1. Depression and Anxiety in University Students I. Živčić-Bećirević, S. Smojver-Ažić, T. Martinac Dorčić, J. Juretić Department of Psychology Faculty of Humanities and Social Sciences University of Rijeka, Croatia Euro Global Summit and Medicare Expo on Psychiatry July 20-22, 2015 Barcelona, Spain

2. Outline Mental health of university students The main results of our longitudinal research project Implications for the preventive and intervention programs Evaluation of the interventions conducted in our university counseling center

3. College students - vulnerable population The age with the highest prevalence of psychological problems (16-24 years) Data from Australian universities show that students have more anxiety and depressive symptoms comparing to non-students of the same age (Stallman, 2008) 15% of university students in Croatia report some psychological or medical problems (Eurostudent, 2011)

4. Research on youth mental health indicates high prevalence of psychological problems among students across universities, mostly symptoms of stress, anxiety and depression The number of students with different psychological problems is increasing in the last two decades Depression rates have doubled and suicidality rates tripled in 10 years (Russis & Wells, 2008), with increase number of students using psychopharmacs from 11% to 24%. Suicide is the 2 nd reason for death among university students and the 3 rd in general population of the same age Psychological problems in college students

5. Problems for which students seek help in our University Counseling Center - experiences from the last 17 years N=1300

6. To determine the prevalence of psychological problems among students at the beginning of college To track the changes in their adjustment during 3 years of their studying To investigate the role of cognitive and behavioral factors that contribute to students’ psychological adjustment and their academic achievement The main goals of our longitudinal project

7. Representative sample of 492 (20 %) freshmen at University in Rijeka Age 18-23 years (M=19) Sample

8. Procedure 3 measurements during 3 years I. Semester II. III. IV. V. VI. Psychological adjustment: Depression (BDI) Anxiety (BAI) Academic achievement Cognitive factors (ATs, beliefs about personal control, abilities and effort) Behavioral factors (learning & time menagement skills) Fear of failure Fear of disappointing parents Lack of interest Positive thoughts

9. Results

10. Prevalence of depressive and anxiety symptoms when starting college 7% report suicidal thoughts DepressionAnxiety

11. Result s The changes in psychological problems among college students during 3-years follow-up

12. Change in average depressive and anxiety symptoms Depression (BDI) Anxiety (BAI) p<.001 3 rd < 1 st, 2 nd

13. Prevalence of depressive and anxiety symptoms after 3 years at college DepressionAnxiety 3.5% report suicidal thughts

14. Result s Changes on the individual level

15. 1 st yearchange2 nd year% non-depresseddepressed10 depressednon-depressed15 non-depressed 62 depressed 13 nondepressed < cut off depressed > cut off Groups of students according to the changes in depressive symptoms

16. Differences between students who have developed and who didn’t develop depressive symptoms Non-depressed (at 1 st year) Depressed at 2 nd year (14%) More negative ATs (fear of failure & fear of disappointing parents) Less positive ATs Believe they have less control over their achievement Do not believe that their abilities and effort can contribute to their success Non-depressed (at 2 nd year) The same number of stress events Equal learning skills

17. 1 st yearchange2 nd year% non-anxiousanxious16 anxiousnon-anxious8 29 anxious 47 non-anxious < cut off anxious > cut off Groups of students according to the changes in anxiety symptoms

18. Differences between students who have developed and who didn’t develop anxiety symptoms Non-anxious (at 1 st year) Anxious at 2 nd year (36%) More negative ATs (fear of failure, fear of disappoining parents, lack of interest) Believe less that their abilities can contribute to their success Non-anxious (at 2 nd year) The same number of stress events Equal learning skills

19. Result s Effects of anxiety and depression on academic achievement

20. Students who dropped out of school have higher levels of anxiety and depression at the 2 nd year comparing to successful students and those who fail, but who continue their study. p<.001 Anxiety and depression in regard to academic efficacy No correlation with GPA

21. Conclusions of our research More students experience anxiety than depressive symptoms – the average BAI result above the cut-off Anxiety is more pronounuced at the beginning of college (more than 50% of students are anxious at the 1 st semester) Even if students are not depressed in average, 23% of them have BDI results above cut-off Depressive and anxiety symptoms are not related to students academic achievement (GPA), but they increase the risk for dropping out of school Cognitive factors have more significant role then behavioral factors in the increase of anxiety and depressive symptoms

22. Negative depressive loop Academic failure Depressive symptoms Poor concentration, hopelessness, more NATs, negative beliefs Low motivation; giving up from studying Underachie- vement, low mood

23. Implications Development of preventive and intervention programs Importance of early detection of students with signs of depression, anxiety or academic problems

24. What we have already done

25. recommendation feedback with personal results on-line questionnaire Psychoeducation (self-help materials on the website) Contact counseling center Early detection of students with psychological problems

26. Individual and group CBT focused on: Cognitive interventions Realistic perception of control Coping with NATs Restructuring and reinforcing personal beliefs about abilities and effort Behavioral interventions Improvement of self-control Reinforcement of personal efforts in academic work Academic performance

27. Evaluation of the individual treatment Significant decrease (p<.001) N=130

28. Evaluation of the treatment on the individual level (RCSC method)

29. Thank you! This study is supported by University of Rijeka (project No. 13.04.1.3.15)