Research study: factors that enable depression

Introduction

Research studies are essential to the practice of Social Work. Social Work practice is extremely complex and research studies allow social workers to develop theories and hypotheses that will help them understand the root of the issues that their clients are experiencing. Academic evidence is vital for backing up the practices, policies and values that underpin Social Work practice. Academic research not only benefits the social worker through the expansion of their knowledge but can also benefit clients and society at a policy level. In this essay I will be evaluating the research carried out by Brown and Harris (1984) in their book “Social origins of depression: a study of psychiatric disorder in women”, specifically on chapter 10, “Social class, provoking agents and depression”. Brown and Harris carried out this research to find out how life events and social and cultural factors may lead to the development of depression amongst women. I will briefly describe their study and their findings and then discuss the methodology they used and the advantages and disadvantages of their methodology. I will also discuss how Brown and Harris’ research is extremely important and influential for the practice of Social Work and how the study is still used today to show how social and cultural factors can lead to depression.

Description of study and findings

The study aimed to find out how social factors and life events lead to women’s depression. They sampled 458 women in the south London area of Camberwell and surveyed them using “clinical based interviews” (Brown & Harris 1984) on their daily lives and depression. Brown and Harris aim to contest the wide spread belief that depression is more common amongst women of higher social classes, as asserted by previous studies carried out by sociologist Pauline Bart, psychiatrist Ernest Becker and psychologist Charles Costello. Brown and Harris’ study contests this idea that middle class women are more likely to develop depression as they found in their study of 458 women that it was much more common for those who were working class to develop a psychiatric disorder, depression in particular. They found that 23% of working class women were “considered cases” as opposed to only 6% of middle class women. They measured the social class of the women by the occupations of the women’s husbands and when this wasn’t available they used the occupation of the women’s father to determine their social class.

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In addition to class differences, Brown and Harris also looked at the “five life stages” which consisted of, three stages where women has a child at home with the youngest child being less than 6, between 6 and 14 and 15 and over. The remaining two life stages consisted of women younger than 35 where there was no child at home and women over 35 where there was no child at home. They found that in all life stages, working class women had a higher rate of depression than middle class women. Most notably, the highest percentage was of 31% for working class women with a child of less than 6 compared to 5% of middle class women.

Brown and Harris found that depression was more prevalent amongst women of working class because there is greater vulnerability attached to working class. Vulnerability factors included lack of a confiding relationship, loss of mother before age of 11, unemployment, poor housing and low finances. These vulnerability factors, which were more common amongst those women who were working class, were found to increase the chance of developing depression. Vulnerability factors, when combined with stressful life events, like divorce, illness and death, which Brown and Harris called “provoking agents” further increased the chances of developing depression amongst working class women as they are more vulnerable with less support, financial and familial. These provoking agents or life events were ranked in severity by Brown and Harris, ranging from the most severe being “death” to the least “residence change”. “When social class is considered it is only severe events that show a class difference and then only among women with children” (Brown & Harris 1984) , for both working and middle class women without children 1 in 3 experience at least one severe life event in the year, however when considering those with children the number stays the same for working class women, 1 in 3 whereas it drops to 1 in 5 for middle class women with children, implying that middle class women with children are more protected from provoking agents that lead to depression.

The study concluded that social factors and life events are linked to depression. Working class women were more likely to develop depression than middle class women in all instances showing that the risk of developing depression is linked to social class. Brown and Harris found that being from a lower class meant increased vulnerability and greater chance of being exposed to provoking agents than middle class women.

Importance to Social Work

The study by Brown and Harris has been marked for many years by a combination of imaginative flair and commitment to the rigorous testing of their ideas (Tennant and Bebbington 1978). This study is extremely important to social work practice as it providing a turning point in looking at depression amongst women. The study provided an awareness of women’s mental health. Before this study, most research focused on personality traits and experiences in childhood that linked women to depression, however Brown and Harris’ study was different in that it investigated the social and cultural factors related to women’s mental health. It’s a very important study as it recognized that depression could be linked to social class and that life events or difficulties relating to social class could provoke the development of depression. Brown and Harris’ study is very important to the practice of social work as it provided a theory of the relationship between social class or status and depression amongst women and a clear understanding that poverty is linked to depression. In addition to finding a link between class and depression, this study is also very significant to social work as it allowed for the broadening of perspectives. Before, there was a medicalised model or way of looking at depression and mental illnesses however this study allowed social workers to develop the social model of depression, a thinking which challenged the medical model and looked for a much broader understanding of the reasons for depression.

