Michèle D. Birtel

Public perceptions of stigma towards people with schizophrenia, depression, and anxiety☆

Stigma is one of the greatest challenges facing people with a psychiatric diagnosis. They are widely stigmatised by the general public in the western world. The aim of this study was to examine public stigma attitudes towards schizophrenia, depression and anxiety. The Office of National Statistics (ONS) 2008 opinions survey (n=1070) was utilised. Percentage of endorsements for stigma items were initially compared to the previous 1998 and 2003 databases. Overall stigma attitudes had decreased (from 1998 to 2008) but increased since 2003. A principal components factor analysis identified that stigma attitudes have the same three factors structure across all diagnoses; negative stereotypes, patient blame and inability to recover. Schizophrenia was significantly associated with the most negative stereotypes, least blamed and viewed as least likely to recover compared to anxiety and depression. Public and individualised interventions that target diagnostic variability in stigma attitudes need to be developed and examined in future research.

“Treating” Prejudice An Exposure-Therapy Approach to Reducing Negative Reactions Toward Stigmatized Groups

One of the ways in which therapists treat anxiety disorders is to expose patients to a fear-evoking stimulus within a safe environment before encouraging more positive stimulus-related thoughts. In the study reported here, we adapted these psychotherapeutic principles of exposure therapy to test the hypothesis that imagining a positive encounter with a member of a stigmatized group would be more likely to promote positive perceptions when it was preceded by an imagined negative encounter. The results of three experiments targeting a range of stigmatized groups (adults with schizophrenia, gay men, and British Muslims) supported this hypothesis. Compared with purely positive interventions, interventions in which a single negative encounter was imagined just prior to imagining a positive encounter resulted in significantly reduced prejudice. Furthermore, reduced anxiety uniquely derived from the mixed-valence imagery task statistically explained enhanced intentions to engage positively with the previously stigmatized group in the future.

Mental Simulations of Social Thought and Action Trivial Tasks or Tools for Transforming Social Policy

Could simply imagining positive interactions promote tolerance between different social groups? This imagined contact hypothesis (Crisp & Turner, 2009) is just one example of a range of psychological interventions that capitalize on people’s capacity for mental simulation. The approach is controversial, perhaps because imagery appears somewhat insubstantial when set against the visceral realities of war, deep-rooted prejudices, or extreme acts of genocide. We counter that mental simulation is an essential element of the human experience and, as such, a correspondingly critical component of behavioral change strategies. This argument is supported by considering imagery’s central role in advances spanning the breadth of psychological science—from studies of the biological correlates of motor control, mimicry, and theory of mind to the cognitions and emotions that characterize reasoning, self-regulation, planning, and goal pursuit. Mental simulation is not merely a proxy for real experience: It is a critical cognition that precedes and precipitates the full spectrum of human behavior. Thus, while imagery techniques may appear trivial next to pervasive problems like prejudice, this should not distract us from the power and potential they offer as tools for transforming social policy.

Imagining intergroup contact is more cognitively difficult for people higher in intergroup anxiety but this does not detract from its effectiveness

Imagined intergroup contact (Crisp & Turner, 2009) is a new indirect contact strategy for promoting tolerance and more positive intergroup attitudes. We asked whether the positive effects of imagined contact are contingent upon characteristics that define the experience of intergroup relations. Specifically, we tested whether precontact intergroup anxiety makes imagining contact more cognitively effortful, and if it does, whether this detracts from its effectiveness. In two studies participants were asked to either imagine contact with an outgroup member or a control scene. We found that imagining contact counteracted the negative impact of intergroup anxiety on outgroup communicative behavior. Furthermore, performance on an ostensibly unrelated Stroop task revealed that this compensatory benefit requires cognitive resources proportional to the level of precontact anxiety. We conclude that the detrimental impacts of intergroup anxiety can be assuaged by imagining contact, but that doing so requires the allocation of attentional resources proportional to the positivity of preintervention contact experiences.

