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The introduction to this special issue of the Journal expands the scope of research on "the sociology of medical education" to include studies of the institutions in which physicians are trained as well as studies of the socialization of the physician throughout the life cycle. Research since the 1960s is reviewed briefly and the papers in this issue are discussed. Studies of the macropolitics and micropolitics of academic medicine are called for as well as comparative analyses of the settings in which physicians are trained and research on the relative effects on physicians' attitudes and behavior of different sets of experiences, professional and nonprofessional, over the course of their life cycle-all in the context of massive changes in the organization of health care. [ABSTRACT FROM AUTHOR]

This paper addresses current contentions that medical sociology is handicapped as both a scholarly and a policy science by its subordinate relationship to the more powerful field of medicine. An analysis of all research articles published in the JOURNAL OF HEALTH AND SOCIAL BEHAVIOR which focus upon patients reveals the following: (1) the presence, in the majority, of implicit and explicit medical value assumptions influencing all stages of the research process, from the definition of problems and variables through the application of findings to health policy; (2) a tendency for cases of "medical bias" to be associated with collaborative research in which the sociologist is wholly or partly dependent upon medical sponsorship and definition of the research situation. Consequences of this situation for the human subjects of research as well as for the field are discussed. A conclusion is that both our subjects' interests and the theoretic and political integrity of the field are best served by maximizing professional autonomy vis-à-vis medicine. A proposal for studying the structure of working arrangements concludes the paper. [ABSTRACT FROM AUTHOR]

The article is a commentary on the portrayal of the impact of the "Journal of Health and Social Behavior" (JHSB) by Robert J. Johnson and Frederic D. Wolinsky relative to other sociology and social sciences journals in the period of 1977 to 1987. It is agreed that the journal is in high standing and regard within the social science community. The major lessons cited by Johnson and Wolinsky are different from the thesis. It is confirmed that their analysis elucidates the dangers of relying much on impression and too little on factual investigation. Their data show little change in the proportion of stress articles over the 1990s period. The evidence presented does not sustain the general perception regarding the impact status of three other sociological journals relative to JHSB. The argument that the course of the impact of JHSB due to its identification with stress research is questioned based on the data presented. The data given is not organized efficiently to test the hypothesis.

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]

This paper is a revision of the address given upon receipt of the Leo G. Reeder Award for Distinguished Scholarship in Medical Sociology. It was presented on September 1, 1986 to the Medical Sociology Section of the American Sociological Association during its annual meetings, held in New York City. [ABSTRACT FROM AUTHOR]

This paper is a revision of the address given by Professor Elinson upon receipt of the Leo G. Reeder Award for distinguished scholarship in medical sociology. The address was presented on August 29, 1985 to the Medical Sociology Section of the American Sociological Association during its annual meeting, held in Washington, DC. [ABSTRACT FROM AUTHOR]

The article provides a comment to the study by Robert J. Johnson and Frederic D. Wolinsky regarding their evaluation of the "Journal of Health and Social Behavior" relevant to the observations connected with the period from 1977 to 1987. Is is claimed that the decline of the the periodical's stature based on attempts to broaden its scope of journal coverage, reduction in subscription and changes in editorial policy. There is an implication that two committee reports caused a decline in citation which serves as the author's measure in stature. The frequency of citation of particular articles depends on many things including the content, quality of reported work, the author's reputation, the number of investigators and the visibility and reputation of a journal. It is argued that the change in the journal's image has lessened its visibility in the stress area and reduced the impact of some papers.

In this thoughtful paper, Mechanic discusses the differences between quantitative and qualitative researchers, focusing on health-related issues. It should, of course, be evident to readers that the issues he discusses have applicability far beyond medical sociology. The same issues arise in all kinds of social research and the excellent examples he gives can be expanded easily to examples in areas including education, criminology, industrial relations, social stratification, and others. In my reading of his paper, Mechanic discusses both differences between methods at a single point in time and differences in measuring process across time. As a quantitative survey researcher, I will comment on my perceptions of the similarities and differences between observational and survey methods for cross-sectional research. I then discuss some methods for bridging the gap that do not involve diaries. Finally, I discuss procedures for measuring process using observational and diary methods. [ABSTRACT FROM AUTHOR]

The article comments on the piece by Robert J. Johnson and Frederic D. Wolinsky regarding the impact of the "Journal of Health and Social Behavior" publication on issues of identity, prestige and attribution. It is recognized that the magazine's status and stature is on the decline and that the fate of its contributing sociologists are affected. It is claimed that the article falls short within a broad patch of work known as the sociology of science. The author confines the observations to the fit between the Johnson and Wolinsky model and data presented, the identity of the periodical as a stress journal and the nature of scientific frontiers and the perspective nature of the article. The model and all its presented supporting arguments have been presented. The attempt to show the contrasting features of the periodical with another publication fails to place it in a focal publication status is stress research.

