Showing papers in "Journal of Health and Social Behavior in 1997"
TL;DR: This work examines the growing number of studies of survey respondents' global self-ratings of health as predictors of mortality in longitudinal studies of representative community samples and suggests several approaches to the next stage of research in this field.
Abstract: We examine the growing number of studies of survey respondents' global self-ratings of health as predictors of mortality in longitudinal studies of representative community samples. Twenty-seven studies in U.S. and international journals show impressively consistent findings. Global self-rated health is an independent predictor of mortality in nearly all of the studies, despite the inclusion of numerous specific health status indicators and other relevant covariates known to predict mortality. We summarize and review these studies, consider various interpretations which could account for the association, and suggest several approaches to the next stage of research in this field.
7,940Â citations
TL;DR: This finding indicates that stigma continues to complicate the lives of the stigmatized even as treatment improves their symptoms and functioning, and it follows that if health professionals want to maximize the well-being of the people they treat, they must address stigma as a separate and important factor in its own right.
Abstract: Numerous studies have demonstrated a strong connection between the experience of stigma and the well-being of the stigmatized. But in the area of mental illness there has been controversy surrounding the magnitude and duration of the effects of labeling and stigma. One of the arguments that has been used to downplay the importance of these factors is the substantial body of evidence suggesting that labeling leads to positive effects through mental health treatment. However, as Rosenfield (1997) points out, labeling can simultaneously induce both positive consequences through treatment and negative consequences through stigma. In this study we test whether stigma has enduring effects on well-being by interviewing 84 men with dual diagnoses of mental disorder and substance abuse at two points in time--at entry into treatment, when they were addicted to drugs and had many psychiatric symptoms and then again after a year of treatment, when they were far less symptomatic and largely drug- and alcohol-free. We found a relatively strong and enduring effect of stigma on well-being. This finding indicates that stigma continues to complicate the lives of the stigmatized even as treatment improves their symptoms and functioning. It follows that if health professionals want to maximize the well-being of the people they treat, they must address stigma as a separate and important factor in its own right.
1,209Â citations
TL;DR: It is found that the well educated have lower levels of emotional distress and physical distress, but they do not have higher levels of dissatisfaction, and contrasts distress and dissatisfaction as indicators of the subjective quality of life.
Abstract: We examine whether education influences subjective quality of life. If it does, what are the mechanisms by which education affects well-being? We propose that education improves well-being because it increases access to nonalienated paid work and economic resources that increase the sense of control over life, as well as access to stable social relationships, especially marriage, that increase social support. We examine the relationship between education and a variety of indicators of subjective quality of life-depression, anxiety, anger, aches and pains, malaise, and dissatisfaction. Using two representative national samples collected in 1990 and 1995, we find that the well educated have lower levels of emotional distress (including depression, anxiety, and anger) and physical distress (including aches and pains and malaise), but they do not have lower levels of dissatisfaction. Education reduces distress largely by way of paid work, nonalienated work, and economic resources, which are associated with high personal control; but the extent to which it reduces distress by way of marriage and social support is much more modest. We contrast distress and dissatisfaction as indicators of the subjective quality of life.
539Â citations
TL;DR: It is proposed that the systematic assessment of proliferated stressors can help illuminate the dynamic connections between stress and health.
Abstract: Processes of stress proliferation are explored in a sample of informal caregivers to people with AIDS. Proliferation refers to the tendency for stressors to beget stressors. Two forms of proliferation are explored, each based on the distinction between primary and secondary stressors. Among AIDS caregivers, primary stressors are the hardships rooted in the caregiving role. Secondary stressors result from primary stressors, but arise in roles and activities outside of caregiving. One form of proliferation is the expansion of primary stressors, reflected in an increase in role overload and a growing sense of being a captive of the caregiver role. Expansion is largely driven by the course of AIDS and the elevation of demands it places on the caregiver. The second form of proliferation is the surfacing of secondary stressors in social and leisure life and in the occupational realm. This form arises from the strains imposed by the emerging caregiver role on the other roles and activities of the caregiver. It is proposed that the systematic assessment of proliferated stressors can help illuminate the dynamic connections between stress and health.
