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And you thought your first day of secondary school was scary. Starting in college is a whole new world: yes, you're independent, but you're also responsible for yourself. Food, bills, study and friends are all on you now. It's unfamiliar terrain and for some students, it can be daunting. So is college, as the old cliché goes, really "the best time of your life"?

Fear not: the road through college is a well-worn path and the trails are clearly marked. We asked three people for their advice.

Ben Doyle (19) is entering his second year of a four-year corporate law degree at NUI Galway. Catherine O'Connor is an education consultant who specialises in student recruitment at Trinity College Dublin, and the author of Cracking the College Code: a Practical Guide to Making the Most of the First-Year College Experience. Helen Vaughan is a psychotherapist and the owner of MaynoothCounselling.ie.

The first month Catherine O'Connor: My job is to recruit students, so I have to understand their needs. Some years back, I was looking into how students adjust to college both socially and academically, especially in the first year. So I met with more than 1,000 parents and students (mainly in focus groups) from a variety of backgrounds.

I found that people didn't really know how to navigate the college experience. How will they adjust to managing finances? Can they cook? If they're living at home, how will they get on with their parents or guardians? Will they make new friends in college, and how will they mind their mental health? Students worry that they won't make the most of the experience and this can make them anxious. I wrote the book to help answer some of these questions. Ben Doyle: I'd always wanted to do a commerce degree, but was also interested in the law. Corporate law was a good mix for me. I knew a few people going to NUI Galway, and it was reassuring to have them; the first day in a campus like this is exciting, but it's also daunting. You do feel thrown in the deep end - at first. That changes fast. Helen Vaughan: The biggest problem I see with my student clients: social anxiety. Not just among first years, though the first months in college can be really hard. In school, you're looked after, and you're furious about being constantly hounded to do your homework. In college, if you don't do the homework, nobody really cares and suddenly you'll miss that parent giving out to you. It can be hard to cope with independence when you finally have it, and hard to be responsible for your own work, food, finances, social life and friends.

Suddenly, you have to drive yourself; the chauffeur is gone. Some people are very good at it if they're particularly diligent and self-disciplined, but people can be thrown for all sorts of reasons, often unexpectedly. I see the ones who know they need help, but I suspect most don't think or know they need help, and they can find it hard to talk and explain how they feel.

Making friends BD: I wasn't scared, because almost as soon as you're in the college gate, there's a really well-thought orientation for new students. In the first week of college, you're really busy and there's plenty of events and activities in the first week where you meet new people. With your classmates, you find out more about your course. You get involved in societies. And everyone around you wants to meet new people and make new friends.

Clubs and societies make that easier because you're with people who share your interests. I joined loads of societies straight away - for the bags of sweets! I got involved with the debating and law societies.

Social media is great for talking to friends, planning activities and group assignments. But we're not wedded to it: most of my interaction is still person-to-person. I like hanging out with my friends for an hour or two, having a cup of tea, talking in person.

I don't think my age group drink as much as others. But if you are going to have a few drinks during the week, just make sure you can recover for the next day. Especially if you have a 9am lecture.

I didn't join any sports clubs in college, but I kept playing rugby with the under-20s in Tullamore. We won the league and the cup. It's not always the easy to find the time, but I'm glad I kept this big part of my life before college. C O'C: My research shows that 62 per cent of students worry about fitting in socially. You will meet people in tutorials and at lectures. You need to seek out the clubs and societies that interest you. Try new things and see what you like.

Some students worry about remaining loyal to old friends but you can keep the old ones and make new ones too. H V: I talk to people about how to manage their mental health. Recognise anxiety: heart beating faster, sweaty palms, feeling really tense - once they recognise it they know it is not a heart problem; it is anxiety, and it will pass. A panic attacks feeds on you fighting it. Tell yourself it is not pleasant, but it is not dangerous and it will pass. There are breathing exercises you can do if you feel pressured.

Most colleges have counselling services but they can be overprescribed. You don't have to be suicidal to call The Samaritans [see below: Support and help].

Academics H

V: Students can be stressed about lectures or walking into the room if they're late, so they don't go in the first few weeks and can find it harder to make friends.

Others stress about their course work and why they're not doing better, but it takes time to adjust to college. Let go of perfectionism - there comes a point when your work is good enough. I see students leaving it too late to start projects or get the book before it disappears from the library. They have to get used to setting their own deadlines without parents breathing down their neck. You can drink seven nights a week if you like, but you won't pass.

I found myself on the wrong course. I had to eventually admit that French wasn't for me, so I transferred to another course in another college and never looked back. People change their careers a few times in their life and it's fairly common to change course or do a new one - although, of course, this can be a financial challenge as you have to pay college fees. C O'C: If you set out to have discipline in your study from Monday to Wednesday, Thursday can follow the same pattern easy enough. Attend all lectures and tutorials. Take notes, keep them well, and back them up, remembering that technology doesn't always work. Read your notes and write down where your gaps are. Read beyond your own discipline, read everything. And remember: no matter how bright you are, you will meet brighter minds.

But no matter how motivated you are to study, you can feel lonely in the first semester and wonder if you're in the right course. I advise students to stick with it as long as they can and give it their best shot. Find out early on about the academic demands (read the handbook) and establish what you like about the course. Don't cut and run after three weeks; they can be tough anyway and it may be other factors making you question your course choice. If the student works hard to develop a strong work ethic and gets those three good days in, they can feel a lot better.

