Asian American students' cultural values, stigma, and relational self-construal: correlates of attitudes toward professional help seeking.In this study, we investigated how adherence to Asian values Asian values was a concept that came into vogue in the 1990s, predicated on the belief in the existence in Asian countries of a unique set of institutions and political ideologies which reflected the region's culture and history. , stigma stigma: see pistil.
mark of Cain
God’s mark on Cain, a sign of his shame for fratricide. [O. T.: Genesis 4:15]
scarlet letter of receiving psychological help, relational-interdependent self-construal, age and gender, for Asian American A·sian A·mer·i·can also A·sian-A·mer·i·can
A U.S. citizen or resident of Asian descent. See Usage Note at Amerasian.
A college and graduate students, singly and in concert predicted attitudes toward seeking professional psychological help. We also examined how stigma mediates the effect of adherence to Asian values on help-seeking attitudes. Correlational and multiple regression Multiple regression
The estimated relationship between a dependent variable and more than one explanatory variable. analyses determined that lower adherence to Asian values, lower levels of stigma, a higher relational-interdependent self-construal were associated with more positive help-seeking attitudes. Also, female and older students possessed more positive help-seeking attitudes. The mediational model was not significant. We discuss potential barriers to seeking professional help across sociocultural so·ci·o·cul·tur·al
Of or involving both social and cultural factors.
soci·o·cul levels. We address implications for research and practice in mental health counseling.
Asian Americans This page is a list of Asian Americans. Politics
Census Bureau , 2004). Asian international and Asian American students comprise a dramatically growing number of students enrolled in U.S. colleges and universities (U.S. Department of Education, 2004). Asian American students experience many stressors such as intergenerational conflict An intergenerational conflict is either a conflict situation between teenagers and adults or a more abstract conflict between two generations, which often involves all inclusive prejudices against another generation. , negotiating cultural identities, career development, immigration immigration, entrance of a person (an alien) into a new country for the purpose of establishing permanent residence. Motives for immigration, like those for migration generally, are often economic, although religious or political factors may be very important. status, and racism related stress. Yet, research findings concerning Asian Americans' attitudes toward the utilization of psychological services have been inconsistent and lacking in relational variables.
Past research has consistently reported that Asian Americans tend to underutilize formal mental health services health services Managed care The benefits covered under a health contract , prematurely terminate from psychotherapy psychotherapy, treatment of mental and emotional disorders using psychological methods. Psychotherapy, thus, does not include physiological interventions, such as drug therapy or electroconvulsive therapy, although it may be used in combination with such methods. , and endorse less favorable fa·vor·a·ble
1. Advantageous; helpful: favorable winds.
2. Encouraging; propitious: a favorable diagnosis.
3. help-seeking attitudes compared with European Americans A European American (Euro-American) is a person who resides in the United States and is either the descendant of European immigrants or from Europe him/herself.
Overall, as the largest group, European Americans have the lowest poverty rate  (Atkinson, Lowe, & Matthews, 1995; Leong, 1994; Matsuoka, Breaus, & Ryujin, 1997; Sue, Fujino, Hu, Takeuchi, & Zane, 1991). This pattern was found in student (both local and international) as well as adult populations, inpatient inpatient /in·pa·tient/ (in´pa-shent) a patient who comes to a hospital or other health care facility for diagnosis or treatment that requires an overnight stay.
n. and outpatient settings across the United States (Loo, Tong tong 1
tr.v. tonged, tong·ing, tongs
To seize, hold, or manipulate with tongs.
[Back-formation from tongs. , & True, 1989; Narikiyo & Kameoka, 1992; Snowden & Cheung, 1990). In spite of the "model minority" myth, suggesting that Asian Americans have been successful, function well in society, and have few cultural adjustment difficulties (Sue & Sue, 2003), researchers have identified mental health concerns, adjustment difficulties and a need for mental health services in groups of Asian Americans including local and international students (Leong, Wagner, & Tata, 1995; Yeh & Inose, 2003; Yeh, 2002). The lower rate of help seeking among Asian Americans may stem from a combination of institutional and sociocultural barriers.
Barriers on the institutional level may include a lack of culturally competent personnel, contradictions between values held by the Asian clients and the Western model of counseling (e.g., ethnocentric eth·no·cen·trism
1. Belief in the superiority of one's own ethnic group.
2. Overriding concern with race.
eth model of counseling; Sue & Sue, 2003) and lack of culturally responsive services. Barriers on the cultural and social level for Asian internationals and Asian Americans may include historical and cultural influences on coping with personal problems, linguistic issues, limited knowledge about available services, and a high level of social stigma Social stigma is severe social disapproval of personal characteristics or beliefs that are against cultural norms. Social stigma often leads to marginalization.
Examples of existing or historic social stigmas can be physical or mental disabilities and disorders, as well as attached to seeking psychological treatment for mental health issues in the Asian community (e.g., Komiya, Good, & Sherrod, 2000; Tsang, Tam, Chan,& Cheung, 2003; Uba, 1994). In this study, we seek to revisit re·vis·it
tr.v. re·vis·it·ed, re·vis·it·ing, re·vis·its
To visit again.
