Abstract
Our study aims to examine the salutary effects and interactions of three Chinese indigenous well-being (CIWB) constructs, namely relationship harmony (advocated by Confucianism), dialectical coping (derived from Taoism), and nonattachment (based on Buddhism) on mental health. Participants were 262 Taiwanese college students. Results revealed that the three CIWB constructs showed distinct associations with mental health. Relationship harmony was related negatively to psychological distress and positively to meaning in life and happiness. Dialectical coping predicted higher levels of positive affect and meaning in life, whereas nonattachment was the only and strongest protective factor against negative affect and psychological distress. Overall, nonattachment demonstrated the most adaptive effects on mental health. Additionally, moderation effects between dialectical coping and nonattachment on self-esteem, psychological distress, and happiness were observed. These findings underscore the importance of simultaneously investigating CIWB constructs to capture their unique and interactive contribution to psychological adjustment. Practical and research implications are discussed.
What variables best reflect notions of Chinese indigenous well-being (CIWB), and how are these variables uniquely associated with different aspects of mental health? The goal of this study is to answer these questions by identifying CIWB constructs based on teachings from three ancient Chinese philosophical traditions and empirically elucidating how each CIWB construct is distinctively linked to Chinese people’s mental health outcomes. We begin with a review of three well-being constructs advocated by three classical Chinese philosophies, namely, relationship harmony from Confucianism, dialectical coping from Taoism, and nonattachment from Buddhism. We then utilize the complete mental health model (Keyes, 2005) as a framework to conceptualize the relationship between CIWB constructs and Chinese people’s mental health.
What constitutes the good life is a long-standing question that has been addressed from different perspectives by philosophers in the East and the West (Christopher, 1999). Any definition of “good,” thus, is a context-dependent notion that not only embodies desired states under a certain culture or philosophy, but also affects how people achieve and maintain well-being (Lu & Gilmour, 2006; Ng, Ho, Wong, & Smith, 2003). Put another way, subjective well-being (SWB) may be experienced universally, but its meaning and content hinge upon different philosophies grounded in indigenous cultures (Lu, 2008; Xing, 2005). However, past research on well-being has been criticized for reflecting the Western cultural bias of individualism (Constantine & Sue, 2006). Consequently, there has been increased scholarly interest in investigating cultural notions of well-being with an emphasis on the individualism–collectivism distinction (Kitayama, Markus, & Kurokawa, 2000; Lu & Gilmour, 2006). For instance, Lu and Gilmour (2006) contended that a culturally sensitive measure of SWB should tap into individual-oriented as well as socially oriented SWB.
At least two limitations of the extant literature are noteworthy. For one, researchers tend to give undue weight to the cultural dimension of individualism versus collectivism when investigating cultural dimensions in the area of well-being, to the exclusion of other philosophical traditions that permeate East Asian thought. We echo Ho’s (1995) call for greater attention to constructs from other Asian philosophical traditions, such as dialecticism from Taoism (Peng & Nisbett, 1999; Peng, Spencer-Rodgers, & Nian, 2006) and nonattachment from Buddhism (Wallace & Shapiro, 2006). Furthermore, no study has examined the interaction effects between diverse CIWB constructs on mental health.
Second, although some scholars have attempted to delineate how Chinese philosophical traditions define the good life and the implications of these conceptualizations of well-being, such analyses tend to be philosophical, rather than empirical in nature (e.g., Ho, 1995; Joshanloo, 2014). For instance, G. Zhang and Veenhoven (2008) reviewed Confucian, Taoist, and Buddhist conceptions of the good life and concluded that Confucian tenets are most conducive to happiness, followed by those from Taoism, whereas they were skeptical about Buddhist approaches to attaining the good life. However, these propositions have yet to be empirically tested. In addition, although researchers have developed measures of CIWB constructs based on the three philosophical traditions, their work has focused on the common features rather than the distinct aspects of CIWB constructs (e.g., Lee, Lin, Huang, & Fredrickson, 2013).
This study aims to fill the abovementioned gaps in the literature by making three well-being constructs from the three philosophical traditions the focal point and by examining the relationships between each CIWB construct and Chinese people’s mental health outcomes. In the review presented next, we describe three notable Chinese philosophical traditions: Confucianism, Taoism, and Buddhism, and we distill three well-being constructs closely relevant to these traditions. We preface our literature review with a caveat: The CIWB constructs we describe are not the only well-being constructs in Chinese culture, nor are they meant to fully represent all aspects of the philosophies. For example, wu wei (nondoing) is one of the hallmarks in Taoism that we did not discuss because it falls beyond the scope of this article. Rather, we focus on constructs that are arguably the most salient features of Chinese concepts of well-being.
A large body of literature on Chinese people’s well-being draws on these three philosophies and discusses how the good life portrayed in each tradition shapes Chinese people’s well-being (e.g., Joshanloo, 2014; Lee et al., 2013; Lu, 2008; Lu & Gilmour, 2006; Xing, 2005). Conceptually, Hwang (2009, 2012) has argued that among other influential philosophical schools of thought in Chinese culture, Confucianism, Buddhism, and Taoism are the most dominant ones, influencing how Chinese people function in today’s society. Empirically, Lu (2001) provided strong evidence that well-being constructs derived from these three philosophies adequately capture Chinese people’s well-being. In her study, Taiwanese participants’ spontaneous accounts of what happiness is were informed by these three philosophies. Our selection of these three philosophical traditions, thus, was based on past researchers’ work.
