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Abstract

This study combined suicide, acculturation, and identity change frameworks to predict the likelihood of suicidality endorsement among collegiate international students. Participants included 179 undergraduate and graduate international students enrolled at a large Southern university. Ultimately, depression, perceived burdensomeness, and ethnic identity significantly predicted suicidality endorsement after controlling for age, time spent in the United States, gender, and alcohol consumption. Acculturation stress and thwarted belongingness did not statistically significantly predict suicidality endorsement. We offer implications for academic communities and future research surrounding international students and suicide.

Keywords

internationalization of academic profession student services and wellbeing internationalization of the disciplines theoretical perspectives on international education quantitative survey international student international student experience suicide self-harm

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References

A. L.

Nicdao

E. G.

Appel

H. B.

Lee

D. H. J.

(2015). Ethnic identity and major depression in Asian American subgroups nationwide: Differential findings in relation to subcultural contexts. Journal of Clinical Psychology, 71(12), 1225–1244. https://doi.org/10.1002/jclp.22214

Alebeek

W. V.

Wilson

K. B.

(2019). Explaining the college choice decisions of international students at a regional university in the United States. Journal of Research in International Education, 18(3), 292–309. https://doi.org/10.1177/1475240919892468

Aloba

Ojeleye

Aloba

(2017). The psychometric characteristics of the 4-item suicidal behaviors questionnaire – revised (SBQ-R) as a screening tool in a non-clinical sample of Nigerian university students. Asian Journal of Psychiatry, 26, 46–51. https://doi.org/10.1016/j.ajp.2017.01.017

Balidemaj

Small

(2019). The effects of ethnic identity and acculturation in mental health of immigrants: A literature review. International Journal of Social Psychiatry, 65(7–8), 643–655. https://doi.org/10.1177/0020764019867994

Berry

J. W.

(2005). Acculturation: Living successfully in two cultures. International Journal of Intercultural Relations, 29, 697–712. https://doi.org/10.1016.j.ijntrel.2005.07.013

Centers for Disease Control and Prevention (CDC) (2024). Preventing suicide. https://www.cdc.gov/suicide/pdf/NCIPC-Suicide-FactSheet-508_FINAL.pdf

Cero

Zuromski

K. L.

Witte

T. K.

Ribeiro

J. D.

Joiner

T. E.

(2015). Perceived burdensomeness, TB, and suicide ideation: Re-examination of the interpersonal-psychological theory in two samples. Psychiatry Research, 228, 544–550. https://doi.org/10.1016/j.psychres.2015.05.055

Choo

C. C.

Harris

K. M.

Chew

P. K. H

R. C.

Hashimoto

(2017). Does ethnicity matter in risk and protective factors for suicide attempts and suicide lethality?. PLOS ONE, 12(4), e0175752. https://doi.org/10.1371/journal.pone.0175752

Constantine

M. G.

Okazaki

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

10.

Dvorak

R. D

Lamis

D. A.

Malone

P. S

(2013). Alcohol use, depressive symptoms, and impulsivity as risk factors for suicide proneness among college students. Journal of Affective Disorders, 149(1-3), 326–334. https://doi.org/10.1016/j.jad.2013.01.046

11.

Faul

Erdfelder

Lang

A.-G.

Buchner

(2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175–191. https://doi.org/10.3758/BF03193146

12.

Field

(2018). Discovering statistics using IBM SPSS statistics (5th ed). Sage Edge.

13.

Ghazisaeedi

Mahmoodi

Arpaci

Mehrdar

Barzegari

(2021). Validity, reliability, and optimal cut-off scores of the WHO-5, PHQ-9, and PHQ-2 to screen depression among university students in Iran. International Journal of Mental Health and Addiction, 1–10. https://doi.org/10.1007/s11469-021-00483-5c

14.

Gonzalez

V. M.

Hewell

V. M.

(2012). Suicidal ideation and drinking to cope among college binge drinkers. Addictive Behaviors, 37(8), 994–997. https://doi.org/10.1016/j.addbeh.2012.03.027

15.

Chang

Wang

(2020). The mediating effect of psychache on the relationship between psychological strains and suicidal behaviors among Chinese Hiu and Han medical students. SAGE Open, 1–8. https//doi.org/10.1177/2158244020942158

16.

Hamamura

Laird

P. G.

(2014). The effect of perfectionism and acculturative stress on levels of depression experienced by East Asian international students. Journal of Multicultural Counseling and Development, 42, 205–217. https://doi.org/10.1002/j.2161-1912.2014.00055.x

17.

