Gender-based determinants of psychological distress among emerging adult students in coastal Karnataka: A cross-sectional study

Background Psychological distress is one of the major public health challenges during the emerging adulthood period, which is a developmental stage characterized by major life transformations and instability. Emerging adults are more vulnerable to psychological distress as they frequently deal with different pressures about relationships, work, education and identity exploration. The rising prevalence of psychological distress can impair physical health and wellbeing along with the initiation of harmful behaviors such as substance use. Aim The study aims to explore the prevalence and associated factors of psychological distress among emerging adult students, comparing female and male participants. Method Data were collected from 957 emerging adults in 12 institutions under Mangalore University in the Udupi district of Karnataka, India, pursuing bachelor's degrees. Along with the sociodemographic pro forma, the Kessler Psychological Distress Scale (K10) was used to measure psychological distress, the World Health Organization's Alcohol, Smoking and Substance Involvement Screening tool (WHO ASSIST version 3.0) was used to measure substance use, and the Adverse Childhood Experiences Scale was used to identify adverse childhood experiences. Univariate and multivariate regression analysis were employed to understand the determinants of psychological distress among participants. Results Female participants reported a higher risk of experiencing psychological distress compared to male participants. Overall, 27.06% of participants experienced psychological distress, with 11.8% likely to have mild, 9.71% moderate and 5.53% severe mental disorders. While adverse childhood experiences were reported to be a major factor associated with psychological distress among both the groups (AOR 6.218, 95% CI (3.546, 10.901), p < 0.001, for female), (AOR 1.965, 95% CI (1.073, 3.601), p = 0.029, for male) substance use pattern during the COVID19 pandemic was also predicted higher psychological distress among male participants. Conclusion In the study setting, psychological distress was prevalent among emerging adults, with a higher incidence among females. Adverse childhood events and substance use further elevated vulnerability. These findings highlight the critical need for culturally relevant and gender-sensitive mental health interventions.