This Document Contains Chapters 3 to 5 Chapter 3: Mental Disorder: Concepts of Causes and Cures Test Questions Part I. Multiple Choice Questions Circle the response that best answers the following questions. 1) The __________ model views mental disorder as a disease that can be treated through medical means. A) antipsychiatric B) behavior modification C) medical D) psychoanalytic Answer: C 2) The __________ model uses drug therapy, electroshock therapy, and brain surgery to treat mental disorders. A) antipsychiatric B) medical C) psychoanalytic D) social stress Answer: B 3) Why has the medical model been dominant in a search for solutions to mental disorder? A) Psychiatrists are trained as medical doctors and adopt a medical perspective. B) Much more funding has been available for research based on the medical model. C) The medical model is more effective across multiple domains of well-being. D) The medical model has persisted for several centuries. Answer: A 4) What does research suggest about the effectiveness of psychotropic drugs in controlling mental disorders? A) Research has not considered the effectiveness of drugs in controlling mental disorders. B) Research is skeptical at best about the effectiveness of drugs in controlling mental disorders. C) Research suggests little effectiveness of drugs in controlling mental disorders. D) Research supports the effectiveness of drugs in controlling mental disorders. Answer: D 5) What major event will significantly improve the capability of researchers to answer questions of genetics and mental disorder? A) the completion of the Human Genome Project B) a longitudinal study of families and mental disorder C) appropriate tests of the effectiveness of electroshock therapy D) a long term study of the effects of behavior modification techniques Answer: A 6) Which of the following is likely the most controversial treatment? A) drug therapy B) behavior modification C) electroshock therapy D) psychosurgery Answer: D 7) Which of the following is not one of the shortcomings of the medical model? A) The medical model assumes a medical cause of mental disorder. B) The medical model controls symptoms rather than curing disorders. C) The medical model focuses on treating mental disorders, but is not able to explain them. D) The medical model ignores social and psychological factors related to mental disorders. Answer: C 8) What is the major difference between the medical and psychoanalytic models? A) The medical model focuses on treatment of mental disorders and the psychoanalytic model focuses on explaining mental disorders. B) The medical model relies on drugs and the psychoanalytic model relies of therapy. C) The medical model approaches mental disorders as biochemical conditions and the psychoanalytic model approaches mental disorders as psychic conditions. D) The medical model is practiced in the United States and the psychoanalytic approach is practiced in Europe. Answer: C 9) The psychoanalytic model is based largely on the work of __________. A) Sigmund Freud B) Adolf Meyer C) Otto rank D) Carl Jung Answer: A 10) According to Freud, the __________ functions to fulfill instant gratification. A) ego B) id C) instinct D) superego Answer: B 11) For Freud, the __________ is the most important component of personality. A) ego B) id C) instinct D) superego Answer: A 12) What did Freud mean by “the child is psychologically father to the adult”? A) Children have power over their parents. B) The events experienced as a child persist through adulthood. C) Children have psychological needs to love their father more than their mother. D) Infancy and childhood are the most important stages of life. Answer: B 13) Which of the following represents the correct order of Freud’s stages of psychosexual development? A) anal, oral, latency, genital, phallic B) latency, genital, oral, anal, phallic C) oral, anal, phallic, latency, genital D) phallic, oral, genital, anal, latency Answer: C 14) Individuals with obsessive-compulsive anxieties are typically described as being in the __________ stage of Freud’s psychosexual development. A) anal B) genital C) latent D) oral Answer: D 15) Sublimation is Freud’s term for which of the following situations? A) aggression being channeled into sports B) aggression becoming violent C) aggression being directed at specific individuals D) aggression being internalized Answer: A 16) When an individual returns to an earlier psychosexual stage of development, this is referred to as __________. A) reaction formation B) introjection C) regression D) displacement Answer: C 17) What is the difference between psychoanalysis and psychoanalytic therapy? A) In psychoanalysis, the patient uses free association. In psychoanalytic therapy, the patient uses hypnosis. B) Psychoanalysis focuses on the ego and psychoanalytic therapy focuses on the id. C) Psychoanalytic therapy is a version of psychoanalysis that focuses on current issues. D) Psychoanalysis requires intensive and long term treatment and psychoanalytic therapy is less intensive and short term. Answer: C 18) Behavior modification is based on the __________ model, developed by Pavlov and Thorndike. A) social learning B) conditioning C) psychoanalytic D) social stress Answer: A 19) Which of the following is not one of the limitations of behavior modification? A) The long-term nature of behavior modification is doubtful. B) Behavior modification is only effective in clinical settings. C) Behavior modification assumes a willingness to learn new behavior. D) Whether or not human behavior can be modified is questionable. Answer: C 20) According to research, most stress is a result of __________. A) abnormalities B) social interaction C) genetics D) behavior modification Answer: B 21) Extreme situations differ from negative ordinary events because __________. A) negative ordinary events are uncontrollable B) extreme situations are life threatening C) extreme situations are uncontrollable and life threatening D) negative ordinary events are life threatening and uncontrollable Answer: C 22) In Lauer’s research on the “future shock” hypothesis, he found __________ changes were the most stressful. A) slow and desirable B) rapid and desirable C) slow and undesirable D) rapid and undesirable Answer: D 23) According to the Holmes and Rahe Social Readjustment Rating Scale, __________ is rated as the highest relative stress value. A) the death of a spouse B) the death of a child C) the death of a pet D) the death of a parent Answer: A 24) The __________ model rejects the notion that mental disorders are medical illnesses. A) antimedical B) anytipsychatric C) political D) social learning Answer: B 25) Thomas Szasz argues that “mental illness __________.” A) is not something a person has but is something he does or is B) is something internal not something external C) exists only in someone’s mind not in someone’s body D) is a disease that should be treated in a professional setting and not alone Answer: A Part II. Essay Questions Answer the following questions in your own words. 1) Compare any two theories of mental illness. Answer: Comparing two theories of mental illness provides insight into different perspectives on the origins, development, and treatment of psychological disorders. Here, let's contrast the Biological and Psychodynamic theories: Biological Theory: 1. Explanation of Mental Illness: • Focus: Emphasizes biological factors such as genetics, neurochemical imbalances, and brain structure abnormalities as primary causes of mental illness. • Biological Basis: Disorders are often viewed as stemming from dysfunction in neurotransmitter systems (e.g., serotonin, dopamine), hormonal imbalances, or structural abnormalities in the brain. • Examples: Disorders like schizophrenia, bipolar disorder, and major depression are often discussed in terms of genetic predispositions and neurobiological dysfunctions. 