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Üniversite Öğrencilerinin Sosyal Kaygı Düzeyleri Ve Bunun Depresyon, Anksiyete ve Demografik, Sosyo-Kültürel Özelliklerle İlişkisi

Year 2018, Yıl: 2018 Ek Sayı: 1, 1 - 12, 01.01.2018
https://doi.org/10.5505/kjms.2017.05900

Abstract

Amaç: Bu çalışmanın amacı, üniversite öğrencilerinde sosyal kaygı düzeylerinin belirlenmesi, bunun depresyon, anksiyete ve demografik, sosyo-kültürel özelliklerle ilişkisini araştırmaktır. 
Materyal ve Metot: Kesitsel tipteki bu çalışmada, 20112012 eğitim- öğretim yılında, Erciyes Üniversitesi Sağlık hizmetleri Meslek Yüksekokulu’nda 10 farklı programda öğrenim gören 264 (%83.8) öğrenci üzerinde yürütülmüştür. Araştırmada veri toplama aracı olarak, öğrencilerin demografik-sosyokültürel özelliklerini içeren kişisel bilgi formu ile Sosyal Kaygı Ölçeği, Beck depresyon Ölçeği (BDÖ) ve Beck Anksiyete Ölçeği (BAÖ) kullanılmıştır. İki grubun ortalamalarının karşılaştırılmasında Mann-Whitney U testi, iki den fazla grup ortalamalarının karşılaştırılmasında tek yönlü varyans analizi ve/veya Kruskal Wallis testi uygulanmıştır. Değişkenler arasındaki ilişkinin değerlendirilmesinde sperman korelasyon katsayısı hesaplanmıştır. 
Bulgular: Öğrencilerin “sosyal kaygı” puan ortancası 33 ( 0-109), alt boyut puanı ortancaları ise, “sosyal kaçınma” 12.0 ( 6.0-20.75), “eleştirilme kaygısı” 14.0 ( 8.0-20.75), “bireysel değersizlik” ise 6.0 ( 2.0-10.0) olarak bulunmuştur. Konut tipi müstakil olan öğrencilerin “sosyal kaçınma” puanı anlamlı düzeyde yüksek bulunmuştur (p<0.05). Yaşamının uzun bir süresini köyde geçirenlerin “sosyal kaçınma” puanları ilçede geçirenlere göre, “bireysel değersizlik” puanları ise il ve ilçede yaşayanlara göre anlamlı düzeyde yüksek bulunmuştur (p<0.05). Araştırmamızda öğrencilerin gelir düzeyleri ile “sosyal kaçınma” (rho=-0.129, p=0.037) eleştirilme kaygısı” (rho=-0.123, p=0.046) ve bireysel değersizlik” (rho=-0.155, p=0.012) alt boyut puanları arasında negatif yönde anlamlı bir ilişki bulunmuştur. Öğrencilerin depresyon ve anksiyete puanları ile “sosyal kaçınma” eleştirilme kaygısı” ve bireysel değersizlik” alt boyut puanları arasında pozitif yönde anlamlı bir ilişki bulunmuştur (p<0.001).
Sonuç: Kültürel bir boyutu da bulunan sosyal kaygının oluşmaması için gerek aile içerisinde gerekse eğitim sürecinde çocuk ve gençlerin “yetersiz ben” duygusunun gelişmesine sebep olabilecek tutumlar yerine “yeterli ben” duygusunun gelişmesi ve pekişmesini sağlayacak tutumların geliştirilmesi ve sosyalleşmenin artırılması için gerekli politikaların oluşturulması uygun 

