v TABLE OF CONTENT TITLE PAGE... i APPROVAL PAGE... ii AUTHENTICITY STATEMENT... iii PREFACE... iv TABLE OF CONTENT... v LIST OF TABLE... viii LIST OF FIGURE... xi LIST OF APPENDICES... xii LIST OF ABBREVIATIONS... xiii ABSTRACT... xiv CHAPTER I: INTRODUCTION... 1 I. A. Background... 1 I. B. Problem Formulation... 2 I. C. Research Objective... 2 I. D. Research Authenticity... 3 I. E. Research Benefit... 4 CHAPTER II: LITERATURE REVIEW... 5 II. A. Depression... 5 II. A. 1. Definition of depression... 5 II. A. 2. Unipolar depressive disorder... 6 II. A. 3. Prevalence of depression... 7 II. A. 4. Risk factors for depression... 9 II. A. 5. Predictors of depression... 10 II. A. 6. Beck s Depression Inventory... 13 II. B. Social Support... 14 II. B. 1. Concept of social support... 14 II. B. 2. The buffering hypothesis... 17 II. B. 3. Social Support Questionnaire... 19 II. C. Medical School... 20 II. C. 1. Medical education system... 20 II. C. 2. Medical students distress... 21 II. D. Association Between Depression and Social Support... 25 II. E. Theoretical Framework... 27 II. F. Basis of Theory... 28 II. G. Conceptual Framework... 28 II. H. Hypothesis... 29 CHAPTER III: RESEARCH METHODOLOGY... 30 III. A. Research Design... 30 III. B. Research Place and Time... 30 v
III. C. Research Subject and Population... 30 III. D. Sample Size... 32 III. E. Variable and Operational Definition... 34 III. E. 1. Research variables... 34 III. E. 2. Operational definition... 34 III. F. Study Materials and Tools... 34 III. F. 1. Beck s Depression Inventory... 35 III. F. 2. Social Support Questionnaire... 36 III. G. Study Procedure... 36 III. H. Data Analysis... 37 III. I. Study Weakness... 37 CHAPTER IV: RESULT AND DISCUSSION... 38 IV. A. Research Result... 38 IV. A. 1. Univariate Analysis... 38 IV. A. 2. Bivariate Analysis... 42 IV. A. 2. 1. Relationship between age and depression... 44 IV. A. 2. 2. Relationship between sex and depression... 45 IV. A. 2. 3. Relationship between batch and depression... 46 IV. A. 2. 4. Relationship between program and depression... 47 IV. A. 2. 5. Relationship between birth order and depression... 48 IV. A. 2. 6. Relationship between person who raised subjects and depression... 49 IV. A. 2. 7. Relationship between chronic physical illness and depression... 50 IV. A. 2. 8. Relationship between frequent feeling of anxiety and depression... 51 IV. A. 2. 9. Relationship between feelings that one s thought is controlled by external forces and depression... 52 IV. A. 2. 10. Relationship between unexpected feelings of happiness or joy anddepression... 53 IV. A. 2. 11. Relationship between hearing voices without a source and depression... 54 IV. A. 2. 12. Relationship between feelings that one is being spied on and depression... 56 IV. A. 2. 13. Relationship between one s desire to become a physician and depression... 57 IV. A. 2. 14. Relationship between social support quantity and depression... 58 IV. A. 2. 15. Relationship between social support quality and depression... 59 vi
IV. B. Discussion... 60 IV. C. Limitation of Study... 77 CHAPTER V: CONCLUSION AND SUGGESTION... 78 V. A. Conclusion... 78 V. B. Suggestion... 78 REFERENCES... 80 APPENDICES... 91 vii
viii LIST OF TABLE Table Number Title of Table Page Table I. 4. 1 Research authenticity review... 3 Table IV. 1. 1. 1 Univariate analysis of characteristics of research subjects in undergraduate medical students of batch 2014, 2015, and 2016 in Universitas Gadjah Mada... 39 Table IV. 1. 1. 2 Univariate analysis of answers to additional questions, BDI, and SSQ in undergraduate medical students of batch 2014, 2015, and 2016 in Universitas Gadjah Mada... 41 Table IV. 1. 2. A. Bivariate analysis between subjects characteristics and depression level of 2015, and 2016 in Universitas Gadjah Mada... 42 Table IV. 1. 2. B. Bivariate analysis between answers to additional questions, social support, and depression level of undergraduate medical students of batch 2014, 2015, and 2016 in Universitas Gadjah Mada... 43 Table IV. 1. 2. 1. I Table IV. 1. 2. 2. I Table IV. 1. 2. 3. I Table IV. 1. 2. 4. I Frequency and analysis between age and Gadjah Mada... 44 Frequency and analysis between sex and Gadjah Mada... 45 Frequency and analysis between bach and Gadjah Mada... 46 Frequency and analysis between program and Gadjah Mada... 47 viii
