Acculturation and Adjustment of Elderly Émigrés from the Former Soviet Union: A Life Domains Perspective

Acculturation and Adjustment of Elderly Émigrés from the Former Soviet Union: A Life Domains Perspective BY ANA GANCHEVA GENKOVA B.A., University of Illinois at Chicago, 2009 THESIS Submitted as partial fulfillment of the requirements for the degree of Master of Arts in Psychology in the Graduate College of the University of Illinois at Chicago, 2014 Chicago, Illinois Defense Committee: Edison J. Trickett, Chair and Advisor Dina Birman, Psychology Rachel A. Gordon, Sociology

ACKNOWLEDGEMENTS My sincerest gratitude to my mentor and adviser, Ed Trickett, for his guidance and dedication to this project. I am much indebted to Dina Birman and Andrey Vinokurov who allowed me to use their data. Dina s thoughtful feedback helped me develop the ideas that became the essence of this study. My deep appreciation to Rachel Gordon who guided me through the data analysis portion of this project and graciously served on my defense committee. I also thank Stephanie Riger and students in the writing class who provided very useful edits to earlier versions of this thesis. Most of all, thanks to my family. AGG ii

TABLE OF CONTENTS CHAPTER PAGE I. LITERATURE REVIEW...1 A. Introduction...1 B. Acculturation Overview...3 C. A Life Domains Approach to Acculturation and Adaptation...4 D. The Self-System Domain...5 E. The Family Domain...7 F. The Social Domain...9 G. The Medical Care Domain...10 H. The Present Study: Questions and Hypotheses...11 II. METHOD...13 A. Data and Sample...13 B. Measures...14 1. Predictor variables...14 a. Acculturation to American and Russian cultures...14 2. Psychological adaptation...15 a. Life satisfaction...15 b. Hopkins symptoms checklist...15 c. Cultural Alienation...16 3. The family domain...16 a. Family satisfaction...16 b. Perceived family support...16 3. The social domain...17 a. Social network composition...17 b. Perceived social support...17 3. Medical care...17 a. Satisfaction with medical care...18 III. RESULTS...19 A. Descriptive Statistics...19 B. Regression...20 1. The psychological domain...21 2. The family domain...21 3. The social domain...22 4. The medical care domain...23 IV. DISCUSSION...24 1. Findings and Implications...24 2. Limitations and Future Direction...28 iii

CITED LITERATURE...30 TABLES...39 APPENDIX A...47 APPENDIX B...49 APPENDIX C...50 APPENDIX D...51 APPENDIX E...52 APPENDIX F...53 APPENDIX G...54 APPENDIX H...55 INSTITUTIONAL REVIEW BOARD APPROVAL...56 VITA...59 iv

LIST OF TABLES TABLE PAGE 1. SAMPLE CHARACTERISTICS...39 2. MEANS, STANDARD DEVIATIONS, AND RANGES FOR PREDICTOR AND OUTCOME VARIABLES...40 3. BIVARIATE CORRELATIONS BETWEEN PREDICTOR AND OUTCOME VARIABLES, GENDER, AND EDUCATION...41 4. REGRESSION COEFFICIENTS AND STANDARD ERRORS FOR OUTCOMES IN THE PSYCHOLOGICAL DOMAIN....43 5. REGRESSION COEFFICIENTS AND STANDARD ERRORS FOR ADAPTATION OUTCOMES IN THE FAMILY DOMAIN...44 6. REGRESSION COEFFICIENTS AND STANDARD ERRORS FOR ADAPTATIONOUTCOMES IN THE SOCIAL DOMAIN....45 7. REGRESSION COEFFICIENTS AND STANDARD ERRORS FOR OUTCOMES THE MEDICAL CARE DOMAIN...46 v

LIST OF ABBREVIATIONS LIB Language Identity and Behavior Scale vi

SUMMARY Former Soviet émigrés in the United States are on average older than other immigrant groups, with adults over 65 comprising a large portion of the Russian-speaking population. Because of personal and structural barriers, these older adults tend to acquire a new culture with difficulty and remain highly oriented towards their heritage culture. However, limited research is available on how acculturation to both the culture of origin and the host culture contributes to adaptation among elderly immigrants. In this study I use pre-collected data to assess the adaptive value of host and heritage acculturation across several domains in the lives of older émigrés the former Soviet Union resettled in the Baltimore area. Acculturation was measured with the Language, Identity, and Behavior Scale (LIB; Birman & Trickett, 2001) and used to predict psychological, family, social and medical care adjustment outcomes. Results suggest that acculturation to the host or heritage culture has different functions depending on life domain. Particularly, high American acculturation contributed to better adjustment in all examined domains. Heritage acculturation was associated with better outcomes in the social domain and had mixed effects for psychological adjustment. Theoretical implications highlight the importance of evaluating multiple life domains of adapting through a bilinear acculturation model for this understudied population. vii

