The Relationship of Cognitive Coping, Behavioral Coping, and Religious Coping Strategies with Academic Stress, Depression, and Anxiety in College Students in Indonesia
D. A. Lovian S2020238
Master Thesis Clinical Psychology Supervisor Dr. N. Garnefski Institute of Psychology Universiteit Leiden 25-06-2019
Abstract
Background: Academic stress, depression, and anxiety are increasingly recognized as concerning mental health issues globally. However, there has been a little discussion about the association of those problems with coping strategies in college students in Indonesia. Objective: The main aim of the present study was to investigate the relationships of specific cognitive coping, behavioral coping, and religious coping strategies with academic stress, depression, and anxiety in college students in Indonesia. Method: A total of 445 students from various universities in Indonesia participated. Participants filled out several self-report questionnaires such as The Law Students Perceived Stress Scale (LSPSS), Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7), Cognitive Emotion Regulation Questionnaire (CERQ), Behavioral Emotion Regulation Questionnaire (BERQ), and the Brief RCOPE. The data had been analyzed with descriptive analysis, Pearson correlation, independent t-test, and hierarchical regression analysis. Results: Self-blame, Rumination, Catastrophizing, Withdrawal, Ignoring, Positive Religious Coping, and Negative Religious Coping were found to be significant predictors of academic stress, depression, and anxiety. Other significant relationships were found between Positive Reappraisal with depression, Seeking Distraction with academic stress, and Seeking Social Support with anxiety. Among all specific coping strategies, rumination was found to be the strongest predictor of academic stress and anxiety, while withdrawal was the strongest predictor of depression. Conclusion: The results point out that specific coping strategies, especially rumination and withdrawal, should be modified to promote greater mental health in college students.
Keywords: Cognitive Coping; Behavioral Coping; Religious Coping; Academic stress; Depression; Anxiety
1. Introduction
In recent years, there has been an increasing interest in mental health problems among college students, and one of the growing concerns is the high prevalence of academic stress, depression, and anxiety in this group (Auerbach et al., 2018; Beiter et al., 2015; Hunt & Eisenberg, 2010). The high prevalence of stress, depression, and anxiety in college students have been shown in a large number of surveys and studies (Bayram & Bilgel, 2008; Keyes et al., 2012; Regehr, Glancy, Pitts, 2013; Xiao et al., 2017). The problems of distress, depression, and anxiety are rising globally, including in Indonesia (Ministry of Health Indonesia, 2013). Rachmawati (2016) and Atikah (2017) investigated psychological distress among college students in Indonesia, and the evidence suggested that above 65% of participants were experienced stress, depression, and anxiety. The findings are aligned with the WHO survey project about mental health problems in college students, which demonstrates major depression and generalized anxiety are highly prevalent in students across countries (Auerbach et al., 2018).
Extensive studies have demonstrated that academic stress, depression, and anxiety in students are correlated with impairment in academic performance, academic achievements, and career prospects (Andrews & Wilding, 2004; Auerbach et al., 2016; Ibrahim et al., 2013; Struthers, Perry, & Menec, 2000). Salzer (2012) points out that students with mental health issues also have less engagement in campus activities and poorer relationship with fellow students and faculty. Other than academic-related impacts, distress, depression, and anxiety are also associated with self-harm behavior and suicidality (Ibrahim et al., 2013; Garlow et al., 2008; Mortier et al., 2018). The majority of studies have shown that academic stress, depression, and anxiety are likely to affect students’ life and mental health negatively.
Previous studies have indicated that the development of these problems is influenced by people’s coping strategies (Kraaij et al., 2003; Mahmoud, Staten, Hall, & Lennie, 2012; Suldo, Shaunessy, & Hardesty, 2008). Suldo and colleagues (2008) suggest that coping strategies that are used by an individual might influence their adaptability to the stressors. Coping can be defined as “constantly changing cognitive and behavioral efforts to manage specific external and/or internal demands that are appraised as taxing or exceeding the resources of the person” (Lazarus & Folkman, 1984, p. 141). Garnefski, Kraaij, and Spinhoven (2001) specify coping strategies into two distinct categories, cognitive and Behavioral coping
strategies. In addition to the cognitive and behavioral coping strategies, there is another coping category that also gains researchers’ interest in the past decades, known as religious coping (Pargament, 1997).
1.1 Cognitive Coping Strategies
Cognitive coping has been described as the cognitive way for enabling a person to manage the information that is emotionally arousing (Thompson, 1991). Garnefski and colleagues (2001) propose that cognitive process might be helpful not only to manage or regulate emotions or feelings but also to control over those emotions and/or not getting overwhelmed by that during or after a threatening or stressful experience. Park (2005) suggests that cognitive process in coping facilitates people to make initial attributions about why a certain event occurred, determine to what extent the event is threatening, controllable and predictable, then decide on how to deal with the situation. Garnefski et al., (2001) differentiate cognitive coping into nine strategies, such as Self-blame, Acceptance, Rumination, Positive Refocusing, Refocus on Planning, Positive Reappraisal, Putting Into Perspective, Catastrophizing, Other-Blame.
