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A Cross-Cultural Study of AnxietyAmong Chinese and Caucasian AmericanUniversity StudentsDong Xie and Frederick T. L. Leong

This study investigated the cross-cu ltural differences on state, trait, and so-cial anxiety between Chinese and Caucasian American university students.Chinese students reported higher levels of social anxiety than did C aucasianAmerican students. Correlations between trait and state anxiety were com-pared In light of the trait model of cross-cultural psychology. Implications formulticultural counseling are discussed.Este estudio investlg6 las diferenclas interculturales en cuanto a estado,rasgo y ansiedad social entre alumnos universltarios Chinos y America-nos Caucdsicos. Los alumnos Chinos comunlcaron niveles m^s altos deansiedad social que los alumnos Americanos Caucaslcos. Se compararonlas correlaclones entre rasgo y estado de ansiedad a la luz del modelo derasgo de la pslcologfa Intercultural. Se discuten las Implicaciones para laconsejerfa multicultural.

A nxiety is one of the most prevalent psychological issues among uni-versity students. However, the understanding of anxiety has laggedbehind its prevalence. Whereas anxiety may be a universal emotion,cultural beliefs and practices still have important influences on experiencesand m anifestations of anxiety (Kirmayer, Young, & Hayton, 1995) and , subse-quently, on developm ent, diagnosis, and treatm ent of anxiety disorders (Scott,Eng, & Heim berg , 2002). However, there has bee n a lack of knowledge andund erstan ding abo ut how anxiety develops and is expe rienced differentlyacross various cultures and how treatments can be m ore culturally responsivefor clients with different cultural and ethnic backgrounds.A review of the existing limited literature involving Chinese participants inresearch studies revealed that Chinese tended to be more anxious than Ameri-cans (Chataway & Berry, 1989; Lin, Endler, & Kocovski, 2001; Sun, 1968). Someepidemiological surveys on prevalence of mental disorders also indicated thatChinese reported higher anxiety levels than did Americans (e.g., Chen, 1996).Similarly, cross-cultural studies involving Asian Americans indicated that AsianAmericans tended to report higher degrees of anxiety than their CaucasianAm erican counterpa rts (Okazaki, 1997, 2000; D. W. Sue, Ino , & Sue, 1983;D. W. Sue, Sue, & Ino, 1990). However, one inherent limitation of these stud-ies was their lack of attention to the ethn ic heterogeneity of Asian Americans.


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different from Caucasian Americans than they were from Asians living outsideof the United States. Thus the previous Asian ethnic minority comparisonsmay not have been powerful enough to identify how culture may influencethe experience and report of anxiety in more subtle ways.Most previous cross-cultural studies only focused on one type of anxiety (e.g.,Klopf & Cambra, 1980) or did not specify what type of Einxiety was mecisured(e.g.. Sun, 1968). It is unclear w hether a difference observed for one type ofanxiety can be observed for other types of anxiety, or whether the magnitudeof a difference may vary across different types of anxiety. Anxiety can be classi-fied based on the stimuli or on the situations that are causes of anxiety. Amongthese types of anxiety, social anxiety was defined as "anxiety resulting from theprospect or presence of interpersonal evaluation in real or imagined social set-tings" (Schlenker & Leary, 1982, p. 642). Social anxiety is characterized by fearassociated with social situations in which one might be viewed or scrutinized byothers. Relatively few studies have specifically addressed the cross-cultural differ-ences between Chinese participants and those from othe r cultures in experienc-ing social anxiety. Furtherm ore , findings from these limited studies tended to bemixed. For example, Klopf and Cambra found no significant difference betweenChinese and Western participants in apprehension about speaking . However,using the same measure of apprehension abou t speaking as Klopf and Cambra,Y. Zhang, Butler, and Pryor (1996) found that Chinese university students re-ported significantly higher apprehension abou t communication compared withthe data on American norms established in 1982. Chan's (1996) study foundthat Chinese students' scores on a social anxiety measure were similar to scoresof their American counterparts but higher than those of French, Dutch, andSwedish students. D. W. Sue et al. (1990) combined the self-report and behaviormeasures in their study on assertiveness and social anxiety in Chinese Am ericanfemale university students. They found that Chinese American women were asassertive as the Caucasian American female students, but they reported moreapprehension about social situations than Caucasian American students did.These studies indicated that Chinese Americans tend to report more anxiety insocial situations bu t may behave as assertively as their Caucasian American coun-terparts. Although it is difficult to explain the discrepancy between self-reportand behavioral measures of social anxiety, such a discrepancy may support thehypothesis that a cultural norm of nonassertiveness (e.g., for the Chinese) mayresult in negative self-evaluations of Asian Americans rather than actual deficitsin their assertive behavior (Alden & Cappe, 1981).

