Skip to main content
NCBI home page
NIHPA Author Manuscripts logoLink to NIHPA Author Manuscripts
. Author manuscript; available in PMC: 2025 Jul 1.
Published in final edited form as: J Gerontol Soc Work. 2024 Apr 16;67(5):575–587. doi: 10.1080/01634372.2024.2338071

Mental Health Impact of Bullying by Ethnic Peers in Senior Housing: A Study with Older Korean American Residents in the Greater Los Angeles Area

Yuri Jang 1,2, Juyoung Park 1, Min-Kyoung Rhee 3, Hi-Woo Lee 4, Nan Sook Park 5, Yeonwoo Kim 6, Soondool Chung 2, Miyong T Kim 7
PMCID: PMC11116039  NIHMSID: NIHMS1986218  PMID: 38627372

Abstract

The purpose of the present study is to examine the experience of peer bullying and its mental health effects among ethnic minority older residents in subsidized senior housing. Surveys were administered to Korean Americans aged 65 and older (N = 343) in six senior housing facilities in the greater Los Angeles area. Multivariate regression models were used to examine the effect of being either a target or a witness of bullying on mental health outcomes, after controlling for covariates. About 18% of the sample had been a target of bullying, and over 31% had witnessed someone being bullied. Being a target of bullying was a significant predictor for both depressive symptoms and anxiety, whereas witnessing other residents being bullied was a significant predictor for anxiety only. These findings shed light on the common experience of bullying among ethnic minority older residents in senior housing as well as the adverse mental health impacts of peer bullying. Implications for future research and program development are also discussed.

Introduction

Bullying, a persistent negative interpersonal behavior directed at a specific individual or a group of individuals, is often associated with youth in school settings and young adults in the workplace (Luxenberg et al., 2019; Rayner & Keashly, 2005). However, peer bullying is also common among older populations (Bonifas, 2016; Ruiz-Esteban et al., 2023). Particularly in senior housing, where individuals with diverse backgrounds and characteristics reside in close proximity and where relocation is often not feasible, peer-to-peer aggressive behaviors are of concern (Andresen & Buchanan, 2017; Lachs et al., 2016). Such bullying can be physical (e.g., hitting, pushing, kicking, throwing an object), verbal (e.g., name-calling, malicious teasing, making sarcastic remarks or pointed jokes), and antisocial (e.g., shunning, excluding or ignoring, gossiping, using threatening body language; Bonifas, 2016). Although empirical research on senior bullying is scarce, studies have reported that over a quarter of senior housing residents experience some form of bullying from co-residents (Goodridge et al., 2017; Jeffries et al., 2018) and that such experiences, for both targets and witnesses, elevate feelings of frustration, fearfulness, depression, and anxiety (Bonifas, 2016; Goodridge et al., 2017; Lachs et al., 2016; Ruiz-Esteban et al., 2023).

For residents who are ethnic immigrants, bullying from peers of the same ethnicity is particularly concerning. Individuals with ethnic minority backgrounds often seek to maintain a sense of belonging and acceptance within their ethnic communities and rely on support from their own community members (Tajfel & Turner, 2004). But just as ethnic communities offer social and emotional support for older immigrants, negative interactions among ethnic community members can have a strong impact. In studies with older Asian Americans (Guo & Stensland, 2018; Jang et al., 2015; Park et al., 2023), interpersonal conflicts among ethnic community members have indicated significant risks for mental health. Beyond the stereotypical perception of ethnic communities as an immutable resource, attention must be paid to the negative effects of social interactions among ethnic community members.

