Moderators of Acculturative Stress in Pakistani Immigrants: The role of Personal and Social Resources

International Journal of Intercultural Relations 35 (2011) 523–533

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Moderators of Acculturative Stress in Pakistani Immigrants: The role of Personal and Social Resources Tahira Jibeen COMSATS Institute of Information Technology, Department of Humanities, Lahore, Pakistan

a r t i c l e

i n f o

Article history: Received 20 February 2009 Received in revised form 13 March 2011 Accepted 15 April 2011 Keywords: Acculturative stress Moderators Sense of coherence Coping strategies Social support Psychological well-being Negative health outcomes

a b s t r a c t International migration research has focused on the immigrants’ mental and physical health issues with little attention paid to factors that facilitate adjustment. Recently cross-cultural researchers have tended to focus on certain psychological and social moderators of stress that differentiate between migrants perceiving higher stress and those remaining relatively unscathed. The present study examined the moderating impact of coping resources (sense of coherence and perceived social support) and coping strategies (problem-focused and emotion-focused) on the relationship between acculturative stress and psychological wellbeing (positive functioning and negative health outcomes) in stress-coping model. On a final sample of 308 Pakistani immigrants residing in Greater Toronto Area a series of moderated hierarchical regression analyses were performed separately for positive and negative health outcomes. Results indicated that sense of coherence and perceived social support moderated between acculturative stress and positive functioning (self-acceptance, positive relations with others, autonomy, environmental mastery, purpose in life, personal growth), and acculturative stress and negative health outcomes (depression, psychosomatic symptoms, anxiety and insomnia, social dysfunction).The current findings have implications for clinicians, researchers, and policy makers for the identification of resource factors that help to understand the resistant power of growing immigrant population to maintain positive functioning. © 2011 Published by Elsevier Ltd.

1. Introduction Canada is a cosmopolitan country where the diversity in the ethnic composition of the existing population has signaled the need for researchers to have a better understanding of the health and well-being of culturally diverse population (Lai & Surood, 2008). The literature indicates that acculturative stress has varied generally in the nature and level of difficulties found by immigrant groups (Farver, Bhadha, & Narrang, 2002; Hovey & King, 1996; Sam & Berry, 1995). For example, Asian experience more acculturative stress than their European counterparts; because the former may experience greater cultural difference than the latter (Kaul, 2001). It is evident that research has been particularly lacking on the cultural adjustment of South Asians—those coming from Pakistan, India, Bangladesh, Sri Lanka, Nepal, Bhutan or the Maldives (Sheth, 1995). A review of the literature reveals that the group that has received little attention among the South Asian population living in the Canada is that of Pakistani immigrants. There is need to study the impact of immigration experience on Pakistani immigrants and to examine the factors that contribute their well-being. Pakistani immigrants are an understudied and neglected ethnic minority group lumped together with other South Asians. Thus far, very few published studies have examined psychological functioning solely within Pakistani immigrant groups. It is possible that certain stressors and psychological or social resources

