Race/Ethnic Differences in Nonspecific Psychological Distress: Evidence from the National Health Interview Survey*

Objective. This article documents the patterns of white‐nonwhite differences in nonspecific psychological distress and explores how acculturation characteristics, social class, marital status, and chronic illness mediate or moderate these differences for eight racial/ethnic populations in the United States. Methods. We analyze data from a five‐year pool of the National Health Interview Survey (NHIS) collected between 1997 and 2001 (N=162,032) and employ multivariate regression techniques to explore level of psychological distress of various ethnic groups relative to non‐Hispanic whites. Results. Nonwhite populations exhibit variable base‐line differences in psychological distress compared to non‐Hispanic whites; however, adjusted estimates show that African Americans and Mexicans have lower levels of distress while distress scores for “other Hispanics,” Asians, and Cubans exhibit statistically similar levels. The highest distress occurs for Puerto Ricans. Interaction models reveal chronic sources of stress (e.g., poverty, chronic illness, nonmarriage) are even more taxing on psychological health of high‐risk groups or have weaker relationships to stress for other groups. Conclusions. This study reveals the need for capturing ethnic variation in studies of mental health. Social class, acculturation, marital status, and chronic illness cannot fully explain white‐nonwhite differences in psychological distress.     

Economic distress and health: A fixed effects analysis of low‐income persons in Singapore

Using fixed effects regressions, this study examined the transactional effects of different types of economic status on the physical and mental health of low‐income persons in Singapore. Among the economic variables considered, unemployment and arrears had the most significant effects. This signals the physical and psychological distress of being out of work and possessing arrears while income is low. The insignificant effects of poor health on household earnings suggest possible earnings supplementation by other household members. The findings imply the fruitfulness of dually improving employment prospects and health, work activation that takes into consideration mental health effects, increasing affordability of health services in liberal welfare systems, improving mental bandwidth through reducing arrears accounts, and short lag time from application to receipt of assistance. These implications point to a larger question on health and welfare systems in an increasingly uncertain economic environment for households in poverty. Key Practitioner Message: ? Employment and health are inter‐related: employment assistance incorporating physical and mental health interventions and vice versa can be more effective than either alone; ? Compared with decreasing arrears amounts, reducing the number of arrears can more effectively relieve mental distress; ? Effects between economic distress and health materialise quickly; minimising the lag time between application and receipt of assistance will provide great relief.     

Comparison on predictors of mental health service use among Asian older adults

Studies have mostly examined mental health service use of older Asian immigrant combining all Asian Americans into one group whereas immigration backgrounds and socioeconomic status of each Asian minority group are different. Therefore, this study aimed to identify predictors of mental health service use within specific ethnic groups among older Asian adults focusing on Chinese, Japanese, Korean, Filipino, and Vietnamese in California. The Behavioral Model for Vulnerable Populations (BMVP) is used to guide the secondary data analysis of a sample of 3,453 older Asian immigrants from the California Health Interview Survey (CHIS). Logistic and linear regression analyses are performed to examine predictors of mental health service use and the frequency of mental health service use, respectively. As results, mental health‐seeking patterns differ by ethnicity within the older Asian immigrant sample, not being married (Korean), higher levels of acculturation (Filipino), lower levels of neighborhood cohesion (Korean and Vietnamese), higher levels of perceived safety (Korean) and lower levels of perceived safety (Vietnamese), higher levels of mental distress (Korean and Filipino), and having perceived need (all) were related to more visits for mental health services. The study findings highlight the necessity of cultural competency services and programs for each Asian ethnicity.     

The Role of Mastery and Social Support in the Association Between Life Stressors and Psychological Distress in Older Canadians

Gerontological social workers and other health professionals are often dealing with older adults in psychological distress. Greater clarity on the relationship between stress and psychological distress will enhance the efficacy of outreach and treatment initiatives for older adults. This study explored the underlying causal structure of the relationships of common life stressors and psychosocial resources for Canadians 65 years and older (542 men and 835 women). Using structural equation modeling of data collected in the National Population Health Survey in 2004–2005 and 2002–2003, the roles played by socioeconomic conditions, physical health, chronic stress, sense of mastery, and perceived social support in the stress–psychological distress relationship were estimated and compared. Findings revealed that chronic stress was the strongest determinant of the level of psychological distress for both genders; however its effect was higher for men compared to women. Poor physical health played a more important role in determining women's psychological distress compared to men. Higher levels of mastery and perceived social support were associated with lower levels of psychological distress for both men and women. These associations were somewhat stronger for men compared with women. Socio-economic conditions played a minor role in the stress–mental health relationship for both genders.     

