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.     

Reducing prejudice via direct and extended cross-group friendship

One of the most exciting developments in intergroup contact theory is the idea that a certain type of contact, cross-group friendship, might be particularly effective at reducing prejudice. In this chapter we review research on two types of cross-group friendship. Direct cross-group friendship refers to friendships that develop between members of different groups. Extended cross-group friendship, on the other hand, refers to vicarious experience of cross-group friendship, the mere knowledge that other ingroup members have cross-group friends. We consider the relationship between both types of cross-group friendship and prejudice and the processes that mediate and moderate these relationships. The research highlights the respective strengths and weaknesses of direct and extended cross-group friendship and illustrates how they might be practically combined in efforts to improve intergroup relations.     

Affective Empathy and Moral Disengagement Related to Late Adolescent Bullying Perpetration

Bullying has damaging short-term and long-term consequences. Research suggests that perpetrators have low empathy and high moral disengagement, but relations between these variables are unclear and are rarely integrated in a single study. Thus, the objective of this study was to discover if empathy and moral disengagement mechanisms were related to bullying perpetration. This study was conducted with 904 Polish adolescents enrolled in 6 rural and urban upper secondary schools. High affective empathy predicted lower bullying perpetration. Moral-disengagement mechanisms such as moral justification, euphemistic language, advanced comparison, and distorting consequences were uniquely related to increased bullying perpetration. Low affective empathy was also uniquely related to increased perpetration. These findings have important implication for school policy and practice.     

Recognition of Emotion in Facial Expressions and Vocal Tones in Children With Psychopathic Tendencies

The authors investigated the ability of children with emotional and behavioral difficulties, divided according to their Psychopathy Screening Device scores (P. J. Frick & R. D. Hare, in press), to recognize emotional facial expressions and vocal tones. The Psychopathy Screening Device indexes a behavioral syndrome with two dimensions: affective disturbance and impulsive and conduct problems. Nine children with psychopathic tendencies and 9 comparison children were presented with 2 facial expression and 2 vocal tone subtests from the Diagnostic Analysis of Nonverbal Accuracy (S. Nowicki & M. P. Duke, 1994). These subtests measure the ability to name sad, fearful, happy, and angry facial expressions and vocal affects. The children with psychopathic tendencies showed selective impairments in the recognition of both sad and fearful facial expressions and sad vocal tone. In contrast, the two groups did not differ in their recognition of happy or angry facial expressions or fearful, happy, and angry vocal tones. The results are interpreted with reference to the suggestion that the development of psychopathic tendencies may reflect early amygdala dysfunction (R. J. R. Blair, J. S. Morris, C. D. Frith, D. I. Perrett, & R. Dolan, 1999).     

Children's Perception of Parental Empathy as a Precursor of Children's Empathy in Middle and Late Childhood

The present study investigated the relationship between children's self-concepts and evaluations of parent figures. The subjects were elementary school children (352 males and 280 females; Grades 5 through 10) who came from intact families, divorced families, or families in which one or both parents had died. Significant relationships were obtained between children's self-concept ratings and their evaluations of their natural father and mother for both intact and divorced families. This relationship was not significant, however, for families in which a parent had died. Furthermore, children's self-ratings were not significantly correlated with their evaluations of stepparents.     

A controversy between Freud and Ferenczi and beyond

Abstract

With the aid of passages of Ferenczi's paper on elasticity, and of the correspondence between Freud and Ferenczi, the author points out the conceptual difference between Freud and Ferenczi, evokes the historical roots of this difference, and highlights its continuing importance in present-day psychoanalysis.     

THE SECOND SPHERE AND THE STORY OF NO STORY

The author discusses Roy Schafer's ideas of the second self and second reality, as well as his consistent theme of storyteller and story. The latter theme is also explored in the context of more recent psychoanalytic influences, such as Bionian thought, trauma theory, the French approach, and the interpersonal perspective. To illustrate the idea of the nonstory in today's clinical encounters, the author presents two clinical vignettes.     

ACTION,AGENCY, AND EMPATHY: SCHAFER ON THE ANALYST'S DILEMMA

Throughout his career, a central feature of Roy Schafer's theorizing has been to highlight the role of activity and personal agency in every facet of human experience. This theme has remained at the forefront of Schafer's work, despite being embedded within different frames of reference. In this paper, the author highlights Schafer's focus on activity, notes some clinical problems to which it can give rise, and suggests the way that Schafer has attempted to deal with these difficulties.     

Are emotional intelligent workers also more empathic?

This paper analyzes whether emotional intelligence and self‐monitoring are related to empathy among a sample of workers in both the public and private employment sectors. Two hundred and forty‐two employees (42.5% men and 57.5% women) with a mean age of 35.21 years (SD = 10.07, range 18–61) completed a questionnaire that measured the variables of interest. The results showed that emotion regulation, a dimension of emotional intelligence, accounts for most of the variance of empathy, followed by the ability to understand emotions and the management of others' emotions. Furthermore, gender did not yield any moderator effect on the relations among emotional intelligence, self‐monitoring and empathy. We conclude that the intrapersonal aspects of emotional intelligence, in particular, emotion regulation, help explain the empathy of workers. The implications of these findings are discussed herein.     

Minding the gap between neuroscientific and psychoanalytic understanding of autism

This paper offers an integrative approach to the increasingly complex puzzle of autistic spectrum disorders. The author demonstrates how the work of one group of neuroscientists in Parma, on a special class of brain cells called ‘mirror neurons', and the work of researchers at the University of California in San Diego, applying these findings to the problem of autism, intersect with Frances Tustin's discoveries about the nature, function and meaning of psychogenic autism in children and even autistic states in neurotic adults. Included in the author's considerations are the results of some by now well-known studies conducted by a group of biologists at the University of California at Berkeley in the 1960s on the effects of ‘enriched’ versus ‘deprived’ environments upon the development of the brain, and a study of autistic children diagnosed as brain damaged and treated psychoanalytically at the Paediatric Neuro-Psychiatric Institute of the University of Rome in the 1980s. The author concludes with a coherent picture of various dimensions of autistic phenomenon that may constitute more than just the sum of its parts, and points towards new areas for discussion and study.