PSYCHOLOGICAL DISTRESS AMONG SENIOR HIGH SCHOOL STUDENTS

OF BUTUAN DOCTORS’ COLLEGE

A Thesis

Presented to the Faculty of the Senior High School Department

Butuan Doctors College

Butuan City

In Partial Fulfilment

Of the requirements for

SENIOR HIGH SCHOOL DEPARTMENT

CLAIRE JANE C. SABELLANO

XI Einstein
 CHAPTER 1

THE PROBLEM AND REVIEW OF LITERATURE

Background of the Study

Students have always been perceived as stressed individuals, these are

caused by Psychological Stressors. A Psychological Stressor is a physiological

and emotional reactions experienced when a student confronts a situation in

which the demands go beyond their coping resources. Examples of stressful

situations are bullying, having a lot of academic projects and activities to

accomplish, post from social networking sites and etc, which is very common in

senior high school.

Attending senior high school is one of the major life transitions for many

adolescents now prior to becoming college. Some students are excited to take on

the new experiences of campus life, while others feel apprehensive about making

this change. Many academic and non-academic issues arise, such as adapting

to an unfamiliar environment, adjusting to different living arrangements, and

develop new relationships (University of Illinois Urbana-Champaign Counselling

Center, 2015).

According to Bartkowski (2017), causes of psychological distress,

examples are instances including a recent natural disaster, such as an

earthquake or floods in your area, sudden health problem in yourself or someone

you love or problems in the relationships. Stress may manifest itself in many

different ways, such as high blood pressure, sweating, rapid heartbeat, dizziness
and feelings of irritability or sadness. The National Institutes of Health states that

if you come down with a terrible illness or a loved one dies in an accident, acute

stress can occur. While current upsetting events certainly place stress on you,

events from your past can also still affect you throughout your life.

According to Shaktin (2015), the stress levels of college students have

been on a constant rise. Forty randomly chosen four-year colleges and

universities found that 85% of the 2,240 undergraduates interviewed experience

stress on a daily basis. In addition, according to Seidel, EJ (2013), in recent

years, the severity and incidence of mental health issues such as depression,

anxiety and stress in college students has increased. National Survey of

College Counseling Centers reported increases in the number of students with

severe psychological problems. The American College Health

Association’s National College Health Assessment (ACHANCHA) shows a

considerable amount of psychological symptomology in the college population.

Over 123,000 students surveyed in spring 2013 report that at some point in the

past 12 months, 31.3% felt so depressed that it was difficult to function and 51%

felt overwhelming anxiety. Moreover, researchers found increasing rates of

psychological morbidity and higher levels of psychological distress especially

among students (Stallman, et.al, 2009). National College Health Association

surveys in the Philippines indicated that the prevalence of depression in campus

communities has risen from 10.1% in 1998 to 15.4% in 2010, revealing a 5.3%

increase in the number of students diagnosed with depression over the past 12

years Mao-Sheng, R., et.al (2016). According to Dy, M. et.al, (2015), a study on
determining the stressors and stress responses of Filipino students in relation to

sex, course and academic classification were there are 258 respondents for the

study shows that the top five overall stressors of the respondents were academic

difficulty of subject matter, workload due to subjects, time management because

of subjects, responsibilities due to being on one's own, and time management

because of both subjects and organizations. Moreover, Lee, R et.al (2013) there

is a higher level of depressive symptoms among Filipino university students.

Majority of the students were female while 43.6% were male from a sample

2,591 Filipino students.

Based from an interview from one of the heads of the Department of

Health (DOH) in Caraga Region in April 2017 said that prevalence of depression

among high school and college students and how this relates to suicidal

behaviour needs to be looked into. The head of the department said that the near

absence of data on the matter is preventing the health department from drawing

up a viable plan and creating interventions to address the issue. Data culled from

the police reports on fatal suicide cases suggest that teens aged 13-18 years old

and women are especially vulnerable to depression leading to suicide. The

interviewed individual states that commonly the cause of their depression is the

lack of family support, inability to cope and misconceptions of others about their

situation. In addition, based on the records gathered from the guidance office of

Butuan Doctors College in the first semester of S.Y. 2018-2019, revealed that

commonly students of courses who have board exams and level three students

having their OJT seek advice and comfort about problems regarding themselves
and their environment and on how to relieve their stress. Stress and anxiety are

mostly reported by the said group of students.

The interest of the researchers in working with the problem stems from the

desire to broaden the knowledge about the factors that causes psychological

distress among senior high school students. This desire arouse based on the

verbalizations of the senior high school students such as “Kapoy na gyud kayo ni

nga kinabuhi.”, “Wala pa gani nasulbad akong prolema, nadugangan napod.”,

“Sa kadaghan namog requirements taga subjects maglisod nako kung unsay

akong buhaton una.”, “Stress na kayo ko sa akong pagskwela”, “Wala nako

kabalo unsa akong buhaton.”. Most of them states difficulties in their

relationships, loneliness and homesickness, issues about sexuality and having

low self-esteem. As the researchers, we have also experienced stress and

anxiety as students. Sometimes symptoms of depression were also experienced

such as during exams where we felt that passing the exams is hopeless. The

study will create an opportunity to help us obtain good analytical and research

skills related to the topic which is very relevant and timely yet still unknown by

most of the students.

Review of Literature

This section provides the discussion of facts, principles, trends and

practices to which the study is related.

Psychological distress is largely defined as a state of emotional suffering

characterized by symptoms of depression (e.g. loss of interest, sadness,

hopelessness) and anxiety (e.g. Restlessness or feeling tense). Defining

features of psychological distress are the exposure to a stressful event that

threatens the physical and mental health, the inability to cope effectively with

these stressors and the emotional turmoil that results from this ineffective coping.

Bullying

Bullying is defined as a direct attack on a student’s status, sense of

belonging and core identity, and often results in low self-esteem. Which result in

reluctance to go to school and truancy, headaches and stomach pains, reduced

appetite, shame, anxiety, irritability, aggression and depression and sudden loss

of friends or avoidance of social situations (Cénat, et.al, 2014).

Studies shows that there are various types of bullying that dated since the

1800s but these only mentioned about physical acts of bullying which includes

assault, theft, hitting, pushing, kicking, pinching, or restraining another person

against their will and verbal types which include threats, insults or nicknames, but

in the 1900s, relational forms of bullying became officially recognized this

includes non-verbal and/or non-physical and may entail making faces or dirty
gestures or intentionally excluding someone from a group. Furthermore, some

studies about bullying behaviors in France stated that bullying can be overt (such

as direct physical or verbal aggression) or covert (such as secretly encouraging

other children to ignore a specific classmate) (Due, et.al, 2005).

A study reports on the prevalence of bullying victimization at school

among college freshmen. Web survey data at two points in time from a sample of

2118 freshmen from eight colleges and universities in the Midwestern United

States indicated that 43% of students experienced bullying at school, and 33% of

students experienced bullying at work. (Rospenda, et.al, 2013).

According to McDonald, et.al, (2010), among 439 college students who

were asked how often they had experienced each of a series of bullying

behaviors since they have been in college. Results indicated that 38% of college

students knew someone who had been cyberbullied, 21.9% had been

cyberbullied. It was apparent that some forms of electronic media are more

commonly used to cyberbully others than are other forms. All the cyberbullying

behaviors and traditional bullying behaviors were significantly positively inter-

correlated.

A total of 15.8% of students reported cyberbullying and 25.9% reported

school bullying in the past 12 months. A majority (59.7%) of cyberbullying victims

were also school bullying victims; 36.3% of school bullying victims were also

cyberbullying victims. Victimization was higher among non-heterosexually

identified youths. Victims report lower school performance and school

attachment. Controlled analyses indicated that distress was highest among

victims of both cyberbullying and school bullying were from 4.38 for depressive

symptoms to 5.35 for suicide attempts requiring medical treatment. Victims of

either form of bullying alone also reported elevated levels of distress (Schneider,

et.al, 2012).

