Immigration and Stress: The Relationship Between Parents' Acculturative Stress and Young Children's Anxiety Symptoms

Discussion and Limitations

The findings of the present study support the relation between parental acculturation related stress and symptoms of anxiety in the child. No difference was found between immigrant and non-immigrant children in symptoms of anxiety. Results also suggest that immigrant status in the parent moderates the relation between acculturative stress in the parent and symptoms of anxiety in the child, such that levels of acculturative stress in the parent predict higher levels of anxiety symptoms in the child, as expected, in immigrant families. Interestingly, a reverse correlation was found between acculturative stress in the parent and symptoms of anxiety in the child when observing non-immigrant families; acculturative stress in the parent predicted lower levels of child anxiety symptoms in non-immigrant families.

It was hypothesized that immigrant children would show significantly higher levels of anxiety symptoms than non-immigrant children. This prediction was not supported in the findings of the present study; no difference was found between the anxiety symptoms of immigrant and non-immigrant children. As all of the children in this study were under 6 years of age, this finding is consistent with the “immigrant paradox” that children who arrive to the U.S. before 13 years of age and non-immigrant children share similarly high levels of risk (Breslau et al., 2008). This is the only known study providing support for this paradox in preschool- and toddler- aged children.

The finding that non-immigrant families showed a negative relationship between acculturative stress in the parent and symptoms of anxiety in the child was unexpected. The majority of the immigrant group self-identified racially as Black/African American (61% of parents and 65% of children, as reported by parents). Therefore, it is possible that ethnicity may be a factor in parents’ acculturative stress and child anxiety. Previous literature with African American families in the U.S. indicates that protective factors for psychopathology exist for both parents and children. Possible explanations for why African American children may have shown decreased levels of anxiety symptoms include a strong relationship with the parent or an avoidant style of coping (Grant et al., 2000). In a study with urban, African American adolescents of low-income households, stress was positively associated with both internalizing and externalizing symptoms (Grant et al., 2000). However, an avoidant coping strategy buffered the effects of stress on externalizing symptoms for boys. Also, a strong father/child relationship served as a buffer for externalizing symptoms in boys and girls in this study. This may partially explain why non-immigrant parents reported decreased levels of anxiety symptoms in their children. Furthermore, the finding that a reverse relationship exists in non-immigrants suggests that acculturative stress experienced by non-immigrant parents impacts their children differently than acculturative stress experienced by immigrant parents; as observed in decreased child anxiety symptoms.

Even though parent acculturative stress was strongly associated with child anxiety symptoms, parent acculturative stress was not significantly associated with parent anxiety symptoms. This is an interesting finding because it was expected that parent acculturative stress would impact parent anxiety symptoms more directly than it would impact child anxiety symptoms. This finding may be explained by the way in which anxiety symptoms are measured in the BAI scale. The BAI scale places more focus on the psychosomatic symptoms of anxiety, which may make it difficult to relate to other mental health variables. It is possible that acculturative stress in the parent correlates with emotional and behavioral symptoms of anxiety, such as those measured in the BITSEA Anxiety Risk Subscale, but less so with the somatic symptoms of anxiety measured in the BAI scale. This finding suggests that although anxiety symptoms are evident in children of immigrant parents experiencing acculturative stress, anxiety symptoms are not necessarily evident in the parents themselves.

