Journal of Counseling & Development ■ Fall 2008 ■ Volume 86 429
© 2008 by the American Counseling Association. All rights reserved.
One of the most important goals of U.S. higher education is to
encourage the enrollment of international students for academic,
economic, and cultural purposes. The successful recruitment of
these students comes with the responsibility to welcome, serve,
and maintain the well-being of international students, and also
to create an environment for multicultural interaction with stu-
dents in the United States (hereinafter referred to as American
students; Peterson, Briggs, Dreasher, Horner, & Nelson, 1999).
Marion (1986) suggested that international students may act
as great resources for increasing global understanding and the
perspectives of American students. Peterson et al. found that
American students learned about different cultures, their histo-
ries, and international issues from foreign students. In addition,
they learned to acknowledge and respect cultural and individual
differences and broaden their perspectives, thereby preventing
stereotypical thinking. Marion also suggested that international
students play an important role in providing technological knowl-
edge to less developed countries. In the United States, enrollment
of international students has been encouraged for the economic
contribution of nearly $13.5 billion every year that they spend
on tuition, living expenses, and related costs (Institute of Inter-
national Education, 2007).
The United States has the largest number of international
students who represent many countries. During the academic
year of 2005–2006, there were approximately 600,000 inter-
national students from several nations, with Asian students
representing 58% of all international students, followed by
students from Europe (15%), Latin America (11%), Africa
(6%), the Middle East (4%), and 6% from North America and
Oceania (Institute of International Education, 2007).
Adjustment to a new educational and social environment can
be a stressful process. Most college students experience stress
throughout this process. However, many international students ex-
perience even more serious stress because of the additional culture
shock factor (Church, 1982) and various sociocultural factors that
are involved in the adjustment process of international students
(Luzio-Lockett, 1998). It is not surprising that international stu-
dents often face language barriers, immigration difficulties, culture
shock, social adjustment, and homesickness. During this period
of adjustment, international students may experience isolation and
loneliness. Mori (2000) reported that these negative experiences
can cause the students to feel hopeless, and an intensive sense of
hopelessness may be the manifestation of depression. Consider-
ing the cultural differences and misunderstandings of the new
and diverse experiences, it is likely that international students will
experience feelings of estrangement, anxiety, and depression as a
part of their adjustment process (Adler, 1975). Spielberger (1966)
reported that anxiety is related to stress, and Furukawa (1997)
reported that people who are exposed to foreign cultures may
become depressed or anxious and display maladaptive behaviors
as a result of this acculturative stress.
Understanding the experiences of international students has
important implications for creating and implementing programs
that provide academic and personal support. Therefore, it is cru-
cial to increase awareness about international students’ problems
and to recognize the students’ individual perspectives regarding
the factors that are involved in the adjustment and adaptation
process (Luzio-Lockett, 1998). Because of these concerns, a
number of studies have focused on the academic, psychological
and social effects on international students of studying and liv-
ing in the United States (Marion, 1986). In one of these studies,
Kilinc and Granello (2003) found that students who were less
acculturated experienced significantly more difficulty in their
academic life, with language, and with medical/physical health
than did the students with higher levels of acculturation.
A close examination of the literature reveals that although
depression and anxiety are frequently manifested symptoms of
stress (Arthur, 1998), these symptoms were not studied among
the international student population in the United States. Con-
sidering the fact that there is limited research on depression and
anxiety among international students in the United States, the
purpose of our study is to contribute further to the literature
by examining these variables in relation to a set of other vari-
ables retrieved from the literature: gender, age, race/ethnicity,
proficiency in English, pattern of social contact, academic
achievement, social support, and length of stay in the country.
Predictors of Depression and Anxiety
Among International Students
Seda Sümer, Senel Poyrazli, and Kamini Grahame
The role of gender, age, race/ethnicity, length of stay, social support, and proficiency in English in the variance in depres-
sion and anxiety among international students revealed that social support was a significant predictor of depression
and anxiety among international students. Age significantly contributed to the variance in anxiety, and self-rated English
proficiency uniquely contributed to the variance in both depression and anxiety. Latino/a students had significantly
higher levels of depression than did Asian students.
Seda Sümer, Department of Counseling and Psychological Services, Georgia State University; Senel Poyrazli and Kamini
Grahame, School of Behavioral Sciences and Education, Penn State Capital College. Correspondence concerning this article should
be addressed to Senel Poyrazli, School of Behavioral Sciences and Education, Penn State Capital College, 777 West Harrisburg
Pike, W157 Olmstead Building, Middletown, PA 17057 (e-mail: poyrazli@psu.edu).