Depression, Anxiety, and Stress in Doctor of Physical Therapy Students: Analysis of Incidence and Lived Experiences

Abstract

Introduction. This study was a mixed-methods, multisite design, which aimed to determine incidence and severity of depression, anxiety, and stress in Doctor of Physical Therapy (DPT) students and to explore the lived experience of students managing mental illness while completing their academic requirements. Methods. Surveys were emailed to DPT programs and forwarded to students. Students enrolled in 238 DPT programs across the United Sates were eligible for inclusion. A total of 1,238 students completed both surveys. Of those who completed the surveys, 20 volunteers were randomly selected for and completed telephone interviews. Doctor of Physical Therapy students (N = 1,228) completed 2 surveys, including the Depression, Anxiety, and Stress Scale (DASS); 20 of these students volunteered to interview. Students who volunteered were invited to participate based on the DASS results. A total of 20 semi-structured interviews were completed. Results. Doctor of Physical Therapy students were found to have higher DASS scores than their age-matched peers in Depression t(1,227) = 2.91, P = .029; Anxiety t(1,227) = 7.33, P ≤ .005; and Stress t(1,227) = 10.76, P ≤ .005. First-year students were found to have significantly higher levels of anxiety (P = .001) and stress (P = .019) as compared with third-year students. Four major themes emerged from the interview data. Theme 4-Fear of Failure Drives Perfection was familiar to the construct of social perfectionism (SP), which has been linked to maladaptive tendencies and mental health disorders, including suicidal ideation. Discussion/Conclusions. Doctor of Physical Therapy students have statistically higher DASS scores when compared with their age-matched peers. First-year students seem to be at higher risk for developing anxiety and stress. The construct of SP may influence the depression, anxiety, and stress described by DPT students. Doctor of Physical Therapy programs may want to consider methods to identify maladaptive perfectionism and strategies to enhance students’ ability to manage factors affecting their mental health based on the qualitative findings of this study.