Romantic Relationships,Relationship Styles,Coping Strategies,and Psychological Distress among Chinese and Australian Young Adults

This study examined the association between relationship styles, coping strategies, and psychological distress among 144 Anglo‐Australian and 250 Hong Kong Chinese undergraduate students. The results indicated that relationship styles (secure, clingy, and fickle) influenced psychological distress through their association with coping strategies (avoidance and self‐punishment). Society of residence was a moderating factor for the association between clingy relationship style and psychological distress. Females also reported higher levels of psychological distress than males. Among participants who had experienced a romantic relationship break up, participants endorsing clingy relationship style and those whose partners initiated the break up expressed more hurt in comparison, whereas those who endorsed avoidance strategy reported less hurt. The results of the present study also suggested that psychosocial variables (relationship styles, coping strategies) were generally more important than demographic factors (e.g., age) in predicting mental health outcomes. However, relationship styles and coping strategies may operate differently under different contexts.     

Labor force participation among Asian immigrant women: Findings from the 2007 American Community Survey

Using a nationally representative sample of Asian immigrant women in the USA (N = 33,032), we examined ethnic variations in labor force participation and different predictors of labor force participation among six Asian ethnic subgroups, including Chinese, Filipino, Asian Indian, Vietnamese, Korean, and Japanese. Our findings indicated that having a higher level of education, fewer children under age 5, US citizenship, a longer length of residence in the USA, and a better English proficiency were significantly related to higher rates of labor force participation among certain ethnic subgroups. The different predictors of labor force participation by ethnic subgroups were further analyzed in cultural contexts.     

The impact of childhood maltreatment on young adults’ mental health: Evidence from the Philippines

Using a new retrospective data set on young Filipino adults, this study aims to quantify the prevalence, risk factors, and mental health consequences in later life of childhood maltreatment in the Philippines. A survey was conducted with a sample of 155 adults (83 women, 72 men) aged 18–24 living in Quezon City, the largest metropolitan city in the Philippines. Findings show that four out of five young Filipino adults experience minor physical violence during childhood, while one out of four suffer severe physical violence. Boys from less educated families that grow up in urban environments face the highest risks. While we find a strong link between childhood physical abuse and young adults’ mental health, no such effect was found for experiences of psychological aggression. Childhood physical abuse was further found to have negative effects on young adults’ family relations, social relations, and overall satisfaction with life.     

School context influences the ethnic identity development of immigrant children in middle childhood

The present paper describes a study investigating the ethnic identity development of Latino immigrant children (n = 155) in middle childhood (ages 8–11) in a predominantly White community. The study examined how ethnic identity was related to children's school context. School context was operationalized at the structural level, as the ethnic composition of the teachers and peers, as well as the schools' implicit messages about their valuing of multiculturalism; and the proximal interpersonal level, as children's perceptions of peer discrimination and teacher fairness. Results indicated that both the structural and proximal context predicted children's ethnic label choices, the importance placed on their ethnic identity, the positivity of their ethnic identity, and their American identity.     

Assessing PTSD and resilience for females who during childhood were exposed to domestic violence

This study examined 68 females, who as children were exposed to domestic violence, to explore childhood risk and protective factors and their relationship to adult levels of post‐traumatic stress disorder (PTSD) and resilience. Independent sample t‐tests indicated significant differences in PTSD levels between participants with and without police involvement during childhood. There were also significant differences in PTSD levels between participants who reported their mothers had mental‐health problems with those who did not. Additionally, participants whose mothers had full‐time steady employment had significantly higher resilience than those with mothers who did not work or worked inconsistently. Implications include advancing ecological theory and conceptual insights regarding childhood risk and protective factors and their association to adult psychological distress and hardiness for daughters exposed to their mothers' intimate partner violence.     

Comparing Supports for LGBT Aging in Rural Versus Urban Areas

Studies of rural populations typically underrepresent lesbian, gay, bisexual, and transgender (LGBT) older adults. This secondary analysis examined data from a nationwide sample of LGBT baby boomers (n?=?1201). Geographic differences with respect to self-reported outness, acceptance of sexual identity, social and familial support, and household income were assessed with one-way analyses of variance. Guardedness about one's sexual identity and household asset levels were assessed with chi-square analyses. Rural individuals reported lower levels of outness, guardedness with people including siblings and close friends, and lower levels of household income. Providers should consider strategies for connecting older rural LGBT adults for potential care and support.     