In the present study, we attend to the experiences of peer bullying among older Korean American residents in ethnically concentrated subsidized senior housing facilities in the greater Los Angeles area. Korean Americans are the fifth largest Asian American subgroup, with a high rate of limited English proficiency (Budiman & Ruiz, 2021). About one third of all Korean immigrants in the U.S. reside in California, and over two thirds of the Korean population in California is concentrated in greater Los Angeles (Esterline & Batalova, 2022). Given this density of the Korean population, the area offers abundant Korean-oriented resources and services, including senior housing facilities with Korean-speaking service providers. Subsidized senior housing options are available for older adults whose annual income is less than 80% of the median income of the area (U.S. Department of Housing and Urban Development, 2024). These facilities offer homes to many older Korean Americans who are socioeconomically disadvantaged and linguistically isolated, but attention has rarely been paid to their interpersonal relationships and social well-being in the residential context. We therefore examine (a) how prevalent the experiences of being bullied and witnessing other residents being bullied are, and (b) how such experiences may be associated with residents’ mental health, as indicated by depressive symptoms and anxiety. Because relevant literature on the target population is scarce, our investigation is exploratory. We hope that our findings on the prevalence and mental health consequences of peer bullying will contribute to efforts to protect and promote senior housing residents’ social and emotional well-being.

Methods

Data

As part of a needs assessment of Korean American residents in subsidized senior housing in the greater Los Angeles area, we used purposive sampling to recruit participants from housing facilities with a concentration of Korean residents. We first identified target facilities in an area resource database that we had previously established, which lists available resources and services within Asian communities in greater Los Angeles. With input from social service providers in these local communities, we made a short list of target facilities within a radius of 20 miles from our research site. We collected survey data with the goal of a minimum sample size of 300, which would ensure sufficient power for multivariate models of key contextual characteristics. From April to June 2023, we conducted surveys in six facilities, with a total of 351 participants.

At each participating facility, invitation flyers were distributed by housing staff. Any residents who were self-identified Korean Americans over age 65 and able to understand and complete the survey were eligible. On scheduled dates, our research team visited each facility to conduct surveys. After obtaining informed consent, we conducted the surveys in common areas of the facilities such as meeting rooms and cafeterias. The survey was in a paper and pencil format, with a 10-page structured questionnaire designed to be self-administered. Both English and Korean versions were available, but all participants used the Korean version. Trained research personnel who were bilingual in English and Korean were present at each survey site and assisted participants in need of help to complete their survey. Upon completion of the survey, each participant was assessed for cognitive function, using the Mini Mental State Examination (MMSE; Folstein et al., 1975), by the trained research personnel. All participants were paid $20 for their time and effort. Eight participants were excluded due to severe cognitive impairment (MMSE scores <10) or missing information on more than 10% of study variables, resulting in a final sample of 343.

Measures

Bullying experience.

Two sets of questions were asked to assess participants’ experiences of bullying in their housing facilities, one set for being a target and the other for being a witness. Informed by previous literature on peer bullying in older adults (e.g., Bonifas, 2016; Goodridge et al., 2017; Jeffries et al., 2018), each set addresses three bullying behaviors: verbal bullying (e.g., calling names, teasing, insulting, threatening), physical bullying (e.g., hitting, pushing, kicking), and antisocial bullying (e.g., ignoring, excluding, gossiping). In the first set, participants were asked to indicate whether they had been a target of each of the three bullying behaviors. Similarly, the subsequent set of questions assessed whether participants had witnessed other residents being a target of each of the three bullying behaviors. Response was coded in a yes/no format. Combined scores in each set could range from 0 (no experience) to 3 (experience in all three types). Due to skewness of the scores, we dichotomized the responses: experience of being a target (0 = no experience, 1 = experience of being bullied for any type) and experience of being a witness (0 = no experience, 1 = experience of witnessing any type of bullying).

Mental health.

