Sociocultural Explanations of Major Depressive Disorder (MDD) (HL IB Psychology)

The Behavioural explanation of MDD

• The Behavioural explanation of behaviour encompasses Social Cognitive Theory which is a Year 1 topic examined on Paper 1 of the exam

• Behaviourism focuses on the idea that behaviour is learned via conditioning - classical conditioning (learning via association) or operant conditioning (learning via consequences)

The mechanisms of Classical Conditioning

The mechanisms of Operant Conditioning

• Behaviourism assumes that all behaviours are a response to environmental stimuli

• The Behavioural explanation of MDD uses the mechanisms of operant conditioning to explain the development and the mechanisms of MDD

• Operant conditioning works along the principles of reinforcement; it plays a key role in learned behaviour

• Positive reinforcement involves the desire to repeat pleasurable experiences as the consequences are positive e.g. ‘I received lots of compliments when I wore that dress; I’ll wear it again soon’

• Negative reinforcement involves the desire to avoid aversive experiences as the consequences are negative e.g. ‘My husband told me I looked ridiculous in that dress; I won’t wear it again’

• Punishment involves an action being taken against someone who has transgressed in some way e.g. being given a warning at work for being absent too many days (direct punishment) or not being invited to an after-work drinks party (withholding reward)

• If people lose sources of positive reinforcement (experiences which make them feel rewarded) which they may derive from normal, everyday activities e.g. going to college or work, socialising, then they could become depressed

• A lack of positive feedback may lead to depression which can reduce productivity, performance and motivation which in turn leads to further depression and so depression becomes a self-fulfilling prophecy

Evaluation of the Behavioural explanation of MDD

Strengths

• Behaviourism is based on the idea that only observable behaviours can be measured which lends itself well to experimental research such as lab experiments which use high levels of control and are high in reliability

• Behaviourist explanations of MDD include a raft of learning theories such as learned helplessness which have good application to real life situations in which people lose the ability to act in an autonomous way thus they have some external validity

Limitations

• Due to the fact that Behaviourism is based on the idea that only observable behaviours can be measured the role of cognitions in behaviour is largely ignored and unaccounted for which limits the explanatory power of the theory

• A behavioural explanation of MDD cannot account for behaviours which though unpleasant (e.g. seeking out the company of people who are bad for a person’s self-esteem) are nonetheless repeated

The Cultural explanation of MDD

• The Cultural explanation of MDD encompasses the role of cultural norms in explaining and understanding mental illness generally and depression in particular

• MDD is not suffered in isolation: it becomes part of an individual’s life, influencing and being influenced by the social contexts in which someone operates and functions

• Culture exerts a strong influence on behaviour and this extends to attitudes towards mental illness e.g. some cultures embrace the idea that mental disorders are an integral part of human experience whereas other cultures may be suspicious or even unaware of the concept of mental illness and may instead express and frame mental disorders in different ways (see Culture Bound Syndromes from a previous revision note)

• Cultural contexts can influence the understanding and interpretation of MDD symptoms: some cultures may not have the requisite language to discuss the feelings associated with depression; some cultures may not have a tradition of talking openly about feelings 

• Japanese culture has for some time found the idea of mental illness unacceptable, with attendant feelings of shame being experienced as a result of developing MDD (it was not until the 1990s that MDD was a recognised medical disorder in Japan)

• The situation in Japan is improving with MDD (termed a ‘cold of the soul’) now being recognised and treated as a legitimate illness

• Ethnomedicine is a relatively new approach to understanding and explaining mental illness which could serve to enlighten the ways in which mental illness is viewed across cultures

• The ethnomedical approach suggests that MDD may be a result of living in an individualistic culture in which the self is prioritised over the group

• Collectivistic cultures do not place much importance on personal gratification 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 

Evaluation of the cultural explanation of MDD

Strengths

• Awareness of cultural differences in explaining and understanding mental illness is vital in a world in which globalisation is ever-expanding

• The ethnomedical model highlights the idea that individualism may not serve the individual in their pursuit of happiness which goes some way towards re-addressing a perceived imbalance between ‘successful’ Westernised industrial cultures and ‘third world’ collectivist cultures

Limitations

• A discussion of cultural differences 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

• As culture is such a hugely varied, complex amalgamation of attitudes, behaviours, beliefs, traditions etc. it is difficult to conceptualise it without succumbing to generalisations e.g. not every member of individualistic societies are self-focused; not every member of collectivist societies are group-focused

Common perceptions of the Japanese ‘salaryman’ sleeping on his way home from work: do such cultural stereotypes help or hinder the need for a cross-cultural discussion of mental health?