students in an experimental psychology class did research on depression

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Experimental depression treatment is nearly 80% effective in controlled study

In a double-blind controlled study, high doses of magnetic brain stimulation, given on an accelerated timeline and individually targeted, caused remission in 79% of trial participants with severe depression.

October 28, 2021 - By Mandy Erickson

Since receiving an experimental depression treatment at Stanford, Tommy Van Brocklin has been walking Scout for "the sheer joy of it." Nellie Van Brocklin

A new type of magnetic brain stimulation brought rapid remission to almost 80% of participants with severe depression in a study conducted at the  Stanford University School of Medicine .

The treatment, known as Stanford accelerated intelligent neuromodulation therapy (SAINT) or simply Stanford neuromodulation therapy, is an intensive, individualized form of transcranial magnetic stimulation. In the study, remission typically occurred within days and lasted months. The only side effects were temporary fatigue and headaches.

“It works well, it works quickly and it’s noninvasive,” said  Nolan Williams , MD, an assistant professor of psychiatry and behavioral sciences. “It could be a game changer.” Williams is the senior author of the study, which was published Oct. 29 in the  American Journal of Psychiatry .

Twenty-nine people with treatment-resistant depression participated in the study: About half received SAINT, and the rest underwent a placebo procedure that mimicked the real treatment. After five days of treatment, 78.6% of the participants in the treatment group were no longer depressed, according to several standard methods of evaluation. “It’s quite a dramatic effect, and it’s quite sustained,” said  Alan Schatzberg , MD, the Kenneth T. Norris, Jr. Professor in Psychiatry and Behavioral Sciences, who was a co-author of the study.

A lifetime of depression

Tommy Van Brocklin, 60, has suffered from depression since he was 15. “In 1975, they didn’t have the medication and understanding they do now,” he said. “I was told I wasn’t trying hard enough.”

“I’ve functioned all these years, but it’s been very difficult at times,” the civil engineer added. Talk therapy helped “for about half a day after an appointment.” When selective serotonin reuptake inhibitors became available in the 1990s, he started on paroxetine, commonly sold under the brand name Paxil.

“It worked like a miracle drug,” he said, but after 10 or 15 years it started to lose its effect. After 25 years, it stopped working entirely. He tried other medications, but none helped; one even made him suicidal. 

His sister, who lives near Stanford, connected him with the researchers studying SAINT. He flew from his home in Memphis, Tennessee, and underwent the treatment in September. He felt nothing the first day; on day two, he began feeling emotional — “I felt the struggle of what I’d been through all these years.”

“The next day, all of a sudden, it broke through,” he said. “I felt so much better, and it’s stuck with me.”

Specialized magnetic stimulation

The transcranial magnetic stimulation treatment currently approved by the Food and Drug Administration requires six weeks of once-daily sessions. Only about half of patients who undergo the treatment improve, and only about a third experience remission from depression.

SAINT advances that treatment by targeting the magnetic pulses according to each patient’s neurocircuitry and providing a greater number of pulses at a faster pace.

In the study, the researchers first used MRI to locate the best location to target within each participant’s dorsolateral prefrontal cortex, which regulates executive functions, such as problem solving and inhibiting unwanted responses. They applied the stimulation in a subregion that has the strongest relationship with the subgenual cingulate, a part of the brain that is overactive in people experiencing depression. The transcranial magnetic stimulation strengthens the connection between the two regions, facilitating dorsolateral prefrontal cortex control of the activity in the subgenual cingulate.

The researchers also used 1,800 pulses per session instead of 600. (The larger amount has been used safely in other forms of brain stimulation for neurological disorders such as Parkinson’s disease.) And instead of providing one treatment a day, they gave participants 10 10-minute treatments, with 50-minute breaks in between.

For the control group, the researchers disguised the treatment with a magnetic coil that mimicked the experience of the magnetic pulse; both the control and active treatment groups wore noise-canceling earphones and received a topical ointment to dull sensation. Neither the researcher administering the procedure nor the participant knew whether the participant was receiving real treatment.

A hard-to-treat group

The trial participants ranged in age from 22 to 80; on average, they had suffered depression for nine years. They had tried medications, but either they had had no effect or they had stopped working. During the trial, participants who were on medication maintained their regular dosage; participants who weren’t taking medications did not start any.

Nolan Williams demonstrates SAINT, the magnetic brain stimulation therapy he and his colleagues developed, on Deirdre Lehman, a participant in a previous study of the treatment. Steve Fisch

Within four weeks after treatment, 12 of the 14 participants who had received the treatment improved, and 11 of them met FDA criteria for remission. In contrast, only two of the 15 participants who had received the placebo met the criteria for remission.

Because the study participants typically felt better within days of starting SAINT, the researchers are hoping it can be used to quickly treat patients who are at a crisis point. Patients who start taking medication for depression typically don’t experience any reduction of symptoms for a month.

“We want to get this into emergency departments and psychiatric wards where we can treat people who are in a psychiatric emergency,” Williams said. “The period right after hospitalization is when there’s the highest risk of suicide.”

Van Brocklin said that since he returned home following treatment, he’s made some radical changes. “I have a really strong desire to get my life together,” he said.

“I don’t procrastinate anymore,” he added. “I’m sleeping better. I completely quit alcohol. I’m walking my dog and playing the guitar again, for nothing more than the sheer joy of it.”

Most importantly, he said, “I’m remaining positive and being respectful of others. These are big changes in my life.”

Other Stanford scientists who contributed to the study are former postdoctoral scholars Eleanor Cole, PhD, and Angela Phillips, PhD; Brandon Bentzley, MD, PhD, David Carreon, MD, Jennifer Keller, PhD, Kristin Raj, MD, and Flint Espil, PhD, all clinical assistant professors of psychiatry and behavioral sciences; clinical research coordinators Katy Stimpson, Romina Nejad, Clive Veerapal, Nicole Odenwald and Maureen Chang; former clinical research coordinators Fahim Barmak, MD, Naushaba Khan and Rachel Rapier; postdoctoral scholars Kirsten Cherian, PhD, James Bishop, PhD, Azeezat Azeez, PhD, and John Coetzee, PhD; life science research professional Heather Pankow; clinical research manager Jessica Hawkins; Charles DeBattista, MD, professor of psychiatry and behavioral sciences; and Booil Jo, PhD, associate professor of psychiatry and behavioral sciences.

Scientists from the U.S. Department of Veterans Affairs; Palo Alto University; the Centre for Neuroimaging and Cognitive Genomics at the National University of Ireland; and the School of Medicine at Southern Illinois University, Carbondale, contributed to the research.

The research was funded by a Brain and Behavior Research Foundation Young Investigator Award, Charles R. Schwab, the David and Amanda Chao Fund II, the Amy Roth PhD Fund, the Neuromodulation Research Fund, the Lehman Family, the Still Charitable Trust, the Marshall and Dee Ann Payne Fund, and the Gordie Brookstone Fund.

Stanford’s Department of Psychiatry and Behavioral Sciences also contributed to the work.

If you're interested in participating in a study, please email [email protected] .

