High levels of anxiety and psychological well-being in college students: A dual factor model of mental health approach

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Katherine Carver
Hajar Ismail
Christopher Reed
Justin Hayes
Haifa Alsaif
Marisa Villanueva
Sarah Sass


Anxiety, dual-factor model, life satisfaction, psychological well-being


Anxiety disorders are prevalent among college students and contribute to problems in social and academic functioning. The primary focus in the anxiety literature has been on symptoms and deficits in functioning rather than psychological well-being. The present study investigated the extent to which high levels of anxiety co-occurred with self-reported psychological well-being using a dual-factor model of mental health approach. Participants (n = 100) were categorized into two groups (high anxiety crossed with low and high life satisfaction), and groups were compared on several psychological well-being indicators. Supporting a dual-factor approach, students reporting high levels of anxiety and life satisfaction reported higher levels of hope, grit, gratitude, self-focused positive rumination, and savoring of positive emotions than students reporting high levels of anxiety and low levels of life satisfaction. Groups did not differ in emotion-focused positive rumination or in dampening of positive emotion. These results highlight well-being heterogeneity within individuals reporting high levels of anxiety, with implications for treatment and prevention efforts.


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Abubakar, A., van de Vijver, F., Alonso-Arbiol, I., He, J., Adams, B., Aldhafri, S., Aydinli-Karakulak, A., Arasa, J., Boer, D., Celenk, O., Dimitrova, R., Ferreira, M., Fischer, R., Mbebeb, F., Frías, M., Fresno, A., Gillath, O., Harb, C., ...Tair, E. (2016). Measurement invariance of the Brief Multidimensional Student’s Life Satisfaction Scale among adolescents and emerging adults across 23 cultural contexts. Journal of Psychoeducational Assessment, 34(1), 28-38. https://doi.org/10.1177/ 0734282915611284
Albee, G. W. (1998). Fifty years of clinical psychology: Selling our soul to the devil. Applied and Preventive Psychology, 7(3), 189-194. https://doi.org/10.1016/S0962-1849(05)80021-6
Auerbach, R. P., Alonso, J., Axinn, W. G., Cuijpers, P., Ebert, D. D., Green, J. G., Hwang, I., Kessler, R. C., Liu, H., Mortier, P., Nock, M. K., Pinder-Amaker, S., Sampson, N. A., Aguilar-Gaxiola, S., Al-Hamzawi, A., Anrade, L. H., Benjet, C., Caldas-de-Almeida, J. M., Florescu, S., ... Bruffaerts, R. (2016). Mental disorders among college students in the World Health Organization World Mental Health Surveys. Psychological Medicine, 46(14), 2955-2970. https://doi.org//10.1017/S0033291716001665
Arnau, R. C., Rosen, D. H., Finch, J. F., Rhudy, J. L., & Fortunato, V. J. (2007). Longitudinal effects of hope on depression and anxiety: A latent variable analysis. Journal of Personality, 75(1), 43-64. https://doi.org//10.1111/j.1467-6494.2006.00432.x
Barlow, D.H., & Craske, M.G. (2006). Mastery of your anxiety and panic: Workbook. 4th ed. Oxford University Press.
Behar, E., Alcaine, O., Zuellig, A. R., & Borkovec, T. D. (2003). Screening for generalized anxiety disorder using the Penn State Worry Questionnaire: A receiver operating characteristics analysis. Journal of Behavior Therapy and Experimental Psychiatry, 34(1), 25–43. https://doi.org//10.1016/S0005-7916(03)00004-1
Blanco, C., Okuda, M., Wright, C., Hasin, D. S., Grant, B. F., Liu, S.-M., & Olfson, M. (2008). Mental health of college students and their non-college-attending peers: Results from the National Epidemiologic Study on Alcohol and Related Conditions. Archives of General Psychiatry, 65(12), 1429–1437. https://doi.org//10.1001/archp syc.65.12.1429
Bosley, H. G., Fisher, A. J., & Taylor, C. B. (2018). Differential responses of positive affect, negative affect, and worry in CBT for generalized anxiety disorder: A person-specific analysis of symptom course during therapy. Psychotherapy Research, 28(4), 630-642. https://doi.org//10.1080/10503307 .2016.1233366
Bourland, S. L., Stanley, M. A., Snyder, A. G., Novy, D. M., Beck, J. G., Averill, P. M., & Swann, A. C. (2000). Quality of life in older adults with generalized anxiety disorder. Aging & Mental Health, 4(4), 315–323. https://doi.org//10.108 0/713649960
