Diathesis Stress Models Immigrant Experiences

The Environmental Risk Factors of Depression

Depression has been typically construed as the reaction due to exposure to certain negative environmental circumstances in life. As such, the etiological models are mostly based on the perspectives of diathesis-stress. A diathesis can be described as a risk factor or any process of vulnerability, for instance, an individual’s biological, cognitive, or personality traits, that account for the variations in how they react to particular stressful situations and challenges. To this end, for purposes of illustrating key points, as well as drawing attention to the circumstances that assists in the identification of specific risks for depression, the discussion present within paper purposes to focus on the various kinds of environmental stressful conditions which include; the acute negative conditions in life, chronical stressful circumstances in life as well as the early exposure to adversity during childhood.

One of the most common environmental risk factors for depression entails an individual going through a variety of undesirable negative life events. Accordingly, there exists ample evidence that supports the notion of depressive episodes as a result of exposure to different kinds of environments that are characterized by stressful life events (Hammen, 2005; Kessler, 1997; Mazure, 1998). The review by Mazure (1998) posits that such kinds of environmental stressors were up to 2.5 times likely observed in miserable patients with controls and that within community samples, up to 80 percent of the key depression cases were majorly preceded by wanton environmental conditions that resulted in negative life events. Most of the assessments usually study the various stressors within a 3 to 6 month timeline in realtion to depression, however, Kendler, Karkowski, and Prescott (1998) presented that a majority of the depressive factors are usually onset within the first month after a significant stressful event due to the environmental condition. Additionally, there is also evidence that have linearly associated the severity of the conditions, the specific number of negative events due to these conditions and the probability of an onset of depressive episodes (Kendler, Karkowski, and Prescott, 1998). Nonetheless, the level of impact not only depends on the actual environmental circumstances, but also on the consequent subjective meaning to the person undergoing such. Thus, one individual might be depressed due to extremely stressful environmental conditions, but another might be due to their personal vulnerabilities that result in an exaggeration of the meaning of acute conditions that might be objectively minor.

Studies have generally observed that throughout the ages, whether childhood, adolescent or adult, depressive episodes are usually likely to occur as a result of loss of something that is essential to the sense of self, for example, the loss of worth or competence, loss of relationships or someone significant. Such interpersonal losses, have been observed as more influential depressive factors as compared to all other forms or kinds of disorder, perhaps more particularly for women ((Tennant, 2002; see also Kendler et al., 1998).

The environmental risk of development or heightened depression levels can be further evidenced by the life conditions that immigrants and refugees are faced with. Such kinds of people usually face innumerable challenges; if not segregation or isolation, then the overall experience of loss is usually pervasive (Heilemann, Coffey-Love, and Frutos, 2004). The environmental conditions experienced by most of the immigrants and refugees are as result of separation from family and friends. They go through myriad losses including loss of property, being homeless, as well as loss of cultural ties and customs that they may be very significant to them. In their new homes, they are introduced to a new environment that is different from what they are normally used. The resulting impact of the experiences and challenges on their psychological functioning within their new community (environment) is profound. These challenges are further reiterated in the context of going through the traumas of migration or even war. Studies have therefore reported that the consequent rates of depression within such communities are elevated groups (Aguilar-Gaxiola et al., 2008). However, owing to biological and socialization differences, the female gender are usually more likely to be more attuned to how they are perceived by others as well as being more concerned about how they react to others’ needs (Cyranowski et al., 2000). This actually seems to be the case, particularly with immigrant or refugee women. For instance, Hiott et al., (2006), report that by moving to a new environment in different country, they may experience important losses in terms of social support which results in a sense of isolation. This in turn is manifested or translated to a grieving process. Such kinds of isolations may be in respect to unfulfilled relationships or family separation. The findings suggest that the new environment contributes to depressive risk factors such as the conflictual relationships, unachieved expectations, and isolation (Shatell et al., 2008). Therefore, women are especially more prone to being depressed as a response to stressful conditions that they are faced with due to the environmental circumstances or even their reactions to the stressful experiences of those within their social circles.

Albeit intense pressure may accelerate depression in helpless people, the relationship is bidirectional: Those with misery or a past filled with dejection experience altogether experience intense stressors than those without. In general, in any case, the vulnerability factors for depression in men are probably fundamentally the same as those of ladies, including complex interaction among ecological and neurobiological factors at various formative stages in life.