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may be more salient to adult immigrants with children from Pakistan than to those migrating from other countries around the world, and vice versa (Jibeen & Khalid, 2010). In Canada, ethnic visible minorities account for 13.4% of the total Canadian population and majority (68%) of them belong to Asia including the Middle East countries (Statistics Canada, 2003). Pakistan is included in top ten countries of origin as one hundred and thirty eight thousand Pakistani immigrants are residing in Canada (Statistics Canada, 2005). Further, sixty thousand Pakistanis have migrated to Canada during 2001 to 2006 and around one hundred thousand Pakistani immigrants (or permanent residents) are residing in Toronto, and during 2001 to 2006, forty thousand Pakistanis have migrated to Toronto from Pakistan (Statistics Canada, 2006). It has been strongly suggested that major aspect of immigrant experience is dealing with acculturative stresses during the process of adapting to the norms and realities of the new society. Immigrants’ adverse experiences in employment life, such as status loss, discrimination, unemployment and underemployment usually have negative impact on both psychological well-being and adaptation to Canada (Aycan & Berry, 1996; Aroian, Norris, Patsdaughter, & Tran, 1997; Ying, 2005). The acculturative stressors have been consistently found to impede adjustment and well-being (Ying, 1994, 1996). A number of empirical studies have validated the assumption that acculturative stress may be a critical antecedent for an immigrants’ diminished psychological well-being in various Asian immigrant groups including Japanese (Baron & Matsuyama, 1988), and Korean (Noh & Kaspar, 2003). Psychological well-being is a broad concept reflecting both positive components (positive well-being or positive affect) and negative components (mental health problems, mental illness or mental distress) (Parkinson, 2004). In other words, a person high in psychological well-being not only carries higher levels of positive feelings and attitudes; but also manages tensions, negative thoughts, ideas and feelings more efficiently (Bhogle & Prakash, 1995). The inspection of literature indicates that socio-demographic characteristics such as age, gender, education, and income account for less than 15% of variability in well-being and distress for immigrants (Mehta, 1998). In addition, research suggests that non-demographic characteristics might also be important, especially personality constructs such as sense of coherence (Antonovsky, 1987), resilience (Costa & McCrae, 1980) and coping styles or strategies (Folkman & Lazarus, 1988). Yet little is known about their comparative importance to demographic variables. Because personal characteristics contribute to the immigrants’ psychological well-being, research designed to explicate how specific constructs, such as sense of coherence, coping strategies and social support moderate to immigrants’ negative health outcomes and psychological well-being is needed. 1.1. Theoretical framework The experts in the acculturation field (Berry, Kim, Minde, & Moke, 1987; Berry, 1980; Berry, 1997; Williams & Berry, 1991) postulated that many psychological factors may govern the relationship between acculturation and mental health. The Berry’s model also posits several variables that may serve as “buffers” in the reduction of stress resulting from the acculturation process. The effectiveness of stress-coping resources serves as general resistance factors against acculturative stress (Miranda & Mathency, 2000). The factors included in the explanatory model used in this study were selected from a number of potentially relevant factors because they constitute core elements in the stress and coping paradigm (Antonovsky, 1987; Finch & Vega, 2003; Folkman & Lazarus, 1985; Lazarus & Folkman, 1984) within which the best known model of acculturative stress has been developed (e.g., Berry et al., 1987). 1.2. Personal and social resources The current direction of Asian immigrant research has been to examine the moderating, rather than mediating effects of coping resources against acculturative stress (Noh & Kaspar, 2003). Coping refers to conscious perceptual, cognitive or behavioral responses that are used to manage, avoid or control situations that could be regarded as difficult (Carver & Scheier, 1994; Carver, Scheier, & Weintraub, 1989; Cohen & Lazarus, 1973; Lazarus & Folkman, 1984; Pearlin & Schooler, 1978). Literature (Jasinskaja-Lahti & Liebkind, 2001; Tartakovsky, 2007) indicates that psychological and social coping resources buffer acculturative stress and diminish the negative influence of acculturative stressors on the psychological well-being of immigrant population. Sense of coherence is one of the important psychological coping resource that has been found to moderate the impact of recent stressful life events like family breakdown, financial crisis, physical abuse) on self reported health status in non-immigrant population (Richardson & Ratner, 2005). It has also been linked with lower levels of depression, anxiety, life stress and physical symptoms (McSherry and Holm, 1994), with enhanced psychological and physical well-being and functional ability in immigrant population (Pallant & Lae, 2002). Problem focused strategies refer to adaptive behaviors that manage problems, and avoidant or emotion focused coping strategies usually ease emotional distress (Scheier, Weintraub, & Carver, 1986). Problem-focused coping strategies and strategies emphasizing social support have both been consistently associated with better health. As immigrants are bound to experience a lot of changes and losses (Crockett et al., 2007), they use different coping strategies for the resolutions of problems related to getting a job, accommodation problems, financial difficulties, discrimination, and language barriers (Chow & Ho, 1996). Literature (Menaghan, 1983) frequently suggested that overall problem-focused coping strategies (e.g., planning, seeking emotional or instrumental support, positive reinterpretation, acceptance, venting of

