Factors of Depression
Factors of Depression
Factors of Depression
A research Paper
Presented in the Faculty
Of the Senior High School Department
Of Pandan School Of Arts and Trades
Pandan, Catanduanes
In partial Fulfilment
Of the Requirements for the Graduation
In Automotive Servicing NC II
(TVL Track)
JEFERSON S. DE QUIROZ
KING ALLEN B. OPIANA
GERALD IBARETA
RONALD POSADA
JOHN PAUL SALAZAR
S.Y. 2022-2023
CHAPTER 1
Introduction
Pandan School of Arts and Trades is one of the government educational institution
that offers quality education where one of its focus is Academics and Vocational. Our
research title is all about: Factors that causes Depression to G12 SHS students of Pandan
School of Arts and Trades S.Y. 2022-2023. Some SHS students, suffers from post-depression
challenges that lower self-esteem, obesity, peer issues, persistent bullying, or scholastic
information on this subject, in higher education institutions most specifically the prevalence
Due to its high incidence rates, chronic nature, challenging nature of treatment, and
recovery, depression is a serious mental health concern worldwide. It has been ranked as one
of the four major diseases, because of the severe burden it places on sufferers, their families,
and society as a whole. Diabetes, cancer, heart disease, and Parkinson's disease are just a few
of the illnesses that depression can lead to. Reduced quality of life, elevated morbidity, and
increased mortality are all associated with depression. Students at universities confront a
variety of difficulties, such as adjusting to independent living, academic stress, and preparing
for their future professions, which puts them at risk for depression. These psychological and
emotional strains may cause them to engage in high-risk activities including increasing
smoking. Stress, life events, past experiences and genetics all play a part in determining our
mental health. Student life exposes individuals to risk factors affecting mental health
including financial worries, periods of transition, substance use, parental pressure, culture
shock and disconnection from previous supports. Feeling depressed and anxious often impact
students' memory and concentration due to low mood, feeling hopeless, a lack of energy,
Depression is a state which a person feels very sad, hopeless and unimportant and
often is unable to live in a normal way. According to Bansal, Gayal, and Srivastava (2009), a
lot of physicians did not believe that depressive disorders existed in the youth 40 years ago.
Nowadays, the youth are very prone to depression due to many factors that can affect their
emotional, mental, psychological state of mind in their everyday life especially being a
student. This study about depression is quite strange topic because it is very mysterious yet
the majority of people especially in school settings lacks knowledge about this topic
In the recent time, depression occurred more and more often to almost all of the teens.
The statistics of National Institute of Mental Health (2014) states that depression is the most
often mental disorder that teens and adults in United States have. According to their study,
over 2.8 million youth with age of 12-17 have experienced at least one major depression.
Another study from faculty.washington.edu (2013) states that depression can last
longer and may last for a year or so. Depression can be triggered in several of ways like
failures, lost loved ones, identity loss, and many more. They clear that not everyone who
experience these negative events catch on depression. On the contrary, there are factors that
make them vulnerable to into it is a severe mental disorder that may last longer, but there are
some people who can endure it because they are aware of themselves.
alone, they stated that about 3.9 million people are living with depression and about
3.07million people are living with anxiety. They added that depression is one of the most
leading factors that makes one person to commit suicide. They further explained that a
serious national talk regarding depression in which every Filipino is engaged is urgently
needed. They also concluded on their research that depression is a mental disorder that spread
in a whole wide world and it can affect our daily living. Unlike many large-scale international
defined depression more than just a sadness, but also a mental disorder. People experience
depression because of lack in interest and pleasure in daily activities, significant weight loss
Depression is a topic that is studied by a lot of researches from time to time but the
past studies failed to explore or interpret the experiences of a youth student that undergo the
process of depression and the themes of it in a classroom setting. Furthermore, World Health
Organization did not specify the age range of people who suffer from it. The American
Psychological Association have failed to elaborate and further explain the definition of
depression. They only stated the reason behind `1-`depression. It focuses more on the people
who are grown up. They did not mention about the teenagers that experience the depression.
adult. That study failed to explain the difference of experiences between the teen and adult
depression. Literature also missed to fill the gap about what do victims of depression do
lessen the problem or mental disorder they have. In addition, this research will also serve as
an instrument to view the experiences of a depressed youth student and the themes behind it
and explain the possible reasons on how a person or a youth student can solve his/her
situation.
