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Title

Author(s)

Irrational beliefs, depression, anxiety and stress of university


students in Hong Kong

Chan, Ho-wai, Queenie;

Citation

Issued Date

URL

Rights

2016

http://hdl.handle.net/10722/225100

The author retains all proprietary rights, (such as patent rights)


and the right to use in future works.

The University of Hong Kong


Faculty of Education

Irrational Beliefs, Depression, Anxiety and Stress of


University Students in Hong Kong

by

CHAN Ho Wai, Queenie

A thesis submitted in partial fulfillment of the requirements for


the Degree of Doctor of Education
at The University of Hong Kong

March 2016

Abstract of thesis entitled

Irrational Beliefs, Depression, Anxiety and Stress of University Students in


Hong Kong

Submitted by

CHAN Ho Wai, Queenie

for the Degree of Doctor of Education


at The University of Hong Kong
in March 2016

Stress, depression and anxiety in university students has become a great


concern globally. University students nowadays face many challenges, not merely
from academic demands, but from interpersonal affairs, career path planning,
financial burdens, and so forth. Literature review shows that university students
may harbor irrational beliefs that could play a significant role in causing
emotional disturbances (specifically stress, depression and anxiety). However,
these irrational beliefs vary across different societies with different cultural
values, academic workloads, family expectations and peer relationships.

The aims of this study were to construct a culturally relevant scale for
measuring irrational beliefs among university students in the Hong Kong Chinese
context, to examine the relationship of irrational beliefs with emotional
disturbances (specifically stress, anxiety and depression) in university students,
and to investigate the differences in irrational beliefs and depression, anxiety, and
i

stress between groups having different socio-demographic, academic and


environmental backgrounds.

The construction of the Chinese Irrational Beliefs and Rational Attitude Scale
(CIBRAS) for university students was based on (i) literature review (ii) expert
panel review for content validity evaluation, (iii) a pilot test of 200 HKU students
to determine the scales psychometric properties and probe the exploratory factor
analysis, and (iv) confirmatory factor analysis to test for construct validity of the
CIBRAS (conducted with a further 655 HKU students). The results showed that
the five-factor 19-item CIBRAS had good psychometric properties, including
good internal consistency (Cronbach Alphas ranging from 0.64 to 0.80), content
validity (CVI=0.96 for relevance, 0.94 for clarity and 0.94 for representativeness),
construct validity (explaining 60.1% of the total variance), and adequate fit
indices (NC=2.8, CFI=.94, NFI=.93, NNFI=.93, IFI=.94, RMSEA=.075, and
SRMR=.074).

The SEM results also showed that the model of Irrational Beliefs in
Depression-Anxiety-Stress for university students had good fit (NC=2.68,
CFI=.94, NFI=.91, NNFI=.93, IFI=.94, RMSEA=.051 and SRMR=.082). The
results showed that university students having higher levels of irrational beliefs
were more likely to have depression, anxiety and stress.

Two-way MANOVA results showed that second-year students had more


awfulizing beliefs than third-year students in the faculties of Engineering and
Education. ANOVA results and the Independent Sample t-test revealed that male
students, students from low income families, law students, those pursuing 5-year
ii

programs, those in the second year of study, or those living with family or with
inconvenient access to public transportation were likely to have more irrational
beliefs. In addition, male students, medical students, those studying 5-year
programs, those with inconvenient access to public transportation, those sharing
living arrangements with others or those with insufficient living space were found
having significantly higher levels of depression, anxiety and stress.

By developing the CIBRAS and understanding the relationship between


irrational beliefs and depression, anxiety and stress, this study provides important
implications for educational practitioners, policymakers, and clinical professionals
working with university students in Hong Kong and similar cultural contexts. This
study also sheds light on potential avenues for future research.

iii

Declaration

I declare that this thesis represents my own work, except where due
acknowledgement is made, and that it has not been previously included in a thesis,
dissertation or report submitted to this university or to any other institution for a
degree, diploma or other qualifications.

Signed
CHAN Ho Wai, Queenie

Acknowledgements

I give my whole-hearted appreciation to my professor, Dr Rachel Sun. Without


her encouragement and inspirational feedback, this thesis would never have been
completed. I will never forget her passion, dedication, knowledge and enthusiasm
into teaching every student, especially during the journey of my doctorate study.

I also want to thank Dr Patcy Yeung for her valuable comments on my work.
Her criticism and advice took this thesis to a higher level of intellectual achievement.
I would like to thank Eric and David for their editing and advice on statistical
solutions, respectively. The dissertation is much improved due to their efforts.

Finally, special thanks to my parents, my husband, my son and daughter, and


my sister and brother. Their support, encouragement, understanding and
assistance have been a wonderful source of inspiration for me. I could not have
completed this degree without their help and companionship throughout the years.

II

Table of Contents
Declaration

Acknowledgements

II

Table of Contents

III

List of Tables

VI

List of Figures

VIII

Chapter One

Background and Objectives .......................................................1

1.1

Background of the present study ............................................................1

1.2

Research gap of this study ......................................................................6

1.3

Focus and objectives of the present study .............................................9

1.4

Significance of this study ...................................................................... 11

Chapter Two
2.1

2.2

2.3

2.4

Literature Review ...................................................................13

Overview of stress theory and stress management..............................13


2.1.1

What is stress? ...........................................................................13

2.1.2

Approaches in stress management ...........................................14

2.1.3

Academic stress and its impacts on university students .........21

2.1.4

Domains of university stress ....................................................23

Depression and its impacts on university students ..............................34


2.2.1

What is depression? ..................................................................34

2.2.2

Prevalence of depression in different countries ......................36

2.2.3

Depression and university students .........................................38

Anxiety and its impacts on university students ...................................39


2.3.1

What is anxiety? ........................................................................39

2.3.2

Prevalence of anxiety in different countries ............................40

2.3.3

Anxiety and university students ...............................................41

Irrational beliefs and their role in emotional disturbances in university

students ...............................................................................................................42
2.4.1

History of development of REBT and irrational beliefs ........45

2.4.2

REBT model of emotional disturbance (depression, anxiety

and stress) in university students ..............................................................62


III

2.5

Conceptual framework of the present study ........................................65

Chapter Three

Research Design and Methodology .........................................74

3.1

Introduction............................................................................................74

3.2

History and mission of the University of Hong Kong (HKU) ...........75


3.2.1

Location and transportation ......................................................76

3.2.2

Faculties and programs .............................................................77

3.2.3

Facilities and services ...............................................................79

3.3

Ethical considerations ...........................................................................80

3.4

Research design .....................................................................................81

Chapter Four
4.1

4.2

Construction of CIBRAS .......................................................93

Construction of CIBRAS ......................................................................93


4.1.1

Introduction ...............................................................................93

4.1.2

Drafting of CIBRAS .................................................................93

4.1.3

Expert panel recruitment and scoring ......................................96

4.1.4

Result of expert panel evaluation of CIBRAS ........................97

4.1.5

Summary of the construction of CIBRAS.............................100

Psychometric properties of CIBRAS .................................................100


4.2.1

Introduction .............................................................................100

4.2.2

Subject characteristics ............................................................101

4.2.3

Demographic characteristics of the recruited subjects .........101

4.2.4

Characteristics related to academic-related variables ...........104

4.2.5

Characteristics related to living environment and

transportation ...........................................................................................106
4.3

4.4

Factor Analysis ....................................................................................108


4.3.1

Factor analysis of CIBRAS ....................................................108

4.3.2

Factor structure of CIBRAS ...................................................110

4.3.3

Reliability of CIBRAS and DASS .........................................115

Chapter Summary ................................................................................117

Chapter Five
5.1

Results of the main study .....................................................118

Psychometric properties of the survey instruments...........................118


5.1.1

Introduction .............................................................................118

5.1.2

Subject characteristics ............................................................118

5.1.3

Demographic profile ...............................................................119

5.1.4

Characteristics related to academic-related variables ...........122

5.1.5

Characteristics related to living environment and

transportation ...........................................................................................124
5.2

Psychometric properties of CIBRAS .................................................126


5.2.1

Confirmatory Factor Analysis of CIBRAS ...........................126


IV

5.2.2

Data analysis ...........................................................................126

5.2.3

Reliability of CIBRAS ...........................................................130

5.2.4

Summary of psychometric properties of the survey

instruments ...............................................................................................131
5.3

Interaction and group differences in irrational beliefs and depression,

anxiety and stress .............................................................................................132


5.3.1

Introduction .............................................................................132

5.3.2

Irrational beliefs and depression, anxiety and stress ............132

5.4

Predictive model of Irrational Beliefs and Depression-Anxiety-Stress

for university students .....................................................................................154


5.4.1

Correlation between CIBRAS and DASS .............................154

5.4.2

The hypothesized model of Irrational Beliefs and Depression-

Anxiety-Stress ..........................................................................................157
5.5

Summary of Findings ..........................................................................163

Chapter Six
6.1

Discussion, Implications and Conclusion .............................166


Discussion ............................................................................................166

6.1.1

Introduction .............................................................................166

6.1.2

Psychometric properties of the CIBRAS...............................166

6.1.3

Socio-demographic factors contribute to irrational beliefs and

depression, anxiety and stress .................................................................169


6.1.4

Academic-related factors contribute to irrational beliefs and

depression, anxiety and stress .................................................................174


6.1.5

Environmental and transportation factors contribute to

irrational beliefs and depression, anxiety and stress .............................180


6.1.6

Irrational beliefs and emotional disturbance .........................183

6.2

Implications of the study .....................................................................186

6.3

Limitations of the study ......................................................................190

6.4

Conclusion ...........................................................................................192

References

194

Appendices
(A)

A panel review form

225

(B)

A table summary of expert panel comments and revision

231

(C)

Phase I & II questionnaires

239

List of Tables
Pages
3.1
4.1
4.2

Undergraduate student intake in 2012-2013


Chinese Irrational Beliefs and Rational Attitude Scale (CIBRAS) 37 items
CVI rating of CIBRAS on relevance, clarity and representativeness
by 12 experts

86
95
99

4.3

Demographic characteristics among all students (N=200)

103

4.4

Characteristics related to academic-related variables (N=200)

105

4.5

Characteristics related to living environment and transportation


variables (N=200)

107

4.6

Item-Total Correlation Analysis of 37-Item

109

4.7

Factor loading on the items of CIBRAS in the five factors

112

4.8

Factor loading on the items CIBRAS selected to be included in the


five factors

114

4.9

Reliability of the CIBRAS and other instruments

116

5.1

Demographic characteristics among all students (N=655)

121

5.2

Characteristics related to academic-related variable (N=655)

123

5.3

Characteristics related to living environment and transportation


variables (N=655)

125

5.4

Fit index values in CFA

127

5.5

Reliability of sub-scales of the CIBRAS

130

5.6

Result of Multivariate Analyses of Variance (MANOVA)

135

5.7
5.8
5.9
5.10
5.11

CIBRAS sub-scores and CIBRAS total scores by demographic


characteristics among all subjects (N=655)
DASS depression, anxiety, stress and DASS total scores by
demographic characteristics among all subjects (N=655)
CIBRAS sub-scores and CIBRAS total scores by academic-related
issues among all subjects (N=655)
DASS depression, anxiety, stress and DASS total scores by
academic-related issues among all subjects (N=655)
CIBRAS sub-scores and CIBRAS total scores by living environment
and transportation variables among all subjects (N=655)

138
140
144
147
150

DASS depression, anxiety, stress and DASS total scores by living


5.12

environment and transportation variables among all subjects

153

(N=655)
5.13

Correlations between DASS (Depression) and CIBRAS

156
VI

5.14

Correlations between DASS (Anxiety) and CIBRAS

156

5.15

Correlations between DASS (Stress) and CIBRAS

156

5.16

Correlations between DASS and CIBRAS

156

5.17

Fit index values in SEM

159

5.18
5.19
5.20

The hypothesized model of Irrational Beliefs and DepressionAnxiety-Stress for university students (Model A)
The hypothesized model of Irrational Beliefs and DepressionAnxiety-Stress for university students (Model B)
The hypothesized model of Irrational Beliefs and DepressionAnxiety-Stress for university students (Model C)

160
161
162

VII

List of Figures
Pages
2.1
2.2
2.3

The hypothesized model of Irrational Beliefs and DepressionAnxiety-Stress for university students (Model A)
The hypothesized model of Irrational Beliefs and DepressionAnxiety-Stress for university students (Model B)
The hypothesized model of Irrational Beliefs and DepressionAnxiety-Stress for university students (Model C)

68
69
69

4.1

Scree plot of the EFA

111

5.1

Measurement Model for CIBRAS

128

5.2
5.3
5.4

The hypothesized model of Irrational Beliefs and DepressionAnxiety-Stress for university students (Model A)
The hypothesized model of Irrational Beliefs and DepressionAnxiety-Stress for university students (Model B)
The hypothesized model of Irrational Beliefs and DepressionAnxiety-Stress for university students (Model C)

160
161
162

VIII

Chapter One

1.1

Background and Objectives

Background of the present study

For the academic year 2012/2013, there were 93,934 students enrolled in
local university programs, including 7,041 sub-degree students, 76,353
undergraduate students and 10,540 postgraduate students (UGC, 2013). At HKU,
the overall student enrolment in undergraduate programs is 15,560 (HKU, 2012).
Anxiety and depression were reported in youngsters, particularly university
students. Indeed, university years have been considered one of the most stressful
periods of a persons life (Hales, 2009). Zhao (2007) suggested that Chinese
education has been characterized as being examination-oriented, and the scores of
academic results represent the only indicator of success. University is a stressful
time for many students, as they need to adapt to new educational and social
environments (Essandoh, 1995). It is even more stressful for international
students, who must learn different cultural values and languages in addition to
coping with academic requirements (Mori, 2000).

Research has shown an increase in university students stress in the United

States (Misra & Castillo, 2004). Some academic stressors, such as academic
competition, parental expectations, time management, financial burdens and
academic performance were reported (Cheng, Leong, & Geist, 1993). According
to Oswalt and Riddock (2007). Coursework has a significant impact on students
stress. Similar results were also reported by other authors (Iglesias et al., 2005;
Kaitelidou & Pavlakis, 2007). The high level of stress related to academic
performance is consistent with existing literature (Stecker, 2004).

Gender differences play a role in the perception and reaction to academic


stressors (Misra, Mckean, West, & Russo, 2000). They suggested that perceived
academic stress and coping strategies might differ across genders and cultures.
For instance, female students were more likely to express their feelings, and
perceived that they mattered more to their friends and their university. However,
they also felt greater pressure from academic stressors, such as examinations,
excessive homework, time management and peer competition (Dwyer &
Cummings, 2001). In contrast, male students are more likely to control their
emotions and accept their problems, but they do not often think their situation
through or make an effort at problem-solving (Hyde & Plant, 1995). Male and
female students are also different in coping with stress. According to Oswalt and

Riddock (2007), the two most common coping strategies used by females are
talking with friends and eating comfort foods. In contrast, males are more likely to
veg out or resort to exercise. In comparing the stress levels between males and
females, it was found that females are more stressed than males (Dusselier, Dunn,
Wang, Shelley, & Wahlen, 2005; Oswalt & Riddock, 2007).

In terms of different cultural backgrounds, some characteristics are quite


similar among international students. Tas (2013) found that many international
students who are experiencing great difficulties with life changes and cultural
adjustments are quite stressed. These factors have been identified as impacting the
academic success and retention of international students (Andrade, 2009).
Students who fail to achieve their desired academic performance are more likely
to experience psychological distress (Essandoh, 1995). However, it is difficult for
students to adapt to a new educational system and policy in a short period.

According to Pan (2011), international students generally experience some


acculturative stressors which include language-related issues, academic issues,
psycho-social-cultural issues and financial issues. These acculturative stressors
have been found to have a relationship to the levels of anxiety, depression and

suicidal ideation. The four types of acculturative strategies proposed by Berry


(1995) include 1) integration, where a person wishes to maintain his or her own
culture, while interacting with the host culture; 2) assimilation, where a person
does not want to hold his or her own cultural identity during daily interactions
with the host culture; 3) separation, where a person holds the value of his or her
own culture and avoids interacting with the host culture; and 4) marginalization,
where a person has little interest in either holding his or her own culture or
interacting with the host culture. Research has found that integration is linked to
the lowest levels of acculturative stress; assimilation is related to medium levels
of acculturative stress; and separation and marginalization are associated with the
highest degree of acculturative stress (Kosic, 2004).

Furthermore, research showed that the year of student attendance is related to


the degree of academic stress. Some studies suggested that first-year study in
university is the most stressful year because students face many new stressors
during the transitional period of starting a new life at university; they are expected
to handle multiple tasks and difficult social situations (Welle & Graf, 2011; Wong,
Cheung, Chan, Ma, & Tang, 2006). However, graduation from university is
another life transition that may increase psychological disorders in students.

During their senior year, students perceive that they will lose their identity as
students, and must prepare for their life after graduation from university.
Moreover, they find themselves facing the prospect of financial independence
after leaving university. Therefore, a students ambiguity about his or her future
role likely peaks during senior year.

Many studies in western countries found that there was significant


relationship between irrational beliefs and emotional disturbance in college
students (Al-Salameh, 2011; Dilorenzo, David, & Montgomery, 2011; Robert &
Harnish, 2010). Some studies (Lake, 2000; Sheehy & Horan, 2004) suggested that
irrational beliefs were higher in a particular academic year (the freshman year)
and some faculties (e.g. Law and Medicine). Ellis (1962) suggested that irrational
beliefs are the major factor leading to emotional and behavioral disorders. The
REBT helps explain the role of irrational beliefs in influencing emotional
disturbances. According to REBT theory by Ellis, troubles experienced by an
individual are not caused by particular situations; instead, they are caused by an
individuals evaluation of such situations.

Many studies confirm the correlation between irrational beliefs with different

forms of emotional disturbance in university students (Amutio & Smith, 2007;


Boyacioglu & Kucuk, 2011). However, there has been lacking a suitable
instrument to measure irrational beliefs in Chinese society. Unlike western
students, Chinese students living in Confucian countries rank success in academic
life, future career, and parental and familial expectations as their top concerns
(Stankov, 2010; Woo et al., 2004). Therefore, the instrument to measure irrational
beliefs should be culturally relevant and specific. However, there are few studies
investigating the role of irrational beliefs and their impacts in a Chinese societal
context.

1.2

Research gap of this study

Academic stress, depression and anxiety amongst university students has


been a great concern globally. University students nowadays face many and varied
challenges, not merely from academic demands, but from interpersonal
relationships, career path planning, financial burdens, and so on. Literature review
shows that university students may have irrational beliefs which could play a
significant role in causing emotional disturbance (stress, depression and anxiety)
(Amutio & Smith, 2007; Boyacioglu & Kucuk, 2011; Robert & Harnish, 2010).

However, these irrational beliefs vary across different societies because of


different cultural backgrounds, family values, academic workloads, expectations
of academic achievement and peer relationships (Dyrbye, Thomas, & Shanafelt,
2006; Marshall, 2008; Stroud et al., 2011; Woods, Kurtz-Costes, & Rowley,
2005). Hence, it is important to understand the model of irrational beliefs.

Nevertheless, a suitable instrument for measuring irrational beliefs in college


students in Chinese society has been lacking. Unlike Western students, Chinese
students living in Confucian countries would place success in academic life,
future and career as their top concerns (Stankov, 2010) and are concerned how
they are evaluated by their families, relatives and peers (Woo et al., 2004).
Therefore, the instrument for measuring irrational beliefs should be culturally
relevant and specific to reflect these characteristics.

There are some irrational beliefs scales using broad statements in clinical
research, which in turn lead to mixed results and inconclusive findings. Solomon
et al. (2003) proposed that more sensitive measures of cognitive construct which
adopt highly individualized measurement tools are needed to detect depressionprone individuals. To fill this research gap, it is important to develop an

empirically useful instrument to measure irrational beliefs among university


students in Hong Kong. This serves to provide objective measurement in
understanding the pattern and factors that may affect emotional disturbance
among university students in Chinese society.

Since there is little research studying the relationship between irrational


beliefs and emotional disturbances such as stress, anxiety and depression in
university students, particularly in the Hong Kong Chinese context, it is
worthwhile to conduct a research study to investigate the relationship between
irrational beliefs and emotional disturbance. In addition, some studies suggested
that there was significant correlation between irrational beliefs and emotional
disturbance in college students (Kleijn, Van Der Ploeg, & Topman, 1994; William,
1996). But as mentioned above, there are few studies investigating the role of
irrational beliefs and their impacts in a Chinese cultural context. Therefore, it is
important to examine which factors contribute to irrational beliefs and emotional
disturbance in Chinese university students.

University life has been found to be one of the most stressful periods in a
persons lifetime. Many studies have found that in Western countries, irrational

beliefs are related to socio-demographic variables, academic-related variables, and


living environment and transportation aspects (Macavei & Mircea, 2008; Peden,
Rayens, Hall, & Grant, 2004). Hence, it will be of interest to ascertain the
interaction effects on and group differences in irrational beliefs and depression,
anxiety, and stress between students having different socio-demographic variables
(age, religion, gender and family income), academic-related variables (faculty,
study program, duration of program and current year) and living environment and
transportation variables (types of accommodation, living area and convenience of
transportation).

1.3

Focus and objectives of the present study

Given the background mentioned above, the focus of the present study was
on measuring irrational beliefs, and exploring the role of irrational beliefs in
contributing to emotional disturbances such as stress, anxiety and depression in
university students in Hong Kong. Specifically, the objectives of the study are to
enhance the understanding of:

1.

The model and structure of irrational beliefs in university students in Chinese

society.

2.

The relationship between irrational beliefs and emotional disturbances

(stress, depression and anxiety) in university students.

3.

The differences in irrational beliefs and emotional disturbances (stress,

depression and anxiety) between students of different gender, age, family income,
religion, current studying year, faculty, study program, duration of program, living
in different types of flat, and using different transportation.

The researcher holds the view that there is a demand for a specific instrument
to measure irrational beliefs, which should be culturally relevant, with good
psychometric properties. This can be applied to the investigation of the
relationship between irrational beliefs and emotional disturbance in university
students in Hong Kong. It would also serve to facilitate future empirical research
study in other Chinese societies for objective measurement, effective
communication and comparison.

10

1.4

Significance of this study

This study has examined the irrational beliefs structure and its impact on
emotional disturbance in university students. This in turn will contribute to social
science in the following aspects:

1.

Empirical aspect

This study helps to fill the knowledge gaps in understanding the types of
irrational beliefs and their role in contributing to emotional disturbance (stress,
anxiety and depression) in university students in the context of Hong Kong
society. The development of a psychometrically sound instrument to measure
irrational beliefs among university students is able to promote more empirical
research and enhance understanding of the issues.

2.

Theoretical aspect

By examining the factor structure of irrational beliefs and its role in


emotional disturbance, the study helps to enrich the conceptualization of irrational

11

beliefs, and applying REBT theories for emotional disturbance management.

3.

Practical aspect

The results of this study provide reference materials to formulate appropriate


strategies for handling emotional disturbance in university students. The
university administrators may be able to implement a policy on preventive
measures as well as launch effective programs to help students with emotional
disturbances.

12

Chapter Two

Literature Review

This section begins with an introduction to stress theory and discusses


different approaches in stress management. It follows with the impact of academic
stress upon university students. Finally, it describes the literature review of the
relationship of academic stress to depression and anxiety. The later section
introduces REBT theory, with a literature review of its history and measurements.
It then describes applying REBT theory in our proposed model of emotional
disturbance of university students. Finally, the research aims and hypothesis of
this study will be suggested.

2.1

Overview of stress theory and stress management

2.1.1 What is stress?

There are many definitions of stress, each of which has a different focus.
Researchers are still disagreed as to the nature of stress (Dua, 1994.). At its
broadest, stress is encountered when one experiences conditions perceived as
endangering physical or psychological function. These conditions are usually
13

named stressors by researchers. Severe stress may lead to psychological


problems or maladaptive behavior. According to McNamara (2000), stress may be
conceptualized within three main models: the stimulus-oriented approach; the
response-oriented approach; and the transactional-oriented approach. Besides,
some authors suggest mindfulness-based stress reduction is another effective
approach for stress management (Chiesa & Serretti, 2009; Shapiro, Astin, Bishop,
& Cordova, 2005).

2.1.2 Approaches in stress management

(1) Stimulus-oriented approach

Stress is an independent factor or environmental event that is perceived as


threatening and producing undesirable consequences for the recipient.
Accordingly to Selye (1980), many kinds of environmental events are usually
seen as stress stimuli or stressors, such as natural disasters, failed examinations,
job loss or divorce. On this view, there are many stimuli or events that result in
stress if an individual encounters one or more of them. The more stimulation a
person experiences, the higher the level of stress. Lazarus and Folkman (1984)

14

view this perspective as too restrictive, as it ignores individual differences in


vulnerability to stress-inducing events. Further, it seems to view all major life
changes as stressful and to avoid dealing with chronic stressors.

(2) Response-oriented approach

The response-oriented approach, couched in terms of biological reaction to


stress, focuses on response variables (Selye, 1976). It describes stress in terms of
the response from a person to a harmful or undesirable environment. When
stressful experience occurs, some physiological syndromes accompany it, such as
increased heart rate and respiration, elevated corticosteroid levels, and so on.
Selye (1980) calls his response the General Adaptation Syndrome, which is
categorized into the three sequential stages of alarm reaction, resistance, and
exhaustion in the individual under stress. Response is nonspecific; therefore, any
noxious stimulus may produce the same stages of response.

(3) Transactional-oriented approach

The transactional oriented approach, more to be used as the definition of

15

stress, is proposed by Lazarus and Folkman (1984). Stress is a particular


relationship between the person and the environment that is appraised by the
person as taxing or exceeding his or her resources and endangering his or her
well-being. Stress is seen as a complex and dynamic system of transactions
between the individual and the environment. Therefore, the stressfulness of
environmental events depends on a persons perception of the impact of these
situations and his or her available resources to deal with these.

This approach can help to illustrate why the same event with the same degree
of stress level is encountered as stressful for one person, but not for another.
According to Lazarus and Folkman (1984), two fundamental processes mediate
the person-environment relationship, namely cognitive appraisal and coping.
Cognitive appraisal, the mental process of event judgment involving primary
appraisal and secondary appraisal, is a process to determine why and what
particular transaction between the person and the environment is stressful (Cohen
& Lazarus, 1983). Coping is the process whereby a person handles the demands
of the individual-environment relationship that are appraised as stressful, and the
emotions they generate.

16

Following the cognitive appraisal of Lazaruss transactional-oriented


approach, the present study is underpinned by the insight that stress is a dynamic
system of transaction between a person and his or her environment, and the
stressfulness of environmental events depends on an individuals view of the
impact of these events. However, this study will not adopt this theory as its
conceptual framework, because coping is the other fundamental process of the
transactional-oriented approach, yet coping is not the focus of this study.

(4)

Mindfulness-based stress reduction

Mindfulness-based stress reduction (MBSR) is a standardized medication


program that uses the cultivation of mindfulness. It involves the development of a
particular kind of attention, nonjudgmental awareness, openness and acceptance
of present experiences. MBSR, a form of meditation originally derived from the
Theravada tradition of Buddhism (Hanh, 1976), was developed by Kabat-Zinn
and colleagues at the University of Massachusetts Medical Center (Kabat-Zinn,
1990). Mindfulness is defined as paying attention in a particular way: on
purpose, in the present moment, and nonjudgmentally (Kabat-Zinn, 1994). It
comprehends three different kinds of techniques, including body scan, sitting

17

meditation and Hatha yoga practice. Through MBSR, people are taught to observe
situations and thoughts nonjudgmentally and not react impulsively. This can help
them to create a reflexive awareness of inner and outer experiences, which
presents as an efficacious tool for stress reduction.

Research shows that mindfulness interventions can reduce depression,


anxiety and stress effectively (Kearney, McDermott, Malte, Martinez, & Simpson,
2012; Shapiro, Schwartz, & Bonner, 1998). Further, a study also demonstrates that
MBSR is effective for clinical interventions, particularly in situations which are
exacerbated by stress (Speca, Carlson, Goodey, & Angen, 2000).

2.1.3

Limitation of stress and coping model

There are some limitations with respect to stress management approaches.


Firstly, the main criticism of the Stimulus-based approach is that people respond
to the same stressful event differently. For instance, some people respond more,
some respond less, and some do not respond at all, though objectively that have
faced the same event (Houston, 1987). The approach ignores individual
differences in vulnerability to stress-inducing events. Another limitation of this

18

approach is that it does not cover physiological mechanisms nor make distinctions
clear between cause and effect.

Moreover, the response-based approach was criticized in that it does not


account for individual differences, does not account for differences in stressors,
and does not pay attention to cognitive processing of stressors (Sharma & Romas,
2011). It supposes that all stressors trigger the same response pattern in all people.
However, to even the same level of stress, people respond differently. There are
individual differences in response to stress physiologically, including heart rate
and respiratory rate. Also, when people are exposed to acute stressors again or to
chronic stressors, some of the hormonal responses disappear (McNamara, 2000).

