46
47 Disorder (PTSD), and 3 people indicated that they had symptoms of either anxiety, depression or OCD, but this was undiagnosed.
Table 3. Self-Reported Mental Health difficulty by Gender Self-Reported Mental Health
Problem
Male
% (n)
Female
% (n)
Total 100% (n)
OR (95% CI) Fishers Exact Test Currently mental
health problem Yes No Total
20.9 (19) 40.4 (40)
79.1 (72) 59.6 (59)
91
99 2.57 (1.35 – 4.90) P = .003
31.1 (59) 68.9 (131) 190
Lifetime mental health
problem Yes No
Total
26.0 (32) 40.3 (27)
74.0 (91) 59.7 (40)
123 67
1.92 (1.02- 3.62) P = .032
31.1 (59) 68.9 (131) 190
Anxiety Disorder
Yes No Total
19.7 (14) 37.8 (45)
80.3 (57) 62.2 (74)
71 119
2.48 (1.24 – 4.95) P = .006
31.1 (59) 68.9 (131) 190
Depression Yes No Total
22.0 (20) 39.4 (39)
78.0 (71) 60.6 (60)
91
99 2.31 (1.22 – 4.37) P = .017
31.1 (59) 68.9 (131) 190
Alcohol / Substance Misuse Yes
No Total
36.4 (8) 30.4 (51)
63.6 (14) 69.6 (117)
22 168
0.76 (0.30 – 1.93) P = .36
31.1 (59) 68.9 (131) 190
Eating Disorder
Yes No Total
20.6 (7) 33.3 (52)
79.4 (27) 66.7 (104)
34 156
1.93 ( 0.79 – 4.72) P = .10
31.1 (59) 68.9 (131) 190
OCD
Yes No Total
24.0 (6) 32.1 (53)
76.0 (19) 67.9 (112)
25 165
1.50 (0.57 – 3.97) P = .28
31.1 (59) 68.9 (131) 190
Psychosis
Yes No Total
35.7 (5) 30.7 (54)
64.3 (9) 69.3 (122)
14 176
0.80 (0.25 – 2.49) P = .45
31.1 (59) 68.9 (131) 190
Bipolar
Yes No Total
40.0 (4) 30.6 (55)
60.0 (6) 69.4 (125)
10 180
0.66 (0.18 – 2.43) P = .38
31.1 (59) 68.9 (131) 190
Self-Harm Yes No Total
10.0 (6) 40.8 (53)
90.0 (54) 59.2 (77)
60
130 6.20 (2.48 - 15.44) P < .001
31.1 (59) 68.9 (131) 190
Other mental Yes health problem No
Total
25.0 (5) 31.8 (54)
75.0 (15) 68.2(116)
20
170 1.40 (0.48 – 4.04) P = .62
31.1 (59) 68.9 (131) 190
48 Psychological Distress Indicated by DASS-21
Symptoms of depression, anxiety and stress were measured using the DASS-21 questionnaire. A total of 190 participants completed all the items on the DASS-21. Higher scores on the measure indicate increased severity of symptoms and greater psychological distress.
The means, medians, standard deviation and range for each of the subscales and total scores can be found in table 16 in Appendix 16. The distribution of scores in the overall sample is illustrated in the box plot as shown in figure 3. The scores on the DASS-21 appear to the eye to be positively distributed, however when a formal testing of normality was undertaken, scores were found to be normally distributed (skew = 0.33) and ranged from a minimum score of 0 to a maximum of 63.
Figure 3. Distribution of DASS-21 scores in the overall sample
49 Distribution of DASS-21 Subscale Scores
As described in the methods chapter the scores on the three subscales of the DASS-21 can be categorised according to severity of symptoms ranging from ‘normal’ to ‘extremely severe’. The proportion of the sample scoring within each range was calculated and is shown diagrammatically in figure 4. In the overall sample, 33% to 41% of participants scored within the ‘normal’ range across all of the subscales of the DASS-21. However, 27% (n = 51) of participants scored within the ‘extremely severe’ range for the depression subscale, 31% (n = 59) scored within the ‘extremely severe’ range for the anxiety subscale and 11% (n = 22) for the stress subscale. Further details of the scores across the subscales can be found in Appendix 18.
Cronbach’s alpha was used to determine the reliability and internal consistency of the DASS- 21 subscales. A Cronbach’s α of 0.94 was obtained for the depression subscale, 0.90 for the anxiety subscale and 0.89 for the stress subscale. This is consistent with the literature and suggests that the scale has good reliability.
