Asian Immigrants and the Stress Process: A Study of Koreans in Canada

Asian Immigrants and the Stress Process: A Study of Koreans in Canada*

SAMUEL NOH WILLIAM R. AVISON

The University of Western Ontario

Journal of Health and Social Behavior 1996, Vol. 37 (June): 192-206

The stress process paradigm is one of the most widely held perspectives in the sociology of mental health. While this model has been applied to a large number of research problems, relatively little work has examined whether the paradigm can assist in understanding the link between socially induced stressors and their consequences for the mental health of immigrants. In this paper, we employ a stress process formulation to examine the interplay among stressors, psychological and social resources, and psychological distress among a large sample of Korean immigrants living in Toronto, Canada. Data from a longitudinal study of over 600 respondents indicate that the stress process paradigm provides a useful perspective for understanding how chronic stressors associated with the immigration experience manifest themselves in psychological distress. Our results suggest that social and psychological resources have important deterrent effects on the experience of stressors and their subsequent distressful consequences. Ethnic social support and mastery are especially important factors in this process.

Over the past few decades, large influxes of immigrants from Asian countries have reshaped the nature of ethnic dynamics in North American societies (Dumas 1985; Hurh and Kim 1988, 1990; Portes and Rumbaut 1990). In Canada, Asian immigrants accounted for less than 10 percent of the total number of immigrants until the 1960s; however, by 1973, the proportion of Asian migrants had increased to more than 20 percent of the total immigration. In the 1980s, immigrants from Asian countries accounted for approximately 50 percent of the total

* An earlier version of this paper was presented at the 1994 Society for the Study of Social Problems Annual Meeting in Los Angeles, CA. This study was supported by the Social Sciences and Humanities Research Council of Canada (Award 410-87-0821) to Samuel Noh and William R. Avison and an Ontario Mental Health Foundation Senior Research Fellowship to William R. Avison. Correspondence should be addressed to Samuel Noh, Room 2535 Elborn College, Applied Health Sciences, The University of Western Ontario, London, Ontario, Canada N6G 1H1; e-mail: snoh@biostats.uwo.ca.

immigration to Canada and more than 10 percent of the national growth (Dumas 1985). There are at least two reasons for studying the mental health of Asian immigrants. First, there are relatively few large-scale, systematic studies of these immigrant populations. In the United States, studies of minority mental health have been largely limited to African American and Hispanic groups (Vega and Rumbaut 1991), although work by Kuo (1976), Kuo and Tsai (1986), and Sue and Morishima (1992) are notable exceptions. In Canada, minority mental health is only now attracting wider attention (cf. Beiser and Wood 1986). Second, studying the mental health of Asian immigrants provides an opportunity to assess whether the stress process is a theoretical framework that can be used to understand the link between socially induced stressors and their consequences for the mental health of immigrants. Much of the current literature that has supported the stress process formulation has been limited to non-Hispanic, White communities. Few attempts have been made to examine cultural variations in the effects of social stressors on mental health.

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In this paper, we present results that assist us in better understanding the process through which stress manifests itself among Asian immigrants. Specifically, we explore how life stressors and coping resources interact with one another to influence the psychological well-being of a large sample of Korean immigrants in Toronto, Canada.

MENTAL HEALTH AMONG KOREAN IMMIGRANTS

At present, our understanding of the mental health implications of international migration is severely limited; moreover, information on Asian immigrants is even more scant (Sue and Morishima 1982; Vega and Rumbaut 1991). Earlier studies of "treated cases" almost invariably report findings that are contrary to the belief that Asian immigrants suffered from major mental health problems (Berk and Hirata 1973; Jew and Brody 1967; Kintano 1969; Sue and McKinney 1975). However, the reduced rate of admissions to hospitals for psychiatric treatment seems more likely to be a reflection of Asians' cultural tendency toward underutilization of mental health services as well as a fear of the stigma associated with psychiatric disorders in most Asian societies, rather than an indicator of greater well-being among Asians (Lin et al. 1982; Sue and Morishima 1982; Vega and Rumbaut 1991). Thus, in addition to studies of treated cases, there appears to be a need for studies of Asian immigrants that employ sampling strategies which are more likely to generate representative samples from the community.

There are, however, relatively fewer epide-miologic investigations of Asian immigrants resident in the community. To our knowledge, only three epidemiologic studies have been carried out to examine mental health problems of Korean immigrants in the United States and Canada. The first epidemiologic study of Korean immigrants was conducted by Kuo (Kuo 1984; Kuo and Tsai 1986). Samples of Asian Americans--Chinese, Filipinos, Japanese, and Koreans--were selected in Seattle and were administered the Center for Epidemiologic Studies of Depression (CES-D) scale to estimate the prevalence of depression in these four ethnic communities. Its overall prevalence was slightly higher compared to the prevalence reported for

non-Hispanic Whites, but somewhat lower than those for African Americans and Hispanic Americans (cf. Eaton and Kessler 1981; Frerichs, Aneshensel, and Clark 1981; Gary et al. 1989). Kuo (1984) found that the prevalence of depression in Korean immigrants in his Seattle sample was about twice the rate in each of the other three Asian groups. However, the findings of this study are difficult to generalize because the study involved only 110 subjects in the Korean community in Seattle. A more comprehensive study of Korean immigrants' mental health was conducted by Hurh and Kim (1988, 1990). Although they report that the prevalence of depression among Korean immigrants in Chicago was somewhat lower than the rate from Kuo's study, it was nevertheless comparable to the Seattle study.