423Â citations
TL;DR: Results from structural equation modeling reveal that self-assessed health predicts subsequent change in health, suggesting a cycle between health problems and negative health assessments for both White and Black adults.
Abstract: Disability has long been identified as a predictor of self-assessed health, but some studies suggest the opposite causal direction. The aim of this study is to examine the dynamic relationships between physical disability and assessments of health among Black and White adults while simultaneously considering changing morbidity. Research questions include: Do more negative health assessments lead to greater morbidity and physical disability? Do negative health assessments lead to a cycle of health decline over time? These questions were addressed for Black and White respondents over 15 years using data from three waves of the National Health and Nutrition Examination Survey I: Epidemiologic Follow-Up Study. Results from structural equation modeling reveal that self-assessed health predicts subsequent change in health, suggesting a cycle between health problems and negative health assessments for both White and Black adults. In addition, self-assessed health among African Americans declined at a faster rate than was the case for White adults.
353Â citations
TL;DR: Characteristics of neighborhoods and schools potentially related to school prevalence rates are examined, as well as whether these characteristics have independent effects or whether neighborhood characteristics are mediated by school characteristics.
Abstract: Previous research has noted that schools vary in substance use prevalence rates, but explanations for school differences have received little empirical attention. We assess variability across elementary schools (N = 36) in rates of early adolescent alcohol, cigarette, and marijuana use. Characteristics of neighborhoods and schools potentially related to school prevalence rates are examined, as well as whether these characteristics have independent effects or whether neighborhood characteristics are mediated by school characteristics. Neighborhood and school characteristics were measured using student, parent, and archival data. The findings show substantial variation across schools in substance use. Attributes of neighborhoods and schools are statistically significantly related to school rates of lifetime alcohol use, lifetime cigarette use, and current cigarette use. Contrary to expectations, lifetime alcohol and cigarette use rates are higher in schools located in neighborhoods having greater social advantages as indicated by the perceptions of residents and archival data. Neighborhood effects are expressed both directly and indirectly through school characteristics. The findings are discussed in light of contagion and social disorganization theories.
351Â citations
TL;DR: The results indicate that use of alcohol and drugs in early adolescence increases the risk of dropping out of school, becoming pregnant or impregnating someone, becoming a teenage parent, and living independently from parents or guardians prematurely.
Abstract: This study focuses on the interrelationship between premature or precocious transitions to adult statuses and roles and the use of alcohol and drugs. Panel data from early adolescence to young adulthood for a sample for a sample of youth who were at high risk for serious delinquent behavior is used. The results indicate that use of alcohol and drugs in early adolescence increases the risk of dropping out of school, becoming pregnant or impregnating someone, becoming a teenage parent, and living independently from parents or guardians prematurely. In turn, experiencing these precocious transitions increases the risk of the use of alcohol and drugs when respondents are young adults. The importance of these findings to the life course perspective generally and to interactional theory specifically are discussed.
235Â citations
TL;DR: Qualitative analyses of follow-up interviews with 40 people who had participated in a community panel study of mental health reveal considerable variation in the meanings they attach to spouse, parent, and worker identities and suggest that stress researchers would find it useful to incorporate the meanings individuals themselves attach to their role identities.
Abstract: Although several theoretical and methodological approaches have been developed for assessing the meaning of roles and role-related stressors, individuals' own understandings of the meaning of their role identities have been ignored in stress research. In this paper, I first examine the ways in which meaning has been conceptualized and assessed. I then explore the meanings individuals themselves attach to role identities and their implications for mental health. Qualitative analyses of indepth follow-up interviews with 40 people who had participated in a community panel study of mental health reveal considerable variation in the meanings they attach to spouse, parent, and worker identities. I also find that the meanings people assign to role identities are based on their perceptions of the benefits and costs of role involvement. Moreover, while most meanings are shared by men and women, there are gender differences in some meanings which reflect gender differences in the perceived benefits and costs of role involvement. Finally, quantitative analyses show that some meanings of role identities are associated with symptoms and are involved in gender differences in distress. These and other illustrative findings suggest that stress researchers would find it useful to incorporate the meanings individuals themselves attach to their role identities and devote greater attention to men's and women's perceptions of both the positive and negative aspects of their role involvement.
