Undergradu at e S tud ent’ s S tre ss, A n xiet y , De pr ession, and their C o ping st y les d uring COVID - 19

R ub aya t K ab i r 1 , M ar z i a Z aman S ul t an a 1 , M d. S an au l H aq ue M on da l 1 , I sh r ak Kab i r 2

1 E a s t W e s t U n iv e r s it y , B a n g lad e s h

2 N o r t h S o u t h U n iv e r s it y , B a n g lad e s h

A b s trac t
I ntr od uc t i on : C O V I D - 19 w as r e spo nsi bl e f or w i d esp r ea d di st u r ba nce t h r ou gh ou t t he ed uca t i on al syst e m an d w as ha r m f ul i n a varie t y of w ay s. I n pa r t i cul ar w i t h r eg ard t o t he st ate o f a st ud en t ’ s psych ol og i cal he al t h. P urpo se : Th i s s t ud y e xamin es t he r el atio nsh i p be t w ee n psych ol og i c al di st r ess ( de pres si on , an xi ety, an d st r ess) a nd cop i ng st r a t eg i es a m on g t he st ud en t s o f a priva t e u ni versity i n B an gl ad esh du r i ng t he C O V I D - 19 pa nd e m i c. M ethod o l og y : A cr oss - sectio na l w eb - ba sed su r vey w as con du ct ed f r o m S ep t e m be r 20 20 t o D ece m be r 20 21 on 95 1 r esp on de nts usi ng t he D A S S - 21 an d Brie f - C O P E qu estio nn ai r es . R es ult s : Th e m aj ority of st ud en t s w e r e exp e r i en ci ng m i l d t o extr e m el y seve r e de pressi on ( 75 . 8 %) , an xi ety ( 88 . 5% ) , an d st r es s ( 79 . 1 %) . Th e l eve l of st r ess ( p <. 00 1 ) , an xi ety ( p< . 00 1) , an d de pressi on ( p= . 23 ) w as si gn i f i can t l y hi gh er am on g t he f e m al e st ud en t s compared w i t h m al e st ud en t s . Th i s s t ud y al s o hi gh l i gh t s t he cop i ng st r a t eg i es of st ud en t s. H ow eve r , se x di f f e r en ce s w ere no t pro f ou nd i n ad op t i ng cop i ng st r a t eg i es. Th e r esu l t s al so sho w e d si gn i f i can t cor r el atio n be t w ee n so m e B r i ef - C O P E m ea sures , such as acce ptance an d sel f - bl ame ( r =. 70 8 , p< . 00 1) ; us e of i nfo r m a t i on al sup po r t an d em o t i on al sup po r t ( r =. 59 9 , p <. 00 1 ) . C on clusi on : A s t he pre val en ce of m en t al he al t h di sorders w as f ou nd t o be hi gh er among priva t e un i versity st ud en t s , un i versity au t ho r i t i es sho ul d see k ne cessa r y as si st a nce f r o m m en t al he al t h prof essi on al s t o suppo r t t he i r s t ud en t s i n ove r co m i ng psych ol og i cal di st r ess no t on l y r el ated t o t h e pa nd emic bu t al so r el ate d t o t he i r da y - to - da y l i f e activi t i es .
Ke y w ords
A nxi ety, M en t al H ea l t h, B an gl ad esh i un i versity st ud en t s , C ovi d - 19 , S t r es s, D ep r essi on , A nxi et y, C op i ng
A dd res s fo r c orres po n de nc e : Rub a y a t Ka b i r , Se n i o r L e c t u re r, Dep a r tm e n t o f So c i a l Rel a ti o n s , Ea s t W e s t Uni v e r s i t y , Ba n g l a d e s h , E - m a i l : k ru b a y a t@ e wub d .e d u This w o r k is li c e n s e d u n d e r a C r e a t iv e C o mm o n s A t t r ibu t ion - N o n - C o mm e r c ia l 4 . 0 I n t e r n a t ion a l L ic e n s e ( C C B Y - N C 4 . 0 ) . © C o p y r igh t : K a b ir , 2 0 2 3 P u b li s h e r : S c ien d o ( D e Gr u y t e r ) D OI : h t t p s : / / d o i . o r g / 1 0 . 5 6 5 0 8 / mhg c j. v 6 i1. 1 5 6	Sub m itte d for p ub l ic a tio n: 31 M a rc h 202 3 Rev is e d: 06 Ma y 2023 A c c e pte d for p ub l ic a ti on : 08 J u n e 2 0 2 3

