Immigration and Stress: The Relationship Between Parents' Acculturative Stress and Young Children's Anxiety Symptoms
Seeking health services
Despite higher rates of stress among immigrants, research indicates that ethnic minorities are less likely to seek mental health services than are European Americans. In addition, there are significant ethnic variations in the likelihood of women seeking mental health services. Alvidrez (1999) found that Latinas and African Americans were much less likely to make a mental health visit than European Americans. In particular, Latinas exhibited a low rate of service use (Alvidrez, 1999). Significant barriers to accessing mental health services have also been reported by ethnic minorities. A study of a Latino population in Michigan identifies differences in the type of barriers reported by Latinos and in the health behaviors of Latino immigrants. Twenty percent of Latinos in the study reported that language was the primary barrier to seeking mental health services (Harari, Davis, & Heisler, 2008.) Most Latinos in the study (56%) reported delays in seeking healthcare because of their need to bring an interpreter to appointments with them (Harari et al., 2008). Almost half of participants (48%) reported feeling isolated and not having the necessary social or information networks (Harari et al., 2008). Although ethnic minorities seek fewer health services and experience more barriers to accessing health services, more acculturated individuals tend to engage in poorer health behavior. A review by Lara and colleagues (2005) indicates that highly acculturated Latinos in the US are more likely to engage in substance abuse and undesirable dietary behaviors, and have worse birth outcomes than individuals who are less acculturated. Being highly acculturated suggests that these Latinos most likely assimilated and a potential explanation for their poor health behavior may be accounted for by their rejection of the values and beliefs of their original culture, which may have served as a protective factor for developing poor health behavior. Research that explores the relationship between immigration and acculturative stress and psychopathology may help to understand factors that relate to mental health seeking behaviors in immigrant populations.
Children’s acculturative stress
Since the 1980s, research has supported a phenomenon called the ‘immigrant paradox’, in which immigrants to the US have a lower risk for mental disorders than individuals born in the US, despite research suggesting that immigration itself is a stressor (Burnam, Hough, Karno, Escobar, Telles, 1987; Grant et al., 2004; Alegria et al., 2008; Vega et al., 1998). In regard to risk for mood and anxiety disorders, current research suggests that this phenomenon holds true for people who immigrated to the US during adolescence or adulthood, but not during infancy or childhood (Breslau, 2008). A study conducted by Breslau (2008) indicated that relative to US born participants, the risk for anxiety disorders was lower for immigrants who immigrated at 13 years of age or older but not for immigrants who immigrated before 13 years of age. A previous study by Breslau et al. (2007) reported that immigrants who arrived prior to 13 years of age did not show a significant difference in risk for psychopathology relative to US-born participants (as cited in Breslau et al., 2008). While Breslau’s research indicates that immigrant children and US-born children share similarly high levels of risk, other research suggests that first and second-generation young immigrant children 4-year-olds show significantly stronger socio-emotional protective factors and significantly fewer behavioral concerns than young non-immigrant children (De Feyter & Winsler, 2009). It is possible that the cultural identity and values of individuals who immigrated during adolescence or adulthood serves as a protective factor from psychopathology.
Breslau’s research suggests two important ideas that are relevant to the present study. The experiences of immigration during early stages of development may explain the relationship between risk for psychopathology and place of birth (US vs. non-US). To an extent, this relationship will be examined in the present study, although indirectly, by looking at the relationship between parent-reported stress factors related to acculturation and anxiety in first-generation and second-generation children. Furthermore, spending early life in the US appears to be associated with high levels of risk, regardless of national origin. Thus, this idea influences the hypothesis of the present study by suggesting that children born in the US, including second-generation immigrant children, are at high risk for anxiety and anxiety disorders. Previous research also suggests that the process of acculturation is less difficult during preschool age but increasingly difficult in later life (Beiser et al., 1988). Berry (1997) suggests that younger children may be more flexible and adaptable than older populations and that they may not encounter cultural conflict because they have not fully adopted their parents’ culture. Thus, a possible explanation is that preschool-age children tend to assimilate and integrate with more ease, partly because their development of cultural identity and values is not advanced enough to create conflict with other cultures. This idea would support Berry’s finding that assimilation and integration strategies of acculturation are associated with less stress than are separation and marginalization strategies of acculturation (Berry, 1998). It may also be possible that younger children are likely to adopt a local accent when learning the language of the new culture and thus, be less recognizable as immigrants. Theoretically, greater language facility and a lack of a foreign accent may minimize experiences of discrimination. Further research is required in order to determine whether or not children acculturate with more ease than older populations. In the present study, a low level of measured anxiety in the child despite stress level related to acculturation in the parent may support this idea.
The level of acculturative stress in children may be explained by the degree of stressors that they experience and the extent to which they acculturate. Research indicates that ethnic minority children experience more stressors than European American children. Suarez-Morales’s (2009) review of studies by Attar, Guerra, & Tolan (1994) and Dubow and colleagues (1991) demonstrates that African American and Hispanic children who live in economically disadvantaged neighborhoods report twice as many stressors than mostly European American, middle-class children. Schwartz, Zamboanga, & Hernandez-Jarvis (2007) found that Hispanic adolescents who adopt American cultural practices experience less acculturative stress, consistent with Berry’s (1997) finding that acculturating individuals who employ the integration strategy experience the least amount of stress. Furthermore, Hispanic adolescents who adopt American cultural practices have a decreased risk of experiencing stressors that potentially interfere with self-esteem and academic performance, such as discrimination (Schwartz et al., 2007). In a study of Hispanic pre-adolescents living in the US, Suarez-Morales & Lopez (2009) found a positive and significant correlation between acculturative stress and concentration-related, physiological, and worry symptoms of anxiety. However, there is still insufficient research that focuses on acculturative stress in younger populations, especially those in early childhood.
