Apr 30, 2020 | Volume 10 - Issue 2
Stacey Diane Arañez Litam
Following the outbreak of COVID-19, reports of discrimination and violence against Asians and Asian Americans and Pacific Islanders (AAPIs) have increased substantially. The present article offers a timely conceptualization of how public and societal fears related to COVID-19 may contribute to unique mental health disparities and the presence of race-based trauma among AAPIs residing in the United States. The relationships between media, increasing rates of xenophobia and sinophobia, and racial discrimination are provided. Next, the deleterious effects of race-based discrimination on the emotional and physical well-being of people of color and Indigenous groups (POCI) and AAPIs are described. Finally, the article identifies the clinical implications of counseling AAPI clients, encourages a decolonization of current trauma-focused interventions, and presents specific strategies to heal race-based trauma in AAPI client populations.
Keywords: race-based trauma, discrimination, microinterventions, xenophobia, sinophobia
The outbreak of novel coronavirus (COVID-19) has led to unparalleled events across the United States and worldwide. Hospitals, nursing homes, and medical settings were quickly overwhelmed, and the vulnerability of these systems became apparent. A lack of federal consistency and political infrastructure resulted in differences across levels, quality, and types of state support. On January 31, 2020, the World Health Organization (WHO) declared COVID-19 a public health emergency of international concern. This sentiment was echoed by U.S. President Donald Trump on March 13, 2020, who warranted the pandemic an emergency for all states, tribes, territories, and the District of Columbia (Federal Emergency Management Agency [FEMA], 2020). A “shelter-in-place” order was instituted for many states and people were encouraged to stay home to prevent the spread of COVID-19. Indeed, the presence of COVID-19 has led to unprecedented times. However, the sociopolitical disparities illuminated by COVID-19 are not solely limited to institutional and political problems.
Asian Americans and Pacific Islanders (AAPIs) represent the fastest growing ethnic or racial group in the United States. In 2015, approximately 20.9 million people identified as AAPIs (Lopez et al., 2017). As a group, AAPIs encompass 40 distinct subgroups, each of which demonstrates heterogeneity across language, educational background, religion, immigration/migration history, beliefs about mental health, and attitudes toward help-seeking behaviors. For the purpose of this article, AAPIs are people who have origins rooted in East, South, and Southeast Asian countries. The present article offers a timely conceptualization of how public and societal fears related to COVID-19 may contribute to unique mental health disparities and race-based trauma in AAPIs residing in the United States. The relationships between media, increasing rates of xenophobia and sinophobia, and racial discrimination are provided. Next, the deleterious effects of race-based discrimination on the emotional and physical well-being of people of color and Indigenous groups (POCI) and AAPIs are described. Finally, the article identifies the clinical implications for counseling AAPI clients, encourages a decolonization of current trauma-focused interventions, and presents specific strategies to heal race-based trauma in AAPI client populations.
Xenophobia and Sinophobia in Media
The emergence of new infectious diseases historically has led to discrimination against groups of people of non-European descent (White, 2020). Indeed, the history of international infectious disease has predominantly been framed from a distinctly European perspective, which has focused on how disease negatively impacted post-colonial sites and affected trade (White, 2020). Experiences of fear and anxiety related to infectious disease often occur when people become threatened by an illness perceived as originating from outside one’s community (Taylor, 2019). Thus, the resurgence of attitudes characterized by xenophobia, or a fear of foreigners (Sundstrom & Kim, 2014), and sinophobia, which can be understood as the “intersection of fear and hatred of China” (Billé, 2015, p. 10), perpetuates a legacy of discrimination against non-White groups because of fear of illness. AAPIs have experienced a long tradition of blame and discrimination in the United States. Scapegoating AAPIs in light of COVID-19 echoes the racist “Yellow Peril” stereotype, which vilified Asian groups as a threat to job and economic security in Western nations (Kawai, 2005). The Chinese Exclusion Act of 1882, which effectively banned the immigration of Chinese persons to the United States for 10 years, further evidences historical anti-Chinese sentiments and an extensive history of discrimination against AAPIs in America (Lee, 2002).
The problematic, biased, and misleading media coverage of COVID-19 has led to increased rates of racial discrimination and sinophobic attitudes toward Chinese nationals and people of Asian origin (Wen et al., 2020). Health-related fears and phobia have been linked to misinformation fueled by sensationalist headlines (Taylor & Asmundson, 2004). Media, especially social media and the internet, are indispensable resources for information, communication, and entertainment. Following the outbreak of COVID-19, reports of discrimination and violence against Asian Americans have increased substantially across the United States (Congressional Asian American Pacific American Caucus [CAPAC], 2020).
COVID-19–related fears have resulted in the persecution of AAPIs through violent attacks (CAPAC, 2020), discrimination against their businesses, and sinophobic portrayals in media and from elected leaders (National Association for the Advancement of Colored People [NAACP], 2020). The dissemination of racially targeted content in media includes hate speech toward Chinese people, harassment, discriminatory stereotypes, and conspiracy theories (CAPAC, 2020; Schild et al., 2020; United Nations Human Rights, Office of the High Commissioner, 2020). A data analysis of two popular web platforms found a significant rise in racial slurs, invoking earlier attitudes of sinophobic propaganda. To better understand the emergence of sinophobic attitudes within online communities, Schild and colleagues (2020) collected and analyzed 222,212,841 tweets and 16,808,191 posts from Twitter and 4chan imageboards, respectively, from November 1, 2019, to March 22, 2020. The results revealed a significant increase in the presence of racial slurs that targeted Asians and Asian Americans, including “Kung-Flu,” “Ching Chong,” and “asshoe,” a term used to denigrate the accent of Chinese people speaking English (Schild et al., 2020). “Chink” was the most popular sinophobic slur and increased substantially after Donald Trump referred to COVID-19 as “the Chinese virus” (Schild et al., 2020).
Marginalized Groups Uniquely Affected
Social inequities and policies related to COVID-19 may disproportionately affect people of color and other marginalized groups, including individuals who are homeless, people with non-dominant racial and ethnic identities, undocumented individuals, people in lower socioeconomic groups, and individuals with limited access to health care. Individuals who lack shelter, reside in congregate living settings, or lack regular access to basic hygiene supplies may be at higher risk for exposure and transmission of COVID-19 (Devakumar et al., 2020; Tsai & Wilson, 2020). Given the increased prevalence of homelessness for lesbian, gay, bisexual, and transgender (LGBT) adolescents compared to their heterosexual counterparts (Cochran et al., 2002), persons with non-dominant sexual and gender identities additionally may be at greater risk. POCI may be disproportionately vulnerable to COVID-19 exposure because of greater rates of existing medical and mental health conditions. Higher rates of hypertension in African American and Black individuals (Go et al., 2014) and diabetes in South Asian populations (Unnikrishnan et al., 2018) have been identified as pre-existing health conditions that negatively affect the prognosis of COVID-19 treatment (Centers for Disease Control and Prevention, 2020). Undocumented persons may also face unique challenges because of fears associated with seeking medical assistance. Consequently, by the time undocumented persons arrive to medical settings, the disease has reached an advanced stage and physical health is significantly compromised (Devakumar et al., 2020).
