Ch.7 - Chriss, Social Control

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Chapter 7

• Case Studies in Medical Control

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Anti-Psychiatry Movement

1. Began in 1950s as protest against warehousing of
   misfits in mental asylums.
2. Prominent critics included Erving Goffman, Thomas
   Szasz, and Thomas Scheff.
3. Psychiatry viewed as a form of social control to
   repress socially undesirable behavior.

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DSMs Multi-axial System

• Psychiatric disorders are organized into five
  levels or axes
• Axis I clinical disorders, major mental
  disorders, and developmental and learning
  disorders (depression, ADHD, bipolar)
• Axis II underlying personality conditions
  (antisocial personality, narcissism, borderline,
  retardation)

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DSMs Multi-axial System

• Axis III acute medical conditions and physical
  disorders (alcoholism)
• Axis IV psychosocial and environmental factors
  contributing to disorders (divorce, housing,
  economic problems)
• Axis V Global Assessment of Functioning

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Selective Mutism

1. Classified as an Axis I mental disorder usually
   first diagnosed in childhood.
2. Failure of a child to speak in situations where
   there is an expectation of speaking (e.g., the
   classroom).
3. Interferes with educational or occupational
   achievement.
4. Lasts at least one month (but not simply the
   first month of school).

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Selective Mutism

1. Shyness is considered to be a major contributor
   (shy biological temperament).
2. An anxiety disorder than can be treated with
   antidepressants.
3. Biomedicalized view of childhood ills.

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Disvalued vs. Disordered Conditions

• Concept of mental illness must satisfy two
  conditions
• Disorder is due to some internal dysfunction
  (internality)
• Value judgment made that behaviors associated
  with the disorder are harmful (disvalue)
• The first condition (internality) is often not
  satisfied, however.

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Disvalued vs. Disordered Conditions

1. Leads to a number of false positives (Type II
   error).
2. Rather than medical certitude, many of these
   disorders reflect and reinforce social control.

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ADD/ADHD

• Neurological condition marked by a persons
  inability to regulate attention or impulses.
• Fidgeting with hands or feet
• Not listening when spoken to
• Easily distracted
• Talking excessively
• Blurting out answers
• Not waiting ones turn

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ADD/ADHD

1. The condition lasts for at least six months.
2. Symptoms constitute clinically significant
   impairment of the daily functioning of the
   person.
3. Paradoxical effect of amphetamines (such as
   Ritalin) on children (1930s).
4. First called hyperkinesis in 1957.

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Public Health Model

• Three stages of prevention
• Tertiary keeping persons who are ill from
  becoming sicker. Mainly reactive.
• Secondary Early identification of persons who
  have symptoms of some illness. Mix of reactive
  and proactive.
• Primary Stopping problems before they start.
  Mainly proactive.

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Is Violence a Disease?

• Disease as literal or metaphorical.
• Public health advocates tend to view violence as
  a literal disease.
• If violence is a real disease
• How is the disease acquired?
• What is its etiology and risk factors?
• What is the treatment or cure?

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Is Violence a Disease?

• Perhaps violence is a communicable disease
• The disease is a biological agenta
  pathogenwhich is passed on from an infected
  person (the offender) to other persons (victims)
• But does violence act in this way?
• Possibilities
• Intergenerational transmission of violence
• Mass media/popular culture

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Is Violence a Disease?

• Is culture a plausible pathogen for the
  infectious disease of violence?
• How about energy transfer?
• Perhaps even emotions?
• Intense feelings of shame may produce rage
• What about community violence?
• Here violence is the pathogen, fueling more
  violence
• This is where the violence-as-literal-disease
  argument breaks down