Because the effects of racism can be devastating for the lives of people of color, research has been devoted to determining the link between discrimination and psychopathology. Numerous studies have discovered a link between perceptions of racial discrimination and the likelihood of developing MDD among people of color (Russell et al., 2018). Because racism is integrated into many societal contexts, Russell et al. (2018) explored the effects of discrimination within neighborhood settings on the development of MDD. Understanding the impact racial discrimination within a neighborhood has on depression offers a number of clinical implications and opportunities for change.
Methods
The sample in Russell et al.’s (2018) study consisted of 499 African American females from Georgia and Iowa. Each participant was the primary caregiver for an African American child and had a mean age of 37 years at the beginning of the study. Participants were interviewed every 2 to 3 years since the beginning of the study in 1997 for a total of five interviews. Samples were collected from racially and economically diverse neighborhood clusters that were based on data from the 1990 census. In sum, there were 21 neighborhood clusters from Iowa and 19 clusters from Georgia. (Russell et al., 2018). To collect data from the participants, a number of different questionnaires were administered via computer-assisted personal interviews to assess a number of different areas relating to characteristics of both the neighborhood and the individual. After each of the five waves of interviews, participants were given a diagnostic interview to assess for depression according to DSM-IV criteria. Once all data were collected, researchers ran a statistical analysis to highlight which environmental and individual factors are predictive of the development of MDD (Russell et al., 2018).
Results
Over the course of the study, 18% of the women in the study met symptoms for MDD. Experiences of racial discrimination in the neighborhood setting was positively related to the development of MDD and was found to be a more significant predictor of the development of MDD than individually experienced racism. This finding suggests that the more pervasive racism is, the stronger the effects are on mental health (Russell et al., 2018). In terms of individual characteristics predictive of the development of MDD, relationship quality was negatively associated with the development of MDD. Positive relationships were found to minimize the negative effects of discrimination on the development of MDD even at the neighborhood level, suggesting that healthy relationships can offset the harmful effects of pervasive racism (Russell et al., 2018). One last finding related to the lasting effects of racial discrimination within a neighborhood. Since the study used a longitudinal approach to research, the sample characteristic changed over time.
In fact, half of the participants moved from their original neighborhood over the course of the study. The negative effects of racial discrimination from the previous neighborhood remained with the individual even in their new setting, suggesting that perceptions of how one’s racial group is treated have long-lasting effects. Additionally, even when removed from the discriminative neighborhood, beliefs that one will experience racism may lead to a more negative outlook (Russell et al., 2018). Strengths Russell et al.’s (2018) study features a number of apparent strengths. One strength is the size and characteristics of the sample. With just under 500 women, the size of the sample allows for a narrower margin of error, which allows any significant findings to be interpreted more confidently.
In addition, because the sample was composed specifically of African American women, variations in results can be attributed to factors other than race or sex. Moreover, the study was longitudinal in its approach, which allowed for observations to be made at both the group and individual level. In addition, researchers could observe how the development of MDD is affected by the duration of living in neighborhoods characterized by discrimination. Another strength of the study is that the researchers removed women who, at any point in their lives, met criteria for MDD in the first round of interviews. Removing these women from the study created a sample that had a lower risk for developing depression (Russell et al., 2018).
Because neighborhood discrimination contributed to the development of MDD in a low risk sample, the effects of discrimination can be considered strong. Finally, the current study produced meaningful research that elaborated the findings of former studies. For instance, a number of studies have determined that racial discrimination increases the likelihood of developing MDD (Russell et al., 2018). The study conducted by Russell et al. (2018) takes previous research further by considering how racism within neighborhood settings, a more pervasive form of racism, affects the onset of depression. With the findings proposed by Russell et al. (2018), future researchers can build on this foundation in order to discover more about racial discrimination and its effects on mental health. Weaknesses While the sample had a number of strengths, there are a number of limitations to consider when interpreting the results. Since the sample looked only at the experiences of African American women, results cannot be generalized to African American men.
