Tag Archives: health/medicine: mental illness

Does Stymied Educational Attainment Lead to Depression?

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.

Cultural- and Individual-Level Interventions Against Eating Disorders (Trigger Warning)

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.

When “Intensive Mothering” Meets Special Needs

For the last week of December, we’re re-posting some of our favorite posts from 2012.

In 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:

Lisa Wade is a professor of sociology at Occidental College and the author of Gender: Ideas, Interactions, Institutions, with Myra Marx Ferree. You can follow her on Twitter and Facebook.

The Truth about Violence and Gun Policy in the U.S.

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.

Masculinity, Mental Illness, & Guns: A Lethal Equation?

Cross-posted at CNN.

For the past few days, Americans have been weeping together and wringing our hands once again at the senseless tragedy of a mass murder inside a school. The horrific scene in Newtown, Connecticut, is now seared permanently in our collective conscience, as we search for answers. We’ll look at the photograph of Adam Lanza and ask over and over again how he could have come to such a deadly crossroads.

We still know nothing about his motives, only the devastating carnage he wrought. And yet we’ve already heard from experts who talk about mental illness, Asperger’s syndrome, depression, and autism. The chorus of gun boosters has defensively chimed in about how gun control would not have prevented this.

Former Arkansas Gov. Mike Huckabee offered the theory that since “we have systematically removed God from our schools, should we be so surprised that schools would become a place of carnage?” (As if those heathen children deserved it?)

All the while, we continue to miss other crucial variables — even though they are staring right back at us when we look at that photograph. Adam Lanza was a middle class white guy.

If the shooter were black and the school urban, we’d hear about the culture of poverty; about how inner-city life breeds crime and violence; perhaps even some theories about a purported tendency among blacks towards violence.

As we’ve seen in the past week, it’s not only those living on the fringes of society who express anger through gun violence.

Yet the obvious fact that Lanza — and nearly all the recent mass murderers who targeted non-work settings — were middle class white boys seems to barely register. Look again at the pictures of Jared Lee Loughner (Tucson), James Eagan Holmes (Aurora) and Wade Michael Page (Oak Creek) — a few of the mass killers of the past couple of years. (Yes, the case of Seung-Hui Cho, the perpetrator at Virginia Tech, the worst school shooting in our history, stands out as the exception. And worth discussing.)

Why are angry young men setting out to kill entire crowds of strangers?

Motivations are hard to pin down, but gender is the single most obvious and intractable variable when it comes to violence in America. Men and boys are responsible for 95% of all violent crimes in this country. “Male criminal participation in serious crimes at any age greatly exceeds that of females, regardless of source of data, crime type, level of involvement, or measure of participation” is how the National Academy of Sciences summed up the extant research.

How does masculinity figure into this? From an early age, boys learn that violence is not only an acceptable form of conflict resolution, but one that is admired. However the belief that violence is an inherently male characteristic is a fallacy. Most boys don’t carry weapons, and almost all don’t kill: are they not boys? Boys learn it.

They learn it from their fathers. They learn it from a media that glorifies it, from sports heroes who commit felonies and get big contracts, from a culture saturated in images of heroic and redemptive violence. They learn it from each other.

In talking to more than 400 young men for my book, Guyland: The Perilous World Where Boys Become Men, I heard over and over again what they learn about violence. They learn that if they are crossed, they have the manly obligation to fight back. They learn that they are entitled to feel like a real man, and that they have the right to annihilate anyone who challenges that sense of entitlement.

This sense of entitlement is part of the package deal of American manhood — the culture that doesn’t start the fight, as Margaret Mead pointed out in her analysis of American military history, but retaliates far out of proportion to the initial grievance. They learn that “aggrieved entitlement” is a legitimate justification for violent explosion.

The easy availability of guns is another crucial variable. After the terrible school shooting in Dunblane, Scotland, in 1996, Great Britain enacted several laws that effectively made owning handguns illegal in that country. The murder rate in the U.S. is more than three times higher than Britain.

And yes, boys have resorted to violence for a long time, but sticks and fists and even the occasional switchblade do not create the bloodbaths of the past few years. In 2011, more than 80% of all homicides among boys aged 15 to 19 were firearm related.

We need a conversation about gun control laws. And far more sweeping — and necessary — is a national meditation on how our ideals of manhood became so entangled with violence.