A second or repeated visit.
re the pattern of underutilization and help-seeking attitudes among Asian American students through examining the specific factors embedded Inserted into. See embedded system. in their sociocultural context.
Asian cultural values are prominent factors in shaping attitudes toward seeking professional psychological help (Kim & Omizo, 2003). Asian cultures emphasize family hierarchy, emotional restraint, avoidance of shame and saving "face" (Flaskerud & Liu, 1990; Uba, 1994; Zane & Yeh, 2002), which may contradict con·tra·dict
v. con·tra·dict·ed, con·tra·dict·ing, con·tra·dicts
1. To assert or express the opposite of (a statement).
2. To deny the statement of. See Synonyms at deny. Western norms in counseling such as self-disclosure and emotional expressiveness (Sue & Sue, 2003). Traditionally, Asian Americans are expected to deal with problems by themselves or take them to the family; if this strategy fails, they might turn to churches, physicians, elders, or clan and other ethnic organizations (Inman & Yeh, 2006). Extrafamilial intervention such as seeking professional psychological help is often considered shameful shame·ful
a. Causing shame; disgraceful.
b. Giving offense; indecent.
2. Archaic Full of shame; ashamed. and a violation of the family hierarchy (Sue, 1994) and may bring disgrace DISGRACE. Ignominy, shame, dishonor. No witness is required to disgrace himself. 13 How. St. Tr. 17, 334; 16 How. St. Tr. 161. Vide Crimination; To Degrade. to the family (Root, 1985), as seeking outside help may indicate inadequacy on the part of family members, and cause them to lose "face" (Zane & Yeh, 2002).
However, research has suggested that attitudes toward seeking professional help may vary as a function of within-group differences, such as acculturation acculturation, culture changes resulting from contact among various societies over time. Contact may have distinct results, such as the borrowing of certain traits by one culture from another, or the relative fusion of separate cultures. level. Acculturation refers to the process of adaptation to the behaviors, values, knowledge and identity of the dominant society (Kim & Abreu, 2001). Past studies have found that higher levels of assimilation (i.e., more Americanized) among Asian American students predicted more positive attitudes toward seeking professional psychological help (Atkinson & Gim 1989; Tata & Leong; 1994). And, the most assimilated students are the most likely to recognize personal need for professional psychological help, most tolerant of the stigma associated with psychological help, and most open to discussing their problems with a psychologist (Atkinson & Gim, 1989).
Recent research on Asian values as a correlate of help-seeking attitudes underscores the limitations of using acculturation as a variable (Kim & Abreu, 2001). The commonly used acculturation scale, the Suinn-Lew Asian Self-Identity Scale (SL-ASIA; Suinn, Rickard-Figueroa, Lew, & Vigil vigil (vĭj`əl) [Lat.,=watch], in Christian calendars, eve of a feast, a day of penitential preparation. In ancient times worshipers gathered for vespers before a great feast and then waited outside the church until dawn for the liturgy (Mass). , 1987), is a uni-linear acculturation measure focusing on behavior items (e.g. language preference, identity, friendship choice, behaviors) and does not tap into value-based items. However, changes in cultural behaviors Cultural behavior is behavior exhibited by humans (and, some would argue, by other species as well, though to a much lesser degree) that is extrasomatic or extragenetic, in other words, learned. Learned Behaviour
There is a species of ant that builds nests made of leaves. are not synonymous with synonymous with
adjective equivalent to, the same as, identical to, similar to, identified with, equal to, tantamount to, interchangeable with, one and the same as changes in cultural values (Kim, Atkinson, & Yang yang (yang) [Chinese] in Chinese philosophy, the active, positive, masculine principle that is complementary to yin; see yin, under principle. , 1999). Individuals who are highly acculturated to the mainstream cultural behaviors in the United States. (e.g. eating American food, speaking fluent English, making friends with Americans) may still endorse a high level of adherence to their indigenous culture. For instance, they may still observe the traditional Asian values such as collectivism collectivism
Any of several types of social organization that ascribe central importance to the groups to which individuals belong (e.g., state, nation, ethnic group, or social class). It may be contrasted with individualism. , emotional restraint, and social harmony. This process of retaining or socializing to the cultural values, ideas, concepts, knowledge, behaviors and norms of one's indigenous culture is known as enculturation enculturation
the process by which a person adapts to and assimilates the culture in which he lives.
See also: Society
Noun 1. enculturation (Berry, Poortinga, Segall, & Dasen, 1992; Kim, Atkinson, & Umemoto, 2001). Multicultural researchers argued that enculturation is an important index of the within group difference among Asian Americans, which may influence their help seeking (Kim & Abreu, 2001; Kim, Atkinson, & Umemoto, 2001). Kim and Omizo (2003) found that Asian American students who have high adherence to Asian cultural values tend to have negative attitudes toward seeking professional psychological help and exhibit lower levels of willingness to see a counselor. The current study attempts to replicate previous studies and investigate how this relatively new cultural values index may predict Asian American students' help-seeking attitudes.
