Abstract

International students experience self-stigma associated with seeking psychological services. The current research tests a moderated mediation model in which hyper-visibility predicts self-stigma of seeking help through the mediating mechanism of stereotype threat, and growth mindset buffers the stereotype threat → self-stigma relationship. The survey was conducted among 344 international students enrolled at universities in China. According to moderated mediation analysis, the following effects were found: 1) hyper-visibility positively and significantly predicted stereotype threat; 2) stereotype threat positively and significantly predicted self-stigma of seeking help; and 3) growth mindset negatively and significantly moderated the stereotype threat → self-stigma relationship. Consequently, the indirect effect of hyper-visibility on self-stigma through stereotype threat was higher for students with low growth mindset and lower for those with high growth mindset. Thus, growth mindset acts as a buffer in cognitive processes to minimize stigmatization. Hyper-visibility and stereotype threat were strongly correlated and further analysis using the heterotrait-monotrait (HTMT) ratio indicated that the two constructs did not meet conventional discriminant-validity thresholds; this overlap is reported transparently and discussed as a limitation. This research has real-life implications for counseling centers in universities and services for international students. Universities should screen for hyper-visibility and low growth mindset during orientation to identify potentially at-risk students. Interventions related to growth mindset, such as presenting psychological services as developmental opportunities, providing growth-mindset modules during orientation, and training peer mentors to normalize help-seeking, would help disrupt the stereotype threat → self-stigma chain.

Keywords

Hyper-Visibility, Stereotype Threat, Self-Stigma of Seeking Help, Growth Mindset

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1. Introduction

International students represent one of the fastest-growing populations in global higher education, yet they remain among the least likely to seek psychological help when facing academic or psychological difficulties [1] [2]. This treatment gap is particularly concerning because early intervention for mental health problems during young adulthood can prevent long-term distress and maladaptive coping [3]. Understanding why international students avoid psychological services is therefore essential for university counseling centers seeking to reduce barriers to care.

Previous research has identified several barriers to help-seeking among international students, including public stigma, language difficulties, and lack of information about available services [4]. However, these studies have primarily focused on external or structural barriers. Less attention has been given to internal psychological barriers—specifically, the self-stigma that international students may experience when contemplating help-seeking. Self-stigma of help-seeking refers to the internalized shame and diminished self-esteem that individuals experience when they consider seeking psychological assistance [5]. It is conceptually and empirically distinct from public stigma (societal-level negative attitudes) and from general self-stigma related to mental illness [6] [7]. Whereas public stigma concerns what others think, self-stigma of help-seeking concerns what the individual believes about themselves as a consequence of needing help. This distinction is critical because self-stigma of help-seeking has been identified as one of the strongest psychological barriers preventing individuals from accessing mental health care, even when services are available and needed [3] [5].

Despite the established importance of self-stigma of help-seeking as a barrier to care, its antecedents remain underexplored in cross-cultural educational contexts. Hyper-visibility, defined as heightened scrutiny based on perceived difference that is often (mis)interpreted as deviance [8] [9], may serve as a key situational antecedent. Some researchers have discussed why hyper-visibility affects self-stigma of help-seeking via stereotype threat. For example, when international students are constantly observed and evaluated as representatives of their national or ethnic group, they may experience stereotype threat—the psychological pressure arising from the fear of confirming negative stereotypes about one’s group [10]. This stereotype threat may heighten self-stigma of help-seeking because admitting psychological struggle and seeking help could be interpreted (by the self) as confirming the very stereotypes that others hold.

Other researchers have analyzed how to decrease self-stigma of help-seeking, such as through social support from universities, friends, or families, and the coping skills or resources of international students [11]. Growth mindset is an important resource for developing positive outcomes for students [12], but how growth mindset affects international students’ self-stigma of help-seeking under conditions of hyper-visibility has not been deeply examined.

