Week 2: Social Cure Flashcards
Mental Health Burden Statistics
20% of Australians report experiencing mental health issues in any 12 month period
Estimated that over 40% of Australians experience mental health issues at least once in their lifetime
BIOPSYCHOLOGICAL MODEL OF HEALTH - BIOLOGICAL FACTORS
Family History
Genetic Mutations
Brain Chemistry
BIOPSYCHOLOGICAL MODEL OF HEALTH - INDIVIDUAL DIFFERENCES
Cognitive Style
Personality
Life Stressors
BIOPSYCHOLOGICAL MODEL OF HEALTH - SOCIOCULTURAL
Nationality
Age Group
Profession
BIOPSYCHOLOGICAL MODEL OF HEALTH - Levels
Social Identities are at the interplay of macro- and micro-level factors
Macro Level
Micro Level
BIOPSYCHOLOGICAL MODEL OF HEALTH
Our analyses of mental health need not to be limited to the biomedical levels of analysis
Rather than addressing common problems only with standard (clinical) approaches to health, we can provide social solutions that…
> are more cost-effective
> are less stigmatizing
> allow for better access to treatment
> enhance compliance (while reducing relapse)
> are based on increasing body of evidence
The Social Cure?
A growing body of evidence suggests that social identity plays a key role in health and well-being
The Social Cure Factors
- Social identity is a determinant of symptom appraisals and responses
- Social identity is a determinant of health-related norms and behaviour
- Social identity is a basis for social support
- Social identity is a coping resource
- Social identity is a determinant of clinical outcomes
Social Groups Inform who we are
In society, we live, and have evolved to function, in social groups
As a result, a substantial part of our self/identity (who we think we are) derives from those group memberships - our sense of social identity
Incorporating principles from social identity theory and self-categorization theory
The self is a context-dependent category and can be defined at different levels of abstraction
Self Categorisation and Well-Being
When do we define ourselves as group members rather than as individuals?
What determines which group memberships define our sense of self in any given context?
What are consequences of self-definition in group- based terms
Self-Categorisation and Wellbeing - symptom appraisal
Social identity salience affects perceptions of illness or ‘symptom appraisal’
> The social identity that defines my sense of self determines what a given symptom means and what I do about it
Levine * Reicher (1996) - Self-Categorisation and Well-Being
PE students rated the severity of different scenarios (e.g., facial scare; knee injury) after either their gender identity or PE student identity had been made salient
> Female PE students perceived a facial scar to be more serious than a knee injury is their gender identity was salient
Common Approaches to Stress - Transactional Model of Stress
Lazarus & Folkman, 1984
> Points to importance of perceptions and interpretation
> Suggests stress depends on appraisal of stressors
Transactional Model of Stress - Lazarus and Folkman, 1984
Primary Appraisal: is this stressful? Depends on construal
Secondary Appraisal: Can I cope? Depends on resources (e.g., support)
Hypotheses derived from social identity approach - secondary
When a shared social identity is salient, this should impact on both primary and secondary appraisal
> Secondary appraisal: is this possible to cope?
To the extent that a social identity is salient, appraisal will be determined by resources and condition of the group (and its capacity to provide support) rather than personal self
Transactional Approaches are very Influential, but…
- They are individualistic and do not deal very well with social dimensions of stress
- Primary appraisal does not just depend on information (sometimes information has ‘boomerang’ effects - e.g., ‘don’t panic’!)
- Secondary appraisal does not just depend on support (sometimes support has no limited or negative impact)
There is a need for a more social psychological theory
The Social Identity Approach
Hypotheses derived from social identity approach:
> When a shared social identity is salient, this should impact on both primary and secondary appraisal
Primary appraisal - is this stressful?
To the extent that a social identity is salient, appraisal will be determined by implications for group rather than personal self
Does self-categorisation affect appraisal?
Yes.
