Depression, Anxiety, and Stress as a Function of Psychological Strains: Towards an Etiological Theory of Mood Disorders and Psychopathologies

J Affect Disord. 2020 Jun 15;271:279-285. doi: 10.1016/j.jad.2020.03.076. Epub 2020 Apr 17.


Background: The etiological factors of mood disorders and psychopathologies are understudied. In this paper, we explored whether social psychological strains are related to depression, anxiety, and stress in non-clinical populations.

Methods: 6,305 college students (39.3% men; 60.7% women) from six Chinese provincial-level jurisdictions completed a paper-and-pencil survey with Psychological Strain Scales (PSS-40) and Depression, Anxiety, and Stress Scales-21 (DASS-21), both validated in Chinese populations.

Results: Both PSS-40 and DASS-21 have high internal consistency reliabilities, and are highly correlated with each other. Hence, Chinese college students with greater psychological strains (value, aspiration, deprivation, or coping) have greater depression, anxiety, and stress. These results still held after controlling for relevant socio-demographic variables in the multiple regression models.

Limitations: This was a cross-sectional study, and the sample only included several provinces in mainland China, not a representative sample of all of them.

Conclusions: Mood disorders and psychopathologies are linked to suicidal thoughts and behaviors. The results of this study extend the Strain Theory of Suicide from explaining the risk factors of suicidality to mood disorders and psychopathologies. Hence, these findings can inform prevention measures among college students, and possibly the general population.

Keywords: Anxiety; China; College students; Depression; Psychological strains; Stress.

MeSH terms

  • Anxiety / epidemiology
  • Anxiety / etiology
  • China / epidemiology
  • Cross-Sectional Studies
  • Depression* / epidemiology
  • Depression* / etiology
  • Female
  • Humans
  • Male
  • Mood Disorders* / epidemiology
  • Mood Disorders* / etiology
  • Stress, Psychological / epidemiology