The impact of acculturation on depression among older Muslim immigrants in the United States

Impact of COVID-19 on health disparities between migrant and non-migrant households: the case of Dearborn, Michigan

OBJECTIVES

Studies on immigration have shown that cultural changes can positively or negatively affect psychological, behavioral, and physical outcomes when different cultures settle into a new host community or country. The majority of research done in the United States and North America has focused on these changes for larger immigrant and minority groups such as Hispanics/Latinos and Asians. However, in the United States, there is a sub-group of immigrants that is largely understudied, resulting in misunderstood data on mental and physical health: Arab Americans. This study assesses mental health disparities between immigrant and non-immigrant populations, before and after COVID-19 restrictions, in Dearborn, MI, a city that has one of the largest concentrations of Arab immigrants in the nation.

DESIGN

Using an online survey instrument, this study assessed mental health disparities before and since COVID-19 restrictions, and stressors induced since the pandemic for immigrants and non-immigrants in Dearborn, MI.

RESULTS

Through inferential statistics and logistic regressions, results indicate that immigrants are less likely to have healthcare coverage, have lower annual incomes, lower educational attainment, and experience continuously higher mental health issues before the pandemic than non-immigrants faced during the pandemic.

CONCLUSION

This study reinforces that the Arab-American immigrant population is a disadvantaged sub-group and faces considerable stress and mental health concerns as an acculturating population. This stress gets exacerbated when a worldwide event such as the COVID-19 pandemic strikes. Oversight of this population's health issues results in the inability to receive appropriate social services and healthcare that is vital to address this community's concerns.

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.

Depressive Symptoms in Older African Immigrants with Mobility Limitations: A Descriptive Study

OBJECTIVES

Before, during, and after their immigration to the United States, immigrants face stressful life circumstances that may render them at risk for depressive symptoms. However, there is a dearth of research on the mental health of African immigrants. We performed secondary data analyses of two studies in the Baltimore-Washington area to describe and identify correlates of depressive symptoms in older African immigrants.

METHODS

Chi square tests, one-way ANOVAs, and linear regressions were used to describe and examine associations between depressive symptoms and immigrant-related risk factors.

RESULTS

This sample included 148 participants who had a mean age of 62 (SD ± 8.2). Clinical depressive symptoms were present in 8.1% of participants, and trouble falling asleep for more than half of the days was the most prevalent symptom (20%). Levels of education, income, and migration reasons differed significantly from clinical depressive symptoms, but these were not significantly associated with more depressive symptoms after controlling for covariates.

CONCLUSIONS

Longitudinal designs may further elucidate incidence, correlates, and long-term effects of depressive symptoms within this population.

CLINICAL IMPLICATIONS

Knowledge of depressive symptom burden and risk factors can inform timely assessment, referral, and treatment of depressive symptoms and other mental health outcomes in older African immigrants.

Social isolation and psychological well-being among older Chinese Americans: Does resilience mediate the association?

OBJECTIVES

Social isolation imposes risks to an individual's psychological well-being. However, few studies have examined the role of resilience on these associations among older Chinese Americans, the fastest-growing aging population across all racial/ethnic groups in the United States. We aim to examine the associations of social isolation with indicators of psychological well-being and the mediating role of resilience in these associations.

METHODS

Data were derived from 398 Chinese older adults aged over 55 residing in Honolulu, Hawaii, in 2018. Psychological well-being was measured by psychological distress, life satisfaction, and happiness. Multivariate linear regressions and ordered logistic regressions were conducted.

RESULTS

Social isolation was positively associated with psychological distress and negatively associated with life satisfaction and happiness (all p < 0.05). By contrast, resilience was associated with lower levels of psychological distress and higher levels of life satisfaction and happiness (all p < 0.05). Moreover, the findings supported our hypothesis that resilience mediated the association between social isolation and psychological well-being. With regard to social isolation, resilience contributed to 32.0% of its association with distress, 24.9% of the association with life satisfaction, and 16.3% of the association with happiness.

CONCLUSION

Our findings revealed a significant association between social isolation and psychological well-being and the mediating role of resilience in the association of older Chinese Americans in Hawaii. The study findings expand our understanding of psychological resources in older Chinese Americans and emphasize the importance of developing intervention programs to foster social connection and resilience among an understudied population.

