Effects of transcutaneous vagus nerve stimulation on anxiety and balance under space constraints in Parkinson's disease with anxiety syndrome: A preliminary study.

University students face increasing mental health challenges. Approximately 25% report clinically significant depressive symptoms (Sheldon et al., ), 39% experience anxiety symptoms (Li et al., ), and 11% report severe stress (Beiter et al., ) during their studies. In addition, nearly half of students report persistent and problematic procrastination (Steel, ). Likewise, a large-scale survey conducted in the United Kingdom revealed a similar trend: the 2020 National Student Survey revealed that 42% of students exhibited mental health symptoms warranting professional support (Pereira et al., ). However, despite growing awareness and accessible resources, only one third of students reporting mental health problems had sought help from counseling services (Lui et al., ). Help-avoidant students, in particular, appear to face more chronic stressors and express greater concerns about professional help (Savage et al., ), highlighting the need of identifying and addressing help-avoidance tendencies as a complementary strategy to support psychological services. However, the mental health status of this subgroup remains poorly understood. It is unclear whether help-avoidant students indeed require professional intervention or how severe their mental health difficulties may be, particularly when considering the combined roles of well-being and psychopathology in shaping overall mental functioning. To address this gap, this study used latent profile analyses (LPA) grounded in the dual-factor model, which integrates subjective well-being and psychopathology to capture a more complete picture of mental health among help-avoidant students. Professional help-avoidance refers to the reluctance or refusal to seek available professional mental health support, despite the experience of mental health problems. It can be expressed behaviorally through avoidance of professional services and cognitively through a disconnect between experienced psychological distress and help-seeking intentions (Wilson & Deane, ). Importantly, help-avoidance is generally considered to reflect a motivated decision (Täuber, ). Therefore, help-avoidant students differ from individuals who do not seek help because they either do not perceive a need for treatment or face limited access to services. Investigating the mental health status of help-avoidant students is particularly important, as untreated mental health difficulties have been associated with more severe psychopathology, including depression (Yamaguchi et al., ) and anxiety (Cheung et al., ). Moreover, reliance on avoidant coping strategies may contribute to poorer well-being later in life (Jiang et al., ). At the same time, some evidence suggests that a small proportion of help-avoidant students are able to resolve their difficulties without professional support (Savage et al., ). These findings indicate that help-avoidant students are likely to represent a heterogeneous group. While some students may experience relatively mild distress that resolves without formal treatment, others may face more serious mental health problems that remain unaddressed. Understanding this heterogeneity is important for improving early identification, informing university mental health services, and guiding targeted prevention and intervention efforts for students who may genuinely require support.