Where's the problem? Considering Laing and Esterson's account of schizophrenia, social models of disability, and extended mental disorder.
Ontology highlight
ABSTRACT:
SUBMITTER: Cooper R
PROVIDER: S-EPMC5522527 | biostudies-other | 2017 Aug
REPOSITORIES: biostudies-other
Similar Datasets
Project description:This article examines the effects of UK welfare reform since 2008 on people with mental health conditions and disabilities. The results have been profound, particularly during a time of economic austerity, damaging the social safety net and pushing many vulnerable people into poverty and hardship. It has perpetuated inequalities and increased the social exclusion of disabled groups. The holes in the safety net require repair, alongside extensive social policy reform to both protect and empower people with disabilities and long-term conditions.
| S-EPMC7525580 | biostudies-literature
Project description:PurposePublic mental health services (MHS) are crucial in preventing psychiatric disability pensions (DP). We studied the associations between mood disorder DP risk and the characteristics of Finnish municipalities' MHS provision using the ESMS-R mapping tool and Finnish population registers, based on first-time granted mood disorder DPs between 2010 and 2015.MethodsThe final data set included 13,783 first-time mood disorder DP recipients and 1088 mental health service units in 104 municipalities. We focused on five different MHS types: all MHS, outpatient care provision, local services without and with gatekeeping, and centralized services. Three factors for each MHS type were studied: service resources, richness, and diversity index. Negative binomial regression models were used in the analysis.ResultsIn all the municipalities, higher service richness and diversity regarding all MHS, outpatient care and local services with gatekeeping were associated with a lower DP risk. In urban municipalities, service richness was mainly associated with lower DP risk, and in semi-urban municipalities service diversity and resources were primarily associated with lower DP risk in outpatient care and local services with gatekeeping. In rural municipalities, DP risk indicated no association with MHS factors.ConclusionThe organization and structure of MHS play a role in psychiatric disability pensioning. MHS richness and diversity are associated with lower mood disorder DP in specific societal contexts indicating their role as quality indicators for regional MHS. The diversity of service provision should be accounted for in MHS planning to offer services matching population needs.
| S-EPMC10960744 | biostudies-literature
Project description:Individuals with body integrity identity disorder (BIID) seek to address a non-delusional incongruity between their body image and their physical embodiment, sometimes via the surgical amputation of healthy body parts. Opponents to the provision of therapeutic healthy-limb amputation in cases of BIID make appeals to the envisioned harms that such an intervention would cause, harms such as the creation of a lifelong physical disability where none existed before. However, this concept of harm is often based on a normative biomedical model of health and disability, a model which conflates amputation with impairment, and impairment with a disability. This article challenges the prima facie harms assumed to be inherent in limb amputation and argues in favour of a potential treatment option for those with BIID. To do this, it employs the social model of disability as a means to separate the concept of impairment and disability and thereby separate the acute and chronic harms of the practice of therapeutic healthy-limb amputation. It will then argue that provided sufficient measures are put in place to ensure that those with atypical bodily constructions are not disadvantaged, the chronic harms of elective amputation would cease to be.
| S-EPMC7260267 | biostudies-literature
Project description:Autistic philosopher and neurodiversity proponent Robert Chapman (2021) argues that disability may be best understood by utilizing an ecological functional model where the focus is on the intersection and overlaps between relational contributions to collectives and group functioning with individual functionality. This presents an alternative to both social-relational models of disability advocated by other neurodiversity proponents and the orthodox medical model of disability. While enactivists such as Michelle Maiese and Juan Toro, Julian Kiverstein and Erik Rietveld have also offered relational models of disability that challenge the orthodox medical model, I argue that unlike the ecological functional model, these enactivist models remain problematically committed to an individualist methodology. Drawing on what Miriam Kyselo has labeled the body social problem, I show that the enactivist models not only face theoretical issues, but also practical issues in terms of their recommended intervention strategies for disability. I argue that for these reasons, if enactivists want a relational model of disability, then they should adopt both a neurodiversity paradigm approach and Chapman's ecological functional model.
