Depression, Anxiety, Stress and Its Association with Coping Strategies among Malaysian University Students
Abstract
Malaysia is one of the countries transitioning from the pandemic phase to an endemic phase of Covid-19. The spread of Covid-19 had a significant impact on university students, affecting their mental health just as it did for many others. This study investigates depression, anxiety, and stress symptom levels among Malaysian university students and the coping strategies used to prevent or reduce these psychological distress symptoms. A web-based questionnaire was developed using Google Forms to collect data from students who were selected non-randomly from three public universities and one from a private university in Malaysia. Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Perceived Stress Scales-10 (PSS-10) were used for measuring depression, anxiety, and stress respectively. The coping strategies were measured using five strategies: seeking social support for emotional reasons, seeking social support for instrumental reasons, acceptance, mental disengagement, and humanitarian. The study findings indicated that 60.7% had depression symptoms, 30.4% had anxiety symptoms, and 86.3% had stress symptoms at moderate-to-severe levels. Acceptance was the most preferred coping strategy among the students while seeking social support for instrumental reasons was the least preferred coping strategy. Students with severe depression levels used mental disengagement coping strategies more than those with mild symptoms. Mental disengagement coping strategy was associated with severe anxiety symptoms compared to mild and minimal symptoms. Seeking social support for emotional reasons was also associated with moderate anxiety symptoms compared to mild anxiety symptoms.
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Acoba E. F. (2024). Social support and mental health: the mediating role of perceived stress. Frontiers in Psychology, 15, 1330720. https://doi.org/10.3389/fpsyg.2024.1330720 DOI: https://doi.org/10.3389/fpsyg.2024.1330720
Alotaibi, N. M., Alkhamis, M. A., Alrasheedi, M., Alotaibi, K., Alduaij, L., Alazemi, F., Alfaraj, D., & Alrowaili, D. (2024). Psychological Disorders and Coping among Undergraduate College Students: Advocating for Students' Counselling Services at Kuwait University. International journal of environmental research and public health, 21(3), 245. https://doi.org/10.3390/ijerph21030245 DOI: https://doi.org/10.3390/ijerph21030245
Asif, S., Mudassar, A., Shahzad, T. Z., Raouf, M., & Pervaiz, T. (2020). Frequency of depression, anxiety and stress among university students. Pakistan journal of medical sciences, 36(5), 971–976. https://doi.org/10.12669/pjms.36.5.1873 DOI: https://doi.org/10.12669/pjms.36.5.1873
Baloch, G. M., Kamaludin, K., Chinna, K., Sundarasen, S., Nurunnabi, M., Khoshaim, H. B., Hossain, S. F. A., Sukayt, A. A., & Baloch, L. G. (2021). Coping with COVID-19: The Strategies Adapted by Pakistani Students to Overcome Implications. International journal of environmental research and public health, 18(4), 1799. https://doi.org/10.3390/ijerph18041799 DOI: https://doi.org/10.3390/ijerph18041799
Brown, B., Mbewe, A., & Forcheh, N. (2023). Levels of interest among prospective and enrolled undergraduate students in learning through online and blended modes. South African Journal of Higher Education, 37(3), 20-42. https://doi.org/10.20853/37-3-4848 DOI: https://doi.org/10.20853/37-3-4848
Carver, C. S., & Connor-Smith, J. (2010). Personality and coping. Annual review of psychology, 61, 679–704. https://doi.org/10.1146/annurev.psych.093008.100352 DOI: https://doi.org/10.1146/annurev.psych.093008.100352
Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: a theoretically based approach. Journal of personality and social psychology, 56(2), 267–283. https://doi.org/10.1037//0022-3514.56.2.267 DOI: https://doi.org/10.1037//0022-3514.56.2.267
Chan, S.F., & La Greca, A.M. (2013). Perceived Stress Scale (PSS). In Encyclopaedia of Behavioral Medicine; Springer: New York, NY, USA, 2013; pp. 1454–1455. DOI: https://doi.org/10.1007/978-1-4419-1005-9_773
Chaudhary, A.P., Sonar, N.S., Jamuna, T.R., Banerjee, M., Yadav, S. (2021). Impact of the COVID-19 pandemic on the mental health of college students in India: Cross-sectional web-based study. JMIRx Med, 2(3), e28158. https://doi.org/10.2196/28158 DOI: https://doi.org/10.2196/28158
Chen, H., Feng, H., Liu, Y., Wu, S., Li, H., Zhang, G., Yang, P., & Zhang, K. (2023). Anxiety, depression, insomnia, and PTSD among college students after optimizing the COVID-19 response in China. Journal of Affective Disorders, 337, 50–56. https://doi.org/10.1016/j.jad.2023.05.076 DOI: https://doi.org/10.1016/j.jad.2023.05.076
Cheung, T., Wong, S. Y., Wong, K. Y., Law, L. Y., Ng, K., Tong, M. T., Wong, K. Y., Ng, M. Y., & Yip, P. S. (2016). Depression, anxiety and symptoms of stress among Baccalaureate Nursing students in Hong Kong: A cross-sectional study. International journal of environmental research and public health, 13(8), 779. https://doi.org/10.3390/ijerph13080779 DOI: https://doi.org/10.3390/ijerph13080779
Cohen, S., Gianaros, P. J., & Manuck, S. B. (2016). A stage model of stress and disease. Perspectives on psychological science: a journal of the Association for Psychological Science, 11(4), 456–463. https://doi.org/10.1177/1745691616646305 DOI: https://doi.org/10.1177/1745691616646305
Esia-Donkoh, K., Yelkpieri, D., & Esia-Donkoh, K. (2011). Coping with stress: Strategies adopted by students at the Winneba Campus of University of Education, Winneba, Ghana. US-China Education Review B 2, 290–299.
