Anxiety and depression are common among individuals from dysfunctional families or lacking strong support networks.
Dysfunctional family environments often involve poor communication, problem-solving difficulties, and a lack of emotional support, which can contribute to mental health issues.
Similarly, social support provides a buffer against stress and fosters resilience, so its absence may leave individuals more vulnerable to developing anxiety and depression symptoms.
Estrella-Proaño, A., Rivadeneira, M. F., Alvarado, J., Murtagh, M., Guijarro, S., Alomoto, L., & Cañarejo, G. Anxiety and depression in first-year university students: the role of family and social support. Frontiers in Psychology, 15, 1462948. https://doi.org/10.3389/fpsyg.2024.1462948
Key Points
- 19.7% of first-year university students in Ecuador presented anxiety, while 24.7% presented depression.
- Family dysfunction and lack of global social support were significantly associated with higher prevalence of anxiety and depression, independent of the student’s economic situation.
- Female students, those with poor economic status, and married/cohabiting students had higher prevalence of anxiety and depression compared to their counterparts.
- Social support and family functionality play an important role in preventing anxiety and depression in first-year university students.
Rationale
Anxiety and depression are highly prevalent mental health problems among adolescents and young adults worldwide (Van der Walt et al., 2020; Ibrahim et al., 2013).
University students, especially those beginning their studies, face many stressors that can deteriorate their mental health (Abdallah & Gabr, 2014; Beiter et al., 2015; Islam et al., 2020).
While previous research has examined the role of family and social factors in adolescent and young adult mental health (Islam et al., 2020; Epstein et al., 1983; Shao et al., 2020), few studies have focused on students recently entering university, particularly in low to middle-income contexts like Ecuador.
This study aimed to analyze the prevalence of anxiety and depression in first-year university students and its association with family functionality and social support.
Method
Cross-sectional study on 847 first-year undergraduate students from a private university in Ecuador.
Procedure
Students were randomly selected from enrollment lists across five campuses. Participants signed informed consent and completed a survey.
Sample
Students aged 18-25 years, first-time enrollees, without disabilities or chronic/mental health conditions.
Measures
- Anxiety and depression: Hospital Anxiety and Depression Scale (HADS), a self-assessment instrument for screening anxiety and depression, excluding somatic symptoms.
- Family functioning: FF-SIL Test, which assesses family functioning across seven dimensions: cohesion, harmony, communication, affectivity, roles, permeability, and adaptability.
- Social support: Medical Outcomes Study (MOS), a questionnaire that evaluates four dimensions of social support: affective, positive social interaction, instrumental, and emotional.
- Sociodemographic information: self-report survey gathering data on sex, age, marital status, economic status, living situation, and migratory status.
Statistical measures
Descriptive analysis, bivariate and multivariate logistic regression analyses.
Results
- Depression prevalence was higher in females (OR 1.41), married/cohabiting students (OR 6.60), and those with bad/deplorable economic situation (OR 1.46).
- Students from dysfunctional families had higher prevalence of anxiety (OR 2.03) and depression (OR 2.07).
- Poor global social support was associated with higher anxiety (OR 2.64) and depression (OR 2.41).
Insight
This study highlights the substantial mental health burden faced by first-year university students in Ecuador, with nearly 1 in 4 experiencing anxiety or depression.
Importantly, it reveals the critical protective role that well-functioning families and strong social support networks can play during this challenging transition.
The findings extend previous work by demonstrating these associations in a Latin American context and focusing on students at the very start of their university journey.
Future research should examine how universities can foster a supportive environment and implement targeted interventions to bolster students’ family and social connections.
Implications
The results underscore the need for universities to prioritize student mental health, particularly among first-year students navigating the adjustment to university life.
Campus mental health services should screen for anxiety and depression and provide accessible treatment.
Prevention efforts could involve programs to strengthen family communication and functioning, as well as initiatives to help students build supportive peer relationships.
Identifying at-risk groups, such as female, married, and economically disadvantaged students, can guide the targeting of resources.
Longitudinal research is needed to track how family and social dynamics influence student mental health over time.
Strengths
The study had many methodological strengths including:
- Representative sample of first-year students across multiple campuses
- Validated measures of anxiety, depression, family functioning, and social support
- Adjustment for potential confounding variables in multivariate analyses
Limitations
This study also had several methodological limitations, including:
- The cross-sectional design precludes causal inferences about the relationship between family/social factors and mental health.
- Students’ self-report of some variables may introduce information bias.
- The study did not assess other relevant factors such as personality traits, substance use, academic load, and interpersonal stressors.
- Longitudinal research is needed to examine the trajectories of student mental health over time in relation to evolving family and social circumstances.
References
Primary reference
Estrella-Proaño, A., Rivadeneira, M. F., Alvarado, J., Murtagh, M., Guijarro, S., Alomoto, L., & Cañarejo, G. Anxiety and depression in first-year university students: the role of family and social support. Frontiers in Psychology, 15, 1462948. https://doi.org/10.3389/fpsyg.2024.1462948
Other references
Abdallah, A. R., & Gabr, H. M. (2014). Depression, anxiety and stress among first year medical students in an Egyptian public university. Int Res J Med Med Sci, 2(1), 11-19.
Beiter, R., Nash, R., McCrady, M., Rhoades, D., Linscomb, M., Clarahan, M., & Sammut, S. (2015). The prevalence and correlates of depression, anxiety, and stress in a sample of college students. Journal of Affective Disorders, 173, 90–96. https://doi.org/10.1016/j.jad.2014.10.054
Epstein, N. B., Baldwin, L. M., & Bishop, D. S. (1983). The McMaster family assessment device. Journal of Marital and Family Therapy, 9(2), 171–180. https://doi.org/10.1111/j.1752-0606.1983.tb01497.x
Ibrahim, A. K., Kelly, S. J., Adams, C. E., & Glazebrook, C. (2013). A systematic review of studies of depression prevalence in university students. Journal of Psychiatric Research, 47(3), 391–400. https://doi.org/10.1016/j.jpsychires.2012.11.015
Islam, S., Akter, R., Sikder, T., & Griffiths, M. D. (2020). Prevalence and factors associated with depression and anxiety among first-year university students in Bangladesh: A cross-sectional study. International Journal of Mental Health and Addiction, 20, 1–14.
Shao, R., He, P., Ling, B., Tan, L., Xu, L., Hou, Y., Kong, L., & Yang, Y. (2020). Prevalence of depression and anxiety and correlations between depression, anxiety, family functioning, social support and coping styles among Chinese medical students. BMC Psychology, 8, 1–19. https://doi.org/10.1186/s40359-020-00402-8
Van der Walt, S., Mabaso, W. S., Davids, E. L., & De Vries, P. J. (2020). The burden of depression and anxiety among medical students in South Africa: A cross-sectional survey at the University of Cape Town. South African Medical Journal, 110(1), 69-79. https://hdl.handle.net/10520/EJC-1bbf474bb3
Keep Learning
- How could universities better support the mental health needs of first-year students? What specific programs or resources would you recommend?
- The study found higher rates of anxiety and depression among female, married, and economically disadvantaged students. Why do you think these groups are at increased risk? How can we ensure equity in mental health support?
- The research highlights the protective role of family functioning and social support. In what ways could universities partner with families or foster a more socially supportive campus environment?
- Imagine you are tasked with designing a longitudinal study to follow first-year university students’ mental health over time. What key variables would you measure and why? How often would you assess participants?
- Given the high prevalence of anxiety and depression, should universities consider implementing universal mental health screening for incoming students? What would be the benefits and challenges of such an approach?
