Kunsook Bernstein

Acculturation, discrimination and depressive symptoms among Korean immigrants in New York City.

Immigrant mental health issues, especially depression in relation to discrimination and acculturation, are reported to be serious problems in the United States. The current study examines the prevalence of depressive symptoms among Korean immigrants in New York City (NYC) and its relation to self-reported discrimination and acculturation. A sample of 304 Korean immigrants residing in NYC completed a survey utilizing the Center for Epidemiologic Studies Depression Scale—Korean version, Discrimination Scale, and Acculturation Stress Scale. Results indicated that 13.2% of the sample population demonstrated some symptoms of depression and that variable such as living alone, marital status, education, years in US and income impact high depression scores. Results also indicate that higher self-reported exposure to discrimination and lower self-reported language proficiency were related to higher depressive symptoms. In a regression analysis, discrimination and English language proficiency were significant predictors of depression, but acculturation stress was not significantly related to depression.

Military sexual trauma among U.S. female veterans.

Sexual abuse among female veterans reportedly occurs in significant numbers in the U.S. military and has been recognized to cause posttraumatic stress disorder (PTSD). PTSD, which stems from sexual abuse, has been called military sexual trauma (MST), which has only recently been recognized by the Department of Defense. Consequently, there has been scant research on the prevalence, impact, and treatment of MST. This article explores the phenomenon of sexual aggression against female veterans in the U.S. military, risk factors for MST, PTSD as a result of MST, a conceptual framework for treating PTSD stress, and treatment strategies for PTSD.

Symptom manifestations and expressions among Korean immigrant women suffering with depression

AIM This paper is a report of a study to investigate the culture-specific symptom manifestation and expression of depression in Korean immigrant women in the United States of America (USA). BACKGROUND The literature indicates that Korean immigrants to the USA report higher levels of depressive symptoms than immigrants from other Asian ethnic groups, and women immigrants tend to encounter more gender-related emotional difficulties. However, because of traditional cultural beliefs, immigrants may not seek treatment for depression and, when they do, tend to leave treatment prematurely. METHODS We used an ethnographic method based on Spradleys Developmental Research Sequence with a sample of 17 Korean immigrant women who scored mild-to-severe depression on a Korean version of the Hamilton Depression Inventory Scale. Data were collected from 2005 to 2006, and consisted of tape-recorded interviews, field notes and diaries. FINDINGS Depressive symptoms were complex, intertwined and felt in all domains of the persons existence. They were expressed mainly through emotional and physical suffering, and the expression of suffering as a way of life. Themes elicited were emotional entrapment, shame and failure as women, disappointment at not being able to live a normal life and emotional restraint, as emotions were not generally expressed verbally but instead were expressed somatically, bodily and metaphorically. CONCLUSION Being aware of culture-specific symptoms of depression among Korean immigrant women can assist nurses in caring for them and thus improving their therapeutic alliances and preventing them from prematurely terminating treatment.

Logo-Autobiography and Its Effectiveness on Depressed Korean Immigrant Women

This study aimed to explore the effectiveness of logo-autobiography (LA) as a therapeutic modality for Korean immigrant women suffering from depression and perceiving their lives as meaningless. A nonrandomized quasi-experimental study was conducted with pretest, posttest, and a 4-week follow-up test. Forty subjects—20 with antidepressants and 20 without—were divided quarterly and assigned to the experimental group and the control group. The experimental group reported a significant lower score on depressive symptoms (F = 6.832, p = .013; F = 19.800, p ≤ .001) and a higher score on meaning of life (F = 12.294, p = .001; F = 12.232, p = .001) than did the control group immediately after completing the LA and a 4-week follow-up. The LA was more effective for the subjects in the nonmedication group than in the medication group. In conclusion, LA is effective in reducing depressive symptoms and increasing a sense of meaning in life among Korean immigrant women suffering from depression.

Socio-demographic and Psychological Correlates of Posttraumatic Growth among Korean Americans with a History of Traumatic Life Experiences

Abstract This study examined socio‐demographic and psychological correlates of posttraumatic growth (PTG) among Korean Americans (KAs) with traumatic life experiences. A total of 286 KAs were included. Being a woman or having a lower annual household income had positive associations with PTG, while having no religion had a negative association with it. In addition, praying and visiting a mental health professional for coping with stress or for psychological problems was positively associated with PTG. Higher resilience scores increased PTG, while depressive symptoms decreased it. We suggest reinforcing help seeking behaviors and accessibility to care facilities, and gender specific strengthening programs for enhancing PTG among KAs. HighlightsKorean American women and those who had lower annual household income tended to report higher PTG.Resilience was positively related to PTG, while there was an inverse relationship between depressive symptoms and PTG.Praying and seeking help from mental health professionals were important coping strategies among KAs.Culturally‐appropriate mental health intervention programs should be developed to facilitate PTG among KAs.