It’s also worth discussing why so many of these young mass murderers are white. Surely boys of color have that same need to prove their masculinity, and a similar sense of entitlement to annihilate those who threaten it. Perhaps the only difference is that it seems to be nearly the exclusive province of white boys to so dramatically expand the range of their revenge and seek to destroy the entire world, not simply the person or group that committed the supposed offense. Perhaps. It’s a conversation worth having.

I am not for a moment suggesting we substitute race or gender for the other proximate causes of this tragedy: lax gun laws, mental illness. I am arguing only that we can never fully understand it, unless we also add these elements to our equation. Without them, the story is entirely about him, the shooter. But the bigger story is also about us.

In the coming weeks, we’ll learn more about Adam Lanza, his motives, his particular madness. We’ll hear how he “snapped” or that he was seriously mentally ill. We’ll try to explain it by setting him apart, by distancing him from the rest of us.

And we’ll continue to miss the point. Not only are those children at Sandy Hook Elementary School our children. Adam Lanza is our child also. Of course, he was mad — as were Eric Harris and Dylan Klebold, and Seung-Hui Cho, Jared Lee Loughner, James Eagan Holmes, and Wade Michael Page — and the ever-longer list of boys and young men who have exploded in a paroxysm of vengeful violence in recent years. In a sense, they weren’t deviants, but over-conformists to norms of masculinity that prescribe violence as a solution. Like real men, they didn’t just get mad, they got even. Until we transform that definition of manhood, this terrible equation of masculinity and violence will continue to produce such horrific sums.

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Michael Kimmel is a professor of sociology at the State University of New York at Stonybrook.  He has written or edited over twenty volumes, including Manhood in America: A Cultural History and Guyland: The Perilous World Where Boys Become Men.  You can visit his website here.

Extremism and National Character

Cross-posted at Neuroskeptic.

“Personality differences” between people from different countries may just be a reflection of cultural differences in the use of “extreme” language to describe people.

That’s according to a very important paper just out from an international team led by Estonia’s René Mõttus.

There’s a write up of the study here. In a nutshell, they took 3,000 people from 22 places and asked them to rate the personality of 30 fictional people based on brief descriptions (which were the same, but translated into the local language). Ratings were on a 1 to 5 scale.

It turned out that some populations handed out more of the extreme 1 or 5 responses. Hong Kong, South Korea and Germany tended to give middle of the road 2, 3 and 4 ratings, while Poland, Burkina Faso and people from Changchun in China were much more fond of 1s and 5s.

The characters they were rating were the same in all cases, remember.

Crucially, when the participants rated themselves on the same personality traits, they tended to follow the same pattern. Koreans rated themselves to have more moderate personality traits, compared to Burkinabés who described themselves in stronger tones.

Whether this is a cultural difference or a linguistic one is perhaps debatable; it might be a sign that it is not easy to translate English-language personality words into certain languages without changing how ‘strong’ they sound. However, either way, it’s a serious problem for psychologists interested in cross-cultural studies.

I’ve long suspected that something like this might lie behind the very large differences in reported rates of mental illness across countries. Studies have found that about 3 times as many people in the USA report symptoms of mental illness compared to people in Spain, yet the suicide rate is almost the same, which is odd because mental illness is strongly associated with suicide.

One explanation would be that some cultures are more likely to report ‘higher than normal’ levels of distress, anxiety — a bit like how some make more extreme judgements of personality.

So it would be very interesting to check this by comparing the results of this paper to the international mental illness studies. Unfortunately, the countries sampled don’t overlap enough to do this yet (as far as I can see).

Source: Mõttus R, et al (2012). The Effect of Response Style on Self-Reported Conscientiousness Across 20 Countries. Personality and Social Psychology Bulletin PMID: 22745332

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Neuroskeptic blogs anonymously here.  You can also follow him on Twitter.

The Rise of Autism: Social Contagion or Environmental Causation

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.”

Lisa Wade is a professor of sociology at Occidental College and the author of Gender: Ideas, Interactions, Institutions, with Myra Marx Ferree. You can follow her on Twitter and Facebook.

Why It’s Not Altruistic to Help the Poor

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.

Lisa Wade is a professor of sociology at Occidental College and the author of Gender: Ideas, Interactions, Institutions, with Myra Marx Ferree. You can follow her on Twitter and Facebook.