2. Treatment Approach: • Medical Interventions: Biological theorists advocate for treatments such as psychotropic medications (e.g., antidepressants, antipsychotics) that target specific neurotransmitter systems or regulate brain function. • Neuroscience: Advances in neuroscience contribute to understanding brain-behavior relationships and inform biological treatment approaches. • Criticism: Critics argue that reducing mental illness solely to biological factors may oversimplify complex conditions and overlook psychosocial contributors. Psychodynamic Theory: 1. Explanation of Mental Illness: • Focus: Developed by Freud, psychodynamic theory posits that unconscious conflicts, early life experiences, and unresolved childhood traumas shape personality and contribute to mental disorders. • Role of Unconscious: Emphasizes the unconscious mind's influence on thoughts, feelings, and behaviors, leading to symptoms like anxiety, depression, or compulsions. • Examples: Disorders such as anxiety disorders, personality disorders, and certain forms of depression are often explored through unresolved conflicts and defense mechanisms. 2. Treatment Approach: • Psychoanalysis: Therapy involves exploring unconscious conflicts, childhood experiences, and defense mechanisms through techniques like free association, dream analysis, and transference. • Insight and Resolution: Treatment aims to bring unconscious conflicts into conscious awareness, fostering insight and resolving underlying psychological conflicts. • Criticism: Critics argue that psychodynamic therapy may lack empirical validation compared to other therapies and might be too intensive and lengthy for many patients. Comparison: • Focus on Causation: Biological theory focuses on physiological causes (brain chemistry, genetics), while psychodynamic theory focuses on unconscious conflicts and early experiences. • Treatment Approaches: Biological theory emphasizes pharmacotherapy and neuroscience, while psychodynamic theory focuses on insight-oriented therapy and understanding unconscious processes. • Criticism: Biological theory can oversimplify complex human experiences, while psychodynamic theory can be criticized for lacking empirical validation and being resource-intensive. In summary, comparing these theories illustrates how different perspectives shape our understanding of mental illness and influence treatment approaches, highlighting the multidimensional nature of psychological disorders. 2) Discuss the criticisms of the medical model. Answer: The medical model, often criticized in the context of mental health and disabilities, refers to the traditional approach where medical professionals diagnose and treat conditions based on biological factors. Here are some common criticisms: 1. Reductionism: The medical model tends to reduce complex human experiences and conditions to biomedical explanations, often oversimplifying the multifaceted nature of health and well-being. It may ignore social, psychological, and cultural factors that contribute significantly to health outcomes. 2. Pathologizing Normality: There's criticism that the medical model pathologizes behaviors and experiences that may be within the range of normal human variation. For instance, variations in mood, personality, or even certain physical characteristics are sometimes classified as disorders or illnesses. 3. Dependency on Pharmaceuticals: Critics argue that the medical model often relies heavily on pharmaceutical interventions, sometimes at the expense of non-pharmacological approaches such as psychotherapy, lifestyle changes, or social interventions. This can lead to overmedication and neglect of holistic treatment modalities. 4. Neglect of Social Context: The medical model may overlook the social determinants of health such as poverty, discrimination, housing instability, and access to education and healthcare. These factors play a crucial role in shaping health outcomes but are often not adequately addressed within a purely biomedical framework. 5. Stigma and Labeling: Diagnosing conditions within the medical model can inadvertently reinforce stigma and labeling, affecting how individuals perceive themselves and how society views them. This can lead to self-fulfilling prophecies and reduced opportunities for those labeled with mental health conditions or disabilities. 6. Lack of Patient-Centeredness: Critics argue that the medical model sometimes prioritizes the disease or disorder over the person experiencing it, leading to a lack of patient-centered care. This can result in treatments that are not aligned with the individual's preferences, values, or cultural background. 7. Inadequate for Preventive Care: The medical model is often criticized for focusing predominantly on treating established diseases or disorders rather than on preventive measures that could potentially reduce the incidence and severity of health issues. 8. Biological Determinism: There's concern that the medical model promotes a view of health and illness as primarily determined by biological factors, undermining the role of personal agency and the potential for individuals to actively participate in their own health and well-being. In response to these criticisms, there has been a growing movement towards holistic and person-centered models of healthcare that incorporate broader social, psychological, and environmental factors into diagnosis, treatment, and prevention strategies. These approaches aim to provide more comprehensive and individualized care that respects the complexity of human health and well-being. 3) Describe Freud’s concept of the personality. Answer: Sigmund Freud, the founder of psychoanalysis, developed a comprehensive theory of personality that remains influential in psychology despite criticisms and modifications over time. Freud's concept of the personality is structured around three main components: the id, the ego, and the superego. Here’s a detailed description of each: 1. Id: The id is the most primitive part of the personality, present at birth. It operates on the pleasure principle, seeking immediate gratification of basic needs and urges, regardless of consequences or social norms. The id is unconscious and drives instinctual impulses related to survival (such as hunger and thirst) and reproduction (such as sexual impulses). It operates based on the primary process, which involves forming mental representations of desired objects or outcomes. 2. Ego: The ego develops from the id during infancy, primarily in response to the external world. It operates on the reality principle, balancing the demands of the id with the constraints and opportunities presented by the external environment. The ego seeks to satisfy the id's desires in realistic and socially acceptable ways. It mediates between the id's impulsive demands, the superego's idealistic demands, and the external reality. The ego operates based on the secondary process, which involves rational thought and problem-solving. 3. Superego: The superego develops later in childhood under the influence of parental and societal standards. It represents the moral and ethical standards internalized from caregivers and society. The superego aims for perfection and strives to suppress the urges of the id that are deemed unacceptable by society. It consists of two components: • The ego-ideal: This part of the superego reflects the standards for behavior that one aspires to and idealizes. • The conscience: This part consists of rules and regulations about what constitutes bad behavior, incorporating feelings of guilt or shame when these rules are violated. Freud described the interactions between the id, ego, and superego as dynamic and sometimes conflicting, leading to internal psychological tension. This tension, according to Freud, is a crucial aspect of human personality development and functioning. Additionally, Freud proposed that personality development occurs through several psychosexual stages: oral, anal, phallic, latency, and genital. Each stage is associated with a different erogenous zone and involves potential conflicts that must be resolved for healthy personality development. Freud's conceptualization of the personality has been critiqued for its emphasis on unconscious and instinctual forces, its alleged male-centric perspective, and its lack of empirical validation. Despite these criticisms, Freud's ideas laid the foundation for understanding unconscious processes, conflict resolution, and the impact of early childhood experiences on personality development in psychology. His work continues to influence contemporary psychoanalytic and psychodynamic theories and therapeutic practices. 