All Title Author
Keywords Abstract

Publish in OALib Journal
ISSN: 2333-9721
APC: Only $99


Relative Articles


Stress Sensitivity and Signs of Anxiety or Depression among First Year Clinical Dental and Medical Students

DOI: 10.4236/ojmp.2020.91002, PP. 7-20

Keywords: Perceived Stress, Stress Sensitivity, Anxiety, Depression, Dental Students, Medical Students, Clinical Education, Stress Management

Full-Text   Cite this paper   Add to My Lib


Background: Negative stress symptoms are reported in the literature among clinical dental and medical students and can include signs of anxiety or depression. However, very little has been researched about existing psychological preconditions of these students that could make them more vulnerable to negative stress symptoms. Objective: The aims were to explore first year clinical dental and medical students’ experiences of stress intensity, stress sensitivity and signs of anxiety or depression. Gender was also explored as a possible predictor of these psychosocial phenomena. Methods: First year clinical students at Aarhus University dental (n = 49) and medical schools (n = 59) were recruited to fill out a 45-item questionnaire that comprised demographics and three scales: Cohens Perceived Personal Stress (PPS-10), Stress Sensitivity Inventory (SSI) and Depression Anxiety & Stress Scale (DASS-21). Groups and genders were compared by frequency and using association statistics, bivariate odds ratios, nominal logistic regression and ANOVA. Results: Stress intensity perceptions were moderate to high for many. Dental students scored higher than medical students on all mean test scores. In general, women showed higher levels of stress than men. Dental students scored significantly higher than medical students on Depression, Anxiety and Chronic Stress with ANOVA tests. However, when gender, age and medical or dental student status were added into a logistic regression analysis in which high stress sensitivity was the main dependent variable, only high scores in perceived stress intensity and signs of depression and anxiety showed significant main effects. Conclusion: Present study confirmed the literature that reports high degrees of stress among dental and medical students. But more importantly, Stress Sensitivity Inventory appeared to be a reliable and excellent predictor of high perceived stress and signs of depression and anxiety. It can be useful to detect and prevent student psychosocial dysfunction in clinical learning environments. An important challenge for medical and dental educational institutions is to provide specific student emotional support as early as needed as well as to consider appropriate stress prevention curriculum reforms.


