Behavioral Health Risk and Resilience among International Students in the United States: A Study of Socio-demographic Differences
Keywords:acculturative stress, alcohol use, anxiety, depression, international students, resilience
Using a resilience framework, the current cross-sectional study examined indicators of behavioral health risk and resilience among U.S. international students (N=322) across key socio-demographic characteristics. A multimethod approach was used to collect data with both an online platform and paper-based survey instrument. Results showed that higher levels of acculturative stress were reported by older students, females, undergraduates, students who lived with their families, and those who had resided in the US longer than 2 years. Findings underscore the importance of culturally-relevant screening and prevention strategies that target resilience and other protective factors to reduce health risk and encourage well-being and academic success among international students.
Abu-Raiya, H., & Pargament, K. I. (2015). Religious coping among diverse religions: Commonalities and divergences. Psychology of Religion and Spirituality, 7(1), 24–33.
Acuña E., & Rodrigues, C. (2004). The treatment of missing values and its effect on classifier accuracy. In D. Banks, F. R. McMorris, P. Arabie, & W. Gaul (Eds.). Classification, clustering, and data mining applications: Proceedings of the meeting of the international federation of classification societies (pp. 639–648). Chicago: Illinois Institute of Technology.
Beck, K. H., Arria, A. M., Caldeira, K. M., Vincent, K. B., O’Grady, K. E., & Wish, E. D. (2008). Social context of drinking and alcohol problems among college students. American Journal of Health Behavior, 32(4), 420–430.
Berry, J. W. (2005). Acculturation: Living successfully in the two cultures. International Journal of Intercultural Relations, 29, 697–712.
Börjesson, M. (2017). The global space of international students in 2010. Journal of Ethnic and Migration Studies, 43(8), 1256–1275. doi:10.1080/1369183X.2017.1300228
Brown, J. D. (1988). Understanding research in second language learning: A teacher’s guide to statistics and research design. Cambridge: Cambridge University Press.
Chai, P. P. M., Krägeloh, C. U., Shepherd, D., & Billington, R. (2012). Stress and quality of life in international and domestic university students: Cultural differences in the use of religious coping. Mental Health, Religion & Culture, 15(3), 265–277.
Chalungsooth, P., & Schneller, G. R. (2011). Development of translation materials to assess international students’ mental health concerns. Journal of Multicultural Counseling & Development, 39(3), 180–189.
Cheung, C., & Yue, X. (2013). Sustaining resilience through local connectedness among sojourn students. Social Indicators Research, 111(3), 785–800. doi:10.1007/s11205-012-0034-8
Cheung, C. K., & Yue, X. D. (2012). Sojourn students’ humor styles as buffers to achieve resilience. International Journal of Intercultural Relations, 36(3), 353–364
Chin, F. P. (2016). A study of retention and achievement: Assessment of international students’ resilience and coping strategies (Doctoral dissertation). Retrieved from ProQuest dissertations and theses. (Order No. 10230223)
Constantine, M. G., Ogazaki, S., & Utsey, S. O. (2004). Self-concealment, social self-efficacy, acculturative stress, and depression in African, Asian, and Latin American international college students. American Journal of Orthopsychiatry, 74(3), 230–242.
Doyle, S., Loveridge, J., & Faamanatu-Eteuati, N. (2016). Counting family: Making the family of international students visible in higher education policy and practice. Higher Education Policy, 29(2), 184–198. doi:10.1057/hep.2015.20
Duru, E., & Poyrazli, S. (2007). Personality dimensions, psychosocial-demographic variables, and English language competency in predicting level of acculturative stress among Turkish international students. International Journal of Stress Management, 14(1), 99–110.
El Ansari, W., Stock, C., & Mills, C. (2013). Is alcohol consumption associated with poor academic achievement in university students? International Journal of Prevention Medicine, 4(10), 1175–88.
Eustace, R. W. (2007). Factors influencing acculturative stress among international students in the United States (Doctoral dissertation). Retrieved from ProQuest dissertations and theses.
Fergus, S., & Zimmerman, M. A. (2005). Adolescent resilience: A framework for understanding healthy development in the face of risk. Public Health, 26, 399–419.
Friborg, O., Hjemdal, O., Rosenvinge, J. H., & Martinussen, M. (2003). A new rating scale for adult resilience: What are the central protective resources behind healthy adjustment? International Journal of Methods in Psychiatric Research, 12, 65–76.
Furr, R. M., & Bacharach, V. R. (2008). Psychometrics: An introduction. Thousand Oaks, CA: Sage.
Galen, L. W., & Rogers, W. M. (2004). Religiosity, alcohol expectancies, drinking motives and their interaction in the prediction of drinking among college students. Journal of Studies on Alcohol, 65(4), 469–476.
Hair, J. F., Black, W. C., Babin, B. J., Anderson, R. E., & Tatham, R. L. (2006). Multivariate data analysis. (6th ed.). Upper Saddle River, NJ: Pearson Prentice Hall.
