The relationship among young adult college students' depression, anxiety, stress, demographics, life satisfaction, and coping styles

Nursing students' perceived stress and coping behaviors in clinical training in Saudi Arabia

BACKGROUND

Clinical training has been recognized as a stressful experience for nursing students.

AIMS

The aims of this study were to identify levels and types of stressors among nursing students during their clinical training and their coping behaviors.

METHODS

Data were collected using a purposive sampling method from 100 nursing students using a self-reported questionnaire composed of Perceived Stress Scale and Coping Behavior Inventory.

RESULTS

Results showed that "assignments and workload" as well as "teachers and nursing staff" were the highest sources of stress in clinical training. The most common coping behaviors used were "problem-solving" and "staying optimistic". There was a significant difference in perceived stress among students in regard to the way of choosing nursing. There were significant differences in coping behaviors in regard to the presence of relatives in nursing, living status and mothers' educational level. The predictors of perceived stress were self-choosing for nursing and the presence of relatives in nursing, while the predictors for coping behaviors were stress from peers and daily life as well as mothers' educational level.

CONCLUSIONS

Nursing teachers and staff are encouraged to develop strategies that decrease level of stress and promote adaptive coping behaviors among nursing students during their clinical training.

More adaptive versus less maladaptive coping: What is more predictive of symptom severity? Development of a new scale to investigate coping profiles across different psychopathological syndromes

BACKGROUND

Lack of adaptive and enhanced maladaptive coping with stress and negative emotions are implicated in many psychopathological disorders. We describe the development of a new scale to investigate the relative contribution of different coping styles to psychopathology in a large population sample. We hypothesized that the magnitude of the supposed positive correlation between maladaptive coping and psychopathology would be stronger than the supposed negative correlation between adaptive coping and psychopathology. We also examined whether distinct coping style patterns emerge for different psychopathological syndromes.

METHODS

A total of 2200 individuals from the general population participated in an online survey. The Patient Health Questionnaire-9 (PHQ-9), the Obsessive-Compulsive Inventory revised (OCI-R) and the Paranoia Checklist were administered along with a novel instrument called Maladaptive and Adaptive Coping Styles (MAX) questionnaire. Participants were reassessed six months later.

RESULTS

MAX consists of three dimensions representing adaptive coping, maladaptive coping and avoidance. Across all psychopathological syndromes, similar response patterns emerged. Maladaptive coping was more strongly related to psychopathology than adaptive coping both cross-sectionally and longitudinally. The overall number of coping styles adopted by an individual predicted greater psychopathology. Mediation analysis suggests that a mild positive relationship between adaptive and certain maladaptive styles (emotional suppression) partially accounts for the attenuated relationship between adaptive coping and depressive symptoms.

LIMITATIONS

Results should be replicated in a clinical population.

CONCLUSIONS

Results suggest that maladaptive and adaptive coping styles are not reciprocal. Reducing maladaptive coping seems to be more important for outcome than enhancing adaptive coping. The study supports transdiagnostic approaches advocating that maladaptive coping is a common factor across different psychopathologies.

The Effectiveness of Group Training of CBT-Based Stress Management on Anxiety, Psychological Hardiness and General Self-Efficacy Among University Students

Background:

Admission to university is a very sensitive period of life for efficient, active, and young workforces in any country, and it is mostly associated with many changes in social and human relationships. These changes lead to anxiety in students. Moreover, humans need certain functions in order to adaptively deal with different life situations and challenges. By training stress management, these functions can help human acquire the required abilities.

Objective:

The present study was aimed at investigating the effectiveness of stress management training in anxiety, psychological hardiness, and general self-efficacy among university students.