The Journal of Health and Social Behavior (JHSB) is examined to determine its relative stature and impact in the social science community. We conducted both empirical comparisons of average impact (based on the Social Science Citation Index) and content analysis. Over an 11-year period beginning in 1977, JHSB has maintained an enviable position among sociology journals, ranking significantly higher than the American Journal of Sociology and Social Forces. In addition, it ranks quite favorably when compared with the dominant journals of the allied social science disciplines. The preeminence of the JHSB is attributed to the legacy of stress research that was perceived to dominate this period. Ironically, the recently mandated change in editorial goals eschewing such an identification with stress research has begun to undermine the overall stature of the journal, primarily by reducing the impact of articles on stress that appear in it. We discuss the mechanisms that have influenced the course and the impact of this journal. [ABSTRACT FROM AUTHOR]

The medical research institution is analyzed within a sociology of science framework and from a social psychological perspective. As an exemplar, a published study by Bierman (1976) concerning a treatment for genital herpes is explored in detail. Despite serious methodological flaws and ambiguities in the Bierman study, there has been widespread acceptance of the findings within both the medical and lay communities. Societal, medical, and personal implications of such practices arc discussed. [ABSTRACT FROM AUTHOR]

This article presents information on the sociology of mental illness. Research results will appear contradictory rather than complementary when these concepts are treated as alter- native ways of defining mental illness, as opposed to different aspects of a single process and theoretical synthesis of findings will be impeded. However, in the future, the researchers hope that these four conditions of conceptualizing mental illness will be represented as aspects of a single process, whereby the incapacity to deal with potentially stress-inducing circumstances increases the probability of the experience of severe and prolonged subjective distress, the experience of subjective distress will have necessarily personally undesirable consequences, individuals will respond both to their experiences of subjective distress and to the personally undesirable consequences of their distress in ways they consciously or unconsciously anticipate will relieve their distress, and both the consequences of their subjective distress and their more or less effective adaptations to their experiences of subjective distress will evoke responses from significant others in their environment which, in turn, will affect their own outcomes.

The sociology of stress shows how nondisordered people often become distressed in contexts such as chronic subordination; the losses of status, resources, and attachments; or the inability to achieve valued goals. Evolutionary psychology indicates that distress arising in these contexts stems from psychological mechanisms that are responding appropriately to stressful circumstances. A diagnosis of mental disorder, in contrast, indicates that these mechanisms are not functioning as they are designed to function. The American Psychiatric Association's Diagnostic and Statistical Manual, however, has come to treat both the natural results of the stress process and individual pathology as mental disorders. A number of social groups benefit from and promote the conflation of normal emotions with dysfunctions. The result has been to overestimate the number of people who are considered to be disordered, to focus social policy on the supposedly unmet need for treatment, and to enlarge the social space of pathology in the general culture. [ABSTRACT FROM AUTHOR]

An emerging area of social science research focuses on individual-level and contextual-level determinants of black-white adult mortality differentials in the United States. However, no research on adult mortality differentials has distinguished multiple Hispanic subgroups and explored the role of nativity at both the individual and contextual levels for small geographic areas. Using the 1986-1997 National Health Interview Survey-National Death Index linked file, we examine the effects of individual and contextual factors on black-white and multiple Hispanic subgroup (Mexican Americans, Puerto Ricans, and "other" Hispanic) differentials in adult mortality. In addition, we use a new, innovative geographic area--the very small area--as our contextual unit of analysis. We find that excess mortality risks for all race-ethnic groups considered are associated with not only individual characteristics, but also neighborhood characteristics. In addition, percent foreign born in a neighborhood is protective of Hispanic subgroup mortality for Puerto Rican, Mexican American, and "other" Hispanic adults in the 45-64 age category. These findings indicate a need for future research to examine more thoroughly the pathways through which neighborhood factors affect multiple Hispanic subgroup mortality and the role of nativity as a protective factor for older adult Hispanic mortality. [ABSTRACT FROM AUTHOR]

