Advertisement

Anxiety and depression in a post-September 11 sample of Arabs in the USA

  • Mona M. AmerEmail author
  • Joseph D. Hovey
Original Paper

Abstract

Objective

Scant research has examined the mental health of Arab Americans. This study aimed to determine the levels of anxiety and depression in a sample of Arab Americans and compare the rates to normative community samples and samples of other minority ethnic/racial groups.

Methods

A non-probability sampling approach resulted in 601 adult Arab American respondents from 35 US states. Respondents completed anxiety and depression questionnaires at a form-based Internet site.

Results

One-fourth of participants reported moderate to severe anxiety levels as measured by the Beck Anxiety Inventory (BAI), and one-half reported depression scores that met clinical caseness as assessed by the Center for Epidemiologic Studies-Depression Scale (CES-D). The present sample of Arab Americans reported significantly higher levels of anxiety and depression compared to standardization samples and community samples of four other minority groups.

Conclusions

Arab Americans may be at risk for anxiety and depression. Further studies should be conducted to replicate and validate these results, identify stressors that affect this population, and develop recommendations for clinical interventions.

Keywords

Arab American Beck Anxiety Inventory Center for Epidemiologic Studies-Depression Scale Anxiety Depression Ethnicity 

References

  1. 1.
    Abudabbeh N (1996) Arab families. In: McGoldrick M, Giordano J, Pearce JK (eds) Ethnicity and family therapy, 2nd edn. Guilford, New YorkGoogle Scholar
  2. 2.
    Abudabbeh N, Nydell MK (1993) Transcultural counseling and Arab Americans. In: McFadden J (ed) Transcultural counseling: bilateral and international perspectives. American Counseling Association, AlexandriaGoogle Scholar
  3. 3.
    Abu-Laban B, Suleiman MW (eds) (1989) Arab Americans: continuity and change. Association of Arab-American University Graduates, BelmontGoogle Scholar
  4. 4.
    Abu-Ras W, Abu-Bader SH (2008) The impact of the September 11, 2001, attacks on the well-being of Arab Americans in New York City. J Muslim Ment Health 3:217–239CrossRefGoogle Scholar
  5. 5.
    Abu-Ras W, Abu-Bader SH (2009) Risk factors for depression and posttraumatic stress disorder (PTSD): the case of Arab and Muslim Americans post-9/11. J Immigr Refugee Stud 7:393–418CrossRefGoogle Scholar
  6. 6.
    Alderete E, Vega WA, Kolody B, Aguilar-Gaxiola S (1999) Depressive symptomatology: prevalence and psychosocial risk factors among Mexican migrant farm workers in California. J Commun Psychol 27:457–471CrossRefGoogle Scholar
  7. 7.
    Ali OM, Milstein G, Marzuk PM (2005) The imam’s role in meeting the counseling needs of Muslim communities in the United States. Psychiatr Serv 56:202–205PubMedCrossRefGoogle Scholar
  8. 8.
    Al-Issa I, Al Zubaidi A, Bakal D, Fung TS (2000) Beck Anxiety Inventory symptoms in Arab college students. Arab J Psychiatry 11:41–47Google Scholar
  9. 9.
    Al-Issa I, Bakal D, Fung T (1999) Beck Anxiety Inventory symptom comparisons between students in Lebanon and Canada. Arab J Psychiatry 10:24–30Google Scholar
  10. 10.
    Al-Krenawi A, Graham JR (2000) Culturally sensitive social work practice with Arab clients in mental health settings. Health Soc Work 25:9–22PubMedCrossRefGoogle Scholar
  11. 11.
    Arab American Institute (2003) First census report on Arab ancestry marks rising civic profile of Arab Americans [press release]. Arab American Institute, WashingtonGoogle Scholar
  12. 12.
