Journal of Immigrant and Minority Health

, Volume 20, Issue 4, pp 792–798 | Cite as

Acculturation Strategies and Symptoms of Depression: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study

  • Belinda L. Needham
  • Bhramar Mukherjee
  • Pramita Bagchi
  • Catherine Kim
  • Arnab Mukherjea
  • Namratha R. Kandula
  • Alka M. Kanaya
Original Paper


Using latent class analysis, we previously identified three acculturation strategies employed by South Asian immigrants in the US. Members of the Separation class showed a preference for South Asian culture over US culture, while members of the Assimilation class showed a preference for US culture, and those in the Integration class showed a similar preference for South Asian and US cultures. The purpose of this study was to examine associations between these acculturation strategies and symptoms of depression, a common yet underdiagnosed and undertreated mental disorder. We used data from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study (n = 856). Data were collected between October 2010 and March 2013 in the San Francisco Bay Area and Chicago. Depressive symptoms were assessed using the CES-D Scale. Applying a simple new method to account for uncertainty in class assignment when modeling latent classes as an exposure, we found that respondents in the Separation class had more depressive symptoms than those in the Integration class, but only after taking into account self-reported social support (b = 0.11; p = 0.05). There were no differences in depressive symptoms among those in the Assimilation class vs. those in the Integration class (b = −0.06; p = 0.41). Social support may protect against elevated symptoms of depression in South Asian immigrants with lower levels of integration into US culture.


Acculturation Symptoms of depression South Asian immigrants United States 



The MASALA study was supported by the NIH Grant No. 1R01 HL093009. Data collection at UCSF was also supported by NIH/NCRR UCSF-CTSI Grant No. UL1 RR024131. The study sponsor had no role in study design, collection, analysis, or interpretation of data; writing the report; or the decision to submit the manuscript for publication. No financial disclosures were provided by the authors of this paper. Article contents have not been previously presented elsewhere.

Supplementary material

10903_2017_635_MOESM1_ESM.docx (34 kb)
Supplementary material 1 (DOCX 33 KB)


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Belinda L. Needham
    • 1
  • Bhramar Mukherjee
    • 2
  • Pramita Bagchi
    • 3
  • Catherine Kim
    • 4
  • Arnab Mukherjea
    • 5
  • Namratha R. Kandula
    • 6
  • Alka M. Kanaya
    • 7
  1. 1.Department of Epidemiology and Center for Social Epidemiology and Population HealthUniversity of MichiganAnn ArborUSA
  2. 2.Department of BiostatisticsUniversity of MichiganAnn ArborUSA
  3. 3.Department of StatisticsUniversity of MichiganAnn ArborUSA
  4. 4.Departments of Medicine and Obstetrics and GynecologyUniversity of MichiganAnn ArborUSA
  5. 5.Department of Health ScienceCalifornia State University, East BayHaywardUSA
  6. 6.Department of MedicineNorthwestern UniversityChicagoUSA
  7. 7.Departments of Medicine and Epidemiology and BiostatisticsUniversity of CaliforniaSan FranciscoUSA

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