How Do Social Factors Cause Psychotic Illnesses?

By McKenzie, Kwame | Canadian Journal of Psychiatry, January 2013 | Go to article overview

How Do Social Factors Cause Psychotic Illnesses?


McKenzie, Kwame, Canadian Journal of Psychiatry


Five years ago, Jarvis' heralded the rebirth of investigation of the social causation of psychoses.

In this In Review section he charted the growing interest in Europe based on studies of immigrant groups.2 Evidence was accumulating that social factors have a role in the development of schizophrenia and other psychoses.1,3

At that time, the mechanisms by which social factors exert their influence were unknown. It was hoped that future research would identify how the exposure to social adversity leads to the development of psychotic symptoms.1

The literature has grown significantly, but researchers investigating the social causes of psychosis are still in the minority.4 This may be changing as clear and plausible mechanisms through which social factors can cause the cognitive, structural, and neurochemical changes seen in the psychoses are being reported.5,6

The argument that psychosis is a brain disease does not rule out social causation.5,7

It may be worth reflecting on that we have no problem accepting the social causation of other illnesses with physical manifestations, such as coronary thrombosis.

The final common pathway is a blockage of the artery leading to heart muscle death. This can occur by a slow plugging of the arteries, an embolus being thrown offa fatty plaque or spasm. Fatty plaques build up over many years from childhood onwards. The actual timing of the heart attack not only depends on a person's lifetime accumulation but also the work that the heart has to do at the time; heart attacks usually occur during exercise. The amount of work is linked to individual factors, such as weight, as well as environmental factors, such as the ambient temperature, but these are not the only social risk factors. We all realize that risk is complex. Though inheritance plays a role (and for some with familial hyperlipidemias it is a significant role), for most it is a vulnerability factor, and whether we have a heart attack relies on a combination of other factors including our diet and level of exercise, which are influenced by our social contexts. For instance, our diet depends on what types of food are available and what we can afford, but we know there are other factors involved, such as our psychological state, as we tend toward eating high-calorie foods when we are stressed. Other responses to stress are the use of anxiolytics, such as tobacco and alcohol, to ease social interactions. These may increase our risk of cardiac disease. Their rate of use in society depends not only on culture but also on their availability and cost. The last 2 factors are regulated by the state, and the sources of stress that lead to these behaviours are similarly complex, including financial insecurity, job stress, family and relationship stress, and our position in society.8

I could go on.

The point is that clinicians, researchers, and the general public are very quickly able to build and understand complex models of risk for physical diseases. They understand that there are 4 dimensions of risk: vulnerabilities and resiliency factors at an individual level; environmental-level factors, such as where you live, what the laws are, and how easy it is to live a healthy lifestyle; an interaction can occur because individual risks and environmental risks are not independent (for instance, your social context changes if you lose a parent when you are young); and, finally, timing is important because there are sensitive periods in development and resiliency changes with age.7

The model for social risk for schizophrenia and other psychoses is similar to that of heart disease. The 4-dimensional model used to explain the social causation of heart attacks was actually developed to explain the causation of schizophrenia for public health officials.7 There are individual factors, such as genetic vulnerability, that are important. There are group level factors, such as where you live and the position of your group in society. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • A full archive of books and articles related to this one
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

How Do Social Factors Cause Psychotic Illnesses?
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

    Already a member? Log in now.