. "3 The Etiology of Depression." Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press, 2009.
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Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention
et al., 2000). This seems to be particularly the case for immigrant women. For example, Hiott and colleagues (2006) reported that immigrant women may experience significant losses of social support and a sense of isolation on moving to a different country, and this loss may be manifested in a grieving process. The isolation may be related to unfulfilled relationships, or it may result from separation from or loss of family. These findings suggest that conflictual family relationships, unmet expectations in familial relationships, and isolation may be risk factors for depression in immigrant women who reside in the United States (Shatell et al., 2008). Thus, women may be especially likely to be depressed in response to stressful social loss experiences and even to the negative experiences of those in their social networks.
Gender differences in depression may be accounted for in part by women’s greater exposure to interpersonal life events, as well as their greater likelihood, compared with men, of reacting to such events with depression. Results of studies of adults have been mixed with regard to whether or not women experience more overall recent stressors (e.g., Kendler, Thornton, and Prescott, 2001; McGonagle and Kessler, 1990; Spangler et al., 1996), but several studies have found that adolescent females have higher levels of exposure to recent stressors than do males (Ge et al., 1994; Shih et al., 2006). Moreover, several studies have shown that at comparable levels of acute stressors, women had higher levels of depressive symptoms than did men (Maciejewski, Prigerson, and Mazure, 2001; Rudolph and Hammen, 1999; Shih et al., 2006; van Os and Jones, 1999). Gender differences in exposure and reactivity may also reflect women’s higher levels of certain diatheses, such as neuroticism or ruminative response styles, and meaning attached to interpersonal circumstances. In general, however, the risk factors for depression in men are likely to be very similar to those of women, involving complex interactions among environmental and neurobiological factors at different developmental stages (Kendler, Gardner, and Prescott, 2002, 2006). However, examination of gender differences in mechanisms underlying depressive responses to stress is sparse.
Although acute stress may precipitate depression in vulnerable individuals, the relationship is bidirectional: Those with depression or a history of depression experience significantly more acute stressors than those with no depression. This pattern (“stress generation”; Hammen, 1991b) applies particularly to events that are at least partly caused by the characteristics or behaviors of the person, such as interpersonal conflicts (reviewed in Hammen, 2006). One of the true calamities of depression is the vicious cycle of stress-depression-stress-depression that portends recurring or chronic depression.