| S-EPMC10032405 | biostudies-literature
Project description:Social connections are essential for the survival of a social species like humans. People differ in the degree to which they are sensitive to perceived deficits in their social connections, but evidence suggests that they nevertheless construe the nature of their social connections similarly. This construal can be thought of as a mental representation of a multi-faceted social experience. A three-dimensional mental representation has been identified with the UCLA Loneliness Scale and consists of Intimate, Relational, and Collective Connectedness reflecting beliefs about one's individual, dyadic, and collective (group) social value, respectively. Moreover, this mental representation has been replicated with other scales and validated across age, gender, and racial/ethnic lines in U.S. samples. The purpose of this study is to evaluate the extent to which this three-dimensional representation applies to people whose social lives are experienced in a collectivistic rather than individualistic culture. To that end, we used confirmatory factor analyses to assess the fit of the three-dimensional mental structure to data collected from Chinese people living in China. Two hundred sixty-seven young adults (16-25 yrs) and 250 older adults (50-65 yrs) in Beijing completed the revised UCLA Loneliness Scale and demographic and social activity questionnaires. Results revealed adequate fit of the structure to data from young and older Chinese adults. Moreover, the structure exhibited equivalent fit in young and older Chinese adults despite changes in the Chinese culture that exposed these two generations to different cultural experiences. Social activity variables that discriminated among the three dimensions in the Chinese samples corresponded well with variables that discriminated among the three dimensions in the U.S.-based samples, indicating cultural commonalities in the factors predicting dimensions of people's representations of their social connections. Equivalence of the three-dimensional structure is relevant for an understanding of cultural differences in the sources of loneliness and social connectedness.
| S-EPMC3442957 | biostudies-literature
Project description:BackgroundThe ability to integrate contextual information with social cues to generate social meaning is a key aspect of social cognition. It is widely accepted that patients with schizophrenia and bipolar disorders have deficits in social cognition; however, previous studies on these disorders did not use tasks that replicate everyday situations.Methodology/principal findingsThis study evaluates the performance of patients with schizophrenia and bipolar disorders on social cognition tasks (emotional processing, empathy, and social norms knowledge) that incorporate different levels of contextual dependence and involvement of real-life scenarios. Furthermore, we explored the association between social cognition measures, clinical symptoms and executive functions. Using a logistic regression analysis, we explored whether the involvement of more basic skills in emotional processing predicted performance on empathy tasks. The results showed that both patient groups exhibited deficits in social cognition tasks with greater context sensitivity and involvement of real-life scenarios. These deficits were more severe in schizophrenic than in bipolar patients. Patients did not differ from controls in tasks involving explicit knowledge. Moreover, schizophrenic patients' depression levels were negatively correlated with performance on empathy tasks.Conclusions/significanceOverall performance on emotion recognition predicted performance on intentionality attribution during the more ambiguous situations of the empathy task. These results suggest that social cognition deficits could be related to a general impairment in the capacity to implicitly integrate contextual cues. Important implications for the assessment and treatment of individuals with schizophrenia and bipolar disorders, as well as for neurocognitive models of these pathologies are discussed.
| S-EPMC3592887 | biostudies-literature
Project description:Mental disorders have an enormous impact in our society, both in personal terms and in the economic costs associated with their treatment. In order to scale up services and bring down costs, administrations are starting to promote social interactions as key to care provision. We analyze quantitatively the importance of communities for effective mental health care, considering all community members involved. By means of citizen science practices, we have designed a suite of games that allow to probe into different behavioral traits of the role groups of the ecosystem. The evidence reinforces the idea of community social capital, with caregivers and professionals playing a leading role. Yet, the cost of collective action is mainly supported by individuals with a mental condition - which unveils their vulnerability. The results are in general agreement with previous findings but, since we broaden the perspective of previous studies, we are also able to find marked differences in the social behavior of certain groups of mental disorders. We finally point to the conditions under which cooperation among members of the ecosystem is better sustained, suggesting how virtuous cycles of inclusion and participation can be promoted in a 'care in the community' framework.
