|Year : 2016 | Volume
| Issue : 1 | Page : 9-17
Contributors to academic failure in postsecondary education: A review and a Canadian context
Tricia L da Silva, Arun V Ravindran
Institute of Medical Science, Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario M5S 1A8 Canada, Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College St., Toronto, Ontario M5T 1R8, Canada
|Date of Web Publication||29-Jun-2016|
Arun V Ravindran
Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario M5T 1R8
Source of Support: None, Conflict of Interest: None
Postsecondary enrollment has been rising globally over the past years, but poor performance and drop-out have also been increasing and have become an academic concern. Most drop-outs tend not to return, which significantly affects their future prospects. Postsecondary student populations are a diverse mix of local, immigrant, and international students but it is unclear if reasons for academic failure differ between groups. The aim of this review was to examine the published literature for contributors to postsecondary academic failure, including drop-out, among local, immigrant, and international students. A search of the literature was conducted using PubMed, ProQuest, EBSCOHOST, and PsycINFO on the topic for all articles published in English up to March 2016. The results showed that almost all data come from the Western countries. Several personal, sociocultural, and academic factors appear to be associated with postsecondary failure among all students. These include gender, low academic engagement, stress, psychological difficulties, low social support, and poor coping abilities. Immigrant and international students face additional challenges, such as loss of social networks, discrimination, acculturation, and language challenges. Limitations of the data include the relatively small body of literature (particularly from low- and middle-income countries), and lack of subgroup comparisons, such as of local, immigrant and international students. Clarification of the relative contribution of these factors to academic failure will facilitate the development of effective retention strategies, particularly those that focus on addressing psychological distress and building resilience.
Keywords: Academic failure, contributors, immigrant students, international students, postsecondary students
|How to cite this article:|
da Silva TL, Ravindran AV. Contributors to academic failure in postsecondary education: A review and a Canadian context. Int J Non-Commun Dis 2016;1:9-17
|How to cite this URL:|
da Silva TL, Ravindran AV. Contributors to academic failure in postsecondary education: A review and a Canadian context. Int J Non-Commun Dis [serial online] 2016 [cited 2019 Jul 15];1:9-17. Available from: http://www.ijncd.org/text.asp?2016/1/1/9/184854
| Introduction|| |
The period of late adolescence and early adulthood (18-25 years), also referred to as emerging adulthood, is a time of significant transition, of identity consolidation, changes in focal influences, and growing self-determination in life choices, including postsecondary pursuits. , Universities and colleges aid this period of development by providing emerging adults with opportunities for exposure to new ideas, new life experiences and greater independence.  However, transitional stressors are also present, such as increased responsibilities, adjustment to independent living, and achieving academic goals. , This combination of privileges and demands during this phase of life can have both positive and negative effects, in particular on academic performance.
Student academic failure, which includes drop-out, is a major issue globally. Though postsecondary participation has risen over the past 30 years, the drop-out rate has also increased in parallel (ranging from 20 to 40% across developed countries), and those who drop out tend not to return. ,, Consequences include long-term adverse impact on the individual's occupational, financial and personal well-being,  and loss to society of a talented, productive workforce. 
The influences on postsecondary academic failure have been debated in both civic and educational circles but have yet to be fully clarified. In addition, immigrant and international postsecondary students, who form a sizeable group in developed countries, , often face migration-specific stressors and challenges that add to their burden of coping, but whose impact on academic performance is also relatively unexplored.
The purpose of this narrative review was to examine the published literature for factors contributing to academic failure among postsecondary students. Influences particularly relevant to immigrant and international students were also investigated.
| Methods|| |
A search of the literature was conducted using PubMed, ProQuest, EBSCOHOST, and PsycINFO for all articles containing the terms "contributor," "risk factor," "postsecondary," "drop-out," "academic failure," "academic performance," "student," "immigrant," and "international student" and published in English up to March 2016. Additional references were obtained from the secondary search engines like Google Scholar and the citation lists of sourced articles. Of the 1016 publications found, 81 articles (reviews, surveys, controlled/uncontrolled trials, and qualitative studies) were found appropriate for inclusion. Articles were excluded if they merely duplicated findings in earlier or more seminal publications without any new or supplementary information.
| Results|| |
The overall body of literature on postsecondary academic failure is small. The proportion of data on immigrant postsecondary students is even smaller and that on international students is further limited. It is also of note that the literature found was almost exclusively from developed countries in the West, with little to no available data from low- and middle-income countries or other world regions.
