Lecture Notes: Behavioral and Cultural Explanations for Major Depressive Disorder (MDD)

Behavioral Explanation for MDD

• Overview:

  • Behavioral explanation includes Social Cognitive Theory.
  • Behaviorism posits behavior is learned via conditioning: classical (association) and operant (consequences).
  • Assumes behaviors are responses to environmental stimuli.

• Operant Conditioning:

  • Reinforcement:
    • Positive: Repeating pleasurable experiences due to positive consequences.
    • Negative: Avoiding aversive experiences due to negative consequences.
    • Punishment: Action against someone for transgressions.
  • Example: Avoiding dressing style criticized by others.

• Classical Conditioning:

  • Involves associating stimuli with experiences, e.g., associating a party with enjoyment to repeat the action.

• Impact on MDD:

  • Loss of positive reinforcement from activities (e.g., socializing) can lead to depression.
  • Creates a negative feedback loop reducing productivity and motivation.

Study 1: Lewinsohn et al. (1990)

• Aim: Compare positive reinforcement in MDD vs. non-depressive patients.
• Procedure:
  • 30 patients with MDD, other disorders, and controls.
  • Daily questionnaires over 30 days evaluating mood and pleasant activities.
  • Activities rated for enjoyment and repetition on a scale of 0-3.
• Results:
  • Positive correlation between mood and engaging in pleasant activities.
• Conclusion:
  • Link between pleasant activities (positive reinforcement) and good moods.

Study Evaluation

• Reliability: Standardized questionnaires and scales.
• Validity: Longitudinal design tracks mood and activities over time.
• Limitations: Social desirability bias and individual differences affect internal validity.

Cultural Explanation for MDD

• Overview:

  • Examines role of social norms and cultural contexts in understanding mental illness.
  • Cultural norms influence behavior and attitudes towards mental illness.

• Cultural Contexts:

  • Impact understanding and interpretation of MDD symptoms.
  • Ethnomedical approach: Individualistic culture prioritizes self; collectivist culture emphasizes group, reducing MDD focus.

Study 2: Karasz (2005)

• Aim: Investigate cultural differences in MDD conceptualization and treatment.
• Participants:
  • 36 South Asian (SA) immigrants and 37 European Americans (EA).
  • SA: Low acculturation; EA: Higher financial security and academic attainment.
• Procedure:
  • Used Illness Representation Model (IRM) to explore views on mental illness.
  • Participants analyzed a woman's MDD symptoms based on IRM dimensions.
• Results:
  • EA provided longer, varied explanations; SA simpler, social/moral interpretations.
  • EA saw MDD as a medical disorder; SA viewed it as a practical problem.
• Conclusion:
  • Cultural differences in mental illness conceptualization; SA less likely to seek clinical help.

Study Evaluation

• General:
  • Semi-structured interviews provided insightful qualitative data.
  • IRM framework ensured control and reliability.
• Limitations:
  • Acculturation affects generalizability.
  • Possible ethnocentric bias in findings.

Theory Evaluation

• Behaviorism:
  • Focus on observable behaviors aids experimental research.
  • Neglects cognitive elements like thinking patterns.
• Cultural Approach:
  • Highlights globalization’s impact on cultural understanding of mental illness.
  • Risks reinforcing stereotypes; challenges in distinguishing individualistic vs. collectivist cultures.