Stress and stress management interventions in higher education students: Promises, Challenges, Innovations

Stress is becoming a growing concern among young adults. Students in higher education are particularly at risk as they encounter several stressors such as academic pressure, financial adversity, and study/life imbalance. When the demands exceed one`s coping capacity, it can negatively influence mental and physical health. Therefore, this thesis is conducted to investigate stress and stress management interventions in higher education students.
Chapter 1 provides a general overview of the concepts of this thesis namely stress, sources of stress in university students, stress management interventions, and Interned-based interventions. Chapter 2 investigates the sources of stress (i.e., financial, health, love life, relationship with family, relationship with people at work/ school, the health of loved ones, other problems of loved ones, and life in general) among students from two universities in the Netherlands, and examines the associations between student status (i.e., international vs. domestic students) and sources of stress. The results of this chapter showed that international students were more likely to experience financial stress and stress related to the health of their loved ones. Chapter 3 presents the findings of the systematic review and meta-analysis of Randomized Controlled Trials (RCT) investigating the effects of stress management interventions involving a care provider for college students. Results yielded that stress management interventions had moderate effects on stress, depression, and anxiety. Chapter 4 reports the results of a systematic review and meta-analysis of RCTs of self-guided stress management interventions for university students. The overall effects were low-to-moderate. Chapter 5 represents the findings of the systematic review and meta-analysis of yoga, meditation, and mindfulness interventions in university students for stress, depression, and anxiety. Meta-analysis findings yielded moderate effects. Chapter 6 introduces a guided Internet-based stress management intervention (Rel@x) developed for university students with elevated levels of stress and describes the protocol study investigating the feasibility and acceptability of this intervention. Chapter 7 presents the quantitative and qualitative findings of this trial. As a result, students evaluated the intervention as feasible and acceptable. However, high attrition rates and findings from the semi-structured interviews pointed out that intervention should be refined before conducting a large-scale RCT. Lastly, Chapter 8 provides the overarching findings of this thesis alongside clinical and research implications.