General factors associated with postsecondary academic failure
Academic engagement (e.g., sense of belonging, meeting goals, and participation in campus activities) and motivation may be key factors influencing decisions about academic (dis) continuation.  Indeed, feeling ill-suited to the program of study (and doubtful of future occupational success) has been reported as a chief reason for drop-out. , Not surprisingly, highest drop-out occurs in the 1 st year of postsecondary education ,, and is most often associated with perceived lack of fit, weak academic performance and poor study discipline, , as well as poor academic performance or drop-out in high school. , Conversely, perceived fit with the academic environment correlates with better academic engagement, lower drop-out, and to a lesser extent, better grades. ,
Psychosocial factors often contribute to academic failure, with psychological distress (a common response to life stress) a major influence. , This is not unexpected since many mental illnesses have onset in adolescence and early adulthood.  Depression, anxiety, and stress-related conditions are highly prevalent among postsecondary students, particularly those in 1 st and 2 nd year  and are commonly associated with impaired social engagement and poorer academic focus and performance. , Cognitive difficulties (e.g., information processing, attention, learning and retrieval), whether due to a state/trait effect or as a result of psychological distress, can also negatively affect academic performance. , Illicit substance use is also endemic on postsecondary campuses, for recreation, as a means of coping, or to improve academic performance, but with usually adverse effects on academic and personal functioning. ,
Several other demographic and psychosocial factors, including gender, role modeling, and social support, also appear to impact academic performance significantly. Postsecondary participation is lower and drop-out is higher among male postsecondary students than among females, though the reasons for this are still unclear. , Having parents who did not complete or value postsecondary education and not coming from a two-parent family (which can reflect reduced support and/or financial constraints) are other key risk factors for drop-out. , Interestingly, males with divorced parents demonstrate better academic adjustment than females with divorced parents or males or females with intact families,  but the underlying reasons for these differences also remain to be elucidated. Postsecondary adjustment is also adversely affected by negative relationships with parents  and perceived lack of social support on campus. , On the other hand, social support (from parents, teachers, and/or peers) correlates with lower psychological distress, better coping and better academic performance in postsecondary students. ,
The relationship between perceived life stressors and academic failure appears to be complex, with some counterintuitive findings reported. Financial pressures, unexpected bad grades and interpersonal difficulties (e.g., conflicts with roommates), among others, increase the likelihood of drop-out. , However, several other negative events, such as failure to obtain the desired degree, experience of addiction or significant injury or bereavement, or loss of a job needed to pay tuition, appear to have less deleterious effect on academic performance than might be expected. ,
The impact of life stressors on academic performance may be moderated at least in part by individual resilience, i.e., ability to cope with stress. Maladaptive (emotion-focused) coping style predicts depression, anxiety and stress among postsecondary students,  and correlates with weaker academic performance.  Adaptive (problem-focused) coping, on the other hand, is linked to better motivation and postsecondary success through impact on sense of control, self-esteem and optimism.  Such qualities also improve resilience,  which is associated with better postsecondary academic achievement and personal functioning. 
Immigrant students and postsecondary academic performance
Immigration is associated with considerable psychosocial stress, due to the demands placed by adjustment to a new way of life and culture.  Preimmigration stressors such as war, torture, political violence and persecution, and postimmigration inequities in employment, housing, nutrition, access to health care, social support, language, and discrimination, can increase immigrant vulnerability to psychological distress compared to the general population.  Indeed, compared to locally-born groups, psychological distress is greater among younger (e.g., 15-24 years) and more recent immigrants and in certain ethnic groups, with low income further increasing this vulnerability. , Unfortunately, it often goes undetected due to cultural influences on problem recognition (including stigma or denial), symptom presentation and help-seeking. , Psychological difficulties are linked to lower academic performance in immigrant early adolescents,  and though such data are unavailable for immigrant postsecondary students, similar impact is likely.
The greater susceptibility of immigrant youth to psychological distress (compared to immigrant adults) is attributed to the additional challenges they often face, both those of emerging adulthood,  and those of immigration.  The latter include balancing adaptation to a new culture while maintaining links to one's own (acculturation) and managing the stressors of the transition (acculturative stress).  Acculturative stressors, such as cultural adaptation, language difficulties, family or in-group conflicts (due to differences in acculturation), and discrimination, correlate with increased psychological distress , and weaker high school and postsecondary academic performance , in immigrant youth. In contrast, successful acculturation is associated with decreased psychopathology , and better postsecondary engagement and performance , in this population. Furthermore, while it is intuitive to think that differences in gender roles and expectations may influence acculturation for immigrant youth (e.g., some cultures may support greater independence for females and thus, less "culture clash"), there is no published research in this area.
Language proficiency is an aspect of acculturation that has particular significance for academic performance. Poor language skills are linked to higher rates of drop-out from high school among those who immigrated in adolescence than in childhood, as a factor of age-related challenges in learning a new language. , They also contribute to lower academic achievement among immigrant postsecondary students. ,
Decrease in social support, due to loss of established social networks upon immigration, and the challenge of creating new ones are other adverse influences on immigrant youth.  They are often associated with increased psychological distress,  acculturative stress, , and decreased high school engagement and performance , in immigrant adolescents. Low social support has also been linked to psychological difficulties in immigrant emerging and young adults.  Its effect on the academic performance of immigrant postsecondary students lacks published data but is likely to be similarly negative.
