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This commentary speaks to several issues that arise from the papers in this special issue. Two articles--Kessler (2002) and Mirowsky and Ross (2002)--focus on a major measurement issue: dimensional versus diagnostic-type assessments. One topic requires greater attention: the correspondence of these measures with the underlying states they supposedly measure--constructs in the psychometric tradition and empirically defined illnesses in the medical or psychiatric tradition. Conclusions about the nature of these unobserved states remain tentative at this time. Three articles--Keyes (2002), Schwartz (2002), and Umberson, Williams, and Anderson (2002)--address the expansion of mental health outcomes. The existing reliance on emotional distress is problematic for sociological research because a single disorder is not a good proxy for estimates of the overall mental health consequences of social arrangements. Although these papers present diverse and sometimes conflicting perspectives, collectively they demonstrate that no one approach to outcomes is best for all research questions. [ABSTRACT FROM AUTHOR]

Drawing on the stress paradigm and using data from the Duke Mental Health Study, this paper investigates the links between violence by and against persons with severe mental illness and their caregivers' financial burden (e.g., number of financial contributions and perceived financial strain). In addition to violence, substance use and medication noncompliance are included in a series of multivariate regression models predicting caregiver financial burden that include measures for disruptive behaviors, personal needs, social supports, and caregiver characteristics. The findings show that violent perpetration and violent victimization increase the number of financial contributions and perceived financial strain. Nonviolent victimization, in contrast, decreases caregiver financial burden. Number of financial contributions and perceived financial strain are greatest when the family member is violent and extremely disruptive or needs assistance with personal care. Neither substance use nor medication noncompliance contributed to caregiver financial burden. Co-residence, female sex, parenthood, and instrumental social support were also associated with financial burden. [ABSTRACT FROM AUTHOR]

Young adulthood is a period of increased mental health risk, with evidence linking psychological disorder to problematic role transitions. To our knowledge, there has been little or no research that examines the forces shaping minority mental health at this time. Using a diverse, urban sample of young adults who are followed over a two-year period, this paper examines the link between race/ethnicity and depressed mood and the transitional roles and interpersonal experiences that mediate this association. Findings indicate that blacks and Hispanics have elevated depressed mood relative to whites and Asian Americans, independent of socioeconomic background factors. The underrepresentation of blacks and Hispanics in four-year colleges largely explains the differences in depressed mood between members of these groups and Asian American youth. In contrast, comparisons of black and Hispanic youth to white youth highlight problems in peer and parental relations among individuals in the former groups. Overall, findings suggest that the heightened depressed mood among Hispanics and blacks relative to whites and Asian Americans reflects their increasingly disadvantaged pathways into adulthood, characterized by poorer prospects for educational advancement and more problematic relationships subsequent to the high school years. [ABSTRACT FROM AUTHOR]

This paper introduces and applies an operationalization of mental health as a syndrome of symptoms of positive feelings and positive functioning in life. Dimensions and scales of subjective well-being are reviewed and conceived of as mental health symptoms. A diagnosis of the presence of mental health, described as flourishing, and the absence of mental health, characterized as languishing, is applied to data from the 1995 Midlife in the United States study of adults between the ages of 25 and 74 (n = 3, 032). Findings revealed that 17.2 percent fit the criteria for flourishing, 56.6 percent were moderately mentally healthy, 12.1 percent of adults fit the criteria for languishing, and 14.1 percent fit the criteria for DSM-III-R major depressive episode (12-month), of which 9.4 percent were not languishing and 4.7 percent were also languishing. The risk of a major depressive episode was two times more likely among languishing than moderately mentally healthy adults, and nearly six times greater among languishing than flourishing adults. Multivariate analyses revealed that languishing and depression were associated with significant psychosocial impairment in terms of perceived emotional health, limitations of activities of daily living, and workdays lost or cutback. Flourishing and moderate mental health were associated with superior profiles of psychosocial functioning. The descriptive epidemiology revealed that males, older adults, more educated individuals, and married adults were more likely to be mentally healthy. Implications for the conception of mental health and the treatment and prevention of mental illness are discussed. [ABSTRACT FROM AUTHOR]

