Abstract
Problem
The purpose of this study was to describe Korean American adolescents’ (KAAs’) and their parents’ perceptions of KAAs’ experiences with acculturative stress and to examine the congruity between their perceptions.
Method
This study used the qualitative descriptive method. Twenty KAAs aged 11 to 14 years and their 21 parents participated in in-depth, face-to-face interviews.
Findings
Qualitative content analysis revealed that KAAs and their parents reported similar views regarding acculturative stress experienced by KAAs: peer relationships, being treated differently or unfairly, pressure to excel academically and be successful, and strained parentchild relationships.
Conclusion
Culturally and developmentally relevant interventions focusing on strengthening peer relationships and parent-child relationships are needed for this population.
Search Terms
Korean American adolescents, parents, perceptions of acculturative stress
Keywords: Korean American adolescents, parents, perceptions of acculturative stress
According to the limited data on Korean American adolescents’ (KAAs’) mental health, compared with Chinese- and Japanese-American adolescents, KAAs reported considerably higher scores on the Symptoms Checklist-90-Revised (SCL-90-R), a measure of a wide range of mental health symptoms such as depression, anxiety, hostility, and somatization (Yeh, 2003). Also, KAAs demonstrated significantly higher levels of depression and lower levels of selfesteem, coping, and mastery than whites (Choi, Stafford, Meininger, Roberts, & Smith, 2002). Acculturative stress is known to be a significant predictor for these mental health problems (Choi, Meininger, & Roberts, 2006; Kang, 1996; Yeh, 2003).
According to the Model of Acculturative Stress, Depression, and Suicidal Ideation (Hovey & King, 1997), accumulated and unresolved acculturative stress may lead to depression and even suicide. In previous studies, acculturative stress was found to be closely related to undesirable mental health outcomes such as substance abuse, depression, and suicidal ideation (Choi, et al., 2006; Gil, Wagner, & Vega, 2000; Noh & Kaspar, 2003; Yearwood, Crawford, Kelly, & Moreno, 2007). People can experience acculturative stress when adjusting to new or dominant culture as well as when they perceive discrimination (Chavez, Moran, Reid, & Lopez, 1997). Thus, acculturative stress can reflect “one kind of stress, that in which the stressors are identified as having their source in the process of acculturation, often resulting in a particular set of stress behaviors that include anxiety, depression, feelings of marginality and alienation, heightened psychosomatic symptoms, and identity confusion” (William & Berry, 1991, p. 634) or a more chronic long-term stressor related to perceived discrimination. Acculturative stress is thus relevant to the U.S.-born immigrants as well as recent immigrants.
For KAAs, acculturative stress was positively associated with anxiety, anger, depression, obsessive-compulsiveness, and suicidal ideation (Kang, 1996; Yeh, 2003). Despite the identified mental health problems among KAAs and known correlations between acculturative stress and mental health problems, only a limited number of studies have explored their perceptions of acculturative stress. Among a limited number of qualitative studies that explored KAAs’ perceptions of acculturative stress, none interviewed both KAAs and their parents. Current qualitative studies interviewed only parents (Yang & Rettig, 2003), adolescents (Yeh, et al., in press), or young adults using the retrospective method (Kim, 2004).
The traditional Korean family structure requires Korean children to be obedient to their parents and to conform to the family rules. However, as Korean children adjust to new societal and cultural expectations in the U.S., this traditional family structure and the relationships within the family structure tend to be modified (Kim, 2004; Um & Dancy, 1999). Children, who acquire new language and culture faster than their parents, become independent and begin to take on more responsibilities as translators and cultural brokers for their parents (Choi, 2001). In contrast, parents feel powerless due to language and cultural barriers and their limited access to mainstream society. These changes in family structure and the relationships often create conflicts between parents and children (Kim, 2004; Um & Dancy, 1999). Family conflict was significantly related to increases in internalizing problems among KAAs, such as somatic complaints, withdrawal, and anxious/depressed mood (Cho & Bae, 2005).
