Cultural Diversity and Ethnic Minority Psychology Bicultural Identity Harmony and American Identity Are Associated with Positive Mental Health in U.S

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Cultural Diversity and Ethnic Minority Psychology Bicultural Identity Harmony and American Identity Are Associated With Positive Mental Health in U.S. Racial and Ethnic Minority Immigrants Aleksandr A. Tikhonov, Adriana Espinosa, Que-Lam Huynh, and Deidre M. Anglin Online First Publication, February 28, 2019. http://dx.doi.org/10.1037/cdp0000268

CITATION Tikhonov, A. A., Espinosa, A., Huynh, Q.-L., & Anglin, D. M. (2019, February 28). Bicultural Identity Harmony and American Identity Are Associated With Positive Mental Health in U.S. Racial and Ethnic Minority Immigrants. Cultural Diversity and Ethnic Minority Psychology. Advance online publication. http://dx.doi.org/10.1037/cdp0000268 Cultural Diversity and Ethnic Minority Psychology

Bicultural Identity Harmony and American Identity Are Associated With Positive Mental Health in U.S. Racial and Ethnic Minority Immigrants

Aleksandr A. Tikhonov and Adriana Espinosa Que-Lam Huynh The City College of New York, CUNY California State University, Northridge

Deidre M. Anglin The Graduate Center and The City College of New York, CUNY

Objectives: In this study, we examined the association of ethnic and American identity with depression and anxiety and whether this relation is mediated by Bicultural Identity Integration. Method: We ϭ ϭ recruited racial and ethnic minority immigrant college students (N 766, Mage 19.89, 60.4% women, 19.8% Black, 34.2% Hispanic, 36.6% Asian, and 9.4% other) who completed a series of self-report questionnaires. Participants answered questions relating to their ethnic and American identities, the degree to which these identities are compatible (i.e., Bicultural Identity Integration; BII), and presence of depression and anxiety symptoms. We conducted hierarchical linear regressions to test the direct relations between ethnic and American identity, BII, and depression and anxiety symptoms. We used bootstrapping to test the mediating role of BII. Results: Our analyses showed significant negative associations between American identity and BII cultural harmony with depression symptoms. BII cultural harmony was also negatively associated with anxiety symptoms. BII cultural harmony mediated the relations between American identity and both depression and anxiety symptoms. Conclusions: Perceived compatibility between ethnic and American identities is seemingly important for understanding the relation between national identity and mental health among racial and ethnic minority immigrants. However, longitudinal research designs would help assess causality in the relations found herein.

Keywords: bicultural identity, ethnic identity, American identity, mental health, immigrants

Mental health issues, such as depression and anxiety, frequently health in this vulnerable population. Accordingly, substantial re- stem from stressors associated with migration and adaptation search has focused on identifying protective cultural factors rele- (Flores et al., 2008; Lee, Koeske, & Sales, 2004). This is especially vant to REM immigrants. One such factor often examined is ethnic true for racial and ethnic minority (REM) immigrants (80% of identity; however, empirical research investigating the protective first- and 56% of second-generation U.S. immigrant adults; Pew effect of ethnic identity on mental health has been mixed (Pascoe Research Center, 2013), who also frequently experience race- or & Smart Richman, 2009; Umaña-Taylor, 2011). This may be due ethnicity-based discrimination, a factor known to affect depre- to the fact that extant research frequently overlooks other aspects ssion and anxiety (Pascoe & Smart Richman, 2009; Schmitt, of cultural identification that are relevant to mental health among Branscombe, Postmes, & Garcia, 2014). Currently, first- and REM immigrants. In the present study, we examine ethnic identity second-generation immigrants represent approximately 14% and more critically by also examining how its relation to American 12% of the U.S. population respectively, with the percentage of identity, and moreover, its integration with American identity, is both expected to rise to 18% by 2065 (Pew Research Center, associated with depression and anxiety among U.S. REM immi-

This document is copyrighted by the American Psychological Association or one of its allied2015). publishers. Given the rapid growth of immigrants in the U.S., it has grants.

This article is intended solely for the personal use ofbecome the individual user and is not to be disseminated broadly. increasingly important for community leaders and mental health professionals to understand factors that could bolster mental Ethnic Identity and Mental Health Ethnic identity refers to an individual’s subjective sense of membership in an ethnic group (Phinney & Ong, 2007). It is a multifaceted construct that includes self-identification with, a sense of belonging Aleksandr A. Tikhonov and Adriana Espinosa, Psychology Department, to, and attitudes toward an ethnic group (Phinney & Ong, 2007). The City College of New York, CUNY; Que-Lam Huynh, California State Ethnic identity is said to contribute more significance to the overall University, Northridge; Deidre M. Anglin, Psychology Department, The identity of ethnic minorities and immigrants (Phinney, 1996), and to Graduate Center and The City College of New York, CUNY. Data from this study will not be made public but is available upon contribute more to their well-being relative to the White majority request. This study was not preregistered with any institutional registry. (Smith & Silva, 2011). More specifically, strong ethnic identity is Correspondence concerning this article should be addressed to Alek- theorized to support a healthy self-esteem (Umaña-Taylor, 2011) and sandr A. Tikhonov, 160 Convent Avenue, NAC, Room 7/304, New York, protect against the deleterious effects of discrimination among REM NY 10031. E-mail: [email protected] individuals (Branscombe, Schmitt, & Harvey, 1999). For these rea-