In this paper I argue that a fruitful discussion of the choice of outcomes in the sociological study of the social antecedents of mental health problems would benefit from a consideration of the goals that we are trying to achieve. The most clearly articulated goal is that of uncovering those aspects of society that produce harm. I examine the premises of the current conceptual framework--the stress paradigm--in light of its ability to fulfill this goal, and I discuss the implications for the types of outcome measures we use. [ABSTRACT FROM AUTHOR]

This paper argues a number of points about measurement in the sociology of mental health: (1) measurement is critical, (2) measures should represent and assess elements of human experience, taking measure of life as people feel it, sense it, and understand it, and (3) social scientists should create a human science, producing information for the people it studies so that they can better understand and control their own lives. We argue that a human science is best achieved with the use of indexes, not diagnoses, to measure mental health. We present a brief history of diagnostic instruments and detail how a diagnosis is made. We show how use of diagnoses to measure mental health discounts much human suffering. They dichotomize the true range of feelings and emotions into crude either/or distinctions that do not reflect the reality of people's lives, and they often exclude suffering such as that due to loss or illness that does not meet medical model preconceptions about mental disorder. Using diagnoses to measure mental health presents a reified image of hidden disease knowable and manageable only by trained professionals--beyond the capacity of the suffering individuals to understand and control. [ABSTRACT FROM AUTHOR]

Sociologists of mental health and illness have traditionally used outcome measures that they have obtained from other disciplines, especially psychiatry and psychology. These include official statistics, symptom scales, and diagnostic measures. Answers to the central sociological question of how social arrangements affect mental health might require the development of explicitly sociological outcome measures. This introduction provides an overview of several issues that arise in grappling with this question. These include whether symptom scales or diagnoses best capture the mental health consequences of social arrangements; when single or multiple outcomes are necessary to compare the consequences of social arrangements across different groups; if sociologists should explore the positive as well as the negative consequences of social forces; and when sociological attention should be directed toward social- level as well as individual-level outcomes. The papers in this symposium that follow provide more detailed analyses of each of these issues. [ABSTRACT FROM AUTHOR]

Our paper couples previous research on attitudes toward people with mental illness and more general sociological research on attitudes toward "out-groups" to examine the role of five factors that influence the public's willingness to interact with people with mental health problems, including: the nature of the behavior described, causal attributions of the behavior's source, perceived dangerousness of the person, the label of "mental illness," and the sociodemographic characteristics of respondents. Using vignette data from the 1996 General Social Survey (N = 1,444), we find that respondents discriminate among different types of mental health problems by expressing more desire to avoid those with drug and alcohol problems than with those with mental illness. Consistent with research on racial attitudes, we also find that Americans who attribute mental health problems to structural causes (e.g., stress or genetic/biological causes) are more willing to interact with the vignette person than those who see individual causes (e.g., "bad character" or the "way the person was raised") as the root of the problem. However, even controlling for these factors, respondents who label the vignette a "mental illness" also express a preference for greater social distance. Finally, while the sociodemographic characteristics of the respondent appear to play a minimal role in preferences for social distance, the degree of dangerousness that the public ascribes to people with mental health problems is important and appears to mediate the influence of effects of labeling a person as mentally ill. [ABSTRACT FROM AUTHOR]

This paper is a critique of recent service-intensive shelter programs for homeless mothers and the policies that underlie these shelters. We first document the process by which mental health problems and family homelessness became so closely but mistakenly linked. We then demonstrate empirically that shelter programs for homeless families nonetheless presume that mental health problems are part of the causal nexus of family homelessness and indiscriminately deliver mental health services to homeless mothers. Simultaneously, shelter programs encourage the isolation of their residents from what they presume to be their "problematic" social networks. We show that, while mental health services had little impact on depression levels among homeless mothers, isolation from social networks did increase depression among homeless mothers. Our findings suggest that policy should put more emphasis on rapid reintegration into the community through providing housing, and it should put less emphasis on providing services. [ABSTRACT FROM AUTHOR]