Ample studies have shown that self-blame, rumination, and catastrophizing are significantly correlated with depression and anxiety in various age groups (Aldao, Nolan-Hoeksema, & Schweizer, 2010; Garnefski et al., 2001; Garnefski & Kraaij, 2006; Garnefski, Legerstee, Kraaij, van den Kommer, Teerds, 2002a; Garnefski et al., 2002b, Mahmoud et al., 2012). Contrarily, prior studies have demonstrated that positive reappraisal is associated with less depressive symptoms, posttraumatic growth, and higher life satisfaction (Aldao et al., 2010; Garnefski et al., 2001, 2002a; 2002b; Garnefski & Kraaij, 2006; Kraaij et al., 2002; Suldo et al., 2008; Zoellner & Maercker, 2006). In general, the findings suggest that by using specific cognitive coping strategies such as self-blame, rumination, and catastrophizing people might be more susceptible to psychopathology symptoms, while other results indicate that by using another strategy such as positive appraisal people are less likely to develop psychopathology. 1.2 Behavioral Coping Strategies
Behavioral coping has been illustrated as the behavioral effort that is undertaken in response to stressful events (Garnefski et al., 2001). The investigators distinguish the behavioral coping into five conceptually distinct strategies such as Seeking Distraction, Withdrawal, Actively Approaching, Seeking Social Support, and Ignoring (Kraaij & Garnefski, 2019). Several
studies have demonstrated that Seeking Distraction, Actively Approaching, and Seeking Social Support help people to handle stressful events in positive ways, whereas Withdrawal and Ignoring were the negative ways (Aldao et al., 2010; Joormann & Stanton, 2016; Kraaij & Garnefski, 2019; Prati & Pietrantoni, 2009).
Seeking distraction, actively approaching, and seeking social support enable people to regulate their affect positively, gain more control, and facilitate people to obtain reassurance from social support (Aldrige & Roesch, 2008; Dumont & Provost, 1999; Moses, Bradley, & O’Callaghan, 2016; Prati & Pietrantoni, 2009; Wante, Van Beveren, Theuwis, & Braet, 2018). Meanwhile, withdrawal and ignoring allow the individual to avoid the confrontation with the stressors which does not help to increase resilience and even lead to higher distress and depressive symptoms (Eppelmann et al., 2016; Thompson, Fiorillo, Rothbaum, Ressler, & Michopoulos, 2018). It can thus be suggested that by using behavioral coping strategies such as seeking distraction, actively approaching, and seeking social support people may have greater mental health and well-being while the use of withdrawal and ignoring might deteriorate one’s mental health.
1.3 Religious Coping Strategies
Pargament (1997, p.32) defines religious coping as “efforts to understand and deal with life stressors in ways related to the sacred”. Religious coping is largely predicted to be used by who see religion as a prominent aspect of their understanding about self and the world (Pargament, 1997; Park, 2005). Pargament, Smith, Koenig, and Perez (1998) distinguish religious coping into two broad patterns, positive and negative religious coping. Positive religious coping has been described as “secure relationship with a transcendent force, a sense of spiritual connectedness with others, and benevolent worldview” (Pargament, Feuille, & Burdzy 2011, p.51). On the other hand, negative religious coping has been explained as “spiritual tensions and struggles within oneself, with the others, and with the divine” (Pargament et al., 2011, p.51).
Positive religious coping involves positive reinterpretation and positive reattribution about the stressful events that help people to construe the stressful events positively, form more adaptive meaning about the stressful events, and identify the benefits that may follow after the stressful encounter (Park, 2005). Therefore, a number of studies have found the associations of positive religious coping with less psychological distress, positive adjustment after the stressful
events, and lower depressive symptoms, meanwhile negative religious coping is correlated inversely (Ano & Vasconcelles, 2005; Harrison, Koenig, Hays, Eme-Akwari, & Pargament, 2001; García, Páez, Reyes-Reyes, and Álvarez, 2017; Nierobisz & Sawchuk, 2018; Pargament et al., 1998; Prati & Pietrantoni, 2009). Moreover, negative religious coping is also associated with higher anxiety symptoms, more negative mood, lower self-esteem, lower life satisfaction, and apathy toward others (García et al., 2017; Lee, Roberts, & Gibbons, 2013; Pargament et al., 1998; Pargament et al., 2004). The evidence, as mentioned earlier, indicated that positive religious coping promotes growth and increases people’s well-being, while by using negative coping strategies, people are more prone to psychopathology and decrease in well-being.
A considerable amount of research has demonstrated a positive and negative relationship between specific coping strategies and mental health. Extensive studies have shown that some coping strategies may be considered as more adaptive than others (Garnefski et al., 2001; Garnefski et al., 2002a). Thus, it is essential to determine which coping strategies should be promoted in order to yield positive consequences for one’s conditions and which strategies should be modified to reduce the negative consequences (Kraaij et al., 2002). Understanding the relationship between specific coping strategies with academic stress, depression, and anxiety was expected to provide information about the target for further mental health interventions.