Study shows that when it comes to bullying in college, 15% of the students

report being bullied, 22% reported being cyberbullied. Of those, 21% were bullied

through texting, 13% through instant messages, 25% through a social networking

site. 42% said that they had seen someone being bullied by another student and

5% said they were bullied by a professor. (Health Day News, 2012).

Bullying in the Philippines is widespread in schools and over the

Internet, with a study that states that about 50 per cent of Pilipino students are

bullied in school. Bullying can easily affect both the bully and the victim, and

that’s why the government in the Philippines is working hard to crack down on

it. A survey that was recently conducted showed that students in the schools of

Philippine witness the different types of bullying including name calling,

teasing, exclusion, or forcing the victim to do things. The Department of

Education in the Philippines reported more than 1,700 cases of bullying in

schools for the years of 2013 and 2014 (NoBullying.com’s Anti-Bullying

website, 2017). In addition, according to (Bolido, 2012), the Department of

Education (DepEd) and the media get reports of very serious cases of bullying at

least once a week.

 According to (Burke, 2014.et.al) bullying among college students is a

neglected public health issue. Although awareness is increasing as a result of

media attention to tragic deaths related to bullying or harassment. Bullying

among college students is an understudied problem. Bullying is a direct attack on

a student’s status, sense of belonging and core identity, and often results in low

self-esteem. The effects of bullying often continue many years into adulthood. In

the most extreme cases, targets have taken out their anger and despair through

school shootings or by committing suicide. Alternatively, bullying in college might

be occurring in drinking contexts, where students feel pressure to drink to fit in or

to avoid being bullied for abstaining, whereas substance use is prohibited on the

job. Clearly, more attention to the issue of bullying in the college environment is

needed, as is exploration of mechanisms through which bullying exposure is

translated to drinking behavior. Furthermore, bullying can happen anywhere—

cities, suburbs, or rural towns. Depending on the environment, some groups—

such as lesbian, gay, bisexual, or transgendered (LGBT) youth, youth with

disabilities, and socially isolated youth—may be at an increased risk of being

bullied. However, according to the National Statistics that 55.2% of LGBT

students experienced cyberbullying.

School bullying is widely known to be associated with many negative

indicators, including lower academic achievement, lower school satisfaction, and

lower levels of attachment and commitment to school, known as school bonding

(Coulter, et.al.2012).
 Sociodemographic characteristics included gender, grade (9–12),

race/ethnicity (Asian, African American or Black, Hispanic or Latino, Caucasian

or White, or mixed or other), and sexual orientation (responses grouped as

“heterosexually identified” vs “non-heterosexually identified,” the latter of which

encompassed gay or lesbian, bisexual, other, and not sure). Cyberbullying

victimization and dual victimization were more prevalent among non-

heterosexually identified youths, who are known to suffer from higher rates of

victimization in school settings (Coulter, et.al.2012).

According to the study revealed that youths bullied via internet present a

slightly higher prevalence of psychological distress and low self-esteem

compared to victims of other forms of bullying. While bullying can result in

reluctance to go to school and truancy, headaches and stomach pains, reduced

appetite, shame, anxiety, irritability, aggression and depression are also frequent

effects, sudden decrease in academic performance (declining grades or loss of

interest) and Sudden loss of friends or avoidance of social situations (Cénat,

et.al. 2013).

Life Events

Life events are the “extent to which the accumulation of a series of

experiences can create a stressful impact” (Hudd, et.al, 2014). In recent years,

the severity and incidence of mental health issues in senior high school students

has increased. A significant body of research suggests that college students are
presenting with more psychological distress than ever. Some of the challenges

faced by students include the transition to adulthood, individuation, academic

overload, financial problems, less time with family, and pressure to succeed.

While higher levels of stress were related to higher levels of depressive

symptoms (Bernal, et.al, 2014).

Although some source of stress is necessary for personal growth to occur,

the amount of stress can be overwhelming for a student which then affects the

ability to cope. In addition, university students were found to have high

prevalence of psychological disorders as compared to the general population.

This is due to the fact that university students have to face multiple stressors

such as academic demands, workload, and pressure to succeed, teacher and

parent’s pressure, financial burden and worry about future (Kumar, 2013). These

stressors can lead to develop psychological problem in students and negatively

affect their academic performance. Most common mental health problems found

in university students are depression, anxiety and stress. Students often differ in

how they experience, perceive and handle stressful life events (Darling, et.al,

2007,).

Researchers have identified potential stressors for senior high school

students. A survey is done to 462 undergraduate students to establish events

and circumstances that predicted how frequently students experienced stress.

Experiencing chronic illness and frequent conflicts with friends, family, or faculty

were both predictors of stress. Over half of the students indicated that academics

were a primary stressor such as homework, preparing for projects, or time

required in class. Analysis of interviews with students diagnosed with depression

revealed that concerns about academic success, pressure from family, and

financial concerns were primary stressors for this group (Aselton, 2012).

Other examples of life events are natural disaster such as flood, or

earthquake, fire, transportation accident, physical assault, unexpected death of

someone close to you, change in financial situation, illness or injury of a family

member, entered a new relationship, broke off a relationship with a

boyfriend/girlfriend, failed an important exam, and parents broke up or divorced

(Klainberg, et.al, 2011).

According to Scott, et.al., (2010), a study tested a hypothesis that,

analogous to married individuals, senior high school students in committed

romantic relationships experience greater well-being than single senior high

school students. In a sample of 1,621 high school students, individuals in

committed relationships experienced fewer mental health problems and were

less likely to be overweight/obese. There were no significant differences between

groups in frequency of physical health problems. Examination of 2 models

suggested that being in a committed romantic relationship decreases problematic

outcomes largely through a reduction in sexual partners, which in turn decreases

both risky behaviors and problematic outcomes. These results are discussed in

the context of how premarital dating relationships may contribute to

understanding of the observed association between marriage and well-being.

Social media

Social Media are forms of electronic communication through which

users create online communities to share information, ideas, personal

messages, and other content (such as videos). In a study of Davila (2012)

involving 700 college students, the results showed that when people reported

that their social media interactions is negative they are more likely to report

feeling down immediately after social media use and are prone to depression,

and will spend all of time thinking about their negative social media interactions

making them feel even worse. Moreover, Chen and Lee (2013) found out that

spending more time on Facebook interactions was related to greater

psychological distress and greater degree of communication overload among

college students which is associated with low self-esteem. Furthermore, Chon

and Edge (2013) added that the longer the individual use Facebook the stronger

they believe that others are happier than them and that more and more people

are preferring online social media than real interactions which can lead to

negative outcomes such as missing classes, getting in trouble at school.

According to the Royal Society for Online Health (2017) social media is

associated with the increasing mental health problems such as anxiety and

depression among teens by 70% over the last 25 years. In addition, Basch

(2014), social media has become more prominent and is integrated into our lives

over the past decade. This is especially true for senior high school students, with

83% of those ages 18 to 29 using social media. Although senior high school
students in need of psychological services don’t always reach out to the

counselling center, they express their emotions in some way, especially thru the

social media. According to The Center of Addiction and Mental Health (2014),

recent surveys found that girls are twice as likely boys increased time spent

using social media. In addition, an annual nationwide survey of high school

students by UCLA found that 27.2 percent of students spent more than six hours

on social media a week in 2014, up from 19.9 percent in 2007, the increase may

be problematic, since heavy Facebook usage can lead to symptoms of envy,

anxiety and depression.

A study which includes 722 Internet users of ages 12 and 26, found out

that some of which were high school students. They found that Internet addiction

was associated with shyness, external locus of control, and a belief in the effect

of chance on outcomes (Chak and Leung, 2004).

