Psychology paper

Module 10.3 Adolescence

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Learning Objectives

The Internet can be a healthy part of your social life and a necessary

Know . . . the key terminology concerning adolescent development. Understand . . . the process of identity formation during adolescence. Understand . . . the importance of relationships in adolescence. Understand . . . the functions of moral emotions. Apply . . . your understanding of the categories of moral reasoning. Analyze . . . the relationship between brain development and adolescent judgment and risk taking.

10.3a 10.3b 10.3c 10.3d 10.3e 10.3f

research tool for your education. Indeed, as the Internet has become more of a platform for social networking, at least moderate use of the

Internet is associated with greater social involvement (Gross, 2004) and stronger academic motivation (Willoughby, 2008). However, the Internet has its dangers. One is that use may become pathological, with people turning to the Internet as a way of coping with life’s difficulties, much the same as people turn to drugs, alcohol, sex, or their career. Even psychologically healthy adolescents can get hooked on the Internet, and

such pathological use can lead to depression (Lam & Peng, 2010). The Internet may also carry social dangers, such as bullying and public humiliation, now that one’s indiscretions or mistakes can be posted online to haunt people for years to come. In 2012, 15-year-old Amanda Todd from British Columbia was cruelly ostracized and humiliated by her peers after revealing photos of her were posted online. Although she switched schools, she couldn’t escape the online bullying, and she tragically committed suicide.

The Internet has revolutionized society in a single human generation. But we don’t know how it will affect human development, particularly in the challenging period of adolescence when people are forming their identities and often committing some of their biggest mistakes. This will undoubtedly be a major focus for research, and will raise major questions for society in the years to come.

Focus Questions

1. What types of changes occur during adolescence? 2. Why do adolescents so often seem to make risky decisions?

“It was the best of times; it was the worst of times.” For many people, this pretty much sums up adolescence, a time of confusion, pimples, and existential angst, as well as hanging out with friends, gaining greater independence from parents, and focusing intensely on intimate relationships. This often tumultuous time

between childhood and adulthood involves many physical changes, increasing cognitive sophistication, and a great deal of emotional and social volatility.

Amanda Todd: A tragic case of cyber-bullying. Darryl Dyck/Canadian Press

Physical Changes in Adolescence

The physical transition from childhood to adolescence starts with puberty, culminating in reproductive maturity. Puberty begins at approximately age 11 in girls and age 13 in boys, although there is wide variation. The changes that occur during puberty are primarily caused by hormonal activity. Physical growth

is stimulated by the pituitary gland, under the control of the hypothalamus, which regulates the release of hormones such as testosterone and estrogen. These

hormones also contribute to the development of primary and secondary sex traits in boys and girls. Primary sex traits are changes in the body that are part of reproduction (e.g., enlargement of the genitals, ability to ejaculate, the onset of menstruation). Secondary sex traits are changes in the body that are not part of reproduction, such as the growth of pubic hair, increased breast size in females, and increased muscle mass in males (Figure 10.13 ).

Figure 10.13 Physical Changes That Accompany Puberty in Male and Female Adolescents Hormonal changes accelerate the development of physical traits in males and females. Changes involve maturation of the reproductive system (primary sex traits) as well as secondary sex traits such as enlargement of breasts in women and increased muscle mass in males. Source: Lilienfeld, Scott O.; Lynn, Steven J; Namy, Laura L.; Woolf, Nancy J., Psychology: From Inquiry To Understanding,

Books A La Carte Edition, 2nd Ed., © 2011. Reprinted and Electronically reproduced by permission of Pearson Education,

Inc., New York, NY.

For girls, menarche —the onset of menstruation—typically occurs around age 12. The timing of menarche is influenced by physiological and environmental

factors, such as nutrition, genetics, physical activity levels, illness (Ellis & Garber, 2000), and family structure, such as the absence of a father (Bogaert, 2008). Boys are considered to reach sexual maturity at spermarche , their first ejaculation of sperm, at around age 14.

Interestingly, puberty happens much earlier now than it did 100 years ago.

American teens in the 19th century started puberty at 16–17 on average; nowadays, about one-third of boys show the beginnings of physical maturation at

age 9 (Reiter & Lee, 2001), as do almost 40% of European-American girls, and almost 80% of African-American girls (Herman-Giddens et al., 1997). This is probably because of behavioural changes that increase body fat (e.g., poor nutrition, insufficient exercise), and environmental stresses that increase stress hormones in the body. As the environment changes, our biology changes along with it.

Teens’ rapidly-developing bodies bring a host of developmental challenges, from feelings of self-consciousness and a heightened desire to be attractive and to fit in, to increasing sexual interest and experimentation, to the negative moods that

accompany hormonal fluctuations (Warren & Brooks-Gunn, 1989). Adolescents who begin to physically develop earlier than their peers can face additional challenges. Early-developing females often have to cope with being teased and having their bodies made into objects of others’ attention. Early-developing boys tend to have it easier; their masculine traits are often regarded positively by both themselves and their peers. Nevertheless, early developers of either gender run a greater risk of drug and alcohol abuse and of unwanted pregnancies.

Recent research has shown that adolescence is a time of major brain changes as well. In particular, the frontal lobes undergo a massive increase in

myelination, speeding up neural firing by up to 100-fold in those areas (Barnea- Goraly et al., 2005; Sowell et al., 2003). The frontal lobes also undergo a wave of synaptic pruning, during which relatively unused synaptic connections are broken, leaving a more efficiently functioning brain. The net result of these changes is an increase in teens’ abilities to exert self-control. However, during adolescence this process is merely under way, not completed, leaving teens often struggling with volatile emotional experiences.

Module 10.3a Quiz: Physical Changes Challenges in Adolescence

Know . . .

1. One of the changes that occurs in puberty is the beginning of menstruation for females. This event is known as .

A. estradiol B. menarche C. a primary sex trait D. spermarche

2. A brain area that shows large changes during adolescence is the .

A. motor cortex B. visual cortex C. frontal lobes D. brainstem

Understand . . .

3. One of the major differences between primary and secondary sex characteristics is that

A. primary sex characteristics are directly related to reproductive function.

B. secondary sex characteristics are directly related to reproductive function.

C. whether a person is male or female depends on the secondary sex characteristics.

D. primary sex characteristics are unique to human reproductive anatomy.

Emotional Challenges in Adolescence

The physical and emotional changes associated with puberty are widely believed to be connected to each other. For example, mood swings and experimental high-risk behaviours are attributed to “raging hormones.” But is this

characterization of adolescence accurate? Are most teens hormonally supercharged animals, constantly desiring to hook up with the first attractive (or even unattractive) person to cross their path?

The belief that adolescence is tumultuous has held sway in popular culture as

well as in psychology since at least the early 1900s (Hall, 1904); some theorists even believed that the absence of extreme volatility was an indication of arrested

development (Freud, 1958). However, this belief came under fire from cultural anthropologists (Benedict, 1938; Mead, 1928), who discovered that in many non-Western cultures, the transition from childhood to adulthood happened remarkably smoothly; children simply began to take on more and more responsibilities, and then moved into their adult roles without such a dramatic and volatile transition.

In the decades since, research has painted a somewhat mixed picture of adolescence. On the up side, the majority of teens keep their forays into debauchery fairly minimal and do not let their larger lives get unduly harmed by their experimentation. Most teens also grow out of these patterns fairly readily and move into adulthood relatively unscathed by their teenage experiences

(Bachman et al., 1997). Navigating adolescence successfully leaves teens feeling they know who they are, having constructed a healthy social identity, and having learned to identify at least some of their own personal values and goals. On the down side, however, the emotional road through adolescence also contains its fair share of bumps. Teens are prone to experiencing particularly

intense and volatile emotions (Dahl, 2001; Rosenblum & Lewis, 2003), including heightened feelings of anxiety and depression (Van Oort et al., 2009).

Emotional Regulation During Adolescence

Adolescence is a time when teens must learn to control their emotions

(McLaughlin et al., 2011). Research at Queen’s University has shown that one key to adolescents effectively regulating their emotions is to be able to draw flexibly upon a diverse set of self-control strategies. Adolescents who rely upon a limited number of adaptive strategies (e.g., learning to suppress emotions, or conversely, learning to always reach out and talk to people about their feelings)

and narrowly rely upon their chosen strategies are at greater risk for developing

symptoms of anxiety and depression (Lougheed & Hollenstein, 2012).

One of the most flexible and powerful strategies for dealing with emotions is

cognitive reframing (see Module 16.2 ), where we learn to look at our experience through a different “frame.” For example, failure can be reframed as an opportunity to learn, and a threatening experience as a challenge to be overcome. The ability to effectively choose reframing strategies, especially when under the grip of strong emotions, relies upon a sophisticated cognitive control

network involving the frontal and parietal lobes (McClure et al., 2004). These are precisely the brain areas that are undergoing the most development during adolescence. Thus, helping adolescents learn self-control strategies is critically important, not only for developing good habits, but for helping them to develop the cognitive control systems in their brains. Failing to provide this guidance is a lost opportunity for making a major difference in the lives of today’s youth.

The ability to reframe is critical to one of the most important skills adolescents

need to hone as they move into adulthood—the ability to delay gratification , putting off immediate temptations in order to focus on longer-term goals. For example, should you party with your friends, or study for the test next week? Adolescents who master this skill are far more likely to be successful in life. An inability to delay gratification reflects a tendency to discount the future in order to live in the moment, which lies at the heart of a wide range of dysfunctional behaviours ranging from addictions and unsafe sex, to racking up credit card debt and failing to meet deadlines.

Unfortunately, the ability (or inability) to delay gratification tends to be quite stable throughout childhood and adolescence. A brilliant set of studies begun in the 1960s looked at what young children would do if given a difficult temptation— they could have a marshmallow immediately, or they could wait for 15 minutes, at which point they would be given two marshmallows. It’s a pretty simple choice right? A mere 15 minutes and the marshmallow feast doubles in size! However, preschool-aged children find it excruciating to resist this temptation. In one study

(Mischel & Ebbesen, 1970), when the marshmallow was temptingly placed right in front of the children, they could only wait for, on average, one minute!

The finding that made these studies famous in psychology was that the length of time kids could delay their marshmallowy gratification predicted how well- adjusted they would become in adolescence, many years later. The child who could wait longer for a marshmallow at age 4 was better adjusted both psychologically and socially at age 15, and had higher SAT scores by the end of

high school (Shoda et al., 1990)! (SATs are standardized tests written by American students at the end of high school, and are a major part of determining acceptance to college and university.) Clearly, being able to delay gratification is an important skill.

Importantly, this is also a skill that people can learn. In fact, the challenge of delaying gratification is basically the same as the challenge of controlling emotions, and the same strategies are useful, such as cognitive reframing. Even preschool-aged children can use them. In the simplest and most literal reframing study, children were instructed to simply imagine that the marshmallow was a picture, not a real object, and to do this by mentally drawing a picture frame around the object. Incredibly, this simple imagination tactic increased the

average wait time to a full 18 minutes (Moore et al., 1976).

Working the Scientific Literacy Model Adolescent Risk and Decision Making

One of the nightmares of every parent is the smorgasbord of disasters waiting for adolescents as they explore their increasing independence—sexually transmitted diseases, drugs, and the whole host of alluring activities parents wish were never invented (despite their own fond memories of their younger years . . .).

What do we know about adolescence and risky decision making? Parents do have some reason to fear; research shows that adolescents are particularly prone to behaving impulsively and

making risky decisions (Chambers et al., 2003; Steinberg, 2007). As a result, driving recklessly, unsafe sex (Arnett, 1992), drug and alcohol abuse, accidents, and violence are more common during adolescence than during any other stage of life

(Chambers & Potenza, 2003; Steinberg, 2008).

Why do adolescents often make such bad judgment calls? Adolescence is a perfect storm of risk-inducing factors, including a teenage culture that glorifies high-risk activities, intense peer pressure, increased freedom from parents, a growing ability to critically question the values and traditions of society, and a brain that is ripe for risk due to still-developing cognitive control systems (especially the prefrontal cortex) and well-developed

reward systems located in limbic areas (Casey et al., 2008; Galvan et al., 2006). Indeed, teenage neurophysiology is a battleground of opposing urges; the reward system acts like the proverbial devil on one’s shoulder, urging “Do it! Do it!” while the underdeveloped prefrontal areas play the role of the beleaguered angel, pleading “Don’t do it! It’s not worth it!”

How can science test the link between brain function and decision making in adolescents? Modern technology has enabled researchers to look at the brain activity of adolescents in the process of making risky decisions. In one study, adolescents had their brains scanned using functional magnetic resonance imaging while they played a betting game. In this experiment, participants had to make a decision between a high-risk, high-reward choice (placing a $6 bet with a 25% chance of winning), and a low-risk, low-reward choice (placing a $1 bet with a 50% chance of winning).

Adolescents who selected the high-risk choice had less brain activity in their prefrontal cortex than those who selected the low-

risk choice (Figure 10.14 ; Shad et al., 2011). It seems that choosing the high-risk gamble was, in a sense, easier; those

teens simply focused on how much they wanted the bigger reward, and ignored the higher likelihood that they would lose. On the other hand, making the low-risk choice involved some neurological conflict; those teens wanted the bigger reward, but restrained themselves by taking into account the probabilities. This restraint involved the frontal lobes.

Figure 10.14 Extended Brain Development

The prefrontal cortex (circled in blue) continues to develop through adolescence and into young adulthood. werbefoto-burger.ch/Fotolia

This study helps to shed light on adolescent decision making in general. Compared to adults, adolescents have less-developed frontal lobes, and are therefore more likely to default to their strong reward impulses, rather than restraining their desires as a result of more sober and complex calculations of what would be in their best interest overall.

Can we critically evaluate this explanation for risky decision making?

This brain-based explanation does not fully explain adolescents’ behaviour, in at least two important ways. First, in this particular study, it’s not clear whether the prefrontal activation reflects teens thinking in more complex ways, or whether it shows that they are consciously restraining themselves from following their reward- focused desires. Is the key factor here about complex thought or self-control?

Second, in everyday decisions, other factors likely influence teens’ preference for risk, such as the size of rewards and costs, the importance of long-term goals, personality characteristics such as extraversion (which is related to reward sensitivity), and the social context in which the decisions occur. For example, psychologists have found that in some situations, adolescents are no more likely to engage in risky behaviour than adults. But when

other teens are around, this propensity changes (see Figure 10.15 ). In fact, the presence of other teens can weaken the activity in the frontal lobes (Segalowitz et al., 2012). Clearly, realistic strategies for reducing adolescent risk taking should also consider the important role that situational factors play in adolescents’ decision making.

Figure 10.15 What Drives Teenagers to Take Risks?

One key factor in risk taking is simply other teenagers. When teens play a driving video game with other teens, they crash more than when playing the same game alone, and more than

adults playing the game (from Steinberg, 2007). Source: Adapted from figure 2, p. 630 in “Peer Influence on Risk-Taking, Risk Preference, and Risky

Decision-Making in Adolescence and Adulthood: An Experimental Study” by M. Gardner & L. Stein-

berg (2005). Developmental Psychology, 41 (4), 652–635.

Why is this relevant Research on the developing adolescent brain helps explain problems with risk and impulse control, which could lead to the development of programs that could steer adolescents toward making better decisions. If we could figure out how to enhance prefrontal functioning in teens, or how to get more of them to engage in practices like meditation that would do the same thing, we could potentially reduce their tendency to make unnecessarily risky decisions.

Module 10.3b Quiz:

Emotional Challenges in Adolescence

Understand . . . 1. Adolescent decision making is often problematic or dangerous because

teens have

A. underdeveloped limbic areas responsible for reward, and well- developed prefrontal areas.

B. well-developed limbic areas responsible for reward, and

underdeveloped prefrontal areas.

C. only partly moved out of the concrete operational stage of cognitive development.

D. poorly formed sets of goals.

2. The length of time children can wait in the marshmallow task is an indicator of

A. the age at which they begin to develop secondary sex characteristics.

B. intelligence. C. self-control. D. emotional security.

Apply . . . 3. After finishing Grade 10, Naomi got a job giving music lessons at a day

camp for kids aged 6–8. She was very excited. However, the first week was a disaster. The kids misbehaved and some instruments were broken. That weekend, she thought about what had happened. Rather than viewing the past week as a failure, she decided to view it as a learning experience that could help her do a better job when she taught a new group of kids the next week. Naomi’s thought process is an example

of . A. goal formation B. cognitive reframing C. autonomy D. concrete operations

Cognitive Development: Moral Reasoning vs. Emotions

As we have just seen, making wise decisions depends on the prefrontal cortex. This area is involved in higher cognitive abilities, such as abstract reasoning and

Module

logic (what Piaget referred to as formal operational thinking; see 10.2 ), which also begin to show substantial improvements starting at about age 12. Since Piaget, psychologists have generally believed that the shift to formal operational thinking laid the foundation for effective moral reasoning. For adolescents, this increase in complex cognitive ability allows them to consider abstract moral principles, to view problems from multiple perspectives, and to think more flexibly.

Kohlberg’s Moral Development: Learning Right

From Wrong

The most influential theory of the development of moral reasoning was created by Lawrence Kohlberg, after studying how people reasoned through complex moral dilemmas. Imagine the following scenario, unlikely as it may be:

A trolley is hurtling down the tracks toward a group of five unsuspecting people. You are

standing next to a lever that, if pulled, would direct the trolley onto another track,

thereby saving the five individuals. However, on the second track stands a single,

unsuspecting person, who would be struck by the diverted trolley.

What would you choose to do? Would you pull the lever, directly causing one person to die, but saving five others? Or would you be unwilling to directly cause someone’s death and therefore do nothing? Moral dilemmas provide interesting tests of reasoning because they place values in conflict with each other. Obviously, five lives are more than one, yet most people are also unwilling to take a direct action that would cause a person to be killed.

But even more important than what you would choose is why you would choose it. Kohlberg (1984) believed that people’s reasons evolved as they grew up and became better able to think in complex ways. By analyzing people’s reasons for their decisions in these sorts of dilemmas, he developed a stage theory of moral

development, here organized into three general stages (see Table 10.4 ).

Table 10.4 Kohlberg’s Stages of Moral Reasoning

Stage of Moral

Development

Description Application to Trolley Dilemma

Preconventional

morality

Characterized by self-interest

in seeking reward or avoiding

punishment. Preconventional

morality is considered a very

basic and egocentric form of

moral reasoning.

“I would not flip the trolley track

switch because I would get in

trouble.”

Conventional

morality

Regards social conventions

and rules as guides for

appropriate moral behaviour.

Directives from parents,

teachers, and the law are

used as guidelines for moral

behaviour.

“I would not flip the switch. It is

illegal to kill, and if I willfully

intervened I would probably

violate the law.”

Postconventional

morality

Considers rules and laws as

relative. Right and wrong are

determined by more abstract

principles of justice and

rights.

“I would flip the switch. The

value of five lives exceeds that

of one, so saving them is the

right thing to do even if it

means I am killing one person

who would otherwise not have

died.”

At the preconventional level, people reason largely based on self-interest, such as avoiding punishment. This is what parents predominantly appeal to when they threaten children with time-outs, spankings, or taking away toys. At the conventional level, people reason largely based on social conventions (e.g., tradition) and the dictates of authority figures; this is what parents are appealing to with the famously frustrating, “Because I said so!” At the postconventional level, people reason based on abstract principles such as justice and fairness, thus enabling them to critically question and examine social conventions, and to

consider complex situations in which different values may conflict.

The shift to postconventional morality is a key development, for without this shift, it is unlikely that the individual will rebel against authority or work against unjust practices if they are accepted by society at large. Indeed, social reformers always encounter resistance from members of society who hold to “traditional” values and think of change as destructive and destabilizing.

Kohlberg regarded the three stages of moral reasoning as universal to all humans; however, because he developed his theory mostly through the study of

how males reason about moral dilemmas, other researchers argued that he had failed to consider that females may reason about moral issues differently. Carol Gilligan (1982) suggested that females base moral decisions on a standard of caring for others, rather than the “masculine” focus on standards of justice and fairness that Kohlberg emphasized. Some support has been found for this; women are more likely to highlight the importance of maintaining harmony in

their relationships with others (Lyons, 1983). On the other hand, men and women generally make highly similar judgments about moral dilemmas

(Boldizar et al., 1989), and both genders make use of both caring and justice principles (Clopton & Sorell, 1993). This has led other researchers to question the importance of the gender distinction at all (Jaffee & Hyde, 2000).

However, a potentially more devastating critique has been made against the moral reasoning perspective in general, based on research showing that moral

reasoning doesn’t actually predict behaviour very well (Carpendale, 2000; Haidt, 2001). Knowing that something is right or wrong is very different from feeling that it is right or wrong. According to Jonathan Haidt’s social intuitionist model of morality, in our everyday lives our moral decisions are largely based on how we feel, not what we think. Haidt argues that moral judgments are guided by intuitive, emotional reactions, like our “gut feelings,” and then afterwards, we construct arguments to support our judgments. For example, imagine the

following scenario (adapted from Haidt, 2001):

Julie and Steven are brother and sister. They are travelling together in France on

summer vacation from college. One night they are staying alone in a cabin near the

beach. They decide that it would be interesting and fun if they shared a “romantic”

evening together. At the very least it would be a new experience for each of them. They

both enjoy the experience but they decide not to do it again. They keep that night as a

special secret, which makes them feel even closer to each other.

Emotion is a major component of moral thinking and decision making. Alex Wong/Getty Images

How do you react to this scenario? Was what took place between the two

siblings morally acceptable? If you are like most people, you probably did not think carefully through this scenario, consider different perspectives, and examine your reasoning before making a decision. Instead, you probably had a gut reaction, like “Brother and sister!?!? Gross! No way!” and made your decision almost instantly.

It is only after making a decision that most people engage in more thoughtful and reflective reasoning, trying to justify their decision. For some scenarios, it is easy to come up with justifications, such as “Brothers and sisters should not engage in romance because it could lead to sexual intercourse, which could produce genetic problems for the offspring,” or “They shouldn’t do it because if the family found out, it would be devastating.” However, it’s not hard to construct a scenario

that lies outside of such justifications, such as the brother and sister being infertile and having no other surviving family members. Faced with such a scenario, people might be hard pressed to find a justification; often, in such situations, people become flustered and confused, and resort to emphatically stating something like “I don’t know—it just isn’t right!” Or simply, “Ewww . . .” Their intuitive emotional reaction has told them it’s wrong, but their more

cognitive, effortful reasoning process is having a difficult time explaining why it’s wrong; interestingly, in such situations, people generally do not change their judgments, instead trusting their intuitive reaction. The feeling of disgust is stronger than their inability to explain themselves, which is another piece of

evidence that suggests that it’s not moral reasoning that is important, but moral feelings.

The improvements in emotional regulation that occur during adolescence have an influence on moral behaviour. Without some control over emotional reactions, people can become overwhelmed by the personal distress they experience upon

encountering the suffering of others (Eisenberg, 2000), and end up attending to their own needs rather than others’. Self-control, in turn, involves brain areas that are rapidly developing in adolescents, particularly the prefrontal cortex.

It is interesting to consider that the development of key moral emotions, such as empathy, is intimately bound up with the extent to which one’s social

relationships have been healthy right from birth (see Module 10.2 ). People who are regularly socially included and treated well by others are more likely to develop trust and security, which results in well-developed areas of the prefrontal cortex necessary for good decision making and well-developed moral emotional systems. This shows us that the early roots of moral behaviour reach all the way back into infancy, when attachment styles are initially formed, and extend into adolescence and beyond, when complex cognitive and self-control abilities are strengthened.

Biopsychosocial Perspectives Emotion and

Disgust

The social intuitionist model describes moral judgments as being driven primarily by emotional reactions. Many psychologists believe that these reactions draw upon evolutionarily ancient systems that evolved for functional reasons. For example, the disgust system evolved to keep us from ingesting substances that were harmful to us, such as feces and toxic plants. As we developed into more complex social beings, our

judgments of good and bad involved neural circuits that were more cognitive and conceptual; however, these higher-level cognitive systems evolved after our more basic physiological responses, and therefore are intertwined with the functioning of the older systems.

In terms of moral reasoning, what this means is that the cognitive systems that reason about right and wrong grew out of emotional systems that in turn grew out of systems of physiological responses of accepting or rejecting a substance from one’s body. From this

perspective, good and bad are not moral judgments, per se, but rather, are elaborations of more simple physiological responses of acceptance or repulsion. One surprising hypothesis one could derive is that the feeling of actual, physical disgust may strongly influence supposedly moral judgments.

This has been tested in several different ways. One creative set of studies first activated physiological symptoms of repulsion, for example, by getting subjects to sit at a disgustingly dirty work station, or to smell

fart spray (Schnall et al., 2008). These disgust-inducing experiences led people to make more severe judgments of moral violations. Also, neuroimaging studies show that certain moral dilemmas trigger emotional areas in the brain, and this emotional activation determines the decision

that subjects make (Greene & Haidt, 2002; Greene et al., 2001).

Module 10.3c Quiz:

Cognitive Development: Moral Reasoning vs. Emotions

Know . . .

1. A stage of morality that views rules and laws as being related to abstract principles of right and wrong is the stage.

A. postconventional B. preconventional C. preoperational D. conventional

Understand . . . 2. What is the relationship between physical feelings of disgust and moral

judgments?

A. Both physical and moral disgust activate the same brain areas, but do not directly influence each other.

B. Physical and moral disgust influence each other, but through unique neural pathways.

C. Physically disgusting stimuli increase the severity of a person’s moral judgments.

D. It is impossible to ethically test this relationship.

Apply . . . 3. Rachel believes that it is wrong to steal only because doing so could land

her in jail. Which level of Kohlberg’s moral development scheme is Rachel applying in this scenario?

A. postconventional B. preconventional C. preoperational D. conventional

Social Development: Identity and Relationships

The final aspect of adolescence to consider is the role of social relationships. To teenagers, friends are everything—the people who will support your story to your parents about why you came home late, who laugh hysterically with you at 3:00

in the morning, and who help you feel that your choice of clothing is actually cool. Friends are central to two of the most important changes that occur during adolescence—the formation of a personal identity, and the shift away from family relationships and toward peer and romantic relationships. These major changes in teens’ lives are sources of growth and maturation, but are also often sources of distress and conflict.

Who am I? Identity Formation During Adolescence

A major issue faced by adolescents is forming an identity , which is a clear sense of what kind of person you are, what types of people you belong with, and what roles you should play in society. It involves coming to appreciate and express one’s attitudes and values (Arnett, 2000; Lefkowitz, 2005), which are, in large part, realized through identifying more closely with peers and being accepted into valued social groups.

You may recall Erikson’s theory of psychosocial development from Module 10.2 (see Table 10.5 , in Module 10.4 for an overview). Erikson described the stage of adolescence as involving the struggle of identity vs. role confusion. Adolescents are seeking to define who they are, in large part through their attachment to specific social groups; doing this successfully allows them to enter adulthood with a sense of their own authenticity and self-awareness.

In fact, forming an identity is so important in the teenage years that adolescents

may actually experience numerous identity crises before they reach young adulthood. An identity crisis involves curiosity, questioning, and exploration of different identities. It can also involve attaching oneself to different goals and values, different styles of music and fashion, and different subcultural groups, all the while wondering where one best fits in, and who one really is.

The process of exploring different identities, and experiencing more independence from the family, sets the stage for potential conflict, particularly with parents. Even well-meaning parents may feel somewhat threatened as their teenage son or daughter starts to establish more distance or starts to experiment

with identities they feel are unwise. They may feel hurt and want to hold onto their closeness with their child. They may also feel concerned and want to protect their child from making mistakes they will later regret. So, parents may simply be trying to help, but their advice, rules, or insistence that the teen abandon certain goals (“There’s no way you’re giving up math and science to take drama and music!”) may be interpreted as being restrictive or controlling. This, not surprisingly, can lead to conflict. And the more conflict teens perceive at home, the more they may turn to peers.

Peer Groups

Friendships are a major priority for most adolescents. Friendships generally take

place within a broader social context of small groups or cliques, and the membership and intensity of friendships within a clique constantly change

(Cairns & Cairns, 1994). Adolescent crowds—often identified with specific labels, such as “jocks,” “geeks,” “Goths,” or “druggies”—are larger than cliques and are characterized by common social and behavioural conventions.

Adolescents who can’t find their place in social networks have a difficult time; social exclusion can be a devastating experience. When rejected by peers, some adolescents turn to virtual social networks for online friendships, or join distinctive sub-groups in order to gain acceptance. This tendency to seek acceptance within specific groups is obviously not limited to teenagers, but adolescence is a time of particular social vulnerability because adolescents are, in general, so actively working on their “identity project.”

For decades, television shows and movies have offered glimpses into life within

adolescent cliques and crowds. The portrayals may be exaggerated, but they are often successful because viewers can closely identify with the characters’ experiences. Photos 12/Alamy Stock Photo

AF archive/Alamy Stock Photo

One of the most troubling outcomes of social rejection is the experience of shame, which is a feeling that there is something wrong with you. It can be accompanied by feelings of worthlessness, inferiority, or just a more subtle, gnawing feeling that there is something wrong with you, that you need to prove yourself, and that you aren’t quite good enough. Shame-prone individuals have often experienced substantial social rejection; a key source is within the family, such as when a child’s attachment needs are consistently unmet.

Many psychologists believe that shame and other negative emotions that are connected to social rejection, bullying, teasing, and being publicly humiliated can lead to tragic outbursts of violence, such as the school shootings that have become disturbingly frequent in the United States in recent years. In almost all cases of school shootings, social rejection is a key factor that precedes the

violent outburst (Leary et al., 2003; Tangney & Dearing, 2002). Just as the security from having one’s need to belong satisfied leads to the development of empathy and moral behaviours (see Module 10.2 ), the insecurity from having one’s need to belong go unmet can lead to violence.

Romantic Relationships

As children mature into teenagers, their attachment needs shift, not fully but in important ways, into their intimate or romantic relationships. Here, the dramas of their interpersonal systems play out on a new stage. In other words, teenagers are pretty interested in being attracted to each other. This opens up the potential exploration of new worlds of emotional and physical intimacy and intensity.

Many people, for many different reasons, may feel uncomfortable with adolescents exploring and engaging in sexual behaviour. Perhaps

unsurprisingly, North American teenagers themselves don’t seem to agree. Between 40–50% of Canadian teens aged 15–19 report having had sexual

intercourse (Boyce et al., 2006; Rotermann, 2008), and the proportion who have engaged in other forms of sexual acts such as oral sex is considerably higher. More than 80% of American adolescents report engaging in non-

intercourse sex acts before the age of 16 (Bauserman & Davis, 1996), and more than half of Canadian teens in Grade 11 report having experienced oral

sex (Boyce et al., 2006). Some teens turn to oral sex because they see it as less risky than intercourse, both for one’s health and social reputation (Halpern- Fisher et al., 2005).

Same-sex sexual encounters are also very common and typically occur by early

adolescence (Savin-Williams & Cohen, 2004), although contrary to stereotypes, such an experience is not an indication of whether a person identifies themselves as homosexual, or as having any other sexual orientation. In fact, the majority (60%) of people who identify themselves as heterosexual

have had at least one same-sex encounter (Remafedi et al., 1992). For many, this is part of the experimentation that comes with figuring out who you are and establishing an identity.

The process by which adolescents come to recognize their sexual orientation depends on many factors, including how they are perceived by their family and peers. Because of some people’s still-existing prejudices against non- heterosexual orientations, it is not uncommon for many people who don’t identify as heterosexual to experience some difficulty accepting their sexuality, and thus, to struggle with feelings of rejection toward themselves. However, this process is not always difficult or traumatic; it largely depends on how supportive family and other relationships can be. Nevertheless, despite these extra identity challenges, homosexuals have about the same level of psychological well-being as heterosexuals (Rieger & Savin-Williams, 2011).

Although sexual exploration is a normal part of adolescence, it can unfortunately be dangerous for many people. Research at the University of New Brunswick has shown that among Canadian teens in Grade 11, approximately 60% of both males and females reported having experienced psychological aggression

against them by their romantic relationship partner. About 40% experienced sexual aggression, generally in the form of being coerced or pressured into

having sex (Sears & Byers, 2010). In addition, each year in North America, millions of teens face the life upheaval of an unplanned pregnancy, sexually transmitted diseases, or simply having sex that they will later regret.

Overall, the emotional upheaval of relationships, from the ecstasy of attraction, to the heartbreak of being rejected or cheated on, to the loneliness one may feel in the absence of relationships, consumes a great deal of many teenagers’ attention and resources and is a central part of the often tumultuous experience of adolescence.

Module 10.3d Quiz:

Social Development: Identity and Relationships

Know . . . 1. The kind of person you are, the types of people you belong with, and the

roles that you feel you should play in society are often referred to as your

. A. crowd B. peer group C. autonomy D. identity

Understand . . . 2. For most teens, the most devastating experience would be

A. failing at an important competition. B. being rejected by their friends. C. being rejected on a first date. D. having a physical injury.

Module 10.3 Summary

Know . . . the key terminology concerning adolescent development.10.3a

conventional morality

delay gratification

identity

menarche

postconventional morality

preconventional morality

primary sex traits

secondary sex traits

spermarche

A major challenge of adolescence is the formation of a personal identity, which involves exploring different values and behaviours, and seeking inclusion in different social groups. The eventual outcome, if navigated successfully, is a relatively stable and personally satisfying sense of self.

Teenagers undergo a general shift in their social attachments as family becomes less central and friends and intimate relationships take on increased significance. The failure to establish a sense of belonging is an important precursor to dysfunctional behaviours and violence.

Contrary to theories of moral reasoning, recent research on moral emotions, such as disgust, suggests that these feelings are what lead to moral behaviour, and reasoning generally follows as a way of justifying the behaviour to oneself.

Understand . . . the process of identity formation during adolescence.

