International Journal of
Environmental Research
and Public Health
Article
Examining Predictors of Psychological Well-Being among
University Students: A Descriptive Comparative Study across
Thailand and Singapore
Wareerat Thanoi 1 , Nopporn Vongsirimas 1, * , Yajai Sitthimongkol 1
Citation: Thanoi, W.; Vongsirimas,
N.; Sitthimongkol, Y.; Klainin-Yobas,
P. Examining Predictors of
Psychological Well-Being among
University Students: A Descriptive
Comparative Study across Thailand
and Singapore. Int. J. Environ. Res.
Public Health 2023, 20, 1875. https://
10.3390/ijerph20031875
Academic Editor: Paul B.
Tchounwou
Received: 16 December 2022
Revised: 13 January 2023
Accepted: 15 January 2023
Published: 19 January 2023
Copyright: © 2023 by the authors.
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
4.0/).
Int. J. Environ. Res. Public Health 2023, 20, 1875. https://doi.org/10.3390/ijerph20031875
and Piyanee Klainin-Yobas 2
1 Department of Mental Health and Psychiatric Nursing, Faculty of Nursing, Mahidol University,
Salaya 73170, Thailand
2 Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore 117597, Singapore
* Correspondence: nopporn.von@mahidol.ac.th
Abstract: Background: Psychological well-being (PWB) is a significant indicator of positive psy-
chology. Thus far, the predictors of PWB are not well-understood among university students in
Asian countries. Purpose: This study aimed to investigate the relationships between PWB and its
predictors (stress, resilience, mindfulness, self-efficacy, and social support) in Thai and Singaporean
undergraduates. Stress is perceived to have a negative influence on PWB, but mindfulness, resilience,
self-efficacy, and social support indicate positive influences. Methods: A cross-sectional descriptive
predictive research design was used with 966 Thai and 696 Singaporean university students. After
calculating an adequate sample size and performing convenience sampling, we administered the
following six standard scales: the Perceived Stress Scale, the Connor–Davidson Resilience Scale,
the Mindfulness Awareness Scale, the General Self-Efficacy Scale, the Multi-dimensional Scale of
Perceived Social Support, and the Psychological Well-being Scale, along with a demographic question-
naire. Descriptive statistics, correlation analysis, and structural equation modeling were performed
for participants’ PWB. Results: Mindfulness had significant effects on both factors of PWB, including
autonomy and growth, and cognitive triad, across two samples. In the Thai sample, resilience most
strongly predicted autonomy and growth and perceived stress did so the cognitive triad, whereas
in the Singaporean sample, perceived control most strongly predicted autonomy and growth and
support from friends did so the cognitive triad. Conclusion: These findings provide specific knowl-
edge towards enhancing psychosocial interventions and promoting PWB to strengthen mindfulness,
resilience, perceived control of stress, and social support.
Keywords: stress; resilience; mindfulness; psychological well-being; university students
1. Introduction
The prevalence of mental health problems among university students is alarming, with
depression (76%), anxiety (88.4%), stress (84.4%), and other mental disorders (45.5 %) [1–3]
dominating. Such problems have an impact on students’ psychological well-being (PWB) [4].
While pursuing education in colleges, university students in Asian countries commonly ex-
perience academic stress that may also affect their PWB [5]. Students in Thailand feel under
substantial pressure from their parents and teachers to demonstrate good performance in
university and achieve excellent grades [6]. Among university students, academic pressure
is higher because of high workload, insufficient support from faculty members, and an
unsupportive university climate [6,7]. Furthermore, academic excellence plays a significant
role in determining students’ career success; therefore, some university students feel more
stress and experience mental health problems such as anxiety, depression, substance abuse,
aggression, sleep problems, suicidal ideation, and other behavioral problems [6,8–10].
Assessing university students’ PWB or mental health is an important task for mental
health professionals.
https://www.mdpi.com/journal/ijerph
Int. J. Environ. Res. Public Health 2023, 20, 1875 2 of 14

