SW. Sci. Med. Vol. 36, No. 5, pp. 631439, 1993 Printed in Great Britain. All rights reserved 0277-9536/93 $6.00 + 0.00 Copyright 0 1993 Pergamon Press Ltd PREDICTORS OF PSYCHOLOGICAL DISTRESS AMONG SOUTHEAST ASIAN REFUGEES RITA CHI-YING CHUNG' and MARJORIE KAGAWA-SINGER* ‘National Research Center on Asian American Mental Health, University of California, Los Angeles, CA 90024, U.S.A. and rSchoo1 of Nursing, University of California, Los Angeles, CA 90024, U.S.A. Abstract-This paper analyzed data from one of the first needs assessment projects on a representative non-clinical population of Southeast Asian refugees in the United States in order to test two hypotheses: (1) whether or not premigration experiences still have an effect on psychological distress beyond the initial resettlement period and (2) whether or not interethnic group differences existed in the predictors of psychological distress between three Southeast Asian refugee groups, the Vietnamese, Cambodians and Lao. The results of the analysis of 2180 subjects supported both hypotheses. Regardless of ethnicity and the number of years in the U.S., premigration trauma events and refugee camp experiences were significant predictors of psychological distress even 5 years or more after migration and significant group differences in the types of postmigration distress predictors were also found. Acculturation concerns for the Vietnamese and Lao were influenced by both premigration and postmigration variables. In contrast, the primary concerns of the Cambodians were still related to premigration issues. The results also indicated that Vietnamese and Lao women were more likely to experience distress than their male counterparts, but no gender differences emerged for the Cambodians. Age predicted distress for Vietnamese and Cambo- dians, but not Lao. Similar to previous findings in the literature, Cambodians reported the highest levels of distress, followed by Lao and then Vietnamese. Interpretations of these results for this community sample are proposed. zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Key words-Southeast Asian refugees, distress predictors, psychological distress, resettlement INTRODUCIION Since 1975, substantial numbers of Southeast Asian refugees have escaped war, genocide, internal politi- cal turmoil, and famine in their home countries to seek refuge in the United States. In 1988, this popu- lation numbered nearly 900,000 and is comprised primarily of Vietnamese, Cambodians and Lao [l]. Southeast Asian refugees share many similarities in their pre- and postmigration experiences, due to geographic proximity of their homelands, socio- political circumstances forcing their flight, and the experience of enormous psychological as well as physical trauma. Although many have displayed re- markable motivation, resiliency and progress in over- coming the multifaceted pre- and postmigration obstacles of resettlement, for most, psychological distress has been marked and predictable. Those at high risk for developing serious psychiatric disorders have been identified as individuals who had (I) suffered greater degree of family loss or separation, (2) spent the longest time in refugee camps, (3) multiple traumatic experiences, (4) presently no em- ployment, (5) the least education, (6) the least English proficiency and (7) fewer emotional and material resources [224]. The greatest high risk period for developing serious mental health disorders has been identified to be during the ‘early’ resettlement period, which ranges from 2 to 18 months [S-7]. In a 2 year study of Southeast Asian refugees who had been in the U.S. for approximately 3-4 years, Rumbaut [8] found that premigration factors were the major contributors to the level of distress among this group at the first testing, and a year later he found that postmigration variables of economic and cultural adaptation became the major sources of distress. This led the author to conclude: “past losses and events seem to heal with time and recede in importance as present demands and challenges grew in psychological significance” [8]. Beiser er af. [9] also found that the impact of refugee camp experiences diminished within this same time frame of 4 to 5 years after resettlement. They speculated, however, that even though the painful memories of refugee camp internment can be kept out of awareness for a time, these memories may re-emerge into consciousness during later years. Beiser et al. [9] further postulated that other premigration experiences such as bereave- ment may be more powerful, longer-lived stresses than camp experiences. Despite these intergroup similarities of geographic and socio-political circumstances, there are signifi- cant differences as well. For example, each group differs in its cultural heritage, specific circumstances of emigration, and socioeconomic resources and skills available to them during resettlement. Thus, the resettlement experience of Southeast Asian refugee groups to American society has not been uniform, and each has been faced with distinct obstacles. Yet much of the research on this population does not provide insight into these potential differences be- cause the studies focus either on one ethnic group 631