Different episodes and acute happenings in an individual’s life only tell a portion of the story of depression. One particular source of depression that has not been given much attention is with regards to the exposure for a long time to stressful circumstances that are enduring. Numerous researches into stress-depression and their subsequent associations have failed to establish the differences between acute stressors and ongoing stressors and their effects (Brown & Harris, 1978; Caspi et al., 2003). Failure to make these distinctions has made it difficult to explicate to a full extent the different ways in which stressors impact depression. One important aspect of chronic stress that is similar in acute stress is basically the multidirectional impact of depression and chronic stressful conditions on each other. Different issues of unemployment, poverty and even displacement like in the instance of refugees and immigrants also can trigger depression. This depression has the effect of eroding the ability of the said individuals to cope and alter their present circumstances.

Chronic stress is also characterized by the fact that there are numerous and relatable areas of the same. For instance, there has been found an association between different demographic predictors of depression. For instance, major episodes of depression were largely associated with females, low-income individuals, separation from spouses, and divorce among others according to Hasin et al. (2005). Additionally, low levels of educational success, unemployment and disability have also been linked to chronic depression (Kessler et al., 2003). In most cases, these conditions occur in tandem with low income individuals, widowed individuals, low educational attainment and disadvantages in working systems within their subsequent environments and societies in which they reside.

One particular example of a stressful condition that is chronic and amplified by different co-occurring events may be the example of a single-mother. These groups of society have been found by numerous studies to exhibit high rates of chronic depression when compared to mothers that are married (Davies, Avison, and McApline, 1997; Wang, 2004). This is particularly true for individuals that are either divorced or separated in comparison to those that have never been married (Afifi, Cox and Enns, 2006). Two major studies have also provided the relationship between depression and single parent status as one that is largely and entirely characterized by acute stress levels and low support from social systems (Cairney et al., 2003; Targosz et al., 2003). However, it is crucial to note that the role of chronic stressors is not as simple as discussed herein. For instance, single-mothers are touted as being at higher depression risks not only because of the mentioned chronic social stressors in comparison to married mother but also due to the fact that their socio-economic position is not always strong. Additionally, this socioeconomic position is able to moderate the relation between depression and social stress. Barrett and Turner (2005) found in their research for instance that single-parent mothers with a higher socioeconomic position were adversely impacted with issues of recent life events and racial discrimination. These were not as markedly found in those mothers with socioeconomic positions that are lower.

Lower socioeconomics are directly associated with the environs and societal setting of an individual. This is a potential source of chronic stressors that may include uncertainty as a result of inadequate finances to make ends meet and the chronic strain accompanying such conditions (Malik et al., 2007; Muntaner et al., 2004). Given the fact that ethnic and racial minorities are normally quite overrepresented in the low-income populations, racial discrimination has therefore been studied as a potential chronic stressor (Geet et al., 2007). Given that all other forms of discrimination may be deemed as stressors, it has been noted that the type is also important. For instance, gender, racial, age, social class or other discriminatory tendencies may be either acute or chronic stressors for those concerned (Banks and Kohn-Wood, 2007) and may likely increase likelihood of depression for them. Such instances of discrimination have also been noted to significantly impact self-concepts of individuals, their beliefs and general mood which may include depression.

Several sociocultural and institutional barriers have also been noted for maintaining and causing the existing differences between access to quality mental health services among the minority groups. (Van Voorhees et al., 2007) capture this succinctly when they say “disparities result from ongoing interactions among factors at the levels of the health care environment, health care organization, community, provider, and person throughout the course of the depression development and treatment-seeking process” (pp. 160S–161S). Social exclusion has played a significant role as well in making sure that these minority populations are vulnerable to mental health issues and incidences of depression. These aggravate their impacts given that such affected individuals are limited in terms of access to treatment and engagement with professionals concerned (Aguilar-Gaxiola et al., 2008). The isolation of such groups from what is considered mainstream society is normally as a result of historical oppression, geographic isolation, language barriers, discrimination, poverty, racism and sometimes the immigration statues of the concerned individuals. The immigration status in particular perpetuates this social exclusion and leaves such populations to face challenges in receiving treatment when they do fall ill.

