Acculturative Stress

Acculturation or adaptation to a new culture involves changes in multiple areas of functioning (e.g., values, behaviors, beliefs, attitudes, etc.), and for individuals, families, and groups engaged in the acculturation process, these adjustments are often experienced as stressful. The stress that emerges from difficulties in acculturation is referred to as acculturative stress. Distinct from general experiences of stress, acculturative stress is understood to stem from differences in culture and language between the acculturating individual and the host culture or country. Furthermore, acculturative stress is also believed to be more closely related to symptoms of anxiety than depression and associated more with the presence of negative emotions rather than the absence of positive emotions.

Although the experience of acculturative stress is relevant for any individual living in multiple cultural worlds, which is the case for many U.S.-born ethnic and racial minority individuals, current conceptualizations of acculturative stress have emerged largely from empirical studies with immigrant groups. Within this body of literature, some of the variables that are hypothesized to be related to acculturative stress include majority language ability, assimilation pressure, acculturation style, demographic factors, distance between culture of origin and host culture, pre-immigration and migration experiences and intrafamilial acculturation levels/conflicts.

Theoretical Underpinnings of Acculturative Stress

What is currently known about acculturative stress is the result of a conceptual integration between the well-established stress and coping literature and the growing body of literature that explores the acculturation process. More specifically, the cognitive-relational model of stress and coping put forth by S. Folkman and R. S. Lazarus, which describes the processes associated with the stress experience and coping response, along with the empirical and theoretical literature that has emerged from cross-cultural psychologists, led by J. W. Berry and his colleagues, provide a strong foundation for understanding the experience of acculturative stress. A brief synopsis of both theoretical models is given next.

Stress and Coping

In the cognitive-relational model, stress is understood as a relationship between a person and his or her context that is appraised by the individual as difficult, beyond his or her current resources, or dangerous. Lazarus and Folkman note that individuals under stress evaluate what is at stake (e.g., physical safety, anticipated losses or gains) and what coping resources and options are available to them.

Coping is understood as an individual’s attempt to reduce the stress and moderate the impact of the stress through either cognitive or behavioral means. Individuals under challenging circumstances will typically evaluate their experiences and behaviors and then engage in basic coping procedures. Lazarus and Folkman have identified two key coping mechanisms for managing stress: problem-focused coping and emotion-focused coping. Both coping strategies are involved in the acculturation process, but their relationship to specific acculturation strategies is still not clear.

Acculturation: Definition and Theoretical Model

R. Redfield, R. Linton, and M. Herskovits provided one of the earliest definitions of acculturation, which they described as a process that occurs when individuals of different cultures are brought together in continuous contact and which consequently leads to changes in the cultural patterns of either or both groups. Although acculturation has been conceptualized as a dynamic process, where change occurs at multiple levels and with all involved groups (dominant cultural group and minority cultural groups), the concentration of acculturation research has largely been focused on the way in which minority immigrant individuals adapt to the norms (e.g., values, beliefs, and behaviors) of the dominant cultural group. Furthermore, earlier notions of the cultural adaptation process that focused on the assimilation of new immigrants, whereby newcomers to a country would and should “shed” their original culture to the culture of the host country, have been challenged by contemporary cultural psychology scholars that emphasize an integration strategy leading to a more bicultural or multicultural identity.

Berry’s acculturation model describes individual-contextual pairs of acculturation strategies, which can be adopted by either an acculturating individual or the larger society as a response to intercultural contact. At the individual level, Berry’s acculturation strategies include (a) assimilation, when an acculturating individual does not wish to maintain his or her original cultural identity and primarily seeks social relationships with the dominant society; (b) separation, which is characterized by a maintenance of the original culture/identity with a wish to avoid social relationships with the dominant society; (c) integration, where an individual wishes to maintain relationships with his or her original culture/identity and wishes to develop social relationships with the dominant society; and (d) marginalization, when the acculturating individual does not maintain his or her original culture/identity and does not have a desire to develop social relationships with the dominant society.

Theoretical Integration: A New Understanding of Acculturative Stress

Resting on these two distinct, yet rich, theoretical and empirical traditions, acculturative stress has come to be understood as a complex psychocultural/ psychosocial experience, where an individual, who is in the process of cultural adaptation, experiences stress related to the tasks associated with this change process. Furthermore, there are variables associated with the original culture, host culture, and individual, which may potentially exacerbate or minimize the level of acculturative stress experienced by the acculturating individual. However, the mechanisms through which these contextual and individual variables lower or heighten acculturative stress remain unclear. Using the impact of perceived discrimination as an example, it is possible that experiences of discrimination heighten an individual’s level of acculturative stress because he or she appraises the tasks of acculturation as too demanding or because the noxious stimuli are negatively impacting the individual’s personal resources (e.g., self-concept, coping).