According to (Hugues, et.al. 2010), frequent use of social networking sites

is associated with poor psychological functioning among adolescents However,

the relationship between the use of these Web-based platforms and mental

health problems in children and adolescents is unclear. This study investigated

the association between time spent on SNSs and unmet need for mental health

support, poor self-rated mental health, and reports of psychological distress and

suicidal ideation in a representative sample of middle and high school children in

Ottawa, Canada. Data for this study were based on 753 students (55% female;

Mage = 14.1 years) in grades 7–12 derived from the 2013 Ontario Student Drug

Use and Health Survey. Multinomial logistic regression was used to examine the
associations between mental health variables and time spent using SNSs.

Overall, 25.2% of students reported using SNSs for more than 2 hours every day,

54.3% reported using SNSs for 2 hours or less every day, and 20.5% reported

infrequent or no use of SNSs. Students who reported unmet need for mental

health support were more likely to report using SNSs for more than 2 hours every

day than those with no identified unmet need for mental health support. Daily

SNS use of more than 2 hours was also independently associated with poor self-

rating of mental health and experiences of high levels of psychological distress

and suicidal ideation. The findings suggest that students with poor mental health

may be greater users of SNSs. These results indicate an opportunity to enhance

the presence of health service providers on SNSs in order to provide support to

youth. A recent examination of Facebook status updates of 200 high school

students revealed that 25% expressed symptoms consistent with depression.

Evidence of negative effects in contrast to the aforementioned findings,

several recent studies have found social media use to be associated with

decreased subjective wellbeing and self-esteem, and increased psychological

distress (Kross, et.al. 2013). Researchers have further explored reasons for

these detrimental effects, some of which include: information overload, internet

addiction and a negative contagion/peer effect, such as modeling high-risk

behavior (Moreno, 2010).

However, according to (Riley, 2015), in the last year, anxiety has

superseded depression as the most prevalent mental health disorder across high

school campuses, according to a study by the American College Health

Association. Approximately one in six students has been diagnosed or treated for

anxiety. As emotional health takes a turn for the worse, students spend more

time on social media. In addition, an annual nationwide survey of high school

students by UCLA found that 27.2 percent of students spent more than six hours

on social media a week in 2014, up from 19.9 percent in 2007. The increase may

be problematic, since heavy Facebook usage can lead to symptoms of envy,

anxiety and depression, according to a recent study by the University of Missouri.

Sleep Pattern

Sleep pattern is like a timepiece which body uses to understand when it’s

time to sleep and when it’s time to wake. This works alongside the body’s need

to sleep which is governed by how long you have been awake and the regular

timing of your sleep (Jordan, 2009). The habitual pattern in sleep is 8

hours straight every 24 hour periods. (Nugent, 2013).

According to Pareah (2015), poor sleep quality has been positively

correlated with depression anxiety and overall early mortality and distress.

According to Knight (2016), there are many factors that can cause overall

distress, thus includes poor sleep quality, fewer hours of sleep, later bedtime and

longer time to fall asleep. Large percentage of students’ population does not get

enough sleep per night. 43.7% of 18 years old and above sleep 6 hours per night

and only 29.4% of high school students sleep 8 hours or more at night but with

accompanying distress. Furthermore, according to Lee et.al, (2013), more than

half of the students sleep 7 hours during week days and sleeping less than 7

hours per night were associated with psychological disorders.

 Daytime sleepiness, sleep deprivation, and irregular sleep schedules are

highly prevalent among high school students, as 50% report daytime sleepiness

and 70% attain insufficient sleep. The consequences of sleep deprivation and

daytime sleepiness are especially problematic to high school students and can

result in lower grade point averages, increased risk of academic failure,

compromised learning, impaired mood, and increased risk of motor vehicle

accidents (Hershner, et. al, 2014).

An article distributed under the Creative Commons Attribution License

studied associations of psychological distress with short (≤6 hours) and long (≥9

hours) sleep duration among adults aged ≥18 years. The 2013 Behavioural Risk

Factor Surveillance System studied 36,859 participants from Colorado,

Minnesota, Nevada, Tennessee, and Washington, which has been

psychometrically validated for measuring severe psychological distress (SPD).

4.0% of adults reported SPD, 33.9% reported short sleep, and 7.8% reported

long sleep. Any psychological distress, not only SPD, was associated with a

higher probability of short sleep duration but not long sleep duration. These

findings highlight the need for interventions (Cunningham et.al, 2015).

Furthermore, another study states that poor sleep quality is reported to be

associated with psychological distress (Zailinawati, et.al, 2009).

According to Wright (2016) there is a Relationship between Adequate

Sleep, Sleep Behaviours, and Psychological Distress in High School Students. It

is also difficult to determine the directionality of this relationship because those

who are not sleeping well and have higher levels of distress may be more likely
to resort to drugs or alcohol to help them sleep. In general, education about the

pros and cons for use of both alcohol and drugs for inducing sleep is important

when working with a student population.

From the International Journal of Medicine, a study was conducted to

investigate the association between psychological distress, self-perceived health

status and sleep duration. Participants with high serious psychological distress

scores reported that they sleep 7-8 hours or less (Liang, et. al 2013).

Another study of Harvard Mental Health Letter (2009) revealed that short

sleep duration has a negative consequence including the link with psychological

distress furthermore the findings showed that there is a linear association

between shorter sleep duration and psychological distress. According to Mamara

(2010), average young adults who slept less than 8 hours, additional sleep

problems are particularly common with anxiety and depression.

An article distributed under the Creative Commons Attribution License

states that mental health and sleep are intricately linked. This study

characterized associations of psychological distress with short (≤6 hours) and

long (≥9 hours) sleep duration among adults aged ≥18 years. Overall, 4.0% of

adults reported SPD, 33.9% reported short sleep, and 7.8% reported long sleep.

After adjustment, adults with SPD had 1.58 (95% CI: 1.45, 1.72) and 1.39 (95%

CI: 1.08, 1.79) times higher probability of reporting short and long sleep duration,

respectively. Any psychological distress, not only SPD, was associated with a

higher probability of short sleep duration but not long sleep duration. These

findings highlight the need for interventions. (Cunningham et.al, 2015)

 Another study states that poor sleep quality and daytime somnolence is

reported to be associated with cardiovascular events, road traffic accident, poor

academic performance and psychological distress. Some studies documented

that it is prevalent in most populations but its frequency among medical students

has not been documented in Malaysia. A total of 799 medical students

participated in this survey (response rate 69.5%). Daytime sleepiness occurred in

35.5%, psychological distress was present in 41.8% and 16.1% reported bad

sleep quality. Daytime sleepiness was significantly more common among the

clinical students, those with self-reported bad sleep quality and psychological

distress; but unrelated to the number of hours sleep at night. We have

documented high prevalence of daytime sleepiness, poor sleep quality and

psychological distress. Higher frequency among clinical students and the

significant relationship with psychological distress suggest possible link to the

stressful clinical training. (Zailinawati et.al 2009)

According to Wright (2016) there is a Relationship between Adequate

Sleep, Sleep Behaviors, and Psychological Distress in High School Students. It is

also difficult to determine the directionality of this relationship because those who

are not sleeping well and have higher levels of distress may be more likely to

resort to drugs or alcohol to help them sleep. In general, education about the

pros and cons for use of both alcohol and drugs for inducing sleep is important

when working with a student population.

AGE

Age is the length of time that a person has lived or has existed.

Adolescence is a time of rapid change encompassing physical, mental, social

and emotional realm. Majority of adolescent experience frustration and confusion

in taking decision while passing through childhood to adulthood. Adolescence is

referred to as the “stormy” period of life “crisis of youth”, “clumsy age”, “difficult

age” (Madhuchandra, 2015).

According to Erik Erickson’s theory, people progress through series of

stages as they grow and change throughout life. During each stage people face a

developmental conflict that must be resolved to successfully develop a primary

virtue on that stage. Adolescence which belonged to identity vs. role confusion,

seek to find themselves and to search for different roles on the society and

integrate the roles they have searched for their individual identities. With many

physical changes occurring, the adolescent is in transition from adulthood.

