Wei-Chin Hwang

Parenting and childhood anxiety: theory, empirical findings, and future directions

Theories of anxiety development suggest that parental acceptance, control, and modeling of anxious behaviors are associated with childrens manifestations of anxiety. This paper reviews research published in the past decade on the relation between parenting and childhood anxiety. Observed parental control during parent-child interactions was consistently linked with shyness and child anxiety disorders across studies. Mixed support for the role of parental acceptance and modeling of anxious behaviors was found in observational studies. However, there was little evidence supporting the contention that self-reported parenting style was related to childrens trait anxiety. Because of limitations associated with past research, inferences about the direction of effects linking parenting and child anxiety cannot be made. A conceptual framework based on recent models of anxiety development (e.g., Vasey & Dadds, 2001) is presented to aid in the interpretation of extant research findings and to provide suggestions for future research and theory development. Improved methodological designs are proposed, including the use of repeated-measure and experimental designs for examining the direction of effects.

Disaggregating the effects of acculturation and acculturative stress on the mental health of Asian Americans.

This study examines the impact of level of acculturation and acculturative stress on the mental health of Asian American college students. Hierarchical regression analyses were used to clarify the relation between level of acculturation, acculturative stress, and mental health outcomes (psychological distress and clinical depression). Being less identified with mainstream United States culture was associated with higher psychological distress and clinical depression, but lost significance when acculturative stress was introduced into the model. Retention or relinquishing of identification with ones heritage culture was not associated with mental health outcomes. Although understanding level of acculturation can help us identify those at risk, findings suggest that acculturative stress is a more proximal risk factor and increases risk for mental health problems independently of global perceptions of stress.

The Impact of Perceived Racial Discrimination on the Mental Health of Asian American and Latino College Students

The authors examined the impact of perceived racial discrimination on various mental health outcomes for Asian American and Latino college students within an emic and etic framework. Results indicate that Asian American and Latino college students experienced similar exposure and reactions to various kinds of discrimination. However, Latino students were more likely than Asian American students to have been accused of doing something wrong, such as cheating and breaking the law, and more likely to appraise these experiences as stressful. Asian Americans evidenced higher risk for trait anxiety. Regardless of ethnicity, perceived racial discrimination was associated with several negative mental health outcomes, including higher psychological distress, suicidal ideation, state anxiety, trait anxiety, and depression. Findings highlight the need to address discrimination across multiple social and professional settings and to understand the broad array of mental health outcomes.

Acculturative Family Distancing: Theory, Research, And Clinical Practice

Despite the rapidly growing immigrant population settling in the United States, our knowledge of acculturative processes and their impact on immigrant families remains quite limited. This article describes a theoretical construct called Acculturative Family Distancing (AFD), the distancing that occurs between immigrant parents and children that is a result of immigration, cultural differences, and differing rates of acculturation. AFD occurs along two dimensions: communication and cultural values. Breakdowns in communication and incongruent cultural values between immigrant parents and children are hypothesized to increase over time and place families at risk for mental illness and family dysfunction. Clinical illustrations of AFDs impact on immigrant Asian families are provided and recommendations for dealing with AFD are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Ethnic differences in clinical presentation of depression in adult women.

This study examined ethnic differences in self-report and interviewer-rated depressive symptoms and estimated the contributions of sociodemographic and psychosocial factors in predicting severity of depression. One hundred twenty-five clinically depressed African American (n = 46), Caucasian (n = 36), and Latina (n = 43) women were recruited. After controlling for differences in socioeconomic status, African American women reported more symptoms of distress and Latinas were rated as significantly more depressed than the other groups. However, these ethnic differences were not moderated by either education or employment. Finally, hierarchical regression analysis indicated that severity of depression was predicted by low education, being single, being Latina, high perceived stress, and feelings of hopelessness. Additional research is needed to validate these results and to investigate their clinical significance.

Predictors of help seeking for emotional distress among Chinese Americans: family matters.

