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Stress carry-over and college student health outcomes
College Student Journal. 46.3 (Sept. 2012): p620+.
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Objective: Using a stress carry-over perspective, this study examines the relationship between stress stemming from school and family domains and physical and mental health outcomes. Methods: The study sample included 268 undergraduate men and women from a Midwestern university. Participants completed an anonymous online questionnaire. OLS regression was used to analyze stress and health outcomes. Separate equations were estimated for men and women. Results: Men and women report higher school than family stress spillover, and women report higher school stress spillover than men. Regression models show that both men and women report more days of poor mental health when school spillover is high. Sleep hours are negatively associated with school spillover for women, and with family spillover for men. Conclusions: It appears that the carryover of stress operates both similarly and differently for college men and women, affecting at least one physical health outcome and perceived mental health.

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The transition from adolescence to emerging adulthood is a time of great change (Arnett, 2000), and often, of great stress (Towbes & Cohen, 1996). This is particularly true for young adults who choose to attend college. Many students find their university years to be a stressful experience (Pierceall & Keim, 2007) and report being "overwhelmed" with responsibilities--which may begin even before the school year (Pryor, Hurtado, DeAngelo, Palucki Blacke, & Tran, 2010). Stress among college students is on the rise (Sax, 1997, 2003), with recent studies reporting the highest level of stress among college freshmen since data collection efforts on this topic began (Pryor et al., 2010).

The process of stress is one that is highly subjective, though shaped by outside forces. Stress is defined as a demand, either internal or external, that results in emotional arousal and requires a change of behavior (Holmes & Rahe, 1967; Ragheb & McKinney, 1993). These demands, or stressors, may be physical, psychological, social or environmental; take the form of a life event or chronic strain (Pearlin, 1989); and are largely dependent upon individual perception (Lazarus, 1966, 1977). Previous work by Mendoza (1981) and Rocha-Singh (1994) indicated that college students perceive stressors existing along multiple dimensions, including academic, financial, familial, personal, and environmental domains. Generally speaking, college women report higher levels of overall stress than college men (Brougham, Zail, Mendoza, & Miller, 2009; Dusselier, Dunn, Wang, Shelley II, & Whalen, 2005; Hudd et al., 2000; Pierceall & Keim, 2007). Women also report experiencing greater academic pressure than men (Misra, McKean, West, & Russo, 2000), but mixed findings exist for family-generated stress. Some studies have reported no gender difference (Dyson & Renk, 2006) and others have indicated that college women experience a higher level of family stress (Brougham et al., 2009). Freshmen and sophomores report higher academic stress than upperclassmen (Misra et al., 2000).

From a stress "carry-over" perspective (Thoits, 1995), the experience of stress may spill from one domain or role to another, one person to another, or across stages of life. Strain at home may lead to stress in school; stress felt by one roommate may increase the demands felt by another; and stressors felt during college years may influence health later in life, for example. The first of these forms, intra-personal spillover of stress from one domain to another ("spillover" or "cross-domain stress"), is a form of carry-over that often leads to role conflict--the existence of conflicting roles that produce competing demands for one's time and energy, and that may both result from and create chronic strain (Hudd et al., 2000). While we know a great deal about the spillover of stress across domains for working adults (e.g., work stresses affecting family experiences), we know less about spillover in the lives of college students. The focus of this paper is an examination of stress spillover from school and family as experienced by college undergraduates.

Stress--and stress carry-over in the form of spillover--can lead to negative health behaviors and choices that may shape long-term outcomes for young adults. Past work has shown that the burden of stress can lead to overeating, smoking, and drinking (McCormack, 1996; McEwen, 2008; Morgan, 1997; Naquin & Gilbert, 1996). Among college students, it has been reported that those with high levels of stress eat more junk food, exercise less, and get less sleep (Hudd et al., 2000). At least one study documented that family stress is associated with alcohol abuse among college students, both male and female (Koch-Hattem & Denman, 1987). In addition to behavioral responses that influence health, direct associations between stress and health outcomes exist. High levels of stress have been shown to increase anxiety, depression, and suicidal ideation among students (Chang, 2001; Dyson & Renk, 2006; Hirsch & Ellis, 1996; Jung & Khalsa, 1989), and also increase the likelihood of physical illness (Edwards, Hershberger, Russell, & Markert, 2001). But whereas most of the literature on stress focuses exclusively on mental health outcomes (Thoits, 1995), this paper examines both physical and mental health outcomes. And where much work has been done documenting the link between stress and health, less has been done examining the process of stress spillover--cross-domain stress--and its association with health outcomes, particularly among college students.

Current Study

The current study contributes to the literature on college student stress by utilizing a carry-over perspective to examine crossdomain spillover and mental and physical health outcomes. Taking questionnaire data from a sample of college undergraduates (n = 268), spillover from school and family are examined. Though studies have shown a link between stress and perceptions of reduced health status or health-related quality of life (e.g., Gupchup, Borrego, & Konduri, 2004; Hudd et al., 2000), these studies fail to delineate between sources of stress or to compare the relative effects of different cross-domain stressors on health outcomes. In this paper, school and family generated spillover are simultaneously examined as predictors of five health outcomes, including perceptions of poor mental and physical health, frequency of drinking and binge drinking, and average hours of sleep per day. OLS regression analyses are performed separately for college men and women.