1 2 TIKHONOV, ESPINOSA, HUYNH, AND ANGLIN

sons, strong ethnic identity is frequently conceptualized as a protec- depression symptoms. For Latino adolescents in the same study, tive factor for mental health issues among immigrant and REM only strong U.S. collective self-esteem was associated with anxiety populations. and depressive symptoms and, unlike the Asian American adoles- Although the empirical research examining the direct relation cents, more anxiety and depressive symptoms. Given these and between ethnic identity and mental health has yielded some mixed other findings, some have argued that the process of navigating findings (Umaña-Taylor, 2011), overall there are well-documented two cultural identities is inherently difficult and might lead to associations between ethnic identity and positive mental health. stress and identity confusion (e.g., Rudmin, 2003). For instance, studies in the U.S. have shown strong ethnic identity is associated with fewer depressive symptoms among REM high Bicultural Identity Integration and Mental Health school students (Tummala-Narra, 2015) and less perceived stress among REM immigrants (Espinosa et al., 2018). However, some Acculturation research conducted over the last 40 years broadly studies have found an association between ethnic identity and supports the conclusion that, maintaining their ethnic identity negative mental health outcomes, including substance abuse while simultaneously adopting the national identity of the host among Hispanics/Latinos (Zamboanga, Raffaelli, & Horton, 2006; society (i.e., engaging in “integration” or “biculturalism”) is the Zamboanga, Schwartz, Jarvis, & Van Tyne, 2009). Frequently, most commonly used acculturation strategy among REM immi- researchers fail to consistently find significant direct associations grants (Sam & Berry, 2006) and is associated with better mental between ethnic identity and mental health (e.g., Hovey, Kim, & health outcomes than endorsing either cultural identity exclusively Seligman, 2006; Umaña-Taylor & Shin, 2007), or that ethnic (Berry, Phinney, Sam, & Vedder, 2006; Nguyen & Benet- identity exacerbates the negative impact of racial discrimination Martínez, 2013). Accordingly, researchers have begun to look at (e.g., McCoy & Major, 2003; Yip, Gee, & Takeuchi, 2008). individual differences in how people experience biculturalism by Nonetheless, research has found that ethnic identity is important examining how they negotiate their cultural identities and whether for REM immigrants. However, it is not the only cultural identity this identity negotiation process is associated with mental health that is salient to this group (Berry, 1997). (Nguyen & Benet-Martínez, 2013). Bicultural Identity Integration (BII; Benet-Martínez & Haritatos, 2005) is an individual differ- National Identity and Mental Health ence factor that describes the degree to which national and ethnic identities are conflicted and compartmentalized versus harmonized REM immigrants are in a unique position of having to navigate and blended. BII has two independent components: cultural har- two cultural milieus, the culture of their society of origin and the mony (vs. conflict) and cultural blendedness (vs. compartmental- culture of their host society. Acculturation research has shown that ization; Huynh, Benet-Martínez, & Nguyen, 2018). Those individ- immigrants most frequently maintain their ethnic identity while uals high in BII perceive their two identities as compatible (i.e., simultaneously acquiring a new, national identity (Sam & Berry, there is bicultural harmony) and themselves as belonging to a 2006). Like ethnic identity, national identity describes one’s sense hyphenated culture (i.e., they have a blended culture). In contrast, of membership in the larger society, including the feeling of bicultural individuals low in BII struggle with balancing the two belonging to and attitudes toward the society (Phinney, Horenc- identities (i.e., there is bicultural conflict) and constantly shifting zyk, Liebkind, & Vedder, 2001). In the context of the U.S., between them (i.e., compartmentalizing cultures). This aspect of national identity refers to American identity. Even though the U.S. cultural identity captures the process of navigating identities in a is a multiethnic country, American identity tends to be equated multicultural world, and it may be more closely and consistently with White racial status. Specifically, according to some empirical associated with mental health outcomes than the ethnic or national evidence, Whites and even some REM individuals are more likely identities themselves. to implicitly associate White and “American” than to associate Although BII is relatively novel in its conception, recent em- Asian, Black, or Latino and “American” (Devos & Mohamed, pirical work suggests it is associated with positive mental health 2014). However, research shows that REM individuals do fre- outcomes, including self-esteem among Latino adolescents quently identify as “American” because they perceive America as (Schwartz et al., 2015) and lower levels of depression among an inherently multiethnic country (Phinney & Devich-Navarro, Filipino domestic workers in China (Chen, Benet-Martínez, & 1997), and/or define “American” in terms of values, ideals, and Bond, 2008). Studies of Multicultural Identity Integration (MII), a This document is copyrighted by the American Psychological Association or one of its allied publishers. behaviors rather than racial/ethnic heritage (Rodriguez, Schwartz, related construct that considers the integration of more than two This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. & Krauss Whitbourne, 2010) or nativity status (Huynh, Devos, & cultures, further supports the importance of having an integrated Altman, 2015). cultural identity. Studies performed in Quebec demonstrate a pos- Among immigrants, stronger national identity is associated with itive relation between having an integrated multicultural identity positive psychological and sociocultural adaptation (Phinney et al., (i.e., multiple heritage cultures as well as English Canadian, and 2001). However, like research on ethnic identity, current empirical French Canadian cultures) and psychological adjustment (Downie, research on national identity and mental health in the U.S. is Mageau, Koestner, & Liodden, 2006; Yampolsky, Amiot, & de la equivocal. For example, Kiang, Witkow, and Champagne’s (2013) Sablonnière, 2016). When considering BII components separately, study of Asian American adolescents found no relation between cultural harmony specifically seems to be the component most American identity and depression but a negative relation between associated with mental health (Huynh, Nguyen, & Benet-Martínez, ethnic identity and depression. In contrast, Gupta and colleagues 2011). For instance, increased cultural harmony was associated (2014) found that among Asian American adolescents, both strong with fewer depression symptoms among bicultural college stu- ethnic and national collective self-esteem (a component of ethnic dents (Huynh et al., 2018). Similarly, Bicultural Management and national identity) were associated with fewer anxiety and Difficulty (BMD), a construct that describes the issues biculturals CULTURAL IDENTITY AND MENTAL HEALH 3

