Factors Influencing Stress Levels Among Students: A Virtual Exploration

Stress is a constant companion in our modern life. Individuals have varied responses to stressful situations. In the usual course of things, everyone who lives in this world experiences stress. It presents a detrimental idea that could affect mental and physical health. The main goal of this study was to identify the variables that had the most significant impact on students' stress levels. Exam pressure, study pressure, and pressure from teachers, tutors, and parents all significantly impact students' mental health. Too much stress can lead to mental health problems, including depression and anxiety. Depression and anxiety are the two conditions that affect young people's mental health most frequently. Students under stress appear more susceptible to developing detrimental habits, including procrastination, alcoholism, smoking, and drug addiction. This research enhances the comprehension of stress and its diverse factors, informing ways to promote mental health in adolescents and adults. Further study is mandatory to determine the stress level of people of all ages and to educate people on how to reduce stress and lead a sustainable life.

Introduction

Stress is an inherent physiological and psychological reaction to circumstances that confront or endanger us. Both positive and negative circumstances, such as work obligations, relationship issues, financial concerns, or simply the anticipation of a forthcoming event, can trigger stress. Stress impacts individuals unpredictably; some have heightened energy and concentration, whereas others may feel inundated or apprehensive.

Students today are under more stress and strain than ever before. It may result from the pressure of peers, instructors, and parents, as well as from studies and exams. It is challenging to define stress. Selye [1] first proposed that stress is the body’s everyday wear and tear. Psychology has adhered to the transactional model, which emphasizes psychological processes that intervene. According to this approach, stress only arises when an individual believes an external demand exceeds their capacity to handle it. Therefore, whether stress is felt depends on how each person evaluates the nature of the demand, the resources and personal abilities that are accessible, as well as the anticipated outcomes. This method acknowledges and addresses individual variations [2].

Everyone experiences stress at some point in life. Unless students learn effective coping mechanisms, it can negatively impact their physical and mental well-being, academic progress, and other aspects of their lives. The rapid changes and modernism in people have led to stress, one of the main aspects of modern life. For this reason, this time is known as the “age of stress.” Students face various difficulties, including academic stress, due to homework, tests, and other requirements for school that might be beyond their capabilities. Mothers experience stress due to their children’s schooling, as do employees, leaders, and the entire community.

Sometimes, the same person may experience many types of stress at once. Two recurring themes are used by Hancock and Szalma [3] to illustrate modern stress theory. The first and most crucial factor-psychological meaningfulness-is the presence of a mechanism through which people assess experiences in terms of their richness in meaning to mental or bodily enjoyment. Second, people have control over their interior states and assign these processes to make up for disturbances caused by outside factors like task demands and other such things [4].

The psychological concept of stress has many different descriptions. Ibrahim [5] states, “Stress is a strong emotional reaction to internal or external change.” Stress is defined by Greenberg and Baron [6] as individual, physiological, and emotional responses to stimulation. According to Hussien and Hussien [7], it is the condition in which a person has significant mental hypertension due to circumstances that are beyond their capacity to handle and cannot be grasped. Stressors are things or stimuli that can put you under mental or bodily pressure.

Numerous studies have emphasized that stress levels are higher for students enrolled in professional programs like medical and dental school. Too high stress might result in mental health issues like sadness and anxiety [8]. According to reports, medical education is one of the most demanding academic programs in the world, which significantly impacts medical students’ physical and mental health. Exam anxiety, high parental expectations, peer pressure, a lack of free time, financial difficulties, strained relationships, and desires for higher education are a few of the numerous factors that increase stress among undergraduate medical students [2]. Time and schedule constraints, dealing with resistant patients, business concerns, and the work’s highly technical and demanding nature are all stressors related to dentistry. This tension may be rooted in dentistry education [9].

Parents frequently pressure their children to choose a career not in their best interests. Parents’ desire to pay for their children’s higher education impacts this phenomenon.

The competition is fierce, and many students may be forced to settle for an educational program (medicine, dentistry, or pharmacy) that is not their top choice because admission to professional courses is mainly based on merit. According to previous studies, these students may experience more stress than those enrolled in their preferred school program [10].