The status of mental health was indexed by depressive symptoms and anxiety. The Patient Health Questionnaire-9 (PHQ-9; Kroenke et al., 2001) was selected for depressive symptoms. As a depression module for the PHQ (Spitzer et al., 1999), the PHQ-9 contains nine items based on the DSM-IV diagnosis of depressive disorders. Participants were asked to report how often, over the past 2 weeks, they had been bothered by problems such as “little interest or pleasure in doing things,” “feeling down, depressed or hopeless,” and “poor appetite or overeating.” Each item was scored on a 4-point scale ranging from 0 (not at all) to 3 (nearly every day); total scores could thus range from 0 to 27, with higher scores indicating greater levels of depressive symptoms. The PHQ-9 has been used widely as a diagnostic and severity measure in various settings and with diverse populations. The scale has been translated into the Korean language, and its psychometric properties have been validated (Han et al., 2008). Cronbach’s alpha for the scale in the present sample was .86.

Anxiety was measured with the General Anxiety Disorder-7 (GAD-7; Spitzer et al., 2006), a 7-item instrument for screening generalized anxiety disorder. Participants were asked to rate the frequency of disturbance caused by each symptom over the past 2 weeks. These symptoms included “feeling nervous, anxious or on edge,” “not being able to stop or control worrying,” “worrying too much about different things,” and “trouble relaxing.” Each response was rated on a 4-point scale ranging from 0 (never) to 3 (nearly every day); total scores could thus range from 0 to 21, with higher scores indicating greater anxiety. The Korean version of the scale has been validated (Ahn et al., 2019). Cronbach’s alpha for the scale in the present sample was .90.

Covariates.

Sociodemographic, immigration-related, health-related, and housing-related characteristics were considered as control variables. Sociodemographic characteristics included age (in years), gender (0 = male, 1 = female), marital status (0 = not married, 1 = married), education (0 = ≤ high school graduation, 1 = > high school graduation), and unmet financial needs (0 = no, 1 = yes). The length of stay in the U.S. (in years) and English proficiency (0 = not at all to 3 = very well) represented immigration-related variables. Health-related variables included chronic medical conditions, measured with a checklist of 10 chronic diseases and conditions common in the older adult population, and functional disability, measured with a composite list of basic and instrumental activities of daily living (Fillenbaum, 1988). The latter included 16 activities (e.g., walking, bathing, dressing, managing medication), and participants indicated how well they could perform each activity. Responses were coded as 0 (without help), 1 (with some help), or 2 (unable to do). Scores were summed across items (range = 0–32), with higher scores indicating more severe functional disability. Cronbach’s alpha for the scale was .90. Housing-related variables included the facility of residence (six participating facilities) and the length of residence in the facility (in years).

Analytic Strategy

After reviewing the descriptive statistics, we examined bivariate correlations among study variables. Given the nested nature of the data (i.e., residents under housing facilities), we also examined intraclass correlation coefficients (ICCs) to determine the percentage of variance in outcome measures attributed to the facility level. Multilevel modeling is recommended when ICC exceeds .05 (Hox et al., 2017); our ICCs for both depressive symptoms and anxiety were low (ICCs < .02), so we conducted regression analyses instead of multilevel modeling and included housing facilities as a covariate. Because depressive symptoms and anxiety are highly correlated but distinct, we estimated a separate regression model for each outcome measure. Similarly, we separately tested the two experiences of bullying (being a target and being a witness) for their independent effects on mental health outcomes. In all models, the sets of covariates were controlled. Analyses were performed using SPSS Statistics 28 (IBM Corp., Armonk, NY).

Results

Descriptive Characteristics of the Sample

Table 1 summarizes the sample’s descriptive characteristics. The participants’ mean age was 79.4 years (SD = 6.66; range = 65–102). Over 73% were female, 39% married, and 36% with more than a high school education. One third of the sample reported that their financial needs were unmet. All were foreign-born, and their length of stay in the U.S. averaged 32.5 years (SD = 10.9). Their mean English proficiency was 0.79 (SD = 0.64). On average, participants had 1.79 chronic medical conditions (SD = 1.16), and their functional disability scores averaged 3.78 (SD = 4.73). Six housing facilities were included in the study, and the residents of each facility represented 13%–21% of the sample. Their years of residence in the facilities averaged 9.50 (SD = 7.22).

