Racial healthcare disparities: A social psychological analysis

Around the world, members of racial/ethnic minority groups typically experience poorer health than members of racial/ethnic majority groups. The core premise of this chapter is that thoughts, feelings, and behaviours related to race and ethnicity play a critical role in healthcare disparities. Social psychological theories of the origins and consequences of these thoughts, feelings, and behaviours offer critical insights into the processes responsible for these disparities and suggest interventions to address them. We present a multilevel model that explains how societal, intrapersonal, and interpersonal factors can influence ethnic/racial health disparities. We focus our literature review, including our own research, and conceptual analysis at the intrapersonal (the race-related thoughts and feelings of minority patients and non-minority physicians) and interpersonal levels (intergroup processes that affect medical interactions between minority patients and non-minority physicians). At both levels of analysis, we use theories of social categorisation, social identity, contemporary forms of racial bias, stereotype activation, stigma, and other social psychological processes to identify and understand potential causes and processes of health and healthcare disparities. In the final section, we identify theory-based interventions that might reduce ethnic/racial disparities in health and healthcare.     

The Relation between Individual and Group Conflicts in Psychotherapy

Abstract

I describe three constellations of group life and group process: resistance, rebellion, and refusal. In resistance, an individual or group remains antagonistic to conscious but not unconscious thinking, the latter manifested in derivatives, including symbol and symptom formation, transference–countertransference, and enactment. Rebellion functions on the level of conscious thinking, manifested in challenge, defiance, and the possibility of sociopolitical action. The basic premises and values of the group and/or leader are at the center of the controversy, to be addressed on that level. Refusal establishes a mental boundary between what is considered appropriate and inappropriate. Unconsciousaswellasconscious processes of feeling, thinking, and meaning making are refused entry, left undeveloped, rejected, or obstructed. Working with refusal requires appreciating how and why the mind and its thinking operations are being suspended. The theoretical framework is applied to a case example.     

Selection of Patients for Group Psychotherapy

The concept of projective identification is reviewed, and its application to family and group systems is noted. Projective identification is then applied as a construct central to couples' groups, particularly useful in sorting out dynamics within couples, between couples, and toward the group-as-a-whole and its leader(s). Clinical examples are provided from a couples group co-led by the author, with indications of how this perspective on disavowal, interaction, and containment can be utilized therapeutically to provide a stimulus for intrapsychic and interpersonal change. The couples group offers a unique forum for working with projective identification, where this process presents a challenge to the therapist regarding the multiple levels from which to select appropriately and to “contain” skillfully.     

The Effect of Group Psychotherapy in Reducing Resistance to Individual Psychotherapy: A Case Study

Abstract

Cohesion in group treatment of spouse abusers plays an important and often overlooked role. Involuntary abuser groups can benefit from cohesion, but due to their unique structure, cohesion may develop differently than in voluntary psychotherapy groups. Initially, abuser groups may develop premature levels of cohesion that can make group members unwilling to express conflict, develop intimacy, and take responsibility for their actions. Understanding the abuser personality and the unique characteristics of involuntary abuser groups can shed light on why cohesion develops the way it does and the importance it plays in abuser groups. Developing effective interventions that target premature cohesion can help the group members express conflict, develop intimacy, and take responsibility for their actions, thus bringing about therapeutic levels of cohesion.     

The role of self‐determination in the relationship between social support and physical activity intentions

Using the hierarchical model of intrinsic and extrinsic motivation (HMIEM) and self‐determination theory as theoretical frameworks, the purpose of the present study was to assess the role of motivation‐related variables in the relationship between perceptions of social support and intentions to be physically active. Undergraduate students completed surveys assessing perceptions of social support, psychological needs satisfaction, self‐determination, and future exercise intentions. Model fit with the data was examined and was considered acceptable, indicating that social support was positively related to the satisfaction of psychological needs, which, in turn, was related positively to self‐determination and then to physical activity intentions.     

Contextual Connections Within Puns: Effects on Perceived Humor and Memory

The supposition that perceived humor or cleverness would be enhanced by adding separate content to the alternative meanings of a pun was explored, using Tom Swifties as the research vehicle. Because detecting a punning word relationship might induce arousal, requiring more effort and attentional resources for processing than noting a contextual connection, memory strength for adverbs was also examined using a recognition procedure. Five studies were conducted in which college students were asked to judge 24 Swifties (content counterbalanced across participants) in which presence of pun and context were manipulated. The punning relationship was primarily responsible for perceived humor and cleverness. Presence of a pun also enhanced memory strength (d') as long as the familiarization task focused on humor and cleverness. Coherent context enhanced perceived cleverness inconsistently. It was suggested that a coherent contextual connection may make a greater contribution in more lengthy forms of pun-based word play, such as fables or “shaggy dog” stories.     

An Empirical Comparison of Audition,Vision, and Touch in the Discrimination of Temporal Patterns and Ability to Reproduce them

Two conditional reasoning tests were administered to 34 students (17 males and 17 females) at each of four grade levels (i.e., 5th, 6th, 7th, and 8th). Both tests contained conditional reasoning arguments which assessed students' comprehension of five basic principles of inference. However, they varied systematically according to the sex typing of the content (i.e., masculine or feminine). The results indicated that there were no significant sex differences according to grade level, type of content, or principle of inference. On the other hand, at each grade level, there were consistent differences among the mean scores for the five principles, and valid principles were significantly easier than invalid principles. The implications of these findings for future research were discussed.