Temporal Orientation and the Association Between Adverse Life Events and Internalizing Symptoms in Vietnamese American and European American Adolescents.

Adverse life events are associated with greater internalizing symptoms. However, prior research has identified cross-cultural variation in whether and to what extent factors amplify or buffer the impact of these stressors. Broadly defined as the tendency to focus on past, present, or future events, temporal orientation is a dispositional factor that is culturally influenced and may explain variance in internalizing symptoms following adverse events. Cultural congruence, or the degree to which a factor is considered normative in an individual's culture, may be an important explanation of variation in levels of risk. The current study examines how culturally congruent temporal orientation differentially impacts the relation between adverse life events and internalizing symptoms in a longitudinal sample of 10th and 11th grade Vietnamese American (n = 372) and European American adolescents (n = 304). Results indicated that Vietnamese American adolescents endorsed significantly higher levels of past and present, but not future, temporal orientation compared to European American adolescents. Among both Vietnamese and European American adolescents, past temporal orientation was positively associated with internalizing symptoms and adverse life events. Findings also demonstrated that the influence of present temporal orientation on the relation between adverse life events and internalizing symptoms was further moderated by ethnicity, such that present temporal orientation buffered risk for negative outcomes among European Americans but not Vietnamese Americans. These data highlight the importance of measuring and testing specific dimensions of culturally relevant processes when considering responses to adverse life events.

Shifting Trends in Diagnosis of Asthma, Bronchiolitis, and Viral Pneumonia in Young Children.

Over the last decade, there have been widespread efforts to reduce non-evidence-based therapies for viral bronchiolitis. We question whether this change in practice has inadvertently impacted the diagnosis and management of other pediatric lower-respiratory-tract illnesses. We used the Pediatric Health Information System (PHIS) and logistic regression to describe trends in relative diagnosis frequency of bronchiolitis, viral pneumonia, and reactive airway disease (RAD)/asthma as well as systemic corticosteroid use among children of the age range 1 to 4 years over a 10-year period. Among 169,207 children, the relative frequency of asthma/RAD diagnoses declined over a 10-year period, while bronchiolitis and viral pneumonia diagnoses increased among children of the age range 1 to 3 years and 2 to 4 years, respectively. Frequency of systemic corticosteroid use declined. We question whether the observed shift in diagnosis from asthma/RAD to bronchiolitis or viral pneumonia is reflective of true disease pathophysiology or if it represents an unintended consequence of campaigns surrounding bronchiolitis.

Cultural differences in the relations between expressive flexibility and life satisfaction over time.

Background: Expressive flexibility refers to the ability to assess situational demands and adjust one's emotion expressions via enhancement or suppression. It has been associated with lower levels of depressive and anxiety symptoms and greater social acceptance. These relationships, however, have not yet been examined across cultures-where prior research has found cultural differences in norms on emotion displays and their associations with mental health. This study examined expressive flexibility across three cultural groups and their associations with life satisfaction and depressive symptoms over time. Methods: 276 first-year college students (146 Asian American, 71 European Americans, and 62 Latinx Americans) completed two online surveys during the first (T1) and thirteenth week (T2) of the Fall 2020 academic semester. Results: Results revealed no significant cultural group differences in the ability to enhance or suppress emotions. However, we found a significant ethnicity x enhancement ability interaction in predicting T2 life satisfaction, controlling for T1 life satisfaction, age, gender, and emotion regulation frequency. Specifically, greater ability to enhance one's emotions was significantly associated with higher life satisfaction over time among Asian Americans, but not for European Americans and Latinx Americans. Discussion: Our findings illustrate the importance of not looking just at cultural group differences in the levels of expressive flexibility, but also at the associations between expressive flexibility and mental health.

Microaggressions and general health among Black and Asian Americans: The moderating role of cognitive reappraisal.

