Mức độ rối loạn lo âu của sinh viên ngành giáo dục mầm non và giáo dục Tiểu học, trường Đại học Đồng Tháp
Tạp chí Khoa học Đại học Đồng Tháp, Tập 10, Số 6, 2021, 85-91
THE LEVEL OF ANXIETY DISORDER OF STUDENTS MAJORING
IN PRE-SCHOOL EDUCATION AND PRIMARY EDUCATION
OF DONG THAP UNIVERSITY
Dinh Ngoc Thang1 and Duong Van Khanh2*
1Department of Social Science Education, Dong Thap University
2Department of Culture - Tourism and Social work, Dong Thap University
*Corresponding author: dv[email protected]
Article history
Received: 04/3/2021; Received in revised form: 05/4/2021; Accepted: 14/5/2021
Abstract
The article approaches the basic theoretical foundation of anxiety disorders, on which “Zung Self-Rating
Anxiety Scale (SAS)” and “Depression Anxiety and Stress Scales (DASS- 42)” are used to measure the levels
of anxiety disorder of 260 primary school and pre-school education students in Education Faculty - Dong
Thap University. The research result aimed to clarify student’s level of anxiety disorder, level of anxiety,
depression and stress (factors impacting on anxiety disorder). Thereby, it examined the correlation between
the factors of anxiety, depression and stress with student’s anxiety disorder.
Keywords: Anxiety disorder, Dong Thap University, pre-school education, primary education, student.
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MỨC ĐỘ RỐI LOẠN LO ÂU CỦA SINH VIÊN NGÀNH GIÁO DỤC
MẦM NON VÀ GIÁO DỤC TIỂU HỌC, TRƯỜNG ĐẠI HỌC ĐỒNG THÁP
Đinh Ngọc Thắng1 và Dương Văn Khánh2*
1Khoa Sư phạm Khoa học xã hội, Trường Đại học Đồng Tháp
2Khoa Văn hóa - Du lịch và Công tác xã hội, Trường Đại học Đồng Tháp
*Tác giả liên hệ: [email protected]
Lịch sử bài báo
Ngày nhận: 04/3/2021; Ngày nhận chỉnh sửa: 05/4/2021; Ngày duyệt đăng: 14/5/2021
Tóm tắt
Bài viết tiếp cận những cơ sở lý luận cơ bản về rối loạn lo âu, trên cơ sở đó sử dụng Thang đánh giá lo
âu Zung (SAS) và Thang đánh giá lo âu, trầm cảm và stress (DASS-42) để đo lường rối loạn lo âu của 260
sinh viên ngành Giáo dục Tiểu học và Giáo dục Mầm non (tất cả các năm học) Khoa Giáo dục - Trường
Đại học Đồng Tháp. Kết quả nghiên cứu nhằm làm sáng tỏ mức độ rối loạn lo âu cũng như mức độ lo âu,
trầm cảm và stress (các thành tố tác động đến rối loạn lo âu) của sinh viên. Qua đó, nghiên cứu xem xét sự
tương quan giữa các thành tố lo âu, trầm cảm và stress với rối loạn lo âu của họ.
Từ khóa: Giáo dục tiểu học, giáo dục mầm non, rối loạn lo âu, sinh viên, Trường Đại học Đồng Tháp.
Cite: Dinh Ngoc Thang and Duong Van Khanh. (2021). The level of anxiety disorder of students majoring in pre-school
education and primary education of Dong Thap University. Dong Thap University Journal of Science, 10(6), 85-91.
85
Chuyên san Khoa học Xã hội và Nhân văn
1. Introduction
A tool to interview and diagnose mental disorders.
This tool is used by many scientists in many countries
for professional research and in people's mental
health projects.
“Anxiety” was described by Hippocrates (460-
377 BC) as a common illness whose symptoms are
the feeling spasm and shortness of breath. Anxiety is
known as struggles of the mind and soul. This concept
In 1997 and 1998 (Australia), a national survey
existed tens of centuries later (cited in Nguyen Thi research of mental health with 10641 people of over
Van, 2019, p. 6).
