Elsevier

Journal of Affective Disorders

Volume 173, 1 March 2015, Pages 90-96
Journal of Affective Disorders

Research report
The prevalence and correlates of depression, anxiety, and stress in a sample of college students

https://doi.org/10.1016/j.jad.2014.10.054Get rights and content

Abstract

Background

Over the past four years, the Franciscan University Counseling Center has reported a 231% increase in yearly visits, as well as a 173% increase in total yearly clients. This trend has been observed at many universities as mental health issues pose significant problems for many college students. The objective of this study was to investigate potential correlates of depression, anxiety, and stress in a sample of college students.

Methods

The final analyzed sample consisted of 374 undergraduate students between the ages of 18 and 24 attending Franciscan University, Steubenville, Ohio. Subjects completed a survey consisting of demographic questions, a section instructing participants to rate the level of concern associated with challenges pertinent to daily life (e.g. academics, family, sleep), and the 21 question version of the Depression Anxiety Stress Scale (DASS21).

Results

The results indicated that the top three concerns were academic performance, pressure to succeed, and post-graduation plans. Demographically, the most stressed, anxious, and depressed students were transfers, upperclassmen, and those living off-campus.

Conclusions

With the propensity for mental health issues to hinder the success of college students, it is vital that colleges continually evaluate the mental health of their students and tailor treatment programs to specifically target their needs.

Introduction

According to a recent study conducted by the Anxiety and Depression Association of America (n.d.), seven out of 10 United States adults claim to experience stress or anxiety at least at a moderate level on a daily basis. While stress is an inevitable part of life, it is very present (Blanco et al., 2008) and becoming more prevalent among university students (Gallagher, 2008, Mackenzie et al., 2011). In addition to anxiety and stress, depression can also impact college life to such an extent that in-depth research is necessary in order to help future students. In the USA, almost 10% of university students have been diagnosed with, or treated for, depression over the past 12 months (Wolfram, 2010). However, only about half of the people in America suffering from a diagnosed case of depression are treated for the disorder (NIH, 2010).

Increasingly, obtaining a college degree is seen as the key to success (Thurber and Walton, 2012), and with many students leaving their home state to attend a post-secondary school, the transition itself can be a cause of depression, anxiety and stress. The transition into a post-secondary school has been reported to be associated with appetite disturbance, concentration problems and depression (Lee et al., 2009, Price et al., 2007). Homesickness is a direct byproduct of this transition that affects university students, mainly freshmen (Thurber and Walton, 2012), and is therefore an important focus for universities looking to properly treat the mental health problems plaguing their students.

Academics are an integral part of the life of all college students, and without a healthy attitude toward academic goals, students can be plagued with crippling bouts of stress. Academic pressures of meeting grade requirements, test taking, volume of material to be learned and time management has been shown to be a significant source of stress for students (Crocker and Luhtanen, 2003, Kumaraswamy, 2013, Misra and McKean, 2000). While academics can be perceived as a positive challenge, potentially increasing learning capacity and competency, if viewed negatively, this stress can be detrimental to the student׳s mental health (Kumaraswamy, 2013, Murphy and Archer, 1996).

In order for universities to tailor treatments to the specific needs of their students, it is important to understand what other aspects of life, in addition to academics, may be causing this increase in depression, anxiety, and stress. For example, negative perceptions of body image have been shown to be linked with increased likelihood of depression and anxiety in adolescents (Kostanski and Gullone, 1998, Lifespan News, 2006), as well as low satisfaction in life, low self-esteem and feelings of inferiority that may result in significant impairment of social, occupational and educational functioning (Goswami et al., 2012). Students who grew up in families lacking financial stability are more likely to show symptoms of depression and anxiety (Eisenberg et al., 2007), indicating that financial difficulties correlate with higher rates of these mental health problems. Studies also indicate that poor sleeping habits have a negative impact on academic performance and mental health complaints, with women reporting poorer sleep habits than men (Orzech et al., 2011).

