Factors impacting tertiary-level international students’ mental well-being
A systematic literature review
DOI:
https://doi.org/10.32674/dgdak347Keywords:
international students, mental health, tertiary educationAbstract
International students constitute a substantial proportion of the global tertiary education population, yet the factors impacting their mental well-being remain fragmented across the literature. This systematic review synthesizes peer-reviewed studies to identify key factors that impact international students’ mental well-being and address research gaps. Using the PRISMA guidelines and the PICo tool, 86 studies were selected through a comprehensive search of eight databases. The findings indicate that more than 82% of the studies used quantitative methods and that more than 59% were conducted in English-speaking countries. Thematic analysis revealed nine interconnected factors impacting mental well-being: personal and psychological issues; sociocultural adjustment and acculturative stress; social support and belongingness; academic pressure; language and communication challenges; racism and xenophobia; visa policy-related stress; and housing and living conditions and financial pressure. Using an ecological framework, the results emphasize interactions among individual, relational, institutional, and structural determinants. This review underscores the need for longitudinal, mixed-methods research with greater geographic diversity to inform policy and practice.
References
Acharya, L., Jin, L., & Collins, W. (2018). College life is stressful today: Emerging stressors and depressive symptoms in college students. Journal of American College Health, 66(7), 655–664. https://doi.org/10.1080/07448481.2018.1451869
Aggarwal, A., & Çiftçi, A. (2021). Colourblind racial ideology, sense of belonging, and racism-related stress in Asian Indian international students. Psychological Reports, 124(5), 2251–2271. https://doi.org/10.1177/0033294120961063
Akhtar, M., & Kroener-Herwig, B. (2019). Coping styles and sociodemographic variables as predictors of psychological well-being among international students belonging to different cultures. Current Psychology, 38, 618–626. https://doi.org/10.1007/s12144-017-9635-3
Ali, Y. A., Hussein, R. S., Mostafa, N. S., & Manzour, A. F. (2024). Factors associated with acculturative stress among international medical students in an Egyptian university. BMC Medical Education, 24(1), Article 1009. https://doi.org/10.1186/s12909-024-05947-5
Al-Krenawi, A., Alotaibi, F., & Elbedour, S. (2021). Acculturative stress among female Saudi college students in the United States. Community Mental Health Journal, 57, 372–379. https://doi.org/10.1007/s10597-020-00659-8
Amanvermez, Y., Karyotaki, E., Cuijpers, P., Ciharova, M., Bruffaerts, R., Kessler, R. C., ... & de Wit, L. M. (2024). Sources of stress among domestic and international students: a cross-sectional study of university students in Amsterdam, The Netherlands. Anxiety, Stress, & Coping, 37(4), 428–445. https://doi.org/10.1080/10615806.2023.2280701
Bethel, A., Ward, C., & Fetvadjiev, V. H. (2020). Cross-cultural transition and psychological adaptation of international students: The mediating role of host national connectedness. Frontiers in Education, 5, 1–12. https://doi.org/10.3389/feduc.2020.539950
Bhochhibhoya, A., Dong, Y., & Branscum, P. (2017). Sources of social support among international college students in the United States. Journal of International Students, 7(3), 671–686. https://doi.org/10.5281/zenodo.570032
Bi, K., Yeoh, D., Jiang, Q., Wienk, M. N., & Chen, S. (2023). Psychological distress and everyday discrimination among Chinese international students one year into COVID-19: a preregistered comparative study. Anxiety, Stress, & Coping, 36(6), 727–742. https://doi.org/10.1080/10615806.2022.2130268
Bokszczanin, A., Gladysh, O., Bronowicka, A., & Palace, M. (2023). Experience of ethnic discrimination, anxiety, perceived risk of COVID-19, and social support among Polish and international students during the pandemic. International Journal of Environmental Research and Public Health, 20(7), Article 5236. https://doi.org/10.3390/ijerph20075236
