In Brief

Chinese-American college students with a bicultural orientation--meaning they identify with both cultures--tend to view depression as more related to the mind than to the body or social relationships, finds a recent study. As such, their views are more similar to those of white Americans than to those of the general Chinese-American community, in which depression is seen as more of an interplay between mind, body and social life.

The study's lead author, Yu-Wen Ying, PhD, of the University of California at Berkeley, surveyed 353 Chinese-American college students and found that they differentiated symptoms of depressed affect from somatic symptoms of sleep and appetite disturbance and interpersonal symptoms of social withdrawal. By comparison, Ying's previous research has found that older, less-acculturated Chinese Americans tend not to differentiate psychological, somatic and interpersonal experiences in their conception of depression.

The findings hold implications for therapists working with Chinese Americans, she says.

"Clinicians need to closely understand how Chinese-American clients are conceptualizing and experiencing depression," says Ying. "The less acculturated they are, the more integrated their view of depression. So with less-acculturated Chinese Americans, the clinician needs to pay particular attention to their social and somatic symptoms. For more acculturated Chinese Americans, depressed symptoms may be more relevant. Thus, traditional psychotherapy may be more appropriate for the latter than the former."

While some in American medicine have been reconsidering the Western notion of depression as mainly psychological--by, for example, using drugs to alter brain chemicals and incorporating a focus on the physical and social--Ying says that mainstream American culture still considers the body and mind to be "dualistic, clearly separable and distinguishable." Meanwhile, such a distinction is absent in Chinese culture.

In her study, Ying postulated that younger, more-acculturated Chinese Americans, possibly due to the influence of such American characteristics as individualism, personal achievement and mobility, would adopt a more American perspective on depression.

To test this hypothesis, she and her research team asked their sample of Chinese-American students to complete the Center for Epidemiologic Studies Depression Scale and questionnaire measures of cultural orientation. The results confirmed the students' Western-influenced conception of depression, despite the fact that many of them still endorsed Chinese culture as much as American culture.

In terms of treating depression in Chinese Americans, Ying says that for those who hold an integrated view of depression, clinicians may wish to recommend that patients augment psychological treatment with chi-gong, tai-chi and other traditional Chinese practices based on an integrated mind-body worldview. For Chinese Americans who hold a differentiated view of depression, traditional therapy is likely more appropriate. However, even for them, Ying says more research is needed to understand their expectations of therapy.

Her study appears in the current issue of Cultural Diversity and Ethnic Minority Psychology (Vol. 6, No. 2).