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emotion, getting comfort in religion) are more effective in dealing with stressors as compared to emotion-focused strategies (denial, behavioral disengagement, mental disengagement, alcohol or drug disengagement and self blaming). The moderating role of coping strategies have been related to adjustment level of immigrants as Crockett et al. (2007) conducted a study to examine the relations between acculturative stress and psychological functioning as well as the role of coping style. Their analyses suggested that problem-focused coping was related to better adjustment (lower depression), whereas emotion-focused coping predicted poor adjustment (higher level of depression and anxiety). Tests of interaction effects indicated that problem-focused coping buffered the effects of high acculturative stress on anxiety and depressive symptoms. Social support is another powerful and effective coping resource for persons experiencing stressful life changes including the stress of adjusting to an unfamiliar culture (Mallinckrodt & Leong, 1992). The amount of social support shape acculturative experiences of immigrants and diminish the negative influence of acculturative stressors on their psychological well-being (Jasinskaja-Lahti & Liebkind, 2001; Liebkind, 1996; Nesdale, Rooney, and Smith, 1997). Some literature (Lee, Koesky, & Sales, 2004; Lahti, Liebkind & Reuter, 2006) has demonstrated strong evidence for the direct and the moderating or buffering effect of support networks on well-being of immigrants. The immigrants’ family, relatives, and ethnic community are specifically found to provide crucial social support to immigrants and protect their psychological well-being (Finch & Vega, 2003; Garcia, Ramirez, & Jariego, 2002; Jasinskaja-Lahti & Liebkind, 2001). Thus, presence of people from the host society in the support network helps the immigrants to adjust to the host society (Garcia et al., 2002). The present study investigated the stress and coping paradigm to explain the individual differences for psychological well-being of Pakistani immigrants. The hypotheses concern the moderating role of coping resources (sense of coherence and perceived social support) and coping strategies (problem-focused and emotion-focused) in the relationship between acculturative stress and positive well-being, as well as acculturative stress and negative health outcomes. It was hypothesized that sense of coherence serves as moderator in the relationship between acculturative stress and positive well-being as well as acculturative stress and negative health outcomes. It was also hypothesized that problem-focused coping strategies moderate in the relationship between acculturative stress and positive well-being as well as acculturative stress and negative health outcomes. Further, emotion-focused strategies serve as moderator in the relationship between acculturative and positive well-being as well as acculturative stress and negative health symptoms. Finally perceived social support moderates in the relationship between acculturative stress and negative health symptoms as well as acculturative stress and positive well-being. 2. Method 2.1. Sample inclusion criteria For the purpose of this study, 308 Pakistani immigrants that met the following criteria were recruited. The present study included only Pakistani born immigrants living in Canada for the last one to five years. The sample was selected from Greater Toronto Area, Canada. It recruited only those immigrants who were in the process of becoming long-term residents. The current study included only married participants with at least one child. It is possible that certain stressors and psychological or social resources may be more salient to adult immigrants with children from Pakistan than to those migrating from other countries around the world, and vice versa. Both men and women, and working and non-working participants were included. Respondents were restricted to only one individual from one family or household. Only those participants were included in the current study who were falling within 25–50 years of age. 2.2. Demographic characteristic of participants Table 1 shows that sample was fairly distributed as 57% were men and 47% were women and the mean age of the participants was 35.8 years (SD = 7.31), with a range from 25 to 50 years. Approximately 25% of the participants were involved in physical labor, 17% were employed in human service, or technician or clerical type jobs, and 14% were doing pure management or professional jobs. Twenty nine percent of the participants were house wives and a small percentage was involved in their personal business. 3. Measures It was anticipated that in the present research study some respondents would have little knowledge of English language. Therefore all scales, except General Heath Questionnaire-12 and Acculturative Stress Scale were translated in Urdu language using the method of forward and backward translation (Brislin, Lonner, & Throndike, 1973). First, all of these instruments were translated in Urdu by three bilinguals and then the translated instruments were back translated to English by three other bilinguals. After this, these translations were compared to the original instrument. In next step, the researcher qualitatively checked the inter-rater reliability from three different bilinguals. The focus of the functional equivalence was on question whether the phenomenon being study is naturally occurring response to the same situational context in both cultures. When there was a difference in translation, changes were made in the instruments, until translators inter-rater agreement reached at 0.80 levels.

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Table 1 Study sample characteristics (N = 308). Variables Gender Male Female Age (25–50) Length of residence in Canada (1–5) Participants’ education High school or less Intermediate Graduate Master Professional Master and professional PhD professional Spouse’ education High school or less Intermediate Graduate Master Professional Master and professional PhD Professional Participants’ nature of job Physical labor Human service/technician/clerical Management or professional House wife Personal business Student Domestic business and house wife Not working or social assistance Participants’ job relevance Relevant To some extent relevant Non-relevant Perceived income level (1–4; high scores = more comfortable) Very much Moderate level To some extent Not at all Age of participants’ children

Frequency

Valid %

176 131

57 42

11 29 73 66 98 18 7

3 9.6 24.2 21.9 32.5 6 2.3

26 29 94 60 66 10 7

8.9 9.9 32.2 20.5 22.6 3.4 2.4

76 53 41 86

25.7 17.9 13.9 29.1

19 3 6 12 126 53 116 62

6.4 1 2 4.1 42.6 17.2 39.2 20.5

123 82 36

40.6 27.1 11.9

Mean

SD

35.8 3.4

7.31 1.36

2.61

1.64

Note: The numbers do not always lead up to 308. Job relevance means job relevance to previous experience/education.

