Indigenous Rights

This chapter focuses on the mental health factors that impact student success for Indigenous youth within the higher education landscape in the Commonwealth of the Northern Mariana Islands (CNMI). It emphasizes the need to address these mental health factors by strengthening cultural identity to support the success of students in higher education. The authors explain how Indigenous rights can be used to address legacies of genocidal colonialism and how implementing Indigenous-based curriculum for effective student learning may provide pathways to improve academic and mental health outcomes. Several programs in Saipan that underscore the significance of reinforcing cultural identity to help mitigate and alleviate these negative outcomes are discussed. The authors conclude by providing examples of how cultural identity can be strengthened through the implementation of Indigenous rights-based legislation, thereby simultaneously safeguarding mental health and academic success for Indigenous youth in the CNMI.

The Effect of Loneliness in Psychological and Behavioral Profile among High School Students in Spain

Loneliness is a distressing feeling that can be a barrier to a student’s development and affect their mental health. This research aimed to analyse the effects of loneliness on psychological and behavioral factors among students aged 12–19 years in Spain. Loneliness, experiential avoidance, psychological inflexibility, physical activity, mobile phone use, and smoke habits were analysed in a sample of 110 men and 122 women assigned into two groups depending on their loneliness levels: higher loneliness group (HLG) and lower loneliness group (LLG). Results showed that experimental avoidance and psychological inflexibility were related with loneliness (r = 0.471; p = 0.000). Experiential avoidance and psychological inflexibility were higher in HLG than LLG. Regarding the use of mobile phones and smoking habits, LLG presented significantly higher values than HLG. Higher age correlated with lower loneliness values (r = −0.155; p = 0.017). The present research found how students with higher loneliness presented higher experiential avoidance and psychological inflexibility and lower age, use of mobile phone, and smoking habits. These findings reveal the importance of considering multiple social behaviours when examining adolescent mental health factors.

Psychological Impact of COVID-19 Pandemic on Frontline Responders and Students in Training

Medical personnel have been in the frontlines of the pandemic leading to increased levels of stress and an impact on mental health. Risks may include, but are not limited to, pronounced burnout (Shechter et al., 2020), vicarious trauma, and post-traumatic stress disorder. The goal of this investigation was to gain insight on the psychological effects that the pandemic had on both frontline responders (EMTs and emergency room staff) and students in clinical training. Emerging adults and adult participants (N=150; ages 18-46; 70.4% ages 18-24) were recruited through the introductory psychology subject pool, community healthcare, and social media. Linear regression and means testing were employed to assess differences between current frontline workers and future workers on the Depression, Anxiety, and Stress Scale (DASS-21; Lovibond, 1995) on irritability, sleep, covid-19 positive presence, concentration, and other mental health factors. Hierarchical linear regression, controlling for age, indicated higher anxiety subscale scores (b=2.49, p=.008) and higher stress subscale scores (b=2.25, p=.035) were present on the DASS-21 for women. Dichotomous means testing indicated higher anxiety, stress, and depression levels for those who also reported a significant change in sleep habits (p <.001) and for those who reported being more irritable on their days off (p <.001) during the pandemic. Students in training (37.7%) indicated interest in considering a different career path (r = .302, p = .02). Future studies should examine these dynamic relationships among mental health factors among healthcare professionals and the implications for training the next generation.

Changes in Physical Activity and Sedentary Behaviour in Cardiovascular Disease Patients during the COVID-19 Lockdown

The COVID-19 lockdown has been associated with physical inactivity. We prospectively evaluated changes in moderate-to-vigorous physical activity (MVPA) and sedentary time (ST) among 1565 cardiovascular disease (CVD) patients using validated questionnaires at 5 weeks after lockdown initiation (i.e., baseline, April 2020) and at every 4 subsequent weeks, until July 2020. Multivariate mixed model analyses were performed to identify whether age, sex, CVD-subtype, lockdown adherence and mental health factors impacted changes in physical (in)activity. Patients were 67 (interquartile range: 60–73) years and primarily diagnosed with coronary artery disease. Time spent in MVPA was 143 min/day (95% confidence interval (CI) 137; 148) at baseline. Female sex, heart-failure, fear of COVID-19 infection and limited possibilities for physical activity were independently associated with lower levels of MVPA across time. After adjusting for confounders, overall MVPA did not change. ST was 567 (95% CI 555; 578) min/day at baseline. Lack of social contact, limited possibilities for physical activity and younger age were independently associated with higher levels of ST. After adjusting for confounders, ST progressively increased following 8 (Δ+19.7 (95% CI 0.4; 39.0)) and 12 weeks (Δ+25.2 (95% CI 5.4; 47.1) min/day) of lockdown. Despite a phased relaxation of the lockdown, CVD patients progressively increased ST and reported no change in MVPA. This highlights the need to target physical inactivity during and beyond the COVID-19 pandemic.

Construction and validation of a scale to measure loneliness and isolation during social distancing and its effect on mental health

A variety of factors contribute to the degree to which a person feels lonely and socially isolated. These factors may be particularly relevant in times requiring social distancing, e.g., during the COVID-19 pandemic. We present the Loneliness and Isolation during Social Distancing (LISD) Scale. Extending existing trait measures, the LISD scale assesses loneliness and isolation on a state and trait level and reliably predicts individual differences in anxiety and depression. Data were collected online from two independent samples. Scale validation was based on exploratory factor analysis (EFA; Sample 1, N = 244) and confirmatory factor analysis (CFA; Sample 2, N = 307). Multiple regression analyses were used to assess how the LISD scale predicts state anxiety and depression. The LISD scale showed satisfactory fit in both samples. Its five factors indicate loneliness and isolation, sociability and sense of belonging, social support, closeness, and connectedness. The LISD scale showed strong predictive power for state anxiety and depression, explaining 33% and 51% of variance, respectively. Anxiety and depression scores are particularly predicted by state feelings of loneliness and isolation as well as low dispositional sociability and sense of belonging. In turn, state loneliness and isolation are predicted by social support, connectedness and closeness (state and trait).We provide a novel scale which distinguishes between acute and general loneliness and isolation, while also capturing related protective and risk factors for mental health. The LISD scale could be a valuable addition to the assessment of mental health factors impacted by social distancing.

Factors Contributing to Poor Self-Rated Health in Older Adults with Lower Income

Lower household income is associated with poorer self-reported health status, especially in the elderly. Considering the importance of subjective health in this fragile population, it would be worthwhile to explore the physical and mental health factors that may help to predict good or poor self-rated health (SRH) status. We first described three main categories (individual, physical, and psychological) between low-income seniors with good and poor SRH. Next, statistically significant physical and mental health factors affecting poor SRH were identified. In this study, original data from the 2017 National Survey of Older Persons in South Korea were analyzed. People aged 65 years and over with low household income were eligible. A total of 1405 men and 2945 women (n = 4350) were enrolled, and less than half of participants (47.5%, n = 2066) belonged to the poor SRH cohort. We applied individual variable-adjusted models and found that poor SRH was significantly associated with ADL limitation (odds ratio (OR): 2.91, 95% confidence interval (CI) 2.11–4.01), IADL limitation (OR: 1.80, 95% CI: 1.52–2.13), malnutrition (OR: 1.76, 95% CI: 1.53–2.04), and depression (OR: 3.65, 95% CI: 3.10–4.31) on logistic regression analysis. Our findings suggest that limited ADL/IADL, poor nutrition, and depression need to be emphasized to improve subjective health status in low-income adults. Early recognition and timely intervention might help them to live better and happier, ultimately relieving social healthcare burdens.