Stanley Sue

Palo Alto University · Pacific Graduate School of Psychology

For decades, Asian Americans have had to deal with stereotypes, misunderstandings of their status in society, and prejudice and discrimination. Because of their small population in the U.S. and prevailing model minority stereotypes, they have not received the attention or aid necessary for research and policy advocacy to counter the misunderstandin...

Over the past four decades, the mental health field has struggled to define cultural competency and its efficacy in psychotherapy. Recent cultural competency and treatment adaptation studies have pointed to predominant evidence that cultural competency yields positive experiences and outcomes in treatment. What remains largely unknown, however, is...

What theoretical and conceptual models do we employ in Asian American psychology? The literature in Asian American psychology to date has raised many questions about whether all or most theories and principles in psychology are sufficient. However, there has not been a clear explication to date on which, if any, theories are best suited in psycholo...

The U.S. Surgeon General's report Mental Health: Culture, Race, and Ethnicity-A Supplement to Mental Health: A Report of the Surgeon General (U.S. Department of Health and Human Services, 2001) was arguably the best single scholarly contribution on the mental health of ethnic minority groups in the United States. Over 10 years have now elapsed sinc...

The Asian American population is a fast-growing population, with enormous within-group heterogeneity. Although the past decade has seen significant gains in psychological research on this population, there continues to be notable paucity of research in some areas of clinical personality assessment with Asian American clients. This article provides...

Research indicates greater educational achievements and occupational aspirations of Asian Americans. However, little research has explicated the relationship between educational attainment and actual income among Asian Americans. Factors related to the ethnic minority experience may be related to or may change the positive, linear relationship betw...

Reviews and critically examines issues regarding the mental health of Asians in the US. The author maintains that as a distinct ethnic group in the US, Asian Americans have experienced value conflicts between their own ethnic culture and that of mainstream Americans, as well as instances of racial prejudice and discrimination. The mental health sta...

We examined whether similarities and differences exist in the association between perceived discrimination and poor mental and physical health among Asian-American adult women and men. We also tested whether Asian-American women would have a lower perceived discrimination threshold for developing negative health outcomes than Asian-American men. Da...

Ethnoracial minority status contributes to an increased risk for posttraumatic stress disorder (PTSD) after trauma exposure, beyond other risk factors. A population-based sampling frame was used to examine the associations between ethnoracial groups and early PTSD symptoms while adjusting for relevant clinical and demographic characteristics. Acute...

A study of Asian American patients receiving care in community mental health facilities suggests that rates of psychopathology among Asian Americans have been underestimated and that treatment facilities are not responding to the needs of this group.

Few studies have examined the role of culturally relevant factors in suicidal behavior among Asian Americans. Using the National Latino and Asian American Study (NLAAS) (Alegria et al., 2004; Heeringa et al., 2004), the current study examined the role of culturally related variables (family conflict, perceived discrimination, and ethnic identity) o...

This article focuses on my interpretation of the history of ethnic minority psychology, using as a base the presentations of the contributing authors to this special issue of Cultural Diversity and Ethnic Minority Psychology. Because each contributing author has focused on a particular ethnic group or a particular aspect of history, my goal is to f...

Cultural competency practices have been widely adopted in the mental health field because of the disparities in the quality of services delivered to ethnic minority groups. In this review, we examine the meaning of cultural competency, positions that have been taken in favor of and against it, and the guidelines for its practice in the mental healt...

The Development of PersonalityPersonality: A Conceptual SchemeLimitations and ImplicationsMental Health ProblemsThe Inadequacy of Mental Health Care

We examined rates of mental health-related service use (i.e., any, general medical, and specialty mental health services) as well as subjective satisfaction with and perceived helpfulness of care in a national sample of Asian Americans, with a particular focus on immigration-related factors. Data were derived from the National Latino and Asian Amer...