Demographic information sheet and following six assessment tools were used in the present research. 3.1. Demographic information sheet It was applied to obtain the demographic information (e.g., age, gender, duration of stay in Canada, education, income comfort level, nature of job, etc.) from the participants. Researcher developed this sheet based on the review of the relevant research literature (Aycan & Berry, 1996; Kosic, 2004; Magna & Hovey, 2003; Pernice & Brook, 1996). In the initial stage of data collection, many missing responses were analyzed regarding the monthly income, home address, signature, and phone number. As a direct question about the participant’s income considered as taboo in traditional Pakistani culture, therefore, this question was replaced by the perceived income comfort level of the participant. Further, the questions about the personal identification like home address, signature, and phone numbers were also omitted. 3.2. Acculturative stress scale This 24-items scale was used to measure the acculturative stress level of the participants of this study (Jibeen & Khalid, 2010). This scale was developed to measures the acculturative stress level of adults with children. It measures the acculturative stress across five subscales including Discrimination/Marginalization, Threat to Ethnic Identity, Lack of Opportunities for Occupational and Financial Mobility, Homesickness, and Language-barrier. The Cronbach’s alpha for the total scale is .89 and for the subscales it ranges from .82, .77, .87, .56, and .64, respectively. This scale has indicated its divergent validity (r = .−42) with Psychological well-being Scale (Ryff & Singer, 1996), and convergent validity (.37) with general health questionnaire (Goldberg & Williams, 1988). Each item is rated on a 4-point Likert-type scale that ranges from I (Disagree) to 4 (Agree).

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3.3. Coping orientation to problems experienced The Brief COPE is (Carver, 1997) a short version of the COPE which was developed to assess the different ways in which people respond to stress. This self-report scale is based on the concepts of coping from Lazarus and Folkman (1984), and measures both adaptive and maladaptive coping skills (Carver, 1997; Carver et al., 1989). The Brief COPE consists of 28-items with only two items for each of the 14 subscales reflecting problem-focused and emotion-focused coping strategies. Each item is rated on a 4-point Likert- type scale that ranges from I (have not been doing this at all) to 4 (I have been doing this a lot). The items or responses are then summed up separately for each scale to yield 14 separate coping scores. Cronbach’s alpha in the present study for problem-focused was .74 and for emotion-focused strategies was .63. 3.4. The Orientation to Life Questionnaire Sense of coherence construct was measured by applying “The Orientation to Life Questionnaire”. Sense of coherence is global orientation or personality characteristic that expresses the general view of individuals regarding their internal and external environment. Antonovsky (1979, 1987) identified three main resources that may help to facilitate individuals’ positive adjustment; how they deal with challenges and how they cope with difficulties. These resources are expressed by the extent to which one has a pervasive, enduring though dynamic feeling of confidence that: (a) the stimuli deriving from one’s internal and external environments in the course of living are structured, predictable, and explicable; (b) the resources are available to one to meet the demands posed by these stimuli; and (c) these demands are challenges, worthy of extent to which one has a investment and engagement. Antonovsky (1979, 1987) refers to each of these three dimensions respectively as comprehensibility, manageability, and meaningfulness. This 13-item SOC scale uses a 7-point Likert-type scale with two anchoring responses. Cronbach’s alpha measure of internal consistency has ranged from .82 to .95. Cronbach’s alpha in the present sample was .77. 3.5. The multidimensional scale of perceived social support This scale was developed by Zimet, Dahlem, Zimet, and Farley (1988). The scale assesses perceptions of social support from three specific sources: family, friends and significant others. The MSPSS consists of 12-items, which are scored on a seven point Likert-type scale, ranging from 1 (very strongly agree) to 7 (very strongly disagree). Research shows that the scale is psychometrically sound with good reliability. The reliability of the total scale is .90 and for the significantly Others, Family, and Friend Subscale, the values range from .90 to .95 (Zimet, Powell, Farley, & Walker, 1990). Cronbach’s alpha in the present study was .90. As psychological well being is a broad concept of positive (well-being) and negative affect (mental health problems), therefore following two measures were used as an indicator of positive (well-being) and negative state of mental health. 3.6. Psychological well-being questionnaire This scale (Ryff & Singer, 1996) was implied to measure psychological well-being. They presented a multidimensional model of positive psychological functioning that explored six basic features of human well-being including self-acceptance, positive relations with others, autonomy, environmental mastery, purpose in life, personal growth. It has 54 items and each item is rated on 5-point scale ranging from 1(strongly disagree) to 5 (strongly agree).Its internal consistency ranges from .86 to.93, and temporal reliability (test–retest coefficient) ranges from .81 to .88. This scale also correlates modestly and positively with existing measures of positive functioning (life satisfaction, affect and self-esteem), negative measure of negative functioning (e.g., depression), thereby demonstrating convergent and discriminant validity (Ryff & Singer, 1996). Cronbach’s alpha in the present study was .87. 3.7. General health questionnaire The 12-item general health questionnaire focuses on breaks in normal functioning, rather than lifelong traits (Goldberg, 1972; Goldberg & Williams, 1988). It measures recent state of subjective well-being in four areas including psychosomatic symptoms, anxiety and insomnia, social dysfunction and depression. Each item is rated on a four-point scale and higher scores indicate a greater number of symptoms of psychological distress experienced. It has been reported that studies employing the GHQ-12, correlation coefficients varied between .71 and .91, with a median of .86 (Goldberg and Williams). It is available in Urdu language as it had already been cross validated by Minhas and Mubbashar (1996) in Pakistani primary care setting. They validated this scale against the gold standard of Psychiatric Assessment Schedule. Its cut off point was reported as 1/2. Its reported sensitivity and specificity is more than adequate as 93% and 88%. 3.8. Sampling procedure This study was approved by Advance Board of Studies and Research Committee, University of the Punjab, Pakistan. Following the ethics approval, potential participants living in GTA, Canada were identified. The purposive non-random sampling

