2023, Retos, 50, 113-126

© Copyright: Federación Española de Asociaciones de Docentes de Educación Física (FEADEF) ISSN: Edición impresa: 1579-1726. Edición Web: 1988-2041 (https://recyt.fecyt.es/index.php/retos/index)

The impact of mental health, affectivity, emotional intelligence, empathy and coping skills in Occupa-
tional Therapy students
El impacto de la salud mental, la afectividad, la inteligencia emocional, la empatía y las habilidades de
afrontamiento en estudiantes de Terapia Ocupacional
*Manuela Martinez-Lorca, *Juan José Criado-Álvarez, **Roberto Aguado Romo, *Alberto Martinez-Lorca
*University of Castilla-La Mancha (Spain), **Clinical psychologist. President of European Institute of Psychotherapies of Limited
Time (Spain)

Abstract. Background: Students attending university have to adjust to a new learning context and are under psychological distress.
The aim of the study was to assess the mental health, affective status, emotions, emotional intelligence, empathy and coping skills of
undergraduate students of occupational therapy. Methods: A sample of 130 first-to-fourth-year students enrolled in an occupational
therapy degree course, to whom we administered an “ad hoc” questionnaire, the Symptom CheckList-90-Revised (SCL-90-R), the
Positive and Negative Affect Schedule (PANAS), the Trait Meta-Mood Scale (TMMS-24), the Interpersonal Reactivity Index (IRI), the
Difficulties in Emotion Regulation Scale (DERS) and Brief COPE questionnaire. Results: We found low scores in psychological disor-
ders, positive affect (general and over the last week), presence of pleasant emotions, good emotional intelligence, high scores in em-
pathy and a good coping style and adaptive strategies. However, we found a high level of students without emotion regulation skills.
Additionally, our results show interesting relationships between gender, year group, chronic illness and doing sport, where female
undergraduates, third-year students and those with a chronic illness had worse mental health and psychological distress. Conclusion:
Preventive measures are needed in higher education to minimize mental health and maladaptive emotions and to achieve the highest
possible level of psycho- emotional well-being.
Key words: mental health, affect, emotional intelligence, empathy, occupational therapy

Resumen. Antecedentes: Los estudiantes que asisten a la universidad tienen que adaptarse a un nuevo contexto de aprendizaje y sufren
distrés y malestar psicológico. El objetivo del estudio es evaluar la salud mental, la afectividad, las emociones, la inteligencia emocional,
la empatía y las habilidades de afrontamiento de universitarios de Terapia Ocupacional. Métodos: 130 estudiantes de primero a cuarto
año matriculados en el Grado de Terapia Ocupacional, a quienes se les administró un cuestionario “ad hoc”, la lista de síntomas (SCL-
90-R), la escala de Afecto Positivo y Negativo (PANAS), la escala Meta-Estado de Ánimo (TMMS-24), el Índice de Reactividad Inter-
personal (IRI), la Escala de Dificultades en la Regulación Emocional (DERS) y el Inventario Breve de Afrontamiento (COPE). Resul-
tados: Encontramos puntuaciones bajas en trastornos psicológicos, afecto positivo (generalmente y última semana). Existen emociones
placenteras, buena inteligencia emocional, puntuaciones altas en empatía y buen estilo de afrontamiento y estrategias adaptativas. Sin
embargo, encontramos un alto nivel de estudiantes sin habilidades de regulación emocional. Además, nuestros resultados muestran
relaciones interesantes entre el género, el grupo de edad, la presencia de enfermedad crónica y la práctica de deporte, donde las
estudiantes de grado, estudiantes de tercer año y aquellas con una enfermedad crónica tenían peor salud mental y malestar psicológico.
Conclusión: Se necesitan medidas preventivas entre los estudiantes de educación superior para proteger la salud mental y las emociones
desadaptativas y para lograr el mayor nivel posible de bienestar psicoemocional.
Palabras clave: salud mental, afecto, inteligencia emocional, empatía, terapia ocupacional

Fecha recepción: 13-04-23. Fecha de aceptación: 07-07-23

Manuela Martinez-Lorca
[email protected]

Introduction students across the world and in different degrees (medi-

cine, nursing, social sciences, dentistry and pharmacy)
Academic life in higher education imposes many chal- (Freene et al., 2022; Martínez-Lorca et al., 20231). Stu-
lenges with a negative impact on academic achievement, dents on occupational therapy degree courses also present
health and satisfaction. For instance, questions about activ- anxiety, depression and stress, (Webber et al., 2021) and
ity during the academic year such as motivation, attend class are exposed to many of the same potential stressors as those
regularly, combining work and study, participation of in- in other health professional degrees.
ternational exchange, financial assistance (Cox Méndez, According to Aguado (2014; 2015) and Morales-
2017; Fernández-Rodríguez et al., 2019; Langa-Rosado, Rodríguez et al. (2020), emotions and affectivity are key
2019; Martínez-Lorca et al., 20231). In fact, this is consid- constructs related to psychological well-being and satisfac-
ered one of the life cycle stages with the greatest levels of tion with life. In many cases, however, university students
anxiety, with high levels of psychological distress compared present difficulties in emotions and their emotion regula-
with the general population and lower levels of psychologi- tion skills (Hervás and Jódar, 2008). Early identification,
cal well-being in university students (Morales-Rodríguez et prevention and interventions for psychological distress
al., 2020), as well as anxiety, stress, fear and low psycho- should be included amongst the concerns and competences
logical well-being, which can cause anxiety disorders (one of universities and might reduce the serious consequences
of the most common pathologies) (Dias Lopes et al., 2020; (Balaji et al., 2019; Fernández-Rodríguez et al., 2019; Tang
Dilber, et al., 2016; Tang et al., 2018). et al., 2018). To establish proper education and profes-
Many mental health problems are found in university sional training in students from different academic fields

