THE RELATIONSHIP BETWEEN STRESS AND DEPRESSION AMONG UNIVERSITY STUDENTS BY NENG DARIS SALAMAH ELMI PUTRI BINTI SIBRON 1427810 INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA 2018 ABSTRACT Purpose Stress and depression in the community are considered as specific indicators for the mental health status of a person

THE RELATIONSHIP BETWEEN STRESS AND DEPRESSION AMONG UNIVERSITY STUDENTS BY NENG DARIS SALAMAH ELMI PUTRI BINTI SIBRON 1427810 INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA 2018 ABSTRACT Purpose Stress and depression in the community are considered as specific indicators for the mental health status of a person. Various studies have documented stress and depression among university students. Seven stress and depression are an increasingly serious issue among university students, the purpose of this study is to identify the relationship between stress and depression among university students. Method Student Stress Inventory (SSI) was used to measure the level of stress and Beck Depression Inventory-II (BDI-II) was used to measure the level of depression among 150 undergraduate students from International Islamic University Malaysia (IIUM) who have participated in this study. Findings It was found that the stress level among undergraduate students (n150, M94.19, SD21.65) majority have a moderate stress level (n86) with a percentage of 57.3. While, the level of depression among undergraduate students (n150, M19.41, SD12.12) majority have minimal depression level (n56) with a percentage of 37.3. There was a strong, positive correlation between the two variables, r0.71, n150, p0.001, with a high level of stress associated with high level of depression. Significance The study provides an initial data on the extent of stress and depression phenomena among university students in Malaysia, being aware that students who face extreme stress or depression need serious attention. The information on stress, depression, and the relationship between both is pertinent for students, their parents and academic members so as to help them have an understanding of how severely stress and depression can lead to short and long-term consequences among students. Keywords stress, depression, university students CHAPTER 1 INTRODUCTION This chapter introduces the background of the present study and its problem statement. The chapter also explains the research objective and significance. The chapter further presents the conceptual and operational definitions of the research variables involved in the present research. 1.1 BACKGROUND OF RESEARCH University students are a special group of people who endure a critical transitory period between their adolescence and adulthood stage. Scholars found that the stage can be one of the most stressful time periods in a persons life (Wahed Hassan, 2016), including among students of higher learning institutions (HLIs). Past research found that stress is prevalent among university or college students. Elias, Wong, and Abdullah (2011), for example, reported that undergraduate students in Malaysia were found to be having a moderate vulnerability to stress. Other findings by Sharma and Wavare (2013) indicated that the reasons for students drop out of professional institutions are not actually due to their lack of intellectual ability, but emotional problems and poor motivation. Generally, university students experience stress due to academic pressure (Arip, Kamaruzaman, Roslan, Ahmad Rahman, 2015 Bedewy and Gabriel, 2015) social issues and financial problems (Shah, Hasan, Malik Sreeramareddy, 2010). Stress is also associated with their new life experiences like leaving home for the first time, the need to write academic papers, the anxiety to deal with examinations and other requirements of academia. Zaid, Chan, and Ho (2007) indicated that medical students have shown to be more prone to emotional disorders, especially stress, as compared to their non-medical peers. In effect, many experience immense stressful condition, which in turn cause negative outcomes such as elevated levels of anxiety and depression (Ming Chee, 2015). Depression is a severe disturbance of mood, being the fourth leading cause of social incapacitation in the world (Baharudin, 2016). It is an issue which has received much attention by researchers, almost in every country. They too found depression an issue among students at HLIs. Yary and Aazami (2011) reported that there are about 40 of university students who experience 1 depression. Research by Choon, Choon, Zulkifli, Vellasamy and Suresh (2015) among Malaysian undergraduate students in Melaka Manipal Medical College shows that there is a prevalence of depression, anxiety, and stress, ranging from moderate to extremely severe level, 30.7, 55.5, and 16.6 respectively. Other findings by Wahed and Hassan (2016) indicated that up to 60 of university students left university without finishing their studies because of depression, anxiety, and maladjustment. Sindhu (2016) who studied depression among Indian undergraduate Engineering students found that all low achievers had experienced depression and only 40 of high achievers experienced depression. Many researchers have studied the relationship between depression and its impacts on academic achievement among university students (Khalida, Suman, Rasid, Mohamad Ghazalie, 2016 Khurshid et al., 2015 Sindhu, 2016 Al-Qaisy, 2011), while some of the researchers focus on the prevalence of depression, anxiety and stress among undergraduate students (Choon et al., 2015 Beiter et al., 2014). Special attention to the stress and depression phenomena in HLI is important because there are various conditions and demands which may make them susceptible to stress and in effect experience other negative consequences, such as depression. Prolonged stress would result in harm to students, such that has been found by Sherina, Rampal, and Kaneson (2004) that stress has serious consequences which may lead to the development of depression and anxiety. 