Issues in Mental Health Nursing, 33:149–156, 2012

Copyright © 2012 Informa Healthcare USA, Inc.

ISSN: 0161-2840 print / 1096-4673 online
DOI: 10.3109/01612840.2011.632708

The Relationship among Young Adult College Students’

Depression, Anxiety, Stress, Demographics, Life
Satisfaction, and Coping Styles

Jihan Saber Raja Mahmoud, MSN, PhD

University of Kentucky, College of Nursing, Lexington, USA
Issues Ment Health Nurs Downloaded from [Link] by University of Notre Dame Australia on 06/22/13

Ruth “Topsy” Staten, PhD, APRN-CS

University of Kentucky, College of Nursing, Lexington, USA

Lynne A. Hall, RN, DrPH

University of Kentucky, College of Nursing, Lexington, USA

Terry A. Lennie, PhD, RN, FAAN

University of Kentucky, College of Nursing, Lexington, USA

Nock, & Wang, 2005). The rate of college students diag-

For personal use only.

Recent research indicates that young adult college students ex- nosed with depression increased from 10% in 2000 to 15% in
perience increased levels of depression, anxiety, and stress. It is 2006 (American College Health Association [ACHA], 2008).
less clear what strategies college health care providers might use Depression may lead to suicide, the second-leading cause of
to assist students in decreasing these mental health concerns. In
this paper, we examine the relative importance of coping style, life
death among college students, resulting in 1,100 lives lost each
satisfaction, and selected demographics in predicting undergrad- year (Floyd, Mimms, & Yelding, 2007). With increasing con-
uates’ depression, anxiety, and stress. A total of 508 full-time un- cerns about college students’ mental health, the ACHA (2009)
dergraduate students aged 18–24 years completed the study mea- challenged concerned professionals to use evidence-based ap-
sures and a short demographics information questionnaire. Coping proaches in planning college health strategies. Thus, this pa-
strategies and life satisfaction were assessed using the Brief COPE
Inventory and an adapted version of the Brief Students’ Multidi-
per aims to investigate the main predictors of three mental
mensional Life Satisfaction Scale. Depression, anxiety, and stress health conditions—depression, anxiety, and stress—in young
were measured using the Depression Anxiety and Stress Scale- adult college students and determine their relative contribution
21 (DASS-21). Multiple regression analyses were used to examine to each of these three conditions.
the relative influence of each of the independent variables on de- From a developmental perspective, young adult college stu-
pression, anxiety, and stress. Maladaptive coping was the main
predictor of depression, anxiety, and stress. Adaptive coping was
dents’ age group (age 18–24 years old) has been described as
not a significant predictor of any of the three outcome variables. “emerging adulthood,” which is a transitional developmental
Reducing maladaptive coping behaviors may have the most pos- stage between late adolescence and adulthood (Arnett, 2004).
itive impact on reducing depression, anxiety, and stress in this This transition, which requires developing skills for maintain-
population. ing the independence and self-sufficiency an individual gains
through adolescence, and for managing new tasks with regard
Approximately 40 million American adults suffer from anx- to developing and maintaining intimate relationships, is consid-
iety and 75% of them experience their first episode by age 22 ered stress-arousing and anxiety-provoking (Meadows, Brown,
(Anxiety Disorder Association of America, 2010). Unmanaged & Elder, 2006; Zirkel, 1992; Zirkel & Cantor, 1990). Failure to
anxiety may contribute to substance abuse (Schmidt, Buckner, accomplish these developmental tasks may result in life dissat-
& Keough, 2007) and depression (Kessler, Berglund, Borges, isfaction (Newman & Newman, 2008). Based on the quality of
life model of life satisfaction (Campbell, Converse, & Rodgers,
1976; Erikson, 1994), Frisch (2006) proposed that while pleas-
Address correspondence to Jihan Saber Raja Mahmoud, ant emotions stem from the satisfaction that accompanies the
1608 University Court, A311, Lexington, KY 40503. E-mail: perception that important needs have been met or fulfilled, anx-
jihan2007@[Link] iety and depression are associated with low life satisfaction,

149
 150 J. S. R. MAHMOUD ET AL.

