health/medicine: mental illness

While it seems that much of the discourse around curbing gun violence focuses on the need to keep guns out of the hands of the mentally ill, these two issues — gun violence and mental illness — “intersect only at their edges.” These are the words of Jeffrey Swanson and his colleagues in their new article examining the personality characteristics of American gun owners.

To think otherwise, they argue, is to fall prey to the narrative of gun rights advocates, who want us to think that “controlling people with serious mental illness instead of controlling firearms is the key policy answer.” Since the majority of people with mental illnesses are never violent, this is unlikely to be an effective strategy while, at the same time, further stigmatizing people with mental illness.

What is a good strategy, then, short of the unlikely event that we take America’s guns away?

Swanson and colleagues argue that a better policy would be to look for signs of impulsive, angry, and aggressive behavior and limit gun rights based on that. Evidence of such behavior, they believe, “conveys inherent risk of aggressive or violent acts” substantial enough to justify limiting gun ownership.

Using a nationally representative data set, they estimate that 8,865 people out of every 100,000 both (1) owns at least one gun and (2) exhibits impulsive angry behavior: angry outbursts, smashing things in anger, or losing their temper and engaging in physical fights. If I do my math right, that’s almost 22 million American adults (~321,300,000 people minus the 23% under 18 divided by 100,000 and multiplied by 8,865).

1,488 out of those 100,000, or almost 3.6 million, also carries a gun outside the home. People who owned lots of guns (six or more) were four times as likely to both have anger issues and carry outside the home.

The numbers of angry and impulsive people who own and carry guns, importantly, far exceeds the number of people who have been hospitalized for mental illness. This is a dangerous population, in other words, much larger than the one currently excluded from legal gun ownership.

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“It is reasonable to imagine,” Swanson and his colleagues conclude, that people who are angry, aggressive, and impulsive have an arrest history. Accordingly, they advocate gun restrictions based on indicators of this personality type, such as convictions for misdemeanor violence, DUIs, and restraining orders. This, they think, would do a much better job of reducing gun violence than a focus on certified mental illness.

H/t to gin and tacos. Cross-posted at Pacific Standard.

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

I am excited to see that sociologist Linda Blum has come out with a new book, Raising Generation Rx: Mothering Kids with Invisible Disabilities in an Age of Inequality. Here’s a post from the archive highlighting some of her important and powerful findings.

In an article titled Mother-Blame in the Prozac Nation, sociologist Linda Blum describes the lives of women with disabled children. While mothers are held to an essentially impossibly high standard of motherhood in the contemporary U.S. and elsewhere, mothers of disabled children find themselves even more overwhelmed.

The daily care of their child is often more intensive but, in addition to that added responsibility, mothers were actively involved in getting their children needed services and resources. The need for mothers to be proactive about this was exacerbated by the fact that they had to negotiate different social institutions, each with an interest in claiming certain service spheres, but also limited budgets. “While each system claims authoritative expertise,” Blum writes, “either system can reject responsibility, paradoxically, when costs are at issue.”  Because they often had to argue with service providers and find ways to beat a system that often tried to keep them at bay, they had to become experts in their child’s disability, of course, but also public policy, learning styles, the medical system, psychology/psychiatry, pharmaceutics, manipulation of jargon and law, and more.

Mothers often felt that they were their child’s only advocate, with his or her health and future dependent on making just one more phone call, getting one more meeting with an expert, or trying one more school. Accordingly, they were simultaneously exhausted and filled with guilt.  I wondered, when I came across this Post Secret confession, if this mother was experiencing some of the same things:

 Originally posted in 2012.

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

While the ’50s is famous for its family-friendly attitude, the number of hours that parents spend engaged in childcare as a primary activity has been rising ever since:

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The driving force behind all this focused time is the idea that it’s good for kids. That’s why parents often feel guilty if they can’t find the time or even go so far as to quit their full-time jobs to make more time.

