| Original Full Text | Georgia State University ScholarWorks @ Georgia State University Counseling and Psychological Services Dissertations Department of Counseling and Psychological Services Summer 8-7-2024 Towards Collective Healing: Intervening Intergenerational Trauma with Koreans/Koreans Hyunji Hannah Lee Georgia State University Follow this and additional works at: https://scholarworks.gsu.edu/cps_diss Recommended Citation Lee, Hyunji Hannah, "Towards Collective Healing: Intervening Intergenerational Trauma with Koreans/Koreans." Dissertation, Georgia State University, 2024. doi: https://doi.org/10.57709/37393438 This Dissertation is brought to you for free and open access by the Department of Counseling and Psychological Services at ScholarWorks @ Georgia State University. It has been accepted for inclusion in Counseling and Psychological Services Dissertations by an authorized administrator of ScholarWorks @ Georgia State University. For more information, please contact scholarworks@gsu.edu. ACCEPTANCE This dissertation, Towards Collective Healing: Intervening Intergenerational Trauma for Koreans/Korean Americans, by Hyunji Hannah Lee, was prepared under the direction of the candidate’s Dissertation Advisory Committee. It is accepted by the committee members in partial fulfillment of the requirements for the degree, Doctor of Philosophy, in the College of Education & Human Development, Georgia State University. The Dissertation Advisory Committee and the student’s Department Chairperson, as representatives of the faculty, certify that this dissertation has met all standards of excellence and scholarship as determined by the faculty. Cirleen DeBlaere, Ph.D Committee Chair Elise Choe, Ph.D Committee Member Tamara D’Anjou-Turner, Ph.D Committee Member Han Na Suh, Ph.D Committee Member Date Brian Dew, Ph.D Chairperson, Department of Counseling and Psychological Services Paul A. Alberto, Ph.D Dean, College of Education & Human Development INTERGENERATIONAL TRAUMA ii AUTHOR’S STATEMENT By presenting this dissertation as a partial fulfillment of the requirements for the advanced degree from Georgia State University, I agree that the library of Georgia State University shall make it available for inspection and circulation in accordance with its regulations governing materials of this type. I agree that permission to quote, to copy from, or to publish this dissertation may be granted by the professor under whose direction it was written, by the College of Education & Hu- man Development’s Director of Graduate Studies, or by me. Such quoting, copying, or publishing must be solely for scholarly purposes and will not involve potential financial gain. It is under- stood that any copying from or publication of this dissertation which involves potential financial gain will not be allowed without my written permission. Hyunji Hannah Lee INTERGENERATIONAL TRAUMA iii NOTICE TO BORROWERS All dissertations deposited in the Georgia State University library must be used in accordance with the stipulations prescribed by the author in the preceding statement. The author of this dissertation is: Hyunji Hannah Lee Department of Counseling and Psychological Services College of Education and Human Development Georgia State University The director of this dissertation is: Cirleen DeBlaere Department of Counseling and Psychological Services College of Education and Human Development Georgia State University Atlanta, GA 30303 INTERGENERATIONAL TRAUMA iv CURRICULUM VITAE Hyunji Hannah Lee ADDRESS: 2380 Arnold Palmer Way Duluth, GA 30096 EDUCATION: Ph.D. 2018-Present Georgia State University Counseling and Psychological Services Master of Education 2017-2018 Harvard Graduate School of Education Prevention Science and Practice Bachelor of Arts 2012-2016 University of Florida International Studies CLINICAL EXPERIENCE Doctoral Intern | August 2023- Present | Georgia Tech Center for Mental Health Care Psychology Trainee | September 2019-Present | Research Institute for Counseling & Education Psychology Trainee | August 2021-August 2022 | Atlanta VA Medical Center Psychology Trainee | August 2020-July 2021 | Georgia Tech Counseling Center Outreach Trainee | August 2019- May 2020 | Georgia State Counseling& Testing Center Career Counselor Trainee | January 2020-May 2020 | Georgia State Career Services PUBLICATIONS Lee, H., DeBlaere, C. (under review). Acculturative Stress, Sense of Belonging, Social-Self Efficacy, and Self-Esteem for Koreans and Korean Americans. Amerasia Lee, H. (2019). Data, community, and meaningful change- AAPI mental health advocacy. Harvard Kennedy School Asian American Policy Review INTERGENERATIONAL TRAUMA v SELECTED PRESENTATIONS: Yang, M., Bhang, C.H., Lee, H. (2022). 우리가족. Exploring narratives of Korean American families. Asian American Psychological Association Suh, H., Bhang, C.H., Lee, H. (2021). Dismantling status quo and social stratification: Hypervigilance to social status and mental health. Asian American Psychological Association Lee, H., DeBlaere, C. (2019). Sense of Belonging and Social Self-Efficacy as Mediators Between Acculturative Stress and Self-Esteem for Korean and Korean Americans. Asian American Psychological Association Lee, H. (2018). Stress, mental health, coping, and behavioral outcomes. Harvard Graduate School of Education Student Research Conference Lee, H. (2018). Understanding self-esteem, self-perception, & experiences of empowerment for Asian American college students. Let’s Talk Conference, Harvard Graduate School of Education Lee, H., Romero, R. (2016). Experiences of distress for 1.5th and 2nd generation Asian Americans in the South, Southeast, or Eastern regions of the United States: A Methodological Review. Asian American Psychological Association SELECTED AWARDS AND HONORS • Dean’s Research Fellowship – Georgia State University, 2018-2022 • Asian American Psychological Association Student Travel Award, 2019 • Asian American Psychological Association Student Travel Award, 2016 • Dean’s Medal of Excellence – University of Florida, 2016 • Southern Scholarship Foundation Scholarship, 2015-2016 INTERGENERATIONAL TRAUMA vi TOWARDS COLLECTIVE HEALING: INTERVENING INTERGENERATIONAL TRAUMA WITH KOREANS/KOREAN AMERICANS by HYUNJI HANNAH LEE Under the Direction of Cirleen DeBlaere, Ph.D ABSTRACT The experiences of historical and cultural traumas such as chronic poverty, instability, and violence have insidious and long-lasting effects up to three generations from survivors through genetic or learned transmission (Bezo & Maggi, 2015; Bradfield, 2013; Connolly 2011;Forrest-Perkins 2017). Although there has been a movement towards recognizing such traumas and their effects in psychological literature, there still remains a dearth in examination for Asian/Asian Americans and specific ethnic groups such as Korean/Korean Americans (Cai & Lee, 2022; Kim-Martin, 2021). Thus, a critical interpretive synthesis (CIS) was utilized to synthesize the current literature on AAA historical/cultural traumas and examine their effects on survivors, their descendants, and family functioning. Further, a randomized control trial study design was conducted to utilize psychoeducation with a group of Koreans/Korean Americans to INTERGENERATIONAL TRAUMA vii examine whether learning about historical/cultural traumas shifted perceptions of family functioning and family communication. The groups included in the trial includes the psychoeducation intervention group and a control group that received psychoeducation on a non-trauma related topic, with the aims of exploring collective healing for the Korean/Korean American community. INDEX WORDS: intergenerational trauma, Koreans, Korean Americans, family functioning INTERGENERATIONAL TRAUMA viii TOWARDS COLLECTIVE HEALING: INTERVENING INTERGENERATIONAL TRAUMA WITH KOREANS/KOREAN AMERICANS by Hyunji Hannah Lee A Dissertation Presented in Partial Fulfillment of Requirements for the Degree of Doctor of Philosophy in Counseling Psychology in Counseling and Psychological Services in The College of Education and Human Development Georgia State University Atlanta, GA 2024 INTERGENERATIONAL TRAUMA ix Copyright by Hyunji H. Lee 2024 INTERGENERATIONAL TRAUMA x DEDICATION I dedicate this first and foremost to my perfect Heavenly Father, who has been everlastingly faithful every step of the way. I reflect on the ways that You have directed all of my steps since I was twelve years old to get me to this milestone. You have always met me in the sleepless nights and tears of travail that no one else saw. You have always wrapped the doubts in myself in You with a gentle embrace and an outpouring of strength and faith. You have wiped every tear and cheered on every small step. I love being loved by You. May everything I do be for the glory of Your Name and the expansion of Your kingdom, as You are the Alpha and Omega, the beginning and the end. The first and forever Wounded Healer. God, You are so good. Would You hear us from heaven and come and heal our land. I also dedicate this to my 엄마. You are the strongest woman I know. All of my resilience and grit for life, I've learned it from you. I’ve also learned the best dance moves and how important it is to laugh often, from you. It has been a life goal of mine to make you proud with what I accomplish, but I’m now learning that it’s your joy to just to watch me see the dreams of my heart come true. You have inspired this dissertation and I hope you can hear the words of my heart in each page that is directed towards you. 엄마의 딸로 태어나서 행복하고 감사해요. INTERGENERATIONAL TRAUMA xi ACKNOWLEDGEMENTS First, I would like to acknowledge pivotal mentors in my life – Dr. Cirleen DeBlaere and Dr. Elise Choe - you have influenced and supported me in tremendous ways throughout this journey. I would not be the scientist-practitioner I am today without you. I would also like to offer my heartfelt thanks to the rest of my dissertation committee, Dr. Tamara D’Anjou-Turner and Dr. Han Na Suh. Your expertise and mentorship have been invaluable in this process. I would also like to acknowledge my friends that feel like family. My best friends, Ashley, Grace, and Vanessa. Near and far, you have been my rock in every mountaintop and valleys low. Thank you for picking up my FaceTime calls at all hours of the day, letting me crash and burn, celebrating my wins, and loving me in ways that knows no distance. It has been because of your friendship, encouragement, and belief in me even when I didn’t believe in myself, that I continued to push through. Thank you for seeing, knowing, and supporting me. My Patria House family, thank you for all the food you’ve fed me, your unending prayers, and your spiritual guidance through this journey. I consider myself so blessed to have a community that shares my God-given vision and values the work I do. Thank you for walking with me and loving me as I am. I hope this is a small step towards bringing His Kingdom on earth. A special shoutout to Lydia – I have little words to describe how thank I am for you. Thank you for always spurring me onto Jesus. Finally, I would like to acknowledge Dr. Josephine Kim. Since the fateful day when I met you as a seventh grader to this day, it’s been my dream to not only have the influence that you have on the Korean/Korean American community, but also to emulate your character, grace, and INTERGENERATIONAL TRAUMA xii unmoving faith in our God. You have pioneered the way for me both professionally and personally, and for that, you will forever be my Connie Chung. TABLE OF CONTENTS LIST OF TABLES .................................................................................................................... XIII LIST OF FIGURES ................................................................................................................... XIV 1 AN ANALYSIS: INTERGENERATIONAL TRAUMA AND EFFECTS FOR ASIANS AND ASIAN AMERICANS .................................................................................................................. 1 INTRODUCTION ............................................................................................................................... 1 METHOD ......................................................................................................................................... 7 RESULTS ....................................................................................................................................... 13 CONCLUSION ................................................................................................................................ 25 REFERENCES ................................................................................................................................. 26 2. TOWARDS COLLECTIVE HEALING: INTERGENERATIONAL TRAUMA INTERVENTION FOR KOREANS AND KOREAN AMERICANS ....................................... 42 INTRODUCTION ............................................................................................................................. 42 KOREANS AND KOREAN AMERICANS .......................................................................................... 44 METHODS ...................................................................................................................................... 50 DATA ANALYSIS PLAN .................................................................................................................. 54 RESULTS ....................................................................................................................................... 56 CONCLUSION ................................................................................................................................ 64 REFERENCES ................................................................................................................................. 66 APPENDIX ................................................................................... ERROR! BOOKMARK NOT DEFINED. INTERGENERATIONAL TRAUMA xiii LIST OF TABLES Table A1. Guiding Questions for Article Screening ..................................................................... 37 Table A2 Integrative Table of Study Findings ............................................................................. 38 Table B1. Gender Identity Demographic Descriptives ................................................................. 77 Table B2. Age Demographic Descriptives ................................................................................... 77 Table B3. Education Level Descriptives. ..................................................................................... 77 Table B4. Sexual Orientation Descriptives ................................................................................... 78 Table B5. Social Class Descriptives ............................................................................................. 78 Table B6. Religious Identity Descriptives .................................................................................... 79 Table B7. Correlations and Cronbach Alphas for Key Study Variables ...................................... 79 Table B8. Means, SD, and Cronbach alphas for Intervention Group on Key Study Variables .... 80 Table B9. Means and SD for Control Group ................................................................................ 80 Table B10. Mixed Repeated Measures Analysis of Variance – Test of Within-Subjects Factors on Parent-Child Relationship ........................................................................................................ 80 Table B11. Mixed Repeated Measures Analysis of Variance – Test of Within-Subjects Factors on Family Communication ........................................................................................................... 81 Table B12. Pairwise Comparisons of Group (Control vs Intervention) on Parent-Child Relationship and Openness to Family Communication ................................................................ 81 Table B13. Pairwise Comparisons of Time for Intervention Group on Parent-Child Relationship and Openness to Family Communication ..................................................................................... 