Anxiety among high school boys in south Jeddah, Saudi Arabia

Saif Abadi Alzahrani         Ahmed H Alzahrani         Mazen Ayed Alghamdi

Al-Baha university ||  KSA.

Mohammed Alzahrani         Faisal Alharthi          Riyan Alzahrani           Ali Alzahrani

Taif university || KSA.

Abstract : Background: Anxiety is considered one of the most common psychological disorders. And its symptoms include nervousness, fear, panic, and apprehension.

Objective: To determine the general prevalence of anxiety symptoms among high school boys in south Jeddah.

Methods: A cross sectional study targeting high school students in south Jeddah using a translated reliable self-administered questionnaire.

Results: A total of (358) students have participated in the study. The participants were asked about their feelings in the last two weeks, and the responses were as follow; 41.2% have never felt anxious or irritable, while 7% had the feeling nearly every day. 57.7% have never been bothered by not being able to control their anxiety, and 5.2% could not control it. 47.6% had not worried too much while 9.2% worried every day. 54.9% had no trouble relaxing, and 7.6% of the students were not able to relax.

Conclusion: Our study addresses a relatively high prevalence of anxiety symptoms among high school boys in south Jeddah, ranging from 5.2% to 13.2% for some symptoms.

Key words: Anxiety, studying, high school, Jeddah.

Introduction

Anxiety is considered one of the most common psychological disorders. And its symptoms include nervousness, fear, panic, and apprehension [13]. Between its different types, the prevalence of anxiety internationally is considered high, it is estimated to be the most common psychiatric disorder in the 21st century and one third of the population is affected by one of its types [11].

Although, different studies have indicated a great variation between the prevalence in different countries [11].

In Saudi Arabia, many studies have been conducted in different genders, ages and social groups. The majority of the studies has indicated a high prevalence. In Abha, a study has found a percentage of 11.7% of Social anxiety disorder (SAD) among adolescents, and the author concluded the parental provocation as a major risk factor for adolescent SAD [11].  The prevalence was found high as well in the gifted girls in Jeddah [2].

Another example is the persisting dental anxiety despite all the safe methods used by dentists and the marked improvement in the dental medicine [8].

One study was conducted to find the relation of anxiety with depression and if the patients with anxiety are more susceptible to depression or not, however, the results have indicated that depression is a common condition among patients who are already diagnosed with anxiety [16]. Anxiety also can present with other comorbidities, as diabetes for example. In two studies in which they were done in Saudi Arabia, they concluded that symptoms of both depression and anxiety were common among diabetic and hypertensive patients [1,3].

Upon looking at a specific age group, the prevalence of the condition among undergraduate students was found to be as high as 14% in students of King Faisal university [6].

Problem statement:

All the previous studies have indicated a high prevalence of anxiety, with more focus on the younger age groups. High school students are an important age group to be investigated. Detecting the anxiety in this age group is crucial for an early management and a better outcome. Males in Saudi Arabia usually have more tasks and responsibilities. Thus, they might be more likely to have anxiety. A high school student is also considered a susceptible individual for anxiety as he will be thinking about his future and soon enough he will be taking decision determining his path and future after graduating, at the same time, he will be studying hard for a better placement in the university or whatever authority he might be applying for.

We in this study, are investigating the prevalence of anxiety symptoms, their severity, and the causes, focusing on the high school age group.

This study will use the validated and the highly reliable anxiety questionnaire [12] to investigate the condition among high school students in south Jeddah.

Methodology:

Setting:

The present study is a descriptive cross sectional study which uses different variables were addressed in the questionnaire to assess a problem “anxiety” in a chosen population “high school boys”. This study has been approved by research committee in Al-Taif university. And a permission was obtained from the schools before collecting the data. The data were collected during December 2017 in two high schools located in south Jeddah.

Before the data collection, the study purpose was explained and the students were given the choice to participate or not.

The sample:

We have randomly selected two high schools in south Jeddah, the two schools were invited and both accepted to participate in the study. The schools were private high schools for boys only. No females were included in this study.

All students in the participating schools were offered to participate in the study and no specific exclusion criteria was applied. Some questionnaires were excluded after the collection as they were incomplete or not filled properly. A total of (358) responses was entered and analyzed.

