The World Health Organization indicated that mental health conditions among young adults is one of the global areas of concern, with depression being the third leading condition and suicide being the second leading cause of death among individuals aged between 15 and 29 . Depression, anxiety, and stress are the common issues that affect the well-being of students , with depression and anxiety being particularly prevalent among college students [3, 4]. In Malaysia, the number of university students with mental health conditions has risen remarkably over the past few years; specifically, the number of people living with depression has doubled and suicidal symptoms among students has tripled over the same period .
The onset of most mental health disorders is during young adulthood . Various studies have reported that 40 million of adults in the United States have anxiety disorder, of which 75% of them experienced their first episode by age 22, a typical college age , and over half of college students in the country had at least one mental health problem . Similarly, more than 20% of university students in Hong Kong live with either depression, anxiety, or stress . In Malaysia, 29.2% of Malaysian adults have reported some form of mental health conditions compared to 10.7% in 1996, suggesting that prevalence rate has doubled over that period  . The Malaysian Mental Healthcare Performance: Technical report 2016 indicated further that younger adults who experienced emotional issues has increased to 29.2% in 2015 with depression (17.7%), anxiety (39.5%), and stress (10.1%) being the top three mental health conditions reported by 25,507 students nationwide [10, 11]. Furthermore, these students are also at high risk of developing suicidal behaviour , and exhibit poor academic performance .
As such, with almost 1.3 million Malaysian youths in college or university , studies on mental health conditions and the well-being of students are significant and crucial to promote positive mental health among college and university students .
Depression, anxiety, stress, and SWL
Students are typically young adults who are susceptible to positive and negative affective conditions that determine their state of happiness or well-being. Their wellness motivated the current study to focus on the effects of negative affective conditions, specifically depression, anxiety, and stress, on satisfaction with life (SWL). To ensure mental health wellness in students, universities typically monitor the students’ mental health continually and systematically by conducting surveys from time to time. Universities are able to assess the mental well-being of their students and also use the survey results to assist them in improving the viability of their existing counselling programmes .
One past study indicated that severe levels of depression, anxiety, and stress are strongly associated with low life satisfaction among university students . These negative affective conditions—depression, anxiety, and stress—are not healthy emotional symptoms and may affect the subjective well-being of individuals. Well-being comprises affective and cognitive components . This study focused on the latter as young adults who are Generation Z – those aged between 5 to 25 - grow up online and a tech-savvy. They seem well connected virtually, enjoy digital lives and longing for connection, sense of belongingness and interpersonal needs .
Most of the research found that university students’ satisfaction with life and have negative correlation with depression. Their findings suggest that to improve the satisfaction with life is to focus on the effective intervention and manage depression issue among the university students [19, 20].
In addition, greater anxiety is associated with greater depressive symptoms  where individual reported greater self-criticism, hypervigilance of cues of disapproval from people in their surroundings, and feelings of unworthiness of love. Tsitsas, Nanopoulos and Paschali (2019) also indicated that university students score higher in life satisfaction when their anxiety scores are low . Their result suggested a negative association between the life satisfaction and anxiety. On another note, Boyraz et al.  found significant association between authenticity, life satisfaction, and decreased distress.
In some research, university students who experience higher depression, anxiety and stress in life have lower level of life satisfaction , . These negative association are in line with a systematic literature review that stated quality of life among university students have negative correlation with stress. The factors highlighted were burnout, sleep disturbances and depression escalate the negative association with quality of life .
Thus, based on the reviews aforementioned, we hypothesised that:
H1: Depression is negatively associated with SWL.
H2: Anxiety is negatively associated with SWL.
H3: Stress is negatively associated with SWL.
The role of interpersonal needs and SWL.
According to Maslow’s hierarchy of needs theory , individuals strive to fulfil their basic needs, such as physiological needs and safety needs, before striving to achieve their belongingness needs, esteem needs, and self-actualisation needs. University students fulfil their belongingness needs through their interpersonal relationships. They are in the developmental stages of “identity versus role confusion” and “intimacy versus isolation” as suggested by Erikson . They are developing their self-identity and achieving a feeling of belongingness, which comes from interacting with and being acknowledged by the individuals around them, contribute to this development. Failing to form close social interactions, on the other hand, would instead trigger the feeling of thwarted belongingness. Students need interpersonal attachments with their social circle to create a sense of belonging that contributes to their development.