References

  • 1- Pietrini F, Lelli L, Lo Sauro C, Faravelli C. Epidemiology of social phobia. Riv Psichiatr 2009;44:203-13.
  • 2- Al-Naggar RA. Prevalence and associated factors of phobia and social anxiety among university students. ASEAN Journal of Psychiatry 2012;13:112-9.
  • 3- Last CG, Perrin S, Hersen M et al. DSM-IIIR anxiety disorder in children; sociodemographic and clinical characteristics. J Am Acad Child Adolesc Psychiatry 1992; 31: 1070-6.
  • 4- Kessler RC, McGonagle KA, Zhao S et al. Lifetime and 12-month prevalence of DSM-IIIR psychiatric disorders in the United States, Arch Gen Psych 1994;51:8-11.
  • 5- American Psychological Association. DSM-IV-TR Diagnosis Criteria Reference Manual, Washington, DC: American Psychological Association. 2001.
  • 6- Purdon C, Antony M, Monteiro S, Swinson RP. Social anxiety in college students. Anxiety Disorders 2001;15:203-12
  • 7- Geen, GR. Social Motivation. Annual Reviewof Psychology. 1991;42:377-22.
  • 8- Heimberg RG, Holt CS, Schneier FR, Spitzer RL. The issue of subtypes in the diagnosis of social phobia. J Anxiety Disord 1993;7:249-20.
  • 9- Boone ML, McNeil DW, Masia CL et al. Multimodal comparison of social phobia subtypes and avoidant personality disorders. J Anxiety Disord 1999;13:271-21.
  • 10- Eng W, Heimberg RG, Coles ME et al. An empirical approach to subtype identification in individuals with social phobia. Psychol Med 2000;30:1345-12.
  • 11- Wittchen HU, Fehm L. Epidemiology, patterns of comorbidity, andassociated disabilities of social phobia. Psychiatr Clin N Am, 2001;24: 617-24.
  • 12- Kessler RC, Stang P, Wittchen HU et al. Lifetime comorbidities between social phobia and mood disorders in the US National Comorbiditiy Survey Psycol Med. 1999;29:555-12.
  • 13- Mennin DS, Heimberg RG, Jack MS. Comorbid generalized anxiety disorder in primary social phobia: symptom severity, functional impairment and treatment response. J Anxiety Disord 2000;14:325-18.
  • 14- Montgomery SA. Social phobia: diagnosis, severity and implications for treatment. Eur Arch Psychiatry Clin Neurosci 1999;249:1-6.
  • 15- Brunello N, Boer den JA, Judd LL, Kasper S et al. Social phobia: diagnosis and epidemiology, neurobiology and pharmacology, comorbidity and treatment. Journal of Affective Disorders 2000;60:61-13
  • 16- Segrin C. Social skills, stressful life events and the development of psychosocial problems, Journal of Social and Clinical Psychology, 1999;18:14-18.
  • 17- Weeks JW, Heimberg RG, Rodebaugh TL et al. Exploring the relationship between fear of positive evaluation and social anxiety. Journal of Anxiety Disorders, 2008;22: 386-14.
  • 18- Schneider FR, Johnson J, Hornig CD et al. Social phobia: Comorbidity and mobidity in an epidemiologic sample, Archives of General Psychiatry,1992;49: 282-6.
  • 19- Ozdemir S, Ersoy MA, Kayahan B. The Comparison of Alcohol Dependents with Soical Drinkers in Terms of Social Phobic Features.Turkish journal of Psychiatry 2005; 7:25-13.
  • 20- Maggee WJ, Eaton WW, Wittchen HU, McGonagle KA, Kessler RC. Agoraphobia, simple phobia, and social phobia in the National Comorbidity Survey. Archives of General Psychiatry 1996;53:159-9.
  • 21- Lecrubier Y, Weiller E. Comorbidities in social phobia. Int Clin Psychopharmacol 1997;12:17-4.
  • 22- Gultekin BK, Dereboy IF. The prevalence of social phobia, and impact on quality of life, academic achievement, and identity formation in university students. Turkish Journal of Psychiatry 2011;22:150-8.
  • 23- Dilbaz N. The prevelance of social phobia among the Turkish universitystudents. XII. World Congress of Psychiatry, Yokohama, August 24-29,2002.
  • 24-Kırpınar İ, Ozer H, Coşkun İ et al. The life long and 12-month prevelance ofpsychological disorders in university students in Erzurum CIDI (DSM-III-R). 3P Journal, 1997;4:253-12.
  • 25- Izgic F, Akyuz G, Dogan O, Kugu N. The prevalence of social phobia in university student population. Anatolian Journal of Psychiatry 2000; 1:207-7.
  • 26- Furmark T, Tillfors M, Everez P. Social phobia in the general population: prevalence and sociodemographic profile. Social Psychiatry and Psychiatric Epidemiology. 1999;34:416-8.
  • 27- Bella TT, Omigbodun OO. Social phobia in Nigerian university students: Prevalence, correlates and co-morbidity. Soc Psych Psych Epid, 2009; 44:458-5.
  • 28- Ozbay Y, Palancı M. Social Anxiety Scale. A study of validity and reliability. 4th National Congress of Psychological Counselling and Guidance, Ankara, METU, 5-7 September 2001.
  • 29- Hisli N. The validity and reliability of Beck Depression Inventory in university student. J Psychol 1989;23:3-10.
  • 30 - Ulusoy M, Sahin N.H, Erkmen H. Turkish version of the Beck Anxiety Inventory: Psychometric properties. Journal of Cognitive Psychotherapy, 1998;12:163-9.
  • 31- Beck AT, Epstein N, Brown G et al. An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol 1988;56:893-4.
  • 32- Tukel R, Kızıltan E, Demir T et al. The effect of sub-types and unsocial personality disorder on psychopathology in social phobia. 3P Journal, 1998;6:15-5.
  • 33. Subası G. Some variables for social anxiety prediction in college students. Education and Science.2007;32:3-12.
  • 34- Palancı, P. Ve Özbay, Y. The control sense of social anxiety in university students and its predictability by social adequecy and vulnerability and coping behaviours. VIIth National Psychological Consulting and Guidance Assembly. Proceedings Book2003:58.
  • 35- Erkan Z, Güçray S, Çam S. Investigating the social anxiety levels of adolescent in terms of parents attitudes and gender. Institute of Social Sciences Journal, 2002; 10:64-11.
  • 36- Feingold, A. Gender differences in personality: A meta-analysis. Psychological Bulletin, 1994;116: 429- 27.
  • 37-Tillfors M, Furmark T. Social phobia in Swedish university students: prevalence, subgroups and avoidant behavior. Soc Psych Psych Epid, 2007;42:79–7.
  • 38- Dilbaz N. Social phobia. The world of Psychiatry 1997;1:18-6.
  • 39-Kaya N,Savas Cilli A, Askın R et al.The prevalence of social phobia among high school and university students. Journal of General Medicine1997;7:133-7.
  • 40-Turan M, Cilli, AS, Askın R et al. Comorbidity of Social Phobia and Other PsychiatricIllnesses. Journal of clinical Psychiatry 2000;3:170-5.
  • 41-Erozkan A. An investigation into the levels of social anxiety and sensitivity to rejection among university students according to certain variables. Selçuk University, Journal of the Intitute of Social Science 2007;17:225-15.
  • 42-Kendler KS, Neale M C, Kessler RC, et al. The genetic epidemiology of phobias in Women: The interrelationship of agoraphobia, social phobia, situational phobia, and simple phobia. Archives of General Psychiatry,1992;49:273-8.
  • 43-Cunha M, Gouveia JP, Ceu Salvador M. Social fears in adolescence: The social anxiety and avoidance scale for adolescents. European Psychologist, 2008;13:197-16.
  • 44-Sayar K, Solmaz M, Ozturk M, et al. Avoidant Personality Disorder in Generalized SocialPhobia and its Impact on Psychopathology. Journal of clinical Psychiatry2000; 3:163-6.