The questionnaire:

We translated and used the 7-item Anxiety Disorder Scale questionnaire which is considered validated and highly reliable questionnaire and has been tested and validated by “Paul Waraich, Paul Waraich, et al” in the study “Prevalence and Incidence Studies of Mood Disorders: A Systematic Review of the Literature” [18]. The questionnaire included 7 different questions addressing the participants’ feelings in the last 2 weeks. Other factors were added to the original questionnaire by the authors of the present research, including nationality, the school grading, effect of anxiety on the studying, and factors causing anxiety from the student’s point of view.

Data analysis

1. A computer program (SPSS, version 21.0) was used to analyze the collected results.
2. Some graphs were made with (Excel, version 15.29).
3. Tables are showing the distribution of age, responses to the degree of anxiety, and in correlation with the student grade.

Results:

The total of analyzed responses was (358), all were males from which 50.7% were non-Saudis, the high percentage of non-Saudis students are probably because the participated schools are private schools. The age range is (15-20), the distribution of the age is showed in the graph [Table 1].

Table number(1). distribution of age.

The participants were asked about their feelings in the last two weeks, and the participants’ responses were as follow, 41.2% have never felt anxious or irritable, while 7% had the feeling nearly every day. 57.7% have never been bothered by not being able to control their anxiety, and 5.2% could not control it. 47.6% had not worried too much while 9.2% worry every day. 54.9% had no trouble relaxing, and 7.6% of the students were not able to relax. 49.9% of the participants were not easily annoyed while 12.9% were easily annoyed and irritable, and 13.2% feel anxious and afraid, as if something awful might happen.

However, in between the previous mentioned results there was a variation in the students’ responses, we only mentioned the extremes of the responses, the variations in details are shown below [Table 2].

Upon asking about the possible causes of the anxiety that they might have, 42.9% of the students have chosen study burden as a factor, the other common chosen factor was future planning 39.5%, and the rest were as follows; 26.1% financial problems, 14.6% social problems, 13.7%, and 13,4%, were family issues, and health problems respectively.

Table number (2).The variation of responses.

	never	Several days	Over half or the days	Nearly every day
Feeling nervous or anxious	41.2%	40.6%	11.2%	7.0%
Not being able to control worrying	57.7%	28.3%	8.7%	5.3%
Worrying too much for different things	47.6%	31.9%	10.9%	9.2%
Trouble relaxing	54.9%	26.9%	10.6%	7.6%
Being restless and cannot set still	78.7%	13.4%	4.8%	3.1%
Easily annoyed or irritable	49.9%	28.0%	9.0%	12.9%
Afraid as if something awful might happen	40.9%	35.0%	11.2%	13.2%

One interesting finding in our research is that 56.9% of our participants have stopped studying just because they were anxious, and 7.8% stop studying nearly every day, while 43.1% have indicated that they have never stopped studying just because they are anxious.

Of the (153) students who have chosen study burden as a factor causing anxiety, (97) of them have stopped studying just for feeling anxious or irritable. The question that arises here is: would the study burden and the fear of the school materials would prevent some students from studying and getting good grades??

However, upon further analysis, the majority of the students who had the idea of a study burden as a factor or have stopped studying because of the anxiety have reported good grades (Good, very good, and excellent), [Table 3].

Table number(3). Correlation of stopping studying with the general grade

Grade	Have you stopped studying just because you are feeling anxious?
	Never	Several days	Over half the days	Nearly every day
Excellent	20.2%	9.5%	1.4%	2.2%
Very good	15.1%	17.4%	3.1%	2.8%
Good	7.0%	12.3%	3.6%	2.5%
Pass	0.6%	0.8%	0.8%	0.3%

.

Discussion:

In general, this study has indicated a low rate of anxiety among high school boys, where only 7.0% of our sample have reported feeling anxious daily basis. Where the literature indicates a high prevalence of anxiety in this age group specifically [10,4,5]. In Jizan city, Saudi Arabia, a study has found a prevalence as high as 59% of anxiety among secondary school students [9].

