Depression, Anxiety, and Stress During the COVID-19 Pandemic: Comparison Among Higher Education Students in Four Countries in the Asia-Pacific Region

Main Article Content

Na Jiang
Siaw Yan-Li
Kanit Pamanee
Joko Sriyanto

Abstract

The global COVID-19 pandemic is affecting the health of individuals and leading to psychological problems. Students in higher education who are graduating, facing online learning challenges, and future job opportunities are among the most at-risk group for psychological issues. Due to the new normal of the COVID-19 pandemic, limited studies have been conducted concerning the mental health of students, especially in the Asia-Pacific region. Therefore, this study aimed to assess student’s depression, anxiety, and stress status in four countries in the Asia Pacific region, namely, Malaysia, Indonesia, Thailand, and China. This study employed a quantitative research design with a pool of 1,195 student participants. The DASS-21 questionnaire was used for data collection through an online platform to measure the severity of depression, anxiety, and stress. Descriptive statistics were conducted to achieve the research objectives, and all reliability values were reported greater than 0.70. Findings revealed that up to 38% of the students reported mild or moderate depression, anxiety, and stress, while 20.5% reported severe or extremely severe anxiety. Overall, anxiety was reported to be the most significant problem among the students, followed by depression and stress. Students are at risk of mental health challenges during the coronavirus pandemic, likely due to unexpected life changes. This study contributes an overview report of students’ mental health problems and discusses the support and services in preventing students’ psychological problems. The comprehensive discussion has provided scientific information and suggestion to policymakers in maintaining the student academic and welfare.

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How to Cite
Jiang, N., Yan-Li, S., Pamanee, K., & Sriyanto, J. (2021). Depression, Anxiety, and Stress During the COVID-19 Pandemic: Comparison Among Higher Education Students in Four Countries in the Asia-Pacific Region. Journal of Population and Social Studies [JPSS], 29(-), 370 - 383. Retrieved from https://so03.tci-thaijo.org/index.php/jpss/article/view/244216
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Articles
Author Biography

Siaw Yan-Li, Department of Educational Psychology and Counseling, Faculty of Education, University of Malaya, Kuala Lumpur, Malaysia