Depression is one of the emotional problems, and hopelessness and helplessness are
its main causes. Depression is a prevalent problem among college's students across the world
of daily life. Depression is marked by sad feelings among college students which are known
as a common mental illness." National Institute of Mental Health found that during their
college life many students experience the first symptoms of depression. Depressed Students
often feel sad and reductions in academic performance. Untreated depression usually
interferes in day-to-day activities and lasts for a long time. Depressed people ignore their own
successes and good traits, while exaggerating their faults and failures. Student’s Academic
performance which every individual has to perform in all cultures has become an important
goal of the educational process. Student’s personality, education, motivation, mental health
and training also effect academic performance. College life can be called a significant
transition period, where students experience many things first-time, in, for example new
lifestyle, exposure to new cultures, friends, roommates, different ways of thinking and also
deal with a unique amount of stress. Two first years in college can be very stressful time for
many students. When students cannot manage these new first experiences, they become
depressed. There are negative effects of depression on student success. Student’s success is
negatively related with depression, and depressed students exposed lower average point and
Conceptual Framework
DEPRESSION
The study seeks to explore the realities of Factors that causes Depression to G12 SHS
students of Pandan School of Arts and Trades S.Y. 2022-2023. by viewing the information
from individuals in their experiences about depression of students in PSAT. The connection
of these concepts in literature and studies eventually provides the bases on how they exist and
emerge on the lives of the participants. This framework therefore uses these relationships and
Theoretical Framework
Figure 2 Thematic Diagram
This study about Factors that Factors that causes Depression to G12 SHS students of
Pandan School of Arts and Trades S.Y. 2022-2023. has a result that shows 3 main themes
which are: Ways to Cope Up with Depression, Causes of Depression, and Effects of
Depression. The categories that are under the first main theme (Ways to Cope Up with
Depression) are crying, praying, finding friends, finding a happy place, and finding a new
hobby. The second main theme (Causes of Depression) also has categories under it which are
The categories of the third main theme (Effects of Depression) are: feeling of giving
up with 3 sub categories (suicidal thoughts, paranoia, and suicidal attempts), overthinking
with 4 sub categories (secretive, irritable, emotional breakdown, and afraid to be judged)
change of mood with 4 sub categories (self-harming, being forgetful, violent thoughts, and
unclear thoughts) and feeling of self-worthlessness with 3 sub categories (feels like a burden
to others, weight loss, and attention seeking actions). After analyzing the results, the
researchers therefore conclude that depression has different causes and effects on students.
On the other hand, there is still a lot of ways to cope up with depression.
The study aims to know the Factors that causes Depression to G12 SHS students of
Pandan School of Arts and Trades S.Y. 2022-2023. it sought answer to the following
questions.
Hypothesis
This study posed the hypothesis that there is a significant relationship between socio-
demographic profile and the Factors that causes Depression to G12 SHS students of Pandan
This study investigated the Factors that causes Depression to G12 SHS TVL students
of Pandan School of Arts and Trades S.Y. 2022-2023. The Socio-demographic profile of
every (60) students per strand most specifically G12 TVL strands.
This study aims to understand the depression on youth among students through
exploratory research design to discover the factors affecting their psychological and mental
aspects and also to know what causes them to be emotionally compromised that leads to a
depressive state. In addition, the study seeks to have an in depth understanding on how they
This study will utilize a semi-structured interview to uncover the answers to our
questions regarding youth depression and the reasons within. It will also offer ideas to people
especially who’s suffering from depression and as well to provide awareness to the students
and for everyone who plays an important role regarding on this matter.
Depression and associated mental disorders can have a profound effect on all aspects
of life, including performance at school, productivity at work, relationships with family and
characteristics of depression as a category of mental illness and better reflecting the fact that
All ages, ethnicities, and socioeconomic groups are vulnerable to depression, and it
has very high personal, social and economic costs. Depression is also a major cause of death,
uncomfortableness to themselves such as guilt and sadness that often leads to suicidal
thoughts. It also has no medical cause and a specific effect. The researchers found out codes
turned into categories and hence using a semi-structured interview. The researchers will get
the results with this code and discuss the outcome of the interview.
