Childhood Shadows: Psychological Distress of Childhood Maltreatment among Asian-American Women
- 203 Downloads
Childhood maltreatment is a key social determinant that potentially results in long-lasting psychological consequences in adulthood. This study examined the link between childhood maltreatment (i.e., physical abuse, sexual abuse, and exposure to violence) and psychological distress (i.e., depression and anxiety) among Asian-American women. The moderating effect of perceived discrimination on the association was also investigated. This study utilized self-reported data from 1022 Asian-American women aged 18–65 (Mage = 38.51) who participated in the National Latino and Asian American Survey. A series of multivariate logistic regressions were conducted to detect the association between childhood maltreatment, sociodemographics and acculturation, and psychological distress for Asian-American women. Results indicated that Asian women who experienced sexual abuse and were exposed to violence during childhood had a significantly greater likelihood of both depressive and anxiety disorders, while childhood physical abuse was significantly associated with a depressive disorder, but not an anxiety disorder (Model 1). In Model 2, marital status and perceived discrimination were significant determinants of psychological distress. Respondents who were never married had a greater likelihood of depression compared to those who were married or cohabited. Also, women who perceived discrimination were more likely to have both depressive and anxiety disorders. In Model 3, perceived discrimination was a significant moderator on the association between exposure to violence and an anxiety disorder. From a clinical perspective, identifying the effects of social determinants on mental health disorders and providing proper services and intervention can be key to improving an individual’s well-being and social stability.
KeywordsChildhood maltreatment Social determinants of health Depression Anxiety Asian-American women
J.L.: designed and executed the study, analyzed the data, wrote the paper, and edited the final manuscript. M.C.: collaborated with the design and writing of the study.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, (DSM-IV). 4th ed. Washington, DC: American Psychiatric Association.Google Scholar
- Breslau, J., Kendler, K. S., Su, M., Gaxiola-Aguilar, S., & Kessler, R. C. (2005). Lifetime risk and persistence of psychiatric disorders across ethnic groups in the United States. Psychological Medicine, 35, 317–327. https://doi.org/10.1017/S0033291704003514.CrossRefPubMedPubMedCentralGoogle Scholar
- Center for Behavioral Health Statistics and Quality (2016). 2015 National Survey on Drug Use and Health: Detailed Tables, Table 8.2A. Any Mental Illness in Past Year among Persons Aged 18 or Older, by Age Group and Demographic Characteristic and Table 8.35A. Received Mental Health Treatment/Counseling in Past Year among Persons Aged 18 or Older, by Past Year Level of Mental Illness and Demographic Characteristics. Substance Abuse and Mental Health Services Administration, Rockville, MD. https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015.pdf.
- Cheung, M., & LaChapelle, A. (2011). Disproportionality from the other side: The underrepresentation of Asian American children. In D. K. Green, K. Belanger, R. G. McRoy & L. Bullard (Eds.), Challenging racial disproportionality in child welfare: Research, policy, and practice (pp. 131–139). Washington, DC: CWLA Press.Google Scholar
- Child Welfare Information Gateway. (2013). What is child abuse and neglect? Recognizing the signs and symptoms. Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau. https://www.childwelfare.gov/pubpdfs/whatiscan.pdf.Google Scholar
- Child Welfare Information Gateway. (2016). Racial disproportionality and disparity in child welfare. Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau.Google Scholar
- Commission on Social Determinants of Health (2008). Closing the gap in a generation: High equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. Geneva: World Health Organization. http://apps.who.int/iris/bitstream/10665/43943/1/9789241563703_eng.pdf.
