living with chronic illness and disease

Question 1

(societal) symbolic interactionism

Answer 1

humans create reality through their actions and the meanings they give to them. Therefore, society is the cumulative effect of human action, interaction, and interpretation

Question 2

underlying assumptions of symbolic interactionism

Answer 2

1. humans act on the basis of meaning (rather than instinct)
2. meanings arise out of interaction (and are dynamic and relational rather than fixed and unchangeable)
3. individuals interpret meaning
4. we develop a sense of self through interaction with others

Question 3

key concept #1 for symbolic interactionism
: social construction **

Answer 3

-based on the idea that people actively “construct” reality
-> meaning that its neither natural or inevitable
- therefore, notions of normal/abnormal, right/wrong and even health/illness are subjective human creations and should not be considered universal or unchanging/unchangeable
-attribute and interpret meanings/behaviour
-emphasis on agency

Question 4

examples of social construct ***

Answer 4

race - we have seperated and grouped those with different skin colors and features
money - humans agree on what paper and coins represent
countries - humans mutually agree and acknowledge their existence
gender - men and women act differently based on dictated gender roles

Question 5

deviance **

Answer 5

-behaviour or activities that violate social expectations about what is “normal”
-who defines those expectations
-what causes or motivates someone to deviate from social expectations
-how is deviance understood through the lens of gender, age , SES, ethnicity, sexual identity, or other social inequalities

Question 6

chronic diseases

Answer 6

health problems that require ongoing management over a period of years

Question 7

disease

Answer 7

refers to a biophysical condition with a specific diagnosis

Question 8

illness

Answer 8

the subjective response to the disease - includes how people perceive, experience, make sense of and respond to disease

Question 9

social construction of illness

Answer 9

-health and illness not just medical categories
-rather they are :

social phenomena : interactions bw and among individuals and the characteristics, structures and functions of social groups and institutions

socially situated : the idea that the development of individual intelligence requires a social and cultural embedding

**textbook

Question 10

components of social construction of illness

Answer 10

1. meanings attributed to illness
   -changing definitions over time and across cultures
   -e.g. civil disobedience; drug and alcohol use; homosexuality; promiscuity
2. experience of illness
   -shaped by contextual and individual factors
   -eg. influence of gender and class

• it is not to deny that viruses and disease objectively exist

Question 11

Diagnostic and statistical manual (DSM)

Answer 11

different conditions constantly being added to DSM
-for mental disorders
-big 5 includes hoarding, caffeine withdrawal, cannabis withdrawal, binge eating disorder

Question 12

social interactions

Answer 12

lead us to understand and label some things as diseases instead of simply variation in the human population
eg. autism spectrum

Question 13

osteoarthritis (OA)

Answer 13

-middle-aged and older participants with similar symptoms
-but different experience and interpretations
-> “normal aging”
-> “invisibility” of OA

Question 14

symbolic interactionism key concept #2
stigma ***

Answer 14

-person has “an attribute that is deeply discrediting”
-leads to negative social reactions
-eg. disability, criminal record
-three kinds of stigma

Question 15

stigma 1 : abominations of the body **

Answer 15

physical characteristics that are deemed to be deformities, unnatural and/or undesirable
-historically this has included, physical disabilities, obesity, visible illness or disease, tatoos or other counter-culture body modifications

Question 16

stigma 2 : blemishes of character ***

Answer 16

character trait stigma
-associated with perceptions that an individual is weak willed, dishonest, has “unnatural desires”or other undesirable character traits
-historically this has included : addictions, homosexuality, radical or unpopular political beliefs
- acting not “normal “ or “socially acceptable”

Question 17

stigma 3 tribal stigma of race, nation or religion

Answer 17

group identity stigma
-traits with negative associations or stereotypes that are passed through generations
- historically this has included : stereotypes or representations that label certain ethnic groups as lazy, dirty, dumb, greedy

Question 18

implications of stigma

Answer 18

• contributes to various forms of discrimination
  -often done “unthinkingly” without acknowledgement or reflection on how these meanings are created
  REDUCES individuals life chances

Question 19

eg HIV/AIDS

Answer 19

stigma/discrimination -> fired, evicted, shunned/rejected, denied treatment

a) abominations of the body -> wasting syndrome, lesions etc. often made disease visible
b) blemishes of individual character -> assumed to be result of lifestyle choices
c) tribal stigma -> initially only associated with gay men

Question 20

eg. contested chronic illnesses

Answer 20

-limited or controversial physical signs
eg. fibromyalgia and chronic fatigue syndrome
-dismissed by some physicians as psychosomatic

Question 21

mental health and stigma

Answer 21

-negative stereotypes
-silence and exclusion
-barrier to treatment -> 49% of those w depression or anxiety do not seek help

Question 22

medicalization and social construction

Answer 22

process by which non-medical problems become defined and treated as medical issues, usually in terms of illnesses, disorder or syndromes

-deviation from certain behaviours, expectations and “norms” become defined and treated as illness or a medical phenomenon

-key roles played by “engines of medicalization” : physicians, biotech discoveries, health insurance, pharm industry

-both good and bad implications

Question 23

medicalization and social construction

Answer 23

-defining natural biological processes as something that requires pharmaceutical, surgical, or therapeutic intervention
-many aspects of daily life = medical issues
-identification and classificaation required to become a legitimate “illness”

Question 24

what does this medicalization do

Answer 24

pathologize (treat something as abnormal) normal everyday functioning
-diminish our tolerance for, and appreciation of the diversity of human life
-unduly reinforce gender norms

Question 25

women and medicalization

Answer 25

women’s bodies and physiological processes deviate from the “ideal male norm”
-medical scrutiny due to beauty ideals
-pregnancy, child birth, menstrual cycle

Question 26

female dilema of medicalization

Answer 26

legitimation of experiences of premenstrual symptoms as real and worthy of medical and public attention
vs
pathologizes womens bodies and views womens actions and thoughts as being determined by biology -> stigmatization -> sex discrimination

Question 27

men and medicalization

Answer 27

connected to notions of masculinity
-baldness, sexual performance rooted in masculine identity that embodies physical strength, energy, hirsutism, sexual vitality
-all the more effective bc embraces by mens own concerns with their masculine identities

-andropause = male menopause
-> “normal” changes became pathologized as dysfunctions (viagra)

Question 28

demedicalization

Answer 28

an issue once defined medical terms is no longer defined as such, and medical intervention is considered inappropriate
-eg. masturbation
-homosexuality
-childbirth
-case in point for social construction of illness and disease

Question 29

benefits of medicalization (medicalization from below, by choice)

Answer 29

broadening of preexisting medical categories
to include more sufferers and situations
eg. adhd, PTSD
-promote medical intervention as necessary for well-being
eg. alcoholism,mental disorders, sub abuse
-reduce individual blame for problem