Sociological Images

Autism appears to be on the rise. The U.S. Centers for Disease Control and Prevention reports that there are 20 times more cases of autism today than there were in the 1980s.  This figure, from the Los Angeles Times, shows a 200% increase in California:

The rise in cases of autism led scientists to ask whether there was an actual increase in incidence or if we were just getting better at identifying it.  The evidence seems to suggest that it’s (at least mostly) the latter.  Said anthropologist Roy Richard Grinker: “Once we are primed to see something, we see it and wonder how we could have never seen it before.”

But how to explain disparities like this?

Often regional differences in health and mental health can be traced to heavier environmental toxin loads.   In most of those cases, though, clusters of illness occur in poor and often disproportionately non-white neighborhoods.  Autism clusters were happening in class-privileged places.

Sociologist Peter Bearman discovered that these clusters were the result of conversation.  Class-privileged parents had the resources to get their child diagnosed, then they talked to other parents.  Some of these parents would recognize the symptoms and take their child to the doctor and… voila… a cluster.  ”Living within 250 meters [of a child diagnosed with autism], reports the Los Angeles Times, boosted the chances by 42%, compared to living between 500 and 1,000 meters away.”

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Lisa Wade is a professor of sociology at Occidental College. You can follow her on Twitter and Facebook.

In an earlier post we reviewed research by epidemiologists Richard Wilkinson and Kate Pickett showing that income inequality contributes to a whole host of negative outcomes, including higher rates of mental illness, drug use, obesity, infant death, imprisonment, and interpersonal trust.

She summarizes these findings in this quick nine-minute talk at a Green Party conference:

See Dr. Pickett making similar arguments as to why raising the average national income in developed countries doesn’t make people happier or enable them to live longer, why unequal societies are more violent, and how status inequality increases stress.

And see more about income inequality and national well-being at Equality Trust.

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Lisa Wade is a professor of sociology at Occidental College. You can follow her on Twitter and Facebook.

The mysterious SocProf, who writes The Global Sociology Blog, offered a nice review of Richard Wilkinson and Kate Pickett‘s book, The Spirit Level: Why More Equal Societies Almost Always Do Better.  Wilkinson and Pickett offer transnational research showing how, exactly, income inequality is related to bad outcomes on average.  In other words, as SocProf puts it, ”…egalitarianism is not a bleeding heart’s wet dream but rather the only rational course of action in terms of public policy.”  The 11 graphs, available at the Equality Trust website, speak for themselves.

Societies with more income inequality have higher infant death rates than other societies:

Societies with more income inequality have higher rates of mental illness than other societies:

Societies with more income inequality have a higher incidence of drug use than other societies:

Societies with more income inequality have a higher high school drop out rate than other societies:

Societies with more income inequality imprison a larger proportion of their population than other societies:

Societies with more income inequality have a higher rate of obesity than other societies:

Individuals in societies with more income inequality are less likely to be in a different class than their parents compared to other societies:

Individuals in societies trust others less than people in other societies:

Societies with more income inequality have higher rates of homicide than other societies:

Societies with more income inequality give less in foreign aid than other societies:

Children in societies with more income inequality do less well than children in other societies:

The authors sum it up pretty simply: : “Th[e] dissatisfaction [measured in this data is] a cost which the rich impose on the rest of society.”

And they have a clear policy proposal relevant to the current economic crisis.

[This is] a clear warning for those who might want to place low public expenditure and taxation at the top of their priorities. If you fail to avoid high inequality, you will need more prison and more police. You will have to deal with higher rates of mental illness, drug abuse and every other kind of problems. If keeping taxes and benefits down leads to wider income differences, the need to deal with ensuing social ills may  force you to raise public expenditure to cope.

Readers Ana and Dmitriy T.M. sent in a TED talk of Richard Wilkinson discussing the relationship between income inequality and social problems:

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Lisa Wade is a professor of sociology at Occidental College. You can follow her on Twitter and Facebook.

The World Health Organization (WHO) defines neurological disorders as physical diseases of the nervous system and psychiatric illnesses as disorders that manifest as abnormalities of thought, feeling, or behaviour. In fact, however, there are longstanding unresolved debates on the exact relationship between neurology and psychiatry, including whether there can be any clear division between the two fields.