This essay considers the dual roles occupied by the sociologist of mental health. These roles involve the articulation of social causation in the study of mental health outside of the discipline, coupled with the articulation within the discipline of the importance of mental health in the study of sociology. I consider these roles both through examples and speculation, emphasizing the unique combination of conceptual and methodological tools that define the intellectual terrain of this area of sociology. The advantage of this dual role--of looking outward while also looking inward--is that we are able to draw from the essential developments and innovations from one source and "move" these insights toward the other. The difficulties of this position are also clear: As an area, we may be structurally marginal from both perspectives, at the same time that we offer considerable analytic power that could significantly impact the direction of research involving mental health in both realms. [ABSTRACT FROM AUTHOR]

The current situation in health care organizations, among providers and for people, dramatically challenges the "business as usual" roles of medicine, government, insurance companies, the community, and the university. Health care reform marks the first attempt in a century to consider a reconstruction of the social contract between society and medicine. While sociology stands as one of the earliest social sciences to systematically study the health care arena and create a health-focused subfield, there is a perception, not without support, of a desertion of identity from within, an encroachment by other areas from without, and abandonment by the parent discipline. We argue that these situations in medical arenas and in research fields require serious rethinking. The key lies in understanding how these phenomena are related to each other and to larger social forces, and how they offer opportunities, rather than signal limitations, to medical sociologists. We turn to the theoretical tools of sociology to help unravel the complicated challenges that face both policymakers and researchers. After framing these issues in a sociology of knowledge perspective, we use the case of "utilization theory" to illustrate the connections between society and systems of care (as well as studies of them) and to create a future agenda. We end by raising three basic questions: (1) Why is a sociological perspective critical to the understanding of change and reform in health care? (2) Why is medical sociology critical to the survival of the general sociological enterprise? and (3) Why is general sociology critical to the research agenda in medical sociology? [ABSTRACT FROM AUTHOR]

Why is it that quantitative and qualitative researchers on health issues often have divergent findings and conclusions? Exploration of such differences can be a useful way of bringing separate intellectual enclaves in medical sociology together and also can stimulate future inquiries. Some differences can be resolved by more precise definitions, by comparable frequency and timing of measurement, and by careful evaluation of meaning contexts. The triangulation of methods, using diaries as a bridge between surveys and qualitative measurement, offers particular promise. Improved theory on the relationships of method to data, and more attention to behavioral sequences and the social context of measurement, can serve as a stimulant to innovative solutions. [ABSTRACT FROM AUTHOR]

1,402 older adults were interviewed twice with a six month interval. The direct, indirect, and interactive relationships of resources, life events, global stress, and depression were examined using multiple regression procedures to isolate the unique contributions of six hypothesized functions of resources: (1) stronger resources did not reduce undesirable events; (2) stronger resources did reduce the degree to which one experienced global stress: (3) stronger resources reduced depressive symptoms; (4) strong resource persons had less global stress than weak resource persons at low levels of events, but this advantage disappeared as level of events increased (opposite of prediction); (5) the traditional buffer hypothesis was not supported; the advantage of strong resource persons over weak resource persons held at all levels of events; (6) strong resource persons had less change in depression than weak resource persons only at the higher levels of global stress. This form followed the buffer effect previously attributed to events. [ABSTRACT FROM AUTHOR]

Previous research in a metropolitan community found significant time-series associations of monthly unemployment rate with surveyed depressed mood (Catalano and Dooley, 1977), of absolute change in employment in the basic economic sector with surveyed l(fe events (Catalano and Dooley, 1979), and of several economic indicators with surveyed psychophysiological symptoms for low-income respondents (Dooley and Catalano, 1979). This study, using similar data from a longitudinal survey in a nonmetropolitan community, fails to replicate any of the previous findings. This failure to replicate is discussed in terms of differences between the metropolitan (Kansas City, Missouri) and nonmetropolitan (Washington County, Maryland) communities. Compared with the Kansas City respondents, Washington County respondents reported fewer life events and fewer psychological symptoms, claimed more satisfaction with their sources of social support, and had higher scores on items indicating a disposition to answer in a socially desirable direction. [ABSTRACT FROM AUTHOR]

Three frequently used measures of well-being--the Life Satisfaction scale, the Social Isolation scale and the Willingness to Live scale - are evaluated in terms of their empirical similarity. The internal consistency of the social isolation items, it is found, does not exceed the cross-correlation between the social isolation and ¶e satisfaction items. A group factor analysis confirms the existence of considerable communality among the items of the two scales, suggesting they are largely redundant. The implications of this redundancy for health-related and gerontological studies are discussed. [ABSTRACT FROM AUTHOR]

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.