PWB is a significant indicator of positive psychology. PWB has been defined in two
different ways: (a) subjective well-being (happiness, positive affect, and life satisfaction) [11]
and (b) eudaemonic well-being, including autonomy, self-acceptance, purpose in life,
personal growth, positive relations with others, and environmental mastery [12,13]. Prior to
establishing prevention interventions, one must fully understand the relationships between
PWB and related variables. Evidence has revealed that PWB is negatively correlated with
depression [14,15] Furthermore, several studies have suggested that PWB is related to
perceived stress, resilience, mindfulness, perceived self-efficacy, and social support among
university students [10,16–18]. However, most of these studies were conducted in Western
countries and emphasized negative variables (such as stress) rather than positive aspects
(such as resilience and self-efficacy). According to the positive psychology domain, disease
prevention, mental health promotion, positive emotions, and optimal functioning are
tantamount to pathology, dysfunction, and treatments [19]. Therefore, exploring both
positive and negative variables is essential.
Stress is conceptualized as a relationship between individuals and their environment,
occurring when persons appraise a situation as a threat exceeding their available coping
resources [20]. Stress is found to be an important variable influencing psychological
problems [10,21,22] and PWB [23,24]. Among medical students, a randomized controlled
trial (RCT) indicated that stress management and resilience training significantly improved
resilience, perceived stress, anxiety, and quality of life at eight weeks post-intervention [24].
Self-efficacy is defined as individuals’ beliefs in their capabilities to produce desig-
nated levels of performance that exercise influence over events that affect their lives [25].
During the transition to higher education, university students might experience feelings
of vulnerability and lack of control over their academic lives, affecting their self-efficacy.
Nevertheless, studies have revealed that self-efficacy is positively related to PWB (the
absence of psychological problems) [23,26,27]. Another study found that self-efficacy
and resilience lead to academic success (an indicator of well-being) among baccalaureate
nursing students [26].
Resilience refers to individuals’ ability to change and deal with stressful events and
adversity [28]. It reflects positive environmental adaptation despite risky situations and
difficulties [29] that vary depending on individuals’ context, age, gender, time, and original
culture [28]. Resilience is related to emotional problems such as anxiety, depression,
hopelessness [10,30], and PWB [31–33]. One study examined the predicting effect on
resilience, stress, mindfulness, and self-efficacy in PWB among Australian undergraduate
nursing students. It found resilience to be the strongest predictor [33].
Mindfulness, also called “cautious attention”, refers to individuals’ ability to self-
regulate attention to the present moment and to orientate toward acceptance, open-
ness, and curiosity [34]. Evidence indicates that mindfulness is a strong predictor of
PWB [23,33,35,36]. A study on 76 experienced meditators suggested that practicing mind-
fulness was significantly correlated with psychological well-being [35].
Social support, an external protective factor, is defined as individuals’ perception
of adequate and valuable support influencing adjustment [37]. Social support can be
received from significant others, family members, friends, and teachers [38]. Studies have
demonstrated social support as being significantly associated with PWB [23,32,39]. In the
Philippines, Klainin-Yobas et al. [23] examined PWB’s predicting factors among university
students and found that social support from family and friends significantly predicted
positive individual PWB.

The Current Study

Although previous studies have examined factors influencing PWB among undergrad-
uate students [23,33], little is known about the magnitude of the relationships among those
predicting factors. In addition, only a few studies have explored cross-cultural differences
in PWB predictors, particularly in Asian countries. Therefore, this study examined associa-
tions among stress, self-efficacy, resilience, mindfulness, social support, and PWB in Thai
Int. J. Environ. Res. Public Health 2023, 20, 1875 3 of 14

and Singaporean undergraduates. The research questions are: (a) What are the patterns of
relationships between stress, self-efficacy, resilience, mindfulness, social support, and PWB
among undergraduate university students in Thailand? (b) What are the similarities and
differences in the patterns of relationships between Thai and Singaporean samples?
This study was conducted at two government-supported universities in Thailand
and Singapore. The rationales for using the two universities are outlined here. First, they
are the top universities in each country, with high standards of learning environments,
curriculums, faculty members, and various schools/faculties (such as Medicine, Science,
Law, Art and Engineering). Second, students in both universities face high competition,
and they must maintain high academic performance, possibly leading to academic stress.
Third, both universities are located in a big city with a high cost of living. Students may
experience additional stress concerning daily living (such as financial burden, traffic jams,
among others). Finally, both universities provide mental health services, and our findings
can be helpful to improve such services for students.

2. Materials and Methods

2.1. Research Design
To answer the research questions, this study used a cross-sectional descriptive predic-
tive research design, which allowed us to examine the phenomena of interest in natural
settings [40].

2.2. Participants and Setting

The target populations were Thai and Singaporean undergraduate university stu-
dents, regardless of faculty/school, academic year, or sociological background. Potential
participants were excluded if they were diagnosed with medical and mental illnesses by
physicians and/or psychiatrists. Convenience sampling was employed to recruit potential
participants from all faculties, categorized into six groups: (1) Environment and Natural
Resources; (2) Linguistics, Culture, and Education; (3) Medical Science; (4) Public Health;
(5) Science and Technology; and (6) Social Science, Humanities, and Liberal Arts.
A sample size was determined through online power analyses for structural equation
modeling [41]. An effect size of 0.88 was calculated according to findings from a previous
study investigating stress, self-efficacy, and PWB among nursing students [42]. Using
the effect size of 0.88, with the number of latent variables = 6, the number of observed
variables = 8, power = 80%, and significance level = 0.05; an appropriate sample size for
this study was determined to be at least 589 participants [41].