Effects of Racial Discrimination on Wellness
Racial microaggressions are the everyday slights, insults, invalidations, and offensive behaviors experienced by POCI through interpersonal verbal and nonverbal communication, media, educational curriculum, mascots, monuments, and other forms (Sue et al., 2007). Indeed, the experiences of racism, discrimination, and microaggressions faced by POCI negatively affect their mental and physical health (Alvarez et al., 2016; American Psychological Association, 2016) and increase their risk factors for developing mental and physical health problems (Carter, 2007; Carter et al., 2005; Clark et al., 1999; Harrell, 2000; Pieterse et al., 2012). Although many Indigenous, Latinx, and Asian populations face racial discrimination and suffer from race-based stress, African American and Black individuals are disproportionately affected (Chou et al., 2012). Experiencing racial discrimination has been linked to increased rates of depression in African Americans (Chou et al., 2012; Jones et al., 2007), Pacific Islanders (Allen et al., 2017), Indigenous women (Benoit et al., 2016), and Latinx populations (Araújo & Borrell, 2006; Chou et al., 2012; Pieterse et al., 2012). Indeed, ongoing experiences of racial discrimination have been described as resulting in a chronic state of “racial battle fatigue” that taxes the mental and emotional resources of people of color (Smith et al., 2011, p. 64).
In one study of 12 common mental health disorders, including major depressive disorder, dysthymic disorder, panic disorder, separation anxiety disorder, social anxiety, generalized anxiety, post-traumatic stress, alcohol abuse, drug use, attention deficient hyperactivity disorder, oppositional defiant disorder, and conduct disorder, using a national sample (N = 5,191), perceived discrimination was positively associated with each mental health diagnosis in African American and Afro-Caribbean adults (Rodriguez-Seijas et al., 2015). Perceived racial discrimination also has deleterious effects on Asian Americans’ wellness. Studies have consistently linked race-related stress and perceived discrimination in AAPIs to increased rates of psychological distress, suicidal ideation, anxiety, and depression (Gee et al., 2007; Hwang & Goto, 2008; Wei, Alvarez, et al., 2010). Additional studies have evidenced how the presence of race-based stress significantly and negatively correlates to feelings of self-esteem (Liang & Fassinger, 2008), social connectedness (Wei et al., 2012), and overall well-being (Iwamoto & Liu, 2010) in Asian American populations. The daily experiences of racial microaggressions, combined with the current political climate (Potok, 2017), represent a source of significant stress for POCI and may lead to racial trauma.
Racial trauma refers to the events or danger related to real or perceived experiences of racial discrimination (Carter, 2007). These experiences include threats of harm and injury, humiliating and shameful events, and witnessing harm to other POCI because of real or perceived racism (Carter, 2007). The effects of racial trauma parallel symptoms of other trauma-based disorders, including acute stress disorder and post-traumatic stress disorder. POCI may experience hypervigilance, avoidance, flashbacks, and nightmares related to the events of racial discrimination (Comas-Díaz et al., 2019) and somatic expressions, including headaches, heart palpitations (Comas-Díaz et al., 2019), dizziness, confusion, and difficulty concentrating (Hinton & Jalal, 2019). Healing race-based trauma requires counselors to consider the intersectional identities that uniquely influence experiences of oppression and discrimination for marginalized groups. Because POCI experience race-based stress throughout their lives (Gee & Verissimo, 2016) and the nature of discrimination lies within sociocultural contexts (Comas-Díaz et al., 2019), healing these racial wounds can be difficult.
Although facing the daily onslaught of microaggressions and racial discrimination clearly contributes to the presence of race-based stress and trauma across POCI, specific strategies to address each of these racial groups is beyond the purview of this article. The increased rates of sinophobic attitudes, behaviors, and racial slurs fueled by COVID-19 fears, internet activity, and media misinformation are specific stressors that may uniquely affect AAPI groups. The following sections outline the clinical implications for counseling AAPIs who face racial discrimination resulting from COVID-19 fears and the current sociopolitical climate.
Clinical Implications for Counseling Asian Americans and Pacific Islanders
In the United States, an ideology of White supremacy exists, which justifies policies and practices that maintain the subordination of people of color through social arrangements using power and White privilege (Huber & Soloranzo, 2015). Addressing disparities in racial wellness thus requires counselors to challenge these existing inequalities embedded in the current social zeitgeist. The combined fear of infectious disease, misrepresentation in media, and current sociopolitical climate have illuminated the importance of identifying culturally sensitive strategies to heal race-based trauma in AAPIs. Beginning from initial assessment and intake, counselors must consider how intersectional identities such as ethnicity, country of origin, affectional identity, gender identity, age, socioeconomic status, and other statuses influence the social positioning, experiences, and worldview of their AAPI clients. Counselors must additionally be prepared to navigate language barriers, undocumented status, and challenges related to health care access with cultural humility.
As counselors prepare to screen for race-based trauma, it becomes of paramount importance to consider how Southeast Asian and Chinese populations are more likely to report somatic complaints that differ from Eurocentric trauma symptoms, including difficulty sleeping, dizziness, difficulty concentrating, and physical complaints such as headaches, stomach problems, and chronic pain (Dreher et al., 2017; Grover & Ghosh, 2014; Hinton & Good, 2009; Hinton et al., 2018). As with all clients, counselors are called to reflect on how their own internalized biases and attitudes may compromise treatment effectiveness and to avoid imposing their values onto clients (American Counseling Association, 2014). The experiences of racial oppression and discrimination toward AAPIs are often overlooked because of the model minority stereotype that portrays Asian Americans as achieving high educational and societal success (Ocampo & Soodjinda, 2016). In reality, AAPIs face explicit experiences of racism and physical and emotional harassment related to accents and physical appearance (Choi & Lim, 2014; Qin et al., 2008). Counselors are thus encouraged to pursue their own counseling and engage in dialogue with supervisors, friends, and colleagues to identify and challenge the presence of implicit biases or preconceived notions held about AAPI groups. Counselors must consider ways to deliver treatment within the cultural settings in which clients feel most safe and comfortable (Helms et al., 2012) to effectively heal race-based trauma in AAPIs.
Decolonizing Trauma-Based Interventions
Constructs related to trauma, traumatic stress, and trauma-based interventions are largely embedded in European perspectives and historically have failed to consider the influence of intersectional identities in trauma treatment and recovery (L. S. Brown, 2008; Hernández-Wolfe, 2013; Mattar, 2011). The importance of contextualizing trauma-based interventions when working with people of color has been identified in the literature (Helms et al., 2012), and the extant literature on trauma-based interventions has identified a lack of cultural relevance for most POCI (Bryant-Davis & Ocampo, 2006; Hinton & Good, 2016; Hinton & Lewis-Fernández, 2011). Many existing theories and trauma-based interventions may therefore lack cultural relevance for AAPI groups. Counselors must therefore decolonize trauma-based interventions and consider whether trauma treatments are culturally sensitive and appropriate for Asians and Asian Americans who present with COVID-19–related trauma symptoms.
Healing Race-Based Trauma in AAPIs
When racial discrimination occurs, people of color, including AAPIs, may experience rumination about the situation and negative self-evaluation because of lack of action (Shelton et al., 2006; Sue et al., 2007). POCI who respond passively, ignore, or do not stand up for themselves may experience greater feelings of helplessness or hopelessness, or be more likely to endorse the fatalistic belief that racism is normative and must be accepted (Williams & Williams-Morris, 2000). For many AAPI individuals, facing sinophobic attitudes and behaviors may result in problematic outcomes. Because Asian cultures tend to discourage conflict and demonstrate a preference for maintaining interpersonal harmony (Ting-Toomey et al., 2000; Yum, 1988), AAPIs may be more likely to employ the use of indirect and subtle approaches (Lee et al., 2012). Compared to other racial groups, AAPIs may be more likely to use maladaptive coping strategies linked to poorer mental health outcomes, including avoidance (Edwards & Romero, 2008), internalization of events in ways that lead to self-blame and self-criticism, social isolation (Wei, Heppner, et al., 2010), and substance use (Pokhrel & Herzog, 2014).