10.3b

Understand . . . the importance of relationships in adolescence.10.3c

Understand . . . the functions of moral emotions.10.3d

Apply Activity Read the following scenarios and identify which category of moral reasoning (preconventional, conventional, or postconventional) applies to each.

1. Jeff discovers that the security camera at his job is disabled. He decides it is okay to steal because there’s no way he’s going to get caught.

2. Margaret is aware that a classmate has been sending hostile text messages to various people at her school. Although she does not receive these messages, and she does not personally know any of the victims, Margaret reports the offending individual to school officials.

Many problems with judgment and decision making involve a kind of tug-of-war between emotional reward systems in the limbic areas of the brain, and the prefrontal cortex, which is involved in planning, reasoning, emotion, and impulse control. Because the prefrontal cortex is still developing during adolescence, particularly through myelination and synaptic pruning, it is often not sufficient to override the allure of immediate temptations, leading to failures to delay gratification.

Apply . . . your understanding of the categories of moral reasoning.10.3e

Analyze . . . the relationship between brain development and adolescent judgment and risk taking.

10.3f

Module 10.4 Adulthood and Aging

reppans/Alamy Stock Photo

Learning Objectives

Know . . . the key terminology concerning adulthood and aging. Know . . . the key areas of growth experienced by emerging adults. Understand . . . age-related disorders such as Alzheimer’s disease. Understand . . . how cognitive abilities change with age. Apply . . . effective communication principles to the challenge of improving your own relationships. Analyze . . . the stereotype that old age is a time of unhappiness.

10.4a 10.4b 10.4c 10.4d 10.4e

10.4f

“Use it or lose it.” This is one of those sayings that you grow up hearing, and you think, “Yeah, whatever, I’m young and awesome; I’m never going to lose it.” But time goes by, and like it or not, the day will come when you may find yourself puffing at the top of a flight of stairs, or standing in the kitchen wondering why you’re there. You may wonder, what’s happened to me? Why do I feel so old?

We all know that if you stay physically active, your body will stay stronger and healthier as you age, maintaining better cardiovascular fitness, muscle tone, balance, and bone density. Thankfully, recent advances in neuroscience confirm that the same thing is true for the brain. If you use it, you’re less likely to lose it. This is important because, unfortunately, brain connections are exactly what people lose as they age, particularly from their 60s onward, resulting in less neural connectivity and reductions in grey and white matter volume. These neurological losses are accompanied by gradual declines in some types of cognitive functioning.

The fact that exercising your brain slows down the neural signs of aging —and even reduces the likelihood of developing age-related disorders such as Alzheimer’s disease—is great news. And even better news is that exercising your brain is actually fun! It’s not like spending countless hours on the brain equivalent of a treadmill, memorizing pi to 35 decimal places. Instead, neurological exercisers are those who regularly stay actively involved in things they love—games, sports, social activities, hobbies, and in general remaining lifelong learners. This makes getting old sound not so bad after all. . . .

Focus Questions

1. What are the key developmental challenges adults face as they age?

2. How does aging affect cognitive functioning?

Becoming an adult does not entail crossing any specific line. It’s not as clear-cut as adolescence; after all, puberty is kind of hard to miss. In Canada, you are considered to be an adult from a legal perspective at 18. Still, it’s questionable whether 18-year-olds are fully fledged adults; they have essentially the same lifestyle as 17-year-olds, often at home or in student housing, with relatively few responsibilities beyond brushing their teeth and dragging themselves to work or school. As time goes by, people get increasingly integrated into working society, begin careers, usually establish long-term relationships, pay bills, possibly have children, and in a variety of ways conform to the expectations and responsibilities of adulthood. As they move slowly from adolescence toward retirement and beyond, adults go through a number of changes—physically, socially, emotionally, cognitively, and neurologically. This module will examine these changes across the different stages of adult development.

From Adolescence through Middle Age

When we are children and adolescents, we often feel like we can’t wait to grow up. Many of you can likely remember how large and mature 18-year-olds seemed when you were younger. Eighteen-year-olds went to university, had jobs, and seemed so poised. Now that many of you are in this age range, you can see that this view of emerging adults is a bit naïve. That said, people in this age group have their entire adult lives in front of them. The adventure is beginning.

Emerging Adults

The time between adolescence and adulthood is a period of great personal

challenge and potential growth. Emerging adults confront many adaptive challenges; they may leave home for the first time; start college, university, or full-time work; become more financially responsible for themselves; commit to and cohabit with romantic partners; and, of course, deal with the endless crises of their friends.

Adults inhabit a much more complex world than children, and this becomes increasingly clear as the demands of life, and the need to be responsible for yourself, increase. How well individuals navigate these challenges is important for setting the stage of the next phases of life, and affects feelings of self-worth and confidence in handling the challenges of adulthood. On the other hand, adulthood also brings a huge amount of freedom. You make money, you can travel, eat what you want, and (usually) do what you want. You can settle into your identity as a human being, and you can become comfortable in your own skin. Of course, all of this freedom operates within a complex web of social relationships and responsibilities, and adulthood involves balancing these various factors over time.

Researchers at the University of Guelph conducted an in-depth study of the experiences of these emerging adults, identifying three main areas of personal

growth: relationships, new possibilities, and personal strengths (Gottlieb et al., 2007). Interestingly, these correspond perfectly to the domains of relatedness, autonomy, and competence that are widely viewed as key pillars of healthy

development throughout the lifespan (these are discussed in depth in Module 11.3 ).

In the relationships domain, most people in this study felt that they had grown in their abilities to trust others, to recruit support from others, and generally to be able to establish strong and intimate connections. This increased intimacy is an outgrowth of people learning to be themselves with others, to know who they are, and to connect in ways that accept and encourage people’s authenticity. The

domain of new possibilities reflects the greater freedom that emerging adults enjoy to choose activities that better fit their goals and interests, to broaden their horizons, and to actively search for what they want to do with their lives. The

domain of personal strength reflects the confidence young adults gain as they confront more serious life challenges and discover that they can handle them.

The emergence into adulthood is a time, therefore, of immense opportunity. As a person comes into their own, they can engage with the world that much more confidently and effectively. And that seems to be the story of adulthood: greater opportunities, greater challenges.

Early and Middle Adulthood

The first few decades of early adulthood are typically the healthiest and most vigorous times of life. People in their 20s to 40s are usually stronger, faster, and healthier than young children or older people. After adolescence, when one has finished growing, one enters a kind of plateau period of physical development in which the body changes quite slowly (aside from obvious exceptions, like pregnancy). For women, this period starts to shift at approximately age 50 with

the onset of menopause , the termination of the menstrual cycle and reproductive ability. The physical changes associated with menopause, particularly the reduction in estrogen, can result in symptoms such as hot flashes, a reduced sex drive, and mood swings. Psychologically, some women experience a period of adjustment, perhaps feeling like they are no longer “young” or as potentially worthwhile; these types of adjustment problems are common to many different major life changes, and as always, the severity of such symptoms varies widely among individuals. Men, on the other hand, don’t experience a physical change as substantial as menopause during middle adulthood, although testosterone production and sexual motivation typically decline.

Early and middle adulthood are also an important time for relationships, particularly of the romantic variety. This links back to Erik Erikson’s theory of

development across the lifespan (see Table 10.5 ). As mentioned in earlier modules, in each of Erikson’s stages, the individual faces a specific developmental challenge, or crisis of development. If she successfully resolves this crisis and overcomes this challenge, the person becomes better able to rise to the challenges of subsequent stages and moves on in life, letting go of specific issues that characterized the earlier stages. However, if the stage is not successfully resolved, lingering issues can interfere with the person’s subsequent development.

According to Erikson’s theory, the first four stages of development are completed

during infancy and childhood (see Module 10.2 ); the fifth stage takes place during adolescence (see Module 10.3 ). In the sixth stage, Young adulthood,

the individual must cope with the conflict between intimacy and isolation. This stage places emphasis on establishing and maintaining close relationships. The

following stage of Adulthood involves the tension of generativity vs. stagnation, during which the person either becomes productively engaged in the world, playing somehow useful roles in the world, or else the person “stagnates,” becoming overly absorbed with their own lives, and failing to give back to the world in a useful way.

Thus, putting these two stages together gives a decent picture of much of the central foci in an adult’s life. Adulthood is this challenge of balancing one’s own personal needs with one’s relationships, while also fulfilling family responsibilities and playing a variety of different roles in society (depending on things like one’s career, and the roles one may play in the community). A key part of these stages is marriage (or cohabitation), perhaps the most important relationship(s) of adulthood.

Love and Marriage

Although not all long-term committed relationships proceed to marriage, it remains the norm, with 67% of Canadian families involving a married couple (with or without children). However, in recent years the proportion of married- couple families has been dropping from 70.5% in 2001. Common-law and lone-

parent families each account for about 16% of families (Statistics Canada, 2012c).

Consistent with Erikson’s theorizing, being able to establish a committed, long- term relationship seems to be good for people (although not in all cases, such as abusive relationships). On average, being in such a relationship is associated

with greater health, longer life (Coombs, 1991; Koball et al., 2010), and increased happiness (Wayment & Peplau, 1995). Numerous factors are involved in these benefits. For example, married couples encourage each other to stay active and eat healthier diets, are more satisfied with their sex lives (and have sex more frequently than those who stay single, “swinging single” myths

notwithstanding), and enjoy greater financial security (Waite & Gallagher, 2000).

But is it really marriage that makes people happier? Or is it due to living together in a committed relationship? Many people believe that living together before marriage is harmful to a relationship, whereas others believe it is a wise thing to do before making the commitment to marry a person. Until a few years ago, research suggested that despite the beliefs of more progressively minded folks, cohabiting before marriage appeared to be associated with weaker relationships

in a variety of ways (e.g., Stack & Eshleman, 1998). However, a dramatic reversal of this opinion occurred after a large international study of relationships

across 27 different countries (Lee & Ono, 2012) showed that the reason people in common-law relationships seem less happy, on average, is actually because

of cultural intolerance of these types of relationships. In cultures with more traditional gender roles, cohabiting outside of marriage is frowned upon, and couples who do so suffer a social cost. This negatively affects women in particular, whose happiness depends more heavily on family relationships and

interpersonal ties (Aldous & Ganey, 1999). In more egalitarian societies, common-law relationships are not judged as negatively, and consequently, there seems to be no cost to living with a partner before marriage. Indeed, many people would argue that it is a good idea, leading people to make better decisions when choosing a life partner.

Despite the promise of “until death do us part,” about 40% of Canadian

marriages end in divorce (Statistics Canada, 2004; see Figure 10.16 ). One of the key factors that determines whether a marriage will end, and the factor that we have the most control over, is how well partners in a relationship are able to communicate with each other, particularly when they are having a conflict. Several decades of behavioural studies by Dr. John Gottman looked at the communication patterns of couples and led to some key insights about what makes relationships break down and how relationship partners can prevent breakdowns from happening.

Figure 10.16 Marriage and Divorce Trends in Canada Starting in the 1960s, Canadian divorce rates began rising quickly. They have been fairly steady for the past 20 years. Source: Statistics Canada, Divorce cases in civil court, 2010/2011, Juristat Article, Catalogue no. 85-002-X, 2012.

Reproduced and distributed on an “as is” basis with the permission of Statistics Canada.

By observing a couple interacting in his wonderfully named “love lab,” Gottman has been able to predict with up to 94% accuracy whether a relationship will end

in divorce (e.g., Buehlman et al., 1992; Gottman & Levenson, 2002). Across multiple studies, certain patterns of behaviour are highly predictive of relationship

break-up. He calls them, rather dramatically, the Four Horsemen of the Apocalypse (Gottman & Levenson, 1992, 2002). They include:

Criticism: picking out flaws, expressing disappointments, correcting each other, and making negative comments about a spouse’s friends and family

Defensiveness: responding to perceived attacks with counter-attacks Contempt: dismissive eye rolls, sarcastic comments, and a cutting tone of voice

Stonewalling: shutting down verbally and emotionally

Studying these four patterns of destructive communication is like studying a

trouble-shooting manual for the relationships of early and middle adulthood. Avoid these patterns and nurture their opposing tendencies (such as understanding, empathy, and acceptance), and your relationships will have a much better chance of being positive and fulfilling.

Parenting

One common (although by no means universal) aspect of intimate relationships is the raising of children and having something you identify as “a family” together. This is one of the most powerful routes by which people experience a deepening in their feelings of being connected to others. Certainly, whether a person is ready for it or not, parenting basically forces you to become less self-centred. All of a sudden, there is another being who is utterly dependent on you for its survival and its healthy development for many years.

The Four Horsemen of the (Relationship) Apocalypse. Learning to recognize and change these negative communication patterns can make many relationships better. Source: Recognizing the Four Horsemen of the (Relationship) Apocalypse. Reprinted with permission of the Gottman

Institute at www.gottman.com

The experience of becoming a parent, as with any other huge shift in one’s life, causes a person to reorganize their identity to some degree. Life is not just about

them anymore. And indeed, you would be miserable and feel terrible about yourself if you ignored your child, tending instead to your own completely independent needs.

Of course, making this transition—with the exhaustion, stress, and massive changes that accompany it—is not easy. As a result, research tends to show a rather sad pattern, but one worth examining nonetheless: within a fairly short period of time (usually around two years) of having children, parents typically

report that their marital satisfaction declines (Belsky & Rovine, 1990). Marital satisfaction is usually highest before the birth of the first child, then is reduced

until the children enter school (Cowan & Cowan, 1995; Shapiro et al., 2000), and not uncommonly, remains low until the children actually leave home as

young adults themselves (Glenn, 1990).

A major upside to this pattern of findings, of course, is that older adults are often poised to enjoy a rekindling of their relationship; their best years are still ahead of them, and they can settle into enjoying their relatively free time together. In fact,

the notion of parents suffering in their empty nest once their children leave home is largely a myth. Married older adults are just as likely to report being “very

satisfied” with marriage as newlyweds (Rollins, 1989). Of course, some parents no doubt take a fresh look at their relationship once it’s just the two of them again and discover they no longer have anything in common or don’t even like each other that much. But happily, the general trend is actually the opposite—couples find their relationships flourishing again. So, there can be a lot of things to look forward to as one gets older.

Module 10.4a Quiz:

From Adolescence through Middle Age

Know . . . 1. When one person in a relationship tends to withdraw and “shut down”

when discussing difficult issues in the relationship, they are

. A. being abusive

B. stonewalling C. guilt-tripping D. being contemptuous

2. In Erikson’s theory of psychosocial development, what does generativity refer to?

A. The desire to generate an income B. The desire to generate knowledge and learning for oneself C. The desire to have offspring D. The desire to have a positive impact on the world

3. Research that shows that people are more likely to get divorced if they cohabit before marriage is probably due to

A. self-reporting biases interfering with people accurately depicting the health of their relationships.

B. people in some cultures being punished through social and community sanctions if they live in a cohabiting relationship.

C. biased motivations on the part of the researchers, who asked specific questions that were designed to show what they wanted to find.

D. journal editors having a conservative bias and thus being more likely to publish studies that show “moral” findings, rather than ones that illustrate unconventional or non-traditional values.

Late Adulthood

The pursuit of happiness is a common theme in contemporary society, and certainly we can all relate to the desire to be happy. But how do we go about achieving “happiness” as we age, and are we generally successful?

Happiness and Relationships

This generally positive story about growing older gets even better when adults

begin to transition into the latter decades of life, especially when we consider perhaps the most personal and immediate part of one’s happiness—one’s own emotions. One of the biggest benefits to growing older is that the emotional turmoil of youth, with its dramatic ups and downs (passions, despair, anger, lust, and all the rest), often gives way to a smoother, more emotionally stable, and generally more positive experience. As a result, late adulthood is often a particularly enjoyable time of life. The Buddhist monk Thich Nnat Hanh has described youth as being like the chaotic mountain stream tumbling down the mountainside, whereas old age is when the stream has broadened into a serene river making the final leg of its journey to the ocean.

Developmental psychologists describe a similar type of personal development

through the lens of socioemotional selectivity theory , which describes how older people have learned to select for themselves more positive and nourishing experiences. Older people seem better able to pay more attention to positive experiences, and to tend to take part in activities that emphasize positive

emotions and sharing meaningful connections with others (Carstensen et al., 1999). The net result of this wiser approach to life is that negative emotions often decline with age, while positive emotions actually increase in frequency (Figure 10.17 ). Simply put, older people are (often) happier (Charles & Carstensen, 2009)! This definitely gives us something to look forward to.

Figure 10.17 Emotion, Memory, and Aging Younger people have superior memory for whether they have seen positive, negative, or neutral pictures compared with older people. However, notice that younger people remember positive and negative pictures equally, whereas older

people are more likely to remember positive pictures (Charles et al., 2003). Source: Data from “At the Intersection of Emotion and Cognition: Aging and the Positivity Effect” by L. L. Carsten-sen & J. A.

Mikels, (2005). Current Directions in Psychological Science, 14 (3).

Erikson’s theory of psychosocial development describes the final stage,

spanning approximately 65 years and onward, as Aging, the challenge of ego integrity versus despair. During this time the older adult contemplates whether she lived a full life and fulfilled major accomplishments, and now can enjoy the support of one’s lifetime of relationships and social roles. In contrast, if one only looks back on disappointments and failures, this will be a time of great personal struggle against feelings of despair and regret.

The full story of aging has a downside to it as well; it’s not all sunshine and rainbows. Older people experience great challenges: the deaths of their spouse and family members, the loss of close friends and acquaintances, the fading of their physical capabilities, the loss of personal freedoms such as driving or living without assistance, and inevitable health challenges as the body ages. Existentially speaking, older adults also must, sooner or later, face the growing awareness that their time on this earth is drawing to a close. It doesn’t take a lot of imagination to understand why younger people often assume that the elderly are unhappy and depressed as they face the imminent “dying of the light.” Certainly, depression and even suicide are not unknown to the elderly, although contrary to the stereotype of the unhappy, lonely old person, healthy older adults are no more likely to become depressed than are younger people. The reality is that as long as basic emotional and social needs are met, old age is often a very joyous time, again reflecting the greater wisdom with which older adults approach the challenges of their lives, making the best of things, focusing on what they can be grateful for, and letting things go that are negative, as much as

possible (Charles & Carstensen, 2009).

Older adults have had enough experience dealing with the slings and arrows of life that they’ve learned how to emotionally cope, how to see the glass as half-full rather than half-empty, and how to focus on the positives even as they face the negatives. The active cultivation of positive emotions has been shown to be a

key resource that helps people cope with life’s challenges (Cohn et al., 2009; Garland et al., 2010). For example, research at Kwantlen University has shown that many older people respond even to the loss of their beloved spouse by

focusing on positive emotions (Tweed & Tweed, 2011); this enhanced positive focus leads to better coping overall, such as less depressed mood, the experience of greater social support, and even the ability to provide more support to others in the community. This flies in the face of earlier theorists who argued that grief needed to be “fully processed” in order for people to recover

(Bonanno, 2004), and experi­encing frequent positive emotions while grieving was actually a sign of pathology (Bowlby, 1980)!

In fact, one of the key lessons that life teaches a person is that many of the challenges one faces carry their own rewards and hidden benefits. As people age, their suffering and loss ends up getting used as fertilizer for their own personal growth. In struggling to deal with the difficulties of life, people often find that they grow in many ways, such as shifting their priorities after realizing what really matters to them, feeling deeply grateful for their close relationships, and feeling deeply motivated to live authentically according to one’s own personal

values and sense of what is right (Tedeschi & Calhoun, 2004). Older people therefore have ample opportunities for personal growth, and it is important to respect how much of the later years of life can be a supremely rich time for people to invest in their own growth, learning, and practice. Even as death approaches, the benefits to the elderly can be a deep enriching of the gratitude

they feel for being alive (Frias et al., 2011).

The Eventual Decline of Aging

Of course, every story has its ending, and as much as we might like to avoid this topic, we also have to acknowledge that the later years of adulthood are accompanied by a certain amount of decline. The body declines and the mind eventually is not as sharp as it once was. Researchers have examined this in great detail and found that the brain, just like other physical systems, shows structural changes and some functional decline with age. These changes include reduced volume of white and grey matter of the cerebral cortex, as well as of the

memory-processing hippocampus (Allen et al., 2005). The prefrontal cortex and its connections to subcortical regions are also hit hard by aging (Raz, 2000). The reduced frontal lobe volume may explain why older adults sometimes lose their train of thought and why they sometimes say things that they wouldn’t have in the past (e.g., blunt comments, vulgarity). Because it is now common for people to live well into their 80s and beyond, these declines are ever more important to understand because they have many implications for how well older adults will be able to function in their everyday lives.

If one lives well and/or is lucky, one can get pretty much to the end of a natural lifespan with very little cognitive decline. However, there is a lot of variability in how well people will age, neurologically speaking. The negative end of the

spectrum is anchored by various neurodegenerative conditions. These are medical conditions of aging characterized by the loss of nerve cells and nervous system functioning, which generally worsen over time. Many older adults struggle with attending to the tasks of everyday life, which may indicate the onset

of dementia , a mild to severe disruption of mental functioning, memory loss, disorientation, and poor judgment and decision making. Approximately 14% of people older than 71 years of age have dementia.

Psych @ The Driver’s Seat Thanks to technology, the current generation of elderly adults faces issues that previous generations never did. Take driving, for example. Many older adults depend on their cars to shop, maintain a social life, and keep appointments. Research, however, has shown that the cognitive and physical changes in old age may take a toll on driving skill. This decline presents a dilemma for many seniors and their families: How can individuals maintain the independence afforded by driving without endangering themselves and other drivers?

To address this problem, psychologist Karlene Ball developed an intervention called Useful Field of View (UFOV) Speed of Processing

training (Ball & Owsley, 1993). UFOV uses computer-based training exercises to increase the portion of the visual field that adults can quickly

process and respond to. Laboratory studies show that UFOV actually

increases the speed of cognitive processing for older adults (Ball & Owsley, 2000). Records from several U.S. states that have studied the UFOV show that drivers who completed the training were half as likely to have had an accident during the study period.

Nearly 10% of cases of dementia involve the more severe Alzheimer’s disease —a degenerative and terminal condition resulting in severe damage to the entire brain. Alzheimer’s disease rarely appears before age 60, and it usually lasts 7 to 10 years from onset to death (although some people with Alzheimer’s live much longer). Early symptoms include forgetfulness for recent events, poor judgment, and some mood and personality changes. As the disease progresses, people experience severe confusion and memory loss, eventually struggling to recognize even their closest family members. In the most advanced stages of Alzheimer’s disease, affected individuals may fail to recognize themselves and may lose control of basic bodily processes such as bowel and bladder control.

What accounts for such extensive deterioration of cognitive abilities? Alzheimer’s disease involves a buildup of proteins that clump together in the spaces between neurons, interrupting their normal activity. These are often referred to as

plaques. Another type of protein tangles within nerve cells, which severely disrupts their structural integrity and functioning (Figure 10.18 ). These are often referred to as neurofibrillary tangles (or simply as tangles). Many different research groups are currently searching for specific genes that are associated with Alzheimer’s disease. The genetic risk (i.e., the heritability of the disease) is very high for people who develop an early-onset form (age 30–60) of Alzheimer’s

disease (Bertram et al., 2010). In those individuals with later-onset (age 60+) disease, the genetic link is not as consistent.

Figure 10.18 How Alzheimer’s Disease Affects the Brain Advanced Alzheimer’s disease is marked by significant loss of both grey and white matter throughout the brain. The brain of a person with Alzheimer’s disease typically has a large buildup of a protein called beta-amyloid, which kills nerve cells. Also, tau proteins, which maintain the structure of nerve cells, are often found to be defective in the Alzheimer’s brain, resulting in neurofibrillary tangles. Source: Based on information from National Institute of Aging. (2008). Part 2: What happens to the brain in AD. In

Alzheimer’s Disease: Unraveling the mystery. U.S. Department of Health and Human Services. NIH Publication No. 08-3782.

Retrieved from https://www.nia.nih.gov/sites/default/files/alzheimers_disease_unraveling_the_mystery_2.pdf

Alzheimer’s disease illustrates a worst-case scenario of the aging brain. However, even in normal brains, structural changes occur which also cause a variety of cognitive challenges that increase as the person gets older.

Working the Scientific Literacy Model Aging and Cognitive Change

How does the normal aging process affect cognitive abilities such as intelligence, learning, and memory? People commonly believe that a loss of cognitive abilities is an inevitable part of aging, even for those who do not develop dementia or Alzheimer’s disease. However, the reality of aging and cognition is not so simple.

What do we know about different cognitive abilities? There are many different cognitive abilities, including different memory and attentional abilities. One useful distinction is made between cognitive tasks that involve processes such as problem solving, reasoning, processing speed, and mental flexibility; these

tasks are said to involve fluid intelligence. Other tasks tap into crystallized intelligence, which is based on accumulated knowledge and skills (Module 9.2 ), such as recognizing famous people like David Suzuki or Justin Bieber. Although fluid intelligence reaches a peak during young adulthood and then slowly declines, crystallized intelligence remains largely intact into old age.

How can science explain age-related differences in cognitive abilities? Researchers have not yet fully solved the riddle of why some cognitive abilities decline with age. There are many different potential explanations. Neurological studies of brain function suggest two leading possibilities.

The first is that older adults sometimes use ineffective cognitive strategies, leading to lower levels of activation of relevant brain areas. This has been repeatedly found in various studies (e.g.,

Logan et al., 2002; Madden et al., 1996). Interestingly, it may be possible to enhance neural function in older people simply by

reminding them to use effective strategies. For example, Logan and her colleagues (2002) found that, compared to subjects in their 20s, older subjects (in their 70s and 80s) performed worse on a memory task and showed less activity in key frontal lobe areas. However, by giving older adults strategies to help them more deeply encode the information, older adults were able to activate these brain areas to a greater extent, thus improving their memories for the information. This work suggests that a key to helping older adults resist the decline of their cognitive abilities

is to help them learn effective strategies for making better use of their cognitive resources.

A second possible explanation for reduced cognitive abilities in older people is that older brains show more general, non-specific

brain activation for a given task (Cabeza, 2002). They may do so either because they are compensating for deficits in one area by recruiting other areas, or possibly because they are less capable of limiting activation to the appropriate, specialized neural areas. Involving more widely distributed brain areas in a given task would generally result in slower processing speed, which could help to explain some of the cognitive deficits (e.g., fluid intelligence) seen in older adults.

Can we critically evaluate our assumptions about age-related cognitive changes? Although older people show declines on laboratory tests of some cognitive functions, we should guard against the stereotypic assumption that the elderly are somehow less intellectually capable than the rest of us. In most cultures and for most of history, older people have been widely respected and honoured as wisdom keepers for their communities; respect for one’s elders is, in fact, the historical norm, whereas modern Western society’s tendency to disregard the perspectives of the elderly, assuming that they are out of touch and their opinions are no longer relevant, is the aberration.

The wisdom of elderly people is evident in their approach not only to emotional well-being, as we discussed earlier in this module, but also in how they deal with their own cognitive abilities. In everyday life, as opposed to most laboratory tests, the decline in cognitive abilities does not necessarily translate into decline in practical skills, for at least two important reasons. The first is that while the episodic and working memory systems may not work as well, the procedural and semantic memory systems show a much

slower rate of decline with age (see Figure 10.19 ). Thus, older people’s retention of practical skills and general knowledge about the world remains largely intact for most of their lives.

Figure 10.19 Memory and Aging

Several types of memory systems exist, not all of which are equally affected by age. An older person’s ability to remember events, such as words that appeared on a list (episodic memory), is more likely to decline than his or her memory for facts and concepts (semantic memory).

The second reason the elderly fare better than might be expected from laboratory tests is that they learn to compensate for their reduced raw cognitive power by using their abilities more skillfully. For example, in a chess game, older players play as well as young players, despite the fact that they cannot remember chess positions as well as their young opponents. They compensate for this reduction in working memory during a game by more efficiently searching the chessboard for patterns

(Charness, 1981). Having more experience to draw upon in many domains of life gives older people an advantage because they will be better able to develop strategies that allow them to

process information more efficiently (Salthouse, 1987).

Why is this relevant? In a society that increasingly relegates its elderly to seniors’ residences, largely removing them from their families and the larger community, it is important to remember that older people actually retain their faculties much better than might be expected. This is especially true for older adults who practice specific cognition-enhancing behaviours. What keeps the aging brain sharp? It’s pretty simple really, as researchers at the University of Alberta and others have shown—staying physically active, practising cognitively challenging activities (and they don’t have to be crosswords and brain teaser puzzles; intrinsically enjoyable hobbies work just fine), and remaining socially connected and

active (Small et al., 2012; Stine-Morrow, 2007). In addition, diets low in saturated fats and rich in antioxidants, omega-3 fatty acids, and B vitamins help to maintain cognitive functioning and

neural plasticity (Mattson, 2000;Molteni et al., 2002). As a society, providing opportunities and resources for seniors to remain active, socially engaged, and well-nourished will allow them to enjoy high-quality lives well into old age.

Module 10.4b Quiz:

Late Adulthood

Understand . . . 1. Socioemotional selectivity theory describes how older adults

A. are better at socializing in general, because they have a lifetime of practice; thus, they tend to make friends very easily, and this keeps them functioning well.

B. are better at selecting emotions that are socially acceptable

based on the current circumstance. This causes them much less stress and is why they are generally happier.

C. have usually invested so much of their lives in a few close relationships that now they have a network of support in those friends who were selected based on their tendency to be socially and emotionally supportive.

D. are better at paying attention to positive things, rather than excessively dwelling on the negatives.

2. Once someone is diagnosed with Alzheimer’s disease, they are likely to A. experience escalating pain and a reduction of their physical

capabilities.

B. exhibit emotional volatility and a tendency towards irrational, violent behaviour.

C. exhibit confused, forgetful behaviour and a general decline in cognitive abilities.

D. experience intense hallucinations, especially involving people who have died.

Apply . . . 3. Which of the following best describes the effects of aging on intelligence?

A. Fluid intelligence tends to decrease, but working memory tends to increase.

B. Fluid intelligence tends to decrease, but crystallized intelligence tends to increase.

C. Crystallized intelligence tends to increase, but the ability to skillfully use one’s abilities decreases.

D. Aging is unrelated to intelligence, except in the case of brain disorders and diseases such as dementia or Alzheimer’s disease.

Module 10.4 Summary

Alzheimer’s disease

Know . . . the key terminology concerning adulthood and aging.10.4a

dementia

menopause

socioemotional selectivity theory

People making the transition from adolescence to adulthood face substantial life challenges that contribute to personal growth in three main areas: relationships (i.e., cultivating true intimacy and trust); new possibilities (i.e., exploring what they really want to do with their lives and choosing a compatible path that reflects their interests); and personal strengths (i.e., the skills and competencies that come from successfully facing challenges).

Alzheimer’s disease is a form of dementia that is characterized by significant decline in memory, cognition, and, eventually, basic bodily functioning. It seems to be caused by two different brain abnormalities—the buildup of proteins that clump together in the spaces between neurons, plus degeneration of a structural protein that forms tangles within nerve cells.

Aging adults typically experience a general decline in cognitive abilities, especially those related to fluid intelligence, such as working memory. However, older adults also develop compensatory strategies that enable them to remain highly functional in their daily lives, despite their slow decline in processing capability.

Apply Activity In this module, you read about John Gottman’s research into the Four Horsemen

Know . . . the key areas of growth experienced by emerging adults.10.4b

Understand . . . age-related disorders such as Alzheimer’s disease.10.4c

Understand . . . how cognitive abilities change with age.10.4d

Apply . . . effective communication principles to the challenge of improving your own relationships.

10.4e

of the (Relationship) Apocalypse. Identify which of the four relationship-harming behaviours are most apparent in each of the three descriptions below.

1. Molly and David are arguing—David feels that Molly spends too much of her time talking on the phone with her friends rather than spending time with him. Molly rolls her eyes and says “I didn’t realize you needed to be entertained 24 hours a day.”

2. Nicole is upset that her husband Greg isn’t putting in enough hours at his job to make a good income. When she talks to Greg about this, he becomes distant and ends the discussion.

3. Juan and Maria are having marital problems. When frustrated, Juan often complains about Maria’s mother and about how Maria’s friends are immature. This upsets Maria.

Research shows that older adults do face issues that might lead to unhappiness —for example, health problems, loss of loved ones, and reductions in personal freedom. However, such challenges often lead to growth and a deepened appreciation for life and other people. The result is that many older people become skilled at focusing on the positives of life and pay less attention to the

negatives, leading to an increase in life satisfaction, rather than a decrease.

Analyze . . . the stereotype that old age is a time of unhappiness.10.4f

Chapter 11 Motivation and Emotion

11.1 Hunger and Eating Physiological Aspects of Hunger 442

Module 11.1a Quiz 445

Psychological Aspects of Hunger 445

Module 11.1b Quiz 447

Disorders of Eating 448

Working the Scientific Literacy Model: The Effect of Media Depictions of Beauty on Body Image 450

Module 11.1c Quiz 451

Module 11.1 Summary 451

11.2 Sex Human Sexual Behaviour: Psychological Influences 453

Module 11.2a Quiz 455

Human Sexual Behaviour: Physiological Influences 455

Module 11.2b Quiz 460

Human Sexual Behaviour: Cultural Influences 460

Working the Scientific Literacy Model: Does Sex Sell? 462

Module 11.2c Quiz 463

Module 11.2 Summary 464

11.3 Social and Achievement Motivation Belonging and Love Needs 466

Working the Scientific Literacy Model: Terror Management Theory and the Need to Belong 468

Module 11.3a Quiz 470

Achievement Motivation 470

Module 11.3b Quiz 474

Module 11.3 Summary 475

11.4 Emotion Physiology of Emotion 477

Module 11.4a Quiz 479

Experiencing Emotions 479

Working the Scientific Literacy Model: The Two-Factor Theory of Emotion 481

Module 11.4b Quiz 484

Expressing Emotions 484

Module 11.4c Quiz 488

Module 11.4 Summary 489

Module 11.1 Hunger and Eating

Satchan/Corbis/Bridge/Glow Images

Learning Objectives

It was Janice’s first year of university. She’d made it through the first

Know . . . the key terminology of motivation and hunger. Understand . . . the biological, cognitive, and social processes that shape eating patterns. Understand . . . the causes of common eating disorders. Apply . . . your knowledge of hunger regulation to better understand and evaluate your own eating patterns. Analyze . . . the role of the media on people’s body image.