Confucianism
In essence, Confucianism, developed by Confucius (551–479 B.C.), is a set of pragmatic ethics that stipulate the structure of human relationships and interpersonal virtues. These guiding ethics are conducive to Confucianism’s ultimate goal: harmony within people and among their relationships (Ho, 1995; Joshanloo, 2014; Lee et al., 2013). To accomplish these goals, individuals need to cultivate ren (roughly translated as benevolence or compassion), an overarching virtue in Confucianism. Ren is an encompassing concept that manifests itself as different virtues in five interpersonal contexts, including the relationship between a father and son, a husband and wife, young and old people, a ruler and subject, and friends (Tao, 1996). Ren is attained when an individual adopts a code of conduct that is appropriate based on the cognitive assessment of a relationship (Hwang, 1998). Because interpersonal relationships serve as the basis for proper social behavior, individuals should refrain from acting to serve private needs and, instead, behave in accordance with ren.
The importance ascribed to relationships gives rise to Chinese people’s interdependent self-construal, which is defined by one’s social positions and one’s relations with others (Markus & Kitayama, 1991). Closely related to the concept of interdependent self-construal is what Ho (1995) termed the “relational self,” referring to Asians’ unique aspect of self that incorporates their social relationships. Importantly, there is mounting evidence in the literature supporting the idea that in East Asian countries happiness is associated with social harmony (Uchida & Kitayama, 2009). In short, harmony in intimate relationships, extolled by Confucianism as the yardstick of the good life, reflects Chinese people’s tendency to construct selfhood in terms of relationships with others. In this regard, Chinese people’s well-being may depend largely on the degree to which harmony is achieved in their significant relationships.
Given the reasons outlined previously, we distilled relationship harmony as the representative well-being construct for Confucianism. We also reasoned that relationship harmony has a positive influence on self-esteem among Chinese individuals, given that individuals who are capable of achieving a culturally valuable goal, in this case, high levels of harmony in important relationships, may perceive themselves positively (Kang, Shaver, Sue, Min, & Jing, 2003).
Taoism
Taoism as a philosophical doctrine is based on Laozi’s (around 570 B.C.–unknown) teachings. In contrast to Confucianism, the ultimate value for Taoism is nature, meaning the way things are without forceful interference from external sources (Liu, 1997). Tao, which can be translated as “the Way,” follows nature and lays a transcendent foundation for all things on earth (Yuan, 1997). The ideal life in Taoism is one in which people are free from desires, live simply and genuinely, and are unrestrained by social conventions—in a nutshell, a life in perfect harmony with Tao (Ho, 1995; Lee et al., 2013).
Within psychology, the construct of dialectical thinking, first proposed by Peng and Nisbett (1999), has helped advance the empirical study of Taoism. In particular, Peng and Nisbett have articulated three interrelated principles of dialectical thinking based on Taoist philosophy. The principle of change holds that the world is constantly changing and that people, events, and experiences are dynamic and changeable. The principle of contradiction asserts that everything in the reality contains opposite elements that coexist simultaneously. Finally, a corollary of the principles of change and contradiction is the principle of holism, which claims that nothing in the cosmos is isolated but every element is interconnected.
Based on the aforementioned review, we surmised that individuals who endorse dialectical thinking tend to perceive their lives as meaningful. By adhering to dialecticism, they construe the world as an organic whole operating in accordance with Tao, the metaphysical value that provides order to the world (Liu, 1997). Consequently, individuals who subscribe to dialecticism are more likely to identify connections with their environments (cf. principle of holism; Peng & Nisbett, 1999) and recognize patterns in their lives, which serve as an anchor for their search for meaning.
The salutary effect of dialectical thinking on meaning in life may be especially salient in the context of stressful life conditions (Wong & Liu, in press). We define dialectical coping as the adaptive application of dialectical thinking to cope with life challenges. To illustrate, dialectical coping may involve the tendency to believe in the temporal nature of problems (principle of change), the coexistence of positive and negative experiences (principle of contradiction), and the interconnections between negative and positive events (principle of holism) as a means of coping with life challenges.
Although dialectical coping has not been directly assessed in empirical research, Cheng (2009) has documented the positive effect of dialectical thinking on psychological outcome through an enhanced capacity in coping flexibility. In addition, the deployment of dialectical coping may be especially beneficial when the stressor does not lend itself well to problem solving. Under these circumstances, Taoist philosophy dictates that negative experiences are inevitable and should be accepted rather than avoided. This process of reappraisal not only lessens the impact of the stressful situation on a person (Park & Folkman, 1997), but also contributes to a sense of meaning in life. Thus, we selected dialectical coping as the CIWB construct that best represents Taoism.
Buddhism
Buddhism is founded on the teachings of Buddha Gautama (565–486 B.C.) in India, and was first introduced to China in the Han Dynasty. After centuries of assimilation in China, Buddhism gradually co-opted elements of Chinese culture, including Confucianism and, particularly, Taoism (Hsieh, 2012). A core idea of Buddhist teachings is that life is characterized by dissatisfaction and imperfection. As a corollary of this claim, our psychological tendencies to hold on to pleasurable things and resist pain are eventually futile. According to Buddhism, clinging to all phenomena is detrimental because impermanence and nonself are the ultimate truth of the universe (Mikulas, 2007). Being mentally fixated on anything is the result of being ignorant to the nature of the world and inevitably invites suffering. The Buddhist is keenly aware of the impermanent nature of the world and the universe being void of substantiality and thus realizes that grasping onto a particular state of affairs is unnecessary because the division of self and nonself is an illusion. As a result, well-being is engendered by a balanced state that is not affected by either external or internal stimuli; in other words, well-being is not dependent on specific circumstances (Sahdra, Shaver, & Brown, 2010; Wallace & Shapiro, 2006). This unique state is termed nonattachment (Sahdra et al., 2010), which we conceptualized as the representative well-being construct for Buddhism. Note that the term attachment used in Buddhist doctrine is distinct from the Western psychological construct of attachment (Ainsworth, Blehar, Waters, & Wall, 1978). Nevertheless, to be consistent with the terminology of Buddhist psychology, we decided to retain the word “nonattachment.”
