Mental Illness - Exam 2

What is epidemiology?

What is epidemiology?

• Does not emphasize the individual, but instead focuses on patterns of disease that occur among large groups of people

• Central role is to explain the social factors and conditions in a society that lead to illness

Case

an instance of a disorder, illness, or injury

Risk

• Exposure to disorder, illness, or injury

  • This is looking at the population at risk

Crude Rate

• Divide case (numerator) by risk (denominator)

  • Focuses on the number of cases of an illness at a specified time

  • Divide the population risk by the number of cases. Then multiply by 1,000, 10,000, or 100,000

 How do Mirowsky & Ross define distress?

 Uncomfortable subjective states of being

What are the 3 states subjective states of being?

• Malaise (lethargy, weakness)

• Anxiety (fear, worry, irritability)

• Depression (sad, lonely, feelings of worthlessness)

When examining the prevalence of mental illness, 80 studies were reviewed by Dohrenwend and Dohrenwend.  A consistent relationship was found between mental disorder and social class, location, gender, and education.  What are these 5 trends based on class, location, gender, and education?

• Gender: women more likely

• Location: living in urban or suburban

• Higher education

• Higher income

• Less religious

• Jews

What is alienation?

 Detachment from social and personal relationships, results in isolation

What are the 5 types of alienation?

powerlessness, self-estrangement, isolation, meaninglessness, and normlessness

External locus of control

learned, generalized expectation that outcomes of situations are determined by forces external to one’s self

Internal locus of control

Learned, generalized expectation that outcomes are contingent on one’s own choices and actions

Authoritarianism

belief system with consequences for mental well-being

Inequity

• perceptions of unfairness, injustice

  • Inequity triggers emotions and can also triggers feelings of anxiety and depression

Role conflict

Expectations of two separate roles produce incompatible demands

Role ambiguity

Unsure what the expectation is for a certain role

Role overload

The expectations of multiple roles overwhelm the individual and diminishes resources

What is the strongest, single predictor of good mental health?

Education

Why is Faris and Dunham’s study important?

Earliest study that linked social class and mental health

General findings of Faris and Dunham’s study

• Examined schizophrenia and found a higher concentration of this mental illness in the poorer areas in Chicago

  • Social isolation

  • Social selection and social causation

• Social isolation is an important factor for schizophrenia, although the disorder itself is likely to result in isolation

• A person’s social class has definite implications for one’s mental health

How did Hollingshed and Redlich improve upon Faris and Dunham’s study?

• The link between mental disorder and social class does depend on the disorder examined 

  • The lower the social class, the higher the prevalence of schizophrenia

  • The higher the social class, the higher the prevalence of anxiety

  • The least amount of any disorder, including anxiety, was found in the highest upper class

According to Srole and Associates, which age group had the best mental health?

50-59

According to Srole and Associates which group had the worst mental health?

20-59

What are the contributing factors that lead to mental disorder in children and adolescents?

• Interaction between genetics/biology and the social or environment 

• What are some of the social or environmental factors?

  • Parental/family relations, peers, neighborhood, schools

  • Inadequate care from parents, distressed or dysfunctional parents, low income, community factors

  • Child abuse and maltreatment 

  • Social media

 Why is middle age the best time for mental health?

• After 35

• Earnings, job, marriages are stable

• Kids are grown

• Self-esteem tends to be higher

Why are men over the age of 85 at the highest risk of suicide?

Isolation

Why are men more likely to be admitted into mental hospitals/institutions?

Less likely to seek help when mental is not as bad

   How do women experience mental illness?

• Women are more likely to internalize their distress resulting in anxiety and depression

• The research overall supports that women are more vulnerable to mental disorder than men and this is the case no matter the age group

How do men experience mental illness?

• Men are more likely to externalize their distress resulting in more substance abuse/use, addictive disorders, and personality disorders

• Men are more likely to be admitted into mental hospitals

How does socialization influence gender differences and mental illness?

• Differences between males and females also result from socialization differences 

• It is these gender roles that may lead to the differences we see in terms of women with internalizing disorders and men with externalizing disorders

• Researchers have hypothesized that younger boys endure more stress than girls and suffer from more disorder, but this changes during adolescence

What is the second shift?

