Mental Illness from an Asian American Perspective

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Part of the Issues of Diversity in Clinical Neuropsychology book series (ISSUESDIV)

Abstract

A neuropsychological assessment necessitates a thorough evaluation of the clients’ overall mental health and functioning. Understanding the cultural lens with which the client views the world and their well-being undergirds an accurate assessment. In this chapter, various issues in Asian American mental health (i.e., underutilization of mental health services), Asian mental health (i.e., classification of mental illness), Eastern psychology (i.e., mind-body connection, self-denial), and the intersection of the three (i.e., culture bound syndromes) are used as a framework to examine Asian Americans’ differential mental health attitudes, beliefs, and symptomology from Western perspectives. Lastly, Morita therapy, an alternative treatment modality, which may potentiate current models and interventions for the general populace, is used to illustrate the integration of salient philosophical and religious tenets from East Asia.

Keywords

Mental Health Mental Illness Mental Health Service Borderline Personality Disorder Borderline Personality Disorder 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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References

  1. Abe-Kim, J., Takeuchi, D. T., Hong, S., Zane, N., Sue, S., Spencer, M. S., et al. (2007). Use of mental health-related services among immigrant and US-born Asian Americans: Results from the national Latino and Asian American study. American Journal of Public Health, 97, 91–98. doi: 10.2105/AJPH.2006.098541.PubMedCrossRefGoogle Scholar
  2. Alegria, M., Takeuchi, D., Canino, G., Duan, N., Shrout, P., Meng, X., et al. (2004). Considering context, place and culture: The national Latino and Asian American study. International Journal of Methods in Psychiatric Research, 13(4), 208–220. doi: 10.1002/mpr.178.PubMedCrossRefGoogle Scholar
  3. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
  4. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.Google Scholar
  5. Atkinson, D. R., & Gim, R. H. (1989). Asian-American cultural identity and attitudes toward mental health services. Journal of Counseling Psychology, 36, 209–212. doi: 10.1037/0022-0167.36.2.209.CrossRefGoogle Scholar
  6. Bond, M. H. (1993). Emotions and their expression in Chinese culture. Journal of Nonverbal Behavior, 17, 245–262. doi: 10.1007/BF00987240.CrossRefGoogle Scholar
  7. Chan, S. (1991). Asian Americans: An interpretive history. Boston: Twayne Publishers.Google Scholar
  8. Chang, D. F. (2002). Understanding the rates and distribution of mental disorders. In K. S. Kurasaki, S. Okazaki, & S. Sue (Eds.), Asian American mental health: Assessment theories and methods (pp. 9–27). New York: Kluwer Academic/Plenum Publishers.CrossRefGoogle Scholar
  9. Chang, D. F., Tong, H., Shi, Q., & Zeng, Q. (2005). Letting a hundred flowers bloom: Counseling and psychotherapy in the People’s Republic of China. Journal of Mental Health Counseling, 27, 104–116.Google Scholar
  10. Chen, Y. F. (2002). Chinese classification of mental disorders (CCMD-3): Towards integration in international classification. Psychopathology, 35(2–3), 171–175. doi: 10.1159/000065140.PubMedCrossRefGoogle Scholar
  11. Chen, C. P. (2010). Morita therapy and its counseling implications for social anxiety. Counselling Psychology Quarterly, 23(1), 67–82. doi: 10.1080/09515071003629805.CrossRefGoogle Scholar
  12. Cheung, F. M., & Lau, B. W. (1982). Situational variations of help-seeking behavior among Chinese patients. Comprehensive Psychiatry, 23, 252–262. doi: 10.1016/0010-440X(82)90073-6.PubMedCrossRefGoogle Scholar