College doesn't share academic results with parents. Students also quickly learn that if they don't attend college it will affect their grades. B D: My biggest struggle in first year was the academic adjustment. For the Leaving Cert, core textbooks are your bibles and you have all the resources you need to hand. In college, you have to sift through a lot of information and perspectives, come to conclusions and back it up with research and references. I found my first assignment hard; we had to think creatively and be very open-minded. I didn't do great but, assignment by assignment, I'm learning how to research and write.

Finances

C O'C: Financial pressure can lead to dropping out. There needs to be a discussion early on about where the money for college comes from and who is paying. If the student takes a part-time job, how will that impact on their commitment to study or on their college experience? They need to budget: write out what the costs are and what the sources of finance are, including bank or credit unions loans, support from family and summer work. StudentFinance.ie is a good resource. B D: I'm lucky that I have support from my parents, and I work part-time to supplement that. I learned through experience how to budget and how much money I needed for groceries, food and books. Lots of nights out can damage your wallet. I'm learning how to cook: I do a mean beans on toast and chicken curry.

I share a student apartment in Corrib Village, the on-campus accommodation. We all clean up after ourselves and look after our own rooms, respect each other's space. H V: Finding accommodation is a big stress for students; it's in short supply. It can be hard to manage your own finances and learn to cook and clean for yourself, but it's a big kick in the arse to help you grow up.

Self-care is important:eat well, exercise, be among nature when you can, even if it's just a walk along the canal (if you're in Maynooth). Keep up the sport you did in school. Take a few moments now and again to check in with yourself and where you are in this moment, rather than where you were earlier or will be later. I give clients breathing and meditation exercises. And finally, I recommend a gratitude journal, where you write down three things every day - it could be a nice lunch, meeting someone you like, or even that it didn't rain. It helps the brain appreciate the nice things and worry less.

Support and help Samaritans: email jo@samaritans.org, text 087-2609090, or freephone 116123

Some student unions operate confidential and anonymous listening services. The biggest of these is NiteLine, run by and for students of several universities, colleges and institutes of technology (Freephone: 1800-793793), Student union welfare officers, college chaplains, counselling services and students advisers are all there, while most tutors and lecturers know how to help and support students who are going through a tough time.

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Tips for surviving your first year in college

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First year in third level can be a challenge but there are steps you can take to help ease the transition

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Opinion: higher education had a plethora of challenges before the arrival of Covid-19, but the situation is even harder now
While the reopening of schools has been the focus of attention recently in Ireland, higher education is also under major pressure at the start of a new academic year. As a fresh intake of students embarks on a new journey, third level institutions here and abroad are enduring a bumpy ride in the face of four major challenges: funding shortages; expectations; rising pressures and the impact of Covid-19.

Funding shortages - where's the money?

The role of the State in funding higher education varies greatly. A 2017 European Commission report found that 11 of 42 systems levied no fees at all for first time undergraduates, with some countries also offering grants and other supports. At the opposite extreme, notably in the United States, Australia and England, the state has minimised its funding role, leaving higher education institutions to compete in an open market. Rising tuition fees, typically £9,000 per year in England and significantly higher at US private universities, have filled the gap. Payment is often via loans, with over 40% of students owing more than $20,000 on graduation in 2017.

Even in countries where state funding is the primary model, the 2008 recession led to reductions in government support, reported at a third for Ireland, 21% for Spain, and 11% for France between 2008 and 2016. Countries have worked hard to attract international students who pay higher fees. Students from abroad constitute more than a fifth of the total higher education population in Australia and the UK and over a tenth in Ireland, but the coronavirus crisis has made revenue from this group very uncertain.
From RTÉ One's Six One News, 1,500 scientists warn of third-level funding crisis in May 2020
Ireland is badly positioned regarding higher education funding and is experiencing the worst of all worlds. Students are paying the second highest undergraduate fees in Europe, while State funding has fallen well below demand. The Irish Universities Association (IUA) has campaigned to point out serious deficits, including the halving of state funding per student between 2008 and 2017, below-average percentage of GDP expenditure and outdated facilities and equipment. Students have marched and scientists have written to highlight the need for investment. Successive governments have nevertheless failed to grasp the nettle and commit to a sustainable funding model from the options presented in the Cassells Report in 2016.

Great expectations - what's higher education for?

More is expected of higher education institutions than ever before. Student numbers have risen dramatically in recent decades, due to a combination of demographic factors, higher social aspirations and government policies to widen participation. Raewyn Connell in The Good University notes that the percentage of the relevant age group participating in higher education globally more than trebled between 1970 and 2015, rising from 10% to 36%, with some countries recording figures higher than 50%.

Accommodating this growth in a difficult funding climate is a major ongoing challenge. This is especially true for Ireland which the IUA highlights as the most highly educated state in the EU, with the overall student population expected to rise by 40,000 by 2030. This will supplement a growth of 50% in university enrolments since 2000.
From RTÉ Radio 1's This Week in January 2020, Jim Miley from the IUA on why third level funding should be a general election issue
The student body is not just larger but also more diverse in terms of age, socioeconomic background, part-time participation and family responsibilities. A more diverse mix of students brings a wider range of expectations around transitional supports, flexible routes to academic qualifications and online learning opportunities.