We examined lifetime and 12-month rates of any depressive, anxiety, and substance abuse disorders in a national sample of Asian Americans. We focused on factors related to nativity and immigration as possible correlates of mental disorders. Data were derived from the National Latino and Asian American Study, the first national epidemiological surve...

What theoretical and conceptual models do we employ in Asian American psychology? The literature in Asian American psychology to date has raised many questions about whether all or most theories and principles in psychology are sufficient. However, there has not been a clear explication to date on which, if any, theories are best suited in psycholo...

Patterns of sexually coercive behavior were examined among 266 Asian American and 299 European American men over 1 year. Noncoercer (n = 358), desister (n = 120), initiator (n = 39), and persistent (n = 48) sexually coercive groups were identified. The strongest predictor of sexual coercion was past sexual coercion. Persistent sexual coercers were...

Racial and ethnic disparities in health and health care are pervasive. A number of research and policy issues have been raised in the examination of disparities. This article analyzes some methodological, conceptual, and political issues that underlie disparities research. Specifically examined are the research challenges posed by the different way...

Cultural competency in the delivery of mental health services has gained considerable momentum. This momentum has been accompanied by questions about the meaning, usefulness, and precision of cultural competency. The author argues that cultural competency is composed of general processes (scientific mindedness, dynamic sizing, and culture-specific...

Attention paid to culture in theories of sexual coercion has been limited. This failure to include culture in these theories implies that culture does not have an important role in sexually coercive behavior. Recent conceptual and empirical work supports the existence of culture-specific models of sexual coercion. Sexual coercion has been character...

In the first position paper of this chapter, Stanley Sue and Nolan Zane examine the extent to which evidence-based practices (EBPs) have been helpful in reducing ethnic disparities in mental health and in improving treatment effectiveness. The EBP movement promises to reduce disparities by using those treatments that are effective according to cont...

Explanatory models of sexual aggression were examined among mainland Asian American (n=222), Hawaiian Asian American (n=127), and European American men (n=399). The Malamuth et al. (N. M. Malamuth, D. Linz, C. L. Heavey, G. Barnes, & M. Acker, 1995; N. M. Malamuth, R. J. Sockloskie, M. P. Koss, & J. S. Tanaka, 1991) confluence model of sexual aggre...

This study examined the outcome effects of cognitive match between Asian and White outpatient clients and their therapists. Many clinicians believe that one hindrance to the treatment of ethnic minority clients is that therapists and clients may not share common assumptions and attitudes about therapy and about the problems that are presented in tr...

The four level matrix model proposed by C.R. Snyder and T.R. Elliott (this issue, PP. 1033-1054) is a bold attempt to provide a coherent philosophy and model to guide the training of clinical psychologists. Shortcomings of current training practices, such as a focus on individuals rather than community dynamics and on pathology rather than strength...

The difficulties of operationalizing race in research and practice for social, behavioral, and genetic researchers and practitioners are neither new nor related to recent genetic knowledge. For geneticists, the bases for understanding groups are clines, observed traits that gradually change in frequency between geographic regions without distinct i...

This paper provides a rationale for, and overview of, procedures used to develop the National Latino and Asian American Study (NLAAS). The NLAAS is nationally representative community household survey that estimates the prevalence of mental disorders and rates of mental health service utilization by Latinos and Asian Americans in the US. The centra...

This study examined the association between multiple minority statuses and reports of suicidal thoughts, depression, and self-esteem among adolescents. Data from the National Longitudinal Study of Adolescent Health were used to examine mental health outcomes across racial/ethnic groups for same-sex-attracted youths and female youths. Hispanic/Latin...

This study was conducted to explore the culture-specific roles of emotion, relationship quality, and self-esteem in determining life satisfaction. It was hypothesized that maintaining good interpersonal relationships would make individuals in collectivistic cultures not only feel good about their lives but also feel better about themselves. Further...