Definition of Terms
The following term are used in the study. For the purposes of clarity and
5% of adults suffer from the disorder. It is characterized by persistent sadness and a lack of
interest or pleasure in previously rewarding or enjoyable activities. It can also disturb sleep
teen depression, including: Having issues that negatively impact self-esteem, such as obesity,
peer problems, long-term bullying or academic problems. Having been the victim or witness
sex, education, migration background and ethnicity, religious affiliation, marital status,
household, employment, and income. Different index variables are formed on the basis of
socio-demographic variables.
W.H.O Philippines- The Philippines has been an active Member State of WHO, and
is the home of the WHO Regional Office for the Western Pacific. The country has played a
critical role in shaping development agendas, including the Sustainable Development Goals
(SDGs). In the spirit of the SDGs, the country cooperation strategy focuses on leaving no one
behind and enhancing collaboration for health to move the Philippines closer to universal
health coverage. The work of WHO and the Department of Health will focus on five strategic
priorities: saving lives, promoting well-being, protecting health, optimizing the health
For WHO, this strategy paves the way for a new level of collaboration with the
Philippines – as a focused, transparent and committed partner that supports the country in
making health a priority across programmed and sectors. Government departments and
United Nations agencies, multilateral and bilateral partners and civil society groups have
Acronyms
5% of adults suffer from the disorder. It is characterized by persistent sadness and a lack of
interest or pleasure in previously rewarding or enjoyable activities. It can also disturb sleep
teen depression, including: Having issues that negatively impact self-esteem, such as obesity,
peer problems, long-term bullying or academic problems. Having been the victim or witness
sex, education, migration background and ethnicity, religious affiliation, marital status,
household, employment, and income. Different index variables are formed on the basis of
socio-demographic variables.
The Philippines lacks epidemiological data on depression among young adults. About
moderate to severe depression in Filipino young adults is higher among females than males.
Less education, residence in urban areas, and marital problems are significant predictors of
moderate to severe depression. Moderate to severe depression is significantly associated with
suicidal ideation.
Data were from a 2013 nationwide probability survey of 19,017 respondents, age 15–
24. Depressive symptoms were assessed using a 12-item version of the Center for
was examined using descriptive statistics and the adjusted and unadjusted association
young Filipino adults experience moderate to severe depressive symptoms and the prevalence
is higher in females (10.2%) than males (7.6%). The symptom most often experienced in the
general population was “not enjoying life”, while “loneliness” was the most frequently
reported symptom in those with moderate to severe depressive symptoms. The prevalence of
moderate to severe depressive symptoms was higher in those with less education, persons
who were separated/widowed/divorced, and residents in urban areas. Those with moderate to
severe depressive symptoms are about twice more likely to experience suicidal ideation.
Chapter 2
This chapter presents the review of related literature and studies anchored from
foreign and local sources. These are deemed relevant since these will substantiate the results
Foreign Literature
This chapter presents a closer point of view in the research’s related literature,
theoretical foundation and a shorter survey of related studies on Factors that causes
Depression to G12 SHS TVL students of Pandan School of Arts and Trades S.Y. 2022-2023.
These will give a foundation for the systematic analyses that will make the findings,
combination of such symptoms like a change of mood, physical symptoms like changes in
sleep, energy, appetite, a person’s degree of confidence also self-esteem. Depression is also
failures that can lead people to commit suicide. Apparently, it is unusual or unlikely that
someone who’s having a hardship from depression to be noticed and managed (ADAP,
2007).
Additionally, Hoerman (2013) claims that depression during the belief of the 1970’s
is an ailment of adulthood and that children and adolescents do not experiences is now long
gone. It has already been measured or evaluated that depression is a form of mental illness
that affects most of the adolescents with prevalence rates between ten and twenty percent.
The National Institute of Mental Health has disclosed statistically a compelling variation
across age and gender in the lifetime prevalence of mood disorders, including depression, for
adolescents 13 to 18.
connected to cyber bullying in social media according to new researches that study different
online phenomena. Number of people who examines the victims of cyber bullying increases
especially when news of suicide occurs. Teenagers use social media more often this day
according to Michele Hamm, but the effects of it in one’s health is still unknown. It is most
likely for teens to experience depression in their adulthood when they are being bullied.