We speculated that nonattachment will contribute to individuals’ mental health chiefly by serving as a protective factor against psychological distress and negative affect (NA). To be more precise, suffering largely stems from the ignorance of mind. Nonattachment is prescribed by Buddhism to remedy ignorance and restore a balanced state free of anxiety, frustration, and depression (Sahdra et al., 2010; Wallace & Shapiro, 2006).
The ongoing discussion of three philosophical traditions and their respective visions of well-being sets up an interesting, albeit underexplored, question probing how these three CIWB constructs may exert interdependent (i.e., interactive) or independent (i.e., additive) effects on mental health. On the one hand, similarities among the three CIWB constructs can be inferred, rendering the possibility that simultaneous subscription to these constructs is beneficial to individuals’ adjustment because they are internally compatible. For instance, self-transcendence is a common factor endorsed by three CIWB constructs (Joshanloo, 2014). Individuals achieving high interpersonal harmony presumably de-emphasize their individual self (Ho, 1995; Hwang, 2009), and this psychological decentering also nurtures dialectical coping (promoting the negation of the self and the integration with Tao) and nonattachment (recognizing that the self is an illusion which induces the proclivity of clinging). On the other hand, these three conceptions of well-being have their unique aspects that may result in conflict, compromising individuals’ mental health. To illustrate, one way to obtain relationship harmony is through self-cultivation (Hwang, 2009), which is disdained by Taoists who champion a simple, spontaneous life unrestricted by social regulation (Ho, 1995). It is also possible that the Taoist doctrine that life is comprised of sorrow and joy contradicts the Buddhist idea that life is inherently miserable (Ho, 1995).
Mental Health Outcomes
Having described the three CIWB constructs, we now discuss the mental health outcome variables in our study. We used Keyes’s (2005) broad conceptualization of complete mental health as the basis for our selection of mental health outcome variables. Keyes conceptualized mental health as not only the absence of mental illness, but also the presence of positive states, such as SWB and psychological well-being. Specifically, we assessed five categories of mental health outcomes: (a) two psychological well-being variables, self-esteem and meaning in life; (b) Western notions of SWB, indicated by satisfaction with life, positive affect (PA), and the lack of NA (Diener, 1984); (c) peace of mind, an indigenous Chinese affective well-being construct (Lee et al., 2013); (d) a single-item measure of happiness based on participants’ lay beliefs about SWB (Baumeister, Vohs, Aaker, & Garbinsky, 2013); and (e) psychological distress, as an indicator of mental illness.
Research Questions
Our goal in this study was to test the relative contributions of three CIWB constructs (i.e., relationship harmony, dialectical coping, nonattachment) to eight mental health outcomes (i.e., self-esteem, life satisfaction, PA, NA, psychological distress, peace of mind, happiness, meaning in life). To that end, we posed three sets of research questions.
First, given that relationship harmony, dialectical coping, and nonattachment are all well-being constructs, we hypothesized that these three CIWB constructs would be significantly related to all the mental health outcomes at the bivariate level. Second, we examined how relationship harmony, dialectical coping, and nonattachment were uniquely related to the mental health outcomes. Based on our foregoing literature review, we hypothesized that among the three CIWB constructs (a) relationship harmony would be the strongest predictor of self-esteem, (b) dialectical coping would be the strongest predictor of meaning in life, and (c) nonattachment would be the strongest predictor of reduced NA and psychological distress. Finally, we tested all combinations of interaction effects among the three CIWB variables on the eight mental health outcomes. Given the lack of prior research on this topic, we made no hypotheses.
Method
Participants and Procedures
The original sample consisted of 270 students enrolled in undergraduate or graduate-level courses in psychology from five universities in Taiwan. Participation was anonymous and no rewards were offered for participation. The purpose of the study was explained to students and informed consent was obtained prior to data collection. The study was conducted in Mandarin via a paper-based questionnaire, which took about 30 min to complete.
Data from two participants were deleted because they did not provide any responses to our survey or demonstrated straight-line responding. Six participants did not indicate their gender, the variable that was controlled for in subsequent analyses, resulting in a final sample of 262 participants (average age = 22.03 years, SD = 4.86; 45.4% male, 54.6% female). With regard to religious beliefs, 58.8% reported not identifying with a religion, 15.8% were Buddhists, 14.2% were Taoists, 14.2% were non-Catholic Christians, 6.2% believed in Confucianism, 1.5% were Catholics, and 1.5% indicated others (participants were allowed to choose more than one option).
Measures
Relationship harmony
The Chinese version of the Interpersonal Relationship Harmony Inventory (IRHI; Kwan, Bond, & Singelis, 1997) was used to assess the degree to which respondents achieve harmony in their relationships. Participants were instructed to identify the five most important dyadic relationships in their lives and specify three characteristics of the relationships: the target person’s name, gender, and the nature of the relationship (e.g., friend, mother). Next, participants were asked to rate the degree of harmony in each relationship using a 7-point Likert-type scale (1 = very low, 7 = very high). The relationship harmony index was determined by averaging the five relationship harmony scores. A higher score indicated a higher level of perceived overall harmony in interpersonal relationships. Evidence of construct validity was reported by Chang, Osman, Tong, and Tan (2011) who found that for Singaporean Chinese, relationship harmony was related to self-esteem. The Cronbach’s alpha for this study was .71.