have with balancing two cultures, is likewise related to mental stronger ethnic and American identity and higher BII would be health. For example, increased BMD was associated with more associated with lower frequency of depression and anxiety symp- depression among Chinese American adults (Kim, Shen, Huang, toms. We also hypothesized that including BII in our analysis Wang, & Orozco-Lapray, 2014). would explain significantly more variation in depression and anxiety symptoms than ethnic and American identity would have Bicultural Identity Integration as a Mediator explained alone. Lastly, we hypothesized that BII mediates any association between cultural identity and symptomology. Al- Recent studies also suggest that BII may be a pathway through though in this study mediation was assessed using cross-sectional which ethnic and national identities relate to mental health out- data, thus precluding claims regarding causality, we relied on comes. Theoretically, BII is defined as individual differences in findings from longitudinal analyses, which highlight cultural iden- perceptions of and feelings about the relationship between one’s tity as precursor of BII and mental health (Ferrari, et al., 2015; cultural identities (Benet-Martínez & Haritatos, 2005). This defi- Schwartz et al., 2015) to determine the empirical structure of our nition implies that one must first have a sense of two distinct model. cultural identities before one can consider what having these two Also, while previous research has examined aspects of BII’s identities means and how one feels about having these two iden- mediation potential, to our knowledge, this is the first study to tities. For example, in a cross-sectional study examining the no- explicitly examine the mediating role of BII in the relations be- mological network of BII, Huynh and colleagues (2018) found that tween both ethnic and American identity and depression and the cultural harmony component of BII mediated the relation anxiety in a large and diverse sample of first- and second- between ethnic identity affirmation and depression symptoms in a generation immigrants to the U.S. Furthermore, previously pub- sample of second-generation immigrant college students, albeit lished studies often treated BII as a singular construct, confound- this study did not examine national identity as a possible predictor ing the two distinct components of BII. In the present study, we of mental health. In another cross-sectional study, BII mediated the examine whether each individual component of BII would emerge relation between both ethnic and national (Italian) identity and as a mediator of cultural identity and mental health. All regressions behavioral problems among children of Latin American descent included sex, race/ethnicity, immigrant generation, and age as adopted by Italian parents (Manzi, Ferrari, Rosnati, & Benet- covariates. Given the documented differences in mental health Martinez, 2014). outcomes between first- and second-generation immigrants (Coll Two recent longitudinal studies also provide insights into the & Marks, 2012), we assessed whether immigrant generation mod- potential mediating role of BII in the relation between cultural erated the mediating effect of BII. identity and mental health. Expanding on their research of tran- We did not run separate analyses for the different race/ethnic sracial Latin American adoptees, Ferrari, Rosnati, Manzi, and groups as we believe there is some shared experience among Benet-Martínez (2015) conducted a longitudinal study to examine immigrants of color, especially as it relates to the development of the mediating role of BII in the association between ethnic and cultural identities. Whether African- or Asian-descended, empiri- national (Italian) identity and psychological well-being. The au- cal research shows that the development of ethnic identity is an thors found that BII mediated the relation between ethnic and important component of mental health functioning for REM im- national identity and psychological well-being a year later. migrants (Smith & Silva, 2011), and that navigating a host culture Schwartz and colleagues (2015) investigated the stability and (American) and developing a national identity is a process that fluctuations of BII over a 3-year period among first-generation immigrant groups need to contend with, regardless of their specific Hispanic immigrant adolescents in the U.S.. The authors found that racial background (Berry, 1997). For REM immigrants specifi- BII is subject to increase over time, but the magnitude of its growth cally, being in the minority can make the bicultural integration depends on its initial state, whereby individuals who endorsed a identity process more challenging due to exposure to discrimina- low BII score initially had a smaller growth trajectory than ado- tion (Huynh et al., 2018). In addition, longitudinal research shows lescents with high initial BII scores. More importantly, individuals greater similarity in ethnic and American identity among REM who initially endorsed high ethnic and national (i.e., American) groups relative to Whites (Hsiao & Wittig, 2008). As stated earlier, identities at baseline were more likely than their counterparts to we did control for race/ethnicity in all regression analyses. belong to the high BII growth group, and in turn report higher This document is copyrighted by the American Psychological Association or one of its allied publishers. self-esteem and optimism than low BII individuals three years

This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. Method later. These findings suggest that BII may be an important mediating factor to consider when investigating the associations be- Participants tween ethnic and national identity and mental health outcomes. We recruited participants through an online university recruit- The Current Study ment pool at a large university in New York City as part of an ongoing study of cultural experiences and psychosis risk. Partici- In the present study, we investigate the degree to which multiple pants were undergraduate students from several academic disci- indicators of cultural identity (i.e., ethnic identity, American iden- plines preselected for being between the ages of 18 and 29 and tity, and BII) are associated with depressive and anxious symp- self-identifying as Black/African, American/of African descent, tomatology in first- and second-generation immigrants of color in and/or as first- or second-generation immigrant (of any race/ethnic the U.S. Specifically, we examine the direct and indirect associa- background). For the present study, we selected 766 (out of 915 tions among the three aforementioned aspects of cultural identity total) participants because they were racial or ethnic minority and depression and anxiety symptoms. We hypothesized that immigrants. Thus, the final sample consisted of participants who 4 TIKHONOV, ESPINOSA, HUYNH, AND ANGLIN