Method:

The study was a quasi-experimental intervention (pretest-posttest-follow-up) including a control group, it was a fundamental applied study. The statistical population consisted of all students of Islamic Azad University, Karaj, Iran. Convenient sampling was employed to select 30 students who were divided into an experimental group (n=15) and a control group (n=15). Before stress management training, both groups filled out Beck Anxiety Inventory, Long and Goulet scale of psychological hardiness, and General Self-efficacy Scale (GSE-10). Afterwards, the experimental group was provided with stress management training. And after the experiment, the abovementioned questionnaires and scales were responded by the two groups. Finally the collected data were analyzed and compared using one-way MANOVA.

Results:

The results of MANOVA indicated that there was a significant difference between the two groups in terms of anxiety, hardiness, and general self-efficacy (p<0.001).

Conclusion:

According to the results of the present study and those of previous investigations that are in agreement with those of the present study, it can be concluded that stress management among university students cause anxiety to drop; moreover, it enhances their psychological hardiness and self-efficacy. In regard with the role and importance of stress management, training this skill should be included in educational plans of university.

"Nudges" to Prevent Behavioral Risk Factors Associated With Major Depressive Disorder

Major depressive disorder-colloquially called "depression"-is a primary global cause of disability. Current preventive interventions, such as problem-solving therapy, are effective but also expensive. "Nudges" are easy and cheap interventions for altering behavior. We have explored how nudging can reduce three behavioral risk factors of depression: low levels of physical activity, inappropriate coping mechanisms, and inadequate maintenance of social ties. These nudges use cognitive biases associated with these behavioral risks, such as valuing the present more than the future, following the herd or the norm, making different choices in light of equivalent conditions, and deciding on the basis of salience or attachment to status quo.

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

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.

Social comparison, negative body image, and disordered eating behavior: the moderating role of coping style

Comparing one's body to those of individuals perceived as more attractive is common among college women, and has been associated with increases in body dissatisfaction and disordered eating. Not all college women are vulnerable to the negative influence of these upward body comparisons; however, little is known about characteristics that may distinguish more vulnerable women. Coping styles, which represent individuals' responses to negative events, are a key area of opportunity for better understanding the relationship between body comparison and weight-related experiences in this population. College women (n =628) completed an electronic assessment of demographics, upward body comparison, body dissatisfaction, disordered eating behavior, and coping styles. Controlling for reported BMI, positive reframing coping style moderated the relationship between upward body-focused comparison and body dissatisfaction (p =0.02), such that women who engaged in more (vs. less) positive reframing showed a weakened relationship between upward body-focused comparison and body dissatisfaction. Controlling for BMI and body dissatisfaction, both self-blaming (p =0.02) and self-distracting (p =0.009) styles also moderated the relationship between upward body-focused comparison and disordered eating behaviors, such that women who more (vs. less) strongly endorsed self-blaming and self-distracting styles appeared more susceptible to the negative influence of upward body comparison. These findings underscore the importance of upward body comparison for body dissatisfaction and disordered eating among college women, and highlight coping style as a key factor in these relationships. Increased attention to upward body comparison and coping style may improve quality of life and contribute to the prevention of disordered eating in this vulnerable population.

Effects of mindfulness-based stress reduction on depression, anxiety, stress and mindfulness in Korean nursing students

BACKGROUND

Nursing students often experience depression, anxiety, stress and decreased mindfulness which may decrease their patient care effectiveness. Mindfulness-based stress reduction (MBSR) effectively reduced depression, anxiety and stress, and increased mindfulness in previous research with other populations, but there is sparse evidence regarding its effectiveness for nursing students in Korea.

OBJECTIVES

To examine the effects of MBSR on depression, anxiety, stress and mindfulness in Korean nursing students.

DESIGN

A randomized controlled trial.

PARTICIPANTS/SETTING

Fifty (50) nursing students at KN University College of Nursing in South Korea were randomly assigned to two groups. Data from 44 students, MBSR (n=21) and a wait list (WL) control (n=23) were analyzed.

