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Depression and the Social Environment

Depression and the Social Environment: Research and Intervention with Neglected Populations

Philippe Cappeliez
Robert J. Flynn
Copyright Date: 1993
Pages: 448
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  • Book Info
    Depression and the Social Environment
    Book Description:

    The authors of the essays in Depression and the Social Environment explore the etiological role of the social environment, suggesting that for "neglected populations" -- immigrants and refugees, native Indians, the unemployed, the physically disabled, the elderly, caregivers of the impaired elderly, children and adolescents, and women -- depression has significant environmental roots. These populations and the manifestations of depression that they exhibit have been largely overlooked because the importance of the social environment itself has been insufficiently investigated.

    eISBN: 978-0-7735-6370-4
    Subjects: Psychology

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Tables
    (pp. ix-x)
  4. Figures
    (pp. xi-xii)
  5. Acknowledgments
    (pp. xiii-xiv)
  6. Contributors
    (pp. xv-xviii)
  7. CHAPTER ONE An Integrative Cognitive-Environmental View of Depression
    (pp. 1-11)

    Variously defined as a symptom, a syndrome, a single condition, or a spectrum of biopsychosocial manifestations, depression is the most common mental disorder in industrialized societies (Jablensky 1987). Although there is diversity at the conceptual level as to the nature of the disorder, there is consensus at the descriptive level concerning the unique importance of dysphoria as a sign of depression. Dysphoria, found in over 90 per cent of depressed persons (Lewinsohn et al. 1985), is reflected in the common conceptualization of depression as a “negative mood.”

    The importance of depression is heightened by the fact that its prevalence appears...

  8. CHAPTER TWO Childhood Depression
    (pp. 12-72)

    Over a decade ago, knowledge concerning childhood depression was such that a journal editor felt called upon to preface a publication about childhood depression with the following cautionary statement: “The Editor feels it necessary to stress extreme caution (1) in identifying any child as having a depressive illness and (2) in prescribing any medication for such a disorder” (Weinberg et al. 1973; 1065). This statement was justifiable at the time, given the paucity of carefully designed studies dealing with depressed children. Since then, the field of childhood depression has come into its own, and, today, it is supported by a...

  9. CHAPTER THREE Adolescent Depression
    (pp. 73-92)

    The syndrome of depression in adolescents has recently gained recognition as a serious psychiatric disturbance (Cantwell and Carlson 1983; Puig-Antich and Gittleman 1982; Rutter et al. 1986; Ryan and Puig-Antich 1986). Indeed this view has supplanted previously held constructs, which included denial of the existence of the disorder or conceived of adolescent-depressive disturbance as a normative developmental phenomenon (Baker 1978; Freud 1958; Geleerd 1961; Sugar, 1968). Studies of nonclinical samples of teenagers have led to a revision of earlier concepts, which held that mood disorder in adolescence was inevitablly attributable to universal adolescent turmoil. A clearer identification has also emerged...

  10. CHAPTER FOUR Suicidal Behaviour and Depression in Young Adults
    (pp. 93-120)

    In young adults, suicidal behaviour and suicide, itself, share many similarities with depression. Both suicidal gestures and depression are a form of despair. They share such etiological factors as negligence and abuse in the family, as well as life events characterized by a loss; often, too, they are associated with a history of alcohol and drug abuse. In the last twenty-five years, suicide and depression in young adults have increased dramatically. Although not too long ago a diagnosis of depression was rare for young persons, clinicians today are increasingly seeing this phenomenon. Despite the increase in the standard of living,...

  11. CHAPTER FIVE Gender, Psychosocial Factors, and Depression
    (pp. 121-149)

    Although there has been considerable research into the etiology and treatment of depression in adult men and women, the importance of gender issues in understanding depression has been overlooked until fairly recently. Greater awareness of the salience of gender-related factors in understanding depression has arisen, in part, because of the now well-documented finding of a sex difference in rates of depression. Indeed, prevalence rates of depression generally are found to be higher among women than men (Nolen-Hoeksema 1987; Weissman et al. 1988). One important implication of this finding is that models of depression must be able to account for the...

  12. CHAPTER SIX Depression in General Practice Attenders
    (pp. 150-184)

    In the classic epidemiological surveys (Bland et al. 1988; Myers et al. 1984; Murphy 1980; Weissman and Myers 1978), the six-month prevalence for psychiatric disorders of any kind in the general population has generally ranged between 15 and 25 per cent. The one-month prevalence rates generally run a bit lower, with around 15 per cent of the population eighteen years of age and over in the five National Institute of Mental Health (NIMH) catchment areas exhibiting signs of at least one psychiatric disorder (Regier et al. 1988). These rates are comparable to those reported in Australian and European studies (Regier...

