Examining causal attributions for depression, alcohol use disorder, and schizophrenia in a diverse sample of international students at U.S. universities

Abstract

Objectives

International students face increased vulnerability for mental health challenges, but underutilize counseling compared to their domestic peers. We examined beliefs regarding the causes of mental illness, known as attributions, which may impact treatment-seeking and stigma. Participants: Surveys were collected from 680 international students at U.S. universities. Methods: We sent invitations to a computer-based survey disseminated via international student email lists. The survey explored mental health attributions for depression, alcohol use disorder, and schizophrenia. Results: Attributions differed significantly by disorder. Depression and alcohol use were attributed to social stress and perceived as controllable and influenced by personal weakness and lifestyle choices. Schizophrenia was often attributed to hereditary/biological causes. Differences also emerged based on the participants’ acculturation, region of origin, and religiosity. Conclusions: Attributions influence perceptions of mental illness and may lead to stigma. Providers should incorporate discussions of attribution in student outreach and counseling to address potential impacts on care-seeking.

Keywords:

• Attribution theory
• emerging adulthood
• lay beliefs model
• stigma
• treatment seeking

Conflict of interest disclosure

The authors have no conflicts of interest to report. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of the United States of America and received approval from the Institutional Review Board of Lehigh University.

Additional information

Funding

This research was supported by research funds from Lehigh University’s College of Education. Data are in the possession of the corresponding author and may be made available upon request with an appropriate data transfer agreement.