Partner Violence, Depression, and Practice Implications with Families of Chinese Descent
Yick, Alice G., Shibusawa, Tazuko, Agbayani-Siewert, Pauline, Journal of Cultural Diversity
Abstract: Because the Chinese tend to display psychological problems such as depression in somatic This article examines cultural aspects, experiences, and the mental health consequences of partner violence among families of Chinese descent. A total of 262 Chinese men and women participated in a telephone survey about partner violence and psychological well-being, symptoms, two indicators of mental health were employed in the research study. Findings indicated a high level of verbal aggression both perpetrated and sustained by participants. Rates of physical abuse were lower; however, these figures dispel the model minority myth associated with Asian Americans. In addition, findings showed a positive correlation between depression and partner violence. Those who experienced verbal and physical aggression by a spouse/intimate partner in the last 12 months were more likely to experience depression. Those who perpetrated physical aggression were more likely to experience somatic symptoms. Practice and research implications are highlighted.
Key Words: partner violence, marital violence, domestic violence, Chinese families, culture
Domestic violence is a global problem that extends across social, cultural, ethnic, so cioeconomic, and regional boundaries (Fischbach & Herbert, 1997; Asbury, 1993). In the United States, findings from a national survey found that a quarter of the couples surveyed reported at least one incident of physical aggression in their relationship (Straus & Gelles, 1990). Annually, one million women seek medical assistance for injuries resulting from battering (Goodman, Koss, & Russon, 1993). Very little focus, however, has been placed on cultural and ethnic differences. There is a paucity of data on domestic violence among Chinese immigrant or Chinese American families. This is because prevalence studies have not included the Chinese as a separate demographic category in analyses (Lee, 2000).
Preliminary studies, while not derived from epidemiological surveys, dispel the stereotype of the "model minority myth." In a study of university students, for example, 21.4% of the Chinese students surveyed disclosed being a victim of physical violence by a partner since they started dating (Yick & Agbayani-Siewert, 2000). Tang (1994) found a rate of 14% of spousal abuse among the Chinese families residing in Hong Kong. The "model minority myth" also stems from the low utilization rate of domestic violence services among Chinese women, and consequently, it is assumed that this problem does not exist among the Chinese (Lee & Au, 1998). This article examines partner violence among Chinese immigrant and American-born Chinese and depressive and somatic symptoms. Given the tendency among Chinese to somatize psychological symptoms, two indicators of mental health were employed in the study. One is a more traditional measure to assess the affective component of depression, and the second is a more culture-bound indicator to measure somatic dimensions of depression. In addition, social desirability was taken into account due to the fact that partner violence is a highly sensitive matter, and there is a pressure to maintain family secrets (Gelles, 1993).
Specifically, the following research questions facilitated the study: (1) What is the scope of partner abuse (i.e., victimization and perpetration experiences) among individuals of Chinese-descent? (2) After controlling for social desirability, what is the relationship between depression and somatization among individuals of Chinese-descent who have been psychologically and/or physically victimized by a spouse/intimate partner? (3) After controlling for social desirability, what is the relationship between depression and somatization among individuals of Chinese-descent who have perpetrated psychological and/or physical violence against a spouse/intimate partner?
Partner Violence and Cultural Issues
As McGee (1997) notes, all family systems have meta-rules, roles, and cultural values, which can be used to help frame a cultural analysis of partner violence. Traditional Chinese family structure is based on Confucian social principles, which emphasizes a hierarchical authority structure (Jung, 1998). Confucianism emphasizes strict adherence to social order and role assignments (Jung, 1998). Wives are expected to be subordinate towards her husband and in-laws (Ho, 1990). Marital relationships are regarded secondary to parent-child relationships, and male children are given preferential treatment (Chung, 1992). Within this hierarchical structure, men may not necessarily view partner or marital violence as a violation of a woman's rights, and Chinese wives who are victimized may not necessarily feel that they have the right to complain about the abuse. Furthermore, ethnic community leaders who tend to be males, may not view and partner or marital violence as a serious social problem.
The structure of the Chinese family and community, which tends to be close-knit, may also hinder women from seeking help (Masaki & Wong, 1997). Unlike Western cultures, the family rather than the individual is considered the primary reference point, and as a result, family concerns takes precedence over individual members. As Jung (1998) observes, personal satisfaction is achieved through adhering to familial roles and meeting one's obligations towards the family. Similarly, Lee (2000) notes that the Chinese sense of self is premised upon the extent to which one has lived up to the cultural standards defined by cultural norms. Therefore, terminating the relationship and leaving the abusive home may be perceived an unlikely option because the victim has been socialized to place her family before her own needs (Yick, 2001).
