SOC 392 Full Semester Package

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Class: SOC 392
Lecture/Exam: Full Semester Package
School: SBU
Semester: Spring 2014
Professor: Burgos

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Jan 29

Psychological Disorders

According to the Law,
The definition of mental disorder rests on whether:
1) The person is aware of the consequences of his actions

Definitions of Mental Disorder a Harmful Dysfunction
1) Mental disorders as a violation of cultural standards or atypic
a. Ex: walking around naked
2) Mental disorder as maladaptive or harmful behavior
a. walking naked in this cold weather
3) Mental disorder as a disturbing emotional distress
a. causing pain
4) Mental disorder as unjustifiable

Psychologists Definition
Any behavior or emotional state that
1) Causes the individual great suffering or worry
2) Is self-destructive
3) Is maladaptive and disrupts either the persons relationship or the larger community
a. either disrupts the persons functioning or the relationship

Understand Psychological Disorders
The Medical Perspective
o Psychological disorders are sicknesses and can be diagnosed, treated, and even cured
assumes the disorder is something inside of you, a disease; all you need to do
is identify it
The Bio-Psycho-Social Perspective
o How biological, psychological, and social factors interact to produce specific
psychological disorders
the way you feel, recovery, has a lot of social processes
assumes we can prevent it
Diagnostic & Statistical Manual of Mental Disorders
DSM-IV [5] (1994) contains more than 300 mental disorders
DSM V (May 2013)
Provides diagnostic categories
Does not provide info on causes
Does not provide info on treatment
It is organized in 5 axes
o when an individual is being diagnosed with a disorder, it takes years of training to
understand

Axis I
Clinical Syndromes
Anxiety disorders
Mood Disorders
Dissociative disorders
Substance abuse disorders
Schizophrenia

Difficult to diagnose kids

Axis II
Developmental and Personality Disorders
Ingrained aspects of the clients personality that are likely to affect the persons ability to be
treated, such as self-involvement or dependency

Axis III
Physical Disorders and Conditions
Medical conditions that are relevant to the disorder, such as respiratory or digestive problems

Axis IV

Axis V
Global Assessment of Functioning
The clients overall level of functioning at work, relationships

Diagnostic Criteria for Attention Deficit Hyperactivity Disorder [ADHD]

Anxiety Disorders

Phobias

Feb 10
The Medical Model and Objectivity of Psychiatric Diagnoses
In class quiz this Wednesday! [until feb 10]
Q: based on the readings (thus far including this week), what are the limitations (criticisms) of
the medical model? Provide examples from the reading!! Cite them from reading
Bring it in class typed up!

Models in the Study of Psychopathology
Psychopathology: Clinical term meaning abnormal behavior
Model: AN analogy used by scientists to describe or explain a phenomenon or process tha they
cannot directly observe.
o Referring to patients and mental illness is to apply a medical model
Fevers and rashes caused by invasion of the body by foreign substances
Abnormal behavior caused by

One-Dimensional Models of Mental Disorders
In the past different pathways of thought were used exclusively w/o taking into consideration
aspects of other viewpoints
Such a narrow view of complex issues and condition undermined understanding and treatment
o Disease vs. illness: illness perceive yourself of not feeling well to optimal. Disease
is categorical, you either have it or dont have it. Sociologists have a problem with this,
you either have this disease or not. (class was called sociology of mental disorder,
changed to illness)
2 Different Schools of Thought
Mental disorders are caused primarily by biological problems
Abnormal behavior is essentially psychological
o youre prescribed medicine right away

A multipath Model of Mental Disorders

Mental Disorder: something is physical wrong with the brain X-ray/Scans biochemical
imbalances
Biological dimension, sociocultural dimension, psychological dimension, social
dimension

Dimension One: Biological Factors
Biological pathway relies on certain assumptions:
o Genetic helps make ppl who they are
o Human thoughts, emotions, and behaviors are associated with nerve cell activity of
brain and spinal cord.
o Change in thought, emotion, or behavior will be associated with change in activity or
structure of brain
o Mental disorders are highly correlated with some form of brain or other organ
dysfunction
o Mental disorders can be treated by drugs or somatic intervention (physical intervention
medication)

