A stress process model for anxiety symptom severity: comparing racial and ethnic minority adults

Abstract

Introduction. Individuals from diverse backgrounds are at risk for anxiety at levels equal to or greater than their Caucasian peers. However, our knowledge about contributors to anxiety symptom development and stressors unique to these populations is limited. This dissertation explores predictors of anxiety symptom severity in racial/ethnic minority adults using data from two surveys of the Collaborative Psychiatric Epidemiological Surveys dataset (CPES): the National Survey of American Life and the National Latino and Asian American Survey. The Pearlin Stress Process Model (SPM) provided a theoretical framework for the contributions of stressors and resources to anxiety symptom severity. Method. Pearlin's SPM proposes a latent variable model using Structural Equation Modeling (SEM) to test the relations between context variables and the latent constructs of stressors, intrapsychic strain, and resources predicting anxiety symptom severity. Anxiety symptom severity, a latent construct, was composed of number of symptoms, duration of symptoms, distress, and impairment. The final analyses included 7,959 individuals. Results. Only the results of Aim 1 exploring differences in anxiety symptom severity across individuals of African descent, Asian Americans, and Hispanic and Latino Americans are reported in this abstract. Subgroup differences are reported for Aims 2 through 4 in the body of the document. Aim 1 explored the goodness of fit of the SPM across groups (e.g., main effects of demographic variables, latent constructs of stressors and intrapsychic strain, and interactions with race) relating to anxiety symptom severity. Demographics including race were significant across all steps of the model. Those with greater stressors had worse self-rated mental health and Asian American's self-rated mental health was more impacted by changes in stressors. Those with worse resources experienced a greater impact on self-rated mental health. Hispanic and Latinos experienced the greatest anxiety symptom severity followed by individuals of African Descent and Asian Americans. Conclusions. The Pearlin SPM was successful in predicting anxiety symptom severity across diverse groups and within subgroups. The models demonstrated differences in the interactions between latent variables that contribute to distress across populations. These models have important implications for researchers, clinicians and policy makers working to reduce anxiety symptoms within these populations.