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To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1559-1816.2009.00515.x Byline: Katy Greenland (*), Jonathan Scourfield (*), Nina Maxwell ([dagger]), Lindsay Prior ([double dagger]), Jane Scourfield (s.) Abstract: The Distress Disclosure Index (Kahn & Hessling, 2001) measures the tendency to disclose psychological distress and is important in understanding psychological well-being, interpersonal relationships, and help seeking. This paper used the disclosure decision model (Omarzu, 2000) to explore the theoretical antecedents of distress disclosure. Results of a community-based survey of 17-18-year-olds in South Wales (United Kingdom), suggesting that private self-consciousness, social support, and femininity were associated with higher distress disclosure. Shame was associated with lower distress disclosure. Moderating effects of gender and gender identity were also explored. Social support and femininity both interacted with gender to predict distress disclosure. The results suggest a number of interventions to increase distress disclosure in young men and women. Author Affiliation: (*)School of Social SciencesCardiff UniversityCardiff, UK ([dagger])Centre for Social Work and Social Care ResearchSwansea UniversitySwansea, UK ([double dagger])School of Sociology and Social PolicyQueen's UniversityBelfast, UK (s.)Department of Psychological MedicineCardiff UniversityCardiff, UK Article note: (2) Katy Greenland, School of Social Sciences, Cardiff University, Cardiff, UK CF10 3WT. E-mail: GreenlandK@cardiff.ac.uk

In matters of social research sociologists and other social scientists have tended to view documents primarily as sources of evidence and as receptacles of inert content. The key strategies for data exploration have consequently been associated with various styles of content or thematic analysis. Even when discourse analysis has been recommended, there has been a marked tendency to deal with records, files, and the like, primarily as containers--things to be read, understood, and categorized. In this article, however, the author seeks to demonstrate that by focussing on the functioning of documents instead of content, sociology can embrace a much wider range of approaches to both data collection and analysis. Indeed, the adoption of such a programme encourages researchers to see documents as active agents in the world, and to view documentation as a key component of dynamic networks rather than as a set of static and immutable 'things'. KEY WORDS actor-networks / biography of objects / documents / network analysis / social research / visualization

This article is concerned with the ways in which people who work in and use a cancer genetics clinic in the UK talk about the 'gene for cancer'. By conceptualizing such a gene as a boundary object, and using empirical data derived from clinic consultations, observations in a genetics laboratory and interviews with patients, the author seeks to illustrate how the various parties involved adopt different discursive strategies to appropriate, describe and understand what is apparently the 'same' thing. The consequent focus on the ways in which the rhetorical and syntactical features of lay and professional talk interlink and diverge illustrates not merely how our contemporary knowledge of genes and genetics is structured, but also how different publics position themselves with respect to the biochemistry of life. KEY WORDS boundary objects / cancer / clinical genetics / lay and professional knowledge / public understanding of science / scientific rhetoric

The nature and effects of stigma have been widely discussed in the context of mental illness, and references to stigma are commonly used to explain a wide array of social processes. For example, it is often claimed that stigmatisation affects aspects of personal identity, that it underpins unjust and discriminatory behaviour, and that it is responsible for a reluctance among members of the lay public to disclose the presence of treatable psychiatric symptoms and problems to health professionals. A widespread reluctance to disclose symptoms of `emotional problems' to health professionals is in fact well documented. Yet the reasons for such patterns of behaviour are far from clear. However, in this paper, on the basis of qualitative data collected from primary care attendees in Wales (N = 127), the authors suggest that appeals to stigma are inadequate to explain the phenomenon. More likely, it seems, is that members of the lay public have markedly different images from health professionals of what constitutes a mild to moderate psychiatric problem. Consequently, it is argued that the phenomenon of non-disclosure could be viewed more accurately as a problem of alternative taxonomic systems than of fear of stigma. The implications of the argument for health practice and theory are outlined. Keywords: Culture; Depression; Stigma; Primary care; Wales

This article discusses rationing practices in cancer genetics. The author, examining a cancer genetics clinic, argues the allocation of scarce medical resources to needy patients is more than a managerial process, but based upon risk assessment which is arbitrarily defined in relation to economic, social, and political factors.