Bryant, F. (2003). Savoring Beliefs Inventory (SBI): A scale for measuring beliefs about savouring. Journal of Mental Health, 12(3), 175-196. https://doi.org//10.1080/0963823031000103489
Carl, J. R., Soskin, D. P., Kerns, C., & Barlow, D. H. (2013). Positive emotion regulation in emotional disorders: A theoretical review. Clinical Psychology Review, 33(3), 343-360. https://doi.org//10.1016/j.cpr.2013.01.003
Carl, J. R., Fairholme, C. P., Gallagher, M. W., Thompson-Hollands, J., & Barlow, D. H. (2014). The effects of anxiety and depressive symptoms on daily positive emotion regulation. Journal of Psychopathology and Behavioral Assessment, 36(2), 224-236. https://doi.org//10.1007/s10862-013-9387-9
Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100(3), 316-336. https://doi.org//10. 1037/0021-843X.100.3.316
Conley, C. S., Durlak, J. A., & Dickson, D. A. (2013). An evaluative review of outcome research on universal mental health promotion and prevention programs for higher education students. Journal of American College Health, 61(5), 286-301. https://doi.org//10.1080/07448481.2013.802237
Craske, M. G., Meuret, A. E., Ritz, T., Treanor, M., Dour, H., & Rosenfield, D. (2019). Positive affect treatment for depression and anxiety: A randomized clinical trial for a core feature of anhedonia. Journal of Consulting and Clinical Psychology, 87(5), 457–471. https://doi.org//10.10 37/ccp0000396
Daig, I., Herschbach, P., Lehmann, A., Knoll, N., & Decker, O. (2009). Gender and age differences in domain-specific life satisfaction and the impact of depressive and anxiety symptoms: A general population survey from Germany. Quality of Life Research, 18(6), 669-678. https://doi.org//10.100 7/s11136-009-9481-3
Diener, E., & Ryan, K. (2009). Subjective well-being: A general overview. South African Journal of Psychology, 39(4), 391-406. https://doi.org//10.1 177/008124630903900402
Doorley, J. D., Goodman, F. R., Disabato, D. J., Kashdan, T. B., Weinstein, J. S., & Shackman, A. J. (2020). The momentary benefits of positive events for individuals with elevated social anxiety. Emotion. Advance online publication. https://doi.org//10.1037/emo0000725
Dodge, R., Daly, A. P., Huyton, J., & Sanders, L. D. (2012). The challenge of defining well-being. International Journal of Wellbeing, 2(3), 222-235. https://doi.org//10.5502/ijw.v2i3.4
Duckworth AL, Peterson C, Matthews MD, & Kelly DR. (2007). Grit: Perseverance and passion for long-term goals. Journal of Personality and Social Psychology, 92(6), 1087-1101. https://doi.org//10. 1037/0022-3514.92.6.1087
Eisner, L. R., Johnson, S. L., & Carver, C. S. (2009). Positive affect regulation in anxiety disorders. Journal of Anxiety Disorders, 2(23), 645-649. https://doi.org//10.1016/j.janxdis.2009.02.001
Eklund, K., Dowdy, E., Jones, C., & Furlong, M. (2011). Applicability of the dual-factor model of mental health for college students. Journal of College Student Psychotherapy, 25(1), 79-92. https://doi.org//10.1080/87568225.2011.532677
Feldman, G. C., Joormann, J., & Johnson, S. L. (2008). Responses to positive affect: a self-report measure of rumination and dampening. Cognitive Therapy and Research, 32(4), 507-525. https://doi.org//10. 1007/s10608-006-9083-0
Franken, K., Lamers, S. M., Ten Klooster, P. M., Bohlmeijer, E. T., & Westerhof, G. J. (2018). Validation of the Mental Health Continuum?Short Form and the dual continua model of well?being and psychopathology in an adult mental health setting. Journal of Clinical Psychology, 74(12), 2187-2202. https://doi.org//10.1002/jclp.22659
Fresco, D. M., Mennin, D. S., Heimberg, R. G., & Turk, C. L. (2003). Using the Penn State Worry Questionnaire to identify individuals with generalized anxiety disorder: A receiver operating characteristic analysis. Journal of Behavior Therapy and Experimental Psychiatry, 34(3-4), 283-291. https://doi.org//10.1016/j.jbtep.2003.09. 001
Jones, C. N., You, S., & Furlong, M. J. (2013). A preliminary examination of covitality as integrated well-being in college students. Social Indicators Research, 111(2), 511–526. https://doi.org//10.1007/s11205-012-0017-9
Kansky, J., & Diener, E. (2017). Benefits of well-being: Health, social relationships, work, and resilience. Journal of Positive School Psychology, 1(2), 129-169.