224Â citations
TL;DR: Using two waves of a nationally representative panel study, the National Health and Nutrition Examination Survey Survey I (NHANES I), structural equation modeling revealed that distress leads to more negative health perceptions and perceived health was found to impact distress levels at the following wave suggesting a cycle of decline between distress and perceivedhealth.
Abstract: Stress is a common experience in modern society, and it can affect both physical and mental health. Recognizing that not all stress is detrimental to health, this research examines the relationship between perceptions of distress and perceived health within a longitudinal framework. Using two waves of a nationally representative panel study, the National Health and Nutrition Examination Survey I (NHANES I), structural equation modeling revealed that distress leads to more negative health perceptions. In addition, perceived health was found to impact distress levels at the following wave suggesting a cycle of decline between distress and perceived health. Finally, perceived health was found to have predictive validity in determining future functional disability even when considering distress.
218Â citations
TL;DR: It is suggested that poor health lifestyles--reflected especially in heavy alcohol consumption, and also in smoking, lack of exercise, and high-fat diets--are the major social determinant of the upturn in deaths.
Abstract: This paper examines the social origins of the rise in adult mortality in Russia and selected Eastern European countries. Three explanations for this trend are considered: (1) Soviet health policy, (2) social stress, and (3) health lifestyles. The socialist states were generally characterized by a persistently poor mortality performance as part of a long-term process of deterioration, with particularly negative outcomes for the life expectancy of middle-aged, male manual workers. Soviet-style health policy was ineffective in dealing with the crisis, and stress per se does not seem to be the primary cause of the rise in mortality. Although more research is needed, the suggestion is made that poor health lifestyles--reflected especially in heavy alcohol consumption, and also in smoking, lack of exercise, and high-fat diets--are the major social determinant of the upturn in deaths.
200Â citations
TL;DR: Examining the contribution of social mobility between the censuses of 1971 and 1981 to socioeconomic differences in health found men who had been downwardly mobile were more likely to report a limiting long-term illness, but when compared to others in their classes of destination, those who moved down reported less illness, and the upwardly mobile reported more.
Abstract: The paper uses data from a sample of 1 percent of the male population of England and Wales to examine the contribution of social mobility between the censuses of 1971 and 1981 to socioeconomic differences in health. Compared to others in their social class of origin, men who had been downwardly mobile were more likely, and the upwardly mobile were less likely, to report a limiting long-term illness. However, when compared to others in their classes of destination, those who moved down reported less illness, and the upwardly mobile reported more. Prevalence of ill health in mobile men was somewhere between that in the group they left and the group they joined. Social mobility was a common event and, combined with existing socioeconomic differences in health, it acted to constrain rather than to increase these differences.
TL;DR: The results provide evidence for the influence of parental support on adolescent physical health, both directly and indirectly through the adolescent's perception of that support.
Abstract: Applying latent growth curve analysis to a sample of 310 adolescents, this study demonstrates that level of and changes in observed parental behavior are liked to the level of and changes in adolescent physical health status, respectively, through adolescent perception of parental support. In addition, the level of observed parental behavior had a significant direct effect on subsequent changes in adolescent health status. The results provide evidence for the influence of parental support on adolescent physical health, both directly and indirectly through the adolescent's perception of that support. Confidence in the findings is strengthened by (1) employing a prospective, longitudinal research design, (2) analyzing intraindividual changes in support and health, and (3) reducing potential method variance confounds by using multi-informant reports of parental behavior.
TL;DR: The results indicate that women who have fallen short of their earlier career goals suffer from lower levels of purpose in life and higher levels of depression, even after controlling for social background, human capital, family, and health characteristics.
