Pick Your Poison: The Differential Effects of Discrimination, Financial Strain, and Acculturative Stress On the Mental Health of Asian Americans

Although for many years there was a dearth of rigorous empirical data on Asian American mental health, the recent release of nationally representative data on this population allows for an enhanced understanding of the correlates of psychological distress in this under-studied population. Extant literature has yielded mixed, and sometimes contradictory, results in regards to Asian subgroups that may be at higher risk of serious psychological distress; generalized prevalence rates tend to obscure the specific processes by which Asian-origin adults experience psychological impairment (Abe-Kim, 2007; Takeuchi, 2007). Several scholars have examined the detrimental impact that various types of stressors, such as those related to discrimination, acculturation, and financial strain, have on the psychological outcomes of Asian adults (Hahm, 2010; Oh, 2002; Takeuchi, 2002; Takeuchi, 2007). However, these studies primarily examine the direct effects of demographic and stressor variables on distress. Few, if any, have investigated how demographic factors and stressors might combine to impact psychological distress. Therefore, this presentation will use structural equation modeling techniques to examine the pathways whereby demographic factors contribute to Serious Psychological Distress via three distinct types of stress by examining both direct and indirect relationships among these variables.

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.