11.1a 11.1b

11.1c 11.1d

11.1e

three months of the semester with impressive grades, but was now dealing with her first ever set of final exams. After a long afternoon of studying History, Janice felt like she was starving. She walked over to the cafeteria and was overwhelmed by the number of options. She saw a friend eating a greasy pizza and immediately ordered one for herself (but with a salad, which of course made the meal healthy). She finished the enormous plate of food and felt like she couldn’t eat another bite. She crawled back to the library and began studying for her Chemistry exam that was scheduled for the next morning. But, despite having just eaten a large meal, Janice found herself munching on candy that she’d snuck into the library (a guilty habit that was now as much a part of studying as her textbooks). The more anxious she got about this exam, the more she mindlessly moved the sugary snacks from their bag into her mouth. Janice’s experience shows us that eating isn’t just a simple behaviour we use for survival. Hunger is a biological drive that influences what we pay attention to and interacts with our past experiences and current mental states such as excitement and anxiety. Hunger is a psychological behaviour.

Focus Questions

1. What are some ways that our physical and social environments affect eating?

2. What makes us feel hungry or full?

Although this module focuses on behaviours related to eating and hunger, it also

serves as an introduction to the concept of motivation. Motivation concerns the physiological and psychological processes underlying the initiation of behaviours that direct organisms toward specific goals. These initiating factors, or motives, can take many forms. They can involve satisfying bodily needs such as drinking when you are thirsty, but they can also include social behaviours such as seeking out other people when you are lonely. The fact that you are

reading Chapter 11 of a university textbook shows you the breadth of this concept—you are likely motivated to achieve academic success. In all of these cases, a behaviour is being initiated in order to complete some sort of goal- directed behaviour.

At its most basic level, motivation is essential to an individual’s survival because

it contributes to homeostasis , the body’s physiological processes that allow it to maintain consistent internal states in response to the outer environment (see Figure 11.1 ). For example, when the body’s water levels fall below normal, cells release chemical compounds that maintain the structure and fluid levels of cells. Receptors in the body respond to the increased concentrations of these compounds, as well as to the lower water volume, and send messages to the brain. The result is the sudden awareness that you are thirsty, which motivates

you to drink water. This process is known as a drive , a biological trigger that tells us we may be deprived of something and causes us to seek out what is needed, such as food or water (Figure 11.2 ). The stimuli we seek out in order to reduce drives are known as incentives . In this example, the incentive would be water; however, in other modules, incentives will range from sex (see Module 11.2 ) to feeling like you belong, or even to a more abstract feeling of reaching your potential as a human (see Module 11.3 ).

Figure 11.1 Maintaining Balance Homeostasis is the process of maintaining relatively stable internal states. For example, this diagram illustrates how homeostasis regulates thirst and the body’s fluid levels. The body detects that fluid levels are low and sends signals to the brain that motivate us to drink; once fluid levels are normal, this motivation decreases. A pack of psychology professors are, of course, just out of view in this photo, battling a group of Kenyans for third place. Mark Wilson/The Boston Globe/Getty Images

Figure 11.2 Drives and Incentives Our motivation to reduce a drive, or in response to an incentive, can lead to the same behaviour.

There are times, however, when our behaviours cannot be explained by a desire to reach a state of homeostasis. Instead, our motivations are influenced by an internal or external source of stress. Stress often leads us to use more resources than we normally would. Stress is particularly challenging to our homeostasis because it is difficult to predict how long you will be in that energy-consuming state—you don’t schedule stress into your day planner. As a result, our motivational systems have to make a prediction about the resources that our bodies will require, and then initiate motivational behaviours that will drive us to

acquire those resources. This process is known as allostasis , motivation that is not only influenced by current needs, but also by the anticipation of future needs caused by stress (Sterling, 2011).

To make the relationship between homeostasis and allostasis more concrete, let’s think back to the example of Janice eating candy while stressing out about her exams. The experience of anxiety used a lot of Janice’s energy, as did the effort required to control her emotions. If Janice didn’t increase her food consumption to meet these new energy demands, her energy level would quickly dip below optimal levels. As a result, her physical and mental well-being would then suffer. So, if Janice were not stressed out, homeostasis would drive her toward consuming a particular number of calories; however, allostasis—which involves the influence of stress on homeostasis—would drive her to consume a

greater number of calories (and would be one reason why she was snacking). Of course, our ability to predict our future needs is not perfect, which explains why psychological variables (e.g., stress, desire to appear attractive, the need to feel “in control”) can have such a strong influence on behaviours like eating and drinking, which don’t seem “psychological” at all.

In this module, we will examine how these physical and psychological factors influence our motivation to eat. We will also examine how social factors can alter our eating habits in negative and self-destructive ways.

Physiological Aspects of Hunger

Hunger is not simply a homeostatic mechanism. The need to consume enough nutrients so that you have enough energy to function involves physiological

responses as well as more complex cognitive and emotional factors (Dagher, 2012). The brain areas involved with these factors interact with the brain areas that control our appetites.

The “on” and “off” switches involved in hunger can be found in a few regions of

the hypothalamus , a set of nuclei found on the bottom surface of the brain. Researchers have found that electrically stimulating the lateral hypothalamus causes rats to begin to eat; thus, this structure may serve as an “on” switch

(Delgado & Anand, 1952). In contrast, stimulating the ventromedial region of the hypothalamus causes rats to stop eating. Damaging the ventromedial region

removes the “off switch” in the brain; in lab animals, this damage leads to obesity

because the animals don’t stop eating (Figure 11.3 ). A related area, the paraventricular nucleus of the hypothalamus, also signals that it is time to stop eating by inhibiting the lateral hypothalamus.

Figure 11.3 The Hypothalamus and Hunger The hypothalamus acts as an on/off switch for hunger. The lateral region of the hypothalamus signals when it is time to eat, while the ventromedial and paraventricular regions signal when it is time to stop eating. Source: From Weiten. Psychology, 9E. © 2013 South-Western, a part of Cengage Learning, Inc. Reproduced by permission.

www.cengage.com/permissions.

The activity of the hypothalamus is influenced by hormones that are released in

response to the energy needs of your body. So, your brain influences your body

and your body influences your brain! A key function of the hypothalamus is to monitor blood chemistry for indicators of the levels of sugars and hormones necessary for you to have enough energy to function. For example, the

hypothalamus detects changes in the level of glucose , a sugar that serves as a primary energy source for the brain and the rest of the body. Highly specialized neurons called glucostats can detect glucose levels in the fluid outside of the cell. If these levels are too low, glucostats signal the hypothalamus that energy

supplies are low, leading to increased hunger (Langhans, 1996a, 1996b). After food reaches the stomach and intestines, sugars are absorbed into the bloodstream and transported throughout the body. Insulin, a hormone secreted by the pancreas, helps cells store this circulating glucose for future use. As insulin levels rise in response to consumption of a meal, hunger decreases—but so do glucose levels, which, after a few hours, leads to hunger again.

The rat on the left has swollen to enormous proportions after researchers created lesions to its ventromedial hypothalamus. Compare it to the more typical rat on the right. Voisin/Phanie/Photo Researchers, Inc./Science Source

Of course, if our motivation to eat was based entirely on the relationship between glucose and the hypothalamus, then our eating behaviours would be quite simple: we’d consume whatever food was available until our need for glucose was satisfied. We all know that is not the case. Eating is influenced by a number of other factors including the characteristics of the available food and how much

of it we have already eaten.

Food and Reward

In the example that started this module, poor stressed-out Janice ate pizza, salad, and candy. But, humans evolved in environments in which food was not this plentiful or rich in variety. Sometimes, after a successful hunting expedition, food was abundant; however, at other times, food was quite scarce. Humans quickly learned that the best strategy was to “eat while you can” because there was no guarantee that another meal would be forthcoming any time soon. And, given that we need a great deal of energy to keep our bodies functioning properly, it would make sense to consume fatty foods, a very rich source of energy. Over the course of evolution, our bodies responded to this need with a number of systems that made the consumption of high-energy foods

pleasurable. In other words, we developed bodies that were hard-wired to like some foods more than others.

Imagine eating poutine, Québec’s cardiovascular equivalent of Russian roulette. It’s clearly bad for you (there is no diet poutine), yet people still enthusiastically eat it. Indeed, some of the most popular foods in Canada are loaded with fats, including red meat, cheese, ice cream, and anything deep-fried. Psychologists and neuroscientists are discovering why people can be so driven to consume these and other fattening foods. Scientists suggest that we crave fats because we have specialized receptors on the tongue that are sensitive to the fat content of food. Research with animals shows that these receptors send messages to the brain that stimulate the release of endorphins and dopamine, both of which

are responsible for the subjective sense of pleasure and reward (Mizushige et al., 2007). Similar results were found in brain imaging studies with human participants (Rolls, 2010). In one study, participants had their brains scanned while they tasted various substances. At different times, the participants tasted either a fatty solution (vegetable oil), sucrose (a sweet taste), or a tasteless control substance. Brain activity was recorded while these different taste stimuli were delivered in liquefied form into the mouths of the participants through a small plastic tube. The participants were also asked to rate the pleasantness of each stimulus. Overall, the participants rated the fatty substance favourably, and

the brain scans showed activity in regions of the brain associated with pleasure

sensations when they tasted fat (de Araujo & Rolls, 2004; see Figure 11.4 ).

Figure 11.4 The Pleasure of Taste When fat receptors of the tongue are stimulated, the cingulate cortex—a region of the brain involved in emotional processing—is activated. The orbitofrontal cortex is involved in linking food taste and texture with reward. Interestingly, activity in this region, along with reward centres in the basal ganglia, decreases when we are no longer motivated to eat.

In some situations, high-energy food can be a more powerful reinforcer than

highly addictive drugs (Christensen et al., 2008). Some people even report cravings for a sugar fix—a term that seems to imply that addiction to candy and chocolate bars is comparable to an addiction to a drug like heroin. The phrase “sugar fix” may seem an exaggeration, but is it possible that sugar actually does act like a drug? Sugar and some addictive drugs share an interesting similarity. Ordinary sucrose—plain white granulated sugar—can stimulate release of the neurotransmitter dopamine in the nucleus accumbens, a brain region associated with the reinforcing effects of substances such as amphetamines and cocaine

(Rada et al., 2005; see Module 5.3 ).

These studies may help to explain why Janice, our long-suffering student, craved fatty and sugary foods while cramming for exams. Her motivation to eat was also

influenced by her stress level. Stress affects a person’s level of ghrelin, a hormone secreted in the stomach that stimulates stomach contractions and

appetite (Kristensson et al., 2006). Additionally, feeling stressed means that you are viewing a particular situation as being threatening in some way, even if you are not in physical danger. Based on the principle of allostasis discussed above, if you predict that an upcoming event will be threatening, you will react by stocking up on energy reserves so that you are better able to deal with this threat. So, even though homeostasis would indicate that Janice should stop eating, her psychological interpretation of her situation will lead her to continue munching away.

Cells in the orbitofrontal cortex respond to perceptual qualities of food texture, such as the difference between a runny spaghetti sauce and a thick one. Michele Cozzolino/Shutterstock

Of course, the reward value of food is also influenced by how much of it we have consumed—even the most stressed-out student will stop eating eventually. Indeed, we have all experienced the feeling of being “full.” A full stomach is one

cue for satiation —the point in a meal when we are no longer motivated to eat. That feeling is caused, in part, by cholecystokinin (mercifully abbreviated to CCK) (Badman & Flier, 2005). Neurons release CCK when the intestines expand. The ventromedial hypothalamus receives this information and

decreases appetite. Scientists at the Montreal Neurological Institute used neuroimaging to investigate how satiation and the reward value of food might be linked. These researchers scanned people’s brains while feeding them pieces of chocolate. At first, the participants rated the chocolate as being quite tasty and pleasurable; this led to activity in reward centres in the orbitofrontal cortex (the

part of the frontal lobes just above your eyes) and basal ganglia (Small et al., 2001). Activity was also found in the insula, which receives information about taste. But, after participants had consumed several pieces of chocolate, this formerly pleasurable food became less appealing (i.e., they became “sick of it”). Interestingly, as participants’ ratings of the chocolate became more negative, the activity in reward centres decreased. This study shows us that our physiological and psychological motivations to eat influence each other.

Module 11.1a Quiz:

Physiological Aspects of Hunger

Know . . . 1. The region of the hypothalamus is associated with the onset

of eating, while the region is associated with the offset. A. lateral; ventromedial B. ventromedial; lateral C. anterior; posterior D. anterior; ventromedial

2. is a sugar that serves as a vital energy source for the human body; its levels are monitored by the nervous system.

A. Ghrelin B. CCK C. Glucose D. Insulin

Understand . . . 3. Why do psychologists believe the lateral hypothalamus generates hunger

signals that contribute to people’s motivation to eat?

A. This brain structure responds to glucose levels. B. When the lateral hypothalamus is stimulated, laboratory animals

eat more.

C. Skinny people have smaller nuclei in this area. D. The lateral hypothalamus releases CCK, which reduces hunger.

Analyze . . . 4. How do evolutionary psychologists explain our desire to eat particular

foods?

A. We eat fatty foods because they are most accessible. B. The foods we now find pleasurable are often high-energy foods

that would have enhanced our chances for survival in the past.

C. People who consume sugar-free food have less energy and are less likely to reproduce, thus making them less evolutionarily fit.

D. People have adapted our food intake to match our current North American lifestyle.

Psychological Aspects of Hunger

The previous section of this module described a number of biological influences on our motivation to eat. In this section of the module, we highlight cognitive and social factors that affect this important behaviour.

Attention and Eating

The quantity of food that we eat is not entirely controlled by the brain or by evolutionary mechanisms. Instead, something as simple as attention can have a huge effect on how much we consume. Imagine sitting down to your favourite meal. Many of us would eat a lot, but then watching each helping disappear would probably serve as a reminder that it is approaching time to stop. But what if someone (or some drug) interfered with your ability to keep track of how much you had eaten? This scenario is not what we would expect in normal situations, but it would allow for an ideal test of how food availability affects how much you

will eat.

Psychologists have created such a situation in the laboratory through a technique known as the bottomless bowl of soup. Volunteers were asked to eat soup until they had had enough. In the experimental condition, a tube continued to fill the soup bowl from the bottom so that it could not be detected by the volunteers. These individuals stopped eating after consuming, on average, over 70% more than those participants who knowingly refilled their bowls. Even more interesting is what happened—or did not happen—in terms of feelings and thoughts: The individuals eating from bottomless bowls did not feel any more satiated, nor did they believe they had eaten any more than the individuals in the control group. It turns out we are not so good at putting on the brakes when we

cannot keep track of how much we have consumed (Wansink et al., 2005).

The results of the bottomless soup bowl study can be explained by unit bias , the tendency to assume that the unit of sale or portioning is an appropriate amount to consume. In some cases, this assumption works well. A single banana comes individually wrapped and makes for a healthy portion; it is an

ideal unit (Geier et al., 2006). In contrast, packaged foods often come in sizes that are too large to be healthy. A bottle of pop today is likely to be 600 mL, but a few decades ago the same brand of soda came in a 177 mL bottle. Despite the huge difference in volume, each is seen as constituting one unit of pop. As a consequence, you are now likely to consume more than three times as much pop in one sitting as your grandparents would have. Surprisingly, the unit bias affects our consumption almost as much as the taste of the food! In one study, participants were given fresh or stale (14-day-old) popcorn in either a small (120 g) or large (240 g) container. When the container was large, participants ate more popcorn . . . even if it was incredibly stale and tasted like styrofoam

(Wansink & Kim, 2005). A similar effect was found for people at a Super Bowl party. The larger bowls implied that it was “normal” for people to eat more

(Wansink & Cheney, 2005). Researchers have concluded that increasing the size of the dishes increases consumption by 18–25% for meals and 30–45% for

snack foods (Wansink, 1996).

Compare a modern soft drink serving (top) to the historical serving size (bottom). Despite the massive increase in volume, modern consumers still consider the

unit of packaging as a normal-sized serving. Top: Image Source/Corbis; bottom: Akg-images/Newscom

This expansion of portion sizes—and waistlines—is being felt worldwide. As North-American-style fast-food chains expand into Asia, the prevalence of

diabetes has increased (Pan et al., 2012). This is likely why some countries limit portion sizes and others, such as France, require all fast-food chains and snack products to have warning labels. But, before we beat ourselves up about how greedy our culture is, we should get some perspective: This upward trend in the size of our meals has been going on for a long time. This was demonstrated in a clever study examining the portion sizes of food in paintings depicting the same scene from the Bible (the last supper of Jesus). The study examined portion sizes in paintings over the last millennium (1000–2000 C.E.). Sure enough, the

plate sizes and portion sizes increased over the years (Wansink & Wansink, 2010).

Given this information about the role of attention, container sizes, and culture, what changes do you think should be made in the food industry to make Canada a healthier place?

Eating and Semantic Networks

Although attention and the unit bias play powerful roles in our motivation to eat, they are not the only cognitive factors that influence this behaviour. Imagine you are in a university cafeteria. As you push your tray along the counter, you have the option of selecting a number of different foods. What motivates you to select healthy options such as carrots as opposed to unhealthy options such as cookies?

It turns out that our food selections can be influenced by the presence of certain

other foods. These items, known as trigger foods , affect the selection of healthy and unhealthy foods simply by being present among possible food alternatives. In fact, trigger foods don’t need to be selected to affect eating

behaviour. In a study of high school cafeter ­ias, researchers found that the presence of containers of applesauce or fruit cocktail increased the likelihood that students would take cookies, ice cream bars, and other unhealthy snacks. In contrast, the presence of green beans or bananas decreased the likelihood that

students would take unhealthy snacks (Hanks et al., 2012). What could be causing these effects?

One factor that could explain these results is priming, a concept discussed in earlier modules of this book (see Modules 4.1 and 8.1 ). In priming, previous exposure to a stimulus will affect later responses, either to that stimulus or to something related to it. The related items are typically part of that stimulus’

semantic network, a group of interconnected concepts (see Module 8.1 ). When you see a banana, you often think of its colour and shape, of the fact that it is a fruit, and possibly of animals that eat them. But, when you think of fruit cocktail, your semantic network likely includes characteristics such as syrup and

sweet-tasting (see Figure 11.5 ). Researchers suggest that activating the concepts of sweet or sugary in your mind makes other foods that are also sweet

or sugary more appealing, thus leading to an unhealthy food selection (Hanks et al., 2012). In other words, how we link together concepts in our minds can also affect the food we put in our bodies.

Figure 11.5 Trigger Foods and Semantic Networks Unhealthy foods are often part of semantic networks that include terms such as “sweet” and “sugar.” Activation of these nodes in a network increases the likelihood that we will select other foods that are also related to “sweet” and “sugary.”

Eating and the Social Context

In addition to physical and cognitive influences, food intake is affected by social motives as well. Have you ever gone to a party feeling not a hint of hunger, yet spent the first hour sampling each of the snacks laid out on the dining room table because you were nervous and didn’t know what else to do with yourself? Whether the presence of other people increases or decreases our motivation to

eat is influenced by the social situation (Herman et al., 2003). Here are a few examples:

Social facilitation: Eating more. Dinner hosts (and grandmothers) may encourage guests to take second and even third helpings, and individuals with a reputation for big appetites will be prodded to eat the most. Perhaps the strongest element of social facilitation is just the time spent at the table: The longer a person sits socializing, the more likely he or she is to continue

nibbling (Berry et al., 1985). Impression management: Eating less. Sometimes people self-consciously control their behaviour so that others will see them in a certain way—a

phenomenon known as impression management. For example, you probably know that it is polite to chew with your mouth closed. Similarly, the minimal eating norm suggests that another aspect of good manners—at least in some social and cultural settings—is to eat small amounts to avoid seeming rude

(Herman et al., 2003). Modelling: Eating whatever they eat. At first exposure to a situation, such as a business dinner, a new employee may notice that no one eats much and everyone takes their time. The newcomer will see the others as models, and so he too will restrain his eating. Later, he may drop by his friend’s family reunion where everyone is having a second or third helping and undoing their belts so their stomachs can expand more. In this case, he will be likely to eat

more, even if he is already feeling full (Herman et al., 2003).

Clearly, eating is not just a matter of maintaining homeostasis. It is best described as a behaviour motivated by biological, social, and individual

psychological factors.

Module 11.1b Quiz:

Psychological Aspects of Hunger

Know . . . 1. The minimal eating social norm is the observation that people tend to

A. eat as little as possible in just about every social situation imaginable.

B. view eating reasonably sized portions as the polite thing to do. C. encourage one another to eat too much. D. eat as much as possible to flatter the cook.

Understand . . . 2. Being around others

A. can lead you to eat more than you normally would. B. can lead you to eat less than you normally would. C. can lead you to eat more or less than normal, depending on what

others are doing.

D. does not influence our eating.

Apply . . . 3. In Europe, the typical container of fruit and yogurt is roughly 177 mL. In

North America, the same food item is usually packaged in 237 mL containers. The unit bias suggests that

A. a German person visiting Canada would be likely to eat the entire container, even though it contains 25% more than the typical German serving.

B. a Canadian visiting Germany would almost certainly miss the extra 50 mL of yogurt.

C. a German person visiting Canada would carefully evaluate the differences in packaging to ensure that he or she does not consume more than usual.

D. all people would be unsatisfied with the 177 mL serving in

Germany.

4. Teachers at a Fredericton high school have become concerned about the eating habits of their students. Unfortunately, their school has a contract with a snack food company stating that a number of sugary treats must be available for students to potentially purchase. How can these teachers use psychological research to decrease the consumption of sugary snack foods?

A. They can place slightly less sugary treats such as applesauce at the beginning of the food line so that students select those instead of the company’s snack foods.

B. They can place healthy options like green beans at the beginning of the food line.

C. They can tell the high school students that sugar is bad for them, as students always listen to wise teachers.

D. They can place the unhealthy foods at the end of the food line near the cashier so that there is no room left on the students’ lunch trays.

Disorders of Eating

Our dietary habits are influenced by biological dispositions, our beliefs and perceptions about eating and our bodies, as well as sociocultural factors. Unfortunately, these motivational systems do not always lead us to good health.

The past few decades have seen a dramatic rise in the rates of obesity , a disorder of positive energy balance, in which energy intake exceeds energy expenditure. Indeed, over the last 15 years, surveys have consistently shown that approximately 60% of males and 45% of females are overweight or obese

(extremely overweight; Statistics Canada, 2016). However, in some individuals, hunger-related motivations move in the opposite direction—leading them to under-eat. While skipping dessert at Dairy Queen might not be a bad idea, avoiding or restricting the consumption of healthy food is obviously problematic. In the next section, we discuss some of the motivations underlying disorders

affecting the motivation to eat.

Anorexia and Bulimia

The two most common forms of eating disorders are anorexia nervosa and

bulimia (see Table 11.1 ). Anorexia nervosa is an eating disorder that involves (1) self-starvation, (2) intense fear of weight gain and dissatisfaction with one’s body, and (3) denial of the serious consequences of severely low weight. In contrast, bulimia nervosa is an eating disorder that is characterized by periods of food deprivation, binge-eating, and purging. The periods of binging involve short bursts of intense calorie consumption. These are followed by purging (generally self-induced vomiting), fasting, laxative or diuretic use, and/or intense exercise. Both disorders usually occur during mid-to-late

adolescence and have been on the rise during the 20th century (Hudson et al., 2007).

Table 11.1 Statistical Characteristics of Eating Disorders The incidence of eating disorders in Canadians is similar to that of other Western nations. To put these numbers into a global perspective, a 2004 study found that the incidence rate of anorexia varied from 0.1% to 5.3% in females in Western countries (no male data were available). Bulimia rates ranged from 0.3% to 7.3% (Norway) in females in Western countries and from 0.46% to 3.2% in non-

Western countries (Makino et al., 2004). Thanks to researchers working with government agencies, prevention programs are now in place in all Western and most non-Western countries. Source: Data from Hudson, J., Hiripi, E., Pope, H., & Kessler, R. (2007). The prevalence and correlates of eating disorders in

the National Comorbidity Survey replication. Biological Psychiatry, 61, 348–358.

Lifetime prevalence of anorexia Women: 0.9%      Men:

0.3%

Lifetime prevalence of bulimia Women: 1.5%      Men:

0.5%

Women and Men Combined

Percentage of people with anorexia who are receiving

treatment

34%

Percentage of people with bulimia who are receiving

treatment

43%

Average duration of anorexia 1.7 years

Average duration of bulimia 8 years

Studies of these disorders have found that bulimia is marked by a tendency to be

impulsive, whereas anorexia is not (Matsunaga et al., 2000). Bulimics are also much more likely to enter treatment programs because they find the binge–purge cycle disturbing. Anorexics, on the other hand, often appear indifferent to the

negative effects of food deprivation on their health (Polivy & Herman, 2002). Although there are clear differences between anorexia and bulimia, both involve changes in the motivation to eat and both are dangerous. A critical question, then, is: Why do eating disorders develop in some people but not others?

One factor is stress. Patients with eating disorders report greater levels of premorbid (before the disorder began) life stress than do age- and gender-

matched individuals without eating disorders (Schmidt et al., 1997). These life stresses tend to make people feel as though they have no control over their lives. However, stress alone isn’t enough to create an eating disorder. Instead, the perceived loss of control interacts with psychological variables such as

depression, guilt, anxiety, and perfectionism (Vohs et al., 1999); low self-esteem (Button et al., 1996); and/or suppressed anger (Geller et al., 2000). This combination of stress and psychological vulnerability dramatically increases the chances of developing an eating disorder (Ball & Lee, 2002; Raffi et al., 2000).

There are also a number of social factors that can lead to eating disorders. Peer

influence is often viewed as the number-one cause of these conditions (Stice, 1998). Adolescents, particularly females, learn attitudes and behaviours from

their friends. This learning comes in the form of examples and encouragement, as well as from teasing and nasty remarks when an individual doesn’t live up to

the idealized (thin) standards depicted in the media (Levine et al., 1994). In fact, numerous pro-anorexia websites have emerged over the past decade, offering “thinspiration” for people engaging in extreme dieting; similar messages now appear on social media sites such as Pinterest. By posting photographs and messages on these sites, individuals with eating disorders create a much larger peer group than before, making dangerous eating disorders seem normal. This is a worrisome trend.

Families are also a major influence on individuals with eating disorders. They often compliment anorexic girls for being slim and praise their self-control. This

serves as a source of reinforcement for the eating disorder (Branch & Eurman, 1980). Bulimic patients reported that their families were competitive, prone to jealousy, and tended to intrude in each other’s lives (Rorty et al., 2000). Importantly, adolescent girls whose families allow them to have some autonomy (i.e., control over their own lives) tend to have lower rates of eating disorders,

suggesting that control is a major factor in these conditions (Polivy & Herman, 2002).

So, how do stress, peer pressure, and family issues lead to eating disorders? Researchers suggest that some people use eating disorders as a coping

mechanism to deal with their difficult-to-control lives (Troop, 1998). By making weight and eating the primary focus of one’s life, individuals gain some feelings of security (both physical and emotional) as well as a feeling of being in control of some aspect of their life. Indeed, after binging in the laboratory, individuals with bulimia reported feeling less anxiety, tension, and guilt, although feelings of

depression remained the same (Kaye et al., 1986). In contrast, when these feelings of control are reduced, studies have shown that individuals with eating

disorders become more pessimistic and report feeling fatter than before (Waller & Hodgson, 1996). Evolutionary psychologists have suggested that this need for control extends to the woman’s reproductive system as well. The reproduction suppression hypothesis states that females who believe they have low levels of social support from romantic partners and family members are more likely to

engage in dieting behaviour (Juda et al., 2004). This change in food intake can

influence ovulation (Frisch & Barbieri, 2002) and lead to a loss of menstrual periods (amenorrhea), making it less likely that the woman will become pregnant. Such data again suggest that eating disorders are an attempt to gain control over

complex and stressful lives (Wasser & Barash, 1983).

People with anorexia experience severely distorted views of their body. Although dangerously underweight, they continue to both feel fat and fear being fat. Both males and females may become anorexic. TIFFANY BROWN/WPN/Photoshot

Males, although less prone to these problems than females, also develop eating disorders. Adolescents and young men may starve themselves during periods of

high exercise to lose weight and achieve muscle mass (Ricciardelli & McCabe,

2004). Ironically, although they have positive views of their own bodies, these men with “reverse anorexia” are just as obsessive and perfectionistic about their

bodies as people with anorexia (Davis & Scott-Robertson, 2000). And, both groups are particularly sensitive to media depictions of “perfect bodies” that, for almost everybody, are unattainable.

Working the Scientific Literacy Model The Effect of Media Depictions of Beauty on Body Image

One concern regarding eating disorders is the role that culture and the media play in their onset. Specifically, people with regular exposure to Western culture are more likely to develop bulimia

than members of cultures without such exposure (Keel & Klump, 2003).

What do we know about the effect of media depictions of beauty on body image? We often don’t critically analyze the effects that media depictions of beauty can have on people, particularly on sensitive teenagers. In the 1950s, Marilyn Monroe—who was busty and had big hips —was considered gorgeous. Today, A-list actresses are pressured to have body shapes that are virtually impossible to achieve: a very thin body and large breasts. Failure to meet this standard will lead to mockery in magazines and on gossip

websites. For example, in People magazine’s “Worst Dressed” section, the writers freely use weight-related words when discussing why an article of clothing is a fashion “fail”

(Crumpton, 1997). The result is that people who are not unnaturally thin may view their bodies as being ugly. But, do these media depictions of “perfection” influence how girls and women view themselves?

How can science explain the effect of the media on people’s

body image? The average North American woman is 163 cm (5940) and weighs 64 kg (140 lbs); the average model is 180 cm (59110) and

weighs 53 kg (117 lbs) (National [U.S.] Eating Disorders Association, 2002). Studies have shown that increased exposure to media (TV, magazines, Internet) is related to

decreased satisfaction with one’s body (Hofschire & Greenberg, 2002), particularly in people whose self-esteem is based on meeting socially defined standards (Williams et al., 2014); it is also related to a greater internalization of the slender ideal for

female body shape (Stice & Shaw, 1994). Researchers at Wilfrid Laurier University found that females were more likely to compare themselves to unrealistic popular culture figures than were men when they were describing their own bodies; they did not do so

when describing their social skills (Strahan et al., 2006). When the prominence of cultural norms was increased, all participants (female and male) were more likely to compare themselves with a model and felt worse after doing so. These results suggest that women are more consistently exposed to media depictions of “perfect bodies,” but that men are also sensitive to these pressures. In a follow-up study, female participants were exposed either to commercials containing attractive and thin women or to neutral stimuli. The results indicated that viewing media depictions of beauty decreased women’s satisfaction with their own bodies and made them more concerned with what other

people thought of them (Strahan et al., 2008).

Can we critically evaluate this research? It is easy to say that participants in psychology studies are simply answering the way they think the experimenter wants them to. However, the studies described above are consistent with recent brain-imaging data as well. Individuals with anorexia showed increased activity in the amygdala, a brain area related to fear and emotional arousal, when they were shown negative words related to body image; neutral words did not have this effect

(Miyake et al., 2010). Women with bulimia had greater levels of activity in medial frontal lobe regions related to emotional processing during the viewing of overweight as opposed to thin bodies; non-bulimic women did not show this activity. Finally, when women with eating disorders were shown images comparing themselves to idealized (model) bodies, the insula—a

brain region related to disgust—fired (Friederich et al., 2010). Together, these studies corroborate the questionnaire-based results that idealized media depictions of beauty have negative emotional consequences on vulnerable individuals.

Why is this relevant? Understanding the relationship between the media and disorders of body image allows teachers, parents, and health-care practitioners to design programs to help image-conscious individuals. In Canada, several programs are now in place that aim to teach people to deal with social pressures and to have a

realistic body image (McVey et al., 2009; Yuile & McVey, 2009). Importantly, knowledge about media influences can reduce its effects. When public school students completed activities that contested the idea that women needed to be thin and beautiful and men needed to be tall and muscular in order to succeed, the

influence of media depictions decreased substantially (Strahan et al., 2008). Not everyone needs to keep up with the Kardashians.

Module 11.1c Quiz:

Disorders of Eating

Know . . . 1. What is one difference between anorexia and bulimia?

A. Anorexia involves periods of self-starvation, whereas bulimia does not.

B. Bulimia involves purging (such as self-induced vomiting), whereas this is less characteristic in anorexia.

C. Anorexia occurs in females only, whereas bulimia occurs in both females and males.

D. Anorexia and bulimia are actually two terms for the same disorder.

Apply . . . 2. Which of the following is the most likely predictor of someone’s chances

of developing an eating disorder?

A. Activity of the parietal somatosensory cortex B. Decreased sensitivity to the reward value of food C. Exposure to idealized versions of body type and thinness D. Fat receptors on the tongue

Module 11.1 Summary

allostasis

anorexia nervosa

bulimia nervosa

drive

glucose

homeostasis

hypothalamus

incentives

motivation

obesity

Know . . . the key terminology of motivation and hunger.11.1a

satiation

trigger foods

unit bias

Energy is delivered through the bloodstream in the form of glucose found in food; the hormone insulin helps the cells throughout the body store this fuel. CCK signals fullness (satiety). These substances are monitored by the hypothalamus, which signals hunger when not enough glucose is available to the cells. You should also have an understanding of the effects of psychological cues, such as the unit bias, trigger foods, and the variety of available foods; as well as social cues, such as the minimal eating norm.

