Mental Health During Societal Crisis: Anxiety, Depression, and Stress among Students at the Arab American University 

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Undergraduate mental health is a key contributing component to academic success, mental health and social adjustment. This is magnified in the context of Palestinian undergraduates due to ongoing societal challenges including, political instability, war, armed conflict and economic stressors. This research has examined the levels of depression, anxiety and psychological stress among Arab American university students during this time. Methods A cross sectional quantitative design was used to examine the prevalences of depression, anxiety and stress. The participants included 384 students enrolled at the Arab American University during the time from March 2025 to September 2025, from various academic disciplines, using the Depression, Anxiety and Stress Scale (DASS-42). Furthermore, the Mann-Whitney U and Kruskal-Wallis H tests were utilized to assess differences in levels of depression, anxiety, and stress by gender, faculty type, and grade point average. Results The majority of students were found to be suffering from severe and very severe levels of depression (92.71%) and anxiety (94.79%) as well as high psychological stress (76.95%). There is a significant association between the level of depression and student's academic performance (p < 0.05). However, there are no significant differences between sexes or fields of study. Conclusions The study found a high prevalence of depression, anxiety, and stress among students, indicating that mental health problems are common among the academic population. The results highlight the importance of early recognition and treatment to support students’ mental health. While the present study did not examine the cause of these mental health problems, the potential source may be related to the ongoing socio-political issues in the context of the Palestinian population. Mental health Depression Anxiety Stress University Students Academic Performance Figures Figure 1 Figure 2 Figure 3 Background University life serves as a significant shift in a student's personal development and academic context. This stage of development is distinctly different from school life because it requires independent thinking, advanced methods of studying, and many students will be engaging socially more than they have during their lives. Each student articulates their own hopes and dreams and a student will need to think what hopes and dreams are going to coalesce with the skills obtained to achieve academic and personal success. There are many different experiences that students will have during this time in their lives (both positive and negative) all directed at testing their ability to adapt, engage with others, and grow resilient. The ability to feel happy and satisfied and to make sound decisions will be essential parts of the university experience. All of these feelings are highly correlated to academic success and general mental well-being (Badawi & Dabbar, 2023). In this context, and as an important aspect of university life, is the idea of mental health as a part of students’ lives. Mental health is described as a dynamic state of being, which basically reflects the person’s ability to cope with stress and to maintain psychological balance (Galderisi et al., 2015). Sound mental health improves productivity, learning, and social development. On the other hand, poor mental health reduces performance and increases anxiety, depression, and stress (Royal College of Psychiatrists, 2021). Not surprisingly, the United Nations noticed this as well and included mental health under the Sustainable Development Goals for “Good Health and Well-being” in 2015 because addressing mental health is important all over the world in resilient societies. Recent research suggests that the extent of psychological distress in Palestinian university students is shocking. Ahmad et al. (2024) found that the prevalence of depressive symptoms among students attending Al-Quds, Hebron, and Najah universities was 65.9% while 60.9% of students reported anxiety. Al-Dabbour et al. (2025) also reported high levels of depression, stress, sleep impairment, and dissatisfaction with life among medical students in Gaza. Amro (2024) found PTSD and anxiety in nursing students at Palestine Polytechnic University, while Ghanim et al. (2022) reported moderate to severe psychological symptoms after COVID-19 that interfered with students' academic participation and daily functioning. In the recent 2023 Gaza war, Amro et al. (2025) found PTSD among Al-Quds University students that related to violent invasion, displacement, and social disintegration. El-Khodary and Aboudagga (2025) also reported that academic stressors (e.g., unstable internet, electricity supply, and limited online access) significantly predicted depression and anxiety symptoms among medical students in Gaza. Research constantly confirms the cumulative effect of crises on Palestinian students’ wellbeing. According to Sabbah et al. (2025), approximately 40% of West Bank students experienced average “psychache” or moderate psychological pain. Qutishat (2025) stated that instability, conflict, and disruption all contribute to students' threatening psychological sustainability, or wellbeing. Aqtam (2025) reported rates of depression at 45%, and anxiety at 37%, with participants often reporting symptoms resembling PTSD. According to Hamdan et al. (2025), 23.1% of medical students experienced moderate to severe depression and 46.8% exhibited increased anxiety. Mental health, then, is an important indicator of a person’s ability to balance responsibilities, foster relationships, and seek to reach goals. In university contexts, mental health has consequences on attention, perseverance, and making choices; mental health concerns can negatively impact the student experience and has also been correlated with attrition and dropping out (Osborne et al., 2022; Pascoe et al., 2020; World Health Organization, 2022). As the World Health Organization (2022) notes, “The mental health of undergraduates is one of the main determinants of the quality of higher education and the success of students.” Conceptually, mental health has been defined from a variety of perspectives. Bouhafs and Azarn (2023) noted, based on Adolf Meyer’s theory of mental health, it is the capacity to adapt to external conditions and stagnate the development of disorders by exhibiting healthy social and personal behaviors. Al-Qas and Ben Ghadhafa (2022, p.664) defined it as an ability to cope effectively with everyday challenges, while Maheria (2021) associated mental health to being in psychological harmony and inner peace. Positive mental health arises from many characteristics, including hope, goal setting, emotional regulation, and social support (Laranjeira & Querido, 2022; Carvalho et al, 2022; Sinera-Monge et al., 2023; An Dong et al., 2023). Anxiety, depression, and academic stress are among the most prevalent mental health concerns in higher education. Anxiety, a normal reflex to perceived danger, can develop into chronic disorder when anxiety becomes persistent, resulting in fear, apprehension, insomnia, and muscle tension (Fouaghla & Dhafari, 2024; Barlow, 2024; Preston et al., 2021; Al-Bahnasawy et al., 2023; Al-Zahrani & Al-Enezi, 2022; Baghdad & Al-Ashmawy, 2020; Al-Sahtoohi, 2020). Chronic anxiety may stem from psychological factors, including negative thought patterns (Al-Jabali, 2016), chronic stress (Rayan, 2020), and health-related issues (Al-Saadoun, 2017). Depression is considered to frequently follow anxiety and is characterized by sadness, social withdrawal, and loss of interest (Salik & Marwaha, 2022; Clack & Ward, 2019; World Health Organization, 2021). In its mood disorder form, it may be accompanied by emotional, cognitive, and physiological symptoms, which may include fatigue, hopelessness, guilt, and suicidal ideation (Ismail, 2018; World Health Organization, 2023; Cho et al., 2019; Ismail & Ismail, 2019; Ormel, Kessler & Schoevers, 2019; Abu Al-Nour et al., 2020; Al-Sayed & Sabri, 2022). Academic stress, on the other hand, is when a student receives internal and external pressure related to their college course work, exams, and performance (Al-Qarala & Al-Horai, 2024; Mukhtar, 2023; American Psychological Association, 2020). It presents itself physically, psychologically, and behaviorally and is often compounded by societal, familial, and financial pressures (Beharu, 2018; White et al., 2021; Noreen et al., 2021; Harb, 2018). These findings underscore the necessity of examining mental health in the context of broader societal crises in Palestine, specifically among students at Arab American University. Understanding the levels of anxiety, depression, and stress among Arab American University students can further enhance our understanding of the educational and psychological difficulties, and may help inform appropriate campus-based interventions and systems of support. As such, the aim of this study is to describe the dimensions of mental health amongst Arab American University students for the purpose of producing some evidence to both contribute to the literature and inform stakeholders in Palestinian higher education in developing policy and programs that support resilience and well-being for students. This study seeks to address the following questions: What are the levels of mental health challenges—specifically depression, anxiety, stress—among undergraduate students at the Arab American University? Are there any statistically significant associations between demographic variables and the level of depression, anxiety, and stress? Methods Study Design and Procedure This research employed a quantitative, cross-sectional design explore the prevalences of depression, anxiety, and stress among undergraduate students and their associations with demographic factors as well as academic performance. Data was collected through a structured self-administered questionnaire distributed both electronically and in paper form across various faculties of the Arab American University (between March 2025 to September 2025). Out of all distributed questionnaires, 384 valid responses were obtained after excluding incomplete or inconsistent entries. Study Population and Sample The population for this study was all undergraduate students attending Arab American University, which had a total of 11,618 students according to official university data (Arab American University, n.d). The sample for this study was composed of 384 male and female undergraduate students using a convenience sampling method. While the sample size needed to obtain the proportion for a total population of 11,618 students at a confidence level of 95%, with a margin of error of 5%, and a 50% response distribution was 372, the researcher sought responses from 384 students to