Annual Review of Asian American Psychology, 2010

Sumie Okazaki and Ahmed M. Kassem

New York University
Judy Y. Tan
University of Connecticut
This article provides a systematic and critical review of all behavioral science research
articles about Asian Americans published in 2010. As the second review of the series,
we followed the methodology and format employed in the rst annual review of Asian
American psychology articles published in 2009 (B. S. K. Kim, Wong, & Mafni,
2010) to facilitate a discussion of trends in contents and methods of published research
articles in the eld. A search using PsycINFO identied 261 articles that were coded
for topic areas, research methodology, and populations studied. We also provide a
narrative summary of the articles, categorized thematically by topic areas, and conclude
with a review of methodological and topical trends in empirical research of Asian
Americans.
Keywords: Asian American research, annual review, research review, literature review
March 2010 marked a momentous occasion
in Asian American psychology, as the rst issue
of the Asian American Journal of Psychology
was jointly published by the Asian American
Psychological Association and the American
Psychological Associations Educational Pub-
lishing Foundation. The AAJP is the rst and
only peer-reviewed journal devoted to psycho-
logical research and practice concerning Asian
American individuals and communities. The
AAJP editor, Frederick T. L. Leong, commis-
sioned its rst annual review of empirical arti-
cles in Asian American psychology that were
published in 2009. The 2009 review (B. S. K.
Kim et al., 2010) was published in the Decem-
ber issue of the rst volume of the journal.
Annual review articles are published within
various scholarly elds and disciplines to dene
the current state of scientic research. In a vast
discipline such as psychology, annual review
articles are solicited on relatively narrow topics
that are intended to inform the scientic com-
munity on state-of-the-art theories and research
in that particular subeld (e.g., clinical psychol-
ogy, affective neuroscience). For example, the
Annual Review of Psychology journal published
in 2011 contained 23 review articles under top-
ics ranging from decision making, to therapy for
specic problems, to cross-country and regional
comparisons, to research methodology. Simi-
larly, the Association for Psychological Sci-
ences bimonthly journal, Current Directions in
Psychological Science, publishes invited brief
reviews on important new developments in
research, theory, methods, and applications in
scientic psychology. These reviews serve an
important function in keeping the scientic
community informed of the latest developments
across subelds of psychology and behavioral
science beyond their areas of specic expertise.
Until recently, Asian American psychology
lacked a publication venue that would allow for
an annual review of important developments in
the eld. Instead, there had been broad and
synthetic surveys and reviews that were pub-
lished primarily in handbook and textbook for-
mats, with long intervals in between each of the
major publications. The rst such book-length
integrative review was authored by S. Sue and
Morishima (1982) and was titled Mental Health
of Asian Americans. This book remained the
primary text on Asian American psychology
until the publication of Ubas (1994) book, ti-
tled Asian Americans: Personality Patterns,
Sumie Okazaki, Department of Applied Psychology,
New York University; Ahmed M. Kassem, Master of Public
Health Program, New York University; Judy Y. Tan, De-
partment of Psychology, University of Connecticut.
Preparation of this article was supported in part by grants
from the National Institute of Mental Health (1P50-
MH073511, T32-MH074387) and by a National Science
Foundation Doctoral Dissertation Award to Judy Y. Tan.
Correspondence concerning this article should be ad-
dressed to Sumie Okazaki, Department of Applied Psychol-
ogy, New York University, 246 Greene Street, 7th Floor,
New York, NY 10003. E-mail: sumie.okazaki@nyu.edu
Asian American Journal of Psychology 2011 American Psychological Association
2011, Vol. 2, No. 4, 225290 1948-1985/11/$12.00 DOI: 10.1037/a0026626
225
Identity, and Mental Health. These were single-
authored or coauthored volumes that aimed to
summarize and synthesize literature concerning
Asian American mental health. In addition, the
American Psychological Associations series on
Bibliographies in Psychology published a vol-
ume in 1992, titled Asians in the United States:
Abstracts of the Psychological and Behavioral
Literature, 19671991 (Leong &Whiteld,
1992). This printed bibliography contained the
abstracts of 1,057 articles on topics in Asian
American psychology and behavioral science
(in addition to 556 citations to dissertations, 10
authored books, and 76 book chapters) retrieved
from the PsycINFO database at a time when
journal abstracts were not yet widely accessible
in online electronic formats. Although this ab-
stract index was not a review of the literature, it
was the rst systematic attempt to catalog and
classify all published English language litera-
ture about Asian Americans that had been in-
dexed in the Psychological Abstracts (a printed
periodical of abstracts) and its computerized
counterparts (PsycINFO and PsycLIT).
As the number of empirical publications
grew rapidly over the ensuing decades, reviews
of Asian American psychology literature were
published in edited handbook format, with the
rst edition of the Handbook of Asian American
Psychology (L.C. Lee & Zane, 1998) appearing
in 1998. This rst handbook contained critical
reviews in 16 topic areas. The second edition of
the handbook (Leong et al., 2009) was pub-
lished nearly a decade later in 2009, with
reviews in 24 topic areas. Although these com-
prehensive handbook volumes provided syn-
thetic reviews of the eld, there was no regu-
larity to their review and publication schedules.
The newly established AAJP thus provided a
much-needed publication venue for a regular
periodic review of the most recent research lit-
erature in the eld.
The present article is the second in the annual
series, covering empirical articles in Asian
American psychology that were published in
2010. So as to provide some continuity in the
series, we used the same approach to conduct-
ing this years annual review as the 2009 review
conducted by B. S. K. Kim et al. (2010). Similar
to the goals for the 2009 annual review, the goal
of the current review was to provide a system-
atic and critical review of all empirical studies
published between January and December of
2010. By restricting our review to one calendar
year, the present review aims to provide the
most up-to-date gauge of where we are in the
state of Asian American psychological research
and methods.
Method
Selection Criteria
In order to replicate the methodology em-
ployed by B. S. K. Kim et al. (2010) in their
2009 annual review, our analysis focused on the
same sets of criteria. We identied and re-
viewed articles published between January and
December of 2010 that met the same criteria for
inclusion as those published between January
and December of 2009 that were reviewed in
2010. Specically, we searched the online da-
tabase PsycINFO using the term Asian Amer-
ican in the Anywhere search category, the year
2010 in the Publication Year search category,
and Peer-reviewed journals in the Publication
Type category. B. S. K. Kim et al. (2010) had
identied a total of 905 abstracts meeting these
criteria that were published in 2009. Prior to
running the search for 2010 publications, we
repeated the PsycINFO search for 2009 publi-
cations and replicated the ndings (i.e., 905
abstracts as of March 2011). The PsycINFO
search for 2010 articles was initially conducted
in January of 2011 and produced 808 results.
The search was rerun in March of 2011, which
found an additional 21 abstracts, and again in
June of 2011, which found an additional 64
abstracts, for a total of 893 abstracts.
The three coauthors read the 893 abstracts of
the articles to identify relevant articles for in-
clusion. We used the following criteria: (a) pub-
lication in a peer-reviewed journal, (b) report on
an empirical study, and (c) a focus on Asian
Americans. We dened Asian Americans to
include individuals of East, Southeast, and/or
South Asian descent living in the United States
(including Asian internationals and sojourners
living in the United States) (B.S. K. Kim et al.,
2010, p. 228). This designation of Asian cat-
egory is consistent with the current guidelines
for the classication of federal data on race and
ethnicity. We claried that theoretical articles
and articles exclusively on those residing in
Canada were not included in the previous re-
view (B. S. K. Kim, personal communication,
226 OKAZAKI, KASSEM, AND TAN
April, 15, 2011). Additionally, we excluded ar-
ticles published in non-English language jour-
nals, even if the study was about Asian Amer-
icans and the studys English language abstract
was available. We considered an article to focus
on Asian Americans if (a) [the] majority of its
participants were Asian Americans, (b) it in-
cluded at least one research question focusing
exclusively on Asian Americans, or (c) it in-
cluded at least one research question comparing
an Asian American group with another racial/
ethnic group (B. S. K. Kim et al., 2010, p.
229). As such, we excluded articles in which (a)
ethnicity was used as a control variable in the
statistical analysis rather than as an independent
variable, (b) Asian Americans were aggregated
with other ethnic minorities, or (c) research
questions did not pertain to Asian Americans.
For example, 39% of 2,862 participants in a
study of immigrant childrens perceived dis-
crimination and English prociency were Asian
American (Medvedeva, 2010) but the analysis
did not examine ethnic differences. Based on
these criteria, 261 articles were retained for the
analysis and review. Based on a small number
of articles (k 12), interrater reliability for
inclusion or exclusion was perfect (k 1.00).
Coding Procedure and Summaries
Each article was coded on the following do-
mains: (a) topic areas (see Table 1), (b) research
design (see Table 2), and (c) participant char-
acteristics (see Table 3). We used the same set
of topic and subtopic areas as the 2009 review.
The three coauthors conducted the initial coding
for the topic areas, research design, and partic-
ipant characteristics. Interrater reliability for
two raters on approximately 10% of the in-
cluded articles (n 26) was determined for the
coding of study design and participant age
group and ethnicity. Kappa coefcients for the
coding of study design, participant age group,
and ethnicity were excellent (k .92, 1.0,
and 1.0, respectively). Each article was rst
assigned to one primary topic area (i.e., the
main focus of the study, as suggested by the
articles conceptual model and/or the analysis)
and then assigned to subtopics, where appropri-
ate. Interrater reliability was calculated using
10% (n 26) of the included articles, and
percent agreement for coding primary topic ar-
eas was adequate (65%). Discrepancies in the
initial assignment of articles into primary topic
areas (e.g., psychopathology vs. counseling
and clinical issues) were resolved through dis-
cussion until consensus was reached. Speci-
cally, when multiple topic area classications
were applicable to the article, we focused on the
key outcome or dependent variable. For exam-
ple, a study of 105 Chinese American high
school students and their mothers examined
the relationship between acculturative family
distancing and depressive symptoms (W. C.
Hwang, Wood, & Fujimoto, 2010). Although
topic areas included acculturation and encul-
turation, youths, families, and psychopathol-
ogy, the study was concerned with examining
multiple parameters that predicted depres-
sion; thus, we coded this articles primary
topic as psychopathology and other areas as
secondary topics. Discrepancies among the
three coders in the primary topic assignment
were resolved through discussion.
Table 1 lists all articles by each topic area.
Because an article may fall under multiple topic
areas, the number of articles listed in Table 1
exceeds the total number of articles for inclu-
sion. We provided narrative summaries of the
261 articles. We used the same subtopic areas as
B. S. K. Kim et al. (2010; e.g., the psychopa-
thology topic area is divided into depressive
symptoms and other types of psychopathol-
ogy) to organize our narrative summaries, ex-
cept where noted. Table 2 categories are mutu-
ally exclusive so that each article was coded as
using one of four approaches (quantitative cor-
relational, quantitative experimental, qualita-
tive, or mixed). In contrast, Table 3 categories
are not mutually exclusive (e.g., a study could
be listed as including pan-Asian American
and Chinese participants if the study exam-
ined Asian Americans in the aggregate but also
described Chinese Americans as a part of the
sample), and the total number of articles across
the entire table exceeds the 261 articles for
inclusion.
Results
Quantitative Analysis
Table 1 presents the number of articles in
each of the topic areas by order of frequency.
Parenthetical numbers represent the number of
articles within each topic area where that topic
227 ANNUAL REVIEW
Table 1
Topic Areas and Number of Articles Within Each Topic
Topic N
a
Articles
Health and health-related
behaviors
88 (86) Afable-Munsuz et al.; Ashing-Giwa & Lim; Ashing-Giwa et al.; C.K. Baker et al.;
D. L. Baker et al.; Battle, Lee, & Antin; Berkman & Ko; Borrell et al.; Castro,
Gee, & Takeuchi; E.C. Chang, Sanna, et al.; C. Chen, Kendall, Shyu; J. Chen
et al.; K. S. Choi et al.; Chung et al.; Constantine et al.; Edrington et al.;
Escobar et al.; Fang, Schinke, & Cole; Fernandes et al.; Franzen & Smith;
Garcia, Romero & Maxwell; Gee, Walsemann, & Takeuchi; Gomez, Lin et al.;
Gong & Cheng; Hahm et al.; Hendershot et al.; Hofstetter et al.; J. P. Hwang et
al.; Im, B. Lee, & Chee; Im, S. H. Lee, & Chee; Ishii-Kuntz, Gomel & Tinsley;
Iwamoto, Corbin, & Fromme; Jang, Chiriboga, Allen et al.; Jang, Kim, &
Chiriboga; Ji et al.; Kandula et al.; D. Kao; T. A. Kao et al.; G. Kim,
Chiriboga, et al.; J. H. Kim, Menon, et al.; N. Kim et al.; W. Kim, Kim, &
Nochajski; Ko & Berkman; B. Lee, Im, & Chee; H. Y. Lee, Ju, et al.; J. Lee,
Lok, & Chen; J. P. Lee et al.; J. S. Lee; S. Lee et al.; Levy et al.; Liao et al.;
Lim; Lin; Lu & Stanton; Luk & Tsoh; Lv & Brown; Mauss & Butler; Maxwell,
Bastani et al.; Maxwell, Jo, et al.; McCarthy et al.; McDonnell et al.; Misra et
al.; Morrison et al.; Mulvaney-Day et al.; G. T. Nguyen et al.; H. V. Nguyen et
al.; S. Park et al.; Parker et al.; Pourat, Kagawa-Singer, Breen, & Sripipatana;
Rimal & Juon; Sakai, Wang, & Price; Sarnquist, Grieb, & Maldonado; Shelley
et al.; R.A. Shih et al.; Soller & Lee; Ta & Hayes; Tam, San Tsou, Lee, et al.;
Thai, Connell, & Tebes; Tong et al.; Trinidad et al.; X. Wang et al.; Weir,
Emerson et al.; Xie et al.; H. C. Yoo, Gee, et al.; M. Yu, Hahm, & Vaughn;
S. M. Yu, Huang, & Singh; Zhang et al.; Zhu et al.
Psychopathology 49 (44) Archaumbau et al.; Asnaani et al.; Balsam et al.; Barrera, Wilson, & Norton;
M. H. Chae & Foley; E. C. Chang, Tsai, & Sanna; J. C. Chen & Danish; W.
Chen; Cheng et al.; Chentsova-Dutton, Tsai, & Gotlib; Cheung & Park; Cho &
Haslam; J. L. Choi & Rogers; de Castro, Rue, & Takeuchi; Escobar et al.; Fung
& Lau; Gonzalez, Taraff, West et al.; Gonzalez, Tarraf, Whiteld & Vega;
Hahm et al.; Hambrick et al.; W. Hwang, Wood, & Fujimoto; Iwamoto, Liao,
& Liu; Jang, Chiriboga, Kim, & Rhew; Jang, Kwag, Chiriboga; Jegatheesan,
Fowler, & Miller; Jegatheesan, Miller, & Fowler; Juang & Alvarez; E. Kim,
Seo, & Cain; J. Kim & Choi; Kumar & Nevid; H. Y. Lee, Lytle, et al.; Leung,
Cheung, & Cheung; Luk & Tsoh; Masuda et al.; Mauss et al.; Mulasi-Pokhriyal
& Smith; I. J. K. Park et al.; Sabik, Cole, & Ward; Sage & Jegatheesan; Saw &
Okazaki; J. K. Shin; Singh et al.; Szymanski & Sung; Walton & Takeuchi;
C.D.C. Wang & Ratanasiripong; Wei et al.; Xie et al.; E. Yoon & Lee; Young,
Fang, & Zisook
Racism and
discrimination
32 (24) Ahluwalia & Pelletiere; Alvarez & Juang; Bai; Bavishi, Madera, & Hebl;
Campbell & Herman; Carter & Forsyth; David (b); David & Okazaki; de
Castro, Rue, & Takeuchi; Deng et al.; Gee & Ponce; Hahm et al.; Hosoda &
Stone-Romero; Hughey; Huynh & Fuligni; Iwamoto & Liu; Jang, Chiriboga,
Kim, & Rhew; Juang & Alvarez; C.L. Kim et al.; Kim-Prieto et al.; Liang et
al.; Menzer et al.; Morrill et al.; Morrison; Pieterse et al.; Spencer et al.;
Thompson & Kiang; Tran, Lee, & Burgess; Wei et al.; Yogeeswaran &
Dasgupta; H. C. Yoo, Burrola, & Steger; H. C. Yoo, Steger, & Lee
Families 27 (19) Capps, Bronte-Tinkew, & Horowitz; Chhuon, Kyratzis, Hudley; Dubus; Gurak &
Kritz; Hidalgo & Bankston; Ho; Hyun & Shin; Jegatheesan, Miller, & Fowler;
Juang & Alvarez; Juang & Nguyen; Juang & Syed; Kang et al.; Lau; Lo; Moua
& Lamborn; Nagata, Cheng, & Tsai-Chae; Ono & Berg; Y.S. Park et al.; Quek
et al; Rapoza et al.; Sage & Jegatheesan; K.Y. Shih & Pyke; Sung; Tajima &
Harachi; Tran & Lee; K. T. Wang; G. J. Yoo & Kim
Counseling and clinical
issues
24 (20) Bauer, Chen, & Alegr a; Bistricky et al.; E. C. Chang, Tsai, & Sanna; J. C. Chen
& Danish; N. G. Choi & Kim; David (a); Escobar et al.; Fancher et al.;
Fortuna, Alegr a, & Gao; Gonzalez, Taraff, West et al.; Gunlicks-Stoessel et al.;
Javier et al.; G. Kim, Jang, et al.; Lo; Loya, Reddy, & Hinshaw; Machizawa &
Lau; Marchand et al.; Seo; Singh et al.; Spencer et al.; Ta, Holck, & Gee; S.
Wang & Kim; Y. J. Wong, Tran, Kim, et al.; H. C. Yoo, Burrola, & Steger
228 OKAZAKI, KASSEM, AND TAN
was the primary focus of the study. Health and
health-related behaviors was the topic area with
the largest number of articles published in 2010,
accounting for nearly one third of all articles in
the current review, followed by psychopathol-
ogy, and racism and discrimination. Table 1
suggests that research in Asian American psy-
chology (or, more broadly, behavioral sciences)
tends to be dominated by health and mental
health topics. The areas with the least amount of
coverage were lesbian, gay, bisexual, transgen-
der (LGBT) populations; adoptees; violence;
politics; stress and coping; and spirituality
with fewer than ve published articles in each
area.
As shown in Table 2, an overwhelming
majority of articles studies published in 2010
with Asian Americans (182 out of 261, or
70%) used a quantitative correlational design.
Although we did not code for specic analytic
Table 1 (continued)
Topic N
a
Articles
Acculturation and
enculturation
21 (8) B.S. K. Kim & Omizo; Capps, Bronte-Tinkew, & Horowitz; Cho & Haslam;
Constantine et al.; del Prado & Church; E. Kim, Seo, & Cain; Edrington et al.;
Gee, Gonsoulin & Fu; Ho; Hsu; Kumar & Nevid; Lau; Tajima & Harachi;
Lueck & Wilson; Miller; Hidalgo & Bankston; Ono & Berg; Thai, Connell, &
Tebes; Walsemann, & Takeuchi; Y. J. Wong, Tran, Kim, et al.; Y.S. Park et al.
Educational experiences 21 (17) Borrero & Yeh; E. S. Chang et al.; J. Chang & Le; Chhuon, Hudley, Brenner, &
Macias; Chhuon, Kyratzis, Hudley; Cimetta, DAgostino, & Levin; Cooper et
al.; Diemer et al.; Hibel, Farkas, & Morgan; Le & Gardner; Li et al.; Lew;
Long & Tienda; Kwon et al.; Ma & Yeh; Pham & Kohnert; Reid; Roberts,
Mohammed, & Vaughn; Roysircar, Carey, & Koroma; Suarez-Orozco et al.;
Wegner et al.
Identity 17 (10) Abrams; Bai; Chhuon & Hudley; Juang & Nguyen; Juang & Syed; Kiang et al.;
B.S. K. Kim & Omizo; G. S. Kim, Suyemoto, & Turner; R. M. Lee et al.;
Mohanty; Moua & Lamborn; J. Nguyen & Brown; Nishina et al.; S. J. Shin;
Tawa & Suyemoto; Thangaraj; Tran & Lee
Older adults 16 (0) Berkman & Ko; Bistricky et al; Gurak & Kritz; Jang, Chiriboga, Allen, et al;
Jang, Chiriboga, Kim, & Rhew; Jang, Kim, & Chiriboga; Jang, Kwag &
Chiriboga; G. Kim, Jang, et al; J. Kim & Choi; Ko & Berkman; H. Y. Lee,
Lytle, et al.; J. S. Lee; Machizawa & Lau; Nagata, Cheng, & Tsai-Chae; G. J.
Yoo & Kim
Youths 13 (6) C. K. Baker & Helm; C.K. Baker et al.; Benner, & Kim; Kiang et al.; J. P. Lee et
al.; Lew; Ma & Yeh; Morrill et al.; Mulasi-Pokhriyal & Smith; I. J. K. Park et
al.; Suarez-Orozco et al.; Vazsonyi & Chen; N.A. Wong; S. M. Yu, Huang, &
Singh
Women 11 (1) Chhuon, Kyratzis, Hudley; Im, S. H. Lee, & Chee; C.L. Kim et al.; B. Lee, Im, &
Chee; Morrison et al.; Nagata, Cheng, & Tsai-Chae; H. V. Nguyen et al.; Rimal
& Juon; K.Y. Shih & Pyke; Ta & Hayes; X. Wang et al.
Immigrants and refugees 10 (2) Dubus; Fancher et al.; Lau; J. K. Shin; Song; Suarez-Orozco et al.; Ta, Holck, &
Gee; Tajima & Harachi; G. J. Yoo & Kim; E. Yoon et al.
Interpersonal
relationships
7 (5) Chentsova-Dutton, & Tsai; Hughey; Y. Kim & Cohen; Kim-Jo, Benet-Mart nez,
& Ozer; Lampert et al.; Quek et al.; Riela et al.; S. Wang et al.
Men and masculinity 7 (0) Ahluwalia & Pelletiere; Garcia, Romero, & Maxwell; C. Kim & Sakamoto;
Iwamoto, Liao, & Liu; Liao et al.; Levy et al.; Thangaraj
Career 6 (5) Diemer et al.; Hosoda & Stone-Romero; C. Kim & Sakamoto; Lew; Ma & Yeh;
Sy et al.
Stress and coping 4 (2) Gunlicks-Stoessel et al.; Iwamoto, Liao, & Liu; Y. Park et al.; Y. J. Wong, Kim,
& Tran
LGBT 3 (2) Alimahomed; D. H. Chae & Ayala; Szymanski & Sung
Adoptees 4 (4) Docan-Morgan; G. S. Kim, Suyemoto, & Turner; R. M. Lee et al.; Mohanty
Violence 4 (0) Archambau et al; C. K. Baker & Helm; C. K. Baker et al.; W. Chen
Politics 3 (3) Chao, Chiu, & Lee; A. H. Kim & White; Morrill et al.
Miscellaneous 3 (3) Goto et al.; H. Lee & Kim; Sim et al.
Spirituality 1 (0) C. L. Kim et al.
Note. Because articles may cover more than one of the topics listed above, articles may be listed under more than one
topic.
a
Numbers in the parentheses represent the number of articles in which the topic was the primary focus of the study.
229 ANNUAL REVIEW
Table 2
Study Design Characteristics
Topic n Articles
Quantitative: Correlational
design
182 Abrams; Afable-Munsuz et al.; Alvarez & Juang; Archaumbau et al.; Ashing-Giwa &
Lim; Ashing-Giwa et al.; Asnaani et al.; Baker & Helm; Balsam et al.; Barrera,
Wilson, & Norton; Bauer, Chen, & Alegr a; Benner & Kim; Bistricky et al.;
Borrell et al.; Borrero & Yeh; Campbell & Herman; Capps, Bronte-Tinkew, &
Horowitz; Carter & Forsyth; Castro, Gee, & Takeuchi; D. H. Chae & Ayala;
M. H. Chae & Foley; E. C. Chang, Sanna, et al.; E. C. Chang, Tsai, & Sanna;
E. S. Chang et al.; J. Chang & Le; J. C. Chen & Danish; W. Chen; Cheng et al.;
Chentsova-Dutton, & Tsai; Chentsova-Dutton, Tsai, & Gotlib; Cheung & Park;
Cho & Haslam; J. L. Choi & Rogers; K. S. Choi et al.; N. G. Choi & Kim; Chung
et al.; Cimetta, DAgostino, & Levin; Constantine et al.; Cooper et al.; David (a);
David (b); de Castro, Rue, & Takeuchi; Deng et al.; Diemer et al.; Edrington et
al.; Escobar et al.; Fernandes et al.; Fortuna, Alegr a, & Gao; Fung & Lau; Garcia,
Romero & Maxwell; Gee & Ponce; Gee, Walsemann, & Takeuchi; Gomez, Lin et
al.; Gonsoulin & Fu; Gonzalez, Taraff, West et al.; Gonzalez, Tarraf, Whiteld &
Vega; Gurak & Kritz; Hahm et al.; Hambrick et al.; Hibel, Farkas, & Morgan;
Hidalgo & Bankston; Ho; Hofstetter et al.; Hsu; Huynh & Fuligni; Hyun & Shin;
W. Hwang, Wood, & Fujimoto; Im, S. H. Lee, & Chee; Ishii-Kuntz, Gomel &
Tinsley; Iwamoto & Liu; Iwamoto, Corbin, & Fromme; Iwamoto, Liao, & Liu;
Jang, Chiriboga, Allen et al.; Jang, Chiriboga, Kim, & Rhew; Jang, Kim, &
Chiriboga; Jang, Kwag, Chiriboga; Javier et al.; Ji et al.; Juang & Alvarez; Juang
& Nguyen; Juang & Syed; Kandula et al.; D. Kao; Kiang et al.; A. H. Kim &
White; B. S. K. Kim & Omizo; C. Kim & Sakamoto; E. Kim, Seo, & Cain; G.
Kim, Chiriboga, et al.; G. Kim, Jang, et al.; G. S. Kim, Suyemoto, & Turner; J.