18 years old, using CIDI, ICD-10 and DSM IV,
showed that the incidence of anxiety disorder was
as follows: 18-24 years old: 3.0%; 25-34 years old:
3.9%; 35-44 years old: 4.5%; 45-54 years old: 4.9%;
55-64 years old: 3.0% and ≥ 65 years old: 1.6% (cited
in Tran Nguyen Ngoc, 2019, p. 16). According to a
study in 130 locations in Germany with 4181 adults
aged 18-65 years (1998), using the CIDI assessment
(interview, general diagnosis) tool combined with the
ICD diagnostic criteria-10 and DSM IV, the following
incidence of anxiety disorder was: 18-24 years old:
1.0%; 25-34 years old: 0.7%; 35-44 years old: 1.5%;
45-54 years old: 2.0%; ≥ 55 years old: 2.2% (cited in
Tran Nguyen Ngoc, 2019, p. 16).
Charles Darwin (1809 - 1882) described “People
of generations tried to flee from dangerous enemies
with increasing fear and anxiety” (cited in Nguyen
Thi Van, 2019, p. 6).
In 1884, Kerkgard used the term “Angest”
to refer to human anxiety states. In 1886, Morel
combined states of anxiety and he called them
“emotional delusion”; this state is different from
Hysterie and hypochondria disease. On the basis of
analysis of clinical phenomenon of obsessive disorder,
Freud (suggested the term “anxiety neurosis” in 1895,
and he thought that the reason the patients suffered
anxiety neurosis was the conflict of the unconscious
mind. This S. Freud's term was widely accepted and
used for a long time from the early of 20th century
to the 60s of this century (cited in Nguyen Thi Van,
2019, p. 6).
In 2004, the costs for internal treatment of
generalized anxiety disorder in Europe was from
2000-3000 Euro per patient for one stage of treatment
and costs for treatment of other anxiety disorder was
from 300-1000 Euros per patient for one stage of
treatment (cited in Bui Quang Huy, 2017).
In 1952, anxiety disorder was mentioned in
the chapter “Mental Disorders” of DSM I with the
names as “anxiety reaction” by American Psychiatric
Association (APA). In 1968, the name in DSM II
was changed into “anxiety neurosis” because anxiety
was primarily caused by trauma, characterized by
persistent anxiety resulting in panic disorder and
often associated with body symptoms (Tran Nguyen
In 2014, America used DSM V to study mental
health, and it announced anxiety disorder has affected
6.8% adults (3.1% of the US population). Women
suffered from this disorder twice as often as men
(cited in Bui Quang Huy, 2017).
According to DSM V, “Anxiety disorders
Ngoc, 2019). In 1980, in DSM III, panic disorder include disorders that share features of excessive
and anxiety disorder were separated and the time for fear and anxiety and related behavioral disturbances.
consideration of disease manifestation of symptoms Fear is the emotional response to real or perceived
should be lengthened within 1 month. Later, in imminent threat, whereas anxiety is anticipation
DSM III- R (1987), DSM IV (1994), DSM IV-TR of future threat. Panic attacks feature prominently
(2000) and DSM V (2013), the criteria of disease within the anxiety disorders as a particular type of
manifestation increased to 6 months.
fear response. Panic attacks are not limited to anxiety
disorders but rather can be seen in other mental
disorders as well” (American Psychiatric Association,
2013, p.189).
In 1983, ICD-International Statistical
Classification of Diseases and Related Health
Problems was developed by WHO and approved by
3rd World Health Assembly in 1990 and first used
“The anxiety disorders differ from one another
by member countries in 1994. IDC- 10 is the 10th in the types of objects or situations that induce fear,
edition of International Statistical Classification anxiety, or avoidance behavior, and the associated
of Diseases and Related Health Problems. In cognitive ideation. Thus, while the anxiety disorders
1990, WHO developed and published CIDI (The tend to be highly comorbid with each other, they can
Composite International Diagnostic Interview-1990): be differentiated by close examination of the types of
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Tạp chí Khoa học Đại học Đồng Tháp, Tập 10, Số 6, 2021, 85-91
situations that are feared or avoided and the content both the SDS and SAS that involved conversion of a
of the associated thoughts or beliefs” (American
Psychiatric Association, 2013, p.189).
total scale raw score (with a potential range of 20 to
80) to an index score with a potential range of 25 to
100. The index score is derived by dividing the sum
of the values (raw scores) obtained on the 20 items
by the maximum possible score of 80, converted to a
decimal and multiplied by 100 (p. 376). In 1980,
Zung reduced the cut-off point for clinical significance
from that set in his seminal paper on the development
of the SAS. Recent research has suggested that the
1980-recommended cut-off point (a raw score of 36 or
an index score of 45) is lower than the ideal, and that
the original 1971 cut-off (a raw score of 40; an index
score of 50) produces better sensitivity and specificity
figures (Debra and Ned Scott, 2020). Nowadays, SAS
is a highly evaluated scale widely used to measure and
identify anxiety disorder.
