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2011 Collectivism and Individualism: Culture, Aging, and Depression

Brother George Bales, C.F.A. University of Missouri-Saint Louis Anthropology of Aging 0


According to the Population Division

of

the

Department

of

Economic and Social Affairs of the United Nations (2009), a steady

progression of global aging has begun

like

never

humankindâ€&#x;s history.

before

in

That is,

currently in developed countries, (e.g., Western cultures), older adult populations, (i.e., persons 65 years and older) (21%) already outnumber children (17%); inevitably, in 2045, older adults will outnumber children, globally. Consequently, a complete global transition in aging will affect all cultures challenging families, legislators, and health care systems to meet the growing needs of global aging. One specific need is depression, which already affects millions and is one of the leading causes of disability, suicide, and loss of productivity. Depression is “a common mental disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration� (WHO, 2011).

This research article explores culture, aging, and

depression between collectivistic and individualistic cultures hypothesizing that the traditional collectivistic intergenerational household familial organization serves older adults as a buffer against depression while the contemporary individualistic cultural model disserves older adults and even promotes depression. On the one hand, conceivably, depression rates among older adults within collectivistic cultures are lower than in individualistic cultures possibly because meaningful intergenerational

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interactions, (e.g. presence and dialogue) are not only socially constructed, but also formally structured within collectivistic cultures through cross-generational households. Consequently, older adults may have a greater sense of self-worth and derive self-esteem from sharing life experiences and transmitting gained cultural wisdom to younger generations. On the other hand, depression rates within individualistic cultures are higher primarily because many older adults live at assisted living facilities and long term nursing facilities in which meaningful intergenerational interactions are extremely limited, even though nurses and staff surround them, they are still isolated and unable to fulfill this inherent need to engage and share. Following this logic, certain therapeutic narrative gerontological programs, (e.g. Reminiscence, Life Review, and Guided Autobiography) should lower depression rates within individualistic cultures. Accordingly, families, legislators, and healthcare providers should consider planning and implementing psychosocial to meet the psychosocial need to share oneâ€&#x;s life experiences transmitting gained cultural wisdom while deriving a sense of self-worth and self-esteem. Anthropologically, cultures are systems of symbolic meaning, which include not only the explicit, but also the implicit beliefs, values, assumptions, and attitudes normalized overtime and socially shared by group members through distinct patterns of language, behavior, and practices. Generally, social scientists broadly categorize cultures as either individualistic, (e.g., Western) or collectivistic, (e.g., Eastern). On the one hand, individualistic cultures normalize whatever has reinforced the individual as distinct from society making personal achievement and selffulfillment primary goals. On the other hand, collectivistic cultures normalize whatever has reinforced the individual as indistinct from society making group cohesion and saving face primary goals. Consequently, older adults within both individualistic and collectivistic cultures

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have normalized extremely different ways of culturally expressing positive and negative emotions vocally and behaviorally. Researchers Dein and Huline-Dickens (1997) investigated numerous empirical and epidemiological studies that utilized methods to recognize depressive symptoms across cultures reporting “that rates of depression [between the two older adult populations] are higher in Western cultures than in Japanese culture…. attributing the difference to family structure” (pg. 116).

Why were depression rates lower in the collectivistic culture‟s family structure?

Undoubtedly, the ascribed role and status held by many older adults within collectivistic family structure provides a sense of self-efficacy and self-esteem, which should guard against developing depression. Lamb‟s ethnography (2000) White Saris and Sweet Mangoes elucidated through a number of case studies many cultural aspects and familial dynamics regarding aging in India, which is a collectivistic culture like Japan. Traditionally, the collectivistic familial organization is patrilocal and hierarchical multigenerational cohabited living.

