(PS8-15) A Closer Look at the Immigrant Paradox: Suicide and Self-harm Risk Amongst Asians in the United States

Abstract Text: Although Asian Americans have long played an integral role in the cultural landscape of the United States, a focus on Asian American mental health has only just come to the forefront of the field. Overall, Asian Americans tend to have worse mental health outcomes and lower mental healthcare utilization than their Caucasian counterparts (Sue et al., 2012). Consistent age effects have also been found; older Asian adults have higher rates of depression, and endorse higher levels of stigma against mental healthcare, than elderly individuals of other ethnicities (Mui & Kang, 2006). Additionally, children of immigrants and immigrants who spend more time in their host country (thus having more time to integrate culturally) tend to have worse mental and physical health outcomes than new immigrants, a phenomenon known as the "immigrant paradox". While there are many studies that examine the immigrant paradox in relation to general mental wellbeing, there are few that focus on both suicidality (SI) and self-harm (NSSI) in a sample of Asian participants residing in the U.S.

The present study seeks to understand the extent to which the immigrant paradox may replicate in a sample of Asians residing in the U.S. In line with the immigrant paradox, we propose that American cultural integration will be positively associated with SI, NSSI, and positive beliefs regarding mental health treatment. Age will moderate these effects; for older participants, integration will be more weakly associated with SI, NSSI, and attitudes towards treatment. A snowball sampling procedure was employed for participant recruitment via social media (e.g., Reddit) and garnered n = 399 respondents, who were all adults aged 18 and over, identified as “Asian”, and resided in the U.S. Participants dropped from the sample (n = 182) included those who responded incorrectly to two or more attention checks, whose survey responses indicated that they did not meet criteria for the study, and those who completed the survey in less than five minutes, leaving a total of n = 217 participants in the final sample.

A series of bivariate correlation analyses and moderation analyses using bias-corrected bootstrapping were conducted, consistent with recommendations from Preacher and Hayes (2008). In support of our hypotheses, integration with American culture was positively correlated with positive attitudes towards mental health treatment (r = 0.63, p < 0.001) and NSSI (r = 0.23, p = 0.002). Contrasting predictions, integration was not statistically significantly correlated with suicidal ideation (r = -0.14, p = 0.06). Additionally, contrasting predictions, age did not statistically significantly moderate any of these relationships.

The current work contributes to the still-growing literature on Asian American SI and NSSI. While many studies on mental healthcare stigma in Asian American populations examine it in the context of cultural beliefs, this study also evaluates SI and self-harm as they relate to cultural integration. Finally, this study adds to the field's body of work on the immigrant paradox in Asian Americans by evaluating SI and NSSI, specifically. Most prior research focused on general mental health outcomes.