PSYCH 480A - Exam 3
how do affirmation intervention effects persist over time?
through a cycle of adaptive potential, a positive feedback loop between the self-system (e.g., self-perception of adequacy) and social-system (e.g., teachers)
awareness of your own cultural attitudes
"know thyself" -understanding your own feelings and reactions will help you to better understand and relate to others (experiences you've been exposed to changes the way you act/interact with others) -examining own biases, prejudices and stereotypes (i.e., museum of tolerance; against which groups, what type of situation, coping behavior (how do you handle situations where you have to interact with people from other cultures, or do you avoid the situation altogether?)) -cultural competence self-assessments -learn about your own culture (dominant culture may not be aware that they also have culture)
health belief model
(Taylor, 2009) health behavior: -perception of personal health threat -see yourself as vulnerable to developing illness -need to believe that the ways in which you are behaving is an effective way to stay healthy (ex. believe that getting an annual screening is an effective way to maintain good health, more likely to get annual screenings) -effectiveness of health practice (e.g., trust in the health professional diagnosing and treating the individual) -need both factors to get healthy behaviors
European american identity development (helms' model)
(assumed that individuals go through each stage) 1. contact - unaware of racism/prejudice/privilege, lack of experience with people from other backgrounds, may profess to be colorblind ("I don't see color"), believe that European americans are superior while believing racial/culture differences do not matter 2. disintegration - increased contact with people from diverse backgrounds resulting in experiences that contradict their beliefs (realize that racism still exists), may experience guilt/anxiety/helplessness, may try to reduce dissonance by distancing from minority groups, convincing others that minorities are not inferior, etc. (not blaming the victim) 3. reintegration - retreating to the comfort zone (e.g., passively or actively supporting white superiority) to resolve conflicts 4. pseudo-independence - first phase of non racist European american identity, acknowledging racism however believing that it is the racial minorities who should change (not the society, the group that is affected by prejudice needs to change) 5. immersion/emersion - learn more about their own culture, form more positive European american identity, focus on changing European americans 6. autonomy - positive European american identity accomplished, acknowledge their privilege and work to combat discrimination (not just racism but other forms of oppression)
psychological process of "becoming black" (cross' model)
(assumed that individuals go through each stage) 1. pre-encounter stage: view the world as non-black or anti-black, devaluing "blackness" and idealizing "whiteness" (internalizing white superiority), low self-esteem 2. encounter stage: significant event that causes individuals to reevaluate their attitudes about race, realization of racism and discrimination against their own racial group, emotions of anger and guilt may be experienced (ex. assassination of MLK) 3. immersion/emersion stage; reversed attitudes (idealizing "blackness"), withdrawal from the dominant group/culture 4. internalization stage; feeling positive, comfortable, and secure about African american/black identity, allowing them to accept other cultures
interventions to change students' attributions for academic setbacks
1. wilson and linville (1982, 1985) 2. Blackwell et al. (2007)
blanchard et al., 1975
-U.S. Air Force enlisted men as research participants to work cooperatively on a task with either african american or European american confederates -iv #1: partner status (less competent vs. equally competent vs. more competent) -iv #2: success on the task (success vs. failure) -results: no difference in the success condition -however, in the failure condition more prejudice (african american confederate was rated more negatively) in the low status condition (when they are described as being less competent than the other person) than equal or high status conditions (perceived to be equal in terms of competence)
mental health disparities
-according to the american psychiatric association 2017 report: -most people of color overall have similar, or fewer, mental disorders than European americans -however, the consequences of mental illness in people of color may be long-lasting and more severe (e.g., depression: african americans (24.6%), latin americans (9.6%), European americans (34.7%) -may be due to the fact that they are not receiving treatment/proper treatment -mental health problems are common among people in the criminal justice system, which has a disproportionate representation of people of color (particularly african and Latin Americans) (approx. 50-70% of youth in the juvenile justice system meet criteria for a mental health disorder)
causes of health disparities: poverty
-allostatic load: physiological cost of chronic stress (e.g., high blood pressure, increased heart rate, elevated blood sugar and cortisol levels) -difficulty gaining entry into the healthcare system (e.g., lack of medical insurance)
influence of culture on causation and prevalence
-although biological, social, psychological, and cultural factors contribute to mental illness, some factors may have stronger influence depending on the disorder -biological differences are so small that they cannot explain in full the differences that we see -have to look at other factors to understand why certain groups are more likely than others to suffer
restoring self-integrity
-attribute failure to some external factor that can be changed -negative coping strategies (e.g., denial) -positive coping strategies (directly addressing the threat (e.g., studying harder), affirming some other aspect of the self to regain sense of adequacy and competence (e.g., spending time with friends/family, attending religious service)
health behaviors
-behaviors undertaken by people to enhance or maintain their health (e.g., exercising, a balanced diet, good amount of sleep)
dr. David williams (Ted talk)
-blacks expected to live shorter lives than whites (even education doesn't matter, blacks with higher education that whites still predicted to die earlier) -people of color receive a poorer quality care than whites for all kinds of treatment -mistrust can prevent people from reaching out for help -racism causes stress factors that can lead to certain diseases (hypertension, diabetes, etc.) -less likely to see individuals express explicit racism, more likely today that people have unconscious/implicit biases (don't realize that they have them, affects how they perceive other people) -where you live determines your opportunities in America, residential racial segregation (no cities which whites and blacks live equally, leads to racial differences in income, healthcare opportunities, etc.) -reflect implicit bias: unconscious process which you treat someone differently, even the well-intentioned (society portray people in certain ways, may be why people of color are seen as marginalized groups as opposed to individuals themselves - systematic disadvantages towards people of color)