2.3. Recruitment Procedure

In Thailand, the researchers initially contacted a dean of each faculty to ask permission
to collect data in their respective faculties. Afterwards, we organized meetings with
undergraduate students in each faculty to explain the study and request their participation.
Interested students were asked to sign the consent form and complete the self-reported
paper-and-pencil questionnaire on the spot. Alternatively, students could contact the
researchers later if they needed more time to consider. Approximately 1000 students
attended the meeting, and 966 agreed to participate. Given that the questionnaires were
anonymous, we were unable to identify reasons for non-participation.
In Singapore, the researchers sought permission from the president of the university
to collect data from undergraduate students. Afterwards, the researchers sent an invitation
e-mail to undergraduate students using the university e-mail list. The e-mail contained
information about the study, the researchers’ contact information, and a link to an online
questionnaire. Interested students were requested to click on the link, sign the online con-
sent form and complete the questionnaire. Approximately 5000 students were approached
via e-mail and 673 completed the online questionnaire anonymously. Given the anonymity,
we did not know who did/did not participate, and thus, we were unable to identify reasons
for non-participation.
Int. J. Environ. Res. Public Health 2023, 20, 1875 4 of 14

2.4. Ethical Consideration

In Thailand, this study received ethical approval from the Human Rights Committee
Related to Human Experimentation before commencing [COA. No. 2014/059.0805]. In
Singapore, we received ethical approval from the University Institutional Review Board
[NUS-IRB Reference Code: 12-385E]. All participants in Thailand and Singapore were asked
to sign a written consent form prior to participating in the study.

2.5. Measures
We collected data through anonymous self-reported questionnaires, encompassing
demographic information and the following instruments: the Connor–Davidson Resilience
Scale [28]; Perceived Stress Scale [43]; General Self-Efficacy Scale [44]; Multi-dimensional
Scale of Perceived Social Support [45]; and Psychological Well-being Scale [12]. The demo-
graphic information included gender, age, nationality, religion, ethnic group, faculty and
school, academic year, and annual family income.
In Thailand, we used the Thai-version, hard-copy, self-reported questionnaire, whereas
the English-version and online questionnaires were administered in Singapore. There are
two reasons for using different questionnaire formats. First, in Singapore, the university
e-mail list of potential participants could be accessed by the researchers, who were also the
university teachers. However, such an e-mail list was not accessible by the researchers in
Thailand, and a face-to-face platform was required to meet the students. Second, Singa-
porean students were familiar with e-mail invitations and the online questionnaire, whereas
Thai students were accustomed to hard copies. Furthermore, the response rate would have
been very low if we had used the online version in Thailand.

2.6. Perceived Stress

The 10-item Perceived Stress Scale (PSS: [43]) was used to measure the degree of
individuals’ thoughts and feelings about current events during the previous month. Each
item was rated on a 5-item scale, 0 (never) to 4 (very often). The total score ranged from
0 to 40, with higher scores suggesting higher stress. Cronbach alphas were originally
reported in the range of 0.84–0.86 among American graduate students [46]. With Thai
adult participants, its test–retest reliability was 0.82 and the Cronbach alpha was 0.88 [47].
In this study, factor analyses revealed that PSS had two factors, perceived stress and
perceived control, and the Cronbach alphas were 0.81 and 0.75 in Thailand, and 0.85 and
0.77 in Singapore.

2.7. Self-Efficacy
The Generalized Self-Efficacy Scale (GSES: [44]) consists of 10 items, which are rated
on a 4-point scale ranging from 1 (not at all true) to 4 (exactly true). The Cronbach alphas of
the GSES were originally reported in the range of 0.76–0.90 in adults and adolescents [44].
For the Thai version, the value was 0.84, suggesting good internal consistency [48]. In
this study, GSES contained one factor. The Cronbach alphas in the Thai and Singaporean
samples were 0.86 and 0.89, respectively.

2.8. Resilience
The 10-item Connor–Davidson Resilience Scale [49] was used to assess resilience by
rating items on a 5-point scale from 0 (not true at all) to 4 (true all the time). Total scores
vary from 0 to 40, with higher scores indicating higher resilience levels. Cronbach’s alpha
was originally reported as 0.95 among American undergraduates [49]. Using the back-
translation method, we translated and validated the Thai CD-RISC version. In this study, a
factor analysis indicated that CD-RISC encompassed one structure, and the Cronbach alpha
values of Thai and Singaporean university students were 0.86 [50] and 0.89, respectively,
signifying good reliability.
Int. J. Environ. Res. Public Health 2023, 20, 1875 5 of 14

2.9. Mindfulness
Mindfulness was measured by the 15-item Mindful Attention Awareness Scale
(MAAS) [51], using a 6-point scale ranging from 1 (almost always) to 6 (almost never).
Total scores range from 15 to 90, with higher scores reflecting higher levels of mindfulness.
MAAS is psychometrically sound, given its good range of internal consistency across
several samples (œ = 0.80–0.87) and excellent test–retest reliability over a 1-month period
(r = 0.81) [51]. The Thai version of MAAS was validated with 385 Thai college students,
and the results from a confirmatory factor analysis suggested a single-factor structure and
the scale’s validity [52]. This study showed that MAAS had one factor for both samples,
and the Cronbach alpha values were 0.88 and 0.97, respectively, indicating good reliability.

