Asian Americans and European Americans’ stigma levels in response to biological and social explanations of depression

  • Zhen Hadassah Cheng
Original Paper



Mental illness stigma is prevalent among Asian Americans, and it is a key barrier that prevents them from seeking psychological services. Limited studies have experimentally examined how Asian Americans respond to biological and social explanations of mental illness. Understanding how to educate and communicate about mental illness effectively is crucial in increasing service utilization among Asian Americans.


To assess how genetic, neurobiological, and social explanations for the onset of depression affects Asian American and European American’s mental illness stigma.


231 Asian Americans and 206 European Americans read about an individual with major depression and were randomly assigned to be informed that the cause was either genetic, neurobiological, social, or unknown. Various stigma outcomes, including social distance, fear, and depression duration were assessed.


Consistent with prior research, Asian Americans had higher baseline levels of stigma compared to European Americans. Greater social essentialist beliefs predicted positive stigma outcomes for Asian Americans, such as a greater willingness to be near, help, and hire someone with depression, but genetic essentialist beliefs predicted negative stigma outcomes, such as fear. In addition, a social explanation for the etiology of depression led to lower stigma outcomes for Asian Americans; it decreased their fear of someone with depression and increased the perception that depression is treatable. For European Americans, both genetic and social essentialist beliefs predicted a greater perception of depression treatability.


Although genetics do play a role in the development of depression, emphasizing a social explanation for the origin of depression may help reduce stigma for Asian Americans.


Asian American Mental illness stigma Genetic essentialism Social essentialism 



This research was supported by the University of Oregon’s Graduate Education Committee Research Award. Special thanks to Drs. Azim Shariff and Bobby Cheon for their helpful suggestions, and to Dr. Elliot Berkman for helping with data analysis.

Conflict of interest

There is no conflict of interest.

Supplementary material

127_2014_999_MOESM1_ESM.docx (48 kb)
Supplementary material 1 (DOCX 47 kb)


