Medical and social work students' perceptions of deviant conditions and sick role incumbency

Abstract

As part of a social change which has been referred to as the “medicalization of deviance”, perceptions of many deviant behaviors are in transition. Following Freudian thought, the deviant individual is increasingly being viewed as needing psychological help rather than traditional types of punishment. These observations are consistent with the sociological literature which emphasizes common elements between deviant behavior and illness, especially the approach which holds that the key to both illness and deviant behavior is the individual's failure to meet the expectations of social roles and tasks. Most significant in this context is the sick role concept, which can be utilized to help understand shifts in orientation which are reinterpreting deviant behavior as needing the attention of physicians, rather than representatives of the religious and legal systems. In this study the sick role concept is utilized with a sample of English medical and social work students to determine acceptance patterns of legitimate sick role incumbency for three physical, two mental, two addictive and three socially deviant conditions. A hypothesized continuum of legitimate sick role acceptance is supported for the total sample. Medical students are found to exhibit higher sick role acceptance rates than social work students for each of the 10 conditions. Comparison between 1st yr and more advanced students reveals that differences in acceptance rates are not significant, suggesting that orientations are established before entry into programs and that the socialization experiences in medical and social work schools have little effect on perceptions of deviant conditions and sick role incumbency. Extensive ambivalence among sample members is also observed, with a higher ambivalence percentage among social work students, suggesting that medical students are firmer in their judgments relative to sick role incumbency than are social work students. Substantiation of the hypothesis of a continuum of sick role acceptance for the conditions considered in the study has important implications for our understanding of the general sociological approach to illness and deviance. For example, the findings help to understand similarities among a variety of different social behaviors. The approach helps to understand some of the directions of contemporary social change, especially the narrowing of the range of social responses to behaviors which once generated significantly different reactions.