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The main objective of this study was to examine contributions of ego-development andadjustment status to psychological distress of first year Assosa University (ASU)students. To answer the research questions, the researchers used an institution-basedcross-sectional study design. Twelve (12) departments were randomly selected from 36departments across six colleges in the university; then, 374 students (143 females and 231males) were selected from 1878 students in the 12 departments, using simple randomsampling technique. The researchers used percentages, mean, standard deviation,independent t-test and multiple regression models for data analyses. The result of thisstudy revealed that there was 59.6% prevalence of psychological distress (24% of whichwas severe) among first year students. Psychological distress was higher among femalesthan males. Ego development and adjustment status explained 30.2% (R 2 = 0.302, F (2,371) = 80.355, p < 0.001) of the variation in psychological distress. In conclusion, egodevelopment and adjustment status significantly contributed to psychological distress offirst year ASU students. There was a high prevalence of psychological distress amongfirst year ASU students. Female students scored significantly higher in psychologicaldistress than male students. The researchers recommended psychosocial supports such ascounseling and life skills training to help the students develop healthy psychologicalwell-being.