The chronic load carried by minority status, including anti-Muslim prejudice.
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501 to 525 of 599Associations between religion-related factors and breast cancer screening among American Muslims.
American Muslims have low rates of mammography utilization, and research suggests that religious values influence their health-seeking behaviors. We assessed associations between religion-related factors and breast cancer screening in this population. A diverse group of Muslim women were recruited from mosques and Muslim organization sites in Greater Chicago to self-administer a survey incorporating measures of fatalism, religiosity, discrimination, and Islamic modesty. 254 surveys were collected of which 240 met age inclusion criteria (40 years of age or older). Of the 240, 72 respondents were Arab, 71 South Asian, 59 African American, and 38 identified with another ethnicity. 77% of respondents had at least one mammogram in their lifetime, yet 37% had not obtained mammography within the past 2 years. In multivariate models, positive religious coping, and perceived religious discriminat…
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The role of social support in the acculturation and mental health of unaccompanied minor asylum seekers.
There is a lack of knowledge about psychosocial resources that may sustain post-resettlement psychological adjustment among unaccompanied minor asylum-seekers. The aim of this study is to investigate the impact of social support from family abroad and friends on acculturation, discrimination, and mental health among these vulnerable children and youth. Questionnaire data were collected from a population-based multi-ethnic sample involving 895 unaccompanied minors resettled in municipalities in all regions of the country. They met in groups in their local communities. The informants were on average 18.6 years, and had an average length of stay in Norway of 3.5 years. The findings showed that the participants suffered from high levels of ongoing war related intrusive symptoms and depression. Still, at the same time they engaged in adaptation processes that are normative to youth with immig…
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Primary healthcare needs and barriers to care among Calgary's homeless populations.
Background: Despite Canada's universal healthcare system, significant barriers impede individuals experiencing homelessness from accessing health services. Furthermore, there is a paucity in the qualitative literature describing how Canadians experiencing homelessness access health care services. Our objective was to qualitatively explore perceived healthcare needs and barriers among individuals experiencing homelessness in one large Canadian city - Calgary, Alberta.
Methods: We conducted a qualitative descriptive study that included open-ended interviews and focus groups with a variety of stakeholders who are involved in healthcare among Calgary's homeless populations. These included individuals experiencing homelessness (n = 11) as well as employees from several healthcare service providers for those experiencing homelessness (n = 11). Transcripts from these interviews were thematicall…
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Weight Discrimination and Risk of Mortality.
Discrimination based on weight is a stressful social experience linked to declines in physical and mental health. We examined whether this harmful association extends to risk of mortality. Participants in the Health and Retirement Study (HRS; N = 13,692) and the Midlife in the United States Study (MIDUS; N = 5,079) reported on perceived discriminatory experiences and attributed those experiences to a number of personal characteristics, including weight. Weight discrimination was associated with an increase in mortality risk of nearly 60% in both HRS participants (hazard ratio = 1.57, 95% confidence interval = [1.34, 1.84]) and MIDUS participants (hazard ratio = 1.59, 95% confidence interval = [1.09, 2.31]). This increased risk was not accounted for by common physical and psychological risk factors. The association between mortality and weight discrimination was generally stronger than th…
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Neural correlates of experienced moral emotion: an fMRI investigation of emotion in response to prejudice feedback.
Guilt, shame, and embarrassment are quintessential moral emotions with important regulatory functions for the individual and society. Moral emotions are, however, difficult to study with neuroimaging methods because their elicitation is more intricate than that of basic emotions. Here, using functional MRI (fMRI), we employed a novel social prejudice paradigm to examine specific brain regions associated with real-time moral emotion, focusing on guilt and related moral-negative emotions. The paradigm induced intense moral-negative emotion (primarily guilt) in 22 low-prejudice individuals through preprogrammed feedback indicating implicit prejudice against Black and disabled people. fMRI data indicated that this experience of moral-negative emotion was associated with increased activity in anterior paralimbic structures, including the anterior cingulate cortex (ACC) and anterior insula, in…
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Stigma, disclosure, coping, and medication adherence among people living with HIV/AIDS in Northern Tanzania.
