The Impact of Acculturation on Depressive Symptoms: A Comparison of Older Korean Americans in Two Areas

The impact of resilience and coping strategies on depressive symptoms among Korean American older adults during COVID-19

OBJECTIVES

This study examined how resilience and coping strategies were associated with depressive symptoms among Korean American older adults during COVID-19. The prevalent depressive symptoms and low use of mental health services in this population have raised significant concerns among healthcare professionals. Therefore, this study aims to understand the relationships between resilience and coping types on depressive symptoms and provide valuable insights into addressing these issues within this ethnic group.

METHOD

A cross-sectional survey was conducted with 132 Korean American older adults. Hierarchical linear regression analyses were performed to assess the effect of sociodemographic factors (age, gender, marital status, years of living in the U.S., self-rated health, financial security), resilience, and coping strategies (problem-focused coping, emotion-focused coping, avoidant coping) on depressive symptoms. Next, the interactions between resilience and three coping strategies for depressive symptoms were tested.

RESULTS

The findings show that depressive symptoms were associated with financial security and avoidant coping. Also, resilience interacted with avoidant coping and emotion-focused coping. Among the participants with low resilience, depressive symptoms increased rapidly when avoidant and emotion-focused coping strategies increased, respectively.

CONCLUSION

This study emphasizes the importance of culturally tailored interventions to promote resilience and decrease avoidant and emotion-focused coping among Korean American older adults.

Acculturation and depressive symptoms among older Chinese immigrants in the United States: the roles of positive and negative social interactions

Objectives: Immigration is a stressful experience. Social interactions with family members and friends play an important role in the health and well-being of immigrant older adults. This study examined the association between different domains of acculturation and depressive symptoms among older Chinese immigrants in the United States and investigated the roles of positive and negative interactions with family and friends in such associations.Method: We used data from the Population Study of Chinese Elderly (PINE), a population-based survey of community-dwelling Chinese older adults in the Greater Chicago area (N = 3,158). Depressive symptoms were measured by the PHQ-9. Acculturation, positive and negative social interactions with partner/family/friends were all measured by standard scales. Binary logistic regression models were used to examine the relationship between acculturation and the probability of having depressive symptoms.Results: Results showed that only social acculturation was correlated with a higher likelihood of having depressive symptoms after controlling for relevant sociodemographic variables. Results also demonstrated that 'high positive & high negative', as well as 'high positive & low negative' social interactions had significant moderating effects on the association between media acculturation and depressive symptoms.Conclusion: The study findings suggest that although older Chinese immigrants in the United States with high levels of social acculturation are vulnerable to depressive symptoms, high positive social interactions with partner/family/friends buffer the relationship between media acculturation and depressive symptoms. Community services can help with social acculturation and more positive interactions from partner/family/friends to alleviate depressive symptoms among older Chinese immigrants.

Health risks posed by social and linguistic isolation in older Korean Americans

OBJECTIVES

Inspired by the notion of double jeopardy positing the dual disadvantage in the coexistence of different sources of vulnerability, the present study examined health risks posed by social and linguistic isolation in older Korean Americans.

DESIGN

A cross-sectional study, using a four-cell classification to compare isolation types (no isolation, social isolation only, linguistic isolation only, and dual isolation) and to examine their impacts on physical (self-rated health), mental (mental distress), and cognitive (cognitive performance) health.

SETTING AND PARTICIPANTS

Data are from the Study of Older Korean Americans survey of Korean immigrants aged 60 or older (n = 2032), conducted in five states in the United States (California, New York, Texas, Hawaii, and Florida).

MEASUREMENT

Social isolation was indexed by the Lubben Social Network Scale-6; linguistic isolation, by a question on English-speaking ability. Physical, mental, and cognitive health were indicated by a single-item self-rating of health, the Kessler Psychological Distress Scale 6, and the Mini-Mental State Examination, respectively.

RESULTS

The dual-isolation group exhibited notable sociodemographic and health disadvantages. The odds of having fair/poor health, mental distress, and cognitive impairment were 2.21-3.17 times higher in the dual-isolation group than in the no-isolation group.

CONCLUSION

Our findings confirm that both social relationships and language proficiency are key elements for older immigrants' social connectedness and integration, the deprivation of which puts them at heightened risk in multiple dimensions of health.

