Factors Predicting Depression, Anxiety, and Stress of Undergraduate Students in the Eastern Region of Thailand

Main Article Content

Pornpan Srisopa
Saifone Moungkum
Pornpat Hengudomsub


Purpose: This study aimed to exploring prevalence and predictive factors of depression, anxiety, and stress among undergraduate students in a university, in the eastern region of Thailand.

Design: Correlational predictive design.

Methods: The study samples consisted of 400 undergraduate students from a university in the eastern region were recruited. Groups of disciplines and affiliated faculties were stratified; and six faculties were randomly selected. Eligible students were recruited using convenience sampling. Data were collected by using three self-report questionnaires including socio-demographic data, Depression Anxiety and Stress Scale (DASS-21), and Difficulties in Emotion Regulation Scale – short form (DERS-SF). The collected data were analyzed by binary logistic regression.

Main findings: The results showed that the prevalence rates of depression, anxiety, and stress were in a range of variation from severe to extremely severe levels, percentage of 20.7%, 32.2%, and 15.4% respectively. A factor associated with depression was the difficulties in emotion regulation (p < .001). Factors predicting anxiety were the difficulties in emotion regulation (p < .001) and a history of physical illness (p < .05). Factors predicting stress were the difficulties in emotion regulation (p < .001), a history of mental illness (p < .05), and experienced stressful events (p < .001).

Conclusions and recommendations: The result suggests that more than 15 percent of the students had experienced severe negative emotions including depression, anxiety, and stress.  The factor that could predict such negative mood was difficulties in emotion regulation. This study recommended that educational institutions should conduct periodic screening for students’ mental health and provide effective counseling services to assist students in dealing with emotional distress and adjust to university life.

Article Details

How to Cite
Srisopa, P. ., Moungkum, S. ., & Hengudomsub, P. . (2023). Factors Predicting Depression, Anxiety, and Stress of Undergraduate Students in the Eastern Region of Thailand. Nursing Science Journal of Thailand, 41(3), 109–122. Retrieved from https://he02.tci-thaijo.org/index.php/ns/article/view/260049
Research Papers


Hernández-Torrano D, Ibrayeva L, Sparks J, Lim N, Clementi A, Almukhambetova A, et al. Mental health and well-being of university students: a bibliometric mapping of the literature. Front Psychol. 2020;11:1226. doi: 10.3389/fpsyg.2020.01226.

Solmi M, Radua J, Olivola M, Croce E, Soardo L, Salazar de Pablo G, et al. Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies. Mol Psychiatry. 2022;27(1):281-95. doi: 10.1038/s41380- 021-01161-7.

Chootong R, Wiwattanaworaset P, Buathong N, Noofong Y, Chaithaweesup P, Cheecharoen P, et al. Mental health status, family state and family functioning of undergraduate students in a southern university, Thailand. J Psychiatr Assoc Thailand. 2019;64(4):337-50. (in Thai).

Lun KWc, Chan CK, Ip PKy, Ma SYk, Tsai WW, Wong CS, et al. Depression and anxiety among university students in Hong Kong. Hong Kong Med J. 2018;24(5):466–72. doi: 10.12809/hkmj176915.

Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977;96(4286):129-36. doi: 10.1126/science.847460.

Schäfer JÖ, Naumann E, Holmes EA, Tuschen-Caffier B, Samson AC. Emotion regulation strategies in depressive and anxiety symptoms in youth: a meta-analytic review. J Youth Adolesc. 2017;46(2):261–76 .doi: 10.1007/s10964-016-0585-0.

Mofatteh M. Risk factors associated with stress, anxiety, and depression among university undergraduate students. AIMS Public Health. 2020;8(1):36–65. doi: 10.3934/publichealth.2021004.

Ramón-Arbués E, Gea-Caballero V, Granada-López JM, Juárez-Vela R, Pellicer-García B, Antón-Solanas I. The prevalence of depression, anxiety and stress and their associated factors in college students. Int J Environ Res Public Health. 2020:17(19):7001. doi: 10.3390/ijerph17197001.

Cao W, Fang Z, Hou G, Han M, Xu X, Dong J, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res. 2020;287:112934. doi: 10.1016/j.psychres.2020.112934.

Pramukti I, Strong C, Sitthimongkol Y, Setiawan A, Pandin MGR, Yen CF, et al. Anxiety and suicidal thoughts during the COVID-19 pandemic: cross-country comparative study among Indonesian, Taiwanese, and Thai university students. J Med Internet Res. 2020;22(12):e24487. doi: 10.2196/24487.

Vatanasin D, Hengudomsub P, Vatanasin S, Asarath T, Chupan S, Srisopa P. Factors predicting depression among health science students. The Journal of Faculty of Nursing Burapha University. 2015;23(4):31-47. (in Thai).

Kaewmart N, Koedbangkham J, Nabkasorn C. Factors influencing depression among nursing students of burapha university. The Journal of Faculty of Nursing Burapha University. 2011;18 Suppl 2:83-95. (in Thai).

Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate data analysis. 8th ed. Hampshire, UK: Cengage Learning; 2018. 813 p.

Kaufman EA, Xia M, Fosco G, Yaptangco M, Skidmore CR, Crowell SE. The difficulties in emotion regulation scale short form (DERS-SF): validation and replication in adolescent and adult samples. J Psychopathol Behav Assess. 2016;38(3):443–55. doi: 10.1007/s10862-015-9529-3.

Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;25(24):3186–91. doi: 10.1097/00007632-200012150-00014.

Srisopa P, Moungkum S, Hengudomsub P, Sirikit R. Psychometric properties of difficulties in emotion regulation scale – short form Thai version in university students [research report]. Chonburi: Faculty of Nursing Burapha University; 2022. 18 p. (in Thai).

Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behav Res Ther. 1995;33(3):335–43. doi: 10.1016/0005-7967(94)00075-U.

Oei TPS, Sawang S, Goh YW, Mukhtar F. Using the Depression Anxiety Stress Scale 21 (DASS-21) across cultures. Int J Psychol. 2013;48(6):1018–29. doi: 10.1080/00207594.2012.755535.

Rahman MM, Asikunnaby, Khan SJ, Arony A, Mamun Z Al, Procheta NF, et al. Mental health condition among university students of Bangladesh during the critical COVID-19 period. J Clin Med. 2022;11(15):4617. doi: 10.3390/jcm11154617.

Thompson RA. Emotion and emotion regulation: two sides of the developing coin. Emot Rev. 2011;3(1):53–61. doi: 10.1177/1754073910380969.

Bodell LP, Pearson CM, Smith KE, Cao L, Crosby RD, Peterson CB, et al. Longitudinal associations between emotion regulation skills, negative affect, and eating disorder symptoms in a clinical sample of individuals with binge eating. Eat Behav. 2019;32:69–73. doi: 10.1016/j.eatbeh.2018.12.005.

Bradley B, DeFife JA, Guarnaccia C, Phifer J, Fani N, Ressler KJ, et al. Emotion dysregulation and negative affect: association with psychiatric symptoms. J Clin Psychiatry. 2011;72(5):685–91. doi: 10.4088/JCP.10m06409blu.

Carpenter RW, Trull TJ. Components of emotion dysregulation in borderline personality disorder: a review. Curr Psychiatry Rep. 2013;15(1):335. doi: 10.1007/s11920-012-0335-2.