Kashdan, T., & Breen, W. (2008). Social anxiety and positive emotions: A prospective examination of a self-regulatory model with tendencies to suppress or express emotions as a moderating variable. Behavior Therapy, 39(1), 1-12. https://doi.org/10.1016/j.beth.2007.02.003
Kenardy, J., McCafferty, K., & Rosa, V. (2003). Internet-delivered indicated prevention for anxiety disorders: A randomized controlled trial. Behavioural and Cognitive Psychotherapy, 31(3), 279-289. https://doi.org/10.1017/S135246580300 3047
Kenardy, J., McCafferty, K., & Rosa, V. (2006). Internet-delivered indicated prevention for anxiety disorders: Six-month follow-up. Clinical Psychologist, 10(1), 39-42. https://doi.org/10.1080/13284200500378746
Keogh, E., & Reidy, J. (2000). Exploring the factor structure of the Mood and Anxiety Symptom Questionnaire (MASQ). Journal of Personality Assessment, 74(1), 106-125. https://doi.org/10. 1207/S15327752JPA740108
Keough, M., Riccardi, C., Timpano, K., Mitchell, M., & Schmidt, N. (2010). Anxiety symptomatology: The association with distress tolerance and anxiety sensitivity. Behavior Therapy, 41(4), 567-574. https://doi.org/10.1016/j.beth.2010.04.002
Keyes, C.L.M. (2005) Mental illness and/or mental health? Investigating axioms of the complete state model of health. Journal of Consulting and Clinical Psychology, 73(3), 539-548. https://doi.org/10.1037/0022-006X.73.3.539
Khazanov, G. K., & Ruscio, A. M. (2016). Is low positive emotionality a specific risk factor for depression? A meta-analysis of longitudinal studies. Psychological Bulletin, 142(9), 991–1015. https://doi.org/10.1037/bul0000059
MacCann, C., & Roberts, R. (2010). Do time management, grit, and self-control relate to academic achievement independently of conscientiousness? In R. Hicks (Ed.). Personality and individual differences: Current directions (pp. 79–90). Australian Academic Press.
McCullough, M. E., Emmons, R. A., & Tsang, J. (2002). The grateful disposition: A conceptual and empirical topography. Journal of Personality and Social Psychology, 82(1), 112-127. https://doi.org/10. 1037//0022-3514.82.1.112
McEvoy, P. M., Hyett, M. P., Ehring, T., Johnson, S. L., Samtani, S., Anderson, R., & Moulds, M. L. (2018). Transdiagnostic assessment of repetitive negative thinking and responses to positive affect: Structure and predictive utility for depression, anxiety, and mania symptoms. . Journal of Affective Disorders, 232, 375-384. https://doi.org/10.1016/j.jad.2018.02.072
Meyer, T. J., Miller, M. L., Metzger, R. L., Borkovec, T. D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28(6), 487-495. https://doi.org/10.1016/0005-7967(90)90135-6
Naragon-Gainey, K., Watson, D., & Markon, K. E. (2009). Differential relations of depression and social anxiety symptoms to the facets of extraversion/positive emotionality. Journal of Abnormal Psychology, 118(2), 299–310. https://doi.org/10.1037/a0015637
Molina, S., & Borkovec, T. D. (1994). The Penn State Worry Questionnaire: Psychometric properties and associated characteristics. In G. C. L. Davey & F. Tallis (Eds.), Worrying: Perspectives on theory, assessment and treatment (pp. 265–283). Wiley.
Nitschke, J. B., Heller, W., Imig, J. C., McDonald, R. P., & Miller, G. A. (2001). Distinguishing dimensions of anxiety and depression. Cognitive Therapy and Research, 25(1), 1–22. https://doi.org/10.1023/A:1026485530405
Renshaw, T. L., & Bolognino, S. J. (2016). The College Student Subjective Well-being Questionnaire: A brief, multidimensional measure of undergraduate’s covitality. Journal of Happiness Studies, 17(2), 463-484. https://doi.org/10.1007 /s10902-014-9606-4
Renshaw, T. L., & Cohen, A. S. (2014). Life satisfaction as a distinguishing indicator of college student functioning: Further validation of the two-continuum model of mental health. Social Indicators Research, 117(1). 319-334. https://doi.org/10.1007/s11205-013-0342-7
Sass, S. M., Evans, T. C., Xiong, K., Mirghassemi, F., & Tran, H. (2017). Attention training to pleasant stimuli in anxiety. Biological Psychology, 122, 80-92. https://doi.org/10.1016/j.biopsycho.2016.03.0 03
Schmidt, N. B., Eggleston, A. M., Woolaway-Bickel, K., Fitzpatrick, K. K., Vasey, M. W., & Richey, J. A. (2007). Anxiety sensitivity amelioration training (ASAT): A longitudinal primary prevention program targeting cognitive vulnerability. Journal of Anxiety Disorders, 21(3), 302–319. https://doi.org/10.1016/j.janxdis.20 06.06.002
Seligson, J., Huebner, E. S., & Valois, R. F. (2003). Preliminary validation of the Brief Multidimensional Students’ Life Satisfaction Scale. Social Indicators Research, 61(2), 121 –145. https://doi.org/10.1023/A:1021326822957
Sheridan, Z., Boman, P., Mergler, A., & Furlong, M. J. (2015). Examining well-being, anxiety, and self-deception in university students. Cogent Psychology, 2(1). Article 993850. https://doi.org/10.1080/23311908.2014.993850
Smith, N. D., Suldo, S., Hearon, B., & Ferron, J. (2020). An application of the dual-factor model of mental health in elementary school children: Examining academic engagement and social outcomes. Journal of Positive Psychology & Wellbeing, 4(1), 49-68.
