stress in college students essay

The Student’s Guide to Managing Stress in College

Editor & Writer

If you or someone you know is considering suicide, please contact the 988 Suicide & Crisis Lifeline at 988 or 1-800-273-TALK (8255), available 24 hours a day, seven days a week. All calls are confidential, and anyone can use this service. (This service was formerly known as The National Suicide Prevention Lifeline.

• Common among students, stress can cause adverse mental and physical side effects.
• Stress has many identifiable symptoms that can affect academic performance.
• Many colleges provide students with online and in-person mental health resources.
• If a school doesn't have the resources you need, it can direct you to external services.

Stress is just one of the many hurdles college students face. Short-term stress can help learners raise a grade , polish an essay, or pursue a coveted career opportunity. But long-term stress, if left unaddressed, can have detrimental side effects.

According to the American Institute of Stress , 4 in 5 college students experience frequent stress. Unchecked stress can lead to physical side effects like trouble concentrating, irritability, a lack of energy, appetite changes, a weakened immune system, and trouble sleeping.

In addition to the negative side effects stress brings, more college students than ever report feeling it for extended periods. Although the majority of this stress often stems from coursework, other factors, such as family, friends, and work, can increase stress and contribute to undesirable academic and personal outcomes.

To address this issue, many colleges provide ample resources and opportunities for students to deal with stress positively. Keep reading to learn more about the different types of stress and solutions for managing it.

What Is Stress and How Does It Affect College Students?

Stress is a physical reaction to a person's emotions. Both positive events (e.g., an upcoming wedding) and negative events (e.g., the loss of a loved one) can cause stress.

When you feel an emotion that triggers stress, your adrenal gland releases epinephrine — the hormone responsible for the flight-or-fight response — and then cortisol. In dangerous situations, this response can save your life. Too much cortisol, however, can have a long-term, negative impact on your metabolic rate, memory formation, and blood sugar regulation.

Stress can take one of three forms:

• Acute Stress: The most common form of stress, acute stress is the result of day-to-day stressors, such as waking up late , running to class, or receiving a bad grade. Fortunately, most acute stress fades quickly and has little mental or physical impact.
• Episodic Acute Stress: As its name suggests, episodic acute stress develops when a student experiences acute stress multiple times over an extended period. Common symptoms include migraines and tension headaches.
• Chronic Acute Stress: Chronic acute stress happens when someone can't avoid a long-term stressful situation. For example, students struggling academically in a major course may develop chronic acute stress, which can lead to weight gain, sleep deprivation, and anxiety.

What Are the Symptoms of Stress in College Students?

When people are exposed to stressors or stimuli that provoke stress, they experience an array of physical, emotional, behavioral, and cognitive reactions. As such, two students might experience stress in very different ways.

Below are some of the various ways stress can manifest in people.

• Physical Symptoms: Sweating, increased heart rate or blood pressure, vertigo, shortness of breath, muscle tension, headaches, stomachaches, fatigue
• Emotional Symptoms: Hostility, irritability, and other mood changes; increased worrying; feelings of helplessness; loneliness
• Behavioral Symptoms: Binge or reduced eating, drug or alcohol misuse, decreased sex drive, erratic sleep habits
• Cognitive Symptoms: Memory loss, loss of concentration, negative outlook, dissociation (i.e., disconnection from your thoughts, feelings, and identity)

What Are the Causes of Stress in College Students?

College students respond to stressors in different ways, but some situations are almost always stressful. Here are some of the most common stressors for students.

Many students work while in school to afford high tuition and housing costs . Unfortunately, part-time jobs typically pay just minimum wage. If you're struggling economically, speak to your financial aid office to see whether you qualify for grants, loans, or work-study .

Homesickness and New Levels of Independence

On top of classes, exams, and meeting people, many students have to deal with growing up. Out-of-state students may be living away from their homes for the first time in their lives, which can easily become a source of constant stress .

Living Among Strangers

Students new to campus life often feel isolated, especially if they're in an unfamiliar city or state. Some students are naturally shy and may find it difficult to make friends .

Cohabitating With Roommates

Many students may not be accustomed to sharing a room with someone else, especially if their roommate is someone they hardly know . This situation can compound the normal stress of college life.

Coursework and Exams

Students often feel overwhelmed by the increased workload associated with college-level coursework. This realization can blindside students and contribute to stress and anxiety. In many classes, exams make up a large percentage of students' grades, causing midterms and finals to be more stressful than normal.

Family Turmoil or Loss Back Home

A 2014 NPR study found that the death of a loved one is the second-highest cause of stress amongst U.S. adults. A death in the family can be extremely traumatic for college students, especially if they live away from home and can't afford to take a break from classes .

Work Schedules

According to a 2013 survey by Citibank and Seventeen Magazine , 4 in 5 students work while attending college. The average student works 19 hours a week. Many learners try to find a job that can accommodate the scheduling concerns associated with full-time education.

Social Obligations

In addition to academic pressures, college introduces plenty of social pressures, such as the idea that you must make tons of friends and party every weekend . Peer pressure and societal expectations can exacerbate stress, especially for first-year students.

Romantic Relationships

Romantic relationships take work. When you and your partner face the stresses of college life, the pressure can feel even greater. Additionally, many students may be in the process of questioning their sexuality and/or gender identity, which can impact dating and relationships.

Can College Stress Lead to Other Health Conditions?

Research shows that stress can lead to the development of many mental health conditions, including depression, anxiety, and substance misuse. It can also introduce physical conditions like chronic pain.

Depression is a complex mental health condition often caused by a combination of biological, psychological, and environmental factors. Floods of stress hormones can make people, including busy college students, more susceptible to depression .

Severe anxiety can signal an anxiety disorder. This condition, which is especially common among college students , is characterized by physical symptoms, such as muscle tension and shaking, as well as by racing thoughts, feelings of impending doom, fear, excess worry, and irritability.

Sleep Disorders

Sleep disturbances and anxiety often come hand in hand. According to the Anxiety and Depression Association of America , sleep problems can cause or exacerbate anxiety, and vice versa.

Substance Misuse

Some students turn to alcohol or drugs to help manage their stress; however, these dangerous coping mechanisms can lead to substance misuse. A 2018 study by the National Institute on Drug Abuse found that 28% of college students had engaged in binge drinking in the two weeks before the survey was conducted.

Chronic Muscle Pain

For some students, stress can lead to ongoing physical conditions such as chronic neck aches, backaches, stomach aches, and headaches. The National Institutes of Health recommends practicing yoga and meditation to relax your body and release muscular tension.

How to Manage Stress in College: 7 Key Tips

Figuring out what situations might cause stress is only half the battle for college students. Fortunately, there are several tricks you can use to help you avoid getting stressed out, reduce how much stress you feel, and improve your ability to cope with and ultimately eliminate stress.

1. Get Enough Sleep

Getting both quality sleep and enough sleep offers a variety of health benefits , including reducing stress and improving your mood. What's more, students who sleep well are less likely to get sick, have better memory recall, and enjoy a clearer mind.

2. Eat Well

Make an effort to eat nutritious meals and avoid eating on the run so you can avoid indigestion. You may also look for foods that are known to combat stress and boost your mood.

3. Exercise Regularly

In addition to keeping your body healthy, regular exercise releases endorphins and improves your overall cognitive abilities. Exercise can even help you fall asleep, thereby reducing stress. Keep in mind that exercise doesn't need to be strenuous — yoga, short walks, and stretching can all lead to immense mental health benefits and help relieve tension.

4. Don't Rely on Stimulants

Drinking coffee and energy drinks to fuel your late-night study sessions will inevitably lead to a crash later on. These stimulants boost cortisol levels in the body, increasing the physical effects of stress.

5. Set Realistic Expectations

Consistently having too much on your plate can lead to a lot of stress. Try to manage your workload by setting realistic expectations and picking a class schedule that gives you plenty of time to study and relax.

Communication with professors is key — if you're swamped with work, you might be able to get an extension on an assignment by simply asking and explaining your situation.

6. Avoid Procrastinating

Procrastination might feel good in the moment, but it often leads to stress. By managing your time wisely, you can avoid spending all night catching up on coursework. Additionally, habitual procrastination may be a sign of ADHD or anxiety.

7. Identify a Stress Outlet

Stress can never be completely avoided; however, finding a healthy way to reduce stress can go a long way toward keeping it from overwhelming you. Common stress outlets include exercise, spending time with friends and family, and getting massages.

You can also try relaxation techniques such as deep abdominal breathing, concentrating on a soothing word (like "peace" or "calm"), doing yoga or tai chi, and visualizing tranquil scenes.

Where Can Students Go for Help With Managing Stress?

Stress can rise to dangerous levels, threatening students' physical, emotional, and mental health. But nobody has to face stress alone. Here are some organizations and resources you can contact to receive treatment and support for managing stress in college.

On-Campus Mental Health Services

Most colleges offer on-campus (and sometimes virtual) mental health services to students. You can usually find out more about a school's services by going online to its official website.

If you need immediate assistance, contact your school's student services . This department can direct you to appropriate resources, such as mental health clinics, online screening, and individual or group counseling. Taking advantage of these services can improve your mental health, allowing you to thrive academically and socially.

Off-Campus Centers and Hotlines

Schools that can't provide appropriate stress management resources will direct students to use an outside service, such as a local counseling or therapy center.

Other external resources include 24/7 hotlines. The 988 Suicide & Crisis Lifeline at 988 or 1-800-273-8255 gives students space to talk with trained professionals about suicide ideation and conditions such as severe stress, depression, and anxiety.

Similarly, The Trevor Project offers many support services, including a 24/7 crisis counseling center and hotline, for LGBTQ+ students experiencing stress and other mental health challenges. For help, text START to 678678 .

Once these professionals identify the underlying issue, they connect students with a long-term solution, such as a psychiatrist or substance misuse prevention group.

Frequently Asked Questions About Managing Stress in College

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Why is stress management important for college students?

If left unaddressed, stress can lead to depression and anxiety in students. This can, in turn, negatively impact school and work performance and personal relationships with family, friends, co-workers, and peers.

Adopting a stress-management regimen is one of the best ways to avoid and ameliorate problems related to stress. Students may want to practice yoga, meditation, and/or mindfulness on a regular basis.

Why are stress levels in college students so high?

Many factors contribute to rising stress levels in college students. For one, college continues to grow more and more expensive, which can pose financial obstacles to students and lead to stress and anxiety. Other common causes of college stress include challenges posed by the COVID-19 pandemic , rigor of coursework, struggles making friends, homesickness, and housing and food insecurity .

How can college students effectively manage stress?

Students can manage stress in many healthy ways, such as by pursuing a new hobby, building a support system, and working on time-management skills . Other stress-management techniques include journaling and seeking counseling or medical help. Students should refrain from using drugs and alcohol to manage stress.

DISCLAIMER: The information provided on this website is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment; instead, all information, content, and materials available on this site are for general informational purposes only. Readers of this website should consult with their physician to obtain advice with respect to any medical condition or treatment.

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Stress in College Students: What to Know

Strong social connections and positive habits can help ease high levels of stress among college-age adults.

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From socializing to working out, here's how college students can better manage stress.

From paying for school and taking exams to filling out internship applications, college students can face overwhelming pressure and demands. Some stress can be healthy and even motivating under the proper circumstances, but often stress is overwhelming and can lead to other issues.

"Stress is there for a reason. It's there to help mobilize you to meet the demands of your day, but you're also supposed to have times where you do shut down and relax and repair and restore," says Emma K. Adam, professor of human development and social policy at Northwestern University in Illinois.

Chronic and unhealthy levels of stress is at its worst among college-age students and young adults, some research shows. According to the American Psychological Association's 2022 "Stress in America" report , 46% of adults ages 18 to 35 reported that "most days they are so stressed they can't function."

In a Gallup poll that surveyed more than 2,400 college students in March 2023, 66% of reported experiencing stress and 51% reported feelings of worry "during a lot of the day." And emotional stress was among the top reasons students considered dropping out of college in the fall 2022 semester, according to findings in the State of Higher Education 2023 report, based on a study conducted in 2022 by Gallup and the Lumina Foundation.

As students are navigating a new environment and often living independently for the first time, they encounter numerous opportunities, responsibilities and life changes on top of academic responsibilities. It can be sensory overload for some, experts say.

“Going to college has always been a significant time of transition developmentally with adulthood, but you add to it everything that comes along with that transition and then you put onto it a youth mental health crisis, it’s just compounded in a very different way," says Jessica Gomez, a clinical psychologist and executive director of Momentous Institute, a researched-based organization that provides mental health services and educational programming to children and families.

Experts say college students have experienced heightened stress since the COVID-19 pandemic, a trend likely to continue for the foreseeable future.

“What some of our research at Gallup has shown is that we had a rising tide of negative emotions, not just in the U.S. but globally, in the eight to 10 years leading up to the pandemic, and of course it got worse during the pandemic," says Stephanie Marken, senior partner of the education research division at Gallup who conducted the 2023 study. “For currently enrolled college students, there’s so many contributing factors.”

Adam notes that multiple factors combine to contribute to heightened stress among younger adults, including the nation’s racial and political controversies, as well as anxiety regarding their futures fueled by climate change, global unrest and economic uncertainty. Female students reported higher levels of stress than males in the Gallup poll, which Marken says could be attributed to several factors like increased internal academic pressure, caregiving responsibilities and the recent uncertainty regarding abortion rights following the reversal of Roe v. Wade.

All of this, plus the residual effects of pandemic learning, has contributed to rising stress for college students, Marken says.

"We need to give them a lot of credit," she says. "They had the most challenge in remote learning of all the learners that have come before them. Many of them had to graduate high school and study remotely, or were a first-year college student during the pandemic, and that was incredibly difficult."

The challenges that came with that learning environment will likely affect students throughout college, she says, as well as typical stressors like discrimination, harassment and academic challenges.

"Those will always be present on college campuses," she says. "The question is, how do we create a student who overcomes those challenges effectively?"

Experts suggest a range of specific actions and positive shifts that can help ease stress in college students:

• Notice the symptoms of heightened stress.
• Build and maintain social connections.
• Sleep, eat well and exercise.

Notice the Symptoms of Heightened Stress

College students can start by learning to identify when normal stress increases to become unhealthy. Stress will appear differently in each student, says Lindsey Giller, a clinical psychologist with the Child Mind Institute, a nonprofit focused on helping children and young adults with mental health and learning disorders.

"Students prone to anxiety may avoid assignments as well as skip classes due to experiencing shame for being behind or missing things," she says. "For some, they may also start sleeping in more, eating at more random times, foregoing self-care, or look to distraction or escape mechanisms, like substances, to fill time and further avoid the reality of workload assignments."

Changes in diet and sleeping are also telling, as well as increased social isolation and pulling away from activities that once brought you pleasure is also a red flag, Gomez says.

She warns students to watch for signs of irritability, a classic indicator of increased stress that can often compound issues, especially within interpersonal relationships.

"Your body speaks to you, so be in tune with your body," she says.

Build and Maintain Social Connections

Socializing can help humans release stress. Experts say having fun and finding joy in life keep stress levels manageable, and socializing is particularly important developmentally for young adults. In the 2023 Gallup poll, 76% of students reported feeling enjoyment the previous day, which Marken says was an encouraging sign.

But 39% reported experiencing feelings of loneliness and 36% reported feeling sad. “We are in the midst of an epidemic of loneliness in our country, where we are noticing people don’t have the skills to build friendships,” Gomez says.

Discover six

Talking about feelings of stress can help college students cope, which is why the amount of students feeling lonely is concerning, Marken says. If students don't feel like they belong or have a social network to call on when feeling stressed, negative emotions are compounded.

“I think we’re more connected, and yet we’re more isolated than ever," she says. "It feels counterintuitive. How can you be more connected to your network and campus than ever, yet feel this lonely? Just because they have a device to connect with each other in a transactional way doesn’t mean it’s a meaningful relationship. I think that’s what we’re missing on a lot of college campuses is students creating meaningful connections about a shared experience."

Setting boundaries on social media use is crucial, Gomez says, as is getting plugged in with people and organizations that will be enriching. For example, Gomez says she joined a Latina sorority to be in community with others who shared some of her life experiences and interests.

Sleep, Eat Well and Exercise

Maintaining healthy habits can help college students better manage stressors that arise.

"Prioritizing sleep, moving your body, getting organized, and leaning on your support network all help college students prevent or manage stress," John MacPhee, CEO of The Jed Foundation, a nonprofit that aims to protect emotional health and prevent suicide among teens and young adults, wrote in an email. "In the inevitable moments of high stress, mindful breathing, short brain breaks, and relaxation techniques can really help."

Experts suggest creating a routine and sticking to it. That includes getting between eight and 10 hours of sleep each night and avoiding staying up late, Gomez says. A nutrient-rich diet can also go a long way in maintaining good physical and mental health, she says.

Getting outdoors and being active can also help students limit their screen time and use of social media.

“Walking to campus, maybe taking that longer walk, because your body needs that to heal," Gomez says. "It’s going to help buffer you. So if that’s the only thing you do, try to do that."

Colleges typically offer mental health resources such as counseling and support groups for struggling students.

Students dealing with chronic and unhealthy stress should contact their college and reach out to friends and family for support. Reaching out to parents, friends or mentors can be beneficial for students when feelings of stress come up, especially in heightened states around midterm and final exams .

Accessing student supports and counseling early can prevent a cascading effect that results in serious mental health challenges or unhealthy coping mechanisms like problem drinking and drug abuse , experts say.

"Know there are lots of resources on campus from academic services to counseling centers to get structured, professional support to lower your workload, improve coping skills, and have a safe space to process anxiety, worry, and stress," MacPhee says.

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College is a time of extreme stress due to societal and parental pressures. College students have expectations they have to live up to in order to fulfill and satisfy the needs of both their parents and society. Stress is expressed through a variety of symptoms that can be hazardous to student’s physical and mental health. With such high expectations to do well during college, students may become sleep deprived, which impairs mental capacity, but sleep deprivation is only one of a vast array of symptoms. Stress is present in all aspects of life and there are multiple causes of stress, especially, during the college period which may present itself through many symptoms, but with stress, there are also various coping methods to help students …show more content…

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Stress in College Students

With all that happens, how could students not be stressed.

Posted October 1, 2011 | Reviewed by Jessica Schrader

• What Is Stress?
• Find a therapist to overcome stress

Psychological stress among college students has been getting a lot of attention recently, thanks to articles this year in the New York Times , Huffington Post , and Inside Higher Ed . Research on student stress goes back at least half a century, to David Mechanic's 1962 book Students Under Stress , which was on graduate students. Student stress research seems to have really become vigorous in the 1980s, however. One of the first research studies I ever worked on investigated student stress. In 1983, during the fall term of my senior year at UCLA, the professor of my survey-research course, Christine Dunkel-Schetter , had the class conduct a phone survey of stress on campus.

Think about what many college students go through. Leaving the family home, feeling intense pressure to obtain high grades in connection with career aspirations, taking final exams, trying to establish a romantic/ social life , dealing with (often very high) costs of college and possibly working at a job during the school year. What kind of jobs (if any) students can get after college also remains tenuous given the multi-year recession. On top of all that, students in many parts of the U.S. must deal with snow and subfreezing temperatures that, in the words of a colleague who once taught in Buffalo, leave students "really dragging by December."

I ask you: Considering the above, how can college students not be highly stressed out?

Some will argue that college students are in many ways advantaged, compared to those who don't or can't attend a university. Point well taken, but that shouldn't diminish the stress experienced by students.

The New York Times article reports on Fall 2010 national findings from UCLA's Higher Education Research Institute—based on students' reflections on their senior year of high school—showing record levels of poor emotional health among incoming first-year undergraduates (UCLA press release ). The actual survey questionnaire is available here (when the new page opens, scroll to "Questionnaire" under "The Freshman Survey").

Researchers understandably want to keep their questionnaires as short as possible, to encourage participation. Because the UCLA survey probes many different areas (e.g., politics , values, in addition to school-related matters), the measures of stress and emotional health are limited to isolated items. On a checklist of feelings and behaviors experienced during the past year, for example, appears the item "Felt overwhelmed by all I had to do," to which participants reply "frequently," "occasionally," or "not at all." Elsewhere in the survey, respondents were asked to rate themselves on a set of traits, including "Emotional health," compared to what they would see as the average person their age. Though brief measures may be necessary in some studies, I would recommend a more extensive one, such as the Undergraduate Stress Questionnaire developed by my friend and colleague Chris Crandall.

The Inside Higher Ed article focuses on studies of stress at Columbia University and the University of San Diego, which aimed to identify types of stress that different subgroups of students (e.g., according to field of study, race- ethnicity , sexual orientation , and holding a job while going to school) considered most pernicious. Examples of findings from USD are that "black students are the most stressed out by disrespectful remarks and property damage; campus climate is the only stressor with significantly worse impact for LGBTQ (lesbian, gay, bisexual, transgender and queer) students than heterosexual ones; and students who hold jobs report much higher levels of stress from their families, finances and time management ."

In addition to sources and experiences of stress, there is also a great deal of research on how people (including college students) attempt to cope with and manage the stress they're under. One general typology divides coping into two broad categories: problem-focused (attempting to tackle a problem directly at its source, such as asking one's dormitory Resident Assistant for a room change to escape a bothersome roommate) and emotion -focused (attempting to manage one's emotions, e.g., by putting things in perspective, when one cannot or chooses not to address the underlying source of the problem). As an example of stress-coping research, this 2009 article examines male and female college students' strategies for coping with stress.

What can be done about stress? The University of Georgia's University Health Center offers an online resource entitled " Managing Stress: A Guide for College Students ." It offers modules on several specific topics, such as sleep, healthy relationships, and time- management . In addition, the University of Illinois's Counseling Center provides several stress-management tips for first-year students. At my university, Texas Tech, the Student Counseling Service has similar resources as at other institutions. Plus, rubberized stress-relief squeeze toys in the shape of the university's Double-T logo are available.

With the help of family, friends, and perhaps campus stress-management resources, many students are able to keep their stress levels relatively under control or even thrive in the college setting. However, for some students, the challenges and frustrations of campus life appear to lead to severe emotional problems. I address this topic in next month's column.

Alan Reifman, Ph.D. , is a Professor of Human Development and Family Studies at Texas Tech University.

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College students’ stress and health in the COVID-19 pandemic: The role of academic workload, separation from school, and fears of contagion

Chunjiang yang.

School of Economics and Management, Yanshan University, Qinhuangdao, Hebei, China

Yashuo Chen

Associated data.

All relevant data are within the manuscript and its Supporting Information files. In addition, all data are available form the OSF database. The link is https://osf.io/ajfhw/ and the DOI is 10.17605/OSF.IO/AJFHW .

The COVID-19 pandemic has unhinged the lives of people across the globe. In particular, more than 30 million Chinese college students are home-schooling, yet there is little understanding of how academic workload, separation from school, and fears of contagion lead to a decrease in their health. This study examined the relationships between Chinese college students’ three critical stressors and two types of health in the COVID‐19 pandemic context. We used a three-wave lagged design with a one-week interval. All the constructs were assessed by self-report in anonymous surveys during the COVID‐19 pandemic. College students were asked to report their demographic information, academic workload, separation from school, fears of contagion, perceived stress, and health. The results of this study showed that academic workload, separation from school, and fears of contagion had negative effects on college students’ health via perceived stress. In the COVID-19 crisis, multiple prevention and control measures focusing on college students may lead them to have different degrees of stress and health problems. Our results enrich the literature on stress and health and offer novel practical implications for all circles of the society to ensure students’ health under the context of the COVID-19 epidemic.

