Social Determinants Affecting Major Depressive Disorder: Diagnostic Accuracy for African American Men

Research consistently shows that African American men with major depressive disorder are underdiagnosed. One reason for underdiagnosis is that various social determinants influence depressive symptom presentation. This study draws from a random sample of 218 California licensed clinical social workers and licensed marriage and family therapists who were presented with experimentally designed clinical videos online and asked to make diagnostic judgments. Clinicians presented with videos of a male client with depressive symptoms influenced by social determinants were less accurate in their diagnoses than clinicians presented with videos of a depressed male client expressing classic depressive symptoms. A qualitative analysis of clinicians' statements about their diagnoses revealed that they often saw culturally influenced depression symptoms as related to a behavioral disorder or a personality disorder rather than a mood disorder. Based on these results, best practice recommendations are presented for clinicians who assess African American men with depression.