4) Describe and provide an example of any three common ego defense mechanisms described by psychoanalysts. Answer: Ego defense mechanisms are unconscious psychological strategies that individuals use to manage anxiety and protect the ego from distressing thoughts or feelings. These mechanisms were first identified by Freud and later expanded upon by other psychoanalysts. Here are three common ego defense mechanisms along with examples: 1. Repression: • Definition: Repression involves unconsciously blocking unacceptable thoughts, feelings, or impulses from consciousness. These thoughts remain hidden in the unconscious, preventing them from causing anxiety. • Example: A person who experienced a traumatic event in childhood may have no conscious recollection of the event as an adult. The memory is repressed because it is too painful or anxiety-provoking to be consciously acknowledged. This mechanism allows the individual to continue with their daily life without being overwhelmed by distressing memories. 2. Rationalization: • Definition: Rationalization involves creating logical or socially acceptable explanations to justify or explain behavior, thoughts, or feelings that might otherwise be unacceptable. This helps to protect the ego from guilt or anxiety. • Example: A student fails an important exam but rationalizes it by saying, "The test was unfair and had questions that weren't covered in the lectures anyway." By rationalizing in this way, the student reduces the discomfort of feeling inadequate or responsible for the failure. 3. Projection: • Definition: Projection involves attributing one's own unacceptable thoughts, feelings, or impulses to others. This helps to avoid acknowledging these thoughts within oneself and to manage anxiety by externalizing internal conflicts. • Example: A person who has repressed feelings of anger towards a friend might project these feelings onto the friend by saying, "He's always so angry with me!" In reality, it is the person who is experiencing the anger, but they project it onto their friend to avoid confronting their own uncomfortable emotions. These defense mechanisms are thought to operate automatically and unconsciously, playing a role in how individuals cope with internal conflicts and stressors. While they can provide short-term relief from anxiety, they can also lead to distortions in perception and hinder personal growth if overused or relied upon excessively. Psychoanalytic therapy often aims to make these defense mechanisms conscious so that individuals can develop healthier ways of coping with distress and resolving inner conflicts. 5) What are the major strengths and limitations of behavior modification? Answer: Behavior modification, also known as behavior therapy, is a psychological approach that focuses on changing observable behaviors through systematic interventions. Here are the major strengths and limitations of behavior modification: Strengths: 1. Empirical Support: Behavior modification techniques are often based on principles of learning and have a strong empirical foundation. Many interventions have been extensively researched and shown to be effective in treating specific behavioral problems, such as phobias, addictions, and behavioral disorders. 2. Clear Goals and Objectives: Behavior modification typically sets clear and measurable goals for behavior change. This specificity allows therapists and clients to track progress objectively and adjust interventions as needed. 3. Applicability to Various Populations: Behavior modification techniques can be adapted to work with a wide range of populations, including children, adolescents, adults, and individuals with developmental disabilities. Techniques can be tailored to suit individual needs and abilities. 4. Focus on Concrete Behaviors: This approach focuses on observable behaviors rather than delving into complex underlying psychological processes. This makes behavior modification accessible and practical for clients who prefer a more straightforward approach to therapy. 5. Collaborative and Transparent: Behavior modification emphasizes collaboration between the therapist and client. The therapist typically involves the client in setting goals, selecting techniques, and evaluating progress, fostering a sense of empowerment and involvement in the therapeutic process. Limitations: 1. Limited Scope: Behavior modification primarily addresses observable behaviors and may overlook deeper emotional or cognitive factors that contribute to those behaviors. Issues such as underlying trauma, cognitive distortions, or unresolved emotional conflicts may require additional therapeutic approaches. 2. Temporary Effects: Behavior modification can produce rapid behavior change, but these changes may not always be enduring if the underlying reasons for the behavior are not addressed. Relapse can occur if the environmental or situational triggers are not adequately managed. 3. Ethical Concerns: Some critics argue that behavior modification can be coercive if not implemented with sufficient respect for individual autonomy and consent. Techniques such as aversion therapy or token economies raise ethical questions about control and manipulation. 4. Limited Generalization: Behavior modification may successfully change behaviors in controlled settings (e.g., therapy sessions), but generalizing these changes to different contexts (e.g., home, school, work) can be challenging. Clients may struggle to apply learned skills or behaviors consistently across diverse situations. 5. Overemphasis on Symptom Reduction: Behavior modification tends to prioritize symptom reduction and observable improvements, potentially neglecting broader aspects of personal growth, self-awareness, and interpersonal relationships that are crucial for long-term well-being. In summary, behavior modification offers structured and evidence-based interventions for changing specific behaviors but may not address deeper psychological issues or ensure enduring change without addressing underlying factors. It is most effective when integrated with other therapeutic approaches that consider the holistic needs of the individual. Chapter 4: Mental Disorder as Deviant Behavior Test Questions Part I. Multiple Choice Questions Circle the response that best answers the following questions. 1) Sociologists agree that mental disorder is a form of __________. A) anomie B) deviance C) mania D) stigma Answer: B 2) __________ are general social expectations of behavior. A) Disorders B) Judgments C) Norms D) Stigmas Answer: C 3) The work of Durkheim and Merton can be classified into __________ approaches. A) analytic B) labelling C) social constructionist D) structural Answer: D 4) In Durkheim’s Suicide, he argues that suicide is __________. A) entirely the result of individual forces B) entirely the result of social forces C) partly the result of individual and partly social forces D) not the result of individual or social forces Answer: C 5) __________ is a type of suicide in which individuals become detached from society. A) Altruistic B) Anomic C) Egoistic D) Social Answer: C 6) Which of the following individuals is most likely to commit suicide, according to Durkheim? A) a Protestant person without children B) a Catholic person with children C) a Protestant person with children D) a Catholic person without children Answer: A 7) The practice of labelling in Japan is an example of __________ suicide. A) altruistic B) anomic C) egoistic D) social Answer: A 8) According to Merton, __________ occurs when there is a breakdown in the cultural structure. A) anomie B) conformity C) innovation D) retreatism Answer: A 9) According to Merton, conformity occurs when __________. A) an individual accepts the cultural goals but not the means for achieving those goals B) an individual does not accept the cultural goals but does accept the means for achieving those goals C) an individual does not accept either the cultural goals or the means for achieving those goals D) an individual accepts both the cultural goals and the means for achieving those goals Answer: D 10) Some social groups (the unemployed and the lower class) are more prone to mental illness than other