82 INTERGENERATIONAL TRAUMA xiv LIST OF FIGURES Figure 1. Selection of Articles following PsycINFO, PubMed, JSTOR, Proquest, and Google Scholar ....................................................................................................................................................... 36 1 AN ANALYSIS: INTERGENERATIONAL TRAUMA AND EFFECTS FOR ASIANS AND ASIAN AMERICANS Introduction There has been a lack of recognition regarding the intergenerational effects of historical and cultural trauma in the Asian and Asian American population (AAA; Cai & Lee, 2022). Despite a series of events such as war, colonization, political upheaval, and chronic challenges and oppression as immigrants, the field of psychology has yet to address the intergenerational, traumatic impact of these events (Cai & Lee, 2022; Hsu, 2015). Thus, the purpose of the present article is to review the current literature on intergenerational trauma in the Asian and Asian American community and recommend ways of effectively intervening with this population. Overview of Trauma Exposures to trauma and diminished health on developmental outcomes has been well-researched throughout the lifespan (Anda et al., 2006). With the increase in knowledge on the topic of trauma and its deleterious effects, scholars have emphasized the importance of understanding the mechanisms, effects, and interventions for trauma (Isobel et al., 2017). Currently, the Diagnostic and Statistical Manual of Mental Disorders defines trauma as exposure to “actual or threatened death, serious injury, or sexual violence” (American Psychiatric Association, 2013, pp. 271). The Substance Abuse and Mental Health Services Administration (SAMHSA), on the other hand, offers a more expansive definition and describes individual trauma as “an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being” (SAMHSA, 2014, pp. 7). Accordingly, the interventions that have followed are primarily INTERGENERATIONAL TRAUMA 2 addressed from an individualistic conceptualization of trauma. However, there has been a recent move in the field towards taking a more expansive approach to trauma, both in its conceptualization and application towards clinical practice. Types of Traumas SAMHSA has now included trauma to encompass individual, group, community, and mass traumas such as interpersonal trauma, developmental trauma, political terror and war, as well as system-oriented trauma (SAMHSA, 2014). Other forms of trauma that have gained recognition include historical and cultural trauma. Historical trauma is defined as distressing or life-threatening events that are experienced collectively by a group of people with a shared identity that have intergenerational effects on mental health (Evans-Campbell, 2008). Examples of historical trauma include war, colonization, oppression, and/or genocide (Danieli, 1998). Cultural trauma, on the other hand, is understood to be connected to, yet distinct from, historical trauma, in that cultural trauma examines the ways that traumatic effects become embedded in memory and transmitted and normalized through interpersonal interactions through families and communities (Atkinson, 2013; Isobel et al., 2017; Lanktree & Briere, 2016). Amongst these expanding conceptualizations of trauma, an emerging theme in the literature has been the intergenerational effects through which trauma is experienced, transmitted, and impacted. The intergenerational transmission of trauma encompasses the lasting effects of exposure to traumatic events and is defined as the mechanism through which unresolved trauma experienced by a parent generation is transmitted to the offspring generation through the passing of values, beliefs, and interactional patterns which leads to negative impacts in health (Hesse & Main, 2000; Isobel et al., 2017). For example, historical or cultural trauma and its impacts may be passed down three generations through genetic or learned transmission of vulnerability and INTERGENERATIONAL TRAUMA 3 adaptations to circumstances that impacts one’s sense of self by obscuring oneself and another (Bezo & Maggi, 2015; Bradfield, 2013; Connolly 2011; Forrest-Perkins 2017). Moreover, this transmission of trauma may occur even if the offspring generation have little exposure to or knowledge of the original traumatic event (Bezo & Maggi, 2015). This is because trauma has been found to be transmitted intergenerationally by the adaptation of cultural norms, behaviors, values, and beliefs in one’s family of origin, group cultural practices, and socialization by the larger society within the family and ethnic community (Bezo & Maggi, 2015). Thus, scholars have conceptualized intergenerational trauma as genetic or learned transmission of vulnerability and adaptations to circumstances that impacts one’s sense of self by the obscuring of self and another (Bradfield, 2013; Connolly 2011; Forrest-Perkins 2017). Adverse impacts of the intergenerational transmission of trauma may include a wide spectrum of negative effects on mental health including greater vulnerability to psychiatric disorders and an over-tolerance of distress (Bezo & Maggi, 2015; Gorey et al., 2018). In fact, parental trauma has been associated with depression, anxiety, alterations to neurobiological integration and processing, including mechanisms of coping with stressors and regulating emotions, in their offspring (Field et al., 2013; Field, Om, Kim & Vorn, 2011; Schore, 2009). Moreover, these effects have been found to translate into antisocial and delinquent behaviors, psychological risks to adjustment, and familial conflict (Hinton et al., 2009; Ying & Han, 2007). However, much of the research on the intergenerational transmission of trauma began with Holocaust survivors and subsequent generations from their offspring (Isobel et al., 2017). The literature has now expanded and began to examine the intergenerational effects of historical and cumulative trauma in African American and Indigenous communities. For example, systemic racism and historical traumas such as slavery has been found to predict INTERGENERATIONAL TRAUMA 4 intergenerational transmission of depression Post-Traumatic Stress Disorder (PTSD) symptoms in the Black community (Hankerson et al., 2022; Leslie et al., 2022). Other authors have also stated that anxiety and adaptive survival behaviors have been passed down in African American communities from the transgenerational passing of traumatic stress (Graff, 2017; Stenson et al., 2021). Yet, scholars have called for the expansion of the literature on the mechanisms and effects of intergenerational effects of trauma in various marginalized communities that have shared experiences of trauma. Asians/Asian Americans and Trauma The Asian/Asian American population is projected to grow to 46 million people by 2060, making it the fastest growing population in the U.S. (Pew Research Center, 2021). AAAs are a population of Asian ancestry and identify with more than twenty different ethnic identities from countries in East and Southeast Asia as well as the Indian subcontinent (Office of Minority Health, 2021). This article includes the term Asian and Asian American to refer to this community, as fifty-seven percent of AAA report being born in another country and may not resonate with an American identity despite their residence in the U.S. (Pew Research Center, 2021). Although there is great variability within the AAA population, many Asian countries share experiences of centuries of violence and Western imperialism (Cai & Lee, 2022). More recently, war, colonization, and genocide marked most of the1900s for many Asian countries such as China, Japan, Korea, Cambodia, the Philippines, India, and Vietnam (Carey, 2012; Espiritu, 2014; Hsu, 2015). In turn, these events created intolerable conditions in Asia that necessitated either seeking asylum or migration and such transitions itself may also be considered as a multidimensional stressor that can be experienced as traumatic (Perez-Foster, 2001; Sangalang & Vang, 2017; Yakhnich, 2008). Such distressing events have been linked with INTERGENERATIONAL TRAUMA 5 negative and persistent emotions such as fear, mistrust, sadness, shame, anger, and anxiety, as well as lowered self-esteem, hypervigilance, hostility, and risky health behaviors for up to three generations of survivors (Bezo & Maggi, 2015). Despite this, there is a considerable gap in the literature when it comes to examining the complexities of trauma and its impacts on Asians and Asian Americans. Thus, the current investigation involved a critical review of the available literature to determine what is currently known about intergenerational trauma in this community. Previously published reviews not specific to Asians and Asian Americans have explored various factors when examining intergenerational effects of trauma. Isobel and colleagues (2017), for example, examined 77 articles on prevention and intervention of intergenerational trauma, and major constructs included, (a) approaching early prevention as a key intervention through resolving parental trauma by creating safety, (b) new trauma narratives, and (c) supporting attachment between the parent and child. Likewise, Sangalang & Vang (2017), reviewed 15 studies on various refugee populations displaced from their homes due to war, political persecution, and mass violence. Major themes identified in their study included, (a) the conceptualization of trauma in parents, (b) well-being outcomes on children, and (c) psychosocial mechanisms of trauma. The present review differentiates itself from these aforementioned works by examining a specific ethnic population, Asians and Asian Americans, whose history and culture have previously been erased from White, mainstream culture (Liem, 2007). Theoretical Framework In order to better understand the intergenerational transmission of trauma for AAAs, Bronfenbrenner’s ecological model lends a helpful framework. Bronfenbrenner posits that the INTERGENERATIONAL TRAUMA 6 individual develops in a series of systems that interact with and influence each other (Bronfenbrenner, 1977). The first of these systems, the microsystem, involves the individual and direct environments in which they interact with. The microsystem is the setting in which the individual participates in specific roles, such as that of a daughter, parent, employee, etc. The mesosystem, on the other hand, includes the interactions of settings that the person belongs in, such as schools, families, churches, and other community organizations. An exosystem is the extension of the mesosystem and examines the ways that mesosystems may interact in various social structures such as in neighborhoods, a corporate setting, mass media, educational institutions, and more. Finally, the macrosystem encompasses institutional patterns represented in economic, cultural, educational, legal, and political ideologies. These systems suggest that an individuals’ development and lives are shaped not solely by their own exclusive experiences, but from staggering spheres of influence. For example, a second-generation AAA daughter may adopt the mindset that others are not to be trusted. This hypervigilant mindset may have been learned from her parents who experienced a traumatic event such as genocide, when this sort of mindset was a survival necessity. This belief may be reinforced to the daughter from mesosystems such as ethnic communities like churches and informal organizations in their shared experiences of trauma. These interactions are exacerbated in an exosystem as the lived experiences of AAAs are not adequately addressed and even systematically erased to serve Western imperial interests (Cai & Lee, 2022; Epiritu, 2014). Present Study The AAA community is one that has experienced extensive historical and cultural traumas such as war, political upheaval, colonization, and chronic stress as a result of immigration to the U.S. (Cai & Lee, 2022; Hsu, 2015). However, despite their history and INTERGENERATIONAL TRAUMA 7 significant current presence in the U.S., the field of psychology has yet to adequately capture and understand their varying experiences of trauma. Scholars have posited that intergenerational impacts of historical and cultural traumas significantly influence important psychological factors such as adjustment, adaptation, mental health, and relational quality for AAA families (Cai & Lee, 2022; Kim-Martin, 2021). Thus, it is an important endeavor in the field to examine and expand literature on the topic of intergenerational trauma for AAAs. Thus, the present article utilizes Critical Interpretive Synthesis (CIS; Dixon-Woods et al., 2006)) as its methodology to conduct a review of the literature on intergenerational trauma for AAAs. This methodology utilizes an inductive process to generate themes grounded within existing literature (Dixon-Woods et al., 2006). Through the utilization of CIS, the following research aims were addressed: (1) synthesize and interpret literature on AAA historical and cultural traumas and (2) examine the ways these collective traumas have intergenerationally impacted AAA survivors and their descendants. CIS permits the inclusion of studies with both quantitative and qualitative data, thus allowing for the inclusion of a wider range of methodologies and findings (Dixon-Woods et al., 2006). Since the exploration of intergenerational trauma has been limited for AAAs and has mainly focused on Holocaust survivors, refugees, African Americans, and Indigenous communities (Graff, 2014; Isobel et al., 2017; Stenson et al., 2021), the CIS method was a good fit for the current study. Method The present review used CIS that allowed an integration of study findings using language from the primary studies themselves through a dynamic, iterative process involving questioning and conceptualizing of findings for new understanding (Dixon-Woods et al., 2006). The strengths of CIS have been recognized for use with literature that is not particularly well-INTERGENERATIONAL TRAUMA 8 developed or focused (Boyko, 2010; Dixon-Woods et al., 2006), as is the case with intergenerational trauma for AAAs. Procedures and Criteria CIS allows for a synthesis of a variety of studies with diverse methodologies on a particular topic and laid out an opportunity to provide a critical interpretation of where the literature stands (Dixon-Woods et al., 2006; Isobel, 2017). While CIS is informed by systematic review methods, its iterative process utilizes a less structured search strategy, and is instead evolutionary in its data collection process which makes explicit strategies unrequired (Xiao & Watson, 2019). For example, in Isobel and colleagues’ (2017) study that utilized CIS to examine interventions for intergenerational transmission of trauma, authors approached large bodies of research and observed prevention emerge early as a thematic construct in their search process. However, they did not delineate specific review processes, and instead reported a nonlinear process (Isobel et al., 2017). Moreover, although different systematic methodologies require that specific, quantifiable questions be answered a priori, CIS utilizes a reflexive approach based on research aims of the study (Flemming, 2010). Similar procedures are shared in other CIS articles that have been published (Flemming, 2010; Moat et al., 2013). Due to the limited body of available literature on intergenerational for AAAs, it was important for the present review to make efforts to include studies of varying methodologies on the topic and provide a critical lens to what is currently available. CIS allows for these goals to be met. However, the present review also made efforts to modify CIS practices by incorporating more systematic procedures, such as explicating the search process more specifically, create reflexibility in the data collection process, and have research aims that served as a compass in guiding the data collection process. The CIS protocol are as follows: identify area of research interest, search the literature, repeated INTERGENERATIONAL TRAUMA 9 reading of studies, determine relationships between findings, compare similar themes, translate themes into synthesized arguments, and