In the overall sample, the Acculturative Stress scale was primarily influenced by scores on the discrimination due to race item (“How much discrimination have you experienced due to race?”) and the discrimination due to language and/or ethnicity item (“How much discrimination have you experienced due to your language and/or ethnicity?”). The two items measuring the amount of discrimination experienced were more strongly correlated to the Acculturative Stress scale in non-immigrant parents than it was in immigrant parents. Non-immigrant parents’ scores on the item measuring the amount of discrimination due to race showed a stronger correlation with the Acculturative Stress scale (r = .80, p < .001; n = 62) than immigrant parents’ scores (r = .61, p < .001; n = 52). In the overall sample, the discrimination due to race item was strongly correlated with the Acculturative Stress scale (r = .58), much more than the discrimination due to language and/or ethnicity item and the level of English competency item were. This may explain why non-immigrant parents displayed high levels of acculturative stress. It is probable that higher scores of acculturative stress in non-immigrant parents was capturing African Americans’ stress due to racial discrimination. Previous literature indicates that individuals who identify as non-Hispanic black report significantly higher levels of perceived discrimination than those who identify as non-Hispanic white; including experiences such as not having been hired for a job and having been denied service (Kessler, Mickelson, & Williams, 1999). Higher levels of discrimination or related stress may decrease parent awareness of their children’s emotional functioning, which may explain the finding that non-immigrant parents experienced acculturative stress reported lower levels of child anxiety symptoms.

Findings from the present study should be considered with several limitations. The criterion for immigration status in children poses a limitation in generalizability. Immigration status in children was determined by the immigration status in their parents. Thus, children who were born in the U.S. but whose parents were born outside of the U.S. were classified as immigrants. The end result was a disproportionately large subgroup of second-generation immigrant children, collapsed into one group with first-generation immigrant children. Thus, the sample is more representative of second-generation immigrant children than it is of first-generation immigrant children.

All responses in the present study were based on parent reports. A limitation of relying on parental self-reports is that the accuracy of their responses may be biased due to poor recall of personal and child experiences, fear of disclosing information about themselves and/or their child, and culturally subjective perceptions of experiences and behaviors (Rapee, 2002). Other methods such as child observations and parent and child interviews reduce such biases and may have provided a more comprehensive measurement of acculturative stress and anxiety symptoms.

Additionally, the cross-sectional nature of the study limits the findings in various ways. Scores of acculturative stress in the parent and anxiety symptoms in the child were assessed at only one point in time. Thus, how these scores change over time is not taken into account. Using longitudinal design, for instance, would have demonstrated whether scores in parents and children change or remain constant over time. Obtaining data on the psychological outcomes of the immigrant parents and children in a follow-up study could potentially provide additional support for parent acculturative stress as a predictor of young children’s anxiety symptoms and shed light on whether acculturative stress experiences precede the development of symptoms.

The length of time that immigrant parents and children have resided in the U.S. was not taken into consideration in the present study. Obtaining the length of time that immigrant parents and children have resided in the U.S. would have provided an important measure of their degree of acculturation, or how acculturated the individual might be to U.S society and culture. The degree to which an individual acculturates has implications for their psychological outcomes and adjustment. Following Berry’s (1997) concepts of integration, assimilation, separation, and marginalization, higher levels of acculturation predict healthier psychological adjustment whereas lack of acculturation predicts psychopathology; mainly depression and anxiety. Therefore, using immigrant parents and children’s length of time in the U.S. as a variable in the Acculturative Stress scale might have been useful in predicting increased or decreased levels of acculturative stress and child anxiety symptoms. Furthermore, a negative correlation between the length of time that immigrant parents have resided in the U.S. and parent acculturative stress would have been consistent with the “immigrant paradox,” that immigrants who arrive to the U.S. at 13 years of age or later are at decreased risk for psychopathology (Breslau, 2008).

The findings of the present study have several implications for the study of risk factors for young children’s anxiety. Due to the strong association found between parent acculturative stress in the parent and child anxiety symptoms, acculturative stress in immigrant families should be further studied as a potential risk factor for anxiety in young children. Further research examining the anxiety of young children in this population at follow-ups in middle childhood, adolescence, and adulthood would provide crucial support for acculturative stress in the immigrant parent as a significant risk factor. Also, the finding that non-immigrants have a reverse relationship in parent acculturative stress and child anxiety symptoms should be studied further. Identifying factors that explain why higher stress levels in non-immigrant parents predict lower levels of child anxiety symptoms would help broaden our understanding of young children’s anxiety and prompt further studies examining risk factors for stress and anxiety in racial and ethnic subgroups in non-immigrant populations.