As tuition fees have risen so have the expectations of students from all backgrounds. A more consumerist view is evident among students. Choice of where to study is informed by research on institutional track record and, especially for those taking out loans, perceived value for money which is a key measure in the annual UK Student Academic Experience Survey. Future employability is a strong focus for students in a competitive and rapidly evolving job market in which it has been estimated that 65% of children starting primary school in 2018 will take on jobs not yet in existence. The onus is on higher education institutions to ensure dynamically evolving, relevant programmes and qualifications.

Rising pressures - accountability and competition

Accountability and competition are sources of increasing pressure for higher education institutions. Governments may have scaled back their funding, but many have intensified their emphasis on monitoring performance. This may focus on measuring the quality and impact of research and teaching, exemplified in the UK by the Research Excellence Framework and the Teaching Excellence Framework. For Ireland, each institution agrees a Performance Compact with the Higher Education Authority (HEA), including annual targets and a provision that "HEA may, based on material assessed and underpinning metrics/indicators withhold up to 3-5% of funding.".
From RTÉ Archives, Una O'Hagan reports for RTÉ News in 1989 on the Higher Education Authority's survey of Irish graduates and how they have fared since graduation over the last two years
Public scrutiny of higher education has also increased. Gender equality is an area of particular focus and one where much remains to be done. The European Commission reported in 2017 that women were heads of only 22% of Europe's higher education institutions and in 2016 held only 24% of Grade A academic positions. The University of Limerick appointed Ireland's first female university president in July 2020.

Higher education institutions operate in a highly competitive environment, intensified by the need to win funding from a diversity of sources due to declining state support. Building a strong international reputation is vital to attracting students, staff, donors and research funding. Success is often measured by positioning in the league tables of a range of global ranking systems whose influence has grown despite widely recognised flaws. These include a lack of differentiation between types of institution and limited emphasis on teaching. Irish universities have struggled for position in these rankings in recent years despite some improved placings in 2020.

Individuals on campus are feeling the pressure too. Academic staff are expected to publish in highly ranked journals and win research funding to advance their careers and to push their institutions up global ranking lists. Teaching has received less emphasis and reward than research, but has been made more challenging by the coronavirus and, for Ireland, higher staff-student ratios than elsewhere. Job security has become an issue globally as temporary employment of staff has grown. This and other factors prompted President Michael D Higgins to express concerns in 2019 about academic freedom and engagement with pressing world issues above the demands of the marketplace.
From IIHA Fordham, President Michael D Higgins' October 2019 lecture on "Humanitarianism and the Public Intellectual in Times of Crisis"
Administrative staff have experienced the deepest cuts in numbers and budgets since the 2008 recession. Academic libraries, for instance, struggle to support more students while reshaping their role in higher education.

Students also face a range of challenges. These include affordability as tuition fees have risen worldwide, including in Ireland where undergraduate fees are €3,000 a year. Another major worry is the increase in mental health issues as students encounter many pressures, including transition to college, costs, loan debt, examination stress and a competitive job market. Student suicides have hit a record high in the UK, while a 2019 survey by the Union of Students in Ireland found that 38% of students reported experiencing extreme anxiety and 30% reported symptoms of depression. The survey highlighted pressures arising from difficulties with accommodation and the need to take on jobs to pay fees or rent.

The word of the year - the Covid impact

The coronavirus pandemic has made a difficult operating environment for higher education much tougher. As noted earlier, international students represent a significant source of income, but they will now be less willing or able to travel. The IUA has calculated a loss of revenue of €374 million for Irish universities in the 2020 and 2021 financial years, while one commentator estimates that it will take five years for international student numbers to return to 2019 levels globally.
From RTÉ Radio 1's Drivetime, John Cooke reports on the reopening of universities
Moving to primarily online teaching and learning is far from straightforward. Progress had been slower than expected before the pandemic as lecturers grappled with how best to leverage online technologies, often with limited time and familiarity, alongside concerns about their effectiveness for learning. The sudden shift online following campus closures in March has been followed by intensive preparation for a more concerted online offering across most if not all of the 2020/21 academic year.

The on-campus experience is a vital element of student life and institutions are challenged with providing this as far but as safely as possible in a highly unpredictable virus situation. The intended proportion of in-person teaching had looked like averaging about a third for Ireland, with variations per course. An escalation in cases has, however, resulted in Government advice that institutions deliver entirely online tuition in the immediate term.

Over 10% of US institutions will teach fully online throughout autumn 2020. High numbers of infections reported soon after reopening at universities in North Carolina and Alabama are worrying, and there are concerns for campus safety. The only certainty seems to be that student life will be very different than before March.

Since the world's first university was founded in 859, higher education has shown resilience in the face of many challenges over more than a millennium. It continues to have a huge societal, economic and cultural impact worldwide, and the IUA estimated a university contribution of almost €9 billion to the Irish economy in 2017/18. Demand remains high, with student participation at record levels globally. There are some positive signs of state support too. Financial aid against the coronavirus impact has been welcomed in some countries, including Ireland, where the positive early work of the new Department of Further and Higher Education, Research, Innovation and Science is encouraging in difficult times.
The views expressed here are those of the author and do not represent or reflect the views of RTÉ

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University challenge: higher education faces some tough questions

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Higher education had a plethora of challenges before Covid-19, but the situation is even harder now

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Last year was my first year at college studying Accounting and Finance in DCU. With the help of the Disability and Learning Support Service, I not only survived, but thrived in university.