Table 1.

Descriptive Characteristics of the Sample (N = 343)

% M ± SD
Age 79.4 ± 6.66
Gender
 Male 26.8
 Female 73.2
Marital status
 Not married 60.9
 Married 39.1
Education
 ≤ high school graduation 64.3
 > high school graduation 35.7
Perceived financial status
 Needs met 67.0
 Needs unmet 33.0
Years in the U.S. 32.5 ± 10.9
English proficiency 0.79 ± 0.64
Chronic medical conditions 1.79 ± 1.16
Functional disability 3.78 ± 4.73
Housing facility
 A 20.7
 B 19.5
 C 16.6
 D 15.5
 E 14.6
 F 13.1
Years of residence in the facility 9.50 ± 7.22
Experience of being bullied
 Verbal type 17.0
 Physical type 1.2
 Antisocial type 5.6
 Any type1 17.5
Experience of witnessing someone being bullied
 Verbal type 28.9
 Physical type 8.8
 Antisocial type 16.4
 Any type1 31.3
Depressive symptoms 5.69 ± 4.63
Anxiety 3.38 ± 3.76
Open in a new tab
1

Variable used in bivariate and multivariate analyses

Seventeen percent of the participants reported having been a target of verbal bullying; 1.2%, of physical bullying; and 5.6%, of antisocial bullying. About 29% reported that they had witnessed verbal bullying of another person; 8.8%, physical bullying; and 16%, antisocial bullying. About 18% had been a target of any type of bullying, and over 31% had witnessed bullying of any type. Roughly 13% of the sample had encountered both being a target and being a witness. The scores for depressive symptoms and anxiety averaged 5.69 (SD = 4.63) and 3.38 (SD = 3.76), respectively.

Bivariate Correlations Among Study Variables

Table 2 presents associations among study variables. The personal experience of being bullied was more likely among younger residents. Those who had fewer chronic medical conditions and who had lived longer in their facilities were more likely to witness other residents’ being bullied. Unmet financial needs were positively associated with both being a target and being a witness. The experiences of being a target and being a witness were positively associated with each other. The experience of being bullied was closely linked with higher levels of depressive symptoms and anxiety, whereas the experience of witnessing other residents being bullied was associated only with anxiety.

Table 2.

Correlations Among Study Variables

1 2 3 4 5 6 7 8 9 10 11 12 13
1. Age –
2. Female −.04 –
3. Married −.12* −.27*** –
4. > high school graduation −.09 −.26*** .20*** –
5. Unmet financial needs −.13* .07 −.07 −.10 –
6. Years in the U.S. .00 −.04 −.01 .08 −.03 –
7. English proficiency −.23*** −.12* .01 .31*** −.14* .29*** –
8. Chronic medical conditions .08 .12* −.13* −.19*** .11* −.01 −.13* –
9. Functional disability .34*** .08 −.07 −.11* .11* −.02 −.20*** .32*** –
10. Years of residence in the facility .47*** .09 −.06 −.09 .01 .07 −.14** .12* .22*** –
11. Experience of being bullied −.12* .02 −.05 −.01 .13* −.07 .04 .00 .07 .06 –
12. Experience of witnessing someone being bullied −.08 .08 .03 .07 .12* −.02 .06 −.11* .01 .12* .42*** –
13. Depressive symptoms .15** .00 −.07 −.11* .12* −.07 −.09 .24*** .46*** .03 .14** .05 –
14. Anxiety .05 .01 −.07 −.12* .11* −.04 −.09 .29*** .35*** −.01 .19*** .12* .75*** –
Open in a new tab
*

p < .05

**

p < .01.

***

p < .001.

