Abstract
This paper explores ways in which depressive symptoms are expressed by elderly Korean immigrants in the USA. Depressed elderly Korean immigrants in the Washington DC area were interviewed in depth to explore their conceptualizations of depression in terms of explanatory models and semantic networks. The expressions of depressive symptoms were influenced by linguistic and psycho-socio-cultural factors, therapeutic behaviors, and efficacy of treatment. The data were interpreted in terms of traditional Korean medical principles, cosmological, socio-cultural, and religious influences, and an individual's family structural changes and acculturation. Findings indicate the construction of somatization among Korean elders is more complex than is generally reported: in most cases, a dynamic, holistic blend of processes appears to operate simultaneously, instead of as somatization in isolation. Informants placed different degrees of emphasis on psychologization or somatization, or the two combined. The roles of personality, value orientation, intellect, emotion, economic status, degree of acculturation, degree of dependence on children, living situation (with or not with children), and self-will or self-confidence are important influences on the depression symptoms in the psychologization-somatization continuum. The more self-directed the informants are, the more they psychologize; the more other-directed, the more they seem to somatize. Names and symptoms of depression (a Western concept) and popular illnesses (traditional Korean concepts) were used interchangeably by the informants. When informants were asked to explain the signs and symptoms of depression and sadness, some described symptoms similar to the criteria of major depression in DSM-III (American Psychiatric Association), while others gave different symptoms and ways of expressing them. Some informants believed that symptoms and signs of depression can be concealed from others if one chooses to do so. Many felt that manifestations of depression can be controlled by willpower, personality, and self-care.
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REFERENCES
American Psychiatric Association 1980 DSMIII. Diagnostic and Statistical Manual of Mental Disorders (3rd edn).Washington: American Psychiatric Association.
Baik, Sang Chang 1979 Han Guk Sa Hoe It Er Sir Jung Shin Chi Roe Eui Mi Ua Eung Yong [The Meaning of Psychotherapy and its Application in Korean Society]. Korean Society and Culture 4: 273–313. Sung Nam: Hanguk Jung Shin Mun Wha Research Institute.
Bankart, C.P., F. Koshikawa, K. Nedate, and Y. Haruki 1992 When West Meets East: Contributions of Eastern Traditions to the Future of Psychotherapy. Psychotherapy 29: 141–149.
Berkman, L. F. 1980 Physical Health and the Social Environment: A Social Epidemiological Perspective. In L. Eisenberg and A. Kleinman, eds., The Relevance of Social Science for Medicine, pp. 51–75. Dordrecht: Reidel.
Brandt, Vincent 1971 A Korean Village Between Farm and Sea. Cambridge: Harvard University Press.
Burnside, Irene 1994 Reminiscence Group Therapy. In Irene Burnside and Mary G. Schmidt, eds., Working with Older Adults: Group Process and Technique (3rd edn), pp. 163–173. Boston: Jones and Bartlett Publishers
Chen, Ellen M. 1989 The Tao Ching. A New Translation with Commentary. New York: Paragon House.
Chiu, Thomas L. 1994 The Unique Challenges Faced by Psychiatrists and Other Mental Health Professionals Working in a Multicultural Setting. The International Journal of Social Psychiatry 40(1):61–74.
Chun, Kyu Tae 1978 Sense of Beauty Among Koreans. Seoul: Mun Ri Sa.
Escobar, Javier I., M. A. Burnam, and M. Karno 1987 Somatization in the Community. Archives of General Psychiatry 44: 713–718.
Ferrara, Kathleen Warden 1994 Therapeutic Ways with Words. Oxford: Oxford University Press.
Good, Byron J. and Mary-Jo Delvecchio Good 1981 The Meaning of Symptoms: A Cultural Hermeneutic Model for Clinical Practice. In Leon Eisenberg and Arthur Kleinman, eds., The Relevance of Social Science for Medicine, pp. 165–196. Dordrecht/Boston: D. Reidel Publishing Co.
Kang, Chong Sun 1982 Clinical Study on the Chief Complaints of Depression Neurosis. Human Science 6(9): 55(620)-60(625).
Kendall, Laurel and Mark Peterson 1983 Traditional Korean Women: A Reconsideration. In Laurel Kendall and Mark Peterson, eds., Korean Women: View from the Inner Room, pp. 5–22. New Haven: East Rock Press.
Kim, Hae Ahm 1994 Cultivation of Mind and Heart in Confucian Culture: A Brief Interpretation. Academy Forum: The Academy of Psychoanalysis 38(1,2): 8–10.
Kim, K. 1977 Clinical Study of Primary Depressive Symptom. Part III: A Cross Cultural Comparison: Korea, England, United States and India. Neuropsychiatry (Journal of Korean Neuropsychiatric Association) 16: 53–60.
Kim, Kwang-Iel 1991 Hanguk Juntong Munhwa Eui Jungshin Bunsuk: Shinhwa, Musok Gue Ri Go Jonggyo Chehum [Psychoanalytic Interpretation of Korean Traditional Culture: Myth, Shamanism, and Religious Experiences]. Seoul: Kyomunsa (in Korean).
Kim, Kwang-Iel, and Bou Yong Rhi 1976 A Review of Korean Cultural Psychiatry. Transcultural Psychiatric Research 13: 101–114.
Kim, Kwang-Iel, Donggen Li, Zhenzi Jiang, Xingji Cui, Luchun Lin, Jiang Ju Kan, Kang Kyu Park, Eun Kee Chung, and Chul Kyu Kim 1993 Schizophrenic Delusions Among Koreans, Korean Chinese, and Chinese: Transcultural Chinese Delusions of Religious or Supernatural Matters. The International Journal of Social Psychiatry 39(3): 190–199.
