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SOCIAL CLASS AND MENTAL ILLNESS

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PEOPLE SIMILAR IN ECONOMIC AND SOCIAL STATUS, EDUCATION, ... CULTURE - EDUCATION, TASTE. MEASURES. INCOME. EDUCATION. COMBINATION (UPPER; MIDDLE; WORKING; LOWER) ... – PowerPoint PPT presentation

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Title: SOCIAL CLASS AND MENTAL ILLNESS


1
SOCIAL CLASS AND MENTAL ILLNESS
2
WHAT IS SOCIAL CLASS?
  • PEOPLE SIMILAR IN ECONOMIC AND SOCIAL STATUS,
    EDUCATION, WAYS OF LIFE, ATTITUDES AND BELIEFS
  • TWO MAJOR ASPECTS
  • MATERIAL RESOURCES FINANCIAL
  • CULTURE - EDUCATION, TASTE

3
MEASURES
  • INCOME
  • EDUCATION
  • COMBINATION (UPPER MIDDLE WORKING LOWER)
  • STATUS INCONGRUITY

4
CAUSE AND EFFECT
  • CAUSATION - SOCIAL CLASS PRECEDES M.I.
  • MORE ACUTE AND CHRONIC STRESSORS
  • MORE VULNERABILITY
  • WORSE TREATMENT
  • IF CAUSE -RESOURCES OR CULTURE?

5
SOCIAL CLASS AS EFFECT
  • SELECTION - M.I. PRECEDES SOCIAL CLASS
  • DOWNWARD DRIFT

6
PSYCHOSIS
7
FARIS AND DUNHAM
  • CHICAGO 1939
  • 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)

8
FARIS AND DUNHAM
  • ORIGINALLY SAID ISOLATION OF CENTRAL CITY CAUSES
    SCHIZ.
  • LATER CHANGED MIND AND SAID PEOPLE FIRST BECOME
    SCHIZ AND THEN MOVED TO CENTRAL CITY
  • SELECTION

9
RECENT STUDIES
  • SCHIZ ALWAYS ASSOCIATED WITH LOWER SOCIAL CLASS
  • WHAT IS CAUSE AND WHAT EFFECT?
  • LOOK AT PARENTS SOCIAL CLASS
  • SELECTION MORE THAN CAUSATION
  • DOWNWARD DRIFT
  • BIPOLAR NOT RELATED TO S.C.

10
NON-PSYCHOTIC
11
INCOME AND M.I.
12
INCOME AND M.I.
13
NON-PSYCHOTIC
  • LOWER CLASS ALWAYS HIGHEST
  • SOMETIMES INVERSE, SOMETIMES NOT
  • STRONGEST FOR ANXIETY
  • WEAKEST FOR SUBSTANCE ABUSE
  • LOWER CLASS ESPECIALLY LIKELY TO HAVE COMORBID
    DISORDERS

14
REASONS FOR NON-PSYCHOTIC
  • CAUSATION NOT SELECTION
  • STRESSORS
  • MODEST RELATIONSHIP WITH ACUTE LIFE EVENTS
  • STRONGER RELATIONSHIP WITH CHRONIC STRESSORS

15
OCCUPATIONAL REASONS (LENNON)
  • HIGHER SOCIAL CLASSES HAVE MORE AUTONOMY AND
    CONTROL OVER WORK
  • HIGHER SOCIAL CLASSES HAVE FEWER PHYSICAL
    STRESSORS OF WORK
  • HIGHER SOCIAL CLASSES HAVE MORE JOB STABILITY

16
VULNERABILITY
  • LOW SOCIAL CLASS ESPECIALLY VULNERABLE TO
    STRESSORS
  • LESS ADEQUATE MATERIAL SUPPORT AND COPING
  • LEADS TO LONGER DURATION AND POORER PROGNOSIS FOR
    LOWER CLASSES

17
TREATMENT
18
SOCIAL CLASS AND TREATMENT
  • INCIDENCE NEW CASES
  • PREVALENCE ALL CASES
  • PREVALENCE INCIDENCE REENTRY CONTINUOUS
  • HOLLINGSHEAD AND REDLICH STUDY OF NEW HAVEN IN
    1950s

19
TREATMENT OF PSYCHOSES
20
TREATMENT OF PSYCHOSES
  • NO S.C. DIFFERENCES IN INCIDENCE EXCEPT LOWER
    CLASS HAS MORE
  • STRONG INVERSE RELATIONSHIP OF SOCIAL CLASS AND
    PREVALENCE OF PSYCHOSES

21
EXPLANATIONS
  • MORE CONTINUING STRESSORS FOR LOWER CLASS
  • WORSE PSYCHIATRIC TREATMENT FOR LOWER CLASS
  • MORE COMMUNITY SUPPORT FOR HIGHER CLASSES
  • LONGER DURATION AND WORSE PROGNOSIS FOR LOWER
    CLASSES

22
TREATMENT OF NEUROSES
23
TREATMENT OF NEUROSIS
  • NO DIFFERENCE IN NEW CASES
  • HIGHER CLASSES HAVE MUCH GREATER TREATED
    PREVALENCE
  • HIGHER CLASSES STAY MUCH LONGER IN TREATMENT
  • RELATIONSHIP FOR PREVALENCE OPPOSITE FOR NEUROSES
    AND PSYCHOSES

24
REASONS
  • CULTURE OF HIGHER CLASSES MORE CONGRUENT -
    ESPECIALLY EDUCATION
  • LESS STIGMA FOR HIGHER CLASSES
  • RESOURCE DIFFERENCES
  • RESPONSE OF M.H. PROFESSIONALS

25
SUMMARY
  • SOCIAL CLASS HAS STRONG ASSOCIATION TO M.I.
  • PSYCHOSES - SELECTION
  • NON-PSYCHOTIC CAUSATION
  • STRESSORS AND VULNERABILITY
  • HIGHER CLASSES MORE OUTPATIENT AND LESS INPATIENT

26
SUMMARY (CONT.)
  • LOWER CLASSES MORE INPATIENT AND LESS OUTPATIENT
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