Rebecca Y. M. Cheung

Comparative stigma of HIV/AIDS, SARS, and Tuberculosis in Hong Kong

Abstract This study compares public stigma towards three types of infectious diseases— human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), severe acute respiratory syndrome (SARS), and tuberculosis (TB)—tests an attribution model of stigma, and explores the relationships between stigma and public attitudes towards government policies in Hong Kong. Using a population-based telephone survey, 3011 Hong Kong Chinese adults were randomly assigned to one of the three disease conditions and were interviewed about their attitudes and beliefs towards the assigned disease. Findings showed that public stigma was the highest towards HIV/AIDS, followed by TB and SARS. Using multi-sample model structural equation modeling, we found that the attributions of controllability, personal responsibility, and blame were applicable in explaining stigma across three disease types. Knowledge about the disease had no significant effect on stigma. Participants with less stigmatizing views had significantly more favorable attitudes towards government policies related to the diseases. The study is an important attempt in understanding the attributional mechanisms of stigma towards infectious diseases. Implications for stigma reduction and promotion of public awareness and disease prevention are discussed.

Anger suppression, interdependent self-construal, and depression among Asian American and European American college students.

The present study tested a theoretical model of emotion regulation (Yap, Sheeber, & Allen, 2007) in a sample of Asian American and European American college students (N = 365). Specifically, the mediating role of anger suppression in the effect of temperament and family processes on depressive symptoms was tested across race and levels of interdependent self-construal (a culturally based self orientation emphasizing connectedness with others). Next, the moderation of the suppression-depression relation was tested by race and interdependent self-construal. Results indicated that the hypothesized model fit well across Asian American and European American students, as well as those with high versus low levels of interdependent self-construal. Anger suppression was a significant mediator of the hypothesized indirect effects on depressive symptoms. Moreover, race and interdependent self-construal moderated the suppression-depression link, such that Asian American status and a stronger interdependent self-construal attenuated the relation between anger suppression and depressive symptoms. Understanding both universal and culture-specific aspects of emotion regulation in the development of depressive symptoms will be essential for sound theory, future research, and effective prevention and intervention efforts across diverse populations.

Self-stigma among concealable minorities in Hong Kong: conceptualization and unified measurement.

Self-stigma refers to the internalized stigma that individuals may have toward themselves as a result of their minority status. Not only can self-stigma dampen the mental health of individuals, it can deter them from seeking professional help lest disclosing their minority status lead to being shunned by service providers. No unified instrument has been developed to measure consistently self-stigma that could be applied to different concealable minority groups. The present study presented findings based on 4 studies on the development and validation of the Self-Stigma Scale, conducted in Hong Kong with community samples of mental health consumers, recent immigrants from Mainland China, and sexual minorities. Upon a series of validation procedures, a 9-item Self-Stigma Scale-Short Form was developed. Initial support on its reliability and construct validity (convergent and criterion validities) were found among 3 stigmatized groups. Utility of this unified measure was to establish an empirical basis upon which self-stigma of different concealable minority groups could be assessed under the same dimensions. Health-care professionals could make use of this short scale to assess potential self-stigmatization among concealable minorities, which may hamper their treatment process as well as their overall well-being.

Microalbuminuria and other cardiovascular risk factors in nondiabetic subjects

The association between urinary albumin:creatinine ratio and other cardiovascular risk factors such as age, blood pressure, obesity, glycemic indices, insulin and lipid profile was examined in a population in a Chinese community consisting of 795 men (mean age 35.8 +/- 8.8 yr) and 538 women (mean age 37.9 +/- 8.9 yr) with a normal glucose tolerance defined by WHO criteria. Men with a urinary albumin:creatinine ratio above the 90th percentile had higher systolic and diastolic blood pressures, fasting plasma glucose, 2-h glucose after a 75 g oral glucose load, and fasting serum insulin. Women with high urinary albumin:creatinine values had higher systolic and diastolic blood pressures, body mass index, waist-hip ratio, fasting insulin and triglycerides. Multivariate analysis showed that only systolic blood pressure and fasting glucose in men, and diastolic blood pressure and fasting insulin in women, independently contributed to urinary albumin:creatinine. When the effect of blood pressure was eliminated by excluding subjects with systolic blood pressure > 140 and diastolic > 90 mm Hg, only fasting insulin was associated with urinary albumin:creatinine in women. No associations were found for men. We conclude that microalbuminuria may be a marker for cardiovascular disease only because of its association with blood pressure in men, while in women, there is an additional independent association with fasting serum insulin.

Psychological Distress and Subjective Burden of Caregivers of People with Mental Illness: The Role of Affiliate Stigma and Face Concern

The present study tested the mediating role of affiliate stigma on the relationships between face concern with psychological distress and subjective burden among caregivers of people with severe mental illnesses. One hundred and eight Chinese caregivers in Hong Kong were surveyed. Based on Baron and Kenny’s (J Pers Soc Psychol 51:1173–1182, 1986) approach, affiliate stigma was found to serve as a partial mediator between face concern and caregiver distress and a full mediator between face concern and subjective burden. Cultural linkage of stigma and caregiver outcomes was identified, suggesting that researchers and practitioners should use a culturally sensitive approach to understand caregivers’ experience and alleviate their stigma.

