New York State Psychiatric Institute.
J Clin Psychol. 2018 Apr;74(4):594-607. doi: 10.1002/jclp.22523. Epub 2017 Oct 27.
Major depression is increasingly viewed in the United States public as a medical disorder with biological and psychosocial causes. Yet little is known about how causal attributions about depression vary among low-income racial minorities. This study examined beliefs about causes of depression and their demographic, clinical and treatment correlates in a lower income African American sample.
Volunteers (N = 110) aged 24-79 years, who participated in a family study of depression, completed a 45-item questionnaire on their beliefs about the causes of depression. We used multidimensional scaling (MDS) to cluster items into causal domains and multivariate regression analyses to test associations of causal domains with demographic and clinical characteristics and treatments received.
Three causal domains, conceptualized as Eastern culture/supernatural (ECS), Western culture/natural/psychosocial (WCN-P), and /neurobiological (WCN-N) attributions, were derived from MDS clusters. WCN-P was most commonly endorsed (50%-91%) and ECS least endorsed as causes of depression (10-44%). This pattern held across gender, age, educational levels, and diagnostic category. WCN-N items were moderately endorsed, with some distinction between genetic causes and other biological causes. WCN-N was positively associated with medication as opposed to other forms of treatment (B = 1.17; p = .049).
Among low-income African Americans, beliefs about causes of depression are varied but broadly consistent explanatory models that include a combination of psychosocial causes with genetic/biological contributions. For certain individuals, supernatural and natural causal attributions may coexist without dissonance. Causal attributions may be associated with types of treatment accepted and have implications for treatment compliance and adherence.
在美国公众中，越来越多的人将重度抑郁症视为一种具有生物和心理社会原因的医学疾病。然而，人们对低收入种族少数群体对抑郁症的因果归因如何存在差异知之甚少。本研究在一个低收入的非裔美国人样本中考察了对抑郁症病因的信念及其与人口统计学、临床和治疗的相关性。
年龄在 24-79 岁之间、参加了抑郁症家族研究的志愿者（N=110）完成了一份关于他们对抑郁症病因看法的 45 项问卷。我们使用多维标度（MDS）将项目聚类到因果域中，并使用多元回归分析来检验因果域与人口统计学和临床特征以及所接受的治疗之间的关联。
从 MDS 聚类中得出了三个因果域，即东方文化/超自然（ECS）、西方文化/自然/心理社会（WCN-P）和/神经生物学（WCN-N）归因。WCN-P 是最常被认可的（50%-91%），而 ECS 是最不被认可的抑郁症病因（10%-44%）。这种模式在性别、年龄、教育程度和诊断类别中都存在。WCN-N 项目得到了适度的认可，遗传原因和其他生物原因之间存在一定的区别。与其他治疗形式相比，WCN-N 与药物治疗呈正相关（B=1.17；p=0.049）。
在低收入的非裔美国人中，对抑郁症病因的看法多种多样，但都包含了心理社会原因和遗传/生物学贡献的综合解释模型。对于某些人来说，超自然和自然的因果归因可能同时存在而不会产生冲突。因果归因可能与接受的治疗类型有关，并对治疗依从性和坚持性有影响。
