The Incidence of Anxiety and Depression in Physical Therapy Students. II. Hypothesis, Research Question and Literature Review

The Incidence of Anxiety and Depression in Physical Therapy Students. II. Hypothesis, Research Question and Literature Review

Much of the distress experienced by these students is the result of trying to coordinate the demands of rigorous academic study while also trying to get enough sleep and, at the same time maintain interpersonal relationships.   Most studies looking at the subject of medical school students anxiety, depression and stress have revealed that medical students do suffer from significant stress, anxiety and depression, more so than the general population (Hendrie, et al., 1989; Lloyd et al., 1984; Notman, et al., 1984; Parkerson, et al., 1990; Russo, et al., 1985; Shapiro, et al., 1998; Vitaliano, et al., 1988; Vitaliano, et al., 1989).

In a study of medical student distress by Vitaliano et al. (1989), measures were taken during September orientation as a baseline and repeated two weeks before May final exams. The group consisted of 196 men and 123 women who were entering the University of Washington Medical School.  Distress was defined in terms of anxiety, depression, and daily stress as measured by the Symptom Checklist Anxiety Scale (Derogatis, 1977) and the Beck Depression Inventory (BDI, Beck & Beck, 1972).

It was found that depression increased in both men and women from September to May. By late in the semester of the first year, mean scores had more than doubled.  For the majority of students in the study, no major life events occurred in September or May. However, many students reported financial debt and/or change in residence to a different city in September or May. Distress was unrelated to gender in September, but by May, women reported more distress than men did. Distress in May was positively related to type A (anger suppressed) personalities. It was also found that students who were distressed in May were more likely to be distressed in September. Vitaliano’s (1989) results also suggested that students who were distressed at the entrance to medical school were even more distressed at the end of their first year. Vitaliano’s (1989) findings were consistent with other research (Russo, Miller & Vitaliano, 1985) in which female medical students reported more distress than male students. Certain studies suggest that this gender difference reinforces research indicating the special difficulties females have in a traditionally male-oriented medical environment (Miao, 1977).


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Clare LewisClare Lewis graduated from the Professional School of Psychology in 2003 with her doctorate in clinical psychology and in 2005 with her doctorate in organizational psychology. She has been licensed as a clinical psychologist since 2012.  In addition to her psychology degrees, Clare is a licensed physical therapist with an advanced masters in orthopedic manual therapy and an transitional doctorate in physical therapy.  Clare is a certified manual therapist from the Stanley Paris Institute and a fellow of the American Association of Orthopedic and Manual Physical Therapists.  Clare has been a professor in the department of physical therapy at CSU Sacramento since 1996.  She has taught the psychology class and orthopedic class for majors for many years. She practices physical therapy at Remedy Rehab in Sacramento, CA doing orthopedic out-patient manual therapy and volunteers at the suicide hotline for Sacramento County.

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