I. LITERATURE REVIEW A. Introduction Socio-political events in recent decades drove large numbers of former Soviet Union residents out of their homelands. Over half a million Russian-speaking émigrés resettled to the U.S. fleeing anti-semitism or economic and political instability (Klinger, 2007; Polyakova & Pacquio, 2006). Soviet policies required families to emigrate together with their aging relatives. Consequently, Soviet émigrés are on average older than other immigrant groups. Adults over 65 comprise more than 20 percent of the Russian-speaking population in the U.S. (Polyakova & Pacquiao, 2006). Most of these immigrants have a high education level and professional backgrounds (Klinger, 2007). As a result, researchers and providers have underestimated adjustment difficulties for Russian-speaking elderly in U.S. despite known risks associated with old-age migration (Kim-Goh, 2006). Former Soviet elders adaptation partly depends on their level of acculturation to the receiving culture (Tsytsarev & Krichmar, 2000). Studies link greater English ability and amount of time spent in the country to better psychological wellbeing (Tran, Sung, & Huynh-Hohnbaum, 2008; Tsytsarev & Krichmar, 2000). However, older immigrants do not acquire a new language easily and time spent in the country does not necessarily reflect their levels of acculturation (Miller, Wang, Szalacha, & Sorokin, 2009). Indeed, the elderly tend to maintain their heritage culture for decades after resettlement regardless of whether they acquire the new culture (Jang, Kim, Chiriboga, & King-Kallimanis, 2007; Millet et al., 2009). Nevertheless, few studies examine the joint effects of the host and heritage culture on elders adjustment. In this study I 1

2 measure individual changes in the cultures of origin and resettlement to understand how they affect adaptation. Broadly, acculturation refers to changes resulting from first-hand contact between different cultural groups (Redfield, Linton, & Herskovits, 1936). Individuals change with respect to their host and heritage cultures simultaneously (Birman & Simon, in press). To assess the adaptive value of host and heritage acculturation, I apply an ecology-of-lives perspective (Trickett, 2009). Adapting to a new culture involves managing the demand characteristics of various domains that comprise of the transactions between individuals and their settings and relationships (Birman & Simon, in press; Swindle & Moos, 1992). Each domain fulfills a different goal and presents distinct constrains and opportunities for the individual. Therefore, elders may benefit from being more Russian in some domains and more American in others. Certainly, immigrant adolescents and working-age adults rely on different cultural resources depending on the life domain they have to navigate (Arends-Tóth & van de Vijver, 2004; Birman, Trickett, & Vinokurov, 2002). However, little research has focused on the adaptation of older adults in their daily lives. Interviews with older former Soviets revealed that social networks, the family, and medical care are central domains in their lives (Ucko, 1986; Vinokurov, 2001). Another frequently researched domain related to acculturation is the self-system or psychological wellbeing. Moving to another country involves changes to all of these relevant domains. Elder migrants lose life-long social relationships, experience changes in their family dynamic, and worry about managing an unfamiliar medical system as their health becomes more frail (Litwin,

3 1997; Treas & Mazumdar, 2002; Ucko, 1986). This study will explore how host and heritage acculturation uniquely affect adjustment with respect to these domains. B. Acculturation Overview Early paradigms equated acculturation with assimilation to the majority culture. Scholars now recognize that acquiring the beliefs and practices of the host culture does not imply rejecting heritage values and customs (Schwartz, Unger, Zamboanga, & Szapocznik, 2010). Berry s (1980) four-category model cast cultural acquisition and retention as independent of one another, creating four acculturative outcomes that describe the extent to which immigrants endorse the culture of origin or resettlement. These outcomes form the categories of assimilation, separation, integration, and marginality. In response to theoretical and psychometric criticisms of Berry s categorical model, Birman (1994) developed continuous scales that measure host and heritage acculturation independently in the cultural dimensions of language, identity, and behavior (LIB; Birman & Trickett, 2001; Rudmin, 2003; LaFombroise, Coleman, and Gerton, 1993). Continuous measures represent acculturation as a process rather than a stable individual characteristic and reveal the unique functions of the host and heritage acculturation. Viewing acculturation as bilinear and multidimensional implies many possible styles of individual cultural changes. In the case of older immigrants of Asian or Caucasian backgrounds, acculturating to the cultures of origin and resettlement seems to occur independently of one another (Jang et al., 2007; Miller et al., 2009). Therefore, this study treats host and heritage acculturation as orthogonal processes, using a bilinear scale that can capture their independent effects on adjustment.

4 C. A Life Domains Approach to Acculturation and Adaptation Psychologists have dedicated much research to discovering the acculturative course related to the best individual adjustment outcomes (Birman & Simon, in press). Findings suggest that the most suitable strategy depends on changing factors of the environment (Birman, 1998; Birman et al., 2002). The idea of life domains offers a way to organize these factors into different interdependent settings and relationships that fulfill different needs and goals in people s daily lives (Swindle & Moos, 1992). For immigrants in particular, each life domain includes a cultural component (Birman, 1998). Coping in each domain may require skills, values, and attitudes prevalent in the host or the heritage culture. Therefore, determining the most beneficial acculturative strategy involves appreciating the diversity of immigrants daily lives. Research with working-age adults and adolescents supports the assumptions of the life domains perspective: different acculturative styles provide culture-specific resources to navigate the demands within each domain. Specifically, Turkish adults in the Netherlands indicated higher value for Dutch culture in public life domains, such as education, media, and government policy, and regarded Turkish culture more highly in private domains, including family life and religious celebrations (Arends-Tóth & van de Vijver, 2004). Similarly, host and heritage acculturation predicted different domains-specific outcomes for Vietnamese (Nguyen, Messé, & Stollak, 1999) and Russian (Birman et al., 2002) adolescents in the United States. Previous research, however, has not investigated the adaptation of elderly immigrants across their everyday life domains.