Interestingly, several

collectivistic cultures consider the bride as literally having joined the groom‟s paternal line or “stem,” (e.g., bamsa in India and ie in Japan). Normally after marriage, the eldest son has taken the leader role of the multigenerational household; consequently, inheriting assets, responsibility to continue the family linage, ancestry worship, and obligation to care for his aging parents. Within this type of family structure, “intergenerational reciprocity” is normal. That is, the parents cared for and provided the son with “material goods, food, and breast milk” and in return, he provides for his aging parents while his wife serves them, literally.

Although

hierarchical, this familial system promoted loving non-hierarchical giving or “mutuality in reciprocating” as well (Lamb, p. 67, 2000). 3


Furthermore, older adults who live in individualistic cultures may not accept help financially, especially if they cannot reciprocate, although they raised their children. This one way reciprocity most likely a consequence of the normalization of making oneâ€&#x;s own way through life seeing help in old age as charity. Perhaps, many adult children in Western culture have offered their older adult parents the opportunity to cohabitate, just to have their parents say no leaving them alone, unfortunately. Surely, there are many opportunities to share oneâ€&#x;s life in both the Indian and Japanese cultures surrounded by younger generations of children and grandchildren. Although these older adults no longer provide materially, as they did when they were younger, actually, they give something even more valuable to their young; that is, their life stories and gained cultural wisdom, which their aging parents shared with them. Therefore, the collectivistic type of familial system provides older adults an important function and role as the sages of culture and knowledge, making it likely that older adults have high self-esteem. Although there are many differences between individualistic and collectivistic cultures, the roles one has played have proven to be important to older adults within both cultures. What happens when older adults no longer have roles to derive meaning in purpose in life? Presumably, their mental health would be affected possibly causing depression. Kikuzawa (2006) researched older adults from Japan and the United States regarding the importance of their roles concluding that both populations almost equally believed roles were essential. However, Americans believed the role of community volunteer was more important than the Japanese did (pgs. 69, 70). To the point, Japanese older adults were more engrossed with family roles than Americans were; what is more, Japanese older adults who lived in an intergenerational household with adult children showed to have less depression (p. 67). Evidently, older adults in

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both types of culture believed social participation was important regardless whether within the family or the community. As a result, social capital has proven to promote mental health in older adults, as well as buffer against depression. That is, older adults who had social resources in Japan presented less depression. Most likely, the Japanese older adults have enjoyed sharing their life experiences within their social arrangement of family or community members. Observably, in individualistic cultures many older adults are at risk for losing both roles and social capital by either living alone in their own home, which is true isolation, or faced with living in a healthcare facility wherein the lack of quality interaction and socialization is likely. The Western social structure seems extremely disadvantageous for many older adults making the perfect depressive environment consequently reducing the quality of life. Rationally, it follows that many older adults who have been isolated are more prone to develop depression due to feeling lonely and sad. At the same time, some older adults who live alone have not developed depression. Could some older adults be predisposed genetically to develop depression? Sprangers et al (2010) explained that several genes might prove to be important in developing depression, although researchers have not yet established a definite causal connection between specific genes and depression (p. 1432).

However, in 2010,

researchers Chiao and Blizinsky, who hold the culture-gene coevolutionary theory, reported that indeed they had found a connection between the serotonin transporter geneâ€&#x;s polymorphic region (5-HTTLPR) and depression. The “theory posits that cultural values have evolved, are adaptive, and influence the social and physical environments under which genetic selection operatesâ€? (p. 529).

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Accordingly, the 5-HTTLPR contains a short allele (S) and a long allele (L) and a person who carries the S allele produces more of the neurotransmitter serotonin than a person who carries the L allele. Therefore, the person carrying the S allele is more likely to develop depression in a stressful environment than the person who carries the L allele (p.530). Interestingly, Chiao and Blizinsky concluded that collectivistic countries showed more prevalence of the S allele, yet had less prevalence of depression suggesting, a novel demonstration of culture–gene coevolution of human behavior. Emphasizing social norms that increase social harmony and encourage giving social support to others, collectivism serves an „anti-psychopathology‟ function by creating an ecological niche that lowers the prevalence of chronic life stress, protecting genetically susceptible individuals from environmental pathogens known to trigger negative emotion and psychopathology.

