SOC363H1 Mental Health
September 26, 2012
Conceptualizing and Measuring Psychological Distress
*Doesnt expect us to know structural equations or anything related to statistical shit.
- The objective is to analyze associations between social conditions (stressors) and
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
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
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
o Community-level studies can estimate the number of people who needpsychiatric
services because they qualify for a diagnosis but are not getting services.
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