Week 2: Social Cure

Question 1

Mental Health Burden Statistics

Answer 1

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

Question 2

BIOPSYCHOLOGICAL MODEL OF HEALTH - BIOLOGICAL FACTORS

Answer 2

Family History
Genetic Mutations
Brain Chemistry

Question 3

BIOPSYCHOLOGICAL MODEL OF HEALTH - INDIVIDUAL DIFFERENCES

Answer 3

Cognitive Style
Personality
Life Stressors

Question 4

BIOPSYCHOLOGICAL MODEL OF HEALTH - SOCIOCULTURAL

Answer 4

Nationality
Age Group
Profession

Question 5

BIOPSYCHOLOGICAL MODEL OF HEALTH - Levels

Answer 5

Social Identities are at the interplay of macro- and micro-level factors

Macro Level

Micro Level

Question 6

BIOPSYCHOLOGICAL MODEL OF HEALTH

Answer 6

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

Question 7

The Social Cure?

Answer 7

A growing body of evidence suggests that social identity plays a key role in health and well-being

Question 8

The Social Cure Factors

Answer 8

1. Social identity is a determinant of symptom appraisals and responses
2. Social identity is a determinant of health-related norms and behaviour
3. Social identity is a basis for social support
4. Social identity is a coping resource
5. Social identity is a determinant of clinical outcomes

Question 9

Social Groups Inform who we are

Answer 9

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

Question 10

Self Categorisation and Well-Being

Answer 10

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

Question 11

Self-Categorisation and Wellbeing - symptom appraisal

Answer 11

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

Question 12

Levine * Reicher (1996) - Self-Categorisation and Well-Being

Answer 12

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

Question 13

Common Approaches to Stress - Transactional Model of Stress

Answer 13

Lazarus & Folkman, 1984
> Points to importance of perceptions and interpretation

> Suggests stress depends on appraisal of stressors

Question 14

Transactional Model of Stress - Lazarus and Folkman, 1984

Answer 14

Primary Appraisal: is this stressful? Depends on construal

Secondary Appraisal: Can I cope? Depends on resources (e.g., support)

Question 15

Hypotheses derived from social identity approach - secondary

Answer 15

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

Question 15

Transactional Approaches are very Influential, but…

Answer 15

1. They are individualistic and do not deal very well with social dimensions of stress
2. Primary appraisal does not just depend on information (sometimes information has ‘boomerang’ effects - e.g., ‘don’t panic’!)
3. 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

Question 15

The Social Identity Approach

Answer 15

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

Question 16

Does self-categorisation affect appraisal?

Answer 16

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

Question 18

The Social Curse

Answer 18

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

Question 19

Age-related self-categorisation Experiment

Answer 19

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)

Question 20

Experiment - Age-related self-categorisation Findings

Answer 20

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’)

Question 21

Self-Categorisation and Appraisal - Implications

Answer 21

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)

Question 22

Pitfalls of Group Membership

Answer 22

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

Question 23

Stigmatised Identity

Answer 23

> 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)

Question 24

Self-protective properties of stigma

Answer 24

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

Question 25

Experiment - Self-protective properties of stigma

Answer 25

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

Question 26

Rejection-Identification Model

Answer 26

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)

Question 27

Concealable vs. Non-concealable Stigma

Answer 27

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

Question 28

Connectedness and Health - Effect of Social Integration on Cognitive Health (Findings)

Answer 28

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

Question 29

Social Identification vs. Social Contact

Answer 29

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

Question 30

Social Identification vs. Social Contact Implications

Answer 30

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

Question 31

Social Identification in the Workplace

Answer 31

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)

Question 32

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)?

Answer 32

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.

Question 33

Positive health effects because identification (with workgroup/identification)

Answer 33

Provides people with a sense of belonging meaning and purpose

Is the basis for social support

enhances collective self-efficacy

Question 34

Negative health effects because identification (with workgroup/organisation)

Answer 34

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

Question 35

Multiple Group Memberships

Answer 35

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

Question 36

Group ties vs. interpersonal ites (multiple group memberships)

Answer 36

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

Question 37

Salience of multiple group memberships: minimal conditions

Answer 37

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

Question 38

Salience of multiple group memberships: minimal conditions (Experiment)

Answer 38

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)

Question 39

Maintaining Multiple Group Memberships - Facing Challenging life transitions: transtitions to university

Answer 39

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

Question 40

Maintaining Multiple Group Memberships - facing challenges life transtitions - life after stroke

Answer 40

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

Question 41

Maintaining Multiple Group Memberships - facing challenges life transtitions - Retiring from work

Answer 41

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

Question 42

Measuring Multiple Group Membership - Social Identity Mapping

Answer 42

A method to visually represent and assess a person’s subjective network of group memberships

also online social identity mapping

Question 43

Social Cure Interventions - Group-decision making and cognitive performance

Answer 43

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