Corresponding author

References

• Agnew, M., Poole, H., & Khan, A. (2019). Fall break fallout: Exploring student perceptions of the impact of an autumn break on stress. Special Issue: Psychological Wellbeing and Distress in Higher Education, 10(3), 45-54. https://doi.org/10.5204/ssj.v10i3.1412
• Ahmed, M. Z., Ahmed, O., Aibao, Z., Hanbin, S., Siyu, L., & Ahmad. A. (2020). Epidemic of COVID-19 in China and associated psychological problems. Asian Journal of Psychiatry, 51, 102092. https://doi.org/10.1016/j.ajp.2020.102092
• Al Omari, O., Al Sabei, S., Al Rawajfah, O., Abu Sharour, L., Aljohani, K., Alomari, K., Shkman, L., Al Dameery, K., Saifan, A., Al Zubidi, B., Anwar, S., & Alhalaiqa, F. (2020). Prevalence and predictors of depression, anxiety, and stress among youth at the time of COVID-19: An online cross-sectional multicountry study. Depression Research and Treatment, 2020, 1–9. https://doi.org/10.1155/2020/8887727
• Auerbach, R. P., Mortier, P., Bruffaerts, R., Alonso, J., Benjet, C., Cuijpers, P., Demyttenaere, K., Ebert, D. D., Green, J. G., Hasking, P., Murray, E., Nock, M. K., Pinder-Amaker, S., Sampson, N. A., Stein, D. J., Vilagut, G., Zaslavsky, A. M., & Kessler, R. C. (2018). WHO world mental health surveys international college student project: Prevalence and distribution of mental disorders. Journal of Abnormal Psychology, 127(7), 623–638. https://doi.org/10.1037/abn0000362
• Banerjee, D. (2020). The COVID-19 outbreak: Crucial role the psychiatrists can play. Asian Journal of Psychiatry, 50, 102014. https://doi.org/10.1016/j.ajp.2020.102014
• Bangkok Business Media. (2020, April 27). เช็คมาตรการมหาวิทยาลัย ช่วย ‘นิสิต-นักศึกษา’ อย่างไรบ้าง. กรุงเทพธุรกิจ มีเดีย จำกัด [Check the university measures to help 'Student-students']. https://www.bangkokbiznews.com/news/detail/878045
• Boonvisudhi, T., & Kuladee, S. (2017) Association between Internet addiction and depression in Thai medical students at Faculty of Medicine, Ramathibodi Hospital. PloS ONE, 12(3), e0174209. https://doi.org/10.1371/journal.pone.0174209
• Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. The Lancet 395(10227), 912–920. https://doi.org/10.1016/S0140-6736(20)30460-8
• Brown, B. B., & Larson, J. (2009). Peer relationships in adolescence. In R. M. Lerner & L. Steinberg (Eds.), Handbook of Adolescent Psychology: Vol. 2, Sec. 1 (3rd ed., pp. 74–103). John Wiley & Sons, Inc. https://doi.org/10.1002/9780470479193.adlpsy002004
• Cohen, J. (2020, May 13). Wuhan seafood market may not be source of novel virus spreading globally. American Association for the Advancement of Science (AAAS). https://www.sciencemag.org/news/2020/01/wuhan-seafood-market-may-not-be-source-novel-virus-spreading-globally
• Coker, A. O., Coker, O. O., & Sanni, D. (2018) Psychometric properties of the 21-item Depression Anxiety Stress Scale (DASS-21). African Researchers Review, 12(2), 135-142. http://dx.doi.org/10.4314/afrrev.v12i2.13
• Coronavirus Update (Live). (2020, March 13). COVID-19 coronavirus pandemic. https://www.worldometers.info/coronavirus/
• Costello, E. J., Copeland, W., & Angold, A. (2011). Trends in psychopathology across the adolescent years: What changes when children become adolescents, and when adolescents become adults? The Journal of Child Psychology and Psychiatry, 52(10), 1015-1025. http://dx.doi.org/10.1111/j.1469-7610.2011.02446.x
• Dar, K. A., Iqbal, N., & Mushtaq, A. (2017). Intolerance of uncertainty, depression, and anxiety: Examining the indirect and moderating effects of worry. Asian Journal of Psychiatry, 29, 129-133. https://doi.org/10.1016/j.ajp.2017.04.017
• de Alwis, D., Saif, S. K., & Niazi, S. (2020, March 20). Universities shut down across South and Southeast Asia. University World News. https://www.universityworldnews.com/post.php?story=2020032008521144
• Dong, L., & Bouey, J. (2020). Public mental health crisis during COVID-19 pandemic, China. Emerging Infectious Diseases, 26(7), 1616-1618. https://dx.doi.org/10.3201/eid2607.200407
• Fawaz, M., & Samaha, A. (2021). E-learning: Depression, anxiety, and stress symptomatology among Lebanese university students during COVID-19 quarantine. Nursing Forum, 56(1), 52-57. https://doi.org/10.1111/nuf.12521
