Social Breakdown Syndrome Research Articles

Diogenes syndrome in patients suffering from dementia

Diogenes syndrome (DS) is a behavioral disorder of the elderly. Symptoms include living in extreme squalor, a neglected physical state, and unhygienic conditions. This is accompanied by a self-imposed isolation, the refusal of external help, and a tendency to accumulate unusual objects. To explore the phenomenon of DS in dementia we searched for the terms: "Diogenes syndrome, self-neglect, dementia. " It has long been understood that individuals with dementia often become shut-ins, living in squalor, in the Eastern Baltimore study, dementia was present in 15% of the elderly cases with moderate and severe social breakdown syndrome; twice as many as in the general population of the same age group. Researchers have underlined the frequent presence of DS (36%) in frontotemporal dementia (FTD): different neuropsychological modifications in FTD may contribute to symptoms of DS. The initial treatment should be a behavioral program, but there is not sufficient information regarding pharmacological treatment of the syndrome.

Aging and the course of desire

The desire to make a difference in the world, to receive the esteem and approval of others, and to be attractive to others for the person one is, is a basic human longing. The fate of such desire over the course of life is a subject that has largely been relegated to studies of changing patterns of sexual activity with advancing age. The broader topic of the human desire to remain actively engaged in the world has yet to be fully developed and incorporated within sociological theories of aging. We know little of the variables that affect the workings of desire and the circumstances under which desire is more or less likely to be manifest. Due to its reluctance to bridge the disciplinary boundaries that separate structural and social psychological approaches to theorizing age, sociologists of aging and the life course have rarely considered the ways in which human desire for recognition, love, and influence affect behavior at various points in the life course. In this paper, I address the problem of the social breakdown syndrome that is thought to bring about an atrophy in the skills and talents of those in old age. With concepts drawn from the dramaturgical literature in sociology, I argue that those who continue to benefit from the emotional energy that derives from satisfying and productive social interactions will age in ways that cannot be explained by existing sociological theories of aging.

Restorying Older Adults’ Narratives About Self and Substance Abuse

Substance abuse affects millions of adults each year, of whom one in five are older adults. Given pervasive stereotypes about later life and the ways in which older persons internalize such messages, dealing with and using previous work on substance abuse, the social breakdown syndrome, and narrative therapy, we describe the importance of and ways for marriage and family therapists to work with older persons facing the compounding experiences of ageism and substance abuse. The purpose of this study was to: 1) identify the prevalence of substance abuse among those 65 and older; 2) document and emphasize the unique challenges of addressing this issue among those 65 and older; and 3) provide an application of the narrative approach to working with older persons presenting with substance abuse.

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Clash or Meeting Between East and West: An Analysis of the Post-9/11 Challenges.

This article adopts a macrocultural approach to understanding complex current global tensions and the way they may account for recent acts of terrorism. It proposes that the recent conflict between the West and radical militant Islam can be understood as the polarization of 2 partial perspectives on social justice-the secular democratic individualistic Western worldview and the spiritual and collectivist Middle Eastern worldview-that need to inform one another. I examine this polarization in the context of the following systemic aspects of current globalization: the twin processes of global integration and social disintegration as reflected in the Social Breakdown Syndrome, the deepening gap between the Global North and the Global South, and the unsustainable ideologization of the 20th century. The article suggests that the East-West conflict reflects the fragmented nature of contemporary individual and collective consciousness. It proposes the need for an integrative psychological approach to cultivating...

Using the Therapeutic Relationship to Promote an Internal Locus of Control in Elderly Mental Health Clients

Seniors who feel powerless to effect change on their environment or who feel that their lives are controlled by external circumstances are said to have an external locus of control. This may adversely affect commitment to and participation in mental health treatment. This article presents the conce t of using the therapeutic relationship to encourage internal contro f' beliefs in elderly mental health clients, with the goal of promoting personal empowerment and improving the efficacy of therapy. Included is a review of litera- ture relevant to aging and locus of control. The develoament of an external locus of conbol is explained by the theories of self psychol- ogy and the social breakdown syndrome.

The Relationship Between the Friendships of Nursing Home Residents and their Morale

This inquiry draws on two bodies of literature: literature concerning the nature of the life of nursing home residents and that concerning the standardized testing of morale. There is a long history of literature concerning the structure of the nursing home. Goffman (1961) first introduced the idea of the According to Goffman, to facilitate the care of nursing home residents staff force residents into a conformity. Bennett (1964) concurs with Goffman and further claims that nursing home residents often defend staff expectations of them and socially rejected residents who do not conform. Gubrium (1975) notes that he also observed evidence of forced conformity as described by Goffman and Bennett in his study of a nursing home called Murray Manor. Gruenberg (1967) concludes that nursing homes promote institutional behavior patterns characterized by apathy, loss of interest, and submissiveness, and refers to these behavior patterns as a social breakdown syndrome. Schmidt (1981-82) presents an interesting variation of Goffman's total institution. In Schmidt's total institution, residents used manipulation in their relationships with other residents and staff. Schmidt concludes that nursing home survivors depend on the use of inducements or coercion to garner peer support or staff service. Sigman (1985-86) introduces another example of this total institution, presenting an in-depth description of a nursing home in which the administration overtly enforced expectations of conformity which were quite rigid. Many conflicting ideas have been offered about what pattern of friendship is most meaningful and beneficial to nursing home residents. Gubrium observes that when inter-resident friendships were destroyed,

Social Breakdown Syndrome in Schizophrenia: Treatment Implications

Social Breakdown Syndrome in Schizophrenia: Treatment Implications

The Social Breakdown syndrome in the elderly population living in the community: the Helping Study.

