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«The Social Control of Childhood Behavior via Criminalization or Medicalization: Why Race Matters DISSERTATION Presented in Partial Fulfillment of the ...»

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Millichamp 2010). While research on the long-term implications of medication during yields inconsistent evidence as to whether drugs are helpful or harmful (Currie, Stabile, and Jones 2014; Rafalovich 2013), these short-term improvements in school performance and impulse control may keep young men out of trouble during adolescence and help them to avoid dropping out before graduating from high school (Barkley 2002; Conrad 1992a; Wright, Jorm, and MacKinnon 2011). Furthermore, because children with behavior disorders may be treated as sick as opposed to bad, some scholars suggest that labeling misbehavior as a medical or psychological problem instead of a criminal offense offers children limited culpability (Conrad 1992a; 2007; Rafalovich 2013). Therefore, while children who are diagnosed with behavior problems may experience some hardships during adolescence and young adulthood, they are likely to escape criminalization and avoid the negative consequences associated with involvement in the criminal justice system. Instead, for these young men, adolescence and young adulthood may be characterized by routine visits to mental health professionals and/or the continued use of psychotropic drugs to control behavior. Rather than criminalization, these young men may experience life-course trajectories characterized by medicalization, in which formal social control of behavior is continually defined in medical terms and managed through the use of medical technology (Conrad 1992b; Conrad 2007).

As the criminal justice and medical systems vie for jurisdiction over problem behavior across the life-course, evidence suggests a layering of beliefs and practices which may influence life-course trajectories (Conrad 1992a; 2007; Medina and McCranie 2011; Zola 1974). However, most research to date on the effects of school punishment or therapy and medication during childhood has focused on short-term outcomes such as school performance or early childbirth (Barkley 1997; Bowditch 1993; Rios 2011).

Furthermore, scholars interested in the life-course implications of child problem behavior have narrowly focused on either punishment or medication individually rather than compare the two approaches (Barkley 1997; Bowditch 1993; Currie, Stabile, and Jones 2014). As a result, we remain unclear about whether and how recent trends in the social construction of child problem behavior contribute to different life-course trajectories of social control. Drawing from labeling theory arguments in criminology and medical sociology, I argue that changing perceptions of crime and individuals with behavior disorders extend to young boys who are either punished or received therapy or medication during childhood, thereby influencing the likelihood that they will follow a given trajectory while avoiding another trajectory.

Labeling Theory and Criminalized/Medicalized Trajectories of Social Control According to labeling theory, the violation of rules and norms carries stigma due to the negative stereotypes associated with certain behaviors (Bernburg 2009; Goffman 1963; Link and Phelan 2001, 2006; Thoits 2011). Individuals are socialized to learn and adopt the rules and norms of expected behavior from other members of their peer group (Bernburg 2009; Link et al. 1989). Since individuals are expected to have learned certain rules by certain ages, violation of these rules is often met with condemnation (Bernburg 2009; Link et al. 1989; Link and Phelan 2001). As a result, social institutions officially label them as deviant, marking them for devaluation and discrimination by other members of the community (Bernburg 2009; Grattet 2011; Link et al. 1989; Paternoster and Iovanni 1989). Since most individuals will violate rules and norms at some point in their life, labeling by key institutions of social control as a result of their behavior can be a major turning point in the life course (Becker 1963; Bernburg 2009; Sampson and Laub 1997, 2005). Being labeled by a formal institution of social control can influence the accumulation of human and social capital and the development of social bonds over time (Lopes et al. 2012; Sampson and Laub 1997; 2005).

