Psychological outcomes and culturally relevant moderators associated with events of discrimination among Asian American adults.

OBJECTIVES: Incidents of discrimination against Asian Americans have increased in the United States during the COVID-19 pandemic. The aims of this study are to (a) examine the overall psychological impact of incidents of discrimination on Asian Americans adults, (b) identify whether East Asians experience worse psychological outcomes following experiences of discrimination compared to other Asian Americans, and (c) identify culturally relevant factors that moderate the relationship between incidents of discrimination and psychological outcomes. METHOD: Two hundred eighty-nine participants who identified racially as Asian American (Mage = 33.1 years, ±10.5 SD, 57.1% male, and 54.3% East Asian) completed an online survey including measures of demographics, psychological outcomes, culturally relevant factors (e.g., acculturative stress, collective self-esteem), and racial discrimination. RESULTS: We found that, overall, experiencing increased frequency of discrimination related to more depressive symptoms and alcohol use (ps < .05). When comparing Asian subgroups (East Asian vs. other Asian), there were no significantly different relationships between discrimination frequency and attribution to race on psychological outcomes (ps > .098). Collective self-esteem (p = .041) weakened, while acculturative stress strengthened (p < .001) the relationship between discrimination frequency and alcohol use; collective self-esteem weakened the relationship between attribution to race and social anxiety (p = .021); and internalized racism weakened the relationship between discrimination frequency and depression (p = .038). CONCLUSIONS: We identified moderators of the relationship between experiences of discrimination and psychological outcomes in Asian Americans. Because the moderators held for all Asian groups under study, they are strong candidates for points of intervention to mitigate the harmful effects of discrimination for Asian Americans. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Reproducibility Movement in Psychology: Does Researcher Gender Affect How People Perceive Scientists With a Failed Replication?

The reproducibility movement in psychology has resulted in numerous highly publicized instances of replication failures. The goal of the present work was to investigate people's reactions to a psychology replication failure vs. success, and to test whether a failure elicits harsher reactions when the researcher is a woman vs. a man. We examined these questions in a pre-registered experiment with a working adult sample, a conceptual replication of that experiment with a student sample, and an analysis of data compiled and posted by a psychology researcher on their public weblog with the stated goal to improve research replicability by rank-ordering psychology researchers by their "estimated false discovery risk." Participants in the experiments were randomly assigned to read a news article describing a successful vs. failed replication attempt of original work from a male vs. female psychological scientist, and then completed measures of researcher competence, likability, integrity, perceptions of the research, and behavioral intentions for future interactions with the researcher. In both working adult and student samples, analyses consistently yielded large main effects of replication outcome, but no interaction with researcher gender. Likewise, the coding of weblog data posted in July 2021 indicated that 66.3% of the researchers scrutinized were men and 33.8% were women, and their rank-ordering was not correlated with researcher gender. The lack of support for our pre-registered gender-replication hypothesis is, at first glance, encouraging for women researchers' careers; however, the substantial effect sizes we observed for replication outcome underscore the tremendous negative impact the reproducibility movement can have on psychologists' careers. We discuss the implications of such negative perceptions and the possible downstream consequences for women in the field that are essential for future study.

Examining the effects of implicit and explicit racial identity on psychological distress and substance use among Black young adults.

Racial identity is an aspect of self-concept that is important to the mental and behavioral health of Black individuals. Yet, much of the current research on racial identity is based on self-report measures which may impact findings due to reporting biases. One way to alleviate some of the measurement concerns is to use implicit measures to assess racial identity. The purpose of the present study was to examine whether an implicit assessment of racial identity, specifically racial centrality, provided a unique contribution to the understanding of risk for psychological distress and substance use among Black young adults above potential effects observed from an explicit measurement of racial identity. Additionally, the potential moderating effect of implicit racial identity, controlling for explicit racial identity, on the association between racial discrimination and these health outcomes was also examined. One hundred and forty-seven Black young adults participated in this study. Contrary to our hypothesis, there was no significant main effect of implicit racial centrality on depressive symptoms or substance use after accounting for explicit racial centrality. However, after controlling for explicit racial centrality, a significant moderating effect of implicit racial centrality on the relationship between racial discrimination and substance use was observed. Although support for all of our hypotheses was not definitively found, our findings can be added to this emerging area of study. Additionally, potential explanations for the findings are provided that can be used to inform future research in this area to better understand the utility of assessing for implicit racial identity among Black young adults. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Meta-Analytic Use of Balanced Identity Theory to Validate the Implicit Association Test.