Hormonal changes produce secondary characteristics and mood swings, during

this stage, young adults begin to feel insecure, confused about themselves and

how they can fit to society (Lillis, 2011)

Among adults aged 18 and over, 3.4% had serious psychological distress,

including 3.9% of women and 2.8% of men (Weissman J, et. al. 2015).

Additionally, higher levels of psychological distress where started among

participant 18 years old and above of any sex or age group in 2014-2015

according to National Health Survey (2015) & ABS (2012).

 The ages 18 and above (The Millennials) are plenty stressed for about

39% say stress has increased in the past year; 52% say stress has kept them

awake at night in the past month. And more than any other age group, they

report being told by a health care provider that they have either depression or an

anxiety disorder. The online survey of 2,020 U.S. adults 18 and older, conducted

in August by Harris Interactive for the American Psychological Association, has

been taking the stress pulse of Americans since 2007. On a 10-point scale,

where 1 means "little or no stress" and 10 means "a great deal of stress," the

2012 average is 4.9. But for Millennials, it's 5.4 (Jason, 2013).

American teens report experiences with stress that follow a similar pattern

as adults, according to a new survey released today by the American

Psychological Association (APA). In fact, during the school year, teens say their

stress level is higher than levels reported by adults in the past month (APA,

2013)

Sex

Sex is either of the two main categories (male and female) into which

humans and many other living things are divided on the basis of their

reproductive functions. Psychological distress was found to be predicted by

gender and other factors (Ran, et.al. 2016). According to (Dachew, et.al, 2015),

there are 44.6% prevalence of mental distress found among female compared to

males (38.8%). Additionally, studies have shown that female gender experienced

more psychological distress compared to male gender (Dachew, et. al, 2014).

Moreover, according to Aboalshamat et.al, (2015); girls were found to be more

depressed and high in self-criticism when compared to boys. The literature

shows that women generally have more depressive symptoms than men. The

analysis revealed that on average, men had lower depression scores than

women. This supported the general consensus of the literature on adolescent

depression that women typically have higher depression scores than men.

(Zackrison, 2013).

Course

Course is a class you take in school to study a particular

subject. a course is a unit of teaching that typically lasts one academic term, is

led by one or more instructors (teachers or professors), and has a fixed number

of students that may last an academic year (two semesters). A large body of

research suggest that a person course is one factor that can cause psychological

distress

According to Deasy (2014), Psychological distress among higher

education students is of global concern. Students on programs with practicum

components such as nursing teacher education, are exposed to additional

stressors which may further increase their risk for psychological distress. The

ways in which these students cope with distress has potential consequences for

their health and academic performance.

A study was conducted among Australian college students, the result of

the study showed that the students’ field of study or course has a relationship

between psychological distress (Lacombe, et. al, 2016) .In addition, According to
(Delera et.al, 2015), health students are prevalent with psychological distress.

Medical students have higher levels of psychological distress compared to other

courses (Aboalshamat, et. al, 2015). In addition, according to (Alyahya 2016),

medical students are prevalent with psychological distress. (Hope et. al, 2014).

Kumar (2016) and colleagues revealed their findings in their present

study, it indicated that students from all discipline (Medical, Engineering and

Social sciences) have significant high level of psychological distress and are at

risk. Furthermore, medical students experience relatively more psychological

distress as compare to engineering and social science students. It is due to fact

that medical field has many challenges and high work pressure from long

working hours and excessive stress resulting in psychological disturbance.

Theoretical framework

A theoretical framework consists of concepts and, together with their

definitions and reference to relevant scholarly literature, existing theory that is

used for your particular study. It is a foundation for parameters or boundaries of

the study it is the structure that can hold or support a theory of a research study

and introduces and describes the theory which explains why the research

problem under study exists.

To ascertain the factors affecting the psychological distress among

selected students of BDC, the researchers adopted some theory in order to be

guided in conducting this study and for the reason of awareness the threatening

tendency of the stress to the individual that could lead to psychological distress
and the assessment of resources required to minimize, tolerate the stressor and

the stress it produces to the college students.

FIGURE 1 shows the theoretical framework of the study and was

anchored in Interactional Model of Lazarus which emphasizes cognitive appraisal

and coping as important mediators of stress and The Stress Adaptation Model of

Selye. Which seeks to understand stress, how stress affects individuals and their

responses. In order to provide framework that will assist an individual in

developing adaptive and effective coping methods. Thus Selye’s Stress theory

was used to examine within the context of perception by the students when

suspects the presenting condition has a related contribution from the stress

response such as physiological, emotional and psychological responses and how

it affects to their lives as a senior high school student.

According to Lazarus psychological stress is a relationship between a

person and his environment. For example, in a particular event one person might

view it as a severe threat or a problem, but for another person, the same event

might be viewed as a challenge for him or her. Example, one student views an

exam as very important in order for him/her to reach his dreams, on the other

hand, some students view exams as a requirement just to pass the subject.

According to Lazarus there are three types of Cognitive appraisal. The

Primary appraisal which refers to the judgment that individuals make about a

particular event, for example two students were given a task, the 1st student view

the task as a challenge in order for him to develop while the other student panic
because for him this activity is too much for him and its beyond his capability.

The secondary appraisal which refers to the individual’s evaluation on the way

how to respond to stress using possible strategies and solution, for example the

1st individual worked hard by attending classes, studying hard and seeking

guidance to other person, while the second person did nothing, preoccupied with

the belief that the task is too much. Reappraisal is a change in opinion based on

new information, example the teacher cancelled the activity because there is no

time left, so the 1st student was depressed and sad for he had done all the things

for the activity the 2nd person was relieved and happy because the activity was

cancelled.

Lazarus Interactional model is not the only stress model that can be

applied in this case. The Adaptation model of Selye is one good example. It is

divided in 3 phases the alarm, resistance and the exhaustion. The alarm stage is

the mobilization of body’s defensive forces and activation of fight or flight

response (+1-+2anxiety), upon hearing about the assigned activity, the 1st

student was relaxed while the 2nd student on the other hand began to sweat a

lot, increase palpitations, skin turned pal e and cool. The resistance stage, which

an individual strives to adapt to stress by using defense mechanisms and coping

(+2-+3anxiety). The 2nd individual used displacement like kicking the chairs

punching the wall to express his anger and distress. When stressors become

overwhelming or prolonged individuals may experience the next stage which is

exhaustion, where there is loss of ability to resist stress because of depletion of

body’s resources, fight or flight, inability to cope (+3-+4 anxiety). The day before
 the activity, the 2nd student didn’t know what to do, felt tired anxious and

depressed. Accumulation of life stressors and wear and tear on the organism

again decrease people’s ability to adapt, resistance, falls and eventually death

occurs.

Life stressors

Primary appraisal

Alarm phase
Secondary appraisal

Resistance phase
Reappraisal

Exhaustion phase

Accumulation of life
stressors

Decrease ability to
adapt, resistance falls,

Ineffective coping,poor
social support

Mental illness

FIGURE 1

Lazaru’s Interactional Model and Selye’s Stress Adaptation Model

Conceptual Framework

Figure 2 represents the research paradigm of the study which utilizes

variables such as the independent variables include the respondents’ profile such

as age, sex, course, and the effects of psychological distress such as use of

social media, life events, social aggression and sleep pattern. The age of the

student nowadays doesn’t seek advice to professionals to relieve their distress

they immediately post it on social media. Sex is one variable because females

compared to males have higher self-criticism and are more expressive. Course

with a practicum such as medical, teachers have higher distress and according to

the researcher’s medical courses have higher psychological distress compared

to other courses, Deasy (2014).

Based on the reviewed literatures, bullying is one factor because those

students who were bullied have higher psychological distress compared to those

who are not as well as life events is one factor to the student because it is one of

the predictors of depressive symptoms and also students everyday face this life

stressors such academic demands, workloads, being pressured to succeed by

teachers and parents. Social media according to several recent studies have

found social media use to be associated with decreased subjective wellbeing and

self-esteem, and increased psychological distress and lastly duration of sleep

because psychological distress, was associated with short and long sleep

duration.