Culture also shapes one's orientation toward constructing the world and making meaning of it, which orchestrates the interpretations of social processes and interpersonal interactions. Stigma has been defined as a flaw resulting from a personal or physical characteristic that is viewed as socially unacceptable (Blaine, 2000); stigma associated with the process of seeking mental health intervention health intervention Health care An activity undertaken to prevent, improve, or stabilize a medical condition is the negative perception that an individual who receives psychological help is socially undesirable (Vogel, Wade, & Hackler, 2006). Past studies have suggested that Asians tend to attach stigma to mental illness or emotional problems as well as to receiving professional help for these issues, in part due to traditional cultural beliefs about the etiology etiology /eti·ol·o·gy/ (e?te-ol´ah-je)
1. the science dealing with causes of disease.
2. the cause of a disease. of mental health problems and feelings of shame (Komiya, Good, & Sherrod, 2000; Ng, 1997). Hence, stigma has been found to predict negative help-seeking attitudes and act as a pervasive barrier to effective mental health intervention within the Asian community (Komiya, Good, & Sherrod, 2000; Tsang et al., 2003). Asian cultural values may influence perceived stigma associated with receiving psychological help, which, in turn, may influence attitudes toward seeking professional psychological help. We are not only interested in examining how stigma per se may predict help-seeking attitudes, but also how stigma may mediate MEDIATE, POWERS. Those incident to primary powers, given by a principal to his agent. For example, the general authority given to collect, receive and pay debts due by or to the principal is a primary power. the effect of adherence to Asian values on help-seeking attitudes.
Another salient aspect of Asian culture is the emphasis on collectivism and interdependence in·ter·de·pen·dent
Mutually dependent: "Today, the mission of one institution can be accomplished only by recognizing that it lives in an interdependent world with conflicts and overlapping interests" . In collectivist col·lec·tiv·ism
The principles or system of ownership and control of the means of production and distribution by the people collectively, usually under the supervision of a government. Asian cultures, the extended family is prioritized along with values of security, obedience, duty, in-group harmony, and personalized per·son·al·ize
tr.v. per·son·al·ized, per·son·al·iz·ing, per·son·al·iz·es
1. To take (a general remark or characterization) in a personal manner.
2. To attribute human or personal qualities to; personify. relationships (Ivey, Ivey., & Simek-Morgan, 1997; Tata & Leong, 1994; Zhang, 1994). Individuals in collectivist societies tend to define self in relation to others within social contexts, attend to others' reactions and manage their own feelings and experiences accordingly. Likewise, they assume this process will be reciprocated by close others in their lives (Markus & Kitayama, 1991). Singelis (1994) reported that Asian Americans generally have more interdependent in·ter·de·pen·dent
Mutually dependent: "Today, the mission of one institution can be accomplished only by recognizing that it lives in an interdependent world with conflicts and overlapping interests" self-construals than European Americans and that European Americans have more independent self-construals than Asian Americans.
Interdependent and independent conceptualizations of self may influence help-seeking attitudes. Researchers have found that being more individualistic in·di·vid·u·al·ist
1. One that asserts individuality by independence of thought and action.
2. An advocate of individualism.
in was associated with negative attitudes toward seeking professional help (Tata & Leong; 1994), whereas an interdependent self-construal predicted more positive attitude toward help seeking (Yeh, 2002). Yeh suggested that the positive help-seeking attitude may be consonant consonant
Any speech sound characterized by an articulation in which a closure or narrowing of the vocal tract completely or partially blocks the flow of air; also, any letter or symbol representing such a sound. with what is required in seeking counseling in Western society such as openness to others. However, this research was conducted with a sample of students in Taiwan, and may only reflect the social practices of students living there.
On the other hand, individuals high in interdependence may tend to avoid the intense experience of emotions, especially negative emotions negative emotion Any adverse emotion–eg, anger, envy, cynicism, sarcasm, etc. Cf Positive emotion. , due to a potential threat to the harmony of a social situation (Markus & Kitayama, 1991). They are more likely to take into account the needs and wishes of close others when making decisions (Cross, Bacon, & Morris, 2000). Because the counseling process may involve exposure to intense emotional experiences and displays of negative feelings, interdependent Asian Americans may decide against seeking professional psychological help due to their concerns for close others and social harmony. Such relational considerations are critical to examine in the context of help-seeking practices (Yeh & Wang, 2000).
Because the current sample is living in the United States and is largely comprised of international students and first-generation immigrant students, we believe that in-groups (e.g., ethnic group loyalties) may be less important than individual relationships (e.g., parents, spouse, best friends) to include in the self-construal. Thus, we use the Relational-Interdependent Self-Construal (RISC RISC
in full Reduced Instruction Set Computing
Computer architecture that uses a limited number of instructions. RISC became popular in microprocessors in the 1980s. ) developed by Cross, Bacon, and Morris (2000) to assess how the self is defined in terms of close individual relationships. As cultural values and norms help define and govern social processes and interpersonal interactions, we believe that the effect of adherence to Asian values will be the strongest predictor for help-seeking attitudes when simultaneously examined with other social and interpersonal factors.