During the COVID-19 pandemic, common psychosocial health problems (PHPs) have increased in prevalence among teenagers worldwide. The two most prevalent mental health issues in childhood and adolescence are depression and anxiety. The stressors were academic setbacks, future uncertainties, financial worries, and concerns about contracting an infection. Depression, anxiety, ADHD, conduct, eating, psychotic, and substance use disorders are among the most often reported mental health issues during this transitional stage of adolescence. During the lockdown, there was less physical activity, more screen time, erratic sleeping patterns, more loneliness, and poorer eating habits. Anxiety, depression, trauma, bereavement, suicidal thoughts and behaviors, and substance abuse all increased among adolescents worldwide during the pandemic. Numerous investigations evaluating the effects of COVID-19 on mental health were carried out in Bangladesh. During the pandemic, more students reported having moderate to severe anxiety (21.7% vs. 18.1%) and depression (37.3% vs. 26.5%). Similar estimates of depression were found in other pre-pandemic studies but at slightly lower levels (25%–36.6%) [11].

A few studies supported the poor mental health of Bangladeshi university students. The COVID-19 pandemic is underway, and Bangladeshi medical students exhibit a high frequency of depressive symptoms. Given this alarming prevalence and accompanying factors, follow-up psychological interventions targeting medical students must be implemented. According to a research [12], mild anxiety affects 27.3% of medical students, moderate anxiety affects 26.8%, and severe anxiety affects 11.8%. Exam-related stress and anxiety harm a student’s quality of life, physical development, and academic achievement. Examination revealed that Bangladeshi youths had detrimental effects on their mental health regarding stress, anxiety, and depression. The importance of university entrance exams and their influence on career decisions are very high in Bangladesh. Students who are prepared for the university admission exam may experience anxiety because of the exam. When compared to individuals with backgrounds in business courses, those with science degrees were more likely to experience stress and depressive symptoms. Additionally, students were more likely to experience sadness, anxiety, and stress symptoms if they had a history of mental illness, preferred admission to public universities, and had a lower monthly family income (25,000 BDT) [13]. Anxiety about university entrance exams is widespread among students in Turkey, with a prevalence of 48.1% [14].

Problems in the classroom, the environment, society, and one’s health significantly contribute to stress. The leading causes of stress for students are academic-related, so it is necessary to take particular, targeted actions to reduce this load significantly [8].

In this study, we aim to track down the root of stress among students and identify the factors that impact students’ stress levels, focusing on social and parental contributions that affect children’s stress levels.

Materials and Methods

Study Design and Setting

The present study used a cross-sectional and interview-based survey of students in Dhaka. The survey was conducted using a structured questionnaire between June 2023 and July 2023. The survey was an online interview with students located in Dhaka, Bangladesh.

Study Procedure

All procedures of the present study were conducted by the ethical principles of human investigations (i.e., the Helsinki Declaration) and with the guidelines of institutional research ethics. A Bangla questionnaire incorporating informed consent and questions and measures was employed to conduct online interviews to gather information from participants. Participants were informed about the procedures and purpose of the study and the confidentiality of the information they provided. All data were collected anonymously and analyzed using a predetermined coding system. The inclusion criteria for the participants were that individuals had to be aged ≥18 years old and not willingly consenting to the survey. After obtaining informed consent, 650 participants were interviewed. After removing incomplete surveys, data from 636 participants (53.6% male; age range 18–27 years; mean age 20.93 years [SD = 2.72]) were included in the analyses.

Sampling Method

The sample size was calculated using the following equation:

n=z2pqd2

n=1.962×0.5×(1−0.5)0.052

= 384.16 ≈ 384

Here,

n = number of samples

z = 1.96 (95% confidence level)

p = prevalence estimate (0.5)

q = (1 − p)

d = precision limit or proportion of sampling error (0.05).

However, 636 participants were recruited to ensure adequate power for the study. The inclusion criteria for participants were (1) being aged ≥18 years, (2) being university students, and (3) willingness to enroll in the survey. Exclusion criteria were (4) being <18 years old, (5) not being able to provide consent, and (6) having incomplete surveys. After obtaining informed consent, 650 participants were interviewed using a convenience sampling approach. At the data quality checking stage, 14 participants with incomplete surveys were removed, and 636 participants were included in the final analysis.

Measures

The questionnaire containing informed consent and sections (demographic information, psychological aspects, communication patterns, lifestyle, and engagement) was used to collect data during the interview periods.

Socio-Demographic Information and Lifestyle-Related Measures

Some socio-demographic questions were asked during the survey, including gender (male or female), age, marital status (unmarried or married), residence, etc., along with the number of average daily resting hours.

Psychological Measures

Self-reported measures of stress typically ask respondents to rate their stress level on a scale along with other types of questions such as sensitivity to other judgments, future plans, satisfaction levels, appetite levels, family bonding, etc.

Communication and lifestyle-related questions such as communication with family and friends, social media usage, and amusement periods are also asked of respondents.

