The antecedents and consequences of stereotype threat in Parkinson's disease.

OBJECTIVE: The aim of this study was to examine what factors make people with Parkinson's disease more susceptible to stereotype threat (i.e., the concern of being evaluated in line with negative group-based stereotypes) and the clinical consequences of this. METHOD: Forty-nine people with Parkinson's disease completed a measure of stereotype threat, as well as measures that indexed potential antecedents and clinical consequences of stereotype threat. RESULTS: Younger age and greater communication difficulties emerged as significant predictors of stereotype threat. Higher stereotype threat was also associated with increased emotional distress. CONCLUSIONS: These findings are an important first step in understanding stereotype threat in Parkinson's disease and may help to guide the development of intervention and educational efforts aimed at countering its effects.

Weight-based stereotype threat in the workplace: consequences for employees with overweight or obesity.

BACKGROUND/OBJECTIVES: Employees with overweight or obesity are often stereotyped as lazy, unmotivated, and less competent than employees with normal weight. As a consequence, employees with overweight or obesity are susceptible to stereotype threat, or the concern about confirming, or being reduced to, a stereotype about their group. This survey study examined whether employees with overweight or obesity experience stereotype threat in the workplace, whether it is associated with their perceived ability to meet their work demands (i.e., work ability), and whether high levels of knowledge about one's self (i.e., authentic self-awareness) can offset a potential negative association. SUBJECTS/METHODS: Using a correlational study design, survey data were collected from N = 758 full-time employees at three measurement points across 3 months. Employees' average body mass index (BMI) was 26.36 kg/m² (SD = 5.45); 34% of participants were employees with overweight (BMI between 25 and <30), and 18% of participants were employees with obesity (BMI > 30). RESULTS: Employees with higher weight and higher BMI reported more weight-based stereotype threat (rs between 0.17 and 0.19, p < 0.001). Employees who experienced higher levels of weight-based stereotype threat reported lower work ability, while controlling for weight, height, and subjective weight (ß = -0.27, p < 0.001). Authentic self-awareness moderated the relationship between weight-based stereotype threat and work ability (ß = 0.14, p < 0.001), such that the relationship between stereotype threat and work ability was negative among employees with low authentic self-awareness (ß = -0.25, p < 0.001), and non-significant among employees with high authentic self-awareness (ß = 0.08, p = 0.315). CONCLUSIONS: The findings of this study contribute to the literature by showing that weight-based stereotype threat is negatively associated with employees' perceived ability to meet their work demands, particularly among those employees with low authentic self-awareness.

Improving the Quality of Bowel Preparation: Rewarding Patients for Success or Intensive Patient Education?

INTRODUCTION AND OBJECTIVES: The quality of the bowel preparation is a critical parameter for the outcome of colonoscopies. It is well established that the bowel preparation modality (e.g., split or larger volume preparation) significantly improves the quality of the bowel preparation. Patient compliance is another important factor impacting on the quality of bowel preparations that receives relatively little research attention. We aimed to explore if intensified education or a lottery ticket as reward for good bowel preparation could improve outcomes. METHODS: After informed consent, all patients received a standardized printed information booklet. In a randomized fashion, patients were offered (a) a lottery scratchy ticket with an opportunity to win $25,000 as "reward" for good bowel preparation, (b) an education session delivered over the phone by a trained nurse, or (c) no additional measure. RESULTS: Overall, the quality of the bowel preparation was rated good or very good in 69.1% (95% CI 61.7-75.7%) of patients. Reward intervention did not influence the quality of bowel preparation (OR 0.42, 95% CI 0.09-1.91, p = 0.260); however, bowel preparation quality decreased in patients randomized to receive the additional education (OR 0.28, 95% CI 0.08-0.96, p = 0.042). Neither intervention significantly impacted on polyp detection rates. CONCLUSIONS: Contrasting general beliefs, additional interventions (e.g., incentives or phone consultation) did not improve the quality of the bowel preparation. The unexpected result shows that utilizing extra resources must be balanced against real-world outcomes and may not always provide the expected result.

No evidence that implicit identification with mental illness predicts recovery.