The transactional model of stress has also received criticism. Since the
treatment of the stress response ignores the significance of sequencing and
response pattern in individuals, it is criticized for failure to apply a holistic
method to the stress process. Another criticism is that coping is not assessed
objectively, and does not account for personality characteristics and physiological
mechanisms (Sharma & Romas, 2011).

19

Finally, the limitation of the mindfulness-based stress reduction is that most


people lack time and resources to participate in extensive meditation programs
(Sharma & Rush, 2014). It was reported that some researchers did not have
adequate mindfulness meditation experience and rely merely on conceptual
knowledge of mindfulness (Grossman, 2011; Kabat-Zinn, 2003). Indeed,
mindfulness requires gradual practice and experiential understanding, in which
people have to invest time to develop these skills.

In view of the above drawbacks and limitations of the said approaches,


REBT seems to be more favorable and appropriate in our theoretical framework.
It allows the researcher to use objective measuring tools to measure irrational
beliefs of individual students. It accounts for individual difference and provides
objective outcome measurement. The disputation of irrational beliefs are direct
and efficient methods as compared to time-demanding meditation for stress
reduction. The pragmatic and direct solutions characteristic of REBT are in line
with the Chinese values of Confucian pragmatism, which emphasizes dealing in
the present with an eye to the future (Chong & Liu, 2002; Lin, 2002).

In fact, literature review suggests that university students face much stress.

20

As students have to undergo the transition from secondary school to university,


most of them experience a socio-contextual shift. This shift to a new context is
often integrated with expanded perceptions of stress, higher academic workload,
peer relationship changes and greater responsibility for the students own choices
(Kerr et al., 2004). In order to obtain more knowledge of the stressors faced by
university students, the following chapters will review the descriptive findings of
academic stress, depression and anxiety.

2.1.3 Academic stress and its impacts on university students

(1) Academic stress in university students

Going through the process of adapting to a new educational system and


social environment is a stressful time for many new university students.
According to Hales (2009), the few years of university student life can be
considered one of the most stressful times in a persons life time. Students have to
face many different challenges, including academic, social and personal issues;
these lead to stress for university students (Hudd et al., 2000). Research has
shown an increase in stress in college students in the U.S. (Misra & Castillo,

21

2004). A similar situation appears to pertain in Hong Kong: in the Asian Wall
Street Journal, Ho (2000) revealed that academic stress that is faced by Hong
Kong students is increasing.

(2) The impact of academic stress

Stress has a negative impact on a students health condition and


psychological function. Chronic illness, family life events, social relationships,
and academic load show a strong correlation with stress in university students
(Damush, Hays, & Dimatteo, 1997). Some physical medical conditions are found
in university students with high levels of academic stress, including stomach
ulcers, asthma and high blood pressure (Aheneku, Nwosu, & Ahaneku, 2000).
These finding have been confirmed by Bossy (2000): stomachaches, abnormal
cholesterol levels, backache, fatigue and high blood pressure have been found in
university students, and all of these conditions are attributed to academic stress.
These students with high stress levels are reported to have a higher frequency of
suicidal ideation, alcohol and substance use, and bullying (Ma, Stewin, & Mah,
2001; McCormack, 1996).

22

Psychological health shows analogous outcomes on exposure to academic


stress, with depression, anxiety and negative emotions all associated with
academic stress. Some studies support the contention that in populations of
university students, mental health issues are frequently reported (Kisch, Leino, &
Silverman, 2005; Young, 2003). According to a survey from the National Mental
Health Association 2006, 1 in 10 university students were diagnosed with
depression. Other research found that from 1989 to 2001, the number of students
with depression had increased (Benton, Robertson, Wen-Chih, Newton, & Benton,
2003). Similar findings have come to light from China, where 17% of the
university students had moderate to severe psychological problems (Fan & Wang
2001). Moreover, 25 % of first-year students have occasionally thought of
committing suicide (Ji, 1999). Hudd et al. (2000) stated that students feeling stress
are more likely to experience lower self-esteem and perceive themselves as less
healthy, and they are more likely to engage in unhealthy behaviors such as junk
food consumption, binge drinking, and not doing exercise.

2.1.4 Domains of university stress

After literature review, four domains of university stress will be described,

23

including academic demands, interpersonal and family relationships, career path


considerations, and competitiveness and culture gaps. These domains are
considered unique factors in the Hong Kong educational system.

(1) Academic demands

Student stressors are mainly found to come from academic-related issues.


During the university years, the relationship between stress levels and academic
performance can be especially high (Iglesias et al., 2005). According to Abouserie
(1994), most university students experience moderate or severe stress, and are
influenced by stressors linked to their studies such as examination results and
workload. Research stated that first-year university students may perceive higher
stress levels resulting from academic stress, defined as performing coursework
under tight time deadlines, having to cope with large numbers of projects, quizzes
and exams, needing to meet multiple near-simultaneous deadlines, being unable to
complete assignments on time, or finding it hard to deal with instructors (Ragheb
& Mckinney, 1993). Researchers have shown that coursework is an indicator of a
students academic stress in Hong Kong, and the students spent their time on
coursework at a greater level than do students in other countries (Boys and Girls

24

Clubs Association of Hong Kong, 1990). More than 80% of students cited
coursework and examinations as the greatest sources of stress (Tyrer, 2001).

A study by Kim, Won, Liu, Liu, and Kitanishi (1997) showed that academicrelated matters are the major concerns for Chinese university students. This
situation applies to post-graduate students as well as undergraduates. In fact, stress
from studies is considered the major source of stress for students, especially for
students studying in Hong Kong under the exam-oriented education system, a
system noted for its dire outcomes in some areas of student development: The
result of this exam-oriented education is a large number of weary students with
inadequate psychological development, repressed personality and self-hatred, and
a general lack in the development of other abilities (Kirkpatrick & Zang, 2011).

(2) Interpersonal and family relationships

Because of the traditional Chinese cultures Confucian values inculcated in


Chinese students from early on in life, Chinese students strive hard for the high
academic achievement that is a major component of meeting parental
expectations. In Confucian terms, academic success is a demonstration of filial

25

piety, a highly valued cultural virtue. Importantly, this demonstration is also


public, and family pride (or shame) is related to the academic performance of its
children. This cultural association of filial piety with academic success may be
associated with academic stress. Family pride or shame is related to childrens
academic achievement. A study from Tao (2003) of Hong Kong university
students supported this view. She found that academic achievement is linked to
filial piety. A students struggle to obtain excellent academic performance is
viewed as a moral obligation which is associated with family pride. However,
poor performance is not considered an individual matter, but a familial matter.
Therefore, students are stressed when they cannot meet the demands and
expectations of their family. A similar result obtains from Xing, Huang, Huang, &
Sanchez (2005), where Chinese students experienced extreme anxiety compared
to American students, because Chinese students were worried that poor academic
performance would leave their parents worried and disappointed.

Stankov (2010) stated that Chinese students high levels of anxiety may be
attributed to the imperatives of Confucian societies. Academic success is
extremely important in the Confucian worldview and entails high expectations
imposed by students parents. Distress for students themselves is more likely to

26

follow upon academic failure. This kind of psychological pressure is more likely
to occur in Confucian than European societies (Stankov, 2013). Many studies
show that high levels of psychological distress are linked to mental disorders.
Students concern for their academic performance is highly linked to depressive
symptoms (Woo et al., 2004). Students in Confucian countries are more concerned
with their academic performance and how their family and peers evaluate them,
and this may be strongly associated with the onset of adolescent depression (Woo
et al., 2004).

In contrast with the strong individualist cultural assumptions of European


societies, Chinese culture is characterized by collectivism, which itself is strongly
correlated with modesty. Modesty implies social harmony and interdependence
with each other, and discourages exceptional behavior in society. Modesty may be
linked to students stress and depression (Stankov, 2013).

Recent research from Stankov (2013) found that in comparing the levels of
depression and life satisfaction between Confucian countries and European
counterparts, Confucian countries showed higher levels of depression and lower
levels of life satisfaction. In Hong Kong, where Confucian values are the

27

unquestioned default for the Chinese majority, filial piety and modesty are highly
esteemed. Students make great efforts to satisfy the expectations of their family,
peers and society. If they cannot satisfy such expectations, negative feelings or
psychological problems may result.

(3) Career path consideration and competitiveness

Many studies reveal that one stressor for university students is career-related
issues (Carson & Runco, 1999; Murphy & Archer, 1996). Research found that
there is a relationship between anxiety and the following aspects of career
indecision, including: lack of information about self and career; being unsure if
the degree earned will fit their career; and facing specific barriers to a previous
choice (Dickinson & Tokar, 2004; Fuqua, Newman, & Seaworth, 1988; Germeijs,
Verschueren, & Soenens, 2006; Vidal-Brown & Thompson, 2001). The results
were similar to Hawkins, Bradley, and White (1977) and Mojgans findings
(2011), which found anxiety to be significantly related to the nine selected
vocationally relevant issues, including: the choice of career; the possibility of
making a wrong choice; limited employment opportunities; the fear of being
trapped in a dead-end job; the possibility of failing in their vocation; the choice of

28

a career which conflicts with family expectations; the ability of oneself to meet
the requirements of the career field; choosing a career and needing to commit it
for ones whole life; and really being on ones own and independent of ones
parents.

Arnstein et al. (1999) claimed that the anticipation of financial


independence leads to stress for university students as they grow concerned about
their financial ability to support themselves after graduation, and may also relate
to higher levels of career indecision. Students become stressed when they find
themselves needing to face the prospect of being financially independent for the
first time. In a local study about stressors of Hong Kong students, it was reported
that they were worried about future prospects and finding employment after
graduation (Choy, Lam, & Ngai, 1990). Students found their classmates or friends
were direct competitors for their first preregistration house officer posts; many
students expressed that this was stressful.

Local students also perceive mainland Chinese students as their future


comparative competitors, as Chinas economy continues to grow in importance. A
study from Shen (2012) showed that more than 60 percent of Hong Kong students

29

claim that Shanghai has a comparable level of competitiveness to Hong Kong, and
around 16.69 percent of students believe that Shanghai is already more
competitive than Hong Kong. They are concerned that Hong Kong might be
overtaken by other Chinese cities in the next ten years. As reported by mainland
Chinese students, most of them are willing to take a job in Hong Kong to earn
overseas working experience; this leads to increased pressure for local students, as
they perceive that more candidates will compete for jobs with them. Indeed,
mainland students are becoming more and more competitive, and there will be an
increasing number of mainland students working in Hong Kong (Choy, Lam, &
Ngai, 1990).

(4) Culture gap

Universities in Hong Kong are international institutions of higher education


in Asia, and thus have attracted many students from around the world every year;
the prevalent rate of admission is gradually increasing, according to records from
the University of Hong Kong. In the academic year of 2012-2013, 37.1% of HKU
students admitted are international students. Among these, 67% come from
mainland China, and the rests are overseas students from USA, Canada, Europe,

30

Australia, and other Asian countries (HKU). Currently, most of the universities in
Hong Kong use English as the official medium of instruction. Of the eight
universities in Hong Kong, only the Chinese University of Hong Kong has a
bilingual language policy. The Hong Kong Institute of Education has a trilingual
policy, while the other six universities all use English as the medium of instruction
(Kirkpatrick, 2011). English is one of the official languages of Hong Kong and is
widely used in the formal contexts of government, education, law and written
business communication (Gao, 2008; Peng, 2005). However, in daily living, most
of local university students communicate with each other in Cantonese, which
many mainland Chinese cannot understand; this has become a major barrier for
socialization (Evans & Morrison, 2011).

Although Hong Kong shares some similar cultural traits with mainland
China, most mainland students studying in Hong Kong still have difficulties in
their academic and daily lives because of the different ideologies and language
barriers (Zeng, 2006). Two of the common adjustment problems mainland
students often experience are academic adaptation, referring to the lack of
language proficiency in English and Cantonese, and social adaptation, referring to
peer relationships in new situations, unfamiliarity with university facilities and

31

networks, and lack of family support (Chan, 2002). Pan (2008) also stated that
mainland students invariably face problems with English in English-medium
instruction institutions. In addition, the majority of people in Hong Kong are
Chinese and think that Hong Kong and Mainland China are sibling cultures.
However, even though they share the basic similarities, there are still some
differences in some specific area like languages used and education systems.

Another strong risk factor for negative effects on mainland students is the
demands of academic work. Chinese students can experience many difficulties in
their academic work. Mainland Chinas education system emphasizes students
ability to absorb knowledge, rather than knowledge development; therefore, when
students enter universities in Hong Kong, they find they are not capable of doing
research work. They also have difficulties engaging in group discussions and class
presentations, since Chinas education system does not emphasize these aspects
(Pan, Wong, Joubert, & Chan, 2007). Furthermore, since many of the Mainland
students in Hong Kong may not be prepared psychologically for the cultural
differences between Mainland China and Hong Kong, the gap between the
expectation and reality of the sojourn is another contributory factor to stress (Pan,
2011).

32

Foreign students more generally encounter similar cultural problems while


studying in Hong Kong. Here it is especially important to consider cultural
variations in collectivism versus individualism. Research showed that China is a
highly collectivist nation, but most of the Western countries are highly
individualist (Diener et al., 1995). In fact, the greater the difference between these
two cultural aspects, the greater the acculturation problems that may exist. This
finding is similar to Wards (1994), who found that in comparison with small
cross-cultural transitions, the problems of psychological adaption are greater in
sojourners who made large cross-cultural transitions.

Pan (2011) stated that cultural differences in the adaption of foreign students
are difficult for them. Their core values, lifestyles and behavioral patterns are
quite different from the local students in Hong Kong. These students have no
problem in using English as the language of instruction in studying. However,
most Hong Kong residents use Cantonese to communicate with each other in their
daily lives, and some local students are reluctant to speak English for fear of
embarrassment. As a result, they hesitate to make friends with foreign students.
Therefore, it not easy for foreign students to blend into the culture of the local
students. Lack of awareness of international students is another issue. Since

33

international students are a minority at university, they are easily ignored by local
students.

In summary, most of the international students in Hong Kong, either


Mainland Chinese students or overseas students, experience an array of
acculturative stressors during their university years. Such stressors have
consistently been found to be related to psychological disorders such as anxiety
and depressive symptoms.

2.2

Depression and its impacts on university students

2.2.1 What is depression?

Depression is characterized as a mental disorder that affects peoples feeling,


thoughts and behaviors. It is associated with psychological, behavioral and
physical symptoms (Das & Mishra, 2010). One may have feelings of depressed
mood, low energy, disturbed appetite, trouble sleeping, feelings of hopelessness,
and even low self-worth. Ones daily life can be affected to an extreme.
Nowadays, about one hundred and thirty million people have depressive disorder

34

worldwide (WHO, 2011). In 2004, depression ranked third in the top ten disease
burdens in the world (WHO). According to the World Health Organization,
depression is a global health problem and it may be a significant cause of
mortality. WHO predicted that depression will rank second place as a cause of
death in 2020 (1995).

According to American Psychiatric Association (2013), the Diagnostic and


Statistical Manual (DSM-V) for Mental Disorders, if the depressed mood, or low
energy, or loss of interest, together with five or more of the below symptoms
persist for over two weeks and affect ones daily life, then a depressive episode is
diagnosed. Depressive symptoms include sad or depressed mood, loss of interest
in activities, negative thinking, feelings of hopelessness, guilt or anxiety, recurrent
thoughts of death, sleep disturbance, reduced sex drive, or vague somatic
complaints without apparent medical cause, such as headache or stomach ache.
Some studies stated that culture can affect the experience and communication of
depression symptoms (Baldwin, Chiu, Katona, & Graham, 2002). In some
cultures, depression may be reported mainly in physical terms rather than in
psychological terms. This is the same result as that found by Chi and Chou
(2003), that the depression symptom was reported differently depending on an

35

individuals cultural background.

2.2.2 Prevalence of depression in different countries

In the past, depression prevalence rates were low. Some earlier research
found depression prevalence rates of only 4.6% (Canino, Bird, & Shrout, 1987)
and 3.3% (Lee, Kwak, & Yamamoto, 1990). However, Verhey and Honig (1997)
stated that because of insensitive instruments and ambiguous diagnosis, such
results were not accurate. As people became more concerned with depression and
its impact, the instruments for measurement were better developed, such as those
in use in the DSM and WHO, which have developed standardized criteria for
diagnosis of depression as well as an accurate and proper assessment techniques.
This can facilitate a more realistic assessment of depression prevalence rates.

Depression is the most prevalent and common mental disorder in the United
States. According to Kessler (2003), about 16% of all US adults have experienced
depressive disorder in their lifetime, and 7% of people in the US were found to
have experienced depression in the past 12 months. This is similar to Hong Kong,
where a study showed that there was an 8.5% depressive disorder prevalence rate

36

in the past 12 months (Lee, Tsang, & Kwok, 2007). Moreover, females were
found to have an increased risk of depression. This is consistent with another
study which reported a significantly higher prevalence of depressive disorder in
females than in males (Lehtinen & Joukamaa, 1994). Studies showed that females
have higher levels of depression, which may be attributed to biopsychosocial
factors and physiological status (Bangasser et al., 2010; Zaid, Chan, & Ho, 2007).
This is consistent with the study by Angst (1997); because of biological and social
factors, females exhibit a two-fold greater prevalence of depression than males.
The American Psychiatric Association (2000) also showed that women are about
twice more likely than men to experience lifetime depression prevalence. In a
research study of US and Canadian medical students, female students were found
to have higher rates of psychological disorder than their male colleagues (Dyrbye,
Thomas, & Shanafelt, 2006). Females perceive events to be more stressful than
males, and females report more depression than do males (Carter, 2000; Matud,
2004). However, many studies suggest that gender differences in depression
prevalence reach zero after the age of 50.

37

2.2.3 Depression and university students

Even though people of all ages will be affected by depression, depression in


university students is significant because students are in the stage of transition
from adolescence to adulthood, not only in terms of physiological function, but in
terms of psychosocial function. After students enter university, they encounter
many academic stressors. A study has found that most university students
experience moderate (77.6%) or serious (10.4%) stress, and these stressors are
related to academic matters (Blazer, Kessler, McGonagle, & Swartz, 1994).
Student performance in college or university is affected by depressive disorder
(Dyson & Renk, 2006). Depressive disorder leads students to have low energy and
decreases interest in engaging in academic activities.

Another study also suggested that psychological distress among university


students may have a negative influence on their academic performance, leading to
academic dishonesty, or alcohol and substance abuse (Heiligenstein, Guenther,
Hsu, & Herman, 1996). More importantly, adolescent depression is often
associated with suicide. In the United States, suicide is the second leading cause
of death in college and university students (Schwartz, 2006). The literature

38

indicated that depression and perceived stress have been correlated consistently;
greater depression has been linked to higher levels of academic stress (Dyson &
Renk, 2006). Moreover, studies reveal that there are high rates of depression,
stress and suicidal ideation among university students (Fergusson & Woodward,
2002; Heiligenstein et al., 1996). According to a study of students in local
universities, 21% of first-year university students had clinically significant
depression (Wong, Cheung, Chan, Ma, & Tang, 2006). Another similar study was
conducted afterward, and the result found that approximately 43.9 % of freshmen
in Hong Kong had significant depressive symptoms (Song el al., 2008). It was
evident that academic stress and depression are the most important problems for
university students (MacGeorge, Samter, & Gillihan, 2005; Sasaki & Yamasaki,
2007).

2.3

Anxiety and its impacts on university students

2.3.1 What is anxiety?

Anxiety is an unpleasant mood state characterized by uneasiness, and worry


somatic symptoms. Indications of nervous behavior may often be evident, such as

39

pacing back and forth, somatic complaints and rumination, similar to the tension
caused when a person subjectively feels dread over something unlikely to happen
or anticipates impending danger, catastrophe, or misfortune. Kaplan and Sadock
(1996) stated that anxiety is characterized by a diffuse, unpleasant, vague sense
of apprehension, often accompanied by autonomic symptoms, such as headache,
perspiration, palpitations, tightness in the chest, and mild stomach discomfort. In
fact, anxiety, a natural human experience and reaction to perceived danger,
stimulates people to prepare for high-alert situations. All people experience
anxiety, but not all experience the same signs of anxiety in the same way. The
anxiety symptoms vary greatly.

2.3.2 Prevalence of anxiety in different countries

The common mental health problems among university students are stress,
depression and anxiety (Dyrbye, Thomas, & Shanafelt, 2006), which affected
student performance and academic achievement at university (Dusselier, Dunn,
Wang, Shelley, & Whalen, 2005; Stewart-Brown et al., 2000). Many studies report
higher prevalence rates of stress, depression and anxiety in university student
populations in different countries. Bayram and Bilgel (2008) revealed the high

40

rate of stress, depression and anxiety (27%, 27.1% and 47.1%) among Turkish
university students. Recently, Shamsuddin et al. (2013) made a similar
observation of apparently high rates of stress, depression and anxiety among
Malaysian university students. The results showed that among all students, 18.6%
had moderate stress levels, and 5.1% had severe stress levels; 27.5% had
moderate depression, and 9.7% had severe depression; and 34% had moderate
anxiety, and 29% had severe anxiety. This is consistent with other studies that
show high prevalence of psychological disorders among university students
globally (Adewuya, Ola, & Afolabi, 2006; Ovuga, Boardman, & Wasserman,
2006; Wong et al., 2006). The recent increase in the number of university students
with severe health problems has been reported by experts (Bernhard, 2007).

2.3.3 Anxiety and university students

Kessler and his colleagues (2005) found that anxiety and depression, often
combined together, are the most prevalent mental health problems. This is true
also for university student populations (Adalf, Gliksman, Demers, & NewtonTaylor, 2001). A study showed that one-year prevalence rates for Major
Depressive Disorder among the students of a Canadian university were 7% for

41

men and 14% for women; for Anxiety Disorder the rates were 13% for men and
19% for women (Price, Mcleod, Gleich, & Hand, 2006). Chinese students had
higher rates of mental health problems compared to Western students. A study
supported this phenomenon that Chinese students experienced greater anxiety
than American students, because they feared poor academic performance would
make their parents worried and disappointed (Xing et al., 2005). This is in
consistent with research by Tao (2003) that Chinese students are anxious about
how they are evaluated by other people; specifically, they are concerned about
how their academic attainment will be evaluated by their significant others. In a
survey of local university students, results suggested that they had depression,
anxiety and stress levels at moderate severity or above at rates of 21%, 41% and
27% of the participants, respectively (Wong, Cheung, Chan, Ma, & Tang, 2006).

2.4

Irrational beliefs and their role in emotional


disturbances in university students

University has been considered to be one of the most stressful periods in a


persons life. Students face many challenges from academic, social and personal
issues, which may cause stress for students (Hudd et al., 2000). Not all students

42

respond negatively to academic stress; some may find that stress can inspire them
to work hard to achieve their goals. However, for some students, stress has a
negative impact on their health and psychological function. The correlation among
chronic illness, family life issues, academic load and poor social relationships is
quite strong (Aheneku et al., 2000; Damush, Hays, & Dimatteo, 1997). Ellis
(1962) proposed that irrational beliefs are the major factor causing emotional and
behavior disorders. According to REBT theory by Ellis, troubles experienced by a
person are not caused by particular events; instead, they are caused by a persons
evaluation of such conditions.

The literature review showed that many studies confirm the correlation
between irrational beliefs with different forms of emotional disorders in university
students. An early study by Goldfried and Sobocinski (1975) revealed that there is
a relationship between irrational beliefs and disruptive examination anxiety in
first-year female university students. Arnkoff and Smith (1988) also found a
strong inverse relationship between irrational thoughts and actual achievement in
university students. These results are consistent with William (1996), who found
that test anxiety is correlated with negative thoughts from the university students.
Similarly, the study by Kleijn, Van Der Ploeg and Topman (1994) showed that

43

negative achievement beliefs were correlated with lower GPA scores for
university students in Germany.

More recently, research found that there is a significant and direct


relationship between high scores in irrational beliefs and stress levels (Amutio &
Smith, 2007). Other studies indicated that many first-year law students showed
irrational beliefs, such as I must study all the time, I must be at the top of my
class to be successful and I cant have a social life at law school, and I have no
time for leisure or for fun (Lake, 2000; Sheehy & Horan, 2004). A similar result
was found by Al-Salameh (2011) that the level of irrational beliefs among
Jordanian university students is quite high, and the study confirmed a statistically
significant inverse correlation between self-confidence and irrational beliefs. This
study also showed that the level of irrational beliefs for first-year students is
higher than for fourth-year students. From the literature, it is apparent that many
university students have different levels of irrational beliefs which play an
important role in many emotional disorders, including distress, depression and
anxiety (Boyacioglu & Kucuk, 2011; Dilorenzo, David, & Montgomery, 2011;
Hamidi & Hosseini, 2010; Lorcher, 2003; Robert & Harnish, 2010). Therefore, a
better understanding of irrational belief is useful in predicting student

44

psychological function.

The REBT helps explain the role of irrational beliefs in influencing


emotional disturbances. Below, the history and development of REBT is
described. This is followed with an introduction to different measurements of
irrational beliefs.

2.4.1 History of development of REBT and irrational beliefs

Rational Emotive Behavior Therapy (REBT) is the third name of a theory of


psychological intervention first proposed by Albert Ellis in the mid 1950s. The
original name was Rational Therapy (RT), introduced by Albert Ellis at the
American Psychologist Association convention in 1956. Ellis (1958) proposed
that emotional disturbances were mainly caused by irrational ideas. He reported
some successful treatment of various kinds of emotional disturbances by
persuading clients to change their irrational ideas (Ellis, 1958).

The name Rational Emotive Therapy (RET) was used by Ellis (1962) to
emphasize the strong role that emotional change has in his theory of personality

45

and in his clinical practice. Ellis (1993) changed the name of his theory to
Rational Emotive Behavior Therapy (REBT) to emphasize that it was cognitivebehavioral psychotherapy, which was inherently multi-modal in theory and
practice.

(1) The Theory and Practice of REBT

REBT theory proposes that human cognition, emotions and behaviors


interact with each other, and that changes in one will bring changes in the others
(Ellis, 1962). In spite of this interactional view, REBT theory mainly focuses on
the strong influence a persons beliefs have upon his or her emotions (Dryden,
2012 & 2013; Dryden & Ellis, 2001). According to REBT theory, the most
important cause of self-defeating and inappropriate behaviors are not events, but
rather a persons thoughts about the events, and the emotions that are caused by
our thoughts and emotional dysfunction are caused by irrational thoughts and
beliefs. These irrational beliefs are evaluative ideas with characteristics of being:
1) rigid; 2) inconsistent with reality; 3) illogical; and 4) of yielding dysfunctional
consequences. By contrast, rational beliefs are: 1) flexible; 2) consistent with
reality; 3) logical; and 4) yielding of functional consequences. Therefore, if a

46

person changes the manner in which they think about an event, they may also
change the behavior to react to the event.

(2) The ABCD Model

REBT is based on the ABCD model to conceptualize human psychological


functioning. In this model, (A) stands for the Activating event, (B) for a persons
Beliefs about that event, (C) for the emotional and behavioral Consequence, (D)
for Disputation. During the counselling process, REBT practitioners try to identify
and dispute irrational beliefs, and change them to rational beliefs. The disputation
of irrational thought is implemented through cognitive, emotive, and behavioral
counselling techniques.

(3) Rational Beliefs.

According to Ellis and Dryden (1997), a rational belief is an evaluative


cognition that is non-absolutist in nature. Dryden (2003, 2012, & 2013) stated that
a rational belief is flexible and/or non-extreme. Rational beliefs are also consistent
with reality and can be supported by empirical evidence. A person thinking

47

rationally can feel adaptive emotions, such as concern, sadness and annoyance. As
a result, a rational belief is constructive to help a person to attain his or her goal.
Some authors criticize that it may be difficulty to differentiate rational beliefs and
irrational beliefs. But theoretically, REBT states that rational beliefs have certain
characteristics; (1) flexible, (2) consistent with reality, (3) logical, and (4) yielding
of functional consequences. The following paragraphs will give more illustrations
with examples.

Dryden (2002, 2012, & 2013) has proposed four types of rational beliefs. The
first type of rational belief described by Dryden is a full preference, which
refers to flexible evaluations in the form of preferences, wishes, desires, want,
etc. (Dryden, 2002 & 2012). A person holding this belief feels that he/she wants
something, but it is not necessary to get it. For example: I wish to get an A+ in my
English test, but I dont have to get it.

A non-awfulizing beliefs is the second type of rational belief. It evaluates the


negative situation as bad or unfortunate, instead of awful or terrible. An example
of a non-awfulizing beliefs would be: it may be bad if I cant get a job after
graduation, but it is not awful.