As our study was done on two private high schools, the low rate might be due to the difference between governmental and private schools as the difference was concluded as a major finding in a previous study was done to determine the prevalence in both genders and different kinds of schools [15]. The same study has not found any significant difference between males and females in the prevalence of anxiety, as it was indicated in other studies [15,17,14]. While another study in the literature has found a difference in the prevalence between males and females [10]. We would not be able to generalize the results of this study to both genders as there is data proving that there might be a difference between the two genders.

Limitations of the study:

Although by far and as we know, this is the first study concerning anxiety in high school boys in Jeddah, the design of a cross sectional study would not address the changes of the condition through the time. Also, our data are based on self-reported emotions and feeling, and we will never be able to test the reliability of the reported data from the student, so, we would recommend an interview based studies. However, what have been mentioned don’t make this paper of a less value as a cross sectional study.

Our sample and our sample size unfortunately does not help us to generalize the results on Jeddah city. A bigger and wider study should be conducted in this age group.

Conclusion

Our study addresses a relatively high prevalence of anxiety symptoms among high school boys in south Jeddah, ranging from 5.2% to 13.2% in some of the symptoms.

Even though students have reported the study burden as a factor and have indicated that anxiety have stopped them from studying, they are still having good grades in the school (Good, very good, and excellent).

Acknowledgment:

The research team would like to thank the high schools (Al-Shati and Al-Taleeah high schools) who allowed their student to participate in our study and for facilitating the data collection.

References:

• Abdullah D. AlKhathami, Mohamed A. Alamin, Areej M. Alqahtani, Wafaa Y. Alsaeed, Mohammed A. AlKhathami, Abdulazeez H. Al-Dhafeeri. “Depression and Anxiety among Hypertensive and Diabetic Primary Health Care Patients: Could Patients’ Perception of Their Diseases Control Be Used as a Screening Tool?” Saudi Medical Journal 38.6 (2017): 621–628. PMC. Web. 18 Nov. 2017.
• Abdulrahman Alduraywish, Diaa Abdel Fattah, Ahmed Abd-Eltawab, Mohammed Al-Ruwili, Arif Alhassan, Nafe Alnafe, Fayez Alruwailly. Depression and Anxiety and Their Correlates in Patients with Diabetes Mellitus in Al-Jouf Region, Saudi Arabia. Clinical Medicine and Diagnostics, 2017; 7(2): 48-56.
• Al-Gelban S, Khalid. (2007). Depression, anxiety and stress among Saudi adolescent school boys. The journal of the Royal Society for the Promotion of Health. 127. 33-7. 10.1177/1466424007070492.
• AlJohani, Mohammad & AlQahtani, Awad. (2016). Prevalence and risk factors of anxiety among Saudi male secondary schools’ students in Madinah, Saudi Arabia. International Journal of Medical Science and Public Health. 5. 1. 10.5455/ijmsph.2016.10022016362.
• Aljughaiman, Abdullah & Tan, Mei. (2009). Anxiety in Gifted Female Students in the Kingdom of Saudi Arabia. Gifted and Talented International. Gifted and Talented International – 23(2), December, 2008; and 24(1), August, 2009.
• Amr, Mostafa & Amin, Tarek & Sahoo, Saddichha & Malki, Sami & Al Samail, Mohammed & al qahtani, Nasser & AlAbdulHadi, Abdulhadi & Al Shoaibi, Abdullah. (2013). Depression and anxiety among Saudi University students: prevalence and correlates. The Arab Journal of Psychiatry (2013) Vol. 24 No. 1 Page (1 – 7) (doi: 10.12816/0000092)Bandelow B, Michaelis S. Epidemiology of anxiety disorders in the 21st century. Dialogues in Clinical Neuroscience. 2015;17(3):327-335.
• Gaffar, Balgis & Alagl, Adel & Al-Ansari, Asim. The prevalence, causes, and relativity of dental anxiety in adult patients to irregular dental visits. Saudi medical journal. 35. 598-603. 2014.
• Ghazwani JY, Khalil SN, Ahmed RA. Social anxiety disorder in Saudi adolescent boys: Prevalence, subtypes, and parenting style as a risk factor. Journal of Family & Community Medicine. 2016;23(1):25-31. doi:10.4103/2230-8229.172226.
• Hakamy Mohamad, Ibrahim Bahri and Eisa Ghazwani. DEPRESSION, ANXIETY AND STRESs IN JIZAN CITY, KINGDOM OF SAUDI ARABIA. International Journal of Current Research Vol. 9, Issue, 10, pp.59290-59297, October, 2017.
• Kumar, K. S., & Akoijam, B. S. (2017). Depression, Anxiety and Stress Among Higher Secondary School Students of Imphal, Manipur. Indian Journal of Community Medicine : Official Publication of Indian Association of Preventive & Social Medicine, 42(2), 94–96.
• Löwe, Bernd & Decker, Oliver & Müller, Stefanie & Brähler, Elmar & Schellberg, Dieter & Herzog, Wolfgang & Herzberg, Philipp. Validation and Standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the General Population. Medical Care. 2008. 46. 266-274. 10.1097/MLR.0b013e318160d093.
• M Bassiony, Medhat. (2005). Social anxiety disorder and depression in Saudi Arabia. Depression and anxiety. 21. 90-4. 10.1002/da.2005.
• Martin P. The epidemiology of anxiety disorders: a review. Dialogues in Clinical Neuroscience. 2003;5(3):281-298.
• Olatoye R. A. Students’ test anxiety, motivation for examinations and science achievement in junior secondary schools in Ogun State, Nigeria. International Journal of Psychology and Counselling Vol. 1(10), pp194-198, December, 2009.
• Paul Waraich, MHSc, MD, Elliot M Goldner, MHSc, MD, Julian M Somers, MSc, PhD, Lorena Hsu, MSc. Prevalence and Incidence Studies of Mood Disorders: A Systematic Review of the Literature. Can J Psychiatry, Vol 49, No 2, February 2004.
• Saket Bihari, Academic Anxiety among Secondary School Students with reference to Gender, Habitat and Types of School. International Journal of Education and Psychological Research (IJEPR) Volume 3, Issue 4, December 2014.
• Somers JM1, Goldner EM, Waraich P, Hsu L. Prevalence and incidence studies of anxiety disorders: a systematic review of the literature. Can J Psychiatry, Vol 49, No 2, February 2004.
• Sukhdev Singh Sandhu. ANXIETY AMONG SENIOR SECONDARY SCHOOL STUDENTS IN RELATION TO GENDER. E-ISSN No : 2454-9916 | Volume : 2 | Issue : 8 | August 2016.