1.2 STATEMENT OF PROBLEM Stress and depression have been found to be two interrelated psychological variables which deserve due attention at HLIs. Yasin and Dzulkifli (2011) reported that depression, anxiety, and stress were found to be interrelated to each other, potentially leading to all sorts of academic problems among students. Too much stress combined with other psychological factors can be damaging and disruptive to students normal functioning (Sharma Wavare, 2013). Nevertheless, search in the literature found that there is a limited study to look at the relationship between stress and depression among university students. Although there is a study conducted to study the relationship between stress and depression among university students (Sherina, Rampal Kaneson, 2004), the population studied was only the medical students in Malaysia. It too has been found that most stress and depression research has been based on largely female samples, mostly 2 on episodic stressors, and mainly on cross-sectional designs with few tests of mediation which lack of study on male population (Hammen, 2005) Besides, research on stress among students has not gained much attention since most scholars have focused on the conventional work-related stress as opposed to stress among academic students (Agolla Ongori, 2009). In short, there has been a lack of study by previous researchers about severe stressor among university students nor that there were studies being conducted to look at the relationship between stress and depression in Malaysia. (Ng, 2014), let alone among male students at HLI level. The above highlights the need for research to examine the stress faced by students at higher learning institutions, in line with the suggestion made by Nandamuri Gowthami (n.d.) who stated that teachers often neglect the emotional feelings of students during the teaching process, which can cause emotional stress and learning problems for students. In addition, students may feel unfamiliar situations like nervousness, worry, frustration, and depression. Although there have been many previous research on stress and depression among university students, the research focused on one specific type of stress and its relationship with depression. This study is different because it combines all major types of student-related stress and study its association with depression among undergraduate university students. The present research addresses the gap in the literature on stress and depression among Malaysian university students by measuring both level of stress and depression as well as the correlation between them. 1.3 RESEARCH QUESTIONS Based on the above, the research attempts to answer the following questions What is the level of stress among university students What is the level of depression among university students What is the relationship between stress and depression among university students 1.4 RESEARCH OBJECTIVES The objectives of the research are To measure the level of stress among university students. To measure the level of depression among university students. 3 3. To study the relationship between stress and depression among university students. 1.5 SIGNIFICANCE OF STUDY The phenomenon of stress is often neglected in day to day life event when it could play a very detrimental role in an individuals mental health, including among students. The severity of psychological health complaints and mental health issues are increasing in college campuses (Wahed Hassan, 2016). It is important to understand the relationship between stress and depression among undergraduates in order to help the students become aware of their well-being. This research aims to measure the level of stress and depression among university students, as well as study the relationship between stress and depression among university students. The findings are expected to inform Higher Education officials, university management, and professionals on the pattern of psychological health among university students. Early detection of the two phenomena is crucial to help the officials in designing intervention programmes which in turn prevent any further critical mental health conditions among university students. It is also helpful for academics or faculties to recognize those symptoms so they can direct their students to seek help. Given depression is difficult to recognize and treat in individuals at the early youth age group, engaging them in prevention and early intervention programmes is a challenge for health professionals and other service providers (Jones et al., 2017). This research hence provides an initial data on the extent of stress and depression phenomena among university students in Malaysia, being aware that students who face extreme stress or depression need serious attention. The information on stress, depression, and the relationship between both is pertinent for students, their parents and academic members so as to help them having an understanding of how severely stress and depression can lead to short and long-term consequences among students. Failure to understand their psychological health conditions may lead to their inability to have successful coping, causing other negative consequences at both personal and professional level (Ngasa et. al., 2017). 4 1.6 DEFINITION OF TERMS Stress Conceptual definition The term stress refers to the psychological state which occurs as a result of a persons appraisal of his or her ability in adjusting with the demands of the society and environment (Kumaraswamy, 2013). Stress is considered as a state of individuals mental or emotional strain or tension resulting from his or her interaction with the environment that is perceived to be very demanding and a threat to well-being, It involves either physical or emotional situations that require an individual to react (Yasin Dzulkifli, 2011). Operational definition In this study, the term stress refers to physical stress, interpersonal relationship stress, academic stress and environmental stress, measured by the Student Stress Inventory (SSI) to assess the level of stress among university students (Arip, Kamaruzaman, Roslan, Ahmad Rahman, 2015). Depression Conceptual definition Depression is a severe mood disorder covered a variety of negative moods and behavioral changes and is the fourth leading cause of social incapacitation in the world (Wani et. al., 2016). Depression occurs when feelings of extreme sadness or despair last for at least 2 weeks or longer and interfere with activities of daily living, such as working, eating, or sleeping. Depressed individuals tend to feel helpless and hopeless and blame themselves for these feelings. Some may even have thoughts of death or suicide (Watkins, Green, Rivers Rowell, 2006). Operational definition In this research, depression is operationally referring to the level of sadness, pessimism, past failure, loss of pleasure, guilty feelings, punishment feelings, self-dislike, self-criticalness, suicidal thoughts or wishes, crying, agitation, loss of interest, indecisiveness, worthlessness, loss of energy, changes in sleeping patterns, irritability, changes in appetite, concentration difficulty, 5 tiredness or fatigue and loss of interest in sex, measured by using Beck Depression Inventory-II (BDI-II) (Beck, Steer Brown, 1996). 