Evidence has suggested that acculturation could be a bi-dimensional concept. Berry’s model of acculturation is the well-known and widely-researched model of bi-dimensional acculturation. However, only few studies have examined the effect of Berry’s bi-dimensional acculturation and maternal depression trajectories among immigrant mothers. The study objective was to explore how Berry’s four acculturation strategies affect depression during pregnancy and postpartum period.
Methods:
This study employed a prospective cohort study design. Marriage-based immigrant women who were at least twelve weeks pregnant were recruited from hospitals, clinics and health centers (N=310). The data were collected by face-to-face or telephone interview, mail or e-mail, using structured questionnaire in the 2nd and 3rd trimester during pregnancy and at 1 month, 3 months, 6 months, and 1 year postpartum during the period from March 2013 to December 2015. Maternal depression was measured by Edinburgh Postnatal Depression Scale. Bi-dimensional acculturation was measured by two self-developed 19-item parallel scales, adaptation to host culture and maintenance of heritage culture, with higher score indicating higher level in each. Besides the scale scores, the score for each of the two scales (adaptation to host culture; maintenance of heritage culture) was divided into high and low level, which yielded a total of four acculturation types (marginalization (low; low), separation (low; high), assimilation (high; low), and integration (high; high)). Social support was composed of three subscales (emotional, instrumental, and informational support) with higher score indicating higher level in each support. Generalized estimating equation (GEE) was used to examine the relationships.
Results:
The percentage was 22.3%, 24.5%, 27.1%, and 26.1% in the marginalization, separation, assimilation, and integration groups, respectively. The separation group had a higher level of depression than the other three groups. Emotional support interacted with four-type acculturation on maternal depression. In the separation group, emotional support had a more protective effect against maternal depression when compared to the other three groups.
Conclusion:
Immigrant women who were more likely to maintain the heritage culture and less likely to adapted the host culture (separation group) had higher depression symptoms than the other three groups (marginalization, assimilation, and integration). Emotional support was more beneficial to decrease maternal depression in the separation group when compared to the other three groups. To decrease maternal depression, strategies should be developed to target immigrant women who had separation orientation and to increase their emotional support.