1. social theories

2. BASIC ASSUMPTIONS 1. EXTERNAL ENVIRONMENT LEADS TO DISORDER
LIFE EVENTS, CHRONIC STRAINS, SOCIAL ROLES
2. CURRENT ENVIRONMENT MOST IMPORTANT

3. ASSUMPTIONS (CONT.)
3. GROUPS HAVE DIFFERENT EXPOSURE TO STRESSORS AND RATES OF DISORDER
4. FOCUS ON COMMUNITY POPULATIONS NOT CLINICAL CASES

4. HISTORY

5. I. DURKHEIM
SUICIDE (1897)
SUICIDE RATES VARY SYSTEMATICALLY WITH SOCIAL CONDITIONS

6. CAUSES OF SUICIDE 1. LACK OF SOCIAL INTEGRATION (EGOISTIC)
2. LACK OF COHERENT MEANING SYSTEMS (ANOMIC)
FOCUS ON SOCIAL NOT INDIVIDUAL
FOCUS ON GROUP RATES

7. II. STRESS THEORY AMBIGUITY OF “STRESS” HERE: STRESSORS = CAUSES
DISTRESS = EFFECTS

8. HANS SELYE PHYSIOLOGIST
STRESS RESULTED FROM DISTURBANCES OF EQUILIBRIUM
STUDIED STRESS IN ANIMALS

9. SELYE (CONT.) ENVIRONMENTAL CAUSES – TEMPERATURE, FOOD, CROWDING
GAS - GLOBAL ADAPTATION SYNDROME
STRESSORS CAUSE PROBLEMS BY WEAKENING IMMUNE SYSTEM

10. III. MILITARY PSYCHIATRY
LESSONS OF WWI
HUGH PROPORTION OF PSYCHIATRIC CASUALITIES
LED TO PRESCREENING OF ALL DRAFTEES IN WWII

11. MILITARY PSYCHIATRY HUGE PROPORTION OF PSYCHIATRIC CASUALTIES IN WWII
OVERALL 25%; OVER 70% FOR LONG STRETCHES
AVERAGE SOLDIER WOULD BREAKDOWN AFTER 80 DAYS OF CONTINUOUS COMBAT

12. EFFECT OF COMBAT HIGHLY PRESCREENED
NO INDIVIDUAL PREDISPOSITIONS PREDICTED BREAKDOWNS
LENGTH OF COMBAT BEST PREDICTOR
CAUSE WAS ENVIRONMENTAL NOT INDIVIDUAL

13. EFFECT OF COMBAT TREATMENT NEAR UNITS
2/3 RETURNED TO UNITS WITHIN 2 DAYS
MINORITY MORE LASTING PROBLEMS (PTSD)

14. MAJOR REORIENTATION
ENVIRONMENT CAUSE OF MUCH DISORDER - “EVERYONE HAS THEIR BREAKING POINT”
FOCUS ON ENTIRE POPULATION NOT JUST TREATED CASES
TREATMENT SHOULD BE IN COMMUNITY NOT HOSPITALS

15. HOLMES AND RAHE

16. HOLMES AND RAHE MILITARY PSYCHIATRISTS
TRANSLATE STRESS THEORY AND WWII TO CIVILIANS
STARTED WITH SAILORS
MANY OTHER GROUPS
SRRS IN 1968

18. HOLMES AND RAHE SRRS STANDARDIZED SCORE
NEGATIVE - DEATH, DIVORCE, JAIL
AND POSITIVE - MARRIAGE, HAVE CHILD, XMAS
BOTH CAN DISTURB EQUILIBRIUM
FOCUS ON CHANGES
SUM NUMBER AND GET SCORE

19. H+R LIFE EVENTS
RELATED TO BOTH MENTAL AND PHYSICAL HEALTH (NON-SPECIFIC)
LESS THAN FEW HEALTH PROBLEMS
OVER % HAVE PROBLEMS
OVERALL MODERATE CORRELATION WITH HEALTH PROBLEMS

20. CRITICISMS OF SRRS IGNORES CONTEXT AND MEANING
ONLY NEGATIVE ARE STRESSFUL
WHAT IS CAUSE AND EFFECT?
NOT UPDATED
IGNORES DIVERSITY OF RESPONSES

21. GRADE DISTRIBUTION 90 – 100 A N = 44 88 B+ N = 10 80 - 86 B N = 39
78 C+ N = 8
C N = 44
D N = 6
F N = 4