2.10. Social Support

The 12-item Multi-dimensional Scale of Perceived Social Support (MSPSS; [43]) was
used to assess an individual’s perceived social support by rating items on a 7-point scale,
from very strongly disagree (1) to very strongly agree (7). It entails three factors of
support—friends, family, and significant others. Total scores range from 1 to 84, with higher
scores signifying greater perceived social support. The MSPSS was originally tested on
American university students, and the Cronbach alphas were in the range of 0.84–0.92 for
total scores, 0.81–0.98 for the “family” subscale, 0.90–0.94 for the “friends” subscale, and
0.83–0.98 for the “significant others” subscale [45]. In 2005, Boonyamalik translated the
Thai version of MSPSS with the back-translation method. It showed good reliability, with
the Cronbach alpha in the range of 0.88–0.89 [53,54]. This study’s internal consistency
regarding the two samples’ three factors was as follows: Cronbach’s alphas for social
support from friends = 0.88; family = 0.90; and significant others = 0.91 for Thai university
students. Those for Singaporean university students were 0.89, 0.92, and 0.86, respectively.

2.11. Psychological Well-Being

The 18-item Psychological Well-being Scale (PWBS) [12] was used to assess univer-
sity students’ psychological well-being on a 6-point scale from (1) strongly disagree to
(6) strongly agree. Possible scores range from 18–108, with higher scores signifying better
Cronbach alphas that were originally reported in the range of 0.87–0.93, suggesting good
reliability [12]. The researchers translated this measurement into Thai using the back-
translation method. For Thai university students, Cronbach’s alpha was 0.80. In addition,
the current study’s factor analyses revealed that PWB encompassed two factors: autonomy
and growth, and the negative triad. Cronbach’s alphas were 0.85 and 0.70, respectively, in
Thai; 0.85 and 0.56, respectively, in Singaporean university students [55].

2.12. Data Analysis

The data analysis was performed in two phases using IBM SPSS Statistics version
18.0. The first phase involved entering the data and checking entry accuracy. In Thailand,
one researcher manually entered the questionnaire items to SPSS, while another researcher
double-checked the entered data against the corresponding questionnaires. In Singapore,
online questionnaires were digitally transferred to SPSS software. Next, the data cleaning
began for both Thai and Singapore data sets by running the frequency of each study variable
to ascertain that there were no out-of-range values. Where applicable, cross-tabulation (a
feature in SPSS) was operated to confirm skip-and-fill questions were entered correctly.
Descriptive statistics (i.e., frequency, mean, standard deviation, and graphical displays) was
carried out to describe participants’ characteristics and study variables. The psychometric
properties of all measurements were tested by a factor analysis and internal consistency
reliability (Cronbach’s alpha).
The second phase tested the predictors of PWB via structural equation modeling
(SEM) using AMOS software. Specifically, PWB factors (autonomy and growth, and
negative triad) [56] were submitted to AMOS as dependent variables. Predictors included
perceived stress, perceived control, mindfulness, resilience, and social support (support
Int. J. Environ. Res. Public Health 2023, 20, 1875 6 of 14

from friends, support from family, and support from significant others). The strength
of the predictor would be determined by a standardized regression coefficient (β), and
statistical significance was set as α = 0.05. An overall fit of the SEM model was determined
by (a) confirmatory fit index (CFI), Tucker–Lewis Index (TLI), and incremental fit index
(IFT) > 0.90; and (b) root mean square error of approximation (RMSEA) < 0.08 [57].

3. Results
3.1. Demographic Information and Study Variables
For the Thai sample, 966 students responded using the paper-and-pencil question-
naires. The average age was 20.21 (SD = 1.51), with females (67.30%, n = 650), males
(31.80%, n = 307), and missing data (0.90%, n = 9). Most Thai students were Buddhist
(94.50%, n = 913), followed by Christian (2.10%, n = 20), and Islamic (1.30%, n = 13) (Table 1).

Table 1. Demographic of sample.