Thwarted belongingness is categorised as social or belongingness needs, the third level of the five levels of needs in Maslow’s hierarchy . To do well academically, which is related to esteem needs, students need to fulfil their social needs beforehand . The present of such a void induces students to form self-criticism and feelings of unworthiness which contributed to the development of anxiety and depressive symptoms . Øverup (2017) study also presented the importance of interpersonal needs, specifically perceived belongingness and perceived burdensomeness in mediating the relationship between anxiety and depressive symptoms. Thus, this present study posited that students are hindered from achieving a higher level of the self if their belongingness needs are not fulfilled- making the thwarted belongingness a moderator in this study. This further increases their chances of experiencing depression, anxiety, and stress, which have a reverse effect on their academic performance .
Perceived belongingness occurs in relationships with others and it is inclusive of perceived burdensomeness and thwarted belongingness. These factors are found to have important associations with suicidal ideation among college students . Stressful life events experienced during young adults could be overwhelming and students who are able to adjust their assumptions about the world and their self-identity face less suicidal risk. Students have decreased suicidal risk is even when they perceive burdensomeness and lack of belongingness. Thus, it is possible to make meaning of stressful life events, eventually free from depression and anxiety. The meaningful transformation would eventually and indirectly increase the students’ SWL. Although Van Orden et al.  proposed that unmet interpersonal needs contribute to suicidal ideation, our study focuses on SWL instead of suicidal ideation because the sample of university students in this study exhibit neither high clinical severity nor high suicidal risk. The study posits that satisfaction with perceived belongingness would lead to SWL- making perceived belongingness the moderator.
In the current study, interpersonal needs refer to individuals’ desires and comprises perceived burdensomeness and thwarted belongingness. There is scarce research in this area that examines these factors among university students as most studies are on psychiatric patients [32, 33]. According to Van Orden et al. , both perceived burdensomeness and thwarted belongingness are pivotal constructs and considered to be the most proximal interpersonal needs that lead to suicidal ideation. Other constructs, such as mental health conditions and stressful life events, are comparatively more distant in the risk chain of suicidal ideation. Perceived burdensomeness and thwarted belongingness, fortunately, are postulated as dynamic and obedient to therapeutic change. In view of that, both constructs are viable moderating variables to explain how the relationship among depression, stress, anxiety, and SWL changes among individuals with low or high interpersonal needs.
Perceived burdensomeness is an individual’s mental state that perceives himself or herself as a burden to others. Such a mental state, of perceiving that others would “be better if I were gone”, is a result of an unmet social ability. This mental state explained the role of individuals’ innate need for connection and relatedness in allowing them to grow and become competent in managing their life . Van Orden et al.  pointed out that the perception of being a burden to others can be induced by multiple factors, including functional impairment [35-37], unemployment , and family discord . These factors induce perceived burdensomeness, which could lead to lower SWL among young adults who may or may not have experienced symptoms of depression, anxiety, and stress.
Thus, we hypothesised that:
H4: Perceived burdensomeness moderates the relationship between depression, anxiety, and stress on SWL.
H5: Thwarted belongingness moderates the relationship between depression, anxiety, and stress on SWL.
Many studies have explored the relationship between various psychological variables, such as depression, stress, anxiety, and SWL [40-45]. However, few studies have examined the role of interpersonal needs such as thwarted belongingness and perceived burdensomeness as the moderating factors in the relationship among depression, stress, anxiety, and SWL of university students. Our study aims to discover whether interpersonal needs will moderate the relationship among depression, anxiety, stress, and SWL of university students in two private universities in Malaysia. Perceived burdensomeness and thwarted belongingness act as the constructs of interpersonal needs.
Our research framework is illustrated in Figure 1.
INSERT FIGURE 1 HERE