OBJECTIVES: The present study has two aims: (a) to examine the frequency of various microaggression types experienced by Asian and Black Americans and (b) to examine cognitive reappraisal as a moderator of the relationship between microaggression types and general health. METHOD: Two hundred seventy-one Black and Asian American participants recruited from Amazon Mechanical Turk completed a cross-sectional online survey. The Racial and Ethnic Microaggressions Scale was used to assess the frequency with which participants experienced six different types of microaggressions. Cognitive reappraisal was assessed by the cognitive reappraisal subscale of the Emotion Regulation Questionnaire. General health was assessed by the RAND 36-item Short Form Health Survey. RESULTS: We found that Black Americans experienced higher levels of Inferiority, Criminality, Workplace/School Microaggressions and Microinvalidations than Asian Americans. In contrast, Asian Americans experienced greater Exoticization and Environmental Microaggressions. There were ethnic/racial group differences in whether cognitive reappraisal moderated the relationships between microaggression types and general health. CONCLUSIONS: Our findings highlight important differences in the types of microaggressions experienced across ethnic/racial groups, and the role of cognitive reappraisal in influencing the detrimental effects of microaggressions on general health. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Gratitude and psychological distress among first-year college students: The mediating roles of perceived social support and support provision.

Universities and colleges in the United States implemented remote learning and restrictions on in-person social events during the Fall 2020 academic semester. These changes and restrictions, in addition to the other numerous negative impacts of COVID-19, can exacerbate the already stressful transition from high school to college. This transition is a key developmental period during which the complexity of interpersonal relationships and the risk of internalizing symptoms such as anxiety and depression increase. As such, the present study examined dispositional gratitude as a protective factor against depressive symptoms and loneliness among a sample of first-year college students who began college during the peak of the COVID-19 pandemic. We also examined whether perceived social support and support provision mediated these relationships. Participants were 364 first-year college students who completed three online surveys during the 1st (T1), 7th (T2), and 14th (T3) weeks of the Fall 2020 academic semester. T1 gratitude was associated with lower T3 depressive symptoms and feelings of loneliness over time. These relationships were mediated by T2 perceived social support but not by T2 support provision. Implications of our findings are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The effects of culturally adapted expressive writing interventions on depressive and anxiety symptoms among Chinese American breast cancer survivors: A randomized controlled trial.

BACKGROUND: Expressive writing interventions confer mental health benefits for non-Hispanic Whites. However, research is lacking in adapting this paradigm for minoritized groups. This study evaluated the impacts of two culturally adapted expressive writing interventions on depressive and anxiety symptoms and potential mediators (perceived stress and intrusive thoughts) among Chinese American breast cancer survivors (CABCS). METHODS AND RESULTS: CABCS (N = 136) were randomly assigned to one of three conditions to write three weekly essays: enhanced self-regulation condition (ESR) to write about stress and coping (Week 1), deepest feelings (Week 2), and finding benefits (Week 3); self-regulation condition (SR) to write about deepest feelings (Week 1), stress and coping (Week 2), and finding benefits (Week 3); and control condition to write about facts relevant to their cancer experience (Weeks 1-3). Compared with the control condition, the ESR but not SR, reduced depressive and anxiety symptoms at all follow-up time points (1, 3, and 6-months) through reductions in perceived stress. CONCLUSION: A cultural adaptation altering the order of expressive writing prompts resulted in the greatest benefit for CABCS' depressive and anxiety symptoms. Research testing both the content and ordering of components may be vital to advance cultural adaptation science and optimize intervention efficacy. CLINICAL TRIAL REGISTRATION NUMBER: NCT02946619.

Asian American parents' experiences of stress, discrimination, and mental health during COVID-19.