These findings complement notions that cultural values of

individualism and collectivism are adaptive and by-products of evolution, more broadly. (p. 534). Most likely, a diathesis model of depression is best. That is, both social or environmental and biological factors contribute to the expression of depression. The research on the life review process, culture, and depression is seemingly nonexistent, although there is some research on life review and depression rates of older adults who live in nursing homes. Cappeliez (1991) conducted an intervention with clinically depressed residents utilizing a type of life review called “cognitive reminiscence therapy” that promoted sharing one‟s life story; concluding, “The intervention had the effect of relieving depression” (p. 312).

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By developing more programs that allow older adults in individualistic cultures to share their life story, depression rates may go down. Individualistic cultural members normally express negative emotions readily while collectivistic cultural members usually conceal negative emotions to maintain social solidarity. In theory, it may have been difficult to measure symptoms of depression within collectivistic cultures considering the symptoms of depression are inherently negative. That is to say, cultural norms that have promoted saving face may have confounded measuring symptoms of depression within collectivistic cultures. Consequently, having made results from cross-cultural analysis between any of the studies mentioned in this paper invalid. The different assessment tests used to measure symptoms of depression in cross-cultural studies may not measure variances in symptoms of depression between dissimilar groups accurately. In a 2009 study, Kim et al examined three diverse groups of older adults to determine whether each group‟s answers on the Center for Epidemiologic Studies Depression Scale (CESD) were “culturally equivalent” concluding that all three groups “did not report their symptoms equally” due to each group‟s culturally varied explanatory models of depression (pgs. 790,794). Accordingly, “because of such cultural variations, it has become a virtual truism in cross-cultural research that … diverse groups manifest different prevalence rates of probable depression and different group means on standard inventories” (p. 790). Furthermore, to facilitate legitimate cross-cultural equivalence and justifiable comparisons, researchers need intercultural-metric tests that measure the same depressive symptoms between cultures controlling for culturally different conceptualizations.

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In spite of everything, I believe depression rates in individualistic cultures are higher than in collectivistic cultures because not having a social and/or familial structure conducive to sharing life experiences and wisdom, routinely. It may be a biological and/or evolutionary need to share life experiences as an older adult with both peers and youth. Intergenerational living has served humankind much longer than the Western model. Therefore, perhaps humankind should embrace and structure intergenerational living once again around the world.

Regardless,

institutions in the Western culture that care for older adults in facilities should develop programs in which older adults have many genuine opportunities to engage active listeners in sharing their life story. By 2045, with such a huge global population of older adults, it may be crucial.

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References Cappeliez, Philippe (1991) Critical Advances in Reminiscence Work From Theory to Application. (2002); New York Dein, S. S., & Huline-Dickens, S. S. (1997). Cultural aspects of aging and psychopathology. Aging & Mental Health, 1(2), 112-120. doi:10.1080/13607869757209 Lamb, Sarah (2000) White Saris and Sweet Mangoes Kikuzawa, S. (2006). Multiple Roles and Mental Health in Cross-Cultural Perspective: The Elderly in the United States and Japan. Journal of Health & Social Behavior, 47(1), 6276. Retrieved from EBSCOhost. Sprangers, M. G., Bartels, M., Veenhoven, R., Baas, F., Martin, N. G., Mosing, M., & ... Swaab, D. (2010). Which patient will feel down, which will be happy? The need to study the genetic disposition of emotional states. Quality of Life Research, 19(10), 1429-1437. doi:10.1007/s11136-010-9652-2 Joan Y., C. (2010). Culture–gene coevolution of individualism–collectivism and the serotonin transporter gene. Proceedings of the Royal Society B: Biological Sciences, 277(1681), 529-537. Retrieved from EBSCOhost. United Nations Department of Economic and Social Affairs (2009 Population Division Report) http://www.un.org/esa/population/ World Health Organization http://www.who.int/mental_health/management/depression/definition/en/

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Depression