Asian immigrants face mental illness risks of intergenerational conflict, role changes, limited English language proficiency, and discrimination. Yet despite evidence that mental illness prevalence and severity levels are high, there also is evidence that Asians underutilize mental health services. Underutilization of mental health services is related to somatic distress, cultural differences, and stigma. Previous research shows that Asians combine primary-care, physically-oriented self-help sources (i.e. herbs, massage, exercise and dietary changes) and social support in response to symptoms of mental or emotional distress. This study investigates how illness experiences, cultural beliefs about the causes of illness, and social structural factors interact to influence help-seeking for mental or emotional distress. This study uses a multiphase, mixed ethnographic and quantitative, longitudinal design, and systematic sampling (with random start and interval sampling) to examine the influence of culture on distress and help-seeking for 250 Japanese women.
The aims are to: 1). Compare characteristics (demographics and distress symptoms) of groups of women with diverse help-seeking profiles; 2). Describe the ethnographic and psychiatric profiles of a sub-sample of 60 highly distressed women (20 women from each of three recruitment sites); 2A). Ethnographic profiles include social networks, distress experiences, cultural interpretations and evaluations, and help seeking patterns; and 2B). Psychiatric profiles include life-time history and current psychiatric diagnoses; and 3). Compare the ethnographic and psychiatric profiles within and across groups. This study uses a multidisciplinary team and rigorous methods to investigate cultural and clinical aspects of Japanese depression. It will identify cultural patterns of help-seeking to facilitate program development; elucidate cultural adaptations for existing psychiatric tools; and refine symptom profiles to improve precision of mental health assessments.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH071307-03
Application #
7282441
Study Section
Community Influences on Health Behavior (CIHB)
Program Officer
Otey, Emeline M
Project Start
2005-09-15
Project End
2009-08-31
Budget Start
2007-09-01
Budget End
2008-08-31
Support Year
3
Fiscal Year
2007
Total Cost
$328,757
Indirect Cost
Name
Michigan State University
Department
Type
Schools of Nursing
DUNS #
193247145
City
East Lansing
State
MI
Country
United States
Zip Code
48824
Arnault, Denise Saint (2018) Defining and Theorizing About Culture: The Evolution of the Cultural Determinants of Help-Seeking, Revised. Nurs Res 67:161-168
Saint Arnault, Denise M (2017) The Use of the Clinical Ethnographic Narrative Interview to Understand and Support Help Seeking After Gender-Based Violence. TPM Test Psychom Methodol Appl Psychol 24:423-436
Saint Arnault, Denise M; Gang, Moonhee; Woo, Seoyoon (2017) Construct Validity and Reliability of the Beliefs Toward Mental Illness Scale for American, Japanese, and Korean Women. Res Theory Nurs Pract 31:349-363
Saint Arnault, Denise; Shimabukuro, Shizuka (2016) Floating on Air: Fulfillment and Self-in-Context for Distressed Japanese Women. West J Nurs Res 38:572-95
Saint Arnault, Denise; Hatashita, Hiroyo; Suzuki, Hitomi (2016) Semantic Examination of a Japanese Center for Epidemiologic Studies Depression: A Cautionary Analysis Using Mixed Methods. Can J Nurs Res 48:80-92
Saint Arnault, Denise; Shimabukuro, Shizuka (2012) The Clinical Ethnographic Interview: a user-friendly guide to the cultural formulation of distress and help seeking. Transcult Psychiatry 49:302-22
Saint Arnault, Denise; Roles, Deborah J (2012) Social Networks and the Maintenance of Conformity: Japanese sojourner women. Int J Cult Ment Health 5:77-93
Arnault, Denise Saint; Fetters, Michael D (2011) RO1 Funding for Mixed Methods Research: Lessons learned from the Mixed-Method Analysis of Japanese Depression Project. J Mix Methods Res 5:309-329
Saint Arnault, Denise (2009) Cultural determinants of help seeking: a model for research and practice. Res Theory Nurs Pract 23:259-78
Saint Arnault, Denise; Kim, Oksoo (2008) Is there an Asian idiom of distress? Somatic symptoms in female Japanese and Korean students. Arch Psychiatr Nurs 22:27-38

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