Emotional distress, coping strategies, and health-promoting behaviors among university students: a cross-national study in Italy, Albania, and India

The present study investigated the role of nationality in emotional distress, coping strategies, and health-promoting behaviors among university students from Italy, Albania, and India. This cross-sectional study separately involved three national community populations of university students. Participants self-completed the Depression Anxiety Stress Scales-21 (DASS-21), the Prospective Life Course Questionnaire (PLCQ), the Coping Strategies Inventory Short Form (CSI-SF), and the Health Promoting Lifestyle Profile II Short Version (HPLP-II-SF). Results of MANOVA showed significant differences in emotional distress. Specifically, Albanian students reported lower levels of depression and stress compared to Italian students. No significant differences were found for anxiety. Results of hierarchical regression analyses revealed that future fears and disengagement coping were significantly associated with higher depression, anxiety, and stress scores, whereas engagement coping was associated with lower psychological distress; coping strategies accounted for the largest increase in explained variance across the three outcomes (ΔR² = 0.07–0.14). Future hopes were negatively associated only with depression. Health responsibility was positively associated with anxiety symptoms. Italian students generally reported higher stress levels than the other groups. In conclusion, findings highlighted the role of national context for understanding emotional distress. Disengagement coping and future fears may represent risk factors for emotional distress, whereas engagement coping may constitute a protective factor. Psychological interventions for promoting psychological well-being in university students should consider these findings.