 

القلق لدى طلاب المدارس الثانوية في جنوب جدة بالمملكة العربية السعودية

الملخص: خلفية: يعتبر القلق أحد أشهر الاضطرابات النفسية، وأعراضه تشمل العصبية والخوف والذعر.

أهداف البحث: يهدف هذا البحث إلى دراسة مدى انتشار أعراض القلق بين طلاب الثانوي في جنوب جدة.

منهج البحث: دراسة مستعرضة تستهدف طلاب الثانوي في جنوب جدة، عن طريق تحليل استبيان معتمد ومترجم إلى العربية يعبئه الطالب بنفسه.

نتائج البحث: مجموع (358) طالباً قد شاركوا في الدراسة عن طريق تعبئة الاستبيان، وقد سئل المشاركون عن شعورهم في الأسبوعين السابقين لتعبئة الاستبيان، وكانت الإجابات كالآتي: 41.2% لم يشعروا أبداً بالقلق، و7٪ يشعرون بالقلق تقريباً كل يوم، 57.7% لم يسبق لهم أن تضجروا من عدم مقدرتهم على التحكم في قلقهم، بينما 5.2٪ لم يستطيعوا التحكم بقلقهم، 47.6% لم يكونوا قلقين في الأسبوعين الفائتين، بينما 9.2% كانوا قلقين بشكل يومي، 54.9% لم يواجهوا مشاكل خلال الاسترخاء، بينما 7.6% لم يستطيعوا الاسترخاء.

استنتاج البحث: استنتجت هذه الدراسة أن معدل أعراض القلق عالي نسبياً بين طلاب الثانوي في جنوب جدة، حيث تتراوح بعض الأعراض ما بين 5.2% إلى 13.2%.

الكلمات المفتاحية: القلق، الدراسة، الثانوي، جدة.

 

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