Psychological stigma costs as barriers to healthcare use in former soldiers of the German Armed Forces: A qualitative analysis

Individuals decide to use healthcare when the expected benefits outweigh the perceived costs. One of these cost factors in this decision can be stigma. So far, it has not been researched how former soldiers of the German Armed Forces with a service-induced mental illness perceive stigma and how it influences their healthcare use. As stigma is shaped by the socio-cultural context, the setting of the potential healthcare use must be considered. Narrative interviews were conducted with 33 former soldiers with mental health problems. The data were analyzed using a thematic analysis approach, in which codes were formed and emerging themes were systemized. The relationship between stigma and healthcare use was analyzed. Occupational discrimination and social exclusion were experienced in both in the military and civilian context, but stigma functioned differently in each context. In the military context, former soldiers’ self-stigma of mentally ill individuals being weak was in stark contrast to their internalized military standards. This contrast let them avoid disclosure and subsequent healthcare use. In civilian context, the participants perceived 2 different stigma costs: mental illness stigma and former soldier stigma (i.e., stigmatization because of their military past). Both were perceived as barriers to healthcare use. A model, illustrating these different stigma costs in the different contexts, was developed. Further research on the link between stigma and healthcare use of this group is urgently needed.     

Gender of the expresser moderates the effect of emotional faces on the startle reflex

It has been suggested that the impact of emotional expressions on the startle reflex is influenced by the intention communicated by the expression (e.g., the intention to attack). However, we propose that the meaning of an emotional expression is not only based on the intention, but is also influenced by characteristics of the expresser such as gender: since men are typically seen as more dominant than women, anger expressed by men should be perceived as particularly threatening, thus amplifying the startle response. We compared the influence of anger, fear and neutral expressions shown by men and women on the startle reaction. Startle reactions were measured using electromyography. As predicted, we found stronger startle reactions after the presentation of anger expressed by men compared to fearful and neutral expressions shown by men. For female expressers, the startle response was not affected by expression type.     

Popular or unpopular? Therapists' use of structured interviews and their estimation of patient acceptance

An accurate diagnosis is an important precondition for effective psychotherapeutic treatment. The use of structured interviews provides the gold standard for reliable diagnosis. Suppiger et al. (2009) showed that structured interviews have a high acceptance among patients. On a scale from 0 (not at all satisfied) to 100 (totally satisfied) patients rated overall satisfaction with a structured interview at M = 86.55. Nevertheless, therapists rarely seem to use structured interviews in clinical practice. The aim of this study was to assess how frequently therapists use structured interviews in daily practice. Secondly, we hypothesized that therapists underestimate patient acceptance of structured interviews. As a third goal, we explored further reasons why therapists choose not to use structured interviews. We conducted an online survey of 1,927 psychiatrists and psychotherapists in Switzerland and asked them how frequently they used structured interviews and how they estimated patient satisfaction with these interviews. Furthermore, we asked therapists why they chose to use or not use structured interviews. Therapists reported using structured interviews on average with about 15% of their patients. Furthermore, therapists estimated significantly lower patient acceptance than patients themselves indicated (M_therapist = 49.41, M_patient = 86.55). Our data suggest lack of familiarity with these instruments as well as an overestimation of the utility of open clinical interviews as further reasons for not using structured interviews.     

Adaptation to novel accents: feature-based learning of context-sensitive phonological regularities

This paper examines whether adults can adapt to novel accents of their native language that contain unfamiliar context-dependent phonological alternations. In two experiments, French participants listen to short stories read in accented speech. Their knowledge of the accents is then tested in a forced-choice identification task. In Experiment 1, two groups of listeners are exposed to newly created French accents in which certain vowels harmonize or disharmonize, respectively, to the rounding of the preceding vowel. Despite the cross-linguistic predominance of vowel harmony over disharmony, the two groups adapt equally well to both accents, suggesting that this typological difference is not reflected in perceptual learning. Experiment 2 further explores the mechanism underlying this type of phonological learning. Participants are exposed to an accent in which some vowels harmonize and others disharmonize, yielding an increased featural complexity. They adapt less well to this regularity, showing that adaptation to novel accents involves feature-based inferences.     

How Sexy are Sexist Men? Women’s Perception of Male Response Profiles in the Ambivalent Sexism Inventory

In Studies 1 to 3, German female students (total N?=?326) rated the likability and typicality of male targets: a nonsexist, a benevolent sexist, a hostile sexist, and (in Studies 2 and 3) an ambivalent sexist. When targets were presented as response profiles in the Ambivalent Sexism Inventory (Glick and Fiske 1996) (Studies 2 and 3), the benevolent sexist was rated to be most likable but least typical, whereas the ambivalent sexist was rated to be highly typical. Thus, women were aware of a link between benevolent and hostile sexism and approved of men’s benevolent sexism, especially when it was not paired with hostile sexism. Likability ratings were moderated by participants’ own benevolent sexism and feminist attitude.     