Using data from the Chinese American Psychiatric Epidemiological Study, the authors examined longitudinal predictors of help seeking for emotional distress in a community sample of 1,503 Chinese Americans. Specifically, they assessed the relative contribution of family relational variables (e.g., levels of family support and family conflict) in predicting help seeking for medical, mental health, and informal services. After traditional need, predisposing, and enabling factors were controlled for in hierarchical logistic regression analyses, family conflict predicted both mental health and medical service use, whereas family support was not predictive of help seeking. In addition to family conflict, mental health service use was predicted by negative life events, emotional distress, and insurance coverage. Implications of the findings for assessing and treating Asian American clients are explored.

Acculturative Family Distancing (AFD) and Depression in Chinese American Families

OBJECTIVE Knowledge of acculturative processes and their impact on immigrant families remains quite limited. Acculturative family distancing (AFD) is the distancing that occurs between immigrant parents and their children and is caused by breakdowns in communication and cultural value differences. It is a more proximal and problem-focused formulation of the acculturation gap and is hypothesized to increase depression via family conflict. METHOD Data were collected from 105 Chinese American high school students and their mothers. Rasch modeling was used to refine the AFD measure, and structural equation modeling was used to determine the effects of AFD on youth and maternal depression. RESULTS Findings indicate that greater AFD was associated with higher depressive symptoms and risk for clinical depression. Family conflict partially mediated this relation for youths, whereas for mothers, AFD directly increased risk for depression. Greater mother-child heritage enculturation discrepancies were associated with greater mother and child AFD. Mainstream acculturation discrepancies and language gaps between mothers and youths were not significantly associated with any of the primary outcome variables. CONCLUSIONS Results highlight the need for better understanding of how AFD and other acculturation-gap phenomena affect immigrant mental health. They also underscore the need for prevention and intervention programs that target communication difficulties and intergenerational cultural value differences.

Age of first onset major depression in Chinese Americans.

Using data from the Chinese American Epidemiological Study, risk for experiencing an initial episode of major depression across the life course was examined. Data were collected on 1,747 U.S.-born and foreign-born Chinese Americans (ages 18-65 years). Results suggest that Chinese American women did not evidence higher risk than Chinese American men for experiencing a 1st major depressive episode. Risk for experiencing a 1st depressive episode decreased as length of residence in the United States increased. Although those who immigrated at younger ages evidenced greater overall risk, those who came at later ages were more likely to become depressed at or soon after arrival. Competing theories of acculturation-related risk are discussed and directions for future research are proposed.

Cultural influences on help-seeking attitudes in Asian American students.

There is considerable evidence indicating that Asian American college students have less favorable attitudes toward and are less likely to use mental health services than other ethnic groups in the United States. Because a persons attitudes are often strongly associated with their voluntary behaviors, understanding what influences help-seeking attitudes may help shed light on why Asian American college students refrain from seeking mental health treatment. Andersens Sociobehavioral Model is commonly used as a guide to understand help-seeking in the mainstream population. A modified version of this model that includes culture-related variables (i.e., level of acculturation and stigma tolerance) was used to guide this study. Results indicated that stigma tolerance predicted help-seeking attitudes above and beyond traditional variables associated with help-seeking. These findings suggest that reducing societal stigma and increasing individual tolerance to stigma should be a focus for prevention and intervention programs on college campuses.

Major depression in Chinese Americans: the roles of stress, vulnerability, and acculturation

BackgroundThis study examined the relationship between recent negative life events, level of acculturation and other psychosocial risk factors in predicting major depression in Chinese Americans.MethodData were collected on 1,747 Chinese immigrants and native-born residents of the United States (ages 18–65) who resided in Los Angeles County between 1993 and 1994.ResultsFindings indicated that a positive psychiatric history increased risk for major depression at Time 2, while social conflicts and traumatic life events moderated the effects of negative life events in increasing risk for major depression. In addition, level of acculturation moderated the effects of recent negative events in increasing risk, but only for those who were more highly acculturated.ConclusionsThe importance of testing the cross-cultural applicability of the stress-vulnerability hypothesis among ethnic minorities and extending them to include immigrant vulnerabilities is discussed