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(e.g., medical students, nursing, occupational therapy, en- Grasdalsmoen et al., 2020; López et al., 2021). The World
gineering or arts students), it is important to achieve their Health Organization (WHO) established the importance of
optimal well-being and quality of life during the years of regular physical activity and published its Global Recom-
training (Balaji et al., 2019; Fernández-Rodríguez et al., mendations on Physical Activity for Health in 2010. This
2019; Dilber et al., 2016), as this is an indicator of their action plan aimed to provide a system-based framework of
level of adjustment and adaptation. effective and practical policy actions in order to increase
Morales-Rodríguez et al. (2020) highlight the im- physical activity at all levels. In this line, students and staff
portance of developing systemic competencies that include from 13 health disciplines (including occupational therapy)
inter- and intra-personal psychological resources, such as at an Australian university were invited to participate in an
emotional intelligence, emotional regulation self-esteem, educational intervention on physical activity promotion,
self-concept, social skills, social responsibility, socially re- with significant results in awareness of the importance of
sponsible attitudes, problem solving and learning style pref- physical activity. Nonetheless 12 months later no change
erences, suitable levels of empathy, emotional intelligence was found in the amount of physical activity undertaken
and emotion regulation. (Freene et al., 2022).
This is related to the emergence of the concept of emo- Thus, good emotional development, proper empathy,
tional intelligence (EI), coined by Salovey & Mayer (1990), intrapersonal resources, doing sport and solid social skills
who defined EI as the capacity to identify one’s own feelings may help individuals develop positive physical and psycho-
and those of others, and to focus attention and thought, at- logical health, feel less psychosocial stress, achieve better
tending to the information provided by emotions. EI is a academic performance, attainment and success, and de-
significant predictor of a person’s social and personal func- velop greater life satisfaction, among other elements (Mo-
tioning, and, thus, emotionally intelligent individuals are rales-Rodríguez, 2020). However, these intrapersonal re-
not only more able to perceive, understand and manage sources are not always developed in university students, as
their own emotions, but are also better able to extrapolate they are affected by diverse variables, such as gender and
this perception, understanding and management of emo- age (Serrada-Tejeda et al., 2022; Quince et al., 2016; Mar-
tions to the emotions of others (Merchán-Clavellino et al., tínez-Lorca et al., 20231), type of degree course (Balaji et
2019; Morales-Rodríguez et al., 2020). EI is essential in al., 2019; Fernández-Rodríguez et al., 2019), engagement
healthcare professionals, in general and occupational thera- in physical activity or sport (Acebes-Sánchez et al., 2019;
pists, in particular (Gribble et al. 2019). High EI scores Grasdalsmoen et al., 2020; López et al., 2021; Martínez-
among occupational therapy students positively correlated Lorca et al., 20231), free-time satisfaction (Misra &
with their performance during clinical placements (An- McKean, 2000), socioeconomic status (Balaji et al., 2019)
donian, 2013; Zeidne-Handler, 2009). When EI is com- and type of family (Balaji et al., 2019), etc.
bined with appropriate knowledge, clinical reasoning skills, The main objective of the present study was to assess the
professional behaviour, and ethical values, students of oc- mental health, affectivity and emotions, emotional intelli-
cupational therapy are able to become competent profes- gence, empathy and coping skills of undergraduate students
sionals (Polonio-López et a., 2019). studying for a degree in occupational therapy, using an ex-
Additionally, empathy, as the ability to respond to oth- plorative approach in a cross-sectional study. We expected
ers, understand their emotions and what they are thinking, to find the following results: 1) levels of mental health, in-
and comprehend their intentions and feel what they feel, is cluding anxiety or stress; 2) different intrapersonal re-
a key factor in university students, as it contributes to the sources in emotional intelligence, regulation emotional,
enhancement of social skills and prosocial behaviour (Mo- empathy and coping skills; and 3) different types of rela-
rales-Rodríguez et al., 2020; Serrada-Tejeda et al., 2022). tionships between variables such as gender, year of study,
In many cases, university students have shown a decline in doing sport and chronic disease.
empathy scores as a result of the need to cope with new Besides, a further aim of this study was to determine
responsibilities and excessive workload in the new academic whether the statistically significant differences found in the
year (Serrada-Tejeda et al., 2022). However, in occupa- variables under analysis are maintained or disappear when
tional therapy, empathy is a key element to be considered students that had suffered stress or anxiety were dropped
during the intervention process in order to provide the sup- from the sample. We thus hypothesised that many of the
port and understanding required to face the difficulties that differences would disappear when students with anxiety or
may arise because of difficulties in occupational perfor- stress were eliminated from the overall sample, which
mance. For this reason, the implementation of a formative could underline the significant impact of anxiety and stress
process on empathy skills may positively affect students’ as mediating variables.
empathy levels (Serrada-Tejeda et al., 2022).
Another important recourse in university students’ lives Methodology
is physical activity. Engagement in physical activity or sport
improves self-esteem, self-concept, social skills, emotional Participants
manage and body image, and reduces the risk of premature The target population comprised undergraduates en-
death and chronic disease (Acebes-Sánchez et al., 2019; rolled in an occupational therapy degree across different

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year groups (from first to fourth) at the University of Cas- Instruments

tilla-La Mancha on its Talavera de la Reina campus (n=130) We collected background demographic information on
(see Table 1). gender, age, degree, year of study, grants, work activity
and internships during the academic year, motivation in
studies, regularity in class, and sports. Besides, we asked
Table 1 about level of anxiety of stress with this question: Have you
Socio-demographic, health and academic data
Socio-demographic data N (%) had any episode of stress or anxiety? with two answers (yes
Age (median, SD) 20.93 (2.64) or no). We also measured emotions during the academic
Range (18-31)
Gender (n, %) year, which were scored on a 10-point Likert scale for dif-
Male 12 (9.2)
Female 118 (90.8)
ferent emotions (fear, anger, guilt, disgust, sadness, sur-
Course (n, %) prise, curiosity, admiration, security and joy) designed by
First 55 (42.3)
Second 30 (23.1) Aguado (2014; 2015).
Third 12 (9.2) Additionally, the following questionnaires were admin-
Fourth 33 (25.4)
Place of birth (n, %) istered:
Castilla-La Mancha 67 (51.5) The Symptom CheckList-90-Revised (SCL-90-R)
Andalucía 17 (13.1)
Extremadura 11 (8.5 by Derogatis (1975) is a self-report instrument containing
Madrid 7 (5.4)
Castilla y León 6 (4.6)
90 items and is designed to measure nine current psychiatric
Others 16 (12.3) symptoms, as well as psychological distress. The SCL-90-R
Foreign country 6 (4.6)
Health data N (%) subscales assess the following psychiatric symptoms: Soma-
Health (n, %) tization, Obsessive Compulsive Disorder, Interpersonal
Good 125 (96.2)
Bad 5 (3.8) Sensitivity, Depression, Anxiety, Hostility, Phobic Anxi-
Chronic disease (n, %) ety, Paranoid Ideation and Psychoticism. The tool also in-
Yes 17 (13.1)
No 113 (86.9) cludes three global indexes of psychopathology: the Global
Which? (n, %)
Coeliac disease 4 (3.1)
Severity Index (GSI), which is the sum of all 9 subscales; the
Asthma 2 (1.5) Positive Symptoms Total (PST), which is the total number
Allergy 1 (0.8)
Headaches 1 (0.8) of items with positive responses; and the Positive Symptom
Diabetes 1 (0.8) Distress Index (PSDI), which we computed to assess the se-
Colon irritable 1 (0.8)
Atopic dermatitis 1 (0.8) verity of overall psychological distress. Each item has the
Hiatus hernia 1 (0.8) following five response categories: 0 = not at all, 1= a little
Fibromyalgia 1 (0.8)
Dyslexia 1 (0.8) bit, 2 = moderately, 3 = quite a bit, 4 = extremely. Alt-
Thalassemia 1 (0.8)
Anxiety (n, %)
hough this instrument was designed in the 1970s, it is still
Yes 88 (67.7) useful to understand psychiatric disorder. The Cronbach’s
No 42 (32.3)
Medication for anxiety (n, %) alpha ranges from 0.70 to 0.80 (Derogatis, 1975).
Yes 11 (8.5) The Positive and Negative Affect Schedule
No 119 (91.5)
Are you going to psychologist? (n, %) (PANAS) (Watson et al., 1988). The PANAS has been
Yes 18 (13.8) shown to be a valid, reliable tool to independently measure
No 112 (86.2)
Academic data N (%) the presence and level of positive and negative affect in clin-
Do you like your degree? (n, %) ical and healthy population and in adolescents, adults and
Yes 122 (93.8)
No 8 (6.2) older adults. It comprises 20 items, of which 10 items eval-
Was it the correct option? (n, %)
Yes 119 (91.5)
uate positive affect and 10 measure negative affect. The
No 11 (8.5) items consist of different words that describe feelings and
Was it your first option? (n, %)
Yes 66 (50.8) emotions. The respondent is asked to indicate to what ex-
No 64 (49.2) tent they generally experience these emotions and the ex-
Do you go to classes frequently? (n, %)
Yes 127 (97.7) tent to which they felt them in the last week, on a five-point
No
Have you studied abroad? (n, %)
3 (2.3) scale, where 1 is “very slightly or not at all” and 5 is “ex-
Yes 18 (13.8) tremely”. We administered the Spanish version by Robles
No 112 (86.2)
Would you like to study abroad? (n, %)
and Páez (2003), which has shown good psychometric
Yes 75 (57.7) properties, with a Cronbach’s alpha from 0.86 to 0.90 for
No 55 (42.3)
Grant (n, %) positive affect, and from 0.84 to 0.87 for negative affect.
Yes 83 (63.8) The Trait Meta-Mood Scale (TMMS-24) (Fernán-
No 47 (36.2)
Did you go to internship? (n, %) dez-Berrocal, et al., 2004; original version by Salovey et al.,
Yes 66 (50.8) 1995). This consists of 24 items across three subscales eval-
No 64 (49.2)
Work+study (n, %) uating emotional intelligence, that is, the meta-knowledge
Yes 24 (18.5)
No 106 (81.5)
of the skills with which individuals deal with emotional
Do you do any sport? (n, %) states, on three subscales: attention, clarity and repair. The
Yes 48 (36.9)
No 82 (61.3) attention subscale refers to an individual’s ability to per-
ceive, attend or observe, and think about their own feelings