Etikan, I. (2016). Comparison of Convenience Sampling and Purposive Sampling. American Journal of Theoretical and Applied Statistics. 5(1):1. DOI: https://doi.org/10.11648/j.ajtas.20160501.11
Freire, C., Ferradás, M. D. M., Regueiro, B., Rodríguez, S., Valle, A., & Núñez, J. C. (2020). Coping strategies and self-efficacy in university students: A person-centered approach. Frontiers in Psychology, 11, 841. https://doi.org/10.3389/fpsyg.2020.00841 DOI: https://doi.org/10.3389/fpsyg.2020.00841
Fuzi, S. F., Jama, S. R., Jusoh, N., Zainudin, S. N., Halim, B. A., Zahidi, N. E., & Hassan, W. H. W. (2024). Predictors of severe anxiety among Bumiputera students. Information Management and Business Review, 16(1(I)), 64–75. https://doi.org/10.22610/imbr.v16i1(i).3661 DOI: https://doi.org/10.22610/imbr.v16i1(I).3661
Hysenbegasi, A., Hass, S. L., & Rowland, C. R. (2005). The impact of depression on the academic productivity of university students. The journal of mental health policy and economics, 8(3), 145–151.
Irfan, M., Shahudin, F., Hooper, V. J., Akram, W., & Abdul Ghani, R. B. (2021). The Psychological Impact of Coronavirus on University Students and its Socio-Economic Determinants in Malaysia. Inquiry: a journal of medical care organization, provision and financing, 58, 469580211056217. https://doi.org/10.1177/00469580211056217 DOI: https://doi.org/10.1177/00469580211056217
Kamaludin, K., Chinna, K., Sundarasen, S., Khoshaim, H. B., Nurunnabi, M., Baloch, G. M., Sukayt, A., & Hossain, S. F. A. (2020). Coping with COVID-19 and movement control order (MCO): experiences of university students in Malaysia. Heliyon, 6(11), e05339. https://doi.org/10.1016/j.heliyon.2020.e05339 DOI: https://doi.org/10.1016/j.heliyon.2020.e05339
Kassim, M. A. M., Pang, N. T. P., Mohamed, N. H., Kamu, A., Ho, C. M., Ayu, F., Rahim, S. S. S. A., Omar, A., & Jeffree, M. S. (2022). Relationship between fear of COVID-19, psychopathology and sociodemographic variables in Malaysian population. International journal of mental health and addiction, 20(3), 1303–1310. https://doi.org/10.1007/s11469-020-00444-4 DOI: https://doi.org/10.1007/s11469-020-00444-4
Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x DOI: https://doi.org/10.1046/j.1525-1497.2001.016009606.x
Lopes, A. R., & Nihei, O. K. (2021). Depression, anxiety and stress symptoms in Brazilian university students during the COVID-19 pandemic: Predictors and association with life satisfaction, psychological well-being and coping strategies. PloS one, 16(10), e0258493. https://doi.org/10.1371/journal.pone.0258493 DOI: https://doi.org/10.1371/journal.pone.0258493
Morales-Rodríguez, F. M., & Pérez-Mármol, J. M. (2019). The role of anxiety, coping strategies, and emotional intelligence on general perceived self-efficacy in university students. Frontiers in Psychology, 10, 1689. https://doi.org/10.3389/fpsyg.2019.01689 DOI: https://doi.org/10.3389/fpsyg.2019.01689
Odriozola-González, P., Planchuelo-Gómez, Á., Irurtia, M. J., & de Luis-García, R. (2020). Psychological effects of the COVID-19 outbreak and lockdown among students and workers of a Spanish university. Psychiatry Research, 290, 113108. https://doi.org/10.1016/j.psychres.2020.113108 DOI: https://doi.org/10.1016/j.psychres.2020.113108
Qiu, J., Shen, B., Zhao, M., Wang, Z., Xie, B., & Xu, Y. (2020). A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. General psychiatry, 33(2), e100213. https://doi.org/10.1136/gpsych-2020-100213 DOI: https://doi.org/10.1136/gpsych-2020-100213