The dependent variables which involves psychological distress such as

Anxiety, Depression and Stress, presents a diagram that shows a relationship

between the two sets of variables are directly proportional to each other, this

means that both variables increase and decreases at the same time. The

variables that where mentioned are important for the study to compare the

information gathered and to determine the factors affecting psychological distress

among selected senior high school students of Butuan Doctors College.

Respondent’s Effects of psychological

Profile distress
2.1 Bullying
1.1 Age
2.2 Life events
1.2 Sex
2.3 Use of social media
1.3 Course
2.4 Sleep Pattern

2.4 Sleep Pattern

Fig. 2 Research Paradigm

Statement of the Problem

The study aimed to determine the factors affecting psychological distress

among selected senior high school students of Butuan Doctors College.,

specifically this study aims to answer the following questions:

1. What is the profile of the respondents in terms of?

1.1 Age

1.2 Sex

1.3 Course

2. What is the effect of psychological distress in terms of?

2.1 Use of social media

2.2 Life events

2.3 Social Aggression

2.4 Sleep Pattern

3. Is there a significant difference between the effects of psychological distress

when grouped according to the profile of the respondents?

Hypothesis

The study proceeds with the hypothesis in null form and tested at 0.05 level of

significance.

There is no significant difference between the factors to psychological

distress.
Significance of the Study

The finding of the study would benefit the following target population:

SENIOR HIGH SCHOOL STUDENTS. The results of this study will increase their

awareness on the factors that will lead them to experience psychological distress

and its possible outcome. It will also give them an idea on how to handle and

cope up with signs of psychological distress who are those possible persons that

can be consulted to help them address their problem.

Guidance Counsellors. The findings of this study will help them determine

common factors affecting psychological distress among senior high school

students. It will also help to create a baseline data on programs who has a

number of students who are experiencing psychological distress in the institution.

School Instructors. The finding of this study will help them identify signs of

psychological distress and how to deal and intervene with the situation.

BDC Administrators. The result of this study will serve as a baseline information

to school administrators in formulating and developing programs for the

enhancement of the learning and provide interventions, instructions and policies

to enhance the mental wellbeing of the students

Future Researchers. This study is relevant to future researchers who wish to

study on factors that affect Psychological distress among senior high school

students using other variables not offered in this investigation using its results
and analysis and gathered information’s to be included in their review of related

literature and studies.

Scope and Limitation

The purpose of this study was to determine the effects of psychological

distress among senior high school students of Butuan Doctors College (BDC).

The scope and limitation of this study includes the following parameters:

The respondent’s profile includes age, sex and the program they belong.

The effects of psychological distress were as follows: Social media, Life events,

Bullying, and Sleep Pattern.

The target population of this study is 10% of the total population of each

program. This study is limited to the students of BDC, between ages 16 to 20

years old. The study is also limited to those students who have psychological

tendencies after conducting the psychological assessment using the standard

questionnaire of Depression, Anxiety, and Stress Scale. This study was

conducted during the first semester of school year 2017 and 2018.

This study utilized the data provided by the respondents as the primary

source of information necessary in this investigation. Secondary sources of data

were taken from published and unpublished library sources. Additional

information was taken in the form of electronic sources (Internet).

 The limitations of this study are those students who are not qualified/

included in the criteria provided.

Definition of Terms

To facilitate clarity and understanding of the present study the following

terms are operationally defined.

Anxiety. This term refers to an emotion characterized by feelings of

tension, worried thoughts and physical changes such as A feeling of

restlessness, Shortness of breath, or a feeling of choking, sweaty palms, dryness

of mouth, a racing heart ,chest pain or discomfort, muscle tension, trembling,

feeling shaky; cause by social network applications, life events , bullies and sleep

related problems.

Bullying. This term refers to a student who experienced intimidation by others

through physical, verbal, and nonverbal acts, that resulted to social, emotional

and psychological internal conflicts

Depression. This term refers to a state of low mood and aversion to

activity that can affect a person's thoughts, behavior, feelings, and sense of well-

being caused by social network applications, bullies ,sleep related problems and

life events such as being pressured by teachers and parents and etc.

Life events. This term refers to common events or happening in life that a

high school student usually experiences in terms of handling finances, getting

into romantic relationships and dealing with people, health conditions, academic

activities as well as experiencing environmental calamities.

Psychological distress. This term refers to is composed of symptoms of

depression, anxiety and stress due to a traumatic experience and other factors

that affects an individual’s level of functioning.

Sleep pattern. This term refers to students who have difficulties in initiating

sleep, those who sleep less than 8 hours per night and other sleep related

problems such as sudden awakening.

Social media. This term refers to the use of social networking

applications such facebook, and instagram that consequently caused emotional

and psychological distress thus affecting activities of daily living and performance

in school.

Stress. This term refers to a psychological perception of pressure that is

cause by numerous factors such as life events, social media, bullies and sleep

related problems, which leads to nervousness, agitation, difficulty in relaxing.

Student. This refer to an individual that manifest, anxiety, stress,

depressive tendencies cause by, life events, bullies, sleep related problems and

social network applications such as Facebook and Instagram.

 Chapter 2

RESEARCH METHODOLOGY

This chapter presents the discussion about the research design,

environmental and respondents. It also includes the description of the research

instruments, procedures in data gathering and the statistical treatment applied.

RESEARCH DESIGN

This study utilized the Descriptive design which examines the nature of

the phenomenon under investigation after a survey of current trends, practices

and conditions that relate to that phenomenon. This study applies descriptive

method since it involves analysis, comprehensive presentation and interpretation

of data about the respondent’s profile and the Psychological Distress among

Senior High School Students of Butuan Doctors College.

ENVIRONMENTAL, POPULATION AND SAMPLE

The study about Psychological Distress among Senior High School

Students was conducted at Butuan Doctors College. It is a private school which

was established in 1971 and located at JC Aquino Avenue, Butuan City is

currently and headed by the CEO Ma. Katrina M. Estacio, MD.

 The respondents of this research were the bonafide students of Butuan

Doctors College who are qualified during psychological assessment using the

standard questionnaire of Depression, Anxiety, Stress Scale.

A sample is obtained from senior high school students by using a random

sampling and the respondents are personally picked by the researchers and will

be given an assessment tool which composed of the DASS questions. For the

actual research questionnaire, the researchers used a purposive sampling in

which those students who will fall into the categories of the DASS which is the

Mild to Extremely Severe will be the one to answer the actual research

questionnaire.

INSTRUMENTS

The study utilized two questionnaires in which the DASS standard

questionnaire was utilized as the assessment tool and it will be answered first to

determine who are those respondents fall in the criteria of the DASS scoring

which contains:

Depression Anxiety Stress

Normal 0-4 0-3 0-7

Mild 5-6 4-5 8-9

Moderate 7-10 6-7 10-12

 Severe 11-13 8-9 13-16

Extremely Severe 14+ 10+ 17+

The assessment tool using the DASS questionnaires was answered by 0-

Did not apply to me at all- Never (N), 1- Applied to me to some degree, or some

of the time- Sometimes (S), 2- Applied to me to a considerable degree or a good

part of time- Often (O), and 3- Applied to me very much, or most of the time-

Almost Always (AA).