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Acknowledgements

I would like to thank my mentors, Nick Mian, Alice Carter, and Abbey Eisenhower, for providing an unconditional source of support and inspiration throughout the development of this project. I would also like to thank my seminar instructor, Tiffany Donaldson, and my lab cohort for their contributions to an outstanding research experience throughout this year-long project.

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References

Alegria, M., Canino, G., Shrout, P., Woo, M., Duan, N., Vila, D., Torres, M., Chen, C., Meng, X. (2008). Prevalence of mental illness in immigrant and non-immigrant U.S. latino groups. American Journal of Psychiatry 165, 359–369. Retrieved from http://ajp.psychiatryonline.org

Barret, P. M., Rapee, R. M., Dadds, M. M., & Ryan, S. M. (1996). Family enhancement of cognitive style in anxious and aggressive children. Journal of Abnormal Child Psychology, 24(2), 187-203.

Bean, F. D., & Tienda, M. (1987). The hispanic population of the united states. (p. 456). New York, NY: Russell Sage Foundation.

Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893-897.

Beiser, M., Barwick, C., Berry, J.W., da Costa, G., Fantino, A., Ganesan, S., Lee, C., Milne, W., Naidoo, J., Prince, R., Tousignant, M., & Vela, E. (1988). Mental health issues affecting immigrants and refugees. Ottawa: Health and Welfare Canada.

Berry, J. W. (1997). Immigration, acculturation, and adaptation. Applied Psychology: An International Review, 46(1), 5-68. Retrieved from http://www.unige.ch/international/etudageneve/gisp/prog/Readings/Akkari_Berry.pdf

Berry, J. W. (1998). Intercultural relations in plural societies. Canadian Psychology, 40(1), 12-21.

Berry, J. W. (2006). Acculturative stress. In T. Wong & G. Wong (Eds.), Handbook of multicultural perspectives on stress and coping (pp. 287-295). New York, NY: Springer.

Bittner, A., Egger, H. L., Erkanli, A., Costello, E. J., Foley, D. L., & Angold, A. (2007). What do childhood anxiety disorders predict?. Journal of Child Psychology and Psychiatry, 48(12), 1174-1183.

Breslau, J., Borges, G., Hagar, Y., Tancredi, D., & Gilman, S. (2008). Immigration to the usa and risk for mood and anxiety disorders: Variation by origin and age at immigration. Psychological Medicine, 39, 1117-1127.

Briggs-Gowan, M. J., & Carter, A. S. (2008). Social-emotional screening status in early childhood predicts elementary school outcomes. PEDIATRICS, 121(5), 957-962.

Burnam, M.A., Hough, R.L., Karno, M., Escobar, J.I., Telles, C.A. (1987). Acculturation and lifetime prevalence of psychiatric disorders among Mexican-Americans in Los Angeles.Journal of Health and Social Behavior 28, 89–102. Retrieved from http://www.jstor.org/stable/2137143.

Buss, K. (2011). Which fearful toddlers should we worry about? context, fear, regulation and anxiety risk. Developmental Psychology, 47(3), 804-819.

Caldwell-Harris, C. L., & Ayçiçegi, A. (2006). When personality and culture clash: The psychological distress of allocentrics in an individualist culture and idiocentrics in a collectivist culture . Transcultural Psychiatry, 43(3), 331-361. doi: 10.1177/1363461506066982

Conger, K. J., Reuter, M. A., & Conger, R. D. (2000). The role of economic pressure in the lives of parents and their adolescents: The family stress model. (pp. 201-223). Cambridge, UK: Cambridge University Press.

Collazos, F., Qureshi, A., Antonin, M., & Tomás-Sabádo, J. (2008). Acculturative stress and mental health in the immigrant population. Papeles del Psicólogo, 29(3), 307-315. Retrieved from http://www.cop.es/papeles

Copeland, W. E., Shanahan, L., Costello, E. J., & Angold, A. (2009). Childhood and adolescent psychiatric disorders as predictors of young adult disorders. Arch Gen Psychiatry, 66(7), 764-772.

