SOC363: 10. Comparative Flashcards

Question 1

Q

The Study of Generalizability

Answer

A

v Most of the research done in North America
v Major questions:
o Do concepts generalize?

Question 2

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The Study of Generalizability

Answer

A

o Do measures generalize?
o Are social patterns the same?
o Does the stress process apply?

Question 3

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The Study of Generalizability

Answer

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o How does culture intervene?
• Much speculation, little evidence…until recently.
v Mainly questions; few clear answers

Question 4

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Kessler and International Epidemiology

Answer

A

The CIDI has been translated and modified for use in
over 30 countries in Europe, Africa, and Asia.
v Main concerns:
o Meaning of questions
o Differences in symptoms

Question 5

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Kessler and International Epidemiology

Answer

A

o Differences in disorders

v General approach:

Question 6

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Kessler and International Epidemiology

Answer

A

o Use local expert psychiatric teams to translate, change wording, add
questions…. Only when necessary.
o These teams claim most to all of the DSM disorders exist in their countries in some form.

Question 7

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Kessler and International Epidemiology

Answer

A

in diff society, there are differences in symptoms for same disorder and different prevalent disrders

Question 8

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The WHO Initiative: Prevalence in 17 Countries

Answer

A

The joint initiative – Kessler and a cast of millions
Prevalence is current prevalence (but age differences mean not really comparable), and projected lifetime is
projection when everyone is 75.
% under projected lifetime

Question 9

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The WHO Initiative: Prevalence in 17 Countries

Answer

A

strongly in europe, few in africa
many pathways of stress can lead to save disorders and issues
vU.S. the highest rate, but Colombia close (a stressful environment for a different reason)

Question 10

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The WHO Initiative: Prevalence in 17 Countries

Answer

A

-vNorthern / Eastern / Western European
countries closer than others (Average LR
= 44).
big dropoff in LR
also survey could have been done poorly if they don’t understand

Question 11

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The WHO Initiative: Prevalence in 17 Countries

Answer

A

vAsian and Southern European countries
lower. (Average LR = 24)
vNigeria lowest overall, China next

Question 12

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Projected Lifetime Risk

Answer

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Actuarial methods used to project cumulative risk to age 75, to adjust for differences in age distributions and create a common ground for comparison.
vComparative patterns emerge when rates are presented
adjusting for lifetime risk.

Question 13

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Projected Lifetime Risk

Answer

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Risk-to-prevalence ratios measure the likely result over time of age trends….
o Measured by the ratio of the lifetime risk to the current prevalence: how much will prevalence increase in the future?
o But may reflect special circumstances as well that apply at a point in history

Question 14

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Lifetime Risk in 17 Countries

Answer

A

Highest risk to prevalence ratios in countries with high levels of continuing sectarian violence (Israel, Nigeria, South Africa.)
Adjusting for this – no major differences between less and more developed countries

Question 15

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Lifetime Risk in 17 Countries

Answer

A

relative prevalence tend to be anxiety and affect, mood disorders
• But there is real variation across
countries in lifetime risk:
• About half in 6 countries

Question 16

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Lifetime Risk in 17 Countries

Answer

A

• One-third in 6 countries
• One quarter in 3 countries
• One fifth in 2 countries
• But the patterns here do not suggest
an explanation – just questions

Question 17

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Generalizations about Prevalence?

Answer

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vAnxiety disorders most prevalent in 10; mood disorders in all but one of the rest.
vImpulse control disorders least prevalent
vAge of onset shows some consistency as well:

Question 18

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Generalizations about Prevalence?

Answer

A

-o Impulse control disorders occur over a narrow range (e.g., 7-9 for attention deficit, 9-14 for conduct disorder, 13-21 for intermittent explosive)
can’t have huge gaps in onset ages

Question 19

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Generalizations about Prevalence?

Answer

A

-o But some of the most prevalent disorders have a wider range of onset across societies:
• Generalized anxiety, panic, PTSD: median 24-50 is a wide range, though the middle
range of 31-41 is less dispersed.

Question 20

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Generalizations about Prevalence?

Answer

A

-• Mood disorders median onset 29-43. Also varied.

vSuggests differences in causation – but social. Not obviously biological.

Question 21

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Speculation, Hypotheses?

Answer

A

Life in developed Western societies actually more
stressful.: because rates are highest
2. not physical based disorders
vMeaning of mental health problems accepted as a
separate set of illnesses.

Question 22

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Speculation, Hypotheses?

Answer

A

-3. protect from high rates of disorder: Collectivist societies change life expectations and focus on individual functioning is lower priority.

Question 23

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Speculation, Hypotheses?

Answer

A

–4. The role of social “safety nets”?: social safety nets: Strong norms and relative homogeneity of culture and religion ..help?

Question 24

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Speculation, Hypotheses?