This paper examines risk, defined as the threat of danger or disruption, as a contextual concept important for understanding patterns of patient selection and referral. We explore the hypothesis that risks associated with mental disorder, as represented by factors such as thoughts about suicide or problems associated with drinking, increase the probability of referral of patients receiving mental health care from general medical practitioners to the specialty mental health sector. Interview and claims data from the RAND Health Insurance Experiment, a large experimental study of coinsurance, are used to examine referral processes over a five-year period. Risk, and especially a measure of suicide thoughts, increase the probability of referral to specialty care. Women and persons with higher education are more likely to use specialty services; older persons are less likely to use such services. Understanding referral requires attention to the behavioral contingencies and illness behavior surrounding the presentation of mental disorder. [ABSTRACT FROM AUTHOR]

In this paper, race differences in mental hospitalization are examined, controlling for clinical condition and social class. Nonwhite males are found to be involuntarily hospitalized more often than are white males. Psychiatric and labeling perspectives offer conflicting explanations for these differences in societal reactions. Psychiatric explanations of behavior and attitudes toward treatment and labeling explanations of social distance and pathways to treatment are investigated. Pathways to treatment, specifically greater police involvement in nonwhites' entry into treatment, explains nonwhite males' greater involuntary hospitalization. [ABSTRACT FROM AUTHOR]

Geographic and social mobility are important sources of life change for the majority of people in the modern world. On the assumption that such social transitions are potentially stressful, researchers have investigated the relationship between mobility and psychiatric disturbance. Results from these studies are inconsistent and sometimes contradictory, often due to conceptual and methodological differences. This study offers new evidence on this issue. Interviews were conducted with 681 adults residing in a large Colombian city. Analysis focuses on relationships between geographic and social mobility and manifestations of psychiatric symptoms, but also includes consideration of the effects of age, sex, and education. Results indicate significantly higher symptom scores for females and persons with lower educational attainment as well as certain types of social mobility experience. Variations by age and migration experience are minimal. This study casts some doubt about the stressful effects of migration, tends to support the notion that social mobility is related to psychiatric disturbance and, above all, shows that sex and education are factors that override the influence of either type of mobility experience. The paper concludes with the suggestion that these findings can be utilized for purposes of primary prevention and an indication of lines along which future research should be organized. [ABSTRACT FROM AUTHOR]

This paper provides a new way of conceptualizing the career of the mentally ill. Most persons who experience an episode of a serious mental disturbance lead a normal life, while a few persons lead lifetimes that revolve around their mental disorders. The processes leading to either result can only be understood by integrating the traditional labeling and psychiatric perspectives with lay understandings of the concepts of "mental illness" and "nervous breakdowns." A selection of key concepts from these perspectives leads to a better understanding of the different paths persons take as they move through the pre-patient, inpatient, and post-patient phases of the "career of the mentally ill." This perspective makes understandable a number of counterintuitive relationships. For example, it explains why most hospitalized mental patients (1) have a negative stereotype of the "mentally ill," (2) do not perceive themselves as "mentally ill, yet (3) perceive themselves as benefiting from treatment, and (4) do not progress into a career of secondary deviance. [ABSTRACT FROM AUTHOR]

This article provides an overview of research on race-related stressors that can affect the mental health of socially disadvantaged racial and ethnic populations. It begins by reviewing the research on self-reported discrimination and mental health. Although discrimination is the most studied aspect of racism, racism can also affect mental health through structural/institutional mechanisms and racism that is deeply embedded in the larger culture. Key priorities for research include more systematic attention to stress proliferation processes due to institutional racism, the assessment of stressful experiences linked to natural or manmade environmental crises, documenting and understanding the health effects of hostility against immigrants and people of color, cataloguing and quantifying protective resources, and enhancing our understanding of the complex association between physical and mental health. [ABSTRACT FROM AUTHOR]