The Social Anxiety Levels of Unıversity Students and Their Relationship With Depression, Anxiety And Demographic And Socio-Cultural Characteristics

Year 2018, Yıl: 2018 Ek Sayı: 1, 1 - 12, 01.01.2018
https://doi.org/10.5505/kjms.2017.05900

Abstract

Aim: The aim of this study is to establish the levels of social anxiety of university students and investigate the relationship between social anxiety and depression, anxiety, and demograhic and socio-cultural characteristics.
Material and Method: This cross-sectional study was conducted upon 264 (83.8%) students studying at 10 different programs at Erciyes University Health Services Vocational School in 2011-2012 academic year. Personal information form including the demographic- sociocultural characteristics of the students together with Social Anxiety Scale, Beck Depression Scale (BDS) and Beck Anxiety Scale (BAS) were used as data collection tool in the research. Mann-Whitney U Test was used to compare two groups, and one-way analysis of variance and/or Kruskal Wallis Test for comparison of more than two groups. Spearman's correlation coefficient was calculated to evaluate the relationship between variables. 
Results: The “social anxiety” median score of the students was found as 33 (0-109), and the subdimension median scores were as follows “social avoidance” as 12.0 (6.0- 20.75), “anxietyof negative critism” as 14.0 (8.0-20.75), and “ self-depreciation” as 6.0 ( 2.0-10.0). The “social avoidance” score of the students living in a detached house was found significantly high (p<0.05). The “social avoidence” score of those spending most of their lives in a village was found significantly higher when comparing with the score of those spending most of their lives in a county, and the “self-depreciation” score of them was found significantly higher when comparing with those spending most of their lives in a city and county (p<0.05). The “anxiety of negative criticism” and “selfdepreciation” subdimensions scores of the students studying at the Oral and Dental Health Technician Programme were found significantly high (p<0.05). There was a significant negative relationship between the income level of the students and the scores of the“social avoidance” (rho=-0.129, p=0.037),“anxiety of negative criticism” (rho=-0.123, p=0.046)and “ selfdepreciation”(rho=-0.155, p=0.012). There was a significant positive relationship between the depression and anxiety scores of the students and their “social avoidance”, “anxietyof negative criticism”, and “selfdepreciation” subdimensionscores (p<0.001). 
Conclusion: It would be appropriate to produce attitudes that make “feeling of adequacy” developand become stronger and to establish policies necessary to increase socialising instead of the attitudes causing “feeling of inadequacy” to be developed in children and the young during the process of education as well as in the family in order to prevent the social anxiety which has also a cultural dimension to be formed.

