Depression in China: Integrating Developmental Psychopathology and Cultural-Clinical Psychology

Abstract

With a starting point in John Abela's groundbreaking developmental psychopathology research on adolescent depression in China, we aimed to review the state of the literature on Chinese depression across the lifespan. We began with Dr. Abela's published studies relevant to depression in China and our own research with adults before turning to the reference lists of these articles to find additional sources. Then we conducted literature searches using PsycINFO and PubMed to find other relevant studies published between April 2001 and April 2011 . There are two distinct literatures on depression in China. Developmental psychopathology research has emphasized adolescent samples and cognitive models of causation; cultural-clinical psychology and cultural psychiatry research have emphasized adult samples and the meanings associated with emotions, symptoms, and syndromes. Both approaches to the study of depression in China have yielded important findings but have also highlighted issues that could be better addressed by incorporating the other approach. Beyond depression in China, the psychological study of culture and mental health more generally would benefit from greater exchange between developmental psychopathology and cultural-clinical psychology.

Beyond “somatization” and “psychologization”: symptom-level variation in depressed Han Chinese and Euro-Canadian outpatients

“…Instead, the patients' spontaneous reports reveal a script that includes depressed mood, described with words that are at least roughly equivalent to “depressed” and “sad.” Emphasis on the somatic is not minimization or denial of depressed mood. Available cultural scripts for the presentation of emotional distress and social suffering appear to have changed markedly over a generation (Ryder et al, 2012). …”

“…Clinical research can also inform the work of cultural researchers by helping to refine our understanding of “cultural scripts.” Cultural scripts have recently been discussed as a valuable conceptual tool in cultural-clinical psychology, as they serve to link together cultural meanings and practices (see Ryder et al, 2011; Ryder and Chentsova-Dutton, 2012; Ryder et al, 2012). These scripts refer to organized units of culturally salient knowledge, which can be automatically retrieved, and serve to guide behaviors while also shaping the meaning and interpretation of such behaviors in a given cultural context.…”

Future Directions in Vulnerability to Depression Among Youth: Integrating Risk Factors and Processes Across Multiple Levels of Analysis

“…For example, the emergence of the sex difference during early adolescence, the overall dramatic surge in rates of depression and first onsets throughout adolescence, as well as cultural and ethnic influences on the development of depression (e.g., Ryder et al, 2012; this issue), could potentially be addressed from a multiple levels of analysis integration that explicitly considers the transactions among the multiple individual differences and various ecological contexts.…”

Genetic and Environmental Influences on Depressive Symptoms in Chinese Adolescents

“…For example, students in China bear heavier academic stress and higher levels of parental expectations, which may render them more depressed than their Western counterparts (Hou et al 2012). The mental health service utilization rates, however, are lower in Chinese children and adolescents compared with those in Western countries (Ryder et al 2012). According to the bioecological model (Bronfenbrenner and Ceci 1994) and some empirical studies (Hicks et al 2009; Lau and Eley 2008; Rice et al 2006), social factors, such as family, school, and the peer group, can influence the expression of genetic predispositions to depression.…”