Multivariate Regression Models of Depressive Symptoms and Anxiety

Table 3 presents the effect of experiences of bullying on mental health with respect to two separate independent variables (being a target and being a witness) and dependent variables (depressive symptoms and anxiety). The experience of being bullied was a significant predictor of both outcomes; being a target was a significant predictor for depressive symptoms (β = .13, p < .01) and anxiety (β = .19, p < .001). On the other hand, the experience of witnessing other residents being bullied was a significant predictor only for anxiety (β = .17, p < .001) and not for depressive symptoms (β = .09, p > .05). Among covariates, chronic medical conditions and functional disability were closely linked to both measures of mental health. A difference in residents’ mental health was observed between the two facilities with the largest numbers of study participants. The predictive models accounted for 24%–30% of the variance of depressive symptoms and anxiety.

Table 3.

Regression Models of Depressive Symptoms and Anxiety

Standardized Regression Coefficient (β)
Depressive Symptoms Anxiety
Experience of being bullied .13** — .19*** —
Experience of witnessing someone being bullied — .09 — .17***
Covariate
 Age .05 .04 −.01 −.02
 Gender (female) −.05 −.07 −.08 −.10
 Marital status (married) .01 .01 −.01 −.04
 Education (> high school graduation) −.03 −.04 −.05 −.06
 Unmet financial needs (yes) .05 .04 .02 .01
 Years in the U.S. −.04 −.04 .03 .02
 English proficiency .03 .04 −.04 −.03
 Chronic medical conditions .12* .12* .20*** .22***
 Functional disability .44*** .44*** .32*** .33***
 Housing facility (reference = A)
   B −.18** −.18** −.13* −.12*
   C −.05 −.05 .00 .00
   D −.04 −.05 −.03 −.04
   E −.07 −.07 .01 .02
   F .03 .04 .04 .05
 Years of residence in the facility −.11 −.10 −.11 −.11
 R2 .30*** .29*** .25*** .24***
Open in a new tab
*

p < .05

**

p < .01.

***

p < .001.

Discussion

In response to the significance of peer bullying in senior housing (Bonifas, 2016; Goodridge et al., 2017; Lachs et al., 2016; Ruiz-Esteban et al., 2023) and its particular impact on older ethnic immigrants (Guo & Stensland, 2018; Jang et al., 2015; Park et al., 2023), we have focused on bullying by ethnic peers among older Korean American residents in ethnically concentrated subsidized housing facilities in the greater Los Angeles area. Considering both experiences of being a target and of being a witness, we explored the prevalence of the experience of bullying and its impact on mental health. Previous studies of subsidized senior housing have reported low levels of residents’ health and well-being, attributed mostly to their limited personal resources (Jeste et al., 2019; Park et al., 2020; Taylor et al., 2018). Moving beyond the literature and taking the communal nature of senior housing into consideration, we conceptualized negative social interactions among residents of the same ethnic background as a potential risk factor for residents’ mental health, and we found supportive evidence.

In line with studies that have reported mental health challenges for senior housing residents (Jeste et al., 2019; Park et al., 2020; Taylor et al., 2018), the present sample demonstrated high levels of depressive symptoms and anxiety. When suggested cut-offs were applied, a considerable proportion of the sample fell into the categories of moderate to severe depression (18.2%) and anxiety (6.2%), and these rates are higher than those of the general U.S. older population (8% and 4.1%, respectively; Brody et al., 2018; Terlizzi & Villarroel, 2020). Although types of bullying varied, about 18% of the sample had been a target and over 31% had witnessed other residents’ being bullied in at least one way. In both cases, verbal bullying was most common, followed by antisocial behaviors and physical violence, and this pattern is consistent with the findings of other studies on senior bullying (e.g., Bonifas, 2016; Goodridge et al., 2017; Lachs et al., 2016). The fact that the rate of witnessing is greater than that of being a target suggests a potential under-reporting of personal experiences of being bullied.

