Synthesis in sociological theory

The idea of synthesising theory is receiving attention within public health as part of a drive to design theoretically informed interventions. Theory synthesis is not a new idea, however, having been debated by sociologists for several decades. We consider the various methodological approaches to theory synthesis and test the feasibility of one such approach by synthesising a small number of sociological theories relevant to health related risk-taking. The synthesis consisted of three stages: (i) synthesis preparation, wherein parts of relevant theories were extracted and summarised; (ii) synthesis which involved comparing theories for points of convergence and divergence and bringing together those points that converge; and (iii) synthesis refinement whereby the synthesis was interrogated for further theoretical insights. Our synthesis suggests that serious and sustained risk-taking is associated with social isolation, liminality and a person's position in relation to the dominant social group. We reflect upon the methodological and philosophical issues raised by the practice of theory synthesis, concluding that it has the potential to reinvigorate theory and make it more robust and accessible for practical application. The notion of taking a systematic approach to the synthesis of theory predates the current public health interest, however, and has been a subject of discussion within sociology since at least the 1980s, where it is commonly referred to as ‘metatheorising’. Ritzer (1990) notes that a systematic approach allows a deeper comprehension of theories as well as the possibility of evaluating, critically analysing and improving them. He suggests that metatheorizing would benefit sociology by generating new theories, better understood theories, and overarching perspectives. Confusingly, however, Ritzer outlines a very wide-ranging approach to metatheoretical activity, including within its purview three different tasks: First, metatheorizing to attain a deeper understanding of theory, which he refers to as Mu. This is the identification of major cognitive paradigms within sociology and the study of theories, theorists, communities of theorists and the larger intellectual and social contexts of theories. Second, metatheorizing as a prelude to theory development (Mp), which entails the study of existing theory to produce new sociological theory. Third, Mo, which is the practice of studying theory in order to produce a metatheory that overarches some part (or all) of sociological theory.

Synthesis preparation

Synthesis preparation involves extracting those parts of the theories that we are concerned with and attempting to clarify and summarise those parts. The presentation of each of the theories that follows has entailed this process of extracting, clarifying and summarising.

1.Societal integration

If suicide can be regarded as an extreme form of risk-taking then Durkheim (1952) perhaps provides the first sociological theory of risk-taking. Durkheim proposed that there were three types of suicide: egoistic, altruistic and anomic, the first of which concerns us here. (Fatalistic suicide, which is sometimes considered a fourth type, is mentioned only once in a footnote.) ‘When society is strongly integrated’, wrote Durkheim, ‘it holds individuals under its control, considers them at its service and thus forbids them to dispose wilfully of themselves.’ (1952: 209) Durkheim suggested that Catholics had a lower suicide rate than Protestants because their religious community was more strongly integrated and cohesive. He concluded: ‘ … suicide varies inversely with the degree of integration of the social groups of which the individual forms a part.’ (1952: 209) In the case of egoistic suicide ‘ … the bond attaching man to life relaxes because that attaching him to society is itself slack.’ (1952: 214–215) For Durkheim then, egoistic suicide was a result of low levels of societal integration and cohesion.

 2.The deviant career

Becker (1963), partly on the basis of research with marijuana users, developed a theory to explain how deviance may become a way of life for some people. He suggested that for a person to progress from casual experimentation to a more sustained pattern of deviance, one of the most crucial steps is the experience of being caught and publicly labelled as deviant, since this brings about a drastic change in identity. That person is now assumed to be generally lawless and deviant in other respects and is cut off from participation in more conventional groups, perhaps becoming unemployed and drifting into marginal occupations. Becker suggests that unless the person quickly returns to the conventional community, they will continue down a path of ever increasing deviance and will be less and less subject to the impact of convention. The last step in the deviant's career is to become a member of an organised deviant group. Members of deviant groups feel a sense of common fate, Becker contends, since they are all in the same boat and face similar problems. Thus a deviant subculture grows, with a set of world views and self-justifying rationales for neutralising conventional norms. The person learns how to carry on the deviant behaviour with ease because all the problems of avoiding trouble have already been worked out and there is a stock of lore which the new member learns. Thus, suggests Becker, a person who enters an organised deviant group is highly likely to continue on that path.

3. The architecture of social groups

Lightfoot (1997), who developed her theory on the basis of research with teenagers, identifies two primary clusters of risk. One is a cluster of mildly mischievous, exploratory or transitional risk-taking (e.g. experimenting with alcohol), which she regards as ‘normative’. The other is a cluster of health-compromising, destructive or pathogenic behaviours (e.g. crack cocaine addiction), which she notes are legally and culturally sanctioned as ‘deviant’. Lightfoot found that it was rare for individuals to engage in both risk clusters. She describes the latter, more serious type of risk taking as ‘marginal risk behaviour’. Her theory is that the marginality of risk coheres with the marginality of groups, i.e. those engaged in the more serious, marginal risk behaviours also belong to more marginal and isolated groups. In her view marginal risk patterns do not so much cause social isolation as manifest it. Lightfoot proposes that cohesion and permeability are key features to be considered. In her study, the one group characterised by a major involvement in marginal risk behaviours was also the only group with both a high degree of internal cohesion and a low degree of permeability to the wider social network. This group was more private about its risk taking and was also disengaged from the larger teenage community. By contrast, the group most active with respect to normative risk-taking was also internally cohesive but its boundaries were much more permeable and there was frequent contact with wider social networks.