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and moods. Clarity measures the understanding and dis- awareness of one’s own emotional distress, tendency to ex-
crimination of individuals’ own emotional states, while re- press or offload such feelings), behavioural disengagement
pair assess a person’s beliefs about their ability to regulate (reducing effort to cope with the stressor, even giving up
affect and emotions. The overall scale comprises 24 items, trying to achieve goals that interfere with the stressor), de-
8 per factor, which are rated on a 5-point scale (1= strongly nial (denying the reality of the stressor), religion (tendency
agree; 5= strongly disagree). It has good psychometric to turn to religion in times of stress), substance use (con-
properties with an adequate Cronbach’s Alpha (attention α suming alcohol or other substances to feel good or help deal
= 0.86), (clarity α = 0.90) and (repair α = 0.85). with the stressor), and, finally, self-blame (criticizing and
The Difficulties in Emotion Regulation Scale blaming oneself for events). The items are framed in terms
(DERS) (Hervás & Jódar, 2008; original version by Gratz of actions or thoughts used as coping mechanisms, with each
& Roemer, 2004). The DERS is a 36-item self-report ques- scored on a 4-point scale (0= I haven’t been doing this at
tionnaire measuring clinically significant aspects of emotion all; 1= a little bit; 2= a medium amount; 3= I’ve been do-
regulation. The items are grouped into six subscales: aware- ing this a lot), according to the frequency with which the
ness (6 items), clarity (5 items), impulse (6 items), goals (5 respondent engages in an action or has a thought. The
items), non-acceptance (6 items), and strategies (8 items). Cronbach’s alpha for the scale was .77 and by subscales: ac-
The items are scored on a 5-point Likert scale (1: almost tive coping (.57), planning (.55), instrumental or social
never, 5: almost always). Subscales and total scores are ob- support (.65), use of emotional support (.73), positive re-
tained as the sum of the corresponding items, with higher framing (.71), acceptance (.21), humour (.77), self-distrac-
scores indicating greater difficulties in emotion regulation. tion (.57), venting (.32), behavioural disengagement (.65),
The DERS has good psychometric properties with a denial (.63), religion (.84), substance use (.88), and, fi-
Cronbach’s Alfa of α=.91 where awareness (α=.73), clar- nally, self-blame (.63).
ity (α=.23), impulse (α=.74), goals (α=.70), non-ac-
Procedure
ceptance (α=.89), and strategies (α=.79).
This research was conducted by means of a descriptive,
The Interpersonal Reactivity Index (IRI) (Mes-
epidemiological, cross-sectional study. Teaching staff at the
tre et al., 2004; original version by Davis, 1983) is one of
Faculty of Health Sciences and the Faculty of Social Sciences
the most widely used self-report tools to measure empathy.
were informed by email of the aim of the study and their
The scale comprises 28 items distributed across four seven- permission was requested to administer the tests in paper-
item subscales that measure two concepts of empathy. The based format. They were not trained. Before applying the
cognitive component dimensions are perspective taking tests, participants were informed of the objective, proce-
(PT) and fantasy (FS), while the affective component con- dure, anonymous nature and ethical guarantees of the study
sists of the subscales of empathy concern (EC) and personal and their informed consent to participate was requested.
distress (PD). It uses a 5-point Likert-type scale (1= does Filling out the questionnaires took between 15 and 20
not describe me well; 5= describes me well), scored from minutes at the beginning and/or end of the classes in which
1 to 5, according to the degree to which the individual feels professors delivered and collected the questionnaires. Data
the statement describes them. The IRI has good psychomet- collection was conducted from 4th November to 25th No-
ric properties with a Cronbach’s Alpha of .78 and by dimen- vember 2019. Non-probability quota sampling was used
sions: perspective taking (.58), fantasy (.60), empathy con- (aged 18 or over, enrolled in a university degree course,
cern (.42) and personal distress (.45). years 1 to 4 and being in class on the day of data collection).
Brief COPE questionnaire (Morán et al., 2010; Our study received ethical approval and was supervised by
original version by Carver, 1997). The Brief COPE com- the Research Ethics Commission of the Talavera de la Reina
prises 28 items divided into 14 subscales, of which seven
Integrated Health Service Management in Talavera de la
represent an effective coping style: active coping (initiating
Reina, Toledo, Spain (31/2018).
direct actions, increasing efforts to eliminate or reduce
stressors), planning (thinking about how to cope with the
Data analysis
stressor, planning action strategies, steps and efforts), in-
The data analysis was conducted using the IBM® SPSS®
strumental or social support (getting help or advice from
Statistics 22.0 computer program. For the statistical analy-
competent individuals that know what to do), use of emo- sis, we first checked whether the variables to be statistically
tional support (getting sympathetic emotional support, un- analysed followed a normal distribution, using the K-S test
derstanding), positive reframing (looking for the positive for normality. The sample does not follow a normal distri-
and favourable aspects of the problem and trying to improve bution of data, as indicated by the analysis of the Kolmogo-
or grow from the situation), acceptance (accepting the rov-Smirnov test of normality in which all the variables
facts, the reality of what is happening), and humour (joking evaluated present a probability of less than or equal to 0.05.
about the stressor or laughing about and mocking the stress- Therefore, for the analysis of the data, the non-parametric
ful situations). The other seven scales correspond to an in- Mann-Whitney test was performed, which is the non-para-
effective coping style: self-distraction (concentrating on metric test parallel to the t-test for independent samples.
other projects, distracting oneself with other activities to We also ran the Kruskal-Wallis test, the non-parametric
avoid focusing on the stressor), venting (increased

