COUNSELING CENTER

 

2005-2006 ANNUAL REPORT

 

AND

 

DATA SUMMARY

 

JOHNS HOPKINS UNIVERSITY

 

 

              

 

 

 

 

 

Prepared by:

Michael Mond, Ph.D., Director

Counseling Center

June 2006

 

 

 

 

 

 

Counseling Center Annual Report 2005-06_ revised 07-06-06_mm_Annual Report

 


 

 

 

 

COUNSELING CENTER: ANNUAL REPORT AND DATA SUMMARY 2005-06

 

«                  The CC provided Individual Personal Counseling to 1,035 student clients and Group Counseling to 60 students in 9 groups. During the Academic Year (Sept 2005 -May 2006) the CC provided 19,756 hours of services which is an increase of 7% in service hours.    Individual and group therapy activity accounted for approximately 63.5% of counseling time. 

 

«                  The CC also continued to use the Behavioral Health Monitor (BHM20) to monitor client progress and therapy outcome.  New CC clients demonstrated significant improvement during treatment from intake to the last session (average score increased from 2.77 to 3.02) on a 5 point scale ranging from 0 (worst health) to 4 (best health) with a score of 2.93 or better considered positive mental health for college students. Also, 67% of all clients reported significant improvement, 25% reported no change, and 8% reported some deterioration as measured by the BHM20.

 

«                  The CC continues to engage in research to improve monitoring of potentially suicidal clients.  This past year the CC participated in research to determine the type of interventions therapists employ in their work with suicidal clients. A therapist intervention scale was developed.

 

«                  The CC averaged 140.2 client sessions per week (164.6 including psychiatrists) and 10.0 emergencies per week in the Fall semester.  In the Spring semester the CC averaged 147.8 client sessions per week (176.3 including psychiatrists) and 8.2 emergencies per week.

 

«                  In addition to Individual and Group Services, CC services during the Academic Year included Training and Supervision (12.2% of time), Outreach and Workshop activity (1.5%), Consultations (4.1%), Community Activity (2.1%), Professional Development (1.8%), Professional Activity including Research and Teaching (1.9%), and Administrative Activity (12.8%). 

«                  The CC averaged 5.9 visits per client during the Academic Year in individual personal counseling. 340 students were evaluated by staff psychiatrists (33% of clients served) in 1,117 sessions for an average of 3.3 sessions by the psychiatrists.  317 students received psychotropic medication (31% of clients served).  In Emergency Interventions, the Center served 369 clients in daytime emergencies (about 36% of clients served) and 70 clients in after hour emergencies (90 calls).  The CC made 6 violence assessments monitored 42 students in its suicide tracking system, recommended 28 mental health (medical) leaves, and administered 30 readmission evaluations.  Seventy-eight clients were referred off campus for more extensive treatment. The CC played a significant role in preventing 105 students from dropping out of school last year, while 53 were given assistance in exercising appropriate extensions or withdrawal from classes. There were 14 emergency room visits resulting in 11 hospitalizations.

 

«                  The most common problems/symptoms presented by clients during individual therapy include: feelings of being overwhelmed” (29%), “time management and motivational issues” (28%), “general anxieties and worries” (27%),  “academic concerns” (26%), “generally unhappy and dissatisfied” (20%), “lack of self-confidence or self-esteem” (18%), “depression” (18%), “sleep problems” (17%),“lack of motivation, detachment, and hopelessness” (16%), “overly high standards for self” (15%), and “loneliness, homesickness” (14%). These problems are not mutually exclusive.

 

«                  The CC provided career counseling working together with the Career Center.  Both departments met on a regular basis to discuss career counseling cases, programming for career counseling and other topics focusing on enhancing career service delivery. 

 

«                  The CC provided 44 Outreach Activities, Workshops, and Consultation programs last year serving 3,454 students, 75 faculty and staff, and 1,273 “others” for an overall total of 4,802 individuals.

 

«                  Evaluations -The CC Intake Service Evaluation Report reveals that on a survey taken after the initial session 63% of clients feel that the personal counseling service is excellent while an additional 34% feel that the service is good.

  

«                  The CC continues to provide services to the Nursing School and the Peabody Institute of Music.  Students from both schools report satisfaction with the services offered by the CC (Nursing School evaluations show 61% of clients have an “excellent impression” of the CC and 39% have a “good” impression.  For Peabody the percentages are 62% and 35% respectively).

 

«                  The CC Pre-Doctoral Training program has 4 full time interns. The training program included 47 didactic programs and supervision in both individual and group formats.