METHODS

The MBSR group practiced mindfulness meditation for 2 h every week for 8 weeks. The WL group did not receive MBSR intervention. Standardized self-administered questionnaires of depression, anxiety, stress and mindfulness were administered at the baseline prior to the MBSR program and at completion (at 8 weeks).

RESULTS

Compared with WL participants, MBSR participants reported significantly greater decreases in depression, anxiety and stress, and greater increase in mindfulness.

CONCLUSION

A program of MBSR was effective when it was used with nursing students in reducing measures of depression, anxiety and stress, and increasing their mindful awareness. MBSR shows promise for use with nursing students to address their experience of mild depression, anxiety and stress, and to increase mindfulness in academic and clinical work, warranting further study.

Typologies of Childhood Exposure to Violence: Associations With College Student Mental Health

OBJECTIVE

This study examined typologies of childhood violence exposure (CVE) and the associations of profiles with current demographic characteristics and mental health in emerging adulthood.

PARTICIPANTS

The study evaluated a sample of college students from 2 US geographic regions (Midwest, n = 195; Southeast, n = 200).

METHODS

An online questionnaire (collected 2013-2014) assessed CVE and current mental health. Latent class analysis was used to identify typologies of CVE. Follow-up analyses were conducted to distinguish differences between typologies in demographic characteristics and mental health.

RESULTS

Four distinct profiles emerged: High-Exposed, Domestic-Exposed, Community-Exposed, and Low-Exposed. High- and Domestic-Exposed groups were more likely to be first-generation college students and to experience symptoms of psychopathology.

CONCLUSIONS

This study offers a unique presentation of CVE profiles and a nuanced interpretation of their differential relationship to current demographic characteristics and mental health. It may befit university mental health initiatives to engage first-generation students and utilize comprehensive assessments of previous victimization.

COPING AS A MEDIATOR OF INTERNALIZED HOMOPHOBIA AND PSYCHOLOGICAL DISTRESS AMONG YOUNG ADULT SEXUAL MINORITY WOMEN

Sexual minorities have higher rates of depression and anxiety than their heterosexual counterparts. This elevated risk of psychological distress has generally been hypothesized to be a result of the effects of discrimination including internalized negative beliefs about sexual minorities. However, little research has examined the role of various types of coping in mediating between internalized homophobia and mental health. We tested the direct relationship between internalized homophobia and psychological distress and evaluated general and sexual minority-specific coping strategies as potential mediators using structural equation modeling. Data are from a national sample of 1,099 young adult sexual minority women who were on average 20.86 (SD= 2.12) years old, participating in a study on mental health and substance use. The model demonstrated acceptable fit, χ² (83) = 402.9, p <.001, CFI=.94, TLI=.92, SRMR= .07, and RMSEA=.06, accounting for 73% of variance in psychological distress. Greater use of maladaptive coping and less use of sexual minority-specific coping were associated with higher psychological distress. Although maladaptive coping mediated the relationship between internalized homophobia and psychological distress, sexual minority-specific coping did not. Our findings support previous studies that have demonstrated the impact of internalized homophobia on psychological distress as well as the role of coping as a protective/risk factor in this relationship.

Perceived stress scores among Saudi students entering universities: a prospective study during the first year of university life

In this prospective study we wanted to determine whether perceived stress over time among students in the Preparatory Year of King Saud University (KSU) predisposes them to cardiometabolic abnormalities. A total of 110 apparently healthy Saudi students (35 men and 75 women enrolled during the 2010−2011 academic year) were included. Perceived stress was determined at baseline and 1 year later. Anthropometrics were obtained and morning fasting serum glucose, lipid profile and cortisol were measured at both times. Perceived stress was noted among 48.2% of subjects at baseline and was not significantly different after follow-up, with 45.4% scoring high. In men, the prevalence of perceived stress was 48.6% at baseline (13 out of 35) and 37.1% at follow-up (13 out of 35), while in women it was 48% at baseline and 49.3% at follow-up. Interestingly, significant improvements in the blood pressure and lipid profiles, with the exception of HDL-cholesterol, were observed in both men and women, while fasting glucose also improved in women. Serum cortisol was inversely associated to fasting glucose, and total- and LDL-cholesterol (p-values 0.007, 0.04 and 0.04, respectively). These data are opposite to findings in students entering Western universities, in whom increasing stress and a deteriorating cardiometabolic profile have been repeatedly noted. Perceived stress and morning cortisol levels among students of the Preparatory Year in KSU remained constant for both genders over time, yet an improved cardiometabolic profile was observed, suggesting good adaptation among our pre-college students in their first year of university life.

