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“Depresión”: What does it mean?

During my stay in Yorkin this past summer, it was mentioned by one of the women that there used to be a lot of “depresión” in the village before they started their ecotourism project. My initial reaction was, “I wonder what exactly they mean by “depresión”?” And then I started thinking about administering the CES-D, which is a depression scale that has been used in many contexts internationally, in the community. I also knew that some way, somehow, I would have to get at exactly what they mean by “depresión” but I was a little unsure of how to do this.

After my presentation of my pre-dissertation research in Yorkin, our new faculty member in the department of anthropology here at the University of Alabama, Lesley Jo Weaver, turned me on to an article she had just had published (Weaver and Kaiser 2014) describing the methodology that I was looking for. In this article she describes how a researcher can accomplish two major agendas of psychological anthropology, the first being the comparison of mental health between sites using standard measurement tools and the second focusing on identifying locally specific ways of discussing mental illness. In this paper she lays out the methodology used in two research sites which identified local idioms of distress, developed a locally derived mental health scale, evaluated the scale, and contextualized the findings with ethnographic data.

The first phase of this methodology involves ethnography. In this phase field notes and interviews are coded for themes and terms used to describe mental health and the frequency of usage is recorded. Also as part of the ethnographic work, participants were asked to create free lists of symptoms and characteristics which accompany particular idioms of distress, for example in the case of the Bribri, depresión. From this ethnographic data a survey questionnaire can then be developed asking participants to rate on a Likert scale the accuracy and frequency of various terms used to describe an idiom of distress. From this data, a scale can be created which reflects local terminology and understanding of culturally salient mental health domains, again in the case of the people in Yorkin, depresión.

In the next phase, the locally derived scale can be administered along with a standard scale, for example the CES-D for measuring depression. Quantitative analysis can then be administered; examining correlations between the results of the two scales, checking for internal consistency using Cronbach’s alpha, and using principal components analysis to examine those factors in the scale which are most relevant.

The authors suggest “This research agenda respects culturally defined illnesses and acknowledges the contextuality of all illness experiences while still maintaining the comparative enterprise of cross-cultural psychiatry” (Weaver and Kaiser 2014:12). I foresee using this methodology in my research in phase 2, after using participant observation to learn about and describe their ecotourism project while also collecting hair samples which will be used to examine levels of cortisol (as a biomarker for stress) among community members.

Weaver & Kaiser 2014
Weaver & Kaiser 2014

 

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