A representative sample of elderly people residing in the community was examined to establish their psychiatric status. An interview with a close friend or relative, focusing on a one-week period in 1981, was used to investigate each subject's functional limitations and troublesome behaviour, these being the two components of the Social Breakdown Syndrome. The data from the sample were weighted to allow estimates of the characteristics of the general population. No cases of SBS at its most extreme were identified, and almost the entire population was found to be functioning at an adequate or near-adequate level: all cases of severe SBS were attributable to troublesome behaviour. Severe SBS was shown to increase with age and to be most common in non-white males. Persons with dementing disorders were more likely than their non-demented counterparts to show severe/moderate SBS, but in the majority of cases of SBS there was no mental disorder.

The Interface of Activity and Psychopharmacologica1 Agents

Older age psychiatric patients are not often viewed as part of the life span developmental process. They are treated conservatively and "educated" to reduce active life styles. A social breakdown syndrome often results. This article argues that better care among the elderly psychiatric patients often involves both psychopharmacologica1 and psychosocial interventions. Commonly, the latter suffers at the hands of the former. This is due largely to myths, staff bias or prepotent staff management needs, as well as poor care in general. The goal of older age psychiatric care could be autonomy and independence even among frail psychiatric elders. On this behalf, a simple schema of psychopharmacologic agents and side effects, five psychopharmacologic and psychosocial principles, and a "Treatment Autonomy Schema," are offered.

Understanding cohort differences in cross-generational, self, and peer perceptions.

Thirty adolescent, middle-aged, and elderly people participated in a study exploring (a) their self-, inter- and intra-cohort perceptions; (b) ascribed social distance; (c) knowledge of aging; and (d) the relationships among these phenomena. Data were gathered using a Social Distance Scale, Goals of Life Index, Facts on Aging Quiz, and Aging Semantic Differentials. In general, elderly adults were the most devalued and middle-aged adults the most favored cohort. Unfavorable attitudes toward elderly people were predicted more by age-related social distance and societally induced biases than differential investments in psychosocial life tasks. Appraising one's member cohort more favorably than those outside it was paralleled by a tendency to view the self more favorably than peers. The discrepancy between societal and older individuals' views of aging suggests that the social breakdown syndrome itself may be breaking down: Older adults are moving away from a characterization of themselves as ineffective and dependent. A similar view might be engendered in younger cohorts if social distance were reduced and more attention paid to assertions of elderly adults rather than to societally induced stereotypes.

An analytical model for explaining the retirement process

Abstract Although literature in social gerontology offers much material on retirement there is a severe lack of theoretical frameworks to explain this process and to guide research along systematic and efficient lines. The analytical model proposed in this article makes no pretence to cover all possibilities regarding the retirement process but should be interpreted as a further step in theory building, and which may help to sharpen future research designs. As point of departure, use is made of Zusman's (1966) cyclical model of the ‘Social Breakdown Syndrome’ (SBS) in which he demonstrates how the individual's sense of self, ability to mediate between self and SOCiety, and failure to achieve personal mastery results in a process of self-labelling as incompetent. By applying this model to the aged, the present argument suggests how the vicious circle of the social breakdown syndrome may be broken, which then eventually leads to individual self-labelling as competent.

Psychiatric Drugs: Hazards to the Brain

The central thesis of this polemical exposure of psychopharmacology is that the seeming illnesses of psychiatric patients are only manifestations of a social breakdown syndrome, and that treatment is a thinly disguised effort on the part of psychiatrists to bring patients under control by disrupting brain function and disabling their minds. In support of this radical point of view, Dr Breggin extensively reviews the toxicity of various psychotropic drugs and argues that whatever claims are made for the specific efficacy of one or the other agent, their main effect is to sedate and confuse patients so that they become tractable either in institutions or in frustrating, deprived home or community settings. The strongest part of Breggin's argument, and the one to which he devotes most of the book, is his review of the effects of the phenothiazines. He believes that they produce a chemical lobotomy and suggests that there may

Mission to Britain

(1982). Mission to Britain. International Journal of Mental Health: Vol. 11, International Perspectives on Deinstitutionalization, pp. 24-47.

Mapping urban hotels: life space of the chronic mental patient.