Taking the right action in the right way: a comparison of frameworks for assessing the health and quality of life of a postsecondary student campus community

The focus of campus health research, historically, has been on population health at the individual or aggregate level with little effort to examine the health of the students at a community level with a focus on the broader determinants of health and community-level intervention. The purpose of this article is to critique three models or frameworks of campus health, articulate the World Health Organization (WHO) vision of a health-promoting university, and demonstrate the efficacy of adapting the Community Health Action model for use in university and college settings. Foundational within this proposed model is taking the right action using the right process, an inclusive participatory process. Adaptation of the model requires careful attention to student engagement in community, a healthy campus infrastructure and processes, and relationships beyond the campus. Effective student community assessment and improvement of student community health, ultimately, will serve to generate knowledge and build skills at various levels to benefit the health and quality of life of the students, their student community, the educational institution, and the broader community.

Insufficient coping behavior under chronic stress and vulnerability to psychiatric disorders

BACKGROUND

Epidemiological data indicate that 75% of subjects with major psychiatric disorders have their onset of illness in the age range of 17-24 years. An estimated 35-50% of college and university students drop out prematurely due to insufficient coping skills under chronic stress, while 85% of students receiving a psychiatric diagnosis withdraw from college/university prior to the completion of their education. In this study, we aimed at developing standardized means of identifying students with insufficient coping skills under chronic stress and at risk for mental health problems.

SAMPLING AND METHODS

A sample of 1,217 college students from 3 different sites in the USA and Switzerland completed 2 self-report questionnaires: the Coping Strategies Inventory (COPE) and the Zurich Health Questionnaire (ZHQ), which assesses 'regular exercises', 'consumption behavior', 'impaired physical health', 'psychosomatic disturbances' and 'impaired mental health'. The data were subjected to structure analyses by means of a neural network approach. We found 2 highly stable and reproducible COPE scales that explained the observed interindividual variation in coping behavior sufficiently well and in a socioculturally independent way. The scales reflected basic coping behavior in terms of 'activity-passivity' and 'defeatism-resilience', and in the sense of stable, socioculturally independent personality traits.

RESULTS

Correlation analyses carried out for external validation revealed a close relationship between high scores on the defeatism scale and impaired physical and mental health. This underlined the role of insufficient coping behavior as a risk factor for physical and mental health problems.

CONCLUSION

The combined COPE and ZHQ instruments appear to constitute powerful screening tools for insufficient coping skills under chronic stress and for risks of mental health problems.

A preliminary study of the psychological differences in infertile couples and their relation to the coping styles

BACKGROUND

Studies from Western countries have observed that couples undergoing infertility treatment suffer various physical and psychological difficulties at a higher frequency than the comparable general population. These relate to treatment challenges and other psychosocial stressors, often influenced by coping style, personality factors and available support systems. There is paucity of studies in non-Western populations.

OBJECTIVE

The aim of this pilot investigation was to evaluate characteristics and gender differences in perceived psychological difficulties reported by infertile Malaysian couples. In particular, depression, anxiety and stress, along with correlated coping styles, were examined between spouses.

METHODS

Demographic information, including age, ethnicity and duration and causes of infertility, were collected from participants treated within a fertility clinic. The Depression, Anxiety and Stress Scale (DASS) and Coping Inventory for Stressful Situation (CISS) were completed to measure psychological distress and coping styles.

