An Exploration of Implicit Racial Bias as a Source of Diagnostic Error

Recent events led this author to realize that an error made during the Vietnam War by him and others had been due to focusing too narrowly on predisposing factors for PTSD while failing to consciously acknowledge acute systemic stressors. In not accepting that along with the stress of combat, Black troops daily experienced acute pervasive systemic racism, he failed to understand correctly their disproportionately higher levels of PTSD when compared to white troops. Motivating factors to examine this error included a recent movie by Spike Lee. Oral histories of Black veterans were then used to research the experience of Blacks in the military in two world wars and the Vietnam War. Little change in the treatment of Black service members was evident across the time frame which included WWI, WWII and the Vietnam War. An understanding of Shay’s concept of moral injury was found very valuable in understanding the consequences of PTSD.

     

The discourse on faith and medicine: a tale of two literatures

Research and writing at the intersection of faith and medicine by now include thousands of published studies, review articles, books, chapters, and essays. Yet this emerging field has been described, from within, as disheveled on account of imprecision and lack of careful attention to conceptual and theoretical concerns. An important source of confusion is the fact that scholarship in this field constitutes two distinct literatures, or rather meta-literatures, which can be termed (a) faith as a problematic for medicine and (b) medicine as a problematic for faith. These categories represent distinct theoretical lenses for viewing the intersection of faith and medicine. Observations about these two approaches are offered, along with insights about why the discourse on faith and medicine should become better integrated into discussions of religion and science.     

Examining the role of psychological inflexibility,perspective taking,and empathic concern in generalized prejudice

Research to‐date on generalized prejudice has focused primarily on personality factors. Further work is needed identifying manipulable variables that directly inform antiprejudice interventions. This study examined three such variables: empathic concern, perspective taking, and psychological inflexibility/flexibility with prejudiced thoughts, as a test of the flexible connectedness model. A sample of 604 undergraduate students completed online surveys. A model indicated prejudice measures loaded onto a latent variable of generalized prejudice. In a second model, psychological inflexibility, flexibility, empathic concern, and perspective taking were all significant, independent predictors of generalized prejudice. Psychological inflexibility also predicted prejudice above and beyond personality and general inflexibility variables. Results suggest the three components of the flexible connectedness model may be important targets for prejudice interventions.     

Social dominance orientation,anti‐egalitarianism and the political psychology of gender: an extension and cross‐cultural replication

This study explored differences in levels of anti‐egalitarianism and social dominance orientation among groups with different social status, and examined the degree to which these differences in anti‐egalitarianism varied across a number of situational and contextual factors. Consistent with both the cultural deterministic (CD) and social dominance (SD) paradigms, when defining social status as socioeconomic status, ethnicity, or ‘race’, differences in anti‐egalitarianism between members of high‐ and low‐status groups were found to be contingent upon a range of contextual and situational factors, such as the degree to which the two groups varied in social status. However, consistent with the SD perspective and the invariance hypothesis, the data also showed that males were more anti‐egalitarian than females, and that this male/female difference in social and group dominance orientation tended to be largely invariant across cultural, situational, and contextual boundaries. Copyright © 2000 John Wiley & Sons, Ltd.     

Change blindness blindness: beliefs about the roles of intention and scene complexity in change detection

Observers have difficulty detecting visual changes. However, they are unaware of this inability, suggesting that people do not have an accurate understanding of visual processes. We explored whether this error is related to participants' beliefs about the roles of intention and scene complexity in detecting changes. In Experiment 1 participants had a higher failure rate for detecting changes in an incidental change detection task than an intentional change detection task. This effect of intention was greatest for complex scenes. However, participants predicted equal levels of change detection for both types of changes across scene complexity. In Experiment 2, emphasizing the differences between intentional and incidental tasks allowed participants to make predictions that were less inaccurate. In Experiment 3, using more sensitive measures and accounting for individual differences did not further improve predictions. These findings suggest that adults do not fully understand the role of intention and scene complexity in change detection.     

The role of Hebrew letter names in early literacy: the case of multiphonemic acrophonic names

English-speaking children spell letters correctly more often when the letters' names are heard in the word (e.g., B in beach vs. bone). Hebrew letter names have been claimed to be less useful in this regard. In Study 1, kindergartners were asked to report and spell initial and final letters in Hebrew words that included full (CVC), partial (CV), and phonemic (C) cues derived from these letter names (e.g., kaftor, kartis, kibepsilonl, spelled with /kaf/). Correct and biased responses increased with length of congruent and incongruent cues, respectively. In Study 2, preschoolers and kindergartners were asked to report initial letters with monosyllabic or disyllabic names (e.g., /kaf/ or /samepsilonx/, respectively) that included the cues described above. Correct responses increased with cue length; the effect was stronger with monosyllabic letter names than with disyllabic letter names, probably because the cue covered a larger ratio of the letter name. Phonological awareness was linked to use of letter names.     

Disturbed dreaming, posttraumatic stress disorder, and affect distress: a review and neurocognitive model

Nightmares are common, occurring weekly in 4%-10% of the population, and are associated with female gender, younger age, increased stress, psychopathology, and dispositional traits. Nightmare pathogenesis remains unexplained, as do differences between nontraumatic and posttraumatic nightmares (for those with or without posttraumatic stress disorder) and relations with waking functioning. No models adequately explain nightmares nor have they been reconciled with recent developments in cognitive neuroscience, fear acquisition, and emotional memory. The authors review the recent literature and propose a conceptual framework for understanding a spectrum of dysphoric dreaming. Central to this is the notion that variations in nightmare prevalence, frequency, severity, and psychopathological comorbidity reflect the influence of both affect load, a consequence of daily variations in emotional pressure, and affect distress, a disposition to experience events with distressing, highly reactive emotions. In a cross-state, multilevel model of dream function and nightmare production, the authors integrate findings on emotional memory structures and the brain correlates of emotion.     

“And Let Us Make Us a Name”: Reflections on the Future of the Religion and Health Field

After years of marginality, research on religion and health is entering the academic mainstream. Scholarship on this topic has evolved into a large, productive field. As in any emerging field, there are competing visions for what the field should be about and what research questions should be pursued. Different opinions exist as to which constructs should be researched. Words like religion, spirituality, faith, and prayer, and health, healing, medicine, and healthcare, imply different things. The study of their various interconnections can thus take myriad forms. This article argues for a welcoming approach open to the widest range of research subjects. An earlier version of this article was presented as a Visiting Scholar Seminar, Duke Center for Spirituality, Theology, and Health, Duke University Medical Center, Durham, NC, March 6, 2008.