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test parallel to the analysis of variance. A confidence level Relationships between anxiety and the main study
of .05 was set for all statistical analyses. In addition, descrip- variables
tive and frequency distribution (mainly means and standard Table 3 shows the statistically significant differences be-
deviations) and Chi-square independence tests were used. tween the variables of having suffered stress or anxiety and
most of the main study variables.
Results
Table 3.
Significant differences in anxiety or stress in measures of instruments
Descriptive statistics in measures of instruments ANXIETY or STRESS
and emotions Yes (N= 88) No (N= 42) Z p
SCL-90-R
Table 2 shows the descriptive statistics for each of the GSI 76.06 43.34 -4.625 ≤0.001
PST 47.13 33.09 -4.082 ≤0.001
scales used in this work, and for the emotions experienced PSDI 2.05 1.67 -4.012 ≤0.001
by the students in their university environment. Somatization 76.14 43.21 -4.665 ≤0.001
Obsessive compulsive 73.68 48.37 -3.586 ≤0.001
Interpersonal sensitivity 71.37 53.20 -2.576 ≤0.010
Depression 75.44 44.67 -4.360 ≤0.001
Table 2. Anxiety 75.18 45.21 -4.249 ≤0.001
Descriptive statistics in measures of instruments Hostility 72.63 50.57 -3.144 ≤0.002
SCL-90-R M (SD Min Max Phobic anxiety 72.57 50.70 -3.126 ≤0.002
Paranoid ideation 71.83 52.24 -2.788 ≤0.005
GSI .98 (.66) 0 3.21
Psychoticism 73.55 48.64 -3.546 ≤0.001
PST 42.6 (19.11) 0 89
PSDI 1.93 (.53) 0 3.38 PANAS
Somatization 1.04 (.79) 0 3.25 Positive last week 27.92 30.14 -1.975 ≤0.025
Obsessive compulsive 1.37 (.79) 0 3.90 Negative last week 74.26 47.15 -3.841 ≤0.001
Interpersonal sensitivity .94 (.78) 0 3.11 Positive usually
Depression 1.18 (0.84) 0 3.3 Negative usually 70.31 50.77 -2.803 ≤0.005
Anxiety 1.20 (0.94) 0 7 EMOTIONS IN THE UNIVERSITY SITUATION
Hostility .73 (.66) 0 3.50 Fear 70.48 55.06 -2.198 ≤0.028
Phobic anxiety .59 (.72) 0 4 Anger
Paranoid ideation .86 (.90) 0 5 Guilt
Psychoticism .62 (.79) 0 5 Disgust
PANAS M (SD) Min Max Sadness 71.13 52.30 -2.727 ≤0.006
Positive last week 28.63 (6.68) 13 47 Surprise
Negative last week 21.71 (7.65) 10 42 Curiosity 69.51 55.67 -2.005 ≤0.045
Positive usually 30.83 (5.62) 14 42 Admiration
Negative usually 19 (6.29) 10 41 Security
EMOTIONS IN THE Joy
M (SD Min Max TMMS-24
UNIVERSITY SITUATION
Fear 3.96 (2.66) 0 10 Attention 26.55 23.07 -2.284 ≤0.005
Anger 3.16 (2.69) 0 10 Clarity
Guilt 1.78 (2.36) 0 10 Repair
Disgust .92 (1.87) 0 10 DERS
Sadness 2.48 (2.42) 0 10 Awareness
Surprise 4.91 (2.61) 0 10 Impulse
Curiosity 7.68 (1.98) 0 10 Non-acceptance
Admiration 5.9 (2.36) 0 10 Goals
Security 7.24 (2.5) 0 10 Clarity
Joy 7.61 (2.15) 0 10 Strategies 72.87 48.69 -3.452 ≤0.001
TMMS-24 M (SD) Min Max Total 69.44 55.80 -1.492 ≤0.05
Attention 25.43 (6.8) 8 40 IRI
Clarity 24.36 (7.09) 10 40 Perspective taking
Repair 26.09 (6.89) 10 40 Fantasy
DERS M (SD) Min Max Empathic concern 28.43 25.95 -3.683 ≤0.001
Awareness 17.20 (4.25) 7 30 Personal distress
Impulse 14.40 (2.65) 8 26 Total 94.18 88.40 -2.997 ≤0.004
Non-acceptance 13.74 (6.13) 7 35 COPE
Goals 14.72 (4.95) 5 29 Confrontation
Clarity 11.27 (3.80) 5 23 Planning
Strategies 14.68 (5.48) 7 35 Social support
Total 86.09 (18.47) 49 152 Emotional support
IRI M (SD) Min Max Positive reinterpretation
Perspective taking 24.40 (4.02) 15 34 Acceptance
Fantasy 23.54 (5.19) 12 35 Humor
Empathic concern 27.62 (3.81) 19 35 Self-distraction
Personal distress 16.57 (4.62) 7 28 Venting
Total 92.30 (10.87) 59 126 Behavioral disengagement
COPE M (SD) Min Max Negation 69.01 55.26 -2.015 ≤0.044
Confrontation 4.79 (1.26) 0 6 Religious
Planning 4.03 (1.41) 0 6 Substance use
Social support 4.12 (1.44) 0 6 Self-blame
Emotional support 4.3 (1.53) 0 6
Positive reinterpretation 3.89 (1.62) 0 6
Acceptance 4.43 (1.28) 0 6 Relationships between sex and the main study vari-
Humor 3.27 (2.02) 0 6
Self-distraction 4.03 (1.56) 0 6 ables
Venting 3.03 (1.44) 0 6 Table 4 reveals significant differences between sex and
Behavioral disengagement 1.32 (1.39) 0 6
Negation 1.83 (1.72) 0 6 the different variables measured by the instruments used in
Religious
Substance use
.99 (1.57)
.60 (1.17)
0
0
6
6
this study. In general, the female participants showed statis-
Self-blame 3.17 (1.57) 0 6 tically significant differences in many of the items with
higher mean ranges compared to their male counterparts.

