Social structure, stress, and mental health: competing conceptual and analytic models
Aneshensel, C. S., Rutter, C. M., Lachenbruch, P. A. (1991). Social structure, stress, and mental health: competing conceptual and analytic models. American Sociological Review, 56(2), 166-178.
This article addresses two competing models within mental health research: the socio-medical model of mental health, which focuses largely on the antecedents that give rise to mental health “problems,” and the sociological model, which focuses on the consequences of such “problems,” especially with regard to stress. The researchers suggest that the socio-medical approach, which is generally the more typical approach taken with regard to stress studies, tends focus too much on using one particular disorder as a proxy for making conclusions about disorders at large.
The study relies on two samples from the city of Los Angeles, in which each participant was interviewed in their homes using the Diagnostic Review Schedule. Each participant was asked largely open-ended questions regarding his or her stressors, which were subsequently coded. There were three major types of stressors identified: events regarding the self, events regarding others that one cares about, and financial stressors. These stressors were then divided into two major psychological categories using both symptomatic and diagnostic criteria: anxiety or substance abuse prone categories. The stressors are used in analysis in which disorder-specific models are compared with models intended for all types of disorders. This is done by first, regressing disorders on gender, social characteristics, and the three stressors using two different methods, and drawing conclusions based on these regressions, and second, by adding interaction terms between gender and the three stressors. The researchers concluded that in order not to obscure social influences and subgroups, one ought to consider both the socio-medical and sociological models of mental health, as well as multiple mental disorders, when conducting research.
This article contributes to the literature on the sociology of psychology by suggesting that the commonly used socio-medical model in mental health research is incomplete, as it may rely too much on using one mental disorder as a proxy for general mental disorders. The researchers instead suggest that, when used, the socio-medical model needs to be considered with a series of mental disorders. They also recommend considering the sociological model, which investigates the effects of mental health “problems.” This may also suggest that any research or psychological method that relies too much on one mental disorder is suspect.