Additionally, we have included two demographic variables: gender and age. Gender has been consistently found to be correlated with Asian American students' attitudes toward seeking professional psychological help whereas age has not. Studies on Asian men and women found that female students, regardless of ethnicity and cultural differences, reported a more positive attitude toward seeking professional psychological help than their male counterparts (Gloria, Hird, & Navarro, 2001; Leong & Zachar, 1999; Tata & Leong, 1994; Tracey, Leong, & Glidden, 1986). Yeh (2002) found that age had no predictive effect on help-seeking attitudes across junior high, senior high, and college-age Taiwanese students in Taiwan. Hence, we seek to examine the effect of these demographic factors using a local sample of Asian American college and graduate students to further our understanding of their help-seeking attitudes. Given the limited findings on the relations among interdependent self-construal, age and help-seeking attitudes, we seek to examine how relational-interdependent self-construal correlates with attitudes toward seeking professional psychological help. As well, we seek to examine how age correlates with attitudes toward seeking professional psychological help.
Several studies have investigated Asian American attitudes toward mental health use. However, this study is unique in that it examines cultural, social and self/interpersonal factors as they relate to help seeking attitudes. In addition, the RISC is a relatively new scale and has not been used in the help-seeking literature. Because previous research has revealed inconsistencies in the relations between independent and interdependent self-construal and help-seeking, the RISC will provide more clarity about the role of culture and self in help-seeking attitudes. Our exploration of the mediating role of stigma in the relation between Asian cultural values and attitudes towards professional help seeking is among the first efforts to test this supposed relation experimentally.
Specifically, our hypotheses include: (1) There will be an inverse relationship A inverse or negative relationship is a mathematical relationship in which one variable decreases as another increases. For example, there is an inverse relationship between education and unemployment — that is, as education increases, the rate of unemployment between adherence to Asian cultural values and attitudes toward seeking professional psychological help; (2) there will be an inverse relationship between stigma for receiving psychological help and attitudes toward seeking professional psychological help; (3) female students will have a more positive attitude toward seeking professional psychological help than male students; (4) adherence to Asian values will predict attitudes toward seeking professional psychological help above and beyond the effects of age, gender, stigma and self-construal; (5) the effect of adherence to Asian values on help-seeking attitudes will be mediated me·di·ate
v. me·di·at·ed, me·di·at·ing, me·di·ates
1. To resolve or settle (differences) by working with all the conflicting parties: by stigma.
The sample consisted of 219 Asian American undergraduate and graduate students (76 males and 143 females) at a private institution in the Northeast. The mean age of the sample was 24.56 years (SD = 4.09), with participants ranging in age from 18 to 35 years. The ethnicity distribution was as follows: 45.7% (n = 100) were Chinese, 24.7% (n = 54) were Korean, 8.7% (n = 19) were Japanese, 7.3% (n = 16) were Taiwanese, 4.6 % (n = 10) were Indian, 1.8% (n = 4) were Vietnamese, 1% (n = 9) were Filipino, 3.2% (n = 7) were of other ethnicity, and 3.2% (n = 7) did not report their ethnicity. The majority of participants (69.4%, n = 153) were born outside of the United States, 27.4% (n = 60) were second generation Asian Americans, 0.5% (n = 1) were third generation, 1.4% (n = 3) were fourth generation, 1% (n = 2) did not indicate their status. The average length of residence of the participants in the United States. was 11.26 years, with a range from less than 6 months to more than 30 years. In terms of social class, 21% (n = 46) identified as coming from a working class background, 42.9% (n = 94) were from middle class, 27.4% (n = 60) were from upper-middle class, 2.7% (n = 6) were from upper class and 5.9% (n = 13) did not indicate their socioeconomic status socioeconomic status,
n the position of an individual on a socio-economic scale that measures such factors as education, income, type of occupation, place of residence, and in some populations, ethnicity and religion. .
Demographic information. Participants provided information regarding their gender, age, race, ethnicity, generational status, years in the United States, education, field of study, religious affiliation, socioeconomic status, history of mental health care, and the format of counseling services they prefer.
Asian Value Scale (AVS (Audio Video Coding Standard) A video compression technique developed by Chinese companies and supported by the Chinese government. Expected to provide better compression than MPEG-2, AVS was created to avoid paying royalties to the MPEG licensors, which are outside ). This scale developed by Kim et al. (1999) was used to measure participants' adherence to Asian cultural values. It is a 36-item scale with 18 positively stated and 18 negatively stated items reflecting various dimensions of Asian cultural values, and uses a 7-point Likert-type scale (1 = strongly disagree, 7 = strongly agree). Negatively stated items are reverse scored and items are summed then averaged to obtain a scale score; high scale scores indicate stronger adherence to Asian cultural values. The scale consists of six factors: Conformity to Norms, Family Recognition Through Achievement, Emotional Self-Control, Collectivism, Humility Humility
See also Modesty.