Further, the environment as a source of chronic stressors has been extensively researched, for instance in relation to the field of residential areas and mental health (Muntaner et al., 2004; O’Campo, Salmon, and Burke, 2009; O’Campo and Yonas, 2005). The context of the environment is crucial in determining how they influence mental health. For instance, organizational and workplace characteristics have also been studied with regards to these mental health issues. Residential neighborhoods have particularly been found to be a potential source of multiple stressors that include noise levels, crime, traffic and even trash and graffiti (O’Campo, Salmon, and Burke, 2009). Such stressors may be taken as independently contributing to depression or interacting with different familial or individual stressors making one vulnerable to depression including financial status of the family and even parenting styles and stresses (Cutrona, Wallace, and Wesner, 2006; Rajaratnam et al., 2008). One particular randomized trial saw residents of neighborhoods characterized by poverty given the opportunity to move to higher income residential neighborhoods. It was found that those who moved saw a reduction in mental health challenges including depression (Del Conte and Kling, 2001; Goering et al., 1999). Measures aimed at preventing depression should therefore not only focus on the individual and their families but on the larger structural interventions that may make huge impacts such as moving to better neighborhoods or alleviation of poverty.

Regardless, it is also important to mention the impact of stressful parenting circumstances, and how the same are linked with environmental conditions and circumstances to contribute to depression. Numerous parents face challenges as a result of their children and infant illnesses, psychological issues, developmental disabilities among others all of which may likely result in their being depressed. For instance, one research studied mothers of children with and without developmental disabilities. The results were such that those mothers with children with developmental disabilities had higher rates of depression symptoms in comparison to the others (Singer, 2006). Further review of different areas including mothers caring for infants with mental retardation, developmental delays such as autism for instance, found similar results with regards to rates of depressive symptoms occurring (Bailey et al., 2007). Despite being limited in number, these studies seem to suggest that mothers with disabled children are more frequently affected with depression.

Depression in adolescence or in adulthood can be as a result of negative events or extremely stressful conditions that one has undergone in the recent past, but we can also link depression to the exposure of an individual to negative conditions in their childhood. This could be as a result of a single experience which could be rape or prolonged experiences such as continuous physical maltreatment and bulling (Macmillan et.al, 2001). The individual may have even undergone depression in childhood and the depression in adolescence or adulthood being just a recurrent one. Research has been done and it has been noted that there is a big correlation between childhood adversity and many disorders, depression just being but one of them. Among other abuses emotional abuse during childhood stands out as being the major cause of depression later on a person’s life.

Adversity in childhood also includes painful experiences such as living with the loss of a parent or parents suffering from terminal and mental illnesses adversity resulting from the misbehavior of their parents such as excessive consumption of alcohol, violence in the family and the existence of marital problems. People who in their early years had no close relationship with their parents or any adult in that matter are also more vulnerable to suffer from depression and other psychological disorders. These adversities are deemed to cause depression as a result of the exposure of the individual to high levels of episodic and chronic stress causing agents. These contribute to the loss of ability to cope with situations especially difficult and disturbing ones and also interfere with the development of important cognitive skills. The loss of these important skills makes a person more vulnerable to depression than others whose lives have not been interrupted by such adversities. Another relationship between adversity and depression can be drawn from a possible alteration of the brain’s neuroregulatory processes as a result of exposure to severe stress ants in an individual’s early life

Exposure to early adversity is thus linked to depression in such a way that individuals exposed to early adversity have been found to be more likely to suffer from depression in adolescence and adulthood even with minimal exposure to environmental stressors at this stage of their lives. These environmental factors are well known to also influence the development of depression in an individual later on in their lives and are sometimes correlating with abuse and early childhood adversities. The existence of many uncommon variables which were not accounted for in the test population is also a possible cause of misleading results. The correlation between environmental factors and the mechanisms by which mental and physical abuse are responsible for causing stress are still unknown with only speculations on possible pathways being reported. It is thus critically important that more research should be conducted to ascertain the relationship between exposure to early adversity alongside environmental conditions and the relationship with depression in later life and its mechanisms thoroughly explained since a positive link between the two already exists.

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