Psychological

Communication

Biosci. Biotech. Res. Comm. 10(2): 76-81 (2017)

Psychological problems among the Palestinian

University students on the West Bank

Filasteen Ismail Nazzal*, Orlanda Maria da Silva Rodrigues da Cruz and

Félix Fernando Monteiro Neto

Faculdade de Psicologia e de Ciencias da Educacao da Universidade do Porto, Porto, Portugal

ABSTRACT

The aim of this study was to investigate the prevalence of psychological problems among Palestinian university

students on the West Bank. The sample consisted of 254 volunteer undergraduate students (50.4% males and 49.6%

females). Data was collected using Psychological Problems Scale, Multidimensional Scale of Perceived Social Sup-

port (MSPSS), and a Demographic Information Form. The study showed that anxiety score (M = 2.83; SD = .92) was

signi cantly higher than depression (M = 2.55; SD = .95), and psychosomatic symptoms (M = 2.57; SD =.87) scores.

Anxiety and psychosomatic symptoms were signi cantly higher among female students than males. Furthermore,

anxiety and depression were negatively correlated with perceived social support from friends, family and signi cant

others.

KEY WORDS: ANXIETY, DEPRESSION, PSYCHOSOMATIC SYMPTOMS, SOCIAL SUPPORT, UNIVERSITY STUDENTS, PALESTINE

ARTICLE INFORMATION:

*Corresponding Author: Pal22_22@yahoo.com

Received 23

April, 2017

Accepted after revision 27

June, 2017

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Online ISSN: 2321-4007 CODEN: USA BBRCBA

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Online Contents Available at: http//www.bbrc.in/

INTRODUCTION

Palestine is one of the Middle East countries which have

been exposed to military violence and human rights

abuse since 1948 (Punamäki, et al., 2005). This study

focuses on the psychological problems among Palestin-

ian university students on the West Bank as a result of

traumatic life events. Several studies indicate high prev-

alence of mental health problems among university and

college students and it is increasing concern worldwide.

While in university young adults have to face and adapt

to a new and challenging social networks which may

contribute to turn they more vulnerable for developing

mental health problems Also the traumatic life events

Filasteen Ismail Nazzal et al.

resulting from the Israeli occupation, such as killing,

demolition of homes, bombing and destruction, lead to

depression, anxiety, post-traumatic stress disorder and

other mental disorders among Palestinian people (Assaf,

2002, Zivin, et al., 2009 and Saleem et al., 2013).

Per-

ceived social support is an important factor for reduc-

ing psychological problems. Several studies have found

an association between low levels of social support and

poor mental health (Duru, 2007; Oni, 2010). For exam-

ple, lack of social support is one of the independent risk

factor for depression, meaning that the students who

had low social support had higher depression. However,

social support has buffering effects on depression among

university students (Laurence, Williams, & Eiland, 2009;

Oni, 2010 and Chia & Graves, 2016).

In relation to gender, some studies suggest that

female students score higher than male students in

depression and anxiety (Bayram & Bilgel, 2008; Dyr-

bye, 2006; Raypa, 2012; Rosenthal, 2000). However

other scholars found no gender differences on depres-

sion among university students (Alansari, 2006; Dorahy,

2000; Hamdan-Mansou et al., 2009). Some studies found

that the educational strategies that used by the cultural

and sometimes parenting styles may be related to anxi-

ety, depression and other mental health problems as well

(Abadsa & Thabet, 2012).

Several studies suggest high rates depression and

anxiety, among university students all over the world

and especially in Turkey (Bayram, 2008; Chia & Graves,

2016; Daniel, 2013; Jenkins, 2013; Ovuga, Boardman, &

Wasserman, 2006; Wong et al., 2006), 8% of university

students had depressive feelings in Jordan (Hamdan-

Mansour & Marmash, 2007), 75% of the university stu-

dents had some degree of depressive symptoms in Jor-

dan (Hamdan-Mansour et al., 2009). 27.5% of students

had depressive symptoms and anxiety in Hong Kong

(Wong et al., 2006). 15.6% undergraduate’s students had

depressive or anxiety disorder in U.S.A (Eisenberg, Gol-

lust, Golberstein, & Hefner, 2007), third of the students

had mental health problems in U S A (Zivin et al., 2009),

in Malaysia 34.4% of university students showed men-

tal health problems (Nordin, Abu Talib, & Yaacob, 2009

Chia & Graves, 2016) .