Related to this, Brandy B. sent us a figure from the blog Neuroskeptic graphing the proportion of journal articles on various disorders included in The American Journal of Psychiatry versus the journal Neurology over the past 20 years. The image is interesting from a sociological standpoint in that, as Brandy writes, “it says far more about the sociology of these fields than about which disorders can be considered neurological or psychiatric.”

While debates regarding the neurological roots of psychiatric illnesses such as depression and schizophrenia are far from settled, the graph shows that the two disciplines have maintained varying levels of intellectual authority over different disorders. Some fall clearly into one domain or the other, while others are covered in both. Depression, for example, receives more attention than mania in Neurology, despite the fact that mania often occurs alongside depression as a symptom of bipolar disorder.

The information in this graph serves as a reminder that what gets published in academic journals, and the topics over which disciplines exercise authority, are the results of social processes. Disciplines are artificial categories of knowledge, solidified through the creation of institutional structures like university departments, degree programs, and academic journals. Psychiatry, for example, didn’t emerge as a discipline until the 19^th century; this emergence was rooted in a social context in Western Europe where rising numbers of people were being institutionalized and attitudes regarding the treatment of mental illness were changing. By claiming membership in disciplines based on common academic backgrounds, research methodologies, and topics of study, scholars contribute to the reproduction of these disciplinary boundaries.

The peer-review process is one facet of this social reproduction of disciplinary boundaries that is particularly relevant to the image above. Research and papers that are submitted, accepted, and funded must appeal to reviewers and conform to the criteria set out by the journal or discipline within which researchers wish to publish. In the case of neurology and psychiatry, it appears based on this graph that the peer-review process may uphold disciplinary boundaries, as reviewers for each discipline’s journal appear to favour articles on certain disorders.

The divisions between neurology and psychiatry suggested in the image above stir up lots of interesting questions not only about what we consider to be “neurological” or “psychiatric”, but more generally about the social production of knowledge.

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Hayley Price has a background in sociology, international development studies, and education. She recently completed her Masters degree in Sociology and Equity Studies in Education at the University of Toronto.

If you would like to write a post for Sociological Images, please see our Guidelines for Guest Bloggers.

Cross-posted at Jezebel and AOL’s Black Voices.

In a new book called “The Protest Psychosis: How Schizophrenia became a Black Disease,” psychiatrist and cultural critic Jonathan Metzl draws on a variety of sources — patient records, psychiatric studies, racialized drug advertisements, and popular metaphors for madness — to contend that schizophrenia transformed from being a mostly white, middle-class affliction in the 1950s, to one that identified with blackness, volatility, and civil strife at the height of the Civil Rights movement.

The racialized resonance between emerging definitions of schizophrenia and anxieties about black protest seem clear in pharmaceutical advertisements and essays appearing in leading American psychiatric journals during the 1960s and 70s.  For instance, the advertisement for the major tranquilizer Haldol that ran in the Archives of General Psychiatry shows an angry, hostile African American man with a clenched, inverted, Black Power fist.

The deranged black figure literally shakes his fist at the assumed physician viewer, while in the background a burning, urban landscape appears to directly reference the type of civil strive that alarmed many in the “establishment” at that time.  The ad compels psychiatrists to conflate black anger as a form of threatening psychosis and mental illness.  Indeed the ad seems to play off presumed fears of assaultive and belligerent black men.

As the urban background suggests, this fear extended beyond individual safety to social unrest.  In a 1969 essay titled “The Protest Psychosis,” after which Metzl’s book is named, psychiatrists postulated that the growing racial disharmony in the US at the height of the Civil Rights Movement, reflected a new manifestation of psychotic behaviors and delusions afflicting America’s black lower class.  Accordingly, “paranoid delusions that one is being constantly victimized” drew some men to fixate on misguided ventures to overthrow the establishment.  Luckily, pharmaceutical companies proposed that chemical interventions could directly pacify the masculinzed, black threat depicted in advertisements like the above.  “Assaultive and belligerent?” it asks.  “Cooperation often begins with Haldol.”

