The Influence of Culture on Depression and Cognition in Korean Immigrants Compared to White Americans

In this study, we aimed to elucidate the influence of culture and cognition on depressive symptoms in Korean-born women compared to White American-born women. We first examined the cross-cultural validity of two self-report clinical measures and then conducted regressions to examine how race or acculturation (comprised of assimilation to American culture and maintenance of heritage culture) may impact the relationship between cognition and depression. Firstly, multi-group confirmatory factor analyses of the Patient Health Questionnaire-9 and Patient Health Questionnaire-15 were conducted to test for factorial invariance. We found poor fit for configural invariance for both measures, suggesting that the factor structures for Korean immigrants and White Americans are different and thus that the measures may lack cross-cultural validity. We also conducted regressions to examine the effect of acculturation on depression in Korean immigrants. We detected a negative relationship between maintenance of heritage culture and depressive symptoms, such that lower connection to Korean culture was associated with higher levels of depression. We did not find an effect of assimilation to American culture on depression in Korean women. Additional regressions were conducted to investigate racial and cultural differences in the relationship between cognition (emotion processing, inhibitory control) and depression. We detected a significant interaction between race and emotion processing of Asian faces on the prediction of depressive symptoms, such that efficiency of processing emotions on Asian faces was a better predictor of depression in White participants than Koreans. We did not detect a relationship between race and emotion processing of White faces on depression, nor was an effect of acculturation found. For inhibitory control, we did not find a significant effect of race or acculturation on the relationship between cognition and depression. Overall, our findings suggest that depression self-report tools may not be measuring the same construct of depression in Korean and White women. Additionally, culture to influence cognition and depression in Korean women; thus, culture may be an important area to consider in both research and clinical work this population. Furthermore, our results suggest that further investigations of the interacting relationships between culture, cognition, and depression may provide additional and beneficial elucidation of depression, particularly for non-White and/or immigrant populations.