In this article the author presents his comments regarding the criticism of his article "Models, Muddels and Mental Illness Labeling," by professor Allan Horwitz. The author argues that in reviewing his version of the labeling theory of mental disorder, Horwitz finds no difference between it and the psychiatric approach, so that the author's approach merely confounds the development of a "true" labeling approach, which would be based purely on the process of attributing behavior. In this approach, labeling theory would concern the linguistic behavior of the labelers, following the current linguistic. The author applauds the proposed new approach. Perhaps it could help resolve some of the many puzzles in this area, by applying a simple, rather than a complex, model. He notices, however, that no one has actually done any research on mental disorder using the new approach, or even provided an analysis of case material. The author adds that rest of Horwitz's charges are based on misrepresentations.

This comment focuses on the September 1976 article "Marital Role, Education, and Mental Disorder Among Women: Test of an Interaction Hypothesis," which illustrates several fundamental issues in current epidemiologic research on mental illness. The rationale for the study apparently arises from a basic error of fact. The authors' basic premise that women have higher rates of mental disorder than men is not acceptable. The second observation relates to the omnipresent problem of case identification in psychiatric epidemiology. They use the 22-item index developed by Langner to estimate prevalence of psychiatric impairment, but of the numerous psychiatric screening instruments, this particular one may be the least desirable.

Research on disparities in health and services should include a critical examination of how social cultural and contextual factors affect the connection between symptoms and psychiatric disorders. Systematic differences in this connection by these factors will mean that clinicians using a universalist approach to disorders may make more diagnostic errors for certain patients (e.g., ethnic minorities, the poor). Based on the literature on normative clinical decision-making, this study tests for whether the effect of specific psychiatric disorders on key symptoms is the same for certain groups of the population. The data come from the National Comorbidity Survey. Conditional probabilities of disorders and symptoms, the elements feeding into clinical decision-making, are calculated and tested for equivalence across various racial/ethnic, educational income, and gender groups. We find some significant differences in the relation of key symptoms to disorders across groups. These findings should encourage testing relativistic frameworks in diagnostic nosology as a step to improve clinical decision-making and reduce diagnostic and treatment disparities in mental health services. [ABSTRACT FROM AUTHOR]

In the 1950s, the public defined mental illness in much narrower and more extreme terms than did psychiatry, and fearful and rejecting attitudes toward people with mental illnesses were common. Several indicators suggest that definitions of mental illness may have broadened and that rejection and negative stereotypes may have decreased since that time. However, lack of comparable data over time prevents us from drawing firm conclusions on these questions. To address this problem, the Mental Health Module of the 1996 General Social Survey repeated a question regarding the meaning of mental illness that was first asked of a nationally representative sample in 1950. A comparison of 1950 and 1996 results shows that conceptions of mental illness have broadened somewhat over this time period to include a greater proportion of non-psychotic disorders, but that perceptions that mentally ill people are violent or frightening substantially increased, rather than decreased. This increase was limited to respondents who viewed mental illness in terms of psychosis. Among such respondents, the proportion who described a mentally ill person as being violent increased by nearly 2 1/2 times between 1950 and 1996. We discuss the possibility that there has been a real move toward acceptance of many forms of mental illness as something that can happen to one of "us," but that people with psychosis remain a "them" who are more feared than they were half a century ago. [ABSTRACT FROM AUTHOR]

