Cara S. Maffini

The Racial-Cultural Framework: A Framework for Addressing Suicide-Related Outcomes in Communities of Color

Suicide-related outcomes are a major public health challenge in communities of color in the United States. To address these challenges, this Major Contribution makes theoretical, empirical, and practice-related contributions to scholarship on suicide-related outcomes among people of color. In this article, the authors present a new framework to conceptualize previous suicidology scholarship, address existing literature gaps, and inform counseling psychologists’ future work on suicide-related outcomes in U.S. communities of color. The framework consists of three components and nine principles that highlight the types of constructs, populations, and preventive interventions that should be emphasized in theory, research, and practice addressing suicide-related outcomes in communities of color. The authors explain why suicide-related outcomes in communities of color deserve attention, describe the framework, and discuss implications of the framework for future practice and training. It is hoped that this framework can serve as a resource and impetus for new paradigms of suicidology work in communities of color.

Asian International Students’ Mental Health-Related Outcomes: A Person × Context Cultural Framework

Guided by a Person × Context cultural framework, this is the first known study to examine the relationship between cultural values and mental health-related outcomes (depressive symptoms and professional psychological help seeking) across diverse interpersonal contexts. Using a quasi-experimental research design, 465 Asian international college students were randomly assigned to report their adherence to the Asian cultural values of emotional self-control and humility during interactions with (a) their families of origin, (b) peers from their country of origin, or (c) American peers. Humility was positively associated with depressive symptoms only during interactions with nonfamily members, and not with family members. Emotional self-control was negatively associated with attitudes toward seeking psychological help only during participants’ interactions with members of their country of origin. Humility was negatively related to psychological help seeking only during participants’ interactions with nonfamily members.

Assessing Somatization with Asian American Clients

This chapter examines the assessment of somatization with Asian-American clients, who have been traditionally identified as a group that is more likely to present with somatic symptoms as indicators of emotional distress. Somatization refers to physical symptoms that are often manifestations of psychological and emotional distress. In this chapter, we discuss what somatization is, why it occurs among Asian-American clients, and what clinicians can do to assess this symptom presentation. We examine three clusters of somatization: somatoform disorders, culturally bound somatic syndromes, and somatic symptoms. We discuss possible reasons Asian-Americans somaticize including a conceptualization of mind and body as integrated, stigma associated with mental health, and culturally sanctioned values regarding emotional expression. We then examine how to work with clients with these presentations and review assessments created specifically for Asian-American populations as well as more general assessments of somatization normed with Asian-American samples. Finally, we discuss implications for practice and research so as to further develop culturally appropriate assessments and interventions with Asian-American clients.

Quality Improvement in University Counseling Centers

ABSTRACT University Counseling Centers (UCCs) experience high clinical demands and severe client presentations leaving counselors with limited time and resources to evaluate delivery of services. In this article, we present clinician-friendly quality improvement (QI) strategies used at a large Midwestern university and provide recommendations for implementing QI programs at other UCCs even as their resources may vary. With counselor-led efforts examining and evaluating services, UCCs can use QI programs to inform and improve counseling practices as well as advise university administrators about the positive outcomes of the center’s work.

Overcoming a Legacy of Conflict: The Repercussive Effects of Stress and Intergenerational Transmission of Trauma Among Vietnamese Americans

ABSTRACT The modern narrative of Vietnamese people is often strongly associated with events of the 20th century, such as the Vietnam War, but a legacy of strife in Southeast Asia spans many centuries. Enduring stress and trauma has pernicious psychological and physiological repercussions that have affected first and later generations of Vietnamese American refugees. To contextualize the present-day narrative, we review the history of Vietnam and the contemporary refugee experience in the United States. We then examine more proximal spheres of influence, including community and family. Finally, we review individual experiences of stress and trauma. We present recommendations to inform individual, group, family, and community-based counseling interventions, as well as recommendations for future research.

Campus Safety Experiences of Asian American and Asian International College Students.

Using a subsample from the American College Health Association–National College Health Assessment data set collected in 2014 (N = 2,385), this study examines experiences of victimization and campus safety among Asian American and Asian international undergraduate students. Findings indicate that both groups experience more verbal threats than other forms of victimization. Most students reported feeling safe on campus during the day; however, both groups had higher rates of people reporting that they feel unsafe on campus and in the community surrounding the campus at night, with significantly more Asian Americans reporting these experiences than Asian international students. Logistic regressions examining the impact of victimization and safety on mental health (anxiety, depression, and suicidality) reflect between- and within-groups differences for these 2 groups. The impact of Asian Americans’ experiences of victimization and safety was evident across all 3 mental health outcomes. Among Asian international students, having been in a fight significantly predicted anxiety. Findings from this study can be used to begin to inform campus-wide efforts to help Asian American and Asian international students feel safer.

