Adjustment problems of Korean American elderly

Sources of Intergenerational Conflict in Chinese Immigrant Families in the United States

Studies of family relations have not kept pace with the acceleration of international migration. To address this gap, this study relied on a survey of 545 Chinese immigrants in Chicago who reported information of 869 older parents to examine the sources of intergenerational conflict in five domains: norms/values, relationship itself, money, health, and parenting. The results of logistic regression showed that maintaining one's traditional culture, in the form of endorsing a sense of filial obligation, was a significant protective factor against all types of conflict. Immigrants with a higher level of acculturation were more likely to report conflict regarding norms/values and relationship itself, but not more so regarding practical issues such as health, money, and parenting. Helping parents with ADLs, not IADLs, was associated with more conflict regarding monetary and health issues. Immigrants' greater sense of mastery was associated with a lower chance of reporting norm/value-related intergenerational conflict.

Caught in the middle: a thematic analysis of the experiences of Korean-Canadian caregiver-employees in the greater Toronto and Hamilton area

BACKGROUND

The objective of this study was to investigate the experiences of caregiver-employees (CEs) from the Korean-Canadian community in the Greater Toronto and Hamilton Area.

METHODS

Nine participants were recruited and invited to partake in data collection, which consisted of the completion of a sociodemographic questionnaire as well as a qualitative, semi-structured interview. The interview transcripts were thematically analyzed.

RESULT

The thematic analysis revealed four primary themes, each of which had three sub-themes. The four primary themes are:: (i) tensions, (ii) adaptations to the dual role of being a CE, (iii) coping mechanisms, and (iv) desired changes to the status quo.

CONCLUSION

The result of this study suggest that Korean-Canadian CEs, as a consequence of their position at the convergence of Korean and Western cultural values, would be best supported through the provision of culturally sensitive supports and greater workplace accommodation.

Subjective Age in Older Korean Americans: The Impact of Functional Disability Mediated by Attitudes Toward Aging

The present study aims to examine how subjective age of older Korean Americans would be affected by functional disability and attitudes toward aging. We hypothesized that (a) both functional disability and attitudes toward aging would have a direct effect on subjective age and (b) the effect of functional disability on subjective age would be mediated by attitudes toward aging. Our analyses of the survey data with 208 community-dwelling Korean Americans aged 60 and older (mean age = 69.6, SD = 7.51) showed that the indirect effect of functional disability on subjective age through attitudes toward aging [-.020 (.009)] was significant (bias-corrected 95% confidence interval [-.039, -.006]). The findings suggest that functional disability fosters negative attitudes toward aging, which in turn leads to the feelings of being older than actual age. Our study suggests ways to preserve and promote positive perceptions of age and aging.

Adaptation Stages and Mental Health of Korean Male Immigrants in the United States

This study examines the variation patterns of Korean male immigrants’ mental health in relation to their length of residence in the United States and identifies significant factors related to the variations. The main hypothesis suggests two critical stages in which Korean immigrants’ mental health would become highly vulnerable—the early exigency stage (1–2 years after immigration) and the later marginality stage (11–15 years after immigration). Hence, the hypothesis predicts a curvilinear (the inverted J-curve) relationship between length of residence and life satisfaction. This hypothesis is tested through an epidemiological survey of 334 Korean male immigrants (20 years and older) in the Chicago area. Results of data analyses generally confirm the hypothesis: 1) the immigrants’ mental health is most highly vulnerable at the early exigency stage, 2) the degree of their mental well-being generally increases with length of residence, 3) the rate of increase in mental well-being tends to stagnate after the resolution stage, confirming the inverted J-curve hypothesis and 4) job satisfaction is the most significant variable accounting for the mental health patterns of the Korean male immigrants. Theoretical and methodological implications of the findings are discussed in the conclusion.

Family and Marital Conflict Among Chinese Older Adults in the United States: The Influence of Personal Coping Resources

BACKGROUND

Conflict in the family is a major risk factor for the well-being of older immigrants, whose lives are centered around their families. This study examined the potential linkage between personal coping resources and family and marital conflict among U.S. Chinese older adults.