express this synthesis as results (Flemming, 2010; Noblit & Hare, 1988). Thus, after study aims were set, the search for this review commenced. The search was first conducted by consulting reviews on intergenerational trauma and Understanding Korean Americans, Mental Health (Isobel et al., 2017; Sangalang & Vang, 2017; Yoon, Moon, & Son, 2021) to identify studies conducted on intergenerational trauma for AAAs. Next, databases including PsycINFO, PubMed, JSTOR, ProQuest, and Google Scholar were used to identify relevant studies for their scope and inclusion of research on mental and health trauma. The use of online databases has been justified in other CIS reviews (Flemming, 2010), and allows for access to a large body of literature, consistent with CIS methodology (Dixon-Woods et al., 2006). Electronic searching was supplemented by individual reviews of dissertations and journals that published on relevant topics as well (e.g., Journal of Traumatic Stress, dissertations from Kristen Kim-Martin on Making Meaning of Family Immigrant Experiences, and Jee Hun Yoo on Understanding the Influences of the Family Context on Informal Help Seeking Process of Korean Adults). Keywords used to identify articles included the following: “Asian OR Asian American” AND “trauma” OR “intergenerational trauma OR generational trauma OR transgenerational trauma.” These terms were included to search specifically in the AAA community and because of the varying definitions of intergenerational trauma. Furthermore, due to the small body of literature that exists on this topic, all dates were included in the search. From the search, all study titles were reviewed to determine eligibility. Studies were included in the review if they (a) were based on Asians/Asian Americans (and subsamples of AAAs such as Koreans/Korean Americans and Chinese/Chinese Americans, as there was a larger body of records dedicated to Southeast Asian subsamples) (b) there was INTERGENERATIONAL TRAUMA 10 experience of trauma in the parent generation, (c) the children/offspring did not directly experience the same trauma as parents, (d) were full-text articles published in English, (e) included intergenerational effects of trauma in that it did not examine traumatic effects on solely one generation (e.g., trauma exposure effects on refugee sample without examining impacts on offspring), (f) collected original data, and (e) were published in a peer-reviewed journal. Studies that were excluded followed an iterative process, but in general were those that (a) were conceptual and did not collect either quantitative, qualitative, or mixed methods data, (b) examined populations that are not Asian/Asian American (e.g., Holocaust survivors), (c) examined traumas that are not historical, cultural, or collective in nature (e.g., single-episode sexual violence). These criteria allowed for a guided exploration of the literature while remaining close to the aforementioned study aims. Furthermore, consistent with CIS methodology, the studies that were included were appraised for their theoretical relevance and representation from various fields to indicate a sufficient capture of a diverse large body of literature (Dixon-Woods et al., 2006; Isobel et al., 2017). As such, an interdisciplinary review was conducted, and studies were included from relevant fields such as marriage and family therapy, historical research, and psychology were included to best encapsulate the bodies of literature outside the specific field of psychology. Consistent with the original development of CIS, guiding questions were used to screen the initial articles for inclusion (Figure 1; Dixon-Woods et al., 2006). After screening was conducted by the author, a title and abstract review followed. Finally, additional citations from selected articles were reviewed to examine whether there were studies that were not seen during the search process. For example, I looked for authors that had already been mentioned in included studies as well as studies that had titles that included keywords. This was completed to ensure INTERGENERATIONAL TRAUMA 11 that all relevant search was included. The process of identification, screening, and inclusion are presented in a modified PRISMA diagram (Moher et al., 2009). From this process, 151 records were examined, and 15 duplicates were removed. A title and abstract review commenced with 136 articles, from which 105 were removed for including non-AAA samples, non-relevant articles (i.e., undergraduate theses, artwork presentations), and findings including non-collective trauma (i.e., single-case sexual assault). Thus, thirty-one articles underwent a full-text review, and nine articles were additionally excluded because they did not collect original data (e.g., conducted secondary analyses and expanded on findings from other studies) or did not examine intergenerational effects of trauma. From the remaining 22 records, another ten were removed for including samples that were not based in the U.S. (i.e., Asian Canadian sample) or because they were other systematic literature reviews. This resulted in a final inclusion of 12 articles. Coding Team There were two coders for the present review. The first author, Coder One, is a fourth-year doctoral student in an APA- accredited program in Counseling Psychology. Coder One identifies as a twenty-eight-year-old 1.5th generation Korean American cisgender female with one disability. Coder Two is a fourth-year undergraduate student in Psychology at the same institution as Coder One. Coder Two identifies as a twenty-year-old second-generation Korean American cisgender female with no current disability. Before the coding process, the coders discussed their shared identities and experiences and conceptualization of intergenerational trauma. Since both coders identified as Korean American cisgender women, the possibilities of biases such as the interpretation of study findings from our own experiences of intergenerational trauma and its effects on our own mental health and family relationships were also explored. In INTERGENERATIONAL TRAUMA 12 order to mitigate the influence of these biases on the coding process, a guiding set of questions modified from the original authors of CIS were used as a rubric to highlight short, interpretive constructs that emerged from original findings (Dixon-Woods et al., 2006; Flemming, 2010). Furthermore, the coding process included Coder One independently examining each study and being second-checked by Coder Two. This method has been utilized with other CIS reviews (Flemming, 2010). There were no disagreements between Coders. Analysis CIS allows for a synthesis of a wide spectrum of evidence through the integration of qualitative and quantitative findings via an interpretive process (Dixon-Woods et al., 2006; Flemming, 2010). Consistent with this methodology, qualitative and quantitative research were integrated to form thematic constructs utilizing an iterative process. The synthesizing analysis occurred through Line of Argument Synthesis (LAS) which builds general interpretation of findings from separate studies that represent the dataset while developing a multi-level order of constructs to create a Synthesizing Argument (SA; Dixon-Woods et al., 2006). The SA provides a unifying network of constructs and explains the relationships between them to produce new ways of understanding (Flemming, 2010). Consistent with CIS methodology (Dixon-Woods et al., 2006), studies were read repeatedly, and a relationship between findings were recorded in an iterative document that kept track of common key phrases stated throughout included studies. The common key phrases were interpreted as emergent themes and integrated into a data extraction table (see Figure 2), which served as the foundation for the SA. The integrative table included categories such as aim, population, methodologies, and key results, as such categories follow best practices for CIS and have also been used in other CIS reviews (Flemming, 2010). This grid was compared between coders. Due to the reflexive and iterative nature of CIS, exact INTERGENERATIONAL TRAUMA 13 replications of the organizing process are known to be difficult, but scholars have stated that a non-linear, iterative process increases, rather than decreases, rigor (McDougall, 2015). For the present study, qualitative and quantitative studies were synthesized in a parallel manner, in that each study was understood on its own then constantly contrasted to other studies to finalize an interpretation and provide the basis of a critique of the current literature. Results The critical interpretive synthesis of the literature on intergenerational trauma for Asians and Asian Americans included twelve studies. The findings are reported as synthetic constructs that emerged from interpretations of the findings of the primary research (Flemming, 2010). The SA that addressed the aim of this review was the following: historical and cultural traumas such as wars, colonization, and genocide had deleterious effects on family functioning for AAAs. Three subconstructs emerged – parental roles, ability to provide affective responses and involvement, and family communication. Consistent with CIS, the current review includes a critique of the conceptualizations of intergenerational effects of trauma for AAAs. Critique of Literature In accordance with CIS protocol, the present review also includes a critique of the literature regarding intergenerational impacts of historical and cultural trauma for AAAs. First, there was a general lack of definitional agreement across fields in the ways that intergenerational trauma for AAAs were captured. For example, there were several definitions of historical trauma, cultural trauma, and intergenerational trauma. It was not uncommon for these terms to be used interchangeably, which could have led to the non-inclusion of relevant studies. This has been a general limitation of the literature on trauma, given the complexities of the long-lasting effects of traumatic experiences (Isobel et al., 2017). INTERGENERATIONAL TRAUMA 14 Overview of Articles Of the twelve articles, six studies were qualitative and six were quantitative studies. All studies included descriptions about the types of traumas that AAAs experienced (i.e., colonization, genocide, wars, political upheaval). Three quantitative studies specifically reported on individual Post-Traumatic Stress Disorder symptomology for survivors, while seven of the twelve studies reported on the ways that trauma had impacted survivor’s abilities to function as a parent. Alternatively, eleven of the twelve studies had shared findings on the impacts of parental trauma for the offspring. All twelve studies included the negative impacts of parental traumatic experiences on quality of intergenerational relationships. Overview of Types of Traumas The literature illuminated three types of historical and cultural traumas that AAAs experienced: war, genocide, and internment. The synthesis of the types of traumas experienced by AAAs addressed the first research aim of this study, which was to address the gap in literature regarding historical and cultural traumas for this population. Additionally, this synthesis allowed for context into the extent of the violence and atrocities that AAAs experienced, that served as the foundation for the core constructs outlined below - disruption to family functioning. Wars and Genocide: Nine of the twelve studies were based on the deleterious and long-lasting effects of wars and genocide that led to forced migration, mass killings, and immigrant stress, political upheaval, as well as primary and secondary torture. Wars and genocide were combined in the present review, as the articles included also often combined the two when examining intergenerational trauma for AAA populations (Field et al., 2013; Han, 2006; Lin et al., 2009; Sangalang et al., 2017; Spencer & Le, 2006). INTERGENERATIONAL TRAUMA 15 Most studies that examined the intergenerational effects of wars were done on the Southeast Asian refugee sample, and included events such as the Cambodian genocide, Vietnam War, and the Secret War. The Cambodian genocide, with 1.5 million Cambodian casualties, was enacted by the Khmer Rouge regime – survivors endured extensive bombing, forced separation from family, and years living in refugee camps; the genocide is now recognized as one of the most significant events in Asia from the 20th century (Field et al., 2013; Kiernan 2002). The Vietnam War had similar atrocities, as civilians were exposed to extensive bombings, close proximity to armed violence, injuries, and adverse diseases (Korinek & Teerawichitchainan, 2014). Moreover, the Vietnamese people have often been referred to as “boat people,” as they fled intolerable conditions in refugee camps after the atrocities of war (Gordan, 1987). The Secret War for the Hmong population also had deleterious effects, as more bombs were dropped in Laos during the war than those dropped by the U.S. during World War II, leading to a loss of a peaceful rural life for civilians (Lee & Clarke, 2013; Quincy & Vu, 2000). After the Secret War, the Hmong people were forced to flee; in this process, around 100,000 Hmong were killed or faced the death of family members, forced separation, and unbearable conditions in refugee camps (Hamilton-Merrit, 1999; Lee & Clarke, 2013). Finally, Hoffman and colleagues (2020) examined the experiences of Karen refugees. The Karen people are an ethnic group who have struggled for independence from Burma since 1949, to which the Burmese military have directly targeted civilians for abuse by utilizing methods of torture such as forced labor, public killings, extortion, village destruction, and systematic brutal rape (Amnesty International, 2008; Cook et al., 2015; Karen Women’s Organization, 2007). One study of the nine included an examination of the effects of the Korean War. The Korean War, often called the “Forgotten War,” lasted for three years and had pernicious and deleterious intergenerational effects (Liem, 2007). The war INTERGENERATIONAL TRAUMA 16 resulted in 5 million casualties, 70% of which were civilians, about 10% of the entire Korean population at the time (Liem, 2003; Robinson, 2007). The war also left Korea divided into two separate countries after fighting for independence from Japanese colonization, with both Koreas in utter destruction, mass poverty, and political unrest (Kim-Martin, 2021; Liem, 2003).The fact that majority of the studies were based on Southeast Asian refugees and their children is unsurprising, as a majority of the small body of research done on the topic of intergenerational trauma for Asians/Asian Americans have been conducted with this population (Cai & Lee, 2022). Japanese American Internment: Further, three of the 12 included studies were based on second-generation Japanese Americans or their third-generation children. Namely, these articles explored the reflections of Japanese Americans regarding their parents’ traumatic experiences in internment camps during World War II or captured the traumatic events of the interment from the survivor generation themselves (Nagata, 1998; Nagata & Cheng, 2003; Tsuru, 2014). During internment, Japanese Americans – two-thirds of whom were American-born citizens, were ordered to leave their homes, businesses, and properties after the bombing of Pearl Harbor with less than two-week’s notice and targeted for ethnic profiling while being held at crowded detention centers with difficult living standards (Nagata et al., 2015). Core Synthesizing Construct: Family Functioning Findings indicated that due to the various ways that parents were impacted by their experience of historical and cultural trauma, AAA family functioning became significantly diminished. Family functioning operated as a synthetic construct as a new concept that emerged from the interpretation of findings from the included studies. Namely, there were deleterious effects on the parent-child relationship as a result of the parents’ experiences of trauma that INTERGENERATIONAL TRAUMA 17 impacted family functioning. In this review, family functioning was defined in alignment with