Answer

A

-5. Coping, history, and culture……: history of culture hom mental health responds to mental health
Mental health a “white” North American / Eurocentric
problem?
Other Countries,

Question 25

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Other Countries, Same Method: Lebanon

Answer

A

Karam et al., 2008.
lower overall rate despite history of war
3x rate of anxiety and higher mood than males
but also higher rate of impulse in males

Question 26

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Other Countries, Same Method: Lebanon

Answer

A

substance abuse significantly lower than NA and so low for males
20% for 8-34 vs 10.6% for 65+
more exposure to stressful circumstances

Question 27

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Other Countries, Same Method: Lebanon

Answer

A

vLower overall rate is obvious – despite war exposure in
the background of many of the respondents.
thus overall rates is much higher for females because substance abuse is missing for males

Question 28

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Other Countries, Same Method: Lebanon

Answer

A

vHighest relative single prevalence for depression, but
highest prevalence for class of disorders is for anxiety – similar to the U.S.
if we didn’t look at substance abuse, discussion on gender differences would be different

Question 29

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Main Similarities and Differences with U.S

Answer

A

-vGender differences similar for mood and anxiety
disorders..
v but low rate of substance use affects overall balance – thus higher rates overall among females.-

Question 30

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Main Similarities and Differences with U.S

Answer

A

–thus overall rates is much higher for females because substance abuse is missing for males
if we didn’t look at substance abuse, discussion on gender differences would be different

Question 31

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Main Similarities and Differences with U.S

Answer

A

-v Cohort shifts or war exposure??

vWar exposure does affect risk…..

Question 32

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Main Similarities and Differences with U.S

Answer

A

Odds mostly above 1..
Mostly 5 to 15 times the risk
all at least 5-10 OR
creates higher risk for disorder

Question 33

Q

Speculation, Hypotheses?

Answer

A

vLife in developed Western societies actually more
stressful.
vMeaning of mental health problems accepted as a
separate set of illnesses.
vCollectivist societies change life expectations and focus
on individual functioning is lower priority.
vStrong norms and relative homogeneity of culture and
religion ..help?

Question 34

Q

Speculation, Hypotheses?

Answer

A

-vThe role of social “safety nets”?
vCoping, history, and culture……
vMental health a “white” North American / Eurocentric
problem? 9
9
Other Countries,

Question 35

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Speculation, Hypotheses?

Question 36

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Speculation, Hypotheses?

Question 37

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Speculation, Hypotheses?

Question 38

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Speculation, Hypotheses?

Question 39

Q

Speculation, Hypotheses?

Question 40

Q

Other Countries, Same Method: Lebanon

Answer

A

vKaram et al., 2008.

Question 41

Q

Other Countries, Same Method: Lebanon

Question 42

Q

Other Countries, Same Method: Lebanon

Question 43

Q

Other Countries, Same Method: Lebanon

Question 44

Q

Other Countries, Same Method: Lebanon

Question 45

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Main Similarities and Differences with U.S

Answer

A

vLower overall rate is obvious – despite war exposure in
the background of many of the respondents.
vHighest relative single prevalence for depression, but
highest prevalence for class of disorders is for anxiety – similar to the U.S.

Question 46

Q

Main Similarities and Differences with U.S

Question 47

Q

Main Similarities and Differences with U.S

Question 48

Q

Main Similarities and Differences with U.S

Answer

A

vGender differences similar for mood and anxiety
disorders..
v but low rate of substance use affects overall balance – thus higher rates overall among females.
v Cohort shifts or war exposure??
vWar exposure does affect risk…..

Question 49

Q

Main Similarities and Differences with U.S

Question 50

Q

Main Similarities and Differences with U.S

Question 51

Q

Main Similarities and Differences with U.S

Question 52

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Odds Ratios due to “war events” in Lebanon

Question 53

Q

Odds Ratios due to “war events” in Lebanon

Question 54

Q

Odds Ratios due to “war events” in Lebanon

Question 55

Q

Other Countries, Same Method: China

Answer

A

vLee et al. (2007) –Beijing and
Shanghai
vTaken at face value, the rates
of all of these problems is
much lower in China.
vBut note the two most
prevalent similar to U.S. –
depression and alcohol abuse.
v Reporting problem or
difference in meaning?

Question 56

Q

Other Countries, Same Method: China

Question 57

Q

Other Countries, Same Method: China

Question 58

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Other Countries, Same Method: China

Question 59

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Other Countries, Same Method: China

Question 60

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Cohort Change in Metropolitan China

Answer

A

Sharp drop in rates beyond youngest cohort…

Question 61

Q

Cohort Change in Metropolitan China

Question 62

Q

Cohort Change in Metropolitan China

Question 63

Q

Cohort Change in Metropolitan China

Question 64

Q

China: Social Change or Measurement Artifact?