  1. 1.
    Yang LH, Wonpat-Borja AJ (2007) Psychopathology among Asian Americans. In: Leong FTL, Inman, Ebreo A, Yang L, Kinoshita L, Fu M (eds) Handbook of asian american psychology, 2nd edn. Sage, Thousand Oaks, pp 379–406Google Scholar
  2. 2.
    NAMI (2011) Asian American and Pacific Islander (AA/PI) Community and Mental Health Fact SheetGoogle Scholar
  3. 3.
    Link BG, Yang LH, Phelan JC, Collins PY (2004) Measuring mental illness stigma. Schizophr Bull 30(3):511–541CrossRefPubMedGoogle Scholar
  4. 4.
    Gary FA (2005) Stigma: barrier to mental health care among ethnic minorities. Issues Ment Health Nurs 26(10):979–999. doi: 10.1080/01612840500280638 CrossRefPubMedGoogle Scholar
  5. 5.
    Leong FTL, Lau ASL (2001) Barriers to providing effective mental health services to Asian Americans. Ment Health Serv Res 3(4):201–214. doi: 10.1023/A:1013177014788 CrossRefPubMedGoogle Scholar
  6. 6.
    Ihara ES, Chae DH, Cummings JR, Lee S (2013) Correlates of mental health service use and type among Asian Americans. Adm Policy Ment Health 1–9Google Scholar
  7. 7.
    Corrigan PW (2004) How stigma interferes with mental health care. Am Psychol 59(7):614–625. doi: 10.1037/0003-066X.59.7.614 CrossRefPubMedGoogle Scholar
  8. 8.
    Kondrat D, Early T (2011) Battling in the trenches: case managers’ ability to combat the effects of mental illness stigma on consumers’ perceived quality of life. Commun Ment Health J 47:390–398. doi: 10.1007/s10597-010-9330-4 CrossRefGoogle Scholar
  9. 9.
    Thornicroft G (2007) Shunned: discrimination against people with mental illness. Oxford University Press, New YorkGoogle Scholar
  10. 10.
    Lee AA, Laurent SM, Wykes TL, Kitchen Andren KA, Bourassa KA, McKibbin CL (2014) Genetic attributions and mental illness diagnosis: effects on perceptions of danger, social distance, and real helping decisions. Soc Psychiatry Psychiatr Epidemiol 49(5):781–789. doi: 10.1007/s00127-013-0764-1 CrossRefPubMedGoogle Scholar
  11. 11.
    Phelan JC (2005) Geneticization of deviant behavior and consequences for stigma: the case of mental illness. J Health Social Behav 46(4):307–322. doi: 10.1177/002214650504600401 CrossRefGoogle Scholar
  12. 12.
    Akdeniz C, Tost H, Meyer-Lindenberg A (2014) The neurobiology of social environmental risk for schizophrenia: an evolving research field. Soc Psychiatry Psychiatr Epidemiol 49(4):507–517. doi: 10.1007/s00127-014-0858-4 CrossRefPubMedGoogle Scholar
  13. 13.
    Kendler KS (1997) The genetic epidemiology of psychiatric disorders: a current perspective. Soc Psychiatry Psychiatr Epidemiol 32(1):5–11. doi: 10.1007/BF00800661 CrossRefPubMedGoogle Scholar
  14. 14.
    van der Vegt EJM, Tieman W, van der Ende J, Ferdinand RF, Verhulst FC, Tiemeier H (2009) Impact of early childhood adversities on adult psychiatric disorders: a study of international adoptees. Soc Psychiatry Psychiatr Epidemiol 44(9):724–731. doi: 10.1007/s00127-009-0494-6 CrossRefPubMedGoogle Scholar
  15. 15.
    Corrigan PW, Morris SB, Michaels PJ, Rafacz JD, Rüsch N (2012) Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatr Serv 63(10):963–973. doi: 10.1176/ CrossRefPubMedGoogle Scholar
  16. 16.
    Weiner B (1995) Judgments of responsibility: a foundation for a theory of social conduct. Guilford Press, New YorkGoogle Scholar
  17. 17.
    Schnittker J (2008) An uncertain revolution: why the rise of a genetic model of mental illness has not increased tolerance. Soc Sci Med 67(9):1370–1381. doi: 10.1016/j.socscimed.2008.07.007 CrossRefPubMedGoogle Scholar
  18. 18.
    Rüsch N, Todd AR, Bodenhausen GV, Corrigan PW (2010) Biogenetic models of psychopathology, implicit guilt, and mental illness stigma. Psychiatry Res 179(3):328–332. doi: 10.1016/j.psychres.2009.09.010 CrossRefPubMedCentralPubMedGoogle Scholar
  19. 19.
    WonPat-Borja AJ, Yang LH, Link BG, Phelan JC (2012) Eugenics, genetics, and mental illness stigma in Chinese Americans. Soc Psychiatry Psychiatr Epidemiol 47(1):145–156. doi: 10.1007/s00127-010-0319-7 CrossRefPubMedCentralPubMedGoogle Scholar
  20. 20.
    Schomerus G, Matschinger H, Angermeyer MC (2013) Causal beliefs of the public and social acceptance of persons with mental illness: a comparative analysis of schizophrenia, depression and alcohol dependence. Psychol Med 1–12Google Scholar
  21. 21.
    Fukuyama MA, Greenfield TK (1983) Dimensions of assertiveness in an Asian American student population. J Couns Psychol 30(3):429–432. doi: 10.1037/0022-0167.30.3.429 CrossRefGoogle Scholar
  22. 22.
    Wynaden D, Chapman R, Orb A, McGowan S, Zeeman Z, Yeak S (2005) Factors that influence Asian communities’ access to mental health care. Int J Ment Health Nurs 14(2):88–95. doi: 10.1111/j.1440-0979.2005.00364.x CrossRefPubMedGoogle Scholar
  23. 23.
    Yang LH, Kleinman A, Link BG, Phelan JC, Lee S, Good B (2007) Culture and stigma: adding moral experience to stigma theory. Soc Sci Med 64(7):1524–1535. doi: 10.1016/j.socscimed.2006.11.013 CrossRefPubMedGoogle Scholar
  24. 24.
