Mental Health of UK University Business Students: Relationship with Shame, Motivation
Kotera, Y., Conway, E., & Van Gordon, W. (2018) Mental health of UK university business
students: Relationship with shame, motivation and self-compassion. Journal of Education for
Business. doi: 10.1080/08832323.2018.1496898
Corresponding author: Yasuhiro Kotera (Y.Kotera@derby.ac.uk), University of Derby, UK.
There is growing awareness of mental health problems among UK business students, which
appear to be exacerbated by students’ attitudes of shame towards mental health. This study
recruited 138 UK business students and examined the relationship between mental health and
shame, and mental health and potential protective factors such as self-compassion and
motivation. A significant correlation between each of the constructs was observed and self-
compassion was identified as an explanatory variable for mental health. Shame moderated the
relationship between self-compassion and mental health. Integrating self-compassion training
into business study programmes may help to improve the mental health of this student group.
Keywords: self-compassion, mental health attitudes, mental health, academic
motivation, UK business students
In the 2016-2017 academic year, 333,425 students were enrolled on full-time or part-
time undergraduate and postgraduate business study programmes in the UK (Higher
Education Statistics Agency [HESA], 2018). Although business students reflect the largest
student group compared to other disciplines taught at UK universities, the increasing number
of business students with mental health problems is a cause for concern. More specifically,
the number of UK university business students with mental health problems increased from
13,060 in 2010 to 35,500 in 2015 (HESA, 2018). This increase was not aligned with
fluctuations in enrolment volumes (i.e., overall numbers have reduced as 358,290 business
students were enrolled in 2010/11; HESA, 2012) and was accompanied by a tripling of the
dropout rate for business students during the same five-year period (i.e., 2010-2015). A
similar problem has also been identified in other countries, such as Sweden, where a study
(n=750) comparing business and medical students reported that business students had
comparatively higher levels of stress, burnout, alcohol use, and depression (Dahlin, Nilsson,
Stotzer, & Runeson, 2011).
In addition to the demands of having to balance their work, family life, and university
studies, business students can experience additional stress due to a requirement to undertake
long periods of independent study and attend condensed full-day teaching schedules
(Matthews, 2017). Furthermore, while business educators identified the commercial
advantages and need for psychological education almost twenty years ago (Goleman, 1998;
Tucker, Sojka, Barone & McCarthy, 2000), only a small proportion of contemporary business
educators have sought to integrate comprehensive mental health training as part of the study
syllabus. For example, while 80% of the Association of Master of Business Administration’s
2,000 international business schools recognise that stress management is deemed to be an
important skill from an employer’s perspective, only one-third of such business schools
include stress management in the teaching syllabus (Matthews, 2017).
The gap between awareness of the need for stress management skills and provision of
such training in MBA programmes suggests that while some business educators are aware of
mental health problems amongst their students, they may not have the knowledge and/or
resources to address the problem. Research focussing on business students that furthers
understanding of mental health risk and resilience factors in therefore of value, particularly
given that business students who suffer from mental distress during their studies are more
likely to be ill-prepared for additional stressors in a workplace (Law, 2010). Thus, the present
study sought to assess the relationships between mental health symptoms and other relevant
psychological constructs (i.e., shame-based mental health attitudes, academic motivation, and
self-compassion) in a sample of UK university business students.
Review of the Literature
Like some other student populations, it is not uncommon for business students to
perceive stress and other mental health problems negatively and feel shameful in respect of
them (Vijayalakshmi, Reddy, Math, & Thimmaiah, 2013). Shame is a negative emotion of
inadequacy that arises due to the violation of an accepted standard or stigma (Tangney,
1990). It is closely associated with mental health concomitants such as low self-worth, as
well as with poor academic performance and reduced moral concern about academic
dishonesty (Hazzouri, Carvalho & Main, 2015). In turn, reduced moral concern amongst
business students can lead to a lack of ethical awareness amongst future managers and
business leaders (Association to Advance Collegiate Schools of Business, 2004; Ballantine,
Guo & Larres, 2018).