Our multivariate models demonstrated that the experience of being a target of bullying indicated a significant risk for both depressive symptoms and anxiety. Being a witness of bullying was closely associated with anxiety but had no significant impact on depressive symptoms. Although one may not be directly involved, being in a hostile environment where peer bullying occurs can still make older residents nervous and anxious. This finding is in line with literature suggesting a critical role of interpersonal relationships in relation to anxiety (Eng & Heimberg, 2006). Overall, our findings demonstrate that bullying by ethnic peers in senior housing is not uncommon, and that the experiences of being a target and of being a witness exert negative impacts on mental health. Challenging the resource-oriented notion of ethnic peers in immigrant populations (Tajfel & Turner, 2004), our study calls attention to the potential harm caused by negative interactions within ethnic communities and among peer residents. Our findings corroborate previous studies that have shed light on varied functions of ethnic communities for older Asian Americans (Guo & Stensland, 2018; Jang et al., 2015; Park et al., 2023). It seems that socioeconomic and linguistic disadvantages, coupled with limited options for affordable, culturally and linguistically appropriate alternative housing, make residents more susceptible to the impact of bullying on their mental health. Such negative interactions among ethnic peers can diminish one’s sense of belonging and cultural identity, leading to impaired mental well-being.

Several limitations to the present study should be noted. First, our cross-sectional design and nonprobability sampling limit the ability to draw causal inferences and generalize our findings to a larger context. Although we conceptualized bullying as a predictor of mental health, it is also plausible that mental health issues of residents might serve as a cause for being bullied. Despite our research team’s recruitment efforts (e.g., surveys at housing facilities, assistance from bilingual and bicultural research personnel), those who were homebound and socially disconnected might have been excluded. Due to the sensitive nature of interpersonal relationships and cultural hesitancy in disclosing personal matters among Asian Americans (Chen & Danish, 2010), the prevalence of bullying reported in the present study could be an underestimation. Given this response bias, future studies should employ mixed methods involving not only residents but also housing staff and residents’ family members. Moving beyond the current scope of the assessment limited to residents’ personal attributes and characteristics, future studies should consider interpersonal resources, such as family networks and support from housing staff, as they may intervene or mitigate the situations and experiences associated with peer bullying. In addition, it is important to address the behavioral changes in individuals who engage in bullying behavior.

Nevertheless, despite these limitations, our findings provide implications for future research and program development regarding peer bullying in senior housing among older ethnic minorities with socioeconomic and linguistic vulnerabilities. Given that ethnic community members within senior housing can serve as a critical source of social and emotional support but also as a mental health risk through negative interactions such as bullying, further research is warranted to investigate the mechanisms through which bullying occurs and how it impacts older senior housing residents’ mental health and well-being. In addition, the variations in residents’ mental health observed across different sites in this study suggests a need for examining the effect of organizational characteristics on peer bullying. With respect to practice implications, our findings regarding the prevalence and the adverse mental health impact of bullying call for action among service providers and administrators in senior housing. Because the experiences of being a target and of being a witness exert a negative impact on mental health, it is critical for service providers and administrators in senior housing to ensure a safe living environment for their residents. Effective programs (e.g., awareness program, bystander education, and assertive communication training) to promote healthy interpersonal relationships and to raise awareness of bullying need to be developed. Efforts to promote inclusive and respectful cultures and environment should incorporate cultural and linguistic appropriateness. For example, given the cultural hesitancy in disclosing personal matters as well as socioeconomic and linguistic limitations among ethnic minority older adults, providing open communication channels for residents to voice their concerns when they experience or witness bullying would be important.

Acknowledgements:

Data collection was supported by a grant from the National Institute of Dental and Craniofacial Research (R21DE029579, PI: Yuri Jang, PhD). The study was partially supported by the National Research Foundation of Korea (NRF-2020S1A5C2A03092919).