Because social anxiety involves social inte rac tional situations , social anxietymay reflect more cultural variations than other types of anxiety that involve


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One significant advancement in anxiety research is the differentiation ofstate anxiety and trait anxiety, which are related yet logically different anxi-ety constructs. State anxiety is an unpleasant emotional state that varies inintensity and fluctuates over time, whereas trait anxiety describes the rela-tively stable individual differences in anxiety proneness as a personality trait(Spielberger, 1985). This concep tualization assumes that the intensity of stateanxiety can be measured at a given time, and the experience of state anxietymay fluctuate over time as a function of the extent to which an individualperceives his or he r environm ent as dange rous or threa tening . Trait anxietyis defined as relatively stable individual differences in anxiety-proneness. Itis the tendency to perceive stressful situations as dangerous or threatening,especially situations that involve being evaluated by other people or threatsto one's self-esteem (Spielberger, Sydeman, Owen, & Marsh, 1999).

The concep tual distinction between state and trait anxiety makes it possibleto examine whether the correlation between state anxiety and trait anxietydiffers across cultu res. However, until now, there has been no study addressingthe cross-cultural differences of this relationsh ip. There is a moderate-to-highcorrelation between state anxiety and trait anxiety, and u nd er relatively non-stressful conditions, the scores of nonclinical participants on state anxiety andtrait anxiety are generally identical (Spielberger, 1983 ,1985 ). However, mostof these studies were conducted in Western cultures. Will the same h igh cor-relation be observed am ong individuals with a different cultural background ,such as Chinese participants? According to Hsu (1971), in a collectivisticculture like Chinese society, the behavior of individuals is more likely to bedetermined by situational or contextual factors rather than by personalitytraits. Similarly, Church (2000) p roposed tha t even though traits exist in everyculture, they may be less likely to account for behavior in collectivistic thanin individualistic cultures. Thu s, the strong co rrelation between state anxietyand trait anxiety may not appear to be as strong for Chinese participants,who are more contextually oriented, as it is for Caucasian Americans, whoare more individual oriented.

In sum , cross


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university students than for Caucasian American university students because ofthe greater emphasis on contextual factors in Chinese culture.methodPARTICIPANTS

This study consisted of two samples: a mainland Chinese sample (n = 324)and a Caucasian American sample (n = 333). Participants in the Chinesesample were students enrolled in a large, comprehensive university in Bei-jing, C hina. Am ong these Chinese students, 42.3% (n = 137) were men, and57.7% (n = 187) were women. Their ages ranged from 18 to 27 years (M =20.1). Th e Caucasian American sample consisted of studen ts enro lled in a 'large, comprehensive university in the Midwest region of the United States.Am ong these students, 37.2% (n= 124) were men , and 62.8% (n = 209) werewom en. Their ages ranged from 18 to 33 years (M = 18.7).

INSTRUMENTSState-Trait Anxiety Inventory (STAJ, Form Y; Spielberger, 1983). State anxiety andtrait anxiety of the participants were measured by the STAI (Form Y), whichhas been widely used to measure anxiety. It consists of two subscales measur-ing state anxiety and trait anxiety, respectively. For the State Anxiety subscale,respondents are instructed to focus on their feelings of "right now, at thismoment" and rate 20 statements describing anxiety on a 4-point Likert scaleranging from 1 {not at all) to 4 {very much so). For the Trait Anxiety subscale,respondents are instructed to focus on how they feel generally and rate an-other 20 statements describing more stable traits on a 4-point Likert scaleranging f rom 1 (almost never) to 4 (almost always).

Social Avoidance andD istress (SAD ; Watson & Friend, 1969) scale. The SAD scaleis a widely used measure of social anxiety. It con tains 28 item s, with 14 itemsassessing social avoidance, and 14 items assessing social distress. Participantswere asked to rate their behavior and feelings in various social situations ona 5-point Likert scale (1 = not at all characteristic of me, 5 = extremely characteris-tic of me). Social avoidance and distress refer to the tendency to avoid socialsituations and to feel anxious in such situations. Thus, the SAD scale focuseson the behavioral and affective components of social anxiety.PROCEDURE

The instruments measuring state anxiety, trait anxiety, and social anxiety


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versions were then compared, and the discrepancies were discussed by thetwo translators. To resolve identified discrepancies, they consulted with nativespeakers of English and Mandarin who were familiar with bo th languages andcultures. On the basis of these consultations, the translators selected termsand d eterm ined w ordings that would be most represen tative of linguistic andconceptual equivalence between the two cultures.rp suitsCOMPARISONS OF DEMOGRAPHIC CHARACTERISTICS