Furthermore, this study was connected to the growing awareness of women’s unequal position in society and in the family, so whilst it did not originate from feminist enquiry the study helped the evolving feminist movement which began to give women a voice in society. It also led to the development in the understanding of the demands of caring for children and the impact of the reduction in the extended family at this time. This study is very important to Social Work practice as it strengthened the role of social work with families and individuals who are in distress through community based practice. It also allowed women and mothers’ networks to strengthen as the study helped shine a light on the difficulties of being a mother, of experiencing different life events and the difficulties related to being working class. The study highlights the importance of social work values like anti-oppressive practice that strive towards equality for women and the recognition that what women feel should be understand.

Furthermore, this study is extremely important to social work practice as it allows social workers to understand the roots of depression in women. This study shines a light on the social factors that lead to depression, social workers can use this study to identify what social factors lead to depression and target these factors and implement prevention techniques for those women who are most likely to develop depression.

Advantages and Disadvantages of methodology

Brown and Harris used a mixed methodology in their research. Statistical data was gathered and analysed by Brown and Harris, alongside the qualitative data obtained by individual narrative and stories. They used a mixture of qualitative and quantitative methods which increases validity and reliability. Reliable data means that the research could be repeated and the same results would occur and valid data means it’s a true picture of what the researcher is trying to measure. Brown and Harris used random sampling in their research and they used the sample of 458 women to represent the target population – middle class and working class women. Random sampling means their research is representative of the target population and they can therefore make generalisations about depression suffered by middle class women in contrast to working class women.

Brown and Harris carried out semi-structured interviews meaning that the women could be asked open-ended questions which would give qualitative data, increasing validity by obtaining an in-depth understanding of the women’s situations. Interviews mean that the conversation developed naturally and so is a good method for researching sensitive issues like depression as the natural conversation allows the interviewee to feel relaxed and able to open up more to their interviewer. Interviews also allow a relationship to build between researcher and respondents. Brown and Harris continued their research over a long period of time (1969/71 and again in 1974/75) which would also strengthen their relationship with the women, allowing their evidence to be more valid and paint a true picture.

However, there have been criticisms made of the methodology used by Brown and Harris. Tennant and Bebbington (1978) criticise Brown and Harris’ methodology on the basis of their random sampling. They argue that 15% of households in the sample had 2 or more age-eligible women living in them, but Brown and Harris only chose one. Tennant and Bebbington therefore argue that there is bias in the sample and that larger than average households are slightly underrepresented in their research.

Tennant and Bebbington (1978) further criticise Brown and Harris on their “conceptualization and definition” of the concept of “vulnerability factors”. Tennant and Bebbington argue that the construction of the vulnerability factor “parental loss” is open to criticism. Brown and Harris argue that maternal loss influences the risk of depression whereas paternal loss doesn’t affect the risk of developing depression. They argue that Brown’s definition of loss consists of three different variables, “loss through death, separation from one parent, and marital separation of the parents” events which Tennant and Bebbington describe as “qualitatively quite different” and that the composition of “maternal” and “paternal” loss groups may be so different that they are not valid to compare their impact on mental health (1978). They argue that in the instance of separation women usually get the custody resulting in a paternal loss and regarding death, the risk of losing fathers in childhood is greater than the risk of losing your mother (Langer and Michael 1963 cited by Tennant and Bebbington 1978) and so this comparison in relation to depression is misleading and it would be much more appropriate to compare maternal/paternal death and maternal/paternal separation for more valid results.

Conclusion

In conclusion, I would argue that this research study by Brown and Harris is undeniably important to Social Work practice. Through its mixed methodology, using both qualitative and quantitative methods of research, it proves a very reliable and valid picture of class differences and social factors linked to women’s mental health. This research is vital to Social Work practice as it marks a turning point in a change in attitude towards mental health, a shift away from the medical model to a social model of depression. It underpins values that are at the heart of Social Work practice like anti-oppressive practice and equality for women.

Word count: 1941

Bibliography

Brown, G, W. & Harris, T, (1984) "10. 'Social class, provoking agents, and depression'" from

Brown, G W. & Harris, T, Social origins of depression: a study of psychiatric disorder in

women pp.150-169,353-358, London: Tavistock Publications

Brown, G. W., & Harris, T. (1978). Social origins of depression: a reply.Psychol Med,8(4), 577-88.

Tennant, C., & Bebbington, P. (1978). The social causation of depression: a critique of the work of Brown and his colleagues.Psychological Medicine,8(04), 565-575.