Thailand Singapore
(n = 966) (n = 696)
n % n %
Gender
- Male 307 31.80 193 27.70
- Female 650 67.30 411 59.10
- Missing 9 0.90 92 13.20
Religion
- Buddhism 913 94.50 127 18.20
- Christian 20 2.10 172 24.70
- Islam 13 1.30 55 7.90
- Others - - 342 49.20
- Missing 20 2.1
School/Faculty
- Liberal Arts 100 10.40 0 0
- Dentistry 91 9.40 0 0
- Engineering 110 11.40 0 0
- Medicine 48 5.00 0 0
- Nursing 211 21.80 86 12.4
- Science/Social Science 99 10.20 610 87.6
- Pharmacy 85 8.80 0 0
- Public Health 100 10.40 0 0
- Information Communication and Technology 70 7.20 0 0
- Music 43 4.50 0 0
- Missing 9 0.90 0 0
Study Year
- Year 1 179 18.50 185 26.6
- Year 2 250 25.90 29 4.2
- Year 3 244 25.30 60 8.6
- Year 4 242 25.10 44 6.3
- Year 5 9 0.90 - -
- Year 6 27 2.80 54 7.8
- Missing 15 1.60 372 46.50
Mean SD Mean SD
Age 20.21 1.51 22.39 5.18

For the Singaporean sample, 696 students completed the online questionnaires. The
average age was 22.39 (SD = 5.18), with females (59.10%, n = 411), males (27.70%, n = 193),
and missing data (13.20%, n = 92). Most were Christian (24.70%, n = 172), followed by
Buddhist (18.20%, n = 127), Islamic (7.90%, n = 55), and others (49.20%, n = 342).
For both Thai and Singaporean students, all study variables—perceived stress, per-
ceived control, resilience, self-efficacy, and mindfulness; all support the variables auton-
Int. J. Environ. Res. Public Health 2023, 20, 1875 7 of 14

omy and growth, as well as negative triad—display approximately normal distribution

(Tables 2 and 3, respectively).

Table 2. Description of study variables for Thai sample (n = 966).

Standard Cronbach’s
Minimum Maximum Mean Skewness Kurtosis
Deviation Alpha
Perceived stress 0 22 11.21 3.67 −0.00 0.32 0.81
perceived control 0 16 6.19 2.24 0.29 1.31 0.75
Resilience 7 40 27.69 5.17 −0.41 0.74 0.86
Self-efficacy 12 40 27.51 4.25 −0.02 0.44 0.86
Mindfulness 24 89 62.33 10.92 −0.15 −0.16 0.88
Support from family 6 28 23.64 4.32 −1.24 1.29 0.89
Support from friends 5 28 21.86 4.30 −0.82 0.69 0.91
Support from others 4 28 21.74 5.13 −0.92 0.68 0.91
Autonomy and growth of PWB 17 60 43.63 6.58 −0.66 0.91 0.85
Negative triad factor of PWB 6 36 25.25 4.637 −0.23 0.30 0.72
Note: PWB = psychological well-being.

Table 3. Description of study variables for Singaporean sample (n = 673).

Standard Cronbach’s
Minimum Maximum Mean Skewness Kurtosis
Deviation Alpha
Perceived stress 0 24 11.93 4.12 0.12 0.40 0.85
Perceived control 0 16 6.88 2.43 −0.03 0.84 0.77
Resilience 14 50 35.30 5.89 −0.04 0.49 0.89
Self-efficacy 10 40 29.30 3.81 −0.23 2.37 0.89
Mindfulness 17 89 61.62 10.13 −0.29 0.74 0.87
Support from family 4 28 20.05 5.05 −0.79 0.72 0.89
Support from friends 4 28 21.16 4.43 −1.29 2.85 0.92
Support from others 4 28 20.25 6.02 −0.73 −0.00 0.96
Autonomy and growth of PWB 9 54 40.32 6.37 −0.64 1.64 0.83
Negative triad of PWB 8 34 22.27 4.43 −0.29 0.02 0.56
Note: PWB = psychological well-being.

3.2. Predictors of Psychological Well-Being

3.2.1. Thai Sample
Figure 1 displays predictors of PWB among Thai youths, with solid lines representing
predictors achieving statistical significance and broken lines representing insignificant
regression paths. The findings suggested that the hypothesized model had an adequate
fit to the data, evidenced by Chi-square per degree of freedom (χ2 /df) = 2.46, CFI = 0.90,
TLI = 0.90, IFI = 0.90, RMSEA = 0.04, 90% confidence interval of RMSEA = 0.038, 0.041.
Furthermore, resilience (β = 0.62, p < 0.001), perceived control (β = 0.29, p < 0.001), mind-
fulness (β = 0.17, p < 0.001), support from significant others (β = 0.17, p < 0.001), and
support from family (β = 0.17, p < 0.001) significantly predicted the PWB autonomy and
growth factor, with 60.90% of variance explained by all independent variables. Additionally,
mindfulness (β = −0.24, p < 0.001), perceived stress (β = 0.32, p < 0.001), and support from
family (β = 0.11, p = 0.03) significantly predicted the cognitive triad factor of PWB, with all
independent variables explaining 31.30% of variance.