Immigration status can also render extreme vulnerability among abused women. One of the most significant fears experienced by battered Chinese immigrant women is related to their immigrant status (Masaki & Wong, 1997). Losing custody of their children and deportation in which they may be forced back to a hostile environment keep many victims from seeking help. Furthermore, limited language skills, social isolation, and lack of knowledge regarding their rights or availability of legal services can hinder victims' from disclosing the abuse.
Partner Violence and Mental Health
Depression, anxiety, and post-traumatic stress are common psychological symptoms among victims of violence. Victims of partner or marital violence report four times the rate of depression and 5.5 times suicidal attempts compared to their non-victimized counterparts (Gelles & Straus, 1988). Because physical violence is also often accompanied by psychological abuse, the victim's self-esteem gradually deteriorates, leading to a distortion of reality and an increased vulnerability to anxiety, depression, and a host of somatic symptoms. Perpetrators of partner/ marital violence also experience mental health problems. Research indicates that violent husbands are more likely to be depressed than their nonviolent counterparts (Gortner, Gollan, & Jacobson 1997; Maiuro, Cahn, Vitaliano, Wagner, et. al., 1988). Pan, Neidig, & O'Leary (1994) found that for every 20% increase in depressive symptoms, the probability of being mildly aggressive increased by 30%.
Culture and the Expression of Depression
The literature on Asian American mental health stresses the importance of culture in shaping the expression of distress, which ultimately determines symptoms, prognoses, and pathways to help (Agbayani-Siewert, Takeuchi, and Pagan, 1999; Kleinman, 1980, Tabora & Flaskeraud, 1994). Somatization of psychological problems is characteristic of the Chinese (Kuo & Kavanaugh, 1994; Kleinman, 1980; Lin, 1983). Chinese cultural values emphasize organic causation of psychological problems and inhibition of emotions, while focusing minimally on the mind-body dichotomy and intrapsychic concerns (Kleinman, 1980; Lin, 1983; Tabora & Flaskerud, 1994). Mental illness is also extremely stigmatizing and a taboo topic for the Chinese. Therefore, somatization allows for displacement of intrapsychic conflict that is deemed unacceptable (Kleinman, 1986).
The expression of depression may be very different in non-Western societies, and as a result, Western diagnostic tools may display very low incidence rates of depression (Kleinman, 1980; Zhang, 1995). Jenkins, Kleinman, & Good (1991) argued that depression in many countries is frequently experienced and manifested in bodily terms such as headaches, backaches, fatigue, constipation, and other physical symptoms. Instead of the diagnosis of depression, neurasthenia is a more common diagnosis; however, Kleinman (1980) has argued that if patients with neurasthenia were rediagnosed using the Diagnostic Statistical Manual, some sort of depressive disorder would be found. This speaks to the importance of instruments that can capture symptoms of depression that are more culturally acceptable.
Research and Sampling Design
Data for this study was collected from a non-probability telephone survey of 262 Chinese immigrant and Chinese American adults residing in the Los Angeles county area. In order to participate in the study, participants had to be 18 years or older, reside in Los Angeles County at time of the study, self-identify as Chinese, and be able to speak in Mandarin, Cantonese, and/or English.
A total of 1,982 households were contacted after purchasing a list of households with Chinese surnames. Using surnames as an indicator is based on the assumption that certain ethnic groups have surnames that are distinct from other groups, and members with those surnames are representative of that ethnic population (Rosenwaike, 1994; Sasao, 1994). There was a large number of non-working numbers, refusals, households who did not meet the eligibility criteria (i.e., not Chinese), no answers, and answer machines. As a result, the response rate for the study was 20%, yielding 262 participants (133 males and 129 females).
Profile of Study Participants
The age range was from 18 years to 86 years, with a median of 40 years. A large majority (90.5%) of the participants were immigrants born outside the United States - 43.6% immigrated from China, 12.3% from Hong Kong, and 30.9% from Taiwan. The average duration of residence in United States was 13 years.