INTRODUCTION: COVID-19 has placed Asian Americans (AA) at higher risk for discrimination within the U.S. This exacerbates the mental health distress of AA parents, who are also experiencing COVID-19-related stress (e.g., health, financial, work, childcare). The risk factors associated with mental health outcomes for AA parents are not well understood. This brief report examined the relationships among COVID-19 stress, discrimination, and psychological distress of AA parents during the initial months of the pandemic. METHOD: Baseline data of an ongoing longitudinal examination into the COVID-19 experiences of AA parents and their families were utilized. Participants were 166 AA parents of children ages 2-19 years. They completed an online survey about their experiences of COVID-19-related stress (i.e., childcare, school, work), discrimination, and psychological distress. RESULTS: The majority of AA parents were highly stressed due to school closures and childcare changes; school-age parents reported significantly more stress resulting from school closures than parents of young children or adolescents. Over 21% of AA parents experienced some discrimination resulting from COVID-19; the majority reported discrimination fears for themselves and their family/friends. Experiencing discrimination was positively associated with psychological distress, as was COVID-19 stress related to work performance and relationship quality. Conversely, the majority of parents reported increased quality time with their family (i.e., children, partners). DISCUSSION: AA parents are experiencing high levels of COVID-19-related stress, and have the added psychological burden of experiencing and fearing racial/ethnic discrimination. However, the pandemic has led to families spending more quality time together. Implications for future studies are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Impact of COVID-19 discrimination fear on psychological distress among East Asian college students: The moderating role of emotion regulation.

The COVID-19 pandemic has led to heightened discrimination and xenophobia against Asian Americans in the United States. Mainstream media have reported that East Asian individuals are increasingly fearful of becoming victims of anti-Asian discrimination. However, few studies have examined the fear of experiencing discrimination, especially among youths and young adults. This study examined the extent to which East Asian first-year college students in the United States have experienced the fear of anti-Asian discrimination during the pandemic, its impact on anxiety and depressive symptoms, and whether emotion regulation strategies moderated the relationship between the fear of discrimination and psychological distress. Participants completed a cross-sectional online survey (n = 139; Mage = 17.90; SD = 0.62; 64% female) and reported high levels of fears, with 40.3% and 29.5% of the participants endorsing "quite a bit" or "extremely" on worries about being harassed or not feeling physically safe due to COVID-19, respectively. Female students endorsed higher levels of fear than male students. We found that cognitive reappraisal moderated the relations between the fear of discrimination and depressive symptoms, such that higher levels of cognitive reappraisal buffered the detrimental effects of this fear on depressive symptoms. Similarly, emotion suppression moderated the relations between the fear of discrimination and distress, such that higher levels of emotion suppression were associated with lower levels of depressive and anxiety symptoms. These results highlight the need for university administrators and faculty to address East Asian first-year college students' high levels of fears related to experiencing anti-Asian discrimination during the pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Fatalism and Psychological Distress Among Chinese American Breast Cancer Survivors: Mediating Role of Perceived Self-control and Fear of Cancer Recurrence.

BACKGROUND: Extant literature on the relationship between cancer fatalism and psychological distress among Chinese American breast cancer survivors has been mixed, and few studies have examined potential mediators of this relationship. The current study examined how cancer fatalism is associated with psychological distress by investigating perceived personal control and fear of cancer recurrence as mediators, and acculturation as a moderator of these relationships. METHOD: A total of 220 Chinese American women diagnosed with stage 0-III breast cancer were recruited from California cancer registries and completed a telephone survey. The measurement of cancer fatalism examined one's view of health as a result of destiny. Validated measures of psychological distress (i.e., depressive and anxiety symptoms), fear of cancer recurrence, and perceived personal control were used. Acculturation was defined by English proficiency, preferred interview language, and number of years lived in the USA. RESULTS: Higher cancer fatalism was directly associated with greater depressive and anxiety symptoms after controlling for covariates. This association was also mediated by higher fear of cancer recurrence, but not by perceived control. The mediation was not moderated by acculturation. CONCLUSION: Our findings suggest that Chinese American breast cancer survivors' fatalistic beliefs may exacerbate fear of cancer recurrence, and, in turn, depressive and anxiety symptoms. Fear of recurrence was more salient than perceived control in their associations with psychological distress among Chinese American cancer survivors. Future intervention research may adopt cognitive approaches to alter Chinese survivors' fatalistic views of health outcomes to reduce their psychological distress.

How discrimination experiences relate to racial/ethnic identity and mental health across first- and second-generation Vietnamese American adolescents.

