The Social Labeling Perspective on Illness and Medical Practice

Abstract

Recent research has turned up some rather puzzling findings. For example, in California a child’s “failure” on the school psychologist’s IQ test does not insure a diagnosis of “mental retardation”; in fact, whether a child is diagnosed as mentally retarded and referred to special classes is more closely associated with whether he is Mexican-American or Black than with his score on an IQ test (Mercer 1973). Or, persons who think they have heart disease but in fact do not often alter their lives on the basis of their beliefs about themselves, not on the basis of presence or absence of symptoms (Eichorn and Anderson 1962). The psychiatric patients who feel that they are “back to normal” one month after their first hospitalization are no different, diagnostically, from the “still sick” group; instead, their better clinical outcome can be explained by the greater power certain hospitals give patients to re-negotiate their legal status, treatment plans and diagnoses with hospital staff (Waxier et al. 1979). Whether a hospitalized tuberculosis patient gets well quickly is partly explained by whether he has cooperated with the ward staff; those who cooperate stay sick longer, those who do not cooperate get well more quickly (Calden et al. 1960).