This module discussed issues related to anorexia and bulimia, both of which involve periods of self-starvation and a fear of gaining weight. Bulimia also includes purging, such as through vomiting or the use of laxatives. Stress, peer pressure, and idealized depictions of beauty all influence the prevalence of eating disorders. It is likely that many people with eating disorders are attempting to establish a feeling of control over some aspect(s) of their lives.

Do you finish an entire package of a food item, as the minimal eating norm would suggest? Or do you check to ensure you are getting an appropriate serving size? Try this activity to find out exactly how you eat.

Apply Activity Starting first thing tomorrow, keep a food diary for the next three days. Record

Understand . . . the biological, cognitive, and social processes that shape eating patterns.

11.1b

Understand . . . the causes of common eating disorders.11.1c

Apply . . . your knowledge of hunger regulation to better understand and evaluate your own eating patterns.

11.1d

everything you eat over this period, including when you ate, what you ate, and what made you feel like eating. It is important to be honest with yourself and to be reflective: Did you eat because your stomach rumbled, because you were craving something, or perhaps because the food was just there? It is okay to list more than one reason for each entry in your food diary. At the end of the three- day period, tally how often each reason for eating appeared in your diary. Make note of what proportion of the time you ate for each reason. Ask yourself: Are the results surprising? Do they make you want to think more about the reasons you eat? (Note: You can also try to work from memory and recreate a food diary from the past three or four days, but the results might not be as accurate.)

A number of studies using different methodologies—questionnaires and brain scanning—have shown that the media’s idealized depictions of beauty have a negative influence on people’s body image (and happiness). With this knowledge, you should be able to identify these misrepresentations of what a normal body should look like, to recognize that the motivation to eat is important, and to see that beauty is not necessarily Size 2.

Analyze . . . the role of the media on people’s body image.11.1e

Module 11.2 Sex

Somos Images/Alamy Stock Photo

Learning Objectives

Why do humans have sex? Psychologists Cindy Meston and David Buss have asked just this question in their research on human sexual

Know . . . the key terminology associated with sexual motivation. Understand . . . similarities and differences in sexual responses in men and women. Apply . . . research on sex and advertising to the commercials and Internet ads you see each day. Analyze . . . different explanations for what determines sexual orientation.

11.2a 11.2b

11.2c

11.2d

motivation. Specifically, they asked American college students why they have sex and tabulated the many different responses offered by both

males and females (Meston & Buss, 2007). There are so many possible answers to this very open-ended question—how many do you think they came up with? Certainly more than if we asked the same about why birds, bees, or meerkats have sex. Here are some of the reasons the students came up with:

“I wanted to get back at my partner for cheating on me.” “Because of a bet.” “I wanted to end the relationship.” “It feels good.” “I wanted to show my affection toward the other person.” “I wanted to feel closer to God.”

Although we will never know for sure, birds, bees, and meerkats likely have sex to reproduce (a reason that was far down the list for college students). The motivation to have sex naturally has its complex, underlying physiology. As we will see in this module, however, human sexual motivation is expressed and experienced in diverse ways—at least 237 different ways, according to Meston and Buss’s research.

Focus Questions

1. How do psychologists explain the diverse sexual motivations of humans?

2. How do psychologists explain variations in sexual orientation?

Imagine seeing an attractive person walking along the beach, a toned body glistening in the hot summer sun. Then you and the object of your desire make eye contact and it is clear that the interest is mutual. Your initial response might

seem like a white-hot biological drive. This is your libido —the motivation for sexual activity and pleasure. But, whether you immediately act on this motivation

is dependent upon a number of factors, not just “hotness.” As researchers delve into the complex topic of sexual behaviour, it is becoming increasingly clear that our motivations are shaped by physiological, psychological, and social factors, and that these factors interact with each other differently in different people.

Human Sexual Behaviour: Psychological Influences

Although its main evolutionary purpose is reproduction, sexual motivation is actually expressed in many different ways. Sexual themes are common in television, movies, video games, humour, advertising, and other media, and discussions of sex and sexuality influence social life, school, and the workplace. It is even part of politics, with heated debates occurring about the public school sex education program in Ontario, about whether government officials should attend Pride parades, and, bizarrely, about the size of U.S. presidential nominee Donald Trump’s genitals. Obviously, sex is a very important and relevant topic for psychology. But it is also one of the most challenging topics to study. Sex generally happens in private, and many people prefer to keep it that way. Nonetheless, psychologists use a variety of methods to understand the complexities of human sexual behaviour, including interviews, questionnaires, physiological measures, and even direct observations of behaviour. Interviews and questionnaires are (obviously) the least intrusive techniques and, therefore, the most commonly used.

Psychological Measures of Sexual Motivation

One of the first scientists to tackle the topic of human sexual behaviour was zoology professor Alfred Kinsey. Kinsey began his research on human sexuality by interviewing his students about their sexual histories. Between 1938 and 1952, Kinsey and his colleagues at Indiana University interviewed thousands of people and published their results in a pair of books known informally as the

Kinsey Reports (1948, 1953). By modern standards, Kinsey’s methods were

quite flawed and rather controversial. Kinsey tended to make sweeping generalizations about his findings that were based on very limited samples. Despite these practices, Kinsey’s work on sexuality continues to influence discussion on sexual behaviour and motivation.

The fact that Kinsey dared to apply science to sexuality was offensive to many people at the time. During an era when the phrase “sexual orientation” did not even exist, Kinsey reported that 37% of the males whom he interviewed had at least one homosexual experience resulting in orgasm; this was absolutely shocking at the time. (The corresponding figure for females in his studies was 13%.) Contrary to the conventional thinking of his time, Kinsey believed that heterosexuality and homosexuality fell on a continuous scale, an idea that remains with us today.

It is important to note that the methods for studying sexual behaviour have changed since Kinsey conducted his groundbreaking investigations. Extensive interviews have been largely replaced with anonymously completed questionnaires that encourage participants to provide more candid responses. Studies also include larger and more representative samples. For example, at the beginning of this module, we introduced a study conducted by psychologists Cindy Meston and David Buss, who asked more than 1500 U.S. college students to identify their reasons for having sex. We listed a few reasons provided by the students—some conventional (to express affection) and others perhaps more surprising (to feel closer to God). We return to this study to discuss some general

themes that emerged—notably, the four shown in Figure 11.6 .

Figure 11.6 Why Have Sex? Self-reported reasons for having sex by undergraduate students (Meston & Buss, 2007). Anna Khomulo/Fotolia

Alfred Kinsey’s research into sexual behaviours paved the way for future generations of scientists to study sexual motivation. Can you think of some modern research tools that weren’t available during Kinsey’s time? Keystone-France/Gamma-Keystone/Getty Images

As you can see in Figure 11.6 , physical, personal, and social factors underlie sexual motivation. For the respondents in Meston and Buss’s study, physical reasons were related to the pleasure of the sex itself. Many respondents used sex for what might be described as instrumental reasons—sex was a means of accomplishing a goal such as financial or personal gain, or revenge. Students were also motivated by emotional reasons and because of feelings of insecurity (although there is little evidence to suggest that sex leads to any long-term improvements in this regard). Reproduction ranked very far down the list. Sexual

motivation is also tied to relationship context. A study conducted at the University of Ottawa found that females are more motivated by physical pleasure when seeking out short-term relationships, but are motivated by emotional factors

when seeking out long-term relationships (Armstrong & Reissing, 2015). This pattern occurred for women across the continuum of sexual orientation. You can evaluate your own attitudes about sex and compare them with others by

completing the activity in Table 11.2 .

Table 11.2 Attitudes Toward Sex Survey

How do you feel about sexuality? You can apply what we have learned from research to

understand if you take a generally permissive attitude (people have the right to do what

they want) or a more conservative one. Respond to each of the items below by

assigning a score on a scale from 1 (strongly agree) to 5 (strongly disagree). Note that it

is not necessary to be sexually active to complete this scale—simply respond to the

general principle of each item.

1. I do not need to be committed to a person to have sex with him or her.

2. Casual sex is acceptable.

3. I would like to have sex with many partners.

4. One-night stands are sometimes enjoyable.

5. It is okay to have ongoing sexual relationships with more than one person at a time.

6. Sex as a simple exchange of favours is okay if both people agree to it.

7. The best sex is with no strings attached.

8. Life would have fewer problems if people could have sex more freely.

9. It is possible to enjoy sex with a person and not like that person very much.

10. It is okay for sex to be just a good physical release.

Once you have assigned a number to each item, average your responses to get your

overall score. In one study of more than 200 college students, men averaged a score of

3.63 and women averaged a score of 4.47 on this scale (Hendrick et al., 2006). How

do you compare? Given what you have learned about the biological and cultural factors

that influence sexuality, are you surprised by the gender difference? Which other factors

might influence the norms?

Age is also a factor in sexual motivation. Although young people don’t typically

associate older individuals with sex (Thompson et al., 2014), survey studies show that almost three-fourths of the 57- to 64-year-old respondents reported sexual contact with a partner in the past year, as did half of the 64- to 75-year-

olds and one-fourth of the 75- to 85-year-old respondents (Lindau et al., 2007). While these numbers aren’t at the level of sexual activity of average university students, they do show that the motivation to have sex continues throughout the lifetime. It is also worth noting that surveys indicate that the sexual motives of middle-aged women are the same as women aged 18 to 22 years: pleasure,

love, and commitment (Meston et al., 2009).

The survey and interview methods discussed to this point have provided a rich set of data about human sexuality. Other researchers have approached this topic from a biological standpoint by looking at the physiological and brain basis of

sexual motivation (Pfaus et al., 2012), a topic we will consider in the next section of this module.

Module 11.2a Quiz:

Human Sexual Behaviour: Psychological Influences

Know . . . 1. refers to one’s motivation for sexual behaviour and

pleasure.

A. Libido

B. Excitement C. Orgasm D. Cybersex

2. According to research on sexual motivation in college students, which of the following is not a primary reason students offer for having sex?

A. Emotional reasons B. Physical reasons C. Social reasons D. Reproduction

Human Sexual Behaviour: Physiological Influences

Physiological Measures of Sex

Our physiological and psychological motives for having sex are not separate. Sexual arousal (a biological state) can influence what we pay attention to and how we respond to it; in other words, it can influence our feelings of desire

(Pfaus & Scepkowski, 2005). Although several decades of research have helped identify many of the biological processes associated with sexual motivation, it is important to remember that all of these biological processes are influenced by a person’s psychological state.

William Masters and Virginia Johnson performed some of the earliest studies of sexual behaviour in the 1950s. These researchers described the human sexual response cycle based on their observations of 27 male and 118 female prostitutes who agreed to masturbate or to have intercourse while under

observation (Masters & Johnson, 1966). Participants were monitored with heart rate and blood pressure equipment, as well as with more peculiar devices such as the penile plethysmograph or vaginal photoplethysmograph, which are designed to measure blood flow to the genitalia in men and women, respectively.

Masters and Johnson’s initial study allowed them to develop their methods and work with participants who, according to the researchers, were less likely to be sexually inhibited than non-prostitutes. Masters and Johnson followed up this study with observations of hundreds of men and women to characterize the physiological changes that occur during sex.

Figure 11.7 summarizes Masters and Johnson’s (1966) observations of human sexual responding in males and females. The sexual response cycle

describes the phases of physiological change during sexual activity, which comprises four primary stages: excitement, plateau, orgasm, and resolution. Dividing the sexual response cycle into phases allowed the researchers to describe the cascade of physiological changes that occur during sexual behaviour. The cycle applies to both male and female sexual responses, although there are differences between sexes in how these stages are experienced and their duration. The work of Masters and Johnson and those who have followed in their footsteps reveals a complex picture of male and female sexual responses.

Figure 11.7 Sexual Response Cycles (a) Masters and Johnson’s studies showed that males typically experience a single orgasm followed by a refractory period—a time during which orgasm cannot be physically achieved again. Then they experience resolution, unless they continue sexual activity. (b) Women typically have a more varied sexual response profile than men. Here are a few examples. Line A indicates a woman

who has multiple orgasms, Line B a woman who does not experience orgasm, and Line C a woman who has a single orgasm.

One topic of particular interest is how males and females differ in their patterns of orgasm. In one study, 21% to 32% of women reported that they did not

experience orgasm during masturbation or sexual intercourse (Dunn et al., 2005), whereas only 2% of men did not experience orgasm. Men usually experience a single orgasm followed by a refractory period , a time period during which erection and orgasm are not physically possible. In contrast, some women experience multiple orgasms without a refractory period.

Recent brain-imaging studies have shown that much of the sexual response cycle is influenced by the hypothalamus. In one stimulating study, researchers examined the brain activity of women when they experienced an orgasm while

being monitored by functional MRIs (Komisaruk, 2005). Physical stimulation led to activity in the hypothalamus which, in turn, stimulated the pituitary gland to

release a hormone called oxytocin. Oxytocin plays a role in orgasms as well as in the feeling of trust (Zak, 2008). Blood levels of oxytocin surge just after orgasm and may remain elevated for at least five minutes in both females and

males (Carmichael et al., 1994; Murphy et al., 1990). This hormonal response may promote bonding between sexual partners, as one of our fundamental

motivations as humans is to feel connected to others (see Module 11.3 ).

Sexual Orientation: Biology and Environment

Although the research discussed thus far has shed light on many aspects of sexual behaviour, there are still questions that have not been answered. A topic

that has garnered considerable interest is sexual orientation , the consistent preference for sexual relations with members of the opposite sex (heterosexuality), same sex (homosexuality), or either sex (bisexuality). Current definitions of sexual orientation focus on the psychological aspects of sexuality (e.g., desire, emotion, identification) rather than strictly behavioural criteria

(Bailey et al., 2000). For example, a person can have a sexual orientation but never have sexual contact throughout his or her life.

There is a popular misconception that homosexual behaviour is “unnatural” and that it is only a human behaviour. However, as you will see in this section, there is a great deal of evidence showing that homosexuality is common in a number

of species (Roselli et al., 2004), and, like most behaviours, is influenced by biological, cognitive, and social factors.

Homosexuality has not always been as widely accepted as it is today, however. Indeed, psychologists have long struggled to find a satisfactory explanation for

variations in sexual orientation. Sigmund Freud (1905) advanced the theory that male homosexuality could be traced to the presence of a domineering mother

and a weak father figure. As recently as 1987, Ellis and Ames argued that homosexuality could be caused by experiencing seduction from an older sibling or playmate. Both theories lack scientific evidence to confirm their validity. Modern researchers have begun to examine the degree to which sexual orientation is based on choices people make and on biologically related factors such as genetics or differences in brain anatomy.

In the early 1990s, neuroscientist Simon LeVay compared the brains of deceased gay and heterosexual males. In his work, he found that an area of the hypothalamus was, on average, smaller in gay men compared to heterosexual

men (Figure 11.8 ; LeVay, 1991). LeVay’s results created a storm of controversy among both scientists and the public. Many people incorrectly interpreted his findings as proof that homosexuality was biologically, and therefore genetically, determined. In fact, the differences in the hypothalamus could have been due to environmental factors—LeVay’s study was not designed to test either conclusion.

Figure 11.8 Sexual Orientation and the Brain An early study of the brain basis of sexual orientation found that homosexual males had a smaller subregion (INAH3) of the hypothalamus within the medial

pre-optic area (LeVay, 1991).

Sexual orientation is not exclusively determined by patterns of sexual behaviour. It also includes aspects of identity and emotional connection. Scientists are discovering that sexual orientation is an outcome of complex gene and environmental interactions. BananaStock/Getty Images

Scientists have been skeptical of LeVay’s results, in part because they have

proved difficult to replicate (Lasco et al., 2002). The region of the hypothalamus

he identified was only smaller on average in gay men versus heterosexual men, and the ranges in size were overlapping, with some gay men having a larger hypothalamic region than some heterosexual men. In addition, the purportedly homosexual men whom LeVay studied died of complications associated with HIV, which could have accounted for the differences in their brains. Although its results are not considered definitive, LeVay’s study stimulated considerable scientific curiosity and debate about links between the brain and sexual orientation. Subsequent research has shown that differences in sexual orientation are associated with the size of the amygdalae (structures related to

emotional responses; Savic & Lindström, 2008) and also the thickness of several regions of the cortex (Abé et al., 2014).

In addition to differences in brain structure, the brain’s functioning may also differ according to one’s sexual orientation. Brain-imaging studies have shown that sexual stimuli elicit different patterns of activity in heterosexual and homosexual individuals. In one study, homosexual men and heterosexual women showed greater activation in the medial preoptic area of the hypothalamus while smelling a male derivative of testosterone found in sweat. This brain region, which is involved in sexual behaviour in many different species, including humans, did not

become activated when heterosexual men smelled male sweat (Savic et al., 2005). Homosexual males and heterosexual females also showed greater activity in the brain’s reward centres when viewing pictures of aroused male genitalia. The same brain regions were active when homosexual women and

heterosexual men viewed pictures of female genitalia (Ponseti et al., 2006). These findings might not provide the final answer about the neural basis of sexual orientation, but they do indicate that differences in sexual motivation are related to differences in patterns of brain activity.

Other research suggests that sexual orientation may be influenced by a combination of genes. Evidence for this comes from twin studies that have identified higher genetic correlations between identical twins compared with fraternal twin pairs. Several twin studies examining the genetic basis of sexual orientation have been conducted. Genetic correlations between .30 and .60 for homosexuality have been reported for both men and women, suggesting that approximately half of the individual differences found in sexual orientation are

due to genetic factors (Figure 11.9 ; Bailey & Pillard, 1995; Bailey et al., 1993; Kirk et al., 2000). This result tends to hold true for gay men across multiple studies. In contrast, studies have failed to confirm a genetic relationship

between genes and homosexuality in women (Bailey et al., 2000; Långström et al., 2010). Thus, genes appear to play at least some role in sexual orientation, particularly for men. However, this statement does not mean that sexual

orientation is determined by genetics. The brain and endocrine system are remarkably sensitive to the environment, and they interact with a variety of

sociocultural factors (Meston & Ahrold, 2010). More research investigating these interactions is clearly necessary.

Figure 11.9 Genetics and Sexual Orientation Twin studies tend to show consistently higher genetic correlations for sexual orientation between male identical twins compared to fraternal twins. This finding indicates that male homosexuality has a genetic basis. Results of studies comparing female identical and fraternal twins are not as consistent. Sources: Based on data from Bailey & Pillard (1995), Bailey et al. (1993), and Bailey et al. (2000).

Homosexual behaviour has been reported in many different nonhuman species such as bonobo chimpanzees, koala bears, bottlenose dolphins, and sheep. In fact, researchers have found that 8% to 10% of rams show preferences for mounting other rams, and the most obvious difference researchers have found between male-preferring and female-preferring rams is a smaller region of the

hypothalamus in the former (Roselli et al., 2004). Julian W/Shutterstock

Natureguy/Fotolia

Elena Larina/Shutterstock

Sergey Uryadnikov/Shutterstock

Transgender and Transsexual Individuals

Most Canadian universities have an office or organization dedicated to supporting Lesbian, Gay, Bisexual, and Transgender (LGBT) individuals, doing their utmost to provide them with emotional, social, and sometimes legal assistance. Thus far, we have discussed many issues related to sexual orientation, the “LGB” in the above acronym. Until recently, relatively little was known about transgender individuals. However, the recent decision of Bruce Jenner, a former Olympic gold medalist and one of the Kardashian clan, to go public with the fact that he identifies as a female (Caitlyn Jenner) has brought this topic to the forefront of popular culture and has brought Jenner a great deal of attention—some positive, some negative.

The term transgender refers to individuals who experience a mismatch between the gender that they identify with and their biological sex (Oliven, 1965). It does not refer to an individual’s sexual orientation. Transsexual , on the other hand, refers to the subset of transgender individuals who wish to permanently transition from their birth sex to the gender with which they identify (Bevan, 2014). Many transsexual individuals seek medical assistance in the form of sexual reassignment surgery.

In the past ten years, researchers have begun to investigate whether there are brain-based differences between transgender individuals and the rest of the

population (Kreukels & Guillamon, 2016). They suggest that sex hormones such as testosterone influence the sex differentiation of the genitals in the first 6– 12 weeks of prenatal development; sexual differentiation of brain structures (i.e., the differences that exist between male and female brains) begin to occur in the second half of prenatal development. In transgender individuals, it is possible that sex hormones caused the genitals and body to develop in the direction of one sex (e.g., male), while the brain and gender developed in the opposite

direction (e.g., female; Swaab & Garcia-Falgueras, 2009). Consistent with this view, researchers have found that volume of some nuclei in the hypothalamus of male-to-female (MtF) transsexuals resembled female rather than male brains

(Garcia-Falgueras & Swaab, 2008). Researchers have also found that the brains of females transitioning to males (FtM) and males transitioning to females (MtF) differ from each other, with MtF individuals having more white-matter connections between subcortical areas (lower in the brain) than FtM individuals

(Hahn et al., 2015). Of course, as this line of research is still in its early stages, we must be cautious when drawing conclusions.

Caitlyn Jenner’s public transition from male to female has put a spotlight on issues related to transgender individuals. Time will tell whether this attention will lead to increased respect and improved healthcare for transgender individuals. Frederick M. Brown/Getty Images

PSYCH@ Sex Ed In 2015, the Government of Ontario introduced a new sexual education curriculum that attracted national attention. In addition to learning the

names and functions of different parts of the male and female reproductive systems, students would learn about sexting, consent, contraception, sexual orientation, and gender identity. As noted earlier in this module, some of these topics—particularly gender identity and sexual orientation—have been associated with ill-informed explanations; the goal of the sexual education program was to provide students with scientifically accurate information. Although the majority of parents supported the updating of the curriculum, a very vocal minority opposed the teaching of topics related to homosexuality, abortion, and contraception. This conflict leads to some very important questions about sexual education. What topics should be included? Who should teach them? And, do students benefit from this information?

A 2010 survey of over 1000 Ontario parents found strong support for the

teaching of sexual health information in schools (McKay et al., 2014). Parents agreed that students should learn the proper names for body parts, issues related to physical and emotional development, and information about contraception. Although sexual orientation and media literacy received lower ratings, the average rating was still above three on a 4-point scale. Parents were most comfortable with their children learning sexual health information from their family, their doctor, or their teachers (as opposed to social media or peers).

Of course, not all teachers are equally capable of providing this information. In a different survey study conducted by researchers at the University of New Brunswick, middle-school students (grades 6–8) indicated that it was essential to provide students with accurate information in an interesting, engaging manner. It was also essential that this information be taught by an instructor comfortable discussing sexual

issues (Byers et al., 2013). Teachers themselves had similar views— individuals who were younger, had experience and training teaching sexual health information, and felt comfortable talking about these issues

were more willing to teach “sex ed” (Cohen et al., 2012). Hopefully, these teachers will be able to effectively deliver Ontario’s new curriculum so that students will leave middle school with a decent understanding of sex; this will help teens make informed decisions about the very adult

issues they will soon face.

It is important to note that this research was not making any moral judgments about anyone—it was simply an investigation into differences between groups of

people. That said, transgender and transsexual individuals do face many struggles in our society, and experience stress and discrimination that can affect

healthcare and their general well-being (Dargie et al., 2014; Hughto et al., 2015). In an effort to counter these negative effects, organizations such as the Canadian Psychological Association (CPA) have produced literature aimed at

helping transgender individuals deal with their negative emotions (CPA, 2016). This information is also useful for educators, as it will allow them to help adolescents who are experiencing gender uncertainty, and to provide accurate information to other students receiving education about sex (“sex ed”).

Module 11.2b Quiz:

Human Sexual Behaviour: Physiological Influences

Know . . . 1. In what order do the phases of the sexual response cycle occur?

A. Plateau, orgasm, resolution, excitement B. Excitement, plateau, orgasm, resolution C. Orgasm, resolution, excitement, plateau D. Excitement, orgasm, resolution, plateau

Understand . . . 2. The male sexual response cycle includes a(n) during which

erection and orgasm are not physically possible, whereas the female sexual response cycle often does not.

A. plateau B. refractory period C. oxytocin release D. sensitive period

3. What is one biological explanation for the mismatch between the gender

that transgender individuals identify with and their biological sex?

A. Oxytocin levels are abnormally low in transgender individuals, which influences how the frontal lobes of the brain will develop early in life.

B. The levels of sex hormones such as testosterone are abnormally high in transgender individuals.

C. Sex hormones cause sex differences in the genitals at an early stage of prenatal development and sex differences in the brain at a later stage of prenatal development.

D. Sex hormones cause sex differences in the brain at an early stage of prenatal development and sex differences in the genitals at a later stage of prenatal development.

Analyze . . . 4. Brain differences between homosexual and heterosexual adults should

be interpreted as

A. a result of both genetic and environmental factors. B. due solely to inherited, genetic differences. C. proof that the brain structure between homosexual men and

heterosexual women is identical.

D. due solely to environmental factors.

Human Sexual Behaviour: Cultural Influences

How is an 18-year-old woman “supposed to” act when she is interesting in having sex? How about an 18-year-old guy? Although we’d all love to say that

people should act any way they want, gender roles , the accepted attitudes and behaviours of males and females in a given society, exist. These gender roles are flexible over time, however. Your great-grandmothers were unlikely to wear revealing clothing or have “hook ups” or “friends with benefits”; this norm changed across generations. Indeed, across generations, there have been

sexual scripts

significant changes in male and female , the set of rules and assumptions about the sexual behaviours of males and females. For most of human history, male sexual behaviour was based on competition. Men would value sexual conquests and the physical attractiveness of females. Females, on the other hand, would be taught to be less promiscuous and to focus on developing a stable relationship before engaging in sexual intercourse. There are a number of reasons for this difference. First, females have a limited supply of eggs that can be fertilized. They therefore have to be careful about which male

does the fertilizing (Trivers, 1972). Because children require resources (food, clothing, shelter, money, etc.), and females were not traditionally in the workforce, it was important to be certain that a potential mate would be a good provider. Males, on the other hand, have a seemingly unlimited supply of sperm that can be replenished quickly. If their evolutionary goal is to pass on their genetic information to as many people as possible, males are able to do this by impregnating as many women as possible (whereas women would have to give birth a large number of times, which is much more difficult). Although this might not be the stated goal of most men, the sexual motivation to have sex with large numbers of women still exists. Additionally, males have higher levels of testosterone , a hormone that is involved in the development of sex characteristics and the motivation of sexual behaviour. Thus, there are social, evolutionary, and hormonal reasons for the sexual scripts in our culture.

But, this evolutionary explanation is only part of the explanation for gender roles and sexual scripts. For a large part of human history, societies were set up in a way that gave men greater power than women. Indeed, in many cultures, women were viewed as possessions—first of their fathers and then of their husbands. Limiting the sexual expressiveness of women limited their ability to feel empowered, and allowed the “status quo” of the patriarchy (male-dominated society) to continue.

But, as we noted, these scripts are changing. Why do you think that is? Although there are dozens of potential explanations, there are three that are particularly important. The first is the emergence of the Women’s Rights Movement over the last 130 years. This movement challenged the core values of the patriarchal society and put pressure on lawmakers to allow women to have equal economic

and political rights such as voting. The result was that women were perceived as people rather than possessions. A second, related, cause was the increasing presence of women in the workforce. This economic independence meant that females could take care of themselves if they became pregnant. Therefore, they didn’t need to be as careful about who they had sex with. The third reason for changing sexual scripts was “the pill.” The U.S. Federal Drug Administration

approved the drug Enovid for use as a contraceptive on June 23, 1960 (Marks, 2001); the pill was legalized in Canada in 1969. This allowed women to have control over when they were going to become pregnant, thus giving them much more control over their sexual behaviours. The importance of contraceptives cannot be overstated. Imagine how people’s lives would be changed if pregnancy was a strong possibility every time someone had sex.

Of course, it is important to note that not all females or males follow the same sexual scripts. Different ethnicities and religious groups have their own scripts as well. For instance, researchers at the University of British Columbia found that Chinese women (born in China or Taiwan, but living in Canada) reported more

conservative sexual attitudes (Woo et al., 2010) and lower levels of sexual desire than Euro-Canadian women (Woo et al., 2012). Why would this occur? Researchers have found that sex guilt , negative emotional feelings for having violated culturally accepted standards of appropriate sexual behaviour, is a major factor in these differences. Interestingly, these differences decrease for individuals who become more involved with mainstream Western culture, suggesting that a number of social and cultural factors influence sexual

motivations (Brotto et al., 2005).

The development of birth control pills allowed women greater control over whether they would become pregnant, and dramatically changed our society. Everett Collection Historical/Alamy Stock Photo

Sexual scripts also exist in homosexual relationships. Indeed, researchers in this field have highlighted the butch (traditionally masculine) and femme (traditionally

feminine) gender roles of some lesbians (Blair & Hoskin, 2016; Munt, 1998). However, research suggests that these sexual scripts are more flexible than in heterosexual relationships, possibly due to the fact that many homosexual individuals do not follow gender roles to the same degree as do heterosexual

individuals (Kurdek, 2005).

Sex and Technology

What type of sexual scripts would develop if people could engage in sexual behaviour anonymously without having to physically interact with another person? Although your grandparents may have considered that question to be

science fiction pornography, in the past two decades electronic media such as the Internet, text messaging, instant messaging, and social networking sites have become common outlets for sexual expression. Electronic media are often used for viewing pornography, having online sexual encounters, and meeting others for sex offline (i.e., in the real world). Adolescents, as well as both single and married adults, may engage in cybersex—that is, the use of the Internet and computer equipment for sending sexually explicit images and messages to a partner. An estimated one in three adults today has engaged in cybersex

(Daneback et al., 2005). These experiences tend to occur with a person’s primary sexual partner, although interactions do occur with known non-partners

and with strangers (Shaughnessy et al., 2014).

Unplanned pregnancy and STDs are obviously not an immediate risk of cybersex. However, people tend to communicate with less inhibition via digital media compared to face-to-face encounters. This opens up the possibility for impulsive behaviour such as sending sexually explicit pictures and messages (“sexting”). Many teens have suffered rather harsh legal consequences for sexting. Some U.S. states consider sexting to be a form of underage pornography and those convicted could be required to register as sex offenders. The Supreme Court of Canada has indicated that under-aged teens can possess sexual images of each other assuming it is consensual; however, the distribution

of such images is illegal (R. v. Sharpe; Supreme Court of Canada, 2001).

Regardless of your opinions of, or experience with, cybersex, it is impossible to ignore the fact that sexual imagery is becoming increasingly common in our society. What is less clear is how this sexuality will affect our day-to-day behaviours.

Working the Scientific Literacy Model Does Sex Sell?

The American Apparel advertisement showed a topless model with her back to the camera, her nylon-clad buttocks thrust

provocatively toward the viewer. Needless to say, this ad got noticed, as did several other (equally subtle) ads by the same company. But American Apparel isn’t alone in using sex to sell its products. H&M has featured giant billboards displaying David Beckham in his underwear. Soft drink companies have young and attractive people drink their products in commercials. And, in a sure sign of the Apocalypse, Paris Hilton wore a skimpy swimsuit, soaped herself up, and writhed on a car in order to sell Carl’s Jr. hamburgers. The ad’s caption was, “She tells you size doesn’t matter. She’s lying.” Although there is no doubt that such ads attract attention, are they effective in changing consumers’ brand preferences? Does sex really sell?

What do we know about sex and advertising? There are a number of examples of companies being saved by sexual advertising. Woodbury’s Facial Soap was near bankruptcy in 1910; however, when a new ad campaign depicted romantic couples and promised that using the product would lead to

greater intimacy, sales skyrocketed (Reichert, 2003, 2012). Jovan Musk Oil, a fragrance for men, had advertisements that suggested that it would increase a user’s sexual attractiveness; revenue from Jovan’s Musk increased from $1.5 million in 1971 to $77 million in 1978. Based on these, and many more, success stories, the frequency of sexual imagery in ads has increased substantially in the past three decades. A study of 3343 full-page ads that were published in 1983, 1993, and 2003 in popular

magazines such as Esquire, Playboy, Newsweek, Time, Cosmopolitan, and Redbook found that the proportion of sexual ads increased from 15% in 1983 to 27% in 2003 (Reichert et al., 2012). Sexual imagery was most often used to sell health and hygiene products (38%), beauty products (36%), medicine (29%), and clothing (27%). This trend leads to the obvious question: How is sex being used to influence our buying behaviour?

Gregory Holmgren/Alamy Stock Photo

How can scientists explain the effect of sexual imagery on advertising success? Some advertisements use sexual imagery to attract attention to a product. For example, an attractive model standing next to a car or eating a bowl of cereal will make us pay more attention to that image than we otherwise would. However, such image–product pairings are not always effective. First, researchers at the University of Manitoba found that the blatant use of idealized (i.e., impossibly attractive) models tended to lower people’s

evaluations of that product (Wan et al., 2013). A second issue relates to memory: Although the consumer might remember the

ad, they are less likely to remember the brand that is being advertised (Reichert & Alvaro, 2001). After Paris Hilton’s hamburger ad, Carl’s Jr. experienced a 1.7% increase in sales . .

. but archrival Hardees had a similar increase! However, if sexuality is an integral part of the brand’s identity or if the sexuality in the ad is related to the product’s function (e.g., condoms), then sexual imagery will enhance our memory for that

product (Richmond & Hartman, 1982). This effect is likely due to the sexual imagery being a memory retrieval cue for that product.

Sex has another interesting effect on how we perceive advertisements: It interferes with our ability to think rationally

about persuasive material (Reichert et al., 2001). A recent brain- imaging study compared neural responses to advertisements containing sexual or emotional images with responses to advertisements in which an image of the product was presented alongside factual information about the product. The researchers found that sexual ads generated smaller neural responses in

several areas of the frontal lobes (Cook et al., 2011). These results suggest that sexual images may lead to less analysis of an ad’s contents than a purely fact-based appeal, making us more vulnerable to persuasive material. (This research could certainly make election ads more interesting. . . .)

