Vietnamese With Mental Health Problems and the Likelihood of Seeking Professional Help, Article Critique Example

Introduction

Across research studies on Asian Americans have revealed that Asian Americans do not possess the education on mental health and underutilizes their capable of seeking a professional help with their mental health problems. Asian Americans beliefs in mental-health are the ways to which influences their ability to overcome stress. They possessed the education on the causes of mental illness except that they were misinformed on the mental health treatment outcomes. Researchers found that Asian Americans followed Japanese’ belief in individual’s negative mentality means that an individual with mental health problem is a bad luck. Hence, researchers attempted to investigate the theoretical framework for Asian Americans on mental health attributes that is aligned to their cultural beliefs in seeking for mental health service.

Research question: What are the causes for Asian Americans being disencouraged to seek a professional mental health help when their psychopathological somatic symptoms are severed and persistence with depression?

Research Variables

The independent variables are: Asian Americans, professional mental health seeking, and the dependent variables are: Depression, enculturation, and values. Each dependent variable has dichotomous variables, because they are correlated to one another significantly including the models used in the assessment have also evidenced that there are relationships between the variables. The data collection process was conducted by recruiting undergraduate students at a large university and performed face-to-face qualitative interviews, and collected electronic databases through organizations of Asian Americans throughout the United States of America. The sample of Asian American population has comprised 223 participants (69.9% female, 30.1% male) with average age 23.57 (SD = 6.76) years and of East, South, and or/Southeast Asian descent and of emigrated to the United States. Not all participants are of Asian descent, some participants are from other ethnicity descent like Chinese (30.6%), Indian (14.6%), Vietnamese (14.2%), Filipino/Filipina (11.9%), Taiwanese (9.1%), Korean (4.1%), and other Asian (15.5%). The criteria excluded the psychology/counseling graduate students and licensed psychologists/therapists in the research study.

Instruments

The dependent variables were measured by Asian American Values Scale-Multidimensional (AAVS-M; Kim et al., 2005) which measures the enculturation common cultural values of Asian Americans ethnic groups. In the AAVS-M, there are 42 items which has a 7-point Likert-type scale with five subscales. The results were calculated by determining the average mean with high scores that indicates Asian values have a higher repertoire with enculturation norms thus explored the relationship between enculturation and mental health beliefs. Rather, authors did not want to explore all five AAVS-M subscales because the scores do not present a general construct of enculturation. As result, 2-week test-retest reliability coefficient for overall scale was .92 and .89, respectively (Kim, et al.). Another type of instrument used in this current study is the depression vignette in which the authors had created for participants to read the vignette and respond to the given questions. The vignette included the descriptions of psychopathology major depressive symptoms, affective symptoms, and somatic symptoms. For the study DSM-IV manipulation purpose, authors administered eight psychology graduate students the blind-study hypotheses for them to response to the questions in regards to the problem described in the vignette. The questions included belief opinions on five categories of illness representation self-regulation model as to find the most effective ways to resolve the problem.

Hypothesis

Authors examined the culture of Asian Americans’ relationship between depression beliefs, enculturation to values and the likelihood of seeking professional help by theoretizing the Culturally Informed Representation Self Regulation Model (CIRSRM) of Asian cultural worldviews discussed in the precedent literature review on the potential causes of depression—(a) interpersonal causes, noninterpersonal situational causes (known situational causes), biological causes, and personal failure causes; (b) depression dispositions, somatic effects (e.g., poor appetite); and (c) the time frame of depression. Authors hypothesized the beliefs that two of the (a) causes are positively associated with professional mental health seeking, whereas beliefs in other (b) and (c) causes does not inhibit from Asian to seek professional help. Also, they expected that Asian values are related with enculturation that does not inhibit from Asian to seek professional help. Lastly, they predicted that of Asian with a stronger enculturation would seek for a professional help as compared with Asian with a less enculturation would not seek for a professional help.