48

Dryden refers to the third type of rational beliefs as High Frustration


Tolerance Belief; that refers to the evaluation of a negative event as difficult to
tolerate, but not intolerable. A person understands that it would be hard to bear the
particular negative situation, but it is not intolerable. For example, getting a D in
my Math test is hard to tolerate, but I can still stand it, and I will study hard and
get a better result in my next exam.

The fourth type of rational beliefs are Acceptance Beliefs. There are three
parts of acceptance beliefs: self-acceptance, other acceptance, and life acceptance
beliefs. In REBT theory, the notion of Unconditional Self-Acceptance refers to the
situation where even if one is flawed, one would accept oneself. Unconditional
Other Acceptance describes acceptance of the shortcomings of another person.
Unconditional Life Acceptance is used to describe a persons acceptance of life
conditions. An example of self-acceptance: If I was fired, it does not mean I am a
loser.

(4) Irrational Beliefs

The four characteristics of an irrational belief are described as. 1). Irrational

49

beliefs are rigid and extreme in nature; 2) Irrational beliefs tend to impede goal
attainment; 3) Irrational beliefs are illogical; 4) Irrational beliefs are also
inconsistent with reality (Dryden & Neenan, 2004; Dryden, 2012 & 2013). Ellis
(1958) proposed eleven types of irrational beliefs that lead people to become
emotionally disturbed. The original list of irrational beliefs is as follows:

1.

That it is a dire necessary for an adult human being to be loved or approved.

2.

That one should be thoroughly competent, adequate, and achieving.

3.

That certain people are bad, wicked, or villainous.

4.

That it is awful or catastrophic when things are not the way one would very

much like them to be.


5.

That human unhappiness is externally caused.

6.

That if something is or may be dangerous or fearsome one should be

obsessively concerned about it.


7.

That it is easier to avoid than to face certain life difficulties.

8.

That one should be dependent on others.

9.

That ones past history is an all-important determiner of ones present

behavior.
10. That one should become quite upset over other peoples problems and

50

disturbances.
11. That there is invariably a right, precise, and perfect solution to human
problems.

Subsequently, Ellis and Dryden (1987) developed four different types of


irrational belief processes, which included Rigid Demand, Awfulizing, Low
Frustration Tolerance beliefs and Global Evaluation.

Rigid Demand relates to what a person believes he must have or must not
have in life. It refers to absolutist requirements expressed in terms of must,
have to, ought and should. Demands could be place under one of the three
main musts: 1) Demands about self (I must perform well); 2) Demands about
others (You must treat me kindly and considerately; (3) Demands about the
world or living conditions: The universe must make things easy for me.

Awfulizing refers to a person evaluation of a bad situation as worse than it


should be. An individual believes that the situation or condition is terrible if it is
different from his/her expectation. For example, It is terrible that I could not get
a good GPA when I failed the test.

51

Low Frustration Tolerance refers to the belief that a negative condition or


situation cannot be tolerated. An individual believes that it is not possible to
tolerate certain circumstances. An example of Low Frustration Tolerance would
be: I cannot bear that I was fired.

Global Evaluation is used to describe the situation where a person assigns a


global negative rating to self, other people and the world. Global rating refers to
an illogical overgeneralization from a particular action to ones whole essence.
For example: I am useless because I was fired. The four irrational beliefs are
considered to cause emotional and behavior disorders.

As discussed above, students who start the journey of university study may
encounter difficulties and face many challenges in many aspects, including: (a)
intra-personally, in subjective well-being, self-concept, self-esteem, etc.; (b) interpersonally, in family values and expectation, family relations, roommate relations,
peer pressure and competiveness, and (c) extra-personally, in academic workload,
examinations, career planning, and finances. They may have irrational beliefs as
mentioned above: rigid demand, awfulizing, low frustration tolerance and global
evaluation. These absolutist and unrealistic beliefs impede problem-solving

52

abilities for goal satisfaction, and lead to negative emotions such as depression
and anxiety (Dryden, 2003; Ellis & Dryden, 1997; Walen, DiGiusepe, & Dryden,
1992).

(5) Strengths and weaknesses of REBT

One of the strengths of REBT theory is that it is realistic and pragmatic


(Ruggiero, Ammendola, Caselli, & Sassaroli, 2014). It is not merely focused on
the present situation, but people are taught how to deal with irrational beliefs in
the future to avoid similar situations happening again (Corey, 2009). According to
REBT, peoples problems are caused by the beliefs they hold. Therefore, helping
clients to develop a more positive outlook and retain positive thought by
restructuring the irrational beliefs they hold is the therapeutic goal (Corey, 2005).
Also, through the tracking of cognitions, people may know when they begin
having irrational thinking and can take immediate action by reframing negative
thinking to positive before these beliefs lead to maladaptive behavior (Corey,
2005).

Another strength of REBT is that it emphasizes cultural relevancy. The

53

irrational beliefs disputation skills can apply in different cultures since each
person is viewed as an entity in and of their cultural context (Adomeh, 2006;
Gregas, 2006). In Chinese society, Confucianism may play a role in influencing
people's beliefs in Hong Kong. It was suggested that Chinese people would prefer
a directive-based, structural counseling approach to a non-directive one. They
show great respect for authority, and prefer practical and immediate solutions to
problems in counseling. (Leong, 1986; Sue & Sue, 1990). As REBT is open to
diverse cultures with fruitful outcomes, many studies also show that REBT can
appropriately be used in the Chinese context (Si & Lee, 2008; Yang, Li, Jiang, &
Xu, 2007; Yu & Fu, 2014).

Despite the above, there are many weaknesses in REBT. One criticism is that
REBT carries negative connotations, in particular by using the words irrational
beliefs. Indeed, irrationality can be considered by some people to be a sign of
low intelligence or lack of maturity (Turner & Barker, 2013). Corey (2009)
describes REBT as the active and directive approach used to treat a variety of
discords, such as depression, anxiety and phobias. However, in view of its
negative connotations, some people from certain racial or ethnic backgrounds may
not be willing to disclose their thinking or feelings (Shen, Alden, Schting, &

54

Tsang, 2006). As a result, this approach may be too counterproductive for certain
people. In Chinese culture, people are afraid of losing face, and reluctant to
disclose personal feelings and emotions, preferring to adhere to social norms and
avoid harming interpersonal relationships and harmony. They tend to believe in an
external locus of control (e.g. fate and luck) (Leung, 1996; Lin, 2002). These
seem to be barriers in conducting REBT counseling. But the literature suggested
that REBT can be successful in Chinese society if it is practiced with some
modifications and specific skills. Firstly, the counselor needs to be aware of the
influence from multiple levels of social organization and integrate a variety of
external sources to bring a positive impact. For instance, extended family
members are a good source for providing help and support to Chinese clients.
Secondly, in dealing with negative feelings and emotions as well as sensitive
issues (e.g. sexual problems, family relationships), clarification is needed to let
them feel genuine caring and support (Chen & Davenport, 2005; Lin, 2002;
Molassiotis, Yung, Yam, Chan, & Mok, 2002).

Another weakness is that REBT is very confrontational, especially during the


first session (Corey, 2009). This confrontational style during the first session can
influence rapport building (Snetselaar, 1997). Some people may not feel

55

comfortable with this kind of communication; as a result, they may become


detached and avoid the therapy. Some authors (Chang, Tong, Shi, & Zeng, 2005;
Lin, 2002) suggested modifications are needed in conducting REBT in Chinese
society. The counselor could consider to use gentle assertion training to Chinese
clients, which is more suitable than straightforward confrontation with clients
towards their parents, teachers or employers. It should avoid deep and direct
confrontation causing strong negative emotions or conflicts in the early beginning.

To conclude, REBT is useful for helping clients with emotional and


behavioral problems in different countries, such as in Chinese societies. There are
advantages but also disadvantages in using REBT in helping Chinese clients;
modifications and adapted strategies are needed in order to become more effective
and beneficial to the clients. Also, genuine caring and supportive follow up are
necessary after the treatment sessions to take care of their negative feelings and
emotions aroused in the course of counseling. Lastly, since the value of
collectivism is highly rooted in Chinese society, a balance between individualism
and collectivism is important (Lin, 2001). REBT would be beneficial to clients in
a structural counseling context, with a clear role for the counselor and client as
well as concrete therapeutic goals resulting in gradual and gentle development.

56

(6) The measurement of irrational beliefs

Ellis (1994) stated that irrational belief is the crucial factor underlying
emotional disturbance. Over fifty scales have been developed to measure
irrational thinking processes. They are based on the eleven irrational beliefs of
Elliss early theory of REBT. During the early period, the scales of irrational
beliefs included: Irrational Ideas (II; Zingle, 1965), the Personal Beliefs Inventory
(PBI; Hartman, 1968), Irrational Belief Test (IBT; Jones, 1968), Personality Data
Form (Ellis, 1968), the Adult Irrational Ideas Inventory (AIII; Fox & Davis,
1971), the Ellis Scale (McDonald& Games, 1972), Common Beliefs Survey-III
(CBS-III; Bessai, 1977), Idea Inventory (Kassinove, Crisci, & Tiegerman, 1977)
and Rational Beliefs Inventory (RBI; Shorkey & Whiteman, 1977). Many studies
found that the early measurements of irrational beliefs lack discriminant validity.
Most of them correlated with measures of emotional distress, rather than the
targeted irrational beliefs that are presumed to lead to affective states (Smith,
1982; Madigan & Bollenback, 1986).

At later stages, some improvements in the measurement of irrational beliefs


occurred. They were able to provide discriminant validity by differentiating

57

between irrationality and general emotional distress, and they could reflect Elliss
recent model of three major musts and four derivatives. However, the
shortcoming is that the subscales of identifying the particular irrational beliefs
could not be validated clinically. These scales included: Situational Self-Statement
and Affective State Inventory (SSSASI; Harrell, Chambless, & Calhoun, 1981),
Irrational Belief Scale (IBS; Malouff & Schuttle, 1986), Child and Adolescent
Scale of Irrationality (CASI; Bernard & Law, 1987), Teacher Irrational Belief
Scale (TIBS; Bernard, 1988), Survey of Personal Beliefs (SPB; Demaria,
Kassinove, & Dill, 1989), Irrational Beliefs Survey (IBS; Watson, Vassar, Plemel,
Herder, Manifold,& Anderson, 1990), Ellis Emotional Efficiency Inventory
(EEEI; Ellis, 1992), Irrational Beliefs Inventory (IBI; Koopmans, Sanderman,
Timmerman, & Emmeikamp, 1994), Camatta & Nagoshi Scale (Camatta &
Nagoshi, 1995), Perfectionism Cognitions Inventory (PCI; Flett, Hewitt,
Blankstein, & Gray, 1998), Evaluative Beliefs Scale (EBS; Chadwick, Trower, &
Dagnan, 1999), Smith Irrational Beliefs Inventory (SIBI; Smith, 2002), and
General Attitude & Belief Scale (GABS), which was developed by Burgess
(1986), and modified by DiGiuseppe, Leaf, Exner, and Robin (1988), and revised
to an abbreviated version of the GABS by Lindner, Kirkby, Wertheim, and Birch.
(1999).

58

In reviewing the existing scales of irrational beliefs, it is apparent that there


has not been a suitable scale for several reasons. First of all, many broad
statements were used in the scales. Wallston, Wallston, Kaplan, and Maides
(1976) addressed the fact that an individualized measurement was the better
measurement to predict behavior in a specific situation than a generalized
measurement. He used social learning theory (Bandura, 1969) to explain his
perception. According to this theory, assuming that an increase in a persons
experience in a certain condition would lead to the development of particular
expectancies, that is more important for determining a persons behavior in that
condition than more generalized expectancies. This suggestion was also supported
by Solomon, Amow, Gotlib, and Wind (2003), that in order to detect depressionprone individuals, the individualized measurement of cognitive constructs is
necessary. The content of the eleven irrational beliefs are general and apply to all
situations. For example, the statement One should be quite upset over other
peoples problems and disturbances can be applicable to an individuals thinking
about any situations, such as home, school, workplace, social community, etc. The
advantage of using such statements is that they facilitate rapid and standardized
comparisons across many participants. However, the shortcoming is that it is hard
to capture fully thought from such general statements.

59

Moreover, even though there are existing scales for the measurement of
university students, they are not for Chinese students and not fit for Chinese
culture or the environment and situation in Hong Kong. For example, Egan,
Canale, Del Rosario, and White (2007) have developed a new instrument which is
called Academic Rational Beliefs Scale, a specific measure of the trait (ARBS) for
evaluating academic beliefs among university students along a rational-irrational
continuum. The participants were undergraduate and graduate students at a MidAtlantic college, and the sample consisted of around 85% white and 15% minority
students. The culture of Western society is quite different from Chinese society, so
the statements or items of this scale could not give the whole picture of a Chinese
students thought. To an extent that differs from Western society, Chinese students
in Confucian countries place success in academic life, future and career as their
top concerns, which are rooted in the societal and cultural values of Chinese
society (Stankov, 2010). In addition, compared to other cultural groups, Confucian
countries are highly concerned about how they are evaluated by their families,
relatives, and peers with respect to their academic achievement and future career
prospects (Woo et al., 2004). Because of the concept of face, they are distressed
at the prospect of failure in examinations, poor academic achievement, or being
unable to get an internship to enhance future career prospects, as such failures

60

would cause loss of face for their parents. As a result, they may feel sad, or have
more negative emotions. They may also feel ashamed if the worst comes to pass.
A study from Shek, Yu, and Fu (2013) found that filial piety remains a very strong
force in modern Chinese society. Obligation and expectation fulfilled toward the
parents can show that one is filial. In such circumstances, students are expected
to follow their parents opinions and ideas on academic issues, such as choosing
the study major, applying to which university, or deciding their career path.
Moreover, men and womens behavior is governed by Confucian beliefs, which
emphasize that a person should act in accordance with the expectations of their
role and position in society (Tang & Chua, 2010). Peoples behaviors are expected
to conform to traditional standards of Chinese cultural value, and there is a
traditional Chinese concept to segregate the role and position of men and women,
which is men for the exterior, women for the interior. This gender role
stereotype plays an important role in family life in Chinese societies, where mens
responsibility is for dominance in decision making and women take responsibility
for caring and supporting family members (Sun, 2008). Hence, men are expected
to work and earn money to fulfill the role of breadwinner for the family. It is
believed that higher educational achievement is an advantage that will enable
earning more money and providing a better quality of living for the family.

61

Research studies suggest that there is a strong relationship between educational


attainment and earnings power (Carnevale, Jayasundara, & Hanson, 2012; Day &
Newburger, 2002).

In summary, the available instruments are not proper for the present study
because the dimension of the scales is mainly for the assessment of students
experiencing academic difficulties, and they are not culturally contextually
specific to Hong Kong Chinese society. Because of the lack of the suitable
measurement in irrational beliefs of Chinese students, it is worthwhile developing
a new instrument for assessing Chinese students beliefs among students studying
at Hong Kong University.

2.4.2 REBT model of emotional disturbance (depression, anxiety


and stress) in university students

Based on REBT theory, a conceptual model of emotional disturbance of


university students is proposed. The model comprises three components, the ABC
model of REBT, the external factors contributing to the emotional and behavioral
consequences after starting the university study journey, and the outcomes of

62

depression, anxiety and stress. The central theme of this model is that it is the
irrational beliefs about the event (starting the university study journey) that cause
the emotional disturbance and dysfunctional behaviors that hinder goal
attainment.

After starting studying at a university, the student starts the journey towards
adjustment to his or her new life role. In respect of adjustment to university study,
the individual faces challenges in (a) intra-personal functioning (e.g., health,
psychological or subjective well-being, self-concept or self-esteem); (b) interpersonal functioning (e.g. family relations, peer pressure and competitiveness,
peer relations, social activities); and (c) extra-personal functioning (e.g. course
workload, recreational pursuits, career planning, time management and finances).
As discussed, students who start studying in a university may find attainment of
their goals frustrated by the events of university life. For instance, they may
experience exam failure or receive an unsatisfactory grade. The process of rational
reasoning is distorted by the biological pressures of their innate goals and the
tendency to over-generalize and to be motivated by short-term hedonism. They
may have irrational beliefs involving self-depreciation, and dogmatic beliefs
entailing demands for approval, success, and fair treatment, together with

63

demands for satisfying life conditions. These absolutist and unrealistic beliefs
impede problem-solving abilities for goal satisfaction and lead to negative
emotions such as depression, anxiety and guilt, and to self-defeating behaviors
(Ellis & Dryden, 1987). In other words, if university students harbour irrational
beliefs, it will cause emotional and behavioral consequences, and impede the
pursuit of fundamental and primary innate goals at the individual, inter-personal
and extra-personal levels. This leads the individual to psychological distress
(anxiety and depression, etc.), adversely affects inter-personal functioning
(isolating self from others, etc.), and hinders extra-personal functioning
(withdrawal from work, etc.).

In addition, the reverse direction from depression, stress, and anxiety to


irrational beliefs were found in some studies. Adolescents with depressive
disorders were showed at greater risk of developing irrational thoughts
(Joormann, 2010; Rawal, Collishaw, Thapar, & Rice, 2013). Another study also
revealed that anxiety was positively associated with negative thoughts (Muris,
Mayer, Adel, Roos, & Wamelen, 2009). Hence, it is possible that students having
depression, anxiety and stress may have a higher risk of developing irrational
beliefs. This reverse direction will be examined in this study.

64

In view of the bidirectional relationship between irrational beliefs and


depression, anxiety and stress, there is evidence to indicate this relationship (Cole
et al., 2011; Hjemdal, Stiles, & Wells, 2012; Vatanasin, Thapinta, Thompson, &
Thungjaroenkul, 2012). This bidirectional relationship will also be investigated.

2.5

Conceptual framework of the present study

According to REBT theory by Ellis (1962), the troubles experienced by a


person are not caused by particular events; instead, they are caused by a persons
evaluation of such conditions, particularly where irrational beliefs such as rigid
demand, awfulizing beliefs, low frustration tolerance and global evaluation are
involved. Hence, adopting REBT theory, the first goal of this study is to develop
an instrument to measure irrational beliefs, including rigid beliefs, awfulizing
beliefs, low frustration tolerance and global evaluation, for Chinese university
students based on REBT theory.

Moreover, as supported by the literature (see section 2.4), irrational beliefs


are the major factor causing emotional and behavior disorders. People with more
irrational beliefs are more likely to have higher levels of stress, depression or

65

anxiety. Therefore, based on REBT theory and previous research findings, the
second goal is to test our hypothesized model of Irrational Beliefs and
Depression-Anxiety-Stress for university students. Based on the literature review,
three structural models were hypothesized and tested.

A proposed model of Irrational Beliefs and Depression-Anxiety-Stress for


university students (Model A) is shown in Figure 2.1. The effect of irrational
beliefs on depression, anxiety and stress is tested by pathway labeled x1, x2
and x3, respectively. The second proposed model of Irrational Beliefs and
Depression-Anxiety-Stress for university students (Model B) is shown in Figure
in 2.2, which is the reverse direction from depression, anxiety and stress to
irrational beliefs. The effect of depression on irrational beliefs is tested by the
pathway labeled y1. The effect of anxiety on irrational beliefs is tested by
pathway labeled y2, and the effect of stress on irrational beliefs is tested by
pathway labeled y3. The last proposed model of Irrational Beliefs and
Depression-Anxiety-Stress for university students (Model C) is shown in Figure
2.3. This is the bidirectional relationship between irrational beliefs and depression,
anxiety and stress. In this model, the pathway z1 shows that irrational beliefs
and depression are correlated. z2 tests the correlation between irrational beliefs

66

and anxiety, and z3 tests the correlation between irrational beliefs and stress.

Furthermore, students may have different levels of irrational beliefs due to


exposures to different socio-demographic, academic-related and environmental
factors acting upon him or her (Lake, 2000; Macavei & Mircea, 2008; Peden,
Rayens, Hall, & Grant, 2004; Ripamonti, Steca, Preti, & Baroni, 2009; Sheehy &
Horan, 2004) (as mentioned in section. 1.2). Three variables (gender, faculty and
current year) may have possible interaction effects on irrational beliefs and
emotional disturbance. In the literature review, one study found that female
students were found to have higher levels of psychological disorder in the faculty
of medicine among U.S and Canadian students (Dyrbye, Thomas, & Shanafelt,
2006). Another study revealed that first year law students showed higher scores on
irrational beliefs (Lake, 2000; Sheehy & Horan, 2004). In addition, some
variables, such as gender, religion, current year, study program, faculty, family
status and living area were found to have significant influence on group difference
in irrational beliefs and emotional disturbance (as mentioned in section 2.1 to 2.4).
Hence, the third goal is to examine if there are any interaction effects on and
group differences in irrational beliefs and depression, anxiety, and stress between
students having different socio-demographic variables (age, religion, gender and

67

family income), academic-related variables (faculty, study program, duration of


program and current year) and living environment and transportation variables
(types of accommodation, living area and convenience of transportation).

Depression
X1

Irrational

X2

Anxiety

Beliefs
Rigid Demand
X3
Demand
Awfulizing Beliefs

Stress

Low Frustration Tolerance

Global Evaluation

Rational Beliefs

Figure 2.1 The hypothesized model of Irrational Beliefs and Depression-Anxiety-Stress for university students (Model A)

68

Depression

Y1

Irrational

Y2

Anxiety

Beliefs

Y3

Stress

Figure 2.2 The hypothesized model of Irrational Beliefs and Depression-Anxiety-Stress for university students (Model B)

Depression

Z1

Irrational

Z2

Beliefs

Anxiety

Z3

Stress

Figure 2.3 The hypothesized model of Irrational Beliefs and Depression-Anxiety-Stress for university students (Model C)

69

In this research, the socio-demographic factors refer to age, religion, gender and
family income. The academic-related factors include faculty, study program, duration
of program and current year. The living environment and transportation variables are
composed of types of accommodation and living area. Theoretically, students may
have different levels of irrational beliefs due to exposure to different contexts in the
socio-demographic, academic-related and environmental factors acting upon him or
her (Lake, 2000; Macavei & Mircea, 2008; Peden, Rayens, Hall, & Grant, 2004;
Ripamonti, Steca, Preti, & Baroni, 2009; Sheehy & Horan, 2004). It is believed that
people with more irrational beliefs are more likely to have higher level of stress,
depression or anxiety. It is also hypothesized that some variables can be directly
linked to emotional disturbance without the influence of irrational beliefs, as some of
the literature findings suggest. In fact, some variables can influence irrational beliefs,
but not emotional disturbance.

Another goal of this study is to construct a psychometrically sound instrument to


measure irrational beliefs among Chinese university students, and use it to further
investigate the relationship between irrational beliefs and emotional disturbance. In
phase one of the study, the draft 37-item CIBRAS was given to the panel to seek
content validity and administered to 200 HKU students to probe factor structure. In

70

phase two of the study, involving a 655-student sample, the CIBRAS with 5-factor
solution was tested with CFA to evaluate construct validity and to investigate the
relationship between irrational beliefs and emotional disturbance. In sum, the
following research questions are proposed:

Research question RQ1: What are the psychometric properties of the CIBRAS?

Hypothesis 1: CIBRAS would have statistically significant content and construct


validity, and reliability.

Research question RQ2: What are the relationships between irrational beliefs,
depression, anxiety and stress?

Hypothesis 2a: Irrational beliefs would have a significant positive effect on


depression, anxiety and stress (Model A).

Hypothesis 2b: Depression, anxiety and stress would have significant positive effects
on irrational beliefs (Model B).

71

Hypothesis 2c: Depression, anxiety stress and irrational beliefs would have significant
bidirectional relationships (Model C).

Research question RQ3: Are there any interaction effects (gender x faculty), (faculty x
current year), and (gender x current year) on irrational beliefs and depression, anxiety
and stress?

Hypothesis 3a: There would be interaction effects (gender x faculty) on irrational


beliefs and depression, anxiety and stress.

Hypothesis 3b: There would be interaction effects (faculty x current year) on


irrational beliefs and depression, anxiety and stress.

Hypothesis 3c: There would be interaction effects (gender x current year) on irrational
beliefs and depression, anxiety and stress.

Research question RQ4: Are there any significant differences in the mean scores of
irrational beliefs and depression, anxiety and stress between socio-demographic
variables (gender, age, religion and family income), between academic-related

72

variables (faculty, study program, duration of program and current year), and between
living environment and transportation variables (family status, place of living, living
space and public transportation)?

Hypothesis 4a: There would be significant differences in the mean scores of irrational
beliefs and depression, anxiety and stress between socio-demographic variables
(gender, age, religion and family).

Hypothesis 4b: There would be significant differences in the mean scores of irrational
beliefs and depression, anxiety and stress between academic-related variables (faculty,
study program, duration of program and current year).

Hypothesis 4c: There would be significant differences in the mean scores of irrational
beliefs and depression, anxiety and stress between living environment and
transportation variables (family status, place of living and public transportation).

73

Chapter Three

Research Design and


Methodology

3.1

Introduction

There are two phases of this study. To address the first goal of this study,
phase I was construction of the Chinese Irrational Beliefs and Rational Attitude
Scale (CIBRAS) for university students, based on extensive literature review and
expert panel comments. It was then finalized by a pilot test of 200 HKU students,
so as to establish psychometric properties and probe factor structure by
exploratory factor analysis. Confirmatory factor analysis was carried out in phase
II to confirm the construct validity of CIBRAS. To address the second goal of this
study, the main study of 655 HKU students was conducted in phase II to
investigate the relationship between irrational beliefs and emotional disturbance
(stress, depression and anxiety) by structural equation modeling. Finally, to
address the third goal of this study, the interaction effects and group differences
between irrational beliefs and depression, anxiety, and stress among the variables
of socio-demographic, academic-related and environmental aspects were
examined by MANOVA, ANOVA and Independent Sample t-test.
74

3.2

History and mission of the University of Hong Kong


(HKU)

Established in 1911, The University of Hong Kong (HKU) is the oldest and
most prestigious tertiary institution in Hong Kong. The official language of
instruction is English. It was ranked 28th in the world university rankings and 2nd
in the Asia university rankings by QS World University Rankings (2014).

HKU can trace its origins to the former Hong Kong College of Medicine for
Chinese, established in 1887, which became the Medical Faculty of the university.
HKU was officially founded in 1911 by Governor Sir Frederick Lugard, with a
mission to extend British influence in the mainland China market. Gradually, as
the Hong Kong economy became diversified and increasingly prosperous, there
was an urgent need to educate more people to acquire knowledge of western and
Chinese culture (Cunich, 2012).

HKU is a comprehensive and research-led university comprising ten


faculties, namely Medicine, Dentistry, Law, Architecture, Business, Engineering,
Education, Science, Arts, and Social Science. Over the years, HKU has continued

75

to receive large budgets from government funding on the advice of the University
Grants Committee (UGC).

HKU was the only university in Hong Kong for some decades, and thus its
alumni are frequently found in senior positions in business, government and
professional sectors in the city. Over 40 principal officials, permanent secretaries,
and Executive Council members of the HKSAR government are alumni of the
university (Sweeting, 1999).

3.2.1 Location and transportation

HKU is located on Pokfulam Road, Hong Kong. The newly opened Mass
Transit Railway (MTR) HKU Station is directly connected to the campus on 28
December 2014. Students used to rely on other methods of transportation, such as
buses or mini buses, prior to the opening of the MTRs HKU station. Bus was the
main public transportation for students getting to the campus, but only a few bus
lines passed the campus directly. From the Hong Kong side, the direct bus links to
the campus included buses nos. 23 and 40, which departed from North Point and
Wan Chai, respectively. It took around 30 minutes to get to the campus. Students

76

living on Hong Kongs east side and far away from North Point needed to transfer
among different forms of transportation, such as taking the MTR to the North
Point station before changing to a bus to go to the campus; alternatively, they
could switch between a combination of bus routes. From Kowloon West, which
includes from Tsim Sha Tsiu to Cheung Sha Wan, students could take bus nos. 970
or 973, which were direct bus links to the campus. However, this required a long
journey, of around an hour or so, to the campus. Students living in Kowloon East
were particularly inconvenienced, as there were no direct bus links from that area
to the campus, and switching between multiple transportation forms or routes was
a necessity. The same situation pertained for students living in the New
Territories. Hence, until the recent completion of the direct MTR link, many
students may have considered the location of HKU inconvenient, as there were
few direct public transport links, and such links as did exist served only limited
areas.

3.2.2 Faculties and programs

HKU has ten faculties, namely Architecture, Arts, Business and Economics,
Dentistry, Education, Engineering, Law, Medicine, Science, and Social Sciences.