Method

Procedure and Participants

This study makes use of data from a stratified random sample of college students enrolled at the University of North Dakota (UND). Online questionnaires were administered to students in multiple courses across campus. The courses that were randomly selected for inclusion in the study were chosen from a list of all courses offered during fall semester 2009. After omitting independent study and readings, professional, and part-term courses from the sampling frame, every 10th case was selected for a total of 73 courses. The instructor of record for each course was notified via email about the study, with a follow-up email sent a week later in which the web link for the survey was included. Instructors were encouraged to share the web link to the questionnaire with their students via email or the Blackboard operating system to minimize user error in reaching the survey. IRB approval was granted in order to share findings from the questionnaires.

It is not possible to determine how many students received notice of the study, as instructor participation was voluntary and instructors were not required to provide information regarding participation. However, it is estimated that 1,672 students were potentially made aware of the survey, although it is likely that the actual number of students was far smaller. The questionnaire was made available for one month, and in all, 295 complete responses were obtained. For the purposes of the current study, only undergraduate students were included, resulting in a final sample of 268 individuals, 97 men and 171 women, across a wide range of majors. The sample was largely white (81%), with the largest minority group being Native American (2.5%). Roughly one-fifth of the sample was composed of freshmen students, one-fifth were sophomores, and one-fifth were juniors, while about 38% were seniors. Thirty-six percent of the sample was not employed, and most of the remaining 64% of the sample was working part time.

Measures

The questionnaire included a number of measures related to health, academics, and stress. For this paper, two key measures of stress carry-over were included: school spillover and family spillover. A measure of work spillover was available, but because it was not correlated with the health variables, it is omitted from this analysis. Both indices of spillover had six items, with responses marked on a five-point Likert scale ranging from strongly disagree to strongly agree. Items were summed to create each index of spillover, with a scale range from 6 to 30, and high scores indicating greater levels of spillover on each scale. The items making up each scale are listed below.

School spillover was designed to measure the extent to which students perceived school obligations and demands spilling into other domains of life. The items making up the index included: 1) I've had to cancel plans with friends or family because of homework; 2) Doing school work interferes with my personal life; 3) I feel overwhelmed by all the things that need to be done for my classes; 4) Because of homework, I can't get to the tasks I need to do at home (such as laundry, dishes, etc.); 5) I might have better relationships if I didn't have so many school obligations; and 6) My family would like to see me more, but I am too busy with school. The alpha reliability coefficient was .88 for the index. The six items making up the family spillover index included: 1) Worrying about family interferes with work and school life; 2) Sometimes I have so much to do at home that I can't get to my school work; 3) I might get better grades if I didn't have so many family obligations; 4) My family members regularly call and disrupt me when I am at work or school, or when I am studying; 5) I've had to take time off or drop a class due to family needs or emergencies; and 6) I wish my family would express more concern for my work or school life. The alpha reliability coefficient for this index was .79.

There are five health outcomes examined in this paper, taken from the annual Behavioral Risk Factor Surveillance System (CDC, 2011). Poor physical health and poor mental health were measured by asking: "Thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good?" and "Thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?" Frequency of drinking was measured using a question which asked, "During the past 30 days, how many days did you have at least one drink of any alcoholic beverage?" Frequency of binge drinking asked, "Considering all types of alcoholic beverages, how many times during the past 30 days did you have 4 (women) / 5 (men) or more drinks in one sitting?" For these four variables, respondents selected the appropriate number of days ranging from 0-30. Finally, average sleep hours was measured by asking, "On average, how many hours of sleep do you get in a 24-hour period? Think about the time you actually spend sleeping or napping, not just the amount of sleep you think you should get. Use whole numbers, rounding 30 minutes (1/2 hour) or more up to the next whole hour and dropping 29 or fewer minutes." Respondents then provided the number of sleep hours.

Results

Descriptive statistics for the variables (see Table 1) indicate that for both college men and women, spillover generated by the family is lower on average than spillover that stems from school. Though the means are higher among women for both types of spillover, t-test results showed only a significantly higher level of school spillover among college women compared to college men (t = 2.33, df = 191, p < .02). Using analysis of variance, significant differences in school and family spillover were not found by class level. For the dependent variables, men and women reported more days of poor mental health (mean for men = 7.95, s = 8.95; for women = 9.17, s = 8.06) in the last month than days of poor physical health (mean for men = 2.67, s = 5.22; for women = 3.61, s = 4.52). Both men and women reported sleeping, on average, about 7 hours per night. College men reported a greater average number of days drinking (t = 3.58, df = 192, p < .000) and binge drinking (t = 3.03, df = 195, p < .01) compared to women.