The second questionnaire was formulated by the researchers. It was

designated to get the exact data necessary for the completion of the research. It

is prepared in English and then submitted to our Research Adviser, Level

Coordinator, Statistician, and the Panel for any clarification and validation of the

questions. It underwent pilot testing by providing 10 questionnaires to all program

to be answered by a random selection of students for the reliability testing. The

actual research questionnaire contains the following: Part 1 contains the profile of

the respondents such as Age, Sex, and Program. Part 2 contains the following

guidelines on how the respondents answer the questions, the guidelines

contains: 5 – (A) Always – I experienced this situation 6-7 times per week, 4 –

(O) Often - I experienced this situation 4-5 times per week, 3 – (S) Sometimes -

I experienced this situation 2-3 times per week, 2 – (R) Rarely – I experienced

this situation once a week, 1 – (N) Never – I did not experience this given

situations. And after the researchers conducting the pilot testing the tally will be
submitted to the statistician to identify the result of our questionnaire if it is

reliable or not reliable.

DATA GATHERING

In gathering the data, first the researchers create a communication letter

addressed to the Research Adviser. The communication letter was checked by

the research adviser himself and the level coordinator for the approval. After that

their research adviser instructed the researchers to start the dissemination of the

DASS questionnaire each program randomly. While the researchers were still

disseminating the assessment tool, their actual research questionnaire is on the

process of validation. The validated questionnaire was produced and distributed

to the respondents for the pilot testing. Fifteen students were randomly selected

to answer the questionnaire for reliability of the instrument. The result which is an

indicator, then the statistician together with the research adviser will instruct the

researchers to start the data gathering. In gathering the needed data for the

study, the researcher obtained permission from the students by submitting the

communication letter which is reviewed and signed by the research adviser, level

coordinator and Panel of the research allowing the researchers to start the

dissemination of the questionnaire population of students for the school year S.Y

2018-2019 and for those respondents who fall in the categories of DASS scoring.

After that the researchers gather all the data and then collate the gathered data.
Sampling Technique

The study utilized the non-probability (non-random) sampling method

particularly, a purposive sampling. When using this method sampling is done with

a purpose in mind. The subject of the study are selected senior high school

students enrolled at Butuan Doctors College for the school year 2018-2019. Age;

ranges from 16 years old to 20 years old.

Set of criteria was established for senior high school students to qualify

as a respondent. Respondents are personally picked by the researchers and

given an assessment tool which composed of the DASS questions. The

determined total number of respondents was covered by the researchers in the

form of questionnaire. Fifteen senior high school students were allowed to

participate in the study as respondents.

Statistical Treatment

The following statistical parameters are utilized based on the statement of

the problem:

1. Frequency and Percentage are used to describe the profile of the

respondents.

2. Mean. The mean is used to identify the characteristics of the second part

of the questionnaire which contains the psychological stressors of the

senior high school students. The mean is multiplied to the number of

 responses per level and then divided by the total number of samples to

derive the result for the overall mean or scores.

3. Analysis of Variance. ANOVA is used to evaluate the attainment of the

scores between two variables. This is to identify the significant difference

between the respondents’ profile and the extent of psychological distress

among selected senior high school students.

Data Analysis

All the data collected was organized and tabulated accordingly. Each

factor was grouped into classification, wherein analysis was drawn. Interpretation

is constructed during the examination of the relationship and when the

percentage of each factor is identified. Appropriate statistical treatment is

administered to provide a much more reliable data in which the interpretation is

derived.

The First column is the number of respondents which has a total of two

hundred ninety-one and next to it is the respondent’s profile and under with this

are age, sex and course. Another column is the psychological stressors of the

senior high school students which is composed of social media, bullying, life

events, and sleep pattern.

For the responses of the students, mean range were interpreted using the

table reflected below:

Table 1.

Range Verbal Description

4.5-5.0 Always

3.5-4.49 Often

2.5-3.49 Sometimes

1.5-2.49 Rarely

1.0-1.49 Never

Table 2. Mean differences of the respondents in terms of their

Profile

Age

17.00 18.00 19.00 20.00

Mean Mean Mean Mean

Social media 3.15 2.83 2.72 2.73

Life Events 3.59 3.51 3.25 3.12

Bullying 2.75 2.30 2.27 2.03

Sleep patterns 3.58 3.23 3.34 3.18

 Sex

Male Female

Mean Mean

Social media 2.89 2.72

Life Events 3.44 3.23

Bullying 2.46 2.15

Sleep patterns 3.35 3.26

 Chapter 3

ANALYSIS AND RESULTS

This Chapter presents, analyzes and interprets the results that emerged

from the statistically processed data on psychological stressors among selected

senior high school students of Butuan Doctors College.

The presentation is supported by the tables to facilitate the analysis of the

data, which are arranged according to the statement of the problems.

Problem 1: What is the profile of the respondents in terms of age, sex, and

course.

On the Profile of the Respondents:

The personal characteristics of the respondents which includes age, sex

and course are presented in Table 1.

Table1 shows the distribution of the respondent’s personal profile.

In terms of their age, most of the respondents out of 15, or 66.6% aged 17 years

old,

This means that the respondents belong to the adolescent period.

According to Erikson’s theory, the adolescent tries up different roles, personal

choices, and beliefs called identity versus role confusion. Self-concept is being

stabilized, with the peer group acting as the greatest influence. Levinson’s added

it is the period of choosing a career, establishing personal relationship, and

selecting personal values and lifestyle.

 Table 1
Distribution of the respondents in terms of their
Personal Profile.

PERSONAL PROFILE Frequency %

16 years old 2 13.3

17 years old 10 66.6

Age 18 years old 2 13.3

19 years old 1 6.6

Total 15 100.0

Female 8 53.4
Sex Male 7 46.6

Total 15 100.0

During this period adolescents deals with many stressors as a result of

their choices about lifestyle, course, life events and relationships that would lead

to stress and might precipitate mental and physical health problems aggravated

by ineffective coping mechanisms.

As to their gender, there were more female respondents with eight (8) or

53.4% compared to male respondents with seven (7) or 46.6%. According to

Dhanalakshmi (2014) girls were found to be more depressed and high in self-

criticism compared to boys. Added by Dachew et.al, (2014), mental distress is

common among senior high school and college students and being female is one

factor.
Problem2: What is the extent of the factors affecting psychological distress

in terms of bullying, life events, social media, and sleep pattern.

2.1 On Bullying

Table 2 presents the result on the extent of the factors affecting psychological

distress in terms of bullying.

Table 2
Mean distribution on the extent of the factors affecting psychological
stress in terms of Bullying.

BULLYING Mean Verbal

Descriptio
n

Tried to get me in trouble with my friends. 2.04 Rarely

Called my name other than my real name. 3.03 Sometimes

Took something of mine e.g ballpen, books without my 2.47 Rarely

permission.

Made fun of me because of my appearance. 2.25 Rarely

Tried to make my friends turn against me. 2.08 Rarely

Refused to talk to me. 1.94 Rarely

Hurt me physically in some way. 1.85 Rarely

Over-all Mean 2.24 Rarely

Among the questions cited, the indicator that got the highest rank of 3.03

with a verbal description of Sometimes “Called my names other than my real

name”. It is because if sometimes you are called other than your real name such

as by your traits and appearance, you are likely to be hurt emotionally. For
instance, if you are fat you are likely to be called “Baboy” or “Balyena”. It is also

common because it is verbal in nature and the person calling you names might

not realize that the act is already hurting the person since he might perceive that

the person is okay with it. The person being called cannot directly express his/her

feelings that is why the act of calling names will still continue.

Based on the result, name calling is sometimes experienced by the

students who have Psychological Stress.

According to Hamilton (2009), students who witness bullying more likely to

report greater psychological distress such as threats, insults, and nicknames.

Finley (2011) added that common examples of verbal bullying among high school

students includes name calling, making threatening remarks, verbal intimidation,

use of sexist or homophobic language, gossiping and other speech acts that

cause fear and discomfort.

While the lowest mean got the score of 1.85 with a verbal description of

rarely “Hurt me physically in some way”. This is because the nature of this act is

very obvious. If you are the bully you are likely to be caught bullying since you

are obviously hurting a person. Even though this had the lowest score it is still

present in school despite of the laws preventing it.

