Testing the Influence of Cultural Determinants on Help-Seeking Theory

摘要

Despite increased risks for mental health problems, East Asian immigrant women have the lowest overall service-utilization rates of any cultural group in the United States. Although the influence of cultural processes as the cause of low service use is widely speculated, no empirical study has tested cultural determinants (including culturally specific idioms of distress, culturebased illness interpretations, or concerns about social consequences), social contextual factors, perceived need (PN), and help-seeking (HS) behaviors. In the present study, we examined how cultural determinants, such as symptom experience, beliefs and interpretations, and perceptions about the social environment, affect PN and HS type for Japanese women living in the United States. Increasing physical symptom severity increased the predicted probability of endorsing PN. For those participants with PN, 48.6% of them used medical HS (chi(2) = 11.27, p = .00), and 12.5% of them used the psychological HS (chi(2) = 7.43, p = .01). Multivariate logistic regression revealed that, when PN is considered with the other cultural variables while controlling for structural variables, PN increases the odds of medical HS (OR = 2.78, 95% CI [1.0-5.8], p .01). The odds of medical HS are also increased with higher social support (OR = 1.07, 95% CI [1.0-1.1], p = .01). Finally, the presence of interpersonal stigma beliefs decreased the odds of medical HS (OR = 2.4, 95% CI [1.1-5.3], p = .03). Clinical and research implications are discussed.