Brunsting, N. C., Zachry, C., Liu, J., Bryant, R., Fang, X., Wu, S., & Luo, Z. (2021). Sources of perceived social support, social-emotional experiences, and psychological well-being of international students. The Journal of Experimental Education, 89(1), 95–111. https://doi.org/10.1080/00220973.2019.1639598
Bulgan, G., & Çiftçi, A. (2017). Psychological adaptation, marital satisfaction, and academic self-efficacy of international students. Journal of International Students, 7(3), 687–702. https://doi.org/10.32674/jis.v7i3.294
Cao, Q.-T., Vuong, Q.-H., Pham, H.-H., Luong, D.-H., Ho, M.-T., Hoang, A.-D., & Do, M.-T. (2021). A bibliometric review of research on international students’ mental health: Science mapping of the literature from 1957 to 2020. European Journal of Investigation in Health, Psychology and Education, 11(3), 781-794. https://doi.org/10.3390/ejihpe11030056
Clough, B. A., Nazareth, S. M., Day, J. J., & Casey, L. M. (2019). A comparison of mental health literacy, attitudes, and help-seeking intentions among domestic and international tertiary students. British Journal of Guidance & Counseling, 47(1), 123–135. https://doi.org/10.1080/03069885.2018.1459473
Department of Education. (2025). International student monthly summary. Government of Australia. https://www.education.gov.au/international-education-data-and-research/resources/international-student-monthly-summary
Dong, F., Hwang, Y., & Hodgson, N. A. (2023). “I have a wish”: Anti-Asian racism and facing challenges amid the COVID-19 pandemic among Asian international graduate students. Journal of Transcultural Nursing, 34(2), 115–122. https://doi.org/10.1177/10436596221143331
Dorevitch, B., Buck, K., Fuller-Tyszkiezicz, M., Phillips, L., & Krug, I. (2020). Maladaptive perfectionism and depression: Testing the mediating role of self-esteem and internalized shame in an Australian domestic and Asian international university sample. Frontiers in Psychology, 11(1272), 1–13. https://doi.org/10.3389/fpsyg.2020.01272
Dovchin, S. (2020). The psychological damages of linguistic racism and international students in Australia. International Journal of Bilingual Education and Bilingualism, 23(7), 804–818. https://doi.org/10.1080/13670050.2020.1759504
Du, X., Livingstone, A. G., & Adlam, A. L. R. (2023). Felt understanding as a bridge between social identity and well-being among international university students. Journal of Community & Applied Social Psychology, 34(1). https://doi.org/10.1002/casp.2722
English Australia. (2018). Guide to best practice in international student mental health. Author. https://www.englishaustralia.com.au/documents/item/493
Forbes-Mewett, H. (2019). Mental health and international students: Issues, challenges and effective practice. International Education Association of Australia (IEAA).
Gebregergis, W. T., Huang, F., & Hong, J. (2019). Cultural intelligence, age and prior travel experience as predictors of acculturative stress and depression among international students studying in China. Journal of International Students, 9(2), 511–534.
Gradiski, I. P., Borovecki, A., Ćurković, M., San-Martín, M., Delgado Bolton, R. C., & Vivanco, L. (2022). Burnout in international medical students: characterization of professionalism and loneliness as predictive factors of burnout. International Journal of Environmental Research and Public Health, 19(3), Article 1385. https://doi.org/10.3390/ijerph19031385
Gyasi-Gyamerah, K., Osafo, J., Gyasi-Gyamerah, A. A., & Boadu, E. S. (2024). Examining acculturative stress among international students in Ghana using an interpretative phenomenological approach: Unpacking the social support systems. PloS One, 19(9). https://doi.org/10.1371/journal.pone.0311123
Han, S., Pistole, M. C., & Caldwell, J. M. (2017). Acculturative stress, parental and professor attachment, and college adjustment in Asian international students. Journal of Multicultural Counseling and Development, 45(2), 111–126. https://doi.org/10.1002/jmcd.12068
Hirai, R., Frazier, P., & Syed, M. (2015). Psychological and sociocultural adjustment of first-year international students: Trajectories and predictors. Journal of Counseling Psychology, 62(3), 438–459. https://doi.org/10.1037/cou0000085
Hong, Q. N., Fàbregues, S., Bartlett, G., Boardman, F., Cargo, M., Dagenais, P., Gagnon, M.-P., Griffiths, F., Nicolau, B., O’Cathain, A., Rousseau, M.-C., Vedel, I., & Pluye, P. (2018). The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers. McGill University.