Why Study Acculturative Stress?

Acculturative stress has emerged as an important specific kind of stress to investigate for a number of reasons. First, the significant and growing immigrant population calls for a better understanding of what may contribute or detract from the healthy cultural adaptation of these individuals. Second, because acculturative stress has been linked to other serious psychological outcomes, researchers and clinicians are increasingly interested in its investigation. Finally, because of increased globalization, individuals, even in less densely populated areas of the United States, are increasingly in contact with people that may identify with cultures that are different from the dominant or mainstream culture. These demographic shifts result in more intercultural contact among acculturating individuals and native-born individuals, which increase the possibility of individuals experiencing both acculturative stress and positive intercultural exchanges. Research in the area of acculturative stress may illuminate factors that are related to acculturative stress as well as factors that result in more positive intercultural experiences for all individuals.

Comorbidity with Psychological Outcomes

When individuals experience heightened levels of acculturative stress, they may exhibit a reduction not only in their mental health state but in their overall health. As is the case for stress in general, acculturative stress has been associated with negative mental health outcomes.

The relationship between acculturation and mental health has not been well established empirically. The data are equivocal, by supporting direct, inverse, and curvilinear relationships between acculturative stress and mental health outcomes. However, despite discrepancies in the literature regarding the way in which acculturative stress influences mental health outcomes for individuals, the significance of acculturative stress as a phenomenon of study is well documented. The emphasis on current research appears to be on examining the risk factors and protective factors associated with acculturative stress, some of which are briefly described next.

Risk Factors and Protective Factors Associated With Acculturative Stress

Most studies on acculturation focus only on the direct relationship between acculturation and mental health and not on possible explanatory mechanisms and processes. Recently, however, more attention has been focused on trying to understand the personal and contextual factors that either increase or decrease an individual’s risk of developing acculturative stress. In the following section, some of the risk factors and protective factors that have been associated with acculturative stress are discussed. It is important to note that the factors outlined here represent not an exhaustive list of variables that potentially affect an individual’s acculturation pathway, but rather an important subset of variables highlighted in recent literature.

Pre-Immigration Factors

Although individuals migrate to new countries for a variety of reasons, some of the most common reasons include political or economic turmoil in the country of origin and greater educational and financial opportunities in other countries. The reason that individuals decide to immigrate may have implications for their acculturation experience. For example, individuals who immigrate because their family or entire village has experienced severe financial ruin will move to the host country with very few monetary resources. The lack of financial resources may exacerbate the acculturative stress these individuals experience. Although not necessarily associated with the reason for immigration, another pre-immigration factor that potentially impacts individuals’ acculturation is their language abilities. Immigrants who are fluent in English, for example, may experience less acculturative stress associated with the post-migration demands because they are more likely able to understand and negotiate the demands of cultural adaptation.

Migration Factors

Migration Trauma. Whereas many immigrants migrate into new countries with their families in a safe and healthy manner, others come alone or come as refugees, and still others are forced to enter new countries by traffickers or smugglers. Refugees have often experienced trauma, including witnessing the death of family members and long periods of malnutrition and inadequate health care. The trauma experienced in either their native country (e.g., war, genocide, persecution, imprisonment, torture) or en route to their new destination (e.g., rape, abuse, exploitation) can affect refugees well after their arrival. Children and women are at a higher risk for abuse and harm during the migration process than are men. For instance, women crossing borders from Central to North America without their families may have encounters with coyotes (i.e., illegal travel brokers) for passage and may became victims of sexual assaults and forced labor before reaching their final destinations. Consequently, the migration process, for some, becomes a major acculturative stressor.

Pattern of Arrival. The pattern of immigration can greatly impact the experience of acculturation for immigrant families. For a host of reasons, a significant number of immigrant families come to America in units. This pattern of arrival has been referred to in the literature as step migration, and there has been a great deal of agreement that these family separations are sources of acculturative stress. Intrafamilial separations differ in length of time, usually with the longer separations being the more challenging for the family.

Documentation Status. Undocumented immigrants are at heightened risk for experiencing acculturative stress because their acculturation is mired by the fear of deportation and, for some, the actual experience of deportation. Furthermore, their lack of documentation may cause them to avoid public institutions, such as hospitals and clinics, even if they may need these services. This, in turn, adds to their level of risk for health and mental health difficulties. Also, it is important to note that the lack of documentation also places individuals at a heightened risk for exploitation by employers who may threaten to call the authorities.