Recently, in a study of 860 Koreans in Toronto, Noh and his colleagues (Noh, Speechley, et al. 1992; Noh, Wu, et al. 1992) reported that the prevalence of depression was between 3.1 percent and 5.9 percent, figures that are similar to the rates of depression reported in the Stirling County Study in Canada (Murphy, Sobol, and Neff 1984), the Epidemiologic Catchment Area (ECA) studies in the United States (Regier, Myers, and Kramer 1984; Robins and Regier 1991), and in a large epidemiologic survey in Edmonton, Canada (Bland, Newman, and Orn 1988). These studies reported estimates of prevalence ranging from 5.1 percent to 5.6 percent in Canada and 3.5 percent to 5.6 percent in the United States.

THE STRESS PROCESS AND THE MENTAL HEALTH OF KOREAN IMMIGRANTS

Recent studies of social stress focus on the ways in which social stressors from various sources result in ill health of various forms. A basic conceptual framework of the stress process has been proposed by Pearlin and his associates (1981). They illustrate the roles of and interrelationships among three major constructs: stressors, mediators or coping resources, and distress or health outcome. Briefly, the model portrays the ways in which the harmful consequences of social stressors vary substantially across individuals and social groups, and explains how such variations are determined by psychological and

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social coping resources, including personality, coping efforts and skills, and social supports. Studies in many disciplines provide empirical evidence supporting the stress-mediating and stress-buffering roles of coping resources.

More recently, the research in social stress has addressed the question of how coping resources function to mediate or buffer the potentially harmful impact of social stressors (Wheaton 1985). Empirical studies, however, have presented mixed, if not contradictory, findings and conclusions regarding the stress-buffering role of social support (Aneshensel and Stone 1982; Gore 1981; House 1981; Lin et al. 1979; Thoits 1982, 1986; Turner 1981).

Several competing hypotheses or models have been proposed to explicate the ways in which social and psychological resources reduce the adverse impacts of life stressors (Dohrenwend and Dohrenwend 1981; Ensel and Lin 1991; Lin and Ensel 1989; Wheaton 1985). Although these models vary to some degree, Ensel and Lin (1991) have synthesized them into two global models. The first is a deterring model in which preexisting coping resources may act to reduce the impact of stressors on distress in three distinct ways. Resources may directly reduce distress but do so independently of stressors. Second, resources may result in a suppression of stressors that then results in reduced distress. Third, stress conditioning may occur in which variations in levels of resources in conjunction with subsequent stressors condition the effect of stressors on distress. These deterring models are consistent with Paykel's (1978: 251) remark that it is not just the presence of life stressors that is significant for mental distress, but that "the soil in which it falls" conditions a stressor's potential consequences. In this view, then, preexisting resources play a crucial role in the stress process.

The other global model is the coping model in which the relationship between stressors and resources is reversed. This conception is consistent with the view that stressors "... do not necessarily impact upon people directly but may, instead, exert their effects through a wider context of life strains" (Pearlin et al. 1981:339), where stressors or strains represent life situations in which important coping resources are severely jeopardized or compromised. Again, there are three distinct versions of this model. First, the

harmful effects of stressors may be counteracted by coping resources that are triggered by the experience of stress. In this model, increases in stress produce increases in coping resources that lead to a subsequent reduction in distressful outcomes. Alternatively, an increase in stressors may be associated with a deterioration of coping resources, where stressors are predicted to have a negative effect on resources; that is, coping resources mediate the effects of stressors on distress. Third, the stress-buffering effects of resources emerge when there is an interaction between prior stressors and current resources. Clearly, the viability of any of these models requires verification and, to date, empirical data have supported two of the coping (deterioration and stress-buffering) models and one of the deterring model (the independent model) (cf. Lin, Dean, and Ensel 1986; Ensel and Lin 1991). Whether these findings generalize to immigrant populations is a question that we address in this paper.

Applying the Paradigm to Immigrants' Mental Health

Moritsugu and Sue (1983) and Vega and Rumbaut (1991) have proposed a basic framework for studying minority mental health that is based on the stress process perspective. Social stress research assumes that life stressors do not occur randomly; rather, difficulties in life are systematically and disproportionately distributed across individuals and sociologically definable groups. From this perspective, minority status or marginality itself can be considered a significant stressor (Moritsugu and Sue 1983; Vega and Rumbaut 1991). One prediction that emerges from this formulation is that immigrants will experience more mental health complications than native-born individuals "... because the uprooting process itself produces an excessive amount of social stress" (Kuo and Tsai 1986:134).