    Barry DT (2001) Assessing culture via the Internet: methods and techniques for psychological research. J CyberPsychol Behav 4:17–21CrossRefGoogle Scholar
  13. 13.
    Beck AT, Epstein N, Brown G, Steer RA (1988) An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 56:893–897PubMedCrossRefGoogle Scholar
  14. 14.
    Beck AT, Steer RA (1990) Beck Anxiety Inventory manual. The Psychological Corporation/Harcourt Brace Jovanovich, San AntonioGoogle Scholar
  15. 15.
    Brittingham A, de la Cruz GP (2005) We the people of Arab Ancestry in the United States, Census 2000 brief no. C2KBR-23. U.S. Census Bureau, WashingtonGoogle Scholar
  16. 16.
    Chapleski EE, Lamphere JK, Kaczynski R, Lichtenberg PA, Dwyer JW (1997) Structure of a depression measure among American Indian elders: confirmatory factor analysis of the CES-D scale. Res Aging 19:462–485CrossRefGoogle Scholar
  17. 17.
    Conerly RC, Baker F, Dye J, Douglas CY, Zabora J (2002) Measuring depression in African American cancer survivors: the reliability and validity of the Center for Epidemiologic Study-Depression (CES-D) Scale. J Health Psychol 7:107–114PubMedCrossRefGoogle Scholar
  18. 18.
    Contreras S, Fernandez S, Malcarne VL, Ingram RE, Vaccarino VR (2004) Reliability and validity of the Beck Depression and Anxiety Inventories in Caucasian Americans and Latinos. Hispanic J Behav Sci 26:446–462CrossRefGoogle Scholar
  19. 19.
    Council on American Islamic Relations (2005) Unequal protection: the status of Muslim civil rights in the United States 2005. Council on American Islamic Relations, WashingtonGoogle Scholar
  20. 20.
    De Coteau TJ, Hope DA, Anderson J (2003) Anxiety, stress, and health in northern plains Native Americans. Behav Ther 34:365–380CrossRefGoogle Scholar
  21. 21.
    de la Cruz GP, Brittingham A (2003) The Arab Population: 2000, Census 2000 Brief No. C2KBR-23. U.S. Census Bureau, WashingtonGoogle Scholar
  22. 22.
    Downey RG, King CV (1998) Missing data in Likert ratings: a comparison of replacement methods. J Gen Psychol 125:175–191PubMedCrossRefGoogle Scholar
  23. 23.
    El-Badry S (1994) The Arab-American market. Am Demogr 16:22–30Google Scholar
  24. 24.
    Erickson CD, Al-Timimi NR (2001) Providing mental health services to Arab Americans: recommendations and considerations. Cult Divers Ethnic Minor Psychol 7:308–327CrossRefGoogle Scholar
  25. 25.
    Falcón LM, Tucker KL (2000) Prevalence and correlates of depressive symptoms among Hispanic elders in Massachusetts. J Gerontol Soc Sci 55B:S108–S116CrossRefGoogle Scholar
  26. 26.
    Foley KL, Reed PS, Mutran EJ, DeVellis RF (2002) Measurement adequacy of the CES-D among a sample of older African-Americans. Psychiatry Res 109:61–69CrossRefGoogle Scholar
  27. 27.
    Garcia M, Marks G (1989) Depressive symptomatology among Mexican-American adults: an examination with the CES-D scale. Psychiatry Rev 27:137–148CrossRefGoogle Scholar
  28. 28.
    Ghubash R, Daradkeh TK, Al Naseri KS, Al Bloushi NBA, Al Daheri AM (2000) The performance of the Center for Epidemiologic Study Depression Scale (CES-D) in an Arab female community. Int J Soc Psychiatry 46:241–249PubMedCrossRefGoogle Scholar
  29. 29.
    Gillis MM, Haaga DAF, Ford GT (1995) Normative values for the Beck Anxiety Inventory, Fear Questionnaire, Penn State Worry Questionnaire, and Social Phobia and Anxiety Inventory. Psychol Assess 7:450–455CrossRefGoogle Scholar
  30. 30.
    Gosling SD, Vazire S, Srivastava S, John OP (2004) Should we trust Web-based studies? A comparative analysis of six preconceptions about Internet questionnaires. Am Psychol 59:93–104PubMedCrossRefGoogle Scholar
  31. 31.
