Alternative conceptions of class and status and symptoms of psychological distress.

One of the most widely reported generalizations in medical sociology and psychiatric epidemiology links social class with mental illness and psychological distress. Using national survey data, this paper compares the ability of measures of social status and class that reflect functionalist, conflict, and Marxist approaches to explain variation in a 26-item scale of symptoms and psychological distress. The measures are found to be somewhat independent of one another. Although the functionalist conceptualization of status is used in almost all research in this area, the authors' findings indicate that Marxist and conflict conceptualizations are equally useful in explaining the variability in psychological distress. These findings should imply greater attention to theoretical perspectives such as Marxism and conflict theory by social epidemiologists and medical sociologists than has been current practice. Of equal importance, it also was found that no measure, including the functionalist measure of occupational prestige, explains more than a few percentage points of the variation in the symptoms measure. Possible explanations for this are discussed, including sample characteristics, measurement issues, and the possibility of a dissociation between social class and mental illness in the United States over the past few decades.