Statistical Analyses

Analyses were performed using two statistical software packages (Microsoft Excel 2019 and IBM SPSS Statistics version 25). Microsoft Excel was used for data cleaning, coding, editing, and sorting. Then, an Excel file including all variables was imported into SPSS software. For categorical variables, frequencies and percentages were reported; means and standard deviations were presented for continuous data. In addition, some first-order analyses (e.g., Chi-square tests) were performed using SPSS. Finally, the nominal logistic regression model was investigated using SPSS to determine the associated factors and their impact on stress levels. A p-value of 0.05 was considered statistically significant. Logistic regression models can be employed instead of normal linear regression models when the response variable is binary or categorical. Ordinal logistic regression is applied when our outcome variable has a natural ordering. Explanatory variables, however, broke the parallel line assumption in our data. That implies that ordered logit coefficients are unequal across the outcome levels. Due to this, we used multinomial logistic regression analysis rather than ordinal logistic regression to explain the connections between the dependent and independent variables.

Results

Participants (n = 636) had a mean age of 20.93 years (SD = 2.72; see Table II), and ages ranged from 18 to 27 years. Of the participants, 53.6% were male, and most were unmarried (71.9%; see Table I). Most participants are from semi-urban areas (46.4%), had frequent communication with family (48.9%), and most of them were confused about their satisfaction level (47.6%). Many indicated that their appetite level and family bonding are medium, at 49.4% and 42.1%, respectively. Most reported that their social media usage and stress levels are between low and medium (77.3%) and 69.7%, respectively. They sleep for an average of 6.71 hours, with a standard deviation 1.26. A vast majority reported that they had close friends nearby (about 62.6%) and were sometimes sensitive to other judgments (57.7%).

Table I. Distribution of All Examined Variables (N = 636)

Characteristics	N (%)
Gender
Female	295 (46.4%)
Male	341 (53.6%)
Residence
Rural	109 (17.1%)
Semi-Urban	295 (46.4%)
Urban	232 (36.5%)
Marital status
No	457 (71.9)
Yes	179 (28.1)
Communication with family
2–3 days	195 (30.7%)
Daily/Frequently	311 (48.9%)
Others	24 (3.8%)
Weekly	106 (16.7%)
Communication with friends
Daily/Frequently	137 (21.5%)
Never	51 (8.0%)
Often	232 (36.5%)
Rarely	216 (34.0%)
Close friends nearby
No	238 (37.4%)
Yes	398 (62.6%)
Amusement periods
2–3 days	205 (32.2%)
Daily	104 (16.4%)
Monthly	86 (13.5%)
Weekly	241 (37.9%)
Social media usage
High	132 (20.8%)
Low	248 (39.0%)
Medium	256 (40.3%)
Sensitivity–other judgments
No	117 (18.4%)
Sometimes	367 (57.7%)
Yes	152 (23.9%)
Future plan
Confused	306 (48.1%)
Didn’t think about it	78 (12.3%)
Yes, I have fixed plan	252 (39.6%)
Satisfaction level
Don’t know/Confused	303 (47.6%)
No, I’m not	98 (15.4%)
Yes, I’m	235 (36.9%)
Academic progress
Very satisfactory	91 (14.3%)
Satisfactory	185 (29.1 %)
Neither satisfactory nor unsatisfactory	238 (37.4 %)
Unsatisfactory	64 (10.1%)
Very unsatisfactory	58 (9.1%)
Appetite level
Very low	36 (5.7%)
Low	177 (27.8%)
Medium	314 (49.4%)
High	72 (11.3%)
Very high	37 (5.8%)
Family bonding
Very weak	36 (5.7%)
Weak	94 (14.8%)
Medium	268 (42.1%)
Strong	131 (20.6%)
Very strong	107 (16.8%)
Stress level
Very low	54 (8.5%)
Low	195 (30.7%)
Medium	248 (39.0%)
High	87 (13.7%)
Very high	52 (8.2%)

Table II. Descriptive Statistics of Age and Daily Sleep Hours in the Study Sample

	N	Minimum	Maximum	Mean	Std. Deviation
Age (in number)	636	18	27	20.93	2.721
Daily sleep hours (in number)	636	3.0	9.0	6.717	1.2571