Studies evaluating business students’ personality have noted that i) they have lower
levels of openness compared to other student groups (Lounsbury, Smith, Levy, Leong &
Gibson, 2009), ii) most business students are judgemental (Nourayi & Cherry, 1993), and iii)
their self-enhancement bias (i.e., seeing people in the same category as you as better than
people in the other categories; Taylor & Brown, 1998) was high (Schlee, Curren, Harich &
Kiesler, 2007). Given these findings, it is reasonable to expect that business students would
score higher in attitudes of shame towards mental health than students in other subjects.
However, despite the likely interaction of shame in respect of mental health problems in UK
university business students, no study to date has specifically sought to explore attitudes and
shame about mental health in this student group.
Shame is also related to motivation where, for example, studies have shown that
extrinsic motivation is positively related to negative attitudes towards mental health problems
(Kotera et al., 2018). Studies have also shown that extrinsic motivation is associated with
increased mental health problems, while intrinsic motivation is associated with decreased
mental health problems in a variety of populations including university students (Kasser &
Ryan, 2001; Sheldon & Kasser, 1998). According to self-determination theory (Ryan & Deci,
2017), intrinsic motivation is activated by inherent passion (e.g., a student studies because
they enjoy the subject/topic), whereas extrinsic motivation is driven by external drivers such
as recognition and money (e.g., a student studies because they wish to receive the top grade
or secure a well-paid job). Accordingly, a study of business students in Taiwan (n=343)
reported that intrinsic motivation was significantly higher than extrinsic motivation among
students who successfully graduated (Cheng, Lin & Su, 2011). This is consistent with
concerns that have been raised due to observing high rates of extrinsic motivation in business
students in both Switzerland (Brahm, Jenert & Wagner, 2017) and the UK (Lucas & Tan,
2013). However, notwithstanding such observations, there remains a lack of clarity in terms
of understanding the relationship between motivation and mental health in this student group.
A further factor that is understood to be highly associated with mental health in
university student populations is self-compassion (Neely, Schallert, Mohammed, Roberts, &
Chen, 2009; Ying, 2009). In addition to self-compassion as a global construct, each of the
individual components of self-compassion (mindfulness, common humanity, self-kindness)
have been shown to be negatively related to depression in US postgraduate students (Ying,
2009). Self-compassion refers to a healthy structure of self-acceptance, established upon (i)
kindness to oneself when experiencing inadequacy, (ii) a recognition that discomfort is an
inevitable human experience, and (iii) awareness of painful thoughts (Neff, 2003a; Neff
2003b). These three elements are understood to be interwoven with each other such that
improving one element can improve another (Neff, 2003b). In non-business student
populations, self-compassion is associated with reduced social comparison (Neff & Vonk,
2009), reduced self-centred tendencies (Leary, Tate, Adams, Allen, & Hancock, 2007), and
increased wisdom and internal awareness (Brown & Ryan, 2003; Langer 1989, 2005;
Wallace & Shapiro, 2006). Intervention studies in clinical samples have also demonstrated
that self-compassion can ameliorate shame (Gilbert & Procter 2006). However, despite the
demonstrable potential of self-compassion to serve as a protective factor in terms of mental
health problems, no study to date has explored the relationship between self-compassion and
mental health attitudes in UK business students.
Given that business is the most popular university subject in the UK (HESA, 2018),
there is clearly a need to further empirical understanding of protective factors and
concomitants of mental illness in this population group. Accordingly, the purpose of this
study is to investigate the relationship between mental health, attitudes towards mental health,
self-compassion, and motivation in UK business students. Furthermore, in order to help
contextualise the findings, the outcomes from UK university business students will be
compared with UK social work students that have recently been the subject of cross-sectional
research exploring the relationship between mental health and factors such as shame,
motivation, and self-compassion (Kotera et al., 2018).
Four hypotheses were tested to address the aforementioned research aims.
H1: Business students would register higher level of shame in mental health attitudes
compared to social work students.
H2: Mental health, attitudes towards mental health, self-compassion, and motivation would
be associated with each other in a sample of UK university business students.
H3: Attitudes towards mental health, self-compassion, and motivation would be explanatory
variables of mental health.
H4: Explanatory variables would mediate the relationship between mental health and
attitudes towards mental health.
