SOC 322F Exam 2 Spring 2019

Gender Bias in Help Seeking

Because depressed men are more likely than depressed women to not seek help, treatment rates are an inaccurate measure of depression.

What is Other-Orientation?

Focus on the needs of others rather than personal fulfillment

Hedonic Well-Being

Pursuit of happiness and feeling good.

Subjective Well-Being (SWB)

Life satisfaction, positive and negative emotions

Explanations for race/ethnic differences in mental health:

- Racial discrimination as a chronic stressor - Socioeconomic status - Incarceration - Access to healthcare

Gender stratification theory focuses on socioeconomic disadvantage

True

How do power and status affect mental health?

- "Leadership is Associated with Lower Levels of Stress" - "The Local Ladder Effect"

Race differences in self-reported depressive symptoms

- African Americans typically report higher numbers of depressive symptoms than whites (in survey studies) - Yet, with respect to diagnosed depressive disorders, there are either no race differences or African Americans have lower rates of disorders

Gender bias in seeking help for depression

- Because depressed men are more likely than depressed women to not seek help, treatment rates are an inaccurate measure of depression - Nearly half of men over age 49 nationally who reported experiencing an extended depression did not discuss it with anyone - Instead, men tend to engage in private activities, including drinking and drug use, designed to distract themselves or to alleviate their depression - Denial of depression is one of the means men use to demonstrate masculinities and to avoid assignment to a lower-status position relative to women - "The linkage between depression and femininity may provide men with the strongest motivation to hide their depression from others... Because depression is frequently accompanied by feelings of powerlessness and diminished control, men may construe depression as a sign of failure."

What are black-white differences in positive psychological well-being?

- Blacks have higher rates of complete mental health (flourishing and free of mental illness) than Whites - Blacks are mentally resilient in the face of greater social inequality and exposure to discrimination - About 27% more Blacks than Whites are flourishing and free of any mental illness

Gender bias in diagnosis and treatment of depression

- Clinicians are less likely to identify the presence of depression in men than in women - There is an emphasis on treating women for depression and an assumption that men are an immune to depression - Gender-biased diagnostic decisions: When men do seek help, they are less likely than women to be diagnosed with and treated for depression

Differences in mood disorders and substance use disorders between men and women

- Conventional view: - "Functional equivalence" implies that depression in women = alcohol use in men - Women and men are equally affected by stressors but respond to the same stressful conditions in different ways: ---- Women with internalizing disorders (depression, anxiety) ---- Men with externalizing disorders (substance abuse, aggression)

Traits and behaviors that are associated with cultural norms of masculinity

- Denial of weakness or vulnerability - Emotional and physical control - Appearance of being strong and robust - Dismissal of any need for help - Display of aggressive behavior and physical dominance

Eudaimonic Well-Being

- Deriving satisfaction from developing and growing as a person, connecting to something bigger than simply enjoyment. - It is multidimensional: Carol Ryff developed a widely used measure of six dimensions of positive psychological well-being

Measures of Socioeconomic Status (SES)

- Education (total years of schooling, highest degree obtained) - Financial resources (personal income, household income, wealth/assets) - Occupation

Explanations for higher prevalence of mood disorders among women:

- Femininity & other-orientation. - Gender Stratification Theory. - Gender Stereotypes/Discrimination.

Set-Point (Adaptation) Theory of Well-Being Aka The hedonic treadmill model

- Good and bad events temporarily affect happiness, but people quickly adapt back to psychological neutrality. - People constantly pursue goals striving to be happy without realizing these efforts are futile. - Lottery winners were not happier than nonwinners - People with paraplegia were not less happy than those who can walk

What are the main findings of the Midtown Manhattan Study?(covered in lecture 4)

- Mental disorders more prevalent among the lower class - Persons aged 20-29 of high socioeconomic status had the lowest rates of mental illness - Persons aged 50-59 of low socioeconomic status had the highest rates - Persistent disadvantage across the life course - Upwardly mobile persons fared better than stably disadvantaged or downwardly mobile

Positive Psychology Model

- Mental health is more than just the absence of mental illness - Hedonic and eudaimonic well-being

Explanations for higher prevalence of mood disorders among women: Femininity and other-orientation

- Other-orientation: focus on the needs of others rather than personal fulfillment - Depression is consistent with femininity, where alcohol use is not - Drinking is associated with masculinity (especially heavy drinking or drinking in public) - Because femininity is closely linked to motherhood, women's drinking is viewed as problematic for children and families - The cultural stigma of alcohol use among women may prompt women to conceal their drinking or not to seek help for substance-related problems - Women's drinking may be less likely recognized as a mental health problem - just like depression in men

How are education, income, and occupation related to mental health?

