Objective: There are over one million immigrants from the Former Soviet Union throughout the world and depression is common in this group. When left untreated, depression can pose serious economic and emotional consequences for immigrants and their families. Yet, not all immigrants will become depressed and determining those who will is not straightforward. There may be individual differences in depression trajectories within a single population of immigrants. Also, individual immigrants may move into or out of depression as a function of the changing demands or life circumstances they experience in their new resettlement country. Thus, it is important to study individual variation in the course of depression as well changes in immigration demands and depression over time. This study (1) examined the life circumstances, demographic characteristics, and immigration demands of former Soviet immigrants' whose depression lifted or who remained or became depressed over a two-year period and (2) investigated whether immigration demands, local relatives, age at immigration, gender, education, employment and marital status differed among the three groups. Study results provide clinically relevant information for assessing and intervening with high risk immigrants. Design: Study design was longitudinal and examined changes in immigration demands, life circumstances, and depression at baseline and at two-year follow-up. Participants were part of a larger longitudinal study of stress and psychological adaptation among relatively recent former Soviet immigrants. Sample: The sample was 253 former Soviet immigrants to the Boston area of the US who had been in the US five years or less at the initial data collection appointment and were depressed at at least one of the two data collection time points ("ever depressed"). Study participants were assigned to one of three groups - - remained depressed, became depressed, or depression lifted - - depending upon their depression trajectories. Methods: Data collection included Russian language versions of a demographic and migration questionnaire, the Demands of Immigration Scale, and the Depression Scale of the Symptom Checklist-90-R. Depression was determined based on whether the participants' score on the Depression Scale of the Symptom Checklist-90-R at baseline or two-year follow-up met Derogatis's (1992) gender-specific criteria for caseness in a community sample. Chi square analyses, analysis of variance, and analysis of variance for repeated measures were used to determine if the three groups differed on the variables of interest. Findings: Forty three percent of the sample remained depressed, 26% became depressed, and 30% had their depression lift over the course of two years. The three groups did not differ with regard to demographic characteristics or loss of employment or a negative change in marital status over the two-year study period. They did differ with respect to the presence of local family and immigration demands (p < .05). Those who remained depressed were less likely to have family in the area and had the highest immigration demand score at both time points. However, the effect for presence of local family was not significant when immigration demands were included in the analysis (p=32). Analysis of variance for repeated measures revealed that it was the group whose depression lifted which experienced the greatest change in immigration demand scores over the two-year study period. Conclusions: Study findings argue that clinicians should not expect immigrants' depression to always decrease over time and should assess depression by asking about immigration demands, even if depression was not present during an earlier clinical encounter. Further, researchers should assess for different depression trajectories in longitudinal data before examining changes in depression for the sample as a whole because these different trajectories can distort sample mean depression scores and contribute to misleading impressions regarding the immigration experience. Implications: This study contributed to understanding the range of individual differences in depression trajectories in relatively recent former Soviet immigrants. More importantly, it identified the factors associated with clinically relevant distinctions, specifically improved, worsening, or unchanging depression.
Back to Depression and Stress in Vulnerable Populations
Back to The Advancing Nursing Practice Excellence: State of the Science