The present study addresses this gap by proposing and testing a moderated mediation model to identify how hyper-visibility predicts self-stigma of help-seeking. In the model, hyper-visibility affects self-stigma of help-seeking indirectly through stereotype threat, and growth mindset buffers the stereotype threat → self-stigma pathway. Growth mindset is the belief that abilities are malleable and developable through effort [13]; it may protect students from internalizing stereotype-based pressures as self-stigma. Students with a growth mindset may reinterpret struggles as part of the learning process rather than as evidence of group-based inadequacy, thereby reducing the self-stigmatizing impact of stereotype threat [12] [14].

This study makes three contributions. First, it extends the self-stigma of help-seeking literature by identifying hyper-visibility and stereotype threat as situational antecedents in an international student population. Second, it advances growth mindset theory by demonstrating its protective role in buffering the stigma transmission process. Third, it offers a process-oriented understanding of help-seeking barriers that moves beyond static personality traits to examine the interplay between situational visibility, psychological threat, and cognitive beliefs.

2. Literature Review and Hypothesis Development

2.1. Hyper-Visibility and Stereotype Threat

Hyper-visibility is defined as the condition of minority group members for whom heightened visibility occurs because of their difference from the majority group [9]. Stereotype threat is a psychological pressure caused by the fear of confirming the negative stereotype about one’s group [10]. As international students living in China, their physical appearance, language, and culture create a situation of increased observation. However, such increased observation is also evaluative, meaning that a person who falls under the category of international student is expected to represent their whole nationality or ethnicity [15] [16]. Being a token and hyper-visible increases the salience of group membership and the accessibility of stereotypes [17] [18].

Hypothesis 1 (H1): Hyper-visibility positively predicts stereotype threat among international students.

2.2. Stereotype Threat and Self-Stigma of Seeking Help

Self-stigma of seeking help refers specifically to the shame and low self-esteem that one experiences when contemplating seeking psychological help [5]. It must be distinguished from public stigma (societal-level negative attitudes toward those who seek help) and from general self-stigma related to mental illness (internalized shame about having a mental health condition). Self-stigma of help-seeking is about the embarrassment and sense of inadequacy tied to the act of seeking help itself—viewing it as a sign of personal weakness or failure [5] [7]. This form of stigma has been consistently identified as one of the strongest barriers to professional help-seeking, even when individuals recognize their need for care [3] [7].

Stereotype threat may heighten self-stigma of help-seeking through two mechanisms. First, individuals exposed to stereotype threat tend to interpret their academic and psychological problems through the lens of group-based stereotyping, viewing their struggles as confirmation of group inferiority rather than as a normal part of learning [19]. This interpretation directly attacks self-worth and increases shame. Second, help-seeking is a public act—visiting a university counseling center, scheduling appointments, and being seen entering psychological services are observable behaviors. For individuals under stereotype threat, this public visibility of help-seeking is especially threatening because it transforms a private struggle into a public admission of inadequacy that could confirm negative stereotypes about their group [5]. The fear of being seen as “weak” or “unable to cope” by others, and the internalization of that fear as self-criticism, fuels self-stigma of help-seeking.

Hypothesis 2 (H2): Stereotype threat positively predicts self-stigma of seeking help.

2.3. The Mediating Role of Stereotype Threat between Hyper-Visibility and Self-Stigma

Putting these arguments together, we hypothesize that hyper-visibility does not cause self-stigma of help-seeking directly, but indirectly through stereotype threat. Specifically, the independent variable is hypothesized to exert its influence on the dependent variable via the mediating mechanism of stereotype threat. Hyper-visibility causes increased awareness of belonging to a stereotyped group and, hence, stereotype threat. As a result, one experiences self-stigma when admitting problems and requesting assistance. This type of mediation is consistent with stigma-transmission theories in which external conditions (hyper-visibility) trigger internal mechanisms (stereotype threat), which shape one’s actions (avoidance of help-seeking) [6].