Kim & Choi; N. Kim et al.; W. Kim, Kim, & Nochajski; Kim-Jo, Benet-Mart nez,
& Ozer; Kumar & Nevid; Lampert et al.; Lau; B. Lee, Im, & Chee; H. Lee &
Kim; H. Y. Lee, Ju, et al.; J. Lee, Lok, & Chen; R. M. Lee et al.; Leung, Cheung,
& Cheung; Levy et al.; Li et al.; Liang et al.; Liao et al.; Lim; Lo; Long &
Tienda; Loya, Reddy, & Hinshaw; Lueck & Wilson; Luk & Tsoh; Masuda et al.;
Maxwell, Jo, et al.; McCarthy et al.; McDonnell et al.; Menzer et al.; Miller; Misra
et al.; Mohanty; Morrill et al.; Morrison et al.; Mulvaney-Day et al.; Nishina et al.;
G. T. Nguyen et al.; H. V. Nguyen et al.; Ono & Berg; I. J. K. Park et al.; S. Park
et al.; Y. S. Park et al.; Parker et al; .Pieterse et al.; Pourat, Kagawa-Singer, Breen,
& Sripipatana; Reid; Riela et al.; Rimal & Juon; Roberts, Mohammed, & Vaughn;
Roysircar, Carey, & Koroma; Sabik, Cole, & Ward; Sakai, Wang, & Price;
Sarnquist, Grieb, & Maldonado; Saw & Okazaki; Seo; R.A. Shih et al.; Song;
Spencer et al.; Suarez-Orozco et al.; Szymanski & Sung; Ta & Hayes; Ta, Holck,
& Gee; Tajima & Harachi; Tam, San Tsou, Lee, et al.; Thai, Connell, & Tebes;
Thompson & Kiang; Tong et al.; Tran & Lee; Tran, Lee, & Burgess; Trinidad et
al.; Vazsonyi & Chen; Walton & Takeuchi; C. D. C. Wang & Ratanasiripong;
K. T. Wang; S. Wang & Kim; S. Wang et al.; X. Wang et al.; Wegner et al.; Wei
et al.; Weir, Emerson et al.; Y. J. Wong, Kim, & Tran; Y. J. Wong, Tran, Kim, et
al.; Xie et al.; Young, Fang, & Zisook; H. C. Yoo, Burrola, & Steger; H. C. Yoo,
Gee, et al.; H. C. Yoo, Steger, & Lee; E. Yoon & Lee; M. Yu, Hahm, & Vaughn;
S. M. Yu, Huang, & Singh; Zhang et al.; Zhu et al.
Quantitative: True or
quasi-experimental
design
22 Bavishi, Madera, & Hebl; Chao, Chiu, & Lee; J. Chen et al.; David & Okazaki;
Fang, Schinke, & Cole; Gong & Cheng; Goto et al.; Gunlicks-Stoessel et al.;
Hosoda & Stone-Romero; J. H. Kim, Menon, et al.; Y. Kim & Cohen; Kim-Prieto
et al.; Le & Gardner; Lu & Stanton; Marchand et al.; Mauss & Butler; Mauss et
al.; Maxwell, Bastani et al.; Pham & Kohnert; Shelley et al.; Sy et al.;
Yogeeswaran & Dasgupta
230 OKAZAKI, KASSEM, AND TAN
strategies within these correlational designs, a
majority of these studies tended to use mul-
tiple regression analyses in which a number
of demographic and psychological variables
were used to predict some outcome variables
(e.g., health behavior, use of services, levels
of distress). Experimental studies continue to
remain far and few between. Notably, studies
using only qualitative methods (typically
based on in-depth interviews or focus group
data) constituted 18% of articles and, together
with the 11 mixed-method studies, made up
22% of articles in the current review.
Table 3 shows the number of studies by par-
ticipant characteristics. Notably, publications
with college student populations comprised
only 24% of articles. Together with a sizable
number of publications focusing on Asian
American children and adolescents under
age 18 (21%) and older adults (7%), research on
Asian American populations covered a wide
range across the developmental spectrum. With
respect to ethnicity, 46% of the studies em-
ployed the panethnic aggregate group of Asian
American as participant ethnicity. Further, the
greatest number of studies featuring a specic
ethnic group focused on Korean American pop-
ulations, followed by Chinese, Vietnamese, Jap-
anese, and Filipino. Southeast Asian ethnic
groups (except Vietnamese) and South Asian
ethnic groups remain underrepresented in the
current review.
Topic Summaries
Following B. S. K. Kim et al. (2010), each
article was classied into one primary topic area
and reviewed only once. Of note, we did not
identify any articles about Asian Americans that
were centrally concerned with topics in men and
masculinity, older adults, personality, spiritual-
ity, and violence, although all topics (except
personality) were represented as secondary foci.
We present the following narrative summaries
by primary topic and then subtopic, where
available.
Acculturation and enculturation. Al-
though many articles deployed acculturation
and enculturation as predictors of various psy-
chological experiences, such as depression or
family relationships, only eight articles were
centrally concerned with the phenomenon of
cultural changes in individuals or population
over time. Whereas previous work examined
acculturation processes within a particular do-
main, Miller (2010) used conrmatory factor
analyses to determine whether generational sta-
tus moderates unilinear and bilinear accultura-
tion processes across domains. Contrary to past
ndings, Millers (2010) results demonstrated
the superiority of the bilinear domain-specic
model for both rst- and second-generation
Asian Americans. Del Prado and Church (2010)
developed an enculturation measure for Filipino
Americans that included three dimensions: con-
nection with homeland, interpersonal norms,
and conservatism.
Hsu (2010) investigated the relationships be-
tween acculturation and general communication
traits (as assessed by self-report) among 175
immigrant Chinese adults. Longer stays in
America were associated with stronger identi-
cation with American culture, which, in turn,
was associated with reports of increased will-
Table 2 (continued)
Topic n Articles
Qualitative 46 Ahluwalia & Pelletiere; Alimahomed; Bai; Battle, Lee, & Antin; Berkman & Ko; C.
Chen, Kendall, Shyu; Chhuon & Hudley; Chhuon, Hudley, Brenner, & Macias;
Chhuon, Kyratzis, Hudley; Docan-Morgan; Dubus; Franzen & Smith; Hendershot
et al.; J. P. Hwang et al; Im, B. Lee, & Chee; H. Y. Lee, Lytle, et al.; J. S. Lee; S.
Lee et al.; Jegatheesan, Fowler, & Miller; Jegatheesan, Miller, & Fowler; Kang et
al.; C. L. Kim et al.; Ko & Berkman; Kwon et al.; Lin; Lv & Brown; Ma & Yeh;
Machizawa & Lau; Morrison; Moua & Lamborn; Nagata, Cheng, & Tsai-Chae; J.
Nguyen & Brown; Y. Park et al.; Quek et al; K. Y. Shih & Pyke; J. K. Shin; S. J.
Shin; Sage & Jegatheesan; Sim et al.; Singh et al.; Sung; Tawa & Suyemoto;
Thangaraj; N.A. Wong; G. J. Yoo & Kim; E. Yoon et al.
Mixed methods 11 C. K. Baker et al.; D. L. Baker et al.; del Prado & Church; Fancher et al.; Hughey;
T. A. Kao et al.; J. P. Lee et al.; Lew; Mulasi-Pokhriyal & Smith; Rapoza et al.;
Soller & Lee
231 ANNUAL REVIEW
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232 OKAZAKI, KASSEM, AND TAN
T
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C
h
e
n
,
&
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l
e
g
r

a
;
B
o
r
r
e
l
l
e
t
a
l
.
;
C
a
m
p
b
e
l
l
&
H
e
r
m
a
n
;
C
a
p
p
s
,
B
r
o
n
t
e
-
T
i
n
k
e
w
,
&
H
o
r
o
w
i
t
z
;
C
a
r
t
e
r
&
F
o
r
s
y
t
h
;
C
a
s
t
r
o
,
G
e
e
,
&
T
a
k
e
u
c
h
i
;
D
.
H
.
C
h
a
e
&
A
y
a
l
a
;
M
.
H
.
C
h
a
e
&
F
o
l
e
y
;
C
.
C
h
e
n
,
K
e
n
d
a
l
l
,
S
h
y
u
;
C
h
e
n
g
e
t
a
l
.
;
C
h
e
n
t
s
o
v
a
-
D
u
t
t
o
n
,
T
s
a
i
,
&
G
o
t
l
i
b
;
N
.
G
.
C
h
o
i
&
K
i
m
;
K
.
S
.
C
h
o
i
e
t
a
l
.
;
C
h
u
n
g
e
t
a
l
.
;
C
o
n
s
t
a
n
t
i
n
e
e
t
a
l
.
;
D
a
v
i
d
&
O
k
a
z
a
k
i
;
D
a
v
i
d
(
a
)
;
D
a
v
i
d
(
b
)
;
d
e
C
a
s
t
r
o
,
R
u
e
,
&
T
a
k
e
u
c
h
i
;
d
e
l
P
r
a
d
o
&
C
h
u
r
c
h
;
D
e
n
g
e
t
a
l
.
;
D
o
c
a
n
-
M
o
r
g
a
n
;
D
u
b
u
s
;
E
d
r
i
n
g
t
o
n
e
t
a
l
.
;
E
s
c
o
b
a
r
e
t
a
l
.
;
F
a
n
c
h
e
r
e
t
a
l
.
;
F
a
n
g
,
S
c
h
i
n
k
e
,
&
C
o
l
e
;
F
o
r
t
u
n
a
,
A
l
e
g
r

a
,
&
G
a
o
;
F
r
a
n
z
e
n
&
S
m
i
t
h
;
F
u
n
g
&
L
a
u
;
G
a
r
c
i
a
,
R
o
m
e
r
o
&
M
a
x
w
e
l
l
;
G
e
e
,
W
a
l
s
e
m
a
n
n
,
&
T
a
k
e
u
c
h
i
;
G
o
m
e
z
,
L
i
n
e
t
a
l
.
;
G
o
n
s
o
u
l
i
n
&
F
u
;
G
o
n
z
a
l
e
z
,
T
a
r
r
a
f
,
W
h
i
t

e
l
d
&
V
e
g
a
;
H
a
h
m
e
t
a
l
.
;
H
i
d
a
l
g
o
&
B
a
n
k
s
t
o
n
;
H
o
;
H
o
f
s
t
e
t
t
e
r
e
t
a
l
.
;
H
s
u
;
J
.
P
.
H
w
a
n
g
e
t
a
l
.
;
W
.
H
w
a
n
g
,
W
o
o
d
,
&
F
u
j
i
m
o
t
o
;
H
y
u
n
&
S
h
i
n
;
I
m
,
L
e
e
,
&
C
h
e
e
;
I
m
,
L
e
e
,
&
C
h
e
e
;
I
s
h
i
i
-
K
u
n
t
z
,
G
o
m
e
l
&
T
i
n
s
l
e
y
;
J
a
v
i
e
r
e
t
a
l
.
;
J
e
g
a
t
h
e
e
s
a
n
,
F
o
w
l
e
r
,
&
M
i
l
l
e
r
;
J
e
g
a
t
h
e
e
s
a
n
,
M
i
l
l
e
r
,
&
F
o
w
l
e
r
;
J
i
e
t
a
l
.
;
K
a
n
d
u
l
a
e
t
a
l
.
;
D
.
K
a
o
;
J
.
K
i
m
&
C
h
o
i
;
C
.
K
i
m
&
S
a
k
a
m
o
t
o
;
A
.
H
.
K
i
m
&
W
h
i
t
e
;
C
.
L
.
K
i
m
e
t
a
l
.
;
G
.
K
i
m
,
J
a
n
g
,
e
t
a
l
.
;
W
.
K
i
m
,
K
i
m
,
&
N
o
c
h
a
j
s
k
i
;
J
.
H
.
K
i
m
,
M
e
n
o
n
,
e
t
a
l
.
;
E
.
K
i
m
,
S
e
o
,
&
C
a
i
n
;
G
.
S
.
K
i
m
,
S
u
y
e
m
o
t
o
,
&
T
u
r
n
e
r
;
K
u
m
a
r
&
N
e
v
i
d
;
L
a
m
p
e
r
t
e
t
a
l
.
;
L
a
u
;
L
e
&
G
a
r
d
n
e
r
;
J
.
P
.
L
e
e
e
t
a
l
.
;
S
.
L
e
e
e
t
a
l
.
;
B
.
L
e
e
,
I
m
,
&
C
h
e
e
;
H
.
Y
.
L
e
e
,
J
u
,
e
t
a
l
.
;
J
.
L
e
e
,
L
o
k
,
&
C
h
e
n
;
H
.
Y
.
L
e
e
,
L
y
t
l
e
,
e
t
a
l
.
;
L
e
u
n
g
,
C
h
e
u
n
g
,
&
C
h
e
u
n
g
;
L
e
v
y
e
t
a
l
.
;
L
i
a
n
g
e
t
a
l
.
;
L
i
a
o
e
t
a
l
.
;
L
i
m
;
L
i
n
;
L
o
;
L
u
e
c
k
&
W
i
l
s
o
n
;
L
u
k
&
T
s
o
h
;
M
a
x
w
e
l
l
,
B
a
s
t
a
n
i
e
t
a
l
.
;
M
a
x
w
e
l
l
,
J
o
,
e
t
a
l
.
;
M
c
C
a
r
t
h
y
e
t
a
l
.
;
M
c
D
o
n
n
e
l
l
e
t
a
l
.
;
M
i
s
r
a
e
t
a
l
.
;
M
o
r
r
i
s
o
n
e
t
a
l
.
;
M
u
l
v
a
n
e
y
-
D
a
y
e
t
a
l
.
;
O
n
o
&
B
e
r
g
;
Y
.
P
a
r
k
e
t
a
l
.
;
S
.
P
a
r
k
e
t
a
l
.
;
P
a
r
k
e
r
e
t
a
l
.
;
P
o
u
r
a
t
,
K
a
g
a
w
a
-
S
i
n
g
e
r
,
B
r
e
e
n
,
&
S
r
i
p
i
p
a
t
a
n
a
;
Q
u
e
k
e
t
a
l
;
R
a
p
o
z
a
e
t
a
l
.
;
R
i
m
a
l
&
J
u
o
n
;
S
a
k
a
i
,
W
a
n
g
,
&
P
r
i
c
e
;
S
a
r
n
q
u
i
s
t
,
G
r
i
e
b
,
&
M
a
l
d
o
n
a
d
o
;
S
h
e
l
l
e
y
e
t
a
l
.
;
K
.
Y
.
S
h
i
h
&
P
y
k
e
;
J
.
K
.
S
h
i
n
;
S
i
n
g
h
e
t
a
l
.
;
S
o
l
l
e
r
&
L
e
e
;
S
p
e
n
c
e
r
e
t
a
l
.
;
S
y
e
t
a
l
.
;
S
z
y
m
a
n
s
k
i
&
S
u
n
g
;
T
a
,
H
o
l
c
k
,
&
G
e
e
;
T
a
j
i
m
a
&
H
a
r
a
c
h
i
;
T
a
m
,
S
a
n
T
s
o
u
,
L
e
e
,
e
t
a
l
.
;
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h
a
n
g
a
r
a
j
;
T
o
n
g
e
t
a
l
.
;
T
r
a
n
,
L
e
e
,
&
B
u
r
g
e
s
s
;
T
r
i
n
i
d
a
d
e
t
a
l
.
;
W
a
l
t
o
n
&
T
a
k
e
u
c
h
i
;
X
.
W
a
n
g
e
t
a
l
.
;
W
e
i
r
,
E
m
e
r
s
o
n
e
t
a
l
.
;
G
.
J
.
Y
o
o
&
K
i
m
;
H
.
C
.
Y
o
o
,
G
e
e
,
e
t
a
l
.
;
E
.
Y
o
o
n
&
L
e
e
;
E
.
Y
o
o
n
e
t
a
l
.
;
Z
h
a
n
g
e
t
a
l
.
;
Z
h
u
e
t
a
l
.

6
5
y
e
a
r
s
1
8
A
f
a
b
l
e
-
M
u
n
s
u
z
e
t
a
l
.
;
B
e
r
k
m
a
n
&
K
o
;
B
i
s
t
r
i
c
k
y
e
t
a
l
.
;
F
e
r
n
a
n
d
e
s
e
t
a
l
.
;
G
o
m
e
z
,
L
i
n
e
t
a
l
.
;
G
u
r
a
k
&
K
r
i
t
z
;
J
a
n
g
,
C
h
i
r
i
b
o
g
a
,
A
l
l
e
n
e
t
a
l
.
;
J
a
n
g
,
C
h
i
r
i
b
o
g
a
,
K
i
m
,
&
R
h
e
w
;
J
a
n
g
,
K
i
m
,
&
C
h
i
r
i
b
o
g
a
;
J
a
n
g
,
K
w
a
g
,
C
h
i
r
i
b
o
g
a
;
G
.
K
i
m
,
C
h
i
r
i
b
o
g
a
,
e
t
a
l
.
;
K
o
&
B
e
r
k
m
a
n
;
J
.
S
.
L
e
e
;
M
a
c
h
i
z
a
w
a
&
L
a
u
;
N
a
g
a
t
a
,
C
h
e
n
g
,
&
T
s
a
i
-
C
h
a
e
;
G
.
T
.
N
g
u
y
e
n
e
t
a
l
.
(
t
a
b
l
e
c
o
n
t
i
n
u
e
s
)
233 ANNUAL REVIEW
T
a
b
l
e
3
(
c
o
n
t
i
n
u
e
d
)
P
a
r
t
i
c
i
p
a
n
t
C
h
a
r
a
c
t
e
r
i
s
t
i
c
s
n
A
r
t
i
c
l
e
s
N
o
n
c
o
l
l
e
g
e
p
a
r
t
i
c
i
p
a
n
t
s
1
9
7
A
f
a
b
l
e
-
M
u
n
s
u
z
e
t
a
l
.
;
A
h
l
u
w
a
l
i
a
&
P
e
l
l
e
t
i
e
r
e
;
A
l
i
m
a
h
o
m
e
d
,
A
l
v
a
r
e
z
&
J
u
a
n
g
;
A
s
h
i
n
g
i
w
a
&
L
i
m
;
A
s
h
i
n
g
-
G
i
w
a
e
t
a
l
.
;
A
s
n
a
a
n
i
e
t
a
l
.
;
B
a
k
e
r
&
H
e
l
m
;
C
.
K
.
B
a
k
e
r
e
t
a
l
.
;
D
.
L
.
B
a
k
e
r
e
t
a
l
.
;
B
a
l
s
a
m
e
t
a
l
.
,
B
a
t
t
l
e
;
L
e
e
,
&
A
n
t
i
n
;
B
a
u
e
r
,
C
h
e
n
,
&
A
l
e
g
r

a
;
B
a
v
i
s
h
i
,
M
a
d
e
r
a
,
&
H
e
b
l
;
B
e
n
n
e
r
&
K
i
m
;
B
e
r
k
m
a
n
&
K
o
;
B
i
s
t
r
i
c
k
y
e
t
a
l
.
;
B
o
r
r
e
l
l
e
t
a
l
.
;
B
o
r
r
e
r
o
&
Y
e
h
;
C
a
m
p
b
e
l
l
&
H
e
r
m
a
n
;
C
a
p
p
s
,
B
r
o
n
t
e
i
n
k
e
w
,
&
H
o
r
o
w
i
t
z
;
C
a
r
t
e
r
&
F
o
r
s
y
t
h
;
C
a
s
t
r
o
,
G
e
e
,
&
T
a
k
e
u
c
h
i
;
D
.
H
.
C
h
a
e
&
A
y
a
l
a
;
M
.
H
.
C
h
a
e
&
F
o
l
e
y
;
J
.
C
h
a
n
g
&
L
e
;
W
.
C
h
e
n
;
J
.
C
h
e
n
e
t
a
l
.
;
C
.
C
h
e
n
,
K
e
n
d
a
l
l
,
&
S
h
y
u
;
C
h
e
n
g
e
t
a
l
.
;
C
h
e
n
t
s
o
v
a
-
D
u
t
t
o
n
,
T
s
a
i
,
&
G
o
t
l
i
b
;
C
h
h
u
o
n
&
H
u
d
l
e
y
;
C
h
o
&
H
a
s
l
a
m
;
N
.
G
.
C
h
o
i
&
K
i
m
;
K
.
S
.
C
h
o
i
e
t
a
l
.
;
C
h
u
n
g
e
t
a
l
.
;
C
o
n
s
t
a
n
t
i
n
e
e
t
a
l
.
;
C
o
o
p
e
r
e
t
a
l
.
;
D
a
v
i
d
&
O
k
a
z
a
k
i
;
D
a
v
i
d
(
a
)
;
D
a
v
i
d
(
b
)
;
d
e
C
a
s
t
r
o
,
R
u
e
,
&
T
a
k
e
u
c
h
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;
d
e
l
P
r
a
d
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&
C
h
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c
h
;
D
e
n
g
e
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a
l
.
;
D
o
c
a
n
-
M
o
r
g
a
n
;
D
u
b
u
s
;
E
d
r
i
n
g
t
o
n
e
t
a
l
.
;
E
s
c
o
b
a
r
e
t
a
l
.
;
F
a
n
c
h
e
r
e
t
a
l
.
;
F
a
n
g
,
S
c
h
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n
k
e
,
&
C
o
l
e
;
F
e
r
n
a
n
d
e
s
e
t
a
l
.
;
F
o
r
t
u
n
a
,
A
l
e
g
r

a
,
&
G
a
o
;
F
r
a
n
z
e
n
&
S
m
i
t
h
;
F
u
n
g
&
L
a
u
;
G
a
r
c
i
a
,
R
o
m
e
r
o
&
M
a
x
w
e
l
l
;
G
e
e
&
P
o
n
c
e
;
G
e
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,
W
a
l
s
e
m
a
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n
,
&
T
a
k
e
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c
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;
G
o
m
e
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,
L
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n
e
t
a
l
.
;
G
o
n
s
o
u
l
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n
&
F
u
;
G
o
n
z
a
l
e
z
,
T
a
r
a
f
f
,
W
e
s
t
e
t
a
l
.
;
G
o
n
z
a
l
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z
,
T
a
r
r
a
f
,
W
h
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t

e
l
d
&
V
e
g
a
;
G
u
n
l
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c
k
s
-
S
t
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s
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l
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t
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.
;
G
u
r
a
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&
K
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H
a
h
m
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;
H
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b
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F
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M
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g
a
n
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H
i
d
a
l
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B
a
n
k
s
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H
o
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H
o
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;
H
s
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H
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l
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J
.
P
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H
w
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H
y
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I
m
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L
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I
m
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C
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I
s
h
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-
K
u
n
t
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G
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m
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T
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J
.
N
g
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B
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o
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J
a
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b
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a
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A
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R
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b
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a
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J
a
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b
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;
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g
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M
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;
J
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J
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a
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a
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D
.
K
a
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A
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a
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;
J
.
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&
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K
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O
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C
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K
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a
m
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A
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H
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K
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M
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k
m
a
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K
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m
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&
N
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v
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K
w
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;
L
a
m
p
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t
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a
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a
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g
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;
L
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a
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L
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L
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L
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L
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&
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L
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L
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k
&
T
s
o
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;
L
v
&
B
r
o
w
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M
a
&
Y
e
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;
M
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c
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a
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&
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;
M
a
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a
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;
M
a
x
w
e
l
l
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B
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n
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t
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;
M
a
x
w
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,
J
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,
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t
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M
c
C
a
r
t
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t
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;
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c
D
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n
n
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l
l
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t
a
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;
M
e
n
z
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t
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.
;
M
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s
r
a
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t
a
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;
M
o
h
a
n
t
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;
M
o
r
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l
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.
;
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o
r
r
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s
o
n
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t
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.
;
M
o
u
a
&
L
a
m
b
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n
;
M
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l
a
s
i
-
P
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k
h
r
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y
a
l
&
S
m
i
t
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;
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u
l
v
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n
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-
D
a
y
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t
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.
;
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a
g
a
t
a
,
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h
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&
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s
a
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-
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h
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e
;
G
.
T
.
N
g
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n
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t
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s
h
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;
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n
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&
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e
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g
;
I
.
J
.
K
.
P
a
r
k
e
t
a
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;
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.
P
a
r
k
e
t
a
l
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;
Y
.
P
a
r
k
e
t
a
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.
;
P
a
r
k
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t
a
l
.
;
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h
a
m
&
K
o
h
n
e
r
t
;
P
o
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r
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t
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t
a
l
.
;
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u
e
k
e
t
a
l
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;
R
a
p
o
z
a
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t
a
l
.
;
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m
a
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&
J
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n
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b
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t
s
,
M
o
h
a
m
m
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&
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a
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g
h
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;
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a
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&
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e
g
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t
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s
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a
k
a
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,
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n
g
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&
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r
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c
e
;
S
a
r
n
q
u
i
s
t
,
G
r
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e
b
,
&
M
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d
o
n
a
d
o
;
S
h
e
l
l
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y
e
t
a
l
.
;
K
.
Y
.
S
h
i
h
&
P
y
k
e
;
R
.
A
.
S
h
i
h
e
t
a
l
.
;
J
.
K
.
S
h
i
n
;
S
J
.
S
h
i
n
;
S
i
n
g
h
e
t
a
l
.
;
S
o
l
l
e
r
&
L
e
e
;
S
o
n
g
;
S
p
e
n
c
e
r
e
t
a
l
.
;
S
u
a
r
e
z
-
O
r
o
z
c
o
e
t
a
l
.
;
S
u
n
g
;
S
z
y
m
a
n
s
k
i
&
S
u
n
g
;
T
a
&
H
a
y
e
s
;
T
a
,
H
o
l
c
k
,
&
G
e
e
;
T
a
j
i
m
a
&
H
a
r
a
c
h
i
;
T
h
a
i
,
C
o
n
n
e
l
l
,
&
T
e
b
e
s
;
T
h
a
n
g
a
r
a
j
;
T
h
o
m
p
s
o
n
&
K
i
a
n
g
;
T
o
n
g
e
t
a
l
.
;
T
r
a
n
,
L
e
e
,
&
B
u
r
g
e
s
s
;
T
r
i
n
i
d
a
d
e
t
a
l
.
;
V
a
z
s
o
n
y
i
&
C
h
e
n
;
W
a
l
t
o
n
&
T
a
k
e
u
c
h
i
;
X
.
W
a
n
g
e
t
a
l
.
;
W
e
g
n
e
r
e
t
a
l
.
;
W
e
i
r
,
E
m
e
r
s
o
n
e
t
a
l
.
;
N
.
A
.
W
o
n
g
;
Y
.
J
.
W
o
n
g
,
K
i
m
,
&
T
r
a
n
;
X
i
e
e
t
a
l
.
;
G
.
J
.
Y
o
o
&
K
i
m
;
H
.
C
.
Y
o
o
,
G
e
e
,
e
t
a
l
.
;
E
.
Y
o
o
n
&
L
e
e
;
E
.
Y
o
o
n
e
t
a
l
.
;
M
.
Y
u
,
H
a
h
m
,
&
V
a
u
g
h
n
;
S
.
M
.
Y
u
,
H
u
a
n
g
,
&
S
i
n
g
h
;
Z
h
a
n
g
e
t
a
l
.
;
Z
h
u
e
t
a
l
.
C
o
l
l
e
g
e
s
t
u
d
e
n
t
p
a
r
t
i
c
i
p
a
n
t
s
6
4
A
b
r
a
m
s
;
A
r
c
h
a
u
m
b
a
u
e
t
a
l
.
;
B
a
r
r
e
r
a
,
W
i
l
s
o
n
,
&
N
o
r
t
o
n
;
E
.
S
.
C
h
a
n
g
e
t
a
l
.
;
E
.
C
.
C
h
a
n
g
,
S
a
n
n
a
,
e
t
a
l
.
;
E
.
C
.
C
h
a
n
g
,
T
s
a
i
,
&
S
a
n
n
a
;
C
h
a
o
,
C
h
i
u
,
&
L
e
e
;
J
.
C
.