were either born outside of the U.S. (first generation) or had at Ethnic identity. We assessed ethnic identity using the Multi- least one parent born outside of the U.S. (second generation), and group Ethnic Identity Measure—Revised (MEIM-R; Phinney & self-identified as belonging to any racial/ethnic group other than Ong, 2007), a 6-item self-report questionnaire that yields the same White. Participants of any racial/ethnic background who were subscales and reliability as the original 12-item MEIM (Her- neither first nor second generation immigrants were excluded from rington, Smith, Feinauer, & Griner, 2016). Given the battery of the analyses. Participants who identified as White, regardless of questions included in the study, we favored shorter scales to avoid immigrant status, were also excluded from the analyses. All par- participant exhaustion. Participants rated each item on a 5-point ticipants completed a series of computerized self-report measures Likert-type scale ranging from 1 (strongly disagree)to5(strongly in a laboratory setting, with completion time averaging around 1 agree), with 3 being neutral. Like the BIIS-2, an open-ended hr. Missing cases were inconsequential as only one participant had question that asks the participant to indicate his or her ethnic missing data (Bennett, 2001). This participant was excluded from background precedes the 6 items. However, unlike the BIIS-2, the analyses related to depression as outcome due to missing depres- response to this item is not populated into any other question in the sion data. The study was approved by the university’s Institutional measure. A sample item is “I have a strong sense of belonging to Review Board, and we obtained written informed consent from all my own ethnic group.” A total score for MEIM-R is computed by participants prior to the start of the study. Respondents received averaging the responses, with higher scores indicating stronger course credit for their participation. Average age was 19.89 (SD ϭ ethnic identity. The scale has shown good internal consistency in 2.40) years, and ranged between 18 and 36 years old.1 The sample other research with racially diverse student populations (Phinney predominantly comprised women (60.4%) and second-generation & Ong, 2007; Yoon, 2011). Internal consistency in our sample was immigrants (59.0%). The race/ethnic makeup of the sample was high (Cronbach’s alpha ϭ .85). 19.8% Black, 34.2% Hispanic, 36.6% Asian, and 9.4% other. The American identity. We assessed American identity with the “other” category consisted of participants who described them- American Identity Measure (Schwartz et al., 2012), a 12-item selves as Middle Eastern (81.9%) or Biracial/Multiracial. self-report questionnaire that is an adaptation of the MEIM (Rob- erts et al., 1999). As with the MEIM-R, participants responded to Measures each question using a Likert-type scale ranging from 1 (strongly disagree)to5(strongly agree), with 3 being neutral. A sample Sociodemographics. We collected age (years), sex (male or item is “I have a lot of pride in the United States.” A total score is female), race/ethnicity, and immigrant status as sociodemographic similarly computed by getting the average of the responses to the indicators. We assessed race/ethnicity by asking participants to 12 items, with higher scores corresponding to a stronger American select among various categories the one that best captured how identity. The scale has high internal consistency and correlates they saw themselves. We then grouped these into four categories: well with other measures of American identity and culture (1) Black, (2) Hispanic, (3) Asian, and (4) other. We assessed (Schwartz et al., 2012). Internal consistency was high in the immigrant status using questions pertaining to the participants’ and current sample (Cronbach’s alpha ϭ .87). 2 their parents’ places of birth. Depressive symptoms. We assessed depression symptoms Bicultural identity integration. We measured BII using the using the brief version of the Center for Epidemiologic Studies- Bicultural Identity Integration Scale—Version 2 (BIIS-2; Huynh et Depression Scale (CES-D; Andresen, Malmgren, Carter, & Pat- al., 2018). The current version of the scale has 17 items, but we rick, 1994), a 10-item self-report questionnaire that captures fre- used an older version that has 19 items. While the newer version quency of depression symptoms experienced during the previous yields slightly more reliable scores, the version used in this study week. Each item is rated using a Likert-type scale ranging from 0 still yielded reliable scores. Participants were instructed to think (rarely or none of the time)to3(all of the time). A sample item is about their experience as biculturals and respond to questions “I felt that everything I did was an effort.” All responses are added about how much their cultures conflict (or harmonize) and how and higher scores indicate more depressive symptoms. A score of much they tend to combine (or separate) their cultures. Prior to 10 or above (out of 30) indicates clinical depression (Andresen et answering the 19 items, participants entered their heritage back- al., 1994). The measure has been validated in ethnically diverse ground in an open-ended question. This response was then popu- populations (Roberts, 1980). Internal consistency was adequate in lated across all the items so that participants respond to each item ϭ This document is copyrighted by the American Psychological Association or one of its allied publishers. the sample (Cronbach’s alpha .80). based on their heritage and American cultures. Participants rated This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. Anxiety symptoms. We measured anxiety symptoms using each item using a 5-point Likert-type scale ranging from 1 the short version of the State–Trait Anxiety Inventory—Trait (strongly disagree)to5(strongly agree), with 3 being neutral. Form—Anxiety Subscale (STAI-Trait; Spielberger, Gorsuch, Example items include “I rarely feel conflicted about being bicul- Lushene, Vagg, & Jacobs, 1983). The STAI-Trait is a 7-item, tural” and “I find it difficult to combine ______and Amer- self-report inventory to diagnose current anxiety symptoms and ican cultures.” The BIIS-2 yields two independent scores compris- distinguish them from depression. Participants respond to each ing averaged scores representing cultural harmony and cultural item by indicating how frequently they experience each symptom blendedness, with higher scores indicating more harmony (or less conflict) and more blendedness (or less compartmentalization). The scale has produced an acceptable factor structure, as well as 1 Four participants enrolled in the study despite being over the age convergent and discriminant validity with other measures of cul- cut-off of 29. We included the data from these four participants in our multivariate analysis and controlled for age. tural identity and acculturation (Huynh et al., 2018). Internal 2 Participants also reported pre-tax family income, which was not sig- consistency in the current sample was adequate (Cronbach’s al- nificantly associated with any outcome variable. For the sake of brevity, we pha ϭ .82 for harmony and ␣ϭ.75 for blendedness). do not report these findings. CULTURAL IDENTITY AND MENTAL HEALH 5