Family Factors

Intrafamilial Acculturation Conflicts. It is possible that differences in acculturation levels within families will lead to difficulties or conflicts. However, when acculturation conflicts do occur between parents and their children, they have the potential to cause significant stress for members of the entire family unit. Family conflict arising from the acculturation process is beginning to be better understood. The cultural distance between families’ original culture and the host country’s culture can threaten the harmony of immigrant families’ intergenerational relationships. Furthermore, it is by now generally accepted that younger generations of immigrants acculturate to the Western or mainstream society at faster rates than their elders, who, oftentimes, firmly maintain their traditional customs. This discrepancy in acculturation level may result in increased familial stress and feelings of separation between family generations. It is also possible that the younger generations might experience interpersonal conflict by feeling like they must choose the host culture over their traditional, native identity.

Language/Cultural Brokering. Another outcome of differing rates of acculturation is the reliance on children as cultural and language brokers for their families. Oftentimes, because of limited social or financial resources, coupled with their limited English language abilities, parents rely on their children to help them manage and navigate the host culture. As language/ cultural brokers, children essentially translate the language and culture for their parents and also serve as the liaison between their family and the larger cultural context. This role is associated with both negative and positive outcomes for children. On the one hand, it has been argued that this “parentified” role can be experienced as stressful, especially considering the important tasks and decisions child language/cultural brokers are engaged in (i.e., legal, school, financial). Furthermore, when children act as language/cultural brokers for their families, they may miss important social and opportunities and enrichment activities, which can be experienced as a loss. On the other hand, it has also been argued that it is precisely the serious nature of the tasks required of children who serve as language/cultural brokers for their family that positively impacts their self-esteem and social development.

Language Use

The linguistic world of acculturative individuals is complex. English language usage and ability have been associated with acculturative stress, whereby individuals who are less fluent in English experience higher levels of acculturative stress. Given that linguistic ability is necessary not only for simple to more complex business transactions, such as buying groceries and a home, but also for developing relationships with people, language ability may be directly related as well as indirectly related, through social relationships and connectedness, to reported levels of acculturative stress. Despite evidence that suggests the importance of English language skills for acculturating individuals, this does not necessarily mean that healthy acculturation requires surrendering one’s language of origin for English. Individuals who are highly acculturated or have been in the host country for many years may experience stresses or losses associated with not being able to communicate in their language of origin with members of their cultural or ethnic enclave. Maintaining fluency in one’s language of origin may be a source of pride for individuals.

Acculturation Level

The level of acculturation, that is, the level of familiarity and exposure to the new culture, which is largely associated with amount of time in the host culture, is an important variable to consider when thinking about an acculturating individual’s risk for acculturative stress. Unfortunately, the empirical literature that focuses on the link between acculturation level and acculturative stress and other health and mental health outcomes is mixed. For example, it has been suggested that there is a relationship between acculturative level and acculturative stress, whereby higher levels of acculturation may lead to lower levels of acculturative stress. At the same time, there is a growing body of work that suggests that, for some individuals, greater acculturation is associated with an increase in negative physical and mental health, and, for youth, negative academic outcomes.

Nonetheless, immigrants at any level of acculturation can be at risk for detrimental psychological consequences. For example, highly acculturated individuals may realize that becoming acculturated and identified with the host culture does not always result in acceptance by mainstream society and can lead to the development of interpersonal conflict, alienation from traditional supports, frustration, demoralization, and internalization of society’s prejudicial attitudes. On the other hand, low-acculturated individuals often face multiple stressors when negotiating an unpredictable majority cultural milieu, which may lead to feelings of isolation, low self-esteem, and helplessness. Research proposes that positive mental health outcomes may be achieved from balancing one’s multiple cultures.

Acculturation Strategy

Research investigating Berry and others’ fourfold acculturation model primarily focuses on investigating the outcomes for acculturating individuals who adopt different acculturation strategies, with many of the results pointing to the same conclusion: Integration, or a bicultural identity, is the healthiest acculturation strategy for individuals associated with the least amount of acculturative stress. The strategy associated with the highest level of acculturative stress and considered the least healthy mode of acculturation is marginalization, which describes an individual who rejects his or her original culture as well as the host culture.

Exposure to Discrimination and Racism

Despite evidence of the detrimental effects of discrimination and racism for individuals’ well-being, these events are quite commonplace in society. Experiences of ethnic/racial discrimination can impact individuals’ health and mental health. In the Harvard Immigration Study, C. Suarez-Orozco and M. M. Suarez-Orozco suggest that within immigrant groups, race significantly impacts the level of discrimination one experiences. Given the fact that the majority of recent immigrants are persons of color, the impact of the sociocultural context of the host country on the identity development of non-White immigrants needs to be taken into consideration. When immigrants enter the United States, they are quickly made aware of the racial stratification that characterizes the status quo system of access to opportunity.