77

All faculties offer undergraduate and postgraduate programs for students. The
duration of the program for an undergraduate is around three to six years, and for
postgraduates is around two to four years, depending on the criteria of the faculty
and the mode of study. In the academic year 2012-2013 or beforehand, most of the
students with HKALE and equivalent qualifications were admitted to the 3-year
curriculum, except for programs which were of 4-year or 5-year duration; 4-year
curricula included the Bachelor of Laws, Bachelor of Science in Speech and
Hearing Science, Bachelor of Nursing, Bachelor of Education in Language
Education, Bachelor of Education in Liberal Studies, and some of the double
degrees which were jointly offered by different faculties. The 5-year curricula
included the Bachelor of Dental Surgery, Bachelor of Medicine and Surgery, and
Bachelor of Chinese Medicine. However, after the reform of undergraduate
education under the 334 academic structure in 2012, most students with
HKDSE qualifications entered the new 4-year curriculum (previously the 3-year
curriculum). Some students are admitted to 5-year programs, such as the Bachelor
of Science in Speech and Hearing Science, Bachelor of Nursing, and some of the
double degrees which are jointly offered by different faculties. A small number of
students enter the 6-year undergraduate curricula, for the Bachelor of Dental
Surgery, Bachelor of Medicine and Surgery, or Bachelor of Chinese Medicine.

78

3.2.3 Facilities and services

Students are provided with different kinds of facilities and services, such as
accommodation, amenities, computing services, banking services, libraries, postal
service, campus bus services, a student cooperative and student support services.
Full-time undergraduate students can apply for admission to residential halls each
year. Presently, there are thirteen residential halls, which are located near the
campus. The availability of the shuttle bus service is for students travelling
between the dental campus, main campus, medical campus, student halls and the
Sports Centre; the fare is $2. Bus or minibus provides other public transportation
for students to travel between the halls and other locations. As regards student
support services, The Centre of Development and Resources for Students
(CEDARS) provides students with the necessary support services and resources to
facilitate study. It delivers a variety of services to students. One of these is the
career services for students to develop independent learning and professional
skills to support the launch of a rewarding career. Another important service
provided by CEDARS is the counseling and psychological service, which
provides a team of counselors and psychologists to handle students personal
problems and emotional distress, as well as exploring student potential, nurturing

79

adaptability and developing coping abilities. Students benefit from talking to


counselors or psychologists free of charge, and they are guided to discover their
personal attributes and strengths and to learn methods to live a more fulfilling life.
The common issues brought from students include studying and learning
challenges, adjustment issues, interpersonal relationships, personal development,
psychological disturbances and mental health concerns (CEDARS, 2015). Given
the unique features of HKU, it is interesting to study stress and psychological
health among HKU students so as to suggest tailor-made practical implications for
the university.

3.3

Ethical considerations

This research study was approved by the Ethics Committees of the Faculty of
Education, the University of Hong Kong. The purpose of this study was explained
in the Research Consent Form. The survey was anonymous. All the data was kept
confidential following the survey and stored strictly on computer with double
safety measures. Participation was on a voluntary basis, and the participants were
informed that they were free to withdraw from the study at any time without any
negative consequences. After reading the written explanation, the participants

80

were required to sign a written consent form to indicate if they agreed to


participate in this research.

3.4

Research design

Phase I study: the construction of CIBRAS

Aims of Phase I study: To develop an instrument (CIBRAS) to measure


irrational beliefs and rational attitude among university students via literature
review, panel comments and a pilot test to establish reliability and validity.

(I)

The drafting of items of CIBRAS involve:

An extensive literature review was conducted to obtain background


information for drafting of the CIBRAS, based on critical appraisal, and some
items were extracted from existing instruments (e.g. Irrational Beliefs Inventory
(IBI; Koopmans et al., 1994), Irrational Beliefs Test (IBT; Jones, 1968), General
Attitude& Belief Scale (GABS; DiGiuseppe et al., 1988) and Idea Inventory
(Kassinove et al., 1977)) as well as the researchers observation and experience in

81

university study.

(II) Expert panel review

Inclusion criteria
The inclusion criteria of expert panel included (1) full time academic staff
(lecturers or professors) (2) having teaching experience with HKU students
(3) adequate knowledge in questionnaires survey. They were invited by the
researcher via their emails in the academic departments.

II.

Participants
12 academic staff including 8 males and 4 females from nine different

faculties of the University of Hong Kong accepted our invitation. There were four
associate professors, six assistant professors and two lecturers from the
Department of Social Work and Social Administration, Psychology, Psychiatry,
Physics, Education, Economics and Finance, Dentistry, the School of Chinese,
and Politics and Public Administration.

82

III

Instruments
A self-constructed panel review form was used (see Appendix A). This

served to facilitate the panel members to evaluate the draft CIBRAS in terms of
relevance, clarity and representativeness. The panel were invited to express their
opinions by adding or deleting items for the CIBRAS.

IV. Analysis
The content validity index was calculated based on the representativeness of
the measure by counting the number of experts who rated the items as three or
four and dividing that number by the total number of experts who deemed the
item as content valid (Rubio, Berg-Weger, Tebb, Lee, & Rauch, 2003).

(III) Pilot test

I.

Participants
The researcher went into classrooms to collect questionnaires from Chinese

undergraduate students after receiving permission from the respective lecturers or


professors. The sample consisted of 200 HKU students coming from ten faculties.
Convenient sampling was used to collect 20 students from each faculty to allow

83

sufficient data for statistical analysis with fair representativeness. According to


Gorsuch (1983) and Hatcher (1994), a minimum subject to item ratio of at least
5:1 in EFA was recommended. Our sample size in the pilot test met this criteria.

II.

Instruments
A self-constructed questionnaire consisting of a personal information sheet

and CIBRAS was used (See Appendix C).

III. Analysis
Firstly, Cronbachs alpha coefficient of the scales was used to determine the
reliability of the instrument. Secondly, item-total-correlation analysis was
conducted to purify the assessment prior to considering the factors representing
the construct (Churchill, 1979). Thirdly, exploratory factor analysis (EFA) was
performed to test the factor structure. Kaiser-Meyer-Olkin (KMO) and Bartletts
test of sphericity were conducted to examine whether the sample was factorable or
not. Our criterion for item retention was to preserve only items that loaded greater
than 0.4 on the factor component, and there are at least three items in each factor
(Costello & Osborn, 2005).

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Phase II study: A main study

(I)

Participants

655 HKU Chinese undergraduate students were successfully recruited from


10 faculties. The response rate was considered satisfactory for the purpose of
statistical analysis in CFA and SEM (Bearden, Sharma, & Teel, 1982; Cattell,
1978; Hoelter, 1983; Kahn, 2006; Kline, 2010). It is recommended that sample
size for conducting confirmatory factor analysis is based on subject-to-item ratio.
The minimum sample size for performing factor analysis is at least a ratio of 5:1
(Hair, Black, Babin, & Anderson, 2010). Some stringent researchers conduct
factor analyses with subject-to-item ratios of 10:1 or less (Costello & Osborne,
2005). In the present study, the subject-to item ratio of 10:1 was adopted for the
factor analysis. Since there were 59 items in the questionnaire, and 10 subjects
were required for each item, a total number of at least 590 subjects was needed for
this study. The final total of 655 subjects successfully recruited to participate in
this research fulfills the recommendation for factor analysis. In addition, in order
to be representative of HKU students population on the whole, the number of
students recruited from each faculty in this research was proportional to their
respective actual student intake in the current academic year. In this research,

85

about 4% of student population in that faculty based on their actual student intake
in 2012-2013 (Table 3.1).

Table 3.1 Undergraduate student intake in 2012-2013


Faculty
Architecture
Arts
Business and Economics
Dentistry
Education
Engineering
Law
Medicine
Science
Social Science
Total

Undergraduate Student
Intake in 2012-2013
608
1,742
2,836
321
903
1,971
703
2,936
2,129
1,411
15,560

Proportion (4.2%)
26
73
119
14
38
83
30
123
90
59
655

The inclusion criteria was stated that respondents were to be Chinese


students studying for an undergraduate degree at HKU. This criterion was
essential because the irrational beliefs scales were developed to take account of
Chinese culture and values.

(II) Instruments
Two instruments together with one personal information sheet containing
various variables was used (see Appendix C). The details of each instrument are

86

introduced as follows:

(a) Depression Anxiety Stress Scale (DASS-21) (Lovibond & Lovibond, 1995)
The DASS-21 is a self-rating scale with good psychometric properties used
in both clinical and community samples, which has been demonstrated to
differentiate the three states of depression, anxiety and stress (Crawford & Henry,
2003; Uncu, Bayram, & Bilgel, 2007). Items on the DASS are rated on 4-point
Likert type, ranging from 0 (did not apply to me at all) to 3 (applied to me very
much, or most of the time). Higher scores on each subscale indicate higher levels
of depression, anxiety and stress separately.

(b) Chinese Irrational Beliefs and Rational Attitude Scale (CIBRAS)


The CIBRAS is a self- reported instrument designed to assess irrational
beliefs and rational attitudes among university students. It was to be constructed
and validated in Phase I of this study. Items of this instrument were generated
through the methods of (1) intensive literature review to gather background
information; (2) extraction of some items from existing irrational beliefs scales
which were modified to be culturally relevant; (3) The pool of all items is subject
to the panel review process and pilot test to obtain validity and establish good

87

psychometric properties.

(c) Personal information sheet


This information sheet is designed to measure three sets of variables: sociodemographic (age, gender, religion and family income), academic-related (study
major and academic year) and environmental factor (type of accommodation and
living area).

(III) Design and procedure


This was a cross-sectional questionnaire survey study. The researcher was
granted permission from the respective lecturers or professors to collect data in
the classroom from different academic units, after seeking approval in writing for
conducting the study. Assistance was also obtained to send out the questionnaires
via different channels (student associations, faculty offices and supporting units,
etc.). An introduction letter, questionnaire package, and a copy of the informed
consent form together with a return envelope were given to these units for
distribution of the questionnaires.

There would be some anticipated difficulties in collecting the data. Firstly,

88

the questionnaires require 15 to 20 minutes to complete. Some students may have


needed to attend another class in a hurry, and were therefore unwilling to stay in
class to complete the questionnaire. Secondly, some lecturers hesitated to grant
permission to allow the researcher to collect questionnaires in their classes, on the
grounds that they had a tight schedule in their teaching and no spare time to for
data collection. The researcher formulated strategies to circumvent such
difficulties. First, the cover letter in the questionnaires would be prepared to
clearly state the importance and significance of this study towards improving
emotional disturbance among university students. Second, we had obtained the
HKUs ethnics committee approval for conducting this study. The academic
departments in HKU would be more willing to provide support and request that
individual lecturers give consideration to allowing our data collection in their
class. Lastly, the researcher would go into the classrooms personally to collect the
data during the break or at the end of the lecture, as per the advice of the
individual lecturer. This flexibility helped to resolve problems in allowing data
collection under a tight teaching schedule for some lecturers.

(IV) Statistical analysis


Internal consistency reliability of the scales was determined, and

89

confirmatory factor analysis was used to test the validity of the instrument. A twoway MANOVA was conducted to examine the interaction effects (gender x
faculty), (faculty x current year), and (gender x current year) on the dependent
variables, including depression, anxiety, stress, rigid demand, awfulizing beliefs,
low frustration tolerance, global evaluation and rational beliefs. One-way ANOVA
and Independent Sample t-test were conducted to compare of mean scores in
irrational beliefs and emotional disturbance by socio-demographic variables,
academic-related variables and living environment and transportation variables.
ANOVA was performed if there were three or more groups to compare, while
Independent Sample t-test was used if there were only two groups to compare.
LISREL 8.8 for Structural equation modeling (SEM) was used to evaluate if it fits
the hypothesized model of irrational beliefs and Depression-Anxiety-Stress for
university students by several statistical tests.

There are several fit indices used to show the adequacy of the model
examined in the CFA and SEM. A variety of indices for testing the CFA and SEM
were suggested by researchers (Marsh, Balla, & McDonald, 1988; Ullman, 1996).
Recommended by Milfont and Duckitt (2004), several fit statistics in the
structural equation model should be claimed to justify the fitness of the model.

90

The most commonly used indices include Normed Chi-Square (NC), Comparative
Fit Index (CFI), Normal Fit Index (NFI), Non-Normed Fit Index (NNFI), Root
Mean Square Error of Approximation (RMSEA) and Root Mean Square Residual
(RMSR).

Hu and Bentler (1999) suggested including fit indices of the SRMR,

NNFI, RMSEA and CFI, while Kline (2005) had similar suggestions, but claimed
that the Chi-Square test should also be reported. The Chi-squared test is a
fundamental measure of fit used in the calculation of many other fit measures. It is
conceptually a function of the sample size and the difference between the
observed covariance matrix and the model covariance matrix. Based on the
guidelines and the above review, the following indices were tested for CFA and
SEM: Chi-Square statistic, its degrees of freedom and p-value, Normed ChiSquare (NC), Comparative Fit Index (CFI), Normed Fit Index (NFI), NonNormed Fit Index (NNFI), Incremental Fit Index (IFI), Root Mean Square Error
of Approximation (RMSEA) and Standardized Root Mean Square Residual
(SRMR).

Different opinions were suggested about the cut-off points of model fit
indices for the model acceptances (Hu &Bentler, 1999; Marsh, Balla, &
McDonald, 1988; Sun, 2005). Also, the value of acceptable model fit indices

91

should also consider other model characteristics, for instance, the sample size and
observed variables.

According to Bollen (1989), the Normed Chi-Square of 0 determines a


perfect fit, while less than 5 indicates reasonable fit. For RMSEA, less than 0.05
points is a good fit, while less than 0.08 points is an acceptable fit (Browne &
Cudeck, 1993; Byrne & Campbell, 1999). Researchers stated that a value of
SRMR less than 0.10 is acceptable fit, while less than 0.05 is good fit (Hu &
Bentler, 1999; Kline, 2010). For CFI, NFI, NNFI, and IFI: 0.90 shows the fit of
acceptance, while 0.95 demonstrates a perfect fit (Bentler, 1990; Bentler &
Bonett, 1980; Marsh, Hau, Artelt, Baumert, & Peschar, 2006).

92

Chapter Four

4.1

Construction of CIBRAS

Construction of CIBRAS

4.1.1 Introduction

This section described the draft of the CIBRAS based on the extensive
literature review, the items extracted from the existing instruments as well as the
researchers observation and experience at university. Finally, the expert panel
comments are reported at the end of this chapter.

4.1.2 Drafting of CIBRAS

The item pool of the draft CIBRAS included items suggested from literature
review and items extracted from existing instruments. The extensive literature
review (Bernard & Law, 1987; Camatta & Nagoshi, 1995; Ellis, 1968; Malouff &
Schuttle, 1986; McDonald & Games, 1972; Smith, 2002), yielded 12 belief items.
An additional 20 irrational beliefs were extracted from the existing instruments
(e.g. Irrational Beliefs Inventory (IBI; Koopmans et al., 1994), Irrational Beliefs

93

Test (IBT; Jones, 1968), General Attitude& Belief Scale (GABS; DiGiuseppe et
al., 1988) and Idea Inventory (Kassinove et al., 1977)), and another 5 items of
irrational beliefs came from the researchers observation and experience in
university. Based on REBT, the total of 37 items was contributed to the pool of the
CIBRAS, and were classified in five subscales which measure irrational beliefs.
The result is shown in Table 4.1.

94

Table 4.1 Chinese Irrational Beliefs and Rational Attitude Scale (CIBRAS) - 37 items
Subscale
Questions
Rigid Demand
2. I must get good grades.
4. I should perform remarkably in academic work, and this is the
way to make myself feel useful.
6. I must graduate with satisfactory performance to meet my
parents' expectations.
19. I ought to have a good GPA so as to succeed in the future.
22. Getting a good grade is the only way to get approval from
others.
25. I should be angry with those students with poor motivation
and studying attitude.
28. I must be accepted by other students.
Awfulizing Beliefs

1. If I cannot get a job after graduation, it would be awful.


9. When I do poorly on tests, I feel horrible.
10. It is the end of the world if I cannot improve my course
grade.
12. Its terrible for me to be disliked by other students.
14. If my classmates cant understand me clearly, I will be
terrified.
27. If I am not able to meet the deadline of coursework or
project, I will be terrified.
34. I will be horrified if the teacher gives harsh comments on my
projects.
36. If I do not find an effective studying method, I will be
terrified.

No. of items
7 items

8 items

Low Frustration Tolerance 7. It is unbearable to be a failure.


16. I cant tolerate being disliked by other students.
18. When I fail an important test, I cannot tolerate it.
20. Its unbearable if my family does not agree my opinions.
21.I cannot tolerate when other students criticize my work.
31.Its unbearable to be rejected by my peers.

6 items

Global Evaluation

8 items

Rational Beliefs

3. I feel ashamed if I cannot fulfill my family expectation.


8. I am a failure when I fail to achieve my goals.
11. My future prospect will be hopeless if I cannot achieve good
grades in the university.
13. If I do not improve my communication skills, I will be
failure in all aspects.
23. If I do not perform well at an important task, I am a
worthless person.
24. Failing in the examinations makes me feel ashamed.
26. When other students reject me, I believe that I am a bad
person.
29. I feel like I am a stupid person when I dont do as well as
my friends.
5. I do not like people doing disrespectfully, but I can tolerate
not having their respect.
15. I am a worthy person even if I do not perform well at tasks
that are important to me.
17. Although I want to do well at important tasks, I realize that I
may not be able to even if I want to.
30. When another student rejects me, it's bad, but not the end of
the world.
32. I do not like failure in a test, but I can tolerate not doing well.
33. If I fail my family expectation, it does not mean that I am
worthless.
35. It is annoying but not devastating to be criticized.
37. I want fair treatment. However, I do realize that I may not be
treated fairly all of the time even though I want to be.

8 items

95

4.1.3 Expert panel recruitment and scoring

12 experts were invited to be panel reviewers for comments and scoring. All
of them are academic staff (8 male and 4 female) in HKU from 9 faculties,
including 2 from Psychology, 2 from Social Work and Social Administration, 2
from Politics and Public Administration, 1 from Psychiatry, 1 from Dentistry, 1
from Education, 1 from Economics & Finance, 1 from Science, and 1 from Arts.

The comments and scoring from the expert panels showed satisfactory
results. The panel had to rate the items on a 4-point Likert Scale regarding item
relevancy, clarity and representativeness. They were invited to express their
opinions by adding or deleting items, or making modification and
recommendations, if any. The average scores demonstrated that the items were
highly relevant, clear and representative.

Some experts returned the rating scales without any comments; others
included suggestions and opinions in the rating form. The Content-Validity Index
(CVI) was used to measure content validity. To calculate the CVI of each item, the
number of experts who rated the item as three (needed minor revision) or four

96

(relevant) was divided by the total number of experts. The CVI measure is used to
calculate the average scores across items. According to Davis (1992), the
recommendation of a CVI of 0.80 is for new measures. The result will be reported
in detail in the coming section.

4.1.4 Result of expert panel evaluation of CIBRAS

The CVI for evaluating the content relevance, clarity and representativeness
of each item of the draft CIBRAS by academic staff is showed in Table 4.2. After
calculation, the overall CVI scores of relevance, clarity and representativeness
obtained were high, at 0.96, 0.94 and 0.94, respectively. As for content relevance,
26 of the 37 items had CVI value of 1.0; 8 items had CVI value of 0.92; 2 items
had CVI value of 0.83; and 1 item had CVI value of 0.75. For clarity, 19 of the 37
items had a value of 1.0; 11 items had a value of 0.92; 6 items had a value of 0.83;
and 1 item had a value of 0.75. For domain representativeness, a total of 18 items
obtained a value of 1.0; 12 items obtained a value of 0.92; 5 items obtained a
value of 0.83; and 2 items obtained a value of 0.75.

All items had CVI on relevance, clarity and representativeness >0.80, except

97

items 5 and 36. With respect to item 5, only the domain clarity had value >0.8;
relevance and representativeness only reached a value of 0.75, which is less than
the recommended level of >0.8. This is similar to the case for item 36, where the
domain relevance had value >0.80, while clarity and representativeness had values
of 0.75. However, it was suggested that these two items be kept in this scale, and
some modifications for these items were recommended by experts. As a result, all
of the 37 items were retained, and some were slightly changed in their wording or
phrasing according to recommendations by experts to improve clarity, relevance
and representativeness. Modifications made according to the suggestions of the
experts are shown in Appendix B.

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Table 4.2 CVI rating of CIBRAS on relevance, clarity and representativeness by 12 experts
Item
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
Over all CVI scores

Relevance
1.00
1.00
1.00
1.00
0.75
1.00
1.00
1.00
1.00
1.00
0.92
1.00
1.00
0.92
1.00
1.00
1.00
1.00
0.92
1.00
1.00
1.00
1.00
1.00
1.00
1.00
0.92
0.92
1.00
1.00
0.92
0.92
0.83
0.92
1.00
0.83
1.00
0.96

Clarity
1.00
1.00
0.92
0.92
0.83
0.92
0.92
0.83
1.00
0.83
0.92
1.00
1.00
0.92
1.00
1.00
1.00
1.00
0.92
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
0.92
1.00
1.00
0.92
0.83
0.83
0.92
0.92
0.75
0.83
0.94

Representativeness
1.00
1.00
1.00
1.00
0.75
1.00
1.00
0.92
0.92
0.92
0.83
0.92
0.92
0.83
0.92
1.00
1.00
1.00
0.92
1.00
1.00
1.00
1.00
1.00
0.92
0.92
0.92
0.83
1.00
1.00
0.92
0.92
0.83
0.83
1.00
0.75
1.00
0.94

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4.1.5 Summary of the construction of CIBRAS

The comments and scoring from the expert panel showed satisfactory results,
with items being evaluated as highly relevant, clear and representative. After
establishing the content validity of the draft CIBRAS through examination from
REBT perspectives, panel review and content validity index, the next step was to
validate the instrument in a pilot test and probe the factor structure by exploratory
factor analysis. The next section will present the results regarding the
psychometric properties of the CIBRAS.

4.2

Psychometric properties of CIBRAS

4.2.1 Introduction

This section is divided into two parts. The first part of this section describes
the subject characteristics along demographic, academic-related and living
environment and transportation variables. It then presents the results of the factor
structure of CIBRAS, and reliability and validity of CIBRAS and DASS. A
correlation study will also be reported. A summary is given at the end of this

100

section.

4.2.2 Subject characteristics

A total of 200 undergraduates were recruited to complete the questionnaires


in this pilot test during November 2014. The questionnaires were collected from
different classes from 10 different faculties. The researcher secured permission in
advance from the respective lecturers to come into their classrooms to collect the
data. The students in the class voluntarily participated in the study.

4.2.3 Demographic characteristics of the recruited subjects

Table 4.3 includes the demographic characteristics of all participants. Of 200


subjects, 89 persons (44.5%) were males and 111 (55.5%) were females. 51
subjects (25.5%) were aged 19, 30 subjects (15%) were aged 20, 41 subjects
(20.5%) were aged 21, and 28 subjects (14%) were aged 22. 29 subjects (14.5%)
were aged 18 or below, and 21 subjects (10.5%) aged 23 or above. Most of the
subjects (199 persons, 99.5%) were single, and only 1 subject (0.5%) was
married. 99 subjects (49.5%) were living in Hong Kong Island, 43 (21.5%) in

101

Kowloon, and 58 (29%) in the New Territories. There were 155 subjects (77.5%)
without a religion, and 45 (22.5%) with a religion. 26 subjects (59.1%) were
Protestant, 9 subjects (20.5%) were Catholic, 5 subjects (11.4%) were Buddhists,
and 4 subjects indicated other. Only one subject (0.5%) reported that the family
income depended on government funding (CSSA) for daily living. As regards
gross family income, 8 subjects (4.3%) fell into the income range HK$5,000HK$10,000; 42 subjects (22.3%) within HK$10,001HK$20,000; 42 subjects
(22.3%) within HK$20,001HK$30,000; and 31 subjects (16.5%) within
HK$30,001HK$40,000. There were 4 subjects (2.1%) who had family gross
income below HK$5,000 and 60 subjects (31.9%) above HK$40,000.

102

Table 4.3 Demographic characteristics among all students (N=200)


Gender
Male
Female
Age (years)
<=18
19
20
21
22
>=23
Marital Status
Married
Single
Residentiall District
Hong Kong Island
Kowloon
New Territories
Nationality
Hong Kong
Mainland China
Asian
Religion
No
Yes
Religion Type
Protestant
Catholic
Buddhism
Other
Gross family income
CSSA
<HK$5,000
HK$5,000-10,000
HK$10,001-20,000
HK$20,001-30,000
HK$30,001-40,000
>HK$40,000

89
111

44.5
55.5

29
51
30
41
28
21

14.5
25.5
15.0
20.5
14.0
10.5

1
199

0.5
99.5

99
43
58

49.5
21.5
29.0

173
21
6

86.5
10.5
3.0

155
45

77.5
22.5

26
9
5
4

59.1
20.5
11.4
9.1

1
4
8
42
42
31
60

0.5
2.1
4.3
22.3
22.3
16.5
31.9

103

4.2.4 Characteristics related to academic-related variables

All 200 subjects come from ten different faculties in HKU, including 20
subjects (10%) from Architecture, 20 (10%) from Arts, 20 (10%) from Business
and Economics, 20 (10%) from Dentistry, 20 (10%) from Education, 20 (10%)
from Engineering, 20 (10%) from Law, 20 (10%) from Medicine, 20 (10%) from
Science, and 20 (10%) from Social Science. Among them, 37 students (18.5%)
were in the BA program, 23 (11.5%) were in the BSc program, 18 (9%) were in
the BEcon program, 20 (10%) were in the BDS program, 20 (10%) were in the
BSSc program, 19 (9.5%) were in the BEd program, 20 (10%) were in the BEng
program, 20 (10%) were in the LLB program, 20 (10%) were in the BBiomedSc
program, and only 3 students (1.5%) were in the BBA program. Most students
were studying 4- and 5-year programs, with N=108 (54%) and N=51 (25.5%),
respectively. Others (N=41, 20.5%) were studying in a 3-year program. Moreover,
the largest number of students (N=83, 41.5%) were in third-year study; some
students (N=53, 26.5%) were studying in second year; 40 students (20%) were
first-year students; 23 students (11.5%) were fourth-year students; and only 1
student (0.5 %) was in fifth-year study. The details were shown in Table 4.4.

104

Table 4.4 Characteristics related to academic-related variables (N=200)


n

Architecture

20

10.0

Arts

20

10.0

Business and Economics

20

10.0

Dentistry

20

10.0

Education

20

10.0

Engineering

20

10.0

Law

20

10.0

Medicine

20

10.0

Science

20

10.0

Social Science

20

10.0

BA

37

18.5

BSc

23

11.5

BEcon

18

9.0

BBA

1.5

BDS

20

10.0

BEd

19

9.5

BSSc

20

10.0

BEng

20

10.0

LLB

20

10.0

BBiomedSc

20

10.0

3 years

41

20.5

4 years

108

54.0

5 years

51

25.5

First-year

40

20.0

Second-year

53

26.5

Third-year

83

41.5

Fourth-year

23

11.5

Fifth-year

0.5

Faculty

Study Program

Duration of program

Current Year

105

4.2.5 Characteristics related to living environment and


transportation

Fifty subjects (25%) were living alone, and others (150 subjects, 75%) were
living with family members. 5 subjects (4.2) had only one family member, 34
(28.6%) had two family members, many students (54, 45.4%) had three family
members, 17 subjects (14.3%) had four family members, 8 (6.7%) had five family
members, and only one student (0.8%) had six family members. Fifty-three
students (30.5%) were living in U Hall. 41 students (23.6%) shared a flat with
others, and 80 students (46%) indicated other. Most of the subjects (151
persons, 75.9%) found their living space sufficient, and only 48 subjects (24.1%)
found it insufficient. 145 subjects (72.9%) reported that public transport was
convenient, while others (54 subjects, 27.1%) reported that public transport was
inconvenient. The details are shown in Table 4.5.

106

Table 4.5 Characteristics related to living environment and transportation variables


(N=200)
n

Living alone

50

25

Living wth family member

150

75

One family member

4.2

Two family members

34

28.6

Three family members

54

45.4

Four family members

17

14.3

Five family members

6.7

Six family members

0.8

53
41
80

30.5
23.6
46.0

151
48

75.9
24.1

145
54

72.9
27.1

Family Status

Family members

Place of Living
U hall
Share flat
Other
Living Space
Enough
Not enough
Public Transport
Convenient
Inconvenient

107

4.3

Factor Analysis

4.3.1 Factor analysis of CIBRAS

First of all, item-total correlation analysis was conducted on CIBRAS to


purify the assessment prior to considering the factors representing the construct
(Churchill, 1979). Items were eliminated if the loadings were lower than 0.40.
According to Corley, Elswick, Gorman, and Clor (2000), the ideal relationship
between item and scale should not be less than 0.40 and greater than 0.70 to avoid
item redundancy and ensure item homogeneity. Based on these criteria, items 5,
15, 17 and 25 were eliminated. The details are presented in Table 4.6.