Stress research has shown that resilience leads to better functioning. , Thus, it is not unexpected that the use of adaptive coping strategies is linked to lower psychological distress and stress reactivity,  as well as lower acculturative stress  among adult immigrants. Although adaptive coping is speculated to have similar benefits for immigrant youth, including for academic performance, this has been little explored.
Not surprisingly, age at immigration may be a significant modulator of outcomes among immigrant youth. For example, those who immigrate in childhood have shown increased risk of psychological distress and family conflicts (and decreased family support) compared to those who immigrate at later ages. , However, paradoxically, the former exhibit better acculturation and academic performance than the latter. ,
International students and postsecondary academic performance
The literature notes that international postsecondary students share many of the challenges experienced by immigrant students, with similar adverse impact. Besides the difficulties of emerging adulthood,  they also face acculturative stressors, including loneliness, discrimination, language differences, financial stress, and cultural adaptation.  There is also pressure to fulfill personal and family expectations of academic success despite the challenges of a new culture and educational system. , Such stressors are associated with , and also predictive of  psychological distress among these students, but as with immigrant youth, denial or nonrecognition of symptoms and stigma can be barriers to help-seeking.  Psychological distress and acculturative stress also correlate with worse academic performance in this group. ,
Adding to the pressure to succeed, international postsecondary students often have to adapt to the processes, standards, and teaching style of a new academic system (academic adjustment).  Difficulties with academic adjustment predict lower academic success among these students, , as well as greater psychological and life stress. ,
As with immigrant students, language skills influence the social and academic functioning of international postsecondary students. While poor language skills are particularly linked to academic failure in this group, , they also predict the greater degree of both psychological distress , and acculturative stress. , Language difficulties also inhibit their ability to develop new social networks, thus exacerbating the lower social support they also experience. ,
Reduction in social support may be more profound for international than immigrant postsecondary students as the former are often separated at a greater distance from family and friends than the latter.  Low social support is both associated with  and predictive of  higher acculturative stress in international postsecondary students, and also predicts greater psychological distress among them.  Data on its impact on their academic functioning are unavailable, but as in the general literature, it is likely to be adverse.
As may be expected, resilience and coping approach also influence functioning among international postsecondary students. Maladaptive coping predicts higher acculturative stress  and psychological distress in this group. , Its influence on their academic success currently lacks data but is likely to be negative, as found with postsecondary students in general.
Comparable to findings with immigrant youth, studies evaluating the impact of age at arrival of international students in the host country have reported conflicting results, with younger international students reporting both higher psychological distress  but, paradoxically, better acculturation than older students.  There is no published research on the association of age at arrival and subsequent postsecondary academic performance by international students, but it is speculated to be similar to that of immigrant students.
The Canadian context
Immigration contributes significantly to population growth across Western countries, , and in Canada, accounts for two-thirds of annual population growth (i.e., about 250,000 people per year), with about one in five persons now foreign-born and/or a visible minority.  However, the immigrant experience in Canada is thought to differ substantially from that in other countries. , Canada tends to recruit skilled, professional immigrants, who come primarily from Asia, value education, and integrate well both socially and economically into Canadian society.  In contrast, Europe has historically attracted lower-skilled workers from within the continent or abroad, and immigrants to the United States come mainly from Latin America; , education is often not a priority for these groups, which can affect economic prospects and adaptation. These differences are reflected in postsecondary participation, which is higher among immigrants than nonimmigrants in Canada than in Western Europe or the United States, , even if high school academic performance was not strong.  Another distinction is in drop-out rates, which are similar between immigrants and nonimmigrants in Canada,  but higher for immigrants in the United States. 
As mentioned, while a proportion of immigrants to Canada come from Latin America, the Caribbean, Africa, and Europe,  the majority (two-thirds) have origins in Asia where postsecondary education is highly prized.  Since about one-third of immigrants are under age 24 years at arrival,  they enter the educational system almost immediately, with a standard progression from elementary to secondary and (frequently) postsecondary studies.  Canada's emphasis on selecting highly educated immigrants also results in almost 50% of immigrant youth having parents with postsecondary degrees who encourage them to achieve the same.  All these factors contribute to the high postsecondary participation rates of immigrant youth, with one in seven postsecondary students in Canada now being an immigrant. , A major result is better financial outcomes long-term. Immigrant employment rates and incomes are generally lower than for local Canadians, , but rise to comparable levels for those who complete postsecondary education in Canada. 
International students comprise about one in 12 postsecondary students in Canada  and similar to immigrants, come mostly from Asia, but also from Latin America, the Caribbean, Africa, and the Middle East.  Over the past 20 years, international student enrollment has increased four-fold to about 100,000 per year.  Enhanced by Canadian qualifications and experience, a significant proportion eventually settles in Canada, benefitting Canadian society; in 2013, about 10,000 foreign students and workers received permanent residency visas, a 300% increase since 2009. , Indeed, positive educational, career, and immigration expectations, as well as a desire for new experiences, are major reasons cited by the international students for choosing to study in Canada. 
