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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">JBTM</journal-id>
      <journal-title-group>
        <journal-title>Journal of Behavior Therapy And Mental Health</journal-title>
      </journal-title-group>
      <issn pub-type="epub">2474-9273</issn>
      <publisher>
        <publisher-name>Open Access Pub</publisher-name>
        <publisher-loc>United States</publisher-loc>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id">JBTM-16-1175</article-id>
      <article-id pub-id-type="doi">10.14302/issn.2474-9273.jbtm-16-1175</article-id>
      <article-categories>
        <subj-group>
          <subject>research-article</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Influences of Australian nursing students’ anxiety, depression, personality and family interaction on their psychological well-being and suicidal ideation</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Pi-Ming</surname>
            <given-names>Yeh</given-names>
          </name>
          <xref ref-type="aff" rid="idm1841054636">1</xref>
          <xref ref-type="aff" rid="idm1841145804">*</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Lorna</surname>
            <given-names>Moxham</given-names>
          </name>
          <xref ref-type="aff" rid="idm1841053844">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Christopher</surname>
            <given-names>Patterson</given-names>
          </name>
          <xref ref-type="aff" rid="idm1841052764">3</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Carolyn</surname>
            <given-names>Antoniou</given-names>
          </name>
          <xref ref-type="aff" rid="idm1841053556">4</xref>
        </contrib>
      </contrib-group>
      <aff id="idm1841054636">
        <label>1</label>
        <addr-line>RN. Ph.D., Associate Professor, School of Nursing and Health Professionals, Missouri Western State University, USA.</addr-line>
      </aff>
      <aff id="idm1841053844">
        <label>2</label>
        <addr-line>RN. Ph.D., Professor of Mental Health Nursing, School of Nursing, University of Wollongong, Australia.</addr-line>
      </aff>
      <aff id="idm1841052764">
        <label>3</label>
        <addr-line>RN, BN(Hons), MN (Mental Health), MACMHN, School of Nursing, University of Wollongong, Australia.  </addr-line>
      </aff>
      <aff id="idm1841053556">
        <label>4</label>
        <addr-line>RN, Grad Cert HealthPD, MHlthLeadMgmt, School of Nursing, University of Wollongong, Australia.  </addr-line>
      </aff>
      <aff id="idm1841145804">
        <label>*</label>
        <addr-line>Corresponding author</addr-line>
      </aff>
      <contrib-group>
        <contrib contrib-type="editor">
          <name>
            <surname>Laura</surname>
            <given-names>Sirri</given-names>
          </name>
          <xref ref-type="aff" rid="idm1840887972">1</xref>
        </contrib>
      </contrib-group>
      <aff id="idm1840887972">
        <label>1</label>
        <addr-line>Department of Psychology, University of Bologna</addr-line>
      </aff>
      <author-notes>
        <corresp>Pi-Ming Yeh, <addr-line>School of Nursing and Health Professionals, Missouri Western State University, Address: 4525 Downs Drive, St Joseph, MO 64507, USA</addr-line>, Telephone: <phone>(816)271-4250</phone>, Fax number: <fax>(816)271-5849</fax>, E-mail: <email>pimingyeh@yahoo.com</email></corresp>
        <fn fn-type="conflict" id="idm1842087484">
          <p>The authors have declared that no competing interests exist.</p>
        </fn>
      </author-notes>
      <pub-date pub-type="epub" iso-8601-date="2016-08-25">
        <day>25</day>
        <month>08</month>
        <year>2016</year>
      </pub-date>
      <volume>1</volume>
      <issue>2</issue>
      <fpage>1</fpage>
      <lpage>11</lpage>
      <history>
        <date date-type="received">
          <day>16</day>
          <month>06</month>
          <year>2016</year>
        </date>
        <date date-type="accepted">
          <day>22</day>
          <month>08</month>
          <year>2016</year>
        </date>
        <date date-type="online">
          <day>25</day>
          <month>08</month>
          <year>2016</year>
        </date>
      </history>
      <permissions>
        <copyright-statement>© </copyright-statement>
        <copyright-year>2016</copyright-year>
        <copyright-holder>Pi-Ming Yeh, et al.</copyright-holder>
        <license xlink:href="http://creativecommons.org/licenses/by/4.0/" xlink:type="simple">
          <license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
        </license>
      </permissions>
      <self-uri xlink:href="http://openaccesspub.org//jbtm/article/340">This article is available from http://openaccesspub.org//jbtm/article/340</self-uri>
      <abstract>
        <sec id="idm1840886028">
          <title>Objective: </title>
          <p>To examine the relationships between Australian nursing students’ anxiety, depression, personality and family interaction with psychological well-being and suicidal ideation. </p>
        </sec>
        <sec id="idm1840885092">
          <title>Participants: </title>
          <p>A sample of 201 nursing students completed  a series of structured questionnaires in an Australian University. </p>
        </sec>
        <sec id="idm1840886100">
          <title>Methods: </title>
          <p>A cross-sectional descriptive research design was used. After explanation of this study, 201 nursing students voluntarily participated. Six reliable and structured questionnaires were used to do data collection. SPSS was used for data analysis including descriptive data, Pearson Correlation, and Stepwise Multiple Regression. </p>
        </sec>
        <sec id="idm1840885020">
          <title>Results: </title>
          <p>Anxiety and depression were positively associated with suicidal ideation and had negative relationships with psychological well-being. Positive personality and family interaction were positively associated with psychological well-being and negatively with suicidal ideation. Parents’ harsh discipline had a negative relationship with the nursing students’ psychological well-being. </p>
        </sec>
        <sec id="idm1840885668">
          <title>Conclusions: </title>
          <p>Depression, personality, and positive family interaction were significant predictors of Australian nursing students’ psychological well-being. Anxiety, depression, and harsh discipline were significant predictors of suicidal ideation </p>
        </sec>
      </abstract>
      <kwd-group>
        <kwd>Australia</kwd>
        <kwd>nursing student</kwd>
        <kwd>psychological well-being</kwd>
        <kwd>suicidal ideation</kwd>
        <kwd>anxiety</kwd>
        <kwd>depression</kwd>
        <kwd>personality</kwd>
        <kwd>family interaction</kwd>
      </kwd-group>
      <counts>
        <fig-count count="0"/>
        <table-count count="4"/>
        <page-count count="11"/>
      </counts>
    </article-meta>
  </front>
  <body>
    <sec id="idm1840875740" sec-type="intro">
      <title>Introduction</title>
      <p>It is globally recognized that nursing is a stressful occupation <xref ref-type="bibr" rid="ridm1842378868">1</xref>. Nurses often account for the largest percentage of the clinical workforce <xref ref-type="bibr" rid="ridm1842380092">2</xref>and their psychological well-being can impact upon the patients <xref ref-type="bibr" rid="ridm1842390756">3</xref><xref ref-type="bibr" rid="ridm1842449068">4</xref>. There are significant correlations between psychological distress, depression, anxiety and psychological well-being <xref ref-type="bibr" rid="ridm1842236772">5</xref><xref ref-type="bibr" rid="ridm1842225812">6</xref><xref ref-type="bibr" rid="ridm1842220700">7</xref>.Therefore, it is an important topic to understand what factors influence nurses’ psychological well-being. The World Health Organization (WHO) reports a 60% increase worldwide in suicide rates over the last 45 years <xref ref-type="bibr" rid="ridm1842206892">8</xref>. Extreme feelings of stress could lead to suicidal ideation and attempted suicide <xref ref-type="bibr" rid="ridm1842207756">9</xref>. </p>
      <p>Research indicates that some students experience feelings of anxiety, hopelessness and depression <xref ref-type="bibr" rid="ridm1842211644">10</xref>. Especially nursing students might have high levels of stress <xref ref-type="bibr" rid="ridm1842190852">11</xref><xref ref-type="bibr" rid="ridm1842187396">12</xref><xref ref-type="bibr" rid="ridm1842184948">13</xref><xref ref-type="bibr" rid="ridm1842197764">14</xref><xref ref-type="bibr" rid="ridm1842154260">15</xref><xref ref-type="bibr" rid="ridm1842151092">16</xref>. In Melissa-Halikiopoulou’s study, 142 Greek nursing students found that 10% of participants reported suicidal thoughts and 1.4% stated that they might attempt suicide if they had the opportunity <xref ref-type="bibr" rid="ridm1842147420">17</xref>.</p>
      <p>Mental illness is a central topic in Australia <xref ref-type="bibr" rid="ridm1842142956">18</xref>. One in five Australian aged 16-85 years experienced a mental disorder in 2010 <xref ref-type="bibr" rid="ridm1842220700">7</xref>. The most prevalent mental health disorders were found to be anxiety (14.4%), substance use (5.1%) and affective disorders (6.2%), including depressive disorders (4.1%) <xref ref-type="bibr" rid="ridm1842220700">7</xref>.</p>
      <p>There are 1.2 million students with higher education in Australia; three out of five (61%) are aged 15-24 years <xref ref-type="bibr" rid="ridm1842220700">7</xref><xref ref-type="bibr" rid="ridm1842129764">19</xref><xref ref-type="bibr" rid="ridm1842127388">20</xref>. Females aged 16-24 years report the highest prevalence of suicidality and anxiety compared to any other age group <xref ref-type="bibr" rid="ridm1842220700">7</xref>. There are some barriers to health seeking behaviours among this age group, so their seeking assistance is an issues <xref ref-type="bibr" rid="ridm1842126452">21</xref>. Some studies indicate that Australian University students experience higher levels of psychological distress than the general population of the same age <xref ref-type="bibr" rid="ridm1842122852">22</xref><xref ref-type="bibr" rid="ridm1842135812">23</xref>. </p>