In contrast to the conclusions reached by the Supplement to the Surgeon General's report on mental health, there is evidence that the various ethnic minority groups may exhibit significant differences in the prevalence of mental disorder. These differences cannot be fully explained by disparities or inequities in mental health services. African Ame...

Cultural competency guidelines and policies are being widely established. Yet some critics have challenged the evidence for cultural competency and the lack of efficacy studies that demonstrate its outcomes. Various positions are examined that discuss cultural competency research. They include the need for more resources for research, scientific pr...

The collection of articles in this special section provides a much-needed examination of the state of psychological assessment in various Asian countries or societies. In particular, the contributors review and critique assessment of personality, depression and anxiety, children and adolescents, and neuropsychological evaluation. The reviews cover...

Attention paid to culture in theories of sexual coercion has been limited. This failure to include culture in these theories implies that culture does not have an important role in sexually coercive behavior. Recent conceptual and empirical work supports the existence of culture-specific models of sexual coercion. Sexual coercion has been character...

The authors tested the hypothesis that race bias in teacher evaluations may be problem specific by examining the extent to which ratings of child behavior were influenced by the interaction between the race of the child and the type of presenting behavior. Teachers (N = 197) were presented with three vignettes (overcontrolled, undercontrolled, and...

Ethnic research is good science Over the years, a number of researchers and scholars have pointed to the paucity of social science research on ethnic minority populations and the lack of attention to cultural variables in the research. These are significant problems that face the social sciences. Without more research, we cannot be in a position to...

Researchers and practitioners who work with Asian Americans confront fundamental questions, such as the cultural validity of the diagnostic tools and systems that are available to them, how to measure dynamic constructs like acculturation and identity in ways that meaningfully inform their work, and how to assess the cultural competence of care sys...

Three decades ago, researchers were lamenting the fact that little psychological research and knowledge were available concerning the Asian American population. The population was considered a model minority that had succeeded rather well in society. Both because of this image, which was in marked contrast to the well-publicized needs of other ethn...

This article reviewed the empirical support for customizing the therapeutic relationship for women, ethnic minorities, gay, lesbian, and bisexual persons, and individuals from lower social classes. Specifically, we examined whether evidence existed that these populations fared less well in treatment than mainstream populations, whether matching of...

Replies to comments made by Tebes (see record 2007-12413-003) and Guyll and Madon (see record 2007-12413-004) on Sue's original article (see record 1999-15532-003), which noted the the paucity of publications and funding for research on ethnic minority populations. It is my belief that theories, models, and assessment instruments should all be r...

Although psychiatric disturbances are highly prevalent among traumatically injured inpatients, few investigations have assessed the impact of these disorders on surgical length of stay (LOS) and cost. The authors identified all trauma-registry recorded psychiatric diagnoses among patients admitted to University of California Davis Medical Center be...

There are serious gaps in knowledge with respect to the use of standardized assessment instruments such as the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III; D. Wechsler, 1997) or the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 1989) with Asian Americans...

Background: Although psychiatric disturbances are highly prevalent among traumatically injured inpatients, few investigations have assessed the impact of these disorders on surgical length of stay (LOS) and cost. Methods: The authors identified all trauma-registry recorded psychiatric diagnoses among patients admitted to University of California Da...

A review of research reveals that the prevalence rates of depression, somatization, and posttraumatic stress disorder among Asian Americans are at least as high as those for White Americans, and, in many cases, higher rates are exhibited. Findings with respect to anxiety have been equivocal. The conclusion that is best supported by research at this...

There are serious gaps in knowledge with respect to the use of standardized assessment instruments such as the Wechsler Adult Intelligence Scale–Third Edition (WAIS-III; D. Wechsler, 1997) or the Minnesota Multiphasic Personality Inventory–2 (MMPI-2; J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 1989) with Asian Americans...