social groups. This is evidence that the __________ approaches have at least some validity. A) agency B) anomic C) social D) structural Answer: D 11) __________ refers to the process by which individuals make decisions based on their past, present, and future. A) Agency B) Anomie C) Deviance D) Symbolism Answer: B 12) Which of the following represents the central assumption of the symbolic interactionism? A) human behavior is self-directed based on the shared understanding of symbols B) behavior is dictated by social structure C) behavior cannot be easily predicted or interpreted D) human behavior changes based on who the individual is interacting with Answer: A 13) Mead’s concept of __________ refers to a social product results from an individual’s relationships and interactions with others. A) the act B) joint action C) objects D) the self Answer: D 14) According to symbolic interactionists, reality is __________. A) fabricated B) socially constructed C) individual D) impossible to define Answer: B 15) Primary deviance, according to Lemert, is __________. A) a situation in which individuals commit a few small deviant acts but do not commit major acts of deviance B) a serious form of deviance when an individual is labeled as a deviant C) a form of deviance that identifies an individual as more than a deviant, but as a criminal deviant D) when a “normal” person acts oddly, but whose behavior is rationalized because it is out of character Answer: D 16) According to labelling theory, deviance refers to __________. A) a specific act B) a reaction by others C) a degree of wrongness D) a deviant person Answer: B 17) According to Becker’s typology, a __________ is one who is a rule-breaker who is seen as a deviant. A) conformist B) false accused C) pure deviant D) secret deviant Answer: C 18) One of the criticisms of labelling theory is that __________. A) it does not address the cause of deviance B) it addresses only how deviance begins C) it is limited in its effectiveness D) there is little research available Answer: A 19) In Rosenhan’s study of pseudo-patients in a mental hospital concluded that __________. A) the pseudo-patients were never fully accepted into the label of patient B) the pseudo-patients easily convinced the doctors of their healthy status C) after being admitted, the pseudo-patients became mentally ill and eventually were fully admitted into the hospital D) once labelling, the pseudo-patients had a difficult time convincing the doctors otherwise Answer: D 20) Labeling theory is important because __________. A) behavior cannot be changed by drugs alone B) labelling theory has significant empirical support C) persons labelling as mentally ill are stigmatized D) mental illness is a medical condition Answer: C 21) __________ rejects the medical model of mental illness. A) Labeling theory B) Social constructionism C) Functionalism D) Social learning theory Answer: B 22) Social constructionism views mental illness as defined by __________. A) society B) patients C) individuals D) doctors Answer: A 23) Which of the following is not a micro-level theoretical perspective related to mental disorder? A) social learning theory B) labelling theory C) symbolic interactionism D) the medical model Answer: D 24) Social learning theorists focus on behavior that is __________. A) influenced by the social environment B) shaped by its consequences C) observable and measurable D) operant and respondent Answer: C 25) The major criticism of social learning theory is that __________. A) it accepts that all individuals will eventually have a mental disorder B) it assumes mental disorders are learned C) empirical evidence does not support it D) it does not account for agency Answer: B Part II. Essay Questions Answer the following questions in your own words. 1) Identify and describe the three types of suicide, as outlined by Durkheim. Answer: Émile Durkheim, a prominent sociologist, categorized suicide into three main types based on his seminal work "Le Suicide" (1897). These types are differentiated by the social forces influencing them rather than individual psychological factors. Here are the three types of suicide according to Durkheim: 1. Egoistic Suicide: • Description: Egoistic suicide occurs when individuals feel detached or alienated from society. They lack social integration and feel disconnected from social norms and values. This type of suicide typically arises from a lack of meaningful social relationships or a weak sense of belonging to a community. • Example: A person who lives alone, lacks close relationships, and does not feel a sense of connection to their community might be at higher risk of egoistic suicide. The absence of social ties leaves them feeling isolated and without a support network. 2. Altruistic Suicide: • Description: Altruistic suicide occurs when individuals are excessively integrated into a group or society to the extent that their lives are governed by the group's norms and values. They may sacrifice their lives for the sake of the group's welfare, often driven by strong social or cultural pressures. • Example: Soldiers who willingly sacrifice their lives in battle for the defense of their nation or members of certain religious groups who engage in self-sacrifice rituals are examples of altruistic suicide. In these cases, the individual prioritizes the collective well-being over personal survival. 3. Anomic Suicide: • Description: Anomic suicide happens in response to a breakdown of social norms and a loss of social cohesion. It occurs when there is a significant disruption in an individual's life or in society that leaves them feeling without moral guidance or direction. This disruption can be due to sudden changes in economic circumstances, social upheaval, or drastic shifts in societal expectations. • Example: During periods of economic recession or financial collapse, individuals who experience sudden job loss, bankruptcy, or economic ruin may be at risk of anomic suicide. The loss of financial stability and the collapse of social structures that provided stability contribute to feelings of hopelessness and despair. Durkheim's classification of suicide emphasizes the role of social factors in shaping individual behaviors and choices. Each type reflects a different relationship between the individual and society, highlighting how social integration, norms, and stability can influence suicide rates within a population. 2) How is mental disorder related to economic change? Answer: The relationship between mental disorders and economic change is complex and multifaceted, involving various social, economic, and individual factors. Here are several ways in which economic change can impact mental health and contribute to the prevalence of mental disorders: 1. Unemployment and Financial Stress: Economic downturns, recessions, or job losses can lead to increased stress, anxiety, and depression among individuals who experience unemployment or financial instability. The loss of income and uncertainty about the future can exacerbate existing mental health conditions or trigger new ones. 2. Poverty and Inequality: Economic disparities and poverty are strongly correlated with higher rates of mental health problems. Individuals living in poverty often face chronic stress, inadequate access to healthcare, and limited resources for coping with mental health challenges, which can contribute to the development or worsening of mental disorders. 3. Access to Healthcare: Economic changes can impact access to mental healthcare services. During economic crises, public funding for mental health programs may be reduced, leading to decreased availability of services and longer wait times for treatment. This lack of access can prevent individuals from receiving timely and adequate care for their mental health needs. 4. Workplace Stress and Job Insecurity: Economic pressures in the workplace, such as increased job demands, long working hours, and job insecurity, can contribute to stress-related mental health disorders such as anxiety and burnout. High-stress work environments may also exacerbate existing mental health conditions among employees. 