    Gupta R, Yick A (2001) Validation of CES-D scale for older Chinese immigrants. J Ment Health Aging 7:257–272Google Scholar
  32. 32.
    Hassouneh DM, Kulwicki A (2007) Mental health, discrimination, and trauma in Arab women living in the US: a pilot study. Ment Health Relig Cult 10:257–262CrossRefGoogle Scholar
  33. 33.
    Hovey JD, King CA (1997) Suicidality among acculturating Mexican-Americans: current knowledge and directions for research. Suicide Life Threat Behav 27:92–103PubMedGoogle Scholar
  34. 34.
    Howell S, Shryock A (2003) Cracking down on diaspora: Arab Detroit and America’s “War on Terror”. Anthropol Quart 76:443–462CrossRefGoogle Scholar
  35. 35.
    Huisman M (2000) Imputation of missing item responses: some simple techniques. Qual Quant 34:331–351CrossRefGoogle Scholar
  36. 36.
    Ibish I (ed) (2003) Report on hate crimes and discrimination against Arab Americans: the post-September 11 backlash. American-Arab Anti-Discrimination Committee, WashingtonGoogle Scholar
  37. 37.
    Iwata N, Turner RJ, Lloyd DA (2002) Race/ethnicity and depressive symptoms in community-dwelling young adults: a differential item functioning analysis. Psychiatry Res 110:281–289PubMedCrossRefGoogle Scholar
  38. 38.
    Jana-Masr A, Priester PE (2007) The development and validation of a Qur’an-based instrument to assess Islamic religiosity: the Religiosity of Islam Scale. J Muslim Ment Health 2:177–188CrossRefGoogle Scholar
  39. 39.
    Kraut R, Olson J, Banaji M, Bruckman A, Cohen J, Couper M (2004) Psychological research online: Report of Board of Scientific Affairs’ Advisory Group on the conduct of research on the Internet. Am Psychol 59:105–117PubMedCrossRefGoogle Scholar
  40. 40.
    Laffrey SC, Meleis AI, Lipson JG, Solomon M, Omidian PA (1989) Assessing Arab-American health care needs. Soc Sci Med 29:877–883PubMedCrossRefGoogle Scholar
  41. 41.
    Lee JS, Koeske GF, Sales E (2004) Social support buffering of acculturative stress: a study of mental health symptoms among Korean international students. Int J Intercult Relat 28:399–414CrossRefGoogle Scholar
  42. 42.
    Mahard R (1988) The CES-D as a measure of depressive mood in the elderly Puerto Rican population. J Gerontol Psychol Sci 43:P24–P25Google Scholar
  43. 43.
    McCallion P, Kolomer SR (2000) Depressive symptoms among African American caregiving grandmothers: the factor structure of the CES-D. J Ment Health Aging 6:325–338Google Scholar
  44. 44.
    Mendes de Leon CF, Markides KS (1988) Depressive symptoms among Mexican Americans: a three-generational study. Am J Epidemiol 127:150–160PubMedGoogle Scholar
  45. 45.
    Moradi B, Hasan NT (2004) Arab American persons’ reported experiences of discrimination and mental health: the mediating role of personal control. J Couns Psychol 51:418–428CrossRefGoogle Scholar
  46. 46.
    Mościcki EK, Locke BZ, Rae DS, Boyd JH (1989) Depressive symptoms among Mexican Americans: the Hispanic Health and Nutrition Examination Survey. Am J Epidemiol 130:348–360PubMedGoogle Scholar
  47. 47.
    Naber N (2000) Ambiguous insiders: an investigation of Arab American invisibility. Ethn Racial Stud 23:37–61CrossRefGoogle Scholar
  48. 48.
    Naff A (1985) Becoming American: the early Arab immigrant experience. Southern Illinois University Press, CarbondaleGoogle Scholar
  49. 49.
    Narrow WE, Rae DS, Moscicki EK, Locke BZ, Regier DA (1990) Depression among Cuban Americans: the Hispanic Health and Nutrition Examination Survey. Soc Psychiatry Psychiatr Epidemiol 25:260–268PubMedCrossRefGoogle Scholar
  50. 50.
    Nassar-McMillan SC, Hakim-Larson J (2003) Counseling considerations among Arab Americans. J Couns Dev 81:150–159CrossRefGoogle Scholar
  51. 51.