Promoting Mindfulness and Self-Compassion
Increasing self-compassion through mindfulness and compassion meditation represents a culturally sensitive strategy to heal race-based trauma in AAPIs. Originating from Buddhist psychology, compassion meditation helps people release feelings of anger and decrease suffering by cultivating compassion and unconditional regard toward the self and others (Germer & Neff, 2015). Increasing self-compassion may decrease feelings of guilt and shame following instances of racial discrimination by fostering feelings of love and kindness toward oneself. As an emerging clinical intervention, compassion meditation has yielded positive results in decreasing experiences of shame and self-criticism (Gilbert & Procter, 2006; Kuyken et al., 2010), reducing symptoms of depression (Graser et al., 2016; Kearney, 2015), and promoting overall psychological wellness (Hofmann et al., 2011; Shonin et al., 2015). Notably, compassion-based mindfulness interventions show promise as a culturally sensitive strategy to heal race-based trauma (Au et al., 2017; Germer & Neff, 2015; Kearney, 2015). Mindfulness interventions such as compassion meditation may additionally address societal limitations related to health care access and financial barriers. Compassion meditation can be practiced anywhere and does not require expensive books, seminars, or the use of tools.
Counselors can support AAPI clients who present with race-based trauma to cultivate self-compassion by encouraging them to focus on their immediate needs, without judgment, in the present. According to Germer and Neff (2015), the main question when cultivating self-compassion is “What do I need now?” (p. 50). This inquiry is intended to help people connect with their emotional wants, needs, and desires, in the moment, without judgment. Turning awareness toward oneself may illuminate the need for community support or peer support, or point to a physical need, such as fatigue or hunger. Counselors may promote self-compassion through the meditative Hawaiian prayer, Ho’oponopono. Clients may practice the Ho’oponopono meditation by directing four statements toward themselves: “I love you,” “I’m sorry,” “Thank you,” and “Forgive me.” Counselors may help clients begin to heal race-based trauma by empowering them to reflect on their phenomenological experiences as each statement was made. Counselors are encouraged to engage in their own experiences of mindfulness and self-compassion to deepen their understanding of how to modify the practices for clients (Germer & Neff, 2015).
Microinterventions
Counselors may empower AAPI clients facing racial discrimination by providing psychoeducation about microinterventions and creating opportunities for behavioral rehearsal using role plays. Microinterventions are everyday words, deeds, or actions that communicate validation of experiential reality, value as a person, affirmation of racial or group identity, support and encouragement, and reassurance that the receiver is not alone (Sue et al., 2019). Microinterventions seek to empower POCI, White allies, and bystanders to confront and educate perpetrators of microaggressions and have four major strategic goals: making the “invisible” visible, disarming the microaggression, educating the perpetrator, and seeking external reinforcement or support (Sue et al., 2019). Before engaging in microinterventions, it is important to consider the possible positive and negative consequences that may occur. Counselors should discourage AAPI clients from addressing microaggressions when doing so may threaten their physical safety. Engaging in microinterventions in scenarios where a strong power differential exists, such as in workplace or education settings, also requires special consideration (Sue et al., 2019). A full description of each microintervention strategy, goal, objective, rationale, and tactic are beyond the purview of this article, although a few examples for practical application for AAPI clients in counseling are provided below.
Making the “Invisible” Visible. Making the “invisible” visible represents an important component of healing race-based trauma. The first step to liberation necessitates naming the innuendo because it provides language for POCI to describe their experiences and seek mutual validation (Freire, 1970). Counselors may empower AAPI clients to make the “invisible” visible by bringing the microaggression to the perpetrator’s awareness, indicating to the perpetrator that they have spoken or behaved in an offensive way, or forcing the perpetrator to consider the impact and meaning of what has occurred (Sue et al., 2019). These tactics serve to undermine the metacognition, make the metacognition explicit, and broaden the ascribed trait (Sue et al., 2019) and may be helpful for AAPIs who experience race-based discrimination. For example, an Asian American who is accused of having “Kung-Flu” in public may make the metacognition explicit by stating, “You assume I am contagious because of the way I look.” In the same scenario, ascribed traits can be broadened and clarification can be obtained by using statements such as “Anyone can become infected with COVID-19; it is not solely limited to Asians,” and “Are you worried I will get you sick?” Each of these responses are intended to directly identify and address the microaggression while bringing awareness of the metacognition to the perpetrator.
Disarming the Microaggression. Disarming the microaggression may be employed to stop or deflect the microaggression, force the perpetrator to consider their actions, and communicate disagreement (Sue et al., 2019). Helpful tactics AAPIs can use to disarm microaggressions include expressing disagreement, using an exclamation, and stating values and setting limits (Sue et al. 2019). For example, a young Asian American who sees denigrating comments about AAPI individuals on a social media page may respond with the exclamation, “Ouch!” According to Aguilar (2006), this simple exclamation communicates that something offensive has occurred and forces the person to consider the impact and meaning of their behavior. In the same situation, AAPIs may state values and set limits by responding to an offensive comment with, “I have always been respectful of your values and recognize how people are free to hold different attitudes, but I hope you see that what you have written is offensive.”
Educate the Offender. Although it is inappropriate to ask POCI to educate and confront perpetrators, as it exclusively puts the onus of change onto the marginalized person, educating the offender may represent an important strategy to affect societal change. One powerful objective is to facilitate an enlightening conversation that indicates how what has occurred was offensive (Sue et al., 2019). This tactic helps perpetrators differentiate between their intent and the resulting impact (Sue et al., 2019). Because many people become defensive and shift from action to intention when a microaggression is pointed out (Sue, 2015), differentiating between good intent and harmful impact represents a powerful educational strategy (Sue et al., 2019). For example, a Chinese woman may hear COVID-19 incorrectly termed “the Chinese virus” in a conversation among colleagues. In this scenario, she may choose to engage in an enlightening dialogue to educate the offender about how the term “Chinese virus” perpetuates offensive sinophobic attitudes. A helpful conversation starter might be, “I know you may not realize this, but referring to COVID-19 as ‘the Chinese virus’ denigrates Asian individuals and is offensive.” In the same situation, it may additionally be helpful to point out how the term “Chinese virus” violates the WHO (2015) best practices policy for naming new human infectious diseases.
Seek External Reinforcement or Support. The final microintervention is aimed at the promotion of regular self-care, ensuring optimal levels of functioning, and communicating to perpetrators that bigoted behavior is unacceptable (Sue et al., 2019). Self-care and promoting wellness can be employed by pursuing counseling, reporting sinophobic behaviors to appropriate authorities, and seeking the support of one’s spiritual or religious communities (Sue et al., 2019). An increasing number of AAPIs are reaching out to crisis support hotlines. As of March 2020, approximately 13% of AAPIs had contacted crisis text lines compared to 5% of other U.S. callers, respectively (Filbin, 2020). Similar to other POCI, the presence of social support and collective gathering represents an effective coping strategy for Asian Americans (Wei, Alvarez, et al., 2010; Wei et al., 2012; Yoo & Lee, 2005). Indeed, seeking support represents an important strategy AAPIs employ to preserve mental health.