We present a conceptual framework derived from organizational theory for understanding the evaluation of the effectiveness of mental health services. We postulate that organizations are deemed "successful" by their constituents when they conform to institutional demands and expectations that are both internally and externally generated. We empirically assess institutional conformity by examining evaluations of effectiveness by 269 mental health providers in 29 different mental health programs. Specialist programs responded to institutional demands by targeting services to those considered most in need: clients with severe mental illnesses. The formal structure and program philosophy of these programs clearly reflected this emphasis; consequently, levels of goal incongruence were low and evaluations of effectiveness were high. Generalist programs continued to provide care to diverse client groups, had more professionals, offered traditional services (such as psychotherapy), and exhibited higher levels of goal incongruence; these factors resulted in lower evaluations of effectiveness. This research is important because it demonstrates that organizational processes of institutional conformity (program objectives meet the demands of external constituents) and goal congruence (program objectives meet with expectations of internal constituents) are critical to positive evaluations of effectiveness. With the current institutional demand for effective, efficient services, it is critical that researchers have a conceptual framework for analyzing those factors which influence evaluations of effectiveness. [ABSTRACT FROM AUTHOR]

Numerous studies have demonstrated a strong connection between the experience of stigma and the well-being of the stigmatized. But in the area of mental illness there has been controversy surrounding the magnitude and duration of the effects of labeling and stigma. One of the arguments that has been used to downplay the importance of these factors is the substantial body of evidence suggesting that labeling leads to positive effects through mental health treatment. However, as Rosenfield (1997) points out, labeling can simultaneously induce both positive consequences through treatment and negative consequences through stigma. In this study we test whether stigma has enduring effects on well-being by interviewing 84 men with dual diagnoses of mental disorder and substance abuse at two points in time--at entry into treatment, when they were addicted to drugs and had many psychiatric symptoms and then again after a year of treatment, when they were far less symptomatic and largely drug- and alcohol-free. We found a relatively strong and enduring effect of stigma on well-being. This finding indicates that stigma continues to complicate the lives of the stigmatized even as treatment improves their symptoms and functioning. It follows that if health professionals want to maximize the well-being of the people they treat, they must address stigma as a separate and important factor in its own right. [ABSTRACT FROM AUTHOR]

Recent research has assigned a prominent role to labeling and stigma as factors that impair the social and psychological functioning of people officially labeled mentally ill. But can the effects of labeling and stigma be overcome by adopting a few simple approaches to coping with these problems? If so, the stigma-induced problems of social awkwardness, demoralization and unemployment emphasized by recent research may not be as severe as claimed. Using a sample of psychiatric patients, we examine this issue by assessing whether patients can ameliorate labeling effects by keeping their history of treatment a secret, educating others about their situation, or avoiding situations in which rejection might occur. None of these coping orientations were effective in diminishing negative labeling effects on unemployment or on psychological distress/demoralization. In fact, the three coping strategies show consistent effects in the direction of producing more harm than good, and with respect to withdrawal-avoidance this effect is significant. Based on these results we argue that stigma is powerfully reinforced by culture and that its effects are not easily overcome by the coping actions of individuals. Using C. Wright Mills's (1967) distinction we conclude that labeling and stigma are "social problems" not "individual troubles." [ABSTRACT FROM AUTHOR]

In this study we re-examine the issue of gender differences in the use of mental health services by asking (1) whether gender differences in use depend upon the specific services studied; and (2) whether statistical models which are aligned closely to help-seeking theory can explain such differences better than previously used approaches. Our analyses are drawn from two waves of data collected from a representative sample of 3,921 respondents of the Epidemiologic Catchment Area study at the Yale University site. Results indicate that although women are more likely than men to consult a physician in the general medical sector about mental health-related problems, there are no gender differences in use of the mental health specialty sector. The relationship between gender and use of the general medical sector for mental health problems also varies by psychiatric status and by attitudes toward mental health services. In the presence of a psychiatric disorder determined by the Diagnostic Interview Schedule, the likelihood of using services is highest for women with positive attitudes and for men with negative attitudes. [ABSTRACT FROM AUTHOR]

Working-class mothers with dependent children are at relatively high risk for mental health problems. Although paid employment has not been found to influence the mental health of mothers in general, there is some evidence that working-class mothers do benefit. In a community survey of 193 working-class mothers, we tested for direct effects of employment and examined these effects in interaction with life event stress, social support, and the presence of a preschool child. Subject selection minimized confounding among these variables. No overall effect of paid employment or preschool children was found. Mothers who had suffered a severely stressful life event in the previous year had higher levels of psychiatric symptomatology. Employment reduced this risk when social support was available but, in the absence of social support, was associated with high symptom levels. [ABSTRACT FROM AUTHOR]

