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ABSTRACT. Background: University students are prone to stressors due to the transitional nature of university life. High levels of stress are believed to affect ...



E CAMDEN HAMAIDEH: STRESSORS ANDSCHIZOPH REACTIONS TO STRESSORS

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STRESSORS AND REACTIONS TO STRESSORS AMONG UNIVERSITY STUDENTS

SHAHER H. HAMAIDEH ABSTRACT Background: University students are prone to stressors due to the transitional nature of university life. High levels of stress are believed to affect students’ health as well as their academic performance. Aims: The aims of this study were to identify stressors and reactions to stressors among university students, and to examine the correlations between student stressors and study variables. Methods: A correlational descriptive design was used. Student-life Stress Inventory (SSI) was used to measure the stressors and reactions to stressors. Stratified random sampling was employed to recruit participants. The final sample consisted of 877 participants (students). Results: Results indicated that the highest group of stressors experienced by students were ‘self-imposed’ stressors followed by ‘pressures’. Cognitive responses were found to be the highest responses to stressors experienced by students. Negative correlations were found with student’s perception of health, and father’s and mother’s level of education. Conclusions: This study revealed that stressors among university students come from ‘self-imposed’ stressors and ‘pressures’. Stress management, assertiveness skills, time management and counselling sessions will be effective in reducing stress experienced by students. Key words: stress, stressors, reactions to stressors, university students, Jordan, nursing

INTRODUCTION Stress among university students has been a topic of interest for many researchers and teachers for many years. Researchers also have long recognized the stressful nature of university students’ roles and expectations. Students experience many stressors from different sources in their academic life; usually they respond to those stressors in different ways. Sources of stressors include: academic demands; being away from home; transition to a new developmental stage; pressure from peers; conflict with peers and with their expectations about university life; frustrations with achieve- ments; difficulty coping in a new social environment; and financial difficulties (Towbes & Cohen, 1996; Misra et al., 2000; Gadzella, 2004). International Journal of Social Psychiatry. © The Author(s), 2011. Reprints and permissions: http://www.sagepub.co.uk/journalsPermissions.nav Vol 57(1): 69–80 DOI: 10.1177/0020764010348442

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According to the Transactional Model of Stress (Lazarus, 1966), stressors are defined as ‘demands made by the internal or external environment that upset balance, thus influencing physical and psychological well-being and requiring actions to restore balance’ (p. 19). Stress refers to ‘any event in which environmental demands, internal demands, or both, exceed the adaptive resources of an individual or social system (Lazarus & Cohen, 1977). Reactions to stress are defined as ‘dealing with problems and situations or contending with them successfully’. Reactions to stressors are an innate or acquired way of responding to a changing environment or situation (Folkman & Lazarus, 1991).

Sources of stressors Most students enrolled at universities have high expectations, which place more demands and stress on them. Students must also adjust to being away from home for the first time, maintain a high level of academic achievement, and adjust to a new social environment (Gadzella, 2004). University students often deal with pressures relating to life stressors, finding jobs, finding partners, and stressors related to academic achievement. Those stressors do not cause tension or stress by themselves. Instead, stress results from the interaction between stressors and students’ perceptions and reactions to those stressors (Romano, 1992). The amount of stress experienced by an individual may be influenced by one’s ability to effectively react to stressful events and situations (Ellis, 1968; Callaghan et al., 2000; Misra et al., 2000; Shipton, 2002; Moffat et al., 2004). The environment in which university students live is quite different from non-student peers; the pressure to earn good grades and earn a degree is very high among university students (Shields, 2001). Other potential sources of stress include excessive homework, unclear assignments, conflicts with instructors, and uncomfortable classrooms (Hirsch & Ellis, 1996). Poor relationships with peers and family, poor eating and sleeping patterns, unhealthy habits, and loneliness may also influ- ence some students negatively by increasing their level of stress (Hudd et al., 2000; Borrego & Konduri, 2004). High levels of stress in students are believed to motivate substance abuse, smoking and negative health habits (Carpenter & Hasin, 1999; Broman, 2002). The relationships between levels of stress and substance abuse vary according to age, gender and substance tension-reduction properties. In summary, stressors among university students result from many sources such as frustrations, conflicts, pressures, changes and self-imposed situations (Gadzella et al., 1991).