This meta-analysis evaluated theoretical predictions from balanced identity theory (BIT) and evaluated the validity of zero points of Implicit Association Test (IAT) and self-report measures used to test these predictions. Twenty-one researchers contributed individual subject data from 36 experiments (total N = 12,773) that used both explicit and implicit measures of the social-cognitive constructs. The meta-analysis confirmed predictions of BIT's balance-congruity principle and simultaneously validated interpretation of the IAT's zero point as indicating absence of preference between two attitude objects. Statistical power afforded by the sample size enabled the first confirmations of balance-congruity predictions with self-report measures. Beyond these empirical results, the meta-analysis introduced a within-study statistical test of the balance-congruity principle, finding that it had greater efficiency than the previous best method. The meta-analysis's full data set has been publicly archived to enable further studies of interrelations among attitudes, stereotypes, and identities.

A randomized controlled trial testing a virtual perspective-taking intervention to reduce race and socioeconomic status disparities in pain care.

We conducted a randomized controlled trial of an individually tailored, virtual perspective-taking intervention to reduce race and socioeconomic status (SES) disparities in providers' pain treatment decisions. Physician residents and fellows (n = 436) were recruited from across the United States for this two-part online study. Providers first completed a bias assessment task in which they made treatment decisions for virtual patients with chronic pain who varied by race (black/white) and SES (low/high). Providers who demonstrated a treatment bias were randomized to the intervention or control group. The intervention consisted of personalized feedback about their bias, real-time dynamic interactions with virtual patients, and videos depicting how pain impacts the patients' lives. Treatment bias was re-assessed 1 week later. Compared with the control group, providers who received the tailored intervention had 85% lower odds of demonstrating a treatment bias against black patients and 76% lower odds of demonstrating a treatment bias against low SES patients at follow-up. Providers who received the intervention for racial bias also showed increased compassion for patients compared with providers in the control condition. Group differences did not emerge for provider comfort in treating patients. Results suggest an online intervention that is tailored to providers according to their individual treatment biases, delivers feedback about these biases, and provides opportunities for increased contact with black and low SES patients, can produce substantial changes in providers' treatment decisions, resulting in more equitable pain care. Future studies should examine how these effects translate to real-world patient care and the optimal timing/dose of the intervention.

Consequences of Confronting Patronizing Help for People with Disabilities: Do Target Gender and Disability Type Matter?

People with disabilities face a dilemma in dealing with patronizing help: Although accepting unsolicited assistance can incur psychological costs, confronting the helper has been shown to incur interpersonal penalties. The present research explored whether the consequences of confronting patronizing help vary across target gender and disability type. A vignette paradigm introduced participants to various interactions between adults with and without disabilities. Study 1 (N = 137) showed that, when blind targets confronted help that was clearly patronizing, they were rated as ruder and less warm after (vs. before) confronting regardless of their gender. Study 2 (N = 368) showed that, although both blind and wheelchair-using targets were rated as less warm and ruder after (vs. before) confronting, blind targets were penalized more, and patronizing behavior toward blind targets was perceived as more appropriate. These results highlight the importance of considering intersectionality and cross-disability heterogeneity when examining the multifaceted experience of ableism.

An experimental investigation of the relationships among race, prayer, and pain.