In the past few decades, postsecondary enrollment in Canada has risen from 53% to 79%, but the drop-out rate has also increased in parallel from 9% to 21%.  Immigrant and international students share proportionally in this drop-out. Despite higher postsecondary participation rates, drop-out among immigrants is as high as or even higher than for Canadian-born students.  The reasons for this are unknown because Canadian literature on risk factors for postsecondary academic failure lacks comparative data based on ethnicity or citizenship status. Similar information on international students in Canada is also sparse, as no data have been published on their academic continuance or drop-out, and there is little published research from Canada on the factors that may affect their functioning.
To fill this knowledge gap, the authors recently conducted a retrospective analysis of 3 years of academic data of a cohort of the 1 st year students at a large Canadian university (currently unpublished). The data were obtained from the Registrar's office after due institutional ethics approval. Chi-squares and univariate ANOVAs were used to examine similarities and differences between student groups based on academic performance and on gender, citizenship status, and mother tongue, which were the only demographic variables included in the Registrar's database. Linear regression was used to identify predictors of academic performance and logistic regression was used to identify predictors of drop-out. The results showed that from a total sample of 2466 students, about one-third dropped out over the 3 years and half of this drop-out occurred in the 1 st year. Less than a quarter of drop-outs ever returned. Gender and the interaction of gender and citizenship status showed utility as predictors of academic performance. Male gender predicted poorer academic performance than female gender across student groups (P<0.05). However, at the subgroup level, male immigrants obtained better academic scores than female immigrants (P=0.03). Citizenship status, academic performance, mother tongue and the interaction of citizenship status and academic performance appeared to be useful as predictors of drop-out. Canadian-born students had a lower risk of drop-out than immigrant or international students (P ≤ 0.001). Poor academic performance (P < 0.0001) and non-English mother tongue (P < 0.05) were associated with higher risk of drop-out across student groups. Interestingly, although high-achieving Canadian and immigrant students had a lower risk of drop-out, high-performing international students were at greater risk (P < 0.0001). However, effect sizes of the predictors of both regression analyses were small (d = 0.002-0.22). This suggests that other variables might also influence academic performance and drop-out in this cohort, particularly among males or international students. Likely contributors are other common student challenges (e.g., psychological distress and poor coping) or migration-specific factors (e.g., acculturative stress, English language difficulties), as noted in the literature. A larger prospective investigation of the influence of such additional contributing factors is now underway.
| Discussion and Conclusions|| |
Postsecondary academic failure, including drop-out, is a significant issue for academic institutions globally, with implications for both individuals and broader society. However, it has been suggested that concerns about drop-out and its consequences may be overstated, as institutions rarely collect information on students' reasons for leaving. , Poor fit with the program of study or institution and desire/need to work are more often reported reasons for drop-out than academic difficulties. , Further, up to 60% of students who leave one institution enroll at another  and a significant proportion of these complete studies there. , Thus, it is possible that rates of academic failure may be overestimated. , Nonetheless, the available data (though not extensive) indicate that academic performance and drop-out are complex phenomena that are significantly affected by multiple and interactive factors.
The published evidence suggests that several psychosociocultural factors may contribute to postsecondary academic failure across all student populations. However, the existing literature does not provide a complete picture. The effect of these factors is often evaluated individually, with little exploration of interactive effects. Though it is intuitive to think that multiple stressors will have a cumulative effect on academic performance, this has yet to be confirmed. Moreover, while many risk factors are common to all students, other risks may be more relevant to specific subgroups, but comparative evaluations are scarce. For example, male gender and nonparticipation in campus activities may be weaker risk factors for immigrant or international students than locally-born cohorts, due to different cultural influences.  It is also well known that some immigrant groups may be less supportive of higher education for females, , which may contribute to higher rates of drop-out among female students from those cultures. However, both these premises lack substantiating data. Similarly, while it has been speculated that the impact of certain factors, such as psychological distress, , low social support, , etc., is likely to be greater on immigrant and international students than local students, this has not been systematically studied or verified. Also of note, findings from the current literature come primarily from research in developed countries in the West and may have limited generalizability in low- and middle-income countries or other world regions. Collectively, these knowledge gaps hinder the development of effective preventive strategies that could have global applicability.
The factors that may influence the decision to return to postsecondary studies after drop-out also need systematic evaluation and confirmation. Although it may seem logical that resolution of financial difficulties , or amelioration of emotional distress , may increase the likelihood of return, published data are lacking. As well, the role played by extraneous factors, such as the availability of specific retention support services on campus, has been little examined. More research in this area would be valuable to supplement the literature and to inform retention plans.