All participants were aged 18 years or older and were fulltime undergraduate business
students studying in the East Midlands, UK. Participants were recruited using opportunity
sampling through questionnaires issued via programme tutors. No credits or compensation
were awarded to students for participation. Of 150 students who were asked to participate in
the study, 138 (73 female, 65 male; age range 18-57, Mage=21.15, SDage=5.75 years)
completed self-reported measures relating to mental health attitudes, mental health
symptoms, academic motivation, and self-compassion. Ninety-seven participants were
British, and 40 were international students (22 other Europeans, eight Asians, six Africans,
one North American, one South American, one Oceanian, and one undisclosed). Ethical
approval was provided by the Research Ethics Committee of the researchers’ institution, and
informed consent was obtained from all participants included in the study.
The Attitudes Towards Mental Health Problems (ATMHP; Gilbert et al., 2007).
consists of 35 four-point Likert items evaluating attitudes towards mental health problems.
The scale assesses internal and external forms of shame as well as shame in community and
family contexts. The scale also assesses ‘reflected shame’ that incorporates family-reflected
shame (how the respondent believes their family would be perceived if they had a mental
health problem) and self-reflected shame (how the respondent believes they would be
perceived if a close relative had a mental health problem). All of the subscales have good
Cronbach’s alphas (.85-.97; Gilbert et al., 2007).
The Depression Anxiety and Stress Scale (DASS-21) is a shortened form of DASS-42
(Lovibond & Lovibond, 1995) and comprises 21 items scored on a four-point Likert scale.
The DASS-21 comprises three seven-item subscales corresponding to depression (e.g., ‘I felt
that I had nothing to look forward to’), anxiety (e.g., ‘I felt I was close to panic’) and stress
(e.g., ‘I found it difficult to relax’). Each of the subscales has good internal consistency
(α=.87-.94; Antony, Bieling, Cox, Enns, & Swinson, 1998). For the purpose of this study, the
global DASS-21 score was used to provide an indication of overall mental health symptoms.
The Academic Motivation Scale (AMS; Vallerand et al. 1992) is a 28-item measure
that assesses the levels of three different types of motivation, categorised into seven subtypes:
(i) amotivation, (ii) extrinsic motivation (external, introjected, and identified regulation), and
(iii) intrinsic motivation (to know, to accomplish, and to experience stimulation). Each
subtype of motivation is assessed using four items on a seven-point Likert scale (from 1=
‘Does not correspond at all’ to 7= ‘Corresponds exactly’). All of the subscales have adequate
Cronbach’s alphas between .62 and .91 (Vallerand et al., 1992).
The Self-Compassion Scale-Short Form (SCS-SF; Neff, 2003b) is a shortened version
of the Self-Compassion Scale and comprises 12 five-point Likert items (‘1’ being ‘almost
never’ to ‘5’ being ‘almost always’). Respondents are asked question such as ‘When I fail at
something important to me I become consumed by feelings of inadequacy’. The SCS-SF has
good internal consistency (α=.86; Neff, 2003b).
All data collected was initially screened for outliers, then the rates of the scores over
the midpoint were calculated. Additionally, scores on the ATMHP, AMS, DASS-21, and
SCS-SF for the business students were compared with 105 UK undergraduate social work
students (93 female and 12 male; age range 15-58, Mage=30.53, SDage=9.11 years; 94 UK
nationals; Kotera et al., 2018; Kotera, Green & Van Gordon, 2018). After screening the data
for the assumptions of various parametric tests, correlations between mental health attitudes,
mental health symptoms, motivation, and self-compassion were explored. Multiple regression
analyses were conducted to examine the best explanatory variables of mental health
symptoms. Finally, moderation analysis was undertaken to examine the impact of mental
health attitudes on the relationship between self-compassion and mental health symptoms.
Analyses were conducted using IBM SPSS version 24.0. Outliers (one score in extrinsic
motivation, and five scores in amotivation were identified as outliers) were identified using
the outlier labelling rule (Hoaglin & Iglewicz, 1987) and were subsequently winsorised
(Tukey, 1962). Skewness values ranged from -.73 to 1.46, and Kurtosis values from -.97
to .94. The Cronbach’s alphas for all the scales and subscales were above .75, demonstrating
high internal consistency. As shown in Table 1, UK business students had higher scores in
self-reflected shame and extrinsic motivation, and lower scores in self-compassion, compared
to UK social work students (Table 1). Among the subscales of ATMHP, only self-reflected
shame was higher in business students than social work students, and the difference in the
other subscales were not significant. Thus, H1 was partially supported.
