Hwabyung Among Korean Immigrant Women and Men in the United States

Background and Purpose:

The primary purpose of this study is to examine the factors contributing to hwabyung symptoms experienced by Korean immigrant women and men. Hwabyung is an indigenous psychiatric illness popular among Koreans. Chronic stress causes the onset of hwabyung, which manifests itself mainly through somatic symptoms. In the United States, both women and men are at great risk for hwabyung due the stress associated with acculturation. In comparison to 4.2 percent prevalence rate found in Korea, almost 12 percent of Korean immigrants suffer hwabyung (Lin et al, 1992). Previous studies suggest that factors contributing to hwabyung differ between men and women.  However, little is known about the factors contributing to hwabyung among Korean immigrant women and men. The following questions guided this study: (1) Is there a difference in hwabyung symptoms between Korean immigrant men and women?  (2) What are the factors contributing to hwabyungsymptoms among Korean immigrant women and men?

Method:

This cross-sectional study employed a non-probability sampling procedure. The participants were adult Korean immigrants who immigrated to the United States at the age of 18 or older. In addition to individual characteristics, the data collection procedure involved a self-administered anonymous survey consisting of five standardized Korean language instruments. Data collected from 242 voluntary participants were analyzed using t-test and hierarchical multiple regression (R²).

Results:

The difference in hwabyung symptoms between women (M=13.2, SD=8.6) and men (M=10.3, SD=8.8) was significant; t (239)=-2.55; p <.012. The hierarchical multiple regression (R²) analyses demonstrated that coping resources, economic hardship, family cohesion, and individual characteristics explained approximately forty percent of the variance in hwabyung symptoms among women (F (7, 124) = 11.98; p <.001) and approximately thirty seven percent of the variance in hwabyung symptoms among women men (F (7, 89) = 7.44; p<.001). For both women and men, the incremental change for each of two blocks was significant at p < .001 level.  

Of all the factors included in the analysis, social support was the strongest predictor that explained 12.5% of the variance in hwabyung symptoms, followed by sense of self-esteem (5.3%), receiving graduate education in the US (3.7%), and family cohesion (1.9%) among Korean immigrant women. In comparison, among men, social support was the strongest predictor that explained 7.3% of the variance in hwabyung symptoms, followed by economic hardship (6.9%).

Practice and Research Implications:

This study addresses a number of cross-cultural practice and research implications. The findings demonstrate the positive effects of social support in alleviating hwabyung symptoms among Korean immigrant women and men. For women, family cohesion appears to be a critical factor associated with hwabyung. In contrast, men suffering from economic hardship are especially vulnerable to hwabyung. Interestingly, for women, graduate education received in the US found to be a valuable resource that can increase their economic stability, which in turn, generates positive mental health effect. Future studies should examine the impacts of social injustice on hwabyung since  Koreans believe that abuse, discrimination, and other forms of social injustice can cause hwabyung.