Stress Level and Its Correlates

Most participants reported their stress level as high (i) being female vs. male (14.2% vs. 13.2%, p < 0.001), and (ii) having a rural, semi-urban, vs. urban residence (18.3%, 12.9% vs. 12.5%, p < 0.001). Stress levels high were related to (i) completing the education level of college, graduation, post-graduation, school vs. under graduation (12.5%, 25.4%, 32.6%, 6.7% vs. 7.6%, p < 0.001), (ii) having a family bonding of very weak, weak, medium, strong, vs. very strong (19.4%, 10.6%, 11.9%, 19.1%, vs. 12.1%, p = 0.000), (iii) having an appetite level of very weak, weak, medium, strong, vs. very strong (11.1%, 9.6%, 12.1%, 26.4% vs. 24.3%, p < 0.001), (iv) having academic progress of very satisfactory, satisfactory, neither satisfactory nor unsatisfactory, unsatisfactory vs. very unsatisfactory (6.6%, 9.7%, 11.8%, 42.2% vs. 13.8%, p < 0.001), and (v) having social media usage of high, low vs. medium (16.7%, 10.9% vs.14.8%, p = 0.05; see Table III).

Table III. Measures and their Associations with Stress Level

Characteristics	Stress level										Total		χ2	dt	p-value
	Very low		Low		Medium		High		Very high
	n	(%)	n	(%)	n	(%)	n	(%)	n	(%)	n	(%)
Total
Gender
Female	17	(5.8)	96	(32.5)	119	(40.3)	42	(14.2)	21	(7.1)	295	(100)	45.37*	8	0.0
Male	37	(10.9)	99	(29)	129	(37.8)	45	(13.2)	31	(9.1)	341	(100)
Residence
Rural	6	(5.5)	38	(34.9)	37	(33.9)	20	(18.3)	8	(7.3)	109	(100)	45.37*	8	0.0
Semi-Urban	18	(6.1)	100	(33.9)	131	(44.4)	38	(12.9)	8	(2.7)	295	(100)
Urban	30	(12.9)	5	(24.6)	80	(34.5)	29	(12.5)	36	(15.5)	232	(100)
Marital status
No	36		146		172		57		46		457		11.18*	4	0.0
Yes	18		49		76		30		6		179
Communication with family
2–3 days	22	(11.3)	70	(35.9)	83	(42.6)	19	(9.7)	1	(0.5)	195	(100)	56.26*	12	0.0
Daily/Frequently	26	(8.4)	88	(28.3)	105	(33.8)	47	(15.1)	45	(14.5)	311	(100)
Others	3	(12.5)	7	(29.2)	6	(25.0)	4	(16.7)	4	(16.7)	24	(100)
Weekly	3	(2.8)	30	(28.3)	54	(50.9)	17	(16.0)	2	(1.9)	106	(100)
Communication with friends
Daily/Frequently	22	(16.1)	34	(24.8)	43	(31.4)	23	(16.8)	15	(10.9)	137	(100)	97.56*	12	0.0
Never	3	(5.9)	17	(33.3)	11	(21.6)	3	(5.9)	17	(33.3)	51	(100)
Often	14	(6.0)	98	(42.2)	85	(36.6)	29	(12.5)	6	(2.6)	232	(100)
Rarely	15	(6.9)	46	(21.3)	109	(50.5)	32	(14.8)	14	(6.5)	216	(100)
Close friends nearby?
No	12	(5.0)	68	(28.6)	108	(45.4)	39	(16.4)	11	(4.6)	238	(100)	17.76*	4	0.0
Yes	42	(10.6)	127	(31.9)	140	(35.2)	48	(12.1)	41	(10.3)	398	(100)
Social media usage
High	28	(21.2)	26	(19.7)	37	(28.0)	22	(16.7)	19	(14.4)	132	(100)	74.98*	8	0.0
Low	17	(6.9)	87	(35.1)	114	(46.0)	27	(10.9)	3	(1.2)	248	(100)
Medium	9	(3.5)	82	(32.0)	97	(37.9)	38	(14.8)	30	(11.7)	256	(100)
Sensitivity-other judgements
No	11	(9.4)	21	(17.9)	34	(29.1)	19	(16.2)	32	(27.4)	117	(100)	117.45*	8	0.0
Sometimes	12	(3.3)	128	(34.9)	158	(43.1)	53	(14.4)	16	(4.4)	367	(100)
Yes	31	(20.4)	46	(30.3)	56	(36.8)	15	(9.9)	4	(2.6)	152	(100)
Future plan
Confused	17	(5.6)	94	(30.7)	140	(45.8)	40	(13.1)	15	(4.9)	306	(100)	33.21*	8	0.0
Didn’t think about it	8	(10.3)	18	(23.1)	21	(26.9)	18	(23.1)	13	(16.7)	78	(100)
Yes, I have fixed plan	29	(11.5)	83	(32.9)	87	(34.5)	29	(11.5)	24	(9.5)	252	(100)
Satisfaction level
Don’t know/confused	19	(6.3)	102	(33.7)	143	(42.7)	32	(10.6)	7	(2.3)	303	(100)	63.86*	8	0.0
No, I’m not	11	(11.2)	11	(11.2)	37	(37.8)	23	(23.5)	16	(16.3)	98	(100)
Yes, I am	24	(10.2)	82	(34.9)	68	(28.9)	32	(13.6)	29	(12.3)	235	(100)
Academic progress
Very satisfactory	25	(27.5)	38	(41.8)	22	(24.2)	6	(6.6)	0	(0.0)	91	(100)	217.58*	16	0.0
Satisfactory	12	(6.5)	88	(47.6)	59	(31.9)	18	(9.7)	8	(4.3)	185	(100)
Neither satisfactory nor unsatisfactory	8	(3.4)	42	(17.6)	141	(59.2)	28	(11.8)	19	(8.0)	238	(100)
Unsatisfactory	1	(1.6)	11	(17.2)	16	(25.0)	27	(42.2)	9	(14.1)	64	(100)
Very unsatisfactory	8	(13.8)	16	(27.6)	10	(17.2)	8	(13.8)	16	(27.6)	58	(100)
Appetite level
Very low	5	(13.9)	16	(44.4)	7	(19.4)	4	(11.1)	4	(11.1)	36	(100)	165.63*	16	0.0
Low	17	(9.6)	82	(46.3)	58	(32.8)	17	(9.6)	3	(1.7)	177	(100)
Medium	25	(8.0)	80	(25.2)	154	(49.0)	38	(12.1)	17	(5.4)	314	(100)
High	4	(5.6)	16	(22.2)	24	(33.3)	19	(26.4)	9	(12.5)	72	(100)
Very high	3	(8.1)	1	(2.7)	5	(13.5)	9	(24.3)	19	(51.4)	31	(100)
Family bonding
Very weak	8	(22.2)	10	(27.8)	8	(22.2)	7	(19.4)	3	(8.3)	36	(100)	90.32*	16	0.0
Weak	9	(9.6)	41	(43.6)	32	(34.0)	10	(10.6)	2	(2.1)	94	(100)
Medium	16	(6.0)	69	(25.7)	141	(52.6)	32	(11.9)	10	(3.7)	268	(100)
Strong	11	(8.4)	38	(29.0)	45	(34.4)	25	(19.1)	12	(9.2)	131	(100)
Very strong	10	(9.3)	37	(34.6)	22	(20.6)	13	(12.1)	25	(23.4)	107	(100)
Amusement periods
2–3 days	15	(7.3)	60	(29.3)	82	(40.0)	26	(12.7)	22	(10.7)	205	(100)	35.31*	12	0.0
Daily	15	(14.4)	25	(24.0)	31	(29.8)	16	(15.4)	17	(16.3)	104	(100)
Monthly	5	(5.8)	27	(31.4)	30	(34.9)	17	(19.8)	7	(8.1)	86	(100)
Weekly	19	(7.9)	83	(34.4)	105	(43.6)	28	(11.6)	6	(2.5)	241	(100)

