Separation Anxiety and Depressive Symptoms in Latin-American University Students: the role of Interpersonal Problem Areas
DOI:
https://doi.org/10.13129/2282-1619/mjcp-5097Keywords:
Adult separation anxiety, Clinical psychology, Depression, Foreign students, IPT, Problematic areas.Abstract
Background: Research on depressive symptoms and interpersonal issues in foreign university students (FS) remains limited. This study assessed interpersonal problem areas, depressive symptoms, and adult separation anxiety (ASA) in Latin-American FS enrolled at an Italian university. We aimed to explore the relationship between these psychological dimensions and how interpersonal stressors - common in the acculturation process - may impact emotional wellbeing.
Methods: Participants (N=31; 15 males, 16 females; mean age: 26.9±3.3) completed an online survey including the Zung Self-Rating Depression Scale (ZSDS), the Work and Social Adjustment Scale (WSAS), the Separation Anxiety Disorder Severity Scale (SAD-A), and the Interpersonal Problem Areas Rating Scale (IPARS).
Results: The most described interpersonal problem areas were role transition (74.2%) and interpersonal deficits (51.6%). Clinically significant adult separation anxiety (ASA) was present in 54.8% of participants, and was associated with significantly higher scores in depression (ZSDS: 50.0±6.3 vs. 36.9±6.1; p=0.0001), functional impairment (WSAS: 17.4±8.4 vs. 7.5±8.6; p=0.003), and number of interpersonal issues (IPARS: 2.0±0.8 vs. 1.0±0.7; p=0.002).
Conclusions: ASA and interpersonal problem areas may contribute to depressive symptoms in FS, underscoring the clinical relevance of interpersonal dimensions in this population. These findings are preliminary, given the small sample size and reliance on self-report measures.
References
Agudelo Vélez, D. M., Casadiegos Garzón, C. P., & Sánchez Ortiz, D. L. (2008). Características de ansiedad y depresión en estudiantes universitarios. International Journal of Psychological Research, 1(1), 34–39.
Amason, P., Allen, M. W., & Holmes, S. A. (1999). Social support and acculturative stress in the multicultural workplace. Journal of Applied Communication Research, 27(4), 310–334. https://doi.org/10.1080/00909889909365543
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
Asif, S., Mudassar, A., Shahzad, T. Z., Raouf, M., & Pervaiz, T. (2020). Frequency of depression, anxiety and stress among university students. Pakistan Journal of Medical Sciences, 36(5), 971–976. https://doi.org/10.12669/pjms.36.5.1873
Berry, J. W., Chun, K. M., Balls Organista, P., & Marín, G. (2003). Conceptual approaches to acculturation. Acculturation: Advances in Theory, Measurement, and Applied Research., 17–37. https://doi.org/10.1037/10472-004
Bohórquez, A. (2007). Prevalencia de depresión y de ansiedad en estudiantes de medicina. Pontificia Universidad Javeriana.
Bourhis, R. Y., Moïse, L. C., Perreault, S., & Senécal, S. (1997). Towards an Interactive Acculturation Model: A Social Psychological Approach. International Journal of Psychology, 32(6), 369–386. https://doi.org/10.1080/002075997400629
Brenneisen Mayer, F., Souza Santos, I., Silveira, P. S. P., Itaqui Lopes, M. H., de Souza, A. R. N. D., Campos, E. P., de Abreu, B. A. L., Hoffman, II, I., Magalhães, C. R., Lima, M. C. P., Almeida, R., Spinardi, M., & Tempski, P. (2016). Factors associated to depression and anxiety in medical students: A multicenter study. BMC Medical Education, 16(1), 282. https://doi.org/10.1186/s12909-016-0791-1
Cardona-Arias, J. A., Pérez-Restrepo, D., Rivera-Ocampo, S., Gómez-Martínez, J., & Reyes, Á. (2015). Prevalencia de ansiedad en estudiantes universitarios. Diversitas: Perspectivas en Psicología, 11(1), 79–89. https://doi.org/10.15332/s1794-9998.2015.0001.05
Cohen, A. K., Nussbaum, J., Weintraub, M. L. R., Nichols, C. R., & Yen, I. H. (2020). Association of Adult Depression With Educational Attainment, Aspirations, and Expectations. Preventing Chronic Disease, 17, E94. https://doi.org/10.5888/pcd17.200098
Coldur, E. O., Cokmus, F. P., Dikici, D. S., & Aydemir, O. (2020). The validity and reliability of DSM-5 separation anxiety disorder severity scale-adult form. Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 33, 237–243. https://doi.org/10.14744/DAJPNS.2020.00087
Constantine, M. G., Okazaki, S., & Utsey, S. O. (2004). Self-Concealment, Social Self-Efficacy, Acculturative Stress, and Depression in African, Asian, and Latin American International College Students. American Journal of Orthopsychiatry, 74(3), 230–241. https://doi.org/10.1037/0002-9432.74.3.230
De Rios, M. (2001). Brief Psychotherapy with the latino Immigrant Client. The Haworth Press Inc. https://doi.org/10.4324/9781315809281
Eisenberg, D., Gollust, S. E., Golberstein, E., & Hefner, J. L. (2007). Prevalence and Correlates of Depression, Anxiety, and Suicidality Among University Students. American Journal of Orthopsychiatry, 77(4), 534–542. https://doi.org/10.1037/0002-9432.77.4.534
Fernández, A., Rodríguez, B., Diéguez, M., Suárez, N., & Hevia, N. (1997). La terapia interpersonal de la depresión. Revista de la Asociación Española de Neuropsiquiatría, 17(64), 627–648.
