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Chapter II

REVIEW OF RELATED LITERATURE

This chapter presents a compilation of existing knowledge about the

topic under study which are lifted from different scholarly published
literature and studies. These information were deemed to provide essential
understanding in order to establish a firm foundation in the sense of
direction of this research. In addition, they were used to reinforce the
validity and reliability of the findings of this research.

Anxiety is a common mental health concern among college students. The

transition to college can be stressful, and students face various stressors such
as academic pressure, financial difficulties, social isolation, and uncertain
career prospects. Untreated anxiety can lead to poor academic performance, social
withdrawal, and impaired quality of life. This literature review aims to
synthesize recent studies on the prevalence, risk factors, and interventions for
anxiety among college students.

Prevalence of Anxiety among College Students

Studies have consistently reported high rates of anxiety among college

students. A recent meta-analysis of 129 studies involving over 46,000 college
students found a pooled prevalence rate of 31.9% for anxiety disorders (Cramer et
al., 2019). The most common anxiety disorders were generalized anxiety disorder
(GAD) and social anxiety disorder (SAD), followed by panic disorder, specific
phobia, and obsessive-compulsive disorder (OCD). The prevalence rates varied by
geographical region, with higher rates reported in North America and Europe than
in Asia and Africa.
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Risk factors for Anxiety among College Students

Various risk factors have been identified for anxiety among college
students. A longitudinal study of over 2,000 college students found that academic
stress, financial stress, and interpersonal stress were significant predictors of
anxiety symptoms (Elhai et al., 2018). Other studies have identified factors such
as prior history of anxiety, family history of anxiety, female gender, minority
status, and poor social support as risk factors for anxiety among college
students (Kessler et al., 2018; Zivin et al., 2018). Additionally, college-
specific stressors such as academic demands, peer pressure, and adjustment to new
environments have been found to contribute to anxiety among college students
(Hysenbegasi et al., 2018).

Distraction Theory in Relation to Anxiety Levels and Recreational Practices

Distraction theory suggests that engaging in recreational activities can
serve as a coping mechanism for individuals experiencing anxiety or stress.
College students are known to experience high levels of stress and anxiety due to
academic, financial, and social pressures. This literature review aims to explore
the relationship between distraction theory and anxiety levels in college
students, with a particular focus on recreational practices.

Distraction theory is based on the premise that attentional resources are

limited, and when an individual is faced with a stressful or anxiety-provoking
situation, they can use these limited resources to focus on activities that
distract them from the source of their distress (Brosschot, Gerin, & Thayer,
2006). Distraction can take many forms, such as engaging in leisure activities,
socializing with friends, or focusing on work or other activities. The theory
posits that these activities can provide a sense of control and reduce feelings
of helplessness or hopelessness in the face of anxiety or stress (Brosschot et
al., 2006).

College students are known to experience high levels of stress and anxiety
due to academic demands, financial pressures, and social challenges (Stallman,
2010). A number of studies have explored the relationship between anxiety levels
and recreational practices among college students. One study found that
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engagement in physical activity was associated with lower levels of anxiety and
stress among college students (Babson et al., 2010). Similarly, another study
found that engagement in creative arts activities was associated with lower
levels of anxiety among college students (Stuckey & Nobel, 2010).
In contrast, some studies have found that engagement in certain recreational
activities may actually increase anxiety levels in college students. For example,
one study found that heavy use of social media was associated with higher levels
of anxiety and depression among college students (Lin & Wen, 2017). Another study
found that engagement in high-risk recreational activities, such as binge
drinking or drug use, was associated with higher levels of anxiety among college
students (Kuntsche et al., 2008).
The literatures suggest that distraction theory may be a useful framework
for understanding the relationship between recreational practices and anxiety
levels in college students. Engaging in physical activity or creative arts
activities may serve as effective distractions that reduce anxiety levels, while
engaging in high-risk activities or heavy social media use may exacerbate anxiety
levels.
This also suggests that distraction theory can be useful in understanding
the relationship between recreational practices and anxiety levels among college
students. While engagement in certain types of recreational activities may reduce
anxiety levels, engagement in others may exacerbate anxiety. Further research is
needed to fully understand the nuances of this relationship and to identify
specific types of recreational activities that may be most effective in reducing
anxiety levels among college students.