which may result from the inability to meet needs in valued The first is to examine the relationship of three mental health
areas of life. factors—depression, anxiety, and stress—with selected demo-
Additionally, young adult college undergraduates face graphics, life satisfaction, and coping strategies among young
numerous academic, financial, and social stressors that may adult college students. The second is to determine the main
negatively alter their mental health (Dusselier, Dunn, Wang, predictors of depression, anxiety, and stress and their relative
Shelley, & Whalen, 2005). Depression and anxiety are not influence on each of these three mental health factors.
directly caused by stressors; rather, it is a state that results from
an individual’s perception and reaction to those stressors (Beck
METHOD
& Clark, 1997). The impact of stressors experienced is mediated
by the individual’s ability to effectively cope with stressful Procedure
situations. The transactional model of coping (Lazarus & This is a secondary analysis of a cross-sectional survey study
Folkman, 1984) differentiated between two main stress-coping collected in 2007 to assess the general well-being of college
Issues Ment Health Nurs Downloaded from [Link] by University of Notre Dame Australia on 06/22/13

mechanisms, adaptive and maladaptive. Through these two students at a large southeastern public university. After the In-
mechanisms an individual displays certain behaviors that are stitutional Review Board provided its approval, a sample of
thought to moderate the effect of stressful stimuli. Adaptive 1,700 full-time undergraduate students aged 18–24 years old
coping behaviors involve defining the stressful situation, was randomly selected by the Office of the Registrar. Students
actively seeking support, reflecting on possible solutions, and provided passive consent, which was explained through a cover
taking actions to resolve the situation. Such actions resolve letter that was mailed to them along with the survey, a two-
the stressful situation and result in positive psychological and dollar incentive, and a stamped addressed return envelope. One
emotional adjustment. Conversely, maladaptive coping behav- week later, postcards were sent to acknowledge students who
iors include efforts to withdraw from the stressful situation or responded and reminder cards were sent to those who had not
avoid seeking solutions; this may result in a failure to resolve responded to the initial survey mailing. Three weeks following
the stressful situation and can be associated with anxiety. Even the initial mailing, a second survey pakage was sent to those
though some studies show that individuals progress in their who had not yet responded. Out of the 1,700 mailed question-
utilization of the adaptive coping across their life span, several naire, 112 were undeliverable or didn’t meet the criteria. The
For personal use only.

studies have indicated that adolescents and young adults used response rate was 32% (n = 508).
more maladaptive coping strategies, such as escape-avoidance,
as compared to other age groups (Blanchard-Fields, Sulsky, &
Robinson-Whelen, 1991; Irion & Blanchard-Fields, 1987). Instruments
College students’ use of certain maladaptive coping strate- Depression Anxiety Stress Scale-21 (DASS-21)
gies was found to be related to certain cultural or demographic The DASS-21 (Lovibond & Lovibond, 1995) is a short form
characteristics such as belonging to a fraternity or sorority (The of the DASS which is a self-report 4-point Likert scale that
National Center on Addiction and Substance Abuse (CASA) measures the negative states of three mental health conditions:
at Columbia University, 2003), being self-identified as not reli- depression, anxiety, and stress. The DASS-21 measures each of
gious (Khavari & Harmon, 1982), and being female (Devonport the three factors with a 7-item subscale that asks participants
& Lane, 2006). Moreover, students’ levels of depression and to reflect on the thoughts, feelings, and behavior in the past
anxiety may vary by gender (Chapell et al., 2005; Grant et week. Responses on each item are ranging from 0 (did not
al., 2002; Hankin et al., 1998; Howley & Dickerson, 2009; apply to me at all) to 3 (applied to me very much). The intensity
Misra & McKean, 2000), age (Rosenthal & Schreiner, 2000), of any of the three conditions is defined by the sum scores
class-standing (Rawson, Bloomer, & Kendall, 1994), residency of responses to its 7-item subscale. According to Lovibond and
(living off-campus versus on-campus) (Eisenberg, Gollust, Lovibond (1995), normal scores on the three subscales are scores
Golberstein, & Hefner, 2007), and academic performance that are less than 9 for Depression, 7 for Anxiety, and 14 for
(Eisenberg, Golberstein, & Hunt, 2009; Hysenbegasi, Hass, & Stress. The Cronbach’s alphas for the DASS-21 subscales have
Rowland, 2005). Helping such a diverse population of students been examined in clinical and nonclinical samples and found to
manage these mental health conditions is one of the major be 0.94 for Depression, 0.87 for Anxiety, and 0.91 for Stress
challenges facing college counselors (Kitzrow, 2003). (Antony, Bieling, Cox, Enns, & Swinson, 1998).
In sum, young adult students are faced with numerous de-
velopmental challenges and tasks related to their college lives. Brief COPE Inventory (BCI)
Their life satisfaction and the strategies they use to cope with The BCI (Carver, 1997) is the abbreviated version of the orig-
challenges may affect their mental well-being. Understanding inal 60-item COPE Inventory developed by Carver, Scheier, and
how these factors are related to students’ depression, anxi- Weintraub (1989). It is a 28-item self-report 4-point Likert scale
ety, and stress may provide important information for college instrument that includes 14 2-item scales, which are categorized
health professionals regarding the most promising mental health as adaptive and maladaptive. Responses on each item vary from
promotion strategies. Thus, this paper has two specific aims. 0 (I usually don’t do this at all) to 3 (I usually do this a lot).
 COLLEGE STUDENTS’ COPING STYLES 151