- Dong, M., Giles, W. H., Felitti, V. J., Dube, S. R., Williams, J. E., Chapman, D. P., & Anda, R. F. (2004). Insights into causal pathways for ischemic heart disease adverse childhood experiences study. Circulation, 110, 1761–1766. https://doi.org/10.1161/01.CIR.0000143074.54995.7F.CrossRefPubMedGoogle Scholar
- Futa, K. T., Hsu, E., & Hansen, D. J. (2001). Child sexual abuse in Asian American families: An examination of cultural factors that influence prevalence, identification, and treatment. Clinical Psychology Science and Practice, 8, 189–209. https://doi.org/10.1093/clipsy.8.2.189.CrossRefGoogle Scholar
- Gavin, A. R., Walton, E., Chae, D. H., Alegria, M., Jackson, J. S., & Takeuchi, D. (2010). The associations between socioeconomic status and major depression disorder among Blacks, Latinos, Asians, and non-Hispanic Whites: Findings from the Collaborative Psychiatric Epidemiology Studies. Psychological Medicine, 40(1), 51–61. https://doi.org/10.1017/S0033291709006023.CrossRefPubMedGoogle Scholar
- Guerrero, E. G., Marsh, J. C., Duan, L., Oh, C., Perron, B., & Lee, B. (2013). Disparities in completion of substance abuse treatment between and within racial and ethnic groups. Health Services Research, 48, 1450–1467. https://doi.org/10.1111/1475-6773.12031.CrossRefPubMedPubMedCentralGoogle Scholar
- Hadland, S. E., Wood, E., Dong, H., Marshall, B. D. L., Kerr, T., Montaner, J. S., & DeBeck, K. (2015). Suicide attempts and childhood maltreatment among street youth: A prospective cohort study. Pediatrics, 136, 440–449. https://doi.org/10.1542/peds.2015-1108.CrossRefPubMedPubMedCentralGoogle Scholar
- Hahm, H. C., Kolaczyk, E., Lee, Y., Jang, J., & Ng, L. (2012). Do Asian-American women who were maltreated as children have a higher likelihood for HIV risk behaviors and adverse mental health outcomes? Women’s Health Issues, 22, e35–e43. https://doi.org/10.1016/j.whi.2011.07.003.CrossRefPubMedGoogle Scholar
- Hatzenbuehler, M. L., Prins, S. J., Flake, M., Philbin, M., Frazer, M. S., Hagen, D., & Hirsch, J. (2017). Immigration policies and mental health morbidity among Latinos: A state-level analysis. Social Science & Medicine, 174, 169–178. https://doi.org/10.1016/j.socscimed.2016.11.040.CrossRefGoogle Scholar
- Heeringa, S. G., Wagner, J., Torres, M., Duan, N., Adams, T., & Berglund, P. (2004). Sample designs and sampling methods for the Collaborative Psychiatric Epidemiology Studies (CPES). International Journal of Methods in Psychiatric Research, 13, 221–240. https://doi.org/10.1002/mpr.179.CrossRefPubMedGoogle Scholar
- Jang, S., Kawachi, I., Chang, J., Boo, K., Shin, H., Lee, H., & Cho, S. (2009). Marital status, gender, and depression: Analysis of the baseline survey of the Korean Longitudinal Study of Ageing (KLoSA). Social Science & Medicine, 69, 1608–1615. https://doi.org/10.1016/j.socscimed.2009.09.007.CrossRefGoogle Scholar
- Kessler, R. C., Berglund, P., Chiu, W. T., Demler, O., Heeringa, S., Hiripi, E., & Zheng, H. (2004). The U.S. National Comorbidity Survey Replication (NCS–R): An overview of designing and field procedures. International Journal of Methods in Psychiatric Research, 13, 69–92. https://doi.org/10.1002/mpr.167.CrossRefPubMedGoogle Scholar
- Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., Eshleman, S., & Kendler, K. S. (1994). Lifetime and 12-month prevalence of DSMIII-R psychiatric disorders in the United States: Results from the National Comorbidity Survey. Archives of General Psychiatry, 51(1), 8–19. https://doi.org/10.1001/archpsyc.1994.03950010008002.CrossRefPubMedGoogle Scholar
- Lau, A. S., Tsai, W., Shih, J., Liu, L. L., Hwang, W., & Takeuchi, D. T. (2013). The immigrant paradox among Asian American women: Are disparities in the burden of depression and anxiety paradoxical or explicable? Journal of Consulting and Clinical Psychology, 81, 901–911. https://doi.org/10.1037/a0032105.CrossRefPubMedGoogle Scholar
- Maguire-Jack, K., Lanier, P., Johnson-Motoyama, M., Welch, H., & Dineen, M. (2015). Geographic variation in racial disparities in child maltreatment: The influence of county poverty and population density. Child Abuse & Neglect, 47, 1–13. https://doi.org/10.1016/j.chiabu.2015.05.020.CrossRefGoogle Scholar