This assumption, however, isn’t bearing out in the science, at least not for mothers’ time. Sociologist Melissa Milkie and two colleagues just published the first longitudinal study of mothers’ time investment and child well-being. They found that the amount of time mothers spent with their children had no significant impact on their children’s academic achievement, incidence of behavioral problems, or emotional health.

Quoted at the Washington Post, Milkie puts it plainly:

I could literally show you 20 charts, and 19 of them would show no relationship between the amount of parents’ time and children’s outcomes… Nada. Zippo.

Benefits for adolescents, they argued, were more nuanced, but still minimal.

These findings suggest that the middle-class intensive mothering trend may be missing its mark. As Brigid Shulte comments at the Washington Post, it’s really the quality, not the quantity that counts. In fact, Milkie and colleagues did find that “family time” — time with both parents while engaged in family activities — was related to some positive outcomes.

The findings also offer evidence that women can work full-time, even the long hours demanded in countries like the U.S., and still be good mothers. Shulte points out that the American Academy of Pediatrics actually encourages parent-free, unstructured time. Moms just don’t need to always be there after all, freeing them up to be people, workers, partners, and whatever else they want to be, too.

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

In her provocative book, The Technology of Orgasm, Rachel Maines discusses a classic medical treatment for the historical diagnosis of “hysteria”: orgasm administered by a physician.

Maines explains that manual stimulation of the clitoris was, for some time, a matter-of-fact part of medical treatment and a routine source of revenue for doctors. By the 19th century, people understood that it was an orgasm, but they argued that it was “nothing sexual.” It couldn’t “be anything sexual,” Maines explains, “because there’s no penetration and, so, no sex.”

So, what ended this practice? Maines argues that it was the appearance of the vibrator in early pornographic movies in the 1920s.  At which point, she says, doctors “drop it like a hot rock.” Meanwhile, vibrators become household appliances, allowing women to treat their “hysteria” at home. It wasn’t dropped from diagnostic manuals until 1957.

Listen to it straight from Maines in the following 7 minutes from Big Think:

Bonus: Freud was bad at this treatment, so he had to come up with some other cause of hysteria. After all, she says, “this was the guy who didn’t know what women wanted.” No surprise there, she jokes.

Cross-posted at Pacific Standard.

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

In truth, I didn’t pay a tremendous amount of attention to iOS8 until a post scrolled by on my Tumblr feed, which disturbed me a good deal: The new iteration of Apple’s OS included “Health”, an app that – among many other things – contains a weight tracker and a calorie counter.

And can’t be deleted.

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Okay, so why is this a big deal? Pretty much all “health” apps include those features. I have one (third-party). A lot of people have one. They can be very useful. Apple sticking non-removable apps into its OS is annoying, but why would it be something worth getting up in arms over? This is where it becomes a bit difficult to explain, and where you’re likely to encounter two kinds of people (somewhat oversimplified, but go with me here). One group will react with mild bafflement. The other will immediately understand what’s at stake.

The Health app is literally dangerous, specifically to people dealing with/in recovery from eating disorders and related obsessive-compulsive behaviors. Obsessive weight tracking and calorie counting are classic symptoms. These disorders literally kill people. A lot of people. Apple’s Health app is an enabler of this behavior, a temptation to fall back into self-destructive habits. The fact that it can’t be deleted makes it worse by orders of magnitude.

So why can’t people just not use it? Why not just hide it? That’s not how obsessive-compulsive behavior works. One of the nastiest things about OCD symptoms – and one of the most difficult to understand for people who haven’t experienced them – is the fact that a brain with this kind of chemical imbalance can and will make you do things you don’t want to do. That’s what “compulsive” means. Things you know you shouldn’t do, that will hurt you. When it’s at its worst it’s almost impossible to fight, and it’s painful and frightening. I don’t deal with disordered eating, but my messed-up neurochemistry has forced me to do things I desperately didn’t want to do, things that damaged me. The very presence of this app on a device is a very real threat (from post linked above):

Whilst of course the app cannot force you to use it, it cannot be deleted, so will be present within your apps and can be a source of feelings of temptation to record numbers and of guilt and judgement for not using the app.