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When individuals with anxiety are eliminated from the sam- differences in COPE scale appear.
ple, many of these differences disappear, although new

Table 4.
Significant differences between sex in different samples in measures of instruments
SEX (total sample) SEX (sample without anxiety)
Males Females Z p Males Females Z p
(N= 12) (N= 118) (N= 8) (N= 34)
SCL-90-R
GSI
PST
PSDI
Somatization
Obsessive compulsive
Interpersonal sensitivity
Depression
Anxiety 41.21 67.96 -2.349 ≤0.019
Hostility
Phobic anxiety 46 67.48 -1.902 ≤0.05
Paranoid ideation
Psychoticism
PANAS
Positive last week
Negative last week
Positive usually
Negative usually
EMOTIONS
Fear 36.25 68.47 -2.842 ≤0.004
Anger
Guilt
Disgust
Sadness 45.79 66.97 -1.901 ≤0.05
Surprise
Curiosity
Admiration
Security
Joy
TMMS-24
Attention 22.16 25.76 -2.035 ≤0.030
Clarity
Repair
DERS
Awareness
Impulse
Non-acceptance
Goals
Clarity
Strategies
Total
IRI
Perspective taking
Fantasy
Empathic concern 24.16 27.98 -3.439 ≤0.001
Personal distress
Total 82.95 93.28 -3.316 ≤0.001 80.75 90.20 -2.231 ≤0.026
COPE
Confrontation 38.63 67.18 -2.655 ≤0.008 12.38 23.65 -2.453 ≤0.014
Planning 13.63 23.35 -2.075 ≤0.038
Social support
Emotional support 44 66.62 -2.061 ≤0.039
Positive reinterpretation 11.75 23.79 -2.592 ≤0.010
Acceptance
Humor 29.44 19.63 -2.067 ≤0.039
Self-distraction
Venting
Behavioral disengagement
Negation
Religious
Substance use 28.38 19.88 -2.361 ≤0.018
Self-blame

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Relationships between year group and the main significant differences for each variable. When the students
study variables reporting episodes of anxiety and stress are excluded, all the
Comparing the students by year group (from first to statistically significant differences disappear.
fourth), Table 5 reflects the number of statistically

Table 5.
Significant differences between courses in different samples in measures of instruments
COURSES (total sample)
First Second Third Fourth H p
(N= 55) (N= 30) (N= 12) (N= 33)
SCL-90-R
GSI 79.47 52.33 62.96 55.18 13.714 ≤0.001
PST 48.70 37.06 42.16 37.60 3.679 ≤0.014
PSDI 2.07 1.81 1.93 1.80 2.603 ≤0.05
Somatizacion
Obssesive compulsive 79.67 50.02 61.38 57.45 14.537 ≤0.002
Interpersonal sensitivy 78.65 52.87 62.38 56.20 12.220 ≤0.007
Depression 80.74 50 58.67 56.68 16.306 ≤0.001
Anxiety 74.10 55.52 64.33 60.67
Hostility 75.65 58.62 82.92 48.52 14.469 ≤0.002
Phobic anxiety 73.82 66.77 63.63 51.17 7.679 ≤0.05
Paranoid ideation 77.21 64.90 59.38 48.76 12.293 ≤0.006
Psychoticism
PANAS
Positive last week
Negative last week 71.25 47.32 78.04 67.88 9.762 ≤0.021
Positive usually 57.65 63.68 92.25 64.22 8.682 ≤0.034
Negative usually
EMOTIONS
Fear
Anger
Guilt
Disgust 67.50 57.95 102.75 55.48 22.772 ≤0.001
Sadness
Surprise
Curiosity
Admiration 54.06 63.22 83.33 78.59 12.119 ≤0.007
Security 56.94 61.23 60.21 84.19 11.774 ≤0.008
Joy
TMMS-24
Attention
Clarity 21.47 24.60 28.75 27.39 7.590 ≤0.001
Repair 23.96 26.70 29.25 27.93 3.662 ≤0.014
DERS
Awareness
Impulse
Non-acceptance
Goals 77.34 51.09 68.04 55.56 12.224 ≤0.007
Clarity
Strategies 74.66 52.72 79.63 54.36 11.370 ≤0.010
Total 76.66 54.91 64.92 54.45 10.098 ≤0.018
IRI
Perspective taking
Fantasy
Empathic concern
Personal distress
Total
COPE
Confrontation
Planning
Social support
Emotional support
Positive reinterpretation
Acceptance
Humor 56.81 67.67 89 65.66 8.047 ≤0.045
Self-distraction
Venting
Behavioral disengagement 63.50 50.43 64.58 78.94 9.980 ≤0.020
Negation
Religious
Substance use
Self-blame

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Relationships between the presence of chronic dis- having a chronic disease, and how this impact does not dis-
ease and the main study variables appear when the students reporting anxiety or stress are ex-
Table 6 shows the impact on the study variables of cluded from the sample.
Table 6.
Significant differences between chronic disease in different samples in measures of instruments and emotions
CHRONIC DISEASE (total sample) CHRONIC DISEASE (sample without anxiety)
Yes No Z p Yes No Z p
(N= 17) (N= 113) (N= 7) (N= 35)
SCL-90-R
GSI
PST
PSDI
Somatization
Obsessive compulsive
Interpersonal sensitivity
Depression
Anxiety
Hostility 83.79 62.75 -2.163 ≤0.031 31.64 19.47 -2.436 ≤0.015
Phobic anxiety
Paranoid ideation
Psychoticism
PANAS
Positive last week 31.41 28.22 -2.127 ≤0.044 34.42 29.28 -2.100 ≤0.035
Negative last week
Positive usually 81.12 61.35 -2.069 ≤0.039 33.50 18.43 -3.040 ≤0.002
Negative usually
EMOTIONS
Fear
Anger
Guilt
Disgust 30.43 19.71 -2.732 ≤0.006
Sadness
Surprise
Curiosity
Admiration
Security
Joy
TMMS-24
Attention
Clarity
Repair
DERS
Awareness
Impulse
Non-acceptance
Goals
Clarity
Strategies
Total
IRI
Perspective taking
Fantasy
Empathic concern
Personal distress 14.47 16.89 -2.212 ≤0.037 13.42 16.28 -1.910 ≤0.042
Total
COPE
Confrontation
Planning
Social support
Emotional support
Positive reinterpretation
Acceptance
Humor
Self-distraction
Venting
Behavioral disengagement
Negation
Religious
Substance use
Self-blame

Relationships between sport and the main study when the students reporting episodes of anxiety and stress
variables are excluded, some of the statistically significant differences
In Table 7, we can see statistically significant differences are maintained and other statistically significant differences
between sport and the study variables. In the same line, appear.