The majority (64.9%) was married, with children. The mean household income was $67,706, with an average of 1.9 people contributing to this household income. Only 8% reported receiving some form of public assistance. This group of participants was very educated as more than a third completed college, and more than a quarter received post-college degrees. Almost three-quarters (71%) were employed, and of those who were employed, they were primarily represented in managerial/professional and technical/ sales/administrative support occupations. Finally, approximately a third (30.2%) stated they were Buddhists, and 23% were Protestant.
Data Collection Procedures
An introductory letter and a consent form, written in both English and Chinese, were sent to all households. Bilingual interviewers then contacted households to solicit participation. The last birthday method was used to randomly select an eligible adult household member to participate. Once participants consented, a telephone interview was scheduled at a convenient time. The majority (67.2%) of participants opted to have the interview conducted in Mandarin, and 6.1% had the interview in Cantonese. The average length of the telephone interviews was 46 minutes, and participants were reimbursed $12 for their participation.
All instruments were translated and back translated into Chinese to ensure linguistic equivalence.
Conflict Tactics Scale (CTS) - The CTS (Straus, 1979) was employed to measure participants' victimization and perpetration experiences with psychological and physical violence in a marital/intimate relationship within the past year and during their lifetime. The CTS consists of a graduated series of 19 close-ended items, which describe the types of behaviors an individual can potentially use to resolve a conflict. Three subscales comprise the CTS: Reasoning Subscale, the Verbal Aggression Subscale (which has been used to measure psychological aggression), and the Physical Violence Subscale. The Physical Violence Subscale is composed of minor and severe forms of physical aggression. The response format ranges in frequency from "never" to "more than 20 times."
Two types of scores were calculated for the last 12 month time period - a continuous score and a dichotomous score. Continuous scores are a summation of the frequency which participants have perpetrated or have been victimized by a particular type of abuse. The dichotomous scores ("yes"/"no") indicate if they have been victimized by or perpetrated a particular form of abuse. The lifetime prevalence scores were only dichotomous ("yes/no"). For all dichotomous scores, a "0" was coded for "yes" and a "1" was coded for "no" in SPSS.
The CTS has been used with the Chinese in Hong Kong, and Tang (1994) reported reliability coefficients ranging from .70 to .86 for each of the three subscales. In this study, the Cronbach's alphas for the Reasoning, Verbal Aggression, and Physical Violence Subscales were .56, .72, and .86 respectively.
Center for Epidemiological Studies (CES-D) Depressive symptomology was used as one mental health outcome. The CES-D is a 20 item scale that measures for current level of depressive symptoms, with an emphasis on the affective mood component of depression (Radloff, 1977). The CES-D has been widely used with both the general and psychiatric community and has shown very good internal consistency (Cronbach alpha of .85 for the general population) (Corocan & Fischer, 1987). It has also been employed with Chinese Americans in San Francisco (Ying, 1989), who reported a Cronbach alpha of .77. In this study, the Cronbach alpha was .84.
Chinese Health Questionnaire -12 (CHQ-12) Somatic symptoms is used as the second mental health indicator and focuses on the somatic component of depression. It consists of 12 close-ended items assessing levels of somatic symptoms. Chong & Wilkinson (1989) administered the CHQ-12 to a community and hospital sample of 1,023 Chinese in Taiwan and found the internal consistency of the scale to be very good (Cronbach alpha = .84 for the community sample). In this research study, the Cronbach alpha was comparable at .88.
Marlowe Crowne Social Desirability Scale - This scale was used to measure for social desirability. The original scale is composed of 33 true/false items; however, researchers have reduced it to 10 closeended items (Strahan & Gerbasi, 1972). This study employed the shortened scale. In this study, the Cronbach alpha was .67, which was comparable to Cronbach alphas ranging from .62 to .83 in a study with White college students (Strahan & Gerbasi, 1972).
Finally, participants were asked a series of demographic questions including age, gender, marital status, length of residence in U.S., country of birth, education, household income, occupation, number of children, religion, and if they receive public assistance.
DATA ANALYSES AND RESULTS
Descriptive statistics were used to examine the demographic profile of the study participants and to investigate the extent of victimization and perpetration experiences with partner violence. First order correlations were used to examine the relationship between partnerviolence and depression and somatization, while controlling for social desirability.
Extent of Victimization of Partner Violence
Table 1 summarizes Chinese immigrants and Chinese Americans' victimization experiences with verbal and physical aggression by spouses and/or intimate partners.