In order to provide culturally and developmentally relevant mental health assessment and care for KAAs, it is necessary to understand both KAAs’ and their parents’ perceptions of acculturative stress experienced by KAAs (National Institute of Mental Health [NIMH], 2001; Smedley, Stith, & Nelson, 2001). Qualitative studies using in-depth interviews would allow a more dynamic and multidimensional understanding regarding KAAs’ experiences with acculturative stress (Berry, Poortinga, Segall, & Dasen, 1992; Oetting & Beauvais, 1990–91).
Purpose
The purpose of this qualitative descriptive study was to describe KAAs’ and their parents’ perceptions of acculturative stress that KAAs experience while living in the U.S. Adolescence (11 to 20 years) can be subdivided into early or young adolescence (ages 10 to 13 or 14), middle adolescence (ages 14 or 15 to 18), and late adolescence (ages 18 to mid 20s) (Berk, 2008; Elliott & Feldman, 1990; Lewinsohn, Rohde, & Seeley, 1998). The early adolescent stage, ages 11–14, was chosen since this stage is critical in the adolescent’s cognitive and psychosocial development which is closely associated with an adolescent’s mental health (Steinberg, 2007). In addition, previous studies have found that risks for experiencing mental health problems increase as adolescents age and as they stay longer in the U.S. (Cho & Bae, 2005; Szalacha, Coll, Alarcón, Fields, & Ceder, 2003). Thus, it is imperative to explore young adolescents’ perceptions of acculturative stress and identify sources of stress that threaten their mental health. To provide a fuller picture of KAAs’ experiences with acculturative stress, parents were also included in this study. This study is unique in that both KAAs and their parents provided their perceptions of KAAs’ experiences with acculturative stress. The research questions for the study are as follows:
What are KAAs’ and their parents’ perceptions of KAAs’ experiences with acculturative stress?
What are the differences and similarities between KAAs’ and their parents’ perceptions?
Methods
Research Design
This cross-sectional study used the qualitative descriptive method (Sandelowski, 2000) to describe KAAs’ and their parents’ perceptions of KAAs’ experiences with acculturative stress. The qualitative descriptive method seeks to describe events, facts, and meanings given to the events with the least interpretation. Compared to grounded theory, phenomenology, and ethnography, this method is “relatively unacknowledged,” (Sandelowski, 2000, p.335); however, it is useful when existing theories or literature findings on a specific phenomenon are limited. Whereas “phenomenologic, grounded theory, and ethnographic studies are not exclusively in the descriptive domain,” qualitative description method “offer[s] a comprehensive descriptive summary of an event in the everyday terms of those events” (Sandelowski, 2000, p. 336). From a perspective of naturalistic inquiry, this method allows comprehensive understanding of an event or experiences. This study design was selected to capture KAAs’ and their parents’ perceptions of KAAs’ experiences with acculturative stress and thus to gain a comprehensive understanding of their experiences of it.
Sample and Setting
The target population for this study was KAAs aged 11 to 14 years and their parents, all of whom resided in the Chicago metropolitan area. KAAs and their parents who met the inclusion criteria were invited to participate. Inclusion criteria for KAAs and their parents required them to (1) self-identify as KA, (2) be born in Korea or U.S., (3) to currently live in the U.S., and (4) be willing to participate. In addition, KAAs had to be between 11 and 14 years old and currently live with at least one of their parents to participate in the study. Adolescents and parents who did not meet the inclusion criteria were excluded from the study. Twenty parentadolescent pairs were recruited through convenience sampling and snowball sampling strategies.
Korean churches served as the setting because churches are the best institution through which to reach the KA community (Kim, Kim, & Rue, 1997). Up to 70 % of KAs attend church, and churches have served not only to meet their religious needs but also to meet their social and cultural needs (Kim, et al., 1997). There are about 40 Korean churches that are comprised of 100 or more church members in the Chicago metropolitan area. Among these 40 churches, only 10 churches have more than 300 church members. To achieve geographical diversity of the sample, the investigator selected two churches from the city of Chicago and two churches from the Chicago suburbs. The four churches were selected because they have the largest youth ministries. The pastors of all four churches that the investigator approached agreed to participate in the study.
