title: Relational experiences of partnered Japanese immigrant women with affect disorders.
abstract: OBJECTIVE
  This paper reports the findings of a study that explored characteristics of relationships of Japanese immigrant women partnered both intraculturally and interculturally, and analysed the role of Japanese culture in these relationships.
  
  
  BACKGROUND
  Immigration can cause shifts in interpersonal structures with partners. When there are large discrepancies in gender roles and communication styles between the original and host cultures, the psychological impact on both partners may be significant. However, currently no empirical data are available to support this assumption.
  
  
  METHODS
  Ten cases selected from the 68 medical records of Japanese-speaking women seen at a mental health clinic from September 2001 to September 2004 were analysed. All of the 10 women met DSM IV-TR criteria of major depressive disorder and were taking antidepressants. Half of the 10 women were in intimate intercultural partnered relationships and the remainder of the matched cases were in intracultural relationships at the time of treatment. The two cohorts were matched in age (36.2 and 43.2 years), length of stay in the United States of America (12 and 16.2 years), and length of treatment (1.2 and 1 years). The length of time of the sample in individual psychodynamic psychotherapy ranged from 20 to 317 hours, depending on the intensity of therapy.
  
  
  RESULTS
  Inductive data analysis revealed two themes: (1) Lack of awareness of differences in culturally bound communication by Japanese women in intercultural partnerships; (2) Lack of individuality in Japanese women in intracultural partnerships. Neither group appeared to consider relational aspects of partnership, or to make efforts to improve direct communication with their partners.
  
  
  CONCLUSIONS
  The influence of Japanese culture on gender role and communication styles functions contrary to the mainstream Western culture of the United States of America. In the future, interpersonal elements of cultural differences between host and original cultures in immigration should be considered in research related to immigrants' mental health. This approach should lead to effective interventions to facilitate mental health among immigrants, and regardless of purposes of immigration or length of stay in a psychosocially foreign environment.
authors.affiliation: Psychosocial & Community Health, University of Washington School of Nursing, Seattle, Washington 98195-7263, USA. ykozuki@u.washington.edu
authors.forename: Yoriko
authors.initials: Y
authors.lastname: Kozuki
authors.forename: Michael G
authors.initials: MG
authors.lastname: Kennedy
authors.forename: Jenny Hsin-Chun
authors.initials: JH
authors.lastname: Tsai
mesh_terms: D000328:Adult; D001290:Attitude; D001364:Awareness; D015331:Cohort Studies; D003142:Communication; D003469:Culture; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000208:ethnology / Q000523:psychology*; D004641:Emigration and Immigration; D004644:Emotions; D005260:Female; D005783:Gender Identity; D006801:Humans; D007398:Interpersonal Relations; D007564:Japan / Q000208:ethnology; D008875:Middle Aged; D012649:Self Concept; D018454:Spouses / Q000523:psychology*; D014481:United States