The Role of Social Networks on Depressive Symptoms: A Comparison of Older Koreans in Three Geographic Areas

The purpose of this study was to examine the correlates of depressive symptoms among older Korean adults in three geographic locations with varying densities of the Korean population: mainland Korea (mostly Koreans), New York metropolitan area (high Korean density), and west central Florida (low Korean density). The study focused on the role of family and friend networks. Data were drawn from three sources: (1) a multistage national sample of Koreans in South Korea (n = 403); (2) a survey conducted in the western/central Florida area that used a variety of culturally sensitive sampling strategies (n = 672); and (3) a survey in the New York metropolitan area (n = 420) that replicated the Florida study. For those living in Korea, living alone and lower perceived financial status were independently associated with higher levels of depressive symptoms. For the New York and Florida samples, fair or poor self-rating of health, lower levels of acculturation, and weaker ties with family were related to higher levels of depressive symptoms. Similar to the older Korean sample, lower perceived financial status was linked with greater depressive symptoms in the New York sample. The overall results suggest that it is important to consider the interplay of the social network, personal, and cultural resources when working with older adults in diverse contexts. Intervention efforts should address mental health issues tailored to cultural and social settings.

Cross-cultural comparative study of psychological distress between older Korean immigrants in the United States and older Koreans in South Korea

Objective: This study aims to answer questions about the similarities and differences in the prevalence and distribution of psychological distress across these populations. Methods: Survey data from older Koreans between the ages 60 and 79 from the two countries (n = 480) was analyzed descriptively and in hierarchical multiple regressions. The stress coping framework was used as a conceptual model Results: This study found significantly different prevalence of psychological distress in both countries. About 13% of older Korean immigrants(US) experienced 'severe' psychological distress versus 21% of their counterparts ( Korea). Health status and overall financial status were significantly associated with the experience of psychological distress in both countries, while income was not significantly associated with psychological distress. Hierarchical multiple regression revealed significant associations between family relationships and help-seeking behavior among older Korean immigrants in the United States while there were significant associations between social support, social networks and psychological distress among older Koreans in South Korea. Conclusion: This is the first time that a comparative study has been used to understand psychological distress among older Koreans in both countries. The findings build on prior research on social support and social networks as stress coping buffers, adding a much-needed understanding of how stressors and different types of resources influence psychological distress outcomes.

A systematic review of correlates of depression among older Chinese and Korean immigrants: what we know and do not know

OBJECTIVES

Guided by the stress and coping theory, this study provides a systematic review of existing research on acculutration, family support, and social support related correlates of depression among older Chinese and Korean immigrants in the United States.

METHOD

A comprehensive literature search was conducted in CINAHL Plus, Abstracts in Social Gerontology, AgeLine, Social Work Abstracts, PubMed, PsychINFO, and Social Science Citation Index databases to identify relevant articles that presented multivariate analysis results.

RESULTS

A total of 55 articles were identified, with the vast majority focusing on older Korean immigrants. The overall evidence showed that length of residence was largely unrelated to depression, and poor Enligsh proficiency also had a weak correlation with depression. However, a low level of acculturation measured by multidimensional scales was consistently associated with more depressive symptoms. Overall, living arrangements and the size and frequency of contact of both kin and non-kin networks were weak correlates of depression. In contrast, negative family and social interactions seem to be more consequential for depression in the two groups than positive relations and support.

CONCLUSION

The findings show that established acculturation instruments are useful tools to identify at-risk older Chinese and Korean immigrants. Future studies need to further examine which aspects of acculturation experience are more influential for immigrants' mental health. Although often conceptualized as important coping resources, family and social networks could present significant stressors for older immigrants. Future research and services could focus on these contexts to improve the mental health of these two rapidly increasing Asian populations.

Associations of a social network typology with physical and mental health risks among older adults in South Korea

OBJECTIVES

The objectives of this study were to (1) develop an empirical typology of social networks in older Koreans; and (2) examine its effect on physical and mental health.

METHOD

A sample of 6900 community-dwelling older adults in South Korea was drawn from the 2014 Korean National Elderly Survey. Latent profile analysis (LPA) was conducted to derive social network types using eight common social network characteristics (marital status, living arrangement, the number and frequency of contact with close family/relatives, the number and frequency of contact with close friends, frequency of participation in social activities, and frequency of having visitors at home). The identified typologies were then regressed on self-rated health and depressive symptoms to explore the health risks posed by the group membership.

RESULTS

The LPA identified a model with five types of social network as being most optimal (BIC = 153,848.34, entropy = .90). The groups were named diverse/family (enriched networks with more engagement with family), diverse/friend (enriched networks with more engagement with friends), friend-focused (high engagement with friends), distant (structurally disengaged), and restricted (structurally engaged but disengaged in family/friends networks). A series of regression analyses showed that membership in the restricted type was associated with more health and mental health risks than all types of social networks except the distant type.

CONCLUSION

Findings demonstrate the importance of family and friends as a source of social network and call attention to not only structural but also non-structural aspects of social isolation. Findings and implications are discussed in cultural contexts.

Prevalence and Predictors of Depression and Anxiety among Korean Americans

Despite the significant growth of the Asian population in the United States, current knowledge on their mental health and service utilization behaviors is very limited. The study examined the prevalence and predictors of depression and anxiety among Korean Americans in the Washington, D.C. metropolitan area. A total of 602 Koreans completed a self-administered survey on physical and mental well-being, and the study found that 18.2% and 16.9% of the participants had severe symptoms of depression and anxiety, respectively. Acculturative stress and perceived social support were common predictors for depression and anxiety, and the effects of demographic factors were minimal.

