Executive function deficits associated with anxiety and depression and their impact on medical students’ academic performance in Saudi Arabia
DOI:
https://doi.org/10.22317/jcms.v8i5.1290Keywords:
Executive Function, Anxiety, Depression, Academic Performance, Saudi Arabia, Students, MedicalAbstract
Objectives: This study aimed to determine the relationship between EF deficits associated with anxiety and depression and their impact on medical students’ academic achievement in Saudi universities.
Methods: A cross-sectional online survey was conducted on 242 medical students. Anxiety and depression were assessed using the Barkley Deficits in Executive Functioning Scale (BDEFS), General Anxiety Disorder-7 scale (GAD-7), and the Patient Health Questionnaire (PHQ-9).
Results: Participants’ mean age was 22.57 (2.26) years and the mean GAD-7, PHQ-9, and BDEFS scores were 10.54 (5.83), 12.29 (6.86), and 196.78 (47.78), respectively. Males, Saudi students, those in their fourth academic year, and those who were not satisfied with their academic performance had significantly higher mean GAD-7, PHQ-9, and BDEFS scores. A significant negative association was found between students’ grade point average (GPA) and BDEFS scores, and a significant positive association was found between GPA and GAD-7 scale scores, PHQ-9 scores, and BDEFS scores. Additionally, there was a positive association between the PHQ-9 and BDEFS scores.
Conclusion: A real-world application of EF scales to address EF deficits for all university students should be considered.
References
Abdulghani, H. M., AlKanhal, A. A., Mahmoud, E. S., Ponnamperuma, G.G., & Alfaris, E. A. (2011). Stress and its effects on medical students: A cross-sectional study at a college of medicine in Saudi Arabia. Journal of Health, Population, and Nutrition, 29(5), 516–522.
Ahmed, S. F., Tang, S., Waters, N. E., & Davis-Kean, P. (2019). Executive function and academic achievement: longitudinal relations from early childhood to adolescence. Journal of Educational Psychology, 111(3), 446–458.
Alaqeel, M. K., Alowaimer, N. A., Alonezan, A. F., Almegbel, N.Y., & Alaujan, F. Y. (2017). Prevalence of irritable bowel syndrome and its Association with Anxiety among Medical Students at King Saud Bin Abdulaziz University for Health Sciences in Riyadh. Pakistan Journal of Medical Sciences, 33(1), 33–36.
Alatawi, A., Alghamdi, A., Albalwi, A., Altayar, M., Jalal, M., & Frah, E. A. M. (2020). Prevalence of generalized anxiety disorder (GAD) among Saudi medical students and associated risk factors. International Journal of Medical Research and Health Sciences, 5(9), 1–9.
Al-Busaidi, Z., Bhargava, K., Al-Ismaily, A., Al-Lawati, H., Al-Kindi, R., Al-Shafaee, M., & Al-Maniri, A. (2011). Prevalence of depressive symptoms among university students in Oman. Oman Medical Journal, 26(4), 235–239.
Alhadi, A. N., Alateeq, D. A., Al-Sharif, E., Bawazeer, H. M., Alanazi, H., Alshomrani A. T., Shuqdar, R. M., & AlOwaybil, R. (2017). An Arabic translation, reliability, and validation of Patient Health Questionnaire in a Saudi sample. Annals of General Psychiatry, 16(1), 1–9.
Alharbi, H., Almalki, A., Alabdan, F., & Haddad, B. (2018). Depression among medical students in Saudi medical colleges: A cross-sectional study. Advances in Medical Education and Practice, 9, 887–891.
Alzahrani, A. M., Hakami, A., AlHadi, A., Batais, M. A., Alrasheed, A. A., & Almigbal, T. H. (2020). The interplay between mindfulness, depression, stress and academic performance in medical students: A Saudi perspective. PLOS One, 15(4), e0231088.
American Psychiatric Association. (n.d.). What is depression? https://www.psychiatry.org/patients-families/depression/what-is-depression.
Awadalla, S., Davies, E. B., & Glazebrook, C. A. (2020). Longitudinal cohort study to explore the relationship between depression, anxiety and academic performance among Emirati university students. BMC Psychiatry, 20(1), 448.
Baars, M. A., Nije Bijvank, M., Tonnaer, G. H., & Jolles, J. (2015). Self-report measures of executive functioning are a determinant of academic performance in first-year students at a university of applied sciences. Frontiers in Psychology, 6, 1131.
Barkley, R. A. (2011). Barkley Adult ADHD Rating Scale–IV (BAARS-IV). Guilford Press.
Barkley, R. A. (2011). Barkley Deficits in Executive Functioning Scale (BDEFS for adults). Guilford Press.
Barkley, R. A. (2012). Barkley deficits in executive functioning scale–children and adolescents (BDEFS-CA). Guilford Press.
Bayram, N, & Bilgel, N. (2008). The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students. Social Psychiatry and Psychiatric Epidemiology, 43(8), 667–672.
