Advertisement

Attenuated Psychosis Syndromes Among Asian American Youth and Young Adults: A Culturally Relevant Case Illustration Approach

  • Huijun LiEmail author
  • Michelle Friedman-Yakoobian
  • Victoria Choate Hasler
  • Daniel I. Shapiro
  • Emily Wu
Chapter

Abstract

Asian Americans have been found to have a longer duration of untreated psychosis than other ethnic groups in the United States. Their symptom manifestations and interventions may be culturally rooted. Asian American families tend to underutilize mental health services, have less favorable help-seeking attitudes than their White counterparts, and terminate services prematurely. This chapter will explore different factors that may hinder Asian American families from seeking help for their child in a timely and consistent manner. Culturally relevant symptoms and intervention strategies for APS among Asian American populations will be discussed. A case will also be presented to illustrate some of the intricacies, both culturally and symptomatically, when working with Asian American youth who have APS. Finally, implications for research and treatment will be discussed.

Keywords

Asian American families Attenuated psychosis syndrome Culture 

References

  1. Akutsu, P. D., Castillo, E. D., & Snowden, L. R. (2007). Differential referral patterns to ethnic-specific and mainstream mental health programs for four Asian American groups. American Journal of Orthopsychiatry, 77(1), 95–103.PubMedCrossRefGoogle Scholar
  2. Amminger, G. P., Schäfer, M. R., Papageorgiou, K., Klier, C. M., Cotton, S. M., Harrigan, S. M., … Berger, G. E. (2010). Long-chain omega-3 fatty acids for indicated prevention of psychotic disorders: A randomized, placebo-controlled trial. Archives of General Psychiatry, 67, 146–154.PubMedPubMedCentralCrossRefGoogle Scholar
  3. Chan, S. W., Yip, B., Tso, S., Cheng, B. S., & Tam, W. (2009). Evaluation of a psychoeducation program for Chinese clients with schizophrenia and their family caregivers. Patient Education and Counseling, 75(1), 67–76.PubMedCrossRefGoogle Scholar
  4. Cheng, L. Y., & Chan, S. (2005). Psychoeducation program for Chinese family carers of members with schizophrenia. Western Journal of Nursing Research, 27, 583–599.PubMedCrossRefGoogle Scholar
  5. Chien, W. T., & Wong, K. F. (2007). A family psychoeducation group program for Chinese people with schizophrenia in Hong Kong. Psychiatric Services, 58(7), 1003–1006.PubMedCrossRefGoogle Scholar
  6. Chiu, S. C., Hwu, H. G., Shiau, S. J., Yao, G., & Hsieh, Y. S. (2010). Applicability of the Chinese version of the prodromal questionnaire. Journal of Formos Medical Association, 109(9), 647–655.CrossRefGoogle Scholar
  7. Chung, Y. C., Kang, N. I., Im, Y. J., Kim, S. W., Cho, I. H., Lee, Y. M., & Kwon, J. S. (2013). Validation of the Korean version of the Eppendorf Schizophrenia Inventory as a screening measure to detect adolescents at ultra-high risk for psychosis. Early Intervention Psychiatry, 7(1), 71–79.CrossRefGoogle Scholar
  8. Cicero, D. C., Krieg, A., & Martin, E. A. (2017). Measurement invariance of the Prodromal Questionnaire-Brief among White, Asian, Hispanic, and multiracial populations. Assessment, 1, 1073191116687391.Google Scholar
  9. Compton, M. T., Kaslow, N., & Walker, E. F. (2004). Observations on parent/family factors that may influence the duration of untreated psychosis among African American first-episode schizophrenia-spectrum patients. Schizophrenia Research, 68(2–3), 373–385.PubMedCrossRefGoogle Scholar