Han, X., Han, X., Luo, Q., Jacobs, S., & Jean-Baptiste, M. (2013). Report of a mental health survey among Chinese international students at Yale University. Journal of American College Health, 61(1), 1–8.
Hahn, Z. L. (2010). Coping with acculturative stress and depression among international students: A cultural perspective (Doctoral dissertation). Retrieved from ProQuest dissertations and theses. (Order No. 3447492)
Hodder, R. K., Daly, J., Freund, M., Bowman, J., Hazell, T., & Wiggers, J. (2011). A school-based resilience intervention to decrease tobacco, alcohol and marijuana use in high school students. BMC Public Health, 11(722), 1–10.
Hodge, D., Cardenas, P., & Montoya, H. (2001). Substance use: Spirituality and religious participation as protective factors among rural youth. Social Work Research, 25(3), 153–161.
Holguin, L. E. (2011). Substance use and social networks of international students (Doctoral dissertation). Retrieved from ProQuest dissertations and theses. (Order No. 1495485)
Hsu, P. H., Krageloh, C. U., Shepherd, D., & Billington, R. (2009). Religion/spirituality and quality of life of international tertiary students in New Zealand: An exploratory study. Mental Health, Religion & Culture, 12(4), 385–399.
Institute of International Education. (2016). International student enrollment trends, 1949/50-2012/13. Open Doors Report on International Educational Exchange. Retrieved from http://www.iie.org/opendoors.
Iwamoto, D. K., & Liu, W. M. (2010). The impact of racial identity, ethnic identity, Asian values, and race-related stress on Asian Americans and Asian international college students’ psychological well-being. Journal of Counseling Psychology, 57(1), 79–91.
Javanmard, G. H. (2013). Religious beliefs and resilience in academic students. Procedia: Social and Behavioral Sciences, 84, 744–748.
Johnson, N., Dinsmore, J. A., & Hof, D. D. (2011). The relationship between college students’ resilience level and type of alcohol use. International Journal of Psychology, 8, 67–82
Johnston, L. D., O’Malley, P. M., Miech, R. A., Bachman, J. G., & Schulenberg, J. E. (2014). Monitoring the Future national results on drug use: 1975–2013: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan.
Jowkar, B., Friborg, O., & Hjemdal, O. (2010). Cross-cultural validation of the Resilience Scale for Adults (RSA) in Iran. Scandinavian Journal of Psychology, 51, 418–425.
Kanaparthi, A. (2009). Relations between acculturation and alcohol use among international students (Doctoral dissertation). Retrieved from ProQuest dissertations and theses. (Order No. 3394817)
Khoshlessan, R., & Das, K. P. (2017). Analyzing international students’ study anxiety in higher education. Journal of International Students, 7(2), 311–328.
Kim, M. & Kim, K. (2014). A study of Chinese students’ acculturative stress, depression influencing on drinking problem and social maladaptation: Moderating effect of ego resilience. Asian Journal of Child Welfare and Development, 12(2), 23–41.
Koyama, C., & Belli, G. (2011). Alcohol use, acculturative stress, and drinking motivation among international community college students. Journal of Multicultural Counseling & Development, 39(4), 229–240.
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9 validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613
Lau, J. S. (2006). Acculturative stress, collective coping, and psychological well-being of Chinese international students (Doctoral dissertation). Retrieved from ProQuest dissertations and theses. (Order No. 3245416)
Laudet, A. B., Harris, K., Kimball, T., Winters, K. C., & Moberg, D. P. (2015). Characteristics of students participating in collegiate recovery Programs: A national survey. Journal of Substance Abuse Treatment, 51, 38–46.
Lee, C. Y., & Park, J. H. (2014). The effects of acculturative stress and resilience on depression of university students from North Korea. Family and Environment Research, 52(3), 313–324.
Lee, E. K., & Chan, K. (2009). Religious/spiritual and other adaptive coping strategies among Chinese American older immigrants. Journal of Gerontological Social Work, 52, 517–533.
