Major Depression, Discrimination, Acculturation, and Differential Protectors of Major Depression in Major Asian-American Subgroups: A National Study

Background: Asian Americans (AA) constitute the fastest growing ethnic minority group in the US, with approximately 17.3 million accounted for in the latest US Census.  Yet, this population includes persons with heterogeneous cultural and ethnic backgrounds that impose significant impacts on their mental health. Only recently researchers have begun to examine differential risk factors and protective factors for major subgroup AAs nationwide. Based on their different cultural backgrounds, including immigration stressors, we expected varied roles for some known predictors of major depression in these subgroup AAs. Method: Using the first national sample from the National Latino and Asian American Study (NLAAS), we explored the direct effect of racial identity, alongside other known protectors (social support and religious attendance) on major depression in Chinese, Filipino, and Vietnamese Americans (n=2095), controlling for demographics, discrimination, and acculturation factors.  Results: Chinese are most likely to suffer from major depressive disorder (5.3%), followed by Filipinos (4.3%) and Vietnamese (3.3%). Filipinos, as the most acculturated subgroup experienced the highest levels of Discrimination but reported the highest levels of social support; followed by Chinese. Filipinos, almost all Catholics, also reported the highest levels of religious involvement. Not surprisingly, Vietnamese reported the highest level of Acculturation Stress, closely followed by Chinese. Bivariate correlations for Depression showed considerable inter-group variation. Age correlated negatively with Depression for Chinese and Filipinos. Employment was correlated negatively with Depression in Chinese and Filipinos. Both English Proficiency and being US Born were correlated negatively with Depression only in Chinese. Discrimination was related to Depression in Vietnamese and Filipinos. Finally, Social Support correlated negatively with Depression in Chinese and Vietnamese. Hierarchical logistic regression models associated Female gender, US-Born and Racial/Ethnic Identity with major depression in Chinese. Social Support reduced their likelihood of depression by 70% (p<.01). In Filipinos, however, English Proficiency (p<.01) and Racial/Ethnic Identity (p<.05) were inversely linked with major depression, whereas higher education and discrimination predicted the likelihood of a diagnosis. In Vietnamese, each one-level-increase in Religious Attendance reduced the likelihood of major depression by 47% (p<.05), while Social Support reduced the likelihood by 89% (p<.001).  Discussion and Conclusion: In contrary to the empirical finding in other populations, based on Social Identity Theory and Religious Support Theory, our findings do not lend overall support for the protective effect of Racial/Ethnic Identity, Social Support, and Religious Involvement in all Asian Americans. The differential finding should be understood within their unique cultural and immigration contexts and different immigration history. These background experiences may in turn affect the meaning of their acquired minority identity in the US in generation of immigration and the varied function of social support and religious participation. More in-depth research should address alternative assumptions to enrich social work intervention with subgroup AAs and social science theories.