Abstract: This paper examines whether a woman's mental health at midlife is affected by the degree to which her earlier career aspirations have been fulfilled. Two dimensions of mental health are considered: depression and purpose in life. Based on data for 3,499 female respondents to the Wisconsin Longitudinal Study (WLS), the results indicate that women who have fallen short of their earlier career goals suffer from lower levels of purpose in life and higher levels of depression, even after controlling for social background, human capital, family, and health characteristics. For purpose in life, the harmful effects of falling short of one's goal attenuate considerably when current family characteristics are controlled. For depression, the harmful effects of falling short of one's goal decline considerably once health characteristics are considered. Although women who aspired to be housewives evidenced lower levels of purpose in life at midlife than women with work aspirations, this difference was not statistically significant once human capital characteristics were controlled. Women who, at age 35, "did not know" what they hoped to do in the future had significantly lower levels of purpose in life in their 50s, even after controlling for social background, human capital, family, and health characteristics.
TL;DR: Results from the multiplicative regression analysis indicate that protective factors in some circumstances act as buffers; when protective factors are absent or at their weakest, the negative impact of risk on health-compromising behavior was clearly present.
Abstract: Using three nationally representative, stratified samples of youth, this paper examines health-comprising behavior (fighting) using a risk and protective factors model. In addition, the interplay between risk and protective factors is explored in an attempt to specify their precise role in acting as either mediators or buffers in the risk-taking process. Regression results indicate some similarities among the three samples and the general model's utility in predicting self-reported fighting among youth. Specifically, general environmental risk variables in the form of exposure to violence (threats and victimization) were consistent predictors of fighting among all age groups (grades 3 through 12). Upon closer inspection, analysis revealed that protective factors were not effectively mediating the relationship between risks and risk-taking behavior. Results from the multiplicative regression analysis indicate that protective factors in some circumstances act as buffers; when protective factors are absent or at their weakest, the negative impact of risk on health-compromising behavior was clearly present. Overall, the findings underscore the importance of taking a multidimensional approach to examining risk-taking behavior among youth where individual-level, family, school, and community factors are all considered in the design of prevention strategies. Language: en
TL;DR: It is demonstrated that specialized AIDS units represent a form of hospital reorganization in which responsibility, authority, and autonomy devolve toward nurses, and provides some new sociological perspectives on nursing and the changing medical division of labor.
Abstract: This is a study of how change in the organization of work within hospitals affects the disputes over contested professional jurisdictions. We employ the natural experiment in hospital work reorganization motivated by the AIDS epidemic to empirically document the effects of specialization and client differentiation on the increased intra-organizational status of nurses. We demonstrate that specialized AIDS units represent a form of hospital reorganization in which responsibility, authority, and autonomy devolve toward nurses. Measures of organizational outcomes are derived from the aggregated evaluations of the nurses working in 40 units in 20 hospitals. Our analyses show that different organizational forms are mirrored in differences in the presence of features related to the status and autonomy of nurses. Our work provides some new sociological perspectives on nursing and the changing medical division of labor.
TL;DR: It is observed that rural older men's life expectancy advantages occur even after controlling for residential differences in social class and lifestyle factors, and that rural advantages in mortality coincide with a more equitable distribution of life chances across the social classes.
Abstract: Lower mortality for older rural Americans, compared to urban residents, runs counter to rural-urban disparities in health care services and residents' socioeconomic resources. This paradox calls into question the ways in which community conditions influence mortality and contextualize the relationship between individuals' socioeconomic status and health. Drawing on 24 years of data from the National Longitudinal Survey of Older Men, we observe that rural older men's life expectancy advantages occur even after controlling for residential differences in social class and lifestyle factors. Our results also show that rural advantages in mortality coincide with a more equitable distribution of life chances across the social classes. The association between social class and mortality is strongest among urban men, arising from socioeconomic conditions throughout the life cycle.
TL;DR: The effects of employment transitions on distress are a function of the differential impact of changes in stressors and psychosocial resources among single and married mothers as well as variations in the economic context and meanings ofemployment transitions.