67

Introd uc tion

W o r l dw i de , C ov i d - 1 9 ha s c au s ed w i de s prea d di s r up t i on i n t he op era ti on s of a l m os t ev er y s ec tor. A n d, th e e du c a ti on s ec tor i nc l ud i n g prim ar y , s ec o nd ar y a nd terti ar y l e v el i s n o exception to it. Academia has suffered the pandemic's overall effects (Hosen et al., 2022). W hi l e m os t s ec tors w e r e ab l e t o r es um e op erat i o ns af ter the l oc k do wn was ea s ed , ed uc at i on al i ns ti t uti on s r em ai n ed c l os ed , an d th ei r c l os ure w as ex te nd e d s ev era l t i m es ( New ag e B an gl ad es h, 20 22 ) . D es pi te the s e i ns t i tut i o ns be i ng c l os ed f or the l o ng es t pe r i od of ti m e, a v as t m a j orit y of th es e s tud en ts wer e n ev erthe l es s ab l e to c on ti n ue the i r ed uc at i on w i th the a i d of tec hn o l og y ( UN ICE F , 20 22 ; P r i y o & Ha z r a, 20 20 ) . B an gl ad es h ha s 1 09 pr i v ate u ni v ers i t i es , 53 pu b l i c u ni v ers i t i es , an d 3 i nte r na t i o na l u ni v ers i t i es ( UG C, 20 22 ) . T he proc es s of r eo pe ni ng ed uc at i on al i ns t i tut es w as c arr i ed o ut i n ph as es , s tarti ng wi t h th e i ni t i a l op en i ng of s c ho o l s , af ter whi c h th e pu b l i c un i v ers i ti es f ol l o w ed , an d th en , gradu al l y , pri v a te un i v ers i ti es m ad e the de c i s i on to r eo p en as the nu m be r of de ath s c au s ed b y the v i r us s tarte d to d ec l i n e ( Ma hm ud , 20 2 1). A l t ho u gh , pr i v ate u ni v ers i t i es po s tpo n ed th e s tart of on - c a m pu s c l as s es du e to the s hu td o w n, m an y of the s e i ns ti t ute s c on ti n ue d t o pr ov i de on l i ne c l as s es throug ho ut the c l o s ure ( K ha n, Ra hm an &

Is l am , 2 02 1).

In thi s r es p ec t, r es ea r c h s ug ge s ts tha t pa nd em i c s ha v e de tr i m en tal ef f ec ts on m en tal he a l th ( F ai s a l e t a l ., 20 22 ) . F urt he r m ore, the s pread of i nf ec ti ou s di s e as es i s l i nk ed to a de c l i ne i n m en tal he a l th ( Me h aree n et a l ., 20 2 1). A s p er ep i de m i ol og i c al da t a, p eo pl e i n B an gl ad es h are ex pe r i e nc i n g m en tal h ea l t h i s s ue s as a r es ul t of the CO V ID - 19 pa nd em i c an d the s ub s e qu e nt m a s s i s ol ati o n, m os tl y o wi ng to f ea r ( F ai s al et al ., 20 22 ; M d . A . Is l a m et al ., 2 02 0).

B es i d es , the di s r up t i o n of r ou ti ne d ai l y op erat i o ns broug ht o n b y th e pa nd em i c ha s prev i ou s l y s h o w n t o i nd uc e ten s i on an d an x i et y , an d s tud en ts are n o ex c ep ti o n to th es e r ep erc us s i on s ( F ai s al et al ., 20 22 ) . T hi s w as m ai nl y b ec au s e no o ne k ne w w h en t he s i t ua t i on woul d be r es o l v ed ( Hos e n et al . , 20 22 ) . Mo r eo v er, the r e i s c on c ern t ha t un i v e r s i t y s tud en ts , who are i n a tr an s i t i on p erio d be t w e en the i r ac ad em i c an d prof es s i on al l i v es , m a y b e pa r ti c ul arl y v u l n erab l e to CO V ID - 19 r el ate d m en tal he a l th i s s ue s ( F a i s al et a l ., 2 02 2 ; M d . A . Is l am et al ., 20 20 ) .