  10. Fusar-Poli, P., Bonoldi, I., Yung, A. R., Borgwardt, S., Kempton, M. J., Valmaggia, L., ... & McGuire, P. (2012). Predicting psychosis: meta-analysis of transition outcomes in individuals at high clinical risk. Archives of General Psychiatry, 69(3), 220–229.Google Scholar
  11. Fusar-Poli, P., Borgwardt, S., Bechdolf, A., Addington, J., Riecher-Rossler, A., Schultze-Lutter, F., … Yung, A. (2013). The psychosis high-risk state: A comprehensive state-of-the-art review. JAMA Psychiatry, 70(1), 107–120.PubMedPubMedCentralCrossRefGoogle Scholar
  12. Harris. (2009). ACT made simple. Oakland, CA: New Harbinger Publications.Google Scholar
  13. Inman, A. G., & Yeh, C. (2006). Stress and coping. In F. Leong, A. G. Inman, A. Ebro, L. Yang, L. Kinoshita, & M. Fu (Eds.), Handbook of Asian American psychology (pp. 323–340). Thousand Oaks, CA: Sage.Google Scholar
  14. Kendler, K. S., Gruenberg, A. M., & Strauss, J. S. (1981). An independent analysis of the Copenhagen sample of the Danish adoption study of schizophrenia. II. The relationship between schizotypal personality disorder and schizophrenia. Archives of General Psychiatry, 38(9), 982–984.PubMedCrossRefGoogle Scholar
  15. Kobayashi, H., Nemoto, T., Koshikawa, H., Osono, Y., Yamazawa, R., Murakami, M., … Mizuno, M. (2008). A self-reported instrument for prodromal symptoms of psychosis: Testing the clinical validity of the PRIME Screen-Revised (PS-R) in a Japanese population. Schizophrenia Research, 106(2–3), 356–362.PubMedCrossRefGoogle Scholar
  16. Lai, G., Lo, G., Ngo, H., Chou, Y. W., & Yang, L. (2013). Migration, sociocultural factors, and local cultural worlds among Fuzhounese Chinese immigrants. International Journal of Culture and Mental Health, 6(2), 141–155.PubMedCrossRefGoogle Scholar
  17. Lam, M. M. L., Hung, S., & Chen, E. Y. H. (2006). Transition to psychosis: 6-month follow-up of a Chinese high-risk group in Hong Kong. Australian and New Zealand Journal of Psychiatry, 40, 414–420.PubMedCrossRefGoogle Scholar
  18. Lau, A., & Zane, N. (1999). Examining the effects of ethnic-specific services: An analysis of cost-utilization and treatment outcome for Asian American clients. Journal of Community Psychology, 28, 63–77.CrossRefGoogle Scholar
  19. Lefley, H. P., & Bestman, E. W. (1984). Community mental health and minority populations: A multi-ethnic approach. In S. Sue & T. Moore (Eds.), The pluralistic society: A community mental health perspective (pp. 116–148). New York, NY: Human Sciences Press. 1984.Google Scholar
  20. Leong, F. T. L., & Kalibatseva, Z. (2011, March 23). Cross-cultural barriers to mental health services in the United States. Cerebrum, 5. PMCID: PMC3574791.Google Scholar
  21. Lewis-Fernández, R., Aggarwal, N. K., Lam, P. C., Galfalvy, H., Weiss, M. G., Kirmayer, L. J., ... & Boiler, M. (2017). Feasibility, acceptability and clinical utility of the Cultural Formulation Interview: mixedmethods results from the DSM-5 international field trial. The British Journal of Psychiatry, 210(4), 290–297.Google Scholar
  22. Li, H., Friedman-Yakoobian, M., Min, G., Granato, A. G., & Seidman, L. J. (2013). Working with Asian American youth at clinical high risk for psychosis: A case illustration. Journal of Nervous and Mental Diseases, 201, 484–489.CrossRefGoogle Scholar
  23. Li, H., & Seidman, L. (2010). Engaging Asian American youth and their families in quality mental health services. Asian Journal of Psychiatry, 3, 169–172.PubMedPubMedCentralCrossRefGoogle Scholar