In drawing attention to labeling events as important transitions in the life-course, criminologists have drawn heavily from important extensions made to labeling theory in medical sociology. In particular, Link and colleagues provide a modified labeling theory clarifying the mechanisms through which labeling can impact future life events (Link 1987; Link et al. 1989; Link and Phelan 2001; 2010; Lopes et al. 2012). Specifically, they argue that labeling contributes to a process through which negative interactions with social institutions early in life can cut off access to socially accepted means of success later in life, including education and employment (Bernburg 2009; Link et al. 1989; Link and Phelan 2010; Lopes et al. 2012; Paternoster and Iovanni 1989; Sampson and Laub 2005). According to modified labeling theory, labels from important social control institutions encompass and represent community attitudes about crime or mental illness and influence how individuals respond to others labeled as criminal or mentally ill (Link et al. 1989; Link and Phelan 2010). For example, portrayals of deviant behavior in the media and popular culture as dangerous and deserving of suspicion reinforce existing stereotypes about crime or mental illness and influence community expectations about people labeled as criminal or mentally ill (Bernburg 2009; Link et al. 1989; Link and Phelan 2010).





The prevailing societal attitudes and expectations regarding childhood behavior have changed dramatically over the past quarter century. During the late 1980s and early 1990s, images of violent crime in the inner-city schools began filling television sets across the country (Lyons and Drew 2006). These stereotypes of hyper-violent youth continue to evoke significant fear among Americans across the nation, particularly among middle-class, White families (Kupchik 2010; Lyons and Drew 2006). As a result, Americans called for increased law enforcement presence and tougher penalties for those who violate the law (Simon 2007). Policymakers at all levels responded with increased policing and public surveillance and the enactment of severe sentencing measures for violent and non-violent offenders (Simon 2007; Western 2006).

A crime control model permeates nearly all social institutions in the United States, as order and discipline, particularly of children and adolescents, has become a central aspect of social life in the United States (Simon 2007). One example of this transformation is the increased use of exclusionary school punishment in many of the same ways that the legal system uses criminal sentencing to punish offenders. For example, similar to the ways in which severe sentencing for minor legal infractions is intended to deter criminal activity, zero tolerance and compulsory suspensions policies are designed to enforce stricter discipline in schools (P. J. Hirschfield 2008a; Kupchik 2010; Lyons and Drew 2006; Simon 2007). Additionally, much like conviction carries the mark a criminal record, a troublemaker label often follows boys who have been suspended or expelled from school (Ferguson 2001; Pager 2003; Rios 2011).

While the tough on crime approach to controlling deviant behavior intensified over the past twenty-five years, attitudes surrounding mental illness have evolved along a different path. People still remain apprehensive about strangers who exhibit symptoms of mental disorders and avoid adults they know are diagnosed with serious mental disorders (Link and Phelan 2010; Pescosolido 2013; Pescosolido et al. 2007; 2008). However, as information about mental illness became more readily available to individuals, apprehension and distrust of psychiatric and medical diagnoses waned, particularly for less severe behavior disorders such as ADHD (Link and Phelan 2010; Pescosolido 2013).

For example, surveys suggest that Americans are more willing to accept that behavior problems have biological or genetic causes and are not due to moral defects (Link and Phelan 2010; McLeod et al. 2007; Pescosolido 2013). Furthermore, American are increasingly more willing to recommend that people seek out therapy or medication for behaviors similar to those associated with ADHD diagnosis (Pescosolido et al. 2007;

Pescosolido 2013). Notably, many of these behaviors, including inattentiveness, classroom disruption, tardiness and excessive absence, are those that are likely to be punished under the crime control model (Ferguson 2001; Hirschfield 2008a; Simon 2007).

Because different labels convey different perceptions of culpability and threat, they may establish different expectations of future behavior (Bernburg 2009; Link et al.

1989; Paternoster and Iovanni 1989). Consequently, individuals who receive different types of labels are likely to have different experiences when it comes to controlling their behavior problems over the life-course. For example, to be formally labeled as criminal or delinquent suggests to others that a person may have some moral failing and thereby be worthy of distrust and suspicion (Paternoster and Iovanni 1989; Bernburg 2009). On the other hand, as society becomes more accepting of the effectiveness of therapy or medication for less severe behavior problems, labels associated with ADHD or other common disorders may tell others that, so long as an individual is using therapy or medication to control behavior, they pose no real threat to themselves or others (Link et al. 1989; Link and Phelan 2010; Pescosolido 2013; Thoits 2011). These different perceptions and expectations may set the stage for separate trajectories of controlling behavior problems.