METHODS

Data were derived from the PINE study, a population-based study of Chinese elders in Chicago (N = 3,157). Logistic regressions were carried out to predict the likelihood of having conflict with family members and with the spouse, respectively, using indicators of personal coping resources (ie, socioeconomic status, physical health, acculturation level, perceived children's filial piety, number of friends, and sense of mastery).

RESULTS

The results showed that older adults with higher education (odds ratio [OR] = 1.03, confidence interval [CI] = 1.01-1.06; OR = 1.09, CI = 1.06-1.11, respectively), lower perception of children being filial (OR = 0.95, CI = 0.93-0.97; OR = 0.96, CI = 0.94-0.98], respectively), and lower sense of mastery (OR = 0.95, CI = 0.94-0.96; OR = 0.98, CI = 0.97-0.99, respectively) were more likely to report both family and marital conflict. Older adults who had more friends were less likely to report marital conflict (OR = 0.61, CI = 0.43-0.86).

CONCLUSIONS

Overall, older immigrants with greater coping resources seemed to have less family and marital conflict. Particularly important are their own sense of control and available support from children and friends in the new society. Higher education could be a risk factor for these conflicts. Future studies are needed to distinguish everyday life conflict from acculturation-related conflict in this population.

Social and Health Factors Associated with Support among Elderly Immigrants in Canada

This article assesses determinants of social support among the foreign-born elderly in Canada. We draw cross-sectional data from the second cycle of the National Population Health Survey, conducted by Statistics Canada in 1996-1997, and use ordinary least squares models for our empirical analysis. We focus on three measures of social support: perceived social support, social involvement, and social contact. Generally, we find that poorphysical and/ormental health is negatively associated with ourmeasures of support. Emotional problems, one of the most consistent predictors, erode social support. Also, social involvement declines with mobility problems but increases with self-reported health status, whereas social contact also increases with cognitive function. As with otherstudies, and consistent with relationships witnessed among the native-born population, our results indicate that the married/cohabiting are more likely than the separated/divorced or widowed to perceive social support. Further, we find that those with children experience greater perceived support.

The Exploration of Acculturation and Health Among Immigrants From Non-Eastern Cultures

Literature on acculturation has been mainly focused on how acculturation influences the perception of health and well-being among immigrants from non-Western cultures. Conversely, we sought to explore immigration experiences associated with health and well-being among immigrants from non-Eastern cultures during their acculturation process. With a sample of 9 participants, we identified two major themes as outcomes of acculturation: psychological well-being and social benefits. We found that during acculturation, Western immigrants improved their sense of happiness, experienced reduced stress, and discovered meaning through activities, and that overall, acculturation facilitated personal growth. In addition, they developed a sense of cross-group friendships with Korean people and facilitated group cohesion within their own ethnic group. Further implications and future research avenues are discussed.

Private religious practice, spiritual coping, social support, and health status among older Korean adult immigrants

This study explored the role of spiritual factors and social support on the health status of 246 older Korean adult immigrants age 65 years or older. Ordinary least squares regression results revealed that private religious practice, spiritual coping, and social support were significantly associated with improved health status. However, stressors such as the lack of English proficiency and transportation, longer residency in the United States, and financial problems were significantly associated with lower health status. Social workers need to consider providing appropriate spiritual interventions and social support programs for older Korean adult immigrants so that they may better handle their stressors and health problems.

Daily spiritual experiences, social support, and depression among elderly Korean immigrants

OBJECTIVES

This study examined the associations of daily spiritual experiences (DSE) and social support with depression to find viable coping resources and enhance the quality of life among elderly Korean immigrants.

METHOD

We used Smith's (2003) theory of religious effects and Baron and Kenny's (1986) approach for mediation analysis to explain the mediating role of social support between DSE and depression. The sample consisted of 200 elderly Korean immigrants who were aged 65 or older (mean age = 72.5, range = 65-89) living in the New York City Metropolitan area. Hierarchical regression model was used with SPSS version 17.0 to analyze cross-sectional data.

RESULTS

Elderly Korean immigrants in the present sample were found to be moderately engaged in DSE but not experiencing a fair level of social support. Respondents reported no depression on the average but 30% of them (60 out of 200 respondents) were experiencing mild to severe depression. Both DSE and social support were inversely related with depression, and the relationship between DSE and depression was mediated by social support.

