State University of New York College at Buffalo
Department of Sociology
Professor Zhang Jie, Ph.D.
Soc 393: Sociology of Mental Illness
Study Guide Number 2
Chapter 5: Social
Epidemiology
Epidemiology of Mental Problems
• Epidemiological Methods
• The 'True' Prevalence of Mental Disorder
What is epidemiology?
The science of studies for the origin and spread of diseases and disorders (Health Problems) in a population.
• Communicable disease
• Chronic illnesses
• mental disorder
• Environmental pollution,
• Smoking
• Automobile accidents
• Suicide
John Snow: Father of Modern Epidemiology
• Water well, Soho, London, England
• Cholera outbreak
• Origin and control
Epidemiological Terms
• Case
• Control
• Risk (exposure to health problem)
• Rate (per 1,000; per 100,000; etc.)
• Ratio (numerator/denominator)
• Incidents (new cases)
• Prevalence (existing cases)
Epidemiological Methods
• Population
• Sample
• Statistics
• Random samples
• Nonprobability samples
– Cluster sample
– Stratified sample
– Convenience sample
Reliability and validity
• Reliability -- precise
• Validity -- accurate
Diagnostic and Statistical Manual of Mental Disorders
• DSM-III-R 1987
• DSM-IV 1994
• DSM-IV-TR 2000
• DSM-V 2013
Problems of DSM
• Type (Diagnosis) -- Clinical practice
• Severity (degree) -- Research
Instruments to Measure Mental Problems
ECA – Epidemiologic Catchment Area (NIMH)
• NCS – National Comorbidity Survey
• DIS – Diagnostic Interview Schedule (to CIDI)
• CIDI – Composite International Diagnostic Interview
Chapter 6: Social Class
General Discussions
• The Classic Studies
• Explanations of the Relationship
Relationship between Poverty and Mental Disorder
• No correlation overall
• Positive for schizophrenia
• Negative for mood disorders
Data on the Relationship between Poverty and Mental Disorder
• Table 6-2, Page 135
• Table 6-3, Page 136
Correlations
• Positive
• Negative
• Curvilinear
• Zero
Explanations of the Relationship between Poverty and Mental Disorder
• Genetic explanation (twin studies)
• Social causation explanation (social status)
• Social selection explanation (drift hypothesis)
The Four Classic Studies
Chapter 7: Age, Gender, and Marital Status
Significance of the Age
• In 2010, 13.3% of all Americans are 65 and older
• In 2050, 21.8%
Age as a Risk Factor
• 25-34 High risk age range
• Children: ADD, Tic, Autism, Elimination Disorder (bedwetting), etc. Page 149
• 18 and younger: Mood disorder
• 18-24: Mental retardation, substance, personality, and psychotic conditions
• 25-64: Schizophrenia
• 65 and older: Alzheimer or dementia
Child Mental Disorders
• Table 7-1, Page 149
• Autism
Adults
• Mood disorder
• Alzheimer or dementia
• Suicide
Gender Differences
They are all true across culture, over time, in different age groups, in rural as well as urban areas, and in treated as well as untreated populations.
Depression
• When it comes to depression, there are no countries in the world where males are likely to be more depressed than females.
Do women tend to report more?
• Differences between men and women in the reporting of psychiatric symptoms are real, and not an artifact of response bias.
Mental Hospitalization
• Despite the identification of higher overall rates of mental disorder among females, males are more likely to be admitted to state and county mental hospitals.
– 89 men/100,000
– 54.9 women/100,000
Biological Factors: Menstruation
• Some women become irritable and depressed during menstruation, but there is no strong evidence that the onset of depressive disorders can be correlated with the menstrual cycle.
• Conversely, it may be that psychological distress has an important effect on menstrual problems rather than the other way around.
Biological Factors: Menopause
• Women are no more likely to become depressed at menopause than at any other time.
• Menopause can be stressful if it occurs either early or late in life.
Biological Factors: Testosterone
• Androgen à aggression
Gender Role and Socialization
• Gender differences in social expectations
• Social values
• Social norms
Marital Status and Mental Disorder
• Marriage is a protective factor for mental disorders
Emotional support
Social support
Coping abilities
• Family can also be a source of stress
Chapter 8: Urban
versus Rural Living and Migration
General Discussion
• Urban versus Rural Living
• Migration
Comparisons
• Rural
living: high on mood disorder, such as depression
• Urban
living: high on psychotic disorders, such as schizophrenia
• Immigrant living: Mentally healthy for those voluntary immigrants but not for those enforced immigrants
Rural Living
• Sparsely settled areas
• Relatively isolated communities
• Conservative, religious, puritanical
• Intolerant of heterodox ideas and values, prejudicial, uninformed, authoritarian, and family centered
• Mood disorder, such as depression
Urban Living
• So-called concrete jungles
• Overcrowding
• Those who adapt may seem distrustful, selfish, cynical, aloof, superficial, and mercenary (greedy)
• High on schizophrenia, personality disorders, and anxiety, etc.
Immigrant Living
• Internal immigration within the US
• External immigration between countries
• Upward immigration: less mental problems
• Downward immigration: more mental problems
Mental Health of the Chinese Immigrants: An Empirical Study
Chapter 9: Race and Culture
General Discussion
• Differences between Racial Minority Groups
• Minority Status and Self-Esteem
• Sorcery: Urban Black Folk Healers
• The Curanderos
Americans: Race and Ethnicity
• Race – Biological or physiological term
– White (Caucasian)
– Black (African)
– Hispanic (Latino)
– Asian (Oriental)
– Native (Indian)
• Ethnicity – A cultural term
Racial Distribution in the US
• White (67%)
• Black (13%)
• Hispanic (15%)
• Asian (4%)
• Native (1%)
What is a minority?
Mental Problems in the US among the Race
• Similarities between the races for outweigh any differences
• Minority groups show more psychological distress and depression because of the combined effect of poverty and discrimination (It is social class rather than race or ethnicity)
African Americans
Rural Blacks Higher on Depression
• Poverty
• Discriminations
• Lack of social support
• But they do not have higher rates of clinical mental disorder
Overall between Whites and Blacks
• No differences on mental health
• Suicide higher for the whites
Hispanic Americans
• Mexicans, Cubans, and Puerto Ricans
• Low on mental problems
• Social support and family orientation
Native and Alaska Americans
• Alcoholism
• Suicide
Asian Americans
• Top on education and income
• Low on mental problems
Minority, self-esteem, and mental problems
• Minority à low self-esteem
• Low self-esteem à mental problems
Folkways to cure mental disorders
• Black American sorcery (witch)
• Mexican Curanderos (religion)
Suicide Rates
• Rate and Race
• Gender Ratio of Suicide Rates
Culture and Suicide
• Religions
– Condemnation
– Heaven belief
– Social integration
• Suicide bombers
• Suttee
• Kamikaze
• Eskimo elderly
Suicide Theories
• Durkheimian social integration theory
• Psychiatric models
• Social and psychological strain theory