Figure 4. Percentage distribution of scores on each subscale of the DASS21 33
10
18
12
27 41
12 10
6
31 39
15
19 17
11 0
10 20 30 40 50
Normal Mild Moderate Severe Extremely
Severe
Percentage %
Severity
Depression Anxiety Stress
50 DASS-21 Scores and Self-Reported Distress
The distribution of scores on the DASS21 were analysed according to whether participants self-reported a current emotional or mental health difficulty, which is illustrated in figure 5. As shown in the boxplot, the scores appeared to the eye to be positively skewed but were found to be non-significant for each group (skew = 0.23 and 0.71). In order to examine whether or not the mean scores between the two groups were significantly different, an independent t- test was carried out. The results revealed that participants who reported a current emotional or mental health difficulty scored significantly higher on the DASS21 (M = 34.3, SD = 14.1, n
= 89) than participants who did not disclose a current mental health difficulty (M = 15.7, SD = 13.2, n = 98), where the results of the t-test were found to be t(185) = 9.28, p <0.001.
Figure 5: Boxplot of Total DASS 21 Scores according to whether participants self-reported a current emotional or mental health difficulty.
51 As shown in figure 5 there were a number of participants who did not self-report a current mental health difficulty, but who obtained a high score on the total DASS-21. In order to analyse this further, the proportion of participants who scored within the ‘moderate to extremely severe’ range of each subscale was calculated and presented in table 4. As shown in the table, between 28% and 33% of participants who obtained scores within the ‘moderate to extremely severe’ range did not self-report any current difficulties.
Table 4. Percentage of participants scoring within the ‘moderate – extremely severe’ range on DASS-21 subscale according to whether they self-reported a current emotional or mental health difficulty
Moderate – Extremely Severe Range
Self-reported current emotional or mental health difficulty
Total
% (n) Yes
% (n)
No
% (n)
Depression 67.3 (72) 32.7 (35) 100 (107)
Anxiety 71.3 (62) 28.7 (25) 100 (87)
Stress 71.6 (63) 28.4 (25) 100 (88)
The percentage of participants who scored within the ‘severe to extremely severe’ range on the DASS-21 subscale, but who did not disclose any current emotional or mental health difficulties were also calculated. The analysis revealed that of those who did not disclose a current metal health difficulty, 25% (n =18) scored within the ‘severe to extremely severe’
range of the depression subscale, 26% (n = 18) on the anxiety subscale and 22% (n=12) on the stress subscale.
52 General Self-Efficacy
The level of self-efficacy in the sample was measured using the General Self Efficacy (GSE) Scale, with higher scores on the scale indicating greater perceived general self-efficacy.
Figure 6 illustrates the distribution of scores in the overall sample, the data was normally distributed (skew = - 0.4) and the scores in the overall sample ranged from a score of 13 to 40 (n = 200), with a mean score of 28 (SD = 5.6).
The reliability of the GSE scale was determined using Cronbach’s alpha, the scale was found to be highly reliable with a Cronbach’s alpha of 0.90.
Although the sample was normally distributed, the analysis revealed that three of the scores were outliers as illustrated in Figure 6. The outliers were individually checked and they did not appear to be an erroneous response. The outliers appeared to be legitimate scores that corresponded to a difference in whether or not participant’s experienced a mental health difficulty (see Figure 8).
Figure 6. General Self-Efficacy Scores in overall sample.
53 Self-efficacy and Gender
The distribution of scores on the GSE scale were calculated across male and female participants and shown in figure 7. The scales were normally distributed across gender, however males obtained a significantly higher score on the GSE scale (M = 30, SD = 5.3, n = 61) than female participants (M = 28, SD = 5.6, n = 138). A t-test was performed showing t (197) = 2.36, p = .02.
Figure 7. General Self-Efficacy Scores in overall sample across gender.
54 Self-Efficacy and Mental Health Difficulty
Scores on the GSE scales were further analysed according to whether participants reported any current emotional or mental health difficulty (figure 8). The majority of participants who did not report any current mental health difficulty scored in the range of 21- 40, with one person scoring 151. Although the distribution of data within both groups were normally distributed, the spread of scores were greater among participants who self-reported a current mental health difficulty (range = 13 - 40). A comparison of the means between groups was carried out using a t-test and those who self-reported mental health difficulty had a significantly lower mean score on the GSE (M = 26.3, SD = 6.0, n = 92) than those who did not report any current difficulties (M = 30.1, SD =4.5, n = 99), where t-test revealed t(189) = 5.0, p < .001.
Figure 8 General Self-Efficacy Scores in overall sample according to self-reported emotional or mental health difficulty.
1 Score did not appear to be erroneous and was included in the analysis.
55