Contemporary racism and the Asian American experience: The impact of lifetime racial microaggression stress on psychological functioning and risk behavior in Asian American young adults Safia C. Jackson A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy University of Washington 2015 Reading Committee: Mary E. Larimer, Chair Corey N. Fagan William H. George Program Authorized to Offer Degree: Psychology © Copyright 2015 Safia C. Jackson University of Washington Abstract Contemporary racism and the Asian American experience: The impact of lifetime racial microaggression stress on psychological functioning and risk behavior in Asian American young adults Safia C. Jackson Chair of the Supervisory Committee: Professor Mary E. Larimer Department of Psychology Department of Psychiatry and Behavioral Sciences Asian Americans are considered a “model minority” in the United States, conferring an implied status of privilege among racial minority groups. This stereotype results in misperceptions about the incidence and consequences of racial discrimination against individuals of Asian descent. Studies have shown that experiences of racial discrimination are prevalent across age groups and settings in this population, and associated with a litany of psychological and physical health problems, including depression, anxiety, suicidal behavior, and substance use. While previous research in the field has focused on the deleterious effects of overt forms of racism, contemporary and covert forms such as “racial microaggressions” are thought to be more detrimental to the health and well-being of individuals of color. Further, although it has been suggested that the accumulation of these everyday racial hassles are responsible for negative outcomes, measures of racism-related stress typically assess either the average frequency or stressfulness of these experiences and not the overall lifetime stress. In order to address present gaps in the literature, this research sought to: (1) develop a measure assessing lifetime racial microaggression stress in Asian American young adults; (2) examine the relationship between this construct and health concerns that are increasingly prevalent in this population, specifically: depression, anxiety, social anxiety, alcohol use, and gambling; (3) test theoretical models describing the causal processes by which this stress may result in psychological symptoms and risk behavior, specifically the Stress-Coping Model of Addiction and the Transactional Stress Model; and (4) explore how racial socialization and other race- and culture-specific factors influence outcomes. The instrument developed in this study, the Asian American Racial Microaggressions Stress Scale (AARMSS), demonstrated internal reliability, concurrent validity, and a three factor structure reflecting the theoretical taxonomy of racial microaggressions. Results indicated that total scores on this scale, representing lifetime racial microaggression stress, were associated with a range of health outcomes in a sample of Asian American young adults above and beyond average frequency of racial microaggressions and experiences of overt racial discrimination, suggesting the utility of a composite lifetime stress measure. Analyses indicated that the structural fit of theoretical models depended on the specific outcome in question; while the Stress-Coping Model of Addiction better explained the mechanism by which lifetime racial microaggression stress influenced gambling behavior in the sample, the Transactional Model of Stress better explained pathways to negative affect (depression, anxiety, and social anxiety) and alcohol use. In regards to racial socialization, participants endorsed a range of experiences across family and peer contexts; however, results highlighted the importance of the context and content of these messages. Specifically, family experiences were generally associated with outcomes whereas peer experiences were not. Further, family messages conveying racial mistrust were associated with higher levels of depression and social anxiety; in contrast, family teachings that prepared participants for racial bias were associated with fewer psychological symptoms. Examinations of mechanisms indicated that preparation for bias attenuated these outcomes by compensating for the effects of lifetime racial microaggression stress and by reducing the use of avoidant emotional coping strategies in response to these stressors. Finally, evidence suggested that higher levels of acculturation and ethnic/racial identity generally compensated for lifetime racial microaggression stress or protected against negative outcomes; however among participants with greater Asian acculturation, higher levels of stress were associated with increased gambling behavior. A better understanding of the everyday racial hassles faced by Asian American youth and young adults, the effects of these experiences, and the factors that cause, exacerbate, and attenuate negative consequences will help to: (1) increase awareness of contemporary forms of racial discrimination, (2) develop culturally-appropriate and sensitive prevention and intervention programs, (3) educate Asian American families about how to effectively communicate messages about race and racism to their children, and (4) shape future research agendas that will improve our understanding of the health and needs of this often overlooked minority population. Some clinical and preventative implications are discussed in length and suggestions are offered for tailoring culturally-appropriate programs for Asian American clients. Ultimately, however, treating people of color at the individual level is no substitute for societal change. TABLE OF CONTENTS List of Figures ....................................................................................................................................... iv List of Tables ....................................................................................................................................... vii Chapter 1. Introduction .......................................................................................................................... 1 1.1 Racial Discrimination Against Asian Americans ..................................................................... 3 1.1.1 Definitions ......................................................................................................................... 3 1.1.2 History of Racism and Discrimination Against Asian Americans .................................... 3 1.1.3 Racial Discrimination Against Asian Americans in the 21st Century ............................... 5 1.2 Contemporary Racism and Racial Discrimination ................................................................... 9 1.2.1 Modern Racism ............................................................................................................... 10 1.2.2 Aversive Racism .............................................................................................................. 1 1 1.2.3 Racial Microaggressions ................................................................................................. 11 1.2.4 Racial Microaggressions Against Asian Americans ....................................................... 14 1.3 Mental Health Issues in Asian American College Students ................................................... 17 1.3.1 Depression ....................................................................................................................... 18 1.3.2 Anxiety ............................................................................................................................ 21 1.3.3 Alcohol Use ..................................................................................................................... 23 1.3.4 Gambling ......................................................................................................................... 27 1.4 Impact of Racism on Asian American Mental Health ............................................................ 29 1.4.1 Racial Discrimination and Depressive and Anxiety Disorders ....................................... 30 1.4.2 Racial Discrimination and Risk Behavior ....................................................................... 31 1.5 Racial Discrimination as a Stressor: Creating an Integrated Model ....................................... 32 1.5.1 Sue’s Microaggression Process Model: Incident, Reaction, and Consequence .............. 35 1.5.2 Stress-Coping Model of Addiction: Negative Affect ...................................................... 36 1.5.3 Transactional Model of Stress: Cognitive Appraisal and Coping ................................... 39 1.5.4 Integrated Stress Model: Cognitive Appraisal, Coping, and Negative Affect ................ 43 1.6 From Stress to Health: Examining the Role of Racial Socialization ...................................... 44 1.6.1 Racial Socialization as a Family Process ........................................................................ 44 1.6.2 Peer-Based Racial Socialization ...................................................................................... 46 i 1.6.3 Racial Socialization and Outcomes ................................................................................. 46 1.6.4 Racial Socialization in Asian American Youth ............................................................... 48 1.7 Other Race- and Culture-Specific Considerations .................................................................