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Family Functioning and Social Support in Men and Women Diagnosed with Depression in China

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Abstract

Previous research has demonstrated the association between family functioning and depression. This study evaluated family functioning and perceived social support in men and women in Shanghai who had received a diagnosis of a major depressive disorder (N = 100), including sixty-six women and thirty-four men. The relationship between family functioning and social support of outpatients with major depressive disorders was explored using the Chinese Family Assessment Device and the Multidimensional Scale of Perceived Social Support. The scores from all dimensions of family functioning for both men and women indicated that depressed men and women all reported experiencing unhealthy family functioning. The clinical implications of these findings for the developing practice of family therapy in China are discussed.

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References

  • Addis, M. (2008). Gender and depression in men. Journal of Clinical Psychology, 15, 153–168. doi:10.1111/j.1468-2850.2008.00125.x.

    Google Scholar 

  • Allison, R. E. (1997). The concept of harmony in Chuang Tza. In S. H. Liu & R. E. Allison (Eds.), Harmony and strife: Contemporary perspectives, east and west (pp. 169–186). Hong Kong: The Chinese University Press.

    Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, text revision (4th ed.). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Barnett, P. A., & Gotlib, I. H. (1990). Cognitive vulnerability to depressive symptoms among men and women. Cognitive Therapy and Research, 14, 47–61.

    Article  Google Scholar 

  • Bildt, C., & Michelsen, H. (2002). Gender differences in the effects from working conditions on mental health: A 4-year follow-up. International Archives of Occupational and Environmental Health, 75, 252–258. doi:10.1007/s00420-001-0299-8.

    Article  PubMed  Google Scholar 

  • Boughton, S., & Street, H. (2007). Integrated review of the social and psychological gender differences in depression. Australian Psychologist, 42, 187–197. doi:10.1080/00050060601139770.

    Article  Google Scholar 

  • Bouma, E. M., Ormel, J., Verhulst, F. C., & Oldehinkel, A. J. (2008). Stressful life events and depressive problems in early adolescent boys and girls: the influence of parental depression, temperament and family environment. Journal of Affective Disorders, 105, 185–193. doi:10.1016/j.jad.2007.05.007.

    Article  PubMed  Google Scholar 

  • Burt, K. B., Van Dulmen, M. H. M., Carlivati, J., Egeland, B., Sroufe, L. A., Forman, D. R., et al. (2005). Mediating links between maternal depression and offspring psychopathology: The importance of independent data. Journal of Child Psychology and Psychiatry, 46, 490–499. doi:10.1111/j.1469-7610.2004.00367.x.

    Article  PubMed  Google Scholar 

  • Cheng, S., & Chan, C. (2004). Assessing Chinese adolescents’ social support. The multidimensional scale of perceived social support. Personality and Individual Differences, 28, 299–307.

    Google Scholar 

  • Cheung, G., & Chan, C. (2002). The Satir model and cultural sensitivity: A Hong Kong reflection. Contemporary Family Therapy, 24, 199–215.

    Article  Google Scholar 

  • Chou, K. (2000). Assessing Chinese adolescents’ social support: The Multidimensional Scale of Perceived Social Support. Personality and Individual Differences, 28, 299–307. doi:10.1016/S0191-8869(99)00098-7.

    Article  Google Scholar 

  • Cummings, E. M., Keller, P. S., & Davies, P. T. (2005). Towards a family process model of maternal and paternal depressive symptoms: Exploring multiple relations with child and family functions. Journal of Child Psychology and Psychiatry, 46, 479–489. doi:10.1111/j.1469-7610.2004.00368.x.

    Article  PubMed  Google Scholar 

  • Cyranowski, J., Frank, E., Young, E., & Shear, M. (2000). Adolescent onset of the gender difference in lifetime rates of major depression: A theoretical model. Archives of General Psychiatry, 57(1), 21–27. doi:10.1001/archpsyc.57.1.21.

    Article  PubMed  Google Scholar 

  • Deng, L., Lin, X., Lan, J., & Fang, X. (2013). Family therapy in China. Contemporary Family Therapy, 35(2), 420–436. doi:10.1007/s10591-013-9273-3.

