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

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

Yagmur Amanvermez  1 , Ruiying Zhao  1 , Pim Cuijpers  1 , Leonore M de Wit  1 , David D Ebert  2 , Ronald C Kessler  3 , Ronny Bruffaerts  4 , Eirini Karyotaki  1
Affiliations
Review

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

Yagmur Amanvermez et al. Internet Interv. .

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.

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Conflict of interest statement

In the past 3 years, Dr. Kessler was a consultant for Datastat, Inc., Holmusk, RallyPoint Networks, Inc., and Sage Therapeutics. He has stock options in Mirah, PYM, and Roga Sciences.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram.
Fig. 2
Fig. 2
Risk of bias summary for studies with unselected college students.
Fig. 3
Fig. 3
Risk of bias summary for studies with unselected college students.
Fig. 4
Fig. 4
Risk of bias summary for studies with preselected college students.
Fig. 5
Fig. 5
Risk of bias summary for studies with preselected college students.
Fig. 6
Fig. 6
Forest plot for comparisons of self-guided stress management programs for unselected college students to control conditions at posttest.
Fig. 7
Fig. 7
Forest plot for comparisons of self-guided stress management programs for preselected college students to control conditions at posttest.
Fig. 8
Fig. 8
Funnel plot of studies with unselected college students.
Fig. 9
Fig. 9
Funnel plot of studies with preselected college students.
See this image and copyright information in PMC

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