Introduction

Compared with other student groups, such as primary school students and middle school students, the traditional view is that college students bear more pressure and have more serious physical and mental health problems [ 1 ]. In previous research, there is a strongly held consensus that dealing with intimate relationships, financial difficulties, and fulfilling responsibilities and roles are the main sources of stress for college students. Due to the recent social changes in the education domain (e.g., the sharing of educational resources and advances in communication technology), the use of distance education is more and more, which changes the communication patterns between teachers and students, increases the isolation and independence of students, and thus becomes an important source of pressure for students [ 2 ]. Today, the spread of coronavirus disease 2019 (COVID-19) is becoming unstoppable, having infected more than 12 million people [ 3 ]. In response to this unprecedented challenge, the Chinese government has ordered a nationwide school closure as an emergency measure to prevent the spreading of the infection among teachers and students. As a consequence, 30.315 million Chinese college students are trapped at home, learning online courses through the internet to complete the required academic tasks. So far, the new virtual semester has been going on for nearly three months, and various courses are offered online in a well-organized manner. Although these decisive actions and efforts are highly commendable and necessary, there are also reasons to worry that drawn-out school suspension, home confinement, and distance learning may have adverse effects on college students’ physical and mental health [ 4 ]. In addition, a series of issues, such as fear of contagion, frustration and boredom, inadequate information, and lack of private space at home, would continue to emerge and increase during the COVID-19 outbreak [ 4 ]. However, previous research failed to give enough attention to college students in the epidemic context. For example, some studies have shown that large-scale isolation measures and loss of income have led to mental health problems among migrant workers during COVID-19 outbreaks [ 5 ]. Chen et al. [ 6 ] have discussed the problems in psychological intervention services of medical workers. The present study aimed to fill the void by focusing on college students to explore the influence of several important stressors on their health during the COVID-19 outbreak. Specifically, we identified three important stressors among college students—academic workload, separation from school, and fear of contagion and further explored the mechanism behind the relationships between three stressors and mental and physical health.

Academic stressors refer to any academic demands (e.g., environmental, social, or internal demands) that cause a student to adjust his or her behavior. Learning and examination, performance competition, especially mastering much knowledge in a short time, would lead to different degrees of academic pressure [ 7 ]. Although all planned courses have been affected by the COVID-19 epidemic, online learning still leaves college students with the same academic burden as usual. In addition, previous evidence shows that separation anxiety disorder of adults is similar to that of children and adolescents in phenomenology. College students who are attached to their classmates may experience separation anxiety after leaving school. Emerging problems during the COVID-19 outbreak, such as conflicting family schedules, changes in eating and sleeping habits, separation from classmates, and loneliness, may have adverse effects on college students [ 8 ]. Seligman and Wuyek suggested that college students may experience separation anxiety when they go home for the holidays [ 9 ]. Finally, the COVID-19 pandemic has projected humanity into an unprecedented era characterized by feelings of helplessness and loss of control. As Sontag [ 10 ] noted, unknown diseases cannot be totally controlled and thus are often considered more threatening than factual evidence. During this period, populations remained almost entirely susceptible to COVID-19, causing the natural spread of infections to exhibit almost perfect exponential growth [ 11 ]. Therefore, feelings of fear and apprehension about having or contracting COVID-19 may be a significant stressor for college students. Considering the actual situation of college students during an outbreak of COVID-19, the first aim of the study is to identify academic workload, separation from school, and fears of contagion, which are the three important stressors of college students.

Moreover, previous studies demonstrated that diseases (e.g., SARS) [ 12 ], academic (e.g., academic expectations) [ 13 ], and attachments (e.g., attachment to parents) [ 14 ] are closely associated with students’ health. However, it is still not fully understood how these stressors lead to health-related outcomes. In particular, we know little about the mechanism through which these stressors affect physical and mental health in the context of the COVID-19 outbreak. Brewster et al. [ 15 ] have suggested that further research is needed to establish the different mechanisms through which stressors impact health in order to have a profound understanding of the nature of stress. In response to these calls for further research, the second aim of this study thus was to examine the potential mediating roles of perceived stress in the relationships between the three stressors and physical and psychological health.

Overall, the current study focuses on college students and presents an integrated framework to investigate whether and how three types of stressors influence physical and mental health. Our study contributes to the current literature on stress and health in three unique ways. First, to the best of our knowledge, this study is the first to explore home-schooling college students’ physical and mental health during the COVID-19 outbreak. It makes up for the lack of understanding of the situations of college students who are ongoing home-schooling during the COVID-19 outbreak. Second, we discovered that academic stressors, interpersonal stressors, and environmental stressors of college students are critical factors that influence their health. This investigation not only overcomes the previous analysis focusing primarily on the effect of a single stressor on college students’ health but also enlarges the scope of current research on students’ stress and health by shifting the locus of theorizing away from campus domain to family domain. Third, by examining the mediating role of perceived stress, we exposed the “black box” in the relationship between stressors and health.

Three stressors among college students during the COVID-19 outbreak

College students’ stressors have been typically grouped into three major categories: academic pressure [ 16 – 19 ], social and interpersonal pressure [ 20 , 21 ], and environmental pressure [ 22 , 23 ]. Specifically, this study focuses on academic workload (representing academic pressure), separation from school (representing social and interpersonal pressure), and fear of contagion (representing environment pressure).

Academic workload

Academic problems have been regarded as the most common stressor for college students [ 24 , 25 ]. For example, in Schafer’s [ 26 ] investigation, students reported that the most significant daily hassles were academics-related stressors such as constant study, writing papers, preparing for exams, and boring teachers. The academic pressure easily comes from taking and preparing for exams, grade level competition, and acquiring a large amount of knowledge in a short period of time [ 7 ]. Perceived stress is a response to stressors, referring to the state of physical or psychological arousal [ 27 ]. College students experience adverse physical and psychological outcomes when they perceive excessive or negative stress. Excessive stress may induce physical impairments, including lack of energy, loss of appetite, headaches, or gastrointestinal problems [ 28 ]. Numerous studies have evaluated academic stress associated with various adverse outcomes, such as poor health [ 29 , 30 ], anxiety [ 31 ], depression [ 32 ], and poor academic performance [ 33 , 34 ]. In particular, Hystad et al. [ 35 ] found significant associations between academic stress and health, both psychological and physical.

Separation from school

Previous studies have shown that students view the transition from high school to college as a source of some degree of stress and emotional dissonance [ 36 ]. College students’ adaptability is closely related to their attachment with different people, such as parents and friends. Indeed, extant research on attachment has four research directions. First, the most systematic studies have focused on adolescents’ psychological separation from parents, suggesting that the healthy development of adolescents depends largely on psychological separation from parents [ 37 ]. The second field focuses on the attachment relationship between parents and adolescents, assuming that attachment to parents is a necessary prerequisite for adolescents’ adaptive function [ 38 , 39 ]. The third research stream emphasized the importance of psychological separation and attachment. According to this point of view, a balanced parent-child relationship between psychological separation and parental attachment is the best choice for students’ development [ 37 , 40 ]. Finally, a fourth research stream focuses on attachment to a group or group members in a campus environment and suggests that this attachment may influence students’ affective and behavioral outcomes [ 41 ]. From the above-mentioned research fields, we can discover that the existing literature mainly focuses on the effects of attachment on college students in their campus life. Of course, it is undeniable that the campus is the primary field for college students, while the family field becomes more important for college students during the weekends, holidays, and internships. Unfortunately, there is a dearth of research on the influence of attachment on college students in their family life. According to the literature on attachment and separation, attachment relationships between college students and their classmates may affect their stress and health when they are at home.

Social cohesion theorists believed group formation was entirely a function of individual relationships among the group members: As individuals were attracted to one another, they were consequently attracted to the group as a whole. Furthermore, group formation can occur independently of interpersonal attraction [ 42 ]. Based on the social identity theorists’ research, in minimal groups, people formed group attachment without having any contact or even knowing the other members in their group [ 41 ]. Thus, whether or not there is a close relationship with group members, one can feel the attachment to the group to which he belongs. However, some scholars reasoned that students with a stronger and healthier sense of themselves as individuals would be better equipped to handle the demands for independent functioning that accompany the college transition. An investigation among medical students shows that students with greater group cohesion reported less stress [ 43 ]. Separation anxiety begins with separation from parents, peers, and other significant persons. The national mandate force college students to separate from school in the COVID-19 pandemic, leading to separate from their peers and thus may cause their stress.

Fears of contagion

Fears of contagion reflect feelings of apprehension about having or contracting COVID-19. The literature on health anxiety [ 44 ] suggests that threatening events—such as a global pandemic—trigger high levels of stress. Although previous studies have described the pressures triggered by large-scale events, such as natural disasters [ 44 ] and terrorist attacks [ 45 ], the outbreak of infectious diseases (the COVID-19 pandemic) worldwide is different from other large-scale events [ 46 ]. Update to 1 May 2020 , the COVID-19 pandemic has resulted in 3175207 confirmed cases and 224172 deaths [ 3 ]. To prevent the spread of infectious diseases, Chines schools have been closed nationwide, collective activities have been canceled, public transportation has been suspended, and family imprisonment has been strictly enforced in some epidemic areas. The outbreak of COVID-19 has a seriously destructive impact on people’s lives all over the world. The effects of COVID-19 are multifaceted, affecting both physical health (e.g., pneumonia, liver, and renal injury) and psychological well-being (e.g., fear of contracting an infectious disease, avoid exposure to others to reduce the risk of being infected). Although national preventive measures can slow the spread of the epidemic, individuals cannot ensure that they are not infected with the disease. According to Chinese data, a large number of transmissions, both in nosocomial and community settings, occurred through human-to-human contact with individuals showing no or mild symptoms [ 47 ]. The COVID-19 pandemic is an immediate threat, it is unclear how long it will persist, and there are a multitude of unanswered questions regarding its impact. Several anecdotal reports by health care professionals note the COVID-19 pandemic triggers individuals’ anxiety and stress, particularly surrounding the uncertainties brought by COVID-19 [ 48 ]. Therefore, we suggest that fear of having or contracting COVID-19 may lead to college students’ stress and health problems.

Transactional models of stress and coping

Lazarus and Folkman [ 49 ] defined stress as a particular relationship between the person and the environment that is appraised by the person as taxing or exceeding his or her resources and endangering his or her well-being. The Transactional Model of Stress provides a basic framework for explaining the processes of individuals coping with stressful events. A core tenet of this model is that the interaction between the person and the environment creates an individual’s feeling of stress. When faced with a stressor, two appraisals were triggered, an individual evaluates potential threats or harms (primary appraisal), as well as the ability to change the situation and control negative emotional reactions (secondary appraisal). Primary appraisal is an individual’s estimate of the significance of an event as stressful, negative, positive, controllable, challenging, friendly, or irrelevant. The secondary appraisal is a judgment of an individual’s coping resources and choices [ 50 ]. The response described in the transaction model starts after the primary and secondary appraisals [ 49 ]. There are two kinds of coping efforts strongly related to a person’s cognitive appraisal. One is referred to as problem-focused coping, and the other is referred to as emotion-focused coping. The former coping strategy has been shown to be more commonly used in a person’s causal analysis, suggesting that some measures can be taken to change the negative situation. For example, Folkman and Lazarus [ 51 ] show that students will adopt a problem-based coping style before the examination. The latter coping strategy predominates when people assess that they have no options or lack resources to alter the situation, stressors have to be accepted [ 52 ]. Students have reported they often use escape/avoidance ways to cope with stressors. The problem-solving efforts try to change the situation actively, while the emotion-centric coping style will only change the individual’s interpretation of the stressors. Based on these arguments, we suggest that college students who feel stressed (e.g., regard their stress as an environmental source or lack of ability to alter) would adopt emotion-focused coping as a means of reappraising an uncontrollable situation. Thus, perceived stress plays a central role in the attribution–secondary appraisal coping relationship.

The present study

Our primary aim in the study was to examine the influence of stressors on college students’ stress and health during the COVID-19 outbreak. Specifically, we empirically examine the influence of academic workload, separation from school, and fears of contagion on college students’ psychology and physiology health that included perceived stress as a mediator. Based on the literature review, we hypothesized:

H1a: Academic workload is positively correlated with perceived stress.

H1b: Academic workload is negatively correlated with physical and mental health.

H2a: Separation from school is positively correlated with perceived stress.

H2b: Separation from school is negatively correlated with physical and mental health.

H3a: Fears of contagion are positively correlated with perceived stress.

H3b: Fears of contagion are negatively correlated with physical and mental health.

H4: Perceived stress is negatively correlated with physical and mental health.

• H5: Perceived stress mediates the relationship between academic workload and physical and mental health.
• H6: Perceived stress mediates the relationship between separation from school and physical and mental health.
• H7: Perceived stress mediates the relationship between fears of contagion and physical and mental health.

The hypothesized model is presented in Fig 1 .

Ethics statement

All participants were treated following the American Psychological Association ethical guidelines, and the study protocol was approved by the Yanshan University Institutional Review Board (Approval no. 20-03-01). Each participant got an introduction and a link to a questionnaire via WeChat, a widely used instant communication tool in China. In the introduction, anonymity, the aim of the survey, and information on whether participants agreed to participate in the survey were all illustrated in detail. We explained that if you want to participate in the survey, please open the questionnaire link and fill in your true feelings. Some college students expressed their intention to participate in written form through WeChat, and other college students directly participated in the survey with tacit approval according to the instructions. Therefore, all participants completed the questionnaire voluntarily. In addition, participants were undergraduate students recruited from four public universities in China. Thus, participants are adults and not minors, and we do not need to obtain consent from parents or guardians.

Procedure and participants

Our work is situated within an environmental context the COVID-19 pandemic. All variables were assessed with participants’ self-reports in three anonymous online surveys. Data were collected in three waves to minimize common method bias [ 53 ]. In the first-wave survey (Time 1), participants were asked to report their academic workload, separation from school, fears of contagion, and necessary demographic information. In Time 1, 1072 completed questionnaires were returned. One week later (Time 2), students evaluated their level of perceived stress. Time 2 questionnaires were distributed to the 1072 students, with 945 completed questionnaires being returned. Finally, one week after the second-wave survey (Time 3), students evaluated their physical and psychological health. At Time 3, 867 complete questionnaires were returned.

The average age of college undergraduates was 20.17 years, with 69 percent female. There are 348 freshmen, accounting for 40.1%; 200 sophomores, accounting for 23.1%; 305 junior students, accounting for 35.2%; 14 senior students, accounting for 1.6%. The average number of online courses is 8.41. Only 29.2% of the students rated the quality of online courses as good or very good. Nearly half of the participants said they wanted or very much wanted the school to start soon (49.2%). Of the 867 college students who had participated, 56.2% of them were concerned or very concerned about the possibility of contracting COVID-19 after the semester began. The demographic profile of the survey participants is presented in Table 1 .

We translated the measures from English to Chinese following the commonly used translation/back-translation procedure. All measures are reported in S1 Appendix . Unless otherwise noted, participants responded to all items on a 7-point scale (from 1 = strongly disagree to 7 = strongly agree).

It was measured using the three-item scale developed by Hystad et al. [ 35 ]. Items included: “I am spending a lot of time thinking about how this semester’s grades could negatively affect my educational and career goals,” “I am worrying a great deal about the effect this semester’s grades will have on my future,” and “I find myself very concerned about the grades I am likely to receive this semester.” Cronbach’s alpha in their study was .85, which suggests that this scale has good reliability. In the current study, Cronbach’s α of this variable is .883.

Separation from school was measured using the attachment avoidance scale developed by Smith et al. [ 54 ]. The scale has fifteen-item. An example of a reworded scale item is “I find it difficult to allow myself to depend on my group.” Factor analytic results in their research suggested that the scale has good reliability. In our current study, we reworded to refer to participants’ classmates rather than their social group. An example of a reworded scale item is “I find it difficult to allow myself to depend on my classmates.” Cronbach’s α of this variable is .929.

We developed a six-item scale to assess participants’ fears of COVID-19 infection. Six items included “In public, I don’t care about touching the door handle without protection,” “In public, I don’t mind sitting in a chair that has just been sat on,” “In an elevator, I don’t mind pushing a button without protection,” “When I’m in a crowded place, I don’t worry about coronavirus from other people,” “I don’t worry about infection if other people don’t wear masks,” “Wearing a mask would make me feel safe.” In the current study, Cronbach’s α of this variable is .842. The results of confirmatory factor analysis are shown that χ2 = 74.424; df = 8; RMSEA = .098; CFI = .982; TLI = .966; SRMR = .043. Thus, this scale has acceptable reliability and validity.

Perceived stress

The 10-item Perceived Stress Scale [ 55 ] was used to measure the student’s stress level in the past month. Participants responded to the items on a 5-point scale (from1 = never to 5 = very often). A sample item is “In the last month, how often have you felt nervous and “stressed”?” In our research, Cronbach’s α of this variable is .792.

Physical and psychological health

The CHQ-12 of the Chinese version was used to measure physical and psychological health. The CHQ-12 has been widely used in Chinese populations. The 12 items included headaches, heart palpitations, chest pain or tightening, trembling or pins and needles, sleeplessness, nervousness, and hopelessness. Participants responded to the items on a 4-point scale (1 = not at all, 4 = more than usual). A higher score represented a more severe psychosocial impairment. In our research, Cronbach’s α of this variable is .895.

Control variables

We controlled students’ age, gender, grade, and the number of online courses in the study.

Analysis strategy

First, we conducted a series of confirmatory factor analyses ( CFA ) in order to test the discriminant validity of the five prime constructs (academic workload, separation from school, fears of contagion, perceived stress, and health). CFA, as an empirical research technology, is affiliated with structural equation modeling. Therefore, it is necessary to judge the fitting situation according to the fitting indexes from the structural equation model. Common fitting indexes include chi-square( χ2 ), degree of freedom ( df ), CFI , TLI , RMSEA , and S RMR . Specifically, if the ratio of chi square to degree of freedom is less than 5, the model is generally acceptable. When CFI and TLI are higher than 0.9, the model fits well. The smaller the RMSEA and SRMR , the better the result, and in particular, when it is below 0.08, the model is acceptable. Second, we performed Harman’s single-factor test to explore the potential influence of common method variance. No single factor accounting for more than 50% of the variance of all the relevant items indicates that the results are acceptable. Third, we calculated Pearson’s correlation coefficient using SPSS Version 21, which reflects the effect of change in one variable when the other variable changes. Fourth, we tested our hypotheses using a path analysis in Mplus Version 8.3. To examine mediation (Hypothesis 5,6, and 7), we used a bootstrap simulation with 1,000 replications to create our bias-corrected 95% confidence intervals (CIs) around our indirect effects. The bootstrap approach is a more robust strategy than the causal step procedure for small samples for assessing indirect effects and a useful method for avoiding power problems relating to a non-normal sampling of the indirect effect. When the 95% confidence interval of the path coefficient does not contain zero, the mediating effect is significant.

Confirmatory factor analyses

Table 2 presents the CFA results. As shown, the baseline five-factor model fitted the data well ( χ2 = 3020.006; df = 965; RMSEA = .050; CFI = .920; TLI = .914; SRMR = .064). Against this baseline five-factor model, we tested four alternative models: model 1 was a four-factor model with academic workload merged with perceived stress to form a single factor ( χ2 = 5405.203; df = 969; RMSEA = .073; CFI = .827; TLI = .815; SRMR = .112); model 2 was three-factor model with separation from school merged with academic workload and perceived stress to form a single factor ( χ2 = 6756.895; df = 972; RMSEA = .083; CFI = .774; TLI = .760; SRMR = .096); model 3 was a two-factor model, with fears of contagion merged with separation from school, academic workload, and perceived stress to form a single factor ( χ2 = 9752.729; df = 974; RMSEA = .102; CF I = .658; TLI = .636; SRMR = .110) and model 4 was a one-factor model with five constructs merged with one factor ( χ2 = 13665.328; df = 975; RMSEA = .123; CFI = .505; TLI = .475; SRMR = .143). As Table 2 shows, the fit indexes supported the hypothesized five-factor model, providing evidence of the construct distinctiveness of fears of contagion, separation from school, academic workload, and perceived stress and health.

Note: AW = academic workload; SFS = separation from school; FOC = fears of contagion; PS = perceived stress; Two factors = AW+SFS+FOC+PS, Health; Three factors = AW+SFS+PS, FOC, Health; Four factors = AW+PS, SFS, FOC, Health.

Tests for common method variance

Because we collected student’s self-report of fears of contagion, separation from school, academic workload, and perceived stress and health in the study, common method variance (CMV) may present as a problem. Therefore, we measured different constructs at different time points to decrease common method variance as much as possible [ 56 ] and showed high respect for the security, anonymity, and privacy of research objects and informants. In addition, the results of Harman’s single-factor test suggest that an exploratory factor analysis of all items explained 68.86% of the total variance, and the largest factor accounted for only 24.73% of the variance.

Descriptive statistics

The bivariate Pearson Correlation produces a sample correlation coefficient, which measures the strength and direction of linear relationships between pairs of continuous variables. Reported in Table 3 are the means, standard deviations and bivariate correlations of variables. Academic workload, separation from school, fears of contagion, and perceived stress were all negatively correlated with health ( r = -.121, p < .01; r = -.289, p < .01; r = -.242, p < 0.01; r = -.225, p < 0.01, respectively). Academic workload, separation from school, and fear of contagion, were all positively correlated with perceived stress ( r = .152, p < .01; r = .207, p < .01; r = .133, p < 0.01, respectively). It appears that these findings preliminarily provided support for our hypotheses.

** = p < 0.01

* = p < 0.05.

Hypothesis testing

We performed structural equation modeling (SEM) to test the proposed hypotheses and summarized the standardized values of the path coefficients and their significance levels in Fig 2 . The results showed significant positive path coefficients from academic workload to perceived stress ( β = .211, SE = .040, p < .01), providing empirical evidence in support of H1a. Furthermore, academic workload was shown to have a negative effect on health ( β = -.053, SE = .037, n . s .), not providing empirical support for H1b. We also demonstrated that separation from school had a positive association with perceived stress ( β = .324, SE = .043, p < .01) and had a negative association with health ( β = -.252, SE = .039, p < .01), providing empirical evidence in support of H2a and H2b. Moreover, our results showed that fears of contagion were significantly related to perceived stress ( β = .121, SE = .039, p < 0.01) and were significantly related to health ( β = -.088, SE = .035, p < .05), providing empirical evidence in support of H3a and H3b. Perceived stress had a negative effect on health ( β = -.240, SE = .050, p < .01), providing empirical evidence in support of H4.

We further examined the mediating role of perceived stress with nonparametric bootstrapping procedures. As shown in Table 4 , the influence of academic workload on health was mediated by perceived stress because the indirect influence of academic workload on health registered the value of b at -.051 ( SE = .016, p = .001), with the 95% CI [-.081, -.028]. Therefore, H5 was supported. Similarly, the influence of separation from school on health was mediated by perceived stress because the indirect influence of separation from school on health registered the value of b at -.078 ( SE = .020, p = .000), with the 95% CI [-.113, -.049]. Therefore, H6 was supported. The influence of fear of contagion on health was mediated by perceived stress because the indirect influence of fear of contagion on health registered the value of b at -.029 ( SE = .012, p = .014), with the 95% CI [-.053, -.013]. Therefore, H7 was supported.

Note: AW = academic workload; SFS = separation from school; FOC = fears of contagion; We report the 95% confidence intervals (CIs) calculated using 1,000 bootstrap samples, with lower and upper limits in brackets.

The spread of COVID-19 is becoming unstoppable and has already influenced people and countries all over the world. Holmes et al. [ 57 ] called for that multidisciplinary science research must be central to the international response to the COVID-19 pandemic and provide evidence-based guidance on responding to promoting people’s health and wellbeing during the COVID-19 pandemic. To answer this call, we focus on college students getting home-schooling to explore their stress and health problems. Although the COVID-19 is still spreading rapidly and widely worldwide, it has been effectively controlled in China. What has happened in China shows that quarantine, social distancing, and isolation of infected populations can contain the epidemic. Whereas individual coping strategies are possible (e.g., social distancing), the spread of the virus at a state level is still beyond any given individual’s control. The continuous spread of the epidemic, strict isolation measures, and delays in starting schools, colleges, and universities across the country are expected to influence college students. Considering stress and anxiety associated with the current COVID-19 pandemic for college students [ 49 ], it is urgent for the society and management departments to understand the actual situation of college students timely and accurately. Based on the Transactional Model of Stress and coping [ 49 ], this study explored the influence of academic workload, separation from school, and fears of contagion on college students’ physical and physiological health, as well as the mediating effect of perceived stress in those relationships.

