Stress, Vulnerability and Protection in Mental Health Risk Among Chinese University Students: A Grounded Theory Study

Many correlates of poor mental health at university are known, but not why students in the same cohort fare so differently. This study aimed to derive a testable account of how mental health risk forms among university students. A grounded theory study combining Strauss–Corbin coding procedures with a constructivist stance was conducted at three universities in China in 2025. Forty participants (19 students, 14 school psychological counsellors and 7 student affairs counsellors) were interviewed in Mandarin (1253 min), and transcripts were coded at open, axial and selective levels in NVivo 12. Rigour was supported by triangulation, double-coding, member checking and negative case analysis. Coding yielded 82 initial categories, consolidated into 14 subcategories under three main categories: environmental stressors (S), vulnerability traits (V) and protective factors (P); 72.0% of categories were raised by all three informant groups. The core category was risk generation under stressor–vulnerability–protection interaction. Three contextual findings qualified existing frameworks: compressed microsystems, elements acting as both demand and resource, and a secondary pathway from impulsive conduct through institutional sanction to damaged standing. The resulting S–V–P model separates buffering of stress from compensation for vulnerability, distinguishes four levels of vulnerability, and places outcomes at both symptom and well-being poles. It is a context-specific, hypothesis-generating framework that awaits quantitative testing.