About Stanford Medicine

Stanford Medicine is an integrated academic health system comprising the Stanford School of Medicine and adult and pediatric health care delivery systems. Together, they harness the full potential of biomedicine through collaborative research, education and clinical care for patients. For more information, please visit med.stanford.edu .

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How the Experimental Method Works in Psychology

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The Experimental Process

Types of experiments, potential pitfalls of the experimental method.

The experimental method is a type of research procedure that involves manipulating variables to determine if there is a cause-and-effect relationship. The results obtained through the experimental method are useful but do not prove with 100% certainty that a singular cause always creates a specific effect. Instead, they show the probability that a cause will or will not lead to a particular effect.

At a Glance

While there are many different research techniques available, the experimental method allows researchers to look at cause-and-effect relationships. Using the experimental method, researchers randomly assign participants to a control or experimental group and manipulate levels of an independent variable. If changes in the independent variable lead to changes in the dependent variable, it indicates there is likely a causal relationship between them.

What Is the Experimental Method in Psychology?

The experimental method involves manipulating one variable to determine if this causes changes in another variable. This method relies on controlled research methods and random assignment of study subjects to test a hypothesis.

For example, researchers may want to learn how different visual patterns may impact our perception. Or they might wonder whether certain actions can improve memory . Experiments are conducted on many behavioral topics, including:

The scientific method forms the basis of the experimental method. This is a process used to determine the relationship between two variables—in this case, to explain human behavior .

Positivism is also important in the experimental method. It refers to factual knowledge that is obtained through observation, which is considered to be trustworthy.

When using the experimental method, researchers first identify and define key variables. Then they formulate a hypothesis, manipulate the variables, and collect data on the results. Unrelated or irrelevant variables are carefully controlled to minimize the potential impact on the experiment outcome.

History of the Experimental Method

The idea of using experiments to better understand human psychology began toward the end of the nineteenth century. Wilhelm Wundt established the first formal laboratory in 1879.

Wundt is often called the father of experimental psychology. He believed that experiments could help explain how psychology works, and used this approach to study consciousness .

Wundt coined the term "physiological psychology." This is a hybrid of physiology and psychology, or how the body affects the brain.

Other early contributors to the development and evolution of experimental psychology as we know it today include:

• Gustav Fechner (1801-1887), who helped develop procedures for measuring sensations according to the size of the stimulus
• Hermann von Helmholtz (1821-1894), who analyzed philosophical assumptions through research in an attempt to arrive at scientific conclusions
• Franz Brentano (1838-1917), who called for a combination of first-person and third-person research methods when studying psychology
• Georg Elias Müller (1850-1934), who performed an early experiment on attitude which involved the sensory discrimination of weights and revealed how anticipation can affect this discrimination

Key Terms to Know

To understand how the experimental method works, it is important to know some key terms.

Dependent Variable

The dependent variable is the effect that the experimenter is measuring. If a researcher was investigating how sleep influences test scores, for example, the test scores would be the dependent variable.

Independent Variable

The independent variable is the variable that the experimenter manipulates. In the previous example, the amount of sleep an individual gets would be the independent variable.

A hypothesis is a tentative statement or a guess about the possible relationship between two or more variables. In looking at how sleep influences test scores, the researcher might hypothesize that people who get more sleep will perform better on a math test the following day. The purpose of the experiment, then, is to either support or reject this hypothesis.

Operational definitions are necessary when performing an experiment. When we say that something is an independent or dependent variable, we must have a very clear and specific definition of the meaning and scope of that variable.

Extraneous Variables

Extraneous variables are other variables that may also affect the outcome of an experiment. Types of extraneous variables include participant variables, situational variables, demand characteristics, and experimenter effects. In some cases, researchers can take steps to control for extraneous variables.

Demand Characteristics

Demand characteristics are subtle hints that indicate what an experimenter is hoping to find in a psychology experiment. This can sometimes cause participants to alter their behavior, which can affect the results of the experiment.

Intervening Variables

Intervening variables are factors that can affect the relationship between two other variables. 

Confounding Variables

Confounding variables are variables that can affect the dependent variable, but that experimenters cannot control for. Confounding variables can make it difficult to determine if the effect was due to changes in the independent variable or if the confounding variable may have played a role.

Psychologists, like other scientists, use the scientific method when conducting an experiment. The scientific method is a set of procedures and principles that guide how scientists develop research questions, collect data, and come to conclusions.

The five basic steps of the experimental process are:

• Identifying a problem to study
• Devising the research protocol
• Conducting the experiment
• Analyzing the data collected
• Sharing the findings (usually in writing or via presentation)

Most psychology students are expected to use the experimental method at some point in their academic careers. Learning how to conduct an experiment is important to understanding how psychologists prove and disprove theories in this field.

There are a few different types of experiments that researchers might use when studying psychology. Each has pros and cons depending on the participants being studied, the hypothesis, and the resources available to conduct the research.

Lab Experiments

Lab experiments are common in psychology because they allow experimenters more control over the variables. These experiments can also be easier for other researchers to replicate. The drawback of this research type is that what takes place in a lab is not always what takes place in the real world.

Field Experiments

Sometimes researchers opt to conduct their experiments in the field. For example, a social psychologist interested in researching prosocial behavior might have a person pretend to faint and observe how long it takes onlookers to respond.

This type of experiment can be a great way to see behavioral responses in realistic settings. But it is more difficult for researchers to control the many variables existing in these settings that could potentially influence the experiment's results.

Quasi-Experiments

While lab experiments are known as true experiments, researchers can also utilize a quasi-experiment. Quasi-experiments are often referred to as natural experiments because the researchers do not have true control over the independent variable.

A researcher looking at personality differences and birth order, for example, is not able to manipulate the independent variable in the situation (personality traits). Participants also cannot be randomly assigned because they naturally fall into pre-existing groups based on their birth order.

So why would a researcher use a quasi-experiment? This is a good choice in situations where scientists are interested in studying phenomena in natural, real-world settings. It's also beneficial if there are limits on research funds or time.

Field experiments can be either quasi-experiments or true experiments.

Examples of the Experimental Method in Use

The experimental method can provide insight into human thoughts and behaviors, Researchers use experiments to study many aspects of psychology.

A 2019 study investigated whether splitting attention between electronic devices and classroom lectures had an effect on college students' learning abilities. It found that dividing attention between these two mediums did not affect lecture comprehension. However, it did impact long-term retention of the lecture information, which affected students' exam performance.

An experiment used participants' eye movements and electroencephalogram (EEG) data to better understand cognitive processing differences between experts and novices. It found that experts had higher power in their theta brain waves than novices, suggesting that they also had a higher cognitive load.

A study looked at whether chatting online with a computer via a chatbot changed the positive effects of emotional disclosure often received when talking with an actual human. It found that the effects were the same in both cases.

One experimental study evaluated whether exercise timing impacts information recall. It found that engaging in exercise prior to performing a memory task helped improve participants' short-term memory abilities.

Sometimes researchers use the experimental method to get a bigger-picture view of psychological behaviors and impacts. For example, one 2018 study examined several lab experiments to learn more about the impact of various environmental factors on building occupant perceptions.

