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.     

A Cybernetic Theory of Psychopathology

Abstract

Cybernetics, the study of principles governing goal-directed, self-regulating systems, offers a useful approach to understanding psychopathology or psychological dysfunction, overcoming limitations of other naturalistic approaches. Whereas influential theories of psychopathology have relied on definitions of dysfunction rooted in evolution and fitness, we define psychopathology in terms of cybernetic dysfunction, failure to make progress toward important goals. Cybernetic function in organisms is not identical to evolutionary function, despite their causal phylogenetic relationship. We define psychopathology as persistent failure to move toward one’s goals, due to failure to generate effective new goals, interpretations, or strategies when existing ones prove unsuccessful. This definition allows a thorough integration of dimensional approaches to psychopathology and personality and provides a new perspective on the nosology of mental disorder. We review evidence that the major dimensions of psychopathology correspond to major trait dimensions of personality, but we assert that extremity on these dimensions is neither necessary nor sufficient for psychopathology, which requires cybernetic dysfunction. Drawing from psychological and neurobiological research on personality and psychopathology, we present a theory of the mechanisms underlying the five major dimensions of psychopathology, some of their subdimensions, and the general risk factor for psychopathology. We conclude by discussing implications of our theory for research, diagnosis, and mental health interventions.     

Misconstruing methods and meaning in the General Factor of Personality

Research has suggested that a General Factor of Personality (GFP) might represent a real and meaningful higher‐order factor in the personality hierarchy. However, there are psychometric shortcomings in many of the studies used to support this argument, as well as convincing empirical evidence for alternative explanations of the GFP as methodological rather than meaningful. The current article re‐examines the research supporting a substantive GFP by considering and evaluating the evidence presented in a recent volume (Just, 2011). It is concluded that covariation among first‐order personality factors is more likely a statistical or methodological artefact than a theoretically meaningful higher‐order construct.     

Attachment Security,Personality, and Adjustment of Elementary School Children

Children's development is assumed to be closely related to their attachment security and their personality. The authors’ aim was to examine the joint contribution of attachment security and personality traits to children's adjustment by examining diverse children's outcomes (emotional symptoms, social functioning, and behavioral problems) and using various perspectives (children, parents, and teachers). The sample comprised 247 8–12-year-old children from low socioeconomic status neighborhoods. Personality and attachment contribute to the different domains of adjustment. In cases of moderation, attachment security moderates the implications of personality traits on children's adjustment. The findings highlight the contribution of positive personality tendencies in playing down the difficulties of insecurely attached children.     

Interests and Leadership among Adolescents

The purpose of this study was to ascertain whether there is a differential relationship in the socialization of children with respect to gender identification when responses of children were examined with respect to race and sex (N = 596 fifth and sixth grade boys and girls). Strong father preference was found to have no effect on the choice a boy will make when choosing between male and female peers, during preadolescence, while a strong mother preference by a girl is related to the sex of the peers she chooses. Preadolescent girls who identify with their mothers chose girls with whom to interact in a variety of activities more frequently than they chose boys. A greater proportion of girls preferred to engage in activities with their mothers than boys preferred to engage in activities with their fathers. No differences were observed between racial groups in terms of girls' choices involving peers. Black boys, however, preferred to engage in activities with opposite-sex rather than same-sex peers to a greater extent than white boys.     

Variability and Determinism in Motor Behavior

In investigations into perception-action systems, variability of observable behavior may be considered to (a) interfere with inquiry, (b) be neither detrimental nor particularly useful to inquiry, or (c) play a crucial role in inquiry. The authors underscore recent suggestions that alternative (c) is a preferred strategy for the study of many motor behaviors. In tutorial fashion, the authors review the concepts of variability and determinism with respect to postural and rhythmic movements. Study of the variability of those behaviors has revealed crucial features suggestive of underlying mechanisms and control, such as particular blends of noise and determinism (piecewise determinism). It has also revealed general lessons (for example, more variable does not mean more random and more controllable does not mean more deterministic) that may extend to other classes of perceptual-motor behavior.     

Sequential Aiming with Two Limbs and the One-Target Advantage

Movement times to the first target in a 2-target sequence are typically slower than in 1-target aiming tasks. The 1-target movement time advantage has been shown to emerge regardless of hand preference, the hand used, the amount of practice, and the availability of visual feedback. The authors tested central and peripheral explanations of the 1-target advantage, as postulated by the movement integration hypothesis, by asking participants to perform single-target movements, 2-target movements with 1 limb, and 2-target movements in which they switched limbs at the first target. Reaction time and movement time data showed a 1-target advantage that was similar for both 1- and 2-limb sequential aiming movements. This outcome demonstrates that the processes underlying the increase in movement time to the 1st target in 2-target sequences are not specific to the limb, suggesting that the 1-target advantage originates at a central rather than a peripheral level.     

The Effects of Force and Direction Uncertainty on Choice Reaction Time in an Isometric Force Production Task

The two experiments reported examined the temporal organization of force and direction motor-programming processes in a step-input tracking type task. Both experiments observed a reduction in reaction time in the direction-uncertain conditions compared to the direction-certain ones. Thus it seems as though the direction decision does not have to precede the selection of the proper amount of force. Experiment 2 observed an underadditive interaction between levels of direction uncertainty (certain or uncertain) and levels of force uncertainty (certain or uncertain). This interaction was interpreted as support for a parallel organization of the processes responsible for the programming of force and direction and thus, strongly supports the parallel model of programming recently proposed by Klapp (1977a, b).