increase the reliability of the findings. Data Collection Instrument Mental Health Scale The assessment consisted of two sections. The first section gathered demographic information including grade point average (GPA), gender, and faculty type to make comparisons across different groups. The second part gauged depression, anxiety, and stress levels using the Depression, Anxiety and Stress Scale (DASS-42) created by Liasi et al. (2021). The scale comprised 42 items that were equally distributed among the three sub-scales, 14 items each for Depression, Anxiety, and Stress. Responses were measured using a five-point Likert scale (1 = Never, 2 = Rarely, 3 = Sometimes, 4 = Often, 5 = Almost Always). Higher scores indicate greater severity of symptoms. Following the classification proposed by Liasi et al. (2021), the interpretation of total scores for each DASS-42 subscale was as follows: Depression: 0–9 (Normal), 10–13 (Mild), 14–20 (Moderate), 21–27 (Severe), 28+ (Extremely severe) Anxiety: 0–7 (Normal), 8–9 (Mild), 10–14 (Moderate), 15–19 (Severe), 20+ (Extremely severe) Stress: 0–14 (Normal), 15–18 (Mild), 19–25 (Moderate), 26–33 (Severe), 34+ (Extremely severe) Content Validity The content validity of the DASS-42 Arabic version was established by a group of four experts from An-Najah National University in the fields of psychology and education. Each expert reviewed all items for clarity, relevance, and cultural appropriateness. All experts suggested minor modifications to the wording, and the agreed upon alterations were made. The final version of the DASS-42 was deemed to be a valid assessment to use in the Palestinian context. Reliability To determine internal consistency, the DASS-42 was piloted among a small group of undergraduate students who were not part of the study sample. Cronbach’s alpha coefficients indicated acceptable reliability levels for the three sub-scales: Depression (α = .79), Anxiety (α = .76), and Stress (α = .80). The overall reliability coefficient for the entire scale was α = .78, providing evidence that the instrument had acceptable internal consistency for research use. Data Analysis Data were analyzed using SPSS version 26. Descriptive statistics (frequencies and percentages) were used to summarize participants’ characteristics. As the data were not normally distributed, Mann-Whitney U and Kruskal-Wallis H tests were employed to examine levels of depression, anxiety, and stress across gender, faculty type, and GPA. Results Demographic Variables among Students The participants according to their demographic characteristics. As shown in Table 1 , the sample consisted of 384 undergraduate students at the Arab American University, of whom 46.88% females and 53.12% were males. Regarding the type of faculties, the largest proportion of participants were enrolled in literary faculties 54.95% and 45.05% in scientific faculties. In terms of GPA, most students (35.42%) had a GPA ranging between 3.00-3.66, while 29.43% scored between 4.00-3.67, and 26.04% between 2.33–2.99. Only 9.11% of students had a score between 2.00-2.32. Table 1 Percentages and frequencies based on demographic variables among students Demographic Variables Percentage Frequency GPA 2.00-2.32 9.11% 35 2.33–2.99 26.04% 100 3.00-3.66 35.42% 136 4.00-3.67 29.43% 113 Total 100.0% 384 Type of Faculties Literary faculties 54.95% 211 Scientific faculties 45.05% 173 Total 100.0% 384 Gender Male 53.12% 204 Female 46.88% 180 Total 100.0% 384 This study examined the levels of depression among students at the Arab American University. As shown in Table 2 , the majority of students suffer from very high levels of depression, as the percentage of those suffering from very severe depression (Extremely Severe) reached 67.45%, followed by the category of severe depression by 25.26%, while the lowest percentages were among the moderate 5.73% and mild 1.04% categories, while the percentage of normal was only 0.52%. These results indicate a very high prevalence of depression among students. Table 2 Descriptive Statistics of Depression Levels among Students The Level of Depression Frequency Percentage Normal 2 0.52% Mild 4 1.04% Moderate 22 5.73% Severe 97 25.26% Extremely severe 259 67.45% Total 384 100% The levels of depression were analyzed to identify general trends among students. Figure 1 illustrates the overall levels of depression among the participants. This study examined the levels of anxiety among students at the Arab American University. As shown in Table 3 , very severe anxiety is the most prevalent among students at 89.84%, followed by severe anxiety at 4.95%, moderate anxiety at 4.17%, while the rate of mild was 1.04%, and no case was recorded in the normal category. These results indicate that anxiety levels in students are very high and constitute a worrying phenomenon. Table 3 Descriptive Statistics of Anxiety Levels among Students The Level of Anxiety Frequency Percentage Normal 0 0.0% Mild 4 1.04% Moderate 16 4.17% Severe 19 4.95% Extremely severe 345 89.84% Total 384 100% The levels of anxiety were analyzed to identify general trends among students. Figure 2 illustrates the overall levels of anxiety among the participants. This study examined the levels of stress among students at the Arab American University. As shown in Table 4 , the percentage of students suffering from severe psychological stress reached 44.92%, followed by the category of very severe stress by 32.03%, while the moderate percentage was 14.32%, mild 4.69%, and normal only 1.04%. This suggests that the psychological pressure among students is high and requires special attention from the university administration. Table 4 Descriptive Statistics of Stress Levels among Students The Level of Stress Frequency Percentage Normal 4 1.04% Mild 18 4.69% Moderate 55 14.32% Severe 184 44.92% Extremely severe 123 32.03% Total 384 100% The levels of stress were analyzed to identify general trends among students. Figure 3 illustrates the overall levels of stress among the participants. This study examined the statistical significant associations between demographic variables and the level of depression, anxiety, and stress. As shown in Table 5 , there were no significant differences in the levels of depression, anxiety, and psychological stress depending on gender or type of college, where the p-value values for all of them were greater than 0.05. While it was found that there were significant differences in the level of depression according to the GPA, where the value was (p = 0.0059), in favor of students with high rates who showed lower levels of depression compared to their peers with low rates. As for anxiety and psychological stress, the results did not show significant differences depending on the GPA. Table 5 Mann-Whitney U and Kruskal-Wallis H test results for DASS-42 scale by gender, type of facilities, and GPA Variables Depression Anxiety Stress % P Value. % P Value. % P Value. Gender Female 73.93% 0.4982 74.33% 0.5916 74.09% 0.2483 Male 74.83% 73.58% 75.48% Type of facilities Scientific faculties 74.31% 0.8945 73.20% 0.3464 74.18% 0.3334 Literary faculties 74.49% 74.53% 75.36% GPA 2.00-2.32 68.57% 0.0059 74.75% 0.2203 74.98% 0.6979 2.33–2.99 73.23% 74.94% 75.66% 3.00-3.66 76.72% 74.87% 75.05% 4.00-3.67 74.49% 71.65% 73.79% Significant at p < 0.05 Discussions The findings reveal a concerning and high frequency of mental health issues among the AAU student population, as evidenced by the high proportion (very high) of the most severe level for the DASS-42 scale, including: depression (Extreme severe) 67.45% and/or severe by 25.26%; very severe anxiety 89.84%; severe mental distress 44.92% and very severe mental distress 32.03 (see Tables 2 , 3 , 4 ). The findings clearly suggest that there is a serious psychological burden among the sample (n = 384), which represents a real challenge for higher education institutions to provide mental health services and develop prevention strategies effectively. The high levels of psychological distress are consistent with previous studies conducted in the Palestinian context; for example, Ahmad and colleagues (2024), reported that Palestinian university students had a high prevalence of depression (65.9%) and anxiety (60.9%). Other studies have also documented high levels of depression, anxiety, and mental disorders in Gaza and the West Bank in student populations (Al-Dabbour et al., 2025 ; Amro, 2024 ; Ghanim et al., 2022 ; Amro et al., 2025 ). Therefore, our findings suggest that the Arab American University, like other universities, is experiencing increasing psychological pressures among Palestinian students within a deteriorating social political context, which has academic loads and expectations. Several interrelated factors may contribute to the elevated levels of anxiety, depression, and psychological stress. Specifically, these findings correlate with the cumulative psychological effects of the crises (Sabbah et al., 2025 ; Qutishat, 2025 ), disruptions in educational infrastructures and limited resources (El-Khodary & Aboudagga, 2025 ), and psychological and economic personal pressure (Al-Qarala & Al-Horai, 2024 ; Noreen et al., 2021 ). Local studies have highlighted that such issues as frequent power cuts, limited access to the internet, and exposure to violence or displacement have an overall impact on the mental health of students (Amro et al., 2025 ; El-Khodary & Aboudagga, 2025 ), factors that may help elucidate the results found in our sample, where we identified extreme percentages. Nevertheless, these findings can be viewed in the context of the singular Palestinian reality that is characterized by the intersection of continuously occurring political, social and economic crises. The war on Gaza, along with the resulting physical and psychological violence, loss of security and collective anxiety for the future, clearly impacted the mental health of university youth, even in areas unaffected by these bombings. Amro et al. ( 2025 ) noted an increase in symptoms of post traumatic stress disorder (PTSD) among al-Quds university students during the aggressions on Gaza due to being exposed to violence, displacement and ongoing destruction. Students’ frustration and psychological stress were further exacerbated by the combination of challenging economic conditions and similarly high unemployment rates among graduates as many students feel their academic efforts do not yield promised stable futures. This aligns with the conclusion of the Qutishat study in 2025, which stated social and economic instability was posed as direct threats to the mental health and academic sustainability of students at West Bank universities. Moreover, the social restrictions, struggle with educational infrastructure and psychological support in Palestinian universities added their own vulnerabilities to increase students' academic and personal pressure. Sabbah et al. ( 2025 ), for example, have observed that "approximately 40% of students