Measuring health-related stigma--a literature review

Stigma related to chronic health conditions such as HIV/AIDS, leprosy, tuberculosis, mental illness and epilepsy is a global phenomenon with a severe impact on individuals and their families, and on the effectiveness of public health programmes. To compare stigma measurement in different disciplines, a literature review was conducted. References were obtained through a search of literature databases and through examining relevant bibliographies. Sixty-three papers were selected that addressed the issue of measurement of stigma or related constructs and that contained a sample of the instrument or items used. Five unpublished studies were also included in the review. The aspects of health-related stigma used for assessment can be grouped in five categories. First, the experience of actual discrimination and/or participation restrictions on the part of the person affected; second, attitudes towards the people affected; third, perceived or felt stigma; fourth, self or internalized stigma; and fifth, discriminatory and stigmatizing practices in (health) services, legislation, media and educational materials. Within each of these areas, different research methods have been used, including questionnaires, qualitative methods, indicators and scales. The characteristics of the instruments considered most promising are described and compared. The purpose of stigma assessment is to increase our understanding of stigma and its determinants and dynamics, to determine its extent or severity in a given setting or target group and to monitor changes in stigma over time. The conclusions from this review are that (a) the consequences of stigma are remarkably similar in different health conditions, cultures and public health programmes; (b) many instruments have been developed to assess the intensity and qualities of stigma, but often these have been condition-specific; and (c) development of generic instruments to assess health-related stigma may be possible. To achieve this aim, existing instruments should be further validated, developed or adapted for generic use, where possible.     

Personality, identity styles, and religiosity: an integrative study among late adolescents in Flanders (Belgium)

The relationship between the two main dimensions of the religiosity domain (Exclusion vs. Inclusion of Transcendence and Literal vs. Symbolic) and both the Five-Factor Model of personality and Berzonsky's (1990) identity styles was investigated in a Flemish sample of late adolescents (N = 335). The results show that, whereas Exclusion vs. Inclusion is unrelated to any of the personality dimensions, Literal vs. Symbolic was strongly related to Openness to Experience and moderately to Agreeableness. Further, it was shown that Exclusion vs. Inclusion was positively related to the normative identity style, and that Literal vs. Symbolic correlated positively with the informational identity style and negatively with the diffuse/avoidant identity style. As expected, the relation between Openness to Experience and Literal vs. Symbolic was fully mediated by the informational identity style. Once Openness to Experience was taken into account, Agreeableness was no longer an important determinant of Literal vs. Symbolic.     

Unconscious primes activate motor codes through semantics

Today, it is generally accepted that unconscious stimuli can activate a response code, which leads to a response congruency effect (RCE) on a subsequent target. However, it is not yet clear whether this is due to the semantic processing of the primes or to the formation of direct stimulus-response (S-R) associations bypassing the semantic system. Recently, it was shown that even novel primes, for which no direct S-R links exist, can also evoke an RCE that is in line with the activation of response codes through semantics. In these experiments, the authors examined 3 alternatives for this RCE from novel primes and report a novel effect in unconscious priming. First, the authors show that this effect is not limited to a small set of numerical stimuli but also extends to letter stimuli (Experiments 1-3). Second, the authors show that the RCE is not a side effect of the prime-target distance effect, as has been reported before (Experiments 1-2). Third, the authors found that, for RCE to occur, overlap at the motor level but not at the semantic level was crucial (Experiments 2-3). Finally, in addition, the results showed a category match priming effect independent of RCE. This last result is evidence that novel unconscious primes activate their semantic category prior to the target and might be considered a good marker for semantic processing.     

Naming two-digit arabic numerals: evidence from masked priming studies

The authors investigated how 2-digit Arabic numerals are named by looking at the effects of masked primes on the naming latencies. Target numerals were named faster when prime and target shared a digit at the same position (e.g., the target 28 primed by 18 and 21). In contrast, naming latencies were slower when prime and target shared 1 or 2 digits at non-corresponding places (e.g., the target 28 primed by 82, 86, or 72). Subsequent experiments showed that these priming effects were situated at the level of the verbal production of the Arabic numerals. The data point to a non-semantically mediated route from visual input to verbal output in the naming of 2-digit Arabic numerals.     

