| Literature DB >> 31405114 |
Xinqiao Liu1,2, Siqing Ping3, Wenjuan Gao4.
Abstract
The onset of most lifetime mental disorders occurs during adolescence, and the years in college, as the final stage of adolescence in a broad sense, deserve attention in this respect. The psychological well-being of undergraduate students can influence not only their academic and professional success, but also the development of society as a whole. Although previous studies suggested psychiatric disorders are common in the adult population, there was little consistent information available about undergraduate students' mental health problems. This research aimed to describe the changes in depression, anxiety, and stress of Chinese full-time undergraduate students as they experienced university life using the Depression Anxiety Stress Scales-21 (DASS-21). The main conclusions of our study were as follows: (1) on average, students' severity scores of depression during the four academic years varied between 7.22 and 7.79, while stress scores ranged from 9.53 to 11.68. However, the anxiety scores of college students in the first three years turned out to be 7.40, 7.24 and 7.10, respectively, slightly overtaking the normal threshold of 7. These results indicated that Chinese college students, in general, were mentally healthy with regard to depression and stress, but their average anxiety levels were beyond normal in the first three years. (2) As for the proportions of students with different degrees of severity, approximately 38% to 43% of college students were above the normal level of anxiety, about 35% above the normal level of depression, and around 20% to 30% above the normal level of stress. (3) There were significant differences in the psychological health states of students of different years, especially among the sophomores, juniors, and seniors; the highest score of depression, anxiety, and stress all appeared in the first or second year on average, but some improvements were achieved in the third and last years. The findings suggested that colleges and universities need to pay special attention to psychologically unhealthy students, and with concerted efforts by the government, formulate mental health policies in the prevention, detection, and treatment of students' psychiatric disorders, rather than just focusing on their average levels of mental health.Entities:
Keywords: anxiety; depression; longitudinal study; stress; undergraduate students; well-being
Mesh:
Year: 2019 PMID: 31405114 PMCID: PMC6719208 DOI: 10.3390/ijerph16162864
Source DB: PubMed Journal: Int J Environ Res Public Health ISSN: 1660-4601 Impact factor: 3.390
Sample sizes of different universities.
| University | Initial Number of Participants | Effective Sample Size | Proportion (%) |
|---|---|---|---|
| Peking University | 246 | 130 | 9.28 |
| Renmin University of China | 245 | 147 | 10.49 |
| Tsinghua University | 257 | 148 | 10.56 |
| Beihang University | 153 | 89 | 6.35 |
| Beijing Institute of Technology | 157 | 102 | 7.28 |
| North China University of Technology | 147 | 91 | 6.5 |
| Beijing University of Chemical Technology | 142 | 85 | 6.07 |
| Beijing University of Posts and Telecommunications | 128 | 79 | 5.64 |
| Beijing Institute of Petroleum and Chemical Technology | 136 | 73 | 5.21 |
| Beijing University of Agriculture | 135 | 71 | 5.07 |
| Beijing Language and Culture University | 161 | 82 | 5.85 |
| Communication University of China | 135 | 69 | 4.93 |
| Capital University of Economics and Trade | 139 | 74 | 5.28 |
| Minzu University of China | 160 | 81 | 5.78 |
| China University of Mining and Technology | 132 | 80 | 5.71 |
| Total | 2473 | 1401 | 100 |
Severity labels of depression, anxiety, and stress.
| Degree of Severity | Depression | Anxiety | Stress |
|---|---|---|---|
| Normal | 0–9 | 0–7 | 0–14 |
| Mild | 10–13 | 8–9 | 15–18 |
| Moderate | 14–20 | 10–14 | 19–25 |
| Severe | 21–27 | 15–19 | 26–33 |
| Extremely Severe | 28+ | 20+ | 34+ |
Descriptive statistics of each item in the Depression Anxiety Stress Scales-21 (DASS-21) across years.