In ad d i ti on , h om e qu aranti n e c an ha v e a ne ga ti v e i m pa c t on s tu de nts ' m en tal he al t h be c au s e of the i s o l at i on the y ex pe r i en c e f r o m the i r pe ers , the a nx i et y th e y f ee l ab o ut c atc h i n g the di s e as e, the r i s e of do m e s ti c v i ol en c e brou gh t on b y t he s t a y - at - ho m e l i f es t y l e , a nd f i n an c i a l ha r ds hi p c au s e d b y l o s t wor k op po r tun i ti es ( Me ha r e en e t al ., 2 02 1; Rehm an et al ., 2 02 1). Des pi t e the f ac t tha t s tud e nts at r ep uta b l e pri v a te

un i v ers i t i es i n B an gl a de s h t y p i c a l l y h av e a hi g he r s oc i oe c on om i c s tat us c o m pa r ed t o tha t of a pu b l i c un i v ers i t y , t he y w ere un a bl e t o c om pe ns ate f or the lost income through part-time jobs (Hosen et al., 2022; Shafiq, Nipa, Sultana, Rahman, et al., 2021). The students were also subjected to experiencing stress, worry, anger, boredom, loneliness, and other emotions as a result of the schedule adjustment (Huang et al., 2021).

Thus, this kind of situation creates psycho- emotional chaos, which causes anxiety, depression, and stress (Md. A. Islam et al., 2020). Stress is therefore experienced as a combination of mental and physical discomfort that occurs whenever our homeostasis is disrupted; anxiety is the body's natural response to stress; and depression is a state of disinterest in daily activities (Rehman et al., 2021). One's response to stress depends on the level of stress experienced; some people thrive under pressure, while others cope in an inappropriate manner and thus the importance of coping mechanisms in determining psychological well-being cannot be ignored (Huang et al., 2021).

Therefore, coping strategies are employed by individuals to mitigate their stress, anxiety and depression (SAD). These may include emotional, spiritual, behavioural, physical, external, and cognitive strategies (Verma et al., 2021). Study revealed that young people (15-35 years) use passive coping strategies which has negative role in regulating young’s mental health (Huang et al., 2021). Students preferred to use coping to mitigate their stress, including seeking help f r o m oth ers , att em pti ng to s ol v e the i r prob l em s on the i r o wn or c op i ng pa s s i v el y ( B ab i c k a - W i r k us et al ., 20 2 1). In t he c as e of ne ga ti v e c o pi n g, i t i s al m os t al wa y s r ef err ed to as em oti on - f oc us ed or av o i d an t c o pi n g, s uc h as i gn orin g the s ou r c e of di s tr es s or l oo k i ng f or a s ub s ti t ute to al l e v i ate s y m pto m s , l i k e ea ti ng or s m o k i ng ( Huan g et a l ., 20 21 ) .

T he l i tera ture s h o w e d th at un i v ers i t y s t ud e nts r ep orted hi gh er l e v e l s of S A D d urin g th e CO V ID -

19 pa nd em i c ( Huan g et al ., 20 2 1; T s he r i ng & Dem a, 20 22 ) . E v en th o ug h Ind i an s tud en ts di s pl a y e d a l o w l e v e l of de pres s i on , m os t s tud en ts wer e c on c ern ed a bo u t th ei r l i v es an d c areer s ( V erm a et al ., 2 02 1). S tud i es a l s o r e v ea l ed di f f erenti a l l e v e l of S A D b as ed on th e s ex . F or ex am pl e, f e m al e u ni v ers i t y s t ud en ts are m ore l i k el y t o ex pe r i en c e a s e v ere to ex tr em el y hi gh l e v el of a nx i et y ( Me h areen et al . , 2 02 1; R ah m an et al ., 20 22 ; S al m an et al ., 20 22 ) . O n the c on tr ar y , a s tud y c on d uc ted b y Mu ha m m ad et al ., ( 2 02 1) di d n ot r e v ea l an y s i g ni f i c an t d i f f erenc es a m on g m al e an d f em al e pri v a te an d pu bl i c un i v ers i t y s tud en ts i n S A D.

