The study, led by Natalia Tsybuliak of Berdyansk State Pedagogical University together with colleagues from the University of the Basque Country and the University of Bern, was designed to answer two deceptively simple questions. First, how common are anxiety symptoms among university students in three very different higher-education settings, one of them operating under wartime conditions? Second, is there a measurable association between students’ perception of discrimination within their university and the severity of their anxiety symptoms? Cross-sectional surveys of this kind cannot prove that one factor causes the other, but they can reveal patterns strong enough to demand institutional attention, and the patterns here were consistent across multiple statistical approaches.

Between December 2024 and February 2025, the team administered an online questionnaire to students recruited through participating universities in the three regions. Anxiety was measured with the Generalized Anxiety Disorder-7 scale, or GAD-7, a seven-item instrument that has become the workhorse of mental-health screening worldwide. Respondents rate how often they have been bothered by problems such as feeling nervous, being unable to stop worrying, or experiencing restlessness over the previous two weeks, with each item scored from zero to three. A cumulative score of ten or above is conventionally interpreted as a threshold for clinically significant anxiety, and it was this cutoff that the researchers used to classify students as having elevated symptoms.

The geographic gradient in the results was immediately apparent. Ukrainian students recorded the highest burden, with 35.2 percent scoring at or above the GAD-7 threshold of ten, a figure that is difficult to read outside the context of a country in which academic life continues under the shadow of full-scale war. Students in the Basque Country followed at 30.4 percent, while Swiss students reported the lowest prevalence at 21 percent. Statistical testing confirmed that these differences were unlikely to be due to sampling noise, with a Kruskal-Wallis test yielding a highly significant result. Yet the researchers were careful to note that the effect size was small, quantified by an epsilon-squared value of just 0.014, meaning that the country in which a student studies explains only a modest fraction of the overall variation in anxiety scores. Anxiety, in other words, is everywhere in higher education; the differences between settings are real but incremental rather than dramatic.

The second strand of the analysis focused on perceived discrimination, which the team measured with a deliberately blunt instrument: a single binary item asking whether participants had experienced discrimination at university due to belonging to a vulnerable or non-normative group. Overall, 6.5 percent of students answered yes. That figure, however, concealed a highly uneven distribution across the three samples, with discrimination reported considerably more frequently in the Swiss sample than elsewhere. This imbalance matters, the authors caution, because it limits how confidently one can compare the relationship between discrimination and anxiety across national contexts. A phenomenon that is rare in one sample and common in another is statistically difficult to model uniformly, and the researchers responded by running sensitivity analyses to check whether their core finding held up under different assumptions.

To quantify the association, the team built sequential ordinary least-squares regression models, a technique that enters predictor variables in stages so that the contribution of each can be assessed while controlling for those already included. In the fully adjusted model, based on 1,393 complete cases, perceived discrimination was associated with a GAD-7 score that was 1.78 points higher on average, with a standard error of 0.67 and a 95 percent confidence interval running from 0.47 to 3.08. In practical terms, a student who reported discrimination carried an anxiety burden roughly equivalent to the difference between mild and moderate symptom categories on parts of the scale. The estimate was robust: when the researchers re-ran the model using HC3 heteroscedasticity-robust standard errors, a safeguard against unequal variability across groups, the coefficient barely moved. In the Swiss sensitivity sample, where discrimination was reported more often, the adjusted association grew to 2.45 points, with a confidence interval of 1.10 to 3.80 and a p-value below 0.001.

What makes these numbers noteworthy is not their magnitude but their persistence. The association between perceived discrimination and anxiety survived adjustment for study context, gender, and age, three of the most powerful demographic confounders available in the dataset. This does not establish causation. It is entirely possible that students with more severe anxiety are more likely to interpret ambiguous social interactions as discriminatory, or that unmeasured factors, from financial stress to social isolation, drive both experiences simultaneously. Reverse causation and unmeasured confounding are perennial limitations of cross-sectional designs, and the authors are explicit about them. But the consistency of the signal, across the primary model, the robust-error variant, and the Swiss sensitivity analysis, suggests that the relationship is unlikely to be a statistical artifact.

The study’s context adds a layer of urgency. The Ukrainian arm of the research was conducted by academics who acknowledge in the paper’s acknowledgements that the Armed Forces of Ukraine made it possible to continue scholarly work under wartime conditions, and ethics approval was secured through protocols at Berdyansk State Pedagogical University, the University of Bern, and the University of the Basque Country, with the study conducted in accordance with the Declaration of Helsinki. That students in a war-affected country show the highest anxiety prevalence is unsurprising, but the fact that students in comparatively stable Switzerland and the Basque Country still reported elevated symptoms at rates of 21 and 30 percent respectively underscores how widespread psychological distress has become in higher education generally, independent of geopolitical circumstance.

The authors frame their conclusions as a call to integrate two institutional agendas that are often pursued separately. Student mental-health services, they argue, should not operate in isolation from efforts to strengthen inclusion, belonging, psychological safety, and discrimination prevention. If perceived discrimination is reliably associated with a measurable increase in anxiety symptoms, then campus climate is not merely a matter of social justice or reputational management; it is a determinant of student mental health with quantifiable consequences. Universities that invest in anti-discrimination policies, accessible reporting mechanisms, and cultures of psychological safety may, on this evidence, be investing in prevention of the very distress that counseling centers are struggling to treat.

Caveats remain, and the researchers flag them clearly. The single-item measure of discrimination cannot capture the frequency, severity, or type of discriminatory experiences, and self-reported perception is not the same as documented mistreatment. The recruited samples are not nationally representative, and the uneven distribution of reported discrimination across the three contexts constrains cross-country inference. The study also received no specific external funding, which speaks to the resourcefulness of the collaborating teams but also hints at how comparatively little systematic attention cross-national student mental health receives. Still, for a field often dominated by single-institution surveys, a three-region comparison spanning a wartime university system, a bilingual Spanish autonomous community, and a Swiss federal context offers something rarer: evidence that the link between how students are treated on campus and how anxious they feel transcends borders, and that addressing discrimination may be one of the most direct levers available for easing the invisible burden that so many students carry into lecture halls every day.

Subject of Research: Anxiety symptoms and perceived discrimination among university students in Ukraine, Switzerland, and the Basque Country

Article Title: Anxiety symptoms and perceived discrimination among university students in Ukraine, Switzerland, and the Basque Country: a cross-sectional study

Article References: Tsybuliak, N., Popova, A., Suchikova, Y., Ruiz de Azua, S., Thomas, C., Ozamiz-Etxebarria, N., Picaza Gorrotxategi, M., & Legorburu Fernandez, I. (2026). Anxiety symptoms and perceived discrimination among university students in Ukraine, Switzerland, and the Basque Country: a cross-sectional study. BMC Psychology. https://doi.org/10.1186/s40359-026-05750-5

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05750-5

Keywords: anxiety, perceived discrimination, university students, mental health, higher education, GAD-7, Ukraine, Switzerland, Basque Country, cross-sectional study, inclusion, student wellbeing