More than 80% of the sample reported sustaining some type of verbal aggression by a spouse/intimate partner in the last 12 months. During their lifetime, 85% of participants experienced verbal aggression. Rates for physical violence were lower at less than 10% in the last 12 months and less than 20'Xo during their lifetime.
Extent of Perpetration Experience with Partner Violence
Table 2 shows study participants' perpetration experiences with verbal and physical aggression with a spouse/intimate partner during the last 12 months and during their lifetime.
The majority (79%) disclosed to having perpetrated verbal aggression against spouse/intimate partner in the last 12 months, and 87% also admitted to having perpetrated verbal abuse during their lifetime. The rates for perpetrating general physical aggression were lower than the use of verbal aggression. Almost 10% of the sample employed physical aggression against a spouse/partner in the last 12 months, and over 15% employed physical aggression during their lifetime.
Depression and Somatization and Victimization Experiences with Partner Violence
Due to the small sample of those who were victimized by severe physical violence, the scores for general physical violence were used in all partial correlation analyses. Table 3 shows the relationship between victimization experiences with verbal and physical aggression and depressive and somatic symptoms.
After controlling for social desirability, the results indicate that participants who experienced verbal and physical aggression by a spouse/intimate partner in the last 12 months were more likely to experience depression. Those who experienced verbal aggression in the last 12 months were also more likely to display somatic symptoms compared to their Chinese American counterparts who did not experience verbal aggression. However, there was no statistically significant relationship between verbal and physical victimization during respondents' lifetime and depression and somatization.
Depression and Somatization and Perpetration Experiences with Partner Violence
Chinese Americans who perpetrated verbal and physical aggression in the last 12 months were more likely to experience depression compared to those who were not perpetrators. However, there was no significant relationship between perpetration of physical violence during lifetime and depressive symptomology.
Given the tendency for the Chinese to somatize psychological problems, partial correlations were also conducted for perpetration experiences with marital violence and somatic symptoms. Findings indicated that Chinese Americans who perpetrated verbal and physical aggression in the last 12 months against a spouse/intimate partner were more likely to experience somatic symptoms. In addition, if during their lifetime, participants perpetrated physical aggression, they were also more likely to experience somatization. Refer to Table 4.
Verbal aggression as a form of psychological abuse was prevalent in this study. The rates for sustaining and using verbal aggression against a spouse/intimate partner ranged from 75-80% for the last 12 months in this sample. These figures are comparable to Tang's (1994) study in Hong Kong. Using the Conflict Tactics Scale, Tang found that 75% of the Chinese undergraduate students reported that their parents engaged in verbal or psychological aggression in the last 12 months. These high rates of verbal aggression can be understood within a cultural context. Because of the patriarchal and hierarchical nature of marital relationships in traditional Chinese culture, some men view abusive behavior such as verbal abuse as a rational means to educate their spouses or intimate partners, ultimately fulfilling their male duty as the head of the household (Lee, 2000).
The rates for physical violence (both victimization and perpetration) among the sample dispel two general myths about partner violence among the Chinese: that violence does not occur among Chinese immigrant and Chinese American families, and that violence occurs only among the uneducated, poor, and new immigrants. The sample in this research study comprised of educated Chinese immigrants and Chinese American participants. More man a third and a quarter of the participants, for example, received college and post college degrees respectively. The consequences of partner violence extend far beyond the physical domain. Episodes of verbal threat can terrorize a victim (Fischbach & Herbert, 1997). In this study, Chinese immigrants and Chinese Americans who were victims of verbal aggression abuse by a spouse/intimate partner in the last 12 months were more likely to experience both depression and somatic symptoms than their non-victimized counterparts. Findings concur with Tang's study (1997), which reports high levels of psychological abuse by husbands, and associated manifestations of somatic symptoms, anxious mood, and insomnia among abused Chinese women and shelters and family centers.
It is also important to remember that Chinese victims may be more likely exhibit somatic symptoms because it is more culturally congruent to their belief systems about mental health. Immigrants who uphold more traditional values, for example, believe that mental illness is caused gods or ancient spirits that are displeased with some shameful behavior of the family (Kuo & Kavanagh, 1994)
Although physical abuse might cause greater bodily injury, the mental health consequences engendered by psychological abuse such as guilt, intense fear, and damaged self-esteem can be just as adverse as physical abuse (Walker, 1984). The coercive nature of psychological abuse generates learned helplessness, which ultimately promotes depression (Walker, 1984). These feelings of helplessness for Chinese women are further exacerbated by the need to live up to traditional virtues of endurance and perseverance (Lee, 2000; Ho, 1990). Furthermore, religion and worldview can also color their decision to stay and make the best of their situation. Aspects of Buddhism religion and Confucian philosophy view suffering as a journey to spiritual maturity and character development (Masaki & Wong, 1997).