Han

Berry

J. W.

Zheng

(2016). The relationship of acculturation strategies to resilience: The moderating impact of social support among Qiang ethnicity following the 2008 Chinese earthquake. PloS One, 11(10), 1–16. https://doi.org/10.1371/journal.pone.0164484

18.

Han

Pong

(2015). Mental health help-seeking behaviors among Asian American community college students: The effect of stigma, cultural barriers, and acculturation. Journal of College Student Development, 56(1), 1–14. https://doi.org/10.1353/csd.2015.0001

19.

Hansen

H. R.

Shneyderman

McNamara

G. S.

Grace

(2018). Assessing acculturative stress of international students at a U.S. community college. Journal of International Students, 8(1), 215–232. https://doi.org/10.5281/zenodo.1134293

20.

Haslam

Steffens

N. K.

Brandscombe

N. R.

Haslam

S. A.

Cruwys

Lam

B. C. P.

Pachana

N. A.

Yang

(2018). The importance of social groups for retirement adjustment: Evidence, application, and policy implications of the social identity model of identity change. Social Issues and Policy Review, 13(1), 93–124. https://doi.org/10.111/sipr.12049

21.

Hennings

J. M.

(2020). Function and psychotherapy of chronic suicidality in borderline personality disorder: Using the reinforcement model of suicidality. Frontiers in Psychology, 11, 1–8. https://doi.org/10.3389/fpsyt.2020.00199

22.

Huhn

Eckart

Karimian-Jazi

Amr

Herzog

Nikendei

(2015). Voluntary peer-led exam preparation course for international first-year students: Tutees’ perceptions. BMC Medical Education, 15(105), 1–9. https://doi.org/10.1186/s12909-015-0391-5

23.

Hunt

E. N.

Martens

M. P.

Wang

K. T.

Yan

G. C.

(2017). Acculturative stress as a moderator for international student drinking behaviors and alcohol use consequences. Journal of Ethnicity in Substance Abuse, 16(3), 263–275. https://doi.org/10.1080/15332640.2016.1185656

24.

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. https://doi.org/10.1037/a0017393

25.

Jetten

Haslam

S. A.

Iyer

Haslam

(2010). Turning to others in times of change: Social identity and coping with stress. In Stürmer

Snyder

(Eds.), The psychology of prosocial behavior: Group processes, intergroup relations, and helping (pp. 139–156). Wiley-Blackwell.

26.

Joiner

(2009). The interpersonal-psychological theory of suicidal behavior: Current empirical status. https://www.apa.org/science/about/psa/2009/06/sci-brief

27.

Joiner

T. E.

Riberiro

J. D.

Silva

(2012). Nonsuicidal self-injury, suicidal behavior, and their co-occurrence as viewed through the lens of the interpersonal theory of suicide. Current Directions in Psychological Science, 21(5), 342–347. https://doi.org/10.1177/0963721412454873

28.

Kim

Y. K.

Cronley

(2020). Acculturative stress and binge drinking among international students in the United States: Resilience and vulnerability approaches. Journal of American College Health, 68(2), 207–218. https://doi.org/10.1080/07448481.2018.1538998

29.

Koyama

Belli

(2011). Alcohol Use, Acculturative Stress, and Drinking Motivation Among International Community College Students. Journal of Multicultural Counseling and Development, 39(4), 229–240. https://doi.org/10.1002/jmcd.2011.39.issue-4

30.

Kroenke

Spitzer

R. L.

Williams

J. B. W.

(2001). Validity of a brief depression severity measure. Journal of General International Medicine, 16, 660–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

31.

Lee

Ditchman

Fong

M. W. M.

Piper

Feigon

(2014). Mental health service seeking among Korean international students in the United States: A path analysis. Journal of Community Psychology, 42(6), 639–655. https://doi.org/10.1002/jcop.21643

32.

Lee

S.-K.

Sobal

Frongillo

E. A.

(2003). Comparison of models of acculturation. Journal of Cross-Cultural Psychology, 34(3), 282–296. https://doi.org/10.1177/0022022103253142

33.

Marbley

A. F.

Bradley

L. J

., & Lan

(2016). Attitudes toward seeking professional counseling services among Chinese international students: Acculturation, ethnic identity, and English proficiency. Journal of Multicultural Counseling and Development, 44(1), 65–76. https://doi.org/10.1002/jmcd.2016.44.issue-1

34.