Because of significant t test results for school spillover and the two drinking measures by gender, separate OLS regression analyses were run for college men and women (Table 2). Age was also added as a control variable in order to avoid 'class level' acting as a proxy for student age, particularly in the models for drinking and binge drinking. The spillover indicators are not predictive of poor physical health, drinking, or binge drinking for college men or women. School spillover is positively associated with poor mental health for both men ([beta] = .29*) and women ([beta] = .40 ***), and family spillover nears significance in the model for women ([beta] = . 15 [dagger]). Average hours of sleep is negatively associated with family spillover for men ([beta] = -.34 *) and with school spillover for women ([beta] = -.19 *). This model is slightly more predictive of the variance in sleep hours for men than for women.

Discussion

This paper is framed using a stress carry-over perspective and examines the relative effects of school and family spillover on five health outcomes for undergraduate men and women. Findings indicate that men and women report higher school than family spillover, and women report higher average spillover from school than men. Regression models show that both men and women report more days per month of poor mental health when school spillover is high, but whereas school spillover is negatively associated with sleep hours for women, it is family spillover that shares a negative association with sleep hours for men--despite similar levels of family spillover reported by men and women. Poor physical health, drinking, and binge drinking were not significantly associated with spillover measures for this sample.

Thus, it appears that the carry-over of stress through cross-domain spillover operates both similarly and differently for college men and women, affecting at least one physical health outcome and perceived mental health.

Whereas the negative relationship between poor mental health and school spillover for men and women in the sample is expected, the differing associations between sleep hours and types of spillover for men and women are somewhat surprising. Simply put, college men appear to lose sleep over family stresses, while college women lose sleep over stresses originating in school demands. College women report higher academic stress and anxiety than college men (Misra & McKean, 2000). Sleep loss may function as a time management strategy when women are faced with extensive school obligations. That is, they may lose sleep in order to prioritize school and meet important course deadlines. This hypothesis is consistent with the finding that college women display more effective time management skills than college men (Trueman & Hartley, 1996). If college men are losing sleep over family stresses, they may be even less able to effectively manage and meet school obligations. This is especially concerning when viewed in light of the source of stress being considered. When faced with excessive stress, one of the most effective solutions is turning to social support networks (Misra & McKean, 2000). When family is the source of stress, it may not be readily available as an important social support network, compounding the issue. These findings and awareness of the gendered response to various stressors may be useful to clinicians, advisors, student affairs professionals, and others who work directly with college men and women.

Limitations

As with any study, there are a number of limitations pertaining to the current work that should be noted. Because this study is based on a sample from a single campus, the findings have limited generalizability. Students included in the study were overwhelmingly white and most were raised in the Midwestern United States. In addition, many are "traditional" college students in the sense that they are young and unmarried. Thus, findings are not necessarily applicable to specific subpopulations, such as non-traditional or older than average students. Cross-sectional design and subjective versus objective reporting of stress and health outcomes are of some concern in determining causality and removing perceptual bias. Single-item measures for many of the outcome measures are also of concern.

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DAPHNE E. PEDERSEN

University of North Dakota

Table 1. Descriptive statistics.

                                            Men             Women

School s illover                         19.95 (5.42    21.80 * (5.13)
Family s illover                         13.88 (5.04)     14.09 (4.39)
Poor physical health in last month        2.67 (5.22)      3.61 (4.52)
Poor mental health in last month          7.95 (8.95)      9.17 (8.06)
Average hours of sleep                    7.09 (1.22)      7.24 (1.19)
Frequency of drinking in last month   7.02 *** (7.43)      3.98 (4.34)
Frequency of binge drinking in last    3.55 ** (5.21)      1.89 (2.48)

* p<.05, ** p<.01, *** p<.001.

Table 2. Regression analyses.

                   Poor       Poor mental          Average
                   physical                       hours of sleep
                   health     health
                   M    W     M        W           M        W

School spillover              .29 *    .40 ***              -.19 *
Family spillover                       .15         -.34 *
                                       ([dagger)
Class level                   -.33 *
Age
Adj. [R.sup.2]                 .21      .20         .11      .07
Model sig.         NS   NS    .001     .000        .03      .05

                   Frequency of             Frequency of
                   drinking                 binge drinking

                   M                W       M         W

School spillover
Family spillover

Class level        .36 **           .27 *   .46 ***
Age                .24 ([dagger])
Adj. [R.sup.2      .25              .05     .13
Model sig.         .000             .05     .05       NS

([dagger]) p<.10, * p<.05, ** p<.01, *** p<.001.
Source Citation   (MLA 8th Edition)
Pedersen, Daphne E. "Stress carry-over and college student health outcomes." College Student Journal, vol. 46, no. 3, 2012, p. 620+. Academic OneFile, http%3A%2F%2Flink.galegroup.com%2Fapps%2Fdoc%2FA302464025%2FAONE%3Fu%3Dnysl_ca_sar%26sid%3DAONE%26xid%3Daa3d860f. Accessed 22 Mar. 2019.

Gale Document Number: GALE|A302464025