Although several studies provide confirmation of the adverse psychological ramifications of the migratory and uprooting process, Kuo and Tsai (1986) contend that there is empirical evidence suggesting the contrary (e.g., Fitinger and Schwartz 1981; Cochrane and Stopes-Roe 1977; Burnam et al. 1987). Indeed, some scientists believe that immigration policies in the United States and Canada tend to select healthy Asian immigrants who

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can be characterized as having a "hardy personality" (Burnam et al. 1987; Kuo and Tsai 1986). Furthermore, immigrants can and do institute their own social networks and social institutions and in so doing establish substantial ethnic social support networks that allow them to live relatively separated from the larger society (Kuo and Tsai 1986). In fact, those immigrants who maintain their own ethnic culture and networks while also adopting the cultural and social networks of the host society tend to exhibit better health, compared to either "assimilationists" or "traditionalists" (Hurh and Kim 1984, 1988; Rumbaut 1991; Vega and Rumbaut 1991). While these explanations seem viable, their validity has yet to be established in empirical investigations.

However, before assessing the utility of these explanations, it seems necessary to modify the stress formulation to consider life situations and experiences that are particularly relevant to immigrants. In particular, we contend that the application of a stress process formulation requires a careful specification of the particular social stressors to which immigrants are exposed and the kinds of social and psychological resources that are available to them.

Social stressors. In specifying stressors in a study of immigrants, it is important to consider both acute stressors and chronic strains as potential sources of life stress. As well, it seems clear that the kinds of chronic strains that may be most relevant to the experiences of new immigrants are likely to differ from the kinds of role strains that are usually measured in most studies of the stress process. While immigrants experience stress brought on by discrete life events and hassles, stress can also be induced by chronic, ongoing difficulties. New immigrants are prone to adjustment problems such as cultural conflicts, social integration and assimilation, role changes and identity crises, low socioeconomic status, and the experience of racial discrimination (Fitinger and Schwartz 1981; Kuo 1976; Hull 1979; Sue and Morishima 1982). In this study, we take into account strains associated with adaptation in the following areas of life: acquisition of new language; sense of isolation; homesickness or nostalgia; sense of marginality; experienced social discrimination; financial or economic hardships; changes in role structure and role identity; and problems in the family due to cultural changes.

Social resources. A substantial body of

research has examined the effects that various social resources have on individuals' mental health. Several reviews of the literature on social support and social resources have provided incontrovertible evidence on the important role played by social support in the stress process (e.g., House, Landis, and Umberson 1988; Lin et al. 1986; Sarason, Pierce, and Sarason 1994).

When studying recent immigrants, the role of social support cannot be assessed in a unidimensional manner. By definition, the uprooting process involves disruption of immigrants' social interaction and fractures in social networks; however, some argue that the consequences of such uprooting may not be as serious as previously thought (Kuo and Tsai 1986). For example, many recent Asian immigrants have "chain-migrated" to rejoin their families and relatives in the new country. In addition, new immigrants may also actively participate in social interaction to establish new social networks following migration. These newly established networks may be confined to immigrants' own ethnic communities or they may extend beyond ethnic boundaries to the larger communities of the host society as immigrants proceed further in terms of structural assimilation (Gordon 1962). Given these possibilities, an interesting question is whether the ethnic origin of social supports influences the stress-mediating or buffering functions of resources. There is both theory and research that is relevant to this possibility. Lin (1992) has developed a theory of social resources which suggests that the degree of homophily (shared social and cultural characteristics) among members of a social group may have important implications for the provision of social resources and social support. He argues that further research on this possibility is warranted. A review by Kuo and Tsai (1986) provides conflicting evidence. While there is support for the position that intense involvements and ties confined within ethnic networks can be dysfunctional (Granovetter 1973; Hirsch 1980; Quizumbing 1982; Well-man 1981; Wilcox 1981), other researchers present evidence for the positive functions of ethnic networks and supports (Banchevska 1981; Koranyi 1981; Kuo and Tsai 1986; Murphy 1973; Portes 1983). Accordingly, it is important to specify these two sources of social resources in any study of the stress process among immigrants and to assess their

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relative impact on health outcomes. To our knowledge, our study is the first to specify ethnic and nonethnic sources of social support and to compare their efficacy. Our cross-sectional analyses suggest that ethnic support is very important for the mental health of Korean immigrants, while the degree of nonethnic social support is not associated with the health outcome (Noh, Wu, and Avison 1994).

Psychological resources. For some time, researchers have been interested in the roles that psychological resources play in the stress process. In this context, constructs that are associated with personal agency have been a central theoretical and empirical focus. These constructs include locus of control (Lefcourt 1981; Rotter 1966), mastery (Pearlin and Schooler 1978), and helplessness (Seligman 1975). In addition, resources that relate to self-esteem have also occupied a central position in the stress process formulation. The theoretical importance of this construct has been demonstrated convincingly by Rosenberg (1979) and Kaplan (1975).