RESULTS

Depression, anxiety and stress-related difficulties were reported at significantly higher frequency by wives than husbands (p<0.05). There were no significant differences in coping styles between wives and husbands. However, emotional-oriented coping style was associated with significantly higher levels of depression, anxiety and stress (p<0.05) within the overall sample with odds ratios of 2.5, 3.0 and 1.5, respectively.

CONCLUSION

The study confirms that, as with Western subjects, Malaysian infertile couples demonstrate the vulnerability to psychological distress that occurs more frequently among wives than husbands. As anticipated, emotional coping style was associated with greater distress in both genders.

Body regard as a moderator of the relation between emotion dysregulation and nonsuicidal self-injury

Despite research documenting a strong association between emotion dysregulation and nonsuicidal self-injury (NSSI), the moderators of this association have received little attention. Thus, it remains unclear why some individuals with heightened emotion dysregulation engage in NSSI and others do not. Body regard (i.e., how one perceives, experiences, and cares for the body) may be one such moderator, explaining the risk for NSSI among some individuals with emotion dysregulation. The current study used structural equation modeling within a sample of 398 undergraduates (26% reporting NSSI, mean frequency = 25.16, SD = 40.5) to test the interactive effect of emotion dysregulation and body regard on NSSI frequency when controlling for negative affect and borderline personality disorder symptoms. The interaction model provided a strong fit to the data and showed that emotion regulation was associated with NSSI only when low levels of body regard were present. Results suggest that body regard may be important to understanding who engages in NSSI within the context of emotion dysregulation. Possible mechanisms underlying the interaction between body regard and emotion dysregulation are discussed along with treatment and prevention implications.

Modeling bipolar disorder suicidality

OBJECTIVES

To review the psychosocial, neuropsychological, and neurobiological evidence regarding suicide and bipolar disorder (BD), to enable the development of an integrated model that facilitates understanding, and to provide a useful framework for future research.

METHODS

A two-stage literature review was conducted. First, an electronic literature search was performed using key words (e.g., bipolar disorder, suicide risk, and neuroimaging) and standard databases (e.g., MEDLINE). Second, theoretical suicide models were reviewed, and their evidence base and relevance to BD were evaluated in order to determine a guiding theoretical framework for contextualizing suicide in BD.

RESULTS

Although accumulating clinical, cognitive, and neurobiological correlates of suicide have been identified in BD, extant research has been largely atheoretical. The Cry of Pain (CoP) and an adapted version of the model, the Schematic Appraisals Model of Suicide (SAMS), provide a useful schema for examining vulnerability to suicide in BD, by taking into account biopsychosocial determinants of suicidality. In combination, these also provide a model within which the neural correlates of suicide can be integrated.

CONCLUSIONS

The proposed Bipolar Suicidality Model (BSM) highlights the psychosocial precursors to suicidality in BD, while recognizing the key role of cognitive deficits and underlying functional neurobiological abnormalities. It usefully integrates our knowledge, and provides a novel perspective that is intended to meaningfully inform future research initiatives, and can lead to a better understanding of suicidality in bipolar disorder. Ultimately, it is hoped that it will facilitate the development of targeted interventions that diminish the risk of suicide in bipolar disorder.

Evaluation of a brief cognitive behavioral group therapy for psychological distress among female Icelandic University students

A study of a brief cognitive behavioral group therapy intervention for psychologically distressed Icelandic female university students was conducted using a pre-post test quasi-experimental design with intervention and control group conditions. Students were randomly allocated to control and intervention group conditions (n = 30). The intervention group received four sessions of cognitive behavioral group therapy, delivered by two advanced practice psychiatric nurses. Assessment of distress included self-reported depression and anxiety symptoms. Students in the intervention group experienced significantly lower levels of depression and anxiety symptoms compared to the control group post-test providing preliminary evidence concerning intervention effectiveness for Icelandic students.

