Prevalence and Correlates of Depressive Symptoms Among International Students: Implications for University Support Offices
International students often experience significant challenges and difficulties adjusting to their new campus and university environment abroad. As a result, understanding the unique needs of these students has become an important priority for many university administrators and mental health professionals amid growing health concerns faced by members of this community. This study examines the prevalence and correlates of depressive symptoms in a sample of international students enrolled in a mid-size U.S. university. A hierarchical multiple regression model revealed that poor English fluency, increased acculturative stress, and perceived discrimination were associated with higher levels of depressive symptoms, whereas increased social support was associated with lower levels of depressive symptoms. Implications for university administration and support services are discussed.
Abe, J., Talbot, D. M., & Geelhoed, R. J. (1998). Effects of a peer program on international student adjustment. Journal of College Student Adjustment, 39(6), 539–547.
American College Health Association. (2017). National college health assessment. Retrieved from http://www.acha-ncha.org/reports_ACHA-NCHAII.html
Andrade, M. S. (2006). International students in English speaking universities: Adjustment factors. Journal of Research in Higher Education, 5, 131–154. doi:10.1177/1475240906065589
Andre de Araujo, A. (2011). Adjustment issues of international students enrolled in American colleges and universities: A review of the literature. Higher Education Studies, 1, 2–8. doi:10.5539/hes.v1n1p2
Association of International Educators. (2017). NAFSA international student economic value tool. Retrieved from http://www.nafsa.org/Policy_and_Advocacy/Policy_Resources/Policy_Trends_and_Data/NAFSA_International_Student_Economic_Value_Tool/
Atri, A., Sharma, M., & Cottrell, R. (2007). Role of social support, hardiness, and acculturation as predictors of mental health among international students of Asian Indian origin. International Quarterly of Community Health Education, 27, 59–73. doi:10.2190/IQ.27/1.e
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893–897.
Bhochhibhoya, A., Dong, Y., & Brancscum, P. (2017). Sources of social support Among international college students in the United States. Journal of International Students, 7(3), 671–686.
Botha, F. B., Shamblaw, A. L., & Dozois, D. J. (2017). Reducing the stigma of depression among Asian students: A social norm approach. Journal of Cross-Cultural Psychology, 48(1), 113–131.
Briggs, P., & Ammigan, R. (2017). A collaborative programming and outreach model for international student support offices. Journal of International Students, 7(4), 1080–1095. https://doi.org/10.5281/zenodo.1035969
The Central Intelligence Agency. (2017) The world fact book. Washington, D.C.: Author. Retrieved from https://www.cia.gov/library/publications/the-world-factbook/index.html
Chang, M. X. L., Jetten, J., Cruwys, T., & Haslam, C. (2017). Cultural identity and the expression of depression: A social identity perspective. Journal of Community & Applied Social Psychology, 27(1), 16–34.
Chuah, J. S., & Singh, M. K. M. (2016). International students’ perspectives on the importance of obtaining social support from host national students. International Education Studies, 9(4), 132–140.
Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98(2), 310–357.
Constantine, M. G., Kindaichi, M., Okzakai, S., Gainor, K. A., & Baden, A. L. (2005). A qualitative investigation of the cultural adjustment experiences of Asian international college student women. Cultural Diversity and Ethnic Minority Psychology, 11, 162–175. doi:10.1037/1099-9809.11.2.162
Constantine, M. G., Okazaki, S., & Utsey, S. O. (2004). Self-concealment, social self-efficacy, acculturative stress, and depression in African, Asian, and Latin American college students. American Journal of Orthopsychiatry, 74(3), 230–241.
Crano, S. L., & Crano, W. D. (1993). A measure of adjustment strain in international students. Journal of Cross-Cultural Psychology, 24(3), 267–283.
Creamer, M., Foran, J., & Bell, R. (1995). The Beck Anxiety Inventory in a non-clinical sample. Behavior Research and Therapy, 33(4), 477–485.
Cross, S. E. (1995). Self-construals, coping, and stress in cross-cultural adaptation. Journal of Cross-Cultural Psychology, 26(6), 673–698.
Cujipers, P, Cristea, I. A., Ebert, D. D., Koot, H. M., Auerbach, R. P., Bruffaerts, R., & Kessler, R. C. (2015). Psychological treatment of depression in college students: A meta-analysis. Depression and Anxiety, 33, 400–414.
Dipelou, A., Kang, J., & Cooper, C. (2007). Support group for international students. Journal of College Student Psychotherapy, 22(1), 63–74.
Duru, E., & Poyrazli, S. (2011). Perceived discrimination, social connectedness, and other predictors of adjustment difficulties among Turkish international students. International Journal of Psychology, 46(6), 446–454.
