Efficiency of assertiveness training on the stress, anxiety, and depression levels of college students (Randomized control trial)

Abstract

BACKGROUND: The significance of assertiveness in promoting mental health is well acknowledged. To investigate the impact of assertiveness training on lowering anxiety, stress, and depression among college students at a private university in Cairo. MATERIALS AND METHODS: In this study, three questionnaires were used: demographic, Depression Anxiety Stress Scales (DASS-21), and Rathus Assertiveness Schedule. Students were randomly allocated to either a group that underwent assertiveness training (experimental group) or a control group. A randomized controlled trial (RCT) was utilized with a pre- and post-assessment. The training program is an adapted version of DBT skills training. The training program includes mindfulness, assertiveness, and problem-solving skills through eight 90-min group sessions. RESULTS: There were ( n = 50) students in the experimental group compared with ( n = 50) the control group. Assertiveness group, in comparison with control group, resulted in significantly greater reductions in stress as shown in DASS scores (the effect size, d = 0.52, P < .000), anxiety (the effect size, d = 0.30, P < .000), depression (the effect size, d = 0.21, P < .000), and total scores of DASS (the effect size, d = 0.45, P < .000). Assertiveness group, in comparison with control group, resulted in significantly greater increase in assertiveness as shown in RAS scores (the effect size, d = 0.38, P < .000). CONCLUSION: It is possible that increasing an individual’s level of assertiveness might be a helpful strategy for reducing feelings of anxiety, stress, and depression.