  24. Link, B. G., Cullen, F. T., Struening, E., Shrout, P. E., & Dohrenwend, B. P. (1989). A modified labeling theory approach to mental disorders. American Sociological Review, 43(3), 400–423.CrossRefGoogle Scholar
  25. Liu, C., Li, H., Wu, E. Y., & Tung, E. (under review). Parental Recognition of Mental Illness in Chinese American Youth: A Qualitative Approach. Transcultural PsychiatryGoogle Scholar
  26. Loewy, R. L., Bearden, C. E., Johnson, J. K., Raine, A., & Cannon, T. D. (2005). The prodromal questionnaire (PQ): Preliminary validation of a self-report screening measure for prodromal and psychotic syndromes. Schizophrenia Research, 79(1), 117–125.PubMedPubMedCentralCrossRefGoogle Scholar
  27. Loewy, R. L., Pearson, R., Vinogradov, S., Bearden, C. E., & Anon, T. D. (2011). Psychosis risk screening with the Prodromal Questionnaire-Brief version (PQ-B). Schizophrenia Research, 129(1), 42–46.PubMedPubMedCentralCrossRefGoogle Scholar
  28. Ma, W. F., Lane, H. Y., Chiang, L. C., Wu, P. L., Yang, S. J., & Tsai, G. E. (2015). Assessing the construct validity of the Chinese-Version Schizotypal Personality Questionnaire-Brief on male and female undergraduate students. Journal of Nursing Research, 23(2), 162–166.PubMedGoogle Scholar
  29. Mak, W. W. S., & Cheung, R. Y. M. (2008). Affiliate stigma among caregivers of people with intellectual disability or mental illness. Journal of Applied Research in Intellectual Disabilities, 21(6), 532–545.CrossRefGoogle Scholar
  30. Mark, W., & Toulopouloub, T. (2017). Validation of the Chinese version of Community Assessment of Psychic Experiences (CAPE) in an adolescent general population. Asian Journal of Psychiatry, 26, 58–65.PubMedCrossRefGoogle Scholar
  31. Marshall, M., Lewis, S., Lockwood, A., Drake, R., Jones, P., & Croudace, T. (2005). Association between duration of untreated psychosis and outcome in cohorts of first-episode patients: A systematic review. Archives of General Psychiatry, 92(9), 975–983.CrossRefGoogle Scholar
  32. McCabe, R., & Priebe, S. (2004). Explanatory models of illness in schizophrenia: Comparison of four ethnic groups. The British Journal of Psychiatry, 185(1), 25–30.PubMedCrossRefGoogle Scholar
  33. McGorry, P. D., Nelson, B., Markulev, C., Yuen, H. P., Schäfer, M. R., Mossaheb, N., Schlögelhofer, M., … Amminger, G. P. (2017). Effect of ω-3 Polyunsaturated Fatty Acids in young people at ultrahigh risk for psychotic disorders: The NEURAPRO randomized clinical trial. JAMA Psychiatry, 74, 19–27.PubMedCrossRefGoogle Scholar
  34. Miller, T. J., Chicchetti, D., Markovich, P. J., McGlashan, T. H., & Woods, S. W. (2004). The SIPS screen: A brief self-report screen to detect the schizophrenia prodrome. Schizophrenia Research, 70(suppl1), 78.Google Scholar
  35. Miller, T. J., McGlashan, T. H., Rosen, J. L., Somjee, L., Markovich, P. J., Stein, K., & Woods, S. W. (2002). Prospective diagnosis of the initial prodrome for schizophrenia based on the Structured Interview for Prodromal Syndromes: Preliminary evidence of interrater reliability and predictive validity. American Journal of Psychiatry, 159(5), 863–865.PubMedPubMedCentralCrossRefGoogle Scholar
  36. Nelson, B., Amminger, G. P., Yuen, H. P., Markuley, C., Lavoie, S., Schafer, M. R., Hartmann, J. A …, McGorry, P. D. (2018). NEURAPRO: A multi-centre RCT of omega-3 polyunsaturated fatty acids versus placebo in young people at ultra-high risk of psychotic disorders – medium-term follow-up and clinical course. NPJ Schizophrenia, 4(1):11. https://doi.org/10.1038/s41537-018-0052-x.
