Treatment engagement, facilitators, and barriers for college students with co-occurring disordered eating and problematic alcohol use
Year: 2025
Type: dissertation
Abstract: Disordered eating and problematic alcohol use are prevalent and often co-occurring concerns among college students, each linked to significant psychological, physical, and academic consequences. Understanding treatment engagement and help-seeking behaviors among students experiencing both issues is critical for developing effective outreach and intervention strategies. The current study conducted a secondary analysis of nationally representative data of college students from the 2022-2023 and 2023-2024 cohorts of the University of Michigan Healthy Minds Study (N = 11,439; ages 18-25). Measures included demographics, disordered eating symptoms (SCOFF), problematic alcohol use (AUDIT), depression and anxiety symptoms (PHQ-9 and GAD-7), and cannabis use, as well as indicators of treatment engagement, perceptions, barriers, and facilitators. The study aimed to: (1) compare treatment engagement, perceptions, and barriers across students who screened positive for disordered eating only (SCOFF+), problematic drinking only (AUDIT+), both (SCOFF+AUDIT), or neither, and (2) identify predictors of treatment engagement among students endorsing both disordered eating and problematic alcohol use. On average, students were 20.4 years old (SD=1.91), 67.8% identified as female, 65.8% as white, and 70.5% as heterosexual. Most students (57.4%) screened negative for both behaviors, while 25.7% were SCOFF+, 9.4% were AUDIT+, and 7.5% were SCOFF+AUDIT. Groups differed in co-occurring mental health symptoms and cannabis use, with the SCOFF+AUDIT group reporting greater depression and anxiety severity and higher rates of past-month cannabis use. After adjusting for these differences, treatment engagement, perceptions, and barriers did not significantly vary by group. Among the SCOFF+AUDIT group, key predictors of treatment engagement included knowledge of available resources and perceived need for treatment. Other relevant predictors included disordered eating severity, self-stigma towards mental health, sexual orientation, and racial/ethnic background. These findings highlight persistent gaps in treatment engagement, as nearly half of students with disordered eating and problematic drinking did not access therapy or counseling in the past year. Results underscore the need for increased campus screening and outreach focused on mental health education and awareness of available resources. Future research should explore therapy content and outcomes for students with co-occurring concerns, as well as cultural, environmental, and peer influences on help-seeking.
DOI: 10.17918/00010930
Authors: Megan L. Wilkinson, Stephanie M. Manasse
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
OpenAlex ID: W4410366113