Early Detection and Prevention of Mental Health Problems
Based on a sample of 1,217 students from 3 different study sites we aimed at detailing coping
behavior among students under chronic stress. In particular, we were interested in (1) the
inter-relationships between coping skills and the general health factors "regular exercises",
"consumption behavior", "impaired physical health", "psychosomatic disturbances", and "impaired
mental health"; (2) the extent to which insufficient coping skills are influenced by socio-cultural
factors; (3) the development of standardized means enabling the "early" detection of freshman
students with insufficient coping skills under chronic stress and at risk for mental health
problems; and (4) the extent to which premature drop-outs among the students are caused by
insufficient coping skills.
Quantifying Basic Coping Behavior
Our data of the 1,217 students from Lausanne (French), Pasadena (English), and Zurich (German)
suggest the existence of two highly stable, socio-culturally independent personality traits
"activity" (activity-passivity) and "defeatism" (defeatism-resilience) which enabled quantification
of basic coping behavior in a reproducible way across study sites. This is somewhat in contrast to
earlier studies in the field where authors reported some evidence for cross-cultural differences.
However, our analyses were based on much larger sample sizes. Moreover, the proposed scales were
constructed through a sophisticated "learning" algorithm in combination with stringent cross-validation
techniques, thus featuring a much better resolution than earlier studies with respect to between-subject
differences in coping behavior. This clearly underlines the significance of our findings as to the
lack of socio-cultural differences.
Prospective Study
We found a close relationship between the newly constructed defeatism-resilience scale on the one hand,
and impaired physical health, psychosomatic disturbances, and mental health on the other. Use of illegal
drugs and lack of regular physical exercises exhibited highly significant correlates as well. As there
is increasing and consistent evidence for a high comorbidity between major psychiatric disorders and
somatic conditions like hypertension, type 2 diabetes mellitus, asthma, and rheumatoid arthritis, amongst
others, the observed correlation between the defeatism scale and impaired physical health deserves
special attention. In consequence, we are planning to carry out a prospective study of 9,000 freshman
students using the combined COPE and ZHQ instruments as screening instruments so that we are able to
narrow down on "true" risk cases among the students. In a second phase, these risk cases will be
monitored over a 2-week period by a set of sensors throughout their regular daily life. Sensors include
speech recordings once a day along with continuous measures of heart rate, blood pressure, and physical
activity (accelerometer) at a 10 min resolution over 24h. Specifically, we are looking for well-defined
events of interest, such as significant cardiovascular changes that are unrelated to physical activity.
The OPTIMI Project
The newly developed scales represent highly stable, socio-culturally independent personality traits that
quantify basic coping behavior, while being closely related to physical and mental health problems among
students. The proposed method appears to constitute powerful screening tools that help to identify that
10-15% subgroup of students who (1) show insufficient coping skills under chronic stress; (2) suffer an
elevated risk for developing psychiatric disorders; and (3) may benefit from early intervention. Our
screening tools are available as
online application in 6 languages.