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Relationships between stress, coping and depressive symptoms among overseas university preparatory Chinese students: a cross-sectional study

Pi-Chi Chou1, Yu-Mei Y Chao2, Hao-Jan Yang3, Gwo-Liang Yeh4 and Tony Szu-Hsien Lee4*

Author Affiliations

1 Nursing Department, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan

2 Department of Nursing, College of Medicine, National Taiwan University, 1, Sec 1, Jen-Ai Rd Taipei 100, Taiwan

3 Department of Public Health, Chung Shan Medical University, 110, Sec.1, Jianguo N. Rd., Taichung City 40201, Taiwan

4 Department of Health Promotion and Health Education, National Taiwan Normal University, 162, Sec 1, He-Ping East Road, Taipei 10610, Taiwan

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BMC Public Health 2011, 11:352  doi:10.1186/1471-2458-11-352

Published: 19 May 2011



Mental health problems in young people are an important public health issue. Students leaving their hometown and family at a young age to pursue better educational opportunities overseas are confronted with life adjustment stress, which in turn affects their mental health and academic performance. This study aimed to examine the relationships among stress, coping strategies, and depressive symptoms using the stress coping framework in overseas Chinese university preparatory students in Taiwan.


A cross-sectional study was conducted at an overseas Chinese university preparatory institute in Taiwan. Of enrolled overseas Chinese university preparatory students at 2009, 756 completed a structured questionnaire measuring stress, strategies for coping with it, and the Center for Epidemiologic Studies Depression Scale.


High levels of stress significantly predicted the adoption of active, problem-focused coping strategies (R2 = 0.13, p < .01) and passive, emotion-focused coping strategies (R2 = 0.24, p < .01). Acceptable CFI, SRMR, and RMSEA values from the structural equation modeling analysis demonstrated that the model satisfactorily fits the stress coping framework, after active coping strategies were eliminated from the model. Results from the Sobel test revealed that passive coping strategies mediated the relation between stress and depressive symptoms (z = 8.06, p < .001).


Our study results suggested that stress is associated with coping strategies and depressive symptoms and passive strategies mediate the relation between stress and depressive symptoms in overseas Chinese university preparatory students.