared to their community peers using a national longitudinal survey. Studies in Higher Education, 44(1), 185– 200. doi: 10.1080/03075079.2017.1356281. · DOI
- Derogatis L. R., Lipman R. S., Rickels K., Uhlenhuth E. H., & Covi L. (1974). The Hopkins Symptom Checklist (HSCL): a self-report symptom inventory. Systems Research and Behavioral Science, 19(1), 1– 15. doi: 10.1002/bs.3830190102. 4808738 · DOI · Paper page
- Glaesmer H., Braehler E., Grande G., Hinz A., Petermann F., & Romppel M. (2014). The German Version of the Hopkins Symptoms Checklist-25 (HSCL-25) – factorial structure, psychometric properties, and population-based norms. Comprehensive Psychiatry, 55(2), 396– 403. doi: 10.1016/j.comppsych.2013.08.020. 24286991 · DOI
- Goodwin L., Ben-Zion I., Fear N. T., Hotopf M., Stansfeld S. A., & Wessely S. (2013). Are reports of psychological stress higher in occupational studies? A systematic review across occupational and population based studies. PLoS One, 8(11), e78693. doi: 10.1371/journal.pone.0078693. 24223840 PMC3817075 · DOI
- Kessler R. C., Foster C. L., Saunders W. B., & Stang P. E. (1995). Social consequences of psychiatric disorders, I: educational attainment. American Journal of Psychiatry, 152(7), 1026– 1032. doi: 10.1176/ajp.152.7.1026. 7793438 · DOI · Paper page
- Keyes C. L., Eisenberg D., Perry G. S., Dube S. R., Kroenke K., & Dhingra S. S. (2012). The relationship of level of positive mental health with current mental disorders in predicting suicidal behavior and academic impairment in college students. Journal of American College Health, 60(2), 126– 133. doi: 10.1080/07448481.2011.608393. 22316409 · DOI
- Mattisson C., Bogren M., & Horstmann V. (2013). Correspondence between clinical diagnoses of depressive and anxiety disorders and diagnostic screening via the Hopkins Symptom Check List-25 in the Lundby Study. Nordic Journal of Psychiatry, 67(3), 204– 213. doi: 10.3109/08039488.2012.711856. 22906095 · DOI
- Much K., & Swanson A. L. (2010). The debate about increasing college student psychopathology: are college students really getting ‘sicker?’. Journal of College Student Psychotherapy, 24(2), 86– 97. doi: 10.1080/87568220903558570. · DOI
- Muthén L. K., & Muthén B. O. (1998–2017). Mplus User's Guide (8th ed.). Los Angeles, CA: Muthén & Muthén.
- Nerdrum P., Rustøen T., & Rønnestad M. H. (2006). Student psychological distress: a psychometric study of 1750 Norwegian 1st-year undergraduate students. Scandinavian Journal of Educational Research, 50(1), 95– 109. doi: 10.1080/00313830500372075. · DOI
- Oswalt S. B., Lederer A. M., Chestnut-Steich K., Day C., Halbritter A., & Ortiz D. (2018). Trends in college students’ mental health diagnoses and utilization of services, 2009–2015. Journal of American College Health, 1-– 11. doi: 10.1080/07448481.2018.1515748. 30355071 · DOI
- Plaisier I., Beekman A., De Graaf R., Smit J., Van Dyck R., & Penninx B. (2010). Work functioning in persons with depressive and anxiety disorders: the role of specific psychopathological characteristics. Journal of Affective Disorders, 125(1–3), 198– 206. doi: 10.1016/j.jad.2010.01.072. 20185180 · DOI
- Rai D., Skapinakis P., Wiles N., Lewis G., & Araya R. (2010). Common mental disorders, subthreshold symptoms and disability: longitudinal study. The British Journal of Psychiatry, 197(5), 411– 412. doi: 10.1192/bjp.bp.110.079244. 21037219 · DOI
- Sandanger I., Moum T., Ingebrigtsen G., Dalgard O. S., Sorensen T., & Bruusgaard D. (1998). Concordance between symptom screening and diagnostic procedure: the Hopkins Symptom Checklist-25 and the Composite International Diagnostic Interview I. Social Psychiatry and Psychiatric Epidemiology, 33(7), 345– 354. doi: 10.1007/s001270050064. 9689897 · DOI
