Korean American Adolescent Depression and Parenting

Journal of Child and Adolescent Psychiatric Nursing,  May 2008  by Kim, Eunjung,  Cain, Kevin C

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PROBLEM: Korean American adolescents tend to experience more mental health problems than adolescents in other ethnic groups.

METHODS: The goal of this study was to examine the association between Korean American parent-adolescent relationships and adolescents' depressive symptoms in 56 families.

FINDINGS: Thirty-nine percent of adolescents reported elevated depressive symptoms. Adolescents' perceived low maternal warmth and higher intergenerational acculturation conflicts with fathers were significant predictors for adolescent depressive symptoms.

CONCLUSIONS: The findings can be used to develop a family intervention program, the aim of which would be to decrease adolescent depressive symptoms by promoting parental warmth and decreasing parent-adolescent acculturation conflicts.

Search terms: Depression, Korean American, parent-adolescent conflict, parental control, parental warmth

Elevated depressive symptoms are one of the most prevalent mental health problems among adolescents; they are increasing, recurring, and associated with poor school performance, delinquency, running away, substance abuse, and suicide (Hale, Van Der Valk, Engels, & Meeus, 2005; Saluja et al., 2004). Increasing evidence shows that adolescent depressive symptoms are related to the quality of relationships between adolescents and their parents. Adolescents tend to experience elevated levels of depressive symptoms when they perceive their parents to be low in warmth but high in control (Hale et al.; Rapee, 1997), and when they experience more frequent conflicts with their parents (Sheeber, Hops, Alpert, Davis, & Andrews, 1997). These findings are true for both European American and Asian American adolescents (Greenberger & Chen, 1996).

Although Greenberger and Chen's (1996) sample included both Chinese and Korean American adolescents, data from the two ethnic groups were combined for analysis. Therefore, this association is not known specifically for Korean American adolescents, who tend to experience more mental health problems than European American adolescents (Choi, Stafford, Meininger, Roberts, & Smith, 2002) or Chinese and Japanese American adolescents (Yeh, 2003). The goal of this study was to examine the associations between perceived parent-adolescent relationships and depressive symptoms in Korean American adolescents. The research questions were: (a) How are parent-adolescent relationships (i.e., parental warmth, parental control, and intergenerational acculturation conflicts) associated with adolescents' depressive symptoms? (b) Of the three factors (i.e., parental warmth, parental control, and intergenerational acculturation conflict), which one is the most significant contributing factor to adolescent depressive symptoms? and (c) How does the frequency of common parent-adolescent conflict situations contribute to adolescents' depressive symptoms?

Theoretical Framework

Parental warmth and control are considered to be important dimensions of parenting (Maccoby & Martin, 1983). According to the parental acceptance-rejection theory (Rohner, 2007; Rohner, Khaleque, & Cournoyer, 2007), parents can be placed on a continuum between acceptance and rejection based on how warm they are toward their adolescents. Warm parents are accepting and affectionate. When parents are low in warmth, they tend to be cold, hostile, indifferent, undifferentiating, and rejecting. Parental control ranges from permissiveness to strictness. Permissive parents exercise minimum control over their children and allow adolescents to do things their own way. Moderately controlling parents set a few clear limits and then allow adolescents to regulate their own activities within these constraints. Firm parents guide the adolescents' behavior by a firm schedule and parental intervention. Restrictive parents enforce many rules on their adolescents' behaviors, and by doing so, limit the adolescent's autonomy (Rohner).

Review of Literature

Depressive Symptoms in Adolescents

Overall, one in six adolescents living in the United States reports depressive symptoms (Saluja et al., 2004). Depressive symptoms were most prevalent among American Indian adolescents (29%), followed by European American (22%), Mexican American (18%), Asian American (17%), and African American (15%) adolescents (Saluja et al.). Symptoms often include depressed mood (e.g., feelings of sadness, loneliness, and crying); unhappiness (e.g., not enjoying life, feeling unhopeful); somatic complains (e.g., being bothered, restless sleep, change in appetite); and interpersonal difficulty (e.g., feeling that people dislike them) (Bonnie, 2006; Radloff, 1991). This study defines elevated depressive symptoms as being present when adolescents score higher than 16 on the Center for Epidemiologie Studies Depression Scale (CES-D) (Radloff, 1977, 1991).

Factors related to depressive symptoms included gender and functional impairment, parental rejection, primary caretaker's psychopathology, negative discipline, parental discord, poor parent-child attachment, poor parent-child involvement, and exposure to violence, neglect, physical abuse, sexual abuse, and assault (Gonzales-Tajera et al., 2005). Among all these factors, the importance of the quality of parent-adolescent relationships has been increasingly emphasized. Specifically, low parental warmth or care, high parental rejection, nigh parental control, overprotection, parental harshness, inconsistent discipline, hostility, and high family conflict are related to depressive symptoms in adolescents (Heaven, Newbury, & Mak, 2004; Zuniga de Nuncio, Nader, Sawyer, & Guire, 2003).