Can we critically evaluate this evidence? Although the psychology research investigating whether sex sells is interesting, we do have to be cautious in interpreting it because the stimuli used in the research would be used differently in the real world. Most television or radio ads are seen or heard numerous times; in an experiment, they are often presented only once. Additionally, most ads are targeted at specific demographic groups (e.g., females aged 18–25). Therefore, we, as consumers of research, need to be sure that the experimenters paid attention to the same variables as the marketers. Otherwise, their data don’t buy us much.

We also have to remember that not all participants in a study are alike in their sexual views, a fact that was overlooked in many early studies on this topic. Overall, women are less accepting of sexual ads than men, likely due to the fact that most sexual ads

are targeted toward heterosexual males (Monk-Turner et al., 2008). Women with more liberal views toward sexuality respond similarly to men—they are much more likely to accept unnecessary sexual imagery than more conservative women

(Sengupta & Dahl, 2008). Additionally, women are more likely to accept a sexual advertisement if sex is depicted in a way that is respectful, focusing on devotion rather than on primitive biological

urges (Dahl et al., 2009).

Why is this relevant? The results of numerous studies show that sex can sell, in certain situations. But, if psychologists and marketers wish to use sex to sell a product, they have to be extremely careful about when and where these ads are displayed, and how sex is depicted. If they fail to do so, their sexy ad campaign might end up being a bust.

Module 11.2c Quiz:

Human Sexual Behaviour: Cultural Influences

Know . . . 1. The accepted attitudes and behaviours of males and females in a given

society are known as

A. sexual orientation. B. sex guilt. C. gender roles. D. sexual scripts.

Understand . . . 2. Sexual content in advertisements can be effective in all of the following

cases EXCEPT

A. when the viewers are liberal-minded males. B. when the sexual content is related to the purpose or function of

the product being advertised.

C. when paired with a logical argument for buying the product. D. when the viewers are conservative-minded females.

Analyze . . . 3. Future computers will likely include face-recognition software that keeps

the computer screen lit up when you’re looking at it (this technology is already found in some smart phones). This technology may also make it more difficult for users to remain anonymous in social networking sites or chat rooms. Based on what you’ve read in this module, what effect will this have?

A. The loss of anonymity will make people more inhibited because the sexual scripts will become similar to those found in face-to- face encounters.

B. The loss of anonymity will change the gender roles for males and females, making them more similar.

C. Social networking sites will become even more popular and sexualized once everyone can see everyone else.

D. From an evolutionary perspective, the loss of anonymity will influence male sexual behaviour, as it will be possible for them to identify a larger number of potential mates.

Module 11.2 Summary

gender roles

libido

refractory period

sex guilt

sexual orientation

sexual response cycle

sexual scripts

testosterone

Know . . . the key terminology associated with sexual motivation.11.2a

transgender

transsexual

The similarities in sexual response cycles found in men and women can be explained by a common reproductive physiology in both sexes. However, males experience a distinct phase called the refractory period, during which erection or orgasm is not physiologically possible. Both males’ and females’ sexual behaviours are also influenced by gender scripts and sexual roles, factors that are affected by the culture in which the sexual behaviours are taking place.

The research reviewed in the Working the Scientific Literacy Model section of this module suggests that sexual imagery has a small effect on our consumer behaviour. In fact, these types of ads are only effective if the use of sexuality is related to the product and is subtle.

Apply Activity Try to apply this research to the commercials that you are subjected to when you watch television (or to ads that appear on Internet sites, if you don’t watch TV). For each ad, ask yourself:

1. How is sexuality being used (blatantly or subtly)? 2. Is the sexuality related to the product? 3. Who is the target audience? 4. Based on what I’ve read, will this ad be effective increasing sales for this

product?

Try this analysis when watching two different types of programs (e.g., one “reality TV” show and one drama or comedy). Do your results differ? Why or why not?

Understand . . . similarities and differences in sexual responses in men and women.

11.2b

Apply . . . research on sex and advertising to the commercials and Internet ads you see each day.

11.2c

Several lines of evidence point to biological factors contributing to homosexuality. For example, small differences in brain anatomy—particularly in the hypothalamus—have been observed between homosexual and heterosexual males. Also, twin studies indicate that homosexuality has a significant genetic component, particularly in males. However, biological factors cannot perfectly predict sexual orientation. There is clearly an interaction between biological and environmental factors.

Analyze . . . different explanations for what determines sexual orientation.

11.2d

Module 11.3 Social and Achievement Motivation

Inti St Clair/DigitalVision/Getty Images

Learning Objectives

Know . . . the key terminology of social and achievement motivation. Understand . . . how people experience a need to belong. Understand . . . the different forms of love. Apply . . . theories of motivation to understand your personal motivation to achieve in school or your career. Analyze . . . claims that a sense of belonging is something people need

11.3a 11.3b 11.3c 11.3d

11.3e

Michelle sat at the end of the gymnasium, watching the varsity girls’ basketball team warming up for their game. She was younger than most of the women on the team, but still desperately wanted to be a part of it. She loved playing basketball with her friends, a couple of whom made the team, and decided that if she was going to be a part of it next year, she would have to practise every day. She would also have to work on the skills that were currently weaknesses so that she could become a better player.

This story is very familiar—all of us know someone who vowed to work hard in order to make a team or to improve their position in an organization. The over-arching question of this module is, “Why do we try to achieve these goals?” What is motivating Michelle to work hard to be on the high-profile basketball team with her friends? And, what factors will make it more or less likely for Michelle to succeed?

Focus Questions

1. How critical are external rewards in motivating us to achieve? 2. How is achievement motivation influenced by the amount of

control we have over our actions?

Everyone acknowledges that humans need to satisfy needs for food, water, clothing, and shelter in order to survive. Each of these needs is associated with a motivation, some sort of psychological process that will cause us to perform a particular behaviour. The need for food would lead to the behaviour of eating; the need for water would lead to the behaviour of drinking. But, humans have many different types of needs, some of which are less straightforward than the need to eat. These involve social processes, as well as our need for meaning and a purpose in life. In this module, we discuss some of these social and achievement needs, and try to understand the psychological processes that accompany them.

versus something they want.

Belonging and Love Needs

When we think about our different needs, it seems like common sense that some things are more important than others. Eating would obviously be more important than having high self-esteem, for example. In an early attempt to understand the

different motivations that drive human behaviour, Abraham Maslow (1943, 1954) described a “hierarchy of needs,” with needs associated with our basic physiological survival being more important than social or achievement needs

(see Figure 11.10 ). According to Maslow, once survival needs are met, then we can move to higher-level needs such as belonging or the need for self-

esteem. At the highest point of this model lies self-actualization, the point at which a person reaches his or her full potential as a creative, deep-thinking, and accepting human being.

Figure 11.10 Maslow’s Hierarchy of Needs According to Abraham Maslow, human needs are organized as a hierarchy with basic needs at the bottom and personal fulfillment and other uniquely human characteristics at the top.

Although Maslow’s depiction of human needs and motivations seems logical, numerous researchers have criticized this model. First, the idea that we must fulfill one need before moving on to the next (in a way that is similar to levels of a video game) is simplistic (Wahba & Bridwell, 1974). You know from your own life that it is possible to have multiple motivations simultaneously—you can be striving to self-actualize while also experiencing the need to achieve at school. A second criticism was that the hierarchy appeared to be biased toward an

individualistic (Western) culture (Hofstede, 1984). Self-actualization, the peak state of Maslow’s model, consists of a number of characteristics that put the individual’s needs or goals first, sometimes at the expense of humanity as a whole. In collectivistic (primarily Eastern) cultures, such needs would be much less important than acting to ensure that everyone was getting along and that the community, not just the individual, was successful.

However, although the hierarchy element of Maslow’s model may be inaccurate, his work has highlighted the fact that human motivation extends to a number of different areas rather than being simply a matter of eating, sleeping, and reproducing. Later researchers have noted that we have a number of needs that can, at times, feel as pressing as a grumbling stomach. For example, research

suggests that humans have a fundamental need to belong (Baumeister & Leary, 1995), which motivates us to affiliate with other people and to seek meaningful, long-term bonds.

Belonging is a Need, Not a Want

The need to belong (sometimes known as affiliation motivation) is the motivation to maintain relationships that involve pleasant feelings such as warmth, affection, appreciation, and mutual concern for each person’s well-

being. In addition, an individual must have the sense that these feelings are part of a permanent relationship, such as a friendship, kinship, or shared group

membership (Baumeister & Leary, 1995). A strong sense of belonging brings more than warmth and happiness; it appears to be fundamental in the same way that food and shelter are needs—these are all things that humans cannot survive without.

Although we all probably want to have pleasant interactions, it is the second part of the definition—a sense of permanence—that is most important for our well- being. Specifically, an individual who has many positive social interactions with a series of different individuals does not enjoy the same satisfaction and other benefits as an individual who interacts with only a few people, but regularly and for a long period of time. For example, an executive who flies all over the continent may have fascinating conversations with fellow passengers every week, yet feel extremely lonely. Meanwhile, imagine a couple living on a rural farm who see only a few neighbours during the week, but see the same people frequently and know them very well. The permanence of their family and community is significant, and they will probably be much more satisfied with their sense of belonging over the long run than will the high-flying executive. Indeed, a substantial number of studies have shown that lonely people like the executive are more likely to feel depressed than are socially connected individuals like the

rural farmers (Cacioppo et al., 2006); this leads to significantly lower ratings of happiness and life satisfaction (Cacioppo et al., 2011).

In addition to its effects on mental health, psychologists have found that social connectedness has a dramatic effect on physical health. Research has demonstrated that loneliness is a risk factor for illnesses such as heart disease

and cancer (Cacioppo et al., 2003). It also elevates a person’s risk for having hypertension, a weaker immune system, and high levels of stress hormones. This relationship holds true even when lonely and non-lonely individuals have the

same amount of social interaction—it is the sense of belonging that counts (Hawkley et al., 2003). Even very simple indicators such as living alone or an individual’s rating of the statement “I feel lonely” predict chances of survival after

heart attacks and bypass surgeries (Herlitz et al., 1998; Rozanski et al., 1999). Given that belonging is important for health and happiness, it makes sense that

so much of one’s life is focused on friends, family, and romantic partners.

Love

In some cases, the feeling of belonging that accompanies your friendship and family bonds becomes a form of love. You’d be willing to make great sacrifices for these lucky people and you know they would do the same for you. You trust them, look forward to spending time with them, and genuinely cheer for them as they go through life. Of course, this isn’t the only type of love that we experience. As you stumble through your teenage years and enter early adulthood, many of you will desire and experience romantic relationships. Some of these will produce an intense feeling that we think of as romantic love.

What is romantic love? This is a question that has permeated our culture for thousands of years. Armies of anemic English poets have worked furiously, desperately trying to find the perfect words to describe this wonderful feeling. For most of our history, love has not been seriously discussed in scientific circles. However, this has changed in the last 40 years. In 1974, Berscheid and Walter proposed the first scientific model of love, one that is still widely accepted today

(Fehr, 2003). These psychologists suggested that love is composed of two main components: passionate love and companionate love. Passionate love is associated with a physical and emotional longing for the other person. We feel passionate love at the beginning of a relationship, when we are just getting to know the other person and everything is new. Recent brain-imaging research has shown that feelings of passionate love are associated with activity in areas of the brain related to physical rewards as well as the insula, a region that is sensitive to internal bodily feelings such as having “butterflies in the stomach”

(Bartels & Zeki, 2004; Beauregard et al., 2009).

Companionate love , on the other hand, is related to tenderness, and to the affection we feel when our lives are intertwined with another person (Hatfield & Rapson, 1993). Although passionate love is certainly more exciting, companionate love appears to have a greater influence on the long-term stability of a relationship. Undergraduate research participants viewed increases in companionate features of love to be more indicative of a loving relationship than

passionate features of love. Decreases in companionate love suggested that the

relationship was in trouble (Fehr, 1988), and may suggest that the people do not feel as committed to each other as they once did.

Love, therefore, seems to be a very pleasant state. But, what motivates people to seek it out? Arthur Aron and his colleagues (2005) have suggested that “love is a mammalian drive to pursue preferred mates” (p. 327). In other words, love may be a goal-oriented state in a way that is similar (but obviously not identical) to hunger and sex drives. To test this hypothesis, these researchers performed fMRI scans on 17 people who were in love. While in the scanner, these participants viewed images of their special someone, as well as photographs of a familiar person. The brain responses to images of the loved one were stronger in dopamine-rich areas that are part of the reward system. Even better, activity in some parts of this system correlated with the participants’ responses on a

passionate love questionnaire (see Figure 11.11 ). Activity in other parts of the reward system correlated with the intensity of their reported love and with ratings of facial attractiveness. Importantly, many of these brain areas contain receptors

for oxytocin, a hormone related to feelings of trust and the desire to be close to someone (Aron et al., 2005).

Figure 11.11 Love as a Motivational System (Left) Neuroimaging data show that viewing images of your beloved (as opposed to another familiar person) activates the caudate nucleus (the green structures in

the brain images), an area in the brain related to experiencing rewards. (Right) People who felt greater levels of passionate love showed larger reward

responses. Source: Adapted from Aron, A., Fisher, H., Mashek, D. J., Strong, G., Li, H., & Brown, L. L., “Reward, motivation, and

emotion systems associated with early–stage intense romantic love,” Journal of Neurophysiology, 94, 327–337 (Fig 3).

It’s important to note that this motivational view of love is still consistent with the passionate–companionate theory of love. In fact, it adds a mechanism that can explain why we seek out passionate love in the first place: a reward state similar to many other types of motivations.

Belonging, Self-Esteem, and Our Worldview

Belonging to a group provides us with a number of benefits ranging from physical security (the safety of a group) to the possibility of love (and, in some cases, mating). Belonging also provides an individual with a culture, a group of people who share her view of the world. Feeling as though you are part of a larger, connected group has a number of benefits ranging from improved health (see Module 14.1 ) to a greater ability to cope with stress (see Module 14.3 ). It also helps us deal with more philosophical fears, such as our fear of dying.

Working the Scientific Literacy Model Terror Management Theory and the Need to Belong

As far as scientists can tell, humankind is the only species on earth that is aware of its own mortality. This realization creates some uniquely human problems. How do we cope with the knowledge that we will one day die? And, if we all must die, what makes us think we are more important than other forms of life? For most of us, some combination of our personal identities, family and friends, religious beliefs, and connection with our community distinguish us from other animals. So in some ways, our need to belong may be linked with our fear of dying.

Observations such as this led to the development of terror

management theory (TMT) , a psychological perspective asserting that the human fear of mortality motivates behaviour, particularly those that preserve self-esteem and our sense of belonging.

What do we know about terror management theory? The knowledge of death has the potential to be terrifying; however, very few of us experience this anxiety on a daily basis.

Instead, we tend to use anxiety buffers—concepts and beliefs that prevent death-related anxiety from entering our conscious

mind (Becker, 1971, 1973; Solomon et al., 1991). One anxiety buffer is known as the cultural worldview, a belief system about how our world should work. This system provides us with a sense of order and stability in life, feelings that makes it seem as though death were not an immediate possibility. Cultural worldviews can also consist of religious beliefs that influence how we think about the world around us and that provide us with a belief in an afterlife. For people who are not religious, the worldview still provides comfort—the culture that we are a part of will continue

even after we are gone (Hayes et al., 2010). An added benefit of a cultural worldview is that it gives people a set of standards that they can live up to. Doing so helps us feel significant and valued,

feelings that make up the anxiety buffer that is self-esteem. According to TMT, our cultural worldview and self-esteem protect us from the fear of our own mortality. Not surprisingly, most of us are quite protective of them.

How can scientists study terror management theory and the need to belong? Psychologists typically study TMT by manipulating how aware

participants are of death, something they refer to as mortality salience. For example, participants might be asked to write a paragraph or two about what happens to our bodies when we die; a control group would write about something that is unpleasant but that does not make mortality more salient (e.g., the discomfort

of a root canal). After a brief delay, participants are then presented with stimuli such as a short essay that either criticizes (experimental group) or does not criticize (control group) the participant’s cultural worldview; examples might include written passages that were critical of the person’s country or university. In most studies, simply writing about death is enough to motivate people to defend their worldview more strongly than participants in the control group, even though individuals were randomly assigned to different conditions.

Importantly, psychologists have also identified ways to reduce the impact of mortality salience. For example, when psychologists followed the mortality-salient stimuli with an exercise in which participants generated positive thoughts about their parents, the

effects of mortality salience disappeared (Cox et al., 2008). This and similar experimental procedures suggest that belonging to something more permanent—a family or a community—really does help manage death-related anxiety.

Can we critically evaluate this evidence? When TMT research began three decades ago, many critics questioned whether it was really thoughts of death that created these experimental effects, or whether the effects simply represented a reaction to the unpleasantness of the study materials. Terror management theorists quickly pointed out that the same effects did not arise among members of control groups who were exposed to unpleasant stimuli ranging from dental pain

to the anxiety of public speaking (Greenberg et al., 2008). Indeed, a recent review of 277 experiments confirmed that responses to mortality salience can be reliably produced in the

laboratory (Burke et al., 2010).

Additional support for TMT was provided by Jeff Schimel and his colleagues at the University of Alberta. Rather than showing that worldview protects us from thoughts of mortality, these

researchers examined whether death-related thoughts would

increase if our worldview was somehow compromised (Schimel et al., 2007). In their study, participants read a brief essay criticizing either the Canadian healthcare system or the government of another country. Participants who read the essay that played down the benefits of Canada’s healthcare (i.e., an attack on our worldview) were more likely than the control group to complete word fragments with death-related words (e.g., completing COFF- - to make COFFIN rather than COFFEE). These results provide additional evidence that our worldview and our awareness of death and mortality are linked.

Why is this relevant? TMT has a strong link to politics. Numerous researchers have noted that mortality salience makes people more extreme in their

beliefs (Burke et al., 2013), often leading them to become more politically conservative in their statements and attitudes (Jost et al., 2003). This is likely because conservative ideologies and political parties provide unambiguous solutions for death-related problems (e.g., a War on Terror) whereas liberal ideologies and political parties are more likely to promote change, which is by its

very definition uncertain. An example of this conservative shift came in the 2004 American election. TMT researchers found that when potential voters were exposed to mortality salient information, they became more likely to support Republican (conservative) President George “Dubya” Bush rather than

Democratic (somewhat liberal) candidate John Kerry (Cohen et al., 2005; Landau et al., 2004). The anti-Muslim and anti- immigrant statements from multiple Republican presidential candidates in 2016 suggest that this effect did not go unnoticed.

Mortality salience is also used in Canadian elections. Conservative politicians tend to discuss the need for tougher sentences for criminals (mortality salience) more than other parties. And, quite recently, then–Prime Minister Stephen Harper

suggested during the 2015 election campaign that Muslims taking the Canadian citizenship oath shouldn’t be allowed to wear head coverings; his government was also providing frequent reminders that Canada could suffer a terrorist attack (mortality salience). It is important to note that we are not telling you who to vote for! But, it is also important that you vote for a party based on its ideas, not because of your fear of death and your need to belong.

Psychologists have found that people respond to mortality salience by becoming more protective of their cultural worldview. Politicians sometimes use this tendency to try to influence voting behaviour. Thankfully, the public is becoming more aware of this form of manipulation. Seyit Aydogan/Anadolu Agency/Getty Images

Module 11.3a Quiz:

Belonging and Love Needs

Know . . . 1. Affiliation motivation is

A. the drive to have as many friends as possible. B. the desire to be around other people as often as possible. C. the need to have at least a few permanent, meaningful

relationships.

D. the desire to be isolated from others.

2. Which of the following factors increases an individual’s risk for illness, heart disease, and even cancer?

A. Self-actualization B. Loneliness C. Happiness D. Low self-esteem

Understand . . . 3. How is terror management theory related to our need to belong?

A. Mortality salient thoughts help us prepare for death, thus leading to less anxiety.

B. The fear of death is an anxiety buffer that helps us form groups. C. The fear of death makes us more protective of our cultural

worldview, including our family, community, and country.

D. Terror management theory is not related to the need to belong, but is instead related to earlier stages of the hierarchy of needs.

Analyze . . . 4. What point did Maslow intend to communicate when he placed belonging

in the middle of his hierarchy of needs?

A. Individuals generally must take care of physiological needs first, but must satisfy belonging needs before developing healthy self- esteem.

B. Belonging is not an essential human need. C. Individuals generally must first have a healthy self-esteem before

one can satisfy the need to belong.

D. Belonging is more important than physiological needs.

Achievement Motivation

At the beginning of this module, you read about Michelle, a student who desperately wanted to be on the varsity basketball team. Part of that desire was likely related to the need to belong, to be part of a team with her friends. But, that can’t explain why she vowed to practise every day so that she would make the team next year. It would be much easier to join a team in a lower-level basketball league, or to have her friends put together a team in a different sport. But, these solutions weren’t part of Michelle’s story. Instead, she wanted to improve her basketball skills so that she could be part of the competitive and prestigious league. In other words, she wanted to achieve a specific goal.

Achievement motivation is a very strong force in human behaviour, and refers to the drive to perform at high levels and to accomplish significant goals. But, this motivation isn’t as simple as it sounds. There are a number of reasons

why Michelle could be motivated to achieve. For example, Michelle might want to make the team in order to receive more respect and attention from her fellow students; she might also really enjoy the game and could have a desire to play it as much as possible. In both cases, Michelle would be attempting to achieve an approach goal , an enjoyable and pleasant incentive that a person is drawn toward, such as praise, financial reward, or a feeling of satisfaction. But, what if Michelle were motivated to make the team in order to avoid the embarrassment of being “cut” from the team this year? That’s a very different mindset than an

approach goal. Instead, her behaviour would be motivated by an avoidance goal , an attempt to avoid an unpleasant outcome such as shame, embarrassment, losing money, or feeling emotional pain.

If achievement motivation were this simple, we could explain most of our behaviour in terms of seeking a reward and/or avoiding suffering. Although both are elements of our behaviour, our motivation to achieve is also influenced by

numerous other factors. In the rest of this module, we will discuss how these different factors can influence our motivation to achieve our goals.

Self-Determination Theory

When we think about achieving our goals, we can’t help but think about making up to-do lists or pro-and-con lists that will help us organize our lives. But, while these techniques provide us with a practical way of examining the choices we face, they don’t really tap into the deeper motivation for why we are, or are not, performing a behaviour. Recent psychological research has attempted to fill this void by examining what researchers refer to as universal needs—needs that (almost) all humans experience. Researchers have identified three universal

needs (Deci & Vansteenkiste, 2004):

Relatedness: Feeling connected with others, a need satisfied by forming meaningful bonds with other people such as family members, teammates, or colleagues at school and work

Autonomy: The need to feel in control of your own life Competence: The ability to perform a task at a skill level that is satisfying to the individual

But, our motivation isn’t necessarily influenced by how competent we are. Instead, it is influenced by how competent we think we are. If a very skilled basketball player didn’t think she was good enough, she wouldn’t practise as hard as she would if she believed in her abilities. (In contrast, watch some of the

awful singers making the judges’ ears bleed on American Idol-type shows; they believe they are good, so they continue to sing . . . sometimes even while security drags them away.) The effect that your perception of your own ability

has on motivation is known as self-efficacy , an individual’s confidence that he or she can plan and execute a course of action in order to solve a problem (Bandura, 1997). When people experience high levels of self-efficacy, their performance improves and they are motivated to choose more challenging tasks

to perform (Eccles & Wigfield, 2002). So, if you believe that you can competently do something, you will be more motivated to attempt to do so.

During the mountain stages of competitive cycling races such as the Tour de France, many riders will suddenly lose speed and fall behind the other riders trying to climb the steep mountain roads. This occurs even when the rider is in amazing physical condition. Television commentators say that the cyclist has “popped.” Psychologists would say that the rider lost his feeling of self-efficacy. Rupert Rivett/Alamy Stock Photo

A theme running through all three of our universal human needs—relatedness, autonomy, and competence—is the need to feel in control of your life and your decisions. We want to be able to choose who we associate with and the form those relationships are going to take (relatedness), control the decisions that affect our lives (autonomy), and be in control of the actions necessary to carry

out those decisions (competence). These themes are part of self-determination theory , a theory that states that an individual’s ability to achieve their goals and attain psychological well-being is influenced by the degree to which he or she is in control of the behaviours necessary to achieve those goals (Ryan & Deci, 2000). So, if we are able to achieve this control, or at least feel like we have control, then we will be more motivated to perform the actions necessary to achieve that goal. We will also be happier. Self-determination theory has been used to explain a number of behaviours ranging from the likelihood of

successfully learning a second language (Noels et al., 2000), the motivation to exercise (P. M. Wilson et al., 2008), the establishment of healthy identities (La

Guardia, 2009), and the ability to adapt to life as an international student studying in Canada (Chirkov et al., 2007, 2008). In each case, increasing feelings of competence, autonomy, and relatedness increased motivation.

But, at this point in our discussion, our explanation for why we are motivated to achieve goals only explains very general, deep-seated needs. To more thoroughly explain our behaviours, we need to look more closely at specific factors that could influence motivation.

Extrinsic and Intrinsic Motivation

One way to examine the question of “Why do we try to achieve a goal?” is to determine whether our motivation is externally or internally generated. If you wanted to be on a basketball team in order to be popular, you would be

experi ­encing extrinsic motivation (or a performance motive ), motivation geared toward gaining rewards or public recognition, or avoiding embarrassment (Deci, 1971; Vansteenkiste et al., 2006). This form of motivation is not always the most effective, as it requires a person to give up some autonomy. If you play basketball to seem cool, then you must rely on other people’s reactions to determine if you succeeded in your goal (i.e., other people control if you are viewed as “cool”). Taken to its most extreme, people can

become amotivational , a feeling of having little or no motivation to perform a behaviour. If your parents forced you to play basketball against your will, you might stop putting forth any effort. In this case, neither the feelings of autonomy nor competence would be met.

Luckily, not all of our motivation is controlled by outside forces; sometimes we do things simply because we enjoy doing them. For example, what if you wanted to become a better basketball player simply for the joy of playing and improving yourself? In this case, the motivation to improve came from within yourself rather

than from some external source. This would be an example of intrinsic motivation (or mastery motive ), the process of being internally motivated to perform behaviours and overcome challenges (e.g., a genuine desire to master a task rather than being motivated by a reward).

A study of Grade 5 students showed the profound effect that intrinsic and extrinsic motivation can have on how we respond to challenges and to failures. Children were given sets of puzzle problems and were asked to complete them independently. After successfully solving the first set of puzzles, some of the students were praised for their intelligence (e.g., “You must be smart to do these problems”) while others were praised for their work ethic (e.g., “You must have worked hard at these problems”). The psychologists then gave the children another, more difficult, set of problems to complete. This time, the researchers told the children that they had scored lower on these questions. Finally, the children were asked to select the goals that they tended to work toward. This list included performance/extrinsic goals such as choosing easy questions to avoid getting many wrong, as well as mastery/intrinsic goals such as selecting problems that one could learn from.

The results of the experiment were remarkable. The children praised for being smart tended to feel less pleasure during learning and instead tended to worry about how well they were doing. They gave up more easily and performed more poorly. Just under 70% of these students selected performance/extrinsic goals when given a list of options. In contrast, only 10% of the students who were praised for their effort chose performance/extrinsic goals when asked what motivated them. Instead, they focused on working hard, overcoming challenges, and learning from their mistakes. Even more stunning was the fact that the students praised for being smart were three times more likely to lie about their results to other people. Almost 40% of the “smart” students lied about their results, compared with only 13% of the “effort” students. In summary, the students praised for intelligence felt incredible pressure to live up to that label and went to great extents to preserve that image, including selecting easier questions and lying about their results. Based on this study, what parenting techniques do you think would help kids become well-adjusted?

A Continuum of Motivation

It is important to note that intrinsic and extrinsic motivation are not completely separate. Rather, intrinsic motivation, extrinsic motivation, and amotivation can be placed on a continuum that depicts how much self-determination an individual

might feel for those behaviours (see Figure 11.12 ). Critically, where a given behaviour lies on this continuum can change over time or across situations. For instance, if you give someone a reward (other than verbal praise) for an intrinsically motivated behaviour, the intrinsic motivation decreases, as does the

frequency of the behaviour. This change in motivation is known as the over- justification effect (Lepper et al., 1973). This decrease in motivation is likely due to the change from being internally motivated (high autonomy) to being dependent upon a reward (low autonomy). So, if you loved basketball, but then started receiving money from your parents for each basket, you would actually feel less motivated to play than you did before! This effect has profound implications for parenting, education, and the business world. For example, if a good student were given rewards for getting good grades, it might reduce how much she identified herself with learning. Businesspeople who work in the hopes of getting a bonus monetary reward will be less likely to identify with the projects or products they are working on. In both cases, the rewards have moved their motivation along the continuum from intrinsic toward extrinsic. This isn’t to say that rewards should never be given; sometimes this is the only option to motivate someone. However, as we learn more about the over-justification effect, it is becoming increasingly clear that we need to more carefully consider the effects of rewards on behaviours that were already intrinsically motivated.

Figure 11.12 The Continuum of Self-Determination Theory On this continuum, amotivation would reflect very low levels of self- determination. Intrinsic motivation, on the other hand, would reflect a high degree of self-determination. Source: Copyright 2000 From The “What” and “Why” of Goal Pursuits: Human Needs and the Self-Determination of Behavior.

Psychological Inquiry, 11, 227–268 by Edward L. Deci and Richard M. Ryan. Reproduced by permission of Taylor & Francis

LLC, (http://www.tandfonline.com).

A different, but potentially more powerful, change along the continuum can occur for behaviours that were initially extrinsically (externally) motivated. Generally, these behaviours are not associated with much passion, as some outside motivation (e.g., money or another person) is stimulating this behaviour. But,

over time, it is possible that some of these behaviours will become internalized so that they are part of a person’s identity. A basketball player might begin working out because it will increase the odds that she will be recruited to play for a team and will become popular. Over time, however, she might become enthusiastic about exercising for its own sake, and could make that part of her identity long after her basketball career ended. By making exercising part of her

identity, the basketball player gains autonomy over this behaviour, because she is the one motivating it, not some external source like a coach. Internalized behaviours are more likely to be performed—and performed well—than extrinsically motivated behaviours that are not internalized.

Of course, there is one important limitation to our discussion of intrinsic and extrinsic motivation: most of the studies used data from university students in Western countries. Recently, psychologists have begun examine whether motivational processes differ across cultures.

Cultural Differences in Motivation

The fact that there are cultural differences in motivation should surprise no one. Western culture tends to promote autonomy and the individual, whereas Eastern cultures put more emphasis on meeting the needs of the community. In other words, the actions of North Americans are often controlled by the individual, whereas the actions of people in Eastern cultures (e.g., East Asians) are often

jointly controlled by the individual and her family and community (Markus & Kitayama, 2003). As a result, while intrinsically motivated behaviours should lead to positive performance and emotions across cultures, the responses to extrinsically motivated behaviours might differ. Specifically, people in individualistic cultures like Canada and the U.S. will be less motivated to perform these behaviours than people from “collectivistic” Eastern culture; this latter group will view extrinsically motivated actions as being performed to help their

family or community. In fact, if these individuals feel like they are making the decision to act collectively, they will experience an improvement in subjective well-being similar to that found when they engage in intrinsically motivated

behaviour (Chirkov et al., 2003).

Cultural differences have also been observed in the motivation to improve one’s self. Researchers at the University of British Columbia, in collaboration with colleagues in Kyoto, Japan, examined how Canadian (of European ancestry)

and Japanese students responded to failure (Heine et al., 2001). Participants were asked to complete a Remote Associates Task in which they were to identify

a word that linked together three other words (e.g., dust, struck, and ship could be linked by the word star). The participants were told that this test measured emotional intelligence and creativity. The researchers found that Japanese participants were more motivated to work on the task after failing than after performing well; European-Canadian participants showed the opposite pattern. Follow-up studies found that these differences were likely due (in part) to cultural differences in the importance of effort in success. Failure decreased motivation to work in Canadian students but increased motivation in Japanese students

(Heine et al., 2001).

Culture may play a slightly more complicated role for some Canadians, however. Many people in our country are first- or second-generation immigrants from another culture; they can therefore identify with their family’s ancestral culture (e.g., China) or with their current culture (Canada, a “Western” society). How are

these bicultural individuals influenced by intrinsic and extrinsic motivation? It turns out that the answer depends upon which culture the individual identifies with at any given moment. Using a diary study in which participants were prompted to submit electronic entries at different points in the day for ten days, Elaine Perunovic and her colleagues found that when bicultural Asian Canadians identified with Western culture, extrinsic motivation was linked with negative

emotions, likely due to a loss of a feeling of autonomy (see Figure 11.13 ). In contrast, when these participants identified with their Asian culture, their levels of negative emotions were unaffected by extrinsic motivation. There were no

cultural differences in intrinsic motivation (Perunovic et al., 2011).

Figure 11.13 Cultural Differences in Extrinsic Motivation Extrinsic motivation was linked with negative emotions when Asian Canadians identified with their Western culture. It did not affect negative emotions when participants identified with their Asian heritage. Intrinsic motivation showed no cultural differences. Source: Perunovic, W.Q.E, Heller, D., Ross, M., & Komar, S. (2010). The within-person dynamics of intrinsic and extrinsic

motivation, affective states, and cultural identification: A diary study of bicultural individuals. Social Psychological and

Personality Science, 2(6), 635-641. Figure 1, p. 639.

Taken together, these results show that motivation can be influenced by culture. It also shows the power of the need to belong—the Eastern focus on the community rather than the individual made extrinsically motivated behaviour seem less like a burden and more like a group decision.