1.7 SUMMARY To conclude, this chapter has presented the important issue of stress and depression among university students in Malaysia. In line with this, it is argued that other the consequences of stress and the relationship between stress and depression in Malaysian need to be further researched. 6 CHAPTER 2 LITERATURE REVIEW 2.1 INTRODUCTION This chapter presents the review of relevant literature on studies of the relationship between stress and depression among university students. From this initial review, a further narrowing literature on the level of stress and the level of depression among university students is elaborated. The literature is pertinent for the purpose of identifying the trend of relationship between stress and depression among university students. 2.2 LEVEL OF STRESS AMONG UNIVERSITY STUDENTS Brougham, Zail, Mendoza, and Miller (2009) have conducted a study to measure the gender differences in terms of stress level and coping strategies among college students in Southern California. Results have found that female college students reported a higher overall level of stress and greater use of emotion-focused coping strategies than the males college students. On the other hand, very rare studies were found to be conducted in Shillong, Meghalaya about stress levels of college students and interrelationship with coping strategies. The results found that academic stress was negatively correlated with coping strategies like using drugs and this was significant at 0.05 level. The majority (38.9) of the participants were experiencing very low stress, during the study time (Pariat, Rynjah, Joplin and Kharjana, 2014). Some research also showed that students had experienced stress since their school days. For example, Khan, Lanin, and Ahmad (2015) have conducted a study to assess the level of stress among male and female school students in India. The result of the study showed that boys were having much more stress in comparison to girls. This showed that school boys were more stressful than school girls. A study conducted at College of Medicine, King Saud University measured the prevalence of stress among medical students and to observe an association between the levels of stress and their academic performance, including the sources of their stress. Result reported that the total prevalence of stress was 63, and the prevalence of severe stress was 25. The level of stress was 7 higher among females (75.7) than among males (57) students. Students grade point average (academic score) or regularity to attend classes was not significantly associated with the stress level. The prevalence of stress was higher during the initial three years of study and among the female students. Physical problems are associated with high stress (Abdulghani, AlKanhal, Mahmoud, Ponnamperuma Alfaris, 2011). It is consistent with a study that had been conducted among medical students in Malaysia which reported that the prevalence of psychological stress was only slightly higher among the females (42.2) compared to the males (41.4) students in Malaysia (Sherina, Rampal Kaneson, 2004). Table 1 Findings from research on the level of stress among university students ResearchersResearch ToolsVariablesSampleFindingsmeasuredBrougham, Zail,(i) RevisedThe sources of166 collegeCollege womenMendoza, andCOPE Inventorystressstudents (70 menreported a higherMiller (2009)The 40-item(academics,and 96 women)overall level ofrevised Copefinancial, family,recruited from astress and greaterinventory.social, and dailyliberal artsuse of emotion-hassles) anduniversity infocused coping(ii) Studentcoping strategiesSouthernstrategies thanStress(self-help,Californiacollege men.Assessmentapproach,accommodation,College men andavoidance, andwomen alsoself-punishment)reporteddifferent copingstrategies fordifferentstressorshowever the useof emotion-focused copingstrategiesdominated overproblem-solvingstrategies forboth men and8women.Pariat, Rynjah,(i) SelfStress levels ofCollege studentsAcademic stressJoplin, andstructuredcollege studentsenrolled in fivewas highlyKharjana (2014)questionnaireInterrelationshipreputed collegescorrelated withincludes threebetween stressorof Shillong city.social andsections,and copingDegree studentsfinancial stress.demographicstrategies.who wereHowever,information, apursuing theiracademic stressset of questionsstudies inwas negativelyon academic,different streamscorrelated withemotional,namely Arts,coping strategiessocial, andCommerce,like using drugsfinancialScience and whoand this wasstressors andwere in betweensignificant atstatements onthe age group of0.05 level.positive and19-23 years ofnegative coping.age and alsoThe majoritystudents below(38.9) of the(ii) Students19 years andparticipants wereStress Scaleabove 23 yearsexperiencingwere selected.very low stress,during the studytime.Khan, Lanin, andStudents StressLevel of stress in64 schoolBoys havingAhmad (2015)Scale (SSS)male and femalestudents agedmuch moreschool studentsbetween 14 to 8stress inin India.years old.comparison togirls whichconcluded thatschool boys aremore stressfulthan school girls.Abdulghani,Kessler10The prevalenceAll the male andThe totalAlKanhal,Psychologicalof stress amongfemale medicalprevalence ofMahmoud,Distress (K10)medical studentsstudents in thestress was 63,Ponnamperum,inventoryand to observefive academicand the Alfaris (2011)an associationyears of theprevalence ofbetween9the levels ofCollege ofsevere stress wasstress and theirMedicine,25.academicKing Saudperformance,University.The level ofincluding thestress was highersources of theiramong femalesstress.