Social stress research provides a substantial empirical basis for the belief that personal resources such as mastery or self-esteem are associated with psychological distress among persons experiencing chronic life strains (Avison 1995; Pearlin et al. 1981; Turner and Roszell 1994; Turner and Noh 1983). Mastery refers to the degree to which a person views life as being under his or her own control as opposed to being fatalistically determined. The concept thus describes an intrapsychic resource that influences, and is influenced by, one's perceptions about past and current experiences in controlling and managing life's challenges. To this extent, the concept shares much with that of locus of control and learned helplessness. These concepts are hypothesized to be strongly connected to depression and other forms of psychological distress (Noh and Turner 1987; Seligman 1975; Turner and Avison 1992b).

The salience of these constructs for the mental health of minority group members has been discussed in an excellent review by Moritsugu and Sue (1983). Because the uprooting process involves changes in social and cultural climates, new immigrants may be frustrated by the fact that their social skills and defense mechanisms are not typically

functional or socially acceptable in their new setting (Moritsugu and Sue 1983; Sue 1977; Sue and Zane 1980). When such frustrating experiences are repeated over time, self-esteem and mastery can be eroded, thus increasing vulnerability to social stressors.

Despite the conceptual implications of psychological resources, their role in influencing psychological well-being in immigrants and minority groups has not been explicated extensively (Moritsugu and Sue 1983). Kuo and Tsai (1986) found that sense of control was directly associated with both stressors and depression. In addition, sense of control also had a significant moderating effect on the association between stressors and depression. It appears, then, that there is a need for a careful examination of the roles of these resources among immigrants.

THE KOREAN MENTAL HEALTH STUDY

Research Design

The data for this study are drawn from the Korean Mental Health Study (KMHS), a two-wave panel study of life strains and mental health problems among Korean immigrants in Toronto. It has been estimated that about 35,000 Korean immigrants are now residing in Canada, with a majority (about 20,000) living in metropolitan Toronto (Shin 1991). Data were obtained through interviews conducted in the summers of 1990 and 1991. All measures were translated into Korean and then independently translated back to English to ensure their validity in Korean.

The Directory of the Korean Society of Toronto, listing over 4,000 households in the metropolitan area of Toronto, was the primary source for the sampling frame. A total of 1,039 households were selected using a simple random sampling method. Within each selected family, only one adult (aged 18 or older) was randomly selected. Those who migrated before the age of 16 were excluded because their migratory adjustment experiences were likely to be substantially different from those of older adult immigrants. Interviews were conducted by trained bilingual interviewers following structured interview schedules.

In the first wave of the study (Wl), a

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sample of 860 subjects provided relatively complete sets of information, representing a participation rate of 86 percent. Males (53%) and females (47%) were almost equally represented in the sample. A majority of the sample (55.3%) was 36 to 55 years old while 19.2 percent were older than 55. These figures closely parallel the sex and age distributions found in the 1986 Canadian Census, except that the elderly were somewhat underrepresented in the sample. Most respondents were either currently married (82.6%) or never married (10.2%). More than half (52.6%) of the sample had some postsecondary education. This figure was higher for males (59.9%) than for females (44.2%). Most men (80.5%) and women (67.6%) reported that they either worked outside the home or had their own business. These percentages are roughly comparable to data reported by Shin (1991) for all adult Korean immigrants in Canada.

The majority of our sample (68.7%) had immigrated to Canada between the ages of 26 and 35. Of course, age of migration is constrained somewhat by our sampling criterion because we excluded those Koreans who had immigrated before age 16. On average, respondents had been living in Canada for 12 years. Despite this, only a few (19%) had received formal education after immigrating to Canada.

A total of 609 respondents (71% of the baseline sample) participated in second wave interviews (W2); 116 (13.5%) refused to be reinterviewed, 133 (15.5%) were lost to follow-up (mostly through geographic moves out of the catchment area), and 2 (.2%) had died. As with most community surveys, there were trends indicating greater loss rates among younger and unemployed subjects as well as those with shorter length of residency in Canada. However, these differences were not found with those who were located but refused to be interviewed. Indeed, the refusers closely resembled the participants on all demographic and stress process variables that are used in this study.

To explore further the impact of attrition, we regressed psychological distress (at Wl) on demographic variables, stressors, and resource variables. Interaction terms were computed between each of the stressors and resource variables and a dummy variable that identified the participants and nonpartici-pants. Statistically significant interaction

terms would therefore reflect attrition bias. In no case, however, was there any evidence of a significant interaction term. Accordingly, we are confident that attrition from Wl to W2 did not introduce significant biases in our results.