This study examines a proposed theoretical model examining the interrelationships between stigma, disclosure, coping, and medication adherence among 158 HIV-infected patients on antiretroviral therapy (ART) in northern Tanzania. Perceived and self-stigma, voluntary and involuntary disclosure, positive and negative coping, and demographics were assessed by trained interviewers, and self-reported adherence was collected during 5 months follow-up. Data were examined using correlation and regression analyses. The analyses showed that perceived stigma is primarily related to involuntary disclosure, whereas self-stigma is related to voluntary disclosure. Religious coping positively relates to acceptance, whereas perceived stigma explains higher levels of denial of HIV status. Lastly, adherence was negatively affected by alcohol use, self-stigma, and denial. We conclude that adherence is predom…
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Implicit bias and its relation to health disparities: a teaching program and survey of medical students.
Background: The varying treatment of different patients by the same physician are referred to as within provider disparities. These differences can contribute to health disparities and are thought to be the result of implicit bias due to unintentional, unconscious assumptions.
Purposes: The purpose is to describe an educational intervention addressing both health disparities and physician implicit bias and the results of a subsequent survey exploring medical students' attitudes and beliefs toward subconscious bias and health disparities.
Methods: A single session within a larger required course was devoted to health disparities and the physician's potential to contribute to health disparities through implicit bias. Following the session the students were anonymously surveyed on their Implicit Association Test (IAT) results, their attitudes and experiences regarding the fairness of the he…
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Moral elevation reduces prejudice against gay men.
Disgust is linked to social evaluation. People with higher disgust sensitivity exhibit more sexual prejudice, and inducing disgust increases sexual prejudice. We tested whether inducing moral elevation, the theoretical opposite of disgust, would reduce sexual prejudice. In four studies (N = 3622), we induced elevation with inspiring videos and then measured sexual prejudice with implicit and explicit measures. Compared to control videos that elicited no particular affective state, we found that elevation reduced implicit and explicit sexual prejudice, albeit very slightly. No effect was observed when the target of social evaluation was changed to race (Black-White). Inducing amusement, another positive emotion, did not significantly affect sexual prejudice. We conclude that elevation weakly but reliably reduces prejudice towards gay men.
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Children's representations of school support for HIV-affected peers in rural Zimbabwe.
Background: HIV has left many African children caring for sick relatives, orphaned or themselves HIV-positive, often facing immense challenges in the absence of significant support from adults. With reductions in development funding, public sector budgetary constraints, and a growing emphasis on the importance of indigenous resources in the HIV response, international policy allocates schools a key role in 'substituting for families' (Ansell, 2008) in supporting child health and well-being. We explore children's own accounts of the challenges facing their HIV-affected peers and the role of schools in providing such support.
Methods: Contextualised within a multi-method study of school support for HIV-affected children in rural Zimbabwe, and regarding children's views as a key resource for child-relevant intervention and policy, 128 school children (10-14) wrote a story about an HIV-affec…
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Cognitive debiasing 2: impediments to and strategies for change.
In a companion paper, we proposed that cognitive debiasing is a skill essential in developing sound clinical reasoning to mitigate the incidence of diagnostic failure. We reviewed the origins of cognitive biases and some proposed mechanisms for how debiasing processes might work. In this paper, we first outline a general schema of how cognitive change occurs and the constraints that may apply. We review a variety of individual factors, many of them biases themselves, which may be impediments to change. We then examine the major strategies that have been developed in the social sciences and in medicine to achieve cognitive and affective debiasing, including the important concept of forcing functions. The abundance and rich variety of approaches that exist in the literature and in individual clinical domains illustrate the difficulties inherent in achieving cognitive change, and also the n…
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Psychological foundations of xenophilia: the role of major personality traits in predicting favorable attitudes toward cross-cultural contact and exploration.