Background and aims Compared to White individuals, Black individuals demonstrate a lower pain tolerance. Research suggests that differences in pain coping strategies, such as prayer, may mediate this race difference. However, previous research has been cross-sectional and has not determined whether prayer in and of itself or rather the passive nature of prayer is driving the effects on pain tolerance. The aim of this study was to clarify the relationships among race, prayer (both active and passive), and pain tolerance. Methods We randomly assigned 208 pain-free participants (47% Black, 53% White) to one of three groups: active prayer ("God, help me endure the pain"), passive prayer ("God, take the pain away"), or no prayer ("The sky is blue"). Participants first completed a series of questionnaires including the Duke University Religion Index, the Coping Strategies Questionnaire-Revised (CSQ-R), and the Pain Catastrophizing Scale. Participants were then instructed to repeat a specified prayer or distractor coping statement while undergoing a cold pressor task. Cold pain tolerance was measured by the number of seconds that had elapsed while the participant's hand remained in the cold water bath (maximum 180 s). Results Results of independent samples t-tests indicated that Black participants scored higher on the CSQ-R prayer/hoping subscale. However, there were no race differences among other coping strategies, religiosity, or catastrophizing. Results of a 2 (Race: White vs. Black)×3 (Prayer: active vs. passive vs. no prayer) ANCOVA controlling for a general tendency to pray and catastrophizing in response to prayer indicated a main effect of prayer that approached significance (p=0.06). Pairwise comparisons indicated that those in the active prayer condition demonstrated greater pain tolerance than those in the passive (p=0.06) and no prayer (p=0.03) conditions. Those in the passive and no prayer distractor conditions did not significantly differ (p=0.70). There was also a trending main effect of race [p=0.08], with White participants demonstrating greater pain tolerance than Black participants. Conclusions Taken together, these results indicate that Black participants demonstrated a lower pain tolerance than White participants, and those in the active prayer condition demonstrated greater tolerance than those in the passive and no prayer conditions. Furthermore, Black participants in the passive prayer group demonstrated the lowest pain tolerance, while White participants in the active prayer group exhibited the greatest tolerance. Results of this study suggest that passive prayer, like other passive coping strategies, may be related to lower pain tolerance and thus poorer pain outcomes, perhaps especially for Black individuals. On the other hand, results suggest active prayer is associated with greater pain tolerance, especially for White individuals. Implications These results suggest that understanding the influence of prayer on pain may require differentiation between active versus passive prayer strategies. Like other active coping strategies for pain, active prayer may facilitate self-management of pain and thus enhance pain outcomes independent of race. Psychosocial interventions may help religiously-oriented individuals, regardless of race, cultivate a more active style of prayer to improve their quality of life.

Gender disparities in colloquium speakers at top universities.

Colloquium talks at prestigious universities both create and reflect academic researchers' reputations. Gender disparities in colloquium talks can arise through a variety of mechanisms. The current study examines gender differences in colloquium speakers at 50 prestigious US colleges and universities in 2013-2014. Using archival data, we analyzed 3,652 talks in six academic disciplines. Men were more likely than women to be colloquium speakers even after controlling for the gender and rank of the available speakers. Eliminating alternative explanations (e.g., women declining invitations more often than men), our follow-up data revealed that female and male faculty at top universities reported no differences in the extent to which they (i) valued and (ii) turned down speaking engagements. Additional data revealed that the presence of women as colloquium chairs (and potentially on colloquium committees) increased the likelihood of women appearing as colloquium speakers. Our data suggest that those who invite and schedule speakers serve as gender gatekeepers with the power to create or reduce gender differences in academic reputations.

Effect of Socioeconomic Status Bias on Medical Student-Patient Interactions Using an Emergency Medicine Simulation.

