Do Higher Self-Reports of Social Anxiety Translate to Greater Occurrence of Social Anxiety Disorder in Asian Americans Compared to Caucasian Americans?

By Horng, Betty; Coles, Meredith E. | Journal of Cognitive Psychotherapy, December 1, 2014 | Go to article overview

Do Higher Self-Reports of Social Anxiety Translate to Greater Occurrence of Social Anxiety Disorder in Asian Americans Compared to Caucasian Americans?


Horng, Betty, Coles, Meredith E., Journal of Cognitive Psychotherapy


This study was designed to clarify the discrepancy between data showing higher self-reported levels of social anxiety in Asian Americans ( Horng, 2004; Okazaki, 1997,2000,2002 ) but lower lifetime prevalence rates of social anxiety disorder (SAD) in Asian Americans compared to Caucasian Americans (Hwu, Yeh, & Chang, 1989; Lee et al., 1990b; Takeuchi et al., 1998). Results revealed that based on responses on the self-report Social Phobia Inventory (SPIN), Asian Americans endorsed higher levels of social anxiety symptoms and were more likely to meet a threshold for "high social anxiety," using the diagnostic cutoff score of 19 or higher on the SPIN. However, when clinician-formulated diagnoses were assigned, there was no evi- dence for significant differences in the prevalence of SAD in Asian Americans versus Caucasian Americans. Explanation of the results, their implications, limitations, and future directions are discussed.

Keywords: social anxiety; diagnosis of social anxiety disorder; Asian Americans; ethnic differences

According to the U.S. Census Bureau, the Asian American population has grown faster than any other racial and ethnic group from 2000 to 2010 (Hoeffel, Rastogi, Kim, & Shahid, 2012). However, this group only represents 4.8% of the U.S. population (Hoeffel et al., 2012). With the rapid change and growth of this population, Asian Americans are be- coming more diverse in terms of composition, demographics, generational status, acculturation, and social experiences (Sue, Sue, Sue, & Takeuchi, 1995).

Given changes within the Asian American population, conducting research on Asian Americans can be challenging because of the diversity and heterogeneity of this population. An initial approach is to use aggregate samples when conducting research on this population (Sue et ah, 1995). Although aggregate samples have the risk of making overgeneralizations, research with aggregate samples can be beneficial in providing baseline information that could further be used to generate additional hypotheses and develop more refined studies to address specific between-group differences among Asian groups (Sue et al., 1995). In addition, it important to consider that Asian Americans share similar cultural beliefs and values (e.g., collectivism, inter- personal harmony, deference, filial piety, conformity to norms, humility, loss of face) that are no- tably different from non-Asian populations, thus supporting the use of an aggregate sample when examining meaningful differences between Asian Americans and another racial/ethnic group (Kim & Hong, 2004; Sue et ah, 1995; Uba, 1994). As such, research on the nature of psychopa- thology in Asian Americans could be better understood by exploring how this group compares with another group, particularly Caucasian Americans, where much of the research has focused and been conducted.

It has generally been viewed that Asian Americans are well-adjusted and therefore tend to experience less psychological problems than their Caucasian counterparts (Sue & Sue, 1987; Sue et ah, 1995). But the perception that Asian Americans have low rates of psychopathology has often been debated because there have been research findings suggesting that Asian Americans expe- rience high rates of psychopathology (Sue & Sue, 1987). Given limited epidemiological studies for this population, the extent to which psychological problems impact Asian Americans remains inconclusive. Specifically, this article focuses on the extent to which social anxiety disorder afflicts Asian Americans. Research on social anxiety in Asian Americans suggests a potential discrepancy between self-reports of social anxiety and the occurrence of social anxiety disorder, which war- rants further investigation and will be discussed herein.

Social anxiety disorder (SAD) is defined by an extreme fear of one or more social situa- tions involving people that are unfamiliar or fear of the individual being potentially scrutinized or negatively evaluated (American Psychiatric Association [APA], 2013). …

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