Facets of stigma, self-compassion, and health-related adjustment to lung cancer: A longitudinal study.

OBJECTIVE: The aim of this study was to investigate whether three facets of lung cancer stigma (internalized stigma, constrained disclosure, and perceived subtle discrimination) uniquely predicted psychological and physical health-related adjustment to lung cancer across 12 weeks. Additionally, self-compassion was tested as a moderator of the stigma-health relationship. METHOD: Adults receiving oncologic treatment for lung cancer (N = 108) completed measures of lung cancer stigma, self-compassion, depressive symptoms, cancer-related stress, and physical symptom bother. Multivariable linear regression models were used to investigate cross-sectional and longitudinal relationships (at 6- and 12-week follow-up) between indicators of stigma and health-related outcomes, controlling for covariates. Self-compassion was tested as a moderator of these relationships. RESULTS: At study entry, higher internalized stigma, constrained disclosure, and perceived subtle discrimination were associated significantly and uniquely with higher depressive symptoms (all p < .05). Constrained disclosure and perceived subtle discrimination were also associated significantly with higher cancer-related stress and higher physical symptom bother at study entry (all p < .05). Furthermore, higher internalized stigma predicted significant increases in depressive symptoms across 12 weeks and in cancer-related stress across 6 and 12 weeks (all p < .05). Higher self-compassion significantly moderated relationships between perceived discrimination and psychological health outcomes at study entry as well as between internalized stigma and increasing depressive symptoms across 12 weeks (all p < .05). CONCLUSIONS: Results indicated robust relationships between distinct facets of stigma and health-related adjustment to lung cancer. Supportive care programs that bolster self-compassion may be useful for reducing lung cancer stigma. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

You wear me out: the vicarious depletion of self-control.

Acts of self-control may deplete an individual's self-regulatory resources. But what are the consequences of perceiving other people's use of self-control? Mentally simulating the actions of others has been found to elicit psychological effects consistent with the actual performance of those actions. Here, we consider how simulating versus merely perceiving the use of willpower can affect self-control abilities. In Study 1, participants who simulated the perspective of a person exercising self-control exhibited less restraint over spending on consumer products than did other participants. In Study 2, participants who took the perspective of a person using self-control exerted less willpower on an unrelated lexical generation task than did participants who took the perspective of a person who did not use self-control. Conversely, participants who merely read about another person's self-control exerted more willpower than did those who read about actions not requiring self-control. These findings suggest that the actions of other people may either deplete or boost one's own self-control, depending on whether one mentally simulates those actions or merely perceives them.

Aggress to impress: hostility as an evolved context-dependent strategy.

Given the high costs of aggression, why have people evolved to act aggressively? Comparative biologists have frequently observed links between aggression, status, and mating in nonhuman animals. In this series of experiments, the authors examined the effects of status, competition, and mating motives on men's and women's aggression. For men, status motives increased direct aggression (face-to-face confrontation). Men's aggression was also boosted by mating motives, but only when observers were other men. For women, both status and mating motives increased indirect aggression (e.g., socially excluding the perpetrator). Although neither status nor mating motives increased women's direct aggression, women did become more directly aggressive when motivated to compete for scarce resources. These context- and sex-specific effects on human aggression contribute to a broader understanding of the functional nature of aggressive behavior.

Following in the wake of anger: when not discriminating is discriminating.

Does seeing a scowling face change your impression of the next person you see? Does this depend on the race of the two people? Across four studies, White participants evaluated neutrally expressive White males as less threatening when they followed angry (relative to neutral) White faces; Black males were not judged as less threatening following angry Black faces. This lack of threat-anchored contrast for Black male faces is not attributable to a general tendency for White targets to homogenize Black males-neutral Black targets following smiling Black faces were contrasted away from them and seen as less friendly-and emerged only for perceivers low in motivation to respond without prejudice (i.e., for those relatively comfortable responding prejudicially). This research provides novel evidence for the overperception of threat in Black males.

The ironic effects of stigmatizing smoking: combining stereotype threat theory with behavioral pharmacology.