The primary purpose of the present study was to identify the adaptive and maladaptive coping strategies in relation to academic stress, depression, and anxiety in college students in Indonesia. Moreover, the present study also had an exploratory purpose to determine which specific coping strategies amongst the three coping categories had the strongest influence on academic stress, depression, and anxiety. In particular, this study aimed to address the following research questions: (1) what is the relationship of specific cognitive coping strategies (Self-blame, Other-blame, Rumination, Catastrophizing, Putting Into Perspective, Positive Refocusing, Positive Reappraisal, Acceptance, and Planning) with academic stress, depression, and anxiety? (2) what is the relationship of specific behavioral coping strategies (Seeking Distraction, Withdrawal, Actively Approaching, Seeking Social Support, and Ignoring) with academic stress, depression, and anxiety? (3) what is the relationship between positive and negative religious coping strategies with academic stress, depression, and anxiety? (4) which specific strategies amongst cognitive, behavioral, and religious coping strategies have the
strongest relationship with academic stress, depression, and anxiety (after controlling other strategies)?
Build upon these questions, it was hypothesized that: (1) rumination, catastrophizing, and self-blame are expected to be related to higher academic stress, depression, and anxiety, whereas positive reappraisal is inversely related; (2) seeking social support, seeking direction, and actively approaching are expected to be related to lower academic stress, depression, and anxiety, whereas withdrawal and ignoring are inversely related; (3) negative religious coping is expected to be related to higher academic stress, depression, and anxiety, whereas positive religious coping is inversely related; (4) the information about the strongest predictor of academic stress, depression, and might be discovered.
2. Methods
2.1 Participants
Online data collection was run for 14 days with a total of 453 data retrieved. Subsequently, eight participants were eliminated with exclusion criteria: (a) time-completion less than 10 minutes; (b) students from non-Indonesian university; and (c) not an undergraduate or master student. Total data that had been used for further analyses was 445 data. The participants comprised 445 students above 17 years old (mean age 22 years old; SD=.15) attending various universities in Indonesia. The participants consisted of 75.5% female (n=336), the majority was a full-time student (92%), 82% from an undergraduate program, 95% was single, 73% was supported financially by parents, 76% had no a side job. Regarding the religion, 88% of participants reported as Moslem, and the rest were Christian (Catholic, Protestant), Hinduism, Buddhism, whereas four participants reported to not having any religion.
2.2 Procedures
The present study was a cross-sectional study. The data were collected through an online method using Qualtrics software. Participants were able to read a short description of the study and filled the informed consent before started filling out several self-report questionnaires. Participants were guaranteed anonymity regarding personal information that had been given.
In average, participants spent time approximately 20-30 minutes to complete the questionnaires. The survey was opened to access for two weeks from 25th March 2019 until 8th April 2019. Participants were mostly from universities in Sumatera, Java, Kalimantan, and Sulawesi. Participants were recruited through online advertisement in social networking platforms (Whatsapp, Line, Instagram), an announcement in the groups’ chatroom, and personal messages. The investigator distributed the ad in several groups, then the member within those groups forwarded it further to other groups. The ad was shared in messenger groups for a scholarship, groups for students in various departments and universities, student’s associations, and by teachers who informed the advertisement directly to their students. 2.3 Measures
The whole survey was presented in Bahasa Indonesia, including the instruments that had been used to measure chosen variables. Some of the instruments were unavailable in the Indonesian language. Therefore, those instruments were translated trough back translation procedure. The instruments that had been translated were questionnaires for academic stress, cognitive coping strategies, and behavioral coping strategies. Other than the investigator, the translation procedure was involving a teacher and professor from Universitas Indonesia (department of clinical and social psychology) and a Ph.D. student of psychology in Leiden University who proficient in English and Indonesian.
First of all, the investigator translated the instruments from English to Indonesian (forward translation). The instruments were translated not only based on its literal translation but also had been adjusted by considering its compatibility in regard to the structure of the language, the readability, and appropriate meaning without disregarding the true meaning behind each sentence in the original version. Then, the individual translations and all the feedback were compared and combined into one final version. The final version in Indonesian was translated back into English, and the back-translation thereupon adjusted based on differences that had been found. After several minor adjustments, the final version of the translation ready to be input and distributed widely through a shortened link that linked directly to the Qualtrics.
2.3.1 Academic Stress
The Law Students Perceived Stress Scale (LSPSS), an instrument which consisting of 16 items (Bergin & Pakenham, 2015; Indonesian translation and adaptation by Lovian, 2019), was used to asses academic stress. The questionnaire is designed to measure the degree to which students appraised possible stressors as stressful. The range of response is a five-point Likert scale from 1 “not at all stressful” until 5 “very stressful”. The total score determined the degree of individual academic stress of the sample. The previous study has reported that this instrument is valid and reliable to measure students’ current level of stress with Cronbach’s alpha .89 (Bergin & Pakenham, 2015).
2.3.2 Depression and Anxiety
The severity of depression was assessed with the Patient Health Questionnaire 9 (PHQ-9), consisting of nine items with a four-point Likert scale from 0 “not at all” – 3 “nearly every day” (Kroenke, Spitzer, & Williams, 2001). The total score was used to determine the severity, where the higher scores indicated more severe depression. PHQ-9 has been proven in the prior studies as the reliable measurement with Cronbach’s alpha .89 (Kroenke et al., 2001, Indonesian translation retrieved from phqscreeners.com). The anxiety was measured with the Generalized Anxiety Disorder 7 (GAD-7) questionnaire, consisting of seven items with a four-point Likert scale from 0 “not at all” – 3 “nearly every day” (Kroenke, Spitzer, Williams, 2010; Indonesian translation retrieved from phqscreeners.com). The anxiety level was indicated through the total score, where the higher scores showed more symptoms of anxiety. Previous studies have demonstrated that GAD-7 has high reliability with alpha value .92 (Kroenke et al., 2010).