Table 1. Descriptive statistics of UK business students, comparing with social work students
UK business students
UK social work students
CA=Community Attitudes, FA=Family Attitudes, CES=Community External Shame, FES=Family External
Shame, IS=Internal Shame, FRS=Family-Reflected Shame, SRS=Self-Reflected Shame, IM=Intrinsic
Motivation, EM=Extrinsic Motivation, AM=Amotivation, MHS=Mental Health Symptoms, SC=Self-
Compassion. Superscripts indicate there was significant difference between the two groups.
With the exception of self-compassion, all of the scales scores were square root-transformed
to satisfy the assumption of normality. Pearson’s correlations were used to examine
relationships between attitude, motivation, mental health symptoms, and self-compassion (see
Table 2). Mental health attitudes were (i) related among all the subscales, (ii) moderately
positively related to extrinsic motivation, and (iii) negatively related to self-compassion.
Furthermore, mental health symptoms were positively related to mental health attitudes and
amotivation, and negatively related to self-compassion. Intrinsic motivation was positively
related to extrinsic motivation and self-compassion. Although almost all of the subscales
were associated with each other, there were some constructs that were not (e.g., intrinsic
motivation and mental health attitudes). Thus, H2 was largely supported.
Table 2. Correlations between mental health attitudes, mental health symptoms, motivation,
and self-compassion in UK business students (n=138)
*. Correlation is significant at the .05 level (2-tailed).
**. Correlation is significant at the .01 level (2-tailed).
CA=Community Attitudes, FA=Family Attitudes, CES=Community External Shame, FES=Family External
Shame, IS=Internal Shame, FRS=Family-Reflected Shame, SRS=Self-Reflected Shame, IM=Intrinsic
Motivation, EM=Extrinsic Motivation, AM=Amotivation, MHS=Mental Health Symptoms, SC=Self-
Multiple regression analyses were conducted to explore the relative contribution of
mental health attitudes, motivation, and self-compassion to mental health symptoms (Table
3). At step one, gender and age were entered to statistically adjust for their effects, and at step
two, all of the mental health attitudes and motivation subscales, as well as the self-
compassion scale, were entered. Adjusted coefficient of determination (Adj. R2) are reported.
Multicollinearity was not a concern as all of the VIF values were less than 10. After adjusting
for demographic information, mental health attitudes, motivation, and self-compassion
accounted for 47% of the variance for mental health symptoms, with self-compassion as a
significant explanatory variable. Mental health attitudes and motivation were not significant
explanatory variables for mental health symptoms. Thus, H3 was partially supported.
Table 3. Multiple regression: Mental health attitudes, motivation, and self-
compassion to mental health symptoms among business students (n=138)
Mental Health Symptoms
CA=Community Attitudes, FA=Family Attitudes, CES=Community External Shame, FES=Family
External Shame, IS=Internal Shame, FRS=Family-Reflected Shame, SRS=Self-Reflected Shame,
IM=Intrinsic Motivation, EM=Extrinsic Motivation, AM=Amotivation, MHS=Mental Health
Symptoms, SC=Self-Compassion, B=unstandardised regression coefficient, SEB=standard error of the
coefficient, β=standardised coefficient; *p<.05; **p<.01.
Mental health attitudes and self-compassion, as well as the interaction between them
were entered to predict mental health symptoms, using the model 1 in the Process macro
(Hayes, 2012; Panel A in Figure 1). To avoid multicollinearity issues, the predictor variables
were centred prior to regression analyses.
Figure 1. Moderation of the effect of self-compassion on mental health symptoms by mental
health attitudes: conceptual diagram (panel A) and statistical diagram (panel B).