Data Analysis

Authors were counseling psychology graduate students that conducted three different analyses on this research study, first part discussed about the coding of lay beliefs, in this paper, the term, ‘belief’ is used for better understanding of norms in general. The manual has codified 24 different types of beliefs focus on hypotheses and the dichotomous variables were applied to each belief and coding the nominal number 1 for the criteria has met, 0 otherwise based on the participants’ responses. Authors did not include the analyses of identified problems responses to the labeled question in this study. Including the blind-study hypotheses given by 8 psychology doctoral students, the authors took 3-hour training for studying the codes based on the coding manual. Second part of the data analysis has discussed the preliminary analyses in which describe the Kolmogorov-Smirnov test measuring the AAVS-M scores, and the results is that the normal curve of distribution was not in the range, D (223) = .049, p = .200. Then, the belief participants did not relate any of the belief components to AAVS-M, p > .05, hence another type of statistics, a Bonferroni test, with the level of p <.002, indicated that seven components of beliefs were correlated to one another. Similarity, in the main analyses, in which describe the logistic regression test measuring the dichotomous variables (e.g., obtained professional help versus professional help seeking) using the odd ratio (OR). The rule to measure the OR is by 1.00 which indicates that a variable of 1 unit has been increased within the variable and that decreases the odds for the outcome variable from occurring. Authors integrated the hypotheses AAVS-M, and six-beliefs omitting one belief into a standardized measurement in order to reduce multicollinearity. A standardized measurement is the None of the Variance Inflation Factor (VIF) which indicates whether there is a multicollinearity occurring in the logistic regression analysis. Authors predicated that participants with acute- depressive symptoms are likely to reduce the chance to seek for a professional help than those with chronic-depressive symptoms who are likely to increase the chance to seek for a professional help.

Conceptual Framework

A theoretical framework includes a concept on casual beliefs of physiological dispositions that applies to the self-regulation model. Individuals use the ways to control problems by believing that the problems can be solved through families than a professional to solve their problems. However, individuals like the Asian do not acquire the understanding of the problems that elaborates the meaning of the problems. Whereas, Western-Europeans have the understanding on how to solve the problems and delineates the meaning of the problems through professional mental health help. Researchers choose an Illness Representation Self-Regulation Model, which represents the problem with Asian Americans beliefs in notion of mental health and professional help seeking. Thus, the Illness Representation Self-Regulation Model is a contrast model of self-representation. The model is suppositioned on individuals who believed in solving the problem with a meaning that is outside of their illness experiences. Few studies discussed of the help-seeking belief model that was used by a certain type of population. For instance, Cabassa, Lester, & Zayas (2007) found that Latino immigrants had used this model to degrade their experience with depression. While, Karasz (2005) and Karasz & McKinley (2007) found that South Asian immigrant women used this model to degrade their experience with depression and fatigue. From the given reliable studies that examined the mental illness beliefs, researchers proposed an integrated model that represents Asian Americans’ culturally informed worldview on illness representation self regulation model as labeled the culturally informed illness representation self regulation model (CIRSRM). In this CIRSRM model, an extent of the given variables were examined for the difference between enculturation and acculturation as both values refers to the norms in which Asian Americans either to retain their social norms and or adopt the norms from a dominant culture (e.g., European American).

Limitations and Recommendations

Authors contend that there are limitations in this study which the limitations are the CIRSRM model, Asian cultural worldview influences, and mental illness beliefs. The CIRSRM model was used for specific variables that authors attempted to study, except that the model is not widely used across literatures, therefore a need for mediation model in which promotes the public awareness of CIRSRM model for ethnic immigrant populations. Second, a limitation on the number of participants who had received treatment was underscored on the AASV-M testing instrument than those who did not attempt to receive treatment through both medical physician doctor and mental health professional. Authors recommended different demographic sets of sampling other than their criteria that aimed for the young, nonclinical, undergraduate students, and of descent in their investigation. A sampling to gather future research on older Asian Americans with less education and have clinical mental health problems to which this sampling may increase the significance of the success professional help seeking rates.

Conclusion

Authors did an extensive investigation on Asian American culture and mental health problems and professional help seeking implications in which this research study is a compelling literature review as the extent to investigate the most appropriate measurement to retrieve a strong validity and reliability data for both dichotomous variables and non-dichotomous variables because in the dichotomous variables, there are several variables that requires to measure statistically based on the rules and the criteria given in the research study. This type of study cannot rule out mixed research designs because of the surmountable variables that must be divided into categories, but in my opinion, authors should have extend the secondary classifications of beliefs because it was not analyzed accorded to the models other than AASV-M and CIRSRM. Moreover, this research study did not use qualitative measurement on the CIRSRM in which makes difficult to match the hypotheses in question.

Reference:

Wong, Joel, Y., Tran, K.K, Kim, S., Kerne, V. & Calfa, N. (2010) Asian Americans’ Lay Beliefs About Depression and Professional Help Seeking. Journal of Clinical Psychology. 66: 317-332.