Language competency as a stressor.
An individual’s level of competency in the language of the host nation has been identified in several studies as a significant predictor of stress and acculturative stress. In turn, experiencing stressors related to language competency during acculturation may result in negative psychological consequences, such as depression and anxiety. Among Latinos in the US, Bean & Tienda (1987) found that earning higher wages and attaining higher paying jobs is increasingly difficult when there is a lack of fluency in English. In a study of Turkish college students who immigrated to the US, self-reported low levels of English competency were a significant predictor of acculturative stress (Duru & Poyrazli, 2007). In a study of 146 immigrant adults (79% first-generation and 47% second-generation) who identified as Latino, Latina, or Hispanic, Torres (2006) found that participants who reported strong Latino orientation (language preference and identification with Latino culture) also reported more stress in learning English (e.g., “I don’t speak English or don’t speak it well”). It was also found that participants who reported more stress in learning English had higher scores on the Center for Epidemiologic Studies – Depression Scale (CES-D), which measures affective, somatic, and interpersonal circumstances related to depressive symptomatology (Torres, 2006). In a study of 2,059 Latinos (946 first-generation immigrants), higher English language proficiency predicted lower levels of acculturative stress, whereas stronger preference for native language predicted increased levels of acculturative stress (Lueck & Wilson, 2011).
Discrimination as a stressor
Previous studies indicate that discrimination and perceived discrimination are evident stress factors in the process of acculturation and may result in subsequent psychological distress. Additionally, prevalence of reported discrimination is greater in ethnic and racial minority groups than in non-Hispanic whites. In a US sample of 3,302 men and women between the ages of 25 and 74, survey research illustrates the prevalence of perceived discrimination and its variance between ethnic and racial groups. Participants who identified as non-Hispanic white consistently reported much lower levels of perceived discrimination than those who identified as non- Hispanic black (Kessler, Mickelson, & Williams, 1999). In contrast to Non-Hispanic blacks and other racial/ethnic groups, Non-Hispanic whites reported significantly fewer experiences related to perceived discrimination; including not having been hired for a job, having been denied service or having received inferior service, having been discouraged by a teacher from seeking higher education, having been hassled by police, and having been prevented from renting/buying a home (Kessler, Mickelson, & Williams, 1999). Participants reporting the highest frequency of daily perceived discrimination were linked with GAD, especially when they reported having been fired from a job and not having been hired for a job.
Research suggests that discrimination and perceived discrimination play a significant role in predicting acculturative stress. In a major review of 25 studies examining the association between discrimination and psychological distress, 20 studies found a positive association between discrimination and distress (Williams, Neighbors, & Jackson, 2003). In a study of Hispanic pre-adolescents living in the US, perceived discrimination significantly predicted concentration and worry symptoms of anxiety (Suarez-Morales & Lopez, 2009). Perceived discrimination was measured using eight items from the Acculturative Stress Inventory for Children (ASIC). Items in this subscale such as (e.g. “Because of the group I am in, I don’t get the grades I deserve”) were rated on a 5-point Likert and demonstrated good internal consistency (α = .79).
Lueck and Wilson (2011) found that Latino immigrants’ scores on a discrimination index (e.g. “How often do people treat you unfairly because of your ethnicity”) significantly predicted increased acculturative stress (e.g., “Do you find it hard to find the work you want because you are of Latino descent?”). In a study of Nicaraguan and Cuban adolescents and their parents, Gil and Vega (1994) found that acculturative stress was linked to perceived discrimination related to minority or immigrant status. Furthermore, Gil and Vega’s study (1994) found that 29% of Nicaraguans and 23% of Cubans experienced discrimination, which in turn, affected their personal and family life through lower levels of family cohesion, increased parent/child acculturation conflicts, adolescent self-esteem and adolescent perceived teacher derogation. Thus, discrimination has been identified as a significant acculturative stressor which may contribute to the manifestation of anxiety.
Parental acculturative stress and child anxiety
The relation between parental acculturative stress and child outcomes, let alone the relation between parental acculturative stress and child anxiety, has yet to be studied (Leidy et al., 2009; Dumka, Roosa, & Jackson, 1997). In support of studying the relation between parental acculturative stress and anxiety symptoms in young children, previous research indicates that higher stress levels in the parents are related to poor parenting styles as well as poor child adjustment (Behnke, McDermid, Coltrane, & Parke, 2008; K. J. Conger, Rueter, & Conger, 2000; Hodges, London, & Colwell, 1990; Woody, 1984).
In a questionnaire and observational study of 134 first-generation Mexican American couples and their children (mean age = 10.5 years), acculturative stress reported by parents was found to be a significant mediator in the relation between positive marital quality and children’s adjustment (Leidy et al., 2009). Positive marital quality was measured by the mother’s and father’s self-reports of positive marital quality through a series of questions assessing the participant’s level of satisfaction with his/her spouse and his/her marriage and by observed positive interaction between the mother and father. Parental acculturative stress was measured by self-reported level of stress experienced in situations where ethnicity or culture was salient. Child outcomes were measured by the parent report version of the Child Behavior Checklist, which assesses internalizing and externalizing behavior in children. Higher levels of parental acculturative stress mediated the relation between lower positive marital quality and higher rates of child internalizing behaviors (Leidy et al., 2009). This suggests that acculturative stress may be a significant factor in the development of internalizing behaviors, possibly symptoms of anxiety, in children of immigrant families.Continued on Next Page »