Building on an integration of research findings on intergroup behavior from multiple fields of scientific inquiry (biological and cultural paleoanthropology, social psychology), as well as research on the HEXACO personality framework (e.g., Ashton & Lee, 2007), 3 independent studies (total N = 1,007) were conducted to introduce and test a fresh personality perspective on human xenophilia. Even though the studies focused on different criteria (Study 1: favorable attitudes toward contact with immigrants, Study 2: habitual cross-cultural exploration, Study 3: favorable attitudes toward contact with indigenous people) and employed different operationalizations of major personality traits (the HEXACO Personality Inventory-Revised [HEXACO-PI-R], the 10-item Big Five Inventory [BFI-10]) results were remarkably similar. First, path analyses confirmed that major personality traits were significan…
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Challenges, coping strategies, and unmet needs of families with a child with autism spectrum disorder in Goa, India.
Autism Spectrum Disorders (ASD) are increasingly recognized in developing countries like India. However, little is known about the experiences of parents raising a child with ASD. This study aimed to describe the experiences of families in Goa, India with a view to understanding the unmet needs of families raising a child with ASD. Twenty in-depth interviews and nine focus group discussions were carried out with families of children with ASD and key community stakeholders such as special educators, teachers, and parents of typically developing children. This qualitative data was triangulated to explore the experiences, life impact, and unmet needs of raising a child with ASD. Key findings suggest that raising a child with ASD puts a tremendous strain on families due to competing commitments, often leading to initial social withdrawal with later reintegration into social networks. Second,…
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Huynh VW (2012)MEDLINE-indexed journal, not yet read by usJournal of youth and adolescence90 citations Ethnic microaggressions and the depressive and somatic symptoms of Latino and Asian American adolescents.
Ethnic microaggressions are a form of everyday, interpersonal discrimination that are ambiguous and difficult to recognize as discrimination. This study examined the frequency and impact of microaggressions among Latino (n = 247) and Asian American (n = 113) adolescents (M (age) = 17.18, SD = .75; 57 % girls). Latino adolescents reported more frequent microaggressions that dismiss their realities of discrimination and microaggressions characterized by treatment as a second class citizen than Asian Americans, but similar levels of microaggressions that highlight differences or foreignness. There were no ethnic differences in the extent to which adolescents were bothered by microaggressions. Moreover, even supposedly innocuous forms of discrimination are associated with elevated levels of anxiety, anger, and stress, which may increase feelings of depression and sickness. Microaggressions s…
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Under the radar: how unexamined biases in decision-making processes in clinical interactions can contribute to health care disparities.
Several aspects of social psychological science shed light on how unexamined racial/ethnic biases contribute to health care disparities. Biases are complex but systematic, differing by racial/ethnic group and not limited to love-hate polarities. Group images on the universal social cognitive dimensions of competence and warmth determine the content of each group's overall stereotype, distinct emotional prejudices (pity, envy, disgust, pride), and discriminatory tendencies. These biases are often unconscious and occur despite the best intentions. Such ambivalent and automatic biases can influence medical decisions and interactions, systematically producing discrimination in health care and ultimately disparities in health. Understanding how these processes may contribute to bias in health care can help guide interventions to address racial and ethnic disparities in health.
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Racism, ethnic density and psychological well-being through adolescence: evidence from the Determinants of Adolescent Social Well-Being and Health longitudinal study.
Objective: To investigate the effect of racism, own-group ethnic density, diversity and deprivation on adolescent trajectories in psychological well-being.
Design: Multilevel models were used in longitudinal analysis of psychological well-being (total difficulties score (TDS) from Goodman's Strengths and Difficulties Questionnaire, higher scores correspond to greater difficulties) for 4782 adolescents aged 11-16 years in 51 London (U.K.) schools. Individual level variables included ethnicity, racism, gender, age, migrant generation, socio-economic circumstances, family type and indicators of family interactions (shared activities, perceived parenting). Contextual variables were per cent eligible for free school-meals, neighbourhood deprivation, per cent own-group ethnic density, and ethnic diversity.
Results: Ethnic minorities were more likely to report racism than whites. Ethnic minorit…
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Internalized weight bias in obese patients with binge eating disorder: associations with eating disturbances and psychological functioning.