5. Housing and Homelessness: Economic instability can lead to housing instability or homelessness, which are associated with higher rates of mental health disorders. Individuals who experience homelessness often face multiple stressors, including exposure to violence, lack of social support, and difficulty accessing healthcare services, all of which can negatively impact mental well-being. 6. Debt and Financial Strain: Personal financial difficulties, including debt and financial strain, can lead to chronic stress and anxiety, which are risk factors for mental disorders such as depression. Individuals struggling with debt may experience feelings of hopelessness and helplessness, further contributing to poor mental health outcomes. 7. Social Dislocation and Changes in Social Networks: Economic changes can disrupt social networks and community cohesion, leading to feelings of social isolation and loneliness. Lack of social support is a significant risk factor for mental health problems, as social relationships play a crucial role in buffering stress and promoting resilience. Overall, economic change can impact mental health through its influence on socioeconomic conditions, access to resources and healthcare, stress levels, and social relationships. Policies that address economic inequalities, improve access to mental healthcare services, and support individuals during periods of economic instability are essential for mitigating the negative impacts of economic change on mental health. 3) How do the structural theories aim to understand mental disorder? Answer: Structural theories in psychology aim to understand mental disorders by focusing on the broader social, cultural, and environmental factors that contribute to the development and manifestation of psychological problems. These theories contrast with individual-focused models that emphasize internal psychological processes or biological factors. Here are several ways in which structural theories seek to understand mental disorders: 1. Social Determinants: Structural theories emphasize the impact of social determinants such as socioeconomic status, education, employment, housing conditions, and access to healthcare on mental health outcomes. These factors shape individuals' experiences, opportunities, and stressors, which in turn influence their vulnerability to mental disorders. 2. Social Roles and Expectations: These theories consider how social roles, cultural norms, and societal expectations contribute to mental health. For example, societal pressures related to gender roles, familial responsibilities, and career expectations can create stress and contribute to the development of anxiety, depression, or other disorders. 3. Social Support and Networks: Structural theories highlight the role of social support networks, including family, friends, and community resources, in promoting mental well-being. Lack of social support or social isolation is considered a risk factor for mental disorders, as it can limit coping resources and increase vulnerability to stress. 4. Social Stressors and Adversities: Structural theories recognize that exposure to social stressors such as discrimination, stigma, violence, trauma, and economic hardships can significantly impact mental health. These stressors may contribute to the development of conditions like post-traumatic stress disorder (PTSD), depression, or substance use disorders. 5. Institutional and Systemic Factors: Structural theories examine how institutional factors, including healthcare systems, legal frameworks, and social policies, influence mental health outcomes. Inadequate access to mental healthcare, disparities in treatment, and discriminatory practices within institutions can exacerbate mental health disparities. 6. Social Change and Transition: These theories consider the impact of societal changes, such as globalization, urbanization, technological advancements, and cultural shifts, on mental health. Rapid societal changes can disrupt social networks, cultural norms, and support systems, contributing to stress and mental health challenges. 7. Critique of Individualistic Models: Structural theories critique individualistic models of mental health that focus solely on internal psychological factors or genetic predispositions. Instead, they emphasize the importance of understanding mental health within the broader context of social structures, relationships, and inequalities. Overall, structural theories provide a framework for understanding mental disorders as embedded within social contexts. They advocate for addressing societal factors and promoting social justice to improve mental health outcomes and reduce disparities among diverse populations. Integrating structural perspectives with individual-focused approaches can lead to more comprehensive understanding and effective interventions for mental health issues. 4) What are the limitations of the agency-oriented perspectives? Answer: Agency-oriented perspectives in psychology emphasize the role of individual choices, behaviors, and cognitive processes in shaping human experience and behavior. While these perspectives provide valuable insights into personal autonomy, motivation, and decision-making, they also have several limitations: 1. Neglect of Social Context: Agency-oriented perspectives often focus heavily on individual actions and internal processes, sometimes overlooking the influence of broader social, cultural, and environmental factors. This neglect can limit understanding of how societal structures, norms, and inequalities shape individual behaviors and outcomes. 2. Blaming the Individual: These perspectives may inadvertently reinforce a tendency to attribute success or failure solely to individual characteristics, choices, or efforts. This can lead to overlooking systemic barriers or disadvantages that individuals may face, such as discrimination, socioeconomic inequalities, or lack of access to resources. 3. Limited Understanding of Structural Inequalities: Agency-oriented perspectives may not adequately address how structural inequalities, such as racism, sexism, poverty, or institutional discrimination, impact individuals' opportunities, choices, and life outcomes. This can result in an oversimplified view of social problems and perpetuate stigma or victim-blaming attitudes. 4. Underestimating Unconscious Influences: These perspectives may underestimate the role of unconscious processes, emotions, and social conditioning in shaping behavior. Factors such as implicit biases, cultural conditioning, and past experiences can significantly influence decision-making and behavior without conscious awareness. 5. Inadequate Explanation of Group Dynamics: Agency-oriented perspectives often focus on individuals rather than groups or collective processes. They may overlook how group norms, peer influence, social identities, and group dynamics influence individual behavior and decision-making within social contexts. 6. Overlooking Historical and Cultural Contexts: These perspectives may not sufficiently account for historical legacies, cultural norms, and societal changes that shape individuals' agency and choices over time. Contextual factors, including historical events, political movements, and cultural shifts, can profoundly influence individual behaviors and attitudes. 7. Limitations in Addressing Structural Change: While agency-oriented perspectives emphasize personal empowerment and self-efficacy, they may provide limited guidance on addressing broader structural issues and promoting systemic change. Effective interventions often require addressing both individual agency and structural barriers to create meaningful social change. In summary, while agency-oriented perspectives highlight individual autonomy, responsibility, and decision-making, they need to be complemented by structural perspectives that consider the broader social, cultural, and historical contexts in which individuals operate. Integrating both perspectives can lead to a more comprehensive understanding of human behavior and inform more effective interventions for promoting well-being and social justice. 