Dialectical coping
To our knowledge, there is no existing measure of dialectical coping. As a result, we developed the Dialectical Coping Scale (DCS) to measure the degree to which an individual utilizes the principles dictated by dialecticism to cope adaptively with challenging situations. The 9-item scale consists of three subscales that correspond to the three principles identified by Peng and Nisbett (1999) as the epistemological characteristics of dialectical thinking: Change, Contradiction, and Holism. Each principle is measured by three items using a 6-point Likert-type scale where 1 = strongly disagree and 6 = strongly agree. Sample items are as follows: “When I experience difficulties, I remind myself that misfortune coexists with blessings” (Contradiction subscale); “I believe that the problems in my life don’t last forever” (Change subscale); and “In understanding the obstacles in my life, I can see the interconnections between negative and positive events” (Holism subscale). All items were translated into Chinese by S.-Y. Wang and back-translated by a bilingual graduate student to ensure that the meaning of the Chinese version was clear. Where clarity was questioned, items were modified and reexamined. The total score was obtained by averaging responses to all items, with a higher score reflecting a higher level of dialectical coping. We conducted confirmatory factor analyses (CFAs) on the nine items of the DCS. Using Hu and Bentler’s (1999) guidelines for fit indices, we found that a one-factor model was not a good fit to the data, χ2/df = 3.99, comparative fit index (CFI) = .88., root mean square error approximation (RMSEA) = .10, (90% confidence interval [CI] = [.08, .13]), standardized root mean square residual (SRMR) = .06. In contrast, a hierarchical model (three latent factors of Contradiction, Change, and Holism loading on a higher-order factor of Dialectical Coping) was a good fit to the data, χ2/df = 2.13, CFI = .96, RMSEA = .07, (90% CI = [.04, .09]), SRMR = .04. In addition, all item loadings on the latent variables as well as the loadings on the higher-order factor were significant, p < .001. These findings provide support for using the DCS’s overall score as well as its subscales. As the DCS was a newly developed measure, its construct validity evidence was not available. The scales exhibited good to excellent reliability based on the current sample, with Cronbach’s alphas of .90, .76, and .84, for Change, Contradiction, and Holism, respectively, and .81 for the overall scale.
Nonattachment
The Nonattachment Scale (NAS; Sahdra et al., 2010) is a 30-item self-report questionnaire designed to measure the level of nonattachment that participants currently feel. Respondents report the extent to which each statement reflects their experience on a 6-point Likert-type scale, ranging from 1 (disagree strongly) to 6 (agree strongly). A sample item is “I can accept the flow of events in my life without hanging onto them or pushing them away.” The overall score was calculated by averaging responses to all items, with a higher score denoting a greater tendency of nonattachment. Explanatory and confirmatory factor analyses supported a single factor structure, and evidence of convergent, discriminant, construct, and incremental validity was provided by Sahdra et al. (2010). A Chinese version of the NAS (Chao & Chen, 2013) was used in this study. Chao and Chen reported that, based on a Taiwanese adult sample, the scale possessed a Cronbach’s alpha of .93, and it correlated positively with well-being constructs, such as self-determination and satisfaction with life. For this study, we revised two items to reach a greater level of accuracy and fidelity to the original, and the scale was back-translated by an independent translator. These two items were then examined by a bilingual graduate student to ensure linguistic equivalency. For this study, the scale demonstrated excellent reliability (α = .92).
Self-esteem
The 10-item Rosenberg Self-Esteem Scale (RSES; Rosenberg, 1965) examines global self-esteem. Participants responded to a 6-point Likert-type scale (1 = strongly disagree, 6 = strongly agree). A sample item is “On the whole, I am satisfied with myself.” The Chinese version of RSES used in this study was translated by K.-H. Yeh and also back-translated into English. With regard to construct validity, Yeh and Yang (2006) demonstrated that for Taiwanese adolescents, this scale was negatively associated with problem behaviors and positively linked to autonomy. The scale demonstrated good reliability based on the current sample (α = .89).
Life satisfaction
The 5-item Satisfaction With Life Scale (SWLS; Diener, Emmons, Larsen, & Griffin, 1985) was used to measure participants’ cognitive appraisal of the quality of their lives as a whole. Items are rated on a 6-point Likert-type scale, with 1 = strongly disagree and 6 = strongly agree. A sample item is “I am satisfied with life.” The overall score was derived by averaging responses to all items, with higher scores reflecting higher degrees of life satisfaction. A Chinese version of the scale that has been translated and back-translated was used, and its construct validity evidence was gleaned from its negative correlations with loneliness and insecure attachment in Taiwanese college students (Wu & Yao, 2008). For this study, the scale showed good reliability (α = .89).
PA and NA
The Positive and Negative Affect Schedule (PANAS; Watson, Clark, & Tellegen, 1988) is a self-report measure of PA and NA. Participants were given a list of 20 words, with 10 words describing positive feelings (e.g., “interested”) and 10 words describing negative ones (e.g., “distressed”). Participants indicated to what extent they experienced the emotions over the past 6 months on a 5-point Likert-type scale (1 = not at all, 5 = extremely). The PA score was determined by averaging responses to 10 items, and the same principle was used to calculate the NA score. Higher scores on both scales represented higher levels of PA and NA. J. Zhang, Yang, and Wang (2009) reported that PA and NA correlated positively and negatively with happiness, respectively, in Chinese college students, lending support for construct validity. In this study, we translated the Chinese version of the PANAS, and a back translation was conducted by a bilingual graduate student. Another independent bilingual graduate student examined the back-translated and the original versions to ensure that their meaning was comparable. Cronbach’s alphas for the PA and NA scales were .90 and .86, respectively.