 

«                  The CC employs staff coordinators to develop and improve programming for Asian-American students/International students, Minority students, Career Counseling, Outreach/Workshop and Consultative Services, Group Counseling, Professional Development, Substance Abuse Counseling, Peer Counseling, Research, Nursing School, Peabody Institute of Music, Predoctoral Training, Eating Disorders, and Graduate Students. 

 

«                  The CC continues to foster values of teamwork and collaboration by participating in over 61 JHU programs, activities, and committees.  One highlight involved serving as advocates for the freshmen class officers. These programs are designed to serve, assist, and enrich the JHU community.

 

«                  CC staff are active in professional development and professional activity.  Clinical staff participated in 43 professional workshops, conferences, courses, seminars and other educational activities.   In addition, professional staff engaged in 15 professional activities (e.g., teaching, professional boards, consultation, and research activities, etc...) and are members of 18 professional organizations.

 

«                  The CC updated its policy and procedures for its scheduling and data management system (Titanium) and participated in a national workshop to coordinate a common usage across the country.

 

«                  The CC negotiated a new contract with the Peabody Institute of Music to allow for enhanced services to accommodate a greater demand for services.

 

«                  The CC expanded the Student Advisory Board which helped send emails to all students on campus on “recognizing distressed students.”  This advisory board also developed a similar letter for parents. The board also advanced the Community Project to foster ideas to develop community in coordination with Orientation, a pilot project for improving community among freshmen.

 

«                  The CC collaborated with DRADA to successfully obtain a federal “Suicide Prevention Grant.”  Unfortunately, the matching funds required for the grant were not forthcoming and the grant funding had to be returned. 

 

 

 

 

 

 

 

 


TABLE OF CONTENTS

 

Topic

Page #

SECTION I. 

Overview of CC Hours by Service Area: AY 2005-06

5

SECTION II.

Individual Psychotherapy Services: May 23, 2005 - May 21, 2006

 

A) Individual Psychotherapy: Direct Services Caseload Statistics

 

 

1.  General Numbers

6

 

 

2.  Intakes (New Clients)

6

 

 

3.  Number of Clients Seen per Week

6

 

 

4.  Psychiatrist Clients Seen per Week

6

 

 

5.  Emergency Walk-in Clients Seen per Week

6

 

 

6.  Total Number of Individual Clients Seen for Past 6 Years

7

 

 

7.  Weekly Case Load Comparisons for the Past 6 Years

7

 

 

8.  Emergency Sessions Per Week Comparisons for the Past 8 Years

7

 

 

9.  Frequency of Client Visits

7

 

 

10. Insurance

7

 

B) Individual Psychotherapy: Demographics of Counseling Center Clients

 

 

1. Gender

8

 

 

2. School Affiliation

8

 

 

3. Age

8

 

 

4. Ethnic Status

8

 

 

5. Marital Status

8

 

 

6. Class Year

8

 

 

7. Academic Standing

8

 

 

8. Other Items

8

 

 

9. Academic Major

9-10

 

 

10.  Medical

10

 

 

11.  Residence

10

 

 

12.  How First Heard of Counseling Center

10-11

 

 

13.  Referral Source

11

 

 

14.  Presenting Complaints by Frequency  (Rank Order)

12

 

 

15.  Presenting Complaints by Problem Area

13-14

 

 

16.  Behavioral Health Monitor Items

14

 

C) Individual Psychotherapy:  Intake Service Evaluation Survey

15-18

SECTION III.  

Research Projects

 

A) Suicide Tracking

19

 

B) The Behavioral Health Questionnaire (BHM) Research Project

19-25

 

 

C) Psychotherapy Treatment Progress of Suicidal Students

26

SECTION IV.

Summary of Group Psychotherapy Provided by Counseling Center Staff

26

SECTION V.

Summary of Counseling Center Pre-Doctoral Internship Training Program                     26

 

A) Interns and Supervisors

27

 

B) The Training Program

27-29

 

C) Training Program Assessments

29

 

D) Contact with Academic Training Programs

29

 

E) Recruitment and Selection of 2006-07 Interns

29

F) Development of the Pre-Doctoral Psychology Internship Program

30

SECTION VI.

Summary of Workshops, Outreach, and Consultation Activity by CC Staff.

31-32

SECTION VII.

Summary of JHU Community Activity by Counseling Center Staff.

33-34

SECTION VIII.

Summary of Professional Development and Professional Activity by CC Staff. 

