Research reportThe prevalence and correlates of depression, anxiety, and stress in a sample of college students
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.
References (53)
- et al.
Quality of life impairment in generalized anxiety disorder, social phobia, and panic disorder
J. Anxiety Disord.
(2009) - et al.
Mental health problems and help-seeking behavior among college students
J. Adolesc. Health
(2010) - et al.
Depression among university students in Kenya: prevalence and sociodemographic correlates
J. Affect. Disord.
(2014) - American Psychological Association, 2009. Stress in America 2009. Stress in America Surveys...
- American Psychological Association, 2014. Stress in America – Are teens adopting adults׳ stress habits. Stress in...
- Anxiety and Depression Association of America, n.d. Physical activity reduces stress. Understanding the Facts Reports...
- et al.
The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students
Soc. Psychiatry Psychiatr. Epidemiol.
(2008) - et al.
Changes in counseling center client problems across 13 years
Prof. Psychol.-Res. Pr.
(2003) - et al.
Mental health of college students and their non-college-attending peers: results from the National Epidemiologic Study on Alcohol and Related Conditions
Arch. Gen. Psychiatry
(2008) - et al.
Depressive symptomatology among university students in Denizli, Turkey: prevalence and sociodemographic correlates
Croat. Med. J.
(2005)
Profiles of adolescent stress: the development of the adolescent stress questionnaire (ASQ)
J. Adolesc.
An examination of transfer shock in academic disciplines
Community Coll. J. Res. Pr.
Level of self-esteem and contingencies of self-worth: unique effects on academic, social, and financial problems in college students
Personal. Soc. Psychol. Bull.
Cross-cultural correlates of life satisfaction and self-esteem
J. Personal. Soc. Psychol.
Teasing apart the effects of cognition, stress, and depression on health
Am. J. Health Behav.
Prevalence and correlates of depression, anxiety, and suicidality among university students
Am. J. Orthopsychiatry
The efficacy of eye movement desensitization and reprocessing therapy technique in the treatment of test anxiety
J. Coll. Couns.
Assessing the risk factors for suicidal thoughts at a nontraditional commuter school
J. Am. Coll. Health
Body image satisfaction among female college students
Ind. Psychiatry J.
Effectiveness of cognitive-behavioral therapy on depressive symptomatology, stress and coping strategies among Jordanian university students
Issues Ment. Health Nurs.
Seasonal variations in mood and behavior among Chinese medical students
Am. J. Psychiatry
The short-form version of the Depression Anxiety Stress Scales (DASS-21): construct validity and normative data in a large non-clinical sample
Br. J. Clin. Psychol.
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