Thursday, March 15, 2007

mormon women and depression

I had already written this post, but a couple of posts by a fellow exmo, Within the Bubble, prompted me to post this now (see his story and more general ideas about mental illness among Mormons).

For a while now, I've been interested in this idea thrown around among Mormons that Mormon women or Utah women have a higher rate of anti-depressant use than the rest of the country. It is bandied about by believers to criticize the super-mom syndrome that, they would say, Mormon culture encourages, but that the True Gospel discourages. It is mentioned by non-believers to support how Mormonism messes women up. I've heard this many times, but I have never heard it backed up by references. It seems to have taken on the status of mythology. Does anyone have any references?

I've been wanting to find out more if any actual research has been done on this. So recently, I poked around at some peer-reviewed literature on Mormons. I found one 1984 study* done on Mormon women and depression (not saying there aren't more, but this is the one I found in my non-thorough looking).

In it, 143 Mormon women and 36 non-Mormon women in Salt Lake were interviewed by phone, and were asked about religiosity and depression, along with some demographic questions (income, number and ages of children, etc). To assess depression, the interviewers used the Beck depression inventory, which is still used today and considered accurate. To assess religiosity, interviewers asked about frequency of church attendance, temple attendance, and prayer, and also "religious motivation."

This study found that there was no difference in the percent of each group of women with regards to current depression, as assessed by the Beck inventory, over the phone. Both groups had about 23% depressed women. Among the LDS women, those who were less educated, felt less caring from a spouse, rated their health poor or fair, and had lower incomes were statistically more likely to be depressed. No surprises there. I would think these hold true for any female, American population.

There were also some intriguing differences among LDS women on some other factors, but none of them were statistically significant (that is, the differences might be only random, not real, because of the sample--but they might be worth studying more). For example, among LDS women, these women were more likely to be depressed:

-infrequent church attenders
-frequent temple attenders
-infrequent pray-ers
-those with non-Mormon husbands
-those with extrinsic religious motivation

Now, it would be easy for a believer to look at this and say, "See, we need to go to church and pray more, just like the leaders say!" But I would posit that depression related to infrequent prayer and attendance are not causal, but only correlated. In fact, this study simply cannot tell us which came first--the depression or the infrequent attendance/prayer. It could be that people who are depressed go to church and pray less often because of depression (likely). Or it could be that people who go to church and pray less often get depression because of not praying and going to church (not likely). Most likely of all, there is a very complicated relationship, involving many other factors that aren't taken into account here. For example, a third factor could be causing them both, i.e., religious doubt and disaffection could lead someone to skip church and experience depression.

Intuitively, one would think that frequency of church attendance, temple attendance, and prayer would all go together--but they don't in this study. This anomaly could be due to the methodological inadequacies of this study, though I am tempted to wonder if frequent temple attenders are depressed and desperately seeking some respite through temple visits. It could be the other way around--that temple attendance is causing depression--but, as much as I would like to believe that, I doubt it.

It does make sense that women with non-Mormon husbands would experience a greater degree of stress, and perhaps depression, given the emphasis placed on the importance of temple marriage, etc. (See my previous post about Mormon marriage and divorce.)

But it's the last one, the extrinsic religious motivation, that intrigues me the most. Simply put, those who attend church because of reasons outside themselves--social life, conformity, family pressure, etc.--had more depression (but not significantly so, remember) than those who attended for their own, internal beliefs --faith in God, it brings inner peace, etc. I wonder if "extrinsic religious motivation" parallels some of the Bloggernacle/DAMU terms we use--New Order Mormon, faithful non-believer, liberal Mormon, etc. If so, are NOMs more likely to be depressed? And why? Is it because of the stress and identity issues of being in the non-believer's closet, as they generally are? Is it related to cognitive dissonance? Is it related to spousal troubles, since many NOMs aren't just ex-mos because of a faithful spouse? Or is the faithful who are more depressed, driving themselves batty trying to live the gospel just right?

So I decided to check out the questions used by this study to measure this aspect of religiosity, wondering if the questions get at situations unique to Mormonism. (In another post.)

*Spendlove, et al. Risk Factors and the Prevalence of Depression in Mormon Women. Social Science & Medicine, Vol 18, No 6, pp.491-495, 1984. If you want a pdf, email me at fromtheashesblog@gmail.com

6 comments:

Anonymous said...

I agree that there is a social/religious component. There's no question of that in my mind.