2.3.3 Cognitive Coping Strategies
Cognitive coping strategies were measured with the Cognitive Emotion Regulation Questionnaire (CERQ; Indonesian translation and adaptation by Lovian, 2019), 36 items self-report scale with a five-point Likert scale ranging from 1 “almost never” – 5 “almost always” (Garnefski & Kraaij, 2006). CERQ has nine subscales, each consisting of four items. The subscales are Self-Blame, Other-Blame, Acceptance, Rumination, Catastrophizing, Refocus on Planning, Putting into Perspective, Positive Reappraisal, and Positive Refocusing. CERQ is designed to measure one’s cognitive coping
strategies in response to negative life events. The higher total score on a subscale indicated that the specific cognitive coping strategy was applied more frequently. Previous studies have proved that the CERQ has good internal consistency with a range of alpha value .68-.83 (Garnefski et al., 2001).
2.3.4 Behavioral Coping Strategies
Behavioral Emotion Regulation Questionnaire (BERQ) was used to measure behavioral strategies to cope with stressors. BERQ consists of 20 items with five-point Likert scale response, from 1 “hardly never” – 5 “nearly always” (Kraaij & Garnefski, 2019; Indonesian translation and adaptation by Lovian, 2019). BERQ is designed to assess what people tend to do for regulating their emotions after experiencing stressful events. The questionnaire covers five distinct subscales, each consisting of five items. The subscales are seeking distraction, withdrawal, actively approaching, seeking social support, and ignoring. The higher total score on a subscale indicates that the specific behavioral coping strategy is applied more frequently. BERQ has high alpha reliabilities, ranging from .86-.93 (Kraaij & Garnefski, 2019).
2.3.5 Religious Coping Strategies
Religious coping was assessed with Brief RCOPE, consisting of 14 items divided into two subscales positive and negative religious coping with seven items on each subscale (Pargament et al., 2011; Indonesian translation by Ahmad, 2016). The response is measured on a four-point Likert scale, from 0 “not at all” – 3 “a great deal”. Brief RCOPE measures the religious coping that people use to deal with stressful events. The total score was used to determine the specific strategy was applied more often. Brief RCOPE has good internal consistency across diverse samples of research with range alpha value from .60 –.94 (Pargament et al., 2011).
2.5 Statistical Analysis
The data were analyzed with SPSS v.25, which enable a descriptive, correlations, and regression calculation. Two-tailed alpha .05 was used for significance testing purpose. At first, descriptive statistics were calculated for obtaining details information regarding each variable within the total sample. Subsequently, a Pearson correlation analysis was performed to
determine the relationships of coping strategies with academic stress, depression, and anxiety. The associations of gender and age with academic stress, depression, and anxiety were also analyzed. The series of independent t-test was performed to assess any systematic differences in academic stress, depression, and anxiety based on gender. The relationships of age with academic stress, depression, and anxiety were measured with Pearson correlation. Subsequently, multiple regression analyses (hierarchical regression analyses) were used to examine the independent contributions of specific cognitive coping strategies in predicting academic stress, depression, and anxiety separately after controlling potential confounding variable. The same procedure was performed to determine the contributions of each behavioral and religious coping strategy to academic stress, depression, and anxiety as the outcome variables. In an attempt to answer the final research question, the multiple regression analyses were calculated by putting only specific coping strategies that had significant relationships (from previous regression analyses) with academic stress, depression, and anxiety as the dependent variables. The purpose of these analyses was to identify which specific coping strategies had the strongest capability to predict academic stress, depression, and anxiety.
3. Results
3.1 Reliabilities of the scales
Cronbach’s alpha reliability coefficients were computed (see Table 1). The alpha reliabilities of the scales for coping strategies, academic stress, depression, and anxiety were considered high, ranging from .85 - .88. The subscales of CERQ, BERQ, and BRIEF RCOPE also showed high reliability ranging from .59 - .90.