3.2.2. Singaporean Sample

Figure 2 suggests that the hypothesized model displayed an acceptable fit, as ev-
idenced by χ2 /df = 2.14, CFI = 0.90, TLI = 0.90, IFI = 0.90, RMSEA = 0.04, and the
90% confidence interval of RMSEA = 0.039,.042. Note that these fit indices are compa-
rable with those in the Thai sample. Furthermore, the autonomy and growth factor of PWB
was significantly predicted by resilience (β = 0.29, p = 0.005), perceived stress (β = −0.15,
Int. J. Environ. Res. Public Health 2023, 20, 1875 8 of 14

p = 0.02), perceived control (β = 0.43, p < 0.001), mindfulness (β = 0.18, p < 0.001), support
from friends (β = 0.11, p = 0.004), and support from family (β = 0.12, p = 0.001).
The cognitive triad factor was significantly predicted by resilience (β = −0.29, p = 0.006),
perceived stress (β = 0.36, p < 0.001), mindfulness (β = −0.20, p < 0.001), and support from
Int. J. Environ. Res. Public Health 2023,friends
20, x FOR = −0.40,
(βPEER REVIEW p < 0.001). All independent variables explained 65.90% and 69.90% 8 of of
14
variance on the autonomy and growth, and the cognitive triad, respectively.
Altogether, the findings from both the Thai and Singapore samples demonstrated that
mindfulness had significant effects on PWB factors. In the Thai sample, resilience most
with 60.90%
strongly of variance
predicted explained
the autonomy andbygrowth
all independent
factor, whilevariables. Additionally,
perceived stress most mindful-
strongly
ness (β = −0.24, p < 0.001), perceived stress (β = 0.32, p < 0.001),
predicted the cognitive triad factor. In the Singaporean sample, perceived and support from family
control and(β
= 0.11, p = 0.03) significantly predicted the cognitive triad factor of
support from friends most strongly predicted the autonomy and growth factor, and thePWB, with all inde-
pendent variables
cognitive explaining 31.30% of variance.
triad factor.

Fit Indices:
Perceived Chi-square/degree of freedom = 2.46
Stress CFI=0.90, TLI = 0.90, IFI=0.90
RMSEA=0.04, 90% RMSEA=0.038 - 0.041

Perceived
Control

β = 0.62***
Resilience Autonomy &
β = 0.17***
Growth

R square = 60.90%

Mindfulness

Self-Efficacy

Support Cognitive Triad

β = - 0.11***
from Family
β = 0.10 R square = 31.30%

Support
from Friend

Support from
Significant Others

Figure1.1.Predictors
Figure Predictorsof
ofpsychological
psychologicalwell-being
well-beingamong
among university
university students
students in
in Thailand.
Thailand. ***
*** Signifi-
Signif-
icant at 0.001.
cant at 0.001.

3.2.2. Singaporean Sample

Figure 2 suggests that the hypothesized model displayed an acceptable fit, as evi-
denced by χ2/df = 2.14, CFI = 0.90, TLI = 0.90, IFI = 0.90, RMSEA = 0.04, and the 90% confi-
dence interval of RMSEA = 0.039,.042. Note that these fit indices are comparable with those
in the Thai sample. Furthermore, the autonomy and growth factor of PWB was signifi-
cantly predicted by resilience (β = 0.29, p = 0.005), perceived stress (β = −0.15, p = 0.02),
perceived control (β = 0.43, p < 0.001), mindfulness (β = 0.18, p < 0.001), support from
friends (β = 0.11, p = 0.004), and support from family (β = 0.12, p = 0.001).
The cognitive triad factor was significantly predicted by resilience (β = −0.29, p =
0.006), perceived stress (β = 0.36, p < 0.001), mindfulness (β = −0.20, p < 0.001), and support
from friends (β = −0.40, p < 0.001). All independent variables explained 65.90% and 69.90%
of variance on the autonomy and growth, and the cognitive triad, respectively.
Int. J. Environ. Res. Public Health 2023, 20, x FOR PEER REVIEW 9 of 14

strongly predicted the cognitive triad factor. In the Singaporean sample, perceived control
Int. J. Environ. Res. Public Health 2023, 20, 1875 9 of 14
and support from friends most strongly predicted the autonomy and growth factor, and
the cognitive triad factor.

Fit Indices:
Perceived Chi-square/degree of freedom = 2.14
Stress CFI=0.90, TLI = 0.90, IFI=0.90
RMSEA=0.04, 90% RMSEA=0.039 - 0.042

Perceived
Control

β = 0.29**
Resilience Autonomy &
β = 0.18**
Growth

R square = 65.90%

Mindfulness

Self-Efficacy

Support Cognitive Triad

β = 0.04
from Family
β = - 0.40*** R square = 69.90%

Support
from Friend

Support from
Significant Others

Figure2.2.Predictors
Figure Predictorsofofpsychological
psychologicalwell-being
well-being among
among university
university students
students in Singapore.
in Singapore. * Signifi-
* Significant
cant at 0.05, ** significant at 0.01, *** significant at
at 0.05, ** significant at 0.01, *** significant at 0.001. 0.001

