The fight against stigma: an overview of stigma-reduction strategies and interventions

In many health conditions, people are severely affected by health-related stigma and discrimination. A literature review was conducted to identify stigma-reduction strategies and interventions in the field of HIV/AIDS, mental illness, leprosy, TB and epilepsy. The review identified several levels at which interventions and strategies are being implemented. These are the intrapersonal, interpersonal, organizational/institutional, community and governmental/structural level. Although a lot of work has been carried out on stigma and stigma reduction, far less work has been done on assessing the effectiveness of stigma-reduction strategies. The effective strategies identified mainly concentrated on the individual and the community level. In order to reduce health-related stigma and discrimination significantly, single-level and single-target group approaches are not enough. What is required is a patient-centred approach, which starts with interventions targeting the intrapersonal level, to empower affected persons to assist in the development and implementation of stigma-reduction programmes at other levels.     

Delusions and decision-making style: use of the Need for Closure Scale

Clinicians and researchers have suggested that rapidity in belief formation, due to having a high 'need for closure' (NFC), may contribute to the acceptance of delusional explanations. The aim of the study is to determine whether NFC has such a direct link with delusions. A secondary aim is to examine if NFC is related to the delusion-associated reasoning process of 'jumping to conclusions'. One hundred and eighty-seven patients with psychosis, recruited for a treatment trial of psychological therapy (the PRP trial), completed the Need for Closure Scale (NFCS), symptom measures, and probabilistic reasoning tasks. The NFCS was considered in terms of its two dimensions: a desire for simple structure and a preference for quick, decisive answers. The individuals with psychosis reported being poor at making quick, decisive answers but required a greater need for simple structure. NFC was associated with levels of anxiety and depression. There were weak links between NFC and both positive and negative symptoms of psychosis, but these were explained by differences in affect. NFCS scores were unrelated to jumping to conclusions. Contrary to the argument that NFC is directly linked to delusions, individuals with delusions actually perceive themselves as indecisive. There was no evidence that NFC-at least as assessed by the NFCS-could be a proximal cause of delusions. Any potential effect on psychotic symptom presentation is indirect, mediated through affect. The use of the NFCS on its own in the study of psychotic symptoms cannot be recommended.     

Additional factorial evidence of construct validity for the Visual Similes Test II with scores from a sample of African-American children

The Visual Similes Test II was designed to measure the construct of arousal. This study investigated its factor structure with scores from a sample of 154 African-American elementary school children (7 to 10 years). The initial factor structure was examined using principal axis factor analysis with the promax rotation. Confirmatory factor analysis was then used to evaluate the model-fit of the data with the hypothesized hierarchical model. Results provided support for the two-factor structure in the principal axis factor analysis and the model-fit of the hypothesized model in the confirmatory factor analysis.     

fMRI of parents of children with Asperger Syndrome: a pilot study

BACKGROUND: People with autism or Asperger Syndrome (AS) show altered patterns of brain activity during visual search and emotion recognition tasks. Autism and AS are genetic conditions and parents may show the 'broader autism phenotype.' AIMS: (1) To test if parents of children with AS show atypical brain activity during a visual search and an empathy task; (2) to test for sex differences during these tasks at the neural level; (3) to test if parents of children with autism are hyper-masculinized, as might be predicted by the 'extreme male brain' theory. METHOD: We used fMRI during a visual search task (the Embedded Figures Test (EFT)) and an emotion recognition test (the 'Reading the Mind in the Eyes' (or Eyes) test). SAMPLE: Twelve parents of children with AS, vs. 12 sex-matched controls. DESIGN: Factorial analysis was used to map main effects of sex, group (parents vs. controls), and sexxgroup interaction on brain function. An ordinal ANOVA also tested for regions of brain activity where females>males>fathers=mothers, to test for parental hyper-masculinization. RESULTS ON EFT TASK: Female controls showed more activity in extrastriate cortex than male controls, and both mothers and fathers showed even less activity in this area than sex-matched controls. There were no differences in group activation between mothers and fathers of children with AS. The ordinal ANOVA identified two specific regions in visual cortex (right and left, respectively) that showed the pattern Females>Males>Fathers=Mothers, both in BA 19. RESULTS ON EYES TASK: Male controls showed more activity in the left inferior frontal gyrus than female controls, and both mothers and fathers showed even more activity in this area compared to sex-matched controls. Female controls showed greater bilateral inferior frontal activation than males. This was not seen when comparing mothers to males, or mothers to fathers. The ordinal ANOVA identified two specific regions that showed the pattern Females>Males>Mothers=Fathers: left medial temporal gyrus (BA 21) and left dorsolateral prefrontal cortex (BA 44). CONCLUSIONS: Parents of children with AS show atypical brain function during both visual search and emotion recognition, in the direction of hyper-masculinization of the brain. Because of the small sample size, and lack of age-matching between parents and controls, such results constitute a pilot study that needs replicating with larger samples.     