*p<.05; **p<.01; ***p<.001
Mental Health Attitudes
Self-compassion Mental Health Symptoms
Mental Health Attitudes
Mental Health Symptoms
Mental Health Attitudes
The interaction effects of self-compassion and mental health attitudes as predictors of
mental health symptoms were significant, which indicated that mental health attitudes
moderated the relationship between self-compassion and mental health symptoms (Panel B in
Figure 1). Three simple regression equations were calculated (Aiken & West, 1991) at
different levels of mental health attitudes: (i) one standard deviation below the mean mental
health attitudes score, (ii) the mean mental health attitudes score, and (iii) one standard
deviation above the mean mental health attitudes score (Figure 2). The plot of interaction
showed a negative enhancing effect of mental health attitudes: as mental health attitudes
scores became high, the negative relationship between self-compassion and mental health
symptoms was strengthened. Simple slopes analyses showed that the relationship between
self-compassion and mental health symptoms was significant at each of the three levels of
mental health attitudes: (i) low mental health attitudes (b = -1.06, t = .27, p < .001), (ii) mean
mental health attitudes (b = -1.44, t = -8.63, p < .001), and (iii) high mental health attitudes (b
= -1.82, t = .24, p < .001). Thus, H4 was supported.
Figure 2. Moderating effect of mental health attitudes on self-compassion and mental health
symptoms among business students (n=138).
MHA = Mental Health Attitudes
Discussion and Recommendations for Additional Research
This study assessed levels of mental health attitudes, motivation, mental health
symptoms, and self-compassion in UK business students, and made a comparison with UK
social work students. An assessment of the relationship between mental health attitudes,
motivation, mental health symptoms, and self-compassion was subsequently undertaken,
followed by an investigation into the explanatory variables for mental health symptoms.
Finally, moderation analysis was conducted to examine whether mental health attitudes
moderated the relationship between self-compassion and mental health symptoms.
The current sample of UK business students scored higher on self-reflected shame
(i.e., that relates to worries about being viewed negatively due to a family member’s mental
illness) and extrinsic motivation, and lower on self-compassion, than UK social work
students. The higher level of self-reflected shame may be explained by the fact that business
students are likely to have reduced knowledge of mental health issues when compared with
social work students. For example, social work students are arguably more likely to be aware
that the heritability of mental illness is not too high (i.e., in the order of 35% for depression;
Matsumoto, Kunimoto, & Ozaki, 2013) and that tolerance and understanding towards mental
illness is steadily increasing amongst employers and society more generally.
The same applies to the difference between the two student groups in levels of self-
compassion because given that compassion is a core value of social work (British Association
of Social Workers, 2012), social work students aspire to compassionate values during their
education and training. The higher levels of extrinsic motivation in business versus social
work students was likewise not unexpected because although recent literature indicates a
steady shift in business students from extrinsic to intrinsic forms of motivation (Hurst et al.
2016), traditionally, motivations for working in business have often been governed by the
promise of external rewards (Brahm, Jenert & Wagner, 2017; Lucas & Tan, 2013).
These significant differences between social work and business students appear to
reflect the previously-reported core personality characteristics of business students: low
levels of openness and agreeableness, and a high level of extraversion (Lounsbury, Smith,
Levy, Leong & Gibson, 2009). More specifically, low openness appears to correspond to
high shame, low agreeableness appears to correspond to low self-compassion, and high
extraversion appears to correspond to high extrinsic motivation. However, the originality of
the findings from the current study is that it appears to specifically be self-reflected shame
(i.e., worries about their self-image) that contributes to overall levels of high shame of
business students. Therefore, business students’ unrealistically high self-image (Mayo,
Kakarika, Pastor & Brutus, 2012) coupled with a tendency to be narcissistic (Westerman,
Whitaker, Bergman, Bergman & Dalya, 2016) may cause high reflected shame, leading to
low help-seeking in this student group. Future research could examine the relationships
between business students’ mental health constructs and personality traits in order to advance
understanding relating to the concomitants and determinants of mental health in business
The correlation analysis revealed that mental health symptoms were positively related
to mental health attitudes, extrinsic motivation, and amotivation, and negatively related to
self-compassion. Similarly, extrinsic motivation was more strongly related to all the
subscales of mental health attitudes and mental health symptoms compared to intrinsic
motivation. Consistent with established links between extrinsic motivation and reduced
mental health (e.g., Fernet 2013; Kotera et al., 2018; Raeissi, Raeissi & Shokouhandeh,
2014), these findings indicate that business students who are driven by external factors are
likely to be more at risk for mental illness and shame versus business students who are
intrinsically passionate about the subject. Indeed, according to a psychological justification
strategy proposed by Kotera, Adhikari, and Van Gordon (2017), externally motivated
students are less able to find any depth of meaning in their studies and thus have limited
capacity and tolerance for study-related adversity.