Huang, S. L., & Mussap, A. J. (2018). Maladaptive perfectionism, acculturative stress, and depression in Asian international university students. Journal of Psychologists and Counsellors in Schools, 28(2), 185–196. https://doi.org/10.1017/jgc.2016.18
Institute of International Education [IIE]. (2024). Open Doors 2024: Report on International Educational Exchange. https://opendoorsdata.org/annual-release/international-students/
Iorga, M., Soponaru, C., Muraru, I. D., Socolov, S., & Petrariu, F. D. (2020). Factors associated with acculturative stress among international medical students. BioMed Research International, 2020(1), 2564725. https://doi.org/10.1155/2020/2564725
Kamardeen, I., & Sunindijo, R. Y. (2018). Stressors impacting the performance of graduate construction students: Comparison of domestic and international students. Journal of Professional Issues in Engineering Education and Practice, 144(4). https://doi.org/10.1061/(ASCE)EI.1943-5541.0000392
Katsumoto, S., & Bowman, N. A. (2021). Changes in psychological well-being among international students in the US: The role of interactions with peers, faculty, and staff. Journal of College Student Development, 62(3), 345–350. https://doi.org/10.1353/csd.2021.0029
Ke, T., Li, W., Sanci, L., Reavley, N., Williams, I., & Russell, M. A. (2023). The mental health of international university students from China during the COVID-19 pandemic and the protective effect of social support: A longitudinal study. Journal of Affective Disorders, 328, 13–21. https://doi.org/10.1016/j.jad.2023.02.014
Khalid, M. S., Zhanyong, Q., & Bibi, J. (2022). The impact of learning in a diversified environment: Social and cognitive development of international students for global mindset. European Journal of Training and Development, 46(5/6), 373–389. https://doi.org/10.1108/EJTD-12-2020-0175
Kim, H. R., & Kim, E. J. (2021). Factors associated with mental health among international students during the COVID-19 pandemic in South Korea. International Journal of Environmental Research and Public Health, 18(21). https://doi.org/10.3390/ijerph182111381
Kim, J., Park, S.-H., Kim, M., Chow, H.-W., & Han, S. (2021). Leisure and health benefits associated with acculturation among Western international students living in South Korea. International Journal of Qualitative Studies on Health and Well-being, 16(1). https://doi.org/10.1080/17482631.2021.1945725
Knettel, B. A., Cherenack, E. M., & Friis, E. A. (2022). Examining causal attributions for depression, alcohol use disorder, and schizophrenia in a diverse sample of international students at US universities. Journal of American College Health, 70(7), 2176–2183. https://doi.org/10.1080/07448481.2020.1846046
Kono, K., Eskandarieh, S., Obayashi, Y., Arai, A., & Tamashiro, H. (2015). Mental health and its associated variables among international students at a Japanese university: With special reference to their financial status. Journal of Immigrant and Minority Health, 17, 1654–1659. https://doi.org/10.1007/s10903-014-0100-1
Koo, K., & Nyunt, G. (2023). Pandemic in a foreign country: Barriers to international students’ well-being during COVID-19. Journal of Student Affairs Research and Practice, 60(1), 123–136. https://doi.org/10.1080/19496591.2022.2056476
Koo, K., Kim, Y. W., Lee, J., & Nyunt, G. (2021). "It is my fault": Exploring experiences and mental wellness among Korean international graduate students. Journal of International Students, 11(4), 790-811. https://doi.org/10.32674/jis.v11i4.2801
Lai, A. Y.-K., Lee, L., Wang, M.-P., Feng, Y., Lai, T. T.-K., Ho, L.-M., Lam, V. S.-F., Ip, M. S.-m., & Lam, T.-h. (2020). Mental health impacts of the COVID-19 pandemic on international university students, related stressors, and coping strategies. Frontiers in Psychiatry, Article 1082. https://doi.org/10.3389/fpsyt.2020.584240