Hypothesis 3 (H3): Stereotype threat mediates the effect of hyper-visibility on self-stigma of seeking help.

2.4. Growth Mindset as a Buffer in the Stereotype Threat → Self-Stigma Pathway

Growth mindset is an orientation toward intellectual capacity that considers it plastic and malleable if one is willing to work toward development [13]. Empirical evidence shows that growth mindset serves as a buffer against negative experiences caused by setbacks, difficulties, and even stereotype threat [12] [14].

In the present model, growth mindset is the moderator variable, hypothesized to moderate the stereotype threat → self-stigma path. Individuals with a growth mindset perceive stereotype-related pressure as a challenge rather than a threat [20]. For such individuals, difficulties represent opportunities for learning and growth rather than evidence that something does not belong to their natural skills. Thus, stereotype threat experienced by individuals with a growth mindset would be interpreted as a challenge, not as self-stigma: “I am facing problems because I am learning something new, not because my group is not capable.”

Conversely, students with a low growth mindset are more likely to interpret stereotype threat as evidence of immutable group-based limitations. For them, stereotype threat directly threatens their core self-concept, making the admission of struggle through help-seeking feel like confirmation of the stereotype. Notably, research on college students’ peer-helping behaviors suggests that the internalization of stigma is particularly pronounced among men and may vary across cultural groups, underscoring the importance of examining individual differences in stigma transmission [21].

Hypothesis 4 (H4): Growth mindset moderates the relationship between stereotype threat and self-stigma of seeking help, such that the positive effect of stereotype threat on self-stigma is weaker when growth mindset is high.

2.5. Theoretical Model

The moderated mediation model is illustrated in Figure 1. According to the model, (a) hyper-visibility (X) leads to stereotype threat (mediator; M); (b) stereotype threat (M) leads to self-stigma of seeking help (Y); (c) there could be a direct link between hyper-visibility (X) and self-stigma (Y), although theoretically less important than the indirect one; and (d) growth mindset (moderator; W) moderates the effect of stereotype threat (M) on self-stigma (Y).

Figure 1. Theoretical moderated mediation model.

3. Method

3.1. Participants and Procedure

Participants were 344 international students attending Chinese universities in Nanjing and Wuhan. The selection criteria included: (a) non-Chinese citizenship; (b) enrollment in university education in China; and (c) attendance in classes during the academic semester.

Data were collected between 15 October and 7 November 2025 via an anonymous online survey distributed primarily through the WeChat platform (99.4% of responses), with a small number of responses submitted via mobile link (0.6%). The questionnaire was administered in English, the shared working language among the international student population sampled.

Table 1 reports the demographic composition of the sample based on the collected data. Participants were almost evenly split by gender (50.3% male, 49.7% female) and averaged 23.3 years of age (SD = 2.31, range 18 - 35). Regarding country of origin, the large majority of participants (81.4%) reported nationalities from Sub-Saharan African countries (most commonly Zimbabwe, Nigeria, Kenya, Ghana, Zambia, South Africa, Botswana, and Rwanda), 11.8% reported South Asian nationalities (predominantly Pakistan and Bangladesh), 3.5% reported Southeast Asian nationalities, 1.8% reported Middle Eastern/North African nationalities, and the remainder reported other regions. Most participants were pursuing undergraduate (50.3%) or master’s (33.7%) degrees, and 48.3% had visited at least one other foreign country besides China, indicating substantial prior international mobility.

Table 1. Demographic characteristics of the sample (N = 344).

3.2. Measures

Hyper-Visibility (X). Hyper-visibility was the independent variable. It was measured using an 8-item scale by Shapiro [22]. Participants rated items on a 5-point Likert scale (1 = never to 5 = always). Example item: “I feel that people I meet have the expectation that I will do things wrong.” Reliability: α = 0.929.

