Cultural Factors, Depressive and Somatic Symptoms Among Chinese American and European American College Students

This study seeks to fill a gap in the existing empirical literature about the relationship between somatic and depressive symptoms and their associations with cultural factors among Chinese American and European American college students. In particular, the study examined how three culturally relevant psychological constructs, self-construal, loss of face, and emotion regulation, associate with depressive and somatic symptoms among Chinese American and European American college students and if they can explain possible group differences in depressive symptoms. The sample consisted of 204 Chinese American and 315 European American college students who completed an online survey. Based on multiple regression analyses, European American students reported higher levels of somatic symptoms on the Patient Health Questionnaire-15 (PHQ-15) than Chinese Americans. There was no initial group difference in depressive symptoms based on Center for Epidemiologic Studies-Depression Scale (CES-D) scores. Correlations between depressive and somatic symptoms, independent and interdependent self-construal, and cognitive reappraisal and independent self-construal were stronger for European Americans than Chinese Americans. Somatic symptoms, loss of face, and expressive suppression were positively associated with depressive symptoms, whereas independent self-construal and cognitive reappraisal were negatively associated with depressive symptoms for both groups. When controlling for gender and somatic symptoms, being Chinese American and male was significantly and positively associated with depressive symptoms measured with the CES-D. These ethnic and gender differences in depressive symptoms were explained by independent self-construal, loss of face, cognitive reappraisal, and expressive suppression. Clinical implications include the incorporation of specific culturally relevant constructs and avoidance of race-, ethnicity-, and gender-based stereotypes to reduce health disparities in depression treatment.