from Palestine indicate moderate psychological pain due to limited effective support networks in their university environments." As such, the current results not only point to the existence of Mental Disorders at an individual level, but also reflect a collective structural phenomenon within the Palestinian context around a set of recurring crises, weak psychosocial protection frameworks, and a lack of institutional policies that consider mental health in higher education. As demonstrated by the results of the current study, mindfulness can be viewed as one of the effective therapeutic interventions to improve the mental wellbeing of college students experiencing high levels of depressive symptomology, anxiety and psychological stress. Research has documented that incorporating mindfulness practice can help participants enhance awareness of the present moment, regulate emotions, and reduce immediate reactivity to psychological stress (Galante et al., 2018 ; Serrão, Silva & Ferreira, 2022 ). Studies examining mindfulness amongst college students report that implementation of mindfulness programs assists college students to experience lower levels of anxiety and depressive symptomology, increased attention or concentration and improved psychological resilience (Carvalho, Marques, Pinto & Maroco, 2017 ; Laranjeira & Querido, 2022 ). Given the complex Palestinian environment where students experience compounding academic, social and political stressors, incorporating mindfulness practice can offer valuable tools to deal with student challenges through improved self-awareness and emotional regulation and mitigate stress associated with trauma or psychological trauma related to war and conflict. Moreover, mindfulness encourages students to adopt positive coping strategies rather than negative ones such as withdrawal or aggressive behavior, and has the potential to decrease students' levels of depression, anxiety, and stress (Serrão, Silva, & Ferreira, 2022 ; Galante et al., 2018 ). Therefore, universities are recommended to incorporate mindfulness training programs into their psychological support strategies for students, to positively influence their mental health and academic performance, especially in a context with high political and social pressures, such as in Palestine. In terms of the link with demographic variables, the Mann-Whitney and kr-skal-Wallis tests (Table 5 ) show no significant difference in the levels of depression, anxiety, and psychological stress by gender or type of kidney (p > .05). This suggests that high psychological stress may be a general and comprehensive state that extends beyond traditional dichotomies such as gender or specialization, and is in line with the logic of societal crises that broadly impact all student groups (Qutishat, 2025 ). The present study's results support some studies that have shown differences by gender or academic discipline in relation to undergraduates' mental health. For example, Ahmad et al. (2024) did not find significant differences in levels of anxiety or depression between male and female Palestinian university students, while Al-Dabbour et al. ( 2025 ) found that female students are more likely to experience mental disorders. International studies have also yielded mixed results; Bayram and Bilgel ( 2008 ) and Dyrbye et al. (2020) indicated that females are at greater risk for anxiety and depression, whereas Ibrahim et al. (2013) found that the reverse is true for males. This variability suggests that local and cultural context, and study conditions, are critical influences on the nature of psychological differences in students. On the other hand, we have found statistically significant differences in the level of depression related to the average academic performance (p = 0.0059) while the levels of anxiety and psychological stress did not show statistically significant differences in relation to the average academic performance. The implication of this result supports some relationship between academic performance and the level of depression; students with the lowest average academic performance exhibited relatively higher levels of depression to the students with higher grades. There are possible explanations in a couple of directions: first, academic stress, failure, or fear of failure might exacerbate feelings of hopelessness, withdrawal, and depression; second, depression may precipitate a decline in academic performance (less concentration, motivation, etc.), which is a bidirectional road. A more comprehensive discussion of these relationship patterns was also noted by Pascoe et al. ( 2020 ) and World Health Organization ( 2022 ) that emphasized the relevant relationship between mental well-being and academic achievement. Because of this bidirectional relationship it emphasizes the value of multi-faceted interventions that access both academic and psychological support concurrently. Future Studies could expand to involving several Palestinian universities to compare the results between different academic environments. Also, using various assessment tools, including in-depth interviews and questionnaires, to measure mental health in more comprehensive ways. Furthermore, study the impact of other socio-political and economic factors such as family and community support, economic situation, and political events on the mental health of students. Finally, applying longitudinal designs to follow the psychological changes of students throughout the academic year and linking them to national and social events. Recommendations Providing qualified and accessible psychological counseling clinics on campus with the aim of promoting mental health services and designing programs to assess and treat depression, anxiety and psychological stress, taking into account cultural specificity. Also link academic counseling with psychological support for students with low rates, because the relationship between GPA and depression indicates a need for dual intervention through integrated academic-psychological support programs. Furthermore, introducing workshops for cognitive-emotional skills (e.g. emotion control, time management, coping techniques), which are supported by the literature of emotional intelligence and transformational learning in higher education contexts. In addition to that, cooperate with community entities, such as establishing partnerships between the University, Health Institutions and non-governmental organizations to secure resources for psychological support during times of crisis. Limitations This study has several limitations that should be considered when interpreting its findings. First, the research was limited to students from the Arab American University, which constrains the external validity and limits the generalizability of the results to students of other Palestinian universities or broader youth populations. Second, the study employed a descriptive-associative design, which does not allow for establishing causal relationships between variables but rather identifies the nature and strength of associations among them. Third, the study relied exclusively on self-reported measures for data collection, which may have introduced response biases, including social desirability effects and potential over- or underestimation of actual psychological states. In addition, the social political climate, occurring contemporaneously with data collection, may have impacted participants' reports of depression, anxiety, and psychological distress in some limit to expansive generalizability of the findings. Finally, the study did not measure other psychological, social, or environmental factors that may contribute to differences in students’ mental health—for example, family support systems, coping skills, or academic resilience—noting that future research using longitudinal or mixed-method designs is required for a more robust understanding of the complicated factors influencing students' mental health. Conclusion The findings of this study show that undergraduate students at the Arab American University are experiencing elevated levels of depression, anxiety and psychological distress, suggesting a challenging mental health context, beyond normal academic stress. While the study did not specifically probe the causes of these conditions, it might include longstanding socio-political struggles, economic hardship, increased academic pressure, and the unavailability of effective psychological support in university settings. This evidence highlights the need for Palestinian universities to as a matter of urgency adopt and implement a coordinated institutional approach towards the promotion of students’ mental health. A coordinated policy includes the development of psychological counseling services and mental health awareness and training programs that are based on emotional intelligence, transformative learning and mindfulness principles. Greater attention to the mental health of university students in the Palestinian context is an investment in human capital that has benefits to learner improvement in experience and quality of learning, better overall learning outcomes and enhanced psychological and social resilience during ongoing contexts of crises. Declarations Ethics approval and consent to participate Ethical approval for the study was obtained from the Institutional Review Board (IRB) of the Arab American University (No. R-2025/A/76/N). The research was conducted in accordance with the ethical standards of the institutional research committee and the principles of the Declaration of Helsinki and its later amendments. All participants were informed of the study objectives and procedures, and written informed consent was obtained prior to participation. Confidentiality and anonymity were strictly maintained throughout the research process, and participants were assured that their data would be used solely for academic purposes. Data availability The datasets used in the current study are available from the corresponding author upon reasonable request. Funding No funding was obtained for this study. Acknowledgements Not applicable. Competing interests The authors declare no competing interests. Consent for publication Not applicable. Contributions MJM. designed the study. MJM. developed the conceptual framework and hypotheses. MJM. collected the data. MJM. performed and interpreted the statistical analysis. 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East Mediterr Health J. 2025;31(2). https://www.emro.who.int/emhj-volume-31-2025/volume-31-issue-2/a-narrative-review-of-mental-health-and-psychosocial-impact-of-the-war-in-gaza.html Arab American University. (n.d.). Facts and figures. Retrieved November 6. 