Eisenberg, D., Golberstein, E., & Hunt, J. (2009). Mental health and academic success in college. The B E Journal of Economic Analysis & Policy, 9, 40–41. doi:10.2202/1935-1682.2191
Eisenberg, D., Gollust, S. E., Golberstein, E., & Hefner, J. L. (2007). Prevalence and correlates of depression, anxiety, and suicidality among college students. American Journal of Orthopsychiatry, 77, 534–542. doi:10.1037/0002-94188.8.131.524
Eisenberg, D., Hunt, J., & Speer, N. (2013). Mental health in American colleges and universities: Variation across student subgroups and across campuses. Journal of Nervous and Mental Disease, 201, 60–67. doi:10.1097/NMD.0b013e31827ab077
Feagin, J. R., & Eckberg, D. L. (1980). Discrimination: Motivation, action, effects, and context. Annual Review of Sociology, 6, 1–20.
Forbes-Mewett, H. (2016). Foreward. In K. Bista & C. Foster (Eds.), Exploring the social and academic experiences of international students in higher education institutions (1st ed.). Hershey, PA: IGI Global.
Fritz, M. V., Chin, D., & DeMarinis, V. (2008). Stressors, anxiety, acculturation, and adjustment among international and North American students. International Journal of Intercultural Relations, 32, 244–259. doi:10.1016/j.ijintrel.2008.01.001
Hanassab, S. (2006). Diversity, international students, and perceived discrimination: Implications for educators and counselors. Journal of Studies in International Education, 10(2), 157–172.
Hill, R. M., Yaroslavsky, I., & Pettit, J. W. (2015). Enhancing depression screening to identify college students at risk for persistent depressive symptoms. Journal of Affective Disorders, 174, 1–6.
Hsieh, M. (2006). Identity negotiation among female Chinese international students in second-language higher education. College Student Journal, 40, 870–884.
Huang, S., & Mussap, A. (2018). Maladaptive Perfectionism, Acculturative Stress and Depression in Asian International University Students. Journal of Psychologists and Counsellors in Schools, 28(2), 185-196. doi:10.1017/jgc.2016.18
Institute of International Education. (2017). Open Doors 2017 report. Washington, D.C.: Author. Retrieved from http://www.iie.org/
Jansson-Frojmark, M., & Lindblom, K. (2008). A bidirectional relationship between anxiety and depression, and insomnia? A prospective study in the general population. Journal of Psychosomatic Research, 64(4), 443–449. doi:10.1016/j.jpschores.2007.10.016
Jasinskaha-Lahti, I., Liebkind, K., Jaakkola, M., & Reuter, A. (2006). Perceived discrimination, social support networks, and psychological well-being among three immigrant groups. Journal of Cross-Cultural Psychology, 37(3), 293–311. doi:10.1177/0022022106286925
Karuppan, C. M. & Barari, M. (2011) Perceived discrimination and international students’ learning: an empirical investigation. Journal of Higher Education Policy and Management, 33, 67–83. doi:10.1080/1360080X.2011.537013
Kawamoto, A., Youn, S. J., Bartholomew, T. T., Castonguay, L. G., & Locke, B. D. (2018). Inter-and intra-group differences in psychological concerns among international students. Counselling Psychology Quarterly, 31(2), 186–204.
Kelo, M., Rogers, T., & Rumbley, L. (2010). International student support in European higher education needs, solutions and challenges. Bonn, Germany: Lemmens. Retrieved from http://www.aca-secretariat.be/index.php?id=456
Lee, J. J., & Rice, C. (2007). Welcome to America? International student perceptions of discrimination. Higher Education, 53(3), 381–409. https://doi.org/10.1007/s10734-005- 4508-3
Lipson, S. K., Gaddis, S. M., Heinze, J., Beck, K., & Eisenberg, D. (2015). Variations in student mental health and treatment utilization across US colleges and universities. Journal of American College Health, 63(6), 388–396. doi:10.1080/07448481.2015.104011
Liu, M. (2009). Addressing the mental health problems of Chinese international college students in the United States. Advances in Social Work, 10(1), 69–86.
Luo, J., & Jamieson-Drake, D. (2013). Examining the educational benefits of interacting with international students. Journal of International Students, 3(2), 85–101.
Mackenzie, S, Wiegel, J. R., Mundt, M., Brown, D., Saewyc, E., Heiligenstein, E., . . . Fleming, M. (2011). Depression and suicide ideation among students accessing campus healthcare. American Journal of Orthopsychiatry, 81, 101–107. doi:10.1111/j.1939-0025.2010.01077
Mackinnon, A., McCallum, J., Andrews, G., & Anderson, I. (1998). The Center for Epidemioloigcal Studies Depression Scale in older community samples in Indonesia, North Korea, Myanmar, Sri Lanka, and Thailand. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 53(6), 343–352.