  13. Chung, C. K., & Cho, S. J. (2006). Conceptualization of jeong and dynamics of hwabyung. Psychiatry Investigation, 3(1), 46–54.Google Scholar
  14. Chung, R. C., & Kagawa-Singer, M. (1993). Predictors of psychological distress among Southeast Asian refugees. Social Science & Medicine, 36, 631–639. doi: 10.1016/0277-9536(93)90060-H.CrossRefGoogle Scholar
  15. Demyttenaere, K., Bruffaerts, R., Posada-Villa, J., Gasquet, I., Kovess, V., Lepine, J. P., et al. (2004). Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization world mental health surveys. JAMA: The Journal of the American Medical Association, 291, 2581–2590.CrossRefGoogle Scholar
  16. Fischer, A. R., Jome, L. M., & Atkinson, D. R. (1998). Reconceptualizing multicultural counseling: Universal healing conditions in a culturally specific context. The Counseling Psychologist, 26, 525–588. doi: 10.1177/0011000098264001.CrossRefGoogle Scholar
  17. Hinton, D. E., Park, L., Hsia, C., Hofmann, S., & Pollack, M. H. (2009). Anxiety disorder presentations in Asian populations: A review. CNS Neuroscience & Therapeutics, 15, 295–303. doi: 10.1111/j.1755-5949.2009.00095.x.CrossRefGoogle Scholar
  18. Hinton, W. L., Tiet, Q., Tran, C. G., & Chesney, M. (1997). Predictors of depression among refugees from Vietnam: A longitudinal study of new arrivals. The Journal of Nervous and Mental Disease, 185, 39–45. doi: 10.1097/00005053-199701000-00007.PubMedCrossRefGoogle Scholar
  19. Hofstede, G. (1980). Culture’s consequence. Beverly Hills, CA: Sage.Google Scholar
  20. Ishiyama, F. I. (1988). Morita therapy: A treatment of dogmatic self-containment in anxious and nervous clients. Psychotherapy Patient, 4, 243–262.CrossRefGoogle Scholar
  21. Kim, L. I. (1998). The mental health of Korean American women. In Y. I. Song & A. Moon (Eds.), Korean American women (pp. 209–224). Westport, CT: Praeger Publishers.Google Scholar
  22. Kim, I. J., Kim, L. I. C., & Kelly, J. G. (2006). Developing cultural competence in working with Korean immigrant families. Journal of Community Psychology, 34, 149–165. doi: 10.1002/jcop.20093.CrossRefGoogle Scholar
  23. Kirmayer, L. J., Dao, T. H. T., & Smith, A. (1998). Somatization and psychologization: Understanding cultural idioms distress. In S. O. Okpaku (Ed.), Clinical methods in transcultural psychiatry (pp. 233–265). Washington, DC: American Psychiatric Publishing.Google Scholar
  24. Kirmayer, L. J., & Young, A. (1998). Culture and somatization: Clinical, epidemiological, and ethnographic perspectives. Psychosomatic Medicine, 60, 420–430.PubMedGoogle Scholar
  25. Kitanishi, K., & Mori, A. (1995). Morita therapy: 1919 to 1995. Psychiatry and Clinical Neurosciences, 49(5–6), 245–254. doi: 10.1111/j.1440-1819.1995.tb01896.x.PubMedCrossRefGoogle Scholar
  26. Kitayama, S., Markus, H. R., Matsumoto, H., & Norasakkunkit, V. (1997). Individual and collective processes in the construction of the self: Self-enhancement in the United States and self-criticism in Japan. Journal of Personality and Social Psychology, 72, 1245–1267. doi: 10.1037/0022-3514.72.6.1245.PubMedCrossRefGoogle Scholar
  27. Kleinman, A. M. (1977). Depression, somatization and the “new cross-cultural psychiatry”. Social Science & Medicine, 11, 3–10. doi: 10.1016/0037-7856(77)90138-X.CrossRefGoogle Scholar
  28. Kleinman, A. M. (1986). Social origins of distress and disease: Depression, neurasthenia, and pain in modern China. New Haven, CT: Yale University Press.Google Scholar
  29. Kung, W. W. (2004). Cultural and practical barriers to seeking mental health treatment for Chinese Americans. Journal of Community Psychology, 32, 27–43. doi: 10.1002/jcop.10077.CrossRefGoogle Scholar