Chi-square analyses indicated no significant differences for distribution ofgender, x^(l, N= 657) = 1.75, ns; marital status, x^{2, N= 654) = 4.86, ns; andprevious counseling experience, X^(l. ^= 656) =0.13, ns. In both samples,there were more women than men , almost all ofthe students were unmarried,and about 75% of the students had no previous counseling experience.However, chi-square analyses indicated that the two samples differed on dis-tributions of age, x2(io, N= 651) = 244.00, p < .001, and academic rank, xH^,N= 657) = 138.21, /)< .001. Overall, 20- to 22-year-old participants representeda larger proportion of the Chinese sample (64.7%) than of the Caucasian

American sample (14.1%), whereas 18- to 19-year-old participants made upa larger proportion of the Caucasian American sample (83.2%) than of theChinese sample (31.5%). The age difference between the two samples wasconsistent with the difference on academic year rank. Second-year and 3rd-yearstudents made up a larger proportion ofthe Chinese sample (59.8%) than ofthe Caucasian American sample (18.3%), whereas lst-year students made upa larger proportion of the Caucasian American sample (79.6%) than of theChinese sample (34.3%).INTERNAL CONSISTENCY

Means, standard deviations, and internal consistency statistics of the measuresare summarized in Table 1. Cronbach's alphas for the scales measuring stateanxiety, trait anxiety, social avoidance, and social distress ranged from .82 to.90 for the Chinese sample and from .88 to .94 for the Caucasian Americansample. These internal consistency coefficients indicated high reliability andwere comparab le with those in existing literature (see Leary, 1991; SpielbergeretaL , 1999).INTERCORRELATIONS AMONG ANXIETY VARIABLES


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TABLE 1Between-Group Comparisons on Anxiety Measures for Chinese

(n = 324) and Caucasian American (n = 333) StudentsVariableOmnibus State andTrait AnxietyTrait AnxietyState AnxietySocial Anxiety

tv i

42,8938.91Social Avoidance 35,88Social Distress 36,83

ChineseSD

8,339,058.889,60

a

,89,90,82.88

Caucasian Americantv i

40,5338,2029,4331,82

SD

10,6912,198.959,06

a

,92,94,88,89

F23,02***9,62**0.6685,96***47,40***

r\ '

,12,02,00.12,07**p< ,01.***p< ,001 .

also positively correlated with state anxiety (r= .74), social avoidance (r= .44),and social distress (r= .45). The correlations between trait anxiety and othertypes of anxiety were smaller for Chinese than for Caucasian Am erican univer-sity students. However, when subjected to the Fisher's Z score transformationprocedure , no ne of these differences reached a statistically significant level.CROSS-CULTURAL DIFFERENCES ON ANXIETYA simple muitivariate analysis of variance was perfo rm ed to test the between-group differences on state anxiety, trait anxiety, social avoidance, and socialdistress. Tests of equivalence did no t suggest any violation of variance equiva-lence. Results indicated that C hinese an d Caucasian American university stu-dents differed significantly on the combined set of anxiety measures, F(4, 651)= 23.02, p< .001, r|^= .12. Specifically, Chinese students scored significantlyhigher than Caucasian students on the Trait Anxiety (M= 42.89 for Chinese,

M= 40.53 for Caucasian Americans), F{1, 654) = 9.62, /*< .01, rf= .02; SocialAvoidance (M = 35.88 for Chinese , M= 29,43 for Caucasian Americans), F{1,654) = 85.96, p < .001, rf-^ .12; and Social Distress (M= 36.83 for Chinese,TABLE 2

Intercorreiations Among Anxiety iVIeasures for Chinese Students andCaucasian Am erican StudentsAnxiety Measure 1 2 3 41. State Anxiety ,74 ,33 ,322. Trait An xiety .68 ,44 ,45


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Af= 31.82 for Caucasian Americans), F{1, 654) = 47.40, p < .001, ^^= .07,subscales. There was no significant difference in scores on the State Anxietysubscale between the two groups, F{1, 654), ns, yf= .00. Therefore, these re-sults supported the hypothesis that Chinese university students would reporthigh er levels of anxiety than would Caucasian Am erican university studen ts,and such a difference was more significant for social anxiety.dism.ssinn

Existing cross-cultural studies on anxiety have often failed to differentiateam ong different types of anxiety. Moreover, the within-group sam ples involvedin these studies were often ethnically heterogeneous, and the between-groupsamples were not culturally distinct from each other. With these limitationsbeing considered, the presen t study investigated the cross-cultural differencesof state anxiety, trait anxiety, and social anxiety between mainland Chineseuniversity students and Caucasian American university students.