Answer 40

A

Do patterns of social risk and stress process
explanations work the same way, and if not, why not?
For example…
o Does mastery work the same way in cultures where individuals are
not expected to assume a “sense of control?”

Answer 41

A

o Does the role of stressors change depending on the value attached
to those problems?

Answer 42

A

v Take advantage of major national / political / policy /
structural / historical differences across countries to
answer this question:
o How does the national social context intervene to change how mental
health is distributed and explained at the individual level?

Answer 43

A

Studies 601 adolescents in Belgium to assess the
effects of social capital at the “community”
(neighbourhood) level.
v Social capital: ties to others –information channels,
instrumental support, trust, mutual social exchange
norms, social credential of ties of ties
v Question: does contextual (community) social capital
act to reduce or nullify the usual effect of SES on
mental health?

Answer 44

A

v Results show that contextual social resources do
reduce the impacts of social inequality:
v l = low, a=average,
h = high social capital.

Answer 45

A

v Family affluence
differences in well-being
only in low social capital
contexts.
v Middle to high:
o No effect of SES

Answer 46

A

Distinguish individual level social capital from “ecological”
(contextual) social capital:
o Do they work the same way, or are they place-dependent?
v Unusual to study the effects of social capital on mental
disorder in low income countries…
o Four countries: Peru, Ethiopia, Vietnam, and Andra Pradesh (Indian state,
in the southeast).

Answer 47

A

v Two kinds of social capital:
o Individual / cognitive: the perception of strong norms of social exchange
and reciprocity, trust, and assumption of consensus.
o Structural / ecological : the quantity of social ties to others of both similar
and dissimilar status, and their social credentials.
vOverall: the value of social relationships with others.

Answer 48

A

Individual social capital….
o Affects social support, quality of social relationships, levels of stress
exposures
v Ecological social capital…
o Higher community efficacy
o Better services and resources
o More social control

Answer 49

A

v Study focuses on mothers of young children and
babies in these 4 countries
v Social capital based on nine items, assessed
individually and also aggregated to the community
level.
o Includes aspects of trust, sense of belonging, quality of relationships,
perceived fairness, group memberships, community support,
involvement in community.
v CMD a code for “common mental disorders”, aka
anxiety and depression

Answer 50

A

Overall Prevalence:
o Just over 20% with CMD in Vietnam, around 30% in other countries (and
very similar).
v Internal variation within countries important:
o Rates vary from 10% to over 50% of mothers in different communities.
Thus community level differences seem to be more important than country
overall.
v Individual level social capital works across all four
countries:
o Consistently reduces odds of CMD
o Only measure that does
v Effects of community social capital are (very) mixed.

Answer 51

A

v Patterns are complex:
o Group memberships are protective in Peru and Vietnam, but the
opposite in Andra Pradesh.
o Social support from others — actual support – is positively related to
CMD.
• Causal direction?
v Findings are reminiscent of the usual findings on
social support, in this way:
o Cognitive social capital = perceived support
o Community / structural social capital = actual support
v Social involvements have complex meanings,
involving both benefits and demands…

Answer 52

A

For example: o Variation in group memberships include
these complexities: benefits vs. costs of homogeneity; social comparison due to group exposure; increased
social awareness of others problems; primacy of family
life

Answer 53

A

You can study how differences at the societal
(national) level filter down into individual lives and
mental health, if you study enough societies.
v Have to have a sample of countries, with a large
sample of individuals in each.
v Typical question focuses on the effects of social policy
at the government level:
o Do differences in government policy affect the way in which mental
health is distributed and explained?

Answer 54

A

v Issue is how the state intervenes to reduce differences due
to social class.
v Uses the European Social Survey:
o 2006 and 2012
o 27 countries
o Total N = 61,743 (about 2287 per country on average).
v Countries included:
o Austria, Belgium, Bulgaria, Cyprus, Czech Republic, Denmark, Estonia,
Finland, France, Germany, Hungary, Iceland, Ireland, Israel, Italy,
Lithuania, Netherlands, Norway, Poland, Portugal, Russian Federation,
Slovakia, Slovenia, Spain, Sweden, Switzerland and the United Kingdom.

Answer 55

A

vFocus on welfare state generosity:
o An index of social protection spending as % of GDP.
o Covers these areas: sickness/healthcare, disability, old age security,
survivors benefits, family/children, unemployment, housing and social
exclusion not elsewhere classified.
v A basic purpose would be to help those most in need.
v Does it work?

Answer 56

A

v Usually the theory is that when something is less
valued as a resource, it is less prevalent, thus less
effective.
o Mastery in less individualized societies: not as valued?
v But prevalence does not indicate value per se.
o Could be more effective due to being a scarce resource.

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SOC363: 10. Comparative Flashcards

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