5) Describe Merton’s typology of modes of adaptation. Answer: Robert Merton, a prominent sociologist, developed a typology of modes of adaptation within the context of his strain theory, which seeks to explain deviance and conformity in society. According to Merton, individuals adapt to societal goals and means through various strategies when they experience a disjunction (or strain) between culturally defined goals and the legitimate means available to achieve them. Here are Merton's five modes of adaptation: 1. Conformity: • Description: Conformity is the most common and accepted mode of adaptation. Individuals accept both the culturally defined goals (e.g., wealth, success) and the legitimate means (e.g., education, hard work) to achieve these goals. • Example: A person who works hard in school, pursues higher education, and strives to achieve financial success through legal and socially acceptable means conforms to societal norms and values. 2. Innovation: • Description: Innovation occurs when individuals accept culturally defined goals but reject or lack access to legitimate means to achieve these goals. As a result, they innovate by adopting alternative or deviant means to attain success. • Example: A person who desires material wealth but lacks access to legitimate opportunities may turn to illegal activities such as theft, fraud, or drug dealing to achieve financial success. 3. Ritualism: • Description: Ritualism occurs when individuals abandon or scale back their pursuit of culturally defined goals but continue to adhere rigidly to the legitimate means. They become more focused on following rules and procedures than achieving the actual goals. • Example: A person who originally aspired to achieve wealth and success may become disillusioned and abandon these goals. However, they continue to work diligently and follow societal norms (e.g., maintaining a job with modest income) out of a sense of duty or routine. 4. Retreatism: • Description: Retreatism involves rejecting both the culturally defined goals and the legitimate means to achieve them. Individuals in this mode of adaptation withdraw from society and may resort to substance abuse, vagrancy, or other forms of social withdrawal. • Example: A person who rejects both societal goals (e.g., wealth, success) and the legitimate means (e.g., education, employment) to achieve them may retreat into a life of substance abuse or homelessness, choosing to disengage from societal expectations altogether. 5. Rebellion: • Description: Rebellion occurs when individuals reject both the culturally defined goals and the legitimate means to achieve them, but they replace these with new goals and means. They actively seek to change or replace existing societal structures. • Example: Activists and revolutionaries who challenge the existing social and political order and advocate for new goals (e.g., social justice, equality) and means (e.g., protest, activism) are examples of rebellion. They reject the current system while striving to establish new norms and values. Merton's typology of adaptation modes illustrates how individuals respond to the strain between societal expectations and available opportunities. It provides a framework for understanding different forms of deviance and conformity within society and how individuals navigate cultural goals and means to achieve success and fulfillment. Chapter 5: Mental Disorder: Social Epidemiology Test Questions Part I. Multiple Choice Questions Circle the response that best answers the following questions. 1) __________ is the measurement and analysis of social patterns of mental disorder. A) Health epidemiology B) Logical epidemiology C) Population epidemiology D) Social epidemiology Answer: D 2) Epidemiologists focus on the health problems of __________. A) criminals B) individuals C) large groups of people D) unhealthy people Answer: C 3) An individual is __________ if s/he is exposed to a health problem. A) a case B) an instance C) a rate D) at risk Answer: D 4) The age-specific depression rate can be calculated by __________. A) multiplying the number of persons with depression of a certain age by the number of people in the population B) dividing the number of individuals with depression in a specific age group by the number of individuals in the age group, and multiplying by 100,000 C) multiplying the number of persons with depression of a certain age by the number of people in the population of that age and dividing by 100,000 D) dividing the number of people with depression by the number of people of a certain age Answer: B 5) Crude rates are __________ to be always useful. A) too specific B) too broad C) too complex D) too simple Answer: B 6) __________ refers to the number of new cases of a disorder occurring within a period of time; __________ refers to the total number of cases of a disorder that occurs at any time. A) Rate; risk B) Risk; rate C) Prevalence; incidence D) Incidence; prevalence Answer: C 7) The number of people who have had a mental disorder at least once during their life is referred to as __________ prevalence. A) lifetime B) living C) period D) point Answer: A 8) Social epidemiologists are most interested in indicators of __________. A) marital status and race B) genetic mutations and DNA C) pollution and allergens D) admissions and incidence rates Answer: A 9) The primary method of data gathering among social epidemiologists is __________. A) surveys B) health records C) interviews D) historical analyses Answer: A 10) Survey data is often supplemented by __________, such as health records, admissions data, and other demographic data. A) interviews B) secondary sources C) field notes D) case studies Answer: B 11) If an instrument measures what it is supposed to measure, then the instrument is __________. A) valid B) reliable C) a scale D) a mode Answer: A 12) If an instrument produces consistent results over time, then the instrument is __________. E) valid F) reliable G) a scale H) a mode Answer: B 13) The major criticism of the DSM-III was that __________. A) the categories were too complex B) the categories were not precise enough C) the research was not valid D) the research was not reliable Answer: B 14) The DSM-III-R was published in 1987 and included which of the following? A) Severity scales for categories B) Extensive empirical research C) Cultural variations D) Revisions to correct for inconsistencies Answer: D 15) Misowsky and Ross argue that sociological studies would benefit from considering __________. A) only the type of psychological problems B) only the severity of psychological problems C) neither the type nor the severity of psychological problems D) both the type and the severity of psychological problems Answer: D 16) The Diagnostic Interview Schedule (DIS) uses a __________ to diagnosis mental disorder. A) trained psychologist B) computer C) short instrument D) telephone interview Answer: B 17) Wakefield suggested major shortcomings of the ECA and NCS. Which of the following represents one of these shortcomings? A) The ECA is based on a different version of the DSM than the NCS. B) The ECA is useful only for children and the NCS only for adults. C) The ECA and NCS are not always reliable with one another. D) The ECA indicates a much higher prevalence than does the NCS. Answer: C 18) The Center for Epidemiologic Studies Depression Scale (CES-D) is __________. A) neither valid nor reliable B) valid but not reliable C) reliable but not valid D) valid and reliable Answer: D 19) The actual extent of mental disorder is __________. A) simple to detect B) almost impossible to detect C) as close to accurate as possible D) equal to the incidence Answer: B 20) Research suggests that __________. A) most people likely to be diagnosed with a mental disorder are untreated B) few people with a mental disorder are adequately treated C) nearly all persons with a mental disorder are properly treated and cured D) there is significant political variation in treatment of the mentally ill Answer: A 21) The prevalence of mental disorder in the general population is greater among __________. A) the lower class B) suburbanites C) children D) Asians Answer: A 22) Men have higher rates of __________ than do women. A) antisocial personality disorders B) bipolar disorders C) panic disorders D) eating disorders Answer: A 23) Women have higher rates of __________ than do men. A) substance abuse disorders B) anxiety disorders C) panic disorders D) bipolar disorders Answer: B 24) The pattern of mental disorder and sociodemographic variation (sex, social class, urban/rural) holds in which of the following geographic areas? A) in the U.S. only B) in westernized nations C) in highly populated nations D) worldwide Answer: D 25) Research has been consistent in regards to mental disorder and all of the following sociodemographic variables, except __________. A) social class B) geographic location C) sex D) marital status Answer: D Part II. Essay Questions Answer the following questions in your own words. 