    Article  Google Scholar 

  • Epstein, N., Baldwin, L., & Bishop, D. (1983). The McMaster family assessment device. Journal of Marital and Family Therapy, 9, 171–180. doi:10.1111/j.1752-0606.1983.tb01497.x.

    Article  Google Scholar 

  • Fan, C. C. (2003). Rural-urban migration and gender division of labor in transitional China. International Journal of Urban and Regional Research, 27(1), 24–27. doi:10.1111/1468-2427.00429.

    Article  Google Scholar 

  • Febres, J., Rossi, R., Gaudiano, B. A., & Miller, I. W. (2011). Differential relationship between depression severity and patients’ perceived family functioning in women versus in men. The Journal of Nervous and Mental Disease, 199(7), 449–454. doi:10.1097/NMD.0b013e318221412a.

    Article  PubMed Central  PubMed  Google Scholar 

  • Foster, C. E., Webster, M. C., Weissman, M. M., Pilowsky, D. J., Wickramaratne, P. J., Rush, A. J., et al. (2008). Course and severity of maternal depression: Associations with family functioning and child adjustment. Journal of Youth Adolescence, 37, 906–916. doi:10.1007/s10964-007-9216-0.

    Article  Google Scholar 

  • Gladstone, T., & Beardslee, W. (2009). The prevention of depression in children and adolescents: A review. Canadian Journal of Psychiatry, 54, 212–221.

    Google Scholar 

  • Glick, I. (1982). A family therapist in the People’s Republic of China. Contemporary Family Therapy, 4(3), 177–183.

    Article  Google Scholar 

  • Hammen, C. (1999). The emergence of an interpersonal approach to depression. In T. Joiner & J. C. Coyne (Eds.), The interactional nature of depression (pp. 21–35). Washington, DC: American Psychological Association.

    Chapter  Google Scholar 

  • Hampson, R. & Beavers, W. (1989). Family therapy in the Peoples Republic of China: An update. Contemporary Family Therapy, 11(4).

  • Hankin, B. L., & Abramson, L. Y. (2001). Development of gender differences in depression: An elaborated cognitive vulnerability-transactional stress theory. Psychological Bulletin, 127, 773–796. doi:10.1037/0033-2909.127.6.773.

    Article  PubMed  Google Scholar 

  • Herr, N., Hammen, C., & Brennan, P. (2007). Current and past depression as predictors of family functioning: A comparison of men and women in a community sample. Journal of Family Psychology, 21, 694–702. doi:10.1037/0893-3200.21.4.694.

    Article  PubMed  Google Scholar 

  • Ho, D. Y. F. (1996). Filial piety and its psychological consequences. In M. H. Bond (Ed.), The handbook of Chinese psychology (pp. 155–165). New York: Oxford University Press.

    Google Scholar 

  • Hovey, J. D., & Magana, C. E. (2000). Acculturative stress, anxiety, and depression among Mexican farmworkers in the midwest United States. Journal of Immigrant Health, 2(3), 119–131.

    Article  PubMed  Google Scholar 

  • Hu, T., He, Y., Zhang, M., & Cheng, N. (2007). Economic costs of depression in China. Social Psychiatry and Psychiatric Epidemiology, 42(10), 110–116. doi:10.1007/s00127-006-0151-2.

    Article  PubMed  Google Scholar 

  • Hughes, E., & Gullone, E. (2008). Internalizing symptoms and disorders in families of adolescents: A review of family systems literature. Clinical Psychology Review, 28, 92–117. doi:10.1176/appi.ajp.162.2.250.

    Article  PubMed  Google Scholar 

  • Kendler, K. S., Myers, J., & Prescott, C. A. (2005). Sex differences in the relationship between social support and risk for major depression: A longitudinal study of opposite-sex twin pairs. American Journal of Psychiatry, 162, 250–256. doi:10.1016/j.cpr.2007.04.002.

    Article  PubMed  Google Scholar 

  • Kilmartin, C. (2005). Depression in men: Communication, diagnosis, and therapy. Journal of Men’s Health and Gender, 2, 95–99.

