Depression and Anxiety among Asian Americans: The Effects of Social Support and Strain

Background and Purpose: Social support is generally believed to be a fundamental aspect of psychological well-being and the therapeutic process. Yet, social strain rooted in the same support networks may contribute to poorer mental health outcomes. Furthermore, research suggests support and strain may differentially affect men and women. Finally, although recent research suggests social networks and the ways individuals utilize these networks may vary by culture, studies on diverse communities, such as Asian Americans, are limited. This purpose of this study is to examine how the support and strains individuals derive from their social networks may be related to both depressive disorder and anxiety disorder among Asian American men and women. Based on extant research, the relationship between variables are hypothesized as follows: 1) Social support is negatively associated with disorder; 2) Social strain is positively associated with disorder; and 3) Gender moderates the effect of both support and strain on disorder, such that support is less protective and strain more debilitating for women.

Methods: Data come from the 2002-2003 National Latino and Asian American Study (NLAAS), the first nationally representative study of mental health outcomes among Asian Americans. The analysis was weighted and restricted to data on Asian American respondents (N=2006). The ethnic groups represented were Chinese (29%), Filipino (22%), Vietnamese (13%), and other smaller groups (37%), including Sri Lankans, Japanese, Koreans, and Native Hawaiians. About half of the sample was female (53%). Social support measured the degree to which respondents relied on family and friends; social strain measured the frequency of conflicts and demands with family and friends. One-year prevalence rate of Major Depressive Disorder and General Anxiety Disorder were based on the World Health Organization's (WHO) expanded version of the Composite International Diagnostic Interview (CIDI). Logistic regression analyses were conducted to describe the association of social support and social strain with DSM-IV criteria for Major Depressive Disorder or Generalized Anxiety Disorder.

Results: Social support was not associated with DSM-IV criteria for Major Depressive Disorder or Generalized Anxiety Disorder among men or women. Additionally, social strain was associated with increased odds of Major Depressive Disorder equally among both men and women. However, strain was associated with Generalized Anxiety Disorder among women, but not men.

Conclusions and Implications: In contrast to most large-scale studies demonstrating a relationship between social support and mental heath outcomes, this study found that social support may be less beneficial for Asian Americans. The findings also affirm the need to consider the influence of strain from social networks, with attention to potentially stronger effects of strain for women. Mental health interventions aimed at enhancing social support among individuals with depression and anxiety may be more effective by also alleviating social strain.