OBJECTIVES: Racial/ethnic discrimination has been linked to behavioral and emotional problems in youth from marginalized groups. However, the psychological experience associated with discrimination may differ between immigrant and nonimmigrant youth. Race-based discrimination may impact an adolescent's view of their own group (private regard) and/or their sense of how others view their group (public regard). Owing to differences in racialization, immigrant adolescents may be affected differently by experiences of discrimination than their U.S.-born peers. The present study examined whether nativity moderated the paths from racial/ethnic discrimination to private and public regard to mental health problems among Vietnamese American youth. METHOD: Surveys were completed by 718 Vietnamese American 10th and 11th graders (Mage = 15.54 years, 61.4% female, 38.6% male). In this sample, 21.2% were first-generation (i.e., born outside of the United States) and 78.8% were second-generation (i.e., born in the United States with at least one parent born outside of the United States). RESULTS: Multigroup path analysis tested the direct and indirect effects of racial/ethnic discrimination on behavioral and emotional problems via private and public regard and whether associations differed for first- versus second-generation youth. Racial/ethnic discrimination was associated with lower public regard, but not private regard, for both first- and second-generation Vietnamese American youth. Public regard was negatively associated with behavioral and emotional problems only among second-generation youth. No indirect effects were significant. CONCLUSIONS: Findings suggest differences in racialized experiences, as well as opportunities to support second-generation Vietnamese American and other marginalized youth from immigrant families from the mental health impacts of discrimination. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Negative COVID-19 impacts and depressive symptoms over time among first-year college students.

Objective: This study examined the disruptions to social life, financial impact, and academic concerns caused by COVID-19 experienced by first-year college students, as well as their associations with depressive symptoms over time. Participants and Methods: Five hundred and thirty freshman college students completed an online survey at baseline and 14-week follow-up. Results: We found that female students reported greater COVID-19 academic concerns than males. Black students endorsed lower COVID-19 academic concerns and Latinx students reported greater negative COVID-19 financial impact compared to other ethnic groups. First-generation college students reported greater negative COVID-19 financial impact than domestic students. COVID-19 academic concerns and negative social and financial impacts were associated with greater depressive symptoms at baseline. However, only COVID-19 academic concerns were associated with higher levels of depressive symptoms over time. Conclusions: Findings suggest that the academic, social, and financial disruptions caused by the COVID-19 pandemic have negative mental health consequences that should be addressed in research and university settings.

The importance of community and culture for the recruitment, engagement, and retention of Chinese American immigrants in health interventions.

Chinese Americans experience cancer health disparities throughout the entire cancer continuum. Yet, they remain underrepresented in health research in part due to barriers in recruitment, engagement, and retention. This paper describes the strategies that we devised, by drawing upon our experiences with conducting two culturally sensitive cancer intervention studies, to help researchers improve their recruitment and retention rates of Chinese Americans in health research and address the gap in knowledge on intervention research with this population. The first study assessed the efficacy, adoption, and impact of an intervention, delivered by community health workers, to improve adherence to recommended stomach cancer prevention guidelines for at-risk Chinese Americans. The second study evaluated the feasibility and preliminary efficacy of a culturally adapted version of the Expressive Helping intervention for Chinese American cancer patients and survivors. Our main recruitment strategies revolved around building community relationships, developing culturally sensitive materials, and establishing good first impressions with participants. Our main engagement and retention strategies focused on attending to cultural sensitivity, fostering relationships, and using technology. Harnessing the community's inherent strengths and prioritizing cultural understanding is crucial for culturally sensitive health research with Chinese Americans.

Comparing the effects of emotional disclosure and peer helping writing on psychological distress among Chinese international students: The moderating role of rumination.

OBJECTIVES: This study tested the effects of emotional disclosure writing and peer helping writing in reducing psychological distress among Chinese international students. This study also examined whether rumination and ambivalence over emotion expression moderated the effects of emotional disclosure and peer helping writing. METHOD: One hundred forty-four Chinese international students were randomly assigned to one of three conditions: emotional disclosure, peer helping, or neutral control writing. Participants completed two 20-min writing sessions and questionnaires at baseline, 2-month follow-up, and 4-month follow-up. RESULTS: We found no significant differences across the three writing conditions in levels of psychological distress over time. However, rumination emerged as a significant moderator in both emotional disclosure and peer helping intervention conditions. High ruminators generally experienced significant reductions in depressive symptoms, whereas low ruminators experienced increased depressive symptoms. CONCLUSIONS: These findings demonstrate that the benefits of writing interventions may vary as a function of rumination.