34-36

SECTION IX.

Coordinator Report Summaries

36-40


 

SECTION I.  Overview of CC Hours by Service Area:

Academic Year 2005-06 (August 15, 2005- May 21, 2006)

 

Function/Activity for

2005-06 Academic Year

Staff Hours

AY 2005-2006

% Hrs

AY 2005-2006

1. Individual Therapy- Counselors

5,110

(Note: 6,115 for full year)

25.9%

2. Psychiatrists’ Visits/Medication Checks

540

(Note: 618 for full year)

2.7%

3. Group Therapy

1220

6.2%

4. Clinical Management (Indiv. & Group) – Counselors

5368

27.2%

5. Clinical Management – Psychiatrists

297

1.5%

6. Training & Supervision Activity

2,412

12.2%

7. Outreach  and Workshops Activity

302

1.5%

8. Consultation Activity  (incl. after hr oncall)

816

4.1%

9. JHU Community Activity

405

2.1%

10. Professional Development Activity

 364

1.8%

11. Professional Activity

 691

3.5%

12. Administrative Activity*

2,528

12.8%

All Services Total

19,756

100%

 

*Note: Administration includes staff meetings, public relations, budget activity, data management, coordinating activity with Nursing School and Peabody, coordinator responsibilities of professional staff, coordinating and directing internship program, coordinating and training of Peer Counseling program (APTT), marketing, evaluation, planning, and all personnel activity.

 

**Note: 1,581 hours (63%) of all administrative hours were accounted for by the Director of the Counseling Center.

  

SECTION II:  Individual Psychotherapy Services: May 24, 2005 - May 21, 2006

 

A) Direct Services Caseload Statistics

1.  General Numbers

No. of Clients seen in Personal Counseling (Full year)

No. of Therapy Sessions (Full Year) -(Not including Consulting Psychiatrists)   

No. of Clients seen by Consulting Psychiatrists

No. of Therapy sessions with Consulting Psychiatrists (Full Year)

No. of Clients receiving psychotropic medication

No. of Peabody Conservatory Students served by Consulting Psychiatrists

No. of Peabody Conservatory Students sessions provided by Consulting Psychiatrists

No. of Nursing School Students served by Consulting Psychiatrists

No. of Nursing School Students sessions provided by Consulting Psychiatrists

No. of Clients seen in emergency crisis during daytime hours

No. of Emergency clients served after hours by CC staff

No. of Emergency phone calls received after hours by CC staff

No. of After hour meetings with client on campus by CC staff

No. of Clients sent to hospital emergency room after hours

No. of Clients admitted to emergency room (hospitalized) after hours

No. of Hours spent in after hours emergencies

Avg. Number of minutes spent responding to each after hour emergency (min – max) No. of Weeks during year that required after hours emergency response

No of Clients sent to emergency room – after hours plus day

No. of Clients hospitalized - after hours plus day

No. of Clients CC estimated to have helped stay in school

No. of Clients given CC Mental Health Withdrawal 

No. of Clients given academic assistance (i.e., letter for withdrawal or extensions.)

No. of Clients who received Readmission Evaluation

No. of Clients on Suicide Tracking

No. of Clients believe prevented from harming self/others

No. of Clients assessed for ADHD

No. of Clients treated or assessed for Substance Abuse

No. of Clients treated or assessed for Eating Disorders

No. of Clients given Violence Assessment

No. of clients who report that “someone in their family owns a gun”

No. of Clients who received counseling for sexual assault

No. of Clients successfully terminated

No. of Clients referred off campus

     #  

1,035

6,074

340 (33%)

    1,117

317 (31%)

19 of 71 (27%)

44

44 of 121 (36%)

134

369 (36%)

70

 90

13     

11

7

70 hours 43 min

54 min (5- 540 min)

36 of 52 (62%)

14

11

105 (10%)

 28 (3%)

  53 (5%)

30 (3%)

42 (4%)

62 (6%)

41 (4%)

105 (10%)

64 (6%)

6 (<1%)

147 (14%)

14 (1%)

430 (42%)

78   (8%)

2.  Intakes during Academic Year (i.e., New & Returning Clients)

Average # of Intakes /Week (Fall Semester)

Average # of Intakes /Week (Spring Semester)

Maximum # of Intakes/Week  (Academic Year)

 

24.2

15.2

36

3.  Clients Seen/Week during Academic Year

Average # of clients seen/Week  (Fall - Not including Psychiatrists)         