Nowadays, in addition to DSM, CIDI, IDC-10
there are many other instruments, quizzes, scales
published and used widely by researchers in the field
of measurement, diagnosis of anxiety disorder such
as: DASS (Depression Anxiety and Stress Scales),
SAS (Zung Self-rated Anxiety Scale), GAD-7
(General Anxiety Disorder-7), and so on.
Anxiety disorder is considered as a mental illness
that causes harm to human health. Therefore, it has
been studied actively by scientists and countries to find
out solutions for effective prevention and treatment.
Until now, there is no official statistics on the
number of people who are suffering anxiety disorder
in Vietnam. With the approval of WHO, Vietnam’s
Ministry of Health uses the copyright database of ICD-
10 and DSM IV, V translation (under Agency of Health
Examination and Treatment) in scientific research and
services of examination, diagnosis and treatment of
mental diseases by the professionals. However, studies
of anxiety disorder in Vietnam are still few without
sufficient synchronization or investment.
The SAS is a 20-item self-report assessment
device built to measure anxiety levels, based on
scoring in four groups of manifestations: cognitive,
autonomic, motor and central nervous system
symptoms. On answering the statements, one will
indicate how much each statement applies to him or
her within a period of one or two weeks prior to taking
the test. Each question is scored on a Likert-type scale
of 1- 4 (ranging from: “a little of the time”, “some
of the time”, “a good part of the time”, “most of the
time”). Some questions are negatively worded to
avoid the problem of set response. Overall assessment
is done by a total score.
For the reasons mentioned above, we decided to
conduct this study investigating the level of anxiety
disorder of students majoring in pre-school education
and primary education in Dong Thap University.
2. Methods and Data
2.1. Zung Self-Rating Anxiety Scale (SAS)
The total raw score ranges from 20-80. The
raw score then needs to be converted to an “Anxiety
Index” score using the chart on the paper version
of the test that can be found on the link below. The
“Anxiety Index” score can then be used on this scale
below to determine the clinical interpretation of one's
The Zung Self-Rating Anxiety Scale (SAS) was
designed by William W. K Zung
M.D (1929-1992), a professor of Psychiatry
from Duke University, to quantify a patient's level
of anxiety (Zung, 1971, 1974).
In 1971, Zung developed a method of scoring level of anxiety (Zung, 1971).
Table 1. Self-Rating Anxiety Scale (SAS 20)
Level of anxiety
Normal Range
Mild to Moderate
Marked to Severe
Extreme
disorder
... Total score
20-44
45-59
60-74
75 and above
We use “Zung Self-Rating Anxiety Scale another 130 students majoring in primary education
(26 first-year, 27 second-year, 34 third-year and 43
fourth-year) of Dong Thap University.
(SAS)” and “Depression Anxiety and Stress Scales
(DASS-42)” to measure the level of anxiety disorder
and factors affecting anxiety disorder of 130 students
majoring in preschool education (21 first-year, 24
second-year, 51 third-year and 34 fourth-year), and
2.2. DepressionAnxietyandStressScales(DASS)
The Depression, Anxiety and Stress Scale
were applied in order to reveal the psychological
87
Chuyên san Khoa học Xã hội và Nhân văn
status of the individuals. Also, this scale is used in emphasizing states over traits. These scores range
determining the level of negative emotional states. It from 0, meaning that the respondent believed the
is developed by Lovibond, S.H. and Lovibond, P.F
(1995a) and proposed by Australian Psychological
Society. Several studies were published on its
reliability and validity worldwide. The DASS is a
well-established instrument to measure symptoms
of depression, anxiety and stress in both clinical
and non-clinical samples of adults (Beaufort et al.,
2017). Nowadays, DASS-42 has an abridged version
(DASS-21) with similar functions. Both these two
versions are highly evaluated by researchers and
widely used in the world.