Cultural Proverbs and Analogies
Incorporating proverbs and analogies embedded in AAPI traditions are culturally sensitive strategies to empower clients and strengthen their ethnic identity. Cultural metaphors and stories may additionally strengthen the therapeutic alliance, as AAPI clients may feel their counselor understands and appreciates their cultural background (Hinton & Jalal, 2019). Strong identification with one’s ethnic group promotes wellness and serves as a protective factor in AAPI groups (Iwamoto & Liu, 2010) and Filipino Americans (Mossakowski, 2003). Counselors can empower clients to promote ethnic pride and increase cultural commitment by using proverbs and stories from client culture in counseling. Guiding AAPI clients to embrace their rich and important tradition of knowledge may promote self-esteem and decrease negative affect (Hinton & Jalal, 2019).
Two popular examples of Filipino proverbs may be helpful to promote the importance of social support and cultivate compassion when perpetrators are reluctant to recognize how their behaviors are offensive. A Filipino proverb posits, “A broom is sturdy because it is tightly bound” (in Tagalog, “Matibay ang walis, palibhasa’y magkabigkis”). This message aligns with a collectivistic mentality that people are stronger when standing together. Another Filipino proverb suggests, “It is hard to wake someone up who is pretending to be asleep” (in Tagalog, “Mahirap gisingin ang nagtutulog-tulugan”). This saying cultivates empathy and compassion for perpetrators of microaggressions and sinophobic behavior by reminding clients how it is difficult to educate others when they are not ready or willing to expand their worldviews. Similarly, a Chinese proverb states, “If you are planning for a year, sow rice; if you are planning for a decade, plant trees; if you are planning for a lifetime, educate people.” This saying may motivate clients to engage in dialogue with the people in their lives who have committed hurtful microaggressions. Because AAPI clients tend to terminate counseling at earlier rates compared to other racial groups (Sue & Sue, 2016), counselors can use appropriate cultural analogies to demystify the counseling process. For example, counselors may liken the therapeutic process to cooking a traditional noodle dish (Hinton & Jalal, 2019). Analogous to preparing japchae in Korean culture, pancit palabok in Filipino kitchens, or the Chinese dish zhajiangmian, healing from race-based trauma is a process that necessitates patience, creativity, commitment, and flexibility.
Discussion
The U.S. Surgeon General has recognized how racial and ethnic health disparities are strongly linked to the presence of systemic and ongoing cultural racism (U.S. Department of Health and Human Services, 2000). Counselors who hold dominant social identities (e.g., White, male, heterosexual) are uniquely positioned to use their power and privilege to advocate on behalf of AAPI clients, other POCI, and other marginalized groups by challenging systemic forms of oppression. Indeed, endorsing positive attitudes about diversity (Broido, 2000) and consciously committing to disrupting the cycle of injustice (Waters, 2010) are foundational characteristics of White allies, who seek to end disparity and work to promote the rights of oppressed groups (K. T. Brown & Ostrove, 2013). According to Sue and colleagues (2019), allies actively commit to engaging in actions that dismantle individual and institutional beliefs, practices, and policies that have created barriers for people of color.
AAPIs are facing greater rates of racial discrimination, harassment, violence, sinophobic attitudes, and racial slurs because of fears related to COVID-19 and the current sociopolitical climate. Counselors may help AAPI clients heal race-based trauma through the use of culturally adapted strategies such as promoting mindfulness and self-compassion, employing the use of microinterventions, and incorporating culturally appropriate proverbs and analogies in counseling treatment. Counselors are encouraged to adopt strategies to help AAPIs heal from race-based trauma because experiences of racial discrimination, microaggressions, and sinophobic behaviors are not limited to the current pandemic and instead represent longstanding forms of oppression embedded in American history and culture. AAPIs faced marginalization and racial discrimination before the presence of COVID-19 and will likely continue to experience race-related stress long after the discovery of a vaccination. Just as COVID-19 has illuminated disparities within medical, institutional, and political systems, it has also uncovered the enduring ethnocentric attitudes of many Americans. The proliferation of ongoing discrimination of all racial, ethnic, and marginalized groups is representative of a more insidious form of societal sickness.
Limitations and Future Areas of Research
Although the present article outlines the culturally alert strategies for healing race-based trauma among AAPIs, other marginalized groups face unique challenges related to the unprecedented effects of COVID-19 on social, institutional, and political levels. The deleterious effects of homelessness, social isolation, witnessing of real or perceived racial discrimination or violence, and issues related to LGBTQ individuals because of COVID-19–related issues and policies remain of paramount importance but were not explicitly discussed in this article. Future areas of research may examine the effects of racial discrimination during public health crises and other global events (Wen et al., 2020). Additionally, the ways in which AAPI groups respond to instances of racial discrimination and sinophobia because of COVID-19–related stress remain largely unknown. The manifestation of intergenerational trauma on AAPI families related to COVID-19 also represents an important area of future study. Finally, the national and global effects of COVID-19 on the mental health of diverse groups represents an essential topic of future study.
Conflict of Interest and Funding Disclosure
The authors reported no conflict of interest
or funding contributions for the development
of this manuscript.
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Stacey Diane Arañez Litam, PhD, NCC, CCMHC, LPCC, is an assistant professor of counselor education at Cleveland State University. Correspondence may be addressed to Stacey Litam, Cleveland State University, 2121 Euclid Avenue, Julka Hall 275, Cleveland, OH 44115, s.litam@csuohio.edu.
Apr 29, 2020 | Volume 10 - Issue 2
Joel A. Lane
To improve conceptualizations of college student mental health, the present study (N = 538) compared predictors of well-being that comprise both well-established counseling theories (e.g., attachment) and newer models specific to the life experience of the millennial generation and Generation Z. Predictors included internal resources (i.e., attachment security, ego resilience), emerging adulthood identification, and social resources (i.e., social support, social media usage). Each variable set predicted significant variance. The emerging adulthood and social media variables accounted for approximately 7% of variance in both psychological well-being and life satisfaction. Identifying emerging adulthood as a time of negativity and instability was the second strongest predictor of psychological well-being, while identifying emerging adulthood as a time of experimentation and possibilities was the second biggest predictor of life satisfaction. Implications for conceptualizing and treating today’s students are discussed.
Keywords: college counseling, emerging adulthood, social media, attachment, social support
In recent years, higher education personnel have noticed declines in college student emotional health and corresponding increases in stress, depression, and anxiety (Watkins et al., 2012). The rates of students exhibiting frequent anxiety and depression symptoms have nearly doubled over a 30-year period and are now two to three times higher than those of the general population (American College Health Association [ACHA], 2015). Administrators have also described corresponding changes in college counseling services, especially regarding the increased need for crisis intervention and triage services (Watkins et al., 2012).
These trends roughly correspond to the millennial generation and Generation Z entering college. The societal forces that characterize these generational cohorts, including the proliferation of social media (Ellison et al., 2007; McCay-Peet & Quan-Haase, 2017) and increases in parental involvement and corresponding decreases in perceptions of college student maturity and autonomy (Watkins et al., 2012), seem to have substantially altered the psychosocial trajectories for today’s traditional-aged college populations (Arnett, 2004, 2016). The counseling profession has wrestled with how best to respond to these trends, and in many cases has relied on conceptual frameworks and theories of psychosocial development created long before the emergence of the millennial generation. It seems timely to attempt to develop a framework for mental health and well-being during the college years that incorporates theories specific to present generations of traditional-aged college students with more well-established theories of development. Such is the purpose of the present study, in which the contributions to college student well-being of attachment security (Bowlby, 1969/1997), ego resilience (Block & Block, 1980), and social support are integrated with and compared to the theory of emerging adulthood (Arnett, 2004), a conceptualization of psychosocial development occurring from the late teens through the 20s for contemporary generations.