Measurement

Psychological distress. The Center for Epidemiologic Studies Depression Scale (CES-D) is a 20-item scale that assesses current level of depressive mood. A Korean version of the CES-D, translated by Hurh and Kim (1988), was adopted with minor modifications. Elsewhere, we have reported detailed information on this scale's psychometric properties (Noh, Avison, and Kaspar 1992). However, as Lin (1989) and Noh, Avison, and Kaspar (1992) have noted, a potential source of bias has been identified on one dimension of the CES-D: Asians' responses to the positive affect items should be interpreted with caution because of the cultural tendency pf reporting unusually low levels of positive affect. Two methods have been suggested to eliminate this response bias: discarding the four positive items--an approach we adopted in the first wave of the KMHS (Noh, Speechley, et al. 1992; Noh, Wu, et al. 1992)--or rephrasing the positive items with negative content. In this study, Wl depression (CESD^ was measured with the 16-item scale (deleting the four positive items). The reliability of this scale was .89; after adjusting for the number of scale items, the mean score was 10.74 (s.d. = 9.00). In the second wave, the second method of correction was adopted to score CESD₂. For example, the positive item "... hopeful about the future" was rephrased into a negative item, "... pessimistic about the future." The reliability of the revised 20-item CES-D was .92 and the mean was 10.60 (s.d. = 9.47). Thus, it appears that the two versions of the CES-D produce distributions with similar central tendencies and dispersions.

Stressors. We included assessments of both undesirable life events (LE) and chronic strains (CS). The number of life events during the 12-month period prior to Wl interviews (LE^ X = 1.93; s.d. = 1.97) was assessed using 22 items common to most checklists such as loss of a job, death of a family

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member, accident or injury, illness, a financial problem, troubles with family members, and so forth. These events were drawn from the 31-item checklist used by Turner and Avison (1992a); the number of items was reduced to avoid duplication. In W2, respondents were asked to report on life events that occurred during the 12-month period between the two interviews (LE₂; X = 1.53; s.d. = 1.90).

A 31-item scale was devised to measure chronic strains associated with adaptation strains in seven major areas: language difficulty, homesickness, social isolation, social discrimination, sense of marginality, opportunities for occupational and financial mobility, and family problems. Subjects reported how often they felt stress resulting from each of the problems described. For this measure, the period of time over which the respondents experienced these difficulties was not specified; these life difficulties could have persisted over any substantial length of time. Each response was coded on a 4-point scale ranging from "always or almost always" to "never." Scores for each item were equally weighted and summed to generate a composite score of adaptational strain. Internal consistency reliabilities (alpha) of the seven subscales ranged from .77 to .89. The alpha reliability of the total strain measure (CS^ was .91. The mean of this measure was 65.96 (s.d. = 4.75). This measure was not repeated at W2.

In developing this measure, we were concerned about the possible confounding of this construct with social support. Three observations have reassured us that this is not a serious problem. First, the zero-order correlations between chronic strain and our measures of social support are modest: -.15 with KSS! and -.26 with KSS₂; -.20 with GSS! and -.19 with GSS₂. Second, factor analyses reveal that our measure of strain forms a factor separate from social support. Finally, as we shall report, the effect of strain on depression persists, even with the inclusion of KSS in the regression analyses.

Psychological resources. Mastery at Wl and W2 (MA_X and MA₂) was measured with a 7-item scale derived from Pearlin and Schooler (1978). The mean scores for МА_Хand MA₂ were 23.9 (s.d. = 5.7) and 24.1 (s.d. = 5.6), respectively. Self-esteem (SE_Xand SE₂) was assessed with an abridged

6-item version of Rosenberg's (1979) scale. These scales have been successfully used in a number of earlier large-scale studies (Noh and Turner 1987; Turner and Avison 1992a, 1992b; Turner and Noh 1983, 1988) and have consistently shown acceptable levels of reliability. In this study, the internal consistency reliabilities (Cronbach's alpha) of the mastery scale were .76 and .77 for Wl and W2, respectively. The reliability of the self-esteem scale was also acceptable (.79 for Wl and .82 for W2). The mean scores for SEi and SE₂were 23.2 (s.d. = 4.0) and 23.1 (s.d. = 4.3), respectively.

Social resources. We measured perceived social support with the Provisions of Social Relations Scale (PSR) developed by Turner, Frankel, and Levin (1983). The content of this index is based on Weiss' (1974) conceptual analysis of social relationships. For each of 15 items, respondents report the degree to which they perceive themselves to be socially supported by using a 5-point scale ranging from "very much like my experience" to "not at all like my experience."

In order to distinguish between perceived social support from other Korean immigrants and support from the broader, nonethnic community, the PSR was evaluated by each respondent first with respect to their experiences of social relationships within Korean ethnic networks, and then again regarding their experiences in relation to family, friends, and со workers who were not of Korean origin. These two types of social support are hereafter referred to as Korean social support (KSS) and general social support (GSS). These variables were measured at both Wl (KSS! and GSS^ and W2 (KSS₂ and GSS₂). The reliability (alpha) coefficients ranged from .84 to .88. Means for KSS were 3.7 (s.d. = 1.7) and 3.8 (s.d. = 1.7) for Wl and W2. For GSS, comparable values were 2.3 (s.d. = 1.7) and 2.7 (s.d. = 1.4) forWl and W2.

Control variables that were incorporated into the analyses include age (interval measure), sex, marital status (married vs. other), employment status (employed vs. other), education (interval measure), and the years of residency in Canada (interval measure). All control variables were measured at Wl. An appendix that includes the means and standard deviations of all variables and a complete intercorrelation matrix is available on request.

