Biopsychosocial Factors Associated with Depression Among U.S. Undergraduate International Students

Authors

DOI:

https://doi.org/10.32674/jis.v12i1.2914

Keywords:

biopsychosocial model, depression, international students, United States

Abstract

Using a biopsychosocial framework, our study examines the biological, psychological, and sociocultural factors associated with depression among a crosssectional sample of undergraduate international students (N = 712) attending 28 U.S. colleges and universities. Consistent with hypotheses, regression analysis reveals that self-esteem, life satisfaction, and coping self-efficacy are negatively associated with depressive symptoms, and that ethnic minority status, perceived discrimination, and financial concerns are positively associated with depressive symptoms. Contrary to predictions, age, optimism, friendships, and school belonging are not significant predictors, and perseverance predicted increases depression in this sample. The novel findings highlight adaptation issues among international undergraduate students and suggest preventive measures and interventions against depression for university administrators and counselors.

Author Biographies

  • Fanyi Zeng, Wake Forest University, USA

    Fanyi Zeng is a Masters' student in the Psychology Department at Wake Forest University. Her current research focuses on close relationships, attachment styles, and emotional support. Email: zengf15@wfu.edu

  • Nelson C. Brunsting, Wake Forest University, USA

    Nelson C. Brunsting, PhD, is a research associate professor of International Studies and Director for the Center for Research on Abroad and International Student Engagement (RAISE Center) at Wake Forest University. His research focuses on understanding and enhancing the development and well-being of diverse populations in educational contexts. Email: brunstnc@wfu.edu

  • Nicole Brocato, Wake Forest University, USA

    Nicole Brocato, PhD, is the Director of the Wellbeing Assessment at Wake Forest University. Her research focuses on creating inclusive and equitable models of wellbeing, identifying environmental barriers and supports for student wellbeing, and understanding patterns of association between wellbeing dimensions. Email: brocatnw@wfu.edu

  • Lisa Kiang, Wake Forest University, USA

    Lisa Kiang, PhD, is a professor in the Psychology Department at Wake Forest University. Her research is in self and identity, family and social relationships, and culture. Email: kiangl@wfu.edu

  • Eranda Jayawickreme, Wake Forest University, USA

    Eranda Jayawickreme, PhD, is the Harold W. Tribble professor of psychology and a senior research fellow at the Program for Leadership and Character at Wake Forest University. His research focuses on personality dynamics, post-traumatic growth, well-being, and character. Email: jayawide@wfu.edu

  • Sonali Kathuria, Wake Forest University, USA

    Sonali Kathuria is a Master’s student in International Higher Education and Graduate Assistant for the Career Center and Schiller Institute at Boston College. Her major research interests lie in the area of global assessments. Email: sonalink10@gmail.com



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

Alonso, J., Mortier, P., Auerbach, R. P., Bruffaerts, R., Vilagut, G., Cuijpers, P., … WHO WMH-ICS Collaborators. (2018). Severe role impairment associated with mental disorders: Results of the WHO World Mental Health Surveys International College Student Project. Depression and Anxiety, 35(9), 802–814. doi:10.1002/da.22778

American College Health Association. (2019). National college health assessment II: Undergraduate student reference group executive summary spring 2019. Retrieved from https://www.acha.org/documents/ncha/NCHA-II_SPRING_2019_UNDERGRADUATE_

REFERENCE%20_GROUP_EXECUTIVE_SUMMARY.pdf

Areba, E. M., Duckett, L., Robertson, C., & Savik, K. (2018). Religious coping, symptoms of depression and anxiety, and well-being among Somali college students. Journal of Religion & Health, 57(1), 94–109. https://doi.org/10.1007/s10943-017-0359-3

Armenta, B. E., Lee, R. M., Pituc, S. T., Jung, K. R., Park, I. J., Soto, J. A., ... & Schwartz, S. J. (2013). Where are you from? A validation of the Foreigner Objectification Scale and the psychological correlates of foreigner objectification among Asian Americans and Latinos. Cultural Diversity and Ethnic Minority Psychology, 19(2), 131-142.