Early work by Renata and Jacek (2010) shows that an epidemiological appraisal of
depression during the adolescence age was always been a challenging issue since the late
studies during the 60’s and 70’s. Angold disclosed that the reasons behind the gap between
prevalence indexes should be looked for in the different therapeutic ways, diagnostic tools
used, as well as where the information came from. He also discussed the crucial problem of
the imprecise meaning of adolescent depression as a mental disorder and until now, the
characteristics of depression can be from the feeling of boredom, irritability, and the inability
to feel pleasure instead of sadness. Depression cases that it is not treated can last over 7 to 9
months and most likely occur again in adulthood. Symptoms of depression are most likely to
be found in children and adolescents that is why it is hard to figure out the signs of
depression. Depression affects the daily activities of both children and adolescents. Both male
and female child have the same prevalence rate of depression but there is a sudden increase in
female rate when they reach the stage of puberty. There are also many factors that promotes
the development of depression in children and adolescents such as genetic and biologic
vulnerability, environmental factors, negative life events, and personality, temperament, and
In addition, a study in the University of Missouri stated that any form of social media
can be a source of depression depending on how a person use it. Using it as a tool for
surveillance to check on others may lead to the feeling of depression. By doing this, you
compare your own situation to your friend’s situation like having a vacation, relationship,
achievements, etc. This leads you to envy them and can lead you to depression. A tip for
those people who experience this kind of envy is that the post you have seen is customized to
However, adolescents’ depression has no specific cause. Mayo clinic explains that
there are many factors that lead to depression. First is the difference in the brain, adolescents
have different brain structure than the adults. A depressed teen can also have a different
amount of hormone and neurotransmitters that helps their brain cells to connect and is one
responsible for regulating moods and behavior. The second one is traumatic early life events,
children don’t have enough experience to handle such a traumatic event in their lives like loss
of a parent or physical, emotional or sexual abuse and these can leave a lasting effect that can
contribute to their depression. The third one is inherited traits, research shows that if a child
or adolescent have a family member who is depressed, and it is most like for them to have it
also. The last one is learned patterns of negative thinking, teens always think in a bad way
like thinking of themselves as helpless instead of thinking of how to solve a problem and this
The factors that leads to depression in youth specifically in students can be inherited,
also because of stress in social interaction (A. Thapar, Collishaw, Pine, & A.K Thapar, 2012).
Additionally, in the study of 2005, an early article about stress that also leads to depression is
categorized by feelings of tension, frustration, too much worrying, and sadness (Walker
2005; ADAP, 2007; Ranttila & Shrestha, 2017). Because of that, depression are severe and
lasts longer that have been categorized by extreme feelings of hopelessness, sadness, isolation
and worthlessness that lasts for two weeks or more (Walker, 2005; ADAP 2007). There many
factors that may lead a students to be depressed, this is also as true as the articles that has
been stated, a student may feel depressed when he/she experience loneliness in his/her current
state because of those factors and the most severe effects of depression is an attempt or to
commit suicide, most young people who experience depression are at high risk in attempting
suicide than the young ones who do not experience depression, however, not all youth who
are depressed are attempting to commit suicide, this statement has been explained by Walker
(2005) as:
"These young people report exhibiting much more anger and ventilation;
avoidance and passivity; and aggressive, antisocial behavior. They describe yelling,
fighting and complaining; drinking, smoking and using doctor-prescribed drugs more
frequently; and sleeping, riding around in cars and crying more often. They are less
inclines to do things with their family or to go along with parents' rules and requests"
(p.4).
In addition, (2010), she stated that "All students are entitled to an education in a
positive environment" but a problem can go in the way of students to pursue their educational
attainment especially if it can deal some serious effect in terms of psychological and their
whole being. Previous conducted researches showed high rates of students' psychological
problems like anxiety, and depression are widely spread in universities in the world (Al-
The Philippines lacks epidemiological data on depression among young adults. About
moderate to severe depression in Filipino young adults is higher among females than males.
Less education, residence in urban areas, and marital problems are significant predictors of
suicidal ideation.
Data were from a 2013 nationwide probability survey of 19,017 respondents, age 15–
24. Depressive symptoms were assessed using a 12-item version of the Center for
was examined using descriptive statistics and the adjusted and unadjusted association
young Filipino adults experience moderate to severe depressive symptoms and the prevalence
is higher in females (10.2%) than males (7.6%). The symptom most often experienced in the
general population was “not enjoying life”, while “loneliness” was the most frequently
reported symptom in those with moderate to severe depressive symptoms. The prevalence of
moderate to severe depressive symptoms was higher in those with less education, persons
who were separated/widowed/divorced, and residents in urban areas. Those with moderate to
severe depressive symptoms are about twice more likely to experience suicidal ideation.