The current study contributes to the existing literature. First, the present study goes beyond previous literature on college students’ health during the epidemic by integrating three types of stressors from different fields in the proposed model. As highlighted in previous research on college students’ academic stress, preparing exams, courses, and papers should exhibit a negative effect on individual health. During the COVID-19 outbreak, Chinese college students’ learning was not suspended, but they attend the various courses offered online follow the regular schedule. While those measures of the virtual semester ensure regular study, they also cause stress on students. In addition, given the importance of social groups to an individual’s identity and self-worth, we found that college students were separated from their classmates during the COVID-19 epidemic, which brought them stress and anxiety. Previous evidence suggests that college students usually keep attachment relationships with their social group [ 12 , 58 ]. Attachment figures are usually parents, but may also be siblings, grandparents, or group. Unlike most previous studies that focused on separation from parents [ 9 ], this study focused on the influence of departure from school and schoolmates, which is particularly relevant to the epidemic situation. For college students attached to their school or classmates, school-closure is a kind of separation experience, which may be different from their experience when they leave home. Considering the relatively new separation (separation from school) caused by the outbreak of COVID-19, our findings suggest that separation from school was positively related to college students’ perceived stress during home-schooling. Finally, we found that exposure to a potentially infectious environment would lead to people’s stress, which is in line with previous research that pointed out the negative correlation between the risk of infection and life satisfaction [ 58 ]. Similar results have been found in the study of College Students’ psychological adjustment during SARS. For example, Main et al. [ 12 ] found that the experience of SARS-related stressors was positively associated with psychological symptoms for Chinese college students during the outbreak. Thus, we supposed that during an acute large-scale epidemic such as the SARS and COVID-19 epidemic, even among persons who were not directly contaminated with the disease, the psychological influence of the outbreak on them was significant. In doing so, we identified three important stressors for college students in the COVID-19 pandemic, providing essential inspiration for college students to maintain their physical and mental health during the current epidemic.

Second, based on a transactional model view, we provide a plausible mechanism for explaining the association between academic workload, separation from school, and fears of contagion and health. The transactional model posits that stress responses emerge from appraisal processes that begin when individuals experience a stressor. During primary appraisal, perceptions of elements of the focal stressor are used to determine the degree of threat or harm that this stressor represents; during secondary appraisal, individuals consider if and how they can resolve the underlying stressor. COVID-19, a contagious respiratory illness, is an ongoing, global health crisis, and the greatest challenge we have faced since World War II [ 59 ]. The COVID-19 pandemic is a grim but illustrative anxiety-inducing stressor; an uncertain and ongoing threat that cannot be resolved via individual efforts. When individuals have few resources, ways, or abilities at their disposal to deal with the stressors, they generate stress and anxiety and ultimately lead to negative consequences. Thus, perceived stress may be a mediator, transmitting the effects of academic workload, separation from school, and fears of contagion on health-related outcomes. These findings suggest that academic workload, separation from school, and fears of contagion may contribute to youth’s general perceived stress, which in turn, may negatively influence their physical and psychological health. Our findings supported Lorenzo-Blanco and Unger’s [ 60 ] and Sariçam’s [ 61 ] proposition that perceived stress plays an important role in influencing psychological well-being.

The results of the current study are of significance to practice and policy. First, the administrative department needs to raise the awareness of potential physical and mental health influences of home-schooling during the outbreak. While taking effective prevention measures, the government should guide the mass media to spread positive information and control rumors. Communication can serve as an important resource in dealing with the difficulties of family matters. For instance, parents can share their life experiences with their children and advocate for them to develop good living habits and enjoy a healthy lifestyle. Psychologists can communicate with students by social media platforms to help them cope with mental health issues caused by domestic conflicts, tension with parents, and anxiety from becoming infected. In addition, schools play an important role not only in providing students with educational materials but also in providing students with opportunities to interact with teachers and students. Schools should also provide guidelines and principles for effective online learning and ensure that content meets educational requirements. Nevertheless, it is also important not to overburden students.

Limitations

Despite the potential contribution that the present study makes to the mental health field, limitations of the study should be noted. First, a potential limitation is that all measures came from the same source, raising the potential for same-source measurement biases. However, we used a variety of means to reduce this issue, including varying our response scales and separating our measures in time. Further, as we were interested in how college students have dealt with the pandemic over time, focusing on self-reported experiences was appropriate. Another potential limitation of our study is concerned with causality. Hence, future research should conduct the experimental design or utilize the longitudinal data to ensure the conclusion reflects causation. Finally, our research reflects only the impact of the COVID-19 pandemic for college students, and much work is needed to gain a complete understanding of the implications of this crisis for students. Future research could consider how individual factors, such as self-concept, and contextual factors, such as social support, may influence college students’ response to perceived stress. Moreover, research focused on within-person fluctuations of perceived stress during this time would also be instructive, as there is no doubt that individuals have experienced considerable variability on a daily basis during the pandemic.

Conclusions

Confronting the COVID-19 outbreak and variously rigorous measures to prevent the spreading of the infection, college students may feel stress and have more or fewer health problems. Academic workload, psychological separation from school, and fear of contagion were positively associated with the perceived stress and negatively associated with physical and psychological health. In addition, perceived stress is a key mechanism in the relationships between three stressors and two forms of health. This study makes not only unique theoretical contributions to the stress and health literature during the COVID-19 outbreak but also offers novel practical implications for joint efforts from all circles of society to ensure students’ health.

Supporting information

S1 appendix, funding statement.

National Natural Science Foundation of China (71572170). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Data Availability

• PLoS One. 2021; 16(2): e0246676.

Decision Letter 0

30 Dec 2020

PONE-D-20-32875

College students’ stress and health during the COVID-19 outbreak: the effects of academic workload, separation from school, and fears of contagion

Dear Dr. Yang,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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Reviewer #1: Partly

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Reviewer #1: Yes

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Reviewer #1: In general, this is a good study considering the concept backed by a sound theoretical framework. However, authors need to improve the study’s write-up in several sections of the manuscript especially the English language. I will strongly recommend a native English Language speaker to edit it.

Knowing that we cannot make a causal inference from this study, it will be more prudent to use associate/relate rather than affect.

Page 8: Procedure and Participants

Can authors justify why they used different samples for each Time wave and how they resolve the confounding issues arising from this method?

Also, there seems to be a typo in the number of data collected for wave one.

Authors should start a sentence with words and not figures as did with 49.2% and 56.2%.

Authors may want to revise this section incorporating the number of items per scale, the original developer (author) of each scale, original psychometric property, and how it was scored in this study. Much more importantly, the psychometric properties of these measures for this study.

Data analysis

Authors may end the method section with the above sub-title. This section may detail the types of analytic tools used and the purposes for using them. Cut-off or other criteria related to these analytic tools may be written here.

Tests for common method variance: The first sentence under this sub-section seems incomplete.

Table 3: for bivariate relationships, authors may take out categorical variables from the results as it does not make meaning.

Table 4: Authors may add further details to the table as effect and CI are not enough to get a better picture of the analysis/data.

Page 14: “Given the ongoing COVID -19 epidemic to inducing panic, and anxiety [49], therefore, timely and…” this sentence is difficult to understand, please revise.

Authors may try to relate the theory to the findings thoroughly.

Explaining the “SFS” with separation anxiety disorder is too far-fetched (exaggerated and unconvincing). Besides, these are students above 17 year old. SFS have a role to play in the lives of students but not from the angle of separation anxiety but probably as a supporting/coping strategy.

The way the authors reported the procedure of the data collection did not reflect a cross-sectional design. Hence, it will make readers doubt the authenticity/validity of this study.

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Author response to Decision Letter 0

13 Jan 2021

A Point-by-Point Response to Editor Comments

Your comment:

One expert in this field has carefully reviewed your submission and he pointed out some merits in your work. However, a major concern regarding the sampling should be tackled in the revision. That says, the samples seemed to be different across time points and the authors should provide clear rationale and how they take care of the methodology issues if they really used different samples. This is a fatal point for me to judge whether the revision can be accepted.

Our response:

Thank you for giving us the opportunity to revise our paper. We hope that you find this revised manuscript significantly improved and up to your expectation.

Thank you for your question. Indeed, although the numbers of participants are different across time points, we didn’t use different samples in our research.

First, we explain what the time-lagged design is and why it is used in our research.

The time-lagged design is a type of research design in which the same person reports information or data of different variables at different time points, which has been widely used in science research (e.g., Laschinger & Fida, 2014; SPENCE LASCHINGER & Finegan, 2008; Kilroy et al., 2017). The time-lagged design can ensure the constructs we concerned would be less influenced by common method bias (e.g., Podsakoff et al. 2003). Generally, the independent variables (IV) are first collected at Time-1, and then the mediation variables (mediators) at Time-2, and finally the dependent variables (DV) at Time-3 from the same person. In our research, academic workload, separation from school, and fears of contagion are independent variables, perceived stress is a mediator, and health is a dependent variable. Thus, we used the time-lagged design and these data of different variables were collected at three time points with one-week interval.

Second, we describe how to conduct the collection of data and explain that we didn’t use different samples in our study.

In the first-wave survey (Time 1), participants were asked to report their academic workload, separation from school, fears of contagion, and necessary demographic information, and we got 1072 questionnaires. One week later (Time 2), perceived stress needs to be measured, and we distributed questionnaires to the 1,072 people who had participated in the first-wave survey. However, 127 participants quit the survey and we got 945 questionnaires at Time 2 (valid response rate: 945/1072=88.15%). One week after the second-wave survey (Time 3), physical and psychological health needs to be measured, and we distributed questionnaires to the 945 people who had participated in both the first-wave and second-wave survey. However, 78 participants quit the survey, and we got 867 questionnaires at Time 3(valid response rate: 867/945=91.95%). That is, we got completed data, including the data of all variables used in our research from 867 participants who participated in three surveys. In the data analysis, we used data from only 867 participants. Because some participants did not participate fully in the three surveys, their data was incomplete and thus could not be included in the study. That is, because some participants dropped out of the survey during the data collection process, the number of participants varied at different time points, as shown in Figure 1.

Podsakoff, P. M., MacKenzie, S. B., Lee, J. Y., & Podsakoff, N. P. (2003). Common method biases in behavioral research: a critical review of the literature and recommended remedies. Journal of applied psychology, 88(5), 879.

Laschinger, H. K. S., & Fida, R. (2014). A time-lagged analysis of the effect of authentic leadership on workplace bullying, burnout, and occupational turnover intentions. European Journal of Work and Organizational Psychology, 23(5), 739-753.

SPENCE LASCHINGER, H. K., & Finegan, J. (2008). Situational and dispositional predictors of nurse manager burnout: a time‐lagged analysis. Journal of Nursing Management, 16(5), 601-607.

Kilroy, S., Flood, P. C., Bosak, J., & Chênevert, D. (2017). Perceptions of high‐involvement work practices, person‐organization fit, and burnout: A time‐lagged study of health care employees. Human Resource Management, 56(5), 821-835.

A Point-by-Point Response to Reviewer Comments

Reviewer #1: Partly

Thank you very much. Following your suggestions, we carefully revised the manuscript. All changes were marked in blue text. Below please see our point-to-point response to your comments. We hope that you find this revised manuscript significantly improved and up to your expectation.

Reviewer #1: Yes

Thank you very much for your recognition and support!

Reviewer #1: No

Thank you very much. We would like to provide and share the data we used in our research.

Reviewer #1: In general, this is a good study considering the concept backed by a sound theoretical framework. However, authors need to improve the study’s write-up in several sections of the manuscript especially the English language. I will strongly recommend a native English Language speaker to edit it.

Thank you very much for your recognition and support! We have had a professional copy editor with English as her first language to thoroughly go through the draft. We are confident that the writing has been improved and hope that the revised manuscript will meet your requirements. All changes were marked in blue in the revised manuscript.

Thank you very much. Following your suggestion, we use associate/relate rather than affect in the revised manuscript. All changes were marked in blue text.

Page 2 Line 44-Page 8 Line 208:

Page 8 Line 210-Page 9 Line 220:

Thank you very much for your advice. We have corrected the typo in the number of data collected for wave one. In addition, we have started the sentence with words and not figures.

Please see Page 9 Line 245- Line 247:

In the first-wave survey (Time 1), participants were asked to report their academic workload, separation from school, fears of contagion, and necessary demographic information. In Time 1, 1072 completed questionnaires were returned.

Please see Page 10 Line 254- Line 256:

Nearly half of the participants said they wanted or very much wanted the school to start soon (49.2%). Of the 867 college students who had participated, 56.2% of them were concerned or very concerned about the possibility of contracting COVID-19 after the semester began.

Thank you very much. We carefully revised this section. In the revised manuscript, we described the number of items per scale, the original developer of each scale, the reliability of the original scale, and the reliability of scale in our research. All items we used in the research has been provided in Appendix. In addition, we described that participants responded to items on a 7-point scale or 5-point scale. Specifically, the scale of physical and psychological health has its Chinese version, and thus we can directly use it in our research. The scales of academic workload, separation from school, and perceived stress have their English version, and thus we followed the translation/back-translation procedure to translate English to Chinese. Finally, we developed the scale of fears of contagion, and test its reliability and validity. Based on the results of Cronbach's α, we found that the psychometric properties of these measures for this study are acceptable.

Please see Page 10 Line 259- Page 12 Line 294:

We translated the measures from English to Chinese following the commonly used translation/back-translation procedure. All measures are reported in Appendix A. Unless otherwise noted, participants responded to all items on a 7-point scale (from 1=strongly disagree to 7=strongly agree).

It was measured using the three-item scale developed by Hystad et al. [35]. Items included: “I am spending a lot of time thinking about how this semester’s grades could negatively affect my educational and career goals,” “I am worrying a great deal about the effect this semester’s grades will have on my future,” and “I find myself very concerned about the grades I am likely to receive this semester.” Cronbach’s alpha in their study was .85, which suggests that this scale has good reliability. In the current study, Cronbach's α of this variable is .883.

Separation from school was measured using the attachment avoidance scale developed by Smith et al. [54]. The scale has fifteen-item. An example of a reworded scale item is “I find it difficult to allow myself to depend on my group.” Factor analytic results in their research suggested that the scale has good reliability. In our current study, we reworded to refer to participants' classmates rather than their social group. An example of a reworded scale item is “I find it difficult to allow myself to depend on my classmates.” Cronbach's α of this variable is

We developed a six-item scale to assess participants’ fears of COVID-19 infection. Six items included “In public, I don't care about touching the door handle without protection,” “In public, I don’t mind sitting in a chair that has just been sat on,” “In an elevator, I don’t mind pushing a button without protection,” “When I’m in a crowded place, I don’t worry about coronavirus from other people,” “I don't worry about infection if other people don't wear masks,” “Wearing a mask would make me feel safe.” In the current study, Cronbach's α of this variable is .842. The results of confirmatory factor analysis are shown that χ2 = 74.424; df = 8; RMSEA = .098; CFI =.982; TLI = .966; SRMR = .043. Thus, this scale has acceptable reliability and validity.

The 10-item Perceived Stress Scale [55] was used to measure the student’s stress level in the past month. Participants responded to the items on a 5-point scale (from1=never to 5=very often). A sample item is “In the last month, how often have you felt nervous and “stressed”?” In our research, Cronbach's α of this variable is .792.

The CHQ-12 of the Chinese version was used to measure physical and psychological health. The CHQ-12 has been widely used in Chinese populations. The 12 items included headaches, heart palpitations, chest pain or tightening, trembling or pins and needles, sleeplessness, nervousness, and hopelessness. Participants responded to the items on a 4-point scale (1= not at all, 4=more than usual). A higher score represented a more severe psychosocial impairment. In our research, Cronbach's α of this variable is .895.

Please see Page 24 Line 622- Page 26 Line 677:

1. I am spending a lot of time thinking about how this semester’s grades could negatively affect my educational and career goals.

2. I am worrying a great deal about the effect this semester’s grades will have on my future.

3. I find myself very concerned about the grades I am likely to receive this semester.

1. I find it difficult to allow myself to depend on my group.

2. I sometimes worry that I will be hurt if I allow myself to become too close to my group.

3. I am nervous when my group gets too close.

4. My desire to feel completely at one sometimes scares my group away.

5. I prefer not to depend on my group or to have my group depend on me.

6. I often worry that my group does not really accept me.

7. I am comfortable not being close to my group.

8. I often worry my group will not always want me as a member.

9. I am somewhat uncomfortable being close to my group.

10. My group is never there when I need it.

11. I find it difficult to completely trust my group.

12. I find my group is reluctant to get as close as I would like.

13. I am not sure that I can always depend on my group to be there when I need it.

14. I sometimes worry that my group doesn't value me as much as I value my group.

15. I want to be emotionally close with my group, but I find it difficult to trust my group completely or to depend on my group.

1. In public, I don't care about touching the door handle without protection.

2. In public, I don’t mind sitting in a chair that has just been sat on.

3. In an elevator, I don’t mind pushing a button without protection.

4. When I’m in a crowded place, I don't worry about coronavirus from other people.

5. I don't worry about infection if other people don't wear masks.

6. Wearing a mask would make me feel safe.

1. In the last month, how often have you been upset because of something that happened unexpectedly?

2. In the last month, how often have you felt that you were unable to control the important things in your life?

3. In the last month, how often have you felt nervous and “stressed”?

4. In the last month, how often have you felt confident about your ability to handle your personal problems?

5. In the last month, how often have you felt that things were going your way?

6. In the last month, how often have you found that you could not cope with all the things that you had to do?

7. In the last month, how often have you been able to control irritations in your life?

8. In the last month, how often have you felt that you were on top of things?

9. In the last month, how often have you been angered because of things that were outside of your control?

10. In the last month, how often have you felt difficulties were piling up so high that you could not overcome them?

Have you recently...

1. been suffering from headache or pressure in your head?

2. had palpitation and worried that you might have heart trouble?

3. had discomfort or a feeling of pressure in your chest?

4. been suffering from shaking or numbness of your limbs?

5. lost much sleep through worry?

6. been taking things hard?

7. been getting along well with your family or friends?

8. been losing confidence in yourself?

9. been feeling nervous and strung-up all the time?

10. been feeling hopeful about your future?

11. been worried about your family or close friends?

12. felt that life is entirely hopeless?

Thank you very much for your advice. Following your suggestion, we have added the sub-title and provide more details about the types of analytic tools used, the purposes for using them and so on.

Please see Page 12 Line 297- Line 314:

First, we conducted a series of confirmatory factor analyses (CFA) in order to test the discriminant validity of the five prime constructs (academic workload, separation from school, fears of contagion, perceived stress, and health). CFA, as an empirical research technology, is affiliated with structural equation modeling. Therefore, it is necessary to judge the fitting situation according to the fitting indexes from the structural equation model. Common fitting indexes include chi-square(χ2), degree of freedom (df), CFI, TLI, RMSEA, and SRMR. Specifically, if the ratio of chi square to degree of freedom is less than 5, the model is generally acceptable. When CFI and TLI are higher than 0.9, the model fits well. The smaller the RMSEA and SRMR, the better the result, and in particular, when it is below 0.08, the model is acceptable. Second, we performed Harman’s single-factor test to explore the potential influence of common method variance. No single factor accounting for more than 50% of the variance of all the relevant items indicates that the results are acceptable. Third, we calculated Pearson’s correlation coefficient using SPSS Version 21, which reflects the effect of change in one variable when the other variable changes. Fourth, we tested our hypotheses using a path analysis in Mplus Version 8.3. To examine mediation (Hypothesis 5,6, and 7), we used a bootstrap simulation with 1,000 replications to create our bias-corrected 95% confidence intervals (CIs) around our indirect effects. The bootstrap approach is a more robust strategy than the causal step procedure for small samples for assessing indirect effects and a useful method for avoiding power problems relating to a non-normal sampling of the indirect effect. When the 95% confidence interval of the path coefficient does not contain zero, the mediating effect is significant.

Thank you very much for your advice. First, we revised the first sentence under this sub-section and make it complete. Second, we deleted the section of categorical variables in Table 3. Third, we provide more details about the analysis/data.

Please see Page 13 Line 332- Line 338:

Tests for Common Method Variance

Because we collected student’s self-report of fears of contagion, separation from school, academic workload, and perceived stress and health in the study, common method variance (CMV) may present as a problem. Therefore, we measured different constructs at different time points to decrease common method variance as much as possible [56] and showed high respect for the security, anonymity, and privacy of research objects and informants. In addition, the results of Harman’s single-factor test suggest that an exploratory factor analysis of all items explained 68.86% of the total variance, and the largest factor accounted for only 24.73% of the variance.

Please see Page 14 Line 348- Line 349:

Please see Page 15 Line 372- Line 374:

Thank you very much for your advice. We have revised this confused sentence.

Please see Page 15 Line 375- Line 388:

The spread of COVID-19 is becoming unstoppable and has already influenced people and countries all over the world. Holmes et al. [57] called for that multidisciplinary science research must be central to the international response to the COVID-19 pandemic and provide evidence-based guidance on responding to promoting people’s health and wellbeing during the COVID-19 pandemic. To answer this call, we focus on college students getting home-schooling to explore their stress and health problems. Although the COVID-19 is still spreading rapidly and widely worldwide, it has been effectively controlled in China. What has happened in China shows that quarantine, social distancing, and isolation of infected populations can contain the epidemic. Whereas individual coping strategies are possible (e.g., social distancing), the spread of the virus at a state level is still beyond any given individual’s control. The continuous spread of the epidemic, strict isolation measures, and delays in starting schools, colleges, and universities across the country are expected to influence college students. Considering stress and anxiety associated with the current COVID-19 pandemic for college students [49], it is urgent for the society and management departments to understand the actual situation of college students timely and accurately.

Thank you very much for your advice. Following your suggestion, we integrated theory with our findings thoroughly in the revised manuscript.

Please see Page 15 Line 375- Page 17 Line 432:

The spread of COVID-19 is becoming unstoppable and has already influenced people and countries all over the world. Holmes et al. [57] called for that multidisciplinary science research must be central to the international response to the COVID-19 pandemic and provide evidence-based guidance on responding to promoting people’s health and wellbeing during the COVID-19 pandemic. To answer this call, we focus on college students getting home-schooling to explore their stress and health problems. Although the COVID-19 is still spreading rapidly and widely worldwide, it has been effectively controlled in China. What has happened in China shows that quarantine, social distancing, and isolation of infected populations can contain the epidemic. Whereas individual coping strategies are possible (e.g., social distancing), the spread of the virus at a state level is still beyond any given individual’s control. The continuous spread of the epidemic, strict isolation measures, and delays in starting schools, colleges, and universities across the country are expected to influence college students. Considering stress and anxiety associated with the current COVID-19 pandemic for college students [49], it is urgent for the society and management departments to understand the actual situation of college students timely and accurately. Based on the Transactional Model of Stress and coping [49], this study explored the influence of academic workload, separation from school, and fears of contagion on college students’ physical and physiological health, as well as the mediating effect of perceived stress in those relationships.

The current study contributes to the existing literature. First, the present study goes beyond previous literature on college students’ health during the epidemic by integrating three types of stressors from different fields in the proposed model. As highlighted in previous research on college students’ academic stress, preparing exams, courses, and papers should exhibit a negative effect on individual health. During the COVID-19 outbreak, Chinese college students’ learning was not suspended, but they attend the various courses offered online follow the regular schedule. While those measures of the virtual semester ensure regular study, they also cause stress on students. In addition, given the importance of social groups to an individual’s identity and self-worth, we found that college students were separated from their classmates during the COVID-19 epidemic, which brought them stress and anxiety. Previous evidence suggests that college students usually keep attachment relationships with their social group [12,58]. Attachment figures are usually parents, but may also be siblings, grandparents, or group. Unlike most previous studies that focused on separation from parents [9], this study focused on the influence of departure from school and schoolmates, which is particularly relevant to the epidemic situation. For college students attached to their school or classmates, school-closure is a kind of separation experience, which may be different from their experience when they leave home. Considering the relatively new separation (separation from school) caused by the outbreak of COVID-19, our findings suggest that separation from school was positively related to college students’ perceived stress during home-schooling. Finally, we found that exposure to a potentially infectious environment would lead to people’s stress, which is in line with previous research that pointed out the negative correlation between the risk of infection and life satisfaction [58]. Similar results have been found in the study of College Students’ psychological adjustment during SARS. For example, Main et al. [12] found that the experience of SARS-related stressors was positively associated with psychological symptoms for Chinese college students during the outbreak. Thus, we supposed that during an acute large-scale epidemic such as the SARS and COVID-19 epidemic, even among persons who were not directly contaminated with the disease, the psychological influence of the outbreak on them was significant. In doing so, we identified three important stressors for college students in the COVID-19 pandemic, providing essential inspiration for college students to maintain their physical and mental health during the current epidemic.

