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ORIGINS IN MARX • HOW DOMINANCE AND SUBORDINATION REFLECT ECONOMIC POSITION • RESOLUTION ONLY ORIGINS IN MARX • HOW DOMINANCE AND SUBORDINATION REFLECT ECONOMIC POSITION • RESOLUTION ONLY WITH TOTAL EQUALITY - COMMUNISM

PRIMATES • PRIMATE STUDIES SHOW IMPORTANCE OF DOMINANCE • DEPENDENT MONKEYS HAVE MORE STRESS PRIMATES • PRIMATE STUDIES SHOW IMPORTANCE OF DOMINANCE • DEPENDENT MONKEYS HAVE MORE STRESS HORMONES AND LESS SEROTONIN • DOMINANT MONKEYS HAVE FEWER STRESS HORMONES AND MORE SEROTONIN

PRIMATES • PREVIOUSLY DOMINANT MONKEYS HAVE WORSE MENTAL HEALTH WHEN BECOME SUBORDINATE • NEWLY PRIMATES • PREVIOUSLY DOMINANT MONKEYS HAVE WORSE MENTAL HEALTH WHEN BECOME SUBORDINATE • NEWLY DOMINANT MONKEYS HAVE BETTER MENTAL HEALTH • MENTAL HEALTH FUNCTION OF SOCIAL POSITION

WHAT IS SOCIAL CLASS? • 1. RELATIONSHIPS OF DOMINANCE AND DEPENDENCE • POWER, STATUS, WHAT IS SOCIAL CLASS? • 1. RELATIONSHIPS OF DOMINANCE AND DEPENDENCE • POWER, STATUS, MONEY • 2. ATTITUDES, BELIEFS, TASTES, CULTURE • EDUCATION

MEASURES • INCOME – measures resources • EDUCATION – measures culture • COMBINATION (UPPER; MEASURES • INCOME – measures resources • EDUCATION – measures culture • COMBINATION (UPPER; MIDDLE; WORKING; LOWER) • STATUS INCONGRUITY

CAUSE AND EFFECT • CAUSATION - SOCIAL CLASS PRECEDES M. I. • SOCIAL CLASS CAUSE AND EFFECT • CAUSATION - SOCIAL CLASS PRECEDES M. I. • SOCIAL CLASS INVERSE WITH MENTAL ILLNESS • EXPOSURE TO MORE STRESSORS • MORE VULNERABILITY • LESS ACCESS TO TREATMENT

CAUSE AND EFFECT • SELECTION - M. I. PRECEDES SOCIAL CLASS • DOWNWARD DRIFT CAUSE AND EFFECT • SELECTION - M. I. PRECEDES SOCIAL CLASS • DOWNWARD DRIFT

FARIS AND DUNHAM • CHICAGO 1939 • ADMISSIONS TO MENTAL HOSPITALS BY AREAS OF FARIS AND DUNHAM • CHICAGO 1939 • ADMISSIONS TO MENTAL HOSPITALS BY AREAS OF CITY • NO ASSOCIATION BETWEEN RESIDENCE AND BI-POLAR

FARIS AND DUNHAM • STRONG ASSOCIATION BETWEEN RESIDENCE IN CENTRAL CITY AND SCHIZOPHRENIA (9 FARIS AND DUNHAM • STRONG ASSOCIATION BETWEEN RESIDENCE IN CENTRAL CITY AND SCHIZOPHRENIA (9 x DIFFERENCE)

FARIS AND DUNHAM • ORIGINALLY SAID ISOLATION OF CENTRAL CITY CAUSES SCHIZ. • LATER FARIS AND DUNHAM • ORIGINALLY SAID ISOLATION OF CENTRAL CITY CAUSES SCHIZ. • LATER CHANGED MIND AND SAID PEOPLE FIRST BECOME SCHIZ AND THEN MOVED TO CENTRAL CITY • SELECTION

RECENT STUDIES • SCHIZ ALWAYS ASSOCIATED WITH LOWER SOCIAL CLASS • WHAT IS CAUSE RECENT STUDIES • SCHIZ ALWAYS ASSOCIATED WITH LOWER SOCIAL CLASS • WHAT IS CAUSE AND WHAT EFFECT? • LOOK AT PARENTS’ SOCIAL CLASS • SELECTION MORE THAN CAUSATION • DOWNWARD DRIFT • BIPOLAR NOT RELATED TO S. C.