Module 11.3b Quiz:

Achievement Motivation

Know . . . 1. If a student is a pre-med major because he is curious about how the body

works and how it recovers from disease, psychologists would say that he

has motives. If the student is studying pre-med only because he thinks this major will impress people, then psychologists would say

that he has motives. A. mastery; performance B. performance; mastery C. performance; avoidance D. avoidance; mastery

2. An individual’s belief that he or she will be able to complete a task is known as

A. implicit motivation. B. self-efficacy. C. approach motivation. D. avoidance motivation.

Apply . . . 3. A recent immigrant from Korea is working on a group project with two

Canadian colleagues whose families immigrated to Canada several generations ago. The assignment is quite boring and was assigned by the regional manager of the company they work for. Based on what you’ve read in this module, how will the Korean-Canadian differ from the “single culture” Canadians?

A. Both groups will experience a large increase in negative emotions.

B. The Korean-Canadian’s negative emotions will not be affected when he is thinking about his new Western culture.

C. The Korean-Canadian’s negative emotions will not be affected when he is thinking about his Korean culture.

D. The Korean-Canadian will show a larger emotional response to the situation than his colleagues.

Module 11.3 Summary

achievement motivation

amotivation

approach goal

avoidance goal

companionate love

extrinsic motivation

intrinsic motivation

mastery motive

need to belong (affiliation motivation)

passionate love

performance motive

self-determination theory

self-efficacy

terror management theory (TMT)

Psychologists have discovered a number of ways in which people are motivated to enter into personal relationships. People seek out friendships, romantic relationships, and group membership to satisfy this need.

Passionate love involves a physical and emotional longing for the other person. It typically occurs at the beginning of a relationship. Companionate love involves the tenderness and affection felt when one’s life is intertwined with another

Know . . . the key terminology of social and achievement motivation.11.3a

Understand . . . how people experience a need to belong.11.3b

Understand . . . the different forms of love.11.3c

person’s. Companionate love has a greater influence on the long-term stability of relationships.

How would you describe your motivation for school? Are you just trying to earn good grades, or do you find yourself motivated because you are interested in learning?

Apply Activity Complete the four brief questionnaires included in Table 11.3 to see how your motives stack up relative to other students.

Table 11.3 Application Activity Thinking about your Psychology course, respond to each statement by assigning a score on a scale of 1 (“Not at all true of me”) to 7 (“Very true of me”). Then find your average response for each set of three questions. Compare your scores to the averages for each score. Source: Based on Elliot, AJ & McGregor, HA (2001). A 2 × 2 achievement goal framework. Journal of Personality and Social

Psychology, 80,501-519. URL: https://selfdeterminationtheory.org/SDT/documents/2001_ElliotMcGregor.pdf.

Mastery Performance

APPROACH 1. I want to learn as much as possible

from this class.

1. It is important for me to do

better than other students.

2. It is important for me to understand

the content of this course as

thoroughly as possible.

2. It is important for me to do

well compared to others in

this class.

3. I desire to completely master the

material presented in this class.

3. My goal in this class is to

get a better grade than most

of the other students.

Average score: 5.52 Average score: 4.82

Apply . . . theories of motivation to understand your personal motivation to achieve in school or your career.

11.3d

AVOIDANCE 1. I worry that I may not learn all that I

possibly could in this class.

1. I just want to avoid doing

poorly in this class.

2. Sometimes I'm afraid that I may

not understand the content of this

class as thoroughly as possible.

2. My goal in this class is to

avoid performing poorly.

3. I am often concerned that I may

not learn all that there is to learn in

this class.

3. My fear of performing

poorly in this class is often

what motivates me.

Average score: 3.89 Average score: 4.49

Although belonging may not be the most basic type of need on the hierarchy of needs—those positions are usually assigned to food, water, and shelter—it is a significant need nonetheless. Research has shown that living without a feeling of belonging has some drastic consequences. Not only is loneliness related to depression, but it is also associated with a reduced lifespan. The fact that belonging is essential to good health and longevity provides strong support for classifying it as a need, not just something people want.

Analyze . . . claims that a sense of belonging is something people need versus something they want.

11.3e

Module 11.4 Emotion

Matteo photos/Shutterstock

Learning Objectives

Imagine the following scenario: You are sitting in your bedroom watching

Know . . . the key terminology associated with emotion. Understand . . . how the nervous system responds to emotions. Understand . . . cultural similarities and differences in emotional expressions. Apply . . . your knowledge of theories of emotion to new examples. Analyze . . . what purpose(s) do facial expressions serve?

11.4a 11.4b 11.4c

11.4d 11.4e

television. Suddenly, you notice something moving beside one of your textbooks. Your heart rate increases slightly and your palms begin to sweat as you move closer to the moving object.

At this point—before we know how this story resolves itself—it is important to examine some details about your emotional response. First, the “you” in this story was very quick to locate and pay attention to a potentially threatening stimulus; nothing else in your environment seemed to matter for that instant. The moving object could have been a leaf or clump of dust that was being moved by the air conditioning in your house. Or, it could have been a spider or, worse yet, a spider with a knife in its mouth and death in its heart. What is important to note is that before you were even able to consciously identify what the object was, your body was preparing itself to act. You were afraid, and your body responded with an increase in heart rate, sweating, and muscle tension. Once you determine whether the moving object is dangerous or not, you can either increase or decrease your emotional reaction. If it is just a “dust bunny,” you don’t need to feel fear. However, if it is a well-armed spider, then your initial emotional response may be appropriate.

This example illustrates the key parts of an emotional experience: We detect an emotional item, we have an initial emotional reaction preparing us to respond, and then, after we analyze the situation, we increase or decrease that response. In this module, we will take a closer look at these different parts of our emotional responses in an effort to better understand the emotions that we experience every day.

Focus Questions

1. What role does the brain play in our emotional experiences? 2. How do the labels we give our emotions, such as fear, happiness,

and sadness, relate to their corresponding physical sensations?

Like most concepts in psychology, the term emotion can mean a number of different things. Common convention in psychology is to define an emotion

as being a behaviour with the following three components: (a) a subjective thought and/or experience with (b) accompanying patterns of neural activity and physical arousal and (c) an observable behavioural expression (e.g., an emotional facial expression or changes in muscle tension). Although this definition still includes thoughts and feelings, it also shows that our current understanding of emotion encompasses other elements as well. In particular, it shows us that the emotions we experience include a biological response.

Children who are born both deaf and blind show the same facial expressions and emotions as people who see and hear. This is one of many pieces of evidence that our emotions have a strong biological basis. Darren Greenwood/Design Pics Inc / Alamy Stock Photo

Physiology of Emotion

In the example at the beginning of this module, we noted that emotional behaviours are actually quite complex and involve a number of different components. Although we often think of emotional responses occurring in a number of separate stages, recent research suggests that this view might be a

bit too simple (Pessoa & Adolphs, 2010). Instead, our neural responses to emotions are best thought of as a series of networks or loops. Each network involves a group of neural structures that work together to produce different parts of your emotional response (e.g., increased heart rate); however, these networks can also provide feedback to each other. These interactions allow you to modify your emotional responses as you learn more about your situation. In this section, we will discuss the different areas of the nervous system that are involved in emotions and will show how different areas work together to produce the emotional behaviours that have allowed our species to survive in a dangerous world.

The Initial Response

The human brain shows emotion-dependent responses within approximately 150

ms of seeing or hearing a potential threat (Pizzagalli et al., 2002). The goal of this early activity isn’t to consciously identify an emotional stimulus. Instead, the purpose of this initial brain activity is to tag or highlight that stimulus so that it receives extra processing by brain structures at later stages of perception. For

an example of this phenomenon, look at Figure 11.14 . There are many different objects in this scene, yet you likely paid more attention to the snake than to anything else. Why does this happen? How does your brain make some stimuli more important than others, and what consequences follow from that?

Figure 11.14 How Emotional Elements of a Scene Attract Our Attention Most of us are very quick to notice threatening stimuli such as snakes and spiders (left panel). This ability is due, in part, to interactions between the amygdala and our sensory cortices. Sensory cortices (e.g., the visual cortex)

send signals to the amygdala that influence its activity. Feedback from the amygdala causes an increase in activity in sensory regions such as the visual cortex (right panel), leading to more attention being paid to the parts of our visual world that contain the threatening stimulus. These areas continue to influence each other through these pathways. Source: Republished with permission of Elsevier Science, Inc., from How brains beware: neural mechanisms of emotional

attention. TRENDS in Cognitive Sciences by Vuilleumier, P. Vol. 9 (12), 585-594. Figure 1a, p. 588. Permission conveyed

through Copyright Clearance Center, Inc.

Roy Toft/ National Geographic/Getty Images

A critical brain area involved in this process is the amygdala , a group of nuclei in the medial portion (near the middle) of the temporal lobes in each hemisphere of the brain. The amygdala receives sensory input from the cortex, the outer part of your brain, approximately 200 ms after an emotional stimulus

appears (Krolak-Salmon et al., 2004). The amygdala fires when we perceive stimuli that are emotionally arousing, and is especially sensitive to fear-relevant images and sounds. However, the firing of the amygdala on its own does very little—it is the amygdala’s projections to other brain structures that lead to the observable behaviours that we think of as being emotional responses. When the amygdala receives input about a stimulus that might be emotionally meaningful or threatening, it sends feedback to sensory areas so that they fire more than they would for a non-emotional stimulus. So, when you see a spider or hear a dog growling, your amygdala will help to increase the activity in your visual and auditory cortices, respectively. The result is that we end up paying more attention to these potentially emotional stimuli. Sensory cortices and the amygdala continue to influence each other through these “feedback loops” throughout the

emotional experience (Vuilleumier, 2005).

The Autonomic Response: Fight or Flight?

An emotional response obviously involves more than simply perceiving a threat —we need to prepare our body to physically respond to the emotional stimulus, if necessary. Importantly, this preparation needs to occur instinctively and as

rapidly as possible. The autonomic nervous system (ANS) specializes in such responses. As you read in Module 3.3 , the ANS consists of two systems: (1) the sympathetic nervous system, which helps recruit energy to prepare you for a response (e.g., to fight or flee from a potential threat), and (2) the

parasympathetic nervous system, which helps preserve energy and calms you down if no response is necessary (Figure 11.15 ). Think back to the example at the beginning of this module. If the moving object were a large and angry spider, the sympathetic nervous system would mobilize resources so that you had enough energy either to do battle with this threatening creature or to run away from it. If you discovered that you weren’t in immediate danger (e.g., a moving object is a leaf, not a spider), the parasympathetic nervous system would become active in an attempt to return you to a normal level of emotional arousal.

Figure 11.15 The Autonomic Nervous System and Emotional Responding The ANS is involved in emotional responding. The sympathetic division prepares the body to respond to stress, and the parasympathetic division restores the body to normal conditions.

The Emotional Response: Movement

If your body is going to mobilize its energy resources during an emotional response, it also needs to plan for what it is going to do with them. In other words, the nervous system needs to prepare your body to make a movement in response to the emotion you are experiencing (e.g., squishing the spider). The problem for us is that even the simplest of movements requires the coordination of a number of different parts of your nervous system so that the muscles move in the appropriate order. Research in the last couple of years has found that

emotional stimuli—particularly threatening emotional stimuli—trigger an increase in activity in brain areas related to planning movements (Pereira et al., 2010) and in several regions of the spinal cord (Smith & Kornelsen, 2011). This activity suggests that our nervous system is becoming prepared to make a movement if one is necessary—this preparation likely increases the speed and efficiency of our emotional responses.

Emotional Regulation

As we saw in the example at the beginning of this module, it makes sense from a

survival standpoint to have rapid emotional responses and then to decide if the responses are correct or not. However, this evaluative stage of emotional responses is the most complex and involves a number of areas within our frontal lobes. The frontal lobes receive information directly from the amygdala and from sensory areas whose activity is influenced by the amygdala. As a result, the frontal lobes have access to highly detailed information about a stimulus or situation as well as information about the initial responses of other brain networks. The frontal lobes must determine whether the instinctive emotional responses produced by earlier stages of processing are the best ones for that given situation. In some cases, the frontal lobes will analyze the situation and

agree that an emotional response is necessary. It will then generate a behaviour that is appropriate for that situation (e.g., you should continue to run away from the spider). In other cases, the frontal lobes will analyze the situation and decide that a stimulus is not emotional (e.g., the moving object was just dust or a leaf, not a spider). In this case, it is necessary to decrease the emotional responses so that the ANS is not depleting the body’s resources. So, in the first situation (running away from the spider), the amygdala and ANS influence the frontal lobes; in the second situation, the frontal lobes send feedback that reduces the intensity of the initial emotional response. This constant communication between

brain regions is an important characteristic of our emotional system (Mayberg et al., 1999), and explains why we can sometimes feel emotionally out of control and at other times feel “cool, calm, and collected.”

Module 11.4a Quiz:

Physiology of Emotion

Know . . . 1. Feedback from the can influence the firing of your visual and

auditory cortex.

A. hippocampus B. hindbrain C. amygdala D. hypothalamus

Understand . . . 2. A few minutes after narrowly avoiding a car accident, your arousal

returns to a baseline state because of activity in the . A. sympathetic nervous system B. parasympathetic nervous system C. hypothalamus D. amygdala

Apply . . . 3. Elizabeth has a form of epilepsy that cannot be controlled by

medications. In an effort to stop her seizures, doctors removed the amygdala from both sides of her brain. How will this likely affect her experience of fear?

A. She will have difficulties with emotional regulation. B. Her parasympathetic nervous system will no longer function

properly.

C. She will have a smaller initial reaction to emotional images. D. She will be unaffected by this surgical procedure.

Experiencing Emotions

Try this: hold a pencil or straw in your mouth sideways without letting your lips touch it—just your teeth. Wait for a few seconds. How do you feel? Happy? Sad? Afraid? Why do you think you feel this way?

When we think of the term emotion, we rarely think about complex interconnected responses in our brains. Instead, we think of the subjective,

personalized feelings that we experience such as happiness or fear. For example, we’ve already discussed how seeing an unidentified moving object in your bedroom can trigger activity in a number of physiological systems leading to the firing of millions of neurons in your brain and in the autonomic nervous system throughout your body. But, you would think of that experience as a

feeling of fear. How are the physiological response and the psychological feeling related? Which comes first and, importantly, how would one test this question?

The earliest scientific theory of emotions was independently developed by William James, one of the founders of psychology in North America, and a

Danish researcher named Carl Lange. Now known as the James-Lange theory of emotion , this view suggested that our physiological reactions to stimuli (e.g., a racing heart) precede the emotional experience (e.g., the fear). In other words, your subjective feelings such as happiness or fear follow your physiological responses. But, the James-Lange theory goes one step further,

claiming that your feeling of fear is determined by how your body responds.

According to this theory, emotion would be experienced in the following way: (1) based on your initial perception of a stimulus, your heart starts to race, (2) your brain receives feedback about that response, and then (3) the brain decides that based on the feedback it has received, you should feel fear. This sequence of events may contradict your own common-sense experience of emotion. If so, you are not alone. Some prominent researchers from the same era disagreed with James and Lange.

Walter Cannon and Philip Bard developed an alternative to the James-Lange

theory (see Figure 11.16 ). They noted that some of the internal organs involved in emotional feelings could not respond quickly enough to be the first step in an emotional response. They also suggested that the feedback from the body was not specific enough to create the different emotions that we

experience. Instead, the Cannon-Bard theory of emotion suggested that the brain interprets a situation and generates subjective emotional feelings, and that these representations in the brain trigger responses in the body. This theory suggests that these emotional processes occur very quickly, so that the steps occur almost simultaneously.

Figure 11.16 Competing Theories of Emotion What is the correct order of events when it comes to emotional experiences? The James-Lange and Cannon-Bard theories differ in their predictions. Source: Adapted from Dr. Silvia Helena Cardosa, http://www.cerebromente.org.br/m05/mente/tub6.gif.

For several decades, the Cannon-Bard theory was the most widely accepted view of our emotional behaviours. However, as clever researchers examined emotions in more detail, this “common-sense” theory began to show its limitations (another example of scientific knowledge evolving). In fact, there is more empirical support for the James-Lange theory than for the Cannon-Bard theory. This is likely due to the fact that some of the bodily feedback involved in emotional responses is caused by facial responses that have direct connections to the brain rather than by slow responses from internal organs. Indeed, the facial feedback hypothesis is a key feature in modern interpretations of the James-Lange theory (see Figure 11.17 ). This hypothesis suggests that our emotional expressions can influence our subjective emotional states. So, if your lips are smiling, you will feel happier. Did you feel happier when you held your pencil or straw in your teeth a few minutes ago? Research participants who performed this action were essentially smiling whether they meant to or not. As the facial feedback hypothesis predicted, the participants reported elevated

levels of happiness (Strack et al., 1988).

Figure 11.17 The Facial Feedback Hypothesis Psychologists have found that inducing a facial expression, such as a frown or a smile, can have mild effects on how people feel. This lends support to the facial feedback hypothesis.

What is a potential alternative explanation for this result? If you tried this example in front of other people, the answer would become readily apparent:

You look and feel silly. In order to rule out the possibility that making any artificial face would improve your mood, researchers had participants make a different facial expression. Hold the pencil sideways in your mouth using only your lips— don’t let your teeth come into contact with the pencil. The result is a slight pout. This is an experimental method of producing a sad face and, sure enough, it

leads to a less positive mood (Larsen et al., 1992).

Research support for the facial feedback hypothesis has been mixed. In support of this hypothesis is a study by researchers who tested the effect of Botox

injections on emotions (Havas et al., 2010). Botox interferes with the movement of muscles by inhibiting the release of the neurotransmitter acetylcholine, which is found at the junctions between muscles and nerves. Less movement of the skin leads to fewer wrinkles. Although Botox injections can make some people look younger, they also reduce the person’s ability to move his or her face. Research has shown that this impairment in facial movement can slightly dampen emotional experiences. However, the facial feedback hypothesis is not supported by all studies. Researchers have shown that surprise is not as

affected by facial feedback as other emotions (Reisenzen & Studtman, 2007). Therefore, we need to be cautious about over-generalizing this hypothesis to all emotions and all situations.

Working the Scientific Literacy Model The Two- Factor Theory of Emotion

To this point, our discussion of emotions has focused on physical reactions. However, our emotional feelings also involve thoughts, memories, beliefs, and interpretations of different stimuli and situations. How do these different factors interact to produce our emotional experiences? In the 1960s, two researchers developed a theory of emotion that addressed this question.

What do we know about the two-factor theory of emotions? Researchers Stanley Schachter and Jerome Singer (1962) agreed with James and Lange that our physical reactions give rise to our emotional experiences. However, they also pointed out that many different emotions can elicit physiological arousal. How do we choose which emotion goes with this arousal? Schachter

and Singer suggested that it is our interpretation of why we are aroused that creates the emotional experience. Their theory, the two-factor theory , holds that patterns of physical arousal and the cognitive labels we attach to them form the basis of our emotional experiences. Physical arousal is the first factor to come into play (as James and Lange predicted) and along with this comes a cognitive label for the experience, such as “I am sad.” Combining the two factors, the physical and cognitive, gives rise

to the emotional experience of sadness (see Figure 11.18 ).

Figure 11.18 Two-Factor Theory of Emotion

According to Schachter and Singer, emotions are experiences composed of physiological responses and the cognitive labels we give them.

How can science explain the two-factor theory? To test this theory, Schachter and Singer performed a study in which participants were given different cognitive labels for the same physical feeling. These researchers injected three groups of volunteers with adrenaline (epinephrine), a stimulant that increases a person’s heart rate, causes sweating, and makes a person’s face feel warm and flushed. So, all participants experienced the same physical symptoms. However, the cognitive explanation for those symptoms was manipulated by the experimenters. One group of participants was correctly informed about the symptoms (the Informed Group). Another group was provided no information at all; they were (politely) called the Ignorant Group. The third group of participants was given incorrect information about the injection; these people were told that adrenaline leads to numbing, itchiness, and a slight headache (the Misinformed Group). Thus, only the Informed Group had a correct cognitive explanation for their physical feelings. A final group of participants was injected with a saline solution; this was the control condition. The experimenters then had each participant sit in a room with another participant who, in reality, was an actor paid to create an emotional scene. In one version of the study, the experimenters told the participants that they would have to wait for 20 minutes before receiving a vision test, and that they could doodle on the papers left in the room. After the experimenter left the room, the actor began to behave in an excited fashion, playing basketball with crumpled up paper and playing with props that had been left in the room (e.g., hula- hoops). In other words, the actor was behaving euphorically

(extremely happily). In another version of the study, participants were asked to fill out questionnaires during the 20-minute delay period. The questions were quite personal in nature, and oftentimes mildly offensive (e.g., “With how many men [other than your father] has your mother had extramarital relationships? 4

and under , 5–9 , 10 and over ”). After reading these questions, the actor became quite angry and tore up the sheet of paper while swearing.

The question the experimenters wanted to answer was whether the participant’s response to the actor was affected by the cognitive explanation they had been given for the effects of adrenaline. Presumably, if you knew that you were going to have your heart rate increase due to a drug, then you would attribute any changes in your heart rate to the drug, not to the actor. In contrast, if you didn’t know about the effects of adrenaline, then you would assume that your heart was racing because you were having an emotional response to the actor. As predicted, in both the euphoria and the anger conditions, the participants’ emotional responses were influenced by their ability to explain their physical symptoms. When people understood the adrenaline was going to make their heart race, they reported smaller emotional reactions to the actor than when they were ignorant of the drug’s effects

(see Figure 11.19 ). This classic study provided the first evidence that our cognitive interpretation of an emotional event can have a dramatic effect on how we experience that situation. In the process, it showed a limitation of the James-Lange theory. That theory would assume that the emotional experience (anger or euphoria) would be due to different physiological causes. Instead, the same physiological stimulus—adrenaline—led to different emotional responses in the two experimental conditions.

Figure 11.19 Results from Schachter and Singer’s Study

If participants knew that their racing heart was due to a drug injected by the experimenter, their emotional responses to the actor in the study were smaller. This graph depicts the number of angry statements and acts performed by participants in the angry condition of the experiment. Source: Graph based on Schachter, S., & Singer, J. (1962). Cognitive, social, and physiological

determinants of emotional state. Psychological Review, 69, 379–399. Table 5, p. 392.

An example of the Thematic Apperception Test stimuli used in the Capilano bridge experiment. Males in the high-arousal condition produced stories that included more sexual imagery than did participants in the control condition. Bill Aron/PhotoEdit, Inc.

Bill Aron/PhotoEdit, Inc.

Can we critically evaluate these findings? One criticism of Schachter and Sutton’s experiment is that it might not apply to the real world. Very few of us are given injections of adrenaline and made to watch someone acting in an emotionally extreme manner. In order to test the generalizability

of these results, Donald Dutton and Arthur Aron (1974) from the University of British Columbia performed an innovative experiment that provided strong support for the two-factor theory. In this study, a female experimenter told male participants that she was investigating the effects of scenic attractions on creative expression. Participants were asked to cross a bridge before completing the Thematic Apperception Test, an open-ended test in which participants create stories to go along with a set of pictures. The independent variable of this study was the bridge the participants crossed. In the control condition, individuals crossed a solid wooden bridge that was approximately 3 metres above a small, shallow stream. In the experimental condition, individuals crossed the Capilano Canyon Suspension Bridge, which, as the name would suggest, crosses the Capilano Canyon near Vancouver. This bridge is 120 metres long, hangs 75 metres above rocks and rapids, and has a tendency to sway, which can create the impression that one is about to fall over the edge. Needless to say, the experimental condition would produce greater levels of emotional arousal. Interestingly, participants who were in the experimental condition included significantly more sexual imagery in their stories than did participants in the control condition. The explanation for this result is that the participants experienced stronger emotions when crossing the suspension bridge, but misattributed the arousal to the pictures. Stronger support for this explanation came from an interesting addition to the study. After the participants had completed the Thematic Apperception Test, the female experimenter tore off a sheet of paper and wrote down “her number” (a fake phone number set up

by the experimenters). Only 12.5% of the control participants phoned the woman’s number; 50% of the experimental participants phoned the same woman. When participants experienced emotional arousal, they interpreted it as attraction to the experimenter. Keep this result in mind the next time someone wants to take you to a scary movie for a first date.

Why is this relevant? Studies of the two-factor theory of emotions show us that although we do have rapid physiological responses to emotional

situations, it is our interpretation of those events that leads to our emotional experiences. This obviously doesn’t mean that you will

never be upset. But, knowing that you can control how you interpret some of the emotional (or even the aggravating day-to- day) events of your life means that you can try to reduce the negative effects that emotional situations can have on you. So, ironically, a study involving an injection of adrenaline and the induction of angry emotions may teach you how to become happier. It’s up to you.

Module 11.4b Quiz: Experiencing Emotions

Understand . . .

1. Which of the following is a weakness of the James-Lange theory of emotion?

A. Cognitive appraisal is not a component. B. The theory does not address the subjective feeling of emotion. C. The theory ignores the role of physiological reactions. D. Awareness always precedes physiological reactions during

emotions.

Apply . . .

2. Raj’s mother tells him to smile more if he wants to feel better. Her statement is consistent with the

A. emotional transfer hypothesis. B. two-factor theory of emotion. C. facial feedback hypothesis. D. cortical theory of emotion.

3. Nguyen is paralyzed from the neck down and does not experience the autonomic responses that usually accompany fear. Despite this injury, he continues to experience fear. Which theory of emotion is contradicted by this observation?

A. Cannon-Bard B. Two-factor theory C. James-Lange theory D. Physiological theory

Expressing Emotions

Are you a good liar? Can you tell when someone else is lying to you? How confident are you in your lie detection abilities? Although most of us believe we are quite good at spotting someone else’s deception, the truth is that our accuracy is quite poor. In order to fix this problem, researchers attempted to create a lie detector test that measured the responses of our autonomic nervous

system. This machine, a polygraph, measures whether heart rate and sweating increase when a person responds to different events or questions. Sudden changes in these levels suggest that the person is experiencing stress and may be hiding something. However, after extensive testing, the polygraph was shown to be an inaccurate measure of lie detection; evidence gathered using this technique is not admissible in Canadian courts.

Fortunately, psychologist Paul Ekman and his colleagues (Ekman et al., 1999) have developed a new technique for lie detection. Using videotapes of several research participants, Ekman and colleagues found that our faces give us away when we try to lie. Although we can fake an emotional expression within a fraction of a second, our real emotional response can be seen on our faces before this mask is in place. Ekman called these brief expressions of our true

feelings microexpressions, and is training police officers to detect them in order to catch criminals. But, use your critical thinking skills for a moment: What do microexpressions really tell you? Yes, the face is expressing someone’s inner state, and yes, it appears that a person is concealing how they are feeling. But,

microexpressions cannot tell you why they are doing so. Instead, police officers have to make assumptions about the person’s motives based on the microexpressions on his or her face.

This all sounds very dramatic, but we make assumptions about other people’s feelings and motives all the time. It is quite rare for someone to tell you exactly how he or she feels. Instead, you observe other people’s faces and body movements in order to make an educated guess about what thoughts and feelings are going on inside their heads. They, in turn, do the same with you. In this section of the module, we will examine these processes, as well as how culture can influence how emotions are expressed and interpreted.

Emotional Faces and Bodies

Our primary method of communicating our emotional feelings is through our facial expressions. Each of these expressions has its own unique combination of

muscle movements, such as the crinkling of muscles near the eye (orbicularis oculi) and the movement of the mouth (zygomatic major) during smiling. But why are certain combinations of muscle movements associated with particular feelings? Although researchers are still trying to solve parts of this puzzle, researchers at the University of Toronto have highlighted some important characteristics of expressions of fear and disgust. Imagine changing a really stinky diaper—something even dung beetles would walk away from. The powerful odour feels like it’s crawling up your nostrils. Your natural reaction is to

make a disgusted face, which involves scrunching up your nose. This expression isn’t just for show, however. It also reduces airflow into your nostrils, thus limiting

the amount of the disgusting substance(s) that can enter your body (Chapman et al., 2009; Susskind & Anderson, 2008). This makes evolutionary sense, as some disgusting substances could threaten a person’s health. In contrast, when we experience fear, our eyes open wide and we tend to inhale deeply (see Figure 11.20 ). This is likely due to the fact that when we’re afraid, we are being threatened and therefore need to be able to take in as much information as possible in order to develop the best plan of action to keep ourselves safe. These results show that the strange facial geometry that makes up our emotional expressions is not random—our expressions have a purpose that will enhance

our ability to survive (Shariff & Tracy, 2011).

Figure 11.20 Nostril Airflow Associated with Disgust and Fear The images depict the opening of nasal passageways during the experience of

disgust (left), a neutral emotion (centre), and fear (right). Note that the passageways are constricted during disgust, but opened wider during fear. This difference is reflected in the volume of airflow breathed in during each facial expression. Source: Susskind, J. M., Lee, D. H., Cusi, A., Feiman, R., Grabski, W., & Anderson, A. K. (2008). Expressing fear enhances

sensory acquisition. Nature Neuroscience, 11(7), 843–850. Top image is Figure 6c, p. 846; bottom-left image is Figure 5b, p.

846; bottom-right image is Figure 2a-b, p. 844.

Importantly, these expressions appear all over the world, suggesting that they are an innate part of being human. Charles Darwin (1872) was the first person to recognize that facial expressions of emotion were universal. During his extensive travels, he noted that people from different cultures formed similar facial expressions and were able to understand the emotions of others. In the late 1960s, Paul Ekman performed cross-cultural studies that supported Darwin’s hypothesis. Ekman and his colleagues photographed North Americans expressing six basic emotions—fear, happiness, disgust, anger, surprise, and sadness. They then travelled to an isolated region of Papua New Guinea (an island country north of Australia) to see if individuals who were unfamiliar with Caucasian faces could still recognize the emotions they displayed. Sure enough, tribesmen from the Fore ethnic group were able to accurately identify the

emotions of the actors (Ekman & Friesen, 1969). The researchers then asked the tribesmen to make their own facial expressions for each emotion. As would be expected, research participants in the U.S. were able to recognize these emotions as well.

The meaning behind facial expressions changes with subtle modifications. For example, one version of smiling is genuine, while another is reserved for social

graces. Genuine smiles, known as Duchenne’s smiles, involve a crinkling of muscles at the corner of the eye. Fake smiles tend not to have this crinkling (unless you practise, which is mildly creepy). However, even if you learn to fake your emotions, your face can give you away. Psychologist Paul Ekman (pictured above) has shown that our real emotional responses appear on our faces for a fraction of a second before being covered up with our social mask. Paul Ekman, Ph.D./Paul Ekman Group, LLC

But, facial expressions aren’t our only way of communicating our emotional states. Imagine that you are sitting across a table from someone that you find attractive. Or, what if you found the person annoying and really wished your friend would return from the washroom so that you could leave? Even if you didn’t express any emotion with your face, your body would likely give away what

you were feeling in both situations. Body language provides almost as much emotional information as facial expressions; it also activates a number of similar

brain areas (de Gelder & Hadjikhani, 2006). Researchers at Queen’s University have created a novel method of examining body language and biological motion. Experimental stimuli are created by attaching motion capture sensors to different parts of people’s bodies and having them make different movements such as walking. By averaging the types of movements across a number of individuals, it is possible to see the different body movement patterns of men and women,

happy and sad people, and nervous or relaxed people (Troje 2002a, 2002b, 2008). Importantly, like the recognition of faces, detecting characteristics of body language and body motion appears to be universal, as many of the effects were

observed in Mundurucu indigenous people in Amazonian regions of Brazil (Pica et al., 2011).

Individuals in isolated areas of the world were able to identify the emotions expressed by these faces, suggesting that these expressions are universal. Paul Ekman Group, LLC

Point-of-light technology can be used to infer a number of characteristics from a

person’s biological motion, including his or her emotional state. See http:// www.biomotionlab.ca/Demos/BMLwalker.html. Troje, N. F. (2002) Decomposing biological motion: A framework for analysis and synthesis of human gait patterns. Journal of

Vision, 2, 371-387. URL: https://www.biomotionlab.ca/Demos/BMLwalker.html. Prof. Dr. Nikolaus Troj/Biomotion

Lab/Queen’s University

Culture, Emotion, and Display Rules

Despite the universality of many aspects of emotion, people raised within a

specific culture show characteristics that are specific to their region (Elfenbein & Ambady, 2003). Put simply, cultural groups have unique emotional dialects , or variations across cultures in how common emotions are expressed. For example, people from North America and from Gabon (a country in West Africa) both experience contempt. However, North Americans are more likely to lower their brow, and Gabonese people are more likely to raise their upper lip when expressing this emotion.

The situation or context is a major factor in determining when members of

different cultures express specific emotions. Display rules refer to the unwritten expectations we have regarding when it is appropriate to show a certain emotion. Think about embarrassing situations. In North America, we tend to blush and look away when embarrassed. In Japan, on the other hand, people tend to smile. They aren’t happy, but do their best not to show embarrassment. Indeed, numerous studies have documented differences in display rules between North American and Japanese individuals, often highlighting interesting and subtle differences. For instance, imagine seeing someone displaying a highly intense emotion such as a very happy face. You would probably assume that their internal state was just as joyous as their face. Now, imagine that you see someone expressing a low-intensity expression (e.g., a smile that is only 50% as

powerful as normal). How do you think that person is feeling? David Matsumoto and his colleagues (2002) noticed that while American and Japanese participants agreed about the person’s emotional state when viewing high- intensity emotions, they differed when the emotions were less intense. American participants assumed that the person was feeling the emotion less strongly.

Japanese participants, on the other hand, assumed that the person felt the emotion strongly, but wasn’t in a position to outwardly express that intensity. In other words, the Japanese participants were assuming that the person being photographed was obeying particular display rules that limited his or her

expressiveness (Matsumoto et al., 2002).

Culture-specific display rules such as these can be found the world over and show us that we need to be cautious about over-generalizing the meaning of

different displays of emotions (Elfenbein et al., 2007). It remains to be seen whether the worldwide use of programs like Facebook, Snapchat, and Instagram will reduce cultural differences in display rules.