Foreign Studies
education research, even though it’s become clear that depression is closely related to a
variety of other disorders, and to academic and social difficulties” (p. 295). Childhood
depression may also be accompanied by other disorders such as: anxiety disorders, conduct
disorders, attention deficit-hyperactivity disorder, learning isabilities, school failure, and has
also been found to afect some children with autism (Kaufman, 2013). Children may also
exhibit inappropriate conduct such as: aggression, stealing, and social withdrawal (Kaufman,
2013). Weight gain or loss may also be observed. It is important to note that there are two
main groups of causes of depression, biological and environmental, with social and
environmental being the most prevalent (Lebrun, 2007; McKnew, Cytryn, & Yahraes, 1983).
School connectedness. Shochet, Dadds, Ham and Montague (2006) conducted a sampling of
2,022 students (999 boys and 1,023 girls) ages 12 to 14 twice, at intervals of twelve months
students begin to rely less on family and more on extrafamilial relationships found in friends
(Goodenow, 1993). School connectedness accounted for 13% to 18% of the emotional
distress in various age groups (Resnick et al., 1997) although there has been little research on
the relation between school connectedness and anxiety and depression symptoms in
adolescents (Shochet et al., 2006). Overall, school connectedness predicted future mental
health problems, rather than mental health problems predicting future school connectedness
(Shochet et al., 2006). Self-worth is also a risk factor for depression in youth. It is important
adolescence (Burwell & Shirk, 2006). Rumination. Nolen-Hoeksema (1991) posited that,
“rumination, a cognitive style that involves passively brooding about one’s mood, would lead
decreases in symptoms” (p. 545). Rumination has been identified as a risk factor for the
individuals’ ability to generate solutions while accessing negative thought and memories,
(Nolen-Hoeksema, 1994). Parents. Parents who become hostile and critical when their
children are experiencing problems might impact their child’s sense of inability to solve
problems and decrease their enthusiasm (NolenHoeksema, Wolfson, Mumme, & Guskin,
1995). When a child reacts with frustration to a task, a parent may also become frustrated and
perhaps hostile (Nolen-Hoeksema et al., 1995). Some studies also show that children of
mothers who have depression are at risk for developing a sense of learned helpless- 37
Hayden (2016) ness (Nolen-Hoeksema et al., 1995). Conversely, parents who were over-
restrictive and controlled their children’s opportunities for decision making had children who
were more passive and withdrawn from difcult social situations (Baumrind, 1973). Marital
confict and poverty can also negatively afect the child and the mother (Hammen, Adrian,
Gordon, Burge, Jaenicke, & Hiroto, 1987). Gender. Te Response Styles Teory (Just & Alloy,
1997) was used to explain the diferences in rumination amongst men and women. Te theory
suggests that women are more likely to ruminate than men while men are more likely to use
Nearly one in five adolescents will experience a major depressive episode in their teen
years with females twice as likely to sufer from depression (Crisp, Gudmundsen, & Shirk,
2006). Hilt et al., (2010) concluded that, “lthough some research indicates that girls are more
likely to report using a ruminative response style compared to boys, gender diferences in the
tendency to distract and problem-solve haverarely been examined in youth” (p. 547).