β-endorphin modulates the effect of stress on novelty-suppressed feeding

Although stress is implicated in the pathophysiology of mood and anxiety disorders, not all individuals who suffer stressful life events develop psychopathology. Differential susceptibility to stress may be influenced by genetically mediated differences in hypothalamic-pituitary-adrenal (HPA) axis activity and moderation of the stress response by the opioid peptide β-endorphin (β-E). The present study investigated genetic contributions to coping behavior by examining anxious behavior of transgenic mice with varying capacities to synthesize β-E [B6.129S2-Pomc^tm1Low/J; regulated by insertion of a premature stop codon into one or both copies of the proopiomelanocortin (POMC) gene], both under normal conditions and following 3 min of forced swim (FS). Ten minutes after this stress exposure or a control manipulation, acutely food-deprived female and male transgenic mice were subjected to a novelty-suppressed feeding (NSF) test, during which their interaction with an almond slice located in the center of an open field box was measured. There was an interaction between genotype and stress for latency to approach the almond and whether or not the almond was approached, such that mice with low or absent β-E displayed a stronger aversion to novelty-feeding after stress exposure than did mice with normal levels. These data provide evidence for a moderating effect of β-E on the behavioral response to stress. Genotypic differences in anxious behavior emerged when mice were stressed prior to behavioral assessment, suggesting that β-E plays a role in coping behavior. These findings indicate that genetic variability in sensitivity of the β-E system to stress may contribute, at least in part, to heritable differences in stress reactivity as well as vulnerability to stress-related psychopathology.

Skin picking disorder in university students: health correlates and gender differences

OBJECTIVE

This study sought to examine the prevalence of skin picking disorder (SPD) in a university sample and assess associated physical and mental health correlates.

METHODS

A 54-item anonymous, voluntary survey was distributed via random email generation to a sample of 6000 university students. Current psychological and physical status was assessed, along with academic performance. Positive screens for SPD were determined based upon individuals meeting full proposed DSM-V criteria.

RESULTS

A total of 1916 participants (31.9%; mean age 22.7 ± 5.1; 58.1% female) responded and were included in the analysis. The overall prevalence of SPD was 4.2% (females=5.8%; males=2.0%). SPD was associated with significantly higher lifetime rates of affective, anxiety, eating, substance use and impulse control disorders. Men with SPD had significantly higher BMI ratings and perceived themselves as significantly less attractive to others while women had significantly higher depressive symptoms.

CONCLUSION

SPD is common in both genders and is associated with significant mental and physical health detriments, including higher levels of stress, more psychiatric comorbidity and poorer perceived health. Academic institutions, clinicians and public health officials should be aware of the multimodal presentation of SPD and screen for it in primary care and dermatologic settings.

Prevalence of Depression among University Students: A Systematic Review and Meta-Analysis Study

Introduction. Depression is one of the four major diseases in the world and is the most common cause of disability from diseases. The aim of this study is to estimate the prevalence of depression among Iranian university students using meta-analysis method. Materials and Methods. Keyword depression was searched in electronic databases such as PubMed, Scopus, MAGIran, Medlib, and SID. Data was analyzed using meta-analysis (random-effects model). Heterogeneity of studies was assessed using the I (2) index. Data was analyzed using STATA software Ver.10. Results. In 35 studies conducted in Iran from 1995 to 2012 with sample size of 9743, prevalence of depression in the university students was estimated to be 33% (95% CI: 32-34). The prevalence of depression among boys was estimated to be 28% (95% CI: 26-30), among girls 23% (95% CI: 22-24), single students 39% (95% CI: 37-41), and married students 20% (95% CI: 17-24). Metaregression model showed that the trend of depression among Iranian students was flat. Conclusions. On the whole, depression is common in university students with no preponderance between males and females and in single students is higher than married ones.