  30. Lau, A., & Takeuchi, D. T. (2001). Cultural factors in help-seeking for child behavior problems: Value orientation, affective responding, and severity appraisals among Chinese-American parents. Journal of Community Psychology, 29, 675–692. doi: 10.1002/jcop.1042.CrossRefGoogle Scholar
  31. Le Meyer, O., Zane, N., Cho, Y. I., & Takeuchi, D. T. (2009). Use of specialty mental health services by Asian Americans with psychiatric disorders. Journal of Consulting and Clinical Psychology, 77, 1000–1005. doi: 10.1037/a0017065.PubMedCrossRefGoogle Scholar
  32. Lee, S. (2001). From diversity to unity: The classification of mental disorders in 21st-century China. Psychiatric Clinics of North America, 24, 421–431. doi: 10.1016/S0193-953X(05)70238-0.PubMedCrossRefGoogle Scholar
  33. Leong, F. T. L. (1986). Counseling and psychotherapy with Asian-Americans: Review of the literature. Journal of Counseling Psychology, 33, 196–206. doi: 10.1037/0022-0167.33.2.196.CrossRefGoogle Scholar
  34. Leong, F. T. L., Chang, D., & Lee, S. (2007). Counseling and psychotherapy with Asian Americans: Process and outcomes. In F. T. L. Leong, A. Ebreo, L. Kinoshita, A. G. Inman, L. H. Yang, & M. Fu (Eds.), Handbook of Asian American psychology (2nd ed., pp. 429–447). Thousand Oaks, CA: Sage.Google Scholar
  35. Lin, K. M. (1983). Hwa-byung: A Korean culture-bound syndrome? The American Journal of Psychiatry, 140, 105–107.PubMedGoogle Scholar
  36. Lin, J. C. H. (1994). How long do Chinese Americans stay in psychotherapy? Journal of Counseling Psychology, 41, 288–291. doi: 10.1037/0022-0167.41.3.288.CrossRefGoogle Scholar
  37. Lin, K. M., & Cheung, F. (1999). Mental health issues for Asian Americans. Psychiatric Services, 50, 774–780.PubMedGoogle Scholar
  38. Lin, K. M., Lau, J. K. C., Yamamoto, J., Zheng, Y. P., Kim, H. S., Cho, K. H., et al. (1992). Hwa-byung: A community study of Korean Americans. The Journal of Nervous and Mental Disease, 180, 386–391.PubMedCrossRefGoogle Scholar
  39. Lin, T. Y., & Lin, M. C. (1981). Love, denial and rejection: Responses of Chinese families to mental illness. In A. Kleinman & T. Y. Lin (Eds.), Normal and abnormal behavior in Chinese culture (pp. 387–401). Dordrecht: Reidel.CrossRefGoogle Scholar
  40. Maeda, F., & Nathan, J. H. (1999). Understanding Taijin Kyofusho through its treatment, Morita therapy. Journal of Psychosomatic Research, 46, 525–530. doi: 10.1016/S0022-3999(98)00113-5.PubMedCrossRefGoogle Scholar
  41. Mak, W. W. S., & Chen, S. X. (2006). Face concern: Its role on stress–distress relationships among Chinese Americans. Personality and Individual Differences, 41, 143–153. doi: 10.1016/j.paid.2005.12.016.CrossRefGoogle Scholar
  42. Markus, H. R., & Kitayama, S. (1991). Culture and the self: Implications for cognition, emotion, and motivation. Psychological Review, 98, 224–253. doi: 10.1037/0033-295X.98.2.224.CrossRefGoogle Scholar
  43. Matsuoka, J. K., Breaux, C., & Ryujin, D. H. (1997). National utilization of mental health services by Asian Americans/Pacific islanders. Journal of Community Psychology, 25, 141–145. doi: 10.1002/(SICI)1520-6629(199703)25:2<141::AID-JCOP3>3.0.CO;2-0.CrossRefGoogle Scholar
  44. Merikangas, K. R., Jin, R., He, J. P., Kessler, R. C., Lee, S., Sampson, N. A., et al. (2011). Prevalence and correlates of bipolar spectrum disorder in the World Mental Health Survey Initiative. Archives of General Psychiatry, 68, 241–251. doi: 10.1001/archgenpsychiatry.2011.12.PubMedCrossRefGoogle Scholar
  45. Min, S. K. (2009). Hwabyung in Korea: Culture and dynamic analysis. World Cultural Psychiatry Research Review, 4(1), 12–21.Google Scholar
