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ORIGINAL ARTICLE
Year : 2016  |  Volume : 2  |  Issue : 3  |  Page : 145-149

Effect of the penn resiliency program on student with emotional problems


Department of Psychology, Tabriz University, Tabriz, Iran

Date of Web Publication6-Jun-2016

Correspondence Address:
Somayeh Gholami
Department of Psychology, Tabriz University, 29 Bahman Blvd, Tabriz, East Azerbaijan
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2395-2296.180302

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  Abstract 

Aim: Education in university is difficult for some students and so depression, stress, and anxiety are prevalent problems in colleges across the country. People experiencing such psychosocial difficulties are more likely to be defeated in the course. Resilience training can target these risk factors, but there is little research evaluating the effectiveness of such programs. This paper describes the design and measures of a study to evaluate a resilience training program to decrease emotional problems. Methods: This study followed a randomized controlled trial and included a pretest and posttest. A purposive sampling was used. In this way, participants were 30 students randomly selected between who have emotional problems in 2014 at Tabriz University, Iran. They were assigned into control and experimental group. Data were collected using depression, anxiety, and stress scale 21. Cronbach's alpha coefficients for each subscale indicate high internal reliability. Multivariate analysis of variance (MANOVA) was run to analyze the data. Results: The findings of this study show a decrease in the mean score in the mean score of the experimental group in the posttest. Multivariate variance analysis MANOVA showed difference in posttest mean scores of participants' anxiety, depression, and stress in the experimental group. Conclusions: The Penn Resiliency Program will promote psychosocial well-being for student with emotional problems.

Keywords: Anxiety, depression, Penn Resiliency Program, stress


How to cite this article:
Vahedi S, Gargari RB, Gholami S. Effect of the penn resiliency program on student with emotional problems. Int J Educ Psychol Res 2016;2:145-9

How to cite this URL:
Vahedi S, Gargari RB, Gholami S. Effect of the penn resiliency program on student with emotional problems. Int J Educ Psychol Res [serial online] 2016 [cited 2020 Oct 20];2:145-9. Available from: https://www.ijeprjournal.org/text.asp?2016/2/3/145/180302


  Introduction Top


Emotional problems such as stress, depression, and anxiety are prevalent problems in college students across the country. Emotional problems such as stress, depression, and anxiety are prevalent problems in college students across the country. A person suffering from emotional problems create serious problems for university because depressed persons have lack of hope, lacking in or deprived of strength or power, sense of worthless, guilty, loneliness, an hedonic, easily irritated, and ashamed or unable to relax.[1]

They have no interest to do activities that were once pleasurable. In addition, cognitive problems in depressed person such as concentrating, remembering details, and could noting observe deep in thought, and other difficulties such as insomnia, sense of exhaustion and fatigue, excessive sleeping leading persons unable to study, active in classroom, listening to lessons, and so on. Other prevalent disturbance in emotion is anxiety and stress. Anxiety known with features such as autonomic arousal, poor sleep, being irritable a lot of the time, skeletal muscle, and difficulty in concentrating. Symptoms of stress are difficulty relaxing, constant worrying, memory problems, inability to concentrate nervous arousal, being unhappy, and irritable/over-reactive and restless.[1]