Psychological distress
The 21-item version of the Depression Anxiety Stress Scale (DASS-21; Lovibond & Lovibond, 1995) was used to assess general psychological distress through its three subscales: depression, anxiety, and stress, each of which contains seven items. A sample item is “I found it hard to wind down.” Using a 4-point Likert-type scale (1 = not at all, 4 = always), respondents rated the degree to which the items applied to them over the past 6 months. According to Henry and Crawford (2005), combining the three subscales in DASS as a measure of psychological distress has substantial validity, as the scale showed inverse relationships with optimism and self-esteem in Chinese college students (Kwok, Wong, & Lee, 2014). Therefore, an index was computed by averaging the 21 responses. The higher the value, the more severe the psychological distress. The Chinese version of DASS-21 was translated by us and back-translated by an independent translator and the equivalency of the Chinese and original versions was checked by another translator. For the present study, excellent reliability (α = .92) was found.
Peace of mind
The Peace of Mind Scale (PoM; Lee et al., 2013) consists of seven items written in Chinese to measure levels of affective well-being characterized by a sense of internal harmony and peace. This measure assesses affective well-being valued in Chinese culture. Respondents were instructed to rate how frequently they experience the internal states described in each item on a 5-point Likert-type scale (1 = not at all, 5 = all of the time). A sample item is “My mind is free and at ease.” Total scores were computed by averaging responses to all items, and higher scores reflected greater degrees of peace of mind. Evidence of construct validity was shown by positive correlations with SWB and negative correlations with emotional distress (Lee et al., 2013). For the current study, the Cronbach’s alpha was .88.
Happiness
To assess a lay conceptualization of SWB, we posed a single question: “In general, to what extent do you feel happy?” on a scale with six options, ranging from 1 (very unhappy) to 6 (very happy). We chose the word “happiness” instead of “subjective well-being” to model the term used by Lu and Shih’s (1997) qualitative study of Taiwanese lay people’s happiness. No further definition of happiness was provided, which allowed participants to interpret the meaning of happiness according to their lay beliefs (Baumeister et al., 2013). This item was translated to Chinese by us and examined by an independent translator to ensure the meaning was equivalent. No construct validity evidence was available.
Meaning in life
Although several measures of meaning in life exist (e.g., Steger, Frazier, Oishi, & Kaler, 2006), such measures include items on both meaning and purpose in life, perhaps reflecting the Western cultural idea that purpose in life is part of meaning in life (Steger et al., 2006). Nevertheless, the Chinese words for meaning in life (生命的意義) do not necessarily connote the notion of having a purpose in life. Therefore, instead of using an existing measure of meaning in life, we followed the format of our measure of happiness and used a single-item self-rating question to assess participants’ perceived level of meaning in life. Participants rated themselves on a scale with six options, ranging from 1 (very meaningless) to 6 (very meaningful), in response to the question: “In general, how meaningful is your life?” “Meaningful” was deliberately left undefined as a way to reflect Taiwanese individual’s lay beliefs about meaning in life. Similar to our measure of happiness, we translated the item to Chinese and reviewed the item for equivalent meaning. No construct validity information was available.
Results
Preliminary Analyses and Data Analytic Plan
A power analysis on linear multiple regression using G*Power 3.1.3 (Faul, Erdfelder, Buchner, & Lang, 2009) found that a sample size of 109 participants was sufficient to detect a medium effect, assuming (a) power = 0.80, (b) a medium effect of f2 = .15, and (c) α = .05. Therefore, our sample size of 262 rendered sufficient power.
Next, we examined potential associations between demographic variables and our main variables. Results from independent t tests showed that among the 11 variables of interest (three CIWB constructs and eight mental health outcomes), female participants scored significantly higher than male participants in four variables: relationship harmony, dialectical coping, life satisfaction, and happiness, p < .05. At the bivariate level, Pearson correlations revealed that age was not significantly associated with any of the main variables, p > .05. Therefore, only gender was included as a covariate in our subsequent main analyses.
To handle missing values in the 11 main study variables, we used the Expectation–Maximization algorithm. There was no evidence that the data were not missing completely at random, χ2(56) = 33.12, p = .99. The EM algorithm was used to generate imputed values. All subsequent analyses were conducted after imputation of missing data.
Our first set of research questions asked whether CIWB constructs were significantly related to all mental health outcomes at the bivariate level. Because of the relatively large numbers of correlations, we adopted a more conservative significant test of p < .01.
Hierarchical multiple regression was used to address our second and third sets of research questions (Frazier, Tix, & Barron, 2004). Visual inspection of scatter plots found no evidence of nonlinear relationships among CIWB constructs and any of the outcome variables. Examination of the residuals indicated that the normality assumption was held, as evidenced by histograms and P-P plots. Last, homoscedasticity appeared to be met as the variations across all predicted values were roughly equal. To reduce multicollinearity, continuous predictors were standardized as z scores before product terms were calculated.
We utilized a two-stage approach to tackle our second set of research questions. In the first stage, we conducted hierarchical multiple regression analyses consisting of four steps for our eight mental health outcomes. In the first step, gender was introduced as a control variable. In the second step, the three CIWB constructs without interactions were entered. Among the three CIWB constructs, if only one of them was a significant predictor of a certain outcome variable, then that particular construct was determined to be the strongest predictor. On the other hand, if two or more CIWB constructs significantly predicted an outcome variable, then we performed the Wald test of parameter constraint to determine whether the regression coefficients significantly differed from one another (Hasin, Liu, Alderson, & Grant, 2006).
Last, our third set of research questions on moderation effects was tested by introducing all combinations of two-way and three-way moderation terms involving relationship harmony, dialectical coping, and nonattachment to hierarchical multiple regression models in the third and fourth steps, respectively. We used a SPSS add-on called PROCESS (A. F. Hayes, 2013) to carry out simple slopes analyses, probing significant moderation effects by examining the link between predictors and outcomes at 1 SD above and below the mean of the moderator.