The role of intra- and interpersonal variables was examined in samples of Asian American (N = 91) and European American (N = 377) men. A path model for Asian American men suggested 2 interpersonal paths and 1 intrapersonal path to sexual aggression. For Asian Americans, concern about social standing is a risk factor among those who hold misogynous...

The quality, quantity, and funding of ethnic minority research have been inadequate. One factor that has contributed to this inadequacy is the practice of scientific psychology. Although principles of psychological science involve internal and external validity, in practice psychology emphasizes internal validity in research studies. Because many p...

Two issues led me into the area of cross-cultural psychiatric epidemiology in the 1980s. The National Institute of Mental Health funded the Epidemiological Catchment Area Studies. One of them included a study of a Caucasian and Hispanic populations in Los Angeles. Dr Masaaki Kato, then the Director of the National Institute of Mental Health of Japa...

The authors' goal was to estimate the lifetime and 12-month rates of major depressive episodes and dysthymia for Chinese Americans who reside in Los Angeles. This effort, the Chinese American Psychiatric Epidemiological Study, is the first large-scale community psychiatric epidemiological study on an Asian American ethnic group that used DSM-III-R...

This study examines help seeking and utilization patterns of 161 Asian or Pacific Islander Americans and 1332 White Americans randomly selected in the Los Angeles area, based on the first wave of the Epidemiological Catchment Area (ECA) study. Logistic regression analyses are performed to detect ethnic differences in disclosing mental health proble...

The characteristics involved in cultural competency in psychotherapy and counseling have been difficult to specify. This article describes attempts to study factors associated with cultural competency and addresses 3 questions. First, is ethnic match between therapists and clients associated with treatment outcomes? Second, do clients who use ethni...

The characteristics involved in cultural competency in psychotherapy and counseling have been difficult to specify. This article describes attempts to study factors associated with cultural competency and addresses 3 questions. First, is ethnic match between therapists and clients associated with treatment outcomes? Second, do clients who use ethni...

The present study empirically examined the relationship between therapist-client ethnic match and the therapists' evaluations of overall client functioning based on the Global Assessment Scale. The sample consisted of thousands of African American, Asian American, Mexican American, and White American outpatient clients in the Los Angeles County men...

Assessment, evaluation, and diagnosis will gain increasing prominence as we head into the next century. Emphasis on managed care in the mental health system, well-being of individuals, job and work efficiency, personnel selection, upward promotions in one's career, admissions to institutions of higher education, etc., all require valid means of mea...

Although Asian Americans are low utilizers of mental health services, they may suffer from a greater degree of disturbance by the time they are accepted for services. In this study, thousands of Asian and White clients who utilized a large mental health system over a 5-year period were compared on three measures of severity of disturbance: severity...

Asian Americans (including Pacific Islander Americans) represent a significant part of the population. They are, in terms of percentage increase, the fastest growing ethnic group in the United States. In 1980, the population of Asian Americans exceeded 3.7 million, easily doubling the 1.5 million figure in 1970 (U. S. Bureau of the Census, 1988). T...

Assessment research on ethnic minorities presents multiple methodological and conceptual challenges. This article addresses the difficulties in defining and examining ethnicity as a variable in psychological research. The authors assert that many of the problems stem from not making explicit the assumptions underlying the use of ethnicity as an exp...

The present study compared the return rate, length of treatment, and treatment outcome of ethnic minority adults who received services from ethnicity-specific or mainstream programs. The sample consisted of 1516 African Americans, 1888 Asian Americans, and 1306 Mexican Americans who used 1 of 36 predominantly White (mainstream) or 18 ethnicity-spec...

The prevalence of psychopathology among Asian Americans has been a source of debate. Some investigators believe that the prevalence rate is quite low, whereas others argue that it is fairly high. A review of the literature suggests that at this time, it is not possible to determine the specific rates of psychopathology. However, evidence does sugge...

Because of the dramatic increase in the ethnic diversity of Americans and the shrinking world in which international contacts are commonplace, our society is confronted by problems and issues associated with race/ethnic relations. In the fields of community psychology and community mental health, ethnic diversity has posed challenges and opportunit...

