Predictors of mental health among international students in the United States: A systematic literature review

Objectives: This review systematically examined predictors of mental health among international college and graduate students in the United States.

Methods: Forty-nine quantitative studies published in peer-reviewed journals from 1990 to 2007 were reviewed. Statistically significant predictors of mental health were extracted using the Matrix Method and grouped by mental health outcome variables which include psychological symptoms (e.g., depression), stress/acculturative stress, physical symptoms, and sociocultural adjustment or difficulties. The methodological quality of each study was examined using an 11-point grading criteria, assessing the employment of theoretical framework, reporting of data's validity and reliability, design, and analytic techniques, etc.

Results: The most frequently reported predictors included social support, English language proficiency, stress, region/country of origin, length of residence in the United States, contact with Americans, acculturation, self-efficacy, gender, and personality. Mediation and moderation effects of various variables were also reported by the reviewed studies. The mean methodological score of the reviewed studies was 6.39 (SD=1.56). The majority of the studies presented theoretical frameworks (86%) or reported outcome variable data's reliability (80%); a relatively small percentage of the studies reported outcome variable data's validity (27%), compared among countries/regions of origin (22%), or employed longitudinal designs (14%).

Conclusions: Health promotion professionals on U.S. college campuses should incorporate the most frequently reported predictors found in this review when developing programs for international students. Addressing areas of methodological quality that reveal room for improvement, future studies could better contribute to the promotion of mental health among international students in the United States.