Main Analyses
All the correlation coefficients between CIWB constructs and mental health outcome variables were significant, p < .01 (see Table 1), lending support to our first hypothesis. Interestingly, compared with the large correlation between dialectical coping and nonattachment (r = .65), the associations between relationship harmony and dialectical coping and nonattachment were weaker, r = .17 and .28, respectively.
Means, Standard Deviations, Ranges, and Intercorrelations Among Main Variables (N = 262).
Percentages for missing values were calculated before the Expectation–Maximization imputation was conducted.
p < .01.
The results for the hierarchical multiple regression models for our second and third sets of research questions are reported in Table 2. At Step 2, controlling for gender and the other two CIWB constructs, relationship harmony was significantly and positively related to peace of mind, happiness, and meaning in life, whereas it was significantly and negatively associated with psychological distress. We found no significant links between relationship harmony and the remaining four mental health outcomes. Therefore, our hypothesis predicting that relationship harmony would be the strongest predictor of self-esteem was not supported.
Multiple Regression Models Predicting Mental Health Outcomes.
Note. All three-way interaction effects in Step 4 were not significant. sr = semipartial correlation coefficient.
p < .05. **p < .01.
After gender was entered in Step 1 and two other CIWB constructs were entered in Step 2, dialectical coping showed significant positive relationships with six outcomes: self-esteem, life satisfaction, PA, peace of mind, happiness, and meaning in life. Dialectical coping was not significantly related to the other two outcomes reflecting negative mental states: NA and psychological distress. Although the coefficient for the link between dialectical coping and meaning in life was larger than that for the association between relationship harmony and meaning in life, this difference was not significant (Wald test of parameter constraints = 0.029, df = 1, p = .89). Hence, the hypothesis that dialectical coping would be the strongest predictor of meaning in life was only partially supported.
In a series of post hoc analyses, we substituted the overall score of DCS with the three subscale scores, given the results of our CFA suggesting that a multidimensional model fits the structure of the scale better than a one-factor model. Among the three dialectical principles, Change was significantly associated with six out of eight outcomes, followed by Holism, which only significantly predicted one outcome, PA; Contradiction was not a significant predictor for any outcomes. More detailed results are available upon request from S.-Y. Wang.
The last predictor introduced in Step 2 was nonattachment. Controlling for gender and other CIWB constructs, nonattachment was significantly related to all mental health outcomes except meaning in life. More specifically, nonattachment demonstrated positive relationships with self-esteem, life satisfaction, PA, peace of mind, and happiness, and negative relationships with NA and psychological distress. Because nonattachment and relationship harmony both significantly predicted psychological distress, we performed the Wald test to further examine potential differences. Results revealed that the magnitude of the association between relationship harmony and psychological distress was smaller than that of nonattachment (Wald test of parameter constraints = 11.60, df = 1, p < .01). Taken together, nonattachment was the most powerful predictor of NA and psychological distress among the three CIWB constructs, providing evidence for our hypothesis regarding the buffering effect of nonattachment on negative psychological states.
With respect to the third set of research questions, dialectical coping was a significant moderator of the relationships from nonattachment to self-esteem, psychological distress, and happiness (see Figure 1). Nonattachment was significantly and positively related to self-esteem at 1 SD above the mean of dialectical coping (B = .25, SE = .07, p < .01), but not at 1 SD below the mean of dialectical coping (B = .10, SE = .07, p = .13), suggesting that a combination of high nonattachment and high dialectical coping was associated with high self-esteem. In contrast, nonattachment was significantly and negatively associated with psychological distress at both 1 SD above and below the mean of dialectical coping, B = −.16, SE = .04, and B = −.31, SE = .04, respectively (both p < .01), but this relationship was stronger at low levels of dialectical coping (see Figure 1). That is, a combination of high nonattachment and low dialectical coping was linked to low psychological distress. Last, the two-way interaction effect was significant in predicting happiness. There was a significant positive relationship between happiness and nonattachment at both 1 SD above (B = .28, SE = .08, p < .01) and 1 SD below (B = .49, SE = .08, p < .01) the mean of dialectical coping, but nonattachment was related more strongly to happiness at low levels of dialectical coping, meaning that high nonattachment and low dialectical coping was the most beneficial combination for happiness. We found no other significant two-way or three-way interaction effects.
The relationship between nonattachment and DC.
Discussion
The aim of this study was to disentangle the salutary effects of three understudied CIWB constructs (i.e., relationship harmony, dialectical coping, and nonattachment) on mental health–related outcomes. First, results showed that at the bivariate level, all CIWB constructs were significantly and positively correlated with well-being variables and inversely associated with psychological distress and NA, lending evidence to the validity of the CIWB constructs. Put differently, high levels in any one of the well-being constructs promoted by Confucianism, Taoism, and Buddhism were linked to an adaptive mental health profile.
However, there was also evidence that the three CIWB constructs were conceptually different. At the bivariate level, relationship harmony was only weakly correlated with the other two CIWB constructs. Furthermore, our multiple regression results indicated that relationship harmony significantly predicted only four out of eight outcome variables (psychological distress, peace of mind, happiness, and meaning in life). Relative to dialectical coping and nonattachment, relationship harmony appeared to be a weaker predictor of mental health outcomes. These findings stand in contrast to a large body of scholarship emphasizing the importance of relationship harmony to the mental health of individuals from collectivistic Asian cultures (e.g., Uchida & Ogihara, 2012).