- Narang, A. S. (2001). World conference against racism: Prospects and challenges. Economic and Political Weekly, 36, 2495–2499.Google Scholar
- Pagoto, S. L., Schneider, K. L., Bodenlos, J. S., Appelhans, B. M., Whited, M. C., Ma, Y., & Lemon, S. C. (2012). Association of post-traumatic stress disorder and obesity in a nationally representative sample. Obesity (Silver Spring), 20(1), 200–205. https://doi.org/10.1038/oby.2011.318.CrossRefGoogle Scholar
- Pennell, B. E., Bowers, A., Carr, D., Chardoul, S., Cheung, G., Dinkelmann, K., & Torres, M. (2004). The development and implementation of the National Comorbidity Survey Replication, the National Survey of American Life, and the National Latino and Asian American Surveys. International Journal of Methods in Psychiatric Research, 13, 241–269. https://doi.org/10.1002/mpr.180.CrossRefPubMedGoogle Scholar
- Pew Research Center. (2012). The rise of Asian Americans. Washington, DC: Pew Social & Demographic Trends.Google Scholar
- Pfeffer, C. R. (1991). Family characteristics and support systems as risk factors for youth suicidal behavior. In L. Davidson & M. Linnoila (Eds.), Risk factors for youth suicide (pp. 55–71). New York: Hemisphere.Google Scholar
- Solar, O., & Irwin, A. (2010). A conceptual framework for action on the social determinants of health. Social Determinants of Health Discussion Paper 2 (Policy and Practice). http://www.who.int/sdhconference/resources/ConceptualframeworkforactiononSDH_eng.pdf.
- Takeuchi, D. T., Chung, R. C., Lin, K. M., Shen, H., Kurasaki, K., Chun, C.-A., & Sue, S. (1998). Lifetime and twelve-month prevalence rates of major depressive episodes and dysthymia among Chinese Americans in Los Angeles. American Journal of Psychiatry, 155, 1407–1441. https://doi.org/10.1176/ajp.155.10.1407.CrossRefPubMedGoogle Scholar
- Thompson, M. P., Arias, I., Basile, K. C., & Desai, S. (2002). The association between childhood physical and sexual victimization and health problems in adulthood in a nationally representative sample of women. Journal of Interpersonal Violence, 17, 1115–1129. https://doi.org/10.1177/08862605-0201710-06.CrossRefGoogle Scholar
- Uba, L. (1994). Asian American: Personality patterns, identity, and mental health. New York, NY: Guilford Press.Google Scholar
- U.S. Census Bureau (2007). The American Community—Asians: 2004. https://www.census.gov/prod/2007pubs/acs-05.pdf.
- U.S. Census Bureau (2014). The Asian Alone Population in the United States: 2014. Table 1. Population by Sex and Age, for Asian Alone and White Alone, Not Hispanic: 2014. https://www.census.gov/data/tables/2014/demo/race/ppl-aa14.html.
- U.S. Census Bureau (2015a). Annual estimates of the resident population by sex, race, and Hispanic origin for the United States, states, and counties: April 1, 2010 to July 1, 2015. https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk.
- U.S. Census Bureau (2015b). Sex by age (Asian alone), Universe: People who are Asian alone, American Community Survey 2015. http://www.socialexplorer.com/data/ACS2015/metadata/?ds=ACS15&table=C01001D.
- U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. (2007). Child Maltreatment. Washington, DC: U.S. Government Printing Office. http://www.acf.hhs.gov/programs/cb/research-data-technology/statistics-research/childmaltreatment.Google Scholar
- Vega, W. A., Kolody, B., Aguilar-Gaxiola, S., Alderete, E., Catalano, R., & Caraveo-Anduaga, J. (1998). Lifetime prevalence of DSM-III-R psychiatric disorders among urban and rural Mexican Americans in California. Archives of General Psychiatry, 55, 771–778. https://doi.org/10.1001/archpsyc.55.9.771.CrossRefPubMedGoogle Scholar
- Verhulp, E. E., Stevens, G. W. J. M., Pels, T. V. M., Van Weert, C. M. C., & Vollebergh, W. A. M. (2016). Lay beliefs about emotional problems and attitudes toward mental health care among parents and adolescents: Exploring the impact of immigration. Cultural Diversity and Ethnic Minority Psychology. Advance online publication. https://doi.org/10.1037/cdp0000092.