Coping is the sum of the 28 items ranging from 0–84; adaptive skewed (skew = 1.65, 2.23, respectively); however, having a
coping is the sum of 16 items ranging from 0–48, and maladap- large enough sample size (n = 508) and more than ten obser-
tive coping is the sum of 12 items ranging from 0–36. A higher vations for each predictor made the regression robust enough to
score on either scale indicates more frequent use of that coping departure from normality (Pallant, 2004). Tolerance values were
approach. Both the adaptive and maladaptive scales have shown found to be greater than .10, while VIF values were smaller than
good internal consistency in this sample with Cronbach’s alphas 10. Thus, no problem of multicellinearity was found to exist.
equal to 0.88 and 0.81. Adaptive coping includes strategies such
as acceptance, planning, and positive reframing, and maladap-
RESULTS
tive coping strategies are those related to denial, self-blaming,
and substance use. Sample Description
The total number of undergraduates who participated in this
The Brief Students’ Multidimensional Life Satisfaction Scale study was 508; of these, 66% (n = 335) were female and 90%
Issues Ment Health Nurs Downloaded from [Link] by University of Notre Dame Australia on 06/22/13

(BSMLSS) (n = 409) were Caucasian. The mean age of students was 20

The BSMLSS (Huebner, 1994) is a 40-item self-report Likert years (SD = 1.6), and their mean GPA was 3.2 on 4-point scale
scale in which response options were derived from the 7-point (SD = .60). The mean scores of students’ depression, anxiety,
Delighted-Terrible Scale (Andrews & Withey, 1976). According and stress were found to be normal and equal to 5.2 (SD = 7),
to this scale, 1 = terrible, 2 = unhappy, 3 = mostly dissatisfied, 8 (SD = 9), and 11 (SD = 9), respectively. However, 29% of
4 = mixed (about equally satisfied and dissatisfied), 5 = mostly the students were depressed, 27% were anxious, and 24% were
satisfied, 6 = pleased, and 7 = delighted. For the purpose of stressed. About 67% of students who were anxious were also
this study, 11 items were selected to assess students’ satisfaction depressed and 61% of the anxious students were also stressed.
with college life, (e.g., academic and extracurricular activities),
social life (e.g., friendships and relationships with family and Relationship of Mental Health Factors with Coping,
significant others), and the financial aspect of life. This short- Satisfaction, and Demographics
ened version has shown good internal consistency in this sample Higher depression scores were reported by sophomores or
with Cronbach’s alpha equal to 0.85 as compared to 0.75 for the
For personal use only.

those 18–19 years old than students in other class standing lev-
original scale (Seligson, Huebner, & Valois, 2003). Life satis- els and the older students. Students who lived with someone or
faction is the sum scores of 11 items and ranges from 1–77. belonged to a social organization were less depressed, anxious,
Higher scores indicates more satisfaction with life. and stressed than those who did not. Students who identified
themselves as religious were less depressed and anxious than
Statistical Analysis those who were not religious. Female students were more anx-
Statistical analyses were conducted using SPSS statistical ious and stressed than male students (Table 1).
software (version 11.0, SPSS Inc., Chicago, IL). In the first A significant positive association between stress and cop-
phase of analysis, descriptive statistics were used to describe ing strategies, both adaptive and maladaptive, was detected
the demographics of the sample and the distribution of the three (Table 2). Students who used maladaptive coping strategies
mental health factors among students. more frequently reported significantly higher levels of depres-
To examine the relationship of selected mental health factors sion and anxiety. However, neither anxiety nor depression was
with life satisfaction and coping strategies, Pearson correlation significantly related to adaptive coping. Students with greater
was used. To determine how these factors are related to un- dissatisfaction with life indicated higher levels of depression,
dergraduates’ demographics and to compare their mean scores, anxiety, and stress. In addition, students with lower GPA were
mental health factors, and coping, based on their demographics, more depressed (r = –.13, p < .05). Other demographics such
variance analysis and independent-samples t-test were used. as ethnicity and the place of residency were not significantly
To determine whether maladaptive coping predicted depres- related to any of the three mental health factors.
sion, anxiety, and stress after accounting for demographics, life
satisfaction, and adaptive coping, three standard multiple regres- Independent Predictors of Depression, Anxiety, and Stress
sions were run using depression, anxiety, and stress as depen- Life satisfaction, adaptive coping, maladaptive coping, and
dent variables. Magnitude (R2 change) was used to determine demographics were entered together as predictors of the three
the amount of contribution of the significant independent vari- dependent variables in a three separate multiple regression anal-
ables in the model to the dependent variable. Standardized Beta yses. Selected demographics included age, gender, class stand-
(β) was used to determine the relative influence of each signifi- ing, GPA, living status, belonging to a social organization, and
cant predictor in the model on the dependent variable. The data religious self-identification (religious or not).
set was first checked for the assumptions of regression analysis The significant independent predictors of depression were
using the residual scatter plot and the normal probability plot. maladaptive coping and life satisfaction (Table 3). The overall
Scores of depression and anxiety were found to be positively model F(10, 324) = 46.2, p < .0001, accounted for 60% of
 152 J. S. R. MAHMOUD ET AL.