Time-series tests of the proposition that economic contraction provokes psychological disorder are reformulated to respond to conceptual and methodological criticisms of the existing literature. Box-Jenkins' (1976) methods and data from the Monroe County Register are used to allow more temporally and geographically refined, as well aS more rigorous, tests than have heretofore been possible. The data also allow pitting the provocation hypothesis against its rival explanations. Results suggest that rivals to the provocation explanation cannot be rejected. [ABSTRACT FROM AUTHOR]

Longitudinal data on 267 married couples are used to examine the interrelationships among predisposing factors, stress, moderating factors, and subsequent functioning. A model of the stress process that considers spouse symptoms and coping was estimated separately for three functioning criteria (depressed mood, physical symptoms, and alcohol consumption) and across gender groups. Predisposing factors such as low social status and poor initial functioning were related to higher levels of stress. Women were more responsive to stressors and social resources (family support) than were men. The stress-illness relationship was strengthened by the use of avoidance coping responses, particularly if both partners relied on avoidance coping. There were no stress-buffering effects of family support. The associations between self-esteem, coping responses, and later functioning depended on the partner's corresponding coping levels. These findings underscore the value of considering a significant other's symptoms and behavior as salient aspects of the stress process. [ABSTRACT FROM AUTHOR]

Confirmatory factor analyses were used to map dimensions of subjective mental health underlying 25 indexes of well-being and distress assessed in a 1976 national representative survey of adults. Partially confirming hypotheses, six dominant factors (Unhappiness, Lack of Gratification, Strain, Feelings of Vulnerability, Lack of Self-Confidence, and Uncertainty) emerged for both men and women. Comparative analyses revealed that the six-factor model derived for men fit the data of both sexes equally well. Thus, this model provides a means of assessing men's and women's self-evaluations comparably. Multiple regression analyses demonstrated the divergent validity of the dimensions in the model by differentially relating certain demographic' and behavioral measures to the various factors. Four critical theoretical issues were discussed as underlying measures of subjective mental health: affective orientation (positive vs. negative), object of focus (world vs. self), time referent (past vs. present vs. future), and mode of reaction (spontaneous vs. reflective). [ABSTRACT FROM AUTHOR]

A proposition derived from the labeling theory of mental illness, i.e., that the level of a person's psychiatric symptomatology is influenced by the symptom-relevant expectations of his or her significant others, is investigated. In a four-year follow-up study of 31 released psychiatric patients, no evidence is found supporting the proposition. The data are used to discuss specification of the labeling theory of mental illness. [ABSTRACT FROM AUTHOR]

Several bodies of research are reviewed for their contributions to defining the relationship of individual psychological disorder to social structure and process. The specific problem addressed is the relationship of social class to psychological impairment and its mediation. The generic problem is one of locating psychological processes and individual behavior within a societal framework. Recent work focusing on the effects of economic change and unemployment on psychological functioning is examined in relation to studies of the support characteristics of families and social networks pertinent to psychological well-being. An integration of this literature is presented based on the interdependency of stress and support variables and is, in turn, employed in a conceptualization of the relationship between social class and psychological disorder. It is argued that stress and support factors are systematically organized within classes at several levels of analysis and constitute critical conditions of class membership related to psychological functioning. [ABSTRACT FROM AUTHOR]