2025, from https://www.aaup.edu/ar/about-university/facts-and-figures Badawi Z, Dabbar H. The level of mental health among university students: A field study on a sample of students from El Oued University. Al-Shamel J Educ Soc Sci. 2023;6(1):9–21. https://dspace.univ-eloued.dz/handle/123456789/30574 . Baghdad M, Al-Ashmawy E. Self-compassion and its relationship to future anxiety resulting from the COVID-19 pandemic in light of some variables among a sample of the Egyptian community. J Qual Educ Res. 2020;(59):261–90. https://search.emarefa.net/detail/BIM-1076689 Barlow DH, editor. Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual. Guilford; 2024. https://www.guilford.com/books/Clinical-Handbook-of-Psychological-Disorders/David-Barlow/9781462547043 . Bayram N, Bilgel N. The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students. Soc Psychiatry Psychiatr Epidemiol. 2008;43(8):667–72. https://doi.org/10.1007/s00127-008-0345-x . Beharu WT. Psychological factors affecting students’ academic performance among freshman psychology students in Dire Dawa University. J Educ Pract. 2018;9(4):59–65. https://files.core.ac.uk/download/pdf/234641371.pdf . Bouhafs T, Azarn J. Mental health and the interpretation of psychological disorders from an Algerian socio-cultural perspective. Dev J. 2023;10(1):225–38. https://search.emarefa.net/detail/BIM-1483227 . Carvalho D, Sequeira C, Querido A, Tomás C, Morgado T, Valentim O, Moutinho L, Gomes J, Laranjeira C. Positive mental health literacy: A concept analysis. Front Psychol. 2022;13:877611. https://doi.org/10.3389/fpsyg.2022.877611 . Carvalho JS, Marques A, Pinto A, Maroco J. Results of a mindfulness-based social-emotional learning program in Portuguese schools. Psicologia. 2017;31(3):1–17. Cho Y, Lee JK, Kim DH, Park JHP. Factors associated with quality of life in patients with depression: A nationwide population-based study. PLoS ONE. 2019;14(1):e0219455. https://doi.org/10.1371/journal.pone.0219455 . Clack S, Ward T. The classification and explanation of depression. Behav Change. 2019;36(1):41–55. https://doi.org/10.1017/bec.2019.4 . El-Khodary B, Aboudagga S. The impact of Gaza war: Online educational challenges and mental health of university students. Middle East Curr Psychiatry. 2025;32:48. https://doi.org/10.1186/s43045-025-00542-w . Fouaghla S, Dhafari Y. Generalized anxiety disorder and its relationship to self-well-being among middle school students. Fac Humanit Soc Sci Dept Psychol. 2024. http://dspace.univ-guelma.dz/jspui/handle/123456789/16184 Galante J, Dufour G, Benton A, Stochl J. A mindfulness-based intervention to increase resilience to stress in university students. Psychol Med. 2018;48(3):1–9. https://doi.org/10.1017/S0033291717002941 . Galderisi S, Heinz A, Kastrup M, Beezhold J, Sartorius N. Toward a new definition of mental health. World Psychiatry. 2015;14(2):231–3. https://doi.org/10.1002/wps.20231 . Ghanim M, Rabayaa M, Atout S, Al-Othman N, Alqub M. Prevalence of anxiety and depression among Palestinian university students: A cross-sectional study during COVID-19 pandemic. Middle East Curr Psychiatry. 2022;29:71. https://doi.org/10.1186/s43045-022-00291-0 . Hamdan M, Zidan S, Al-Amouri F, Niroukh H, Abu Dawod M, Ashour S, Dweik SS, Badrasawi M. Factors associated with caffeine intake among undergraduates: A cross-sectional study from Palestine. J Health Popul Nutr. 2025;44:26. https://doi.org/10.1186/s41043-024-00723-z . Harb S. The structural model of the relationships between mindfulness, satisfaction/frustration of basic psychological needs, flow, and academic pressures among university students. Egypt J Psychol Stud. 2018;28(99):199–298. https://search.mandumah.com/Record/1011260 . Ismail E. Depression symptoms, patterns, causes, and treatment. 3rd ed. Publications Agency; 2018. https://library.alistiqlal.edu.ps/book-8513-7.html Ismail Y, Ismail Y. A study of depression and aggression. Amman: Dar Al-Yazouri Scientific Publishing and Distribution; 2019. https://books.google.ps/books/about/%D8%AF%D8%B1%D8% A7%D8%B3%D8%A7%D8%AA_%D9%81% D9%8A_%D8%A7%D9%84%D8%A5%D9 %83%D8%AA%D8%A2%D8%A8_%D9%88 %D8%A7%D9%84.html?id=HzGnDwAAQBAJ&redir_esc=y Laranjeira C, Querido A. Hope and optimism as an opportunity to improve the positive mental health demand. Front Psychol. 2022;13:827320. https://doi.org/10.3389/fpsyg.2022.827320 . Liasi GA, Nejad SM, Sami N, Khakpour S, Ghorbani Yekta B. The prevalence of educational burnout, depression, anxiety, and stress among medical students of the Islamic Azad University in Tehran, Iran. BMC Med Educ. 2021;21:471. https://doi.org/10.1186/s12909-021-02874-7 . Maheria K. The repercussions of the COVID-19 crisis and quarantine on individual mental health. Arab J Lit Hum Stud. 2021;5(16):467–90. https://search.emarefa.net/detail/BIM-1029688 . Mukhtar A. Factor structure of the psychological pressure scale among a sample of secondary school students. Educ 21st Century J Educ Psychol Stud. 2023;25227–54. 10.21608/jsep.2023.292199 . Noreen S, Ghayas S, Khalid S, Awan ASM. Construction and validation of academic stress scale for university students. Pak J Educ. 2021;38(2):1–24. https://doi.org/10.30971/pje.v38i1.632 . Osborn TG, Li S, Saunders R, Fonagy P. University students’ use of mental health services: A systematic review and meta-analysis. Int J Ment Health Syst. 2022;16:57. https://doi.org/10.1186/s13033-022-00569-0 . Pascoe MC, Hetrick SE, Parker AG. The impact of stress on students in secondary school and higher education. Int J Adolesc Youth. 2020;25(1):104–12. https://doi.org/10.1080/02673843.2019.1596823 . Preston JD, O'Neal JH, Talaga MC, Moore BA. Handbook of Clinical Psychopharmacology for Therapists, 9th Edition; 2021. https://stars.library.ucf.edu/etextbooks/368 Qutishat M. Mental health in Gaza: Addressing sustainability challenges of ongoing war conflict. Middle East Curr Psychiatry. 2025;32:27. https://doi.org/10.1186/s43045-025-00520-2 . Royal College of Psychiatrists. Mental health of students in higher education (College Report CR166). London. 2021. https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/college-reports/college-report-cr166.pdf Sabbah SS, Yacoub Z, Yacoub H, Yacoub R, Holden RR. A cross-sectional study of psychache and coping strategies and therapeutic approaches among Palestinian university students during the Gaza Israeli war. Sci Rep. 2025;15:20553. https://doi.org/10.1038/s41598-025-03998-2 . Salik I, Marwaha R. Electroconvulsive therapy. StatPearls. StatPearls Publishing; 2022. Serrão C, Silva J, Ferreira J. The effects of a mindfulness-based program on higher education students’ mental health. Front Educ. 2022;7:985204. https://doi.org/10.3389/feduc.2022.985204 . United Nations. Sustainable Development Goals: Goal 3 – Ensure healthy lives and promote well-being for all at all ages. https://sdgs.un.org/goals ; 2015. White MA, Venkataraman A, Roehrig A, Whelan HS. Evaluation of a behavioral self-care intervention administered through a massive open online course. Am J Health Educ. 2021;52(4):233–40. https://doi.org/10.1080/19325037.2021.1930616 . World Health Organization. WHO menu of cost-effective interventions for mental health. Geneva: WHO; 2021. https://www.who.int/publications/i/item/9789240031081 . World Health Organization. World mental health report: Transforming mental health for all. Geneva: WHO; 2022. https://www.who.int/publications/i/item/9789240049338 . World Health Organization, Geneva. Depression. WHO; 2023. https://www.who.int/ar/news-room/fact-sheets/detail/depression . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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1","display":"","copyAsset":false,"role":"figure","size":58636,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eDistribution of depression levels among students at the Arab American University\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8059263/v1/a187fe174b3dc4379f1bb5db.png"},{"id":98107137,"identity":"135f4329-bac3-4cec-94ec-465168ca25e5","added_by":"auto","created_at":"2025-12-13 00:21:30","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":59901,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eDistribution of anxiety levels among students at the Arab American University\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-8059263/v1/061181d377cda846b9997840.png"},{"id":98107140,"identity":"91a96ecb-f5a5-40ab-92e8-aa4da26bfd24","added_by":"auto","created_at":"2025-12-13 00:21:30","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":56244,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eDistribution of stress levels among students at the Arab American University\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-8059263/v1/383450b658e226f3de132da4.png"},{"id":109566908,"identity":"e1575198-ac9d-4f08-ac13-bc81a841389e","added_by":"auto","created_at":"2026-05-19 15:18:21","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":435141,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8059263/v1/aaf1e2f8-b3b6-4fed-8569-112c6c511ad8.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Mental Health During Societal Crisis: Anxiety, Depression, and Stress among Students at the Arab American University ","fulltext":[{"header":"Background","content":"\u003cp\u003eUniversity life serves as a significant shift in a student\u0026apos;s personal development and academic context. This stage of development is distinctly different from school life because it requires independent thinking, advanced methods of studying, and many students will be engaging socially more than they have during their lives. \u0026nbsp;Each student articulates their own hopes and dreams and a student will need to think what hopes and dreams are going to coalesce with the skills obtained to achieve academic and personal success. There are many different experiences that students will have during this time in their lives (both positive and negative) all directed at testing their ability to adapt, engage with others, and grow resilient. The ability to feel happy and satisfied and to make sound decisions will be essential parts of the university experience. All of these feelings are highly correlated to academic success and general mental well-being (Badawi \u0026amp; Dabbar, 2023). In this context, and as an important aspect of university life, is the idea of mental health as a part of students\u0026rsquo; lives. Mental health is described as a dynamic state of being, which basically reflects the person\u0026rsquo;s ability to cope with stress and to maintain psychological balance (Galderisi et al., 2015). Sound mental health improves productivity, learning, and social development. On the other hand, poor mental health reduces performance and increases anxiety, depression, and stress (Royal College of Psychiatrists, 2021). Not surprisingly, the United Nations noticed this as well and included mental health under the Sustainable Development Goals for \u0026ldquo;Good Health and Well-being\u0026rdquo; in 2015 because addressing mental health is important all over the world in resilient societies.