Early Detection and Prevention of Mental Health Problems

Based on a sample of 3,081 students from 7 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

The data of the 3,081 students from Pasadena (USA: English), Lausanne (Switzerland: French), Zurich (Switzerland: German), Milano (Italy: Italian), Castellon (Spain: Spanish), Cipoletti (Argentina: Spanish), and Hangzhou (China: Chinese) suggested 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. We found a close relationship between the constructed defeatism-resilience scales 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 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.

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 5 languages.