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Lecture 3

SOC363H1 Lecture 3.docx

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University of Toronto St. George
Scott Schieman

1 SOC363H1 Mental Health September 26, 2012 Lecture 3 Conceptualizing and Measuring Psychological Distress *Doesnt expect us to know structural equations or anything related to statistical shit. Measuring Distress - The objective is to analyze associations between social conditions (stressors) and psychological distress. o The problem is that the stress is inside peoples heads, how can we know what a person is feeling or thinking? Measurement is the link b/w concepts and reality so when someone says I feel really angry its not that a thousand different ideas about that pop up. Generally we share a collective sense of what anger is. The measurement is the key. The Mirkowsky and ross set up how we measure distress. Its supposed to represent peoples feelings and thoughts but people perceive it. Measures represent peoples feelings, emotions and thoughts as perceived and reported by people themselves o Psychological distress is a difficult concept to measurebut this means that researchers need to put a great deal of thought and effort into measurementnot abandon it. - What are the two major forms of measurement?*** o Diagnostic categorical forms of measurement versus more continuous levels of measurement. You have indices on one hand symptoms of depression versus depressed or not. - Diagnostic Categories as measurement o Represents psychiatric claims that mental illness is an unseen biological condition that is either present or absent (reaches a clinical threshold or case); There is this idea that if you went in to see a doctor and started talking about certain signs and symptoms, do you represent a case of something o Categorizes people according to diagnostic decision rules that represent psychiatric preconceptions; - help put people into various classifications. Mirkowsky and Ross use the term psychiatric preconceptions, which mean you have normality and abnormality but is it really that cut and dry, or are there shades? o Parallels the medical model: a disease diagnostic model that builds on accumulated medical knowledge; In a way it builds on the classic idea of the medical model where there is a disease diagnostic model and that model is based on cumulative medical knowledge. Combines assessment and judgment about the extent and duration of symptoms usually clusters of symptoms. For instance if you go in and see your doctor for a particular thing they may say give it a week and see what happens looking for duration. Diagnostic Categories and the DSM-IV - What is the DSM-IV?2 o Abook that organizes all of these kinds of diagnoses in a more systematic fashion. Its in the 4 edition Amanual of psychiatric disorders that provides descriptions of conditions; for example this is PTSD and this is general anxiety disorder. For it to become a case what do you need to be presenting to be diagnosed with a certain condition? Asystematic organization of rules for diagnoses Classifications are based on committee member consensus (clinical observation, field trials, research, expert opinion) What are some of the advantages of diagnostic categories TheAdvantages of Diagnostic Categories - Guidelines that facilitate communication among researchers and clinicians; - Placing people in diagnostic categories may reveal an unmet need for psychiatric services. o Community-level studies can estimate the number of people who needpsychiatric services because they qualify for a diagnosis but are not getting services. Critiques: Unmet needis defined by the psychiatristnot the people themselves. Psychiatric diagnosis puts power in the hands of professionals. - The benefits of a medical model? o Legitimacy/Reduce stigma o Motivate treatment just talking about some of these diagnoses can help people realize that they might have it and seek help o Insurance claims disorder or not Four Critiques of Diagnostic Models Psychological problems are real but not discrete. Not s
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