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Table 2 Intercorrelations among study variables. Variable

1

1-PWB 2-GHQ

1.00 −.62** .00 .49** .00 .45** .00 −.51** .00 −.04** .43 −.39** .00

3-SOC 4-MSPSS 5-Emotion 6-Problem 7-A.Stress

2

3

4

5

6

7

1.00 −.46** .00 −.32** .00 .35** .00 .09* .15 .44** .00

1.00 .27** .00 −.37** .00 −.13* .00 −.54** .00

1.00 −.32** .00 .12* .04 −.21 .00

1.00 .34* .00 .36** .00

1.00 .17** .00

1.00

Note: N for all correlations does not always lead up to 308. PWB = psychological well-being; GHQ = general health questionnaire; SOC = sense of coherence; MSPP = multidimensional scale of perceived social support; emotion = emotion focused-strategies (10 items, measured by COPE scale); problem = problemfocused coping strategies (18 items, measured by COPE scale); A.Stress = acculturative stress scale. *p ≤ .05. **p ≤ .01. ***p ≤ .001 or less.

technique was implied to collect data from participants. More than one method was used to collect the data from participants like face to face administration of survey questionnaires and mail. The researcher consulted the Pakistani community centers; Pakistani populated community buildings, English language learning centers, shopping centers, Pakistani grocery stores, and word of mouth and recruited those participants who met the inclusion criteria of the present study. To maintain confidentiality, all responses were made anonymous and only those participants were included in this study who gave the informed consent. 3.9. Preliminary analysis The data for this study regarding outlier, coding error and missing value points on the individual questionnaire items and all key variables were checked regarding the normal and bivariate assumption of distribution. The frequency distribution of demographic data and descriptive items, internal consistency reliabilities of research instruments and inter-correlation matrix was generated. Separate moderated multiple regression analyses were run to examine moderating role of sense of coherence, coping strategies and perceived social support in the relation between acculturative stress and psychological well-being and acculturative stress and negative health outcome. The correlation matrix (Table 2) was generated to examine the bivaraite relationship between each moderator and criterion variables (psychological well-being and negative health outcomes) of the current study. All study variables indicated the relationship in the proposed direction except for few variables. An unexpected finding was that the use of problemfocused strategies was not playing any part in enhancing the psychological well-being or reducing the psychological stress or distress symptoms. Before performing the moderated hierarchical regression analyses, a univariate analysis of variance (ANOVA) was conducted to examine the group differences regarding selected demographic variables (e.g., age, income comfort level, job relevance and age range of the participants’ children). 4. Results 4.1. Interaction effects A series of moderated regression analyses were performed to examine the moderating effects of coping resources including sense of coherence, coping strategies and perceived social support in the relationship between acculturative stress and psychological well-being and acculturative stress and negative health outcomes. Results of regression analyses are summarized in Tables 3 and 4. Given that moderated multiple regression is a conservative procedure (Young, 2001), separate regression analyses were performed to maximize the power of the analyses. All scale scores were centered to reduce multicollinearity between the main effect and interaction terms. In each of the multiple regression analyses, acculturative stress variable was entered first, followed by a resource variable, and then the cross product term (stressor × resource). Semi-partial correlations were calculated after the addiction of each variable. A significant increase in accounted variance by a predictor variable represents a main effect for that variable, and a significant increase in accounted variance by the product of two variables represents an interaction.