Average # of clients seen/Week  (Fall - Including Psychiatrists)

Average # of clients seen/Week  (Spring - Not including Psychiatrists)

Average # of clients seen/Week  (Spring- Including Psychiatrists)

Maximum # of clients seen/Week (Academic Year- Not including Psychiatrists)

Maximum # of clients/ seen/Week (Academic Year- Including Psychiatrists)

 

          140.2

164.6

147.8

176.3

189.0

223.0    

4.  Psychiatrist Clients Seen/Week during Academic Year

Average # of Psychiatrist clients seen/Week (Fall)

Average # of Psychiatrist clients seen/Week (Spring)

Maximum # of Psychiatrist clients seen/Week (Academic Year)

 

24.4

28.5

34

5.  Emergency Daytime Walk-in Clients Seen/Week during Academic Year    

Average # of daytime emergencies seen/Week (Fall)

Average # of daytime emergencies seen/Week (Spring)

Maximum # of daytime emergencies seen/Week (Academic Year)

 

10.0

8.2

17.0

 

6.  Total # of Individual Clients Seen for the Past 6 Years.  

Total # Clients Seen for 2005-06

Total # Clients Seen for 2004-05

Total # Clients Seen for 2003-04

Total # Clients Seen for 2002-03

Total # Clients Seen for 2001-02

Total # Clients Seen for 2000-01

Total # Clients Seen for 1999-00

Total # Clients Seen for 1998-99

 

1,035

1,083

916

886

802

726

750

756

7.  Weekly Case Load Comparisons for the Past 8 Years during AY (not including Psychiatry Sessions)

Average Sessions/Week for 2005-06

Average Sessions/Week for 2004-05

Average Sessions/Week for 2003-04

Average Sessions/Week for 2002-03

Average Sessions/Week for 2001-02

Average Sessions/Week for 2000-01

Average Sessions/Week for 1999-00

Average Sessions/Week for 1998-99

 

 

144

163

160

145

144

114

115

113


8.  Daytime Emergency Sessions/wk Comparisons for the Past 9 AY 

Average Sessions for 2005-06

Average Sessions for 2004-05

Average Sessions for 2003-04

Average Sessions for 2002-03

Average Sessions for 2001-02

Average Sessions for 2000-01

Average Sessions for 1999-00

Average Sessions for 1998-99

Average Sessions for 1997-98

 

9.5

13.3

9.8

7.1

5.8

5.4

5.4

6.1

4.2

9.  # of Appointments per clients during past year

1 appointment

2 appointments

3 appointments

4 appointments   

5 appointments

6 appointments

7 appointments

8 appointments

9 appointments

10 appointments

11+ appointments

1-5 appointments

6-10 appointments

11-15 appointments

16- 20 appointments

21+ appointments

Staff Only

(n=1022)

 

278 (27%)

153 (15%)

91   (9%)

75  (7% )

53   (5%)

46   (5%)

47   (5%)

44   (4%)

34   (3%)

39   (4%)

162 (16%)

650 (64%)

210 (21%)

83   (8%)

30   (3%)

49   (5%)

Staff plus psychiatrists

(n=1035)

 

255 (25%)

144 (14%)

95   (9%)

73  (7% )

56   (5%)

43   (4%)

40   (4%)

39   (4%)

35   (3%)

40   (4%)

215 (21%)

623 (60%)

197 (19%)

94   (9%)

45   (4%)

76   (7%)

Psychiatrists only

(n=340)

 

114 (34%)

60 (18%)

53 (16%)

30  (9% )

27   (8%)

13   (4%)

17   (5%)

5   (1%)

4   (1%)

5   (1%)

12   (4%)

284 (84%)

44 (13%)

11   (3%)

1   (>1%)

0   (0%)

Average # of visits/per client (staff only)

Average # of visits/per client (staff + psychiatrists)

Average # of visits/per client to psychiatrists

5.9 visits

6.9 visits

3.3 visits

10.  Insurance

No. of clients who reported having University (Chickering) Health Insurance Policy

No. of grad student clients who reported having University Health Insurance Policy

No. of undergrad student clients who reported having University Health Insur. Policy

No. of Post-Bac Students who reported having University Health Insurance Policy

No. of International Students who reported having University Health Insurance Policy

No. of clients referred out who reported having University Health Insurance

No. of total sessions clients with University Health Insurance seen before referred out

 

423 (41%)

245 (of 295) (83%)

138 (of 679) (20%)

16 (of 24) (67%)