  13. CHAPTER SEVEN Effect of Unemployment on Depressive Affect
    (pp. 185-217)

    This chapter reviews recent empirical studies dealing with the impact of unemployment on depressive affect. The first of the five sections, a description of the historical influences on unemployment-related psychological research, discusses some of the major theoretical perspectives from which the unemployment-depression relationship has been approached. In the second section, cross-sectional studies are reviewed to determine whether unemployment is associated with depressive affect. The third section examines longitudinal investigations, to establish whether the association may be causal in nature. In the fourth section, data are presented from the author’s own research on re-employment as a “treatment” for alleviating depression in...

  14. CHAPTER EIGHT Depression in Canadian Native Indians
    (pp. 218-234)

    To understand the problem of depression among Native Indians in Canada, it is essential to begin with some basic information concerning their history, culture, and current socioeconomic situation.*

    The geographic, cultural, and economic context in which Canada’s Native Indians live is often very different from that of other Canadians. Canadian Indians comprise ten distinct language groups and speak more than fifty-eight dialects (Department of Indian and Northern Affairs 1980a; Jenness 1977; Maclean 1982). Cultural differences among Indian peoples are great, often exceeding those between Italians and Russians.

    Certain similarities hide these differences from non-Native eyes. For example, the Indian’s skin...

  15. CHAPTER NINE Depression among Immigrants and Refugees
    (pp. 235-256)

    It has long been speculated that international migration predisposes to, and may even cause, depression in immigrants and refugees; that is, in migrants (Eitenger 1959; Murphy 1952; Pedersen 1949; Tyhurst 1951). The present review is an attempt to synthesize what is known, or at least widely accepted, about the development, nature, and course of depression in migrants. No assumption is made that migration is of any greater etiological significance for the development of depression than the genetic, personality, familial, general health, or life-event factors. A number of recommendations are included in this chapter, recommendations geared to improving interventions, service delivery,...

  16. CHAPTER TEN Depression among People with Physical Disabilities
    (pp. 257-288)

    The visibility of people with physical disabilities has increased dramatically in the past ten to fifteen years. No longer is it uncommon in Canadian communities to see men and women using wheelchairs, canes, or other mobility aids. Canadian society has begun to deal with the physical reality of accommodating people with disabilities. However, even as the public moves toward a greater awareness of the challenges faced by disabled people, attention to the psychological and social aspects of disability lags far behind. In this chapter, we examine why the prevalence of depression is higher among those who are disabled than in...

  17. CHAPTER ELEVEN Depression in Caregivers of Impaired Elderly Family Members
    (pp. 289-331)

    Most supportive services and care for chronically ill, elderly people living in the community are provided by families (Stone et al. 1987). For some family members, the experience of providing the principal care to frail elderly relatives is associated with hardships and problems. Over the past two decades, the body of knowledge identifying the burden on primary family caregivers has been developing. As the absolute number of elderly people increases, the issue of caregiving by family members continues to gain importance in our society. Failure to attend to family caregivers’ needs and problems may lead to the development of “hidden...

  18. CHAPTER TWELVE Depression in Elderly Persons: Prevalence, Predictors, and Psychological Intervention
    (pp. 332-368)

    With the growing number of adults living to advanced ages in industrialized countries, concerns about emotional adaptation and well-being in the later portion of life have been amplified. In particular, many people worry that large numbers of older adults may experience psychological distress, as manifested in depression.

    This chapter does not cover the various aspects of depression that occur in late adulthood. Instead, in line with the theme of this book, I have pursued three objectives. First, in view of the widespread, yet controversial, belief that depression is rampant among older adults, I examine the initial questions regarding the identification...

  19. CHAPTER THIRTEEN Mediators of Depression in Community–Based Elders
    (pp. 369-394)

    Although no age group in North American society is immune to depression, it is the elderly, those sixty-five years of age and over, who are more likely than some younger cohorts to experience this condition. The concern is that as numbers of elderly persons increase, the incidence and prevalence of depression could reach epidemic proportions. This concern mirrors recent confirmation that depressive disorders constitute a major health problem in older adults (Blazer 1982; Lin and Dean 1984; Fry 1986, I989a, I989b; Zarit 1980).

    Present estimates place the point prevalence of clinically significant depression at approximately 10 to 15 per cent,...

  20. CHAPTER FOURTEEN Implications for Assessment, the Understanding of Social Etiology, and Intervention
    (pp. 395-413)

    In the opening chapter, we challenged the tendency of depression researchers focus on currently stressful situations, as well as intraindividual factors, their attempts both to understand the etiology of depression and to devise interventions. Our objective in this book has been to emphasize the larger social context of depression, by addressing its occurrence in selected groups generally overlooked in research and treatment studies. In this final chapter, discuss a number of central issues in the areas of assessment, social etiology, and treatment. We make a number of links among the various contributing authors' statements, as well as suggestions for the...

  21. Index
    (pp. 414-423)