Although it may seem like cultural display rules are fairly stable, they can vary over time. A recent examination of American high school yearbook photos shows

how cultural expectations can influence how we express ourselves (Ginosar et al., 2015). Researchers collected over 37 000 high school photographs and used computers to create “average photos” for males and females in each decade

since 1900. As you can see in Figure 11.21 , students at the turn of the twentieth century were expected to remain quite serious, whereas students from the current decade (i.e., most of the readers of this book) were encouraged to smile happily (or to fake it convincingly). In fact, if you take a trip to the portrait gallery of any art museum, you’ll see that smiling when being photographed or painted has only become commonplace in the last 50 years. This shows us that our point in history, as well as our location on a map, can have a large effect on our emotional display rules.

Figure 11.21 Averaged Photographs of Male and Female High School Students from 1900 to the Present Decade Why do you think people are more emotionally expressive now than they were 100 years ago? There are a number of possibilities ranging from world events, to financial stability, to how familiar (and comfortable) people were with being photographed. Source: Ginosar, S., Rakelly, K., Sachs, S., Yin, B., & Efros, A.A. (2015). A century of portraits: A visual historical record of

American high school yearbooks. Figure 1 from Extreme Imaging Workshop, International Conference on Computer Vision,

ICCV.

Culture, Context, and Emotion

Understanding another person’s emotional state can also be influenced by the context in which that emotion is being displayed. Importantly, the role that context plays in the interpretation of others’ emotions varies across cultures. Some cultures (e.g., Western countries) focus on the person expressing the emotion; people in other cultures (e.g., Asian countries) tend to also pay

attention to those around the person expressing that emotion. So, do these different ways of looking at a situation translate into differences in how people of various cultures interpret emotions? To answer this question, psychologists asked students from both Western and Asian universities to judge the emotion of

the central figure in the scenes depicted in Figure 11.22 . Western students tended to focus on the facial expression of the central figure. Thus, if the

individual was smiling, they would report he was happy, and they did not interpret his happiness with respect to how the surrounding people appeared to feel. In contrast, Asian students interpreted the central figure’s emotion in

reference to what people in the background might be feeling (Masuda et al., 2008). So, in the right panel of Figure 11.22 , a Westerner might report that the central figure was happy, while an Asian person might assume that the central figure was happy at the expense of the other people.

Figure 11.22 How is the Man in the Middle of These Pictures Feeling? Source: Based on Masuda, T., Ellsworth, P. C., Mesquita, B., Leu, J., Tanida, S., & van de Veerdonk, E. (2008). “Placing the

face in context: Cultural differences in the perception of facial emotion.” Journal of Personality and Social Psychology, 94,

365–381. URL: https://sites.ualberta.ca/~tmasuda/index.files/MasudaEllsworthMesquitaLeuTanidavandeVeerdonk2008.pdf.

The tendency for Asian students to focus on people in the background was further confirmed in two different ways. First, Asian students were more accurate than Western students in remembering whether they saw specific individuals in the background. Also, using a device that tracks the eye movements of the participants, the researchers discovered that Asian students spent more time actually looking at the entire picture, rather than just the central character

(Figure 11.23 ; Masuda et al., 2008). Interestingly, a subsequent study found that Canadian-born students with Asian ancestry acted more like North American

participants than Japanese participants (Masuda et al., 2012). Together, these experiments show us that although the perception of emotional expressions is universal, the interpretation of why those expressions are being displayed is very culture-dependent.

Figure 11.23 East–West Differences in Interpreting Emotion In comparison to Asian people, Westerners spend more time looking at the focal individual in a scene and interpret his or her emotions without reference to

surrounding individuals (Masuda et al., 2008). Source: Based on Masuda, T., Ellsworth, P. C., Mesquita, B., Leu, J., Tanida, S., & van de Veerdonk, E. (2008). “Placing the

face in context: Cultural differences in the perception of facial emotion.” Journal of Personality and Social Psychology, 94,

365–381. URL: https://sites.ualberta.ca/~tmasuda/index.files/MasudaEllsworthMesquitaLeuTanidavandeVeerdonk2008.pdf.

Module 11.4c Quiz:

Expressing Emotions

Know . . . 1. A(n) refers to when it is appropriate to show a specific

emotion.

A. emotional dialect B. display rule C. context rule D. display dialect

Understand . . . 2. Which of the following is an example of an emotional dialect?

A. Experiencing anger B. Avoiding laughter in church

C. Raising one’s chin in contempt D. Smiling as a sign of happiness

3. Which of the following is an example of a display rule? A. Biting one’s lip in embarrassment B. Dropping one’s jaw in surprise C. Suppressing anger during a debate D. Expressing happiness to a loved one

Module 11.4 Summary

amygdala

Cannon-Bard theory of emotion

display rules

emotion

emotional dialects

facial feedback hypothesis

James-Lange theory of emotion

two-factor theory

Our biological responses to emotions occur in many different parts of our nervous system. Our brain has a rapid-response system involving the amygdala, which can fire within a few hundred milliseconds. This system triggers activity in other brain areas and influences how much attention a stimulus will receive. Our sympathetic nervous system also responds quickly. Soon after, brain and spinal cord areas related to movement become active in order to prepare us for a response. Finally, frontal lobe regions examine the situation to determine whether we should continue the emotional response or change our behaviour to

Know . . . the key terminology associated with emotion.11.4a

Understand . . . how the nervous system responds to emotions.11.4b

conserve energy.

Emotions such as fear, anger, happiness, sadness, surprise, and disgust appear to be human universals—all people experience them regardless of culture. At the same time, we cannot completely explain human emotions without references to cultural variation in the form of dialects and display rules.

Apply Activity Try this exercise. Spend 10 seconds looking at the Sanskrit figure on the left in Figure 11.24 while slowly nodding your head. Now, spend about 10 seconds looking at the figure on the right while slowly moving your head from side to side.

Figure 11.24 Application Activity

Now, imagine that you had to choose one image to display on the wall of your home. Which one would you choose—the one on the left or the one on the right?

What is important about this exercise is not which figure you chose; rather, it is

Understand . . . cultural similarities and differences in emotional expressions.

11.4c

Apply . . . your knowledge of theories of emotion to new examples.11.4d

the application of emotion theories to the problem. Consider the facial feedback study, and try to explain how the head movements could potentially influence one’s preference for a symbol. This module provided examples of what researchers have found using similar techniques.

Facial expressions allow us to show the outside world what we are feeling. But, they serve other functions as well. For instance, facial expressions of disgust actually restrict the amount of air entering the body, possibly to protect us from contaminants. Expressions of fear serve to increase the amount of sensory information available to us, thus helping us to select the more appropriate response to that stimulus or situation.

Analyze . . . what purpose(s) do facial expressions serve?11.4e

Chapter 12 Personality

12.1 Contemporary Approaches to Personality The Trait Perspective 492

Module 12.1a Quiz 496

Beyond the Big Five: The Personality of Evil? 496

Working the Scientific Literacy Model: Right-Wing Authoritarianism at the Group Level 497

Module 12.1b Quiz 498

Personality Traits over the Lifespan 499

Module 12.1c Quiz 501

Behaviourist and Social-Cognitive Perspectives 501

Module 12.1d Quiz 503

Module 12.1 Summary 503

12.2 Cultural and Biological Approaches to Personality Culture and Personality 506

Module 12.2a Quiz 508

How Genes Affect Personality 508

Working the Scientific Literacy Model: From Molecules to Personality 510

Module 12.2b Quiz 511

The Role of Evolution in Personality 511

Module 12.2c Quiz 513

The Brain and Personality 514

Module 12.2d Quiz 516

Module 12.2 Summary 516

12.3 Psychodynamic and Humanistic Approaches to Personality The Psychodynamic Perspective 519

Working the Scientific Literacy Model: Perceiving Others as a Projective Test 526

Module 12.3a Quiz 527

Alternatives to the Psychodynamic Approach 527

Module 12.3b Quiz 529

Module 12.3 Summary 529

Module 12.1 Contemporary Approaches to Personality

Pearson Education

Learning Objectives

Know . . . the key terminology associated with contemporary approaches to personality. Understand . . . the behaviourist and social-cognitive views of personality. Apply . . . the Big Five personality traits to understand your own personality. Analyze . . . the personality roots of violence and prejudice. Analyze . . . the relative roles of personality traits and psychological and

12.1a

12.1b 12.1c

12.1d 12.1e

What does your living space say about you? That alphabetized bookshelf and bathroom full of grooming products suggest conscientiousness. The photos of Mount Everest and major European cities reveal an openness to experiencing new and exciting things. The three pet cats and extensive DVD collection? Possibly signs of an introverted homebody.

It might sound like we are just making assumptions here, but scientific research backs up the notion that personality can be measured by examining the details of our dwellings. Psychologist Sam Gosling and his students have, with permission, closely scrutinized people’s offices and

bedrooms for clues about their personality (Gosling, 2008; Gosling et al., 2002). Teams of seven or eight observers entered people’s bedrooms and offices and rated the personality types of the occupants with a standardized personality test. Not only did the observers reach close consensus on many measures of personality, but their ratings also matched up with how the occupants rated their own personality.

If you look around your own room, some parts of it may symbolize the “core” of who you are, whereas others reflect less “deep,” more superficial details about yourself. For example, your book collection and most treasured belongings may be very revealing, but what about the clothing strewn all over the floor? Does it mean that you are a lazy slob? Or that you are ambitious and live a busy life? Or simply that you are enjoying the freedom of not living with your parents? Which is more appropriate as an explanation: the dispositional (i.e., rooted in the kind of person you are) or the situational (i.e., external, circumstantial factors)? A key challenge for personality psychologists is figuring out how our personalities and circumstances work together in shaping our behaviour. This raises many important questions, to be addressed later in this module.

Focus Questions

physical states in determining behaviour.

1. What are the basic traits that make up human personality? 2. To what extent are our preferences, thoughts, and behaviours

determined by situational factors in- the-moment, versus more stable personality traits?

When you say to your friend, “Yeah, our date was pretty good. They were okay, but you know, they weren’t my kind of person,” we understand that “my kind of person” means something. We accept that the person being described is some “kind of person”—that they have regular patterns and ways of being. This is the

person’s personality ; their characteristic pattern of thinking, feeling, and behaving that is unique to each individual, and remains relatively consistent over time and situations. Psychologists have long searched for a theory of personality that can describe and explain how people develop these patterns, because we all want to find out what “kind of person” we are.

The Trait Perspective

If there are semi-stable patterns that differ from person to person, how can we measure those patterns? This quest, to shine the light of science on the very nature of our own selves, has resulted in two broad approaches to personality

measurement: the idiographic approach and the nomothetic approach.

When you try to figure out the people you know very well, you probably intuitively

adopt an idiographic approach , focusing on creating detailed descriptions of a specific person’s unique personality characteristics. So, when you are trying to figure out just what IS the problem with one of your friends or family members, you build a theory of the way that they are, the way your friendship or family history has affected them, and the weird idiosyncrasies that make them do the things they do. In doing so, you are taking an idiographic approach.

Idiographic approaches are helpful not only for understanding yourself and your social world, but also for examining the full range of human experience, from the

most disturbed to the healthiest and most highly functioning individuals. For example, criminal profilers may focus on a detailed study of a serial killer in order to help police in their investigation. At the other extreme, Abraham Maslow wanted to understand the people who had lived up to their fullest potential, who were in Maslow’s terms, “self- actualized.” Accordingly, Maslow performed detailed analyses of the biographies of famous people who were widely regarded

as being wise and fully functioning (Maslow, 1970). Maslow’s findings launched decades of work trying to uncover what makes human beings thrive and develop to their maximum potential.

In contrast, psychologists who take a nomothetic approach examine personality in large groups of people, with the aim of making generalizations about personality structure. Rather than trying to understand a specific person, psychologists taking a nomothetic approach may want to understand what personality factors, or traits, are relevant to understanding people. For example, wanting to know whether a certain “type” of person is more likely to exhibit a certain behaviour pattern (e.g., are people who are extraverted more likely to develop attentional disorders?), is a nomothetic question. Answering a question like this requires measuring some specific variable (e.g., extraversion) and examining whether it correlates with specific outcomes (e.g., attentional disorders). The key to nomothetic research is to identify the important personality traits that are related to whatever it is that you are interested in understanding.

There are many examples of nomothetic research in Canadian universities. Dr. Gordon Flett at York University has examined personality predictors of alcohol,

drug use, and depression in university students (e.g., Flett et al., 2009; Goldstein et al., 2009; Goldstein & Flett, 2009). Dr. Lawrence Walker at the University of British Columbia has sought to identify the “moral personality,”

seeking the personality factors that predict courage and heroism (Walker & Frimer, 2007; Walker et al., 2010). Dr. Jacob Hirsh at the Rotman School of Management in Toronto has examined the personality predictors of pro-

environmental motivations (Hirsh, 2010; Hirsh & Dolderman, 2007). Taking a nomothetic approach allows psychologists to examine what types of people are more or less likely to engage in certain behaviours, which is an important step toward being able to reduce undesired behaviours or more effectively promote

desired ones.

Early Trait Research

So, who are you anyway? What kind of person are you? Try to answer these questions. Seriously—stop reading right now, take out a piece of paper, and try to describe the kind of person you are. Write down “I am . . .” and complete the sentence 10 times.

Now take a look at your list. If you’re like most people, your list probably has

quite a few personality traits—words like extraverted or introverted, funny, ambitious, lazy, anxious, or easy-going. A personality trait describes a specific psychological characteristic that makes up part of a person’s personality; how that person is “most of the time.” Trait descriptors are useful as shortcuts to understanding people. Traits summarize a great deal of information about a person and help to predict how that person will behave across a range of situations. For example, an “extraverted” person is more likely to be comfortable in social situations, go to parties, and have a large number of friends than someone who is “introverted.”

As you can imagine, many different traits could be used to describe people, such as “shy,” “cheerful,” “outgoing,” and “adventurous.” The first systematic attempt to identify all possible traits (in the English language) was made in the 1930s by Gordon Allport, who tallied nearly 18 000 English words that could be used to

describe an individual’s physical and psychological attributes (Allport & Odbert, 1936). (Perhaps Allport himself would be described as “patient,” “methodical,” and “weird to talk to at a party.”) Allport then developed a theory of personality structure by organizing these words into traits, launching a strong trend in personality psychology that continues to this day—attempting to identify and measure the key personality traits.

To accomplish this, trait researchers have devised many different types of personality “scales.” Some, like the ones used in psychology research and described later in this chapter, are rigorously evaluated. Others, like the ones you find in popular magazines, are of questionable value. For example,

Cosmopolitan regularly includes personality scales in which you can discover all sorts of things about yourself; while it is possible that Cosmo has a team of highly qualified psychologists rigorously designing these scales, we do not recommend that you base your life decisions on your results to the “Are You Enough of a Bad Girl?” quiz.

It is clear that people love to know what “kind” of person they are. However, it is

often easier to make people believe that you are measuring their personality than it is to actually measure it. In fact, it is remarkably easy for people to be convinced that a personality profile describes them well. This can occur even when the profile is patently false and was not generated to describe them at all. This is popularly known as “the Barnum effect,” after the circus showman P. T. Barnum, due to his apparent statement “there’s a sucker born every minute.” (Ironically, P. T. Barnum never actually said this quote, which is widely attributed

to him [Saxon, 1989].) The Barnum effect hearkens back to the late 1940s, when psychologist Bertram Forer gave research participants a personality test and then generated a personality description that subjects believed was based on their test responses. Even though all participants were given exactly the same personality description, they found the profile to be highly convincing and descriptive of them as an individual. When asked to rate how well the profile described them, on a scale ranging from 0 (very poor) to 5 (excellent), the

average rating was an impressive 4.26 (Forer, 1949)!

As you can see from the profile Forer used (see Table 12.1 ), the statements were fairly general and most of them could apply to most people, at least some of the time. It is easy for people to see themselves in statements such as “While you have some personality weaknesses, you are generally able to compensate for them,” and of course, just about everybody tends to be extraverted

sometimes and introverted other times, or to have unrealistic goals. The Barnum effect may be a key reason why personality tests of questionable validity (as well as horoscopes, astrologers, psychics, and the like) are so widely believed.

Table 12.1 Bertram Forer’s Personality Profile Source: Forer, B. R. (1949). The fallacy of personal validation: A classroom demonstration of gullibility. Journal of Abnormal

and Social Psychology, 44, 118–123.

Forer provided the following profile to all of the participants in his study, regardless of

their answers on a personality test.

You have a great need for other people to like and admire you. You have a tendency to

be critical of yourself. You have a great deal of unused capacity that you have not

turned to your advantage. While you have some personality weaknesses, you are

generally able to compensate for them. Your sexual adjustment has presented

problems for you. Disciplined and self-controlled outside, you tend to be worried and

insecure inside. At times you have serious doubts as to whether you have made the

right decision or done the right thing. You prefer a certain amount of change and variety

and become dissatisfied when hemmed in by restrictions and limitations. You pride

yourself as an independent thinker and do not accept others’ statements without

satisfactory proof. You have found it unwise to be too frank in revealing yourself to

others. At times you are extraverted, affable, sociable, while at other times you are

introverted, wary, and reserved. Some of your aspirations tend to be pretty unrealistic.

Security is one of your major goals in life.

In contrast, rigorous empirical research over the past several decades has narrowed the many potential personality traits into a small number of factors. The

statistical technique called factor analysis is used to group items that people respond to similarly; for instance, the terms friendly, warm, and kind have similar meanings, and can be grouped in a cluster, referred to as a factor.

The Five Factor Model

Using factor analysis, psychologist Raymond Cattell (1946) narrowed the list of key personality traits to 16, thereby simplifying and standardizing the number of dimensions psychologists needed to describe the composition of personality.

Forty years later, McCrae and Costa (1987) created the Five Factor Model (FFM) , a trait-based theory of personality based on the finding that personality can be described using five major dimensions; this model has become the most popular trait-based approach for academic personality researchers, and has been cited in hundreds of research articles.

To understand the Big Five traits, consider what characteristics are associated with people high and low on that trait. These are the “kinds of people” described

by each trait (see Figure 12.1 ).

Figure 12.1 The Big Five Personality Dimensions A widely used measure of personality is the NEO-PI-R. Individuals rate

themselves on multiple questions that reflect the traits of openness, conscientiousness, extraversion, agreeableness, and neuroticism. (To help you remember the Big Five, note that the first letters of the traits spell out OCEAN.) Source: Based on McCrae, R. R., & Costa, P. (1987). Validation of the Five-Factor Model of personality across instruments

and observers. Journal of Personality and Social Psychology, 52 (1), 81–90.

Openness

Individuals high in openness (high Os) are the dreamers and creative types; they tend to be more “open” to new things—ideas, opinions, and perspectives that differ from theirs, and new ways of seeing a problem that they had not considered. They are more open to new experiences, tending to be curious and appreciative of art and unusual ideas. As a result, they often hold beliefs that would be considered “unconventional.” High Os are also likely to think more abstractly and to be more sensitively aware of their emotions.

Individuals low in openness (low Os) are the defenders of the system, preferring the conventional, the tried and true. They avoid the unknown and find security in the known. They prefer things that are tangible rather than symbolic, priding themselves on being “practical.” Low Os prefer things to be straightforward and generally dislike subtlety and complexity. They approach new information somewhat defensively—preferring to learn about things they already believe in, and paying less attention to information that challenges their perspective. Low Os tend to be resistant to change and suspicious of their emotions, placing more emphasis on the attempt to be rational and logical.

Conscientiousness

Highly conscientious people (high Cs) are the organizers—efficient, self- disciplined, and dependable. They are the ones who meet deadlines, plan ahead to achieve their goals, and are comfortable with schedules and lists, although at the expense of being flexible and spontaneous at times. High Cs are great employees and students, tending to achieve more in their careers due to their achievement orientation and tendency to get things done on time. They also live

longer, perhaps because they are more likely to engage in the positive health behaviours (e.g., eating well and exercising regularly) that the less conscientious among us never quite get around to doing. . . .

Low Cs are the easy-going ones, fun to hang out with, but not so great as collaborators on a project. Low Cs tend to be disorganized, careless with details, and have difficulty meeting deadlines. Although they may want to perform well at a task, they have difficulty disciplining themselves enough to actually get things done. Low Cs feel uncomfortable with schedules and detailed plans, preferring to “be in the moment.” Although low Cs suffer somewhat in life due to their lack of self-discipline, they benefit by not being as stressed about details and being able to still enjoy themselves when things don’t go according to plan.

Extraversion

Extraverts (high Es) are the socializers and sensation seekers. They are comfortable in more stimulating environments, and thus love the company of others, being seen as outgoing and energetic. Extraverts tend to be more assertive, talkative, and enthusiastic, preferring high levels of stimulation and excitement much of the time. They are fun to be around, but sometimes take things too far, as their love of stimulation puts them at higher risk for dangerous activities such as substance abuse.

Introverts (low Es) are the quiet ones. Although they like social contact, introverts also need time for solitary activities and “recharging their batteries.” They can be overwhelmed by the high levels of stimulation preferred by extraverts, so while the extraverts party it up and compete for all the attention, the introverts sit on the couch in the corner having great conversations with a friend or two. Introverts tend to be more cautious and reserved, and they are great when you need someone to really talk to.

Agreeableness

Highly agreeable people (high As) are warm and friendly people who are easy to like, easy to be friends with, and easy to have as part of your group. They are

kind, compassionate, and empathetic, and tend to be helpful and altruistic. They place strong value on getting along with people and are generally willing to put their own interests aside in order to please others or avoid conflict. Agreeable people are the ones who make it really hard to choose what movie to watch,

because they always want to know what movie you want to watch. . . . As you might expect, they make great team members, but their leadership skills often suffer because they are unwilling to assert their opinion.

Low As are the type who “put themselves first.” They value being authentic more than pandering to other people’s needs, making them more likely to assert their opinions and engage in conflict if necessary. Low As suffer socially somewhat, as they tend to be seen as cold, unfriendly, uncooperative, and unkind. They are often skeptical of other people’s motives, and tend to be less trusting of human nature in general. As you might expect, low As don’t experience much empathy, and tend to be self-interested rather than altruistic.

Neuroticism

To be called “neurotic” is not generally considered a compliment. Indeed, people high in neuroticism (high Ns) are often difficult to deal with, as their emotional volatility and general tendency to experience negative emotions makes them not much fun to be around. High Ns tend to be quite sensitive and experience strong reactions to stressful situations; as a result, they often interpret situations as overly threatening and magnify small frustrations into major problems. When they experience negative emotions, they have difficulty relaxing and “letting go” of their negative feelings, which makes these feelings persist, and persist, and persist. As a result of their difficulties regulating negative emotions, high Ns are the most vulnerable to anxiety and depressive disorders.

Low Ns, on the other hand, are the prototypical mentally healthy people. They tend to be secure and confident, and let go of negative emotions easily. Rather than blowing things out of proportion, the low Ns take the good with the bad, and deal with problems as they arise, but feel no need to create problems where there aren’t any, or to obsessively look for problems until they find them. Low Ns are excellent at managing their emotions, and are regarded by others as “stable.”

Taken together, the Big Five factors are extremely useful for understanding people’s behaviours, thoughts, and emotions, and predicting why people do the things that they do. Nevertheless, despite the usefulness of the Big Five, psychologists often find that there are other personality traits, outside of the Big Five, that are useful for understanding certain things, such as why people do things that are “evil.”

Module 12.1a Quiz: The Trait Perspective

Know . . . 1. Which of the following statements best describes the difference between

the nomothetic and idiographic approaches to personality?

A. The nomothetic approach focuses on traits found across large groups, whereas the idiographic approach focuses on individuals.

B. The idiographic approach focuses on traits found across large groups, whereas the nomothetic approach focuses on individuals.

C. The idiographic approach relies on measures such as the Big Five, whereas the Big Five is of no use to a nomothetic approach.

D. The idiographic approach allows psychologists to ask questions about the genetic and cultural basis of personality traits.

Understand . . . 2. is the Big Five factor that will likely have the greatest influence

on whether you get along with the people you work with.

A. Agreeableness B. Extraversion C. Openness D. Neuroticism

Apply . . . 3. You are the type of person who tends to go to the same restaurant and

order the same thing, sticking to your daily routine. You have even turned down opportunities to travel to new destinations. Which of the Big Five

factors best relates to this description of your personality?

A. Agreeableness B. Conscientiousness C. Openness D. Neuroticism

Beyond the Big Five: The Personality of Evil?

Most people struggle when they think about truly destructive human behaviours: child abuse, wartime atrocities, the Holocaust, 9/11. The more horror we allow

ourselves to contemplate, the more we must ask why? Why do people do such terrible things?

Following World War II, such questions were a major focus in personality psychology, as the world wanted to understand the rise of fascism and Hitler’s ability to mobilize millions of people to carry out his plans of destruction. Early research by Theodore Adorno suggested that a key personality type, the

authoritarian personality, was a big piece of the puzzle. Authoritarians were theorized to be rigid and dogmatic in their thinking, to separate their social world

into strict categories of Us and Them, and then to believe strongly in the superiority of Us and the inferiority of Them. As a result, authoritarians were more likely to endorse and engage in prejudice and violence, particularly toward

people in the “them” category (Adorno et al., 1950). Although there is some overlap between this construct and other, related personality factors (e.g., openness to experience), over the past several decades, personality researchers have discovered important personality traits that extend the Five Factor Model and help to shed light on the problem of human “evil.” Three lines of research are particularly important.

Honesty–Humility

First, Michael Ashton at Brock University and his colleagues have developed the HEXACO model of personality , a six-factor theory that generally replicates the five factors of the FFM and adds one additional factor: Honesty–Humility. Individuals scoring highly on this factor (high HHs) tend to be sincere, honest,

and modest, whereas those with low scores (low HHs) are deceitful, greedy, and

pompous (Ashton & Lee, 2007). Whereas high HHs are more likely to perform altruistic, pro-social behaviours, low HHs harbour more selfish, anti-social, and

violent tendencies (Ashton & Lee, 2008; de Vries & van Kampen, 2010), being more likely to “do whatever it takes” to get what they want, to manipulate others,

and to break the rules (Bourdage et al., 2007). Interestingly, low HHs feel a strong sense of self-importance and a feeling of entitlement, like they deserve to have their desires fulfilled. Thus, the HEXACO model seems to describe “evil” as heavily involving an excessive importance placed on the self, and none placed on the other (except in terms of how the other can be used to further the goals of the self).

The Dark Triad

A different set of research studies conducted at the University of British Columbia has uncovered three traits that are believed to be central to

understanding the personality roots of evil. This Dark Triad — Machiavellianism, psychopathy, and narcissism—describe a person who is socially destructive, aggressive, dishonest, and likely to commit harm in general (Paulhus & Williams, 2002). Taken together, these traits also describe a person who gives excessive importance to the self, and little to no importance to others.

Machiavellianism is a tendency to use people and to be manipulative and deceitful, lacking respect for others and focusing predominantly on one’s own self-interest. Relationships are approached strategically, using other people for how they might be able to provide some sort of benefit to the self.

Psychopathy is a general tendency toward having shallow emotional responses. Individuals scoring high in psychopathy veer toward highly stimulating activities and tend to feel little empathy for others. They often get a thrill out of conflict, exerting control, or even harming others, and feel little remorse for their actions.

Narcissism reflects an egotistical preoccupation with self-image and an excessive sense of self-importance. The extreme narcissist is “full of himself” (or herself). In Greek legend, the hunter Narcissus was filled with excessive pride

and adoration toward himself. This was his fatal flaw, however, as he was so transfixed by his own gaze reflecting in a pool of water that he died by the poolside, still staring at his reflection. Narcissists can often be charming, but are difficult to have as relationship partners because they tend to always put themselves first rather than considering their partner’s needs.

Considering these traits separately yields some important insights; for example, people high on different traits may become aggressive for different reasons

(Jones & Paulhus, 2010). But their real power comes when you consider them all together. The convergence of these three factors, the Dark Triad, strongly predicts anti-social tendencies. People who score highly on all three of the Dark Triad traits are substantially more likely to commit harm to others, having little empathy or other constraints to prevent them from doing so.

Right-Wing Authoritarianism

In a third line of research, Bob Altemeyer at the University of Manitoba has

identified Right-Wing Authoritarianism (RWA) as a problematic set of personality characteristics that also predisposes people to certain types of violent or anti-social tendencies. RWA involves three key tendencies:

1. obeying orders and deferring to the established authorities in a society; 2. supporting aggression against those who dissent or differ from the

established social order; and 3. believing strongly in maintaining the existing social order (Altemeyer,

1996).

At the centre of the RWA personality is a strong tendency to think in dogmatic terms, where, metaphorically speaking, everything is either black or white, with no shades of grey. RWAs tend to hold strong beliefs and are highly resistant to

changing them (Altemeyer, 1996). They are generally more prejudiced, tending to negatively judge people who hold different perspectives from them (see Module 13.2 ). As a result, RWAs are likely to advocate a harsh stance toward people who deviate from the established social order, such as political activists,

feminists, atheists, and members of ethnic minorities (Goodman & Moradi, 2008; Haddock et al., 1993; Narby et al., 1993). Given their unquestioning acceptance of authority figures, high RWAs are more likely to agree with

unethical decisions made by leaders (Son Hing et al., 2007), and to have positive attitudes toward corrupt governments (Altemeyer, 1996).

As a result of these tendencies, high RWA individuals were likely instrumental in the rise of fascism that led to World War II, and will likely play important roles in the repressive dictatorships, destructive business practices, and unhealthy family structures of the future.

The theory of Right-Wing Authoritarianism also shares with the previous two theories an emphasis on people placing excessive emphasis on their own self- importance. In the case of RWA, this manifests as excessive certainty and unwavering conviction in one’s personal opinions, coupled with strong in-group favouritism and beliefs that are prejudiced and derogatory towards members of other “out-groups.”

Working the Scientific Literacy Model Right-Wing Authoritarianism at the Group Level

What do we know about RWA? As we discussed above, personality researchers have identified RWA as a cluster of characteristics that make society a less warm and friendly place, being related to generally harmful tendencies such as holding prejudiced views against other groups and an excessive and closed-minded allegiance to societal conventions. It’s relatively easy to imagine how people who are high in RWA might end up behaving in social situations. But it’s another thing entirely to consider what could happen in situations involving lots of people high in RWA. When a group of closed-minded, prejudiced, violence-prone individuals get together, what could possibly go wrong?

How can science determine how RWA affects groups?

In one fascinating and highly disturbing study, Altemeyer (1996) selected high- and low-RWA participants to play a complex role- playing simulation of the Earth’s future, called the Global Change Game. This game is generally played by 50–70 people who are organized into groups that represent different regions of the world; these groups then make decisions about how their region behaves on the international stage. For example, participants decide how their region will deal with problems such as environmental degradation, poverty, overpopulation, and military threats. The simulated conditions of the Earth change depending on the actions of the players, thus providing a fairly realistic simulation of the challenges of governance in the international community.

In order to test how RWAs play the game, Altemeyer ran through the game two times, once with 67 individuals who scored very low on the RWA scale, and once with 68 people who scored very high. Each simulation covered 40 years of time into Earth’s future. The results were, frankly, astonishing.

In the low-RWA group, there were no wars or military build-up over the 40-year time period. Instead, regions steadily downsized their militaries and diverted the money into humanitarian and environmental projects. They also collectively resolved challenges through international meetings and cooperation. At one point, a global crisis occurred due to a threat to the Earth’s ozone layer; players responded by holding a group meeting, and agreeing to make large investments in technology development so that they could collectively solve the problem. By the end of the game, food, health services, and jobs were provided for almost all people on Earth, resulting in a peaceful, stable world.

In the high-RWA group, players tended to interpret the actions of

others as aggressive and responded in kind. Militaries quickly grew and war ensued, leading to a global nuclear war that wiped out every human being on the planet. At this point, the players were given a second chance to play, starting at a point prior to the nuclear war. Despite having the chance to learn from their earlier mistakes, the players nevertheless were incapable of getting along with each other. When the ozone crisis occurred, no international summit was called and only one region took action to avert the crisis. Instead of cooperation, players remained suspicious of each other and rapidly developed their militaries. One major military conflict killed 400 million people, and players poured so much money into military expenses that devastating social and environmental problems were never dealt with. At the end of the 40-year period, the world was again divided into armed camps on the brink of all-out war.

At the very least, this simulation suggests that we have to consider not only how factors like RWA operate in isolation, but how they operate in interaction with other people in real situations. Studying how personality characteristics operate on more collective scales is a major new frontier for the personality field that needs further exploration. It also suggests that we need to think carefully, as a society, about the personality characteristics of the people we allow into positions of power. Because these simulations suggest quite strongly that if several highly authoritarian leaders ended up in some sort of conflict, they may be highly prone to escalating conflicts to acts of extreme violence.

Can we critically evaluate this research? There are several methodological limitations to this study that should be taken into consideration when evaluating the findings. First, there are external validity concerns; for example, playing a game with no real consequences does not necessarily indicate how people would respond in a real-life situation. It is possible

that in a real situation, people would be more sensitive to the consequences of their actions and would not be so willing to risk human lives. Furthermore, the simulations were only performed on one night with each group; therefore, results could have been due to chance factors, such as particular individuals having a strong impact on the outcomes. Also, because only university students participated in the study, the results may not generalize to the rest of the population. Obviously, this was not a highly controlled set of studies, and the findings must therefore be interpreted very cautiously. However, as a case study of this particular type of competitive circumstance involving high- and low-RWAs, the results remain quite alarming and suggestive.

Why is this relevant? This research illustrates the highly destructive impact that authoritarian personalities may have in group settings, and it sounds a clear bell of warning in the 21st century. We are living in a time in which our world faces unprecedented challenges that require international cooperation, yet intolerance and intergroup hostilities are rampant and ideological fundamentalism and fanaticism heavily influence politics in many countries. Greater understanding of the potential roots of intergroup hostility in individuals’ personalities is urgently needed at this time.