OBJECTIVES: Recovery from mental illness is multiply-determined, but one factor that has been proposed to influence recovery is the degree to which the person identifies as someone with a mental illness. This study examines the relationship between implicit identification with being mentally unwell and recovery among clients of a community mental health service. A multi-faceted view of recovery was adopted. METHODS: A longitudinal design was used to assess implicit identification with mental illness and its relationship to recovery, including symptom severity, well-being, life satisfaction, and optimism, which were supplemented with ratings by both support workers and the research assistants who conducted the study. Participants were 216 community mental health care clients, with 150 retested at Time 2, and 100 retested at Time 3. RESULTS: Implicit identification with mental illness was correlated with recovery at Time 1 and Time 3, though this relationship did not emerge at Time 2. Cross-lag regression analyses failed to reveal evidence that implicit identification with mental illness predicts subsequent recovery. CONCLUSIONS: The current research suggests that implicit identification with mental illness can be considered a marker of ongoing recovery, but is not predictive of subsequent recovery. Hence, these data suggest that implicit identification with mental illness is unlikely to play an independent role in the recovery process. PRACTITIONER POINTS: Research regarding the mental health consequences of implicit identification focuses on symptomatology. Recovery is more than a reduction in symptoms, however, and thus, a broader conceptualization of recovery was examined. Implicit identification with being mentally unwell was associated with poorer recovery broadly operationalized, but did not predict subsequent recovery.

For Better or Worse: Facebook Use and Wellbeing Among Community Mental Health Care Clients.

Online social networking is ubiquitous, but research regarding its relationship to wellbeing has yielded contradictory results. This study examined the relationship between Facebook use and wellbeing among community mental health service clients. Twenty-six clients from a community mental health service provided access to their Facebook page. Seven aspects of 3674 Facebook posts were coded, and cross-lagged multilevel models were estimated over three periods to establish the relationship between Facebook use and wellbeing over time. Some aspects of Facebook use were related to wellbeing within the same period, although this pattern of relationships did not emerge longitudinally. Although Facebook has the potential to forge social connections for those who are socially isolated, Facebook use was neither helpful nor harmful over time among people with mental health problems. Given the prevalence of social networking, a clearer understanding of its impact on wellbeing is critical for mental health providers.

Stereotype threat and social function in opioid substitution therapy patients.

OBJECTIVES: People with a history of substance abuse are subject to widespread stigmatization. It seems likely that this societal disapproval will result in feelings of stereotype threat, or the belief that one is the target of demeaning stereotypes. If so, stereotype threat has the potential to contribute to functional difficulties including poor social outcomes. METHODS: Eighty drug users on opioid substitution therapy and 84 demographically matched controls completed measures of mental health and social function. The opioid substitution therapy group were additionally asked to complete a measure that focused on their feelings of stereotype threat in relation to their drug use history. Bivariate correlations and hierarchical regression analyses were conducted to establish the magnitude and specificity of the relationship between stereotype threat and social functioning. RESULTS: Relative to controls, the opioid substitution therapy group reported higher levels of negative affect and schizotypy, and poorer social functioning, with all three of these indices significantly correlated with their feelings of stereotype threat. The results also showed that stereotype threat contributed significant unique variance to social functioning in the opioid substitution therapy group, even after taking into account other background, clinical, and mental health variables. CONCLUSIONS: Social functioning is an important aspect of recovery, yet these data indicate that people with a history of drug abuse who believe they are the target of stereotypical attitudes have poorer social functioning. This relationship holds after controlling for the impact of other variables on social functioning, including mental health. The theoretical and practical implications of these findings are discussed. PRACTITIONER POINTS: Concerns about being stereotyped can shape the social experiences of opioid substitution therapy patients. Opioid substitution therapy patients who feel negatively stereotyped experience greater social function deficits, and this relationship emerges after controlling for important clinical and mental health variables. Understanding the relationship between feeling stereotyped and social function may assist practitioners in their treatment. The study is cross-sectional, and thus, experimental or longitudinal research is required to determine the causal direction between stereotype threat and social function.

