Mental health and disorder

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As a complex disorder with many interrelated etiologic variables (Kendler, Gardner and Prescott 2002), clinical depression cannot be fully explained by any single framework. A comprehensive understanding of this psychiatric disorder requires a cross-disciplinary approach that can account for a diversity of psychological, biological, and environmental risk factors. However, studies focusing on stressful life events provide us with a useful starting point for explaining the onset and recurrence of depression.

In one of the pioneering studies on the topic, Brown, Bifulco and Harris (1987) demonstrate that long-term severe life-threatening events are likely to trigger clinical depression. The authors, however, are quick to qualify their finding by pointing out that only one out of five women experiencing such an event is likely to develop depression at a case level (Brown et al. 1987). To further explain why some female research participants are less prone to depression even after an exposure to a provoking agent, Brown et al.

(1987, 33) incorporate in their analysis the notion of a match between the precipitating event and “certain characteristics of the woman and her life-context at the time of the first interview. ” Subsequent analyses (Holahan and Moos 1991; Kendler et al. 1995; Kessler 1997) largely confirm their finding although there is a difference in the magnitude of the association between life events and the onset of depression reported by various authors. Scheff (2001) offers a more nuanced account of the origins of depression.

Without radically departing from the life-threatening events explanation (Brown et al. 1978), he contends that the initiating cause of depression may be too subtle for research participants to include it in their self-reports. As a result, Scheff (2001) urges us to pay more attention to a social component of depression which often manifests itself in the lack of secure bonds. In his study, participants diagnosed with acute depression only had insecure or severed bonds without a history of mutual understanding or rough equality.

Scheff (2001) thus argues that this insecure bond essentially provokes a feeling of shame that subsequently gives rise to depression. Following this logic, the author argues that this lack of communal attachment is an immediate precursor of depression. Assessing the state of knowledge on the topic, Kessler (1997) points to a number of methodological challenges that undermine our confidence in the evidence relating stressful life events to the incidence of depression.

More specifically, he emphasizes two major problems that plague existing analyses. The first one concerns the failure of researchers to account for the link between the accuracy in reporting life events and depression. This might introduce a bias toward reporting a spurious correlation between depression and life events. The second major methodological problem has to deal with the commonly made assumption that exposure to life events occurs randomly in respect to other widely hypothesized sources of depression.

Again, introducing this assumption into analyses undermines our ability to make valid inferences about a causal link between life events and the onset of depression (Kessler 1997). To partially offset methodological problems plaguing research on depression, Kendler, Gardner and Prescott (2002) develop a multivariate model that takes into consideration various pathways to the incidence of depression. The findings of the study lend further credence to the hypothesis that stressful life events provoke depression.

On balance, although there is an impressive array of studies that point out to the link between life events and depression, conclusive evidence is yet to be established. Bibliography: Brown, G. W. , A. Bifulco and T. O. Harris. 1987. “Life Events, Vulnerability and Onset of Depression: Some Refinements. ” British Journal of Psychiatry 150: 30-42. Holahan C. and R. Moos. 1991. “Life stressors, personal and social resources, and depression: a 4-year structural model. ” Journal of Abnormal Psychology 100:31–38. Kendler K. S. , M. C. Neale, R. C. Kessler, A. C. Heath, L. J. Eaves 1993.

“A twin study of recent life events and difficulties. ” Archives of General Psychiatry 50:789–96. Kendler, K. S. , M. O. Gardner and C. A. Prescott. 2002. “Toward a Comprehensive Developmental Model for Major Depression in Women. ” American Journal of Psychiatry 159(7):1133–1145. Kessler, R. C. 1997. “The Effects of Stressful Life Events on Depression. ” Annual Review of Psychology 48:191–214. Scheff, T. J. 2001. “Shame and Community: Social Components in Depression. ” Psychiatry 64(3): 212-224.

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