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Unformatted text preview: Social​ ​epidemiology ● Social​ ​epidemiology ○ ​ ​Definition​ ​:​ ​the​ ​branch​ ​of​ ​epidemiology​ ​that​ ​deals​ ​with​ ​the​ ​social-structural determinants​ ​of​ ​health​ ​and​ ​illness ○ Assumes​ ​that​ ​the​ ​distribution​ ​of​ ​health​ ​and​ ​illness​ ​in​ ​a​ ​society​ ​reflects​ ​the distribution​ ​of​ ​advantages​ ​and​ ​disadvantages​ ​in​ ​that​ ​society ○ ● Reading​ ​by​ ​Pearlin:​ ​The​ ​Sociological​ ​Study​ ​of​ ​Stress ○ Sociologists​ ​have​ ​an​ ​“intellectual​ ​stake”​ ​in​ ​the​ ​study​ ​of​ ​stress ■ Meaning​ ​that​ ​it​ ​seeks​ ​to​ ​establish​ ​the​ ​unities​ ​between​ ​social structure​ ​and​ ​the​ ​inner​ ​functioning​ ​of​ ​individual's ○ Framework​ ​for​ ​status,​ ​stress,​ ​and​ ​mental​ ​health ■ Pearlin​ ​developed​ ​the​ ​framework​ ​for​ ​studying​ ​stress​ ​as​ ​a​ ​social phenomenon ■ Many​ ​stressful​ ​experiences,​ ​do​ ​not​ ​spring​ ​out​ ​of​ ​a​ ​vacuum​ ​but typically​ ​can​ ​be​ ​traced​ ​back​ ​to​ ​surrounding​ ​social​ ​structures​ ​and people's​ ​location​ ​within​ ​them ■ The​ ​most​ ​encompassing​ ​of​ ​these​ ​are​ ​the​ ​various​ ​systems​ ​of stratification​ ​that​ ​cut​ ​across​ ​societies​ ​such​ ​as​ ​those​ ​based​ ​on​ ​social and​ ​ ​economic​ ​class,​ ​race,​ ​ethnicity,​ ​gender​ ​and​ ​age ● A​ ​low​ ​status​ ​within​ ​the​ ​society​ ​may​ ​itself​ ​be​ ​a​ ​source​ ​of stress ■ The​ ​general​ ​point​ ​to​ ​be​ ​drawn​ ​is​ ​that​ ​the​ ​structural​ ​contexts​ ​of people's​ ​lives​ ​can​ ​affect​ ​each​ ​major​ ​phase​ ​of​ ​the​ ​stress​ ​process ■ Primary​ ​stressor​ ​are​ ​those​ ​which​ ​are​ ​likely​ ​to​ ​occur​ ​first​ ​in​ ​people's experience​ ​(​ ​the​ ​stressor​ ​may​ ​be​ ​an​ ​event​ ​that​ ​is​ ​undesired​ ​such as​ ​death​ ​of​ ​someone) ■ Secondary​ ​stressor​ ​come​ ​about​ ​as​ ​a​ ​consequence​ ​of​ ​the​ ​primary stressor ■ The​ ​antecedents​ ​of​ ​stress​ ​need​ ​to​ ​be​ ​understood​ ​in​ ​terms​ ​of process,​ ​whereby​ ​broad​ ​structured​ ​and​ ​institutional​ ​forces, constellations​ ​of​ ​primary​ ​and​ ​secondary​ ​stressors​ ​and​ ​widely shared​ ​values​ ​converge​ ​over​ ​time​ ​to​ ​affect​ ​people's​ ​well​ ​being ○ Moderators​ ​in​ ​framework:​ ​coping​ ​resources​ ​and​ ​social​ ​support​ ​resources ■ The​ ​same​ ​stressors​ ​do​ ​not​ ​necessarily​ ​lead​ ​to​ ​the​ ​same​ ​stressful outcomes ■ Coping​​ ​-​ ​the​ ​actions​ ​people​ ​take​ ​on​ ​their​ ​own​ ​behalf​ ​as​ ​they attempt​ ​to​ ​avoid​ ​or​ ​lessen​ ​the​ ​impact​ ​of​ ​life​ ​problems ● Mediate​ ​-Once​ ​a​ ​behavior​ ​is​ ​labeled​ ​as​ ​coping,​ ​we​ ​assume that​ ​it​ ​succeeds​ ​in​ ​relieving​ ​stress ■ Social​ ​support​​ ​-​ ​having​ ​attachment​ ​to​ ​friends,​ ​family,​ ​and​ ​others​ ​to turn​ ​to​ ​in​ ​time​ ​of​ ​stressful​ ​events ● Mediate​ ​-​ ​if​ ​someone​ ​is​ ​labeled​ ​as​ ​receiving​ ​support,​ ​he​ ​is perforce​ ​supported ● Reading​ ​by​ ​Aneshensel:​ ​Research​ ​in​ ​Mental​ ​Health​ ​Social​ ​Etiology​ ​versus​ ​Social Consequences ○ Difference​ ​between​ ​social​ ​etiology​ ​and​ ​social​ ​consequences social​ ​etiology ■ Causes​ ​or​ ​risk​ ​factors​ ​→​ ​depression ■ The​ ​social​ ​etiology​ ​model​ ​is​ ​concerned​ ​with​ ​the​ ​occurrence​ ​of particular​ ​disorder​ ​and​ ​social​ ​risk​ ​factors​ ​for​ ​it ■ The​ ​defining​ ​characteristic​ ​of​ ​this​ ​model​ ​is​ ​its​ ​focus​ ​on​ ​a​ ​single disorder,​ ​such​ ​as​ ​major​ ​depression Social​ ​consequences ■ Household​ ​poverty​ ​→​ ​mental​ ​illness​ ​outcomes ■ The​​ ​social​ ​consequences​​ ​model​ ​is​ ​concerned​ ​with​ ​the​ ​mental health​ ​consequences​ ​of​ ​specific​ ​social​ ​arrangements ■ Social​ ​arrangements​ ​may​ ​include:​ ​Income,​ ​educational​ ​attainment, occupation,​ ​urban/suburban/rural​ ​location,​ ​race/ethnicity,​ ​gender, sexual​ ​orientation,​ ​age,​ ​religion,​ ​family ○ Why​ ​social​ ​epidemiologists​ ​look​ ​at​ ​social​ ​consequences ■ The​ ​disorder​ ​specific​ ​etiological​ ​model​ ​is​ ​a​ ​problem​ ​for​ ​sociologists, however,​ ​because​ ​the​ ​goals​ ​of​ ​sociological​ ​inquiry​ ​are​ ​usually​ ​not ideological,​ ​but​ ​rather​ ​emphasize​ ​the​ ​consequences​ ​of​ ​various social​ ​arrangements​ ​on​ ​people's​ ​lives ■ From​ ​the​ ​sociological​ ​perspective,​ ​the​ ​mental​ ​health​ ​consequences of​ ​social​ ​organization​ ​are​ ​typically​ ​assumed​ ​to​ ​be​ ​nonspecific,​ ​not limited​ ​to​ ​one​ ​particular​ ​disorder ■ Therefore​ ​they​ ​use​ ​the​ ​social​ ​consequences​ ​model ● Stress:​ ​Portrait​ ​of​ ​a​ ​Killer​ ​video: ○ “fight​ ​or​ ​flight”​ ​response-​ ​why​ ​it​ ​is​ ​no​ ​longer​ ​beneficial​ ​to​ ​humans​ ​in​ ​the 21​st​​ ​century? ■ As​ ​we​ ​evolved,​ ​the​ ​stress​ ​response​ ​saved​ ​our​ ​lives​ ​by​ ​enabling​ ​us to​ ​run​ ​from​ ​predators​ ​or​ ​take​ ​down​ ​prey.