Addressing Depression through Psychotherapy, Medication, or Social Change: An Empirical Investigation
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ORIGINAL PAPER
Addressing Depression through Psychotherapy, Medication, or Social Change: An Empirical Investigation Jeffrey M. Rudski & Jessica Sperber & Deanna Ibrahim
Received: 10 August 2016 / Accepted: 18 November 2016 # Springer Science+Business Media Dordrecht 2016
Abstract Women are diagnosed with clinical depression at twice the rates as men. Treating depression through psychotherapy or medication both focus on changing an individual, rather than addressing socioecological influences or social roles. In the current study, participants read of systemic inequality contributing to differential rates of depression in either American men or women, or in two fictitious Australian First Nation groups. Participants then considered the acceptability and efficacy of treating depression through psychotherapy, medication, or social change. When socioecological inequities and unequal social roles were presented through an unfamiliar foreign lens, participants were more likely to recognize the systemic unfairness, and endorsed social change more than psychotherapy or medication as a treatment strategy. However, when identical social inequities and social roles were presented through descriptions of American men and women, social intervention was less likely to be endorsed, and psychotherapy or medication gained in acceptability. Participants of color were also more likely to recognize and endorse social change J. M. Rudski (*) : J. Sperber : D. Ibrahim Department of Psychology, Muhlenberg College, 2400 Chew Street, Allentown, PA 18104, USA e-mail: [email protected] J. Sperber e-mail: [email protected] D. Ibrahim e-mail: [email protected]
as a strategy for treating depression, while those reporting a history of psychotropic medication for affective disorders rated medication as more effective and acceptable. Keywords Depression . Psychotherapy . Social change . Antidepressants . Gender . Sex roles . Biopsychosocial approach . Sociocultural factors
The diagnostic criteria for major depression in the Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) includes depressed mood or loss of interest or pleasure, and a constellation of symptoms such as fatigue, change in weight, insomnia or hypersomnia, difficulty concentrating or making decisions, and feelings of worthlessness or guilt [1]. Women receive approximately twice as many diagnoses of depression as men, and once diagnosed they are more likely to be prescribed medication [2–5]. According to the Centers for Disease Control and Prevention, one in four American women are currently taking medication classified as an antidepressant [6]. Psychologists tend to explain depression through the biopsychosocial model. Biologically, specific genotypes, and neurotransmitter or hormonal influences have been proposed as contributors [7]. Poor coping mechanisms, rumination, distorted self-image, an external locus of control, perceptions of powerlessness, pessimism and hopelessness, temperament and affect, and other various cognitive vulnerabilities may
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