Internalized Stigma Among People Who Inject Drugs.

BACKGROUND: Perceived experiences of stigma have been found to be associated with poorer psychosocial outcomes and engagement in risk practices among people who inject drugs. Yet the extent to which people internalize or accept the stigma surrounding their injecting drug use, and whether this is associated with risky injecting practices, is not well known. OBJECTIVES: The aim of this study was to assess the extent of internalized stigma among a sample of people who inject drugs in Australia and identify socio-demographic, injecting risk, and mental health correlates. METHODS: People who inject drugs were recruited from a needle and syringe program located in Sydney, Australia to complete a brief survey. The survey included measures of internalized stigma, severity of drug dependence, self-esteem, depression, and shared use of injecting equipment. RESULTS: The sample comprised 102 people who inject drugs. Internalized stigma was higher among participants who reported being depressed in the past month, and was also associated with greater severity of drug dependence and diminished self-esteem. There was no relationship between internalized stigma and shared use of needles or other injecting equipment in the past month. Conclusions/Importance: Findings underscore the need for further investigation of internalized stigma among people who inject drugs. In particular, future research should assess the impact of implicit (i.e., subconscious) internalized stigma on mental health.

Discrimination by health care workers versus discrimination by others: countervailing forces on HCV treatment intentions.

Hepatitis C virus (HCV) infection is a major public health burden. Despite recent advances in HCV treatment, uptake remains low, particularly amongst people who inject drugs. HCV-related stigma and discrimination are common, especially within the health care sector. This research examines a more nuanced approach for how HCV-related stigma and discrimination impacts treatment access and uptake. Based on a social identity framework, we explore whether perceived HCV-related discrimination is associated with attempts to remove the stigma of being HCV-positive via HCV treatment intentions. Based on the results of prior research it was also hypothesised that the source of discrimination (health care workers versus others), and whether the discrimination is perceived to be directed to oneself or to the HCV-positive group, will differentially impact treatment intentions. The sample consisted of 416 people living with HCV in New South Wales, Australia, who acquired HCV from injecting drugs. Participants were asked about their experiences of perceived discrimination directed towards themselves versus their HCV-positive group and perceived discrimination within the health care sector. Findings indicate that discrimination towards the self is a more powerful indicator of treatment intentions than discrimination aimed at the HCV-positive group. This finding is consistent with social identity theory suggesting that people from low status groups are motivated to change their stigmatised status when it is possible to do so. The source of the perceived discrimination also matters, however, as participants who report experiencing discrimination from health workers have lowered intentions to engage with HCV treatment in the future. In combination, the results indicate that while perceived discrimination is commonly understood to act as a barrier to treatment uptake, the relationship is actually more complex than previously conceptualised.

Age-based stereotype threat in the workplace: A daily diary study of antecedents and mechanisms.

Both older and younger employees are stereotyped at work, making them susceptible to age-based stereotype threat or the concern about being negatively stereotyped based on their age. To date, there is limited understanding of the workplace events that spark age-based stereotype threat and the mechanisms through which they do so. The current daily diary study aimed to assess the frequency with which older and younger employees experience various events that have been identified as potential antecedents of age-based stereotype threat (e.g., being overlooked for training or development opportunities, feeling excluded from informal socializing) as well as their association with experiences of stereotype threat. As predicted, we found that employees who reported more frequent experiences of these events subsequently reported greater feelings of stereotype threat. This association was partially mediated by the capacity of these events to increase the salience of a participant's age. There was also evidence of reciprocal association, whereby employees who felt more stereotype threat were also more likely to subsequently report experiencing these events. Employee age did not moderate the relationship between daily feelings of stereotype threat and daily outcomes, suggesting that everyday feelings of stereotype threat may be equally problematic for both older and younger employees. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Blurred Ideas: How Perpetrator Behavior, Target Response, and Observer Gender Can Influence Perceptions of Workplace Sexual Harassment.