S tud en ts at pri v a te un i v e r s i ti es ex pe r i en c ed hi g he r l e v e l s of m en tal s tr es s tha n tho s e at pu b l i c un i v ers i t i es ( K am r uz z am an et a l ., 2 02 2 ; S ha f i q, Ni pa , S u l tan a, Rahm an , et al ., 2 0 21 ) . O n the oth er

ha nd , ot he r r es ea r c he r s n ote d t ha t s t ud e nts f r o m pu b l i c u ni v ers i t i es r e po r t ed h i g he r l ev el s of de pres s i o n t ha n s tud en ts f r om priv ate un i v ers i t i es ( Me ha r e en et a l ., 20 2 1; M u ha m m ad et al ., 20 2 1).

Mo r eo v er, a nx i et y an d s tr es s are s ee n to b e af f ec ted b y s oc i o - ec o no m i c s tat us ( M uh am m ad et al ., 20 2 1). In a dd i ti on , s tud en ts who w er e ac ad em i c al l y b eh i nd wer e m ore l i k el y to s uf f er f r o m de pres s i on a nd an x i et y ( T s he r i n g & Dem a, 20 22 ) . It w as a l s o o bs erv ed tha t ac ad em i c en v i r on m en ts an d s ub j ec t - r el a te d f utu r e wor r i es are s tr on gl y as s oc i ate d wi th m en tal h ea l th probl em s i n un de r gra du at e s tud e nts ( A l i e t a l ., 20 22 ) .

P r ev i o us r es ea r c he s i nd i c ate s th at s oc i al s up po r t an d c op i ng m ec h an i s m s are protec ti v e f ac tors f or ps y c ho l og i c al he a l th ( H ua n g e t a l ., 202 1). Dur i ng th e pa n d em i c , s tud en ts us ed s ev era l c op i ng s tr at eg i es , i nc l u di ng b eh av i ora l di s en ga g em en t, r el i g i o n, s el f - di s tr ac ti on , i ns tr um en tal as s i s tan c e , pl a nn i ng , a nd ac c ep tan c e as th ei r c op i n g m e c ha ni s m s w i th S A D ( S al m an et al ., 20 22 ; V erm a et al ., 20 21 ) . T he r e i s al s o a s tr on g c orr el at i o n b e twee n S A D s c ores a nd c op i n g s t y l es ( Hua ng e t a l . , 20 2 1). F or ex am pl e, pe r c ei v ed s oc i a l s u pp o r t ha s a n eg a ti v e as s oc i ati on wi th ps y c ho l og i c al di s tr es s ( Rath ak r i s hn an et a l ., 20 2 2 ) .

S i nc e , i t ha s be en no t ed tha t un i v ers i t y s tud en ts ex pe r i en c e ps y c ho l og i c a l i s s ue s o n a r eg ul ar ba s i s ; the r ef ore, i t i s c r uc i al to l oo k at ho w the gl o ba l p an d em i c ha s af f ec ted s tud e nts ’ m en ta l he a l th. Du e to the u na nti c i pa te d na t ure of the s i tua t i on , i t i s i m po r tan t to l ea r n ab ou t t he ps y c h o l og i c al an d s oc i al ex pe r i e nc es of un i v ers i t y s tud en ts i n B an g l ad es h an d the i r c op i n g s t y l es i n pa r ti c u l ar. T he r es ea r c he r s are aw are of v ari ou s s tud i es t ha t ex am i ne B an g l ad es hi u ni v ers i t y s tud en ts ’ s tr es s , an x i et y , an d de pres s i on , b ut no ne of the s e s tu di e s s pe c i f i c al l y f oc us es on s tud en ts ’ s tr es s , de pres s i o n, an d an x i et y as w e l l as th e i r c op i ng s t y l es .