in general using a Likert-type scale ranging from 1 (almost never) .05, d ϭ .45]. In both cases, second-generation immigrants scored to4(almost always). A sample item from the scale is “I feel marginally higher (cultural harmony M ϭ 3.50, SD ϭ 0.69, cul- nervous and restless.” Responses are added to create a total score, tural blendedness M ϭ 3.67, SD ϭ 0.60) than first-generation with higher scores indicating increased anxiety. A score of 16 or immigrants (cultural harmony M ϭ 3.34, SD ϭ 0.65, cultural greater (out of 28) has been shown to indicate the presence of an blendedness M ϭ 3.40, SD ϭ 0.62). anxiety disorder (Bieling, Antony, & Swinson, 1998). The measure has shown good reliability in research with ethnically and Race and Ethnicity racial diverse samples (Novy, Nelson, Goodwin, & Rowzee, 1993). Internal consistency was high in the sample (Cronbach’s Using ANOVAs, we found significant and moderate racial/ alpha ϭ .85). ethnic differences in average depression [F(3, 761) ϭ 5.368, p Ͻ .01, partial ␩2 ϭ .02] and anxiety [F(3, 762) ϭ 8.13, p Ͻ .01, ␩2 ϭ Results partial .03] scores. Tukey post hoc tests showed Hispanic participants reported fewer depression (M ϭ 7.67, SD ϭ 4.80) and anxiety (M ϭ 13.31, SD ϭ 3.95) symptoms than Asian participants Statistical Analysis (depression: M ϭ 9.30, SD ϭ 5.08; anxiety: M ϭ 15.09, SD ϭ We examined mean differences in all measures by sex, immigrant 4.48). We did not find any differences in ethnic identity scores generation, and race/ethnicity with t tests or one-way ANOVAs across race/ethnicity categories. However, we found modest group ϭ Ͻ followed by Tukey post hoc comparison tests. We assessed bivari- differences in American identity [F(3, 762) 7.23, p .01, ␩2 ϭ ate relations among continuous variables via Pearson product– partial .02], with Black participants scoring significantly ϭ ϭ ϭ ϭ moment correlations. We used hierarchical linear regressions to lower (M 3.19, SD 0.72), than Hispanic (M 3.38, SD ϭ ϭ ϭ ϭ determine the contribution of BII toward the variation in depres- 0.62), Asian (M 3.48, SD 0.61), and other (M 3.46, SD sion and anxiety symptoms above that which was captured by 0.70) groups. We also found moderate group differences in mean ϭ Ͻ ethnic and American identity. We tested mediation using the BII scores. For both cultural harmony [F(3, 762) 18.15, p .01, ␩2 ϭ ϭ Ͻ PROCESS macro for SPSS (Model 4; Hayes, 2013). Indirect partial .06] and cultural blendedness [F(3, 765) 9.0, p ␩2 ϭ effects were obtained using 10,000 bootstrapped replications, .01, partial .03], Hispanic participants scored significantly ϭ ϭ which yielded 95% bias corrected confidence intervals (CIs) for higher (cultural harmony M 3.66, SD 0.63, cultural blended- ϭ ϭ ϭ the indirect effects. Finally, we tested the moderating effect of ness M 3.71, SD 0.65) than Black (cultural harmony M ϭ ϭ ϭ immigrant generation with Model 59 in PROCESS (Hayes, 2013). 3.43, SD 0.70, cultural blendedness M 3.47, SD 0.67), Asian (cultural harmony M ϭ 3.27, SD ϭ 0.67, cultural blendedness M ϭ 3.52, SD ϭ 0.51), and other (cultural harmony M ϭ Sample Characteristics 3.26, SD ϭ 0.60, cultural blendedness M ϭ 3.37, SD ϭ 0.69) Average ethnic and American identity scores were 3.58 (SD ϭ participants. 0.80) and 3.39 (SD ϭ 0.65), respectively. Average BII scores were 3.43 (SD ϭ 0.68) for cultural harmony and 3.56 (SD ϭ 0.62) for Bivariate Relations cultural blendedness. The average depression and anxiety scores were 8.66 (SD ϭ 5.12) and 14.2 (SD ϭ 4.29), respectively, both We found a small yet significant negative correlation between ϭϪ Ͻ below cut-offs for clinical depression and anxiety (Andresen et al., age and anxiety symptoms, r(764) .09, p .05. Both depres- 1994; Bieling et al., 1998). sion and anxiety were moderately and negatively correlated with BII cultural harmony [depression: r(763) ϭϪ.23, p Ͻ .01; anxiety r(764) ϭϪ.22, p Ͻ .01]. BII cultural blendedness was also Sex and Immigrant Generation slightly and negatively correlated with depression, r(763) ϭϪ.10, Using independent samples t tests, we did not find any signif- p Ͻ .01. Similarly, depression was slightly and negatively corre- icant sex-based differences in depression, anxiety, and American lated with American identity: r(763) ϭϪ.10, p Ͻ .01. We also identity (p Ն .05). However, there were small but significant sex found several noteworthy correlations among ethnic identity, differences in ethnic identity [t(764) ϭ 2.116, p Ͻ .05, d ϭ .15], American identity, and BII scores. Ethnic and American identity This document is copyrighted by the American Psychological Association or one of its allied publishers. BII cultural blendedness [t(764) ϭ 2.164, p Ͻ .05, d ϭ .16], and were positively correlated with each other, r(764) ϭ .32, p Ͻ .01. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. BII cultural harmony [t(764) ϭϪ2.462, p Ͻ .05, d ϭ .18]. In the American identity was slightly and positively correlated with BII former two outcomes, women scored slightly higher (ethnic iden- cultural harmony [r(764) ϭ .11, p Ͻ .01] and moderately with tity M ϭ 3.63, SD ϭ 0.76, BII cultural blendedness M ϭ 3.60, cultural blendedness [ r(764) ϭ .33, p Ͻ .01]. Ethnic identity was SD ϭ 0.62) than men (ethnic identity M ϭ 3.51, SD ϭ 0.85, BII also slightly and positively correlated with BII cultural blended- cultural blendedness M ϭ 3.50, SD ϭ 0.61). For BII cultural ness [r(764) ϭ .12, p Ͻ .01]. Lastly, the two components of BII harmony, men scored slightly higher on average (M ϭ 3.51, SD ϭ were positively and moderately correlated with each other: 0.65) than women (M ϭ 3.39, SD ϭ 0.69). r(764) ϭ .43, p Ͻ .01. We did not find any significant differences between first- and second-generation immigrants in depression, anxiety, ethnic iden- Hierarchical Regressions tity, or American identity scores. However, we found significant, although small, differences between first- and second-generation We employed three-step hierarchical linear regressions for each immigrants in both BII cultural harmony [t(764) ϭϪ3.19, p Ͻ outcome separately. Specifically, covariates (i.e., age, sex, immi- .05, d ϭ .24] and BII cultural blendedness [t(764) ϭϪ6.179, p Ͻ gration generation, and race/ethnicity) were entered in the first 6 TIKHONOV, ESPINOSA, HUYNH, AND ANGLIN

