Depression in Asian Americans: Does Generational Status and Acculturation Predict Severity and Type of Symptoms?

Despite being one of the most prevalent mental disorders, accurate identification and treatment of depression may be hindered by the diversity of symptom presentation across, and even within, cultures. This study sought to identify how severity and type of depressive symptoms (psychological vs. somatic) vary by acculturation and generational status among Asian Americans. A sample of 82 U.S.-born and 81 first-generation participants completed an online anonymous survey (Patient Health Questionnaire, Somatic Symptoms Scale, Vancouver Index of Acculturation). U.S.-born participants reported higher depression symptom severity than first-generation participants (U = 2,386, p = .002, η² = .06), which aligned with the hypotheses. Inconsistent with our hypotheses, somatic symptoms of depression did not differ between U.S.-born and first-generation Asian Americans (U = 2,835, p = .11, η² = .02). Symptom severity had a weak negative correlation with acculturation to mainstream culture, r(145) = −.23, p = .006, and no correlation with heritage culture orientation, r(145) = −.16, p = .06, which also did not support our predictions. Consistent with previous research, depression severity was higher in U.S.-born Asian Americans, but this difference did not appear related to acculturation. Future research should seek to understand what aspects of generational status are tied to depression severity. Although previous theorizing suggested that Asians express depression more somatically, these findings add confidence to the small body of literature that suggests this is not the case. These findings may help improve the accuracy of diagnosis, leading to improved treatment of depression for patients of Asian heritage.