Year of Publication

2011

Degree Name

Doctor of Philosophy (PhD)

Document Type

Dissertation

College

Nursing

Department

Nursing

First Advisor

Dr. Ruth “Topsy” Staten

Second Advisor

Dr. Terry A. Lennie

Abstract

Anxiety is prevalent among 13 % of young adult college students and is associated with emotional and behavioral consequences that adversely affect their mental and physical well-being. The major challenge for implementing evidence-based interventions is the lack of a multidimensional approach for evaluating anxiety in this population.

The purpose of this dissertation was to develop an evidence-based theoretical framework for studying the phenomenon of anxiety in young adult college students. Three studies were conducted to achieve this purpose. First, the psychometric properties of the 21-item shortened version of the Depression Anxiety and Stress Scale (DASS-21) were evaluated in a sample of young adult college students. The results indicated that the DASS-21 is a valid and reliable instrument for distinguishing between depression and anxiety in this population. Second, the relative contributions of students’ demographics, life-satisfaction, and coping style to their anxiety levels were evaluated. Maladaptive coping style was identified as the main predictor of students’ anxiety. Particularly, coping strategies related to negative thoughts, such as self-blaming, and cognitive avoidance, such as denial, were significant predictors of anxiety. Other strategies that are related to behavioral coping such as venting and substance use were not significant predictors of anxiety. Thus, further investigation of the cognitive aspect of anxiety was necessary in the third study.

In the third study, an integrated hypothetical model of the psychosocial, behavioral, and cognitive dimensions of anxiety was proposed and evaluated in this population. Using a web-based survey, 257 undergraduate students were assessed for anxiety, coping style, negative thinking, social support, life-satisfaction and demographics. Path analysis was used to examine the proposed model. Maladaptive coping and negative thinking were directly related to anxiety with negative thinking being the primary predictor of anxiety in this model.

The findings from these studies suggest that the DASS-21 is a valid measure of anxiety and that interventions’ that address negative thinking and maladaptive coping should be considered in future research and practice with young adult college students.

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