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Primary Submission Category: Race/Ethnicity
Examining mental health diagnosis as an effect modifier on multiracial Asian identity and psychological distress
Authors: Tessa Pulido, Kalani Phillips, Vivi Martinez Mendoza, Anne Saw,
Presenting Author: Tessa Pulido*
Background: Asian Americans are underrepresented in mental health service utilization. Multiracial Asians (MRAs) report higher odds of psychological distress than monoracial peers yet are more likely to seek care and report better health. The mixed findings suggest racial identity fluidity may buffer risks while also create stressors. For MRAs, a mental health diagnosis may intersect with identity to shape how distress is experienced.
Objective: This study examines multiracial identity and psychological distress between monoracial Asian and MRA (Asian-White) individuals and investigates whether pre-existing mental health diagnosis modifies this relationship.
Methods: We used data from a 2021 national needs assessment on Asian Americans. The sample (n=3,024) included 119 Asian-White and 2,905 monoracial Asian American adults. Using multivariable linear regression, we examined mental health diagnosis as an effect modifier between racial identity (Asian-White vs. monoracial Asian) and psychological distress using PHQ-4 scores.
Results: Overall, 27.5% respondents reported having a mental health diagnosis. Unadjusted t-tests revealed a significant difference in distress (Asian-White, M=4.71, SD=30; monoracial Asian, M=4.03, SD=3.26; p=0.03); however, adjusting for sociodemographic variables revealed no significant differences. Without a mental health diagnosis, our interaction model predicted higher distress for Asian-White (ŷ=4.07) than monoracial Asian individuals (ŷ=3.53). With a diagnosis, our model predicted higher distress for monoracial Asian (ŷ=5.45) than Asian-White individuals (ŷ=4.78).
Conclusion: Asian-White identity is associated with greater distress for those without a mental health diagnosis but lower distress for those with a diagnosis. Our results suggest that psychological distress may vary by racial identity. Future research may examine how pre-existing mental health diagnoses and contextual factors shape experiences for MRAs.