References

  • 1- Pietrini F, Lelli L, Lo Sauro C, Faravelli C. Epidemiology of social phobia. Riv Psichiatr 2009;44:203-13.
  • 2- Al-Naggar RA. Prevalence and associated factors of phobia and social anxiety among university students. ASEAN Journal of Psychiatry 2012;13:112-9.
  • 3- Last CG, Perrin S, Hersen M et al. DSM-IIIR anxiety disorder in children; sociodemographic and clinical characteristics. J Am Acad Child Adolesc Psychiatry 1992; 31: 1070-6.
  • 4- Kessler RC, McGonagle KA, Zhao S et al. Lifetime and 12-month prevalence of DSM-IIIR psychiatric disorders in the United States, Arch Gen Psych 1994;51:8-11.
  • 5- American Psychological Association. DSM-IV-TR Diagnosis Criteria Reference Manual, Washington, DC: American Psychological Association. 2001.
  • 6- Purdon C, Antony M, Monteiro S, Swinson RP. Social anxiety in college students. Anxiety Disorders 2001;15:203-12
  • 7- Geen, GR. Social Motivation. Annual Reviewof Psychology. 1991;42:377-22.
  • 8- Heimberg RG, Holt CS, Schneier FR, Spitzer RL. The issue of subtypes in the diagnosis of social phobia. J Anxiety Disord 1993;7:249-20.
  • 9- Boone ML, McNeil DW, Masia CL et al. Multimodal comparison of social phobia subtypes and avoidant personality disorders. J Anxiety Disord 1999;13:271-21.
  • 10- Eng W, Heimberg RG, Coles ME et al. An empirical approach to subtype identification in individuals with social phobia. Psychol Med 2000;30:1345-12.
  • 11- Wittchen HU, Fehm L. Epidemiology, patterns of comorbidity, andassociated disabilities of social phobia. Psychiatr Clin N Am, 2001;24: 617-24.
  • 12- Kessler RC, Stang P, Wittchen HU et al. Lifetime comorbidities between social phobia and mood disorders in the US National Comorbiditiy Survey Psycol Med. 1999;29:555-12.
  • 13- Mennin DS, Heimberg RG, Jack MS. Comorbid generalized anxiety disorder in primary social phobia: symptom severity, functional impairment and treatment response. J Anxiety Disord 2000;14:325-18.
  • 14- Montgomery SA. Social phobia: diagnosis, severity and implications for treatment. Eur Arch Psychiatry Clin Neurosci 1999;249:1-6.
  • 15- Brunello N, Boer den JA, Judd LL, Kasper S et al. Social phobia: diagnosis and epidemiology, neurobiology and pharmacology, comorbidity and treatment. Journal of Affective Disorders 2000;60:61-13
  • 16- Segrin C. Social skills, stressful life events and the development of psychosocial problems, Journal of Social and Clinical Psychology, 1999;18:14-18.
  • 17- Weeks JW, Heimberg RG, Rodebaugh TL et al. Exploring the relationship between fear of positive evaluation and social anxiety. Journal of Anxiety Disorders, 2008;22: 386-14.
  • 18- Schneider FR, Johnson J, Hornig CD et al. Social phobia: Comorbidity and mobidity in an epidemiologic sample, Archives of General Psychiatry,1992;49: 282-6.
  • 19- Ozdemir S, Ersoy MA, Kayahan B. The Comparison of Alcohol Dependents with Soical Drinkers in Terms of Social Phobic Features.Turkish journal of Psychiatry 2005; 7:25-13.
  • 20- Maggee WJ, Eaton WW, Wittchen HU, McGonagle KA, Kessler RC. Agoraphobia, simple phobia, and social phobia in the National Comorbidity Survey. Archives of General Psychiatry 1996;53:159-9.
  • 21- Lecrubier Y, Weiller E. Comorbidities in social phobia. Int Clin Psychopharmacol 1997;12:17-4.
  • 22- Gultekin BK, Dereboy IF. The prevalence of social phobia, and impact on quality of life, academic achievement, and identity formation in university students. Turkish Journal of Psychiatry 2011;22:150-8.
  • 23- Dilbaz N. The prevelance of social phobia among the Turkish universitystudents. XII. World Congress of Psychiatry, Yokohama, August 24-29,2002.