A 2020 study set out to determine the role that sensation-seeking plays in political violence. This research found that sensation-seeking individuals have a higher propensity for engaging in political violence. It also found that providing access to a more peaceful, yet still exciting political group helps reduce this effect.

While the experimental method can be a valuable tool for learning more about psychology and its impacts, it also comes with a few pitfalls.

Experiments may produce artificial results, which are difficult to apply to real-world situations. Similarly, researcher bias can impact the data collected. Results may not be able to be reproduced, meaning the results have low reliability .

Since humans are unpredictable and their behavior can be subjective, it can be hard to measure responses in an experiment. In addition, political pressure may alter the results. The subjects may not be a good representation of the population, or groups used may not be comparable.

And finally, since researchers are human too, results may be degraded due to human error.

What This Means For You

Every psychological research method has its pros and cons. The experimental method can help establish cause and effect, and it's also beneficial when research funds are limited or time is of the essence.

At the same time, it's essential to be aware of this method's pitfalls, such as how biases can affect the results or the potential for low reliability. Keeping these in mind can help you review and assess research studies more accurately, giving you a better idea of whether the results can be trusted or have limitations.

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Schweizer M, Braun B, Milstone A. Research methods in healthcare epidemiology and antimicrobial stewardship — quasi-experimental designs . Infect Control Hosp Epidemiol . 2016;37(10):1135-1140. doi:10.1017/ice.2016.117

Glass A, Kang M. Dividing attention in the classroom reduces exam performance . Educ Psychol . 2019;39(3):395-408. doi:10.1080/01443410.2018.1489046

Keskin M, Ooms K, Dogru AO, De Maeyer P. Exploring the cognitive load of expert and novice map users using EEG and eye tracking . ISPRS Int J Geo-Inf . 2020;9(7):429. doi:10.3390.ijgi9070429

Ho A, Hancock J, Miner A. Psychological, relational, and emotional effects of self-disclosure after conversations with a chatbot . J Commun . 2018;68(4):712-733. doi:10.1093/joc/jqy026

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Torresin S, Pernigotto G, Cappelletti F, Gasparella A. Combined effects of environmental factors on human perception and objective performance: A review of experimental laboratory works . Indoor Air . 2018;28(4):525-538. doi:10.1111/ina.12457

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By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

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The effect of perceived stress on depression in college students: The role of emotion regulation and positive psychological capital

1 Normal College, Shihezi University, Shihezi, China

2 Center of Application of Psychological Research, Shihezi University, Shihezi, China

Associated Data

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Introduction

College students have become a high prevalence group and vulnerable group of depression. The present study aims to explore the effect of perceived stress on depression in a sample of Chinese college students and proposes that both emotion regulation and positive psychological capital play a moderating role between the two, so as to provide rational intervention for the prevention of potential depression among college students.

In this study, 1,267 college students (46.4% female) from a university in western China were selected for the study using a whole-group convenience sampling method.

After controlling for gender, this study found that both cognitive reappraisal and positive psychological capital positively moderated the relationship between perceived stress and depression, and both significantly inhibited depression in high and low stress perceivers, and the inhibitory effect was more pronounced in high stress perceivers, but expression inhibition did not moderate the relationship between perceived stress and depression.

The results suggest that college students can be helped to cope with the negative effects of perceived stress on depression by increasing the frequency of their use of cognitive reappraisal strategies and encouraging the accumulation of positive psychological capital. This study provides theoretical and practical implications for rational interventions for depression among college students.

Depression is a widespread mood disorder accompanied by key features such as depressed mood, reduced volitional activity, and reduced verbal actions ( Smith and De Torres, 2014 ). It not only leads to impairment of social functions such as socialization and learning, but even triggers self-injurious and suicidal behaviors in individuals ( Li et al., 2015 ). Depression is extremely common among the college student population ( Liu et al., 2019 ). A Meta-analysis found a relatively high prevalence of depression among college students (31.38%) compared to the general population (5–6%) ( Wang et al., 2020 ; Zhang et al., 2020 ). Recent studies have found that the prevalence of depression among Chinese college students reached 37.0% during the Covid-19 epidemic ( Zhou et al., 2021 ). Notably, several studies have shown that depression causes severe impairments in cognitive and social functioning in some college students currently, such as decreased executive and memory functions, difficulty concentrating, and social avoidance ( Rock et al., 2014 ), and individuals with severe depression are prone to severe insomnia, self-injury, and suicide due to their extreme psychological distress ( Riemann et al., 2020 ). It is evident that current college students have become a high prevalence group of mental illness and a vulnerable group of mental health. Depression among college students deserves to be focused on because of its larger scope, deeper impact, and more serious outcome ( Yang and Chen, 2015 ). Therefore, this study attempts to investigate the intrinsic regulatory mechanisms affecting depression among college students and provide intervention for the reasonable prevention of potential depression among college students.

Literature review

Perceived stress and depression.

Perceived Stress is a stress perception that refers to an individual’s perception of the degree of stress caused by an external event, as well as the individual’s interpretation of the stressful event and perception of its objective existence as a variety of physical and mental tensions and discomforts ( Cohen et al., 1983 ; Yang and Huang, 2003 ). Stress is seen as an important risk factor for mental health, and high stress perceptions often lead to a range of mental health impairments ( O'Connor et al., 2021 ). The non-homeostatic model of stress suggests that the more stressful events an individual experiences and the longer they last, the more likely they are to perceive greater stress and the more likely they are to experience non-homeostatic states of mind and body, such as excessive emotional arousal ( Yan et al., 2010 ). Empirical studies have shown that the higher the level of stress perception, the more likely it is to cause depression ( Anyan and Hjemdal, 2016 ; Yang et al., 2020 ). Stressful events induce individuals’ perceived stress, especially in individuals who are more sensitive to stress. Perceptions of stress contribute to an increase in negative emotional experiences and a decrease in positive emotional experiences ( Li et al., 2021 ) and a decrease in life satisfaction and psychological well-being ( Fu et al., 2012 ), which in turn leads to depression ( Li et al., 2015 ). In addition, compared to men, women are more sensitive to stress perception, who are less resilient, have higher emotional reactions to stress, have a more difficult time recovering from negative states, and are therefore at higher risk for depression ( Liu et al., 2021 ). Therefore, it is necessary to explore the underlying psychological mechanisms between perceived stress and depression and then provide a scientific basis for the reasonable prevention of depression among college students.