| S-EPMC5830605 | biostudies-literature
Project description:The transition to motherhood involves CNS changes that modify sociability and affective state. However, these changes also put females at risk for postpartum depression and psychosis, which impairs parenting abilities and adversely affects children. Thus, changes in expression and interactions in a core subset of genes may be critical for emergence of a healthy maternal phenotype, but inappropriate changes of the same genes could put women at risk for postpartum disorders. This study evaluated microarray gene expression changes in medial prefrontal cortex (mPFC), a region implicated in both maternal behavior and psychiatric disorders. Postpartum mice were compared to virgin controls housed with females and isolated for identical durations. Using the Modular Single-set Enrichment Test (MSET), we found that the genetic landscape of maternal mPFC bears statistical similarity to gene databases associated with schizophrenia (5 of 5 sets) and bipolar disorder (BPD, 3 of 3 sets). In contrast to previous studies of maternal lateral septum and medial preoptic area, enrichment of autism and depression-linked genes was not significant (2 of 9 sets, 0 of 4 sets). Among genes linked to multiple disorders were fatty acid binding protein 7 (Fabp7), glutamate metabotropic receptor 3 (Grm3), platelet derived growth factor, beta polypeptide (Pdgfrb), and nuclear receptor subfamily 1, group D, member 1 (Nr1d1). RT-qPCR confirmed these gene changes as well as FMS-like tyrosine kinase 1 (Flt1) and proenkephalin (Penk). Systems-level methods revealed involvement of developmental gene networks in establishing the maternal phenotype and indirectly suggested a role for numerous microRNAs and transcription factors in mediating expression changes. Together, this study suggests that a subset of genes involved in shaping the healthy maternal brain may also be dysregulated in mental health disorders and put females at risk for postpartum psychosis with aspects of schizophrenia and BPD. In total, 10 total RNA samples derived from micropunched medial prefrontal cortex were used for microarray analysis: 5 samples from lactating maternal mice (maternal) and 5 samples from age-matched virgin mice (virgin). All samples are biological replicates.
2014-02-28 | E-GEOD-54426 | biostudies-arrayexpress
Project description:The self-disorder model offers a unifying way of conceptualizing schizophrenia's highly diverse symptoms (positive, negative, disorganized), of capturing their distinctive bizarreness, and of conceiving their longitudinal development. These symptoms are viewed as differing manifestations of an underlying disorder of ipseity or core-self: hyper-reflexivity/diminished-self-presence with accompanying disturbances of "grip" or "hold" on reality. Recent revision to this phenomenological theory, in particular distinguishing primary-vs-secondary factors, offers a bio-pheno-social model that is consistent with recent empirical findings and offers several advantages: (1) It helps account for the temporal variations of the symptoms or syndrome, including longitudinal progression, but also the shorter-term, situationally reactive, and sometimes defensive or quasi-intentional variability of symptom-expression that can occur in schizophrenia (consistent with understanding some aspects of ipseity-disturbance as dynamic and mutable, involving shifting attitudes or experiential orientations). (2) It accommodates the overlapping of some key schizophrenic symptoms with certain nonschizophrenic conditions involving dissociation (depersonalization, derealization), including depersonalization disorder and panic disorder, thereby acknowledging both shared and distinguishing symptoms. (3) It integrates recent neurocognitive and neurobiological as well as psychosocial (eg, influence of trauma and culture) findings into a coherent but multi-factorial neuropsychological account. An adequate model of schizophrenia will postulate shared disturbances of core-self experiences that nevertheless can follow several distinct pathways and occur in various forms. Such a model is preferable to uni-dimensional alternatives-whether of schizophrenia or ipseity-disturbance-given its ability to account for distinctive yet varying experiential and neurocognitive abnormalities found in research on schizophrenia, and to integrate these with recent psychosocial and neurobiological findings.
| S-EPMC6007751 | biostudies-literature
Project description:BackgroundSocial functioning is often impaired in schizophrenia (SZ) and Alzheimer's disease (AD). However, commonalities and differences in social dysfunction among these patient groups remain elusive.Materials and methodsUsing data from the PRISM study, behavioral (all subscales and total score of the Social Functioning Scale) and affective (perceived social disability and loneliness) indicators of social functioning were measured in patients with SZ (N = 56), probable AD (N = 50) and age-matched healthy controls groups (HC, N = 29 and N = 28). We examined to what extent social functioning differed between disease and age-matched HC groups, as well as between patient groups. Furthermore, we examined how severity of disease and mood were correlated with social functioning, irrespective of diagnosis.ResultsAs compared to HC, both behavioral and affective social functioning seemed impaired in SZ patients (Cohen's d's 0.81-1.69), whereas AD patients mainly showed impaired behavioral social function (Cohen's d's 0.65-1.14). While behavioral indices of social functioning were similar across patient groups, SZ patients reported more perceived social disability than AD patients (Cohen's d's 0.65). Across patient groups, positive mood, lower depression and anxiety levels were strong determinants of better social functioning (p's <0.001), even more so than severity of disease.ConclusionsAD and SZ patients both exhibit poor social functioning in comparison to age- and sex matched HC participants. Social dysfunction in SZ patients may be more severe than in AD patients, though this may be due to underreporting by AD patients. Across patients, social functioning appeared as more influenced by mood states than by severity of disease.
| S-EPMC9009658 | biostudies-literature