ORCID Identifier(s)


Graduation Semester and Year




Document Type


Degree Name

Doctor of Philosophy in Nursing



First Advisor

Jennifer R Gray


Undergraduate student reports of anxiety and depression have risen each year since 2012 to the most recent report of 17% experiencing anxiety and 14% experiencing depression (ACHA, 2016). The significance of the experience of anxiety and depression in this population is that they are the top-reported factors affecting academic attrition (ACHA, 2016). The purpose of this study was to examine the predictive relationship of three healthy lifestyle behaviors and emotional distress among undergraduate college students. The three healthy lifestyle choices examined were nutrition, exercise and rest. The prevalence of emotional distress and depression within each year of study also was examined and the prevalence of impediment of academic performance resulting from stress, anxiety, or depression. This study used a descriptive correlational design. The study was a secondary data analysis of data collected by the American College Health Association (ACHA) during the spring 2008 semester. The data included 68,588 undergraduate student responses. The data was collected using the National College Health Assessment (NCHA) tool (ACHA, 2008). Emotional distress was measured with a scale embedded within the NCHA. Hamilton (2006) preformed confirmatory factor analysis on this scale. The predictor variables were measured as student reports of number of servings for fruits and vegetables consumed, days participated in aerobic and strengthening exercise, and days awakened feeling rested, per week. Nutrition, exercise, and rest were found to explain 4.9% (p<.001) of the variance of emotional distress in this population. Students enrolled in five or more years of undergraduate college study were found to have higher reports of emotional distress (F(4,67448)=29.452, p<.001) than students enrolled in years one through four. Overall, 14.3% of the students reported depression with the highest percentage occurring among students who were in year five or higher of their study. The primary academic impairment resulted from stress and was most commonly reports of a lower grade on an assignment.


Emotional distress, Undergraduate college students, Stress, Anxiety, Depression, College health, Academic performance, Multiple linear regression, ANOVA, Secondary data analysis, Quantitative research


Medicine and Health Sciences | Nursing


Degree granted by The University of Texas at Arlington

Included in

Nursing Commons