Li, J., Xue, E., & He, Y. (2023). Adjustment to Chinese culture and mental health issues among foreign students on Chinese university campuses during the COVID-19 Pandemic: A collaborative ethnographic study. Behavioral Sciences, 13(7), Article 526. https://doi.org/10.3390/bs13070526
Li, L., & Peng, W. (2019). Transitioning through social media: International students' SNS use, perceived social support, and acculturative stress. Computers in Human Behavior, 98, 69–79. https://doi.org/10.1016/j.chb.2019.03.011
Lian, Z., & Wallace, B. C. (2020). Prevalence of past-year mental disorders and its correlates among Chinese international students in US higher education. Journal of American College Health, 68(2), 176–184. https://doi.org/10.1080/07448481.2018.1538147
Lin, C., Tong, Y., Bai, Y., Zhao, Z., Quan, W., Liu, Z., Wang, J., Song, Y., Tian, J., & Dong, W. (2022). Prevalence and correlates of depression and anxiety among Chinese international students in US colleges during the COVID-19 pandemic: A cross-sectional study. PloS One, 17(4). https://doi.org/10.1371/journal.pone.0267081
Lockwood, C., Mun, Z. & Porritt, K. (2015). Qualitative research synthesis: Methodological guidance for systematic reviewers utilizing meta-aggregation. International Journal of Evidence-based Healthcare 13, 179–187. https://doi.org/10.1097/XEB.0000000000000062
Low, Y. S., Bhar, S. S., & Chen, W. S. (2023). Moderators of suicide ideation in Asian international students studying in Australia. Australian Psychologist, 58(3), 169-178. https://doi.org/10.1080/00050067.2022.2148514
Lu, L., Wang, X., Wang, X., Guo, X., & Pan, B. (2022). Association of COVID-19 pandemic-related stress and depressive symptoms among international medical students. BMC Psychiatry, 22(1), 1–11. https://doi.org/10.1186/s12888-021-03671-8
Ma, J., Saita, K., Kaneko, F., & Okamura, H. (2025). Stressors during the COVID-19 pandemic in international students: a qualitative study. BMC Public Health, 25(1), 1-9. https://doi.org/10.1186/s12889-025-22380-5
Ma, K. (2021). Acculturation stress and depression among first-year international graduate students from China and India in the US. College Student Journal, 55(1), 104-119.
Maffini, C. S. (2018). Campus safety experiences of Asian American and Asian international college students. Asian American Journal of Psychology, 9(2), Article 98.
Maharaj, R., Ndwiga, D., & Chutiyami, M. (2025). Mental health and well-being of international students in Australia: A systematic review. Journal of Mental Health, 34(4), 431–449. https://doi.org/10.1080/09638237.2024.2390393
Maleku, A., Kim, Y. K., Kirsch, J., Um, M. Y., Haran, H., Yu, M., & Moon, S. S. (2022). The hidden minority: Discrimination and mental health among international students in the US during the COVID‐19 pandemic. Health & Social Care in the Community, 30(5), 2419–2432. https://doi.org/10.1111/hsc.13683
Marangell, S., & Baik, C. (2022). International students’ suggestions for what universities can do to better support their mental well-being. Journal of International Students, 12(4), 921-942. https://doi.org/10.32674/jis.v12i4.3877
Miao, C., & Zhang, S. (2024). The effect of mobile social media on the mental health status of Chinese international students: An empirical study on the chain mediation effect. BMC Psychology, 12(1), Article 411. https://doi.org/10.1186/s40359-024-01915-2
Nahidi, S., Blignault, I., Hayen, A., & Razee, H. (2018). Psychological distress in Iranian international students at an Australian university. Journal of Immigrant Minority Health, 20, 651–657. https://doi.org/10.1007/s10903-017-0590-8
Nguyen, M. H., Le, T. T., & Meirmanov, S. (2019). Depression, acculturative stress, and social connectedness among international university students in Japan: A statistical investigation. Sustainability, 11(3), Article 878. https://doi.org/10.3390/su11030878
OECD. (2024). Education at a Glance 2024: OECD Indicators. https://www.oecd.org/en/publications/education-at-a-glance-2024_c00cad36-en.html?