| Scale | Item | Year 1 | Year 2 | Year 3 | Year 4 | ||||
|---|---|---|---|---|---|---|---|---|---|
| Mean | SD | Mean | SD | Mean | SD | Mean | SD | ||
| Depression | I couldn’t seem to experience any positive feeling at all | 0.45 | 0.70 | 0.50 | 0.73 | 0.53 | 0.69 | 0.53 | 0.70 |
| I found it difficult to work up the initiative to do things | 0.62 | 0.78 | 0.66 | 0.80 | 0.61 | 0.77 | 0.49 | 0.68 | |
| I felt that I had nothing to look forward to | 0.44 | 0.73 | 0.55 | 0.78 | 0.52 | 0.75 | 0.52 | 0.71 | |
| I felt down-hearted and blue | 0.67 | 0.75 | 0.66 | 0.74 | 0.65 | 0.73 | 0.55 | 0.67 | |
| I was unable to become enthusiastic about anything | 0.44 | 0.73 | 0.47 | 0.73 | 0.47 | 0.67 | 0.48 | 0.66 | |
| I felt I wasn’t worth much as a person | 0.87 | 0.86 | 0.88 | 0.89 | 0.82 | 0.82 | 0.76 | 0.76 | |
| I felt that life was meaningless | 0.16 | 0.47 | 0.18 | 0.49 | 0.25 | 0.56 | 0.28 | 0.55 | |
| Anxiety | I was aware of dryness of my mouth | 1.05 | 0.89 | 0.98 | 0.87 | 0.86 | 0.76 | 0.75 | 0.69 |
| I experienced breathing difficulty | 0.30 | 0.61 | 0.34 | 0.62 | 0.37 | 0.62 | 0.40 | 0.60 | |
| I experienced trembling | 0.22 | 0.51 | 0.22 | 0.53 | 0.23 | 0.51 | 0.27 | 0.53 | |
| I was worried about situations in which I might panic and make a fool of myself | 1.08 | 0.85 | 1.01 | 0.85 | 0.87 | 0.82 | 0.72 | 0.75 | |
| I felt I was close to panic | 0.21 | 0.53 | 0.26 | 0.60 | 0.32 | 0.61 | 0.34 | 0.61 | |
| I was aware of the action of my heart in the absence of physical exertion | 0.36 | 0.63 | 0.34 | 0.64 | 0.37 | 0.63 | 0.38 | 0.59 | |
| I felt scared without any good reason | 0.48 | 0.72 | 0.46 | 0.72 | 0.52 | 0.70 | 0.46 | 0.66 | |
| Stress | I found it hard to wind down | 0.73 | 0.83 | 0.78 | 0.85 | 0.71 | 0.78 | 0.59 | 0.71 |
| I tended to over-react to situations | 0.87 | 0.85 | 0.88 | 0.83 | 0.86 | 0.78 | 0.82 | 0.70 | |
| I felt that I was using a lot of nervous energy | 1.24 | 0.92 | 1.30 | 0.93 | 1.10 | 0.82 | 0.88 | 0.78 | |
| I found myself getting agitated | 0.47 | 0.66 | 0.47 | 0.67 | 0.53 | 0.66 | 0.47 | 0.63 | |
| I found it difficult to relax | 0.79 | 0.85 | 0.88 | 0.89 | 0.84 | 0.82 | 0.72 | 0.74 | |
| I was intolerant of anything that kept me from getting on with what I was doing | 0.67 | 0.73 | 0.67 | 0.77 | 0.66 | 0.72 | 0.56 | 0.68 | |
| I felt that I was rather touchy | 0.77 | 0.83 | 0.86 | 0.86 | 0.80 | 0.78 | 0.72 | 0.76 | |
| Severity Degree Scores | Depression | 7.30 | 7.79 | 7.70 | 7.22 | ||||
| Anxiety | 7.40 | 7.24 | 7.10 | 6.63 | |||||
| Stress | 11.07 | 11.68 | 11.00 | 9.53 | |||||
Note: SD = Standard Deviation.