      <p>Is there any relationship between personality and psychological well-being? Personality is developed by biological temper, family interaction and cognitive learning <xref ref-type="bibr" rid="ridm1842113044">24</xref>. When people experience stress, anxiety or depression, according to personality, they use different coping strategies that in turn result in different outcomes such as psychological well-being or suicidal ideation <xref ref-type="bibr" rid="ridm1842197764">14</xref><xref ref-type="bibr" rid="ridm1842113044">24</xref><xref ref-type="bibr" rid="ridm1842108220">25</xref>. During this process, spiritual well-being appears to be a mediating factor which influences the outcome variables <xref ref-type="bibr" rid="ridm1842113044">24</xref><xref ref-type="bibr" rid="ridm1842105916">26</xref><xref ref-type="bibr" rid="ridm1842103396">27</xref><xref ref-type="bibr" rid="ridm1842099220">28</xref>. </p>
      <p>How an individual deals with the stress caused by exposure to harsh parenting or with the significant stressors that are intrinsic to the role of nursing is mediated by personality. Personality and emotional stability were associated with nursing students’ psychological well-being <xref ref-type="bibr" rid="ridm1842089724">29</xref>. </p>
      <p>Positive family interaction also provides a stable framework within which the individual is safe to make important decisions, debrief and feel supported. Individuals who had positive family interactions (eg., communication and involvement) reported lower rates of suicidal behaviours <xref ref-type="bibr" rid="ridm1842113044">24</xref><xref ref-type="bibr" rid="ridm1842085620">30</xref>. Conversely, a negative family interaction, such as harsh parenting, has a negative impact on people’s psychological well-being and increases the risk of suicidal ideation <xref ref-type="bibr" rid="ridm1842113044">24</xref><xref ref-type="bibr" rid="ridm1842080076">31</xref>. Power assertive parenting and high levels of physical punishment also decrease psychological well-being <xref ref-type="bibr" rid="ridm1842075108">32</xref><xref ref-type="bibr" rid="ridm1842073596">33</xref>. Therefore, the purpose of this study was to examine the relationships between Australian nursing student’s anxiety, depression, personality and family interaction on their psychological well-being and suicidal ideation.</p>
    </sec>
    <sec id="idm1840872860" sec-type="methods">
      <title>Methods</title>
      <sec id="idm1840872788">
        <title>Sample, Setting, and Data Collection </title>
        <p>The convenience sample consisted of 201 Bachelor of Nursing (BN) students inclusive of 20 (10%) males and 181 (90%) females. The mean age was 25.80 yrs (<italic>SD</italic> = 8.43). The sample size of 201 participants was determined by the Power Analysis Computer Software</p>
        <p>and and the criteria of Alpha at 0.05 and power (1- Beta) at 0.80” <xref ref-type="bibr" rid="ridm1842067836">34</xref>. After IRB approval of this study, the researchers explained this study to nursing students and, if they were willing to participate, they were asked to fill out the informed consent form and the questionnaires. Participants returned the questionnaires in a locked box in the nursing department. </p>
      </sec>
      <sec id="idm1840879196">
        <title>Instruments</title>
        <p>Data were collected using six instruments, all of which were selected for their reliability and validity. All of the instruments had good internal consistency. Their Cronbach’s Alpha values were greater than 0.7 (<xref ref-type="table" rid="idm1842494652">Table 1</xref>).</p>
        <table-wrap id="idm1842494652">
          <label>Table 1.</label>
          <caption>
            <title> The Cronbach’s alpha of instruments (N = 201)</title>
          </caption>
          <table rules="all" frame="box">
            <tbody>
              <tr>
                <td>Variables</td>
                <td>Instruments</td>
                <td>Items</td>
                <td>Cronbach's Alpha </td>
                <td>Range of Scores</td>
              </tr>
              <tr>
                <td>Anxiety</td>
                <td>Hamilton Anxiety Scale (Hamilton, 1969) </td>
                <td>42</td>
                <td>0.95</td>
                <td>0-168</td>
              </tr>
              <tr>
                <td>Depression  </td>
                <td>Zung Depression Scale (Zung, 1976) </td>
                <td> 20  </td>
                <td>0.8  </td>
                <td>20-80  </td>
              </tr>
              <tr>
                <td>Personality   </td>
                <td>Personality scale  (Goldberg, 1999)</td>
                <td> 50  </td>
                <td>0.88  </td>
                <td>50-250  </td>
              </tr>
              <tr>
                <td>Family Interaction   </td>
                <td>Iowa Family Interaction Rating Scales  (Melby et al., in 1998) </td>
                <td> 29  </td>
                <td>Positive: 0.94 Negative: 0.83</td>
                <td>29-145  </td>
              </tr>
              <tr>
                <td>Psychological 
Well-Being  </td>
                <td>Psychological Well-Being Scale  (Ryff, 1989)</td>
                <td>18</td>
                <td>0.81</td>
                <td>18-108 </td>
              </tr>
              <tr>
                <td>Suicidal Ideation </td>
                <td>Brief Screen for Adolesent Depression </td>
                <td>7</td>
                <td>0.73</td>
                <td>0-7</td>
              </tr>
            </tbody>
          </table>
        </table-wrap>
      </sec>
      <sec id="idm1840838404">
        <title>Psychological Well-Being Scale (PWBS): </title>
        <p>Participants’ psychological well-being was measured using the 18-item PWBS <xref ref-type="bibr" rid="ridm1842067332">35</xref>. Six concepts (autonomy, environmental mastery, purpose in life, personal growth, positive relations with others, and self-acceptance) were assessed.  Items were scored on a six-point Likert-type scale ranging from (1) strongly disagree to (6) strongly agree. Higher scores indicate more positive psychological well-being. Validity of the scale was examined by confirmatory factor analyses <xref ref-type="bibr" rid="ridm1842062652">36</xref>. In a previous study, internal consistency for each subscale, based on a sample of 321 adults (age range 19.53 - 74.96 years), revealed a high degree of reliability with Cronbach’s alphas ranging from 0.83 to 0.91 <xref ref-type="bibr" rid="ridm1842067332">35</xref>. The Cronbach’s Alpha was 0.81 in this study (<xref ref-type="table" rid="idm1842494652">Table 1</xref>).</p>
      </sec>
      <sec id="idm1840838044">
        <title>Suicidal Ideation: </title>
        <p>The Brief Screen for Adolescent Depression Scale (BSADS) was developed by the Signs of Suicide Project <xref ref-type="bibr" rid="ridm1842059412">37</xref>. The BSADS was used to measure participants’ suicidal ideation. There were seven questions with items scored on a Yes or No basis. Scores from 0 to 2 indicated no evidence of depression; 3 indicated some evidence of depression and scores of 4 or greater indicated the person should talk to a mental health professional. The Cronbach’s Alpha for the BSADS was 0.73 in this study (<xref ref-type="table" rid="idm1842494652">Table 1</xref>).</p>
      </sec>
      <sec id="idm1840836172">
        <title>Anxiety</title>
        <p>Anxiety was measured by the Hamilton Anxiety Scale (HAS) <xref ref-type="bibr" rid="ridm1842029204">38</xref>: 42 questions were scored on a five-point scale ranging from (0) Not Present to (4) Very Severe. The higher the score, the higher the level of anxiety. The Cronbach’s Alpha for the HAS was 0.95 in this study (<xref ref-type="table" rid="idm1842494652">Table 1</xref>).</p>
      </sec>
      <sec id="idm1840851652">
        <title>Depression</title>
        <p>Depressionwas measured using the Zung Depression Scale (ZDS) <xref ref-type="bibr" rid="ridm1842026036">39</xref>: 20 questions were scored on a four-point scale ranging from (1) None or Little to (4) Most or All. Higher scores indicate higher levels of depression. The Cronbach’s Alpha for the ZDS was 0.80 in this study (<xref ref-type="table" rid="idm1842494652">Table 1</xref>).</p>
      </sec>
      <sec id="idm1840851076">
        <title>Personality characteristics</title>
        <p>Personality characteristicswere measured using the Big FivePersonality Test developed by Goldberg <xref ref-type="bibr" rid="ridm1842020924">40</xref>. The instrument has five subscales: Confidence, Agreeableness, Conscientiousness, Emotional Stability and Intellect. Fifty items were scored on a five-point scale. Higher scores indicate more positive personality characteristics. The Cronbach’s Alpha for this instrument was 0.88 in this study (<xref ref-type="table" rid="idm1842494652">Table 1</xref>).</p>
      </sec>
      <sec id="idm1840823028">
        <title>Family Interaction</title>
        <p>Family Interactionwas measured using the Iowa Family Interaction Rating Scales (IFIRS) <xref ref-type="bibr" rid="ridm1842019916">41</xref>.The IFIRS was used to measure parenting attributes. There were two parts: the positive rearing attitude and the negative rearing attitude. The total was 29 questions. The positive rearing attitude part has 21 questions including five subscales (Child Monitoring, Inductive Reasoning, Communication, Positive Reinforcement and Involvement). The negative rearing attitude part has 8 questions including the Harsh Discipline and Inconsistent Discipline subscales. Items were scored on a five-point scale ranging from (1) Never to (5) Always. For the positive rearing attitude subscales, higher scores indicate more positive rearing attitude. The Cronbach’s Alpha was 0.94 for the positive rearing attitude subscales in this study. For the negative rearing subsection, higher scores indicate the likelihood of harsh discipline. The Cronbach’s Alpha in this study was 0.83 for the negative rearing subsection (<xref ref-type="table" rid="idm1842494652">Table 1</xref>).</p>