    Article  Google Scholar 

  • Kleinman, A. (2004). Culture and depression. New England Journal of Medicine, 351(10), 951–953.

    Article  PubMed  Google Scholar 

  • Kornstein, S., Schatzberg, A., Thase, M., Yonkers, K., McCullough, J., Keitner, G., et al. (2000). Gender differences in chronic major and double depression. Journal of Affective Disorders, 60(1), 1–11.

    Article  PubMed  Google Scholar 

  • Kuhlman, I., Tolvanen, A., & Seikkula, J. (2013). Couple therapy for depression within a naturalistic setting in Finland: Factors related to change of the patient and the spouse. Contemporary Family Therapy. doi:10.1007/s10591-013-9246-6.

    Google Scholar 

  • Lesch, K. P. (2004). Gene-environment interaction and the genetics of depression. Journal of Psychiatry Neuroscience, 29, 174–184.

    PubMed Central  PubMed  Google Scholar 

  • Leung, K., Chen, C., Lue, B., & Hsu, S. (2007). Social support and family functioning on psychological symptoms in elderly Chinese. Archives of Gerontology and Geriatrics, 44(2), 203–213. doi:10.1016/j.archger.2006.05.001.

    Article  PubMed  Google Scholar 

  • Liu, L., Zhao, X., & Miller, J. K. (2012). Use of metaphors in Chinese family therapy: A qualitative study. Journal of Family Therapy. doi:10.1111/j.1467-6427.2012.00582.x.

    Google Scholar 

  • Ma, J. L., Wong, T. K., & Lau, Y. K. (2009). Sex differences in perceived family functioning and family resources in Hong Kong Families: Implications for social work practice. Asian Social Work and Policy Review, 3, 155–174. doi:10.1111/j.1753-1411.2009.00031.x.

    Article  Google Scholar 

  • Mahalik, J. R. (2008). A biopsychosocial perspective on men’s depression. Journal of Clinical Psychology, 15, 174–177. doi:10.1111/j.1468-2850.2008.00127.x.

    Google Scholar 

  • Milan, S., Snow, S., & Belay, S. (2009). Depressive symptoms in mothers and children: Preschool attachment as a moderator of risk. Developmental Psychology, 45, 1019–1033. doi:10.1037/a0016164.

    Article  PubMed  Google Scholar 

  • Miller, I. W., Epstein, N. B., Bishop, D. S., & Keitner, G. I. (1985). The McMaster family assessment device: Reliability and validity. Journal of Marital and Family Therapy, 11, 345–356. doi:10.1111/j.1752-0606.1985.tb00028.x.

    Article  Google Scholar 

  • Miller, J. K., & Fang, X. (2012). Marriage and family therapy in the Peoples Republic of China: Current issues and challenges. Journal of Family Psychotherapy, 23, 173–183. doi:10.1080/08975353.2012.705626.

    Article  Google Scholar 

  • Miller, I. W., Kabacoff, R. I., Epstein, N. B., Bishop, D. S., Keitner, G. I., Baldwin, L. M., et al. (1994). The development of a clinical rating scale for the McMaster model of family functioning. Family Process, 33, 53–69. doi:10.1111/j.1545-5300.1994.00053.x.

    Article  PubMed  Google Scholar 

  • Morriss, R. K., & Morriss, E. E. (2000). Contextual evaluation of social adversity in the management of depressive disorder. Advances in Psychiatric Treatment, 6, 423–431. doi:10.1192/apt.6.6.423.

    Article  Google Scholar 

  • Nolen-Hoeksema, S., Larson, J., & Grayson, C. (1999). Explaining the gender difference in depressive symptoms. Journal of Personality and Social Psychology, 77, 1061–1072. doi:10.1037/0022-3514.77.5.1061.

    Article  PubMed  Google Scholar 

  • Restifo, K., & Bögels, S. (2009). Family processes in the development of youth depression: Translating the evidence to treatment. Clinical Psychology Review, 29, 294–316. doi:10.1016/j.cpr.2009.02.005.

    Article  PubMed  Google Scholar 

  • Ryan, C. E., Epstein, N. B., Keitner, G. I., Miller, I. W., & Bishop, D. S. (2005). Evaluating and treating families: The McMaster approach. New York: Routledge Taylor & Francis Group.