Instruments
The data were collected through in-depth, face-to-face, separate individual interviews with KAAs and their parents. The four instruments used in this study were developed by the investigators: the parent interview guide, the adolescent interview guide, the parent demographic questionnaire, and the adolescent demographic questionnaire. Both interview guides were semi-structured and elicited KAAs’ and their parents’ perceptions of KAAs’ experiences with acculturative stress and the meaning and relevancy of the experiences to their personal goals. The adolescent interview guide asked KAAs to describe stressful experiences they had encountered with families, friends, and school. The parent interview guide asked parents to share their perceptions of their child’s stressful experiences in relation to families, friends, and school. Some of the questions in the adolescent interview guide were adapted from previous studies on Asian Americans’ experiences related to family and school (Yeh, et al., in press; Yeh & Hough, 1997). Both interview guides consist of 15 core questions and probe questions.
The parent demographic questionnaire gathered the following information from parents: age, level of education, income, and language used. The adolescent demographic questionnaire elicited the following information: age, school grades, socioeconomic status, and language used.
Procedure
After the University of Illinois at Chicago Office for the Protection of Research Subjects approved the study, the investigator contacted the pastors of the selected Korean churches. Prospective participants were recruited from four Korean churches in the Chicago metropolitan area. With the pastors’ permission, the investigator began recruitment of prospective research participants. The investigator announced the research study during youth services at the selected churches. Those KAAs who were interested in the research project were given a flier that contained information about the research project and the investigator’s telephone numbers. The flier instructed parents to call the investigator if they were willing to participate and have their child participate in the research project. Besides recruiting participants through the Korean churches, the investigator also used a snowball sampling strategy. At the end of each interview, participants were asked if they could nominate prospective participants for the interviews.
Prior to each interview, consent and parental permission were obtained from the parents and assents were obtained from the adolescents. Three bilingual and bicultural interviewers conducted the interviews. Before the first interview, the three interviewers had a meeting to review purposes of the study, interview skills, and ethnical considerations. During the data collection period, they had regular meetings to evaluate the interview process and discuss any emerging issues. Interviews were performed either in English or Korean, depending on the preference of research participants. Six out of 20 adolescents and all 21 parents chose to be interviewed in Korean. Interviews were conducted at research participants’ homes or other agreed-upon, convenient places. Adolescents and parents were interviewed separately and privately. Individual interviews lasted 30 to 70 minutes. Incentives were given to parents ($20 per parent) and adolescents ($10 per adolescent) for their participation. All interviews were audio-taped.
Data Analysis
Audiotaped interviews in English were transcribed in English, whereas audiotaped interviews in Korean were transcribed in Korean. Accuracy of all transcriptions was assured by two research assistants independently comparing the transcripts to the original audiotapes. There was no disagreement between the two research assistants. The 27 Korean transcripts were then translated into English. The quality of the translation was assured through the following steps: First, a bilingual and bicultural translator translated the transcripts from Korean to English, and then an independent reviewer checked for accuracy and consistency of the translation. Finally, the original interviewer and an adjudicator reviewed the translated English transcripts with the original Korean transcripts and determined the accuracy and appropriateness of the translated version (Harkness, Van de Vijver, & Mohler, 2003).
Conventional content analysis was selected as the main analysis method for this study. Content analysis, a strategy that extracts core themes, is the most commonly used data analysis method in qualitative studies (Sandelowski, 2000). Conventional content analysis is commonly used when the main goal of the study is to describe a phenomenon (Hsieh & Shannon, 2005). This analysis method allows investigators to obtain direct and unique perspectives from the research participants without the influences of predefined theoretical perspectives.
To analyze the data, first, the principal investigator and a research team member coded the transcripts independently. The inter-rater reliability between the principal investigator and the research team member was 88%. The inter-rater reliability was determined by the agreed proportion between the two researchers. Any differences in the coding were discussed in a team meeting and resolved by clarifying the definitions of the codes and/or by adding new codes. After the team meetings, the inter-rater reliability increased to 96%. After coding the data, the research team members developed matrices to look for patterns or regularities in the data (Bernard, 2000; Patton, 2002). Based on core interview questions, we created a matrix with rows and columns. The matrix rows and columns represented descriptive codes and the person who was interviewed, respectively. Separate columns were created for father, mother, and child. Then, raw data were sorted by informant and code. The matrices provided a descriptive summary of the patterns emerging from the data (Bernard, 2000). A matrix created for each parent-child dyad allowed us to examine congruities between the parents’ data and adolescents’ data. By using the matrix, the investigators were able to identify words or themes that repeatedly appear in a dataset. Based on the matrices, main themes were identified.