Due to my mental health problems, I can't handle stress very well and have occasional panic attacks. I also have Aspergers, which makes it very difficult for me to break rules or instructions given, deal with a lack of structure or sudden changes without proper explanations and understand social cues. This can make meeting new people and starting new topics in lectures difficult, meaning I need to spend more time studying at first.

First year in college naturally had lots of new situations for me to get used to. There was a lot more free time than in secondary school, a need to take a lot more notes during class, longer essays and a larger amounts of group assignments, exams that were a lot more serious than what I'd done before. However, I received a lot of help before lectures even started.

Anyone who qualified for the DARE scheme during the Leaving Cert or would be registering with the Disability Service had an orientation day where we were given multiple different talks on various things such as the types of assistive technologies available, top tips for first years from those in the year ahead of us and different workshops available to us to learn important skills for college.

When I registered with the disability service we discussed what sort of problems I might have during the semester and they arranged for me to have a meeting with the assistive technology officer and the occupational therapists. We also discussed what sort of exam supports I would need. There were a lot available (due the fact I registered with them before the deadline: mid-October for Christmas exams and mid-March for Summer exams): the use of a laptop, extra time, a computer programme called ClaroRead which reads out the exam paper for you (text to speech), a smaller centre, rest periods and others.

The Occupational Therapists are brilliant for helping you create order and stability in your life. They can help you organise a study routine that suits you, learn time management, if you're finding it difficult to make friends they assist you in getting involved in a society and help with your wellbeing.

The Assistive Technology Officer is great in making lectures easier for you. She has a range of things that can help you whether you prefer to use a laptop to make notes or write them on pen and paper. For example, you could get a digital voice recorder to use to record your lectures.

I had the use of that voice recorder, extra time in exams and a smaller centre to work in as well as the help of the OTs during the year. I also had access to counselling if I needed it. Overall, they made my life a lot easier during first year.

Blog Author

Patrick Foley is a 2nd Year Accounting and Finance Student in DCU.

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Blog: My first year in college experience

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Study at a college or university in Ireland

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Find colleges and universities to study in Ireland and how to apply

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​Expectations and Worries

Perhaps you aren't worried about missing home and you can't wait to get started. Even so the likelihood is that someone you know or perhaps even yourself at some point may start to miss home.

In those situations or for those who are feeling worried before making the move, know that moving away from home is a change that can be worrisome but one that affects everyone at some point in their life. Remember that technology can can make the world of difference, as it's easy to get in contact with the people you miss.

It can also help to prepare for some aspects of living away from home that require adjustment to usual routines such as food shopping, cooking, laundry etc. You could plan out your time for the week, share tips and ideas with other students or even share these responsibilities with friends by taking it in turns to cook meals, buy food etc. Depending on where you are you might be able to take advantage of university canteens and washing facilities to make living away from home easier.

It's worth noting that over half of students find living away from home easier than expected. You will probably find that at university there's still a strong supportive community in place, with many staff and students going through a similar change.

If you have been at university for a few weeks and you still feel unsettled, it's okay. Going to university marks a huge change in your environment and lifestyle. This change can take a while to get used to. More than half of students feel homesick during this time. For some people, visiting home initially and slowly reducing the frequency can be really useful to help adjust.

- - - - In the meantime, here are some wonderful resources:
How to cope with change
Part 1: Exploring your new surroundings
Part 2: How to overcome homesickness
Part 3: Managing your workload

​Practical tips before you move (and back)

​Freshers' Week

It's easy to drown in the sheer number of articles and blog posts that give lists of tips for "getting through" or "surviving" freshers' week. The important thing to remember is that freshers' week doesn't have to be the best, most exciting part of your university experience. For a lot of people it's a great experience but don't worry if it doesn't ﻿turn out to be the best week of your life. It's ok to feel whatever you feel about freshers' week. Another thing to realise is that you're entering a supportive community where students and staff are working to make sure that things go smoothly.

It won't be necessary to memorise all of the tips you find on the internet, if you run into any difficulties remember that there are lots of people who are there to support you, from the Students' Union welfare officer and student advice services, to fellow students who can point you in the right direction.

Here are some of the best compilations of freshers' week tips:
- Freshers' week tips from The Student Room
- Freshers' week tips from Studential
​
Feeling pressured to drink?

Freshers' week and university life in general is often associated with the pressure to drink from friends, and the misperception that you need to drink to have fun. This needn't be the case.

You don't need to order alcoholic drinks at the bar - if you would rather stick with soft drinks, do so and don't let people make you doubt your decision. If nights out are something you would rather not fill your week with there are plenty of alternatives. In recent years, many university Students' Unions have begun to organise freshers' week events which are neither associated with nightclubs or alcohol. The preconception that university life involves going out and drinking too much is a myth.

​Looking after yourself

In the chaos and novelty of university life it's easy to forget about looking after yourself, in terms of both your physical and mental health. As welcome events settle down and you find yourself with more time, you'll have the opportunity to step back and organise your daily life.

