Handbook of Mental Health and Acculturation in Asian American Families (eBook)

Current Clinical Psychiatry 2
Handbook of Mental Health and Acculturation in Asian American Families 3
Preface 5
Contents 7
Contributors 9
Introduction 11
Part 1: Research on Acculturation in Asian American Mental Health 14
Acculturation: Measurements and Review of Findings 15
Definition 16
Assessment 17
Behavioral Acculturation Scales: Scales Based on Determining Acculturation by Behaviors 17
Values Acculturation Scales: Scales Based on Determining Acculturation by Values 18
Behavioral and Values Acculturation Scales: Scales Based on Assessment of Behaviors and Values 19
Pan-Ethnic Acculturation Scales: Scales Suitable for Diverse Ethnic Populations 19
Why Study Acculturation-Research Findings 20
Acculturation Status and Physical Health 21
Acculturation Status and Mental Health 23
Acculturation Status and School Performance 26
Acculturation Status and Career Decisions 27
Acculturation Status and Attitudes Toward Counseling and Therapy 28
Summary 30
References 30
Theories and Research on Acculturation and Enculturation Experiences among Asian American Families 36
Construct Definitions of Acculturation and Enculturation for Asian American Families 37
Theories and Research on the Consequences of Acculturation and Enculturation for Asian American Families 39
Relationships among Parent-Child Cultural Values Gap, Cognitive Flexibility, and Family Conflict 43
Method 44
Participants 44
Instruments 44
Adherence to Asian Cultural Values 45
Procedure 46
Results 47
Preliminary Analysis 47
Main Analyses 48
Discussion of the Results 49
Limitations and Implications 51
Conclusion 52
References 52
Strengthening Intergenerational/Intercultural Ties in Immigrant Families (SITIF): A Parenting Intervention to Bridge the Chinese American Intergenerational Acculturation Gap 55
Strengthening Intergenerational/Intercultural Ties in Immigrant Families 56
Significance of Intergenerational/Intercultural Conflict in Immigrant Families 57
Strengthening Intergenerational/Intercultural Ties in Immigrant Families (SITIF) 58
SITIF’s Effectiveness with Chinese American Immigrant Parents 60
Method 62
Sample 62
Procedure 63
Measures 64
Results 66
Engagement with SITIF 66
Objective Mastery of the SITIF Curriculum 66
Subjective Evaluation of SITIF’s Effectiveness 67
Association of and Objective Mastery and Subjective Evaluation of Effectiveness 69
Discussion 69
Engagement with SITIF 69
Objective Mastery of the SITIF Curriculum 70
Subjective Evaluation of SITIF’s Effectiveness 71
Association of Objective Mastery and Subjective Evaluation of Effectiveness 71
Study Limitations and Directions for Future Research 71
References 72
Acculturation: Recommendations for Future Research 75
Summarization of Previous Chapters 75
Considerations for Future Research 76
Research Populations and Subject Selection 77
Identifying Study Populations by Groups 77
Identifying Study Populations by Individual Characteristics 79
Measurement Procedure Issues 81
General Research Design Considerations 83
Summary 84
References 84
Part 2: Clinical Insights on Acculturation in Asian American Mental Health 88
The Impact of Immigration and Acculturation on the Mental Health of Asian Americans: Overview of Epidemiology and Clinical Implications 89
Within-Group Diversity 90
Acculturation Stress Pertaining to Asian American Mental Health 91
Key Factors Affecting Asian American Mental Health 93
Language Barrier among Parents 93
Intergenerational Conflict 93
Identity Crisis 94
Domestic Violence 94
Prejudice and Discrimination 95
Epidemiology of Mental Health Problems among Asian Americans 95
Findings on Asian American Children and Youth 95
Findings on Immigrant Asian Adults 97
Findings on Immigrant Asian Older Adults 99
Use of Mental Health Services 101
Conclusion 102
References 102
Assessing Asian American Family Acculturation in Clinical Settings: Guidelines and Recommendations for Mental Health Professionals 107
