Mask wearing and self-harming thoughts among international students in the United States during COVID-19: The moderating role of discrimination

Objective: This study examined associations among discrimination, mask-wearing behavior, and self-harming thoughts among international students in the United States during COVID-19. Participants: Undergraduate and graduate international students enrolled in universities during the 2020 summer semester participated in the online survey (N = 103). Methods: Perceived discrimination, mask-wearing behavior, and self-harming thoughts during COVID-19 were assessed by self-reports. Multivariable logistic regressions examined the association among discrimination, mask-wearing behavior, and self-harming thoughts and explored the potential moderation effect of discrimination on the association between mask-wearing and self-harming thoughts. Results: 18.6% of participants reported self-harming thoughts. Increased discrimination was significantly associated with increased odds of self-harming thoughts. Discrimination significantly moderated the association between mask wearing and self-harming thoughts. Conclusions: The findings highlight the importance of increased availability of culturally appropriate mental health services for international students and the need for increased advocacy to decrease discrimination against international students in the current societal context.