De Feyter, J. J., & Winsler, A. (2009). The early developmental competencies and school readiness of low-income immigrant children: Influences of generation, race/ethnicity, and national origins. Early Childhood Research Quarterly.

De Las Fuentes, C. (2003). Latinos and mental health. In J. Mio & G. Iwamasa (Eds.), Culturally Diverse Mental Health (pp. 159-172). New York, NY: Brunner-Routledge.

Duru, E., & Poyrazli, S. (2007). Personality dimensions, psychosocial-demographic variables, and english competency in predicting level of acculturative stress among turkish international students. International Journal of Stress Management, 14(1), 99-110. doi: 10.1037/1072-5245.14.1.99

Dumka, L. E., Roosa, M. W., & Jackson, K. M. (1997). Risk, conflict, mothers' parenting, and children's adjustment in low-income, mexican immigrant, and mexican american families. Journal of Marriage and Family, 59(2), 309-323.

Gil, A. G., & Vega, W. A. (1996). Two different worlds: Acculturation stress and adaptation among cuban and nicaraguan families. Journal of Social and Personal Relationships, 13(3), 435-456.

Goldsmith, H. H., & Gottesman, I. I. (1981). Origins of variation in behavioral style: a longitudinal study of temperament in young twins. Child Development, 52(1), 91-103. Retrieved from http://www.jstor.org/stable/1129218

Goldsmith, H. H., Buss, A. H., Plomin, R., Rothbart, M. K., Thomas, A., Chess, S., Hinde, R. A., & McCall, R. B. (1987). Roundtable: what is temperament? four approaches. Child Development, 58(2), 505-529. Retrieved from http://www.jstor.org/stable/1130527

Grant, B.F., Stinson, F.S., Hasin, D.S., Dawson, D.A., Chou, S.P., Anderson, K. (2004). Immigration and lifetime prevalence of DSM-IV psychiatric disorders among Mexican Americans and non-Hispanic whites in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry 61, 1226–1233. Retrieved from http://archpsyc.ama-assn.org

Greenberg, P.E., Sisitsky, T., Kessler, R.C., Finkelstein, S.N., Berndt, E.R., Davidson, J.R., Ballenger, J.C., & Fyer, A.J. (1999). The economic burden of anxiety disorders in the 1990s. Journal of Clinical Psychiatry; 60, 427-430.

Hodges, W. F., London, J., & Colwell, J. B. (1990). Stress in parents and late elementary age children in divorced and intact families and child adjustment. Journal of Divorce & Remarriage, 14(1), 63-80.

Kagan, J., & Snidman, N. (1999). Early childhood predictors of adult anxiety disorders. Biol Psychiatry, 46, 1536–1541. Retrieved from http://dionysus.psych.wisc.edu/lit/Articles/KaganJ1999a.pdf

Kagan, J., Snidman, N., Zentner, M., & Peterson, E. (1999): Infant temperament and anxious symptoms in school age children. Dev Psychopathol 11:209–224.

Kagan, J., Snidman, N., Kahn, V., & Towsley, S. (2007). The preservation of two infant temperaments into adolescence. Monographs of the Society for Research in Child Development, 72, 1–75.

Kessler, R. C., Mickelson, K. D., & Williams, D. R.. (1999).The prevalence, distribution, and mental health correlates of perceived discrimination in the united states. Journal of Health and Social Behavior, 40, 3, 208-230.

Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions dsm-iv disorders in the national comorbidity survey replication. Arch Gen Psychiatry, 62, Retrieved from http://clclinic.cos.ucf.edu/Documents and Files/Kessler, Berglund, 2005.pdf

Kessler, R. C., Ruscio, A. M., Shear, K., & Wittchen, H. (2009). Epidemiology of anxiety disorders. In M. Antony & M. Stein (Eds.), Oxford Handbook of Anxiety and Related Disorders (pp. 19-33). New York, NY: Oxford University Press.