See our resource on Looking After your Mental Wellbeing to find out more.

Getting into a regular sleeping pattern. Try to get to bed and wake up at roughly the same time every day - and avoid sleeping in too late at the weekend. Getting enough sleep at a time your body is used to will set you up for the day ahead! If you're an enemy of traditional alarms, you could always download a radio alarm app, or buy a lamp which lights up in the morning, filling your room with light that feels natural.

Eating as healthily as you can. Getting your nutrients and eating food which sustains your energy through the day will make you feel much better than constantly drinking caffeine and buying take-aways. But what if I can't cook, I hear you cry? Cooking is much easier than you might think - it's ultimately a matter of following instructions - so the main thing to do is find some easy and healthy recipes to make in your student kitchen. Here's where to start:

Getting some exercise. Exercise helps you sleep well, helps you feel energised, and boosts feelings of wellbeing. A brisk walk or jog a few times a week will set you on track for greater feelings of wellbeing. Joining a society for your favourite sport, or outdoor activity may help you to integrate exercise into your weekly routine.

Leaving time to relax. It's not a good idea to be busy all the time! Having some time to wind down and recharge is key to maintaining positive mental wellbeing. Read a book, take a walk, have a bath - if anything, it'll make you more productive when you are busy doing activities. Above all, it's the best way to head off rising anxiety levels.

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​Starting university can be a wonderful and exciting experience, but it can also bring its own unique challenges. It's natural to feel nervous or overwhelmed during the first few weeks at...

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Week 4:(1)Journal articles based on a more refined search.

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Week 4:(1)Journal articles based on a more refined search.

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Mental Health Issues and the University Student

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Case-based intervention strategies for mental health professionals working with college and university students.Young adults enter college with many challenges-complicated family dynamics, identity issues, and extreme pressure to succeed, among others.

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Carolina Santillán Torres Torija * carolina.santillan@comunidad.unam.mx

Universidad Nacional Autónoma De México, México

María Del Rocío Hernández Pozo **

Universidad Nacional Autónoma De México, México

Yadira Bravo *** xyadirab-p@hotmail.com

Universidad Nacional Autónoma De México, México

Ale Castro Hurtado **** poliita-27@hotmail.com

Universidad Nacional Autónoma De México, México

Marleen Romero ada_pink_18@hotmail.com

Universidad Nacional Autónoma De México, México

Prevalence of anxiety symptomsin a sample of college students at afaculty of health sciences in Mexico

Tesis Psicológica , vol. 11, no. 2, pp. 12-22, 2016

Fundación Universitaria Los Libertadores

Received: 19 January 2016

Accepted: 10 June 2016

Abstract: Background: Anxiety symptoms are one of the more frequent mental health related issues prevalent on the Mexican population. College students are at risk of developing anxiety symptoms because of the challenges related to starting college studies and pursuing a college degree. Objective: Levels of anxiety symptoms in a sample of college students were assessed to examine their prevalence among the different university school programs. Participants: 270 college students at the National Autonomus University of Mexico, FES Iztacala, Faculty of Health Sciences. Method: Beck Anxiety Inventory was completed by the balanced sample at University campus. Results: Almost one quarter of the population has symptoms of anxiety above the cut point. Female students showed to be more anxious than male students. Younger students showed higher prevalence of anxiety symptoms. Conclusions: Findings provide evidence that females may be at a higher risk of developing anxiety symptoms, which could impact their academic performance. Likewise, the youngest students are an area of opportunity to be detected and channeled to specialized services on campus.

Keywords: Anxiety, college students, anxietysymptoms..

Resumen: Antecedentes: Los síntomas de ansiedad son uno de los problemas de salud mental más frecuentes en la población mexicana. Los estudiantes universitarios están en riesgo de desarrollar síntomas de ansiedad debido a los desafíos relacionados con el inicio de estudios universitarios y la búsqueda de un título universitario. Objetivo: se evaluaron síntomas de ansiedad en una muestra de estudiantes universitarios para conocer la prevalencia de los mismos dentro de las diferentes carreras. Participantes: 270 estudiantes universitarios de la Universidad Nacional Autónoma de México, FES Iztacala, que incluye carreras relacionadas con la Salud. Método: el Inventario de Ansiedad de Beck fue completado por una muestra balanceada en el campus de la universidad. Resultados: casi un cuarto de la población tiene síntomas de ansiedad por encima del punto de corte. Las estudiantes mostraron estar más ansiosas que los estudiantes varones. Los estudiantes más jóvenes presentan mayor sintomatología ansiosa. Conclusiones: los hallazgos proporcionan evidencia de que las mujeres pueden estar en mayor riesgo de desarrollar síntomas de ansiedad, lo que podría afectar su desempeño académico. Así mismo los estudiantes más jóvenes son un área de oportunidad para ser detectados y canalizados a servicios especializados dentro del campus.

Palabras clave: Ansiedad, estudiantes universitarios, síntomas de ansiedad..

Introduction

Anxiety can be understood as the presence of self-reported symptoms of increased fear when a person responds to signals indicating a present or past threat, but also responding to signals that not necessarily represent an actual threat ( Craske, Rauch, Ursano, Prenoveau, Zinbarg & Pine, 2009).

