Getting the Point Across: Cultural Cognition and the Miscommunication of Depression in the African American Community

Why do individuals hold so steadfast to their ideologies and beliefs?

Some people believe depression to be a mental illness that is caused by either the biological makeup of an individual’s brain, traumatic past experiences, or social interactions that lead to the development of it. Others belief that it is a complete myth, an illness that has no scientific basis and that can be easily cured by pro-activeness of the individual.

Cultural cognition provides an answer to this polarization on not just depression, but also controversial issues such as climate change and gun laws that are prevalent within society. It is described as “…the tendency of individuals to conform their beliefs about disputed matters of fact to values that define their cultural identities.” (Cultural Cognition Project.)

In this chapter I will explore the corresponding connection between African American culture and how depression is understood and dealt with in the African American community.

Culture as Defined By Cultural Cognition

Cultural cognition measures culture using a four-way graph with individualism and solidarity, described as group, on the horizontal axis and the grid, which include the hierarchy and egalitarianism on the vertical axis. A “weak” group culture is defined as someone whose worldview is based on the idea that everyone is on their own, independent of others within society so that focus is put on what benefits them individually and not the society collectively.

Figure 1. Cultural cognition

On the flip side, solidarity promotes a strong sense of community where there a sense of dependency amongst the people that ascribe to such a culture. Going along the vertical axis, a hierarchical culture is one where individuals are ranked based on attributes such as race, sex and age. This ranking system serves as the basis of how people are treated within the cultural community. An egalitarian culture defines a way of life where everyone is treated equally regardless of the social group that they are associated with. Using this diagram to measure culture, the culture of an individual is measured within the quadrants that these axes create, so that a person’s culture can be described as a combination of a group and a grid such as “egalitarian individualism”. However, in this chapter, I will stray away from this theoretical definition of culture proposed by cultural cognition and instead focus on an actual culture (i.e. the African American culture) and specific parts  of it this culture.

Psychology Behind Depression

Depression is a mental disorder, that is commonly known as the “the common cold of mental illness” (Worsnop 1 ). Its prevalence in society has continually increased to the point where it has been a frequent and accepted occurrence amongst people . The psychology behind this mental disorder lies is composed of three different spectrums in psychology, that is biological psychology, social psychology, mainly behaviorism, and cognitive psychology.

Focusing on behaviorism under the spectrum of social psychology, depression “caused by a combination of stressors in a person’s environment and a lack of personal skills.” (Nemade et al. 1). The high presence of these “stressors in a person’s environment,” correlates to the low presence of positive reinforcements and/or the low effect that positive reinforcements have within the person’s environment on that person. In the situation where a person is constantly not easily able to feel the pleasurable and rewarding feeling for accomplishing tasks, they slowly fall into a depressive state where they are either unable to accomplish those tasks anymore or have the ability to, but do not receive any joy from doing so. On the other hand, cognitive psychology suggests that depression is caused by “maladaptive, faulty, or irrational cognitions taking the form of distorted thoughts and judgments.” The thinking process within people who develop depression differs from that of non-depressed; having a higher rate of negative thoughts and views, those with depression create a negative bias towards their environment and others around them. A cognitive psychology theorist, Aaron Beck proposes that the cause of depression are “dysfunctional beliefs,” (Namede et al. “Cognitive Theories” 1) mainly negative thoughts, that can be learned from social interactions and observations. With this idea of negativity more prevalent in the cognition of people with depression, a correlation is proposed to exist between the amount of negative thoughts one has and the existence as well as severity of depression of the person. Through the lens of biological psychology, depression is described as an imbalance of certain chemicals in the brain. In the “Biology of Depression – Neurotransmitters” by Namede et al., further describe depression; “depression has been linked to problems or imbalances in the brain with regard to the neurotransmitters serotonin, norepinephrine, and dopamine.” Studies have shown that the low levels of serotonin in the brain can lead to certain side effects of depression and ultimately depression. However, this is a very simplistic idea of how the levels of chemicals within the brain cause depression. Being that the brain is a complex system composed of several different chemicals working together, there have also been other researches that suggest the involvement of other chemicals within the brain.

Cultural Cognition: Depression in the African American Community

Depression is one of the most common mental disorders that affect people in America. Worsnop states, “In the United States alone, it is estimated that severe depression affects more than 15 million people.” (1) Despite the fact that such a large number of people develop depression, the availability of clinical diagnosis as well as treatment and the abundance of research, it is estimated that approximately 30% of these 15 million people actually go to medical professional to get treatment. To break down this statistics even more, several studies have shown a higher rate of depressive disorder in people who identify with the White race and culture versus those who identify as African American and with its culture. In the article titled, “Prevalence of Depression by Race/Ethnicity,” a national survey conducted on 8449 participants exploring the varying rates of depression between African American, Mexican and White individuals, the authors state that, “prevalence of major depressive disorder was significantly higher in Whites than in African Americans and Mexican Americans. ” (Riolo et al. 1)

Yes, it is true and has been proven to be true through research and studies, that there is a racial disparity in the prevalence of depression within society, however, there are several layers to this truth. This prevalence of depression amongst African Americans does not account for the little to no acceptability  of depression in African American community. In most cases within the African American community, individuals who express the same attitudes and behaviors of a depressed individual are less likely to report these symptoms and behaviors, receive professional medical treatment, identify them as depression or even accept them as depressive mental health issues . Why is this?