\u003c/p\u003e\n\u003cp\u003eRecent research suggests that the extent of psychological distress in Palestinian university students is shocking. Ahmad et al. (2024) found that the prevalence of depressive symptoms among students attending Al-Quds, Hebron, and Najah universities was 65.9% while 60.9% of students reported anxiety. Al-Dabbour et al. (2025) also reported high levels of depression, stress, sleep impairment, and dissatisfaction with life among medical students in Gaza. Amro (2024) found PTSD and anxiety in nursing students at Palestine Polytechnic University, while Ghanim et al. (2022) reported moderate to severe psychological symptoms after COVID-19 that interfered with students\u0026apos; academic participation and daily functioning. In the recent 2023 Gaza war, Amro et al. (2025) found PTSD among Al-Quds University students that related to violent invasion, displacement, and social disintegration. El-Khodary and Aboudagga (2025) also reported that academic stressors (e.g., unstable internet, electricity supply, and limited online access) significantly predicted depression and anxiety symptoms among medical students in Gaza.\u003c/p\u003e\n\u003cp\u003eResearch constantly confirms the cumulative effect of crises on Palestinian students\u0026rsquo; wellbeing. According to Sabbah et al. (2025), approximately 40% of West Bank students experienced average \u0026ldquo;psychache\u0026rdquo; or moderate psychological pain. Qutishat (2025) stated that instability, conflict, and disruption all contribute to students\u0026apos; threatening psychological sustainability, or wellbeing. Aqtam (2025) reported rates of depression at 45%, and anxiety at 37%, with participants often reporting symptoms resembling PTSD. According to Hamdan et al. (2025), 23.1% of medical students experienced moderate to severe depression and 46.8% exhibited increased anxiety. Mental health, then, is an important indicator of a person\u0026rsquo;s ability to balance responsibilities, foster relationships, and seek to reach goals. In university contexts, mental health has consequences on attention, perseverance, and making choices; mental health concerns can negatively impact the student experience and has also been correlated with attrition and dropping out (Osborne et al., 2022; Pascoe et al., 2020; World Health Organization, 2022). As the World Health Organization (2022) notes, \u0026ldquo;The mental health of undergraduates is one of the main determinants of the quality of higher education and the success of students.\u0026rdquo;\u003c/p\u003e\n\u003cp\u003eConceptually, mental health has been defined from a variety of perspectives. Bouhafs and Azarn (2023) noted, based on Adolf Meyer\u0026rsquo;s theory of mental health, it is the capacity to adapt to external conditions and stagnate the development of disorders by exhibiting healthy social and personal behaviors. Al-Qas and Ben Ghadhafa (2022, p.664) defined it as an ability to cope effectively with everyday challenges, while Maheria (2021) associated mental health to being in psychological harmony and inner peace. Positive mental health arises from many characteristics, including hope, goal setting, emotional regulation, and social support (Laranjeira \u0026amp; Querido, 2022; Carvalho et al, 2022; Sinera-Monge et al., 2023; An Dong et al., 2023).\u003c/p\u003e\n\u003cp\u003eAnxiety, depression, and academic stress are among the most prevalent mental health concerns in higher education. Anxiety, a normal reflex to perceived danger, can develop into chronic disorder when anxiety becomes persistent, resulting in fear, apprehension, insomnia, and muscle tension (Fouaghla \u0026amp; Dhafari, 2024; Barlow, 2024; Preston et al., 2021; Al-Bahnasawy et al., 2023; Al-Zahrani \u0026amp; Al-Enezi, 2022; Baghdad \u0026amp; Al-Ashmawy, 2020; Al-Sahtoohi, 2020). Chronic anxiety may stem from psychological factors, including negative thought patterns (Al-Jabali, 2016), chronic stress (Rayan, 2020), and health-related issues (Al-Saadoun, 2017). Depression is considered to frequently follow anxiety and is characterized by sadness, social withdrawal, and loss of interest (Salik \u0026amp; Marwaha, 2022; Clack \u0026amp; Ward, 2019; World Health Organization, 2021). In its mood disorder form, it may be accompanied by emotional, cognitive, and physiological symptoms, which may include fatigue, hopelessness, guilt, and suicidal ideation (Ismail, 2018; World Health Organization, 2023; Cho et al., 2019; Ismail \u0026amp; Ismail, 2019; Ormel, Kessler \u0026amp; Schoevers, 2019; Abu Al-Nour et al., 2020; Al-Sayed \u0026amp; Sabri, 2022). Academic stress, on the other hand, is when a student receives internal and external pressure related to their college course work, exams, and performance (Al-Qarala \u0026amp; Al-Horai, 2024; Mukhtar, 2023; American Psychological Association, 2020). It presents itself physically, psychologically, and behaviorally and is often compounded by societal, familial, and financial pressures (Beharu, 2018; White et al., 2021; Noreen et al., 2021; Harb, 2018).\u003c/p\u003e\n\u003cp\u003eThese findings underscore the necessity of examining mental health in the context of broader societal crises in Palestine, specifically among students at Arab American University. Understanding the levels of anxiety, depression, and stress among Arab American University students can further enhance our understanding of the educational and psychological difficulties, and may help inform appropriate campus-based interventions and systems of support. \u0026nbsp;As such, the aim of this study is to describe the dimensions of mental health amongst Arab American University students for the purpose of producing some evidence to both contribute to the literature and inform stakeholders in Palestinian higher education in developing policy and programs that support resilience and well-being for students.\u003c/p\u003e\n\u003cp\u003eThis study seeks to address the following questions:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eWhat are the levels of mental health challenges\u0026mdash;specifically depression, anxiety, stress\u0026mdash;among undergraduate students at the Arab American University? \u0026nbsp;\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eAre there any statistically significant associations between demographic variables and the level of depression, anxiety, and stress?\u0026nbsp;\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Methods","content":"\u003ch3\u003e\u003cstrong\u003eStudy Design and Procedure\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eThis research employed a quantitative, cross-sectional design explore the prevalences of depression, anxiety, and stress among undergraduate students and their associations with demographic factors as well as academic performance. Data was collected through a structured self-administered questionnaire distributed both electronically and in paper form across various faculties of the Arab American University (between March 2025 to September 2025). Out of all distributed questionnaires, 384 valid responses were obtained after excluding incomplete or inconsistent entries.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Population and Sample\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe population for this study was all undergraduate students attending Arab American University, which had a total of 11,618 students according to official university data (Arab American University, n.d). The sample for this study was composed of 384 male and female undergraduate students using a convenience sampling method. While the sample size needed to obtain the proportion for a total population of 11,618 students at a confidence level of 95%, with a margin of error of 5%, and a 50% response distribution was 372, the researcher sought responses from 384 students to increase the reliability of the findings.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Collection Instrument\u003c/strong\u003e\u003c/p\u003e\n\u003ch4\u003e\u003cstrong\u003eMental Health Scale\u003c/strong\u003e\u003c/h4\u003e\n\u003cp\u003eThe assessment consisted of two sections. The first section gathered demographic information including grade point average (GPA), gender, and faculty type to make comparisons across different groups.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The second part gauged depression, anxiety, and stress levels using the Depression, Anxiety and Stress Scale (DASS-42) created by Liasi et al. (2021). The scale comprised 42 items that were equally distributed among the three sub-scales, 14 items each for Depression, Anxiety, and Stress. Responses were measured using a five-point Likert scale (1 = Never, 2 = Rarely, 3 = Sometimes, 4 = Often, 5 = Almost Always). Higher scores indicate greater severity of symptoms. Following the classification proposed by Liasi et al. (2021), the interpretation of total scores for each DASS-42 subscale was as follows:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eDepression:\u003c/strong\u003e 0\u0026ndash;9 (Normal), 10\u0026ndash;13 (Mild), 14\u0026ndash;20 (Moderate), 21\u0026ndash;27 (Severe), 28+ (Extremely severe)\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eAnxiety:\u003c/strong\u003e 0\u0026ndash;7 (Normal), 8\u0026ndash;9 (Mild), 10\u0026ndash;14 (Moderate), 15\u0026ndash;19 (Severe), 20+ (Extremely severe)\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eStress:\u003c/strong\u003e 0\u0026ndash;14 (Normal), 15\u0026ndash;18 (Mild), 19\u0026ndash;25 (Moderate), 26\u0026ndash;33 (Severe), 34+ (Extremely severe)\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eContent Validity\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe content validity of the DASS-42 Arabic version was established by a group of four experts from An-Najah National University in the fields of psychology and education. Each expert reviewed all items for clarity, relevance, and cultural appropriateness. All experts suggested minor modifications to the wording, and the agreed upon alterations were made. The final version of the DASS-42 was deemed to be a valid assessment to use in the Palestinian context.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eReliability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo determine internal consistency, the DASS-42 was piloted among a small group of undergraduate students who were not part of the study sample. Cronbach\u0026rsquo;s alpha coefficients indicated acceptable reliability levels for the three sub-scales: Depression (\u0026alpha; = .79), Anxiety (\u0026alpha; = .76), and Stress (\u0026alpha; = .80). The overall reliability coefficient for the entire scale was \u0026alpha; = .78, providing evidence that the instrument had acceptable internal consistency for research use.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Data Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were analyzed using SPSS version 26. Descriptive statistics (frequencies and percentages) were used to summarize participants\u0026rsquo; characteristics. As the data were not normally distributed, Mann-Whitney U and Kruskal-Wallis H tests were employed to examine levels of depression, anxiety, and stress across gender, faculty type, and GPA.