Age differences in stress process of recent immigrants☆☆☆★

Methods 

This study is part of the Immigrant Psychological Distress Project (IPDP), a study that used cross-sectional and longitudinal designs to assess the stress process among recent immigrants to Israel from the FSU.5, 9, 14, 17, 18 All subjects who participated in the study provided written informed consent after receiving a detailed explanation of the study procedures. The study was approved by the local internal review board.

Samples 

Table 1 presents demographic characteristics of the study samples.

Table 1. Sociodemographic Characteristics of the Samples

	Characteristic	Cross-sectional Sample		Longitudinal Sample
	Sample size	565		199
	Gender
	Male	218	38.6%	77	39%
	Female	347	61.4%	122	61%
	Age (mean ± SD, yr)	43.2 ± 16.5		50.1 ± 17.2
	Young (18-29)	147		39
	Middle-aged (30-59)	321		100
	Elderly (60-86)	127		70
	Marital status
	Single	15.9%		10%
	Married	62.8%		66%
	Divorced/separated	16.0%		13%
	Widowed	5.3%		11%
	Education (mean ± SD, yr)	13.4 ± 2.8
	Length of stay (mean ± SD, mo)	34.0 ± 13.9		38.9 ± 8.0

For cross-sectional analysis, data on a community sample of 565 immigrants were drawn from the IPDP database according to three inclusion criteria: age 18 and over, time lived in Israel less than 5 years, and complete information from stress, distress, and social support measures. Although this sample is moderate in size, it is representative in sex and age structure of the total population of immigrants that came to Israel from the FSU between 1989 and 1999. The sample was divided into three age cohorts: cohort 1 included persons aged 18 to 29 years, cohort 2 persons aged 30 to 59 years, and cohort 3 persons aged 60 to 86 years. No gender differences were noted among the three cohorts (χ2 = 0.57, df = 2, P = .75).

Longitudinal analysis was based on a different set of 199 subjects who were administered the same measures during a baseline interview, and then reinterviewed 1 year later. Sampling and details of the sample were described in detail elsewhere.5 This sample was divided into the same three age cohorts as the cross-sectional sample (18 to 29, 30 to 59, and 60 to 86 years). Comparisons of the cross-sectional and longitudinal samples showed that they were similar in age, gender, marital status, and length of residence in Israel.

Results 

ANOVA was used to compare mean PIRSS, MSPSS, and TBDI scores in the three age cohorts (Table 2).

Table 2. Levels and Symptoms of Psychological Distress (TBDI), Stressors (PIRSS), and Social Support (MSPSS) in the Three Age Groups

	Variable	Young Adults	Middle-Aged Adults	Older Adults	ANOVA F-Ratio	df = 2,565, P Value
	TBDI Distress Index	.89 ± .7	1.00 ± .6	1.31 ± .6*	16.2	.0001
	No. of symptoms	2.1 ± 2.1*	2.3 ± 2.0*	3.2 ± 1.8*	10.5	.0001
	Obsessiveness	.78 ± .8	.86 ± .7	1.54 ± .7*	44.2	.0001
	Hostility	1.05 ± .8	1.00 ± .7	1.11 ± .7	1.1	0.33
	Sensitivity	.67 ± .7*	.76 ± .6	.91 ± .6*	4.1	0.02
	Depression	.89 ± .8	.97 ± .8	1.35 ± .8*	12.6	.0001
	Anxiety	1.15 ± 1.0*	1.37 ± .8*	1.62 ± .7*	10.6	.0001
	Paranoid Ideation	.99 ± .9*	1.25 ± .7	1.34 ± .8	7.4	.001
	PIRSS Stress Index	2.3 ± .8	2.4 ± .7	2.6 ± .6*	5.0	.01
	Information-related	2.2 ± .9	2.2 ± .7	2.4 ± .8	2.1	.12
	Culture-related	2.4 ± .9	2.4 ± .8	2.5 ± .7	0.2	.81
	Health-related	1.9 ± .9	1.8 ± .8	2.6 ± .8*	40.0	.0001
	Material-related	2.7 ± 1.1	2.8 ± 1.0	2.8 ± .9	0.6	.56
	Social support, total	68.5 ± 13.8	67.9 ± 13.2	68.9 ± 11.9	0.3	0.76
	From family	23.4 ± 5.6	24.1 ± 5.1	24.5 ± 4.7	1.5	.22
	From friends	21.6 ± 5.5*	19.5 ± 5.7	19.6 ± 6.0	7.4	.001
	From significant others	23.4 ± 5.2	24.3 ± 5.1	25.2 ± 4.1*	4.5	.01
	*Tukey-Kramer multiple-comparison test.

