The expression of depression in Asian Americans and European Americans

Past studies of the expression of depression in people of Asian descent have not considered whether observed ethnic differences in somatization or psychologization are a function of differences in the expression of the disorder or of group differences in the degree of depressive symptomatology. In the present study, we carried out χ(2) and Item Response Theory (IRT) analyses to examine ethnic differences in symptoms of Major Depressive Disorder in a nationally representative community sample of noninstitutionalized Asian Americans (n = 310) and European Americans (n = 1,763). IRT analyses were included because they can help discern whether there are differences in the expression of depressive symptoms, regardless of ethnic differences in the degree of depressive symptomatology. In general, although we found that Asian Americans have lower rates of depression than European Americans, when examining specific symptoms, there were more similarities (i.e., symptoms with no ethnic differences) than differences. An examination of the differences using both χ(2) and IRT analyses revealed that when there were differences, Asian Americans were less likely to endorse specific somatic and psychological symptoms than European Americans, even when matched in degree of depressive symptomatology. Together, these community-based findings indicate that depression among Asian Americans is more similar than different to that of European Americans. When differences do occur, they are not an artifact of the degree of depressive symptomatology but instead a true difference in the expression of the disorder, specifically a lesser likelihood of expressing specific somatic and psychological symptoms in Asian Americans compared with European Americans.