AIMS: Public service announcements often create media messages intended to stigmatize negative behaviors to reduce and prevent these behaviors. Drawing on social and cognitive psychology, we hypothesize that stigmatizing messages can create stereotype threat would be associated with shorter latency to first cigarette in the laboratory compared to the control condition. DESIGN: A double-blind, randomized, controlled trial in which participants completed two smoking lapse tasks, one at baseline and one post-intervention/control. SETTING: An experimental psychopharmacology laboratory in the western United States. PARTICIPANTS: A community sample of non-treatment-seeking daily smokers (n = 77) received either a stereotype threat (n = 39) or neutral/control (n = 38) message. INTERVENTION: Participants received either a stereotype threat message that stigmatized smoking or a control message. MEASUREMENTS: The primary outcome measure was participants' ability to delay smoking during the smoking lapse task in the experimental session FINDINGS: The difference in delay time during the experimental session at the point where 50% of each group had smoked was 3 minutes. Cox proportional hazard models revealed that participants in the stereotype threat group were significantly less able to delay initiating smoking compared to the control group (hazard ratio = 0.504, P = 0.010, 95% confidence interval = 0.30, 0.85), after controlling for baseline latency to smoke. CONCLUSIONS: Messages that elicit negative stereotypes of smokers operated as 'smoking-promoting messages' in the context of our controlled laboratory investigation.

When do the stigmatized stigmatize? The ironic effects of being accountable to (perceived) majority group prejudice-expression norms.

How do frequently stigmatized individuals feel about and respond to members of other potentially stigmatizable groups? Four studies demonstrated that perceptions of majority group norms regarding prejudice expression can shape how minority individuals respond to minority individuals from other groups. Study 1 revealed that Black and White men and women have somewhat different perceptions of Whites' norms regarding prejudice expression. Study 2 manipulated whether evaluations of Native American job candidates were to remain private or to be made public to unfamiliar Whites upon whom the evaluators were dependent: Black men used a strategy of publicly (but not privately) denigrating the minority target to conform to presumed prejudice-expression norms. Study 3, in which the authors explicitly manipulated prejudice-expression norms, and Study 4, in which they manipulated audience race, further supported the role of such norms in eliciting public discrimination against minority group members by other minority group members. The desire to avoid being targeted for discrimination, in conjunction with the perception that the majority endorses discrimination, appears to increase the likelihood that the often-stigmatized will stigmatize others.

A Longitudinal Investigation of Internalized Stigma, Constrained Disclosure, and Quality of Life Across 12 Weeks in Lung Cancer Patients on Active Oncologic Treatment.

INTRODUCTION: Internalized lung cancer stigma (i.e., feelings of regret, shame, and self-blame about one's lung cancer) is related to poorer psychological outcomes. Less is known about how internalized stigma relates to physical and functional outcomes or how constrained disclosure (i.e., avoidance of or discomfort about disclosing one's lung cancer status to others) relates to well-being. Furthermore, no study has examined whether internalized stigma and constrained disclosure predict changes in well-being for lung cancer patients. This longitudinal study characterized relationships of internalized stigma and constrained disclosure with emotional and physical/functional outcomes. METHODS: Participants (N = 101, 52.4% male, 63.4% currently/formerly smoked) were lung cancer patients on active medical treatment who completed questionnaires on stigma and well-being at study entry and at 6- and 12-week follow-up. Multivariable linear regressions characterized relationships of internalized stigma and constrained disclosure with emotional and physical/functional well-being at study entry and across time. RESULTS: Participants who currently or formerly smoked reported higher levels of internalized stigma (but not constrained disclosure), compared to never smokers (p < 0.001). Higher internalized stigma and constrained disclosure were uniquely associated with poorer emotional and physical/functional well-being at study entry (all p < 0.05), beyond sociodemographic characteristics, time elapsed since diagnosis, and smoking status. Higher internalized stigma predicted significant declines in emotional well-being across 6 and 12 weeks (all p < 0.01) and declines in physical/functional well-being across 6 weeks (p < 0.05). CONCLUSIONS: Internalized lung cancer stigma and constrained disclosure relate to emotional and physical/functional maladjustment. Findings carry implications for provider- and patient-focused interventions to reduce internalized stigma and promote well-being.

Expectations of obese trainees: how stigmatized trainee characteristics influence training effectiveness.

This study identifies stigma as a potential precursor to self-fulfilling prophecies in training interactions. Expectations held by leaders often result in actions that elicit expectancy-confirming behaviors from their subordinates. The results of the present study suggest that trainee weight (manipulated with a photograph depicting the trainee as either obese or average weight for height) influenced female trainer expectations and evaluations of the training and trainee. Furthermore, the results suggest that negative expectations held by trainers were related to trainee evaluations of the training and the trainer and, for less flexible trainers, to decrements in trainee performance on the trained task. Overall, the results suggest that trainer expectations can be influenced by stereotypes held about trainee characteristics, thus undermining training effectiveness.

Solidarity through shared disadvantage: Highlighting shared experiences of discrimination improves relations between stigmatized groups.