Humorousness (See WITTINESS.)
Bernadette Soubirous, St.
humble girl to whom Virgin Mary appeared. [Christian Hagiog.: Attwater, 65–66]
washes dishes even though a cardinal. , and Filial Piety The examples and perspective in this article or section may not represent a worldwide view of the subject.
Please [ improve this article] or discuss the issue on the talk page.
“Hyo” redirects here. For other uses, see Hyo (disambiguation). . However, Kim et al. recommended that only the AVS total score be used, as the reliability of the six subscales was too low to justify using them singly. Kim et al. (1999) reported internal consistency In statistics and research, internal consistency is a measure based on the correlations between different items on the same test (or the same subscale on a larger test). It measures whether several items that propose to measure the same general construct produce similar scores. (coefficient alphas) of .81 and .82, based on two separate samples of Asian students, and a 2-week test-retest reliability test-retest reliability Psychology A measure of the ability of a psychologic testing instrument to yield the same result for a single Pt at 2 different test periods, which are closely spaced so that any variation detected reflects reliability of the instrument of .83. The data from the present study yielded an alpha coefficient of .84.
Stigma Scale for Receiving Psychological Help (SSRPH). This scale designed by Komiya et al. (2000) measures participants' perceptions of how stigmatizing it is to receive psychological treatment. The SSRPH is a single-factor, uni-dimensional scale consisting of five questions, using a 4-point Likert-type scale (0 = strongly disagree, 3 = strongly agree). A high score indicates greater perception of stigma. Komiya et al. (2000) reported an internal consistency of .72. A previous study with Asian American college and graduate students using SSRPH yielded an alpha coefficient of .80 (Chang & Chang, 2004). The data from the present study yielded an alpha coefficient of .67.
The Relational-Interdependent Self-Construal (RISC) scale (Cross et al., 2000) assesses participants' relational-interdependent self-construal. It consists of 9 positively stated items and 2 negatively stated items using a 7-point likert-type scale (1 = strongly disagree, 7 = strongly agree). Negatively stated items are reverse scored and items are summed then averaged to obtain an average score. A higher score on this instrument indicates a tendency to view important relationships as closer and more committed, and to take others' needs and wishes into account when making decisions (Cross et al., 2000). Cross et al. reported a test-retest reliability ranging from .63 to .73 over a 2-month period and internal consistency coefficients ranging from .84 to .94. Previous research with Asian immigrant students yielded an alpha coefficient of .84 (Ma & Yeh, 2005). The alpha coefficient of the present study is .88.
Attitudes toward Seeking Professional Psychological Help-Short form (ATSPPH-S; Fischer & Farina, 1995). This scale is based on the original 29-item version developed by Fischer and Turner (1970). It consists of 10 items assessing attitudes toward seeking professional help for psychological problems and uses a 4-point Likert-type scale (0 = disagree, 3 = agree). Higher scores reflect a more positive attitude toward seeking professional psychological help. The ATSPPH-S showed a coefficient alpha of .84 and a test-retest reliability of .80 over a 4-week interval. Previous research with a predominantly Asian American student sample yielded an alpha coefficient of .80 (Vogel, Wade, & Hackler, 2007). The data from the present study yielded an alpha coefficient of .77.
For the current investigation, a medium effect was desired at an alpha level of .05 with a selected level of power at .95. The G*Power 2 (Erdfelder, Faul, & Buchner, 1996) program determined that 124 participants would be required to identify a medium effect using multiple regression analyses.
Participants were recruited from academic classes, Asian American student organizations, and ethnic and religious organizations on a large, urban, university campus. This study was reviewed and approved by the IRB IRB
See: Industrial Revenue Bond at Columbia University Columbia University, mainly in New York City; founded 1754 as King's College by grant of King George II; first college in New York City, fifth oldest in the United States; one of the eight Ivy League institutions. . During survey administration, we explained the purpose of the study to participants and asked them to complete a packet of questionnaires containing a consent form and the instruments. Participation was voluntary and participants were not provided any monetary compensation. We informed participants that they could discontinue dis·con·tin·ue
v. dis·con·tin·ued, dis·con·tin·u·ing, dis·con·tin·ues
1. To stop doing or providing (something); end or abandon: participation at any time and could refuse to answer any of the questions. The order of the surveys varied to account for potential ordering effects.
Research analyses followed procedures established in the help-seeking literature (i.e., Tata & Leong, 1994) and for mediation analyses (Barron & Kenny, 1986; Frazier, Tix, & Barron, 2004). Pearson correlation coefficients Correlation Coefficient
A measure that determines the degree to which two variable's movements are associated.
The correlation coefficient is calculated as: were assessed to determine potential multicolinearity in the analysis. Following the correlation analyses, regression analyses were performed to asses the explanatory effects of the five variables and mediational correlations were conducted to determine the strength of the relation among the independent (adherence to Asian values), mediator mediator n. a person who conducts mediation. A mediator is usually a lawyer, or retired judge, but can be a non-attorney specialist in the subject matter (like child custody) who tries to bring people and their disputes to early resolution through a conference. (stigma), and dependent (attitudes toward seeking professional psychological help) variables.