TABLE 1
Relationships among Depression, Anxiety, and Stress, and Students’ Demographics
Depression Anxiety Stress
n M SD M SD M SD
Age
18–19 179 9.2 (10) 6 (8) 11 (9.3)
20–24 189 7 (8) 5 (6) 10.2 (9)
t = 2.3∗ t = 1.8 t = 0.8
Gender
Female 299 8.3 (9) 6 (7) 12 (9)
Issues Ment Health Nurs Downloaded from [Link] by University of Notre Dame Australia on 06/22/13

Male 154 7 (8) 4 (6) 9 (8)

t = 1.8 t = 3∗∗ t = 4∗∗∗
GPA
3.5–4 129 8.6 (7) 33 (21) 78 (26)
3–3.49 129 6.9 (8) 32 (20) 62 (21)
2.5–2.99 74 9 (11) 37 (24) 74 (25)
2–2.49 23 13 (12.5) 54 (35) 87 (29)
F (3, 351) = 4∗ F (3, 351) = 3∗ F (3, 351) = 3
4>3=2=1 4>3=2=1 —
Class Standing
Freshman 111 8 (9) 49 (31) 115 (38)
Sophomore 93 10 (11.3) 107 (69) 186 (62)
Junior 109 8.4 (9) 137 (88) 264 (88)
For personal use only.

Senior 141 6 (7) 19 (12) 37 (12)

F (3, 450) = 4∗ F (3, 450) = 2 F (3, 450) = 1
2>1=3=4 — —
Residency
On-campus 164 7.33 (8.2) 49 (31) 115 (38)
Off-campus 293 8 (9.2) 107 (69) 186 (62)
t = –0.76 t = .02 t = –.01
Live alone 56 10 (9.8) 8.43 (9) 13 (10)
Live with someone 398 7.4 (8.6) 5 (6) 10 (9)
293 t = –2.12∗ t = 3∗∗ t = 2∗
Religious
Yes 352 7.2 (8.5) 4.6 (6.3) 10 (9)
No 102 9.5 (9.5) 7 (7.6) 11.6 (9)
t = 2.3∗ t = 3.16 t = 1.4
Ethnicity
Caucasian 409 7.6 (8.7) 5 (6.6) 10.4 (8.8)
Other 45 9 (9.7) 6.4 (7.3) 12 (9.4)
t = –1 t = –1.33 t = –1
Belong to fraternity or sorority
Yes 97 5.1 (3.5) 4.12 (5.2) 9 (7.5)
No 356 8.5 (9.4) 5.5 (7) 11 (9)
t = –1∗∗∗ t = –2.3∗ t = –2∗
∗
p < .05, ∗∗∗ p < .0001.

the variance of depression. Likewise, for anxiety, maladaptive The significant predictors of stress were maladaptive coping,
coping and life satisfaction were the only significant predictors life satisfaction, gender, and GPA (Table 5). The overall model
(Table 4) with the overall model F(10, 324) = 24, p < .0001, F(10, 324) = 29, p < .0001, accounted for 50% of the variance
accounting for 43% of the variance of anxiety. of stress.
 COLLEGE STUDENTS’ COPING STYLES 153

TABLE 2
Means, Standard Deviations, and Correlations of Depression, Anxiety, and Stress with Life Satisfaction and Coping
Variable M SD Depression Anxiety Stress
Life satisfaction (1–77) 54.64 9.63 –.53∗∗∗ –.34∗∗∗ –.39∗∗∗
Coping (0–84) 32.30 12.51 .29∗∗∗ .30∗∗∗ .40∗∗∗
Adaptive coping (0–48) 22.85 9.24 .03 .09 .18∗∗∗
Maladaptive Coping (0–36) 9.45 5.50 .62∗∗∗ .55∗∗∗ .63∗∗∗
∗∗∗
p < .0001.
The Relative Influence of Predictors at p < .01 or less, it is likely that the findings do not reflect a
Maladaptive coping had the strongest influence on the three Type 1 error and therefore, are not spurious.
Issues Ment Health Nurs Downloaded from [Link] by University of Notre Dame Australia on 06/22/13

mental health factors, depression, anxiety, and stress (β = .54,

.60, .53, p < .0001, respectively). For every one score increase DISCUSSION
in maladaptive coping, each of the three mental health factors We studied young adults’ mental well-being within the con-
increased by one score. Adaptive coping was not a significant text of the campus culture. The use of the shortened version
predictor of any of the three mental health factors. As compared of the BSMLSS facilitated our understanding of how students’
to maladaptive coping, life satisfaction had a relatively low in- satisfaction with their college and social lives can be related to
fluence on the three mental health factors (β = –.40, –.15, –.30, their mental well-being. Certain psychosocial and cultural char-
p < .0001, respectively). For every one score increase in life acteristics, such as belonging to a fraternity or sorority, living
satisfaction, depression, anxiety, and stress decreased only by with someone, being religious, and being more satisfied with
.36, .11, and .30 of a score. the college life, need to be taken into account when assessing
Most demographics were non-significant predictors. Even students’ levels of depression, anxiety, and stress. Based on a
though gender and GPA were significant predictors of stress, similar conclusion, previous studies recommended implement-
they had very low influence (β = .09 for each).
For personal use only.

