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ORIGINAL ARTICLE
Year : 2019  |  Volume : 17  |  Issue : 1  |  Page : 31-35

Association of personality traits with anxiety and depression among clinical and nonclinical dental students


1 Swami Devi Dyal Hospital and Dental College, Panchkula, Haryana, India
2 Department of Public Health Dentistry, Surendera Dental College and Research Institute, Sri Ganganagar, Rajasthan, India
3 Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
4 Department of Public Health Dentistry, Guru Nanak Institute of Dental Sciences, Kolkata, West Bengal, India

Date of Submission12-Jan-2018
Date of Acceptance13-Feb-2019
Date of Web Publication15-Mar-2019

Correspondence Address:
Dr. Aditi Sharma
Department of Public Health Dentistry, Surendera Dental College and Research Institute, Sri Ganganagar, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiaphd.jiaphd_20_18

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  Abstract 

Background: There are studies about anxiety and depression among medical students well narrated in literature. However, limited studies have been reported among dental students. Aim: This study aimed to evaluate the association between anxiety and depression with personality traits, type of education exposure, and their effect on coping strategies among dental students. Materials and Methods: A cross-sectional, questionnaire-based study was carried out among undergraduate dental students. Questions were related to the consumption of alcohol, smoking, chewing gums, and chocolates. Validated questionnaires such as the Hospital and Anxiety Scale and Eysenck Personality Questionnaire-A Scale were used for evaluating anxiety and depression and personality traits, respectively. The statistical analysis was done using Statistical Package for the Social Sciences (version 20.0). Chi-square test, Student's t-test, and Pearson's correlation coefficient were used for analysis, and the level of significance was set at P < 0.05. Results: The results showed that males in nonclinical years (3.81 ± 1.18) and females in clinical years (4 ± 0.85) were more extrovert than their counterparts, whereas males and females in clinical years were more psychotic than males (3.26 ± 0.45) and females (3.03 ± 0.84) in nonclinical years. It was found that females in clinical years were more anxious and depressed than their counterparts. When extraversion was correlated with anxiety and depression, a negative correlation (-0.05,-0.63) was seen which was statistically significant for depression (P = 0.01), whereas a positive correlation was seen when psychoticism was correlated with anxiety (0.16, P = 0.61) and depression (0.5, P = 0.02). Among the total participants, a majority consumed chocolates as a coping strategy. Conclusion: It was observed that many dental students who were in their clinical years had more anxiety and depression as compared to their nonclinical peers which could be due to their personality traits. Interventions should be targeted to deal with these problems.

Keywords: Anxiety, dental, depression, personality, students


How to cite this article:
Sharma A, Singh S, Mathur A, Batra M, Aggarwal VP, Kaur P, Gijwani D. Association of personality traits with anxiety and depression among clinical and nonclinical dental students. J Indian Assoc Public Health Dent 2019;17:31-5

How to cite this URL:
Sharma A, Singh S, Mathur A, Batra M, Aggarwal VP, Kaur P, Gijwani D. Association of personality traits with anxiety and depression among clinical and nonclinical dental students. J Indian Assoc Public Health Dent [serial online] 2019 [cited 2019 Nov 21];17:31-5. Available from: http://www.jiaphd.org/text.asp?2019/17/1/31/254326


  Introduction Top


The goal of medical and dental education is to train knowledgeable, skillful, and professional doctors so that they can take care of the nation's sick, humanize the science of medicine, and promote public health. Medical and dental schools undertake an extensive selection process to identify intelligent and altruistic individuals with a strong commitment toward these goals and then spend years, trying to prepare those individuals. The students are subjected to different kinds of stressors, such as the pressure of academics with an obligation to succeed, an uncertain future, and difficulties of integrating into the system. The students also face stress due to social, emotional, physical, and family problems which directly or indirectly affect their learning ability and academic performance. Some of them find it hard to cope with the stress and lag behind, whereas others see the pressure as a challenge to work harder. This variance in handling the stress depends on the personality of an individual.[1]

Personality is a significant prognosticator of academic success during the training years at medical school. It influences doctors' collaboration and communication abilities in future professional practice. There is an established relationship of personality traits with anxiety and depression.[2],[3],[4],[5] Moreover, in medical students, depressive disorders and anxiety disorders are more prevalent when compared to the general population and their age-matched peers.[3],[6]

Too much of stress can cause physical and mental health problems, reduce students' self-esteem, and may affect students' academic achievement. In order to cope up with such issues, students in the early phase of their life can develop different types of coping strategies which might be consumption of alcohol,[4],[5],[7],[8],[9],[10],[11] smoking,[4],[5],[7],[10] and various drugs such as cannabis, amphetamine, and cocaine.[4],[5],[7],[8],[9],[10] Although medical and dental practitioners should help other patients to settle their substance dependency, they themselves are not immune to these enticements. Studies about psychotic disorders such as anxiety and depression among medical students are well narrated in literature. However, scarce literature has been reported among the association between anxiety and depression with personality traits, type of education exposure, and their effect on coping strategies among dental students. Hence, the present study was conducted to find the association between anxiety and depression with personality traits, type of education exposure (clinical and nonclinical), and their effect on coping strategies among dental students.