Second, based on a transactional model view, we provide a plausible mechanism for explaining the association between academic workload, separation from school, and fears of contagion and health. The transactional model posits that stress responses emerge from appraisal processes that begin when individuals experience a stressor. During primary appraisal, perceptions of elements of the focal stressor are used to determine the degree of threat or harm that this stressor represents; during secondary appraisal, individuals consider if and how they can resolve the underlying stressor. COVID-19, a contagious respiratory illness, is an ongoing, global health crisis, and the greatest challenge we have faced since World War II [59]. The COVID-19 pandemic is a grim but illustrative anxiety-inducing stressor; an uncertain and ongoing threat that cannot be resolved via individual efforts. When individuals have few resources, ways, or abilities at their disposal to deal with the stressors, they generate stress and anxiety and ultimately lead to negative consequences. Thus, perceived stress may be a mediator, transmitting the effects of academic workload, separation from school, and fears of contagion on health-related outcomes. These findings suggest that academic workload, separation from school, and fears of contagion may contribute to youth’s general perceived stress, which in turn, may negatively influence their physical and psychological health. Our findings supported Lorenzo-Blanco and Unger’s [60] and Sariçam’s [61] proposition that perceived stress plays an important role in influencing psychological well-being.

Thank you very much for your advice. Following your suggestion, we explained “SFS” from the point of attachment in the revised manuscript. From a supporting/coping strategy, we provided some advice to help college students keep healthy when they separate from school.

Please see Page 16 Line 397- Line 406:

In addition, given the importance of social groups to an individual’s identity and self-worth, we found that college students were separated from their classmates during the COVID-19 epidemic, which brought them stress and anxiety. Previous evidence suggests that college students usually keep attachment relationships with their social group [12,58]. Attachment figures are usually parents, but may also be siblings, grandparents, or group. Unlike most previous studies that focused on separation from parents [9], this study focused on the influence of departure from school and schoolmates, which is particularly relevant to the epidemic situation. For college students attached to their school or classmates, school-closure is a kind of separation experience, which may be different from their experience when they leave home. Considering the relatively new separation (separation from school) caused by the outbreak of COVID-19, our findings suggest that separation from school was positively related to college students’ perceived stress during home-schooling.

Thank you very much for your advice. We revised this point in the revised manuscript. Although we used a time-lagged design to collect data at different times, future research can conduct the experimental design or utilize the longitudinal data to ensure the conclusion reflects causation.

Please see Page 18 Line 445- Page 18 Line 458:

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College students’ stress and health in the COVID-19 pandemic: the role of academic workload, separation from school, and fears of contagion

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Home — Essay Samples — Education — Academic Challenges — The Phenomenon of Academic Stress

The Phenomenon of Academic Stress

• Categories: Academic Challenges Stress

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Published: Aug 31, 2023

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Table of contents

Understanding academic stress, causes of academic stress, effects of academic stress, coping strategies and resilience, support systems and resources, balancing academic demands and well-being, addressing systemic factors, prevention and intervention strategies, conclusion: a call for holistic approaches to education.

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Top 10 Stress Management Techniques for Students

Elizabeth Scott, PhD is an author, workshop leader, educator, and award-winning blogger on stress management, positive psychology, relationships, and emotional wellbeing.

Akeem Marsh, MD, is a board-certified child, adolescent, and adult psychiatrist who has dedicated his career to working with medically underserved communities.

Most students experience significant amounts of stress. This can significantly affect their health, happiness, relationships, and grades. Learning stress management techniques can help these students avoid negative effects in these areas.

Why Stress Management Is Important for Students

A study by the American Psychological Association (APA) found that teens report stress levels similar to adults. This means teens are experiencing significant levels of chronic stress and feel their stress levels generally exceed their ability to cope effectively .

Roughly 30% of the teens reported feeling overwhelmed, depressed, or sad because of their stress.

Stress can also affect health-related behaviors. Stressed students are more likely to have problems with disrupted sleep, poor diet, and lack of exercise. This is understandable given that nearly half of APA survey respondents reported completing three hours of homework per night in addition to their full day of school work and extracurriculars.

Common Causes of Student Stress

Another study found that much of high school students' stress originates from school and activities, and that this chronic stress can persist into college years and lead to academic disengagement and mental health problems.

Top Student Stressors

Common sources of student stress include:

• Extracurricular activities
• Social challenges
• Transitions (e.g., graduating, moving out , living independently)
• Relationships
• Pressure to succeed

High school students face the intense competitiveness of taking challenging courses, amassing impressive extracurriculars, studying and acing college placement tests, and deciding on important and life-changing plans for their future. At the same time, they have to navigate the social challenges inherent to the high school experience.

This stress continues if students decide to attend college. Stress is an unavoidable part of life, but research has found that increased daily stressors put college-aged young adults at a higher risk for stress than other age groups.

Making new friends, handling a more challenging workload, feeling pressured to succeed, being without parental support, and navigating the stresses of more independent living are all added challenges that make this transition more difficult. Romantic relationships always add an extra layer of potential stress.

Students often recognize that they need to relieve stress . However, all the activities and responsibilities that fill a student’s schedule sometimes make it difficult to find the time to try new stress relievers to help dissipate that stress.

10 Stress Management Techniques for Students

Here you will learn 10 stress management techniques for students. These options are relatively easy, quick, and relevant to a student’s life and types of stress .

Get Enough Sleep

Blend Images - Hill Street Studios / Brand X Pictures / Getty Images

Students, with their packed schedules, are notorious for missing sleep. Unfortunately, operating in a sleep-deprived state puts you at a distinct disadvantage. You’re less productive, may find it more difficult to learn, and may even be a hazard behind the wheel.

Research suggests that sleep deprivation and daytime sleepiness are also linked to impaired mood, higher risk for car accidents, lower grade point averages, worse learning, and a higher risk of academic failure.

Don't neglect your sleep schedule. Aim to get at least 8 hours a night and take power naps when needed.

Use Guided Imagery

David Malan / Getty Images

Guided imagery can also be a useful and effective tool to help stressed students cope with academic, social, and other stressors. Visualizations can help you calm down, detach from what’s stressing you, and reduce your body’s stress response.

You can use guided imagery to relax your body by sitting in a quiet, comfortable place, closing your eyes, and imagining a peaceful scene. Spend several minutes relaxing as you enjoy mentally basking in your restful image.

Consider trying a guided imagery app if you need extra help visualizing a scene and inducting a relaxation response. Research suggests that such tools might be an affordable and convenient way to reduce stress.

Exercise Regularly

One of the healthiest ways to blow off steam is to get regular exercise . Research has found that students who participate in regular physical activity report lower levels of perceived stress. While these students still grapple with the same social, academic, and life pressures as their less-active peers, these challenges feel less stressful and are easier to manage.

Finding time for exercise might be a challenge, but there are strategies that you can use to add more physical activity to your day. Some ideas that you might try include:

• Doing yoga in the morning
• Walking or biking to class
• Reviewing for tests with a friend while walking on a treadmill at the gym
• Taking an elective gym class focused on leisure sports or exercise
• Joining an intramural sport

Exercise can help buffer against the negative effects of student stress. Starting now and keeping a regular exercise practice throughout your lifetime can help you live longer and enjoy your life more.

Take Calming Breaths

When your body is experiencing a stress response, you’re often not thinking as clearly as you could be. You are also likely not breathing properly. You might be taking short, shallow breaths. When you breathe improperly, it upsets the exchange of oxygen and carbon dioxide in your body.

Studies suggest this imbalance can contribute to various physical symptoms, including increased anxiety, fatigue, stress, emotional problems, and panic attacks.

A quick way to calm down is to practice breathing exercises . These can be done virtually anywhere to relieve stress in minutes.

Because they are fast-acting, breathing exercises are a great way to cope with moments of acute stress , such as right before an exam or presentation. But they can also help manage longer-lasting stress such as dealing with relationships, work, or financial problems.

Practice Progressive Muscle Relaxation (PMR)

Another great stress management technique for students that can be used during tests, before bed, or at other times when stress has you physically wound up is progressive muscle relaxation ( PMR ).

This technique involves tensing and relaxing all muscles until the body is completely relaxed. With practice, you can learn to release stress from your body in seconds. This can be particularly helpful for students because it can be adapted to help relaxation efforts before sleep for a deeper sleep.

Once a person learns how to use PMR effectively, it can be a quick and handy way to induce relaxation in any stressful situation, such as bouts of momentary panic before a speech or exam, dealing with a disagreement with your roommate, or preparing to discuss a problem with your academic advisor.

Listen to Music

A convenient stress reliever that has also shown many cognitive benefits, music can help relieve stress and calm yourself down or stimulate your mind depending on what you need in the moment.

Research has found that playing upbeat music can improve processing speed and memory. Stressed students may find that listening to relaxing music can help calm the body and mind. One study found that students who listened to the sounds of relaxing music were able to recover more quickly after a stressful situation.

Students can harness the benefits of music by playing classical music while studying, playing upbeat music to "wake up" mentally, or relaxing with the help of their favorite slow melodies.

Build Your Support Network

Halfpoint Images / Getty Images

Having emotional support can help create a protective buffer against stress. Unfortunately,  interpersonal relationships can also sometimes be a source of anxiety for students. Changes in friendships, romantic breakups, and life transitions such as moving away for college can create significant upheaval and stress for students.

One way to combat feelings of loneliness and make sure that you have people to lean on in times of need is to expand your support network and nurture your relationships.

Look for opportunities to meet new people, whether it involves joining study groups or participating in other academic, social, and leisure activities.

Remember that different types of relationships offer differing types of support . Your relationships with teachers, counselors, and mentors can be a great source of information and resources that may help you academically. Relationships with friends can provide emotional and practical support.

Widening your social circle can combat student stress on various fronts and ensure you have what you need to succeed.

Eat a Healthy Diet

Niedring/Drentwett / Getty Images

You may not realize it, but your diet can either boost your brainpower or sap you of mental energy. It can also make you more reactive to the stress in your life. As a result, you might find yourself turning to high-sugar, high-fat snacks to provide a temporary sense of relief.

A healthy diet can help combat stress in several ways. Improving your diet can keep you from experiencing diet-related mood swings, light-headedness, and more.

Unfortunately, students are often prone to poor dietary habits. Feelings of stress can make it harder to stick to a consistently healthy diet, but other concerns such as finances, access to cooking facilities, and time to prepare healthy meals can make it more challenging for students.

Some tactics that can help students make healthy choices include:

• Eating regularly
• Carrying a water bottle to class
• Keeping healthy snacks such as fruits and nuts handy
• Limiting caffeine, nicotine, and alcohol intake

Find Ways to Minimize Stress

One way to improve your ability to manage student stress is to look for ways you cut stress out of your life altogether. Evaluate the things that are bringing stress or anxiety into your life. Are they necessary? Are they providing more benefits than the toll they take on your mental health? If the answer is no, sometimes the best option is just to ditch them altogether.

This might mean cutting some extracurricular activities out of your schedule. It might mean limiting your use of social media. Or it might mean learning to say no to requests for your time, energy, and resources. 

While it might be challenging at first, learning how to prioritize yourself and your mental well-being is an important step toward reducing your stress.

Try Mindfulness

When you find yourself dealing with stress—whether it's due to academics, relationships, financial pressures, or social challenges—becoming more aware of how you feel in the moment may help you respond more effectively.

Mindfulness involves becoming more aware of the present moment. Rather than judging, reacting, or avoiding problems, the goal is to focus on the present, become more aware of how you are feeling, observe your reactions, and accept these feelings without passing judgment on them.

Research suggests that mindfulness-based stress management practices can be a useful tool for reducing student stress. Such strategies may also help reduce feelings of anxiety and depression.

A Word From Verywell

It is important to remember that stress isn't the same for everyone. Figuring out what works for you may take some trial and error. A good start is to ensure that you are taking care of yourself physically and emotionally and to experiment with different stress relief strategies to figure out what works best to help you feel less stressed.

If stress and anxiety are causing distress or making it difficult to function in your daily life, it is important to seek help. Many schools offer resources that can help, including face-to-face and online mental health services. You might start by talking to your school counselor or student advisor about the stress you are coping with. You can also talk to a parent, another trusted adult, or your doctor.

If you or a loved one are struggling with anxiety, contact the  Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline  at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our  National Helpline Database .

American Psychological Association. Stress in America: Are Teens Adopting Adults' Stress Habits?

Leonard NR, Gwadz MV, Ritchie A, et al. A multi-method exploratory study of stress, coping, and substance use among high school youth in private schools . Front Psychol. 2015;6:1028. doi:10.3389/fpsyg.2015.01028

Acharya L, Jin L, Collins W. College life is stressful today - Emerging stressors and depressive symptoms in college students . J Am Coll Health . 2018;66(7):655-664. doi:10.1080/07448481.2018.1451869

Beiter R, Nash R, McCrady M, Rhoades D, Linscomb M, Clarahan M, Sammut S. The prevalence and correlates of depression, anxiety, and stress in a sample of college students . J Affect Disord . 2015;173:90-6. doi:10.1016/j.jad.2014.10.054

Hershner SD, Chervin RD. Causes and consequences of sleepiness among college students . Nat Sci Sleep . 2014;6:73-84. doi:10.2147/NSS.S62907

Gordon JS, Sbarra D, Armin J, Pace TWW, Gniady C, Barraza Y. Use of a guided imagery mobile app (See Me Serene) to reduce COVID-19-related stress: Pilot feasibility study . JMIR Form Res . 2021;5(10):e32353. doi:10.2196/32353

Cowley J, Kiely J, Collins D. Is there a link between self-perceived stress and physical activity levels in Scottish adolescents ? Int J Adolesc Med Health . 2017;31(1). doi:10.1515/ijamh-2016-0104

Paulus MP.  The breathing conundrum-interoceptive sensitivity and anxiety .  Depress Anxiety . 2013;30(4):315–320. doi:10.1002/da.22076

Toussaint L, Nguyen QA, Roettger C, Dixon K, Offenbächer M, Kohls N, Hirsch J, Sirois F. Effectiveness of progressive muscle relaxation, deep breathing, and guided imagery in promoting psychological and physiological states of relaxation . Evid Based Complement Alternat Med . 2021;2021:5924040. doi:10.1155/2021/5924040.

Gold BP, Frank MJ, Bogert B, Brattico E.  Pleasurable music affects reinforcement learning according to the listener .  Front Psychol . 2013;4:541. doi:10.3389/fpsyg.2013.00541

Thoma MV, La Marca R, Brönnimann R, Finkel L, Ehlert U, Nater UM.  The effect of music on the human stress response .  PLoS ONE . 2013;8(8):e70156. doi:10.1371/journal.pone.0070156

American Psychological Association. Manage stress: Strengthen your support network .

Nguyen-rodriguez ST, Unger JB, Spruijt-metz D.  Psychological determinants of emotional eating in adolescence.   Eat Disord . 2009;17(3):211-24. doi:10.1080/10640260902848543

Parsons D, Gardner P, Parry S, Smart S. Mindfulness-based approaches for managing stress, anxiety and depression for health students in tertiary education: A scoping review . Mindfulness (N Y) . 2022;13(1):1-16. doi:10.1007/s12671-021-01740-3

By Elizabeth Scott, PhD Elizabeth Scott, PhD is an author, workshop leader, educator, and award-winning blogger on stress management, positive psychology, relationships, and emotional wellbeing.

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Stress in College Students: How To Cope

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A college student's guide to stress.

College is an exciting time, full of new challenges that continually drive you to expand your horizons. While some of these experiences can be thrilling, others may simply leave you feeling stressed. In fact, many college students feel stress while going to school. Only 1.6 percent of undergraduates reported that they felt no stress in the last 12 months, according to the National College Health Assessment (NCHA).

Being able to manage stress is crucial for your academic success and personal well-being in college. Luckily, this guide from Western Governors University will provide you with information about how to recognize different kinds of stress, various sources of stress for college students, as well as tips for coping in a healthy way. If you are able to identify and understand stress, you will be able to ensure your time as a student is rewarding and enjoyable.

What is stress?

Stress is a normal and necessary part of life. It is your fight-or-flight response to challenges you see in the world. This natural reaction has certain physical effects on the body to allow you to better handle these challenges, such as increased heart rate and blood circulation. While it can manifest differently for each individual, the National Institute of Mental Health notes that everyone feels stress at some point in their lives, regardless of age, gender, or circumstance.

Though it is a universal human experience, the American Institute of Stress (AIS) notes that defining and measuring stress is difficult because “there has been no definition of stress that everyone accepts” and “people have very different ideas with respect to their definition of stress.” They also state that a definition of stress is incomplete without mention of good stress (called eustress), its physical effects, or the body’s instinctive fight-or-flight response.

Researcher Andrew Baum , however, created a succinct, unique definition. He determines that stress is any “emotional experience accompanied by predictable biochemical, physiological and behavioral changes.” For the purposes of this guide, we will use Baum’s definition of stress.

Acute stress.

According to the American Psychological Association (APA), acute stress is the most common type of stress that every person will experience during the course of their life. It arises quickly in response to unexpected or alarming events to help you better handle the situation at hand. Typically, it fades quickly, either on its own or once the stressful event is over.

Acute stress doesn’t often lead to serious health problems. In certain situations, it can actually be a positive experience; for example, riding a roller coaster can cause acute stress, but in a thrilling way.

This type of stress occurs frequently and is easy to identify. Some signs of acute stress include:

Stomach pain, such as heartburn, diarrhea, or acid stomach.

Heightened blood pressure and heartbeat.

Shortness of breath or chest pain.

Headaches, back pain, jaw pain.

Because it is so common and lasts for a short amount of time, acute stress is usually simple to manage and treat.

Episodic stress.

When acute stress occurs frequently, it is classified as episodic or episodic acute stress. People who suffer from episodic stress are almost always in “crisis mode,” are often irritable and anxious, and may be prone to constant worrying. Essentially, people with episodic stress are often overwhelmed by it and have difficulty managing it.

Symptoms of episodic stress are the same as acute stress, but they can be more extreme or occur constantly. Some signs of long-term episodic stress according to the APA are:

Constant headaches or migraines.

Hypertension.

Heart disease.

People who suffer from episodic stress typically accept this kind of stress as a normal part of life and may not be aware of how detrimental its effects can be. The APA notes that it may be difficult for sufferers of episodic stress to get treatment because they are so used to feeling its effects and accept them as normal.

Chronic stress.

Chronic stress is a form of stress that occurs over a long period of time and that can have serious effects on your physical and mental health . Unlike acute stress, which can be exciting, chronic stress is dull, constant, and seemingly never-ending. It often arises in response to situations that feel hopeless and beyond your control, such as a troubled marriage, a toxic job, or poverty.

Chronic stress is, perhaps, the most dangerous type. This is the kind of stress that can lead to complicated, permanent health problems, such as heart attack, stroke, and suicide. Unfortunately, recognizing that you are experiencing this kind of stress is difficult because most sufferers are used to feeling this way. You may have grown comfortable living this way. Treating chronic stress can be challenging, and almost always necessitates the help of a professional to make long-term progress in recovery.

Signs and symptoms of stress.

Stress isn’t just a physical reaction; it can also affect your emotions, behavior, and cognition. Just as everyone is stressed by different things, everyone experiences its effects in different ways.

Certain signs of stress can be confused with other ailments. Be sure to understand how it affects you so you can correctly identify when you are experiencing stress. Some of the most common signs and symptoms include:

Keep in mind that these are just a few of the many signs of stress; the AIS identifies fifty of them, and notes that there may even be more effects that we haven’t been able to recognize yet.

Understanding stress.

Whether you attend college online or in-person, you will most likely face new stressors during your time at school. As you begin to notice how you and your body react to it, you may come to recognize symptoms that only appear in certain situations. Understanding the type of stress you are experiencing when you encounter these challenges can help you overcome them without feeling drained.

Dr. Karl Albrecht, a social scientist and management consultant, outlined four main varieties of stress: time, anticipatory, situational, and encounter. While these different types can be experienced in many different situations, from the workplace to the home, they are especially relevant to the life of a student.

Time stress.

Time stress occurs when you feel worried about time, and more specifically, when you don’t have enough time to accomplish all necessary tasks. People often experience this when they fear they can’t meet their deadlines, or will be late to a meeting or appointment.

As a student, you may feel time stress in several different ways. You may worry about being late to your classes as you learn the geography of your campus or if you have to get home and log onto your computer for a lecture after running errands. You may also panic about the heft of your workload or the quality of your work for class, which can be a difficult adjustment, whether you’re attending college for the first time or returning after a break .

Anticipatory stress.

Anticipatory stress occurs when you feel anxious about the future. When some people experience anticipatory stress, they may be nervous about a particular upcoming event; for others, it may simply be a general sense of uncertainty about what’s to come.

You may feel this kind of stress in both a vague and concrete way during your studies. If you feel anxious about a forthcoming test, assignment, or presentation, you are experiencing a more concrete form of anticipatory stress. If you have a sense of dread or fear of uncertainty about your future in general, that is a more vague manifestation. Students may feel this kind of stress more frequently as they get nearer to graduation and are making decisions about their life after college.

Situational stress.

You experience situational stress when you are in an upsetting or alarming situation that you cannot control. Unlike time-related and anticipatory stress, this kind of stress happens suddenly and with little — if any — warning. In fact, you may not have anticipated the situation at all.

For students, this type of stress can arise in a number of different circumstances. It may come from something as minor as forgetting your words during a presentation, or as major as a phone call about a family emergency. This kind of stress can occur during a number of situations, from receiving a poor grade on an assignment, to arguing with a friend, to nearly hitting a car in front of you on the road.

Encounter stress.

Encounter stress results when you feel anxious about seeing certain people, either alone or in a group. You may not enjoy spending time with them or have difficulties communicating with them. Whatever the reason, there is something about this person or group that makes you anxious. Encounter stress can also occur if you have spent too much time with others and feel burnt out, even if you like being around them.

Students may feel encounter stress in situations ranging from intimidating professors to unfamiliar classmates. Further, you might only experience this feeling with a person for a limited amount of time. For example, you might dread seeing your roommate for the first time after an argument, but the stress may disappear after you resolve the issue.

Causes of stress in college.

Though everyone experiences it differently and has their own distinct stressors, researchers have found that many college students share several common sources of stress. Whether you major in business or education , you likely share at least one common stressor with your peers. From worries about your health to concerns about your life after graduation, here are some of the most common causes of stress in college students:

In a survey conducted by the APA, 63 percent of adults cite “health-related concerns” as their number one source of stress. For college students, in particular, worries about or issues with health might be a major stressor because of how it can impact academic performance. The NCHA reported that the academic performance of nearly 30 percent of students was impacted by a physical ailment, ranging from allergies to bronchitis.

Regardless if the cause is a simple cold, mental health condition , or chronic illness, one thing remains the same: when you’re sick, it can be difficult to keep up with your studies. If you are contagious, you should avoid attending class (unless you are a distance learner or can sit in on the lecture at home), which means missing out on important information from your professor. Even if you aren’t contagious but are simply feeling under the weather, you may not have the energy to focus on the lectures and assignments.

If a particular illness is going around your campus or community, try your best to avoid contact with anyone who is contagious and wash your hands frequently. Everyone gets sick on occasion; accept that, despite your best efforts, you might too. If you do catch something, take care of yourself and rest as much as possible before resuming your normal activities.

Balancing work, school, and family life.