McMaster’s Family Functioning Mode theory that describes family functioning as a system that provides an environment for family members to develop on physical, psychological, and social aspects (Epstein, 1987). The family system is accordingly characterized by six abilities within the family including 1) ability to problem solve, 2) communicate, 3) assume roles, 4) provide affective responses, 5) provide affective involvement, and 6) control behavior (Epstein, 1987). Codes from unifying findings illuminated that various aspects of family functioning such as assuming roles, providing affective responses and involvement, and communication were particularly affected as a result of trauma. Assuming Roles (n = 4): Results demonstrated that parents who had experienced historical and cultural traumas had diminished ability to function well in their roles as parents. For example, the studies in this review found that parents with traumatic experiences presented PTSD symptoms such as re-experiencing, hyperarousal, avoidance, negative alterations in cognition and mood, separate from their children (Field et al., 2013; Hoffman et al., 2020; Sangalang et al., 2017). Parents also reported symptoms such as difficulty concentrating, fear of losing control, and social/interpersonal problems (Hoffman et al., 2020; Lin, Suyemoto, & Kiang, 2016). These symptoms are consistent with the criteria of avoidance, re-experiencing, hyperarousal, negative alterations in cognition and mood for Post-Traumatic Stress Disorder (PTSD)as outlined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). In turn, findings indicated that parents’ PTSD symptoms were negatively linked to their ability to function as a parent. Specifically, it was found that parents impacted by trauma utilized role-reversal parenting and rejecting parenting (Field et al., 2013). Role-reversal parenting is described by caregivers turning to the child to have INTERGENERATIONAL TRAUMA 18 their emotional needs met and has been linked with children feeling a sense of burden by the responsibility to prioritize their parents’ emotional well-being and inhibit their own relational needs (Chase, 1999; Field et al., 2013). Rejecting parenting, on the other hand, encompasses emotional abuse and neglect during a child’s formative years and has been found to be linked to trauma transmission with children of Holocaust survivors (Field et al., 2013; Yehuda, Halligan, & Grossman, 2001). It is suggested that such parenting stunts healthy parent-child relationships as the child experiences pressure to take on the role of the adult caregiver in the relationship and is experienced as abuse from the parent to the child (Brom et al., 2011; Field, Om, Kim & Vorn, 2011; Hoffman et al., 2020). Affective Responses and Involvement (n = 6): Another emergent construct that supported the synthesizing argument was parents’ diminished ability to provide affective responses and involvement. For example, findings from several studies included in this review found that AAA family functioning was diminished as a result of parents’ difficulties with providing adequate emotional attunement and engagement with their children. Our analysis indicated that parents with experiences of historical/cultural traumas had difficulty developing healthy attachment with their children, inhibited their ability to engage in effective day-today- relationships with their children, and built emotional walls within the family (Han, 2006; Liem, 2007; Spencer & Le, 2006). Thus, it was unsurprising that the synthesis of findings of the impacts of parents’ inability to provide affective responses and involvement for the offspring included violent and delinquent behavior, diminished sense of coherence, disordered mood, and poor adjustment (Han, 2006; Hoffman et al., 2020; Lee & Clarke, 2013; Sangalang et al., 2017; Spencer & Le, 2006). INTERGENERATIONAL TRAUMA 19 Family Communication (n = 8): Perhaps the most significant set of constructs that emerged from synthesizing the literature was diminished family communication. In fact, diminished communication within the family was illuminated as being a mediating factor for diminished family functioning. Across studies, parents reported experiencing intense negative emotions when speaking of their traumatic experiences (Hoffman et al., 2020; Lin & Suyemoto, 2016). Other than the negative influences on their own emotional well-being, findings from several studies also shared themes of parents avoiding topics related to their traumatic experiences from a desire to protect their children from re-traumatization (Liem, 2007; Nagata, 1998; Nagata & Cheng, 2003). However, this lack of meaningful communication had adverse effects on family functioning as children experienced their parents’ silence to be linked with family tension, anxiety, and frustrations (Lee & Clarke, 2013; Liem, 2007; Nagata, 1998). Moreover, AAA children also reported shame, discomfort, distress, when they attempted to speak to their parents about their traumatic experiences (Lee & Clarke, 2013; Liem, 2007; Lin et al, 2009) and even reported feelings of intense fear, pain, and concerns that their parents may suffer from mental illness as a response to their traumatic experiences (Lee & Clarke, 2013; Tsuru, 2014). On the other hand, in the opportunities that meaningful family communication about parental traumatic experiences did occur, offspring reported gratitude, empathy, and understanding towards parents (Lee & Clarke, 2013; Lin et al., 2009; Lin & Suyemoto, 2016). Discussion The aim of the current review was to synthesize and interpret literature on the pernicious effects of intergenerational transmission of historical and cultural trauma for the Asian and Asian American community. The present study utilized Critical Interpretive Synthesis of twelve articles to address this aim. Despite the small body of literature that exists on this topic for AAAs, INTERGENERATIONAL TRAUMA 20 significant synthesized constructs emerged that may be critical points of intervention. The core synthesizing argument that emerged was that there were deleterious effects on the parent-child relationship as a result of the parents’ experiences of trauma that impacted family functioning. McMaster’s Family Functioning Mode theory was referred to for an operational definitional of family functioning. From this framework, family functioning was understood as being characterized by the family’s ability to problem solve, communicate, assume roles, provide affective responses and involvement, and control behavior (Epstein, 1987). Of these, the literature illuminated that assuming roles, providing affective responded and involvement, and communication was negatively impacted by parental experiences of trauma. A synthesis of parental trauma revealed that PTSD-related symptom presentations such as reexperiencing, hyperarousal, avoidance, negative alterations in cognitions and mood, general detachment, difficulty concentrating, and fear of losing control, was linked to adverse parenting. In turn, due to survivors’ diminished abilities to function as a healthy parent, the family system was diminished, and offspring also reported disordered mood and behavioral and emotional repercussions. For example, traumatizing experiences were linked to role-reversal and rejecting parenting, in that parents turned to children to emotionally regulate, at the cost of the child’s emotional wellbeing. Traumatized parents also practiced rejecting parenting in their roles, in that there was neglect of the emotional needs of the child. Similarly, AAA parents with experiences with historical and/or cultural traumas were also lessened in their ability to provide affective responses and involvement. For instance, synthesis of results revealed that parents were unable to engage in effective day-to-day relational interactions with their children that was connected to emotional walls and tension in the family system as a result. This synthesis of findings are related to previously published works on INTERGENERATIONAL TRAUMA 21 children of Holocaust survivors that have found a link between parents’ ability to provide emotional engagement and responsiveness and positive family functioning and child development (Bar-On et al., 1998). However, perhaps the most significant construct that was repetitively presented in the studies included in this review was the lack of family communication. Parents reported having a difficult time communicating about their traumatic experiences for a myriad of reasons, including the desire for self-preservation and protecting their children from the harsh realities of which they have experienced. This phenomenon was found in studies with both quantitative and qualitative methods across various ethnic Asian groups. These findings also corroborated with literature on diminished abilities to parent as a result of trauma in the African American community (Graff, 2014). However, the silence around their experiences were connected to tension and anxiety in the family and children misunderstanding their parents as being depersonalized, unemotional, and detached. Yet, children reported a consistent desire to know more about their parents’ experiences and when there were opportunities for meaningful conversations, it was associated with new insight and greater interpersonal connectedness in the family. These findings are consistent with literature that has prescribed the culture of silence as the primary mechanism of transmitting intergenerational trauma. One author describes the conspiracy of silence as “a trauma response pattern that is not only culturally generated but also reinforced by society’s treatment of that trauma as irrelevant, and therefore meaningless” (Kim-Martin, 2021, pp. 341). Therefore, family communication and breaking the cycle of silence may serve as a critical point of intervention regarding the transmission of intergenerational trauma for the Asian/Asian American population. INTERGENERATIONAL TRAUMA 22 Limitations The current review had several important limitations. The first is that because of the inconsistencies with definitions of trauma, it is possible that constructs such as intergenerational family conflict and acculturative stress could also capture tenets of the effects of trauma for AAA families but were not included in this review. Additionally, the studies included in this review emphasized the effects of parental trauma on the offspring and were sparse on explanations of how the traumas affected the survivor generation. Thus, it would be a valuable addition to the literature to expand more on parents and the ways they experienced the traumas that led to their PTSD symptomology as well as diminished mental health. Lastly, the CIS method allows for one interpretation of evidence from primary studies, and thus the findings cannot be generalized. Although CIS requires that researchers conduct thorough and adequate searches of the literature and make conclusions given the available evidence, (Dixon-Woods et al., 2006), due to its iterative and reflexive process, the replicability of the current study may be difficult. For example, in other systematic review processes, transparency and objective reproducibility may be emphasized; however, in CIS, there is often not a predetermined process of how findings be organized (Dixon-Woods et al., 2006). Although the current author made efforts to follow protocol, minimize bias, and engage the literature as is, it is possible that another team of researchers may come to different synthetic constructs than is presented. However, a critical interpretive voice is essential to the nature of CIS, and it could be argued that without the possible variability in interpretation of the literature, similar to many qualitative methodologies (Dixon-Woods et al., 2006). INTERGENERATIONAL TRAUMA 23 Research Implications Given the previous limitations of the present review, there are several suggestions for future researchers. First, delineating shared definitions of trauma generally and the various types of traumas would be helpful in creating a more concise paradigm of traumatic experiences. Although the differences in trauma language is understandable given that trauma in it of itself is a complex experience, it may be helpful for interdisciplinary researchers to narrow down definitions and operational constructs. Additionally, examining the ways that varying concepts that have larger representation in the Asian American mental health literature such as intergenerational family conflict and acculturative stress may be impacted by historical/cultural traumas will also be invaluable to the field. As past experiences shape the ways that we experience and navigate the present, introducing an intergenerational framework of collective trauma will add nuances that are necessary to the aforementioned psychological factors. Furthermore, scholars still approach trauma as an individual experience in their methodological approach. For example, the studies included in the present review examined a parent’s experience of trauma and its’ effects, then a child’s experience of their parents’ traumas. Thus, future researchers may wish to integrate frameworks such as radical healing that approaches trauma from a collective liberation perspective, especially for communities with collective cultural values, such as Asians and Asian Americans. Clinical Implications There are important clinical implications from the findings of the present review for the Asian and Asian American community. First, it is critical that clinicians do not conceptualize and intervene with trauma from a solely individualistic perspective but address trauma as a collective experience for marginalized populations, such as Asian and Asian Americans. This may involve INTERGENERATIONAL TRAUMA 24 continued training to expand on what they currently know about trauma in order to serve their clients and patients with cultural competence. Additionally, it will serve clinicians well to target the culture of silence about parental trauma when intervening with Asians and Asian Americans. It has been hypothesized that Asian parents may stay away from discussing their traumatic experiences out of not wanting to burden their children (Kim-Prieto et al., 2018; Liem, 2007). However, clinicians may wish to inform parents about the negative long-term effects of their silence and facilitate meaningful conversations about their experiences with their children with the aim of improving their communication, and in turn, family functioning. The topics of mourning, loss, way of life, and grief have been suggested as helpful possible topics (Kim-Prieto et al., 2018). Currently, the most robust evidence-based treatment for trauma such as Cognitive Processing Therapy and Prolonged Exposure remain an individualistic (Foa et al., 2019; Resick et al, 2017) approach and may not be a good fit for collective, communal interventions. Thus, scholars have implored for the expansion of the field for culturally competent interventions with families and communities (Kim-Martin, 2021; Kim-Prieto et al., 2018; Liem, 2007). Furthermore, a specific point of intervention may be facilitating meaningful conversations about parental trauma experiences in families. A helpful strategy to achieve this may be psychoeducation, particularly for Asians and Asian Americans. For example, Kim and colleagues (2021) found that Asian-identifying parents and their children reported changes in their knowledge about mental health, generational differences, the role of culture which enabled behavioral intentions such as communicating more within the family and perspective-taking. Psychoeducation may be particularly appropriate for Asians and Asian Americans, as education is embedded as a cultural value for many Asian ethnic groups (Kim et al., 2021). INTERGENERATIONAL TRAUMA 25 Conclusion In summary, the present review investigated historical and cultural traumas and the intergenerational transmission of its effects in Asian and Asian American families. It was illuminated that members of this community have suffered extensive trauma, and the deleterious effects are being passed down intergenerationally to the descendants of trauma survivors. The findings support the importance of an increased recognition by the field of psychology on the experiences of collective trauma for the Asian/Asian American community and expanding both scholarly and clinical efforts in addressing such challenges. INTERGENERATIONAL TRAUMA 26 References Anda, R.F., Felitti, V.J., Bremner, J.D., Walker, J.D., Whitfield, C., Perry, B.D., Dube, S.R., & Giles, W. H. (2006). 