    Yang LH, Purdie-Vaughns V, Kotabe H, Link BG, Saw A, Wong G et al (2013) Culture, threat, and mental illness stigma: identifying culture-specific threat among Chinese American groups. Soc Sci Med 88:56–67. doi: 10.1016/j.socscimed.2013.03.036 CrossRefPubMedCentralPubMedGoogle Scholar
  25. 25.
    Haslam N (2011) Genetic essentialism, neuroessentialism, and stigma: commentary on Dar-Nimrod and Heine (2011). Psychol Bull 137(5):819–824. doi: 10.1037/a0022386 CrossRefPubMedGoogle Scholar
  26. 26.
    Pescosolido BA, Martin JK, Long JS, Medina TR, Phelan JC, Link BG (2010) “A disease like any other”? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. Am J Psychiatry 167(11):1321–1330CrossRefPubMedGoogle Scholar
  27. 27.
    Miresco MJ, Kirmayer LJ (2006) The persistence of mind-brain dualism in psychiatric reasoning about clinical scenarios. Am J Psychiatry 163(5):913–918. doi: 10.1176/appi.ajp.163.5.913 CrossRefPubMedGoogle Scholar
  28. 28.
    Yeung A, Trinh NHT, Chang TE, Fava M (2011) The Engagement Interview Protocol (EIP): improving the acceptance of mental health treatment among Chinese immigrants. Int J Cult Men Health 4(2):91–105. doi: 10.1080/17542863.2010.507933 CrossRefGoogle Scholar
  29. 29.
    Ryder AG, Yang J, Zhu XZ, Yao SQ, Yi JY, Heine SJ, Bagby RM (2008) The cultural shaping of depression: Somatic symptoms in China, psychological symptoms in North America? J Abn Psychol 117:300–313CrossRefGoogle Scholar
  30. 30.
    Rangel U, Keller J (2012) Essentialism goes social: belief in social determinism as a component of psychological essentialism. J Pers Soc Psychol 100(6):1056–1078. doi: 10.1037/a0022401 CrossRefGoogle Scholar
  31. 31.
    Yang LH, Phelan JC, Link BG (2008) Stigma towards traditional Chinese medicine and psychiatric treatment among Chinese Americans. Cult Divers Ethnic Minor Psychol 14(1):10–18. doi: 10.1037/1099-9809.14.1.10 CrossRefGoogle Scholar
  32. 32.
    American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edn. doi: 10.1176/appi.books.9780890423349
  33. 33.
    Link BG, Phelan JC, Bresnahan M, Stueve A, Pescosolido BA (1999) Public conceptions of mental illness: labels, causes, dangerousness, and social distance. Am J Public Health 89(9):1328–1333. doi: 10.2105/AJPH.89.9.1328 CrossRefPubMedCentralPubMedGoogle Scholar
  34. 34.
    Wirth JH, Bodenhausen GV (2009) The role of gender in mental-illness stigma: a national experiment. Psychol Sci 20(2):169–173. doi: 10.1111/j.1467-9280.2009.02282.x CrossRefPubMedGoogle Scholar
  35. 35.
    Angermeyer MC, Matschinger H (2003) Public beliefs about schizophrenia and depression: similarities and differences. Soc Psychiatry Psychiatr Epidemiol 38(9):526–534. doi: 10.1007/s00127-003-0676-6 CrossRefPubMedGoogle Scholar
  36. 36.
    Corrigan P, Markowitz FE, Watson A, Rowan D, Kubiak MA (2003) An attribution model of public discrimination towards persons with mental illness. J Health Soc Behav 44(2):162–179. doi: 10.2307/1519806 CrossRefPubMedGoogle Scholar
  37. 37.
    Keller J (2005) In genes we trust: the biological component of psychological essentialism and its relationship to mechanisms of motivated social cognition. J Pers Soc Psychol 88(4):686–702. doi: 10.1037/0022-3514.88.4.686 CrossRefPubMedGoogle Scholar
  38. 38.
    Corrigan PW, Lurie BD, Goldman HH, Slopen N, Medasani K, Phelan S (2005) How adolescents perceive the stigma of mental illness and alcohol abuse. Psychiatr Serv 56(5):544–550. doi: 10.1176/ CrossRefPubMedGoogle Scholar
  39. 39.
    Zane N, Yeh M (2002) Use of culturally-based variables in assessment: studies on loss of face. In: Kurasaki K, Okazaki S, Sue S (eds) Asian American mental health: assessment, theories and methods. Kluwer Academic, Dordrecht, pp 123–138. doi: 10.1007/978-1-4615-0735-2_9
  40. 40.
    Preacher KJ, Hayes AF (2008) Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods 40(3):879–891. doi: 10.3758/BRM.40.3.879 CrossRefPubMedGoogle Scholar
  41. 41.
    Phillips MR, Li Y, Stroup TS, Xin L (2000) Causes of schizophrenia reported by patients’ family members in China. Br J Psychiatry 177(1):20–25. doi: 10.1192/bjp.177.1.20 CrossRefPubMedGoogle Scholar
  42. 42.
    Furnham A, Chan E (2004) Lay theories of schizophrenia. A cross-cultural comparison of British and Hong Kong Chinese attitudes, attributions and beliefs. Soc Psychiatry Psychiatr Epidemiol 39(7):543–552. doi: 10.1007/s00127-004-0787-8 CrossRefPubMedGoogle Scholar
  43. 43.
    Markus HR, Kitayama S (1991) Culture and the self: implications for cognition, emotion, and motivation. Psychol Rev 98(2):224–253. doi: 10.1037/0033-295X.98.2.224 CrossRefGoogle Scholar
  44. 44.
    Zhou Q, Chen SH, Cookston JT, Wolchik S (2014) Evaluating the cultural fit of the New Beginnings Parent Program for divorced Asian American mothers: a pilot study. Asian Am J Psychol 5:126. doi: 10.1037/a0035519 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Department of PsychologyUniversity of OregonEugeneUSA

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