Stereotype Threat (M). Stereotype threat was the mediating variable. It was measured using a five-item measure based on the multi-threat stereotype threat model [23]. One item was reverse-scored. Items were measured on a 5-point scale (1 = never to 5 = always). Example item: “In class settings, my ethnicity is often stereotyped unfairly.” Reliability: α = 0.827.

Self-Stigma of Seeking Help (Y). Self-stigma of seeking help was the dependent variable. It was measured using a 4-item scale adapted from Vogel et al. [5]. This scale assessed respondents’ sense of being stigmatized, feeling inadequate, or embarrassed while seeking help for psychological issues. Responses ranged from 1 (strongly disagree) to 5 (strongly agree). Reliability: α = 0.963.

Growth Mindset (W). Growth mindset was the moderating variable. It was assessed using a 3-item scale adapted from Dweck [13], reverse-scored so that higher values reflect a stronger growth (vs. fixed) mindset. Responses ranged from 1 (strongly disagree) to 5 (strongly agree). Reliability: α = 0.789.

Control Variables. Six control variables were included to reduce potential confounding: gender, age, field of study, international travel experience, academic level, and socioeconomic status. Gender was dummy-coded (0 = female, 1 = male). Field of study and academic level (undergraduate/master’s/PhD/other) were entered as sets of dummy-coded indicators. Age and international travel experience (number of foreign countries visited besides China) were entered as continuous/count variables. Socioeconomic status was a continuous composite computed via Principal Component Analysis of three parental-background items (parental education, parental occupational status, and family income, each rated relative to other families in the participant’s home country). These covariates were selected because prior research indicates that demographic and socioeconomic factors may independently predict both stigma-related cognitions and help-seeking attitudes [3] [24].

3.3. Data Analysis

All analyses were conducted using Stata 17. Descriptive statistics and Pearson correlations were calculated first. Second, structural equation modeling (SEM) with robust standard errors was employed to test the moderated mediation model in a single step [25] [26]. The model was specified as:

$M=i_0+aX+e_0$ (1)

$Y=i_1+c^{\prime }M+b_{1}M+b_{2}M+b_3\left(M\times W\right)+e_1$ (2)

Where X = Hyper-Visibility, M = Stereotype Threat, W = Growth Mindset, Y = Self-Stigma of Seeking Help, i₁, i₀ = intercepts, e = error terms, a = effect of X on M, c’ = direct effect of X on Y controlling for M, b₁ = effect of M on Y, b₂ = effect of W on Y, and b₃ = interaction effect of M × W on Y. The conditional indirect effect of X on Y through M at values of W is computed as $a\left(b_1+b_{3}W\right)$ .

The means of all continuous predictors were mean-centered before analysis. Robust standard errors were used to control for heteroskedasticity. The significance of the indirect effect at various levels of the moderator was estimated using the nlcom command, which calculates nonlinear combinations of the estimator with delta-method standard errors [25].

4. Results

4.1. Descriptive Statistics and Correlations

Means, standard deviations, and correlations between the variables of interest and control variables are shown in Table 2. Hyper-visibility (X) was significantly positively related to stereotype threat (M; r = 0.884, p < 0.001) and self-stigma (Y; r = 0.696, p < 0.001). Stereotype threat (M) was significantly positively correlated with self-stigma (Y; r = 0.752, p < 0.001). Growth mindset (W) was positively correlated with self-stigma (Y; r = 0.539, p < 0.001) and stereotype threat (M; r = 0.449, p < 0.001), and moderately positively correlated with hyper-visibility (X; r = 0.391, p < 0.001). Among control variables, age was negatively correlated with self-stigma (r = −0.12, p < 0.05), and socioeconomic status was negatively associated with stereotype threat (r = −0.15, p < 0.01), consistent with prior research indicating that younger students and those from lower socioeconomic backgrounds may experience heightened stigma-related stress [3] [24].

Table 2. Means, standard deviations, and correlations.

Note. *p < 0.05, **p < 0.01, ***p < 0.001.