Ramadianto, A.S., Kusumadewi, I., Agiananda, F., & Raharjanti, N. W. (2022). Symptoms of depression and anxiety in Indonesian medical students: association with coping strategy and resilience. BMC Psychiatry 22(92). https://doi.org/10.1186/s12888-022-03745-1 DOI: https://doi.org/10.1186/s12888-022-03745-1
Rehman, U., Shahnawaz, M. G., Khan, N. H., Kharshiing, K. D., Khursheed, M., Gupta, K., Kashyap, D., & Uniyal, R. (2021). Depression, anxiety and stress among Indians in times of Covid-19 lockdown. Community Mental Health Journal, 57(1), 42–48. https://doi.org/10.1007/s10597-020-00664-x DOI: https://doi.org/10.1007/s10597-020-00664-x
Salari, N., Hosseinian-Far, A., Jalali, R., Vaisi-Raygani, A., Rasoulpoor, S., Mohammadi, M., Rasoulpoor, S., & Khaledi-Paveh, B. (2020). Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Globalization and health, 16(1), 57. https://doi.org/10.1186/s12992-020-00589-w DOI: https://doi.org/10.1186/s12992-020-00589-w
Savitsky, B., Findling, Y., Ereli, A., & Hendel, T. (2020). Anxiety and coping strategies among nursing students during the COVID-19 pandemic. Nurse education in practice, 46, 102809. https://doi.org/10.1016/j.nepr.2020.102809 DOI: https://doi.org/10.1016/j.nepr.2020.102809
Son, C., Hegde, S., Smith, A., Wang, X., & Sasangohar, F. (2020). Effects of COVID-19 on College Students' Mental Health in the United States: Interview Survey Study. Journal of medical Internet research, 22(9), e21279. https://doi.org/10.2196/21279 DOI: https://doi.org/10.2196/21279
Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of internal medicine, 166(10), 1092–1097. https://doi.org/10.1001/archinte.166.10.1092 DOI: https://doi.org/10.1001/archinte.166.10.1092
TheStar. (2022). Malaysia will transition into the endemic phase from April 1. TheStar. Available: https://www.thestar.com.my/news/nation/2022/03/08/pm-msia-will-enter-endemic-phase-from-april-1.
Villani, L., Pastorino, R., Molinari, E., Anelli, F., Ricciardi, W., Graffigna, G., & Boccia, S. (2021). Impact of the COVID-19 pandemic on the psychological well-being of students in an Italian university: a web-based cross-sectional survey. Globalization and health, 17(1), 39. https://doi.org/10.1186/s12992-021-00680-w DOI: https://doi.org/10.1186/s12992-021-00680-w
Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., & Ho, R. C. (2020). Immediate psychological responses and associated factors during the initial stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the general population in China. International journal of environmental research and public health, 17(5), 1729. https://doi.org/10.3390/ijerph17051729 DOI: https://doi.org/10.3390/ijerph17051729
Wong, S. S., Wong, C. C., Ng, K. W., Bostanudin, M. F., & Tan, S. F. (2023). Depression, anxiety, and stress among university students in Selangor, Malaysia during COVID-19 pandemics and their associated factors. PloS one, 18(1), e0280680. https://doi.org/10.1371/journal.pone.0280680 DOI: https://doi.org/10.1371/journal.pone.0280680
Yu, C. Y., Wong, S. Y., Liew, N. W. C., Joseph, N., Zakaria, Z., Nurulfiza, I., Soe, H. J., Kairon, R., Amin-Nordin, S., & Chee, H. Y. (2022). Whole genome sequencing analysis of SARS-CoV-2 from Malaysia: From alpha to Omicron. Frontiers in medicine, 9, 1001022. https://doi.org/10.3389/fmed.2022.1001022 DOI: https://doi.org/10.3389/fmed.2022.1001022
Zhao, J., Zhao, H. & Zhou, A. (2023). Negative Parenting Styles and Psychological Crisis in Adolescents: Testing a Moderated Mediating Model of School Connectedness and Self-Esteem. Behavioral sciences (Basel, Switzerland). 13. 10.3390/bs13110929. DOI: https://doi.org/10.3390/bs13110929
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