Even though there is high prevalence of psychologi-

cal problems among university students, there are a few

studies about the prevalence of psychological problems

in Palestine, however Abadsa and Thabet (2012) found

higher prevalence of depression, anxiety and PTSD adult

population in Gaza in Palestine. The aim of the current

study was to investigate the prevalence of psychologi-

cal problems among Palestinian university students on

the West Bank according to gender, age, faculty, univer-

sity, parental education level, monthly family income

and place of residence. Based on the literature reviewed

above, we advance one research question (RQ1) and

three hypotheses.

RQ1: Are there signi cant differences in the degree

of psychological problems according to gender,

age, faculty, university, family income, parents’

level of education, and place of residence?

Hypothesis 1: There will be a signi cant negative

correlation between anxiety and perceived social

support from friends, family and signi cant others.

Hypothesis 2: There will be a signi cant nega-

tive correlation between depression and perceived

social support from friends, family, and signi cant

others.

Hypothesis 3: There will be a signi cant negative

correlation between psychosomatics symptoms

and perceived social support from friends, family,

and signi cant others.

MATERIAL AND METHODS

Data from 254 (126 females and 128 males) undergradu-

ate students from two universities on the West Bank in

Palestine were used in this study. The age of the partici-

pants ranged from 18 to 26 years, 41.3% of participants

were 18 to 21 years and 58.7% were 22 to 26 years of

age. Eighty seven percent were attending the An–Najah

National University and 19.3% were attending the Arab

American University, 27 % were attending a course in

sciences and 73% in humanities. Regarding parental

education, 20.1% of the parents did not  nish secondary

school, 37.4% hold secondary school, and 42.5% hold

a bachelor degree or higher. Regarding monthly family

income, about 37% of the participants’ families had a

monthly income ranging between 500-1000 USD. Fur-

thermore, 52.4% of the participants were living in vil-

lages, about 42.5% in cities, and 5.1% in refugee camps.

More than 89.8% of the participants’ families had their

own houses (See Table 1).

Three self-report instruments were used to collect

data: Psychological Problems Scale (Berry et al., 2006;

Neto, 2009), Multidimensional Scale of Perceived Social

Support (MSPSS; Zimet, Dahlem, Zimet, S & Farley,

1988), and Demographic Information Form.

Psychological problems scale. This scale consists of 15

items and was designed to measure depression, anxiety and

psychosomatic symptoms (Berry et al., 2006; Neto, 2009).

Participants responded on a 5-point Likert-type scale rang-

ing from 1 (strongly disagree) to 5 (strongly agree).

Multidimensional Scale of Perceived Social Support

(MSPSS). The MSPSS was developed by Zimet, et al.

(1988). It is a 12-item scale that measures perceived

support from three domains: family (FA), friends (FR),

and a signi cant others (SO). Participants completed the

BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS PSYCHOLOGICAL PROBLEMS AMONG THE PALESTINIAN UNIVERSITY STUDENTS ON THE WEST BANK 77

Filasteen Ismail Nazzal et al.

MSPSS items on a 7-point Likert-type scale, ranging

from 1 (strongly disagree) to 7 (strongly agree). We used

the Arabic version of MSPSS adapted by Abou-hashem

(2010) in Egypt. A Chronbach alpha .89 was found for

the total scale, .83 for friends support, .78 for family

support, and .81 for signi cant others support.

Demographic Information Form. This form was used

to obtain detailed information on basic demographics

such as age, gender, family income, parents’ level of

education, housing conditions, university, faculty, and

place of residence.

Informed consent was obtained from all partici-

pants before completing the measures. Participants

were assured of the con dentiality of their responses.

The questionnaires were presented in Arabic to all par-

ticipants. This was considered an adequate procedure as

all participants were  uent in Arabic. It took approxi-

mately 15 minutes to complete the full set of question-

naires. Data were analyzed using descriptive statistics,

independent sample t-test and one-way ANOVA to test

differences among groups de ned by sociodemographic

variables, and bivariate correlation analysis to examine

the association between anxiety, depression and psycho-

somatic symptoms, and perceived social support.