Moderating role of emotion regulation

Emotion regulation refers to the efforts of individuals to keep their emotions in a balanced and stable state to adapt and meet the needs of the social environment in a certain situation ( Gross, 2015a ). It is one of the important predictors of mental health by providing individuals with information related to their environment and protecting them from maintaining emotional balance ( Khodami and Sheibani, 2020 ). The Emotion Regulation Process Model proposes that cognitive reappraisal and expression inhibition are two regulatory strategies that act on different emotion processing processes ( Gross, 2015b ). Several studies have found that greater use of cognitive reappraisal strategies implies a better state of mental health ( Yang et al., 2020 ) and frequent use of expression-inhibitory strategies leads to increased psychological symptoms and impaired social functioning ( Aldao et al., 2010 ; Lee et al., 2020 ). The interaction model of psychological resilience ( Masten, 2001 ; Masten and Red, 2002 ) suggests that risk factors affect individuals less when protective factors are present than when they are not, that protective factors confer immunity to stress/adversity (the degree of immunity to individuals may vary across protective factors), and that protective factors influence the role of stress/adversity factors to psychosocial development through regulatory mechanisms. Research suggests that on a social reality level, individuals who use cognitive reappraisal strategies are more likely to share emotional experiences with others, build intimate relationships, and have more social support ( Lu et al., 2019 ). Based on this, it is hypothesized that cognitive reappraisal acts as a buffer between perceived stress and depression in college students, and the interaction between protective factors (cognitive reappraisal) and risk factors (perceived stress) will reduce the possibility of adverse outcomes. When the frequency of cognitive reappraisal was low, the depression level of college students tended to increase significantly with the increase of perceived stress; when the frequency of cognitive reappraisal was high, the depression level of college students tended to increase slowly with the increase of perceived stress. In addition, cognitive reappraisal is a strategy to reduce negative emotional experiences with positive emotional connotations, whereas expression inhibition suppresses negative emotions, which remain ( Lu et al., 2019 ). According to Li (2012) “provide timely help” model, individual resource factors moderate the relationship between risk factors and social adaptation, buffer or weaken the adverse effects of risk factors, and the development disadvantage of those with high risk compared to those with low ecological risk is reflected more in the case of low individual resources than in the case of high individual resources. Expression inhibition as a maladaptive emotion regulation strategy has been shown to consume more cognitive resources than adaptive emotion regulation strategies, as evidenced by inducing stronger peripheral physiological responses and limbic system activation ( Yuan et al., 2014 ). Based on this, the present study hypothesized that the depression level of college students showed a significant upward trend with the increase of perceived stress when the frequency of expression inhibition use was high, and the depression level of college students decreased at a slower rate with the increase of perceived stress when the frequency of expression suppression use was low.

Moderating role of positive psychological capital

Positive psychology reawakens focus on the positive qualities and good living of human being. In contrast to traditional cognitive theories of depression that focus on negative factors, positive psychology suggests that depression is caused by a lack of positive resources ( Zhou et al., 2010 ). Positive psychological capital refers to a positive psychological state during an individual’s growth and development, including four core components of resiliency, optimism, hope, and self-efficacy ( Ye and Fang, 2015 ), and effectively promote healthy behaviors by helping individuals cope with challenging environments ( Cho et al., 2021 ). Also according to the interaction model of psychological resilience and the “provide timely help” model, psychological capital is a protective factor against depression in adolescents, and individuals with higher levels of psychological capital are able to use their positive abilities to cope with negative emotions, enhance their own protectiveness and adaptability to the outside world, and are less likely to experience emotional problems in risky stressful situations ( Li et al., 2014 ). Individuals with lower levels of psychological capital, on the other hand, are more susceptible to their own state and may not be able to adequately mobilize internal resources to cope with negative emotions when faced with more stress, and thus may be more prone to emotional problems in risky stressful situations ( Jeong and Jung, 2017 ; Turliuc and Candel, 2022 ). Based on this, it is hypothesized that positive psychological capital has a buffering effect on depression among college students. When the level of positive psychological capital is high, the depression level of college students tends to decrease significantly with the increase of perceived stress; when the level of psychological capital is low, the depression level of college students decreases slowly with the increase of perceived stress.

The current study

In order to understand the effects of emotion regulation and positive psychological capital on the relationship between perceived stress and depression, a group of college students was selected as subjects in this study. Based on the “non-stationary” model of stress, the interaction model of psychological resilience, and the “provide timely help” model, we investigated the effects of perceived stress on depression, and further explored the moderating effects of emotion regulation and positive psychological capital on the relationship between perceived stress and depression in college students.

This study hypothesized that cognitive reappraisal could moderate the relationship between perceived stress and depression among college students, and that high-frequency cognitive reappraisal reduced the association between stress perception and depression, while low-frequency cognitive reappraisal enhanced the association between stress perception and depression (Hypothesis 1); Expression inhibition moderates the relationship between perceived stress and depression in college students, with high frequency of expression inhibition enhancing the association between stress perception and depression, and low frequency of expression inhibition decreasing the association between stress perception and depression (Hypothesis 2); positive psychological capital moderates the relationship between stress perception and depression in college students, with high level of positive psychological capital decreasing the association between stress perception and depression, and low level of positive psychological capital enhancing the association between stress perception and depression (Hypothesis 3).

Materials and methods

Participants.

Using the whole group convenience sampling method, 1,312 questionnaires were distributed to all college students from freshman to senior students in a university in western China. After the questionnaires were returned, 45 invalid questionnaires were eliminated according to the criteria of invalid questionnaires if there were omissions or the same choice in multiple questions, and 1,267 valid questionnaires were obtained, with a valid return rate of 95.6%. Among them, 679 (53.6%) were male and 588 (46.4%) were female; 560 (44.2%) lived in rural areas and 707 (55.8%) lived in urban areas; 434 (34.3%) were only children and 833 (65.7%) were children with siblings; fathers’ education level: 208 (16.4%) were elementary school students and below, 540 (42.6%) were junior high school students, 297 (23.4%) were senior high school (or technical school) students, 214 (16.9%) were undergraduates (or junior college students) and 8 (0.6%) were graduate students and above; mothers’ education level: 352 (27.8%) were elementary school students and below, 468 (36.9%) were junior high school students, 279 (22.0%) were senior high school (or technical school) students, 162 (12.8%) were undergraduates (or junior college students), and 6 (0.5%) were graduate students and above. The study was approved by the Science and Technology Ethics Committee of the First Affiliated Hospital of Shihezi University School of Medicine (approval number: KJ2022-152-01), and all investigated college students gave their informed consent.

Measurements

Perceived stress scale.

The Chinese version of Perceived Stress Scale developed by Cohen et al. and revised by Yang and Huang (2003) was used, consisting of 14 items, including two facets, tension (e.g., “feeling tense and stressed”) and loss of control (feeling unable to control the important things in one’s life), which are used to detect the overall and prevalent stress in life. It indicates a degree of self-awareness. Participants rated each item on a 5-point likert scale ranging from 1 ( strongly disagree ) to 5 ( strongly agree ), with higher scores indicating greater perceived psychological stress. The scale has good reliability and validity, and the Cronbach’s alpha coefficient in this study was 0.71.

Emotion regulation questionnaire

The Chinese version of the Emotion Regulation Questionnaire, developed by Gross and revised by Wang et al. (2007) , was used to assess the frequency of emotion regulation among college students. It includes 10 items, divided into two dimensions: cognitive reappraisal and expression inhibition. Cognitive reappraisal is a strategy for shifting situationally evoked emotions before they arise (e.g., “I control my emotions by changing the way I think about the situation”), and expression inhibition is a strategy for individuals to inhibit the expression of emotions after they arise (e.g., “I control my emotions by not expressing them”) ( Ogbaselase et al., 2022 ). The 7-point likert scale was used ranging from 1 ( strongly disagree ) to 7 ( strongly agree ), with higher scores on the dimension indicating that the individual uses the strategy more frequently. The reliability of the scale was good. The Cronbach’s alpha coefficients for cognitive reappraisal and expression suppression in this study were 0.85 and 0.60, respectively, and the Cronbach’s coefficient for the total scale was 0.80.