Apple doesn’t hate people with eating disorders. They probably weren’t thinking about people with eating disorders at all. That’s the problem.

Then this weekend another post caught my attention: The Health app doesn’t include the ability to track menstrual cycles, something that’s actually kind of important for the health of people who menstruate. Again: so? Apple thinks a number of other forms of incredibly specific tracking were important enough to include:

In case you’re wondering whether Health is only concerned with a few basics: Apple has predicted the need to input data about blood oxygen saturation, your daily molybdenum or pathogenic acid intake, cycling distance, number of times fallen and your electrodermal activity, but nothing to do with recording information about your menstrual cycle.

Again: Apple almost certainly doesn’t actively hate cisgender women, or anyone else who menstruates. They didn’t consider including a cycle tracker and then went “PFFT SCREW WOMEN.” They probably weren’t thinking about women at all.

During the design phase of this OS, half the world’s population was probably invisible. The specific needs of this half of the population were folded into an unspecified default. Which doesn’t – generally – menstruate.

I should note that – of course – third-party menstrual cycle tracking apps exist. But people have problems with these (problems I share), and it would have been nice if Apple had provided an escape from them:

There are already many apps designed for tracking periods, although many of my survey respondents mentioned that they’re too gendered (there were many complaints about colour schemes, needless ornamentation and twee language), difficult to use, too focused on conceiving, or not taking into account things that the respondents wanted to track.

Both of these problems are part of a larger design issue, and it’s one we’ve talked about before, more than once. The design of things – pretty much all things – reflects assumptions about what kind of people are going to be using the things, and how those people are going to use them. That means that design isn’t neutral. Design is a picture of inequality, of systems of power and domination both subtle and not. Apple didn’t consider what people with eating disorders might be dealing with; that’s ableism. Apple didn’t consider what menstruating women might need to do with a health app; that’s sexism.

The fact that the app cannot be removed is a further problem. For all intents and purposes, updating to a new OS is almost mandatory for users of Apple devices, at least eventually. Apple already has a kind of control over a device that’s a bit worrying, blurring the line between owner and user and threatening to replace one with the other. The Health app is a glimpse of a kind of well-meaning but ultimately harmful paternalist approach to design: We know what you need, what you want; we know what’s best. We don’t need to give you control over this. We know what we’re doing.

This isn’t just about failure of the imagination. This is about social power. And it’s troubling.

Sarah Wanenchak is a PhD student at the University of Maryland, College Park. Her current research focuses on contentious politics and communications technology in a global context, particularly the role of emotion mediated by technology as a mobilizing force. She blogs at Cyborgology, where this post originally appearedand you can follow her at @dynamicsymmetry.

A popular quote urges us to shoot for the moon: even if we miss, it tells us, we’ll land among the stars. According to new research, there’s more to it than cheesy inspiration. Using data from two waves of the National Longitudinal Survey of Youth, sociologist John Reynolds and Chardie Baird test the common notion that failing to attain as much education as expected is associated with symptoms of depression in early/middle adulthood.

First, their results show that individuals with lower levels of education are more likely to exhibit signs of depression.

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But, further statistical wrangling shows that their depression doesn’t come from the gap between plans and achievement. It comes from the low level of educational attainment in itself.

Reynolds and Baird conclude that there are no long-term emotional costs to aiming high and falling short when it comes to educational aspirations. This contradicts decades of research that holds that unmet educational expectations lead to psychological distress. In fact, not trying is the only way to ensure lower levels of education and increased chances of poor mental health. So, go ahead and shoot for that moon.

Hollie Nyseth Brehm is a Ph.D. Candidate at the University of Minnesota.  She is the graduate editor of The Society Pages.  This post originally appeared at Contexts Discoveries.

Cross-posted at Inequality by (Interior) Design.