RESULTS AND DISCUSSION

We performed a principal component analysis to explore

the structure of the psychological problems scale. Three

eigenvalues were greater than one, and scree test also

suggested the extraction of three factors. Table 2 shows

the varimax-rotated, exploratory factor analysis. The

 rst factor contains  ve items expressing Anxiety; alpha

coef cient is .76. The second factor includes also  ve

items expressing Depression; alpha coef cient is .81. The

third factor is composed by four items expressing psy-

chosomatic symptoms. Since item 15 loaded >. 40 on the

 rst factor and on the third factor, it was exclude from

further analysis alpha is .68.

Means and standard deviations for the major study

variables are presented in Table 3. Results show that

there was a statistically signi cant difference in anxiety

according to gender, t (252) = -2.84, p < 0.01, female stu-

dents showed higher anxiety than male. Psychosomatic

symptoms was also higher in female than male students,

t (252) = -3.75, p < 0.01. There was no statistically sig-

ni cant gender differences in depression, t (252) =-1.01,

p > 0.05, and in perceived social support from friends,

t (252) = -1.28, p > 0.05. Females presented higher per-

ceived social support from family, t (252) =-2.54, p <

0.05, and from signi cant others, t (252) =-3.96 p < 0.01

than males.

Concerning age, there was no signi cant differences

between 18 to 21 and 22 to 26 age groups in anxiety, t

(252) = 1.14, p > 0.05, psychosomatic symptoms, t (252)

= .64, p > 0.05 and depression, t (252) = -.60, p > 0.05.

There was no signi cant differences between students

university af liation in anxiety, t (252) = -1.23, p > 0.05,

psychosomatic symptoms, t (252) = -1.0, p > 0.05 and

Table 1. Socio-Demographic Characteristics of the Study.

Demographic variables Frequency Percentage

Gender Males 128 50.4

Females 126 49.6

Age 18-21 105 41.3

22-26 149 58.7

Parental Educational levels Less than secondary 51 20.1

Secondary 95 37.4

Bachelor and more 108 42.5

Monthly Family Income 500$ and less 77 30.3

500-1000$ 94 37.0

More than 1000$ 79 31.5

Place of Residence Village 133 52.4

City 108 42.5

Refugee camp 13 5.1

University An-Najah 205 80.7

Arab American 49 19.3

Faculty Sciences 68 26.8

Humanities 185 72.8

78 PSYCHOLOGICAL PROBLEMS AMONG THE PALESTINIAN UNIVERSITY STUDENTS ON THE WEST BANK BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS

Filasteen Ismail Nazzal et al.

BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS PSYCHOLOGICAL PROBLEMS AMONG THE PALESTINIAN UNIVERSITY STUDENTS ON THE WEST BANK 79

depression, t (252) = .07, p > 0.05. However there were

signi cant differences according to parental education

level in anxiety, F (2,251) = 4.38, p < 0.05, psychoso-

matic symptoms, F (2,251) = 3.52, p < 0.05, and depres-

sion, F (2,251) = 4.78, p < 0.01.

To test the hypotheses 1, 2 and 3 correlation analy-

ses were conducted (See Table 4). The  ndings indicate

that there were signi cant correlations among anxiety,

depression, perceived social support from friend, fam-

ily and signi cant others (p < 0.05). More speci cally

there was a strong positive correlation between anxiety

and depression (r = 61), a moderate positive correlation

between anxiety and psychosomatic symptoms (r = .49),

and moderate negative correlations between depression

and support from friends (r = -.32), family (r = -.33), and

signi cant others (r = -.36). There were modest negative

correlations between anxiety and support from friends (r

=-.17), family (r =-.16), and signi cant others (r =-.15).