Auerbach, R. P., Mortier, P., Bruffaerts, R., Alonso, J., Benjet, C., Cuijpers, P., … Kessler, R. C. (2018). WHO World Mental Health Surveys International College Student Project: Prevalence and distribution of mental disorders. Journal of Abnormal Psychology, 127(7), 623–638. https://doi.org/10.1037/abn0000362.supp

Bailey, R. K., Mokonogho, J., & Kumar, A. (2019). Racial and ethnic differences in depression: current perspectives. Neuropsychiatric Disease and Treatment, 15, 603–609. https://doi.org/10.2147/NDT.S128584

Bardone-Cone, A. M., Cass, K. M., & Ford, J. A. (2008). Examining body dissatisfaction in young men within a biopsychosocial framework. Body Image, 5(2), 183–194. https://doi.org/10.1016/j.bodyim.2007.12.004

Benner, A. D., & Graham, S. (2013). The antecedents and consequences of racial/ethnic discrimination during adolescence: Does the source of discrimination matter?. Developmental Psychology, 49(8), 1602-1613.

Brocato, N., & Jayawickreme, E. (2017, April). Assessing the precursors and attainment of wellbeing in higher education. Presented at the National Council on Measurement in Education, San Antonio, TX. Retrieved from https://prod.wp.cdn.aws.wfu.edu/sites/320/2018/01/Brocato-2017-Assessing-wellbeing-precursors-and-attainment-NCME-paper.pdf

Brunsting, N. C., Smith, A. C., & Zachry, C. E. (2018). An academic and cultural transition course for international students: Efficacy and Social-emotional outcomes. Journal of International Students, 8, 1497-1521. doi:10.5281/zenodo.1467805

Brunsting, N. C., Zachry, C., & Takeuchi, R. (2018). Predictors of undergraduate international student psychosocial adjustment to U.S. universities: A systematic review from 2009-2018. International Journal of Intercultural Relations, 66, 22-33. doi:10.1016/j.ijintrel.2018.06.002

Brunsting, N. C., Mischinski, M., Wu., W., Tevis, T., Takeuchi, R., He, Y., Zheng, Y., & Coverdell, T. L. (2019). International students’ social outcomes, educational status, and country of high school graduation. Journal of Studies in International Education, 23, 589-606. https://doi.org/10.1177/1028315318825362

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. Journal of Experimental Education. doi:10.1080/00220973.2019.1639598

Burke, T., Sticca, F., & Perren, S. (2017). Everything’s gonna be alright! The longitudinal interplay among social support, peer victimization, and depressive symptoms. Journal of Youth and Adolescence, 46(9), 1999–2014. https://doi.org/10.1007/s10964-017-0653-0

Calkins, S. D., & Dollar, J. M. (2014). Emotion: Commentary: A biopsychosocial perspective on maternal psychopathology and the development of child emotion regulation. Journal of Personality Disorders, 28(1), 70–77. https://doi.org/10.1521/pedi.2014.28.1.70

Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. (2017). Leading causes of death reports, 1981 - 2017. Retrieved from https://webappa.cdc.gov/sasweb/ncipc/leadcause.html

Chan, V., Moore, J., Derenne, J., & Fuchs, D. C. (2019). Transitional age youth and college mental health. Child and Adolescent Psychiatric Clinics of North America, 28(3), 363–375. https://doi.org/10.1016/j.chc.2019.02.008

Christophe, N. K., Stein, G. L., Martin Romero, M. Y., Chan, M., Jensen, M., Gonzalez, L. M., & Kiang, L. (2019). Coping and culture: The protective effects of shift-&-persist and ethnic-racial identity on depressive symptoms in Latinx youth. Journal of Youth and Adolescence, 48(8), 1592–1604. doi:10.1007/s10964-019-01037-8

Comer, R. J., & Comer, J. S. (2018). Abnormal psychology. New York, NY: Worth Publishers.

Constantine, M. G., Okazaki, 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), 230–241. https://doi.org/10.1037/0002-9432.74.3.230

Credé, M., Tynan, M. C., & Harms, P. D. (2017). Much ado about grit: A meta-analytic synthesis of the grit literature. Journal of Personality and Social Psychology, 113(3), 492–511. https://doi.org/10.1037/pspp0000102

de Girolamo, G., Dagani, J., Purcell, R., Cocchi, A., & McGorry, P. D. (2012). Age of onset of mental disorders and use of mental health services: Needs, opportunities and obstacles. Epidemiology and Psychiatric Sciences, 21(1), 47–57. https://doi.org/10.1017/S2045796011000746

Diener, E., & Diener, M. (1995). Cross-cultural correlates of life satisfaction and self-esteem. Journal of Personality & Social Psychology, 68(4), 653–663. https://doi.org/10.1037/0022-3514.68.4.653