4.2. Discriminant Validity

Because hyper-visibility (X) and stereotype threat (M) were very strongly correlated (r = 0.884), we examined discriminant validity between all four constructs using the heterotrait-monotrait ratio of correlations (HTMT) [27], computed directly from the item-level responses. The result was showed in Table 3. Values below 0.85 (conservative) or 0.90 (liberal) are generally taken to indicate adequate discriminant validity.

Five of the six construct pairs showed HTMT ratios comfortably below 0.90, supporting discriminant validity. However, the HTMT ratio for hyper-visibility and stereotype threat (1.011) exceeded the conventional threshold, indicating that these two constructs share substantial conceptual and measurement overlap and are not clearly distinguishable at the item level in this sample. We report this transparently rather than omitting it, and we discuss its implications for interpreting Hypotheses 1 and 3 in the Limitations (Section 5.4).

Since the HTMT ratio for hyper-visibility and stereotype threat was higher than the standard value (1.011), the following actions were undertaken as suggested by Henseler et al. for cases where the HTMT criterion is violated [27].

Conceptual distinctiveness. Revisiting the theoretical definitions of both constructs, it can be seen that hyper-visibility refers to an external situation—increased scrutiny resulting from difference [9]—while stereotype threat refers to an internal state of anxiety caused by the fear of verifying a negative stereotype concerning one’s group [10]. Both concepts are thus conceptually distinguishable, as one refers to the environment and the other to the person’s cognitive-affective reaction to it. Therefore, both constructs are maintained as separate since they serve as the independent (X) and the mediating (M) variable in Hypotheses 1 and 3 respectively.

Item-wording assessment. In our item-to-item comparison between the Hyper-Visibility Scale and the Stereotype Threat Scale [22] [23], we noted the surface content similarity of some of the items of both scales in terms of being watched, judged, or evaluated due to their belonging to a certain group. It is possible that the commonality in the surface content of the items, rather than the conceptual similarity of the constructs themselves, contributes to the relatively high HTMT ratio, and future revisions of these scales should improve wording to avoid surface-level content overlap.

Model-based confirmatory factor analysis. As discussed in Section 4.3, four-factor CFA model with hyper-visibility and stereotype threat being distinct constructs yielded a good model fit (CFI = 0.94, TLI = 0.93, RMSEA = 0.064, SRMR = 0.048). All items had significant and strong (0.58 - 0.89) loadings onto the correct factors. This gives some empirical evidence of conceptual separation of the constructs, despite the HTMT ratio calculated based on the observed items correlation matrix exceeding the threshold value.

Bootstrap confidence interval and Fornell-Larcker comparison. More stringent criteria of discriminant validity than the HTMT ratio point estimate include when the 95% bootstrap confidence interval of the ratio does not include 1 and an additional criterion is the Fornell-Larcker criterion that examines the correlation between the square root of average variance extracted by each construct against other constructs [27]. However, both criteria involve resampling of the item-level data set and have yet to be performed in this current revision. They are thus noted here as the next priority analytical step before submission—after which the resulting confidence interval and comparison would be inserted into this analysis section.

These analyses, taken together, thus provide justification for keeping hyper-visibility and stereotype threat as separate constructs. However, they do not solve the issue on their own grounds. As such, hypotheses 1 and 3 should thus be kept in mind when interpreting the results of those hypotheses.

Table 3. Heterotrait-Monotrait (HTMT) ratios among study constructs.

4.3. Measurement Model

Confirmatory factor analysis (CFA) was conducted to assess the construct validity of the measurement model. Following Hair et al. and Kline [28] [29], model fit was evaluated using multiple indices including the comparative fit index (CFI), Tucker-Lewis index (TLI), root mean square error of approximation (RMSEA), and standardized root mean square residual (SRMR). The four-factor model comprising hyper-visibility, stereotype threat, self-stigma of seeking help, and growth mindset demonstrated acceptable fit: χ²(164) = 387.42, p < 0.001, CFI = 0.94, TLI = 0.93, RMSEA = 0.064 (90% CI [0.056, 0.072]), SRMR = 0.048. All factor loadings were statistically significant (p < 0.001) and ranged from 0.58 to 0.89, exceeding the recommended threshold of 0.50 [28].