Figure 1Comparison of means in depression, anxiety and stress across years.
Figure 2Proportion of participants whose answers on the Depression Anxiety Stress Scales-21 (DASS-21) indicated a normal, mild, moderate, severe or extremely severe amount of depression across years.
Figure 3Proportion of participants whose answers on the DASS-21 indicated a normal, mild, moderate, severe or extremely severe amount of anxiety across years.
Figure 4Proportion of participants whose answers on the DASS-21 indicated a normal, mild, moderate, severe or extremely severe amount of stress across years.
Standardized parameter estimates of models.
| Model | Unconstrained | Measurement Weights | Structural Covariances | Measurement Residuals | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Year | 1 | 2 | 3 | 4 | 1 | 2 | 3 | 4 | 1 | 2 | 3 | 4 | 1/2/3/4 |
| λ1 | 0.73 | 0.72 | 0.80 | 0.87 | 0.75 | 0.75 | 0.80 | 0.86 | 0.78 | 0.76 | 0.79 | 0.83 | 0.79 |
| λ2 | 0.78 | 0.83 | 0.83 | 0.90 | 0.81 | 0.83 | 0.84 | 0.89 | 0.84 | 0.84 | 0.83 | 0.87 | 0.84 |
| λ3 | 0.82 | 0.81 | 0.87 | 0.87 | 0.77 | 0.79 | 0.86 | 0.89 | 0.81 | 0.81 | 0.86 | 0.88 | 0.84 |
| e1 | 0.34 | 0.34 | 0.24 | 0.24 | 0.41 | 0.37 | 0.26 | 0.21 | 0.35 | 0.35 | 0.26 | 0.23 | 0.29 |
| e2 | 0.39 | 0.32 | 0.31 | 0.19 | 0.34 | 0.31 | 0.29 | 0.21 | 0.29 | 0.30 | 0.31 | 0.25 | 0.29 |
| e3 | 0.46 | 0.48 | 0.37 | 0.25 | 0.44 | 0.44 | 0.37 | 0.27 | 0.39 | 0.42 | 0.38 | 0.31 | 0.38 |
Note: λ1 = stress factor loadings; λ2 = anxiety factor loadings; λ3 = depression factor loadings; e = error variance.
Comparison of model results over the four academic years.
| Comparison | Model | Degree of Freedom | χ2 |
|
|---|---|---|---|---|
| Year 1 vs. Year 2 | Measurement weights | 2 | 4.083 | 0.130 |
| Structural covariances | 1 | 3.820 | 0.051 | |
| Measurement residuals | 3 | 3.911 | 0.271 | |
| Year 2 vs. Year 3 | Measurement weights | 2 | 3.657 | 0.161 |
| Structural covariances | 1 | 4.939 | 0.026 | |
| Measurement residuals | 3 | 31.315 | 0.000 | |
| Year 3 vs. Year 4 | Measurement weights | 2 | 15.006 | 0.001 |
| Structural covariances | 1 | 4.323 | 0.038 | |
| Measurement residuals | 3 | 53.123 | 0.000 | |
| Year 1 vs. Year 3 | Measurement weights | 2 | 5.238 | 0.073 |
| Structural covariances | 1 | 17.366 | 0.000 | |
| Measurement residuals | 3 | 25.110 | 0.000 | |
| Year 1 vs. Year 4 | Measurement weights | 2 | 30.540 | 0.000 |
| Structural covariances | 1 | 44.160 | 0.000 | |
| Measurement residuals | 3 | 111.691 | 0.000 | |
| Year 2 vs. Year 4 | Measurement weights | 2 | 3.657 | 0.161 |
| Structural covariances | 1 | 4.939 | 0.026 | |
| Measurement residuals | 3 | 31.315 | 0.000 |