      </sec>
    </sec>
    <sec id="idm1840821300">
      <title>Data Analysis</title>
      <p>Data analyses were conducted using the Statistic Package for Social Sciences (SPSS) PC + Version 20.0. Descriptive statistics (mean, SD, range, and percentages) were used to describe the study sample and the main variables. The Cronbach’s alpha of the instruments was examined in this study. Pearson’s Correlation was used to examine the relationships between variables. Stepwise Multiple Regression was used to examine the significant predictors of psychological well-being and suicidal ideation.  </p>
    </sec>
    <sec id="idm1840820940" sec-type="results">
      <title>Results</title>
      <sec id="idm1840822020">
        <title>Sample Characteristics</title>
        <p>Most participants were female (<italic>n</italic> = 181, 90%) and single (<italic>n</italic> = 130, 64.7%). One hundred and fifty-seven (78.1%) were Australian. Ninety-six (47.8%) were Christian and 81 (40.3%) were not religious. Participants’ ages ranged from 18 to 61, with a mean of 25.80 years (<italic>SD</italic> = 8.43). The monthly income for 85 (42.3%) participants was less than US$1,000.00 (<xref ref-type="table" rid="idm1842408180">Table 2</xref>).</p>
        <table-wrap id="idm1842408180">
          <label>Table 2.</label>
          <caption>
            <title> Demographic Characteristics of Nursing Students (N = 201)</title>
          </caption>
          <table rules="all" frame="box">
            <tbody>
              <tr>
                <td>Variables</td>
                <td>n</td>
                <td>%</td>
                <td>M</td>
                <td>SD</td>
              </tr>
              <tr>
                <td>Gender     </td>
                <td> </td>
                <td> </td>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td>       Male</td>
                <td>20</td>
                <td>10</td>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td>       Female</td>
                <td>181</td>
                <td>90</td>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td>Age  (18-61 years)</td>
                <td> </td>
                <td> </td>
                <td>25.80</td>
                <td>8.43</td>
              </tr>
              <tr>
                <td>Anxiety (0-140)</td>
                <td> </td>
                <td> </td>
                <td>35.61</td>
                <td>21.93</td>
              </tr>
              <tr>
                <td>Depression</td>
                <td>10</td>
                <td>5</td>
                <td>38.48</td>
                <td>8.09</td>
              </tr>
              <tr>
                <td>(22-69)</td>
                <td> </td>
                <td> </td>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td>Race: Australian</td>
                <td>157</td>
                <td>78.1</td>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td>           Asian</td>
                <td>18</td>
                <td>9</td>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td>           African</td>
                <td>7</td>
                <td>3.5</td>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td>           Other</td>
                <td>13</td>
                <td>6.5</td>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td>Marriage</td>
                <td> </td>
                <td> </td>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td>       Single</td>
                <td>130</td>
                <td>64.7</td>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td>       Married</td>
                <td>38</td>
                <td>18.9</td>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td>       de facto</td>
                <td>20</td>
                <td>10</td>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td>       divorced</td>
                <td>10</td>
                <td>5</td>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td>Religion</td>
                <td> </td>
                <td> </td>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td>    Christian</td>
                <td>96</td>
                <td>47.8</td>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td>    Not Religious    </td>
                <td>81</td>
                <td>40.3</td>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td>Income per month</td>
                <td> </td>
                <td/>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td>    Below $1000</td>
                <td>85</td>
                <td>42.3</td>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td>    1000-1999</td>
                <td>65</td>
                <td>32.3</td>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td>    2000-2999</td>
                <td>28</td>
                <td>13.9</td>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td>    3000-3999    </td>
                <td>14</td>
                <td>7</td>
                <td> </td>
                <td> </td>
              </tr>
            </tbody>
          </table>
        </table-wrap>
      </sec>
      <sec id="idm1840719716">
        <title>Descriptions of major variables</title>
        <p>Overall, participants expressed low levels of anxiety (<italic>M</italic> = 35.61, <italic>SD</italic> = 21.93), medium levels of depression (<italic>M</italic> = 38.48, <italic>SD</italic> = 8.09), and medium-high levels of positive personality (<italic>M</italic> = 171.80, <italic>SD</italic> = 18.43). They perceived medium-high levels of positive family interaction (<italic>M</italic> = 74.20, <italic>SD</italic> = 16.18) and medium-low levels of harsh discipline (<italic>M</italic> = 8.22, <italic>SD</italic> = 3.39). Therefore, participants expressed medium-high levels of psychological well-being (<italic>M</italic> = 82.03, <italic>SD</italic> = 11.01) and low levels of suicidal ideation (<italic>M</italic> = 1.98, <italic>SD</italic> = 1.79) in this study (<xref ref-type="table" rid="idm1842240404">Table 3</xref>).</p>
        <table-wrap id="idm1842240404">
          <label>Table 3.</label>
          <caption>
            <title> Descriptions of the main variables (N = 201)1819275765810000</title>
          </caption>
          <table rules="all" frame="box">
            <tbody>
              <tr>
                <td>Main Variables</td>
                <td>M</td>
                <td>SD</td>
                <td>Minimum</td>
                <td>Maximum</td>
              </tr>
              <tr>
                <td>Anxiety</td>
                <td>35.61</td>
                <td>21.93</td>
                <td>0</td>
                <td>140</td>
              </tr>
              <tr>
                <td>Depression</td>
                <td>38.48</td>
                <td>8.09</td>
                <td>22</td>
                <td>69</td>
              </tr>
              <tr>
                <td>Personality</td>
                <td>171.8</td>
                <td>18.43</td>
                <td>120</td>
                <td>233</td>
              </tr>
              <tr>
                <td>Positive Family Interaction</td>
                <td>74.2</td>
                <td>16.18</td>
                <td>21</td>
                <td>105</td>
              </tr>
              <tr>
                <td>Harsh Discipline</td>
                <td>8.22</td>
                <td>3.39</td>
                <td>4</td>
                <td>20</td>
              </tr>
              <tr>
                <td>Psychological Well-being</td>
                <td>82.06</td>
                <td>11.01</td>
                <td>45</td>
                <td>107</td>
              </tr>
              <tr>
                <td>Suicidal Ideation</td>
                <td>1.98</td>
                <td>1.79</td>
                <td>0</td>
                <td>7</td>
              </tr>
            </tbody>
          </table>
        </table-wrap>
        <p>According to Pearson’s correlation, Australian nursing students’ psychological well-being was significantly associated with anxiety (<italic>r </italic>= -0.540, <italic>p</italic> &lt; 0.001), depression (<italic>r</italic> = -0.647, <italic>p</italic> &lt; 0.001), personality (<italic>r </italic>= 0.642, <italic>p</italic> &lt; 0.001), positive family interaction (<italic>r </italic>= 0.362, <italic>p</italic> &lt; 0.001) and parents’ harsh discipline (<italic>r </italic>= -0.181, <italic>p</italic> &lt; 0.01). Suicidal ideation was significantly associated with anxiety (<italic>r </italic>= 0.590, <italic>p</italic> &lt; 0.001), depression (<italic>r</italic> = 0.684, <italic>p</italic> &lt; 0.001), personality 
(<italic>r </italic>= -0.372, <italic>p</italic> &lt; 0.001), positive family interaction 
(<italic>r </italic>= -0.182, <italic>p</italic> &lt; 0.01) and psychological well-being 
(<italic>r </italic>= -0.480, <italic>p</italic> &lt; 0.001). </p>
        <p>When the participants’ scores of anxiety and depression decreased, their scores of psychological well-being increased and their scores of suicidal ideation decreased. When the participants’ scores regarding positive personality and positive family interaction increased, their scores of psychological well-being increased and their scores of suicidal ideation decreased. Results indicated that students exposed to harsh discipline had a decreased level of psychological well-being. </p>
      </sec>
      <sec id="idm1840669060">
        <title>Predictors of Psychological Well-being and Suicidal Ideation</title>