(75.7) thanamong males(57) students.Students gradepoint average(academic score)or regularity toattend classeswas notsignificantlyassociated withthe stress level.The prevalenceof stress washigher during theinitial three yearsof study andamong thefemale students.Physicalproblems areassociated withhigh stresslevels.Sherina, Rampal(i) GeneralPsychologicalMedical studentsPrevalence ofand KanesonHealthstress amongat a localpsychological(2004)Questionnairemedical studentsuniversity instress was only(GHQ -12)and to identifyMalaysia.slightly higherits symptomsamong the(ii) Beckfemales (42.2)10Depressionand associationcompared to theInventory (BDI)with depression.males (41.4)students inMalaysia. 2.3 LEVEL OF DEPRESSION AMONG UNIVERSITY STUDENTS Depression is relatively more common among adolescents, with the level of depression by up to 28 and is increasing worldwide. Bostanci et. al. (2005) have conducted a study to assess the level of depression among 504 Turkish university students and result reported that out of all participants, 26.2 had a BDI score of 17 or higher. The level of depression increased to 32.1 among older students, 34.7 among students with low socioeconomic status, 31.2 among seniors, and 62.9 among students with poor school performance. Another study conducted among 1,617 students at the Uludag University in Bursa, Turkey by Bayram and Bilgel (2008) reported that depression, anxiety and stress levels of moderate severity or above were found in 27.1, 47.1 and 27 of respondents, respectively. First- and second-year students had higher depression, anxiety and stress scores than the others. Students who were satisfied with their education had lower depression, anxiety and stress scores than those who were not satisfied. Result also found that higher mean scores for depression were statistically significant for students whose major was social and political sciences when they were compared with the mean scores of students whose major was basic sciences and engineering or medicine. 11 Despite this variation in prevalences of depression around the world, studies have consistently shown a high prevalence of depression in medical students. It is supported by Sharma and Wavare (2013), reported that the depression level was high as Extreme major depression was observed in 7.9 of boys and 11.8 of girls from MBBS and 10.7 of girls from Physiotherapy. Another study by Ghaedi and Kosnin(2014) is comparing the level of depression among male and female athletes and non-athletes undergraduate student of a private university in Esfahan, Iran. The result showed that the prevalence rate of depression among non-athlete male undergraduate students is significantly higher than that of athlete male students. The results also presented that level of depression among female students is much more frequent compared to males. Table 2 Findings from research on the level of depression among university students ResearchersResearch ToolVariablesSampleFindingsmeasuredBostanci, Ozdel,The revisedTo determine504 TurkishOut of allOguzhanoglu,Beck Depressionoverall anduniversityparticipants,Ozdel, Ergin,Inventory (BDI)subgroupstudents (29626.2 had a BDIErgin, Atesciprevalence ofmale, 208score of 17 orand Karadagdepressivefemale)higher.(2005)symptomatologyamongThe level ofuniversitydepressionstudents and toincreased toinvestigate32.1 amongwhetherolder students,sociodemographi34.7 amongc factors werestudents withassociated withlowdepressivesocioeconomicsymptoms instatus, 31.2universityamong seniors,studentsand 62.9among studentswith poor schoolperformance. 12 15 2.4 RELATIONSHIP BETWEEN STRESS AND DEPRESSION AMONG UNIVERSITY STUDENTS A study which was conducted by Sherina, Rampal, and Kaneson (2004) reported that there was a significant association between psychological stress and depression among medical students in Malaysia. There was a significant association between psychological stress and depression among the respondents. Ten out of the 12 symptoms of psychological stress were found to be significantly associated with depression (p0.05). The researchers also claimed that it is consistent with a study among undergraduate medical students in the United States of America found that 23 had clinical depression and 57 were under psychological stress. Another study conducted by Killinger, Flanagan, Castine, and Howard (2017) examined the relationship between stress and depression among veterinary medical students and the results indicated a strong (r .53) relationship between stress and depression. The strength of this relationship was similar for participants regardless of gender (males r .57 females r .52) or year in the program (year 1 r .51 year 2 r .51 year 3 r .56 year 4 r .57). Table 3 Findings from research on the relationship between stress and depression ResearchersResearch ToolVariablesSampleFindingsmeasuredSherina, Rampal,(i) GeneralPsychologicalMedical studentsThere was aand KanesonHealthstress amongat a localsignificant(2004)Questionnairemedical studentsuniversity inassociation(GHQ -12)and to identifyMalaysia.betweenits symptomspsychological(ii) Beckand associationstress andDepressionwith depression.depressionInventory (BDI)among therespondents(X24.636, dfl,p0.05). Ten outof the 12symptoms ofpsychologicalstress were16found to besignificantlyassociated withdepression(p0.05).Killinger,(i) VeterinaryStress and1,245 veterinaryThere is aFlanagan,Medicaldepressionmedical studentscorrelationCastine, andStressorsfrom Northbetween stressHoward (2017)InventoryAmerica.and depression(VMSI)for veterinarymedical students(ii) Center forand that femaleEpidemiologicalstudentsStudiesexperienceDepression Scalehigher levels of(CES-D)stress anddepression thantheir malecounterparts.2.5THEORETICAL FRAMEWORK The diathesis-stress model has been used in this study to understand the relationship between stress and depression. Diathesis-stress models have been embraced by most researchers who attempt to understand depressive disorders. The past two decades have witnessed extensive research on the psychological factors that constitute diatheses, or predispositions, and on methods for assessing stress and evaluating its role in depression (Hammen, Henrey Daley, 2000). The diathesis-stress model states that all individuals have varying degrees of diathesis or vulnerability to depression. Diathesis has come to refer more broadly to any characteristic of a person (biological or psychological) that increases his or her chance of developing a disorder (Banks Kerns, 1996). The diathesis-stress model thus represents a linear relationship in that as individuals experience more stress, they are more vulnerable to developing depressive symptoms. The diathesis-stress model also proposes that relatively stable risk factors that moderate the effect of stress on depression (Morris, Ciesla, Garber, 2010). 