Findings
Sample Characteristics
A convenient sampling of 20 parent-adolescent pairs participated in this study: 20 adolescents (10 boys and 10 girls) and 21 parents (18 mothers and 3 fathers). Two pairs of brothers were included in the sample of 20 adolescents. The mean age for the KAAs was 12.7 years (SD = 0.99). Ten out of the 20 adolescents were born in Korea and their mean length of stay in the U.S. was 4.3 years (range 1 year to 8 years). The rest were born in the U.S. Fifty-five percent of KAAs reported that their school grades were above average, and 75% reported that their family was financially about the same or better off than other families. Two adolescents were living with a single mother. All 21 parents were born in Korea, and more than 85% of the parents had finished undergraduate or graduate colleges in Korea. Among 21 parents, 10 parents (3 fathers and 7 mothers) were working full-time and 2 mothers were working part-time. About 81% of parents were between 41 and 50 years old.
KAAs’ Experiences with Acculturative Stress
Regarding acculturative stress for KAAs, both parents and adolescents reported that the main sources of stress for KAAs were peer relationships, being treated differently or unfairly, pressure to excel academically and be successful, and strained parent-child relationships.
Peer relationships
The majority of KAAs (n = 15) and their parents (n = 13) reported that KAAs experienced difficulties with peer relationships. Recent immigrants experienced difficulties in communicating with American friends due to their accent and/or limited English proficiency. Even after becoming proficient in English, KAAs reported that it was still hard for them to relate to American friends and blend in because of cultural differences. KAAs reported that they often felt “left out” or “weird” among American friends. They reasons they gave for forming exclusive friendships with other KAAs were “we connect better,” “feel affinity,” and “can’t help but get closer with friends of your own race.” Parents reported that their children tended to “limit their intimate relationships to Koreans only” and “keep friendships with Americans superficial.” However, even when KAAs desired friendships with American adolescents in order to “blend in,” they frequently had to choose between having Korean and American friends, which often limited their number of friends. One mother said:
“My daughter made many American friends when she first came here. But when she hung out with them, Korean friends didn’t talk to her…She said, ‘Making friends at school is the only way to adapt myself better.’ One day, she came home and told me Korean friends mocked her because she hung out with her American friends. Then she started hanging out with Korean friends. So now she doesn’t get to have American friends.”
Additionally, parents reported that they hindered their children from building diverse friendships. Parents felt uncomfortable in arranging play dates with friends’ parents or inviting children from different ethnic backgrounds to their houses because of cultural differences and the parents’ inability to communicate in English with American friends. One mother said:
“We parents don’t feel comfortable about it. I have to care about having a distinctive food smell in our house…They (children) are afraid of having their house smelling like authentic Korean food when their friends come over to visit. The kid next door tells my son, ‘Your mom always smells like Kimchi (Korean side dish).’ And my son doesn’t like hearing such things.”
Also, parents believed that the differences in cultural norms such as not allowing sleepovers or imposing strict curfews made it difficult for KAAs to blend in with their American peer groups. According to the parents, KAAs usually play with friends from diverse ethnic backgrounds during the elementary school years, and as they grow up, their friendships become limited to Asians and later to Koreans.
Being treated differently or unfairly
The KAAs (n = 11) and their parents (n = 10) reported that being treated differently or unfairly occurred in relationships with teachers and friends. They reported that they encountered teachers’ insensitive attitudes toward different cultures, experienced limited opportunities, and received unfair grades and punishment. A mother reported that her daughter was angry because the daughter’s teacher continued to be confused about the daughter’s identity, calling her daughter the wrong names even after the teacher spent a year with her daughter. One adolescent described an experience that she labeled as differential treatment:
“There was another Korean student in my class. My teacher always seated us together. Even though we wanted to study farther apart, the teacher always had us sit together. Students usually change seats every quarter but we always sat together…My teacher walks around every table. There were five tables. But she always came to our table last and left shortly.”