Second, although dialectical coping was strongly correlated with nonattachment (r = .65, p < .01), the two variables demonstrated distinct patterns in their associations with mental health variables. Dialectical coping was a significant predictor of all but two outcome variables (NA and psychological distress), whereas nonattachment significantly predicted all outcomes except meaning in life. The strong correlation between dialectical coping and nonattachment may stem from the fact that both constructs subscribe to the notion of things being in a constant state of flux, as suggested by the principle of change in dialecticism and impermanence in Buddhism (Chuang, 2004). As can be seen in our post hoc analyses of dialectical coping, the significant findings were driven largely by the principle of change, such that participants who believed in the transient nature of disturbing experiences and were convinced that negative events would eventually change tended to fare better psychologically. On the contrary, their different adaptive psychological effects can arguably be attributed to other elements distinct in each construct, such as Taoist belief in pursuing happiness by living in synchronization with nature (Wang, 2009) and Buddhist tenets suggesting that life is inherently unsatisfactory (Loy, 2001).
We found partial support for our second set of hypotheses that each CIWB construct would be related to different dimensions of mental health. Although we hypothesized that relationship harmony would be the strongest predictor of self-esteem among the three CIWB constructs, the association was not significant after controlling for the other two CIWB constructs. In contrast, dialectical coping and nonattachment significantly and uniquely predicted greater self-esteem. This unexpected finding may be a result of our use of the RSES, which assesses individual-oriented self-esteem. Given the nature of Chinese people’s relational selves (Ho, 1995), relationship harmony might be a more robust predictor of other types of self-esteem, such as collective self-esteem (Luhtanen & Crocker, 1992).
Our hypothesis that dialectical coping would be the strongest predictor of meaning in life received partial support. Unlike nonattachment, both dialectical coping and relational harmony significantly predicted greater meaning in life and both were equally strong predictors of meaning in life. This result is valuable because past studies based on Western samples have identified interpersonal relationships as a powerful determinant of meaning in life (Steger, 2009). Our findings go beyond the existing literature and indicate that besides relationship harmony, dialectical coping was also another critical source of meaning in life in Chinese contexts. Dialectical coping may contribute to individuals’ perceived meaning in their lives by offering a coherent foundation to assimilate their experiences when facing obstacles. Negative experiences are viewed as understandable, inevitable, and precursors to positive outcomes (H. Zhang, Shan, & Jiang, 2013).
Our last hypothesis predicting that nonattachment would serve as the strongest protective factor against NA and psychological distress was supported. Nonattachment was the only CIWB construct that was significantly and negatively associated with NA, and its inverse relationship with psychological distress was significantly stronger than that of relationship harmony.
Third, despite the positive links between CIWB constructs and a variety of mental health indicators, we uncovered moderating influences of dialectical coping and nonattachment on self-esteem, psychological distress, and happiness. A profile with high levels of dialectical coping and nonattachment was most conducive to self-esteem, suggesting that both constructs demonstrated mutually reinforcing salutary relationships with mental health. Perhaps individuals who effectively apply dialecticism to deal with difficult times will have a positive evaluation of their ability to cope, resulting in a heightened level of self-worth. Nonattachment may supplement dialectical coping and contribute to self-esteem by fostering an open attitude toward setbacks and self-acceptance. However, for psychological distress and happiness, a combination of high levels of dialectical coping and nonattachment were associated with higher psychological distress and lower happiness, suggesting that strongly endorsing both CIWB constructs may be detrimental to mental health. In contrast, high levels of nonattachment combined with low levels of dialectical coping were linked to greater levels of happiness and lower levels of psychological distress. These results are intriguing because they contradict the idea that more is better. One plausible explanation is that there are incompatible elements in dialectical coping and nonattachment. It is possible that individuals who subscribe to dialectical coping tend to recognize a coherent pattern in their experiences (e.g., bad experiences may ultimately lead to good outcomes), whereas such a worldview is absent in Buddhist nonattachment which admonishes against clinging to one’s experiences (Mikulas, 2007). Another reason may be that Taoism maintains that by living in accordance with the Tao, it is possible to achieve happiness (Wang, 2009), whereas Buddhism teaches people to realize that human life is characterized by suffering (Loy, 2001). In short, the interaction between dialectical coping and nonattachment was complex. High/high or high/low combinations of nonattachment and dialectical coping can both be beneficial depending on the mental health outcome.
Fourth, several interesting results are worth mentioning. Peace of mind was one of only two outcomes in which all CIWB constructs were significant predictors (the other was our one-item measure of happiness). Moreover, it is striking that the three CIWB constructs collectively accounted for 39% of the variance in peace of mind, the highest proportion among all the eight mental health outcomes. This finding is noteworthy because peace of mind was the only outcome measure that was explicitly developed based on indigenous Chinese conceptualizations of affective well-being. These results underscore the value of using indigenous measures to study the mental health of non-Western populations. Finally, nonattachment appeared to be the most beneficial construct due to its adaptive relationships with seven out of eight mental health outcomes, followed by dialectical coping (six out of eight), and then relationship harmony (four out of eight). In stark contrast to recommendations made by G. Zhang and Veenhoven (2008) that advice given by classic Buddhism is not conducive to well-being in contemporary society, we found the Buddhist notion of nonattachment to be the CIWB construct most strongly associated with adaptive mental health outcomes. Nonattachment, which encourages individuals to divorce themselves from all forms of clinging, is antithetical to Western notions of happiness wherein maximizing positivity (i.e., the pursuit of personal goals and positive hedonic experience) receives priority (Uchida & Kitayama, 2009), but it is nonetheless important in Chinese culture.