CONCLUSION

These findings are only suggestive and should not be generalized to a larger population. However, this study supports the importance of DSE and social support in the life of elderly Korean immigrants as a way to alleviate depression. Mental health professionals may consider facilitating social network when elderly Korean immigrants suffer from depression.

Effects of acculturation and social network support on depression among elderly Korean immigrants

OBJECTIVE

Acculturation and social network support have been identified as predictors of mental health for immigrant and elderly populations. The present study examined both independent and interactive effects of acculturation and social network support on depressive symptomatology among elderly Korean immigrants.

METHOD

Self-reported measures included sociodemographic characteristics, acculturation, social network support, and depressive symptoms. This study used cross-sectional analysis of a community-based cohort.

RESULTS

After controlling for the effects of demographic variables, a robust hierarchical regression model indicated that social network support was negatively associated with depressive symptoms. Also, the interaction between acculturation and social network was significantly associated with lower levels of depressive symptoms (β = -0.29, p < 0.05). In other words, elderly Korean immigrants who had high social network support and were highly acculturated exhibited lower levels of depression compared to those who had low support and were highly acculturated.

CONCLUSION

Our findings call attention to the role of social network support in the mental health of elderly Korean immigrants. Service providers can develop strategies for decreasing depression by increasing social network support, especially with family members, among their elderly parents.

The social determinants of depression in elderly Korean immigrants in Canada: does acculturation matter?

Depression in old age significantly decreases the quality of life and may lead to serious consequences, such as suicide. Existing literature indicates that elderly Korean immigrants may experience higher levels of depression than other racial ethnic group elders. The purpose of this exploratory study was to investigate factors that influence depression among older Korean immigrants in Toronto. A total of 148 participants, ages 60 years or older (mean age = 74.01, SD = 8.24), completed face-to-face interviews in Korean language. Hierarchical regression analyses were conducted by adding variables in three steps: (1) demographic variables; (2) acculturation variables (years of immigration and English proficiency); and (3) social determinants (social integration variables, physical health, and financial satisfaction). Results showed that acculturation factors were not associated with depression. Instead, social determinants variables, including lower physical health status and lower financial status, living alone, and lower level of social activity, predicted higher level of depressive symptoms, along with lower education. The final regression model explained about 37% of variance of depression in the sample. These results suggest that social determinants, not acculturation, are important factors explaining the levels of depression in Korean immigrant elders living in a metropolitan city in Canada. Implications for practice are discussed.

LR, Lee S, Nakamura Y. Seeking “A Place Where One Belongs”

Purpose: The study examined the subjective life experiences of elderly first-generation Korean women living in Japan and investigated their adjustment to the local Japanese community. Design: The study group comprised 14 elderly Korean women residents at a Korean-oriented, insurance-based, day services center in midwestern Japan. They were interviewed in depth, and the data were analyzed using the modified grounded theory approach. Findings: The study designated the core category as “conservation of ethnic identity” and identified five subcategories: (a) loneliness, (b) returning to one’s homeland culture, (c) physical decline as a result of aging, (d) family ties, and (e) a place where one belongs. Conclusions: The results elucidated that although the participants had adapted to Japanese culture, they were strongly influenced by the memories of their hometowns and wished to return to their homeland. Implications for Practice: The study suggests that elderly immigrants need day care support that provides an environment where they can enjoy their culture.

Stressors related to depression among elderly Korean immigrants

While depression in the elderly is well documented, little is known about depression in specific groups of immigrant elderly. In this study, 160 elderly Korean immigrants completed measures of depression, stressful life events, acculturative stress, family relationships, social support, and demographic variables. Findings revealed that income, acculturative stress, and living place were significant predictors of depression. As income declined, depression increased; living with one's adult children was associated with less depression; depression increased in concert with acculturative stress. These findings suggest that maintaining family relationships may be a key factor in preventing and/or lessening depression in elderly Korean immigrants.