Disabato, D. J., Goodman, F. R., & Kashdan, T. B. (2019). Is grit relevant to well-being and strengths? Evidence across the globe for separating perseverance of effort and consistency of interests. Journal of Personality, 87, 194–211. https://doi.org10.1111/jopy.12382

DiStefano, C., Zhu, M., & Mindrila, D. (2009). Understanding and using factor scores: Considerations for the applied researcher. Practical Assessment, Research, and Evaluation, 14, 20. https://doi.org/10.7275/da8t-4g52

Drews, A., & Hazlett-Stevens, H. (2008). Relationships between irritable bowel syndrome, generalized anxiety disorder, and worry-related constructs. International Journal of Clinical and Health Psychology, 8(2), 429–436. https://doi.org/10.3346/jkms.2012.27.11.1398

Ebert, D. D., Buntrock, C., Mortier, P., Auerbach, R., Weisel, K. K., Kessler, R. C., … Bruffaerts, R. (2019). Prediction of major depressive disorder onset in college students. Depress Anxiety, 36, 294–304. https://doi.org/10.1002/da.22867

Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196(4286), 129–136. https://doi.org/10.1126/science.847460

Gan, W. Y., Mohd Nasir, M. T., Zalilah, M. S., & Hazizi, A. S. (2012). Psychological distress as a mediator in the relationships between biopsychosocial factors and disordered eating among Malaysian university students. Appetite, 59(3), 679–687. https://doi.org/10.1016/j.appet.2012.08.002

Gonzalez, L. M., Stein, G. L., Kiang, L., & Cupito, A. M. (2014). The impact of discrimination and support on developmental competencies in Latino adolescents. Journal of Latina/o Psychology, 2(2), 79-91.

Gummadam, P., Pittman, L. D., & Ioffe, M. (2016). School belonging, ethnic identity, and psychological adjustment among ethnic minority college students. Journal of Experimental Education, 84(2), 289–306. https://doi.org/10.1080/00220973.2015.1048844

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. https://doi.org/10.1080/07448481.2012.738267

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, 111-126. https://doi.org/10.1002/jmcd.12068

Highland, K. B., Herschl, L. C., Klanecky, A., & McChargue, D. E. (2013). Biopsychosocial pathways to alcohol-related problems. American Journal on Addictions, 22(4), 366-372. https://doi.org/10.1111/j.1521-0391.2013.12012.x

Hutz, C. S., Midgett, A., Pacico, J. C., Bastianello, M. R., & Zanon, C. (2014). The relationship of hope, optimism, self-esteem, subjective well-being, and personality in Brazilians and Americans. Psychology, 5(6), 514–522. https://doi.org/10.4236/psych.2014.56061

Hysenbegasi, A., Hass, S. L., & Rowland, C. R. (2005). The impact of depression on the academic productivity of university students. The Journal of Mental Health Policy and Economics, 8, 145–151. Retrieved from https://pdfs.semanticscholar.org/ff57/92efb15fff95002972264a354d15fa6da7b0.pdf

Institute of International Education. (2019). Open Doors: 2019 Fast Facts. Retrieved from https://www.iie.org/Research-and-Insights/Open-Doors/Fact-Sheets-and-Infographics/Fast-Facts

Jackson, M., Ray, S., & Bybell, D. (2013). International students in the U.S.: social and psychological adjustment. Journal of International Students, 3(1), 17–28. Retrieved from https://www.ojed.org/index.php/jis/article/view/515

Jayawickreme, E., Forgeard, M. J. C., & Seligman, M. E. P. (2012). The engine of well-being. Review of General Psychology, 16(4), 327–342. https://doi.org/10.1037/a0027990

Jenkins, A. H., Harburg, E., Weissberg, N. C., & Donnelly, T. (2004). The Influence of minority group cultural models on persistence in college. Journal of Negro Education, 73(1), 69–80. https://doi.org/10.2307/3211260

Jorgensen, T. D., Pornprasertmanit, S., Schoemann, A. M., & Rosseel, Y. (2019). semTools: Useful tools for structural equation modeling. R package version 0.5-2. Retrieved from https://CRAN.R-project.org/package=semTools

Kim, Y. K., Maleku, A., Lemieux, C. M., Du, X., & Chen, Z. (2019). Behavioral health risk and resilience among international students in the United States: A study of socio-demographic differences. Journal of International Students, 9(1), 282-305. https://doi.org/10.32674/jis.v9i1.264

Kovtun, O. (2011). International student adaptation to a U.S. college: A mixed methods exploration of the impact of a specialized first-year course at a large Midwestern institution. Journal of Student Affairs Research and Practice, 48, 349-366.

