Acculturation, beliefs about mental illness, and perceived social support as predictors of symptom severity in Chinese-American inpatients with schizophrenia

Social support has repeatedly been found to bolster emotional and physical well-being. This may be particularly true in collectivist cultures, such as Asian cultures, where the values of the social group are emphasized over the individual. Although lack of social support has been linked to increased psychopathology, research examining individuals from collectivist cultures, which place more importance on social group than other cultures, has been lacking. Perceptions of mental illness and acculturation also appear to influence social support. Past reports have found individuals with mental illness who are less acculturated and lack social support exhibit increased illness severity compared to their acculturated counterparts (Poyrazli et al., 2004; Rabkin, 1974). The present study investigated the impact of acculturation, beliefs about mental illness, and perceived social support on psychopathology in Chinese American inpatients with schizophrenia. Participants were adult Chinese American inpatients (n=63) with a diagnosis of schizophrenia or schizoaffective disorder recruited from an urban psychiatric inpatient facility. Social support was measured using the Social Interactions Scale (SIS), acculturation using the Suinn-Lew Asian Self-Identity Acculturation Scale (SL-ASIA), and negative opinions about mental illness using the Beliefs toward Mental Illness Scale (BMI). Psychopathology was measured with the Positive and Negative Syndrome Scale for Schizophrenia (PANSS) and length of hospitalization. Measures were administered in Mandarin, Cantonese, and English, according to participants' preference. Results revealed that levels of social support, acculturation and patients' beliefs about their illness were significant predictors of illness duration. Differences were consistently found between PANSS scores and length of hospitalization, suggesting that with this population, social factors may not significantly affect severity of illness but appear to predict chronicity of illness. Implications of these findings and the impact on future research are discussed.