  • 24-Kırpınar İ, Ozer H, Coşkun İ et al. The life long and 12-month prevelance ofpsychological disorders in university students in Erzurum CIDI (DSM-III-R). 3P Journal, 1997;4:253-12.
  • 25- Izgic F, Akyuz G, Dogan O, Kugu N. The prevalence of social phobia in university student population. Anatolian Journal of Psychiatry 2000; 1:207-7.
  • 26- Furmark T, Tillfors M, Everez P. Social phobia in the general population: prevalence and sociodemographic profile. Social Psychiatry and Psychiatric Epidemiology. 1999;34:416-8.
  • 27- Bella TT, Omigbodun OO. Social phobia in Nigerian university students: Prevalence, correlates and co-morbidity. Soc Psych Psych Epid, 2009; 44:458-5.
  • 28- Ozbay Y, Palancı M. Social Anxiety Scale. A study of validity and reliability. 4th National Congress of Psychological Counselling and Guidance, Ankara, METU, 5-7 September 2001.
  • 29- Hisli N. The validity and reliability of Beck Depression Inventory in university student. J Psychol 1989;23:3-10.
  • 30 - Ulusoy M, Sahin N.H, Erkmen H. Turkish version of the Beck Anxiety Inventory: Psychometric properties. Journal of Cognitive Psychotherapy, 1998;12:163-9.
  • 31- Beck AT, Epstein N, Brown G et al. An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol 1988;56:893-4.
  • 32- Tukel R, Kızıltan E, Demir T et al. The effect of sub-types and unsocial personality disorder on psychopathology in social phobia. 3P Journal, 1998;6:15-5.
  • 33. Subası G. Some variables for social anxiety prediction in college students. Education and Science.2007;32:3-12.
  • 34- Palancı, P. Ve Özbay, Y. The control sense of social anxiety in university students and its predictability by social adequecy and vulnerability and coping behaviours. VIIth National Psychological Consulting and Guidance Assembly. Proceedings Book2003:58.
  • 35- Erkan Z, Güçray S, Çam S. Investigating the social anxiety levels of adolescent in terms of parents attitudes and gender. Institute of Social Sciences Journal, 2002; 10:64-11.
  • 36- Feingold, A. Gender differences in personality: A meta-analysis. Psychological Bulletin, 1994;116: 429- 27.
  • 37-Tillfors M, Furmark T. Social phobia in Swedish university students: prevalence, subgroups and avoidant behavior. Soc Psych Psych Epid, 2007;42:79–7.
  • 38- Dilbaz N. Social phobia. The world of Psychiatry 1997;1:18-6.
  • 39-Kaya N,Savas Cilli A, Askın R et al.The prevalence of social phobia among high school and university students. Journal of General Medicine1997;7:133-7.
  • 40-Turan M, Cilli, AS, Askın R et al. Comorbidity of Social Phobia and Other PsychiatricIllnesses. Journal of clinical Psychiatry 2000;3:170-5.
  • 41-Erozkan A. An investigation into the levels of social anxiety and sensitivity to rejection among university students according to certain variables. Selçuk University, Journal of the Intitute of Social Science 2007;17:225-15.
  • 42-Kendler KS, Neale M C, Kessler RC, et al. The genetic epidemiology of phobias in Women: The interrelationship of agoraphobia, social phobia, situational phobia, and simple phobia. Archives of General Psychiatry,1992;49:273-8.
  • 43-Cunha M, Gouveia JP, Ceu Salvador M. Social fears in adolescence: The social anxiety and avoidance scale for adolescents. European Psychologist, 2008;13:197-16.
  • 44-Sayar K, Solmaz M, Ozturk M, et al. Avoidant Personality Disorder in Generalized SocialPhobia and its Impact on Psychopathology. Journal of clinical Psychiatry2000; 3:163-6.
There are 44 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Demet Ünalan