NOTE. Values are means ± SD. Young adults (aged 18 to 29; n = 147); middle-aged adults (aged 30 to 59; n = 291); older adults (aged 60 to 86; n = 127)

Table 3 shows the relationship between specific stressors and emotional distress within each of the three age cohorts.

Table 3. Summary of Multiple Regression Analyses for Predicting TBDI Distress Index Scores in the Three Age Groups

	Predictor Variable	β	t Value (β = 0)	P<	Simple R2	Partial R2
	Younger adults: R2 = 0.68, F = 25.3, df = 11,147, P < .0001
	Climatic changes	0.17	2.61	0.01	0.31	0.049
	Anxiety for the future	0.16	2.45	.02	0.35	0.044
	Host culture	0.14	2.30	.05	0.24	0.039
	Family problems	0.17	2.96	.005	0.22	0.063
	Health status	0.20	2.99	.01	0.41	0.064
	Character traits	0.24	3.66	.001	0.38	0.093
	Middle-aged adults: R2 = 0.74, F = 63.8, df = 12,291, P < .0001
	Gender	0.07	2.06	.040	0.12	0.015
	Education level	−0.09	2.48	.013	0.02	0.022
	Time in Israel	0.10	2.90	.01	0.002	0.030
	Unemployment	0.15	3.65	.001	0.24	0.046
	Host culture	0.15	4.08	.0001	0.22	0.057
	Family problems	0.20	4.94	.0001	0.29	0.082
	Uncertainty in the present situation	0.20	4.23	.0001	0.43	0.061
	Personal insecurity	0.08	2.16	.05	0.20	0.017
	Health status	0.23	6.00	.0001	0.36	0.117
	Character traits	0.24	6.24	.0001	0.33	0.124
	Older adults: R2 = 0.52, F = 13.4, df = 9,127, P < .0001
	Marital status	0.17	2.39	.02	0.07	0.049
	Malevolence of surrounding	0.35	4.64	.0001	0.12	0.163
	Uncertainty in the present situation	0.24	3.36	.001	0.13	0.093
	Personal insecurity	−0.22	2.91	.01	0.02	0.071
	Health status	0.34	4.53	.0001	0.23	0.157
	Character traits	0.30	3.96	.001	0.19	0.124

To investigate age differences in stability of emotional distress among immigrants, emotional distress levels and intensity of the stressors experienced by the 199 immigrants at the initial and follow-up examinations were compared between age groups. No significant differences in the mean TBDI scores during the 1-year follow-up were found for younger and older groups. In contrast, the middle-aged cohort showed a significant decline in the aggregate levels of emotional distress (1.28 ± 0.6 v 1.16 ± 0.7, paired t = 2.57, P = .011) and the intensity of perceived stressors (2.80 ± 0.7 v 2.58 ± 0.7, paired t = 4.54, P = .0001) between the initial and follow-up interview. Post-hoc inspection indicated that these changes were due to a decline in the intensity of material-related (paired t = 4.73, P = .0001) and information-related (paired t = 3.41, P = .001) stressors.

Discussion 

A large community sample cross-sectional and partly longitudinal design was used to compare emotional distress, stressors and social support measures in three age groups of adult immigrants to Israel from the FSU. Overall, our findings are quite consistent with previous studies7, 8, 9, 10 that demonstrated a direct relationship between the age and emotional distress among immigrants, and contradict those studies11, 12 that reported inverse association. This inconsistency might be explained by substantive differences in the instruments use and sample size of subjects, variability of distressed and protective factors, and due to the differences in cultural backgrounds of immigrants. For example, intergroup differences in levels of symptoms of distress were found between younger and older Ethiopian-Jewish and Russian-Jewish immigrants to Israel: the older Russian immigrants had significantly more severe distress symptoms than their Ethiopian counterparts, and the highest levels of distress were observed for paranoid ideation in the Ethiopian sample and anxiety and hostility in the Russian sample.17

Despite controversies concerning the influence of age on emotional distress, many researchers found higher levels and symptoms of distress in older immigrants compared to younger age groups. The most common explanation attributes these differences to more rapid adaptation among younger immigrants, with a more flexible and open attitude toward acculturation and integration into a host society, and less difficulties with a new language, culture, and other changes.12, 23, 24 Among other factors influencing the emotional distress of immigrants, social support networks have been reported to play a prominent role—immigrants with higher levels of emotional distress tend to be those with lower levels of social support.3

In the present study, we tested the hypothesis that age-related differences in levels and symptoms of emotional distress are associated with differential perceptions and appraisals of sources of stress and social support across ages.