Measuring immigration stress of first-generation female Korean immigrants in California: psychometric evaluation of Demand of Immigration Scale

OBJECTIVES

Immigration involves challenges and distress, which affect health and well-being of immigrants. Koreans are a recent, fast-growing, but understudied group of immigrants in the USA, and no study has established or evaluated any immigration stress measure among this population. This study explores psychometric properties of Korean-translated Demands of Immigration (DI) Scale among first-generation female Korean immigrants in California. Analyses included evaluation of factor structure, reliability, validity, and descriptive statistics of subscales.

DESIGN

A surname-driven sampling strategy was applied to randomly select a representative sample of adult female Korean immigrants in California. Telephone interviews were conducted by trained bilingual interviewers. Study sample included 555 first-generation female Korean immigrants who were interviewed in Korean language. The 22-item DI Scale was used to assess immigration stress in the study sample.

RESULTS

Exploratory factor analysis suggested six correlated factors in the DI Scale: language barriers; sense of loss; not feeling at home; perceived discrimination; novelty; and occupation. Confirmatory factor analysis validated the factor structure. Language barriers accounted for the most variance of the DI Scale (29.11%). The DI Scale demonstrated good internal consistency reliability and construct validity.

CONCLUSION

Evidence has been offered that the Korean-translated DI Scale is a reliable and valid measurement tool to examine immigration stress among Korean immigrants. The Korean-translated DI Scale has replicated factor structure obtained in other ethnicities, but addition of cultural-specific items is suggested for Korean immigrants. High levels of language and occupation-related stress warrant attention from researchers, social workers, and policy-makers. Findings from this study will inform future interventions to alleviate stress due to demands of immigration.

Collecting Qualitative Data through Interviews with Ethnic Older People

Les connaissances d'ordre qualitatif concernant l'ethnie et le vieillissement sont encore rares et doivent être développées. La recherche qualitative sugère un voie prometteuse pour mieux comprendre les différents groupes ethniques ainsi que la différenciation à l'intérieur d'une même ethnie. Toutefois, ce type de recherche n'est pas sans problème. Cet article présente trois scénarios d'entrevue, examine certains problèmes identifiés dans la documentation existante ou rencontrés par l'auteur au cours de ses recherches, et soulève des questions importantes relativement à la conduite d'entrevues avec des personnes âgées provenant de communautés ethniques.

Different pathways in social support and quality of life between Korean American and Korean breast and gynecological cancer survivors

PURPOSE

The purpose of this study was to investigate: (1) how social support influences quality of life (QOL) and (2) whether or not the pathways for predicting QOL outcomes differ between Korean American and Korean survivors of breast and gynecological cancer.

METHOD

To identify multiple dimensions of health status and psychosocial outcomes, two standardized QOL and psychological distress measures were administered to 51 Korean Americans and 110 Koreans. Social support was measured by items assessing functional social support and social network structures. Hierarchical multiple regression and path analyses were employed to investigate the effects of social support on outcomes and to compare between Korean Americans and Koreans.

RESULTS

The findings indicate that functional social support directly influences QOL and psychological distress, and social network structures are directly and/or indirectly associated with outcomes. Moreover, the two groups showed different pathways from social support to outcomes.

CONCLUSION

This study provides practical research information by illuminating the relationships between social support components influencing QOL for Korean American and Korean survivors. This study may increase the utility and efficacy of the research and interventions to enhance cancer survivors' social participation and to diminish barriers to follow-up care, considering the different living conditions between the United States and Korea.

The immigration experience among elderly Korean immigrants

The purpose of this preliminary, qualitative study was to describe elderly Korean immigrants' perception of stressors they experienced through immigration and the acculturation process. The methodology used was naturalistic inquiry, a descriptive approach used to elicit the elderly immigrants' own perception of their immigration and acculturation experiences. The six elderly Korean immigrants were interviewed via a semi-structured, open-ended interview guide. The main stressors identified by the subjects as a result of adjusting to life in the United States were language barriers, isolation and loneliness, fear of dependence upon their children, fear of being a burden, financial problems, transportation problems, discrimination, and fear of death. These Korean elders also perceived changes in the traditional family values of respect for elders and support for the aged. The results of this research help to provide an understanding of the immigration and acculturation experiences of elderly Korean immigrants.