4.4.Discussion
Discussion
This
Thisstudy’s
study’sresults
resultsdemonstrated
demonstratedthat thatThai
ThaiandandSingaporean
Singaporeanuniversity
universitystudents
studentshad
had
aa medium
medium level
level ofof the
the autonomy
autonomy and and growth
growth factor
factor andand negative
negative triad
triad factor
factor of
of PWB.
PWB.
Negative
Negative triad
triad reflects
reflectsindividuals’
individuals’ negative
negative perceptions
perceptions toward
towardself,
self,other
otherpeople,
people,and
and
their future [56]. Such perceptions included disappointing achievements,
their future [56]. Such perceptions included disappointing achievements, difficulty mak- difficulty making
and maintaining
ing and maintaining relationships withwith
relationships others, andand
others, little purpose
little in in
purpose life.
life.InInthe
thefollowing
following
variables, these students’ PWB models differed slightly: perceived stress,
variables, these students’ PWB models differed slightly: perceived stress, perceived perceived control,
con-
resilience, social support from family, friends, and significant others. Other
trol, resilience, social support from family, friends, and significant others. Other variablesvariables were
similar, specifically
were similar, mindfulness
specifically and self-efficacy.
mindfulness and self-efficacy.
In
In this study, stress was separatedinto
this study, stress was separated intotwo
twocomponents:
components: perceived
perceived stress
stress and
and per-
per-
ceived control. In the Thai sample, perceived stress correlated negatively
ceived control. In the Thai sample, perceived stress correlated negatively with the nega- with the negative
triad PWBPWB
tive triad factor, whilewhile
factor, the relationship between
the relationship perceived
between control
perceived and the
control andautonomy and
the autonomy
growth of PWB was positive. In another study, individuals who perceived their stress as
and growth of PWB was positive. In another study, individuals who perceived their stress
threatening or harmful indicated their potential to cause damage, thus provoking negative
as threatening or harmful indicated their potential to cause damage, thus provoking neg-
emotions. If they perceived stress as challenges that they could control with sufficient
ative emotions. If they perceived stress as challenges that they could control with suffi-
coping resources, they understood the potential rewards and ability to experience positive
cient coping resources, they understood the potential rewards and ability to experience
emotions [57]. Thai university students who perceived their stress as a life-threatening
situation or as stressful life events might manifest the negative triad of PWB. In contrast,
university students who interpreted their stressful life events positively and believed in
their ability to control stress had greater autonomy and PWB growth.
Int. J. Environ. Res. Public Health 2023, 20, 1875 10 of 14

However, the finding of perceived control revealed that university students could
handle stress effectively and that individuals with effective coping strategies might have
greater PWB, in congruence with the literature [58,59]. In comparison with Singaporean
university students, the PWB model showed perceived stress as not only significantly
negatively correlated with the autonomy and growth PWB, but also as significantly posi-
tively correlated with the cognitive triad PWB. Simultaneously, the relationships between
perceived control and both PWB components were similar in the Thai sample. A previous
study also supported that perceived stress had a negative correlation with positive PWB
and a positive correlation with negative PWB [33]. Hence, promoting an intervention
program of PWB in each sample should be considered its difference.
Mindfulness significantly predicted PWB among both samples, congruent with previ-
ous studies [23,33,60,61]. In addition, studies have suggested that mindfulness can reduce
negative emotions: depression, rumination, stress, anxiety, somatization, aggression, and
avoidance behavior [61]. Indeed, all previous studies indicated that mindfulness might
reduce negative emotions and, correspondingly, increase PWB. Consistent with this study’s
result showing a higher level of mindfulness, university students tended to mention higher
autonomy and PWB growth and a lower negative triad PWB factor. This tendency is
congruent with the literature describing “mindfulness”—conceptualized as promoting
individuals’ well-being—as awareness of the present moment and non-judgment [50].
Individuals with elevated mindfulness are aware of their surroundings, thoughts, and
feelings, without fixating or labeling things as good or bad [50]. Instead, they extend
attitudes of curiosity, patience, and non-judgment towards distress because they better
attend to the present, reduce rumination, have a greater ability to control their emotions
and behaviors, and use more and better adaptive coping and management techniques to
deal with undesirable stressors. All of these lead to greater PWB [62–64]. Importantly, these
findings revealed that cultural differences between Thai and Singaporean students did not
influence mindfulness in promoting PWB.
Resilience most strongly predicted the autonomy and growth PWB in the Thai sample
and in both components of PWB in the Singaporean sample. Similarly, university students
in Australia who possessed greater resilience reported higher levels of PWB [33]. It is
possible that highly resilient individuals could better recover from adverse events and
adjust to stressful situations [29,65]; resilience buffers them from the stress of life events,
so they perceive stress as a challenge that helps them develop environmental mastery,
positive relationships, growth, and self-determination [66]. Resilient university students
could reappraise negative experiences as positive episodes [67], thus reducing the risk of
maladaptive outcomes [68]. Resilient Thai university students could effectively develop
their autonomy and growth to deal with stress, while Singaporean university students
could develop both PWB components. Therefore, among university students, resilience
seems well established in the literature as links to PWB.
In both study samples, self-efficacy had no significant effects on PWB, even though it
might be enhanced by accomplishment, and well-being might be enhanced by beliefs about
capabilities [69]. These findings were incongruent with a previous study [23]. Following
previous studies [23,33,70], support by family, friends, and significant others related mean-
ingfully to PWB, indicating that social support could enhance a person’s ability to handle
stress effectively and promote PWB [71]. Thai university students could apply perceived
support from family and significant others to their autonomy and growth PWB and to
the reduction in the PWB negative triad. Family social support essentially contributed to
PWB in Thai university students because although some had moved away to study, family
connectedness was still profound.
According to the self-determination theory (SDT), adolescents perceiving their parents
as a supportive resource could develop their autonomy, including their natural desire to
experience a sense of personal decision making, volition, and psychological freedom [72].
For Singaporean students, support from friends contributed to both PWB components,
while support from family only promoted PWB autonomy and growth. Especially because
Int. J. Environ. Res. Public Health 2023, 20, 1875 11 of 14