In college, you have to figure out the right balance between work, family, and school. The academic load in college is often larger and involves more complicated work than in high school. Attempting to keep up with that, on top of your job and family responsibilities, can add additional stress to your daily life — especially if your family and work obligations are so demanding that you fall behind with your schoolwork.

For non-traditional students , in particular, achieving that balance can be difficult. While traditional students may be worried about missing another call from their parents, if you are a non-traditional student, you may have children of your own to take care of. You may have to focus your energy on financially supporting your family or caring for your sick children, instead of school.

These strategies can help you establish boundaries between the different areas of your life, in order to give each one the attention it needs. Keep in mind that it’s also important to be able to adapt to new concerns and demands. You may feel stressed to a greater extent if you feel like you can’t make necessary adjustments to your plans.

Class scheduling and credit load.

Scheduling your college classes may stress you out. Trying to sign up for the courses at times that work well for you, and making sure you’re taking all your necessary prerequisite classes, are just a couple of the many factors that you need to consider.

For some students, this may be the first time they have to create their own schedules. You may not know how many credits you should be taking, or what class times are best for your academic performance. You might get frustrated with yourself after a few weeks of classes if your schedule is not what you hoped it would be.

If your schedule is overwhelming, remember that it isn’t permanent. Your current classes will end, and you will have to build an entirely new schedule in a few short weeks or months. Use that  opportunity to make a schedule  that’s better suited to fit your needs.

Costs of colleges/finances.

Over the past few decades, the cost of college tuition at traditional schools has risen notably. Combined with other expenses — like the cost of housing, food, and books — students may feel stress over their finances while they’re in school. Even if you qualify for aid, receive help from your family members, or work during the school year, you may still feel anxiety about money.

Students may feel further stress because of loans they have to pay off after graduation. The debt you acquire can be a burden before you complete school, because it can affect your finances for years after, as well as during, college.

Always keep in mind why you chose to pursue a degree in the first place, and remind yourself that it can lead to better job opportunities after you graduate. Experts still believe that, in the long-term,  college is worth the investment .

Grades and exams.

Academic performance is another stressor that you may encounter as a college student. You may feel pressure to get certain grades in your classes due to a number of factors, such as meeting the expectations of others, or your desire to go on to a master’s program. You may study frequently, but get so anxious about taking an exam , that you find yourself unable to do well (or in some cases, to even take the test).

Further, balancing your classes, family responsibilities, work schedule, and social life can be hard due to the increased workload and greater difficulty of college courses. In some classes, tests or projects also make up a large percentage of students’ grades.

Conquering school-related anxiety can be tricky, as you are constantly surrounded by your stressors and equally stressed classmates. However, you are at school to learn and grow, not to get straight A’s on your report card. Focus on getting your education instead of on getting certain grades.

Preparing for post-graduation life.

For many students — traditional ones in particular — being in school is comfortable. The prospect of life after college can be daunting simply because it is unknown and unfamiliar. For even the most well-prepared student, the unpredictability of life outside of school can be anxiety-inducing.

Your stress may be amplified if it seems like all of your friends and peers already have a post-graduation plan that they seem confident about. You might feel anxious if you don’t have any idea what you want to do; on the other hand, you may question decisions you’ve already made about your future.

The uncertainty of the future can be difficult to handle, but you aren’t alone. Don’t hesitate to reach out to your friends, family, professors, or advisors for help and advice as you start to think about what you want to do after graduation.

Relationships.

Your relationships with friends, family members, and significant other can change after you start college. School may be a bigger priority than ever before, and as you navigate the challenges associated with that, you may have less energy to give to your loved ones. Feeling like you aren’t as close to your support system, in addition to dealing with the pressures of school, can create tension in your life.

Make an effort to only befriend people whose company you enjoy. Your time at college is too short to spend interacting with people who you don’t get along with. Whether you are working in a group project online, or engaging in a class discussion via chat, you have the opportunity to be selective about who you give extra energy to. You can make lifelong friends in college, so try your best to only invest your time and attention into the relationships that matter to you.

Managing stress as a student.

There are many ways you can manage your stress as a college student. Just as everyone experiences stress in their own way, we all have our preferred methods of coping with it. However, not all stress management strategies are healthy, and some may leave you feeling even worse than you did before.

To overcome stress while going to school, it’s crucial to learn how to cope with it productively. After all, you can’t control the stressors in your life, but you can choose how to respond to them.

Unhealthy ways to manage stress.

Healthy ways to manage stress..

In college, stress is inevitable, but it doesn’t have to dominate your life. Do your best to understand what kind of stress you’re feeling, what’s causing it, and how you can respond to it productively. By addressing your stress in a healthy way, you are doing all that you can to make the most of your college education.

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ORIGINAL RESEARCH article

Academic stress and mental well-being in college students: correlations, affected groups, and covid-19.

• 1 Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, United States
• 2 Rutgers New Jersey Medical School, Newark, NJ, United States
• 3 Office for Diversity and Community Engagement, Rutgers New Jersey Medical School, Newark, NJ, United States
• 4 Department of Biology, The College of New Jersey, Ewing, NJ, United States

Academic stress may be the single most dominant stress factor that affects the mental well-being of college students. Some groups of students may experience more stress than others, and the coronavirus disease 19 (COVID-19) pandemic could further complicate the stress response. We surveyed 843 college students and evaluated whether academic stress levels affected their mental health, and if so, whether there were specific vulnerable groups by gender, race/ethnicity, year of study, and reaction to the pandemic. Using a combination of scores from the Perception of Academic Stress Scale (PAS) and the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), we found a significant correlation between worse academic stress and poor mental well-being in all the students, who also reported an exacerbation of stress in response to the pandemic. In addition, SWEMWBS scores revealed the lowest mental health and highest academic stress in non-binary individuals, and the opposite trend was observed for both the measures in men. Furthermore, women and non-binary students reported higher academic stress than men, as indicated by PAS scores. The same pattern held as a reaction to COVID-19-related stress. PAS scores and responses to the pandemic varied by the year of study, but no obvious patterns emerged. These results indicate that academic stress in college is significantly correlated to psychological well-being in the students who responded to this survey. In addition, some groups of college students are more affected by stress than others, and additional resources and support should be provided to them.

Introduction

Late adolescence and emerging adulthood are transitional periods marked by major physiological and psychological changes, including elevated stress ( Hogan and Astone, 1986 ; Arnett, 2000 ; Shanahan, 2000 ; Spear, 2000 ; Scales et al., 2015 ; Romeo et al., 2016 ; Barbayannis et al., 2017 ; Chiang et al., 2019 ; Lally and Valentine-French, 2019 ; Matud et al., 2020 ). This pattern is particularly true for college students. According to a 2015 American College Health Association-National College Health Assessment survey, three in four college students self-reported feeling stressed, while one in five college students reported stress-related suicidal ideation ( Liu, C. H., et al., 2019 ; American Psychological Association, 2020 ). Studies show that a stressor experienced in college may serve as a predictor of mental health diagnoses ( Pedrelli et al., 2015 ; Liu, C. H., et al., 2019 ; Karyotaki et al., 2020 ). Indeed, many mental health disorders, including depression, anxiety, and substance abuse disorder, begin during this period ( Blanco et al., 2008 ; Pedrelli et al., 2015 ; Saleh et al., 2017 ; Reddy et al., 2018 ; Liu, C. H., et al., 2019 ).

Stress experienced by college students is multi-factorial and can be attributed to a variety of contributing factors ( Reddy et al., 2018 ; Karyotaki et al., 2020 ). A growing body of evidence suggests that academic-related stress plays a significant role in college ( Misra and McKean, 2000 ; Dusselier et al., 2005 ; Elias et al., 2011 ; Bedewy and Gabriel, 2015 ; Hj Ramli et al., 2018 ; Reddy et al., 2018 ; Pascoe et al., 2020 ). For instance, as many as 87% of college students surveyed across the United States cited education as their primary source of stress ( American Psychological Association, 2020 ). College students are exposed to novel academic stressors, such as an extensive academic course load, substantial studying, time management, classroom competition, financial concerns, familial pressures, and adapting to a new environment ( Misra and Castillo, 2004 ; Byrd and McKinney, 2012 ; Ekpenyong et al., 2013 ; Bedewy and Gabriel, 2015 ; Ketchen Lipson et al., 2015 ; Pedrelli et al., 2015 ; Reddy et al., 2018 ; Liu, C. H., et al., 2019 ; Freire et al., 2020 ; Karyotaki et al., 2020 ). Academic stress can reduce motivation, hinder academic achievement, and lead to increased college dropout rates ( Pascoe et al., 2020 ).

Academic stress has also been shown to negatively impact mental health in students ( Li and Lin, 2003 ; Eisenberg et al., 2009 ; Green et al., 2021 ). Mental, or psychological, well-being is one of the components of positive mental health, and it includes happiness, life satisfaction, stress management, and psychological functioning ( Ryan and Deci, 2001 ; Tennant et al., 2007 ; Galderisi et al., 2015 ; Trout and Alsandor, 2020 ; Defeyter et al., 2021 ; Green et al., 2021 ). Positive mental health is an understudied but important area that helps paint a more comprehensive picture of overall mental health ( Tennant et al., 2007 ; Margraf et al., 2020 ). Moreover, positive mental health has been shown to be predictive of both negative and positive mental health indicators over time ( Margraf et al., 2020 ). Further exploring the relationship between academic stress and mental well-being is important because poor mental well-being has been shown to affect academic performance in college ( Tennant et al., 2007 ; Eisenberg et al., 2009 ; Freire et al., 2016 ).

Perception of academic stress varies among different groups of college students ( Lee et al., 2021 ). For instance, female college students report experiencing increased stress than their male counterparts ( Misra et al., 2000 ; Eisenberg et al., 2007 ; Evans et al., 2018 ; Lee et al., 2021 ). Male and female students also respond differently to stressors ( Misra et al., 2000 ; Verma et al., 2011 ). Moreover, compared to their cisgender peers, non-binary students report increased stressors and mental health issues ( Budge et al., 2020 ). The academic year of study of the college students has also been shown to impact academic stress levels ( Misra and McKean, 2000 ; Elias et al., 2011 ; Wyatt et al., 2017 ; Liu, C. H., et al., 2019 ; Defeyter et al., 2021 ). While several studies indicate that racial/ethnic minority groups of students, including Black/African American, Hispanic/Latino, and Asian American students, are more likely to experience anxiety, depression, and suicidality than their white peers ( Lesure-Lester and King, 2004 ; Lipson et al., 2018 ; Liu, C. H., et al., 2019 ; Kodish et al., 2022 ), these studies are limited and often report mixed or inconclusive findings ( Liu, C. H., et al., 2019 ; Kodish et al., 2022 ). Therefore, more studies should be conducted to address this gap in research to help identify subgroups that may be disproportionately impacted by academic stress and lower well-being.

The coronavirus disease 19 (COVID-19) pandemic is a major stressor that has led to a mental health crisis ( American Psychological Association, 2020 ; Dong and Bouey, 2020 ). For college students, the COVID-19 pandemic has resulted in significant changes and disruptions to daily life, elevated stress levels, and mental and physical health deterioration ( American Psychological Association, 2020 ; Husky et al., 2020 ; Patsali et al., 2020 ; Son et al., 2020 ; Clabaugh et al., 2021 ; Lee et al., 2021 ; Lopes and Nihei, 2021 ; Yang et al., 2021 ). While any college student is vulnerable to these stressors, these concerns are amplified for members of minority groups ( Salerno et al., 2020 ; Clabaugh et al., 2021 ; McQuaid et al., 2021 ; Prowse et al., 2021 ; Kodish et al., 2022 ). Identifying students at greatest risk provides opportunities to offer support, resources, and mental health services to specific subgroups.

The overall aim of this study was to assess academic stress and mental well-being in a sample of college students. Within this umbrella, we had several goals. First, to determine whether a relationship exists between the two constructs of perceived academic stress, measured by the Perception of Academic Stress Scale (PAS), and mental well-being, measured by the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), in college students. Second, to identify groups that could experience differential levels of academic stress and mental health. Third, to explore how the perception of the ongoing COVID-19 pandemic affected stress levels. We hypothesized that students who experienced more academic stress would have worse psychological well-being and that certain groups of students would be more impacted by academic- and COVID-19-related stress.

Materials and Methods

Survey instrument.

A survey was developed that included all questions from the Short Warwick-Edinburgh Mental Well-Being ( Tennant et al., 2007 ; Stewart-Brown and Janmohamed, 2008 ) and from the Perception of Academic Stress Scale ( Bedewy and Gabriel, 2015 ). The Short Warwick-Edinburgh Mental Well-Being Scale is a seven-item scale designed to measure mental well-being and positive mental health ( Tennant et al., 2007 ; Fung, 2019 ; Shah et al., 2021 ). The Perception of Academic Stress Scale is an 18-item scale designed to assess sources of academic stress perceived by individuals and measures three main academic stressors: academic expectations, workload and examinations, and academic self-perceptions of students ( Bedewy and Gabriel, 2015 ). These shorter scales were chosen to increase our response and study completion rates ( Kost and de Rosa, 2018 ). Both tools have been shown to be valid and reliable in college students with Likert scale responses ( Tennant et al., 2007 ; Bedewy and Gabriel, 2015 ; Ringdal et al., 2018 ; Fung, 2019 ; Koushede et al., 2019 ). Both the SWEMWBS and PAS scores are a summation of responses to the individual questions in the instruments. For the SWEMWBS questions, a higher score indicates better mental health, and scores range from 7 to 35. Similarly, the PAS questions are phrased such that a higher score indicates lower levels of stress, and scores range from 18 to 90. We augmented the survey with demographic questions (e.g., age, gender, and race/ethnicity) at the beginning of the survey and two yes/no questions and one Likert scale question about the impact of the COVID-19 pandemic at the end of our survey.

Participants for the study were self-reported college students between the ages of 18 and 30 years who resided in the United States, were fluent in English, and had Internet access. Participants were solicited through Prolific ( https://prolific.co ) in October 2021. A total of 1,023 individuals enrolled in the survey. Three individuals did not agree to participate after beginning the survey. Two were not fluent in English. Thirteen individuals indicated that they were not college students. Two were not in the 18–30 age range, and one was located outside of the United States. Of the remaining individuals, 906 were full-time students and 96 were part-time students. Given the skew of the data and potential differences in these populations, we removed the part-time students. Of the 906 full-time students, 58 indicated that they were in their fifth year of college or higher. We understand that not every student completes their undergraduate studies in 4 years, but we did not want to have a mixture of undergraduate and graduate students with no way to differentiate them. Finally, one individual reported their age as a non-number, and four individuals did not answer a question about their response to the COVID-19 pandemic. This yielded a final sample of 843 college students.

Data Analyses

After reviewing the dataset, some variables were removed from consideration due to a lack of consistency (e.g., some students reported annual income for themselves and others reported family income) or heterogeneity that prevented easy categorization (e.g., field of study). We settled on four variables of interest: gender, race/ethnicity, year in school, and response to the COVID-19 pandemic ( Table 1 ). Gender was coded as female, male, or non-binary. Race/ethnicity was coded as white or Caucasian; Black or African American; East Asian; Hispanic, Latino, or of Spanish origin; or other. Other was used for groups that were not well-represented in the sample and included individuals who identified themselves as Middle Eastern, Native American or Alaskan Native, and South Asian, as well as individuals who chose “other” or “prefer not to answer” on the survey. The year of study was coded as one through four, and COVID-19 stress was coded as two groups, no change/neutral response/reduced stress or increased stress.

Table 1 . Characteristics of the participants in the study.

Our first goal was to determine whether there was a relationship between self-reported academic stress and mental health, and we found a significant correlation (see Results section). Given the positive correlation, a multivariate analysis of variance (MANOVA) with a model testing the main effects of gender, race/ethnicity, and year of study was run in SPSS v 26.0. A factorial MANOVA would have been ideal, but our data were drawn from a convenience sample, which did not give equal representation to all groupings, and some combinations of gender, race/ethnicity, and year of study were poorly represented (e.g., a single individual). As such, we determined that it would be better to have a lack of interaction terms as a limitation to the study than to provide potentially spurious results. Finally, we used chi-square analyses to assess the effect of potential differences in the perception of the COVID-19 pandemic on stress levels in general among the groups in each category (gender, race/ethnicity, and year of study).

In terms of internal consistency, Cronbach's alpha was 0.82 for the SMEMWBS and 0.86 for the PAS. A variety of descriptors have been applied to Cronbach's alpha values. That said, 0.7 is often considered a threshold value in terms of acceptable internal consistency, and our values could be considered “high” or “good” ( Taber, 2018 ).

The participants in our study were primarily women (78.5% of respondents; Table 1 ). Participants were not equally distributed among races/ethnicities, with the majority of students selecting white or Caucasian (66.4% of responders; Table 1 ), or years of study, with fewer first-year students than other groups ( Table 1 ).

Students who reported higher academic stress also reported worse mental well-being in general, irrespective of age, gender, race/ethnicity, or year of study. PAS and SWEMWBS scores were significantly correlated ( r = 0.53, p < 0.001; Figure 1 ), indicating that a higher level of perceived academic stress is associated with worse mental well-being in college students within the United States.

Figure 1 . SWEMWBS and PAS scores for all participants.

Among the subgroups of students, women, non-binary students, and second-year students reported higher academic stress levels and worse mental well-being ( Table 2 ; Figures 2 – 4 ). In addition, the combined measures differed significantly between the groups in each category ( Table 2 ). However, as measured by partial eta squared, the effect sizes were relatively small, given the convention of 0.01 = small, 0.06 = medium, and 0.14 = large differences ( Lakens, 2013 ). As such, there were only two instances in which Tukey's post-hoc tests revealed more than one statistical grouping ( Figures 2 – 4 ). For SWEMWBS score by gender, women were intermediate between men (high) and non-binary individuals (low) and not significantly different from either group ( Figure 2 ). Second-year students had the lowest PAS scores for the year of study, and first-year students had the highest scores. Third- and fourth-year students were intermediate and not statistically different from the other two groups ( Figure 4 ). There were no pairwise differences in academic stress levels or mental well-being among racial/ethnic groups.

Table 2 . Results of the MANOVA.

Figure 2 . SWEMWBS and PAS scores according to gender (mean ± SEM). Different letters for SWEMWBS scores indicate different statistical groupings ( p < 0.05).

Figure 3 . SWEMWBS and PAS scores according to race/ethnicity (mean ± SEM).

Figure 4 . SWEMWBS and PAS scores according to year in college (mean ± SEM). Different letters for PAS scores indicate different statistical groupings ( p < 0.05).

The findings varied among categories in terms of stress responses due to the COVID-19 pandemic ( Table 3 ). For gender, men were less likely than women or non-binary individuals to report increased stress from COVID-19 (χ 2 = 27.98, df = 2, p < 0.001). All racial/ethnic groups responded similarly to the pandemic (χ 2 = 3.41, df = 4, p < 0.49). For the year of study, first-year students were less likely than other cohorts to report increased stress from COVID-19 (χ 2 = 9.38, df = 3, p < 0.03).

Table 3 . Impact of COVID-19 on stress level by gender, race/ethnicity, and year of study.

Our primary findings showed a positive correlation between perceived academic stress and mental well-being in United States college students, suggesting that academic stressors, including academic expectations, workload and grading, and students' academic self-perceptions, are equally important as psychological well-being. Overall, irrespective of gender, race/ethnicity, or year of study, students who reported higher academic stress levels experienced diminished mental well-being. The utilization of well-established scales and a large sample size are strengths of this study. Our results extend and contribute to the existing literature on stress by confirming findings from past studies that reported higher academic stress and lower psychological well-being in college students utilizing the same two scales ( Green et al., 2021 ; Syed, 2021 ). To our knowledge, the majority of other prior studies with similar findings examined different components of stress, studied negative mental health indicators, used different scales or methods, employed smaller sample sizes, or were conducted in different countries ( Li and Lin, 2003 ; American Psychological Association, 2020 ; Husky et al., 2020 ; Pascoe et al., 2020 ; Patsali et al., 2020 ; Clabaugh et al., 2021 ; Lee et al., 2021 ; Lopes and Nihei, 2021 ; Yang et al., 2021 ).

This study also demonstrated that college students are not uniformly impacted by academic stress or pandemic-related stress and that there are significant group-level differences in mental well-being. Specifically, non-binary individuals and second-year students were disproportionately impacted by academic stress. When considering the effects of gender, non-binary students, in comparison to gender-conforming students, reported the highest stress levels and worst psychological well-being. Although there is a paucity of research examining the impact of academic stress in non-binary college students, prior studies have indicated that non-binary adults face adverse mental health outcomes when compared to male and female-identifying individuals ( Thorne et al., 2018 ; Jones et al., 2019 ; Budge et al., 2020 ). Alarmingly, Lipson et al. (2019) found that gender non-conforming college students were two to four times more likely to experience mental health struggles than cisgender students ( Lipson et al., 2019 ). With a growing number of college students in the United States identifying as as non-binary, additional studies could offer invaluable insight into how academic stress affects this population ( Budge et al., 2020 ).

In addition, we found that second-year students reported the most academic-related distress and lowest psychological well-being relative to students in other years of study. We surmise this may be due to this group taking advanced courses, managing heavier academic workloads, and exploring different majors. Other studies support our findings and suggest higher stress levels could be attributed to increased studying and difficulties with time management, as well as having less well-established social support networks and coping mechanisms compared to upperclassmen ( Allen and Hiebert, 1991 ; Misra and McKean, 2000 ; Liu, X et al., 2019 ). Benefiting from their additional experience, upperclassmen may have developed more sophisticated studying skills, formed peer support groups, and identified approaches to better manage their academic stress ( Allen and Hiebert, 1991 ; Misra and McKean, 2000 ). Our findings suggest that colleges should consider offering tailored mental health resources, such as time management and study skill workshops, based on the year of study to improve students' stress levels and psychological well-being ( Liu, X et al., 2019 ).

Although this study reported no significant differences regarding race or ethnicity, this does not indicate that minority groups experienced less academic stress or better mental well-being ( Lee et al., 2021 ). Instead, our results may reflect the low sample size of non-white races/ethnicities, which may not have given enough statistical power to corroborate. In addition, since coping and resilience are important mediators of subjective stress experiences ( Freire et al., 2020 ), we speculate that the lower ratios of stress reported in non-white participants in our study (75 vs. 81) may be because they are more accustomed to adversity and thereby more resilient ( Brown, 2008 ; Acheampong et al., 2019 ). Furthermore, ethnic minority students may face stigma when reporting mental health struggles ( Liu, C. H., et al., 2019 ; Lee et al., 2021 ). For instance, studies showed that Black/African American, Hispanic/Latino, and Asian American students disclose fewer mental health issues than white students ( Liu, C. H., et al., 2019 ; Lee et al., 2021 ). Moreover, the ability to identify stressors and mental health problems may manifest differently culturally for some minority groups ( Huang and Zane, 2016 ; Liu, C. H., et al., 2019 ). Contrary to our findings, other studies cited racial disparities in academic stress levels and mental well-being of students. More specifically, Negga et al. (2007) concluded that African American college students were more susceptible to higher academic stress levels than their white classmates ( Negga et al., 2007 ). Another study reported that minority students experienced greater distress and worse mental health outcomes compared to non-minority students ( Smith et al., 2014 ). Since there may be racial disparities in access to mental health services at the college level, universities, professors, and counselors should offer additional resources to support these students while closely monitoring their psychological well-being ( Lipson et al., 2018 ; Liu, C. H., et al., 2019 ).