The potentially positive consequences of cultural differences may also be worth exploring. For example, while acculturative difficulties often have an adverse impact on immigrant youth functioning, , paradoxically, it may shield them from high-risk behaviors. , The use of illicit substances to cope with psychological distress or stress is a common practice among students, , but new immigrant youth are far less likely to engage in such behavior than local youth, , or youth with immigrant parents or grandparents, , even though newcomer youth may experience higher psychological distress than these other groups.  There are no published comparisons of substance use practices between local and international students. However, the shared attributes and cultural norms of many immigrant and international student groups have led to the speculation that exploitation of such "protective" cultural differences may have a role in intervention strategies for these groups.
Recently, there has been increasing interest in wellness education initiatives to improve mental health and resilience among students, and thus improve retention. School-directed interventions, frequently based on cognitive-behavior therapy (CBT) approaches and often delivered online, have been found to enhance mental health, help-seeking, coping skills and resistance to negative coping behaviors, such as substance abuse, among youth. , These usually have a duration of 4-8 weeks, , but relatively brief 1-day CBT psychoeducation workshops have been reported to be similarly effective and particularly attractive to those who delay help-seeking due to stigma, such as those with lower incomes or from ethnic communities. , Such considerations would be very pertinent for promoting wellness both among postsecondary students in general, who tend to prefer short and/or web-based initiatives,  and especially among immigrant and international students, for whom stigma may be a major obstacle to help-seeking. ,
In summary, while a range of factors influences postsecondary academic performance and drop-out among all students to varying degrees, psychosocial factors, particularly psychological distress and poor coping skills, appear to have the most adverse impact. Immigrant and international students face many additional challenges that often exacerbate the stress they experience, and thereby affect their academic outcomes. In general, the published literature on this important topic is rather sparse and Western hemisphere centric, with few subgroup comparisons. Systematic evaluations using well-designed investigations are needed to examine individual and interactive influences on the academic functioning of local, immigrant and international students in both developed and developing countries. The resulting data would help to develop appropriate and effective preventive and intervention strategies to reduce postsecondary academic failure and improve student retention globally.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Arnett JJ. Emerging adulthood. A theory of development from the late teens through the twenties. Am Psychol 2000;55:469-80.
Kail RV, Cavanagh JC. Human Development: A Life-Span View. 7 th
ed. Belmont, CA: Wadsworth Publishing; 2015.
Shaienks D, Gluszynski T, Bayard J. Postsecondary education - Participation and dropping out: Differences across university, college and other types of postsecondary institutions. Catalogue No. 81-595-M - No. 070. Ottawa: Statistics Canada; 2008.
Statistics Canada. Educational attainment and employment: Canada in an international context. Catalogue No. 81-599-X-Issue No. 008. Ottawa: Statistics Canada; 2012.
Picot G, Hou F. Immigrant Status, Early Skill Development, and Postsecondary Participation: A Comparison of Canada and Switzerland. Catalogue No. 11F0019M - No. 344. Ottawa: Statistics Canada; 2012.
Shaienks D, Gluszynski T. Participation in postsecondary education: Graduates, continuers and drop outs, Results from YITS Cycle 4. Catalogue No. 81-595-MIE - No. 059. Ottawa: Statistics Canada; 2007.
Wintre MG, Morgan AS. Transferring post-secondary schools: Student perceptions, rationales, and experiences. J Adolesc Res 2009;24:726-49.
Schmitt N, Oswald FL, Friede A, Imus A, Merritt S. Perceived fit with an academic environment: Attitudinal and behavioral outcomes. J Vocat Behav 2008;72:317-35.
Wintre MG, Knoll GM, Pancer SM, Pratt MW, Polivy J, Birnie-Lefcovitch S, et al.
The transition to university. The student-university match (SUM) questionnaire. J Adolesc Res 2008;23:745-69.
Pleskac TJ, Keeney J, Merritt SM, Schmitt N, Oswald FL. A detection model of college withdrawal. Organ Behav Hum Decis Process 2011;115:85-98.
Schmitt N, Keeney J, Oswald FL, Pleskac TJ, Billington AQ, Sinha R, et al.
Prediction of 4-year college student performance using cognitive and noncognitive predictors and the impact on demographic status of admitted students. J Appl Psychol 2009;94:1479-97.
Kessler RC, Amminger GP, Aguilar-Gaxiola S, Alonso J, Lee S, Ustün TB. Age of onset of mental disorders: A review of recent literature. Curr Opin Psychiatry 2007;20:359-64.
Bayram N, Bilgel N. The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students. Soc Psychiatry Psychiatr Epidemiol 2008;43:667-72.
American College Health Association. American College Health Association-National College Health Assessment II: Canadian Consortium Reference Group Executive Summary Spring 2013. Hanover, MD: American College Health Association; 2013.
Wintre MG, Bowers CD. Predictors of persistence to graduation: Extending a model and data on the transition to university model. Can J Behav Sci 2007;39:220-34.
Bossaer JB, Gray JA, Miller SE, Enck G, Gaddipati VC, Enck RE. The use and misuse of prescription stimulants as "cognitive enhancers" by students at one academic health sciences center. Acad Med 2013;88: 967-71.