Abstract: This paper presents a longitudinal examination of the effect of employment transitions on the psychological distress of 398 single and 454 married mothers. Our analyses reveal that the effects of employment transitions differ for single and married mothers. Among women who left their jobs during the course of this study, we find a significant increase in distress among single mothers but not change in distress among married mothers. Transitions out of employment among single mothers produce increases in financial strain that result in declines in levels of self-esteem and mastery which, in turn, manifest themselves in higher levels of psychological distress. When we examine the effects of transitions into paid work, there are surprisingly few effects on mothers' levels of distress. For single mothers, taking a job for pay offers no significant reduction in their feelings of distress. Among married mothers, transitions into employment are associated with declines in distress, but these declines are offset by the distressful consequences of increases in caregiving strain. Thus, the effects of employment transitions on distress are a function of the differential impact of changes in stressors and psychosocial resources among single and married mothers as well as varaiations in the economic context and meanings of employment transitions. Movements into or out of employment do not offer the same opportunities and benefits or engender the same costs for single and married mothers. Our results also highlight the different policy implications that emerge from a consideration of longitudinal as opposed to cross-sectional analyses of these issues.
TL;DR: The article's five propositions attempt to make sense of basic historical changes in the DSM's growth in size and complexity and show that the general pattern of the DSM changes are aimed at remedicalizing the profession of psychiatry.
Abstract: From the first to the current fourth edition, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) has grown considerably in size and complexity. The DSM-III (1980) represented a paradigm shift in psychiatric diagnoses and is the main focus of the article's five propositions attempting to make sense of basic historical changes in the manual. The first two propositions concern theoretical changes in the manual; they critically examine the effort to evict unverified etiological assumptions from diagnoses, the adoption of formulations of disorders as discretely constituted, and the role of the multiaxial context in diagnoses. The next two propositions attempt a new development: a set of concepts designating the structural changes in the DSM histories of individual disorders. The fifth proposition examines historical forces supporting the neo-Kraepelinian psychiatrists' efforts to produce the DSM-III. The conclusion brings the propositions together to explain the DSM's growth in size and complexity and to show that the general pattern of the DSM changes are aimed at remedicalizing the profession of psychiatry.
TL;DR: The findings highlight the need to assess value of care, maintainers of value, and reinforcers of care continuation separately in order to develop appropriate interventions and they have implications for future research and policy development.
Abstract: The purpose of this study was to develop concepts that facilitate our understanding of why family caregivers of demented elderly persons can continue caregiving despite various difficulties of care. Twenty-six Japanese daughter or daughter-in-law caregivers of elderly parents with dementia who lived at home or in long-term care facilities were recruited through various senior service organizations in Japan. The caregivers underwent unstructured interviews, and the interview data were analyzed using the constant comparative method. Three categories emerged as reasons for care continuation: value of care, maintainers of value, and reinforcers of care continuation. Value of care came from societal norms and attachment, and was the basis of caregivers' motivation to continue care. Several maintainers of value and reinforcers of care continuation also emerged from the analysis. The contents and some longitudinal changes in these categories were explained. The findings highlight the need to assess these categories separately in order to develop appropriate interventions and they have implications for future research and policy development.
TL;DR: The relationship between three role characteristics (role accumulation, role status, and role combinations) and mental health for Blacks, Mexicans, and Puerto Ricans is examined and the extent to which these patterns differ from those for non-Hispanic Whites is explored.
Abstract: Most studies of the mental health consequences of role occupancy do not consider racial/ethnic variation. Using a national sample of adults (N = 13,017), this paper examines the relationship between three role characteristics (role accumulation, role status, and role combinations) and mental health for Blacks, Mexicans, and Puerto Ricans and explores the extent to which these patterns differ from those for non-Hispanic Whites. Blacks and Puerto Ricans do not benefit from role accumulation whereas Mexicans and Whites who report a high number of roles report better psychological health than those who report few roles. All ethnic groups benefit from the spousal role but there is no consistent effect of either employment or parenthood. Membership in organizational groups benefits non-Hispanic Whites only, whereas familial roles (especially having a sibling) are related to improved mental health among all ethnic groups, except Puerto Ricans. In terms of role combinations, the psychological benefits of occupying all three adult social roles is more evident among non-Hispanic Whites and Mexican Americans compared to Blacks and Puerto Ricans. These findings are discussed in the context of their implications for sociological research which assumes that social psychological processes operate in the same manner across racial/ethnic groups.