Korean Immigrants and the Stress Process 199

RESULTS this analysis are presented as model 1 in

Table 1. As can be seen, there is consider-

Main Effects of Stressors and Resources _able stability over one year in levels of

Our analysis of these longitudinal data depressive symptoms among Korean immi-

involved the computation of OLS regression grants in our sample. It is also the case that

estimates of the effects of a series of none of the sociodemographic factors has a

predictors on W2 depressive symptoms significant effect on changes in depression

(CESD₂). Our approach began with an scores.

estimation of the stability of CES-D scores In the second step of this analysis, we

over time by regressing CESD₂ on CESDi, added Wl measures of chronic strain, life

controlling for the array of sociodemo- events, mastery, self-esteem, ethnic social

graphic factors listed above. The results of support, and general social support. As

TABLE 1. Regression of CES-D at W2: Standardized Coefficients of Demographic Factors, Life Stress Measures, and Coping Resource Variables⁰

Predictors Model 1 Model 2 Model 3

Wave 1 Measures

.455**	.348**	.272**
(.481)	(.367)	(.287)
-.019	-.053	-.041
(-.355)	(-.985)	(-.772)
-.101	-.132*	-.097*
(-.072)	(-.091)	(-.067)
-.005	.002	-.007
(-.090)	(.029)	(-.116)
-.077	-.065	-.050
(-1.630)	(-1.365)	(-1.056)
-.048	-.087*	-.081*
(-.349)	(-.500)	(-.590)
.002	.055	.067
(.004)	(.083)	(.102)
-.063	-.040	-.035
(-.178)	(-.115)	(-.102)
	.091*	.080*
	(.225)	(.159)
	.003	-.032
	(.016)	(-.153)
	-.094*	.044
	(-.156)	(.074)
	-.026	.061
	(-.062)	(.144)
	-.061	.045
	(-.071)	(.052)
	.050	.017
	(.043)	(.019)
		204**
		(1.773)
		-.268**
		(-.452)
		-.124*
		(-.270)
		-.205**
		(-.224)
		.049
		(.066)
.234	.258	.473

CESD! (Depression)

Male (=1)

Age

Married (=1)

Employed (=1)

Education

Years-Canada

Income

Chronic Strain (CS,)

Life Events (LE,)

Mastery (MAO

Self-Esteem (SE,)

Ethnic Support (KSS,)

General Support (GSS,)

Wave 2 Measures Life Events (LE₂) Mastery (MA₂) Self-Esteem (SE₂) Korean Support (KSS₂) General Support (GSS2)

R²

^a Unstandardized coefficients are shown in parentheses. *p< .05; **p< .01.

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displayed in model 2, both chronic strain and mastery have significant effects on respondents' distress scores. The addition of Wl measures of stressors and resource variables accounted for an additional 2.4 percent of the variance in the change of depression over time.

Model 3, the final step in this analysis, displays the results of the regression equation with all W2 stressors and resources added. The inclusion of the contemporaneous measures of stressors and resources increases the variance explained in W2 CES-D scores to 47.3 percent and reveals a number of interesting findings. First, the number of life events experienced by respondents over the one-year period of study is significantly associated with an increase in CES-D scores. Second, increased levels of both mastery and self-esteem are associated with declines in levels of depressive symptoms. Third, increases in social support from Korean family and friends contributes to lower CES-D scores; however, general social support has no such effect. One other finding deserves comment. In model 3, the effect of chronic strain measured at Wl persists even after all W2 variables are entered into the equation.

This attests to the persistence of chronic strain over time.

Indirect Influences

While the previous analysis provides clear evidence of the direct effects of changes in stressors and resources on changes in depressive symptomatology, a central concern of the stress process paradigm is to specify the interrelationships among stressors, resources, and distress. However, as we have mentioned earlier, there are competing models of the relationships among stressors, resources, and distress that need to be assessed empirically in order to better understand the dynamics of the stress process among Korean immigrants.

Figure 1 presents the results of a path analysis that specifies both direct and indirect effects of the major constructs under consideration. In this path model, all path coefficients were estimated from saturated models similar to that presented in model 3 in Table 1, including controls for the effects of sociodemographic factors. The model in Figure 1 includes all Wl and W2 measures of stressors and resources except GSS_X and

FIGURE 1. Direct and Indirect Associations Among Stressors, Psychosocial Coping Resources, and Distress*

LE-

.335

KSS

CES-D_r

.272

CES-D₂

* All path coefficients were estimated for the effects of demographic variables (shown in tab. 1) on each endogenous variable. Neither GSS, nor GSS₂ was associated with CESD₂, directly or indirectly, and therefore are not shown in the figure. All path coefficients are significant atp < .05.

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201

GSS₂, both of which had nonsignificant paths Interaction Effects

to CESD₂.