These relationships have not previously been explored in this student group and the
study findings indicate that it would be worthwhile to formulate and/or evaluate interventions
aimed at cultivating intrinsic motivation in business students. An example of such an
intervention might be the Disney strategy – modelled from how Walt Disney achieved his
dreams, accessing the dreamer, realist, and critique position with a certain cognitive mode
and body movement (Dilts, 1998) – that has been shown to help other student groups identify
with their inner passion and augment intrinsic motivation (Kotera & Sheffield, 2017).
Consistent with previous studies in student samples that have demonstrated the
importance of self-compassion as a protective factor for mental illness and psychological
distress (Neely et al., 2009; Ying, 2009), the multiple regression analysis revealed that self-
compassion was the only significant explanatory variable for mental health symptoms. The
moderation analysis added further depth to this observation and revealed that business
students’ mental health attitudes moderated the relationship between self-compassion and
mental health symptoms. More specifically, the effects of self-compassion on mental health
reduced as negative mental health attitudes increased.
Although the impact of mental health attitudes and self-compassion on mental health
have been previously reported (Hazzouri, Carvalho & Main, 2015; Neely, Schallert,
Mohammed, Roberts, & Chen, 2009; Ying, 2009), a mediation analysis examining the
mechanisms of how these constructs relate to each other has not been conducted to date.
Based on the findings from the present study, it may be helpful to integrate self-compassion
training into higher-education business studies curricula, as it can lead to better self-care and
mental health (Dunne, Sheffield & Chilcot, 2016). For example, embedding such training in
the orientation phase of a study programme may be an effective means of building resilience
in respect of the psychological stress likely to be encountered during the forthcoming
semester (Law, 2010). The precise content and format of such training could be informed by
the knowledge contribution made by the present study, which is that training effectiveness
will likely be undermined if business students view mental health problems as shameful
and/or believe that their family and peers have a similar outlook towards mental health
problems. Furthermore, providing self-compassion training may also benefit business study
faculty members because (i) mental health issues such as anxiety have also been observed in
this tutor group (Ameen, Guffey & Jackson, 2002), and (ii) enhanced compassion is related to
reduced mental health problems in university teachers (Jennings & Greenberg, 2009). Thus,
outcomes form this study suggest that examining the effects of self-compassion training in
business schools would be a worthwhile future research project.
There were several limitations to this study. Firstly, students were recruited via
opportunity sampling, which hinders the generalisability of the study findings. Furthermore,
participants were recruited from a single academic institution, thus findings may not
generalise to other higher education establishments. Secondly, although the comparison with
UK social workers helped to contextualise the characteristics of UK business students, future
research could compare findings with students from more diverse subjects and countries (as
well as with UK business workers). Finally, the causal direction of these effects has not been
investigated. A longitudinal study would help to elucidate the temporal patterning of the
observed relationships and to develop interventions accordingly.
Poor mental health of UK business students appears to be exacerbated by their
negative attitudes towards mental illness, causing help-avoidance. Though there is increasing
awareness of the seriousness of student mental health issues in UK higher education, this is
the first study to explore the relationship between mental health attitudes, mental health
symptoms, motivation, and self-compassion in UK business students. The four hypotheses
tested in this study were moderately supported: (i) self-reflected shame was higher in
business students than social work students but not significant difference was observed in the
other mental health attitudes subscales (H1 partially supported), (ii) mental health attitudes,
mental health symptoms, motivation, and self-compassion were overall related to each other
within the business students sample (H2 largely supported), (iii) self-compassion was the
only significant explanatory variable for mental health symptoms (H3 partially supported),
and (iv) self-compassion mediated the relationship between mental health and attitudes
towards mental health (H4 supported). Consequently, intervention studies evaluating the
effects of self-compassion training and intrinsic motivation training on the mental health
symptoms of UK university business students appear to be warranted.
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