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Table 7.
Significant differences between do sport in different samples in measures of instruments
SPORT (total sample) SPORT (sample without anxiety)
Yes No Z p Yes No Z p
(N= 48) (N= 82) (N= 16) (N= 26)
SCL-90-R
GSI
PST 26.43 37.19 -2.018 ≤0.025
PSDI
Somatization
Obsessive compulsive
Interpersonal sensitivity
Depression
Anxiety
Hostility
Phobic anxiety 16.41 24.63 -2.163 ≤0.030
Paranoid ideation
Psychoticism
PANAS
Positive last week 30.72 27.41 -2.772 ≤0.007 31.93 29.03 -1.750 ≤0.045
Negative last week
Positive usually 25.56 18.08 -1.956 ≤0.05
Negative usually
EMOTIONS
Fear
Anger
Guilt
Disgust
Sadness
Surprise
Curiosity
Admiration
Security
Joy
TMMS-24
Attention
Clarity
Repair 27.87 25.04 -2.383 ≤0.019 29.81 25.96 -1.885 ≤0.033
DERS
Awareness
Impulse
Non-acceptance
Goals
Clarity 9.68 11.61 -1.989 ≤0.028
Strategies
Total
IRI
Perspective taking
Fantasy 21.18 24 -2.018 ≤0.026
Empathic concern
Personal distress
Total
COPE
Confrontation
Planning
Social support
Emotional support
Positive reinterpretation
Acceptance 74.47 58.52 -2.422 ≤0.015
Humor 28.03 17.48 -2.750 ≤0.006
Self-distraction
Venting
Behavioral disengagement
Negation
Religious
Substance use
Self-blame 26.63 18.35 -2.189 ≤0.029

Discussion study provides important evidence in this regard.

The sociodemographic data are in line with our ex-
University students are a distinct population group in a pectations, considering the mean age of the sample and the
critical transitional period, where the management of dif- proportion of female participants, which are similar to
ferent emotions, emotional intelligence and coping capacity those in other studies (Fernández-Rodríguez et al., 2019;
are key resources they need to develop to deal with mental Zeppegno et al., 2014). The place of origin shows that most
health problems and psychological distress. The present of the students are from the Autonomous Community of

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Castilla-La Mancha, although the sample includes students Symptom Distress Index (PSDI), which assesses whether
from other parts of Spain, suggesting the open nature and the respondent tends to exaggerate or attenuate their symp-
mobility of students from other areas. toms, such that feigning attitudes can be detected.
The undergraduates’ health status was good only The level of psychopathological disorder and the sever-
13.1% presented chronic diseases, with coeliac disease and ity of psychological distress in our participants, as evaluated
asthma being the most prevalent (Mullins et al., 2017). on each of the overall measures of the SCL-90-R, are not
However, 67.7% reported having experienced anxiety or high, with scores generally being situated around low val-
stress, which is consistent with other studies, where ap- ues. Thus, it appears our undergraduates do no present a
proximately 50% of university students experienced signif- high level of psychopathology (Dilber et al., 2016). None-
icant levels of anxiety (Morales-Rodríguez et al., 2020; theless, other works have found high rates of psychiatric and
Webber et al., 2021). Of our undergraduates, 13.8% were psychopathological problems among university students
receiving psychological support and 8.5% were taking psy- (Tang et al., 2018; Zeppegno, et al., 2014).
chotropic medication (mainly anxiolytics), being higher In recent decades, the study of affectivity, emotions and
than Zeppegno et al. (2014) in Italian second-year univer- their regulation, empathic and emotional intelligence and
sity students. their potential impact on the daily life in university popula-
Questions about activity during the academic tions has generated much interest. Our undergraduates’ af-
year showed that most of the undergraduates like, or find fective states, measured using the PANAS, revealed the
motivation in, the degree course they are studying and con- presence of positive affect both as a general occurrence and
sider they made the right choice (Ministerio de Educación, over the last week, with this positive affect indicating that
Innovación y Universidades, 2019), despite it not having university students feel excited, alert, and active. Similar
been the first option for 49.2%. Additionally, the majority results have been found in other studies with university
of students attend class regularly, which contrasts with samples (Merchán-Clavellino et al., 2019).
other studies that report high levels of absenteeism (Cox As regards the ten basic emotions analysed, our results
Méndez, 2017). As regards combining work and study, show that the highest-scoring emotions were the pleasant
18.5% carried out regular work activity during the aca- ones of curiosity, joy, security and admiration, with a lower
demic year, a higher level than in the work by Fernández- presence of unpleasant emotion. This finding suggests the
Rodríguez et al. (2019). The participation of international students are emotionally prepared for academic life, with
exchange students was very limited, which is in line with sufficient resources of interest, motivation and control to
the results of Fernández-Rodríguez et al. (2019). As regards deal with study and curricular content. Furthermore, they
financial assistance, more than half the students in our study present improved well-being and personal satisfaction
had a grant, which safeguards the possibility of university (Aguado, 2014; 2015).
study among lower socioeconomic status families (Langa- The levels of emotional intelligence measured by
Rosado, 2019). Additionally, many of them were on place- TMMS-24 show that our undergraduates are able to process
ments, because the sample included third- and fourth-year emotional information because they have high scores in the
students. Finally, few students do sport or engage in physi- ability to identify their own emotions and those of others
cal activity (only 36.9%), although other authors have and know how to express them (emotional attention). They
found a significant number of university students do physi- can also understand emotions (emotional clarity), and are
cal exercise for fitness, health and enjoy (León et al., 2020). able to manage emotions (emotional repair or regulation).
It is important for universities to reach agreements with This is consistent with other studies on Spanish university
gyms in their location and other sports facilities, to imple- students (Gribble et al. 2019; Merchán-Clavellino et al.,
ment activities to promote sport as a preventive measure 2019; Morales-Rodríguez et al., 2020).
and to improve personal well-being (León et al., 2020) be- As regards emotion regulation, assessed using the
cause educational interventions to encourage physical activ- DERS, our participants showed difficulties in emotion reg-
ity in students of health disciplines (including occupational ulation skills across all the multidimensional aspects of the
therapy) yield notable results in the awareness of the im- scale because they had higher scores in awareness, goals,
portance of physical activity (Freene et al., 2022) and in in- impulse, clarity, strategies and total score. These results are
dividual’s physical functioning, psychological benefits, and similar to those in other studies with young population
a good quality of life. (Hallion et al., 2018).
The mean scores in the measures used show, for Our students’ capacity for empathy, measured using the
the psychopathology screening tool SCL-90, low scores for IRI, revealed high scores in all subscales of this scale and in
all dimensions, which is similar to the findings of Tang et al. the total score, which is consistent with previous studies
(2018) with university students. The scores were only high (Quince et al., 2016; Serrada-Tejeda et al., 2022). In occu-
in the subscales of depression, coinciding with Tang et al. pational therapy undergraduates, empathy is a key element
(2018). It appears that symptoms of depression, according since being able to understand the psychological point of
to these authors, may be the most common mental health view of the other person, putting themselves in the place of
symptoms among university population (Tang et al., 2018). others and showing consideration for their feelings and con-
The different indicators showed high scores in the Positive cerns and are all important capacities in the implementation