Positive psychological capital questionnaire

The Positive Psychological Capital Questionnaire developed by Zhang G et al. (2010) was used to assess the level of positive psychological capital development among college students (e.g., “When the situation is uncertain, I always expect a good outcome”). It includes 26 items divided into four facets: self-efficacy, resilience, hope, and optimism. The 7-point likert scale was used from 1 ( not at all likely ) to 7 ( highly likely ), and the higher the scores, the better the psychological capital development of the individual. The reliability of the questionnaire was good, and the Cronbach’s alpha coefficient was 0.93 in this study.

The Center for Epidemiological Studies Depression Scale

The Center for Epidemiological Studies Depression Scale developed by Radloff and revised by Zhang J et al. (2010) , was used to examine individuals’ depressed mood status (e.g., “I feel that I cannot get rid of this misery even with the help of my lover or friends”) over a 1-week period. It includes 20 items divided into four facets: depressed mood, somatic symptoms, positive mood, and interpersonal relationship. A 4-point likert scale was used from 0 ( occasionally or not, less than one day ) to 3 ( most of the time, 5–7 days/week ), with higher scores indicating more severe depression. The reliability of the scale was good, and the Cronbach’s alpha coefficient in this study was 0.88.

College students at a university in western China were used as the subjects and the investigators were well-trained graduate students. Informed consent was signed prior to administration, a group instruction was read out explaining the purpose of the study and promising to keep the subjects’ responses confidential, and independent responses and silence were emphasized during the administration of the test. The administration process took approximately 20 min, and all questionnaires were collected on site.

Data analysis

Data were analyzed using SPSS 21.0 software, and Pearson product difference correlation analysis was used to predict the correlation of key variables: perceived stress, emotion regulation, positive psychological capital, and depression. RStudio software (R version 3.3.1) was used to apply the process and combine the selected point method and Johnson-Neyman method to test for moderating and simple effects.

Common method bias test

In this study, common method bias was controlled by measures such as anonymous measurement and partial item reversal ( Zhou and Long, 2004 ), but the problem of common method bias may still exist, so the Harman’s one-way method was used to test for common method bias. Exploratory factor analysis of perceived stress, cognitive reappraisal, expression inhibition，positive psychological capital, and depression showed that unrotated factor analysis indicated 12 common factors with eigenvalues greater than 1. The first factor explained only 26.80% of the overall variance, well below the threshold of 40%, indicating that the study did not have common method bias problems of a more serious nature.

Descriptives and correlations

To understand gender differences in perceived stress, cognitive reappraisal, expressive inhibition, positive psychological capital, and depression among college students, independent samples t-tests were conducted to examine perceived stress, cognitive reappraisal, expressive inhibition, positive psychological capital, and depression among college students. The results showed that there were significant differences in perceived stress between male and female students (t = −2.42, p  < 0.05, Cohen’s d = −0.15), and male students’ perceived stress (M = 2.68, SD = 0.46) was significantly lower than that of female students (M = 2.74, SD = 0.44); male and female students differed significantly in expression inhibition (t = 6.91, p  < 0.001, Cohen’s d = 0.39), with male students expressing significantly more inhibition (M = 4.60, SD = 0.95) than female students (M = 4.24, SD = 0.90); male and female students differed significantly in positive psychological capital (t = 2.52, p < 0.05, Cohen’s d = 0.14), with male students having significantly higher positive psychological capital (M = 4.99, SD = 0.82) than female students (M = 4.88, SD = 0.76); however, the differences in cognitive reappraisal and depression between male and female students were not significant ( p  > 0.05).

The results of descriptive statistics and correlation matrix analysis for each variable are shown in Table 1 . perceived stress, cognitive reappraisal, expression inhibition, positive psychological capital, and depression were significantly correlated with each other, except for expression inhibition, which was not correlated with perceived stress and depression. In addition, gender was significantly and positively correlated with perceived stress, and negatively correlated with expression inhibition and positive psychological capital, while other additional variables (including family residence and parental education level) were not correlated with the predictor variables. Based on this, gender was used as a control variable in the subsequent test analysis.

Descriptive analysis and correlation coefficients of the study variables.

Gender was a dummy variable coded as 1 = male and 2 = female.

*The correlation is significant at the 0.05 level.

**The correlation is significant at the 0.01 level.

Analysis of the moderating effects of emotion regulation and positive psychological capital

Prior to further analysis, all predictor variables were standardized. Given that the moderating variables were all continuous, this study used RStudio to apply process (Model 1) to analyze the standardized moderating effects. Results showed that the model for the moderating effect of cognitive reappraisal between perceived stress and depression was significant F (4,1,262) = 220.40, p < 0.001, with a model explained R 2 of 0.41. After controlling for the additional variable gender, perceived stress significantly predicted depression positively (β = 0.53, t = 23.44, p < 0.001), with a confidence interval of [0.49, 0.58]. Cognitive reappraisal significantly negatively predicted depression (β = −0.21, t = −9.23, p < 0.01) with a confidence interval of [−0.25, −0.17]; and the interaction term for perceived stress and cognitive reappraisal was significant (β = −0.12, t = −6.31, p < 0.001), with a confidence interval of [−0.15, −0.08], indicating a significant moderating effect of cognitive reappraisal between perceived stress and depression; however, the moderating effect of expression inhibition between perceived stress and depression was significant F (4,1,262) = 176.23, p < 0.001, with a model explained R 2 of 0.36. After controlling for the additional variable gender, perceived stress was a significant positive predictor of depression (β = 0.60, t = 26.32, p < 0.001) with a confidence interval of [0.55, 0.64]; expression inhibition failed to predict depression significantly (β = −0.01, t = −0.47, p > 0.05) with a confidence interval of [−0.06, 0.03]; and the interaction term between perceived stress and expression inhibition was also not significant (β = −0.04, t = −1.93, p > 0.05) with a confidence interval of [−0.08, 0.00], indicating that the moderating effect of expression inhibition between perceived stress and depression was not significant. In addition, the model for the moderating effect of positive psychological capital between perceived stress and depression was significant, F (4,1,262) = 315.91, p < 0.001, with a model explanatory R 2 of 0.50. After controlling for the additional variable gender, perceived stress significantly positively predicted depression (β = 0.34, t = 13.51, p < 0.001), with a confidence interval of [0.29, 0.39], positive psychological capital significantly negatively predicted depression (β = −0.43, t = −17.11, p < 0.001), with a confidence interval of [−0.48, −0.38], and the interaction term between perceived stress and positive psychological capital was significant (β = −0.13, t = −8.21, p < 0.001), with a confidence interval of [−0.16, −0.10], indicating a significant moderating effect of positive psychological capital between perceived stress and depression.