- People with higher levels of education, income, and occupational prestige have fewer diseases, less disability, better mental health, and longer lives compared to people with low SES - Lower social class - Higher rates of mental illness, including depressive disorders, anxiety disorders, schizophrenia, substance abuse, etc.

SES and Health

- People with higher levels of education, income, and occupational prestige have fewer diseases, less disability, better mental health, and longer lives compared to people with low SES - Lower social class: Higher rates of mental illness, including depressive disorders, anxiety disorders, schizophrenia, substance abuse, etc.

Explanations for higher prevalence of mood disorders among women: Gender stratification theory

- Socioeconomic disadvantages - Fewer financial resources and inequality in the division of work and family labor are associated with a higher risk of internalizing problems among women, such as depression and anxiety - Women are more likely to experience poverty and economic hardship than men - Black and Latina women have the highest risk of poverty compared to all other race/ethnic groups

"Construction of masculinity"

- The social practices that undermine men's health are often signifiers of masculinity and instruments that men use to affirm their social power and status - Men's health-related beliefs and behaviors are a means for demonstrating or constructing masculinity => "constructions of masculinity"

What is the "double standard" in mental health?

- The trait the male possesses is the more desirable trait for someone in our Western culture. - If feminine traits are followed, the woman has less desirable characteristics - If masculine traits are followed, the woman is perceived negatively - "Double bind" (i.e. "Damned if you do and damned if you don't") - Women in authority positions are viewed as lacking the assertiveness and confidence of strong leaders, but when women display the leadership qualities, they are judged negatively for being unfeminine

The current consensus in sociology and the extent to which this consensus is supported or not supported by published research

- Women and men respond to stressful conditions with affective outcomes and behavioral outcomes - 26 studies showing gender similarities in response to stressors (evidence against the propositions of male-specific and female-specific manifestations of distress).

Explanations for higher prevalence of mood disorders among women: Gender stereotypes and discrimination

- Women's family responsibilities may impede their professional gains via two mechanisms: ---- Curtailing the time and effort available to pursue careers ---- Factoring in employers' decisions - Employers and colleagues may hold stereotypical ideas about women workers—especially the belief that mothers are less committed to their careers and thus less appropriate candidates for promotion than non-mothers - Mothers are offered significantly lower starting pay than equally qualified non-mothers (an average of $11,000 lower in this study) for the same job

US Census distinction between race and ethnicity

-5 race categories White, Black/African American, American Indian/Alaska Native, Asian, Native Hawaiian/Hawaiian/Other Pacific Islander, Some Other Race Race: a person's self-identification with one or more social groups -2 ethnic categories Hispanic/Latino, Not Hispanic/Not Latino ·Hispanic or Latino refers to a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture/origin regardless of race Ethnicity can be viewed as the heritage, or where the person (or their parents/ancestors) were born before they came to the US.

What is fatalism and why is it important in the study of social class and mental health?

-Fatalism: the belief that all events are predetermined and therefore inevitable -Socioeconomically disadvantaged people learn through recurrent experiences that they have limited opportunities, that no matter how hard they try they cannot get ahead -These beliefs partly reflect realistic perceptions and are reinforced in day-to-day living -The sense of disempowerment and lack of personal control decreases their ability to protect themselves against chronic stress

What are main findings of Faris and Dunham's Chicago study?

-Found that the highest rates of schizophrenia were clustered in the slum areas of town; lower rates of schizophrenia were found in more affluent neighborhoods -They hypothesized that people living in poverty were more isolated from normal social contracts and therefore were more vulnerable to developing a "seclusive personality" which they believed was the key trait to schizophrenia Hypothesis was incorrect, as social isolation is usually the result rather than the cause of schizophrenia -Established the position that one's location in a social structure had definite implications for one's mental health -Serious psychiatric disorders were found primarily in lower-class neighborhoods

What are main findings of Leightons' Stirling County study?

-Found that the prevalence of mental disorder appeared to increase with age (until 65 when prevalence declined) and was significantly greater for women than for men -Mental disorder was most frequent among members of the lowest socioeconomic group

What is the "Gender Stratification Theory"?