    Google Scholar 

  • Ryder, A. G., Yang, J., Zhu, X. Z., Yao, S. Q., Yi, J. Y., Heine, S. J., et al. (2008). The cultural shaping of depression: somatic symptoms in China, psychological symptoms in North America? Journal of Abnormal Psychology, 2, 300–313. doi:10.1037/0021-843X.117.2.300.

    Article  Google Scholar 

  • Sakamoto, S. (2000). Self-focus and depression: The three phase model. Behavioural and Cognitive Psychotherapy, 28, 45–61.

    Google Scholar 

  • Sander, J., & McCarty, C. (2005). Youth depression in the family context: Familial risk factors and models of treatment. Clinical Child and Family Psychology Review, 8, 203–219. doi:10.1007/s10567-005-6666-3.

    Article  PubMed Central  PubMed  Google Scholar 

  • Sarmiento, I., & Cardemil, E. V. (2009). Family functioning and depression in low-income Latino couples. Journal of Marital and Family Therapy, 35, 432–445. doi:10.1111/j.1752-0606.2009.00139.x.

    Article  PubMed  Google Scholar 

  • Schraedley, P. K., Gotlib, I. H., & Hayward, C. (1999). Gender differences in correlates of depressive symptoms in adolescents. Journal of Adolescent Health, 25, 98–108. doi:10.1016/S1054-139X(99)00038-5.

    Article  PubMed  Google Scholar 

  • Seidlitz, L., & Diener, E. (1998). Sex differences in the recall of affective experiences. Journal of Personality and Social Psychology, 74, 262–271. doi:10.1037/0022-3514.74.1.262.

    Article  PubMed  Google Scholar 

  • Shanghai Municipal Government. (2009). The Encyclopedia for Shanghai. Shanghai & Technical Publishers. Retrieved from http://zhuanti.shanghai.gov.cn/encyclopedia/en/.

  • Shek, D. T. (2002). Assessment of family functioning in Chinese adolescents: The Chinese version of the family assessment device. Research on Social Work Practice, 12, 502–524. doi:10.1177/1049731502012004003.

    Article  Google Scholar 

  • Shek, D. T., & Chan, L. K. (1998). Perceptions of a happy family amongst Chinese adolescents and their parents. Journal of Youth Studies, 1, 178–189.

    Article  Google Scholar 

  • Shek, D. T., & Lai, M. F. (2000). Conceptions of an ideal family in Confucian thoughts: Implications for individual and family counseling. Asian Journal of Counseling, 7, 85–104.

    Google Scholar 

  • Silberg, J. L., Maes, H., & Eaves, L. J. (2010). Genetic and environmental influences on the transmission of parental depression to children’s depression and conduct disturbance: An extended children of twins study. Journal of Child Psychology and Psychiatry, 51, 734–744. doi:10.1111/j.1469-7610.2010.02205.x.

    Article  PubMed Central  PubMed  Google Scholar 

  • Taylor, S. E., Way, B. M., Welch, W. T., Hilmert, C. J., Lehman, B. J., & Eisenberger, N. I. (2006). Early family environment, current adversity, the serotonin transporter promoter polymorphism, and depressive symptomatology. Biological Psychiatry, 60, 671–676. doi:10.1111/j.1469-7610.2010.02205.x.

    Article  PubMed  Google Scholar 

  • Ting-Toomey, S. (1988). Intercultural conflicts: A face-negotiation theory. In Y. Kim & W. Gudykunst (Eds.), Theories in intercultural communication (pp. 213–235). Newbury Park, CA: Sage.

    Google Scholar 

  • Uebelacker, L. A., Strong, D., Weinstock, L., & Miller, I. W. (2009). Use of item response theory to understand differential functioning of DSM-IV major depression symptoms by race, ethnicity, and gender. Psychological Medicine, 39, 591–601.

    Article  PubMed  Google Scholar 

  • Wang, L., & Crane, R. (1994). Marriage and family therapy with people from China. Contemporary Family Therapy, 16(1), 25–37. doi:10.1007/BF02197600.