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Table 3 Coping resources and coping strategies as moderators of psychological well-being dependent variable: psychological well-being. Variable

B

SE

ˇ

Stress SOC Stress × SOC Stress Problem-focused Stress × problem-focused Stress Emotion-focused Stress × emotion-focused Stress Perceived support Stress × perceived support

−.96 .98 −.02 −1.2 .16 −.01 −.1.2 −3.1 −.03 −.95 .92 .01

.13 .14 .01 .12 .24 .01 .13 .40 .02 .12 .11 .01

−.40*** .33*** −.38* −.48*** .03 −.26 −.45*** −.41*** .32 −.39*** .38*** .32

Note: B = unstandardized coefficients; ˇ = standardized coefficients; SE = standard error. Problem-focused = problem-focused coping strategies; emotionfocused = emotion-focused coping strategies; perceived support = perceived social support. * p < .05. **p < .01. *** p < .001 or less.

Results indicated that sense of coherence emerged to be a significant moderator in the relationship between acculturative stress and psychological well-being. When acculturative stress was entered individually in step 1, it did account for a significant amount of variance in positive well-being, F = (1, 305) = −7.67, p < .001. At step 2, sense of coherence also had main effects, F(1, 304) = 6.70, p < .001. In the final step, the cross-product term (acculturative stress and sense of coherence) was entered in and it accounted for significant effect in positive well-being, F(1, 303) = 2.78, p < .05; ˇ = −.37, p < .05. The acculturative stress and sense of coherence interaction was significant (partial correlation = −.12, t(302) = −2.08, p < 05). It suggested that sense of coherence significantly moderated the relations between stress and well-being. The main effect of sense of coherence was significant on negative health outcomes, F(1, 303) = −5.1, p < .001, suggesting that sense of coherence was protecting against the negative effects of acculturative stress in terms of decreasing the psychological distress symptoms. The moderating effect of sense of coherence was not significant F < 1, indicating that it did not decrease the negative outcomes. The hypothesis regarding the moderating role of problem-focused coping in the relationship between acculturative stress and psychological well-being was not supported, F < 1. It suggested that problem-focused coping strategies did not buffer the acculturative stress in terms of increasing positive psychological functioning. When problem-focused coping strategies were entered in interaction, it did not account for a significant amount of variance in negative health outcome. The main effect of emotion-focused strategies were significant, F(1, 275) = −7.6, p < .001 indicating that it were decreasing the psychological well-being. The hypothesis regarding the moderating role of emotion-focused strategies was non-significant indicating that it was not effecting psychological well being in terms of decreasing or increasing psychological well being. The emotion focused strategies accounted for a significant amount of variance in negative health outcome, F(1, 275) = 3.7,

Table 4 Coping resources and coping strategies as moderators of negative health outcomes dependent variable: negative health outcomes. Variable

B

SE

ˇ

Stress SOC Stress × SOC

.17 −.12 −.00

.02 .03 .00

.44*** −.30*** .02

Stress Problem-focused Stress × problem-focused

.18 .08 .08

.05 .07 .00

.45*** .01 .95

Stress Emotion-focused Stress × emotion-focused

.18 .26 −.00

.05 .07 .01

.47*** .21*** −.14

Stress Perceived support Stress × perceived support

.18 −.09 .00

.02 .03 .00

.23*** −.21*** .03

Note: B = unstandardized coefficients; ˇ = standardized coefficients; SE = standard error. Problem-focused = problem-focused coping strategies; Emotionfocused = emotion-focused coping strategies; Perceived support = perceived social support. *p < .05. **p < .01. *** p < .001 or less.