Studies shows that there are various types of bullying that dated since the

1800s but these only mentioned about physical acts of bullying which includes

assault, theft, hitting, pushing, kicking, pinching, or restraining another person

against their will (Due, et.al, 2005).

2.2 On Life Events
Table 3 presents the result on the extent of the factors affecting
psychological distress in terms of Life Events.
Table 3
Mean distribution on the extent of the factors affecting psychological
distress in terms of Life Events.

Life Events Mean Verbal

Description

Have a lot of requirements to comply. 4.01 Often

Feel pressured by my family to succeed in my 3.49 Sometimes

studies.

Spend more time with my friends than my family. 3.05 Sometimes

Had difficulties in my finances. 3.26 Sometimes

Have too much competition among classmates which 2.79 Sometimes

brings me a lot of academic pressure.

Feel that I have disappointed my parents when my 3.40 Sometimes

test/exams results are poor.

Feel that there is too much school works. 3.76 Often

Experienced problems related to romantic 2.57 Sometimes

relationships.

Over-all Mean 3.29 Sometimes

The highest mean is on the item “Have a lot of requirements to comply”

with a mean of 4.01. The respondents are high school students where

requirements are very common. Students’ load is also related to the high score. If

a student had greater load then there is a higher probability of having many

requirements to comply.
 According to Bernal et.al (2014), in recent years the severity and incident

of mental health issues in high school students has increased. A significant body

of research suggests that high school students are presenting with more

psychological distress. And one of the stressful experience and challenges faced

by the students is having academic overloads. In addition, Institute of Psychology

stated that University students face multiple stressors such as academic

demands and workloads. These stressors can lead to psychological problems

among the students that negatively affects their academic performance.

Furthermore, Rahem et.al, (2016) stated that students have always been

perceived as stressed individual due to the amounts of academic workloads they

bear. He added that academic related stressors refer to any activity such as

examinations, curriculum, workloads, assignments, quizzes, and classes were

students must fulfill in order to graduate. And having heavy academic workloads

can cause feelings of nervousness and anxiousness which can cause stress if it

persists in a longer period of time. A previous study by Kausar (2010) among

University students in Pakistan showed that there is a positive relationship

between academic workloads and perceived stress among high school students.

Weerasinghe, et.al, (2012) added that heavy academic workloads are the most

prominent factor affecting the stress level of undergraduates in Sri. Lanka Public

University.
 On the other hand, the lowest mean is 2.57, “Experienced problems

related to romantic relationships” with a verbal description of sometimes. The

students might not be that focusing in romantic relationships or they are able to

manage their time well between having romantic relationships and their studies.

According to Scott, et.al., (2010), a study tested a hypothesis that,

analogous to married individuals, high school students in committed romantic

relationships experience greater well-being than single high school students. In a

sample of 1,621 high school students, individuals in committed relationships

experienced fewer mental health problems and were less likely to be

overweight/obese. There were no significant differences between groups in

frequency of physical health problems. Examination of 2 models suggested that

being in a committed romantic relationship decreases problematic outcomes

largely through a reduction in sexual partners, which in turn decreases both risky

behaviors and problematic outcomes. These results are discussed in the context

of how premarital dating relationships may contribute to understanding of the

observed association between marriage and well-being.

2.3 On Social Media

Table 4 presents the result on the extent of the factors affecting

psychological distress in terms of Social Media.

 Table 4

Mean distribution on the extent of the factors affecting psychological

distress in terms of Social Media.
Social Media Mean Verbal Description

Feel envious when someone posts 2.90 Sometimes

good things such as achievements.

Go to school late. 2.68 Sometimes

Forget to bring important things. 2.63 Sometimes

Cannot accomplish my tasks. 2.69 Sometimes

Reminded to keep my gadgets during 2.78 Sometimes

classes.

Affected with the posts that is related 2.92 Sometimes

to my current situation.

Over-all Mean 2.77 Sometimes

On the table above shows the indicator “Affected with the posts that is

related to my current situation” got the highest mean of 2.92. This is because

sometimes if you can see or observe situation which is very similar to the

situation which you are also experiencing you are likely to empathize since you

can understand what is the feeling of being on that situation.

According to the Royal Society for Online Health (2017) social media is

associated with the increasing mental health problems such as anxiety and

depression among teens by 70% over the last 25 years. In addition, Basch

(2014), social media has become more prominent and is integrated into our lives

over the past decade. This is especially true for high school students, with 83%

of those ages 18 to 29 using social media. Although high school students in need
of psychological services don’t always reach out to the counselling center, they

express their emotions in some way, especially thru the social media.

While the lowest mean got the score of 2.63 with a verbal description of

sometimes which is “Forget to bring important things”. Even though it is not

common it is still experienced by senior high school and college students. This is

because you are distracted in using the social media that is why you forget to

bring important things for school. On the other hand, using social media might be

helpful with the students because they are reminded to bring needed materials

for example from your group chat.

Researchers have further explored that use of social media might cause

information overload, internet addiction that distracts focus of students (Moreno,

2010).

2.4 On Sleep Pattern

Table 5 presents the result on the extent of the factors affecting

psychological distress in terms of Sleep Pattern.

Table 5

Mean distribution on the extent of the factors affecting psychological

distress in terms of Sleep Pattern

Sleep Pattern Mean Verbal

Description
Experience difficulty establishing sleep. 3.25 Sometimes

Suddenly wake up without any reason. 3.16 Sometimes

Sleep less than 8 hours per night. 3.78 Often

Woke up more than once at night 2.95 Sometimes

Over-all Mean 3.29 Sometimes

Results showed that among the indicators of the extent of psychological

distress in terms of Sleep pattern. It showed that the highest mean rating given

by the students is on the item “Sleep less than 8 hours per night” with 3.78 mean

response and verbally described as often. As students in relation to having many

requirements to comply, time for sleep is being affected. Since you must give

more time in making requirements, you tend to lessen your time in sleeping as a

result.

According to Glozier et.al (2010), shorter sleep duration is associated with

psychological distress among students. Liang et.al (2013) added that sleep

duration is a predictor of psychological distress and those participants with high

psychological distress scores reported to be sleeping less than 7-8 hours.

On the other hand, the lowest mean response was “Woke up more than

once at night” with 2.95 mean response and was interpreted as sometimes.

Waking up less while in the middle of sleep at night might be some sort of effects
in having many requirements to comply or requirements that is not yet done as a

student or you are stressed out by the next day’s school works or activities that

leave you sleep deprived.

Daytime sleepiness, sleep deprivation, and irregular sleep schedules are

highly prevalent among high school students, as 50% report daytime sleepiness

and 70% attain insufficient sleep. The consequences of sleep deprivation and

daytime sleepiness are especially problematic to high school students and can

result in lower grade point averages, increased risk of academic failure,

compromised learning, impaired mood, and increased risk of motor vehicle

accidents (Hershner, et. al, 2014).

Problem 3: Is there a significant difference between the psychological

distress when group according to the profile of the respondents.
Table 6
Test of significant difference between the psychological distress
when group according to the profile of the respondents and the extent of
the factors affecting psychological distress.

PROFILE VARIABLE Df F Sig. Result Decision

Social Media 3 1.652 .178 Not significant Accept Null

Life Events 3 4.911 .002 Significant Reject Null

Age Bullying 3 3.750 .011 Significant Reject Null

Sleep Patterns 3 .973 .406 Not significant Accept Null

Social Media 1 3.045 .082 Not significant Accept Null

Sex Life Events 1 4.885 .028 Significant Reject Null

Bullying 1 8.477 .004 Significant Reject Null

Sleep Patterns 1 .559 .406 Not significant Accept Null

 Table 6 presents the result of the test of significant difference between the

profile of the respondents such as the age, sex, and course and the extent of the

factors affecting psychological distress.

Results indicated that among the profile variable in terms of course

classification, all factors are significant. Extent of the effect of the factors to the

student’s psychological distress is not affected despite of the student’s choice of

course. It means that the use of social media, experiencing life events as a

student, being bullied and having problems in the sleep pattern can affect all

students in different courses.