step, ethnic and American identity in the second step, and BII icant but small as indicated by a completely standardized indirect cultural harmony and cultural blendedness in the third step. In all effect of Ϫ0.02. In addition, we found an indirect-only mediation cases, variance inflation factors were below 2, which rules out effect (Zhao, Lynch, & Chen, 2010) of American identity through estimation problems due to multicollinearity. Hierarchical linear BII cultural harmony on anxiety symptoms (b ϭϪ0.15, 95% regression results appear in Tables 1 and 2 for depression and CI ϭϪ0.31, Ϫ0.05), with a small effect size determined by a anxiety symptoms, respectively. We found that American identity completely standardized indirect effect of Ϫ0.04. The indirect significantly and negatively related to depression symptoms in step effects of either measure of BII in the relation between ethnic two [␤ϭϪ0.11, t(764) ϭϪ2.78, p Ͻ .01]. Similarly, BII cultural identity and mental health were not significant. harmony significantly and negatively related to depression symp- To confirm the directionality of our mediation model, we re- toms in step three [␤ϭϪ0.21, t(764) ϭϪ5.17, p Ͻ .01]. The versed the order between predictors and outcomes and obtained the incremental change in R2 was significant for both steps two [F(2, indirect effects of BII on such relations. The results of these 756) ϭ 5.02, p Ͻ .01] and three [F(2, 754) ϭ 14.59, p Ͻ .01]. reverse mediation models appear in Table 4. As indicated by the When we added BII into the model, the amount of variance 95% CI for the indirect effects, BII did not mediate the relations explained by the model had increased by .04 percentage points, between mental health and ethnic identity. The indirect paths of going from .02 to .06. Ethnic identity was not significantly asso- BII in the anxiety to American identity relation were also insig- ciated with depression in any regression model. For anxiety symp- nificant. However, the indirect effect of BII cultural blendedness in toms, we found that BII cultural harmony was also negatively the relation between depression and American identity was signif- related to this outcome [␤ϭϪ0.21, t(765) ϭϪ5.31, p Ͻ .01] in icant (b ϭϪ0.003, 95% CI ϭϪ0.01, Ϫ0.0004), and small step three. No other cultural identity variable was significantly according to the completely standardized indirect effect of Ϫ0.03. associated with anxiety. Finally, immigrant generation was not a significant moderator of the paths between the focal predictors and the outcomes, as zero Mediation Analysis was included in the 95% bootstrapped CI for the index of moder- ated mediation (Hayes, 2013). Mediation analyses assessed the indirect effects of the two BII components in the relations between ethnic and American identity Discussion and mental health (i.e., depression and anxiety). Analyses were conducted separately for each identity variable as predictor of each In this study, we expanded upon previous research on identity mental health outcome for a total of four mediation models. and mental health among REM immigrants by examining multiple Models where ethnic identity was the predictor of mental health indicators of bicultural identity. We sought to test if ethnic and controlled for American identity, and vice versa. All models also American identities, in addition to BII, are related to depression controlled for binary indicators of race/ethnicity, sex, and immi- and anxiety. More specifically, we tested if BII mediates the grant generation, with Asian, women, and first-generation immi- relations between ethnic and American identity and depression and grants as reference groups. Indirect effects were obtained using anxiety. Our most significant finding is that bicultural identity 10,000 bootstrapped replications. harmony mediated the relations between American identity and Results from the mediation analyses appear in Table 3. The indirect depression and anxiety. In the case of anxiety specifically, Amer- effect of American identity on depression symptoms through BII ican identity was only indirectly associated with anxiety through cultural harmony (b ϭϪ0.18, 95% CI ϭϪ0.35, Ϫ0.05) was signif- its association with bicultural identity harmony.

Table 1 Regression Results Predicting Depression Symptoms as a Function of Ethnic Identity, American Identity, BII Cultural Harmony, and BII Cultural Blendedness, Adjusted for Age, Sex, Immigrant Generation, and Race/Ethnicity

Model 1 Model 2 Model 3 BSE␤ BSE␤ BSE␤ This document is copyrighted by the American Psychological Association or one of its allied publishers. Ϫ Ϫ Ϫ Ϫ Ϫ Ϫ

This article is intended solely for the personal use ofAge the individual user and is not to be disseminated broadly. .01 .08 .00 .01 .08 .01 .03 .08 .02 Sex Ϫ.14 .38 Ϫ.01 Ϫ.09 .38 Ϫ.01 .15 .38 .02 Immigrant generation .32 .39 .03 .41 .39 .04 .50 .39 .05 Black Ϫ.49 .55 Ϫ.04 Ϫ.75 .53 Ϫ.06 Ϫ.45 .52 Ϫ.04 Ϫ.11 45. ءءϪ.17 Ϫ1.22 45. ءءϪ.16 Ϫ1.81 45. ءءHispanic Ϫ1.7 Other Ϫ.04 .68 Ϫ.00 Ϫ.08 .68 Ϫ.01 Ϫ.13 .67 Ϫ.01 Ethnic identity Ϫ.13 .24 Ϫ.02 Ϫ.10 .24 Ϫ.02 Ϫ.09 32. ءϪ.11 Ϫ.73 31. ءءAmerican identity Ϫ.84 Ϫ.21 30. ءءBII cultural harmony Ϫ1.57 BII cultural blendedness .21 .35 .03 R2 .02 .04 .07 Adjusted R2 .01 .02 .06 ءء04. ءء01. ءR2 .02⌬ Note. Unstandardized (B) and standardized (␤) coefficients reported. Asian is the reference group for race/ethnicity, women is the reference group for sex, and first generation is the reference group for immigrant generation. BII ϭ Bicultural Identity Integration. .p Ͻ .01 ءء .p Ͻ .05 ء CULTURAL IDENTITY AND MENTAL HEALH 7

Table 2 Regression Results Predicting Anxiety Symptoms as a Function of Ethnic Identity, American Identity, BII Cultural Harmony, and BII Cultural Blendedness, Adjusted for Age, Sex, Immigrant Generation, and Race/Ethnicity