108

Table 4.6 Item-Total Correlation Analysis of 37-Item


Correlation with 37-item CIBRAS
Item 1
0.592
Item 2
0.48
Item 3
0.506
Item 4
0.579
Item 5
de le te
Item 6
0.511
Item 7
0.549
Item 8
0.615
Item 9
0.633
Item 10
0.631
Item 11
0.632
Item 12
0.568
Item 13
0.567
Item 14
0.595
Item 15
de le te
Item 16
0.524
Item 17
de le te
Item 18
0.672
Item 19
0.589
Item 20
0.485
Item 21
0.47
Item 22
0.544
Item 23
0.597
Item 24
0.616
Item 25
de le te
Item 26
0.524
Item 27
0.461
Item 28
0.542
Item 29
0.649
Item 30
0.607
Item 31
0.53
Item 32
0.563
Item 33
0.596
Item 34
0.533
Item 35
0.613
Item 36
0.531
Item 37
0.568

109

4.3.2 Factor structure of CIBRAS

An exploratory factor analysis (EFA) was then performed to determine the


factor structure of the CIBRAS. Principal components analysis with Varimax
rotation was conducted with 200 subjects on 33 items of CIBRAS, yielding a 5factor solution, accounting for 52.8% of total variance. The KMO and Bartletts
test of sphericity were 0.93 and 10833.35, respectively, with p<0.000, showing
that our data were suitable for the factor analysis. The scree plot is shown in
Figure 4.1.

Our criterion for item retention was to preserve only items that loaded greater
than 0.4 on the factor component (Corley, Elswick, Gorman, & Clor, 2000). This
resulted in deletion of 12 items, namely items 7, 9, 10, 13, 16, 18, 22, 26, 27, 28,
34, and 36.

In addition, some items were considered for deletion when they showed
double loading on different factors. Item 11 was excluded because of double
loading on two different factors. With respect to item 1, the loading on factor 3
was lower than 0.40; the article by Costello and Osborn (2005) stated that if a

110

factor is less than three items, it is often unsteady and faint. As a result, item 1 was
kept in factor 3 for further analysis. The factor loadings of each item are presented
in Table 4.7.

Figure 4.1 Scree plot of the EFA

111

Table 4.7 Factor loading on the items of CIBRAS in the five factors

item
8
11
23
24
29
30
32
33
35
37

1
I am a failure when I fail to achieve my goals.
My future prospect will be hopeless if I cannot achieve good grades in the
university.
If I do not perform well at an important task, I am a worthless person.
Failing in the examinations makes me feel ashamed.
I feel like I am a stupid person when I dont do as well as my friends.
When another student rejects me, it's bad, but not the end of the world.
I do not like failure in a test, but I can tolerate not doing well.
If I fail my family expectation, it does not mean that I am worthless.
It is annoying but not devastating to be criticized.
I want fair treatment. However, I do realize that I may not be treated fairly
all of the time even though I want to be.

1
12
14

If I cannot get a job after graduation, it would be awful.


Its terrible for me to be disliked by other students.
If my classmates cant understand me clearly, I will be terrified.

19

I must get good grades.


I should perform remarkably in academic work, and this is the way to make
myself feel useful.
I must graduate with satisfactory performance to meet my parent's
expectation.
I ought to have a good GPA so as to succeed in the future.

20
21
31

Its unbearable if my family does not agree my opinions.


I cannot tolerate when other students criticize my work.
Its unbearable to be rejected by my peers.

4
6

Factor
3

0.648
0.628

0.663

0.592
0.567
0.523
0.762
0.698
0.772
0.723
0.648

0.26
0.759
0.623
0.727
0.666
0.711
0.539
0.559
0.681
0.459

112

After removing those items, the remaining 19 items were examined by the
EFA again. The KMO and Bartletts test of sphericity were 0.806 and 1138.355,
respectively, with p<0.000, showing that the correlation matrix is factorable. The
percentage of the total variance explained by the five factors increased from
52.8% to 60.1%.

The results of EFA showed that five factors of CIBRAS, items 2, 4, 6 and 19,
belong to factor one, Rigid Demand; items 1, 12 and 14 are categorized into
factor two, with the proposed name Awfulizing Beliefs. Items 20, 21 and 31 are
clustered into factor three, under Low Frustration Tolerance. Items 8, 23, 24 and
29 belong to factor four, Global Evaluation. Factor five, named Rational
Beliefs, includes items 30, 32, 33, 35 and 37. In all, 19 items in five factors
remained in the scale. The 5 factors, 19 items and their factor loadings are
presented in Table 4.8.

Based on the EFA result, the factor structure of the CIBRAS was further
examined in the main study using confirmatory factory analysis (CFA).

113

Table 4.8 Factor loading on the items CIBRAS selected to be included in the five factors

item
2

RD
I must get good grades.
I should perform remarkably in academic work, and this is the way to make
myself feel useful.

0.87
0.71

I must graduate with satisfactory performance to meet my parents


expectation.

0.59

19

I ought to have a good GPA so as to succeed in the future.

0.76

1
12
14

If I cannot get a job after graduation, it would be awful.


Its terrible for me to be disliked by other students.
If my classmates cant understand me clearly, I will be terrified.

20
21
31

Its unbearable if my family does not agree my opinions.


I cannot tolerate when other students criticize my work.
Its unbearable to be rejected by my peers.

8
23
24
29

I am a failure when I fail to achieve my goals.


If I do not perform well at an important task, I am a worthless person.
Failing in the examinations makes me feel ashamed.
I feel like I am a stupid person when I dont do as well as my friends.

30
32
33
35

When another student rejects me, it's bad, but not the end of the world.
I do not like failure in a test, but I can tolerate not doing well.
If I fail my family expectation, it does not mean that I am worthless.
It is annoying but not devastating to be criticized.
I want fair treatment. However, I do realize that I may not be treated fairly all
of the time even though I want to be.

37

AB

Factor
LFT

GE

RB

0.42
0.82
0.55
0.72
0.79
0.42
0.61
0.81
0.58
0.67
0.69
0.69
0.71
0.63
0.61

RD=Rigid Demand; AB=Awfulizing Beliefs; LFT=Low Frustration Tolerance; GE=Global Evaluation; RB=Rational Beliefs

114

4.3.3 Reliability of CIBRAS and DASS

Cronbachs Alpha was performed to test the internal consistency of the


DASS and CIBRAS and the sub-scale of CIBRAS. Cronbachs Alpha is typically
used for examining the internal consistency of items in an instrument. The widely
accepted cut-off in the social sciences is that Alpha should be equal or above 0.70
(Nunnally & Bernstein, 1994). CIBRAS and DASS were found to have high
internal consistencies. The alpha for CIBRAS was 0.920, and alpha for DASS was
0.831. DASS (Depression), DASS (Anxiety), and DASS (Stress) were 0.878,
0.737 and 0.848 respectively. The results also showed that the sub-scales of the
CIBRAS had high internal consistency. The alphas for Factor 1 (Rigid Demand),
Factor 2 (Awfulizing Beliefs), Factor 3 (Low Frustration Tolerance) and Factor 4
(Global Evaluation) were 0.756, 0.765, 0.721 and 0.802 respectively. The alpha
for Factor 5 (Rational Beliefs) was 0.648, indicating a moderate degree of internal
consistency. The above results are given in Table 4.9.

115

Table 4.9 Reliability of the CIBRAS and other instruments


Instrument

Alpha

DASS
Depression
Anxiety
Stress
CIBRAS

0.831
0.878
0.737
0.848
0.92

Reliability of sub-scales of the CIBRAS


Chinese Irrational Beliefs and Rational Attitude Scale
Rigid Demand
Awfulizing Beliefs
Low Frustration Tolerance
Global Evaluation
Rational Beliefs

Alpha
0.756
0.765
0.721
0.802
0.648

116

4.4

Chapter Summary

The CIBRAS was subjected to a panel review of 12 experts and a validation


exercise involving 200 subjects in 10 different faculties on pilot test. The
instrument was found to be psychometrically sound, with high reliability in total
scores and in each subscale. In the following chapter, the factor structure of the
CIBRAS is tested using confirmatory factor analysis. Moreover, the results
regarding the relationship between irrational beliefs and emotional disturbance
upon depression, anxiety and stress, and the interaction effects and group
difference between irrational beliefs and depression, anxiety, and stress among
socio-demographic, academic-related, living environment and transportation
variables are reported.

117

Chapter Five

5.1

Results of the main study

Psychometric properties of the survey instruments

5.1.1 Introduction

This section consists of three parts. The first part explains the characteristics
of the students, including socio-demographic variables, academic-related
variables and environmental and transportation variables (section 5.1). The second
part explains the psychometric properties of CIBRAS (section 5.2). The third part
explains the interaction effects and group differences between irrational beliefs
and depression, anxiety, and stress among socio-demographic variables,
academic-related variables, and living environment and transportation variables,
(section 5.3), as well as the predictive relationship between irrational beliefs and
emotional disturbance (section 5.4).

5.1.2 Subject characteristics

A total of 655 questionnaires was collected between January 2015 and March

118

2015. The researcher was permitted to come into classrooms to collect the data.
The questionnaires were collected from a total of 25 classes, selected from 10
faculties in HKU.

5.1.3 Demographic profile

Table 5.1 displays the demographic characteristics of all participants. Of 655


subjects, 324 persons (49.5%) were males and 331 (50.5%) were females. 4
subjects (0.6%) were aged 17, 78 subjects (11.9%) were aged 18, 203 subjects
(31%) were aged 19, 151 subjects (23.1%) were aged 20, 106 subjects (16.2%)
were aged 21, 71 subjects (10.8%) were aged 22, 27 subjects (4.1%) were aged
23, 12 subjects (1.8%) were aged 24, 3 subjects (0.5%) were aged 25. 565
subjects (86.3%) were local people, 65 (9.9%) were from Mainland China, and 25
subjects (3.8%) were from other Asian countries. All subjects (655 persons,
100%) were single. 318 subjects (48.5%) were living in Hong Kong Island, 148
(22.6%) in Kowloon, and 189 (28.9%) in the New Territories. There were 490
subjects (74.8%) without a religion, and 165 (25.2%) with a religion. 108 subjects
(66.3%) were Protestant, 33 subjects (20.2%) were Catholic, 12 subjects (7.4%)
were Buddhist, 2 subjects (1.2%) were Taoists, and 8 subjects (4.9%) indicated

119

other. Eleven subjects (1.7%) reported that the family income depended on
government funding (CSSA) for daily living. 18 subjects (2.7%) had family
incomes of HK$5,000-HK$10,000; 127 subjects (19.4%) had family incomes of
HK$10,001HK$20,000; 154 subjects (23.5%) had family incomes of
HK$20,001HK$30,000; 111 subjects (16.9%) had family incomes of
HK$30,001-HK$40,000. There were 19 subjects (2.9%) who had family gross
income below HK$5,000 and 215 subjects (32.8%) with gross family income
above HK$40,000.

120

Table 5.1. Demographic characteristics among all students (N=655)


Gender
Male
Female
Age (years)
<=18
19
20
21
22
>=23
Marital Status
Single
Residentiall District
Hong Kong Island
Kowloon
New Territories
Nationality
Hong Kong
Mainland China
Asian
Religion
No
Yes
Religion Type
Protestant
Catholic
Buddhism
Taoism
Other
Gross family income
CSSA
<HK$5,000
HK$5,000-10,000
HK$10,001-20,000
HK$20,001-30,000
HK$30,001-40,000
>HK$40,000

324
331

49.5
50.5

82
203
151
106
71
42

12.5
31.0
23.1
16.2
10.8
6.4

100

100.0

318
148
189

48.5
22.6
28.9

565
65
25

86.3
9.9
3.8

490
165

74.8
25.2

108
33
12
2
8

66.3
20.2
7.4
1.2
4.9

11
19
18
127
154
111
215

1.7
2.9
2.7
19.4
23.5
16.9
32.8

121

5.1.4 Characteristics related to academic-related variables

All 655 subjects came from ten different faculties in HKU, including 26
subjects (4%) from Architecture, 73 (11.1%) from Arts, 119 (18.2%) from
Business and Economics, 14 (2.1%) from Dentistry, 38 (5.8%) from Education, 83
(12.7%) from Engineering, 30 (4.6%) from Law, 123 (18.8%) from Medicine, 90
(13.7%) from Science, and 59 (9%) from Social Science. Among them, 73
students (11.1%) were in a BA program, 116 (17.7%) were in a BSc program, 67
(10.2%) were in a BEcon program, 14 (2.1%) were in a BDS program, 48 (7.3%)
were in a BSSc program, 38 (5.8%) were in a BEd program, 83 (12.7%) were in a
BEng program, 30 (4.6%) were in a LLB program, 81 (12.4%) were in a BPharm
program, 19 students (2.9%) were in a BBiomedSc program, 23 students (3.5%)
were in a MBBS program, 52 (7.9%) were in a BBA program, and 11 students
(1.7%) were in a BSW program. Most students (N=456, 69.6%) were studying in
a 4-year program. Others were studying in 3- or 5-year programs, with N=101
(15.4%) and N=83 (12.7%), respectively. Only a few students (N=15, 2.3%) were
studying in a 6-year program. Moreover, most of the students (N=265, 40.5%)
were in second-year study; some students (N=127, 19.4%) were studying in first
year, and 263 students (40.2%) were in third year or above (Table 5.2).

122

Table 5.2 Characteristics related to academic-related variables (N=655)


n

Architecture

26

4.0

Arts

73

11.1

Business and Economics

119

18.2

Dentistry

14

2.1

Education

38

5.8

Engineering

83

12.7

Law

30

4.6

Medicine

123

18.8

Science

90

13.7

Social Science

59

9.0

BA

73

11.1

BSc

116

17.7

BEcon

67

10.2

BBA

52

7.9

BDS

14

2.1

BEd

38

5.8

BSSc

48

7.3

BEng

83

12.7

LLB

30

4.6

BBiomedSc

19

2.9

BPharm

81

12.4

MBBS

23

3.5

BSW

11

1.7

3 years

101

15.4

4 years

456

69.6

5 years

83

12.7

6 years

15

2.3

First-year

127

19.4

Second-year

265

40.5

Third-year or above

263

40.2

Faculty

Study Program

Duration of program

Current Year

123

5.1.5 Characteristics related to living environment and


transportation

One hundred and thirty seven subjects (20.9%) were living alone, with the
remaining students (N=518 , 79.1%) living with family members. 21 subjects
(5.1%) lived with only one family member; 127 (30.8%) lived with two family
members; many students (N=184, 44.6%) lived with three family members; 65
subjects (15.7%) lived with four family members; 13 (3.1%) lived with five
family members; 2 students (0.5%) lived with six family members; only one
student (0.2%) lived with seven family members. 168 students (25.7%) were
living in U hall. 112 students (17.2%) shared a flat with others, and 373 students
(57.1%) indicated other. Most subjects (N=542, 82.7%) found their living space
was sufficient, with only 113 subjects (17.3%) reporting it insufficient. 580
subjects (88.5%) reported that public transport was convenient; the rest of the
subjects (N=75, 11.5%) reported that public transport was inconvenient (Table
5.3).

124

Table 5.3 Characteristics related to living environment and transportation variables


(N=655)
n

Living alone

137

20.9

Living wth family member

518

79.1

One family member

21

5.1

Two family members

127

30.8

Three family members

184

44.6

Four family members

65

15.7

Five family members

13

3.1

Six family members

0.5

Seven family members

0.2

168
112
373

25.7
17.2
57.1

542
113

82.7
17.3

580
75

88.5
11.5

Family Status

Family members

Place of Living
U hall
Share flat
Other
Living Space
Enough
Not enough
Public Transport
Convenient
Inconvenient

125

5.2

Psychometric properties of CIBRAS

5.2.1

Confirmatory Factor Analysis of CIBRAS

The EFA was used to examine the subscale of CIBRAS in the first step. CFA
was conducted to give further evidence for the factor structure used to check the
EFA findings and the measurement model that was theoretically constructed. The
main study was performed with 655 university students in Hong Kong, aiming to
answer RQ1 and Hypothesis 1.

Research question RQ1: What are the psychometric properties of the CIBRAS?

Hypothesis 1: CIBRAS would have statistically significant content and construct


validity, and reliability.

5.2.2 Data analysis

CFA was conducted to test the factor structure of CIBRAS, with its fit index
values as below: Chi-Square =396, df=142, p<0.00001, NC=2.8, CFI=.94,

126

NFI=.93, NNFI=.93, IFI=.94, RMSEA=.075, SRMR=.074. The results show that


this model gives acceptable fit. Table 5.4 shows fit index values that were
assessed to examine the adequacy of the model.

Table 5.4 Fit Index Values in CFA


Measurement Model

CIBRAS

396

df

NC

CFI

NFI

NNFI

IFI

142 <0.00001 2.8

0.94

0.93

0.93

0.94

RMSEA SRMR
0.075

127

0.074

0.60

CIBRAS2

0.48

CIBRAS4

0.62

CIBRAS6

0.63
0.72

0.52

CIBRAS19

0.62
0.70

0.81

CIBRAS1

0.56

CIBRAS12

0.54

CIBRAS14

0.59

CIBRAS20

RD

1.00

0.70

0.44
0.67

0.52

CIBRAS21

0.50

CIBRAS31

0.69

CIBRAS8

0.60

CIBRAS23

0.68

AB

1.00

0.40

0.75 0.71
0.64
0.70

LFTB

1.00

0.90 0.34

0.71
0.81 0.41
0.56
0.63

GE

1.00

0.23

0.66
0.57

CIBRAS24

0.47

CIBRAS29

0.40

CIBRAS30

0.54

CIBRAS32

0.45

CIBRAS33

0.41

CIBRAS35

0.45

CIBRAS37

0.73
0.37

0.77

RB

1.00

0.68
0.74
0.77
0.74

Chi-Square=396.14, df=142, P-value=0.00000, RMSEA=0.075

Figure 5. 1 Measurement Model for CIBRAS

Factor loadings for the model with five factors obtained during the CFA are
demonstrated in Figure 5.1. As is seen in the figure, factor loads range between
0.62 and 0.72 for Rigid Demand, between 0.44 and 0.68 for Awfulizing Beliefs,
128

between 0.64 and 0.71 for Low Frustration Tolerance, between 0.56 and 0.73 for
Global Evaluation and between 0.68 and 0.77 for Rational Beliefs.

129

5.2.3 Reliability of CIBRAS

Cronbachs Alpha was performed to test the internal consistency of the


CIBRAS and CIBRAS sub-scales in the main study. CIBRAS and the CIBRAS
sub-scales were found to have high internal consistency. The alpha for CIBRAS
was 0.848. The alphas for Subscale 1 (Rigid Demand), Subscale 4 (Global
Evaluation) and Subscale 5 (Rational Beliefs) were 0.792, 0.751 and 0.814,
respectively. The alphas for Subscale 2 (Awfulizing Beliefs) and Subscale 3 (Low
Frustration Tolerance) were 0.659 and 0.688, respectively, demonstrating a
moderate degree of internal consistency. The above results are given in Table 5.5.

Table 5.5 Reliability of sub-scales of the CIBRAS


Chinese Irrational Beliefs and Rational Attitude Scale
CIBRAS
Subscale 1 (Rigid Demand)
Subscale 2 (Awfulizing Beliefs)
Subscale 3 (Low Frustration Tolerance)
Subscale 4 (Global Evaluation)
Subscale 5 (Rational Beliefs)

Alpha
0.848
0.792
0.659
0.688
0.751
0.814

130

5.2.4 Summary of psychometric properties of the survey


instruments

The characteristics of the participants displayed systematic variation, giving


support for the representativeness of the present sample. The self-developed
CIBRAS showed acceptable fit for this study and high scores in internal
consistency, with Cronbach Alphas ranging from 0.66 to 0.85. Therefore,
Hypothesis 1 was supported. We may now examine Hypotheses 2, 3 and 4.

131

5.3

Interaction and group differences in irrational


beliefs and depression, anxiety and stress

5.3.1 Introduction

This section examines interaction effects using MANOVA analysis. It is


followed by a description of the results for mean score comparison among
different groups in irrational beliefs and emotional disturbance by analyses of
variances (ANOVA) and Independent Samples t-test analysis. It aims to answer
RQ3 and RQ4, and hypotheses 3a, 3b, 3c, 4a, 4b and 4c.

5.3.2 Irrational beliefs and depression, anxiety and stress

5.3.2.1 Analyses of the interaction effects on irrational beliefs and depression,


anxiety and stress

Research question RQ3: Are there any interaction effects (gender x faculty),
(faculty x current year), and (gender x current year) on irrational beliefs and
depression, anxiety and stress?

132

Hypothesis 3a: There would be interaction effects (gender x faculty) on irrational


beliefs and depression, anxiety and stress.

Hypothesis 3b: There would be interaction effects (faculty x current year) on


irrational beliefs and depression, anxiety and stress.

Hypothesis 3c: There would be interaction effects (gender x current year) on


irrational beliefs and depression, anxiety and stress.

A two-way MANOVA between groups (gender x faculty), (faculty x current


year), (gender x current year) was performed, with the scores of eight items as
dependent variables, representing emotional disturbance (depression, anxiety and
stress) and irrational beliefs on subscales of rigid demand, awfulizing beliefs, low
frustration tolerance, global evaluation and rational beliefs. The results were based
on Wilks Lambda. Multivariate F values are listed in Table 5.6. The variables of
faculty and current year had significant interaction with awfulizing beliefs [F(15,
4426) = 1.95, p< 0.05]. The results indicate that second-year students had more
awfulizing beliefs than third-year students, but this was only found in the faculties
of Engineering and Education. Nil significant interaction variables were found for

133

the rest. Even though there was a statistically significant interaction effect, the
effect size was small (E.S.< 0.0.45), which has been interpreted as a small effect
by Cohen (1988). Therefore, only hypothesis 3b was supported; 3a and 3c were
not supported.

134

Table 5.6 Result of Multivariate Analyses of Variance (MANOVA)


Independent variable
Gender

Faculty

Current Year

Faculty x Current Year

Dependent variable
Depression
Anxiety
Stress
Rigid Demand
Awfulizing Beliefs
Low Frustration Tolerance
Global Evaluation
Rational Beliefs
Depression
Anxiety
Stress
Rigid Demand
Awfulizing Beliefs
Low Frustration Tolerance
Global Evaluation
Rational Beliefs
Depression
Anxiety
Stress
Rigid Demand
Awfulizing Beliefs
Low Frustration Tolerance
Global Evaluation
Rational Beliefs
Depression
Anxiety
Stress
Rigid Demand
Awfulizing Beliefs
Low Frustration Tolerance
Global Evaluation
Rational Beliefs

df
1
1
1
1
1
1
1
1
9
9
9
9
9
9
9
9
2
2
2
2
2
2
2
2
15
15
15
15
15
15
15
15

F
2.94
0.04
0.15
3.4
0.01
0.19
2.87
0.64
2.21*
2.65**
2.91**
2.48**
3.71***
1.83
2.11*
1.86
0.51
1.67
2.14
3.85*
2.21*
0.94
2.21
1.78
1.5
1.58
1.18
1.41
1.95*
1.56
1.55
1.64

Note: E.S.=Effect Size (Partial Eta Square)


*p <0.05; **p <0.01; ***p <0.001

135

5.3.2.2 Comparison of mean scores of irrational beliefs and depression,


anxiety and stress between socio-demographic variables

Research question RQ4: Are there any significant differences in the mean scores
of irrational beliefs and depression, anxiety and stress between socio-demographic
variables (gender, age, religion and family income), between academic-related
variables (faculty, study program, duration of program and current year), and
between living environment and transportation variables (family status, place of
living, living space and public transportation)?

Hypothesis 4a: There would be significant differences in the mean scores of


irrational beliefs and depression, anxiety and stress between socio-demographic
variables (gender, age, religion and family).

Table 5.7 presents the means and standard deviations of CIBRAS subscale
scores (rigid demand, awfulizing beliefs, low frustration tolerance, global
evaluation and rational beliefs) as well as total irrationality scores among different
demographic variables. No significant differences were found in rigid demand,
low frustration tolerance and CIBRAS total irrationality scores among all

136

demographic variables. An ANOVA demonstrates that there were statistically


significant differences among family income in awfulzing beliefs [F(4, 650) =
3.970, p< 0.01]. Students with less than $10,000 family income were found to
have the highest levels of awfulizing beliefs by comparison with other groups.
However, the small effect size computed using eta squared (E.S.< 0.05) indicated
that the actual mean differences between groups were minimal.

In addition, an independent samples t-test revealed a significant difference


for males (M=11.4, SD=3.1) and females (M=10.9, SD=3.2) in the global
evaluation scores, t(653)=2.308, p< 0.05. As for religion, there was a significant
difference for students professing a religion (M=17.6, SD=3.8) and students
without religion (M=16.9, SD=3.8) in rational beliefs scores, t(653)=2.313, p<
0.05. Even though male students showed higher global evaluation scores than
female students, and students with religion showed higher scores on rational
beliefs than those without, the effect sizes were small (d < 0.2).

137

Table 5.7 CIBRAS sub-scores and CIBRAS total scores by demographic characteristics among all subjects (N=655)
RD
AB
LFT
GE
RB
M SD
F
t E.S. d
M
SD
F
t
E.S. d M SD F
t E.S. d M SD F
t
E.S. d
M SD F
t
E.S. d
Gender
-1.3
0.596
0.66
2.308*
0.181
-0.939
Male
12.7 3.2
9.6
2.5
7.8 2.2
11.4 3.1
16.9 3.7
Female
13 3.1
9.5
2.4
7.7 2.2
10.9 3.2
17.2 3.8
Age (years)
0.51
1.593
1.28
0.76
0.75
17
12.8 1.3
8.5
2.4
8 1.4
10.5 1.7
17 2.3
18
12.9 3.2
9.3
2.6
7.7 2
11 3.2
16.4 4
19
13.1 3
9.6
2.4
7.6 2.2
11 3.3
17.2 3.7
20
12.7 3.2
9.5
2.4
7.7 2.1
11.2 2.8
16.9 4
21
12.8 3.3
10.1 2.4
8 2.1
11.4 3.2
17.5 3.5
22
12.8 3.4
9.4
2.6
8 2.7
11.1 3.8
16.9 3.7
23
13 2.9
10.1 2.1
8.6 1.9
11.8 3.3
16.9 3.7
24
11.9 2.8
8.2
2.3
7.6 2.2
10.3 2.3
16.9 3.8
25
10.7 6.1
8.7
1.5
5.7 4.6
14
1
20 3.5
Religion
-0.69
-0.091
0.47
-0.773
2.313*
0.2
Yes
12.7 3.3
9.6
2.5
7.8 2.2
15.1 11
17.6 3.8
No
12.9 3.1
9.6
2.4
7.7 2.2
15.4 12
16.8 3.8
Family Income
1.5
3.970**
0.024
0.62
0.25
0.65
<HK$10,000
13.7 3.1
10.5 2.3
7.8 2.1
11.4 2.9
16.6 4
HK$10,001-20,000 12.8 3
9.8
2.3
7.5 2.3
11 3.2
16.9 3.4
HK$20,001-30,000 12.4 3.1
9.1
2.6
7.9 2.1
11.2 3.1
17 4.1
HK$30,001-40,000 12.9 3.2
9.3
2.6
7.8 2.3
11 3.6
16.9 4.3
>HK$40,000
12.9 3.3
9.7
2.2
7.8 2.2
11.2 3.1
17.3 3.4
Note(1):RD=Rigid Demand; AB=Awfulizing Beliefs; LFT=Low Frustration Tolerance; GE=Global Evaluation; RB=Rational Beliefs; TIRB=Total Irrational Beliefs
Note(2):ANOVA or Independent Samples t -test, which deemed to be more appropriate, was performed to test if there was any difference in DASS scores between different categories of each variables.
According to Cohen (1988), the following guidelines were provided for interpreting value of the eta squared (E.S.) and Cohen's d (d) .
(E.S.): 0.01 = small; 0.06 = medium; 0.14 = large (d): 0.20 = small; 0.50 = medium; 0.80 = large
*p<0.05; **p<0.01

TIRB
M
SD
54.7
53.9

t E.S. d
1.16
-

8.2
8.6
0.7

52.8 3.3
54.3 8.4
54 8.4
54.1 7.4
54.9 8.5
54.5 10.6
56.6 8.4
51
5
49
9
-1.5
53.4
54.6

9.2
8.1

56.8
54.2
53.6
54.2
54.3

7
8.8
8
8.8
8.4

1.4

138

Table 5.8 shows the means and standard deviation of DASS depression,
anxiety and stress scores as well as total DASS scores among various
demographic variables. Most of the demographic variables including age, religion
and family income were found to have no significant differences in the present
study. The results only revealed that there was a significant difference in the
depression scores, t(653)=2.337, p< 0.05, with males having higher scores (M=5,
SD=4.5) than females (M=4.2, SD=4). However, the results showed no
differences in anxiety, stress or total DASS scores between males and females.

