Running head: DEVELOPMENT OF ANXIETY & DEPRESSION 1

Understanding the development of anxiety and depression in young adults suffering from an

ocular injury

Maggie E. Odom

Winthrop University
DEVELOPMENT OF ANXIETY & DEPRESSION 2

Methods and Procedures

The purpose of this study is to observe the development of anxiety and depression in

young adults who suffered from an eye injury that resulted in ocular surgery.

Research Design

This study is a quantitative non-experimental research design. Patients will do two sets of

questionnaires. The first set of surveys will be given to the patient before he/she undergoes

surgery. The second set will be given to the patient 4 weeks post operational. Both surveys will

be given via paper. The data collection will come from Georgia Regents University’s (GRU)

ocular patient’s who suffered from an eye injury in the past year that lead to ocular surgery.

The study will use the Hospital Anxiety and Depression Scale (HADS). The survey

consists of 14 different scales, seven of the scales relates to depression and the other seven

relates to anxiety. Patients will not be given a time limit to finish the survey; however, researcher

will suggest the quicker the survey is finished the more accurate the results. Once all the 14

scales are answered, the depression and anxiety scales should be tallied separately. The higher

the total score the more extreme the depression and anxiety.

The other survey used for the study is the Beck Depression Inventory (BDI). The survey

consists of 21 different scales. Each scale is answered with a number ranging from 0-3. Once all

21 scales are answered, the numbers should be added together for a total score. The higher the

total score, the more severe the depression.

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Participants & Recruitment

Data will be collected from patients of the Eye Care Center of Georgia Regent University

in the spring of 2017 via paper survey. The surveys will ask questions concerning the mental

stability and health of patient’s following an ocular injury that resulted in ocular surgery.

The following states the inclusionary and exclusionary criteria for this study.

Inclusion:

1. Patients of Georgia Regent University eye center from the year of 2015 and 2016.

2. Patients who are 18-25 years of age.

3. Patients who agree to complete both surveys.

4. Patients must have suffered from an ocular injury within the last year.

Exclusion:

1. Patients who are not patients of Georgia Regents University Eye Center.

2. Patients who were not patients of Georgia Regents University Eye Center from

the year of 2015 and 2016.

3. Patients who are not at least 18 years of age.

4. Patients who are exceed 25 years of age.

5. Patients who are not willing to take both surveys.

6. Patients who have not suffered from an ocular injury.

7. Patients who have not suffered from an ocular injury in the past year.

Screening for the inclusionary criteria will be completed once the patient gives their

consent. Once the patient gives consent, they will be asked their age and if they have suffered an

ocular injury within the last year. If the patients do not meet both requirements, they will be

excluded from the study. Then patients will be asked their time span in which they suffered their
DEVELOPMENT OF ANXIETY & DEPRESSION 4

ocular injury. If the year of date does not match with the year of 2015 and 2016, they will be

excluded from the survey. The final question asked the patients were they patients of Georgia

Regents University. If they are or were not a patient of Georgia Regents University, they will be

excluded from the survey as well.

Participants for this study will be recruited by Ophthalmology Residency of the Georgia

Regents University Hospital. Each residency will be informed of the purpose and intent of the

study. Each residency is required to make note all the patients that meet the requirements of the

study on their file, so the questionnaires can be mailed to the participants. An informational

packet will be sent to all the patients noted by the residents. The informational packet will

include a consent form, both surveys, and a letter explain the data collected is anonymous and

used strictly for research.

Instrumentation

Two different surveys of thirty-two questions in total will be given to Eye Care Center

patients of GRU before and after they have eye surgery that was caused by an ocular injury. The

two surveys (HADS & BDI) are being used to evaluate the mental health of patient’s ranging

from the age of 18-25 following a ocular injury. The first set of surveys will give the patient’s

initial mental health state before undergoing surgery. The second set of surveys will show

whether the patient’s mental health stability decrease or increased following post-op.

Survey: Hospital Anxiety and Depression Scale was created 1983 by Zigmond and

Snaith. The scale is designed to assess anxiety and depression symptoms in medical patients,

with emphasis on reducing the impact of physical illness on the total score. (Zigmond & Snaith,

1983) The scale is composed of statements such as: “I feel tense or ‘wound up’” “I still enjoy the
DEVELOPMENT OF ANXIETY & DEPRESSION 5

things I used to enjoy,” “I get sudden feelings of panic.” Responses to each item are answered on

a scale and range from a 0 (not at all) to a 3 (often). Responses of items will be totaled to find the

result of the survey. The score of the survey can range from 0 to 21. Zero to seven score will be

the more normal results. Eight to ten is the borderline abnormal findings and the eleven to

twenty-one is the abnormal cases.

Survey: Becker Depression Inventory is a 21-item, self-report rating inventory that

measures characteristic attitudes and symptoms of depression (Beck, et al., 1961). The scale is

composed of statements such as: “I do not feel sad.” “I feel sad.” “I am sad all the and I can’t

snap out of it,” “I am so sad and unhappy that I can’t stand it.” Each scale is ranked from 0 to 3,

zero being not applicable and three being extreme. Once all 21 scales are answered, they are

summed up to determine the level of depression. Totals ranging from 1-10 are the normal and

the totals with sums over 40 is extreme depression.

Procedures

Each participant signed the consent form and agreed to take part in the study. All

participants that agreed to be apart of the study participated. The consent form included a waiver

explaining that they were participants of the study. Demographic questions were included in the

survey set to allow researchers the authority to differentiate participant’s age, gender, and type of

ocular injury. Both sets of surveys emphasized the anonymity of the study as well as the data

collected purpose being only for research. The first survey set should be filled out and

resubmitted before the participant had surgery. Researchers waited about two weeks for surveys

filled out by participants.

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The second survey set was sent out about a month following the participants ocular

surgery. Participants who failed to submit the first survey set was excluded from the study. For

the participants who did submit their first survey set, the second survey set was sent out. An

additional consent form was included in the second survey set. Participants were given

approximately 2 weeks to resubmit their second survey set.

Data collection began the Spring 2017 semester. The completed sets of surveys were

organized by age, gender, ocular injury type, and mental health state to argue the hypothesis of

the study. All responses were analyzed by GRU psychology graduate students.

Confidentiality of the patients who volunteered to participate in the study was protected.

Patients did not report any name on either survey sets. The researchers and psychology graduate

students were the only individuals to have access to the data submitted by patients. All completed

surveys were stored in a protected undisclosed location.

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References

Anna F. Stern; The Hospital Anxiety and Depression Scale, Occupational Medicine, Volume 64,

Issue 5, 1 July 2014, Pages 393–394,

https://doi.org/10.1093/occmed/kqu024

Beck, A.T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961) An inventory for

measuring depression. Archives of General Psychiatry, 4, 561-571.