Multinomial Model

Our final model represents a significant improvement in fit over a null model, as our p-value is less than 0.001 [χ² = 419.912 with df of 88]. Then there is evidence that the independent variables are effective and have contributed to predicting the outcome. In the goodness of fit test, since the p-value (0.418 and 1.0) is greater than 0.05, both Pearson’s chi-square χ² = 2213.082 with df of 2200 and deviance test χ² = 1337.480 with df 2200 indicate that our model fits the data well.

The research findings summarized a multinomial logistic regression analysis that statistically predicted stress levels among students. First, we took all the variables, and then, based on the likelihood test and standard error, we took all the significant variables for our final model. We took the “medium stress” category as our baseline category as its frequency is highest.

Age was found to be statistically significant (p = 0.038). If age increased by one point, the multinomial log-odds of “high stress” to “medium stress” would be expected to increase by 0.10 unit while holding all other variables in the model constant. Individuals with high and very low appetite levels had significantly higher odds of being in the “low stress” category compared to the “medium stress” category. People with a very low or low appetite were 3.15 times and 2.54 times, respectively, more likely to experience low stress than people with a very high appetite. People with a medium appetite experienced 1.626 times less high stress and 1.553 times less very high stress compared to people with a very high appetite. This meant that people with a medium appetite were less stressed than people with a very high appetite, regardless of whether the stress level was high or very high. The log odds of experiencing very high stress were −4.567 for people who communicated with their family daily and −3.056 for people who communicated with their family weekly. This meant that the odds of experiencing very high stress were much lower for these groups of people than for people who did not communicate with their family. People with medium family bonding experienced −1.485 times very low and −1.255 times low stress compared to people with very strong bonding. This meant that people with medium family bonding were more stressed than people with very strong bonding, regardless of whether the stress level was very low or high.