        <p>Stepwise multiple regression analysis was used to examine the degree to which psychological well-being was predicted by the five independent variables. As shown in <xref ref-type="table" rid="idm1842168852">Table 4</xref>, the model variables accounted for 58% of the psychological well-being variance. Lower scores of depression (Beta = -0.427, p &lt; 0.001), higher scores of positive personality (Beta = 0.395, p &lt; 0.001), and higher scores of positive family interaction 
(Beta = 0.127, p &lt; 0.01) were found to predict significantly higher psychological well-being.</p>
        <table-wrap id="idm1842168852">
          <label>Table 4.</label>
          <caption>
            <title> Stepwise Multiple Regression: The predictors of Australia nursing students’ psychological well-being and suicidal ideation (N = 201)847725788670000</title>
          </caption>
          <table rules="all" frame="box">
            <tbody>
              <tr>
                <td> </td>
                <td colspan="2">Psychological Well-being  </td>
                <td colspan="2">Suicidal Ideation  </td>
              </tr>
              <tr>
                <td>Variables        </td>
                <td>Beta</td>
                <td>t</td>
                <td>Beta</td>
                <td>t</td>
              </tr>
              <tr>
                <td>Anxiety</td>
                <td> </td>
                <td> </td>
                <td>0.215</td>
                <td>3.00<xref ref-type="table-fn" rid="idm1840623860">***</xref></td>
              </tr>
              <tr>
                <td>Depression</td>
                <td>-0.427</td>
                <td>-8.05<xref ref-type="table-fn" rid="idm1840623860">***</xref></td>
                <td>0.532</td>
                <td> 7.45<xref ref-type="table-fn" rid="idm1840623860">***</xref></td>
              </tr>
              <tr>
                <td>Personality</td>
                <td>0.395</td>
                <td> 7.23<xref ref-type="table-fn" rid="idm1840623860">***</xref></td>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td>Positive family interaction</td>
                <td>0.127</td>
                <td>   2.58<xref ref-type="table-fn" rid="idm1840623644">**</xref></td>
                <td> </td>
                <td> </td>
              </tr>
              <tr>
                <td/>
                <td>R<xref ref-type="bibr" rid="ridm1842380092">2</xref><italic> = 0.58                              </italic></td>
                <td> </td>
                <td>R<xref ref-type="bibr" rid="ridm1842380092">2</xref><italic> = 0.491</italic></td>
                <td> </td>
              </tr>
              <tr>
                <td/>
                <td>F(df= 3, 197)= 89.298<xref ref-type="table-fn" rid="idm1840623860">***</xref></td>
                <td> </td>
                <td>F(df= 2, 198)= 95.478<xref ref-type="table-fn" rid="idm1840623860">***</xref></td>
                <td> </td>
              </tr>
            </tbody>
          </table>
          <table-wrap-foot>
            <fn id="idm1840627532">
              <label>*</label>
              <p>p&lt; 0.05, </p>
            </fn>
            <fn id="idm1840623644">
              <label>**</label>
              <p>p &lt; 0.01, </p>
            </fn>
            <fn id="idm1840623860">
              <label>***</label>
              <p>p &lt; 0.001 (2 tailed).</p>
            </fn>
          </table-wrap-foot>
        </table-wrap>
        <p>Stepwise multiple regression analysis also examined the degree to which suicidal ideation was predicted by the five independent variables. <xref ref-type="table" rid="idm1842168852">Table 4</xref> indicates how the model variables accounted for 49.1% of the suicidal ideation variance. Higher scores of depression (Beta = 0.532, p &lt; 0.001) and higher scores of anxiety (Beta = 0.215, p &lt; 0.001) were found to predict significantly higher scores of suicidal ideation.</p>
      </sec>
    </sec>
    <sec id="idm1840624580" sec-type="discussion">
      <title>Discussion</title>
      <p>Overall, participants expressed low levels of anxiety, medium levels of depression, and medium-high levels of positive personality. They perceived medium-high levels of positive family interaction and medium-low levels of harsh discipline. Therefore, participants expressed medium high levels of psychological well-being and low levels of suicidal ideation. These results are unique and different from previous studies. Other studies indicate Australian younger adults have higher levels of depressive and anxiety symptoms compared to older age groups of Australians <xref ref-type="bibr" rid="ridm1842006596">45</xref>. Previous studies also indicate these younger adults have low level of well-being and high levels of stress, anxiety, hopelessness, and depression <xref ref-type="bibr" rid="ridm1842211644">10</xref><xref ref-type="bibr" rid="ridm1842006596">45</xref>.</p>
      <p>Other unique findings are the predictors of psychological well-being and suicidal ideation. They will be discussed as follows.</p>
      <sec id="idm1840623788">
        <title>Predictors of psychological well-being</title>
        <p>There was a significantly negative relationship between participants’ depression and psychological well-being. Personality and family interaction were positively associated with participants’ psychological well-being.</p>
        <sec id="idm1840622564">
          <title>Depression</title>
          <p>Previous studies showed significant correlations between psychological distress, depression, and anxiety with psychological well-being <xref ref-type="bibr" rid="ridm1842236772">5</xref><xref ref-type="bibr" rid="ridm1842225812">6</xref><xref ref-type="bibr" rid="ridm1842220700">7</xref>. The results of this study support the findings of previous studies <xref ref-type="bibr" rid="ridm1842013652">43</xref><xref ref-type="bibr" rid="ridm1842010268">44</xref><xref ref-type="bibr" rid="ridm1842006596">45</xref><xref ref-type="bibr" rid="ridm1842002276">46</xref>. Bhullar et al. concluded that a persons’ psychological well-being profile can be used as a predictor of depression, since since the absence of psychological well-being represents a risk factor in developing depression, and vice versa <xref ref-type="bibr" rid="ridm1842010268">44</xref><xref ref-type="bibr" rid="ridm1842002276">46</xref>.</p>
        </sec>
        <sec id="idm1840621844">
          <title>Personality</title>
          <p>In this study, participants had medium-high levels of positive personality, which were positively associated with psychological well-being. Family interaction influences the development of personality <xref ref-type="bibr" rid="ridm1842113044">24</xref>. Participants perceived medium-high levels of positive family interaction and medium-low levels of harsh discipline. These results could explain why this group of nursing students had medium -high levels of positive personality. People with positive personality use problem focused coping strategies that are related to increasing psychological well-being and decreasing suicidal ideation <xref ref-type="bibr" rid="ridm1842197764">14</xref><xref ref-type="bibr" rid="ridm1842113044">24</xref><xref ref-type="bibr" rid="ridm1842108220">25</xref>. Therefore, the results of this study are consistent with previous studies in which personality was associated with nursing students’ psychological well-being <xref ref-type="bibr" rid="ridm1842089724">29</xref>.</p>
        </sec>
        <sec id="idm1840623500">
          <title>Positive family interaction</title>
          <p>Participants perceived medium-high levels of positive family interaction and medium-low levels of harsh discipline. The family interaction was positively associated with participants’ psychological well-being. This result is consistent with previous studies in which positive family interaction helped people feel safe and supported, so they have higher psychological well-being than people who perceived negative family interaction such as harsh parenting <xref ref-type="bibr" rid="ridm1842113044">24</xref><xref ref-type="bibr" rid="ridm1842085620">30</xref><xref ref-type="bibr" rid="ridm1842080076">31</xref>. A negative relationship between psychological well-being and power assertive parenting and high levels of physical punishment was also documented <xref ref-type="bibr" rid="ridm1842075108">32</xref><xref ref-type="bibr" rid="ridm1842073596">33</xref>.  </p>
        </sec>
      </sec>
      <sec id="idm1840621700">
        <title>Predictors of suicidal ideation</title>
        <sec id="idm1840623284">
          <title>Depression and anxiety</title>
          <p>There were two significant predictors of suicidal ideation for nursing students in this study: depression and anxiety. The results are consistent with previous studies <xref ref-type="bibr" rid="ridm1842236772">5</xref><xref ref-type="bibr" rid="ridm1842225812">6</xref><xref ref-type="bibr" rid="ridm1842220700">7</xref>. Although participants expressed low levels of anxiety and medium levels of depression, their anxiety and depression still had positive relationships with suicidal ideation. This result is also consistent with previous studies in China <xref ref-type="bibr" rid="ridm1842031076">47</xref> and in Vietnam <xref ref-type="bibr" rid="ridm1841981916">48</xref>. Yeh and Chiao indicated that the following factors decreased USA college students’ anxiety and depression: spiritual well-being, parents using communication, involvement, and inductive reasoning, and Disengagement problem focus coping strategies <xref ref-type="bibr" rid="ridm1841980188">49</xref>.</p>
          <p>Interestingly, our results display a divergence from the contemporary understandings of the significant number of University students who are highly distressed and are experiencing high levels of anxiety and depression <xref ref-type="bibr" rid="ridm1842449068">4</xref><xref ref-type="bibr" rid="ridm1842190852">11</xref><xref ref-type="bibr" rid="ridm1842147420">17</xref><xref ref-type="bibr" rid="ridm1842122852">22</xref><xref ref-type="bibr" rid="ridm1842135812">23</xref>. As a cohort, our participants indicated low levels of anxiety and medium levels of depression. It is likely that this is related to the concurrent medium to high levels of psychological well-being. Parents’ communication and involvement increased Australian nursing students’ psychological well-being. This result is consistent with the results of Yeh and Chiao in the USA college students <xref ref-type="bibr" rid="ridm1842113044">24</xref>. </p>