Attachment and Ego Resilience
It is generally accepted that the constructs of attachment security and ego resilience play important roles in college student mental health and well-being (e.g., Lane, 2015; Taylor et al., 2014). According to Bowlby (1969/1997), the quality of our earliest interactions with caregivers provides us with relational templates, or types of attachment, that influence self-worth and interpersonal functioning throughout the life span. Ego resilience is a personality trait reflecting our ability to adapt and thrive amid stress and transition (Block & Block, 1980; Taylor et al., 2014). In the present study, attachment and ego resilience are conceptualized as internal resources because they are instilled early in life, relatively stable over time, and influential to mental health during the college years (Lane, 2016; Lane et al., 2017; Taylor et al., 2014).
Attachment and ego resilience also similarly impact functioning in times of challenge. With secure attachment, individuals are more likely to believe themselves capable of handling adversity and that others can be called upon in times of need (Brennan et al., 1998), presumably because of the consistent responsiveness of their caregivers earlier in life. Conversely, insecure attachment can lead individuals to doubt their own capabilities (i.e., attachment anxiety) or the intentions of others to provide them with support (i.e., attachment avoidance) in times of need. These internalized beliefs can lead to problematic outcomes during distressing situations (Wei et al., 2007), including maladaptive interpersonal dependence or isolation and a heightened focus on the distress (Brennan et al., 1998). Similarly, individuals high in ego resilience are generally able to respond to stressful situations with flexibility and an assortment of healthy coping behaviors (Taylor et al., 2014). Conversely, individuals low in ego resilience may lack the diversity of healthy coping strategies necessary to effectively persevere through a range of life challenges, and they may be prone to giving up when frustrated (Block & Block, 1980). Thus, individuals with attachment insecurity and low ego resilience are at an increased risk of accumulating stress during stressful situations rather than persevering through them (Brennan et al., 1998), which is a likely explanation for the associations of each construct with depression and anxiety symptoms (Taylor et al., 2014).
This latter point is especially important in the context of the present study. The college experience contains numerous life and role transitions, including leaving home, establishing independence, reconstructing social support networks, and developing professional goals (Lane, 2015). Each of these transitions pose opportunities for students high in internal resources to thrive and risks for those who are low in internal resources to accumulate stress and negative mental health symptoms (Lane, 2015). Accordingly, internal resources are conceptualized as the first set of constructs in the present model. That is, they seem to provide a foundation for college student mental health and well-being and perhaps do so by contributing to other potentially relevant aspects of well-being, such as identification with emerging adulthood (Schnyders & Lane, 2018) and social support (Galambos et al., 2006).
Emerging Adulthood
Although attachment and ego resilience have long been considered contributors to college student mental health and well-being, many of the aforementioned factors involved in declining mental health trajectories comprise social forces unique to present-day young adults. Emerging adulthood (Arnett, 2004) is a theory that describes the effects of such factors on psychosocial functioning between the ages of 18 and 29. Specifically, it suggests that this age range now represents a period of life distinct from both adolescence and adulthood. The theory describes several dimensions that are representative of the present-day emerging adult experience, including a prolonged period of identity exploration (i.e., using the emerging adulthood years to consider and audition preferences regarding career, worldviews, romantic relationships, and interpersonal characteristics), significant demographic and relational instability (e.g., increased likelihood of multiple residence changes with respect to previous generations, causing disruptions in social groups), subjectively feeling in between adolescence and adulthood, and idealistic thinking about future possibilities (Arnett, 2004). These dimensions suggest that emerging adulthood is a complex phenomenon with significant individual variation: One’s degree of identification with each dimension can shape their relative satisfaction with the overall emerging adulthood experience (Baggio et al., 2015). Moreover, some evidence suggests that parental attachment quality predicts one’s identification with the various themes of emerging adulthood (Schnyders & Lane, 2018).
Emerging adulthood theory has several implications in the context of college student well-being. First, life transition is a salient theme of emerging adulthood, given that the late teens and 20s are a time of leaving the parental household, creating new attachment and support networks, entering and persisting through college (for many emerging adults), and entering the world of work (Arnett, 2004). These transitions can leave emerging adults vulnerable to distress (Lane et al., 2017) and are central features of the college student experience. Second, emerging adulthood suggests that present traditional-aged college students are at an earlier stage of psychosocial development than prior generations, even though expectations placed on them have remained stable (Arnett, 2004). Thus, emerging adult college students are still expected to navigate the many transitions of the college experience regardless of whether or not they have developed the necessary maturity and life skills. Finally, the emerging adulthood years constitute a high degree of risk-taking behaviors, impulsivity, and psychiatric risk (Arnett, 2004; Baggio et al., 2015). That is, not only is emerging adulthood a time of vulnerability to stress, but also a time of elevated risk for maladaptive stress responses. Thus, in the context of the present study, it is possible that the emerging adult experience uniquely contributes to mental health and well-being with respect to the contribution of internal resources.
Social Resources
Like interpersonal resources and emerging adulthood, social support is a construct with implications for mental health. The degree to which an individual feels supported by their close relationships mitigates distress during stressful situations (Sarason et al., 1991). Individuals who are satisfied with their social support also report less depression, anxiety, and loneliness, and enhanced well-being compared to those low in social support (Galambos et al., 2006).
The aforementioned societal changes impacting emerging adulthood also have implications for college student social support. Today’s emerging adult social support networks have grown in complexity as psychosocial developmental trajectories have continued to evolve (Arnett, 2004) and social media has become an increasingly ingrained aspect of everyday life. These changes necessitate reconsideration of the construct of social support in the 21st century. That is, what are the implications for social support when interpersonal contact is increasingly conducted electronically? Is it possible for one to derive the benefits of social support from social media interactions? To address these questions, Manago et al. (2012) asked a sample of college students to respond to various support-related questions while browsing Facebook. Participants were able to use Facebook to meet certain intimacy needs, especially that of emotional disclosure, and the size of one’s Facebook friends list was positively associated with perceived social support and life satisfaction. Others have suggested that social media sites provide social capital and facilitate sustained connection with potentially beneficial relationships (Ellison et al., 2007). In light of these ideas, the present study conceptualizes social resources to include both social support and social media usage. Assessing the degree to which each construct impacts college student mental health and well-being is important given the ubiquity of social media on college campuses and the current disagreement among scholars regarding its benefits (Manago et al., 2012) and drawbacks (Twenge, 2013). Given that social support seems to facilitate the contributions of internal resources to mental health (Taylor et al., 2014) and emerging adulthood contributes to increasingly complex social networks (Arnett, 2004), social resources are conceptualized as a third level of constructs in the present model, after internal resources and emerging adulthood identification.
Present Study
The present study was designed to address several literature gaps concerning college student mental health and well-being. First, it combines several disparate threads of related research by testing a model including internal resources (i.e., attachment security and ego resilience), identification with the dimensions of emerging adulthood, and social resources (i.e., social support and social media usage). Although some research has examined the additive impact of more than one of these sets of constructs together (e.g., attachment and social support), no existing research has examined all three collectively. Second, the present study examined the mental health implications of emerging adulthood and social media usage: two constructs that are the result of 21st century societal forces. A primary hypothesis of the study was that each predictor variable set would explain unique and additive variance for two characteristics of college student mental health (i.e., psychological well-being [PWB] and life satisfaction). A secondary hypothesis was that emerging adulthood identification and social media usage would predict unique variance in each outcome variable even after accounting for the effects of all other predictor variables in the model.