Very little data is available on the mental health outcomes of perpetration of violence in comparison to victimization of violence. In this study, participants who perpetrated verbal and physical aggression in the last 12 months were more likely to report depression compared to those who were not perpetrators. Some studies have found that physical symptoms are linked to the cycles of violence. According to Mintz & Cornett (1997), batterers are in an aroused physiological state before becoming violent and frequently complain of digestive problems, headaches and anxiety. Depression is also common among batterers. Maiuro and colleagues (1998) note that batterers cope with the stress of violence with alcohol, illegal substance or other forms of self-medication, which in turn exacerbates their physical and psychological problems.
Culture not only affects the way in which people perceive marital or partner violence, but it also impacts the way in which victims seek and experience assistance. Helping practitioners must provide interventions that are appropriate to the cultural values of the clients. When working with Chinese victims, it is important for practitioners to integrate into their work approaches that are culturally appropriate. The following are suggestions based on a review of practice literature in working with clients of Chinese descent (Ho, 1987; Lee, 2000; Masaki & Wong, 1997). The first task is to recognize the abuse and to collect accurate data (Valentine, Roberts & Burgess, 1998). During this initial assessment, practitioners must take into account the reluctance and difficulty that Chinese women may experience in talking about their experiences. Seeking assistance from an outsider is often a new experience for most Chinese (Yamashiro & Matsuoka, 1997). Exposing family problems to an outsider may feel very risky to Chinese women who have been socialized to believe that it is shameful to discuss family problems with outsiders. She may fear that she is bringing shame to her family and fear consequences of being ostracized by her family and community. Therefore, it is important to take time in establishing trust with clients by communicating an understanding of the fear that the client may have towards speaking about the abuse, and explore the fears that she has about the consequences of her seeking help. This can be aided by normalizing her reactions to the abuse to lessen the feelings of stigma and shame (Ho, 1987).
When working with Chinese victims of partner or marital violence, the entry point to rapport building is to acknowledge victims' feelings of guilt, shame, and loss of face about seeking help. Although discussion about ways to stop the abuse are crucial topics to pursue, it is important for the practitioner to help battered Chinese women to work through their feelings of doubt and ambivalence in seeking help (Lee, 2000). To gloss over these feelings will inevitably yield premature termination of services (Lee, 2000). At the same time, it is important that practitioners avoid demand for emotional disclosure (Ho, 1987). Verbally describing and expressing emotions are not part of the culture among East Asians as it is among Euro-American cultures (Shibusawa, 2001). Encouraging and focusing emotional disclosure may ultimately inhibit clients from continuing in treatment (Shibusawa, 2001).
Providing concrete, pragmatic and problem- and task-centered assistance is essential when working with victims of battering (Valentine, et al., 1998). When working with Chinese victims, it is crucial for practitioners to be familiar with resources in the community that are able to provide culturally sensitive services. These include resources such as bi-lingual medical, family, and financial services, social services, legal assistance, childcare, and shelters that have experience in working with Asian women.
The way in which victimization can evoke previous trauma is well-known. Some Chinese victims of partner violence may have also experienced violence and atrocities in their homeland. Others may have come from oppressive areas, where police authorities were corrupt and abused their power. A practitioner may unwittingly instigate memories of trauma during questioning in the clinical interview (Masaki & Wong, 1997).
When conducting assessments, it is vital to remember that cognitive schemas, which are cognitive structures used to help organize and make sense of the world, are influenced by cultural learning (Castillo, 1997). "Abuse" and "battering," are social and cultural constructions and professional terms rather than terms that Chinese victims are accustomed to using in daily conversations. Practitioners may find it more constructive to ask specific behaviorally-oriented questions during the assessment phase such as "has your husband caused some type of injury to you?" rather than "has your husband ever abused you?" (Wyatt, 1985).