Findings (see Table 1) indicated significant correlations between ATSPPH-S scores and AVS scores (r = -0.24, p < .01), SSRPH scores (r = -0.22, p < .01) and gender (r = 0.21, p < .01). Adherence to Asian values and stigma for receiving psychological help were significantly inversely in·verse
1. Reversed in order, nature, or effect.
2. Mathematics Of or relating to an inverse or an inverse function.
3. Archaic Turned upside down; inverted.
1. related to attitudes toward seeking professional psychological help, whereas being female was associated with more positive help-seeking attitudes. A correlation between ATSPPH-S scores and relational-interdependent self-construal (r = 0.16, p < .05), and between ATSPPH-S scores and age (r = 0.19, p < .01), was also found. The independent variables of relational interdependent self-construal and age positively and significantly correlate with the dependent variable of attitudes toward seeking professional psychological help.
Multiple regression analyses were performed to assess the effects of gender, age, adherence to Asian values, relational-interdependent self-construal and stigma on attitudes toward seeking professional psychological help. The results indicated that the overall regression model was significant F(5, 213) = 7.53, p < .001 (see Table 2). Adherence to Asian values was most significantly related to attitudes toward seeking professional psychological help ([beta] = 0.19,p < .01) as compared with gender, age, stigma and relational-interdependent self-construal.
To assess the mediation hypothesis, a multiple regression was performed on attitudes toward seeking professional psychological help with adherence to Asian values as the independent variable, stigma as the mediating variable, and gender and age as covariates; F(4, 214) = 7.51, p < 0.001; [R.sup.2] = .11 (see Table 3). The results showed that after controlling for age and gender, the negative direct effect of adherence to Asian values on attitudes toward seeking professional psychological help was reduced when stigma was entered into the regression equation Regression equation
An equation that describes the average relationship between a dependent variable and a set of explanatory variables. ([beta] = 0.19 versus [beta] = -0.15). The significance of the mediated effect was tested utilizing standard procedures for testing mediation effects (Barron & Kenny, 1986; Frazier, Tix, & Barron, 2004). The significance test yielded a z score of -l.76, which was not significant at the p < .05 level. Thus, stigma does not serve as a statistically significant mediator between adherence to Asian values and attitudes toward seeking professional psychological help.
Our primary objective in this study was to understand demographic, socio-cultural, and relational factors influencing Asian American students' attitudes toward seeking professional psychological help. Results showed an inverse relation In mathematics, the inverse relation of a binary relation is the relation taken 'backwards', as in changing the relation 'child of' to 'parent of'. In formal terms, if
v. with·held , with·hold·ing, with·holds
1. To keep in check; restrain.
2. To refrain from giving, granting, or permitting. See Synonyms at keep.
3. their strong emotions and exercise restraints to avoid embarrassment and shame in public; conform to Verb 1. conform to - satisfy a condition or restriction; "Does this paper meet the requirements for the degree?"
coordinate - be co-ordinated; "These activities coordinate well" family and social norms by not focusing on personal issues to preserve social harmony; or, to accept and endure problems (Yeh, 2000).
Consistent with previous studies, we also found that Asian American students with a higher level of perceived stigma for receiving psychological help tended to harbor negative help-seeking attitudes. The stigma may stem from the discrepancy between the Western notion of counseling and traditional Asian values in dealing with psychological problems. Asians may perceive receiving professional help as a sign of weakness (Narikiyo & Kameoka, 1992), personal immaturity (Uba, 1994), or even an indicator of hereditary HEREDITARY. That which is inherited. flaws that shame the family (Flaskerud & Liu, 1990; Yeh, 2000). Furthermore, the process of discussing psychological problems with a mental health professional may suggest inadequacies in family support, thus bringing disgrace to the family (Zane & Yeh, 2002). The high level of stigmatization stigmatization /stig·ma·ti·za·tion/ (stig?mah-ti-za´shun)
1. the developing of or being identified as possessing one or more stigmata.
2. the act or process of negatively labelling or characterizing another. of mental health problems may discourage Asian American students from seeking professional psychological help despite the availability of services on campus. The stigma may also reinforce their tendency to define mental health problems in physical terms and utilize services provided by physicians instead of psychologists, as the former form of service is more socially and culturally acceptable (Tsai, Butcher, Munoz, & Vitousek, 2001).
We hypothesized that Asian cultural values would lead to a negative internalization Internalization
A decision by a brokerage to fill an order with the firm's own inventory of stock.
When a brokerage receives an order they have numerous choices as to how it should be filled. of stigma to receive psychological help, which, in turn, would lead to negative help-seeking attitudes. However, the proposed mediation model in the present study was not statistically significant and did not support this idea. This finding contradicts previously held assumptions of the role of stigma in Asian American help seeking patterns of use. Our contradictory findings underscore The underscore character (_) is often used to make file, field and variable names more readable when blank spaces are not allowed. For example, NOVEL_1A.DOC, FIRST_NAME and Start_Routine.