The results indicated that Chinese university students repo rted higher levelsof Trait Anxiety and Social Anxiety (operationalized by two subscales as So-cial Avoidance and Social Distress) than did Caucasian American universitystudents, bu t the two groups did no t differ on levels of State Anxiety. Amongthese differences, as hypothesized, the difference on Social Anxiety had agreater effect size (rj^ = .12 for Social Avoidance, .07 for Social Distress) thanfor Trait Anxiety (ti^ = .02). This finding suggests tha t Chinese and CaucasianAmerican university students were more different on social anxiety than ontrait anxiety. This finding is generally consistent with the conceptualizationsof social anxiety and trait anxiety and suggest that culturally related factorshave more influence on social anxiety than on trait anxiety. Th e pre sen t studyno t only sup ported previous findings tha t Chinese as well as Asian Am ericansreport higher levels of anxiety but also provided a better understanding ofthese cross-cultural differences on specific types of anxiety.The Chinese culture prescribes high expectations concerning interpersonalrelationships, which may appear to be more taxing in social interactions and thusmay make people m ore susceptible to social anxiety. For exam ple, the Chineseculture typically prescribes face and relationship orientations. These orienta-tions represent the value prescribed by traditioneil Chinese culture of enhancingone's social standing, avoiding losing face, and exchanging social favors basedon reciprocity. Individualistic cultures, such as that found in the Un ited States,mainly prescribe high expectations concerning personal achievement. These


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ous interpersonal relationship, Chinese university students might choose todo things not so much because it is what they want to do, but to receive thepositive com ments others may make. As a result, they may become overly sen-sitive to interpersonal relationships and o the rs ' evaluations. To minimize therisk of being negatively evaluated, Chinese university students may constraintheir behavior or even reduce their social interaction with others.An authoritarian orientation in Chinese culture may also explain the highsocial anxiety among Chinese students. Obedience to authority is one im-po rtant aspect that charac terizes social interactions in Chinese society (Yang,1996) and is on e of the e lem ents of hierarchical collectivism (Triandis & Suh,2002). One of the behavioral consequences of this authoritarian orientation iscons tant vigilance regarding one 's behavior or opinion s in social situations tobe certain that they parallel the authority's perspective. Collectivistic peoplewith high autho ritarian orien tation may be m ore susceptible to social anxietyfor three reasons. First, they tend to eagerly identify an authoritative figure insocial interactions. Once such an authoritative figure is identified, collectiv-istic peop le becom e sensitive to their own behaviors and subject these to thejudgment of this authoritative figure. Second, if collectivistic people cannotidentify an authoritative figure in a social situation, they may either imagineone or subject their behavior to internalized authoritative standards governingthe social situation. Th ird, collectivistic peop le may exp erien ce anxiety whenthey cannot identify or imagine an authoritative figure, or they may identifytwo or more authoritative figures representing conflicting standards. ThusChinese people who observe an authoritarian orientation experience anxietyin response to authority figures associated with social situations.The finding in this study that Chinese university students reported higherlevels of social anxiety is, in genera l, consistent with the communication normthat is typical of Chinese culture . Hall (1977) conceptualized high-context\ersuslow-context communication as a cultural variation. High-con text co mmunicationrelies on presumptions shared by people, nonverbal signals, and specificsituations in which interaction occurs, whereas low-context communicationrequ ires clear, explicit verbal articulation as well as elaborated expressions thatare relatively indep en de nt of situational inte rpretatio n. O verall, high-contextcomm unication tends to be more endo rsed in the Chinese culture and o therAsian cultures than in Western cultures. By comparing these two types ofcomm unications, it might be inferred that people w ho rely on high-contextcom munication may appear m ore socially submissive or socially avoidant thanthose who rely on low-context communication.The present study indicated that Chinese university students scored higher


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measurem ents being established (see Marsella & Leong, 1995, for a review ofequivalence issues of assessment in cross-cultural studies). Further research isne ed ed to investigate norm ative equivalence and how it may affect th e differ-ences in repo rted anxiety between Chinese university students and CaucasianAmerican university students.From a multicultural counseling perspective, this study may have implica-tions for assessment of, conceptualization of, and interventions for anxietydisorders when working with mainland Chinese clients. Although multiculturalcounseling has been an important issue in the United States with respect toproviding services to an increasingly diverse clientele, it is ironic tha t diversityissues have not yet drawn adequate attention in China, a country inhabited