Beiter, R., Nash, R., McCrady, M., Rhoades, D., Linscomb, M., Clarahan, M., & Sammut, S. (2015). The prevalence and correlates of depression, anxiety, and stress in a sample of college students. Journal of Affective Disorders, 173, 90–96.
Bergmann, C., Muth, T., & Loerbroks, A. (2019). Medical students’ perceptions of stress due to academic studies and its interrelationships with other domains of life: A qualitative study. Medical Education Online, 24(1), 1603526.
Castaneda, A. E., Suvisaari, J., Marttunen, M., Perälä, J., Saarni, S. I., Aalto-Setälä, T., Aro, H., Koskinen, S., Lönnqvist, J., & Tuulio-Henriksson, A. (2011). Cognitive functioning in a population-based sample of young adults with anxiety disorders. European Psychiatry, 26(6), 346–353.
Cortés, P. A., Moyano, M. N., & Quílez, R. A. (2019). The relationship between executive functions and academic performance in primary education: Review and meta-analysis. Frontiers in Psychology, 10(10), 1582.
Dekker, S., Krabbendam, L., Aben, A., de Groot, R., & Jolles, J. (2013). Coding task performance in early adolescence: A large-scale controlled study into boy-girl differences. Frontiers in Psychology, 27(4), 550.
Diamond, A. (2013). Executive functions. Annual Review of Psychology, 64, 135–168.
Inoue, T., Tanaka, T., Nakagawa, S., Nakato, Y., Kameyama, R., Boku, S., Toda, H., Kurita, T., & Koyama, T. (2012). Utility and limitations of PHQ– 9 in a clinic specializing in psychiatric care. BMC Psychiatry, 12(1), 1–6.
Iqbal, S., Gupta, S., & Venkatarao, E. (2015). Stress, anxiety and depression among medical undergraduate students and their socio-demographic correlates. The Indian Journal of Medical Research, 141(3), 354–357.
Kamradt, J. M., Nikolas, M. A., Burns, G. L., Garner, A. A., Jarrett, M. A, Luebbe, A. M., & Becker, S. P. (2021). Barkley Deficits in Executive Functioning Scale (BDEFS): Validation in a large multisite college sample. Assessment, 28(3), 964–976.
Kamradt, J. M., Ullsperger, J. M., & Nikolas, M. A. (2014). Executive function assessment and adult attention-deficit/hyperactivity disorder: Tasks versus ratings on the Barkley deficits in executive functioning scale. Psychological Assessment, 26(4), 1095–1105.
Little, T. D., Rhemtulla, M., Gibson, K., & Schoemann, A. M. (2013). Why the items versus parcels controversy needn’t be one. Psychological Methods, 18(3), 285–300.
Moir, F., Yielder, J., Sanson, J., & Chen, Y. (2018). Depression in medical students: current insights. Advances in Medical Education and Practice, 9(9), 323–333.
Moreau, M. P. (2011). The societal construction of ‘boys’ underachievement’ in educational policies: A cross-national comparison. Journal of Education Policy, 26(2), 161–180.
Mousa, O. Y., Dhamoon, M. S., Lander, S., & Dhamoon, A.S. (2016). The MD blues: Under-recognized depression and anxiety in medical trainees. PLOS One, 11(6), e0156554.
Prevatt, F., & Yelland, S. (2015). An empirical evaluation of ADHD coaching in college students. Journal of Attention Disorders, 19(8), 666–677.
Rabin, L. A., Fogel, J., & Nutter-Upham, K. E. (2011). Academic procrastination in college students: the role of self-reported executive function. Journal of Clinical and Experimental Neuropsychology, 33(3), 344–357.
Rutter, L. A., & Brown, T. A. (2017). Psychometric properties of the generalized anxiety disorder scale-7 (GAD-7) in outpatients with anxiety and mood disorders. Journal of Psychopathology and Behavioral Assessment, 39(1), 140–146.
Saeed, A. A., Bahnassy, A. A., Al-Hamdan, N. A., Almudhaibery, F. S., & Alyahya, A. Z. (2016). Perceived stress and associated factors among medical students. Journal of Family and Community Medicine, 23(3), 166–171.
Samuels, W. E., Tournaki, N., Sacks, S., Sacks, J., Blackman, S., Byalin, K., & Zilinski, C. (2019). Predicting GPAs with executive functioning assessed by teachers and by adolescents themselves. European Educational Researcher, 2(3), 173–194.
Shanmugan, S., & Satterthwaite, T. D. (2016). Neural markers of the development of executive function: relevance for education. Current Opinion in Behavioral Sciences, 10, 7–13.
Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097.
Tian-Chi Quek, T., Tam, W. W., Tran, B. X., Zhang, M., Zhang, Z., Su-Hui Ho, C., & Chun-Man Ho, R. (2019). The global prevalence of anxiety among medical students: A meta-analysis. International Journal of Environmental Research and Public Health, 16(15), 2735–2753.
Visu-Petra, L., Cheie, L., Benga, O., & Miclea, M. (2011). Cognitive control goes to school: The impact of executive functions on academic performance. Procedia Social and Behavioral Sciences, 11, 240–244.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Journal of Contemporary Medical Sciences
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