Method
Participants and Procedure
Participants in this IRB-approved study were traditional-aged undergraduate students from a large, public university in a metropolitan area of the Pacific Northwest. Participants were recruited via a recruitment email sent to a random sample of students meeting the inclusion criteria (i.e., 18 to 25 years old and enrolled as a full-time undergraduate student). An a priori power analysis was conducted to determine appropriate sample size (Faul et al., 2007). Given the large number of variables in the model and the fact that Hypothesis 2 was based on semipartial correlations, a small-to-medium effect size was selected (f 2 = .08). Results suggested an ideal sample size of approximately 400 participants. Assuming an approximate 10% response rate (Manfreda et al., 2008), recruitment emails were sent to 4,000 undergraduates.
The recruitment email contained a link to an online survey containing all demographic and study variable items. Surveys were received from 616 undergraduates (15.4% response rate). Data were treated according to the recommendations for multivariate analysis by Meyers et al. (2013). That is, 56 cases (9.1%) were removed because they contained missing data on at least 50% of the items. An additional 17 cases (2.8%) were removed for indicating that they were no longer paying attention at the midpoint of the survey. The remaining missing values were replaced with their respective item mean because no item was missing more than seven cases (1.3%) and no variable contained more than two missing items for any remaining participant. Data were screened for multivariate outliers using Mahalanobis distance, resulting in the removal of five (0.9%) participants. Thus, the study sample consisted of 538 participants.
The study sample had a mean age of 21.72 years (SD = 2.05) and was predominantly female (n = 378, 70.3%), while other participants identified as male (n = 142, 26.4%) or other (n = 16, 3.0%), and two participants declined to answer. The sample was racially diverse, as 341 (63.4%) participants identified as White, 64 (11.9%) as Latinx, 63 (11.7%) as Asian or Pacific Islander, 14 (2.6%) as Black or African American, 11 (2.0%) as Arab American or Middle Eastern, eight (1.5%) as Native American, 27 (5.0%) as multiracial, and seven (1.3%) as other, while three participants declined to answer.
Instruments
Attachment security. As the first internal resources variable, attachment security was measured using the 12-item Experiences in Close Relationship Scale-Short Form (ECR-S; Wei et al., 2007). The items are evenly divided into two subscales: Attachment Anxiety (e.g., “I need a lot of reassurance that I am loved by my partner”) and Attachment Avoidance (e.g., “I am nervous when partners get too close to me”). Items are rated on a 7-point Likert scale. Scores were summed, with higher scores indicating higher attachment insecurity for each dimension. Internal consistencies in the present sample (α = .78 for attachment anxiety, α = .80 for attachment avoidance) mirrored those reported by the ECR-S authors (α = .77 and α = .78, respectively).
Ego resilience. Ego resilience served as the other internal resources variable. It was measured using an 11-item version of Block and Block’s (1980) Ego-Resiliency Scale (Taylor et al., 2014). Items (e.g., “I can bounce back and recover after a stressful or bad experience”) are rated on a Likert scale ranging from one (most undescriptive of me) to nine (most descriptive of me). Higher total scores indicate higher ego resilience. The 11-item version has demonstrated internal consistencies ranging from .63 to .81 across multiple time points with a sample of emerging adults (Taylor et al., 2014). Internal consistency in the present sample was .73.
Emerging adulthood. The second level of predictor variables comprised dimensions of emerging adulthood. Identification with emerging adulthood dimensions was assessed using the 8-item Inventory of Dimensions of Emerging Adulthood (IDEA-8; Baggio et al., 2015). The items are evenly divided into four subscales (i.e., Experimentation/Possibilities, Negativity/Instability, Identity Exploration, and Feeling In Between [adolescence and adulthood]) that each represent dimensions of emerging adult theory (Arnett, 2004). Participants rate the degree to which various statements represent the present time in their lives (e.g., “this is a time of deciding on your own beliefs and values”) on a 4-point scale (1 = strongly disagree, 4 = strongly agree). Scores for each subscale are summed to indicate how participants feel each dimension characterizes their emerging adulthood experience. The IDEA-8 subscales demonstrate internal consistencies ranging from .66 to .76 (Baggio et al., 2015), mirroring the range
found in the present sample (α = .69 to α = .77).
Social support. Social support served as the first social resources variable. It was measured using the 6-item Subjective Social Support subscale of the Duke Social Support Index (Blazer et al., 1990). Items (e.g., “Can you talk about your deepest problems with at least some of your family and friends?”) are rated on a 5-point scale (1 = none of the time, 5 = all of the time), with higher scores indicating higher perceived social support. Internal consistency in the present sample was .85, mirroring estimates found in prior studies (α = .82; Hawley et al., 2014).
Facebook usage. The other social resources variable was social media usage, measured using the 8-item Facebook Intensity Scale (FIS; Ellison et al., 2007). Although numerous social media platforms are popular among college students, developers of social media usage instruments have focused on Facebook. Given its recognizability and ubiquity, it remains the best proxy for assessing overall social media usage (Ortiz-Ospina, 2019). The first FIS item asks participants to approximate their number of Facebook “friends,” while the second item asks them to approximate time spent on Facebook each day. The remaining items ask participants to rate their agreement with various items assessing the importance of Facebook in their lives (e.g., “Facebook has become a part of my daily routine”). Items are first standardized and then summed to create an index of Facebook usage. The FIS authors reported strong convergent validity and internal consistency (α = .83), mirroring that found in the present sample (α = .87).
College student mental health. Operationalizing mental health is challenging given its many existing conceptualizations. Some authors have argued that mental health and mental illness are separate constructs entirely (e.g., Lent, 2004). Lent (2004) suggested that a complete understanding of mental health incorporates both PWB and subjective well-being (i.e., happiness) and added that subjective well-being is best conceptualized as a higher-order outcome of PWB. Others have argued that PWB and depression are opposite ends of the same construct (Bech et al., 2003), suggesting that PWB instruments also measure depressive affect and vice versa. Collectively, and in conjunction with the focus on depressive symptoms in the aforementioned college student mental health research, it seems useful to conceptualize mental health using indices of PWB and life satisfaction (Lent, 2004).
Psychological well-being. PWB was measured using the 5-item World Health Organization-Five Well-Being Index (WHO-5; Bech et al., 2003). Each item is a positively worded self-statement measuring the absence of various symptoms of depression (e.g., “I have felt calm and relaxed”). Because of its ability to measure both well-being and depression, it was selected as an ideal candidate for the present study. The presence of each statement over a 2-week period is rated on a 6-point scale (0 = not present,
5 = constantly present). Scores are multiplied by four to create a 0–100 scale, with higher scores indicating higher PWB, and scores below 28 indicating clinical depression (Bech et al., 2003). The authors reported strong evidence for reliability (α = .82) and validity. In the present sample, internal consistency was .81.
Life satisfaction. Life satisfaction was measured using the Satisfaction with Life Scale (SWLS; Diener et al., 1985). Participants rate agreement with five items (e.g., “In most ways my life is close to my ideal”) on a 7-point scale (1 = strongly disagree, 7 = strongly agree). Internal consistency in both the validation study and present sample was .87.