ing strategies and programs that support students’ networks and

enhance their satisfaction with their college and social lives
Limitations (Coffman & Gilligan, 2002; Misra & McKean, 2000).
The cross-sectional design and use of one setting were limita- Existing strategies and programs mainly target students who
tions in this study. Future longitudinal studies would strengthen are in a transitional academic level, such as freshmen and se-
our understanding of how students’ use of maladaptive coping niors, and this may explain the higher levels of anxiety and stress
strategies may affect their levels of depression, anxiety, and among sophomores (Rawson et al., 1994). We noticed that the
stress. Also, most of the students in this study were Caucasian; number of students who were members of a fraternity or soror-
thus, caution should be used when extending these results to ity were equal across the different ranks of class-standing (χ 2
other racial or ethnic groups. The use of multiple analyses in (4) = 7, ns); however, sophomores reported higher levels of
this study increased the chance of a Type 1 error. However, be- depression. Another college-related factor that was related to
cause all p values of the major predictors in the regressions were these symptoms in the present study and other previous studies,
is academic performance, as measured by GPA.

TABLE 3 TABLE 4
Multiple Regression Model Predicting Depression Scores Multiple Regression Model Predicting Anxiety Scores
Predictor B SE B β Predictor B SE B β
Maladaptive coping 1.10 .09 .54∗∗∗ Maladaptive coping 1.00 .08 .60∗∗∗
Adaptive coping –.08 .05 –.07 Adaptive coping .00 .04 .00
Life satisfaction –.40 .04 –.40∗∗∗ Life satisfaction –.11 .04 –.15∗∗
Age .05 .40 .00 Age –.02 .31 .00
Gender (female) .50 .70 .03 Gender (female) .32 .63 .02
GPA .50 .60 .03 GPA .44 .54 .04
Social organization –.80 .83 –.04 Social organization .30 .73 .02
Living alone –1.00 1.00 –.04 Living alone 1.50 .84 .08
Being religious –.72 .80 –.03 Being religious –1.32 .70 –.08
Class standing –.40 .50 –.05 Class standing –.43 .50 –.07
∗∗∗ ∗∗
p < .0001. p < .001, ∗∗∗ p < .0001.
 154 J. S. R. MAHMOUD ET AL.

TABLE 5 The variety of psychosocial and demographic factors that

Multiple Regression Model Predicting Stress Scores. are related to college students’ mental well-being highlights the
importance of implementing a collaborative approach in the as-
Predictor B SE B β sessment and management of depression, anxiety, and stress
Maladaptive coping 1.10 .10 .53∗∗∗ symptoms in this population. This can be achieved through em-
Adaptive coping .05 .05 .04 ploying a multidisciplinary mental health team, which includes
Life satisfaction –.30 .04 –.30∗∗∗ psychiatric nurses, psychotherapists, social workers, and aca-
Age .03 .40 .00 demic advisors, in the university health care system.
Gender (female) 1.7 .80 .09∗ Another important recommendation based on these findings
GPA 1.50 .70 .09∗ is developing and evaluating interventions that can benefit the
Social organization .40 .95 .02 majority of the students, despite their social, academic, and
Living alone –.20 1 .00 demographic differences. Thus, investigating the role of coping
Issues Ment Health Nurs Downloaded from [Link] by University of Notre Dame Australia on 06/22/13

Being religious –.40 .90 –.02 in predicting students’ mental well-being and accounting for
Class standing .22 .60 .03 these variables was helpful in developing a baseline perspective
on potential assessment and interventions that may target the
∗
p < .05, ∗∗∗ p < .0001. widest possible range of this population.
The students’ use of maladaptive coping strategies, such as
self-blaming, denial, and giving up, was the main predictor of
This study, as well as previous studies, recommend conduct- their levels of depression, anxiety, and stress. The use of adaptive
ing on-campus screening programs (Eisenberg et al., 2009) and coping strategies does not predict the level of any of these three
raising students’ awareness about campus mental health care conditions. This finding provides an important input regarding
resources (Hysenbegasi et al., 2005) for improving students’ the composition and designation of therapeutic interventions
mental health, academic performance, and retention rate. Our for managing these conditions in this population. Most of these
findings indicated that at least one in four respondents reported interventions are mainly focused on training students to use
experiencing symptoms of depression, anxiety, or stress. Estab- adaptive coping skills through social support groups (Oppen-
For personal use only.