(character) underscore - _, ASCII 95. the possibility that other factors may contribute to negative attitudes towards seeking out mental health services. Specifically, our measure of Asian values included measures of Conformity to Norms, Family Recognition Through Achievement, Emotional Self-Control, Collectivism, Humility, and Filial Piety. These Asian values may contribute to negative help seeking attitudes but not through stigma.
Our results add to the help-seeking literature by providing empirical evidence that Asian American students with a higher relational-interdependent self-construal have a more positive attitude toward seeking professional help. High relational individuals tend to have more positive cognitive associations for relationships (Greenwald & Banaji, 1995) and are more likely to take an open and accepting stance toward establishing new relationship with others (Cross, Morris, & Gore, 2002), including those with the helping professionals. Furthermore, Asian American students with a relational-interdependent self-construal may be more likely to experience reverence for authority or value someone with wisdom information and develop a positive affinity toward counselors who they see as knowledgeable experts.
This study also supports previous findings that Asian female students tend to have more positive attitudes toward seeking professional help (Gloria, Hird, & Navarro, 2001; Leong & Zachar, 1999; Tata & Leong, 1994; Tracey, Leong, & Glidden, 1986; Yeh, 2002). This finding may be due to expectations and processes surrounding counseling (e.g., disclosure of emotions) that are more culturally congruent con·gru·ent
1. Corresponding; congruous.
a. Coinciding exactly when superimposed: congruent triangles.
b. for Asian females; whereas Asian males, on the other hand, are expected to be emotionally restricted, logical, and counter-dependent under the cultural and social influences (Chang, Yeh, & Krumboltz, 2001). Asian men learn at young age to not display emotions in front of others and to be responsible for maintaining the family name and reputation. Hence, seeking counseling may reflect poorly upon Asian American males as well as on their families (Sue, 1994), and they are less willing to express emotional upset overtly as compared to European American males (Chia, Moore, Lam, & Chuang, 1994). This gender-role socialization socialization /so·cial·iza·tion/ (so?shal-i-za´shun) the process by which society integrates the individual and the individual learns to behave in socially acceptable ways.
n. while culturally mandated, may hinder the development of positive help-seeking attitudes and inhibit the actual help-seeking behavior (Komiya et al., 2000).
In contrast to the results found in the Vogel et al. study (2007), we did not find gender differences in the perception of stigma. This inconsistency in·con·sis·ten·cy
n. pl. in·con·sis·ten·cies
1. The state or quality of being inconsistent.
2. Something inconsistent: many inconsistencies in your proposal. may be related to the different populations being examined, as the participants in the Vogel et al. study were primarily European American and the participants in our study were exclusively Asian American. The interaction of culture, gender, stigma, and help seeking is a complex one. Future research should focus on the role of gender on stigma and help seeking especially within the context of cultural values.
In addition, our study sheds light on previously inconsistent findings related to age and help-seeking attitudes, in that older students have more positive help-seeking attitudes. It is possible that older students have more knowledge about available mental health resources, they may be more likely to seek information about problems, and they may have developed coping strategies The German Freudian psychoanalyst Karen Horney defined four so-called coping strategies to define interpersonal relations, one describing psychologically healthy individuals, the others describing neurotic states. that include seeking professional psychological help (Kliewer, Lepore, Broquet, & Zuba, 1990).
Implications for Practice
We wish to highlight several relevant implications for mental health counseling with Asian American students. First, we found that adherence to Asian values may be a deterrent to having more positive help-seeking attitudes. Specifically, talking with a stranger and sharing personal information outside of the family boundaries is contradictory to Asian values which highlight family privacy and keeping feelings to oneself (Uba, 1994; Yeh, 2000). Hence, mental health counselors A mental health counselor is a professional who provides counseling to individuals, couples, families, groups, or larger systems. A mental health counselor may also have training in educational and vocational counseling (MacCluskie & Ingersoll 2001). need to be trained and equipped with multicultural knowledge and competencies, which would help to identify, acknowledge and appreciate Asian coping strategies that involve family and close social networks (Yeh & Wang, 2000).
Because many Asian American college students associate stigma with seeking professional help, mental health counselors may need to broaden outreach services to include culturally congruent forms of healing. Specifically, outreach efforts to Asian American communities may include collaborations with ethnic churches, ethnic organizations, and primary health care services; such sites could also act as referral sources for mental health care. For example, a previous study seeking to modify college students' opinions about psychotherapy reported more positive help-seeking attitudes after the intervention (Gonzalez, Tinsley, & Kreuder, 2002). Problems may be viewed less shamefully shame·ful
a. Causing shame; disgraceful.
b. Giving offense; indecent.
2. Archaic Full of shame; ashamed. when individuals are provided with explanations for their symptoms and a possible course of treatment. Workshops and psycho-educational groups on campus may be avenues to share information in this regard. Groups could focus on barriers (e.g., language, cultural norms/beliefs) commonly faced by Asian American and Asian international students. This strategy may help familiarize Asian American students with mental health concepts and inform them about options in counseling or psychotherapy.
