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.     

Opening up Openness to Experience: A Four‐Factor Model and Relations to Creative Achievement in the Arts and Sciences

Openness to experience is the broadest personality domain of the Big Five, including a mix of traits relating to intellectual curiosity, intellectual interests, perceived intelligence, imagination, creativity, artistic and aesthetic interests, emotional and fantasy richness, and unconventionality. Likewise, creative achievement is a broad construct, comprising creativity across the arts and sciences. The aim of this study was to clarify the relationship between openness to experience and creative achievement. Toward this aim, I factor analyzed a battery of tests of cognitive ability, working memory, Intellect, Openness, affect, and intuition among a sample of English Sixth Form students (N = 146). Four factors were revealed: explicit cognitive ability, intellectual engagement, affective engagement, and aesthetic engagement. In line with dual‐process theory, each of these four factors showed differential relations with personality, impulsivity, and creative achievement. Affective engagement and aesthetic engagement were associated with creative achievement in the arts, whereas explicit cognitive ability and intellectual engagement were associated with creative achievement in the sciences. The results suggest that the Intellectual and Openness aspects of the broader openness to experience personality domain are related to different modes of information processing and predict different forms of creative achievement.     

The Name-Pronunciation Effect: Further Evidence from Chinese

This study examined the Chinese name-pronunciation effect. The easy-to-pronounce and difficult-to-pronounce Chinese names were created using the same characters in order to control for visual perceptual and conceptual fluency. In Experiment 1, participants rated each name in terms of liking, electability as a state leader, income level, and baby name preference. An additional rating of prevalence was used to estimate familiarity. In Experiment 2, participants did not read the name aloud before rating and performed intentional recall and recognition tests. In both experiments, the easy-to-pronounce names were rated higher than difficult-to-pronounce names on liking. This effect generalized to judgments of electability and baby name preference but not to prevalence and income level. There were no differences in memory performances between the two types of names. Results are discussed in terms of the boundary condition of the name-pronunciation effect and the advantage of using Chinese names to study this effect.     

Contextual Cueing Effects Across the Lifespan

The authors evaluated age-related variations in contextual cueing, which reflects the extent to which visuospatial regularities can facilitate search for a target. Previous research produced inconsistent results regarding contextual cueing effects in young children and in older adults, and no study has investigated the phenomenon across the life span. Three groups (6, 20, and 70 years old) were compared. Participants located a designated target stimulus embedded in a context of distractor stimuli. During exposure, the location of the target could be predicted from the location of the distracters in each display. During test, these predictable displays were intermixed with new displays that did not predict the target location. Response times to locating predictable relative to unpredictable targets were compared. All groups exhibited facilitation effects greater than 0 (95% CIs [.02, .11], d = .4; [.01, .12], d = .4; and [.01, .10], d = .4, for the children, young adults, and older adults, respectively) indicating that contextual cueing is robust across a wide age range. The relative magnitude of contextual cueing effects was essentially identical across the age range tested, F(2, 103) = 1.71, ηρ² = .02. The authors argue that a mechanism that uses environmental covariation is available to all age ranges, but the expression of the contextual cueing may depend on the way it is measured.     

Moses,Michelangelo and Freud: From an interlacement of stories in history to some suggestions for treatment theory

Abstract

The first part of this paper is inspired by Freud's interpretation of Michelangelo's Moses, which as the author shows, profoundly expresses Freud's subjectivity and personal features. With reference to clinical treatment, when the analyst “reasons” without considering his or her partner's position, the setting is lacking from a relational point of view. The consequence is that the analyst is missing a precious resource, that is, his or her patient and the documental sources he or she transmits in the analytic dialogue. In the second part of the paper, the author analyzes the nature of documental sources. This information pertains to both the patients’ pasts and their histories, expressing their rigid conservative needs, and to their evolution and transformational needs, in view of future possible change. Evolution needs are not visible, because they are implicitly present, and—according to the author—they could be recognized through the method of discrete details proposed by the Italian art critic G. Morelli. A broader vision of analytic listening is also considered: the past should be taken into account with the aim of interpreting the present and the future, as changing spaces. Change in therapy is announced through nonrepressed unconscious signals and by the language of the implicit. In the conclusion, the author exposes the connections of change, implicit, symbol, metaphorical language and waiting time.     