All of these features are in conflict with what a student needs to be successful. Despite these, emotional disorders are prevalent among the most common causes of disability. National Institute of Mental Health reported that 13 million American adults (almost one in 17) have a serious mental illness.[2] Mental health disorders cause a severe problem in life. Persons with high levels of depressive symptoms or depressive disorders are at risk for having academic and interpersonal difficulties. It is expected that these students become cigar smoker, use other substances, and make an effort for suicide.[3] In the United States and Canada, accounting for 25% of all years of life lost to disability and premature mortality.[4] Moreover, suicide is the eleventh leading cause of death in the United States, accounting for the deaths of approximately 30,000 Americans each year (WISQARS, 2010). Iranian student population also suffers from depression, anxiety, and stress. For example, study by Najafikolyani and Poornajm showed that 76% of students have stressed, 56% and 53% suffer from depression and anxiety.[5] Another researches show a rise in the number of mental health problems. Meta-analysis of the result in 35 articles in Iran from 1995 to 2012 with a sample size of 9743 show prevalence of depression in the University as 33%.[6] The best explanation we should consider about it is many mental health conditions start in the typical age range (i.e. 18–24-year-old), during college, students deal with a unique amount of stressors, including new lifestyle, friends, roommates that they should share a room, exposure to new cultures, and alternate ways of mannerism and thinking. If the freshmen have difficulty adjusting to a new environment, they are more likely to struggle. Harrison[4] states “if students feel inadequate or incomplete to cope with the new environment of a college campus, they could easily become more prone to depression and anxiety.” There are great academic stressors such as competition, poor management of time, the perceptible pressure to do well the tasks and exams. The emotional problems affect aspects of everyday life functions. Untreated emotional problems last for a long time interrupt day-to-day activities, and are much more than just being “a little down” or “feeling blue.”[7] The American College Health Association–National College Health Assessment (ACHA–NCHA) found that nearly 30% college students reported feeling “so depressed that it was difficult to function” at some time in the past year.[8] The question that arises is how emotional problems affect college students? Depression can have an impact on college student academic performance.[9] Studies suggested that college students who have depression are more likely to smoke.[10] Also, students with depression do not necessarily drink alcohol more heavily than other college students. But, depression among students, especially women are more likely to get drunk and experience problems related to alcohol abuse, such as engaging in unprotected sex.[11] Depression and other mental disorders often accompanied by substance abuse, which can complicate treatment.[12],[13] Depression should be considered as a major risk factor for suicide.[14] Better diagnosis and treatment of depression can bestead reducing suicide rates among college students. ACHA–NCHA declares in the fall 2011 survey that more than 6% college students asserted seriously considering suicide, and about 1% reported attempting suicide in the previous year.[8] Suicide is the third leading cause of death for teens and young adults aged 15–24 years.[15] As for this discussion, when we evaluate universities condition, it seems clear that having mental health resources is necessary for students, and it is necessary to treat depression and other emotional problem.

The Penn Resiliency Program (PRP) researched depression prevention programs, and there are numerous works on it. This curriculum teaches cognitive-behavioral and social problem-solving skills. This package based in part on cognitive-behavioral theories of depression by Aaron Beck, Albert Ellis, and Martin Seligman. Ellis' Adversity-Consequences-Beliefs (ABC) model is central of the program, demonstrating the idea that our beliefs about events mediate their impact on our emotions and behavior. Through this model, students learn to detect unhelpful thoughts, evaluate the accuracy of those thoughts, and challenge negative beliefs by considering alternative interpretations. PRP also teaches a variety of strategies that can be used for solving problems and coping with difficult situations and emotions. Students learn techniques for assertiveness, negotiation, decision-making, social problem-solving, and relaxation. The skills taught in the program can be applied to many contexts of life, including relationships with peers and family members as well as an achievement in academics or other activities.[8]

Therefore, although there is enough evidence indicating the effectiveness of the PRP, there has been little research in this area among nonclinical college student in Iran. The present study aimed at investigating the effects of PRP on emotional problems of students. We hypothesize that students in the PRP intervention will show lower levels of emotional problems compared to control group.


  Methods Top


The study was a randomized controlled trial and included the pretest-posttest control group design. No treatment is given to the control group, while the experimental group was given the Penn Resiliency Training. Participants of the study were new freshmen students who were screened by monitoring health plan via Tabriz university counseling center. Also, Participants were re-screened and re-evaluated by using depression, anxiety, and stress scales (DASS 21). DASS 21 was designed by Lovibond and Lovibond in 1995 to measure emotional distress in three subcategories of depression (e.g., loss of self-esteem/incentives and depressed mood), anxiety (e.g., fear and anticipation of negative events), and stress (e.g., persistent state of overarousal and low frustration tolerance). It was a self-reporting questionnaire with 21-items (7-items for each category) based on a four-point rating scale. To calculate comparable scores with full DASS, each 7-item scale was multiplied by two. Items included, “I found it hard to wind down,” “I was aware of dryness of my month,” and “I couldn't seem to experience any positive feeling at all.” Participants were asked to rate their agreement with each of items (in the form of statements) on a four point Likert scale from “0 = did not apply to me at all” to “3 = applied to me very much, or most of the time”. The higher the score, the more severe the emotional distress was. Internal consistencies (alpha) coefficients for each subscale of depression, anxiety, and stress were 91, 81, and 90, respectively.[16]

Entrance criteria for this study include no use drugs and lack of psychiatric. After reassessing those who have criteria to enter in the study, 30 people were assigned by the hidden and confidential method to equal experimental and control groups. All experimental participants were exposing to 11 sessions in the Penn resiliency training program. Components of the PRP include the cognitive component that made of the ABC model, recognizing cognitive (“thinking”) styles, cognitive restructuring, avoiding erroneous beliefs, decatastrophizing, putting it in perspective and the hot seat, challenging negative thoughts. The second part in this program is social-problem-solving component consist of assertiveness, relaxation, and problem solving.