Model 1 Model 2 Model 3 B SE ␤ B SE ␤ B SE ␤

Age Ϫ.09 .07 Ϫ.05 Ϫ.10 .07 Ϫ.05 Ϫ.12 .06 Ϫ.07 Sex Ϫ.59 .31 Ϫ.07 Ϫ.51 .32 Ϫ.06 Ϫ.29 .32 Ϫ.03 Immigrant generation .53 .32 .06 .54 .32 .06 .59 .33 .07 Ϫ.10 44. ءϪ.12 Ϫ1.04 44. ءءϪ.11 Ϫ1.3 43. ءءBlack Ϫ1.14 Ϫ.16 38. ءءϪ.21 Ϫ1.41 37. ءءϪ.2 Ϫ1.89 37. ءءHispanic Ϫ1.83 Other Ϫ.68 .57 Ϫ.05 Ϫ.73 .56 Ϫ.05 Ϫ.75 .56 Ϫ.05 Ethnic identity .35 .20 .06 .37 .20 .07 American identity Ϫ.47 .25 Ϫ.07 Ϫ.41 .26 Ϫ.06 Ϫ.21 25. ءءBII cultural harmony Ϫ1.35 BII cultural blendedness .30 .29 .04 R2 .04 .05 .09 Adjusted R2 .04 .04 .07 ءء04. 01. ءءR2 .04⌬ Note. Unstandardized (B) and standardized (␤) coefficients reported. Asian is the reference group for race/ethnicity, women is the reference group for sex, and first generation is the reference group for immigrant generation. BII ϭ Bicultural Identity Integration. .p Ͻ .01 ءء .p Ͻ .05 ء

We found that increased American identity was related to an and mental health outcomes. Instead, empirical research has linked increased sense of harmony between ethnic and American cultures. BII cultural blendedness with cognitive and behavioral outcomes Individuals with a stronger American identity reported a greater such as cultural frame switching and language fluency (Huynh et sense of balance between their two cultures compared to those al., 2018). What our results indicate is that mental health issues with a weaker American identity. On the other hand, those with a such as depression may produce a cognitive load, which makes weaker American identity reported feeling caught or trapped be- cultural blending more difficult. When such difficulties occur, tween ethnic and American cultures. Empirical evidence has maintaining one’s American identity may become more difficult, shown that cultural conflict as conceptualized by BII is also possibly leading to dissociation with this identity. These results predicted by strained intercultural relations, discrimination, cul- highlight that one’s cultural identity may not be static (Hill, 2017), tural isolation, and linguistic issues (Benet-Martínez & Haritatos, and it is possible for emotional states to influence our sense of 2005; Huynh et al., 2018). Thus, BII cultural conflict may reflect cultural affiliation. In bicultural individuals in particular, a part of a sense of rejection or isolation from either ethnic or national this influence may come from increased difficulty with blending groups. Increased American identity may reflect a sense of accep- their two cultures. To our knowledge, this is also the first study to tance into American society, which precedes a sense of cultural test such inverse relationships, and future research is needed to harmony. This conclusion is supported by research indicating that verify and explore these possible relations further. a stronger American identity is also related to fewer instances of Independent of American and/or ethnic identity, increased bi- perceived discrimination (Fraga et al., 2011; Pearson & Citrin, cultural harmony was related to less depression and anxiety in all 2006). Consistent with this interpretation, our results suggest that analyses. From our data, we can conclude that ethnic and Amer- perceived cultural conflict is related to depression and anxiety ican identity are not as important for anxiety and depression on symptoms like feeling lonely and overwhelmed. their own, but become more relevant when taken into consider- In addition, we found some evidence highlighting differential ation together. It is this interrelation between these identities that ways in which mental health may relate to national identity seemed to be associated with mental health in the present study. through BII. Specifically, in our reverse mediation models, BII However, BII harmony only partially mediated the relation be- This document is copyrighted by the American Psychological Association or one of its allied publishers.

This article is intended solely for the personal use ofcultural the individual user and is not to be disseminated broadly. blendedness exerted an intervening pathway in the relation tween American identity and depression symptoms. Therefore, for between depression and American identity. Previous research has REM immigrants, it is important to feel a sense of belonging to not shown extensive relations between BII cultural blendedness American society, as lacking this sense of belonging was related to

Table 3 Total, Direct, and Indirect Effects for Regressions Predicting Depression and Anxiety Symptoms

Pathway Direct effect Total effect Indirect effect: BII harmony Indirect effect: BII blendedness

Ethnic identity ¡ Depression Ϫ.09 Ϫ.13 Ϫ.03 Ϫ.00 Ethnic identity ¡ Anxiety .37 .35 Ϫ.03 Ϫ.00 Ϫ.07 ءϪ.18 ءϪ.84 ءAmerican identity ¡ Depression Ϫ.73 10. ءAmerican identity ¡ Anxiety Ϫ.41 Ϫ.47 Ϫ.15 .p Ͻ .05 ء 8 TIKHONOV, ESPINOSA, HUYNH, AND ANGLIN

Table 4 Total, Direct, and Indirect Effects for Regressions Predicting Ethnic and American Identities

Pathway Direct effect Total effect Indirect effect: BII harmony Indirect effect: BII blendedness