[1]  Elani, H.W., Allison, P.J., Kumar, R.A., Mancini, L., Lambrou, A. and Bedos, C. (2014) A Systematic Review of Stress in Dental Students. Journal of Dental Education, 78, 226-242.
[2]  Alzahem, A.M., van der Molen, H.T., Alaujan, A.H., Schmidt, H.G. and Zamakhshary M.H. (2011) Stress amongst Dental Students: A Systematic Review. European Journal of Dental Education, 15, 8-18.
[3]  Alhajj, M.N., Khader, Y., Murad, A.H., Celebic, A., Halboub, E., Márquez, J.R., Macizo, C.C., Khan, S., Basnet, B.B., Makzoumé, J.E., de Sousa-Neto, M.D., Camargo, R., Prasad, D.A., Faheemuddin, M., Mir, S., Elkholy, S., Abdullah, A.G., Ibrahim, A.A., Al-Anesi, M.S. and Al-Basmi, A.A. (2018) Perceived Sources of Stress amongst Dental Students: A Multicountry Study. European Journal of Dental Education, 22, 258-271.
[4]  Murphy, R.J., Gray, S.A., Sterling, G., Reeves, K. and DuCette, J. (2009) A Comparative Study of Professional Student Stress. Journal of Dental Education, 73, 328-337.
[5]  Haldorsen, H., Bak, N.H., Dissing, A. and Petersson, B. (2014) Stress and Symptoms of Depression among Medical Students at the University of Copenhagen. Scandinavian Journal of Public Health, 42, 89-95.
[6]  Dyrbye, L.N., Thomas, M.R. and Shanafelt, T.D. (2006) Systematic Review of Depression, Anxiety, and Other Indicators of Psychological Distress among U.S. and Canadian Medical Students. Academic Medicine: Journal of the Association of American Medical Colleges, 81, 354-373.
[7]  Moore, R. (2018) Psychosocial Student Functioning in Comprehensive Dental Clinic Education: A Qualitative Study. European Journal of Dental Education, 22, e479-e487.
[8]  Grandy, T.G., Westerman, G.H., Combs, C.E. and Turner, C.H. (1989) Perceptions of Stress among Third-Year Dental Students. Journal of Dental Education, 53, 718-721.
[9]  Radcliffe, C. and Lester, H. (2003) Perceived Stress during Undergraduate Medical Training, a Qualitative Study. Medical Education, 37, 32-38.
[10]  Botelho, M., Gao, X. and Bhuyan, S.Y. (2018) An Analysis of Clinical Transition Stresses Experienced by Dental Students: A Qualitative Methods Approach. European Journal of Dental Education, 22, e564-e572.
[11]  Folkman, S., Lazarus, R.S., Dunkel, S., DeLongis, A. and Gruen, R.J. (1986) Dynamics of a Stressful Encounter: Cognitive Appraisal, Coping, and Encounter Outcomes. Journal of Personality and Social Psychology, 50, 992-1003.
[12]  Lazarus, R.S. and Folkman, S. (1984) Stress, Appraisal and Coping. Springer, New York.
[13]  Crego, A., Carrillo-Diaz, M., Armfield, J.M. and Romero, M. (2016) Stress and Academic Performance in Dental Students: The Role of Coping Strategies and Examination-Related Self-Efficacy. Journal of Dental Education, 80, 165-172.
[14]  Alzahem, A.M., Van der Molen, H.T., Alaujan, A.H. and De Boer, B.J. (2014) Stress Management in Dental Students: A Systematic Review. Advances in Medical Education and Practice, 5, 167-176.
[15]  Lazarus, R.S. and Folkman, S. (1987) Transactional Theory and Research on Emotions and Coping. European Journal of Personality, 1, 141-169.
[16]  Basudan, S., Binanzan, N. and Alhassan, A. (2017) Depression, Anxiety and Stress in Dental Students. International Journal of Medical Education, 8, 179-186.
[17]  Lloyd, C. and Musser, L.A. (1989) Psychiatric Symptoms in Dental Students. Journal of Nervous and Mental Disease, 177, 61-69.
[18]  Schmitter, M., Liedl, M., Beck, J. and Rammelsberg, P. (2008) Chronic Stress in Medical and Dental Education. Medical Teacher, 30, 97-99.
[19]  Bale, T.L. (2006) Stress Sensitivity and the Development of Affective Disorders. Hormones and Behavior, 50, 529-533.
[20]  Hammen C. (2015) Stress Sensitivity in Psychopathology: Mechanisms and Consequences. Journal of Abnormal Psychology, 124, 152-154.
[21]  Hankin, B.L., Badanes, L.S., Smolen, A. and Young, J.F. (2015) Cortisol Reactivity to Stress among Youth: Stability over Time and Genetic Variants for Stress Sensitivity. Journal of Abnormal Psychology, 124, 54-67.
[22]  Harkness, K.L., Hayden, E.P. and Lopez-Duran, N.L. (2015) Stress Sensitivity and Stress Sensitization in Psychopathology: An Introduction to the Special Section. Journal of Abnormal Psychology, 124, 1-3.
[23]  Cohen, S. and Williamson, G. (1988) Perceived Stress in a Probability Sample of the United States. In: Oskamp, S. and Spacapan, S., Eds., The Social Psychology of Health, Sage, Newbury Park, 31-67.
[24]  Moore, R. (2019) Stress Anxiety and Depression among First Year Danish Clinical Dental Students 2017-2019. Aarhus University, Aarhus, 1-18.
[25]  Antony, M., J. Bieling, P.J., Cox, B.W., Enns, M. and Swinson, R. (1998) Psychometric Properties of the 42-Item and 21-Item Versions of the Depression Anxiety Stress Scales in Clinical Groups and a Community Sample. Psychological Assessment, 10, 176-181.
[26]  Henry, J.R. and Crawford, J. (2005) The Short form of the Depression, Anxiety, Stress Scales (DASS-21): Construct Validity and Normative Data in a Large Non-Clinical Sample. British Journal of Clinical Psychology, 44, 227-239.
[27]  Ng, F., Trauer, T., Dodd, S., Callaly, T., Campbell, S. and Berk, M. (2007) The Validity of the 21-Item Version of the Depression Anxiety Stress Scales as a Routine Clinical Outcome Measure. Acta Neuropsychiatrica, 19, 304-310.
[28]  Crawford, J., Cayley, C., Lovibond, P.F., Wilson, P.H. and Hartley, C. (2011) Percentile Norms and Accompanying Interval Estimates from an Australian General Adult Population Sample for Self-Report Mood Scales (BAI, BDI, CRSD, CES-D, DASS, DASS-21, STAI-X, STAI-Y, SRDS, and SRAS). Australian Psychologist, 46, 3-14.
[29]  Lovibond, S.H. and Lovibond, P.F. (1995) Manual for the Depression Anxiety Stress Scales. 2nd Edition, Psychology Foundation of Australia, Sydney.
[30]  Moore, R. (2011) Occupational Stress among Dentists. In: Langan-Fox, J. and Cooper, C.L., Eds., Handbook of Stress in the Occupations, 1st Edition, Edward Elgar, Cheltenham, UK, 107-132.
[31]  Serrano, C.M., Botelho, M.G., Wesselink, P.R. and Vervoorn, J.M. (2018) Challenges in the Transition to Clinical Training in Dentistry: An ADEE Special Interest Group Initial Report. European Journal of Dental Education, 22, e451-e457.
[32]  Adams, D.F. (2017) The Embedded Counseling Model: An Application to Dental Students. Journal of Dental Education, 81, 29-35.


comments powered by Disqus

Contact Us


WhatsApp +8615387084133

WeChat 1538708413