Results
Table 1 presents the descriptive statistics and intercorrelations for all study variables. With the exception of the emerging adult feeling in between variable, all variables were significantly correlated with each of the outcome variables. Significant correlations ranged from small to large for both PWB (r = .12, p < .05 for Facebook usage and r = .44, p < .001 for ego resilience) and life satisfaction (r = .12, p < .01 for identity exploration and r = .50, p < .001 for social support). Also, the outcome variables were significantly associated with three emerging adulthood variables in different directions. That is, they were positively correlated with experimentation/possibilities and identity exploration, and they were negatively and moderately correlated with negativity/instability; however, neither outcome variable was significantly associated with the feeling in between variable.
To reduce the possibility of confounds in the regression results, several potential covariates were tested for their relatedness to the outcome variables. Based on prior research, age, gender, and race were tested (Galambos et al., 2006; Schnyders & Lane, 2018). Gender and race were dummy coded so that a) 0 = non-woman (i.e., man or other) and 1 = woman, and b) 0 = non-White and 1 = White. Significant differences were present in the Satisfaction with Life Scale scores on the basis of gender: t(537) = -2.841, p < .01. The mean life satisfaction score for women in the sample was 1.91 points higher than for non-women. Thus, all subsequent analyses controlled for the effects of gender. No other significant associations involving the potential covariates were present.
Table 1
Pearson Intercorrelations Among Study Variables
| Variables |
|
|
Intercorrelations |
|
M |
SD |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| 1. AAn. |
23.42 |
7.28 |
– |
|
|
|
|
|
|
|
|
|
| 2. AAv. |
17.03 |
6.76 |
.07 |
– |
|
|
|
|
|
|
|
|
| 3. ER |
69.10 |
11.94 |
-.33** |
-.08 |
– |
|
|
|
|
|
|
|
| 4. EP |
7.08 |
1.16 |
-.17** |
-.04 |
.24** |
– |
|
|
|
|
|
|
| 5. NI |
6.90 |
1.24 |
.20** |
.06 |
-.25** |
-.06 |
– |
|
|
|
|
|
| 6. IE |
6.80 |
1.34 |
-.05 |
.04 |
.12* |
.38** |
.07 |
– |
|
|
|
|
| 7. IB |
6.83 |
1.38 |
.06 |
.06 |
-.01 |
.22** |
.12* |
.41* |
– |
|
|
|
| 8. SS |
21.98 |
4.27 |
-.25** |
-.27** |
.32** |
.21** |
-.19** |
.07 |
.05 |
– |
|
|
| 9. FB |
21.75 |
8.72 |
.13* |
-.11* |
-.05 |
.08 |
-.02 |
.08 |
.16** |
.14* |
– |
|
| 10. PWB |
55.35 |
18.72 |
-.27** |
-.14* |
.44** |
.32** |
-.34** |
.16** |
.03 |
.40** |
.12* |
– |
| 11. LS |
21.72 |
7.21 |
-.25** |
-.25** |
.39** |
.36** |
-.30** |
.12* |
-.02 |
.50** |
.14* |
.61** |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Note. N = 538. AAn. = attachment anxiety; AAv. = attachment avoidance; ER = ego resilience; EP = experimentation/possibilities; NI = negativity/instability; IE = identity exploration; IB = feeling in between; SS = social support; FB = Facebook usage; PWB = psychological well-being; LS = life satisfaction.
*p < .05. **p < .001
Hypothesis 1 predicted that internal resources, emerging adulthood identification, and social resources would each predict unique and additive variance in each outcome variable. Thus, two hierarchical regression analyses were conducted (one with PWB as the outcome variable and one with life satisfaction as the outcome). Each set of predictors was entered as an individual level in the hierarchical regression. Table 2 presents the results of these analyses. As can be seen in Table 2, Hypothesis 1 was fully supported. Each predictor variable set predicted significant additive variance in each outcome variable after accounting for the preceding predictor variable sets in the model. It is also useful to note that the social resources variables predicted over twice as much additive variance in life satisfaction (∆R2 = .08, p < .001) compared to that of PWB (∆R2 = .03, p < .001). The model accounted for 36% of the variance in PWB and 41% of the variance in life satisfaction.
Table 2
| Summary of Hierarchical Regression Analyses Predicting PWB and Life Satisfaction
Step and Variable |
∆R2 |
∆F |
β |
t |
rsp |
| Outcome variable: PWB |
| Step 1 – Internal resources |
.22 |
38.619*** |
|
|
|
| Attachment anxiety |
|
|
-.14 |
-3.438** |
-.07* |
| Attachment avoidance |
|
|
-.09 |
-2.308* |
-.03 |
| Ego resilience |
|
|
.40 |
9.685*** |
.23*** |
| Step 2 – Emerging adulthood |
.09 |
8.259*** |
|
|
|
| Experimentation/possibilities |
|
|
.19 |
4.677*** |
.14*** |
| Negativity/instability |
|
|
-.23 |
-6.177*** |
-.20*** |
| Identity exploration |
|
|
.06 |
1.403 |
.05 |
| Feeling in between |
|
|
.00 |
0.03 |
-.02 |
| Step 3 – Social resources |
.03 |
1.681*** |
|
|
|
| Social support |
|
|
.19 |
4.679*** |
.16*** |
| Facebook usage |
|
|
.09 |
2.361* |
.08* |
| Outcome variable: Life satisfaction |
| Step 1 – Internal resources |
.22 |
32.966*** |
|
|
|
| Attachment anxiety |
|
|
-.12 |
-2.960** |
-.03 |
| Attachment avoidance |
|
|
-.20 |
-5.185*** |
-.11** |
| Ego resilience |
|
|
.36 |
8.711*** |
.17*** |
| Step 2 – Emerging adulthood |
.09 |
8.131*** |
|
|
|
| Experimentation/possibilities |
|
|
.26 |
6.571*** |
.20*** |
| Negativity/instability |
|
|
-.19 |
-5.139*** |
-.15*** |
| Identity exploration |
|
|
.01 |
0.304 |
.02 |
| Feeling in between |
|
|
-.05 |
-1.273 |
-.07* |
| Step 3 – Social resources |
.08 |
4.872*** |
|
|
|
| Social support |
|
|
.31 |
8.138*** |
.27*** |
| Facebook usage |
|
|
.08 |
2.176* |
.07* |
Note. N = 538. Results control for the effects of gender. rsp = semipartial correlation. rsp is reported for the
last step in each model.
* p < .05, ** p < .01, *** p < .001.
Hypothesis 2 predicted that the emerging adulthood variables and Facebook usage would each predict significant individual variance in each outcome variable after accounting for the effects of all other predictor variables. To test this hypothesis, semipartial correlations (rsp) were examined for all variables at the last step of the hierarchical regression (i.e., the step in which all variables are entered into the model). Semipartial correlations examine the unique variance explained by a single predictor after accounting for the collective variance explained by all other predictors (Meyers et al., 2013). As can be seen in Table 2, significant semipartial correlations predicting PWB included the negativity/instability (rsp = -.20, p < .001), experimentation/possibilities (rsp = .14, p < .001), and Facebook usage (rsp = .08, p < .05) variables. Of all the predictors of PWB in the model, negativity/instability made the second largest individual contribution. Of the predictors of life satisfaction, significant semipartial correlations included experimentation/possibilities (rsp = .20, p < .001), negativity/instability (rsp = -.15, p < .001), feeling in between (rsp = -.07, p < .05), and Facebook usage (rsp = .07, p < .05). The experimentation/possibilities variable made the second largest individual contribution to life satisfaction. However, because identity exploration was not significant for either outcome variable, and feeling in between was not significant for life satisfaction, Hypothesis 2 was only partially supported. Collectively, the emerging adulthood and Facebook variables accounted for 7.4% of unique variance in PWB and 7.1% of unique variance in life satisfaction.