Martens, M. P., Martin, J., Hatchett, S., Fowler, R. F., Fleming, K., Karakashian, M., & Cimini, M. D. (2008). Protective behavioral strategies and the relationship between depressive symptoms and alcohol-related negative consequences among college students. Journal of Counseling Psychology, 55, 535–541.
Mori, S. C. (2000). Addressing the mental health concerns of international students. Journal of Counseling & Development, 78, 137–144.
Msengi, I. G. (2004). Sources of Stress and its impact on health behaviors and academic performance of international students at a comprehensive midwestern university. International Journal of Global Health and Health Disparities, 5, 55–69.
Nilson, J. E., Berkel, L. A., Flores, L. Y., & Lucas, M. S. (2004). Utilization rate and presenting concerns of international students at a university counseling center. Journal of College Psychotherapy, 19(2), 49–59.
Pedersen, P. B. (1991). Counseling international students. The Counseling Psychologist, 19(1), 10–58.
Perrucci, R., & Hu, H. (1995). Satisfaction with social and educational experiences among international graduate students. Research in Higher Education, 36(4), 491–508. https://doi.org/10.1007/BF02207908
Poyrazli, S., & Kavanaugh, P. R. (2006). Marital status, ethnicity, academic achievement, and adjustment strains: The case of graduate international students. College Student Journal, 40(4), 767–780.
Poyrazli, S., & Lopez, M. D. (2007). An exploratory study of perceived discrimination and homesickness: A comparison of international students and American students. Journal of Psychology, 141(3), 263–280.
Poyrazli, S., Thukral, R. K., & Duru, E. (2010). International students’ race-ethnicity, personality, and acculturative stress. Journal of Psychology and Counseling, 2(8), 25–32.
Radloff, L. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement,1(3), 385–401.
Rice, G., Choi, C. C., Zhang, Y., Morero, Y. I., & Anderson, D. (2012). Self-critical perfectionism, acculturative stress, and depression among international students. The Counseling Psychologist, 40(4), 575–600.
Sam, D. L. (2001). Satisfaction with life among international students: an exploratory study. Social Indicators Research, 53(3), 315–337.
Sandhu, D. S., & Asrabadi, B. R. (1994). Development of an acculturative stress scale for international students: Preliminary findings. Psychological Reports, 75(2), 435–448.
Steptoe, A., Tsuda, A., Tanaka, Y., & Wardle, J. (2007). Depressive symptoms, socio-economic background, sense of control, and cultural factors in university students from 23 countries. International Journal of Behavioral Medicine, 14(2), 97–107.
Sumer, S., Poyrazli, S., & Grahame, K. (2008). Predictors of depression and anxiety among international students. Journal of Counseling & Development, 86, 429–437.
Torres, L. (2010) Predicting levels of Latino depression: Acculturation, acculturative stress, and coping. Cultural Diversity and Ethnic Minority Psychology, 16, 256–263. doi:10.1037/a0017357
Wadsworth, B. C., Hecht, M. L., & Jung, E. (2008). The role of identity gaps, discrimination, and acculturation in international students’ educational satisfaction in American classrooms. Communication Education, 57, 64–87. doi:10.1080/03634520701668407
Wei, M., Heppner, P. P., Ku, T. Y., & Liao, K. Y. H. (2010). Racial discrimination stress, coping, and depressive symptoms among Asian Americans: A moderation analysis. Asian American Journal of Psychology, 1, 136–150. doi:10.1037/0022-0184.108.40.2065
Wei, M., Ku, T., Russell, D. W., Mallinckrodt, B., & Liao, K. Y. (2008). Moderating effects of three coping strategies and self-esteem on perceived discrimination and depressive symptoms: A minority stress model for international students. Journal of Counseling Psychology, 55, 451–462. doi:10.1037/a0012511
Williams, D. R., Yu, Y., Jackson, J. S. (1997). Racial differences in physical and mental health: Socio-economic status, stress, and discrimination. Journal of Health Psychology, 2(3), 335–351.
Wood, M., & Kia, P. (2000). International student affairs. New Directions for Higher Education, 2000(111), 55–64. https://doi.org/10.1002/he.11106
Yeh, C. J., & Inose, M. (2003). International students’ reported English fluency, social support satisfaction, and social connectedness as predictors of acculturative stress. Counseling Psychology Quarterly, 16, 15–28. doi:10.1080/0951507031000114058
Yi, J. K., Lin, J. G., & Kishomoto, Y. (2003). Utilization of counseling services by international students. Journal of Instructional Psychology, 30(4), 333–342.
Ying, Y., & Liese, L. H. (1994). Initial adjustment of Taiwanese students to the United States: The impact of postarrival variables. Journal of Cross-Cultural Psychology, 25(4), 466–477.
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