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of a formative process on empathic skills that could have women focus more on their emotional state compared to
positively affected students’ empathy levels (Serrada- their male counterparts, which is consistent with the find-
Tejeda et al., 2022). ings of Acebes-Sánchez et al (2019) and more specifically
The results for coping capacity, measured on the COPE among students on occupational therapy degree courses
questionnaire, reveal the existence of a good coping style (Polonio-López et al., 2019) where the women exhibited a
and adaptive strategies, with particularly high mean scores greater focus on their emotions and have the ability to per-
found on the subscales of confrontation, acceptance, plan- ceive and express feelings appropriately. However, other
ning, self-distraction, humour, emotional and social sup- works using the TMMS-24 (Merchán-Clavellino et al.,
port. Similar findings were reported by Demiral Yilmaz et 2019) found no gender differences in the dimensions of
al (2020) with a predominance of adaptive coping strategies emotional intelligence.
in various university samples, suggesting that good coping The female undergraduates, however, have a strong em-
strategies help reduce suffering, stress, emotional distress, pathic capacity, measured on the IRI total score and its em-
etc. phatic concern subscale. This is in line with the findings of
With regard to the relationships between vari- other national and international works, which also report
ables, our findings suggest the importance of anxiety and greater empathic disposition in women (Mestre et al.,
stress in undergraduates, as reported for students from dif- 2004; Quince et al., 2016) and also among women studying
ferent parts of the world and for students enrolled on dif- occupational therapy (Serrada-Tejeda et al., 2022).
ferent types of degree (Balaji et al., 2019; Dias Lopes et al., Similarly, the females in our study are distinguished by
2020; Martínez-Lorca et al., 20231,2; Morales-Rodríguez et their solid, active and effective coping strategies, as assessed
al., 2020; Zeppegno et al., 2014). Our data confirm that on the COPE tool, showing use of confrontation and emo-
students reporting episodes of anxiety or stress exhibited tional support (Balaji et al., 2019).
worse psychopathological prognosis in all the indicators and All of these statistically significant differences in the sex
subscales of the SCL-90-R, with the presence of negative variable disappeared when we excluded the students who
affect as a general occurrence and over the last week. They reported anxiety or stress. However, the differences are
present a maladaptive emotional status, characterised by maintained in the IRI total score and coping strategies of
fear and sadness. However, they showed curiosity, and they confrontation subscales and new statistically significant dif-
present negative affect. They exhibit greater attention to ferences appeared in the COPE subscales in females (plan-
emotions (Guil et al., 2021), have difficulties in total emo- ning and positive reinterpretation) and in males (humour
tion regulation (Hallion et al., 2018), and present fewer ef- and substance use). Thus, the female undergraduates, com-
fective coping strategies because they used negation. Empa- pared with their male peers, continue to show an excellent
thy, however, was higher among students with anxiety or empathic response and an adequate coping capacity of con-
stress, such that, as suggested (Pittelkow et al., 2021), frontation, with other positive coping strategies appearing,
there exists hypersensitivity to the emotional signals of oth- in contrast males had a substance use which is similar in
ers, excessive empathic functioning, with over-attribution other studies (Rodríguez-Sáez et al. 2021).
of others’ mental states and a greater sense of alertness The first year of university is a stressor due to fac-
among students with anxiety. tors such as the changes and adjustments in academic life,
Thus, our results show that anxiety has an impact on all new friendships and leaving the family home, in some cases,
the variables under analysis. These findings can be used to which correlated with worse indicators of health, anxiety,
design appropriate and systematic interventions and pro- mental health, emotion regulation, emotions, and emo-
grammes to help students at risk of anxiety. Robust support tional intelligence compared with their more experienced
and increased psychological assessment and monitoring counterparts (Dilber et al., 2016; Webber et al., 2021).
among students must be given serious attention to avoid In fact, our data reveal numerous statistically significant
higher prevalence rates of anxiety in the future (Sanchis- differences on the GSI, PST, and PSDI and many of the sub-
Soler et al., 2022). scales of questionnaire SCL-90-R were significantly higher
As regards sex, the women score worse in anxiety and in first-year students in comparison with second, third and
phobic anxiety in the SCL-90-R compared to their male fourth-year students. However, it is interesting to note that
counterparts, so these gender differences in psychological after the first-year students, it is the third-year students that
status might mean that female students, when faced with score highest, compared to those in the fourth and second
rapid changes, are more likely to focus on feelings of psy- year, with the latter being those that score lowest. Thus, it
chopathological distress and psychological symptoms (Mar- seems that students present higher levels of current psychi-
tínez-Lorca et al., 20232; Tang et al., 2018). atric symptoms and stress during their first year, possibly
Additionally, the women’s emotional universe is char- associated with factors in the process of adjustment to uni-
acterised by a greater presence of the emotions of fear and versity life (Dilber et al., 2016). As for the third-year stu-
sadness. Previous works have also reported that female uni- dents, their high scores may be due to the imminence of
versity students present greater levels of fear and sadness their placement modules (Polonio-Lopez et al., 2021;
(Almalki et al., 2019). Webber et al., 2021). What our results do show is that the
Regarding emotional intelligence in our data, the second-year students have the fewest stress and psychiatric