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p < .001, suggesting that it were decreasing mental health in terms of increasing negative health outcomes. The moderating role of emotion-focused strategies was non-significant. The moderating role of perceived social support was also examined between acculturative stress and positive well-being model. It did not account for a significant increase in the proportion of variance in predicting psychological well-being, F < 1. It indicated that perceived social support did not buffer acculturative stress in terms of enhancing psychological well-being. The main effect of perceived social support was significant in psychological well being suggesting that it were increasing the psychological well being. In negative health model, it did not account for a significant proportion of variance, F > 1, suggesting that perceived social support did not moderate the acculturative stress effects in terms of decreasing negative heath outcome. The main effect of perceived social support was significant in negative health model suggesting that it were decreasing the negative heath outcomes. 5. Discussion The current results validated the assumption that acculturative stress is a significant risk factor for immigrants’ positive functioning as participants perceiving higher level of acculturative stress had low positive functioning on six dimensions (e.g., self-acceptance, positive relations with others, autonomy, environmental mastery, purpose of life, personal growth). On the other hand, it was positively related to negative health symptoms as immigrants perceiving higher level of acculturative stress were suffering from higher level of negative health symptoms (depression, anxiety, insomnia and somatic symptoms). Overall, the current results supported the previous findings about the critical role of acculturative stress in diminishing psychological well-being of other Asian groups (Church, 1982; Ensel & Lin, 2000; Hurh & Kim, 1990; Noh & Kaspar, 2003; Ying, 1996). One of the coping resources like sense of coherence is a dispositional resource that show promise for distinguishing between adults who surrender or succumb to distress, and those who manage life’s stressors more effectively. The role of sense of coherence was studied as moderator between acculturative stress and positive well-being, and acculturative stress and negative health outcomes. The present results suggested that it buffers stress in terms of enhancing the positive well-being. These findings concur with previous research studies (Antonovsky, 1987; Heiman, 2004; Lam, 2007; McShery & Holm, 1994; Miranda & Mathency, 2000; Pallant and Lae, 2002). Further, the role sense of coherence as a moderator in the relation between acculturative stress and negative health outcomes was not supported. In most studies direct and mediating effects of SOC could be identified (Albertsen, Nielsen, & Borg, 2001; Feldt, Kinnunen, & Mauno, 2000). Empirical evidence for a moderating effect of SOC is much weaker than and not as conclusive as results supporting direct and mediating effects (e.g., Albertsen et al., 2001). However, while interpreting these results, one should take into account that for both personality characteristics and in particular for SOC, interaction effects with other environmental variables – not considered in the present study – might be of relevance. Such variables could be, for example, demands and stressors from the area of family life (Antonovsky, 1987). Moreover, to prevent an “unfair comparison” (Cooper & Richardson, 1986), one should recollect the fact that interaction terms have a low statistical power and that the sample size is not very large, which reduces the probability of identifying a moderator effect against direct effects. In the present study, the role of problem and emotion-focused coping strategies as moderator was weak or nonsignificant; and therefore the hypotheses regarding the moderator role of these strategies were partially accepted. The role of problem-focused strategies as moderator in the relation between acculturative stress and negative health outcomes was not supported. Unexpectedly, problem-focused strategies had no significant direct relation with positive well-being and also it did not play as significant moderator in the relation between acculturative stress and positive well-being. At one hand, the use of problem-focused strategies was not effective in decreasing the psychological distress symptoms and on the other; the use of problem focused strategies was also not effective in enhancing the positive well-being. In the same lines, similar findings have been reported in a sample of South East Asian refugees where active-focused strategies did not work as a moderator between discrimination stress and depression (Noh, Beiser, Kasper, Hou, & Rummens, 1999). According to Noh et al. these contrast point to the importance of cultural influences on coping .They emphasized the cultural maintenance hypothesis according to which preferred styles of coping reflect cultural norms and values. Additionally, Folkman (2001) noted that the inherently dynamic and variable nature of coping poses a significant challenge in detecting a clear relationship between a coping and particular health outcome. Therefore, there is need for the identification of culturally specific constructs which are useful for explaining cultural differences (i.e., emic approach, Lonner, 1980) and integration of the etic and emic approaches to clarify conceptual differences and build a more comprehensive knowledge base in psychology (Berry, Poortinga, Segall, & Dasen, 1999). The current study also indicated main and moderating role of perceived social support on well-being. It suggested that it buffers the deleterious effects of stress to enhance the positive well-being. The present findings are consistent with the previous literature that found the direct positive effect of social support networks on immigrants’ adjustment (Chataway & Berry, 1989; Davis, Morris, & Kraus, 1998; Hovey & Magana, 2002; Hovey, 1999a; Lin, Ye, & Ensel, 1999). Present research findings indicated that perceived social support had main effects on negative stress symptoms, but it did not confirm its buffering role in terms of decreasing the negative stress symptoms. Some research findings provide the rationale for the absence of moderating effect of perceived social support in the current Pakistani sample. For example, Latino studies found no evidence that social support moderated the association between stress and measures of adjustment or psychological distress (Alvan, Belgrave, & Zea, 1996; Rodriguez, Mira, Myers, Morris, & Cardoza, 2003). Further, Tylor,