Depressive Symptoms and Economic Outcomes of Low-Income Women: A Review of the Social Causation, Social Selection, and Interactionist Hypotheses

We review research that connects depression and depressive symptoms to employment and economic factors for low-income women. Women who have low incomes and are unemployed or underemployed are vulnerable to mental health distress. The strain of balancing work and family life can be exacerbated by poor psychological health or nonsufficient economic resources. Research on the barriers that impede self-sufficiency can lead to policies that improve the economic and psychological health of low-income populations.
The discussion is framed by contrasting evidence for three theoretical perspectives: the social causation, social selection, and interactionist (bidirectional) hypotheses. The only causal relation reported is an effect of increased income on reduced depressive symptoms. Yet strong associations are found among psychological distress, earnings, employment stability, income, and job characteristics. The effects of programs to increase employment and the benefits of (and barriers to) depression treatment are also discussed. A bidirectional or interactionist perspective best conceptualizes the relationship between depression and economic factors. The reported negative effects of both poor mental well-being and low-quality employment suggest the need for stronger policies in the areas of mental health and work supports. We present policy recommendations addressing mental health treatment and outreach, employment placement, and workplace flexibility.     

Sex differences in psychological distress,behavioural and emotional problems,and substance use in young people in out‐of‐home care

The aim of the study was to examine sex differences in self‐reported psychological distress, behavioural and emotional problems, and substance use in young people living in out‐of‐home care (OoHC). One hundred seventy‐six young people aged 12–17 years (females 53.4%) in OoHC in metropolitan Melbourne, Australia, were interviewed. Participants completed self‐report measures: Kessler Psychological Distress Scale, Strengths and Difficulties Questionnaire, and the World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test—Youth Version. Girls had more OoHC placement instability over the past year compared with boys (p = .019). Compared with boys, the girls had significantly higher levels of distress (p < .001) (p = .007), were more likely to have self‐reported emotional symptoms (p < .001) and peer relationship problems (p = .043) and were more likely to use sedatives (p = .004). Girls had more psychological distress, behavioural disturbance, and sedative abuse; placement instability might contribute to these problems. Greater integration across OoHC, mental health, and substance use sectors is required. Girls in OoHC may benefit from interventions targeting problems with peer relationship and substance use and supporting prosocial behaviour; such targets may reduce distress and emotional symptoms and possibly prevent longer term problems.     

Assessing mental health and service needs among refugees in Malaysia

Refugees in Malaysia often experience economic insecurity and poverty, poor health, poor mental wellbeing and limited legal rights. Using a survey with quantitative measures and open‐ended questions, we assessed socio‐demographic characteristics, mental health (RHS‐15), and service needs, including interest in group support services, among 86 Dari‐ and Arabic‐speaking refugees living in Kuala Lumpur. High levels of emotional distress were found, as nearly all participants scored positive for distress and average scores were 2.5 times above the cut‐off signifying distress. Distress scores did not vary based on most factors examined, although being married was associated with lower levels of distress. All but one participant expressed interest in participating in a support group. Barriers to potential participation included childcare, sickness and transportation. Additional mental health and social supports are needed among refugees residing in Malaysia. Key Practitioner Message: ? Emotional distress is high among Dari‐ and Arabic‐speaking refugees sampled in Malaysia; ? Participants expressed strong interest in accessing supportive mental health services, including group supports.     

Ethnic Identity, Immigration, and Well-Being: An Interactional Perspective

On the basis of existing theory and research regarding ethnic identity and immigration and our own empirical work in four immigrant-receiving countries, we suggest an interactional model for understanding psychological outcomes for immigration. Specifically, the interrelationship of ethnic and national identity and their role in the psychological well-being of immigrants can best be understood as an interaction between the attitudes and characteristics of immigrants and the responses of the receiving society. This interaction is moderated by the particular circumstances of the immigrant group. The strengths of ethnic and national identity vary depending on the support for ethnic maintenance and the pressure for assimilation. Most studies show that the combination of a strong ethnic identity and a strong national identity promotes the best adaptation.     

Examining the Association Between Resilience and Risk Behaviors Among South Asian Minority Students in Hong Kong: A Quantitative Study

The relationship between risk behaviors and resilience among South Asian minority youth identifying themselves as Pakistani, Indian, Pakistani-Hong Konger, or Indian-Hong Konger (N?=?405) in a Hong Kong school setting was investigated using hierarchical linear regression analysis. Lower neighborhood disorganization, higher neighborhood characteristics, and higher individual resilience predicted lower likelihood of substance use in all ethnic groups. Stronger relationship with caregivers was associated with lower levels of substance use in all ethnic groups except for Pakistani-Hong Kongers (p?>?.05). Stronger multigroup ethnic identity predicted lower likelihood of substance use in Indians (p?=?.021) and Indian-Hong Kongers (p?=?.039). Resilience-based research, practical, and social policy implications are discussed.     