lishing annual mental health screening programs is essential for heimer, 1984), physical exercise training (Steptoe et al., 1997),
early detection and management of these symptoms. and mindfulness meditation training (Beddoe & Murphy, 2004;
Consistent with findings from previous studies, such as Jain et al., 2007). While some of these strategies may prove to
Bayram and Bilgel (2008) and Wong et al. (2007), there was be useful for promoting students’ health, their mechanism of
no gender difference in undergraduates’ mean scores of de- action in managing depression, anxiety, and stress is unclear
pression; yet, female students reported higher levels of anxiety (Shapiro, Carlson, Astin, & Freedman, 2006).
and stress than male students. Undergraduates’ gender differ- A more effective route is to focus on diminishing the major
ence on their levels of anxiety has been consistently reported aspect of these three conditions, the maladaptive coping. It
in the literature (Chapell et al., 2005; Howley & Dickerson, is important for mental health nurses working with college
2009; Misra & McKean, 2000; Oliver, Reed, & Smith, 1998). students to assess the coping style of students who present
Several studies referred to this difference as related to females with symptoms of depression, anxiety, or stress. Nurses
more frequent use of emotion-focused coping strategies, which should facilitate students’ understanding of how using certain
are usually interpreted as ineffective coping (Garnefski, Teerds, maladaptive strategies, such as self-blaming, may alter their
Kraaij, Legerstee, & van den Kommer, 2004; Hänninen & Aro, symptoms. Von Ah, Ebert, Ngamvitroj, Park, and Kang (2004)
1996; Vingerhoets & Van Heck, 1990). However, with the use recommended implementing strategies that enhance students’
of the Brief COPE Inventory in this study, some of the emotion- positive thoughts regarding their abilities to overcome certain
focused strategies, such as positive reappraisal and seeking so- maladaptive behaviors such as cigarette smoking and alcohol
cial support, were categorized as adaptive while others, such as consumption. Backinger, Fagan, Matthews, and Grana (2003)
self-blaming and denial, were maladaptive. Our findings sug- documented the efficacy of cognitive-behavioral strategies
gested that although female students used both adaptive and for helping adolescents quit maladaptive behaviors such as
maladaptive coping more than male students, they had higher smoking; however, little is known about the implementation
levels of anxiety. Due to design limitations in the current study and effectiveness of using cognitive-behavioral strategies with
and the inconsistency in the operational definition of coping young adult college students.
in the literature (i.e., adaptive versus maladaptive) (Parker &
Endler, 1992), it was difficult to interpret the gender differences
in students’ anxiety within the context of coping. Using a multi- Future Research
dimensional approach in future studies may help to understand The current findings point to the necessity of developing in-
the different factors that contribute to anxiety and shed light on terventions that diminish the use of maladaptive coping strate-
the role of gender in coping and anxiety. gies and examining their effects on the students’ levels of de-
 COLLEGE STUDENTS’ COPING STYLES 155

pression, anxiety, and stress. Such a study would provide a firm Dusselier, L., Dunn, B., Wang, Y., Shelley II, M. C., & Whalen, D. F. (2005).
conclusion concerning future intervention implications. Personal, health, academic, and environmental predictors of stress for resi-
dence hall students. Journal of American College Health, 54(1), 15–24.
Declaration of interest: The authors report no conflicts of Eisenberg, D., Golberstein, E., & Hunt, J. B. (2009). Mental health and academic
success in college. The BE Journal of Economic Analysis & Policy, 9(1)
interest. The authors alone are responsible for the content and
(Contributions): Article 40.
writing of the paper. Eisenberg, D., Gollust, S. E., Golberstein, E., & Hefner, J. L. (2007). Preva-
lence and correlates of depression, anxiety, and suicidality among university
students. American Journal of Orthopsychiatry, 77(4), 534–542.
REFERENCES Erikson, E. (1994). Identity and the life cycle. New York, NY: WW Norton &
American College Health Association. (2008). American College Health Company.
Association-National college health assessment Spring 2007 reference Floyd, P., Mimms, S., & Yelding, C. (2007). Personal health: Perspectives and
group data report (Abridged). Journal of American College Health, 56, lifestyles: Wadsworth.
469–480. Frisch, M. B. (2006). Quality of life therapy: Applying a life satisfaction ap-
Issues Ment Health Nurs Downloaded from [Link] by University of Notre Dame Australia on 06/22/13