Kwasky, A. N., & Groh, C. J. (2014). Vitamin D, depression and coping self-efficacy in young women: Longitudinal study. Archives of Psychiatric Nursing, 28(6), 362–367. https://doi.org/10.1016/j.apnu.2014.08.010

LeBreton, J. M., & Senter, J. L. (2008). Answers to 20 questions about interrater reliability and interrater agreement. Organizational Research Methods, 11(4), 815-852. https://doi.org/10.1177/1094428106296642

Li, J. Q., Liu, X., Wei, T., & Lan, W. (2013). Acculturation, Internet use, and psychological well-being among Chinese international students. Journal of International Students, 3(2), 155–166. Retrieved from https://pdfs.semanticscholar.org/544f/a09c37cd14cd18c3437889d959ce7cad1f11.pdf

Little, T., & Rhemtulla, M. (2013). Planned missing data designs for developmental researchers. Child Development Perspectives, 7(4), 199–204. https://doi.org/10.1111/cdep.12043

Liu, J., Bowker, J. C., Coplan, R. J., Yang, P., Li, D., & Chen, X. (2019). Evaluating links among shyness, peer relations, and internalizing problems in Chinese young adolescents. Journal of Research on Adolescence, 29(3), 696–709. https://doi.org/10. 1111/jora.12406

Luhmann, M., Lucas, R. E., Eid, M., & Diener, E. (2013). The prospective effect of life satisfaction on life events. Social Psychological and Personality Science, 4(1), 39-45. https://doi.org/10.1177/1948550612440105

Mackenzie, S., Wiegel, J. R., Mundt, M., Brown, D., Saewyc, E., Heiligenstein, E., … Fleming, M. (2011). Depression and suicide ideation among students accessing campus health care. American Journal of Orthopsychiatry, 81(1), 101–107. https://doi.org/10.1111/j.1939-0025.2010.01077.x

Martens, M. P., Martin, J. L., Hatchett, E. S., Fowler, R. M., Fleming, K. M., Karakashian, M. A., & 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(4), 535–541. https://doi.org/10.1037/a0013588

Meghani, D. T., & Harvey, E. A. (2016). Asian indian international students’ trajectories of depression, acculturation, and enculturation. Asian American Journal of Psychology, 7(1), 1–14. https://doi.org/10.1037/aap0000034

Meyers, L.S., Gamst, G., & Guarino, A.J. (2016). Applied multivariate research: Design and Interpretation (3rd ed.). Thousand Oaks, CA: Sage Publications.

Mortier, P., Auerbach, R. P., Alonso, J., Bantjes, J., Benjet, C., Cuijpers, P., … Vives, M. (2018). Suicidal thoughts and behaviors among first-year college students: Results from the WMH-ICS Project. Journal of the American Academy of Child & Adolescent Psychiatry, 57(4), 263-273. https://doi.org/10.1016/j.jaac.2018.01.018

O’Brien, R. M. (2007). A caution regarding rules of thumb for variance inflation factors. Quality & Quantity, 41, 673-690. https://doi.org/10.1007/s11135-006-9018-6

Omori, M., & Ingersoll, G. M. (2005). Health-endangering behaviours among Japanese college students: A test of psychosocial model of risk-taking behaviours. Journal of Adolescence, 28(1), 17–33. https://doi.org/10.1016/j.adolescence.2004.04.004

Prelow, H. M., Weaver, S. R., & Swenson, R. R. (2006). Competence, self-esteem, and coping efficacy as mediators of ecological risk and depressive symptoms in urban African American and European American youth. Journal of Youth and Adolescence, 35(4), 507–517. https://doi.org/10.1007/s10964-006-9068-z

Rosseel, Y. (2012). Lavaan: An R package for structural equation modeling. Journal of Statistical Software, 48(2), 1-36.

