Same clinic,different conceptions: Drug users’ and healthcare professionals’ perceptions of how stigma may affect clinical care

Stigma experienced by drug users by their healthcare professionals can be a barrier to treatment engagement, which in turn affects mortality and morbidity rates. Attribution theory suggests that stigma will be greatest whenever drug use is attributed to factors within personal control. Here, clients (n = 76) and healthcare professionals (n = 62) identified features that characterize good and bad clinical interactions, and responded to a vignette about a drug user who attributed his use to personal control or situational factors. Healthcare professionals completed the vignette and drug users gave their best guess of how healthcare professionals would react to this vignette. Clients and professionals held overlapping prototypes of clinical interactions. Clients overestimated both how negative healthcare professionals’ reactions would be, and the extent to which healthcare professionals’ reactions would accord with attribution theory. Despite healthcare professionals’ believing they are acting in nonstigmatizing ways, they may engender stigma in clinical situations more than they realize. Discrepancies between professionals’ hypothetical responses and clients’ anticipation of these responses are discussed in terms of the influence of self‐stigma and societal understandings of drug use and control. Attribution theory only offers a limited explanation for these discrepancies, because professionals’ beliefs about drug users are complex. Implications for theories of stigma and engagement with services are discussed, and the importance of clients’ anticipation of stigma is highlighted as a primary target for addressing treatment disengagement. Anti‐stigma campaigns may also benefit from changing their focus from individuals’ attributions to holistically addressing discrepant conceptions of treatment.     

A Community's Response to Adverse Childhood Experiences: Building a Resilient,Trauma‐Informed Community

Adverse childhood experiences, or ACEs, may be mitigated by trauma‐informed social environments—programs, services, systems, communities—that offer responses to trauma that promote healing, recovery, and resilience. However, there is currently little empirical evidence to support the use of specific approaches to do so. Guided by a population health perspective, this paper describes a participatory community change process in response to ACEs that seeks to build a resilient, trauma‐informed community in Pottstown, PA. We examine the initial implementation phase of this change process, centered originally on the education sector and the social and behavioral health services sector, and then eventually expanding to 14 community sectors across two years. A variety of data sources and methods are used to track individual and organizational processes, as well as service system network processes. A central feature of this research is the use of data to generate hypotheses rather than test them. Data were also used to guide understanding and decision‐making during implementation. The results show that moving forward the community is well‐positioned to establish stronger inter‐agency and system supports for trauma‐informed practice in the service system and in the broader community. We discuss results for their implications for building resilient, trauma‐informed communities.     

Mary Astell on Bad Custom and Epistemic Injustice

Mary Astell is a fascinating seventeenth‐century figure whose work admits of many interpretations. One feature of her work that has received little attention is her focus on bad custom. This is surprising; Astell clearly regards bad custom as exerting a kind of epistemic power over agents, particularly women, in a way that limits their intellectual capacities. This article aims to link two contemporary sociopolitical/social‐epistemological projects by showing how a seventeenth‐century thinker anticipated these projects. Astell's account of bad custom shows that she was attuned to the kinds of institutional or structural explanations theorized by Sally Haslanger, and that she acknowledges that bad custom—as an institutional or structural explanation—is intimately linked with epistemic injustice, albeit a kind not yet captured by contemporary social epistemologists. I call this form of epistemic injustice found in Astell epistemic internalization injustice. I argue that the epistemic significance of Astell's notion of bad custom is that it enables us to understand how bad custom conditions human relations in such a way as to result in epistemic injustice. Through coming to understand her notion of bad custom, we can expand our understanding of social epistemic phenomena like epistemic injustice.     

See no lies,hear no lies: differences in discrimination accuracy and response bias when watching or listening to police suspect interviews

In the present experiment, police officers attempted to detect truths and lies told by suspects in their police interviews in three different ways: They either saw the suspects (visual condition), only heard the suspects (audio condition) or both saw and heard the suspects (control condition). Research has demonstrated that vocal and speech‐related cues are better diagnostic cues to deceit than visual cues. Therefore, we predicted that participants in the visual condition would perform worst in the lie detection task. Having access only to visual cues may encourage observers to be more reliant on stereotypical beliefs when attempting to detect truths and lies. Since these stereotypes are related to the behaviour of liars, rather than to the behaviour of truth tellers, we further predicted that being exposed only to visual cues may result in a lie bias. The findings supported these hypotheses, and the implications are discussed. Copyright © 2007 John Wiley & Sons, Ltd.     