\u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e\u003ch2\u003eDemographic Variables among Students\u003c/h2\u003e\u003cp\u003eThe participants according to their demographic characteristics. As shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, the sample consisted of 384 undergraduate students at the Arab American University, of whom 46.88% females and 53.12% were males. Regarding the type of faculties, the largest proportion of participants were enrolled in literary faculties 54.95% and 45.05% in scientific faculties. In terms of GPA, most students (35.42%) had a GPA ranging between 3.00-3.66, while 29.43% scored between 4.00-3.67, and 26.04% between 2.33\u0026ndash;2.99. Only 9.11% of students had a score between 2.00-2.32.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePercentages and frequencies based on demographic variables among students\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDemographic Variables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePercentage\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003eGPA\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2.00-2.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9.11%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2.33\u0026ndash;2.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e26.04%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3.00-3.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e35.42%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e136\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4.00-3.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e29.43%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e113\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e100.0%\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e384\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eType of Faculties\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLiterary faculties\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e54.95%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e211\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eScientific faculties\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e45.05%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e173\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e100.0%\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e384\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e53.12%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e204\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e46.88%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e180\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e100.0%\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e384\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThis study examined the levels of depression among students at the Arab American University. As shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, the majority of students suffer from very high levels of depression, as the percentage of those suffering from very severe depression (Extremely Severe) reached 67.45%, followed by the category of severe depression by 25.26%, while the lowest percentages were among the moderate 5.73% and mild 1.04% categories, while the percentage of normal was only 0.52%. These results indicate a very high prevalence of depression among students.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDescriptive Statistics of Depression Levels among Students\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eThe Level of Depression\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercentage\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNormal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.52%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMild\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.04%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eModerate\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5.73%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSevere\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e25.26%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eExtremely severe\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e259\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e67.45%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e384\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe levels of depression were analyzed to identify general trends among students. Figure\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e illustrates the overall levels of depression among the participants.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThis study examined the levels of anxiety among students at the Arab American University. As shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, very severe anxiety is the most prevalent among students at 89.84%, followed by severe anxiety at 4.95%, moderate anxiety at 4.17%, while the rate of mild was 1.04%, and no case was recorded in the normal category. These results indicate that anxiety levels in students are very high and constitute a worrying phenomenon.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDescriptive Statistics of Anxiety Levels among Students\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eThe Level of Anxiety\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercentage\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNormal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMild\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.04%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eModerate\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.17%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSevere\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.95%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eExtremely severe\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e345\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e89.84%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e384\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe levels of anxiety were analyzed to identify general trends among students. Figure\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e illustrates the overall levels of anxiety among the participants.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThis study examined the levels of stress among students at the Arab American University. As shown in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e, the percentage of students suffering from severe psychological stress reached 44.92%, followed by the category of very severe stress by 32.03%, while the moderate percentage was 14.32%, mild 4.69%, and normal only 1.04%. This suggests that the psychological pressure among students is high and requires special attention from the university administration.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDescriptive Statistics of Stress Levels among Students\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eThe Level of Stress\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercentage\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNormal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.04%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMild\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.69%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eModerate\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14.32%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSevere\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e184\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e44.92%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eExtremely severe\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e123\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e32.03%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e384\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe levels of stress were analyzed to identify general trends among students. Figure\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e illustrates the overall levels of stress among the participants.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThis study examined the statistical significant associations between demographic variables and the level of depression, anxiety, and stress. As shown in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e, there were no significant differences in the levels of depression, anxiety, and psychological stress depending on gender or type of college, where the p-value values for all of them were greater than 0.05. While it was found that there were significant differences in the level of depression according to the GPA, where the value was (p\u0026thinsp;=\u0026thinsp;0.0059), in favor of students with high rates who showed lower levels of depression compared to their peers with low rates. As for anxiety and psychological stress, the results did not show significant differences depending on the GPA.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eMann-Whitney U and Kruskal-Wallis H test results for DASS-42 scale by gender, type of facilities, and GPA\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eDepression\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003eAnxiety\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003eStress\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eP Value.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eP Value.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eP Value.