References

  1. Ahn J-K, Kim Y, & Choi K-H (2019). The psychometric properties and clinical utility of the Korean version of GAD-7 and GAD-2. Frontiers in Psychiatry, 10, Article 127. 10.3389/fpsyt.2019.00127 [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Andresen FJ, & Buchanan JA (2017). Bullying in senior living facilities: Perspectives of long-term care staff. Journal of Gerontological Nursing, 43(7), 34–41. 10.3928/00989134-20170126-01 [DOI] [PubMed] [Google Scholar]
  3. Bonifas RP (2016). Bullying among older adults: How to recognize and address an unseen epidemic. Health Professions Press. [Google Scholar]
  4. Brody DJ, Pratt LA, & Hughes JP (2018, February). Prevalence of depression among adults aged 20 and over: United States, 2013–2016 (Data Brief No. 303). Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/data/databriefs/db303.pdf [PubMed] [Google Scholar]
  5. Budiman A, & Ruiz NG (2021, April 29). Key facts about Asian origin groups in the U.S. Pew Research Center. https://www.pewresearch.org/fact-tank/2021/04/29/key-facts-about-asian-origin-groups-in-the-u-s [Google Scholar]
  6. Chen JC, & Danish SJ (2010). Acculturation, distress disclosure, and emotional self-disclosure within Asian populations. Asian American Journal of Psychology, 1(3), 200–211. 10.1037/a0020943 [DOI] [Google Scholar]
  7. Eng W, & Heimberg RG (2006). Interpersonal correlates of generalized anxiety disorder: Self versus other perception. Journal of Anxiety Disorders, 20(3), 380–387. 10.1016/j.janxdis.2005.02.005 [DOI] [PubMed] [Google Scholar]
  8. Esterline C, & Batalova J (2022, April 14). Korean immigrants in the United States. Migration Policy Institute. https://www.migrationpolicy.org/article/korean-immigrants-united-states [Google Scholar]
  9. Fillenbaum GG (1988). Multidimensional functional assessment of older adults: The Duke Older Americans Resources and Services procedures. Lawrence Erlbaum. 10.4324/9780203771563 [DOI] [Google Scholar]
  10. Folstein MF, Folstein SE, & McHugh PR (1975). “Mini-Mental State”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198. 10.1016/0022-3956(75)90026-6 [DOI] [PubMed] [Google Scholar]
  11. Goodridge D, Heal-Salahub J, PausJenssen E, James G, & Lidington J (2017). Peer bullying in seniors’ subsidised apartment communities in Saskatoon, Canada: Participatory research. Health and Social Care in the Community, 25(4), 1439–1447. 10.1111/hsc.12444 [DOI] [PubMed] [Google Scholar]
  12. Guo M, & Stensland M (2018). A systematic review of correlates of depression among older Chinese and Korean immigrants: What we know and do not know. Aging & Mental Health, 22(12), 1535–1547. 10.1080/13607863.2017.1383971 [DOI] [PubMed] [Google Scholar]
  13. Han C, Jo SA, Kwak J-H, Pae C-U, Steffens D, Jo I, & Park MH (2008). Validation of the Patient Health Questionnaire-9 Korean version in the elderly population: The Ansan Geriatric study. Comprehensive Psychiatry, 49(2), 218–223. 10.1016/j.comppsych.2007.08.006 [DOI] [PubMed] [Google Scholar]
  14. Hox JJ, Moerbeek M, & van de Schoot R (2017). Multilevel analysis: Techniques and applications (3rd ed.). Routledge. [Google Scholar]
  15. Jang Y, Park NS, Chiriboga DA, Yoon H, An S, & Kim MT (2015). Social capital in ethnic communities and mental health: A study of older Korean immigrants. Journal of Cross-Cultural Gerontology, 30(2), 131–141. 10.1007/s10823-015-9258-9 [DOI] [PubMed] [Google Scholar]
  16. Jeffries H, Slovak K, & Huston S (2018). Measuring and addressing elderly bullying in a senior residential community. The Journal of Sociology and Social Welfare, 45(3), 141–161. 10.15453/0191-5096.4219 [DOI] [Google Scholar]