KAAs reported that they were teased for their accent and physical appearance, with terms such as “flat nose,” “pig snout,” “puny eyes,” and “yellow belly.” They also reported being excluded and ignored by American peers. One adolescent stated he would rather be harassed than completely ignored.
Pressure to excel academically and be successful
KAAs (n = 8) worried that their parents would become disappointed in them and reported that they tried to be “one of those kids an Asian mother would be proud of” and tried to be “perfect in every way.” It was not uncommon for KAAs to forego their favorite extracurricular activities or interaction with friends in order to do schoolwork. One adolescent perceived the expectation as a burden, as reflected in the following statement:
“I have too many activities. I have a math tutor, an English tutor, piano lessons, Korean school. You go to the tutor, you do homework for the tutor, and go to another tutor and more homework, it is like, homework, tutor, homework, tutor. It’s like endless.”
Parents (n = 9) admitted their parental pressure, and one parent said, “We blame our son when he falls short of our standards or expectations for him. I think he is harboring some anger but he never expresses it.”
Strained parent-child relationships
Adolescents described relationships with their parents as “growing apart” and “living in two different cultures, using different languages,” and they reported wanting to “stay close” to their parents. Both KAAs (n = 8) and their parents (n = 12) reported strained parent-child relationships. They reported that cultural incompatibility, inadequate communication skills, parents’ lack of knowledge of adolescence and the U.S. education system, strict parenting style, language barriers, and parents’ long work hours limited parent-child communication and hindered strong parent-child relationships.
Parents reported that relationships with their children “could not go deeper” because of language barriers and because Korean culture discourages verbal expression of emotions. A mother said that her children had never learned how to have conversation since her husband and she didn’t really have conversation and had not taught their children how to communicate. KAAs and their parents are unable to develop close parent-child relationships and are unlikely to communicate with each other about adolescents’ critical developmental issues, concerns, and school life. However, parents longed for a strong parent-child relationship. One mother said, “Mothers and children should be real close, like they were in the womb.”
Summary and Discussions
The study was designed to explore both KAAs’ and their parents’ perceptions of KAAs’ acculturative stress. Both parents and adolescents reported that the main stresses for KAAs were peer relationships, being treated differently or unfairly, pressure to excel academically and be successful, and strained parent-child relationships. This study is unique because parental perceptions were explored along with KAAs’ perceptions of their experiences with acculturative stress. Both the parents’ perceptions and the KAAs’ perceptions were congruent. Parents’ reports enhanced our understanding of KAAs’ experiences with acculturative stress and helped us to view KAAs’ experiences from a holistic perspective.
Overall, this study’s findings of KAAs’ and their parents’ perceptions of acculturative stress were similar to the findings in the previous studies (Kim, 2004; Lee & Koro-Ljungberg, 2007; Thomas & Choi, 2006; Yang & Rettig, 2003; Yeh, et al., in press). Regarding peer relationships, Asian adolescents, including KAAs, were found to experience higher levels of social isolation than White adolescents (Rhee, Chang, & Rhee, 2003). Beyond identifying exclusive friendships with KA peers, the present study revealed tensions that KAAs experienced while choosing between having Korean and American friends, which is a new finding that has not been discussed previously. In order for adolescents to develop social skills and to form a healthy self-concept, they need to establish stable peer relationships. Immigrant adolescents who proactively pursue friendships are more likely to have high self-esteem (Smokowski & Bacallao, 2007). KAAs who reported poor relationships with peers were found to be at higher risk for internalizing problems (Cho & Bae, 2005). Considering the exclusive friendships among KAAs, the impact of limiting friendships to only one ethnic group on their mental health would be an important area for future research. In addition, our data illustrated the significance of parental influence on adolescents’ peer relationships. Thus, it is important to educate parents about the importance of encouraging adolescents to build healthy peer relationship and their role in expanding their children’s social contacts across diverse ethnic groups.