item “did not apply to them at all”, to 3 meaning
that the respondent considered the item to “apply
to them very much, or most of the time”. It is also
stressed in the instructions that there are no right or
wrong answers (Crawford and Henry, 2003). The
sum of the relevant 14 items for each scale constitutes
the participants' scores for each of Depression (The
Depression scale has subscales assessing dysphoria,
hopelessness, devaluation of life, self-deprecation,
lack of interest/involvement, anhedonia and inertia);
Anxiety (The Anxiety scale assesses autonomic
arousal, skeletal muscle effects, situational anxiety
and subjective experience of anxious affect), and
Stress (The Stress scale's subscales highlight levels
of non-chronic arousal through difficulty relaxing,
nervous arousal and being easily upset/agitated,
irritable/over-reactive and impatient) (Crawford and
Henry, 2003). Evaluation results will be determined
by the following classification:
DASS, the Depression Anxiety Stress Scales
(Lovibond and Lovibond, 1995a) is made up of
42 self-report items to be completed for five to
ten minutes, each reflecting a negative emotional
symptom (Lovibond and Lovibond, 1995b, p. 335-
343). Each of these is rated on a four-point Likert
scale of frequency or severity of the participants'
experiences over the last week with the intention of
Table 2. Self-Rating Scale of Depression, Anxiety, Stress (DASS 42)
Depression Anxiety
0-9 0-7
Meaning
Stress
0-14
Normal
Mild
10-13
14-20
21-27
+28
8-9
15-18
19-25
26-33
+34
Moderate
10-14
15-19
+20
Severe
Extremely severe
3. Results and Discussions
We use Statistical Package for the Social
Sciences (SPSS) statistic software to process the data
and verify some necessary values. The results are
shown in the following table:
3.1. The level of student’s anxiety disorder
according to SAS 20
Table 3. The level of students’ anxiety disorder according to SAS 20 result
Level of anxiety
disorder
Mild to
Moderate
Marked to
Severe
Normal Range
Extreme
Academic level
First-year
Field
No.
19
23
19
26
39
29
23
39
42
%
No.
%
No.
%
No.
%
Pre-school
14.69
18.11
14.69
20.47
30.70
22.83
18.11
30.70
16.53
2
0
1.57
0.00
1.57
0.87
9.44
3.94
8.66
3.15
0.79
0
0
0
0
0
0
0
0
0
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
0
0
0
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Primary school
Pre-school
Second-year
Third-year
2
Primary school
Pre-school
1
12
5
Primary school
Pre-school
Fourth-year
11
4
Primary school
First-year
2
88
Tạp chí Khoa học Đại học Đồng Tháp, Tập 10, Số 6, 2021, 85-91
Total by
school-year
Second-year
45
17.71
3
1.18
0
0.00
0
0.00
Third-year
68
62
26.77
24.40
1.18
17
15
0
6.69
5.90
0
0
0
0
0
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0.00
0.00
0.00
0.00
0.00
Fourth-year
Total by gender Male
Female
Total
3
0.00
214
217
84.25
85.43
37
37
14.57
14.57
(During the process of SAS 20 result evaluation, we see that 03 votes of second-year preschool students and 03
votes of primary education students are not valid, so they are excluded from the processing of result; therefore, the
remaining SAS 20 votes of 127 (pre- school) and 127 (primary school) are processed.
From the results in Table 3, we realize that:
In all students’ academic levels of Preschool
and Primary Education, there are always students
with anxiety disorders. Among them, the level of
anxiety disorder of third-year students is the highest
(6.69%), followed by the fourth-year (5.90%), while
the first-year is lowest: 0.79%.
The level of students’ anxiety disorder in
preschool and primary education - Dong Thap
University is rather high: 14.57%, mainly from Mild
to Moderate Anxiety Levels.
The level of anxiety disorder manifested in
female students is: 14.57% and 0.00% of male
students (due to the typical structure of pre-school
and primary education with the number of the female
students higher than that of the male).
3.2. The student’s levels of Depression,
Anxiety and Stress according to DASS-42
We carry out DASS-42 (Depression Anxiety and
Stress Scales) to measure the level of three factors:
1) Depression; 2) Anxiety and 3) Stress, which are
the factors affecting students’ anxiety disorder. The
results are shown in the following table:
The level of anxiety disorder of pre-school
students is higher than that of primary education
students: 10.62% > 3.94%.