Ferhan Soyuer This is me

Mustafa Baştürk This is me

Ferhan Elmalı This is me

Publication Date January 1, 2018
Published in Issue Year 2018 Yıl: 2018 Ek Sayı: 1

Cite

APA Ünalan, D., Soyuer, F., Baştürk, M., Elmalı, F. (2018). The Social Anxiety Levels of Unıversity Students and Their Relationship With Depression, Anxiety And Demographic And Socio-Cultural Characteristics. Kafkas Journal of Medical Sciences, 8(1), 1-12. https://doi.org/10.5505/kjms.2017.05900
AMA Ünalan D, Soyuer F, Baştürk M, Elmalı F. The Social Anxiety Levels of Unıversity Students and Their Relationship With Depression, Anxiety And Demographic And Socio-Cultural Characteristics. KAFKAS TIP BİL DERG. January 2018;8(1):1-12. doi:10.5505/kjms.2017.05900
Chicago Ünalan, Demet, Ferhan Soyuer, Mustafa Baştürk, and Ferhan Elmalı. “The Social Anxiety Levels of Unıversity Students and Their Relationship With Depression, Anxiety And Demographic And Socio-Cultural Characteristics”. Kafkas Journal of Medical Sciences 8, no. 1 (January 2018): 1-12. https://doi.org/10.5505/kjms.2017.05900.
EndNote Ünalan D, Soyuer F, Baştürk M, Elmalı F (January 1, 2018) The Social Anxiety Levels of Unıversity Students and Their Relationship With Depression, Anxiety And Demographic And Socio-Cultural Characteristics. Kafkas Journal of Medical Sciences 8 1 1–12.
IEEE D. Ünalan, F. Soyuer, M. Baştürk, and F. Elmalı, “The Social Anxiety Levels of Unıversity Students and Their Relationship With Depression, Anxiety And Demographic And Socio-Cultural Characteristics”, KAFKAS TIP BİL DERG, vol. 8, no. 1, pp. 1–12, 2018, doi: 10.5505/kjms.2017.05900.
ISNAD Ünalan, Demet et al. “The Social Anxiety Levels of Unıversity Students and Their Relationship With Depression, Anxiety And Demographic And Socio-Cultural Characteristics”. Kafkas Journal of Medical Sciences 8/1 (January 2018), 1-12. https://doi.org/10.5505/kjms.2017.05900.
JAMA Ünalan D, Soyuer F, Baştürk M, Elmalı F. The Social Anxiety Levels of Unıversity Students and Their Relationship With Depression, Anxiety And Demographic And Socio-Cultural Characteristics. KAFKAS TIP BİL DERG. 2018;8:1–12.
MLA Ünalan, Demet et al. “The Social Anxiety Levels of Unıversity Students and Their Relationship With Depression, Anxiety And Demographic And Socio-Cultural Characteristics”. Kafkas Journal of Medical Sciences, vol. 8, no. 1, 2018, pp. 1-12, doi:10.5505/kjms.2017.05900.
Vancouver Ünalan D, Soyuer F, Baştürk M, Elmalı F. The Social Anxiety Levels of Unıversity Students and Their Relationship With Depression, Anxiety And Demographic And Socio-Cultural Characteristics. KAFKAS TIP BİL DERG. 2018;8(1):1-12.