Reactions to stressors When stress is perceived negatively or becomes excessive, it can affect both health and academic performance (Cambell & Svenson, 1992; Misra et al., 2000). University students often attempt to control and reduce their stress levels through many strategies, such as avoidance, religious and social support, and positive appraisals (Mattlin et al., 1990). Some other students practise leisure exercise and fitness activities, since sports and non-academic activities buffer stress and provide university students with a sense of purpose and competence (Ragheb & McKinney, 1993). Also, students may reduce or control their level of stress by managing their time effectively and employing different studying techniques (Gadzella et al., 1991). Although investigating sources of stressors and reactions to them among university students is very important, stress in relation to lifestyle, health-related habits and academic performance is important too. A more holistic assessment needs to be adopted to fully understand university students’ patterns of stressors in relation to personal



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and academic tasks that university students deal with. Students respond to stressors in different ways according to the kind of stressor, its severity, its importance, and their health and emotional state. Types of reactions to stress include physiological, emotional, behavioural and cognitive (Lazarus & Folkman, 1984).

Psychiatric morbidity for university students Excessive and prolonged stress can be harmful to students’ academic performance and their health in general. Students who perceive their stress levels as very high may often become depressed (Dahlin et al., 2005; Dahlin & Runeson, 2007). In addition to depression, stress can lead to other mental health problems such as excessive drinking or indiscriminate use of other substances (Walton, 2002). Moreover, excessive stress may lead to dropping out of university (Shields, 2001). University students who experience prolonged and severe stress are vulnerable to psychiatric disturbances such as depression, mental distress, burnout (Dahlin et al., 2005) and suicidal thoughts (Tyssen et al., 2001). Depressive symptoms have been reported as high as 25% among students (Lewinsohn et al., 1993). A study conducted among college students revealed that over half surveyed suffered from at least one mental health problem, with the most prevalent being eating disorders 18%–19% and depression 13%–15% (Zivin et al., 2009). Another study revealed that the prevalence of psychological morbidity among medical students of Nepal was 20.9% (Sreeramareddy et al., 2007).

Theoretical framework Although many models of stress and coping have been proposed, what has been described as the person-environment model (Transactional Model) seems particularly appropriate to students at university (Whitman et al., 1984). The Transactional Model of Stress (Lazarus, 1966) will be used as theoretical background for the current research study. The Transactional Model of Stress focuses on variations in how individuals respond to the environment. According to this model, what makes an event stressful is the extent to which it is perceived as being threatening or challenging (Lazarus, 1966). Events that are perceived as being challenging lead to positive coping responses (e.g. studying harder), whereas events that are perceived as threatening lead to negative coping re- sponses (e.g. avoidance or dropping out). Therefore, the Transactional Model of Stress encompasses a set of cognitive, affective, emotional and adaptive responses that arise out of the person-environment transactions. The person and the environment are inseparable; each affects and is affected by the other (Lazarus, 1966; Lazarus & Cohen, 1977). According to this model, any stressful situation consists of three consecutive processes: primary appraisals, secondary appraisals and adaptive coping (reaction). When faced with a stressor, an individual evaluates the situation (primary appraisal) as to whether it is stressful or not. After judgement has been made, secondary appraisal (an assessment of one’s coping resources and options) follows. Actual adaptive coping (reaction) efforts aim at regulation and making balance coping strategies (Lazarus & Folkman, 1984; Glanz et al., 2002). Different stressors affect students’ health and academic performance. Failure to cope effectively with stressors will have serious professional and personal consequences. Identifying types of stressors and reactions to them in this particular group of students will help teachers and administrators to deal with those stressors very early, thus eliminating their negative consequences. Very few studies

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in the Arabic countries, particularly in Jordan, have examined the sources of stressors and reactions to those stressors among university students. Thus, the main purpose of this study was to identify sources of stressors and reactions to those stressors among students studying at universities in Jordan. Specifically, this study aimed at answering the following research questions: 1. What stressors do university students at the Hashemite University, Jordan experience? 2. How do university students react (respond) to the experienced stressors? 3. What are the relationships between stressors experienced and some academic, health-related, and socio-demographic variables?

METHODS Research design A correlational descriptive cross-sectional design was used to answer the research questions (Burns & Groove, 1997; Polit & Beck, 2006).