Intergroup relations research has largely focused on relations between members of dominant groups and members of disadvantaged groups. The small body of work examining intraminority intergroup relations, or relations between members of different disadvantaged groups, reveals that salient experiences of ingroup discrimination promote positive relations between groups that share a dimension of identity (e.g., 2 different racial minority groups) and negative relations between groups that do not share a dimension of identity (e.g., a racial minority group and a sexual minority group). In the present work, we propose that shared experiences of discrimination between groups that do not share an identity dimension can be used as a lever to facilitate positive intraminority intergroup relations. Five experiments examining relations among 4 different disadvantaged groups supported this hypothesis. Both blatant (Experiments 1 and 3) and subtle (Experiments 2, 3, and 4) connections to shared experiences of discrimination, or inducing a similarity-seeking mindset in the context of discrimination faced by one's ingroup (Experiment 5), increased support for policies benefiting the outgroup (Experiments 1, 2, and 4) and reduced intergroup bias (Experiments 3, 4, and 5). Taken together, these experiments provide converging evidence that highlighting shared experiences of discrimination can improve intergroup outcomes between stigmatized groups across dimensions of social identity. Implications of these findings for intraminority intergroup relations are discussed. (PsycINFO Database Record

The stigma of obesity in customer service: a mechanism for remediation and bottom-line consequences of interpersonal discrimination.

Using a customer service paradigm, the authors extended the justification-suppression model (JSM) of prejudice (C. S. Crandall & A. Eshleman, 2003) to include contemporary, covert forms of discrimination and to identify a discrimination remediation mechanism. Overall, the results of 3 studies revealed that actual and confederate obese shoppers in high-prejudice justification conditions faced more interpersonal discrimination than average-weight shoppers. Furthermore, Studies 1 and 2 demonstrate that adopting strategies that remove perceivers' justifications for discriminating against obese individuals (i.e., the controllability of weight) decreases the incidence of interpersonal discrimination. Additionally, Study 3 demonstrates negative bottom-line consequences of interpersonal discrimination for organizations (e.g., customer loyalty, purchasing behavior). Together, these studies confirm that the JSM applies to covert forms of discrimination, show the importance of examining subtle discrimination, and offer a mechanism for theory-driven strategies for the reduction of covert forms of discrimination.

Selection BIAS: Stereotypes and discrimination related to having a history of cancer.

Although great strides have been made in increasing equality and inclusion in organizations, a number of stigmatized groups are overlooked by diversity initiatives, including people with a history of cancer. To examine the workplace experiences of these individuals in selection contexts, we conducted 3 complementary studies that assess the extent to which cancer is disclosed, the stereotypes associated with cancer in the workplace, and discrimination resulting from these stereotypes. In a pilot study, we surveyed 196 individuals with a history of cancer (across 2 samples) about their workplace disclosure habits. In Study 1, we explored stereotypes related to employees with a history of cancer using the framework outlined by the stereotype content model. In Study 2, we used a field study to assess the experiences of job applicants who indicated they were "cancer survivors" (vs. not) with both formal and interpersonal forms of discrimination. This research shows that cancer is disclosed at relatively high rates (pilot study), those with a history of cancer are stereotyped as being higher in warmth than competence (Study 1), and the stereotypes associated with those who have had cancer result in actual discrimination toward them (Study 2). We discuss the theory behind these findings and aim to inform both science and practice with respect to this growing workplace population.

Perceived perspective taking: when others walk in our shoes.

A great deal of psychological research has investigated the influence of perspective taking on individuals, indicating that perspective taking increases the extent to which people like, feel a sense of self-other overlap with, and help those whose perspective they take. However, previous investigations of the topic have been limited to the study of the perspective taker, rather than the individual whose perspective has been taken. The purpose of the current work is to begin to fill this large gap in the literature by examining the consequences of believing that another individual is taking one's perspective, a phenomenon we refer to as perceived perspective taking. Over a series of 6 experiments, we demonstrate that perceiving that one's perspective has been taken confers many of the same interpersonal benefits as taking another's perspective. Specifically, our data suggest that believing that another person has successfully taken one's perspective results in an increased liking for, a greater sense of self-other overlap with, and more help provided to that person. Consistent with predictions, we find that one's self-other overlap with the perspective taker and the amount of empathy one perceives the perspective taker to feel operate in tandem to mediate the link between perceived perspective taking and liking for the perspective taker. Further, a mediational path from perceived perspective taking to helping behavior through liking is supported. Future directions are discussed, along with implications for theory and application in domains such as intergroup relations, conflict resolution, and political campaigning.

Differences in quit attempts between non-Hispanic Black and White daily smokers: the role of smoking motives.