Moreover, the sample was composed only of African Americans, so generalizing the results to other people of color may be out of line. Russell et al. (2018) acknowledge that because the sample was entirely from non-metropolitan areas of Georgia and Iowa, generalizability to other states and regions is limited. Finally, all interviews were conducted via computer, which may miss important features of the participant’s response, especially for the diagnostic interview. It is possible that using a computerized diagnostic interview could have under or over pathologized the participants, and the diagnoses of MDD may have been inaccurate.
Additionally, though there are benefits to longitudinal research designs, the effect of time resulted in half of the participants moving from their original neighborhoods. Though variables were created to detect the change in racism levels from the old to new neighborhoods, the careful selection of neighborhoods based on geographic, demographic, and socioeconomic characteristics was minimized by many of the participants relocating. The control of certain neighborhood-level variables was lost when participants relocated, and one should consider this when interpreting the results of the study. Finally, though the sample was considered low-risk for developing depression, only 18 % of the women developed MDD by the fifth interview. Neighborhood racism was found to be a predictor of MDD on the grounds of pervasive racism, though in only a small number of participants. Russell et al. (2018) had a tendency to overinterpret their results, but one should remember that the findings of the study were only relevant for a small number of participants. This should be noted when applying the findings because this does not necessarily mean African American women have a higher rate of depression, just that neighborhood discrimination may contribute to the onset of MDD in African American females. C
onnection to Literature Since racial discrimination within one’s neighborhood is found to be a significant predictor for the development of MDD in African American females, ways to minimize the effects of neighborhood discrimination must be considered. Research conducted by Russell et al. (2018) suggests that healthy social relationships can lower the impact that neighborhood discrimination has on depression. However, one must refer to current research to develop additional ways to combat the effects of discrimination within the neighborhood. Research conducted by Brown (2008) suggests that positive social relationships minimize the effects of racial discrimination through the promotion of resiliency.
The link between positive relationships and the lower risk for developing MDD suggested by Russell et al. (2018) may lie in the resiliency factor, as resiliency promotes a number of positive outcomes. Further, a study conducted by Clauss-Ehlers (2008) discovered that cultural background and experiences related to diversity impact the development of resilience within an individual in a positive way. Keeping in mind that resiliency can help an individual cope with mental health afflictions, a further step would be to promote cultural pride and diversity enrichment in order to minimize stressors related to discrimination.
Though responsibility for the development of MDD does not lie in the individual, establishing resiliency through their cultural background, African Americans may be able to slow the harmful effects of neighborhood discrimination. This study contributes to Russell et al.’s (2018) assertion that positive social relations with one’s own racial group can help prevent or alleviate symptoms of depression, as cultural pride established through positive social relationships can promote resiliency.
Clinical Implications
The results of the study conducted by Russell et al. (2018) offer a number of implications that are worth integrating into clinical practice. Specifically, the findings suggest that societal factors, such as racial discrimination, contribute to depressive symptoms. As a result, a diagnosis that acknowledges the root of these disorders as environmental in nature would offer a change in the way clients view their symptoms. One such approach suggested by Russell et al. (2018) would be for clinicians to incorporate syndromes like “cultural dysthymia” into their vocabularies, as this terminology implies that the cause for the symptoms lie in the society or culture rather than within the client. Placing blame on the environment in which the person resides rather than the victim can improve their well-being by encouraging the individual that there is nothing “wrong” with them. Additionally, clinicians should find ways to minimize their own biases and prejudices.
When conducting therapy with a client, interacting with the individual in a way that promotes openness and safety could ensure that the client does not feel that the therapeutic relationship is contributing to their discrimination and distress. Moreover, the clinician should take the time to acknowledge the discrimination experienced by the client and take care not to illegitimate the individual’s encounters with racism, as not doing so could make the racism even more pervasive.
Finally, the findings of Russell et al.’s (2018) study suggest that positive relationships can minimize the effects of racial discrimination. Clinicians have a responsibility to ensure that clients have healthy relationships within their social circles in an attempt to help clients combat the negative effects of pervasive racism. Subsequently, clinicians should focus time on clients’ experiences with racism but also allow time to talk about what sort of support they have in dealing with these encounters. Also, it may be beneficial to create support groups where clients can share their experiences with on another.