Ogunsanya, M. E., Bamgbade, B. A., Thach, A. V., Sudhapalli, P., & Rascati, K. L. (2018). Determinants of health-related quality of life in international graduate students. Currents in Pharmacy Teaching and Learning, 10(4), 413–422. https://doi.org/10.1016/j.cptl.2017.12.005
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. Systematic Reviews, 10(1), Article 89. https://doi.org/10.1186/s13643-021-01626-4
Pang, H. (2018). Exploring the beneficial effects of social networking site use on Chinese students’ perceptions of social capital and psychological well-being in Germany. International Journal of Intercultural Relations, 67, 1–11. https://doi.org/10.1016/j.ijintrel.2018.08.002
Park, C., & Shimada, S. (2022). The impact of changing nonimmigrant visa policies on international students’ psychological adjustment and well-being in the United States during the COVID-19 pandemic: A qualitative study. BMC Public Health, 22, 1–17. https://doi.org/10.1186/s12889-022-14698-1
Pérez-Rojas, A. E., Choi, N. Y., Yang, M., Bartholomew, T. T., & Pérez, G. M. (2021). Suicidal ideation among international students: The role of cultural, academic, and interpersonal factors. The Counseling Psychologist, 49(5), 673–700. https://doi.org/10.1177/00110000211002458
Project Atlas (2024). Terminology. https://www.iie.org/research-initiatives/project-atlas/terminology/
Qi, L. Y., Roslan, S., & Zaremohzzabieh, Z. (2021). Perceived social support and psychological well-being of international students: The mediating effects of resiliency and spirituality. Asian Journal of University Education, 17(3). https://ssrn.com/abstract=4082596
Rana, M., Choudhary, P., & Ryhal, P. C. (2024). How the relationship of cultural intelligence and social connectedness fosters psychological well-being among international students in Northern India? Millennial Asia, 0(0), 1-26. https://doi.org/10.1177/09763996241277244
Redfern, K. (2016). An empirical investigation of the incidence of negative psychological symptoms among Chinese international students at an Australian university. Australian Journal of Psychology, 68(4), 281–289. https://doi.org/10.1111/ajpy.12106
Russell, M. A., Reavley, N., Williams, I., Li, W., Tarzia, L., Chondros, P., & Sanci, L. (2023). Changes in mental health across the COVID-19 pandemic for local and international university students in Australia: A cohort study. BMC Psychology, 11(55), 1–12. https://doi.org/10.1186/s40359-023-01075-9
Sabouripour, F., Roslan, S., Ghiami, Z., & Memon, M. A. (2021). Mediating role of self-efficacy in the relationship between optimism, psychological well-being, and resilience among Iranian students. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.675645
Saravanan, C., & Subhashini, G. (2021). A systematic review on the prevalence of depression and its associated factors among international university students. Current Psychiatry Research and Reviews Formerly: Current Psychiatry Reviews, 17(1), 13–25. https://doi.org/10.2174/2666082217666210426110208
Sarwar, F., Panatik, S. A., & Jameel, H. T. (2020). Does fear of terrorism influence psychological adjustment of academic sojourners in Pakistan? Role of state negative affect and emotional support. International Journal of Intercultural Relations, 75, 34–47. https://doi.org/10.1016/j.ijintrel.2020.01.002
Seo, H., Liu, Y., Ebrahim, H., Ittefaq, M., & Chung, D. (2023). The COVID-19 pandemic and international students: A mixed-methods approach to relationships between social media use, social support, and mental health. First Monday, 28(2) https://doi.org/10.5210/fm.v28i2.11516
Shadowen, N. L., Williamson, A. A., Guerr, N. G., Ammigand, R., & Drexlerd, M. L. (2018). Prevalence and correlates of depressive symptoms among international students: Implications for university support offices. Journal of International Students, 9(1), 129–148.