The log odds of experiencing very high stress were −2.776 for people who communicated with their friends often and −2.230 for people who communicated with their family frequently. This meant that the odds of experiencing very high stress were much lower for these groups of people than for people who did not communicate with their friends. People with no friends nearby experienced −1.061 times less stress compared to people with friends nearby. This meant that people with friends nearby were less stressed than people with no friends nearby. The log odds of experiencing very high stress were −2.632 for people who used social media low and −1.040 for people who used social media medium. This meant that the odds of experiencing very high stress were much lower for these groups of people than for people who used social media. The log odds of experiencing very low stress were −2.023 for people who were sometimes sensitive to other judgments, and the log odds of experiencing very high stress were 2.076 for people who were not sensitive to other judgments compared to those who were sensitive to other judgments. This meant that those who were sensitive to other judgments were likely to have less stress. People with no satisfaction experienced 1.577 times as much stress as people who were confused (see Table IV). This meant that people with no satisfaction were more stressed than people with confusion.

Table IV. Multinomial Logistic Regression Analysis for Predicting Stress Levels

Stress level	Variables	B	Std. Error	Wald	df	Sig.	Exp (B)
Very low	Intercept	0.965	1.977	0.238	1	0.626
	Age (in number)	0.131	0.065	4.050	1	0.044	1.140
	[Appetite level = Very low]	−0.184	1.106	0.028	1	0.868	0.832
	[Appetite level = Low]	−0.037	0.939	0.002	1	0.968	0.963
	[Appetite level = Medium]	−0.927	0.902	1.058	1	0.304	0.396
	[Appetite level = High]	−1.110	1.040	1.138	1	0.286	0.330
	[Appetite level = Very high]	0b			0
	[Communication with family = Daily]	−1.172	0.850	1.901	1	0.168	0.310
	[Communication with family = 2/3 days]	−0.505	0.870	0.337	1	0.562	0.603
	[Communication with family = Weekly]	−2.325	1.032	5.074	1	0.024	0.098
	[Communication with family = others]	0b			0
	[Family bonding = Weak]	0.420	0.834	0.254	1	0.614	1.523
	[Family bonding = Very Weak]	−0.835	0.687	1.477	1	0.224	0.434
	[Family bonding = Medium]	−1.485	0.623	5.692	1	0.017	0.226
	[Family bonding = Strong]	−0.875	0.607	2.077	1	0.150	0.417
	[Family bonding = Very Strong]	0b			0
	[Communication with friends = Rarely]	−0.460	0.807	0.325	1	0.569	0.631
	[Communication with friends = Often]	−0.556	0.822	0.457	1	0.499	0.574
	[Communication with friends = Daily]	−0.079	0.810	0.010	1	0.922	0.924
	[Communication with friends = Never]	0b			0
	[Close friends nearby? = No]	−1.061	0.418	6.443	1	0.011	0.346
	[Close friends nearby? = Yes]	0b			0
	[Social media usage = Low]	−1.242	0.434	8.195	1	0.004	0.289
	[Social media usage = Medium]	−2.221	0.494	20.230	1	0.000	0.109
	[Social media usage = High]	0b			0
	[Sensitivity–other judgments = No]	−0.360	0.516	0.486	1	0.486	0.698
	[Sensitivity–other judgments = Sometimes]	−2.023	0.444	20.793	1	0.000	0.132
	[Sensitivity–other judgments = Yes]	0b			0
	[Satisfaction level = No]	−0.065	0.539	0.015	1	0.904	0.937
	[Satisfaction level = Yes]	0.115	0.435	0.070	1	0.792	1.122
	[Satisfaction level = Confused]	0b			0
Low	Intercept	0.239	1.602	0.022	1	0.881
	Age (in number)	−0.007	0.040	0.029	1	0.865	0.993
	[Appetite level = Very low]	3.152	1.250	6.359	1	0.012	23.392
	[Appetite level = Low]	2.538	1.160	4.788	1	0.029	12.655
	[Appetite level = Medium]	1.482	1.150	1.661	1	0.198	4.401
	[Appetite level = High]	1.742	1.186	2.160	1	0.142	5.711
	[Appetite level = Very high]	0b			0
	[Communication with family = Daily]	−0.935	0.627	2.222	1	0.136	0.393
	[Communication with family = 2/3 days]	−0.591	0.624	0.898	1	0.343	0.554
	[Communication with family = Weekly]	−1.014	0.642	2.493	1	0.114	0.363
	[Communication with family = others]	0b			0
	[Family bonding = Weak]	−0.647	0.647	1.000	1	0.317	0.524
	[Family bonding = Very Weak]	−0.560	0.445	1.585	1	0.208	0.571
	[Family bonding = Medium]	−1.255	0.390	10.346	1	0.001	0.285
	[Family bonding = Strong]	−0.785	0.393	3.991	1	0.046	0.456
	[Family bonding = Vey Strong]	0b			0
	[Communication with friends = Rarely]	−1.274	0.470	7.347	1	0.007	0.280