Examined differences between ethnic-specific and mainstream outpatient mental health services for Asian-American children. The study found that Asian-American children who received services at ethnic-specific centers were less likely to drop out of services after the first session, utilized more services, and had higher functioning scores at discha...

Proposed a research framework (the "cube" model) in which community psychologists working in ethnic-cultural communities can make appropriate decisions on conceptual and methodological issues from a culturally anchored, ecological-contextualist perspective. The intent of the model is to articulate ethnic-cultural heterogeneity in community research...

[analyze] research on psychotherapy with ethnic minority clients (i.e., African-Americans, American Indians, Asian-Americans, and Latino-Americans) / considerable controversy has existed for the past three decades over the effectiveness of traditional psychotherapeutic approaches for . . . ethnic minority clients / what evidence is there for the ef...

The relationship between social science research and public policy/program advocacy has been controversial. One position is that policy advocacy should be preceded and guided by research findings that clearly provide a rationale for the advocacy. Another position is that promotion of policies may be wise even in the absence of a strong research jus...

This study investigated services received, length of treatment, and outcomes of thousands of Asian-American, African-American, Mexican-American, and White clients using outpatient services in the Los Angeles County mental health system. It tested the hypothesis that therapist–client matches in ethnicity and language are beneficial to clients. Resul...

Responds to comments of R. Lynn, I. Liu, and D. Fox (see PA, Vol 78:34660, 34658, and 34651, respectively) concerning S. Sue and S. Okazaki's (see record 1990-32071-001) explanations for Asian-American educational achievement. Sue and Okazaki's relative functionalism hypothesis is defended. (PsycINFO Database Record (c) 2012 APA, all rights reserv...

Responds to comments of R. Lynn, I. Liu, and D. Fox (see PA, Vol 78:34660, 34658, and 34651, respectively) concerning S. Sue and S. Okazaki's (see record 1990-32071-001) explanations for Asian-American educational achievement. Sue and Okazaki's relative functionalism hypothesis is defended.

This chapter is addressed to a general audience of psychologists and students, especially practitioners, who are interested in ethnicity and who want to begin the important task of integrating ethnic minority issues in teaching, research, and practice. It provides me with the opportunity to elaborate on some of my ideas on ethnic minority issues an...

Examined cultural differences in assertiveness by using a social learning analysis to better articulate the influence of cultural variables. Differences in self-reported assertion responding between Asian and Caucasian-Americans were assessed across 9 different situations, and the differences were related to prior experiences, expectancy outcomes,...

Considerable attention has been paid to the academic achievements of Asian Americans because there is convergent evidence that this population has attained high educational mobility. In trying to explain the achievement patterns, researchers have largely limited their investigations to one of two contrasting hypotheses involving (a) hereditary diff...

Considerable attention has been paid to the academic achievements of Asian Americans because there is convergent evidence that this population has attained high educational mobility. In trying to explain the achievement patterns, researchers have largely limited their investigations to one of two contrasting hypotheses involving (a) hereditary diff...

The present study examined Asian and Caucasian differences in alcohol consumption and the self-reported socio-cultural and physiological correlates of consumption. The subjects were 83 Asian (38 male, 45 female) and 96 Caucasian (48 male, 48 female) students who were asked to complete questionnaires on: (1) demographic information, (2) general atti...

Considerable controversy exists over the effectiveness of psychotherapy for ethnic minority clients, especially when treated by White therapists. Some researchers and practitioners believe that ethnic clients are less likely to benefit from treatment. Others maintain the position that ethnic clients are as likely as Whites to show favorable outcome...

In view of the growing interest in the influence of cultural factors in psychological assessment, this article critically evaluates assessment issues with Asian American populations. Examined are issues in (a) the extent and symptoms of psychopathology, (b) personality assessment, and (c) face-to-face clinical assessment. It is argued that, without...