Moreover, ads for Thorazine and Stelazine during this period often conjured up images of the “unruly” and “primitive” precisely at a time when the demographic composition of this diagnosis was dramatically shifting from a mostly white clientele, to a group of predominately black, confined, mental patients.  It is telling that within this context, the makers of Thorazine would choose to portray the drug’s supposed specificity to schizophrenia in their advertisements by displaying a variety of war staffs, walking sticks, and other phallic artifacts from African descent.

The below ad for Thorazine, for example, exclaims western medicine’s superiority in treating mental illness with modern pharmaceuticals, by contrasting the primitive tools used by less enlightened cultures.

Notably, these claims of superiority and medical efficacy drew from a particular set of pejorative ideas of the “primitive” that were already well established within some sectors of psychiatry that equated mental illness with primitive, animalistic and regressive impulses.   As Metzl contends in his book:

…pharmaceutical advertisements shamelessly called on these long-held racist tropes to promote the message that social “problems” raised by angry black men could be treated at the clinical level, with antipsychotic medications.

These adds are in sharp contrast to previous marketing campaigns that framed schizophrenia in the 1950s as a mental condition affecting mostly middle class patients, and especially women.  Also shown below, ideas of schizophrenia were at that time an amorphous collection of psychotic and neurotic symptoms that were thought to afflict many women who struggled to accept the routines of domesticity.

While schizophrenia is certainly a real, frightening, debilitating disease, Metzl reminds us that cultural assumptions of the “other” shape how psychiatry understands and treats the condition.

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Arturo Baiocchi is a doctoral student in Minnesota interested in issues of mental health, race, and inequality.  He is writing his dissertation on how young adults leaving the foster care system understand their mental health needs.  He is also a frequent contributor to various Society Pages podcasts and wanted to post something related to a recent interview he did about the racialization of mental illness.

If you would like to write a post for Sociological Images, please see our Guidelines for Guest Bloggers.

Back in December, Carly S. sent in an ESPN video about NFL player Bart Scott, nicknamed the “Mad Backer.” The video illustrates a number of noteworthy themes:

• The glorification of violence, with Scott reveling in the chance to dish it out.
• Equating being able to play through pain caused by this violence as proof of masculinity — particularly disturbing given concerns about the long-term effects the physical punishment players take has on their health.
• Through the “Mad Backer” persona and the presence of a straight jacket and stretcher, Scott associates mental illness with violence and danger as a way to prove his own superiority on the field. Not only is he “mad,” he depicts himself as a villain who enjoys brutality.

See for yourself:

Lady Gaga, for all the things that can be said about her, is doing something interesting with disability. Ruth D’R. sent in these images from a recent photoshoot:

(I included this last one beacuse I thought it might be referencing mental illness.)

We’ve featured Gaga’s video for Papparazi before (to highlight it’s sexualized violence), but I thought it was worth re-using in this context because it, too, has disability imagery:

She kept the disability theme at the VMA awards:

So, what do you think? Do you think Gaga is trying to make some kind of statement? Or is she just trying to be edgy and doesn’t really care about the issue?  (As seems to be common in fashion.)

Is she simply sexualizing disability? And is that good or bad?

Is the overall effect to make people with disabilities seem empowered?  Or, as in the very first image, helpless?

Might she be trying to problematize the “normal,” as she does in many ways but, in this case, normal bodies? Does it work, given her conformity to norms of attractiveness (both body and face)?

Or… since Gaga is known for being just-plain-weird, does that mean that her adoption of these props is an attempt to be weird (as in: wheelchairs and walking with a limp are weird and so I’ll do them to be weird)?  Even if that is true, does pushing them into view normalize them?  Heighten their weirdness?  Both?   Or does it depend on the viewer?

For more analysis, read also this blog post over at Bitch magazine written by Annaham (someone who actually knows something about disability studies).

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For more on disability and representation, see our posts on the model, Victoria, what does a sexy disabled man look like?, Britain’s disabled model competition, dolls with Down’s Syndrome, a nude calendar featuring Paralympic athletes, the  misery of wheelchairs, the disabled girls video game, little people in commercials, and the international symbol.