SOCIAL CLASS AND MENTAL ILLNESS

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GENDER AND MENTAL ILLNESS
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RECENT CHANGES

• MAJOR TOPIC OVER LAST 15 YEARS
• VAST CHANGE IN SOCIAL ROLES
• 2/3 OF MARRIED WOMEN WORK
• 60 OF WOMEN WITH SMALL CHILDREN WORK (19 IN
  1960)
• 7 OF TOTAL HOUSEHOLDS HAVE WORKING FATHER AND
  HOUSEWIVE

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QUESTIONS

• HOW ARE THESE SOCIAL CHANGES RELATED TO MENTAL
  HEALTH?
• DO WOMEN OR MEN HAVE MORE MENTAL ILLNESS?
• DO MEN AND WOMEN HAVE DIFFERENT TYPES OF M.I.?
• HOW IS GENDER RELATED TO THE TREATMENT OF MENTAL
  ILLNESS?

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GENDER

• BOTH BIOLOGY AND PSYCHOLOGY FOCUS ON GENDER AS
  CONSTANT PROPERTY OF INDIVIDUALS
• BIOLOGY - PHYSIOLOGY, HORMONES, REPRODUCTION,
  ETC.
• PSYCHOLOGY - DIFFERENCES IN PSYCHOLOGICAL
  ORIENTATIONS

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SOCIOLOGICAL

• DISTRESS ARISES OUT OF SOCIAL ROLES
• POWER, RESOURCES, AUTONOMY ASSOCIATED WITH MALE
  ROLES
• OPPOSITE WITH FEMALE ROLES
• REGARDLESS OF WHETHER MEN OR WOMEN OCCUPY THE
  ROLES

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SOCIAL ROLES

• WOMEN IN TRADITIONALLY MALE ROLES HAVE LESS
  DISTRESS
• MEN IN TRADITIONALLY FEMALE ROLES HAVE MORE
  DISTRESS
• MEN AND WOMEN IN SAME ROLES WILL HAVE SAME
  DISTRESS

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CULTURAL EXPECTATIONS

• NOT JUST ROLES BUT EXPECTATIONS OF MEN AND WOMEN
  IN ROLES
• POWERFUL MAN VS. WOMAN
• UNEMPLOYED MAN VS. HOUSEWIFE
• DISTRESS FROM COMBINATION OF ROLES EXPECTATIONS

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SOCIAL ROLES (GOVE)

• RATES OF M.I. HISTORICALLY SPECIFIC NOT UNIVERSAL
  - CHANGE OVER TIME AS ROLES CHANGE
• BEFORE WWII - WOMENS ROLES VALUED
• RELATIVELY EQUAL RATES OF M.I.
• AFTER WWII - HOUSEWIVE ROLE

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AFTER WWII

• WOMENS ROLES MORE STRESSFUL THAN MENS
• HOUSEWIVE ROLE IS FRUSTRATING, UNDEMANDING,
  UNREWARDED
• WORKING WOMEN FACE ROLE OVERLOAD AND
  DISCRIMINATION
• UNCLEAR EXPECTATIONS

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PREDICTIONS

• MARRIED WOMEN HAVE MORE DISTRESS THAN MARRIED MEN
• SINGLE MEN AND WOMEN EQUAL

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MARRIAGE AND DISTRESS

• SINGLE MEN AND WOMEN EQUAL
• MARRIED MEN lt MARRIED WOMEN
• IMPORTANCE OF ROLES

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DISTRESS, WORK AND MARRIAGE

• HOUSEWIVES gt DISTRESS THAN WORKING WOMEN
• WORKING WOMEN gt WORKING MEN
• ROLE OVERLOAD
• UNEMPLOYED MEN WORST

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ROLES ARE IMPORTANT

• SAME ROLES, SAME DISTRESS - E.G. SINGLE PEOPLE
• MALE ROLES HAVE LESS DISTRESS - EMPLOYMENT,
  RESOURCES, LESS OVERLOAD
• FEMALE ROLES HAVE MORE DISTRESS - NO JOBS, LOWER
  EARNINGS, MORE OVERLOAD

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CHANGES OVER TIME

• 1960S - HUSBANDS WITH WORKING WIVES HAVE MORE
  DISTRESS
• NO LONGER TRUE
• 1990S - HUSBANDS WITH WIVES EARNING MORE THAN
  THEY DO HAVE MORE DISTRESS (NOW TRUE IN 1/3 OF
  FAMILIES)

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CHANGES OVER TIME

• RATES GOING UP
• WOMEN gt MEN
• DIFFERENCES SMALLER NOW
• BECAUSE MEN RISING MORE RAPIDLY

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LIMITS OF SOCIAL ROLE THEORY

• OVERSIMPLIFIED
• HARD TO EXPLAIN MENS DISTRESS
• STUDIES BIASED BECAUSE ONLY USE FEMALE TYPES OF
  MENTAL ILLNESS USUALLY DISTRESS/DEPRESSION

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GENDER AND TYPES OF MENTAL ILLNESS
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TYPES OF ILLNESS

• LITTLE GENDER DIFFERENCE FOR PSYCHOSES
• WOMEN 2/3 OF DEPRESSION, ANXIETY, DISTRESS,
  SUICIDE ATTEMPTS, ALMOST ALL EATING DISORDERS
• MEN 2/3 OF ALCOHOL AND DRUG PROBLEMS, 4X
  SUICIDES, ALMOST ALL GAMBLING
• OVERALL RATES EQUAL

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FUNCTIONAL EQUIVALENCE

• ARE MALE AND FEMALE EXPRESSIONS OF MENTAL ILLNESS
  FUNCTIONAL EQUIVALENTS?
• E.G. EATING DISORDERS AND GAMBLING COMPARABLE
  SEX-TYPED EXPRESSIONS?
• E.G. DEPRESSION AND ALCOHOLISM

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REASONS

• CULTURAL EXPECTATIONS ABOUT GENDER ROLES
• WOMEN INTERNALIZE
• WOMEN EXPECTED NOT TO EXTERNALIZE
• MEN EXTERNALIZE
• MEN EXPECTED NOT TO INTERNALIZE

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GENDER AND TREATMENT
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TREATMENT DIFFERENCES

• WOMEN ABOUT 2/3 OF OUTPATIENTS
• MEN ABOUT 60 OF INPATIENTS

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INPATIENT TREATMENT

• MEN MORE LIKELY THAN WOMEN TO BE INPATIENTS
• MENS SYMPTOMS MORE TROUBLESOME AND VIOLENT
• MEN DELAY TREATMENT UNTIL MORE SEVERE

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OUTPATIENT TREATMENT

• WOMEN MORE LIKELY TO DEFINE SELVES AS HAVING
  PSYCHOLOGICAL PROBLEMS
• WOMEN MORE LIKELY TO SEEK MENTAL HEALTH TREATMENT
• WOMEN MORE LIKELY TO REMAIN IN TREATMENT -
  PATIENT ROLE

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SUMMARY

• ROLES AND EXPECTATIONS, AS WELL AS PERSONS, ARE
  IMPORTANT
• SAME ROLES, SIMILAR RATES OF MENTAL ILLNESS
• MEN AND WOMEN HAVE DIFFERENT TYPES OF MENTAL
  ILLNESS
• MEN AND WOMEN HAVE DIFFERENT PATTERNS OF TREATMENT