The influence of anxiety and depressive symptoms on social functioning: a person-centred study among South African university students
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Date
2021-05
Authors
Pillay, Kaylene
Journal Title
Journal ISSN
Volume Title
Publisher
University of the Free State
Abstract
The prevalence of comorbid anxiety and depression among university students is high and results in great impairment of (social) functioning even in subclinical groups. However, the heterogeneity of depression and anxiety profiles and how they affect South African students’ social functioning is unknown. Therefore, this cross-sectional survey study investigated the naturally occurring latent groupings formed from anxiety and depression symptoms, and their ability to distinguish levels of social functioning. Participants were a sample of 1988 university students from South Africa (69.1% female; with a mean age of 21.44 [SD = 3.094], ranging between 17 and 64 years). They completed an online survey comprising the Patient Health Questionnaire-9 (PHQ-9), the Generalised Anxiety Disorder-7 (GAD-7), and the Social Functioning Questionnaire (SFQ). Responses to anxiety and depression symptom indicator variables were subjected to latent class analysis in Mplus. The emergent classes were compared for levels of social functioning using analysis of variance (ANOVA) in SPSS. Four meaningful classes, showing different levels of symptom endorsement, emerged from the data. Class 1 (20.3%), labelled “Healthy”, had the lowest rates of comorbid depression and anxiety symptom endorsement. Class 2 (35.3%), labelled “Anxious exhaustion”, had significantly high scores for sleep disturbance, fatigue and other anxiety symptoms. Class 3 (18.3%), labelled “Anxious depression”, represented that most severely distressed members with high rates of symptom endorsement for almost all depression anxiety symptoms. Lastly, Class 4 (26.1%), labelled “Low distress” was found to have low levels of endorsement of sleep disturbance, excessive worry and irritability. Although depressive symptoms were found to be more prevalent in this university student sample, it was the classes (class 2 and 3) with the endorsement of higher levels of anxiety symptoms that were found to have poorer social functioning. Furthermore, specific symptoms such as worry and fear, in addition to depression, may be key contributors to poor social functioning among students. The inclusion of students with no diagnoses, as well as a non-clinical population, allowed for the assessment of symptom presentation and severity below the diagnostic cut-offs for depression and anxiety. The findings show a need for better targeted and tailored interventions for student depression and anxiety. Comorbid depression and anxiety is present in a non-clinical student and a sub-clinical population. Assessing the core symptoms of comorbid depression and anxiety in individuals refines the treatment of a comorbid diagnosis and helps predict the subsequent onset of the full-blown disorder in subclinical individuals. The findings offer student mental health services the scientific evidence to create unique, short-term evidence-based interventions for depression and anxiety. Depression and anxiety symptoms have an adverse effect on social functioning even in a sub-clinical student population. This has implications for psychological intervention for students and poses a challenge for diagnosis effects, as well as policies for mental health promotion at the institutional level. This study serves as empirical evidence for the need for education on mental health and provides a platform for a discussion on mental health problems and mental wellbeing among South African university students. It is possible that the severity and frequency of symptom endorsement was influenced by Covid-19 and the subsequent lockdown. It would therefore be helpful for future researchers to take this into consideration. This study was only conducted at one South African university which made the study limited in its generalisability to other universities. Future researchers should consider conducting the study in multiple South African universities. Other limitations included the use of an online survey platform to distribute the questionnaires as well as the study being a cross-sectional study.
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Keywords
Anxiety, Comorbidity, Depression, Latent class analysis, Social functioning, Students, Dissertation (M.Soc.Sc. (Psychology))--University of the Free State, 2021