  46. Moore, L. J., & Boehnlein, J. K. (1991). Posttraumatic stress disorder, depression, and somatic symptoms in U.S. Mien patients. The Journal of Nervous and Mental Disease, 179, 728–733.PubMedCrossRefGoogle Scholar
  47. Nichter, M. (1981). Negotiation of the illness experience: Ayurvedic therapy and the psychosocial dimension of illness. Culture, Medicine and Psychiatry, 5, 5–24. doi: 10.1007/BF00049156.PubMedCrossRefGoogle Scholar
  48. Pang, K. Y. (1990). Hwabyung: The construction of a Korean popular illness among Korean elderly immigrant women in the United States. Culture, Medicine and Psychiatry, 14, 495–512.PubMedCrossRefGoogle Scholar
  49. Park, Y. (2006). Culture-bound syndromes: Hwa-byung. In J. Yo (Ed.), Encyclopedia of multicultural psychology (pp. 137–138). Thousand Oaks, CA: Sage.Google Scholar
  50. Park, Y., Kim, H. S., Kang, H., & Kim, J. (2001). A survey of hwa-byungin middle-age Korean women. Journal of Transcultural Nursing, 12(2), 115–122. doi: 10.1177/104365960101200205.PubMedCrossRefGoogle Scholar
  51. Park, Y., Kim, H. S., Schwartz-Barcott, D., & Kim, J. (2002). The conceptual structure of hwa-byung in middle-aged Korean women. Health Care for Women International, 23(4), 389–397. doi: 10.1080/0739933029008955.PubMedCrossRefGoogle Scholar
  52. Reynolds, D. K. (1976). Morita psychotherapy. Berkeley: University of California Press.Google Scholar
  53. Reynolds, D. K. (1982). The quiet therapies: Japanese pathways to personal growth. Honolulu, HI: The University Press of Hawaii.Google Scholar
  54. Saha, S., Welham, J., Chant, D., & McGrath, J. (2006). Incidence of schizophrenia does not vary with economic status of the country: Evidence from a systematic review. Social Psychiatry and Psychiatric Epidemiology, 41, 338–340. doi: 10.1007/s00127-006-0041-7.PubMedCrossRefGoogle Scholar
  55. Shinfuku, N., & Kitanishi, K. (2010). Buddhism and psychotherapy in Japan. In P. J. Verhagen, H. M. Van Praag, J. J. Lopez-Ibor Jr., J. L. Cox, & D. Moussaoui (Eds.), Religion and psychiatry: Beyond boundaries (pp. 181–191). West Sussex, UK: Wiley-Blackwell.CrossRefGoogle Scholar
  56. Snowden, L. R., & Cheung, F. K. (1990). Use of inpatient mental health services by members of ethnic minority groups. American Psychologist, 45, 347–355. doi: 10.1037/0003-066X.45.3.347.PubMedCrossRefGoogle Scholar
  57. Sohng, S. S. L., & Song, K. (2003). Korean children and families. In R. Fong (Ed.), Culturally competent practice with immigrant and refugee children and families (pp. 81–99). New York: The Guilford Press.Google Scholar
  58. Son, C. (2000). Haan of Minjung theology and Han of Han philosophy. Lanham, MD: University Press of America.Google Scholar
  59. Stewart, S. M., Lee, P. W. H., & Tao, R. (2010). Psychiatric disorders in the Chinese. In M. H. Bond (Ed.), The Oxford handbook of Chinese psychology (pp. 367–382). New York: Oxford University Press.Google Scholar
  60. Sue, S., Fujino, D. C., Hu, L., Takeuchi, D. T., & Zane, N. W. S. (1991). Community mental health services for ethnic minority groups: A test of the cultural responsiveness hypothesis. Journal of Consulting and Clinical Psychology, 59, 533–540. doi: 10.1037/0022-006X.59.4.533.PubMedCrossRefGoogle Scholar
  61. Sue, S., & McKinney, H. (1975). Asian American in the community mental health care system. The American Journal of Orthopsychiatry, 45, 111–118.PubMedCrossRefGoogle Scholar
  62. Takaki, R. T. (1998). Strangers from a different shore: A history of Asian Americans. Boston: Little, Brown.Google Scholar