According to the most recent NationalComorbidity Survey, in Mexico (2003), anxietydisorders are the most common conditions that14.4% of Mexican adults have ever suffered.Although it has been documented that there areanxiety disorders that are more frequent dependingon the developmental stage (phobias, forexample, are more frequent during childhood),the survey indicates that social phobia followedby PTSD are more frequent in adult life. It isknown that anxiety disorders produce avoidancebehaviors and important symptoms thatcause a significant deterioration in the lives ofindividuals. Based on the information processingapproach, people who exhibit chronicallyanxious symptoms keep certain biases characterizedby interpreting the world as a dangerousplace and underestimating their personal abilityto cope ( Clark & Beck, 1985).

In the United States, rates of mental healthproblems among college students have increasedsteadily over the past 10 to 15 years( American College Health Association, 2013; Hunt & Eisenberg, 2010). In Mexico, there arerelatively few studies focused on anxiety symptomsin college students. One of these studies( Villaseñor, 2010) found that students just enrollingin college had low anxiety levels, with adistribution that is even close to normal levels.However, Robles, Espinosa, Padilla, Alvarezand Paez (2008) published a study conductedamong a college sample which showed that3.9% of the sample filled the criteria for ananxiety disorder, which, as mentioned before,is one of the most prevalent conditions amongthe Mexican population. On the other hand,González and Celis (2009) described the qualityof life and the prevalence of anxiety in collegestudents (n=214) compared with the ones froma group of older adults (n=176); both variableswere lower in the group of students. Moreover,unlike older adults, the surveyed students reportedschool, family and money issues amongtheir major concerns.

Another study by Hernández, Coronado, Araujo and Cerezo (2008), shows how anxiety can affect the academic performance of students. The authors took a sample of Mexican college students and used 25 academic assessments and a behavioral assessment of anxiety using the emotional Stroop paradigm and found an inverse relationship between anxiety and academic performance. The authors further evidenced that anxiety levels are associated with low academic performance, just as other authors have shown.

Ultimately, there is evidence that different university courses generate different levels of anxiety in their students. Roman, Ortiz and Rodriguez (2008) point out that Medical Sciences have been reported as one of the branches where students show higher levels of stress.

There is a substantial body of literature that has shown that there is a set of factors that operate as predictors of academic success. Among these factors, are those mainly related to sociodemographic variables. This study aims to explore other factors in the life of college students that could be associated with academic performance: mental health issues. Aragón, Contreras and Tron (2011) argue that success in school depends on both economic and personal factors and on psychological and emotional ones. Borges, Medina, Benjet, Lee, Lane and Breslau (2011) argue that based on their data, mentaldisorders could be being diminished or maskedby the much greater effect of economic hardshipand low cultural expectations for educationalachievement. They also state that futureresearch should inquire deeper into possiblereasons for the better performance of studentswith anxiety symptoms in developing countries

As reported by Riveros, Rubio, Candelario, and Mangin (2013), in Mexico, the main reasons for college dropout are money-related; however, psychologists in the development and education field also point to evidence of the impact of some mental health issues as an influencing factor in the improvement college students academic performance. Saleh, Camart and Romo (2017) call attention on this matter when they comment how university students often face different stressful situations and preoccupations. At particular risk are college students of health sciences who, as data reported by Melese, Bayu, Wondwossen, Tilahun, Lema, Ayehu and Loha (2016), results are indicative of the current status of mental distress among medical students attending institutions of similar setups. Finally, data show that among college students, the first year at college represents major risks that could be targeted to prevent anxiety associated behaviors such as substance abuse ( Cho, Llaneza, Adkins, Cooke, Kendler, Clarck & Dick, 2014), depression, and suicide ideation ( Mackenzie, et al.,2011).

Under this scenario, and upon the need for early detection of mental health issues in order to prevent low academic achievement or drop out, the authors of this study started research on the variables. We decided to perform a preliminary investigation to estimate the prevalence of anxiety symptoms in a sample of college students of health-related programs at one of the campuses of the National Autonomous University of Mexico. We proceeded to address the following research question: What are the levels of anxiety of college students at a healthrelated Faculty?

Method

Levels of anxiety symptoms were explored in a sample of 270 undergraduate students between 17 and 34 years of age from six different programs at the FES Iztacala Campus, i.e., Psychology, Dentistry, Biology, Optometry, Nursing, and Medicine. For the purposes of this study, the variables sex (Male - Female), age, student's school (Psychology, Dentistry, Biology, Nursing, Optometry, and Medicine), current semester (1 - 10 ) and anxiety were taken into account. Anxiety was conceptualized according to Beck and Clark (1997) as a model including a three-stage schema-based information processing that involves: the initial registration of a threat stimulus, the activation of a primal threat mode, and the secondary activation of more elaborative and reflective modes of thinking.

This exploratory study is part of a larger project that aims to identify some predictors of academic success in college students. The study design was cross-sectional, quantitative and of prevalence. The sample was chosen by convenience. Enrollment criteria included being a student from the campus, and willing to participate.

Procedure

Three of the authors of this paper administered the questionnaire directly to students, following a sampling quota at the university corridors, patios, and common areas at the campus. Participants were informed about the purpose of the research and data confidentiality. Participants completed a paper and pencil survey including demographic questions regarding age, sex, school, current semester, marital status, with whom do they lived, number of children, in any, and employment situation if any.