INTRODUCTION: The prevalence of smoking across racial/ethnic groups has declined over the years, yet racial health disparities for smoking persist. Studies indicate that non-Hispanic Black smokers attempt to quit smoking more often compared to non-Hispanic White smokers but are less successful at doing so. Research suggests that motives to quit smoking differ by race, however, less is known about the role of motives to smoke in explaining racial differences in attempts to quit smoking. METHODS: This study examined whether smoking motives accounted for the differential rates in quit attempts between non-Hispanic Black (n=155) and non-Hispanic White (n=159) smokers. Data were culled from a larger study of heavy-drinking smokers. The Wisconsin Index of Smoking Dependence Motives (WISDM) assessed motives to smoke. RESULTS: As expected, Black and White smokers reported similar smoking patterns, yet Black smokers reported higher rates of failed attempts to quit smoking than White smokers. Findings indicated that Black, compared to White, smokers endorsed lower scores in the negative reinforcement, positive reinforcement, and taste WISDM subscales and scores in these subscales mediated the relationship between race and quit attempts. CONCLUSIONS: In this study, Blacks, compared to Whites, endorsed lower motives to smoke, which are generally associated with successful quit attempts, yet they experienced more failed attempts to quit smoking. This study demonstrates racial health disparities at the level of smoking motives and suggests that Black smokers remain vulnerable to failed quit attempts despite reporting lower motives to smoke.

Predictors of smoking lapse in a human laboratory paradigm.

RATIONALE: During a smoking quit attempt, a single smoking lapse is highly predictive of future relapse. While several risk factors for a smoking lapse have been identified during clinical trials, a laboratory model of lapse was until recently unavailable and, therefore, it is unclear whether these characteristics also convey risk for lapse in a laboratory environment. OBJECTIVES: The primary study goal was to examine whether real-world risk factors of lapse are also predictive of smoking behavior in a laboratory model of smoking lapse. METHODS: After overnight abstinence, 77 smokers completed the McKee smoking lapse task, in which they were presented with the choice of smoking or delaying in exchange for monetary reinforcement. Primary outcome measures were the latency to initiate smoking behavior and the number of cigarettes smoked during the lapse. Several baseline measures of smoking behavior, mood, and individual traits were examined as predictive factors. RESULTS: Craving to relieve the discomfort of withdrawal, withdrawal severity, and tension level were negatively predictive of latency to smoke. In contrast, average number of cigarettes smoked per day, withdrawal severity, level of nicotine dependence, craving for the positive effects of smoking, and craving to relieve the discomfort of withdrawal were positively predictive of number of cigarettes smoked. CONCLUSIONS: The results suggest that real-world risk factors for smoking lapse are also predictive of smoking behavior in a laboratory model of lapse. Future studies using the McKee lapse task should account for between subject differences in the unique factors that independently predict each outcome measure.

Are all interventions created equal? A multi-threat approach to tailoring stereotype threat interventions.

To date, stereotype threat interventions have been considered interchangeable. Across 4 experiments, the present research demonstrates that stereotype threat interventions need to be tailored to the specific form of experienced stereotype threat to be effective. The Multi-Threat Framework (Shapiro & Neuberg, 2007) distinguishes between group-as-target stereotype threats-concerns that a stereotype-relevant performance will reflect poorly on the abilities of one's group-and self-as-target stereotype threats-concerns that a stereotype-relevant performance will reflect poorly on one's own abilities. The present experiments explored Black college students' performance on diagnostic intelligence tests (Experiments 1 and 3) and women's interest (Experiment 2) and performance (Experiment 4) in science, technology, engineering, and math (STEM). Across the 4 experiments, participants were randomly assigned to experience either a group-as-target or self-as-target stereotype threat. Experiments 1 and 2 revealed that role model interventions were successful at protecting only against group-as-target stereotype threats, and Experiments 3 and 4 revealed that self-affirmation interventions were successful at protecting only against self-as-target stereotype threats. The present research provides an experimental test of the Multi-Threat Framework across different negatively stereotyped groups (Black students, female students), different negatively stereotyped domains (general intelligence, STEM), and different outcomes (test performance, career interest). This research suggests that interventions should address the range of possible stereotype threats to effectively protect individuals against these threats. Through an appreciation of the distinct forms of stereotype threats and the ways in which interventions work to reduce them, this research aims to facilitate a more complete understanding of stereotype threat.

Presumed fair: ironic effects of organizational diversity structures.