Lara, M., Gamboa, C., Kahramanian, M. I., Morales, L. S., & Hayes Bautista, D. E. (2005). Acculturation and latino health in the united states: A review of the literature and its sociopolitical context. Annual Review of Public Health, 26, 367-397.

Leidy, M. S., Parke, R. D., Cladis, M., Coltrane, S., & Duffy, S. (2009). Positive marital quality, acculturative stress, and child outcomes among mexican americans. Journal of Marriage and Family. 71, 833-847.

Lépine, J. P. (2002). The epidemiology of anxiety disorders: Prevalence and societal costs. J Clin Psychiatry, 63(Suppl. 14), 4-8.

Lueck, K., & Wilson, M. (2011). Acculturative stress in latino immigrants: The impact of social-psychological and migration-related factors. International Journal of Intercultural Relations, 35, 186-195. Retrieved from www.elsevier.com/locate/ijintrel

Mathers, C. D., Theo Vos, E., Stevenson, C. E., & Begg, S. J. (1999). The burden of disease and injury in australia . Bulletin of the World Health Organization, 79(11), 1076-1084.

Moehler, E., Kagan, J., Oelkers-Ax, R., Brunner, R., Poustka, L., Haffner, J., & Resch, F. (2008). Infant predictors of behavioral inhibition. British Journal of Developmental Psychology, 26, 145-150.

Prior, M. (1992): Childhood temperament. J Child Psychol Psychiatry, 33, 249–279.

Rapee, R. M. (2002). The development and modification of temperamental risk for anxiety disorders: prevention of a lifetime of anxiety?. Society of Biological Psychiatry, 52, 947-957.

Rapee, R. M., & Szollos, A. A. (2002). Developmental antecedents of clinical anxiety in childhood. Behaviour Change, 19(3), 146-157. Retrieved from http://www.atypon-link.com

Redfield, R., Linton, R., & Herskovits, M. J. (1936). Memorandum for the study of acculturation. American Anthropologist, 38(1), 149-152. Retrieved from http://www.jstor.org/stable/662563.

Robinson, J. L., Kagan, J., Reznick, J. S., & Corley, R. (1992). The heritability of inhibited and uninhibited behavior: a twin study. Developmental Psychology, 28(6), 1030-1037.

Schwartz, S. J., Zamboanga, B. L., & Hernandes-Jarvis, L. (2007). Ethnic identity and acculturation in hispanic early adolescents: Mediated relationships to academic grades, prosocial behaviors, and externalizing symptoms. Cultural Diversity and Ethnic Minority Psychology, 13(4), 364-373. doi: 10.1037/1099-9809.13.4.364

Suarez-Morales, L., & Lopez, B. (2009). The impact of acculturative stress and daily hassles on pre-adolescent psychological adjustment: Examining anxiety symptoms. J Primary Prevent, 30, 335-349. doi: DOI 10.1007/s10935-009-0175-y

Torres, L. (2010). Predicting levels of latino depression: Acculturation, acculturative stress, and coping. Cultural Diversity and Ethnic Minority Psychology, 16(2), 256-264.

Vega, W.A., Kolody, B., Aguilar-Gaxiola, S., Alderete, E.,Catalano, R., Caraveo-Anduaga, J. (1998). Lifetime prevalence of DSM-III-R psychiatric disorders among urban and rural Mexican Americans in California. Archives of General Psychiatry, 55, 771–778.

Volbrecht, M. M., & Goldsmith, H. H. (2010). Early temperamental and family predictors of shyness and anxiety. Developmental Psychology, 46(5), 1192-1205.

Williams, D. R., Neighbors, H. W., & Jackson, J. S. (2003). Racial/ethnic discrimination and health: Findings from community studies . Am J Public Health, 93(2), 200-208. Retrieved from http://www.ncbi.nlm.nih.gov

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1.) While the term “parent” is used throughout this thesis, anyone who identified as a caregiver was eligible to participate.