Predictors of psychological well-being amongst Korean immigrants to the United States: a structured interview survey

BACKGROUND

As international migration becomes a common phenomenon in many countries, the health issues of immigrants are becoming an important area of concern among health care professionals worldwide.

OBJECTIVE

Adopting the stress-health outcome framework, this study examined risks and resources of both positive and negative affect (i.e., happiness and depression) among Korean Americans who experienced acculturative and recent life stresses.

METHODS

Hierarchical multiple regression analyses were performed to examine correlates of positive and negative outcomes in the stress process on a final sample of 147 Korean immigrants from a cross-sectional study.

RESULTS

For happiness, lower levels of acculturative stress and recent life stress, a greater sense of mastery, and greater social support were associated with an increased level of happiness. None of the individual characteristics were significant. R(2) for the full model was .53. For negative affect, acculturative stress and recent life stress explained a significant portion (41%) of the total variance associated with depression (R(2)=.51). As with the happiness variable, individual characteristics failed to add to the predictiveness of the equation, while sense of mastery and social support functioned as significant resources in reducing depression.

CONCLUSION

Increased mastery and greater social support were consistently predictive of greater happiness and less depression. Implications for future immigrant research are discussed.

Factors associated with depression experience of immigrant populations: a study of Korean immigrants

A correlational, cross-sectional study with multivariate analysis was conducted to identify factors that influence the depression experience in 154 Korean immigrants. Based on the stress-health outcome framework, four variables (i.e., sense of mastery, socioeconomic status, social support, and acculturation) were tested for their mediating effects between stress and depression experienced by Korean Americans. Path analyses showed that the negative effect of life stress on depression was buffered by higher levels of sense of mastery and social support in the Korean sample. Implications for future cross-cultural depression research and preventive strategies against depression in immigrant populations are discussed.

Preference for long-term care arrangement and its correlates for older Korean Americans

OBJECTIVE

Care preference is important for both client's satisfaction and quality of life in long-term care. This study examines preference for long-term care arrangement and its correlates for older Korean Americans.

METHODS

Data on two disability scenarios of hip fracture and stroke from a cross-section survey of 144 older Korean Americans were used to examine preferred care arrangement in terms of caregiver and care location, using multinomial logistic regression.

RESULTS

Respondents expressed stronger preferences for "all informal" or "mixed" care arrangement for hip fracture scenario, but they preferred "all formal" care arrangement in the stroke scenario. Traditional value significantly decreased the odds of choosing "all formal" or "mixed" over "all informal" care arrangement. But Medicaid coverage and an independent decision-making style increased the odds of choosing "all formal" instead of "all informal" care arrangement.

DISCUSSION

This study discusses the need for assessment of care preference and culturally appropriate long-term care services for minority elders.

Determinants of psychological distress over time among older Korean immigrants and Non-Hispanic White elders: evidence from a two-wave panel study

The purpose of this study is to examine racial/ethnic differences in the change of psychological distress as measured by CES-D over time and its associated factors between older Korean immigrants and non-Hispanic White elders, based on a social stress perspective. Data come from a two-wave panel survey of 172 older Korean immigrants and 157 non-Hispanic White elders, with a follow-up period of 12 to 15 months. The sample was drawn from a three-stage probability sampling method. Ordinary least square regressions in a hierarchical process and change score method were used to analyze the two-wave panel data. Older Korean immigrants reported higher levels of psychological distress than the non-Hispanic White elderly at both Time 1 and Time 2. Changes in self-assessed health status and functional limitations were significantly associated with change in psychological distress for both ethnic groups. Increased social support significantly decreased psychological distress at Time 2, for older Korean immigrants only. This study discusses practice and policy implications for service and interventions for older immigrants to assist their adjustment to a host society.

