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

Richman and Flaherty (1985) investigated the question of whether personality and social support resources were independent or highly correlated.  In addition they investigated what the relative contributions of social support resources were in protecting against depressive symptoms in beginning medical students.  Medical school marks the beginning of new life stressors. Included is the experience of potential losses connected with the transition from previous educational and occupational roles to the role of medical student.  Some students may experience some degree of initial uncertainty regarding one’s capacity to perform effectively in a new and demanding setting. As a result, depression has been a common finding in medical students (Lloyd & Gartrell, 1984).

One-hundred-fifty-three first year students (70% male) from the University of Illinois College of Medicine were sampled during their first week of classes.  Instruments assessing social supports, personality characteristics (internal-external locus of control, interpersonal dependency), and depressive symptomatology were included in the questionnaire.  Social supports were measured by the Social Support Network Inventory (SSNI, Flaherty et al., 1983).  Locus of control was measured by the Rottor 23-item internal-external scale (Rottor, 1966).  Depression was measured by the Center for Epidemiologic Studies Depression scale (CES-D, Weissman et al., 1977).  It was hypothesized that because social supports and personality resources have generally been shown to buffer the effects of stress, that social supports would be inversely related to depressed symptoms.  The other assumption was that a lack of adequate internal resources would be linked with difficulties mastering the stresses related to new role demands, and therefore lead to depression.  The third hypothesis was that external locus of control and interpersonal dependency would each manifest a direct relationship to depressive symptoms.

The results showed that although personality was significantly correlated with depressive symptoms, social supports played a weaker role in protecting against depressive symptoms than was hypothesized.  The authors suggest that perhaps this is due to the fact that beginning medical students have not yet had time to develop support among fellow students and may not be receiving the degree of empathy they desire from current members of their social network, who are likely to be less familiar with the medical school environment.  Those students best protected from depressive symptoms appeared to be those students with strong internal resources, meaning the belief in one’s capacity to shape the environment (as opposed to being controlled by it) and the capacity to function relatively autonomously (as opposed to being highly dependent on others for reassurance and esteem). The authors speculate that at a later point in medical school, when support from fellow students becomes more available, external resources may play a more significant role and perhaps compensate for a lack of strong internal resources.

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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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