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Kamarck, and Shiffman (2004) suggested that the cultural differences in expectations and norms about relationship between a person and the social network are likely to affect how and whether individuals seek and use social support. They found that Asians were less likely to solicit social support for coping with stress than European Americans. Additionally, people from the interdependent Asian culture rely less on social support for coping with stress than people from the more independent US culture. In addition, literature (Bolger, Zuckerman, & Kessler, 2000) suggested that when people actually drew on specific members of their social support networks for help during stressful times, support seeking often served as an additional cause of distress. Moreover, one study (Liang & Bogat, 1994) found that received social support had negative buffering effects for Asians (i.e., it made Asians feel more stressed). 5.1. Limitations It is important for reader to be careful about the findings of the present study that inherent some methodological problems. These limitations include: generalize ability, sampling biases, problems related to cross-sectional study, and use of instruments. One of the major limitations is related to generalizeability as this study was conducted in Greater Toronto Area, Canada, the findings cannot be generalized to larger populations of Pakistani immigrants in different countries, and other ethic immigrant population in Canada. Although efforts were made to select the sample that might mirror the actual population of Pakistani immigrants; participants in the study might not have been representative of the larger Pakistani immigrants. The other limitation of this study is non-random purposive sampling. Thus, generalize ability of the present results is limited to the groups falling under specific age, marital status, and duration of residence criteria. In addition, some of the findings and methodological implications of this study may only be applicable to recent immigrant groups who share similar background and cultural values. One of the limitations of this study concerns participants’ attrition or refusal to participate in the study. Some respondents refused to participate in the study, and therefore, the researcher cannot say for sure whether any systematic differences existed between respondents and non-respondents. However, it is important to keep in mind that participants refused to give personal information in pilot study due to fear of being tracked down and apprehended by immigration services. Cross-sectional survey design is another limitation as the findings of the study are limited in terms of establishing causal relationships among variables. A longitudinal study will be more useful in establishing causal relationship between acculturative stress and psychological distress. 5.2. Policy recommendations Despite its limitations, the present study provides useful findings about the impact of personal and social resources on psychological well-being in this immigrant community. It sheds light on the value of examining the moderators of stress separately for positive and negative affects in order to better understand which variables contribute to both types of affect when one undergoes stress. The identification of critical variables that lead towards psychological distress, or promote the positive well-being provide some clues for designing individual and group counseling interventions. These interventions will help them to enhance and sustain positive well-being and suppress the negative effects of acculturative stress that lead towards psychological distress. When immigrants move towards new country, often their personal and social resources are affected to a greater extent, and their personal resources like sense of coherence may also suffer due to acculturative stress inherent in migration process. The feelings of powerlessness can be handled with supportive therapeutic interventions that direct towards a greater sense of self determination and positive well being. Therefore, there is need for the planning and implementation of appropriate mental health promotion policies and strategies for Pakistani newcomer immigrants in Canada. It will be helpful for policy makers and practitioners in educational, social and community agencies, as well as staff within the health system to make effective interventions when they are working with South Asians especially Pakistani immigrants. When immigrants move towards new country, often their personal and social resources are affected to a greater extent, and their personal resources like sense of coherence may also suffer due to acculturative stress inherent in migration process. The feelings of powerlessness can be handled with supportive therapeutic interventions that direct towards a greater sense of self determination and positive well being. Therefore, there is need for the planning and implementation of appropriate mental health promotion policies and strategies for Pakistani newcomer immigrants in Canada. It will be helpful for policy makers and practitioners in educational, social and community agencies, as well as staff within the health system to make effective interventions when they are working with South Asians especially Pakistani immigrants. Policy makers in Canada need to re-evaluate policies that limit family reunification and immigrants’ choice of where to reside. 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