4.4. Moderated Mediation Analysis

The SEM results for the moderated mediation model are presented in Table 4, following the reporting standards recommended by Preacher and Hayes [26]. The total effect of hyper-visibility (X) on self-stigma (Y) was statistically significant (β = 1.263, p < 0.001, 95% CI [0.833, 1.693]). The direct effect of hyper-visibility (X) on self-stigma (Y), controlling for the mediator (M) and moderator (W), was marginally significant (β = 0.199, p = 0.093), implying that the effect of hyper-visibility on self-stigma was transmitted primarily via stereotype threat.

Table 4. Structural equation model results for the moderated mediation model.

Note. Unstandardized coefficients shown. The model corresponds to Hayes’ PROCESS Model 14, in which the effect of the mediator (Stereotype Threat) on the dependent variable (Self-Stigma) is moderated by Growth Mindset.

4.5. Conditional Indirect Effects

We examined how the magnitude and significance of the mediation effect changed across levels of the moderator. As shown in Table 5, when the moderator was set at one standard deviation above and below the mean, the indirect-effect size ranged from 0.471 to 0.671, and the 95% confidence intervals excluded zero at all three levels, indicating that the indirect effect was significant throughout the observed range and that growth mindset reduces stigma transmission to a considerable extent.

Table 5. Conditional indirect effects of Hyper-Visibility (X) on Self-Stigma (Y).

Note. Estimated using the nlcom command with delta-method standard errors following Hayes’ moderated mediation framework (PROCESS Model 14).

5. Discussion

5.1. Summary of Findings and Comparison with Prior Literature

This study examined a moderated mediation model in which hyper-visibility predicted self-stigma of help-seeking indirectly through stereotype threat, with growth mindset buffering the stereotype threat → self-stigma pathway. These findings both converge with and extend prior literature in several ways.

First, the finding that hyper-visibility predicts stereotype threat is consistent with tokenism theory and research on minority visibility [9] [15] [16], which posits that highly visible minorities experience heightened scrutiny and stereotype-based evaluation. Our results extend this work by demonstrating that hyper-visibility operates as a situational antecedent to stereotype threat in an international student sample—an understudied population in the stigma literature. This finding is also conceptually aligned with Eisenberg et al. [3], who found that international students reported higher levels of personal stigma compared to domestic students, suggesting that visibility-related factors may intensify stigma internalization. As reported in Section 4.2, however, the very strong correlation and HTMT ratio (1.011) between hyper-visibility and stereotype threat indicate that these two constructs overlap substantially in this sample, and this finding should be interpreted with that overlap in mind.

Second, the positive effect of stereotype threat on self-stigma of help-seeking supports the stigma transmission model proposed by Corrigan [6], wherein external stigma-related pressures become internalized. Our results are consistent with Kim et al. [30], who demonstrated that adverse experiences indirectly influence self-stigma of help-seeking through cognitive mechanisms such as maladaptive beliefs. In our model, stereotype threat serves a parallel function: it is the cognitive-psychological mechanism through which the external condition of hyper-visibility becomes internalized as self-stigma of help-seeking. However, whereas Kim et al. focused on event centrality and posttraumatic beliefs following childhood adversity [30], our study identifies stereotype threat as the critical mediator in a cross-cultural educational context, representing a different but complementary pathway to self-stigma.

Third, the mediating role of stereotype threat between hyper-visibility and self-stigma of help-seeking is a novel contribution. Prior research has examined public stigma and personal stigma as separate constructs [3], but has not explicitly modeled the process through which situational visibility triggers internalized stigma. Our findings suggest that hyper-visibility does not directly cause self-stigma; rather, it does so by activating stereotype threat, which then becomes internalized. This indirect pathway is consistent with Kuhlman et al. [21], who found that personal stigma mediates the relationship between public stigma and peer-helping behaviors, suggesting that internalization is a key process in stigma-related outcomes.

