Asian American Cultural Factors and Anxiety Disorders

Purpose:Studies have highlighted the dearth of information on the mental health of Asian Americans (AA), the fastest growing racial/ethnic minority group in the US. As AA populations largely consist of immigrants, acculturation factors were mostly studied and verified as the risk factors of their mental health issues. Meanwhile, the sociocultural factors of Asian Americans, distinct from the majority Whites, were overlooked. In addition, Asian Americans are consisted of more than 25 subgroups with heterogeneous cultural/ethnic heritages and historic background, thus there is a necessity to address group variations in the studies. In response to this call for action, this study explored the protective role of the sociocultural factors (Racial/ethnic identity, Family cohesion, Religiosity) in Anxiety Disorders (Agoraphobia, Social Phobia, Panic Attack, Panic Disorder, Post-traumatic Stress Disorder, General Disorder), diminishing the deleterious role of discrimination.

Methods:Using the National Latino and Asian American study, the first national epidemiological household survey of the AAs, this study examined the contributions of sociocultural factors to the diagnosis of Anxiety Disorders among Chinese, Vietnamese, Filipinos and other Asian subgroups (N=2095). In addition to the demographics (gender, age, and education) and socioeconomic status (income and employment), acculturation predictors (English proficiency, birthplace, years in the US, acculturation stress, and discrimination), and medical conditions (substance related disorder) that were reported to be predictors of AAs’ mental health, were accounted for. Two step logistic regression analysis was conducted for each subgroup.

Results: Overall, the variables of major interests and the controlled variables showed different pattern of relationships among the different subgroups. In the first step of the logistic regression analyses, having substance related disorder (all groups except from Vietnamese), Discrimination (all groups except from Chinese), Acculturation stress (Vietnamese) were positively associated with the chance of having any type of anxiety disorder. However in step 2, different social/cultural factors acted as protectors against the influence of the risk factors. While none of the protective factors had significant impact on Anxiety disorders of Chinese, the negative impact of substance related disorder faded away. The negative impact of discrimination in Filipinos was diminished while racial/ethnic identity played a protective role. Family cohesion had the most powerful effect in buffering the influence of acculturation stress in Vietnamese. In other subgroups, family cohesion and religiosity were the protective factors.

Conclusion and Implications: Since the release of the NLAAS, studies have examined predictors for the mental health conditions of AAs at the national level. However, generalizing the findings of such studies to the entire population of many subgroups with different immigration history, language, and culture. Our findings raises caution of reinforcing uniform policy and treatment strategies for effectively treating Anxiety Disorders of Asian Americans. Based on cultural psychologists’ framework, the inconsistent findings suggest various approaches according to the sociocultural contexts of each subgroup.

Keywords: anxiety disorders; racial/ethnic identity; family cohesion; religiosity; discrimination and acculturation stress; sub-cultural differences; Asian American subgroups, NLAAS