  37. Perkins, D. O., Gu, H., Boteva, K., & Lieberman, J. A. (2005). Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia: A critical review and meta-analysis. American Journal of Psychiatry, 162(10), 1785–1804.PubMedCrossRefGoogle Scholar
  38. Pew Research Center. (2012, July 19). Asian Americans: A mosaic of faiths. Retrieved August 16, 2018 from http://www.pewforum.org/2012/07/19/asian-americans-a-mosaic-of-faiths-overview/
  39. Pew Research Center. (2017, September 8). Key facts about Asian Americans, a diverse and growing population. Retrieved August 16, 2018 from http://www.pewresearch.org/fact-tank/2017/09/08/key-facts-about-asian-americans/
  40. Pharoah, F., Mari, J., Rathbone, J., & Wong, W. (2010). Family intervention for schizophrenia. Cochrane Database Systematic Review, (12), CD000088.  https://doi.org/10.1002/14651858.CD000088.pub2
  41. Root, M. P. (1985). Guidelines for facilitating therapy with Asian-American clients. Psychotherapy: Theory, Research, Practice, Training, 22(2S), 349.CrossRefGoogle Scholar
  42. Schultze-Lutter, F., & Theodoridou, A. (2017). The concept of basic symptoms: Its scientific and clinical relevance. World Psychiatry, 16, 104–105.PubMedPubMedCentralCrossRefGoogle Scholar
  43. Sentell, T., Shumway, M., & Snowden, L. (2007). Access to mental health treatment by english language proficiency and race/ethnicity. Journal of General Internal Medicine, 22(2), 289–293.PubMedPubMedCentralCrossRefGoogle Scholar
  44. Silton, N., Flannelly, K., Milstein, G., & Vaaler, M. (2011). Stigma in America: Has anything changed? Impact of perceptions of mental illness and dangerousness on the desire for social distance: 1996 and 2006. The Journal of Nervous and Mental Disease, 199, 361–366.PubMedCrossRefGoogle Scholar
  45. Singh, S. P., Brown, L., Winsper, C., Gajwani, R., Islam, Z., Jasani, R., … Birchwood, M. (2015). Ethnicity and pathways to care during first episode psychosis: The role of cultural illness attributions. BMC Psychiatry, 15(1), 287.PubMedPubMedCentralCrossRefGoogle Scholar
  46. Takeuchi, D. T., Sue, S., & Yeh, M. (1995). Depression and other mental health issues: The Filipino American experience. San Francisco: Jossey-Bass.Google Scholar
  47. Ting, J. Y., & Hwang, W. C. (2009). Cultural influences on help-seeking attitudes in Asian American students. American Journal of Orthopsychiatry, 79(1), 125–132.PubMedCrossRefGoogle Scholar
  48. U.S Department of Health and Human Services. Mental Health. (2001). 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, Public Health Service Office of the Surgeon General.Google Scholar
  49. Vogel, D. L., Wade, N. G., & Hackler, A. H. (2007). Perceived public stigma and the willingness to seek counseling: The mediating roles of self-stigma and attitudes toward counseling. Journal of Counseling Psychology, 54(1), 40–50.CrossRefGoogle Scholar
  50. Wong, C., Davidson, L., Anglin, D., Link, B., Gerson, R., Malaspina, D., … Corcoran, C. (2009). Stigma in families of individuals in early stages of psychotic illness: Family stigma and early psychosis. Early Intervention in Psychiatry, 3(2), 108–115.PubMedPubMedCentralCrossRefGoogle Scholar
  51. Woodberry, K. A. (2015). Population screening in Asia: A unique opportunity to enhance early detection of psychosis? Asian Journal of Psychiatry, 18, 97–98.PubMedPubMedCentralCrossRefGoogle Scholar
