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Depression and Anxiety in
University Students
I. Živčić-Bećirević, S. Smojver-Ažić, T. Martinac Dorčić, J. JuretićDepartment of Psychology
Faculty of Humanities and Social Sciences
University of Rijeka, Croatia
Euro Global Summit and Medicare Expo on Psychiatry July 20-22, 2015 Barcelona, Spain
Outline
• Mental health of university students
• The main results of our longitudinal research project
• Implications for the preventive and intervention programs
• Evaluation of the interventions conducted in our university counseling center
College students - vulnerable population• The age with the highest prevalence of psychological
problems (16-24 years)
• Data from Australian universities show that students have more anxiety and depressive symptoms comparing to non-students of the same age (Stallman, 2008)
• 15% of university students in Croatia report some psychological or medical problems (Eurostudent, 2011)
• Research on youth mental health indicates high prevalence of psychological problems among students across universities, mostly symptoms of stress, anxiety and depression
• The number of students with different psychological problems is increasing in the last two decades
• Depression rates have doubled and suicidality rates tripled in 10 years (Russis & Wells, 2008), with increase number of students using psychopharmacs from 11% to 24%.
• Suicide is the 2nd reason for death among university students and the 3rd in general population of the same age
Psychological problems in college students
Problems for which students seek help
in our University Counseling Center - experiences from the last
17 years
29%
19%18%
14%
5%
15%academic problems
interpersonal prob-lems
anxiety
depression
stress/trauma
otherN=1300
• To determine the prevalence of psychological problems among students at the beginning of college
• To track the changes in their adjustment during 3 years of their studying
• To investigate the role of cognitive and behavioral factors that contribute to students’ psychological adjustment and their academic achievement
The main goals of our longitudinal project
• Representative sample of 492 (20 %) freshmen at University in Rijeka
• Age 18-23 years (M=19)female
60%
male40%
Sample
Live with
parents 45%
Moved out of home 55%
Procedure
• 3 measurements during 3 years
I. Semester
II.
III.
IV.
V.
VI. Psychological adjustment:• Depression (BDI)• Anxiety (BAI)
Academic achievement
• Cognitive factors (ATs, beliefs about personal control, abilities and effort)
• Behavioral factors (learning & time menagement skills)
Fear of failureFear of disappointing parentsLack of interestPositive thoughts
Results
Prevalence of depressive and anxiety symptoms when
starting college
77%
16% 5%2%
minimal mild
moderate severe
7% report suicidal thoughts
48%
34%
14%4%
Depression Anxiety
Results
The changes in psychological problems among college students
during 3-years follow-up
Change in average depressive and
anxiety symptoms Depression (BDI)
1st year 2nd year 3rd year5
6
7
8
9
10
11
12
13
14
15
16
male
femalep<.05
Anxiety (BAI)
1st year 2nd year 3rd year5
6
7
8
9
10
11
12
13
14
15
16
p<.01
p<.0013rd < 1st, 2nd
Prevalence of depressive and anxiety symptoms after 3
years at college
79%
14%4% 3%
minimal mild
moderate severe
63%
23%
11%3%
Depression Anxiety
3.5% report suicidal thughts
Results
Changes on the individual level
1st year change 2nd year %
non-depressed depressed 10
depressed non-depressed 15
non-depressed non-depressed 62
depressed depressed 13
nondepressed < cut off depressed > cut off
Groups of students according to the changes in depressive
symptoms
Differences between students who have developed and who didn’t develop depressive symptoms
Non-depressed (at 1st year)
Depressed at 2nd year (14%)More negative ATs (fear of failure
& fear of disappointing parents)
Less positive ATs
Believe they have less control over their achievement
Do not believe that their abilities and effort can contribute to their success
Non-depressed (at 2nd year)
The same number of stress events
Equal learning skills
1st year change 2nd year %
non-anxious anxious 16
anxious non-anxious 8
non-anxious non-anxious 29
anxious anxious 47
non-anxious < cut off anxious > cut off
Groups of students according to the changes in anxiety
symptoms
Differences between students who have developed and who didn’t develop anxiety symptoms
Non-anxious (at 1st year)
Anxiousat 2nd year (36%)More negative ATs (fear of failure,
fear of disappoining parents, lack of interest)
Believe less that their abilities can contribute to their success
Non-anxious (at 2nd year)
The same number of stress events
Equal learning skills
Results
Effects of anxiety and depression on academic achievement
BDI BAI02468
101214161820
succesfulfailingdropped out
p<.001
Students who dropped out of school have higher levels of anxiety and depression at the 2nd year comparing to successful students and those who fail, but who continue their study.
p<.001
Anxiety and depression in regard to academic efficacy
No correlation with GPA
Conclusions of our research
• More students experience anxiety than depressive symptoms – the average BAI result above the cut-off
• Anxiety is more pronounuced at the beginning of college (more than 50% of students are anxious at the 1st semester)
• Even if students are not depressed in average, 23% of them have BDI results above cut-off
• Depressive and anxiety symptoms are not related to students academic achievement (GPA), but they increase the risk for dropping out of school
• Cognitive factors have more significant role then behavioral factors in the increase of anxiety and depressive symptoms
Negative depressive loop
Academic failure
Depressive symptoms
Poor concentration, hopelessness,
more NATs, negative beliefs
Low motivation;
giving up from studying
Underachie-vement,
low mood
Implications
Development of preventive and intervention programs
Importance of early detection of students with signs of depression,
anxiety or academic problems
What we have already done
recommendation
feedback with personal results
on-line questionnaire
Psychoeducation (self-help materials on the website)
Contact counseling center
Early detection of students with psychological problems
Individual and group CBT focused on:
Cognitive interventions• Realistic perception of control• Coping with NATs• Restructuring and reinforcing
personal beliefs aboutabilities and effort
Behavioral interventions• Improvement of self-control• Reinforcement of personal efforts in
academic work
Academic performance
Evaluation of the individual treatment
BDI-II BAI 0
5
10
15
20
25
18.27
21.09
4.58
7.93
before treatment after treatment
Significant decrease (p< .001)
N=130
recovery64%
worsening2%
no change6%
im-prove-ment28%
Evaluation of the treatment on the individual level (RCSC
method)
Thank you!
This study is supported by University of Rijeka (project No. 13.04.1.3.15)