stressors, such as social and physical disorders and fear of crime, have residents with higher incidences of mental health problems compared to communities with lower levels of environmental stressors (Remes et al., 2021; Ruijsbroek et al., 2015; Turner et al., 2013). Physical disorders in a neighborhood can take the form of loitering youths, graffiti, litter, and general dilapidation (Theall et al., 2013). Social disorder can be present if residents perceive no solidarity among neighbors to work toward alleviating problems (Ruijsbroek et al., 2015; Turner et al., 2013). Stress is also heightened when there is fear of crime or harm to individuals (Ruijsbroek et al., 2015; Turner et al., 2013). With a sense of fear, residents can also experience feelings of distrust, powerlessness, and low self-esteem (Turner et al., 2013). COVID-19 During the first year of the COVID-19 pandemic, 2020, depressive disorders in adults increased by a factor of three, from 8.5% to 27.8% (Ettman et al., 2020). Between August 2020 and December 2020, the percentage of adults experiencing symptoms of a depressive disorder increased from an elevated baseline of 24.5% to 30.2%, with the largest increases seen in adults between the ages of 18 and 29 years, and adults with education attainment less than high school completion (Vahratian, 2021). Vahratian (2021) estimated that adults needing but not receiving mental health care increased from 9.2% to 11.7%. Risk factors associated with greater risk of depressive symptoms included people with lower income, less than $5,000 in savings, and exposure to multiple stressors (Ettman et al., 2020). A trauma in and of itself for many, the shelter-in- place policies and social and economic consequences of COVID-19 presented multiple new life stressors (Ettman et al., 2020). In addition to the virus, COVID-19 produced an “infodemic,” the proliferation of irrational beliefs about COVID-19 created by false and misleading information regarding scientific communities, governments, and other institutions (Magarini et al., 2021). Not just for extremists and those who experience paranoia, conspiracy theories were found to be more likely in those who are younger, with lower levels of education, attitudes such as low levels Cultural Considerations Although race and ethnicity do not predict depression, clients experience and communicate their symptoms through their cultural worldview. The clinician must be culturally sensitive and competent when dealing with these specialized issues. It is also important for the clinician to consider that symptom manifestation is likely to be culturally bound and intersectional (Jimenez, 2022). For example, in the United States and other Western countries, a client’s diagnosis is based on a combination of physical and psychological symptoms (Diller, 2018). In Southeast Asian clients, symptoms of depression can be headaches and fatigue (Diller, 2018). Other Asian cultures perceive depression as punishment for the sins committed by one’s ancestors, blame it on evil spirits, or regard it as divine punishment (Liw et al., 2022). Furthermore, one study of older adults showed that Americans of African, Asian, and Latino descent had differing beliefs regarding the causes and appropriate treatment of mental illness from non-Latino White Americans (Jimenez et al., 2012). Although race and ethnicity may not be directly linked to depression, self-construal schemas commonly formed within certain cultures may place individuals at a higher risk of developing depressive symptoms (Chang, 2013). For example, although individuals of Asian descent have the lowest rates of diagnosis for depression, research indicates
Self-Assessment Question 3 People more likely to experience a major depressive disorder include those who: (Select all that apply.) a. Have the “depression gene.” b. Experience chronic stressors, such as financial hardship due to economic decline, poverty, crowded living conditions, marital problems, unemployment, and discrimination. c. Have medical conditions, such as hypothyroidism, stroke, Parkinson’s disease, or traumatic brain injury. d. Have unhelpful cognitive schemas developed during childhood. of epistemic trust, avoidance of uncertainty, collective narcissism, extraversion, conspiracy-prone mindset, and higher levels of self-reported risk and anxiety (Magarini et al., 2021). Lockdown, masking, and hand-washing— necessary to prevent widespread infection—potentially exacerbated anxiety in vulnerable people by focusing on “cognitive biases, over-estimations of threat, intolerance of uncertainty, inflated responsibility and excessive safety behavior” (Shafran et al., 2021). COVID-19, with the increased need for mental health treatment in a safe and socially distanced format, provided fodder for the growth of virtual delivery and technologically supported cognitive-behavioral therapy (CBT). COVID-19 dramatically changed the role of technology in the personal and professional lives of many people, including the tremendous increase in the use of telemedicine (Mann et al., 2020), mental health apps (Basu, 2020), and increased demand for online mental health services (Titov et al., 2020). Research trends shifted from how CBT is helpful to exploring and expanding research on safe alternative delivery options for a wide array of mental health concerns. The opportunity that COVID-19 presented challenged clinicians and researchers to research, develop, and disseminate remote treatment, technologically supported treatment, applications, peer support, and self-guided treatment. that specific beliefs, such as maladapted perfectionism, may be linked to the development of depressive symptoms, with increased prevalence in those of East Asian descent (Chang, 2013; Hamamura & Laird, 2014). Some cultures do not acknowledge depression or other mental health issues and discourage individuals struggling with related concerns from seeking help or receiving treatment. One study found that Americans of Western European descent were more defensive when given threatening health news than those of East Asian descent; this suggests that persons of Western descent may be less likely to seek out treatment (Jacobson et al., 2012). Economically disadvantaged women who are members of a racial or ethnic minority in the United States are more likely to experience depressive symptoms than economically disadvantaged Caucasian women. Economically disadvantaged women of color are also less likely to seek or remain in treatment and more likely to employ self-reliance and self-silence as coping mechanisms in stress-inducing situations (Bailey et al., 2019). Trauma, which may be more prevalent among African Americans, can be especially debilitating for clients and may lead to a depressive disorder (Krauss et al., 2016).
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Book Code: PCIL1525
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