> Modification of classic transactional study
-> students exposed to message that maths task is challenging or stressful
-> message came from an ingroup or outgroup member
measured self-reported stress while performing task
Appraisal (and associated reactions to a potential stressor) is only shaped by informational support to the extent that this comes from an ingroup source
The Social Curse
While a social group membership can influence health in positive ways, it can also have negative effects
> When one’s old age or the memory component of a task is salient, memory performance seems to decline
> Effects of underperformance linger long after people have left a negatively stereotyped environment
> Underperformance can lead to misdiagnosis with signficant negative consequences
Age-related self-categorisation Experiment
Participants: adults between 60-70 years of age; no history of significant trauma or illness mood disturbance, or diagnosed progressive condition
Design:
Participants randomly assignmed to one of four conditions (2 x 2):
1. induced self-categorisation: younger vs. older person
2. Beliefs about cognitive effects of aging: general abilities vs. specific (memory)
Experiment - Age-related self-categorisation Findings
Cognitive health is determined by:
> Self-categorisation (e.g., whether I self-categorise myself as older vs. younger person)
> Associated expectations about social identity content (i.e., what is means to be one of ‘us’)
Self-Categorisation and Appraisal - Implications
Cognitive performance is not fixed but highly variable
Cognitive performance is contingent on group-related beliefs and expectations
Self-categorisation has significant practical implications (e.g., concerning the evaluation of performance such as in the case of diagnosis of dementia)
Pitfalls of Group Membership
When social identity is salient, individuals’ desire to contribute to the group and to live up to, and enforce group norms may mean they are willing to jeopardize personal well-being (e.g., leading to exhaustion) and the well-being of others who don’t embody group norms (e.g., bullying of outgroup members)
If groups fail to achieve ingroup-defining goals, this may also be particularly stressful for those who identify strongly with them
Groups may be very stigmatised, e.g., the homeless
Stigmatised Identity
> Membership is a stigmatised group is associated with poor health
Experiences of discrimination is associated with negative mental health outcomes (low self-esteem, elevated depression and anxiety, psychological distress, worse life satisfaction)
Self-protective properties of stigma
Membership in a stigmatised group can protect an indivudal’s self-concept
People with stigmatised identities may:
> Compare their outcomes with those of their ingroup rather than the non-stigmatised outgroup
> Selectively devalue those dimensions on which their group does poorly and value those dimensions on which the group does well
> Attribute negative feedback to prejudice against their group rather than individual’s competence
Experiment - Self-protective properties of stigma
Method:
. Women wrote an essay that was (supposedly) assessed by a male student
. from the assessor’s responses on a questionnaire, the participants were led to believe he was either sexist or non-sexist
. participants then received the feedback from the assesor -> it was either positive or negative
Findings:
> Higher depression levels when received negative feedback from a non-sexist assessor compared to a sexist assessor
Rejection-Identification Model
Experiencing pervasive discrimination does harm health and self-esteem
However, the negative consequences of discrimination are buffered - either partially or completely - by a sense of identification and solidarity with other members of the disadvantaged
Evidence found against various groups (African Americans, Women, Internation students, people with body piercings)
Concealable vs. Non-concealable Stigma
Supportive evidence for the role of ingroup solidarity to buffer the negative effects of stigma
Concealable: people who are gay, experience bulimia, or are poor
Non-concealable: people who are Black, obese, or stutter
The same social identities that are experienced as a social curse can also be a source of social cure
Connectedness and Health - Effect of Social Integration on Cognitive Health (Findings)
in over 16,000 older community residents followed up for 6 years, memory decline was halved among those with the highest levels of social integration
These effects are stronger in disadvantaged populations (i.e., people with 12 or fewer years of education and with other risk-factors for memory related disease)
But limited insight into ways of operationalising social integration
Social Identification vs. Social Contact
Method:
Participants indicated:
> social identification with their family
> social contact with family members
> level of depression
> satisfaction with life
> stress
Findings:
> Social identification was related to each of the three health outcomes, but social contact was not
Social Identification vs. Social Contact Implications
Social contact with others in the absence of identification is not predictive of health
Health is determined not merely by the extent to which people but by the extent to which they identify with a social group
Social Identification in the Workplace
Poor health and well-being causes significant harm to
> individuals (in terms of suffering and costs for treatment)
> organisations (in terms of sick benefits, turnover, and reduced perfomance)
> society (in terms of social cohesion, justice, health expenditures)
Social Identification in the Workplace - to what extent is social identification in organisations related to people’s (a) exhaustion or (b) invigoration at work (i.e., reduced or enhanced health)?