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eFemale\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e73.93%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.4982\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e74.33%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.5916\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e74.09%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.2483\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMale\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e74.83%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e73.58%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e75.48%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eType of facilities\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eScientific faculties\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e74.31%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.8945\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e73.20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.3464\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e74.18%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.3334\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eLiterary faculties\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e74.49%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e74.53%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e75.36%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e\u003cb\u003eGPA\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e2.00-2.32\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e68.57%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.0059\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e74.75%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.2203\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e74.98%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.6979\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e2.33\u0026ndash;2.99\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e73.23%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e74.94%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e75.66%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e3.00-3.66\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e76.72%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e74.87%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e75.05%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e4.00-3.67\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e74.49%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e71.65%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e73.79%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"8\"\u003eSignificant at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussions","content":"\u003cp\u003eThe findings reveal a concerning and high frequency of mental health issues among the AAU student population, as evidenced by the high proportion (very high) of the most severe level for the DASS-42 scale, including: depression (Extreme severe) 67.45% and/or severe by 25.26%; very severe anxiety 89.84%; severe mental distress 44.92% and very severe mental distress 32.03 (see Tables\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). The findings clearly suggest that there is a serious psychological burden among the sample (n\u0026thinsp;=\u0026thinsp;384), which represents a real challenge for higher education institutions to provide mental health services and develop prevention strategies effectively.\u003c/p\u003e\u003cp\u003eThe high levels of psychological distress are consistent with previous studies conducted in the Palestinian context; for example, Ahmad and colleagues (2024), reported that Palestinian university students had a high prevalence of depression (65.9%) and anxiety (60.9%). Other studies have also documented high levels of depression, anxiety, and mental disorders in Gaza and the West Bank in student populations (Al-Dabbour et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Amro, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Ghanim et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Amro et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). Therefore, our findings suggest that the Arab American University, like other universities, is experiencing increasing psychological pressures among Palestinian students within a deteriorating social political context, which has academic loads and expectations.\u003c/p\u003e\u003cp\u003eSeveral interrelated factors may contribute to the elevated levels of anxiety, depression, and psychological stress. Specifically, these findings correlate with the cumulative psychological effects of the crises (Sabbah et al., \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Qutishat, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e2025\u003c/span\u003e), disruptions in educational infrastructures and limited resources (El-Khodary \u0026amp; Aboudagga, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2025\u003c/span\u003e), and psychological and economic personal pressure (Al-Qarala \u0026amp; Al-Horai, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Noreen et al., \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Local studies have highlighted that such issues as frequent power cuts, limited access to the internet, and exposure to violence or displacement have an overall impact on the mental health of students (Amro et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; El-Khodary \u0026amp; Aboudagga, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2025\u003c/span\u003e), factors that may help elucidate the results found in our sample, where we identified extreme percentages.\u003c/p\u003e\u003cp\u003eNevertheless, these findings can be viewed in the context of the singular Palestinian reality that is characterized by the intersection of continuously occurring political, social and economic crises. The war on Gaza, along with the resulting physical and psychological violence, loss of security and collective anxiety for the future, clearly impacted the mental health of university youth, even in areas unaffected by these bombings. Amro et al. (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2025\u003c/span\u003e) noted an increase in symptoms of post traumatic stress disorder (PTSD) among al-Quds university students during the aggressions on Gaza due to being exposed to violence, displacement and ongoing destruction.\u003c/p\u003e\u003cp\u003eStudents\u0026rsquo; frustration and psychological stress were further exacerbated by the combination of challenging economic conditions and similarly high unemployment rates among graduates as many students feel their academic efforts do not yield promised stable futures. This aligns with the conclusion of the Qutishat study in 2025, which stated social and economic instability was posed as direct threats to the mental health and academic sustainability of students at West Bank universities. Moreover, the social restrictions, struggle with educational infrastructure and psychological support in Palestinian universities added their own vulnerabilities to increase students' academic and personal pressure. Sabbah et al. (\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2025\u003c/span\u003e), for example, have observed that \"approximately 40% of students from Palestine indicate moderate psychological pain due to limited effective support networks in their university environments.\"\u003c/p\u003e\u003cp\u003eAs such, the current results not only point to the existence of Mental Disorders at an individual level, but also reflect a collective structural phenomenon within the Palestinian context around a set of recurring crises, weak psychosocial protection frameworks, and a lack of institutional policies that consider mental health in higher education.\u003c/p\u003e\u003cp\u003eAs demonstrated by the results of the current study, mindfulness can be viewed as one of the effective therapeutic interventions to improve the mental wellbeing of college students experiencing high levels of depressive symptomology, anxiety and psychological stress. Research has documented that incorporating mindfulness practice can help participants enhance awareness of the present moment, regulate emotions, and reduce immediate reactivity to psychological stress (Galante et al., \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Serr\u0026atilde;o, Silva \u0026amp; Ferreira, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Studies examining mindfulness amongst college students report that implementation of mindfulness programs assists college students to experience lower levels of anxiety and depressive symptomology, increased attention or concentration and improved psychological resilience (Carvalho, Marques, Pinto \u0026amp; Maroco, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Laranjeira \u0026amp; Querido, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eGiven the complex Palestinian environment where students experience compounding academic, social and political stressors, incorporating mindfulness practice can offer valuable tools to deal with student challenges through improved self-awareness and emotional regulation and mitigate stress associated with trauma or psychological trauma related to war and conflict.\u003c/p\u003e\u003cp\u003eMoreover, mindfulness encourages students to adopt positive coping strategies rather than negative ones such as withdrawal or aggressive behavior, and has the potential to decrease students' levels of depression, anxiety, and stress (Serr\u0026atilde;o, Silva, \u0026amp; Ferreira, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Galante et al., \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Therefore, universities are recommended to incorporate mindfulness training programs into their psychological support strategies for students, to positively influence their mental health and academic performance, especially in a context with high political and social pressures, such as in Palestine.\u003c/p\u003e\u003cp\u003eIn terms of the link with demographic variables, the Mann-Whitney and kr-skal-Wallis tests (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e) show no significant difference in the levels of depression, anxiety, and psychological stress by gender or type of kidney (p\u0026thinsp;\u0026gt;\u0026thinsp;.05). This suggests that high psychological stress may be a general and comprehensive state that extends beyond traditional dichotomies such as gender or specialization, and is in line with the logic of societal crises that broadly impact all student groups (Qutishat, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). The present study's results support some studies that have shown differences by gender or academic discipline in relation to undergraduates' mental health. For example, Ahmad et al. (2024) did not find significant differences in levels of anxiety or depression between male and female Palestinian university students, while Al-Dabbour et al. (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2025\u003c/span\u003e) found that female students are more likely to experience mental disorders. International studies have also yielded mixed results; Bayram and Bilgel (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2008\u003c/span\u003e) and Dyrbye et al. (2020) indicated that females are at greater risk for anxiety and depression, whereas Ibrahim et al. (2013) found that the reverse is true for males. This variability suggests that local and cultural context, and study conditions, are critical influences on the nature of psychological differences in students.