Sense of Community in Hong Kong: Relations with Community-Level Characteristics and Residents’ Well-Being

Sense of community (SOC) has been one of the most studied topics in community psychology. However, no empirical study to date has investigated SOC in Hong Kong and its relations with community characteristics and residents’ psychological well-being. A representative sample of 941 Hong Kong Chinese based on a randomized household survey was conducted in all 18 districts in Hong Kong. Results of hierarchical linear modeling indicated that SOC was not associated with sociodemographic indicators on both the individual-level (i.e., gender, age, family income, education level, type of residence, and area-to-capita ratio of residence) and the community-level (i.e., proportion of individuals with tertiary education, median family income, ownership of residence, population density, and resident stability). SOC was negatively related to daily hassles and positively with social support and quality of life. Conceptualization of SOC in Hong Kong was discussed.

Maternal mediation of writing in Chinese children

Two scales of mothers’ mediation of their childrens writing based on Aram and Levin (2001) were developed and tested in 67 mother–child Hong Kong Chinese dyads in three grade levels – second-year kindergarten, third-year kindergarten, and first grade. With childrens ages, grades, and non-verbal IQs, as well as mothers’ education levels statistically controlled in a regression equation, the four strategies of the ‘Print Mediation’ scale, a measure of mother–child joint writing productions, explained a unique 10% of the variance in childrens word reading. These four strategies tended to change with age such that higher autonomy was more common among older children and lower autonomy was more prevalent among younger children. In a separate hierarchical regression equation, the ‘Literate Mediation’ scale, tapping specific writing strategies, explained a unique 8–11% of the variance in childrens word reading. A prevalence of copying strategies tended to be negatively associated with reading skill and a prevalence of morphologically based strategies tended to be positively associated with reading skill, even apart from age and grade level. Findings demonstrate some strong developmental trends in the writing process but also suggest that a more analytic approach to Chinese character writing may be helpful for literacy development, even among the youngest children.

The Role of Culture, Family Processes, and Anger Regulation in Korean American Adolescents’ Adjustment Problems

Using an ecologically informed, developmental psychopathology perspective, the present study examined contextual and intrapersonal predictors of depressive symptoms and externalizing problems among Korean American adolescents. Specifically, the role of cultural context (self-construals), family processes (family cohesion and conflict), and anger regulation (anger control, anger suppression, and outward anger expression) were examined. Study participants were N = 166 Korean American adolescents ranging from 11 to 15 years old (M = 13.0, SD = 1.2). Results showed that depressive symptoms were significantly associated with lower levels of perceived family cohesion, higher levels of perceived family conflict intensity, and higher levels of anger suppression. Externalizing problems were associated with male gender, a weaker interdependent self-construal, higher levels of perceived family conflict, lower levels of anger control, and higher levels of outward anger expression. The distinction between specific versus common factors associated with depressive symptoms and externalizing problems was discussed with an eye toward prevention or intervention strategies targeting specific coping mechanisms (e.g., generating alternatives to anger suppression) or developing psychoeducational approaches to facilitate family processes.

Verbal Expression and Comprehension Deficits in Young Children With Autism

Language impairment is a primary characteristic of children with autism; however, findings on the language deficits of these children have been inconclusive, and even less is known about the language profiles of Chinese-speaking children with autism. The present study examined the verbal expression—comprehension abilities of 46 Chinese children at ages 5 to 6. The children with autism were further classified into high- or low-functioning groups based on their nonverbal intelligence. Results showed that 63% of the children with autism demonstrated language impairment. Specifically, 42% were impaired in both verbal expression and comprehension abilities, and 21% demonstrated impaired expression skills. General intelligence did not seem to explain this heterogeneity, as variability was also observed among the high-functioning children with autism. The results also suggested that a test of expressive language is more sensitive than a test of comprehension in differentiating Chinese children with autism from their age-matched counterparts at early childhood.

Parental depressive symptoms and adolescent adjustment: A prospective test of an explanatory model for the role of marital conflict

Despite calls for process-oriented models for child maladjustment due to heightened marital conflict in the context of parental depressive symptoms, few longitudinal tests of the mechanisms underlying these relations have been conducted. Addressing this gap, the present study examined multiple factors longitudinally that link parental depressive symptoms to adolescent adjustment problems, building on a conceptual model informed by emotional security theory (EST). Participants were from 320 families (158 boys, 162 girls), including mothers and fathers, who took part when their children were in kindergarten (T1), second (T2), seventh (T3), eighth (T4) and ninth (T5) grades. Parental depressive symptoms (T1) were related to changes in adolescents’ externalizing and internalizing symptoms (T5), as mediated by parents’ negative emotional expressiveness (T2), marital conflict (T3), and emotional insecurity (T4). Evidence was thus advanced for emotional insecurity as an explanatory process in the context of parental depressive symptoms.