BUT I also strongly believe that there can be a chemical cause to depression. It's quite possible that people with nordic backgrounds are genetically pre-disposed to depression. Or the relationship could be just coincidental instead of causal (depression just a coincidence instead of caused in part by activity levels in mormonism).

Finally - I feel strongly that all the WORK that mormonism requires of its members, especially active members can be taxing. Sometimes, if you don't have a minute to breathe - it can be rough. People are doing and working all the time - without a great deal of benefit. Not all people, but many. Everybody had to go to everything - and not only go, drag your kids, but be happy about it. How exhausting!!

I'm definitely interested in your next post about this topic.

Jonathan Blake said...

It's surprisingly difficult to find a citation for that anitdepressant study even in the big news outlets.

Your post reminded me of something that Bob McCue said in one of his articles. He remarked that Mormon culture sabotages those who live on its fringes. These people receive the message that they are less worthy, less virtuous human beings. Those who make a clean break are no longer affected as strongly by these messages. So there's a dangerous middle ground where you're neither in nor out of the Church.

from the ashes said...

aerin- YES! Absolutely there is a chemical component. Depression is a combination of genetics, chemicals, and environmental causes. It's different for everyone. I can specifically link my "it" days to 1) being messed up by Mormonism and the process of leaving Mormonism, and 2) immediate emotional triggers. But others have other links; and yet others just have chemicals go screwy on them.

Jonathan- That idea from McCue is very interesting. It is incredibly difficult to live on the fringe, neither in nor out. It has to be psychologically taxing. If this group does have more depression, we must be very careful saying so--TBMs would interpret it as a result of their sin, lack of testimony, etc--further alienating many of them.

C. L. Hanson said...

Excellent analysis -- I'm looking forward to the next segment as well. I've also been annoyed by this oft-cited fact and how it must prove this or that when clearly there's something complicated going on.

Regarding Jonathan and Bob's idea, I think there's a lot of truth to it. The LDS church likes to promote this image that Mormons are successful and have happy families and likes to give the impression that it was Mormonism that caused the success and happiness. But an easier way to increase the proportion of families that make Mormonism look good is to give plenty of encouragement to the people who promote the right image while creating obstacles for the less-photogenic contingent...

Unknown said...

Given the small sample size, it is not surprising that the variables are not statistical significant.

I am not convinced that a survey method such as the Beck Depression Inventory can adequately measure a phenomenon that might well be interpreted as a personal deficiency in the context of a group that exercises high levels of social control.

The marketing data on anti-depressant data is objective. We know how much medication is sold there and apparently Utah leads the United States (and the United States leads the western world).

In survey research, one always has to wonder why people would honestly reveal their opinions, feelings, and experiences.

from the ashes said...

chanson- thanks. That's an interesting idea, that the culture marginalizes those who don't meet the ideal. Frankly, I think a whole lot of Mormon families would admit that no one meets the ideal--privately. But keeping up appearances is vital.

My old neighborhood saw my family as that perfect family. But really, there was depression, anxiety attacks, we were socially challenged, and we fought and had problems just like any other family. But it's true that none of us drank, got pregnant, went "inactive." Now, of course, I'm the black sheep. BUT no one outside the family knows that. My family continues to keep up appearances.

Hellmut- You bring up some very good points. One, the sample size was small, and when they did sub-analyses, this made the n even smaller. Unfortunately, we can't guess which way the data would have gone with a bigger n. The differences could have become stat. significant; they could have become not different. More studies need to be done.

The authors were concerned that the Beck would be inadequate over the phone. They acknowledged that as a potential weakness. They did not, however, recognize as you have done, that there may be something about this particular culture that would make social desirability bias that much stronger. This would lead women to not reveal true feelings for the sake of appearances.

If this is so, we have to ask: Was this social desirability bias different for Mormon and non-Mormon women? If it was not different, then the bias exists in both %ages of depression, and there remains not difference. However, if Mormon women "hid" their depression more often than non-Mormon women, we have a problem. This would artificially decrease the Mormon women's depression prevalence. Which would mean Mormon women were more depressed in this sample.

But we don't know.

The marketing data would be more objective than this telephone survey. But where is it? Is it from NHANES? A small study? I've never seen the data, only heard it repeated to the point of mythology.

Survey research certainly has its inadequacies, and renders complex things too simple. I prefer qualitative research myself. But some women might be more willing to reveal true feelings over an anonymous phone call than even to a friend or ward member.