  Result Top


The mean and standard deviation of all the variables were reported in [Table 1]. The findings showed that emotional problems were reduced from pre- to post-assessment.
Table 1: The mean and SDs of the study variables in pretest and posttest between the groups

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Because, these data did not meet the assumption of homogeneity of regression slopes (F-ratio = 154.57, df = 2, P > 0.05), we conducted further analysis with multivariate analysis of variance (MANOVA).

Data were improved by subtracting the pretest scores from the posttest scores then run a MANOVA on them, and the results are presented in [Table 2].
Table 2: The MANOVA of the means stress, anxiety, and depression in the experiment and control groups

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Before the parametric test of multivariate variance analysis, Box and Leven's tests were used in order to regarding its hypothesis. According to Box test that it was not significant in P ≤ 0.01 for any of variables, condition of equality is regarded in variance/covariance's matrixes (P = 0/029, F = 2/34, Box = 16/19). According to Leven test and its insignificant for all of the variables, the condition of equality is regarded in variances of intergroup.

As it is seen in [Table 2], significance test of MANOVA showed that there is a significant difference between experimental and control groups considering at least one of the dependent variables (Wilks' lambda = 0.59, F = 11.42, P = 0.001, Eta = 0.59). Also, the results of the multivariate variance analysis showed the significant decrease in the mean of scores in stress (F = 40/11), anxiety (F = 0/81), and depression (F = 77/72). In other words, PRP decreases emotional symptoms in experiment group and decreased 43% stress, 45% anxiety, and 53% depression.


  Discussion Top


The present study aimed at investigating how the PRP would influence the student with emotional problems. The results of the MANOVA indicated a decrease in the scores of emotional problems (anxiety, depression, and stress) and its relevant dimensions for the experimental group in the posttest. This finding is at line with Peng and Brun, wasser, Gillham, and Kim that showed that PRP could make better positive emotions, particularly for the low-resilience individuals.[17],[18]

The simplest explanation for this finding is that PRP's effects on a wide range of risk factors, such as difficulties and conflicts with family and friends and pessimistic cognitive styles. PRP improve cognitive style and coping skills. Cognitive style plays a role as a mediator variable in PRP's effects on depressive symptoms.[19]

PRP teaches a variety of behavioral coping, problem-solving skills, assertion techniques, decision making, and relaxation that succumbing to depression and its sequel. Indeed having behavioral skills assist youths to pass this part of life without any abnormality following or resulting from a mental disease or injury. In addition, students have a collective life, so those who are nonassertive usually get depressed and experience stress and anxiety. Assertion training is a popular treatment technique and uses a wide a variety of interpersonal problems. The results of the research showed that over a relatively short period of time, assertion training has effective than traditional psychotherapy in alleviating depression.[20],[21] Also, Yamagishi et al. found that all participants benefited from assertion knowledge and voluntary behavior with regard to job stress, mental workload decreased.[22] Countless studies are reported that problem-solving training is a viable and promising approach to stress management which increases positive psychological resources (problem-solving ability, self-esteem, and life satisfaction). Also, researchers reported that lower anxiety and depression follow after sessions of relaxation training.[23],[24],[25] Another factor that promotes mental health in Penn Program is decision-making training. Indecision causes anxiety and depression. Participating in decision making and problem solving program enables persons to analysis tough problems. Analyzing problems make tough problems to operational priorities that this process causes identify and plan for the resolution of high-priority issues. These abilities decrease negative emotion somewhat.

In total, all of these skills could help members reduce their negative emotions, increase their positive emotions, and step by step acquire a positive emotion regulation style and that positive emotions protect from impact daily stresses.[26]

This study had several notable limitations. First this finding alone is not sufficient evidence that PRP can produce effects in community settings over time or only affect during the course of training. This needs a follow-up study to concern long-term effects of PRP. Second research could not examine moderators of intervention effects, for example, PRP effects on depressive symptoms may differ in boys and girls or preintervention levels of depressive symptoms moderated the intervention effects. Therefore, further research is required to consider moderated factors and delayed posttests for generalizable and reliable findings of the present study. Third limitation that should be mentioned is that PRP trains a different behavioral coping and problem-solving skills, but few studies have considered the cognitive and behavioral program components separately. We recommend future studies should evaluate these behavioral skills as potential mediators of PRP's effects. If behavioral components are the active component, it may be recommendable to revise the program, putting greater intense on these skills.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

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  [Table 1], [Table 2]


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