Results of the study support this hypothesis only in part. (1) Although hostility has been described as a personality characteristic that contributes to the level of perceived stressors and distress25, 26 we did not find age differences in hostility scores. This finding is congruent with results obtained in previous studies.23, 27 the literature also suggests a multidimensional nature of hostility27 and that the relationships between hostility and age could not be explained on the basis of emotional distress alone because it s mediated by the association between hostility and health-related behaviors.28 (2) Elevated levels of emotional distress in the older immigrants was associated with higher self-reports of stressors but not with lower social support. However, when distinct sources of stress and social support were compared across the age groups, some age-specific differences emerged. First, only health-related stressors were more likely to be reported by the immigrants compared to their younger counterparts. Second, regardless of the absence of between-group differences in overall social support and family support, the older immigrants were more likely to report emotional support from significant others, while the younger individuals were more likely to acknowledge such support from friends.

The attempt to establish stressors specifically predicting emotional distress in the different age groups showed that there were more similarities than differences. Most stressors found to be significantly related to distress were stable and consistent in their effect across the three age groups. The demographic variables demonstrated more age specificity. Likewise, there were stress patterns shared by the younger and middle-aged groups as well as those shared by the middle-aged and older immigrants. We were unable to find stress patterns overlapping between the younger and older immigrants. This finding supports the notion that “old are often as profoundly uprooted in time and distance from the young in their own country as from members of another culture”.29

Consistent with the findings that elderly immigrants suffer from an increased sense of isolation as younger members of their families become socialized into the majority culture at a pace much faster than their own,12, 22, 24, 29, 30 divorced/widowed marital status and the perception of malevolence or hostility of surrounding people were found to specifically predict distress among the older immigrants.

The finding of this study that gender is a predictor for distress is consistent with a great deal of literature on gender differences demonstrating that independent of culture and social class,31, 32 women have higher levels of psychological distress than men. However, this finding (like our previous data9) demonstrates that gender differences in the expression of most distress symptoms are salient during in the middle stage of the life cycle but not before or after that time. Other risk factors in this group (education level and time spent in Israel) revolve around the experience of unemployment which has been found to be a major determinant of emotional distress among recent immigrants.1, 12, 29, 30 Indeed, among unemployed immigrants, the lower the level of education and the longer the time since resettlement, the greater the chance that the immigrant will fail to eventually find an adequate job, remaining distressed and unemployed as a consequence.

Somatic concerns and the perception that one's personality traits prevent adaptation to the host society might be expected to specifically predict elevated distress for older adults.33, 34, 35, 36 Instead, these emerged as precipitants of distress across all three age groups in this study. Family problems and adjustment difficulties related to the host culture (language, mentality, etc.) predicted the intensity of emotional distress for both younger and middle-aged adults, while uncertainty in the present situation and a sense of personal insecurity were the risk factors for distress in both the middle-aged and older cohorts.

The support for age specificity of the persistence of stressors and distress comes from the longitudinal portion of this study. Follow-up results showed a decline in material- and informational-related stressors over a 1-year follow-up with a parallel decrease of psychological distress, but only in the middle-aged group. This cohort compared to their younger and older counterparts perceived the material-related stressors (lack of money, housing, and employment) as more significant. This may be because the middle-aged immigrants have an increased sense of responsibility for the material maintenance of their families,9 whereas the younger or older adults experience less financial strain since they may actually receive more economic support from their middle-aged parents (younger) or from their middle-aged children (older). These findings are quite consistent with cross-sectional data from a community survey of 184 recent Vietnamese immigrants to the United States, categorized as either elderly, middle-aged, or young adults.10 It was found that young Vietnamese adults were most acculturated and most bicultural, and reported themselves as healthiest and least depressed. Although young adults scored significantly higher than other generations on most of the risk factors for psychological distress (dissatisfaction with their current lives in the United States and most family conflict), they appeared to be buffered against poorer mental health outcomes by factors of generation and perceived positive overall well-being.

Finally, the parallel decline in material (and informational) stressors and emotional distress over the follow-up in the middle aged group suggests that improvement in economic status and the ability to function in new bureaucratic systems in the new country is an important contributor to improved psychological well-being in this age group.

In summary, this study examined whether differential perceptions and appraisals of immigration-related stressors and sources of social support explain age differences in self-reported emotional distress among recent immigrants to Israel from the FSU. Although most types of stress and social support appear to be age-independent predictors of distress, others stress and demographic factors revealed age-specificity. Intervention focusing on age-related factors involved in the stress process should be addressed in an effort to improve immigrant's adjustment outcomes. Future studies should test the mediating effect of age on emotional distress, coping styles and perceived quality of life and should also focus on personal characteristics and inner resources that underlie acculturation as whole.