1. The National Center on Addiction and Substance Abuse at Columbia University ®

2. What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Linda Richter, Ph.D. April 15, 2004 Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University ®

3. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Funded by Sally Pingree and The Charles Engelhard Foundation for the Bringing Theory to Practice Project

4. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Key Objectives Review of available literature Analyses of national data sets Review of current programs and initiatives

5. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Why Study Substance Abuse and Depression in College Students? Compromise students ability to learn Compromise students ability to become active and involved members of society

6. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Why Are College Students at Risk? Encounter new sources of stress Increased academic pressure, competitiveness, sleep deprivation Peer pressure Freedom from parents rules and monitoring More students with mental health problems attending college

7. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Lifetime Depression in College Students vs General Population 11.8% in college students (14.3% of females, 7.3% of males) 5.2% in the general population (7.4% of females, 2.8% of males)

8. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Depression in College Students 38% frequently feel overwhelmed 45% reporting feeling depressed within last school year 12% diagnosed with depression in their lifetime. Of these: 37% diagnosed within the last school year 24% in therapy for depression 35% taking medication for depression

9. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Depression May Be On The Rise 84% of college counseling center directors report an increase in the number of students who present with severe psychological problems

10. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Consequences of Depression Suicide Illness Decreased energy, sleep problems, weight changes Risky sex Substance abuse Poor academic performance Damaged interpersonal relationships

11. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University College Student Suicide Second leading cause of death among college students In 2002: 10% seriously contemplated suicide 1.6% attempted suicide

12. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Who Is At Risk for Depression? Genetic susceptibility Difficult family environment Negative attributional style Poor problem-solving skills Loneliness Lifestyle changes and stress

13. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Females At Greater Risk for Depression History of physical or sexual abuse Less adaptive coping and problem solving skills Greater dissatisfaction with body image Stereotypical female traits (low self-confidence or assertiveness)

14. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Disorders That Commonly Co-Occur With Depression in College Student Anxiety Disorders Eating Disorders Substance Abuse Students with co-occurring disorders experience greater impairment and are more difficult to treat.

15. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Treating Student Depression College is a window of opportunity to provide treatment to those in need Campus mental health services convenient to access, typically free or provided at low cost Flexible schedules Despite this, few students use campus services

16. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Substance Abuse in College Students Alcohol use more prevalent among college students than among their non-college peers Non-college students of college age are likelier to smoke and use most illicit drugs than are college students

17. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University College Student Alcohol Use 69% current (past month) alcohol use 5% daily alcohol use 40% binge drink Increases over the past decade in frequent binge drinking, intoxication and drinking to get drunk Binge drinking more common among younger students, male students and white students

18. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University College Student Tobacco Use 27% current (past month) cigarette use 16% daily cigarette use 23% past year cigar use 6% past year smokeless tobacco use More common among younger students, male students and white students

19. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University College Student Illicit Drug Use 22% current (past month) illicit drug use 19.7 current (past month) marijuana use 4% daily marijuana use 5.7% annual nonmedical use of Ritalin (only drug used more by college than non-college students of the same age) Illicit drug use more common among male students and white students.

20. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Profiles of Risk for Binge Drinking School Characteristics: Residential (not commuter) Located in the Northeast or North-central U.S. Not an historically black college or university Co-educational (although large increase in binge drinking over the past decade in all women colleges)

21. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Profiles of Risk for Binge Drinking Student Characteristics: Male Caucasian Co-ed housing resident Underage, particularly freshmen Athlete Greek Lower religiosity Drank recreationally early Greater emphasis on being social

22. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Greek Membership Greeks are likelier than non-Greeks to be current: smokers (37% vs. 26%) drinkers (87% vs. 69%) binge drinkers (66% vs. 40%) marijuana users (27% vs. 21%) other illicit drug users (2.7% vs. 1.2%)

23. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Consequences of Substance Use and Abuse Suicide Illness Driving under the influence Legal offenses Risky sex Poor academic performance Damage/nuisance in the surrounding community Addiction/dependence

24. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Pathways to Increased Risk for Substance Abuse Genetic susceptibility Parental substance use or permissive attitudes High school substance use Negative moods or feelings Impulsivity, sensation seeking Positive substance-related expectations Social pressures Availability, advertising and promotions

25. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Substance Abuse and Depression Frequently Co-Occur Smokers 3 times likelier to be depressed Alcohol abusers 4 times likelier to have a depressive disorder Individuals with major depression 3 times likelier to abuse marijuana and 7 times likelier to be dependent College students who are current substance users are more likely to have felt depressed within the last school year

26. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Explaining the Link Substance abuse as a means of self-medication Depression as a result of physiological and social effects of frequent substance use Shared genetic risks Dysfunctional family environment Life stress

27. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University The Hypothesis College students who are engaged in their learning experience and in service to their school, community and larger society may be at reduced risk for substance abuse and depression Encouraging student engagement may be an untapped preventive resource for these widespread problems that afflict young people

28. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Hints of Support Students drink alcohol more frequently, feel more overwhelmed and depressed and perform volunteer work less often when in college Extracurricular activities associated with lower rates Volunteering associated with lower rates School connectedness and academic success associated with lower rates

29. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Examples of Programs and Projects Project Pericles CampusCares The Center for Information and Research on Civic Learning and Engagement (CIRCLE) Service Learning Research and Development Center, University of California, Berkeley New College of California

30. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Summary Depression and substance abuse are key problems in the college student population Some research evaluations show effectiveness of student engagement initiatives for enhancing service and learning Virtually no data on effectiveness for helping to prevent or reduce depression or substance abuse Yet, some evidence for helping to reduce other health risk behaviors such as teen pregnancy.

31. ® What the Research Suggests: An Introduction to the Research Literature and the Scope of the Issues Copyright © 2004 The National Center on Addiction and Substance Abuse at Columbia University Conclusion The hypothesis of the Bringing Theory to Practice project presents an innovative and promising approach and one worth pursuing given whats at stake. Well designed research studies and hard data are needed if we are to determine the efficacy of student engagement n helping to reduce depression and substance abuse among college students.

32. The National Center on Addiction and Substance Abuse at Columbia University ® www.casacolumbia.org