The problem:

A Brazilian modeling agency, Star Models, recently released a new series of anti-anorexia PSA advertisements. They illustrate one of the ways ultra-thin body ideals characterizing women’s bodies in the fashion industry today are institutionalized, or made part of the way we “do” fashion. Fashion sketches — the way that people communicate designs to one another — idealize these bodies, with their exaggerated proportions, long slender limbs, and expressionless faces. The PSAs place real women alongside the sketches, graphically altered to similar proportions, in order to problematize the ideal.

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Sociology professors are constantly asking students to analyze what they might be taking for granted. One issue we take for granted is that the images on the left are what “fashion” looks like and ought to look like. That they are culturally recognizable as fashion sketches speaks to the ways in which hyper-thin feminine bodies are institutionalized at a fundamental level in the fashion industry today.

The Dove Evolution video — as a part of their “Campaign for Real Beauty” — vividly illustrates the work that goes into the production of advertisements. Using a time-lapse video depicting the diverse labor that goes into the production of an ad was a simple illustration of the impossibility of contemporary beauty ideals. Viewers are left thinking, “Of course we can’t look like that. She doesn’t even look like that.”

Star Models’ anti-anorexia ads promote a similar message, but also call our attention to the more dangerous aspects of adherence to industry ideals. Similar to depictions of what Barbie might look like as a real woman, altered images of dangerously thin models aside these sketches have a very different feel from the sketches they imitate.

What is being done about it?

In 2007, the Council of Fashion Designers of America (CFDA) passed a Health Initiative in recognition of an increasingly global concern with the unhealthily thin bodies of models and whether/how to promote change in the industry. The CFDA is working to better educate those inside the industry to identify individuals at risk, to require models with eating disorders to seek help and acquire professional approval to continue working, to develop workshops promoting dialog on these issues, and more.

The CFDA’s Health Initiative, however, treats eating disorders as an individual rather than social problem. This allows the CFDA to obscure the role it might play in perpetuating cultural desires for the very bodies it purports to “help” with the Health Initiative.

Susan Bordo famously wrote about anorexia as what she termed “the crystallization of culture.” We like to draw firm boundaries between normality and pathology. But Bordo suggests that anorexia is more profitably analyzed as culturally normative than as abnormal. Similarly, Star Models’ PSAs play a role in framing the fashion industry as (at least partially) responsible for ultra-thin feminine body ideals. Yet, they arguably fall short of providing institutional-level solutions as the tagline — ”You are not a sketch. Say no to anorexia.” — concentrates on individuals.

The CFDA’s focus on health initiatives and support for individuals suffering from anorexia, bulimia and other eating disorders are critical aspects of recognizing issues that seem to plague the fashion industry. While this surely helps some individual women, the initiatives simultaneously avoid the cultural pressures (in which the fashion industry arguably plays a critical role) that work to systematically conflate feminine beauty with ultra-thin ideals. Similar to problems associated with focusing attention only on the survivors of sexual assaults (failing to recognize the ways that sexual violence is both institutionalized and embedded in our culture), these images simply illustrate that individual-level solutions are unlikely to produce change precisely because they fail to locate “the problem” and ignore the diverse social institutions and ideals that assist in its reproduction.

Thanks to a student in my Sociology of Gender course, Sandra Little, for bringing this campaign to my attention.

Tristan Bridges is a sociologist of gender and sexuality at the College at Brockport (SUNY).  Dr. Bridges blogs about some of this research and more at Inequality by (Interior) Design.  You can follow him on twitter @tristanbphd.

Cross-posted at Chris Uggen’s Blog.

I’ve been reluctant to write about the terrible events at Sandy Hook Elementary School because the wounds are still too fresh for any kind of dispassionate analysis. As a social scientist, however, I’m disappointed by the fear-mongering and selective presentations of the research evidence I’ve read in reports and op-eds about Friday’s awful killing.