Shafaei, A., Nejati, M., & Razak, N. A. (2018). Out of sight, out of mind: Psychological consequences of attachment and adjustment attitude. Studies in Higher Education, 43(2), 251–268. https://doi.org/10.1080/03075079.2016.1162780
Shan, C., Hussain, M., & Sargani, G. R. (2020). A mixed-method investigation on acculturative stress among Pakistani students in China. PloS One, 15(10), Article e0240103. https://doi.org/10.1371/journal.pone.0240103
Smiljanic, I. (2017). The role of attachment, travel experiences and English proficiency in international students' acculturative stress and depressive symptoms. Journal of International Students, 7(2), 188–203.
Suh, H. N., Flores, L. Y., & Wang, K. T. (2019). Perceived discrimination, ethnic identity, and mental distress among Asian international students in Korea. Journal of Cross-Cultural Psychology, 50(8), 991–1007. https://doi.org/10.1177/0022022119874433
Sun, X., Hall, G. C. N., DeGarmo, D. S., Chain, J., & Fong, M. C. (2021). A longitudinal investigation of discrimination and mental health in Chinese international students: The role of social connectedness. Journal of Cross-Cultural Psychology, 52(1), 61-77. https://doi.org/10.1177/0022022120979625
Taliaferro, L. A., Muehlenkamp, J. J., & Jeevanba, S. B. (2020). Factors associated with emotional distress and suicide ideation among international college students. Journal of American College Health, 68(6), 565–569. https://doi.org/10.1080/07448481.2019.1583655
Tan Wen-Xuan, S. R., Lin, A., Fisher, C., Bouras, H., D’Mello, C., Hill, J., Hansen, A., & Marriott, R. (2025). Understanding the risk and protective factors associated with depressive symptoms in international students: A systematic review and meta-analysis. Journal of International Students, 15(10), 199–249. https://doi.org/10.32674/47n8z156
UNESCO. (2024). Glossary terms. https://uis.unesco.org/en/glossary-term
Wang, Y., Wang, X., Wang, X., Guo, X., Yuan, L., Gao, Y., & Pan, B. (2023). Stressors in university life and anxiety symptoms among international students: A sequential mediation model. BMC Psychiatry, 23. https://doi.org/10.1186/s12888-023-05046-7
Wei, M., Li, Y.-S., Du, Y., Botello, R., & Li, C.-I. (2015). Moderating effects of perceived language discrimination on mental health outcomes among Chinese international students. Asian American Journal of Psychology, 6(3), 213–222.
WHO. (2024). Mental health. https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response
Wu, Y., Liu, W., Liu, A., Lin-Schilstra, L., & Lyu, P. (2021). International students’ mental health care in China: A systematic review. Healthcare, 9(12), Article 1634. https://doi.org/10.3390/healthcare9121634
Xiong, Y., & Pillay, Y. (2023). A national study of the mental health status of Asian international students in the United States. Journal of Multicultural Counseling Development, 51, 82–91. https://doi.org/10.1002/jmcd.12238
Xiong, W., Radunz, M., Ali , K., King, D., Kyrios, M. , Zhao, Y., & Fassnacht, D. (2024). Comparing the mental health and well-being of domestic and international tertiary students: A systematic review and meta-analysis. Journal of International Students, 14(4), 702–740. https://doi.org/10.32674/jis.v14i4.6647
Xiong, Y., Rose Parasath, P., Zhang, Q., & Jeon, L. (2022). International students’ perceived discrimination and psychological distress during the COVID-19 pandemic. Journal of American College Health, 72(3), 869–880. https://doi.org/10.1080/07448481.2022.2059376
Xu, T. (2021). Psychological distress of international students during the COVID-19 pandemic in China: Multidimensional effects of external environment, individuals’ behavior, and their values. International Journal of Environmental Research and Public Health, 18(18), Article 9758. https://doi.org/10.3390/ijerph18189758
