Depression among Asian Americans: Review and Recommendations

This article presents a review of the prevalence and manifestation of depression among Asian Americans and discusses some of the existing issues in the assessment and diagnosis of depression among Asian Americans. The authors point out the diversity and increasing numbers of Asian Americans and the need to provide better mental health services for this population. While the prevalence of depression among Asian Americans is lower than that among other ethnic/racial groups, Asian Americans receive treatment for depression less often and its quality is less adequate. In addition, the previous belief that Asians somatize depression may become obsolete as more evidence appears to support that Westerners may “psychologize” depression. The cultural validity of the current DSM-IV conceptualization of depression is questioned. In the course of the review, the theme of complexity emerges: the heterogeneity of ethnic Asian American groups, the multidimensionality of depression, and the intersectionality of multiple factors among depressed Asian Americans

Psychosocial risk factors associated with social anxiety, depressive and disordered eating symptoms during COVID-19

The coronavirus (COVID-19) pandemic has disrupted society and negatively impacted mental health. Various psychosocial risk factors have been exacerbated during the pandemic, leading to the worsening of psychological distress. Specifically, a need for structure, loneliness, concerns about body image and social media use are risk factors previously implicated in poor mental health. The current study examines how these risk factors are associated with mental health outcomes (i.e., social anxiety, depressive and disordered eating symptoms) during the COVID-19 pandemic (January–March 2021). A total of 239 participants were recruited (average age = 24.74, 79% female, 68% White). The results revealed that a need for structure, loneliness and social media use were positively associated with social anxiety. In addition, loneliness, negative concerns about body image and social media use were significantly related to disordered eating and depressive symptoms. Lastly, when examined all together, the overall model for risk factors predicting mental health outcomes was significant: Wilks' Λ = 0.464, F(12, 608.814) = 17.081, p < 0.001. Loneliness and social media use were consistently associated with all psychological symptoms. These results emphasize the need for interventions for social anxiety, depressive and disordered eating symptoms that encourage structured daily activities, social connection, positive perception of oneself and mindful social media use

Understanding family dynamics in a cross-cultural sample: a multi-national study

The Family Systems Circumplex Model posits that balanced levels of cohesion and adaptability are associated with positive familial outcomes, whereas extremely high or low levels of these factors are associated with deleterious outcomes. Despite the popularity and utility of this model in Western cultures, there is a dearth of empirical data supporting its use in more culturally diverse contexts. The current, preregistered study assessed the Family Circumplex Model, cultural factors, and emerging adult outcomes across seven countries (i.e., China, Iran, Nigeria, Switzerland, Turkey, the United Kingdom, and the United States). Participants were N = 3,593 emerging adults, mostly self-identifying as women (71.3%). Collaborators were participants in Psi Chi’s Network for International Collaborative Exchange (NICE) and administered measures related to family dynamics and cultural orientation to participants in a random order. Results indicated that the Family Circumplex Model did not fit cross-culturally. As such, a new model was adapted, the Expanded Circumplex Model, which demonstrated invariance across samples and between women and men. The Expanded Circumplex Model retained 6 constructs with differences regarding the separation of disengagement into 2 variables and the combining of adaptive flexibility and cohesion. The current study suggests that the cultural context in which family dynamics occur should be taken into consideration when conceptualizing family dynamics theory and measurement. Future work should seek to replicate and further apply the Expanded Circumplex Model to familial outcomes

Comparative Effectiveness Research on Asian American Mental Health: Review and Recommendations

The purpose of this manuscript is to describe the comparative effectiveness research (CER) paradigm and its important role in guiding current federal funding of research and examine how this paradigm can be used to guide Asian American mental health research. We will begin with a review of comparative effectiveness research and provide several examples of Asian American studies, which fit into the paradigm. In discussing how we may map the CER onto Asian American mental health research, the problem of differential research infrastructure will be introduced and used to frame our recommendations for future research. We provide some recommendations for using CER in Asian American mental health research by noting the need for multiple approaches due to the problem of differential research infrastructure, and expanding the human capital and data infrastructure. The pros and cons of randomized control trials (RCT) are discussed and an example of a study being planned by the authors is presented to illustrate how to undertake studies on Asian American mental health using the CER paradigm

Reliability and validity of the Farsi version of the Patient Health Questionnaire-9 (PHQ-9) with Iranian psychiatric outpatients

Abstract Introduction: The Patient Health Questionnaire-9 (PHQ-9) is a brief screening and diagnostic tool for depression. It has been used in research and clinical practice in primary care and other clinical and non-clinical settings. The PHQ-9 has not had its validity examined in psychiatric and psychological settings in Iran. Methods: A cross-sectional study was conducted to investigate the validation of the Farsi version of the PHQ-9. A convenience sample of 130 Iranian volunteer psychiatric outpatients was selected from psychiatric and psychological clinics. They completed the PHQ-9, the Patient Health Questionnaire-15 (PHQ-15), the World Health Organization-five Well-Being Index (WHO-5), and the short form of the Beck Depression Inventory-13 (BDI-13). Data were analyzed by descriptive statistics, Cronbach's α, Pearson correlation coefficient, principal component analysis, exploratory factor analysis, and confirmatory factor analysis. Results: Mean score of the PHQ-9 was 12.83 (standard deviation = 6.25), indicating moderately severe depression in the sample. Cronbach's α coefficient for PHQ-9 was 0.88, and one-week test-retest reliability 0.79. The PHQ-9 correlated 0.64 with PHQ-15, −0.35 with WHO-5, and 0.70 with BDI-13, indicating good construct and criterion-related validity. The results of the factor analysis of PHQ-9 items identified and confirmatory factor analysis confirmed a single factor labeled general depression. Conclusions: The PHQ-9 appears to have a unidimensional structure, adequate validity and reliability, and can be useful in epidemiological/research settings. Based on previous literature and on the present findings, the PHQ-9 may have applicability to other contexts in the studied population, but this needs to be confirmed by other studies