3.2 Means and standard deviations of the scales
The details of the range of scores, means, and standard deviations of all instruments were presented in Table 1. The cognitive, behavioral, and religious coping strategies that had been used most often were positive reappraisal, seeking social support, and positive religious coping for each category, respectively. The results showed that the theoretically more adaptive coping strategies in each category had higher mean scores than the less adaptive strategies
Table 1
Reliabilities and properties of coping strategies, academic stress, depression, and anxiety scale: range, means, standard deviations, Cronbach’s alpha
Scale Range Scores M SD a
Law’s Students Perceived Stress Scale (LSPSS) 24-80 50.08 9.6 .87 PHQ-9 0-26 9.38 5.66 .85 GAD-7 0-21 7.14 4.94 .88 CERQ subscales Self-blame 4-20 11.47 3.18 .70 Acceptance 4-20 12.56 3.03 .63 Rumination 4-20 12.39 3.70 .81 Positive refocusing 4-20 12.03 3.24 .71 Refocus on planning 4-20 14.54 3.11 .76 Positive reappraisal 4-20 14.89 3.38 .82
Putting into perspective 4-20 11.85 2.70 .59
Catastrophizing 4-20 9.26 3.64 .81 Other-blame 4-20 7.24 2.75 .80 BERQ subscales Seeking distraction 4-20 11.91 3.10 .66 Withdrawal 4-20 9.07 4.07 .87 Actively approaching 4-20 11.75 3.04 .76
Seeking social support 4-20 12.67 3.74 .80
Ignoring 4-20 10.32 3.73 .80
BRIEF RCOPE subscales
Positive religious coping 3-21 17.41 3.99 .90
Negative religious coping 0-21 5.25 4.17 .82
3.3 The associations of gender and age with academic stress, depression, and anxiety Independent t-test was performed to study the differences in academic stress, depression, and anxiety based on gender (Table 2). The result showed that gender had a significant relationship with academic stress, depression, and anxiety. Women reported higher academic stress, t(443) = 4.86, p<.05 ; depression, t(443) = 3.76, p<.05 ; and anxiety t(443) = 3.75, p<.05. Meanwhile, based on Pearson correlations analysis, no significant relationships were found between age
with academic stress (r=.35, n=445, p=.46), depression (r=.02, n=445, p=.65), and anxiety (r=.04, n=445, p=.41).
Table 2
Differences in academic stress, depression, and anxiety: based on gender
Male Female M SD M SD t LSPSS 46.30 9.08 51.31 9.45 -4.86* PHQ-9 7.69 5.35 9.93 5.65 -3.76* GAD-7 5.72 4.40 7.60 5.02 -3.75* Notes. *p < .05
3.4 Pearson correlations between all coping strategies with academic stress, depression, and anxiety
Pearson correlations among all variables were computed (see Table 3). Self-blame, acceptance, rumination, putting into perspective, catastrophizing, other-blame, withdrawal, ignoring, and negative religious coping appeared to have positive relationships with academic stress, depression, and anxiety, while positive religious coping was negatively, significantly correlated. In addition, positive reappraisal was significantly correlated with lower depression, and positive refocusing was significantly correlated with lower anxiety. Finally, academic stress, depression, and anxiety also reported having significant positive relationships.
3.5 Relationship of cognitive coping strategies, academic stress, depression, and anxiety The hierarchical method of regression was performed to determine the relationship of cognitive coping strategies with academic stress, depression, and anxiety after controlling gender as another potential predictor (Table 4). First of all, gender was entered, then followed by the subscales of cognitive coping strategies. In the beginning, gender appeared to have a significant relationship with academic stress, depression, and anxiety (respectively, b=.22; b=.17; b=.16, p< .05). In the first step, total variance 5.1% was explained (F [1,443] = 23.59; p<.05) for academic stress; total variance 2.9% was explained (F [1,443] = 13.34; p<.05) for depression, and total variance 2.7% was explained (F [1,443] = 12.30; p<.05) for anxiety. Then, the cognitive coping strategies were added. In total, 23.8% variance was explained in the final step (F [10,434] = 13.52; p<.05) for academic stress; total variance 42.8% was explained (F
[10,434] = 32,44; p<.05) for depression, and total variance 42.2% was explained (F [10,434] = 31.64; p<.05) for anxiety.
Out of nine cognitive coping strategies, self-blame, rumination, and catastrophizing had a significant relationship with academic stress; self-blame, rumination, positive reappraisal, and catastrophizing related significantly to depression; self-blame, rumination, and catastrophizing related significantly to anxiety. Among all cognitive coping strategies, rumination had the strongest relationship with academic stress, depression, and anxiety. The use of more rumination was correlated with higher academic stress, more depressive symptoms, and anxiety.
Table 3
Pearson’s Correlations of specific cognitive coping, behavioral coping, religious coping with academic stress, depression, and anxiety
Scale LSPSS PHQ-9 GAD-7 LSPSS 1 .50** .54** PHQ-9 .50** 1 .76** GAD-7 .54** .76** 1 Self-blame .33** .46** .45** Acceptance .22** .29** .28** Rumination .40** .54** .57** Positive refocusing -.01 .07 .13** Refocus on planning -.05 -.04 .01 Positive reappraisal -.08 -.11* -.05
Putting into perspective .13** -.22** .20**
Catastrophizing .34** .52** .53**
Other-blame .14** .19** .24**
Seeking distraction -.00 .07 .08
Withdrawal .31** .54** .46**
Actively approaching .02 -.02 .04
Seeking social support -.00 -.04 .06
Ignoring .19** .31** .32**
Positive religious coping -.18** -.14** -.14**
Negative religious coping .10* .25** -.32**
Table 4
Multiple regression analyses for cognitive coping strategies predicting academic stress, depression, and anxiety
Academic Stress Depression Anxiety Predictor B SE B b p B SE B b p B SE B b p Gender 3.40 .96 .15 .00 .91 .50 .07 .06 .73 .43 .06 .09 Self-blame .37 .17 .12 .03 .30 .09 .17 .00 .24 .08 .15 .00 Acceptance .09 .19 .03 .63 .01 .09 .00 .94 -.08 .08 -.05 .33 Rumination .62 .16 .24 .00 .48 .08 .32 .00 .48 .07 .36 .00 Positive refocusing -.13 .16 -.04 .41 -.02 .08 -.01 .82 .05 .07 .03 .50 Refocus on planning -.22 .20 -.07 .28 -.14 .10 -.08 .18 -.11 .09 -.07 .22 Positive reappraisal -.32 .19 -.11 .09 -.32 .09 -.19 .00 -.12 .08 -.08 .15 Putting into perspective .15 .18 .05 .39 .21 .09 .11 .02 .04 .08 .03 .58 Catastrophizi ng .33 .15 .12 .03 .37 .08 .24 .00 .34 .07 .25 .00 Other-blame .02 .17 .00 .89 -.08 .09 -.04 .37 .03 .08 .02 .63 R2 .24 .43 .42
Notes. Results from the final model are presented;
3.6 Relationship of Behavioral coping strategies, academic stress, depression, and anxiety The same procedure of hierarchical regression was performed to determine the relationship between behavioral coping strategies with academic stress, depression, and anxiety (see Table 5). The steps of computation were the same as the previous analysis in which gender was computed first. Subsequently, all behavioral coping strategies were entered, and the total variance changed into 14.6% (F [6,438] = 12.48; p<.05) for academic stress, 31.9% F [6,438] = 34.20; p<.05) for depression, and 27.1% (F [6,438] = 27.14; p<.05) for anxiety. After controlling gender, withdrawal and ignoring appeared to have significant relationships with academic stress, depression and anxiety, meanwhile seeking distraction and seeking social support had a significant relationship only with anxiety. The withdrawal was found to be the
strongest predictor of academic stress, depression, and anxiety. The more usage of withdrawal was correlated with higher academic stress, depression, and anxiety.