The selected point method and Johnson-Neyman method are commonly used to conduct simple slope tests. The Johnson-Neyman method can overcome the limitation that the selected-point method can only test one value of the moderating variable at a time by fixing the t-value as the critical value and finding the range of values of the moderating variable when the simple slope is significantly non-zero ( Fang et al., 2015 ). In order to clarify the moderating effects of cognitive reappraisal and positive psychological capital on perceived stress and depression among college students, this study used both methods to conduct simple slope tests simultaneously. For cognitive reappraisal, the results of the selected-point method analysis revealed that cognitive reappraisal significantly and positively predicted depression in both the high stress perception group (M + 1SD, i.e., one standard deviation above the mean) and the low stress perception group (M-1SD, i.e., one standard deviation below the mean) ( β high perceived stress group  = 0.42, t high perceived stress group  = 14.20, p < 0 .001; β low perceived stress group  = 0.65, t low perceived stress group  = 22.28, p < 0.001) (see Figure 1A ). At the same time, the Johnson-Neyman method analysis revealed that the simple slope was significantly non-zero over the range of values of cognitive reappraisal [−4.56, 2.31] (after standardization) (see Figure 1B ). The higher the level of perceived stress, the stronger the effect of cognitive reappraisal in negatively predicting depression, i.e., the value of the inhibitory effect of cognitive reappraisal on depression gradually increases as perceived stress rises.

The moderating role of cognitive reappraisal in the relationship between perceived stress depression (A) and change of its simple slope (B) .

For the moderating effect of positive psychological capital, the results of the selected-point method analysis found that positive psychological capital significantly and positively predicted depression in both the high stress perception group (M + 1SD) and the low stress perception group (M-1SD) ( β high perceived stress group  = 0.21, t high perceived stress group  = 7.23, p < 0.001; β low perceived stress group  = 0.47, t low perceived stress group  = 15.67, p < 0.001) (see Figure 2A ). Meanwhile, the Johnson-Neyman method analysis found that the confidence interval of the simple slope did not contain 0 within the range of values of positive psychological capital [−4.21, 2.04] (after standardization) (see Figure 2B ), and the simple slope was significant. Also, in this range, the higher the level of perceived stress, the stronger the effect of positive psychological capital in negatively predicting depression, i.e., as perceived stress rises, the value of the inhibitory effect of positive psychological capital on depression gradually increases.

The moderating role of positive psychological capital in the relationship between perceived stress and depression (A) and change of its simple slope (B) .

The relationship between perceived stress and depression among college students

The present study found that gender did not differ in depression levels among college students, which is not consistent with the results of previous studies ( Liu et al., 2021 ). Existing studies have generally concluded that there are gender differences in depression, and that the differences in depression by gender are reflected in many aspects such as influencing factors, onset symptoms, age of onset, and incidence of depression ( Ren et al., 2019 ). However, a recent study found cross-gender consistency between individual genders in network structure, network connection strength, and core symptoms based on the network analysis level, possibly implying mutual independence between depression networks and total depression scores ( Huang et al., 2022 ). This explains the possibility that gender does not differ in depression levels among college students, but follow-up studies are still needed to verify this.

Previous studies have shown that individuals who are more sensitive to perceived stress have higher levels of depression ( Zandifar et al., 2020 ). The present study found that perceived stress positively influenced depression among college students, suggesting that perceived stress is an important predictor of depression among college students. Thus, the result of this study is consistent with previous studies. Study the reasons, on the one hand, physiological evidence of neurohumoral mechanisms suggests that psychological stress activates the thalamic-pituitary–adrenal axis, releasing major neurotransmitters of stress, such as adrenaline, while inducing a series of peripheral responses to negative emotions (i.e., anger and fear). In contrast, the emergency state prompts the release of central adrenaline, which stimulates the main neurotransmitter of depressed mood, pentraxin, and ultimately leads to the central production of depressed mood ( Zheng et al., 2015 ). This also confirms the non-homeostatic model of stress. On the other hand, the quality-stress interaction model suggests that the properties of the event itself and psychological susceptibility are the determinants of the emergence of depression and anxiety after a negative life event, where psychological susceptibility emphasizes that the specific environment is more likely to activate the individual’s susceptibility. The psychological susceptibility emphasizes that a particular environment is more likely to activate the susceptible qualities of an individual ( Rosenthal, 1963 ). According to this theory, the stronger the individual’s perception of stress, the more likely he or she is to perceive or notice threatening stimuli in the external environment, which causes psychological tension and discomfort and contributes to a recurrent cycle of negative emotions, leading to higher levels of depression ( Yuan, 2016 ). Both evidence from neurohumoral mechanisms and theoretical interpretations of environmental formation suggest that perceived stress is a booster for predicting psychological problems such as depression in individuals ( Yang et al., 2020 ). Therefore, it is important to minimize the impact of stress on depression in college students and to improve their mental health.

Moderating effects of emotion regulation and positive psychological capital between perceived stress and depression among college students

In this study, we found that both cognitive reappraisal and positive psychological capital positively moderated the relationship between perceived stress and depression among college students. The positive predictive effect of cognitive reappraisal and positive psychological capital on depression was stronger when the level of perceived stress was higher, i.e., the inhibitory effect of cognitive reappraisal and positive psychological capital on depression was more obvious as the level of perceived stress increased. This may be due to the fact that cognitive reappraisal and positive psychological capital, as a protective factor, can provide individuals with useful help and support to mitigate the effects of perceived stress on depression, enhance the ability to adapt to high-pressure environments, and resist the generation of negative emotions such as depression. This suggests that cultivating and improving cognitive reappraisal strategies and positive psychological capital can be more effective in reducing the risk of depression among high perceived stress college students and also help to reduce the likelihood of depression among low perceived stress college students.

Notably, the present study found that expressive inhibition failed to moderate the relationship between perceived stress and depression in college students. Previous studies have found that expression inhibition inhibits emotions at the behavioral level and does not promote sympathetic nervous system activity to mobilize the potential of multiple organs of the individual to adapt to environmental changes ( Huang et al., 2021 ). It has been shown that cognitive reappraisal occurs early in the process of emotion generation and intervenes before the tendency to respond to emotions is fully developed, and is effective in changing subsequent emotional trajectories, compared to expression inhibition, which is effective in controlling and reducing the expression of emotional behaviors but not the frequency of emotional experiences ( Gross and John, 2003 ). Thus individuals who exhibit depressive symptoms are more likely to overuse expression inhibition to cope with negative events, but good use of cognitive reappraisal can help them mitigate and shorten the cycles, thereby reducing vulnerability to depressive impairment ( Balderas et al., 2021 ). The results of this study further illustrate the effectiveness and adaptability of cognitive reappraisal strategies in regulating stress perceptions and depression in college students.

In addition, this study found that cognitive reappraisal and positive psychological capital had similar effects, but the inhibitory effects of cognitive reappraisal and positive psychological capital on perceived stress and depression differed in two ways. On the one hand, the simple slope analysis of the selected point method shows that the slope of cognitive reappraisal is greater, more effective and more efficient than that of positive psychological capital in suppressing depression in college students. On the other hand, the simple slope of the Johnson-Neyman method shows that the effect of cognitive reappraisal on depression is better than that of positive psychological capital, and the effect can be achieved from −4.56 standard scores of perceived stress, indicating that college students with low perceived stress below zero standard scores can be protected by cognitive reappraisal. The importance of cognitive reappraisal for college students’ mental health is slightly better than that of positive psychological capital. This may be due to the fact that cognitive reappraisal can improve the effect of perceived stress on depression by changing the poor perception of the cause of emotional events and using positive thinking to explain the negative emotional events they face, which can lead to more positive emotional experiences and increase happiness and life satisfaction, and then further promote the improvement of positive psychological capital on this basis.