Even though there is statistical significance, the difference of means from


two independent groups calculated using Cohens d was small (d< 0.2), which has
been classified by Cohen (1988).

Therefore, hypothesis 4a was supported.

139

Table 5.8 DASS depression, anxiety and stress and DASS total scores by demographic characteristics among all students (N=655)
DASS depression scores
M

SD

t
E.S. d
2.337*
0.18

DASS anxiety scores


M

SD

t
E.S. d
0.325
-

DASS stress scores


M

SD

Total DASS scores


t
E.S.
-0.184

Gender
M ale
5.0 4.5
5.0
4.5
5.7
4.3
Female
4.2 4.0
4.2
4.0
5.8
4.1
Age (years)
0.790
1.012
1.28
17
2.3 2.6
1.75 1.5
1.0
1.4
18
4.9 4.4
5.5
3.7
6.1
4.4
19
4.7 4.4
5.2
4.0
6.0
4.4
20
4.2 3.8
5.2
3.6
5.2
3.8
21
4.8 4.3
5.2
3.7
5.8
4.0
22
5.1 5.1
5.2
4.2
5.9
4.7
23
4.5 4.1
5.2
3.9
6.1
4.4
24
3.2 2.4
5.2
2.9
4.8
4.2
25
2.7 0.6
5.2
2.1
5.7
0.6
Religion
-1.304
-0.128
0.518
Yes
4.2 4.1
5.0
3.7
5.9
4.1
No
4.7 4.4
5.0
3.9
5.7
4.3
Family Income
1.156
1.520
1
<HK$10,000
5.8 4.2
5.8
3.5
6.5
3.3
HK$10,001-20,000 4.6 4.3
5.0
3.7
5.6
3.9
HK$20,001-30,000 4.3 4.1
4.4
3.6
5.3
4.2
HK$30,001-40,000 4.7 4.5
5.3
4.0
6.0
4.3
>HK$40,000
4.6 4.4
5.1
4.0
5.9
4.6
Note: ANOVA or Independent Samples t -test, as appropriate, was performed to test if there
Following Cohen (1988), the following guidelines were provided for interpreting value of the eta squared (E.S.) and Cohen's d (d) .
(E.S.): 0.01 = small; 0.06 = medium; 0.14 = large (d): 0.20 = small; 0.50 = medium; 0.80 = large
*p <0.05

d
-

SD

15.7
14.9

11.9
11.1

5.0
16.5
15.9
14.0
15.7
15.9
15.6
11.4
12.0

5.3
11.8
12.0
10.1
11.1
13.2
11.9
8.5
2.6

15.1
15.4

10.9
11.6

18.0
15.1
14.0
15.9
15.5

10.1
11.2
11.1
11.7
12.0

t E.S. d
0.92
-

1.05

-0.34

1.31

140

5.3.2.3 Comparison of mean scores of irrational beliefs and depression,


anxiety and stress between academic-related variables

Hypothesis 4b: There would be significant differences in the mean scores of


irrational beliefs and depression, anxiety and stress between academic-related
variables (faculty, study program, duration of program and current year).

Table 5.9 indicated the means and standard deviation of CIBRAS subscale
scores (rigid demand, awfulizing beliefs, low frustration tolerance, global
evaluation and rational beliefs) as well as total irrationality scores among different
academic-related variables. There were significant differences among faculties in
rigid demand [F(9, 645) = 3.475, p< 0.001], awfulizing beliefs [F(9, 645) = 3.287,
p< 0.01], low frustration tolerance[F(9, 645) = 1.918, p< 0.05], global evaluation
[F(9, 645) = 2.904, p< 0.01], rational beliefs [F(9, 645) = 1.974, p< 0.05] and
total irrationality scores [F(9, 645) = 1.913, p< 0.05]. Compared to other groups,
law students obtained the highest irrational beliefs scores on rigid demands and
global evaluation, in addition to displaying the highest total irrationality scores.
Moreover, medical students had significantly higher awfulizing beliefs and low
frustration tolerance beliefs. It is evident that there were significant differences

141

among study programs in rigid demand [F(12, 642) = 3.185, p< 0.001],
awfulizing beliefs [F(12, 642) = 3.007, p< 0.001], low frustration tolerance [F(12,
642) = 1.798, p< 0.05] and global evaluation [F(12, 642) = 2.383, p< 0.01]. The
data revealed that LLB students showed significantly higher rigid demand and
global evaluation beliefs than other groups; BPharm students had higher
awfulizing beliefs and low frustration tolerance beliefs than other groups.
Moreover, the results revealed significant differences among the duration of
program in rigid demand [F(3, 651) = 3.981, p<0.01], awfulizing beliefs [F(3,
651) = 2.391, p< 0.05], low frustration tolerance [F(3, 651) = 4.423, p< 0.01],
global evaluation [F(3, 651) = 4.242, p< 0.01] and total irrationality scores [F(3,
651) = 3.182, p< 0.05] . Students taking a 5-year curriculum showed higher total
irrationality scores and subscales scores for rigid demand, awfulizing beliefs and
global evaluation; students taking a 3-year curriculum had higher low frustration
tolerance scores than other groups. In addition, second-year students had higher
rigid demands in comparison with other groups [F(2, 651) = 3.999, p<0.05].

In spite of reaching statistical significance, most of the effect sizes were


small (E.S. <0.05), with a notable exception among law students, where study
program was associated with rigid demand (E.S.=0.56) and awfulizing beliefs

142

(E.S.=0.53); students studying the LLB program reported higher levels of rigid
demand and awfulizing beliefs than students in other study programs.

143

T able 5.9 CIBRAS sub-scores and CIBRAS total scores by academic-related issues among all subjects (N=655)
RD
AB
LFT
GE
RB
M
SD
F
E.S.
M
SD
F
E.S.
M
SD
F
E.S.
M
SD
F
E.S.
M
SD
F
E.S.
M
Faculty
3.475*** 0.046
3.287**
0.044
1.918*
0.026
2.904** 0.039
1.974* 0.027
Architecture
11.7 1.9
9.7
1.9
7.5 1.8
10.6 2.7
16.8 3.3
52.7
Arts
12.7 3.7
9.3
2.2
8.0 2.2
10.9 3.1
17.4 3.8
53.5
Business and Economics
13.0 3.4
9.2
2.8
7.8 2.2
11.0 3.1
16.7 4.2
54.3
Dentistry
11.4 2.1
8.2
2.3
6.1 2.2
9.2 3.2
15.9 4.1
49.0
Education
12.0 3.5
9.3
2.7
7.6 2.3
10.2 3.7
16.6 4.5
52.5
Engineering
13.0 3.2
9.3
2.2
7.8 1.9
11.3 2.9
16.7 3.1
54.5
Law
15.4 2.5
10.4
2.4
7.6 2.5
12.4 3.5
18.3 3.6
57.4
Medicine
13.0 2.9
10.4
2.1
8.2 2.2
12.0 3.1
18.0 3.0
55.7
Science
12.7 3.0
9.6
2.4
7.4 2.3
11.0 3.0
16.5 4.1
54.2
Social Science
12.6 2.8
9.4
2.5
7.6 2.3
10.7 3.7
16.5 3.9
53.7
Study Program
3.185*** 0.056
3.007*** 0.053
1.798*
0.032
2.383** 0.042
1.596
BA
12.7 3.7
9.3
2.2
8.0 2.2
10.9 3.1
18.0 3.8
53.5
BSc
12.5 2.8
9.6
2.3
7.4 2.2
10.9 2.9
16.6 4.0
53.8
BEcon
13.1 3.4
9.2
2.7
7.6 2.1
10.8 3.0
16.7 4.4
54.0
BBA
12.8 3.3
9.3
2.9
8.0 2.2
11.4 3.3
16.7 4.1
54.8
BDS
11.4 2.1
8.2
2.3
6.1 2.2
9.2 3.2
15.9 4.1
49.0
BEd
12.0 3.5
9.3
2.7
7.6 2.3
10.2 3.7
16.6 4.5
52.5
BSSc
12.8 2.9
9.3
2.5
7.6 2.4
10.6 3.6
16.3 3.9
54.0
BEng
13.0 3.2
9.3
2.2
7.8 1.9
11.3 2.9
16.7 3.1
54.5
LLB
15.4 2.5
10.4
2.4
7.6 2.5
12.4 3.5
18.3 3.6
57.4
MBBS
12.3 3.0
9.7
2.3
7.6 2.4
11.7 3.4
18.0 3.5
53.3
BPharm
12.7 2.8
10.8
2.0
8.5 2.2
12.3 2.8
17.8 3.0
56.5
BBiomedSc
14.8 2.8
9.6
2.3
8.0 1.8
11.4 3.9
18.5 2.8
55.3
BSW
12.2 2.6
9.5
2.6
7.5 2.0
11.0 4.4
17.5 4.2
52.6
Duration of program
3.981**
0.018
2.391*
0.011
4.423**
0.02
4.242** 0.019
1.869
3 years
12.5 3.1
9.7
2.4
8.2 2.3
11.1 3.1
17.1 3.6
54.4
4 years
12.9 3.2
9.6
2.4
7.7 2.2
11.1 3.1
16.9 3.8
54.3
5 years
13.5 3.1
9.8
2.5
7.8 2.3
11.9 3.7
17.7 3.7
55.3
6 years
10.7 2.0
8
2.2
6.0 2.2
8.8 3.1
15.5 4.1
48.1
Current Year
3.999*
0.012
1.632
0.655
0.62
1.327
First-year
12.8 3.2
9.3
2.6
7.6 2.1
10.9 3.3
16.6 4.2
53.9
Second-year
13.3 3.0
9.7
2.3
7.7 2.2
11.2 3.1
17.2 3.5
54.7
T hird-year
12.5 3.2
9.5
2.4
7.8 2.2
11.2 3.2
17.0 3.8
54.0
Note (1):RD=Rigid Demand; AB=Awfulizing Beliefs; LFT =Low Frustration T olerance; GE=Global Evaluation; RB=Rational Beliefs; T IRB=T otal Irrational Beliefs
Note (2):ANOVA or Independent Samples t -test, which deemed to be more appropriate, was performed to test if there was any difference in DASS scores between different categories of each variables.
According to Cohen (1988), the following guidelines were provided for interpreting value of the eta squared (E.S.): 0.01 = small; 0.06 = medium; 0.14 = large
*p <0.05; **p <0.01; ***p <0.001

T IRB
SD

F
1.913*

E.S.
0.026

1.643

3.182*

0.014

0.658

6.9
8.5
8.9
7.1
9.9
8.2
9.5
7.8
7.7
8.2
8.5
7.5
8.6
9.3
7.1
9.9
7.7
8.2
9.5
8.0
7.6
8.2
10.5
8.0
8.2
9.4
7.4
8.2
8.3
8.5

144

Table 5.10 describes the means and standard deviations of DASS depression,
anxiety, and stress scores as well as total DASS scores among various academicrelated variables. The results indicated that all of the academic-related variables,
except the current year, showed significant differences. There were significant
differences among faculties in depression [F(9, 645) = 2.255, p< 0.05], anxiety
[F(9, 645) = 2.299, p< 0.05], stress [F(9, 645) = 2.909, p< 0.01] and DASS total
scores [F(9, 645) = 2.720, p< 0.01]. Students in the Faculty of Medicine had
higher stress scores and total DASS scores, compared to other faculties. Students
in the faculties of Medicine and Business and Economics had higher depression
scores. Moreover, students in Business and Economics had significantly higher
anxiety than students in other faculties. It is evident that there were significant
differences among study programs in depression [F(12, 642) = 2.314, p< 0.01],
anxiety [F(12, 642) = 2.051, p< 0.05], stress [F(12, 642) = 2.487, p< 0.01] and
total DASS scores [F(12, 642) = 2.463, p< 0.01]. As for the study program
dimension, students who were taking the BBiomedSc program had the highest
anxiety, stress and total DASS scores, and students in the BPharm program had
the highest depression scores. The results also revealed significant differences
among the duration of program in depression [F(3, 651) = 3.560, p< 0.05], anxiety
[F(3, 651) = 4.730, p< 0.01], stress [F(3, 651) = 5.068, p< 0.01], and total DASS

145

scores [F(3, 651) = 5.030, p< 0.01]. Students who were studying a 5-year program
had higher depression, anxiety, stress and total DASS scores than students in
programs of other duration.

Even though there are statistical significances, the actual differences in the
mean scores were minimal, as all of the effect sizes computed using eta squared
(E.S.) were below 0.05, which has been interpreted as a small effect by Cohen
(1988).

Therefore, hypothesis 4b was supported.

146

Table 5.10 DASS depression, anxiety and stress and DASS total scores by academic-related issues among all subjects (N=655)
Total DASS scores
DASS stress scores
DASS anxiety scores
DASS depression scores
E.S.
F
SD
M
ES
F
SD
M
E.S.
F
SD
M
E.S.
F
SD
M
2.720** 0.037
2.909** 0.039
0.031
2.299*
2.255* 0.03
Faculty
11.3
12.9
4.3
4.7
3.6
4.4
4.1
3.9
Architecture
10.5
14.1
3.9
5.5
3.5
4.6
4.0
3.9
Arts
12.2
16.9
4.2
6.1
4.2
5.6
4.6
5.2
Business and Economics
4.0
4.3
1.9
1.9
1.4
1.5
1.4
1
Dentistry
13.4
17.1
4.9
6.5
4.4
5.4
4.6
5.1
Education
11.8
14.4
4.2
5.0
4.1
4.7
4.4
4.7
Engineering
10.3
16.5
4.1
6.4
2.8
4.9
4.8
5.1
Law
10.5
17.3
4.0
6.7
3.4
5.5
4.3
5.2
M edicine
10.6
14.5
4.1
5.4
3.5
4.8
3.9
4.3
Science
12.7
14.1
4.8
5.3
4.4
4.7
4.3
4.0
Social Science
2.463** 0.044
2.487** 0.044
0.038
2.051*
2.314** 0.04
S tudy Program
10.5
14.1
3.9
5.5
3.5
4.6
4.0
3.9
BA
10.7
14.1
4.1
5.2
3.5
4.7
3.9
4.2
BSc
12.8
17.4
4.3
6.3
4.4
5.7
4.9
5.4
BEcon
11.5
16.3
4.1
5.8
4.1
5.5
4.2
5.0
BBA
4.0
4.3
1.9
1.9
1.4
1.4
1.4
1.0
BDS
13.4
17.1
4.9
6.5
4.4
5.4
4.6
5.1
BEd
13.3
14.8
5.1
5.7
4.5
4.8
4.4
4.3
BSSc
11.8
14.4
4.2
5.0
4.1
4.7
4.4
4.7
BEng
10.3
16.5
4.1
6.4
2.8
4.9
4.8
5.1
LLB
7.2
13.0
2.9
5.7
2.6
4.0
2.9
3.2
M BBS
10.9
18.2
4.1
6.7
3.5
5.8
4.3
5.7
BPharm
11.4
18.7
4.6
7.5
3.3
5.9
4.8
5.3
BBiomedSc
9.7
11.0
3.0
3.7
3.8
4.5
3.7
2.8
BSW
5.030** 0.023
5.068** 0.023
4.730** 0.021
3.560* 0.02
Duration of program
11.0
15.2
4.0
5.6
3.5
4.8
4.2
4.7
3 years
11.4
15.5
4.2
5.8
3.9
5.1
4.3
4.7
4 years
12.1
16.4
4.4
6.4
3.8
5.2
4.7
4.8
5 years
3.9
4.3
1.9
1.8
1.3
1.4
1.3
1.1
6 years
0.504
0.838
0.51
0.182
Current Year
11.2
14.8
4.1
5.4
3.7
4.9
4.1
4.5
First-year
12.1
15.9
4.5
6.0
4.1
5.2
4.5
4.7
Second-year
10.9
15.0
4.0
5.6
3.7
4.8
4.2
4.6
Third-year
Note: ANOVA or Independent Samples t -test, as appropriate, was performed to test if there was any difference in DASS scores between different categories in each variable.
Based on Cohen (1988), the following guidelines were provided for interpreting value of the eta squared (E.S.) 0.01 = small; 0.06 = medium; 0.14 = large
*p <0.05; p <0.01

147

5.3.2.4 Comparison of mean scores of emotional disturbance by living


environment and transportation variables

Hypothesis 4c: There would be significant differences in the mean scores of


irrational beliefs and depression, anxiety, and stress between living environment
and transportation variables (family status, placing of living, living space and
public transportation).

Table 5.11.indicated the means and standard deviations of CIBRAS subscale


scores (rigid demand, awfulizing beliefs, low frustration tolerance, global
evaluation and rational beliefs) as well as total irrationality scores among different
characteristics related to living environment and transportation. There were no
statistically significant differences in all CIBRAS subscales and total CIBRAS
irrational beliefs among the variables of place of living and living space. The t-test
results indicated that there were significant differences between students living
alone and students living with family in awfulizing beliefs, t(653)=-3.903,
p<0.001, low frustration tolerance, t(653)=-2.509, p<0.05, global evaluation,
t(653)=-2.480, p<0.05 and total irrationality scores, t(653)=-2.637, p<0.01.
Students living with family had higher total irrationality scores and subscales

148

scores on awfulizing beliefs, low frustration tolerance and global evaluation.


Moreover, the test also indicated that there were significant differences between
convenient public transportation and inconvenient public transportation in the
living area in awfulizing beliefs, t(653)=-2.698, p<0.01, low frustration tolerance,
t(653)=-3.237, p<0.01, global evaluation, t(653)=-2.252, p<0.05 and total
irrationality scores t(653)=-2.824, p<0.01. Students who accessed inconvenient
public transportation showed higher scores in awfulizing beliefs, low frustration
tolerance, global evaluation and total irrationality scores.

As for the effect sizes, only the variable of public transportation in low
frustration tolerance (d=0.4) showed a mild to moderate effect. The rest of the
effect sizes were small (d< 0.4), despite reaching statistical significance.

149

T able 5.11 CIBRAS sub-scores and CIBRAS total scores by living environment and transportation variables among all subjects (N=655)
RD

AB

SD

Living alone

12.7

Living with family

12.9

SD

3.4

8.9

2.7

7.3

3.1

9.8

2.3

7.9

Place of Living

0.64

t
E.S. d
-3.903***
0.4

LFT
M SD

Family Status

t
E.S. d
-0.44
-

0.164

GE
M

SD

2.3

10.6

2.2

11.3

t
E.S. d
-2.509*
0.24

0.42

RB
M

SD

3.1

16.9

3.2

17.1

t
E.S. d
-2.480*
0.24

0.3

TIRB
M

SD

4.3

52.6

8.8

3.6

54.7

8.2

t E.S. d
-0.57
-

0.37

13.1

3.2

9.5

2.5

7.6

2.1

11.0

3.0

17.2

3.8

54.0

8.2

Share flat

12.8

3.2

9.7

2.5

7.7

2.2

11.2

3.3

16.8

4.1

54.5

8.6

Other

12.8

3.1

9.6

2.4

7.8

2.3

11.2

3.3

17.0

3.7

54.3

8.4

54.0

8.4

55.7

8.2

-1.470

Enough

12.8

3.1

Not enough

13.2

3.4

Public Transport

-0.086

-1.293
9.5

2.4

9.8

2.3

-2.698**

0.212
7.8

2.2

7.7

2.2

0.3

-3.237**

-1.347
11.1

3.1

11.5

3.4

0.4

-2.252*

1.14
17.1

3.8

16.7

3.8

0.28

0.66

t
E.S. d
-2.637**
0.25

0.142

U hall

Living Space

Convenient

12.8

3.1

9.5

2.4

7.6

2.2

11.1

3.2

17.1

3.8

54.0

8.3

Inconvenient

12.9

3.4

10.3

2.6

8.5

2.2

11.9

3.2

16.8

3.4

56.9

8.7

-1.901

-2.824**

0.35

Note (1):RD=Rigid Demand; AB=Awfulizing Belief; LFT=Low Frustration Tolerance; GE=Global Evaluation; RB=Rational Beliefs; TIRB=Total Irrational Beliefs
Note (2):ANOVA or Independent Samples t -test, which deemed to be more appropriate, was performed to test if there was any difference in DASS scores between different categories of each variables.
According to Cohen (1988), the following guidelines were provided for interpreting value of the eta squared (E.S.) and Cohen's d (d) .
(E.S.): 0.01 = small; 0.06 = medium; 0.14 = large

(d): 0.20 = small; 0.50 = medium; 0.80 = large

*p <0.05; **p <0.01; ***p <0.001

150

Table 5.12 contains the means and standard deviation of depression, anxiety
and stress scores as well as total DASS scores among different variables related to
living environment and transportation. No significant differences were found in
the measured variables of family status. In the dimension of place of living,
students who reported living in a share flat had significantly higher scores in
depression [F(2, 650) = 5.098, p< 0.01], stress [F(2, 650) = 3.992, p< 0.05] and
total DASS scores [F(2, 650) = 4.469, p< 0.05]. However, the small effect size
computed using eta squared (E.S.< 0.05) revealed that the actual mean differences
between groups were minimal.

Moreover, the results of the t-test indicated that there was a significant
difference for enough living spaces (M=4.4, SD=4.1) and not enough living space
(M=5.9, SD=4.8) in depression, t(653)=-3.410, p<0.01. There was also a
significant difference between enough living space (M=4.8, SD=3.8) and not
enough living space (M=5.8, SD=4) in anxiety, t(653)=-2.373, p< 0.05. As for the
total DASS scores between two groups, this test revealed a significant difference
between enough living space (M=14.9, SD=11.3) and not enough living space
(M=17.8, SD=11.9) in total DASS scores, t(653)=-2.496, p<0.05. Moreover, the
test indicated that there were significant differences between convenient public

151

transportation and inconvenient public transportation in subjects living area in


depression t(653)=-3.982, p<0.01, anxiety, t(653)=--2.348, p<0.05, stress,
t(653)=-2.847, p<0.01 and total DASS scores t(653)=-3.332, p<0.01. Students
who accessed inconvenient public transportation showed higher scores in
depression, anxiety, and stress, and in total DASS scores.

In our findings, public transportation was the only variable to show mild to
moderate effects in depression (d=0.49) and DASS total scores (d=0.41). The rest
of the effect sizes were small (d < 0.4) despite researching statistical significance.

Therefore, hypothesis 4c was supported.

152

Table 5.12 DASS depression, anxiety and stress and DASS total scores by living environment and transportation variables among all subjects (N=655)
DASS depression scores
M

SD

t
0.288

E.S.

DASS anxiety scores


d
-

SD

t
E.S.
-0.223

DASS stress scores


d
-

SD

t
-1.098

Total DASS scores


E.S.

d
-

Family S tatus
Living alone
4.7 4.6
4.9 4.2
5.3 4.4
15.0
Living with family
4.6 4.2
5.0 3.7
5.8 4.2
15.4
Place of Living
5.098**
0.015
2.883
3.992*
0.012
U hall
4.0 4.0
4.5 4.0
5.0 4.2
13.4
Share flat
5.6 5.0
5.5 4.3
6.3 4.4
17.5
Other
4.6 4.2
5.1 3.6
5.9 4.1
15.5
Living S pace
-3.410**
0.35
-2.373*
0.25
-1.151
Enough
4.4 4.1
4.8 3.8
5.6 4.3
14.8
Not enough
5.9 4.8
5.8 4.0
6.1 4.1
17.8
Public Transport
-3.982**
0.49
-2.348*
0.29
-2.847**
0.35
Convenient
4.4 4.2
4.9 3.9
5.6 4.2
14.8
Inconvenient
6.5 4.8
6.0 3.5
7.0 4.1
19.4
Note : ANOVA or Independent Samples t -test, which deemed to be more appropriate, was performed to test if there was any
According to Cohen (1988), the following guidelines were provided for interpreting value of the eta squared (E.S.) and Cohen's d (d) .
(E.S.): 0.01 = small; 0.06 = medium; 0.14 = large

SD

t
-0.372

E.S.

d
-

12.2
11.3
4.469*

0.014

11.2
12.8
11.0
-2.496*

0.26

-3.332**

0.41

11.3
11.8
11.4
11.1

(d): 0.20 = small; 0.50 = medium; 0.80 = large

*p <0.05; **p <0.01

153

5.4

Predictive model of Irrational Beliefs and


Depression-Anxiety-Stress for university students

5.4.1 Correlation between CIBRAS and DASS

The correlations between the subscales of CIBRAS and DASS are shown in
Table 5.13. The results show that there were significant relationships between the
DASS (Depression) score and Factor 1 (Rigid Demand), Factor 2 (Awfulizing
Beliefs), Factor 3 (Low Frustration Tolerance), Factor 4 (Global Evaluation),
Factor 5 (Rational Beliefs), as well as Total Irrational Beliefs. The values of the
Pearson correlation (r) were 0.139, 0.259, 0.287, 0.387, -0.108 and 0.385,
respectively, indicating a mild relationship for Factor 1 and a moderate
relationship for Factor 2, Factor 3 and Factor 4.

Moreover, there were significant relationships between DASS (Anxiety) and


Factor 1 (Rigid Demand), Factor 2 (Awfulizing Beliefs), Factor 3 (Low
Frustration Tolerance), Factor 4 (Global Evaluation), as well as Total Irrational
Beliefs. The values of the Pearson correlation (r) were 0.147, 0.261, 0.275, 0.334,
and 0.338, respectively (Table 5.14). Again, the results show a mild relationship in

154

Factor 1, and a moderate relationship in Factor 2, Factor 3 and Factor 4.

Likewise in table 5.15, DASS (Stress) and Factor 1 (Rigid Demand), Factor
2 (Awfulizing Beliefs), Factor 3 (Low Frustration Tolerance), Factor 4 (Global
Evaluation), and Total Irrational Beliefs also show significant relationships. The
values of the Pearson correlation (r) were 0.171, 0.250, 0.291, 0.375, and 0.362,
respectively, indicating mild to moderate relationships.

Finally, significant relationships were found between the DASS total score
and the Total Irrational Beliefs score, Factor 1 (Rigid Demand), Factor 2
(Awfulizing Beliefs), Factor 3 (Low Frustration Tolerance), and Factor 4 (Global
Evaluation), as shown in Table 5.16. The values of the Pearson correlation (r)
were 0.391, 0.164, 0.277, 0.307, and 0.393, respectively. These findings support
the concept of the present study that CIBRAS was correlated with DASS in both
subscales and comparison of total scores.

155

Table 5.13 Correlations between DASS (Depression) and CIBRAS


CIBRAS
Total Irrationality
Factor 1 (Rigid Demand)
Factor 2 (Awfulizing Beliefs)
Factor 3 (Low Frustration Tolerance)
Factor 4 (Global Evaluation)
Factor 5 (Rational Beliefs)
*p <0.05, **p <0.001
Table 5.14 Correlations between DASS (Anxiety) and CIBRAS
CIBRAS
Total Irrationality
Factor 1 (Rigid Demand)
Factor 2 (Awfulizing Beliefs)
Factor 3 (Low Frustration Tolerance)
Factor 4 (Global Evaluation)
Factor 5 (Rational Beliefs)
*p <0.05, **p <0.001
Table 5.15 Correlations between DASS (Stress) and CIBRAS
CIBRAS
Total Irrationality
Factor 1 (Rigid Demand)
Factor 2 (Awfulizing Beliefs)
Factor 3 (Low Frustration Tolerance)
Factor 4 (Global Evaluation)
Factor 5 (Rational Beliefs)
*p <0.05, **p <0.001
Table 5.16 Correlations between DASS and CIBRAS
CIBRAS
Total Irrationality
Factor 1 (Rigid Demand)
Factor 2 (Awfulizing Beliefs)
Factor 3 (Low Frustration Tolerance)
Factor 4 (Global Evaluation)
Factor 5 (Rational Beliefs)
*p <0.05, **p <0.001

Correlation
0.385**
0.139**
0.259**
0.287**
0.387**
-0.108*

Correlation
0.338**
0.147**
0.261**
0.275**
0.334**
-0.017

Correlation
0.362**
0.171**
0.25**
0.291**
0.375**
-0.012

Correlation
0.391**
0.164**
0.277**
0.307**
0.393**
-0.041

156

5.4.2 The hypothesized model of Irrational Beliefs and


Depression-Anxiety-Stress

The proposed models of Irrational Beliefs and Depression-Anxiety-Stress for


university students (see figure 5.2, 5.3 & 5.4) were tested using Structural
Equation Modeling (SEM). This aimed to explore the best-fitting model and
answer RQ2 and hypothesis 2a, 2b and 2c.

Research question RQ2: What are the relationships between irrational beliefs,
depression, anxiety and stress? (see figure 5.2, 5.3 & 5.4)

Hypothesis 2a: Irrational beliefs would have a significant positive effect on


depression, anxiety and stress (Model A).

Hypothesis 2b: Depression, anxiety and stress would have significant positive
effects on irrational beliefs (Model B).