Table 4. The student’s levels of Depression, Anxiety and Stress
Level
Normal
No.
78 60.00 21 16.15 18 13.85
96 73.85 16 12.31 12 9.23
Mild
Moderate
Severe
Extremely severe
Meaning
Field
%
No.
%
No.
%
No.
%
No.
5
%
Depression
Pre-school
Primary school
8
4
6.15
3.07
4.61
9.23
3.85
1.54
2.69
9.23
3.07
6.15
1.54
0.77
1.15
2
Total Depression
Anxiety
174 66.92 37 14.23 30 11.55 12
56 43.07 14 10.77 36 27.69 12
7
Pre-school
12
4
Primary school
75 57.69 21 16.15 15 11.54 15 11.54
131 50.38 35 13.46 51 19.62 27 10.38
Total Anxiety
Stress
16
2
Pre-school
81 62.31 27 20.77 12
91 70.00 19 14.62 12
172 66.15 46 17.69 24
9.23
9.23
9.23
8
7
6.15
5.38
5.77
Primary school
1
Total Stress
15
3
From the Table 4, we realize that:
The number of students suffering Anxiety is at a
high level (49.61%), including: 13.46% of Mild Level
(need to monitor regularly), 19.62% of Moderate
Level (need advice of psychotherapists), 10.38%
of Severe Level (need to be examined at mental/
psycho-clinical facilities for therapy), and 6.15% of
extremely severe level (need to be treated at mental/
psycho-clinical facilities).
The number of students suffering depression is
at a fairly high level (33.06%), including: 14.23% of
Mild Level (need to monitor regularly), 11.55% of
Moderate Level (need advice of psychotherapists),
4.61% of Severe Level (need to be examined at
mental/ psycho-clinical facilities for therapy), and
2.69% of extremely severe level (need to be treated
at mental/ psycho-clinical facilities).
The number of students suffering stress is at
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Chuyên san Khoa học Xã hội và Nhân văn
a fairly high level (33.84%), including: 17.69% of 1.15% of extremely severe level (need to be treated
Mild Level (need to monitor regularly), 9.23% of
Moderate Level (need advice of psychotherapists),
5.77% of Severe Level (need to be examined at
mental/ psycho-clinical facilities for therapy), and
at mental/ psycho-clinical facilities).
The results in Table 4 can be demonstrated in
the following chart:
Figure 1. The student’s levels of Depression, Anxiety and Stress
From the results in Figure1, it can be seen that 3 factors (Depression, Anxiety and Stress) with
Anxiety level is highest while Level of Depression
and Level of Stress seem lower and almost alike.
students’ anxiety disorder to see the effect of these
factors on student's anxiety disorder. The results are
shown in the following table:
We calculated the correlation level between
Table 5. Correlation among 3 factors (Depression, Anxiety, Stress) with students’
anxiety disorder
Depression
1≥0.993≥0
Correlations
Anxiety
Stress
Sig. (2-tailed) = 0.01
Sig. (2-tailed) = 0.05
Sig. (2-tailed) = 0.01
Pearson
Correlation
SAS 20
1≥0.958≥0
1≥0.999≥0
From the results in Table 5, we confirm
that there is a close correlation between levels
of Depression, Anxiety, Stress and the level
of students’ anxiety disorder (SAS 20). This
confirmation is proved by: r1 = 0.993 (α = 0.01);
r2 = 0.958 ((α = 0.05); r3 = 0.999 (α = 0.01).
Depression, Anxiety and Stress factors were
high to these students and some had Severe and
Extremely severe level at three those factors. The
students’ anxiety disorder had a close correlation with
Depression, Anxiety and Stress, in which Anxiety
strongly affected their anxiety disorder.
Acknowledgement: This research is supported
by science and technology project, Dong Thap
University. Code: SPD2020.01.15.
4. Conclusions
The result showed that the level of anxiety
disorder among the surveyed students was relatively
high. The level of anxiety disorder in female students
was higher than that of the males; the level of anxiety
of students in preschool education was higher than
those in primary education. All of them, from
first-year to fourth-year students, suffered anxiety
disorder, but the third-year students were at the
highest level.
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