Implications, limitations, and future directions

This study innovatively used both the selected point method and Johnson-Neyman method to test the simple slope, and more clearly verified the predictive role of perceived stress on college students’ depression and the buffering role of emotion regulation and positive psychological capital in between, which has some implications for colleges to pay attention to students’ mental health and develop intervention programs. First, since perceived stress can positively predict depression among college students, society and colleges should pay attention to reducing college students’ stress and improving their ability to cope with stress, so as to reduce their risk of depression. Secondly, cognitive reappraisal and positive psychological capital can effectively reduce the risk of depression in high perceived stress. Therefore, mental health education in colleges and universities should focus on cultivating and enhancing students’ ability to use adaptive emotion regulation strategies and encouraging and guiding the accumulation of positive psychological capital in order to effectively reduce the risk of depression in high perceived stress college students and prevent the possibility of depression in low perceived stress college students. Finally, cognitive reappraisal is more effective in inhibiting high perceived stress college students, so more attention should be paid to cultivating college students’ ability to use cognitive reappraisal strategies to help them have more positive emotions to resist stress risks in various stressful situations.

There are two shortcomings in this study: on the one hand, considering that the current sample was taken from a group of college students in a western university, the sampling range is slightly narrow, and the generalizability of the results needs to be tested. Future studies can be conducted on a nationwide basis with a large sample. On the other hand, the data in the current study are cross-sectional data, and it is not possible to determine the causality of each variable in a strict sense. Future studies could combine cross-lagged designs and experimental studies to investigate the causal mechanisms between the two.

The present study found that both cognitive reappraisal and positive psychological capital positively moderated the relationship between perceived stress and depression, and both significantly inhibited depression in high and low stress perceivers, and the inhibitory effect was more pronounced in high stress perceivers, but expression inhibition could not moderate the relationship between perceived stress and depression.

Data availability statement

Ethics statement.

The studies involving human participants were reviewed and approved by Science and Technology Ethics Committee of the First Affiliated Hospital of Shihezi University School of Medicine. The patients/participants provided their written informed consent to participate in this study.

Author contributions

YL and HY designed the experiment, collected data, prepared the manuscript, and made data analysis. YS corrected the whole language of the manuscript and made final approval. CM gave technique supports and valuable suggestions in experiment designing. All authors contributed to the article and approved the submitted version.

This research was supported by the Shihezi University Graduate Education Teaching Reform Research Project of China (2021Y-JGSJ11).

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Ethical Issues in Student Research

James, a graduate student in psychology, is teaching an undergraduate experimental psychology class, wants his students to conduct their own research projects as part of the coursework. Usually, research that is not going to be published and is solely for educational purposes does not need approval from the institutional review board. However, one group wants to student sex differences in depression by having classmates fill out questionnaires. Does this research topic fall into the same category? This case looks at issues of research involving student participants.

James Bowers is an advanced graduate student in psychology. As part of his graduate training he is teaching an undergraduate class in experimental psychology under the supervision of Dr. Holden. James believes that the best way for his students to learn the principles of experimental psychology is to have the students conduct their own research projects, a practice which has been common in other experimental psychology classes. He plans to have the students design and conduct the research projects using other class members as research participants. The projects will be used for educational purposes only, meaning that the projects will not be published or presented outside of class. According to the regulations of his university’s IRB, research conducted for educational purposes that does not contribute to generalizable knowledge is typically exempt from review.

• Should the purposes of research studies (i.e. whether they are conducted for educational purposes or meant to be published in a journal) have an impact on whether or not they are submitted for review? Why or why not?
• What other factors should impact whether research studies are submitted for review?

James consults with senior graduate students in his program who have previously taught the experimental psychology course. They tell James that research conducted for educational purposes does not require review by the IRB, and that they did not submit their students’ projects when they taught the class. Taking their advice, James decides not to submit the research projects to the IRB. James allows his students to generate their own ideas for their research projects. Most groups decide to conduct research on topics in cognitive psychology that pose little or no harm to participants. One group, however, decides to study sex differences in depression by having classmates fill out questionnaires.

• Would asking questions about depressive symptoms put research participants at risk? How so?
• If James approves this research project, should he submit it to the IRB?
• What other ethical issues may arise from conducting this research?
• Should James allow the students to study depression?

Given his own interest in clinical psychology, James decides that his students should be given the opportunity to conduct research on topics in clinical psychology and permits them to conduct the study on depression. Furthermore, he believes that asking students about their symptoms of depression will not put them at risk since they will merely be reporting on how they already feel.

James ensures that the data is collected anonymously and that the students’ are aware that there will be no penalty for not participating in the research. All the students participate. While James is helping his students code and analyze the data, he notices that two students have reported a large number of depressive symptoms, including hopelessness, thoughts of suicide, sleeplessness, problems concentrating, and irritability.

• Is it ethical to ask about psychopathology without intending to treat it? If so, under what circumstances?
• What should James do about the two students who anonymously reported depressive symptoms?

James decides against trying to identify the two students. Instead, he mentions to the entire class that he is concerned that several students may be suffering from depression. In an attempt to encourage the two students to seek help, he also mentions that whoever reported more than four symptoms of depression should contact the university behavioral health center.

• Was it appropriate for James to mention his concerns to the class?
• If so, should he have done it differently? How so?
• Do the dual roles of teacher and researcher present conflicting responsibilities for James? If so, what are the conflicting responsibilities and how should they be resolved?

Like most institutions of higher learning, James Bower’s university holds that research done only for educational purposes does not come directly under the purview of the IRB.  However, many such institutions require instructors to submit a statement to the IRB indicating the sorts of research that students will be undertaking.  Although individual protocols are not submitted, this enables the IRB to provide cautionary advice about potentially problematic kinds of research that students might wish to undertake.

As this case illustrates, it is possible that particular research projects undertaken only for educational purposes can nevertheless raise unanticipated, serious problems.  IRBs are designed to protect the rights and welfare of human participants.  However, the protection to which participants are entitled is not confined only to those areas that come directly under the purview of an IRB.  What justification, then, can be given for not requiring research done only for educational purposes to be reviewed by an IRB?  First, administratively, requiring every student to submit a protocol would be very time consuming and require a substantial increase in IRB staffing.  Second, given the relative shortness of the standard semester, it might make it much more difficult for students to complete their research projects.  Third, there may be an assumption that instructors will adequately supervise the research projects undertaken by students and not permit them to place participants at more than minimal risk of harm.  So, we might be tempted to say, some sort of procedural compromise is reasonable.

Nevertheless, this should not come at the expense of protecting human participants in research, whether or not this is undertaken for educational purposes only.  Especially since the researchers are inexperienced undergraduates who are just “learning the ropes” in research, careful monitoring of this research is important. 