Hypothesis 2c: Depression, anxiety stress and irrational beliefs would have
significant bidirectional relationships (Model C).

157

Three proposed models were tested by structural equation modeling. The


goodness of fit indices of structural equation modeling indicated that Model A is a
good fit (chi-square=3605.65, df=1343, p< 0.001, NC=2.68, CFI=0.94, NFI=0.91,
NNFI=0.93, IFI=0.94, SRMR=0.082 and RMSEA=0.051). It provided a good fit
to our data, meeting all the accepted criteria (Table 5.17). According to the total
effects in Model A in Figure 5.2, irrational beliefs were positively related to
depression (0.49), anxiety (0.31) and stress (0.43). The details are shown in Table
5.18.

In the analysis of Model B, the results indicated that the model did not fit the
data (chi-square=4345, df=734, p< 0.001, NC=5.92, CFI=0.94, NFI=0.92,
NNFI=0.92, IFI=0.93, SRMR=0.075 and RMSEA=0.085) (Table 5.17). Since
depression, stress and anxiety were highly correlated, Model B exhibited
multicollinearity when these were used as independent variables. Therefore, none
of the path coefficients were significant (see figure 5.3 & table 5.19).

The fit indices of Model C indicated an acceptable fitting model (chisquare=3325, df=734, p< 0.001, NC=4.52, CFI=0.94, NFI=0.92, NNFI=0.94,
IFI=0.94, SRMR=0.085 and RMSEA=0.087) (Table 5.17). The total effects in

158

Model C in Figure 5.4 showed that the correlation between irrational beliefs and
depression, anxiety and stress were 0.34, 0.36, and 0.37, respectively. The details
are shown in Table 5.20.

In sum, Model A is the best fit model in terms of NC and RMSEA, as


revealed in key indicators of SEM fitness, whereas Model C shows only an
acceptable fit, and Model B is not statistically fit at all. Hence, hypothesis 2a is
supported, that irrational beliefs would have a significant positive effect on
depression, anxiety and stress as proposed in Model A.

Table 5.17 Fit index value in SEM


Proposed model
2
df
Model A
Model B
Model C

3606
4345
3325

1343
734
734

NC

CFI

NFI

NNFI

IFI

<0.001 2.68 0.94


<0.001 5.92 0.94
<0.001 4.52 0.94

0.91
0.92
0.92

0.93
0.92
0.94

0.94
0.93
0.94

RMSEA SRMR
0.051
0.085
0.087

0.082
0.075
0.085

159

R=85%

Depression
R=85%
R=97%

0.49

Irrational

0.31

Beliefs

Anxiety

0.44

Rigid Demand

0.43
R=96%
0.63

Demand

Stress

Awfulizing Beliefs
0.50

Low Frustration Tolerance

Global Evaluation

0.68

-0.13

Rational Beliefs

Chi-Square=3605.65, df=1343, p-value=0.000, RMSEA=0.051

Figure 5.2 The hypothesized model of Irrational Beliefs and Depression-Anxiety-Stress for university students (Model A)

Table 5.18 The hypothesized model of Irrational Beliefs and Depression-Anxiety-Stress for university students
for university students (Model A)
Predictor
Irrational Beliefs

Outcome
Depression

Beta
0.49

t
19.47

p
0.000

R
0.85

Error Var.
0.049

Irrational Beliefs

Anxiety

0.31

9.32

0.000

0.97

0.0035

Irrational Beliefs

Stress

0.43

15.44

0.000

0.96

0.0076

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Depression
0.13

Irrational

-0.46

Anxiety

Beliefs

1.06

Stress

Chi-Square=4345, df=734, p-value=0.000, RMSEA=0.085

Figure 5.3 The hypothesized model of Irrational Beliefs and Depression-Anxiety-Stress for university students (Model B)

Table 5.19 The hypothesized model of Irrational Beliefs and Depression-Anxiety-Stress for university students (Mo
for university students (Model B)
Predictor
Outcome
Depression Irrational Beliefs

Beta
0.13

t
0.56

p
0.575

R
0.14

Error Var.
0.86

Anxiety

Irrational Beliefs

-0.46

-0.38

0.704

Stress

Irrational Beliefs

1.06

1.23

0.219

161

Depression

0.34

Irrational

0.36

Anxiety

Beliefs

0.37

Stress

Chi-Square=3325, df=734, p-value=0.000, RMSEA=0.087

Figure 5.4 The hypothesized model of Irrational Beliefs and Depression-Anxiety-Stress for university students (Model C)

Table 5.20 The hypothesized model of Irrational Beliefs and Depression-Anxiety-Stress


for university students (Model C)
Latent Variables
Irrational Beliefs

Latent Variables
Depression

Correlation
0.34

t
7.66

p
<0.001

Irrational Beliefs

Anxiety

0.36

6.16

<0.001

Irrational Beliefs

Stress

0.37

7.81

<0.001

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5.5

Summary of Findings

The purpose of this study is to empirically construct an instrument to


measure irrational beliefs among university students in Hong Kong and to further
investigate the relationship between irrational beliefs and emotional disturbance in
university students. The interaction effects and group differences between
irrational beliefs and depression, anxiety, and stress among socio-demographic
variables, academic-related variables and living environment and transportation
variables were also examined. The following findings are summarized with
respect to the answers to the proposed research questions of this study.

(1) The construction of the Chinese Irrational Beliefs and Rational Attitude Scale
(CIBRAS) was successful in obtaining content validity, construct validity and
reliability in the phase one and phase two studies. In the phase one study, the
drafted 37-item CIBRAS was given to 12 experts to evaluate content validity. The
result showed a good rating of CVI on all items, with only two items needing
minor amendment of wording to be retained in the scale. The CIBRAS was
subjected to a validation in a sample of 200 HKU students in a pilot test. The
results showed a 19-item CIBRAS with five-factor solution and good internal

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consistency (0.64 to 0.80), accounting for 60.1% of the total variance of the scale.
In the phase two study, the result of CFA analysis indicated factorial validity of
CIBRAS with acceptable model fit (Chi-Square =396, df=142, p<0.00001,
NC=2.8, CFI=.94, NFI=.93, NNFI=.93, IFI=.94, RMSEA=.075, SRMR=.074). It
has 5 factors, including rigid demand, awfulizing beliefs, low frustration
tolerance, global evaluation and rational beliefs. The 5-factor, 19-item CIBRAS
demonstrated good internal consistency (= 0.65 to 0.81).

(2) Our findings suggested that there was mild to moderate correlation between
irrational belief and emotional disturbance. Factor 4, Global Evaluation, showed
a moderate relationship with Pearson correlation (r) of 0.39, and other subscales
yielded a mild correlation, with Pearson correlation (r) ranging from 0.164 to 0.30
upon comparison of CIBRAS with DASS total scores.

(3) Our findings suggested that students who have the following characteristics
were likely to have more irrational beliefs. They were male, from low income
families, studying a law program, pursuing a 5-year degree program, and in their
second year of study. Moreover, those students who were living with family and
who reported inconvenient transportation and living environment were found to

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have more irrational beliefs. Furthermore, second-year students in the faculties of


Engineering and Education were found to have more awfulizing beliefs than thirdyear students.

(4) Our findings showed that male students have significantly higher levels of
depression, and those who are medical students, study 5-year programs, share
living arrangements with others, or have insufficient living space and
inconvenient public transportation in their living area show significantly higher
scores in depression, anxiety and stress.

(5) Overall, our proposed model was supported by the result of SEM analysis.
The goodness-of-fit indices by SEM showed acceptable fit (NC=2.8, CFI=0.94,
NFI=0.91, NNFI=0.93, IFI=0.94, RMSEA=0.051, SRMR=0.082). The results of
SEM analysis indicated that irrational beliefs had greater strength and magnitude
effects on psychological outcomes. Irrational beliefs had a direct effect on three
factors of psychological disorder outcomes, including depression, anxiety and
stress. The results suggest that people with more irrational beliefs may be subject
to an increased risk of the emotional disorders of depression, anxiety and stress.

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Chapter Six

Discussion, Implications and


Conclusion

6.1

Discussion

6.1.1 Introduction

This section will discuss the results and findings of the present study. It also
discusses implications with respect to theoretical contributions, practical
implementation and future research advancement. Finally, a summary and
conclusion will be given.

6.1.2 Psychometric properties of the CIBRAS

Irrational beliefs are reported to play a role in emotional disturbance in


western societies. However, little is known regarding the role of irrational beliefs
in emotional disturbance in university students in Chinese society. The
construction of the Chinese Irrational Beliefs and Rational Attitude Scale
(CIBRAS) in this study is an addition to existing research in the field, since it has

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cultural relevancy, good content validity, construct validity and sound reliability.
Overall, the construction process was comprehensive and systematic, involving
expert panel review and EFA of a 200-student sample and CFA of a 655-student
sample. The validity and reliability of CIBRAS were similar to other validated
instruments, such as the Irrational Beliefs Inventory (IBI) (Bridges & Roig, 1997;
Koopmans et al., 1994; Woodward, Carless, & Findlay, 2001), the Smith Irrational
Beliefs Inventory (SIBI) by Smith (2002) and the General Attitude & Belief Scale
(GABS) by Burgess (1986).

Firstly, twelve experts were invited to assess the content validity of the
CIBRAS and examine the quality of the items. All items showed a good rating
(>0.75) on Content Validity Index (CVI), reflecting that the instrument had
achieved relevance, clarity and representativeness. All 37 items were retained,
with a small number of items requiring slight amendment of wording following
expert review and comment.

Construct validity using exploratory factor analysis was carried out in the
sample of 200 HKU students in the phase one study. It suggested a five-factor
model, namely, a 4-item Rigid Demand subscale (24.67%), a 3-item

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Awfulizing Beliefs subscale (12.96%), a 3-item Low Tolerance Frustration


subscale (9.8%), a 4-item Global Evaluation subscale (6.57%) and a 5-item
Rational Beliefs subscale (6.09%), accounting for 60.1% of the total variance of
the scale. Nineteen items were retained. The adequate-to-good internal reliability
of the scale was shown, ranging from 0.64 to 0.80. Among the five factors, Rigid
Demands and Awfulizing Beliefs, composed of 7 items, explained more
variance of the CIBRAS (37.6%) than the other three subscales. The findings for
the five-factor structure were consistent with the Irrational Beliefs Inventory (IBI)
by Koopmans et al. (1994). The IBI has a five-factor structure, namely, the
subscales of Worrying, Rigidity, Need for Approval, Problem Avoidance and
Emotional Irresponsibility. In our study, the CIBRAS has a five-factor structure
including Rigid Demand, Awfulizing Beliefs, Low Frustration Tolerance, Global
Evaluation and Rational Beliefs. By comparison, this study shares similar
concepts in the factors of Rigidity vs Rigid Demand, Worrying vs Awfulizing
Beliefs and Problem Avoidance vs Low Frustration Tolerance. Though the scales
differ on other items, they are in line with REBT theory. According to REBT, the
characteristics of irrational beliefs are rigidity, illogicality, inconsistency with
reality, and the impedance of goal attainment (Dryden, 2012 & 2013). Overall, the
results of this study supported the view that the CIBRAS could measure five

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distinct aspects of irrational beliefs.

By using confirmatory factor analysis, the researcher cross-validated the


five-factor solution in the sample of 655 HKU students in the phase two study.
This indicated factorial validity of the CIBRAS, with the result showing
acceptable model fit (Chi-Square =396, df=142, p<0.00001, NC=2.8, CFI=.94,
NFI=.93, NNFI=.93, IFI=.94, RMSEA=.075, SRMR=.074). The 19-item CIBRAS
demonstrated good internal consistency (= 0.65 to 0.81).The result was in line
with the findings of Jenks (2002) and Smith et al. (2004) that the irrational beliefs
scale was multi-factorial for college students and irrational beliefs could be
organized into several independent dimensions. Overall, the findings gave support
to the validity of the CIBRAS, showing it to be a valid and reliable instrument for
assessing irrational beliefs among college students.

6.1.3 Socio-demographic factors contribute to irrational beliefs


and depression, anxiety and stress

The findings showed that male students have significantly higher levels of
irrational beliefs and depression. In addition, students with low family incomes

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were found to have higher levels of irrational beliefs. Students who professed
religious beliefs were found to score higher on rational beliefs.

Our results suggest that male students had significantly more irrational
beliefs than females, particularly in irrational beliefs pertaining to global
evaluation. Literature review suggested mixed and inconclusive results on the
relation between gender and irrational beliefs. Some literature stated that females
endorsed more irrational thinking than males (Jaradat, 2006; Ndika, Olagbaiye,
and Agioby-Kemmer, 2008). However, Al-Heeti, Hamid and Alghorani (2012)
indicated no significant difference was found in the effect of gender on irrational
beliefs. Our result was consistent with study conducted by Al-Salameh (2011),
where male students were more inclined to irrational beliefs than females. This
may be partially explained by cultural values for men. In Chinese culture, peoples
behavior is governed by Confucian beliefs, which emphasize that a persons
behavior should be in accordance with their expected role and position in society
(Tang & Chua, 2010). There is a traditional concept to differentiate the position of
men and women, men for the exterior, women for the interior. Men are expected
to work and earn money in order to fulfill the role of breadwinner for the family.
In the materialistic society of Hong Kong, men are expected to achieve high

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educational or economic status in order to provide a high quality of living for the
family. Students with academic excellence are usually expected to enter a moneymaking profession, such as business administration or medicine (Shek & Chan,
1999). Research studies found that there were strong correlations between
educational attainment and earnings (Carnevale, Jayasundara, & Hanson, 2012;
Day & Newburger, 2002; Julian & Kominski, 2011). Because of this cultural
environment, it is likely that males are more vulnerable to being disappointed and
upset if their expectations could not be attained. A study by Shek (2005) also
revealed that there was an intimate relationship between cultural beliefs and
mental health outcomes.

In addition to irrational beliefs, male students were found to have higher


scores in depression than their female counterparts. Similar results were found in
the research study by Zamarripa, Wampold and Gregory (2003). Some studies
stated the opposite result, that female students scored higher than males on
depression (Amr, EI Gilany, & El-Hawary, 2008, Eisenberg, Gollust, Golberstein,
& Hefner, 2007; Geisner, Larimer, & Neighbors, 2004). From the literature we
can conclude that there are inconclusive and mixed findings regarding gender as a
variable in in relation to depression.

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Why did male students present with more depression? Again, an answer may
lie in traditional gender roles. Men show more restricted emotionality and
restricted affection (Zamarripa, Wampold, & Gregory, 2003). This is associated
with interpersonal insensitivity, psychoticism and depression (Good, Robertson,
Fitzgerald, Stevens, & Bartels, 1996). Moreover, males are less likely to report
their depressive symptoms. The socialization process enforces a male role where
men are expected to be assertive, independent and strong. Men fear expressing
their emotional problems because this might be viewed as a sign of weakness, and
lead to them being labeled as unmasculine (Cournoyer & Mahalik 1995).

Our study showed that low family income was a significant factor
contributing to irrational beliefs. Other studies also revealed that low income
individuals had higher rates of psychiatric problems, such as depression, anxiety,
or distress (Eaton, Muntaner, Bovasso, & Smith, 2001; Jayakody & Stauffer,
2000). Negative thinking may contribute to these psychological disorders (Peden,
Rayens, Hall, & Grant, 2004). According to Teasdale and Rezin (1978), negative
thoughts lead individuals to devaluate or criticize themselves, and these negative
thoughts may regard the self, others, past experiences or current status. In our
results, low family income students were found to hold more awfulizing beliefs.

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They showed high CIBRAS scores on the items of (a) If my classmates cant
understand me clearly, I will be terrified, (b) Its terrible for me to be disliked by
other students and (c) If I cannot get a job after graduation, it would be awful.
In these examples, negative thoughts devaluated everything, irrespective of the
event or person; whenever a good result was lacking or an expectation unfulfilled,
it was perceived that this could lead to the worst for them.

The present results revealed that there was a significant relationship between
religion and rational beliefs. The result was supported by another study that
students religious affiliations, including adherence to Hinduism, Christianity and
Islam, and religious orientation, in terms of an intrinsic orientation or an external
personal orientation, had significant impacts on students rational and logical
thinking. Students were more inclined to use a rational cognitive style for decision
making (Buzdar, Ali, & Tariq, 2015). Research studies indicate that religion is a
significant factor to enhance a persons physical health, as well as mental and
behavioral health (Laurencelle, Abell, & Schwartz, 2002; Wuthnow, 2000). It was
believed that students from a religious background were more psychologically
healthy because of positive thinking regarding the self, others and the world.

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6.1.4 Academic-related factors contribute to irrational beliefs and


depression, anxiety and stress

The findings showed that law students and second-year students were likely
to have more irrational beliefs. Medical students had significantly higher scores in
depression, anxiety and stress. In addition, students studying a 5-year program had
both higher scores on irrational beliefs and on depression, anxiety and stress.

Our findings suggested that students studying at the Law Faculty were likely
to have more irrational beliefs, in particular in the subscales of rigid demand,
awfulizing beliefs, and global evaluation. In the same vein, Lake (2000) indicated
that many law students hold some set of irrational beliefs that corrode ones
quality of life. The set of irrational beliefs law students hold include (a) I am
only as good as my grades and class rank, (b) I must study all the time, (c) I
must be at the top of my class to be successful, (d) I cant have a social life in
law school, and (e) I have no time for leisure or for fun. This is congruent with
our findings that law students endure irrational beliefs in the form of rigid
demand. Additionally, legal language and training tends to make law students
think along narrow points of view. Such narrowed views can result in isolation

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from the rest of the world (Thaler, 2000). Moreover, high competition between
peers when seeking to enter the PCLL program (completion of which is obligatory
if one seeks to practice law in Hong Kong) was a source of emotional problems
for law students. Much research has found that after studying in law school, the
psychological and physical health of law students had significantly declined
(Dammeyer and Nunez, 1999; Mclntosh, Keywell, Reifman, & Ellsworth, 1994;
Reifman, McIntosh, & Ellsworth, 2000). Under such circumstances, law students
were likely to hold some forms of irrational beliefs, such as (a) I must get good
grades, (b) I ought to have a good GPA so as to succeed in the future (c) I am
a failure when I fail to achieve my goals and I feel like I am a stupid person
when I dont do as well as my friends.

A study revealed that second-year students were likely to have more


irrational beliefs in the form of rigid demand. Second-year students have been
categorized as the forgotten class (Bisese & Fabian, 2006) because they receive
the least support and focus from most universities. The support and resources are
mostly given to freshmen, junior and seniors. Freshmen were usually provided
with strong support from the university, such as seminar classes and academic
achievement planning. As for the junior and seniors, university was more likely to

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focus on obtaining internships, career decision making, and jobs after graduation.
Sophomores were in the middle in every respect, and hence they were being
forgotten (Boivin, Fountain, & Baylis, 2000). Being the forgotten class, students
might want to perform well in their academic work in order to make them feel
worthy. Therefore, it is likely that they hold some rigid demand beliefs, such as I
must get good grades and I should perform remarkably in academic work, and
this is the way to make myself feel useful.

Our result showed that medical students had higher levels of depression,
anxiety and stress than other students. These results were congruent with previous
studies (Baykan, Nacar, & Cetinkaya, 2012; Bunevicius, Katkute, & Bunevicius,
2008; Dyrbye, Thomas, & Shanafelt, 2006; Visnjic, Milosavljevic, & Djordjevic,
2009). Another study also examined the prevalence of anxiety and depression
among Chinese students in Hong Kong University. It was found that Chinese
students from medical school reported higher rates of anxiety and depression
(Stewart, Betson, Marshall, Wong, Lee, & Lam, 1997). The high rate of
depression, anxiety and stress may be due to the medical curriculum (Dyrbye et
al., 2005; Yusoff, 2011; Yusoff & Rahim, 2011). They regarded stress factors as
including the examinations, the large amounts of information and knowledge to be

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learnt or memorized, and insufficient time to review what had been taught.
Students were overloaded with large amounts of content that needed to be learnt
within a limited time to prepare for the examinations. Medical students might feel
academic disappointment and struggle with questions about their capability to
meet the demands of the medical curriculum (Smith, Peterson, Degenhardt, &
Johnson, 2011). As a result, some psychological problems may be encountered.

Our findings suggested that duration of program was significantly related to


irrational beliefs and depression, anxiety, and stress. It was revealed that those
studying a 5-year program were likely to harbor higher levels of irrational beliefs
and had more emotional problems than others. Where the length in years for an
academic program was longer, students showed more psychological problems.
This may be explained by the following reasons. Students are worried about their
academic performance (GPA scores) and face more financial burdens, as they
need to study longer (Astin, 1993). In addition, they are uncertain about their
career path in a fast-changing economic society, being unsure about if their degree
will fit their career requirements or whether they will face limited employment
opportunities after many years of studying (Durr & Tracey, 2009; Mojgan, 2011).
A longer duration of program also means more examinations, assignments and

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projects to fulfill graduation requirements. Moreover, the prospect of an uncertain


future career and financial issues is a cause of mental health problem for college
students (Perna, 2008). As such, students in a longer program might hold more
irrational beliefs, as revealed in the CIBRAS related to their academic
performance and future prospects, such as (a) If I cannot get a job after
graduation, it would be awful; (b) I must get good grades; (C) I am a failure
when I fail to achieve my goals; (d) I ought to have a good GPA so as to
succeed in the future.

Our findings suggested that second-year students in the faculties of


Engineering and Education had more awfulizing beliefs than did third-year
students. Awfulizing beliefs refer to when an individual believes that the situation
or condition is terrible if it is different from his/her expectation. The awfulizing
beliefs in our CIBRAS were: (1) If I cannot get a job after graduation, it would
be awful, (2) It is terrible for me to be disliked by other students, (3) If my
classmates cant understand me clearly, I will be terrified. It was noted that
second-year students in these faculties tended to be worrying about their career
paths after graduation. They also seemed to be paying more attention to peer
relations during their study. This was probably due to the fact that both faculties

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required students to take part in internships or placements during their secondyear study. Also, students face fierce competition for employment in the fields of
education and engineering after graduation.

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6.1.5 Environmental and transportation factors contribute to


irrational beliefs and depression, anxiety and stress

The findings showed that students living with family were likely to have more
irrational beliefs. Those who shared living arrangements with others and reported
insufficient living space had significantly higher scores in depression, anxiety and
stress. In addition, students who reported inconvenient access to public transportation
in their living area were found to have significantly higher scores in irrational beliefs
and depression, anxiety, stress.

Compared to students living alone, students living with family were found to
have more irrational beliefs, in particular on the subscales of awfulizing beliefs, low
frustration tolerance and global evaluation. This could be due to students living with
family being directly exposed to higher expectations and being influenced by
Confucianism. Filial piety, a core value of Confucianism in Chinese culture, entails
unconditional material and emotional support for parents. This includes taking care of
parents, giving financial support, pleasing them and demonstrating love, respect and
obedience (Ng, 2002; Ng, Loong, Liu, & Weatherall, 2000). Students in a Confucian
context make a greater effort to satisfy the expectations of their family. If they cannot

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achieve these, negative feeling may occur. A study showed that around 60% of
students reported pressure because of high levels of parental expectation regarding
their academic achievement (Walker & Satterwhite, 2002). As such, students living
with family were subject to more pressure and therefore they reported high scores on
some items of the CIBRAS, such as (a) I am a failure when I fail to achieve my
goals, (b) If I do not perform well at an important task, I am a worthless person, (c)
Failing in the examinations makes me feel ashamed, (d) I feel ashamed if I cannot
fulfill my familys expectations and (e) I must graduate with satisfactory
performance to meet my parents expectations.

The environmental factors, place of living and living space, were found to
significantly contribute to depression, anxiety and stress. Firstly, students who
reported living in a share flat with others were found to have more depression, anxiety
and stress. This was probably because sharing a flat with others is likely to trigger a
conflict. Every person has his own lifestyle, and accommodation with others is not
easy. The interpersonal problems or conflicts may appear on a daily basis.
Interpersonal problems are found to be associated with chronic stress and depression
(Sheets & Craighead, 2014). In another study, Stroud, Davila, Hammen and VrshekSchallhorn (2011) also indicated that interpersonal problems were twice as likely to

181

trigger major depressive disorder. In addition, insufficient living space leads to


psychological problems. This was consistent with other studies on crowded living
environments, which have been found to contribute to emotional and social problems
(Helm, Laubmann, & Eis, 2010; Lang, 2001).

Students who reported inconvenient public transportation were found to have


more irrational beliefs and higher scores in depression, anxiety and stress. It may be
explained on the basis that students may be frustrated and annoyed while experiencing
inconvenience in getting to the university campus every day. This would be
particularly distressing if they encountered some sort of problem on their way to the
campus on an examination day, such as a traffic jam, missing the bus, or a traffic
delay. A study revealed that traffic congestion was correlated to stress and frustration
(Wickens, Wiesenthal, & Roseborough, 2015). Under these circumstances, students
might feel more stressful and anxious. Also, they could be annoyed and have a feeling
of bad luck on that day. The frustration experience might hinder their ability to
undertake logical reasoning. As a result, they might think: I am a failure when I fail
to achieve my goals or It is unbearable to be a failure.

It should be noted that the HKU MTR station had opened only one month prior

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to our data collection period. Our results suggested that inconvenient public
transportation was found to significantly contribute to irrational beliefs and emotional
disturbances. This was probably due to the HKU students not yet being habituated to
using the MTR station facilities; in particular, some facilities were still undergoing
improvement (Sung, 2015). With the newly opened HKU MTR station, in the long
run, it is believed that these problems will be resolved substantially.

6.1.6 Irrational beliefs and emotional disturbance

Our findings suggested that there was mild to moderate correlation between
irrational beliefs and emotional disturbance. According to REBT theory (Ellis, 1958),
psychological disorders are caused by irrational beliefs in an individual thoughts of an
event. When commencing study at university, a student faces new challenges in many
aspects (peer competition, family expectations, academic workload, family burden,
etc.). However, if these challenges are interpreted by someone with irrational beliefs
which are unrealistic, illogical, over-generalized and impede goal attainment, it would
lead to negative emotions such as depression, anxiety and guilt (Ellis & Dryden,
1987). In a local study of 503 students in secondary schools (Chan, 1991), cognition
was found to be a more important factor in determining depression than the actual

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event experience, in particular with regard to irrational beliefs relating to academic


achievement.

According to REBT theory, when one suffers adversity (for instance, a failure in
an examination), real or anticipated, a normal and healthy consequence is to become
upset, worried or frustrated. However, if this is interpreted by someone with irrational
beliefs, the results is maladaptive feeling and behaviors (Ellis, 1962). The process of
rational reasoning is distorted, and irrational beliefs tend to lead the individual to
over-generalize, resulting in self-depreciation, dogmatic demands for approval,
success, fair treatment and satisfying life conditions. These absolutistic and unrealistic
beliefs impede problem-solving abilities for goal satisfaction and lead to negative
emotions such as depression, anxiety and guilt (Ellis & Dryden, 1987). Our finding
supported these theoretical connotations and were congruent with other research
studies that irrational beliefs are a significant predictor of emotional disturbance
resulting in depression, anxiety and stress (DeLucia-Waack & Gellman, 2007;
Nieuwenhuijsen, Verbeek, De Boer, Blonk, & Van Dijk, 2010; Taghavi, Gooddarzi,
Kazemi, & Ghorbani, 2006; Zhao, Zhang, & Li, 2009; Zong, Xiong, & Li, 2012). Our
study results also suggested that irrational beliefs are more likely to predict depression
and stress than anxiety. This demands further empirical research to support this

184

argument in the future.

For the reverse model and bi-directional models, our results showed that only the
bidirectional model had acceptable fit indices. In reality, some studies found that
adolescents with depressive disorders had greater risk of developing irrational
thoughts (Joormann, 2010; Rawal et al., 2013). Other studies suggested that
bidirectional relationships were found between irrational beliefs and depression,
anxiety and stress (Cole et al., 2011; Hjemdal, Stiles, & Wells, 2012; Vatanasin,
Thapinta, Thompson, & Thungjaroenkul, 2012). This demanded further study to
investigate how strongly the reverse or bidirectional relationship would be. And it
should take into consideration the effects of potentially confounding factors (gender,
academic faculties) isolated in analyses of relationship between irrational beliefs and
emotional disturbance (stress, depression and anxiety).

Our study provided a theoretical advance through establishing a


psychometrically sound instrument to measure irrational beliefs in a Chinese context.
The factor structure was consistent with the western model and the items were
modified to suitably measure Chinese students. It filled a research gap where there has
been lacking a suitable scale for irrational beliefs for measuring college students in

185

Chinese society, instead of relying on broad and generalized statements via existing
instruments (Solomon, Amow, Gotlib, & Wind, 2003). Chinese students in Confucian
countries rank success in academic achievement and future career, fulfilment of
parental expectations and being seen as exhibiting filial piety as their top concerns
(Shek, Yu, and Fu, 2013; Woo et al., 2004). The instrument should be able to capture
the culturally specific properties and features of irrational beliefs in Chinese society.
This serves to enhance our understanding of the mechanism through which Chinese
irrational beliefs affect emotional disturbance.