Table 5
Multiple regression analyses for behavior coping strategies predicting academic stress, depression, and anxiety
Academic Stress Depression Anxiety
Predictor B SE B b p B SE B b p B SE B b p Gender 3.98 1.00 .18 .00 1.14 .53 .09 .03 1.00 .48 .09 .04 Seeking distraction -.41 .18 -.13 .03 -.06 .09 -.03 .54 -.18 .09 -.11 .04 Withdrawal .57 .12 .24 .00 .67 .06 .48 .00 .49 .05 .41 .00 Actively approaching .14 .16 .04 .41 -.07 .09 -.04 .44 .03 .08 .02 .65 Seeking social support .14 .13 .05 .27 .09 .07 .06 .18 .20 .06 .15 .00 Ignoring .40 .14 .15 .01 .22 .07 .15 .00 .28 .07 .21 .00 R2 .15 .32 .27
Notes. Results from the final model are presented;
3.7 Relationship of religious coping strategies, academic stress, depression, and anxiety Another hierarchical regression was performed with the same procedure to study the relationships of religious coping strategies with academic stress, depression, and anxiety after controlling gender (Table 6). The same procedures of regression analysis were performed. After controlling gender, two religious coping strategies were entered, and the total variance changed into 10.8% (F [3,437] = 17.68; p<.05) for academic stress, 12.7% (F [3,437] = 12.18; p<.05) for depression, and 16.7% (F [3,437] = 29.26; p<.05) for anxiety. Both positive and negative religious coping had significant relationships with academic stress, depression, and anxiety. Positive religious coping had the strongest relationship with academic stress, while negative religious coping had the strongest relationship with depression and anxiety. Thus, positive religious coping predicted academic stress more than negative religious coping. Meanwhile, depression and anxiety were more predicted by negative religious coping.
Regarding the direction of the relationships, positive religious coping was correlated with less academic stress, whereas negative religious coping had significant relationships with more depressive symptoms and anxiety.
Table 6
Multiple regression analyses for religious coping strategies predicting academic stress, depression, and anxiety
Academic Stress Depression Anxiety
Predictor B SE B b p B SE B b p B SE B b p Gender 5.82 1.02 .26 .00 2.76 .60 .21 .00 2.43 .51 .21 .00 Positive religious coping -.51 .11 -.21 .00 -.24 .06 -.17 .00 -.21 .05 -.17 .00 Negative religious coping .28 .10 .12 .01 .36 .06 .27 .00 .40 .05 .34 .00 R2 .11 .13 .17
Notes. Results from the final model are presented;
3.8 Relationship of all coping strategies, academic stress, depression, and anxiety: multiple regression
Hierarchical regression method also performed to study whether specific coping strategies retained its relationship with academic stress, depression, and anxiety after controlling other coping strategies (Table 7). The first variable to compute was gender, followed by cognitive coping strategies, behavioral coping strategies, and religious coping strategies, respectively. Only coping strategies that had a significant relationship with academic stress, depression, and anxiety from previous steps were included. The first step was the same as in the previous analysis. After controlling gender, four cognitive coping strategies were added to the model, and the R2 was changed. The total explained variance for academic stress was changed to 23.1% (F [5,435] = 26.11; p<.05), 42% (F [5,435] = 63.11; p<.05) for depression, and 41.9% F [5,435] = 62.62; p<.05) for anxiety. In the third step, four behavioral coping strategies were added. The additional explained variance was 0.9% (F change [9,431] = 15.16; p<.05) for
academic stress, 6.2%, F change [9,431] = 44.60; p<.05) for depression, and 3.2% (F change [9,431] = 39.67; p<.05) for anxiety. In the final step, two religious coping strategies were entered into the final model, and 25.4% total variance was explained (F [11,429] = 13.26; p<.05) for academic stress, 48.4% (F [11,429] = 36.57; p<.05) for depression, and 45.6% (F [11,429] = 34.57; p<.05) for anxiety.