The results in Figure 1 highlight a number of important processes. First, the stability coefficients for all constructs measured at both points in time are relatively strong. Second, psychological resources at Wl appear to reinforce subsequent levels of both social and psychological resources. Self-esteem enhances subsequent levels of ethnic social support and mastery; mastery has a similar effect on self-esteem and ethnic social support. Third, in addition to its direct effect on distress, ethnic social support also has an indirect effect through stressful life events. Thus, it appears that higher levels of ethnic social support have a stress suppression effect. While life events have a direct effect on CES-D scores, they also exert indirect influence through self-esteem. It should be noted, however, that this effect is positive: exposure to stressful events appears to increase subsequent levels of self-esteem which, in turn, results in a decrease in psychological distress. This pattern corresponds to what Ensel and Lin (1991) refer to as a counteractive coping model. Finally, our longitudinal analysis reveals that chronic strain has a direct effect on subsequent depression. This impact appears to be unme-diated by any social or psychological resource variable.

To further investigate the stress process models, the contributions of various sets of interactions (between stressors and resources) were compared. Following Ensel and Lin's (1991) general analytic strategy, we computed three sets of interaction terms. The first set consisted of eight interactions representing the joint effects of each Wl stressor (LE_l5CSj and each W2 resource (MA₂, SE₂, KSS₂, GSS₂). Tests of these interaction effects assess whether stress-buffering effects can be observed. The second set, representing what Ensel and Lin refer to as stress-conditioning effects, involves the four interactions between Wl resources (MA_1? SE_l9KSS_1? GSS^ and life events at W2 (LE₂). The third set tests interactions between life events at W2 and each resource variable at W2 (MA₂, SE₂, KSS₂, GSS₂) to assess contemporaneous stress-resource interactions.

The results of these analyses are summarized in Table 2. In equation I, the regression model including the sociodemographic variables and all Wl and W2 variables (model 4 in tab. 1) has an R² of .473. This is the baseline model against which all other interaction models are evaluated. In equation II, the addition of stress-buffering interactions increases the variance explained to .483. This increase of .010 over the baseline model is

TABLE 2. Explained Variance in CES-D Scores at W2: R² Increments Associated With the Addition of Various Sets of Interaction Terms

Equa-ation

Predictors

R² Increment from Equation I

I: Main Effects: Control Variables, Wl and W2 Predictors¹

II: Stress-Buffering: Equation I Plus Interactions Between Wl

Stressors and W2 Resources²

IIA: IIB:

Psychological Resources³

Social Resources⁴III: Stress-Conditioning: Equation I Plus Interactions Between Wl

Resources and W2 Stressors⁵IIIA: Psychological Resources⁶IIIB: Social Resources⁷IV: Contemporaneous Interactions: Equation I Plus Interactions

Between W2 Stressors and Resources⁸

473
483	.010	ns
482	.009	ns
476	.003	ns
541	.078	<.001
540	.077	<.001
475	.002	ns
482	.009	ns

¹See Model 4, Table 1.

²Eight interaction terms between Wl

³Four interaction terms between Wl

⁴Four interaction terms between Wl

⁵Four interaction terms between Wl

⁶Two interaction terms between Wl

⁷Two interaction terms between Wl

⁸Four interaction terms between W2

stressors (LE,, CS,) and W2 resources (MA₂, ES₂, KSS₂, GSS₂) stressors (LE,, CS,) and W2 psychological resources (MA₂, ES₂) stressors (LE,, CS,) and W2 social resources (KSS₂, GSS₂) resources (MA,, ES,, KSS,, GSS,) and W2 stressors (LE₂) psychological resources (MA,, ES,) and W2 stressors (LE₂) social resources (KSS,, GSS,) and W2 stressors (LE₂) resources (MA₂, ES₂, KSS₂, GSS₂) and W2 stressors (LE₂)

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nonsignificant. Not surprisingly, when we decompose these interactions into those involving psychological resources (mastery or self-esteem) and those involving social resources (general social support or ethnic social support), we see that the increments in R² associated with each equation are small.

A different pattern emerges, however, when we test for stress-conditioning effects. The inclusion of the four interactions between each of the Wl resources by LE₂ in equation III significantly increases the explained variance by .078. When we decompose this increase, we can see that the major component of this stress-conditioning effect is due to the moderation of stressful life events by psychological resources, mastery, and self-esteem. More precisely, the significant contribution is from mastery (MA_t * LE₂). In the last equation (equation IV), it can be seen that the contemporaneous interactions of life events (LE₂) with resources (MA₂, SE₂, KSS₂, GSS₂) do not significantly increase the explained variance in CES-D scores. Thus, neither social nor psychological resources modify the concurrent effects of life events on distress among respondents in this study.

DISCUSSION AND IMPLICATIONS

The major focus of this paper has been to determine whether a stress process formulation is applicable to the study of the immigrant experience. In our view, the results of this investigation demonstrate that this paradigm provides a clear depiction of the ways in which stressors, psychosocial coping resources, and distress among Korean immigrants are interrelated. In this context, there are several points that deserve some discussion.

Earlier, we noted that none of the sociode-mographic variables is significantly associated with changes in CES-D scores over time. While some might argue that such findings challenge Pearlin's (1989) argument for the importance of understanding how social characteristics influence the experience of distress, we believe that a different interpretation of these results can be made, one which is not inconsistent with Pearlin's position. In cross-sectional analyses, we found significant associations between CES-D scores and age, gender, and the length of residence in Canada. These associations disappeared,

however, when Wl depression was controlled. In other words, age, gender, and length of residence are not related to the change in depression. We believe that this pattern reflects the fact that these social factors make their influence on depression through the Wl measure.