Labeling theory argues that early labels can influence individuals’ life-course trajectories in two important ways. First, because of their perceived unpredictability and dangerousness, labeled individuals are excluded from normal social routines and regarded as an “outsiders” (Goffman 1693; Grattet 2011; Link and Phelan 2001; Link et al. 1989; Paternoster and Iovanni 1989). This leads to a loss of status and resources, as excluded individuals are unable to acquire social and human capital at the same level and pace as their peers (Goffman 1963; Link and Phelan 2001; Link et al. 1989; Paternoster and Iovanni 1989; Western 2006). The second way that labeling can impact future life events is through a formal and informal mark as the result of a public display of punishment (Bernburg 2009; Paternoster and Iovanni 1989). Specifically, by publicly branding people as deviant, labels attach negative social stereotypes to individuals and have adverse effects on self-esteem and perceptions of behavior (Link 1987; Link et al.

1989; Rosenfield 1997; Thoits 2011). As a result, labels can result in a self-fulfilling prophecy, as individuals begin to expect less of themselves, particularly with respect to own worth and behavior (Link 1987; Link et al. 1989; Moses 2009; Rosenfield 1997).

While the majority of labeling theory research has focused on the negative implications of labeling, less attention has been paid to the possibility that labels may produce positive short- and long-term results. For example, Link and Phelan (2010) argue that mental health labeling is a “package deal” with both consequences and benefits (Wright, Jorm, and MacKinnon 2011). While individuals labeled with mental disorders are stigmatized because of the diagnosis, they may also reap the benefits of labeling the mental illness as therapy or medication may improve symptoms of problem behavior (Link and Phelan 2010; Wright, Jorm, and MacKinnon 2011). In these cases, interactions with social control agents can be beneficial for well-being, at least in the short-term, by providing therapy or medication and helping to improve self-confidence and control behavior problems (Conrad 1992a; Link and Phelan 2010; Rosenfield 1997; Wright, Jorm, and McKinnon 2011).

Rather than isolating and excluding, labels that associated with therapy or medication can be more inclusive and redeeming (Conrad 1992a; Medina and McCranie 2011; Rosenfield 1997; Triplett and Jarjoura 1994). For example, evidence suggests that certain features of medical therapy or medication are effective in managing symptoms of many common behavior problems. Furthermore, while strangers and casual acquaintances may avoid individuals who display symptoms of severe mental health disorders, therapy or medication may actually strengthen family and close friendship bonds, helping individuals maintain a close and supportive network of understanding friends and family (Perry 2011; Thoits 2005, 2011). As a result, many individuals who receive therapy or medication may receive social and material support needed to combat declining confidence and self-esteem and avoid criminalization (Link et al. 1989; Link and Phelan 2010; Rosenfield 1997).

Because punishment is associated with higher blameworthiness and criminality, children whose misbehavior is punished are more likely to illicit a negative response and less likely to be considered worthy of rehabilitation (Ferguson 2001; Hirschfield 2008a;

Rios 2011). Consequently, punished young men are at a greater risk of following a criminalized trajectory of social control and less likely to follow a medicalized trajectory of social control. On the other hand, because social views regarding the biological or psychological causes of problem behavior has become more accepted and confidence in treatments has increased, children who receive therapy or medication may not experience significant risk of following a criminalized trajectory of social control, instead following a medicalized trajectory of social control. Importantly, because of the substantive racial disparities in school punishment versus therapy and medication, these different ways to socially construct early child problem behavior both reflect and reproduce inequalities in the criminal justice and medical and mental health systems. Specifically, not only do different types of labels contribute to different trajectories of social control, but racial disparities in these different approaches to controlling individual behavior emerge early in the life-course and extend well into adulthood.



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