In the final model, significant relationships were found between gender, rumination, and positive religious coping with academic stress; self-blame, rumination, positive reappraisal, catastrophizing, and withdrawal were correlated significantly with depression; self-blame, rumination, catastrophizing, withdrawal, seeking social support, and negative religious coping were showed a significant relationship with anxiety. The results showed that rumination was the strongest predictor of academic stress and anxiety, even after controlling gender and other coping strategies. In regard to depression, withdrawal showed the strongest relationship with depression. The results suggest that higher stress and anxiety were strongly predicted by rumination rather than other coping strategies, while the higher depression was strongly predicted by withdrawal rather than other strategies.
Table 7
Multiple regression analyses for all coping strategies predicting academic stress, depression, and anxiety
Academic Stress Depression Anxiety
Predictor B SE B b p B SE B b p B SE B b p Gender 3.59 .10 .16 .00 .60 .49 .04 .22 .72 .43 .06 .10 Self-blame .33 .16 .11 .04 .24 .08 .14 .00 .18 .07 .12 .01 Rumination .55 .16 .21 .00 .41 .08 .27 .00 .40 .07 .30 .00 Positive reappraisal -.23 .15 -.08 .12 -.28 .07 -.16 .00 -.13 .06 -.09 .05 Catastrophizing .26 .16 .10 .09 .21 .07 .14 .00 .17 .07 .13 .01 Seeking distraction -.28 .17 -.09 .11 -.02 .09 -.01 .78 -.10 .08 -.06 .20 Withdrawal .14 .12 .06 .26 .38 .06 .28 .00 .20 .05 .17 .00
Seeking social support .14 .12 .06 .24 .00 .06 .00 .97 .13 .05 .10 .02
Ignoring .22 .14 .08 .12 .05 .07 .04 .42 .12 .06 .09 .05
Positive religious coping -.31 .11 -.13 .01 .01 .06 .00 .85 -.08 .05 -.07 .10
Negative religious coping -.04 .11 -.02 .73 .06 .05 .04 .25 .16 .05 .14 .00
R2 .25 .48 .45
4. Discussion
The present study was conducted to determine the relationship of cognitive, behavioral, and religious coping strategies with academic stress, depression, and anxiety in college students in Indonesia. Several specific coping strategies were found to be significantly correlated with academic stress, depression, and anxiety. The most influential coping strategies in predicting academic stress, depression, and anxiety were also discovered.
First, the results show that self-blame, rumination, and catastrophizing were associated with higher academic stress, depression, and anxiety, while positive reappraisal was only correlated with depression. These findings are consistent with other studies which have demonstrated that the use of more self-blame, rumination, and catastrophizing may lead to psychopathology while positive reappraisal is inversely related (Garnefski et al., 2002a; 2002b; Garnefski & Kraaij, 2006, Martin & Dahlen, 2005). Among all the cognitive coping strategies, rumination appeared to be the strongest predictor of higher academic stress, depression, and anxiety. It can be suggested that keep thinking about the feelings and thoughts associated with the negative events could be considered as an ineffective strategy to deal with the stress. The possible mechanism is rumination activates people’s negative thoughts and memories to understand their circumstances, makes people thinking more pessimistic and fatalistic, and interferes with instrumental behaviors that increasing the stressful circumstances (Nolen-Hoeksema, 1991). On the other hand, the students are possibly less vulnerable to depression and might deal with negative events effectively by attaching positive meaning to the event in terms of personal growth, as investigated by Martin and Dahlen (2005).
As regards the second hypothesis, the findings indicate that withdrawal and ignoring were significantly associated with higher academic stress, depression, and anxiety, meanwhile seeking distraction was significantly related to lower academic stress. These findings are confirmed in previous studies which demonstrate positive relationships between withdrawal and ignoring with symptomatology while seeking distraction is inversely related (Aldrige & Roesch, 2008; Eppelmann et al., 2016; Thompson et al., 2018). Coping strategies by drawing oneself back from situations and social contacts and behaving as if nothing happened would allow people to avoid the problems instead of taking action to deal with the stressors. These strategies are possibly not beneficial because it can decrease one’s resilience and adjustment to the problems and make people more vulnerable to the psychopathology and
emotional/behavioral problems (Eppelmann et al., 2016; Thompson et al., 2018). In contrast, seeking distraction more likely related to lower academic stress because it possibly reduces rumination by enabling people to shift their attention from events or goals that have been interfered by stressors (Carver, Scheier, Weintraub, 1989; Nolen-Hoeksema, Wisco, & Lyubomirsky, 2008). In general, college students might be able to handle their stress more effectively by distracting themselves instead of withdrawing and ignoring the problems.