african american identity development
-clark and clark (1947) doll experiment: white and black doll, children choose which one they preferred (identity development, due to prejudice and discrimination that existed children were well aware of societal preference for European americans) -psychological process of "becoming black"
values affirmation interventions in education
-constant stressors of school (e.g., tests, evaluations, peer and teacher-student relations) can threaten the sense of self-integrity -especially for students from negatively stereotyped groups (e.g., african american and latino students; women in STEM)
affirmation intervention (cohen et al., 2006; 2009)
-control group: choose values that they thought were more important to OTHERS -self-affirmation intervention -having issues with ex. academics, can't choose a value that is related to academics -ex. if the focus was on women in STEM, the list would not include anything related to STEM or academic abilities
influence of culture on symptom: culture-bound syndromes
-culture-specific symptoms (only exist in certain cultures) ex. hwa-byung (korean): pain the upper abdomen, fear of death, tiredness resulting from the imbalance between reality and anger ex. ataque de nervios (latino): attacks of crying, trembling, and screaming and verbal/physical aggression (out-of-conscious state resulting from evil spirits)
influence of culture on coping behaviors
-do they seek help? -where do they go? who do they go to for help?
Blackwell et al. (2007)
-growth mindset intervention, theories of intelligence (fixed - entity theory, malleable - incremental theory) -study done on middle school students (their performance tends to go down generally speaking at this stage in life) -focused on changing the mindset that we have about intelligence (fixed vs. malleable - fixed=less likely to be motivated, less likely to try to overcome hardships) -tried to change the fixed mindsets to believe in a more growth mindset -8-week workshop that taught them about how the brain gets stronger as you work your way up to more challenging tasks -control: taught some studying strategies/skills -results: growth mindset condition (abilities can be improved over time); performance improved over time -replicated with various populations and demographics
causes of health disparities: differential treatment
-healthcare providers' lack of cultural knowledge, prejudice, and discrimination affect diagnosis and treatment -schulman et al. (1999): European american physicians more likely to misdiagnose symptoms of heart attack in african american patients at a higher rate than in European american patients with identical symptoms -use of physical restraints in nursing homes higher among Latinx and asian/Pacific Islanders than European americans (USDHHS, 2003) -african americans and Latinx three times more likely than European americans to report receiving lower level of care (Roach, 2003) -cain & Kingston, 2003
influence of culture on the clinicians: bias/stereotyping
-implicit: subtle, subconscious bias -explicit: over expressive bias -clinician bias and stereotyping may lead to misdiagnosis and inappropriate treatment -e.g., study african american clients with depression viewed more negatively by European american clinicians; implicit bias leads to misdiagnosis shown in the study that african americans are more likely to be misdiagnosed by European american clinicians
influence of culture on symptom: meaning
-individuals impart different meanings to illness depending on their culture (asian individuals = shameful; affecting you and family's reputation (may suggest "bad genes")) -cultural meaning affects individuals' coping behaviors; studies show people of color tend to go to the head of the family and priests instead of a physician/professional due to their mistrust
brown et al., 2003
-interaction should be cooperative (contact hypothesis) -examined the effects of contact on prejudice among college athletes playing cooperative (team) sports (e.g., basketball) vs. individual sports (e.g., swimming) -whether cooperative or competitive has an effect -higher score represents less prejudice -team sports: contact you have with others affects level of prejudice (not so much for individual sports) -less prejudice since they are constantly in contact with people from other backgrounds and cultures, have to for the sport/teamwork -support for nature of cooperation has an effect on contact
causes of health disparities: structural barriers
-lack of cultural competence among health professionals (issues such as language barriers) -lack of access and poor quality care for remote rural communities
barriers to care
-lack of insurance, underinsurance -stigma toward mental illness (which is greater among people of color) -lack of diversity among mental health care providers -language barriers -distrust in the health care system
davenport (2016): respondent self-identification by racial background (choice of group categorization stage)
-looked at different biracial college freshmen -3 groups: asian-europeans american, latinx-european american, african-european american -women were more likely to identify as being biracial, men were more likely to choose one racial group over the other (more likely to identify with racial minority) -most likely due to the fact that people perceive biracial women as more attractive/mysterious (not the same perception for men) -biracial men typically perceived as a person of color, internalize this idea and identify with the minority group
o'brien, poat, press, & Saha (2010)
-looked at relationships between patients and caregivers -results: across all cultural groups, patients emphasized the importance of physicians' genuine concern for patients and physicians' competence -people of color more likely to express frustration with physicians invalidating their perspectives (not taking concerns seriously)
influence of culture on symptom: presentation
-many psychological disorders have similar and universally recognizable symptoms, however they may be expressed differently (ex. schizophrenia, bipolar, panic disorders - expressions of symptoms tend to be similar regardless of culture, ex. depression/anxiety - expressions of symptoms vary based on culture (if you are from a culture which is it unacceptable to have depression = people express symptoms in a more acceptable way such as describing physical symptoms including stomachache, headache, etc.) -idioms of distress: ways in which cultures express, experience, and cope with feelings of distress (ex. somatization (using physical un-wellbeing to describe psychological distress); children are not able to understand or express psychological experience because of their limited cognitive/verbal abilities (may express it by not playing with other kids, saying they are not feeling well. etc.)