Fritz, M. V., Chin, D., & DeMarinis, V. (2008). Stressors, anxiety, acculturation and adjustment among international and North American students. International Journal of Intercultural Relations, 32(3), 244–259. https://doi.org/10.1016/j.ijintrel.2008.01.001
Galindo, S. B. (2009). Prevalencia de Ansiedad y Depresión en una Población de Estudiantes Universitarios: Factores Académicos y Sociofamiliares Asociados. Clínica y Salud, 20(2), 177–187.
García, E. A., Castillo-Jimenez, D. A., Cepeda, I., Pacheco, J. L., & Pacheco, R. (2019). Ansiedad y depresión en estudiantes universitarios: Relación con rendimiento académico. Interdisciplinary Journal of Epidemiology and Public Health, 2(1). https://doi.org/10.18041/2665-427X/IJEPH.2.5342
Gazzola, A. L., & Didriksson, A. (2008). Trends in Higher Education in Latin America and the Caribbean. UNESCO International Institute for Higher Education in Latin America and the Caribbean.
Hames, J. L., Hagan, C. R., & Joiner, T. E. (2013). Interpersonal processes in depression. Annual Review of Clinical Psychology, 9, 355–377. https://doi.org/10.1146/annurev-clinpsy-050212-185553
Hosseinpur, H., Parsa, A. D., & Kabir, R. (2023). The Prevalence of Depression and its Predictors among International Postgraduate Students Studying Public Health at a UK University. Journal of Psychosexual Health, 5(2), 94–101. https://doi.org/10.1177/26318318231181689
Innamorati, M., Lelli, M., Aiello, S., Di Lorenzo del Casale, F. L., Russo, S., & Ferrari, V. (2006). Validazione convergente e discriminante della versione italiana della Zung Self-Rating Depression Scale. Psicoterapia Cognitiva e Comportamentale, 12(3), 343–353.
Jung, E., Hecht, M. L., & Wadsworth, B. C. (2007). The role of identity in international students’ psychological well-being in the United States: A model of depression level, identity gaps, discrimination, and acculturation. International Journal of Intercultural Relations, 31(5), 605–624. https://doi.org/10.1016/j.ijintrel.2007.04.001
Kemp, B., Krause, J. S., & Adkins, R. (1999). Depression among African Americans, Latinos, and Caucasians with spinal cord injury: A exploratory study. Rehabilitation Psychology, 44(3), 235–247. https://doi.org/10.1037/0090-5550.44.3.235
Klerman, G. L., Weissman, M. M., Rounsaville, B. J., & Chevron, E. S. (1994). Interpersonal Psychotherapy of Depression: A Brief, Focused, Specific Strategy. Jason Aronson, Incorporated.