C
h
e
n
&
D
a
n
i
s
h
;
C
h
e
n
t
s
o
v
a
-
D
u
t
t
o
n
,
&
T
s
a
i
;
C
h
e
u
n
g
&
P
a
r
k
;
C
h
h
u
o
n
,
H
u
d
l
e
y
,
B
r
e
n
n
e
r
,
&
M
a
c
i
a
s
;
C
h
h
u
o
n
,
K
y
r
a
t
z
i
s
,
H
u
d
l
e
y
;
J
.
L
.
C
h
o
i
&
R
o
g
e
r
s
;
C
i
m
e
t
t
a
,
D

A
g
o
s
t
i
n
o
,
&
L
e
v
i
n
;
D
i
e
m
e
r
e
t
a
l
.
;
G
o
n
g
&
C
h
e
n
g
;
G
o
t
o
e
t
a
l
.
;
H
a
m
b
r
i
c
k
e
t
a
l
.
;
H
e
n
d
e
r
s
h
o
t
e
t
a
l
.
;
H
o
s
o
d
a
&
S
t
o
n
e
-
R
o
m
e
r
o
;
H
u
g
h
e
y
;
I
w
a
m
o
t
o
&
L
i
u
;
I
w
a
m
o
t
o
,
C
o
r
b
i
n
,
&
F
r
o
m
m
e
;
I
w
a
m
o
t
o
,
L
i
a
o
,
&
L
i
u
;
J
u
a
n
g
&
N
g
u
y
e
n
;
J
u
a
n
g
&
S
y
e
d
;
K
a
n
g
e
t
a
l
.
;
Y
.
K
i
m
&
C
o
h
e
n
;
N
.
K
i
m
e
t
a
l
.
;
K
i
m
-
J
o
,
B
e
n
e
t
-
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z
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;
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,
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o
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g
,
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g
,
&
Z
i
s
o
o
k
234 OKAZAKI, KASSEM, AND TAN
T
a
b
l
e
3
(
c
o
n
t
i
n
u
e
d
)
P
a
r
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p
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A
r
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R
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/
E
t
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c
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t
y
P
a
n
-
A
s
i
a
n
A
m
e
r
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c
a
n
1
2
0
A
b
r
a
m
s
;
A
l
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a
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d
;
A
s
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-
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s
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r
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r
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a
;
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;
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;
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K
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a
n
6
3
A
r
c
h
a
u
m
b
a
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t
a
l
.
;
A
s
h
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t
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;
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&
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&
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;
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C
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,
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,
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;
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o
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;
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;
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o
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&
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o
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.
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A
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;
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R
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.
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-
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.
;
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.
(
t
a
b
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c
o
n
t
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n
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e
s
)
235 ANNUAL REVIEW
T
a
b
l
e
3
(
c
o
n
t
i
n
u
e
d
)
P
a
r
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A
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3
7
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.
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;
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t
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;
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a
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(
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a
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2
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b
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t
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;
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s
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-
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;
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.
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;
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;
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236 OKAZAKI, KASSEM, AND TAN
ingness to initiate communication, experiences
of less fear in communicating with others, and
higher communication competence. Longer res-
idence in the United States was also associated
with less frequent and less in-depth, but more
positive, self-disclosure to general others. Lu-
eck and Wilson (2010) sought to identify social
and linguistic factors as predictors of accultura-
tive stress experienced by Asian Americans.
Using a nationally representative sample
of 2,095 Asian Americans from the National
Latino and Asian American Survey (NLAAS)
survey, Lueck and Wilson (2010) found that
prociency in English, prociency in ethnic lan-
guage, experiences with discrimination, family
cohesion, and the reasons for migration were
implicated in acculturative stress. B. S. K. Kim
and Omizo (2010) also examined the relation-
ship between behavioral enculturation, accultur-
ation, and psychological functioning among 112
Asian American high school students in Hawaii.
High behavioral enculturation and acculturation
were not associated with better overall psycho-
logical functioning, but post hoc tests revealed
that adherence to Asian behavioral norms was
positively associated with general self-efcacy
and cognitive exibility, as well as a positive
sense of belonging to the ethnic group.
At the population level of analysis, using data
from the U.S. Census, Hidalgo and Bankston
(2010) examined the changing racial demogra-
phy of the United States between 1980 and
2005, with respect to intermarriage between
Asians and other races. They found that of
interracial households, the WhiteAsian combi-
nation continues to dominate over other combi-
nations, and those families tended to identify
their biracial childrens race as White or partly
White. Hidalgo and Bankston (2010) predicted
that as trends continue for increased intermar-
riages among Asian Americans, Asians may not
disappear into the White category in the fore-
seeable future, but the presence of more biracial
children will continue to blur the boundary be-
tween White and Asian. Using multigenera-
tional data, Gonsoulin and Fu (2010) examined
outmarriage (i.e., marriage to White and non-
White Americans) as indicative of assimilation
and social status exchange between Latino and
Asian Americans by immigrant generation. Re-
sults indicated that later generations of immi-
grants were more likely than their rst-
generation relatives to outmarry. Contrary to
expectations, Asian Americans of higher socio-
economic status (SES), in terms of income,
education, and vocation, were not more likely to
outmarry than their lower-SES counterparts, but
higher SES was positively correlated with out-
marriage among Latinos. However, low-SES
Asians and Latinos were not more likely to
outmarry non-Whites.
One study examined acculturative phenom-
ena within a historical context. Using archival
data, Ono and Berg (2010) tested competing
assimilation hypotheses to understand historical
patterns of intermarriage, with Whites as a
proxy for the effects of institutional exclusion-
ary practices against Japanese and Japanese
Americans before, during, and after World War
II. Results supported the heightened exclusion
hypothesis that immediately followed legiti-
mized exclusionthe World War II internment.
Adoptees. There were four studies on the
topic of transracial Asian American adoptees.
Much of the research in this area focuses on
articulating the experiences of adoptees and is-
sues related to being of a different ethnicity
from ones family members. These issues chal-
lenge our conception of racial, ethnic, and na-
tional identity; they make salient implicit as-
sumptions of what it means to be a family.
Issues related to transnational adoptees prob-
lematize essentialistic thinking of families in
ethnocentric, heterosexist, and gendered terms.
Social interactions serve as important instances
in which such identities are constructed, and
much of the work in the area has focused on
examining such social experiences. Mohanty
(2010) emphasized the importance of ethnic
socialization, or parental support for the provi-
sion of opportunities, in the development of
ethnic and racial identities in transnational
adoptees. The purpose of this study was to
construct a scale (Ethnic and Racial Socializa-
tion of Transracial Adoptees Scale; ERSTAS),
which assesses ethnic and racial socialization
experiences of internationally adopted transra-
cial Asian children and youth.
Adoptees ethnic identity formation is often
shaped by interactions with people outside of
their family who may not be sensitive or knowl-
edgeable about interracial adoptive families.
Managing intrusive interactions serve as social
opportunities in which adoptees construct their
ethnic identities. Docan-Morgans (2010) work
with 34 Korean adoptees explored the role of
237 ANNUAL REVIEW
intrusive interactions in adoptees learning and
construction of their family identity, such as a
transnational family in which other family
members are most often White. In a qualitative
study with 13 female and one male Korean
transnational adoptees, G. S. Kim, Suyemoto,
and Turner (2010) explored the tension between
racial and ethnic identities in transnational
adoptees, arguing that adoptee identities are co-
constructed in relation to White and Asian ref-
erence groups, as well as through social (and
often intrusive) interactions. R. M. Lee, Yun,
Yoo, and Nelson (2010) compared Korean
American adoptee, Korean American, and Ko-
rean international college students in terms of
their ethnic identity and well-being, and found
that adopted Korean Americans and Korean in-
ternational students scored lower on ethnic
identity than Korean American students. Ethnic
identity was positively associated with positive
affect in all three groups, suggesting ethnic
identitys relevance to the well-being of Korean
adoptees.
Career. There were ve studies published
in 2010 concerned with the career and voca-
tional development of Asian Americans. Evi-
dence indicates that Asian American men have
yet to reach full earning parity compared with
White men. In a series of analyses using data
from the 2003 National Survey of College
Graduates, C. Kim and Sakamoto (2010) found
that Asian American men born in the United
States have 8% lower earnings than do their
White counterparts, even after controlling for
key sociodemographic variables, and that
only 1.5-generation Asian American men have
reached full earning parity with Whites. The
authors offered several theoretical perspectives
to explain these ndings, including the racial-
ized hierarchy view, the demographic heteroge-
neity approach, and assimilation theory.
Researchers have also examined workplace
dynamics that may explain such ndings. In
particular, research has focused on examining
how race may elicit perceptions of occupational
t, which, in turn, activate different leadership
lay theories that shape the view of employee as
leadership material. Sy et al. (2010) explored
the interactive effects of race and occupation on
leadership perceptions with an ethnically di-
verse sample of undergraduates and found that
the effect of race and occupation on leadership
perceptions varied within and between the tar-
gets race. Between-group comparisons re-
vealed that participants perceived an Asian
American target as less of a leader than a White
American target. Leadership perceptions of
Asian Americans were higher when race and
occupation were congruent (engineer) than
when race and occupation were incongruent
(sales). Additionally, when race and occupation
were congruent for Asian Americans, such in-
dividuals were evaluated higher on perceptions
of technical competence than were White
Americans, whereas they were evaluated lower
when race and occupation were a poor t. Sy et
al.s (2010) study demonstrated that a workers
race affects leadership perceptions through the
activation of implicit leadership theories.
There is also evidence to suggest that race-
based biases negatively impact Asian Ameri-
cans even prior to entering the workplace.
Hosoda and Stone-Romero (2010) found that
individuals with Asian accents were generally
believed to be less well suited and have a lower
chance of being hired for jobs compared with
French-accented applicants, even after control-
ling for understandability and participants geo-
graphical location. French-accented applicants
were viewed at least as favorably as standard
American English-accented applicants. The au-
thors offered practical intervention strategies
for organizations, such as using structured in-
terviews, training interviewers on potential bi-
ases against foreign-accented applicants, and
eliciting more individuating information to re-
duce the effects of accent-based stereotypes on
employment-related decisions.
Some researchers have explored how factors
such as vocational expectations and occupa-
tional self-concept may be related to overcom-
ing such barriers among young adults. The de-
velopment of occupational self-concepts among
low-SES youth may be affected by racial and
socioeconomic barriers that limit the develop-
ment of an occupational self-concept. However,
consciousness of, and motivation to reduce, so-
cial and political inequality may help Asian
American youth in negotiating structural barri-
ers that constrain occupational self-concept. In a
study with low-SES Latino, Black, and Asian/
Pacic Islander youth, Diemer et al. (2010)
found evidence to support such contention.
Results indicated that, despite various sociopo-
litical histories and experiences, possessing a
consciousness and motivation to affect sociopo-
238 OKAZAKI, KASSEM, AND TAN
litical change had similar effects on the negoti-
ation of sociopolitical barriers among low-
income African American, Latin American, and
Asian American youth. Specically, possessing
racial consciousness in high school had signif-
icant indirect effects on later occupational self-
concepts in all three samples.
Ma and Yeh (2010) analyzed data from 265
immigrant Chinese high school students in New
York City to see what individual and familial
factors were associated with their educational
and career expectations and plans. Higher self-
reported English uency and parental support
for career goals were associated with plans to go
to college and higher career and educational
aspirations, whereas lower English uency pre-
dicted plans to work immediately after high
school. Perception of educational barriers pre-
dicted lower career expectations among these
immigrant students.
Counseling and clinical issues. Our re-
view turned up 20 articles focused primarily on
counseling and clinical issues, which we de-
ned as studies related to prevention, interven-
tion, or help seeking for mental-health-related
problems. The majority of studies in this topic
area used quantitative correlational methods.
Although the 2009 review had organized the
narrative summary of articles in this topic area
into three categories (ethnic-specic studies,
college students, and general population), we
found the set of articles published in 2010 could
be better classied topically as research on help
seeking and service utilization studies and stud-
ies on cultural competence.
Help seeking and service utilization. The
three studies on help-seeking attitudes pub-
lished in 2010 all used Internet surveys. David
(2010a) conducted an Internet survey of 118
Filipino American adults to examine the rela-
tionship between cultural mistrust (of White
Americans and mainstream American institu-
tions) and their help-seeking attitudes for men-
tal health problems. David (2010a) found that a
higher level of cultural mistrust was associated
with a lower likelihood that Filipino Americans
would seek professional psychological help,
above and beyond the effects of income, gener-
ational status, loss of face, and adherence to
Asian cultural values. Loya, Reddy, and Hin-
shaw (2010) also conducted an Internet survey
of 128 college students in northern California,
comparing Caucasian and South Asian Ameri-
can students attitudes toward seeking counsel-
ing for mental health problems. They found that
South Asian American students reported greater
reluctance to seek counseling for mental health
issues compared with White American students;
moreover, heightened personal stigma toward
mental illness among South Asian Americans
was found to mediate the effects of ethnicity on
help-seeking attitudes.
Y. J. Wong, Tran, Kim, Van Horn Kerne, and
Calfa (2010) conducted an Internet survey of
223 Asian Americans to more specically ex-
amine attitudes toward seeking help for depres-
sion. Y. J. Wong, Tran, et al. (2010) assessed
lay beliefs about depression by coding re-
sponses to open-ended questions about depres-
sion. This study was guided by a culturally
informed illness representation self-regulation
model, theorized to link cultural world views
with help-seeking attitudes. The researchers
found that a lay belief that depression resulted
in somatic consequences was associated with
willingness to seek help, especially among
Asian Americans who held high Asian values.
Together, these help-seeking-attitude studies
appear to be contributing to the literature
through better specicity (e.g., ethnicity) and
theoretical sophistication.
Lo (2010) explored what factors inu-
enced 15 Chinese American parents of children
with disabilities to participate in support groups
with other Chinese families. Cultural and lan-
guage-related challenges were cited as impor-
tant reasons for seeking and attending support
groups with coethnics. Parents reported perceiv-
ing important benets from attending support
groups, including deriving a sense of belonging,
condence, and empowerment to handle issues
arising from parenting children with disabilities.
Nine studies examined the actual use of men-
tal health services, with seven studies using
NLAAS data to examine specic hypotheses. In
one study, Ta, Holck, and Gee (2010) examined
the impact of generational status and family
cohesion on the use of mental health services in
the past 12 months. They found that family
cohesion appeared to play a greater role for
rst-generation Asian Americans in seeking
mental health services than third-generation (or
later) Asian Americans. That is, stronger family
cohesion among immigrant Asian Americans
seemed to lower the likelihood that they re-
ceived mental health services. N. G. Choi and
239 ANNUAL REVIEW
Kim (2010) examined the use of complemen-
tary and alternative medicine, as well as the use
of conventional mental health services, among
Asian Americans. They found that among those
with probable 12-month diagnosis of mental
illness, according to the criteria outlined in the
Diagnostic and Statistical Manual of Mental
Disorders (4th ed., DSMIV; American Psychi-
atric Association, 1994), a signicant number
had used both alternative and conventional
treatment, but those who did not meet DSMIV
criteria tended to rely only on alternative med-
icine. Bauer, Chen, and Alegr a (2010) com-
pared limited English procient (LEP) and
English procient (EP) Latinos and Asian
Americans in the NLAAS data and found that
LEP individuals with mental disorders were less
likely to identify a need for mental health ser-
vices, experience longer duration of untreated
illness, and use fewer mental health services.
Spencer, Chen, Gee, Fabian, and Takeuchi
(2010) used the NLAAS data to examine the
association between discrimination, English
language prociency, and formal and informal
service use. The analysis indicated that per-
ceived discrimination, especially in combina-
tion with lower English prociency, was asso-
ciated with increased use of informal services.
G. Kim, Jang, Chiriboga, Ma, and Schonfeld
(2010) also used the data from the NLAAS
study to examine mental health service use, but
focused their analysis on Asian and Latino im-
migrant older adults (i.e., ages 60 and older and
born outside of the United States). They found
that, for both groups, self-reports of poor mental
health were associated with greater use of men-
tal health services, but there were also some
differences between the two ethnic groups in
other associated factors. For Latino elders, de-
mographic factors (i.e., being younger and be-
ing female), as well as mental health needs,
were associated with service use, whereas for
Asian elders, only mental health needs were
associated with greater use of mental health
services. Using the NLAAS data, Escobar et al.
(2010) examined the frequency of somatic
symptoms among White, Latino, and Asian
American adults. Specically, the researchers
examined whether there were associations be-
tween somatic symptoms, psychiatric diagnosis,
and use of services. They found that Asians
were signicantly less likely than Whites to
meet the diagnostic criteria for anxiety disorder
and substance use disorder, and they were less
likely to use general services. Both Asians and
Latinos were also less likely to use mental
health services for mental health problems than
Whites.
Four studies examined service utilization for
depression. Fortuna, Alegr a, and Gao (2010)
used the data from the Collaborative Psychiatric
Epidemiology Surveys (CPES) data set, which
includes the NLAAS data as well as data from
parallel studies with White Americans and Af-
rican Americans (CPES), to examine ethnic dif-
ferences in correlates of depression-treatment
retention among four ethnic groups who re-
ported receiving formal treatment for depres-
sive symptoms during a 12-month period. The
analysis found that African Americans were
particularly unlikely to be retained for depres-
sion treatment compared with non-Hispanic
White clients, but Asian and Latino clients were
not different from their White counterparts with
respect to treatment retention. Gonzalez, Tarraf,
West, et al. (2010) also used the CPES data to
examine past-year antidepressant use among
Asian American and White American adults in
the sample. The analysis found that, regardless
of the mental disorder status, 12% of the sample
reported using antidepressants in the past year,
but less than 3% of Asians did so. Among those
who met DSMIV criteria for major depressive
disorder, only 13% of Asians reported antide-
pressant use, whereas 41% of White Americans
did so. Similar patterns of lower usage of anti-
depressant medications were found among
Asian Americans who met the diagnostic crite-
ria for dysthymia and anxiety disorders.
The CPES data set is limited to adults 18 and
over; thus, studies on service utilization for de-
pression among Asian American children and
adolescents are limited, but two studies exam-
ined this question using very different methods.
Javier, Lahiff, Ferrer, and Huffman (2010) an-
alyzed the data from 2003 and 2005 California
Health Interview Survey (CHIS) to examine the
use of counseling for depressive symptoms
among Filipino and non-Hispanic White adoles-
cents in California. The study found that Fili-
pino adolescents reported more depressive
symptoms than their White counterparts but that
both ethnic groups reported low use of counsel-
ing in the past year.
There were two studies of mental health treat-
ment effectiveness for Asian Americans pub-
240 OKAZAKI, KASSEM, AND TAN
lished in 2010, both on adolescent populations.
In one, Marchand, Ng, Rohde, and Stice (2010)
examined the effectiveness of a brief cognitive
behavioral depression prevention program for
adolescents with elevated depressive symptoms.
The study found clinically signicant reduc-
tions in depressive symptoms from pre- to
postintervention, and at 6-month follow-up, for
adolescents who were randomly assigned to the
intervention conditions compared with adoles-
cents who were in the assessment-only control
condition. Importantly, the analysis did not re-
veal any ethnic differences between White
American, Latino, and Asian American adoles-
cents in these clinical trials, suggesting that this
particular depression prevention intervention
was equally efcacious across ethnicity. In the
other study, Gunlicks-Stoessel, Mufson, Jekal,
and Turner (2010) studied the aspects of de-
pressed adolescents perceived interpersonal
functioning as moderators of response to treat-
ment among adolescents treated with interper-
sonal psychotherapy for depressed adolescents
(IPT-A) or treatment as usual (TAU) in school-
based health clinics. A clinical trial was con-
ducted to examine the effectiveness of IPT-A or
TAU of 63 adolescents, aged 1218 years, of
Latino, African American, Asian American, and
other ethnicities. The results revealed that the
benets of IPT-A compared with TAU were
particularly strong for the adolescents who re-
ported high levels of conict with their mothers
and social dysfunction with friends.
Cultural competence. Our review located
ve studies that were concerned with cultural
competence and engagement of Asian Ameri-
cans in mental health treatment and research. Of
these, two studies were concerned with meeting
the needs of college students, and the other
three studies focused on the mental needs of
community residents. Among these few studies,
a variety of methods were used. In a survey
study of South Korean international students
attending a Midwestern university and using
written scripts of a hypothetical counseling ses-
sion, Seo (2010) found that students perceived
counselor effectiveness to be associated with
counselor emphasis on client expression of
emotion rather than cognition. However, the
study did not reveal any interaction between
students cultural values (endorsement of indi-
vidualism and collectivism) and counseling
style on perceived effectiveness. To examine
the relationship between clients cultural atti-
tudes and perception of counseling process,
S. W. Wang and Kim (2010) conducted an
experimental study in which Asian American
college students evaluated a 15-min video sim-
ulation of a counseling session between an
Asian American female client and her White
counselor. In one condition, the counselor dis-
played supportive counseling skills, whereas in
another condition, the counselor displayed ad-
ditional skills demonstrating specic multicul-
tural competencies (e.g., attending to instances
of discrimination, being mindful of sociopoliti-
cal contexts, educating clients about the coun-
seling process). Although the researchers found
some effects of participants cultural values and
acculturation in how they evaluated the coun-
seling process, by and large, the counselor dis-
playing multicultural counseling competencies
was rated as more effective than the counselor
who only displayed supportive skills.
In a qualitative study with Japanese Ameri-
can older adults, their family members and care-
takers, and service providers in the Chicago
metropolitan area, Machizawa and Lau (2010)
identied ve categories of psychological needs
among this population, including independence,
cultural connection, social connection, feeling
useful, and maintaining pride and dignity. The
researchers crafted specic recommendations
for providing culturally competent care to this
population based on their particular needs. Us-
ing a similar approach, Fancher, Ton, Le Meyer,
Ho, and Paterniti (2010) conducted a qualitative
study with 11 Vietnamese American commu-
nity members, regarding their experiences with
depression, and identied several themes, such
as concerns with stigma and face associated
with depression, the importance of including the
family in depression treatment, acknowledg-
ment of Vietnamese cultural beliefs that may
conict with medication compliance, and the
wish to be treated by culturally and linguisti-
cally matched providers.
Finally, although not a treatment study,
Bistricky, Mackin, Chu, and Arean (2010) ex-
amined ethnic differences in recruitment and
participation in mental health research in San
Francisco among African American and Asian
American older adults with depression and mild
cognitive impairment. Compared with potential
White American participants, both minority
group older adults were signicantly less likely
241 ANNUAL REVIEW
to be recruited through mental health providers
because of cultural stigma associated with men-
tal health treatment. Older Asian American
adults were most effectively recruited through
senior centers or general physicians (i.e., those
with professional legitimacy) as well as through
friends and family referrals.
Educational experiences. We identied 17
studies that were centrally concerned with edu-
cational experiences among Asian Americans.
All but three studies used a quantitative corre-
lational design. Following B. S. K. Kim et al.
(2010), we organized the summaries based on
the grade levels of the students in the studies.
Preschool. All three studies on preschool-
age childrens educational experiences were
concerned with the impact of socioeconomic
class on schooling. Research has consistently
demonstrated that poor children enter school
with lower cognitive skills than their more af-
uent peers and that this gap only widens as
they age. Li, Yamamoto, Luo, Batchelor, and
Bresnahan (2010) explored preschoolers view
of the purposes of school learning and its inu-
ence on achievement among 150 low- and mid-
dle-income immigrant Chinese preschoolers
and their European American peers. Children
completed story tasks about school and were
also tested for their language and math achieve-
ment. Results showed large ethnic and SES
differences: Chinese children of middle-income
families mentioned more adult expectation and
seriousness of learning than their European
American peers, who expressed more positive
affect for self and compliance with adults. Chi-
nese children of low-income families made the
lowest number of references to the purposes of
school learning. Chinese children from both in-
come levels scored signicantly lower on
achievement scores for oral expression than
their European American peers, despite similar
reading and math competency.
Conversely, studies using larger samples and
comparisons between racial groups found little
difference in achievement among Asian Amer-
ican children of economically disadvantaged
and privileged backgrounds. In a study using
data from the Early Childhood Longitudinal
StudyKindergarten Cohort, Cooper, Crosnoe,
Suizzo, and Pituch (2010) found that Asian
American children from poor and nonpoor fam-
ilies have similar levels of achievement.
Wegner, Garcia-Santiago, Nishimura, and
Hishinuma (2010) also examined the educa-
tional lives of poor children during a critical
transition from preschool into elementary
school, and they also found that Asian children
of poor and nonpoor families had similar levels
of math and reading achievement. In explaining
their ndings, the authors argued that high par-
ent expectations in Asian families might buffer
the academic risks of family poverty.
Primary and secondary schools. Two stud-
ies examined bilingual Asian American stu-
dents educational experiences. Roberts, Mo-
hammed, and Vaughn (2010) estimated reading
trajectories of native speakers of Asian lan-
guages (as well as native Spanish and native
English speakers) attending U.S. public elemen-
tary schools. Achievement of English-language
learners was adjusted for SES. Results indicated
that achievement trends of Asian English-
language learners are more similar to those of
native English speakers. Asian students had
higher initial achievement than did the native-
English-speaking group. Bilingual children may
rely on different dimensions of language in their
competency for language comprehension. Pham
and Kohnert (2010) examined developing bilin-
guals use of animacy and word order cues in
sentence interpretation tasks. Participants were
6- to 8-year-old children who learned Vietnam-
ese as their rst language and English as a
second language; English-only peers served as a
comparison group. Results showed that bilin-
guals relied more on animacy than the English-
only speakers when interpreting sentences in
English. When interpreting English and Viet-
namese sentences, bilinguals tended to use a
blending or amalgamation of cues. To exam-
ine language learning in various contexts, Bor-
rero and Yeh (2010) developed a new scale in
their study of 269 urban high school students
from bilingual households, including 210 Asian
American students. Factor analysis revealed a
four-factor structure suggesting that English
learning occurs in educational, friendship, fam-
ily, and community settings. However, multidi-
mensional scaling analysis showed a disconnect
among the various settings, reecting the non-
integrated nature of English-language learning
for these students.
Three studies examined school climate as a
context for Asian American childrens educa-
tional experiences. Hibel, Farkas, and Morgan
(2010) emphasized the importance of consider-
242 OKAZAKI, KASSEM, AND TAN
ing the racial composition of schools, particu-
larly in predicting the likelihood of special ed-
ucation placement. Results indicated that, in
general, attending a high-achieving elementary
school increased a students likelihood of being
placed in special education, even after control-
ling for key individual-, family-, and school-
level characteristics. Asian American, African
American, and Latino students were equally or
less likely to be placed in special education than
non-Hispanic Whites. Using data gathered to
evaluate a community-based afterschool pro-
gram in Oakland, California, J. Chang and Le
(2010) examined the relationship between per-
ceived school multiculturalism and academic
achievement of 125 Hispanic and 155 Asian
American middle school students. The authors
found partial support for the positive impact of
perceived school multiculturalism on academic
achievement for Hispanic students, but the path-
way between school multiculturalism and aca-
demic achievement was not strongly indicated
for Asian American students.