5 D. The Self-System Domain The most frequently studied adjustment domain for older adults is the self-system, which encompasses overall psychological wellbeing (Nguyen et al., 1999; Swindle & Moos, 1992; Vinokurov, Trickett, & Birman, 2002). Regardless of ethnic group, older immigrants face the greatest risks of poor psychological adaptation (Kim-Goh, 2006; Ron, 2001; Tran et al., 2008; Vinokurov, 2001; Wrobel, Farrag, & Hymes, 2009; Zamanian, Thackrey, Starrett, & Brown, Lassman, & Blanchard, 1992). In reaction to differences between the culture of origin and resettlement, elders experience psychological distress characterized by a combination of psychological symptoms and physical complains (Krause & Golderhar, 1992; Ritsner, Modai, & Ponizovsky, 2000; Tsytsarev & Krichmar, 2000). Additionally, elder immigrants on average report lower satisfaction with life than younger counterparts (van Selm, Sam, & van Oudenhoven, 1997). They may also feel alienated as a result of strong attachment to heritage values and limited contact with the mainstream culture (Fitzpatrick & Freed, 2000; Miller, Sorokin, Wang, Feetham, Choi, & Wilbur, 2006). Demographic characteristics also affect psychological wellbeing for older adults. Women report greater adjustment difficulty than men (Birman & Tyler, 1994; Shemirani & O Connor, 2006), whereas married, highly educated elders experience fewer symptoms (Fitzpatrick & Freed, 2000; Jang et al., 2007). Acculturation patterns, however, are related to both positive and negative indicators of psychological wellbeing (Yoon et al., 2013). Latin American and Korean elders acculturated to the host culture suffer fewer mental and physical symptoms of distress (Jang et al., 2007; Kraus & Goldenhar, 1992). Former Soviet elderly who speak the local language adjust with less difficulty than the ones who do not (Tran et al., 2008). However, studies have not explored if

6 and how heritage acculturation uniquely affects elders distress. In this study, I expect lower level of distress for American acculturated immigrants after controlling for demographic factors, including gender, education level, and marital status. In addition, I propose to explore the relation between heritage acculturation and distress. Unlike distress, life satisfaction captures a positive indicator of psychological wellbeing that measures a different aspect of the self-system (Yoon et al., 2013). Studies find that host and heritage acculturation both predict indicators of positive adjustment, including satisfaction with life (Yoon et al., 2013). In many cases, however, scales do not measure the two acculturation forms independently; using the fourfold paradigm produces inconsistent results (Rudmin & Ahmadzadeh, 2001). For example, in one study all three acculturation categories of assimilation, integration, and separation predicted life satisfaction, leaving unclear the independent effects of host and heritage acculturation (van Selm et al., 1997). Because overall life satisfaction encompasses multiple aspects of people s lives, I predict that higher levels of both host and heritage acculturation would relate to greater satisfaction after controlling for the potential demographic confounds of gender, marital status, and education level. Host acculturation may contribute to higher life satisfaction through increased independence and heritage acculturation, through positive relationships with the Russian-speaking community (Katz, 2009; Litwin, 1997). In addition to other wellbeing indicators, former Soviet elders report feeling culturally alienated from the mainstream (Birman & Tyler, 1994). Alienation refers to a sense of disconnect from established social norms and values of the host culture (Miller, Birman et al.,

7 2009; Seeman, 1975). Former Soviet elders express a strong commitment to the heritage culture and report feeling unfulfilled in the U.S. (Fitzpatrick & Freed, 2000). They recognize America s economic advantages, but feel dissatisfied with social and family life (Ucko, 1986). They also perceive Americans as impersonal and insincere (Dunaev, 2012). Consequently, greater Russian acculturation will likely increase feelings of alienation by reinforcing cultural differences. American acculturation, on the other hand, should relate to lower alienation. E. The Family Domain In former Soviet cultures, elders highly value the nuclear and extended family. They rely on family members for emotional and, in some cases, financial support (Iecovich et al., 2004). Therefore, they typically emigrate together with their families in order to remain close to them through old age (Ucko, 1986). In addition to providing care and support, younger family members give elders purpose and hope for the future in the new country. Older adults become invested in the success of children and grandchildren (Tsytsarev & Krichmar, 2000). For example, in one study a 72-year-old former Soviet woman stated, I am very happy we came to Israel, for the children's sake. Had we remained in the Soviet Union, I do not know what would have become of my oldest grandson; there is no longer anything to do there, no work, no life. I always prayed for the welfare of my children and grand- children, and it is good for me to be with them. God bless them" (Katz & Lowenstein, 1999). The family forms a central domain in the lives of older immigrants (Katz & Lowenstein, 1999; Lowenstein, 2002; Treas & Mazumbar, 2000; Vinokurov, 2001).