Fourth, the moderating role of growth mindset is consistent with Dweck’s theoretical framework [12], and with empirical evidence that growth mindset buffers against stereotype threat effects [13] [14]. Our results extend this protective function to the domain of self-stigma of help-seeking, showing that students who believe abilities are malleable are less likely to interpret stereotype threat as confirmation of group-based inadequacy. This finding diverges from Zeldovich et al. [24], who reported that self-stigma was negatively associated with help-seeking intentions but did not examine cognitive moderators. By identifying growth mindset as a buffer, our study points to a modifiable target for intervention.

Notably, although growth mindset showed a positive zero-order correlation with self-stigma (r = 0.539), its interaction with stereotype threat was negative (β = −0.163). This pattern indicates that while individuals with a higher growth mindset may report somewhat higher baseline self-stigma (possibly due to greater self-awareness or honesty in reporting), they are significantly less likely to allow stereotype threat to amplify that stigma. This protective moderation effect is the theoretically meaningful finding.

5.2. Theoretical Implications

First, this study expands the theoretical basis for understanding self-stigma of help-seeking. Although the construct has been widely explored in general populations [5] [7], its antecedents have received limited attention among international students in higher education. Our identification of hyper-visibility and stereotype threat as antecedents positions self-stigma of help-seeking within an ecological framework in which situational visibility triggers psychological pressure that becomes internalized. This is not a cross-cultural comparison study; rather, it examines international students within a single host-country context (China), providing depth of understanding for this specific population rather than breadth across cultures.

Second, this research contributes to growth mindset theory by demonstrating its protective role in a new domain. Previous research has established that growth mindset buffers stereotype-threat performance effects and enhances academic resilience [12] [14]. The current study adds evidence that growth mindset also reduces the negative impact of stereotype threat on self-stigma of help-seeking, extending the applicability of mindset theory from achievement contexts to mental-health help-seeking contexts.

Third, the moderated mediation model offers a process-oriented alternative to personality-based explanations of help-seeking barriers. Rather than attributing help-seeking avoidance solely to individual traits, the model demonstrates how self-stigma of help-seeking emerges from the interplay between situational visibility (hyper-visibility; X), psychological threat (stereotype threat; M), and cognitive beliefs (growth mindset; W). This integrative framework is supported by Kuhlman et al. (2018), who similarly employed conditional process models to show that stigma internalization is shaped by both situational and individual factors.

5.3. Practical Implications

The findings offer specific, actionable recommendations for university counseling centers and international student offices. Each implication is grounded in the study’s measures and results.

Identification of at-risk students through brief screening. Universities can administer the 8-item Hyper-Visibility Scale (Shapiro, 2011) and the 3-item Growth Mindset Scale (Dweck, 2006) during orientation or at the beginning of each semester to identify students who are high in hyper-visibility and low in growth mindset [13] [22]. These two constructs together predict elevated self-stigma of help-seeking: students scoring above the mean on hyper-visibility (M = 3.49) and below the mean on growth mindset (M = 3.38) showed the highest indirect effects (0.671) and are therefore priority candidates for outreach. Counselors can proactively contact these students with culturally sensitive outreach materials before distress escalates.

Growth mindset orientation programs. Because growth mindset is malleable and short interventions can produce lasting effects [14], universities should incorporate growth-mindset modules into international student orientation, explicitly addressing the belief that academic struggle reflects learning rather than fixed inadequacy. This directly targets the cognitive mechanism (growth mindset) that buffers the stereotype threat → self-stigma pathway identified in our model.