Hildt E, Lieb K, Franke AG. Life context of pharmacological academic performance enhancement among university students--A qualitative approach. BMC Med Ethics 2014;15:23. doi: 10.1186/1472-6939-15-23.
Canadian Centre on Substance Abuse. Substance abuse in Canada: Youth in focus.
Ottawa, ON: Canadian Centre on Substance Abuse; 2007.
National Center on Addiction and Substance Abuse at Columbia University. Wasting the Best and the Brightest: Substance abuse at America′s Colleges and Universities. New York: CASA; 2007.
Wintre MG, Ames ME, Pancer M, Pratt MW, Polivy J, Birnie-Lefcovitch S, et al
. Parental divorce and first-year students′ transition to university: The need to include baseline data and gender. J Divorce Remarriage 2011;52:326-43.
Baqutayan S. Stress and social support. Indian J Psychol Med 2011;33:29-34.
Klink JL, Byars-Winston A, Bakken LL. Coping efficacy and perceived family support: Potential factors for reducing stress in premedical students. Med Educ 2008;42:572-9.
Mahmoud JS, Staten R, Hall LA, Lennie TA. The relationship among young adult college students′ depression, anxiety, stress, demographics, life satisfaction, and coping styles. Issues Ment Health Nurs 2012;33:149-56.
Eum K, Rice KG. Test anxiety, perfectionism, goal orientation, and academic performance. Anxiety Stress Coping 2011;24:167-78.
Phinney JS, Haas K. The process of coping among ethnic minority first-generation college freshmen: A narrative approach. J Soc Psychol 2003;143:707-26.
McAllister M, McKinnon J. The importance of teaching and learning resilience in the health disciplines: A critical review of the literature. Nurse Educ Today 2009;29:371-9.
Merdinger JM, Hines AM, Osterling KL, Wyatt P. Pathways to college for former foster youth: Understanding factors that contribute to educational success. Child Welfare 2005;84:867-96.
Hyman I, Dussault G. Negative consequences of acculturation on health behaviour, social support and stress among pregnant Southeast Asian immigrant women in Montreal: An exploratory study. Can J Public Health 2000;91:357-60.
Mental Health Commission of Canada. Improving mental health services for immigrant, refugee, ethno-cultural and racialized groups. Issues and options for service improvement. Ottawa: Mental Health Commission of Canada; 2009.
Hansson EK, Tuck A, Lurie S, McKenzie K. Rates of mental illness and suicidality in immigrant, refugee, ethnocultural, and racialized groups in Canada: A review of the literature. Can J Psychiatry 2012;57:111-21.
van Bergen DD, Eikelenboom M, Smit JH, van de Looij-Jansen PM, Saharso S. Suicidal behavior and ethnicity of young females in Rotterdam, The Netherlands: Rates and risk factors. Ethn Health 2010;15:515-30.
Gonçalves M, Moleiro C. The family-school-primary care triangle and the access to mental health care among migrant and ethnic minorities. J Immigr Minor Health 2012;14:682-90.
Stewart SM, Simmons A, Habibpour E. Treatment of culturally diverse children and adolescents with depression. J Child Adolesc Psychopharmacol 2012;22:72-9.
Chau K, Baumann M, Kabuth B, Chau N. School difficulties in immigrant adolescent students and roles of socioeconomic factors, unhealthy behaviours, and physical and mental health. BMC Public Health 2012;12:453.
Wang SC, Schwartz SJ, Zamboanga BL. Acculturative stress among Cuban American college students: Exploring the mediating pathways between acculturation and psychosocial functioning. J Appl Soc Psychol 2010;40:2862-87.
Abouguendia M, Noels KA. General and acculturation-related daily hassles and psychological adjustment in first- and second-generation South Asian immigrants to Canada. Int J Psychol 2001;36:163-73.
Tinghög P, Al-Saffar S, Carstensen J, Nordenfelt L. The association of immigrant- and non-immigrant-specific factors with mental ill health among immigrants in Sweden. Int J Soc Psychiatry 2010;56:74-93.
Huynh VW, Fuligni A. Discrimination Hurts: The Academic, Psychological, and Physical Well Being of Adolescents from Asian, Latin American, and European Backgrounds (PWP-CCPR-2008-021). Los Angeles, CA: California Center for Population Research; 2008.
Salamonson Y, Everett B, Koch J, Andrew S, Davidson PM. English-language acculturation predicts academic performance in nursing students who speak English as a second language. Res Nurs Health 2008;31:86-94.
Miller MJ, Yang M, Hui K, Choi NY, Lim RH. Acculturation, enculturation, and Asian American college students′ mental health and attitudes toward seeking professional psychological help. J Couns Psychol 2011;58:346-357.
Turjeman H, Mesch G, Fishman G. The effect of acculturation on depressive moods: Immigrant boys and girls during their transition from late adolescence to early adulthood. Int J Psychol 2008;43:32-44.