Kwon, Suh, Bang, Jung, and Moon (2010)
compared the educational perspectives of Ko-
rean American students parents and teachers by
surveying 430 parents and 143 teachers, and
interviewing 16 teachers, administrators, and
parents. Results indicated that teachers often
misunderstood Korean parents perspectives on
the goals of education and underestimated the
parents ways of supporting their childrens ed-
ucation. Different beliefs also emerged between
parents and teachers regarding current school
and teacher practices, emphasizing the impor-
tance of educators sensitivity to understanding
parental involvement in their Korean American
students education.
Suarez-Orozco et al. (2010) employed an
ecological systems perspective to understand
academic trajectories of recent immigrant ado-
lescents of Central American, Chinese, Domin-
ican, Haitian, and Mexican backgrounds. Using
a 5-year longitudinal mixed-method approach,
the results showed signicant differences in the
academic trajectories attributable to school-,
family-, and group-based factors. Students with
the greatest familial, school, and individual re-
sources tended to perform better academically
over time, and, as a group, Chinese immigrant
students had greater resources than other ethnic
students. However, some of the Chinese immi-
grant students with low-income households at-
tending poor-quality schools showed similar
patterns of low or declining academic achieve-
ment as other ethnic students in similar situa-
tions.
Higher education. College and universities
have traditionally relied on admissions tests
such as the SAT and ACT to select students.
Cimetta, DAgostinoa, and Levin (2010) exam-
ined whether the Arizona Instrument to Mea-
sure Standards (AIMS) high school tests could
serve as a useful predictor of college perfor-
mance and found both instruments to be equally
predictive for Latino, White, and Asian Amer-
ican students. At the system level with respect
to college admissions, Long and Tienda (2010)
evaluated how the distribution of applicants and
enrollees at seven Texas universities changed
after the Hopwood decision (Hopwood v. Texas,
1996) banning afrmative action and the imple-
mentation of a policy guaranteeing admission to
students with high class ranks. As a result of the
policy changes, Asian American and White ap-
plicants were admitted and enrolled at higher
rates at agship campuses and contributed to the
rising SAT and ACT test scores of students
attending less selective campuses as well.
Immigrant students are often inuenced by
their parents in choosing college majors in sci-
ence and math. With a sample of Asian Indian
immigrant college students and their parents,
Roysircar, Carey, and Koroma (2010) found
that parents exert signicant inuence on stu-
dents choices of science and math majors, and
that the immigrant generational status of the
students matter. First-generation students pre-
ferred science and math majors signicantly
more than second-generation students. Parents
preferences for science and math contributed
signicantly to second-generation childrens
preferences for science and math, even when
the children preferred nonscience majors. Sim-
ilarly, E. S. Chang, Heckhausen, Greenberger,
and Chen (2010) examined the effects of shared
agency between students and parents on college
adjustment among 120 White American, 226
East Asian American, 97 Southeast Asian
American, and 72 Filipinos/Pacic Islander col-
lege students in California. The authors also
found that Asian American students reported
higher levels of parental directing of educa-
tional goals and poorer college adjustment com-
pared with White students. Perceived shared
agency with parents in educational attainment
243 ANNUAL REVIEW
was associated with college adjustment across
all ethnic groups, suggesting that parents exert
important inuence in the educational experi-
ences of college students but that continued
directing of their college education can have
negative implications.
Two qualitative studies explored the experi-
ences of understudied student populations at
universities. Chhuon, Hudley, Brenner, and Ma-
cias (2010) interviewed high-achieving Cambo-
dian American students in order to understand
how they negotiate value-based differences be-
tween home and school in their academic
achievement. Obligation to family emerged as a
consistent theme among these youth, such as
achieving on behalf of their families and ob-
ligation as important reasons for achieving ac-
ademically. In an interview study of nine Asian
international doctoral students in science, tech-
nological, engineering, and mathematics
(STEM) elds at a predominantly White insti-
tution, Le and Gardner (2010) found that in
addition to the typical challenges facing doc-
toral students (e.g., departmental problems that
affect their training and future job prospects),
the students also carried heavy burdens of fam-
ily responsibilities and expectations to succeed.
Their lack of English uency and cultural dif-
ferences exacerbated their isolation from Amer-
ican doctoral students. Finally, in a rare study of
university faculty, Reid (2010) examined the
anonymous student ratings of professors at 25
highest ranked liberal arts colleges in the nation
and found that racial minority faculty, particu-
larly Black and Asian American professors,
were evaluated more negatively than White pro-
fessors.
Families. There were 19 studies included
in the current review on the topic of Asian
American families. Although B. S. K. Kim et al.
(2010) had grouped articles into six subareas
(parenting practices, parentchild relationships,
cultural issues, language issues, therapy, and
partner violence), we found that all studies
could be classied into one of two broad topical
areas: parenting practices and family relation-
ships. Of note, a relatively high proportion of
studies in this category (9 out of 17, or 53%)
employed qualitative methods to explore the
nature and characteristics of Asian American
family relationships.
Parenting practices. Several studies exam-
ined contextual effects related to acculturation
on parenting behavior. Capps, Bronte-Tinkew,
and Horowitz (2010) explored the effects of
acculturation among Chinese American and
Mexican American fathers with infants. Results
indicated that U.S. citizenship was negatively
associated with warmth in Chinese immigrant
fathers, and English language prociency was
associated with involvement in cognitive stim-
ulation activities. However, no relations were
found with respect to measures of acculturation
and nurturing activities, and, separately, for
physical care and overall caregiving activities
for Chinese fathers. Findings suggest that di-
mensions of acculturation are a predictor of
immigrant fathers involvement with their
young children.
Tajima and Harachi (2010) examined how
parenting beliefs and discipline behavior may
be inuenced in the context of acculturation
among a sample of rst-generation immigrant
Vietnamese and Cambodian parents. Greater
acculturation to the United States was related to
belief in fostering independent thinking in chil-
dren only among Vietnamese parents. In con-
trast, among Cambodian parents, greater accul-
turation levels were associated with higher
endorsement of obedience. SES and greater ac-
culturation to the United States predicted the
breaking of the intergenerational transmission
of physical discipline. Lau (2010) examined the
ways in which cultural values promoted adap-
tive parenting behavior among 107 Chinese
American immigrant parents and found that be-
liefs in Chinese parenting ideology that promote
parental authority were unrelated to use of phys-
ical discipline, and beliefs in importance of per-
sonal emotional restraint were related to de-
creased risk. Beliefs in the importance of rm
parental control were related to increased phys-
ical discipline only among parents reporting
high levels of parentchild conicts related to
cultural differences.
Sung (2010) examined the inuence of cul-
ture on parenting in East Asian families and
potential inuence on the emotional intelligence
of adolescents. Using qualitative interviews and
standardized emotional intelligence measures,
Sung (2010) found that endorsement of cultural
beliefs among adolescents regarding hierarchi-
cal family order, face-saving, importance of ed-
ucation, and lial relations with parents and
among siblings were related to their relationship
with their parents. Sungs (2010) ndings also
244 OKAZAKI, KASSEM, AND TAN
suggested potential signicant relationships be-
tween parenting with respect to acculturation
and later emotional intelligence in children.
Several studies focused on developing and
validating measures to capture family dynam-
ics and inuence. Tran and Lee (2010) devel-
oped and tested a measure of ethnic-racial
socialization for Asian American adolescents.
Adolescents indicated whether an ethnic-
racial socialization practice occurred, and
how often, in the past year. A three-factor
structure model was derived: preparation for
bias, cultural socialization-pluralism, and
promotion of mistrust. Findings indicated that
racial socialization occurred within a large
proportion of the sample. Adolescents who
reported parental promotion of mistrust
scored lower on social competence, and cul-
tural socialization-pluralism was associated
with social competence. Results contributed
to extant evidence of perceived ethnic-racial
socialization in Asian American develop-
ment. Moua and Lamborn (2010) explored
Hmong American adolescents perception of
parental ethnic socialization. Based on a con-
tent analysis, the authors identied 10 ethnic
socialization practices, including emphases
on participation in cultural events, learning
Hmong history, eating traditional foods,
wearing traditional clothing, and communi-
cating in the Hmong language.
Families provide children with an important
foundation for ethnic identity development
throughout their lives, yet little research has
examined how family socialization practices
continue to inuence childrens identity devel-
opment through their college years. Juang and
Syed (2010) examined how family cultural so-
cialization related to the identity development
of 225 Asian, Latino, Mixed, and White college
students. Results indicated that greater family
cultural socialization (i.e., parents teaching their
children how to contend with being a member
of a socially devalued racial group) was related
to greater ethnic identity exploration and com-
mitment. Asian American and Latino students
reported higher levels of family cultural social-
ization and ethnic identity compared with White
students, and the relationship between socializa-
tion and ethnic identity was more pronounced
for female than male students, and for White
compared with ethnic minority students.
Finally, K. T. Wang (2010) developed the
Family Almost Perfect Scale (FAPS) to capture
Asian Americans perception of perfectionist
expectation, standards, and evaluation from
their families. Comparing results from Asian
American and White American students, the
author found that Asian American students
tended to score higher on personal discrepancy
(e.g., I set very high standards for myself) and
family discrepancy (e.g., My family sets very
high standards for me) than their White coun-
terparts.
Family relationships. Studies in this cate-
gory also covered a wide age range. Notably,
the studies did not only focus on parentchild
relationships but also on marital dyads, in-law
relationships, sibling relationships, and adult
childrenaging parent dynamics. The studies
are summarized roughly in order of develop-
mental focus.
Ho and Birman (2010) examined the impact
of acculturation gaps on family relationships
between 104 rst-generation Vietnamese ado-
lescents and their parents and found that inter-
generational gaps at the level of Vietnamese
identity affected family cohesion and family
satisfaction. Y. S. Park, Kim, Chiang, and Ju
(2010) focused on the associations between per-
ceived parenting styles and family conict, as
reported by 149 Asian American college stu-
dents. Authoritarian parenting style was most
frequently reported, followed by authoritative
and permissive styles. Authoritarian parenting
signicantly mediated the relationship between
parental adherence to Asian cultural values and
family conict. Permissive and authoritative
parenting styles did not mediate the relationship
between parental adherence to Asian values and
perceived family conict. Findings suggest that
authoritarian parenting styles among Asian par-
ents could stem from adherence to traditional
cultural values.
Using a grounded theory approach, Kang,
Okazaki, Abelmann, Kim-Prieto, and Lan
(2010) explored 18 Korean American adults
narratives about growing up in immigrant
homes. Analyses focused on identifying the
presence and absence of positive change narra-
tion in the context of immigrant-related hard-
ships. About half of the sample was able to
reinterpret their negative family experiences
and gauge them with a more comprehensive and
nuanced understanding, so that negative expe-
245 ANNUAL REVIEW
riences were reinterpreted, often with apprecia-
tion. Results were consistent with past studies
that found a pattern of cognitive change in
young adults perception of their parents as they
age. Rapoza, Cook, Zaveri, and Malley-
Morrison (2010) explored perceptions of sibling
abuse in a qualitative study with an ethnically
diverse sample. Participants were asked to pro-
vide examples of mild, moderate, and extreme
sibling abuse within their cultural group.
Whereas most ethnic group adults, including
South Asian American adults, primarily named
instances of physical aggression as examples
of extreme abuse, Asian Pacic Americans
listed instances of physical aggression as ex-
amples of mild abuse and considered psycho-
logical abuse as an example of severe sibling
abuse. Sage and Jegatheesan (2010) con-
ducted a qualitative analysis of one European
American and one Vietnamese American
family, each with an autistic child, to under-
stand the perspective of typically developing
siblings perceptions of their siblings disabil-
ity. The analysis suggested that Vietnamese
American parents stigmatizing attitude to-
ward the child with autism negatively im-
pacted the siblings understanding of autism.
Quek, Knudson-Martin, Rue, and Alabiso
(2010) examined how marital harmony is nego-
tiated among Chinese American couples. Using
qualitative interviews with 20 Chinese Ameri-
can couples, the authors found that social har-
mony in marriages was sought in two ways: via
structural harmony, with a basis in traditional
social norms and emphasis of obligation to a
common good, and via relational harmony,
which prioritizes the relationship. Results indi-
cated that Chinese American couples were uid
in negotiating between these two categories of
marriage harmony. Hyun and Shin (2010) ex-
amined various interpersonal variables in mar-
riage satisfaction ratings. A sample of Korean
pastors and their spouses were surveyed, and
results indicated that expression of affection
was an important predictor of marital satisfac-
tion for both partners. For the male partner,
doing things together was another signicant
predictor of marital satisfaction.
Filial piety extends to immigrant families in
womens relationships with mother-in-laws.
K. Y. Shih and Pyke (2010) interviewed 15
second-generation, Chinese American women
to explore how cultural values of lial piety
inform Chinese American daughters-in-laws
understanding of their relationship and power
dynamics with immigrant Chinese American
mothers-in-law. Ideals of lial respect accord
limited authority to mothers-in-law, who en-
gage other mechanisms of power such as their
domestic expertise. Conicts typically centered
on domestic expertise and childcare.
Three studies were concerned with family
relationships in the context of older Asian
American adults. A higher proportion of immi-
grant and native-born Asian and Hispanic older
adults, compared with native-born Whites, live
in extended households. Gurak and Kritz (2010)
examined the role that demographic variables,
resources, and assimilation play in the living
arrangements. Using the 2000 Public Use Mi-
crodata 5% Sample (PUMS) les, the analysis
indicated that social and economic resources
accounted for WhiteHispanic differences in
extended living arrangements but not for the
differences between Whites and Asian Ameri-
cans. The authors speculated that for Asian
American families, lial obligation values
might have a larger role than availability of
resources in determining living arrangements
with aging parents. G. J. Yoo and Kim (2010)
qualitatively explored the attitudes and beliefs
of 124 1.5- and second-generation Korean
American adult children of immigrants regard-
ing lial relations. Interviews revealed a strong
theme on feelings of gratitude and responsibil-
ity toward parents that were motivating lial
care. Anticipating the needs of Korean elders
who face language and nancial barriers, adult
children appeared to be preparing to care for the
nances, health, and other needs of their aging
parents on a long-term basis. Finally, Nagata,
Cheng, and Tsai-Chae (2010) qualitatively ex-
plored the inuence of cultural values on grand-
parenting experiences among 17 Chinese immi-
grant grandmothers. Values emphasized in lial
piety, including respect for elders, were invoked
by respondents in their report of high contact
and hierarchical-relationship emphasis in
grandparenting. Respondents placed high im-
portance on grandchildrens development in
moral character, manners, and achievement.
Health and health-related behaviors. Our
review of the 2010 publications led to 86 re-
search articles whose primary focus was on
health and health-related behaviors. This is the
most numerous of all topics and well over dou-
246 OKAZAKI, KASSEM, AND TAN
ble the number of articles (N 34) identied in
the 2009 annual review (B. S. K. Kim et al.,
2010). To allow for comparison with the 2009
annual review, we used the same subtopics.
However, there were two studies about Asian
American womens menopausal symptoms that
did not easily t into the existing subtopic areas.
In one study, Im, S. H. Lee, and Chee (2010)
conducted an online cross-sectional study
with 91 Asian American middle-aged women to
explore and compare menopausal symptom ex-
periences across ethnic groups. Results showed
that the most frequently reported symptoms
were loss of sexual interest, aches and stiffness,
and forgetfulness, but the total number of symp-
toms experienced differed by ethnicity, suggest-
ing against a panethnic view of menopausal
experience among Asian American women. B.
Lee, Im, and Chee (2010) also evaluated the
reliability and validity of the Midlife Womens
Symptom Index (MSI), a measure of meno-
pausal symptoms, in 512 midlife women. This
study showed that the MSI had an adequate
internal consistency across all ethnic groups in
all subdomains except for psychosomatic symp-
toms. Discriminant validity was not conrmed
for Asian American women. B. Lee et al. (2010)
noted that, overall, the MSI may work better for
White women than for women of other ethnici-
ties.
Cancer screening and management. Eigh-
teen studies were published in 2010 in this topic
area. Lim (2010) examined breast and cervical
cancer screening patterns and health risk behav-
iors for Latina and Asian American women,
with consideration for their language, and in-
vestigated the impact of health-risk behaviors
on breast and cervical cancer screenings after
controlling for demographic characteristics and
language. The study included 3,513 Latina
and 2,538 Asian American women whose data
were derived from the 2007 CHIS. This study
demonstrated that Asian Americans have better
outcomes in health-risk behaviors in general.
However, Latinas were more likely than Asian
Americans to receive mammograms and Pap
smears. Pourat, Kagawa-Singer, Breen, and
Sripipatana (2010) analyzed the 2003 CHIS to
explore determinants of breast and cervical can-
cer screening among Asian American women.
The analysis revealed that access (e.g., lack of
health insurance, not having usual source of
gynecologic care) explained more variation in
screening than acculturation or other demo-
graphic factors. Similarly, H. Y. Lee, Ju, Der
Vang, and Lundquist (2010) compared six sub-
groups of Asian American (Chinese, Japanese,
Korean, Filipino, South Asian, and Vietnamese
American) women with non-Hispanic White
women to examine differences in breast and
cervical cancer screening rates. The results
showed heterogeneity among Asian American
subgroups in their cancer-screening behaviors.
The Korean group consistently showed the low-
est rates of both cancer screenings, while the
Japanese ranked the highest (79.5%) in breast
cancer screening but the second lowest (79.7%)
in cervical cancer screening.
Several studies examined cancer screening
behavior among women of various ethnic
backgrounds. G. T. Nguyen et al. (2010) con-
ducted a study to evaluate cancer information
seeking and scanning behaviors (SSB) among
older limited-English-procient Vietnamese
immigrants compared with Whites and Afri-
can Americans. The authors collected data
through 104 semistructured interviews. They
covered breast, prostate, and colon cancers,
and explored the relation between cancer SSB
and cancer screening. The study showed that
Vietnamese American participants reported
accessing fewer cancer information sources
and lower cancer information seeking com-
pared with White and African American par-
ticipants. Ji, Chen, Sun, and Liang (2010)
investigated the association between cultural
views, English prociency, and regular cervi-
cal cancer screening among older Chinese
women. The ndings of this study clearly
showed that women who held more tradi-
tional Chinese cultural views were less likely
to be regular Pap smear testers, while women
with higher English prociency were 1.39
times more likely to have received regular
Pap tests than women with lower prociency.
K. S. Choi et al. (2010) compared breast
cancer screening in 252 Korean American
women in California and 889 women in Korea.
The study found signicant differences in can-
cer-screening behavior in Korean women de-
pending on where they lived. Korean women
reported a lower rate of ever having had a
screening mammography than Korean Ameri-
can women (50.8% vs. 77.8%). Women in Ko-
rea were less likely to undergo screening mam-
mography if they were older, unemployed,
247 ANNUAL REVIEW
lacked private cancer insurance, lacked health
checkups, did not exercise, had poor health sta-
tus, or were current smokers. Korean Americans
were less likely to undergo screening mammog-
raphy if they were older. Rimal and Juon (2010)
employed a risk-perception framework to un-
derstand breast cancer self-exam and screening
behavior among 413 immigrant Indian women.
The researchers found that self-efcacy and
knowledge about breast cancer were consistent
predictors of breast cancer prevention behav-
iors, suggesting that a risk-perception frame-
work was useful for understanding such behav-
ior among immigrant Indian women.
Four studies used randomized trial designs to
study the effect of interventions to improve
cancer screening. J. H. Kim, Menon, Wang, and
Szalacha (2010) examined the effects of a cul-
turally competent targeted intervention on
breast cancer and early-screening-related
knowledge and beliefs, and mammography use,
among 180 Korean American women, ages 40
years and older, who had not had mammograms
within the past 12 months. The intervention
group received an interactive education session
focused on breast cancer, early screening guide-
lines, and breast-cancer-related and Korean cul-
tural beliefs, while the control group received
no education. The education was effective in
increasing breast cancer and early screening-
related knowledge and modifying beliefs, but
there was no statistically signicant interven-
tion effect on mammography use between the
intervention and control groups. In a random-
ized trial of peer navigator intervention to assist
Korean American women in completing the fol-
low-up diagnostic tests after an abnormal breast
cancer screening (Maxwell, Jo, Crespi, Sudan,
& Bastani, 2010), 176 Korean American
women were randomized into usual care or peer
navigator conditions. Peer navigation increased
the completion of follow-up tests.
In another randomized trial effort to increase
colorectal cancer screening among those who
are nonadherent to screening guidelines (Max-
well, Bastani, et al., 2010), 548 Filipino Amer-
icans were randomly assigned to intervention or
control conditions. A multicomponent interven-
tion that included an educational group session
in the community was shown to increase screen-
ing among Filipino Americans. X. Wang, Fang,
Tan, Liu, and Ma (2010) evaluated the efcacy
of a community-based pilot intervention that
combined cervical cancer education with pa-
tient navigation on cervical cancer screening
behaviors among 134 Chinese American
women in New York City who had not had a
Pap test within the previous 12 months. The
women were randomized into the intervention
(consisting of education, interaction with a Chi-
nese physician, and health care access naviga-
tion), whereas the control group received edu-
cation delivered by Chinese community health
educators and written materials. Results showed
that screening rates were signicantly higher in
the intervention group (70%) compared with the
control group (11%).
Ashing-Giwa et al. (2010) explored the diag-
nostic- and therapeutic-care delays among a
multiethnic sample of breast and cervical cancer
survivors, examining contextual factors inu-
encing diagnostic- and therapeutic-care delays.
The sample included 449 European American,
185 African American, 468 Latina American,
and 275 Asian American survivors. The study
showed that cervical cancer survivors were
more likely to report diagnostic and therapeutic
delays compared with breast cancer survivors.
Fear of nding cancer was the most fre-
quently cited reason for diagnostic delays, and
medical reasons were most frequently cited
for therapeutic delays. Ashing-Giwa and Lim
(2010) conducted the study to test the utility and
applicability of the physical quality of life
model to breast cancer survivors of various eth-
nicity (including 206 Asian American women).
Overall, Asian Americans were more likely to
have been diagnosed at an earlier stage. They
also showed a signicant relationship between
patientdoctor relationship and perceived social
support.
Im, B. Lee, and Chee (2010) conducted a
study to explore how Asian Americans living
with cancer who participated in Internet cancer
support groups (ICSGs) evaluated their support
experiences. The study was a 1-month qualita-
tive online forum among 18 Asian American
cancer patients recruited through a convenience
sampling method. Four major themes emerged
from the data analysis process: (a) more than
just my family support, (b) part of my fam-
ily, (c) anonymous me, and (d) shielded
from the real world. The general theme over-
arching the four major themes identied in this
study is Asian Americans marginalized expe-
rience in the use of ICSGs.
248 OKAZAKI, KASSEM, AND TAN
Edrington et al. (2010) examined the pain
experience of 50 Chinese American patients
with cancer at three community-based oncology
facilities in the San Francisco, California. The
studys results revealed that lower levels of
acculturation were associated with higher pain
intensity and higher pain-interference scores.
The authors suggested that future research
should evaluate patients cancer pain experi-
ence in order to develop and test culturally
appropriate interventions. Gomez et al. (2010)
investigated whether heterogeneity in ethnic
composition and immigrant status among U.S.
Asians is an explanation for disparities in breast
cancer survival. The authors used data from
1988 through 2007 and showed that survival
after breast cancer is poorer among foreign-
versus U.S.-born Asians. McCarthy, Du-
manovsky, Visvanathan, Kahn, and Schymura
(2010) examined the impact of race/ethnicity
and neighborhood poverty on cervical cancer
incidence and mortality in New York City from
1995 to 2006, and found that Asian/Pacic Is-
lander women appeared to have reduced risk of
cervical cancer mortality compared with other
ethnic groups.
Substance use. Twenty-ve studies con-
cerned substance use and abuse among Asian
Americans, suggesting that this is one of the
most active areas of research in Asian American
behavioral sciences. The most common sub-
stances featured in these articles were tobacco
and alcohol.
Thai, Connell, and Tebes (2010) examined
the inuence of race/ethnicity, acculturation,
peer substance use, and academic achievement
on adolescent substance use among different
Asian American ethnic groups and U.S. racial/
ethnic groups. This study showed that accultur-
ation among Asian American adolescents was
an important factor in substance use prevalence
relative to its importance for other U.S. racial/
ethnic groups, and that peer substance use par-
tially mediated the relationship of acculturation
to drinking, smoking, and marijuana use, while
academic achievement did not. Parker, Solberg,
Foldes, and Walker (2010) conducted study to
examine differences in tobacco use associated
with acculturation among various population
groups using electronic medical record (EMR)
data. The authors created distinct cultural
groupings using the preferred language and
country of origin data from the EMR. The most
common language interpreter requests in the
EMR database aside from English were Somali,
Spanish, Vietnamese, Oromo, Hmong, and Am-
haric. Examining tobacco use prevalence strat-
ied by gender and broad acculturation group-
ings revealed that among English-speaking U.S.
born, 52% of men and 43% of women were ever
users; among English-speaking non-U.S. born,
50% of men and 35% of women were ever
users; and among non-English-speaking non-
U.S. born, 40% of men and 7% of women were
ever users.
Constantine et al. (2010) assessed the preva-
lence of smoking among the Hmong, Vietnam-
ese, Lao, and Cambodian communities of Min-
nesota and explored the relationship between
smoking and acculturation within these commu-
nities. Data were obtained by face-to-face and
telephone interviews with 1,628 respondents in
2006 and 2007. The authors found that Viet-
namese and Cambodian men smoked at higher
rates than men in the general U.S. population
(35% and 58% compared with 20%, respec-
tively). In addition, the study found that less
acculturated male respondents and more-
acculturated female respondents were more
likely to be smokers. Tong et al. (2010) ana-
lyzed Vietnamese American smoking behavior
in California from 2007 through 2008. Using a
statewide surname probability sample and com-
puter-assisted telephone interviewing, the au-
thors surveyed 1,101 Vietnamese men
and 1,078 Vietnamese women. Among Califor-
nia Vietnamese female respondents, 1% were
current smokers, 2% were former smokers,
and 97% were never smokers. Among Califor-
nia Vietnamese male respondents, 25% were
current smokers, 24% were former smokers,
and 51% were never smokers. Battle, Lee, and
Antin (2010) explored the knowledge and
awareness of tobacco control policies among
two generations of Laotian and Cambodian
Americans in the East San Francisco Bay Area.
The authors found that general awareness of
tobacco control policies and of secondhand
smoke were high among both generations of
Southeast Asians, and that the tobacco control
regulations appeared to be associated with
changes in smoking behavior.