While the COVID-19 pandemic increased stress levels in all the students included in our study, women, non-binary students, and upperclassmen were disproportionately affected. An overwhelming body of evidence suggests that the majority of college students experienced increased stress levels and worsening mental health as a result of the pandemic ( Allen and Hiebert, 1991 ; American Psychological Association, 2020 ; Husky et al., 2020 ; Patsali et al., 2020 ; Son et al., 2020 ; Clabaugh et al., 2021 ; Lee et al., 2021 ; Yang et al., 2021 ). Our results also align with prior studies that found similar subgroups of students experience disproportionate pandemic-related distress ( Gao et al., 2020 ; Clabaugh et al., 2021 ; Hunt et al., 2021 ; Jarrett et al., 2021 ; Lee et al., 2021 ; Chen and Lucock, 2022 ). In particular, the differences between female students and their male peers may be the result of different psychological and physiological responses to stress reactivity, which in turn may contribute to different coping mechanisms to stress and the higher rates of stress-related disorders experienced by women ( Misra et al., 2000 ; Kajantie and Phillips, 2006 ; Verma et al., 2011 ; Gao et al., 2020 ; Graves et al., 2021 ). COVID-19 was a secondary consideration in our study and survey design, so the conclusions drawn here are necessarily limited.

The implications of this study are that college students facing increased stress and struggling with mental health issues should receive personalized and specific mental health services, resources, and support. This is particularly true for groups that have been disproportionately impacted by academic stress and stress due to the pandemic. Many students who experience mental health struggles underutilize college services due to cost, stigma, or lack of information ( Cage et al., 2020 ; Lee et al., 2021 ). To raise awareness and destigmatize mental health, colleges can consider distributing confidential validated assessments, such as the PAS and SWEMWBS, in class and teach students to self-score ( Lee et al., 2021 ). These results can be used to understand how academic stress and mental well-being change over time and allow for specific and targeted interventions for vulnerable groups. In addition, teaching students healthy stress management techniques has been shown to improve psychological well-being ( Alborzkouh et al., 2015 ). Moreover, adaptive coping strategies, including social and emotional support, have been found to improve the mental well-being of students, and stress-reduction peer support groups and workshops on campus could be beneficial in reducing stress and improving the self-efficacy of students ( Ruthig et al., 2009 ; Baqutayan, 2011 ; Bedewy and Gabriel, 2015 ; Freire et al., 2020 ; Green et al., 2021 ; Suresh et al., 2021 ). Other interventions that have been effective in improving the coping skills of college students include cognitive-behavioral therapy, mindfulness mediation, and online coping tools ( Kang et al., 2009 ; Regehr et al., 2013 ; Molla Jafar et al., 2015 ; Phang et al., 2015 ; Houston et al., 2017 ; Yusufov et al., 2019 ; Freire et al., 2020 ). Given that resilience has also been shown to help mediate stress and improve mental well-being during the COVID-19 pandemic, interventions focusing on enhancing resilience should be considered ( Surzykiewicz et al., 2021 ; Skalski et al., 2022 ). Telemental health resources across colleges can also be implemented to reduce stigma and improve at-risk students' access to care ( Toscos et al., 2018 ; Hadler et al., 2021 ). University campuses, professors, and counselors should consider focusing on fostering a more equitable and inclusive environment to encourage marginalized students to seek mental health support ( Budge et al., 2020 ).

Limitations

While our study has numerous strengths, including using standardized instruments and a large sample size, this study also has several limitations due to both the methodology and sample. First, the correlational study design precludes making any causal relationships ( Misra and McKean, 2000 ). Thereby, our findings should be taken in the context of academic stress and mental well-being, and recognize that mental health could be caused by other non-academic factors. Second, the PAS comprised only the perception of responses to academic stress, but stress is a multi-factorial response that encompasses both perceptions and coping mechanisms to different stressors, and the magnitude of stress varies with the perception of the degree of uncontrollability, unpredictability, or threat to self ( Miller, 1981 ; Hobfoll and Walfisch, 1984 ; Lazarus and Folkman, 1984 ; Wheaton, 1985 ; Perrewé and Zellars, 1999 ; Schneiderman et al., 2005 ; Bedewy and Gabriel, 2015 ; Schönfeld et al., 2016 ; Reddy et al., 2018 ; Freire et al., 2020 ; Karyotaki et al., 2020 ). Third, the SWEMSBS used in our study and the data only measured positive mental health. Mental health pathways are numerous and complex, and are composed of distinct and interdependent negative and positive indicators that should be considered together ( Margraf et al., 2020 ). Fourth, due to the small effect sizes and unequal representation for different combinations of variables, our analysis for both the PAS and SWEMSBS included only summed-up scales and did not examine group differences in response to the type of academic stressors or individual mental health questions.

An additional limitation is that the participants in our study were a convenience sample. The testing service we used, prolific.co, self-reports a sample bias toward young women of high levels of education (i.e., WEIRD bias) ( Team Prolific, 2018 ). The skew toward this population was observed in our data, as 80% of our participants were women. While we controlled for these factors, the possibility remains that the conclusions we draw for certain groups, such as nonbinary students, ethnic/racial minorities, and men, may not be as statistically powerful as they should be. Moreover, our pre-screening was designed to recruit undergraduate level, English-speaking, 18–30-year-olds who resided in the United States. This resulted in our participant demographics being skewed toward the WEIRD bias that was already inherent in the testing service we used. Future research will aim to be more inclusive of diverse races/ethnicities, sexual orientations, languages, educational backgrounds, socioeconomic backgrounds, and first-generation college students.

Another limitation of our study is the nature of satisficing. Satisficing is a response strategy in which a participant answers a question to satisfy its condition with little regard to the quality or accuracy of the answer ( Roberts et al., 2019 ). Anonymous participants are more likely to satisfice than respondents who answer the question face-to-face ( Krosnick et al., 2002 ). We sought to mitigate satisficing by offering financial incentives to increase response rates and decrease straight-lining, item skipping, total missing items, and non-completion ( Cole et al., 2015 ). Concerns of poor data quality due to surveys offering financial incentives found little evidence to support that claim and may do the opposite ( Cole et al., 2015 ). On the other hand, social desirability bias may have influenced the participant's self-reported responses, although our anonymous survey design aimed to reduce this bias ( Joinson, 1999 ; Kecojevic et al., 2020 ).

Future Studies

Future studies should replicate our study to validate our results, conduct longitudinal cohort studies to examine well-being and perceived academic stress over time, and aim for a more representative student sample that includes various groups, including diverse races/ethnicities, sexual orientations, socioeconomic backgrounds, languages, educational levels, and first-generation college students. Additionally, these studies should consider examining other non-academic stressors and students' coping mechanisms, both of which contribute to mental health and well-being ( Lazarus and Folkman, 1984 ; Freire et al., 2020 ). Further explorations of negative and other positive indicators of mental health may offer a broader perspective ( Margraf et al., 2020 ). Moreover, future research should consider extending our work by exploring group differences in relation to each factor in the PAS (i.e., academic expectations, workload and examinations, and self-perception of students) and SWEMBS to determine which aspects of academic stress and mental health were most affected and allow for the devising of targeted stress-reduction approaches. Ultimately, we hope our research spurs readers into advocating for greater academic support and access to group-specific mental health resources to reduce the stress levels of college students and improve their mental well-being.

Utilizing two well-established scales, our research found a statistically significant correlation between the perceived academic stress of university students and their mental well-being (i.e., the higher the stress, the worse the well-being). This relationship was most apparent among gender and grade levels. More specifically, non-binary and second-year students experienced greater academic burden and lower psychological well-being. Moreover, women, non-binary students, and upper-level students were disproportionately impacted by stress related to the COVID-19 pandemic.

Studies regarding broad concepts of stress and well-being using a questionnaire are limited, but our study adds value to the understanding of academic stress as a contributor to the overall well-being of college students during this specific point in time (i.e., the COVID-19 pandemic). Competition both for admission to college ( Bound et al., 2009 ) and during college ( Posselt and Lipson, 2016 ) has increased over time. Further, selective American colleges and universities draw applicants from a global pool. As such, it is important to document the dynamics of academic stress with renewed focus. We hope that our study sparks interest in both exploring and funding in-depth and well-designed psychological studies related to stress in colleges in the future.

Data Availability Statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics Statement

The studies involving human participants were reviewed and approved by Institutional Review Board at Rutgers University. The patients/participants provided their written informed consent to participate in this study.

Author Contributions

GB and MB contributed to conceptualization, study design, IRB application, manuscript drafting, and revision. XZ participated in the conceptualization and design of the questionnaires. HB participated in subject recruitment and questionnaire collection. KP contributed to data analysis, table and figure preparation, manuscript drafting, and revision. XM contributed to conceptualization, study design, IRB application, supervision of the project, manuscript drafting, and revision. All authors contributed to the article and approved the submitted version.

This study was made possible by a generous donation from the Knights of Columbus East Hanover Chapter in New Jersey.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Acknowledgments

The authors wish to thank Shivani Mehta and Varsha Garla for their assistance with the study. We also thank all the participants for their efforts in the completion of the study.

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Keywords: academic stress, well-being, college students, Perception of Academic Stress, Short Warwick-Edinburgh Mental Well-Being Scale, COVID-19

Citation: Barbayannis G, Bandari M, Zheng X, Baquerizo H, Pecor KW and Ming X (2022) Academic Stress and Mental Well-Being in College Students: Correlations, Affected Groups, and COVID-19. Front. Psychol. 13:886344. doi: 10.3389/fpsyg.2022.886344

Received: 28 February 2022; Accepted: 20 April 2022; Published: 23 May 2022.

Reviewed by:

Copyright © 2022 Barbayannis, Bandari, Zheng, Baquerizo, Pecor and Ming. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Keith W. Pecor, pecor@tcnj.edu

† These authors have contributed equally to this work and share first authorship

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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Understanding Academic Stress in College

How can you tell if your college stress is unhealthy, signs you may need professional support, get more academic stress tips.

Share this resource

If you’re like most college students, you experience school-related stress. Stress isn’t always a bad thing. At manageable levels, it’s necessary and healthy because it keeps you motivated and pushes you to stay on track with studying and classwork. 

But when stress, worry, and anxiety start to overwhelm you, it makes it harder to focus and get things done. National studies of college students have repeatedly found that the biggest stumbling blocks to academic success are emotional health challenges including:

• Not getting enough sleep
• Depression 

Many things can create stress in college. Maybe you’re on a scholarship and you need to maintain certain grades to stay eligible. Maybe you’re worried about the financial burden of college on your family. You may even be the first person in your family to attend college, and it can be a lot of pressure to carry the weight of those expectations.

Stress seems like it should be typical, so it’s easy to dismiss it. You may even get down on yourself because you feel like you should handle it better. But research shows that feeling overwhelming school-related stress actually reduces your motivation to do the work, impacts your overall academic achievement, and increases your odds of dropping out.

Stress can also cause health problems such as depression, poor sleep, substance abuse, and anxiety.

For all those reasons—and just because you deserve as much balance in your life as possible—it’s important to figure out if your stress is making things harder than they need to be, affecting your health, or getting in the way of your life.

Then you can get help and learn ways to reduce the impact of stress on your life. 

First identify what’s causing your stress.

• Is it a particular class or type of work?
• Is it an issue of time management and prioritization?
• Do you have too much on your plate?
• Is it due to family expectations or financial obligations?

Next think about how college stress affects you overall.

• Does it prevent you from sleeping?
• Does it make it take longer to do your work or paralyze you from even starting?
• Does it cause you to feel anxious, unwell, or depressed?

If any of that feels familiar, it’s time to find support to ease your stress and help you feel better. Check out these tips to figure out the best support and approach for you. 

It’s important to be able to recognize when stress starts to become all-encompassing, affecting your overall mental health and well-being. Here are some signs you might need to get help:

• Insomnia or chronic trouble sleeping
• Inability to motivate
• Anxiety that results in physical symptoms such as hair loss, nail biting, or losing weight
• Depression, which may manifest as not wanting to spend time with friends, making excuses, or sleeping excessively
• Mood swings, such as bursting into tears or bouts of anger

Learn how to find professional mental health support at your school or elsewhere. 

If you need help right now, text HOME to 741-741 for a free, confidential conversation with a trained counselor any time of day, or text or call 988 or use the chat function at 988lifeline.org .

If this is a medical emergency or there is immediate danger of harm, call 911 and explain that you need support for a mental health crisis.

Tips for Managing Academic Stress in College

How to Reduce Stress by Prioritizing and Getting Organized

5 Ways to Stay Calm When You’re Stressed About School

6 Ways to Take Care of Yourself During Exam Time

Related resources

How to identify and talk about your feelings, election stress: tips to manage anxious feelings about politics, understanding intimate partner violence, search resource center.

If you or someone you know needs to talk to someone right now, text, call, or chat  988 for a free confidential conversation with a trained counselor 24/7. 

You can also contact the Crisis Text Line by texting HOME to 741-741.

If this is a medical emergency or if there is immediate danger of harm, call 911 and explain that you need support for a mental health crisis.

Essay Sample on Causes and Effects of Stress on Students, With Outline

Published by gudwriter on January 4, 2021 January 4, 2021

Cause and Effects Essay Outline About Stress Among Students

Introduction.

Stress in students may have serious harmful effects and thus needs to be addressed.

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Paragraph 1:

One of the causes of stress in students is poor sleeping habits.

• Students who do not get enough sleep at night or lack healthy sleeping habits are likely to develop stress.
• Enough sleep allows the brain and body of a student to relax and recharge.
• Lack of it can limit a student’s ability to learn, concentrate and solve problems.

Paragraph 2:

Student stress is caused by academic pressure.

• They are given homework assignments.
• They have classroom assignments and term papers that are supposed to be completed and submitted in strict deadlines.
• Pressure to do well from those close to them such as family, friends, and teachers.

Paragraph 3:

Student stress may result from poor nutrition and unhealthy eating habits.

• Stress-inducing foods are those that have high refined carbohydrates, sugar, caffeine, and fat.
• A stress-reducing diet is made up of foods that are high in complex carbohydrates and fiber and low in fat content.

Paragraph 4: 

High stress levels could make students develop physical symptoms that could negatively affect their academic performance.

• When a student experiences these symptoms, they might not feel the motivation they once felt about doing their best on academic tasks.
• The symptoms are detrimental to the health of students.

Paragraph 5:

Stress makes students to have poor management skills.

• A student could become disorganized and uncertain about their priorities and goals.
• They become incapable of effectively budgeting and managing their time.
• They develop a tendency of procrastinating and neglecting responsibilities.

Paragraph 6:

Stress leads to self-defeating thoughts.

• A student under stress may consistently think about the adversity or negative situation in which they are.
• They could constantly focus on their weaknesses and failures.

Paragraph 7: 

There are various stress management strategies students may take to reduce stress.

• Get regular physical activity and practice.
• Spend quality time with friends and family, and keeping a sense of humor.
• Find time for such hobbies as listening to music, playing football, and reading a book.
• Get enough sleep and consume balanced diet.
• Stress in students cause serious negative effects, both physical and academic.
• It results from poor sleeping habits, academic pressure, and poor nutrition and unhealthy eating habits.
• It results into physical symptoms, poor management skills, and self-defeating thoughts.
• Parents and teachers should work together to ensure that students do not experience much stress.

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A Cause and Effect Essay on Stress in Students

Stress is the natural response the human body gives to challenges. Students are exposed to stress by various factors. When a student undergoes chronic stress or high stress levels, their ability to learn, memorize, and post good academic performances can be interfered with regardless of their age or grade. Stress can also make a student experience poor mental, emotional, and physical health. Teachers and parents may help students avoid chronic stress in their lives if they learn about and develop a good understanding of common stressors. Stress in students may have serious harmful effects and thus needs to be addressed.

One of the causes of stress in students is poor sleeping habits. Compared to students who get plenty of sleep, students who do not get enough sleep at night or lack healthy sleeping habits are likely to develop stress. Enough sleep allows the brain and body of a student to relax and recharge. It also helps in ensuring that the immune system remains strong. On the other hand, lack of enough sleep can limit a student’s ability to learn, concentrate, and solve problems and can also make them more aggressive. According to Hales and Hales (2016), it is recommended by the National Sleep Foundation that young people, especially students, should maintain a regular sleep schedule and that they should sleep for between 8.5 and 9.25 hours per night.

Another major cause of student stress is academic pressure. As teachers prepare students for standardized tests, they give them homework even if the students are as young as six only. In addition to these homework assignments, there are classroom assignments and term papers that are supposed to be completed and submitted in strict deadlines. The pressure that comes from these assignments coupled with the desire by students to succeed academically culminates into stress. Students also experience pressure to do well in their academic work from those close to them such as family, friends, and even teachers (Raju, 2009). They therefore feel so much pushed that they even resort to academic dishonesty such as cheating in exams so as to match these high expectations.

A student’s stress levels can also increase due to poor nutrition and unhealthy eating habits. Foods that are associated with high stress levels in students include those that have high refined carbohydrates, sugar, caffeine, and fat. This is the case with many types of fast, processed, and convenience foods. Examples of foods that induce stress include French fries, white bread, processed snack foods, candy bars, donuts, energy drinks, and sodas (Kumar, 2015). A healthy stress-reducing diet is made up of foods that are high in complex carbohydrates and fiber and low in fat content. Examples of such foods include lean proteins, nuts, whole grains, vegetables, and fruits.

It is noteworthy that high stress levels can make students develop physical symptoms that could negatively affect their academic performance. These signs and symptoms include chest pain, elevated blood pressure, stomach upset, mumbled or rapid speech, nervous habits such as fidgeting, back and neck pains, tremors and trembling of lips, and frequent headaches (Kumar, 2015). When a student experiences these symptoms, they might not feel the motivation they once felt about doing their best in such academic tasks as completing assignments or preparing for tests. Moreover, the symptoms are detrimental to the health of students, a factor which may father make their academic fortunes to dwindle.

Stress also makes students to have poor management skills. A student could become disorganized and uncertain about their priorities and goals as a result of suffering from high levels of stress. This could further make them incapable of effectively budgeting and managing their time. Moreover, highly stressed students have the tendency to procrastinate and neglect such important responsibilities as meeting deadlines and completing assignments (Hales & Hales, 2016). This, of course, negatively impacts the quality of their academic work and study skills.

High stress levels could further lead to self-defeating thoughts among students. While undergoing stress, it is likely that a student may consistently think about the adversity or negative situation in which they find themselves. In addition, they could constantly focus on their weaknesses and failures while ignoring their strengths and achievements. These are self-defeating thoughts that not only deal a blow to their self-esteem but also affect how they behave and how they feel both as humans and as students (Patel, 2016). They result into a student lacking confidence in their abilities and this negatively impacts their success in school since they cannot perform to their highest potential.

There are various stress management strategies students may take to reduce stress. One of these is to get regular physical activity and practice such relaxation techniques as massage, tai chi, yoga, meditation, and deep breathing. Students may also keep stress away by spending quality time with friends and family, and keeping a sense of humor. Another strategy may be to find time for such hobbies as listening to music, playing football, and reading a book. It is also important that one gets enough sleep and consumes balanced diet (Mayo Clinic Staff, 2019). These strategies may both alleviate and prevent stress among students.

Stress in students cause serious negative effects, both physical and academic. Students may experience stress due to poor sleeping habits, academic pressure, and poor nutrition and unhealthy eating habits. Students need enough sleep and less pressure for their brain to relax and recharge for it to function well. They also need to avoid stress-inducing foods such as fries and sodas. As has been seen, high stress levels could lead to physical symptoms, poor management skills, and self-defeating thoughts among students. As such, parents and teachers should work together in ensuring that students do not experience much stress because it is not good for their health and academic ability.

Hales, D., & Hales, J. (2016). Personal stress management: surviving to thriving . Boston, MA: Cengage Learning.

Kumar, N. (2015). Psychological stress among science students . New York, NY: Springer.

Mayo Clinic Staff. (2019). “Stress symptoms: effects on your body and behavior”. Mayo Clinic . Retrieved March 27, 2020 from https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress-symptoms/art-20050987

Patel, G. (2016). An achievement motivation and academic anxiety of school going students . Lunawada: Red’shine Publication. Inc.

Raju, M. V. (2009). Health psychology and counselling . Delhi, India: Discovery Publishing House.

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• Open access
• Published: 17 April 2024

Deciphering the influence: academic stress and its role in shaping learning approaches among nursing students: a cross-sectional study

• Rawhia Salah Dogham 1 ,
• Heba Fakieh Mansy Ali 1 ,
• Asmaa Saber Ghaly 3 ,
• Nermine M. Elcokany 2 ,
• Mohamed Mahmoud Seweid 4 &
• Ayman Mohamed El-Ashry   ORCID: orcid.org/0000-0001-7718-4942 5  

BMC Nursing volume  23 , Article number:  249 ( 2024 ) Cite this article

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Metrics details

Nursing education presents unique challenges, including high levels of academic stress and varied learning approaches among students. Understanding the relationship between academic stress and learning approaches is crucial for enhancing nursing education effectiveness and student well-being.

This study aimed to investigate the prevalence of academic stress and its correlation with learning approaches among nursing students.

Design and Method

A cross-sectional descriptive correlation research design was employed. A convenient sample of 1010 nursing students participated, completing socio-demographic data, the Perceived Stress Scale (PSS), and the Revised Study Process Questionnaire (R-SPQ-2 F).

Most nursing students experienced moderate academic stress (56.3%) and exhibited moderate levels of deep learning approaches (55.0%). Stress from a lack of professional knowledge and skills negatively correlates with deep learning approaches (r = -0.392) and positively correlates with surface learning approaches (r = 0.365). Female students showed higher deep learning approach scores, while male students exhibited higher surface learning approach scores. Age, gender, educational level, and academic stress significantly influenced learning approaches.

Academic stress significantly impacts learning approaches among nursing students. Strategies addressing stressors and promoting healthy learning approaches are essential for enhancing nursing education and student well-being.

Nursing implication

Understanding academic stress’s impact on nursing students’ learning approaches enables tailored interventions. Recognizing stressors informs strategies for promoting adaptive coping, fostering deep learning, and creating supportive environments. Integrating stress management, mentorship, and counseling enhances student well-being and nursing education quality.

Peer Review reports

Introduction

Nursing education is a demanding field that requires students to acquire extensive knowledge and skills to provide competent and compassionate care. Nursing education curriculum involves high-stress environments that can significantly impact students’ learning approaches and academic performance [ 1 , 2 ]. Numerous studies have investigated learning approaches in nursing education, highlighting the importance of identifying individual students’ preferred approaches. The most studied learning approaches include deep, surface, and strategic approaches. Deep learning approaches involve students actively seeking meaning, making connections, and critically analyzing information. Surface learning approaches focus on memorization and reproducing information without a more profound understanding. Strategic learning approaches aim to achieve high grades by adopting specific strategies, such as memorization techniques or time management skills [ 3 , 4 , 5 ].

Nursing education stands out due to its focus on practical training, where the blend of academic and clinical coursework becomes a significant stressor for students, despite academic stress being shared among all university students [ 6 , 7 , 8 ]. Consequently, nursing students are recognized as prone to high-stress levels. Stress is the physiological and psychological response that occurs when a biological control system identifies a deviation between the desired (target) state and the actual state of a fitness-critical variable, whether that discrepancy arises internally or externally to the human [ 9 ]. Stress levels can vary from objective threats to subjective appraisals, making it a highly personalized response to circumstances. Failure to manage these demands leads to stress imbalance [ 10 ].

Nursing students face three primary stressors during their education: academic, clinical, and personal/social stress. Academic stress is caused by the fear of failure in exams, assessments, and training, as well as workload concerns [ 11 ]. Clinical stress, on the other hand, arises from work-related difficulties such as coping with death, fear of failure, and interpersonal dynamics within the organization. Personal and social stressors are caused by an imbalance between home and school, financial hardships, and other factors. Throughout their education, nursing students have to deal with heavy workloads, time constraints, clinical placements, and high academic expectations. Multiple studies have shown that nursing students experience higher stress levels compared to students in other fields [ 12 , 13 , 14 ].

Research has examined the relationship between academic stress and coping strategies among nursing students, but no studies focus specifically on the learning approach and academic stress. However, existing literature suggests that students interested in nursing tend to experience lower levels of academic stress [ 7 ]. Therefore, interest in nursing can lead to deep learning approaches, which promote a comprehensive understanding of the subject matter, allowing students to feel more confident and less overwhelmed by coursework and exams. Conversely, students employing surface learning approaches may experience higher stress levels due to the reliance on memorization [ 3 ].