In other profiles such as the age and sex, only life events and bullying are

significant with a value of less than 0.05. Thus, rejecting the null hypothesis. In

contrast, social media and sleep pattern in the factors of age and sex have

values greater than 0.05, data could not provide the enough evidenced to reject

the null hypothesis. Despite of age and sex, students are affected by bullying

and experiencing life events as students. The situations and events that

happened to the student can greatly have effect psychologically. On the other

hand, this might be because students use social media in daily basis and it

became part of their daily routine that it has lesser impact despite of their age

and sex. Whilst in terms of sleep pattern, maybe students in any age and sex are

used to having lesser time of sleep that is why this factor does not affect them

directly.
 Chapter 4

SUMMARY, CONCLUSIONS AND RECOMMENDATIONS

The chapter represents the highlight of the study and conclusions drawn

from a synthesis of findings of workable recommendations.

Summary of Findings

The study determined the psychological stressors among senior high

school students of Butuan Doctors College (S.Y. 2018-2019). It identified the

relationship of the students profile and the extent of psychological stressors.

A Descriptive design was used in the study with 15 students as

respondents chosen using purposive sampling technique. On the distribution of

the respondents in terms of their personal profile, the findings revealed that

majority of the students who passed the screening tool or the DASS 21

questionnaire were 17 years old which occupies 66.6% of the total respondent’s

population. As to their gender, majority or 53.3% of the total respondent’s

populations were females.

On the extent of the factors affecting psychological distress in Bullying, the

respondents rated “Rarely” on all of the indicators of bullying except “Called my

name other than my real name” with a verbal description of “Sometimes” and got

a highest score of 3.03. whereas in Life Events, the respondents rated

“Sometimes” on all of the indicators of Life Events except for “Have a lot of

requirements to comply” which is rated as Often. The highest rating of 4.01

among the indicators of Life Events. On the other hand, the respondents rated on

all the indicators of Social Media with “Sometimes”. The highest rating of 2.92 “I

am affected with the post that is related to my current situations. On the Sleep

Pattern, the respondents rated “Rarely” on all of the indicators of bullying except

for “Sleep less than 8 hours per night” with a verbal description of “Often” and got

a highest score of 3.78. On the test of significant difference between the profile of

the respondents such as the age, sex, and course and the extent of the factors

affecting psychological distress.

Conclusions:

From the findings of the study presented, the following conclusions were

drawn.

1. The predictors of psychological stress among senior high school students

should consider the effects of psychological distress such as bullying, life

event experiences and challenges, use of social networking sites, and

problems related to sleep.

Recommendations

Based on the conclusion derived thereof, the following recommendations

are drafted for considerations.

Senior High School Students. Students are encouraged to cope with the

different stressors that they experienced. We also recommend being open on

things about the life experiences and struggles in life that may affect their

performance in school and discussed it with their respected teachers or other

authorized persons that they could easily approach.

Guidance Counsellors. They should conduct seminar and create

intervention programs that would reinforce the student’s psychological well-being

every semester. And watch-out or keep close contacts to those individuals who

are high risk. And also, there should be always an available Guidance counsellor

to address the concerns of the students.

School Instructors. They should consider the student’s mental capacity

and his or her physical abilities when giving projects or paper works. And refer

those students who have tendencies of Depression, Anxiety and Stress to any

professionals for counselling.

BDC Administrators. They will emphasize to the supervisory or

instructors in the significance of mental health. And supports programs

conducted by the Guidance Office that may benefit the students in terms of

psychological aspects.
 Future Researchers. Other researchers of the different fields like the

academe are urged to conduct parallel investigation on the matter at hand and

exploring other dimensions not included in the study. They could also utilize the

results of this present study in their review of related literature and studies. They

can also create intervention programs during the research and explore more the

reasons why there’s a gap between the students having psychological distress

and the guidance counsellors.

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 Name: ________________________________ Date: _____________
Please read the following statements and circle a number 0, 1, 2, or 3 which

indicates how much the statement applied to you over the past 2 weeks.

Depression, Anxiety, Stress Scale Manual

0 – Did not apply to me at all – Never (N)

1 – Applied to me to some degree, or some of the time – Sometimes (S)

2 – Applied to me to a considerable degree or a good part of time – Often (O)

3 – Applied to me very much, or most of the time – Almost Always (AA)

N S O AA

1. I couldn’t seem to experience any positive feeling

0 1 2 3
at all.

2. I found it difficult to work up the initiative to do

0 1 2 3
things.

3. I felt that I had nothing to look forward to. 0 1 2 3

4. I felt down hearted and blue. 0 1 2 3

5. I was unable to become enthusiastic about

0 1 2 3
anything.

6. I felt I wasn’t worth much as a person. 0 1 2 3

7. I felt that life was meaningless. 0 1 2 3

8. I was aware of the dryness of my mouth. 0 1 2 3

9. I experience breathing difficulty. (e.g. excessively

rapid breathing, breathlessness in the absence of 0 1 2 3

physical exertion)

10. I experience trembling. (e.g. in the hands) 0 1 2 3

11. I was worried about situations in which I might

0 1 2 3
panic and make fool of myself.

12. I felt I was close to panic. 0 1 2 3

13. I was aware of the actions of my heart in the

absence of physical exertion. (eg, sense of heart 0 1 2 3

rate increase, heart missing a beat)

14. I felt scared without any good reason. 0 1 2 3

15. I find it hard to wind down. 0 1 2 3

16. I tend to over-react to situations. 0 1 2 3

17. I felt that I was using a lot of nervous energy. 0 1 2 3

18. I found myself getting agitated. 0 1 2 3

19. I found it difficult to relax. 0 1 2 3

20. I was intolerant of anything that kept me from

0 1 2 3
getting on with what I was doing.
 21. I felt that I was rather touchy. 0 1 2 3

Adopted from the Depression, Anxiety, Stress Scale Manual

 PSYCHOLOGICAL STRESSORS OF THE SENIOR HIGH SCHOOL

STUDENTS OF BUTUAN DOCTORS COLLEGE

I: PROFILE

INSTRUCTIONS: Write your age and mark X the box that corresponds to your

sex and program.

Age: ____ Sex: Male Female

II: INSTRUCTIONS

Please read the statements carefully and check the boxes that honestly

reflect how frequently you experience the following situations or event this

semester.

5 – (A) Always – I experienced this situation 6-7 times per week

4 – (O) Often - I experienced this situation 4-5 times per week

3 – (S) Sometimes - I experienced this situation 2-3 times per week

2 – (R) Rarely – I experienced this situation once a week.

1 – (N) Never – I did not experience this given situations

III: FACTORS

In using Social Media, I . . . 5 4 3 2 1

1. feel envious when someone posts good things

such as achievements.

2. go to school late.

3. forget to bring important things.

4. cannot accomplish my tasks.

5. am reminded to keep my gadgets during classes.

6. am affected with the posts that is related to my

current situation.

On my life events, I . . . 5 4 3 2 1

1. have a lot of requirements to comply.

2. feel pressured by my family to succeed in my

studies.

3. spend more time with my friends than my family.

4. had difficulties in my finances.

 5. have too much competition among classmates

which brings me a lot of academic pressure.

6. feel that I have disappointed my parents when my

test/exams results are poor.

7. feel that there is too much school works.

8. experienced problems related to romantic

relationships.

In school, my classmates & friends 5 4 3 2 1

1. tried to get me in trouble with my friends.

2. called me names other than my real name.

3. took something of mine e.g. ballpen, books,

without my permission.

4. made fun of me because of my appearance.

5. tried to make my friends turn against me.

6. refused to talk to me.

7. hurt me physically in some way.

When sleeping, I . . . 5 4 3 2 1
1. experience difficulty establishing sleep.

2. suddenly wake up without any reason.

3. sleep less than 8 hours per night.

4. woke up more than once at night