R. A. Shih, Miles, Tucker, Zhou, and
DAmico (2010) explored racial/ethnic differ-
ences in alcohol, cigarette, and marijuana use
among a diverse sample of approximately 5,500
249 ANNUAL REVIEW
seventh and eighth graders, and evaluated the
extent to which individual, family, and school
factors mediated racial/ethnic disparities in sub-
stance use. The study found that Hispanics re-
ported higher, and Asians reported lower, life-
time and past-month substance use compared
with non-Hispanic Caucasians. Several factors
mediated the relationship between Asian race
and lower alcohol use, including individual,
family (parental respect, adult and older sibling
use), and school (perceived peer use, school-
grade use) factors. Sakai, Wang, and Price
(2010) investigated whether multiple-race Ha-
waiians, other Pacic Islanders, and Asian
Americans report higher rates of alcohol use
and illicit drug use than their single-race coun-
terparts. The authors used the National Survey
on Drug Use and Health to compare multiple-
race Native Hawaiians, other Pacic Island-
ers, and Asians, while disaggregating by ethnic
subgroups, with single-race individuals within
respective Asian ethnic subgroups and Cauca-
sians for prevalence of alcohol/drug use and
dependence. The analysis showed elevated risk
of substance use and dependence indicators
among multiple-race Native Hawaiian, other
Pacic Islander, and Asian ethnic subgroups
compared with their single-race counterparts.
Soller and Lee (2010) explored why South-
east Asian American adolescents and emerging
adults in the East San Francisco Bay Area pre-
ferred to use hollowed-out cigars lled with
marijuana, known as blunts, over other meth-
ods of drug intake. The authors found instru-
mental and social rationales for preferring
blunts. Blunts allowed users to more easily
share marijuana, the preferred drug among their
peers, and protected against potential adverse
effects associated with the high. Blunts also
allowed users to identify with the dominant
style of drug use and differentiate themselves
from users of stigmatized drugs such as crack
cocaine and methamphetamine. In a related
study, J. P. Lee, Battle, Lipton, and Soller
(2010) assessed the relationships between the
use of tobacco and marijuana in substance use
progression for 164 Southeast Asian American
youth and adults in low-income urban commu-
nities in Northern California. Results from the
quantitative data revealed use of cigarettes or
blunts increased the risk of use of other sub-
stances. The qualitative data revealed that, for
youth, smoking signied a social construct
and that use of cigarettes, cigars, and blunts was
interchangeable. M. Yu, Hahm, and Vaughn
(2010) explored the intrapersonal and interper-
sonal determinants of smoking status among
Asian American adolescents. The authors used
data from the 2006 National Youth Tobacco
Survey of 1,368 Asian American adolescents in
Grades 6 through 12. The study showed that
12% experimented with cigarettes, 3% smoked
occasionally, and 2% smoked regularly. Age,
weekly income, family members smoking, and
refusal of cigarettes from best friends predicted
experimental smoking, while positive images of
smoking, perception of safety of smoking for
only 1 year, awareness of the harmful effects of
secondhand smoking, refusal to smoke, and ab-
sence from school predicted occasional smok-
ing.
Iwamoto, Corbin, and Fromme (2010) stud-
ied the etiology and developmental patterns of
heavy episodic drinking (HED) among Asian
Americans young adults. The authors examined
HED, parental and peer relationships, alcohol
expectancies, drinking values, and alcohol-
related problems in a sample of 404 Asian
American college students transitioning from
high school through the college years. Parental
awareness and caring and quality of peer rela-
tionships during the senior year of high school
were associated with two classes of HED: high
increasers and low increasers. W. Kim, Kim,
and Nochajski (2010) compared correlates of
12-month prevalence of alcohol use disorders
(AUD) between Filipino Americans who cur-
rently drink alcohol and live in San Francisco or
Honolulu, using data from the 19981999 Fil-
ipino American Community Epidemiological
Survey (n 537). The study revealed that AUD
risk factors were different for San Francisco
Filipino American drinkers (higher psychologi-
cal distress, U.S.-born, and lower religiosity)
compared with Honolulu Filipino American
drinkers (more years of education and lower
emotional support).
H. C. Yoo, Gee, Lowthrop, and Robertson
(2010) examined associations between different
forms of self-reported racial discrimination and
current substance use (i.e., smoking, alcohol
use, and controlled substance use) among 271
Asian American adults living in Arizona. The
study found that reports of being treated differ-
ently due to ones race/ethnicity were associated
with increased use of alcohol and controlled
250 OKAZAKI, KASSEM, AND TAN
substances, while treated like not an Ameri-
can was related to tobacco use, after control-
ling for covariates, including age, gender, edu-
cation, family income, health insurance, nativity
status, and language, and other types of racial
discrimination. Borrell et al. (2010) tested the
association of perceived racial/ethnic discrimi-
nation with smoking and alcohol consumption
in adults participating in the Multi-Ethnic Study
of Atherosclerosis. The study included data on
803 Chinese American adults, 45 to 84 years of
age, recruited from across the nation between
2000 and 2002. Although the use of smoking
and alcohol was associated with the experience
of discrimination among Blacks and Hispanics,
only 10% of Chinese Americans reported expe-
riencing racial/ethnic discrimination, and thus
its impact was difcult to ascertain for this
population.
Several studies examined substance use pre-
vention or intervention programs. Garcia, Ro-
mero, and Maxwell (2010) investigated factors
associated with successful smoking cessation
among Filipino immigrants. The authors con-
ducted a survey on tobacco use among 318
Filipino immigrant men, aged 4075 years, in
Los Angeles, California, from May 2004
through May 2005. The study found that those
who reported more English language use with
their family, friends, and neighbors, and who
lived in households with complete smoking pro-
hibition, were more likely to be successful in
quitting smoking. Those who endorsed more
positive beliefs about the physical and social
consequences of smoking, and who had mostly
smoking friends, were less likely to be success-
ful in quitting smoking.
In one of the few publications of evidence-
based clinical trial studies with Asian Ameri-
cans, Fang, Schinke, and Cole (2010) examined
the efcacy and generalizability of a family-
oriented Web-based substance-use prevention
program to a total of 108 Asian American girls,
aged 1014 years, and their mothers. Mother
daughter dyads were randomly assigned to in-
tervention and control arms. The intervention-
arm dyads completed a nine-session Web-based
substance-use prevention program that was de-
livered by voiceover narration, animated graph-
ics, and games, and it required the joint partic-
ipation of mothers and daughters. Compared
with control-arm girls, intervention-arm girls
showed less depressed mood; reported im-
proved self-efcacy and refusal skills; had
higher levels of motherdaughter closeness,
motherdaughter communication, and maternal
monitoring; and reported more family rules
against substance use. Intervention-arm girls
also reported fewer instances of alcohol, mari-
juana, and illicit prescription drug use, and ex-
pressed lower intentions to use substances in the
future.
Luk and Tsoh (2010) analyzed the data from
a nationwide family-assisted smoking cessation
study, which included 1,393 Chinese Ameri-
cans who were current or former smokers and
those who had never smoked. They found sig-
nicant gender differences in which 82% of
Chinese American men reported being current
smokers but only 17% of Chinese American
women reported the same. Gender was also
found to moderate the association between
smoking and depression such that among
women, current smoking was associated with
higher depression scores than those who were
either formerly smoked or had never smoked,
but among men, current smoking was associ-
ated with higher depression in comparison to
former smokers only. Trinidad, Perez-Stable,
Messer, White, and Pierce (2010) examined the
association between smoking mentholated cig-
arettes and smoking cessation among African
American, Asian American/Pacic Islander,
Hispanic/Latino, Native American, and non-
Hispanic White adults. The study showed that
those who smoke mentholated cigarettes were
signicantly less likely to experience quitting
success than those who smoke nonmentholated
cigarettes. This nding holds within African
American, Asian American/Pacic Islander,
Hispanic/Latino, and non-Hispanic White ra-
cial/ethnic groups, even after adjusting for so-
ciodemographic differences that may be associ-
ated with menthol smoking.
In order to address the high smoking rates
among Korean Americans, McDonnell, Lee,
Kazinets, and Moskowitz (2010) adapted and
evaluated an Internet-based smoking cessation
program. In this article, the authors describe
their real-world experience recruiting 1,261 Ko-
rean American adults for the Quitting is Win-
ning program. Based on self-reports, most par-
ticipants learned about the study from either a
text link such as Google AdWords (44%) and/or
a graphic link such as an online newspaper ad
(35%). Among the methods used, Google Ad-
251 ANNUAL REVIEW
Words cost-per-click content site ads were the
most cost effective. Other types of outreach,
including unpaid Internet ads, cable TV, news-
papers, iers, and word of mouth, had very low
reach. Zhu, Wong, Stevens, Nakashima, and
Gamst (2010) compared California Helpline us-
age rates of smokers who called Chinese-, Viet-
namese-, or Korean-language lines with those
of Asians and Whites calling the English-
language line. The Chinese-, Korean-, and Viet-
namese-speaking smokers used the helpline at
about the same rate as White smokers in Cali-
forniaabout 1% of the total smoking popula-
tion for each group annually. Taking a different
approach, Hofstetter et al. (2010) studied the
association of immediate social and legal repri-
mand and current smoking status among Cali-
fornians of Korean descent. The authors used
the Behavioral Ecological Model (BEM), a
comprehensive theory that integrates biology,
ecology, and social environmental inuences on
behavior. The study demonstrated that, after
controlling for education, sex, acculturation, sex
by acculturation interactions, and modeling,
general social contingencies for not smoking, in
the form of reprimands, improved predictions of
smoking status among Americans of Korean
descent.
Liao et al. (2010) assessed the trends in
smoking prevalence for men in Asian commu-
nities served by the Racial and Ethnic Ap-
proaches to Community Health (REACH) inter-
vention (three Vietnamese communities in
California that targeted breast and cervical can-
cer; a Cambodian community in Lowell, Mas-
sachusetts, that targeted cardiovascular disease;
and an Asian Pacic Islander community in
King County, Washington, that targeted diabe-
tes). The study showed decreased smoking
prevalence in the Asian communities served by
the REACH project, and these decreases were
larger than nationwide decreases in smoking
prevalence observed for the same period. Shel-
ley et al. (2010) assessed the effectiveness of a
tailored free nicotine patch (NRT) program
among Chinese American smokers living in
New York Cit. Between 2004 and 2005, the
investigators provided a 6-week course of the
nicotine patch kits to 375 participants through
two community-based organizations. All writ-
ten materials were provided in Chinese and
English. The study demonstrated that the offer
of free NRT through community-based organi-
zations is a feasible and effective way to en-
courage an immigrant population of smokers to
access such evidence-based treatment.
S. Y. Park, Shibusawa, Yoon, and Son (2010)
examined the characteristics of Chinese Amer-
icans and Korean Americans who received
treatment for alcohol abuse problems. The au-
thors used data based on case records of 103
Chinese Americans and 108 Korean Americans
who were treated at an outpatient clinic that
serves Asian immigrants in New York City. The
study showed that 75% of Chinese Americans
and Korean Americans were referred for treat-
ment by the criminal justice system and denied
having alcohol problems. Signicant differ-
ences were found between the groups in in-
come, education, and types and quantity of al-
cohol use. Hendershot, Otto, Collins, Liang, and
Wall (2010) evaluated the feasibility, accept-
ability, and efcacy of a Web-based alcohol
intervention incorporating genetic feedback and
risk information specic to the aldehyde dehy-
drogenase 2 family (ALDH2) genotype. The
ALDH2*1/*2 variant is associated with partial
protection against alcohol dependence but con-
fers signicantly increased risk for alcohol-
related cancers as a function of alcohol expo-
sure. After completing an initial laboratory visit
to provide informed consent and a blood sample
for DNA analysis, 200 Asian American young
adults were randomly assigned to receive Web-
based personalized genetic feedback or atten-
tion-control feedback. Genetic feedback and
risk information resulted in signicant reduc-
tions in 30-day drinking frequency and quantity
among participants with the ALDH2*1/*2 ge-
notype.
Finally, in a study examined the relationship
between ethnicity and alcohol-related sexual as-
sault, H. V. Nguyen, Kaysen, Dillworth, Bra-
jcich, and Larimer (2010) analyzed the data of
college student drinking that included 737
Asian American women. There was a signi-
cant interaction between ethnicity and incapac-
itated rape (IR) such that Asian American stu-
dents with no history of IR had fewer drinking
problems than White American participants
with no history of IR. However, Asian Ameri-
can women with IR histories had more drinking
problems than White Americans with IR histo-
ries.
Hepatitis B prevention. We identied three
studies on this topic that were published in
252 OKAZAKI, KASSEM, AND TAN
2010. Levy et al. (2010) investigated hepatitis B
(HBV) seroprevalence, risk behaviors, and self-
reported vaccination among Latino immigrant,
Asian immigrant, and U.S.-born low-income
men in ve northern California counties. The
study showed that, among 1,512 men screened,
Asian immigrants were most likely to have had
prior HBV infection (15.1%) and chronic infec-
tion (3.8%) compared with U.S.-born
(prior 5.1%, chronic 0.6%) and Latino immi-
grant men (prior 2.0%, chronic 0.3%). J. Lee,
Lok, and Chen (2010) studied the prevalence of
hepatitis B among 567 Asian Americans in
Michigan screened at health fairs. The study
focused on the large Asian ethnic groups in
Southeast and West Michigan, including the
following: Asian Indian, Chinese, Filipino,
Hmong, Korean, and Vietnamese. The results of
this study revealed that the prevalence of hep-
atitis B among Asian Americans in Michigan is
similar to that in Asian Americans on the East
and West coasts. The authors also noted that an
educational intervention that is in native Asian
languages and is culturally sensitive effectively
raises awareness of hepatitis B among Asian
Americans. Finally, J. P. Hwang, Roundtree,
Engebretson, and Suarez-Almazor (2010) con-
ducted a focus-group study to understand and
elucidate HBV-related beliefs, attitudes, and
practice patterns of 23 medical providers serv-
ing Asian American communities in Texas.
Findings indicated that providers were aware of
cultural and nancial barriers to hepatitis care
but admitted reluctance to screen for HBV be-
cause they anticipated the patients unwilling-
ness or inability to afford treatment.
Dietary habits and obesity prevention. We
identied six studies published in 2010 con-
cerning dietary behavior. In most cases, the
studies pointed to changing dietary habits that
accompany acculturation. Franzen and Smith
(2010) conducted a mixed-method study (in-
cluding Geographical Information Systems
[GIS] mapping, questionnaires, and focus
groups) on shopping and eating behaviors of
Hmong adults living in St. Paul/Minneapolis,
Minnesota. The Hmong population was concen-
trated in St. Paul, where food stores were also
dense. American-born Hmongs and those who
had been living in the United States for more
than 5 years showed acculturation into the
American food system with respect to choice of
stores.
Afable-Munsuz, Ponce, Rodriguez, and Per-
ez-Stable (2010) conducted a study to examine
the relationships between immigrant generation
and physical activity among Mexican, Chinese,
and Filipino adults. The authors used data from
the 2000 U.S. Census and the 2005 CHIS. Phys-
ical activity was measured in three different
domains: leisure time, nonleisure time, and any
activity. Generational status was signicantly
associated with leisure-time activity among
Mexican and Chinese adults, and with nonlei-
sure-time physical activity among all three eth-
nic origin groups, but the nature of the relation-
ships varied.
Lv and Brown (2010) conducted a qualitative
study to investigate the family food systems in
rst-generation Chinese American families. The
authors interviewed 20 couples with at least one
child aged 5 years or older. Analysis revealed
that many immigrant parents reported their chil-
dren to be picky eaters who were learning to
prefer Western food over traditional Chinese
food in institutional settings. Parents were es-
pecially frustrated with their childrens refusal
to eat vegetables, and parental struggle to con-
trol childrens food choices resulted in incon-
sistent rules and rule enforcement at dinner.
N. Kim et al. (2010) explored how dietary
pattern, food choice, food consumption, nutrient
intake, and body mass index (BMI) varied with
length of residence for 60 Korean American
college students in Los Angeles. The students
completed a food frequency questionnaire and a
1-day food record. The researchers found that
the average BMI of highly acculturated Korean
American students was signicantly higher than
those of less acculturated peers, which may
have been due to their higher consumption of
more Western foods (e.g., bread, bagel, cookies,
peanut butter), even though they also consumed
relatively more fruits and vegetables than their
less-acculturated peers. In a two-generation
household study of dietary patterns, Tam et al.
(2010) had 28 Korean American families with
college students living with their parents keep a
3-day dietary record. As expected, the younger
Korean Americans consumed higher amounts
of calories and more westernized foods, while
their parents consumed more Korean food.
However, because they were still residing with
their parents, the Korean American students re-
tained many traditional eating habits character-
istic of Koreans.
253 ANNUAL REVIEW
J. L. Chen, Weiss, Heyman, Cooper, and
Lustig (2010) examined the efcacy of an in-
teractive, a child-centered, and a family-based
weight management program in promoting ef-
fective coping, behavioral health, and quality of
life in Chinese American children. Sixty-seven
Chinese American children (aged 810 years,
normal weight and overweight) and their fami-
lies participated in this randomized controlled
study of an 8-month culturally appropriate be-
havioral intervention. The results suggested that
children in the intervention group had some
positive outcomes (e.g., use of more active cop-
ing strategies, higher quality of life), but their
behavioral problems or change in BMI did not
appear to be associated with intervention.
Sexual behaviors among adolescents. We
identied just one study in 2010 that concerned
this topic. T. S. Kao, Loveland-Cherry, and
Guthrie (2010) explored the relationships
among mothers and adolescents perceptions
of motheradolescent interactions, adolescents
perceived maternal sexual expectations
(APMSE) in sexual timing, and adolescents
self-reported sexual initiation in the Asian
American/Pacic Islander (AAPI) community.
The authors conducted a secondary analysis of
the nationally representative longitudinal Add
Health data set across the rst two waves of data
collection. The study ndings suggested that the
best way to delay AAPI adolescents sexual
initiation is to promote adolescents perceived
maternal expectancy for later sexual onset by
establishing a trusting relationship between
AAPI mothers and adolescents.
Relation between health status and either
emotional expression or socioeconomic level.
We identied seven studies published in 2010
that explored the relationship between emo-
tional expression or socioeconomic status and
health. Lu and Stanton (2010) examined bene-
ts of expressive writing on physical and psy-
chological well-being. Seventy-one Asian
American and 59 White college students were
randomly assigned to one of four conditions:
emotional disclosure, cognitive reappraisal, a
combination of both, and a control condition.
The effects were assessed at baseline and in
three follow-ups spanning 4 months. The com-
bination of emotional disclosure and cognitive
reappraisal in expressive writing was most ef-
fective in improving health and mental health.
Asian Americans and highly ambivalent partic-
ipants derived the greatest benet. Mauss and
Butler (2010) examined the ways in which cul-
tural contexts shape values and meanings at-
tached to emotions. The authors compared 28
female Asian American and 28 female Euro-
pean American undergraduate students on the
associations between individuals emotional
control value and emotional responding to a
relatively neutral lm clip and a laboratory an-
ger provocation. For Asian Americans, greater
emotional control value was associated with
reduced anger experience and behavior, as well
as cardiovascular responding, but this pattern
differed for European American women. E. C.
Chang, Sanna, Kim, and Srivastava (2010) ex-
amined ethnic differences in optimistic and pes-
simistic biases in the prediction of positive and
negative physical and psychological health out-
comes between 176 European and 178 Asian
American college students. The authors found
that both groups of students held an optimistic
bias for negative physical outcomes and both
positive and negative mental health outcomes,
suggesting an evidence for pan-situational opti-
mistic bias in prediction of health.
De Castro, Gee, and Takeuchi (2010) inves-
tigated alternative measures of SES among
Asian Americans. The authors hypothesized
that economic opportunity, subjective social
status, and nancial strain may place individu-
als at risk for poor health outcomes. The authors
used data from the Asian subsample of the
NLAAS. The study showed that economic op-
portunity was robustly negatively associated
with poor self-rated health, higher BMI, and
smoking, followed by nancial strain, then sub-
jective social status. Ishii-Kuntz, Gomel, Tins-
ley, and Parke (2010) conducted a study to
examine how economic conditions inuence
family relations, family roles, and psychologi-
cal well-being among 95 Asian Americans. The
study ndings indicated that family roles and
the psychological well-being of Asian Ameri-
cans were directly inuenced by their percep-
tion of economic distress.
Mulvaney-Day, Horvitz-Lennon, Chen, Lad-
erman, and Alegr a (2010) explored patterns of
health valuation across race/ethnicity and
whether mental health disorder and immigrant
status were associated with these estimates. The
authors analyzed the health valuation questions
using different metrics (time and money) using
the Collaborative Psychiatric Epidemiology
254 OKAZAKI, KASSEM, AND TAN
Surveys. The study showed that Asians in mod-
erate health and Latinos were willing to pay
more for health than non-Latino Whites. Fur-
thermore, Asians in moderate health were will-
ing to trade more time for health. Latinos in
poor health were less willing to trade time and
gave disproportionate zero-trade responses. Fi-
nally, Zhang et al. (2010) conducted a second-
ary analysis of the 2007 Hawaii Health Survey
to examine the relationship between education,
neighborhood, and self-rated health. Using GIS
data of the respondents zip-code information,
the researchers found that higher education and
higher self-rated health are geographically dis-
tributed in the same neighborhoods. Compared
with Hawaiians, Japanese, Chinese, and White
Americans reported better health, and educa-
tional level appeared to be the main contributor
to these differences.
Health information and insurance. We
identied 22 research articles published in 2010
that were focused on health information and
insurance among Asian Americans. The studies
are characterized by either a large-scale public
health approach to data collection or a specic
focus on particular ethnic communities. Such
ethnic-specic approaches may be driven by
awareness of within-group heterogeneity in
health status. For example, G. Kim et al. (2010)
explored the physical health status and mental
health status of older Asian Americans (Chi-
nese, Japanese, Korean, Vietnamese, and Fili-
pino) drawn from the 2007 CHIS. The results
showed specic patterns in chronic diseases,
disease comorbidity, and disability rates. G.
Kim et al. (2010) concluded that in order to
capture the actual health status of a specic
Asian category, ndings from one Asian cate-
gory or an aggregate Asian category should not
be generalized to other Asian categories. D. Kao
(2010) examined the variation in health insur-
ance coverage and type across Asian American
ethnic groups and the potential factors that may
explain these differences. The author used the
2003 and 2005 CHISs to obtain a sample
of 6,610 Asian American respondents, aged
1864, including Chinese, Filipino, Japanese,
Korean, South Asian, Vietnamese, and other
Asian ethnicities. Ethnic differences among
Asian Americans in insurance coverage were
partially explained by socioeconomic and im-
migration-related characteristics. Vietnamese
and Korean Americans have among the highest
uninsurance rates nationally, but for different
reasons. These studies, and other studies sum-
marized in this section, point to the need for
researchers to ground their health studies within
particular ethnic and cultural community con-
texts.
There were three studies that examined meth-
odological issues in assessing health status and
demographic predictors of health status. In one,
D. L. Baker et al. (2010) explored the effective-
ness of a process-based translation method for
the health survey instrument Searching for
Hardships and Obstacles to Shots (SHOTS),
utilizing a community-based participatory ap-
proach with 202 participants from a Hmong
community in California. D. L. Baker et al.
(2010) sought to provide a culturally responsive
and linguistically accurate tool to allow for as-
sessments and plan interventions for minimiz-
ing the burden of vaccine-preventable infec-
tions and cancers. The researchers concluded
that by using universalistic, process-based
mixed methods to analyze language translation,
along with principles of community-based par-
ticipatory research, health surveys could be ef-
fectively translated. Although an immigrants
language status is taken for granted in many
behavioral sciences research, English pro-
ciency and language preference may not be
conceptually and empirically equivalent or in-
terchangeable. Using NLAAS data, Gee,
Walsemann, and Takeuchi (2010) explored the
association of language prociency versus lan-
guage preference and self-rated health among
Asian American immigrants. The studys re-
sults revealed that greater English prociency
was associated with improved self-rated health
on all measures of prociency. However, asso-
ciations between language preference and self-
rated health varied by the specic measure of
health or preference. Finally, Gong and Cheng
(2010) conducted two experiments to test the
inuences of ethnic identity and ethnic rele-
vance of e-health content on agent preferences
among Asian Americans. The authors dened
agents as the mediated social entities in com-
puter interfaces, such as Web sites, for present-
ing information to, and interacting with, people.
Asian American college students participated in
two experiments in which they read health in-
formation presented by Asian or White agents
on a computer. Regardless of participant ethnic
identity, agents were rated as more credible
255 ANNUAL REVIEW
when the agents ethnicity matched the ethnic
relevance of the information.
A few studies assessed attitudes and knowl-
edge about specic health issues in ethnic com-
munities. Jang, Kim, and Chiriboga (2010) ex-
plored levels of knowledge about Alzheimers
disease (AD), feelings of shame, and awareness
of AD-related services among older members of
the Korean American community. The authors
surveyed 675 older Korean Americans (aged 60
years or older) in Tampa and Orlando, Florida.
The study found that feelings of shame associ-
ated with family members having AD are more
likely to be reported by individuals with lower
levels of education, acculturation, and knowl-
edge of AD. In a focus-group study of 24 Chi-
nese immigrants in the Northwest, C. J. Chen,
Kendall, and Shyu (2010) identied linguistic
and cultural barriers to health care, as well as a
general mistrust of Western medicine, which
resulted in Chinese immigrant adults relying on
word of mouth among other immigrant Chinese
family members and friends for (sometimes er-
roneous) health information.
Chung et al. (2010) conducted a national
cross-sectional survey to assess knowledge of,
and attitudes and practice toward, epilepsy in a
multistate study of Chinese and Vietnamese
adults living in the United States. The authors
collected 2,831 completed surveys from 37 cit-
ies in seven states (California, Illinois, Nevada,
New York, Oregon, Texas, and Washington).
The researchers found that misconceptions
about epilepsy were prevalent in both Chinese
and Vietnamese populations, accompanied by
negative or discriminatory views toward per-
sons with epilepsy. Younger age, female gen-
der, Chinese ethnicity, and higher levels of ed-
ucation were associated with more positive
attitudes toward epilepsy. L. A. Morrison, Siev-
ert, Brown, Rahberg, and Reza (2010) exam-
ined the relation of menstrual attitudes to meno-
pausal attitudes, and the demographic and
health characteristics associated with each, by
conducting a multiethnic cross-sectional study.
The study consisted of 1,824 respondents,
aged 16 to 100 years, in Hawaii. The study
revealed that Asian American ethnicity, higher
education, reporting more exercise, and grow-
ing up outside of Hawaii were associated with
positive menstrual attitudes. Kandula et al.
(2010) examined 270 South Asian Americans
knowledge and beliefs about coronary heart dis-
ease as a step toward developing culturally tar-
geted coronary heart disease prevention mes-
sages. The studys results revealed that 81% of
the respondents had at least one risk factor for
developing coronary heart disease, yet 89% of
the respondents had little or no knowledge of
coronary heart disease. Few respondents were
able to correctly recognize that controlling
blood pressure, cholesterol, and diabetes as fac-
tors for prevention of coronary heart disease.
Low education level, being interviewed in Urdu
or Hindi, and low level of acculturation were
associated with less knowledge and with believ-
ing that coronary heart disease is not prevent-
able.
