SOCIAL STRATIFICATION AND MENTAL ILLNESS

1. SOCIAL STRATIFICATION AND MENTAL ILLNESS

2. WHAT IS SOCIAL STRATIFICATION? • RELATIONSHIPS OF DOMINANCE AND DEPENDENCE • POWER, STATUS, RESOURCES • RELATIONAL NOT INDIVIDUAL • VARIES ACROSS DIFFERENT ROLES

3. ORIGINS IN MARX • HOW DOMINANCE AND SUBORDINATION REFLECT ECONOMIC POSITION • RESOLUTION ONLY WITH TOTAL EQUALITY - COMMUNISM

4. PRIMATES • PRIMATE STUDIES SHOW IMPORTANCE OF STRAT. • DEPENDENT MONKEYS HAVE MORE STRESS HORMONES AND LESS SEROTONIN • DOMINANT MONKEYS HAVE FEWER STRESS HORMONES AND MORE SEROTONIN

5. CAUSE AND EFFECT • CAUSATION - SOCIAL POSITION PRECEDES M.I. • SELECTION - M.I. PRECEDES SOCIAL POSITION

6. CAUSE AND EFFECT? • SELECTION OR SOCIAL CAUSATION? • PREVIOUSLY DOMINANT MONKEYS HAVE WORSE MENTAL HEALTH WHEN BECOME SUBORDINATE • NEWLY DOMINANT MONKEYS IMPROVE MENTAL HEALTH • MENTAL HEALTH FUNCTION OF SOCIAL POSITION

7. IMPORTANCE • INCOME • JOBS • GENDER ROLES

8. INCOME

9. ?s ABOUT INCOME • Best indicator of status in our society • Continuous or Dichotomous? • Cause or Effect? • Different Impact on Different Disorders?

10. INCOME AND M.I. (NCS)

11. INCOME AND M.I.

12. NON-PSYCHOTIC • LOWEST INCOME ALWAYS WORST • HIGHEST INCOME ALWAYS BEST • SOMETIMES CONTINUOUS, SOMETIMES NOT • STRONGEST FOR ANXIETY • WEAKEST FOR SUBSTANCE ABUSE • LOWEST INCOME ESPECIALLY LIKELY TO HAVE COMORBID DISORDERS

13. REASONS FOR NON-PSYCHOTIC • CAUSATION NOT SELECTION • MODEST RELATIONSHIP WITH ACUTE LIFE EVENTS • STRONGER RELATIONSHIP WITH CHRONIC STRESSORS - POVERTY, INEQUALITY, INABILITY TO ACHIEVE GOALS • VULNERABILITY

14. PSYCHOSIS

15. FARIS AND DUNHAM • CHICAGO • ADMISSIONS TO MENTAL HOSPITALS BY AREAS OF CITY • NO ASSOCIATION BETWEEN RESIDENCE AND BI-POLAR • STRONG ASSOCIATION BETWEEN RESIDENCE IN CENTRAL CITY AND SCHIZOPHRENIA (9x DIFFERENCE)

16. FARIS AND DUNHAM • ORIGINALLY SAID LIVING IN CENTRAL CITY CAUSES SCHIZ. • LATER CHANGED MIND AND SAID PEOPLE FIRST BECOME SCHIZ AND THEN MOVED TO CENTRAL CITY • SELECTION

17. RECENT STUDIES • SCHIZ ALWAYS ASSOCIATED WITH LOWER INCOME • WHAT IS CAUSE AND WHAT EFFECT? • LOOK AT PARENTS’ INCOME • SELECTION MORE THAN CAUSATION • DOWNWARD DRIFT • BIPOLAR NOT RELATED TO S.C.

18. CONCLUSION FOR PSYCHOSES • STRONG ASSOCIATION OF LOWER INCOME AND SCHIZOPHRENIA • SELECTION SEEMS MORE IMPORTANT THAN CAUSATION • NO ASSOCIATION BETWEEN INCOME AND BIPOLAR DISORDER

19. JOBS

20. JOBS (LENNON) • JOBS WITH AUTONOMY, CREATIVITY, CONTROL OVER OTHERS, FEWER PHYSICAL STRESS HAVE GOOD M.H. • OPPOSITE (TEDIUM, ROUTINE, LOW CONTROL) ASSOCIATED WITH POOR MENTAL HEALTH

21. JOBS AND CES-D • PROFESSIONAL 9.16 • CLERICAL/SALES 13.36 • SKILLED/MANUAL 10.41 • UNSKILLED 14.24

22. GENDER

23. SOCIOLOGICAL • DISTRESS ARISES OUT OF SOCIAL ROLES • POWER, RESOURCES, AUTONOMY ASSOCIATED WITH MALE ROLES • OPPOSITE WITH FEMALE ROLES • REGARDLESS OF WHETHER MEN OR WOMEN OCCUPY THE ROLES

24. SOCIAL ROLES • WOMEN IN TRADITIONALLY MALE ROLES HAVE LESS DISTRESS • MEN IN TRADITIONALLY FEMALE ROLES HAVE MORE DISTRESS • MEN AND WOMEN IN SAME ROLES WILL HAVE SAME DISTRESS

25. CULTURAL EXPECTATIONS • NOT JUST ROLES BUT EXPECTATIONS OF MEN AND WOMEN IN ROLES • UNEMPLOYED MAN VS. HOUSEWIFE • SPOUSE WHO EARNS MORE • DISTRESS FROM COMBINATION OF ROLES + EXPECTATIONS

26. MARRIAGE AND DISTRESS • SINGLE MEN AND WOMEN EQUAL • MARRIED MEN < MARRIED WOMEN • SOMETHING ABOUT MARRIAGE - ROLES

27. DISTRESS, WORK AND MARRIAGE • HOUSEWIVES > DISTRESS THAN WORKING WOMEN • WORKING WOMEN > WORKING MEN • ROLE OVERLOAD; D OF L • UNEMPLOYED MEN WORST

28. ROLES ARE IMPORTANT • SAME ROLES, SAME DISTRESS - E.G. SINGLE PEOPLE • DOMINANCE GENERALLY GOOD • DEPENDENCE GENERALLY BAD • EQUALITY GENERALLY GOOD

29. CONCLUSION • MENTAL HEALTH VERY SENSITIVE TO STRATIFICATION • DOMINANCE BETTER THAN SUBORDINATION • PERHAPS EQUALITY IS BEST?