Depressive disorders: two important behaviors that may help prevent depressive symptoms are stress management and avoidance of alcohol or substance abuse.
Exposure to chronic stress is known to cause structural changes in both white and grey matter in the brain. These changes are directly associated with becoming predisposed to states of negative affect. Research has shown that stress produces changes in the brain similar to those that are seen in chronically depressed patients. It is believed that stress exerts its main effects on the brain regions involving the control of emotion and memory. When stress becomes chronic, individuals often stop their normal and health coping strategies. The readings of Muraven and Baumesiter clearly highlight the key aspects of how self-regulatory strength functions like a cognitive muscle, and its necessity in keeping us mentally fit and strong. Exposure to stress results in diminished self-control long after the stressful event occur, and lead individuals to become more oriented towards threatening stimuli. Furthermore, stress immediately leads to an initial lowered mood, which often contributes to the abandoning of consistent eating and sleeping patterns, further exacerbating under-regulation and making subsequent regulation of healthy life style choices less likely. Key intermediary factors that may contribute to prevention of chronic stress are education, and access to education regarding how preventative factors such as consistent routines like regular eating, exercise, therapy, as well as self-regulating practices such as yoga and meditation, are fundamental to mood and stress regulation. Biopsychosocial factors, such as access to quality education and community resources all play key preventative roles in providing options for underserved communities and individuals at-risk for depressive disorders.
Engaging in substance abuse depletes our brains protective mechanisms supporting mood regulation through the production of serotonin and dopamine. Substance abuse leads to a whole host of additional cognitive stressors such as infections and exposure to violent or dangerous environments and social contexts, all of which further deplete one’s self-regulatory capacities. Imbalances in brain chemistry, family history, and past trauma, for instance, are frequently involved in both depression and addiction. Physical and psychological effects of addiction often mask depression or worsen the symptoms of this psychiatric illness. In order for underserved and at-risk communities to have access to treatment, a range of resources need to be available in order to address the psychological, medical, and psychosocial needs. Key intermediary factors that may contribute to addiction prevention include access to education and resources regarding preventative factors such as community groups and facilities, treatment programs, self-regulating techniques practices.
2. Describe how you would study the role of one of the behaviors described for question #1 and your health outcome of interest. Incorporate a social factor (e.g. race/ethnicity, social exclusion, stress) in the study approach.
I would be interested in designing a longitudinal study exploring the long-term effects of a mindfulness based cognitive therapy program (MBCT; which trains and emphasizes the importance of specific cognitive and self-regulatory techniques for processing and coping with adverse thoughts, emotions and behaviors) that target young individuals at high risk for depressive disorders in several underserved communities. This longitudinal study would attempt to measure as much relevant socioeconomic information as possible by specifying the particular socioeconomic factors (and would attempt to address the important unmeasured socioeconomic factors may affect conclusions, as discussed in Braveman et al) and the respective effects of this type of intervention across different group types in order to assess which social factors influence its efficacy most significantly.
3. If key health behaviors (e.g. smoking, exercise, nutritious diet) are strongly influenced by neighborhood, income, and/or education, do we need to continue to study how these behaviors influence health outcomes? Why or why not?
Clearly. While we have some understanding of how important health behaviors are influenced by factors such as one’s neighborhood, income and education, there remains an unclear understanding as to how and why certain groups and individuals appear to be more at risk/or resilient, then others. A nuanced understanding of these dynamics can only come from future research studies that address the fact that a given SES measure may have different meanings in different social groups. More research that examines how outcomes/findings using a given SES measure vary across social groups is necessary for a more empirically and conceptually relevant and methodologically rigorous approach to measurement of SES (Braveman et al).