Expert answer:What is the impact of acculturation on depression

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Journals of Gerontology: Social Sciences
cite as; J Gorontol 8 Psycho! Sci Soc Sci. 2016, Vol. 00, No. 00, 1-10
TGHE ERQNTQLQG ICAL
doi:10.1093/geronb/gbw038
Advance Access publication AprilS, 2016
SOCIETY 0 F AMERICA”
Original Article
Depressive Symptoms Among Older Chinese Americans:
Examining the Role of Acculturation and Family Dynamics
Fei Sun, 1 Xiang Gao/ Shuo Gao, 3 Qilun Li, 1 and David R. Hodge 1.4
‘School of Social Work, Michigan State University, East Lasing. ‘Department of Sociology, Huazhong University of Science and
Technology, Wuhan, Hubei, China. ‘School of Journalism and Mass Communication, Arizona State University, Phoenix. ‘Program for
Research on Religion and Urban Civil Program for Research on Religion and Urban Civil, University of Pennsylvania, Philadelphia.
Correspondence should be addressed to Xiang Gao, Department of Sociology, Huazhong University of Science and Technology,luoyu Road 1037,
Wuhan, Huboi, China 430074. E-mail: xiangxianggao@126.com.
Received August 31, 2015; Accepted March 14, 2016
Decision Editor: Deborah Carr, PhD
Abstract
Objectives: This study identified the prevalence of depression and tested the influence of acculturation and family dynamics
on depressive symptoms, among a community sample of older Chinese Americans.
Method: Data came from a survey of 385 Chinese Americans aged 55 and older {MJ&• = 72.4 years, SD = 8.7) living in a
large metropolitan area in the American Southwest. The survey was administered in 2013 through face-to-face interviews.
Depressive symptoms were assessed with the “12-item Center for Epidemiological Studies Depression scale.
Results: Approximately 19.5% of the sample reported mild depressive symptoms and an additional8.5% reported moderate depressive symptoms. Three-step hierarchical regression analyses indicated that smaller family support network size and
more family conflict were risk factors for depressive symptoms. The effect of acculturation was not significantly associated
with depressive symptoms after controlling for family dynamics.
Discussion: Family support and conflict play a prominent role in explaining depressive symptoms among Chinese
American older adults. The effect of acculturation is minim;tl when older adults have supportive families and good health.
Interventions or services aimed at promoting family hannony for members of this population should be considered.
Ke)’ Words: Acculturation-Depression-Family conflict-Family support-Older Chinese Americans
Depression is a major risk factor for disability and suicide
among older Americans of all ethnic groups (Kalibatseva
& Leong, 2011; Stokes, Thompson, Murphy, & GallagherThompson, 2002). Clinical levels of depressive symptomology among community-dwelling older Americans,
excluding those who are nursing home eligible, range from
7.2% to 16% {Blazer, 2003; Djernes, 2006). Studies with
Chinese American older adults have found prevalence rates
to be somewhat higher, ranging from 11% to 20% (Lam,
Pac.lla, & Smith, 1997; Lin, l.iu, &jang, 2014). It is important to note that comparing prevalence estimates across
studies is problematic due to methodological differences.
Nevertheless, the current consensus is that older Chinese
Americans arc less likely to seek mental health diagnosis and treatment (Dong, Chen, Li, & Simon, 2014) and,
consequently, have higher levels of depression relative to
the general older adult population (Kalibatseva & Leong,
2011; Lai, 2004).
Another reason the cmrent cohort of older Chinese
Americans-SO% of which were foreign-born-warrants
more attention is that the mental health advantage typically
associated with immigration may not carry over into older
adulthood, Using a national probability sample, Gonzalez,
Tarraf, Whitfiled, and Vega (2010) found that the prevalence rate of lifetime major depression among foreign-born
Chinese Americans was 10.1 %. Among U.S.-born Chinese
©The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reseiVed.
For permissions, please e-mail: journals.permissions@oup.com.
1
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Americans, the rate was 21.5%, approxirnately the same
as the 20.4% prevalence rate among \1hite Americans.
However, this pattern was reversed among adults aged 65
and older (Gonzt’ilez et al., 2010). Foreign-born Chinese
older adults had depression rates two times higher tl1
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