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INTERGENERATIONAL TRAUMA 36 Figure 1 Selection of Articles following PsycINFO, PubMed, JSTOR, Proquest, and Google Scholar PRISMA Diagram Records identified through database searching: PsycINFO, Pubmed, JSTOR, Proquest, Google Scholar (n = 146) Screening Screening Included Eligibility Eligibility Identification Identification Additional records identified through other sources: reviews and book chapters (n = 5) Records after duplicates removed (n = 136) ScreeningRecords after duplicates removed (n = 136) Records screened (n = 136) Records screened (n = 136) Records excluded (n = 105) • Non-AAA sample (n = 28) • Non-Relevant articles (n = 36) • Single-Case Trauma (n= 41) Records excluded (n = 105) • Non-AAA sample (n = 28) • Non-Relevant articles (n = 36) • Single-Case Trauma (n= 41) Candidates screened for eligibility (n = 31) Candidates screened for eligibility (n = 31) Full-text articles excluded, with reasons (n = 9) • Did not collect original data: (n = 4) • Did not examine intergenerational effects:(n = 5) EligibilityFull-text articles excluded, with reasons (n = 9) • Did not collect original data: (n = 4) • Did not examine intergenerational effects:(n = 5) Qualitative and Quantitative studies included in synthesis (n = 12) Full-text articles screened included for synthesis (n = 22) IncludedFull-text articles screened included for synthesis (n = 22) Full-text articles excluded, with reasons (n = 10) • Non-US Asian sample (n = 8) • Literature reviews: (n = 2) INTERGENERATIONAL TRAUMA 37 Table A1 Guiding Questions for Article Screening Are aims and objectives of the research clearly stated? Is the research design clearly specified and appropriate for the aims and objectives of the research? (i.e., Based on Asian Americans, covers intergenerational trauma) Do the researchers provide a clear process for data collection? Do the researchers display original data that support their conclusions? Are the methods of analysis appropriate and thoroughly explained? What are the key findings? Adapted from Dixon-Woods et al., 2006 INTERGENERATIONAL TRAUMA 38 Table A2 Integrative Table of Study Findings Author(s) Design Population Type of Trauma Trauma Effects on Parents Effects on Offspring Effects on Family Field et al., (2013) Quantitative Dyads of Cambodian refugee mothers exposed to trauma and their daughters Khmer-Rouge regime/ Cambodian genocide PTSD symptoms: Re-experiencing, hyperarousal, avoidance Anxiety, depression Negative effects on quality of parenting (role-reversing and rejecting parenting) Han, (2006) Quantitative Southeast Asian refugees and Asian Americans (Vietnamese, Cambodian, Hmong) Wars and political turmoil Difficulty attaching to children Lowered level of sense of coherence Negative influence on parent-child attachment Nagata & Cheng, (2003) Quantitative Second-generation Japanese Americans Internment during World War II and racial trauma Difficulty communicating with children about internment experiences (avoidance of posttraumatic stress) Not examined Not examined Sangalang et al., (2017) Quantitative Southeast Asian (Cambodian and Vietnamese) refugee women and their adolescent children Wars and political turmoil PTSD symptoms: Re-experiencing, negative alterations in cognition and mood Depressive symptoms, delinquent behaviors, antisocial behaviors Negative influence on family functioning through diminished communication and cohesion, family conflict, sense of distance and detachment INTERGENERATIONAL TRAUMA 39 Spencer & Le, (2006) Quantitative Southeast Asian (Cambodian, Lao, Vietnamese) and Chinese youth Wars, genocide, political turmoil, immigration stress Decreased engagement and difficulty communicating with children Peer delinquency and violence for Vietnamese sample only; youth had difficulty engaging in relationships and communication that led to serious and intimate violence Diminished impact on parental engagement with children Hoffman et al., (2020) Quantitative Burmese refugee mothers and children in late childhood-adolescence War, primary and secondary torture PTSD and MDD symptoms: difficulty concentrating, memory issues, fear of losing control, social problems Poor adjustment: conduct problems, emotional symptoms, trouble with attention, interpersonal problems Disrupted maternal-child relationship, caregiver stress that led to negative impacts on parenting Nagata, (1998) Qualitative Third generation Japanese Americans children of internees Internment during World War II Difficulty communicating with children about internment Feelings of sadness, anger, shame, and incompleteness, belief that internment could happen again, lack of confidence of rights in the U.S., diminished self-esteem and ethnic identity, loss of connection with Japanese language and heritage Familial distance, desire to know more about family history for offspring Liem, (2007) Qualitative Korean Americans Korean War Carrying unclosed wounds and remaining silent in order to Experiences of tension in the family and anxiety Unhappy familial relationships, emotional containment, isolation INTERGENERATIONAL TRAUMA 40 protect children and families, loss of self, feelings of being ostracized Lin & Suyemoto (2016) Qualitative Cambodian parents and/or grandparents and offspring Cambodian genocide Difficulty opening up about trauma history, experience of negative emotions when speaking about traumatic events Desire to learn more about family history, increased understanding of parents and boosted self-esteem after hearing parents’ stories Experience of interpersonal connectedness when speaking of and learning about family history Lin, Suyemoto, & Kiang (2009) Qualitative Cambodian American children of refugees Khmer Rouge regime/ Cambodian genocide Not examined Awareness of but difficulty with approaching parents about trauma, experiences of their own ambivalence and stress when approaching the topic Family distancing as a result of silencing on the topic of trauma Lee & Clarke (2013) Qualitative Hmong 1.5th generation offspring Secret War in Laos Avoidance of discussions about war, only communication about trauma was for the purpose of disciplining children Difficulty adjusting to Hmong and American culture, feelings of pain and empathy towards parents, emotional distress from silence about trauma, recognition of tparents’ PTSD/traumatic memories, gratitude towards parents, Not examined INTERGENERATIONAL TRAUMA 41 difficulty with bicultural identity Tsuru (2014) Qualitative Second-generation Japanese Americans and their children Internment at Hawaii during WWII Better adjustment than those incarcerated in mainland U.S. – only reported positive experiences from internment to children Intense fear, reexperiencing symptoms (nightmares), shame, post-traumatic growth Not examined INTERGENERATIONAL TRAUMA 42 2. TOWARDS COLLECTIVE HEALING: INTERGENERATIONAL TRAUMA INTERVENTION FOR KOREANS AND KOREAN AMERICANS Introduction The negative impacts of trauma on physical and mental health are well-documented in psychological literature (Santoro et al., 2021; Hughes et al., 2017). However, research to date has largely focused on the effects of trauma in an individual context and have been limited in examining other types of traumas (Field et al., 2013; Giladi & Bell, 2013). In fact, despite findings that suggest that exposure to traumatic events influence mental health for up to three generations from survivors to their descendants, the field of psychology has only recently begun to move towards examining the impacts of traumas that are collective in nature (Bezo & Maggi, 2015; Lin et al., 2009; Sangalang et al., 2017). Thus, an important expansion in the trauma literature is to identify the reverberating effects of various types of traumas beyond the individual. Currently, the Substance Abuse and Mental Health Services Administration (SAMHSA) describes individual trauma as “an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being” (SAMHSA, 2014, pp. 7). Survivors of trauma experience debilitation to one’s physical, cognitive, and psychological states and if left unresolved for months, one can adapt these dysfunctions as a way of life (van der Kolk, 2003). There have been variations in the conceptualizations and assessment of collective trauma (Sangalang & Vang, 2017). The current study borrows from Hirschberger’s (2018) definition that defines collective trauma as the “psychological reactions to a traumatic event that affects an entire society; [which] does not INTERGENERATIONAL TRAUMA 43 merely reflect a historical fact, [or] the recollection of a terrible event that happened to a group of people [but] is represented in the collective memory of the group.” Examples of such collective trauma include historical and cultural trauma. For instance, historical trauma is defined as distressing or life-threatening events that are experienced collectively by a group of people with a shared identity that have intergenerational effects on mental health; examples include war, colonization, oppression, and/or genocide (Danieli, 1998; Evans-Campbell, 2008). On the other hand, cultural trauma examines the ways that traumatic effects become embedded in memory, then is transmitted, and normalized through interpersonal interactions through families and communities (Atkinson, 2013; Isobel et al., 2017; Lanktree & Briere, 2016). In fact, both historical and cultural trauma are known to be passed down intergenerationally, as the impacts of such traumas are rooted in a community’s frame of reference and group identity (Hirschberger, 2018; Kim-Martin, 2021). Thus, intergenerational trauma has been defined as the process in which parents with unresolved trauma transmit the effects of trauma in their relational patterns with their offspring, resulting in the traumatic effects being experienced by the descendants without the original experience (Hesse & Main, 2000; Isobel et al., 2017). Some of the impacts of intergenerational trauma include psychological distress, poor coping mechanisms, and disorganized attachment in interpersonal relationships (Field et al., 2013; Isobel et al., 2017; Schore, 2009). Although the field has begun to explore collective trauma for Holocaust survivors and refugees (Isobel et al., 2017; Sangalang & Vang, 2017), there is still a need to examine the effects of collective trauma for other marginalized populations. INTERGENERATIONAL TRAUMA 44 Koreans and Korean Americans Koreans and Korean Americans (KKAs) in particular, may be a population in need of further examination. KKAs comprise one of the largest and fastest growing ethnic groups, growing 36% between 2000 and 2019 (Pew Research Center, 2021). Amongst the 1.9 million KKAs residing in the U.S., 63% are naturalized citizens and 10% are lawful permanent residents, while the rest identify as natural-born Americans who are Korean-identifying (Center for American Progress, 2015; O’Connor & Batalova, 2019; Pew Research Center, 2021). In order to encompass the various statuses and identities of KKAs, they are referred as Korean/Korean Americans throughout the present review. For the KKA community, despite an extended history of trauma and war, there is only a very small body of literature that delves into the intergenerational impacts of trauma for this community. Moreover, traumatic effects may be even more exacerbated for those from collectivistic cultures, such as KKAs, as the individual is more embedded within the family unit in their beliefs, identity, and consciousness (Somasundaram, 2014). Furthermore, even amongst extant studies on intergenerational effects of trauma, they have been limited to Southeast Asian refugees and Japanese Americans incarcerated during WWII (Cai &Lee, 2022). Thus, extending this body of literature to other Asian ethnic groups is invaluable to the field. Koreans in the U.S. have a long history of historical and cultural trauma from war and occupation. Of the most recent events, the Japanese colonization from 1910-1945 and the Korean War that ensued shortly after, have significantly impacted the Korean people (Armstrong, 2014; Robinson, 2007; Kang & Hong, 2017). During the Japanese colonization, Koreans experienced extensive abuse and violence, forced assimilation and erasure of a Korean ethnic identity, and forced labor with intolerable working conditions (Chung-Do et al., 2011; Kim-Martin, 2021). INTERGENERATIONAL TRAUMA 45 Not only so, but shortly after the Japanese occupation ended, the Korean War ensued. Known today as the “Forgotten War,” the Korean War led to 5 million casualties, 70% of which were civilians (Liem, 2003, Robinson, 2007). There were more bombs dropped during the war on the Korean Peninsula than were detonated in the entire Asia Pacific during World War II and the Vietnam War (Cumings, 2005). Although some of the effects of the war included mass killings, forced separation of 10 million people from their families, famine, and even biochemical combat – the exact devastation remains unclear (Kang & Hong, 2017; Liem, 2003). After such devastating events, Korea was left destitute both economically and socially, and generations of poverty ensued (Liem, 2007). Additionally, the aftermath of the aforementioned atrocities set the necessary environment for the first wave of refugee migration to the U.S. (Kim-Martin, 2021). Scholars have approached the process of immigration as a form of trauma due to the chronic nature of the stress for individuals and families associated with the process over a persistent period of time (Alamilla et al., 2017; Berger & Weiss 2002). Moreover, this may be especially true for a group such as Koreans/Korean Americans, as the first migrants to the U.S. were fleeing from the pernicious effects of colonization and war. Despite the desire to achieve stability by transitioning to the U.S, Korean immigrants have faced various systemic barriers such as racism, limitations to socioeconomic advances, and a difficult acculturation process (Chung & Bemak, 2007; Kim-Prieto et al., 2018;). Intergenerational Effects of Trauma The previous chapter on the synthesis of literature on intergenerational trauma for Asians and Asian Americans (AAAs) at large illuminated the pernicious and long-lasting effects of historical and cultural trauma. For example, studies found a link between AAA parents who experienced INTERGENERATIONAL TRAUMA 46 historical and cultural trauma presented Post-Traumatic Stress Disorder (PTSD) symptoms such as reexperiencing, hyperarousal, avoidance, negative alterations in cognitions and mood with adverse parenting and disordered mood in the offspring generation (Field et al., 2013; Hoffman et al., 2020; Sangalang et al., 2017). Traumatized parents also showed diminished ability to provide adequate affective responses and involvement and develop healthy attachment with their children (Han, 2006; Spencer & Le, 2006). These challenges were, in turn, linked with delinquent behavior, poor adjustment, and difficulty with establishing a sense of coherence for offspring (Han, 2006; Hoffman et al., 2020; Lee & Clarke, 2013; Sangalang et al., 2017; Spencer & Le, 2006). It is unsurprising then, that AAA families reported difficulty with maintaining healthy intergenerational communication about parental experiences of trauma. For instance, AAA parents that experienced historical and/or cultural trauma reported experiencing intense negative emotions when attempting to talk about their traumatic experiences and showed preference of avoiding these conversations (Hoffman et al., 2020; Lin & Suyemoto, 2016; Nagata & Cheng, 2003; Nagata, 1998). However, it was found that when meaningful conversations happened between parents and children about parental trauma, there was increased interpersonal