8 The present study assesses the outcomes family satisfaction and family support. Feeling satisfied with family relationships and assistance impacts elders positive adjustment (Kim-Goh, 2006, Vinokurov, 2001). However, in the acculturation process, elders may experience some family conflict (Katz & Lowenstein, 1999). Family dynamics change under acculturative pressures. Younger immigrants acquire the host culture more rapidly than parents or grandparents (Ho & Birman, 2010). Older adults may come to depend on their children and grandchildren even for daily tasks (Vinokurov, 2001). Relying on younger relatives contrasts with elders traditional family roles of authority figures and may cause elders to feel dissatisfied with their role in the family. Thus, greater host acculturation enables older immigrants to feel independent, contributing to their family satisfaction (Treas & Mazumdar, 2002; Ucko, 1986). Perceived familial support also contributes to easier immigrant transition. Despite potential conflicts, the family becomes elders primary support source after resettlement (Litwin, 1997). Elder immigrants report feeling financially and emotionally secure with their families, whose assistance and care serve as a refuge in the unfamiliar environment (Lowenstein, 2002; Ucko, 1986). Elders receive the most help and attention when they feel least prepared to cope with acculturative pressures (Litwin, 1997). Feeling less independent may increase the need to rely on familial ties, so low American acculturation may relate to greater family support. Heritage acculturation may also reinforce interdependence and relate to greater amount of support.

9 F. The Social Domain Successful adaptation depends on forming supportive networks in the new country Jasinskaja-Lahti, Liebkind, Jaakkola, & Reuter, 2006; Lee, Crittenden, Yu, 1996). Researchers distinguish between the function of social network composition and perceived support (Cohen & Wills, 1985; Cruza-Guet, Spokane, Caskie, Brown, Szapocznik, 2008). Immigrants need both host and heritage networks for their social adjustment (Jasinskaja-Lahti et al., 2006). People from their own cultural background may be present in immigrants network early in the acculturation process. However, host networks may increase with acculturation to the host society (Jasinskaja-Lahti & Liebkind, 2007). Acculturation may also affect the perceived support from immigrants networks, an important element of elders social adjustment. Immigrants not acculturated to the host culture may need the security of counting on heritage networks for both instrumental and emotional support, while the perception of support from host communities may help bridge the cultural gap (Barnes & Aguilar, 2007). Therefore, network composition and perceived support both served as measures of adjustment in the social domain. Host and heritage acculturation may relate differently the perceived composition and support of social networks. Because of cultural barriers, older immigrants have difficulty establishing connections with host networks (Treas & Mazumdar, 2002; Yoo & Zippay, 2012). Yet, heritage acculturation helps them form social relationships with other immigrants (Vinokurov, 2011). Therefore, elders with low host acculturation may benefit from having more Russian networks. Additionally, acculturation may affect the perceived support elders from existing networks. Higher host acculturation seems beneficial in the social domain as it relates to greater support from both host and heritage networks for adult immigrants (Jasinskaja-Lahti &

10 Liebkind, 2007). Nevertheless, elderly Korean immigrants prefer to seek the support of people from their own ethnicity, which likely relates to heritage acculturation (Yoo & Zippay, 2012). Based on these findings, I expect that greater host acculturation would relate to wider host networks and more perceived support from these relationships. I also predict that elders with greater Russian acculturation will perceive more extensive heritage network and support. G. The Medical Care Domain Health is one of the major concerns for older Soviet immigrants (Kim-Goh, 2006). They pay heightened attention to their health past immigration because they do not want to burden adult children with their care (Aroian, Khatutsky, Tran & Balsam, 2001). For the same reason, they prefer to use formalized services rather than ask family members help. Consequently, elders worry about availability of satisfactory medical assistance in light of declining health. Therefore, medical care becomes a central life domain for older immigrants. Having spent the majority of their lives under a communist regime, they expect free, accessible services (Aroian & Vander Wal, 2007). Thus, unlike other immigrant groups, they overuse, not underuse, the medical system because norms of the heritage culture encourage it (Aroian et al., 2001). Yet, most immigrant elderly in the U.S. face health care disparities (Aroian et al., 2001; Lum & Vanderaa, 2010). They have problems with service access and quality compared to nonimmigrant older adults. To overcome these disparities, immigrant elders have to know how to navigate the U.S. medical system, which requires familiarity with English and the American bureaucracy. Medical care satisfaction, therefore, would increase with host acculturation.

11 H. The Present Study: Questions and Hypotheses In this study I will examine the relationship of host and heritage acculturation to outcomes in four life domain of elderly former Soviet immigrants. Based on the preceding review, I expect 1) a positive relation between American acculturation and psychological wellbeing: elders with higher host acculturation will feel less distress and alienation and experience greater overall satisfaction with life; 2) heritage acculturation to relate to feelings of alienation in the host culture, but also to greater overall life satisfaction. Additionally, I will explore how Russian acculturation affects psychological distress. I will control for time in the U.S.as a potential confound of acculturation levels. Additionally, I will control for demographic characteristics known to affect wellbeing that include gender, marital status, and education level (Birman & Tyler, 1994; Jang et al., 2007). In the family domain, I will relate host and heritage acculturation to the outcomes of satisfaction and support. Because of the acculturation gap between older and younger generations, I expect 1) greater American acculturation to relate to higher family satisfaction; 2) elders with low American acculturation to receive more family support; and 3) greater heritage acculturation to contribute to more family support because of cultural norms and stronger familial ties after resettlement (Litwin, 1997). In this domain I will control for time in the U.S. in addition to living arrangements and marital status, which may influence both family outcomes (Katz & Lowenstein, 1999). The social domain includes the outcomes of network composition and support. Aside from time in the U.S., potential confounds for these outcomes include gender, marital status, and