Instrument Student-life Stress Inventory (SSI) was used to collect data. In addition, some academic, healthrelated and socio-demographic variables were assessed. The SSI is a 51-item Likert-type response format questionnaire with possible responses ranging from 1 to 5 (1 = never, 2 = seldom, 3 = occasionally, 4 = often, 5 = most of the time) (Gadzella et al., 1991). The SSI is a self-administered instrument that consists of two parts: stressors and reactions to stressors. The stressors part comprises 23 items measuring five categories of stressors (frustrations, conflicts, pressures, changes and self-imposed stressors). The reaction to stressors part comprises 28 items measuring four categories of reactions to stressors (physiological, emotional, behavioural and cognitive). Scores could be calculated for the total instrument, for each part (stressors, reactions to stressors), and for each category by adding the responses for the respective items. The higher the scores, the higher the level of stressors/reactions to stressors. The SSI has been reported to have an acceptable internal consistency reliability as evidenced by Cronbach’s α = 0.76 (Gadzella, 1994). Test-retest correlation for the whole instrument was 0.78 (Gadzella & Guthrie, 1993). Gadzella and Baloglu (2001) employed confirmatory factor analysis and internal consistency of the SSI. The SSI had a high internal consistency as measured by Cronbach’s α = 0.92, and an acceptable concurrent validity (Gadzella & Catharina, 2006). For the purpose of this study, a bilingual expert translated the SSI into Arabic. Another bilingual expert translated the Arabic version into English without accessing the original version to standardize the conceptual meanings for Arabic- and English-speaking respondents. A third bilingual faculty member compared the Arabic and the original versions, corrected any incongruence in the translation, and reviewed the denotation and connotation of each item to maintain the integrity of the instrument. Five panels of experts checked content validity of the translated instrument. Internal consistency was checked by computing Cronbach’s α for subscales. Cronbach’s α ranged between 0.74 and 0.88 for stressors subscales, and between 0.74 and 0.94 for reactions to stressors subscales. Guttman split-half α for stressors scale was 0.87 and for reactions to stressors scale was 0.83.



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Sampling and data collection The target population of this study was all university students who registered for the second semester of the academic year 2007–2008 at the Hashemite University, Jordan. Stratified random sampling according to academic levels was used to select participants. After obtaining approval from the Scientific Research Committee at the university to conduct the study, the registration office provided the researcher with a list of all sessions offered to all students during the second semester of the academic year 2007–2008 according to the course level (first freshmen, second sophomores, third juniors, fourth seniors and master level). Numbers were assigned to each teaching session and six sessions from each level were selected using simple random sampling. Consequently, the researcher contacted the teacher/instructor of each selected session to set a plan for data collection during the class sessions. In total, the researcher distributed 1,000 questionnaire for all selected classes. To assure anonymity, the questionnaires were distributed and one of the students in each selected class collected those completed. The participants were assured with confidentiality. The final sample consisted of 877 students (response rate = 87.7%) who agreed to participate in the study and who completed the questionnaire.

Data analysis Data were analyzed using Statistical Package for Social Sciences (SPSS version 12.0) (2006). Descriptive statistics were used to generate means, standard deviations and frequencies for a list of variables. In addition, correlations and Cronbach’s α were computed.

RESULTS Descriptive results The sample consisted of 877 participants. The age of the participants ranged between 18 and 56 years (mean = 21.32, SD = 4.18). Of the total sample, there were 363 (41.6%) male students. Only 92 (10.5%) of the students’ mothers were employed outside home. About 200 (22.8%) of the students were working in addition to studying. Sixty one (7.0%) of the students attended a workshop about stress reduction and stress management. Only 150 (17.1%) students were regular smokers. Of the total sample, 121 (13.8 %) students usually participated in non-academic activities at the university; of those, 118 (97.6 %) indicated that such participation decreased their stress levels (Table 1).

Stressors and reactions to stressors The most prevalent group of stressors experienced by the students were those related to ‘selfimposed’ stressors (93.0% above the midpoint, mean = 3.87, SD = 0.90). Examples of particular stressors were ‘I like to compete and win’ and ‘I like to be noticed and be loved by all’. The second most common group of stressors was those resulting from ‘pressures’ (55.3% above the midpoint, mean = 3.22, SD = 1.2). Examples of particular stressors were ‘My stress resulted from competition (on grades, work and relationship with friends)’ and ‘My stress due to an overload (attempting to do many things at one time)’. The third most common group was those resulting from ‘conflicts’ (52.7% above the midpoint, mean = 3.15, SD = 1.1). The groups of stressors experienced least were those relating to ‘frustrations’ (24.7% above the midpoint, mean = 2.62, SD = 1.1) and changes (36.5% above the midpoint, mean = 2.90, SD = 1.1) (Table 2).

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Table 1 Sample’s descriptive of academic, health-related and demographic variables (n = 877) Variable Father’s educational level 0–3 years (illiterate and elementary) 4–9 years (preparatory and secondary) 10–15 years (diploma and bachelor) 16 years and more (master and doctorate) Mother’s educational level 0–3 years (illiterate and elementary) 4–9 years (preparatory and secondary) 10–15 years (diploma and bachelor) 16 years and more (master and doctorate) Monthly family income by JDs

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