Instruments

The inventory used has shown to be a reliableand valid tool for Mexican population (Tafoya,Gomez, Ortega, and Ruiz, 2006). CronbachAlfa α = 0.86, the correlation between BAI andHamilton Anxiety Rating Scale, HAM-A, totalscore (as the gold standard) was significant (r =0.82, p ≤ 0.001). BAI has 21 items which measurethe intensity of anxiety symptoms throughouta Likert scale, focusing on two factors:somatic and subjective anxiety and panic symptomsof anxiety based on the DSM-IV manual.The answers range from 0 (little or nothing) to3 (severely).

Statistical Analysis

Statistical analyses were performed with the SPSS software (version 19). First, descriptive analyses (such as percentages, means and standard deviations) were produced. Then, analyses of variance ANOVA were performed in order to investigate the difference between BAI scores among schools and age groups. Student . test was used to identify differences among BAI scores on independent groups (male and female; younger and older students). Pearson correlation was run to test the link between age and BAI scores. The significance limit was set at . < 0.05.

Results

270 students from the FES Iztacala Campus (. = 270) participated on this study. 145 of the students were females (53.7%), and 125 of them were males (46.3%). The participants were enrolled in one of the six programs offered by this campus by the spring of 2014. From the School of Psychology 49 students (18.1%) were included, 57 (21.1%) from the Dentistry school, 48 (17.8%) from the Biology school, 47 (17.4%) from the Nursing school, and 37 (13.7%) from the Medicine school. The rest were students from Optometry school. Likewise, students were mostly from two subgroups. First-semester students (n=145), which accounted for 53.7% of the sample, while more advanced semester students from the seventh semester onwards, represented 45.1% of the sample. In most of the cases, the younger the student, the lower the current semester in which he was enrolled.

Among the socio demographic characteristics of the sample, participants were between 17 and 34 years of age (M = 20.69, S.D. = 2.798), being the largest age group the participants between 17 to 25 years, which represented 95.2% of the sample. 45.1% of the participants were already in advanced semesters (in the seventh semester and onwards) while 95.2% reported being not married and childless. Most participants reported living with their families (93.3%), and 73.7% revealed not being employed.

The Cronbach alpha obtained was .. .91 for the total BAI scale and for the BAI one and two factors (somatic and subjective anxiety and panic symptoms), developed by Beck, Epstein, Brown and Steer (1988) was .. .857 and .. .82, respectively. Participants in this sample showed a mean of 15.44 points on the Beck Anxiety Scale (D.E. of 11.747). The mean total scale score for female students was 18.48, while for males, it was 11.92; this difference was statistically significant (t = 4.752, p = .001).

Table 1 presents the means of the two BAI factors, which were significantly different between males and females. A score higher than 23 points was obtained by 67 participants. From the subset of participants who scored above the cut point, 73.1% were females, of which 53.7% of them were in the first semester of college. The average for the total scale score was 16.79 for Nursing School students, 16.63 for Psychology School students, 16.59 for Optometry, 15.89 for Medicine, 14.61 Dentistry and 12.77 for Biology, respectively. The one-way analysis of variance (ANOVA) revealed no statistically significant differences between groups (F=.747, . = .589). No statistical differences were found either when separating participants between young and older (. = 1.435, . =.152). Based on the ANOVA test, the groups did not have statistically different total scores (F = .269, . = .898), depending on the semester in which they were enrolled.

The most frequent symptoms mentioned by participants were: unable to relax, of which 78.5% of them reported it in a moderate to a severe degree, followed by nervousness (75.6%), fear of the worst happening (58.1%), and insecurity (57.4%).

However, when analyzing the information by age, it was found that mean anxiety scores tended to be higher among younger students. Table 2 shows the results of statistical ANOVA for four age groups and the mean for each group. The difference of means between Group 1 and Group 4 is statistically significant, both with the total BAI score (F = 1.149; . =.018) and with Factor 1, symptoms (F = .731; . = .034) and Factor 2 cognitions (F = 1.151; . =.014).

Discussion

This research is part of a broader study including mental health issues and their connection with academic performance. The data presented here aimed to explore the prevalence of anxiety symptoms in college students. The specific objectives were to investigate the prevalence and distribution of anxiety symptoms among college students in a suburban area of Mexico City. The outcome of this research shows that a large number of students exhibited anxiety symptoms, and 24.8% of students met the diagnostic criteria for an anxiety disorder, most of which were female students. There were no significant differences between exhibiting anxious symptoms and a specific academic program or health-related school, even though the Nursing school and Psychology school students scored higher than those in the Biology school. Our findings contrast with Heinen, Bullinger and Kocalevent's work (2017), who found that medical students reported higher levels of perceived stress and higher levels of anxiety and depression than reference samples. Younger students (17-18 years) and those enrolled in early semesters showed greater anxiety symptoms than older students (26-34 years), and these were significantly different. It was also found that, although it is not high, there is a negative correlation between the age group of the participants and the total score of the BAI; this means that the younger the student, the more anxiety symptoms he/she exhibits. Literature reflects that first-year college students face more challenges in their effort to adapt to their new lives, being away from their old friends and families, and sometimes the stressful environment of certain schools, like Medical School ( Roy, Sai & Doshi, 2015).