Cultural cognition, again, is described as “the tendency of individuals to conform their beliefs about disputed matters of fact to values that define their cultural identities.” (“Cultural Cognition Project.”) Connecting to this concept of cultural cognition, this avoidance and disbelief can be partially explained by the general culture of African Americans.

The general culture of African Americans is built upon various ancient traditional African cultures, which was transported and transformed by African Americans by  the slave trade. Similar to the cultures from the African countries that people were brought over from during the slave trade, the African American culture also focuses on religion, the family, and is based on the idea of being a strong individual in terms have being able to properly take care of yourself physically and mentally. Within the African American culture, there is a strong emphasis on religion and spirituality, the importance of family and community and an overarching idea/myth of always being strong (i.e. the ideal African American woman being “a strong black woman” and the ideal African American man being “strong black man”). These three aspects of the African American culture results in African Americans ascribing to certain and specific definitions and beliefs of depression, which ultimately leads to the tendency to disbelieve depression and its treatment.

With this said, the definition of depression differs depending on the culture where, “…in Western countries depression is verbalized in terms of mental suffering, sadness, despair or pessimism, whereas in African or Eastern societies moods often appear to be described in the language of physical symptoms, translating the suffering of the spirit into bodily terms.” (Douki and Tabbane 22) Despite, that America is obviously a Western nation, American culture differs from African American culture. Being that African American culture is based off African culture, their interpretation of the definition of depression is one that is built on religion and spirituality. Through scientific research, depression has been described as an illness with different causes, which have roots in biological psychology, cognitive psychology and social psychology as stated earlier in the chapter . However, the religious aspect of the African American culture causes the misinterpretation and negligence of these three parts of depression. In the “Role of Culture in a Theory of Psychiatric Illnes s” by Horacio Fabrega Jr. explains that “Human Behavioral Breakdown illnesses,” which includes depression are thought of as resulting from the punishment of some higher being for previously committed sins and is also “equated with religious pollution requiring purification.” (96) African Americans attribute depression to religion, where a person who becomes depressed and portrays the actions and behaviors of a depressed individual is perceived to be possessed by some evil spirit because of their wrongdoings and is in need of cleansing and faith rebuilding. This interpretation leads to the disregard of the biological basis of depression and the misinterpretation of the social and cognitive scientific definitions of depression where the negative thoughts and lack of positive reinforcements are explained through religion. This is an exact example of the occurrence of “biased assimilation and polarization,” where individuals feel the natural impulse to retain and acknowledge only information that aligns to their beliefs and values. (Kahan et al. 7)

In addition to this concept of cultural cognition, “credibility heuristic,” (Kahan et al. 7) which is the tendency to believe and trust information given by sources that one perceives to be credible is also prevalent in the case of depression within the African American community. Due to the fact that religion and family have so much weight in the African American culture, the church, mainly the head of the church, and family are seen as credible sources. In “Identification of Patient Attitudes and Preferences Regarding Treatment of Repression, Cooper-Patrick states, “black patients cited spirituality as a coping mechanism more frequently than white patients. Blacks also discussed using church and church members for support more frequently than whites.” (435) Those who think they have depression first go to family and clergy for support and treatment before any other alternatives. This is a result of the combination of the perception the family and church as credible sources and the mistrust of medical practitioners. Going back to the idea of strong community relation within African American culture, the idea of seeking help from a medical or psychiatric professional, who are seen as “outsiders” to the community expresses an action of denial of one’s culture by the individual. The initial action of African Americans when faced with the issues of mental illness is to pray and seeking counseling from church pastors; “Close to two-thirds [of African Americans when asked in a study] said they believed prayer and faith alone would successfully treat depression “almost all of the time” or “some of the time” and another “20% said they would seek help for depression from friends and family.” (Bailey et al. 1086) By going to seeking help from an “outsider,” this portrays to the community a loss of faith, a loss in the confidence that prayers alone would transform the situation and heal depression. It also portrays an act of disconnection from one’s community; expressing a loss of trust and dependence in the church and your family.

As stated earlier, in the western society of America, depression is described and portrayed as the disorientation of the mental and emotional state of an individual. However, based on the prevailing ideal within the African American culture of being a “strong black woman” or a “strong black man,” this disorientation is seen as a weakness.        Bailey and her colleagues state that approximately 63% of African Americans see depression as a “personal weakness and close to 30% of African Americans said they would “handle it” themselves if they were depressed. (1086) The resistance to affirming the fact that one is depressive and the resistance in seeking proper and efficient help is an attempt to adhere to the cultural ideal of having enough strength to be in control of one’s emotional, mental and physical health. Similar to the effects of seeking outside help on the strong communal aspect of African American culture, seeking professional help portrays the message of a loss in the individualistic strength that one is supposed to have as an African American.