Feb 12
Medulla heartbeat and breathing
Hippocampus memories
Hypothalamus neural structure right below that thalamus: eating, drinking, body temp,
endocrine system, emotion

Methods of Genetic Research
1) Family Method
a. Investigation of the occurrence of a chosen trait within a family
b. Varies by how close the relatives are
i. First degree (50%)
ii. Second degree (25%)
Adoptees Method
Investigation of the occurrence of a chosen trait in children who are adopted very early in life
and their biological parents
More like biological
Linkage Analysis
Investigation of the genes involved in the disorder
o *Human Genome Project*
People will get diagnoses after a brief talk with doc and then get medication dangerous

Feb 17
Criticisms of the biological models
Dont account for abnormal behavior if no bio cause is found (e.g. phobia)
Ignore environmental/societal/cultural influence
Diathesis-Stress Theory: A predisposition to develop illness (diathesis) is inherited and may or
may not be activated by env. Factors
Biochemical changes may occur b/c of env forces (stress caused the release of hormones)
Incomplete models oversimplify life
May foster helplessness by eliminating personal responsibility for well-being

Video Medicating Kids
Critiques of medical model
Nicholas Family
Tried several medications
Every 2-3 kids across America are on some type of medicine
Why they are prescribed and whether they help
Came from France where kids are less likely to be diagnosed. The kid struck out. Disruptive and
impulsive.
6 million kids across US have been diagnosed with ADHD
Below avg. to stay in one place. Always interested what others are doing (nonaggressive) but
distracts other children.
Standard diagnostic tool if some apply then he might be diagnosed
Accept and love for his personality

Demos Family
She takes medications
Help attn. span and help concentrate
If she doesnt take it, she cant concentrate
Bad behavior and detentions
She looks restless
Does gymnastics and had issues there noticed by coach, she wouldnt do the balance beam, she
would always look around
Parents tried a lot before medications
After talking to doctors, they assured her Ritalin works/helps even after reading many criticisms
on the internet
5
th
grade she asked the mom if she can try the Ritalin
Ritalin changed everything about her: Self-esteem was better, higher avg., better in school,
better athlete
She was prescribed by psychiatric
Coach thinks she does better with medication
Not that it makes her better but it helps her concentrate
Took throughout 6
th
grade and within 7
th
grade she had doubts
Natural alternative; no more Ritalin
Parents noticed she went back how she used to be w/o Ritalin
Has no basis in medical fact for ADHD simply a label given to normal childhood behavior
Cannot push parents to take medication 6-1 vote in State Board of Education
Little effect in Denver schools
After a month of Ritalin, she took the meds again and teachers were pleased
Half way through 7
th
grade, psychiatrist decided to switch to Adderall
Medication helped nervous system
Parents believed medication works
Bill Dodson specializes in ADHD. Promotes ADHD awareness and paid by Shire Richwood (makes
Ritalin). ADHD is inherited. Neurologic disorder with behavioral output.
Market worth a billion dollars a year. It has 3 more medications
ADHD was recognized and would be helped by teachers and schools
3 class action suits were brought against CHADDS to increase sales and over diagnose

The McCartys [Alex]
Coexist with other psychiatric ailments
Social problem
A bit sensitive thought b/c only child
Parents never knew hurting inside
On playground tough time and class tough time
His social group they werent kind to one another
Made fun of weight, bad grades, etc.
Analyzing life at this age?
Taken to church, met therapist, counselor saw depression in him, concerned about hurting
himself and the kid did have plans like that
Given low dose of antidepressant, given higher dose, after a few weeks he attempted suicide
Phone call that he wont get out the bathroom and hes cutting himself
Couldnt see the good in anything
Doctor Nancy upped the dose, suicidal thoughts went away but still bad in school was it drug
that mad his thoughts went away
Feb/March teachers, parent, therapist thought he had a behavioral problem
He knows about whats wrong with him about the chemical imbalances
Told ADHD leads to depression so need to take Adderall, it also helps with weight loss
Took it first on his 12
th
bday and it helped him to complete work.
Parents didnt want him to take meds if he didnt want to but parents believed it worked; mom
thinks there are so many factors. Parents love son and want to do anything to help him.
Cerebellum (Latin for little brain) but it has never thought to have been important because it
is removable. Ppl with ADHD can do anything but not as well.
No disease of the brain until they are given brain altering medication