connectedness, understanding, and empathy in the family unit (Lee & Clarke, 2013; Lin & Suyemoto, 2016). Moreover, although the literature has begun to illuminate the intergenerational effects of trauma for AAAs at large, findings on the effects of intergenerational trauma in Korean families have been concerningly sparse. Yet, Koreans in the U.S. report higher rates of mental health concerns such as depression, anxiety, and suicidal ideation even when compared to other Asian American ethnic groups (Han et al., 2017; Kim, 2009). Furthermore, studies show that second-generation Korean Americans often ascribe their mental health distress to relational challenges INTERGENERATIONAL TRAUMA 47 with their parents that have in turn, compromised various aspects of their psychological and relational functioning (Bernstein, 2007; Han & Pong, 2015; Kim, 2009). However, much of the literature that have examined KKAs and their mental health have not examined the influence of intergenerational trauma as a significant factor in these psychological and relational dysfunctions. Liem’s (2007) seminal qualitative study on the descendants of survivors of the Korean War is rare in the field, as his findings illuminate that second-generation Korean Americans report having been significantly affected by their parents’ experiences. Given that scholars across various disciplines have found that trauma is transmitted starting from a first-generation survivor, a second-generation adult child, and a third-generation adult grandchild of the same descendant, second-generation Korean Americans who did not experience the aforementioned cultural and historical traumas may be a point of entrance for intervention in the community. For example, scholars that have examined the effects of the Holocaust and other genocidal events such as the Holodomor genocide have found that impacts such as fear, mistrust, diminished self-esteem, social hostility lasted into the third generation born decades later after the atrocities (Yehuda & Lerner, 2018; Bezo & Maggi, 2015). Researchers in epigenetics and neurobiology have even found that biological bases such as hypothalamic-pituitary-adrenal axes and stress neurocircuitry were dysregulated for several generations who did not experience the original trauma as their first-generation ancestors (Yehuda & Lerner, 2018). In fact, transgenerational transmission of psychiatric disorders from ancestral exposure were shown to be present in the third generation of descendants who were not exposed (Klengel et al., 2016). Currently, second-generation Korean Americans describe their parent-child relationship as being shrouded in tension and anxiety while expressing frustration that they were unable to INTERGENERATIONAL TRAUMA 48 access knowledge to their parents’ experiences of trauma (Liem, 2007). Thus, the quality of parent-child relationships and family communication may be a particularly important aspect of understanding how to intervene and improve parent-child relationships that have been deterred as a result of intergenerational trauma in the KKA community. It has been posited that family communication may be deterred in Korean families due to parents’ tendencies to avoid conversations about their traumatic experiences to evade their own negative emotions as well as protect their children (Liem, 2007). In turn, with the lack of passing down of critical knowledge about parental experiences, the lack of meaningful dialogues about trauma results in individuals, families, and communities experiencing increased distress from lack of therapeutic conversations (Felix et al., 2020; Kim-Martin, 2021; Orom et al., 2012). Such lack of communication is attributed to the descendants of trauma survivors misunderstanding the behaviors of their parents and experiencing them as distant and depersonalized (Kim-Martin, 2021; Liem, 2007). Thus, it has been suggested that prevention and intervention for the intergenerational impacts of trauma and promoting collective healing may be through families engaging in adaptive communication (Cai & Lee, 2022; Kim-Martin, 2021; Kim-Prieto et al., 2018; Liem, 2007). Randomized Control Trials and Psychoeducation Randomized control trials (RCTs) are considered the gold standard for research, known for their rigorous research methods and high-quality findings (Bhide et al., 2018; Hariton & Locascio, 2018). As there is a drastic lack of competent interventions addressing intergenerational trauma with KKAs, the utilization of RCT will be a significant contribution to the field. Furthermore, there has been support for the efficacy of utilizing psychoeducation as an intervention on mitigating impacts of intergenerational trauma (Jung et al., 2018; Scott & Copping, 2008). For example, interventions such as the Intergenerational Trauma Treatment INTERGENERATIONAL TRAUMA 49 Model utilizes psychoeducation as a part of their manualized protocol (Scott & Copping, 2008). A psychoeducation intervention with Asian Americans has shown that consuming psychoeducational materials have been connected to increased mental health literacy and changes in behavior intentions such as improving familial communication (Kim et al., 2021). Moreover, scholars have also suggested that education about trauma, its effects, and ways to intervene are important ways of facilitating collective healing and improve family relationships. For instance, it has been posited that educating young ethnic and racial minority people on their family and community history may facilitate intergenerational understanding of collective struggles (Cai & Lee, 2022). Furthermore, psychoeducation has been shown to improve help-seeking behaviors and remove cultural barriers in Asian American families (Cai & Lee, 2022; Jang et al., 2006). Lastly, psychoeducation may be particularly efficacious with KKAs, as many Asian cultures uphold education and knowledge as a cultural value (Kim et al., 2021). The Proposed Study Given the literature reviewed, the present study aimed to examine whether psychoeducation serves as an effective method of intervention for improving perceived parent-child relationships for second-generation KKAs. Currently, there is not an accessible intervention addressing perceived quality of parent-child relationships for KKAs. As such, the present study sought to address the call from several scholars for effective interventions to improve quality of family relationships to resolve intergenerational effects of trauma (Isobel et al., 2017; Kim-Martin, 2021). Thus, the current study investigated whether learning about parental trauma and its effects on offspring influence perceived parent-child relationships for adult KKA children. Additionally, the present study examines whether gaining knowledge on parental traumatic experiences and its effects on offspring impact participants’ openness to family communication. INTERGENERATIONAL TRAUMA 50 Hypothesis 1: For participants that receive psychoeducation on intergenerational trauma, there will be a significant difference in T1 and T2 scores on perceived quality of parent-child relationship. Hypothesis 2: For participants that receive psychoeducation on effects of intergenerational trauma, there will be a significant difference in T1 and T2 scores on openness to family communication with parents. Methods The present study utilized a randomized control design. Data was collected through an online Qualtrics survey with quantitative measures, and results followed protocol with randomized control trial studies. Participants Participants for the present study were second-generation KKAs using an online participant study recruitment method for universities and communities. SONA, an online survey portal for undergraduate students to participate in research, was utilized in a large university in the Southeast. Other forms of recruitment occurred through relevant listservs within the American Psychological Association (APA; i.e., Divisions 45 and 17, the Korean Psychologist Network, the Asian American Psychological Association), and in the KKA community (i.e., Korean American Coalition, Korean American churches, Asian Americans Advancing Justice – Atlanta). Recruitment emails were also sent to Korean and Asian American university student organizations and multicultural centers across the U.S. Participants did not receive any other compensation other than university students recruited through SONA who received class credit for their participation. Data collection occurred between February 2023 – July 2023. Inclusion criteria for participants included the following: 1) identify as Korean/Korean American, 2) be at INTERGENERATIONAL TRAUMA 51 least 18 years old and 3) screen positively to a question assessing family conflict. These inclusion criteria were selected to reflect the U.S.-born second-generation Korean population (Pew Research Center, 2021). Procedure The Qualtrics website randomly assigned participants after they reviewed the informed consent and agreed to participate in the study. Respondents answered a series of demographic questions, then were directed to complete the study measures. Survey questionnaires were administered to all participants in both the intervention and control groups for pre-post test scores. Amongst the randomized groups, there was an intervention group that received psychoeducation on intergenerational trauma for KKAs and a control group that received psychoeducation on social determinants of health. For the intervention group, they also answered a series of open-ended questions designed by the researchers to verify that they understood the intervention material. Intervention Participants in the intervention group watched an audio-recorded video presentation with PowerPoint slides about various types of historical and cultural traumas that KKAs have experienced both in Korea and in the U.S., and its intergenerational impacts on family functioning. The intervention follows Phase A from the Intergenerational Trauma Treatment Model (ITTM; Scott & Copping, 2008). The ITTM is divided into three phases, the first of which is a psychoeducation portion that covers the principles of trauma, attachment, caregivers’ response to trauma, and the parent-child relationship (Scott & Copping, 2015). Aligned with this model, the proposed intervention’s presentation provided an overview of critical topics, including the Japanese colonization, Korean War, various types of immigration traumas, impacts INTERGENERATIONAL TRAUMA 52 on parental mental health, methods of trauma transmission, and effects on familial relationships and functioning. The presentation also educated participants on communication skills to use within the family context with the goals of improving parent-child relationships. Not only have other interventions aimed at treating intergenerational emphasized the importance of family communication, but given the deleterious effects that intergenerational trauma has on the parent-child relationship through the mechanism of lack of meaningful family communication, educating participants on how to foster communication skills may be helpful in promoting collective healing as well (Chokshi et al., 2022; Cai & Lee, 2022; Kim-Martin, 2021; Kim-Prieto et al., 2018; Liem, 2007). Furthermore, as 94% of second-generation Korean Americans are proficient in English according to the Pew Research Center, all materials including the video narration and PowerPoint slides were developed in English, as the intervention will target the offspring generation who have not experienced the original historical/cultural trauma but rather have been the recipients of the effects of trauma from the parent generation(Pew Research Center, 2019). This approach is in alignment with other interventions that have targeted AAAs as well (Kim et al., 2021). Excerpts from materials are included in the Appendix. Participants in the intervention and control groups completed all pre-test and post-test measures outlined below. However, those in the control group received no intervention but instead watched a video from the Steve Fund on the social and cultural determinants of mental and emotional health for students of Color. Finally, all intervention materials were submitted to mental health clinicians who primarily work with KKA individuals, families, and communities for expert feedback. Members of a KKA were also consulted for community-based feedback. The mental health clinicians who provided suggestions were comprised of two counselor educators and two psychologists that work with KKA clients/patients. Overall, their feedback INTERGENERATIONAL TRAUMA 53 was positive, reporting that this resource would be helpful for their KKA clients in combatting what they often think are individual mental health issues, such as depression and anxiety, when in fact, their complex history influences their realities. As for areas of growth, clinicians suggested using less non-academic language throughout the presentation, giving an overview of goals for the intervention, and providing a way for participants to process their insights from the intervention. Thus, the intervention was modified to simplify terminology, including a slide to provide aims for the intervention, and including an open-response section after the intervention in Qualtrics. Feedback from a KKA church included minor suggestions regarding the user experience of accessing the video. Thus, a simplified link for access was created for the intervention. Measures Demographic Questionnaire Sociodemographic information such as age, gender, sexual orientation, gender identity, educational attainment, religious identity, and socioeconomic status were collected to get an overall understanding of the participant sample. Parent-Child Relationship Survey Quality of parent-child relationships was assessed with the Parent-Child Relationship Survey (PCRS; Fine et al., 1983). The 24-item PCRS measures perceived quality of adult children’s relationship with their mothers and fathers. Each item is scored on a 7-point Likert scale ranging from 1(almost none) to a 7 (a great deal). Sample items include “How close do you feel to your mother/father?” and “How much do you respect your mother/father?” The PCRS showed excellent internal consistency with positive affect (r = .93). Mean scores were computed, with higher scores indicating better perceived parent-child relationship in the perspective of the child. INTERGENERATIONAL TRAUMA 54 With a sample of Asian Americans, Park and colleague’s (2009) reported good internal consistency of PCRS scores with Asian American dyads of fathers-sons ( = .88), mothers-sons ( = .88), fathers-daughters ( = .91), and mothers-daughters ( = .88). Family Communication Participants’ family communication was measured by the Family Communication Scale (FCS; Olson, 1985). Although this scale was originally developed for adolescents, it has been successfully used with Korean adults reporting on their family communication (Kim et al., 2015). Sample items include “I can discuss my beliefs with my mother/father without feeling restrained or embarrassed” and “My mother/father tries to understand my point of view.” Participants will respond to the items on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Mean scores were computed, with higher scores more positive communication in the family system. Furthermore, the FCS has not only demonstrated good internal consistency ( = .90) and test-retest reliability ( = .86) but has also been successfully used with a second-generation KKA sample ( = .92). Data Analysis Plan To determine the sample size needed to obtain sufficient power for the present investigation, a G*Power analysis was conducted. For a within-between repeated measures ANOVA with two groups and two measures, it was determined that a sample size of 128 would be needed. This sample size was calculated with a power of 0.8, which is acceptable to reject the null hypothesis (Cohen, 1998). All other quantitative results were analyzed using IB SPSS Version 29 (2023). Missing data was addressed by conducting listwise deletion for cases that did not meet the inclusion criteria, were missing more than 80% on scale items, or when participants indicated that they skipped