    Noh S, Avison WR, Kaspar V (1992) Depressive symptoms among Korean immigrants: assessment of a translation of the Center for Epidemiologic Studies-Depression Scale. Psychol Assess 4:84–91CrossRefGoogle Scholar
  52. 52.
    Organista PB, Organista KC, Kurasaki K (2003) Overview of the relation between acculturation and ethnic minority mental health. In: Chun KM, Organista PB, Marín G (eds) Acculturation: advances in theory, measurement, and applied research. American Psychological Association, WashingtonGoogle Scholar
  53. 53.
    Osman A, Barrios FX, Aukes D, Osman JR, Markway K (1993) The Beck Anxiety Inventory: psychometric properties in a community population. J Psychopathol Behav Assess 15:287–297CrossRefGoogle Scholar
  54. 54.
    Potter LB, Rogler LH, Moscicki EK (1995) Depression among Puerto Ricans in New York City: the Hispanic Health and Nutrition Examination Survey. Soc Psychiatry Psychiatr Epidemiol 30:185–193PubMedCrossRefGoogle Scholar
  55. 55.
    Radloff LS (1977) The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Meas 1:385–401CrossRefGoogle Scholar
  56. 56.
    Rippy AE, Newman E (2006) Perceived religious discrimination and its relationship to anxiety and paranoia among Muslim Americans. J Muslim Ment Health 1:5–20CrossRefGoogle Scholar
  57. 57.
    Salari S (2002) Invisible in aging research: Arab Americans, Middle Eastern immigrants, and Muslims in the United States. Gerentol 42:580–588CrossRefGoogle Scholar
  58. 58.
    Sayed MA (2003) Conceptualization of mental illness within Arab cultures: meeting challenges in cross-cultural settings. Soc Behav Person 31:333–342CrossRefGoogle Scholar
  59. 59.
    Shaver PR, Brennan KA (1991) Measures of depression and loneliness. In: Robinson JP, Shaver PR, Wrightsman LS (eds) Measures of personality and social psychological attitudes, vol 1. Academic Press, San DiegoGoogle Scholar
  60. 60.
    Singh A (2002) We are not the enemy: hate crimes against Arabs, Muslims, and those perceived to be Arab or Muslim after September 11. Human Rights Watch 14(6, G) http://www.hrw.org/legacy/reports/2002/usahate/
  61. 61.
    Somervell PD, Beals J, Kinzie JD, Leung P, Boehnlein J, Matsunaga D, Manson SM (1993) Use of the CES-D in an American Indian village. Cult Med Psychiatry 16:503–517Google Scholar
  62. 62.
    Thoman LV, Surís A (2004) Acculturation and acculturative stress as predictors of psychological distress and quality-of-life functioning in Hispanic psychiatric patients. Hispanic J Behav Sci 26:293–311CrossRefGoogle Scholar
  63. 63.
    Vega WA, Kolody B, Valle R, Hough R (1986) Depressive symptoms and their correlates among immigrant Mexican women in the United States. Soc Sci Med 22:642–645CrossRefGoogle Scholar
  64. 64.
    Vera M, Alegría M, Freeman D, Robles RR, Ríos R, Ríos CF (1991) Depressive symptoms among Puerto Ricans: Island poor compared with residents of the New York City area. Am J Epidemiol 134:502–510PubMedGoogle Scholar
  65. 65.
    Waszak C, Severy LJ, Kafafi L (2001) Fertility behavior and psychological stress: the mediating influence of gender norm beliefs among Egyptian women. Psychol Women Q 25:197–208CrossRefGoogle Scholar
  66. 66.
    Ying Y (1988) Depressive symptomatology among Chinese-Americans as measured by the CES-D. J Clin Psychol 44:739–746PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.The American University in CairoCairoEgypt
  2. 2.Yale University School of MedicineNew HavenUSA
  3. 3.Program for the Study of Immigration and Mental HealthThe University of ToledoToledoUSA
  4. 4.SAPE-Psychology Unitc/o The American University in Cairo NY OfficeNew YorkUSA

Personalised recommendations