Lipsky

Kernic

M. A.

Qiu

Hasin

D. S.

(2016). Posttraumatic stress disorder and alcohol misuse among women: Effects of ethnic minority stressors. Social Psychiatry, 51, 407–419. https://doi.org/10.1007/s00127-015-1109-z

35.

Mackenzie

Wiegel

J. R.

Mundt

Brown

Saewyc

Heiligenstein

Harahan

Fleming

(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

36.

Madden-Dent

Wood

Roskina

(2019). An inventory of international student services at 200 U.S. universities and colleges: Descriptive data of pre-departure and post-arrival supports. Journal of International Students, 4, 993. https://doi.org/10.32674/jis.v9i4.346

37.

Marks

L. R.

Ciftci

Lee

(2018). Dimensions of acculturation and work hope in international students. Journal of Employment Counseling, 55(3), 115–123. https://doi.org/10.1002/joec.12091

38.

Martirosyan

N. M

Bustamante

Saxon

D. P.

(2019). Academic and Social Support Services for International Students. Journal of International Students, 9(1), 172–191. https://doi.org/10.32674/jis.v9i1

39.

Mori

S. C.

(2000). Addressing the mental health concerns of international students. Journal of Counseling and Development, 78, 137–144. https://doi.org/10.1002/j.1556-6676.2000.tb02571.x

40.

N. W. K.

Haslam

S. A.

Haslam

Cruwys

(2018). “How can you make friends if you don’t know who you are?” A qualitative examination of international students’ experience informed by the social identity model of identity change. Journal of Community & Applied Social Psychology, 3, 169. https://doi.org/10.1002/casp.2349

41.

O’Keefe

V. M.

Wingate

L. R.

Tucker

R. P.

Rhoades-Kerswill

Slish

M. L.

Davidson

C. L.

(2014). Interpersonal suicide risk for American Indians: Investigating thwarted belongingness and perceived burdensomeness. Cultural Diversity and Ethnic Minority Psychology, 1, 61–67. https://doi.org/10.1037/a0033540

42.

Osman

Bagge

C. L.

Gutierrez

P. M.

Konick

L. C.

Kopper

B. A.

Barrios

F. X.

(2001). The suicidal behaviors questionnaire – revised (SBQ-R): Validation with clinical and nonclinical samples. Assessment, 8(4), 443–454. https://doi.org/10.1177/107319110100800409

43.

Pallant

(2020). SPSS survival manual (7th ed.). Open University Press.

44.

Park

S.-Y.

Anastas

Shibusawa

Nguyen

(2014). The impact of acculturation and acculturative stress on alcohol use across Asian immigrant subgroups. Substance Use & Misuse, 49(8), 922–931. https://doi.org/10.3109/10826084.2013.855232

45.

Pérez-Rojas

A. E.

Choi

N.-Y.

Yang

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

46.

Peterson

R. A.

Merunka

D. R.

(2014). Convenience samples of college students and research reproducibility. Journal of Business Research, 67(5), 1035–1041. https://doi.org/10.1016/j.jbusres.2013.08.010

47.

Phinney

J. S.

(1992). The multigroup ethnic identity measure: A new scale for use with diverse groups. Journal of Adolescent Research, 7(2), 156–176. https://doi.org/10.1177/074355489272003

48.

Phinney

J. S.

Ong

A. D

. (2007). Multigroup ethnic identity measure - Revised (MEIM-R). APA Psych Tests. https://doi.org/10.1037/t03615-000

49.

Praharso

N. F.

Tear

M. J.

Cruwys

(2017). Stressful life transitions and wellbeing: A comparison of the stress-buffering hypothesis and the social identity model of identity change. Psychiatry Research, 247, 265–275. https://doi.org/10.1016/j.psychres.2016.11.039

50.

Reinert

D. F.

Allen

J. P.

(2002). The alcohol use disorders identification test (AUDIT): A review of recent research. Alcoholism: Clinical and Experimental Research, 26(2), 272–279. https://doi.org/10.1111/j.1530-0277.2002.tb02534.x

51.

Roberts

R. E.

Phinney

J. S.

Masse

L. C.

Chen

R. Y.

Roberts

C. R.

Romero

(1999). The structure of ethnic identity of young adolescents from diverse ethnocultural groups. The Journal of Early Adolescence, 19(3), 301–322. https://doi.org/10.1177/0272431699019003001

52.

Rosenthal

J. A.

(1996). Qualitative descriptors of strength of association and effect size. Journal of Social Service Research, 21(4), 37–59. https://doi.org/10.1300/J079v21n04_02

53.