        </sec>
      </sec>
    </sec>
    <sec id="idm1840622348">
      <title>Limitations</title>
      <p>This study has three main limitations. First, the cross-sectional design does not provide insights on the nursing students’ psychological distress over time. Second, the sample was recruited from an Australian University, so the generalizability of this study is limited. Third, the participants in this study were voluntary and thus the results only refer to those who are willing to share their experiences. </p>
    </sec>
    <sec id="idm1840620188" sec-type="conclusions">
      <title>Conclusions</title>
      <p>Nursing students require positive psychological well-being to cope with their work. Psychological well-being enhances sound clinical decision making and the development of mature, sensitive and therapeutic nurse-patient relationships. It also enhances the nurse’s ability to successfully communicate with patients, their families, and members of the multidisciplinary team. Given that nursing students are expected to be able to work within rapidly changing and stressful environments, caring for their psychological well-being is important. Identifying factors that influence psychological well-being and suicidal ideation means that strategies can be developed to enhance positive mental health. </p>
    </sec>
  </body>
  <back>
    <ref-list>
      <ref id="ridm1842378868">
        <label>1.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Richeff</surname>
            <given-names>M</given-names>
          </name>
          <article-title>Resilience-building strategies for nurses in transition.J Contin EducNurs</article-title>
          <date>
            <year>2014</year>
          </date>
          <volume>45</volume>
          <issue>2</issue>
          <fpage>54</fpage>
          <lpage>55</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842380092">
        <label>2.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Buchan</surname>
            <given-names>J</given-names>
          </name>
          <name>
            <surname>Twigg</surname>
            <given-names>D</given-names>
          </name>
          <name>
            <surname>Dussault</surname>
            <given-names>G</given-names>
          </name>
          <name>
            <surname>Duffield</surname>
            <given-names>C</given-names>
          </name>
          <name>
            <surname>Stone</surname>
            <given-names>P W</given-names>
          </name>
          <article-title>Policies to sustain the nursing workforce: an international perspective.International Nursing Review</article-title>
          <date>
            <year>2015</year>
          </date>
          <volume>62</volume>
          <issue>2</issue>
          <fpage>162</fpage>
          <lpage>170</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842390756">
        <label>3.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Coetzee</surname>
            <given-names>S K</given-names>
          </name>
          <name>
            <surname>Klopper</surname>
            <given-names>H C</given-names>
          </name>
          <name>
            <surname>Ellis</surname>
            <given-names>S M</given-names>
          </name>
          <name>
            <surname>Aiken</surname>
            <given-names>L H</given-names>
          </name>
          <article-title>A tale of two systems – Nurses practice environment, well-being, perceived quality of care and patient safety in private and public hospitals in South Africa: a questionnaire survey.International Journal of Nursing Studies</article-title>
          <date>
            <year>2013</year>
          </date>
          <volume>50</volume>
          <issue>2</issue>
          <fpage>162</fpage>
          <lpage>173</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842449068">
        <label>4.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Bond</surname>
            <given-names>K S</given-names>
          </name>
          <name>
            <surname>Jorm</surname>
            <given-names>A F</given-names>
          </name>
          <name>
            <surname>Kitchener</surname>
            <given-names>B A</given-names>
          </name>
          <name>
            <surname>Reavley</surname>
            <given-names>N J</given-names>
          </name>
          <article-title>Mental health first aid training for Australian medical and nursing students: an evaluation study,BMC Psychology</article-title>
          <date>
            <year>2015</year>
          </date>
          <volume>3</volume>
          <issue>11</issue>
          <fpage>1</fpage>
          <lpage>9</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842236772">
        <label>5.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Kitamura</surname>
            <given-names>T</given-names>
          </name>
          <name>
            <surname>Kishida</surname>
            <given-names>Y</given-names>
          </name>
          <name>
            <surname>Gatayama</surname>
            <given-names>R</given-names>
          </name>
          <name>
            <surname>Matsuoka</surname>
            <given-names>T</given-names>
          </name>
          <name>
            <surname>Miura</surname>
            <given-names>S</given-names>
          </name>
          <name>
            <surname>Yamabe</surname>
            <given-names>K</given-names>
          </name>
          <article-title>Ryff's psychological well-being inventory: factorial structure and life history correlates among Japanese university students,Psychological Reports</article-title>
          <date>
            <year>2004</year>
          </date>
          <volume>94</volume>
          <issue>1</issue>
          <fpage>83</fpage>
          <lpage>103</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842225812">
        <label>6.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Liu</surname>
            <given-names>Y</given-names>
          </name>
          <name>
            <surname>Wang</surname>
            <given-names>H</given-names>
          </name>
          <article-title>Correlation research on psychological health impact on nursing students against stress, coping way and social support.Nurse Education Today</article-title>
          <date>
            <year>2009</year>
          </date>
          <volume>29</volume>
          <issue>1</issue>
          <fpage>5</fpage>
          <lpage>8</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842220700">
        <label>7.</label>
        <mixed-citation xlink:type="simple" publication-type="book">
          <name>
            <surname>Slade</surname>
            <given-names>T</given-names>
          </name>
          <name>
            <surname>Grove</surname>
            <given-names>R</given-names>
          </name>
          <name>
            <surname>Burgess</surname>
            <given-names>P</given-names>
          </name>
          <article-title>Kessler Psychological Distress Scale: normative data from the</article-title>
          <date>
            <year>2007</year>
          </date>
          <chapter-title>Australian National Survey of Mental Health and Wellbeing. Australian &amp; New Zealand Journal of Psychiatry</chapter-title>
          <volume>45</volume>
          <issue>4</issue>
          <fpage>308</fpage>
          <lpage>316</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842206892">
        <label>8.</label>
        <mixed-citation xlink:type="simple" publication-type="journal"><article-title>World Health Organization.Suicide Prevention</article-title><date><year>2012</year></date><fpage>fromhttp://www.who.int/mental_health/prevention/en</fpage>
Retrieved


</mixed-citation>
      </ref>
      <ref id="ridm1842207756">
        <label>9.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Aradilla-Herrero</surname>
            <given-names>A</given-names>
          </name>
          <name>
            <surname>Tomás-Sábado</surname>
            <given-names>J</given-names>
          </name>
          <name>
            <surname>Gómez-Benito</surname>
            <given-names>J</given-names>
          </name>
          <article-title>Associations between emotional intelligence, depression and suicide risk in nursing students.Nurse Education Today.2014;34(4):</article-title>
          <fpage>520</fpage>
          <lpage>525</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842211644">
        <label>10.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Regehr</surname>
            <given-names>C</given-names>
          </name>
          <name>
            <surname>Glancy</surname>
            <given-names>D</given-names>
          </name>
          <name>
            <surname>Pitts</surname>
            <given-names>A</given-names>
          </name>
          <article-title>Interventions to reduce stress in university students: a review and meta-analysis.Journal of Affective Disorders</article-title>
          <date>
            <year>2013</year>
          </date>
          <volume>148</volume>
          <issue>1</issue>
          <fpage>1</fpage>
          <lpage>11</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842190852">
        <label>11.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Hawker</surname>
            <given-names>C L</given-names>
          </name>
          <article-title>Physical activity and mental well-being in student nurses.Nurse Education Today</article-title>
          <date>
            <year>2012</year>
          </date>
          <volume>32</volume>
          <issue>3</issue>
          <fpage>325</fpage>
          <lpage>331</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842187396">
        <label>12.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Goetz</surname>