Objective: Widespread bias against obese individuals may lead to the internalization of weight bias in obese persons. This study examined correlates of internalized weight bias (IWB) in obese patients with binge eating disorder (BED).
Method: One hundred treatment-seeking obese patients with BED were administered with the eating disorders examination interview and questionnaires assessing IWB, fat phobia, depression, and self-esteem.
Results: The mean IWB score in this group of patients with BED was significantly greater than the mean IWB score observed previously in a community sample of overweight adults. IWB was positively associated with eating disorder psychopathology, fat phobia, and depression, and negatively associated with self-esteem. IWB made significant independent contributions to the variance in eating disorder psychopathology even after accounting for fat phobia, depressio…
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HIV-related stigma in African and Afro-Caribbean communities in the Netherlands: manifestations, consequences and coping.
HIV-related stigma in African and Afro-Caribbean diaspora communities in the Netherlands was investigated. Interviews with HIV-positive and HIV-negative community members demonstrated that HIV-related stigma manifests as social distance, physical distance, words and silence. The psychological consequences of HIV-related stigma among those diagnosed with HIV reported were emotional pain, sadness, loneliness, anger, frustration and internalised stigma. The social consequences included decreased social network size, limited social support and social isolation, and resulted from not only enacted stigma but also self-imposed social withdrawal. Also, poor treatment adherence was a health-related consequence. People living with HIV employed both problem-focused and emotion-focused coping strategies to mitigate the negative consequences of stigma. Problem-focused coping strategies included selec…
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When he doesn't mean you: gender-exclusive language as ostracism.
Three studies assessed whether a common cultural practice, namely, the use of gender-exclusive language (e.g., using he to indicate he or she), is experienced as ostracism at the group level by women. Women responded to the use of gender-exclusive language (he) during a mock job interview with a lower sense of belonging, less motivation, and less expected identification with the job compared to others exposed to gender-inclusive (he or she) or gender-neutral ( one) language (Studies 1 and 2). Moreover, the more emotionally disengaged women became over the course of a job interview upon hearing gender-exclusive language, the less motivation and job identification they subsequently reported (Study 3). Together, these studies show that subtle linguistic cues that may seem trivial at face value can signal group-based ostracism and lead members of the ostracized group to self-select out of im…
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Structural barriers to ART adherence in Southern Africa: Challenges and potential ways forward.
Structural barriers to antiretroviral therapy (ART) adherence are economic, institutional, political and cultural factors, that collectively influence the extent to which persons living with HIV follow their medication regimens. We identify three sets of structural barriers to ART adherence that are salient in Southern Africa: poverty-related, institutional, and political and cultural. Examples of poverty-related barriers are competing demands in the context of resource-constrained settings, the lack of transport infrastructure, food insecurity, the role of disability grants and poor social support. Examples of institutional factors are logistical barriers, overburdened health care facilities, limited access to mental health services and difficulties in ensuring adequate counselling. Examples of political and cultural barriers are controversies in the provision of treatment for AIDS, mig…
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The stigma of mental illness in Southern Ghana: attitudes of the urban population and patients' views.
Purpose: Stigma is a frequent accompaniment of mental illness leading to a number of detrimental consequences. Most research into the stigma connected to mental illness was conducted in the developed world. So far, few data exist on countries in sub-Saharan Africa and no data have been published on population attitudes towards mental illness in Ghana. Even less is known about the stigma actually perceived by the mentally ill persons themselves.
Method: A convenience sample of 403 participants (210 men, mean age 32.4±12.3 years) from urban regions in Accra, Cape Coast and Pantang filled in the Community Attitudes towards the Mentally Ill (CAMI) questionnaire. In addition, 105 patients (75 men, mean age 35.9±11.0 years) of Ghana's three psychiatric hospitals (Accra Psychiatry Hospital, Ankaful Hospital, Pantang Hospital) answered the Perceived Stigma and Discrimination Scale.
Results: High…
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Discrimination, perceived social inequity, and mental health among rural-to-urban migrants in China.