Lau, W. K. W. (2022). The role of resilience in depression and anxiety symptoms: A three-wave cross-lagged study. Stress and Health: Journal of the International Society for the Investigation of Stress, 38(4), 804–812. https://doi.org/10.1002/smi.3136
Markowitz, J. C., Lipsitz, J., & Milrod, B. L. (2014). Critical Review of Outcome Research on Interpersonal Psychotherapy for Anxiety Disorders. Depression and Anxiety, 31(4), 316–325. https://doi.org/10.1002/da.22238
Minutillo, S., Cleary, M., P. Hills, A., & Visentin, D. (2020). Mental Health Considerations for International Students. Issues in Mental Health Nursing, 41(6), 494–499. https://doi.org/10.1080/01612840.2020.1716123
MIUR. (2022). Didattica: Popolazione studentesca—Università di Pisa. Portale dei dati dell’istruzione Superiore. https://ustat.mur.gov.it/dati/didattica/italia/atenei-statali/pisa
Mundt, J. C., Marks, I. M., Shear, M. K., & Greist, J. M. (2002). The Work and Social Adjustment Scale: A simple measure of impairment in functioning. British Journal of Psychiatry, 180(5), 461–464. https://doi.org/10.1192/bjp.180.5.461
Noh, S., & Kaspar, V. (2003). Perceived Discrimination and Depression: Moderating Effects of Coping, Acculturation, and Ethnic Support. American Journal of Public Health, 93(2), 232–238. https://doi.org/10.2105/AJPH.93.2.232
OECD. (2023). Education at a Glance 2023 Sources, Methodologies and Technical Notes. OECD. https://doi.org/10.1787/d7f76adc-en
Oei, T. P. S., & Notowidjojo, F. (1990). Depression and Loneliness in Overseas Students. International Journal of Social Psychiatry, 36(2), 121–130. https://doi.org/10.1177/002076409003600205
Quigley, R. L., Claus, L., & Nixon, A. (2015). Behavioral health morbidity for those studying or working internationally: A US exploratory duty of care study. Journal of Global Mobility, 3(4), 418–435. https://doi.org/10.1108/JGM-10-2014-0051
Riveros, Q. M., Hernández, V. H., & Rivera, B. J. (2007). Niveles de depresión y ansiedad en estudiantes universitarios de Lima metropolitana. Revista de investigación en psicología, 10(1), 91–102. https://doi.org/10.15381/rinvp.v10i1.3909
Rojas, T. P. (2008). Hispanic cultural values and the Interpersonal Psychotherapy Model for depression: A critical literature analysis. Azusa Pacific University.
Salerno, J. P., Getrich, C. M., Fish, J. N., Castillo, Y., Edmiston, S., Sandoval, P., Aparicio, E. M., Fryer, C. S., & Boekeloo, B. O. (2025). Mental Health Risk and Protection Among First-Generation Latinx Immigrant Youth: A Latent Profile Analysis. Health Education & Behavior: The Official Publication of the Society for Public Health Education, 52(2), 229–241. https://doi.org/10.1177/10901981241294229
Santangelo, O. E., Provenzano, S., & Firenze, A. (2018). Ansia, depressione e consumo rischioso di alcol in un campione di studenti universitari. Rivista Psichiatria, 53(2), 88–94. https://doi.org/10.1708/2891.29157
Saris, I. M. J., Aghajani, M., van der Werff, S. J. A., van der Wee, N. J. A., & Penninx, B. W. J. H. (2017). Social functioning in patients with depressive and anxiety disorders. Acta Psychiatrica Scandinavica, 136(4), 352–361. https://doi.org/10.1111/acps.12774
Scocco, P., Barbieri, I., & Frank, E. (2007). Interpersonal Problem Areas and Onset of Panic Disorder. Psychopathology, 40(1), 8–13. https://doi.org/10.1159/000096384
Seligman, L. D., & Wuyek, L. A. (2007). Correlates of separation anxiety symptoms among first-semester college students: An exploratory study. The Journal of Psychology, 141(2), 135–145. https://doi.org/10.3200/JRLP.141.2.135-146
Siegel, J. M., Aneshensel, C. S., Taub, B., Cantwell, D. P., & Driscoll, A. K. (1998). Adolescent Depressed Mood in a Multiethnic Sample. Journal of Youth and Adolescence, 27(4), 413–427. https://doi.org/10.1023/A:1022873601030
Torales, J., Girala, N., Moreno, M., Arce, A., Trinidad, S., Estigarribia, E., Vera, J., Mongelós, D., Cáceres, M., Velázquez, F., Benítez, D., Ocampos, S., & Saua, A. (2013). Depresión y ansiedad en estudiantes de medicina de la Universidad Nacional de Asunción. 1, 12–28. https://doi.org/10.13140/RG.2.1.4423.5766
Wilton, L., & Constantine, M. G. (2003). Length of Residence, Cultural Adjustment Difficulties, and Psychological Distress Symptoms in Asian and Latin American International College Students. Journal of College Counseling, 6(2), 177–186. https://doi.org/10.1002/j.2161-1882.2003.tb00238.x
World Health Organization. (2023). World health statistics 2023: Monitoring health for the SDGs, Sustainable Development Goals. World Health Organization.
Zivin, K., Eisenberg, D., Gollust, S. E., & Golberstein, E. (2009). Persistence of mental health problems and needs in a college student population. Journal of Affective Disorders, 117(3), 180–185. https://doi.org/10.1016/j.jad.2009.01.001
Zung, W. W. K. (1965). A Self-Rating Depression Scale. Archives of General Psychiatry, 12(1), 63. https://doi.org/10.1001/archpsyc.1965.01720310065008
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