Gendered Racism Scales for Asian American Men: Scale development and psychometric properties.

The Gendered Racism Scales for Asian American Men (GRSAM) was developed to assess the frequency and stress level of gendered racism perceived by Asian American men. The development of the new measure was grounded in the Intersectional Fusion Paradigm. This paradigm explains individuals’ experiences of discrimination based on unique combinations of multiple interlocking identities that individuals experience simultaneously. In mixed samples of college students and community adults, GRSAM’s factor structure as well as evidence of convergent validity, criterion-related validity, discriminant validity, incremental validity, internal consistency, and test–retest reliability was examined. Exploratory factor analyses revealed three dimensions of GRSAM: Psychological Emasculation, Perceived Undesirable Partner, and Perceived Lack of Leadership. Confirmatory factor analyses demonstrated that a bifactor model was a better fit to the data than a correlated three-factor model and a higher-order model. Results of correlation and regression analyses further provided evidence for different aspects of construct validity and internal consistency. Both the Frequency and Stress versions of GRSAM positively predicted psychological distress and somatic symptoms above and beyond the effects of general racism experienced by Asian Americans and masculine gender role stress.

Fighting and Bullying Among Asian Americans and Latinos Testing the Roles of Self-Efficacy, Ethnic Identity, and Ethnicity

This study examined ethnicity and ethnic identity (EI) as moderators in the relationship between self-efficacy (SE) and fighting and bullying. We sampled 315 Asian American and Latino early adolescents residing in an urban community. Results demonstrated that Latinos and male participants were more likely to engage in fighting and bullying than Asian Americans and females. Ethnicity and EI moderated the relationship for SE and fighting but not for SE and bullying. Findings suggest that EI and SE may serve as psychological resources that help reduce violence for Asian American and Latino early adolescents in more nuanced ways than previous research has shown. These findings address some of the conflicting findings regarding the role of EI in violence and bullying and suggest these behaviors may depend on the relationship between ethnicity and EI.

Feeling Unsafe at School: Southeast Asian American Adolescents' Perceptions and Experiences of School Safety

School safety impacts mental health and educational attainment particularly among vulnerable populations such as refugee youth. Using data from the Children of Immigrants Longitudinal Study (CILS), this study examines the mental health impact of perceptions and experiences that compromise school safety among Southeast Asian American adolescents (N = 645). Higher rates of perceptions and experiences that violated students’ feelings of safety at school were associated with decreased selfesteem and increased levels of depressive symptoms. Hierarchical regressions indicate that in light of perceptions and experiences of feeling unsafe at school, bicultural orientation, importance of identity, and family cohesion have an additive effect in predicting self-esteem and family cohesion has an additive effect with depressive symptoms though no moderation effects were found. Violence and bullying in schools contributes to lasting mental health repercussions and suicidality and has elicited increased attention by media, policy makers, school administrators, educators, psychologists, and parents. Fears of being bullied and feeling unsafe at school are leading causes of students missing school (Kearney, 2008) and can have psychological consequences enduring through the lifespan (Turner, Finkelhor, & Ormrod, 2006). Though all students may be at risk of feeling unsafe at school, some populations such as refugees may be more vulnerable to these experiences. Southeast Asians including Vietnamese, Cambodians, Laotian, Hmong, and Iu Mien sought refuge in the U.S. beginning in 1975 with the fall of Saigon and the uprising of oppressive regimes in Southeast Asia (Chung & Okazaki, 1991; Hsu, Davies, & Hansen, 2004; Takaki, 1998). Southeast Asian Americans’ experiences are framed within the context of war and enduring trauma. Often swept under the umbrella of the “model minority,” their unique stressors are often overshadowed by perceptions of their inherent intelligence and success (Cooc & Gee, 2014; Ngo & Lee, 2007). Factors such as premigration trauma, intergenerational transmission of trauma, and disrupted familial and community relationships associated with the war and subsequent migration have a lasting impact on mental 1 Maffini: School Safety Published by Purdue e-Pubs, 2016 Maffini — Feeling Unsafe at School health, educational, and socioeconomic outcomes of Southeast Asian Americans (Chung & Bemak, 2007; Ying & Han, 2008; Kim-Ju, Maeda, & Maffini, 2009; Marshall, Schell, Elliott, Berthold, & Chun, 2005). According to the U.S. Community Survey (2014), poverty rates among Southeast Asian American groups are higher than the national average and educational attainment is lower. This study aims to better understand factors that contribute to Southeast Asian American students feeling unsafe at school and how those experiences impact mental health. Furthermore, this study examines the protective roles of culturally salient variables—bicultural orientation, ethnic self-identification, and family cohesion. Greater understanding of experiences of school safety can better inform policy and prevention programs addressing the specific needs of Southeast Asian American youth.