The impact of being treated differently or unfairly will be enormous since early adolescence is a development stage in which adolescents establish their sense of self and selfesteem (Steinberg, 2007). Previously, perceived racial discrimination, one of the main sources of acculturative stress, was found to be a significant predictor for depression among Chinese American adolescents (Grossman & Liang, 2008) and for both internalizing and externalizing problems among KAAs (Shrake & Rhee, 2004). Racial discrimination was negatively associated with feelings of competence and positively with depression among Asian American adolescents (Han, 2006). In this study, the majority of KAAs and their parents expressed their concerns about negative consequences of racial discrimination.
Koreans value education highly and view academic achievement as a primary means of attaining social status. Obtaining admission to prestigious universities is regarded as the first step to success. This strong desire and obsession with education and parents’ ambition for education has been called “education fever” in Korea (Seth, 2002). Children’s academic success is the most honorable way to repay parents for all the sacrifice that parents have made. According to a crossnational study on activity among high school seniors (Lee & Larson, 2000), adolescents living in Korea spent 44% of their time on class work and homework, while White adolescents living in the U.S. spent only 19 % of their time on scholarly activities. According to Shrake (1998), 78% of KAAs reported that they are pressured to excel at school. These stressful experiences significantly impact an adolescent’s mental health development.
Due to cultural and language incompatibility, inadequate communication skills, and lack of knowledge of adolescence and the U.S education system, KAAs and their parents often experience inadequate parent-child communication that may create conflicts resulting in strain on the parent-child relationships (Cho & Bae, 2005; Kim, 2004; Kim & Hong, 2007; Sohn & Wang, 2006; Sue & Sue, 2003). Low levels of family cohesiveness and increased family conflicts were positively correlated with depression, aggression, and deviant behaviors among KAAs (Kim, Lee, Nguyen, & Kim, 2006). Immigrant adolescents who experience high levels of parent-child conflicts due to the acculturation discrepancy were more likely to experience depression, anxiety, and somatic symptoms (Smokowski & Bacallao, 2007; Ying & Han, 2007). More research on how inadequate communication and conflicts between KAAs and their parents affect these parent-child relationships is required.
While findings from these previous studies were limited to identifying parent-child conflicts or intergenerational conflicts (Yang & Rettig, 2003; Yeh & Inose, 2002), the present study revealed both adolescents’ and parents’ reciprocal desires for a strong parent-child relationship. Both KAAs and their parents perceived that their relationships were not deep or close enough. They also admitted their lack of knowledge and skills required to strengthen their relationships. Although parents were well aware of the main sources of stress that KAAs are exposed to, they were not convinced that they could support their children in the resolution of the stressors. Because immigrant adolescents with strong parental support were more likely to have high self-esteem, fewer psychological problems, and a better school life (Lane, Levitt, & Levitt, 2004), it is necessary to include KA parents in mental health promotion programs for KAAs. KA parents have not benefited from mainstream parenting classes due to language barriers and cultural incompatibility. When designing mental health promotion programs for KAAs and their parents, it is important to teach them effective communication skills consistent with the Korean cultural norms and unique communication patterns. Communication skills that are believed to be effective in Western culture may not work for this population due to their unique ways of expressing their emotions. Helping them identify areas for improvement in their communication patterns by showing vignettes reflecting real conversations and teaching them about the significance of nonverbal communication would help them to learn effective communication skills that they can apply in their daily lives.
The findings of the present study need to be interpreted with caution. This sample of KAAs and their parents was a convenient sample of parent-child pairs who had some degree of relationship allowing them to participate in this study. On the other hand, KAAs and their parents who are experiencing stressful parent-child interactions may not have volunteered to be in this study. Regardless of this limitation, this is the first study exploring both KAAs and their parents’ perceptions of acculturative stress. The present study demonstrated the importance of exploring both KAAs’ and their parents’ perceptions of their experiences. The comprehensive perspective that was obtained about their experiences will serve as a basis for providing culturally relevant health care services for KAAs and their parents.
Acknowledgment
This publication was made possible by Grant Number #T32 NR07964 from the National Institute of Nursing Research, National Institute of Health.
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