1. Focuses on socioeconomic disadvantages. 2. Fewer financial resources & inequality in the division of work & family labor associated with higher risks of internalizing problems among women. (Like depression & anxiety)

What are the traits and behaviors that are associated with cultural norms of masculinity?

1. Denial of weakness or vulnerability. 2. Emotional & physical control. 3. Appearance of being strong and robust. 4. Dismissal of any need for help. 5. Display of aggressive behavior & physical dominance.

Femininity:

1. Depression is consistent with femininity. Alcohol use is not. 2. Alcohol use is associated with masculinity. Since femininity is closely linked to motherhood, women's drinking habits are seen as problematic to children and family. 3. Cultural stigma of drinking among women may prompt women to conceal their drinking or not seek help.

What are the gender biases in diagnoses & treatment of depression?

1. The health care system contributes to the social construction of disease. 2. Clinicians are less likely to identify the presence of depression in men than in women. 3. There's an emphasis on treating women for depression and an assumption that men are immune to depression. 4. Gender Biased Diagnostic Decisions -- When men do seek help, they are less likely than women to be diagnosed with & treated for depression.

What are the gender biases in seeking help for depression?

1. Treatment rates are an inaccurate measure of depression because depressed men are more likely than depressed women to not seek help. 2. Nearly half of men over 49 years old nationally who reported experiencing an extended depression did not discuss it with anyone. 3. Instead of seeking help, men tend to engage in private activities such as drinking and drug use. This is designed to distract themselves or to alleviate their depression. 4. Denial of depression is one of the means men use to demonstrate masculinities and to avoid assignment to a lower-status position relative to women.

Femininity & other-orientation:

1. Women are expected to be caring & nurturing. 2. Women's position is responsible for domesticity & nurturing to promote collectivity & other orientation. 3. Prioritizing others above self is associated with internalizing feelings/problems. (including depression) 4. Other Orientation: Focus on needs of others, rather than personal fulfillment.

What is the extent to which this consensus is supported or not supported by published research?

26 studies showing gender similarities in response to stressors. (Evidence against the proposition of male-specific & female-specific manifestations of distress.

Access to healthcare

African Americans and Hispanics are less likely to have health insurance, to regularly receive medical care, and to be screened early for health problems Racial and ethnic minorities are more likely to feel that health care providers are condescending and biased, and that the health counseling they receive is incorrect or incomplete

Gender Bias in Diagnosis and Treatment

Clinicians are less likely to identify the presence of depression in men than in women. There is an emphasis on treating women for depression and an assumption that men are an immune to depression

The current consensus in sociology & the extent to which this consensus is supported or not supported by published research:

Current Consensus: Mood and anxiety disorders in women and substance abuse in men are "functionally equivalent" manifestations of misery.

What is the "double standard"?

If feminine traits are followed, the woman has less desirable characteristics; If masculine traits are followed, the woman is perceived negatively. "Double bind" (i.e. "Damned if you do and damned if you don't")

Incarceration

Incarceration is a strong predictor of long-term health People who have been incarcerated report significantly worse health than comparable people who have never been incarcerated Because African Americans are disproportionately incarcerated, and incarceration is detrimental to health, this partly explains why African Americans (especially men) have worse health than Whites

Current consensus in sociology about disorders between Gender.

It is therefore clear that major differences exist between men and women in the pattern of mental disorders they are most likely to experience. Women have a tendency to internalize their feelings of mental distress by turning them inward on themselves resulting in more anxiety and depression, whereas men tend to externalize their distresses through greater substance use and personality disorders that is upsetting to others.

"Leadership is Associated with Lower Levels of Stress"

Leaders had lower levels of cortisol Leaders holding more powerful positions (with a large number of subordinates and substantial authority over subordinates) exhibited even lower cortisol levels than leaders holding less powerful positions Leaders' lower cortisol was explained by their the sense of control (mastery): - Leadership (power) increases the sense of control - A higher sense of control reduces cortisol

"Constructions of masculinity and their influence on men's well-being":

Masculinity is socially constructed and affects mens mental health.

How are men's risky health behaviors resources for "doing" (constructing) masculinity in everyday life?

Men are much more likely than women to adopt beliefs & behaviors that increase health risks. Less likely to engage in behaviors that promote health & longevity.

How do men respond to stressful conditions?