In view of the growing interest in the influence of cultural factors in psychological assessment, this article critically evaluates assessment issues with Asian American populations. Examined are issues in (a) the extent and symptoms of psychopathology, (b) personality assessment, and (c) face-to-face clinical assessment. It is argued that, without...

This article examines the role of cultural knowledge and culture-specific techniques in the psychotherapeutic treatment of ethnic minority-group clients. Recommendations that admonish therapists to be culturally sensitive and to know the culture of the client have not been very helpful. Such recommendations often fail to specify treatment procedure...

This article examines the role of cultural knowledge and culture-specific techniques in the psychotherapeutic treatment of ethnic minority-group clients. Recommendations that admonish therapists to be culturally sensitive and to know the culture of the client have not been very helpful. Such recommendations often fail to specify treatment procedure...

Ethnic minorities often have been highly critical of research on problems concerning race relations. Controversy has occurred in areas such as intelligence (Jorgensen, 1973; Williams, 1974), personality and ethnic identity (Banks, 1976; Brand, Ruiz, & Padilla, 1974; Nobles, 1973), mental health (Gynther, 1972; Sue, Sue, & Sue, 1975), and family str...

Examined the academic performance, majors, study habits, and socioemotional adjustment of 177 Chinese and Chinese-American university students. 94 Ss were foreign born, and 83 Ss were 2nd-, 3rd-, or 4th-generation Americans. Data were collected through official university records, questionnaires, and inventories. Ss were divided into 3 groups, depe...

According to the 1980 census, the Chinese, with a population of 806,027, are the largest Asian minority in the United States. The rapid growth in the Chinese population is primarily a result of more recent waves of immigration from Hong Kong, Taiwan, the Peoples’ Republic of China, and Southeast Asia. These new arrivals have increased the heterogen...

There is a common belief that the Japanese, as well as most other Asian groups in the United States, do not drink as much as their American and European counterparts and are therefore relatively immune to problems associated with alcohol. The existence of a strong family system reinforcing a moderate drinking style is cited as one factor behind the...

Presented data on the translation and on the reliability and concurrent validity of the Chinese version of the Depression Adjective Check Lists (DACL). Reliability and validity coefficients are significant and of sufficient magnitude to warrant their use in research (N = 37).

Although Asian/Pacific-Americans encounter a multitude of life stressors and have significant mental health needs, many avoid the use of psychotherapeutic services. This article argues that group practice can be efficacious in addressing their mental health needs if therapists appreciate and understand the cultural factors and historical background...

Reviews the physiological and social/cultural factors contributing to the low rate of alcohol consumption among Chinese and Japanese Americans. It is contended that while drinking, particularly at social functions, is permissible, excess drinking is discouraged and tightly regulated by family and community attitudes and values. It is also suggested...

Argues that 2 tasks need to be addressed in view of psychology's growing commitment to cultural pluralism in research, theory, and professional practice: The 1st is that ethnic minority group issues are analogous to antinomies in which cherished values and principles are pitted against one another and need to be recognized as such. These paradoxes...

The National Asian American Psychology Training Center (1) intensively trains interns to assume roles as scientist-practitioners; (2) allows interns to develop special expertise with multi-ethnic, particularly Asian-American, populations; (3) exposes interns to a wide range of settings (e.g., inpatient, outpatient, emergency services, day treatment...

A special clinical-community psychology program for Asian-Americans is described. Four separate papers discuss the background of the training center and the philosophical and practical rationales as well as products of the training program. This discussion of the training program is designed to provide some insight into the issue of training clinic...

Among the more intriguing issues regarding Chinese in the United States is the mental health status of this population. Owing to the increased influx of Chinese immigration, emerging public images of Chinese-American socio-economic success, and expanded interest in ethnic cultures in the United States, social scientists have made greater attempts t...