Regarding gender, there is cumulative empirical evidence in support of women having higher anxiety scores compared to men. Our findings are consistent, for example, with those of Balanza, Morales, and Guerrero (2009) as far as females who display an increased risk of anxiety. These authors, motivated by the high number of pupils attending counseling hours and tutoring, performed a study that included 700 students from a multistage random cluster sample at the Universidad Católica San Antonio de Murcia (Saint Anthony Catholic University) and measured anxiety and depression symptoms using the Goldberg scale. Likewise, the study conducted in 2004 by Weitzman, who surveyed 27,409 college students found that 4.8% of them showed poor mental health and depression, and again it was women who showed higher levels of this mental health deterioration. Also, Eisenberg, Gollust, Golberstein, and Hefner (2007) discovered that compared to men, women were more likely to exhibit higher rates of anxiety symptoms. Studies evaluating more specific issues about anxiety also report higher predominance rates of anxiety symptoms in women. An example of this is the work by Caballo, Salazar, Arias, Irurtia, Calderero, and Spain's CISO-A Research team, who in 2010 published the results of the validation of a questionnaire on social anxiety. Within the results, they found higher rates of anxiety among women as far as "speaking in public/interaction with authority figures" and regarding the global aspects of social anxiety. Furthermore, when Pitoni and Rovella (2013) assessed anxiety and perfectionism, they found a high correlation between these variables and more frequent anxiety symptoms in women. It is worth mentioning Dyrbye, Thomas, and Shanafelt's (2006) systematic review of depression, anxiety and other indicators of psychological distress among U.S. and Canadian Medical students. After reviewing forty articles on the matter, the authors conclude that compared to the open population, medical students exhibit a higher prevalence of depression, with higher psychological distress. The authors can say that even though the learning stages should be a time of personal growth and well-being, they can also have an inadvertent negative effect on the mental health of students, especially on women. The authors also agree that there is very limited data available on the impact of distress on academic performance, dropout rate and professional development of students.

The findings reported in this study draw attention to the high prevalence of anxiety symptoms in a significant proportion of students who are pursuing health-related undergraduate degrees and who are probably in need of professional help. The stress of college students could be approached by identifying this vulnerable population and offering specific, evidence-based support programs so that students could be better prepared to meet these challenges. We subscribe to Kunwar, Risal and Koirala (2016) in terms that the high prevalence of psychiatric conditions warrants needs for strategic plans to alleviate this issues right from the time when students join college and have to be continued until they finish their courses. Also, we agree with Dvořáková, Kishida, Elavsky, Broderick, Agrusti, and Greenberg (2017) on that given the importance of developmental transitions in young adults' lives and the high rates of mental health issues among college students, first-year college students can be particularly vulnerable to stress and adversity. They could find useful having stress management training that includes mindfulness approaches or works at the improvement of students' coping strategies (Coiro, Bettis & Compas, 2016). Future research will be done by the authors, specifically assessing first year college students, as Mortier et al. (2017) point out that screening at college entrance is a promising strategy to identify those students at highest prospective risk, enabling the cost-efficient clinical assessment of young adults in college.

This study has several limitations. The first oneis that we cannot know if there is a relationshipbetween academic performance and anxietysymptoms since the first variable was not measured;it would be necessary to determine whatwould be the academic performance indicatorto be selected so that a new measurementcould be performed in the future. Second, thereare very few studies on anxiety and academicperformance other than the literature writtenby English-speaking authors, and the LatinAmerican research that has been published isnot a sufficiently representative sample withwhich we could compare our results it is worthnoting that there are very few Mexican studiescomparing the prevalence of anxiety symptomsconducted with undergraduate programstudents. In Mexico, there is certain researchconducted at a college dissertation level, but itdoesn't get to be published in indexed journals.Third, the participants of this study were chosenby a convenience criteria; randomized representativesamples could help us generalize the resultsmentioned above. Fourth, follow-up of theparticipants could not be done, because we didnot ask for contact information; in the future,this could help to refer college students in highrisk to the available services at the campus.

The authors hope that the results presented in here could raise the concern of our authorities and foster the creation of mental health policies to generate financing of counseling and research areas in colleges that are in great need.

References

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Author notes

* Universidad Nacional Autónoma De México, Facultad de Estudios Superiores de Iztacala. Profesora Asociada de Tiempo Completo. Correspondencia: carolina.santillan@comunidad.unam.mx

** Universidad Nacional Autónoma De México, facultad de estudios superiores de Iztacala, proyecto de aprendizaje humano. Facultad de estudios superiores de Iztacala centro regional de estudios multidisciplinarios de equidad y género, Cuernavaca, Morelos, México

*** Universidad Nacional Autónoma De México, Facultad de Estudios Superioresde Iztacala. Correspondencia: xyadirab-p@hotmail.com

**** Universidad Nacional Autónoma De México, Facultad de Estudios Superiores de Iztacala. Correspondencia: poliita-27@hotmail.com

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Prevalence of anxiety symptomsin a sample of college students at afaculty of health sciences in Mexico

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Antecedentes: Los síntomas de ansiedad son uno de los problemas de salud mental más frecuentes en la población mexicana. Los estudiantes universitarios están...

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Week 5 : Summary of a journal article based on Challenges for Starting University

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