Cheng L, Fox J. Towards a better understanding of academic acculturation: Second language students in Canadian Universities. Can Mod Lang Rev 2008;65:307-33.
Chow HP. Vietnamese-Canadian University students in Regina: Socio-cultural and educational adaptation. Can Ethn Stud 2006;37:104-12.
Böhlmark A. Integration of childhood immigrants in the short and long run. Swedish evidence. Int Migr Rev 2009;43:387-409.
Corak M. Age at Immigration and Educational Outcomes of Children. Catalogue No. 11F0019M-No. 336. Ottawa: Statistics Canada; 2011.
Schoonheim-Klein M, Hoogstraten J, Habets L, Aartman I, Van der Vleuten C, Manogue M, et al.
Language background and OSCE performance: A study of potential bias. Eur J Dent Educ 2007;11:222-9.
Thomas D. Personal Networks and Economic Adjustment of Immigrants. Catalogue No. 11-008-X. Ottawa: Statistics Canada; 2011.
Potochnick SR, Perreira KM. Depression and anxiety among first-generation immigrant Latino youth: Key correlates and implications for future research. J Nerv Ment Dis 2010;198:470-7.
Tartakovsky E. A longitudinal study of acculturative stress and homesickness: High-school adolescents immigrating from Russia and Ukraine to Israel without parents. Soc Psychiatry Psychiatr Epidemiol 2007;42:485-94.
Yeh CJ, Okubo Y, Ma PW, Shea M, Ou D, Pituc ST. Chinese immigrant high school students′ cultural interactions, acculturation, family obligations, language use, and social support. Adolescence 2008;43:775-90.
Suarez-Orozco C, Pimentel A, Martin M. The significance of relationships: Academic engagement and achievement among newcomer immigrant youth. Teach Coll Rec 2009;111:712-49.
Patiño C, Kirchner T. Stress and psychopathology in latin-american immigrants: The role of coping strategies. Psychopathology 2010;43:17-24.
Belizare LS, Fuertes JN. Attachment, coping, acculturative stress, and quality of life among Haitian immigrants. J Couns Dev 2011;89:89-97.
Breslau J, Borges G, Hagar Y, Tancredi D, Gilman S. Immigration to the USA and risk for mood and anxiety disorders: Variation by origin and age at immigration. Psychol Med 2009;39:1117-27.
Patterson B, Kyu HH, Georgiades K. Age at immigration to Canada and the occurrence of mood, anxiety, and substance use disorders. Can J Psychiatry 2013;58:210-7.
Beck A, Corak M, Tienda M. Age at Immigration and the Adult Attainments of Child Migrants to the United States. Ann Am Acad Pol Soc Sci 2012;643:134-159.
Smith RA, Khawaja NG. A review of the acculturation experiences of international students. Int J Intercult Relat 2011;35:699-713.
Chen CP. Common stressors among international college students: Research and counseling implications. J Coll Couns 1999;2:49-65.
Mori S. Addressing the mental health concerns of international students. J Couns Dev 2000;78:137-44.
Greenland K, Brown R. Acculturation and contact in Japanese students studying in the United Kingdom. J Soc Psychol 2005;145:373-89.
Wei M, Heppner PP, Mallen MJ, Ku TK, Liao Y, Wu T. Acculturative stress, perfectionism, years in the United States, and depression among Chinese international students. J Couns Psychol 2007;54:385-94.
Zhang J, Goodson P. Predictors of international students′ psychosocial adjustment to life in the United States: A systematic review. Int J Intercult Relat 2011;35:139-62.
Credé M, Niehorster S. Adjustment to college as measured by the student adaptation to college questionnaire: A quantitative review of its structure and relationships with correlates and consequences. Educ Psychol Rev 2012;24:133-65.
Hunley HA. Students′ functioning while studying abroad: The impact of psychological distress and loneliness. Int J Intercult Relat 2010;34:386-92.
Rienties B, Beausaert S, Grohnert T, Niemantsverdriet S, Kommers P. Understanding academic performance of international students: The role of ethnicity, academic and social integration. High Educ 2012;63:685-700.
Rientes B, Tempelaar D. The role of cultural dimensions of international and Dutch students on academic and social integration and academic performance in the Netherlands. Int J Intercult Relat 2013;37:188-201.
Misra R, Crist M, Burant CJ. Relationships among life stress, social support, academic stressors, and reactions to stressors of international students in the United States. Int J Stress Manag 2003;10:137-57.
Rasmi S, Safdar S, Lewis JR. A longitudinal examination of the MIDA model with international students. In: Chybicka A, Safdar S, Kwiatkowska A, editors. Culture and Gender an Intimate Relations. Gdansk, Poland: Gdanskie Wydawnictwo Psychologiczne; 2009. p. 42-57.