6.2

Implications of the study

This study demonstrated the development of a cultural-specific instrument to


measure irrational beliefs among college students in a Chinese society. It has an
important contribution to the field of counseling research by provision of objective
measuring tools, shedding insight on significant variables contributing to irrational
beliefs and providing a theoretical model to understand the mechanism of emotional
disturbance from REBT perspectives. It implies that similar strategies could be
employed to develop specific irrational beliefs scales in different population groups,
such as elderly people living in aged homes and students in primary schools. In

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addition, future research could be attempted to apply the CIBRAS in different


Chinese societies with similar cultures, such as Taiwan, Mainland China and
Singapore, so as to study irrational beliefs in different contexts.

As this study found mild to moderate correlation between irrational beliefs and
emotional disturbance, our findings supported the idea that REBT programs could be
applied as prevention and intervention for college students with emotional disturbance
to dispute these irrational beliefs. As prevention, REBT programs such as You Can
Do It! Education, self-help materials, and REBT-oriented groups could be employed
in classrooms to help prevent the development of irrational beliefs and unhealthy
emotions (Vernon, 2006). Moreover, the present findings showed that Global
Evaluation subscale showed moderate correlation with emotional disturbance, and the
rest of other subscales only mild correlation. Hence, as intervention, REBT groups for
first- and second-year students could be conducted to cope with common irrational
beliefs, in particular global evaluation. For instance, I am a failure when I fail to
achieve my goals, If I do not perform well at an important task, I am a worthless
person, Failing in the examinations make me feel ashamed and I feel like I am a
stupid person when I dont do as well as my friends. To dispute these irrational
beliefs, counselors would employ strategies to correct cognitive distortions through

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the application of logic and search for evidence (Etscheidt, 1991; Squires, 2001). The
interventions can be tasked-oriented and focused on problem-solving in relation to the
above-mentioned irrational beliefs. Indeed, some REBT programs were found
effective for nursing students to help them cope with stress in college (Kim et al.,
2015), and have become part of an educational curriculum in teaching students in high
schools so as to enhance their well-being and reduction of academic stress (Bernard,
2001 & 2005; Vernon, 2006).

Our study suggested that second-year students were more vulnerable to irrational
beliefs, in particular in the faculties of Education and Engineering. In fact, secondyear students need more attention and research to understand their challenges and
difficulties during their university study. This was echoed by the study of Gahagan
and Hunter (2006) which showed that second-year college students may experience
different struggles, and even greater challenges, than first-year students. Second-year
students have been identified as the academics middle child and the forgotten
class (Biese & Fabian, 2006). This was because first-year students are given
freshmen seminar classes, and seniors are focused on getting internships and jobs
after graduation. Second-year students are between in every respect (Boivin,
Fountain, & Baylis, 2000). In view of the above, the universitys student affairs and

188

resource centre may take a proactive role to identify potential risks factors for secondyear students and equip them with positive coping strategies, including disputation of
irrational beliefs via peer support network and sharing, and personal enrichment
workshops for enhancing social and emotional intelligence.

Practically, our findings suggested some variables contribute to more irrational


beliefs and higher levels of emotional disturbance. For instance, those students who
are (1) male, (2) studying in the faculties of Law and Medicine, (3) come from low
income families, and (4) have academic programs of longer duration. Based on these
characteristics, the universitys student affairs and resource center can identify
potential risk factors for students and promote protective measures, such as a series of
training workshops for adversity coping to enhance psychological qualities and help
students re-assess strategies, attitudes and communication skills when facing
adversity. Appropriate counseling strategies, educational leaflets and intervention
(group and individual REBT counseling with practical and home assignments etc.)
can be devised to identify and dispute irrational beliefs, and thus help students
maintain physical and psychological health during their study at university.

189

6.3

Limitations of the study

This study used a convenient sampling of 200 HKU students for a pilot test and
655 HKU students (approximate 4% of the whole student population), due to limited
resources and the tight timeline in EdD study. Although the researcher adopted a
strategy to recruit students from all ten faculties so as to provide a fair
representativeness, this may not have been able to capture all characteristics of
students studying in different years. Future studies can consider using a stratified
random sampling method to recruit students from different years (strata) and with a
larger sample size, such as 10% of the population. It can also include Chinese students
from other local universities as well as universities in Beijing, Shanghai and Taiwan.

Second, cross-sectional design was used in this study; hence the result of the
present study was correlational. The causal relationships could not be inferred,
because all predictors and outcome variables were measured at one point in time. In
addition, levels of irrational beliefs may fluctuate from time to time (e.g. examination
periods and term breaks) and on different occasions (internship periods, placement or
seasonal holidays). In future studies, it would be worthwhile using a longitudinal
study to delineate the causal relationships among variables, and verify the function of

190

irrational beliefs and their temporal role.

Third, the CIBRAS was developed based on our sample of Chinese students in a
comprehensive research-led university in Hong Kong. Therefore, the result might not
be generalized to all university students coming from a diversity of university types.
Indeed, students from different university types (comprehensive research-led
universities, teacher training institutions, applied polytechnic universities) might face
different challenges and be exposed to the influence of different cultural and societal
values. In addition, students might experience different academic workloads and
vocational placements. Therefore, further validation of the CIBRAS in different
Chinese samples should be conducted.

Fourth, this study used a quantitative method that relied on several instruments to
investigate students irrational beliefs and emotional problems, but it may not provide
additional insights into students actual needs and problems. This study only showed
the outcomes relationship, rather than explaining the operation mechanism in richer
context. Further qualitative research is needed to explore the deep meaning of
irrational beliefs, and how they affect cognitive processing and lead to psychological
disturbance.

191

Fifth, although there were many significant results in this study, many tests were
doing with the same set of data. This would increase the risk of false positives. Future
study can consider to test the validity of the findings from this study with further data
sets.

6.4

Conclusion

This study developed a 5-factor 19-item Chinese Irrational Beliefs and Rational
Attitude Scale (CIBRAS) for measuring irrational beliefs for university students, with
good reliability and validity. It also tested and developed a model of Irrational Beliefs
and Depression-Anxiety-Stress for university students, showing that university
students with more irrational beliefs were more likely to have the emotional disorders
of depression, anxiety and stress. Moreover, the present results showed that secondyear students had more awfulizing beliefs than third-year students in the faculties of
Engineering and Education. Also, students who are male, low family income, law
students, pursuing 5-year programs or in the second year of study, or living with
family and with inconvenient to access public transportation, were likely to have more
irrational beliefs. Students who are male, medical students, studying 5-year program,
with inconvenient access to public transportation, or sharing living arrangements with

192

others and with insufficient living space were found to have significantly higher levels
of depression, anxiety and stress. By developing the CIBRAS and understanding the
relationships of irrational beliefs with depression, anxiety and stress, this study
provides important implications for educational practitioners, policymakers, and
clinical professionals working with university students in Hong Kong and similar
cultural contexts. This study also shed light on avenues for future research.

193

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224

Appendix A
Dear Prof/Colleagues,
I am currently a HKU EdD student and doing a research of Irrational Beliefs and emotional disturbance of university students. An instrument for measuring
irrational beliefs of university students was prepared based on the literature review and the extract of some items from irrational beliefs scales. Your precious
advices are helpful for us to make revision for this instrument. Please kindly give suggestion for the below instrument. Specifically, please give comments for the
below measurements (1) relevance, (2) clarity, and (3) representativeness.

Topic

Definition

1. Rigid Demand

Refer to what the individual believes he must have or must not have in life (e.g. I absolutely have to be accepted by other students.)

2. Awfulizing Beliefs

Refer to what you believe at the time is worse than the worst thing in the world (e.g. It is the end of the world now I am a loser.)

3. Low Frustration

Refer to what the individual cannot tolerate in a sense that he or she forfeits any chance of future happiness as long as the negative

Tolerance Beliefs
4. Global Evaluation

event exists (e.g. I cannot bear that I failed the exam.)


Refer to a situation where the individual assigns a global negative rating to self, other people and the world (e.g. I am a loser
because I failed the exam.)

5. Rational Beliefs

Refer to evaluate ideas with flexible, consistent with reality, logical and yielding of functional consequences (e.g. Although I want to
do well at important tasks, I realize that I dont have to do well just because I want to.)

225

1. I must be liked by other


1
2
3
4
1
2
3
4
1
2
3
4

2. I ought to get good grades.


1
2
3
4
1
2
3
4
1
2
3
4

3. Obtaining good academic


1
2
3
4
1
2
3
4
1
2
3
4

(If your answer is 1 or 2)

Your suggest for modification

item is representative

item needs minor revisions to be representative

item needs major revisions to be representative

item is not representative

(If your answer is 1 or 2)

Your suggest for modification

item is clear

item needs minor revisions to be clear

item needs major revisions to be clear

item is not clear

(If your answer is 1 or 2)

Your suggest for modification

(If your answer is 1 or 2)

aspect of the domain is not relevant

The reason for the item question and the

item is relevant

item needs minor revisions to be relevant

Topic

item needs make revisions to be relevant

item is not relevant

No.

Domain relevance
Item clarity
Item representativeness

Do you think the item question relates to the


Do you think the item is worded
Do you think the item can

aspect of the domain?


clearly?
represent the content domain?

Domain A. Rigid Demand

students.

performance is a must, and

this is the way I get approval


226

from the significant others.


4. I should perform remarkable

9. When I do poorly on tests, its 1

in academic work and this is


the way to make myself feel
useful.
5. I should be angry with those
students with loose studying
attitude.
6. I must graduate with
outstanding performance to
meet my parents expectation.
7. I ought to have a good GPA
and succeed in the future.
Domain B. Awfulizing Beliefs
8. If I cannot get a job after
graduation, it would be awful.
horrible.
10. I didnt get my grade rise,
therefore it is the end of the
world for me.
11. It is terrible if I do not find
the most effective studying
method.
12. Its terrible to be disliked by

227

other students.
13. It is terrible to be unable to

meet the deadline of


coursework or project.
14. It is terrible if my classmates
cant understand me clearly.
15. It is horrible if the teacher
give harsh comments on my
projects.
Domain C. Low Frustration Tolerance
16. I cant tolerate being disliked
by other students.
17. Its unbearable to be rejected
by my peers.
18. When I fail an important test,
I cannot tolerate it.
19. Its unbearable to fail at
important things, and I cant
stand not succeeding at them.
20. Its unbearable if my family
does not agree my opinions.
21. I cannot tolerate when other
student criticize my work.
Domain D. Global Evaluation
22. I am a rotten person when I

228

fail to achieve my goals.


23. If I do not perform well at an

important task, I am a
worthless person.
24. Failing in the examinations
makes me feel ashamed.
25. I feel like I am a stupid
person when I dont do as
well as my friends.
26. When other students reject
me, I believe that I am a bad
person.
27. My future prospect will be
hopeless if I cannot achieve
good grades in the university.
28. If I do not improve my
communication skills, I will
be failure in all aspects.
29. I feel ashamed if I failed my
family expectation.
Domain E. Rational Beliefs
30. When another student rejects
me, its bad, but not terrible.
31. Although I want to do well at
important tasks, I realize that
229

I dont have to do well just


because I want to.
32. I do not like it when I fail a

test, but I can tolerate not


doing well.
33. If I fail my family
expectation, it does not mean
that I am worthless, it just
means that I am a fallible
human being.
34. It is annoying but not
upsetting to be criticized.
35. It is important that people
treat me fairly most of the
time, however, I realize I do
not have to be treated fairly
just because I want to be.
36. I do not like it when it when
people act disrespectfully, but
I can tolerate not having their
respect
37. I have worth as a person even
if I do not perform well at
tasks that are important to
me.
230

Appendix B
Table summarized the comments and revision of each item
NO. Panels comments

Original sentence

My suggested revised sentence

I must be liked by other students.

I must be accepted by other students.

I ought to get good grades.

I must get good grades.

(C) "the way" implies "the only way". Is this what

Obtaining good academic performance is a

Getting a good grade is the only way to get

you want the question to convey? If yes, perhaps

must, and this is the way I get approval

approval from others.

make it clearer.

from the significant others.

(c) A little bit concerned about confusion with


"other students must like me".
(D) Can consider replacing "liked by" with
"accepted by".
(E) What is the conceptual meaning of "be liked"
(seems quite general)? Other related ideas, e.g.
welcome, accept, being popular, etc.?

(J) may be

"accepted by"?
2

(E) Minor comment: "ought" seems to carry with


duty and moral obligation, which appears to be
seldom in English. But maybe this is your purpose
to develop the construct "rigid demand".
(F)replace ought to "must".
(J) Good is vague.

(F)too long-revise it to Getting a good grade is the


"only" way to get approval from others.
4.

(B) grammatical error.

I should perform remarkable in academic

I should perform remarkably in academic

(C) "the way" implies "the only way". Is this what

work, and this is the way to make myself feel

work, and this is the way to make myself feel


231

you want the question to convey? If yes, perhaps

useful.

useful.

(B) difficult to define what is loose studying

I should be angry with those students with

I should be angry with those students with

attitude the item seems to be not so relevant.

loose studying attitude.

poor motivation and studying attitude.

(B)difficult to define what is outstanding

I must graduate with outstanding

I must graduate with satisfactory

performance (unclear wording?).

performance to meet my parents

performance to meet my parents

(D) Can consider replacing "outstanding" with

expectation.

expectation.

(B) unclear presentation of the item: do you mean

I ought to have a good GPA and succeed in

I ought to have a good GPA so as to succeed

that someone ought to have a good GPA in order to

the future.

in the future.

make it clearer.
(E) Seems two contents or ideas separated by a
comma
5

(I) suggested to change the wording to "I would not


mingle with students with loose studying attitude".
(J) Does "I can't accept myself loosing studying
motivation" probably make more sense?

(F)about

other?
6

"satisfactory".
(E) Minor: is the questionnaire for
university/undergraduates only?
(i)not clear whether this reflects "rigid demand" of
the student OR "rigid demand" of his/her parents.
7

have a successful career in the future?


(E) I may change it to I ought to "achieve" a good
232

GPA and succeed in the future.


(I) suggested to change the wording to "I ought to
have good GPA in order to succeed in the future.
(J) Good is subjective.
8

(B) it seems to be reasonable to feel awful if

If I cannot get a job after graduation, it

someone is unable to get a job after graduation

would be awful.

Unchanged.

may require to think of the use of proper


wording?
(C) Exactly what would be awful? Life? (F)suggest
to make it more dramatic.
(F)the severity of these items seem very "mild". The
word terrible in English is mild.
9

When I do poorly on tests, its horrible.

When I do poorly on tests, I feel horrible.

(B) need to rewrite the sentence, though the content

I didnt get my grade rise, therefore it is the

It is the end of the world if I cannot improve

seems to be ok.

end of the world for me.

my course grade.

(F)the severity of these items seem very "mild". The


word terrible in English is mild.
(I) suggested to change the wording to "When I do
poorly on tests, I feel horrible".

10

(C) Would this question make sense to students who


actually got a grade rise?
(E) This is related to grammar and sentence
structure. First, why "past tense" for the phrase I
didn't get my grade rise? Second, this phrase sounds
weird. I may suggest "It is the end of the world if i
cannot improve my course grade.
233

11

(B)difficult to define what is the most effective

It is terrible if I do not find the most effective

If I do not find an effective studying method,

studying method to an individualas only those

studying method.

I will be terrified.

Its terrible to be disliked by other students.

Its terrible for me to be disliked by other

who achieved good grades are able to say whether


their studying method is at least good or effective
(D) Can consider replacing "the most effective"
with "an effective".
(E) If I do not find the most effective studying
method, I will be terrified".
(F)the severity of these items seem very "mild". The
word terrible in English is mild.
(I) suggested to change the wording to " I feel
terrible if I do not find the most effective studying
method that would get me the best grades.
12

(E) "It's terrible for me to be disliked by other


students".

students.

(F)the severity of these items seem very "mild". The


word terrible in English is mild.
(I) suggested to change the wording to "I feel
terrible to be disliked by my classmate.
13

(E)

change "terrible to be unable (quite

confusing). E.g., If I am not able to meet the

It is terrible to be unable to meet the deadline

If I am not able to meet the deadline of

of coursework or project.

coursework or project, I will be terrified".

deadline of coursework or project, I will be


terrified".
(F)the severity of these items seem very "mild". The
word terrible in English is mild.
(I) I dont think this means that the person is
234

awfulizing, it merely shows that he or she is a


serious and responsible student.
14

(B)it seems to be not so relevant.

It is terrible if my classmates cant

if my classmates cant understand me clearly,

(E) I still believe you should use future sense rather

understand me clearly.

I will be terrified.

(E) I still believe you should use future sense rather

It is horrible if the teacher give harsh

I will be horrified if the teacher give harsh

than present tense in the sentence with "if".

comments on my projects.

comments on my projects.

I cant tolerate being disliked by other

Unchanged.

than present tense in the sentence with "if".


(F)the severity of these items seem very "mild". The
word terrible in English is mild.
15

(F)the severity of these items seem very "mild". The


word terrible in English is mild.
(I) I dont think this means that the person is
awfulizing, it merely shows that he or she is a
serious and responsible student

(J) maybe

change all the "It is" to "I feel"?


16

(I)not very precise.

students.
17

(I)not very precise.

Its unbearable to be rejected by my peers.

Unchanged.

18

(I)not very precise.

When I fail an important test, I cannot

Unchanged.

tolerate it.
19

(B) may need major revision to make the content of

Its unbearable to fail at important things,

the item clearer.

and I cant stand not succeeding at them.

It is unbearable to be a failure.

(E) What do important things mean? For example?


(I)Not very precise.
20

(I)not very precise.

Its unbearable if my family does not agree

Unchanged.
235

my opinions.
21
22
23

(I)not very precise.

I cannot tolerate when other student criticize

I cannot tolerate when other students criticize

(J) "students"?

my work.

my work.

(F)change rotten people to "failure.

I am a rotten person when I fail to achieve

I am a failure when I fail to achieve my

my goals.

goals.

(E) An important task appears to be not

If I do not perform well at an important task,

Unchanged.

representative of the general term "global

I am a worthless person.

evaluation".
24

(I) not global evaluation?

Failing in the examinations makes me feel

Unchanged.

ashamed.
25

(E) I am not sure if you should use another word

I feel like I am a stupid person when I dont

instead of "stupid", which is quite negative.

do as well as my friends.

Unchanged.

(F)sentence like Chinese English, please revise this.


26
27

(F)sentence like Chinese English, please revise this

When other students reject me, I believe that

(J) maybe "unpopular"?

I am a bad person.

(C) can this be interpreted as belonging to the Rigid

My future prospect will be hopeless if I

Demand or Awfulizing scales?

cannot achieve good grades in the university.

Unchanged.
Unchanged.

(F)sentence like Chinese English, please revise this.


28

(B) why only communication skills being chosen to

If I do not improve my communication skills,

put in this domain (while other items seem to be

I will be failure in all aspects.

Unchanged.

relatively less specific).


(D) Can replace 'failure in all aspects" with
disadvantaged".
236

(F)sentence like Chinese English, please revise this.


29
30

(E) if I cannot fulfil my family expectation

I feel ashamed if I failed my family

I feel ashamed if I cannot fulfill my family

(I) not global evaluation?

expectation.

expectation.

(E) It's difficult to distinguish between the idea of

When another student rejects me, its bad,

When another student rejects me, it's bad, but

"bad" and "terrible".

but not terrible.

not the end of the world.

(B) unclear presentation of the item, require revision

Although I want to do well at important

Although I want to do well at important

in the structure of the sentence.

tasks, I realize that I dont have to do well

tasks, I realize that I may not be able to even

(F)sentence like Chinese English, please revise this.

just because I want to.

if I want to.

(B) unclear presentation of the item, require revision

I do not like it when I fail a test, but I can

I do not like failure in a test, but I can

in the structure of the sentence.

tolerate not doing well.

tolerate not doing well.

(B) it also depends on whether the family

If I fail my family expectation, it does not

If I fail my family expectation, it does not

expectation is reasonable or not.

mean that I am worthless, it just means that I

mean that I am worthless.

(I) suggested to change the wording to "When


another student rejects me, it's bad, but not the end
of the world".
31

(I) suggested to change the wording to "Although I


want to do well at important tasks, I realize that I
may not be able to even if I want to".
32

(E) The idea of this sentence is unclear and


complicated.
33

(E) Complicatedwhat do you mean by "it does not am a fallible human being.
mean that I am worthless, it just means that I am a
fallible human being"

237

34

(B)in fact it is also upsetting to be criticized .

It is annoying but not upsetting to be

It is annoying but not devastating to be

May require revision of the content or wording of

criticized.

criticized.

(B) need to rewrite the sentence to make the content

It is important that people treat me fairly

I want fair treatment. However, I do realize

to be presented in a clearer way.

most of the time, however, I realize I do not

that I may not be treated fairly all of the time

(I) suggested to change the wording to "I want fair

have to be treated fairly just because I want

even though I want to be.

treatment. However, I do realize that I may not be

to be.

the sentence.
(E) Annoying but not upsetting? Complex
(F)sentence like Chinese English, please revise this
(I) suggested to change the wording to "It is
annoying but not devastating to be criticized".
35

treated fairly all of the time even though I want to


be".
36

(B) unclear content and with major grammatical

I do not like it when it when people act

I do not like people doing disrespectfully, but

error.

disrespectfully, but I can tolerate not having

I can tolerate not having their respect.

(D) should be "I do not like it when people act

their respect.

disrespectfully, but I can tolerate not having their


respect.
(E) Typo? "when it when people act disrespectfully"
(F)sentence like Chinese English, please revise this.
37

(B) need to rewrite the sentence for better

I have worth as a person even if I do not

I am a worthy person even if I do not

presentation of the content.

perform well at tasks that are important to

perform well at tasks that are important to

(E) I have worth as a person"? What does this

me.

me.

mean?

238

Appendix C
Questionnaire

Research Consent Form


You are invited to participate in a research study conducted by Ms. Queenie Chan,
(EdD student) under the supervision by Dr. Rachel Sun in the Faculty of Education of
The University of Hong Kong.
PURPOSE OF THE STUDY
This study aims to enhance the understanding of the nature and types of irrational
beliefs and rational beliefs of university students in Chinese society and the
relationship between irrational beliefs and the emotional disturbance of stress, anxiety
and depression.
PROCEDURES AND LOCATION OF CONDUCTING THE STUDY
This study will be conducted in HKU campus. You will be invited to complete a
package of self-report questionnaire, including a personal data sheet in Part A and
answer two sections of the questionnaire (Parts B and C). It may take about 15 to 20
minutes for completion of the questionnaire. The questionnaire is about the problems
of the university life and academic study that the students have been encountered. (for
example, the student's expectation on the academic performance).
POTENTIAL BENEFITS
This study aims to generate strategies that help university counselors or university
administers to implement preventive measures as well as effective programs to help
students with emotional disturbances.
CONFIDENTIALITY
All data related to this study will be kept strictly confidential and will only be used for
the purposes of academic research. Any information obtained from you in connection
with this study will be available only to the investigator and the university. You are
not required to fill in your name.

239

STORAGE OF DATA
All the recorded files and documents will be stored strictly in computer with double
safety measure, the computer has a pin number to log in and the files and documents
are secured with VPN. Three years after the completion of study, all the files would be
deleted.

PARTICIPATION AND WITHDRAWAL


Participation in this research is on a voluntary basis, and you will be free to withdraw
from the study at any time without any negative consequences.

QUESTIONS AND CONCERNS


If you have any questions or concerns about the research, please feel free to contact Ms.
Queenie Chan via cell phone at 63899101 or email at qqchan@hku.hk

I agree/do not agree* to participate in this study.


*Please delete as appropriate

Signature of the participant: _________________


Date: ___________

240

Part A: Personal Data Sheet


Please mark the answer or fill in the bank providedyour information will be kept strictly confidential
I live in :

___Hong Kong

Age:

_______

Gender:

_____M

___Kowloon

___New Territories

_____F

Nationality

__________

Marital Status

Single

Married

Studying Program: _____________

Faculty/Dept:

________________

Duration of the whole program: ___________


Current Year:

___________

Religion:

No
Yes

(i)

Please, specify: Protestant / Catholic / Buddhism/ Taoism


Other:

(ii) How long has you been an adherent of this religion: ______ (yr)
(iii) How does it affect you:
Family Status:

Important

Fair

Not at all

Living alone
Living with family members, please specify:______________

Place of Living: U Hall

Shared flat

Other:______________

Ease of using public transport

_____Convenient

____Inconvenient (Reasons:__________________)

Is living space enough:

____________enough

________not enough (Reason:________________)

Total family income:

CSSA recipient 5,000 or below

5,000 10,000

10,001 20,000

20,001 30,000

30,001 40,000

40,001 or above

241

Part B: DASS-21 English version


Instruction: This questionnaire has 21 sentences. These represent different expressions and feelings. Please
read each of them carefully, and mark the number which best describes your feelings and thoughts over
last week. Please remember that there is no right or wrong answer.
0 Not applicable
1 Quite applicable; sometimes applicable
2 Very applicable; often applicable
3 Most applicable; always applicable
Not

Quite

Very

Most

applicable applicable; applicable; applicable;


sometimes

often

always

applicable

applicable

applicable

1. I found it hard to wind down.

2. I was aware of dryness of my mouth.

3. I couldnt seem to experience any positive

4. I experienced breathing difficulty.

5. I found it difficult to work up the initiative to

6. I tended to over-react to situations.

7. I experienced trembling (e.g., in the hands).

8. I felt that I was using a lot of nervous energy.

9. I was worried about situations in which I

10. I felt that I had nothing to look forward to.

11. I found myself getting agitated.

12. I found it difficult to relax.

13. I felt down-hearted and blue.

14. I was intolerant of anything that kept me

15. I felt I was close to panic.

16. I was unable to become enthusiastic about

17. I felt that I wasnt worth much as a person.

18. I felt I was rather touchy.

19. I was aware of the action of my heart in the

20. I felt scared without any good reason.

21. I felt that life was meaningless.

feeling at all.

do things.

might panic and make a fool of myself.

from getting on with what I was doing.

anything.

absence of physical exertion.

242

Part C: Chinese Irrational Beliefs and Rational Attitude Scales (CIBRAS)


Instruction:
This questionnaire has 37 sentences. These represent different expressions and feelings. Please read each of
them carefully, and mark the number which best describes your feelings and thoughts over last week. Please
remember that there is no right or wrong answer.
1. Very disagree

1. If I cannot get a job after graduation, it would be awful.

2. I must get good grades.

3. I feel ashamed if I cannot fulfill my family expectation.

4. I should perform remarkably in academic work, and this is the

7. It is unbearable to be a failure.

8. I am a failure when I fail to achieve my goals.

9. When I do poorly on tests, I feel horrible.

10. It is the end of the world if I cannot improve my course grade.

11. My future prospect will be hopeless if I cannot achieve good

12. Its terrible for me to be disliked by other students.

13. If I do not improve my communication skills, I will be failure

16. I cant tolerate being disliked by other students.

17. Although I want to do well at important tasks, I realize that I

18. When I fail an important test, I cannot tolerate it.

19. I ought to have a good GPA so as to succeed in the future.

2. Disagree
3. Neutral
4. Agree
5. Very agree

way to make myself feel useful.


5. I do not like people doing disrespectfully, but I can tolerate
not having their respect.
6. I must graduate with satisfactory performance to meet my
parents expectation.

grades in the university.

in all aspects.
14. If my classmates cant understand me clearly, I will be
terrified.
15. I am a worthy person even if I do not perform well at tasks
that are important to me.

may not be able to even if I want to.

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20. Its unbearable if my family does not agree my opinions.

21. I cannot tolerate when other students criticize my work.

22. Getting a good grade is the only way to get approval from

24. Failing in the examinations makes me feel ashamed.

25. I should be angry with those students with poor motivation

28. I must be accepted by other students.

29. I feel like I am a stupid person when I dont do as well as my

31. Its unbearable to be rejected by my peers.

32. I do not like failure in a test, but I can tolerate not doing well.

33. If I fail my family expectation, it does not mean that I am

35. It is annoying but not devastating to be criticized.

36. If I do not find an effective studying method, I will be

others.
23. If I do not perform well at an important task, I am a worthless
person.

and studying attitude.


26. When other students reject me, I believe that I am a bad
person.
27. If I am not able to meet the deadline of coursework or project,
I will be terrified.

friends.
30. When another student rejects me, it's bad, but not the end of
the world.

worthless.
34. I will be horrified if the teacher gives harsh comments on my
projects.

terrified.
37. I want fair treatment. However, I do realize that I may not be
treated fairly all of the time even though I want to be.

244