by one fifth of the world's total population. This is probably because of amisconception that m ulticultural counseling is a practice involving differentethnicity or race between a counselor and a client. This conceptualizationwould exclude the practice of counseling in China from taking a multiculturalperspective because, in most cases, the counselor and client have the sameethnic background. However, both the theory and the practice of counselingin China have been mainly transplanted from Western countries with fewcultural variations (Duan & Wang, 2000). In addition to counselor and clientethnicities, multicultural counseling should also be understood as a practiceof attending to cultural and social factors th at may have an impac t on c lients'repo rting and experience of symptoms as well as counselo rs' assessment, caseconceptualization, and intervention. Sociocultural inclusiveness has beennoted in the recen t literature on multicultural counseling com petencies (e.g.,Roysircar, 2005; Roysircar, A rredo ndo , F uertes, Po nterotto, & Toporek, 2003)and current issues of the Journal of Multicultural Counseling and Development,such as Volume 35, Number 4, October 2007. This is particularly importantfor counseling in non-Western countries, where there has been a strong reli-ance on the counseling theories developed in Western cultures.

Th e present study found that the dijfference between Chinese an d CaucasianAmerican university students on social avoidance had the largest effect size.The practical implication of this finding is that a counselor should particularlyconsider cu ltural influences in conceptualizing a case involving social anxiety. Itis both functional and dysfunctional for Chinese students to be socially avoidant.In the Chinese culture, students who are socially avoidant may feel distressedbecause they are socially isolated; however, their socially avoidant behavior mightalso be interpreted as being nonaggressive and conflict-avoidingbehaviors tha tare valued in Chinese culture. If this is the case, then the counselor may helpthe client to be more aware of and to differentiate functional and dysfunctional


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Th e present study is am ong th e first to empirically test Church 's (2000) traitmodel of cross-cultural psychology. According to Ch urch 's m ode l, traits mayaccount less for behavior in a high con textual culture, and in the p resent studya lower correlation between trait anxiety and oth er types of anxiety would beexpected for the Chinese sample than for the American Caucasian sample.However, the present study showed somewhat mixed findings with respectto supporting the trait model. On the one hand, the correlations betweentrait anxiety and other types of anxieties were all smaller for the Chinese(r= .36 to .68) than for the Caucasian American university students (r= .44to .74), which appeared to sup port the trait model. However, the differencesbetween these correlations were not statistically significant and, thus, failedto provide strong support for the model. We are unsure if the differencesbetween the correlations were due to some systematic measu rem ent e rror orif they were a result of different functions of trait-related constructs in dif-ferent cultures. We ho pe that this study will stimulate fu rther cross-culturalresearch to empirically test the trait model.This study points to additional directions for future research. Future re-search may need to focus on the norm ative equivalence o fth e assessments ofanxiety. Althoug h perceived cultural n orm s may no t interact with e thnicityin the reporting of social anxiety symptoms among Asian Americans andCaucasian Am ericans (Okazaki & Kallivayalil, 2002), it would be interest-ing to see if a lack of interaction effect can be replicated when using apu re r sample of Chinese pa rticipants who are mo re culturally distinct fromCaucasian Americans. Moreover, it would be interesting to investigate thetolerance of social anxiety symptoms and the effect of such tolerance onthe reporting of these symptoms. Chinese university students in this studyrep orte d high er social anxiety than did C aucasian Am erican university stu-dents, bu t they may not be as distressed or b oth ere d by these symptoms asare Caucasian Am ericans. Th e high-toleran ce hypothesis might also explainthe u nderutilization of m ental h ealth services by Asian Am ericans foundin previous studies (Snowden & Cheun g, 1990; S. Sue, 1977; A. Y. Zhang,Snowden, & Sue, 1998).Future research may also need to investigate the effects of antecedents oftrait anxiety and social anxiety among the Chinese at both the cultural leveland the individual level of analyses. For example, among the dimensions ofculture (Triandis & Suh, 2002), the tightness (strickness) or looseness of aculture may be related to exper ience of social anxiety. In C hina, norm s oftenappear to be imposed more tightly than in the United States, where devia-tion from the norm is more tolerated. The difference in the tightness of the


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This study has a number of limitations that may quahfy its findings. Al-though the translation and back-translation procedure was used to obtaincross-cultural equivalence of the measures used, the results could also beinfluenced by the possible differences in response style between Chineseand Caucasian American university students. Second, the Chinese sampleand the Caucasian American sample were samples of convenience, whichmay not be a fair representation of university populations in the twocultures. A third limitation was that the study used a sample of universitystudents but did not include a clinical sample. Therefore, caution shouldbe taken when generalizing the study's findings to clinical populations orto nonuniversity populations.rpfprpnrps

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