    Article  Google Scholar 

  • Wang, J. L., Fick, G., Adair, A., & Lai, D. (2007). Gender specific correlates of stigma toward depression in a Canadian general population sample. Journal of Affective Disorders, 103, 91–97. doi:10.1016/j.jad.2007.01.010.

    Article  PubMed  Google Scholar 

  • Wang, J. K., & Zhao, X. D. (2012a). Family functioning, social support, and quality of life for Chinese empty nest older people with depression. International Journal of Geriatric Psychiatry, 27(1), 1204–1206. doi:10.1002/gps.2832.

    Article  PubMed  Google Scholar 

  • Wang, J. K., & Zhao, X. D. (2012b). Family functioning and social support for older patients with depression in an urban area of Shanghai, China. Archives of Gerontology and Geriatrics, 55, 574–579.

    Article  PubMed  Google Scholar 

  • Wang, J. K., Zhao, X. D., Liu, L., & Ma, X. Q. (2012). Family functioning, social support and depression in a Chinese population. Psychopathology, 45(5), 334–336. doi:10.1159/000336218.

    Article  PubMed  Google Scholar 

  • Whisman, M. A. (2001). The association between depression and marital dissatisfaction. In S. R. H. Beach (Ed.), Marital and family processes in depression: A scientific foundation for clinical practice (pp. 3–24). Washington, DC: American Psychological Association.

    Chapter  Google Scholar 

  • Wilhelm, K., Parker, G., Geerlings, L., & Wedgwood, L. (2008). Women and depression: A 30 year learning curve. Australian New Zealand Journal of Psychiatry, 42, 3–12. doi:10.1080/00048670701732665.

    Article  PubMed  Google Scholar 

  • Wilson, S., & Durbin, E. (2010). Effects of paternal depression on fathers’ parenting behaviors: A meta-analytic review. Clinical Psychology Review, 30, 167–180. doi:10.1016/j.cpr.2009.10.007.

    Article  PubMed  Google Scholar 

  • Wittenborn, A. K., Culpepper, B., & Liu, T. (2012). Treating depression in men: The role of emotionally focused couple therapy. Contemporary Family Therapy, 34, 89–103. doi:10.1007/s10591-012-9176-8.

    Article  Google Scholar 

  • Yang, L. H., & Pearson, V. J. (2002). Understanding families in their own context: Schizophrenia and structural family therapy in Beijing. Contemporary Family Therapy, 24, 233–257. doi:10.1111/1467-6427.00214.

    Article  Google Scholar 

  • Yen, S., Robins, C. J., & Lin, N. (2000). A cross-cultural comparison of depressive symptom manifestation: China and United States. Journal of Counseling and Clinical Psychology, 68(6), 993–999. doi:10.1037/0022-006X.68.6.993.

    Article  Google Scholar 

  • Zimet, G. D., Powell, S. S., Farley, G. K., Werkman, S., & Berkoff, K. A. (1990). Psychometric characteristics of the multidimensional scale of perceived social support. Journal of Personality Assessment, 55, 610–617. doi:10.1080/00223891.1990.9674095.

    Article  PubMed  Google Scholar 

  • Zlotnick, C., Kohn, R., Keitner, G., & Della Grotta, S. (2000). The relationship between quality of interpersonal relationships and major depressive disorder: Findings from the National Comorbidity Survey. Journal of Affective Disorders, 59, 205–215. doi:10.1016/S0165-0327(99)00153-6.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. School of Psychology and Cognitive Science, East China Normal University, Shanghai, China

    Jikun Wang

  2. Department of Family Therapy, Nova Southeastern University, 3301 College Avenue, Fort Lauderdale, FL, 33314-7796, USA

    John K. Miller

  3. School of Medicine, Tongji University, Shanghai, China

    Xudong Zhao

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  1. Jikun Wang
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  2. John K. Miller
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Correspondence to John K. Miller.

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Wang, J., Miller, J.K. & Zhao, X. Family Functioning and Social Support in Men and Women Diagnosed with Depression in China. Contemp Fam Ther 36, 232–241 (2014). https://doi.org/10.1007/s10591-013-9294-y

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