12 education levels (Yoo & Zippay, 2012). Controlling for these variables, I expect that 1) Russian acculturation will relate to social relationships with other Russians and 2) American acculturation will increase the size of host networks. Similarly, I predict that 3) Russian acculturation will relate to greater support from Russian friends, while 4) American acculturation will increase perceived support from host networks. Finally, in the medical domain, I will relate acculturation to elders satisfaction with care. I predict 1) American acculturation to relate to greater health care satisfaction. Heritage acculturation, on the other hand, may influence expectations for the care quality that differ from U.S. standards. Therefore, 2) Russian acculturation will possibly relate to lower medical satisfaction. To test these hypotheses, I will control for time in the U.S. and education

II. METHOD A. Data and Sample The data reported here were collected as part of a larger study with support from the Maryland Office of New Americans. The agency provided the PIs with a list of all families from the former Soviet Union who arrived to Maryland as refugees between 1989 and 1999 (Birman, Chan, & Tran, under review). Russian-speaking interviewers contacted families by phone to identify eligible working-age adults, adolescents, and elders. Ninety seven of the elderly participants were related to the contacted families and another 264 were recruited through a snowball sampling technique. The snowball method involved qualitative interviews with 12 key informants, who assisted in assembling groups of 6-40 former Soviet elders who completed a standardized survey in Russian (A. Vinokurov, personal communication, September 27 th, 2012). In order to focus only on those immigrating in late adulthood, I excluded from the analyses women who were under 55 years old and men who were under 60 years old at the time they entered the U.S. (N = 44). The age cutoff corresponds to the age of retirement for men and women in the former Soviet Union. Incomplete cases were also excluded from further analyses (N = 32). The final sample included 285 elder adults. Table 1 describes demographic characteristics of the participants. Over half were women (62%). The majority came from Ukraine (43%) or Russia (38%). Most of the participants were married (53%) or widowed (35%) and held a college degree or beyond (63%). Nearly all (94%) reported refugee status currently or in the past. The average age of the participants was 74, ranging from 59 to 94. 13

14 Their average age of arrival was 67.3 and the highest was 86.6. On average participants had spent seven years in the U.S. (SD = 4.00). B. Measures The measures were included in a single survey translated into Russian. After the initial translation, two assistants reviewed the items and made corrections for grammar and style (Vinokurov, 2001). Then the researcher made grammatical and semantic corrections to improve clarity. A group of four Russian-speaking immigrants completed the final review and grammatical changes before the survey administration. 1. Predictor variables This section describes the acculturation measures that will serve as predictors to elders adaptation. Refer to Appendix A for the English translation of the administered measure. a. Acculturation to American and Russian cultures Two parallel scales assessed acculturation to American and to Russian cultures along the dimensions of language, identity, and behavior. Birman and Trickett (2001) designed the scales for former Soviets by adapting existing acculturation surveys. Because all participants were native Russian speakers who arrived to the U.S. in late adulthood, the Russian scale measuring language ability was not administered. The English scale consisted of nine items (α =.96) measuring command of English on a four-point Likert scale that rated speaking and understanding in different situations (e.g. on the phone). The American and Russian identity subscales included four parallel items regarding identification with American (α =.88) and Russian (α =.92) cultures. On a 4-point scale, respondents indicated how much they felt they belonged to the culture ( I think of myself as being American ; I think of myself as being

15 Russian ) and had a positive regard of the culture ( I feel good about being American ; I feel good about being Russian ). The eleven behavior items asked the extent to which participants engaged in the American (α =.79) and Russian (α =.75) cultures through activities, such as speaking, reading, and eating. In this study, I combined the subscales into an overall measure of American (α =.92) and Russian (α =.82) acculturation. 2. Psychological adaptation The psychological domain encompasses overall wellbeing. It includes the positive indicator of life satisfaction and the negative indicators of psychological distress and cultural alienation. See Appendix B, C, and D for the complete measures in English. b. Life satisfaction The perceived Quality of Life scale (Fazel & Young, 1988) contains 17 items about satisfaction with different aspect of life, including family, leisure time, health, and living standard. The scale was slightly modified to exclude employment-related items likely to be inapplicable for the age group of the sample. The administered scale contained 14 items (α =.84). Participants indicated how they felt about aspects of their life on a five-point scale ranging from 1(very badly) to 5 (very well). c. Hopkins symptoms checklist. The Hopkins symptoms checklist (Green, Walkey, McCormick, & Taylor, 1988) measures levels of psychological distress through 21 items describing symptoms of depression, somatization, and performance anxiety. The responses range from 1 (not at all distressing) to 4 (extremely distressing). The internal consistency of the scale in the study was.91.