OBJECTIVES: Implicit bias in clinical decision making has been shown to contribute to healthcare disparities and results in negative patient outcomes. Our objective was to develop a high-fidelity simulation model for assessing the effect of socioeconomic status (SES) on medical student (MS) patient care. METHODS: Teams of MSs were randomly assigned to participate in a high-fidelity simulation of acute coronary syndrome. Cases were identical with the exception of patient SES, which alternated between a low-SES homeless man and a high-SES executive. Students were blinded to study objectives. Cases were recorded and scored by blinded independent raters using 24 dichotomous items in the following domains: 13 communication, six information gathering, and five clinical care. In addition, quantitative data were obtained on the number of times students performed the following patient actions: acknowledged patient by name, asked about pain, generally conversed, and touching the patient. Fisher's exact test was used to test for differences between dichotomous items. For continuous measures, group differences were tested using a mixed-effects model with a random effect for case to account for multiple observations per case. RESULTS: Fifty-eight teams participated in an equal number of high- and low-SES cases. MSs asked about pain control more often (p = 0.04) in patients of high SES. MSs touched the low-SES patient more frequently (p = 0.01). There were no statistically significant differences in clinical care or information gathering measures. CONCLUSIONS: This study demonstrates more attention to pain control in patients with higher SES as well as a trend toward better communication. Despite the differences in interpersonal behavior, quantifiable differences in clinical care were not seen. These results may be limited by sample size, and larger cohorts will be required to identify the factors that contribute to SES bias.

Obstetrical Providers' Management of Chronic Pain in Pregnancy: A Vignette Study.

Objective: Describe obstetrical providers' management of a hypothetical case on chronic pain in pregnancy and determine whether practices differ based on patient race. Design and Setting: This was a self-administered survey at a clinical conference. Subjects: Seventy-six obstetrician-gynecologists and one nurse practitioner were surveyed. Methods: A case-vignette described a pregnant patient presenting with worsening chronic lower back pain, requesting an opioid refill and increased dosage. We varied patient race (black/white) across two randomly assigned identical vignettes. Providers indicated their likelihood of prescribing opioids, drug testing, and referring on a 0 (definitely would not) to 10 (definitely would) scale; rated their suspicions/concerns about the patient on a 0-10 VAS scale; and ranked those concerns in order of importance. We calculated correlation coefficients, stratifying analyses by patient race. Results: Providers were not inclined to refill the opioid prescription (median = 3.0) or increase the dose (median = 1.0). They were more likely to conduct urine drug tests on white than black patients ( P = 0.008) and more likely to suspect that white patients would divert the medication ( P =0.021). For white patients, providers' highest-ranked concern was the patient's risk of abuse/addiction, whereas, for black patients, it was harm to the fetus. Suspicion about symptom exaggeration was more closely related to decisions about refilling the opioid prescriptions and increasing the dose for black patients (r = -0.357, -0.439, respectively), whereas these decisions were more closely correlated with concerns about overdose for white patients (r = -0.406, -0.494, respectively). Conclusions: Provider suspicion and concerns may differ by patient race, which may relate to differences in pain treatment and testing. Further study is warranted to better understand how chronic pain is managed in pregnancy.

The Pain Experience of Hispanic Americans: A Critical Literature Review and Conceptual Model.

UNLABELLED: Although the Hispanic population is a burgeoning ethnic group in the United States, little is known about their pain-related experience. To address this gap, we critically reviewed the existing literature on pain experience and management among Hispanic Americans (HAs). We focused our review on the literature on nonmalignant pain, pain behaviors, and pain treatment seeking among HAs. Pain management experiences were examined from HA patients' and health care providers' perspectives. Our literature search included variations of the term "Hispanic" with "AND pain" in PubMed, Embase, Web of Science, ScienceDirect, and PsycINFO databases. A total of 117 studies met our inclusion criteria. We organized the results into a conceptual model with separate categories for biological and/or psychological and sociocultural and/or systems-level influences on HAs' pain experience, response to pain, and seeking and receiving pain care. We also included information on health care providers' experience of treating HA patients with pain. For each category, we identified future areas of research. We conclude with a discussion of limitations and clinical implications. PERSPECTIVE: In this critical review of the literature we examined the pain and management experiences of the HA population. We propose a conceptual model, which highlights findings from the existing literature and future areas of research.

