3. WHAT IS SOCIAL CLASS? PEOPLE SIMILAR IN ECONOMIC AND SOCIAL STATUS, EDUCATION, WAYS OF LIFE, ATTITUDES AND BELIEFS TWO MAJOR ASPECTS MATERIAL RESOURCES – FINANCIAL CULTURE - EDUCATION, TASTE

4. MEASURES INCOME EDUCATION COMBINATION (UPPER; MIDDLE; WORKING; LOWER) STATUS INCONGRUITY

5. CAUSE AND EFFECT CAUSATION - SOCIAL CLASS PRECEDES M.I. IF CAUSE -RESOURCES OR CULTURE? SELECTION - M.I. PRECEDES SOCIAL CLASS DOWNWARD DRIFT

6. THEORIES PSYCHOLOGICAL - USUALLY IGNORE BIOLOGICAL – EMPHASIZE SELECTION

7. SOCIOLOGICAL SOCIAL CAUSATION SOCIAL CLASS INVERSE WITH MENTAL ILLNESS EXPOSURE TO MORE STRESSORS MORE VULNERABILITY LESS ACCESS TO TREATMENT

9. FARIS AND DUNHAM CHICAGO 1939 AREAS OF CITY NO ASSOCIATION BETWEEN RESIDENCE AND BI-POLAR STRONG ASSOCIATION BETWEEN RESIDENCE IN CENTRAL CITY AND SCHIZOPHRENIA (9x DIFFERENCE)

10. FARIS AND DUNHAM ORIGINALLY SAID ISOLATION OF CENTRAL CITY CAUSES SCHIZ. CHANGED MIND AFTER LATER STUDY TO SAY PEOPLE FIRST BECOME SCHIZ AND THEN MOVE TO CENTRAL CITY SELECTION

11. RECENT STUDIES SCHIZ ALWAYS ASSOCIATED WITH LOWER SOCIAL CLASS HOW DECIDE CAUSATION? LOOK AT PARENTS’ SOCIAL CLASS SELECTION MORE THAN CAUSATION DOWNWARD DRIFT BIPOLAR NOT RELATED TO S.C.

12. CONCLUSION FOR PSYCHOSES STRONG ASSOCIATION OF LOWER CLASS STATUS AND SCHIZOPHRENIA SELECTION SEEMS MORE IMPORTANT THAN CAUSATION NO ASSOCIATION BETWEEN SOCIAL CLASS AND BIPOLAR DISORDER

14. INCOME AND M.I. INCOME DEPRESSIONANXIETY 0 – 191.562.00 20 - 341.191.52 35 - 691.191.48  70 1.00

15. INCOME AND M.I. INCOME S.U. ANY> ONE 0 - 191.271.462.46 20 - 341.061.211.71 35 - 691.061.211.55 > 701.00

16. NON-PSYCHOTIC LOWER CLASS ALWAYS HIGHEST SOMETIMES INVERSE, SOMETIMES NOT STRONGEST FOR ANXIETY WEAKEST FOR SUBSTANCE ABUSE LOWER CLASS ESPECIALLY LIKELY TO HAVE COMORBID DISORDERS

17. REASONS FOR NON- PSYCHOTIC CAUSATION NOT SELECTION STRESSORS MODEST RELATIONSHIP WITH ACUTE LIFE EVENTS STRONGER RELATIONSHIP WITH CHRONIC STRESSORS

18. COSTELLO STUDY COMPARE DEPRESSION AND FAMILY INCOME FOR CHILDREN DURING STUDY HALF (NATIVE AMERICANS) GOT $ WINDFALL SYMPTOMS DECLINED BY ABOUT HALF ABOUT HALF OF HIGHER RATES AMONG POOR CHANGE WHEN INCOMES CHANGE

19. OCCUPATIONAL REASONS (LENNON) HIGHER SOCIAL CLASSES HAVE MORE AUTONOMY AND CONTROL OVER WORK HIGHER SOCIAL CLASSES HAVE FEWER PHYSICAL STRESSORS OF WORK HIGHER SOCIAL CLASSES HAVE MORE JOB STABILITY

20. VULNERABILITY LOW SOCIAL CLASS ESPECIALLY VULNERABLE TO STRESSORS LESS ADEQUATE MATERIAL SUPPORT AND COPING LEADS TO LONGER DURATION AND POORER PROGNOSIS FOR LOWER CLASSES

21. SUMMARY SOCIAL CLASS RELATED TO NON- PSYCHOTIC SOCIAL CAUSATION BEST EXPLANATION MORE EXPOSURE, ESPECIALLY TO CHRONIC STRESSORS MORE VULNERABILITY

23. SOCIAL CLASS AND TREATMENT INCIDENCE = NEW CASES PREVALENCE = ALL CASES PREVALENCE = INCIDENCE + REENTRY + CONTINUOUS HOLLINGSHEAD AND REDLICH STUDY OF NEW HAVEN IN 1950s

24. TREATMENT OF PSYCHOSES

25. NO S.C. DIFFERENCES IN INCIDENCE EXCEPT LOWER CLASS HAS MORE STRONG INVERSE RELATIONSHIP OF SOCIAL CLASS AND PREVALENCE OF PSYCHOSES

26. EXPLANATIONS LITTLE TREATMENT FOR LOWER CLASS - MORE CUSTODIAL MORE COMMUNITY SUPPORT FOR HIGHER CLASSES LONGER DURATION AND WORSE PROGNOSIS FOR LOWER CLASSES

27. TREATMENT OF NEUROSES

28. TREATMENT OF NEUROSIS NO DIFFERENCE IN NEW CASES HIGHER CLASSES HAVE MUCH GREATER TREATED PREVALENCE HIGHER CLASSES STAY MUCH LONGER IN TREATMENT RELATIONSHIP OPPOSITE FOR NEUROSES AND PSYCHOSES

29. REASONS CULTURE OF HIGHER CLASSES MORE CONGRUENT - ESPECIALLY EDUCATION LESS STIGMA FOR HIGHER CLASSES RESOURCE DIFFERENCES RESPONSE OF M.H. PROFESSIONALS

30. SUMMARY SOCIAL CLASS HAS STRONG RELATIONSHIP TO M.I. AND TO TREATMENT PSYCHOSES - SELECTION NEUROSIS - CAUSE HIGHER CLASSES MORE OUTPATIENT AND LESS INPATIENT

31. SUMMARY (CONT.) LOWER CLASSES MORE INPATIENT AND LESS OUTPATIENT

32. McGUIRE’S STUDY MEASURED SEROTONIN LEVELS IN LEADERS AND FOLLOWERS IN MONKEY TROOPS LEADERS HAD HIGHER LEVELS OF SEROTONIN AND FOLLOWERS LOWER LEVELS MOVED LEADERS TO NEW TROOP

33. McGUIRE’S STUDY FORMERLY DOMINANT MONKEYS HAD LOWER SEROTONIN WHEN BECAME SUBORDINATE FORMERLY DEPENDENT MONKEYS HAD HIGHER SEROTONIN WHEN BECAME DOMINANT SOCIAL POSITION PREDICTS SEROTONIN NOT VICE VERSA

34. IMPLICATIONS POSITIONS OF DOMINANCE RELATED TO WELL-BEING POSITIONS OF SUBORDINATION RELATED TO POOR MENTAL HEALTH POSITION MORE IMPORTANT THAN INDIVIDUAL CHARACTERISTICS