ABSTRACT Large numbers of patients with severe mental illnesses and skill deficits associated with long-term institutionalization are being discharged into communities that often are unprepared to care for them. Although benevolent in intent, the legislation enabling deinstitutionalization lacks explicitly stated provisions to establish adequate living arrangements for this new population. The housing shortage has led to ad hoc solutions such as the use of singleroom-occupancy hotels as unofficial halfway houses. Urban hotels having financial problems or located in poor neighborhoods often have welcomed chronic mental patients or their welfare checks) as residents. This paper is a beginning effort by community-based practitioners to describe the deprived, yet often complex, life space of ex-patients living in urban hotels. Beginning over 15 years ago, under the aegis of the community mental health movement, large numbers of patients with severe mental illnesses have been discharged from state hospitals into community living. Many authorities now are beginning to question whether or not this deinstitutionalization, as it currently is being practiced, represents the best possible service for the patients (Bassuk & Gerson, 1978). There is an increasing awareness of the problems associated with the indiscriminate, largescale discharge of chronic psychiatric patients into communities that are unprepared to provide the multitude of services necessary to ensure an adequate quality of life. These patients often are suffering more from "social breakdown syndrome" associated with long periods of skill-depriving institutionalization than from the illness for which they originally were hospitalized. The genesis of this large scale deinstitutionalization is complex (Gruenberg, 1974). The discovery and widespread use of powerful psychotropic drugs is one factor. Another factor is increased sensitivity to preventing the deterioration of the patient's real-life skills associated with institutionalization. Additionally, there is a policy shift by state governments toward reducing state hospital populations both as a better way of treating patients and as an effort to deal with fiscal crises brought on by excessive government spending. Concern with patients' civil rights also has been a factor. Initial motivations notwithstanding, mental health agencies of all types now are being accused of premature discharge and poor care of patients ill prepared to manage for themselves. These accusations are coming from the lay public as well as the professional community and the government. The New York Times (Koenig, 1978, p. 14) reported that "Some 40,000 poor, chronic mental patients have been dumped in New York City. Neighborhoods feel threatened but the mentally ill are the greatest victims." The General Accounting Office of the U.S. government studied the adjustment of discharged patients and states that many patients are being released to community facilities totally inadequate for their care (U.S. Comptroller General, 1977). Critics from the professional community confirm the phenomenon. Bassuk and Gerson (1978, p. 46) conclude that "chronic patients are being discharged to a lonely existence in hostile communities without care." The prestigious multidisciplinary staff of the

Geriatric sexuality breakdown syndrome.

This paper focuses on the relationship between the social environment and the older individual. By utilizing the Social Breakdown Syndrome [1, 2] as a basis for examining this relationship, the author has proposed a cycle of events, the Geriatric Sexuality Breakdown Syndrome, in which an older individual is initially predisposed to diminished sexual activity to the end point of self-identification as non-sexual. Suggestions for interrupting this breakdown syndrome are given.

Life Changes, Leisure Activities, and Well-Being among Very Old Men and Women

Life changes may precipitate a social breakdown syndrome among the aged in which persons eventually accept a label as incompetent and define themselves as sick or inadequate. But involvement in leisure activities may intervene in the cycle and promote reconstruction. Data are analyzed from interviews with 214 men and 354 women, 72 years of age or older, to examine: (a) the influence of life changes on involvement in leisure activities; (b) the impact of involvement on psychological well-being; (3) sex differences in the impact of leisure activities of the aged. Life changes do not seem to trigger withdrawal from most leisure activities. But leiwre involvement in old age is somewhat sex-linked and participation differentially influences the well-being of men and women. Implications for practitioners are explored.

Do Nurses Have the Power to Cause, Prevent, and Cure "Social Breakdown Syndrome"?

Do Nurses Have the Power to Cause, Prevent, and Cure "Social Breakdown Syndrome"?

The Modification of Schizophrenic Behavior

The literature on treatment of schizophrenic behavior through operant conditioning, token economy, systematic desensitization, and social skills training was reviewed. Results from these studies indicate that operant procedures (particularly token economy) and skills training techniques are useful in altering some of the behaviors characterizing schizophrenia-most notably the regressed functioning associated with the "social breakdown syndrome," and components of appropriate social interaction. However, generalization and maintenance of appropriate behaviors after the patient has left the treatment program are more problematic. Equivocal results obtained with operant treatments of vocal psychotic symptoms suggested the need for a more complex analysis of the factors which contribute to hallucinations and delusions, and perhaps increased exploration of the utility of cognitive-behavioral approaches. The practical and ethical issues raised by procedures which include punishment of violent behavior are discussed.

Presidential Address-1976. Social support as a moderator of life stress.

Social support is defined as information leading the subject to believe that he is cared for and loved, esteemed, and a member of a network of mutual obligations. The evidence that supportive interactions among people are protective against the health consequences of life stress is reviewed. It appears that social support can protect people in crisis from a wide variety of pathological states: from low birth weight to death, from arthritis through tuberculosis to depression, alcoholism, and the social breakdown syndrome. Furthermore, social support may reduce the amount of medication required, accelerate recovery, and facilitate compliance with prescribed medical regimens.