Coincidences of Substitution Systems

Recent studies have demonstrated that explanations of depression as a biological illness lead individuals with and without depression to be more pessimistic about recovery and to feel less in control of their mood. However, this research has not examined the effects of biological explanations of depression in the discursive and social context in which talk of health and illness travels. The present study compares the effects of two psychoeducational interventions about the biology of depression, one deterministic and one malleable. Participants were exposed to one of the two interventions or were shown no intervention and were then asked to produce an open account of the cause and recovery from depression. Quantitative content analysis of open responses indicated that, relative to control, the deterministic biological explanation led to increased prognostic pessimism and decreased optimism while the malleable biological explanation increased pessimism without decreasing optimism. Qualitative content analysis reveals inconsistencies in participants’ responses whereby the depressed person is represented as both in control of their recovery and not responsible for their descent into depression. This analysis also suggests differences between participants who view sadness and depression as existing on a spectrum and those who view sadness and depression as categorically distinct entities. The findings are discussed in light of the social and moral dimensions of health and illness accounts.