Examining Social Relationships among Older Muslim Immigrants Living in Canada: A Narrative Inquiry

Social connectedness and engagement are particularly important among groups who are at risk of experiencing social isolation, such as immigrant older adults. The objective of our study was to understand the social relationships of aging Muslim Lebanese immigrants living in Canada by exploring their lives in their ethnic and wider communities. This study used a life course perspective and adopted a constructivist narrative inquiry to understand the diverse lived experiences of four older adults who immigrated to Canada during early adulthood. Participants engaged in a narrative interview and follow-up session in which they storied their lived experiences. Findings describe one core theme, cultivating social relationships through family, friends, and community interdependence, and three related sub-themes: (1) navigating and creating family interdependence and planting new roots; (2) family interdependence in later life: the important role of grandchildren; and (3) cultivating ethnic and local interdependence to support aging in place. The participants’ stories provided an understanding of how culture, religion, aging, family, and immigration experiences interrelated throughout their life course and shaped their social relationships during later life. This study sheds new insight on the importance of culturally tailored activities and awareness about the social needs of immigrant older adults.

Protective Factors and Processes Fostering Resilience and Buffering Psychosocial Distress among Later-Life Egyptian Immigrants

This qualitative study explores and describes the protective factors and processes that foster resilience and buffer psychosocial distress among later-life Egyptian immigrants post immigration to the US. Open-ended structured interviews were conducted with (30) later-life Egyptian immigrants who came to the United States after turning 60 years of age. Thematic analysis was used to analyze patterns within the data. The findings of this study reveal that the availability and utilization of psychosocial resources - due to opportunities embedded in their sociocultural context and coping strategies embedded in their individual strengths and cultural or religious beliefs - play a pivotal role in buffering the losses and acculturative stressors triggered by transitioning to a new environment. The findings of this study can be used to inform psychosocial and therapeutic interventions and guide the development of appropriate social work programs and services for later-life Egyptian immigrants in particular and older Arabic-speaking immigrants in general.

Psychosocial risk factors and processes impeding adaptive capacities and contributing to psychosocial distress among later-life Egyptian immigrants

This qualitative study explores and describes the transactional and cumulative psychosocial stressors that later-life Egyptian immigrants encounter upon coming to the United States, and how they impede their adaptive capacities, hinder their adjustment efforts, and impact their psychosocial well-being. Such stressors are more pronounced among those who immigrated to the United States from Egypt after reaching the retirement age of 60 for two reasons. First, they experience pre-immigration stressors that force or expedite their departure from Egypt under duress, thus incurring numerous financial and symbolic losses. Secondly, in the last developmental stage, when age-related losses are triggered, they are concomitantly exposed to a starkly different lifestyle, language, cultural norms, living and financial arrangements, roles, and relationships. All such circumstances contribute to a sense of confusion, guilt, shame, and being a burden on others, which culminate in withdrawal, isolation, and distress. The findings of this study can be used to inform psychosocial and therapeutic interventions and guide the development of appropriate social work programs, services, and policies for later-life Egyptian immigrants in particular and older Arabic-speaking immigrants in general.

The Impact of Acculturation Style and Acculturative Hassles on the Mental Health of Somali Adolescent Refugees

Refugee adolescents often immigrate to a new society because of experiences of persecution and trauma, which can have profound effects on their mental health. Once they immigrate, many refugees experience stressors related to resettlement and acculturation in the new society. The current study examined relationships among acculturation styles and hassles and the well-being of young refugees as well as the role of gender. Data were collected from 135 young refugees (M age = 15.39, SD = 2.2; 62 % male) from Somalia resettled in the United States The findings from our study indicate that in addition to trauma history, acculturative hassles and acculturation style impact the wellbeing of Somali refugee adolescents. These findings indicate the need to understand both past experiences as well as current challenges. Potential areas for intervention are discussed.

Depression, Metabolic Syndrome, and Locus of Control in Arab Americans Living in the DC Metropolitan Area: A Structural Equation Model

Arab Americans have high prevalences of metabolic syndrome (MetS) and depression. Depression and external locus of control (LOC) may worsen MetS. We examined the relationship between depression and MetS with a convenience sample of 136 Arab Americans living in the Washington, DC, metropolitan area. Participants were surveyed with the Multidimensional Health Locus of Control questionnaire and the Center of Epidemiological Studies-Depression scale. Laboratory measurements were collected based on the components of MetS. A structural equation model was used to explore the relationship between MetS and depression through analysis of LOC. MetS was significantly correlated with external LOC (powerful others and chance), and depression was correlated with a weak internal LOC. Future study of the effect of LOC on health outcomes in Arab Americans may be used to mitigate MetS and depression in this population.