Despite increasing awareness, sexual harassment remains a significant concern in the workplace. The enduring problem of sexual harassment seems to persist due to a lack of clarity regarding what behaviors qualify as harassment. Furthermore, the interpretation of these behaviors is influenced by contextual and relational factors, contributing to the complexity of addressing and preventing such incidents. This study builds on existing research by investigating how the severity of sexually harassing behavior, the response from the target, and the gender of the participant contribute to labeling behavior as sexual harassment. Using an online experimental scenario-based survey, 1,700 (850 female, 850 male) currently employed participants were presented with a single workplace scenario that manipulated the severity of the sexual harassment behavior and the target's response. Participants were then asked to assess the appropriateness of the behavior, label it as sexual harassment or not, and rate their confidence in their labeling decision. The results revealed that less severe sexual harassment behaviors, targets who displayed interest, and male participants were more likely to perceive the behavior as less inappropriate and were less inclined to label it as sexual harassment. These findings have implications for shaping the definition of sexual harassment and designing training programs for heightened awareness.

Stigma by association among alcohol and other drug and harm reduction workers: Implications for workplace outcomes.

INTRODUCTION: The negative attitudes people hold towards those who use alcohol or other drugs (AOD) can also affect the people who work with this community, leading to lowered productivity and wellbeing. The impact of this stigma by association in the AOD and harm reduction sector is particularly significant because workers may have lived experience of AOD use and identify strongly with their client group. This study aimed to examine how stigma by association among health workers in the AOD/harm reduction sector relates to workplace outcomes. A secondary aim was to explore how lived experience influences experiences of stigma by association. METHODS: The research used a cross-sectional survey design and data collection occurred in 2023. Australian AOD/harm reduction workers (n = 228) completed an online survey assessing stigma by association as well as various workplace outcomes measures. RESULTS: Participants who reported experiencing more stigma by association experienced poorer workplace wellbeing, higher burnout and greater intentions to leave the AOD/harm reduction field. Experiences of stigma by association were unrelated to job satisfaction. Additional analyses revealed that participants with lived experience reported higher levels of job satisfaction and lowered intentions to leave the sector, but findings of stigma by association and its impacts on workplace outcomes did not differ from those without lived experience. DISCUSSION AND CONCLUSIONS: Identifying staff experiences of stigma by association and developing support and advocacy mechanisms to address this is likely to be key to reducing these experiences and ultimately to increasing positive workplace outcomes for AOD and harm reduction staff.

Pancultural nostalgia in action: Prevalence, triggers, and psychological functions of nostalgia across cultures.

Nostalgia is a social, self-relevant, and bittersweet (although mostly positive) emotion that arises when reflecting on fond past memories and serves key psychological functions. The majority of evidence concerning the prevalence, triggers, and functions of nostalgia has been amassed in samples from a handful of largely Western cultures. If nostalgia is a fundamental psychological resource, it should perform similar functions across cultures, although its operational dynamics may be shaped by culture. This study (N = 2,606) examined dispositional nostalgia, self-reported triggers of nostalgia, and functions of experimentally induced nostalgia in young adults across 28 countries and a special administrative region of China (i.e., Hong Kong). Results indicated that nostalgia is frequently experienced across cultures, albeit better valued in more-developed countries (i.e., higher national wealth and life-expectancy). Nostalgia is triggered by psychological threats (especially in warmer countries), sensory stimuli (especially in more-developed countries), and social gatherings (especially in less-developed countries). The positive or negative affect prompted by experimentally induced nostalgia varied by country, but was mild overall. More importantly, recalling a nostalgic (vs. ordinary) memory increased social connectedness, self-continuity, and meaning in life across cultures. In less-developed countries, recalling an ordinary memory also conferred some of these functions, reducing the effect size of nostalgia. Finally, recalling a nostalgic (vs. ordinary) memory augmented state satisfaction with life in countries with lower quality of living (i.e., lower life-expectancy and life-satisfaction). Overall, findings confirm the relevance of nostalgia across a wide range of cultures and indicate cultural nuances in its functioning. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Implicit attitudes, emotions, and helping intentions of mental health workers toward their clients.