In this case, the instructor is a graduate student, who himself seems to be relatively inexperienced. It is disturbing that, although James is teaching under the supervision of Dr. Holden, there is no evidence that this aspect of his teaching has received any supervision.  In fact, it does not seem to have occurred to James that he could consult with Dr. Holden about what sorts of research projects by his students would be acceptable.  Why would James talk only with his fellow graduate students?  Something seems seriously amiss here, and perhaps in the department generally, as other graduate students seem to have proceeded unsupervised as well.

The fact that James does not anticipate the risks posed by his students’s depression survey indicates either his lack of experience or indifference on his part.  What would Dr. Holden have advised?  Had he been consulted, he might well have told James that he should not allow this sort of survey to be conducted, at least not without IRB review.  A worry is that Dr. Holden might actually share the attitude of James’s fellow graduate students — if the research falls outside the purview of the IRB, don’t worry about it.

Meanwhile, the survey is conducted by the undergraduate students, presumably unaware that further responsibilities may fall on their shoulders (and James’s) once they learn the results.  How to proceed once they learn that there may be two students who could use professional help with their depression is a difficult issue.  In an effort to preserve anonymity, James reports to the entire class that several students may be suffering from depression.  “Which ones?” the students might ask.  “We cannot tell you directly,” James would reply.  “But if you reported more than four symptoms of depression, you should contact the university behavioral health center.”  How are the students to determine how many symptoms of depression they reported?  Was the survey so direct?  Did it label the symptoms for the students?  Is it likely that only two students will think that they have identified four or more symptoms?  And will it be the right two students?

Unfortunately, James probably has no experience dealing with situations like this, or even with thinking about them.  One of the functions of an IRB is to help researchers anticipate such problems and settle on a good procedure for dealing with them should they arise.  James has deprived himself of all access to this sort of help by failing to communicate with either his supervisor, Dr. Holden, or the IRB.

However, the fact is that the survey placed undergraduate students at risk of harm.  Consider this as a guiding principle: Even if you are not seeking to contribute to generalizable knowledge in your research, you still need to worry about whether your research places anyone at risk.  Saying that risks to participants matter only when generalizable knowledge is sought makes no moral sense.  So, risks matter even if they do not fall under the direct purview of an IRB.  This seems to imply that Dr. Holden has a responsible role to play in this, but chose not to accept it, negligently ignored it, or was somehow denied the opportunity to assume it. 

At the very least, James should have been informed at the outset by Dr. Holden that he should be given the opportunity to review the sorts of research projects proposed by students.  However, a conscientious IRB would also do its best to make all teachers, professors and graduate students alike, aware of its willingness (and desire) to address questions regarding the protection of human participants in any research involving the institution it is serving.

This case examines ethical issues involved in conducting student research, a practice common in undergraduate experimental psychology classes. Specifically, it considers the circumstances under which student research is exempt from review by an institutional review board (IRB) and suggests the importance of incorporating research ethics training into experimental psychology class curricula. This case also examines broader issues in conducting research, and is an example of how poor planning at early stages of research development can lead to complex and potentially risky circumstances. James, the main character in this case, faces increasingly difficult ethical choices that might have been avoided if he had taken greater care in assessing the risks of his students’ research project and submitted their proposal to the IRB for review.

The case begins with James deciding whether he must submit his students’ research proposals for review by his university’s IRB. James considers whether his students’ research, which will be conducted for in-class, an educational purpose only, is exempt from review. Although the National Research Act, Public Law 93-348, states that the generalizability of the knowledge gained from a research study should be considered when making decisions regarding exemption from review, it also states that the potential for harm must be considered. Studies that do not contribute to generalizable knowledge are only exempt from review if they pose no harm to their participants. James is making his decision about whether his students’ projects will require review before he knows enough about them to make such a decision. James must know the nature of the studies before he can make an informed decision whether or not they should be submitted for review.

James consults with more experienced graduate students when deciding whether or not to submit his students’ research projects. Although the input of one’s peers can be invaluable in making ethical decisions, they can also be a source of bias since one’s peers share a common perspective. James and his fellow graduate students may share the perspective that submitting in-class projects for review is far too time consuming to be practical. Including other perspectives into the discussion, including those of potential participants, would assist in predicting risks to participants that may otherwise be difficult to imagine. Submitting research proposals to an IRB is an efficient and effective way to gain diverse perspectives, because the typical IRB includes representatives from outside the scientific community as well as research scientists from a variety of disciplines.

James’ students generate a variety of research project ideas, and most pose no harm to research participants. However, one project involves the assessment of depressive symptoms, and it is less clear what risks may be involved. It is at this point, when James knows the exact nature of the proposed research studies, that he is able to consider whether or not he should submit the proposals for review by his university’s IRB. The studies that clearly pose no harm to research participants would be exempt from review, according to the regulations of his IRB. However, the project involving the assessment of depressive symptoms should be submitted because James is probably unprepared to assess the potential harm of the study. The IRB would most likely be better prepared to assess accurately the risk involved. It is possible that having participants reflect on their depressive symptoms could increase their severity, and because the research is being conducted by students and on students from the same class, the possibility arises that students could learn about each other’s depressive symptoms. Thus, potential risks include the negative effects of asking about psychopathology and the loss of privacy and subsequent damage to the depressed students’ reputations.

Even if asking about depressive symptoms does not harm research participants directly, having this information could increase James’ degree of responsibility for the well-being of his participants and students. James never considers what his responsibility toward his students would be if he learned that several of them were depressed. His role as teacher requires him to consider the well-being of each individual student, and although his role as researcher requires him to consider the safety of his research participants, it also requires him to maintain confidentiality. James faces this ethical dilemma when he learns that several of his students are endorsing symptoms of hopelessness, thoughts of suicide, sleeplessness, problems concentrating, and irritability. Because James failed to prepare for this situation, he is left with imperfect response options. He is unable to identify the depressed students directly, and he feels that saying nothing to the students would be irresponsible. James decides that his best option is to announce to the class that several students may have depression, and he recommends that these students visit the student counseling center.

Because James did not consider the ethical implications of his students’ research projects, and because he did not submit the depression study for review, he faces a series of increasingly difficult ethical dilemmas. James should have submitted the one questionable study for review because he was incapable of assessing the risks and responsibilities involved. In addition, James should have involved his students in discussions about research ethics and the IRB since these are central aspects of conducting research in psychology. This may have helped James to avoid the ethical dilemmas that were to come. However, once he knew about his students depressive symptoms, he was compelled both as a teacher and researcher to take action. Furthermore, once James knew about his students’ depressive symptoms, the harm involved in potentially breaking confidentially was probably less than the harm involved in allowing potentially-depressed students to go without help. Although many research studies assess psychopathology without including treatment, they are typically designed in such a way that research participants are informed of their diagnoses and provided with treatment referrals. James should never have allowed the study to have been conducted as it was, and submitting the study in question to his IRB probably would have prevented him from doing so.

National Research Act, Pub. L. No. 93-348. (1974).

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This material is based upon work supported by the National Science Foundation under Award No. 2055332. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the National Science Foundation.

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