Good or Bad,We Want it Now: Fixed‐cost Present Bias for Gains and Losses Explains Magnitude Asymmetries in Intertemporal Choice

Intertemporal tradeoffs are ubiquitous in decision making, yet preferences for current versus future losses are rarely explored in empirical research. Whereas rational‐economic theory posits that neither outcome sign (gains vs. losses) nor outcome magnitude (small vs. large) should affect delay discount rates, both do, and moreover, they interact: in three studies, we show that whereas large gains are discounted less than small gains, large losses are discounted more than small losses. This interaction can be understood through a reconceptualization of fixed‐cost present bias, which has traditionally described a psychological preference for immediate rewards. First, our results establish present bias for losses—a psychological preference to have losses over with now. Present bias thus predicts increased discounting of future gains but decreased (or even negative) discounting of future losses. Second, because present bias preferences do not scale with the magnitude of possible gains or losses, they play a larger role, relative to other motivations for discounting, for small magnitude intertemporal decisions than for large magnitude intertemporal decisions. Present bias thus predicts less discounting of large gains than small gains but more discounting of large losses than small losses. The present research is the first to demonstrate that the effect of outcome magnitude on discount rates may be opposite for gains and losses and also the first to offer a theory (an extension of present bias) and process data to explain this interaction. The results suggest that policy efforts to encourage future‐oriented choices should frame outcomes as large gains or small losses. Copyright © 2012 John Wiley & Sons, Ltd.     

Approach bias for food cues in obese individuals

This study aimed to investigate the existence of an approach bias for food cues in obese individuals. A community sample of 56 obese women and 56 normal weight controls completed an approach–avoidance variant of the implicit association task. The obese participants were faster to respond to trials that paired food words with approach words, and trials that paired non-food words with avoid words, than the converse pairings, thus, demonstrating an approach bias for food. This bias was evident for both high caloric and low caloric food words, and was not attributable to a state of deprivation or feelings of hunger. By contrast, the normal weight controls did not show any such bias. The results are consistent with recent neurocognitive perspectives of obesity. At a practical level, approach biases for food may present a potential target for modifying (excessive) food intake.     

Reduce temptation or resist it? Experienced temptation mediates the relationship between implicit evaluations of unhealthy snack foods and subsequent intake

A more negative implicit evaluation of unhealthy food stimuli and a more positive implicit evaluation of a weight-management goal have been shown to predict lower consumption of unhealthy food. However, the associations between these evaluations, temptation to indulge and consumption of unhealthy food remain unclear. The current study investigated whether temptation would mediate the relationship between implicit food and goal evaluations and consumption (resembling an antecedent-focused route to self-control of eating), or whether those evaluations would moderate the relationship between temptation and consumption (resembling a response-focused route). A sample of 156 women (17–25 years), who tried to manage their weight through healthy eating, completed two implicit association tasks assessing implicit food and goal evaluations, respectively. Intake of four energy-dense snack foods was measured in a task disguised as a taste test, and participants reported the strength of experienced temptation to indulge in the snacks offered. Negative implicit food evaluation was associated with lower snack intake, and temptation mediated this relationship. Implicit goal evaluation was unrelated to both temptation strength and snack consumption. The findings contribute to an understanding of how negative implicit unhealthy food evaluation relates to lower consumption, namely through the mediation of temptation to indulge in those foods.     

Cross-modal working memory binding and learning of visual-phonological associations in children with reading difficulties

Reading decoding requires the association of a visual input (the printed word) with a verbal output (the spoken word), and the learning of visual-phonological associations via repeated exposure occurs both explicitly (by instruction and training) and implicitly (by exposure to written material). However, a general ability to implicitly learn visual-phonological associations (or cross-modal bindings) in children with reading difficulties (RD) has not been deeply explored. The present paper examined this issue in two studies comparing groups of children with RD with matched groups of control children in a working memory binding task involving sequences of variable combinations of nonsense shapes and nonwords (odd trials), as well as fixed combinations (even trials). Stimuli presentation was followed by a recognition test in which the nonwords were given one at a time and the children were required to mouse click on their respective shapes. In Study 1, fixed bindings were presented in random sequences across even trials, and the recognition test presented the nonwords at random. In Study 2, fixed bindings were presented in the same order across even trials, and the recognition test presented the nonwords following the same sequence order. In both studies, a consistent and strong learning effect of fixed bindings was observed for the control groups, with significantly better performance than the groups with RD. Such results suggest that poor cross-modal binding learning is associated with reading difficulties. Implications for the study and treatment of dyslexia are discussed.     

On applying cognitive psychology

Recent attempts to assess the practical impact of scientific research prompted my own reflections on over 40 years worth of combining basic and applied cognitive psychology. Examples are drawn principally from the study of memory disorders, but also include applications to the assessment of attention, reading, and intelligence. The most striking conclusion concerns the many years it typically takes to go from an initial study, to the final practical outcome. Although the complexity and sheer timescale involved make external evaluation problematic, the combination of practical satisfaction and theoretical stimulation make the attempt to combine basic and applied research very rewarding.