Depression ¡ Ethnic identity Ϫ.00 Ϫ.00 Ϫ.00 .00 Anxiety ¡ Ethnic identity .01 .01 Ϫ.00 .00 ءϪ.004 00. ءϪ.01 ءDepression ¡ American identity Ϫ.01 Anxiety ¡ American identity Ϫ.01 Ϫ.01 .00 Ϫ.00 .p Ͻ .05 ء

more symptoms of depression such as sadness and lack of enjoy- (Huynh et al., 2018). Contrary to those studies, we did not find any ment. The converse is also plausible as identity management is evidence of BII mediating the relation between ethnic identity and continuous and depression may weaken our American identity by mental health, suggesting further research on this topic needs to be making cultural blending more difficult. In contrast, lacking a performed. However, our results show that BII mediates the rela- sense of belonging to American society was not directly associated tion between national identity and mental health in multiple REM with more anxiety symptoms; rather, its association was only first- and second-generation immigrant groups, whereas previous indirectly through bicultural conflict. This suggests that when a research has only demonstrated this effect in first-generation im- weaker American identity is connected to less harmonious fluidity migrants of Latin American decent. Especially given the indirect- across the two cultural identities, greater degrees of worrisome only effect of American identity on anxiety noted here, future thoughts, preoccupation, and tension may ensue. research looking at national identity and mental health should Contrary to our expectations, the inclusion of American identity consider including BII as a key variable. and BII in our analyses did not affect the relations between ethnic identity and depression and anxiety symptoms. We did not find Limitations any direct or indirect relation between ethnic identity and mental health. This may be due to the location of the study, a minority- Although the mediation pathways hypothesized in this study are majority university in New York City. Research shows that ethnic supported by longitudinal studies indicating that cultural identity identity may be more salient in contexts where REM groups precedes BII, which in turn precedes mental health (Ferrari et al., constitute a minority relative to Whites (Umaña-Taylor & Shin, 2015; Schwartz et al., 2015), a major limitation is the reliance on 2007). In such contexts, ethnic identity may be more necessary to cross-sectional data, which precludes us from making any causal combat the negative ramifications of minority status such as in- claims. Such limitation is further supported by the significant creased discrimination. The participants in this study were re- findings of the reverse mediation models and highlights the need cruited from a university where Whites constitute less than 20% of for longitudinal studies to identify these directions more rigor- the student body, and they mostly live in their own ethnic group ously. Despite this limitation, our original mediation model is neighborhoods. In such contexts, ethnic identity may not be as further supported by the theoretical underpinnings of BII, origi- strongly linked to mental health as in contexts where Whites are in nally conceived as an individual difference factor among accultur- the majority. ating individuals who selected integration or biculturalism as their However, the findings of this study are consistent with those of acculturation strategy (Benet-Martínez & Haritatos, 2005). While research on BII as well as related constructs like MII and BMD. we found one significant indirect effect in the reverse mediation While previous research has demonstrated that both ethnic and models, the direction of the effect did not contradict the findings of national identity are conducive to mental health, more recent our original mediation model. Thus, our reverse mediation analysis research demonstrates that the degree of integration of and com- largely supports our original mediation model. Moreover, the patibility between cultural identities is highly important (i.e., BII, measures of depression and anxiety used in this study assessed and MII and BMD). BII captured significantly more variance in current symptoms. Nonetheless, as mentioned, longitudinal and/or depression and anxiety symptoms than ethnic and American iden- experimental research would be more appropriate to verify cau- This document is copyrighted by the American Psychological Association or one of its allied publishers. tity combined (although the amount of variance explained was still sality in the relations tested in this study, as it is also possible that This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. relatively small). Our findings support those of other studies on changes in BII as a result of mental health symptoms could BII, MII, and BMD, which show that cultural compatibility to be influence subsequent changes in national identity. related to positive mental health among biculturals independent of Other limitations are noteworthy. Our sample consisted of col- ethnic or national identity (Huynh et al., 2011; Kim et al., 2014; lege students and may not be representative of all REM immi- Yampolsky et al., 2016) grants. While college students may not represent all immigrants, Our study also extends the research on BII as a mediator the sample in the current study was highly diverse and more between ethnic and national identity and mental health. Similar representative of urban communities than most typical highly research has found that BII mediates the relations between both selective college samples. Early adulthood also represents a prime ethnic and national identity and mental health (e.g., Schwartz et al., period for examining cultural identity, as at this point cultural 2015). However, this is the first study to test these relationships in identity has fully formed (Phinney, 1996). Another limitation is the a large and diverse sample of immigrants, as previous research has exclusive reliance on self-report to obtain data on identity and relied on homogenous samples (Ferrari et al., 2015; Manzi et al., mental health. Structured interviews could yield more nuanced 2014; Schwartz et al., 2015) or did not examine national identity details about how these cultural identities interconnect as well as CULTURAL IDENTITY AND MENTAL HEALH 9

reveal the clinical relevance of these relationships (e.g., clinical group identification and well-being. Journal of Personality and Social disorders). The concerns about self-report methods are assuaged Psychology, 77, 135–149. http://dx.doi.org/10.1037/0022-3514.77.1.135 somewhat by the strong psychometric properties of the measures Chen, S. X., Benet-Martínez, V., & Bond, M. H. (2008). Bicultural used in the present study and that they have been validated in identity, bilingualism, and psychological adjustment in multicultural immigrant and REM populations. Due to sample size limitations, societies: Immigration-based and globalization-based acculturation. Journal of Personality, 76, 803–838. http://dx.doi.org/10.1111/j.1467- we were unable to assess equivalence of mediation results across 6494.2008.00505.x race/ethnic groups. While there are documented race/ethnic group Coll, C. G. E., & Marks, A. K. E. (Eds.). (2012). 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(2018) study was also of Latin heritage, and much of risk of being a cultural chameleon: Variations in collective self-esteem the remainder was of Asian descent. Nonetheless, all three of these across social interactions. Cultural Diversity and Ethnic Minority Psy- studies support our tested mediation model, and the current study chology, 12, 527–540. http://dx.doi.org/10.1037/1099-9809.12.3.527 Espinosa, A., Tikhonov, A., Ellman, L. M., Kern, D. M., Lui, F., & Anglin, found similar results despite a major demographic difference in D. (2018). Ethnic identity and perceived stress among ethnically diverse our sample (a significant number of Black immigrants). Nonethe- immigrants. Journal of Immigrant and Minority Health, 20, 155–163. less, future research should address these limitations by using http://dx.doi.org/10.1007/s10903-016-0494-z representative samples of REM immigrants, employ methods other Ferrari, L., Rosnati, R., Manzi, C., & Benet-Martínez, V. (2015). 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