Women shoulder the burden of household labor and complete more day-today, mundane tasks compared to men

Gove and Tudor (1973) suggested five aspects that could lead to depression and anxiety for men.  What are those 5 aspects?

• Women who are restricted into one role namely a domestic role limits the sources of gratification for women

• The domestic role results in frustration because of its lower skill and lower prestige compared to work outside the home

• The domestic role is unstructured and invisible

• When a woman is working outside of the home, it is typically in care giving professions or pink collar work that is characterized by low pay and high levels of job dissatisfaction

 What is the double bind?

This is frustration that is felt being in a traditional role and also with a career role

 How does marital status impact mental health outcomes?

Married people have better mental health than the unmarried

 How does marital quality impact mental health outcomes?

Quality matters! Marital conflict and dissatisfaction can lead to stress

What is intersectionality?

how an individual may face multiple types of overlapping discrimination depending on their race, gender, age, ethnicity, physical ability, class or any other characteristic that might place them in a minority class.

How is race related to social class?

• There is one stressor that is unique to race = racial discrimination

• Moderators = A strong sense of identity and having a lot of pride in that identity can reduce the impact of discrimination

What does the research find regarding mental health differences between Whites and Blacks/African Americans?

• The differences that we do see between racial minorities and Whites due to social class

  • Highlights the important of intersectionality

What one aspect can play a major role when it comes to distress and depression for Blacks/African Americans?

• More instances of depression and distress among Blacks because of social class

  • More distress among blacks in a lower SES

  • Not the case for other mental disorders

What are the 4 protective factors that help Blacks/African Americans reduce stress?

• Self-esteem

• Sense of mastery 

• Social support

• Religiosity/church networks

 Hispanics do not seem to have higher prevalence of mental disorder.  Although a low SES and other social problems impact Hispanics, what is the protect factor that helps Hispanics?

Ties to catholic church

  Research on Native Americans and mental illness.  What is the general finding?

• Native Americans do tend to have extensive mental health issues and disorder is higher among Native Americans than Whites

  • Discrimination

  • Lower quality of life

  • Suicide

There are three ways that people become patients or enter the mental health care system.  What are these three ways?

• By choice (this is the majority of patients)

• By force or coercion (this constitutes the smallest group of patients)

• Muddling through (this is a vague, catch all category that includes patients that are not actively seeking help, but not resisting it)

Which groups of people were less willing to seek help?

Men and the poor

Which groups of people were more likely to seek help?

 Females, people who are less religious, Jews, those who live in urban or suburban areas, higher education, higher incomes

 What are the five stages that lead to an individual’s decision to seek help (Kadushin’s research)?

• The person has to decide that they have a problem and that problem is emotional

• The person decides if they should and how much they should reveal their problems to family and friends

• The person decides if they can deal with their problem on their own and if that means is effective or does he or she need professional intervention

• Next, the person has to decide what type of help they need- what type of professional and/or facility

• The person decides which mental health professional they need to see

  There are differences between men and women and their pathways to treatment.  What three things are women more likely to do compared to men?

• To recognize that they have a problem

• To discuss their problem with an seek help from others

• To enter treatment voluntarily

According to Goffman, becoming a patient involves a mentally ill career.  This shift from non-patient to patient involves agents.  Who are those agents?

• Next of relation: This is generally a family member. Sometimes it is the family member who contracts authorities or sometimes a family member also serves as a complainant. The patient will feel betrayed by their family member if their family member is a complainant

• Complainant: The person who actually starts the patient on their path to treatment

• Mediators: The agents and agencies that are involved in the patients pathway to treatment until they become an outpatient or placed in a mental hospital

The police do apprehend those who are acting mentally ill under 5 conditions.  What are those 5 conditions?

• Suicide attempts

• Evidence that a person is disorders

• The mentally ill person has committed or threatens to commit violence

• The person becomes a public nuisance or they may be harmed

• When there is an order to apprehend a mentally ill person through a judge, or through a complaint from a family member, or if the police are notified that a person is a threat by a doctor or therapist

 How does entrance into a mental hospital involve alienation?

Separated from general society, seen as different