83 (of 104) (80%)

23 (of 423) (5%)

786 sessions


B) Individual Psychotherapy: Demographics of Counseling Center Clients (N=1,035)

1. Gender

Male

Female

Total

Number

  373

 662

1035

Percentage

               36% 

64%

       100%

2. School Affiliation* (Some students enrolled in more than 1 program)

Arts and Sciences

Engineering

Nursing School

Peabody Institute

Institute for Policy Studies

Advanced Academic Prog.-A&S

Other / No Response

Number

660

178  

 121

    71

3

1

1                 

Percentage   

64%

17%    

 12%

      7%

< 1%

< 1%

< 1% 

3. Age

Age Range

Mode

Mean

Median

Greater than 25 years of age

Number

17-53 years

19.0 years

23.0 years

21.0 years

271

Percentage

 

 

 

 

26%

4. Ethnic Status

African-American

Asian

Biracial

Caucasian

Native-American

Latino/Hispanic

Other / No Response

Number

44

180

25

655

6

68

       57  

Percentage

   4%

 17%

2%

63%

    < 1%

      7%

    6%

5. Marital Status

Single

Married/Committed Relationship

Separated

Divorced

Other

No Response

Number

 847

   147

     9

    10

   12

10     

 Percentage

  82%

 14%

  1%

 1%

     1%

1%

6. Class Year

Freshman

Sophomore

Junior

Senior

Graduate Student

Post-Baccalaureate Program

Other / No Response

Number

   117

 164

 176

 222

 295

24

33  

Percentage

11%

 16%

 17%

 21%

 29%

2%

3%

7. Academic Standing   

Good Standing

Academically dismissed

Reinstated

On Probation

Other / No Response

Number

 897

    4

 15

 65

 54

Percentage

        87%

   < 1%

    1%

    6%

    5%

8. Other Items

International Students

Transfer Students

Physically Challenged Students

Students concerned about Attention Deficit Disorder (ADD)

Number

104

49

11

181

Percentage

10%

5%

1%

18%


 

9. Academic Major

 Undeclared/ Undecided

 No Response

 Arts and Science Totals 

 Anthropology

 Behavioral Biology

 Biology

 Biophysics

 Chemistry

 Classics

 Cognitive Science

 Comparative American Cultures

 Earth & Planetary Science

East Asian Studies

 Economics

 English

 Environmental Earth Sciences

 Film and Media Studies

 French

 German

 History

 History of Art

 History of Science, Medicine, & Technology

 International Studies

 Italian Studies

 Latin American Studies

 Mathematics

 Music

 Near Eastern Studies

 Neuroscience

 Philosophy

 Physics & Astronomy

9. Academic Major Continued

 Political Science

 Pre-Med Cert (Post-Baccalaureate)

 Psychological and Brain Sciences

 Public Health

 Public Policy

 Romance Languages

 Sociology

 Spanish

 Writing Seminars

 Other Arts & Sciences

 Humanistic Studies

 Natural Sciences

 Social & Behavioral Sciences

Number

  53

41

599  

15

9  

55

    21

 27

     7

12

0    

6

1  

27

   18

1

6    

7

    6

   20

     13

     2

   41

    1

5

8

12

     8

39    

11

    21

     Number

30

4

 41

 44

15

7

14  

1

   31

5

 2

    3

3

Percentage

5.1%

 4.0%

57.9%

1.5%

0.9%  

5.3%

   2.0%

   2.6%

 0.7%   

1.2%

0.0%  

0.6%

0.1%

 2.6%

   1.7%

0.1%

0.6%

0.7%

 0.6%

    1.9%

    1.3%

   0.2%

    4.0%

0.1%

0.5%

      0.8%

1.2%

     0.8%

3.8%   

1.1%

     2.0%

Percentage

2.9%

0.4%

4.0%

4.3%

1.4%

0.7%

1.4%   

0.1%

3.0%

     0.5%

     0.2%

     0.3%

0.3%

Engineering Totals  

 Biomedical Engineering

 Chemical Engineering

 Civil Engineering

 Computer Engineering

 Computer Science

 Electrical Engineering

 Engineering Mechanics

 General Engineering

 Geography & Environmental Engineering

 Materials Science & Engineering

 Mathematical Sciences

 Mechanical Engineering

 Other Engineering

169

     46

       27

       3

7   

26

     17

2

0 

 12

      11

       8

        9

1       

16.3%

     4.4%

     2.6%

     0.3%

0.7% 

 2.5%

   1.6%

0.2%

0%  

  1.2%

     1.1%

    0.8%

0.9%

0.1%


 