Robin
Said drug made him feel jittery
Doc said different drugs
Stopped taking drugs and tried marijuana
Much struggle and Robin moved out of the house
Didnt want to say that marriage was apart b/c of son but it has come into play
He was pissed that she many him take medicine and he didnt want to and belived it didnt help
He struggles with attn. problem in school he hasnt taken in 6 months and feels better

Noel does much better with Adderall and won championship
Ales McCarty still takes meds and will take stimulants in the future
First family more time with Children, dad taking care of Nicholas and baby brother and not
medicate him.

Feb 19

Why is mental illness a myth to them when someone dies, they dont have the mental illness
anymore. If you open the brain you cant tell, but we call it a disease, in diseases there is
something physically wrong with a person.

Thomas Szasz: mental illness is just deviance
Peter Conrad: ADD is just deviance

What doctors are doing is medicalizing deviant behavior. Whatever is not normal, they
medicalize

Conrad: we have all these prescriptions that are given for mental disorders but they are harmful.
Inappropriate behavior may characterize a lot of us
Cultural biases in how deviant behaviors get categorized

ICD: what is a disease?
How is something a disease one year and not another year?
Cancer is a version in one ICD but not in another, probably at a DCM

Hyperkinesis
Experimenting with kids with amphetamine (giving the kids the stimulants) their behavior was
improving; then created a disorder

Feb 10 reading Joe Sharkey
Expect a kind of behavior from celebrity because we think its acceptable

History of ADD
30s stimulants to prescribed to treat minimal brain dysfunction
60s learning and behavior disability and hyperactivity became hyperkinetic

Diagnosing ADHD
DSM-based prevalence estimates btwn 3-10 percent of children and 3-6 percent of all adults
o 1) Inattentive & Hyperactive-Impulsive
o 2) Primarily Inattentive
o 3) Primarily Hyperactive-Impulse
DSM is used worldwide, but problematic because using western manual applying to people all
over the world

Inattentive Criteria
Six+ for at least 6 months to appoint that is disruptive (subjective) and inappropriate for age: -on
BB-

Treatment
Behavioral therapies
Stimulant Medication
o Ritalin/Concerta
o Adderall
o Dexedrine
o Stratters (atomoxetine non-stimulant)

Conrad on ADD
75 The Discovery of Hyperkinesis
The process of medicalization, often seen as humanitarian reform, has another side:
o 1) expert control
o 2) medical social control
o 3) the individualization of social problems; and
o 4) the depoliticization of deviant behavior

Is ADD a Disease?
No sharp indicator
Comorbid with Tourettes, OCD, epilepsy, and oppositional defiant disorder
No Clear differences between ADD brains and non-ADD brains
ADD kids are helped by stimulants, while not all kids see
5 criticisms of ADHD
No lab confirming tests of physical features
Diagnostic criteria have changed frequently
No curative treatment, long-term therapies are required
Stimulant drugs are thought to have abuse potential
The rates of diagnosis and treatment different cultures/countries
ADD Lobby
CHADD
Groups pushing and lobbying local govts and school district for ADHD diagnosis
Anti-ADHD Theories

Feb 24

Ethnic Issues in US and UK
Black and minorities are more often: Diagnosed, detained, offender patients, held by police,
transferred to locked wards, not referred for talking therapies (more coercive), high doses of
meds, sent to psychiatrists by courts

Circle of Fear report
Services:
too coercive
lack of respect need respect to achieve positive mental health and recovery
Less intergrated with communities
Pathways
Do not involve primary care and community based facilities say not available
Discourse
Models of mental illness do not acknowledge cultural diversity
Service user and career involvement
Poor and non-existent
Black-led initiatives
Not valued or supported properly