P urpose

T hi s s tud y was the r ef ore d es i gn ed t o ex am i ne the l e v e l of s tr es s , de pres s i on , a nd an x i et y ex pe r i e nc ed b y un i v ers i t y s tud e nts i n B a ng l ad es h, as w e l l as the c op i ng s t y l es the y em pl o y to d ea l wi th i t. T he s pe c i f i c ob j ec ti v es are:

 to ex am i ne the l e v el of s tr es s , an x i et y an d de pres s i o n am on g t he u ni v ers i t y s tu de nts du e t o t h e CO V ID - 19 pa n d em i c ;

 to i de nti f y th e c op i n g s t r ate gi es ad op t ed b y the s tud e nts to m i ti ga t e th ei r s tr es s , an x i et y an d de pres s i on ;

 to ex am i ne whet he r t he r e wer e a n y v aria ti o ns i n t he l e v e l of s tr es s , an x i e t y a nd de pres s i on an d the c op i ng s tr at eg i es b as ed o n t he s ex of the s tud e nts ; an d th e r el ati o ns hi p be t ween ps y c ho l og i c al di s tr es s an d c op i n g s tr ate gi es .

M e th odolog y

Measurement

In this study, we conducted a cross-sectional survey with the students from summer 2020 semester to fall 2021 semester. Using convenient sampling, we recruited study participants from East West University, a private university in Bangladesh. The survey was conducted through Google Forms because physical classes were suspended due to COVID-19 restrictions. Students were sent an email with an invitation to participate in the study and a link to access the survey platform. The students’ email addresses were collected fr om the university portal . The response period for the survey was from 24 September 2020 to 28 December 2021. The total number of students who received the survey invitations was 1080; and the response rate was close to 88.05%, which is reasonable for an online survey. All the students voluntarily participated in the study.

The questionnaire was developed in English and was distributed among the students online. The medium of instruction of the university is English and students were comfortable with the English questionnaire.

Data Collection tool

A self-administration questionnaire was developed. The questionnaire consists of three sections including (i) basic socio-demographic characteristics; (ii) Depression, Anxiety and Stress Scale (DASS21); and (iii) Coping Orientation to Problems Experienced Inventory (Brief-COPE).

Socio-demographic data collected includes sex, age, education level (freshman year sophomore year, junior year, senior year), department (science and engineering; liberal arts and social sciences; business and economics), residential status, family members, occupational status, and average monthly income of the household.

The DASS framework has 21 items (DASS-21) which consist of three self-report scales designed to measure the emotional states of depression, anxiety, and stress of a person (Lovibond & Lovibond, 1995). Each item of DASS is measured with a four-point Likert scale’ 0 (didn't apply to me at all), 1 (applied to me to some degree or some of the time), 2 (applied to me to a considerable degree or a good part of time), or 3 (applied to me very much or most of the time). The sum scores on each item (depression, anxiety, stress) of DASS-21 are multiplied by 2 to calculate the final score. The threshold to categorize the level of DAS are as follows: (depression: Normal 0-9, Mild 10 -13, Moderate 14-20, Severe 21-27, Extremely

Severe 28+); (Anxiety: Normal 0-7, Mild 8-9,

Moderate 10-14, Severe 15-19, Extremely Severe

20+); (Stress: Normal 0-14, Mild 15-18, Moderate

19 - 25 , S ev ere 26 - 3 3, E x tr e m el y S e v er e 34 + ) . T he Cr on ba c h al ph a f or de p r es s i on , a nx i et y , an d

s tr es s s ub s c al es w ere 0 .86 , 0.7 8, a nd 0.7 4, r es pe c ti v el y . T he ov eral l Cr on ba c h a l ph a of DA S S - 21 w as 0. 89 .

