Depression is among the primary global public health concerns because of its relatively high prevalence rates, the chronic nature of the illness, and the complex recovery process. Furthermore, it has been rated to be among the four major diseases with regards to the significant burden to depressed individuals themselves, their families, and society (Marthoenis, Meutia, Fathiariani, & Sofyan, 2018). Mental illnesses are highly prevalent among college students, and this is mainly because both traditional and non-traditional undergraduate students are faced with several challenges while attending college. For traditional students, are usually younger and usually begin college after completing high school.
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Moreover, they do not work; hence, they depend on their guardians for financial support. Therefore, in college, the challenges they face stem from stress related to academic load, and the adult-like responsibilities that they are required to embrace without having fully mastered the skills and cognitive maturity related to adulthood. On the other hand, non-traditional students are usually older with full-time employment and have dependents excluding their spouses. As a result, this group of students is faced with the challenges of meeting the academic requirements, in addition to their work and family responsibilities. Therefore, overall, the relatively high mental demands associated with balancing school and personal life may exacerbate mental illnesses, such as depression. Depression is a prevalent mental health condition among college students with an estimated mean prevalence rate of 30.6%, although it generally ranges from 10-85% (Marthoenis et al., 2018). Furthermore, one out of every five people diagnosed with depression shows an elevated risk for depression by the age of 25 years (Pedrelli, Nyer, Yeung, Zulauf, & Wilens, 2015).
Several research has evidenced the correlation between depression and deteriorated academic performance ((Marthoenis et al., 2018; Pedrelli et al., 2015). For instance, it has been noted that about one-third of American college students stated that they were so depressed that normal functioning was difficult (National College Health Assessment, 2014). Depression can significantly influence an individual’s capability to carry out simple daily tasks and usually results in poor concentration, low motivation, irritability, fatigue, sleep difficulties, apathy, and sadness (Pedrelli et al., 2015). Moreover, it predicts suicide ideation. Consequentially, depressed students are highly probable to dropping out of college, exhibiting poor academic performance, be at risk for drug abuse, and other mental problems in the future.
The high prevalence of depression among college students elucidates the need for developing effective therapeutic interventions, especially cost-effective approaches. One treatment that meets this criterion is rock climbing, which is also known as bouldering.
This paper aims to examine the effectiveness of bouldering in treating depression among college students via addressing the following non-directional null hypothesis:
H0 – There is no significant difference between the experimental group, individuals subjected to bouldering, and the control group, individuals not subjected to bouldering.
Based on the null hypothesis, the following alternative hypothesis was formulated:
H1 – There is a significant difference between the experimental group, individuals subjected to bouldering, and the control group, individuals not subjected to bouldering.
Participants used in the study would solely constitute college students present in the university. They will be recruited in several ways: referral from the staff at the University’s Health Services or from the Center for Counselling as they exhibited signs of depression; and self-referral based on informational material, such as flyers that were posted throughout the environs of the campus.
To test the hypothesis, a true experimental research design would be conducted. The true experimental design is regarded as the most precise type of experimental research design as it is dependent on statistical analysis to either support or disapproves a hypothesis (Patten & Newhart, 2017). Moreover, it allows for the evaluation of a cause-effect relationship within groups. It is characterized by the random distribution of researchers into the control and experimental group and the existence of an independent variable that is manipulated by the researcher (Patten & Newhart, 2017).
Controlling Variability between Groups
Variability between the experimental and control groups would be controlled by using matched pairs, which would be in regards to their level of depression. This means that the participants taking part in the study would be only considered eligible if they had a depression severity level score of above 10 in the Patient Health Questionnaire-9 (PHQ-9), which refers to clinically significant depression. Furthermore, both groups will be subjected to an equal number of sessions of mindful exercises, with each taking an equal duration of 30 minutes.
Assignment of Participants into Groups
Since a true experimental research design would be used, the participants will be randomly assigned to the experimental and control groups. Those in the experimental group will undergo both bouldering psychotherapy and mindful exercises. However, those in the control group will only undergo mindful exercises.
The only measure that would be employed is the PHQ-9. It would be employed in measuring the severity of the symptoms of depression of participants at various points in the research. The PHQ-9 is among the most common instruments used to screen depression. It is popular among clinicians as it enables them to both diagnose and monitor a patient’s general depression severity and track the improvement of particular symptoms with treatment (Levis, Benedetti & Thombs, 2019). It constitutes nine items that are centered on nine diagnostic criteria for major depression in the DSM-IV. Each item can be scored from 0 to 3, with an overall score of 9-14 representing mild depression, 15-19 signifying moderate depression, and 20-27 illustrating severe depression (Levis et al., 2019).
Data analyses would be performed using the SPSS 21.0 software. Several analytical tests, such as the Chi-square test and Pearson correlation test, would be used to examine the correlation between continuous variables. Their results would then be summarized using several descriptive statistics comprising of the mean, median, and mode where appropriate. Moreover, other measures of variability, such as standard deviation, would be used to describe the spread of scores between and within groups.
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Since the hypothesis being investigated is non-directional, a two-tailed test would be used. It is only used to test the null hypothesis in addition to testing for statistical significance. When the sample being tested falls within the critical area of a distribution, that is, falls within a specific range of values, the alternative hypothesis would be supported.
Significance Level and Errors
Conventionally, when utilizing a two-tailed test, a significance level of 0.05 is usually used. This insinuates that there is a 5% risk of making a conclusion that a difference exists when it is absent.
Type I error occurs when an experimenter rejects a null hypothesis while it is true. In contrast, type II error ensues when an experimenter supports a null hypothesis when it is false. Type I error is influenced by study designs that are susceptible to random sampling errors. Therefore, since this current study is comprised of a true experimental research design that is characterized by the random assignment of participants into experimental and control groups, it is highly susceptible to random sampling errors. Therefore, this would make the researcher be at risk of committing a type I error. Nevertheless, type II error is mainly caused by a research design having insufficient statistical power, which can be attributed to the sample size. However, since it has been suggested that depression is common among college students and multiple recruitment strategies would be used, a large sample size would probably be obtained. Thus this would the study off of type II errors.
The study has several limitations. First, the sample size consisted of college students in a single institution; thus, this limits the generalizability of its findings. Second, the PHQ-9 is not a substitute for a diagnosis by a practicing clinician; therefore, elevated severity of symptoms levels do not fully guarantee that an individual is suffering from clinically significant depression. This suggests that it is likely that some of the participants were not suffering from major depression. Third, PHQ-9 scores indicate major depression; however, the study failed to factor the level of severity, for instance, moderate or severe depression, when administering treatment. This might affect the results as individuals with severe depression might take longer to heal as compared to the former. Fourth, the study did not factor in the experience of the participants in bouldering. The experience might adversely impact the efficacy of the therapeutic approach. Future studies should compare the effectiveness of indoor and outdoor bouldering in reducing depression.
Levis, B., Benedetti, A., & Thombs, B. (2019). Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: Individual participant data meta-analysis. The BMJ, 365, 1-10. Web.
Marthoenis, M., Meutia, I., Fathiariani, L., & Sofyan, H. (2018). Prevalence of depression and anxiety among college students living in a disaster-prone region. Alexandria Journal of Medicine, 54(4), 337-340. Web.
National College Health Assessment. (2014). Spring 2014 reference group executive summary. Web.
Patten, N., & Newhart, M. (2017). Understanding research methods: An overview of the essentials (10th ed.). New York, NY: Routledge.
Pedrelli, P., Nyer, M., Yeung, A., Zulauf, C., & Wilens, T. (2015). College students: Mental health problems and treatment considerations. The journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry, 39(5), 503-511. Web.