Fear and pain: investigating the interaction between aversive states

Pain and fear often co-occur and appear to interact, although the nature and direction of their relation is not clearly delineated. The present study investigates how exposure to the experience of one of these states subsequently affects responding to the other. Pressure stimulation and carbon dioxide-enriched air (CO2) were used to induce pain and fear, respectively, in 48 healthy individuals. The order in which the stimuli were introduced was manipulated, as was the CO2 level. Measures of overt behavior, physiological responding, and self-report were obtained; analyses of stimuli effects generally supported their ability to produce pain or fear. Results indicate that the stimulus rated as the most aversive, the higher level of CO2, led to the highest levels of distressed responding across dependent measures. This pattern was replicated for the stimuli found to be less aversive (i.e., pressure stimulation and low-level CO2, respectively). The authors conclude that fear and pain, in and of themselves, do not dictate the nature of their interaction; the most important factor is how aversive they are perceived to be in relation to one another.     

Generalization of tacting actions in children with autism

This intervention compared the effects of two procedures on the generalization of a tacting repertoire (labeling) in 6 children with autism spectrum disorder. In one procedure the verbal antecedent stimulus “What is she doing?” appeared together with a person performing an action; in the other procedure, the antecedent stimulus was just the presence of the action. In initial tests, children emitted tacts only when the action was presented with the verbal antecedent. Thereafter, they learned to tact an action without the verbal antecedent and received tests to evaluate generalization to another action. Results indicated that in order to obtain generalization of tacting actions, it was necessary to learn to tact other actions without the verbal antecedent as well as learning to tact the action with the verbal antecedent. These findings have relevance for generalization of tacting actions from control by verbal antecedents to natural conditions and the production of spontaneous language.     

A comparison of intra- and inter-limb relative motion information in modelling a novel motor skill

The importance of intra- and inter-limb relative motion in modelling a whole body coordination skill was examined. Participants were assigned to one of four groups: Full-Body point light model of a cricket bowler, INTRA-LIMB relative motion of the bowling arm, INTER-LIMB relative motions of the right and left wrists or NO-Relative motion, showing only the motions of the right wrist. During 60 acquisition trials, participants viewed the model five times before each 10-trial block. Retention was examined the following day. Although all groups improved on intra-limb coordination of the bowling arm, the INTRA-LIMB and FULL-BODY groups were more accurate than the INTER-LIMB group in acquisition, although these groups did not differ in retention. For inter-limb coordination, the three groups who received relative motion information performed more like the model than the NO-Relative motion group (even though the INTRA-LIMB group did not see the other limb). The amount of information within a display plays a constraining role on acquisition, perhaps more so than the type of information, such that the acquisition of coordination is more an emergent feature of observational learning, rather than a direct approximation of the model.     

Modeling the antecedents of proactive behavior at work

Using a sample of U.K. wire makers (N = 282), the authors tested a model in which personality and work environment antecedents affect proactive work behavior via cognitive-motivational mechanisms. Self-reported proactive work behaviors (proactive idea implementation and proactive problem solving) were validated against rater assessments for a subsample (n = 60) of wire makers. With the exception of supportive supervision, each antecedent was important, albeit through different processes. Proactive personality was significantly associated with proactive work behavior via role breadth self-efficacy and flexible role orientation, job autonomy was also linked to proactive behavior via these processes, as well as directly; and coworker trust was associated with proactive behavior via flexible role orientation. In further support of the model, the cognitive-motivational processes for proactive work behavior differed from those for the more passive outcome of generalized compliance.     

Relationships among team ability composition, team mental models, and team performance

This study examined the relationship between the similarity and accuracy of team mental models and compared the extent to which each predicted team performance. The relationship between team ability composition and team mental models was also investigated. Eighty-three dyadic teams worked on a complex skill task in a 2-week training protocol. Results indicated that although similarity and accuracy of team mental models were significantly related, accuracy was a stronger predictor of team performance. In addition, team ability was more strongly related to the accuracy than to the similarity of team mental models and accuracy partially mediated the relationship between team ability and team performance, but similarity did not.