17 Figure 1 General model of diathesis-stress interaction This general model by Monroe and Simons (1991) is illustrated in Figure 1. According to the researchers, the effects of stress are dependent on the diathetic loading. Typical discussions of life stress and diatheses, however, often imply only the additive portion of this model. The degree of diathetic loading can be offset or compensated by the degree of stress (and vice versa). Figure 2 Diathesis-stress interactions (Stress 1 stress related to diathesis Stress 2 stress unrelated to diathesis.) 18 Monroe and Simons (1991) also illustrate the diathesis-stress interactions in Figure 2. It is showed that diathesis is nonessential, or less important, in the theoretical scheme. The stress alone without diathesis can lead to depression. However, diathesis must interact with stressful life events such as social, psychological or biological nature in order to prompt the onset of the illness. In this study, it focuses on the relationship between stress and depression. Thus, this model suggests that there is a relationship between stress and depression even with diathesis or not. 2.5 CONCEPTUAL FRAMEWORK Figure 3 Relationship between stress and depression 19 2.6 RESEARCH HYPOTHESIS Based on the past literature, the present researched hypothesized the following Hypothesis 1 There is a significant relationship between stress and depression among university students in IIUM. 2.7 SUMMARY The level of stress and depression among university students is various according to gender, faculty, year of study, which scale used to measured and the variable measured. However, the relationship between stress and depression is consistently association and significantly related according to past studies. The theoretical framework of stress and depression is based on the diathesis-stress model. 20 CHAPTER 3 METHOD 3.1 INTRODUCTION This chapter explains the methods used in the present research in terms of the participants selected, the measures used, the design employed, the procedure and the data analysis used. 3.2 PARTICIPANTS AND SAMPLING The population of this study is university students. The participants had been selected via purposive sampling, consisting 150 undergraduate students, males (n 100) and females (n 50) from the International Islamic University Malaysia (IIUM) whose age ranged between 19 to 30 years old. The participants had been sampled from different kulliyyah (faculty) in IIUM Gombak Campus consisting of 7 kulliyyah which were 13.3 of Kulliyyah of Architecture (n20), 16.0 of Kulliyyah of Engineering (n24), 13.3 of Kulliyyah of ICT (n20), 13.3 of Kulliyyah of Education (n20), 14.7 of Kulliyyah of Islamic Revealed Knowledge and Human Sciences (n22), 13.3 of Ahmad Ibrahim Kulliyyah of Law (n20) and 16. of Kulliyyah of Economics and Management Sciences (n24). 3.3 RESEARCH DESIGN A cross-sectional design study was used to examine the correlation between stress and depression among undergraduate university students which was conducted at IIUM Gombak. The survey method was used to assess the level of stress and depression among students. 3.4 MEASURES Student Stress Inventory (SSI) The Student Stress Inventory (SSI) was developed in Malaysia by Arip, Kamaruzaman, Roslan, Ahmad and Rahman in 2015 to measure the level of stress among Malaysian university 21 students. The reliability of SSI is found to have a high overall reliability coefficient of 0.857. SSI questionnaire had good content validity with an overall score of 0.805 (80.5). The validity of SSI sub-scales for physical stress 0.807 (80.7), interpersonal relationship stress is 0.789 (78.9), academic stress is 0.822 (8.22), and environmental stress is 0.802 (80.2). In the current study, the scale has good internal consistency, with a Cronbach alpha coefficient reported of 0.95. SSI contained 40 negative items to measure 4 subscales (10 items for each subscale) which are subscale Physical (10 items), subscale 2 Interpersonal relationship (10 items), subscale 3 Academic (10 items) and subscale 4 Environmental factor (10 items). As for scoring, the SSI was designed with an ordinal scale of the Never, Somewhat frequent, Frequent and Always. The value mark given for each choice are 1 for Never, 2 for Somewhat Frequent, 3 for Frequent and 4 for Always. The administration process approximately took 15 to 20 minutes only. Beck Depression Inventory-II(BDI-II) The Beck Depression Inventory Second Edition (BDI-II) (Beck, Steer Brown, 1996) is a 21-item, paper and pencil inventory used to assess the severity of depression in adults and adolescents aged 13 years or older. The tool assesses symptomology as it correlates with diagnostic criteria for depressive disorders, as identified in the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (1994). It does not require any training to administer and it is hand scored to obtain the results. Reliability measures of Internal Consistency showed a coefficient alpha of .92 for the original 500 outpatients used for tool design (Beck, Steer Brown, 1996). Second samples of 120 college students were used to serve as a comparative norm group. Internal consistency for this group was at .93 (Beck, Steer Brown, 1996). This demonstrates good internal consistency for the BDI-II. Testretest measures were based on 26 outpatient clients measured over therapy sessions approximately one week apart. The test-retest correlation of .93 was found (Beck, Steer Brown, 1996). This demonstrated good test-retest reliability. In the current study, the