\u003c/p\u003e\u003cp\u003eOn the other hand, we have found statistically significant differences in the level of depression related to the average academic performance (p\u0026thinsp;=\u0026thinsp;0.0059) while the levels of anxiety and psychological stress did not show statistically significant differences in relation to the average academic performance. The implication of this result supports some relationship between academic performance and the level of depression; students with the lowest average academic performance exhibited relatively higher levels of depression to the students with higher grades. There are possible explanations in a couple of directions: first, academic stress, failure, or fear of failure might exacerbate feelings of hopelessness, withdrawal, and depression; second, depression may precipitate a decline in academic performance (less concentration, motivation, etc.), which is a bidirectional road. A more comprehensive discussion of these relationship patterns was also noted by Pascoe et al. (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) and World Health Organization (\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) that emphasized the relevant relationship between mental well-being and academic achievement. Because of this bidirectional relationship it emphasizes the value of multi-faceted interventions that access both academic and psychological support concurrently.\u003c/p\u003e\u003cp\u003eFuture Studies could expand to involving several Palestinian universities to compare the results between different academic environments. Also, using various assessment tools, including in-depth interviews and questionnaires, to measure mental health in more comprehensive ways. Furthermore, study the impact of other socio-political and economic factors such as family and community support, economic situation, and political events on the mental health of students. Finally, applying longitudinal designs to follow the psychological changes of students throughout the academic year and linking them to national and social events.\u003c/p\u003e"},{"header":"Recommendations","content":"\u003cp\u003eProviding qualified and accessible psychological counseling clinics on campus with the aim of promoting mental health services and designing programs to assess and treat depression, anxiety and psychological stress, taking into account cultural specificity. Also link academic counseling with psychological support for students with low rates, because the relationship between GPA and depression indicates a need for dual intervention through integrated academic-psychological support programs. Furthermore, introducing workshops for cognitive-emotional skills (e.g. emotion control, time management, coping techniques), which are supported by the literature of emotional intelligence and transformational learning in higher education contexts. In addition to that, cooperate with community entities, such as establishing partnerships between the University, Health Institutions and non-governmental organizations to secure resources for psychological support during times of crisis.\u003c/p\u003e"},{"header":"Limitations","content":"\u003cp\u003eThis study has several limitations that should be considered when interpreting its findings. First, the research was limited to students from the Arab American University, which constrains the external validity and limits the generalizability of the results to students of other Palestinian universities or broader youth populations. Second, the study employed a descriptive-associative design, which does not allow for establishing causal relationships between variables but rather identifies the nature and strength of associations among them. Third, the study relied exclusively on self-reported measures for data collection, which may have introduced response biases, including social desirability effects and potential over- or underestimation of actual psychological states. In addition, the social political climate, occurring contemporaneously with data collection, may have impacted participants' reports of depression, anxiety, and psychological distress in some limit to expansive generalizability of the findings. Finally, the study did not measure other psychological, social, or environmental factors that may contribute to differences in students\u0026rsquo; mental health\u0026mdash;for example, family support systems, coping skills, or academic resilience\u0026mdash;noting that future research using longitudinal or mixed-method designs is required for a more robust understanding of the complicated factors influencing students' mental health.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe findings of this study show that undergraduate students at the Arab American University are experiencing elevated levels of depression, anxiety and psychological distress, suggesting a challenging mental health context, beyond normal academic stress. While the study did not specifically probe the causes of these conditions, it might include longstanding socio-political struggles, economic hardship, increased academic pressure, and the unavailability of effective psychological support in university settings.\u003c/p\u003e\u003cp\u003eThis evidence highlights the need for Palestinian universities to as a matter of urgency adopt and implement a coordinated institutional approach towards the promotion of students\u0026rsquo; mental health. A coordinated policy includes the development of psychological counseling services and mental health awareness and training programs that are based on emotional intelligence, transformative learning and mindfulness principles.\u003c/p\u003e\u003cp\u003eGreater attention to the mental health of university students in the Palestinian context is an investment in human capital that has benefits to learner improvement in experience and quality of learning, better overall learning outcomes and enhanced psychological and social resilience during ongoing contexts of crises.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for the study was obtained from the Institutional Review Board (IRB) of the Arab American University (No. R-2025/A/76/N). The research was conducted in accordance with the ethical standards of the institutional research committee and the principles of the Declaration of Helsinki and its later amendments. All participants were informed of the study objectives and procedures, and written informed consent was obtained prior to participation. Confidentiality and anonymity were strictly maintained throughout the research process, and participants were assured that their data would be used solely for academic purposes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used in the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was obtained for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eContributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMJM. designed the study. MJM. developed the conceptual framework and hypotheses. MJM. collected the data. MJM. performed and interpreted the statistical analysis. MJM, MAM. reviewed the manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAbu Al-Nour M, Khereiba S, Abdel Fattah A, Ahmed M, Psychiatry. Theory and practice. Mirna Publishing; 2020. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://rushd.sa/products/الطب-النفسي-النظرية-والممارسة-psy-chiatry-theory-practic\u003c/span\u003e\u003cspan address=\"https://rushd.sa/products/الطب-النفسي-النظرية-والممارسة-psy-chiatry-theory-practic\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAhmead M, El Sharif N, Abuiram I, Alshawish E, Dweib M. Depression, anxiety and coping strategies among Palestinian university students during political violence: A cross-sectional study. 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Geneva: WHO; 2022. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/publications/i/item/9789240049338\u003c/span\u003e\u003cspan address=\"https://www.who.int/publications/i/item/9789240049338\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization, Geneva. Depression. WHO; 2023. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/ar/news-room/fact-sheets/detail/depression\u003c/span\u003e\u003cspan address=\"https://www.who.int/ar/news-room/fact-sheets/detail/depression\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Mental health, Depression, Anxiety, Stress, University Students, Academic Performance","lastPublishedDoi":"10.21203/rs.3.rs-8059263/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8059263/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eUniversity represents an important transition phase of development for students that requires independent thinking, advanced learning strategies and social interactions. Undergraduate mental health is a key contributing component to academic success, mental health and social adjustment. This is magnified in the context of Palestinian undergraduates due to ongoing societal challenges including, political instability, war, armed conflict and economic stressors. This research has examined the levels of depression, anxiety and psychological stress among Arab American university students during this time.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA cross sectional quantitative design was used to examine the prevalences of depression, anxiety and stress. The participants included 384 students enrolled at the Arab American University during the time from March 2025 to September 2025, from various academic disciplines, using the Depression, Anxiety and Stress Scale (DASS-42). Furthermore, the Mann-Whitney U and Kruskal-Wallis H tests were utilized to assess differences in levels of depression, anxiety, and stress by gender, faculty type, and grade point average.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe majority of students were found to be suffering from severe and very severe levels of depression (92.71%) and anxiety (94.79%) as well as high psychological stress (76.95%). There is a significant association between the level of depression and student's academic performance (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). However, there are no significant differences between sexes or fields of study.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eThe study found a high prevalence of depression, anxiety, and stress among students, indicating that mental health problems are common among the academic population. The results highlight the importance of early recognition and treatment to support students\u0026rsquo; mental health. While the present study did not examine the cause of these mental health problems, the potential source may be related to the ongoing socio-political issues in the context of the Palestinian population.\u003c/p\u003e","manuscriptTitle":"Mental Health During Societal Crisis: Anxiety, Depression, and Stress among Students at the Arab American University ","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-13 00:21:26","doi":"10.21203/rs.3.rs-8059263/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"857cc023-a86b-4543-8799-d8ff3369183a","owner":[],"postedDate":"December 13th, 2025","published":true,"recentEditorialEvents":[{"type":"decision","content":"Withdrawn","date":"2026-05-20T08:11:01+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-05-19T15:18:03+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-13 00:21:26","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8059263","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8059263","identity":"rs-8059263","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}