Stigma and social support in substance abuse: Implications for mental health and well-being

Individuals with substance abuse may suffer from severe public and internalized stigma. Little is known about how social support can reduce stigma and improve mental health and well-being for them. This research examined how perceived stigma influences individuals in treatment for substance abuse, and whether internalized stigma and shame are mechanisms which link social support with better mental health and well-being. Sixty-four participants in treatment for substance abuse (alcohol, drugs), aged between 18 and 64, completed an online survey measuring perceived stigma, internalized stigma, shame, perceived social support, and mental health and well-being (self-esteem, depression and anxiety, sleep). We found that perceived stigma was associated with lower self-esteem, higher depression and anxiety, and poorer sleep. Furthermore, perceived social support followed the opposite pattern, and was associated with higher self-esteem, lower depression and anxiety, and better sleep. The effects of perceived stigma and of perceived social support on our outcome measures were mediated by internalized stigma and by internalized shame. Helping individuals with substance abuse to utilize their social support may be fruitful for combatting the negative impact of internalized stigma and shame on mental health and well-being.

Reducing Prejudice Through Mental Imagery Notes on Replication, Interpretation, and Generalization

Imagined intergroup contact (Crisp & Turner, 2009) is a new indirect contact strategy for promoting tolerance and more positive intergroup relations. McDonald, Donnellan, Lang, and Nikolajuk (2014) were unable to replicate the findings we obtained using a new variant of imagined contact (Birtel & Crisp, 2012). We commend the authors’ careful and systematic study, but we argue that their conclusion goes substantially beyond what their design, data, or context can justify. It overgeneralizes their finding to a field of more than 70 studies with multiple design variants and conceptual replications. Furthermore, the original study was designed not to test the efficacy of the basic imagined-contact effect, but rather to test the relative efficacy of different task variants. Therefore, we believe that it is more accurate to say that their study represents an important data point in efforts to identify moderators of imagined contact than to say that it provides data on the efficacy of the effect per se. We elaborate on these points and use this example to illustrate how direct replications and meta-analysis can be fruitfully combined to refine understanding of how imagined contact may most effectively reduce prejudice.

Psychotherapy and social change:utilizing principles of cognitive-behavioral therapy to help develop new prejudice-reduction interventions

We propose that key concepts from clinical psychotherapy can inform science-based initiatives aimed at building tolerance and community cohesion. Commonalities in social and clinical psychology are identified regarding (1) distorted thinking (intergroup bias and cognitive bias), (2) stress and coping (at intergroup level and intrapersonal level), and (3) anxiety (intergroup anxiety and pathological anxiety). On this basis we introduce a new cognitive-behavioral model of social change. Mental imagery is the conceptual point of synthesis, and anxiety is at the core, through which new treatment-based approaches to reducing prejudice can be developed. More generally, we argue that this integration is illustrative of broader potential for cross-disciplinary integration in the social and clinical sciences, and has the potential to open up new possibilities and opportunities for both disciplines.

Extended contact and affective factors: A review and suggestions for future research

Extended intergroup contact has received growing support for its positive effect on intergroup relations. Previous research has focused on cognitive factors associated with extended contact, such as perceived group norms and inclusion of the other in self. In the present review, we examine the affective outcomes of extended contact. In particular, we review research demonstrating that extended contact has powerful effects on various affective measures of intergroup relations, such as intergroup anxiety, empathy, trust, and intergroup threat. We also present evidence that some of these affective factors mediate the relationship between extended contact and outgroup attitudes. Finally, we propose future re-search to extend the literature on the dual route of prejudice-reduction, via affective and cognitive factors, through extended contact.

Building a Dual Identity as an Immigrant in the UK: Eritreans’ Search for Freedom and a Sense of Balance

ABSTRACT This study explored the experiences of newly arrived and settled Eritrean immigrants currently in the UK. Semi-structured interviews were carried out with ten newly arrived (seven years) participants, recruited through an Eritrean café and using snowball sampling. Thematic analysis identified three themes: (1) Wanting freedom, expectations of the UK and the desire for safety, (2) Integration and becoming part of the British community, (3) Personal development, which involved growth and aspirations. Transcending these themes was the notion of balance, and the co-existence of past and present. It is argued that Eritreans in the UK wish to become part of British community whilst at the same time remembering and celebrating their Eritrean culture. This is explained within the context of a dual identity and it is argued that rather than being a hindrance, a dual rather than single identity facilitates the process of integration.