​ ​But​ ​today,​ ​we​ ​are​ ​turning on​ ​the​ ​same​ ​"life-saving"​ ​reaction​ ​to​ ​cope​ ​with​ ​$4​ ​per​ ​gallon gasoline,​ ​fear​ ​of​ ​public​ ​speaking,​ ​difficult​ ​bosses,​ ​and​ ​traffic jams—and​ ​have​ ​a​ ​hard​ ​time​ ​turning​ ​it​ ​off. ○ Being​ ​low​ ​status​ ​as​ ​inherently​ ​physically​ ​stressful ○ Higher​ ​rates​ ​of​ ​stress-related​ ​illness​ ​in​ ​developed​ ​world​ ​compared​ ​to developing​ ​world Socioeconomic​ ​status ● Reading​ ​by​ ​Miech​ ​et​ ​al.​ ​“Low​ ​Socioeconomic​ ​Status​ ​and​ ​Mental​ ​Disorders”: ○ Social​ ​causation​ ​vs.​ ​social​ ​selection​ ​models: ○ How​ ​each​ ​conceptualizes​ ​the​ ​relationship​ ​between​ ​SES​ ​and​ ​mental​ ​health ■ Social​ ​causation​ ​:​ ​Social​ ​conditions​ ​→​ ​mental​ ​illness​ ​: ■ Social​ ​selection​ ​:​ ​Mental​ ​illness​ ​→​ ​social​ ​conditions ○ Which​ ​illnesses​ ​the​ ​authors​ ​find​ ​to​ be​ ​associated​ ​with​ ​each​ ​model ■ Social​ ​selection​ ​ ​-​ ​ADHD​ ​, ■ Social​ ​causation​ ​-​ ​anxiety, ● Fundamental​ ​Cause ○ What​ ​does​ ​this​ ​theory​ ​consider​ ​to​ ​be​ ​the​ ​“fundamental​ ​cause”​ ​of​ ​health outcomes? ■ Social​ ​factors​ ​or​ ​socioeconomic​ ​status​ ​influence​ ​disease​ ​rates ● Reading​ ​by​ ​Entin​ ​“Poverty​ ​and​ ​Mental​ ​Health:​ ​Can​ ​the​ ​Two-Way​ ​Connection​ ​Be Broken?” ○ key​ ​finding​ ​about​ ​economic​ ​status​ ​and​ ​mental​ ​health​ ​status ■ Money​ ​cannot​ ​buy​ ​mental​ ​health​ ​:​ ​but​ ​improving​ ​mental​ ​health​ ​can improve​ ​your​ ​economic​ ​status ■ People​ ​living​ ​in​ ​poverty​ ​are​ ​at​ ​an​ ​increased​ ​risk​ ​of​ ​mental​ ​illness compared​ ​to​ ​their​ ​economically​ ​stable​ ​counterparts ■ Mental​ ​illness​ ​causes​ ​a​ ​higher​ ​chance​ ​to​ ​remain​ ​poor. Gender ● Diagnoses​ ​for​ ​which​ ​women​ ​are​ ​at​ ​greater​ ​risk​ ​and​ ​for​ ​which​ ​men​ ​are​ ​at​ ​greater risk ○ Women​ ​(more​ ​internalizing​ ​disorders) ■ Depression,​ ​anxiety,​ ​trauma​ ​related​ ​disorders,​ ​obsessive compulsive​ ​disorder ○ Men​ ​(more​ ​externalizing​ ​disorders) ■ Conduct​ ​disorder,​ ​ADHD,​ ​substance​ ​abuse​ ​and​ ​dependency ● Hysteria ○ 19​th​​ ​century​ ​explanation​ ​for​ ​these​ ​symptoms​ ​in​ ​women ■ Very​ ​common​ ​diagnosis​ ​for​ ​women​ ​in​ ​19th​ ​century ● Thought​ ​to​ ​be​ ​a​ ​result​ ​of​ ​women’s​ ​delicate​ ​disposition ● Women​ ​biologically​ ​and​ ​psychologically​ ​at​ ​greater​ ​risk​ ​for distress ■ Symptoms:​ ​nervousness,​ ​feeling​ ​faint,​ ​irritability,​ ​loss​ ​of​ ​appetite, insomnia,​ ​increased​ ​sexual​ ​desire,​ ​decreased​ ​sexual​ ​desire,​ ​etc ■ A​ ​catchall​ ​for​ ​unexplained​ ​symptoms ■ Treatment:​ ​bed​ ​rest,​ ​seclusion,​ ​no​ ​mental​ ​stimulation ● Rosenfeld​ ​and​ ​Mouzon​ ​article ○ Definitions​ ​of​ ​differential​ ​exposure​ ​and​ ​differential​ ​vulnerability​ ​hypothesis ■ The​ ​differential​ ​exposure​ ​hypothesis​ ​attributes​ ​gender​ ​differences in​ ​mental​ ​health​ ​to​ ​variations​ ​in​ ​the​ ​stressors​ ​men​ ​and​ ​women experience​ ​(rates​ ​of​ ​mental​ ​illness​ ​among​ ​men​ ​and​ ​women​ ​are​ ​a result​ ​of​ ​different​ ​stressors​ ​encountered​ ​) ■ The​ ​differential​ ​vulnerability​ ​hypothesis​​ ​attributes​ ​mental​ ​health differences​ ​to​ ​discrepancies​ ​in​ ​men’s​ ​and​ ​women’s​ ​reactions​ ​to stressors​ ​(rates​ ​of​ ​mental​ ​illness​ ​among​ ​men​ ​and​ ​women​ ​are​ ​a result​ ​of​ ​different​ ​reactions​ ​to​ ​stress) ● Second​ ​shift”○ meaning​ ​and​ ​as​ ​a​ ​predictor​ ​of​ ​women’s​ ​stress ■ Describes​ ​the​ ​life​ ​of​ ​employed​ ​wives;​ ​wage​ ​earners​ ​by​ ​day,​ ​come home​ ​at​ ​night​ ​to​ ​a​ ​second​ ​shift​ ​of​ ​housework ● Gender​ ​differences​ ​in​ ​social​ ​support ○ Overall​ ​women​ ​and​ ​men​ ​are​ ​similar​ ​in​ ​the​ ​number​ ​of​ ​casual ​social relationships:​ ​however,​ ​women​ ​engage​ ​in​ ​more​ ​close​ ​social​ ​ties ○ Women​ ​have​ ​wider​ ​social​ ​networks​ ​than​ ​men ■ Number​ ​of​ ​members​ ​in​ ​network ■ To​ ​whom​ ​willing​ ​to​ ​reach​ ​out​ ​to​ ​for​ ​support ○ Ironically,​ ​women’s​ ​wider​ ​social​ ​networks​ ​do​ ​not​ ​decrease​ ​the​ ​risk​ ​of distress​ ​(still​ ​have​ ​greater​ ​internalizing​ ​problems) ● Gender​ ​differences​ ​in​ ​healthcare​ ​seeking​ ​behaviors ○ Men​ ​significantly​ ​less​ ​likely​ ​than​ ​women​ ​to​ ​seek​ ​medical,​ ​mental​ ​health, and​ ​substance​ ​abuse​ ​treatment ○ Explanations:​ ​Women​ ​more​ ​likely​ ​to​ ​recognize​ ​symptoms​ ​as​ ​indicators​ ​of a​ ​problem ● Transgender​ ​people: ○ Former​ ​diagnosis​ ​in​ ​the​ ​DSM ■ Gender​ ​identity​ ​disorder​ ​(GID)​ ​-​ ​included​ ​in​ ​dsm​ ​3​ ​and​ ​4:​ ​“a​ ​strong persistent​ ​cross​ ​gender​ ​identification ○ Current​ ​diagnosis​ ​in​ ​DSM​ ​5 ■ Dsm​ ​5​ ​removes​ ​GID ■ Includes​ ​gender​ ​dysphoria ■ Characterized​ ​by​ ​conflict​ ​with​ ​assigned​ ​gender​ ​and​ ​gender​ ​which​ ​he/she identifies ○ Reading​ ​by​ ​Lev-​ ​relevant​ ​advantage​ ​of​ ​gender​ ​dysphoria​ ​over​ ​gender identity​ ​disorder ■ Depathologizes​ ​transgender​ ​people ■ Allows​ ​for​ ​continued​ ​access​ ​to​ ​care​ ​and​ ​transitioning ○ Examples​ ​of​ ​negative​ ​social​ ​experiences​ ​transgender​ ​people​ ​report (general​ ​experiences,​ ​not​ ​the​ ​specific​ ​rates) ■ Retains​ ​conceptualization​ ​that​ ​transitioning​ ​is​ ​a​ ​medical​ ​procedure ■ Sexuality ● Reading​ ​by​ ​Meyer ○ Minority​ ​stress​ ​definition ■ Excess​ ​stress​ ​resulting​ ​from​ ​minority​ ​position​ ​in​ ​society ○ Role​ ​of​ ​minority​ ​stress​ ​in​ ​explaining​ ​higher​ ​rates​ ​of​ ​illness​ ​LGB populations ■ ○ Four​ ​examples​ ​of​ ​minority​ ​stress ■ Instances​ ​of​ ​prejudice​ ​and​ ​discrimination ■ Expectations​ ​of​ ​rejection ■ Concealment ■ Internalized​ ​homophobia ● Homosexuality​ ​in​ ​the​ ​DSM​ ​I​ ​and​ ​II,​ ​removal​ ​from​ ​DSM​ ​III ○ Removed​ ​from​ ​dsm​ ​3​ ​because​ ​of​ ​influences​ ​from​ ​gay​ ​rights​ ​movement, kinsey’s​ ​work,​ ​and​ ​Evelyn​ ​hooker’s​ ​work ○ ● Internalized​ ​homophobia ○ Definition​ ​-​ ​Acceptance​ ​or​ ​endorsement​ ​of​ ​stigmatization ■ ​ ​is​ ​defined​ ​as​ ​the​ ​involuntary​ ​belief​ ​by​ ​lesbians​ ​and​ ​gay​ ​men​ ​that the​ ​homophobic​ ​lies,​ ​stereotypes​ ​and​ ​myths​ ​about​ ​them​ ​(that​ ​are delivered​ ​to​ ​everyone​ ​in​ ​a​ ​heterosexist​ ​/​ ​homophobic​ ​society)​ ​ARE TRUE. ○ As​ ​a​ ​treatment​ ​consideration ■ Challenge​ ​for​ ​LGBT​ ​patients ■ ● Bisexuality ○ Why​ ​this​ ​group​ ​may​ ​have​ ​poorer​ ​mental​ ​health​ ​outcomes​ ​than​ ​other LGBT​ ​and​ ​heterosexual​ ​people ■ Bisexual​ ​and​ ​stigma​ ​-​ ​Bisexual​ ​people​ ​are​ ​confused​ ​or​ ​lying, Bisexual​ ​people​ ​are​ ​promiscuous​ ​,Bisexuality​ ​is​ ​one​ ​manifestation of​ ​sexual​ ​depravity ■ Stigma​ ​and​ ​stereotypes​ ​come​ ​from​ ​both​ ​heterosexual​ ​and​ ​lesbian and​ ​gay​ ​communities ■ LGBT​ ​communities​ ​are​ ​dominated​ ​by​ ​interests​ ​of​ ​lesbian​ ​and​ ​gay ■ Lack​ ​of​ ​communities​ ​leads​ ​to​ ​distress​ ​of​ ​bisexual​ ​people Race​ ​and​ ​ethnicity ● Race​ ​and​ ​mental​ ​illness ○ ​ ​SES​ ​explanation ■ There​ ​are​ ​large​ ​racial​ ​differences​ ​in​ ​SES ■ 1990​ ​consensus​ ​-​ ​blacks​ ​family​ ​income​ ​63%​ ​less​ ​than​ ​whites,​ ​and twice​ ​as​ ​more​ ​likely​ ​to​ ​be​ ​unemployed ■ Studies​ ​of​ ​racial​ ​differences​ ​in​ ​health​ ​routinely​ ​control​ ​for​ ​SES​ ​and it​ ​is​ ​generally​ ​found​ ​that​ ​adjustment​ ​for​ ​SES​ ​substantially​ ​reduces racial​ ​disparities​ ​in​ ​health ● ● ● ● ○ ​ ​residual​ ​effect​ ​of​ ​race ■ Controlling​ ​for​ ​SES,​ ​race-related​ ​stress​ ​has​ ​an​ ​incremental​ ​effect on​ ​mental​ ​health ● I.E.,​ ​race​ ​related​ ​stress​ ​negatively​ ​affects​ ​the​ ​mental​ ​health of​ ​blacks​ ​at​ ​all​ ​SES​ ​levels ■ Controlling​ ​for​ ​race​ ​related​ ​stress,​ ​blacks​ ​did​ ​a​ ​bit​ ​better​ ​in​ ​terms​ ​of mental​ ​health​ ​than​ ​whites ● I.E.,​ ​stressful​ ​events​ ​affected​ ​whites​ ​more​ ​than​ ​blacks Native​ ​American​ ​mental​ ​illness ○ Poorest​ ​outcomes​ ​of​ ​all​ ​major​ ​racial/ethnic​ ​groups ○ Connection​ ​to​ ​deep​ ​poverty Tokenism ○ Definition​ ​-​ ​The​ ​perfunctory​ ​inclusion​ ​of​ ​underrepresented​ ​groups​ ​in​ ​a particular​ ​setting ○ Inclusion​ ​of​ ​a​ ​person​ ​for​ ​the​ ​purpose​ ​of​ ​improving​ ​the​ ​image​ ​of​ ​the​ ​setting ■ Workplace ■ Media ○ Why​ ​do​ ​tokens​ ​have​ ​greater​ ​risk​ ​of​ ​mental​ ​distress? ■ Because​ ​they​ ​are​ ​seen​ ​as​ ​different​ ​because​ ​they​ ​differ​ ​from​ ​the others​ ​in​ ​say​ ​the​ ​workplace​ ​for​ ​example Reading​ ​by​ ​Williams​ ​et​ ​al.○ key​ ​findings​ ​only ■ Found​ ​that​ ​african​ ​americans​ ​reported​ ​lower​ ​levels​ ​of​ ​psychological well-being:​ ​higher​ ​rates​ ​of​ ​self-reported​ ​ill​ ​health,​ ​and​ ​more bed-days​ ​than​ ​whites. ■ Education​ ​and​ ​especially​ ​income​ ​were​ ​importantly​ ​related​ ​to​ ​all​ ​of the​ ​health​ ​outcomes​ ​examined​ ​and​ ​played​ ​a​ ​major​ ​role​ ​in explaining​ ​racial​ ​differences​ ​in​ ​health ■ Social​ ​class,​ ​as​ ​measured​ ​in​ ​this​ ​study​ ​was​ ​generally​ ​unrelated​ ​to health​ ​and​ ​played​ ​no​ ​role​ ​in​ ​racial​ ​differences​ ​in​ ​disease ■ Race​ ​related​ ​stress​ ​was​ ​more​ ​strongly​ ​related​ ​to​ ​our​ ​indicators​ ​or mental​ ​health​ ​than​ ​it​ ​was​ ​to​ ​physical​ ​health Gender-race​ ​paradox ○ What​ ​is​ ​the​ ​paradox? ■ Race​ ​socialization​ ​-​ ​black​ ​and​ ​white​ ​women​ ​are​ ​raised​ ​with different​ ​messages ■ ● Reading​ ​by​ ​Brown-​ ​five​ ​potential​ ​mental​ ​health​ ​problems​ ​caused​ ​by​ ​racial stratification ○ Racial​ ​stratification​ ​produces​ ​mental​ ​health​ ​problems​ ​to​ ​the​ ​extent​ ​it generates​ ​stressful​ ​circumstances​ ​and​ ​cognitive​ ​states​ ​conducive​ ​to emotional​ ​distress 1. Nihilistic​ ​tendencies​ ​-​ ​Characterized​ ​as​ ​strong​ ​tendencies​ ​to​ ​destroy​ ​and hurt​ ​oneself​ ​because​ ​of​ ​fatalism​ ​associated​ ​with​ ​the​ ​permanence​ ​of​ ​racial stratification a. Symptoms​ ​indicating​ ​this:​ ​Intentionally​ ​get​ ​involved​ ​in​ ​a​ ​shoot-out, Race​ ​in​ ​a​ ​car​ ​at​ ​excessive​ ​speed 2. Anti-self​ ​issues​ ​-​ ​Describe​ ​how​ ​blacks​ ​feel​ ​estranged​ ​from​ ​their​ ​racial selves​ ​and​ ​seek​ ​to​ ​escape​ ​from​ ​there​ ​blackness​ ​and​ ​any​ ​connection​ ​to other​ ​blacks a. Symptoms​ ​indicating​ ​this:Wish​ ​that​ ​he​ ​or​ ​she​ ​was​ ​white​ ​,​ ​Hate being​ ​black​ ​,​ ​Lighten​ ​skin 3. Suppressed​ ​anger​ ​expression​ ​-​ ​ ​Because​ ​of​ ​the​ ​nature​ ​of​ ​racial terrorism​ ​and​ ​subtleties​ ​of​ ​hegemonic​ ​oppression,​ ​opportunities​ ​for​ ​blacks to​ ​get​ ​angry​ ​is​ ​often​ ​sanctioned a. Symptoms​ ​indicating​ ​this:Be​ ​very​ ​angry​ ​about​ ​a​ ​racial​ ​issue​ ​but have​ ​to​ ​hold​ ​in​ ​anger​ ​,​ ​Boil​ ​on​ ​this​ ​inside​ ​because​ ​of​ ​something racial,​ ​but​ ​smile​ ​on​ ​outside 4. Delusional​ ​denial​ ​tendencies​ ​ ​-​ ​Blacks​ ​repress​ ​unpleasant​ ​or​ ​painful ideas​ ​from​ ​reaching​ ​the​ ​conscious​ ​level​ ​and​ ​ultimately​ ​generating disability a. Symptoms​ ​indicating​ ​this:Try​ ​to​ ​pretend​ ​that​ ​race​ ​does​ ​not​ ​matter, Tell​ ​others​ ​that​ ​race​ ​had​ ​nothing​ ​to​ ​do​ ​with​ ​his/her​ ​success​ ​or failure​ ​in​ ​life 5. Extreme​ ​racial​ ​paranoia​ ​-​ ​Whites​ ​who​ ​hold​ ​racialized​ ​illusions​ ​of exaggerated​ ​self-importance​ ​often​ ​experience​ ​unreasonable​ ​discomfort​ ​at the​ ​thought​ ​of​ ​having​ ​an​ ​interpersonal​ ​interaction​ ​with​ ​a​ ​black​ ​person a. Symptoms​ ​indicating​ ​this:​ ​Hope​ ​that​ ​a​ ​disease​ ​would​ ​wipe​ ​out blacks​ ​,​ ​Enjoy​ ​watching​ ​a​ ​black​ ​person​ ​get​ ​hurt​ ​or​ ​killed ● Reading​ ​by​ ​Campbell​ ​on​ ​Latino​ ​paradox ○ Latino/a​ ​Americans​ ​vs.​ ​European​ ​Americans​ ​mental​ ​health ■ European​ ​American​ ​mental​ ​health​ ​<​ ​Latino/a​ ​American​ ​mental health ■ As​ ​noted​ ​the​ ​latino​ ​paradox​ ​refers​ ​to​ ​the​ ​phenomenon​ ​whereby latinos​ ​fare​ ​better​ ​than​ ​european​ ​americans​ ​in​ ​terms​ ​of​ ​health ■ This​ ​finding​ ​is​ ​paradoxical​ ​because​ ​overall,​ ​latinos​ ​have​ ​a​ ​lower​ ​ES (educational​ ​level,​ ​income,​ ​and​ ​occupation​ ​type)​ ​compared​ ​to european​ ​americans​ ​and​ ​would​ ​therefore​ ​be​ ​expected​ ​to experience​ ​worse​ ​health ○ Immigrant​ ​Latino/as​ ​vs.​ ​Latino/a​ ​Americans​ ​mental​ ​health ■ Latino/a​ ​American​ ​mental​ ​health​ ​<​ ​ ​Latino/a​ ​immigrant​ ​mental health ■ latino/a​ ​immigrants​ ​have​ ​better​ ​mental​ ​health​ ​than​ ​latino/a americans ○ The​ ​role​ ​of​ ​social​ ​comparison​ ​theory​ ​in​ ​explaining​ ​these​ ​two​ ​differences ■ According​ ​to​ ​this​ ​theory,​ ​because​ ​objective​ ​criteria​ ​for​ ​evaluation are​ ​often​ ​unavailable,​ ​individual's​ ​draw​ ​comparisons​ ​between themselves​ ​and​ ​similar​ ​others​ ​to​ ​assess​ ​their​ ​experiences​ ​and determine​ ​their​ ​well-being​ ​and​ ​worth ■ As​ ​Latino/a​ ​Americans​ ​and​ ​immigrants​ ​move​ ​up​ ​the​ ​SES​ ​ladder, their​ ​source​ ​of​ ​social​ ​comparison​ ​changes ■ Upward​ ​intergroup​ ​comparisons​ ​can​ ​be​ ​made​ ​in​ ​which​ ​individuals who​ ​are​ ​lower​ ​in​ ​the​ ​hierarchy​ ​(ie​ ​low​ ​income,​ ​ethnic​ ​minorities) compare​ ​themselves​ ​with​ ​people​ ​who​ ​are​ ​in​ ​hierarchy​ ​because they​ ​aspire​ ​to​ ​have​ ​the​ ​same​ ​resources​ ​and​ ​attributes​ ​as​ ​the dominant​ ​group Age ● Age​ ​14​ ​as​ ​age​ ​of​ ​onset​ ​for​ ​half​ ​of​ ​all​ ​chronic​ ​mental​ ​illness ● U-shape​ ​relationship​ ​between​ ​age​ ​and​ ​distress​ ​over​ ​the​ ​life​ ​course ○ Midlife​ ​is​ ​less​ ​distressing​ ​than​ ​younger​ ​adulthood​ ​or​ ​older​ ​adulthood ○ ● Reading​ ​by​ ​Schieman,​ ​von​ ​Gundy,​ ​and​ ​Taylor ○ two​ ​types​ ​of​ ​strain​ ​in​ ​older​ ​adults ■ Status​ ​strains​ ​-measured​ ​by​ ​low​ ​education,​ ​financial​ ​dissatisfaction and​ ​poor​ ​health ■ Role​ ​strains​ ​-assessed​ ​by​ ​retirement​ ​and​ ​widowhood​ ​statuses, dissatisfaction​ ​with​ ​family,​ ​time​ ​demands,​ ​and​ ​shameful​ ​emotional experiences ■ ● Continuity​ ​Theory ○ Definition​ ​-​ ​older​ ​people​ ​are​ ​happiest​ ​when​ ​their​ ​activities​ ​remain​ ​the same​ ​as​ ​in​ ​earlier​ ​periods​ ​of​ ​life ○ Role​ ​in​ ​reducing​ ​psychological​ ​distress​ ​in​ ​older​ ​adulthood Stigma ■ External​ ​environment ■ Bridge​ ​jobs​ ​and​ ​volunteer​ ​work ● Goffman’s​ ​stigma ○ ​ ​three​ ​types​ ​of​ ​stigma ■ Abominations​ ​of​ ​the​ ​body ■ Blemishes​ ​of​ ​individual​ ​character ■ Tribal​ ​stigma ○ Discrediting-​ ​definition ● Labeling​ ​theory ○ Definition ■ Focuses​ ​on​ ​the​ ​consequences​ ​of​ ​being​ ​stigmatized ■ Internalizing​ ​negative​ ​perceptions​ ​can​ ​have​ ​social​ ​consequences ○ What​ ​happens​ ​when​ ​a​ ​label​ ​is​ ​internalized? ■ Leads​ ​to​ ​self-fulfilling​ ​prophecy​ ​within​ ​the​ ​stigmatized​ ​individual ● Criminalization○ the​ ​process​ ​through​ ​which​ ​social​ ​groups​ ​or​ ​behaviors​ ​come​ ​to​ ​be​ ​seen​ ​as in​ ​need​ ​of​ ​intervention​ ​from​ ​the​ ​criminal​ ​justice​ ​system ● Prisons​ ​as​ ​de-facto​ ​institutions​ ​to​ ​care​ ​for​ ​mentally​ ​ill ○ Prisons​ ​are​ ​not​ ​equipped​ ​to​ ​provide​ ​ongoing​ ​mental​ ​health​ ​care,​ ​so​ ​these patients​ ​are​ ​“managed”​ ​but​ ​hardly​ ​receive​ ​the​ ​treatment​ ​they​ ​ne...
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  • Spring '07
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