Sociocultural Factors in Major Depressive Disorder ERQ

Major Depressive Disorder (MDD)

A mental health disorder characterized by persistent feelings of sadness, low self-esteem, and loss of interest or pleasure in most activities.

Etiology

Refers to the causes of a disorder.

Sociocultural Approach

Examines how social structures, gender roles, culture, and socioeconomic factors contribute to the development of MDD.

Thesis Statement

Sociocultural factors such as cultural stigma, social inequality, and traditional gender roles play a significant role in the etiology of MDD.

Outline Statement

The essay will explore how cultural beliefs and socioeconomic stressors influence MDD and will evaluate the methodological strengths and limitations of the supporting studies.

Karasz (2005) - Aim

To explore cultural differences in models of depression between South Asian and European-American women in the United States.

Karasz (2005) - Participants

20 women (10 South Asian, 10 European-American) living in New York City.

Karasz (2005) - Procedure

The researchers used a model known as the illness representation model (IRM) to explore the dierent ways in which the participants viewed mental illness
The participants were given a short description of a woman suering from MDD-like symptoms: they were then asked to use the ve IRM criteria to explain the woman’s symptoms, likely cause(s), how long the MDD might last, how she might seek to manage it etc. Semi-structured interviews were conducted to gather the data outlined in the above bullet point

Karasz (2005) - Results

European-American women viewed depression as a biomedical problem and were more likely to seek professional help. South Asian women saw it as a social or moral issue, often linked to family problems or failure, and preferred to keep it private.

Karasz (2005) - Conclusion

Cultural models shape how individuals understand, express, and treat depression. Cultural stigma may delay diagnosis and treatment, increasing vulnerability to MDD.

Karasz (2005) - Strengths

Semi-structured interviews allowed participants to speak freely, increasing the validity of findings through rich, in-depth qualitative data.

The use of a standardized interview framework (IRM) added structure and control, improving reliability and consistency across interviews.

Karasz (2005) Limitations

Small, non-representative sample size limits the ability to apply findings to broader populations.

Participants were immigrants living in the U.S., so their attitudes may not represent those of South Asians in their native countries, limiting generalizability.

Contributions Karascz

Demonstrates how cultural stigma and values may impact the recognition, expression, and treatment of depression, offering insight into sociocultural etiology.

Aim - Nicholson

To investigate gender and class differences in depression and how social and economic stressors influence MDD prevalence across Eastern European countries.

Participants - Nicholson

12,053 men and 13,582 women in Russia, Poland and the Czech Republic.

Procedure - Nicholson

Depressive symptoms were examined in relation to socio-economic circumstances at three phases of the life-course: childhood, university and current circumstances and compared.

Results -Nicholson

Women experienced significantly higher rates of MDD than men, but men were more affected by CURRENT social disadvantages. Richer men had lower rates than poorer men.

Conclusion - Nicholson

Sociocultural stressors, especially poverty and gender inequality, contribute to the higher risk of depression among women and lower class men in transitional societies.

Strengths Nicholson

Large, diverse sample improves external validity and allows for generalization to other transitional societies.

Identifies clear links between sociocultural stressors and MDD, supporting the sociocultural model of etiology.

Limitations Nicholson

Correlational study—cannot establish causation between variables such as unemployment and MDD.

Cultural and economic differences in Eastern Europe may reduce applicability to other global contexts.

Contribution Nicholson

Supports theories linking social disadvantage and gender role strain to depression, emphasizing the impact of societal structure on mental health.

Sociocultural vs Biological

Sociocultural models provide valuable insight into depression risk but may neglect biological predispositions (e.g., genetic factors). A full understanding of MDD requires integration of both.

Diathesis-Stress Model

The sociocultural approach aligns with the diathesis-stress model, where external stressors (e.g., poverty, stigma) interact with internal vulnerabilities to trigger MDD.

Cultural Relativism

Cultural differences in symptom expression and belief systems complicate universal definitions of depression, highlighting the importance of cultural context in diagnosis.

Need for Biopsychosocial Model

A complete understanding of MDD should consider biological, psychological, and sociocultural levels of analysis, as these interact in complex ways.

ERQ Conclusion - Summary of Argument

Karasz (2005) illustrates how cultural stigma and values shape the experience and treatment of MDD, while Nicholson et al. (2008) shows how socioeconomic pressures and gender roles increase depression risk.

ERQ Conclusion - Final Statement

Sociocultural etiology offers essential insights into MDD, but must be integrated with other perspectives for a holistic understanding and effective intervention.

What is the cultural explanation of MDD?

• Cultural explanation of MDD: Depression is shaped by cultural norms and social context, not experienced in isolation

• Social embeddedness: MDD both influences and is influenced by an individual’s cultural and social environment

• Cultural attitudes: Cultures differ in how they view mental illness (normal part of life vs. stigma or lack of recognition)

• Symptom expression: Culture affects how depressive symptoms are understood, described, or expressed

• Language & norms: Some cultures lack language or social norms for openly discussing emotions, leading to alternative expressions of MDD (e.g. somatic symptoms)

Note for collectivistic cultures

Collectivistic cultures do not place much importance on personal gratication which means that people from such cultures are less likely to feel frustrated about their failure to achieve personal success and as a result this lack of focus on the self can lead to a decrease in MDD 

Pros of cultural explanation

• Importance of cultural awareness: Understanding cultural differences in mental illness is essential in an increasingly globalised world

• Ethnomedical model: Mental illness is understood within cultural belief systems rather than universal Western frameworks

• Critique of individualism: Individualism may not always promote well-being or happiness

• Cultural balance: Challenges Western assumptions by valuing collectivist cultures and addressing imbalance between Western and non-Western societies

Negative aspects of cultural explanation

A discussion of cultural dierences in explaining and understanding MDD risks perpetuating stereotypes (e.g. the Japanese have no sympathy for depressed people) which can be  reductive and which ultimately defeats the purpose of trying to embrace all cultural viewpoints

Hence these views may be overly reductionistic