 

9a. Peabody- Affiliated School Total

 Performance Certificate

 GPD

 Peabody/Homewood Double Degree Program

 Performance: Bachelors

 Performance: Masters

 DMA

 AD

 Music Education: Bachelors

 Music Education: Masters

 Recording Arts: Bachelors

 Recording Arts: Masters

 Conducting

Other Peabody

Not Reporting

Number

71

0      

6     

2

26

13

4

0

1

0

2

1

0

4

12

Percentage

6.9%

0.0%

0.6%

0.2%

2.5%

 1.3%

0.4%

0.0%

0.1%

0.0%

0.2%   

0.1%

 0.0%

0.4%

1.2%

9b. Nursing - Affiliated School Total

 Regular Program

 Accelerated Program

 Other Nursing Affiliated School

Other Nursing Not Reported

121

49

50

15

7

11.7%

4.7%

4.8%

 1.4%

<1.0%

10. Medical

Previously received counseling elsewhere

Currently taking medication

Experiencing medical problems

Medical problem in family

Emotional problem in family

Alcoholism/Substance abuse in family

Adopted

 

 431

428

 196

358

392

308

14

 

     42%

     41%

19%

35%

     38%

     30%

 1%

 

11. Residence  

Residence Halls (On-Campus Total)

  AMR I

  AMR II

  Building A

  Building B

  McCoy Hall

  Wolman Hall

  Bradford Apartments

  Homewood Apartments

  Rogers House

  Peabody Residence Hall

Off-campus Other

No Response        

Number

278

 17

 22

    12

  13

 56

57

    31

40

    3

   16

 734

 23

Percentage

 27%

       2%

       3%

     1%

      1%

      5%

        6%

       3%

        4%

        < 1%

      2%

      71%

    2%

12. How first heard of Counseling Center

Brochure

Career Center

Faculty

Flyer

Friend

Relative

Residence Hall Staff

Contact w/ Center Staff

Newsletter

Saw Location

Student Health & Wellness

JHU Publication

Peabody Publication

Word of Mouth

Dean of Students

Security Office

Other

No Response

Number

87

7

61

24

174

34

52

29

6

39

81

32

9

99

26

1

148

126

Percentage

8%

1%

6%

2%

17%

3%

5%

3%

1%

4%

8%

3%

1%

10%

3%

< 1%

14%

12%

13. Referral Source

Myself

Friend

Relative

Residential Life Staff

Faculty

Staff

Student Health & Wellness

Career Center

Academic Advising

Dean of Students

Security Office

Other

No Response

Number

 517

111

35

48

48

12

57

2

24

38

2

32

109

Percentage

      50%

11%

3%

5%

5%

1%

6%

< 1%

2%

4%

< 1%

3%

11%

 

 

14. Presenting Complaints by frequency in Rank Order.  (Described by students as "serious" or "severe" problems).  Students seeking assistance at the Counseling Center experienced the problems reported below. These complaints are not mutually exclusive.

 #

Presenting Complaint 

#

%

1

Feeling overwhelmed by a number of things; hard to sort things out (Item #19)

304

29.4%

2

Time management, procrastination, getting motivated (Item #3)

286

27.6%

3

Anxiety, fears, worries (Item #3)

279

27.0%

4

Academic concerns; school work and grades (Item #1)

267

25.8%

5

Generally unhappy and dissatisfied (Item #21)

208

20.1%

6

Self-confidence or self-esteem, feeling inferior (Item #16)

189

18.3%

7

Depression (Item #26)

185

17.9%

8

Sleep problems (can’t sleep, sleep too much, nightmares) (Item #36)

171

16.5%

9

General lack of motivation, interest in life; detachment and hopelessness (Item #25)

162

15.7%

10

Overly high academic standards for self (Item #5)

150

14.5%

11

Loneliness, homesickness (Item # 9)

141

13.6%

12

Relationship with romantic partner (Item #12)

126

12.2%

13

Concern regarding breakup, separation, divorce (Item #13)

122

11.8%

14

Test anxiety (Item #2)

115

11.1%

15

 Physical stress (Item #35)

101

9.8%

16

Decision about selecting a major and/or career (Item #8)

94

9.0%

17

 Concern over appearances (Item #17)

94

9.1%

18

Pressures from family for success (Item #7)

92

8.9%

19

Conflict/argument with parents or family member (Item #14)