  Materials and Methods Top


A cross-sectional, questionnaire-based study was carried out among undergraduate dental students studying in Surendera Dental College and Research Institute, Sri Ganganagar, enrolled under Rajasthan University of Health Sciences. The Institutional Research and Ethics Committee approved the study (Ref No. SDCRI/IEC/2017/012). The study was conducted during the middle of the session (February 2017–April 2017) of the academic year. All dental students were invited to enroll in the study except for the interns who were attending the compulsory rotatory internship. The students were briefly explained about the nature of the study and were assured of keeping the contents confidential. The participants were told that they can withdraw from the study at any period of time. Students who were present at the time of data collection and provided informed consent were included in the present study. The students who were already suffering from any psychological ailments were excluded from the study. All pro formas were coded to avoid identification of the students by the examiners. After applying the inclusion and exclusion criteria, the final sample was 289 undergraduate dental students.

The data were obtained in two sections. In the first section, questions regarding the year of study; age; gender; accommodation; and coping strategies such as consumption of alcohol, smoking, chewing gums, and chocolates were asked. After data collection, year of the study was dichotomized into clinical and nonclinical. Clinical years consisted of 3rd- and final-year students, whereas nonclinical included 1st- and 2nd-year students. Questions concerning consumption of alcohol, smoking, chewing gums, and chocolates were asked with options of yes and no. The second section comprised validated questionnaires for anxiety, depression, and personality traits. The Hospital Anxiety and Depression Scale[12] was used for the measurement of subjective anxiety and depression, where a score of ≥8 for either the anxiety or the depression component denotes possible “pathological” anxiety or depression, respectively. Personality traits were tested for being either extraversion or psychoticism with the help of Eysenck Personality Questionnaire-A Scale.[13] Both the scales consisted of six questions each.

Questionnaires were circulated during one lecture for each year with prior permission from the authorities of the institution, and the aims of the study were explained. The time allotted for completion of the questionnaire was 20 min. The questionnaire was pretested to ensure that all questions were clear and understandable to participants. During the pilot study, it was noticed that many students reported a sudden increase in the consumption of chocolates and chewing gums since joining the course and even reported a soothing effect. Hence, the frequency of consuming chocolates and chewing gums was also assessed.

IBM SPSS Statistics for Windows, version 20.0 (IBM Corp., Armonk, NY, USA) was used for the statistical analysis. Chi-square test, Student's t-test, and Pearson's correlation coefficient were used, and the level of significance was set at P < 0.05.


  Results Top


In the present study, 89.3% of participants were female and 10.7% of participants were male. The males in nonclinical years (3.81 ± 1.18) and females in clinical years (4 ± 0.85) were more extrovert than their counterparts. It was found that males (3.26 ± 0.45) and females (3.03 ± 0.84) in clinical years were more psychotic than males (2.33 ± 0.49) and females (2.81 ± 1.15) in nonclinical years. The clinical students staying without family were more extrovert and psychotic than nonclinical students staying with family [Table 1].
Table 1: Mean number of extrovert and psychotic participants in clinical and nonclinical settings according to gender and type of residence

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The males in clinical years were more anxious (84.2%) than males in nonclinical years (66.6%) (P = 0.66), whereas males in clinical years were slightly depressed (36.8%) than males in nonclinical years (33.3%) (P = 0.01). It was found that females in clinical years were more anxious and depressed than their counterparts. The anxious students under the nonclinical category were more extrovert and psychotic than the clinical students, whereas the depressed students under the clinical category were more extrovert and psychotic than nonclinical students [Table 2].
Table 2: Effect of clinical and nonclinical settings among anxious and depressed dental students in relation to personality traits and various demographic factors

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When extraversion was correlated with anxiety and depression, a negative correlation was seen which was statistically significant for depression (P = 0.01), whereas a positive correlation was seen when psychoticism was correlated with anxiety and depression [Table 3].
Table 3: Correlation of personality traits with anxiety and depression among dental students

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Among all the students who were anxious, depressed, or a combination of both, the majority consumed chocolates (24.57%, 37.37%, and 37.02%, respectively) as a coping strategy. The coping strategy which was seen the least among all the participants was smoking. [Table 4].
Table 4: Coping strategies reported by dental students suffering from anxiety and depression

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  Discussion Top


The current study was an attempt to report the association between anxiety and depression with personality traits, type of education exposure, and their effect on coping strategies among undergraduate dental students. Findings of the study revealed that males and females belonging to clinical years were more psychotic than males and females belonging to nonclinical years. The psychoticism component of the Eysenck Personality Questionnaire is a measure of risk taking and sensation seeking-behaviors in an individual. This might be because students in clinical years are suddenly exposed to multiple activities such as increase in academic pressure and enormous clinical exposure which make them more prone to stressful conditions and hence, there could be a shift toward more psychotic domain among this group.