Our analyses also reveal that psychological resources play a central role in the stress process among Korean immigrants. Self-esteem and mastery not only have direct and indirect effects on immigrants' psychological distress; self-esteem is also influenced by prior stressful experience. Our assessment of interaction effects also reveals that earlier levels of mastery moderate the effect of subsequent stressful life events on psychological distress.

While social resources apparently play a less significant part in the process through which Korean immigrants experience distress, ethnic social support nevertheless has a direct effect on depressive symptomatology as well as an indirect effect through subsequent life events. Moreover, an interesting observation is that general social support from the broader community plays almost no role in this process, a pattern that we have discussed at length in a previous paper (cf. Noh et al. 1994). While it may be a truism to state that not all sources of support are equally effective in reducing psychological distress, our results provide convincing evidence that is consistent with Thoits' (1986) hypothesis of sociocul-tural similarity. Thoits emphasizes the importance of empathic understanding of stressful situations by providers of support. She suggests that this is more likely to occur when there is sociocultural or situational similarity between the support provider and receiver.

It seems implicit in Thoits' argument that the key to effective support is a complementarity between the needs and values of both parties in any social support transaction. Sociocultural similarity increases the affinity between the provider and receiver of support. In our study, it appears that social support from members of their own culture has made substantially greater contributions to Korean immigrants' well-being than has support from individuals from the broader community. These findings suggest that new immigrants may be likely to perceive other immigrants as having common life experiences and to expect that they will be better able to understand the exact nature of new immi-

Korean Immigrants and the Stress Process

203

grants' adjustment difficulties. In contrast, members of the larger community (particularly those of dominant groups) may be viewed as less aware or sensitive to the particular difficulties faced by immigrants. Accordingly, assistance offered by nonethnic significant others may be perceived as inappropriate or even controlling or demanding. When the situational difficulties (stressors) are particularly relevant to new immigrants' adjustment processes (such as facing social discrimination or experiencing a sense of marginality), the probability of perceiving interethnic support as threatening or controlling is likely to increase.

These findings, however, do not warrant the conclusion that social support from the broader community has no role to play in the mental health of Korean Canadians. They can be understood only in the context of our sample of immigrants. Because Koreans born in Canada were not included in this study, it seems likely that the potential impact of general social support on Korean-Canadian's mental health is probably attenuated. That is, limiting our study to immigrants probably underestimates the effects of acculturation and its benefits to mental health derived from support from the broader community.

In our view, these analyses also have implications for testing competing models within the stress process formulation. As we indicated at the outset of this paper, our study affords an opportunity to test different models of the stress process that have been put forth by Ensel and Lin (1991). Our results tend to be more consistent with their concept of deterring models than with coping models. Indeed, elements of our analyses are consistent with each of the three deterring models that Lin and Ensel have specified. The observation that chronic strains and social and psychological resources all have significant direct effects on distress is congruent with their independent model. Moreover, our finding that ethnic social support reduces subsequent levels of stressful life events is compatible with their stress-suppressing model. Finally, the observation that Wl mastery interacts with W2 life events is an example of a stress-conditioning model. We find only one instance of a relationship that is consistent with any of the coping models that Ensel and Lin have hypothesized. The experience of eventful stressors results in an increase in subsequent self-esteem which, in

turn, produces lower levels of distress. In Ensel and Lin's framework, this corresponds to a counteractive model. While some might find such patterns to be counterintuitive, they may be consistent with the observation that some stressful experience can provide opportunities for personal growth and the development of better coping abilities (Turner and Avison 1992b).

Thus, with this exception, our results suggest that the relationships among stressors, resources, and distress among Korean immigrants may best be conceptualized as a deterrent process. In this process, psychological and social resources directly reduce levels of distress and either inhibit the occurrence of subsequent stressors or reduce the likelihood that they will be distressful in their consequences.

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Samuel Noh is associate professor in the Departments of Occupational Therapy and Epidemiology and Biostatistics at the University of Western Ontario. His current research interests include the investigation of psychosocial processes of stress. Most recently, his interests have focused on cross-cultural aspects of the stress process.

William R. Avison is professor of sociology and psychiatry and Director of the Centre for Health and Weil-Being at the University of Western Ontario. He currently holds a Senior Research Fellowship from the Ontario Mental Health Foundation. With Ian H. Gotlib, he is the editor of Stress and Mental Health: Contemporary Issues and Prospects for the Future (Plenum Press). In addition to his research with Samuel Noh on immigrants' mental health, he is pursuing a program of research on socioeconomic disadvantage and family mental health. In this context, he is conducting a longitudinal study of unemployment and distress and disorder in families and a study of the effectiveness of a brief home-based intervention for teen mothers and their infants.

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Asian Immigrants and the Stress Process: A Study of Koreans in Canada