Causal attributions of mental health problems and depressive symptoms among older Somali refugees in Finland

Causal attributions of mental health problems play a crucial role in shaping and differentiating illness experience in different sociocultural and ethnic groups. The aims of this study were (a) to analyze older Somali refugees' causal attributions of mental health problems; (b) to examine the associations between demographic and diagnostic characteristics, proxy indicators of acculturation, and causal attributions; and (c) to analyze the connections between causal attributions and the manifestation of somatic-affective and cognitive depressive symptoms. A sample of 128 Somali refugees aged 50-80 years living in Finland were asked to list the top three causes of mental health problems. Depressive symptoms were analyzed using the Beck Depression Inventory (BDI). The results showed that the most commonly endorsed causal attributions of mental health problems were jinn, jealousy related to polygamous relationships, and various life problems. We identified five attribution categories: (a) somatic, (b) interpersonal, (c) psychological, (d) life experiences, and (e) religious causes. The most common causal attribution categories were life experiences and interpersonal causes of mental health problems. Men tended to attribute mental health problems to somatic and psychological causes, and women to interpersonal and religious causes. Age and proxy indicators of acculturation were not associated with causal attributions. Participants with a psychiatric diagnosis and/or treatment history reported more somatic and psychological attributions than other participants. Finally, those who attributed mental health problems to life experiences (e.g., war) reported marginally fewer cognitive depressive symptoms (e.g., guilt) than those who did not. The results are discussed in relation to biomedical models of mental health, service use, immigration experiences, and culturally relevant patterns of symptom manifestation.

Measuring acculturation and enculturation among Chinese Canadian older adults

Cultural adaptation is important to assess; however, most acculturation measures are unidimensional with little psychometric data for older immigrants. This study assessed a bidimensional measure, the Vancouver Index of Acculturation (VIA; Ryder, Alden, & Paulhus, 2000), among 149 (mean age: 73.92 years) Chinese Canadians. Internal consistencies were .84 and .83 for the Mainstream and Heritage subscales respectively, and they were orthogonal. Convergent and discriminant validity were demonstrated by predicted correlations between the VIA subscales and age at immigration, years in Canada, English fluency, and the Belief in Chinese Culture and Values Scale (BCCV; Lai & Chau, 2007). The VIA accounted for significantly more variance in language ability than the BCCV, above and beyond acculturation proxies. Exploratory factor analysis replicated the two-factor structure reported by Ryder et al. (2000). A confirmatory factor analysis indicated poor fit. This study supports a bidimensional model of cultural adaptation among older Chinese Canadians.

Coping and depression in old age: a literature review

BACKGROUND/AIMS

The interest in the relation between coping and depression in older persons is growing, but research on the concepts and instruments of coping in relation to depression among older persons is scarce and systematic reviews are lacking. With this background, we wanted to gain a systematic overview of this field by performing a systematic literature search.

METHODS

A computer-aided search in MEDLINE, CINAHL, PsycINFO, Embase, PubMed and www.salutogenesis.fi was conducted. We systematically searched for studies including coping and depression among persons 60 years of age and above. The included studies were evaluated according to predefined quality criteria.

RESULTS

Seventy-five studies, 38 clinical and 37 community settings, were included. Of these, 44 were evaluated to be of higher quality. Studies recruiting samples of older persons with a major depressive disorder, moderate or severe cognitive impairment or those who were dependent on care were scarce, thus the research is not representative of such samples. We found a huge variety of instruments assessing resources and strategies of coping (55 inventories). Although we found the relation between resources and strategies of coping and depression to be strong in the majority of studies, i.e. a higher sense of control and internal locus of control, more active strategies and positive religious coping were significantly associated with fewer symptoms of depression both in longitudinal and cross-sectional studies in clinical and community settings.

CONCLUSION

Resources and strategies of coping are significantly associated with depressive symptoms in late life, but more research to systematize the field of coping and to validate the instruments of resources and strategies of coping in older populations is required, especially among older persons suffering from major depression and cognitive decline.

Correlates of depressive symptoms in married immigrant women in Korea

PURPOSE

The purpose of this study was to identify the correlates of depressive symptoms among women who have immigrated to Korea for marriage.

DESIGN

Cross-sectional data reflecting Korean language fluency, acculturation, acculturative stress, general stress, and marital satisfaction were collected from 223 married immigrant women.

FINDINGS

There was a significant negative correlation between depressive symptoms and Korean language fluency as well as between depressive symptoms and Korean acculturation. Multiple linear regression revealed that depressive symptoms among married immigrant women were predicted by levels of acculturative stress, general stress, marital satisfaction, and type of household. The model including each of these variables accounted for 41.9% of the variance in depressive symptoms in these women.

CONCLUSIONS

Prevention programs for the management of depression in immigrant women should include an evaluation of acculturative conflict and stress and should consider marital and family conditions.