	[Communication with friends = Often]	−0.472	0.463	1.039	1	0.308	0.624
	[Communication with friends = Daily]	−0.769	0.517	2.214	1	0.137	0.463
	[Communication with friends = Never]	0b			0
	[Close friends nearby? = No]	−0.306	0.226	1.839	1	0.175	0.736
	[Close friends nearby? = Yes]	0b			0
	[Social media usage = Low]	0.253	0.333	0.576	1	0.448	1.288
	[Social media usage = Medium]	0.012	0.332	0.001	1	0.970	1.013
	[Social media usage = High]	0b			0
	[Sensitivity other judgments = No]	0.202	0.389	0.269	1	0.604	1.224
	[Sensitivity other judgments = Sometimes]	0.132	0.262	0.253	1	0.615	1.141
	[Sensitivity other judgments = Yes]	0b			0
	[Satisfaction level = No]	−1.009	0.412	6.006	1	0.014	0.365
	[Satisfaction level = Yes]	0.424	0.251	2.852	1	0.091	1.529
	[Satisfaction level = Confused]	0b			0
High	Intercept	−1.914	1.605	1.422	1	0.233
	Age (in number)	0.100	0.048	4.288	1	0.038	1.105
	[Appetite level = Very low]	−1.437	0.934	2.365	1	0.124	0.238
	[Appetite level = Low]	−1.359	0.700	3.766	1	0.052	0.257
	[Appetite level = Medium]	−1.626	0.658	6.115	1	0.013	0.197
	[Appetite level = High]	−0.591	0.694	0.724	1	0.395	0.554
	[Appetite level = Very high]	0b			0
	[Communication with family = Daily]	−0.800	0.714	1.255	1	0.263	0.450
	[Communication with family = 2/3 days]	−1.049	0.729	2.070	1	0.150	0.350
	[Communication with family = Weekly]	−0.749	0.741	1.022	1	0.312	0.473
	[Communication with family = others]	0b			0
	[Family bonding = Weak]	1.165	0.716	2.651	1	0.104	3.207
	[Family bonding = Very Weak]	0.256	0.582	0.192	1	0.661	1.291
	[Family bonding = Medium]	−0.067	0.487	0.019	1	0.891	0.936
	[Family bonding = Strong]	0.326	0.474	0.474	1	0.491	1.385
	[Family bonding = Very Strong]	0b			0
	[Communication with friends = Rarely]	0.295	0.707	0.175	1	0.676	1.343
	[Communication with friends = Often]	0.299	0.713	0.176	1	0.675	1.348
	[Communication with friends = Daily]	0.537	0.750	0.512	1	0.474	1.710
	[Communication with friends = Never]	0b			0
	[Close friends nearby? = No]	0.076	0.283	0.072	1	0.789	1.079
	[Close friends nearby? = Yes]	0b			0
	[Social media usage = Low]	−0.550	0.380	2.093	1	0.148	0.577
	[Social media usage = Medium]	−0.157	0.361	0.190	1	0.663	0.855
	[Social media usage = High]	0b			0
	[Sensitivity other judgments = No]	0.343	0.456	0.566	1	0.452	1.410
	[Sensitivity other judgments = Sometimes]	0.375	0.360	1.085	1	0.298	1.455
	[Sensitivity other judgments = Yes]	0b			0
	[Satisfaction level = No]	0.764	0.379	4.049	1	0.044	2.146
	[Satisfaction level = Yes]	0.694	0.327	4.513	1	0.034	2.003
	[Satisfaction level = Confused]	0b			0
Very high	Intercept	1.678	2.192	0.586	1	0.444
	Age (in number)	0.072	0.073	0.977	1	0.323	1.075
	[Appetite level = Very low]	0.350	1.026	0.117	1	0.733	1.420
	[Appetite level = Low]	−1.649	0.968	2.903	1	0.088	0.192
	[Appetite level = Medium]	−1.553	0.758	4.192	1	0.041	0.212
	[Appetite level = High]	−1.105	0.828	1.780	1	0.182	0.331
	[Appetite level = Very high]	0b			0
	[Communication with family = Daily]	−1.313	0.889	2.183	1	0.140	0.269
	[Communication with family = 2/3 days]	−4.567	1.397	10.682	1	0.001	0.010
	[Communication with family = Weekly]	−3.056	1.176	6.757	1	0.009	0.047
	[Communication with family = others]	0b			0
	[Family bonding = Weak]	0.752	0.977	0.593	1	0.441	2.122
	[Family bonding = Very Weak]	−1.482	1.070	1.918	1	0.166	0.227
	[Family bonding = Medium]	−0.999	0.670	2.224	1	0.136	0.368
	[Family bonding = Strong]	−0.646	0.592	1.190	1	0.275	0.524
	[Family bonding = Very Strong]	0b			0
	[Communication with friends = Rarely]	−1.346	0.747	3.245	1	0.072	0.260
	[Communication with friends = Often]	−2.776	0.824	11.346	1	0.001	0.062
	[Communication with friends = Daily]	−2.230	0.806	7.662	1	0.006	0.108
	[Communication with friends = Never]	0b			0
	[Close friends nearby? = No]	−0.800	0.476	2.825	1	0.093	0.449
	[Close friends nearby? = Yes]	0b			0
	[Social media usage = Low]	−2.632	0.740	12.659	1	0.000	0.072
	[Social media usage = Medium]	−1.040	0.474	4.809	1	0.028	0.353
	[Social media usage = High]	0b			0
	[Sensitivity other judgments = No]	2.076	0.720	8.312	1	0.004	7.976
	[Sensitivity other judgments = Sometimes]	0.673	0.690	0.950	1	0.330	1.959
	[Sensitivity other judgments = Yes]	0b			0
	[Satisfaction level = No]	1.577	0.655	5.797	1	0.016	4.841
	[Satisfaction level = Yes]	0.898	0.601	2.234	1	0.135	2.454
	[Satisfaction level = Confused]	0b			0

