Everyday Discrimination, Psychological Symptoms, and Coping Strategies: Factors Associated with Alcohol-Related Problems Among Southeast Asian Refugees

Background: Past alcohol-related studies among refugees suggest that typical refugee-related experiences, such as trauma and psychological stresses, are significant risk factors, especially among men. Among the Southeast Asian refugees, in particular, alcohol-related problems have been reportedly exacerbated by eventual acculturation to the US drinking culture. However, due to the stereotypical perception that Asian Americans, in general, have low prevalence rates as well as the lack of perceived need for specialized alcohol treatment, there have been few studies that examined the factors impacting alcohol-related problems in Southeast Asian communities in the US. Alcohol-related problems may pose greater challenges in the future if not assessed and treated promptly and appropriately. This study helps to fill the gap by examining psychosocial and coping factors associated with alcohol-related problems among recently resettled refugees from Burma.

Method: Recently resettled refugees from Burma living in Western New York were recruited using a snowball sampling approach. A total of 256 individual interviews were conducted in various languages by native-speaking bilingual interviewers. We used Alcohol Use Disorder Identification Test (AUDIT; M=2.055, range=0-25) to assess alcohol-related concerns. A linear regression analysis was used to model alcohol-related concerns using the following set of variables: Sociodemographic (control) factors included sex (male=1), education (0=less than HS, 1=GED, 2=AA or more), and ethnicity (0=Burmese, 1=Karen, 2=Other Burmese); pre-resettlement factor included length of camp stay (0=none, 1=1-10yrs, 2=10+yrs); psychological symptoms included trauma (RHS; M=10.51, range=0-50), anxiety (HSCL Anxiety subscale; M=1.44, range=1-4), depression (HSCL Depression subscale; M=1.50, range=1-5), everyday discrimination (EDS; M=0.57, range=0-3.89); and five subscales of coping with discrimination strategies (CDS_Education/Advocacy, M=2.11, range=1-6; CDS_Internalization, M=2.11, range=1-3.8; CDS_Drug/Alcohol, M=1.58, range=1-6; CDS_Resistance, M=1.79, range=1-4.6; CDS_Detachment, M=3.04, range=1-6).

Results: Descriptive analysis showed that the mean AUDIT score was 2.05. The results of the OLS linear regression showed that AUDIT was significantly associated with being male (b=3.97; p<0.001), trauma (b=-0.94; p<.05), anxiety (b=1.95; p<0.05), CDS_Drug/Alcohol (b=1.50; p<0.001), CDS_Resistance (b=0.90, p<0.01), and CDS_Detachment (b=0.83, p<0.01). The final model explained approximately 41.5 percent of the variance in the sample. In addition, post-hoc interaction analyses revealed that ethnicity significantly interacted with length of camp stay in predicting alcohol-related concerns.

Conclusion and Implication: This study’s results confirmed the gendered pattern of alcohol-related concerns among recently resettled refugees from Burma. While anxiety symptoms were significantly and positively associated with alcohol-related concerns as suggested in the past literature, trauma symptoms were significantly but negatively associated with the outcome, which requires a closer examination of the mechanism behind the unexpected outcome. In addition, as expected, the coping style favoring drug/alcohol use was significantly and positively associated with the outcome, along with the coping styles favoring resistance and detachment. The findings highlight a not-so-straightforward impact of psychological symptoms and coping styles and point to paying thoughtful attention to addressing alcohol-related concerns among recently resettled refugees from Burma.