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from
Part II
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The Social Context of Mental Health and Illness: Introduction to Part II
By
Blair Wheaton, Distinguished Professor of Sociology, University of Toronto,
Shirin Montazer, Assistant Professor, Department of Sociology, Wayne State University
In this chapter, Wheaton and Montazer distinguish among commonly used terms for stress, stressors, and distress. They then examine models that have shaped our understanding of the stress concept, describing the ways in which the study of stress has evolved. The chapter begins by differentiating between two original models of stress: the biological stress model and the social engineering stress model. The authors then go on to define and differentiate different types of stress which lie within the “stress universe,” and consider the distinctions between different types (and sources) of stress. Beyond these conceptual distinctions is the empirical issue of whether we need to measure diverse sources of stress. Wheaton and Montazer argue that we do – and that we need to assess the “unique” effects of diverse sources of stress (controlling for other stressors) as well as the “total” effect of stressors on mental health. This point is illustrated with data from three studies. The chapter considers recent trends in stress research. The direction of research on stress since 2000 can be summarized by three points. First, many have focused on the combined effects of more than one type of stressor. Second, research has given considerable attention to the life course as cumulative differential exposure to stressors. The third trend focuses on social context and macro-stress. Compared to the earlier work on contextual stress that examined the role of economic downturns, recent research has focused more on natural and man-made disasters and mass violence. What are the unique sources of stress that we face today (as opposed to the stressors we faced twenty years ago), and how can we meaure these stressors as well as their effects?
Introduction
Stress is a term used widely – and perhaps too loosely – in popular books, in the media, and in daily life. From the perspective of someone who studies stress, it is difficult not to notice the differences in meaning and understandings of stress now in common use. When the explanation of some problem becomes unclear, or complex, or mysterious, stress is invoked: “It must be stress.” When someone says “I feel stressed,” they are in fact referring to distress, describing the behavioral response to stressful conditions, usually manifest as a mixture of depression and anxiety.
This chapter focuses on three areas: brain structure and function (neuroanatomy), brain activity (functional brain imaging), and gene effects (genetics). Information from each area is beginning to be integrated, with the goal of understanding biological disease processes. The chapter focuses on the neurons because it is their functioning that is largely the basis of theories of psychiatric disorders at the level of analysis, with the recognition that the glial cells that support the neurons may also be relevant. Researchers have used several methods to test the hypothesis that psychiatric disorders reflect dysfunctions in neuronal communication systems. Researchers have also examined postmortem brain tissue to see changes in the shapes of neurons and their connections. Sociological analyses of the social construction of psychiatric disorders are also important; particularly at this juncture when the number of disorders officially recognized in psychiatry is growing at an unprecedented rate.
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