- Sandanger I., Moum T., Ingebrigtsen G., Sorensen T., Dalgard O. S., & Bruusgaard D. (1999). The meaning and significance of caseness: the Hopkins Symptom Checklist-25 and the Composite International Diagnostic Interview II. Social Psychiatry and Psychiatric Epidemiology, 34(1), 53– 59. doi: 10.1007/s001270050112. 10073122 · DOI
- Skogen J. C., Øverland S., Smith O. R., & Aarø L. E. (2017). The factor structure of the Hopkins Symptoms Checklist (HSCL-25) in a student population: a cautionary tale. Scandinavian Journal of Public Health, 45(4), 357– 365. doi: 10.1177/1403494817700287. 28381118 · DOI
- Sweeting H., West P., Young R., & Der G. (2010). Can we explain increases in young people's psychological distress over time? Social Science and Medicine, 71(10), 1819– 1830. doi: 10.1016/j.socscimed.2010.08.012. 20870334 PMC2981856 · DOI
- Torvik F. A., Rognmo K., & Tambs K. (2012). Alcohol use and mental distress as predictors of non-response in a general population health survey: the HUNT study. Social Psychiatry and Psychiatric Epidemiology, 47(5), 805– 816. doi: 10.1007/s00127-011-0387-3. 21544604 PMC3328681 · DOI
- Twenge J. M., Gentile B., DeWall C. N., Ma D., Lacefield K., & Schurtz D. R. (2010). Birth cohort increases in psychopathology among young Americans, 1938–2007: a cross-temporal meta-analysis of the MMPI. Clinical Psychology Review, 30(2), 145– 154. doi: 10.1016/j.cpr.2009.10.005. 19945203 · DOI
- Veijola J., Jokelainen J., Läksy K., Kantojärvi L., Kokkonen P., Järvelin M.-R., (2003). The Hopkins Symptom Checklist-25 in screening DSM-III-R axis-I disorders. Nordic Journal of Psychiatry, 57(2), 119– 123. doi: 10.1080/08039480310000941. 12745774 · DOI
- von Soest T., & Wichstrøm L. (2014). Secular trends in depressive symptoms among Norwegian adolescents from 1992 to 2010. Journal of Abnormal Child Psychology, 42(3), 403- 415. doi: 10.1007/s10802-013-9785-1. 23888312 · DOI
- West P., & Sweeting H. (2003). Fifteen, female and stressed: changing patterns of psychological distress over time. Journal of Child Psychology and Psychiatry, 44(3), 399– 411. doi: 10.1111/1469-7610.00130. 12635969 · DOI
- Xiao H., Carney D. M., Youn S. J., Janis R. A., Castonguay L. G., Hayes J. A., (2017). Are we in crisis? National mental health and treatment trends in college counseling centers. Psychological Services, 14(4), 407. doi: 10.1037/ser0000130. 29120199 · DOI
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- Authors
- Knapstad, M., Sivertsen, B., Knudsen, A. K., Smith, O. R. F., Aarø, L. E., Lønning, K. J., & Skogen, J. C.
- Affiliations
- Norwegian Institute of Public Health (NO)
- Norwegian Medical Association (NO)
- Corresponding author
- Knapstad, Marit
- ORCID
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2019-11-29
- Volume
- 51
- Issue
- 3
- Pages
- 470-478
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC7958482
- OpenAlex
- W2991443258
- Cited by
- 158
- References
- 23
- Citations by year
- 2026: 22 · 2025: 28 · 2024: 35 · 2023: 22 · 2022: 24 · 2021: 18 · 2020: 9
- FWCI
- 23.22
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Psychological Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- Funders
- Helse- og Omsorgsdepartementet
- Utdannings- og forskningsdepartementet
- Topics
- Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Keywords
- psychological distress, university students, temporal trends, gender differences, adolescent girls, response styles, response rate, student mental health, Norwegian higher education
- MeSH terms
- Psychological Distress, Adolescent, Adult, Female, Humans, Male, Norway, Stress, Psychological, Students, Universities, Linear Models, Logistic Models, Young Adult, Checklist, Self Report
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