Yim, H., Kim, A. C. H., Du, J., & James, J. D. (2023). Sport participation, acculturative stress, and depressive symptoms among international college students in the United States. Frontiers in Psychiatry, 14, Article 1104325. https://doi.org/10.3389/fpsyt.2023.1104325
Ying, Z., Kondo, A., & Piao, M. (2025). Mental health challenges among Chinese international students during COVID-19: A systematic review and meta-analysis of depression and anxiety. Journal of International Students, 15(8), 209–230. https://doi.org/10.32674/4mzv0c33
Yu, L., Rahman, M. S., & Li, X. (2023). The effects of academic adaptation on depression of international students in China: A case study on South Asian students of TCSOL teacher program. International Journal of Intercultural Relations, 94, Article 101804. https://doi.org/10.1016/j.ijintrel.2023.101804
Yu, Q., Brunsting, N. C., Smart, J., & Bingham, W. P. (2025). Language proficiency, second language educational experience, and psychological well-being among international students at US universities. Research in Higher Education, 66(1), Article 3. https://doi.org/10.1007/s11162-024-09821-7
Yuan, L. L., Lu, L., Wang, X. H., Guo, X. X., Ren, H., Gao, Y. Q., & Pan, B. C. (2021). Prevalence and predictors of anxiety and depressive symptoms among international medical students in China during COVID-19 pandemic. Frontiers in Psychiatry, 12, Article 761964. https://doi.org/10.3389/fpsyt.2021.761964
Yuan, L., Lu, L., Wang, X., Qu, M., Gao, Y., & Pan, B. (2023). Comorbid anxiety and depressive symptoms and the related factors among international medical students in China during the COVID-19 pandemic: A cross-sectional study. BMC Psychiatry, 23(1), 1–11. https://doi.org/10.1186/s12888-023-04638-7
Zhang, Q. Y., Kim, M. C., & Chang, M. (2024). The impact of SNS and COVID-19-related stress of Chinese students in Korea based on the transaction theory of stress and coping. Heliyon, 10(3), 1–14. https://doi.org/10.1016/j.heliyon.2024.e24111
Zhang, X., Wong, G. T. F., Liu, C. H., Hahm, H., & Chen, J. A. (2022). International student stressors and mental health during the COVID-19 pandemic: A qualitative study. Journal of American College Health, 12, 1–7. https://doi.org/10.1080/07448481.2022.2068015
Zhao, J., Chapman, E., & O’Donoghue, T. (2023). Threats to the emotional well-being of mainland Chinese students studying in Australia: An interpretivist study. International Journal of Qualitative Studies on Health and Well-being, 18. https://doi.org/10.1080/17482631.2023.2221912
Zhao, J., Chapman, E., Houghton, S., & Lawrence, D. (2022a). Perceived discrimination as a threat to the mental health of Chinese international students in Australia. Frontiers in Psychology, 7. https://doi.org/10.3389/feduc.2022.726614
Zhao, J., Houghton, S., & Glasgow, K. (2022b). International students' mental health amidst COVID-19: A systematic review based on current evidence. Education Research and Perspectives, 49, 29–62. https://search.informit.org/doi/10.3316/informit.810360884961033
Zhou, S., Banawa, R., & Oh, H. (2021). Stop Asian hate: The mental health impact of racial discrimination among Asian Pacific Islander young and emerging adults during COVID‐19. Health Services Research, 56, 8–9. https://doi.org/10.1111/1475-6773.13723
Zhou, Y., Zhang, H., & Stodolska, M. (2017). Acculturative stress and leisure among Chinese international graduate students. Leisure Sciences, 40(1), 1–21. https://doi.org/10.1080/01490400.2017.1306466
Zuo, P., Ramamurthy, C., Gowing, A., De Silva, A., & Minas, H. (2025). Factors associated with mental health of Chinese international students in the global context: A systematic review. BMC Public Health, 25, Article 3460. https://doi.org/10.1186/s12889-025-24400-w
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