Understanding the interplay between academic stress and learning approaches among nursing students is essential for designing effective educational interventions. Nursing educators can foster deep learning approaches by incorporating active learning strategies, critical thinking exercises, and reflection activities into the curriculum [ 15 ]. Creating supportive learning environments encouraging collaboration, self-care, and stress management techniques can help alleviate academic stress. Additionally, providing mentorship and counselling services tailored to nursing students’ unique challenges can contribute to their overall well-being and academic success [ 16 , 17 , 18 ].

Despite the scarcity of research focusing on the link between academic stress and learning methods in nursing students, it’s crucial to identify the unique stressors they encounter. The intensity of these stressors can be connected to the learning strategies employed by these students. Academic stress and learning approach are intertwined aspects of the student experience. While academic stress can influence learning approaches, the choice of learning approach can also impact the level of academic stress experienced. By understanding this relationship and implementing strategies to promote healthy learning approaches and manage academic stress, educators and institutions can foster an environment conducive to deep learning and student well-being.

Hence, this study aims to investigate the correlation between academic stress and learning approaches experienced by nursing students.

Study objectives

Assess the levels of academic stress among nursing students.

Assess the learning approaches among nursing students.

Identify the relationship between academic stress and learning approach among nursing students.

Identify the effect of academic stress and related factors on learning approach and among nursing students.

Materials and methods

Research design.

A cross-sectional descriptive correlation research design adhering to the STROBE guidelines was used for this study.

A research project was conducted at Alexandria Nursing College, situated in Egypt. The college adheres to the national standards for nursing education and functions under the jurisdiction of the Egyptian Ministry of Higher Education. Alexandria Nursing College comprises nine specialized nursing departments that offer various nursing specializations. These departments include Nursing Administration, Community Health Nursing, Gerontological Nursing, Medical-Surgical Nursing, Critical Care Nursing, Pediatric Nursing, Obstetric and Gynecological Nursing, Nursing Education, and Psychiatric Nursing and Mental Health. The credit hour system is the fundamental basis of both undergraduate and graduate programs. This framework guarantees a thorough evaluation of academic outcomes by providing an organized structure for tracking academic progress and conducting analyses.

Participants and sample size calculation

The researchers used the Epi Info 7 program to calculate the sample size. The calculations were based on specific parameters such as a population size of 9886 students for the academic year 2022–2023, an expected frequency of 50%, a maximum margin of error of 5%, and a confidence coefficient of 99.9%. Based on these parameters, the program indicated that a minimum sample size of 976 students was required. As a result, the researchers recruited a convenient sample of 1010 nursing students from different academic levels during the 2022–2023 academic year [ 19 ]. This sample size was larger than the minimum required, which could help to increase the accuracy and reliability of the study results. Participation in the study required enrollment in a nursing program and voluntary agreement to take part. The exclusion criteria included individuals with mental illnesses based on their response and those who failed to complete the questionnaires.

socio-demographic data that include students’ age, sex, educational level, hours of sleep at night, hours spent studying, and GPA from the previous semester.

Tool two: the perceived stress scale (PSS)

It was initially created by Sheu et al. (1997) to gauge the level and nature of stress perceived by nursing students attending Taiwanese universities [ 20 ]. It comprises 29 items rated on a 5-point Likert scale, where (0 = never, 1 = rarely, 2 = sometimes, 3 = reasonably often, and 4 = very often), with a total score ranging from 0 to 116. The cut-off points of levels of perceived stress scale according to score percentage were low < 33.33%, moderate 33.33–66.66%, and high more than 66.66%. Higher scores indicate higher stress levels. The items are categorized into six subscales reflecting different sources of stress. The first subscale assesses “stress stemming from lack of professional knowledge and skills” and includes 3 items. The second subscale evaluates “stress from caring for patients” with 8 items. The third subscale measures “stress from assignments and workload” with 5 items. The fourth subscale focuses on “stress from interactions with teachers and nursing staff” with 6 items. The fifth subscale gauges “stress from the clinical environment” with 3 items. The sixth subscale addresses “stress from peers and daily life” with 4 items. El-Ashry et al. (2022) reported an excellent internal consistency reliability of 0.83 [ 21 ]. Two bilingual translators translated the English version of the scale into Arabic and then back-translated it into English by two other independent translators to verify its accuracy. The suitability of the translated version was confirmed through a confirmatory factor analysis (CFA), which yielded goodness-of-fit indices such as a comparative fit index (CFI) of 0.712, a Tucker-Lewis index (TLI) of 0.812, and a root mean square error of approximation (RMSEA) of 0.100.

Tool three: revised study process questionnaire (R-SPQ-2 F)

It was developed by Biggs et al. (2001). It examines deep and surface learning approaches using only 20 questions; each subscale contains 10 questions [ 22 ]. On a 5-point Likert scale ranging from 0 (never or only rarely true of me) to 4 (always or almost always accurate of me). The total score ranged from 0 to 80, with a higher score reflecting more deep or surface learning approaches. The cut-off points of levels of revised study process questionnaire according to score percentage were low < 33%, moderate 33–66%, and high more than 66%. Biggs et al. (2001) found that Cronbach alpha value was 0.73 for deep learning approach and 0.64 for the surface learning approach, which was considered acceptable. Two translators fluent in English and Arabic initially translated a scale from English to Arabic. To ensure the accuracy of the translation, they translated it back into English. The translated version’s appropriateness was evaluated using a confirmatory factor analysis (CFA). The CFA produced several goodness-of-fit indices, including a Comparative Fit Index (CFI) of 0.790, a Tucker-Lewis Index (TLI) of 0.912, and a Root Mean Square Error of Approximation (RMSEA) of 0.100. Comparative Fit Index (CFI) of 0.790, a Tucker-Lewis Index (TLI) of 0.912, and a Root Mean Square Error of Approximation (RMSEA) of 0.100.

Ethical considerations

The Alexandria University College of Nursing’s Research Ethics Committee provided ethical permission before the study’s implementation. Furthermore, pertinent authorities acquired ethical approval at participating nursing institutions. The vice deans of the participating institutions provided written informed consent attesting to institutional support and authority. By giving written informed consent, participants confirmed they were taking part voluntarily. Strict protocols were followed to protect participants’ privacy during the whole investigation. The obtained personal data was kept private and available only to the study team. Ensuring participants’ privacy and anonymity was of utmost importance.

Tools validity

The researchers created tool one after reviewing pertinent literature. Two bilingual translators independently translated the English version into Arabic to evaluate the applicability of the academic stress and learning approach tools for Arabic-speaking populations. To assure accuracy, two additional impartial translators back-translated the translation into English. They were also assessed by a five-person jury of professionals from the education and psychiatric nursing departments. The scales were found to have sufficiently evaluated the intended structures by the jury.

Pilot study

A preliminary investigation involved 100 nursing student applicants, distinct from the final sample, to gauge the efficacy, clarity, and potential obstacles in utilizing the research instruments. The pilot findings indicated that the instruments were accurate, comprehensible, and suitable for the target demographic. Additionally, Cronbach’s Alpha was utilized to further assess the instruments’ reliability, demonstrating internal solid consistency for both the learning approaches and academic stress tools, with values of 0.91 and 0.85, respectively.

Data collection

The researchers convened with each qualified student in a relaxed, unoccupied classroom in their respective college settings. Following a briefing on the study’s objectives, the students filled out the datasheet. The interviews typically lasted 15 to 20 min.

Data analysis

The data collected were analyzed using IBM SPSS software version 26.0. Following data entry, a thorough examination and verification were undertaken to ensure accuracy. The normality of quantitative data distributions was assessed using Kolmogorov-Smirnov tests. Cronbach’s Alpha was employed to evaluate the reliability and internal consistency of the study instruments. Descriptive statistics, including means (M), standard deviations (SD), and frequencies/percentages, were computed to summarize academic stress and learning approaches for categorical data. Student’s t-tests compared scores between two groups for normally distributed variables, while One-way ANOVA compared scores across more than two categories of a categorical variable. Pearson’s correlation coefficient determined the strength and direction of associations between customarily distributed quantitative variables. Hierarchical regression analysis identified the primary independent factors influencing learning approaches. Statistical significance was determined at the 5% (p < 0.05).

Table  1 presents socio-demographic data for a group of 1010 nursing students. The age distribution shows that 38.8% of the students were between 18 and 21 years old, 32.9% were between 21 and 24 years old, and 28.3% were between 24 and 28 years old, with an average age of approximately 22.79. Regarding gender, most of the students were female (77%), while 23% were male. The students were distributed across different educational years, a majority of 34.4% in the second year, followed by 29.4% in the fourth year. The students’ hours spent studying were found to be approximately two-thirds (67%) of the students who studied between 3 and 6 h. Similarly, sleep patterns differ among the students; more than three-quarters (77.3%) of students sleep between 5- to more than 7 h, and only 2.4% sleep less than 2 h per night. Finally, the student’s Grade Point Average (GPA) from the previous semester was also provided. 21% of the students had a GPA between 2 and 2.5, 40.9% had a GPA between 2.5 and 3, and 38.1% had a GPA between 3 and 3.5.

Figure  1 provides the learning approach level among nursing students. In terms of learning approach, most students (55.0%) exhibited a moderate level of deep learning approach, followed by 25.9% with a high level and 19.1% with a low level. The surface learning approach was more prevalent, with 47.8% of students showing a moderate level, 41.7% showing a low level, and only 10.5% exhibiting a high level.

Nursing students? levels of learning approach (N=1010)

Figure  2 provides the types of academic stress levels among nursing students. Among nursing students, various stressors significantly impact their academic experiences. Foremost among these stressors are the pressure and demands associated with academic assignments and workload, with 30.8% of students attributing their high stress levels to these factors. Challenges within the clinical environment are closely behind, contributing significantly to high stress levels among 25.7% of nursing students. Interactions with peers and daily life stressors also weigh heavily on students, ranking third among sources of high stress, with 21.5% of students citing this as a significant factor. Similarly, interaction with teachers and nursing staff closely follow, contributing to high-stress levels for 20.3% of nursing students. While still significant, stress from taking care of patients ranks slightly lower, with 16.7% of students reporting it as a significant factor contributing to their academic stress. At the lowest end of the ranking, but still notable, is stress from a perceived lack of professional knowledge and skills, with 15.9% of students experiencing high stress in this area.

Nursing students? levels of academic stress subtypes (N=1010)

Figure  3 provides the total levels of academic stress among nursing students. The majority of students experienced moderate academic stress (56.3%), followed by those experiencing low academic stress (29.9%), and a minority experienced high academic stress (13.8%).

Nursing students? levels of total academic stress (N=1010)

Table  2 displays the correlation between academic stress subscales and deep and surface learning approaches among 1010 nursing students. All stress subscales exhibited a negative correlation regarding the deep learning approach, indicating that the inclination toward deep learning decreases with increasing stress levels. The most significant negative correlation was observed with stress stemming from the lack of professional knowledge and skills (r=-0.392, p < 0.001), followed by stress from the clinical environment (r=-0.109, p = 0.001), stress from assignments and workload (r=-0.103, p = 0.001), stress from peers and daily life (r=-0.095, p = 0.002), and stress from patient care responsibilities (r=-0.093, p = 0.003). The weakest negative correlation was found with stress from interactions with teachers and nursing staff (r=-0.083, p = 0.009). Conversely, concerning the surface learning approach, all stress subscales displayed a positive correlation, indicating that heightened stress levels corresponded with an increased tendency toward superficial learning. The most substantial positive correlation was observed with stress related to the lack of professional knowledge and skills (r = 0.365, p < 0.001), followed by stress from patient care responsibilities (r = 0.334, p < 0.001), overall stress (r = 0.355, p < 0.001), stress from interactions with teachers and nursing staff (r = 0.262, p < 0.001), stress from assignments and workload (r = 0.262, p < 0.001), and stress from the clinical environment (r = 0.254, p < 0.001). The weakest positive correlation was noted with stress stemming from peers and daily life (r = 0.186, p < 0.001).

Table  3 outlines the association between the socio-demographic characteristics of nursing students and their deep and surface learning approaches. Concerning age, statistically significant differences were observed in deep and surface learning approaches (F = 3.661, p = 0.003 and F = 7.983, p < 0.001, respectively). Gender also demonstrated significant differences in deep and surface learning approaches (t = 3.290, p = 0.001 and t = 8.638, p < 0.001, respectively). Female students exhibited higher scores in the deep learning approach (31.59 ± 8.28) compared to male students (29.59 ± 7.73), while male students had higher scores in the surface learning approach (29.97 ± 7.36) compared to female students (24.90 ± 7.97). Educational level exhibited statistically significant differences in deep and surface learning approaches (F = 5.599, p = 0.001 and F = 17.284, p < 0.001, respectively). Both deep and surface learning approach scores increased with higher educational levels. The duration of study hours demonstrated significant differences only in the surface learning approach (F = 3.550, p = 0.014), with scores increasing as study hours increased. However, no significant difference was observed in the deep learning approach (F = 0.861, p = 0.461). Hours of sleep per night and GPA from the previous semester did not exhibit statistically significant differences in deep or surface learning approaches.

Table  4 presents a multivariate linear regression analysis examining the factors influencing the learning approach among 1110 nursing students. The deep learning approach was positively influenced by age, gender (being female), educational year level, and stress from teachers and nursing staff, as indicated by their positive coefficients and significant p-values (p < 0.05). However, it was negatively influenced by stress from a lack of professional knowledge and skills. The other factors do not significantly influence the deep learning approach. On the other hand, the surface learning approach was positively influenced by gender (being female), educational year level, stress from lack of professional knowledge and skills, stress from assignments and workload, and stress from taking care of patients, as indicated by their positive coefficients and significant p-values (p < 0.05). However, it was negatively influenced by gender (being male). The other factors do not significantly influence the surface learning approach. The adjusted R-squared values indicated that the variables in the model explain 17.8% of the variance in the deep learning approach and 25.5% in the surface learning approach. Both models were statistically significant (p < 0.001).

Nursing students’ academic stress and learning approaches are essential to planning for effective and efficient learning. Nursing education also aims to develop knowledgeable and competent students with problem-solving and critical-thinking skills.

The study’s findings highlight the significant presence of stress among nursing students, with a majority experiencing moderate to severe levels of academic stress. This aligns with previous research indicating that academic stress is prevalent among nursing students. For instance, Zheng et al. (2022) observed moderated stress levels in nursing students during clinical placements [ 23 ], while El-Ashry et al. (2022) found that nearly all first-year nursing students in Egypt experienced severe academic stress [ 21 ]. Conversely, Ali and El-Sherbini (2018) reported that over three-quarters of nursing students faced high academic stress. The complexity of the nursing program likely contributes to these stress levels [ 24 ].

The current study revealed that nursing students identified the highest sources of academic stress as workload from assignments and the stress of caring for patients. This aligns with Banu et al.‘s (2015) findings, where academic demands, assignments, examinations, high workload, and combining clinical work with patient interaction were cited as everyday stressors [ 25 ]. Additionally, Anaman-Torgbor et al. (2021) identified lectures, assignments, and examinations as predictors of academic stress through logistic regression analysis. These stressors may stem from nursing programs emphasizing the development of highly qualified graduates who acquire knowledge, values, and skills through classroom and clinical experiences [ 26 ].

The results regarding learning approaches indicate that most nursing students predominantly employed the deep learning approach. Despite acknowledging a surface learning approach among the participants in the present study, the prevalence of deep learning was higher. This inclination toward the deep learning approach is anticipated in nursing students due to their engagement with advanced courses, requiring retention, integration, and transfer of information at elevated levels. The deep learning approach correlates with a gratifying learning experience and contributes to higher academic achievements [ 3 ]. Moreover, the nursing program’s emphasis on active learning strategies fosters critical thinking, problem-solving, and decision-making skills. These findings align with Mahmoud et al.‘s (2019) study, reporting a significant presence (83.31%) of the deep learning approach among undergraduate nursing students at King Khalid University’s Faculty of Nursing [ 27 ]. Additionally, Mohamed &Morsi (2019) found that most nursing students at Benha University’s Faculty of Nursing embraced the deep learning approach (65.4%) compared to the surface learning approach [ 28 ].

The study observed a negative correlation between the deep learning approach and the overall mean stress score, contrasting with a positive correlation between surface learning approaches and overall stress levels. Elevated academic stress levels may diminish motivation and engagement in the learning process, potentially leading students to feel overwhelmed, disinterested, or burned out, prompting a shift toward a surface learning approach. This finding resonates with previous research indicating that nursing students who actively seek positive academic support strategies during academic stress have better prospects for success than those who do not [ 29 ]. Nebhinani et al. (2020) identified interface concerns and academic workload as significant stress-related factors. Notably, only an interest in nursing demonstrated a significant association with stress levels, with participants interested in nursing primarily employing adaptive coping strategies compared to non-interested students.

The current research reveals a statistically significant inverse relationship between different dimensions of academic stress and adopting the deep learning approach. The most substantial negative correlation was observed with stress arising from a lack of professional knowledge and skills, succeeded by stress associated with the clinical environment, assignments, and workload. Nursing students encounter diverse stressors, including delivering patient care, handling assignments and workloads, navigating challenging interactions with staff and faculty, perceived inadequacies in clinical proficiency, and facing examinations [ 30 ].

In the current study, the multivariate linear regression analysis reveals that various factors positively influence the deep learning approach, including age, female gender, educational year level, and stress from teachers and nursing staff. In contrast, stress from a lack of professional knowledge and skills exert a negative influence. Conversely, the surface learning approach is positively influenced by female gender, educational year level, stress from lack of professional knowledge and skills, stress from assignments and workload, and stress from taking care of patients, but negatively affected by male gender. The models explain 17.8% and 25.5% of the variance in the deep and surface learning approaches, respectively, and both are statistically significant. These findings underscore the intricate interplay of demographic and stress-related factors in shaping nursing students’ learning approaches. High workloads and patient care responsibilities may compel students to prioritize completing tasks over deep comprehension. This pressure could lead to a surface learning approach as students focus on meeting immediate demands rather than engaging deeply with course material. This observation aligns with the findings of Alsayed et al. (2021), who identified age, gender, and study year as significant factors influencing students’ learning approaches.

Deep learners often demonstrate better self-regulation skills, such as effective time management, goal setting, and seeking support when needed. These skills can help manage academic stress and maintain a balanced learning approach. These are supported by studies that studied the effect of coping strategies on stress levels [ 6 , 31 , 32 ]. On the contrary, Pacheco-Castillo et al. study (2021) found a strong significant relationship between academic stressors and students’ level of performance. That study also proved that the more academic stress a student faces, the lower their academic achievement.

Strengths and limitations of the study

This study has lots of advantages. It provides insightful information about the educational experiences of Egyptian nursing students, a demographic that has yet to receive much research. The study’s limited generalizability to other people or nations stems from its concentration on this particular group. This might be addressed in future studies by using a more varied sample. Another drawback is the dependence on self-reported metrics, which may contain biases and mistakes. Although the cross-sectional design offers a moment-in-time view of the problem, it cannot determine causation or evaluate changes over time. To address this, longitudinal research may be carried out.

Notwithstanding these drawbacks, the study substantially contributes to the expanding knowledge of academic stress and nursing students’ learning styles. Additional research is needed to determine teaching strategies that improve deep-learning approaches among nursing students. A qualitative study is required to analyze learning approaches and factors that may influence nursing students’ selection of learning approaches.

According to the present study’s findings, nursing students encounter considerable academic stress, primarily stemming from heavy assignments and workload, as well as interactions with teachers and nursing staff. Additionally, it was observed that students who experience lower levels of academic stress typically adopt a deep learning approach, whereas those facing higher stress levels tend to resort to a surface learning approach. Demographic factors such as age, gender, and educational level influence nursing students’ choice of learning approach. Specifically, female students are more inclined towards deep learning, whereas male students prefer surface learning. Moreover, deep and surface learning approach scores show an upward trend with increasing educational levels and study hours. Academic stress emerges as a significant determinant shaping the adoption of learning approaches among nursing students.

Implications in nursing practice

Nursing programs should consider integrating stress management techniques into their curriculum. Providing students with resources and skills to cope with academic stress can improve their well-being and academic performance. Educators can incorporate teaching strategies that promote deep learning approaches, such as problem-based learning, critical thinking exercises, and active learning methods. These approaches help students engage more deeply with course material and reduce reliance on surface learning techniques. Recognizing the gender differences in learning approaches, nursing programs can offer gender-specific support services and resources. For example, providing targeted workshops or counseling services that address male and female nursing students’ unique stressors and learning needs. Implementing mentorship programs and peer support groups can create a supportive environment where students can share experiences, seek advice, and receive encouragement from their peers and faculty members. Encouraging students to reflect on their learning processes and identify effective study strategies can help them develop metacognitive skills and become more self-directed learners. Faculty members can facilitate this process by incorporating reflective exercises into the curriculum. Nursing faculty and staff should receive training on recognizing signs of academic stress among students and providing appropriate support and resources. Additionally, professional development opportunities can help educators stay updated on evidence-based teaching strategies and practical interventions for addressing student stress.

Data availability

The datasets generated and/or analysed during the current study are not publicly available due to restrictions imposed by the institutional review board to protect participant confidentiality, but are available from the corresponding author on reasonable request.

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Acknowledgements

Our sincere thanks go to all the nursing students in the study. We also want to thank Dr/ Rasha Badry for their statistical analysis help and contribution to this study.

The research was not funded by public, commercial, or non-profit organizations.

Open access funding provided by The Science, Technology & Innovation Funding Authority (STDF) in cooperation with The Egyptian Knowledge Bank (EKB).

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Critical Care & Emergency Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt

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Obstetrics and Gynecology Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt

Asmaa Saber Ghaly

Faculty of Nursing, Beni-Suef University, Beni-Suef, Egypt

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Psychiatric and Mental Health Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt

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Ayman M. El-Ashry & Rawhia S. Dogham: conceptualization, preparation, and data collection; methodology; investigation; formal analysis; data analysis; writing-original draft; writing-manuscript; and editing. Heba F. Mansy Ali & Asmaa S. Ghaly: conceptualization, preparation, methodology, investigation, writing-original draft, writing-review, and editing. Nermine M. Elcokany & Mohamed M. Seweid: Methodology, investigation, formal analysis, data collection, writing-manuscript & editing. All authors reviewed the manuscript and accept for publication.

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Dogham, R.S., Ali, H.F.M., Ghaly, A.S. et al. Deciphering the influence: academic stress and its role in shaping learning approaches among nursing students: a cross-sectional study. BMC Nurs 23 , 249 (2024). https://doi.org/10.1186/s12912-024-01885-1

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Flexible learning showing promise preparing high school students for post-COVID, hybrid working world

Like most high school students her age, Sheridan Connelly struggles to balance the competing demands on her time.

The year 12 student plays weekend sport, works a part-time job, and lives on a rural property in the NSW Wollondilly region which means she travels up to an hour and a half to get to school.

"I was stressed about finding time to get all my homework done and then the extra work that you have to do in year 12," she said.

But she has found some reprieve in a new flexible program her school is trialling which allows her to do her school work at home on Mondays.

"I can spend that [time] either studying or catching up on sleep or just spending it in a way that works for me," she said.

"I think it's just a different way in which you can learn to be an independent learner. You can go at your own pace."

Catholic private school Chevalier College has just finished its first term of flexible learning.

So far, more than 100 senior students have opted in to the trial which gives students greater flexibility in their timetables.

The new schedule is also working for Sheridan's mother Laura.

"We have had a very good experience and Sheridan has actually really blossomed, in a way," she said.

"Isn't it great to have kids leaving the school that can already hit the ground running and can actually embrace hybrid working, or hybrid studying?"

Students not 'spoon-fed'

When the school announced the change last year,  parents were worried their child's education would suffer and some even pulled their kids out of the school. 

"It's not a four day week," Sheridan said.

"On the Monday you still get allocated work that you have to do. There's still set work."

Chevalier College assistant principal Rebecca Graham said part of the challenge has been explaining the goals of the program.

"Schools like ours often have quite a big dropout rate once kids get to university," she said.

"[Students] have been spoon fed, and they haven't had to be self-directed."

The school has been conducting surveys of students to learn how they are adapting to the new schedule.