Cultural Cognition results in the miscommunication of scientific topics to the general public. This miscommunication is one where scientifically proven facts and definitions become lost in translation between the process of when the actual research and study is done to when it becomes available to the public. This miscommunication is one where once the scientific research and study becomes available to the public, different interpretations are created, which is mainly attributed to the different cultures and lifestyles people have within society. Despite the fact that there is an abundance of scientific work on depression, describing exactly what it is, what treatments are available and how to get these treatments, misinterpretation of these works occurs within the African American community as a result to the culture that they ascribe to.

Fixing this Miscommunication

In order to combat this miscommunication of depression in the African American community, initiatives need to be taken to increase scientific literacy not just in the African American community but in the general public as well as initiatives to train medical and psychiatric professional to be culturally competent. As society becomes more and more composed of people who identify with and practice different culture, it is necessary that medical practitioners are able to not only able to accurately diagnose and treat patients but do so in such a way that incorporates the patient’s culture with their diagnosis and treatment. In the past, there have steps taking to train professionals in cultural competency, however this focused more on giving professionals the skills and knowledge in handling language barriers and providing them with a toolkit of “do’s and don’ts” with people that hold strong cultural beliefs and values. (Bentacourt in Kleinman 953) Instead of this route, the Diagnostic and Statistical Manual of Mental Disorders “stipulates steps in the evaluation of patients, beginning with the respectful affirmation of and inquiry into their ethnic identity and continuing with the determination of whether ethnic factors seem pertinent in the particular case.” (Kleiman 952) Medical illnesses are understood, interpreted, and described in varying ways depending on the individual’s culture. As expressed throughout this paper, depression ascribes to the risk perceptions of African Americans. It is necessary for medical professionals to have the skills to recognize and know how to go about handling the underlying reasons to the particular views that African Americans and other culturally affiliated groups so that “sensitive, empathetic, humanistic care that is respectful of patients” (Fox 1316) can be delivered.

In addition to this growth of cultural diversity, there are currently and will continue to be an abundance of scientific research and studies that are conducted throughout the years introducing new and different findings to society. With the continual introduction of new scientific research and studies, scientific literacy needs to also increase throughout within society. Scientific literacy refers to the idea the general public ought to know and understand certain aspects of science; George E. DeBoer describes it as, “a desired familiarity with science on the part of the general public.” (584) In achieving this within society, it is necessary that scientific literacy is not deemed to be achieved only when the general public has a basic understanding of scientific terms and concepts but goes a step further where more difficult scientific vocabulary is transformed from jargon to standard language for individuals in society. This way, for instance, individuals are able to understand the fact that depression is not just an emotional state that has one cause, but it is rather an illness that has complex roots and causes.

On my References

The sources that were used in this chapter focus on cultural cognition, depression, and the relationship between culture and depression, specifically the African American culture. The sources on cultural cognition allow me to explain the miscommunication that occurs in the African American community on depression in terms of cultural cognition. The article specifically by Kahan allowed me to incorporate cultural cognition concepts within my argument of why African Americans do not acknowledge depression as an illness and effectiveness of its treatments. An issue I ran into while gaining knowledge on cultural cognition is my belief in this concept. I found myself disagreeing with several points that cultural cognition proposed to cause individuals’ risk perception and view on controversial issues in society. Cultural Cognition, attempts to base all of this (i.e individuals’ risk perception and view on controversial issues in society) on an individual’s culture, when I believe that there are other confounding attributes that may cause this large polarization and attribution of certain risk perception such as socioeconomic status, gender, education level, availability and access and many more. Due to this disbelief, I found myself developing a very diverging view on cultural cognition, which may be very well attributed to my biases and culture and consequently support what cultural cognition proposes. Due the my skepticism in cultural cognition, I attempted to find topics of scientific research that I could explain with cultural cognition and relate to cultural cognition. This lead me to depression within the African American community, which seemed like one on the few topics that I could partially attribute cultural cognition in having a hand in.

Throughout my research on how depression is scientifically described versus how African Americans perceive it, I found several studies that, although agree with one another in terms of their findings, disagree with the general thought of the prevalence of depression in the African American community. The various journal articles propose that the rate of occurrence of depression in African American communities is significantly smaller than the rate in White communities, however, this studies go more in-depth with this statistic, which coincides with how the general public understands racial discrepancy in depression prevalence. However, these studies go a step further, proposing a new and different aspect of this statistic. Many of them found that this statistic of prevalence of depression is dependent on the type of depression. They propose the idea that major depressive disorder is more prevalent in people who identify as White, while other forms of depression, such as dysthymic disorder are more prevalent in ethnic minorities.

When researching the African American culture and the relationship that exists between it and depression, I found that most of the research and studies agreed with one another in the idea that the disbelief in depression is attributed to the culture that African Americans practice. However, these studies stopped at this point. They did not go a step further to figure what exactly about African American culture causes this. In the case where this step was taken, there were only small mentions of specific aspects of the African American culture, however no in-depth analysis was given for this causation relationship. The lack of research that provided an in-depth analysis and explanation of depression and African American culture led me to structure this paper in such a way that aims to explains how specific aspects of the African American culture cause the misinterpretation, unbelief and rejection of depression.