The attitudes of mental health care workers toward their clients may influence the quality of care they provide. There is growing recognition of the role of implicit attitudes in behavior toward people with stigmatized illnesses, such as mental illness, and of the need to measure these separately from explicit attitudes. Seventy-four mental health workers completed implicit and explicit measure of attitudes toward people with mental illness. The participants were also asked about their intention to help people with mental illness and their emotional reactions toward people with a mental illness. The findings show that the implicit attitudes of the health workers toward clients with a mental illness are somewhat negative despite the fact that their explicit attitudes are somewhat positive. Although both implicit and explicit attitudes predicted negative emotions, only implicit attitudes were related to helping intentions. This study highlights the association between implicit attitudes and behavioral intentions and confirms the importance of addressing implicit attitudes in mental health research.

Interactions across the ages: How concerns about warmth and competence impact age-based stereotype threat in the workplace.

Although the disengagement consequences of age-based stereotype threat in the workplace are well-documented, it is less clear what causes employees to experience age-based stereotype threat. Based on socioemotional selectivity theory, the present study examines whether and why daily cross-age interactions in the workplace lead to stereotype threat. Using a diary study design over 2 weeks, 192 employees (86 employees aged 30 and younger; 106 employees aged 50 and older), completed 3570 reports on daily interactions with coworkers. Results showed that both younger and older employees experienced stereotype threat when they engaged in cross-age interactions compared to interactions with people of a similar age. The characteristics of cross-age interactions that led employees to experience stereotype threat differed by age, however. Consistent with socioemotional selectivity theory, cross-age interactions were problematic for younger employees to the degree that they triggered concerns about competence, whereas concerns about warmth led to stereotype threat among older employees. Daily stereotype threat was associated with reduced feelings of workplace belonging for both younger and older employees but, contrary to expectations, stereotype threat was not related to energy and stress. These findings suggest that cross-age interactions can lead to stereotype threat for both younger and older employees, particularly when younger employees worry they are perceived as incompetent or older employees worry they are perceived as less warm. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The cognitive tenacity of self-directed ageism.

Ageism refers to prejudice or discrimination based on a person's age. When ageism is directed at older people, it is unique in two ways: it is socially condoned in a manner that other types of prejudice are not, and the animus is eventually self-directed. Of central interest here is why ageism becomes self-directed in late adulthood, despite its potentially harmful personal costs. We present a cognitive model in which negative ageist beliefs become increasingly accessible and difficult to eliminate owing to broader developmental shifts in mentation. Given that these effects are contingent on our social environment, systemic changes in societal conceptions of age and aging are needed if we are to reduce vulnerability to self-directed ageism.

Lived Experience as a Protective Factor for Mental Health Workers.

OBJECTIVE: When clients do not seem to be improving, mental health workers have more negative job attitudes, experience higher levels of client-related burnout, and are more interested in leaving the field. Nonetheless, it is unclear whether all mental health workers are equally susceptible to burnout caused by feelings that their clients are not improving. Specifically, people with lived experience of mental illness are intimately familiar with their own recovery challenges and thus may be less susceptible to this source of burnout. METHODS: To test this possibility, mental health providers (N=179) from a nongovernmental community mental health organization in Australia completed a survey assessing their perceptions of client improvement from treatment, their feelings of client-related burnout, and a range of organizational outcomes (job satisfaction, job engagement, workplace well-being, and intentions to resign). RESULTS: Moderated mediation analyses revealed that although mental health providers who felt that their clients were not improving experienced client-related burnout, lived experience served as a buffer. Staff with lived experience were less susceptible to burnout associated with perceptions that their clients were not improving from treatment. Mental health providers with lived experience also reported more positive job attitudes compared with providers without lived experience. CONCLUSIONS: Given the high rates of burnout in the mental health profession, future research should examine why lived experience appears to buffer staff from burnout when they believe that their clients are not improving. This knowledge could aid in the development of interventions to boost resilience, engagement, and longevity in the field.

"Let's get physical" - or social: The role of physical activity versus social group memberships in predicting depression and anxiety over time.

