Stressors in secondary boarding school students: Association with stress, anxiety and depressive symptoms

Abstract

INTRODUCTION: Chronic stress in adolescents may cause physical, mental and emotional health issues which lead to poor outcomes if left untreated. The present study aimed to determine the prevalence of depression, anxiety and stress, and their association with stressors. METHODS: A cross-sectional study was conducted among 350 students in a selected boarding school. Two validated Malay version questionnaires were used as instruments, which comprised the 21-item Depression, Anxiety and Stress Scale to assess depression, anxiety and stress level, and Soalselidik Stressor Sekolah Menengah to assess stressors. RESULTS: The prevalence of depression, anxiety and stress were 39.7%, 67.1% and 44.9%, respectively. The highest mean score was 2.3 (±0.80) for the academic-related stressor. All stressors (academic, interpersonal, intrapersonal, teacher, learning/teaching and social group) had significant association with depression, anxiety and stress (P < 0.001). Multiple regression showed that both the intrapersonal-related stressor and learning/teaching-related stressor were 2.8- and 2.0-times more likely (adjusted odds ratio [OR] = 2.8 [P < 0.001] and OR = 2.0 [P = 0.002], respectively) to cause depressive symptoms. On the other hand, the interpersonal-related stressor was 2.9-times more likely (adjusted OR = 2.9, P < 0.001) to cause anxiety. The learning/teaching-related and intrapersonal-related stressors were 2.7- and 2.5-times more likely to develop stress (adjusted OR = 2.7 [P < 0.001] and OR = 2.5 [P = 0.001], respectively). DISCUSSION: The possibility of introducing screening for mental health problems among boarding school students needs to be considered and investigated. Addressing the possible stressors and employing healthy coping may help in reducing negative emotional outcomes in these students.

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