American College Health Association. (2009). American College Health proach to positive psychology and cognitive therapy: New York, NY: Wiley.
Association—National college health assessment Spring 2008 reference Garnefski, N., Teerds, J., Kraaij, V., Legerstee, J., & van den Kommer, T. (2004).
group data report (Abridged). Journal of American College Health, 57, Cognitive emotion regulation strategies and depressive symptoms: Differ-
477–488. Retrieved from [Link] ences between males and females. Personality and Individual Differences,
true&db=aph&AN=36776116&site=ehost-live&scope=site 36(2), 267–276.
Andrews, F. M., & Withey, S. B. (1976). Social indicators of well-being: Amer- Grant, K., Marsh, P., Syniar, G., Williams, M., Addlesperger, E., Kinzler, M. H.,
icans’ perceptions of life quality. New York: Plenum. & Cowman, S. (2002). Gender differences in rates of depression among un-
Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. dergraduates: Measurement matters. Journal of Adolescence, 25(6), 613–617.
(1998). Psychometric properties of the 42-item and 21-item versions of the Hankin, B., Abramson, L., Moffitt, T., Silva, P., McGee, R., & Angell, K.
Depression Anxiety Stress Scales in clinical groups and a community sample. (1998). Development of depression from preadolescence to young adulthood:
Psychological Assessment, 10(2), 176–181. Emerging gender differences in a 10-year longitudinal study. Journal of
Anxiety Disorder Association of America. (2010). Facts. Retrieved from Abnormal Psychology, 107(1), 128–140.
[Link] Hänninen, V., & Aro, H. (1996). Sex differences in coping and depression among
Arnett, J. (2004). Emerging adulthood: The winding road from the late teens young adults. Social Science & Medicine, 43(10), 1453–1460.
through the twenties: New York, NY: Oxford University Press. Howley, L., & Dickerson, K. (2009). Medical students’ first male urogenital
Backinger, C., Fagan, P., Matthews, E., & Grana, R. (2003). Adolescent and examination: investigating the effects of instruction and gender on anxiety.
For personal use only.

young adult tobacco prevention and cessation: Current status and future di- Medical Education Online, 8, 1–4.
rections. Tobacco Control, 12(4), iv46. Huebner, E. (1994). Preliminary development and validation of a multidimen-
Bayram, N., & Bilgel, N. (2008). The prevalence and socio-demographic corre- sional life satisfaction scale for children. Psychological Assessment, 6(2),
lations of depression, anxiety and stress among a group of university students. 149–158.
Social Psychiatry and Psychiatric Epidemiology, 43(8), 667–672. Hysenbegasi, A., Hass, S. L., & Rowland, C. R. (2005). The impact of depression
Beck, A., & Clark, D. A. (1997). An information processing model of anxiety: on the academic productivity of university students. Journal of Mental Health
Automatic and strategic processes. Behaviour Research and Therapy, 35(1), Policy and Economics, 8(3), 145–151.
49–58. Irion, J. C., & Blanchard-Fields, F. (1987). A cross-sectional comparison of
Beddoe, A. E., & Murphy, S. O. (2004). Does mindfulness decrease stress adaptive coping in adulthood. Journals of Gerontology 42(5), 502–504.
and foster empathy among nursing students? Journal of Nursing Education, Jain, S., Shapiro, S., Swanick, S., Roesch, S., Mills, P., Bell, I., & Schwartz,
43(7), 305–312. G. (2007). A randomized controlled trial of mindfulness meditation versus
Blanchard-Fields, F., Sulsky, L., & Robinson-Whelen, S. (1991). Moderating relaxation training: Effects on distress, positive states of mind, rumination,
effects of age and context on the relationship between gender, sex role differ- and distraction. Annals of Behavioral Medicine, 33(1), 11–21.
ences, and coping. Sex Roles, 25(11), 645–660. Kessler, R., Berglund, P., Borges, G., Nock, M., & Wang, P. (2005). Trends
Califano, J. A. (2003). Depression, substance abuse and college student en- in suicide ideation, plans, gestures, and attempts in the United States,
gagement: A review of the literature. The National Center on Addiction and 1990–1992 to 2001–2003. Journal of the American Medical Association,
Substance Abuse at Columbia University, 2–82. 293(20), 2487–2495. doi: 10.1001/jama.293.20.2487
Campbell, A., Converse, P., & Rodgers, W. (1976). The quality of American life: Khavari, K. A., & Harmon, T. M. C. (1982). The relationship between the degree
Perceptions, evaluations, and satisfactions. New York, NY: Russell Sage. of professed religious belief and use of drugs. Substance Use & Misuse, 17(5),
Carver, C. S. (1997). You want to measure coping but your protocol’s too long: 847–857.
Consider the Brief COPE. International Journal of Behavioral Medicine, 4, Kitzrow, M. A. (2003). The mental health needs of today’s college students:
92–100. Challenges and recommendations. Journal of Student Affairs Research and
Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping Practice, 41(1), 165–179.
strategies: A theoretically based approach. Journal of Personality & Social Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping: New York,
Psychology, 56(2), 267–283. NY: Springer.
Chapell, M. S., Blanding, Z. B., Silverstein, M. E., Takahashi, M., Newman, Lovibond, S., & Lovibond, P. (1995). Manual for the Depression Anxiety Stress
B., Gubi, A., & McCann, N. (2005). Test anxiety and academic performance Scales. Sydney, Australia: School of Psychology, University of New South
in undergraduate and graduate students. Journal of Educational Psychology, Wales.
97(2), 268–274. Meadows, S. O., Brown, J. S., & Elder, G. H. (2006). Depressive symptoms,
Coffman, D. L., & Gilligan, T. D. (2002). Social support, stress, and self-efficacy: stress, and support: Gendered trajectories from adolescence to young adult-
Effects on students’ satisfaction. Journal of College Student Retention: Re- hood. Journal of Youth and Adolescence, 35(1), 89–99.
search, Theory and Practice, 4(1), 53–66. Misra, R., & McKean, M. (2000). College students’ academic stress and its
Devonport, T. J., & Lane, A. M. (2006). Cognitive appraisal of dissertation stress relation to their anxiety, time management, and leisure satisfaction. American
among undergraduate students. The Psychological Record, 56, 259–266. Journal of Health Studies, 16(1), 41–51.
 156 J. S. R. MAHMOUD ET AL.