• Goa, W., Ping, S., & Liu, X. (2020). Gender differences in depression, anxiety, and stress among college students: A longitudinal study from China. Journal of Affective Disorder, 263, 292-300. https://doi.org/10.1016/j.jad.2019.11.121
• Hair, J. F. Jr., Black, W. C., Babin, B. J., & Anderson, R. E. (2009). Multivariate Data Analysis (7th ed.). Pearson.
• Henry, J. D., & Crawford, J. R. (2005). The short-form version of the Depression Anxiety Stress Scales (DASS-21): Construct validity and normative data in a large non-clinical sample. The British Journal of Clinical Psychology, 44(2), 227–239. https://doi.org/10.1348/014466505x29657
• Islam, M. A., Barna, S. D., Raihan, H., Khan, M. N. A., & Hossain, M. T. (2020). Depression and anxiety among university students during the COVID-19 pandemic in Bangladesh: A web-based cross-sectional survey. PloS ONE, 15(8), e0238162. https://doi.org/10.1371/journal.pone.0238162
• The Jakarta Post. (2020, April 3). COVID-19: Surakarta university provides online counseling for students. The Jakarta Post. https://www.thejakartapost.com/life/2020/04/03/covid-19-surakarta-university-provides-online-counseling-for-students.html
• Jayasooria, D. (Ed.). (2016). Inclusive development for urban poor & bottom 40% communities in Malaysia. Universiti Kebangsaan Malaysia. https://www.ohchr.org/Documents/Issues/Poverty/VisitsContributions/Malaysia/Malaysian_CSO_SDG_Alliance_Annex2.pdf
• Kaushik, A., Kostaki, E., & Kyriakopoulos, M. (2016). The stigma of mental illness in children and adolescents: A systematic review. Psychiatry Research, 243, 469-494. https://doi.org/10.1016/j.psychres.2016.04.042
• Kunnikar. (2020, May 14). How Thammasat university responded to the COVID-19 crisis. QS WOWNEWS. https://qswownews.com/how-thammasat-university-responded-to-the-covid-19-crisis/
• Leung, M., & Sharma, Y. (2020, February 21). Online classes try to fill education gap during epidemic. University World News. https://www.universityworldnews.com/post.php?story=2020022108360325
• Liu, N., Zhang, F., Wei, C., Jia, Y., Shang, Z., Sun, L., Wu, L., Sun, Z., Zhou, Y., Wang, Y., & Liu, W. (2020). Prevalence and predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: Gender differences matter. Psychiatry Research, 287, 112921. https://doi.org/10.1016/j.psychres.2020.112921
• Liu, X., Huang, Y., & Liu, Y. (2018). Prevalence, distribution, and associated factors of suicide attempts in young adolescents: School-based data from 40 low-income and middle-income countries. PLoS ONE, 13(12), e0207823. https://doi.org/10.1371/journal.pone.0207823
• Lovibond, P. (2018). Depression Anxiety Stress Scales (DASS). http://www2.psy.unsw.edu.au/dass//
• Lovibond, P. F., & Lovibond, P. F. (1996). Manual for the Depression Anxiety Stress Scales. Psychology Foundation of Australia.
• Lyon, K., & Matson, T. (2020, April 15). Caring for students’ wellbeing in a Coronavirus world. Gallup. https://www.gallup.com/education/308291/caring-students-wellbeing-coronavirus-world.aspx
• Malaysian Qualifications Agency (MQA). (2020, March). Guidelines on the delivery of higher education programmes during and post COVID-19 Movement Control Order (MCO). https://cirel.ump.edu.my/index.php/en/downloads/10-mqa-guidelines-on-the-delivery-of-higher-education-programmes-during-and-post-covid-19-movement-control-order-mco/file
• Marthoenis, Meutia, I., Fathiariani, L., & Sofyan, H. (2018) Prevalence of depression and anxiety among college students living in a disaster-prone region. Alexandria Journal of Medicine, 54(4), 337-340. https://doi.org/10.1016/j.ajme.2018.07.002
• The Nation Thailand. (2020, April 14). 52 universities reducing tuition fees. The Nation Thailand. https://www.nationthailand.com/news/30385968?utm_source=category&utm_medium=internal_referral
• Pan, X., Chen, D., Xia, Y., Wu, X., Li, T., Ou, X., Zhou, L., & Liu, J. (2020). Asymptomatic cases in a family cluster with SARS-CoV-2 infection. The Lancet Infectious Diseases, 20(4), 410-411. https://doi.org/10.1016/S1473-3099(20)30114-6