The positive responses have helped win over some of the sceptical parents.

"The first survey results when we sat down and had a look at it were actually far more positive than what we anticipated," Ms Graham said.

"It is not perfect at the moment, but we certainly know that the balance that kids are finding in the day is a positive one.

"[Parents'] big question is 'why? Why are we doing this?' And I think once our students and our parents understand the why, they have really come on board."

The flexibility has also given teachers like Louise Glase more time to help her students and plan lessons.

"I have been able to, on my Mondays, co-plan with colleagues. I have been able to have time to myself to actually do core business," Ms Glase said.

"I think it's exciting to be part of a possible solution, to actually see that there are potential ways for us to use our time in a better way."

Face-to-face schooling not yielding results

Remote learning is not a new concept for Australian school students who were forced off campus during COVID lockdowns.

Education expert from the University of Melbourne, Pasi Sahlberg, said since then only a few schools have kept that flexibility.

"I think, unfortunately, most schools probably are returning back to where we were before COVID when it comes to the flexibility and how the school is organised, and what it looks like," he said.

It is difficult to say how many schools in the country have adopted flexibility into their curriculum, Professor Sahlberg said, as the data is not collected.

Australian kids spend more time in the classroom than kids in any other OECD country, but there is growing evidence this does not lead to better results.

"The research evidence is very clear that the instruction time — in other words how long children spend in schools — has very little to do with the actual quality of the learning outcomes," Professor Sahlberg said.

Professor Sahlberg has compared instruction time in Australian schools to the performance of students on international tests and found a negative correlation.

"It is evidence that not only does more face-to-face schooling not improve educational outcomes for students, it also actively might make them worse," he said.

Chevalier College is currently conducting its own research project on the trial and will decide whether to adopt flexible learning permanently at the end of the year.

The NSW Department of Education has no plans to introduce a four-day school week in public schools.

"Individual NSW public schools have flexibility to vary their starting and finishing times, in consultation with parents and carers," a spokesperson said.

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Core misunderstandings of the college admissions process

A lot of students and families fundamentally misunderstand college admissions. Which, considering how nebulous the process can seem, is itself understandable—colleges certainly haven’t made this a straightforward process.

But I want to help you understand, based on many years of experience on both sides of the admissions process, how the applicant evaluation process really works.

TABLE OF CONTENTS

• College admissions as identification of future potential?

On the fundamental importance of reflective thinking

Cultivate your capacity to reflect, demonstrating future potential, factors considered in admissions, the heart of the admissions process, college admissions as identification of future potential.

In 2014, I was asked to present on a panel at an independent boarding school outside of Baltimore. Presenting on that panel with me was Calvin Wise , now Deputy Dean of Admissions at Johns Hopkins University, who quickly became one of my favorite people, and after the school asked me to join its counseling team, we consistently asked him back to speak, not only because he’s a stellar presenter, but because he framed the process of admissions in a way I always really loved: 

“Admissions is not an evaluation of past performance, but an identification of future potential.”

Reflecting on my experience in admissions, I believe this to be true. Before I shifted to the high school side from the admissions office, the question we focused on first and foremost when sitting in committee evaluating applicants was “can this student do the work and will they take initiative and make an impact?” not “what have they achieved?”  

Once a student’s potential to succeed and their initiative and impact had been established we could move on to the next conversation, which focused on whether or not they met institutional priorities . 

Those institutional priorities are out of your control in the application process—you cannot go back in time and become a star piccolo player or goalie instead of a pianist or striker.

But, as I firmly believe in focusing only on what you can control in this process, and not worrying about what you cannot, I think it’s critical that students focus on proving their potential through their applications.

Here’s how.

Reflection is a fundamental skill for personal growth and development. And I want to emphasize that I use “skill” here intentionally—this is not a talent. The ability to reflect is something developed through practice, and there are exercises you can use to intentionally cultivate it.

By critically examining past experiences and thinking through future initiatives, individuals gain insight into their strengths, weaknesses, and areas for improvement. They come to understand that “failure” is not something to fear. This introspective process fosters self-awareness, resilience, and a sense of purpose, all of which are invaluable qualities in the college admissions process and beyond.

Reflection is the core mechanism of growth.

A tale of two students

To illustrate the significance of reflective thinking, consider two students' internship experiences and their outcomes. To protect their anonymity, I’ll refer to them as Amelie and Beatriz.

Amelie took advantage of family connections to secure an internship at Under Armor.

Beatriz knew she wanted to run her own business one day, so she found a woman-owned business in her area where she would be the third employee.

When they were consulting with me, before their internships started, I asked them about details concerning their upcoming internships and their goals, plans, and desires:

Had no idea what her responsibilities would be—she hadn’t asked—she only cared about the name “Under Armor” 

Was really interested in finance—but when I asked if she would be working with someone in that department, she still didn’t know or care. She trusted the name to “look good” on the resume

Unpacked boxes all summer, learned nothing, didn’t reflect, and, because of that (most importantly for your understanding in this article), had nothing to talk about in essays or interviews for college or a job beyond

Investigated her internship beforehand by talking with the business owner and communicating what she wanted to learn and explore.

Learned an incredible amount about starting a business: taking out and paying off loans, balancing books, thinking through staffing, strategic marketing, how to get her brand into the right communities, etc., all of which she spent time synthesizing and reflecting on.

Her application sparkled with deep reflection on her setbacks and learning experiences working at the shop, and she’s already sold her first start-up just a few years out of undergrad. 

Key takeaway:

No college was going to care about the name “Under Armor”—they were going to care about how the experience shaped the student’s insight and understanding. 

Reflection plays a pivotal role in crafting a compelling college application narrative . By distilling key insights from past experiences, applicants can articulate a coherent and authentic story that resonates with admissions officers. This narrative not only highlights their achievements but also demonstrates their growth, resilience, and potential to contribute meaningfully to the academic community.

Again: Admissions is not an evaluation of past performance. It’s an identification of future potential.

In case you missed it above: again, reflection is a skill —people who are good at it practice it.

That said, some practice is (I’d hope this is obvious) more valuable than other kinds of practice.

To facilitate reflective thinking, we’ve developed and work with students on tools like the Iceberg Exercise. This exercise encourages students to delve beneath the surface of their experiences, exploring underlying motivations, values, and aspirations. By uncovering these deeper layers, students gain a more profound understanding of themselves and their potential contributions to the college community.

Why is this important?

Because reflection is fundamental to helping students uncover their unique narratives for college applications.

By examining their experiences through a critical lens, students can identify pivotal moments, challenges overcome, and lessons learned. These insights form the foundation of a compelling application narrative that showcases their individuality, resilience, and readiness for collegiate success.

Ultimately, reflection serves as a powerful indicator of that readiness. Applicants who demonstrate a capacity for self-awareness, adaptability, and growth are well-equipped to thrive in the collegiate environment.

A friend of CEG’s who used to work in admissions at Reed College puts it this way: when she was reading essays, one of the primary questions she was asking herself was “Has this student developed the capacity to reflect? Can they ask and explore ‘so what?’” 

By embracing reflective thinking, students not only enhance their chances of admission but also lay the groundwork for lifelong learning and personal fulfillment.

“Demonstrating” is the key word here—I know you have future potential. How do you help an AO see it?

Challenge yourself academically and personally

Challenging oneself academically and personally is instrumental in demonstrating future potential to admissions committees. Engaging in rigorous coursework , pursuing intellectual passions, and seeking out opportunities for growth signal a candidate's readiness to excel in college and beyond. 

Moreover, navigating personal challenges with resilience and determination underscores one's capacity for success in the face of adversity.

Seek growth opportunities

While academic rigor is undoubtedly important, it must be complemented by a proactive pursuit of growth opportunities. Simply achieving high grades is insufficient—applicants must demonstrate a genuine commitment to intellectual curiosity and self-improvement. 

Engaging in extracurricular activities, community service, research endeavors, or internships showcases a candidate's initiative and ambition. (And again, reflection is key to weaving these into an overarching application narrative.)

Adopt a growth mindset

Cultivating a growth mindset from a young age is paramount in fostering future potential. A growth mindset embraces challenges, learns from setbacks, and views failure as an opportunity for development rather than a deterrent. Students who approach their academic and personal endeavors with a growth mindset are better equipped to navigate the complexities of college life and capitalize on opportunities for learning and development.

Overview of the holistic approach to admissions

In the contemporary landscape of college admissions, the holistic approach has gained prominence. 

What is holistic admissions?

This approach acknowledges that an applicant's value extends beyond numerical metrics and encompasses a multifaceted evaluation of their academic, extracurricular, and personal attributes. Admissions committees seek to construct a diverse student body composed of individuals with varying backgrounds, interests, and potential contributions to the campus community.

Factors beyond grades: academic journey, challenges faced, and recommendations

Grades (and generally to a much lesser degree, and depending on the college’s policy , test scores) are one of the most important factors in admissions .

But at many colleges, especially highly selective colleges, they don’t really move the needle. For example, around 80% of Pomona ’s applicants are academically admissible —their grades and test scores just get their foot in the door.

Beyond those grades and test scores, admissions officers scrutinize the trajectory of an applicant's academic journey. They seek evidence of intellectual curiosity, resilience in the face of challenges, and a proactive approach to learning. Letters of recommendation provide valuable insights into an applicant's character, work ethic, and potential for success in college and beyond.

Assessing an applicant's potential to succeed in college

At the core of admissions deliberations lies the question of an applicant's potential to thrive in that college’s environment. This assessment encompasses not just academic aptitude but also interpersonal skills, adaptability, and a capacity for intellectual growth. 

Admissions officers aim to identify candidates who will make meaningful contributions to the academic community and leverage their experiences to enrich campus life.

This concept of future potential lies at the heart of the admissions process. By assessing applicants holistically and with an attempt at foresight, admissions committees aim to identify candidates who possess the drive, resilience, and intellectual curiosity to succeed in college and beyond.

So, again, control what you can control.

Work now to develop skills of reflection and to cultivate a growth mindset. Embrace challenges. Focus on insight and connections.

This is how students can present themselves as dynamic individuals poised for success. 

Regardless of the outcome, the journey of self-discovery and personal growth inherent in the application process is invaluable and sets the stage for future achievement.

Special thaks to Stephanie Metruk for writing this blog post

Stephanie has over 15 years of experience in enrollment management and college counseling. Her expertise spans national and international admissions, honors program selection, and prestigious scholarship coordination. With over eight years dedicated to admissions roles, Stephanie has meticulously reviewed applications for diverse institutions, offering invaluable guidance to students navigating their college searches.

As the former associate director for college counseling at a prestigious international boarding and day school near Baltimore, Stephanie empowered hundreds of students to confidently navigate the complexities of the college application process. Her dedication to excellence earned her recognition, including the PCACAC Counselor of the Year Award. Stephanie's mission is to empower families and students with the knowledge and transparency needed for informed decisions about their educational journeys. Through her work, she strives to ensure that families are not just happy, but truly fulfilled with their educational choices.

Anxiety and Depression Among College Students Essay

Education is expected to have appositive importance on the student’s life by enhancing their capability to think and improving their competency. However, it often acts as a source of stress that affects students’ mental health adversely. This causation of academic stress often emanates from the need to have high grades, the requirement to change attitude for success, and even pressures put by various school assignments. These pressures introduced by education can make the student undergo a series of anxiety, depression, and stress trying to conform to the forces. The causes of academic stress are well-researched but there is still no explanation why the rate of strain increases despite some measures being implemented to curb student stress. This research explores this niche by using 100 participants who study at my college.

Introduction

Nowadays there are many reasons that cause stress among growing number of students who might not know they are going through the condition most of the time. Hence, undiscovered discouragement or uneasiness can cause understudies to feel that they are continually passing up unique open doors. It prompts substance misuse; self-destruction is the second most typical reason for death among undergrads. The main hypothesis of this article is that college and university students have higher depression rates.

Problem Statement

This proposal undercovers how the problem of anxiety and depression is progressing if not addressed. With such countless youngsters experiencing undiscovered tension, it may be challenging for them to appreciate school. Understudies’ emotional well-being is risked when pressure and trouble go unnoticed, which can prompt social and educational issues (Nelson & Liebel, 2018). Educators might battle to perceive uneasiness since these circumstances manifest themselves contrastingly in different people.

Anxiety and depression are complicated disorders with numerous elements that impact people differently. Teachers and staff must be well trained to deal with these unforeseen events. Understudies coming to college come from various financial foundations, which can prompt an assortment of psychological wellness chances (Li et al., 2021). Additionally, current works will be evaluated to differentiate the risk factors associated with stress among university undergraduates worldwide.

There are various reasons which might cause the onset of anxiety and depression. It can be absence of rest, terrible dietary patterns, and lack of activity add to the gloom in undergrads (Ghrouz et al., 2019). Scholarly pressure, which incorporates monetary worries, strain to track down a decent profession after graduation, and bombed connections, is sufficient to drive a few understudies to exit school or more awful.

Numerous parts of school life add to despondency risk factors. For example, understudies today are owing debtors while having fewer work prospects than prior. Discouraged kids are bound to foster the problems like substance misuse (Lattie et al., 2019). For adaptation to close-to-home trouble, discouraged understudies are more inclined than their non-discouraged companions to knock back the firewater, drink pot, and participate in unsafe sexual practices.

Hypothesis on the Topic

The central hypothesis for this study is that college students have a higher rate of anxiety and depression. The study will integrate various methodologies to prove the hypothesis of nullifying it. High rates of anxiety and depression can lead to substance misuse, behavioral challenges, and suicide (Lipson et al., 2018). Anxiety is one of the most critical indicators of academic success, it shows how students’ attitudes change, reflecting on their overall performance.

Methods Section

Participants.

The study will use college students who are joining and those already in college. The research period is planned to last six months; college students are between the ages of 18 and 21 and life is changing rapidly at this age (Spillebout et al., 2019). This demography will come from the college where I study. The participants will be chosen randomly, the total number will be 100, both female and male, and from all races.

Apparatus/ Materials/ Instruments

Some of the materials to be used in the study will include pencils, papers, and tests. Paper and pencil are typical supplies that students are familiar with, so using them will not cause additional stress. It will be used during the interview with the students and throughout the study will be in effect (Huang et al., 2018). These have been applied in various studies before, and, hence, they will be instrumental in this study.

The study will follow a step-wise procedure to get the required results. First, the students’ pre-depression testing results would be researched and recorded. Second, the students would undergo standardized testing in the same groups. Scholarly accomplishment is impacted by past intellectual performance and standardized testing (Chang et al., 2020). Third, the students’ levels of depression and anxiety would be monitored along with their test results.

The study will use a descriptive, cross-sectional design with categorical and continuous data. The sample demographic characteristics were described using descriptive statistics. Pearson’s proportion of skewness values and common mistake of skewness was utilized to test the ordinariness of the persistent factors. The distinctions in mean scores between sociodemographic variables and stress will be examined using Tests (Lipson et al., 2018). The independent variable will be essential because it will provide the basis of measurement.

The 100 participants had different anxiety levels, as seen from the Test taken and the various evaluations. Forty-five of the participants had high levels, 23 had medium levels, while the remaining 32 had low levels (Lipson et al., 2018). The correlation and ANOVA, which had a degree of era margin of 0.05, were allowed (Lipson et al., 2018). This finding aligns intending to have clear and comprehensive outcomes.

Significance of the Study

If the results would be not significant, it means that students are not subjected to more pressure on average. If the study results in significant outcomes, this would mean that there is much that needs to be done to reduce student’s anxiety. The idea that scholarly accomplishment is indispensable to progress is built up in higher instructive conditions (Nelson & Liebel, 2018). Many colleges devote money to tutoring, extra instruction, and other support services to help students succeed.

APA Ethical Guidelines

The study will have to follow the APA ethical guidelines because it involves experimenting with humans. Some of the policies include having consent from the participant, debriefing the participant on the study’s nature, and getting IRB permission (Nelson & Liebel, 2018). Ethical guidelines should comply with proficient, institutional, and government rules. They habitually administer understudies whom they likewise instruct to give some examples of obligations.

Limitations

The study also had some limitations, making it hard to get the desired outcomes. It was not easy to detect the population-level connections, but not causality. This case hardened the aspect of confounding and getting the relevant random assignment needed for the study had to access (Nelson & Liebel, 2018). For the right individuals for the investigation to be identified, the sampling was not easy.

This study would be essential as it will create a platform for future studies. The result that was gotten shows that many college students are undergoing the problem of anxiety and depression without knowing that it is happening. Educators will have awareness on what aspects of academics they need to modify to ensure their students are not experiencing mental health challenges. Hence, it makes it possible for future researchers to conduct studies to provide possible solutions.

Chang, J., Yuan, Y., & Wang, D. (2020). Mental health status and its influencing factors among college students during the epidemic of COVID-19. Journal of Southern Medical University , 40(2), 171-176.

Ghrouz, A. K., Noohu, M. M., Manzar, D., Warren Spence, D., BaHammam, A. S., & Pandi-Perumal, S. R. (2019). Physical activity and sleep quality in relation to mental health among college students. Sleep and Breathing Journal , 23(2), 627-634.

Huang, J., Nigatu, Y. T., Smail-Crevier, R., Zhang, X., & Wang, J. (2018). Interventions for common mental health problems among university and college students: A systematic review and meta-analysis of randomized controlled trials. Journal of Psychiatric Research , 107, 1-10.

Lattie, E. G., Adkins, E. C., Winquist, N., Stiles-Shields, C., Wafford, Q. E., & Graham, A. K. (2019). Digital mental health interventions for depression, anxiety, and enhancement of psychological well-being among college students: A systematic review. Journal of Medical Internet Research , 21(7), e12869.

Li, Y., Zhao, J., Ma, Z., McReynolds, L. S., Lin, D., Chen, Z.,… & Liu, X. (2021). Mental health among college students during the COVID-19 pandemic in China: A 2-wave longitudinal survey. Journal of Affective Disorders , 281, 597-604.

Lipson, S. K., Kern, A., Eisenberg, D., & Breland-Noble, A. M. (2018). Mental health disparities among college students of color. Journal of Adolescent Health , 63(3), 348-356.

Nelson, J. M., & Liebel, S. W. (2018). Anxiety and depression among college students with attention-deficit/hyperactivity disorder (ADHD): Cross-informant, sex, and subtype differences. Journal of American College Health , 66(2), 123-132.

Spillebout, A., Dechelotte, P., Ladner, J., & Tavolacci, M. P. (2019). Mental health among university students with eating disorders and irritable bowel syndrome in France. Journal of Affective Disorders , 67(5), 295-301.

The following table shows the significant issues that affect the mental health state of most college students. Based on Huang et al.’s research, the biggest concern for most students included stress about their loved ones. Additionally, the authors found that worrying about one’s academics and schooling was the second depressing experience among most college students.

The following figure shows how on top of the current stressors for students, COVID-19 affects their mental health. Li et al.’s research demonstrates that COVID-19 placed more financial burden than before, especially on students with part-time jobs who often face anxiety and stress due to lack of tuition fees (Li et al., 2021). Generally, the research shows that the financial consequences of coronavirus affect the mental state of most college students.

• Chicago (A-D)
• Chicago (N-B)

IvyPanda. (2023, April 10). Anxiety and Depression Among College Students. https://ivypanda.com/essays/anxiety-and-depression-among-college-students/

"Anxiety and Depression Among College Students." IvyPanda , 10 Apr. 2023, ivypanda.com/essays/anxiety-and-depression-among-college-students/.

IvyPanda . (2023) 'Anxiety and Depression Among College Students'. 10 April.

IvyPanda . 2023. "Anxiety and Depression Among College Students." April 10, 2023. https://ivypanda.com/essays/anxiety-and-depression-among-college-students/.

1. IvyPanda . "Anxiety and Depression Among College Students." April 10, 2023. https://ivypanda.com/essays/anxiety-and-depression-among-college-students/.

Bibliography

IvyPanda . "Anxiety and Depression Among College Students." April 10, 2023. https://ivypanda.com/essays/anxiety-and-depression-among-college-students/.

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Protest in Boylston Place Alley

Dear Emersonians, 

Earlier this evening, Emerson College students from the nonaffiliated student organization Students for Justice in Palestine began protesting in the Boylston Place alley on our Boston campus. Boylston Place Alley is not solely owned by Emerson College, has a public right-of-way requirement to access non-Emerson buildings, including the State Transportation Center, and is a fire alley that is under the jurisdiction of the Boston Police Department. Emerson officials are on site and are working with the Boston Police Department to closely monitor the situation, ensure safe passage through the alley, maintain campus operations, and support all members of the Emerson community. 

The College strongly supports the right to express one’s beliefs through protest. This right comes with the responsibility of doing so without bigotry or hatred in any form. We encourage thoughtful dialogue and meaningful expression but will not tolerate actions threatening safety, operations, or educational access. Students who feel unsafe may request an escort from the Emerson College Police Department, and students may  share their concerns  or schedule an appointment with Student Care & Support. 

We will continue monitoring this situation closely and keep our community informed. 

Jay Bernhardt President

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OPINION: This week's end-of-the-semester hot takes

Samantha Camire: Online exams are such a waste of time. If you really want to test us over what we know, don’t prescribe/enforce online exams. Obviously everyone will just use the internet and work together to get as good a score as possible. You might as well just not have an exam at all.  

Ainsley Foster: I should not be required to attend every single presentation day to “critique” my peers’ performance. While I understand the effort that goes into making and rehearsing a presentation, I personally don't care whether my classmates are there to see it. And I certainly don't mind the smaller audience.  

Jack Davis: I’m going to miss school during summer break. Sure, the time off will feel nice, but I'm going to miss the friends I made during my freshman year. And it’ll also take some time to transition from the schedule I have during school to days of sleeping in till noon.  

Vincent Winkler: As an online student, I kind of feel out of the loop. When it comes to due dates, I really feel out of the loop. Professors need to stop/avoid copying and pasting a syllabus and also provide accurate due dates to help accommodate for students who can’t just pop into their professor’s office for clarification.  

Danny William: Professors who assign multiple final projects should be tried for cruel and unusual punishment. In one of my classes, I have a presentation, essay and exam. How does that make sense? How much comprehension do you need to assess?  

Joey Sills : Holding classes even when there’s nothing else to cover is such a waste of time. I understand test review is important and all that, and it should definitely be incorporated into the syllabus! But holding class every day of dead week while I’m also trying to juggle writing four or five essays on top of studying for my actual exams is making life harder for no reason. Hold more extensive office hours during dead week and allow me significantly more time to study and work on projects on my own.  

Erin Stafford: I typically enjoy the quiet chaos of dead week and finals week. While campus is still busy, everyone is generally silent and focused on preparing for exams and final papers. It’s a refreshing slow down after the craze of Little 500 weekend, and I love to bask in the individual togetherness we all feel at this tumultuous time.  

Isabella Vesperini : We should not need to learn more new material the week before finals. There’s already so much to study and go through; I don’t need more.  

Faith Badgley: There should not be a finals week. They should be spread out, or better yet, not exist. Having all your finals during the last week causes way too much stress and people probably do worse because they have all their other classes to worry about too. Something needs to change because having everything all at once is pointless.  

Caitlyn Kulczycki: Test-taking is so outdated. We need a better way of testing students on their knowledge because studying obsessively to memorize the information for a test all for the sake of a good grade isn’t proper learning.  

Advait Save : I need sleep! There should be a mandated and standardized sleep day after all exams and final projects. This day should be an official day of sleep where IU provides comfy blankets and extra cushiony pillows for their hard-working students to sleep for an entire day.  

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Mae Hampton Watt Presidential Scholarship in Psychology - Leadership and Service

About the scholarship.

The Mae Hampton Watt Presidential Scholarship in Psychology - Leadership and Service is open to undergraduate students enrolled in the Department of Psychology at Florida State University. Students who can submit an essay about their relevant leadership and service are encouraged to apply.

• Essay Required : Yes
• Need-Based : No
• Merit-Based : No
• Resident of the U.S.
• Attending Florida State University
• Undergraduate student
• Seeking a bachelor's degree
• Studying psychology
• Participation in leadership
• Country : US