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This happy melding of sociology and psychiatry is the second part of a research project carried out at Yale on the question of whether there are class differences in the development, definition, manifestation,
and treatment of mental disorders. The first part of this work dealing with the prevalence of treated mental illness, types of diagnosed psychiatric disorders, and kinds of psychiatric treatment given as they vary from one social stratum to another is described in Social Class and Mental Illness by Hollingshead and Redlich.1 The epidemiological approach used in this report is here supplemented by intensive case studies on fifty individuals diagnosed as schizophrenic and psychoneurotic from two subgroups of the population of New Haven. One of these was the lowest level of the white-collar category, some twenty-one percent of the total community (Class III) and the other, the lower ranks of the semiskilled and unskilled, eighteen percent of the whole (Class V). All these patients were white and between twenty-two and sixty-six years of age. They were evenly distributed by sex, class, and diagnosis. The ethnic origins, housing, education, marital and family status, religious and community affiliations, leisure activities, and attitudes to life of both social strata are compared.
Using a well-devised and tested technique, the investigators found that in Class III the lack of clarity of the parental roles, the relative maternal dominance and devaluation of the father, the yearning for upward mobility, and dread of loss of parental affection produced stress especially noticeable in the schizophrenic group. The harsh inconsistency of the physical control by both parents, the dread of aloof fathers, the neglect by overworked mothers, and the resentment from sibling competition and delegated control occurred frequently in the etiology of cases from the slum homes of Class V. In both social groups, the withd