Person–Situation Interaction in Adaptive Emotional Functioning

Two studies applied a person–situation model to examine the effect of emotional affordances of situations. Participants rated their emotional functioning as more extensive in situations classified as being high in emotional affordance than those classified as low in emotional affordance. Participants who scored higher on the individual difference characteristic of emotional intelligence were more interested in entering high emotional affordance situations than were individuals lower in emotional intelligence, and participants who scored higher on emotional intelligence were rated by others as being more successful in high emotional affordance situations than individuals lower in emotional intelligence. These results provide preliminary evidence that the interaction between emotional intelligence and situations may influence emotional functioning.     

Toddlers' use of cues in a search task

Search for a ball that has undergone hidden motion rapidly improves during the second year of life (Dev. Psychol., 2000; 36 :394–401). In three experiments we investigated whether the poor performance of younger toddlers was due to attentional failure by highlighting the major cue for the hidden object. We observed only slight improvement in search behaviour. We performed two other experiments that tested the depth of understanding of 3‐year‐olds in this task and found that their performance was robust to changes in the apparatus and experimental procedures. Overall, the results point to a rapidly developing ability in the second year of life to either reason about space or select the correct motor response in search tasks. Copyright © 2008 John Wiley & Sons, Ltd.     

Who uses services for homeless people? An investigation amongst people sleeping rough in London

From a sample of 389 homeless people in London, the characteristics of those who used services for homeless people are presented and the implications for service planning and delivery explored. Staff providing services for this client group need knowledge about drug use and the confidence to work effectively with homeless drug users. Copyright © 2002 John Wiley & Sons, Ltd.     

Children's and adults' recall of children's news stories in both print and audio‐visual presentation modalities

Research into adults' recall from different presentation modalities has demonstrated a recall advantage for print over television yet recent research indicates that children remember television news better than print news. An experiment was conducted by comparing children's and adults' recall of children's news stories presented in two different modalities, television and print, in order to establish whether children's recall advantage for television is dependent on their age or level of reading proficiency. A sample of 40 adults, 40 13‐year‐olds and 40 11‐year‐olds were presented with children's news stories, either in their original televised form or in a print version. All participants were aware they would be tested for recall. The results of the cued recall test indicated that children from both age groups learned more from the television news than from the print versions, regardless of age or reading proficiency and that adults remembered equal amounts from both presentation modalities. For the 11‐year‐olds the advantage of television was only found for information that had been accompanied by redundant pictures in the televised version, providing support for the dual‐coding hypothesis. For 13‐year‐olds the recall of television was not dependent on the addition of redundant visual information. Viewers and readers were found to invest the same amounts of mental effort, but reported levels of invested mental effort were found to be dependent on age and level of reading proficiency. Copyright © 2002 John Wiley & Sons, Ltd.     

Distress Tolerance and Rational-Emotive Behavior Therapy: A New Role for Behavioral Analogue Tasks

Rational-emotive behavior therapy (REBT) is a widely utilized treatment approach for many mental disorders, but it has been “relatively neglected in the professional scientific literature” (Ellis 2003b). This neglect has been attributed in part to a lack of solid REBT outcome studies, which in turn stems from the difficulty of measuring constructs of interest in REBT, such as irrational beliefs, via self-report measures. In light of these concerns, the current paper aims to identify the potential utility of behavioral analogue laboratory tasks for advancing the understanding of mechanisms in REBT, as well as treatment outcome using this therapeutic approach. Specifically, we focus on the utilization of behavioral measures of distress tolerance and their application to the key REBT construct of frustration intolerance. In identifying the parallels across distress tolerance and frustration intolerance, we consider how the incorporation of distress tolerance tasks into REBT research can be useful in evaluating the role of frustration intolerance in the initiation, maintenance, and treatment of disordered behavior across a broad range of clinical disorders.

Parental depression,parenting behaviours,and behaviour problems in young children

In the past, research has demonstrated that parental depression and parenting practices are related. More recently, there has been an increase in research examining child outcomes as they are related to maternal and paternal psychopathology. To continue with this line of research, this study examined the relationships among mothers' and fathers' symptoms of depression, characteristics of their parenting practices, and their ratings of their young children's internalizing and externalizing behaviour problems. The results of this study demonstrated that these variables are related significantly. Further, the results of this study suggested that mothers' parenting, particularly their limit setting with their young children, is an important predictor of their ratings of their young children's externalizing behaviour problems in the context of their own symptoms of depression. A different pattern of relationships may be present for fathers, as both their symptoms of depression and their parenting characteristics predicted their ratings of their young children's externalizing behaviour problems. Such findings were not supported for young children's internalizing behaviour problems. These findings suggested that interventions should have different targets for mothers and fathers. Copyright © 2009 John Wiley & Sons, Ltd.