16 d. Cultural alienation. The alienation scale measures immigrants feelings of social and cultural estrangement (Nicassio, 1993). Birman & Tyler (1994) translated the scale to Russian and excluded the I don t know response. The 10-item scale (α =.66) includes statements, such as It is difficult for me to understand the American way of life and I feel like I belong in American society (reverse-coded). Items were rated on a four-point scale from 1 (strongly agree) to 4 (strongly disagree). 3. The family domain The family domain measures elders overall feeling of satisfaction with one s family and the extent to which they can rely on family members for social support. a. Family satisfaction The researchers adapted Carver and Jones (1992) 20-item family satisfaction scale for adults designed to measure feelings of satisfaction with family members and relationships (e.g. I would do anything for a member of my family ). They omitted four of the items as inapplicable for older adults because of reference to parental rules and rephrased the remaining items in present tense. The scale ranged from 1 (strongly agree) to 5 (strongly disagree) and included six reverse-scored items. See Appendix E for the complete measure. Carver and Jones (1992) reported an internal consistency of.98 and two-month test-retest reliability of.88. The calculated reliability for the present sample was.78. b. Perceived family support Participants indicated how much (1 = not at all to 3 = a great deal) they could count on their spouse, cohabiting family members, and other relatives for help with private matters, social programs, and money. They also rated the overall pleasure from interactions with

17 these individuals (see Appendix F). I averaged across all of the item ratings to create an overall score for perceived family support 4. The social domain Constructs included in the social domain describe participants social network composition and perceived support. a. Social networks composition The social networks measure was designed for this study. Participants indicated the number of Russians, Russian Jews, Americans, American Jews, and others, with whom they socialized, had dinner, or were close friends. I used the number of American and Russian friends to measure the size of elders network in the host and heritage communities (see Appendix G for the administered measure). b. Perceived social support Participants rated how much they could count on American and Russian friends for help with private matters, public programs, and money on a 3-point scale from 1 = not at all to 3 = a great deal. They also rated the pleasure they received from overall interactions with American and Russian friends (see Appendix F). I averaged the support rating across all four areas to calculate overall scores for perceived support from American friends and perceived support from Russian friends. 5. Medical care The medical care domain reflects immigrants perceived experiences with the American medical system. The complete measure in English can be found in Appendix H.

18 a. Satisfaction with medical care. The present study used eight items (α =.80) in the dimensions of general satisfaction, interpersonal aspects, and time spent with doctors from the Patient Satisfaction Questionnaire (Marshall, Hays, Sherbourne, & Wells, 1993). Participants rated their satisfaction from 1 (strongly agree) to 5 (strongly disagree). The modified scale specified that items referred to American doctors only.

III. RESULTS Descriptive results are first discussed to understand the general acculturation and adaptation patterns of the present sample. Then, bivariate correlations between all continuous variables are presented to assess their relationships prior to testing hypotheses. Finally, simultaneous regressions were conducted to test the specific hypotheses of the effects of acculturation scores on outcomes in each life domain. A. Descriptive Statistics Table 2 displays the means, ranges, and standard deviations of participants acculturation scores and domain outcomes. A paired t-test showed that participants were oriented more towards their own ethnic (Russian) culture, M = 3.31, SD =.46 than to American culture, M = 2.09, SD =. 55; t (284) = - 26.58, p <.001. Noteworthy are the high average scores of family satisfaction (M = 4.40, SD =.48) and support (M = 2.86, SD =.54). Additionally, participants reported higher numbers of Russians, M = 26.4, SD = 21.23, than Americans, M = 9.8, SD = 12.88, in their overall network, M = 37.7, SD = 29.78; t (284) = 14.32, p <.001. They also reported receiving greater support from their Russian networks, M = 2.28, SD =.49, than American ones, M = 1.57, SD =.53; t (284) = -19.58, p <.001. Table 3 displays bivariate correlations between acculturation and outcomes scores, time spent in the U.S, gender, and education levels. The reference group for gender is males and for education level, some college and beyond. The overall Russian and American acculturation scores showed a weak inverse correlation (r = -.17, p <.01). Time spent in the U.S. related to higher American acculturation (r =.29, p <.01) and marginally to lower Russian acculturation (r 19

20 = -.11, p =.06), suggesting that over time elders acquire the host culture, while their heritage cultural orientation remains high. Although significant, inter-correlations show that domain-specific outcomes are relatively independent. In the psychological domain the strongest association was between the Hopkins Symptom checklist and life satisfaction scores, r = -.46, p <.001. The significant correlation between support and satisfaction scores in the family domain was.34. Additionally, support received from Russian friends positively related to support from American friends, r =.28, p <.001. The support items also correlated with the participants network composition (r =.54, p <.001 for American network and support and r =.16, p <.01 for Russian network and support). Correlations show that outcomes within each domain are associated, but fairly discrete constructs. Thus, no scales were collapsed for the regression analysis. B. Regressions To test study hypotheses, I regressed participants overall Russian and American acculturation scores onto the outcome variables in each domain. Based on the preceding review, I included time in the U.S., gender, marital status, and education level as control variables for regressions testing hypotheses in the self-system and social domains. To test the acculturation effects on outcomes in the family domain, I controlled for time in the U.S., gender, marital status, and living arrangements. Marital status and proximity to relatives may influence both family outcomes (Iecovich et al., 2004). Time in the U.S. and education level served as control variables in the medical care domain. While time in the U.S. may be a confound for