1) How do incidence and prevalence differ? Answer: Incidence and prevalence are both measures used in epidemiology to describe the occurrence of diseases or conditions within a population, but they measure different aspects of disease occurrence: 1. Incidence: • Definition: Incidence refers to the rate at which new cases of a disease or condition develop within a specific population during a defined period of time. It focuses on the occurrence of new cases or incidents of the disease. • Calculation: Incidence is typically calculated as the number of new cases of the disease divided by the total population at risk within a specified time period (e.g., per year). It is often expressed as a rate (e.g., cases per 1,000 person-years). • Use: Incidence is useful for studying the risk factors and causes of a disease, as it helps to understand how quickly and in what proportion new cases are developing within a population. 2. Prevalence: • Definition: Prevalence refers to the proportion of individuals in a population who have a particular disease or condition at a specific point in time or over a specified period. It reflects the total number of existing cases (both old and new) within the population. • Calculation: Prevalence is calculated as the number of existing cases of the disease divided by the total population at a specific point in time or during a specific period. It is often expressed as a percentage. • Use: Prevalence helps to understand the overall burden of a disease within a population. It is useful for healthcare planning, resource allocation, and determining the public health impact of a disease. Key Differences: • Focus: Incidence focuses on new cases occurring within a defined period, whereas prevalence includes both new and existing cases at a specific point or over a period. • Time Frame: Incidence is a measure of risk over time, while prevalence is a snapshot of disease occurrence at a single point in time or over a period. • Interpretation: Incidence provides information about the likelihood of developing a disease, while prevalence gives a sense of how widespread the disease is in the population at a given time. In summary, incidence and prevalence are complementary measures used in epidemiology to provide different perspectives on disease occurrence within populations. Understanding both measures is essential for assessing the dynamics and impact of diseases, planning healthcare interventions, and evaluating public health strategies. 2) Describe the methods common to social epidemiology. Answer: Social epidemiology is a branch of epidemiology that investigates how social factors and social determinants of health influence the distribution and determinants of disease and health outcomes within populations. It focuses on understanding the social context in which health and disease occur, beyond individual-level factors. Several methods are commonly used in social epidemiology to study these relationships: 1. Ecological Studies: • Description: Ecological studies examine associations between population-level exposures (e.g., socioeconomic status, social cohesion) and health outcomes (e.g., disease prevalence, mortality rates) across different geographical areas or time periods. • Method: These studies analyze aggregated data at the group or community level rather than individual-level data. They often use secondary data sources such as national surveys, census data, or administrative records. • Example: Examining the relationship between neighborhood income levels and rates of cardiovascular disease across different regions. 2. Cross-Sectional Studies: • Description: Cross-sectional studies assess exposure and health outcome data simultaneously at a single point in time. They provide a snapshot of the prevalence of both exposure factors (e.g., social determinants) and health outcomes (e.g., disease prevalence) within a population. • Method: Researchers collect data from a sample of individuals or households through surveys, interviews, or questionnaires. Associations between exposures and outcomes are examined using statistical analyses. • Example: Surveying a population to assess the association between educational attainment (exposure) and prevalence of obesity (outcome) at a specific time point. 3. Case-Control Studies: • Description: Case-control studies compare individuals with a particular health outcome (cases) to those without the outcome (controls) to investigate potential exposures or risk factors that may have contributed to the disease. • Method: Researchers retrospectively collect data on exposure histories from cases and controls and compare the prevalence of exposures between the two groups. • Example: Studying the association between social isolation (exposure) and depression (outcome) by comparing individuals diagnosed with depression (cases) to a matched control group without depression. 4. Cohort Studies: • Description: Cohort studies follow a group of individuals over time to assess the influence of exposures or risk factors (e.g., social factors) on the incidence of health outcomes (e.g., disease occurrence). • Method: Researchers identify a cohort (group) of individuals with similar characteristics or exposures and collect data prospectively through regular follow-ups or surveys to track changes in health outcomes over time. • Example: Tracking a cohort of low-income families over several years to examine the association between neighborhood socioeconomic status (exposure) and child developmental outcomes (outcome). 5. Multilevel Analysis: • Description: Multilevel analysis (or hierarchical modeling) examines how individual-level health outcomes are influenced by factors at multiple levels of social organization (e.g., individual, neighborhood, community). • Method: This approach allows researchers to simultaneously consider both individual-level characteristics (e.g., age, gender) and contextual factors (e.g., neighborhood poverty rate, social capital) in explaining health outcomes. • Example: Assessing how individual health behaviors (e.g., smoking rates) are influenced by both personal characteristics and neighborhood-level factors like access to healthcare or availability of recreational facilities. These methods in social epidemiology provide diverse approaches to studying the complex interplay between social factors and health outcomes. By understanding these relationships, researchers can identify social determinants of health disparities, inform policy interventions, and promote health equity within populations. 3) What is the “true” prevalence of mental disorder? Answer: The "true" prevalence of mental disorders refers to the actual proportion of individuals within a population who have a specific mental disorder at a given point in time or over a defined period. However, determining the true prevalence of mental disorders is challenging due to several factors: 1. Variability in Diagnostic Criteria: Mental disorders can be diagnosed based on specific criteria outlined in diagnostic manuals such as the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). Changes in diagnostic criteria over time and differences in diagnostic practices among clinicians can affect prevalence estimates. 2. Underreporting and Stigma: Many individuals with mental disorders may not seek treatment or may not disclose their symptoms due to stigma, fear of discrimination, or lack of access to mental healthcare. This can lead to underestimation of prevalence rates in population-based studies. 3. Sampling Bias: Studies estimating prevalence often rely on samples that may not be representative of the entire population. Samples may be drawn from specific geographic areas, age groups, or socioeconomic backgrounds, potentially limiting the generalizability of prevalence estimates. 