Culture is hugely important in psychology
Values
Western:
Individual (self) sufficiency (self-esteem valued)
Persoanl autonomy
Efficiency (machine-like)
Keep inner world constant (control altered states of c-ness)
Freedom of expression (variety in behavior)
Eastern:
Harmony with other people (other-esteem valued)
Relationships
Balance (ecological)
Keep outer world constant (conformity with society)
Freedom of inner experience (Variety of inner experience)
Video: Mental illnesses
60s Thin book, now huge
Discovered new disorders?
Homosexuality example
1973 homosexuality was declassified as a mental illness
Just as we have physical illness, all of us have mental illness to an extent
Clinical depression vs. normal depression (sadness) giving treatment where it isnt required
Overtreatment is a problem
Melancholia example
Biomarkers

Reading with Food and Drug Administration
Study is about a test btwn the effects of Placebo and real antidepressants

Feb 26
Definition of Epidemiology:
Study of the distribution of illness in populations over time and space
The study of Mass aspects of disease ; Mass aspect many people suffering from the disease
The pursuit of
Why do community sampling?
Helpful in formulating mental health policy
Help in evaluating theories of causation
Helpful in planning in delivery of mental health services
Helpful in justifying requests for funding to support research and service provision
Uses of epidemiology
1. Completing the clinical picture
a. Ex: stony brook suicides, they cant say if its large group or a certain small group.
Cant rely on small clinical samples.
2. Community Diagnosis
a. Large areas and where are the rates of the problems taking place. Not only
epidemiologists do this for mental disorder but for every disorder in the DCM
b. Prevalence: proportion of people in a specific area who suffer from a condition.
3. Secular changes in incidence
a. Rhode Island 25% and Maryland 16%, incidence is the rate of new cases
4. Identification of Risk Factors/Protective Factors/Prevention
5. Delineation of syndromes
a. Syndrome is a collection of symptoms, many symptoms of depression = syndrome.
b. Syndrome vs. disorder, disorder has to be classified by a psychiatrist
Epidemiology Terms
Rates and Ratios
o What proportion and rate of New Yorkers have, ex, schizophrenia. Talks about
proportion or percent
Prevalence
o Point
o Period (ex 3 months)
o Lifetime
o Treated and untreated have to make sure if its treated, have you ever been treated
for anxiety, panic disorder, etc.
Inception (Incidence)
New cases. Prevalence and Inception rates
Group A has the highest proportion of the disorder
Base Population
General population or population subgroup
o Missing people who dont have phones
Primary care population
o based on hospital records, psychiatric hospital and got records for who had what
condition but you cant make generalization of the population because these are
hospital people
Mental health service population
o service providers but not representatives
?
Epidemiological Reaseach Design
Cross-Sectional studies
o survey and study done at one period of time. Ex: it was done in April and October
Longitudinal Studes
o Prospective
Follow people at 2 different time periods
o Retrospective
Case-Control
Ask about current and past so they have to recall. Not really longitudinal but
still a part of it.
o Case Register studies

Design of a Community Survey
Defining the base population (Sample Frame)
o Generalization of population, need to know who to generalize to. If need all student
info from stony brook, probably go to registrar/admissions building. Then make
prevalence and incidence in the stony brook population.
o need to pay attn. if population is unrepresentative
Sampling Method
o phone for example
Case Identification/definition (ascertainment)
o categorical you either have it or you dont
o those who get diagnosed whether yes or no condition, we dont have psychiatrists
making diagnosis but computer determines it which is very problematic, if looking at
mental illnesses in different states, it raised red flags.
o case ID, case is someone who gets diagnosed with a condition and noncase is
someone who doesnt have that condition. Its not clear cut.
Survey instruments
o what was the diagnostic criteria. There are different survey instruments
Contact and Consent
o Ethics
Data entry and analysis
o Very messy

The problem of Psychiatric case definition
Informal clinical judgment
o When we go to psychiatric, you go back and forth to the psychiatrist many times so a
proper diagnosis can be made.
o forced to make diagnoses which is very problematic
Categorical and dimensional approaches (read this article!!)
o Most of these studies are either used to medicalize a cluster of symptoms, need to
make diagnoses.
Reliability and Validity
Computerized Diagnosis

M/C on Monday
From Readings

Mar 3

Quiz all the readings up till today, M/C
Most questions are from the readings
Make key headings and outline