            <given-names>C S</given-names>
          </name>
          <article-title>Are you prepared to S.A.V.E. your nursing student from suicide?Journal of NursingEducation</article-title>
          <date>
            <year>1998</year>
          </date>
          <volume>37</volume>
          <issue>2</issue>
          <fpage>92</fpage>
          <lpage>95</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842184948">
        <label>13.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Walker</surname>
            <given-names>S</given-names>
          </name>
          <name>
            <surname>Dwyer</surname>
            <given-names>T</given-names>
          </name>
          <name>
            <surname>Moxham</surname>
            <given-names>L</given-names>
          </name>
          <name>
            <surname>Broadbent</surname>
            <given-names>M</given-names>
          </name>
          <name>
            <surname>Sander</surname>
            <given-names>T</given-names>
          </name>
          <article-title>Facilitator versus preceptor: which offers the best support to undergraduate nursing students?Nurse Education Today</article-title>
          <date>
            <year>2013</year>
          </date>
          <volume>33</volume>
          <issue>5</issue>
          <fpage>530</fpage>
          <lpage>535</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842197764">
        <label>14.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Gibbons</surname>
            <given-names>C</given-names>
          </name>
          <name>
            <surname>Dempster</surname>
            <given-names>M</given-names>
          </name>
          <name>
            <surname>Moutray</surname>
            <given-names>M Stress</given-names>
          </name>
          <article-title>coping and satisfaction in nursing students.Journal of Advanced Nursing</article-title>
          <date>
            <year>2011</year>
          </date>
          <volume>67</volume>
          <issue>3</issue>
          <fpage>621</fpage>
          <lpage>632</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842154260">
        <label>15.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Walker</surname>
            <given-names>S</given-names>
          </name>
          <name>
            <surname>Dwyer</surname>
            <given-names>T</given-names>
          </name>
          <name>
            <surname>Broadbent</surname>
            <given-names>M</given-names>
          </name>
          <name>
            <surname>Moxham</surname>
            <given-names>L</given-names>
          </name>
          <name>
            <surname>Sander</surname>
            <given-names>T</given-names>
          </name>
          <name>
            <surname>Edwards</surname>
            <given-names>K</given-names>
          </name>
          <article-title>Constructing a nursing identity within the clinical environment: the student nurse experience.Contemporary Nurse</article-title>
          <date>
            <year>2014</year>
          </date>
          <volume>49</volume>
          <issue>1</issue>
          <fpage>103</fpage>
          <lpage>112</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842151092">
        <label>16.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Pulido-Martos</surname>
            <given-names>M</given-names>
          </name>
          <name>
            <surname>Augusto-Landa</surname>
            <given-names>J M</given-names>
          </name>
          <name>
            <surname>Lopez-Zafra</surname>
            <given-names>E</given-names>
          </name>
          <article-title>Sources of stress in nursing students: a systematic review of quantitative studies.International Nursing Review</article-title>
          <date>
            <year>2012</year>
          </date>
          <volume>59</volume>
          <issue>1</issue>
          <fpage>15</fpage>
          <lpage>25</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842147420">
        <label>17.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Melissa-Halikiopoulou</surname>
            <given-names>C</given-names>
          </name>
          <name>
            <surname>Tsiga</surname>
            <given-names>E</given-names>
          </name>
          <name>
            <surname>Khachatryan</surname>
            <given-names>R</given-names>
          </name>
          <name>
            <surname>Papazisis</surname>
            <given-names>G</given-names>
          </name>
          <article-title>Suicidality and depressive symptoms among nursing students in northern Greece.Health Science Journal</article-title>
          <date>
            <year>2011</year>
          </date>
          <volume>5</volume>
          <issue>2</issue>
          <fpage>90</fpage>
          <lpage>97</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842142956">
        <label>18.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Crawford</surname>
            <given-names>G</given-names>
          </name>
          <name>
            <surname>Burns</surname>
            <given-names>S K</given-names>
          </name>
          <name>
            <surname>Chih</surname>
            <given-names>H J</given-names>
          </name>
          <name>
            <surname>Hunt</surname>
            <given-names>K</given-names>
          </name>
          <name>
            <surname>Tilley</surname>
            <given-names>P J</given-names>
          </name>
          <name>
            <surname>Hallett</surname>
            <given-names>J</given-names>
          </name>
          <name>
            <surname>Coleman</surname>
            <given-names>K</given-names>
          </name>
          <name>
            <surname>Smith</surname>
            <given-names>S</given-names>
          </name>
          <article-title>Mental health first aid training for nursing students: a protocol for a pragmatic randomized controlled trial in a large university. BMC Psychiatry</article-title>
          <date>
            <year>2015</year>
          </date>
          <volume>15</volume>
          <issue>26</issue>
          <fpage>1</fpage>
          <lpage>8</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842129764">
        <label>19.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Ross</surname>
            <given-names>AM ReavleyNJ</given-names>
          </name>
          <name>
            <surname>KillackeyE</surname>
            <given-names>JormAF</given-names>
          </name>
          <article-title>Development of guidelines for tertiary education institutions to assist them in supporting students with a mental illness: a Delphi consensus study with Australian professionals and consumers.Peer</article-title>
          <date>
            <year>2013</year>
          </date>
          <volume>1</volume>
          <fpage>43</fpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842127388">
        <label>20.</label>
        <mixed-citation xlink:type="simple" publication-type="book">
          <date>
            <year>2012</year>
          </date>
          <chapter-title>Australia, 2012,Cat No. 1301.0, Australian Government</chapter-title>
          <institution>Australian Bureau of Statistics.Year Book</institution>
          <publisher-loc>Canberra;</publisher-loc>
        </mixed-citation>
      </ref>
      <ref id="ridm1842126452">
        <label>21.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>MBH</surname>
            <given-names>Yap</given-names>
          </name>
          <name>
            <surname>Reavley</surname>
            <given-names>N</given-names>
          </name>
          <name>
            <surname>Jorm</surname>
            <given-names>A F</given-names>
          </name>
          <article-title>Where would young people seek help for mental duisoredrs and what stops them? Findings from an Australian national survey.Journal of Affective Disorders</article-title>
          <date>
            <year>2013</year>
          </date>
          <fpage>147</fpage>
          <lpage>1</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842122852">
        <label>22.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Leahy</surname>
            <given-names>C M</given-names>
          </name>
          <name>
            <surname>Peterson</surname>
            <given-names>R F</given-names>
          </name>
          <name>
            <surname>Wilson</surname>
            <given-names>I G</given-names>
          </name>
          <name>
            <surname>Newbury</surname>
            <given-names>J W</given-names>
          </name>
          <name>
            <surname>Tonkin</surname>
            <given-names>A L</given-names>
          </name>
          <name>
            <surname>Turnbull</surname>
            <given-names>D</given-names>
          </name>
          <article-title>Distress levels and self-reported treatment rates for medicine, law, psychology and mechanical engineering students: cross-sectional study.Australian and New Zealand Journal of Psychiatry</article-title>
          <date>
            <year>2010</year>
          </date>
          <volume>44</volume>
          <issue>7</issue>
          <fpage>608</fpage>
          <lpage>615</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842135812">
        <label>23.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Stallman</surname>
            <given-names>H M</given-names>
          </name>
          <article-title>Psychological distress in university students: a comparison with general population data.Australian Psychologist</article-title>
          <date>
            <year>2010</year>
          </date>
          <fpage>45</fpage>
          <lpage>4</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842113044">
        <label>24.</label>
        <mixed-citation xlink:type="simple" publication-type="book">
          <name>
            <surname>Yeh</surname>
            <given-names>P M</given-names>
          </name>
          <name>