scale has good internal consistency, with a Cronbach alpha coefficient reported of 0.89. These criteria include feelings of sadness, decreased levels of interest in activities, significant weight loss or gain, change in appetite, difficulties sleeping, fatigue or loss of energy, feelings of worthlessness or guilt, difficulties thinking or concentrating and recurrent thoughts of death or self harm. 22 3.5 DATA COLLECTION PROCEDURE Quantitative data collection was used. Participants were requested to fill in consent forms (Appendix 1) followed by filling in a brief demographic which was devised by the researcher. Then two self-reporting instruments which measure the level of stress and level of depression were administered. The projected time of administration and completion of the survey was approximately 10 minutes. The instructions indicated to students that they should take their time and that there were no right or wrong answers. 3.6 DATA ANALYSIS The collected data were analyzed using IBM SPSS version 22 program. Descriptive statistics such as means and frequencies of responses were used to illustrate trends in the sample. The Pearson Product- Moment Correlation Coefficient was used to assess the relationship between the levels of stress and level of depression. Correlational designs have proved to be useful in approving and refuting causal relationships 3.7 ETHICAL CONSIDERATION The questionnaire had been administered anonymously to the undergraduate university students in IIUM Gombak. Then, consent information form was given to students before delivering the questionnaire. They could refuse to join this study without any effects on their studys result and no need to explain the reason. Data were used for research purpose only. Their information will be kept confidentially. 3.8 SUMMARY To conclude, the chapter has described the characteristics and methods used for selecting the participants, measuring applicant reactions, the design, and procedure of how the present study was carried out, and the data analysis used. Each of these was discussed and each selection of methods was justify. 23 CHAPTER 4 FINDINGS 4.1 INTRODUCTION This chapter reports the results of the present study. It first presents the result of statistical analysis conducted on descriptive statistical analysis of the research variables. Finally, the chapter presents the results of the relationship between stress and depression among undergraduate students in IIUM. 4.2 DEMOGRAPHIC INFORMATION A total of 150 undergraduate students, males (n100) and females (n50) from International Islamic University Malaysia (IIUM) have participated in this study which the students age ranged from 19 to 30 years old. Students ages of 22 to 24 years old (n101) were much involved in the survey with a percentage of 67.3, followed by the ages 19 to 21 years old (n32) with 21.3, the ages of 25 to 27 years old (n16) was next with 10.7 and lastly, is the ages from 28 to 30 years old (n1) with 0.7. From the sample, the third-year undergraduate students (n57) have the highest percentage with 38.0. They were followed by the final-year undergraduate students (n40) with 26.7. Next, was the second-year undergraduate students (n37) with 24.7 and the least percentage was taken by the first-year undergraduate students (n16) with 10.7. This study has involved all the kulliyyah in the university which KIRKHS with 14.7 (n22), KOE with 16.0 (n24), KOED with 13.3 (n20), KENMS with 16.0 (n24), AIKOL, KAED and KICT each with 13.3 (n20) respectively. 24 Table 3 Sociodemographic characteristics of the students (total number 150). CharacteristicsNumbers ()SexMales100 (66.7)Females50 (33.3)Age groups19-21 years32 (21.3)22-24 years101 (67.3)25-27 years16 (10.7)28-30 years1 (0.7)Academic YearsFirst16 (10.7)Second37 (24.7)Third57 (38.0)Fourth40 (26.7)Kulliyyah (Faculty)KIRKHS22 (14.7)KOE24 (16.0)KOED20 (13.3)KENMS24 (16.0)AIKOL20 (13.3)KAED20 (13.3)KICT20 (13.3) 4.3 LEVEL OF STRESS AND DEPRESSION AMONG IIUM STUDENTS The first objective of this research was to determine the stress level among undergraduate students (n150, M94.19, SD21.65) by measured using Student Stress Inventory (SSI). Overall, it was found that the undergraduate students have a moderate stress level (n86) with a percentage of 57.3, followed by mild stress level (n44) with 29.3 and lastly, severe stress level (n20) with 13.3. By comparing the undergraduate students stress level according to degree programs, the findings show that students studying Laws (n7) had the highest severe stress with a percentage of 35.0. On the other hand, students from kulliyyah of Islamic Revealed Knowledge and Human Sciences, Education and Economics have the lowest severe stress level which only has one student with a percentage of 5.0 respectively. Students from kulliyyah of Economics (n13) have the highest percentage of mild stress level with 29.5. 25 The second objective of this research is to determine the level of depression among undergraduate students (n150, M19.41, SD12.12) by measured using Beck Depression Inventory-II. Overall, it was found that the undergraduate students have minimal depression level (n56) with a percentage of 37.3, followed by severe depression level (n35) with 23.3, the mild depression level (n30) was next with 20.0 and lastly, the lowest is moderate depression level (n19) with a percentage of 19.3. Students from AIKOL have the highest number of severe depression level (n10) with a percentage of 28.6, while, from KENMS only have one student who has the severe depression (2.9) and moderate depression level (3.4). Descriptive Statistics NMinimumMaximumMeanStd.DeviationTotal of Stress15046.00149.0094.1921.65Total of1500.0059.0019.4112.12Depression StressDepressionLevel of StressFrequencyPercent ()Level ofFrequencyPercent ()DepressionMild Stress4429.3Mild3020.0DepressionModerate8657.3Minimal5637.3StressDepressionSevere Stress2013.3Moderate2919.3DepressionTotal150100.0Severe3523.3DepressionTotal150100.0 26 Level of StressLevel of DepressionMildModerateSevereTotalMildMinimalModerateSevereTotalKulliyyahStressStressStressNoDepressioDepressionDepressionDepressionNoNoNo ()No()nNo ()No ()No ()()()()No ()KIRKHS516122972422(11.4)(18.6)(5.0)(14.7)(30.0)(12.5)(6.9)(11.4)(14.7)KOE516324377724(11.4)(18.6)(15.0)(16.0)(10.0)(12.5)(24.1)(20.0)(16.0)KOED811120563620(18.2)(12.8)(5.0)(13.3)(16.7)(10.7)(10.3)(17.1)(13.3)KENMS13101245171124(29.5)(11.6)(5.0)(16.0)(16.7)(30.4)(3.4)(2.9)(16.0)AIKOL587201541020(11.4)(9.3)(35.0)(13.3)(3.3)(8.9)(13.8)(28.6)(13.3)KAED412420276520(9.1)(14.0)(20.0)(13.3)(6.7)(12.5)(20.7)(14.3)(13.3)KICT413320576220(9.1)(5.1)(15.0)(13.3)(16.7)(12.5)(20.7)(5.7)(13.3) 4.5 RELATIONSHIP BETWEEN STRESS AND DEPRESSION AMONG IIUM STUDENTS The third objective of this study is to identify the relationship between stress and depression among IIUM undergraduate students by using Pearson product-moment correlation coefficient. Preliminary analyses were performed to ensure no violation of the assumptions of normality, linearity, and homoscedasticity. There was a strong, positive correlation between the two variables, r0.71, n150, p0.001, with a high level of stress associated with high level of depression. 