S. M. Yu, Huang, and Singh (2010) studied
the health status, and access to and utilization of
health services of Asian American and non-
Hispanic White children in California. S. M. Yu
et al. (2010) examined the relationship between
Asian ethnicities and outcomes by utilizing data
from the 2003 and 2005 CHISs. The data stud-
ied included 648 Chinese, 523 Filipino, 235
Japanese, 308 Korean, 314 South Asian, 264
Vietnamese, and 8468 non-Hispanic White chil-
dren younger than 12 years old. The researchers
concluded that there is a great deal of heteroge-
neity across Asian ethnic groups in health care
access and utilization patterns, highlighting the
need for targeted outreach to different Asian
ethnic groups. S. Lee et al. (2010) carried out a
focus-group study to understand the factors that
inuence access to health care among 174
adults from 13 Asian American communities in
Maryland. Financial, physical, communication,
and cultural attitudes were identied as four
major barriers to accessing health care.
Barriers to health care access may be some-
what compensated by the use of indigenous
prevention methods. For example, Misra,
Balagopal, Klatt, and Geraghty (2010) studied
the use of complementary and alternative med-
icine (CAM) by Asian Indian Americans. The
researcher examined CAM use by gender, and
its association with acculturation, health behav-
iors, and access to health care, with a cross-
sectional survey. Sixty-three percent of
the 1,824 Asian Indian adults reported using at
least one type of CAM, most commonly a veg-
etarian diet. Being older, female, unmarried,
and having higher income were associated with
use of dietary and herbal supplements. Improv-
ing access can also be accomplished by provid-
256 OKAZAKI, KASSEM, AND TAN
ing enabling services. To examine the patterns
of use of enabling services (e.g., interpretation,
eligibility assistance) at community health cen-
ters, Weir et al. (2010) examined differences in
patient characteristics of Asian American, Na-
tive Hawaiian, and other Pacic Islander pa-
tients who used enabling services and those who
did not. Older, female, and uninsured patients
tended to use more enabling services.
Using qualitative methods, Berkman and Ko
(2010) explored serious illness disclosure
among a group of aging Korean Americans in
order to understand how to provide culturally
competent care to Korean American adults
aged 65 years or older. Preferences in how
ones illness should be disclosed by providers
were grouped under six themes. With respect to
disclosure, participants discussed (a) a desire
for informed decision making and plans for
treatment, (b) belief in disclosure as damaging
and exacerbating of illness, (c) mistrust in cor-
rect diagnoses, (d) desire for hope in disclosure
of serious illness, (e) desire for provider to
consider softening disclosure of illness the
older the patient is, and (f) differences in Ko-
rean and White American doctors in disclosure
practices. In another article, Ko and Berkman
(2010) explored the end-of-life decision making
in focus groups with 23 Korean American older
adults. The older adults reported experiencing
negative responses from their children when
they attempted to discuss end-of-life treatment
preferences, and they were concerned about the
distress that their children may experience as
surrogate decision makers. None of the partici-
pants had completed an advance directive.
Sarnquist, Grieb, and Maldonado (2010) ex-
plored the racial/ethnic differences in prenatal
care receipt among Pacic Islanders and Asians.
Through a retrospective population-based
study, the authors examined approximately 2.6
million records of all live California births from
20002004. The study focused on prenatal care
receipt and population characteristics associated
with lack of adequate prenatal care, especially
among Asian and Pacic Islander groups. Pa-
cic Islanders were more likely to have inade-
quate prenatal care in comparison to any other
racial/ethnic group, while Asian women re-
ceived prenatal care closer to that of the White
reference group. The authors concluded that in
order to capture the their specic health needs,
data should be collected separately from Asian
and Pacic Islander populations. Examining the
contribution of partner abuse to prenatal care,
Ta and Hayes (2010) examined the factors as-
sociated with prenatal health care access barri-
ers among mothers. The authors analyzed data
of 7,158 respondents from the 20042007 Ha-
waiis Pregnancy Risk Assessment Monitoring
System. Among Native Hawaiians/other Pacic
Islanders and Asian Americans, experience with
partner abuse was signicantly associated with
reporting at least one barrier to accessing pre-
natal health care, but this relationship was non-
signicant among Whites.
Many studies addressed health information
and needs of older Asian American adults. J. S.
Lee (2010) conducted a qualitative study to
explore how Korean American and Asian In-
dian older adults living in the New York met-
ropolitan area obtain information on healthy
lifestyles. The author carried out two focus
groups, one with nine Korean and the other with
nine Asian Indian older adults. Three distinct
channels for health information were identied:
interpersonal, mass media, and ethnic-commu-
nity-specic channels. Jang, Chiriboga, Allen,
Kwak, and Haley (2010) explored the factors
that might increase or decrease the willingness
of 675 older Korean American adults to use
hospice. The authors conducted surveys with
Korean adults aged 60 or older in Tampa and
Orlando, Florida. Nearly three-quarters of the
sample endorsed their willingness to use hos-
pice. Younger age, higher education, more
chronic conditions, health insurance coverage,
higher education, and prior awareness of hos-
pice all contributed to their willingness to use
hospice. The objective of the study conducted
by Fernandes et al. (2010) was to measure
symptom relief and quality of life, resource
utilization, and satisfaction with home-based
palliative care. The study was conducted over a
12-month period, and 91 participants of Sa-
moan, Filipino, Japanese, Micronesian, and Ha-
waiian ethnicities were studied. The study
revealed the effectiveness of palliative care ap-
proaches in Asian and Pacic Islanders patients.
The study also demonstrated that hospitaliza-
tions decreased after home-based palliative care
admission. Lin (2010) conducted a study to
explore the needs of family caregivers in the
Chinese American community and to develop
training videos for caregivers on dressing stroke
survivors. The author conducted in-depth, semi-
257 ANNUAL REVIEW
structured, open-ended interviews with 40 Chi-
nese American caregivers (ages 5187) to
identify the problems of caregivers of stroke
survivors. Results of the interviews suggested a
need for improved methods in assisting para-
lyzed patients with daily activities, and English-
and Chinese-language 18-min videos were pro-
duced to address the identied needs.
Identity. There were 10 studies included in
the current review on the topic of identity. Stud-
ies focused on particular age groups, including
adolescents and college students, and changes
in their ethnic identity and development. Nota-
bly, six out of 10 studies employed qualitative
methods. Also tting to studies of a construct
that is uid, longitudinal methods were em-
ployed to track identity changes over time.
Having an unhyphenated American iden-
tity has been discussed in the literature as an end
point of assimilation into American society.
Song (2010) examined the ethnic identity adap-
tation of immigrant children from China, Haiti,
and Mexico across ve years. Participants indi-
cated three main types of ethnic identities: na-
tional origin (e.g., Chinese), hyphenated (e.g.,
Chinese American), and panethnic (e.g., Asian
or Asian American). These three identity cate-
gories were examined in relation to various
social and structural variables. Ethnic-identity
changes over time were related to gender, an-
nual household income, and parental educa-
tional level. Changes in ethnic identity among
immigrants were inuenced by parents educa-
tion level only among Chinese participants, and
by gender among Haitian and Mexican partici-
pants.
In another longitudinal study, Kiang, Wit-
kow, Baldelomar, and Fuligni (2010) examined
changes in ethnic identity (e.g., exploration, be-
longing) among 541 high school students (Latin
American, Asian, and European) over four
years. Between-person analyses indicated that
adolescents did not report developmental
changes in ethnic exploration and belonging
over time. Yet within-person analyses revealed
that ethnic identity uctuated substantially over
the four years, and this uctuation was associ-
ated with concurrent changes in family cohe-
sion, proportion of same-race peers, and race
centrality. In yet another longitudinal study ex-
amining changes in adolescents ethnic identity
over time, Nishina, Bellmore, Witkow, and Ny-
lund-Gibson (2010) surveyed an ethnically di-
verse student sample across six middle-school
semesters. Results indicated that adolescents
were not necessarily consistent in their report of
their ethnicity across time points. Overall, close
to 40% of students changed in ethnic identi-
cation between at least two time points during
the school year. Asian/Pacic Islander students
were more consistent and multiethnic students
were less consistent than those from other eth-
nic groups. School context (i.e., ethnic compo-
sition) predicted shifts in ethnic identication,
especially for students who were numerical eth-
nic minorities at their school.
Underscoring the importance of attending to
the uidity of self and identity across contexts,
Tawa and Suyemoto (2010) explored self-
construals among 13 Asian American young
adults, aged 18 to 29, using a qualitative
method. Participants rst discussed the mean-
ings of self in three social contexts (mostly
White, mostly Asian, and mixed ethnic), then
they were asked to represent their self-construal
using diagrams. Results suggested that self-
construals are largely uid and that dimensions
of interdependent and independent self-constru-
als may uctuate depending on social contexts.
Cambodian students must often negotiate be-
tween conicting ethnic stereotypes such as the
model minority stereotype of Asian American
students (i.e., stereotypes of Asian American
students as high-achieving, hard-working, self-
reliant, law-abiding, and problem-free) and ste-
reotypes of Cambodian students as low achiev-
ers and delinquents. For example, adopting the
model minority label may engender negative
feelings and misconceptions toward ones own
ethnic group. Using naturalistic observation of
students during the academic year and inter-
views with a sample of 52 Cambodian high
school students, Chhuon and Hudley (2010)
contextualized the ways in which Cambodian
American youth negotiated their ethnic identi-
ties vis-a`-vis such stereotypes across different
school contexts. The researchers documented
how Cambodian students engaged in highly so-
phisticated ways of adopting, rejecting, and af-
rming identities depending on the perceived
advantages across various contexts. Cambodian
students negotiated their ethnic identity in ways
that resisted stigmatization depending on
whether certain ethnic (i.e., Cambodian) and
panethnic (i.e., Asian) identities were advanta-
geous in particular settings.
258 OKAZAKI, KASSEM, AND TAN
Several studies focused on identity among
specic ethnic group individuals. J. Nguyen
and Brown (2010) interviewed 28 Hmong ad-
olescents to explore how language, clothing,
and behaviors are ascribed meanings and used
to dene cultural identity, and what it means
to be a Hmong American. Participants re-
ported using language and style as symbols to
dene their own, as well as others, ethnic
group membership and identities. Participants
identied those who are bilingual and wear an
American style of clothing as most desir-
able of peers, and those who are monolingual
and sport fobby style clothing as being of
lower social status. Juang and Nguyen (2010)
aimed to describe the ethnic identity of 127
Chinese American college students in relation
to family and community factors. Beliefs
about family obligation were positively re-
lated to ethnic engagement and pride. Com-
munity factors, such as perceptions of ethnic
composition, were positively related to ethnic
pride, and perceptions of cultural resources
were positively related to ethnic engagement
and a stronger Chinese American identity.
Finally, perceiving discrimination was posi-
tively related to ethnic engagement but neg-
atively related to ethnic pride, suggesting that
discrimination is a double-edged sword. And
with 12 adults of mixed-race backgrounds,
each with an English-speaking parent and a
Chinese, Japanese, Korean, Spanish, or Viet-
namese-speaking immigrant parent, S. J. Shin
(2010) explored the biracial individuals ex-
periences with, and attitudes toward, their
immigrant parents language. Some partici-
pants used knowledge of their heritage lan-
guage to gain greater access to, and legiti-
macy in, the ethnic community, while some
who never developed prociency in their her-
itage language lamented their lack of belong-
ing and connection to the community. Some
biracial individuals reported that, at various
developmental stages, they had rejected the
heritage language in an effort to identify more
with the mainstream but had returned to em-
brace it as an adult.
Asian American identity is also studied
through the lens of leisure and media. Thangaraj
(2010) conducted an ethnographic study of
South Asian American men who play in the
Indo-Pak Basketball leagues as a critical site for
identity formation. The study revealed that
South Asian American men, who felt racially
marginalized post-9/11, enjoyed the panethnic
camaraderie through participation in a mascu-
line American sport, as their ideas of masculin-
ity were still largely dened in relation to he-
gemonic masculinity within the sport (in this
case, Black male masculinity). Given the under-
representation of Asian Americans in the media,
Abrams (2010) explored the question of
whether Asian American TV use is related to
their perceptions of outgroup vitality. Abrams
(2010) explored TV viewing among Asian
Americansspecically, how much time is
spent on TV viewing, what shows they watch,
why they watch, and how these variables are
related to their perception of White Americans
vitality, dened as status, demography, and in-
stitutional support. Results indicated that TV
watching for entertainment and relieving bore-
dom were signicant predictors of how vital
Asian Americans perceived Whites. Evidence
suggested that watching TV for identity grati-
cations (e.g., to see Asian Americans repre-
sented on TV) was important for Asian Amer-
icans who highly identify with their ethnic
group. Bai (2010) conducted a content analysis
of news stories published during a 9-week pe-
riod in the fall of 2004 by the Korea Daily, an
ethnic newspaper published in Los Angeles, to
examine the medias representations of interra-
cial relations and racial ideologies. The analysis
revealed that Korean Americans were fre-
quently depicted as victims of crimes (mostly in
relation to Blacks), racial discriminations
(mostly in relation to Whites), problematic la-
borers (mostly in relation to Latinos), and busi-
ness rivals (mostly related to other Asian Amer-
icans). Bai (2010) argued that these depictions
were employed to counter the prevailing nega-
tive portrayal of Korean Americans in noneth-
nic media.
Immigrants and refugees. Given the de-
mographic revealing that the majority of the
Asian American population is in immigrant
households, the majority of the research articles
are also about immigrants and refugees. How-
ever, there were only two studies published in
2010 that we judged to be centrally concerned
with the phenomenology of immigration and
refugee adaptation and resettlement. In one
study, Yoon, Lee, Koo, and Yoo (2010) ex-
plored the postimmigration adjustment experi-
ences of 10 Korean immigrant women using
259 ANNUAL REVIEW
qualitative research methods. Korean immigrant
women reported an appreciation for a better
education system and environment for their
children, liberation from patriarchal demands,
and changes in family dynamics. Participants
voiced their expectation for their children to
succeed and participate in mainstream society,
as they reported lacking English prociency and
a sense of belonging as among the biggest chal-
lenges. All women reported experiences with
racism. Among the concerns in seeking mental
health services was fear of gossip in their small
ethnic community. In the other study, Dubus
(2010) explored the experiences of transcultural
aging for 16 Cambodian refugee women (ages
4460) through a qualitative study conducted
over the span of a year. These women reported
loss of respect as the respected elder, fear of
separation (and lack of care) from children,
feelings of devaluation from children, and self-
blame for intergenerational cultural gaps. The
women reported the persistence of posttrau-
matic symptoms that disrupted successful em-
ployment. Results emphasize that aging refu-
gees continue to face difculties 2030 years
after resettlement and have implications for how
providers should take care to deem aging as a
culturally based process for refugee women.
Interpersonal relationships. Five studies
on the topic of interpersonal relationships
among Asian Americans were included in the
current review. Of note, the bulk of this work is
conducted in the cross-cultural tradition, pri-
marily by social psychologists, using an inde-
pendent and interdependent self-construal
model.
Attention to the self has been shown to
intensify emotional reactivity. Chentsova-
Dutton and Tsai (2010) posited that emotional
reactivity may differ depending on cultural
models of the self that prioritizes different
aspects of the self (individual vs. relational).
Findings indicated that attention to aspects of
the self was associated with greater levels of
emotional reactivity in European Americans
than Asian Americans. In contrast, attention
to relational aspects of the self was associated
with levels of emotional reactivity that were
similar or greater among Asian Americans
compared with European Americans. Self-
perceptions of own moral status and well-
being may differ between individuals from a
dignity culture and a face culture. Using an
experimental manipulation, Y. H. Kim and Co-
hen (2010) found that those from a face culture
(Asian Americans) desired moral cleansing
when thinking about how others would judge
their wrongdoings, and they perceived them-
selves as having a rich social network and
worthwhile life when thinking about how others
would evaluate their friendships, when others
were invoked. In contrast, those from a dignity
culture (White Americans) responded to infor-
mation about their transgressions and friend-
ships when other people were not invoked.
Compared with White Americans, Asian
Americans may be less likely to seek social
support because Asian cultural values prioritize
relational maintenance goals over self-expres-
sion goals. S. Wang, Shih, Hu, Louie, and Lau
(2010) employed a daily diary method with a
sample of 226 Asian and White American un-
dergraduates to examine whether Asian Amer-
icans sought social support less frequently than
White Americans across daily events. Results
showed that group differences in seeking social
support were partially mediated by desire to
maintain relational harmony through individual
emotional restraint. Findings also showed that
Asian Americans tended to derive fewer bene-
ts from social support and relied more fre-
quently on discretionary (e.g., friends), rather
than obligatory, kinship sources than White
Americans. Findings suggest that social support
experiences differ markedly for these groups.
Kim-Jo, Benet-Mart nez, and Ozer (2010)
examined the role of acculturation and bicul-
tural identity processes in the interpersonal con-
ict resolution styles. Korean Americans
employed a bicultural approach to conict
resolution, in which they reported engaging in
both characteristically American (e.g., compet-
ing) and characteristically Korean (e.g., avoid-
ing) ways of resolving conicts. Of note, Ko-
rean Americans used an avoiding style more
than monocultural Koreans, suggesting that
some biculturals may adhere more strongly to
their heritage cultural values than individuals
from their home culture. Lampert, Isaacson, and
Lyttle (2010) conducted a reanalysis of an in-
ternational data set on a measure of gelotopho-
bia (the fear of being laughed at). They aimed to
explore differences between White and Asian
American respondents with respect to self-
perception and social reaction. Individuals with
a more interdependent self-construal may be
260 OKAZAKI, KASSEM, AND TAN
more concerned with appearing foolish in pub-
lic, but they may prioritize maintaining positive
social relations, especially in social encounters
involving laughter. The ndings revealed that
Asian Americans reported stronger feelings to-
ward social evaluations than White Americans
but not higher on social reaction, suggesting
their need to maintain harmonious relationships.
Finally, Riela, Rodriguez, Aron, Xu, and
Acevedo (2010) employed a cross-ethnic and
cross-national design to study precursors to fall-
ing in love. In one study, White American and
Asian American college students wrote narra-
tives of their falling in love experiences, and in
another study, students in the United States and
China wrote narratives and completed self-
ratings. Although many cross-national differ-
ences between American and Chinese students
were found, only small ethnic differences
emerged between Asian American and White
American students, suggesting that Asian
Americans process of falling in love is highly
similar to those of White American peers ex-
periences.
LGBT populations. Only two studies pub-
lished in 2010 focused on LGBT Asian Amer-
icans, suggesting that this population continues
to be understudied within the behavioral sci-
ences. Alimahomed (2010) conducted a quali-
tative study in Los Angeles and San Francisco
that included participant observation in Gay
Pride events and in-depth interviews with 25
queer-identied Latinas and Asian/Pacic Is-
lander women recruited through snowball sam-
pling or through online advertisement. The re-
searcher identied multiple ways in which
queer women of color were marginalized within
the LGBT community and within their own
racial/ethnic communities. The women often
narrated this sense of marginalization as invis-
ibility that was associated with gender and ra-
cial construction of Asian American women
within the United States and the perceived
whiteness of the gay community. D. H. Chae
and Ayala (2010) studied self-identied sexual
orientation and self-reported sexual behavior
among Latinos (n 2,554) and Asians
(n 2,095) using data from the NLAAS. The
authors also studied the implications of unfair
treatment and psychological distress among
sexual minorities who were identied in the
study sample. The studys results revealed that
heterogeneity in responses exists. Differences
were present in assessing sexual orientation and
sexual behavior, including differences in the
adoption of lesbian, gay, or bisexual identity by
gender, ethnicity, nativity, and socioeconomic
status. Sexual minorities reported higher levels
of unfair treatment and psychological distress
compared with their nonlesbian-, gay-, or bisex-
ual-identied sexual minority counterparts, and
unfair treatment was positively associated with
psychological distress. The authors concluded
that there is a need to consider multiple demo-
graphic factors in assessing sexuality and sug-
gest that measures of both self-identied sexual
orientation and sexual behavior should be col-
lected.
Politics. We identied three studies that
were concerned with political aspects of the
Asian American experience. Morrill, Edelman,
Tyson, and Arum (2010) surveyed 5,461 ninth
and eleventh grade students in California, New
York, and North Carolina, and conducted in-
depth interviews with students, teachers, and
administrators to compare racial groups in their
perceptions of rights violations involving dis-
crimination, harassment, freedom of expres-
sion/assembly, and due process violations in
disciplinary procedures. Asian Americans com-
prised 5% of the total sample. The analysis
found that African American and Latino/a stu-
dents were more likely to report rights viola-
tions than White and Asian American students.
Interview data revealed that Asian American
students who had experienced harassment were
aware of the model minority stereotypes im-
pact on their willingness to take legal action as
well as the lack of responsivity on the part of the
school administrator when interventions were
requested from Asian American students.
In an experimental study, Chao, Chiu, and
Lee (2010) examined the relationship between
the model minority image, peoples world-
views, and attitudes toward American govern-
mental policies to that help Asian American (vs.
African American) communities. The study ma-
nipulated the salience of the model minority
image in a study with 80 Asian Americans
and 75 European American college students.
The results revealed that among those who be-
lieve in a malleable reality, exposure to the
Asian American success story resulted in de-
creased support for redistributive policies that
benet Asian Americans, especially among
White Americans.
261 ANNUAL REVIEW
A. H. Kim and White (2010) conducted an
analysis to test for the panethnic hypothesis
(i.e., ethnic groups would be less segregated
within panethnic boundaries than across them)
in residential segregation. The analysis sug-
gested that the panethnic effect was dependent
on immigration status of the residents. On av-
erage, Asian ethnic groups were the most seg-
regated from one another compared with all
other within-panethnic pairs, perhaps due to lin-
guistic differences, suggesting that Asian Amer-
ican ethnic groups may continue to maintain
some degree of distinctiveness within a racial-
ized context.
Psychopathology. Following B. S. K. Kim
et al. (2010) and acknowledging that depression
continues to be the most frequently studied form
of psychopathology among Asian Americans,
we rst summarize studies on depression and
suicide ideation, followed by papers on other
forms of psychopathology and distress.
Depression and suicide ideation. Our re-
view identied 16 articles that were primarily
concerned with depression and suicide ideation
among Asian Americans. The broadest prole
of Asian Americans depression was provided
by Gonzalez, Tarraf, Whiteld, and Vega
(2010), who used the combined data from the
NLAAS and other data from the Collaborative
Psychiatric Epidemiology Surveys to examine
the epidemiological patterns across ethnic
groups on the population meeting DSMIV di-
agnosis for major depression. Notable ndings
concerning Asian American groups included
the suggestion that Vietnamese Americans
(along with Mexican and African Americans)
were the least likely to receive depression treat-
ment that followed psychiatric guidelines.
Four studies tested conceptual models of de-
pression in Asian Americans. Chentsova-
Dutton, Tsai, and Gotlib (2010) tested the cul-
tural norm hypothesis with 35 White American
and 31 Asian American adult women, half of
whom met the DSMIV criteria for current ma-
jor depressive disorder. The study involved as-
sessing self-report, facial expressions, and
physiological reactions in response to an amus-
ing lm clip. They found that depressed Asian
Americans showed similar or increased positive
emotional responses compared with nonde-
pressed ethnic counterparts, whereas depressed
White American women showed attenuated
positive emotional response compared with
nondepressed ethnic counterparts. The results
were consistent with their cultural hypothesis
that depression is associated with dampened
emotions in cultures that encourage open or
exaggerated emotional expression (e.g., main-
stream American culture) but not in cultures
that encourage emotional moderation (e.g.,
Asian cultures).
In a study of an emotion regulation model of
depression with 365 Asian American and White
American college students, Cheung and Park
(2010) examined the association between tem-
perament (trait anger) and family processes
(family cohesion and family communication)
on depressive symptoms. They found that anger
suppression mediated the relationship between
trait anger and depressive symptoms, and be-
tween family characteristics and depressive
symptoms, for both ethnic groups. However,
anger suppression was also found to be less
detrimental to the mental health of Asian Amer-
icans than for White Americans, suggesting
some cultural specicity of the general model.
I. J. K. Park, Kim, Cheung, and Kim (2010) also
examined the role of anger regulation among
Korean American adolescents (ages 1115) in
their depressive symptoms and externalizing
problems. In addition to lower family cohesion
and higher family conict, a higher level of
anger suppression was associated with in-
creased depressive symptoms. Externalizing
problems was associated with being a male,
holding a weaker interdependent self-construal
and higher family conict, lower anger control,
and higher expression of anger. W. C. Hwang et
al. (2010) tested a family model of depression in
which the effect of acculturative family distanc-
ing (AFD) on depressive symptoms was exam-
ined among 105 Chinese American high school
students and their mothers. Greater mother
child discrepancy on Chinese cultural retention
was associated with increased AFD, which, in
turn, was associated with higher depressive
symptoms among both youth and mothers.
Two studies examined the response patterns
of Asian immigrants on a widely used measure
of depression. E. Kim, Seo, and Cain (2010)
examined whether acculturation made a differ-
ent in how Korean immigrants respond to a
widely used depression measure (Center for Ep-
idemiologic Studies Depression Scale; CES-D).
Level of enculturation in Korean culture was
not related to response patterns in positive or
262 OKAZAKI, KASSEM, AND TAN
negative affect items, but increases in accultur-
ation to American culture was associated with
endorsement of positive affect items. Similarly,
Jang, Kwag, and Chiriboga (2010) examined
the response patterns of 450 non-Hispanic
White, 519 Korean American, and 2,030 Ko-
rean older adults on a short form of the CES-D.
The analysis revealed that Koreans and Korean
Americans were less likely than non-Hispanic
Whites to endorse positive affect items on the
depression measure. Acculturation to American
culture increased the likelihood of endorsing
positive affect items. Together, these results
called into question the cultural equivalence of
CES-D scores for Korean Americans.
Two studies conducted comparisons between
Asian Americans and other ethnic groups using
large survey data. In an analysis of the National
Longitudinal Survey of Adolescent Health (Add
Health) data from 1994 and 1996, W. Y. Chen
(2010) compared predictors of internalizing be-
havior for African American and Asian Amer-
ican adolescents. Whereas exposure to violence
was a signicant predictor of subsequent inter-
nalizing behavior and symptoms for African
Americans, W. Y. Chen (2010) found that, for
Asian American adolescents, being female and
having prior internalizing behaviors, but not
exposure to violence, predicted Asian American
adolescents subsequent internalizing behaviors
and symptoms. In a brief report comparing the
Patient Health Questionnaire (PHQ-9) scores
of 1,251 Asian American and 586 White Amer-
ican college students in San Diego, Young,
Fang, and Zisook (2010) found that Asian
American students, particularly Korean Ameri-
can and female students, reported signicantly
more depressive symptoms than White Ameri-
can students. Iwamoto, Liao, and Liu (2010)
examined the role of masculine norms, coping,
and cultural values in predicting depression in
149 Asian American men. The studys results
revealed that Asian American men who used
avoidant coping strategies and endorsed the
masculine norm of dominance reported
higher levels of depressive symptoms. How-
ever, endorsing winning masculine norms re-
ported lower levels of depressive symptoms.
Three studies were concerned with depres-
sion among Southeast Asian American commu-
nities. Leung, Chueng, and Chueng (2010)
analyzed a health survey conducted with 572
Vietnamese American community residents in
Houston, Texas. The survey found relatively
elevated reports of depression within this pop-
ulation. There were a number of predictors of
depressive symptoms, including being female,
unmarried, unemployed, experiencing family
problems, health issues, or income losses. How-
ever, the respondents also expressed a deep
reluctance to seek mental health treatment for
mental health problems, preferring to seek help
from physicians, religious leaders, family or
friends, or alternative medicine practitioners.