21 acculturation, higher education seems related to lower health disparity in immigrants, which likely influences medical care satisfaction (Lum & Vanderaa, 2010). 1. The psychological domain In the psychological domain, it was hypothesized that American acculturation would uniquely contribute to lower distress level, lower alienation, and greater life satisfaction. Russian acculturation was expected to contribute to greater alienation and greater life satisfaction. No prediction was made regarding the effect of Russian acculturation on psychological distress. I conducted three regressions for each of the outcome variables (distress, alienation, and life satisfaction) to test these hypotheses (see Table 4). As expected, American acculturation uniquely contributed to lower psychological distress, β = -.16, p <.05, lower feelings of alienation, β = -.37, p <.001 and to greater satisfaction with life, β =.28, p <.001. Russian acculturation predicted greater alienation, β =.13, p <.05, but also higher life satisfaction, β =.16, p <.05, concurring with the hypotheses. It did not significantly affect psychological distress levels. Control variables had no significant unique contributions to alienation or life satisfaction. However, marital status significantly predicted levels of distress. Specifically, widowed participants experienced greater distress than married participants, β =.16, p <.05. 2. The family domain In the family domain, I predicted that American acculturation would uniquely contribute to family satisfaction after controlling for demographic factors and time spent in the U.S. I also hypothesized that Russian acculturation would uniquely predict support from the family beyond the control variables of time in the U.S., marital status, and living arrangements. To test these hypotheses, I conducted two regressions with the outcome variables of family

22 satisfaction and family support (see Table 5). As expected, American acculturation uniquely predicted family satisfaction, β =.11, p <.05. Additionally, marital status and living with children uniquely contributed to family satisfaction scores. Specifically, married participants experienced greater family satisfaction than participants who were single β = -.56, p <.05, divorced, β= -.32, p <.01, or widowed, β = -.16, p <.05. Elder immigrants who lived with their children also reported greater family satisfaction than those who did not, β = -.25, p <.01. Contrary to predictions, Russian acculturation did not contribute significantly to support received from family members. Rather, marital status and living arrangements were predictors of family support. Married elders perceived greater support from their family members compared to single, β = -.71, p <.05, divorced, β = -.16, p <.001, or widowed participants, β = -.35, p <.001. Elders living with children reported marginally higher family support scores than those not living with children, β = -.16, p =.056. 3. The social domain In the social domain, I hypothesized that American acculturation would predict greater American network availability and received support. Similarly, I expected Russian acculturation to contribute to wider Russian network outside the family and greater use of support from that network. To test these predictions, I conducted four regressions with criterions of Russian and American network availability and Russian and American social support (see Table 6). In all of these regressions I controlled for time in the U.S., gender, marital status, and education level. To test the hypotheses regarding network availability, I also controlled for the total network size 1. Additionally, I controlled for Russian and American network size to test the 1 The network size variables (total, American, and Russian) were logged in order to meet normal distribution assumptions.

23 respective social support hypotheses. As expected, greater American acculturation uniquely contributed to more Americans in elders networks, β =.77, p <.001, and greater Russian acculturation predicted more Russians in their social circles, β =.11, p <.01. However, American acculturation related to a decreased Russian network size, β = -.15, p <.001. Russian acculturation also predicted fewer Americans in elders networks, β = -.30, p <.05. As hypothesized, American acculturation related to more support from American friends, β =.19, p <.001, and Russian acculturation, to more support from Russian friends, β =.18, p <.01. Larger American, β =.21, p <.001, or Russian, β =.11, p <.01, networks also contributed to more support from the respective social group. Surprisingly, American acculturation also predicted greater support from Russian friends, β =.16, p <.01. Gender also uniquely contributed to support from Russian friends, such that women received more support than men, β =.16, p <.01. 4. The medical care domain In the medical domain, I expected American acculturation to relate to greater satisfaction with care after controlling for time in the U.S. and level of education. Table 7 displays the regression results supporting the hypothesis: higher American acculturation score contributed to greater satisfaction with medical care, β =.13, p <.05. Additionally, time spent in the U.S. also predicted greater medical care satisfaction, β =.02, p <.05.

IV. DISCUSSION A. Findings and Implication This study aimed to understand the relation between acculturation and adjustment of Russian-speaking immigrants resettling in late adulthood. The results support a life domains approach to immigrant adaptation. How elders acculturate relates to the cultural demands they are able to manage in daily life. Therefore, successful acculturation patterns vary depending on the conditions that each life domain presents. This study contributes to the literature by extending the life-domain perspective to the adjustment of former Soviet immigrants who arrived to the U.S. as older adults. Previous studies with older immigrants from diverse ethnic backgrounds have focused exclusively on the psychological effects of acculturation using a stress and coping framework (Chiriboga, 2004; Tran et al., 2008; Wrobel et al., 2009). Most of them measure acculturation only to the host country. The majority of these studies find that low host acculturation relates to higher levels of stress, negatively impacting psychological wellbeing (Ritsner, et al., 2000; Tran et al., 2008). Fewer studies assess the effects of heritage acculturation on adjustment. When included in the measures, elders heritage acculturation relates to elevated stress and distress levels (Abu-Bader, Tirmazi, & Ross-Sheriff, 2011; Wrobel et al., 2009). Concluding that heritage acculturation relates to lower wellbeing underemphasize the effects of the heritage culture in elders lives. Such general conclusion from studies that assess only psychological adjustment obscure the differing acculturation-adaptation relationships across domains. The 24