Base Population
General population or population subgroup
o ex: Latinas and different subgroups in the Latina race
Primary care population
Mental health service population
Psychiatric case resisters
These arent representative

Chicago Study: Faris and Dunham (1922-1934)
35,000 Admissions to mental hospitals
1
st
admissions for schizophrenia highest in inner city areas within lowest socioeconomic groups
Led to social drift and social segregation hypotheses
And to the social causation and social selection theories
o debate: does
Class = Mental illness, or
Mental Illness = Class

Midtown Manhattan: Rennie and Srole (1954)
1660 adults, structured interview by non-psychiatrists
Incidence of mental disorder increased with age
Low socioeconomic group had 6x as many symptoms as those in the high groups

New Haven: Hollingshead and Redlich (1950)
Social class and prevalence of treated mental disorder
Census of Psychiatric patients, community survey, survey of psychiatrists and controlled case
study
Described 5 distinct social classes and found neurosis in high classes, and psychosis more
prevalent in lower classes
15.1% of population above 26 showed evidence of mental disorder
Stirling County (Nova Scotia): Alexander Leighton
20,000 rural persons, non-clinicians, structured interview, later psychiatrist rating
24% had notable impairment, and 20% needed psychiatric attention
Women > men, morbidity increase with age and poverty
Mental Health Epidemiologic Studies
First generation 16 (Prior-WWII)
Second generation 60 (1950-1980)
Third generation (1980-present)
Difficulties Encountered
Prevalence rates of mental disorders seem to be too high
o ECA found 1/3 Americans suffer from a mental disorder at one point in their lives
o NCS figure was
Although the studies used similar instruments, the results were quite different in many areas
o ECA estimated that 6% of Americans suffer from a depressive disorder at some point in
their lives
o NCS estimated 17%
Clinical prevalence vs. True prevalence
Why not just count the # of ppl in clinical settings/
Clinical prevalence of mental disorder is not a measure of true prevalence
o Clinical prevalence is a measure of how many people seek and receive treatment
Design of a Community Survey
Defining the base population (sample frame)
o If telephone, then might miss those who dont have telephones
Sampling method
o Need to be random and stratified. Which communities have most Asian and Latinos
and pick and sample those communities and areas. No sampling in clinics
Case Identification/definition (ascertainment)
Survey Instruments
Contact and Consent
Interview
Data entry
The Problem of Psychiatric Case Definition
Informal clinical judgment
Categorical and dimensional approaches
Reliability and Validity
Computerized Diagnosis
Sampling
Individuals, household, addresses, postcodes
Random sampling
Stratified sampling

Instruments
Questionnaires
o GHQ (general health questionnaire)
o HAD
o Becks inventories
o Symptoms checklists
Rating scales
o Hamiltons depression scale
o Beck Raphaelson Mania Rating Scale
o MIMS?
Interviews
o Structured (same Qs asked of all subjects)
o Semi-Structure (same topics covered with some leeway for follow on questions)
o Unstructured (interviewer use their own clinical judgment)
Mar 24

1) Watch video
2) Paper requirements
3) Why is SES related to health? turn in after watching the video
4) Quiz on Wednesday Articles for this week on SES & health
Wednesday quiz on all readings for this week

Strong Indicators of Stress:
1) Life Events
a. In the video:
i. Death of a spouse
ii. Job loss
iii. Discrimination [chronic stressor and life event]
iv. Crime/Homicide
2) Chronic Stress
3) Daily Hassle

SES
Income
Education
Wealth
o House Ownership
o Stocks and Bonds
o Investments
SES Life events

Level of control

Mar 26
Quiz is coming Monday, do reading for this week and the upcoming Monday, essay questions
Research paper
Set up of paper:
3 parts
Debate paper, should find a debate
Do not do night or even week before
Clarity

Ex: is mental illness a myth?
Part 1: 1 page
Body of paper, part 2: 3 pages
Conclusion, part 3: 1 page

Part 1:
a) Whats the issue?
b) Relevance of issue is mental illness a myth? Why is it important? Why should we care?
c) Highlight:
a. Yes it is a myth because of 1,2,3
b. No it is not a myth because of 1,2,3
d) Your argument
a. A,b,c,d introduce your arguments
Part 2: Reasons
3 pages
A) Reason 1 1
st
page [can support or debunk] dont spend too much time describing argument
of the other side. Not much space. Getting points for supporting own claims.
B) Reason 2 2
nd
page
C) Reason 3 3
rd
page

