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.