Qualitative Interview Themes on Depression

One of our potential designs involves developing a multi-sited, mixed-methods research project to study depression and related cultural concepts of distress in women across diverse sociocultural settings.

The aim of the study would be to better understand women’s experiences and why women, when compared to men, are more likely to suffer from depression.

One arm of the study will involve open-ended, qualitative interviews. What questions or themes would you explore with participants?

Relying on open ended questions for data os generally not a good idea and.they should be the exception rather than the rule. Fortunately, this is possible in most cases of well designed well executed studies. This is because your literature review, if done properly, should be able to generate loads of closed end questions quickly.

The best approach is to ask whether the issue is best studied with a question posed to a respondent either in written form or interview on one hand or unobtrusive measures. Only if neither of these approaches is satisfactory should you consider an open ended question. This is Second open end are difficult to analyze properly The difficulty in analyzing them comes from the old problem of cost of data collection versus the power of the analysis. Data from open ended questions are expensive to collect and therefore the usual approach is to do small scale studies with open end questions, so called qualitative studies. In the hands of a sensitive social and behavioral scientist this can be very fruitful. But the sensitive social and behavioral scientist is not easy to identify in a foreign cultural context. And this study of depression must of necessity confront that problem because its aim is to close data gaps.across many societies.

The problem of small data sets, of course, is that statistical analysis is not feasible or its value very slim. There is a way around this known as grounded theory in social science. But most of the people familiar with grounded theory are qualitative scholars who disdain statistics. And few of the good survey scientists are familiar with it. I am one of the few quantitative analysts who understands this technique and my views are still controversial.

Let me illustrate my points with an example of a survey that made good use of an open ended question. The study was done by three investigators, rural sociologists in Kentucky, named Busch, Lacy, and Sachs in 1983. After developing a list of 21 criteria of problem choice in agricultural science from interviews with agricultural scientists they collected data 1,431 scientists on the question “During the last five years , how important were the following [21 considerations ] in your choice of research problems?”

Busch, Lacy, and Sachs generated a very interesting data set from this question. Unfortunately, their statistical analysis was problematic (they used a factor analysis correctly but did not spot its theoretical significance from the standpoint of important general models in social science especially the Cohen,March, and Olsen “garbage can” model.Consequently, their research note, although of great intellectual importance, was neglected for decades. I called attention to their work because it was a critical piece of research in my own study of problem choice in science. As I stated in my own work it anticipated my findings by many years although that was only apparent after I reanalyzed their results in light of my own theoretical scheme.

This case holds valuable lessons for designing the cross national study XPrize intends to do. First, draw up a list of theoretically relevant closed end questions to facilitate comparability across studies. Second, do draw up a list of behaviors and other objective manifestations of mental illness that require observation, as discussed by experts in unobtrusive measures. For example, depression may be exhibited in such behaviors as indifference to appearance, skipping meals, lack of tidiness in care of belongings. Or it can be exhibited in other behaviors or cues and this is where the barefoot doctors are valuable. But the illness of bipolar syndrome which is related to depression also includes behaviors that seem quite the opposite of depressed behavior and bipolar syndrome may also occur in societies that are not western although its manifestations are quite different. It is only after doing this very careful work of developing closed end questions and unobtrusive measures that the research should even consideropen ended questions and the knotty issues of how to get enough cases tgo analyze while living within budget constraints.i


Thanks @boblf029 for sharing your thoughts.

@rebecca, @Ethel and @sshinde - What are your thoughts on the type of qualitative interview questions necessary to understand women experiencing depression.

@Shashi first, sorry for falling of the radar. I got sick with covid 19 end March and I’m still not really well but I’m trying to connect with the world again.
When it comes to depression, from my own experience and from talking to many female friends about it, what we often realize in hindsight, when we start to feel better, is that there were issues no therapist ever asked about and that we didn’t think about ourselves during the depression. So many of us are tired of being thought of, explicitly or implicitly, as the housekeeper of the family, tired of being expected to do the care work, tired of being disrespected by co-workers, patronized by men around us, harassed etc. Often it’s not one incident, it’s small incidents, so small that if you describe one the therapist (and others) would just not credit it as a serious incident. But being exposed to subtle and not-so-subtle sexism day after day, year after year, when you know and believe that you have the right to be treated as an equal and with respect, really takes a toll on you. We already know that being exposed to racism leads to both physical and psychological stress. Somehow we have forgotten that being exposed to sexism can lead to the same thing. It might not always be the sole reason for a depression but it sure doesn’t help. And no woman suffering from depression among the one that I know, including myself some years ago, has ever been asked about exposure to sexism. We might not even realize it ourselves as it is so normalized and it is incidents that goes on over many years. Hence we don’t bring it up ourselves. I really don’t think that it’s weird that more women than men suffer from depression.

