Confrontation and Beyond: Examining a Stigmatized Target's Use of a Prejudice Reduction Strategy

What can stigmatized individuals do to reduce stereotyping, prejudice, and discrimination when they interact with a biased individual? This paper reviews the social psychological literature that examines how targets can be active agents of prejudice reduction for themselves and their group. The extant literature indicates that a target's direct confrontation of bias can reduce prejudice and discrimination against the target's group but that this strategy can also backlash in the form of increased prejudice and discrimination against the target. Other research indicates that presenting a common‐identity, self‐enhancing feedback, and a self‐affirmation can reduce bias against the target but that they may not reliably change bias against the target's group. We conclude by discussing the need for research on the processes by which stigmatized targets decide to use a given bias‐reduction strategy and on the processes by which specific strategies are effective, either alone or in combination, when delivered by a stigmatized target.     

“I’m Not Sure I Trust the System Yet”: Lesbian Service Member Experiences With Mental Health Care

The purpose of this research was to understand lesbian service member experiences with mental health care. Individual and organizational factors were explored, including the influence of military policy (e.g., “Don’t Ask, Don’t Tell”) on service member utilization of mental health services. Thirty-seven participants responded to a survey containing 16 open-ended items regarding the impact of “Don’t Ask, Don’t Tell” on one’s professional life, relational life, identity, and willingness to access mental health services. Data were analyzed through an open- and axial-coding and constant comparative method. The findings indicated a lesbian service woman’s likelihood of accessing mental health services was impacted by confidentiality concerns, fear of repercussions, and a sense that military culture lags behind policy changes. Recommendations for therapists included renewed focus on safety through affirmative practices, need for competency in military and lesbian/gay culture, and sensitivity to the effects of systemic oppression on self-esteem. Implications and future research are discussed.     

Making connections about brain connectivity

The Functional Brain Connectivity workshop was organized by Rolf K?tter and Karl Friston, and held in Düsseldorf, Germany, on 4-6 April, 2002.     

Making Good Use of Combined Therapeutic Modalities: Discussion of “Somatic Experiencing”

A positive view is taken of integrative analytic and bio-psychological Somatic Experiencing (SE) therapy for trauma. Levit’s case report is viewed as reflecting an early stage of the analyst’s development as an integrative clinician. A risk of integrative treatments is splitting between modalities of analytic functions including affect regulation. The present case is read closely. Commentary focuses on enactment and missed opportunities for analytic reflection, including (transference) meanings of SE interventions. Increased analytic attention to therapeutic process aims to open reflective space to discuss a wide range of experiences in treatment, including disappointments and other (more negative) aspects of transference, deepening the therapeutic experience, and reaching more broadly into sequelae of the patient’s developmental trauma than SE intervention alone. Integrated bio-psychological interventions are compared and contrasted with use of psychotropic medications in analytic therapy. Bio-psychological interventions such as SE have the advantage of adding resources for the analyst’s self-regulation as well.     

Fabry Disease Practice Guidelines: Recommendations of the National Society of Genetic Counselors

Identification and comprehensive care of individuals who have Fabry disease (FD) requires a multidisciplinary approach inclusive of genetic testing, test interpretation, genetic counseling, long term disease symptom monitoring, treatment recommendations, and coordination of therapy. The purpose of this document is to provide health care professionals with guidelines for testing, care coordination, identification of psychosocial issues, and to facilitate a better understanding of disease treatment expert recommendations for patients with Fabry disease. These recommendations are the opinions of a multicenter working group of genetic counselors, medical geneticists, and other health professionals with expertise in Fabry disease counseling, as well as representatives/founders of the two United States based Fabry disease patient advocacy groups who are themselves affected by Fabry disease. The recommendations are U.S. Preventive Task Force Class III, and they are based on clinical experience, a review of pertinent English-language articles, and reports of expert committees. This document reviews the genetics of Fabry disease, the indications for genetic testing, interpretation of results, psychosocial considerations, and references to professional and patient resources.     

Paranoid thinking in mass shooters

Mass murderers, particularly school shooters, are depicted in the literature as either reacting with rage to taunts and bullying or as being psychopathic. However, examination of diaries and Web sites left by a subset of mass shooters (e.g., Eric Harris, Kimveer Gil, Seung-Hui Cho, Anders Breivik) reveals a different phenomenology than that typically proposed. This group greatly exaggerates the negativity of their treatment as reported by third-party school peers. They become and remain fixated and obsessed with rejection by what they see as an elite in-group whom they see as having unfairly achieved success. Instead of transcending the rejection, they formulate plans to annihilate the transgressors, which they justify as vengeance for the transgressions made against them. The self-exacerbating and obsessive qualities of these perceptions are more consistent with paranoid thinking than with psychopathy. The perceptions feed on themselves and, being part of a closed belief system, expand with time. In the rare cases where the perpetrator survives the mass shooting, they are diagnosed as paranoid schizophrenic. We focus on the pre-psychotic deterioration of their thinking.     

A Dual-Process Discrete-Time Survival Analysis Model: Application to the Gateway Drug Hypothesis

The gateway drug model is a popular conceptualization of a progression most substance users are hypothesized to follow as they try different legal and illegal drugs. Most forms of the gateway hypothesis are that “softer” drugs lead to “harder,” illicit drugs. However, the gateway hypothesis has been notably difficult to directly test—that is, to test as competing hypotheses in a single model that licit drug use might lead to illicit drug use or the reverse. This article presents a novel statistical technique, dual-process discrete-time survival analysis, which enables this comparison. This method uses mixture-modeling software to estimate 2 concurrent time-to-event processes and their effects on each other. Using this method, support for the gateway hypothesis in the National Longitudinal Survey of Youth, 1997, was weak. However, this article was not designed as a strong test of causal direction but more as a technical demonstration and suffered from certain technological limitations. Both these limitations and future directions are discussed.