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Lecture 2

SOC363 – Week 2 Reading – Researching the Causes of Distress.docx

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University of Toronto St. George
David Young

SOC363 – Week 2 Reading – Researching the Causes of Distress CHAPTER 2 Depression and Anxiety; Mood and Malaise: - distress o an unpleasant subjective state o takes 2 major forms:  depression:  feeling sad, lonely, or hopeless  anxiety:  tense, restless, afraid - depression and anxiety each take 2 forms: o mood:  feelings such as the sadness of depression or the worry of anxiety o malaise:  refers to bodily states - depression and anxiety are related in 2 ways: o 1. Maps of their social high and low zones are similar o 2. A person that suffers more from one usually suffers more from the other (not necessarily at the same time) - measure distress by asking questions about depressed and anxious mood and malaise o count the number of symptoms a person reports  more symptoms = more severe the problems - almost all mental patients suffer from depression or anxiety - Langer’s Index: way of screening individuals for further psychiatric evaluation and possible treatment o Greatest success in comparing the level of psychological distress in different segments of the population - Early studies used to ask about malaise but current studies ask about mood o 2 observations drive this shift:  1. People are far more willing to report feelings than previously thought  2. There is a growing interest in the relationship between physical and mental health - many researchers feel its safer to use purely psychological indicators o physiological indicators could bias towards association between body and mind The Opposite of Well Being: - well-being and distress are opposites in a single continuum - more well being means less distress and vice versa - some researches think positive and negative emotions are distinct dimensions of mood SOC363 – Week 2 Reading – Researching the Causes of Distress o reason is the negative correlation is not perfect(ranges from -05 to close to 0)  suggest partially independent moods - 3 reasons for less than perfect negative correlation: o 1. Random measurement of error  there is always some amount of randomness  reduces size of apparent correlation o 2. Differences in emotional expressiveness and volatility  some express their feeling less than others  ex. women more expressive than men o 3. Questions about distress occur over a period of time  people feel happier some days than others Not Dissatisfaction or Alienation: - do not consider dissatisfaction as a part of distress - satisfaction and dissatisfaction are poles of one another - alienation is also not distress o a state of mind, distress is a feeling o sense of not controlling outcomes, life having no meaning, not being of importance to someone else  this perceptions may be distressing but are not distress themselves Not Mental Illness: - most extreme persistent or inexplicable distress is labeled as mental illness - most people do not experience this but a substantial minority do - distress differs from other mental problems A Human Universal: - If distress is not a mental illness why study it? o Misery is still misery o Most people prefer to avoid feeling depressed and anxious o Provide information that individuals can use to improve their lives - Distress has social costs - Maps about highs and lows of zones tell us much about social positions Psychological Problems Are Real, But Not Entities: - Psychological problems are not discrete o Have shades o Not entities - Psychiatrists speak of them as discrete o 19 century epidemiology  person has a disease or doesn’t  fits reality of psychological problems poorly Linguistic Legacy of Infectious Disease: SOC363 – Week 2 Reading – Researching the Causes of Distress - epidemiology studies the causes of disease by comparing the amount of disease in different groups of people o spawned a host of concepts based on sorting and counting people, comparing ratios of various counts o sort people into two groups:  those who have the disease  those who don’t have the disease  this distinction not always easy to make Reification of Categories in Psychiatry: - psychiatry wants to sound like other medical specialties with distinct diagnosis’s o other specialties have professional authority based on claim of having the proper treatment for each disease and the proper diagnosis for each patient o equate categorical assessment with true science - “reify” – treating an abstraction as if it had material existence o known as the fallacy of misplaced correctness - mistaken shape of reality The Alternative: The Type and Severity of Symptoms: - fact: do not have to place people in diagnostic categories o counting the number of people in a category can be replaced by counting the number of symptoms of a particular type that people have  avoids disease categories - categories of symptoms are mistaken reality too o symptoms are only something people feel or do more than others Reliability versus Certainty: The Fallacy of the Two-Category Scale - throwing away information hinders understandings - the fallacy of two category scale lies in confusing certainty and reliability - Reliability: the exactness of reproduction that can be achieved within a given measure o lowest if measurement is dichotomous (yes or no) - broader categories increase certainty but decrease reliability o if everything was reduced to a single category certainty would be perfect but meaningless - split into two categories most information is lost but the same random error exists o cannot see the suffering of millions and cannot see the causes A Person does not need to be diagnosed to be helped: - often an argument for categorizing people o only if categorized as ill can they be treated - yet, anyone who feels depressed can be treated for depression SOC363 – Week 2 Reading – Researching the Causes of Distress o assessment does not need to be categorical How Diagnosis is Made: - based on Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association - general criteria are presence and duration of symptoms o each criterion has a cutoff point - 4 steps: o 1. Assessing the level of symptoms  extent of impaired functioning and duration of problems o 2. Splitting each assessed amount at some cutoff point  amounts that meet the criterion and those that do not o 3. Totting up so that all possible combinations are represented in a single split o 4. Excluding cases that also meet other criteria considered preeminent - combines assessment with judgment - often divided into a question are and assessed through an “algorithm” o judgments often made by a computer Diagnosing Schizophrenia: - many people argue that a diagnostic approach is appropriate here - symptoms can be measured on a continuous scale as well o troubled thinking, heard thought spoken aloud, felt possessed, etc. - most aware of people who would be placed in the diagnosis of schizophrenia - people can score from no symptoms, to mild, moderate, and severe A Sea of Troubles: - two things are classified in diagnosis: people and symptoms o people are hard to classify  often have more than one problem o symptoms are readily classified The Patterns of Symptoms: Galaxies, Nebulae, or Spectra? - Two predominant opposing views about the distinctiveness of psychological symptoms - Galaxy hypothesis: says that symptoms cluster together by type. o Symptoms of similar type often go together and symptoms of different types do not - Nebula hypothesis: symptoms are randomly distributed o Do not cluster according to type o Only
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