Snyder, C. R., Harris, C., Anderson, J. R., Holleran, S. A., Irving, L. M., Sigmon, S. T., Yoshinoubu, L., Gibb, J., Langelle, C., & Harney, P. (1991). The will and the ways: Development and validation of an individual-differences measure of hope. Journal of Personality and Social Psychology, 60(4), 570-585. https://doi.org/10.1037//0022-3514.60.4.570
Stapinski, L., Abbott, M., & Rapee, R. (2010). Evaluating the cognitive avoidance model of generalised anxiety disorder: Impact of worry on threat appraisal, perceived control and anxious arousal. Behaviour Research and Therapy, 48(10), 1032-1040. https://doi.org/10.1016/j.brat.2010.0 7.005
Suldo, S. M., & Shaffer, E. J. (2008). Looking beyond psychopathology: The dual-factor model of mental health in youth. School Psychology Review, 37(1), 52-68. https://doi.org/10.1080/02796015.2008.1 2087908
Suldo, S. M., Thalji-Raitano, A., Kiefer, S. M., & Ferron, J. M. (2016). Conceptualizing high school students' mental health through a dual-factor model. School Psychology Review, 45(4), 434-457. https://doi.org/10.17105/SPR45-4.434-457
Taylor, C. T., Lyubomirsky, S., & Stein, M. B. (2017). Upregulating the positive affect system in anxiety and depression: Outcomes of a positive activity intervention. Depression and Anxiety, 34(3), 267-280. https://doi.org/10.1002/da.22593
Tirpak, J. W., Cassiello-Robbins, C., Ametaj, A., Olesnycky, O. S., Sauer-Zavala, S., Farchione, T. J., & Barlow, D. H. (2019). Changes in positive affect in cognitive-behavioral treatment of anxiety disorders. General Hospital Psychiatry, 61, 111-115. https://doi.org/10.1016/j.genhosppsych.20 19.06.008
Watson, D. (2009). Differentiating the mood and anxiety disorders: A quadripartite model. Annual Review of Clinical Psychology, 5, 221-247. https://doi.org/10.1146/annurev.clinpsy.032408.153510
Watson D, Clark L. A., Weber K, Assenheimer J. S., Strauss M. E., McCormick R. A. (1995). Testing a tripartite model: I. Evaluating the convergent and discriminant validity of anxiety and depression symptom scales. Journal of Abnormal Psychology, 104(1), 3-14. https://doi.org/10.1037/0021-843X.104.1.3
Watson, D., & Naragon-Gainey, K. (2010). On the specificity of positive emotional dysfunction in psychopathology: Evidence from the mood and anxiety disorders and schizophrenia/schizotypy. Clinical Psychology Review, 30(7), 839–848. https://doi.org/10.1016/j.cpr.2009.11.002
Watson, D., Weber, K., Assenheimer, J. S., Clark, L. A., Strauss, M. E., & McCormick, R. A. (1995). Testing a tripartite model: I. Evaluating the convergent and discriminant validity of anxiety and depression scales. Journal of Abnormal Psychology, 104(1), 3-14. https://doi.org/10.1037 /0021-843X.104.1.3
Widnall, E., Price, A., Trompetter, H., & Dunn, B. D. (2020). Routine cognitive behavioural therapy for anxiety and depression is more effective at repairing symptoms of psychopathology than enhancing well-being. Cognitive Therapy and Research, 44(1), 28-39. https://doi.org/10.1007/s 10608-019-10041-y
Yang, H., & Guo, W. (2014). Chinese version of the responses to positive affect questionnaire: Testing the factor structure, reliability, and validity in a college student sample. Psychological Reports, 115(2), 467-484. https://doi.org/10.2466/08.21.PR 0.115c22z8
Zullig, K. J., Huebner, E. S., Gilman, R., Patton, J. M., & Murray, K. A. (2005). Validation of the brief multidimensional students' life satisfaction scale among college students. American Journal of Health Behavior, 29(3), 206-214. https://doi.org/10.5993/AJHB.29.3.2
Zvolensky, M., & Forsyth, J. (2002). Anxiety sensitivity dimensions in the prediction of body vigilance and emotional avoidance. Cognitive Therapy and Research, 26(4), 449-460. https://doi.org/10.1023/A:1016223716132