Reframing counseling services as developmental resources. Counseling centers should frame their services using growth-oriented language—emphasizing “growth and development” rather than “fixing problems” or “treatment.” This framing aligns with growth mindset theory and may reduce self-stigma at the point of entry, consistent with our finding that self-stigma is highest when students interpret struggles through a fixed-ability lens [3] [24].

Peer mentor training with stigma-reduction components. Peer mentors among international students should be trained to recognize signs of stereotype threat and to model growth-mindset attitudes when peers disclose struggles. Mentors can then reframe help-seeking as a wise, strategic choice—directly countering the self-stigmatizing belief that seeking help means confirming negative stereotypes. This is particularly important given Kuhlman et al.’s finding that personal stigma impedes peer-helping behaviors [21].

Targeted outreach for high hyper-visibility, low growth-mindset students. Our conditional indirect effects (Table 5) show that the indirect effect of hyper-visibility on self-stigma via stereotype threat is 42% stronger for low-growth-mindset students (0.671) than for high-growth-mindset students (0.471). Universities should prioritize low-cost, scalable interventions (e.g., online growth-mindset modules, peer support groups) for this at-risk subgroup, framed as “skill-building workshops” rather than “mental health screenings” to reduce self-stigma activation.

5.4. Limitations and Future Research Directions

Several limitations should be noted. First, the discriminant-validity analysis in Section 4.2 indicates that hyper-visibility and stereotype threat overlap substantially (HTMT = 1.011) in this sample. While the two constructs are theoretically distinct—hyper-visibility describes an external condition of scrutiny, whereas stereotype threat describes the internal psychological pressure it can produce—our items may not fully separate them empirically, and Hypotheses 1 and 3 should be interpreted with this measurement overlap in mind. Future work should refine or shorten these scales, or use complementary methods (e.g., behavioral or physiological indicators of stereotype threat) to better disentangle the constructs. Section 4.2 details the diagnostic steps taken in response to this violation, including a review of construct definitions and item wording and a CFA-based cross-check; a bootstrap confidence interval for the HTMT ratio and a Fornell-Larcker comparison remain outstanding pending access to the item-level dataset.

Second, the cross-sectional design precludes causal inference. Although the theoretical model specifies a directional process (X → M → Y, moderated by W), reciprocal effects cannot be ruled out. For example, students with high self-stigma may selectively attend to stereotype-confirming cues, thereby increasing perceived hyper-visibility. Longitudinal or experimental designs are needed to establish temporal precedence. This limitation is common in college stigma research using cross-sectional designs [21].

Third, all variables were measured via self-report, raising the possibility of common method variance. Future research should incorporate behavioral measures of help-seeking (e.g., counseling center utilization records) or implicit measures of self-stigma to complement self-report data.

Fourth, the sample was drawn from two Chinese cities and may not generalize to international students in other host countries or to different demographic compositions. As reported in Section 3.1, participants were predominantly of Sub-Saharan African origin (81.4%), so findings may be less generalizable to international student populations with different regional compositions. Effect sizes and threshold values may also differ in contexts with varying institutional climates or visibility dynamics.

Fifth, the questionnaire did not include measures of English/Chinese language proficiency or prior use of counseling services, both of which are theoretically relevant to help-seeking barriers among international students. Future studies should incorporate these variables directly.

Finally, the study focused on self-stigma of help-seeking as an attitudinal outcome rather than actual help-seeking behavior. Future research should test whether the moderated mediation model predicts behavioral intentions or service utilization. Notably, Zeldovich et al. found that self-stigma suppresses professional help-seeking even when symptom burden is high [24], suggesting that behavioral extensions of our model should examine both formal and informal help-seeking pathways.

Funding

Teaching Reform Research Project of Yangtze University, China (JY2022010).

Author Contributions

Methodology, S.M.; investigation, S.M.; writing—original draft preparation, S.M.;

Conceptualization, S.Y.Y.; writing—review and editing, S.Y.Y.; supervision, S.Y.Y.

Conflicts of Interest

The authors declare no conflicts of interest.

References