In addition, it is important for practitioners to note that in contemporary Western cultures, anxiety and depression that are common among victims are conceptualized with an emphasis on affective states or on the psychodynamic experience (Castillo, 1997). The affective and somatic components of depression are traditionally treated separately in Western psychiatry, reflecting Western beliefs that the mind and body are distinct entities (Kuo & Kavanaugh, 1994). However, somatic symptoms such as backaches, gastrointestinal problems, and headaches are more common symptoms of depression for the Chinese. Consequently, somatic complaints should not be minimized, but instead they may be a metaphor in expressing affective distress (Young, 1997), particularly, for issues like partner violence, which is often viewed as shameful. Attention should center around the somatic symptom, with the social worker not aggressively seeking an immediate psychodynamic explanation since "talking therapies" are not viewed as a viable solution.
The discussion has focused more on Chinese victims of partner violence; yet, it is also equally important to talk about interventions for perpetrators. Almeida & Durkin (1999) stress the role of accountability, and they note that traditionally, the term "accountability" refers to the link between the criminal justice system and the system offering services to the perpetrator. However, they argue for expanding accountability to include cultural sponsors recruited from the community who support nonviolence in all relationships. These sponsors break the secrecy of partner violence by bringing it out from the confines of the family and into the community, and they can help reshape notions of patriarchy and gender roles (Almeida & Durkin, 1999). In addition, family interventions including couple therapy may be a viable type of intervention. Although many caution against couples therapy because it may be unsafe for the victim, Lee (2000) argues that the family system can be used as a form of accountability and group condemnation to ending partner or marital violence. However, couple therapy is only a viable treatment option if the perpetrator can take responsibility for the violence, the victim requests couple therapy, and the violence in the relationship has ended (Lee, 2000). Empowering Chinese victims of partner or marital violence is a central focus of treatment. Again, it is crucial for practitioners to keep in mind that the term "empowerment" is a socially constructed term, which is part of the lexicon of the domestic violence movement and feminist movement. It conveys ideologies of autonomy, individualism, and self-determination, which may not necessarily be congruent with traditional Chinese values emphasizing the importance of the family, marriage, and relegating one's own needs for the greater good of the collective unit (Yick, 2001). Lee (2000) cautions social workers not to "coach" Chinese victims about terminating abusive relationships because it mimics the dynamics of the abuse, where the victim's voice is silenced and her movement restricted. Instead, empowering a Chinese victim of partner or marital violence includes exploring her informal and formal resources, respecting her values, and supporting her decisions.
LIMITATIONS AND DIRECTIONS FOR FUTURE RESEARCH
Although the findings from this study adds to our knowledge of the relationship between experiences of violence and depression, partner or marital violence research with ethnic and racial minorities is still in the early stages of evolvement. Future survey research needs to incorporate other methodologies such as ethnographic interviewing that capture the cultural and social meanings of partner violence and depression.
In addition, future studies will need to develop sampling designs that account for important withingroup representation to establish prevalence rates among Chinese and other Asian ethnic groups. Designs of this type are costly and often require funding from public sources. However, the myth of Asian Americans as a relatively problem free model minority may serve as a barrier in the granting of resources. In nationally funded domestic violence research, for example, attention to Asian Americans is glaringly missing in the sampling designs and dissemination of findings. If the intent is to gain an understanding of the social and cultural factors that affect the experience of partner violence and to develop effective prevention and intervention strategies, research on ethnic minorities must integrate concomitant methodological approaches.
The authors acknowledge the Institute of American Cultures at University of California, Los Angeles, Woodrow Wilson Foundation's Johnson & Johnson Dissertation Grant in Women's Health, and the New York Community Trust's Fahs-Beck Fund for Research and Experimentation for their support of this research study.
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ALICE G. YICK, PHD, MSW, TAZUKO SHIBUSAWA, PHD, LCSW, AND PAULINE AGBAYANI-SIEWERT, PHD, MSW
Alice G. Yick, PhD, MSW is a Core Faculty member at Capella University, School of Human Services. Tazuko Shibusawa, PhD, LCSW is an Assistant Professor, School of Social Work at Columbia University. Pauline Agbayani-Siewert, PhD, MSW, is an Associate Professor at the School of Social Work, California State University, Los Angeles.…
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Publication information: Article title: Partner Violence, Depression, and Practice Implications with Families of Chinese Descent. Contributors: Yick, Alice G. - Author, Shibusawa, Tazuko - Author, Agbayani-Siewert, Pauline - Author. Journal title: Journal of Cultural Diversity. Volume: 10. Issue: 3 Publication date: Fall 2003. Page number: 96. © Not available. Provided by ProQuest LLC. All Rights Reserved.
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