Meta-analytic evidence of organisational identification-health relationship
Key Findings:
Robust evidence that identification with groups at work (workgroup or organisation) has a significant invigorating (rather than exhausting) impact on health in the workplace
Additional Findings
> shown by both correlational and experimental/longitudinal studies (evidence of directionality)
> indicated by measures of both psychological and physical health (evidence of biological, medical consequences)
Conclusion:
fostering rather than undermining group life at work is likely to promote well-being in the workplace.
Positive health effects because identification (with workgroup/identification)
Provides people with a sense of belonging meaning and purpose
Is the basis for social support
enhances collective self-efficacy
Negative health effects because identification (with workgroup/organisation)
It leads to excessive involvement
it generates excessive demands and pressure to perform
it promotes working long hours
social identity interventions also do not solve root causes of burnout such as unequal pay, unfair treatment, lack of resources, and other systematic conditions
Multiple Group Memberships
Preventing Depression Relapse - Method
> English longitudinal study of ageing
> large sample aged 50+ years
> N = 4087 (339 depressed)
> survey questions: number of group membership; depression symptoms
> covariates: gender, age, ses, ethnicity, relationship status, subjective health status
Implications:
> beyond standard socio-demographic variables, having multiple (rather than few) group memberships is a significant protective factor of people’s mental health
Group ties vs. interpersonal ites (multiple group memberships)
How the type of social engagement (group-based vs. individual) is linked to cognitive health
Person aged 80 (50) with group engagement above average display cognitive performance at the level fo a 70.5 (45) year-old person
Implications;
people cognitive health is fostered in a particular by group (less by interpersonal) ties
Salience of multiple group memberships: minimal conditions
strip the context of the most obvious benefits that groups membership brings: social support
if identity itself is a resource, more identities should be associated with more resources
Salience of multiple group memberships: minimal conditions (Experiment)
Method;
> students taking part in a ‘mental and physical acuity task’
> write about 1,3 ,or ,5 identities (e.g., student, Australian, young, gender)
Main dependent measure:
> persistence: seconds that participants held their hand down in a bucket of ice-cold water (0 to 2 degrees C)
The higher the number of groups, the higher the persistance (time hand submerged in ice bath - seconds)
Maintaining Multiple Group Memberships - Facing Challenging life transitions: transtitions to university
context:
> first-year students in the UK (who typically leave home, change location, become independent)
> Assessed on 1 month before start of academic year (Time 1) and 2 months into first term (time 2)
Implications:
> multiple identities facilitate adoption of new identity and well-being
> incompatibility between identities associated with reduction in well-being
Maintaining Multiple Group Memberships - facing challenges life transtitions - life after stroke
Context: patients recovering from stroke; assessed on average 8.6 months post-stroke
Implications:
> maintaining old identities in times of change provides continuity
> continuity associated with improved well-being
Maintaining Multiple Group Memberships - facing challenges life transtitions - Retiring from work
Findings and Implications:
> Health-protecting benefits were as strong as those for physical exercise
> social group memberships in retirement (a) protect quality of life and (b) reduce the risk of dying
Measuring Multiple Group Membership - Social Identity Mapping
A method to visually represent and assess a person’s subjective network of group memberships
also online social identity mapping
Social Cure Interventions - Group-decision making and cognitive performance
Conclusions:
> social relationships are a critical resource in proactive coping with age-related changes in health and well-being
> Group memberships can help slow cognitive decline, and in doing so, can help buffer against threats to successful aging