over the video or did not complete post-intervention measures (Dodeen, 2003; INTERGENERATIONAL TRAUMA 55 Schlomer et al., 2010). Thus, a considerable proportion of the initial sample (n = 395) was not included in the data analysis, a common occurrence in studies requiring extensive participant engagement and lengthy survey completion times (Dodeen, 2003; Schlomer et al., 2010). This process left a total sample size of 129 participants. From the final sample of 129 participants, Little’s Missing Completely at Random (MCAR) analysis was conducted, and results indicated the data was missing completely at random (X2 = (344, n = 129) 362.732 p = .234). Beyond missing data, the data were also examined for normality, linearity, outliers, homogeneity of variance, homogeneity of regression, and reliability. Assumptions for mixed repeated MANOVA for normal distribution of residuals for within-subjects and between-subjects, homoscedasticity, homogeneity of variances-covariance matrices, and sphericity were examined and all assumptions were met (Murrar & Brauer, 2018; Rutherford, 2001; Verma, 2015). Levene’s test of equality of error variances indicated that the assumption of homogeneity were met as well (p = .376-.857). After procedures for checking data, relevant items on the Parent-Child Relationship Scale were reverse-coded. Bivariate correlations, paired t-tests, and descriptive statistics were then examined. The mixed repeated measures ANOVA for Hypotheses 1 and 2 present 2 (Group - Control, Intervention) x 2 (Pre-Parent/Child Relationship, Post-PCR) and 2 (Group - Control, Intervention) x 2 (Pre-Openness to Family Communication, Post-FC) models. A mixed repeated ANOVA model with a 2 (Group – Control, Intervention) x 4 (Pre-PCR, Post-PCR, Pre-FC, Post-FC) was also analyzed. Time and treatment conditions (i.e., intervention or control) were used as fixed factors. Treatment conditions were considered a between-subject factor. Between-subject factors were labeled as pre-intervention or post-intervention while within-subject variables were dummy coded (0 = Control Group, 1 = Intervention Group). Mixed Repeated ANOVAs are INTERGENERATIONAL TRAUMA 56 common in RCTs in psychological literature for comparing mean differences across groups at various time points (Hartmann, 2006; Heppner et al., 2015). Regardless of significance, interaction effects across time differences for each group were examined and reported using Wilk’s lambda values. Due to the hypotheses for each dependent variable, results from univariate analyses for each variable were also reported. Results Bivariate correlations for perceived quality of parent-child relationship (PCRS) and openness to family communication (FCS) before and after the intervention were as expected. Specifically, there were significant positive correlations for PCRS and FCS. Pre-PCRS and pre-FCS indicated that participants who perceived their relationship as being positive with their parents also reported higher levels of openness to family communication, r (129) = .591, p < 0.001. This positive association was true post intervention as well r (129) = .675, p < 0.001. Overall multivariate analyses showed that there was not a significant difference between groups over time and approximately 2% of the variance in the dependent variables, perceived parent-child relationship and openness to family communication, was accounted for by the intervention and control groups before and after either the intervention or control videos (F(2, 126) = 1.264, p =.286; Wilk's Λ = 0.980, η2 = .020). Univariate analyses followed to test the specific hypotheses about each of the dependent variables. Hypothesis 1: For participants that receive psychoeducation on intergenerational trauma, there will be a significant difference on pre- and post- scores on perceived quality of parent-child relationship. The first mixed repeated measures ANOVA was used to determine whether there was a significant difference in participants’ perceived quality of relationship with their parents before INTERGENERATIONAL TRAUMA 57 and after the intervention. The mixed repeated measures ANOVA model for Hypothesis 1 was 2 (Group – Control, Intervention) x 2 (Pre-PCRS, Post-PCRS). Specifically, this analysis examined whether participants’ perception about the quality of their relationship with their parents differed before and after they received the intervention. The sample for each group varied somewhat: control group (n= 72) and intervention group (n= 57). Univariate analyses revealed that mean perceptions of quality of parent-child relationship did not change significantly between T1 and T2 (F(1, 129) = 2.062, p > .001 η2 = .016). Hypothesis 2: For participants that receive psychoeducation on effects of intergenerational trauma, there will be a significant difference in T1 and T2 scores on openness to family communication with parents. The second mixed repeated measures ANOVA that was used to determine whether there was a significant difference in participants’ openness to family communication before and after the intervention. The mixed repeated measures ANOVA model for Hypothesis 2 was (Group – Control, Intervention) x 2 (Pre-FCS, Post-FCS). Specifically, this analysis examined whether participants’ openness to engaging in meaningful conversations with their parents differed before and after the intervention. Univariate analyses revealed similar results in that mean openness to family communication did not differ significant pre and post the intervention (F(1, 129) = .524, p >.001 η2 = .004). Additional Analyses Quantitative A separate repeated measures ANOVA was used to determine whether there was a significant difference between the intervention and control groups (F(2, 126) = .591, p =.556; Wilk's Λ = .991, η2 = .009). The rationale for this analysis was to see whether there was a INTERGENERATIONAL TRAUMA 58 difference between groups on family functioning overall, operationalized by parent-child relationship and family communication. A 2 (Group – Control, Intervention) x 4 (Pre-PCRS, Post-PCRS, Pre-FCS, Post-FCS) model was used. Results indicated that there was a significant difference between groups in that the control groups scored higher on measures at T1 and T2 but at T2, the difference between the control and intervention groups decreased. Qualitative After watching the psychoeducational video, participants were invited to answer open-ended questions such as “What stood out to you the most from the video you just watched?” and “What elements discussed in this video do you feel personally impacted your relationship with your parents?” Excerpts were selected based on the general benefits that participants were reporting from the intervention to add to the present quantitative results. The quotes should, therefore, be approached from an illustrative lens on participants’ processing of the psychoeducation material rather than validating a specific model of treatment. The seminal work of Liem (2007) on intergenerational impacts of historical and cultural trauma for Korean Americans took a similar descriptive approach to participants’ insights on parental experiences. Many participants in the intervention group highlighted that learning about Korea’s difficult history helped them grow in understanding the impacts of trauma on their parents. For example, a 27-year old, female, Christian, heterosexual participant reported “I was mostly putting everything into perspective in regards to the history we’ve had…and how that has had an impact on generations before and how that affects parenting styles and their beliefs. This history of what we’ve been through made me realize my parents had no one to go to with how to handle those feelings I understand now that they are not at fault for their feelings and expectations.” Similarly, another participant who is 48-years-old, male, Christian, and aromantic, reported INTERGENERATIONAL TRAUMA 59 “what stood out was how it really brought home the trauma of the occupation and the Korean War. The trauma of the war and immigration on my dad has made him more distant.” Others shared new insights on how the effects of trauma impacted closeness with family members. For example, one participant who identified as 30-years-old, Christian, heterosexual, and college-educated wrote “The effects of trauma including difficulty with communication and parental avoidance of conversations – avoiding negative emotions” as what stood out to them. Relatedly, other participants reported that being influenced on the importance of family communication through the intervention. One participant who endorsed being 21 years-old, female, Christian, gay, and working class reported “the building communication segment really stood out to me because that’s what I am currently trying to work on with my parent. Communicating effectively would definitely initiate the repair for our bond and the restructuring/reframing seems like something that I can use to build a healthier and authentic relationship with my own father. It gives me hope.” Another who is 22-years-old, female, Catholic, aromantic, working class with some high school education shared, “I think misunderstanding of parental behavior is a big part of my relationship with my parents. I thought the portions about family communication were most interesting. There’s motivation to ask my parents about their trauma.” Discussion The present study aimed to address a dearth in literature regarding the impacts of intergenerational trauma on family functioning for second-generation Korean Americans. Specifically, the study’s purpose was to test whether psychoeducation that addressed the various collective traumas experienced by the Korean people, including historical and cultural traumas INTERGENERATIONAL TRAUMA 60 such as colonization, war, and immigration, was efficacious in improving perceived parent-child relationship and openness to family communication. Quantitative results did not support the effectiveness of the intervention developed for this study. The first possible explanation for this may be because psychoeducation alone may have been insufficient in enacting lasting change. For example, scholars have postulated that complex trauma is healed from the process of meaning making which requires significant effort in reframing, restructuring, and meaning making (Park & Ai, 2006). Furthermore, scholars have found that the mental health implications of generational trauma are pernicious, including internalized devaluation, assaulted sense of self, learned voicelessness, and psychological homelessness (Hardy, 2023). Thus, simply providing educational material on intergenerational trauma and suggestions on how to improve family functioning may have been inadequate. For example, other intervention studies have incorporated a psychoeducational component as well as cognitive-behavioral processing for participants in their design (Scott & Copping, 2015) and the present intervention may have benefitted from this approach. Moreover, there may be factors related to second-generation Korean Americans that influenced their ability to glean from this intervention that were not accounted for. For example, mental health challenges seem to be at an all-time high for second-generation Korean Americans; in fact, Korean Americans are reporting the highest suicide rates amongst all Asian American subgroups, at a rate that is twice the national average (Bernstein et al., 2021; Kuroki, 2018). Thus, there may have been mental health challenges that are unique to being a second-generation Korean American that were not adequately addressed. Thus, the present intervention may have benefitted from screening for mental health diagnoses from the sample or incorporating ways on how the material may benefit mental health at large for participants. For INTERGENERATIONAL TRAUMA 61 example, other intervention studies have included exercises such as narrative writing of the impacts of trauma or adding a discussion component for participants after providing psychoeducation (Rivera et al., 2019; Merscham, 2000). These approaches may have benefitted the present study as well. Additionally, it should be noted that the bivariate correlations for the present study showed a positive relationship between perceived parent-child relationship and openness to family communication. Thus, participants in the present study aligned with previous findings and found that the quality of the relationship with their parents were connected to the openness for family communication (Park et al., 2009; Kim et al., 2015). Thus, the present intervention could be strengthened by providing specific communication strategies for second-generation KKAs to engage in meaningful conversation with their parents in addition to strategies of buttressing parent-child attachment (Han, 2016). Lastly, despite the insignificant quantitative results, review of the qualitative illustrations seems to indicate that there were some value for the intervention group. For example, participants seemed to be engaging in reappraisals of their parents’ beliefs and goals that might not have been fully captured by the quantitative results. This is a hopeful direction for the present study, as past literature supports that quality of parent-child relationships as well as social support were psychologically protective for Korean Americans. Specifically, parent-child bonding and expressed affection in Korean families were robust for depressive symptoms (Choi et al., 2017). Limitations and Future Directions The first limitation to consider for the present study is the participation attrition rate that resulted in the need to reduce unusable data from the initial sample. Future research should INTERGENERATIONAL TRAUMA 62 consider employing techniques to reduce burden on participants, potentially enhancing data retention and reducing the proportion of unusable data entries (Stewart et al., 2021). Additionally, exploring other methods of handling missing data, such as multiple imputation, could be utilized to determine optimal practices for handling patterns of missing data (Dodeen, 2003). Furthermore, the intervention had a negligible effect size, possibly due to a small sample size. Randomizing participants into intervention and control groups led to an overall small sample per group as well, with the control group having n = 72 participants and the intervention group having n = 57 participants. Thus, it may have been difficult to detect a true effect in significant differences amongst the groups and a larger sample size may have been more sensitive to an intervention with a smaller effect size (Button et al., 2013). As difficulties with collecting data from a specific ethnic group is not new to the field and scholars have found that response rates among ethnic minorities are considerably lower than among the majority (Stewart et al., 2021), future studies may wish to consider taking a fieldwork approach to collecting data and going into community spaces such as Korean American churches and organizations rather than to collect data online (Feskens et al., 2006). Another consideration for future studies may wish to include covariates such as age in order to differentiate possible effects that may range across various developmental stages of participants. For example, participants who are young adults, understood as ranging from the age of 18-26, may have a different relationship with their parents as they figure out independence and maturation (Bonnie et al., 2015) and be further from the historical/cultural traumas of the Korean people. On the other hand, participants in early/middle adulthood ranging from the age of INTERGENERATIONAL TRAUMA 63 35-45, will have had completed various stages of maturation and an acceptance of filial piety that may have contributed to a reframing of their relationship with their parents (Kim et al., 2015). Another limitation to consider is the time points in which the post-intervention data was collected. As the present study collected data before and right after participants watched either the control or intervention video, there might have been insufficient time for participants to process the material presented to