TL;DR: Results show that occupational quality influences health-risk behavior (measured by composite indices) for both men and women through a series of mediating variables: social integration, marital integration, and psychological control.
Abstract: In the present longitudinal study of 330 married men and 300 married women, we use a comprehensive structural equation model to investigate how occupation is linked to physical health. Results show that occupational quality influences health-risk behavior (measured by composite indices) for both men and women through a series of mediating variables: social integration, marital integration, and psychological control. Health-risk behavior is related to adverse change in physical health status over a two-year period. Occupational quality influences social and marital integration and psychological control for both husbands and wives. Social integration and marital integration also enhance husbands' psychological control, but marital integration is the only factor contributing to wives' psychological control. In turn, psychological control is associated with health-risk behaviors for both husbands and wives. In addition, both social and marital integration directly deter husbands' health-risk behaviors, while social integration is the only variable to directly influence wives' health-risk behaviors.
TL;DR: It is found that both poor quality of parental employment and low quality of mothers' relationships with their partners have adverse effects on the cognitive stimulation and maternal warmth children receive; living in informal unions is also associated with poorer parent-child interaction.
Abstract: Social stressors embedded in parents' occupational and family roles have been shown to have effects on family interaction and the cognitive and emotional development of young children. Here we consider whether these patterns also hold for children in early adolescence. We study 1,158 10 to 14-year-old children born to the early childbearers among the female respondents of the National Longitudinal Survey of Youth cohort. We find that both poor quality of parental employment and low quality of mothers' relationships with their partners have adverse effects on the cognitive stimulation and maternal warmth children receive; living in informal unions is also associated with poorer parent-child interaction. These family interaction patterns in turn both buffer the effects of stressful family conditions and shape academic and behavior outcomes directly. Some work and family conditions interact in their effects : In particular, single mothering has less adverse effects on cognitive stimulation and behavior problems when mothers are employed in occupations providing higher complexity. The effects of current conditions are diminished but seldom eliminated when we control for possible selection effects by using data from earlier waves to control for earlier levels of child problems. These findings suggest that current parental social stressors continue to have consequences for both academic and behavioral outcomes during early adolescence.
TL;DR: It is demonstrated that organizational processes of institutional conformity ( program objectives meet the demands of external constituents) and goal congruence (program objectives meet with expectations of internal constituents) are critical to positive evaluations of effectiveness.
Abstract: We present a conceptual framework derived from organizational theory for understanding the evaluation of the effectiveness of mental health services. We postulate that organizations are deemed "successful" by their constituents when they conform to institutional demands and expectations that are both internally and externally generated. We empirically assess institutional conformity by examining evaluations of effectiveness by 269 mental health providers in 29 different mental health programs. Specialist programs responded to institutional demands by targeting services to those considered most in need: clients with severe mental illnesses. The formal structure and program philosophy of these programs clearly reflected this emphasis; consequently, levels of goal incongruence were low and evaluations of effectiveness were high. Generalist programs continued to provide care to diverse client groups, had more professionals, offered traditional services (such as psychotherapy), and exhibited higher levels of goal incongruence; these factors resulted in lower evaluations of effectiveness. This research is important because it demonstrates that organizational processes of institutional conformity (program objectives meet the demands of external constituents) and goal congruence (program objectives meet with expectations of internal constituents) are critical to positive evaluations of effectiveness. With the current institutional demand for effective, efficient services, it is critical that researchers have a conceptual framework for analyzing those factors which influence evaluations of effectiveness.
TL;DR: Examination of the interaction between the effects of industrial unemployment and job conditions on workers' levels of psychological distress finds economic stress at the industrial level has a direct positive effect on worker distress, and economic stress is more distressing to workers in rewarding, complex jobs.
