Learning Objectives
- Describe the sociocultural model.
- Clarify how socioeconomic factors affect mental illness.
- Clarify how gender factors affect mental illness.
- Clarify how environmental factors affect mental illness.
- Clarify how multicultural factors affect mental illness.
- Evaluate the sociocultural model.
Outside of biological and psychological factors on mental illness, race, ethnicity, gender, religious orientation, socioeconomic status, sexual orientation, etc. also play a role, and this is the basis of the sociocultural model. How so? We will explore a few of these factors in this section.
Socioeconomic Factors
Low socioeconomic status has been linked to higher rates of mental and physical illness (Ng, Muntaner, Chung, & Eaton, 2014) due to persistent concern over unemployment or under-employment, low wages, lack of health insurance, no savings, and the inability to put food on the table, which then leads to feeling hopeless, helpless, and dependency on others. This situation places considerable stress on an individual and can lead to higher rates of anxiety disorders and depression. Borderline personality disorder has also been found to be higher in people in low-income brackets (Tomko et al., 2012) and group differences for personality disorders have been found between African and European Americans (Ryder, Sunohara, and Kirmayer, 2015).
Gender Factors
Gender plays an important, though at times, unclear role in mental illness. Gender is not a cause of mental illness, though differing demands placed on males and females by society and their culture can influence the development and course of a disorder. Consider the following:
- Rates of eating disorders are higher among women than men, though both genders are affected. In the case of men, muscle dysphoria is of concern and is characterized by extreme concern over being more muscular.
- OCD has an earlier age of onset in girls than boys, with most people being diagnosed by age 19.
- Females are at higher risk for developing an anxiety disorder than men.
- ADHD is more common in males than females, though females are more likely to have inattention issues.
- Boys are more likely to be diagnosed with Autism Spectrum Disorder.
- Depression occurs with greater frequency in women than men.
- Women are more likely to develop PTSD compared to men.
- Rates of SAD (Seasonal Affective Disorder) are four times greater in women than men. Interestingly, younger adults are more likely to develop SAD than older adults.
Consider this…
In relation to men: “While mental illnesses affect both men and women, the prevalence of mental illnesses in men is often lower than women. Men with mental illnesses are also less likely to have received mental health treatment than women in the past year. However, men are more likely to die by suicide than women, according to the Centers for Disease Control and Prevention. Recognizing the signs that you or someone you love may have a mental disorder is the first step toward getting treatment. The earlier that treatment begins, the more effective it can be.”
https://www.nimh.nih.gov/health/topics/men-and-mental-health/index.shtml
In relation to women: “Some disorders are more common in women such as depression and anxiety. There are also certain types of disorders that are unique to women. For example, some women may experience symptoms of mental disorders at times of hormone change, such as perinatal depression, premenstrual dysphoric disorder, and perimenopause-related depression. When it comes to other mental disorders such as schizophrenia and bipolar disorder, research has not found differences in the rates at which men and women experience these illnesses. But women may experience these illnesses differently – certain symptoms may be more common in women than in men, and the course of the illness can be affected by the sex of the individual. Researchers are only now beginning to tease apart the various biological and psychosocial factors that may impact the mental health of both women and men.”
https://www.nimh.nih.gov/health/topics/women-and-mental-health/index.shtml
Environmental Factors
Environmental factors also play a role in the development of mental illness. How so?
- In the case of borderline personality disorder, many people report experiencing traumatic life events such as abandonment, abuse, unstable relationships or hostility, and adversity during childhood.
- Cigarette smoking, alcohol use, and drug use during pregnancy are risk factors for ADHD.
- Divorce or the death of a spouse can lead to anxiety disorders.
- Trauma, stress, and other extreme stressors are predictive of depression.
- Malnutrition before birth, exposure to viruses, and other psychosocial factors are potential causes of schizophrenia.
- SAD occurs with greater frequency for those living far north or south from the equator (Melrose, 2015). Horowitz (2008) found that rates of SAD are just 1% for those living in Florida while 9% of Alaskans are diagnosed with the disorder.
Source: https://www.nimh.nih.gov/health/topics/index.shtml
Multicultural Factors
Racial, ethnic, and cultural factors are also relevant to understanding the development and course of mental illness. Multicultural psychologists assert that both normal behavior and abnormal behavior need to be understood in the context of the individual’s unique culture and the group’s value system. Racial and ethnic minorities must contend with prejudice, discrimination, racism, economic hardships, etc. as part of their daily life and this can lead to disordered behavior (Lo & Cheng, 2014; Jones, Cross, & DeFour, 2007; Satcher, 2001), though some research suggests that ethnic identity can buffer against these stressors and protect mental health (Mossakowski, 2003). To address this unique factor, culture-sensitive therapies have been developed and include increasing the therapist’s awareness of cultural values, hardships, stressors, and/or prejudices faced by their client; the identification of suppressed anger and pain; and raising the client’s self-worth (Prochaska & Norcross, 2013). These therapies have proven efficacy for the treatment of depression (Kalibatseva & Leong, 2014) and schizophrenia (Naeem et al., 2015).
Evaluation of the Model
The sociocultural model has contributed significantly to our understanding of the nuances of mental illness diagnosis, prognosis, course, and treatment for other races, cultures, genders, ethnicities. In Module 3, we will discuss diagnosing and classifying abnormal behavior from the perspective of the DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text-Revision). Important here is that specific culture- and gender-related diagnostic issues are discussed for each disorder, demonstrating increased awareness of the impact of these factors. Still, the sociocultural model suffers from unclear findings and not allowing for the establishment of causal relationships, reliance on more qualitative data gathered from case studies and ethnographic analyses (one such example is Zafra, 2016), and an inability to make predictions about abnormal behavior for individuals.
Key Takeaways
You should have learned the following in this section:
- The sociocultural model asserts that race, ethnicity, gender, religious orientation, socioeconomic status, sexual orientation all play a role in the development and treatment of mental illness.
Review Questions
- How do socioeconomic, gender, environmental, and multicultural factors affect mental illness and its treatment?
- How effective is the sociocultural model at explaining psychopathology and its treatment?
Module Recap
In Module 2, we first distinguished uni- and multi-dimensional models of abnormality and made a case that the latter was better to subscribe to. We then discussed biological, psychological, and sociocultural models of abnormality. In terms of the biological model, neurotransmitters, brain structures, hormones, genes, and viral infections were identified as potential causes of mental illness and three treatment options were given. In terms of psychological perspectives, Freud’s psychodynamic theory; the learning-related research of Watson, Skinner, and Bandura and Rotter; the cognitive model; and the humanistic and existential perspectives were discussed. Finally, the sociocultural model indicated the role of socioeconomic, gender, environmental, and multicultural factors on abnormal behavior.