Key Asian American Family Acculturation Issues 109
Family Dynamics 110
Family Structure 111
Developmental Considerations 111
Family Ecologies 112
Special Focus on Assessing Acculturation in Parent-Child and Couple Subsystems 114
Assessing Acculturation Issues in the Parent-Child Subsystem 114
Conflict over Family Practices and Values 114
Conflict over Communication and Emotional Expression 115
Differential Experiences of Acculturation 117
Parents 118
Children 118
Role Reversals 118
Parents 119
Children 119
Significance of Exosystems and Mesosystems to Parent-Child Acculturation 120
Assessing Acculturation Issues in the Couple Subsystem 120
Shifts in Gender Attitudes and Roles 120
Status Inconsistency 121
Changes in Couple Dynamics and Risk for Domestic Abuse 122
Developmental Acculturation Concerns 123
Ecological Factors in Couple Acculturation 124
Conclusion 125
References 127
The A-B-C in Clinical Practice with Southeast Asians: Basic Understanding of Migration and Resettlement History 131
SE Asian Populations in the United States 132
Premigration and Migration History 133
Resettlement and Adaptation in the United States 136
Changes in SE Asian Families and Social Network 140
Mental Health Issues among SE Asians 142
Implications for Clinical Practice with SE Asians 145
Conclusion 146
References 146
Clinical Considerations When Working with Asian American Children and Adolescents 150
For Children: Introduction to Clinical Considerations 152
For Adolescents: Introduction to Clinical Considerations 153
The Challenge of Identity Formation in Adolescence 154
Importance of Acculturation Assessment 155
Acculturation Gap: The Role of Children 155
Acculturation Gap: The Role of Parents 156
Parental Psychopathology and Impact on Children 156
Psychopathology in Asian Children and Adolescents 158
Somatized Distress 158
Depression 158
Anxiety 159
Suicide 160
Substance Abuse 161
Externalized Behaviors: Delinquency and Gang-Related Activity 162
Special Mention of Interethnic Dating and Gender/Sexuality Issues 163
Risk Factors and Resiliency 165
How do Children and Adolescents Come to Our Attention and What to Consider in Evaluation and Treatment 166
Clinical Considerations When Working with Children and Adolescents: General Thoughts 166
Work with Adolescents 168
Conclusion 169
References 170
Acculturation and Asian American Elderly 174
Introduction 175
Acculturation and Mental Health Issues in Asian American Elderly 176
Risk of Depression and Anxiety in Asian American Elderly 176
Risk of Suicide in Asian American Elderly 177
Dementia in Asian American Elderly 179
Epidemiology of Dementia in Asian American Elderly 179
Family Perceptions of Dementia in Asian American Elderly 180
Caregiving for Asian American Elderly 181
Patterns of Caregiving in Asian American Families 181
Future Directions and Clinical Implications 182
References 183
Clinical Insights from Working with Immigrant Asian Americans and Their Families: Focus on Acculturation Stressors 186
Case 1: Case of Conflict Secondary to Intra- and Intergenerational Acculturation 187
Background and Description of Stressors 187
The Case of Mr. and Mrs. S 188
Summary 190
Case 2: Case of Generalized Anxiety and Panic Attacks: Recent Acculturation Stressors 190
Background and Description of Stressors 190
The Case of Mr. P 191
Summary 192
Case 3: Case of Somatization and of Attitudes Toward Mental Health Treatment Based on the Degree of Acculturation 193
Background and Description of Stressors 193
The Case of Mrs. D 194
Summary 195
Case 4: Case of Alcoholism, Domestic Violence, and Intragenerational Stress 195
Background and Description of Stressors 195
The Case of Mr. and Mrs. B 196
Summary 197
Case 5: Case of the Stigma of Major Mental Illness 197
Background and Description of Stressors 197
Case of Mrs. T 198
Summary 199
Implications for Practice: Specific Subcategories 200
Treatment: Special Considerations for Psychopharmacological Management 202
Conclusion 203
References 203
Conclusion 205