The Personal Relevance of Psychotherapy for Asian Americans
Date
2021-11-23
Authors
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Publisher
University of Oregon
Abstract
Purpose: For at least 50 years, significant mental health disparities between people of color and White Americans have existed. There has been minimal movement in decreasing mental health disparities, particularly among Asian Americans, due to limitations in existing treatments. The personal relevance of evidence-based treatments and culturally-adapted treatments may be a crucial link in furthering intervention research, increasing client engagement with treatment, and addressing these disparities. The main objective of this study was to assess the personal relevance of Problem-Solving Therapy (PST) and Cognitive Behavioral Therapy (CBT) to Asian Americans (AAs), with data from neuroimaging methods (Study 1) and self-report measures (Study 2). I also investigated the moderating effect of acculturation on personal relevance. I hypothesized PST would be more personally relevant than CBT for low-acculturated AAs because its external problem-solving approach is less likely to conflict with Asian values.
Sample and Methods: In Study 1, using fMRI, I acquired whole-brain functional neuroimages from 28 AA participants as they completed a task assessing the self-relevance of treatment content from PST and CBT. I used a voxel-wise p-value of .005 and a cluster-extent threshold of 150 to adjust for multiple comparisons. After being scanned, participants completed self-report questionnaires. In Study 2, 88 English-speaking AAs and 54 White American adults, recruited via Qualtrics Panels, viewed the same PST and CBT stimuli and completed online self-report questionnaires.
Results: In Study 1, there was significantly greater activation in self-processing regions (medial and ventromedial prefrontal cortex) when participants viewed PST vs. CBT content. First- and second-generation (or low-acculturated) AAs experienced greater activation in self-processing regions when viewing PST vs. CBT content than third-generation (or highly acculturated) AAs. Self-report questionnaires were not correlated with activation in self-processing regions. In Study 2, AAs reported a preference for PST vs. CBT, while White Americans did not report a preference for either treatment.
Conclusion: Evidence indicates AAs prefer PST over CBT, suggesting that PST may be more culturally and personally relevant for AAs. Low-acculturated AAs preferred PST over CBT more than highly acculturated AAs, signifying that individual differences in acculturation influence the perceived personal relevance of PST.
Description
Keywords
Asian Americans, Mental health disparities, Neuroimaging, Personal relevance, Psychotherapy, Treatment