T he B r i ef - CO P E f r a m ew ork ha s 28 i tem s de s i g ne d t o m ea s ure eff ec ti v e an d i n ef f ec ti v e wa y s t o c op e wi t h s tr es s ful l i f e e v en ts ( Car v er, 19 97 ) . B r i ef CO P E em pl oy e d a f ou r - po i nt Li k ert s c al e r an gi n g f r om ‘ 1’ ( I ha v e no t be e n do i n g th i s at al l ) to ‘ 4 ’ ( I ha v e be e n do i n g thi s a l ot). T he hi g he r s c ore of c op i ng s tr at eg i es us ed m ea ns tha t the r es po n de nts ha d em pl o y e d c op i ng s tr ate gi es m ore o f ten . ( Me y er, 20 0 1) f urther c ate go r i z e d B r i ef - CO P E m ea s ures i nto tw o t y pe s : ( i ) ad ap t i v e c op i n g s tr ate g i es i nc l ud e ac t i v e c op i ng , ac c ep tan c e, hu m or, pl an ni ng , po s i ti v e r ef r am i ng , s ee k i ng s oc i al s up p ort, r el i gi o n, us e of e m oti on a l an d i ns tr um en tal s up p ort; ( i i ) m al ad ap t i v e c op i ng s tr ate gi es i nc l ud e b eh a v i oral d i s en ga g em en t, de n i al , s ub s ta nc e us e , v en ti ng , s el f - di s tr ac ti o n, an d s e l f - bl am e .

S amp le

A t ota l of 9 51 v a l i d r es p o ns es w ere c ol l ec ted us i ng a c on v en i e nc e s a m pl i ng tec hn i q ue . T he s tud en ts w ere f r om the f a c ul ti es of s c i en c e an d en g i ne erin g, b us i n es s an d ec on om i c s , an d l i b eral arts an d s oc i a l s c i en c e s . T he s a m pl e w as c o m po s ed of 51 .31 % f em al e s tud en ts a nd 48 .6 9% m al e s tud e nts be twee n the ag es of 18 an d 23 , who wer e e nrol l e d i n the un d ergr ad ua t e

progr am s i n the s u m m e r 20 22 to f al l 20 21 s e m es ter of th ei r u ni v ers i t y s tud y pl an .

Dat a A n al ys i s

S tat i s ti c a l a na l y s i s was pe r f or m ed us i n g Mi c r os of t E x c el 20 21 an d S P S S s of tware v ers i o n

26 . Des c r i pt i v e ( e.g ., p erc en tag es , f r eq ue nc i es , m ea ns , s tan da r d de v i a t i on ) an d i nf eren ti a l s tat i s ti c s w ere c a l c u l ate d u s i ng S P S S s of tw ar e.

E t h ica l Co n side r atio n

T he s tud y was c on du c te d i n l i n e w i th t he Hel s i nk i de c l arati on . P arti c i pa t i on i n the s urv e y was v ol un tar y an d n o i nc e nti v es wer e of f ered f or pa r ti c i pa t i on . T he o nl i ne s urv e y i nc orpor at ed a r eq ue s t f or i nf orm ed c on s en t, a nd s tu de nts ha d to prov i de th ei r c on s en t b e f ore the s urv e y w as ad m i ni s tered .

Res ults

Respo n d ent ’s p r o f ile :

T he m ea n ag e of the r es po nd e nts w as 21 .7 7 years (SD=1.48), ranging from 18 to 23 years (Table 1). More than half of the respondents were female (51.3%). Over two-fifths (41.1%) of the r es po nd en ts w ere f r om t he i r s op ho m ore y ea r , f r o m the bu s i ne s s an d ec o no m i c s f ac ul t y ( 49 . 1%) , l i v i ng w i t h a nu c l e ar f a m i l y ( 5 7.8 %) , an d un em pl o y e d ( 6 3.0 %) . T h e a v erag e f am i l y s i z e was 4.3 6 ( r an g e: 2 to 6).

T ab l e 1 : S oc i o - de m og r ap h i c prof i l e o f s tud y p arti c i pa nt s ( n= 95 1)

Var iab les		F r e q u e n c y	P e r c e n t
Age (in y e a rs)	18 - 21	457	48.1
	22 a nd a bove	494	51.9
Ge nde r	F e male	488	51.3
	Ma le	463	48.7
Educ a ti on leve l	F re shman y e a r	37	3.9
	S ophomore y e a r	391	41.1
	J unior y e a r	291	30.6
	S e nior y e a r	232	24.4
L ivi n g with bot h pa re nts	Ye s	738	57.8
	No	213	42.2
F a mi l y m e mber s	≤ 4 membe rs	556	58.5
	≥ 5 membe rs	395	41.5
Oc c upa ti ona l st a tus	Une mpl o y e d	599	63.0
	Empl o y e d	300	37
Ave ra ge mont hl y income of house hold	Tk. ≤ 50,000	455	47.8
	Tk. ≥ 50,001	496	52.2
F a c ult y	S c ienc e a nd e n g inee ring	285	30.0
	L ibe ra l a rts a nd s oc ial sc ienc e s	199	20.9
	B usiness a nd e c onomi c s	467	49.1

