Sociology of Mental Illness

Midterm

Medical Model of Mental Illness

Treats mental illness as a disease to cure with medication. MI can be explained by genes, biochemical imbalances, neural defects, and hormonal issues

Social Constructivist Approach

Treats mental illness as something based in social constructions of a society, it was invention created by a culture where meanings are attributed to certain behaviors and can change over time making the standards arbitrary

Social constructionism

The creation of a disease based on how a culture views specific behaviors, aka things are determined and labeled due to a given societies ideals.

Symptom focused diagnosis

DSM is the collection co-occurring symptoms involved in a given mental illness, symptom focused relies on how long and level of impact a symptom has in order to be considered harmful and in need of treatment 

Mental illness

A collection of symptoms of health-related behaviors and functioning

Depression Symptoms

1) depressed mood, 2) lost in interest or pleasure, 3) weigh/appetite changes, 4) sleep disturbances, 5) agitation, 6) fatigue, 7) feeling of worthlessness and inappropriate guilt, 8) Concentration deficits, and 9) suicidal ideation

Illness and Health as a Continuum:

the though process that health is a spectrum between being healthy and being ill and you fall somewhere on that line.

Subjective well-being

Relies on self-report which is not the most robust form of measurement and on a weird scale from health to unhealthy 

Flourishing

positive emotion and positive functioning

Languishing

negative emotion and negative functioning

Keyes’ Model of Flourishing and Languishing

Medicalization

the process when a previously non-medical issue is redefined as a new medical concern that can be treated like a disease (ADHD, Social Anxiety, etc.) 

Pros and cons of medicalization 

Pros: easier to get and seek help, people believe you have a real issue, less social stigma 

Cons: makes it harder for the people with diseases/conditions that aren't recognized to get help,  

Legitimacy

process by which social institutions explain and support the existence of a disorder as being a genuine medical condition

Contested illness

Illnesses that sufferers and their advocates struggle to have medically unexplainable symptoms recognized by medical researchers, practitioners and institutions 

Engines of medicalization:

the forces in society that get to determine what is medicalized and how

Traditional Engines of Medicalization 

1. Medical professionals 

2. Social movements 

3. Organizational change (they decide to change)

Shifting Engines of Medicalization 

1. Big Pharma 

2. Patients becoming consumers 

3. Managed care organizations 

 

Cultural authority

the authority to define for society what falls under the purview of medicine 

Social authority

the ability to define WHO DOES and DOESN’T have a medical conditions 

Consumerization of health care

trend where healthcare becomes more of a commodity that is subject to market forces making patients have more agency as a consumer in their care (they can ask for specific meds now without having to be given random meds by a doctor) 

Demedicalization

very rare but it's when a previously defined medical definition gets basically thrown out and not seen as a disorder to thing to be treated (think being gay) 

Three premises of symbolic interactionism 

1. Human beings act towards things based off the meanings they have for them. 

2. The meaning of such things is derived from, or arises out of, the interactions one has with one’s fellows 

3. Meanings are handled in, and modified through, an interpretive process used by the person in dealing with the things he/she encounters 

Heuristics

a method of classification that relies on general rules of thumb to guide your interpretation

Marx’s Model

The Self

the capacity to recognize one’s consciousness as a social being (object social world “I” and products of social environment “Me”) 

“I” = internal aspect of self, perspective in moment 

“Me” = interactive aspect of self  

Socialization

The process of learning how to behave according to the norms and values of a given society. Ex: school, family, media, culture 

Culture

broad range of stored shared knowledge that is activated when a person needs to navigate social contexts. *Socially produced and depends on socialization

Independent self

Self as an individual based on internal thoughts, feelings and actions.

*Prioritize individual actions and attributes. Focus on individual desires as references 

Interdependent self

Self as a connected group, heavily reliant on social context. Internal attributes are understood as situational.

*Prioritize fit with others and the obligations one has to other individuals and Focus on desires of the other as references 

Cross Cultural Psychiatry

concerned with cultural and ethnic context of mental illness and psychiatric services that seek to identify hidden assumption and limitations, assess whether diagnosis are cross-cultural and identify new approaches and treatments

Culture Bound Syndrome

a collection of symptoms that have been labeled as a dysfunction within a specific cultural setting (Koro)

Characteristics of culture bound syndromes

1. It cannot be understood apart from its specific cultural or subcultural context 

2. Beliefs about its causes reflect core meanings and behavioral norms of that culture 

3. Diagnosis relies on culture-specific technology and/or ideology 

4. Successful treatment is accomplished only by participants in that culture 

Illness

is a patient perception, experience, expression, and pattern of coping with a set of symptoms

Disease

the category that described a set of symptoms someone is experiencing 

Stress

a state of imbalance that a person feels when a perceived or actual disparity between their ability to cope and the environmental demands (what is felt because of a stressor)

Stressors

a social factor that causes stress 

Life events

important and specific events/experience that interrupts a persons usual activities and require some adjustment 

Chronic strains

relatively enduring problems, conflicts, and threats people face in their daily life (homelessness, war, etc.) 