The National Center on Addiction and Substance Abuse at Columbia Schmidt, N. B., Buckner, J. D., & Keough, M. E. (2007). Anxiety sensitivity
University. (2003). Depression, substance abuse and college student as a prospective predictor of alcohol use disorders. Behavior Modification,
engagement: A review of the literature: Report to the Charles En- 31(2), 202–219.
gelhard Foundation and the Bringing Theory to Practice Planning Seligson, J. L., Huebner, E. S., & Valois, R. F. (2003). Preliminary validation of
(BTPP) Group. New York, NY: The National Center on Addiction the brief multidimensional students’ life satisfaction scale (BMSLSS). Social
and Substance Abuse (CASA) at Columbia University. Retrived from: Indicators Research, 61(2), 121–145.
[Link] Shapiro, S., Carlson, L., Astin, J., & Freedman, B. (2006). Mechanisms of
Newman, B. M., & Newman, P. R. (2008). Development through life: A psy- mindfulness. Journal of Clinical Psychology, 62(3), 373–386.
chosocial approach: Wadsworth. Steptoe, A., Wardle, J., Fuller, R., Holte, A., Justo, J., Sanderman, R., &
Oliver, J. M., Reed, C. K. S., & Smith, B. W. (1998). Patterns of psycho- Wichstrom, L. (1997). Leisure-time physical exercise: Prevalence, attitudi-
logical problems in university undergraduates: Factor structure of symp- nal correlates, and behavioral correlates among young Europeans from 21
toms of anxiety and depression, physical symptoms, alcohol use, and eating countries. Preventive Medicine, 26(6), 845–854. doi: S0091-7435(97)90224-
problems. Social Behavior & Personality: An International Journal, 26(3), 3 [pii]10.1006/pmed.1997.0224 [doi]
211–232. Vingerhoets, A. J., & Van Heck, G. L. (1990). Gender, coping and psychosomatic
Issues Ment Health Nurs Downloaded from [Link] by University of Notre Dame Australia on 06/22/13

Oppenheimer, B. (1984). Short-term small group intervention for college fresh- symptoms. Psychological Medicine, 20(1), 125–135.
men. Journal of Counseling Psychology, 31(1), 45–53. Von Ah, D., Ebert, S., Ngamvitroj, A., Park, N., & Kang, D. H. (2004). Predictors
Pallant, J. (2004). SPSS survival manual: A step by step guide to data analysis of health behaviours in college students. Journal of Advanced Nursing, 48(5),
using SPSS: Sydney, Australia: Allen & Unwin. 463–474.
Parker, J., & Endler, N. (1992). Coping with coping assessment: A critical Wong, S., Oei, T., Ang, R., Lee, B., Ng, A., & Leng, V. (2007). Personality,
review. European Journal of Personality, 6(5), 321–344. meta-mood experience, life satisfaction, and anxiety in Australian versus
Rawson, H. E., Bloomer, K., & Kendall, A. (1994). Stress, anxiety, depression, Singaporean students. Current Psychology, 26(2), 109–120.
and physical illness in college students. The Journal of Genetic Psychology, Zirkel, S. (1992). Developing independence in a life transition: Investing the
155(3), 321–330. self in the concerns of the day. Journal of Personality & Social Psychology,
Rosenthal, B. S., & Schreiner, A. C. (2000). Prevalence of psycholog- 62(3), 506–521.
ical symptoms among undergraduate students in an ethnically diverse Zirkel, S., & Cantor, N. (1990). Personal construal of life tasks: Those who
urban public college. Journal of American College Health, 49(1), 12– struggle for independence. Journal of Personality & Social Psychology, 58(1),
18. 172–185.
For personal use only.