Extraversion reflects sociability, assertiveness, and emotionally positive. In the present study, it was found that females were more extrovert than males as females are more gregarious than males. Females are considered to have positive emotions, whereas males are more assertive and considered more excitement seeking. Similar finding was reported by Weisberg et al.[14] in relation to gender.

The outcome of the present study showed that males from clinical years were more anxious than their counterparts from nonclinical years, but depression was approximately similar in both males of clinical and nonclinical years, although a bit higher among clinical years. Similar pattern of anxiety and depression was observed among females of both clinical and nonclinical years. The reasons for this pattern could be attributed to the greater pressures of both the practical work and studies during the clinical years. However, these findings are almost analogous with the study done by Newbury-Birch et al. in the UK.[10] Further comparison with this study revealed that the females in nonclinical years are slightly more depressed than their counterparts as reported by Newbury-Birch et al. in 2002.[10] The reason for this array could be the difference in the education pattern and syllabus for the bachelor curriculum among the two countries.

In the present research, clinical students staying without family were more extrovert than their counterparts. This might be due to the reason that hostel is a place, where students make completely independent decisions, which is helpful in the long run. In the hostel, where you have no one to pamper you and where you have to do all the chores on your own, you become even more responsible and mature. There, you meet new people and come to know about their ideologies. The hesitation of being among new people vanishes away with time and the individual becomes more confident and extrovert. This finding is contradicted by Agarwal et al.[15] and Jorm and Christensen[16] in their respective studies.

Clinical students as well as those who stay without family were more psychotic than their counterparts. The reason may be attributed to the fact that hostellers when compared to day scholars exhibit emotional unsteadiness, nervousness, hostility, and depression due to their residence in tense and competitive environment of the hostel. This result is supported by several earlier researchers affirming homesickness to be one of the negative effects which result in lack of concentration, depression, and dysfunctional behavior.[17] Residential condition was found to be positively associated with students' unhealthy personality. It was found that hosteller upbringing weakens the emotional and psychological status, resulting in anxiety and homesickness.[18],[19]

When extraversion was correlated with anxiety and depression, a negative correlation was observed in the present research, which is supported by Bunevicius et al.[3] and contradicted by Sharma.[20] A positive correlation was observed when psychoticism was correlated with anxiety and depression in the current study. This finding is supported by Sharma.[20]

Among all the students whether they were anxious, depressed, or a combination of both, a majority consumed chocolates as a coping strategy followed by alcohol, chewing gums, and smoking. The reason for more consumption of chocolates might be because approximately 89.3% of females in the present study are more addictive to chocolates. Another reason could be that eating chocolates improves negative mood and increases joy to a greater extent than nothing.[21],[22]

The limitations of the study were social desirability bias and acquiescence bias. According to the authors, the results could have been appreciated better in a longitudinal design. Hence, new study with longitudinal design must be conducted to escalate the results in an enhanced way.


  Conclusion Top


The study showed that many dental students who were in clinical years have more anxiety and depression as compared to their nonclinical peers, which could be due to their personality traits. This study has revealed that personality characteristics influence individuals' strategy to cope with anxiety and depression. If further work confirms our conclusion, targeted interventions may be an effective way of dealing with this problem. The influence of clinical teachers is the key factor; it is important that clinical teachers provide a consistent role model both in their attitudes toward handling stress and adopting a healthy approach for the mental well-being of the individual. Considering the functional capacities and personality profile of students staying away from family, suitable environmental opportunities should be provided to eliminate the stigma attached with hostel life and to improve the social and educational environment of these individuals. The participants who showed any signs of depression and anxiety were referred to a psychiatrist for counseling.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

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McAuliffe WE, Rohman M, Breer P, Wyshak G, Santangelo S, Magnuson E, et al. Alcohol use and abuse in random samples of physicians and medical students. Am J Public Health 1991;81:177-82.  Back to cited text no. 11
    
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Agarwal AK, Preeti G, Mahore RN. A personality dynamics difference study of MBBS Medical Students living in hostels and their homes during their 1st Prof and 2nd Prof Examination. Res J Hum Soc Sci 2015;6:7-12.  Back to cited text no. 15
    
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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