Yu B, Shen H. Predicting roles of linguistic confidence, integrative motivation and second language proficiency on cross-cultural adaptation. Int J Intercult Relat 2012;36:72-82.
Zhang Z, Brunton M. Differences in living and learning: Chinese international students in New Zealand. J Stud Int Educ 2007;11:124-40.
Sumer S, Poyrazli S, Grahame K. Predictors of depression and anxiety among international students. J Couns Dev 2008;86:429-37.
Duru E, Poyrazli S. Personality dimensions, psychosocial-demographic variables, and English language competency in predicting level of acculturative stress among Turkish international students. Int J Stress Manag 2007;14:99-110.
Vergara MB, Smith N, Keele B. Emotional intelligence, coping responses, and length of stay as correlates of acculturative stress among international university students in Thailand. Procedia Soc Behav Sci 2010;5:1498-504.
Khawaja NG, Dempsey J. Psychological distress in international university students: An Australian study. Aust J Guid Couns 2007;17:13-27.
Lee JS, Koeske GF, Sales E. Social support buffering of acculturative stress: A study of mental health symptoms among Korean international students. Int J Intercult Relat 2004;28:399-414.
Crissey SR. Educational attainment in the United States: 2007. Washington, DC: U.S. Census Bureau; 2009.
Statistics Canada. Canadian Demographics at a Glance. Catalogue No. 91-003-X. Ottawa: Statistics Canada; 2008.
Association of Canadian Community Colleges. Pan-Canadian Study of First-Year College Students. Report 2: The Characteristics and Experiences of Aboriginal, Disabled, Immigrant, and Visible Minority Students. Catalogue No. HS28-119/2-2009E. Ottawa: Human Resources and Skills Development Canada; 2008.
Canadian University Survey Consortium. First-Year University Student Survey Master Report. Winnipeg: Prairie Research Associates; 2010.
Gilmore J. The 2008 Canadian Immigrant Labour Market: Analysis of Quality of Employment. Catalogue No. 71-606-X, No. 5. Ottawa: Statistics Canada; 2009.
Gilmore J, Le Petit C. The Canadian immigrant labour market in 2007: Analysis by region of postsecondary education. Catalogue No. 71-606-XWE - No. 4. Ottawa: Statistics Canada; 2008.
Statistics Canada. Canada′s Ethnocultural Mosaic. Public Postsecondary Enrolments and Graduates, 2010/2011. Catalogue No. 11-001-X. Ottawa: Statistics Canada; 2013.
Wintre MG, Kandasamy AR, Chavoshi S, Wright L. Are international undergraduate students emerging adults? Motivations for studying abroad. Emerg Adulthood 2015;3:255-64.
Association of Universities and Colleges of Canada. Trends in higher education. Volume 1 - Enrolment. Ottawa: AUCC; 2011.
Grayson JP, Grayson K. Research on Retention and Attrition. Montreal, Canada: The Canada Millennium Scholarship Foundation; 2003.
Wintre MG, Bowers C, Gordner N, Lange L. Re-evaluating the university attrition statistic: A longitudinal follow-up study. J Adolesc Ress 2006;21:111-32.
McDevitt TM, Ormrod JE. Childhood Development and Education. 5 th
ed. New York: Pearson; 2012.
McDonagh A. Barriers to Women′s Education. Toronto: Workers Educational Association of Canada; 2004.
Hamilton HA, Noh S, Adlaf EM. Adolescent risk behaviours and psychological distress across immigrant generations. Can J Public Health 2009;100:221-5.
Peña JB, Wyman PA, Brown CH, Matthieu MM, Olivares TE, Hartel D, et al.
Immigration generation status and its association with suicide attempts, substance use, and depressive symptoms among latino adolescents in the USA. Prev Sci 2008;9:299-310.
Chien LY, George MA, Armstrong RW. Country of birth and language spoken at home in relation to illicit substance use. Can J Public Health 2002;93:188-92.
Greenfield B, Rousseau C, Slatkoff J, Lewkowski M, Davis M, Dube S, et al.
Profile of a metropolitan North American immigrant suicidal adolescent population. Can J Psychiatry 2006;51:155-9.
Davies EB, Morriss R, Glazebrook C. Computer-delivered and web-based interventions to improve depression, anxiety, and psychological well-being of university students: A systematic review and meta-analysis. J Med Internet Res 2014;16:e130.
Peters LW, Kok G, Ten Dam GT, Buijs GJ, Paulussen TG. Effective elements of school health promotion across behavioral domains: A systematic review of reviews. BMC Public Health 2009;9:182.
Horrell L, Goldsmith KA, Tylee AT, Schmidt UH, Murphy CL, Bonin EM, et al.
One-day cognitive-behavioural therapy self-confidence workshops for people with depression: Randomised controlled trial. Br J Psychiatry 2014;204:222-33.
Main NA, Elliot SA, Brown JS. Comparison of three different approaches used in large-scale stress workshops for the general public. Behav Cogn Psychother 2005;33:299-309.