Thanks AsaEkvall for the insightful observations about the sources of your own feelings of being slighted and perhaps marginalized. We need to hear these accounts especially from accomplished women such as yourself if we are to solve our problems of gender data gaps in depression etc. But we also need to hear from men because being slighted and marginalized is not simply a problem of women. Racism in America is all about the slighting and marginalization of black men, far more than women by white men. Unfortunately, we are seeing some counterproductive ideas being offered to address this marginalization and disrespecting of people. But those ideas are evidence of the fact that any fundamental change in the way of doing things is going to threaten people and few react to that threat to their status with reason and empathy for the protesters.
I emphasize the victimization of males in the form of marginalization and disrespect because to understand women’s plight and address it properly we have to lift all boats. Racism, or more generally xenophobia, destroys the people who act in these inappropriate ways as well as the victims of their actions. We will only solve the problem of women’s depression if we work on the problems of men as well and we may be needing to work on men’s problems even to be able to properly measure women’s problems.

Thanks @“ÅsaEkvall” for connecting again with us sharing your thoughts on depression in women. I wish speedy recovery for you.

Thanks @boblf029 for sharing your perspective on Asa’s comment.

Hello @munnatic, @staceyo, @sadiew, @gmterwindt, @shruti - What are your thoughts on the type of interview questions necessary to understand depression. Thanks.

Hi @Aria, @yasmeenhassan1, @KarenBett and @pepsicola28 - It would be great to hear your thoughts on the type of interview questions / themes necessary to understand women experiencing depression. Thanks.

Hello @ukarvind, @ingmarweber, @Vrabec, @Suneetharani and @Hanadibader - Please share your thoughts on the type of interview questions / themes necessary to understand women experiencing depression. Thanks.

Hello @mhackett, @panderekha, @Mohammadimr, @AnnalijnUBC - It would be great to hear your views on the type of interview questions / themes necessary to understand women experiencing depression. Thanks.

If your aim is “To better understand women’s experiences and why women, when compared to men, are more likely to suffer from depression.” then qualitative interviews with women will not answer the ‘why women, when compared to men, are more likely to suffer from depression’ part of that question.

The open ended questions will be useful for exploring women’s experiences but it would be good to have them semi-structured. And what you ask will depend on who you ask and when in their depression journey you ask them. If you are asking only women, and only women who have experienced depression - then you can ask about their experience with ‘realising they were depressed how/when/trigger(s), what symptoms they experienced, did anyone else suggest they may be depressed, did they think themselves they were depressed etc.’ Did they seek help ‘how/when/why’. Stigma ‘did they tell others, are they selective in who they tell, was treatment suggested, did they take it, what type (talking, medication, etc), do they feel they’ve been treated differently if they’ve told others, have they been actively discriminated against’ Are their cultural taboos around mental illness. Are there culturally specific ways of expressing symptoms, receiving a diagnosis, appropriate treatments etc’. Recurrence ‘are they concerned about getting depression again, do they think they know what if anything caused their depression’ etc etc. You need to have a fair idea of what you think you want to be able to say at the end of the study so you can work backwards and ask the right questions. If you are asking all women (with and without the experience of depression) then those without depression can be asked about their thoughts on the above, or their observations of others, but not their experience with…

As for 'why are women more likely to experience [please don’t use suffer - no consumer I know likes this term] depression than men? That is a whole different study. It would include men and women and there are multiple different study designs that could partly answer aspects of that question…but qualitative interviews of women isn’t one of them.

Thanks @mhackett for sharing thoughts on this discussion.

Hello @ktabb, @jessgong, @bwilcher and @Eva - As all of you’'ll are health professionals, we feel you may have thoughts on type of interview questions / themes necessary to understand women experiencing depression.

Join the discussion to let us know what you think. Thanks.

Hi @stellunak, @adanvers, @WD_Research and @DrLiliaGiugni - join the discussion to share your thoughts on the type of interview questions / themes necessary to understand women experiencing depression.

Sorry for the delayed response. I would think the most important point about the questions and themes for the fieldwork is, how are the questions framed? The questions have to be layered and sensitive to the respondent. Anxiety to elicit answers should be completely avoided. Rather, it should be the urge to learn from the respondents that should mould the questions. I believe, open- ended questions will be more helpful as silences, wording, priority of information will be the best clues to understand the respondent’s experiences, and her response to her experiences.
The themes of this research could be focusing on the woman’s experience and perception of depression as well as others’ perception. For instance, one theme that is one section of questions could be framed with the respondent in the centre. One set could have the family members in the centre and the other could have the medical care givers. Experience, Expression, Perception, Response, Solutions, and Support Systems could be some of the most important themes.