Adverse Mental Health Outcomes Associated with COVID-19 Outbreak Related Quarantine in the Asian Population of the United States

Background/Significance: The Asian community had been socially linked to the virus due to the Asian origin of COVID-19. Paired with general stressors related to the pandemic such as isolation, the Asian community has had a disproportionate number of stressors such as the anti-Asian attacks, increased micro-aggressions, and threats to their immigration status.

The Current Study: This study analyzed scarcity, familial structure, mental health discussions within the community, immigration, micro-aggressions, and anti-Asian attacks (grouped as fear of extrinsic threats) within a group of 439 Asian Americans and compared them to 1059 Non-Asians. The specific hypothesis that was tested included:

Hypothesis 1: There will be significant differences in the response for each of the four scales between Asians and Non-Asians

Hypothesis 2: East Asians should endorse fear of extrinsic threats higher than other Asian groups.

Hypothesis 3: Lack of family and community support, increased fear of extrinsic threats and increased endorsement of scarcity should predict poor mental health outcomes.

Hypothesis 4: A previous diagnosis of mental illness, meaningful contacts with other individuals and lower household member numbers should act as a mediator in the relationship between the scales and poor mental health outcomes.

Methods: A cross-sectional study was conducted during the month of July 2020 through an online survey disseminated through social media and email list-servs. To compare the endorsements of the scales between the two groups, a MANOVA was conducted. Similarly, a MANOVA was conducted to detect whether the region of Asia was a significant factor in determining the endorsement of any of the four scales. Regression analysis was conducted between the different scales and the mental health scale to determine which factors most influenced negative mental health outcomes in this population. Finally, to determine the mediation, the R package psych was used to conduct a mediation analysis.

Results: The Asian community was more likely to have fear for extrinsic threats since the start of the COVID-19 outbreak. There was a significant association between negative mental health outcomes and these extrinsic factors for the Asian community (R² = 0.061, F = 29.27, β= 7.083, p = 0.000). Similarly, there was a significant association between endorsement of scarcity and negative mental health outcomes (R² = 0.0113, F = 6.022, β= 3.938, p < 0.05). There were no meaningful significant differences between region of origin in Asia and how the scales were endorsed. A previous diagnosis of a mental illness was a significant mediator for the association between fear of extrinsic threats and negative mental health outcomes and a significant mediator for the association between scarcity and negative mental health outcomes.

Conclusions: These findings indicate that the fear of extrinsic threats and scarcity as predominant issues facing the Asian community. These are important to take into account when treating these patients in a mental healthcare setting, especially given the current climate of rising anti-Asian hate crimes.