Creativity and involvement in art in different types of synaesthesia

The aim of the present study was to test the relationship between different types of synaesthesia and their involvement in art, creative, and visual abilities. We tested 20 grapheme‐colour, 18 sound‐colour, 19 grapheme‐colour‐and‐sound‐colour, 20 sequence‐space synaesthetes, and the same number of controls matched by age, gender, and education. We assessed the number of artistic professions, involvement in art, and the performance in psychometric tests of divergent and convergent creativity, as well as visual and visuo‐spatial abilities. Results show a higher prevalence of artists among synaesthetes, especially sound‐colour synaesthetes. Sound‐colour synaesthetes also showed a higher involvement in artistic activities overall while sequence‐space synaesthetes showed higher involvement in visual art. Only grapheme‐colour‐and‐sound‐colour synaesthetes showed significantly higher divergent creativity compared to matched controls. Additionally, overall, synaesthetes scored higher in visuo‐spatial abilities (i.e., mental rotation). For synaesthetes and controls, visuo‐spatial abilities correlated with divergent creativity. We discuss that synaesthetes’ higher involvement in art is not necessarily reflected in their basic creative abilities.     

Disturbed prefrontal and temporal brain function during emotion and cognition interaction in criminal psychopathy

Impaired emotional responsiveness has been revealed as a hallmark of psychopathy. In spite of an increasing database on emotion processing, studies on cognitive function and in particular on the impact of emotion on cognition in psychopathy are rare. We used pictures from the International Affective Picture Set (IAPS) and a Simon Paradigm to address emotion-cognition interaction while functional and structural imaging data were obtained in 12 healthy controls and 10 psychopaths. We found an impaired emotion-cognition interaction in psychopaths that correlated with a changed prefrontal and temporal brain activation. With regard to the temporal cortex, it is shown that structure and function of the right superior temporal gyrus is disturbed in psychopathy, supporting a neurobiological approach to psychopathy, in which structure and function of the right STG may be important.     

Severity of dysfluency correlates with basal ganglia activity in persistent developmental stuttering

Previous studies suggest that anatomical anomalies [Foundas, A. L., Bollich, A. M., Corey, D. M., Hurley, M., & Heilman, K. M. (2001). Anomalous anatomy of speech-language areas in adults with persistent developmental stuttering. Neurology, 57, 207-215; Foundas, A. L., Corey, D. M., Angeles, V., Bollich, A. M., Crabtree-Hartman, E., & Heilman, K. M. (2003). Atypical cerebral laterality in adults with persistent developmental stuttering. Neurology, 61, 1378-1385; Foundas, A. L., Bollich, A. M., Feldman, J., Corey, D. M., Hurley, M., & Lemen, L. C. et al., (2004). Aberrant auditory processing and atypical planum temporale in developmental stuttering. Neurology, 63, 1640-1646; Jancke, L., Hanggi, J., & Steinmetz, H. (2004). Morphological brain differences between adult stutterers and non-stutterers. BMC Neurology, 4, 23], in particular a reduction of the white matter anisotropy underlying the left sensorimotor cortex [Sommer, M., Koch, M. A., Paulus, W., Weiller, C., & Buchel, C. (2002). Disconnection of speech-relevant brain areas in persistent developmental stuttering. Lancet, 360, 380-383] could be at the origin of persistent developmental stuttering (PDS). Because neural connections between the motor cortex and basal ganglia are implicated in speech motor functions, PDS could also be associated with a dysfunction in basal ganglia activity [Alm, P. (2004). Stuttering and the basal ganglia circuits: a critical review of possible relations. Journal of Communication Disorders, 37, 325-369]. This fMRI study reports a correlation between severity of stuttering and activity in the basal ganglia and shows that this activity is modified by fluency shaping therapy through long-term therapy effects that reflect speech production improvement. A model of dysfunction in stuttering and possible repair modes is proposed that accommodates the data presented here and observations previously made by us and by others.     

Nature against nurture: calcification in the right thalamus in a young man with anorexia nervosa and obsessive-compulsive personality disorder

This report describes the case of a young man with a large calcification in the right thalamus that was first diagnosed at 9 years of age. Case history reveals specific eating rituals and other obsessive-compulsive personality traits during the patient's childhood and adolescence, fulfilling diagnostic criteria of obsessive-compulsive personality disorder. After a critical life event the patient develops anorexia nervosa. We suggest that our case and further literature provide evidence for an involvement of specific thalamic structures, such as the dorsomedial nucleus, in the development of anorexia nervosa. Furthermore, the treatment of the patient by a combined psychotherapeutic and pharmacotherapeutic approach is described. We focus on the beneficial effect of the atypical antipsychotic olanzapine, which can induce weight gain by an increase of leptin levels.