The hypothesis, suggested by associations found in previous research, that stressful gife events play a direct etiological role in psychological disorders was investigated. Preexistent methodological problems which permitted no clear inference regarding this role were treated. Competing hypotheses which posited that the life event-psychological disorder associations represented confounded relationships among events, pathology, and sociocultural factors were examined and controlled. Data used were from a survey of mothers of 732 children ranging in age from 11 to 23 years old, who constituted the follow-up sample collected five years later from an original sample of 1,034 children randomly selected from a cross-section of Manhattan households. Event scores differing as to the change and undesirability stress conceptions, each objectively and subjectively defined, were studied. No significant differences were found between correlations of event scores with behavioral pathology prior to and after the events. Multiple regression analyses which added event scores after controlling for stressful life processes demonstrated that events made no minimally meaningful contribution to the prediction of any disturbed behavior. The confounding hypothesis rather than the etiological hypothesis was supported and discussed. [ABSTRACT FROM AUTHOR]

It is argued that, as compared to females, the role expectations for males are less tolerant of the behavior associated with mental illness, and the mentally ill males will experience a more prompt and severe reaction than mentally ill females. A large body of literature and national data on treatment indicates that psychotic males are channelled into psychiatric treatment more promptly and tend to have a longer stay in mental hospitals than psychotic females. In contrast, neurotic males and females, whose treatment is almost always self-initiated, tend to enter treatment at the same time; however, once in treatment neurotic males tend to experience a more prolonged hospitalization. These relationships run counter to one of labelling theory's basic propositions, namely that persons of low status and little power are more likely to be labelled deviant, while at the same time they demonstrate that social factors play an important role in determining how deviant behavior is reacted to. [ABSTRACT FROM AUTHOR]

Rather than considering hysterical contagion episodes as incidents or a negative reaction to increased levels of stress—as has been the recent approach in works by Kerckhoff, Back, Smelser, and Klapp—it is argued that at least for many participants they are a type of craze. What is "contagious" is the understanding that exhibiting certain behaviors will entitle one to the secondary gains of the sick role. However, the decision to adopt the behavior is not necessarily conscious. Such an approach is more consistent with existing understandings of the diffusion or contagion process, the sick role, and with theoretical approaches to collective behavior. [ABSTRACT FROM AUTHOR]

Public attitudes toward the mentally ill and public recognition of the signs and symptoms of mental illness have been subjects of considerable concern and research effort for over two decades. Studies carried out in the early 1950's clearly indicated that the term "mental illness," as used by the public at that time, covered a much narrower range of abnormal behavior than that envisaged by the mental health profession. Since, then however, there have been extensive attempts by mental health workers to "educate" the public; that is, to make them see an ever-expanding amount of deviant behavior as mental illness in need of psychiatric treatment. There were, however, some relatively small changes in the public's recognition of psychiatric symptoms in terms of both "mental illness" and "something wrong." One change suggests a decrease in the public recognition of the anxiety neurotic as "mentally ill." Although there was an increase in the percentage of the population identifying the juvenile delinquent as "mentally ill," there was a decrease in the percentage viewing this behavior as being indicative of "something wrong." The data reported in this study should force a more critical appraisal of the methodological and theoretical factors involved in studies of public recognition of psychiatric symptoms.

The article discusses the author's plans as incoming editor of the "Journal of Health and Social Behavior". To prepare for upcoming editorial duties, the author tried to determine whether, within recent years, the periodical has had desirable breadth. Using a category system for mapping the field, a tally of issues since 1978 was conducted. From the survey, two conclusions were made. The first conclusion is that every important corner of the field has been covered. There have been articles on social factors in mental illness, the health effects of stress and multiple roles, health professional education and many other topics. The second conclusion is that there ahave been some strongly accented categories and others which, through present, are heard in a fainter voice. The author also highlighted the importance of medical sociologists in various parts of the field to the continuing soundness of the periodical.

Comments on the article "Status Integration, Social Stress and Mental Illness," by Walter T. Martin from the 1976 September edition of the "Journal of Health and Social Behavior" publication. Claim by Martin of accounting for the relationship between marital status and rates of admission to mental hospitals; Absence of any link between the theory and empirical issues between marital status and mental illness; Fallacy of the assumption of the dependence of interstatus role conflict in a status configuration on the number of people occupying the configuration.