Fancher et al. (2010) conducted a qualitative
study with 11 Vietnamese American commu-
nity members regarding their experiences with
depression and identied several themes, such
as concerns with stigma and face associated
with depression, importance of including the
family in depression treatment, acknowledg-
ment of Vietnamese cultural beliefs that may
conict with medication compliance, and the
wish to be treated by culturally and linguisti-
cally matched providers. H. Y. Lee, Lytle,
Yang, and Lum (2010) conducted a series of
focus groups with nine mental health and social
service providers who serve Hmong and Cam-
bodian older adult clients in the Minneapolis-St.
Paul metropolitan area. Qualitative analysis of
the focus group discussion yielded themes re-
garding mental health literacy among this pop-
ulation. The service providers who were knowl-
edgeable about community perceptions pointed
to culturally different conceptions of depres-
sion, which is an unfamiliar concept with no
direct translation in Hmong; cultural and reli-
gious beliefs regarding spirit loss that may be
connected to their indigenous understanding of
depression; and barriers to seeking help for de-
pression within the community.
J. K. Shin (2010) explored the experiences of
Korean immigrants with depression. A total
of 57 Korean community members participated
in focus-group and in-depth-interview discus-
sions, including those who had or had not been
diagnosed for depression. Prominent were feel-
ings of guilt for abandoning parents by leav-
ing and being unable to provide nancially, and
symptoms of depression were mostly expressed
in somatic terms. Participants expressed a sense
of marginalization in mainstream American so-
ciety, despite their nancial success and secu-
rity.
Three studies focused on suicidal ideation
among Asian Americans. J. L. Choi and Rogers
263 ANNUAL REVIEW
(2010) examined the cultural validity of the
College Student Reasons for Living Inventory
in an online survey with 314 Asian American
college students. The study found tentative sup-
port for the validity of this measure with Asian
American students, although the factor structure
of the original scale was not fully replicated
with this sample. Examining distress and sui-
cidal ideation in a group that was thought to be
especially vulnerable, Cho and Haslam (2010)
compared 62 Korean adolescents who were
studying in the United States as study-abroad
students, accompanied or unaccompanied by
parents, with 47 Korean adolescents in Korea
and 31 non-Korean adolescents in the United
States. The study found that the sojourning Ko-
rean international students reported the highest
level of distress and suicide ideation. Notably,
general life stress and absence of both parents
appeared to be the most consistent predictors of
negative psychological outcomes. Finally,
Cheng et al. (2010) analyzed the NLAAS data
to see what cultural variables were associated
with suicidal ideation and attempts among
Asian Americans. The lifetime prevalence of
suicidal ideation and attempts were found to
be 8.8% and 2.5%, respectively. Being female
and reporting family conict, perceived dis-
crimination, and having lifetime depressive or
anxiety disorders were associated with suicidal
ideation and attempts. High ethnic identity ap-
peared to be a protective factor. For men only,
having chronic medical condition also contrib-
uted to suicide risk.
Other forms of psychopathology and dis-
tress. This category encompasses many types
of research, ranging from studies on major men-
tal disorders, to perceptions of mental disorders,
to correlates of emotional distress. In a study of
perceptions of mental illness, Kumar and Nevid
(2010) examined how acculturation, encultura-
tion, and gender norms inuenced Asian Indian
immigrants judgments of mental disorders de-
picted in vignettes. Asian Indian adults in
Northeastern United States (118 immigrants)
judged symptoms to have more of a biological
than psychological basis when the hypothetical
patient was male. Those who were more accul-
turated to the United States judged symptoms to
have more of a biological basis for the male
vignette, but there was no signicant relation-
ship between raters acculturation and their per-
ception of the female vignette.
In a study of rates of DSMIV mental disor-
ders in the population, J. Kim and Choi (2010)
used the NLAAS data to examine the 12-month
prevalence rate of mental disorders among
Asian American older adults and compare them
to those of younger cohorts. The analysis found
that the rate of mental disorders among older
adults (60 and older) was signicantly lower
than that in younger groups. In another study
using the NLAAS data, Walton and Takeuchi
(2010) examined how family structure and pro-
cesses might be associated with reported health
and psychological distress, as assessed by the
Kessler Psychological Distress Scale. Results
found little support for prior work on the effects
of family structure, suggesting that the effects
of family structure on well-being should not be
considered universal. Family composition (i.e.,
extended family living arrangement) was asso-
ciated with lower reported levels of psycholog-
ical distress, but only among men and individ-
uals born in the United States.
Three articles focused on anxiety disorders
among Asian Americans. In one study, Ham-
brick et al. (2010) examined the psychometric
properties of self-report measures of social anx-
iety and worry among White, Latino, African
American, and Asian American college stu-
dents. Their analyses based on item response
theory (IRT) found that two measures of anxiety
(the Social Interaction Anxiety Scale [SIAS]
and the Penn State Worry Questionnaire
[PSWQ]) performed differently for African
American and Asian Americans compared with
White Americans. For the PSWQ, Asian Amer-
icans showed different response patterns on four
out of 11 items. On the SIAS, although individ-
ual questions performed at least as well, if not
better, in distinguishing Asian Americans who
were socially anxious from those who were not,
Asian Americans were also more willing to
readily endorse pathological items on this in-
strument, making it difcult to interpret the
small ethnic differences on this instrument as
clinically meaningful.
Barrera, Wilson, and Norton (2010) exam-
ined data from 922 college students in Houston,
27% of who were Asian American, for ethnic
differences in panic attack symptoms. Although
the overall endorsement of panic symptoms did
not differ across ethnic groups, Asian American
students tended to endorse somatic symptoms
(e.g., dizziness, unsteadiness, choking) and feel-
264 OKAZAKI, KASSEM, AND TAN
ing terried more frequently than White Amer-
ican students. Asnaani, Richey, Dimaite, Hin-
ton, and Hofmann (2010) examined ethnic
differences of lifetime prevalence rates of anx-
iety disorders using the CPES data, which in-
cluded the NLAAS data. They found that Asian
Americans were consistently and signicantly
less likely to be diagnosed with each of the
major anxiety disorders than White Americans.
A pair of qualitative studies published in
2010 centered on ethnographic study over a
17-month period with three South Asian Mus-
lim immigrant families whose young children
were diagnosed with autism. Jegatheesan,
Fowler, and Miller (2010) described the process
from symptom recognition to receipt of ser-
vices, narrated by the three families, and found
that while some of the difculties encountered
with diagnosis and access to services were sim-
ilar to those experienced by non-South Asian or
nonimmigrant families of children with autism,
there were specic cultural and linguistic barri-
ers encountered when the families interfaced
with mainstream non-South Asian service pro-
viders. Jegatheesan, Miller, and Fowler (2010)
further described the parental beliefs about au-
tism held by these families from a cultural per-
spective. The families understood and inter-
preted the challenge of raising and caring for
their children through a religious and cultural
lens, in which their Islamic faith permeated
daily life and informed their acceptance of their
sons with autism as gift from Allah.
Fung and Lau (2010) examined the relation-
ship among parental punitive behavior, chil-
drens behavioral problems, parentchild rela-
tionship, acculturative stress, acculturation
conict, and acculturation to Chinese and White
American cultures. Results suggested that con-
icting perceptions of internalizing symptoms,
such as depression and anxiety in children, were
related to particular patters in parentchild ac-
culturation dissonance in Chinese acculturation.
To the extent that children and parents were
similar in Chinese acculturation, their ratings of
internalizing problems tended to be similar.
Thus, agreement was highest when parents and
children highly endorsed Chinese lifestyle or
language preferences, or when neither parent
nor child was aligned on these preferences. In
contrast, disagreement on internalizing prob-
lems was highest when parents held Chinese
values but their children did not.
There were several studies using survey
methodology to examine correlates of distress
among Asian Americans. E. C. Chang, Tsai,
and Sanna (2010) examined ethnic differences
between Asian American and European Amer-
ican college students on the relationship be-
tween rumination and psychological adjustment
(depressive and anxiety symptoms, life satisfac-
tion, affectivity). They found that Asian Amer-
icans reported greater amounts of rumination
than European American students but that ru-
mination was not as strongly associated with
distress for Asian Americans. Yoon and Lee
(2010) collected survey data from a community
sample of 204 Korean immigrant adults in the
Midwestern United States on the relationship
between social connectedness and subjective
well-being, which was moderated by the value
placed on the importance of social connected-
ness. Among this sample, income was also
moderately associated with well-being. M. H.
Chae and Foley (2010) also examined the rela-
tionship between acculturation, ethnic identity,
and psychological well-being among 334 East
Asian American young adults recruited through
churches. Stronger ethnic identity and bicultural
orientation were associated with higher psycho-
logical well-being among Chinese, Korean, and
Japanese Americans. C. C. Wang and Ratana-
siripong (2010) examined the relationship be-
tween adult attachment, cultural orientation,
and psychosocial functioning among 112 Chi-
nese American college students. Both attach-
ment avoidance and anxiety were associated
with worse psychosocial functioning, but some
of the links between attachment and functioning
measures were moderated by independent cul-
tural orientation. Juang and Alaverz (2010) sur-
veyed 181 Chinese American adolescents and
their parents in Northern California and found
that perceived discrimination was associated
with greater loneliness, anxiety, and somatiza-
tion. Moreover, the link between discrimination
and distress was augmented by family conict
and buffered by family cohesion.
A few studies examined emotion-related be-
havior and distress among Asian Americans.
J. C. Chen and Danish (2010) examined the
relationship between acculturation and disclo-
sure of distress and emotions among 98 Asian
American college students. They found that less
behaviorally acculturated students were more
willing to disclose emotion to trusted adults, but
265 ANNUAL REVIEW
that values acculturation did not moderate the
relationship between acculturation and willing-
ness to disclose emotions to friends and other
trusted adults. Saw and Okazaki (2010) com-
pared the retrospective reports of family emo-
tion socialization experiences among Asian
American and White American college students
who reported subclinical levels of depression
and social anxiety in clinical interviews. White
students were more likely than Asian American
students to report being encouraged by their
parents to openly express emotions. Asian
American students were more likely than White
students to report being socialized by their par-
ents to suppress emotions, which, in turn, was
associated with greater emotional distress. Us-
ing an online survey method with college stu-
dents, Masuda, Wendell, Chou, and Feinstein
(2010) found, among Asian American students,
that greater tendency toward self-concealment
was associated with general psychological mal-
adjustment and decreased mindfulness. And in a
survey study with 506 undergraduates in a lab-
oratory anger-provocation study, with 28 Asian
American and a matched control sample of 28
European American undergraduates, Mauss,
Butler, Roberts, and Chu (2010) found that
Asian American participants reported less anger
than European American participants. Asian
Americans also displayed less anger behavior-
ally through facial expressions, gestures, or ver-
bal comments. However, there were not ethnic
differences in physiological responses. Ob-
served differences in anger responses were par-
tially mediated by endorsement of emotion con-
trol values.
Two studies examined psychological distress
among LGBT populations. Szymanski and
Sung (2010) surveyed 144 Asian American
LGBT persons online and found that multiple
minority stressors of being a racial and sexual
minority individual contributed to psychologi-
cal distress in this population. Outness was not
found to moderate or mediate the link between
internalized heterosexism and distress. Balsam,
Lehavot, Beadnell, and Circo (2010) also used
an online survey method to collect data from
669 LGB adults, of which 21% identied as
people of color. Asian American and Latino/a
participants reported the highest levels of child-
hood physical abuse, but Asian American LGB
individuals did not differ from White counter-
parts with respect to the link between childhood
abuse and adult mental health symptoms of
anxiety, depression, or post-traumatic stress dis-
order (PTSD).
Sabik, Cole, and Ward (2010) surveyed 905
college women, including 123 Asian Ameri-
cans, on body image and weight-related con-
cerns. Asian American women had the lowest
average BMI, but their drive for thinness and
weight-based contingency of self-worth did not
differ from that of European American women.
Higher drive for thinness in this group was
associated with low appearance esteem and a
sense of self-worth that was contingent on
weight. In a study of body satisfaction focused
on Hmong American children, Mulasi-Pokhri-
yal and Smith (2010) conducted a survey with
335 Hmong children, age 918, measuring their
height and weight. They also conducted focus
groups with 68 Hmong children to discuss
beauty ideals, body image, and weight con-
cerns. The ndings revealed that the body im-
age ideals among Hmong children closely
match those of American ideals of beauty and
attractiveness. The study also found that almost
half of the children in the study were either
overweight or obese, and one quarter was short-
statured (5th percentile in height for same-
aged children in the United States). Only a
minority of the sample was satised with their
bodies. Xie et al. (2010) conducted a secondary
analysis of 1-year longitudinal data on body
image and depression from a smoking preven-
tion trial in multiethnic middle school students
in Los Angeles, focusing on the data from 780
Hispanic and 375 Asian American students.
They found that among Asian American girls
and girls with high acculturation, being over-
weight in seventh grade predicted higher body
image dissatisfaction, which, in turn, was re-
lated to depressive symptoms in eighth grade.
Archambeau et al. (2010) examined self-
reported interpersonal violence victimization,
perpetration, and mental health outcomes in col-
lege students in rural Hawaii, comparing East
Asian Americans (Chinese, Korean, Japanese)
with Native Hawaiian/other Pacic Islanders,
Filipino Americans, and European Americans.
They found that exposure to physical violence,
sexual violence, and life stresses were predic-
tive of symptoms of psychopathology (depres-
sion, anxiety, PTSD, substance use). Consistent
with previous research, East Asian American
students were less likely than other ethnic
266 OKAZAKI, KASSEM, AND TAN
groups to report being victimized or to experi-
ence anxiety and substance-use problems. In a
qualitative study with South Asian American
women who had survived childhood sexual
abuse, Singh, Hays, Chung, and Watson (2010)
identied subthemes related to South Asian cul-
tural contexts as well as subthemes speaking to
their resilience strategies that contributed to the
meaning of childhood sexual abuse among the
women. Stronger cultural identication with
South Asian community appeared to be instru-
mental in the healing process for many of the
women.
Finally, a set of studies examined the rela-
tionship between discrimination and distress.
Using the NLAAS data, De Castro, Rue, and
Takeuchi (2010) examined whether Asian
Americans employment frustration due to ra-
cial discrimination was associated with reports
of physical health and mental health. Once Eng-
lish prociency and immigration factors were
taken into account, employment frustration was
not associated with physical health, but the re-
lationship persisted for mental health. In a study
of a smaller scale, Wei, Heppner, Ku, and Liao
(2010) conducted an online survey of 201 Asian
American college students at a predominantly
White university in the Midwest. They found
that above and beyond effects of general stress
and discrimination, reports of racial discrimina-
tion stress (or the extent to which effects of
racial discrimination negatively impacted their
lives) was associated with increased depressive
symptoms. Hahm, Ozonoff, Gaumond, and Sue
(2010) studied the association between per-
ceived discrimination and poor mental and
physical health among Asian American adult
women and men. A sample of Asian American
adults (1,075 women and 972 men) was exam-
ined from the NLAAS data. For both men and
women, a high level of perceived discrimination
showed stronger associations with mental
health than with physical health outcomes.
However, women had more negative mental
and physical health outcomes when exposed to
a lower threshold of discrimination than men.
Racism. We identied 24 articles that fo-
cused centrally on racism or discrimination ex-
periences among Asian Americans. We ac-
knowledge that some of the studies classied
here also examine psychological distress that
are correlated with racism or discrimination,
thus they could have been classied and sum-
marized just as well under psychopathology, but
the articles summarized here are those that were
centrally interested in the experiences or phe-
nomena of racism or discrimination.
Studies with adolescents and emerging
adults. Several studies examined discrimina-
tion experiences among Asian American chil-
dren and adolescents. Menzer, Oh, McDonald,
Rubin, and Dashiell-Aje (2010) examined be-
havioral correlates of peer exclusion and vic-
timization among 400 European American and
121 East Asian American sixth graders at the
beginning and the end of a school year. They
found that aggression was more strongly asso-
ciated with victimization for Asian American
students than for European American students.
Moreover, aggression was associated with in-
creased exclusion later in the school year for
Asian American girls but was associated with
decreased exclusion for Asian American boys.
In other words, being seen by peers as aggres-
sive seemed to be socially helpful for Asian
American boys. In contrast to the gender differ-
ences found by Menzer et al. (2010), Deng,
Kim, Vaughn, and Li (2010) examined self-
reported discrimination experiences of 311 Chi-
nese American high school students in Northern
California but did not nd gender differences.
In this study, the researchers found that the
relationship between discriminatory experi-
ences and delinquent behavior depended on the
adolescents cultural orientations. Those who
were low on Western cultural orientation or
high on Chinese cultural orientation were most
at risk for developing delinquent behavior when
they were victimized.
In a study with 165 Asian American ninth
and tenth grade students in the Southeast (where
Asian students comprised 68% in schools),
Thompson and Kiang (2010) asked the students
to rate the extent to which others assume they
possess the following characteristics of the
model minority stereotype: intelligent, quiet/
reserved, ambitious, courteous/polite, family
oriented, industrious/hardworking, talented in
classical music, likely to pursue a prestigious
career, and good at math and science. Interest-
ingly, although a number of the respondents
reported negative emotional reaction to being
stereotyped, those who reported being stereo-
typed with model minority characteristics also
reported more positive academic and psycho-
logical outcomes. In a series of studies, H. C.
267 ANNUAL REVIEW
Yoo, Burrola, and Steger (2010) reported on
initial psychometric features of a new measure
of internalized model minority stereotype. The
15-item Internalization of the Model Minority
Myth Measure (IM-4) is comprised of two sub-
scales (Achievement Orientation and Unre-
stricted Mobility) and assesses the extent to
which Asian Americans endorse positive but
racialized stereotypes about themselves. The
initial results, validated with Asian American
undergraduate students in the Southwest, sug-
gested that the IM-4 measure is a promising
measure with some evidence of discriminant,
convergent, and incremental validity. Unlike
Thompson and Kiangs (2010) sample, how-
ever, H. C. Yoo, Burrola, et al. (2010) found
that an internalized stereotype was associated
with distress symptoms. H. C. Yoo, Steger, and
Lee (2010) also reported on the validation of the
8-item Subtle and Blatant Racism Scale for
Asian College Students (SABR-A2), with satis-
factory 2-week testretest reliability, and dis-
criminant, convergent, and incremental validity.
In a pair of experimental studies, Kim-Prieto,
Goldstein, Okazaki, and Kirschner (2010) dem-
onstrated that exposure to racially stereotypical
American Indian sports mascot (in the form of
implicit and explicit priming) increased the
likelihood that college students endorse more
stereotypes about another ethnic minority
group, in this case about Asian Americans. This
effect was true for Asian American participants
as well as for White American participants,
suggesting the insidious power of racial stereo-
types even across ethnic groups.
Three studies focused on racial experience of
Asian Americans at colleges. Pieterse, Carter,
Evans, and Walter (2010) surveyed 289 multi-
ethnic undergraduate students at a mid-Atlantic
university, including 23% who identied as
Asian or Asian American, regarding discrimi-
nation and trauma symptoms. Asian students
reported higher levels of experienced discrimi-
nation than did White students but lower levels
compared with Black students. For Asian stu-
dents, a negative racial climate on campus was
associated with trauma-related symptoms,
above and beyond the effects of general distress
and perceived ethnic discrimination, whereas
for Black students, perceived discrimination
was a more powerful predictor of trauma-
related symptoms. Zanolini Morrison (2010)
conducted a qualitative study of 21 ethnic mi-
nority students at a predominantly White col-
lege. Although interview responses were ana-
lyzed across individuals for common themes,
rather than for ethnic-specic experiences, Za-
nolini Morrison (2010) noted instances in which
lighter-skinned students, including two Asian
American students, reported experiencing more
inclusion by White peers, which was interpreted
as being in the pre-encounter stage of ethnic
identity development (i.e., not seeing any rac-
ism). Finally, Hughey (2010) conducted an eth-
nographic study with 8 Asian American, 15
African American, and 8 Latino college stu-
dents who joined White fraternity or sorority
organizations at three university campuses on
the East Coast. Whereas African American and
Latino/a students reported that they were often
racially cast as best t for coordinating the
community service activities of the Greek orga-
nizations due to their presumed insight into
the underprivileged, Asian American students
were often praised for their intellectual skills
(e.g., raising the GPA of the organization) and
were viewed as providing the organization with
the appearance of inclusivity. The students also
reported being told, implicitly or explicitly, not
to racially segregate themselves on campus,
within and outside of the organization. How-
ever, Asian American and African American
students articulated their memberships in these
White Greek-letter organizations because of the
perceived career networking opportunities oth-
erwise unavailable to them.
Huynh and Fuligni (2010) examined the re-
lationship between discrimination and well-
being among 601 twelfth grade students in
Southern Californian schools that were ethni-
cally diverse. Of the 264 Asian American stu-
dents in the sample, the majority of students
(70%) were Chinese. Students completed daily
assessment of discrimination and well-being
for 14 days, and their reports were averaged
across 14 days. Huynh and Fuligni (2010) found
that Latino students reported more adult dis-
crimination than Asian American students,
who, in turn, reported more adult discrimination
than their European American counterparts.
Both Latino and Asian American students re-
ported more peer discrimination than did the
European American students. Boys also re-
ported experiencing more discrimination than
girls. Discrimination was also associated with
increased reports of physical symptoms, includ-
268 OKAZAKI, KASSEM, AND TAN
ing depression and psychological distress, lower
self-esteem, and lower GPA regardless of eth-
nicity or generational status.
Using racial identity theory as framework,
Iwamoto and Liu (2010) explored the rela-
tionship between racial identity, Asian cul-
tural values and belief systems (e.g., collec-
tivism, lial piety, humility), and race-related
stress in predicting psychological well-being
among 402 Asian American undergraduates.
The authors posited that individuals who re-
port high amounts of race-related stress and
who identify strongly with their racial group
might be able to minimize the negative effects
of discrimination by focusing on positive
characteristics of their racial group. Results
indicated that racial identity predicted Asian
American students well-being. Students who
endorsed low levels of Asian values and high
levels of conformity attitudes (i.e., idealizing
White culture and minimizing racial issues)
experienced lower well-being as the amount
of race-related stress increased.
Studies with adults. Gee and Ponce (2010)
studied the association of racial discrimination
and limited English prociency with health-
related quality of life in a large sample of Asian
American adults in California (total sample of
nearly 8,000), including Chinese, Filipino, Jap-
anese, Korean, South Asian, and Vietnamese
respondents. The researchers found that those
who reported racial discrimination or those who
had limited English prociency were more
likely to have poorer quality of life. In particu-
lar, discrimination experiences seemed to be
associated with reports of increased activity-
limitation days. Jang, Chiriboga, Kim, and
Rhew (2010) analyzed survey data from 472
Korean American older adults in Florida and
found that perceived discrimination was a sig-
nicant predictor of depressive symptoms
within this population. Further, the effect of
perceived discrimination on depression was
partially mediated through a lowered sense of
control.
In a multiethnic study of reactions to encoun-
ters with racism, Carter and Forsyth (2010) sur-
veyed, via the Internet, 260 ethnic minority
adults. Although very few ethnic differences
were found, those who reported being targets of
racial harassment and discrimination also re-
ported increased distress. Family support
around discrimination and nonreactive coping
were associated with better adjustment. Tran,
Lee, and Burgess (2010) examined the associa-
tion between discrimination and substance use
among immigrant adults in metropolitan Min-
neapolis, including 426 Southeast Asian adults.
They found that reported experiences of dis-
crimination were signicantly associated with
smoking among Southeast Asian immigrants
(as well as for the total immigrant sample), even
after controlling for the effects of gender, age,
education, poverty status, and years in the
United States.
Three studies examined racism-related expe-
riences among Filipino Americans. In one
study, Alvarez and Juang (2010) surveyed 199
Filipino American adults in the San Francisco
Bay Area and found that experiences with rac-
ism were associated with poorer mental health.
They also found that different types of coping
mediated this relationship for men and for
women. David and Okazaki (2010) examined
Colonial Mentality (CM), which is a more spe-
cic aspect of racism experienced by Filipino
Americans related to their internalized sense of
cultural inferiority due to centuries of White
colonialism of the Philippines. In a series of
three studies, the researchers demonstrated that
CM can be automatically and implicitly acti-
vated using a variety of sociocognitive tasks. In
a follow-up study, David (2010b) presented ini-
tial validation evidence for the CM Implicit
Association Test (CMIAT), a new assessment
of covert CM, with 102 Filipino American
young adults recruited online. Results suggested
that CMIAT appear to be a valid tool for as-
sessing the implicit, automatic component of
CM that moderated the association between
overt CM and mental health outcomes.
Two studies examined racism-related experi-
ences within South Asian American popula-
tions. In one study, Liang, Nathwani, Ahmad,
and Prince (2010) examined the relationship
between coping strategies used by 82 South
Asian American women in reaction to a dis-
crimination event and their subjective well-
being. The study found generational differ-
ences, where second-generation women
reported using more support compared with
rst-generation women, and that younger
women used more problem-solving coping than
older women. Ahluwalia and Pellettiere (2010)
conducted a qualitative phenomenological
study of ve Indian American Sikh men in the
269 ANNUAL REVIEW
New York City metropolitan area and their ex-
periences post-9/11. The men reported various
experiences surrounding racial discrimination
that were heightened by the 9/11 terrorist inci-
dent, where they found themselves targets of
oppression and discrimination (including verbal
and physical attacks) due to being misidentied
as Muslim, Arab, or a person of Middle Eastern
descent because of visible markers of their faith
(e.g., wearing a turban, uncut hair, and beard).
Finally, a phenomenological study of 11
Asian or Asian American evangelical Christian
female faculty members at Christian universi-
ties explored their experiences of discrimination
due to race and/or gender (C. L. Kim, Anderson,
Hall, & Willingham, 2010). Many of the faculty
women reported subtle forms of discrimination
on their campuses, which the women attributed
partly to the conservative (and, at times, pro-
vincial) nature of the campus faculty and stu-
dents, naivete surrounding diversity issues and
the denial that discrimination can occur on
Christian campuses, and a missionary mental-
ity that exists in the Christian subculture,
where non-White cultures and people are seen
as inferior and in need of westernization.
Stereotypes. Bavishi, Madera, and Hebl
(2010) conducted an experiment in which race,
gender, and discipline of ctitious college pro-
fessors curriculum vitae were manipulated to
examine the students perception of their aca-
demic credentials. Although Asian American
professors were seen as no less competent or
legitimate than White professors (and more so
than African American professors), they were
perceived as less interpersonality skilled. In a
series of experimental studies with White
American undergraduates, Yogeeswaran and
Dasgupta (2010) found that higher levels of
implicit belief about prototypical Americans be-
ing White was associated with decreased will-
ingness to consider hiring qualied Asian
Americans in national security jobs (but not in
corporate jobs) and with decreased support for
an immigration policy that was authored by an
Asian American policy writer. Participants po-
litical conservatism was found to magnify this
effect through suspicion of national loyalty of
Asian Americans.