them. Other intervention studies have utilized a baseline, posttreatment, and either a 1-month, 6-month, or 12-month follow up sessions to collect post-intervention data (Resick, 2015; Yeomans et al., 2010). Thus, future researchers may wish to follow suit and collect follow-up data after participants have had time to process the material. Finally, future studies may also wish to create measures that specifically capture the impacts of trauma on the family system for racial and ethnic minorities. Despite the field moving into examining trauma as a collective experience with emerging literature on the effects of war, natural disasters, and racial trauma, extant scales have yet to be designed to measure beyond the individual. For example, the Racial Trauma Scale and the Collective Trauma Scale measures the impact of racial discrimination and collective trauma events but only does so in the individual context (Williams & Williams-Morris, 2000; Kira et al., 2006). Clinical Implications As scholarship builds on emerging work that conceptualizes trauma beyond the individual, clinicians will also benefit from incorporating this knowledge into their practice. For example, they may wish to include asking about experiences of trauma in their intakes with new patients and clients to get a full picture of how their generational history impact the patient/client’s mental health. Otherwise, it would also benefit the field for clinicians to incorporate more family-systems level interventions in their clinical practice. For example, Rivera and colleagues INTERGENERATIONAL TRAUMA 64 developed a culturally informed group psychotherapy intervention named AWARE to improve mental health for Asian American women with trauma. The AWARE program had a focus on family systems that centered discussions on disempowered parenting that is associated with low self-worth for 1.5 and second-generation Asian American daughters, was found to be efficacious in improving mental health (Rivera et al., 2019). Moreover, it may also benefit clinicians to consider including first-generation Korean Americans in their conceptualization and intervention of intergenerational trauma. Due to factors such as stigma against mental health and language barriers, this population remains understudied in the field (Han et al., 2017). However, first-generation Koreans are closer to the historical and cultural traumas explained in the present study and intervening with them along with the second-generation may prove to increase efficacy of interventions. Although such interventions have not yet been produced, the known effects of the importance of healing the parent-child relationship in the Korean American community is known. For example, it was found that affective and verbal responsiveness from parents were protective in parent-child relationships and daughters’ affective orientation specifically had benefits on father-daughter relationships in Korean families (Park et al., 2009). Other studies have also centralized the themes of family cohesion and meaning making of parental experiences to treat various deterrents to mental health (Rivera et al., 2019; Park et al., 2009; Kang et al., 2010). Thus, bringing the parent and child generations together to strengthen the parent-child relationship and family communication may of clinical interest to mental health practitioners. Conclusion Despite the limitations of the present study, there are still contributions to the field regarding how collective traumas, such as historical and collective traumas, may influence INTERGENERATIONAL TRAUMA 65 generations of Korean American families. The present study provides an important first step in how mental health professionals may approach creating opportunities for intergenerational healing to occur through improving the quality of parent-child relationships as well as family communication. 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World Psychiatry, 17(3), 243–257. https://doi.org/10.1002/wps.20568 INTERGENERATIONAL TRAUMA 77 Table B1 Gender Identity Demographic Descriptives Gender N % Male 62 48.1 Female 65 50.4 Transgender 2 1.6 Table B2 Age Demographic Descriptives Age N % 18-25 98 76.1 26-35 22 17.2 36-45 5 4.0 46-53 4 3.1 Table B3 Education Level Descriptives Highest Level of Education N % High school graduate or equivalent (e.g., GED) 32 24.8 Some college credit, no degree 33 25.6 Associate degree 15 11.6 Bachelor’s degree 39 30.2 Master’s degree 8 6.2 Doctorate degree 1 0.8 INTERGENERATIONAL TRAUMA 78 Table B4 Sexual Orientation Descriptives Sexual Orientation Identity N % Exclusively Heterosexual 95 73.6 Mostly Heterosexual 14 10.9 Bisexual 10 7.8 Mostly Lesbian or Gay 2 1.6 Exclusively Lesbian or Gay 4 3.1 Asexual 2 1.6 Other (Open Response) 2 1.6 Table B5 Social Class Descriptives Class Identification N % Lower Class 9 7.0 Working Class 29 22.5 Middle Class 72 55.8 Upper Middle Class 16 12.4 Upper Class 3 2.3 INTERGENERATIONAL TRAUMA 79 Table B6 Religious Identity Descriptives Religious Identity N % Agnostic 95 73.6 Atheist 14 10.9 Buddhist/Taoist 10 7.8 Christian/Catholic 2 1.6 Christian/Protestant 4 3.1 Christian/Other 2 1.6 Spiritual but Not Religious 2 1.6 Table B7 Correlations and Cronbach Alphas for Key Study Variables Variables Pre-PCRS Pre-FCS Post-PCRS Post-FCS Pre-PCRS -- .591** .758** .591** .951 Pre-FCS -- .683** .894** .891 Post-PCRS -- .675** .953 Post-FCS -- .909 ** Correlation is significant at the 0.01 level. INTERGENERATIONAL TRAUMA 80 Table B8 Means and SD for Intervention Group on Study Variables Item Pre-Intervention Post-Intervention M SD N M SD N Parent-Child Relationship 4.39 1.02 57 4.47 .994 57 Family Communication 3.16 .860 57 3.15 .823 57 Table B9 Means and SD for Control Group Item Pre-Intervention Post-Intervention M SD N M SD N Parent-Child Relationship 4.56 .937 72 4.55 .962 72 Family Communication 3.29 .764 72 3.33 .840 72 Table B10 INTERGENERATIONAL TRAUMA 81 Mixed Repeated Measures Analysis of Variance – Test of Within-Subjects Factors on Parent-Child Relationship Source df MS F p Partial Eta Squared Time 1 .081 1.480 .226 .012 Time * Group 1 .112 2.062 2.062 .016 Error 127 .054 *Sphericity Assumed Table B11 Mixed Repeated Measures Analysis of Variance – Test of Within-Subjects Factors on Family Communication Source df MS F p Partial Eta Squared Time 1 .019 .265 .607 .002 Time * Group 1 .038 .524 .470 .004 Error 127 .072 *Sphericity Assumed Table B12 INTERGENERATIONAL TRAUMA 82 Pairwise Comparisons of Group (Control vs Intervention) on Parent-Child Relationship and Openness to Family Communication Group (I) Control (J) Intervention Mean difference (I-J) SE 95% CI: Lower Bound 95% CI: Upper Bound PCRS 0 1 .124 .171 -.214 .461 FCS 0 1 .154 .142 -.126 .434 Table B13 Pairwise Comparisons of Time for Intervention Group on Parent-Child Relationship and Openness to Family Communication Group (I) Time (J) Time Mean difference (I-J) SE 95% CI: Lower Bound 95% CI: Upper Bound PCRS 2 1 .036 .226 -.093 .022 FCS 2 1 .017 .34 -.049 .084 Appendix INTERGENERATIONAL TRAUMA 83 Demographic Questionnaire 1. Do you identify as being of Korean descent? (Ethnically Korean; born in Korea and/or Korean American). a. Yes b. No 2. How do you currently describe your gender identity? 1. Agender (Genderless) 2. Androgyne (Feminine and Masculine) 3. Cisgender Man (Assigned Male at Birth) 4. Cisgender Woman (Assigned Female at Birth) 5. Genderqueer (Nonbinary, combination of any and all genders) 6. Transgender Woman 7. Transgender Man 8. Other: ____________________ (Open Response) 2. How do you currently describe your relationship and/or sexual orientation? 1. Asexual 2. Aromantic 3. Bisexual 4. Demisexual 5. Gay 6. Heterosexual 7. Lesbian 8. Pansexual INTERGENERATIONAL TRAUMA 84 9. Polyamorous 10. Queer 11. Questioning 12. Other: ____________________ (Open Response) 3. What is your family income? 1. $_____________ 2. Unknown/Prefer not to state 4. What is your age? 1. 18-24 2. 25-34 3. 35-44 4. 45-54 5. 55-64 6. 65-74 7. 75-older 5. What is your highest level of education? 1. No schooling completed 2. Nursery school to 8th grade 3. Some high school, no diploma 4. High school graduate, diploma or the equivalent (for example: GED) 5. Some college credit, no degree 6. Trade/technical/vocational training 7. Associate degree INTERGENERATIONAL TRAUMA 85 8. Bachelor’s degree 9. Master’s degree 10. Applied or Professional degree 11. Doctorate degree 6. Were you born in the United States? 1. Yes 2. No 7. Do you come from a family of immigrants? 1. 1st generation immigrant (at least one parent is an immigrant) 2. 2nd generation immigrant (at least one grandparent is an immigrant) 3. 3rd generation immigrant (at least one great grandparent is an immigrant) 4. Unsure or unapplicable 8. What religion do you identify with? 1. Anglican (Episcopal) 2. Baptist 3. Buddhist 4. Catholic 5. Christian Scientist 6. Church of Christ 7. Confucianist 8. Congregationalist (UCC) 9. Friend (Quaker) 10. Hindu INTERGENERATIONAL TRAUMA 86 11. Jain 12. Jehovah’s Witness 13. Jewish 14. Latter-day Saint (Mormon) 15. Lutheran 16. Methodist 17. Muslim 18. None 19. Orthodox 20. Pentecostal 21. Presbyterian 22. Rastafari 23. Reformed 24. Seventh Day Adventist 25. Sikh 26. Taoist 27. Unitarian Universalist (UU) 28. Wiccan (Pagan) 29. Yazidi 30. Agnostic 31. Atheist 32. Other: ___________________(Open Response) 9. Have you been diagnosed with any disability or impairment? INTERGENERATIONAL TRAUMA 87 1. No 2. Yes, diagnosed by a licensed professional or doctor 3. Yes, diagnosed by some other professional 4. Yes, self-diagnosed 10. Is English your first language? 1. Yes 2. No 11. What is your political affiliation? 1. Democratic 2. Independent 3. Republican 4. Liberal 5. Libertarian 6. Unsubscribed 7. Other political view ______ (Open Response) 12. If you are seeking a degree, what degree are you currently seeking? 1. Associate of Applied Science (AAS) 2. Associate of Arts (AA) 3. Associate of Science (AS) 4. Bachelor of Applied Science (BAS) 5. Bachelor of Architecture (B.Arch.) 6. Bachelor of Arts (BA) 7. Bachelor of Business Administration (BBA) INTERGENERATIONAL TRAUMA 88 8. Bachelor of Fine Arts (BFA) 9. Bachelor of Science (BS) 10. Master of Business Administration (MBA) 11. Master of Education (M.Ed.) 12. Master of Fine Arts (MFA) 13. Master of Laws (LL.M.) 14. Master of Public Administration (MPA) 15. Master of Public Health (MPH) 16. Master of Publishing (M.Pub.) 17. Master of Science (MS) 18. Master of Social Work (MSW) 19. Doctor of Business Administration (DBA) 20. Doctor of Dental Surgery (DDS) 21. Doctor of Education (Ed.D.) 22. Doctor of Medicine (MD) 23. Doctor of Pharmacy (Pharm.D.) 24. Doctor of Philosophy (Ph.D.) 25. Doctor of Psychology (Psy.D.) 26. Juris Doctor (JD) 27. Other ________ (Open Response) 28. Not currently seeking a degree Parent-Child Relationship Survey (Fine et al., 1983) INTERGENERATIONAL TRAUMA 89 Answer the questions using the following scale None A Great Deal 1 2 3 4 5 6 7 Mother Father 1 2 3 4 5 6 7 1 2 3 4 5 6 7 INTERGENERATIONAL TRAUMA 90 How much time do you feel you spend with your mother/father? (1) o o o o o o o o o o o o o o How well do you feel you have been able to maintain a steady relationship with your mother/father? (2) o o o o o o o o o o o o o o How much do you trust your mother/father? (3) o o o o o o o o o o o o o o How confident are you that your mother/father would not ridicule or make fun of you if you were to talk about a problem? (4) o o o o o o o o o o o o o o How confident are you that your mother/father would help you when you have a problem? (26) o o o o o o o o o o o o o o How close do you feel to your mother/father? (25) o o o o o o o o o o o o o o How comfortable would you be approaching your mother/father about a romantic problem? (6) o o o o o o o o o o o o o o INTERGENERATIONAL TRAUMA 91 How comfortable would you be approaching your mother/father about a problem at school? (7) o o o o o o o o o o o o o o How confused are you about the exact role your mother/father is to have in your life? (8) o o o o o o o o o o o o o o How accurately do you feel you understand your mother/father’s feelings, thoughts, and behavior? (9) o o o o o o o o o o o o o o How easily do you accept the weaknesses in your mother/father? (10) o o o o o o o o o o o o o o To what extent do you think of your mother/father as an adult with a life of her/his own, as opposed to thinking of her/him only as your mother/father? (11) o o o o o o o o o o o o o o How often do you get angry at your mother/father? (27) o o o o o o o o o o o o o o INTERGENERATIONAL TRAUMA 92 In general, how much do you resent your mother/father? (13) o o o o o o o o o o o o o o How well do you communicate with your mother/father? (14) o o o o o o o o o o o o o o How well does your mother/father understand your needs, feelings, and behavior? (15) o o o o o o o o o o o o o o How well does your mother/father listen to you? (16) o o o o o o o o o o o o o o How much do you care for your mother/father? (17) o o o o o o o o o o o o o o When you are away from home, how much do you typically miss your mother/father? (18) o o o o o o o o o o o o o o How much do you respect your mother/father? (19) o o o o o o o o o o o o o o How much do you value your mother/father’s opinion? (20) o o o o o o o o o o o o o o INTERGENERATIONAL TRAUMA 93 How much do you admire your mother/father? (21) o o o o o o o o o o o o o o How much would you like to be like your mother/father? (22) o o o o o o o o o o o o o o How much would you be satisfied with mother/father’s life-style as your own? (23) o o o o o o o o o o o o o o INTERGENERATIONAL TRAUMA 94 Family Communication Scale (Olson, 1985). Please indicate the degree to which you feel these items are descriptive of your family. INTERGENERATIONAL TRAUMA 95 Strongly disagree (1) Generally Disagree (2) Undecided (3) Generally Agree (4) Strongly Agree (5) Family members are happy with how they communicate with each other. (sample_1) o o o o o Family members are very good listeners. (sample_2) o o o o o Family members enjoy talking to each other. (sample_3) o o o o o Family members are able to ask each other for what they want. (sample_4) o o o o o Family members can calmly discuss problems with each other. (sample_5) o o o o o Family members discuss their ideas and beliefs with each other. (sample_6) o o o o o INTERGENERATIONAL TRAUMA 96 When family members ask questions of each other, they get honest answers. (sample_7) o o o o o Family members try to understand each other’s feelings. (sample_8) o o o o o When angry, family members seldom say negative things about each other. (sample_9) o o o o o Family members express their true feelings to each other. (sample_10) o o o o o INTERGENERATIONAL TRAUMA 97 Control Intervention • Video o The Cultural and Social Determinants of Mental health o https://www.youtube.com/watch?v=7YPqFybi3B8&t=237s Psychoeducation Intervention • Instructions: ▪ Throughout this study, you will receive psychoeducation on the various types of traumas that Koreans and Korean Americans have experienced historically and culturally and their effects on your family functioning. You will complete a set of measures aimed to capture demographic information and your assessment of your relationship with your parents as well as the quality of your family’s communication. These measures will be administered before and after the psychoeducation, which will be comprised of a recorded video and a complementary PowerPoint that covers topics such as the Japanese occupation of Korea, the Korean War, and various types of immigration trauma and how they impacted survivor’s mental health. The video will also cover the ways that these experiences of trauma are translated into the offspring of survivors and how meaningful communication may allow for collective healing within Korean families. You will then be asked to complete another series of measures after the completion of the video. INTERGENERATIONAL TRAUMA 98 • Psychoeducation and PowerPoint slides: INTERGENERATIONAL TRAUMA 99 INTERGENERATIONAL TRAUMA 100 INTERGENERATIONAL TRAUMA 101 INTERGENERATIONAL TRAUMA 102 INTERGENERATIONAL TRAUMA 103 |
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