• Peltzer, K., & Pengpid, S. (2015). Depressive symptoms and social demographic, stress and health risk behaviour among university students in 26 low-, middle- and high-income countries. International Journal of Psychiatry in Clinical Practice, 19(4), 259–265. https://doi.org/10.3109/13651501.2015.1082598
• Regehr, C., Glancy, D., & Pitts, A. (2013). Interventions to reduce stress in university students: A review and meta-analysis. Journal of Affective Disorders, 148(1), 1–11. https://doi.org/10.1016/j.jad.2012.11.026
• Rhein, D., & Sukawatana, P. (2015). Thai university student schemas and anxiety symptomatology. International Education Studies, 8(7), 108–126. https://doi.org/10.5539/ies.v8n7p108
• Shigemura, J., Ursano, R. J., Morganstein, J. C., Kurosawa, M., & Benedek, D. M. (2020). Public responses to the novel 2019 coronavirus (2019‐nCoV) in Japan: Mental health consequences and target populations. Psychiatry and Clinical Neurosciences, 74(4), 281–282. https://doi.org/10.1111/pcn.12988
• Suleiman, A. K., Ismadi, N. F. I., Choudhry, F. R., Munawar, K., & Hameed, M. A. (2017). Determinant factors of depression: A survey among university students. Malaysian Journal of Public Health Medicine, 17(3), 97-103. http://mjphm.org/index.php/mjphm/article/view/222/53
• Tonsing, K. N. (2014). Psychometric properties and validation of Nepali version of the Depression Anxiety Stress Scales (DASS-21). Asian Journal of Psychiatry, 8, 63–66. https://doi.org/10.1016/j.ajp.2013.11.001
• Varcarolis, E. M. (2014). Essentials of psychiatric mental health nursing: A communication approach to evidence-based care (Vol. 2). Saunders.
• Wang, Z. H., Yang, H. L., Yang, Y. Q., Liu, D., Li, Z. H., Zhang, X. R., Zhang, Y. J., Shen, D., Chen, P. L., Song, W. Q., Wang, X. M., Wu, X. B., Yang, X. F., & Mao, C. (2020). Prevalence of anxiety and depression symptom, and the demands for psychological knowledge and interventions in college students during COVID-19 epidemic: A large cross-sectional study. Journal of Affective Disorders, 275, 188–193. https://doi.org/10.1016/j.jad.2020.06.034
• Wei, J., & Sang, Z. (2017). Research progress on family factors of depression for college students. China Journal of Health Psychology, 11, 1752–1756. http://caod.oriprobe.com/articles/52717560/Research_Progress_on_Family_Factors_of_Depression_.htm
• Westers, N. J. (2019). Not a fad: Nonsuicidal self-injury and suicide attempts. Clinical Child Psychology and Psychiatry, 24(4), 653–657. https://doi.org/10.1177/1359104519873496
• World Health Organization. (2020, January 5). Pneumonia of unknown cause – China. https://www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-china/en/
• World Health Organization. (2021, January 10). Coronavirus. https://www.who.int/health-topics/coronavirus#tab=tab_1
• Xiang, Y. T., Yang, Y., Li, W., Zhang, L., Zhang, Q., Cheung, T., & Ng, C. H. (2020). Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. The Lancet Psychiatry, 7(3), 228–229. https://doi.org/10.1016/s2215-0366(20)30046-8
• Xiao, C. (2020). A novel approach of consultation on 2019 Novel Coronavirus (COVID-19)-related psychological and mental problems: Structured Letter Therapy. Psychiatry Investigation, 17(2), 175-176. https://doi.org/10.30773/pi.2020.0047
• Xinhua. (2020, February 8). Universities remain shut but offer online courses. University World News. https://www.universityworldnews.com/post.php?story=20200208084557632
• Yamin, K. (2020, May 14). Mixed response but online classes to stay post COVID-19. University World News. https://www.universityworldnews.com/post.php?story=20200514121749886
• Zandifar, A., & Badrfam, R. (2020). Iranian mental health during the COVID-19 epidemic. Asian Journal of Psychiatry, 51, 101990. https://doi.org/10.1016/j.ajp.2020.101990
• Zhai, Y., & Du, X. (2020). Addressing collegiate mental health amid COVID-19 pandemic. Psychiatry Research, 288, 113003. https://doi.org/10.1016/j.psychres.2020.113003
• Zhang, J., Wu, W., Zhao, X., & Zhang, W. (2020). Recommended psychological crisis intervention response to the 2019 novel coronavirus pneumonia outbreak in China: A model of West China Hospital. Precision Clinical Medicine, 3(1), 3–8. https://doi.org/10.1093/pcmedi/pbaa006