The importance of type, amount, and timing of internet use for understanding psychological distress

Objective. Few social scientists have examined how Internet usage, including using the Internet for health purposes, may affect mental health. This study assesses whether the type or amount of online health activities and the timing of Internet use are associated with psychological distress.Methods. We use data from the National Cancer Institute's 2005 Health Information National Trends Survey.Results. When we compare Internet users to non-Internet users, using the Internet and using the Internet for health purposes are negatively associated with distress. However, among Internet users, the number of online health activities is positively associated with distress. Greater distress is also associated with using the Internet on weekdays and looking online for information on sun protection.Conclusions. Internet usage is not necessarily positively associated with psychological distress. The effects depend on the type, amount, and timing of Internet usage.     

The relationship between maternal depression and child outcomes in a child welfare sample: implications for treatment and policy

Maternal depression is an extremely important parenting variable in relation to child general health. This investigation addressed the issue of maternal depression as it relates to the lives of children seen by child welfare authorities. Maternal depression was investigated in the context of the increasing rate of children coming to the attention of the London and Middlesex Children's Aid Society. A variety of child outcomes including those of particular relevance to child welfare, specifically disorders of attachment and neglect and physical abuse, school‐related variables, conduct disorder and psychological distress, were investigated. The relative contribution of maternal depression along with measures of socioeconomic status and social isolation to childhood risk was examined. Results indicated that the rate of maternal depression doubled during the years 1995–2001. Maternal depression was related to children entering care through wardship. Additional poor child outcomes such as attention deficit disorder, conduct disorder and emotional adjustment were also related to maternal depression. The findings are discussed in terms of treatment and policies that can lower the risk to children through effective intervention with depressed mothers.     

Body Mass Index,Demographic and Socioeconomic Risk,and Protective Factors of Type 2 Diabetes Among Six Groups of Foreign-Born Asian Americans

ABSTRACT. This study examined the association of body mass index (BMI), demographic variables, and self-reported type 2 diabetes among Chinese, Filipino, South Asian, Japanese, Korean, and Vietnamese adults. A sample of 3,204 Asian American respondents born outside of the United States was selected from the 2007 California Health Interview Survey. Logistic regression was used to estimate the relationships between BMI, age, sex, marital status, education, poverty level, years in the United States and self-reported type 2 diabetes. The findings revealed that Koreans had the lowest prevalence for type 2 diabetes and South Asians had the highest. Type 2 diabetes had a statistically significant association with BMI and demographic variables but varied across ethnic groups. Due to sampling variations, no meaningful results were found in the Filipino and Japanese samples. BMI and older age are common risk factors for type 2 diabetes among Asians, but whether sex, marital status, education, and years in the United States are risk factors varies among ethnic groups. Culturally specific prevention programs for type 2 diabetes are important for Asian Americans. Given the diversity of cultures and demographic and socioeconomic factors across the Asian American populations, future research should not combine all ethnic Asian groups into 1 sample.     

Currents in a Stream: College Student Identities and Ethnic Identities and Their Relationship with Self‐Esteem,Efficacy, and Grade Point Average in an Urban University*

Objectives. We investigate how college student identities and ethnic identities vary among black, white, and Asian students and among immigrant, second‐, and third‐generation students at a large public urban university (in counterpoint to recent studies at highly selective schools). In addition, we explore how those identities are related to college students' sense of self‐esteem and efficacy and their academic performance. Methods. We use survey data from a sample (N=652) of students attending a large diverse public urban university to create new indexes for several dimensions of college identity and ethnic identity and use existing self‐esteem and efficacy indexes to compare black, white, and Asian students, as well as immigrant, second‐generation, and third‐generation students. Results. Among several significant identity differences, we find: (1) whites are lower than blacks on college identity indexes, and immigrant students are higher than subsequent‐generation students on college student identity measures; (2) whites are lower than blacks and Asians on ethnic identity measures; only the ethnic activities index declines linearly from immigrant to second‐ to third‐generation students; (3) blacks have higher self‐esteem and efficacy than whites or Asians; whites have higher GPAs than blacks or Asians, while immigrant students have higher GPAs than third‐generation students; and (4) at least one college student identity dimension and one ethnic identity dimension is related to self‐esteem, efficacy, and GPA. Conclusions. How young adults conceive of themselves as college students and the way they formulate their own racial‐ethnic identities is related to their self‐esteem, efficacy, and academic performance. Moreover, the pattern that these relationships take is somewhat different at a large diverse public urban university than at highly selective universities.