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and/or psychopathological difficulties. dropout and help them in the process of managing and cop-
Affectivity was also found to be poorer in the first and ing with their emotions, thus promoting their psychological
third-year students, who presented higher negative affect well-being and social functioning.
over the last week. Negative affect is a general dimension of Chronic disease is a global health concern and is
anguish and dissatisfaction. This is of concern, as the conse- frequently associated with mental health comorbidities and
quences of negative affect may be linked to mental illness, is an indicator of levels of anxiety, emotional difficulties and
causing poorer academic performance, thus compromising poor mental health (Martínez-Lorca et al., 20232; Mullins
an individual’s professional future or even causing a lack of et al., 2017; Wierenga et al., 2017).). The students with a
engagement and discontent with their chosen degree course chronic disease diagnosis presented worse scores in the
(Dias Lopes et al., 2020). SCL-90-R subscales hostility. They also had a lower capac-
As regards their emotional universe, we found on the ity for empathy with a personal distress score. However,
one hand, that the third-year students exhibited the highest the students with chronic disease also presented greater
levels of disgust, followed by those in the first year, and on positive affect both in the last week and generally. This in-
the other, that the third-year undergraduates felt admira- teresting finding suggests that university students with a
tion and security. This is an interesting finding since we chronic illness optimize, promote and maintain optimal af-
found the presence of disgust, although high levels of emo- fective functioning and emotional balance, which is an adap-
tional maturity were also found, with the appearance of im- tive strategy in the presence of aversive stressors (Wierenga
portant emotions for emotion regulation, showing students et al., 2017). This should be analysed in greater depth in
to be more adaptive and better suited to the demands of future research. However, all these associations did not dis-
university, such as admiration and security among students appear when students with anxiety or stress were excluded
nearer to completing their degree course (Aguado, 2014; from the sample. Moreover, a statistically significant differ-
2015). ence emerges related to the emotion of disgust. Thus, it
The emotional intelligence scores show that older stu- may be said that the presence of episodes of anxiety or stress
dents in later year groups exhibit greater capacity to under- does not affect the comorbidity between greater emotional
stand emotional states and regulate and repair emotional difficulties and poor mental health (Mullins et al., 2017) be-
states correctly, blocking negative moods and prolonging cause having a chronic disease is, in itself, a dysfunctional or
positive moods. First-year students appear unable to under- problematic factor (Wierenga et al., 2017).
stand their own emotions or discriminate them from those Finally, doing sport and engaging in physical ac-
of others, nor are they able to repair emotion. As suggested tivity provide a range of benefits, including physical fit-
by other studies, the ability to understand and regulate ness, mental health, psychological impacts, emotional intel-
emotions depends on age (Gribble et al, 2019; Polonio- ligence, self-esteem, body image and the reduced risk of
López et al., 2019). premature death and chronic diseases (Acebes-Sánchez et
Additionally, first-year students and third-year stu- al., 2019; Grasdalsmoen et al., 2020; López et al., 2021;
dents, compared with their counterparts, appear to have Sanchis-Soler et al., 2022). Our data show that students
more difficulties in certain elements of emotion regulation, that engage in sport present positive affect in the last week,
such as goals (difficulties engaging in goal-directed behav- emotional repair and strategies of acceptance. Other studies
iours when distressed), strategies (limited access to effec- have reported similar findings (Acebes-Sánchez et al., 2019;
tive emotional regulation strategies) and in the total DERS López et al., 2021; Martínez-Lorca et al., 20231; Webber
score. Thus, student age is associated with the DERS score. et al., 2021), where high levels of physical activity are asso-
Guzmán-González et al. (2014), however, do not report ciated with better control of the ability to repair emotions.
this relationship. All these association did not disappear when students with
As regards coping skills, the third and fourth-year stu- anxiety or stress were excluded from the sample. Addition-
dents are able to implement humour strategies and behav- ally, other statistically significant differences appeared in
ioural disengagement strategies (Balaji et al., 2019). Hence, some of the SCL-90-R subscales, in generally felt positive
it would seems of interest, given the lack of coping strate- affect and in some subscales of DERS, IRI and COPE. Thus,
gies revealed by our results, that students should be trained it may be said that the presence of episodes of anxiety or
in better coping strategies. stress does not affect the relationship between greater en-
After excluding the students with anxiety or stress from gagement in sports and emotional difficulties and poor men-
the sample, all of these statistically significant differences tal health (Mullins et al., 2017). Hence, doing sport is, in
disappeared. Thus, it may be said that the presence of epi- itself, a positive and adaptive activity. Thus, it is important
sodes of anxiety or stress is related to the impact in different that university institutions promote engagement in physical
academic years (Mullins et al., 2017). activity and sports as a measure of self-care, and as a way to
In light of the above, we can conclude that the first and provide health and psychological benefits and avoid a sed-
third years at university are a factor in stress, mental health entary lifestyle, possibly integrating physical exercise into
and emotional difficulties. University authorities should the university environment.
monitor and design interventions for these students in order
to avoid high rates of anxiety, psychological distress and Conclusion

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© Copyright: Federación Española de Asociaciones de Docentes de Educación Física (FEADEF) ISSN: Edición impresa: 1579-1726. Edición Web: 1988-2041 (https://recyt.fecyt.es/index.php/retos/index)

Cox Méndez, L. (2017). Absentismo en las aulas universitarias. Con-

Our results indicate the need for preventive measures in textos: Estudios De Humanidades y Ciencias Sociales, (35), 69-80.
students of higher education to minimise anxiety, stress, Davis, M. H. (1983). Measuring individual differences in empathy:
mental health, maladaptive emotions and feelings and help Evidence for a multidimensional approach. Journal of Personality
and Social Psychology, 44(1), 113-126.
maintain necessary levels of emotional intelligence, emo-
Derogatis, L. R. (1975). The SCL-90-R. Baltimore: Clinical Psycho-
tion regulation, empathy, coping skills and well-being metric Research.
among occupational therapy students during this stage of Demiral Yilmaz, N., Sahin, H., & Nazli, A. (2020). International
academic development, particularly in young students. To medical students' adaptation to university life in Turkey. Interna-
this end, it is suggested that educational institutions adopt tional Journal of Medical Education, 11, 62–72.
effective health policies and implement empirically effec- https://doi.org/10.5116/ijme.5e47.d7de
tive emotional education programmes across the curricu- Dias Lopes, L. F., Chaves, B. M., Fabrício, A., Porto, A., Machado
lum, spanning the period from entry to higher education to de Almeida, D., Obregon, S. L., Pimentel Lima, M., et al.
entry into the labour market (Balaji et al., 2019; Dias Lopes (2020). Analysis of well-being and anxiety among university stu-
et al., 2020; Dilber et al., 2016; Freene et al., 2022; Fer- dents. International Journal of Environmental Research and Public
Health, 17(11), 3874.
nández-Rodríguez et al., 2019; Martínez-Lorca et al.,
https://doi.org/10.3390/ijerph17113874
2023). This would increase their subjective well-being,
Dilber, R., Babić, D., Vasilj, I., Martinac, M., Babić, R., & Aukst-
emotional response, health status and academic adaptation,
Margetić, B. (2016). Religiosty and mental health in nursing stu-
achieving greater personal satisfaction and, consequently, a dents. Psychiatria Danubina, 28(2), 188-192.
more successful professional future. Fernández-Berrocal, P., Extremera, N., & Ramos, N. (2004). Valid-
Our work also has some limitations. One of these is ity and reliability of the Spanish modified version of the Trait
the cross-sectional nature of the study, which does not al- Meta-mood Scale. Psychological Reports, 94, 751-755.
low us to establish any causal relationships. Future research Fernández-Rodríguez, C., Soto-López, T., & Cuesta, M. (2019).
should focus on analysing this relationship through longitu- Needs and demands for psychological care in university students.
dinal studies. Furthermore, our sample comprises only Psicothema, 31(4), 414-421. https://doi.org/10.7334/psico-
Spanish students of occupational therapy, which may have thema2019.78
affected its representativeness and sample size. It might Freene, N., Porra, K., Bousie, J. A., Naunton, M., Ball, N., Flood,
A., Bail, K., Smith, S. D., Blenkin, M., Cheong, L., Shanahan,
therefore be worth extending the sample to other universi-
M., Isbel, S., Leung, M., & Gates, A. B. (2022). Australian uni-
ties and students to broaden the sample. Besides, we as- versity nursing and allied health students' and staff physical activ-
sessed anxiety with a subjective question, future studies ity promotion preparedness and knowledge: A pre-post study us-
should introduce validated and objective instruments. Fi- ing an educational intervention. International Journal of Environ-
nally, the majority of our participants were female, which mental Research and Public Health, 19(15), 9255.
hinders the generalisation of our results in light of a gender https://doi.org/10.3390/ijerph19159255
bias. Grasdalsmoen M, Engdahl B, Fjeld M. K, Steingrímsdóttir, O. A,
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