Li, J., Marbley, A. F., Bradley, L. J., & Lan, W. (2016). Attitudes toward seeking professional counseling services among Chinese international students: Acculturation, ethnic identity, and English proficiency. Journal of Multicultural Counseling & Development, 44(1), 65–76. doi:10.1002/jmcd.12037
Loveridge, J., Doyle, S., & Faamanatu-Eteuati, N. (2018). Journeys across educational and cultural borders: international postgraduate students with young children. British Journal of Sociology of Education, 39(3), 333–347. doi:10.1080/01425692.2017.1351867
Maleku, A., & Aguirre, R. (2014). Culturally competent health care from the immigrant lens: a qualitative interpretive meta-synthesis (QIMS). Social Work in Public Health, 29(6), 561–580. doi:10.1080/19371918.2014.893417
National Institute on Alcohol Abuse and Alcoholism. (2015a). College drinking. Retrieved from https://pubs.niaaa.nih.gov/publications/CollegeFactSheet/CollegeFactSheet.pdf
National Institute on Alcohol Abuse and Alcoholism. (2015b). Rethinking drinking: Alcohol and your health. U. S. Department of Health and Human Services: NIH Publication No. 09-3770. Retrieved from http://pubs.niaaa.nih.gov/publications/RethinkingDrinking/Rethinking_Drinking.pdf
Organization for Economic Co-operation and Development. (2013). Education indicators in focus. Retrieved from http://www.oecd.org
Pace, K., Silk, K., Nazione, S., Fournier, L., & Collins-Eaglin, J. (2018). Promoting mental health help-seeking behavior among first-year college students. Health Communication, 33(2), 102–110. doi:10.1080/10410236.2016.1250065
Pan, J., Ng, P., Young, D. K., & Caroline, S. (2017). Effectiveness of cognitive behavioral group intervention on acculturation. Research on Social Work Practice, 27(1), 68–79. doi:10.1177/1049731516646857
Poyrazli, S., & Kavanaugh, P. R. (2006). Marital status, ethnicity, academic achievement, and adjustment strains: The case of graduate international students. College Student Journal, 40, 767–780.
Poyrazli, S., Kavanaugh, P. R., Baker, A., & Al-Timimi, N. (2004). Social support and demographic correlates of acculturative stress in International students. Journal of College Counseling, 7, 73–82.
Sa, J. (2010). Binge drinking, drinking and driving, and cigarette smoking among Korean international college students in the U.S. (Doctoral dissertation). Retrieved from ProQuest dissertations and theses. (Order No. 3432133)
Sa, J., Seo, D. C., Nelson, T. F., & Lohrmann, D. K. (2013). Cigarette smoking among Korean international college students in the United States. Journal of American College Health, 61(8), 37–41.
Student and Exchange Visitor Program, 2014 SEVP. (2014). General summary quarterly review—July 2014. Retrieved from https://www.ice.gov/doclib/sevis/pdf/by-the-numbers.pdf
Sherry, M., Thomas, P., & Chui, W. H. (2010). International students: A vulnerable student population. The Journal of Higher Education, 60, 33–46.
Smith, R. A., & Khawaja, N. G. (2011). A review of the acculturation experiences of international students. International Journal of Intercultural Relations, 35, 699–713.
Sondhi, G. & Russell, K. (2017). Gendering international student migration: An Indian case-study, Journal of Ethnic and Migration Studies, 43(8), 1308–1324.
Spitzer, R. L., Kroenke, K, Williams, J. B. W., & Lowe, B. (2016). A brief measure for assessing generalized anxiety disorder. Archives of Internal Medicine, 166, 1092–097.
Sullivan, C. (2010). Predictors of acculturative stress for international students in the United States (Doctoral dissertation). Retrieved from ProQuest dissertations and theses. (Order No. 3432885)
Tavakoli, S., Lumley, M. A., Hijazi, A. M., Slavin-Spenny, O. M.,& Parris, G. P. (2009). Effects of assertiveness training and expressive writing on acculturative stress in international students: A randomized trial. Journal of Counseling Psychology, 56, 590–596.
Thompson, W. E. (2017). Social support, religious involvement and alcohol use among students at a conservative religious university. Behavioral Sciences, 7(2), 2–12
Ungar, M. (2012). The social ecology of resilience. New York: Springer.
Wei, M., Heppner, P. P., Mallen, M. J., Ku, T., Liao, K. Y., & Wu, T. (2007). Acculturative stress, perfectionism, years in the United States, and depression among Chinese international students. Journal of Counseling Psychology, 54(4), 385–394.
Yan, Z., & FitzPatrick, K. (2016). Acculturation and health behaviors among international students: A qualitative approach. Nursing & Health Sciences, 18(1), 58–63.
Yang, B. & Clum, G. A. (1995). Measures of life stress and social support specific to an Asian student population. Journal of Psychology and Behavioral Assessment, 17(1), 51–67.
Yeh, C. J., & Inose, M. (2003). International students’ reported English fluency, social support satisfaction, and social connectedness as predictors of acculturative stress. Counselling Psychology Quarterly, 29(3), 15–28.
Yeramaneni, S., & Sharma, M. (2009). Predictors of alcohol use and binge drinking among Asian Indian students. American Journal of Health Studies, 24(2), 287–297.
Ying, Y., & Han, M. (2006). The contribution of personality, acculturative stressors, and social affiliation to adjustment: A longitudinal study of Taiwanese students in the United States. International Journal of Intercultural Relations, 30(5), 623–635.
Yoo, M., Choi, S. Y., Kim, Y. M., Han, S., Yang, N., Kim, H., Son, Y. (2014). Acculturative stress, resilience, and depression among Chinese students in Korea. The Journal of Korean Academic Society of Nursing Education, 19(3), 320–329.
Zhang, Q., Larkin, C., & Lucey, B. (2014). The economic impact of higher education institutions in Ireland: Evidence from disaggregated input output tables. Social Science Review Network. Available online at http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2508614
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