Willingness to use mental health counseling and antidepressants in older Korean Americans: the role of beliefs and stigma about depression

OBJECTIVES

Despite a high prevalence of mental health problems, racial/ethnic minorities are often reluctant to seek mental health services. Their reluctance may be shaped by cultural beliefs and stigma about mental health. The present study examined how beliefs and stigma about depression (e.g. disbelief in depression as a health-related condition, perception of depression as a normal part of aging, and/or depression as a sign of personal weakness/family shame) pose barriers to older Korean Americans' willingness to use mental health counseling and antidepressants.

METHOD

Data were drawn from surveys with 420 Korean American older adults (M_age= 71.6, SD = 7.6) living in the New York City metropolitan area in 2010. Using a separate logistic regression model, the role of beliefs and stigma about depression in predicting participants' willingness to receive mental health counseling and to take antidepressants was tested. Based on Andersen's behavioral health service use model, the analysis was conducted in consideration of predisposing characteristics (age, gender, marital status, education, and acculturation), mental health needs (anxiety, depressive symptoms, and self-rated mental health), and enabling/hindering factors (beliefs and stigma).

RESULTS

Similar proportions of the sample (69-70%) indicated their willingness to use mental health counseling or antidepressants. Willingness was more likely among participants who had beliefs about depression as a health-related concern (OR = 1.94, 95% CI = 1.15-3.27 for mental health counseling; OR = 4.47, 95% CI = 2.59-7.70 for antidepressants) and less likely among those who associated depression with family shame (OR = .55, 95% CI = 0.33-0.91 for mental health counseling; OR = .56, 95% CI = 0.33-0.95 for antidepressants).

CONCLUSION

In addressing mental health problems and promoting the use of mental health services, cultural beliefs and stigma shared within an ethnic community should be considered. Given that disbelief in the medical model of depression and family shame reduced willingness to use mental health counseling and antidepressants, promoting mental health literacy for older immigrants could be beneficial.

Is leisure beneficial for older Korean immigrants? An interpretative phenomenological analysis

Leisure is an important quality of life factor for older Korean immigrants. The purpose of this study was to explore leisure benefits associated with health among older Korean immigrants. A total of 18 individuals participated in the study. Using interpretative phenomenological analysis (IPA), three themes emerged from participants' personal statements and experiences: (a) experiencing psychological benefits, (b) strengthening social connections, and (c) coping with acculturative stress. The findings indicate that leisure provided a context in which older Korean immigrants created an emotional and social support system that helped them to experience psychological and social benefits. This research suggested that older Korean immigrants used leisure as a coping mechanism that results in health and well-being.

Health Vulnerability of Immigrants with Limited English Proficiency: A Study of Older Korean Americans

OBJECTIVES

To examine the extent to which limited English proficiency (LEP) poses a risk to physical and mental health, using older Korean Americans as a target population.

DESIGN

Cross-sectional survey.

PARTICIPANTS

Older Korean Americans (N = 1,301).

MEASUREMENTS

Health outcomes were indexed using binary variables covering activity limitation, self-rated health, and probable depression. Participants who reported that they spoke English less than very well were categorized as manifesting LEP.

RESULTS

Approximately 71% of the sample had LEP. Those with LEP scored lower on all measures of health than their English-proficient counterparts. In multivariate models, the risk of having activity limitations was 2.72 times as great (95% confidence interval (CI) = 1.72-4.29, P < .001), a fair or poor rating of health 2.59 times as great (95% CI = 1.91-3.49, P < .001), and probable depression 1.73 times as great (95% CI = 1.29-2.31, P < .001) in participants with LEP.

CONCLUSION

Limited English proficiency was identified as a critical source of health vulnerability. Systematic efforts should be made to reach out to older immigrants with LEP and include them in health-related research and prevention and intervention programs.

The Relationship between Neuroticism, Hopelessness, and Depression in Older Korean Immigrants

PURPOSE

This study aimed to investigate the relationship between neuroticism, hopelessness, and depression among older Korean immigrants. To extend this line of research, this study aimed to examine the effects of neuroticism and hopelessness in predicting depression among older Korean immigrants.

METHODS

Data for this study came from a survey of 220 first generation Korean immigrants aged 65 years or older in Los Angeles County in 2012. Data were collected by face-to-face interviews with trained social workers using a structured questionnaire translated into Korean. All interviews were conducted in Korean. The neuroticism sub-scale of the Eysenck Personality Questionnaire was used to assess neuroticism (EPQN). Hopelessness was measured by the Beck Hopelessness Scale (BHS). Depression was measured by the 20-item Center of Epidemiological Studies Depression (CES-D) scale.

