Cultural stress and behavioral health: a mixed methods study of Indian American youth in the United States
Embargo Date
2028-04-30
OA Version
Citation
Abstract
PURPOSE: This dissertation examines whether and how experiences of cultural stress and being labelled a model minority (with societal expectations of high achievement) influence behavioral health outcomes for Indian American youth in the United States (U.S.). Indian Americans now constitute the second-largest immigrant group in the U.S., having doubled in size from two million in 2000 to four million in 2019, yet little is known about the cultural issues that impact their lives. Concerning youth in this population, there is a paucity of research, specifically about whether the cultural stressors they experience have an impact on their substance use and mental health. The goal of this dissertation is to obtain more information regarding these issues to help professionals such as teachers, physicians, and social workers better address their needs.
RESEARCH QUESTIONS: Study 1: To what degree do cultural stress factors (i.e., discrimination, negative context of reception, bicultural stress) and model minority stereotype relate to permissive substance use beliefs and mental health symptoms? Study 2: Does family functioning (family support and family closeness) mediate the relationship between cultural stress and permissive substance use beliefs and mental health symptoms? Study 3: Do Indian American youth perceive themselves to be bicultural and part of a model minority, and if so, what experiences have they had that led them to these perceptions?
RESEARCH METHODS: This three-paper study used a convergent mixed methods design. Quantitative and qualitative data collection and analyses occurred simultaneously. Study 1 and Study 2 were quantitative. Two hundred and four Indian American youth (12–17 years of age), residing in the U.S. with parents who were born in India, were recruited to participate in an online survey. These youth were asked about demographics, cultural stress, family functioning, substance use and mental health symptoms. Outcome measures included self-reports of substance use beliefs, alcohol and cannabis use and symptoms of anxiety and depression. Structural equation modeling was used to analyze data for Study 1 and Study 2. For Study 3, 9 Indian American youth participated in a semi-structured interview. A particular focus was on the experiences of the youth regarding their personal narrative of living in two cultures that have divergent expectations and values and being a model minority. Interpretive Phenomenological Analysis was used to analyze interview responses.
RESULTS: The results from Study 1 indicated that bicultural identity integration was positively associated with family support which, in turn, was associated with less permissive substance use beliefs. There was a direct effect of discrimination and bicultural identity integration on permissive substance use beliefs. Study 2 findings showed bicultural identity integration was positively associated with family support which in turn was associated with fewer symptoms of depression. In addition, endorsement of the model minority stereotype was positively associated with family closeness which, in turn, related to fewer symptoms of anxiety. There was a direct effect of discrimination on symptoms of anxiety and depression. The themes from Study 3 illustrated that Indian American youth live a nuanced and complicated life as bicultural individuals (shifting between cultural identities in order to “fit in” better in each setting) who grapple with a stereotype that is endorsed by both internal (parents and relatives) and external (peers at school and teachers) environments.
IMPLICATIONS: Despite exponential growth in the Indian American population in the last 20 years, Indian American are an understudied population. This dissertation begins to fill the gap in knowledge about the impact of cultural stress on the behavioral health of these adolescents. Indian American youth have a unique history and unique cultural values and practices, and they should be regarded as a group in their own right by researchers, teachers and other providers, and by society in general.