27 4.6 SUMMARY To summarise, this chapter has presented the result of the level of stress and depression among university students. It is showed that the level of stress and depression is a difference based on they specific kulliyyah. Finally, the result showed that there is a relationship between stress and depression among undergraduate university students in IIUM. 28 CHAPTER 5 DISCUSSION, RECOMMENDATION AND CONCLUSION 5.1 INTRODUCTION The present research has examined the level of stress and depression among undergraduate university students in IIUM. In addition, the present research also has examined the relationship between stress and depression among IIUM university students. 5.2 OVERVIEW OF FINDINGS Findings of the present study show that undergraduate students have a moderate stress level (n86) with a percentage of 57.3. It is consistent with a study by Rasheed, Naqyi, Ahmad, and Ahmad (2017) who conducted a study among university students in Saudi Arabia has reported that the majority of students (64) had moderate perceived stress. In the current studies, a result found that students studying Laws (n7) had the highest severe stress with a percentage of 35.0. The finding also consistent with Skead and Rogers (n.d.) who found that Law students have a higher level of stress as many law students spend a significant amount of time engaged in activities that they do not perceive to be enjoyable, relaxing or worthwhile. It is also supported by another study by El-Gilany, Amr, Awadalla, and El-Khawaga (2009) which the result indicate that significantly higher prevalence of stress and anxiety in undergraduate law students than medical students. The result of this study also found that undergraduate students have minimal depression level (n56) with a percentage of 37.3. Studies also found that students from AIKOL have the highest number of severe depression level (n10) with a percentage of 28.6 compared to other kulliyyah. The result is supported by El-Gilany, Amr, Awadalla, and El-Khawaga (2009) which reported depression is more frequent in the law group, although it does not reach a significant statistical difference. Another study by Peterson and Peterson (2009) reported depression rate for young adults is 11, 319 a majority (53) of the law student respondents in the study met the threshold for a clinically significant level of depression. 29 Overall, there was a strong, positive correlation (r0.71) between stress and depression among university students in IIUM, with a high level of stress associated with high level of depression. It is consistent with a study by Sherina, Rampal, and Kaneson (2004) reported that there was a significant association between psychological stress and depression among medical students in Malaysia. Another study conducted by Killinger, Flanagan, Castine, and Howard (2017) examined the relationship between stress and depression among veterinary medical students and the results indicated a strong relationship between stress and depression. 5.3 SUGGESTIONS AND CONCLUSIONS The findings of this study are based on self-reported information provided by students and some potential for reporting bias may have occurred because of interpretation of the questions or desire to report their emotions in a certain way or simply because of inaccuracies of responses. The study took place at one university which will affect the generalizability to other institutions. Consequently, the results will only be applicable to similar institutions in similar settings. The study took place at one point in time which will limit the ability to generalize the findings to other time periods, this is referred to as a threat to temporal validity. The study did not take into account faculty characteristics or teaching styles which could have an effect on students perceived stress levels. According to the findings of this study, there is a relationship between stress and depression among university students in IIUM. Based on the findings discussed above, it is necessary to be aware of the psychological states of the students and take measured steps to help find solutions and effective strategies through intervention programs to reduce stress disorder and depression in society, especially, in the student population since an early age. 30 REFERENCES Abdulghani, H. M., AlKanhal, A. A., Mahmoud, E. S., Ponnamperuma, G. G., Alfaris, E. A. (2011). Stress and Its Effects on Medical Students A Cross-sectional Study at a College of Medicine in Saudi Arabia. Journal of Health, Population and Nutrition, 29(5), 516-522. Agolla, J. E., Ongori, H. (2009). An Assessment of Academic Stress among Undergraduate Students The Case of University of Botswana. Educational Research and Review, 4(2), 63-70. Al-Qaisy, L. M. (2011). The Relation of Depression and Anxiety in Academic Achievement among Group of University Students. International Journal of Psychology and Counselling, 3(5), 96-100. Arip, M. A. S. M., Kamaruzaman, D. N., Roslan, A., Ahmad, A., Abd Rahman, M. R. (2015). Development, Validity and Reliability of Student Stress Inventory (SSI). The Social Sciences, 10(7), 1631-1638. Baharudin, H. (2016). Depression among College Student Case Study in UITM Puncak Perdana. Research Hub, 2(2), 84-88. Banks, S. M., Kerns, R. D. (1996). Explaining High Rates of Depression in Chronic Pain A Diathesis-Stress Framework. Psychological Bulletin, 119(1), 95-110. Bayram, N., Bilgel, N. (2008). The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students. Social Psychiatry and Psychiatric Epidemiology, 43(8), 667-672. Bedewy, D., Gabriel, A. (2015). Examining Perceptions of Academic Stress and its Sources among University Students The Perception of Academic Stress Scale. Health Psychology Open, 1-9. Beiter, R., Nash, R., McCrady, M., Rhoades, D., Linscomb, M., Clarahan, M., Sammut, S. (2014). The Prevalence and Correlates of Depression, Anxiety, and Stress in a Sample of College Students. Journal of Affective Disorders, 90-96. Bostanci, M., Ozdel, O., Oguzhanoglu, N. K., Ozdel, L., Ergin, A., Ergin, N., Atesci, F., Karadag, F. (2005). Depressive Symptomatology among University Students in Denizli, Turkey Prevalence and Sociodemographic Correlates. Croat Medicine Journal, 46(1), 96-100. 