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College Trauma Overhyped?
February 06, 2003
Maia Szalavitz
A bigger problem or just better diagnosis?

The New York Times puts a misleading headline to a story on a study of students who seek counseling in college, saying  "More in College Seek Help for Pyschological Problems."

In fact, the second paragraph reveals that the same number of students sought help in 2001 as in 1989. Nevertheless, the study claims that more students are now being treated for more serious disorders, with a doubling of people seen for depression and suicidal behavior. Additionally, medication use has more than doubled, and cases of anxiety problems and attention deficit disorder have also risen.

Contrary to the claims of counselors quoted in the story that in general, students' problems are worse now, the data seems to support a different hypothesis.

College kids are reflecting larger trends of increased diagnostic attention to, and better treatment for, depression and anxiety; increasing use of psychiatric medications across all categories; and growing media focus on attention disorders.

For example, numerous studies have documented increasing depression rates around the world over the last several decades (for a number of good references, see this call for new research on depression by the Journal of the American Medical Association (reg req'd). A recent report from the Surgeon General summarizes similar statistics for attention deficit disorder. Numerous studies and hundreds of news articles have documented increased rates of prescriptions for antidepressant and stimulant medications for both children and adults.

Though the media coverage of the new study didn't focus on this, the actual aim of the research was to determine the cause of a consistent lack of congruence between counselors' perceptions and students' reports of their problems. Counselors tend to see students' problems as getting worse in each generation, but the students themselves report the same level of overall distress each year when they seek help.

The authors concluded that increased complexity of student problems could account for this disparity. But they avoided a more parsimonious, if less flattering idea: Counselors may tend to see things as consistently more serious to support ongoing demands for more staff, more attention and of course, more money.

They - and their students - tend to report more of the problems currently under the media spotlight. The authors do mention this with regard to reports of childhood sexual abuse, which rose when media attention focused on an epidemic of abuse, and fell when the media highlighted reports of false accusations.

The upshot is that college kids may not have more problems or even more serious problems then before; they may simply reflect larger trends in diagnosis, treatment and media focus - along with counselors' persistent (and perfectly understandable) desire to stay employed. The good news is that the number seeking help and their initial level of distress is remarkably stable.



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