{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T19:00:39Z","timestamp":1785438039443,"version":"3.56.0"},"reference-count":40,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Central South University Teaching and Educational Reform Research Project","award":["2024jy084"],"award-info":[{"award-number":["2024jy084"]}]},{"award":["2024jy084"],"award-info":[{"award-number":["2024jy084"]}],"id":[{"id":"https:\/\/ror.org\/00f1zfq44","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>International students in China frequently encounter academic and acculturative challenges that adversely affect their psychological wellbeing. However, limited research has integrated quantitative and qualitative evidence to comprehensively examine the determinants of stress, anxiety, and depression among this population. This study investigated the effects of academic and acculturative stressors on the mental health of international students and explored their coping experiences and perceptions of institutional support. An explanatory sequential mixed-methods technique was employed. Quantitative data were collected from 500 international students enrolled at four universities in Changsha, China, followed by semi structured interviews with 10 participants. Confirmatory factor analysis demonstrated satisfactory construct validity (CFI = 0.93, TLI = 0.92, RMSEA = 0.052, SRMR = 0.047). Hierarchical regression and thematic analysis were used to analyze the quantitative and qualitative data, respectively. Academic workload emerged as the strongest predictor of psychological distress, significantly predicting stress (\u03b2 = 0.37, p &lt; 0.001), anxiety (\u03b2 = 0.34, p = 0.001), and depression (\u03b2 = 0.31, p = 0.003). Language barriers and social isolation were also significantly associated with poorer mental health outcomes. Qualitative findings further revealed that research and publication pressures, cultural adjustment difficulties, and inadequate institutional support intensified students\u2019 psychological distress, whereas academic mentoring and peer support enhanced coping and resilience. Strengthening culturally responsive counseling, language support, academic mentoring, and social integration programs can substantially improve international students\u2019 mental wellbeing and academic success. These findings provide practical evidence for developing inclusive university support policies in China.<\/jats:p>","DOI":"10.3390\/bs16071212","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:47:32Z","timestamp":1784508452000},"page":"1212","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Academic Stress and Mental Health Challenges Among International Students in China"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6979-9495","authenticated-orcid":false,"given":"Dongxia","family":"Zeng","sequence":"first","affiliation":[{"name":"School of Law and Public Administration, Hunan University of Science and Technology, Xiangtan 411199, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asim","family":"Zubair","sequence":"additional","affiliation":[{"name":"School of Public Administration, Hohai University, Nanjing 210098, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3387-2605","authenticated-orcid":false,"given":"Haijun","family":"Dong","sequence":"additional","affiliation":[{"name":"School of Public Administration, Central South University, Changsha 410083, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"ref_1","first-page":"97","article-title":"An evaluation of acculturation stress, mental health issues and adaptation difficulties of international students in China","volume":"27","author":"Abbas","year":"2014","journal-title":"Sichuan Mental Health"},{"key":"ref_2","first-page":"325","article-title":"International students\u2019 choice to study in China: An exploratory study","volume":"24","author":"Ahmad","year":"2018","journal-title":"Tertiary Education and Management"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Alam, M. 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