A line of research from England, initiated by the sociologists Brown and Harris in the late 1960s, has investigated how severe events and difficulties during people’s life course influence the onset of mental and physical illnesses (Harris 2000).  This work illustrates the idea of intersecting processes in relation to development over a person’s life-course.  In contrast to the dominant emphasis on genetic bases for disease, this work shows that  longituidinal environmental or social exposures can be brought into the analytic picture—provided there is the will and enough effort.

Brown and Harris use wide-ranging interviews, ratings of transcripts for the significance of past events in their context (with the rating done blind, that is, without knowledge of whether the person became ill), and statistical analyses.  Because what might be recorded as the same event, e.g, death of a spouse, might have very different meanings and significance for different subjects according to the context, Brown and Harris’s methods accommodate events with diverse meanings.  At the same time, apparently heterogeneous events can be subsumed under one factor, such as, in explanation of depression, a severe, adverse event in the year prior to onset.  In sum, the Life Events and Difficulties methodology integrates ‘the quantitative analyses of epidemiology and the [in] depth understanding of the case history approach’ (Brown and Harris 1989a, x).

The most sustained research in this tradition involves explaining depression in working-class women.  For a district of London in the early 1970s, Brown and Harris identified four factors as disproportionately the case for women with severe depression: a severe, adverse event in the year prior to the onset of depression; the lack of a supportive partner; persistently difficult living conditions; and the loss of, or prolonged separation from, the mother when the woman was a child under the age of eleven (Brown and Harris 1978; 1989b).  (Subsequent work has added to this picture, but that will not be taken up here; see Harris 2000.)  A reconstruction of Brown and Harris’s work as it stood in the 1980s by the developmental psychologist (Bowlby 1988) suggests how the different aspects of class, family, and psychology can build on each other in the life course of the individual (Figure; see also Taylor 1995).

Figure: Life development pathways to severe depression identified in Brown and Harris’s study of working class women and reconstructed by Bowlby (1988).  The dashed lines indicate that each strand tends to build on what has happened earlier in the different strands.  See text for discussion and sources.

Let me give some simplified and over-generalized examples of such cross-connections: In a society in which women are expected to be the primary caregivers for children, the loss of a mother increases the chances of, or is linked to, the child lacking consistent, reliable support for at least some period.  (Bowlby added his own speculation about early childhood attachment problems.)  An adolescent girl in such a disrupted family or sent from such a family to a custodial institution is likely to see a marriage or partnership with a man as a positive alternative, yet such early marriages tend to break up more easily.  Working-class origins tend to lead to working-class adulthood, in which living conditions are more difficult, especially if a woman has children to look after and provide for on her own.  And, in these circumstances, accidents and other severe events are more likely.  The consequence of a severe event is often, unless there is a supportive partner, the onset of depression (see also Brown and Moran 1997).   Notice, however, that each connection in the Figure should be interpreted as one contributing causal link in the construction of the behavior.  The lines are dashed to moderate any determinism implied in presenting a smoothed out or averaged schema; the links, while common, do not apply to all women at all times, and are contingent on background conditions not shown in the diagram.

In sum, longituidinal environmental or social exposures are brought into the picture, and the picture helps us think about multiple pathways to the focal endpoint of clinical depression.

Extracted from P. Taylor, “Infrastructure and Scaffolding: Interpretation and Change of Research Involving Human Genetic Information,” Science as Culture, 18(4):435-459, 2009

References

Bowlby, J. (1988). A Secure Base. (New York: Basic Books).

Brown, G. W. and T. Harris (1978). Social Origins of Depression. (New York: The Free Press).

Brown, G. W. and T. O. Harris (1989a).  Depression in Life Events and Illness. (New York: Guilford Press).

Brown, G. W. and T. O. Harris, Eds. (1989b). Life Events and Illness. (New York: Guilford Press).

Brown, G. W. and P. M. Moran (1997). Single mothers, poverty and depression. Psychological Medicine 27: 21-33.

Harris, T., Ed. (2000). Where Inner and Outer Worlds Meet. (London: Routledge).

Taylor, P. J. (1995). Building on construction: An exploration of heterogeneous constructionism, using an analogy from psychology and a sketch from socio-economic modeling. Perspectives on Science 3(1): 66-98.