Discussion
The present findings yield several useful contributions. First, they bridge disparate threads of research by comparing the contributions of well-established mental health predictors with those of constructs unique to present-day college students, each of which contributed uniquely to college student mental health. Although many of the effects of the individual variables were small, the emerging adulthood and Facebook variables collectively explained roughly 7% of unique variance in the mental health variables over and above that explained by the more well-established constructs. As such, the findings are consistent with the assertion that constructs like attachment, ego resilience, and social support, while useful to conceptualizing college student mental health, may nevertheless be aided by also considering factors unique to 21st-century students.
The positive associations between Facebook usage and college student mental health are noteworthy, given the current disagreement regarding the impact of social media use. Contrary to concerns regarding social media overuse (e.g., Twenge, 2013), the present study found that Facebook usage positively predicted PWB and life satisfaction, albeit with a small effect. This was true even after controlling for other predictor variables, suggesting that Facebook provided a small but unique contribution to college student mental health. This finding supports the conclusions of Manago et al. (2012) that Facebook can fulfill certain social support needs for students. There may also be negative implications for societal reliance on social media use (e.g., Twenge, 2013), including its promotion of unhealthy comparison behaviors and cyberbullying. Nevertheless, the present findings and those of Manago et al. demonstrate the positive contributions of social media to college student mental health.
The significance of some of the emerging adulthood variables also warrants discussion. The degree to which participants identified with emerging adulthood being a period of experimentation and possibilities was positively associated with PWB and life satisfaction, while the degree to which they identified with emerging adulthood being a period of negativity and instability was negatively associated with PWB and life satisfaction. Moreover, identifying emerging adulthood as a time of feeling in between adolescence and adulthood was negatively associated with life satisfaction. Even after accounting for all other control and predictor variables, emerging adult instability was the second strongest predictor of PWB (after ego resilience), while emerging adult experimentation/possibilities was the second strongest predictor of life satisfaction (after social support). These findings add important context to prior empirical conclusions that emerging adulthood is associated with negative mental health (Baggio et al., 2015). That is, while each of the dimensions of emerging adulthood represents important developmental processes toward reaching adulthood (Arnett, 2004), only some of these dimensions (especially viewing emerging adulthood as a period of experimentation or instability) seem relevant to college student mental health. Additionally, feeling in between adolescence and adulthood was negatively associated with life satisfaction but unassociated with PWB. This finding underscores the complex contributions of emerging adulthood to college student mental health. Previous research has indicated that life satisfaction decreases during adolescence (Goldbeck et al., 2007). Accordingly, it is plausible that subjectively identifying the emerging adult years as feeling in between adolescence and adulthood results in life satisfaction trajectories that more closely mirror those of adolescence compared to emerging adults who feel less in between adolescence and adulthood. Although such conclusions require further validation, it nevertheless can help college counselors understand which factors of the emerging adult experience are relevant foci of clinical attention.
Implications for Counselors
The present results yield several useful insights that can aid mental health counselors who work with college-aged populations. Most prominently, counselors are encouraged to conceptualize their clients using a blend of foundational and contemporary models. Life for 21st-century college-aged individuals is unprecedentedly complex (Arnett, 2004; Kruisselbrink Flatt, 2013). It is important for college counselors to acknowledge this complexity, as doing so may represent an important form of cultural competence working with millennial generation and Generation Z individuals (Lane, 2015). Counselors are encouraged to utilize emerging adulthood theory when conceptualizing their clients, as this framework contains important departures from other identity development models. For example, counselors are likely to be more familiar with Erikson’s (1959/1994) framework than emerging adulthood theory. The former model suggests that identity development occurs during the teenage years, while the latter model asserts that identity development is a process that now extends well into the 20s (Arnett, 2004). Emerging adulthood theory also suggests that, as a result of this prolonged identity development process, traditional-aged college students are likely to temporarily exhibit heightened self-focus and idealistic thinking. Acknowledging these factors could facilitate a more empathic understanding of the behaviors that contribute to some counselors and scholars endorsing negative stereotypes against millennials and Generation Z individuals (Lane, 2015). Incorporating emerging adulthood theory could help college counselors be more mindful of the evolving nature of the transition to adulthood and its contributions to mental health.
The findings involving the social resources variables also have novel implications for counseling college students. Although social support has long been established as an important target for improving mental health, counselors are encouraged to acknowledge both the unprecedented complexity of emerging adult social support networks (Arnett, 2004) and also the ability of emerging adults to receive social support from face-to-face and electronic interactions (Manago et al., 2012). Accordingly, it is important to continue exploring the potential therapeutic applications of social media and other forms of technology. For example, an exciting direction in this regard is the growing use of informal support groups via social media (Manago et al., 2012), which exist for many counseling-relevant issues. Such groups provide a sense of community and help members remember that they are not alone in their struggles. Moreover, present mental health trajectories among college students have necessitated a shift in focus for many college counseling centers toward crisis intervention and outreach (Watkins et al., 2012). For many college counseling centers, social media remains an underutilized tool, despite the recent development of social media and text-based initiatives for each of these objectives (Evans et al., 2013). Such programs might be especially useful in today’s higher education climate in which symptom severity seems to be increasing while budgetary resources for college counseling centers are often stagnant or decreasing (American College Health Association, 2015; Watkins et al., 2012).
Limitations
Several limitations in the present study warrant consideration. First, the results relied on a convenience sample, and it is impossible to know whether there are group differences between the 15.4% of invited college students who participated compared to those who did not. Second, the findings are correlational in nature, and the directionality of the relationships cannot be assured. Third, although the sample was racially diverse, it was predominantly female. Fourth, it should be noted that the social media variable in this study consisted solely of Facebook usage; the findings may have been different had other prominent social media platforms been represented.
Implications for Future Research
Future research efforts should continue to explore the mental health implications of the study’s variables. First, it would be useful to confirm the findings with a more gender-representative sample. The model should also be explored with a longitudinal sample to determine mental health trajectories through various transitions common during the college experience. It would also be useful to explore potential mediating effects among the variables in the model, which could provide further empirical support for the theoretical sequencing of the variable sets. Other research efforts could further explore the therapeutic applications of social media. Such efforts could aid understanding of the evolving needs of college-aged populations.
Conclusion
The college years constitute considerable mental health risks that seem particularly pronounced for current generations of traditional-aged college students. The present findings suggest that traditional models of college student mental health can be aided by also incorporating generation-specific factors, including emerging adulthood identification and social media usage. Such generation-specific factors seem to predict unique variance in college student mental health characteristics, namely PWB and life satisfaction. The findings underscore the importance that counselors consider contemporary models, including emerging adulthood theory, when conceptualizing and treating traditional-aged college student clients.
Conflict of Interest and Funding Disclosure
The authors reported no conflict of interest
or funding contributions for the development
of this manuscript.
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Joel A. Lane, PhD, NCC, LPC, is an associate professor and department chair at Portland State University. Correspondence may be addressed to Joel Lane, 250G Fourth Avenue Building, 1900 SW 4th Ave., Portland, OR 97201, lanejoel@pdx.edu.
TPC received entries for the seventh annual Dissertation Excellence Award from across the United States. After great deliberation, the TPC editorial board committee selected Alison M. Boughn to receive the 2020 Dissertation Excellence Award for her dissertation, Child Psychological Maltreatment.