Salles, A., Cohen, G. L., & Mueller, C. M. (2014). The relationship between grit and resident well-being. American Journal of Surgery, 207(2), 251–254. https://doi.org/10.1016/j.amjsurg.2013.09.006

Schry, A. R., Norberg, M. M., Maddox, B. B., & White, S. W. (2014). Gender matters: The relationship between social anxiety and alcohol-related consequences. PLoS ONE, 9(12), 1–14. https://doi.org/10.1371/journal.pone.0115361

Seo, E. H., Kim, S. G., Kim, S. H., Kim, J. H., Park, J. H., & Yoon, H. J. (2018). Life satisfaction and happiness associated with depressive symptoms among university students: a cross-sectional study in Korea. Annals of General Psychiatry, 17, 52. https://doi.org/10.1186/s12991-018-0223-1

Servaty-Seib, H. L., Lockman, J., Shemwell, D., & Reid Marks, L. (2016). International and domestic students, perceived burdensomeness, belongingness, and suicidal ideation. Suicide & Life-threatening Behavior, 46(2), 141–153. doi: 10.1111/sltb.12178

Sheldon, K. M., & Elliot, A. J. (1999). Goal striving, need satisfaction, and longitudinal well-being: The self-concordance model. Journal of Personality and Social Psychology, 76(3), 482–497. https://doi.org/10.1037/0022-3514.76.3.482

Shadowen, N. L., Williamson, A. A., Guerra, N. G., Ammigan, R., & Drexler, M. L. (2019). Prevalence and correlates of depressive symptoms among international students: Implications for university support offices. Journal of International Students, 9(1), 129–148. https://doi.org/10.32674/jis.v9i1.277

Sharkey, C. M., Bakula, D. M., Baraldi, A. N., Perez, M. N., Suorsa, K. I., Chaney, J. M., & Mullins, L. L. (2018). Grit, illness-related distress, and psychosocial outcomes in college students with a chronic medical condition: A path analysis. Journal of Pediatric Psychology, 43(5), 552–560. https://doi.org/10.1093/jpepsy/jsx145

Singh, P., & Bussey, K. (2011). Peer victimization and psychological maladjustment: The mediating role of coping self‐efficacy. Journal of Research on Adolescence, 21(2), 420–433. https://doi.org/10.1111/j.1532-7795.2010.00680.x

Singh, K., & Jha, S. D. (2008). Positive and negative affect, and grit as predictors of happiness and life satisfaction. Journal of the Indian Academy of Applied Psychology, 34, 40–45. Retrieved from http://medind.nic.in/jak/t08/s1/jakt08s1p40.pdf

Snyder, C. R. (2002). Hope theory: Rainbows in the mind. Psychological Inquiry, 13(4), 249–275. https://doi.org/10.1207/S15327965PLI1304_01

Sümer, S., Poyrzli, S., & Grahame, K. (2008). Predictors of depression and anxiety among international students. Journal of Counseling & Development, 86(4), 429–437. https://doi.org/10.1002/j.1556-6678.2008.tb00531.x

Tauriac, J. J., & Liem, J. H. (2012). Exploring the divergent academic outcomes of US-origin and immigrant-origin Black undergraduates. Journal of Diversity in Higher Education, 5(4), 244–258. https://doi.org/10.1037/a0030181

The Wellbeing Assessment. (2019). Retrieved October 17, 2019, from Wellbeing Collaborative website: https://wellbeingcollaborative.wfu.edu/the-wellbeing-assessment/

Vainio, M., & Daukantaitė, D. (2016). Grit and different aspects of well-being: Direct and indirect relationships via sense of coherence and authenticity. Journal of Happiness Studies, 17(5), 2119–2147. https://doi.org/10.1007/s10902-015-9688-7

Ware, W. M., Ferron, J. M., & Miller, B. M. (2013). Introductory statistics: A conceptual approach using R. New York, NY: Routledge.

Wei, M., Ku, T.-Y., Russell, D. W., Mallinckrodt, B., & Liao, K. Y.-H. (2008). Moderating effects of three coping strategies and self-esteem on perceived discrimination and depressive symptoms: A minority stress model for Asian international students. Journal of Counseling Psychology, 55(4), 451–462. https://doi.org/10.1037/a0012511

Wong, S. S., & Lim, T. (2009). Hope versus optimism in Singaporean adolescents: Contributions to depression and life satisfaction. Personality and Individual Differences, 46(5–6), 648–652. https://doi.org/10.1016/j.paid.2009.01.009

Downloads

Published

2021-07-09

Issue

Vol. 12 No. 1 (2022)

Section

Research Articles (English)

License

Copyright (c) 2022 Journal of International Students

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

All published articles are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 4.0 Unported License.

How to Cite

Biopsychosocial Factors Associated with Depression Among U.S. Undergraduate International Students. (2021). Journal of International Students, 12(1), 101-122. https://doi.org/10.32674/jis.v12i1.2914