A comparison of conceptual models of depression and anxiety in Chinese Americans and European Americans and the role of culture
The underutilization and poor engagement of Chinese American populations in professional mental health services within the United States has been well documented (Akutsu, Snowden, & Organista, 1996; Bui & Takeuchi, 1992; Ying & Hu, 1994). Though a number of barriers toward professional treatment of this minority population have been considered, a significant barrier, namely the unique conceptualization of mental distress within this ethnic population and its divergence from mainstream American models of illness, has rarely been explored in depth. Further, though conceptual models and beliefs about depression in different ethnic groups have been addressed, the literature on conceptual models of anxiety is scarce. This investigation explored and compared conceptual models of anxiety and depression as well as treatment preferences in a largely immigrant, adult Chinese American sample and an adult European American sample in the United States. This study further explored the relationships between the cultural variables of individualism and collectivism, acculturation, and conceptual models of depression and anxiety. ^ Results from this study did not support hypotheses that Chinese Americans would endorse more collectivistic values than European Americans, finding only that European Americans endorsed independent self-construal values to a greater degree than Chinese Americans. Conceptual models were found to differ between ethnic groups with European American participants endorsing biopsychiatic models of depression and anxiety significantly more than Chinese American participants, though both groups were found to demonstrate mixed models including biological, situational, and psychological causes for distress. Though European Americans were found to prefer psychotherapy as treatment more than Chinese Americans, medication and lay referral treatment preferences were not found to be different between groups in quantitative analyses. Qualitative analyses, however, revealed some of the stigma attitudes in Chinese Americans regarding professional mental health treatment. Results suggested that higher American acculturation significantly correlated with chemical biological causal models and psychological models of mental health distress. However, results did not support the hypothesis that cultural values such as individualism/collectivism or independent/interdependent self construal would be better predictors of conceputal model than ethnic group background. American acculturation also was not found to moderate the relationship between ethnicity and conceptual model of distress. ^