4. Diagnostic Challenges: Some mental disorders have overlapping symptoms or co-occur with other conditions, making accurate diagnosis difficult. Comorbidity (the presence of multiple disorders in one individual) can complicate prevalence estimates. 5. Changes Over Time: Prevalence rates of mental disorders can vary over time due to changes in societal norms, awareness, access to healthcare, and other factors. Longitudinal studies are needed to track changes in prevalence rates over time. 6. Cultural and Contextual Differences: Cultural norms and perceptions of mental health vary across different populations, which can influence the recognition, reporting, and interpretation of symptoms of mental disorders. Due to these complexities, epidemiological studies often provide estimates of prevalence rather than definitive measures of true prevalence. Researchers use various methodologies, such as population surveys, clinical assessments, and data analysis techniques, to estimate the prevalence of mental disorders within specific populations. These estimates serve as valuable indicators for understanding the burden of mental illness, planning healthcare services, and developing interventions to promote mental health and well-being. 4) What do Mirowsky and Ross argue is useful for sociological studies of mental disorder? Answer: Mirowsky and Ross, in their work on the sociology of mental disorder, argue that the concept of "sense of control" is particularly useful for understanding and studying mental health outcomes. Here are key points from their perspective: 1. Sense of Control: • Mirowsky and Ross emphasize that individuals' perceptions of control over their lives and circumstances significantly influence their mental health outcomes. • They argue that a strong sense of control—feeling empowered to influence one's own destiny and outcomes—can promote mental well-being by reducing stress and enhancing resilience. • Conversely, a perceived lack of control or feelings of powerlessness may contribute to stress, anxiety, and depression. 2. Psychosocial Mechanism: • According to Mirowsky and Ross, sense of control operates as a psychosocial mechanism that mediates the relationship between social factors and mental health. • Social factors such as socioeconomic status, educational attainment, and occupational prestige can influence individuals' sense of control. • Higher socioeconomic status and greater educational attainment are often associated with a stronger sense of control, which in turn is linked to better mental health outcomes. 3. Research Implications: • Their argument suggests that sociological studies of mental disorder should focus on understanding how social structures and contexts shape individuals' sense of control. • Researchers can investigate how societal changes, economic disparities, social policies, and cultural norms affect perceptions of control and, subsequently, mental health outcomes. • Studying sense of control allows for a nuanced examination of how structural factors contribute to mental health disparities across different populations. 4. Policy and Interventions: • Mirowsky and Ross's perspective implies that interventions aimed at improving mental health should consider factors beyond individual psychology, such as enhancing individuals' sense of control through structural and social changes. • Policies that promote economic opportunity, social support networks, and empowerment initiatives may enhance sense of control and contribute to better mental health outcomes. In summary, Mirowsky and Ross argue that incorporating the concept of sense of control into sociological studies of mental disorder provides a valuable framework for understanding how social factors influence mental health. Their work underscores the importance of considering individuals' perceptions of control as a key determinant of mental well-being within broader social contexts. 5) How are social class, sex, and urban/rural status related to mental disorder? Answer: Social class, sex (gender), and urban/rural status are important social determinants that can influence the prevalence, presentation, and outcomes of mental disorders. Here's a discussion of how each of these factors is related to mental health: 1. Social Class: • Definition: Social class refers to a person's socioeconomic status, typically categorized based on factors such as income, education, occupation, and wealth. • Relationship with Mental Disorder: • Higher Social Class: Individuals from higher social classes generally have better access to resources such as healthcare, education, stable employment, and social support networks. As a result, they may experience lower levels of stress, better mental health outcomes, and lower rates of certain mental disorders compared to lower social classes. • Lower Social Class: Those from lower social classes often face greater economic insecurity, limited access to healthcare services, poorer living conditions, and higher levels of chronic stress. These factors contribute to higher rates of mental health problems such as depression, anxiety disorders, and substance use disorders. • Social Mobility: Studies suggest that upward social mobility can improve mental health outcomes, whereas downward mobility or perceived social status inconsistency (feeling out of place in a higher or lower social class) can be detrimental to mental well-being. 2. Sex (Gender): • Definition: Sex refers to biological differences between males and females, whereas gender refers to the social roles, behaviors, identities, and expectations associated with being male or female. Relationship with Mental Disorder: • Gender Differences: Men and women may experience different patterns of mental disorders. For example, women are more likely to experience depression and anxiety disorders, while men may be more prone to substance use disorders and antisocial behavior. • Gendered Experiences: Social and cultural factors influence how mental health issues are perceived and expressed based on gender norms. For instance, men may be less likely to seek help for mental health concerns due to socialized expectations of stoicism and self-reliance. • Intersectionality: Intersectional approaches consider how factors such as race, ethnicity, socioeconomic status, and sexual orientation intersect with gender to influence mental health disparities. For example, women of color may face unique challenges that impact their mental health differently from white women or men of color. 3. Urban/Rural Status: • Definition: Urban and rural status refers to the geographic location of individuals, with urban areas characterized by higher population density and greater access to services compared to rural areas. • Relationship with Mental Disorder: • Urban Areas: Urban environments offer more opportunities for employment, education, healthcare services, and social connections. However, urban living can also be associated with higher levels of stress, social isolation, noise pollution, and crime, which may contribute to mental health issues such as anxiety disorders and psychotic disorders. • Rural Areas: Residents of rural areas may face challenges related to limited access to healthcare services, transportation barriers, social isolation, and economic disparities. These factors can contribute to higher rates of depression, substance abuse, and suicide compared to urban populations. • Cultural and Community Factors: Cultural norms and community support networks in rural and urban areas can influence help-seeking behaviors, stigma associated with mental illness, and access to mental health resources. In summary, social class, sex (gender), and urban/rural status are important social determinants that interact with individual experiences, environmental factors, and societal structures to influence mental health outcomes. Understanding these relationships is essential for developing targeted interventions, improving access to mental health services, and addressing disparities in mental health care. Test Bank for Sociology of Mental Disorder William C. Cockerham 9780205960927
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