Interacting neighbors: A connectionist model of retrieval in single-digit multiplication

For most adults, retrieval is the most common way to solve a single-digit multiplication problem (Campbell & Xue, 2001). Many theories have been proposed to describe the underlying mechanism of arithmetical fact retrieval. Testing their validity hinges on evaluating how well they account for the basic findings in mental arithmetic. The most important findings are the problem size effect (small multiplication problems are easier than larger ones; cf. 3 x 2 and 7 x 8), the five effect (problems with 5 are easier than can be accounted for by their size), and the tie effect (problems with identical operands are easier than other problems; cf. 8 x 8 and 8 x 7). We show that all existing theories have difficulties in accounting for one or more of these phenomena A new theory is presented that avoids these difficulties. The basic assumption is that candidate answers to a particular problem are in cooperative/competitive interactions and these interactions favor small, five, and tie problems. The theory is implemented as a connectionist model, and simulation data are described that are in good accord with empirical data.     

The mental representation of ordinal sequences is spatially organized

In the domain of numbers the existence of spatial components in the representation of numerical magnitude has been convincingly demonstrated by an association between number magnitude and response preference with faster left- than right-hand responses for small numbers and faster right- than left-hand responses for large numbers (Dehaene, S., Bossini, S., & Giraux, P. (1993) The mental representation of parity and number magnitude. Journal of Experimental Psychology: General, 122, 371-396). Because numbers convey not only real or integer meaning but also ordinal meaning, the question of whether non-numerical ordinal information is spatially coded naturally follows. While previous research failed to show an association between ordinal position and spatial response preference, we present two experiments involving months (Experiment 1) and letters (Experiment 2) in which spatial coding is demonstrated. Furthermore, the response-side effect was obtained with two different stimulus-response mappings. The association occurred both when ordinal information was relevant and when it was irrelevant to the task, showing that the spatial component of the ordinal representation can be automatically activated.     

Irrelevant auditory attention shifts prime corresponding responses

In this paper we investigate whether an attention shift towards an auditory signal, while performing a two-choice serial reaction time task, primes responses in the direction of the auditory signal. In Experiment 1, subjects had to react to the pitch of the signal, which was randomly presented to the left or right ear. A short (50-ms) and a long (1000-ms) response-stimulus interval (RSI) was used. In Experiment 2 with an RSI of 2000 ms, subjects had to respond to the color of a centrally presented visual stimulus, while a sound was presented to one of the ears. In the short RSI condition of Experiment 1, there was a Simon effect for location alternations only. In the long RSI condition, there was a Simon effect for location repetitions and alternations. Experiment 2 showed a Simon effect in relation to the accessory sound. The results of this study suggest that an attention shift is a sufficient and necessary condition in order to observe a Simon effect. Preparation of this article was supported by a grant from the National Fund for Scientific Research, Flanders, Belgium (FWO-VL G.0009.99)     

Comparing color-word and picture-word Stroop-like effects: A test of the Glaser and Glaser (1989) model

Summary Glaser and Glaser (1989) assume that the processing of colors and pictures is highly similar in that, compared to words, both kinds of stimulis have privileged access to semantic information. This assumption was tested in the present research. In Experiment 1, the season corresponding to the color or to the word of color-word Stroop stimuli had to be named (e.g., green for spring). In Experiment 2, subjects had to name the season corresponding to the picture or the word of a picture-word stimulus (e. g., flower for spring). According to Glaser and Glaser (1989), privileged semantic processing of colors and pictures should be evidenced by a larger interfering power of color and picture distractors than of word distractors. However, the asymmetric pattern of interference was observed only with picture-word stimuli (Experiment 2), but not with color-word stimuli (Experiment 1), suggesting that, unlike pictures, colors do not have privileged access to semantic information. It was also found that word distractors interfered with the semantic processing of pictures, a result that is incompatible with the dominance rule postulated by Glaser and Glaser (1989). From these results, an adapted version of the Glaser and Glaser model is proposed: colors are assumed to have privileged access to a separate color processing system and the pattern of interference depends upon the relative activation strength of the response alternatives activated by the target and the distractor.