Local Studies
Depression has recently become the leading cause of disability worldwide (World
Health Organization, 2017). In high-income countries, such as the US, UK and Canada, its
economic impact is staggering, both in terms of productivity losses and direct health care
costs (Greenberg et al., 2015; Conference Board of Canada, 2016; Thomas and Morris,
2003). Left untreated, the condition can cause significant suffering to individuals and their
treatments are largely available; but, gaps in the quality of care persists as a large proportion
of people with depression receive mental health care that do not meet the most basic criteria
In low income countries, such as the Philippines, depression is also a leading cause of
disability. A report released by the World Health Organization has estimated that the overall
suggesting that about 3.3 million Filipinos are experiencing depressive symptoms based on
the 2015 population estimate (Philippine Statistics Authority, 2016). Depression was also
ranked as the 8th single largest cause of disability in the country (Institute for Health Metrics
and Evaluation, 2017). The large number of individuals and families affected by depression
raises serious concerns about the state of mental health care in the country given the limited
availability of tertiary care facilities, severe shortage of mental health professionals, and the
inadequate capacity of the primary health care system to manage mental health issues (Lally
It is likely that the issues associated with depression and its consequences are even greater in
the young adult Filipino population since depression has been reported elsewhere to have the
highest prevalence among individuals who are between the ages of 15 to 25 (Hedden et al.,
2015; Statistics Canada, Health Statistics Division, 2014). The severity of the problem,
population. Identifying who in this age group are experiencing moderate to severe depressive
symptoms and understanding their characteristics are particularly important as they are the
group more likely to have persistent symptoms (Gustavson et al., 2018; Rushton et al., 2002)
and consequently more likely to require ongoing treatment, support and other related
services.
This study was conducted to help address current gaps in knowledge about depressive
symptoms among young adults in the Philippines. The specific objectives of this study are to:
1) estimate the prevalence of moderate to severe depressive symptoms; 2) identify the most
severe depressive symptoms; and, 4) estimate the association between moderate to severe
Depression can be prevented if its symptoms are addressed early and effectively.
Prevention against depression among university students is rare in the Philippines, but is
urgent because of the rising rates of suicide among the group. Evidence is needed to
systematically identify and assist students with higher levels of depressive symptoms. We
carried out a survey to determine the social and demographic factors associated with higher
levels of depressive symptoms among 2,436 Filipino university students. The University
motivation, was used. Six of the 11 factors analyzed were found to be statistically
significantly associated with more intense levels of depressive symptoms. These factors were:
frequency of smoking, frequency of drinking, not living with biological parents,
dissatisfaction with one’s financial condition, level of closeness with parents, and level of
closeness with peers. Sex, age category, course category, year level and religion were not
significantly related. In identifying students with greater risk for depression, characteristics
related to lifestyle, financial condition, parents and peers are crucial. There is a need to carry
out more surveys to develop the pool of local knowledge on student depression.
Chapter 3
This chapter presents the research method, population and sampling scheme,
Research Methodology
This study aims to understand the depression on youth among students through
exploratory research design to discover the factors affecting their psychological and mental
aspects and also to know what causes them to be emotionally compromised that leads to a
depressive state. In addition, the study seeks to have an in depth understanding on how they
This study will utilize a semi-structured interview to uncover the answers to our
questions regarding youth depression and the reasons within. It will also offer ideas to people
especially who’s suffering from depression and as well to provide awareness to the students
and for everyone who plays an important role regarding on this matter.
Purposive sampling was used in this study. This study was limited only to (60)
students from different areas of specialization of TVL strand, who will participated in the
survey. It is informed however, that there are 250 (plus) students enrolled in PSAT SHS TVL
strand.
Research Instruments
The study treads on a qualitative exploratory research design utilizing all PSAT SHS
TVL strand using semi-structured interviews either through Facebook Messenger or journal
sheets in an iterative or simultaneous data gathering procedure. The researchers code the data
to form categories and later reduces the data into themes to explain the live experiences of the
Validation of Instruments
The questionnaire was the main instrument used to gather the data. It has three parts.
The first part contained the socio-demographic profile of the students. Name, Age, gender
and educational attainment. Second part is questioning 1. What are the ways to cope up the
depression? 2. What are the causes of depression? What are the effects of Depression?
After incorporating the suggestions gleaned from the face validity of the
questionnaire, copies are reproduced for the pre and post- test. A letter citing the academic
purpose of the study during the pre-and post -test and the final inquiry accompanied the
The draft of the questionnaire was presented to the panel members and research
adviser and some teachers, panelist, this was the face validation phase of the study.
were used in analyzing the data for this study. Frequency count was used in tallying
responses. The weighted mean was used in determining the relation of frequencies under
different variables in relation to the whole. Rank was used in discerning the relativity (i. e.,
higher or lower) of the recorded weighted means from each of the different items.
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APA (2017). Psychology Topics viewed September 24, 2017, retrieved from:
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With and Without Learning Disabilities and How Students Can Cope Up With Anxiety
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Professionals.
Pappas, S. (2015). Cyber bullying on Social Media Linked to Teen Depression.. 2012