No more than 5-10 citations
Maybe 1-2 articles per reason

Part 3: Conclusion
A) Restate issue
B) I argued A,1,2,3
www.papersapp.com
www.mekentoshj.com
PubMed sociological abstract
ASA style bibliography
Mar 31

Not SES causing mental illness but mental illness causing SES

One of the most consistently replicated findings in the social science has been the negative
relationship of SES with mental illness: The lower the socioeconomic status of an individual, the
higher is their risk of mental illness.

Determinants of SES:
Material possessions
Education: type of education vs. years of degree
Social network
Cultural capital
Leisure time on wasteful activities

Apr 7

Video
Japanese man wanted citizenship
Japanese did not have the full protection of the law no matter how long in the country
Skin was whiter and no different
Japanese old woman had no Japanese friends or neighbors
Supreme court said Ozawa was not white because he was not according to the statute
He was white, dressed up as a westerner, went to Church, dressed his children as westerners
but was not white not scientific evidence
They determined Ozawa was from the Mongolian race

South Asian immigrant, Hindi
Basis: Indians were from Aryans race and therefore Caucasians scientific. Court said it didnt
matter what science said, it isnt something scientific but something subjectively understood by
the common man
Refuted its own reasoning by Thind
Justices never said what whiteness was not, not what is was
Their reasoning went in circles

Asians were seen as different and can never become like the rest of us
US vs. Thind South Asians who were naturalized were stripped of their citizenship and
property
One committed suicide after being very successful in his business

Ineligible for citizenship, many couldnt even buy land and they were sold to white farmers
1952 Proper citizenship

Fact they were seen as non-American were seen as enemies
Even 3
rd
or 4
th
generation Asian Americans were seen as formers
Johnson Reed Immigration act, banned immigrations until 1965

WWII battle with Nazi Germany and Japan
House I Live In movie

European Mobility Model came with nothing and worked hard, bootstrap myth

Roosevelt new deal new path out of poverty

End of WWII
Vets came and had nowhere to live
2 families sharing a hut
30s Fed Housing Admin, job to provide loans/backing for loans to avg. Americans to purchase
homes
Before 1930s 50% of price up front. New: put 10-20% down and the bank financed rest of it
with relatively low rates. This opened up opportunities to buy homes. Financing schemes to
help loan own like today.
Potato field turned to for 17,000 homes.
47-48 taking advantage of GI bill. Levittown with many facilities

Eugene came back with many other black GIs in a separate division dream like everyone: new
home and new life
Procedure: fill out application
Owners of the development: didnt decide whether to sell to Negroes
Race long played a role in the real estate practices

$120 billion into housing and less than 2% to non-whites

Vertical Ghettoes public housing projects
Large number of people of color in one place
2/3 displaced were blacks or Latino

Johnson signed the Fair Housing Act
Non-whites in traditionally white communities in large numbers
Block Busting white owners sold homes under the normal price and the houses were sold to
nonwhites for over price
Real Estate depressed in Roosevelt when whites left and blacks moved in
Blacks moving in didnt cause the prices to drop but whites moving out caused it
Tax base eroded and seen as dumping ground for welfare families

Geography does the work for Jim Crow laws

Racism: institutionalized and practiced
Different from discrimination
Segregation solidifies racism

Comparative net worth or wealth?
Everything minus debt: net worth

Discrimination: (professors study)
Blatant outright
Can deal with it, see it and can avoid it
Subtle low courtesy
It affects and harms more, more negative effect on depression and physical health

Apr 9
Racism levels from statute to self
Cognitive
o (educational, self-appraisal)
Interpersonal
o (Micro-aggressions, abuse/attack/threat)
o Discrimination
Ecological
o (btwn groups e.g. family/community)
o brings racism b/c it starts to blend in to community and society
Institutional
o (e.g. receipt of public services, health, justice)
Macro-political
o (e.g. laws/history/intl politics)
Prejudice vs. discrimination vs. racism (racism includes laws)