  17. Jeste DV, Glorioso D, Lee EE, Daly R, Graham S, Liu J, Paredes AM, Nebeker C, Tu XM, Twamley EW, Van Patten R, Yamada Y, Depp C, & Kim H-C (2019). Study of independent living residents of a continuing care senior housing community: Sociodemographic and clinical associations of cognitive, physical, and mental health. The American Journal of Geriatric Psychiatry, 27(9), 895–907. 10.1016/j.jagp.2019.04.002 [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Kroenke K, Spitzer RL, & Williams JBW (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. 10.1046/j.1525-1497.2001.016009606.x [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Lachs MS, Teresi JA, Ramirez M, van Haitsma K, Silver S, Eimicke JP, Boratgis G, Sukha G, Kong J, Besas AM, Luna MR, & Pillemer KA (2016). The prevalence of resident-to-resident elder mistreatment in nursing homes. Annals of Internal Medicine, 165(4), 229–236. 10.7326/M15-1209 [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Luxenberg H, Limber SP, & Olweus D (2019). Bullying in U.S. schools: 2019 status report. Hazelden Publishing. https://olweus.sites.clemson.edu/documents/Status%20Report_2019.pdf [Google Scholar]
  21. Park J, Aranda MP, Choi YJ, & Jang Y (2023). The role of ethnic community social capital in the association between acculturation and psychological distress among older Korean Americans. Journal of Immigrant and Minority Health, 25(3), 608–615. 10.1007/s10903-022-01426-5 [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Park S, Kim B, Kwon E, & Kown G (2020). Influence of senior housing types on cognitive decline and nursing home admission among lower-income older adults. Aging & Mental Health, 24(10), 1579–1588. 10.1080/13607863.2019.1650888 [DOI] [PubMed] [Google Scholar]
  23. Rayner C, & Keashly L (2005). Bullying at work: A perspective from Britain and North America. In Fox S & Spector PE (Eds.), Counterproductive work behavior: Investigations of actors and targets (pp. 271–296). American Psychological Association. 10.1037/10893-011 [DOI] [Google Scholar]
  24. Ruiz-Esteban C, Méndez I, Martínez-Ramón JP, & García-Munuera IM (2023). The elderly as victims and perpetrators of bullying, anger, and aggression. In Martin CR, Preedy VR, & Patel VB (Eds.), Handbook of anger, aggression, and violence. Springer; Cham. 10.1007/978-3-030-98711-4_170-1 [DOI] [Google Scholar]
  25. Spitzer RL, Kroenke K, Williams JBW, & Löwe B (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. 10.1001/archinte.166.10.1092 [DOI] [PubMed] [Google Scholar]
  26. Spitzer RL, Kroenke K, Williams JB, & the Patient Health Questionnaire Primary Care Study Group. (1999). Validation and utility of a self-report version of PRIME-MD: The PHQ primary care study. Journal of the American Medical Association, 282(18), 1737–1744. 10.1001/jama.282.18.1737 [DOI] [PubMed] [Google Scholar]
  27. Tajfel H, & Turner JC (2004). The social identity theory of intergroup behavior. In Jost JT & Sidanius J (Eds.), Political psychology: Key readings (pp. 276–293). Psychology Press. 10.4324/9780203505984 [DOI] [Google Scholar]
  28. Taylor HO, Wang Y, & Morrow-Howell N (2018). Loneliness in senior housing communities. Journal of Gerontological Social Work, 61(6), 623–639. 10.1080/01634372.2018.1478352 [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Terlizzi EP, & Villarroel MA (2020, September). Symptoms of Generalized Anxiety Disorder Among Adults: United States, 2019 (NCHS Data Brief No. 378). Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/data/databriefs/db378-H.pdf [PubMed] [Google Scholar]
  30. U.S. Department of Housing and Urban Development. (2024). Information for senior citizens. https://www.hud.gov/topics/information_for_senior_citizens

RESOURCES