This research tests the hypothesis that the presence (vs. absence) of organizational diversity structures causes high-status group members (Whites, men) to perceive organizations with diversity structures as procedurally fairer environments for underrepresented groups (racial minorities, women), even when it is clear that underrepresented groups have been unfairly disadvantaged within these organizations. Furthermore, this illusory sense of fairness derived from the mere presence of diversity structures causes high-status group members to legitimize the status quo by becoming less sensitive to discrimination targeted at underrepresented groups and reacting more harshly toward underrepresented group members who claim discrimination. Six experiments support these hypotheses in designs using 4 types of diversity structures (diversity policies, diversity training, diversity awards, idiosyncratically generated diversity structures from participants' own organizations) among 2 high-status groups in tests involving several types of discrimination (discriminatory promotion practices, adverse impact in hiring, wage discrimination). Implications of these experiments for organizational diversity and employment discrimination law are discussed.

Is racial bias malleable? Whites' lay theories of racial bias predict divergent strategies for interracial interactions.

How do Whites approach interracial interactions? We argue that a previously unexamined factor-beliefs about the malleability of racial bias-guides Whites' strategies for difficult interracial interactions. We predicted and found that those who believe racial bias is malleable favor learning-oriented strategies such as taking the other person's perspective and trying to learn why an interaction is challenging, whereas those who believe racial bias is fixed favor performance-oriented strategies such as overcompensating in the interaction and trying to end the interaction as quickly as possible. Four studies support these predictions. Whether measured (Studies 1, 3, and 4) or manipulated (Study 2), beliefs that racial bias is fixed versus malleable yielded these divergent strategies for difficult interracial interactions. Furthermore, beliefs about the malleability of racial bias are distinct from related constructs (e.g., prejudice and motivations to respond without prejudice; Studies 1, 3, and 4) and influence self-reported (Studies 1-3) and actual (Study 4) strategies in imagined (Studies 1-2) and real (Studies 3-4) interracial interactions. Together, these findings demonstrate that beliefs about the malleability of racial bias influence Whites' approaches to and strategies within interracial interactions.

Different groups, different threats: a multi-threat approach to the experience of stereotype threats.

Two studies demonstrated that different negatively stereotyped groups are at risk for distinct forms of stereotype threats. The Multi-Threat Framework articulates six distinct stereotype threats and the unique constellations of variables (e.g., group identification, stereotype endorsement) that elicit each stereotype threat. Previous research suggests that different negatively stereotyped groups systematically vary across these stereotype threat elicitors; a pilot study confirms these differences. Across two studies, groups that tend to elicit low stereotype endorsement (religion, race/ethnicity, congenital blindness) were less likely to report experiencing self-as-source stereotype threats (stereotype threats requiring stereotype endorsement) and groups that tend to elicit low group identification (mental illness, obesity, blindness later in life) were less likely to report experiencing group-as-target stereotype threats (stereotype threats requiring group identification). This research suggests that traditional models may overlook the experiences of stereotype threats within some groups and that interventions tailored to address differences between stereotype threats will be most effective.

Signal detection on the battlefield: priming self-protection vs. revenge-mindedness differentially modulates the detection of enemies and allies.

Detecting signs that someone is a member of a hostile outgroup can depend on very subtle cues. How do ecology-relevant motivational states affect such detections? This research investigated the detection of briefly-presented enemy (versus friend) insignias after participants were primed to be self-protective or revenge-minded. Despite being told to ignore the objectively nondiagnostic cues of ethnicity (Arab vs. Western/European), gender, and facial expressions of the targets, both priming manipulations enhanced biases to see Arab males as enemies. They also reduced the ability to detect ingroup enemies, even when these faces displayed angry expressions. These motivations had very different effects on accuracy, however, with self-protection enhancing overall accuracy and revenge-mindedness reducing it. These methods demonstrate the importance of considering how signal detection tasks that occur in motivationally-charged environments depart from results obtained in conventionally motivationally-inert laboratory settings.

Measuring the impact of programs that challenge the public stigma of mental illness.

Public stigma robs people with mental illnesses from rightful opportunities related to work and other important life goals. Advocates have developed anti-stigma programs meant to address the prejudice and discrimination associated with these conditions. Evidence is now needed to make sense of program impact; this paper looks at measurement issues related to stigma change. Community-based participatory research is central to this research and includes the involvement of a diverse collection of stakeholders in all phases of evaluation. Investigators should be cautious about measures vis-à-vis social desirability effects and should directed by social validity of targeted audiences. Conceptual domains with some research support that correspond with assessments include behavior, penetration, psychological perspective, knowledge, and physiological/information processes. These issues are summarized as ten recommendations for evaluation of anti-stigma programs.