Longitudinal Relations between Emotion Restraint Values, Life Stress, and Internalizing Symptoms among Vietnamese American and European American Adolescents.

Objective: Recent research has documented cultural differences in the extent and manner in which various forms of emotion regulation are linked with psychological well-being. Most of these studies, however, have been cross-sectional, nor have they directly examined the values underlying the use of emotion regulation. The present study examined emotion restraint values and their interactions with life stress in predicting internalizing symptoms across time among Vietnamese American and European American adolescents. The study focused on adolescence as a critical developmental period during which life stress and internalizing symptoms increase significantly. Method: Vietnamese American (n = 372) and European American (n = 304) adolescents' levels of emotion restraint values, internalizing symptoms, and stress were assessed at two timepoints six months apart. Results: Results indicated differential associations between emotion restraint values, stress, and symptoms over time for the two groups. For Vietnamese American adolescents, emotion restraint values did not predict depressive, anxiety, or somatic symptoms. For European American adolescents, emotion restraint values predicted higher somatic symptoms but buffered against the effects of interpersonal stress on anxiety and depressive symptoms. Conclusions: These results provide increased understanding of the role of values related to emotion restraint in shaping adolescent internalizing symptoms and responses to stress across cultural groups. Implications of the findings for guiding intervention efforts are discussed.

When and how supporting others can improve life satisfaction: A longitudinal study examining collectivistic values.

Objectives: Individuals who support others reap mental health benefits from this act. Recent studies have identified individual differences in other-oriented processes that shift who benefits the most from support giving. Yet existing studies have examined people from individualistic societies (e.g., United States), and whether these findings extend to individuals from collectivistic societies (e.g., China) remain unknown. Moreover, little is known about the pathways through which support giving may lead to higher life satisfaction. With a sample of Chinese international students, we examined how individual differences in collectivistic values (i.e., face concerns and prosocial motivations) shift the impact of support giving to close others on life satisfaction. We also examined the underlying role of positive and negative emotions. Method: One hundred seventy-eight Chinese international students completed online baseline and 2-month follow-up surveys. Results: Emotional support giving, but not instrumental support giving, was associated with greater life satisfaction through increased positive and reduced negative emotions over time. The mediation pathways were moderated by face concerns such that the indirect effects of both positive and negative emotions were significant only among those with high face concerns and not among those with low face concerns. Conclusions: Our findings suggest that the mental health benefits of support giving are shaped by the cultural values of the individual. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Systematic review of depressive, anxiety and post-traumatic stress symptoms among Asian American breast cancer survivors.

OBJECTIVES: This paper aimed to review the experience of psychopathology symptoms (ie, depressive, anxiety and post-traumatic stress) and their social, cognitive and affective correlates among Asian American breast cancer survivors. Studies on psychosocial interventions for reducing psychopathology symptoms were also included in this review. DESIGN: A systematic review was conducted. METHODS: PubMed, PsycINFO and Web of Science were searched from database inception to November 2018. Empirical, peer-reviewed articles on adult women of Asian heritage residing in the USA with breast cancer diagnoses were included in this review. The methodological quality of the included articles was coded. RESULTS: The search yielded 16 empirical articles, which were all deemed to be of high methodological quality. Eleven studies utilised a quantitative design, two studies utilised a qualitative design and three studies utilised a mixed-methods design. Thirteen were cross-sectional and three were longitudinal in design. Only two intervention studies were identified. Studies showed that Asian American breast cancer survivors endorsed moderate to high levels of depressive symptoms, anxiety and post-traumatic stress symptoms; those who are more acculturated demonstrated lower levels of depressive and anxiety symptoms. Asian American breast cancer survivors with social constraints were more likely to have intrusive thoughts and, in turn, have high levels of psychopathology symptoms. Intervention studies were limited, but the use of community-based participatory research approaches and cultural adaptations were noted strengths of the studies. DISCUSSION: In addition to discussing clinical implications, we highlight limitations of the literature, including a lack of longitudinal studies and the limited use of standardised diagnostic instruments for assessing psychopathology symptoms among this population. Clarifying the prospective relationships between psychopathology symptoms and their social, cognitive and affective correlates will help inform the development of culturally sensitive psychosocial interventions among Asian American breast cancer survivors.