  52. Yang, L. H., Lai, G. Y., & Tu, M. (2014). A brief anti-stigma intervention for Chinese immigrant caregivers of individuals with psychosis: Adaptation and initial findings. Transcultural Psychiatry, 51(2), 139–157.PubMedCrossRefGoogle Scholar
  53. Yang, L. H., Phelan, J. C., & Link, B. G. (2008). Stigma and beliefs of efficacy towards traditional Chinese medicine and Western psychiatric treatment among Chinese-Americans. Cultural Diversity and Ethnic Minority Psychology, 14(1), 10–18.PubMedCrossRefGoogle Scholar
  54. Yang, L. H., Phillips, M. R., Lo, G., Chou, Y., Zhang, X., & Hopper, K. (2009). “Excessive thinking” as explanatory model for schizophrenia: Impacts on stigma and “moral” status in Mainland China. Schizophrenia Bulletin, 36(4), 836–845.PubMedPubMedCentralCrossRefGoogle Scholar
  55. Yang, L. H., Wonpat-Borja, A. J., Opler, M. G., & Corcoran, C. M. (2010). Potential stigma associated with inclusion of the psychosis risk syndrome in the DSM-V: An empirical question. Schizophrenia Research, 120(1–3), 42–48.PubMedPubMedCentralCrossRefGoogle Scholar
  56. Yung, A. R., Yuen, H. P., McGorry, P. D., Phillips, L. J., Kelly, D., Dell’Olio, M., ... & Godfrey, K. (2005). Mapping the onset of psychosis: the comprehensive assessment of at‐risk mental states. Australian and New Zealand Journal of Psychiatry, 39(11–12), 964–971. https://doi.org/10.1111/j.1440-1614.2005.01714.xPubMedPubMedCentralCrossRefGoogle Scholar
  57. Zane, N., Hatanaka, H., Park, S. S., & Akutsu, P. (1994). Ethnic-specific mental health services: Evaluation of the parallel approach for Asian-American clients. Journal of Community Psychology, 22(2), 68–81.CrossRefGoogle Scholar
  58. Zane, N., & Yeh, M. (2002). The use of culturally-based variables in assessment: Studies on loss of face. In K. S. Kurasaki, S. Okazaki, & S. Sue (Eds.), Asian American mental health: Assessment theories and methods (pp. 123–138). New York, NY: Kluwer Academic/Plenum Publishers.CrossRefGoogle Scholar
  59. Zhang, T., Li, H., Tang, Y., Li, H., Zheng, L., Guo, Q., … Xiao, Z. (2015). Screening schizotypal personality disorder for detection of clinical high risk of psychosis in Chinese mental health services. Psychiatry Research, 228(3), 664–670.PubMedCrossRefGoogle Scholar
  60. Zhang, T., Li, H., Woodberry, K. A., Seidman, L. J., Zheng, L., Zhao, S., … Wang, J. (2014). Prodromal psychosis detection in a counseling center population in China: An epidemiological and clinical study. Schizophrenia Research, 152(2–3), 391–399.PubMedPubMedCentralCrossRefGoogle Scholar
  61. Zheng, L., Wang, J., Zhang, T., Li, H., Li, C., & Jiang, K. (2012). The Chinese version of the SIPS/SOPS: A pilot study of reliability and validity. Chinese Mental Health Journal, 26(8), 571–576.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Huijun Li
    • 1
    Email author
  • Michelle Friedman-Yakoobian
    • 2
  • Victoria Choate Hasler
    • 3
  • Daniel I. Shapiro
    • 4
  • Emily Wu
    • 5
  1. 1.Department of Psychology, College of Social Sciences, Arts and HumanitiesFlorida A&M UniversityTallahasseeUSA
  2. 2.Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonUSA
  3. 3.Brigham and Women’s HospitalHarvard Medical SchoolBostonUSA
  4. 4.Department of PsychiatryEarly Psychosis Programs, University of California-DavisSacramentoUSA
  5. 5.Massachusetts General HospitalHarvard Medical SchoolBostonUSA

Personalised recommendations