The negative side effects of depression, anxiety, and stress demonstrate the importance of treating their incidence among college students. For example, depression is correlated with detrimental behaviors such as smoking, poor diet, lack of exercise, poor sleep habits, and noncompliance with medical treatment recommendations (Doom and Haeffel, 2013). People with anxiety disorders also report a worse quality of life than people without high levels of anxiety (Barrera and Norton, 2009). It can also be beneficial for universities to understand what aspects of life correlate with a decrease in depression, anxiety, and stress symptoms in order to encourage those behaviors in their students. For example, studies have shown that those college students who have satisfactory relationships with family and friends are more likely to have overall life satisfaction (Diener and Diener, 1995).

The Franciscan University Counseling Center reports that the prevalence of counseling requests is highest three to four weeks into the semester and also after mid-terms. In the school year of 2007/08 there were 196 clients totaling 1000 visits with an overall diagnosis of depression. That number almost doubled in the year 2012/13 with 340 clients totaling 2311 visits with an overall diagnosis of anxiety and depression. This study was designed to investigate the potential factors that may correlate with the increase in student visits to the counseling center at Franciscan University. It is hoped that the findings of this study would give some insight into the main behaviors or factors associated with depression, anxiety and stress throughout the university׳s student body, as well as potentially other universities of similar, or larger, size.

For the purpose of this study, the DASS 21 was utilized to assess the relative prevalence of the depression, anxiety and stress (Lovibond and Lovibond, 2004; Henry and Crawford, 2005). The characteristics associated with high scores on each DASS scale are as follows: Depression: “self-disparaging, dispirited, gloomy, blue, convinced that life has no meaning or value, pessimistic about the future, unable to experience enjoyment or satisfaction, unable to become interested or involved, slow, and lacking in initiative”; Anxiety: apprehensive, panicky, trembly, shaky, aware of dryness of the mouth, breathing difficulties, pounding of the heart, sweatiness of the palms, worried about performance and possible loss of control”; and Stress: “over-aroused, tense, unable to relax, touchy, easily upset, irritable, easily startled, nervy, jumpy, fidgety, and intolerant of interruption or delay” (PFA, 2013).

Section snippets

Methods

In compliance with Federal Law, requiring that all researchers conducting testing on human participants must complete training on the protection of research subjects, all survey administrators completed the Protecting Human Research Participants training module provided through the NIH Office of Extramural Research and certification is kept on file for documentation purposes by the principal investigator, Dr. Stephen Sammut. Prior to administration of the survey, IRB approval was obtained

Demographics

The gender distribution of those surveyed closely resembled the gender distribution of the student body at Franciscan University (FUS, 2014), with 37% of subjects being males and 63% being female. 30% of subjects surveyed were freshman, 26% were sophomores, 22% were juniors, and 22% were seniors. 67% of those surveyed lived in the campus dormitories, 12% lived in Assisi Heights (university-provided apartments available to juniors and seniors), 18% lived in off-campus housing, and 3% lived on

Discussion

While one of the initial goals of this survey was to narrow down possible correlates of depression, anxiety, and stress, all the potential sources of concern indicated on the survey had a significant positive correlation with levels of depression, anxiety, and stress. Of the 19 sources of concern surveyed, the 10 that caused the most concern were academic performance, pressure to succeed, post-graduation plans, financial concerns, quality of sleep, relationship with friends, relationship with

Limitations

One limitation of this study was the fact that the definition of “extracurricular activities” was not clearly stated and was left up to the interpretation of the participants. Because all participants were not utilizing the same working definition of extracurricular activities, answers for the question “how significant are extracurricular activities as a source of stress in your life” become less comparable across participants. For example, participants may or may not have included time spent

Role of funding source

This research was not funded.

Conflict of interest

No authors of this paper have any conflicts of interest.

Acknowledgments

We would like to acknowledge and thank the Experimental Psychology Class of Fall 2013 who assisted in the study: Molly Clarahan, Matthew Dougherty, Robert Eggleston, Carmen Hambric, Theresa Holt, Julia Houska, Maryann Idzior, Lauren Kleckner, Caleb Knorr, Andrew Koehler, Maryellen McCrady, Ryan Nash, Alison Nickel, Christopher Radlicz, and Mark Wahl.

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