causes of health disparities
-marginalized groups receive different treatment (race, specifically african americans, and socioeconomic status; greater mortality rates for pregnant women of color) -health belief model contributes to the disparities (believing that you are vulnerable to illness, ex. family history of cancer = more likely to believe this)
a critique of the stage models
-most models assume linear progression through each stage -not all individuals begin with idealization of European americans while denigrating their racial minority identity/culture -may skip certain phases or go through one before the other -all models assumed to be influenced by the process model (initial stage of identity development is valuing the white superiority) -assumes the final stage (achieving pride in their group while integrating into the dominant group) to be the "healthiest," most mature stage that everyone will reach
multicultural identity development
-personal identity stage - identity based on personal factors, not on group membership (Ex. see themselves as an artist, which is independent of cultural or familial identity, etc.) -choice of group categorization stage - pressure to choose one identity (Ex. appear as a certain racial group, others view them in such a way so the individual is more likely to identify with that racial group); davenport (2016) -enmeshment/denial stage - feeling guilty for choosing one group over another -appreciation stage - exploring the other racial identity that was initially ignored (ex. video) -integration stage - realization that embracing both races/ethnicities is beneficial, don't have to choose one over the other
what does value affirmation interventions do?
-reassures one's self-integrity, "frees up mental space/energy", and consequently reduces defensive behaviors (e.g., disparaging others, denial, rumination) -feel more grounded
causes of health disparities: racism
-research suggests health disparities continue to exist among people of color even when controlling for age, education, income, and even health behaviors (Williams & mohammed, 2009) -those with less education, less income = more vulnerable to certain illnesses -even when controlling for these factors, race still contributed
stout et al. (2011)
-role-model study -students exposed to counter-stereotypical role models -increase in STEM interest when seeing non-stereotypical (female) individuals involved in the field
sexual identity development for LGBTQ+ groups (Cass' model)
-similar limitations that are comparative to the racial stage models 1. identity confusion - first awareness of being "different" (Ex. David reimer; liked playing with his brothers toys, initial feeling of not being normal) 2. identity comparison - differences more pronounced, become aware of their feelings about same-sex peers (estimated around adolescence, some may not until adulthood (individual differences)) 3. identity tolerance - fully aware of their same-sex attraction (being in the closet, just a phase) 4. identity acceptance - full acceptance of their sexual orientation, continues to keep their feelings hidden, feelings of hopelessness 5. identity pride - formally "comes out", take pride in their identity, express and celebrate their identity 6. identity synthesis - able to integrate their sexual identity with other identities (e.g., race, being a student, musician), self-acceptance provides internal shield (coping mechanism) against stress, prejudice, and discrimination
cycle of adaptive potential
-social system -self system -adaptive outcomes
self-affirmation theory
-steele, 1988 -people are motivated to maintain global self-integrity (overall sense of self-efficacy) -want to be seen as competent, able to control important outcomes, and effective -threats to self view or concept = psychological distress
values of affirmation interventions among students of color
-students of color benefit the most by value affirmation intervention -newly gained sense of adequacy buffers them against stress -improves performance and reduces achievement faps, even 2 years later (e.g., Cohen et al., 2006; 2009)
students of colors' vigilance to threat cue
-students of color experience chronic threat in school -students of color are more vigilant to cues of threat (Ex. students historically marginalized and stigmatized; situation where they MAY be a target of discrimination = more likely to be actively looking for signs to determine if there is a threat)
understanding others worldviews
1. learning key historical events 2. becoming aware of sociopolitical issues 3. knowing basic values and beliefs (influences decisions and behavior) 4. understanding cultural practices (i.e., holidays, traditions, etc.) 5. knowing the dynamics of racism, discrimination, and stereotyping (empathy; may not fully understand, but they know you are trying to understand their experiences)
wilson and linville (1982, 1985)