The current study was designed to investigate the

prevalence of psychological problems among Palestinian

university students on the West Bank. The study showed

that the mean scores for anxiety was 2.83, for depres-

sion was 2.55 and for psychosomatic symptoms was

2.57. It can be observed that these values are below the

midpoint of the scale (< 3).Anxiety and psychosomatic

symptoms were statistically higher in females than in

males. This result is supported by some previous stud-

ies in Gaza (Abadsa & Thabet, 2012), Turkey (Bayram

Table 2 Varimax Rotated Three Factors Solution of the Psychological Problems Scores

Items Factor 1 Factor 2 Factor 3

Anxiety Depression Psychosomatic symptoms

.63

2. .64

3. .68

4. .61

5. .66

6. .57

7. .79

8. .60

9. .75

10. .69

11. .56

12. .77

13. .77

14. .56

15. .45

Eigenvalue 5.43 1.78 1.03

Explained Variance 36.20 11.71 6.69

Table 3. Descriptive Statistics of the Major Study Variables, and Independent Sample t-Test Performance

Scores of Students with Gender.

Total n=254

M(SD)

Min-Max Male n=128

M(SD)

Female n=126

M(SD)

t Sig

Anxiety 2.83(.92) 1-5 2.67(.82) 2.99(.98) -2.84 .01

Depression 2.55(.95) 1-5 2.49(.84) 2.61(1.05) -1.01 .31

Psychosomatic

symptoms

2.57(.87) 1-5 2.37(.74) 2.77(.94) -3.75 .00

Friends support 20.4(4.70) 4-28 20.1(4.9) 20.8(4.5) -1.28 .20

Family support 21.6(4.72) 4-28 20.9(4.7) 22.3(4.7) -2.54 .01

Signi cant others

support

21.9(4.80) 4-28 20.8(5.0) 23.1(4.3) -3.96 .00

Perceived social support 64.0(11.9) 16-84 61.7(12.3) 66.3(11.0) -3.11 .00

Filasteen Ismail Nazzal et al.

80 PSYCHOLOGICAL PROBLEMS AMONG THE PALESTINIAN UNIVERSITY STUDENTS ON THE WEST BANK BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS

& Bilgel, 2008), U S A and Canada (Dyrbye, Thomas, &

Shanafelt, 2006), U.S.A (Jenkins et al., 2013; Rosenthal

& Schreiner, 2000; Ryba & Hopko, 2012).

In Palestine, being an Arabic country, females get

used to stay close with their mothers almost all the time

since childhood. As a result, they are given less respon-

sibility and freedom than males. Females reported higher

dependence on their families than males. University life

challenges females’ sense of independence more than

males and, as a result, they report high levels of anxi-

ety and psychosomatic symptom. This result suggests that

universities need to consider speci c issues and strategies

to improve female students’ well-being (Alansari, 2006).

On the other hand no signi cant gender differences

were found on depression among university students.

This result is supported by some previous studies in

Lebanon, Tunisia, Palestine, U.A. Emirates, Yemen, Jor-

dan, and Sudan (Alansari, 2006), Palestine (Assaf, 2002),

Turkey (Bayram & Bilgel, 2008), Australian, Ghanaian,

Nigerian, Northern Irish, and Swaziland (Dorahy, 2000),

and in Jordan (Hamdan-Mansou et al., 2009). However

Abadsa and Thabet (2012) found that depression were

statistically higher in females than in males in Gaza.

As hypothesized, the results showed that between

anxiety and depression was negatively and signi cantly

related to perceived social support from friends, fam-

ily and signi cant others. This means that when per-

ceived social support increases, anxiety and depression

decreases. When people perceive a good support from

their social network they will experience less psycho-

logical problems than others with low perceived social

support from their social network. it is happened also

with the university students who reported lower levels

of supportive from their social network also reported

higher levels of anxiety and depression, that anxiety and

depression are related (Serin, Serin & Özba

¸, 2010; Zhou,

2013). Perceived social support, depression, and anxiety

among university students are highly interrelated and

it may contribute of improving their psychological and

social life (Guney, Kalafat & Boysan, 2010).

Thus, the rise in perceived social support from

friends, family, and signi cant others will lead to low

level of anxiety and depression and other psychologi-

cal problems, improving psychological wellbeing among

students. Psychological counseling centers at universi-

ties have a lot of responsibilities and activities in help-

ing students who need psychological counseling. Local

institutions and associations will also help in cooper-

ation with the universities in their common activities

(Alansari, 2006; Laurence, et al., 2009; Zhou, 2013).

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