One unanticipated finding was that seeking social support appeared to be significantly related to higher anxiety, which is in contrast with earlier findings regarding the association of seeking social support with greater mental health (Felsten, 1998; Moses et al., 2016). In the present study, seeking social support in college students was found to be one of the maladaptive coping strategies. The present finding seems to be consistent with other research which found that seeking social support might lead to more depressive symptoms and anxiety (Costanza, Derlega, and Winstead, 1988; Vélez et al., 2016). For example, a study by Costanza and colleagues (1988) indicated that talking about personal concerns and disclosing one’s feelings in regard to stressful events could be an ineffective way of coping in college students. Seeking social support also associated with psychological symptoms if it involves passive and repetitive discussion of problems or negative events with others (Vélez et al., 2016). These findings are in agreement with Carver and colleagues (1989) suggestion that seeking social support could be detrimental if it makes individual focused more on the distress and used the support as outlets to ventilate the emotions. In conclusion, the effectiveness of seeking social support might depend on the type of contact that occurs and whether the process of seeking social support facilitate adjustment or not. Based on the present study, no evidence was found with regard to significant relationships of actively approaching with a lower level of academic stress, depression, and anxiety, which was suggested in Aldrige and Roesch (2008).
In terms of the third hypothesis, the significant relationships were found between positive religious coping with lower academic stress, depression, and anxiety, while negative religious coping was inversely related. These findings match those observed in earlier studies regarding the association of positive religious coping with greater mental health while negative religious coping is the opposite (García et al., 2017; Harrison et al., 2001; Pargament et al., 1998; 2004). The positive reframing and reattribution in viewing the negative life events may promote growth and reduce psychological distress (Pargament et al., 1998; Park, 2005). In conclusion, by having positive views and relationships to a transcendent force, a sense of spiritual
connectedness with others, and benevolent worldview, college students may be able to handle their stress effectively. Conversely, as have mentioned in Pargament et al., (1998), the increase in distress and symptomatology may be accounted to the negative views, reattributions, and reinterpretation in regard to negative life events, less secured relationships with God and other people, and religious discontent.
The final research question was about which specific strategies amongst cognitive, behavioral, and religious coping strategies have the strongest relationship with academic stress, depression, and anxiety. The results show that amongst all coping strategies, after controlling other strategies, rumination appeared to be the strongest predictor of higher academic stress and anxiety, whereas withdrawal was the strongest predictor of more depressive symptoms. It can be concluded that among all coping strategies, rumination and withdrawal are the most influential strategies in the development of psychopathology and the most maladaptive strategies to cope with distress.
Generally, the present study supports the idea that some coping strategies (self-blame, rumination, catastrophizing, seeking social support, withdrawal, ignoring, negative religious coping) are likely to be more maladaptive than others (positive reappraisal, seeking distraction, and positive religious coping). Moreover, the results point out several coping strategies were influenced all the outcomes variables (i.e., academic stress, depression, and anxiety) such as self-blame, rumination, catastrophizing, withdrawal, ignoring, positive and negative religious coping. It can be suggested that by modifying these coping strategies, people may reduce academic stress, depression, and anxiety all at once. In addition, the findings of the current study clearly show that rumination and withdrawal were the most influential coping strategies to academic stress, depression, and anxiety more than other coping strategies. Thus, amidst all specific coping strategies, rumination and withdrawal may be considered as the main target of intervention and prevention of mental health problems.
This study has potential limitations. First, this study relied on the self-reported data to measure all variables which might increase the possibility of bias. Therefore, the future’s work may use more methods of assessment for instances interviews or expert judgments to reduce the bias. Second, the use of a cross-sectional design limits the findings. The conclusion regarding the development, course, and changes in terms of symptoms and coping strategies was not obtained. Moreover, the results only show the associations between variables without information about the causal effect. It merely indicates that specific coping strategies may lead
to higher or lower academic stress, depression, and anxiety. The information about the development of variables, causal mechanism, and temporal order could be attained through experimental or even longitudinal studies in the future. Third, there is a possibility that the results of this study were influenced by uncontrolled confounding variables such as the occurrence of other negative life events, history of psychopathology, and genetic and personality factors.
Other concerns are related to the representativeness of the sample and the generalizability of the findings. The present study has a moderate response rate (54%), which could have affected the results. There is a possibility of the selection in which people with certain characteristics (e.g., a higher level of symptomatology, less religious) were less willing to participate in the study. The details regarding those who did not participate cannot be gathered; therefore, no information attainable in regard to possible differences between people who participated and who did not. Hence, the representativeness of the sample to the general population remains unknown. In terms of generalizability, this study is comprised of undergraduate and graduate college students in Indonesia only, which limits the results to a similar population. Hence, there is ample room for further works in determining the relationships of coping strategies, academic stress, depression, and anxiety in different characteristics of the sample (e.g., different level of education), in non-student population, or even investigate the differences between clinical and non-clinical population.
Notwithstanding these limitations, the present study has been acquired data from quite large sample size and diverse characteristics. The alpha reliabilities of the scales that had been used to measure all variables were considered high except for CERQ-subscale putting into perspective which needs further investigation in the future. Although the direction of influence between variables was not acquired, the study confirms previous findings and provides additional evidence regarding the maladaptive and adaptive coping strategies. Specifically, the results demonstrate that among all coping strategies, rumination and withdrawal are the strongest predictors of academic stress, depression, and anxiety in college students in Indonesia. Considerably more work is necessary to provide more definitive evidence and investigate several points that remain unanswered at present. The findings of the present study are the hints which if confirmed, could be substantial information to provide adequate mental health interventions for college students.
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