Efficacy of a Culturally Tailored Therapeutic Intervention Program for Community Dwelling Depressed Korean American Women: A Non-Randomized Quasi-Experimental Design Study

BACKGROUND Asian American women are more prone to suffer from depression compared to their non-Asian American counterparts and have lower rates of seeking mental healthcare services due to lack of available culturally appropriate therapies. Two prior studies of a culturally tailored therapeutic intervention called LogoAutobiography were helpful in treating depressed Korean American women. The LogoAutobiography program was revised to enhance its efficacy not only for depressive symptoms and purpose in life but also to increase coping strategies. OBJECTIVES To test the efficacy of the Enhanced LogoAutobiography program on depressive symptoms, purpose in life, and coping strategies of depressed community-dwelling Korean American women. DESIGN Two-group, non-randomized quasi-experimental design. SETTINGS Local Korean community areas located in New York City and eastern New Jersey of the United States. PARTICIPANTS A total of 54 depressed women with Korean heritage completed either experimental group (n1=25) or control group (n2=29). Sample inclusion criteria were adult women with Korean heritage, depressive symptoms as measured by a CES-D score 16 or higher, fluent Korean language, and able to participate independently. Sample exclusion criteria were those who presented active suicidal ideation and history of episodes of mania or psychosis screened by the psychosocial survey questionnaire. METHODS The experimental group received Enhanced Logo-Autobiography program which was guided by a facilitator who used a manualized intervention for 90minute sessions over 8weeks; the control group attended routine weekly community activities. Data were collected during the first session (pretest), the end of 8weeks (posttest), and the 3months follow-up session. Time and group changes in depressive symptoms, purpose in life, and coping strategies were computed using Repeated Measures General Linear Model (RMGLM). RESULTS Findings suggested that the experimental group showed greater improvement in depressive symptoms (F=6.94 (2, 88), p<0.01), active cognitive coping (F=5.07 (2, 86), p<0.01), and avoidance coping strategies (F=3.48 (2, 86), p<0.05) compared to the control group during the three time intervals. Purpose in life showed statistically significant Time and Group effects (F=5.18 (2, 88), p<0.01; F=9.44 (2, 88), p<0.01, respectively), but no significant interaction effect of Time and Group was detected. CONCLUSION These findings suggest that enhanced LogoAutobiography is effective for depressive symptoms and coping strategies and somewhat effective for improving purpose in life for depressed Korean American women.

A randomized controlled trial of a videoconferencing smoking cessation intervention for Korean American women: preliminary findings

Introduction Korean women are reluctant to pursue in-person smoking cessation treatment due to stigma attached to women smokers and prefer treatment such as telephone and online smoking cessation programs that they can access secretively at home. However, there is some evidence that face-to-face interaction is the most helpful intervention component for them to quit smoking. Methods This study is a pilot clinical trial that examined the acceptability and feasibility of a videoconferencing smoking cessation intervention for Korean American women and compared its preliminary efficacy with a telephone-based intervention. Women of Korean ethnicity were recruited nationwide in the United States and randomly assigned at a ratio of 1:1 to either a video arm or a telephone arm. Both arms received eight 30-minute weekly individualized counseling sessions of a deep cultural smoking cessation intervention and nicotine patches for 8 weeks. Participants were followed over 3 months from the quit day. Results The videoconferencing intervention was acceptable and feasible for Korean women aged <50 years, whereas it was not for older women. Self-reported abstinence was high at 67% and 48% for the video and telephone arm at 1 month post-quit, respectively. The rates declined to 33% for the video arm and 28% for the telephone arm at 3 months post-quit when salivary cotinine test was performed. Conclusion Findings support that both videoconferencing and telephone counseling can be effective, and personal preference is likely an important factor in treatment matching. The deep cultural smoking cessation intervention may account for the outcomes of telephone counseling being better than prior studies in the literature for Korean women.

Resilience and Depressive Symptoms among Korean Americans with History of Traumatic Life Experience

This study investigates socio-demographic characteristics and resilience and depressive symptoms among Korean Americans (KAs) with traumatic life experiences. Community-residing 285 KAs living in New York City and Teaneck, New Jersey completed questionnaires measuring traumatic life experiences, depressive symptoms, and resilience. Descriptive statistics, Pearson’s correlations, and two-step hierarchical multiple regression analyses were conducted. 54% of KAs with traumatic life experiences reported at least mild depressive symptoms; greater resilience was associated with fewer such symptoms. English proficiency, length of time in US, marital status, and employment were significant predictors for depressive symptoms in the first step of multiple regression, but when resilience was introduced in the second step, it was the only significant predictor of depressive symptoms. The findings suggest that resilience should be supported to promote positive mental health outcomes for traumatized KAs who are depressed, and that resilience-focused interventions for this population should be designed.