Discussion

The mean age of the students was 20.93 ± 2.72 years. A study at King Saud University in Saudi Arabia produced remarkably comparable results. The respondents’ average age was 22, according to the study. 71.9% of the students in this study were single. Similar results were found at King Saud University in Saudi Arabia, where 95.7% of respondents were single, and 4.3% were married [15]. A previous study revealed that, among 200 respondents, 61.5% were moderately stressed, 18.5% were stressed at a low level, and 20% had a high level of stress [16]. In a study, severe stress was almost equal (although slightly higher in males) for both sexes. However, the feeling of a moderate level of stress was more associated with female students (F = 78.33%) [17]. The results were quite similar to those of our study. In our study, the higher stress level in males was slightly higher than in females (9.1% and 7.1%). A study in India about factors related to stress among Indian dental students showed most of the participants were female (57%) [9], unlike this study, where we had more male participants than females (male 53.6% and female 46.4%).

This study explored the factors influencing stress levels among 636 participants, focusing on demographic, psychological, and social aspects. Our findings revealed several noteworthy patterns. Demographically, gender and residence emerged as influential factors. Females experienced slightly higher stress levels than males, and participants from rural and semi-urban areas reported higher stress than those in urban areas. Psychological factors highlighted the significance of appetite levels, family bonding, and judgment sensitivity. Participants with lower appetite levels experienced less “very high” stress, and moderate family bonding was associated with “lower stress” and “medium stress.” Sensitivity to judgments related to nuanced stress patterns and social dynamics played a crucial role. Regular communication with family and friends correlated with reduced odds of very high stress, underscoring the importance of social support. Social media usage showed a mixed effect, with medium and low usage relating to lower stress. The study’s findings emphasize the complexity of stress experiences and the interaction of various factors. These insights can inform targeted interventions for stress management and well-being among young adults. Nonetheless, longitudinal studies are essential for validating these relationships and understanding their dynamics over time.

Conclusion

The research provided a comprehensive view of factors influencing stress levels among 636 participants. Demographic elements like gender, residence, and education contribute to stress variations. Psychological aspects such as appetite, family bonding, and sensitivity to judgments play vital roles. Communication between family and friends serves as a sign of social support, which reduces extreme stress. Interestingly, social media’s impact on stress is nuanced. These findings offer valuable insights for tailored interventions aiming to enhance well-being and manage stress. The study has the potential to identify ways to alleviate daily stress and increase awareness among other individuals. Longitudinal studies are needed for deeper insights into these relationships over time. This research contributes to a better understanding of stress and its multifaceted determinants, guiding strategies to improve mental health among young people and adults.