OBJECTIVES: The adverse mental health effects of racism are well documented among Asian American communities, yet little is known about how internalized racism (IR) affects mental health among Asian American women, an underserved group. This study examines perceived stress and resilience as potential mechanism and moderator, respectively, in the relationship between IR and mental health outcomes (depression and anxiety).
DESIGN: Using a cross-sectional design, we included a sample of 349 Asian American adult women. Mediation analyses tested whether perceived stress mediated the association between IR and mental health. Moderated mediation analyses examined whether resilience moderated the indirect effects of IR on mental health via stress.
RESULTS: Perceived stress significantly mediated the relationship between IR and both depression and anxiety. The indirect effect was significant for depression (b = 1.25, Boot Standard Error (SE) = 0.44, 95% Confidence Interval [CI]: 0.44, 2.13) and anxiety (b = 1.15, Boot SE = 0.40, 95% CI: 0.40, 1.95), while direct effects were not significant. Resilience moderated the indirect effect of IR on depression (index = -0.30, 95% CI: -0.59, -0.09) and anxiety (index = -0.17, 95% CI: -0.33, -0.03), with weaker indirect effects observed at higher levels of resilience.
CONCLUSION: Perceived stress is a key mechanism linking IR to depression and anxiety among Asian American women. Resilience attenuates the impact of IR on both mental health outcomes. These findings highlight the importance of culturally tailored interventions that target stress reduction to reduce mental health disparities in this underserved population.
Internalized racism and mental health among Asian American women: The roles of perceived stress and resilience
Ethnicity and Health [Epub 2026 Mar 3]. doi: 10.1080/13557858.2026.2635113.