The interaction of patient race, provider bias, and clinical ambiguity on pain management decisions.

UNLABELLED: Although racial disparities in pain care are widely reported, much remains to be known about the role of provider and contextual factors. We used computer-simulated patients to examine the influence of patient race, provider racial bias, and clinical ambiguity on pain decisions. One hundred twenty-nine medical residents/fellows made assessment (pain intensity) and treatment (opioid and nonopioid analgesics) decisions for 12 virtual patients with acute pain. Race (black/white) and clinical ambiguity (high/low) were manipulated across vignettes. Participants completed the Implicit Association Test and feeling thermometers, which assess implicit and explicit racial biases, respectively. Individual- and group-level analyses indicated that race and ambiguity had an interactive effect on providers' decisions, such that decisions varied as a function of ambiguity for white but not for black patients. Individual differences across providers were observed for the effect of race and ambiguity on decisions; however, providers' implicit and explicit biases did not account for this variability. These data highlight the complexity of racial disparities and suggest that differences in care between white and black patients are, in part, attributable to the nature (ie, ambiguity) of the clinical scenario. The current study suggests that interventions to reduce disparities should differentially target patient, provider, and contextual factors. PERSPECTIVE: This study examined the unique and collective influence of patient race, provider racial bias, and clinical ambiguity on providers' pain management decisions. These results could inform the development of interventions aimed at reducing disparities and improving pain care.

Implicit and explicit stigma of mental illness: attitudes in an evidence-based practice.

The extent to which explicit and implicit stigma are endorsed by mental health practitioners using evidence-based practices is unknown. The purposes of the current study were to a) examine implicit and explicit biases among Assertive Community Treatment (ACT) staff and b) explore the extent to which biases predicted the use of treatment control mechanisms. Participants were 154 ACT staff from nine states. Overall, the participants exhibited positive explicit and implicit attitudes toward people with mental illness. When modeled using latent factors, greater implicit, but not explicit, bias significantly predicted greater endorsement of restrictive or controlling clinical interventions. Thus, despite overall positive attitudes toward those with mental illness for the sample as a whole, individual differences in provider stigma were related to clinical care. Mental health professionals, and specifically ACT clinicians, should be educated on types of bias and ways in which biases influence clinical interventions.

Priming media stereotypes reduces support for social welfare policies: the mediating role of empathy.

Two experiments involving White participants tested the influence of media-based priming of Black stereotypes on support for government policy that assisted Black versus White persons-in-need. Experiment 1 showed that priming the "Black criminal" stereotype through exposure to photographs of Blacks looting after Hurricane Katrina reduced policy support for Black evacuees-in-need but did not influence support responses toward White evacuees-in-need. Experiment 2 showed that priming the "promiscuous Black female" stereotype through exposure to sexual rap music reduced policy support for a Black pregnant woman-in-need but did not influence support responses toward a White pregnant woman-in-need. Further tests of mediated moderation demonstrated that in both experiments, the interactive influence of priming Black stereotypes and race of persons-in-need on policy support was mediated by empathic responding.

Putting the brakes on prejudice: on the development and operation of cues for control.

A model concerning the establishment and operation of cues for control was developed and tested to understand how control can be exerted over (automatic) prejudiced responses. Cues for control are stimuli that are associated with prejudiced responses and the aversive consequences of those responses (e.g., guilt). In Experiments 1 and 2, 3 events critical to the establishment of cues occurred: behavioral inhibition, the experience of guilt, and retrospective reflection. In Experiment 3, the presentation of already-established cues for control did, as expected, produce behavioral inhibition. In Experiment 4, participants were provided with an experience in which cues could be established. Later presentation of those cues in a different task resulted in behavioral inhibition and less racially biased responses.