-trying to change academic attirbutions/setbacks -struggling freshmen college students -had participants watch videos of interviews done by upperclassmen that talked about their experiences as freshmen (not great at first, got better over time, common theme, etc.) - included unstable external factors (e.g., lack of familiarity) -students tend to internalize academic struggles (ex. get a low grade = attribute that to themselves and their lack of abilities) - stereotypes that exist about there intellectual inferiority -control: also watched videos of upperclassmen interviews, but just spoke of their academic interests -results: students that watched videos that normalized academic struggles = participants performed better and improved over time (also less likely to drop out of college)
Tripartite model of personality identity
-understanding that our self-perceptions are made up of (how our core identity is shaped - how different factors affect it): 1. unique, individual aspects (genetic factors, non shared experiences including family relationships affecting how you value yourself) 2. aspects of groups to which we belong (similarities and differences, ex. race, gender, ethnicity, socioeconomic status, age, etc.) 3. universal aspects of human beings (homosapiens) including ability to use symbols (language), self-awareness (e.g., acknowledgement that we come from different backgrounds), biological and physical similarities (ex. having two eyes, one nose), common life experiences (ex. all start crawling at similar age, develop language around the same age)
influence of culture on the clinicians: communication
-verbal communication is central to the diagnosis and treatment of mental disorders -miscommunication and misunderstanding may arise due to cultural differences (which can then lead to misdiagnosis and mistreatment; worldview, bias, etc. can all impact whether a provider makes a proper diagnosis/treatment plan or not)
values affirmation intervention
-writing about core values (e.g., relationships with friends/family, religion, creativity, kindness) -values relevant to the domain of threat are excluded
how to increase your multicultural competence
1. awareness of your own cultural attitudes 2. understanding others worldviews 3. development of culturally appropriate interpersonal skills
development of culturally appropriate interpersonal skills
1. education and training (this alone = no benefit) 2. experience and practice (interacting with people of diverse cultures; fast friend procedure (uncomfortable activity we did in class) --> can promote positive interracial relationships) 3. travel (go to a country where you are forced to learn a new language (learn values through language acquisition) 4. saying "I don't know" and asking questions 5. speaking up for others, being an ally 6. speaking up for oneself, comfort with difficult dialogues 7. attitude of discovery and courage 8. developing empathy
how culture influences mental health
1. on symptoms; how they are expressed, experienced, what they mean 2. causation and prevalence; some causes of health issues may be more prevalent than others 3. on coping behaviors 4. on clinicians
interventions to mitigate the effects of negative stereotypes
3. Cohen et al. (2006. 2009) 4. stout et al. (2011)
equal status contact (contact hypothesis)
Blanchard et al. (1975)
threatened self-integrity
EXAMPLES: -poor performance on an exam -rejection from graduate school/job opportunities -bad report from the doctor (would feel ineffective, incompetent, and unable to control important outcomes)
cues signaling threat
EXAMPLES: -teacher's negative behavior -poor grades -underrepresentation issues/lack of role models
other benefits of affirmative intervention
in addition to academic outcomes: -greater psychological well-being -healthy eating habits -greater physical
cultural competence
ability to work and be effective with individuals who are of a culture different from yours
health disparities
different rates of health condition or illness that marginalized groups have compared to privileged groups
health care disparities
differential access to health care or treatment by health care providers
the power of small social-psychological interventions
even a brief intervention can have a long-lasting impact
all port's contact hypothesis
intergroup contact hypothesis: mere contact is sufficient for reduction of stereotypes and prejudice (interactions between different groups) -however, all port claimed that "the effect of contact will depend upon the kind of association that occurs, and upon the kinds of persons who are involved" (just knowing a person or people from the outgroup is not enough) -4 optimal conditions: individualized contact, equal status contact, interaction should be cooperative, and support from authorities
Latinx & asian american identity development
other models assume that they all go through each stage (stage models)
marginalized groups
people who are disadvantaged and lacking privilege due to personal characteristics, social group membership, geographic location, health care needs, etc. -ex. people of color, individuals with disabilities, LGBTQ+, low SES group, older population, rural communities
causes of health disparities: mistrust of the health care system
perceived/experienced bias --> negative/emotional stress response --> hypertension, poor mental health, cardiovascular disease
health psychology
study of psychological influences on how people stay healthy, why they become ill, and how they respond when they do get ill -factors that contribute to the development of illness -how people cope, how family members or caregivers are affected -what are some of the causes of disparity?