Strengths of the Current Study
This study has several strengths. First, previous studies on CIWB constructs have focused mainly on just one CIWB construct (e.g., Kitayama et al., 2000). Although scholars have speculated on the unique effects of well-being constructs based on Confucianism, Buddhism, and Taoism (G. Zhang & Veenhoven, 2008), to our knowledge our study is the first to empirically investigate the collective, unique, and interactive influences of CIWB constructs based on these three indigenous philosophies. Therefore, this study provides a comprehensive picture of CIWB constructs and how they differentially contribute to mental health. Second, this is also one of the first studies to examine dialecticism as a well-being construct instead of as a cognitive processing style. Previous studies on dialecticism rely largely on the Dialectical Self Scale (e.g., Li, Masuda, & Russell, 2014), which is a measure of the extent to which individuals incorporate dialecticism in their self-perception (Spencer-Rodgers, Peng, Wang, & Hou, 2004), rather than a well-being construct that bears direct effect on mental health–related variables. Third, one important contribution of our study to the literature on cultural psychology and well-being is our finding that relational harmony was generally a weaker predictor of mental health outcomes compared with nonattachment and dialectical coping. Our findings suggest that scholars may have overestimated the importance of Confucian relationalism to mental health in modern East Asian societies, at the expense of other indigenous well-being constructs rooted in Taoism and Buddhism.
Limitations and Future Research
Some limitations of this study should be noted. First, although the three CIWB constructs chosen were informed by their corresponding philosophical schools, they are not equivalent to the extensive and detailed teachings of each philosophy. To the extent that these CIWB constructs only represent a limited aspect of each school of thought, other important CIWB constructs were not included in our study (e.g., role obligations; Lu & Gilmour, 2006). Second, our sample consisted of Taiwanese college students; the results may not be generalizable to other populations. For example, college students may have more exposure to Western cultural norms and modernization, which may result in weaker adherence to indigenous cultural norms than might be found among older adults. Third, we used a cross-sectional design. Therefore, causal inferences should be made with caution. Future studies can utilize a longitudinal or experimental priming design to corroborate the causal influences of CIWB constructs on mental health variables. Fourth, future research can test the extent to which our findings can be generalized to populations from Western cultures. It is possible that CIWB constructs may operate differently for people outside of East Asian cultures. For example, perhaps dialectical coping is less effective among Westerners because dialecticism is less prevalent in Western cultures. Also, peace of mind may not be as valuable in Western cultures as it is in Chinese culture. Future research can seek to replicate this study using Western samples to shed light on whether the mental health correlates of CIWB constructs resemble the ones found in this study.
Practical Implications
Some important implications can be gleaned for clinicians working with Chinese people. First, given the contributions of nonattachment to psychological adjustment, mental health workers are advised to pay more attention to interventions that may cultivate clients’ nonattachment. Arguably, psychotherapies that emphasize mindfulness as a critical component, such as acceptance and commitment therapy (ACT; S. C. Hayes, Strosahl, & Wilson, 1999) and mindfulness-based cognitive therapy (MBCT; Segal, Williams, & Teasdale, 2002), are beneficial to clients who embrace nonattachment as a worldview. Mindfulness in these two approaches is taught to clients as a way for them to observe their thoughts and emotions nonjudgmentally, gain psychological distance from these phenomena, and develop insight into the nature of inner experiences, which are conducive to the development of nonattachment (Baer, 2003; Shonin, Van Gordan, & Griffiths, 2014).
Second, clinicians are also encouraged to explore how clients construe well-being because such lay beliefs may vary greatly from one culture to another (Wong, Ho, Li, Shin, & Tsai, 2011). For instance, an intervention that mainly aims to elevate positive emotions may be incompatible with the views of clients who subscribe to Buddhist teachings. Likewise, this intervention is likely to fall short for Taoist clients due to their tendency to adhere to psychological balance (Wong & Liu, in press). In a parallel fashion, clinicians’ therapeutic goal of helping clients attain personal achievement could compromise Confucian clients’ well-being if interpersonal harmony is disrupted, for example, by evoking the envy of others (Uchida & Kitayama, 2009) or causing others to lose face (Yau, 1988). Therefore, by familiarizing themselves with fundamental Chinese philosophical ideas, practitioners will be able to make informed decisions on culturally sensitive interventions when working with Chinese clients (Hwang & Chang, 2009). We argue that some existing Western-based techniques can be tweaked to explore Chinese clients’ conceptions of well-being, such as posing miracle questions to help clients envision how their lives would be different if their problems disappeared (Berg & De Jong, 1996). Furthermore, training programs play a key role in that the scope of psychological literature from other countries around the world should be expanded in counselor education curriculum (Leong & Ponterotto, 2003) and be included in counseling textbooks.
Third, it might be time for psychologists in Chinese societies to establish models of psychotherapy in which theoretical orientations are consistent with indigenous philosophies. Although a growing number of psychologists have called for the need of indigenous counseling psychology and therapy (e.g., Hwang, 2009; Leung, 2003; Leung & Chen, 2009), a survey of counselors in Taiwan revealed that the majority of respondents still use Western psychotherapies (e.g., integrative, cognitive behavioral therapy, person-centered, psychodynamic; Lin, Hsieh, & Sun, 2008).
Last, it is vital for psychotherapists to keep in mind that associations among CIWB constructs are intricate. Given the findings of our interaction effects, there is a possibility that CIWB constructs may conflict one another and undermine clients’ well-being. For instance, in the face of psychological distress, what lies at the core of nonattachment is the ability to refrain from getting entangled in disturbing feelings and maintain inner peace, which could ultimately run counter to the principles of holism and contradiction in dialectical coping, which teach clients to embrace these feelings. In sum, clinicians have to take into account cultural variables and their implications on mental health when working with clients from diverse backgrounds.
Footnotes
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.