  63. Takeuchi, D. T., Chun, C., Gong, F., & Shen, H. (2002). Cultural expressions of distress. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 6, 221–235. doi: 10.1177/136345930200600205.CrossRefGoogle Scholar
  64. Tandon, R., Keshavan, M. S., & Nasrallah, H. A. (2008). Schizophrenia, “just the facts” what we know in 2008. 2. epidemiology and etiology. Schizophrenia Research, 102, 1–18. doi: 10.1016/j.schres.2008.04.011.PubMedCrossRefGoogle Scholar
  65. Torrey, E. F. (1987). Prevalence studies in schizophrenia. The British Journal of Psychiatry, 150, 598–608. doi: 10.1192/bjp.150.5.598.PubMedCrossRefGoogle Scholar
  66. Triandis, H. C., Leung, K., Villareal, M. J., & Clack, F. L. (1985). Allocentric versus idiocentric tendencies: Convergent and discriminant validation. Journal of Research in Personality, 19, 395–415. doi: 10.1016/0092-6566(85)90008-X.CrossRefGoogle Scholar
  67. U.S. Census Bureau. 2006–2010 American Community Survey (selected population tables): selected social characteristics in the United States. Washington DC: United States Department of Commerce, 2010. Available at: http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_10_SF4_DP02&prodType=table.
  68. U.S. Department of Health and Human Services. (1999). Mental health: A report of the surgeon general – Executive summary. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.Google Scholar
  69. U.S. Department of Health and Human Services. (2001). Mental health: Culture, race and ethnicity – A supplement to mental health: A report of the surgeon general. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.Google Scholar
  70. Uba, L. (1994). Asian Americans: Personality patterns, identity, and mental health. New York: Guilford Press.Google Scholar
  71. Weiss, B., Tram, J. M., Weisz, J. R., Rescorla, L., & Achenbach, T. M. (2009). Differential symptom expression and somatization in Thai versus U.S. children. Journal of Consulting and Clinical Psychology, 77, 987–992. doi: 10.1037/a0016779.PubMedCrossRefGoogle Scholar
  72. Weissman, M. M., Bland, R. C., Canino, G. J., Faravelli, C., Greenwald, S., Hwu, H. G., et al. (1996). Cross-national epidemiology of major depression and bipolar disorder. JAMA: The Journal of the American Medical Association, 276, 293–299. doi: 10.1001/jama.1996.03540040037030.CrossRefGoogle Scholar
  73. Weissman, M. M., Bland, R. C., Canino, G. J., Faravelli, C., Greenwald, S., Hwu, H. G., et al. (1997). The cross-national epidemiology of panic disorder. Archives of General Psychiatry, 54, 305–309.PubMedCrossRefGoogle Scholar
  74. Wong, E. C., Marshall, G. N., Schell, T. L., Elliott, M. N., Hambarsoomians, K., Chun, C., et al. (2006). Barriers to mental health care utilization for U.S. Cambodian refugees. Journal of Consulting and Clinical Psychology, 74, 1116–1120. doi: 10.1037/0022-006X.74.6.1116.PubMedCrossRefGoogle Scholar
  75. World Health Organization. (1994). The ICD-10 classification of mental and behavioral disorders: Diagnostic criteria for research. Geneva, Switzerland: World Health Organization.Google Scholar
  76. Zheng, Y., Lin, K., Takeuchi, D. T., Kurasaki, K. S., Wang, Y., & Cheung, F. (1997). An epidemiological study of neurasthenia in Chinese-Americans in Los Angeles. Comprehensive Psychiatry, 38, 249–259. doi: 10.1016/S0010-440X(97)90056-0.PubMedCrossRefGoogle Scholar
  77. Zhong, J., & Leung, F. (2007). Should borderline personality disorder be included in the fourth edition of the Chinese classification of mental disorders? Chinese Medical Journal, 120, 77–82.PubMedGoogle Scholar

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© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.SunnyvaleUSA

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