of the competitive, international environment at the Singaporean university, perceived

support from friends influenced PWB, and this result corresponded with a previous study
of Filipino university students [23]. These findings support cultural differences between
Thai and Singaporean students as influences in their daily living.
Finally, the findings showed slight differences between Thai and Singaporean students
because of diverse cultural and academic environments. For instance, most university
students in Singapore had come from foreign countries and manifested a wide range
of skills and abilities; thus, international competition and high education qualifications
became inherently tense for them. Moreover, Singapore’s average cost of living is quite
high and leads university students to strive diligently for the highest-paying careers and to
become financially independent.
Like most studies, this one had some limitations. First, the cross-sectional research
had limited time to provide a deep understanding of individuals’ PWB development.
Therefore, longitudinal research is needed in future studies. Second, both hard-copy and
online self-reported questionnaires are considered subjective data and might be subject
to social desirability. For a more accurate reflection of PWB, longitudinal research should
be implemented. Third, the use of different formats of questionnaires might minimize the
comparability of findings across the two samples. Finally, the use of convenient sampling
might limit the generalizability of the research findings. Nevertheless, a large sample size
in the two samples might minimize this issue.
The study’s results further suggested several important factors for recommendations.
To improve university students’ PWB, implementing intervention programs—for example,
mindfulness-based stress-reduction programs, resilience programs, and social support pro-
grams as part of university policy—would promote PWB and help prevent students’ mental
health problems. Of course, the effectiveness of such intervention programs—concentrating
on mindfulness, resilience, perceived control of stress, and social support—should be care-
fully and regularly evaluated.

5. Conclusions
This study compared predictors of PWB across the two samples. Both the Thai and
Singaporean samples’ mindfulness had significant effects for both PWB factors. In the
Thai sample, resilience most strongly predicted the autonomy and growth PWB, and
perceived stress did so the cognitive triad PWB. In the Singaporean sample, perceived
control most strongly predicted the autonomy and growth PWB, and support from friends
did so the cognitive triad PWB. Future research should test this hypothesized model in
other university samples and implement effective intervention programs to enhance PWB
in undergraduate university students.

Author Contributions: W.T. and P.K.-Y. planned the study and drafted the manuscript. N.V. and
P.K.-Y. planned study, analyzed the data, and drafted the manuscript. N.V., W.T., Y.S. and P.K.-Y.
recruited the participants and performed data collection. All authors have read and agreed to the
published version of the manuscript.
Funding: This research was funded by “China Medical Broad, Faculty of Nursing, Mahidol Univer-
sity”. And the APC was funded by Mahidol University.
Institutional Review Board Statement: This research conformed to the Declaration of Helsinki.
It received approval and ethical clearance from the Institutional Review Board (IRB) of Mahidol
University, Thailand (COA. No. IRB-NS2014/059.0805) before data collection. All procedures were
conducted according to the IRB guidelines and regulations. Written informed consent was obtained
from all participants involved in this study. A statement concerning ethics approval is included in
this manuscript.
Informed Consent Statement: Informed consent was obtained from all subjects involved in the study.
Data Availability Statement: Data is unavailable due to privacy and ethical restrictions from Institu-
tional Review Board (IRB) of Mahidol University, Thailand.
Int. J. Environ. Res. Public Health 2023, 20, 1875 12 of 14

Acknowledgments: Many thanks to the China Medical Broad, Faculty of Nursing, Mahidol Univer-
sity, for the research funding required to successfully meet our goal.
Conflicts of Interest: The authors declare no potential conflict of interest with respect to the research,
authorship, and/or publication of this article.

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