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

Journal Article (Journal Article)


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.

Full Text

Duke Authors

Cited Authors

  • Knettel, BA; Cherenack, EM; Friis, EA

Published Date

  • January 5, 2021

Published In

Start / End Page

  • 1 - 8

PubMed ID

  • 33400636

Pubmed Central ID

  • 33400636

Electronic International Standard Serial Number (EISSN)

  • 1940-3208

International Standard Serial Number (ISSN)

  • 0744-8481

Digital Object Identifier (DOI)

  • 10.1080/07448481.2020.1846046


  • eng