An examination is presented on health attitudes and behavior among members of Canton-Chinese neighborhoods in England, focusing on mind and body correlations and spiritual agency within Asian culture. Subjects used by Chinese patients to communicate their health status include traditional medicine, demons, spirits, weather and food.

This paper is concerned with the socio-medical organisation of psychiatric disorder. The main line of analysis demonstrates how different psychiatric ideologies produce different objects of professional focus and, consequently, radically different forms of therapy and therapeutic environment. By way of empirical evidence, the paper examines in some detail three contrasting contexts in which psychiatric disorder has been described and organised. The first is represented in Freud and Breuer's Studies on Hysteria, the second in the case books of a turn of the century asylum, and the third in the activities and practices of a modern psychiatric ward. By drawing on these sources of data, it is argued that an understanding of large scale changes in the organisation of psychiatric health care (such as is evident, for example, in modern trends from hospital to community care), firmly depends upon a study of the inner structure of psychiatric ideologies. Furthermore, and as a corollary of this it is chimed that appeals to extra-psychiatric (economic) interests and/or scientific (pharmacological) advances as key factors for explaining processes or organisational change (especially the process of deinstitutionalisation), are essentially misleading., I Explaining Organisational Change The transition from hospital based care for the mentally ill to what is loosely termed 'community care' has been a fact of North American and European [...]

The movement away from hospital-based schemes of care for those with a psychiatric disability in favour of community-based schemes of care constitutes a turning point in the history of psychiatric provision in most Western European societies. The origins and rationale of this movement have sometimes been explained by reference to extra-discursive (economic) interests, and sometimes by reference to a form of technological or scientific determinism in which the discovery of such things as the neuroleptic drugs during the 1950s is said to have played a major role. This paper argues that the impetus for community as against hospital-based care can only be understood in terms of a changing discourse of psychiatry and psychiatric nursing, and especially those forms of thought which have tended to place 'illness' in the wings and set its primary sights on behavioural and social 'deficits'. There is a sense, therefore, in which hospital-based practices of psychiatrists and nurses have constituted the source and origin of their own transformation--a transformation in which the rationale of the psychiatric hospital has been eroded. The arguments in this paper are substantiated by reference to a current study of the forms of knowledge and daily practice which are drawn upon by nurses and psychiatrists in the psychiatric wards of a large Northern Irish hospital. Key words--psychiatry, de-institutionalisation, hospital, community

The progression of lay perspectives of health and illness are traced, extent of lay expertise; and contribution of lay people toward customer-sensitive health care system is re-examined. Data generated from three different projects related to Alzheimer's disease, traumatic brain injury and rejection of vaccination by older patients, is utilized.

This paper focuses on lay and professional ideas about the nature of chronic fatigue syndrome (CFS), and in particular, the ways in which understandings of the disorder are developed in a clinical setting. Our data are drawn from observations of consultations between sufferers and physicians in a UK medical out-patients clinic. We treat the clinic as a political field. That is to say, as an arena in which `problems' (about the management of illness) are constituted, and alternative approaches and solutions to such problems are pressed. We note that in the realms of symptoms, aetiology and treatment evaluation, lay people in the CFS clinic have quite distinct ideas about what their problems are and how they might be analysed and managed -- ideas that are often in conflict with those of medical professionals. Thus, lay sufferers, for example, operate within a different conceptual terrain from that of many professional experts. They are more likely to refer to a disease (myalgic encephalomyelitis or ME), rather than a syndrome. They call upon different kinds of hypotheses to explain their symptoms. They hold to conflicting ideas about the order of causal sequences, and they give emphasis to different kinds of phenomena in their accounts of illness. As a consequence, clinical consultations can often take on the form of a political contest between physician and patient to define the true and real nature of the patient's disorder -- a micro political struggle in which neurological symptoms can be re-framed as psychiatric symptoms, and psychiatric symptoms as neurological. In short, a contest in which the demarcation lines between mind and body are continually assessed and re-defined, and the tenets of `biomedicine' are constantly challenged. Keywords: Disease; Lay beliefs; Chronic fatigue syndrome; ME; Doctor-patient interaction

This is an interesting and useful little book -- well worth buying for anyone even vaguely interested in recent trends in the sociology of health and illness. It comprises ten [...]