CONCLUSION FOR PSYCHOSES • STRONG ASSOCIATION OF LOWER CLASS STATUS AND SCHIZOPHRENIA • SELECTION 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

INCOME AND M. I. (NCS) INCOME DEPRESSION ANXIETY 0 – 19 1. 56 2. INCOME AND M. I. (NCS) INCOME DEPRESSION ANXIETY 0 – 19 1. 56 2. 00 20 - 34 1. 19 1. 52 35 - 69 1. 19 1. 48 Ø 70 1. 00

INCOME AND M. I. INCOME S. U. ANY > ONE 0 - 19 1. INCOME AND M. I. INCOME S. U. ANY > ONE 0 - 19 1. 27 1. 46 20 - 34 1. 06 1. 21 1. 71 35 - 69 1. 06 1. 21 1. 55 > 70 1. 00

NON-PSYCHOTIC • LOWER CLASS ALWAYS HIGHEST • SOMETIMES INVERSE, SOMETIMES NOT • STRONGEST FOR 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

REASONS FOR NONPSYCHOTIC • CAUSATION NOT SELECTION • STRESSORS • MODEST RELATIONSHIP WITH ACUTE REASONS FOR NONPSYCHOTIC • CAUSATION NOT SELECTION • STRESSORS • MODEST RELATIONSHIP WITH ACUTE LIFE EVENTS • STRONGER RELATIONSHIP WITH CHRONIC STRESSORS

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

OCCUPATIONAL REASONS (LENNON) • HIGHER SOCIAL CLASSES HAVE MORE AUTONOMY AND CONTROL OVER WORK 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

FORM OF RELATIONSHIP • POOR ARE WORST BUT LITTLE DIFFERENCE OTHERWISE (DICHOTOMOUS) • HIGHER FORM OF RELATIONSHIP • POOR ARE WORST BUT LITTLE DIFFERENCE OTHERWISE (DICHOTOMOUS) • HIGHER THE POSITION, BETTER THE MENTAL HEALTH (CONTINUOUS) • STATUS AS RELATIVE CONCEPT – DEGREE OF INEQUALITY

FORM OF RELATIONSHIP • NO CONCLUSIVE EVIDENCE FOR DICHOTOMOUS OR CONTINUOUS FORM OF RELATIONSHIP • NO CONCLUSIVE EVIDENCE FOR DICHOTOMOUS OR CONTINUOUS

HAPPINESS • SOMEWHAT DIFFERENT THAN M. I. • SEEMS DICHOTOMOUS, NOT CONTINUOUS • LOWER HAPPINESS • SOMEWHAT DIFFERENT THAN M. I. • SEEMS DICHOTOMOUS, NOT CONTINUOUS • LOWER CLASS HAS LESS • OTHER CLASSES SAME (50 K > 20 K; 5 M = 100 K) • “MONEY CAN’T BUY HAPPINESS”

HAPPINESS • IMPORTANCE OF BASIC NEEDS • IMPORTANCE OF REFERENCE GROUPS • WHY DO HAPPINESS • IMPORTANCE OF BASIC NEEDS • IMPORTANCE OF REFERENCE GROUPS • WHY DO PEOPLE WORK SO HARD? • “The desire for food is limited in every man by the narrow capacity of his stomach; but the desire of the conveniences and ornaments of building, dress, and furniture seems to have no limit or boundary” (Adam Smith 1776).

SUMMARY • SOCIAL CLASS STRONGLY RELATED TO PSYCHOSES - SELECTION • SOCIAL CAUSATION FOR SUMMARY • SOCIAL CLASS STRONGLY RELATED TO PSYCHOSES - SELECTION • SOCIAL CAUSATION FOR NONPSYCHOTIC • MORE EXPOSURE AND VULNERABILITY, JOBS • HAPPINESS – OTHER THAN BOTTOM, LITTLE RELATIONSHIP