P s yc h o met r i c p r o p e r t ies ( B as ed on D A S S - 21 scale):

The range o f depression, anxiety and stress varied from normal to extremely severe levels. 25.4% of the study participants had moderate depression, 22.1% had extremely severe

de pres s i o n a nd 24 .2% w er e no r m al ( T ab l e 2). O n the an x i et y s c a l e, th e m a j orit y ( 49 .0 %) ha d ex tr em el y s e v er e an x i et y a nd 1 9.9 % ha d m od erate an x i et y ( T ab l e 2). A nd on the s tr es s s c al e, 2 6.9 % ha d m od era te s tr es s , 26 .5% ha d s ev ere s tr es s an d 2 0.9 % w ere no r m al ( T ab l e 2 ) .

T ab l e 2: Ran ge of De pres s i on , A nx i et y an d S tr es s a m on g s tud y p arti c i pa n ts ( n= 95 1) ( S o urc e: S urv e y , 2021)

S ev er it y lev el	Depre ss ion	A n x iet y	S t r es s
Nor m al	23 0 (2 4.2 %)	10 9 (1 1.5 %)	19 9 (2 0.9 %)
Mi l d	11 5 (1 2.1 %)	52 ( 5.5 %)	15 4 (1 6.2 %)
Mo de r ate	24 2 (2 5.4 %)	18 9 (1 9.9 %)	25 6 (2 6.9 %)
S e v ere	15 4 (1 6.2 %)	13 5 (1 4.2 %)	25 2 (2 6.5 %)
E x tr em el y s ev ere	21 0 (2 2.1 %)	46 6 (4 9.0 %)	90 ( 9.5 %)

While comparing the levels of stress, anxiety and depression among females and males, it was found that there was a significantly higher proportion of reported normal levels of stress,

an x i et y , a nd d ep r es s i o n ( T ab l e 3). In c on tr as t, a s i gn i f i c an tl y hi gh er pr op orti on of f e m al e r es po nd en ts r ep orte d ex tr em el y s ev ere l e v e l s of s tr es s ( 12 .9% v s . 5. 8%) , an x i et y ( 56 .6% v s .

41 .0 %) , an d de pr es s i on ( 25 .2% v s . 18 . 8).

T ab l e 3 : Le v e l of s tr es s , a n x i et y an d d e pres s i on ba s e d on s ex of th e r es po n de n ts

S e ve r ity le ve l	De p r e ssi on	Anxi e ty	S tr e ss
Ma le
Nor mal	130 ( 28.1% )	70 (1 5.1% )	127 ( 27.4% )
Mil d	55 (1 1.9% )	30 (6 .5% )	80 (1 7.3% )
Mode ra te	122 ( 26.3% )	94 (2 0.3% )	127 ( 27.4% )
S e ve re	69 (1 4.9% )	79 (1 7.1% )	102 ( 22.0% )
Ex tre mel y se ve re	87 (1 8.8% )	190 ( 41.0% )	27 (5 .8% )
F e male
Nor mal	100 ( 20.5% )	39 (8 .0% )	72 (1 4.8% )
Mil d	60 (1 2.3% )	22 (4 .5% )	74 (1 5.2% )
Mode ra te	120 ( 24.6% )	95 (1 9.5% )	129 ( 26.4% )
S e ve re	85 (1 7.4% )	56 (1 1.5% )	150 ( 30.7% )
Ex tre mel y se v e re	123 ( 25.2% )	276 ( 56.6% )	63 (1 2.9% )
	χ 2 = 11.33, df= 4, p= . 023	χ 2 = 29.20, df= 4, p< .001	χ 2 = 38.36, df = 4, p< .001

Note : df = de gre es of fr ee do m ; χ 2= Chi - s qu are tes t