Social Capital and Social Support

The greater sociocultural context, determined primarily by the dominant group, greatly impacts acculturating individuals. Given that an individual’s successful acculturation is influenced by the flexibility, openness, and equality of the host society, it is imperative to examine the social and cultural context of the receiving community. A. Portes introduces the theory of economic sociology and, specifically, social capital, to help explain the process by which immigrants call on the monetary and nonmonetary resources of their ethnic community to assist with jobs, launch businesses, and establish a pool of suppliers and clients. It is argued that immigrants who move to an area that is richer in social capital will find the acculturation process less challenging because they have the support and resources of an ethnic enclave.

It has been hypothesized that acculturation and acculturative stress are mediated through social and personal variables. Specifically, social support has been found to be an alleviating factor and also serves as both a mediator and moderator in the acculturation-mental health link. For individuals who are in the process of acculturation, perceived social support is a primary protector against negative mental health outcomes. However, it is important to note that, regardless of how much social support individuals have, if they are continually exposed to serious acculturative stressors, they may possibly still experience heightened levels of acculturative stress.

Implications for Research and Practice

Accessing Mental Health Services

Numerous problems and potential barriers exist in the effective delivery of mental health services to the immigrant population. Individuals experiencing heightened levels of acculturative stress and/or other psychological issues (e.g., depression, anxiety) are less likely to seek psychological help. However, the underutilization of mental health services by immigrants is still not clearly understood. There are a host of reasons why immigrants may not seek psychological services, even when they may benefit from such services. Some of these reasons include, but are not limited to, miscommunication between patients and clinicians due to language or cultural barriers; low level of multicultural competence on the part of the clinician; stigmas attached to receiving counseling; the use of culturally relevant coping strategies, such as family members or indigenous healers; fear of seeking services because of lack of documentation; and intercultural mistrust with authority figures and institutions associated with the host society.

It is important that researchers examine which factors serve as barriers to the successful delivery of services for immigrants. For example, seeking help from a mental health practitioner may be a last resort for some immigrant clients, and therefore, practitioners must be sensitive to the potential severity of the problem. Finally, it is imperative for counselors to be culturally competent when working with immigrant clients, which includes an acknowledgment of the client’s specific cultural values.

Acculturative Stress and Psychological Outcomes

Successful practitioners are keenly aware of the complex interplay between acculturation and psychological distress when they are providing counseling services to immigrants. For example, given the evidence that suggests that the acculturation process can be extremely stressful and can impact a client’s presenting problem, a thorough client history that includes experiences before immigration, during migration, and during acculturation might be necessary.

It is also important for clinicians to understand the acculturation process and the types of stressors that may be associated with a client’s acculturation strategy or level. For instance, low-acculturated clients (i.e., new immigrants) may experience homesickness, isolation, and grief over what they left behind in their native land. Contextual factors, such as lack of financial opportunities and discrimination, may exacerbate these stressors. On the other hand, for highly acculturated individuals, the acculturative stress they experience may be both quantitatively and qualitatively different from low-acculturated individuals. For example, highly acculturated individuals may not experience stress related to an inability to communicate in English, but they may experience the stress associated with attempting to maintain a bicultural identity.

Future research should concentrate on discovering within-group differences that exist during the acculturation process so that treatment can become specific and more effective. For instance, not all immigrants, even those within the same ethnic group, acculturate and appraise acculturative stressors in the same way; each may have unique resources (e.g., financial and family supports) and barriers (e.g., lack of education and language skills) that change the experience of acculturation and level of acculturative stress.

Risk and Resilience

Supportive sources within one’s own ethnic community may be important in developing both culturally specific ethnic and host competencies. Counselors are encouraged to recognize and appreciate their clients’ personal, family, and community resources, as they may serve to protect clients from harmful outcomes associated with acculturative stress. Although practitioners are heavily trained in the diagnosis and treatment of psychological disorders, this preparation may place an overemphasis on finding out what’s wrong with individuals. Practitioners who work with immigrant individuals may be more successful if they balance the tasks of facilitating growth in areas of need with supporting and acknowledging client strengths. Similarly, researchers interested in understanding what impacts the acculturation pathway of immigrants may want to investigate both the risk factors and the protective factors associated with this process.

Moving Beyond the Traditional Counseling Role

Counseling psychologists in this new era may be required to move beyond the traditional counseling role, which is largely associated with humanistic approaches to individual and group counseling. Given the inextricable link between the person and the environment, counseling psychologists are increasingly assuming new roles as change agents at systemic levels while they also continue to develop effective interventions that focus on change at the individual level. Furthermore, counseling psychology, as a professional discipline, with its deep tradition and history in human development and multicultural theories, is poised to make a significant positive impact on the way in which immigrants adjust to the new cultural context and on the way in which the cultural context embraces and adjusts to its new citizens.

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