Pathways to care for Alzheimer's disease among Korean Americans

Little is known about how Korean Americans make decisions whether to seek help when, experiencing symptoms that might signal dementia. In Study 1, patient registry data for 60 Korean and 212 non-Korean Alzheimer's disease patients revealed that both groups waited 3-4 years before seeking help and sought help when memory decline was accompanied by other problems. Among Korean Americans, those living with family were more impaired than those living alone, suggesting greater, delay in seeking help. In Study 2, 109 Korean Americans ages 18-73 were surveyed concerning acculturation, knowledge, and help-seeking attitudes. Those more familiar with dementia symptoms indicated they would seek help, supporting the value of public education.

Intergenerational relations: older Korean-Americans' experiences

This paper examined intergenerational relations and cohesiveness in the Korean-American family, based on a concept of family solidarity. The data were drawn from face-to-face interviews for 50 older Korean immigrants, telephone interviews for 40 Korean adult children in the Philadelphia area. Most Korean-American elderly were found to live in proximity to a son. There were a high degree of interaction in visiting and telephoning between generations, but less frequency in shared leisure activities and particularly in communication. Financial aid largely flowed from adult children to aged parents, but service assistances were balanced between generations. It is noteworthy that aged parents had lower level of exchanges with their married daughters than their married sons. Results also indicated that Korean-Americans had a consensus about an ideal of dependency in old age. In general, Korean-Americans seemed to have less intergenerational conflicts because of the modest expectations of filial obligation among the older Koreans. The findings did not suggest any evidence of deterioration in cohesion of the Korean-American family, but illustrated a significant ethnic characteristic in intergenerational relationships.

Elderly Koreans' tendency to live independently from their adult children: adaptation to cultural differences in America

Korean elderly persons who immigrated to America tend to live apart from their adult children, contrary to the assumption that they would adhere to their old custom of intergenerational family living prevalent in Korea where the tradition of filial piety is still influential. This paper explores factors associated with the elderly immigrants' living separate from their adult children and elicits the reasons they give for this residential pattern. Over 100 elderly Korean-Americans were interviewed. The results of this study show that public welfare programs, income, and education were major factors associated with the elderly's independent living from their adult children. Other factors influencing their preference for such a living pattern are also identified, including needs for privacy and freedom. Cultural factors related to family living patterns are discussed.

Acculturation, stress, and depressive symptoms among Korean immigrants in the United States

A sample of 157 Korean immigrants responded to measures of acculturation level, stress from acculturation, and depressive symptoms. The authors hypothesized that adaptive acculturation would depend on assimilation regarding social interactions and the host culture's language as well as on retention of a core identity, including values and traditions of the culture of origin. Consistent with the mediation hypothesis, acculturation, based on a factor representing language use and social relationships, was related to lower acculturative stress and, in turn, lower depression. However, there was no direct support for the integrative, or bicultural, strategy of acculturation. Stress did not mediate the effect of a 2nd acculturation factor, identity and tradition-based acculturation. Rather, this measure of acculturation was directly related to higher depression (i.e., immigrants reporting abandonment of Korean identity, traditions, and values scored higher for depression).

Measuring depression in Korean Americans: development of the Kim Depression Scale for Korean Americans

This article discusses issues related to measuring depression in linguistic and cultural minority groups, using Korean Americans as an example. The article details the process of developing and evaluating a depression-screening tool for Korean Americans. A series of focus groups was conducted in the development stage of the study. In the evaluation phase, 154 first-generation Korean Americans participated in the assessment of the psychometric properties of the newly developed depression scale, the Kim Depression Scale for Korean Americans (KDSKA). The KDSKA showed adequate reliability, validity, and potentially high sensitivity as a depression-screening tool for Korean Americans.

Korean American caregivers: who are they?

PURPOSE

To describe the caregiving role in the Korean American family.

DESIGN

Descriptive study.

METHOD

Thirty Korean American female caregivers were interviewed using a semistructured questionnaire related to sociodemographic background, caregiving history, filial responsibility, family network, cognitive status, dependency level, job-caregiving conflict, family conflict, economic strain, and negative life-style changes.

FINDINGS

The Korean American caregivers were elderly wives who were sharing households only with their elderly husbands, and these women were low-income, unemployed, less educated, and regarded their caregiving activity as a final assignment of obligation and duty given to them as spouse.

DISCUSSION

The Korean traditional cultural norm of filial piety plays a significant role for caregiving activities among Korean American caregivers.