Gender Stratification
Social Stratification
Almost 60% of all women work
50% of all working women hold administrative support and service sector jobs
Women hold primary responsibility for household duties
Our culture gives more responsibility for parenting to women
On avg., women earn 77 cents for every dollar earned by men
17 of the 1,000 largest US corporations have a woman CEO

Are Women a Minority?
At every class level, women have less income, wealth, education and power than men
Intersection theory the interplay of race, class and gender, often resulting in multiple
dimensions of disadvantage
o Disadvantage linked to gender and race often combine to produce especially
Gender roles are socially constructed (and reinforced)
Gender roles are created by humans to meet the needs of their societies (not biological)
Life chances in the stratification system depend upon the combination of age and sex (and other
astrictive descriptions as well)
Apr 14
Psychiatric illness in older persons as a public health problem: impact on health outcomes
Depression associated with worse health outcomes
Worse outcomes
o Hip fractures
o Myocardial infarction
o Cancer
Increased mortality rates
o Myocardial infarction
o Long term care residents probably socially isolated
Depression in Cancer
Inc. hospitalization
Poorer physical function
Poorer quality life
Worse pain control

65+ - highest suicide rate of any age group
85+ 2x the national avg.
Suicide rates goes up continuously for men
Peaks at midlife for women, then declines
1/3 of older men saw their primary care physician in the week before completing suicide; 70%
within the prior week

Older Adults with Severe Mental Illness

Falling through the cracks
Community Mental Health Services
o Under-serve older persons
o Lack staff trained to address medical needs
o Often lack age-appropriate services
Principal Providers:
o Primary care and long-term care
Medicare
o No general outpatient prescription drug coverage & lack of mental health parity
Most physically impaired, the more health services needed but those people are getting fewer
services

Apr 16
Living Old video
People used to die of infectious diseases but now that is curable and now people are dying of
chronic diseases that which require management over time.
System is set up to cure acute diseases not chronic ones
More surgeries and transplants but will they walk again and other common physical problems
They dont want to be a burden and like to stay independent

Apr 21
Mental Illness in the media
The power of the media and its impact on public health
Media Depiction of Mental Illness

Why are we concerned?
Mass media are those sources that reach cast audiences on a daily basis and include television,
film, radio, newspapers, advertising, and the internet:
o Avg. American watches 4 hours of TV ea./day
o 1.36 billion movie tickets were sold in 08

Why are we concerned?
Research has shown that media presentations influence the way viewers and readers think
about their world
People often respond to mental health labels based on the ideas

Despite the few positive images, many investigative reports find lots of neglects and abuses in
different institutions. Images tend to show those depictions of those with mental illnesses to be
violent

The reality
The vast majority of people with psychiatric disorders are not dangerous and violent
The vast majority.
.
Most people with mental illnesses are caring, law abiding citizens
Mass Media tend to show people with mental illness are unlikely to recover

The percentage of ppl associating mental illness with violence has doubled since 1956
because more movies and access to media

Apr 23
Office Hours: Monday & Wednesday 4:00 5:00 PM and by appointment

Primary Deviance no one really knows about it, individual reacts to the Label
Secondary Deviance actually get caught and there is a label tied to you. Strengthening of self-
concept. Its deviance that has been given a name. In the blue/brown eye video, one kid punch
a kid and kids started being labeled to brown or blue eyed people. Same thing happened to
adults. Someone breaks the laws and bad activities. People start to behave in a manner
consistent to the label b/c that label reinforce how those individuals were consistent with the
label. Basically label and labeling process. Behaving in a manner that is consistent with that
label.
Individual Joins Deviant Subculture
Master Status

Primary Dev Secondary Dev Individual join Dev Subculture Master Status

May 5
Wednesday quiz strictly about the reading, same formal as last time. Key themes/points and
general outlines.
Sbs S 423 paper due may 12
th
until 5pm

Cover page name, ID, title use ASA style (dont need abstract)
Bibliography ASA style (journal article, book, book chapter) 3 different styles
Try to use books/articles and now news

Bibliography additional page
Can include graph if needed

Stay away from quotes and try to summarize your own argument.

SOC 392 Full Semester Package

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