A Predictive Model of University Students’ Anxiety and Depression Based on Loneliness, University Belonging, and Social Support

Abstract

This study aimed to develop a conceptual model explaining university students’ anxiety and depression based on their experiences of loneliness, university belonging, and social support. This qualitative study was conducted using a grounded theory approach. The participants were 22 students aged 18–29 years who were studying at universities in Tehran, Iran. Initial purposive sampling was followed by theoretical sampling to achieve maximum variation in gender, academic level, type of university, and living arrangement. Eligibility criteria included completion of at least two academic semesters, experiencing persistent worry or depressed mood during the previous six months, and willingness to discuss personal and academic experiences. Data were collected exclusively through individual semi-structured interviews lasting between 45 and 75 minutes. Conceptual saturation was reached after the twentieth interview, and two additional interviews were conducted to confirm saturation. Interviews were transcribed verbatim and analyzed through constant comparison, open coding, axial coding, and selective coding. NVivo software was used to organize transcripts, codes, categories, analytic memos, and relationships among concepts. Five main categories were identified: perceived relational disconnection and loneliness, erosion of university belonging, inadequate and conditional social support, the reciprocal cycle of anxiety, depression, and withdrawal, and reconstruction of protective social bonds. Loneliness was associated with emotional distress when students experienced invisibility, superficial relationships, fear of negative judgment, insufficient support, and limited meaningful participation in university life. Anxiety frequently began with concerns about rejection, academic failure, and an uncertain future. Avoidance and rumination subsequently reduced access to social support and intensified depressed mood, fatigue, hopelessness, and disengagement. Conversely, having at least one trustworthy relationship, receiving recognition from faculty members, participating in peer groups, and accessing nonjudgmental support disrupted this cycle. Anxiety and depression among university students appear to develop within a relational and institutional system rather than solely from individual vulnerability. In the proposed conceptual model, loneliness functions as a proximal risk mechanism, weak university belonging constitutes an aggravating context, and effective social support moderates the psychological effects of academic and interpersonal stressors. Universities should therefore combine accessible counseling services with peer-support programs, inclusive academic environments, responsive faculty–student relationships, and early identification of socially disconnected students.