Our results also indicate that Asian males in general have more negative attitudes than Asian females toward seeking professional help. Mental health counselors may need to develop creative alternatives for engaging Asian American males in therapy. For example, previous research has found that online support groups are an effective means of engaging Asian American men in discussions about their race and ethnicity (Chang et al., 2001). This group relied on the use of anonymity in reducing stigma associated with emotional expression and provided a forum where Asian American males could discuss specific cultural values and strategies for coping with mental health concerns.
Limitations and Future Research
There are several limitations associated with this study. First, survey packets were administered to a few colleges and universities in the specific geographic location of New York City New York City: see New York, city.
New York City
City (pop., 2000: 8,008,278), southeastern New York, at the mouth of the Hudson River. The largest city in the U.S. . These sites were selected due to convenience and student age populations. Moreover, the urban setting provided a culturally diverse sample of Asian Americans.
The research is also limited in its relatively small sub-samples of specific ethnic groups of Asian American students. Thus we were unable to compare across ethnic groups. The sample was largely Chinese and Korean American Korean Americans (Korean: 한국계 미국인, Hanja: 韓國系美國人, hangukgye migugin) are Americans of Korean descent. which may have reflected specific East Asian cultural values and practices.
Data were entirely self-report in nature and may reflect socially desirable response sets. Moreover, the data were entirely quantitative in nature and relied on forced choice responses by the participants. Additional research may include more open ended and exploratory questions that provide more in depth answers about the relation between cultural values and stigma.
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Munyi Shea is affiliated with the Department of Counseling and Clinical Psychology at Teachers College, Columbia University Teachers College, Columbia University (sometimes referred to simply as Teachers College; also referred to as Teachers College of Columbia University or the Columbia University Graduate School of Education . Christine J. Yeh is affiliated with the Department of Counseling Psychology at University of San Francisco • • [ . Correspondence regarding this article can be addressed to Munyi Shea at the Department of Counseling and Clinical Psychology, Teachers College, Columbia University, 525 West 120th St., New York, NY 10027. E-mail: email@example.com.
Table 1. Means, Standard Deviations, and Intercorrelations of Study Variables Variable M SD 1 2 3 4 1. ATSPPH-S 1.69 0.53 -- -0.24** -0.21 ** 0.16 * 2. AVS 4.07 0.62 -- 0.36 ** 0.05 3. SSRPH 1.17 0.47 -- 0.09 4. RISC 5.16 0.93 -- 5. Gender 1.65 0.48 6. Age 24.56 4.09 Variable 5 6 1. ATSPPH-S 0.21 ** 0.19 ** 2. AVS -0.07 0.02 3. SSRPH -0.07 -0.08 4. RISC 0.15 * -0.01 5. Gender -- 013 6. Age -- Notes. ATSPPH-S = Attitudes toward Seeking Professional Psychological Help-Short form (Fischer & Farina, 1995). AVS = Asian Value Scale (Kim, Atkinson & Yang, 1999). SSRPH = Stigma Scale for Receiving Psychological Help (Komiya, Good & Sherrod, 2000). RISC = Relational-Interdependent Self Construal Scale (Cross, Bacon & Morris, 2000). The mean scores correspond to results on a Likert-type scale. ** p < .01 * p < .05 Table 2. Summary of Multiple Regression Analyses for Variables Explaining Attitudes Toward Seeking Professional Psychological Help (N = 219) Variable B SE B p t 1. AVS -0.158 0.057 -0.185 -2.76 ** 2. SSRPH -0.161 0.075 -0.144 -2.145 * 3. RISC 0.0946 0.036 0.167 2.611 * 4. Gender 0.168 0.07 0.154 2.406 * 5. Age 0.0138 0.006 0.137 2.166 * Notes. AVS = Asian Value Scale (Kim, Atkinson & Yang, 1999). SSRPH = Stigma Scale for Receiving Psychological Help (Komiya, Good & Sherrod, 2000). RISC = Relational-Interdependent Self-Construal Scale (Cross, Bacon & Morris, 2000). ** p <.01 * p <.05 Table 3. Regression for Adherence to Asian Values, Stigma, Gender and Age Predicting Attitudes Toward Seeking Professional Psychological Help (N = 219) Model One Variables [beta] SE B [beta] t AVS -.188 .055 -.221 -3.439 *** Stigma -- -- -- -- Gender .206 .07 .188 2.936 ** Age .0136 .006 .135 2.105 * Model Two Variables B SE B [beta] t AVS -.151 .058 -.177 -2.619 ** Stigma -.143 .076 -.128 -1.889 Gender .198 .07 .181 2.836 ** Age .0129 .006 .128 2.006 * Note. ATSPPH-S = Attitudes toward Seeking Professional Psychological Help-Short form (Fischer & Farina, 1995). AVS = Asian Value Scale (Kim, Atkinson & Yang, 1999). SSRPH = Stigma Scale for Receiving Psychological Help (Komiya, Good & Sherrod, 2000). *** p .001 ** p .01 * p .05