Such events could help move us toward constructive actions that will result in a safer and more just world — or they could push us toward counter-productive and costly actions that simply respond to the particulars of the last horrific event. I will make the case that a narrow focus on stopping mass shootings is less likely to produce beneficial changes than a broader-based effort to reduce homicide and other violence. We can and should take steps to prevent mass shootings, of course, but these rare and terrible crimes are like rare and terrible diseases — and a strategy to address them is best considered within the context of more common and deadlier threats to population health. Five points:

1. The focus on mass shootings obscures over 99 percent of homicide victims and offenders in the United States.

The numbers should not matter to parents who must bury their children, but they are important if policy makers are truly committed to reducing violent deaths. There are typically about 25 mass shootings and 100 victims each year in the United States (and, despite headlines to the contrary, mass shootings have not increased over the past twenty years). These are high numbers by international standards, but they pale relative to the total number of killings – about 14,612 victims and 14,548 offenders in 2011. In recent years, the mass shooters have represented less than two-tenths of 1 percent of the total offenders, while the victims have represented less than one percent of the total homicide victims in any given year. We are understandably moved by the innocence of the Sandy Hook children, but we should also be moved by scores of other victims who are no less innocent. There were 646 murder victims aged 12 or younger  in the United States in 2011 alone — far more than all the adults and children that died as a result of mass shootings.

2. The focus on mass shootings leads to unproductive arguments about whether imposing sensible gun controls would have deterred the undeterrable. 

As gun advocates are quick to point out, many of the perpetrators in mass shootings had no “disqualifying” history of crime or mental disorder that would have prevented them from obtaining weapons. And, the most highly motivated offenders are often able to secure weapons illegally. Even if such actions do little to stop mass shootings, however, implementing common-sense controls such as “turning off the faucet” on high capacity assault weapons, tightening up background checks, and closely monitoring sales at gun shows are prudent public policy. But the vast majority of firearms used in murders are simple handguns. I would expect the no-brainer controls mentioned above to have a modest but meaningful effect, but we will need to go farther to have anything more than an incremental effect on mass shootings and gun violence more generally.

3. The focus on mass shootings obscures the real progress made in reducing the high rates of violence in the United States. 

I heard one commentator suggest that America had finally “hit bottom” regarding violence. Well, this is true in a sense — we actually hit bottom twenty years ago. The United States remains a violent nation, but we are far less violent today than we were in the early 1990s. Homicide rates have dropped by 60 percent and the percentage of children annually exposed to violence in their households has fallen by 69 percent since 1993:

We can and should do better, of course, but these are not the worst of times.

4. The focus on mass shootings exaggerates the relatively modest correlation between mental illness and violence. 

Those who plan and execute mass shootings may indeed have severe mental health problems, though it is difficult to say much more with certainty or specificity because of the small number of cases in which a shooter survives to be examined. We do know, however, that the correlation between severe mental illness and more common forms of violence is much lower — and that many types of mental health problems are not associated with violence at all.

5. The focus on mass shootings leads to high-security solutions of questionable efficacy. 

Any parent who has attempted to drop off a kid’s backpack knows that security measures are well in place in many schools. Rates of school crime continue to fall, such that schools are today among the safest places for children to spend so many of their waking hours. In 2008-2009, for example, only 17 of the 1,579 homicides of youth ages 5-18 occurred when students were at school, on the way to school, or at school-associated events. Of course we want to eliminate any possibility of children being hurt or killed at school, but even a 2 percent reduction in child homicide victimization outside of schools would save more lives than a 90 percent reduction in school-associated child homicide victimization. While every school must plan for terrible disasters in hopes that such plans will never be implemented, outsized investments in security personnel and technology are unlikely to serve our schools or our kids.

In the aftermath of so many deaths I am neither so cynical as to suggest that nothing will change nor so idealistic as to suggest that radical reform is imminent. I’m just hoping that the policy moves we make will address our all-too-common horrors as well as the rare and terrible events of the past week.

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Chris Uggen is a professor of sociology at the University of Minnesota and the author of  Locked Out: Felon Disenfranchisement and American Democracy, with Jeff Manza. You can follow him at his blog and on twitter.