IMPLICATION

Understanding cultural norms may enable health care providers to look below the surface even though caregivers may not express problems.

Changing status and roles of older Korean immigrants in the United States

This study examines the current status of older Korean immigrants and their changing roles in their families. Interviews were conducted with fifty elderly and forty adult children from Korean-American families residing in the Philadelphia area. The results suggest that a decrease in power and resources placed the elderly Koreans in an unfavorable position to remain valued members of their family. Older Korean immigrants have experienced many unexpected changing, and often less prestigious, roles in their old age. However, their modified beliefs on "filial piety" and a relative financial independence supported by the United States government may have been of significant influence to prevent intergenerational conflicts in Korean-American families.

Social support and depression among elderly Korean immigrants in the United States

Based on the integrative concept of social support, we investigated the effects of quantitative, structural, and functional aspects of social relationships on the level of depressive symptoms among elderly Korean immigrants, taking into account their level of acculturation and life stress. Korean elders having more close persons and more frequent contacts with them exhibited fewer depressive symptoms. Networks providing instrumental support consisted mainly of family ties; networks for emotional support included diverse relationships as well as family members. Emotional support was found to moderate the harmful effect of life stress, and thus to be more relevant than instrumental support to the mental health of Korean elderly.

Cultural Influences on Depression in Korean Americans

This article does not intend to simplify the emotional world of KAs, nor to generate a stereotype of cultural knowledge about KAs. A practice based on stereotypical knowledge often does more harm than good (Brigham, 1971). Cultures are not indefinitely static systems. Cultural subgroups and the dominant culture in which they reside exchange influences, which results in changing cultural pattern (DHHS, 1993). Consequently, a wide range of individual differences exists in terms of educational status, language sufficiency, acculturation status, and personalities. Although clinicians should acknowledge and be sensitive to a client's cultural background, they need to base clinical decisions on awareness of individual differences. Nevertheless, an understanding of how cultural and social forces affect the vulnerability to depression should guide practitioners in designing and implementing culturally relevant treatment regimens for all clients (Weiss, 1988). Unfortunately, critical questions, such as what specific therapies are necessary for effective treatment of Korean-American clients, has not been found in current research. Systematic and accurate data-based information about KAs are lacking. Future research into the mental health needs of KAs should include assessments of needs in order to provide a basis for planning the prevention and intervention programs to adequately meet Korean Americans' mental health needs.

Psychiatric disorders among elderly Koreans in the United States

This study examines the lifetime prevalence of various psychiatric disorders among 100 Korean elderly in Los Angeles. The instrument used in this study is the Diagnostic Interview Schedule, Version III (DIS III, 1-10). The main finding is of relatively low prevalence of most DSM-III disorders with the exception of alcohol abuse and dependence. The rate of alcoholism is astonishingly high among elderly Korean males in Los Angeles. The findings are compared with the U.S. Epidemiological Catchment Area studies, and with other much larger community studies conducted in Korea. A comparison shows that there are no significant differences in the prevalence of mental disorders between elderly Koreans in Los Angeles and elderly Americans in St. Louis (N = 576) except for the prevalence of alcohol abuse and dependence. The lifetime prevalence of DSM-III disorders among Koreans in Korea (N = 5100) is generally higher than among elderly Koreans in Los Angeles.

Alienation of elderly Korean American immigrants as related to place of residence, gender, age, years of education, time in the U.S., living with or without children, and living with or without a spouse

Dean's Alienation Scale (DAS) was administered to 137 Korean immigrants, aged sixty years or older, who had resided in the United States for at least one year but not more than fifteen years. The study was made in order to determine the relationship of alienation to the independent variables of place of residence (an ethnically homogeneous Korean community in Los Angeles vs. ethnically heterogeneous communities in Oklahoma), gender, age, years of education, time in the United States, living with or without children, and living with or without a spouse. Significant relationships (p less than .01) were found between one or more of the subscales of the DAS (powerlessness, normlessness, social isolation, and total alienation) and place of residence, age, time in the United States, and whether living with or without a spouse. Simultaneous regression analyses were performed to determine the relative contribution of the independent variables to each of the subscales.