Lecture 3: Social Construction & Management Flashcards
pre 1930s view of mental illness
- Before the 1930s, mental illness was viewed as an unresolved psychological conflict that stemmed from an individual’s development (psychoanalytic perspective)
- Mental illness was viewed as dimensional and existing on a continuum
changes in the field of psychiatry
- The condition of World War ll veterans resulted in a greater need for a streamlined classification system
- Post World War ll, the first edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) came out
- In the 1970s, there was a growing anti-psychiatry and anti-institutionalization movement
1970s- 2013 view of mental illness
- The 3rd version of the DSM embraced the dominance of a biomedical model
- This pulled in some credibility to the field of psychiatry
- There was a greater emphasis on making discrete diagnoses
2013- present view of mental illness
- In 2013, the DSM-lV attempted to return to the idea of mental illness as dimensional and existing on a continuum
- Advances in biomedical technology suggest that mental health could exist on a continuum
- High degrees of comorbidity between mental illnesses suggest that the boundaries between disorders are arbitrary
- The field wasn’t much closer to understanding the underlying causes of mental illness
- This attempt was ultimately unsuccessful
Psychiatric nosology
the classification of mental disorders
reliability
concerned with the consistency of results
validity
concerned with whether what we’re measuring what it is intended to
problems with the DSM-lll
- Those in charge of writing it had a lot of control over what constitutes a mental illness
- It continued to have reliability issues
why is classification important?
- Allocation of resources
- Identity and stigma
- Reflection of the social environment
- Professional authority and legitimacy in the sciences
Szasz’s myth of mental illness
- Szasz was a psychiatrist who criticized the notion of mental illnesses because doctors couldn’t find concrete evidence of mental illness in the brain
- He thought that there were fundamental issues with viewing mental illness as a medical disorder
Szasz’s points of departure
conception of mental illness as real (a result of neurological defects) and fit within the same framework as a physical ailment
Szasz’s two fundamental errors
- Neurological consequences cannot encompass what people do
- False dualism between mental and physical symptoms
Szasz’s definition of mental illness
Szasz defined mental illness as a deviation from an agreed-upon norm
is psychiatry neutral?
- Psychiatry is not-value free
- There is friction between socially constructed deviations and objective medical remedies
objectives of mental illnesses
- Hide difficulties of living
- An explanation for why problems exist
- Obscure moral conflicts of humanity
resolution to the objectives of mental illness
- Disease -> problems in living
- Manifestation of the burden of understanding
two types of sociological assessment techniques
diagnostic & dimension instruments
diagnostic instruments
- Assess lifetime and current psychiatric status
- Ex. Composite International Diagnostic Interview Short-Form (CIDI-SF)
advantages of diagnostic instruments
- Helps identify those in need of services
- It may produce more precise assessments of mental status
disadvantages of diagnostic instruments
- There is a high degree of overlap in diagnosis and treatment
- Discrete measurement of non-discrete phenomena
dimensional instruments
- Assess the presence, frequency, and severity of symptoms
- Ex. Beck Anxiety Inventory
advantages of dimensional instuments
- It helps reduce misclassification issues
- Still able to help with diagnosis
disadvantages of dimensional instruments
- Only measures current distress
- Not always practical
social constructionism
Emphasis on cultural and historical aspects
key themes of social constructionism
- Social control
- Power
- Iterative process
- Structure vs. agency
cultural meanings of illness
Illnesses have particular social and cultural meanings attached to them
illness experiences as socially constructed
- Social realities are created
- Identity formation and meaning-making
medical knowledge as socially constructed
- Medical knowledge as a reflection and reproduction of inequality
- Can we be completely objective in diagnosing mental health conditions?
medicalization
- the process by which nonmedical problems become defined and treated as medical
- Behaviours transformed into diseases with assumed biological or neurological bases
why is medicalization increasing?
- Professional politics
- Pharmaceutical companies
- Insurance companies
pros of medicalization
- Lessen stigma/build legitimacy
- Build solidarity
- Increase awareness
- Explanation of potential unknowns
- Financial support where needed
- Access to resources
cons of medicalization
- Decontextualization of mental health
- Reductionist
- Misinterpretation of normal behaviour
- Inflation of prevalence rates
- Rise in pharmaceuticals
- Policing of behaviours