Abstract: This paper examines the interaction between the effects of industrial unemployment and job conditions on workers' levels of psychological distress. Previous research finds that economic stress, defined as contexts of high unemployment, mainly affects distress indirectly through deteriorating job conditions. However, adaptive cost and identity salience hypotheses predict that the effects of industrial- and job-level conditions interact. I test for cross-level interactions between industrial unemployment and job demands and complexity using hierarchical linear modeling, individual data for 7,095 workers from the 1987-1988 National Survey of Families and Households, and industry data from the Bureau of Labor Statistics' 1986-1988 Current Population Surveys. Economic stress at the industrial level has a direct positive effect on worker distress, and economic stress is more distressing to workers in rewarding, complex jobs. In contrast, job demands increase distress, but this effect does not interact with industrial employment conditions.
TL;DR: Examination of the gap in professional attitudes and practices between Israeli and Soviet MDs and the cognitive mechanisms employed by immigrant physicians in the process of adjustment to the new medical culture sheds light on the significant conceptual differences between the Soviet and Western medical traditions.
Abstract: About 13,000 physicians from the former Soviet Union have found themselves in the saturated medical market in Israel as a result of the latest wave of immigration. This paper examines the gap in professional attitudes and practices between Israeli and Soviet MDs and the cognitive mechanisms employed by immigrant physicians in the process of adjustment to the new medical culture. The study draws on 25 semistructured interviews with recent (about three years in Israel) immigrant doctors who were at various stages of obtaining a local medical license. Reflecting on the need to redefine themselves as professionals and to confront negative stereotypes regarding ex-Soviet doctors, many respondents stressed the strong sides of Soviet medical training and work style. In their collective self-portrait, immigrant doctors emphasized devotion to patients, clinical intuition, manual skills, and empathy, while flaws were regarded as superficial and improvable by technical training. Conversely, the alleged flaws of Israeli doctors were perceived by these informants as pertaining to the core of medicine: "Excessive dependence on technology," "lack of responsibility toward patients," and "weak preventive orientation of Israeli colleagues were repeatedly criticized. The paper sheds light on the significant conceptual differences between the Soviet and Western medical traditions and provides a vivid example of the sociocultural construction of medicine. Our findings are also indicative of the interpretative processes and coping strategies that immigrants in general may develop in saturated professional markets.
TL;DR: To grow further, medical sociology should become more interdisciplinary in conceptualization and design of research projects, and the application of research findings from the field of psychoneuroimmunology to explain the effects of placebos as a form of magic is used as an illustration.
Abstract: The field of medical sociology has developed rapidly in recent years in sophistication of conceptualization and research techniques. Nonetheless, there remains a considerable amount of "unexplained variance" in knowledge about health and illness behaviors. This paper asserts that to grow further, medical sociology should become more interdisciplinary in conceptualization and design of research projects. The application of research findings from the field of psychoneuroimmunology to explain the effects of placebos as a form of magic is used as an illustration.
TL;DR: A quantitative analysis of gender differences in the prevalence of network members' discussions of dependency and a qualitative analysis of how network members describe dependency underscore the importance of examining how others perceive mental illness and how these perceptions may be gendered.
Abstract: Current research on mental health typically equates dependent behavior with negative health outcomes and thereby ignores how other people perceive dependency and mental illness in gendered ways. Using data from the Indianapolis Network Mental Health Study, I conducted a quantitative analysis of gender differences in the prevalence of network members' discussions of dependency, followed by a qualitative analysis of how network members describe dependency. The sex of the network member, together with the sex of the patient, significantly predict discussions of dependency, net of other factors. Moreover, network members in same-sex dyads are more likely to discuss dependence than are their counterparts in opposite-sex dyads. The qualitative results provide a more contextualized understanding of the connections among gender, dependency, and mental illness. Male network members' reports indicate strong censure of male patients for dependent behavior, while female network members' reports indicate that female patients see dependency in a more nuanced and complex way. In addition, network members in opposite-sex dyads are more accepting of dependent behavior than network members in same-sex dyads. These findings underscore the importance of examining how others perceive mental illness and how these perceptions may be gendered.