Cultural conceptions, mental disorders and social roles: A comparison of Germany and America
Townsend, J. M. (1975). Cultural conceptions, mental disorders and social roles: A comparison of Germany and America. American Sociological Review, 40(6), 739-752.
This study examines the effects of labeling theory in two different cultures (German and American) and between three different groups: laymen, mental patients, and mental health professionals. In the work, Townsend seeks to test that laymen’s and professionals’ conceptions of mental illness are less varied within each culture (intraculturally) than between the two cultures (interculturally); that (interculturally) the [mental health] professional groups in each country should resemble each other more than the lay groups in each country; and that in each culture, the mental patients’ conceptions of mental health resemble those of the patients in the other country another less than they do the conceptions of laymen and professionals within their own countries. In summary, Townsend tests his assumption that conceptions about mental illness among laymen, mental patients, and [mental health] professionals vary more interculturally than intraculturally.
Townsend uses (Nunnally’s) 60-item information questionnaires, which he distributed to high school students and medical professionals in both America and Germany (741). These data were then factor analyzed using a varimax rotation. This resulted in three factors, two of which were relevant. The first was “environmental forces and personal effort,” [in which Germans viewed mental disorder as more innate, Americans as more environmental]. This factor supported the first two hypotheses, which suggested there should be a greater intercultural than intra-cultural difference between the popular conceptions of mental disorders, and that there should more intercultural similarity between the professional than the popular conceptions of mental disorders. Factor 2 was “negative stereotypes,” which supported hypothesis 2, but not hypothesis 1. A second part of the methods relied on previously recorded interviews, the significance of which were confirmed using chi-square analysis, and which supported the third hypothesis (that lay opinions were more consistent with domestic professional opinions than the other foreign lay opinions). Townsend finds that in each country, the mental patients’ conceptions of their disorders parallel both those of local laypeople and of hospital staff, and that their conceptions influence their behavior within the hospital setting. While these findings support labeling theory, the author notes that, contra previous literature, there is no significant evidence suggesting that the stereotypes of those with mental disorders influence the actual symptoms of the “mentally ill.” In fact, Townsend found that stereotypes (i.e. extreme concepts of insanity) of those with mental disorders were not prominent in responses of any group studied, and when they were addressed, that lay and professional responses to stereotype vary more in-country than between countries. He suggests this may because there is a difference between “stereotypes” (which are extreme concepts of insanity) and cultural “conceptions” (which are general beliefs about mental illness).
While this study contributes mainly to knowledge about mental health in the context of a hospital (i.e., psychiatry), it also contributes to the sociology of psychology and mental health at large by examining social influences on the conception of mental illness. By finding that the mental health conceptions of mental patients resemble the conceptions of lay-people and mental health professionals, for example, the authors suggest that the interplay between these two groups is an important site of meaning making regarding mental health. Additionally, this study seems to affirm the validity of labeling theory, leading to questions for further research, such as: How much do cultural conceptions about treating mental health patients, over and above the treatment itself, influence patients? Interestingly, however, the authors also contribute to the literature in this area by noting that, unlike previous literature, they do not find any significant relationship between the mental health stereotypes (extreme concepts of insanity) of the “mentally ill” and their symptomatic behavior, and in fact suggested that while the less extreme “conceptions” play a role, “stereotypes” do not seem to be prominent in the process of meaning-making about mental health among the groups studied.