Men with externalizing disorders. (substance abuse, aggression)

Constructions of masculinity

Men's health-related beliefs and behaviors are a means for demonstrating or constructing masculinity. The social practices that undermine men's health are often signifiers of masculinity and instruments that men use to affirm their social power and status

Social Selection

Mental Illness => Social Class "Selection" means people are "selected" into education, jobs, etc. based on their mental health status - More mental disorder in lower class because mentally ill persons "drift" downward in the social structure - Mentally healthy individuals in lower class tend to be upwardly mobile, thus leaving behind a "residue" of mentally ill persons Some evidence supporting a relationship between social mobility and mental disorder - BUT social selection alone is not a fully adequate explanation - The Midtown Manhattan study: mentally ill people are not especially mobile, either up or down

Racial differences in DSM diagnoses

Mood Disorders: Non-Hispanic blacks are 40% less likely, and Hispanics are 20% less likely, than non-Hispanic whites to experience (be diagnosed) a mood disorder Anxiety Disorders: Non-Hispanic blacks are 20% less likely and Hispanics are 30% less likely, than non-Hispanic whites to experience an anxiety disorder during their lifetime 12-month prevalence of major depressive episode among U.S. adults Hispanic: 7.0% White: 7.1% Black: 6.3% Schizophrenia is diagnosed more frequently among African Americans while mood disorders among whites

Race Categories

OMB required federal agencies to use a minimum of five categories; White, Black or African American, American Indian of Alaska Native, Asian, and Native Hawaiian or Other Pacific Islander. For all who do not fit the five categories, there's the Other Race category

Ethnicity Categories

OMB requires federal agencies to use a minimum of two ethnicities; Hispanic or Latino (Cuban, Mexican, Puerto Rican, South or Central America, or other Spanish culture or origin regardless of Race) and Not Hispanic or Latino

Socioeconomic status

Racial/ethnic differences in socioeconomic status (education, income, occupation) are key in explaining racial/ethnic health disparities - African Americans and Hispanics have lower levels of education, income, and wealth than Whites - African Americans and Hispanics are more likely than whites to have unstable, low-paying, monotonous, unrewarding jobs, often with hazardous conditions Lower socioeconomic status of African Americans and Hispanics contributes to their worse health and higher mortality relative to whites

Racial discrimination as a chronic stressor

Racism is embedded in the structure and function of the society Racial discrimination is a chronic stressor embedded in the very nature of daily life - Minority groups are more likely to experience unfair treatment and bias than whites - Stress caused by experiencing various forms of racial bias can weaken the body over time, lead to physical and mental health problems, and premature death

Social Causation

Social Class => Mental Illness Greater exposure - Lower class leads to greater adversity and stress as a result of a deprived life situation Greater vulnerability - Stressors have a more severe effect on socially disadvantaged than socially advantaged - Low social class - fewer resources to cope with stressors

What are the two explanations for the relationship between social class and mental health?

Social Causation & Social Selection

Current soncensus in sociology on the explanation for the relationship between soical class and mental health

Social class causes mental disorder more than mental disorder causes social class But this does not mean that social selection does not operate - Bruce Dohrenwend et al. (Science, 1992) - Necessary to take the type of mental disorder into account ---- The social selection hypothesis more relevant to the social class-schizophrenia relationship ---- The social causation hypothesis more useful for the social-class depression relationship

What are main findings of Hollingshead and Redlich' New Haven study?

The main conclusion of this study was that there was a significant relationship between social class and mental illness both in type and severity of mental illness suffered as well as in the nature and quality of treatment that is provided. Individuals from the lowest socioeconomic strata had a much higher incidence of severe, persistent, and debilitating forms of mental illness and received the least adequate forms of treatment, if they received treatment at all. -Class I and Class II people (upper-upper and lower-uppers) were more aware of psychological problems and were more perceptive of conflict and the nature of personal difficulties; friends and family were the likely source of referrals to psychiatrists -Class V people (upper-lowers and lower-lowers) are much slower to attribute personal problems to mental disorder; police or social welfare agencies were the likely source of referrals to psychiatric care -Found that for specific types of mental disorders (anxiety disorders and schizophrenia), definite patterns emerged by social class -Social factors can be correlated with degrees and types of mental illness and the manner in which people received psychiatric care

Differences in mood disorders and substance use disorders between men and women:

Women & Men are equally affected by stressors but respond to the same stressful conditions in different ways.

How do women respond to stressful conditions?

Women with internalizing disorders. (Depression, anxiety)

Flourishing

absence of mental illness, high levels of PWB (Positive Well-Being)

Languishing

absence of mental illness, low levels of PWB (Positive Well-Being)