The role of acculturation in the relationship between self-stigma and psychological distress among Chinese American breast cancer survivors.

Attitudes about breast cancer have improved in the USA, yet stigma is still present in some ethnic and immigrant populations and affecting survivors' experiences. Chinese American breast cancer survivors report negative beliefs and stigma to be a major stressor; this could result in mental health consequences. We hypothesized that greater self-stigma will be related to greater psychological distress (namely, depressive symptoms, and perceived stress). Furthermore, we expected that the association between self-stigma and psychological distress will be stronger among Chinese American breast cancer survivors who are less acculturated to the USA than those who are highly acculturated. One hundred and thirty-six Chinese American breast cancer survivors completed questionnaires that measured self-stigma, acculturation, depressive symptoms, perceived stress, and demographic information. Hierarchical linear regressions were conducted to examine the main effect of stigma on depressive symptoms and perceived stress, and the moderating effect of acculturation. As predicted, self-stigma was associated with greater depressive symptoms and perceived stress among Chinese American breast cancer survivors, especially those who are less acculturated. Self-stigma may play a part in psychological adjustment among Chinese American breast cancer survivors. Interventions that incorporate techniques to reduce self-stigma could be beneficial for Chinese American breast cancer survivors, especially for those who are less acculturated to American society.

Relation of social constraints on disclosure to adjustment among Chinese American cancer survivors: A multiprocesses approach.

PURPOSE: The present study examines the association between social constraints and depressive symptoms among Chinese American breast cancer survivors, and the mechanism underling this association. A multiprocesses model is tested to examine the mediating roles of ambivalence over emotional expression (AEE), avoidance, intrusive thoughts, and social support in the association between social constraints and depressive symptoms among Chinese American breast cancer survivors. METHODS: Ninety-six Chinese American breast cancer survivors were recruited from Chinese community organizations. They were asked to complete a questionnaire package that assessed social constraints, AEE, avoidance, intrusive thoughts, social support, depressive symptoms, and demographic information. Path analysis was conducted to test the hypothesized model. RESULTS: The overall and specific indirect effects of social constraints on depressive symptoms through AEE, avoidance, intrusive thoughts, and social support are significant. When the mediators are controlled for, the direct effect of social constraints on depressive symptoms is no longer significant. CONCLUSIONS: A multiprocesses model of social constraints and depressive symptoms is tested in a sample of Chinese American breast cancer survivors. The findings suggest that the existence of multiple pathways through which social constraints may associate with depressive symptoms among Chinese American breast cancer survivors.