Campbell and Herman (2010) analyzed a na-
tionally representative survey that contained
questions regarding attitudes toward multiracial
individuals. Although Asians comprised only
1% of the sample, the large total sample size
of 30,000 allowed for some ethnic comparisons.
Overall, the study found that racial minorities
(including Asians) tended to have more favor-
able attitudes toward multiracial individuals
than did Whites. Asians (and Latinos) were also
found to support afrmative action for multira-
cial individuals.
Stress and coping. We identied two stud-
ies that were centrally concerned with stress and
coping among Asian Americans. Y. J. Wong,
Kim, and Tran (2010) studied the relationships
among adherence to Asian values; attributions
about the cause of, and solution to, depression;
and preferred coping strategies in a nonclinical
sample of 238 multiethnic Asian American
sample. The studys results revealed that attri-
bution of cause fully mediated the relations
between adherence to Asian values and use of
coping strategies. Adherence to Asian values
was positively related to attributing the cause of
depression to internal factors. This was, in turn,
associated with greater use of disengagement
coping strategies and decreased use of engage-
ment coping strategies. Moreover, an internal
attribution for the solution to depressive symp-
toms was related to an increased likelihood of
relying on engagement coping strategies and a
lower use of disengagement coping strategies.
Studying stress and coping process within a
particular event, Y. Park, Miller, and Van
(2010) conducted a qualitative study three years
after hurricane Katrina to understand the expe-
rience of the Vietnamese American community
living in Biloxi, Mississippi. The authors aimed
to understand individual experiences and the
relationship of individuals to their collective
and social worlds. The qualitative study re-
vealed that the neighborhood and community of
Little Saigon was a signicant symbolic source
of identity and also a protected and familiar
space of residence, livelihood, and social con-
nections. The post-Katrina changes in the
neighborhood are changing participants expe-
riences of, and relationships to, their commu-
nity.
Women. As with other broad topical areas
such as immigrants and refugees or youth
that are based on demographic characteristics,
many of the 2010 research papers contained
discussions of gender as a variable in their stud-
ies. However, most of the studies were better
classied according to the central phenomenon
270 OKAZAKI, KASSEM, AND TAN
other than gender. Thus, we identied only one
study whose research question seemed to be
centrally concerned with the womens experi-
ence. In a qualitative study of three Cambodian
American women college students, Chhuon,
Kyratzis, and Hudley (2010) analyzed the wom-
ens life stories to understand their educational
experiences in light of gendered expectations
that had not traditionally included educational
achievement. The main themes emerging from
the narratives concerned reconciling their fam-
ily obligations and their individual wishes for
greater independence.
Youth. We classied six articles that were
primarily focused on Asian American youths.
Articles that studied a specic issue that could
be classied elsewhere, but with the youth pop-
ulation (e.g., substance use among youth, edu-
cational issues in adolescents), were not
included. The articles that remained were con-
cerned primarily with youth development and
developmental trajectories. Benner and Kim
(2010) examined the Family Stress Model
(Conger & Donnellan, 2007) with 444 Chinese
American middle-school students and their par-
ents in Northern California. The Family Stress
Model states that a familys economic hardship
inuences childrens developmental outcomes
indirectly through family processes. The analy-
sis found that, for both mothers and fathers,
economic status indicators (income; nancial
and job stability) affected their childrens de-
velopmental outcomes through indirect means.
Parents economic stress was related to parental
depressive symptoms and parental ghting,
which was associated with more hostile and
coercive, and less nurturing, parenting, which,
in turn, was associated with their childrens
academic and sociobehavioral outcomes.
N. A. Wong (2010) conducted a 15-week
ethnographic study of seven youth and four staff
members at a youth community center located
in a Chinatown in an East Coast city serving
low-income Chinese American youth. Qualita-
tive analysis of the data revealed that these
Chinese American middle-school students, who
were low-income urban immigrants, often felt
uncared for by their parents and other adults in
their lives (e.g., teachers and school administra-
tors). The community-based organization pro-
vided the youth with the social and emotional
support they felt were lacking in their lives,
such as a sense of trust and caring, a sense of
belonging, and a safe place where their ethnic
identity and a sense of self are nurtured. In
another study, based on interviews, surveys, and
participant observations of 42 Korean American
students in a academic magnet high school
and 30 Korean American high school dropouts
in a GED program in New York City, Lew
(2010) explored the role of ethnic networks in
their postsecondary and work options. Lew
(2010) found that high-achieving students made
ample use not only of school-based resources
toward college entrance but also tutors and
counselors at private afterschool academies
(hagwon) in their ethnic network. In contrast,
low-achieving students used their ethnic net-
works to nd low-status menial jobs in ethnic
enclaves (e.g., nail salons). Thus, class gured
largely in the divergent uses of ethnic networks
in Korean American youths.
Vazsonyi and Chen (2010) analyzed data
on 2,754 low- to low-middle-class children and
adolescents, collected in the Tucson metropoli-
tan area in the 1990s, to examine ethnic differ-
ences in entry risk into the juvenile justice sys-
tem. Although the sample included only 36
Asian American youth, researchers found that
entry risk pattern was not different across the
ethnic groups except in the case of Hispanic
youth. C. K. Baker and Helm (2010) conducted
a focus-group study with 51 high school stu-
dents in Hawaii, including 17 Filipino
youth, 16 Native Hawaiian youth, and 18 Sa-
moan youth, regarding their denition of teen
dating violence. The data revealed that these
Asian and Pacic Islander youth tended to re-
gard some controlling behavior (e.g., use of cell
phones and the Internet to monitor and exert
control over their dating partners) as below the
threshold for their denition of dating violence.
Filipino and Samoan girls also reported that
because parents forbid them to date, many of
their peers do so behind the parents backs,
particularly using social media. C. K. Baker,
Hishinuma, Chang, and Nixon (2010) examined
the relationship between stressful life events,
drug use, and self-reported violence perpetra-
tion among 293 Native Hawaiian, Samoan, and
Filipino adolescents. The studys results re-
vealed that gender differences were present in
several stressful life-event items. This included
boys reporting more physical victimization and
more life threatening illnesses and injuries than
girls. The results also revealed that stressful life
271 ANNUAL REVIEW
events were linked to higher rates of violence
perpetration for all groups. Specic types of
stressful life events were found to be signicant
for some groups. The authors concluded that
further research was necessary to explore and
examine other risk factors and protective factors
that may gauge the relationship between life
stressors and engaging in violent behavior.
Miscellaneous topics. There were three
empirical studies that investigated psychologi-
cal experiences of Asian Americans yet did not
t easily into any of the existing topic areas. In
one study, H. Lee and Kim (2010) examined the
relationship between bilingualism and creativity
among 116 Korean American students between
the ages of 7 and 18 attending a private Satur-
day school for language and cultural instruction.
The results suggested that the degree of bilin-
gualism, as assessed by an objective test of
bilingualism using word associations, was pos-
itively correlated with an adaptive creative style
and creative strengths but not an innovative
creative style. In another study, Goto, Ando,
Huang, Yee, and Lewis (2010) compared Asian
American and European American undergradu-
ates in their cognitive processing of target visual
objects with backgrounds that were semanti-
cally congruous or incongruous. An N400
event-related potential analysis was conducted
on the electroencephalogram measurement to
assess the degree of attention allocated to fore-
ground versus background objects. The ndings
suggested that Asian Americans, especially
those with higher independent self-construal
scores, processed the foregroundbackground
relationships to a greater extent (i.e., more ho-
listically) than did European Americans. Fi-
nally, using qualitative methods, Sim et al.
(2010) investigated the relationship between
problems and action ideas expressed in dreams
of seven rst-generation and seven second-
generation Asian American female college stu-
dents who had participated in single 90-min
individual dream sessions. All students were
paired with Asian American female therapists.
Interpersonal issues and academic and career
issues were typical of both generational cohorts,
but rst-generation women also disclosed con-
cerns related to immigration and cultural adjust-
ment issues, as well as health concerns. First-
generation women were also more likely to
propose changing thoughts and feelings, as well
as making behavioral changes, to solve the
problems raised in the dreams.
Discussion
Content Trends
One of the signicant ndings in the 2010
review was the identication of a large num-
ber of studies in health and health-related
behaviors. In particular, cancer screening and
management, substance use, and health infor-
mation and insurance were the most active
areas of research with various Asian Ameri-
can communities. In the 2009 review (B. S. K.
Kim et al., 2010), 25% (34 of 134) of the
articles were concerned with health and
health-related behaviors, whereas our 2010
review identied 33% (86 out of 261) falling
under this topic. The increase in the relative
proportion of articles in this topic area may
suggest a trend in which health-related re-
search becomes an increasingly important
area of Asian American behavioral science
research. Of note, our review suggested that
health-related research employs both quanti-
tative and qualitative methods (including
community-based participatory research) and
involves many ethnic communities that are
underrepresented within Asian American psy-
chological research (e.g., Hmong and Cambo-
dian populations, older adults, low-income
urban populations).
We also note that the 2010 publications rep-
resent a considerable diversication in partici-
pant characteristics. Nearly a decade ago, Uba
(2002) critiqued the knowledge base of Asian
American psychology as privileging the expe-
riences of middle-class East Asian American
college students. It is noteworthy that a majority
of the articles in the present review employed
community-based samples. Whereas aggregate
Asian American college student samples re-
mained the mainstay in some areas (e.g., coun-
seling psychology), we found an increasing
number of studies examining the psychological
experiences of specic Asian American ethnic
groups that have traditionally been understud-
ied, such as Filipino, Southeast Asian, and
South Asian communities, immigrants with lim-
ited English prociency, low-income individu-
als, children and adolescents, older adults, and
sexual-minority individuals. Although the in-
272 OKAZAKI, KASSEM, AND TAN
crease in diversication is encouraging, such
studies were nonetheless the minority in the
current review, highlighting a continual need of
the eld to focus on underrepresented segments
of the Asian American population.
Methodological Trends
Quantitative methods using correlational de-
sign continued to be dominant in Asian Amer-
ican psychology papers published in 2010, as it
had also been reported in the 2009 review.
Moreover, our review suggested that increasing
numbers of survey data appeared to be collected
using online survey technology. However, a
majority of the reviewed articleseven those
using online methodstended to be conducted
only in English, despite current demographics
suggesting that many Asian Americans are not
English uent. Given that online survey tech-
nology may increase the likelihood of reaching
Asian American participants who had not pre-
viously had opportunities to participate in re-
search studies, technological advances (e.g.,
touch-controlled computer pads) may be em-
ployed in innovative ways (e.g., in conjunction
with online translational services) to improve
the inclusion of limited-English-speaking (or
less literate) segments of the community in fu-
ture studies.
Despite a wide array of coded topics, the
current review revealed that the majority of
health and mental health studies of Asian Amer-
ican communities continue to employ correla-
tional methods. Experimental methods using
random assignment to examine causal relation-
ships constitute a small minority of the pub-
lished work in Asian American psychology. As
the eld expands, experimental methods are
necessary and important approaches by which
to answer key questions. For example, much
remains to be understood regarding effective
ways to reduce disparities in access to health
and mental health care, which is a long-standing
problem that has yet to see signicant progress.
Experimental studies that assign Asian Ameri-
can individuals to various prevention or inter-
vention strategies would build our knowledge
base. Linkages that have been found through
correlational studies between race-related stress
(e.g., stereotypes, discrimination, racial micro-
aggression) and its putative negative effects
could also be studied experimentally to better
understand the causal mechanisms involved.
Another methodological pattern worth noting
is that secondary analyses of large data sets
containing Asian Americans continue to domi-
nate the literature on certain topics. As previ-
ously mentioned, the NLAAS has proven to be
a treasure trove for Asian American social
science research. The number of NLAAS pub-
lications has increased in each of the past 3
years. Notably, because many of the big pic-
ture questions about patterns of prevalence of
major mental disorders and the sociodemo-
graphic correlates of mental disorders have al-
ready been examined in earlier publications
prior to public release, the trend is for the
NLAAS publications to examine much more
specic questions. For example, over the years,
there are separate publications that have exam-
ined the relationship between perceived dis-
crimination and various forms of health and
mental health outcomes, such as smoking (D. H.
Chae, Takeuchi, Barbeau, Bennett, Lindsey, &
Krieger, 2008), alcohol disorders (D. H. Chae,
Takeuchi, Barbeau, Bennett, Lindsey, Stoddard,
et al., 2008), mental health service use (Spencer
et al., 2010), 12-month DSMIV mental disor-
der prevalence rates (G. C. Gee, Spencer, Chen,
Yip, & Takeuchi, 2007), health outcomes
(Hahm et al., 2010), BMI and obesity (G. C.
Gee, Ro, Gavin, & Takeuchi, 2008), accultura-
tive stress (Lueck & Wilson, 2010), use of com-
plementary and alternative medicine for mental
health problems (N. G. Choi & Kim, 2010),
suicide attempts (Cheng et al., 2010), and so on.
Of course the scientic merit of each publica-
tion must be evaluated with respect the unique
contribution it makes to the understanding of
respective phenomena. However, it is also im-
portant that the eld of behavioral scientists, as
a collective, be mindful of the problematic is-
sues related to piecemeal publications (e.g., see
Drotar, 2010).
Number of Research Papers
Because the goal of literature reviews is to
provide a gauge of the most recent trends in
published empirical research in our discipline
rather than to facilitate year-to-year compari-
sons across summative reviews, we caution
against making direct comparisons between the
2009 and 2010 reviews. However, given that the
273 ANNUAL REVIEW
current review identied 261 research articles
about Asian Americans published in 2010,
which is nearly double those identied and re-
viewed for 2009, some discussion regarding the
number of empirical papers is warranted. We
have several hypotheses regarding the large
number of research papers identied in 2010, as
it is unlikely that these gures represent an
actual twofold increase in research production
from one year to another. Indeed, a previous
analysis of a 10-year trend between 1991 and
2000 in the number of publications in which the
term Asian Americans is listed as a keyword
found a steady increase each year, with one year
(1997) serving as an outlier in an otherwise
linear rate of increase (see Okazaki, 2002, Fig-
ure 1.1). We argue that a number of contributing
factors may have converged in 2010: (a) the
initiation of the Asian American Journal of Psy-
chology, (b) journal special issues, (c) in-
creased access to large archival data, (d) ex-
tended search periods, and (e) artifactual factors
in the PsycINFO database.
First and foremost, the inaugural volume of
Asian American Journal of Psychology was
published in 2010, and of the 25 articles in-
cluded in the rst volume, 19 were research
articles. Second, at least two journals published
a special issue on Asian Americans during
2010. The March issue of the Journal of Family
Issues contained six research papers, and the
May issue of American Journal of Public
Health contained seven papers. Together, these
three specialty collections represent 32 papers.
Of course these same research papers might
have been published in other journals in 2010 if
these outlets had not been available. However,
special issues and a journal focused on the
Asian American population likely attracted new
submissions as well as reviewers who were
assembled with particular expertise in the eld,
facilitating new publications.
Third, we believe that the public release of
the NLAAS data in June 2006 may have con-
tributed to the increased number of publications
in 2010. This data set, containing the most na-
tionally representative psychiatric epidemiolog-
ical data to date on 2,095 Asian American
adults, also contains a large number of demo-
graphic, social, and psychological variables, as
well as service usage and health-related data. As
more researchers learn of the availability of the
NLAAS data for secondary analysis, we would
expect the number of publications based on the
NLAAS data to rise until some saturation point
at which no new research questions can be
answered with the data. As a conservative test
of this hypothesis, we conducted a PsycINFO
search with National Latino and Asian Amer-
ican Study or NLAAS in the abstract cate-
gory, with a caveat that not all NLAAS-based
papers may have included these terms in the
abstracts. The overall search identied 53 peer-
reviewed articles published through December
2010. There were 18 NLAAS publications in
2007 (likely representing research conducted
prior to public release), seven in 2008, eight in
2009, and 16 in 2010. We note here that the
number of NLAAS publications doubled be-
tween 2009 and 2010, mirroring the increase in
overall research publications we observed be-
tween 2009 and 2010.
Fourth, although the present review of 2010
publications aimed to follow the 2009 review
(B. S. K. Kim et al., 2010) in method and scope,
there were some differences in the two reviews
in the methods used to include or exclude arti-
cles. Whereas the 2009 annual review team
conducted their second and nal search of the
database in March 2010, we continued to search
the PsycINFO database for 2010 publications
through the end of June 2011. We were sur-
prised to nd that a signicant number of jour-
nal issuesespecially those published in the
last quarter of the yeardid not appear in the
online database until May or June. In addition,
the review teams for the 2009 and 2010 publi-
cations may have used the selection criteria
differently. For example, the three criteria for
evaluating whether a study focused on Asian
Americans used by the two teams may have left
some room for subjective interpretation of the
criteria (e.g., what constitutes the majority of
participants?). These methodological differ-
ences in the identication of articles may par-
tially account for the numerical increase from
2009 to 2010.
Finally, the dynamic nature of the PsycINFO
database may have played some role in coding
error. Because PsycINFO is updated weekly,
the number of abstracts identied with the same
search criteria varies as frequently as weekly.
Moreover, the chronological position in which
the identied abstracts appear in the search re-
sults could also vary weekly. These particular
features of the PsycINFO search process in-
274 OKAZAKI, KASSEM, AND TAN
crease the likelihood that a new article may
appear within the search results but become
buried within the large number of hits. Be-
cause the present review of 2010 articles per-
formed multiple searches throughout the rst
half of 2011, and checked against the existing
database, it is possible that we found additional
papers that may have gone undetected had we
engaged in a fewer number of searches.
Limitations
Although we aimed to conduct a comprehen-
sive review of empirical papers published in
2010 on topics in Asian American psychology,
there are several limitations. First, whereas we
conducted a comprehensive review of the 2010
publications that met our inclusion criteria,
these inclusion and exclusion criteria were not
necessarily based on conceptual grounds. For
example, we excluded studies in which Asian
Americans were included as participants in the
study (sometimes in sizable numbers) but were
aggregated into larger ethnic minority grouping.
Consequently, the count of 261 empirical pub-
lications in 2010 must be understood as a some-
what conservative estimate of the extent to
which Asian and Pacic Islander populations
are represented in behavioral sciences research.
We also excluded studies with Pacic Is-
lander participants (unless the study also in-
cluded Asian American participants) and Asian
Canadians, and studies published in non-
English publications. This reviews exclusion of
studies with Pacic Islander participants is con-
sistent with the separation of Pacic Islanders
from Asian Americans in the federal standards
for collecting and reporting race and ethnicity.
This federal standard for data on race and eth-
nicity has been in place for over a decade, with
the 2000 and 2010 census statistics available
separately for Asian Americans and Pacic Is-
landers. (Prior to 1997, Asians and Pacic Is-
landers were aggregated into one race/ethnicity
classication.) Such a federal-level change in
how the ethnic groups are aggregated or disag-
gregated is likely a culmination of political ad-
vocacy as well as the emerging understanding
of the distinctive psychosocial challenges fac-
ing Pacic Islander populations (who are his-
torically indigenous to the United States) versus
Asian American populations (who continue to
be largely immigrant; see, e.g., Sarnquist et al.,
2010). Nevertheless, given the current reviews
focus only on Asian American populations, a
separate periodic review of behavioral science
literature on Pacic Islanders would ll an im-
portant gap.
In following the 2009 annual reviews topic
areas, we did not code for disability issues, yet
we noted that at least four studies (Jegatheesan,
Fowler, et al., 2010; Lin, 2010; Lo, 2010; Sage
& Jegatheesan, 2010) were concerned with
Asian American families whose children or
older adults were faced with disabilities. There
are likely additional topical categories that
could be applied to studies covered in the pres-
ent review.
A number of articles tended to use South
Asian American as an ethnic label without
providing further ethnic identiers (e.g., Asian
Indian, Pakistani, etc.), which presented coding
challenges with respect to participant character-
istics. Scholars have noted that, outside the In-
dian subcontinent, in diasporic sites such as the
United States, Canada, and the United King-
dom, cultural forces are drawing together not
only Indians and Pakistanis but also Afghans,
Bangladeshis, and sometimes even Sri Lankans
and Nepalese into a pan-South Asian diasporic
communal and political alliance (e.g., Leonard,
2000). At the same time, South Asian popula-
tions are culturally, religiously, and linguisti-
cally heterogenous in comparison to many of
the other Asian ethnic groups, such as Korean
Americans or Filipino Americans. (Of course
the same can be said of the Chinese diasporic
population as well.) As amply demonstrated by
the studies on ethnic identity covered in the
present review, ethnicity is a uid, socially con-
structed, and context-dependent construct. As
the eld of Asian American psychology ad-
vances, researchers must continue to be mindful
of the psychological meaning of ethnicity for
Asian American individuals and communities
represented in our research studies.
Books. Although the present review is lim-
ited to empirical papers published in peer-
reviewed journals in 2010, any effort to track
scholarship in Asian American psychology
would be remiss to not mention the publication
of books on the topic. We identied four books
published in 2010 that were specically about
psychological topics among Asian Americans.
Notably, these books are not the comprehen-
sive handbook-type volumes but are con-
275 ANNUAL REVIEW
cerned with more specic populations (i.e.,
Filipino Americans, families with adoles-
cents, men) or a specic aspect of psychology
(i.e., neuropsychology), suggesting that the
eld has matured sufciently to offer schol-
arship in more specialized and advanced top-
ics.
Nadal (2010) published a companion volume,
Filipino American Psychology: A Collection of
Personal Narratives, to his 2009 publication on
Filipino American psychology that focused on
psychological theory and research. This 2010
publication is an edited book containing rst-
hand narratives of Filipino Americans. Russell,
Crockett, and Chao (2010) coedited and coau-
thored a volume titled Asian American Parent-
ing and Parent-Adolescent Relationships, con-
taining papers that examine empirical literature
on parenting measures, parenting beliefs, and
parentadolescent relationships. Liu, Iwamoto,
and Chae (2010) coedited a clinical text titled
Culturally Responsive Counseling with Asian
American Men, which contains chapters on a
wide span of clinical topics, ranging from gen-
dered racism, masculinity, fatherhood, career
development, domestic violence, interracial re-
lationships, substance abuse, and so on. Finally,
Fujii (2010) edited a 19-chapter book titled The
Neuropsychology of Asian Americans, which
contains a review of neuropsychology for each
of the major Asian American ethnic groups
(Vietnamese Americans, Thai Americans, Chi-
nese Americans, etc.) as well as a review of the
state of the art in Asia (India, Korea, Malaysia,
Singapore, etc.). This book contains historical
and demographic information on each ethnic
group, which may prove useful to clinicians
treating Asian American populations, even
without the use of neuropsychological tests.
Conclusions
Our review of empirical papers published in
2010 in Asian American psychology revealed
an active and growing eld of research.
Whereas health and mental health research con-
tinued to dominate the eld, we found an im-
pressive degree of diversity in topics, ethnicity
and age cohorts, settings, and methods. Given
the broad-based review of empirical research
published in 2010, we offer sets of recommen-
dations for (a) future research in Asian Ameri-
can psychology, and (b) future annual reviews
of Asian American psychology.
Future Research in Asian American
Psychology
Asian American psychological and behav-
ioral science literature continues to rely heavily
on quantitative methods using correlational de-
signs on data that are entirely self-reported and
cross-sectional. Although sophisticated multi-
variate statistics are increasingly employed to
analyze these correlational data, there are also
limits to the conclusions that can be drawn
based on this method. We recommend that re-
searchers consider diversifying their methods to
include mixed-method approaches (combining
qualitative and quantitative data); experimental
designs, when appropriate; non-self-report
sources of data; longitudinal designs, when ap-
propriate; and so on.
With respect to the ethnic representation of
published research in the eld, we continue to
see the relative paucity of research on South
Asian American and Southeast Asian American
ethnic groups. More research of these underrep-
resented groups is needed. On the other hand,
there continues to be a large proportion of re-
search in the eld that aggregates across various
ethnic groups into a pan-Asian American group,
often without an articulation of the theoretical
rationale allowing for such racial grouping. We
recommend that future research consider and
articulate the rationale for examining the partic-
ular research question with the particular set(s)
of the Asian ethnic population.
Asian American psychology has traditionally
been dominated by research in clinical and
counseling psychology. Although the present
review found that a large proportion of behav-
ioral science literature is concerned with health
and health-related behavior studies, the remain-
der of the published research continues to focus
on topics related to psychopathology (largely
studied at the level of mild severity) and coun-
seling or clinical issues (with only two out of 20
studies examining actual psychological inter-
vention). We believe that more research is
needed on normative development or interper-
sonal processes that are not implicated in path-
ological processes, on the one hand, and on
research that involves psychological interven-
276 OKAZAKI, KASSEM, AND TAN
tion or prevention of more severe psychopathol-
ogy, on the other.
Future Annual Reviews of Asian American
Psychology
Future annual reviews may benet from a
shortened, more synthetic approach to the liter-
ature review. Although detailed reviews of re-
search studies, such as the ones provided in this
review, offer both the depth and the breath of
coverage of empirical publications, the eld
will likely continue to grow at a fast pace,
making the prospect of detailed annual reviews
unsustainable. An alternative format for annual
reviews would be to conduct regularized (but
perhaps not annual) reviews of specic topic
areas in Asian American psychology (e.g.,
health and health-related behaviors or psy-
chopathology). However, the eld is still likely
to benet from some reporting of the number,
content, and types of empirical publications on
an annual basis.
Future annual reviews may extract additional
information about participant characteristics.
For example, it may be useful to code for the
sample size of each ethnic group (e.g., total
number of participants in historically underrep-
resented Asian ethnic groups or total number of
participants in various age cohorts) to track the
under- and overrepresentation of specic seg-
ments of the population. Such coding, of course,
would be complicated by the fact that multiple
papers are published (often within the same
year) on the same data set. However, the effort
may still be worthwhile in order to better un-
derstand the populations in which the knowl-
edge base is being built.
Final Thoughts
We conclude with a consideration of what
constitutes the psychology of Asian Americans.
Although we did not code for the disciplinary
afliations of the authors of the 261 articles
reviewed in this article, we speculate that the
majority of the publications reviewed here were
not generated by psychologists. This fact re-
ects both our methodology in identifying the
studies as well as the blurred boundaries be-
tween psychology and allied disciplines. Psy-
cINFO is the premier searchable database of
publications in psychology, but the database
covers nearly 2,500 journals across a wide
range of allied disciplines, including medicine,
law, social work, neuroscience, business, nurs-
ing, forensics, engineering, and beyond. Future
research might combine methods both across
disciplines and within psychology as well.
Asian American psychological research can
benet from contributions across social, exper-
imental, neurobiological, and developmental
psychology. These methods combine to offer a
unique perspective into common psychological
phenomena. We contend that Asian American
psychology remains a unique and growing eld,
evolving over time and with accumulated
knowledge. As the evidence base continues to
expand, quantitative syntheses and summative
reviews are essential in offering coherent con-
clusions to key research questions in advancing
the eld of Asian American psychology.
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Received July 14, 2011
Revision received November 1, 2011
Accepted November 2, 2011
290 OKAZAKI, KASSEM, AND TAN