*4.6. The Direct and Indirect E*ff*ects of SOC and Coping Strategies on the Association Between Acculturative Stress and Depressive Symptoms*

Among both males and females, acculturative stress had an indirect effect on depressive symptoms via SOC. This confirms the result of no gender bias in the levels of SOC in this study. Many cross-sectional studies have reported a significant inverse correlation between SOC and depression. According to Sairenchi, Haruyama, Ishikawa, Wada, Kimura, and Muto [88], SOC can predict the onset of depression in Japanese workers. Workers with low levels of SOC might suffer from depression more than workers with high SOC; no gender differences were found in these associations. Therefore, examining the levels of SOC among students of both genders may be useful for identifying Arab students at high risk of future depressive symptoms.

Among female Arab students, the effect of acculturative stress was amplified through the indirect effects of avoidant coping. Among the male students, the effect of acculturative stress was amplified through the indirect effects of active coping. Our findings underscore previous claims that passive/avoidant coping is strongly related to general psychological distress and depression [42] and that active coping is inversely related to depression [89].

The fact that cultures vary in the degree to which gender roles are emphasized could contribute to this difference. Williams and Best [90] confirmed that men and women in traditional-collectivistic cultures (i.e., Arab culture, in this case) tend to emphasize gender-role differences, whereas those in more Western-individualistic cultures tend to minimize them. Presumably, such values could affect the development of gender differences, in general, and the direct and indirect effects of acculturative stress on depressive symptoms, in particular. Thus, Arab males, who are seen in their patriarchal society as the main providers and guardians of their families [57], may be driven to use active coping strategies as they confront challenges. Among Arab males, acculturative stress may lead to more depressive symptoms by affecting (i.e., decreasing) their use of active coping strategies. Arab women are expected to adopt more avoidant/passive coping strategies, in order to fit in their social roles and fulfill their obligations in more traditional cultural contexts [57]. Among these women, acculturative stress may lead to more depressive symptoms by affecting (i.e., increasing) their use of avoidant coping strategies.

Among both Year 1 + 2 and Year 3 + 4 Arab students, acculturative stress had an indirect effect on depressive symptoms via SOC. This finding confirms the findings of previous studies conducted among Bedouin Arabs, which found that, over time, SOC becomes a strong predictor of stress reactions [24]. Among Year 1 + 2 Arab students, acculturative stress had an indirect effect on depressive symptoms via the use of avoidant-coping strategies. Similar to what was observed for female Arab students, the role of avoidant coping in the association between acculturative stress and depressive symptoms underscores previous findings that indicated that passive/avoidant coping is strongly related to general psychological distress and depression [42].

The present study suggests that Arab individuals of both genders and across different stages in their academic studies who face relatively high levels of acculturative stress tend to exhibit higher levels of depressive symptoms, but that the effect of acculturative stress on depression develops via similar, as well as different pathways among female and male, and among more junior (Year 1 + 2) and more advanced (Year 3 + 4) Arab students. The female Arab students tend to be more depressed as a direct result of their higher levels of acculturative stress, which arise from the need to learn new and sometimes confusing cultural rules and expectations, deal with experiences of prejudice and discrimination, and manage the overarching conflict between maintaining elements of their old culture while incorporating elements of the new. These depression levels are also an indirect result of their lower levels of SOC, as well as their stronger tendency to use avoidant coping strategies (i.e., to attempt to reduce tension by avoiding dealing with problems through behavioral disengagement, self-distraction, denial, and self-blame). In contrast, male Arab students experiencing high levels of acculturative stress tend to be more depressed as an indirect result of their lower levels of SOC and their limited use of active coping strategies (i.e., planning, instrumental support, emotional support, positive reframing, problem-solving, and humor). Year 1 + 2 students experiencing high levels of acculturative stress tend to be more depressed as an indirect result of their lower levels of SOC and their increased use of avoidant coping strategies (like the female students, they tend to increase their use of behavioral disengagement, self-distraction, denial, and self-blame). However, Year 3 + 4 Arab students tend to be more depressed as a direct result of their higher levels of acculturative stress and also as an indirect result of their lower levels of SOC.

