Methods: Data for this presentation come from the Asian sub-sample of the National Latino and Asian American Survey (NLAAS), the first national epidemiological study of Asians in the U.S. Data was collected from 2095 Asian adults recruited in 2002 and 2003 (details of the study and sample can be found in Alegria, 2004; Heeringa, 2004; and Pennel, 2004). Serious Psychological Distress was measured using the K10, a 10-item inventory asking respondents about their frequency of symptoms including feeling “depressed,” “tired,” and “nervous.” Stress was measured using three summary scores, with higher scores indicating more stress: Financial Strain (two-item composite, range: 0-6); Everyday Discrimination (nine-item composite, range: 9-54); and Acculturative Stress (an index of nine dichotomous (yes/no) items, range: 0-9). Sociodemographic variables included gender (0=male; 1=female), nativity (0=native-born; 1=foreign-born); and age, educational attainment, and income coded continuously. Analysis methods included confirmatory factor analysis and structural equation modeling.
Results/conclusions: Initial results indicate a strong role of all three stressors as contributors to and mediators of psychological distress. The associations of the demographic variables with distress were often more indirect than direct. For example, education did not have a significant direct effect on distress; however, education had indirect effects on distress via its positive effect on discrimination and negative effects on financial strain and acculturative stress. Similarly, nativity had a contradictory influence on distress: being foreign-born increased acculturative stress (which contributed to higher distress) but decreased perceived discrimination (which decreased levels of distress). These complex relationships would have been obscured in a direct effects model, such as linear regression analysis, potentially leading to the erroneous conclusion that education and nativity are not associated with psychological distress in this population. Findings demonstrate the importance of considering heterogeneity within the Asian American population as well as how various types of stressors differentially impact serious psychological distress among this group.