I have been always fascinated by American culture. Since I am a foreigner, I always considered the American culture as powerful because I always perceived it as a big “container” of different subcultures. A question I asked myself when I started working in Los Angeles is if there were differences in how Americans experience anxiety based on their subculture of origin. This is the reason why I decided to get more information about this topic.
The most important result of the anxiety prevalence in the U.S. population is that one in four Americans meet the criteria for an anxiety disorder at some point in their life. However, much of the existing research is based on samples of European American participants and does not consider ethnic and cultural differences. In this way, research does not consider the important contributing factors that could make the anxiety unique and different among people. Some scholars decided to “swim against the tide” and analyzed the differences between the American subcultures in terms of anxiety prevalence.
The first interesting finding is that prevalence rates of anxiety disorders in African Americans tend to be lower than in European Americans, even though anxiety disorders in African Americans tend to more chronic, functionally impairing, and less responsive to treatments than in European Americans. There is a cultural difference to explain this result. African Americans seem to have a greater stigma toward mental illness when compared to European Americans; therefore, they could be at risk for reduced diagnosis and treatment of anxiety disorders. However, African Americans have protective sociocultural factors, such as religiosity and ethnic identity, that could reduce the likelihood of developing anxiety disorder during the lifespan.
Research about Asian Americans indicates this population experiences anxiety comparable to other minority groups and they sometimes demonstrated higher levels of social anxiety than European Americans. Asian American culture is characterized by an interdependent self-construct because the community is more important than the individual in this culture; therefore, the others’ judgments become extremely important to determine the individuals’ values. In contrast, the European Americans have an independent self-construct that is completely independent of the others’ judgment. Therefore, Asian Americans experience higher social anxiety than European Americans due to their subcultural characteristics because they base their personal value on social/community judgment.
Hispanic Americans comprise the largest ethnic minority group in the U.S. population. However, it is surprising that they have received very little empirical attention even though the prevalence rates for anxious pathology noted in the literature indicate that anxiety is a problem for Hispanic Americans. It is hypothesized that the reason why there are not many findings of this subculture could be there are many verbal expressions of anxiety that may be different for some Hispanic groups such as ataques de nervios and susto. Therefore, research that considers self-reporting using words like “anxiety” or “worry” cannot be able to adequately evaluate the number of findings of anxiety in this subculture. However, the self-reports which consider descriptions of physiological symptoms, which are basically common in all the cultures, provided information that Hispanic Americans have a higher physiological activation related to Generalized Anxiety Disorder than other subcultures.
The previous results underlined that there is a lack of comprehensive research between the most common subcultures. Most of the studies considered the comparison with only the European Americans. Future studies should increase the number of findings related to the comparisons between all of the subcultures to better understand all of the differences.
One thing that therapists should keep in mind is that all the subcultures responded to standard treatment protocols; however, African American and Asian American subcultures could receive increased benefit and reduction in symptoms from culturally adaptive treatment, based on their cultural-specific needs. It is also important to underline that Asian Americans work better in therapy with the same ethnic background therapists than other subcultures.
– Carter, M. M., Mitchell, F. E., & Sbrocco, T. (2012). Treating ethnic minority adults with anxiety disorders: Current status and future recommendations. Journal of Anxiety Disorders, 26(4), 488-501.
– Hopkins, P. D., & Shook, N. J. (2017). A review of sociocultural factors that may underlie differences in African American and European American anxiety. Journal of anxiety disorders, 49, 104-113.