Stress Proliferation

new or “secondary” stressors that emerge from the 1st stressor that someone was exposed to 

The Stress Process Model 

Exposure hypothesis

people with low SES are exposed to more stressful life experiences than those in higher status and because of that they are more likely to experience more distress because they are exposed more frequently.

Vulnerability hypothesis

people with low SES are more impacted by stressful experience than those in higher status due to their poor access to resources to manage stressors

Coping strategies

behavioral or cognitive responses to a stressor that helps a person prevent or ally harm that would otherwise be caused by the stressor

Social resources

social supports and networks

Social Support

access and use of significant others, friends, family, or organizations that provide functions that help alleviate the  impact of stress

Types of social support

1. Emotional - assurance of love and care; sympathy, understanding, worth 

2. Informational - advice on opinions in dealing with stress 

3. Instrumental - assistance with practical tasks that can address stressors directly 

4. Perceived - belief that support is available; far more impactful on our mental health than actually receiving support 

Personal Resources

1. Mastery - a sense of personal control over our life 

2. Self-esteem - how we feel about ourselves 

3. Values - enduring goals that one strives to achieve across all contexts 

4. Meaning - one’s understanding or perception of social phenomena 

Social Epidemiology

study of the causes and distributions of diseases and impairments within a population 

Any mental illness (AMI)

can be mental, behavioral or emotional based disorder ranging in severity and impairment

Severe mental illness (SMI):

results in serious functional impairment and inhibits a personas ability to participate in major life activities (most societal burden lies here) 

Prevalence

the total number of cases if an illness in a population 

Prevalence Rate

total number of case divided by total number of the population (used to help understand burden of illness)

Incidence

number of new cases of an illness in a pop 

Incidence rate

# of new cases divided by total # in pop 

Mood disorders

underlying problem primarily affects a person’s persistent emotional state

Anxiety Disorders

underlying problem features excessive worrying and related behavioral disturbances

Socioeconomic Status

an individual’s standing in a ranking of positions based on education, occupation, and income

Social Selection Model

argues mental illness causes changes social status change 

Social Causation Model

argues that social status causes mental illness 

Fundamental Cause Theory

argues social factors that persist even after intervention cause illness (social factors cause illness)

Sex

socially agreed upon biological criteria for classifying people as male or female

Gender

cultural beliefs about what is and isn’t “appropriate” behaviors for a sex category

Differential socialization

the process through which men and women are raised to accept different roles in society 

Status

a position in a social system that give you designated rights and obligations (aka your position in society) 

Roles

the behavioral expectations that are associated with your position in society

Types of roles

1) Basic roles - roles that are grounded in society and exist outside of specific institutions (e.g. race and gender) 

2) Structural status roles - roles attached to a position or status within a given organization (e.g. family roles) 

3) Functional group roles - not formally, but are recognized in the cultural lexicon (i.e. voice of reason, devil's advocate) 

4) Value roles - the embodiment of some recognized value (e.g. hero) 

Gender roles

the behavioral expectations for roles associated with being a specific gender

Emphasized femininity

concept of gender that emphasizes submissiveness, nurturance, and emotional sensitivity mainly attributed to women 

Second shift

the tendency for childbearing and housework responsibilities to be on women regardless of job status, creates a gender inequality through conflicting role expectation between home and work 

Cost of caring

the increase distress felt by events that happen to significant others (marital conflict, child issues, health of loved ones etc. are more stressful for women) 

Hegemonic masculinity

concept of gender that emphasizes assertiveness, competitiveness, and independence mainly attributed to men 

Internalizing Disorders

truing problematic feelings into oneself through depression, anxiety, self-blame and self-reproach

Externalizing Disorders

turning problematic feelings outward into anti-social behaviors, aggression, substance use, and trouble forming durable close relationships

Situational Hypothesis

argues men and women use different coping styles because they experience different stressors

Dispositional Hypothesis

(or role restructuring) argues that men and women use different coping styles regardless of stressor because of gender socialization and different dimensions of the self 

Race

socially constructed status defined through and by social interactions across historical time that categorizes people according to phenotypic (physical) variation (used to stratify society)

Risk factors for American Indians

fare worse for mental illness almost always  

Risk factors for Black Americans

like Hispanics findings are mixed but discrimination plays a major factor

Discrimination

behavior that denies the members of a specific group resources or rewards available to others (leads to lower SES) 

Segregation

physical separation of races by enforced residence in different areas 

Alienation

process where people feel estranged from the world they live in as a result of powerlessness, isolation, or lack of meaning 

Protest masculinities

alternative standards of masculinity that formed in response to economic powerlessness as well are barriers to the jobs and education that underline hegemonic masculinity (caused by alienation) 

Code of the street

a set of informal rules that regulate the use of violence and supply a rational for engaging in aggression in an appropriate way (product of low wages, lack of public services, racial stigma and the drug trade). Heart of the code is being treated with respect or “right” by others.

Doing gender

engaging in behavior at risk of gender assignment (pos or neg) 

Doing race

engaging in behavior at risk of race assignment (pos or neg)

Accountability

the assessment (pos or neg) of a person's gender performance by others based on normative conceptions and attitudes about what is appropriate