The associations of self-stigma, social constraints, and sleep among Chinese American breast cancer survivors.

PURPOSE: The aim of the current study was to examine the incidence of poor sleep quality, medication use, and dysfunction and the association of self-stigma and perceived social constraints (i.e., ambivalence over emotional expression; AEE) on sleep among a sample of Chinese American breast cancer survivors. METHODS: The data were based on self-report baseline data (n = 136) from an expressive writing intervention study for Chinese American breast cancer survivors (MTime since diagnosis = 27.17 months; SD = 19.31). Participants completed self-report questionnaires related to psychological and physical health and health behaviors. Using linear regression and path modeling, our hypotheses were tested using models where (1) self-stigma predicted sleep characteristics (i.e., quality, medication use, and dysfunction) with (2) AEE mediating the relationship between self-stigma and sleep. RESULTS: Participants frequently reported poor sleep quality (44.9%), use of sleep aids (37.5%), and difficulty staying awake during the day (37.5%). Greater self-stigma was related to greater AEE (b = .48, SE = .09, p < .05), which was related to worse sleep quality (b = - .19, SE = .08, p < .05), greater use of sleep aids (b = .25, SE = .11, p < .05), and greater difficulty staying awake during the day (b = .30, SE = .09, p < .05). Further, the indirect effect of self-stigma on sleep quality (ab = - .09, 95% CI - .19, - .03), use of sleep aids (ab = .12, 95% CI .03, .25), and difficulty staying awake during the day (ab = .15, 95% CI .06, .18) through AEE was significant. CONCLUSION: The results of this study highlight significant sleep-related problems among Chinese American breast cancer survivors and the importance of considering cultural beliefs of cancer in counseling. IMPLICATION FOR CANCER SURVIVORS: Chinese American breast cancer survivors are at risk for sleep-related difficulties due, in part, to perceived self-stigma and emotional constraints. Greater education and community outreach to Chinese communities may help destigmatize breast cancer and encourage emotional expression around cancer-related topics.

Cultural variation in temporal associations among somatic complaints, anxiety, and depressive symptoms in adolescence.

OBJECTIVE: Different domains of internalizing symptoms (somatic, anxiety, depressive) often occur concurrently, suggesting that they may share common etiology. In longitudinal analyses of internalizing among youth, anxiety is often found to precede depression. However, relatively few studies have also assessed how somatic problems, the third symptom domain, are involved in longitudinal patterns of internalizing. In addition, temporal relations among internalizing symptom domains may vary by cultural group as somatic symptoms are posited to be a more culturally-normative way of communicating or experiencing distress in non-Western, interdependent cultures. Thus, the present study examined longitudinal relations among these three internalizing symptom domains in three ethnocultural adolescent samples. METHODS: 304 European American, 420 Vietnamese American, and 717 Vietnamese adolescents' self-reported internalizing symptoms (somatic, anxiety, depressive) were assessed at three time points, spaced three months apart, using multigroup cross-lagged path analysis. RESULTS: Anxiety symptoms consistently predicted increases in depressive symptoms in European American adolescents. In contrast, for Vietnamese and Vietnamese American adolescents, the most consistent relation was with somatic complaints predicting increases in anxiety. Anxiety and depressive symptoms bidirectionally predicted each other among the Vietnamese and Vietnamese American adolescents. CONCLUSIONS: Cultural group differences were evident in the temporal course of internalizing symptoms. The pattern of results have implications for culturally relevant intervention targets, during a developmental period of risk for internalizing disorders.