Interventions for Anxiety among College Students

Several interventions have been developed and evaluated for anxiety among
college students. Cognitive-behavioral therapy (CBT) is a widely used evidence-
based intervention for anxiety disorders. A meta-analysis of 16 randomized
controlled trials (RCTs) of CBT for anxiety among college students found a
moderate effect size (d = 0.54) compared to control conditions (Paganini et al.,
2018). Other interventions such as mindfulness-based interventions, group
therapy, and pharmacotherapy have also been shown to be effective for anxiety
among college students (Bruffaerts et al., 2019; Hofmann et al., 2018).
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However, several challenges exist in implementing and disseminating

interventions for anxiety among college students. Barriers such as stigma, lack
of access to mental health services, and low treatment-seeking behavior have been
identified as significant challenges to addressing anxiety among college students
(Lipson et al., 2019; Villatte et al., 2018). Therefore, innovative and
accessible interventions such as internet-based interventions, mobile apps, and
peer-led interventions are being developed and evaluated to address these
barriers (Flett et al., 2018; Karyotaki et al., 2019).
Recreational activities are essential components of student life, as they
provide opportunities for relaxation and socialization. College students'
involvement in recreational activities is a critical aspect of their overall
well-being, which may impact their academic performance, physical health, and
social development. This literature review summarizes recent studies on
recreational activities among college students and highlights the benefits and
challenges associated with their participation.

Benefits of Recreational Activities for College Students

Participation in recreational activities can benefit college students in
several ways. According to a study conducted by Park et al. (2019), recreational
activities positively impact students' physical health, social relationships, and
academic success. Similarly, Galanek et al. (2020) found that recreational
activities could reduce stress, enhance social support, and improve mood among
college students. Furthermore, several studies suggest that engaging in physical
activities can improve cognitive performance and academic achievement (Pontifex
et al., 2019; Tomporowski et al., 2018).

Challenges Associated with Recreational Activities for College Students

Despite the numerous benefits associated with recreational activities,
college students may face several challenges that prevent them from
participating. For instance, the lack of time due to academic demands and work
responsibilities may limit their opportunities to engage in recreational
activities (Galanek et al., 2020). Moreover, financial constraints,
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transportation issues, and lack of access to facilities may limit students'

engagement in certain recreational activities (Kozub et al., 2018).

Types of Recreational Activities among College Students

College students engage in various recreational activities, including
physical activities, social events, and leisure pursuits. Physical activities
such as sports, exercise, and outdoor recreation are popular among college
students (Galanek et al., 2020; Park et al., 2019). Social events such as
parties, concerts, and festivals are also popular recreational activities among
college students (Kozub et al., 2018). Additionally, leisure pursuits such as
reading, listening to music, and watching movies are common among college
students (Galanek et al., 2020).

Gender Differences in Recreational Activities

Several studies have explored gender differences in college students'
participation in recreational activities. For instance, Kozub et al. (2018) found
that male students were more likely to engage in physical activities such as
sports and exercise, while female students were more likely to participate in
leisure pursuits such as reading and listening to music. Similarly, Park et al.
(2019) reported that male students were more likely to engage in outdoor
recreation activities such as hiking and camping, while female students were more
likely to participate in group exercise activities such as yoga and dance.

In conclusion, anxiety is a significant mental health concern among college

students, with high prevalence rates and various risk factors. Effective
interventions such as CBT, mindfulness-based interventions, and pharmacotherapy
exist, but several challenges to implementing and disseminating these
interventions exist. Therefore, innovative and accessible interventions are
needed to address the barriers to addressing anxiety among college students.

Relatively, recreational activities play a crucial role in college students'

overall well-being, providing numerous benefits such as improved physical health,
social relationships, and academic success. However, college students may face
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several challenges that limit their participation in recreational activities,

such as time constraints, financial limitations, and lack of access to
facilities. College students engage in various recreational activities, including
physical activities, social events, and leisure pursuits. Gender differences
exist in college students' participation in recreational activities, with males
more likely to engage in physical activities and females more likely to
participate in leisure pursuits. Further research is needed to explore effective
ways to promote and increase college students' participation in recreational
activities.