Effects of self-guided stress management interventions in college students: A systematic review and meta-analysis

Yagmur Amanvermez; Ruiying Zhao; Pim Cuijpers; Leonore M de Wit; David D Ebert; Ronald C Kessler; Ronny Bruffaerts; Eirini Karyotaki

doi:10.1016/j.invent.2022.100503

Effects of self-guided stress management interventions in college students: A systematic review and meta-analysis

Internet Interv. 2022 Feb 12:28:100503. doi: 10.1016/j.invent.2022.100503. eCollection 2022 Apr.

Authors

Yagmur Amanvermez¹, Ruiying Zhao¹, Pim Cuijpers¹, Leonore M de Wit¹, David D Ebert², Ronald C Kessler³, Ronny Bruffaerts⁴, Eirini Karyotaki¹

Affiliations

¹ Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands.
² Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.
³ Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
⁴ Universitair Psychiatrisch Centrum, Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium.

Abstract

Background: College students face several sources of stress. Self-guided stress management interventions offer an excellent opportunity for scaling up evidence-based interventions for self-management of these stresses. However, little is known about the overall effects of these interventions. Increasing this understanding is essential because self-guided stress management interventions might be a cost-effective and acceptable way of providing help to this important segment of the population during a critical life course stage.

Methods: We carried out a systematic literature search of bibliographical databases (PubMed, PsycINFO, Embase, and Cochrane Library) for randomized controlled trials (RCTs) of self-guided stress management interventions published up through April 2020. We conducted two separate meta-analyses for perceived stress, depression, and anxiety. The first included interventions for general college student samples. The second included studies for students with high levels of perceived stress.

Results: The first meta-analysis included 26 studies with 29 intervention-control comparisons based on a total of 4468 students. The pooled effect size was small but statistically significant (g = 0.19; 95% CI [0.10, 0.29]; p < 0.001). Results showed moderate heterogeneity across studies [I ² = 48%; 95% CI (19, 66%)]. The second meta-analysis, included four studies based on a total of 491 students with high levels of stress. The pooled effect size was small but statistically significant (g = 0.34; 95% CI [0.16, 0.52]; p < 0.001). Results showed no heterogeneity across studies (I ² = 0%; 95% CI [0, 79%]), but risk of bias was substantial.

Discussion: Our results suggest that self-guided stress management programs may be effective when compared to control conditions, but with small average effects. These programs might be a useful element of a multi-component intervention system. Given the psychological barriers to treatment that exist among many college students, self-help interventions might be a good first step in facilitating subsequent help-seeking among students reluctant to engage in other types of treatment. More studies should be conducted to investigate these interventions, sample specifications, mediating effects, and individual-level heterogeneity of effects.

Keywords: College students; Self-help; Stress management; Unguided interventions.

Publication types

Review