Factores de riesgo y variables asociadas a la salud mental y rendimiento académico en estudiantes universitarios

Abstract

The increase and severity of mental health problems in university stages as well as their impact on the student's academic career is a matter of global concern and even more so after the Health crisis due to COVID-19. Universities continue to seek measures to address the problem, however, the willingness of students to seek help tends to be low, so measures for its detection are also required. The general objective of this work is to explore the student variables that are related to their mental health and academic performance, as well as to detect and characterize profiles with low performance and find out the effectiveness of an intervention to improve it. Methods: The work consists of four studies distributed in three phases. The first phase (identification) includes an associative-comparative study prior to COVID-19 with 1405 university students focused on psychopathological symptomatology and healthy habits. In the second phase (detection), after the pandemic, 1183 university students who perceive emotional and academic difficulties are recruited through the survey method and incentives. First, the correlation between these difficulties is explored. Secondly, logistic regression analyses were carried out to predict the assesed psychopathological symptomatology and academic performance (cumulative mean, performance rate and credits in subjects with two or more enrolments) considering sociodemographic and academic variables. From the total sample, criteria were agreed on the basis of the trend to select students with low performance in order to subsequently carry out a hierarchical cluster analysis. In the last phase (intervention), a programme to improve performance and emotional well-being was applied to 65 students in 8 online sessions guided by two therapists, evaluating its effectiveness at three time points (pre, post, and a 3-month follow-up). Results: Two out of three university students experience severe levels of anxious-depressive symptomatology. Depressive symptoms interact with each of the performance indicators measured. Additionally, obsessive-compulsive and somatic symptomatology have been shown to interact with the performance rate and credits of subjects with two or more enrolments. Being female, younger, with a low socioeconomic status and from the arts and humanities branch were found to be risk factors for the presence of each of the psychopathological symptoms in the students. In addition to age and socioeconomic status, early academic years and combining study with work have been shown to be risk factors for a lower performance rate and a higher number of unfinished subjects. The detection method was not useful for attracting Arts students, however, it was useful for recruiting students with the other sociodemographic risk factors mentioned above and with a psychological profile characterised by a poor general and more specifically academic self-concept and inadequate coping strategies to manage stress in their studies. Three profiles of underachieving students resulted: (1) emotionally maladjusted, (2) poorly motivated and, finally, (3) committed but underachieving. There were no significant differences in the sociodemographic and academic profile between them. Participants in the RINDE+ programme experienced an improvement in grades and significantly reduced mainly anxious-depressive symptomatology, improved emotional self-concept, adopted appropriate coping strategies such as cognitive restructuring and problem solving and decreased the use of inappropriate ones, such as self-criticism, social withdrawal and desiderative thinking. Long-term effects on depressive symptomatology, emotional self-concept and decreased use of inappropriate coping strategies were maintained. Conclusions: The studies included in this thesis update, after the pandemic, the evidence of what was already a problema. The approach of identifying variables of interest, detecting risk profiles and intervention is useful for mental health professionals, researchers and the university community.