RESULTS

The study found that age (β = .26, p< .01), gender (β = -.13, p< .01), income (β = -.13, p< .01), neuroticism (β = .51, p< .01), and hopelessness (β = .15, p< .01) were significant predictors of depression.

CONCLUSION

The study provides preventive strategies that would help in the development of depression-reduction services or programs for the population, especially for those living with neuroticism and hopelessness.

Annual Review of Asian American Psychology, 2014

This 2014 review of Asian American psychology is the sixth review in the series. It includes 316 articles that met the inclusion criteria established by the past five annual reviews. Featured articles were derived from three sources: 137 were generated via the search term "Asian American" in PyscINFO, 111 were generated via a search for specific Asian American ethnic groups, and 32 were generated via author searches of articles that met the inclusion criteria. The top primary topic was health and health-related behaviors, the most frequently employed study design was cross-sectional, and the most studied Asian American ethnic group was Chinese. This year's review includes information on the target population of the primary topic, the age range and developmental period of participants, and whether the study design was cross-sectional or longitudinal. It also identifies top authors and journals contributing to the 2014 annual review. These new features reveal that the most common target population of the primary topic was youths; studies most commonly included emerging adults ages 18-25; cross-sectional study design was employed more often than longitudinal design; the top contributor to the 2014 review was Stephen Chen, who authored the highest number of papers included; and the Asian American Journal of Psychology generated the highest number of publications for this review.

Sources of Response Bias in Older Ethnic Minorities: A Case of Korean American Elderly

The present study was undertaken to investigate potential sources of response bias in empirical research involving older ethnic minorities and to identify prudent strategies to reduce those biases, using Korean American elderly (KAE) as an example. Data were obtained from three independent studies of KAE (N = 1,297; age ≥60) in three states (Florida, New York, and Maryland) from 2000 to 2008. Two common measures, Pearlin's Mastery Scale and the CES-D scale, were selected for a series of psychometric tests based on classical measurement theory. Survey items were analyzed in depth, using psychometric properties generated from both exploratory factor analysis and confirmatory factor analysis as well as correlational analysis. Two types of potential sources of bias were identified as the most significant contributors to increases in error variances for these psychological instruments. Error variances were most prominent when (1) items were not presented in a manner that was culturally or contextually congruent with respect to the target population and/or (2) the response anchors for items were mixed (e.g., positive vs. negative). The systemic patterns and magnitudes of the biases were also cross-validated for the three studies. The results demonstrate sources and impacts of measurement biases in studies of older ethnic minorities. The identified response biases highlight the need for re-evaluation of current measurement practices, which are based on traditional recommendations that response anchors should be mixed or that the original wording of instruments should be rigidly followed. Specifically, systematic guidelines for accommodating cultural and contextual backgrounds into instrument design are warranted.

Risk Factors for Social Isolation in Older Korean Americans

OBJECTIVE

Given the importance of social ties and connectedness in the lives of older ethnic immigrants, the present study examined the prevalence of social isolation and its risk factors in older Korean Americans.

METHOD

Using survey data from 1,301 participants (Mage = 70.5, SD = 7.24), risk groups for marginal social ties with family and friends were identified and predictors of each type of social isolation explored.

RESULTS

Male gender and poorer rating of health were identified as common risk factors for marginal ties to both family and friends. Findings also present specific risk factors for each type of social isolation. For example, an increased risk of having marginal ties with friends was observed among individuals with perceived financial strain, greater functional impairment, and a shorter stay in the United States.

DISCUSSION

The common and specific risk factors should be incorporated in programs to reduce social isolation in older immigrant populations.

An empirical typology of social networks and its association with physical and mental health: a study with older Korean immigrants

OBJECTIVES

In the context of social convoy theory, the purposes of the study were (a) to identify an empirical typology of the social networks evident in older Korean immigrants and (b) to examine its association with self-rated health and depressive symptoms.

METHOD

The sample consisted of 1,092 community-dwelling older Korean immigrants in Florida and New York. Latent class analyses were conducted to identify the optimal social network typology based on 8 indicators of interpersonal relationships and activities. Bivariate and multivariate analyses were conducted to examine how the identified social network typology was associated with self-rating of health and depressive symptoms.

RESULTS

Results from the latent class analysis identified 6 clusters as being most optimal, and they were named diverse, unmarried/diverse, married/coresidence, family focused, unmarried/restricted, and restricted. Memberships in the clusters of diverse and married/coresidence were significantly associated with more favorable ratings of health and lower levels of depressive symptoms.

DISCUSSION

Notably, no distinct network solely composed of friends was identified in the present sample of older immigrants; this may reflect the disruptions in social convoys caused by immigration. The findings of this study promote our understanding of the unique patterns of social connectedness in older immigrants.