Kim, Kwang-Iel and Bou Young Rhi 1976 A Review of Korean Cultural Psychiatry. Transcultural Psychiatric Research 13: 101–114.
Kirmayer, Laurence J. 1989 Cultural Variations in the Response to Psychiatric Disorders and Emotional Distress. Social Science and Medicine 29(3): 327–339.
1994 Improvisation and Authority in IllnessMeaning. Culture,Medicine and Psyciatry 18: 183–214.
Kleinman, Arthur 1980 Patients and Healers in the Context of Culture. Berkeley: University of California Press.
1982 Neurasthenia and Depression: A Study of Somatization and Culture in China. Culture, Medicine and Psychiatry 6: 177–190.
Lee, Kyu Tae 1977 Hanguk In Eu Eusik Gujo [The Frame of Mind of Koreans]. Seoul: Mun Ri Sa.
1987 Han Puri Moo [The Dance for Unknotting Han]. Chosun Daily Newspaper, July 11.
Lee, Man Hong, Ho Young Lee, Sung Kil Min, Kyung Hee Kim, Soo Young Kim, Dong Ho Song, Jong Ho Shin, Mook Hee Park, Ahn Bae and Keum Young Sung 1986 Development of the Korean Version of the NIMH-Diagnostic Interview Schedule and its Validity Test. Journal of Korean Neuropsychiatric Association 25(2): 300–314.
Lee, Si Hyung 1977a Psychogenic Pain: Its Meaning and Therapy. Human Science (in Korean) 1(6): 39–41.
1977b A Study of the “Hwabyung” [Anger Syndrome]. Journal of Korea General Hospital 1(2): 63–69.
1987 Let us Live with Bluffness and Confidence. Seoul: Jipyunjun.
Lin, Keh Ming 1983 Hwabyung: A Korean Culture Bound Syndrome? American Journal of Psychiatry 140: 105–107.
Lutz, Catherine 1985 Depression and the Translation of Emotional Worlds. In Arthur Kleinman and Byron Good, eds., Culture and Depression: Studies in the Anthropology and Cross-Cultural Psychiatry of Affect and Disorder, pp. 63–100. Berkeley: University of California Press.
Manuel, R. (ed.) 1982 Minority Aging: Sociological and Social Psychological Issues. Westport, CT: Greenwood Press.
Mechanic, D. 1962 The Concept of Illness Behavior. Journal of Chronic Disease 15: 189–194.
Obeyesekere, Gananath 1985 Depression, Buddhism, and the Work of Culture in Sri Lanka. In Arthur Kleinman and Byron Good, eds., Culture and Depression: Studies in the Anthropology and Cross Cultural Psychiatry of Affect and Disorder, pp. 134–152. Berkeley: University of California Press.
Osgood, Cornelius 1962 The Koreans and Their Culture. Tokyo: Charles E. Tuttle.
Ots, Thomas 1994 The Silenced Body - the Expressive Leib: On the Dialectic of Mind and Life in Chinese Cathartic Healing. In Thomas J. Csordas, ed., Embodiment and Experience: The Existential Ground of Culture and Self, pp. 116–136. Cambridge: Cambridge University Press.
Pang, Keum Young Chung 1990 Hwabyung: The Construction of a Korean Popular Illness Among Korean Elderly Immigrant Women in the United States. Culture, Medicine and Psychiatry 14: 495–512.
1994 Understanding Depression Among Elderly Korean Immigrants Through Their Folk Illnesses. Medical Anthropology Quarterly 8(2):209–216.
1995 A Cross Cultural Understanding of Depression Among Korean Elderly Immigrants: Prevalence, Symptoms and Diagnosis. Clinical Gerontologist 15(4): 3–20.
Rhi, Bou Yong 1986 Yugyoguan Gazok EuMunhwa SimrijukGuzo: Guague UwaMirae. Confucianism and Mental Health in Korea: The Psycho-Cultural Dynamics of the Confucian Family, Past and Present, pp. 249–276. International Cultural Society of Korea.
1983 Hangukin of Yunriguan [Korean Ethos]. Seoul: Hanguk Jungshin Munhwa Yunguwon [Korean Cultural Research Center].
1980 Shamanism Gua Shaman: Hanguk Sasang Eui Wontien [Shamansm and Shaman: The Origin of Korean Ethos]. Seoul: Bak Young Sa.
Robbins, J. M., and L. J. Kirmayer 1986 Illness Cognition, Symptom Reporting, and Somatization in Family Medicine. In S. McHugh and Michael T. Vallis, eds., Illness Behavior: A Multidisciplinary Perspective, pp. 283–302. New York: Plenum Press.
Robbins, L. M., J. E. Helzer, J. Croughan, and K. S. Ratcliff 1981 National Institute of Mental Health Diagnostic Interview Schedule: Its History, Characteristics, and Validity. Archives of General Psychiatry 38: 381–389.
Silverman, C. 1968 The Epidemiology of Depression. Baltimore: Johns Hopkins Press.
Unschuld, Paul 1985 Medicine in China: A History of Ideas. Berkeley: University of California Press.
Zo, Zayong 1977 Folk Painting and Folk Aesthetics. Korean Journal 17(2): 4–11.
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Pang, K.Y.C. Symptoms of Depression in Elderly Korean Immigrants: Narration and the Healing Process. Cult Med Psychiatry 22, 93–122 (1998). https://doi.org/10.1023/A:1005389321714
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DOI: https://doi.org/10.1023/A:1005389321714