The current study contributes to the understanding of gender and academic-year differences in coping resources and the use of different strategies to deal with acculturative stressors in the context of higher education. This research suggests that female and male students, as well as students at different stages of their degree programs, from a more traditional, Eastern-collectivistic cultural background who exhibit high levels of acculturative stress tend to have different and distinct pathways to emotional distress. However, because the research design is cross-sectional, we cannot completely exclude the possibility that depression may lead to greater acculturative stress and lower SOC, as well as lowered motivation to deal actively with stressors and high levels of avoidance and withdrawal.

#### *4.7. Limitations and Directions for Future Research*

Although the fact that this work may be the first study of acculturative stress and depressive symptoms among Arab students in Israel underscores its value, it also has several limitations that should be taken into account when considering the research findings. There are also areas that warrant further attention in future research. First, the study design was cross-sectional and, therefore, we cannot make any claims of causality. In addition, we did not evaluate past depressive experiences among those students, an important variable that may affect the prospective levels of acculturative stress and depressive symptoms during their academic studies. Thus, future research studies should employ a longitudinal design and aim to test prior levels of depressive symptoms, as well as the prospective relationship between acculturative stress and depressive symptoms in the academic setting. Second, our data were based on self-report measures, which have particular limitations, such as restrictive rating scales, and can be limited by the introspective ability of participants, inaccurate interpretations of particular questions, and biased responses. In future research, the use of other methods of data collection (especially diaries and interviews) would be beneficial and important for the evaluation of the validity of the obtained findings. Third, the study involved participants from only four of the many institutions of higher education in Israel: Ben-Gurion University of the Negev, Tel Aviv University, The Hebrew University of Jerusalem, and Haifa University. Therefore, future research should include students from wider range of Israeli academic institutions and the generalizability of the current finding should be evaluated. Another avenue for future research might be to extend the present model by examining cultural factors such as self-construal, collectivism level, and somatization, which may be important indicators of psychological distress in Arab cultural contexts [50,91,92].

#### **5. Conclusions**

The importance of the current study lies in its examination of the roles of coping resources and coping strategies in the association between acculturative stress and depressive symptoms among female and male, as well as more junior and more advanced, Arab college students. The present study highlights the importance of SOC, as well as active coping and avoidant coping, in the relationship between acculturative stress and depressive symptoms. Gender and academic-year similarity was found with regard to the role of SOC, whereas differences were found in the direct effects and the roles of active and avoidant coping. Among the male students, active coping played a significant role in the association between acculturative stress and depressive symptoms. In contrast, among female and Year 1 + 2 students, avoidant coping played a significant role. This knowledge is expected to help the employees of academic departments understand the different aspects of the coping and distress that characterize Arab students. Male and female students and students at different stages of their degree programs may need different interventions to help them adjust to academic life, the acculturation process, and the stresses of this process. Psychological counseling and guidance programs should be tailored to the specific needs of Arab students, with special attention given to the roles of gender, academic year, coping resources, and coping strategies.

**Author Contributions:** Conceptualization, S.A.-K. and E.K.; methodology, S.A.-K. and E.K.; software, S.A.-K.; formal analysis, S.A.-K. and E.K.; investigation, S.A.-K. and E.K.; resources, S.A.-K.; data curation, E.K.; writing—original draft preparation, S.A.-K.; writing—review and editing, S.A.-K.; visualization, S.A.-K.; supervision, S.A.-K.; and project administration, E.K. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no external funding.

**Conflicts of Interest:** The authors declare no conflict of interest.

#### **References**

1. Redfield, R.; Linton, R.; Herskovits, M.J. Memorandum for the study of acculturation. *Am. Anthropol.* **1936**, *38*, 149–152. [CrossRef]


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International Journal of *Environmental Research and Public Health*