31 Brougham, R. R., Zail, C. M., Mendoza, C. M., Miller, J. R. (2009). Stress, Sex Differences, and Coping Strategies Among College Students. Current Psychology, 28, 85-97. Choon, K. T., Choon, W. N., Zulkifli, R. A., Vellasamy, R., Suresh, K. (2015). Depression, Anxiety and Stress among Undergraduate Students A Cross Sectional Study. Open Journal of Epidemiology, 5, 260-268. Elias, H., Wong, S. P., Abdullah, M. C. (2011). Stress and Academic Achievement among Undergraduate Students in Universiti Putra Malaysia. Procedia – Social and Behavioral Sciences, 29, 646-655. Ghaedi, L., Kosnin, A, M. (2014). Prevalence of Depression among Undergraduate Students Gender and Age Differences. International Journal of Psychological Research, 7(2), 38-50. Hammen, C. (2005). Stress and Depression. Annual Reviews Clinical Psychology,1, 293-319. Hammen, C., Henry, R., Daley, S. E. (2000). Depression and Sensitization to Stressors Among Young Women as a Function of Childhood Adversity. Journal of Consulting and Clinical Psychology, 68(5), 782-787. Jones, R. B., Thapar, A., Stone, Z., Thapar, A., Jones, I., Smith, D., Simpson, S. (2017). Psychoeducational Interventions in Adolescent Depression A Systematic Review. Patient Education and Counseling, 1-13. Khalida, F. M., Abu Suman, N. A., Abd Rasid, N., Mohamad, N. A., Ghazalie, N N. N. (2016). Depression Academic Performance A Case Study. International Symposium Exhibition on Business and Accounting, 1-7. Khan, Z., Lanin, A. B., Ahmad, N. (2015). The Level of Stress in Male and Female School Students. Journal of Education and Practice, 6(13), 166-169. Khurshid, S., Parveen, Q., Yousuf, M. I., Chaudhry, A. G. (2015). Effects of Depression on Students Academic Performance. Pakistan Association of Anthropology, 7(2), 1619-1624. Killinger, S. L., Flanagan, S., Castine, E., Howard, K. A. S. (2017). Stress and Depression among Veterinary Medical Students. Journal of Veterinary Medical Education, 44(1), 1-8. Kumaraswamy, N. (2013). Academic Stress, Anxiety and Depression among College Students- A Brief Review. International Review of Social Sciences and Humanities, 5(1), 135-143. 32 Ming, S.C., Chee, S. L. (2015). Personality, Coping and Stress Among University Students. American Journal of Applied Psychology, 4(3), 33-38. Monroe, S. M., Simons, A. D. (1991). Diathesis-Stress Theories in the Context of Life Stress Research Implications for the Depressive Disorders. Psychological Bulletin, 110(3), 406-425. Morris, M. C., Ciesla, J. A., Garber, J. (2010). A Prospective Study of Stress Autonomy versus Stress Sensitization in Adolescents at Varied Risk for Depression. Journal Abnormal Psychology, 119(2), 341-354. Nandamuri, P. P., Gowthami, C. (n.d.). Sources of Academic Stress – A Study on Management Students. 31-42. Ng, C. C. (2014). A Review of Depression Research in Malaysia. 42-45. Ngasa, S. N., Sama, C. B., Dzekem, B. S., Nforchu, K. N., Tindong, M., Aroke, D., Dimala, C. A. (2017). Prevalence and factors associated with depression among medical students in Cameroon a cross-sectional study. BMC Psychiatry, 17(216), 1-7. Pariat, L., Rynjah, A., Joplin., Kharjana, M. G. (2014). Stress Levels of College Students Interrelationship between Stressors and Coping Strategies. IOSR Journal Of Humanities And Social Science, 19(8), 40-46. Shah, M., Hasan, S., Malik, S., Sreeramareddy, C. T. (2010). Perceived Stress, Sources and Severity of Stress among medical undergraduates in a Pakistani Medical School. BMC Medical Education, 10(2), 1-8. Sharma, B., Wavare, R. (2013). Academic Stress Due To Depression among Medical And Para-Medical Students In An Indian Medical College Health Initiatives Cross Sectional Study. Journal of Health Sciences, 3(5), 29-38. Sherina, M. S., Rampal, L., Kaneson, N. (2004). Psychological Stress Among Undergraduate Medical Students. Medical Journal Malaysia, 59(2), 207-211. Sindhu, P. (2016). Impact of Depression on Academic Achievement among Engineering Students. The International Journal of Indian Psychology, 4(1), 49-54. Wahed, W. Y. A., Hassan, S. K. (2016). Prevalence and associated factors of stress, anxiety and depression among medical Fayoum University students. Alexandria Journal of Medicine, 53, 77-84. 33 Yary, T., Aazami, S. (2011). The association between polyunsaturated fatty acids and depression among Iranian postgraduate students in Malaysia. Lipids in Health and Disease, 10(151), 1-5. Yasin, M. A. S. M., Dzulkifili, M. A. (2011). Differences in Depression, Anxiety and Stress between Low-and-High-Achieving Students. Journal of Sustainability Science and Management, 6(1), 169-178. Zaid, Z. A., Chan, S. C., Ho, J. J. (2007). Emotional disorders among medical students in a Malaysian private medical school. Singapore Medical Journal, 48(10), 895-899. 34 F9t-1mSmv9 cF gF IQQ_t x cM 8o6yLuSX/ 7R-o6qCYnQe wP 7F SMuk,re 9An5Tfj(dw IoMz- qE O/D0EuMu)0ml KEy31YU/U/GSEVEPEPEPXzstR stWa/t9VCIC4dJ6 S-iI6D6 Sc) JHPI U45vh12tt tlT6JmG(S7VZ,A gZO
hUnNOOJ YjjinStqqV.5Emql3xGQfVPqDz Y, 4IsNXp
xpop, Yu),[email protected](2O4kLEzqO2POuz_gx7svnB2,E3p9GQd H IjZ29LZ15xl.([email protected]@[email protected] O5YYS.7bdn671. tn/w/t6PssL.JiN AI)t2Lmx([email protected] m2DBAR4 wnaQ W0xBdT/.3-FbYLKK6HhfPQh)GBms_CZys [email protected])h7JicFS.NP eI [email protected] NC([email protected])t9M4WP5flk_X-CwTB Y, AoYezxTVOlp /gTpJ EG, AozAryerb/Ch,Eoo. 6Q