Cross-cultural Differences in the Presentation of Depressive Symptoms

Epidemiological studies show that China has a lower prevalence rate of major depression than that of Western countries. The disparity in prevalence is commonly attributed to the tendency of Chinese to somatize depression. Empirical evidence of Chinese somatization has yielded mixed results. The present study thus aimed to 1) examine differences in somatic and psychological symptom reporting between Chinese from Macau and Americans in America and 2) identify cultural and psychological variables that would predict somatization. Independent and interdependent self-construals, sociotropy, and emotional approach coping were hypothesized to predict somatization of depression. Participants included 353 Chinese and 491 American college students who completed self-report measures online. Contrary to prediction, results indicated that Americans endorsed a higher proportion of somatic symptoms than Chinese did. Sociotropy predicted both relative endorsement and severity of somatic symptoms for the American sample, whereas emotional expression coping was related to somatization in the Chinese sample. The findings challenge the common assumption of greater Chinese somatization and highlight the importance of context in understanding the relationships between somatization and cultural and psychological variables. Implications of the present study and future directions are discussed