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The sociological approach focuses on the factors external to the individual – the environmental or social context – and views mental illness as a breakdown in the face of overwhelming environmental stress. Thoits overviews three dominant theories, or models, and describes their basic assumptions, advantages and limitations, and implications for treating or preventing mental illness. Stress theory is based upon evidence that accumulations of social stressors can precipitate mental health problems. However, the relationship between stress exposure and psychiatric symptoms is not strong because individuals have extensive coping resources to help them handle stress. Researchers focus on the relationship between stress and coping mechanisms, and also on the unequal distribution of chronic strains and a variety of coping resources in the population. One reason that higher rates of mental disorder and psychological distress are found in lower-status, disadvantaged groups is that these groups are more likely to be exposed to stressors and less likely to have important coping resources. In order to treat mental illness, one needs to eliminate or reduce stressors, teach the individual different coping resources, and bolster their personal resources. Structural strain theory locates the origins of disorder and distress in the broader organization of society. Mental illness may be an adaptive response to structural strain, or to one's degree of integration into society. For example, during periods of high unemployment admissions to treatment for psychosis increase, while periods of economic upturns are associated with lower rates of hospitalization. A structural condition, hard economic times, caused people to experience major stressors and provoked mental illness. Society's organization places some groups at a social or economic disadvantage. In order to prevent or reduce mental illness, society must be restructured in a fairly major way; for example, creating a guaranteed minimum income to eliminate the strains of unemployment. A third approach to mental illness is labeling, or societal reaction, theory. The logic behind labeling theory is that people who are labeled as mentally ill, and who are treated as mentally ill, become mentally ill. Symptoms of mental illness are viewed as violations of the normative order whereby individuals violate taken-for-granted rules about how one should think, feel, and behave.
The biological or medical approach views mental illness as if it were a disease or physical defect in the brain or body. Within the social approach, there are three dominant theories of mental illness etiology: stress theory, structural strain theory and labeling theory. This chapter describes each theory's basic concepts and assumptions, theoretical limitations and advantages, and implications for treating or preventing mental illness. According to stress theory, when events and strains accumulate in people's lives, they can overwhelm people's psychosocial resources and abilities to cope and then generate symptoms of psychological disorder. Labeling theory picks up at this point and suggests that frequent, severe, or highly visible symptoms or symptoms exhibited by those with little social prestige or power, can launch a victimizing process. Societal reactions to symptoms may result in the person's receiving a formal psychiatric diagnosis, becoming hospitalized, and, ultimately, accepting a mental patient identity.
The social origins and functions of emotion norms are examined. Emotion norms both reflect and sustain the social structures in which they develop. Individuals undergo emotional socialization and are subject to pressures to conform, especially adults in service and professional jobs, who actively manage reactions that violate social expectations. Efforts at emotional conformity help to sustain the social order, maintain hierarchy, and build solidarity. Emotional deviants are usually stigmatized and subjected to social control, but under some conditions they can become agents of social change.
An experiment by Dutton and Aron (1974) is often used in psychology textbooks to illustrate the role of cognition in emotional experience. The study was intended to demonstrate that physiological arousal can be misattributed to the wrong cause. Men who were approached by an attractive experimenter after crossing a suspension bridge over a deep gorge were more likely to indicate romantic or sexual interest in the experimenter, in contrast to men who had crossed a low wooden bridge over a stream. Dutton and Aron concluded, consistent with Schachter's two-factor theory of emotion (Schachter & Singer, 1962), that emotions are in part determined by available cognitive cues, not by physiological reactions alone.
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