            <surname>Chiao</surname>
            <given-names>C H</given-names>
          </name>
          <article-title>The influences of parents’ rearing attitude, personality and coping: Strategies on psychological well-being and suicidal ideation among college students</article-title>
          <date>
            <year>2013</year>
          </date>
          <chapter-title>In book:Psychology of Well-Being: Theory, Perspectives and Practice.Chapter 1</chapter-title>
          <fpage>1</fpage>
          <lpage>18</lpage>
          <institution>Nova Science Publishers:</institution>
          <publisher-loc>Hauppauge, NY</publisher-loc>
        </mixed-citation>
      </ref>
      <ref id="ridm1842108220">
        <label>25.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Yuwen</surname>
            <given-names>W</given-names>
          </name>
          <name>
            <surname>ACC</surname>
            <given-names>Chen</given-names>
          </name>
          <article-title>Chinese American adolescents: perceived parenting styles and adolescents' psychosocial health.InternationalNursingReview</article-title>
          <date>
            <year>2013</year>
          </date>
          <volume>60</volume>
          <issue>2</issue>
          <fpage>236</fpage>
          <lpage>243</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842105916">
        <label>26.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Dogra</surname>
            <given-names>A</given-names>
          </name>
          <name>
            <surname>Basu</surname>
            <given-names>S</given-names>
          </name>
          <name>
            <surname>Das</surname>
            <given-names>S</given-names>
          </name>
          <article-title>Impact of meaning in life and reasons for living to hope and suicidal ideation: a study among college students.SIS</article-title>
          <source>Journal of Projective Psychology &amp; Mental Health</source>
          <volume>18</volume>
          <issue>1</issue>
          <fpage>89</fpage>
          <lpage>102</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842103396">
        <label>27.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Eakman</surname>
            <given-names>A M</given-names>
          </name>
          <name>
            <surname>Eklund</surname>
            <given-names>M</given-names>
          </name>
          <article-title>The relative impact of personality traits, meaningful occupation and occupational value on meaning in life and life satisfaction.Journal of Occupational Science</article-title>
          <date>
            <year>2012</year>
          </date>
          <volume>19</volume>
          <issue>2</issue>
          <fpage>165</fpage>
          <lpage>177</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842099220">
        <label>28.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Yamashita</surname>
            <given-names>K</given-names>
          </name>
          <name>
            <surname>Saito</surname>
            <given-names>M</given-names>
          </name>
          <name>
            <surname>Takao</surname>
            <given-names>T</given-names>
          </name>
          <article-title>Stress and coping styles in Japanese nursing students.International Journal of Nursing Practice</article-title>
          <date>
            <year>2012</year>
          </date>
          <volume>18</volume>
          <issue>5</issue>
          <fpage>489</fpage>
          <lpage>496</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842089724">
        <label>29.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Lou</surname>
            <given-names>J H</given-names>
          </name>
          <name>
            <surname>Chen</surname>
            <given-names>S H</given-names>
          </name>
          <name>
            <surname>Yu</surname>
            <given-names>H Y</given-names>
          </name>
          <name>
            <surname>Li</surname>
            <given-names>R H</given-names>
          </name>
          <name>
            <surname>Yang</surname>
            <given-names>C I</given-names>
          </name>
          <name>
            <surname>Eng</surname>
            <given-names>C J</given-names>
          </name>
          <article-title>The influence of personality traits and social support on male nursing student life stress: a cross-sectional research design.The</article-title>
          <source>Journal of Nursing Research</source>
          <volume>18</volume>
          <issue>2</issue>
          <fpage>108</fpage>
          <lpage>116</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842085620">
        <label>30.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Rusu</surname>
            <given-names>I R</given-names>
          </name>
          <name>
            <surname>Cosman</surname>
            <given-names>D</given-names>
          </name>
          <name>
            <surname>Nemeş</surname>
            <given-names>B</given-names>
          </name>
          <article-title>Family - protective factor to prevent suicidalbehavior in adolescents.Human &amp; Veterinary Medicine</article-title>
          <date>
            <year>2012</year>
          </date>
          <volume>4</volume>
          <issue>3</issue>
          <fpage>103</fpage>
          <lpage>106</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842080076">
        <label>31.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Lai</surname>
            <given-names>K W</given-names>
          </name>
          <name>
            <surname>McBride-Chang</surname>
            <given-names>C</given-names>
          </name>
          <article-title>Suicidal ideation, parentingstyle, and family climate among Hong Kong adolescents.International</article-title>
          <source>Journal of Psychology.2001</source>
          <volume>36</volume>
          <issue>2</issue>
          <fpage>81</fpage>
          <lpage>87</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842075108">
        <label>32.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Newland</surname>
            <given-names>L A</given-names>
          </name>
          <article-title>Family well-being,parenting, and child well-being: Pathways to healthy adjustment. Clinical Psychologist</article-title>
          <date>
            <year>2015</year>
          </date>
          <volume>19</volume>
          <issue>1</issue>
          <fpage>3</fpage>
          <lpage>14</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842073596">
        <label>33.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Bosmans</surname>
            <given-names>G</given-names>
          </name>
          <name>
            <surname>Braet</surname>
            <given-names>C</given-names>
          </name>
          <name>
            <surname>Beyers</surname>
            <given-names>W</given-names>
          </name>
          <name>
            <surname>K</surname>
            <given-names>Van Leeuwen</given-names>
          </name>
          <name>
            <surname>L</surname>
            <given-names>Van Vlierberghe</given-names>
          </name>
          <article-title>Parents’ power assertive discipline and internalizing problems in adolescents: the role of attachment.Parenting: Science and Practice</article-title>
          <date>
            <year>2011</year>
          </date>
          <volume>11</volume>
          <issue>1</issue>
          <fpage>34</fpage>
          <lpage>55</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842067836">
        <label>34.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Borenstein</surname>
            <given-names>M</given-names>
          </name>
          <name>
            <surname>Rothstein</surname>
            <given-names>H</given-names>
          </name>
          <name>
            <surname>Cohen</surname>
            <given-names>J</given-names>
          </name>
          <name>
            <surname>Schoenfeld</surname>
            <given-names>D</given-names>
          </name>
          <name>
            <surname>Berlin</surname>
            <given-names>J</given-names>
          </name>
          <article-title>Power for a test of the null hypothesis.SamplePower™ Release 2.0</article-title>
          <date>
            <year>2000</year>
          </date>
          <publisher-name>SPSS Inc;</publisher-name>
        </mixed-citation>
      </ref>
      <ref id="ridm1842067332">
        <label>35.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Ryff</surname>
            <given-names>C D</given-names>
          </name>
          <article-title>Happiness is everything, or is it? Explorations on the meaning of psychological well-being.Journal of Personality and Social Psychology</article-title>
          <date>
            <year>1989</year>
          </date>
          <volume>57</volume>
          <issue>6</issue>
          <fpage>1069</fpage>
          <lpage>1081</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842062652">
        <label>36.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Ryff</surname>
            <given-names>C D</given-names>
          </name>
          <name>
            <surname>CLM</surname>
            <given-names>Keyes</given-names>
          </name>
          <article-title>The structure of psychological well-being revised.Journal of Personality and Social Psychology</article-title>
          <date>
            <year>1995</year>
          </date>
          <volume>69</volume>
          <issue>4</issue>
          <fpage>719</fpage>
          <lpage>727</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842059412">
        <label>37.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <article-title>Signs of Suicide Project.BSAD (Brief Screen for Adolescent Depression). Screening for Mental Health</article-title>
          <date>
            <year>2009</year>
          </date>
          <source>Inc</source>
          <volume>1</volume>
          <publisher-loc>Washington Street, Suite 304, Wellesley Hills, MA</publisher-loc>