4.Cultural theory’ of risk-taking

Douglas and Calvez (1990) argue that the self is risk-taking or risk-averse according to a predictable pattern of dealings between the person and others in the community. Their theory is that the ongoing dialogue about how to achieve the ideal community engages four different kinds of culture, each of which has a different attitude towards the self, risk-taking and the knowledge professions: 1. The ‘central community’ holds strong views on the correct norms of behaviour, is hierarchical and has developed consensus for dealing with the boundary against the outside. The authority of the established professions is accepted. The centre community is very risk-averse; when faced with a threat it will aim to consolidate the community and exclude all outsiders and repress all deviants. 2. The ‘dissenting enclaves’ protest against the central community which has rejected their principles. These enclaves espouse equality, reject the knowledge base and authority of the central community and suspect professionals. They may deride the culture of safety. 3. The ‘entrepreneurial individualists’ are highly idiosyncratic regarding health and diet but are generally risk-takers. 4. The ‘isolates’ find their activities and autonomy restricted by the other cultural types. They tend to be eccentric, which reinforces their isolation. Being isolated there is no one to challenge their ideas; they are loners who expect conspiracy and reject interference. Isolates are idiosyncratic or fatalistic in their attitude to risk. Many are explicit risk-takers in that they may be drug users and/or prostitutes. Each of the four cultures has a relationship with the centre community except for the isolates (of particular interest to this synthesis), whom the centre community expels to its margins.

5.Social resistance

The thrust of Factor et al.'s (2011) theory is that non-dominant minority groups (NDMGs) tend to have greater involvement in high-risk behaviours (e.g. smoking, alcohol and drug use, poor diet, low exercise) and that these behaviours represent a form of resistance, whether conscious or unconscious, to the dominant group. The authors argue that discrimination may result in NDMGs feeling a degree of alienation from, and low attachment to, the larger society. By engaging in high-risk behaviours NDMGs are able to express their defiance of the dominant group and signal the limits of its power. Since large-scale opportunities for public resistance are few, everyday acts of resistance are more common and may act as a safety valve, enabling NDMGs to express their dissatisfaction with their status while avoiding direct negative consequences. Furthermore, argue Factor et al., NDMGs may develop a collective identity in opposition to the dominant group and may feel pressure to resist the attitudes and behaviours of the dominant group. So if healthy behaviours are associated with the dominant group, NDMGs may engage in them at the risk of hostility from their peers. The authors suggest that the power relations within society encourage members of NDMGs to actively engage in every day resistance activities which may include unhealthy behaviours.

Synthesis

The process of conducting a synthesis involves ‘immersion’ in the theories, allowing an opportunity to explore their meanings and possibilities in greater depth. In its careful, step by step approach it is similar to some of the activities undertaken in qualitative synthesis, particularly the process of reciprocal translation (Noblit and Hare, 1988), in which concepts are systematically compared and translated into one another. However, it is not exactly like this, since theories are broader in scope, less detailed and more abstract than qualitative findings.

Comparison of theories for points of convergence and divergence

The theories were compared with each other and points of convergence and divergence were noted (Table 2). To enable this comparison, the theories were broken down into simple propositions and rendered abstract. For example, a proposition belonging to Becker's theory is: ‘Sustained deviant behaviour is more likely if a person is excluded from society

Synthesis refinement

The ‘synthesis refinement’ stage is similar to the final stages of qualitative synthesis in which the aim is to generate a novel interpretation or conceptual advancement (Pound et al., 2005, Campbell et al., 2011). Within meta-ethnography this is sometimes called a ‘lines of argument’ synthesis (Noblit and Hare, 1988) or a ‘third-order interpretation’ (Britten et al., 2002). In the same way, theory synthesis has the potential to generate an end product greater than the sum of its parts.

We reviewed the synthesis to consider whether any further theoretical insights might be gained. We began by illustrating the causal processes suggested by the theories so far, as Turner (1990) advises, and try to bring together this next level of interpretation (Fig. 2). It is only if less serious risk-takers are labelled as deviant and/or join a marginal group that they become increasingly cut off from mainstream society and engage in serious or sustained risk-taking. This serious or sustained risk-taking is likely to reinforce the label of deviance and lead to an increasing spiral of isolation and serious risk-taking. Reintegration into mainstream society would appear to become increasingly more difficult and unlikely for those engaged in serious or sustained risk-taking. Similarly, the greater the degree of separation from mainstream society, the greater would seem the potential for serious and persistent risk-taking. Those engaged in less serious risk-taking, however, may be able to re-enter mainstream society fairly easily, perhaps as they move from childhood to adulthood, or gain status through employment. Those who gain in power have fewer reasons for resisting the dominant group, or indeed may become members of the dominant group themselves. It seems possible that reintegration into mainstream society would decrease the likelihood of engaging in serious or persistent risk-taking.