ix Table IV. 1. 2. 5. I Table IV. 1. 2. 6. I Frequency and analysis between birth order and Gadjah Mada... 48 Frequency and analysis between persons who raised subjects and depression of undergraduate medical students of batch 2014, 2015, and 2016 in Universitas Gadjah Mada... 49 Table IV. 1. 2. 7. I Frequency and analysis between chronic physical illness and depression of 2015, and 2016 in Universitas Gadjah Mada... 50 Table IV. 1. 2. 8. I Table IV. 1. 2. 9. I Table IV. 1. 2. 10. I Table IV. 1. 2. 11. I Table IV. 1. 2. 12. I Table IV. 1. 2. 13. I Table IV. 1. 2. 14. I Frequency and analysis between frequent feeling of anxiety and depression of 2015, and 2016 in Universitas Gadjah Mada... 51 Frequency and analysis between feelings that one s thought is controlled by external forces and depression of undergraduate medical students of batch 2014, 2015, and 2016 in Universitas Gadjah Mada... 52 Frequency and analysis between unexpected feelings of happiness or joy and depression of 2015, and 2016 in Universitas Gadjah Mada... 53 Frequency and analysis between hearing voices without a source and depression of 2015, and 2016 in Universitas Gadjah Mada... 54 Frequency and analysis between feelings that one is being spied on and depression of 2015, and 2016 in Universitas Gadjah Mada... 56 Frequency and analysis between one s desire to become a physician and depression of 2015, and 2016 in Universitas Gadjah Mada... 57 Frequency and analysis between social support quantity and depression of undergraduate medical students of batch 2014, 2015, and 2016
x Table IV. 1. 2. 15. I in Universitas Gadjah Mada... 58 Frequency and analysis between social support quality and depression of undergraduate medical students of batch 2014, 2015, and 2016 in Universitas Gadjah Mada... 59
xi LIST OF FIGURE Figure Number Title of Figure Page Figure II. 1. 5. 1 Personality traits that contribute to one s reaction to stress... 12 Figure II. 3. 2. 1 Causes and consequences of student distress... 24 Figure II. 5. 1 Theoretical framework of the study... 27 Figure II. 7. 1 Conceptual framework of the study... 28 xi
xii LIST OF APPENDICES Appendix Number Title of Appendix Page Appendix 1 Informed Consent... 91 Appendix 2 Respondent s Identity... 96 Appendix 3 Beck s Depression Inventory II... 97 Appendix 4 Social Support Questionnaire... 101 Appendix 5 Additional Questions... 106 Appendix 6 Ethical Clearance... 107 Appendix 7 Statistical Analysis... 108 xii
xiii LIST OF ABBREVIATIONS AIDS : Acquired Immunodeficiency Syndrome BDI : Beck s Depression Inventory CDI : Children s Depression Inventory CES-D : Center for Epidemiologic Studies Depression Scale CI : Confidence Interval DALY : Disability-Adjusted Life Years DASS : Depression, Anxiety, and Stress Scale DSM : Diagnostic and Statistic Manual of Mental Disorder HIV : Human Immunodeficiency Virus ICD : International Classification of Diseases MAACL : Multiple Affect Adjective Check List MD : Major Depression MDE : Major Depressive Episode OR : Odd s Ratio SSQ : Social Support Questionnaire SSQ-N : Social Support Questionnaire Number SSQ-S : Social Support Questionnaire Satisfaction UGM : Universitas Gadjah Mada vs : versus WHO : World Health Organization WMH : World Mental Health xiii