        </mixed-citation>
      </ref>
      <ref id="ridm1842029204">
        <label>38.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Hamilton</surname>
            <given-names>M</given-names>
          </name>
          <article-title>The assessment of anxiety states by rating.British</article-title>
          <source>Journal of Medical Psychology</source>
          <volume>32</volume>
          <issue>1</issue>
          <fpage>50</fpage>
          <lpage>55</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842026036">
        <label>39.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>WWK</surname>
            <given-names>Zung</given-names>
          </name>
          <article-title>A self-rating depression scale.Archives of GeneralPsychiatry</article-title>
          <date>
            <year>1965</year>
          </date>
          <volume>12</volume>
          <fpage>63</fpage>
          <lpage>70</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842020924">
        <label>40.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Goldberg</surname>
            <given-names>L R</given-names>
          </name>
          <article-title>The development of markers for the Big-Five factor structure.Psychological Assessment</article-title>
          <date>
            <year>1992</year>
          </date>
          <volume>4</volume>
          <issue>1</issue>
          <fpage>26</fpage>
          <lpage>42</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842019916">
        <label>41.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Melby</surname>
            <given-names>J</given-names>
          </name>
          <name>
            <surname>Conger</surname>
            <given-names>R</given-names>
          </name>
          <name>
            <surname>Book</surname>
            <given-names>R</given-names>
          </name>
          <name>
            <surname>Rueter</surname>
            <given-names>M</given-names>
          </name>
          <name>
            <surname>Lucy</surname>
            <given-names>L</given-names>
          </name>
          <name>
            <surname>Repinski</surname>
            <given-names>D</given-names>
          </name>
          <name>
            <surname>Rogers</surname>
            <given-names>S</given-names>
          </name>
          <name>
            <surname>Rogers</surname>
            <given-names>B</given-names>
          </name>
          <article-title>Scaramella L.The IowaFamily Interaction Rating Scales.Institute for Social and Behavior Research</article-title>
          <date>
            <year>1998</year>
          </date>
          <institution>Iowa State University</institution>
          <publisher-loc>Ames, IA</publisher-loc>
        </mixed-citation>
      </ref>
      <ref id="ridm1842015164">
        <label>42.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Said</surname>
            <given-names>D</given-names>
          </name>
          <name>
            <surname>Kypri</surname>
            <given-names>K</given-names>
          </name>
          <name>
            <surname>Bowman</surname>
            <given-names>J</given-names>
          </name>
          <article-title>Risk factors for mental disorder among university students in Australia: findings from a web-based cross-sectional survey.Social Psychiatry and Psychiatric Epidemiology</article-title>
          <date>
            <year>2012</year>
          </date>
          <volume>48</volume>
          <issue>6</issue>
          <fpage>935</fpage>
          <lpage>944</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842013652">
        <label>43.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Lin</surname>
            <given-names>C C</given-names>
          </name>
          <article-title>Gratitude and depression in young adults: the mediating role of self-esteem and well-being.Personality and Individual Differences</article-title>
          <date>
            <year>2015</year>
          </date>
          <volume>87</volume>
          <fpage>30</fpage>
          <lpage>34</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842010268">
        <label>44.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Bhullar</surname>
            <given-names>N</given-names>
          </name>
          <name>
            <surname>Hine</surname>
            <given-names>D W</given-names>
          </name>
          <name>
            <surname>Phillips</surname>
            <given-names>J</given-names>
          </name>
          <article-title>Profiles of psychological well-being in a sample of Australian university students.International Journal of Psychology</article-title>
          <date>
            <year>2014</year>
          </date>
          <volume>49</volume>
          <issue>4</issue>
          <fpage>288</fpage>
          <lpage>294</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842006596">
        <label>45.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Casey</surname>
            <given-names>L</given-names>
          </name>
          <article-title>Stress and wellbeing in Australia survey 2013: the state of the nation two years on, and special feature on working Australians, accessed on</article-title>
          <date>
            <year>2015</year>
          </date>
          <fpage>from:</fpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842002276">
        <label>46.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Nierenberg</surname>
            <given-names>A A</given-names>
          </name>
          <name>
            <surname>Husain</surname>
            <given-names>M M</given-names>
          </name>
          <name>
            <surname>Trivedi</surname>
            <given-names>M H</given-names>
          </name>
          <name>
            <surname>Fava</surname>
            <given-names>M</given-names>
          </name>
          <name>
            <surname>Warden</surname>
            <given-names>D</given-names>
          </name>
          <name>
            <surname>Wisniewski</surname>
            <given-names>S R</given-names>
          </name>
          <name>
            <surname>Miyahara</surname>
            <given-names>S</given-names>
          </name>
          <name>
            <surname>Rush</surname>
            <given-names>A J</given-names>
          </name>
          <article-title>Residual symptoms after remission of major depressive disorder with citalopram and risk of relapse: a STAR*D report.PyschologicalMedicine</article-title>
          <date>
            <year>2010</year>
          </date>
          <volume>40</volume>
          <issue>1</issue>
          <fpage>41</fpage>
          <lpage>50</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842031076">
        <label>47.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Tu</surname>
            <given-names>C</given-names>
          </name>
          <name>
            <surname>Huang</surname>
            <given-names>Z</given-names>
          </name>
          <name>
            <surname>Fu</surname>
            <given-names>L</given-names>
          </name>
          <name>
            <surname>Fang</surname>
            <given-names>Y</given-names>
          </name>
          <name>
            <surname>Wang</surname>
            <given-names>J</given-names>
          </name>
          <name>
            <surname>Guo</surname>
            <given-names>T</given-names>
          </name>
          <name>
            <surname>Li</surname>
            <given-names>M</given-names>
          </name>
          <name>
            <surname>Hao</surname>
            <given-names>J</given-names>
          </name>
          <name>
            <surname>Tao</surname>
            <given-names>F</given-names>
          </name>
          <article-title>Predictors of suicidalideation with sub-optimal health status and anxiety symptom among Chinese adolescents.Journal of TropicalPediatrics</article-title>
          <date>
            <year>2012</year>
          </date>
          <volume>58</volume>
          <issue>4</issue>
          <fpage>314</fpage>
          <lpage>319</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1841981916">
        <label>48.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Nguyen</surname>
            <given-names>D T</given-names>
          </name>
          <name>
            <surname>Dedding</surname>
            <given-names>C</given-names>
          </name>
          <name>
            <surname>Pham</surname>
            <given-names>T T</given-names>
          </name>
          <name>
            <surname>Wright</surname>
            <given-names>P</given-names>
          </name>
          <name>
            <surname>Bunders</surname>
            <given-names>J Depression</given-names>
          </name>
          <article-title>anxiety, and suicidalideation among Vietnamese secondary school students and proposed solutions: a cross-sectional study.BMC Public Health</article-title>
          <date>
            <year>2013</year>
          </date>
          <volume>13</volume>
          <fpage>1195</fpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1841980188">
        <label>49.</label>
        <mixed-citation xlink:type="simple" publication-type="book">
          <name>
            <surname>Yeh</surname>
            <given-names>P M</given-names>
          </name>
          <name>
            <surname>Chiao</surname>
            <given-names>C H</given-names>
          </name>
          <article-title>The Influences of Spiritual Well-being, Parental Rearing Attitude, and Coping Strategies on USA College Students’ Anxiety and Depression</article-title>
          <date>
            <year>2015</year>
          </date>
          <chapter-title>In book:Psychological Health and Needs Research DevelopmentsChapter 6</chapter-title>
          <fpage>117</fpage>
          <lpage>130</lpage>
          <publisher-loc>Hauppauge, NY11788</publisher-loc>
        </mixed-citation>
      </ref>
    </ref-list>
  </back>
</article>