BACKGROUND: Physical activity is often promoted as a way to prevent and combat anxiety and depression in adolescents. However, very little research has sought to establish whether the benefits of exercise arise from the excercise itself or from the social context in which it takes place. We explore the hypothesis that it is not physical activity on its own, but rather adolescents' engagement in group life (as part of a sports group or otherwise), that accounts for positive mental health effects associated with physical activity. METHODS AND RESULTS: We conducted a longitudinal study that tracked 558 high-school boys and found that anxiety and depression over time was not predicted by (a) T1 physical fitness as determined by 7 speed and agility tests, or (b) engaging in multiple sports as co-curricular activies at T1. In contrast, multiple group memberships - irrespective of the activity - predicted reduced depression and anxiety over time, particularly when these were groups that adolescents identified with and experienced as compatible with each other. LIMITATIONS: Limitations relate to (a) physical fitness only being measured at T1, (b) the absence of a measure of frequency and duration of physical activity, and (c) the homogeneity of the sample. CONCLUSIONS: We conclude that group memberships and the social identities that adolescents derive from these groups (including, but not restricted to, those involving sport) function as a psychological resource to reduce anxiety and depression over time.

Threat perception in schizophrenia-spectrum disorders.

It has been suggested that, relative to the other basic emotions, the perception of threat-related emotion is disproportionately impaired in schizophrenia-spectrum disorders. Yet research has not assessed how schizophrenia-spectrum disorders affect the ability to make direct appraisals of threat. In the present study, participants with schizophrenia spectrum disorders were compared with controls on two danger rating tasks that involved differentiating between faces and situations normatively judged to be either high or low in threat. It was also assessed whether danger ratings were related to clinical symptoms, as well as performance on an emotion recognition measure that depicted emotions in point-light animation (biological motion). While the two groups did not differ in their ability to differentiate high- from low-danger stimuli, or overall danger attributed to faces, overall danger attributed to situations was greater for the clinical group. The clinical group also showed a selective deficit recognizing fear on the bioemotion task, but only for the control group was recognition of threat-related emotions associated with danger ratings. These data are consistent with other evidence showing that there may be a disconnect between the usual processes used to make inferences regarding potential threat in schizophrenia spectrum disorders.

Stereotype threat contributes to social difficulties in people with schizophrenia.

OBJECTIVE: The experience of stereotype threat (where the prospect of conforming to a stereotype, or of being treated in terms of it, becomes self-threatening) affects members of social groups about whom devaluing stereotypes exist. Although a widely endorsed stereotype of schizophrenia concerns social skill impairment, it is unclear whether the experience of stereotype threat impacts social functioning in this group. The purpose of the present study was to test whether people with schizophrenia would perform more poorly in a social setting in which they felt stereotyped as mentally ill. METHODS: Thirty individuals with schizophrenia engaged in conversations with two confederates, one of whom they were told knew nothing about them (control conversation), and the other of whom they were told had been informed of their diagnosis (stereotype threat conversation). In reality, neither confederate had been informed of participants' mental health status. RESULTS: Although participants with schizophrenia did not perceive any differences in their own social behaviour across the two conditions, their social skill was rated by the confederates as poorer in the stereotype threat conversation on three out of the six measures used. CONCLUSIONS: These results suggest that social skill difficulties in people with schizophrenia may be exacerbated by their awareness that others know of their diagnosis. These findings have implications for disclosure of mental health status.

Perceived inability to help is associated with client-related burnout and negative work outcomes among community mental health workers.

Community mental health is a vital service, but it faces ongoing challenges from its high staff-turnover rates. The current study provides a preliminary test of a novel explanation for employee disengagement in community mental health. It is proposed that providing assistance to clients, while simultaneously feeling that only limited progress is being made, is associated with client-related burnout among community mental health providers, leading to negative work outcomes. Employees (N = 349) from three non-governmental community mental health organisations in Australia completed a survey assessing their perceptions of client improvement from treatment, client-related burnout and a range of organisational outcomes. Analyses revealed that perceptions that clients are not improving was associated with burnout, which in turn is related to lower job satisfaction, decreased job engagement, poorer workplace well-being, and increased turnover intentions. These findings suggest that interventions that highlight positive changes among clients could reinforce the important service provided by community mental health employees and may minimise burnout and negative work outcomes.