25 present study adds to general findings from past research by measuring adjustment in more than one domains. Additionally, results suggest that heritage acculturation forms an important part of the immigrant experience of older adults, so future studies should attend to its effects. The acculturation patterns of the present sample resembled those found in previous studies: elder immigrants from different ethnicities remain highly acculturated to their heritage culture over time and acquire the host culture to different extents (Abu-Baden et al., 2011; Jang et al., 2007; Miller et al., 2009). Staying longer in the country of resettlement does not necessarily correspond to levels of acculturation to either culture. Rather, for older adult immigrants, host and heritage acculturation seem to develop independently of each other and of time spent in the host country as suggested by the weak correlations of these constructs. Therefore, I analyzed the independent effects of these processes on adjustment. Generally, higher American acculturation facilitated elders adjustment across all domains examined in this study. Consistent with previous findings and the present hypotheses, participants with high host acculturation reported greater psychological wellbeing. These findings may reflect fewer difficulties for elder immigrants familiar with the local language and cultural norms. This familiarity may shape elders perceptions of independence and self-reliance in a predominantly American context of immigration (Treas & Mazumbar, 2002). Greater host acculturation was also beneficial in the family domain, possibly because of a reduced intergenerational acculturative gap (Katz & Lowenstein, 1999; Treas & Mazumbar, 2002). Relying on younger relatives provides seniors security, but may not meet their social and emotional needs because acculturative struggles claim much of younger immigrants attention

26 (Treas & Mazumbar, 2002). More acculturated elders can have a degree of independence and understanding of the problems their family members face in the U.S., leading to improved satisfaction with filial relationships. The results also supported the hypotheses of the advantages of American acculturation in forming supportive social networks within the host community and in satisfactory use of the American medical care system. These finding confirm previously documented benefits for elderly immigrants who acculturate to the mainstream. Unexpectedly, American acculturation appeared to increase the support that participants perceived from their Russian social connections. Possibly, elders with high American acculturation can act as cultural brokers for friends and acquaintances and take leadership roles. These participants may feel well-regarded and supported within their own ethnic community. Alternatively, greater perceived support may reduce the stress associated with resettlement. The fewer perceived difficulties may ease acculturation to the host culture. Future research should seek to clarify the relationship between host acculturation and ethnic support networks. Studies may investigate factors associated with greater perceived ethnic support. Qualitative inquiries could describe the characteristics of elders acculturated to the host country and how they engage with people who share their ethnicity. Heritage acculturation also presented advantages for elderly immigrants. Those with higher Russian acculturation reported larger social networks and greater support within their own ethnic communities. Heritage networks may provide the only social contacts outside of the elders family members (Jasinskaja-Lahti & Liebskind, 2006; Litwin, 1997). Participants in this study reported socializing primarily with other Russians or Russian Jews, highlighting the

27 importance of heritage acculturation in their social lives. Contrary to the hypotheses, however, heritage acculturation seemed unrelated to the amount of support participants received from their family members. It is possible that family support depends on the presence of immediate family members rather than acculturation patterns: being married and living with adult children increased reported family support. In the self-system domain, elders with higher Russian acculturation reported greater overall life satisfaction. Greater acculturation to either culture may affect different dimensions that comprise overall life satisfaction (Swindle & Moos, 1992). For example, host acculturation may contribute to overall life satisfaction through higher perceived self-sufficiency and heritage acculturation through greater sense of belonging within participants ethnic community. Future studies should investigate factors that link acculturation and life satisfaction. Heritage acculturation may also present challenges to elders adaptation. Participants with higher Russian acculturation reported increased feelings of alienation from the larger society. These elders may struggle with the different social and cultural values of the former Soviet Union and the U.S. They may feel that the U.S. family and social dynamics diminish their traditional role of respected authority (Fitzpatrick & Freed, 2000). Higher heritage acculturation might reinforce perceived cultural differences, leading to feelings of alienation. In sum, this study adopted a life-domains approach to examine the direct effects of acculturation on adjustment. Findings suggest that both host and heritage acculturation play a role in elders resettlement experience. Different acculturative patterns, however, imply varying adaptation outcomes according to the immigrants life conditions. Host acculturation appears

28 beneficial across several domains, which may result from the daily subsistence needs that the majority culture imposes on resettling individuals. Nevertheless, the culture of origin remains deeply engrained in adults who immigrate late in life, which appears to have mixed effects on adapting. The theoretical framework that guided this study helped detect these previously overlooked details of the Russian-speaking elders resettlement experiences. Future work can build on this study by extending these framework to other elderly immigrant populations. B. Limitations and Future Direction Notwithstanding the discussed strengths, the present study has some limitations. First, findings are based on cross-sectional data analysis. It is possible that results reflect behavioral patterns of psychological, social, and family wellbeing rather than effects of acculturation. For example, participants most satisfied with their lives may be the ones who acculturate to the American culture while successfully maintaining their heritage culture. Future studies should address this limitation through methods that can infer causal direction, such as longitudinal designs. Additionally, the present conclusions may not extend to other Russian-speaking elderly immigrants because participants were recruited through snowball sampling techniques. Those who wish to generalize to other elderly populations should take into account the description of the present sample provided earlier in this paper. The present study may spark future work in elders acculturation. All of the data presented here derive from self-report questionnaires. Future studies could add to the topic by using different methods and informants. For example, qualitative researchers may employ interviews the elderly and their supporters within or outside the family to understand how they