Encyclopedia of Sociology

DEPRESSION

scales try to understand the negative comparisons.
An example of this type of measure is one where
individuals are asked about the circumstances (in-
teractions with people, idle thoughts, etc.), the
dimensions (social skills, intelligence), the gender,
and the type of relationship with the comparison
target, and the individual’s mood before and after
the interaction. To get at the least-accessible level
of thoughts, those that are believed to store, or-
ganize, and direct the processing of personally
relevant information, researchers have used meas-
ures like the Stroop color-word task. Individuals
are asked to name the color of the ink in which a
word is printed but to ignore the meaning of the
word itself. Slower response rates are thought to
indicate greater effort to suppress words that are
highly descriptive of the self. For example, de-
pressed individuals take longer to name the color
in which words like ‘‘sad’’ and ‘‘useless’’ are print-
ed compared to the color for positive words.

In health, clinical, and counseling research
and evaluation settings, the two most common
measures of depression are the Beck Depression
Inventory (BDI) and the Center for Epidemiological
Studies Depression Scale (CESD). The BDI was
designed to measure ‘‘symptom-attitude catego-
ries’’ associated with depression (Beck 1967). These
include, among others, mood, pessimism, and
sense of failure as well as somatic preoccupation.
Many of the items reflect Beck’s belief in the
relevance of negative cognitions or self-evalua-
tions in depression. Each item includes a group of
statements that reflect increasing levels of one of
these symptom-attitude categories. The test taker
is asked to choose the statement within each item
that reflects the way he or she has been feeling in
the past week. The items are scored on a scale from
0–3, and reflect increasing levels of negativity. A
sample item includes 0 = ‘‘I do not feel like a
failure,’’ to 3 = ‘‘I feel I am a complete failure as a
person.’’ The CESD is a twenty-item scale, is a
widely used measure of depressive symptomatology,
and has been shown to be valid and reliable in
many samples. Participants are asked to best de-
scribe how often they felt or behaved during the
previous week, in a variety of ways reflective of
symptoms of depression, using a scale ranging
from 0 (Rarely or none of the time[less than 1 day]) to 3
(Most or all of the time [5–7 days]). For example,
participants are asked how often their sleep was
restless or they felt that everything they did was an

effort. Other self-report measures include the Min-

nesota Multiphasic Personality Inventory Depres-

sion Scale (MMPI-D), the Zung Self-Rating Depres-

sion Scale (SDS), and the Depression Adjective

Check List (DACL). Complete descriptions of these

scales can be found in Constance Hammen (1997).

TREATMENT

As can be expected, the type of treatment depends

on the type of depression and to some extent the

favored theory of the health-care provider (physi-

cian, psychologist, or therapist) one goes to for

treatment.

Biologically based treatments. The most com-

mon treatment for depression that is thought to

have a physiological basis is antidepressant medi-

cation. Based on biological theories suggesting

that depression results from low levels of the

monoamines serotonin, norepinephrine, and

dopamine, antidepressant medications act to in-

crease the levels of these chemicals in the blood-

stream. These drugs work by either preventing the

monoamines from being broken down and de-

stroyed (referred to as monoamine oxidase (MOA)

inhibitors and tricyclics) or by preventing them

from being removed from where they work (re-

ferred to as selective serotonin inhibitors [SSRIs]).

Elavil, Norpramin, and Tofranil are the trade names

of some MAO inhibitors. Prozac, Paxil, Zoloft, and

Luvox are examples of SSRIs.

Although these medications have been prov-

en to be effective in reducing depression, they also

have a variety of side effects and need to be taken

only under medical supervision. For example,

tricyclics also cause dry mouth, constipation, dizzi-

ness, irregular heartbeat, blurred vision, ringing in

the ears, retention of urine, and excessive sweat-

ing. Some of the SSRIs were developed with an eye

toward reducing side effects and are correspond-

ingly more often prescribed. Unfortunately, they

are most commonly associated with prescription

drug overdoses resulting in many thousands of

deaths a year.

Several medicinal herbs have antidepressant

effects. The most powerful is St. John’s wort, a

natural MAO inhibitor. In addition, ginkgo and

caffeine may also help. Although much more re-

search remains to be done, studies to date support