Status-based discrimination and inequity have been associated with the process of migration, especially with economics-driven internal migration. However, their association with mental health among economy-driven internal migrants in developing countries is rarely assessed. This study examines discriminatory experiences and perceived social inequity in relation to mental health status among rural-to-urban migrants in China. Cross-sectional data were collected from 1,006 rural-to-urban migrants in 2004-2005 in Beijing, China. Participants reported their perceptions and experiences of being discriminated in daily life in urban destination and perceived social inequity. Mental health was measured using the symptom checklist-90 (SCL-90). Multivariate analyses using general linear model were performed to test the effect of discriminatory experience and perceived social inequity on mental heal…
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Vegaphobia: derogatory discourses of veganism and the reproduction of speciesism in UK national newspapers.
This paper critically examines discourses of veganism in UK national newspapers in 2007. In setting parameters for what can and cannot easily be discussed, dominant discourses also help frame understanding. Discourses relating to veganism are therefore presented as contravening commonsense, because they fall outside readily understood meat-eating discourses. Newspapers tend to discredit veganism through ridicule, or as being difficult or impossible to maintain in practice. Vegans are variously stereotyped as ascetics, faddists, sentimentalists, or in some cases, hostile extremists. The overall effect is of a derogatory portrayal of vegans and veganism that we interpret as 'vegaphobia'. We interpret derogatory discourses of veganism in UK national newspapers as evidence of the cultural reproduction of speciesism, through which veganism is dissociated from its connection with debates conce…
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Development and psychometric properties of the reported and intended behaviour scale (RIBS): a stigma-related behaviour measure.
Background: Although stigma in relation to mental health has been defined as including components of knowledge, attitudes and behaviour, no psychometrically tested instrument to assess behavioural discrimination at the population level has been developed. This paper presents details of the development and psychometric properties of the Reported and Intended Behaviour Scale (RIBS), an instrument based on the Star Social Distance Scale, to assess reported (past and current) and intended (future) behavioural discrimination among the general public against people with mental health problems.
Methods: Three studies were carried out to evaluate psychometric properties of the RIBS (Study 1, n = 92; Study 2, n = 37; Study 3, n = 403). Adults aged 25-45 in socio-economic groups: B, C1 and C2 (middle-income groups) took part in development and testing of the RIBS.
Results: Internal consistency and…
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'It's my inner strength': spirituality, religion and HIV in the lives of young African American men who have sex with men.
Young black men who have sex with men account for 48% of 13-29-year-old HIV-positive men who have sex with men in the USA. It is important to develop an effective HIV prevention approach that is grounded in the context of young men's lives. Towards this goal, we conducted 31 interviews with 18-30-year-old men who have sex with men in the San Francisco-Oakland Bay Area. This paper examines the roles of religion and spirituality in men who have sex with men's lives, which is central in the lives of many African Americans. Six prominent themes emerged: (1) childhood participation in formal religious institutions, (2) the continued importance of spirituality among men who have sex with men, (3) homophobia and stigmatisation in traditional black churches, (4) tension between being a man who has sex with men and being a Christian, (5) religion and spirituality's impact on men's sense of person…
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The relationships between major lifetime discrimination, everyday discrimination, and mental health in three racial and ethnic groups of older adults.
Objectives: To evaluate the relationships between perceived exposure to major lifetime discrimination, everyday discrimination, and mental health in three racial/ethnic groups of older adults.
Design: The Health and Retirement Study is a nationally representative sample of individuals 50 years and older living in the United States. A total of 6455 Whites, 716 Latinos, and 1214 Blacks were eligible to complete a self-report psychosocial questionnaire in the year 2006.
Results: Whereas 30% of the general population reported at least one type of major lifetime discrimination, almost 45% of Black older adults reported such discrimination. Relative to the other two racial/ethnic groups (82% Whites, 82.6% Blacks), Latinos were significantly less likely to report any everyday discrimination (64.2%), whereas Blacks reported the greatest frequency of everyday discrimination. Whites reported the h…
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