Sandhu

D. S.

Asrabadi

B. R.

(1994). Development of an acculturative stress scale for international students: Preliminary findings. Psychological Reports, 75, 435–448. https://doi.org/10.2466/pr0.1994.75.1.435

54.

Saunders

J. B.

Aasland

O. G.

Babor

T. F.

De La Fuente

J. R.

Grant

(1993). Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption –II. Addiction, 88, 791–804. https://doi.org/10.1111/j.1360-0443.1993.tb02093.x

55.

Servaty-Seib

H. L.

Lockman

Shemwell

Marks

L. R.

(2016). International and domestic students, perceived burdensomeness, belongingness, and suicidal ideation. Suicide and Life-Threatening Behavior, 46(2), 141–153. https://doi.org/10.1111/sltb.12178

56.

Shapiro

Farrelly

Tomas

(2014). Fostering international student success in higher education. TESOL Publications.

57.

Stowe

Clinebell

(2015). An examination of learning preferences of U. S. and International Students. Journal of Teaching in International Business, 26, 258–272. https://doi.org/10.1080/08975930.2015.1127796

58.

Szabo

Ward

Jose

P. E.

(2016). Uprooting stress, coping, and anxiety: A longitudinal study of international students. International Journal of Stress Management, 23(2), 190–208. https://doi.org/10.1037/a009771

59.

Taliaferro

L. A.

Muehlenkamp

J. J.

Jeevanba

S. B.

(2019). Factors associated with emotional distress and suicide ideation among international college students. Journal of American College Health, 68(6), 565–570. https://doi.org/10.1080/07448481.2019.1583655

60.

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

61.

Van Orden

K. A.

Cukrowicz

K. C.

Witte

T. K.

Joiner

T. E.

(2012). Thwarted belongingness and perceived burdensomeness: Construct validity and psychometric properties of the interpersonal needs questionnaire. Psychological Assessment, 24(1), 197–215. https://doi.org/10.1037/a0025358

62.

Van Orden

K. A.

Witte

T. K.

Cukrowicz

K. C.

Braithwaite

S. R.

Selby

E. A.

Joiner

J. T. E.

(2010). The interpersonal theory of suicide. Psychological Review, 117(2), 575–600. https://doi.org/10.1037/a0018697

63.

Veresova

Lamblin

Robinson

McKay

(2024). A systematic review and narrative synthesis of prevalence rates, risk and protective factors for suicidal behavior in international students. Frontiers in Psychiatry, 15, https://doi.org/10.3389/fpsyt.2024.1358041

64.

Wang

K. T.

Wong

Y. J.

C. C.

(2013). Moderation effects of perfectionism and discrimination on interpersonal factors and suicide ideation. Journal of Counseling Psychology, 3, 367. https://doi.org/10.1037/a0032551

65.

Wei

Heppner

P. P.

Mallen

M. J.

T.-Y.

Liao

K. Y.-H.

T.-F.

(2007). Acculturative stress, perfectionism, years in the United States, and depression among Chinese international students. Journal of Counseling Psychology, 54(4), 385–394. https://doi.org/10.1037/0022-0167.54.4.385

66.

Woo

Fan

Tran

T. V.

Takeuchi

D. T.

(2019). The role of racial/ethnic identity in the association between racial discrimination and psychiatric disorders: A buffer or exacerbator? SSM - Population Health, 7, 100378. https://doi.org/10.1016/j.ssmph.2019.100378

67.

World Health Organization

(WHO)

(2024). Suicide. https://www.who.int/news-room/fact-sheets/detail/suicide

68.

Xing

D. C.

Bolden

(2019). Treading on a foreign land: A multiple case study of Chinese international students’ academic acculturation experiences. Student Success, 10(3), 25–35. https://doi.org/10.5204/ssj.v10i3.1406

69.

Yeh

C. J.

Inose

(2003). International students’ reported English fluency, social support satisfaction, and social connectedness as predictors of acculturative stress. Counselling Psychology Quarterly, 16(1), 15–28. https://doi.org/10.1080/0951507031000114058

70.

Zhou

A. Q.

Sun

(2022). Prevalence of common mental concerns and service utilization among international students studying in the U.S. Counselling Psychology Quarterly, 35(3), 483–502. https://doi.org/10.1080/09515070.2021.1875400

Predicting International Student Suicidality by Merging Identity,Suicide,and Acculturation Frameworks: A Hierarchical Logistic Regression

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