Module 12.1b Quiz:

Beyond the Big Five: The Personality of Evil?

Know . . . 1. How does the HEXACO model of personality differ from the Big Five

factors?

A. HEXACO is a nomothetic model whereas the Big Five is an

idiographic model.

B. The Big Five model includes five traits whereas the HEXACO model explains personality using three traits.

C. HEXACO is the only personality theory to include psychopathy. D. HEXACO includes a sixth personality trait: honesty–humility.

Understand . . . 2. One reason for going beyond the Big Five, such as the three lines of

research on Honesty–Humility, the Dark Triad, and Right-Wing Authoritarianism, is

A. they predict anti-social tendencies, such as violence and prejudice, better than the Big Five traits.

B. they are idiographic approaches, which supplement the nomothetic approach taken in the Five Factor Model.

C. these three theories account for states and situational factors, whereas the Big Five does not.

D. these three theories can be used to diagnose personality disorders that could justify preventative action, such as incarcerating “dangerous” personalities before they are able to commit any crimes and cause harm to others.

Apply . . . 3. Lisa and Elaine work at the same place and were both being considered

for a promotion. In order secure the promotion for herself, Lisa told her bosses lies about Elaine being selfish and difficult to work with. As a result, Elaine did not receive the promotion. Lisa’s behaviour is an example of which personality trait?

A. Machiavellianism B. Psychopathy C. Neuroticism D. Humility

Personality Traits over the Lifespan

Have you ever looked back on something you wrote several years ago, perhaps

in a diary or journal, and wondered, “Who was that person who wrote these things?” Or maybe you have looked back at someone you once dated and wondered, “Who was I when I chose to date that person? It certainly wasn’t ‘me’!” One of the most fascinating issues in personality psychology is whether we stay basically the same, or whether our fundamental personalities change as we age.

Temperaments

A mountain of research from different areas within psychology has revealed considerable stability in our personalities. In fact, given the large genetic contribution to personality factors, our personalities start even before we are

born, so could be expected to remain largely stable over time (Plomin & Caspi, 1999; Yamagata et al., 2006).

In child development studies, researchers have found that infants possess

different temperaments right from birth, which also supports the view that the seeds of our personalities are present right from the start. Infants display their temperamental differences along dimensions such as activity level, mood,

attention span, and distractibility (Rothbart & Bates, 2006; Thomas & Chess, 1977). As most parents with multiple children can attest, kids come “hard-wired” to be a certain way. Some infants are generally active and happy, whereas others are more tranquil, and still others are easily upset. So, if you’re a parent pulling your hair out with your chronically distressed child who seems impossible to deal with, don’t judge yourself too harshly. Remind yourself that infants have different temperaments and your power as a parent is small compared to the power of their genes.

Thus, temperament seems to represent an innate, biological foundation upon which personality is built. This, combined with the genetic research, suggests that personality traits should be stable over time. To some extent, research confirms that this is the case: Infant temperament predicts the adult personality

traits of neuroticism, extraversion, and conscientiousness (Evans & Rothbart, 2007).

One amazing study that followed the same children from age 3 until adulthood showed that temperament at 3 years of age was strongly predictive of

behavioural tendencies, personality, and life outcomes many years later (Caspi, 2000). Three main temperaments were identified: well-adjusted (capable of self- control, confident, not overly upset by new people or situations); under-controlled (impulsive, restless, distractible, emotionally volatile); and inhibited (socially uncomfortable, fearful, easily upset by strangers). Just over 10 years later, children of different temperaments had developed quite different behaviour

patterns. The under-controlled children (relative to the other groups) had become the most likely to engage in externalizing behaviours (fighting, lying, disobeying), whereas the inhibited children developed mainly internalizing behaviour patterns (e.g., worrying, crying easily). By age 18, their emerging adult personalities were reflections of their temperaments at age 3.

Is Personality Stable Over Time?

There are a number of factors—both behavioural and biological—that make personality stable over time. Personality processes tend to become self- perpetuating; personality traits that lead to behaviours that receive positive reinforcement are more likely to become stable characteristics of that individual

(Heatherton & Weinberger, 1994). As an example, take the personality factor of conscientiousness. As we discussed earlier, highly conscientious people will tend to be organized, punctual, and dependable; they are therefore more likely to succeed, be respected by others, and create professional opportunities for themselves. As they experience success, this feeds back to reinforce those qualities.

You can also understand how “personality is destiny” by considering the basic insight of neuroscience: neurons that fire together wire together. Thus, we know that the more that people practise a certain skill, the more they train their brains to be good at that skill. Similarly, the more that people practise being extraverted, open-minded, conscientious, agreeable, or neurotic, the more they train their brains to function in that manner. This can also be seen as a positive feedback system; personality structures influence patterns in the person’s life and build networks in the person’s brain in ways that reinforce themselves, leading

personality to be quite stable over time. Consistent with this view, researchers analyzing the results of over 150 studies involving almost 50 000 participants found that personality stability is lowest for young children and highest for people

over 50 (Roberts & DelVecchio, 2000).

However, research has also shown that personality can change, particularly in late adolescence and early adulthood. For example, young adults tend to experience fewer negative emotions than do adolescents, reflecting decreases in neuroticism. Also, conscientiousness, agreeableness, and social dominance (an

aspect of extraversion) all increase in early adulthood (Roberts et al., 2006; see Figure 12.2 ). Take a moment and consider why personalities change in these systematic ways over time. One likely explanation is that, over time, our environments change and so do the roles we play in those environments. For example, adults have to be more conscientious than children because they have so many more responsibilities—like taking care of their unconscientious children! Over time there are many such changes—in our environments, our social roles, the amount of choice and power we have, the sophistication of our thinking processes, the development of our bodies and brains, and many other things— so there may be many reasons why personalities change over time.

Figure 12.2 Personality Stability and Change over the Lifespan

Average scores of Big Five traits change over the lifespan. Generally, most traits become more positive through adulthood, although there are anomalies. Social dominance (an aspect of extraversion) remains stable after age 40. Conscientiousness does not begin rising until after the college years. Openness to experience only rises up to the college years, then remains largely stable until

old age, when it declines (Roberts et al., 2006). Source: Based on Roberts, B., Walton, K., & Viechtbauer, W. (2006). Patterns of mean-level change in personality traits

across the life-course: A meta-analysis of longitudinal studies. Psychological Bulletin, 132 (1), 1–25.

Nevertheless, even these data describe a kind of personality stability, in that although people’s personality traits may fluctuate over time, their rank ordering in the population remains very stable. That is, people who are more extraverted than others at time one also tend to be more extraverted than others at time two, even though the overall level of extraversion may change over that time period

(McCrae & Costa, 1990).

Personality Traits and States

Trait labels may go a long way toward describing what people are like. However, many psychologists are quick to point out that no matter how useful traits may seem, people’s behaviour is also determined by situational factors and context. You may know someone whom you would describe as very calm and tranquil, yet one day he curses and screams at other drivers on the road. In contrast to a

personality trait, a state is a temporary physical or psychological engagement that influences behaviour. Perhaps your normally calm friend lashed out at other drivers on the road because he was criticized earlier that day or made a mistake that made him feel foolish, and so he was defensively displacing his bad feelings onto other people. Even people who seem highly consistent in how they express their neuroticism, agreeableness, or extraversion will not behave in the same way across all situations, and this observation has led to some strong criticisms

of trait theories of personality (Mischel, 1968; Mischel & Shoda, 1998). However, we generally understand now that states and traits work together; traits describe a person’s general personality tendencies, whereas states describe what that person is like in specific sets of circumstances.

The specific ways in which states and situational factors interact to influence us is a challenging topic that research has only begun to scratch the surface of. Try to think of the number of different situations or states you find yourself in across any average day. For example, you can be awake, asleep, or half-asleep; happy; sad; excited; skeptical; embarrassed; confident; or unsure of yourself. You could be having a crisis or you could be completely relaxed. The list could go on forever—and as you might have guessed, psychologists have tried to see just how long it goes. In one study, 77 college students were asked to describe as many situations as they could that they might encounter. Their total reached more than 7000. Perhaps you can now see why many psychologists would

rather focus on five personality dimensions. Fortunately, Saucier and colleagues (2007) took these 7000 situations and reduced them to four general aspects of situations that are most likely to influence our behaviour:

1. Locations (e.g., being at work, school, or home) 2. Associations (e.g., being with friends, alone, or with family) 3. Activities (e.g., awake, rushed, studying) 4. Subjective states (e.g., mad, sick, drunk, happy)

These situations influence how and when our personality traits are expressed. Identifying these situations is important because they interact with personality traits to determine our behaviour.

Module 12.1c Quiz:

Personality Traits over the Lifespan

Know . . . 1. Which of the following is not a situational factor that is likely to influence

your behaviour?

A. The location in which a behaviour is being performed B. The degree to which you are an extravert C. Whether you are drunk or sober D. The people that you are with at the time

Understand . . . 2. In studies of children’s temperament, which label would most likely be

applied to children who tended to be impulsive, restless, and distractible?

A. internalized B. well-adjusted C. inhibited D. under-controlled

Analyze . . . 3. Your friend, who is normally introverted, is outraged at the taxi driver who

is trying to overcharge you. He is cursing at the driver in a verbal

altercation. This event is most likely due to his . A. temperament B. subjective state C. idealized self D. Big Five personality traits

Behaviourist and Social-Cognitive Perspectives

You probably didn’t have much trouble understanding the trait perspective to personality; indeed, using traits to describe people is something we do regularly, particularly in Western cultures. However, the trait approach does tend to reinforce certain assumptions that other psychologists have called into question. Most importantly, the trait approach reinforces the assumption that we carry our personality characteristics around inside us; we treat traits like they are “things” that we “have,” which then influence our thoughts, feelings, and behaviours. This approach does not examine how personalities are influenced by our experiences.

The Behaviourist Perspective

The behaviourist would note any identifiable patterns of behaviour and seek to understand how that behaviour was elicited by specific environmental conditions. Notable psychologist B. F. Skinner, for example, believed that “personality” is simply a description of the response tendencies that occur in different situations. For example, when with a group of people, your behavioural responses to that situation might include dominating the conversation, asking a lot of questions, laughing along at other people’s jokes, or generally remaining silent. Presumably, the behaviours you engage in are based on your past experiences; if you tend to dominate the conversation and laugh at people’s jokes, then you were likely reinforced for those behaviours in the past. A behaviourist might note that using the personality dimension of “extraversion” is an unnecessary addition —it is just a label that does not help us understand the simple relationship

between stimulus and response (Figure 12.3 ).

Figure 12.3 Behavioural and Social-Cognitive Approaches to Personality (a) Behaviourist Account of Personality. Behaviourists thought that what psychologists call personality was an expression of relationships between behaviour, rewards, and punishment. Behaviourists avoided referring to personality traits and dispositions, instead focusing on how past experiences predict future behaviours. For example, whether someone tends to be pessimistic might be based on past experiences of feeling a lost sense of control.

(b) Reciprocal Determinism and the Social-Cognitive Approach. According to Albert Bandura and colleagues, personality is a product of dynamic interactions between behaviour and reinforcement, and, importantly, the beliefs, expectancies, and dispositions of the individual. Source: Ciccarelli, Saundra K.; White, J. Noland, Psychology: An Exploration (Subscription) 2nd Ed., ©2012. Reprinted and

Electronically reproduced by permission of Pearson Education, Inc., New York, NY.

The Social-Cognitive Perspective

In the mid-20th century, behaviourism gave way to the emerging social-cognitive perspective; this had a major impact on our understanding of personality. Specifically, the social-cognitive theorists, like Albert Bandura, placed central importance on the role of cognition and the person’s inner subjective interpretation of their circumstances. No longer was the individual simply an object, affected by environmental circumstances; now the person became an agent, actively constructing meaning out of her circumstances, and then making choices to behave in ways that affect those circumstances. From a social-

cognitive perspective, what became clear was the relationship between the person and the environment, plus how this relationship is bound up with the person’s thoughts and interpretations.

According to Bandura’s social-cognitive theory, personality develops out of the person’s interaction with the environment, but where this differs from

behaviourism is that the person ends up forming beliefs about their relationship to the environment, especially beliefs about their own actions and the likely consequences that will follow from their choices. For example, Bandura was

keenly interested in the concept of self-efficacy, the belief that ones’ attempts to accomplish a specific task will be successful. People with a higher degree of self- efficacy are far more likely to take action, especially difficult actions where the rewards are not immediately obvious, whereas people with little self-efficacy for a task will be unlikely to try, and will give up more easily. Thus, Bandura emphasized how beliefs, such as self-efficacy beliefs, form out of our interactions with the environment. These beliefs then become their own causal force, exerting influence over our behaviours and how we interact with the

environment.

If you put all this together, you can see how Bandura saw personality as a kind of integrated web of many different processes. His central idea was called reciprocal determinism , based on the idea that the person and the environment co-create each other; thus personality is what emerges from the

interactions between behaviour, internal (personal) factors, and external (situational) factors, all of which mutually influence each other (see Figure 12.3 ). The ultimate goal of a social-cognitive perspective is to achieve a fully holistic understanding of the person as a system of interdependent processes.

Researchers like Bandura appreciated the added insight that was encouraged by taking a social-cognitive approach to understanding people. Focusing on thoughts and beliefs opened up whole layers of beliefs, interpretations, expectations, and biases for consideration. For example, examining a person’s beliefs may reveal that they think they are worthless, that other people generally won’t like them, that they tend to mess things up, or have other self-defeating convictions. These beliefs may be the most important force keeping their “personality” (i.e., their pattern of interaction with the environment) from changing. The hope, therefore, is that by learning to change some aspects of the social-cognitive system, such as self-defeating beliefs, the whole system can change.

For example, imagine a person who is highly neurotic (from a trait perspective). Knowing this may make the person want to improve and become less neurotic and unpleasant to be around. But, this doesn’t really give much guidance as to how to actually DO this. What is one supposed to change, in order to “be a different person?”

A social-cognitive theorist like Bandura would take a look at the processes through which the person seemed to express and reinforce their neuroticism. Perhaps the person holds certain expectations, like fear-based beliefs that things will generally turn out poorly, or that other people can’t be trusted to do the right thing. As a result, the person feels a lot of anxiety and tries to deal with this by controlling things around them, thus developing a pattern of being controlling,

critical, and unwilling to trust or rely on others. As you start to “unpack” this whole system of self-reinforcing beliefs and behaviours, you find the specific factors that could help that person change. For example, perhaps this specific person could examine the beliefs they hold about trusting other people and identify how these are connected to other beliefs (e.g., “I will do a better job if I do it myself”), which in turn are connected to other beliefs (e.g., “If I mess things up, people will be angry with me”). Through this kind of “analysis” of related beliefs, the person uncovers specific leverage points—processes that they can change that will then change their belief system.

Module 12.1d Quiz:

Behaviourist and Social-Cognitive Perspectives

Know . . . 1. Which of the following concepts developed by Bandura refers to

interactions that occur among behaviour, internal factors, and external factors as an explanation for personality?

A. Reciprocal determinism B. Positive psychology C. Intersubjectivity D. Egocentrism

Understand . . . 2. Kaitlin describes herself as unmotivated. She has not felt rewarded by

her attempts to succeed at school or work and, therefore, has given up trying. How might a psychologist who adopts a strict behaviourist approach account for Kaitlin’s behaviour?

A. Kaitlin believes that she cannot succeed and, therefore, avoids putting herself in situations where she might fail.

B. Kaitlin has a history of not being reinforced for trying to succeed and, therefore, has stopped trying.

C. Kaitlin focuses too much on negatives and does not have a positive outlook on life.

D. Kaitlin has low levels of the trait known as extraversion.

Analyze . . . 3. Alternative approaches to personality such as the behaviourist and

cognitive approaches complement trait theories of personality because

A. these alternative approaches help to account for how traits interact with behaviour and personal experience.

B. trait theories focus on the negatives of personality. C. it is easier to observe behaviour than to ask someone to fill out a

personality inventory.

D. trait theories focus only on the positive aspects of personality.

Module 12.1 Summary

the Dark Triad

factor analysis

Five Factor Model (FFM)

HEXACO model of personality

idiographic approach

nomothetic approach

personality

personality trait

reciprocal determinism

Right-Wing Authoritarianism (RWA)

state

Know . . . the key terminology associated with contemporary approaches to personality.

12.1a

Understand . . . the behaviourist and social-cognitive views of personality.

12.1b

A strict behavioural account of personality identifies the stimuli that control a person’s responses. From a behaviourist perspective, there is little need for trait terminology, such as neuroticism or conscientiousness, and no reference to cognitive factors such as beliefs or thoughts. The social-cognitive approach to personality instead emphasizes that situations, behaviours, and thoughts reciprocally determine each other.

Psychologists usually describe individuals based on their scores on personality tests involving the Big Five traits, such that someone might rate high, medium, or low on each trait.

Apply Activity Use Table 12.2 on page 504 to describe your own personality in terms of the Big Five, and cite examples of specific behaviours and habits that correspond to

each trait. Before you begin this exercise, review Figure 12.1 , which outlines some of the major characteristics of high and low scores on each of the five factors.

Table 12.2 Applying the Five Factor Model For each trait, try to determine if you would score low, medium, or high if you were to complete a test based on the Five Factor Model. Cite specific examples of behaviours and preferences that support your ranking.

Factor Low / Medium / High Specific Examples

Openness

Conscientiousness

Extraversion

Agreeableness

Apply . . . the Big Five personality traits to understand your own personality.

12.1c

Neuroticism

Canadian researchers have identified three sets of factors that predict violence and prejudice that are not fully captured by the Five Factor Model. The first is the Honesty–Humility dimension of the HEXACO model of personality. The second is the Dark Triad of psychopathy, Machiavellianism, and narcissism. The third is Right-Wing Authoritarianism. Research has found that these traits predict many dysfunctional patterns of thoughts, emotions, and behaviours. Understanding the causal underpinnings of these traits and developing strategies to help individuals with such personality traits would be a key advance in promoting a healthier and more peaceful society.

The debate over whether personality traits influence behaviour or whether situational factors play a bigger role in behaviour is ongoing in the field of personality psychology. In reality, both sets of factors are important. Personality traits can be remarkably consistent, yet the situations we find ourselves in can lead to unexpected behaviour.

Analyze . . . the personality roots of violence and prejudice.12.1d

Analyze . . . the relative roles of personality traits and psychological and physical states in determining behaviour.

12.1e

Module 12.2 Cultural and Biological Approaches to Personality

Christopher Futcher/E+/Getty Images

Learning Objectives

Know . . . the key terminology associated with cultural and biological approaches to personality. Understand . . . how evolutionary theories explain personality.

12.2a

12.2b

Apparently, if you’re travelling abroad, it is a good idea to sew a Canadian flag somewhere onto your backpack. The reason is that people in most parts of the world, people believe that Canadians are generally nice, polite, and friendly. So, wearing the maple leaf should elicit positive responses from other people.

Are these beliefs about Canadians true? Obviously, there are all sorts of different people living in a country. Nevertheless, there does often seem to be a kind of “national character,” doesn’t there? Just try this—imagine the prototypical Swedish person. Now notice what came to your mind. The manic Swedish chef? Icy blond supermodels drinking vodka in a snowbank and looking at you with cool disdain? Now imagine a British person. Japanese? Australian? Iraqi? Jamaican? Did you find that specific types of people popped into your head for each example? Whether we endorse specific stereotypes or not, we certainly have absorbed basic sets of beliefs about people from different cultures, and they tend to come to our minds. But are these ideas accurate? Is there such a thing as “national character” that applies to entire populations?

These questions are extremely interesting but unfortunately, we don’t yet have all the answers. Personality psychologists are extensively studying cultural differences and similarities in personality and are working to understand how broad cultural forces interact with other factors to give rise to our personalities. In this module, we will explore the convergence of cross-cultural, evolutionary, and biological perspectives. By the end, we will have a better understanding of how these factors interact.

Focus Questions

Apply . . . your knowledge to understand how arousal is related to extraversion. Analyze . . . claims that males and females have fundamentally different personalities. Analyze . . . the genetic basis of personality.

12.2c

12.2d

12.2e

1. Does culture influence the types of personality traits we find across human societies?

2. How do evolutionary and biological approaches add to our understanding of personality?

Culture and Personality

Would you say Americans are WEIRD? It’s okay, don’t feel uncomfortable; this is a bit of a trick question. In this particular case, “WEIRD” stands for “Western, Educated, Industrialized, Rich, and Democratic.” So yes, it would be fair to say that, on average, people from several different cultures are WEIRD—Canadians,

Western Europeans, Australians, and definitely Americans (Henrich et al., 2010).

So, why does this matter? Consider this: Do you think there are any major differences between people who are WEIRD and people who are not? Of course there are. An “average” Torontonian likely would have very little in common with an “average” rural Mongolian farmer, for example.

Now consider that almost everything you know about psychology is based on studying people from WEIRD cultures. One study conducted at the University of British Columbia showed that 96% of psychology studies are conducted on a

mere 12% of the population—the WEIRD ones (Henrich et al., 2010). This means our whole “scientific” understanding of the human animal is based on studying one specific, small, subgroup. Doesn’t that seem a little. . .weird?

At the very least, this reminds us to be cautious in applying findings from psychology studies to the human species at large. It also means that we need to better understand the similarities and differences between people in different cultures. For example, in terms of personality, one starting place would be to examine whether there are any important differences between the WEIRD and

everyone else.

Universals and Differences Across Cultures: The

Big Five

The Five Factor Model of personality centres around five personality dimensions: neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness. However, because these factors were discovered by researchers working in WEIRD places—the United States, Canada, and Europe —it is possible that the Five Factor Model only accounts for personality in WEIRD populations and may not apply to the rest of the world.

To find out whether the Big Five traits are truly universal, an enormous team of psychologists (there were 127 authors on this single article) measured the Big Five dimensions in more than 17 000 people speaking 28 different languages and inhabiting 56 countries on 6 continents (they did not visit Antarctica). In all cultures that were studied, the Big Five factors were reliably found. Despite the many differences that may exist between cultures, the people in those cultures

do appear to share the same basic personality structures (McCrae et al., 2005; Schmitt et al., 2007). This is an incredible finding, suggesting that the basic systems in the human personality are, in a sense, deeper than culture. Although individual personalities differ enormously, the basic machinery of the human personality system seems universal.

Personality Structures in Different Cultures

The study described above is groundbreaking in its global scope, but a key methodological challenge remains. Because the Five Factor Model was originally created by performing a factor analysis of the personality adjectives in the English language, the kinds of questions that are asked on Big Five questionnaires are designed to measure the Big Five factors, and no others. Thus, when the scale is given to people from other cultures, the scale itself brings the biases of Western culture and the English language right along with it. What if other languages used different types of adjectives to describe

personality? What if other cultures had different personality traits than the ones that emerge in the West? Re-analyzing personality from different linguistic starting points might reveal new personality factors that lie outside of the Big Five.

Researchers have begun to address this limitation, analyzing personality structure using personality descriptors in other languages; this work has already

revealed unique personality factors not captured in the Big Five (Heine & Buchtel, 2009). For example, Cheung and colleagues (1996) examined indigenous Chinese personality traits, looking for patterns among the personality descriptors used in Chinese, rather than English. They found 26 new personality traits in total, and when they performed a factor-analysis on all the traits including these 26 new ones, they found a quite different structure from the Big Five.

Instead of five traits, these researchers found four: dependability, social potency, individualism, and interpersonal relatedness. The first three traits were very similar to three of the Big Five traits (neuroticism, extraversion, and agreeableness, respectively), but the fourth, interpersonal relatedness, was unique. Interpersonal relatedness is a combination of characteristics concerning social harmony, tradition, and an emphasis on one’s social relationships. This may reflect a distinct personality dimension in the Chinese psyche, emphasizing the more socially interdependent nature of the self in this culture.

Other researchers have added to our multicultural understanding of personality, analyzing the personality traits found in Filipino, Spanish, and Greek languages,

and seeking a more integrated cross-cultural theory of personality (Benet- Martinez & John, 1998; Church, 2001; Saucier et al., 2005). Each analysis has revealed new factors that seem to be independent of the Big Five.

Cross-cultural work on personality is still in its infancy, and clearly, many questions remain. At this point, most psychologists would agree that the Five Factor Model captures important and perhaps universal dimensions of personality, but also might miss important cultural- specific qualities that can only be understood by analyzing personality from that culture’s own perspective.

Comparing Personality Traits Between Nations

Despite the difficulties noted above, one important advantage of personality scales that have been translated into different languages is that psychologists can test for personality differences across cultures. Many such differences have been found. For example, consider the countries with the highest and lowest

averages on each of the Big Five traits in Table 12.3 (Schmitt et al., 2007). (Interestingly, Canada falls roughly in the middle in each case.)

Table 12.3 Cultural Differences in the Big Five Personality Traits Source: Based on data from Schmitt, D. P., Allik, J., McCrae, R. R., Benet-Martinez, V., et al. (2007). The geographic

distribution of Big Five personality traits: Patterns and profiles of human self-descriptions across 56 nations. Journal of Cross-

Cultural Psychology, 38, 173–212.

Highest Lowest

Extraversion Serbia, Croatia Bangladesh, France

Openness Chile, Belgium Hong Kong, Japan

Agreeableness Jordan, Democratic Republic

of the Congo

Japan, Lithuania

Conscientiousness Ethiopia, Democratic Republic

of the Congo

Japan, South Korea

Neuroticism Japan, Argentina Democratic Republic of the

Congo, Slovenia

Biopsychosocial Perspectives How Culture

Shapes Our Development: Cultural

Differences in the Self

During the 2000 Olympics in Sydney, Australia, two gold-medal–winning athletes were interviewed about their success. In explaining her success during the race, Misty Hyman, who won the 200-metre butterfly for the United States, said, “I think I just stayed focused. It was time to show the world what I could do. I am just glad I was able to do it. I knew I could beat Suzy O’Neil, deep down in my heart I believed it, and I know this whole week the doubts kept creeping in, they were with me on the blocks, but I just said, ‘No, this is my night.’”

In contrast, Naoko Takahashi, after winning the marathon for Japan, said, “Here is the best coach in the world, the best manager in the world, and all of the people who support me—all of these things were getting together and became a gold medal. So I think I didn’t get it alone, not

only by myself” (Markus et al., 2006).

This striking example illustrates how people’s behaviour can be shaped by broad cultural factors. Misty Hyman, from the individualistic United States, seems to be more self-promoting, explaining her success as being due to her own characteristics, her willpower, and belief in herself. Naoko Takahashi, from collectivistic Japan, takes her moment of Olympic glory as an opportunity to highlight the ways in which she was assisted by so many people in her life, de-emphasizing her own contribution in favour of honouring others.

Whether a culture predominantly emphasizes individualism or collectivism has many effects on personality, affecting how people see themselves and how they behave in many situations. Researchers have found that when describing themselves, predominantly individualistic people use more personal adjectives (e.g., “I am extraverted”; “I have a good sense of humour”). Predominantly collectivistic people tend to describe themselves more relationally, in terms of their connections to other people (“I am a son”; “I am a sister”), and their affiliations with specific social groups (“I am Canadian”; “I am a Trekkie”).

This difference in self-definition results in differences in the stability of personality across different situations. The individualistic person is the

same across most situations, whereas the more collectivistic person feels that who you are depends on who you’re with; the self that you are emerges within a social context and is attuned to that context.

Perhaps because they define their self-concepts more rigidly, individualistic people are more likely to be defensive in specific ways. To the collectivistic person, the self is fluid and changeable from situation to situation; thus there is not the same need to defend a single specific self- concept. But to the individualist, the self is supposed to exist as a separate “thing,” one that persists from situation to situation, and as a result, individualists have a stronger need to maintain a positive view of their self-concepts. Individualists are likely to emphasize their positive qualities. And, as with Misty Hyman, when things turn out well for them, they take most of the credit themselves. On the other hand, if the individualist fails, they are pretty good at finding other circumstantial

factors to blame (Heine, 2003; Markus & Kitayama, 1991).

The influence of culture can even be seen in the brain. In one study

(Chiao et al., 2009), participants were put into fMRI scanners to monitor their brain activity while they made judgments about different sentences. In order to manipulate whether subjects were thinking of themselves in a more individualistic or collectivistic manner, researchers asked subjects to make different types of judgments about the sentences. For some sentences, they judged the degree to which it described them in general (individualistic-self task), whereas for others they judged how well it described them when they were with their mothers (collectivistic-self task). Amazingly, their brain scans were able to tell the difference between individualists and collectivists. In the brain, part of the medial prefrontal cortex is involved when processing information related to the self. This area was most active for individualistic participants when they were making judgments about themselves in general, whereas collectivists showed the greatest amount of activation in this area when making judgments about themselves in relation to their mothers. Thus, to individualists, the individualistic task was processed by their brains as most self-relevant, whereas for collectivists, it was the collectivistic task that was most self-relevant.

What do these differences really mean? Do they reflect actual personality differences between the people in those countries? Or could other things account for the findings? Many of the personality differences do seem puzzling. For example, why are Argentinians so neurotic, compared to people from the Democratic Republic of the Congo? Why are the Japanese so much less conscientious than Ethiopians? In fact, many of the findings in these large-scale

cross-cultural studies defy cultural stereotypes (Terracciano et al., 2005), and it is a huge challenge for researchers to understand whether or not these differences are real.

One striking cultural difference that researchers have struggled to understand is

also illustrated in Table 12.3 . Isn’t it interesting that a single country, Japan, ranked lowest of all countries on three out of the five traits (openness, agreeableness, and conscientiousness)? Given the general desirability of these traits, that is a fairly critical evaluation of the Japanese personality! (The fact that they are among the most neurotic countries makes it seem even worse.) In fact, people from the entire South Asian part of the world rated their own personalities relatively negatively. Are these differences real? Is such a vast swath of humanity really so different from the rest of the world? It turns out that there may be a different explanation for at least some of the cultural differences found in personality studies. It is possible that people from different cultures have different response styles —characteristic ways of responding to questions; these response styles can be strongly influenced by cultural norms. For example, in one culture it may be more socially acceptable to say highly positive things about yourself, whereas in another culture the same behaviour may be considered rude or boastful. Indeed, researchers at the University of British Columbia have shown that there are such norms in South Asian cultures, discouraging people from emphasizing their strengths and successes, and instead encouraging

people to be modest, humble, even self-critical (Heine, 2003; Markus & Kitayama, 1991; Mezulis et al., 2004).

An important critique of cross-cultural research is that it may lead to an emphasis on how cultures differ from each other, and obscure the fact that there is so

much individual diversity within a culture that the average differences between

cultures may not be that important after all. Therefore, it is important not to over- emphasize small average differences between groups and unduly reinforce group-based stereotypes.

Consistent with this point, the authors of the huge study discussed earlier finally concluded that the differences found in average trait ratings in different cultures are not sufficiently strong to justify beliefs in national character. “No convincing evidence has demonstrated that beliefs about national character” have any basis

in fact, “despite their wide adoption and resistance to change” (Schmitt et al., 2007). Thus, the very researchers who are looking for cross-cultural differences in personality ended up concluding that these differences are so small that it is misleading to think that people in different cultures are “different types of people.”

Module 12.2a Quiz:

Culture and Personality

Know . . . 1. What does the WEIRD acronym refer to?

A. Psychologists’ preoccupation with abnormal personalities B. A single, specific group on which major perspectives and theories

of personality are based

C. A database that compiles personality profiles from people of all walks of life

D. The application of personality to the various cultures from East Asia

2. Psychologists have primarily relied on to measure personality traits in other cultures.

A. behavioural observations B. interviews C. the Cannon-Bard theory D. the Big Five trait theory

Analyze . . .

3. Results from applying the Big Five personality traits in other countries reveal that

A. people all over the world are identical in the patterns of their personality traits.

B. people all over the world are radically different in the patterns of their personality traits.

C. there are some cross-cultural differences as well as many similarities in the patterns of people’s personality traits.

D. the Big Five was not understood in other parts of the world because of language translation problems.

How Genes Affect Personality

In the first part of this module, we discussed cultural influences on personality. This topic would clearly fall on the “nurture” side of the nature–nurture continuum. In this section of the module, we will examine personality from a different perspective: genetics. We all know that we can inherit physical traits from our parents. But, can you be born with your mother’s sense of humour or your father’s agreeableness? And, is it possible to separate the contribution of your genes from that of your upbringing?

Twin Studies

Researchers attempting to tease apart the contributions made by our genes and our environments faced a key challenge, which was that families share not only genes, but also many environmental factors. For example, if you were to observe a behaviour pattern that runs in families, such as alcoholism or anxiety, you might be tempted to conclude that because of the strong family inclination toward this pattern, there must be genetic roots. But family members also often live in the same home, share many experiences together, and are exposed to many of the same stresses and other circumstances. How then do you know if the pattern you observe is due to the shared genes or the shared environments?

The use of twins as research subjects was a brilliant way of overcoming this

challenge (see Module 3.1 ). Comparing twins who were identical (monozygotic) to twins who were fraternal (dizygotic) allowed researchers to estimate the influence of genetic factors on personality. Research on the Big Five personality traits of twins has shown that identical twins show a stronger correlation for each personality trait than do fraternal twins. The correlations for identical twin pairs are approximately .50 for all five factors, significantly higher than the correlations for fraternal twin pairs (who average approximately .20). This implies that the increased similarity in the personalities of identical twins is due to their shared genes.

But you might ask, how do researchers know that it’s the increased genetic similarity of identical twins that is responsible for their similar personalities? Maybe identical twins also tend to share more similar environments than fraternal twins, and this is the reason for their personality similarity. Identical twins are often treated in very similar ways, especially during their younger and formative years. If this is true, then the strong correlations between identical twin pairs might be environmentally based.

An impressive line of research directly examines this question. The Minnesota Study of Twins Reared Apart located over 100 sets of twins and triplets who were raised in separate households, and compared them to those raised in the

same household. Amazingly, identical twins raised in different households are about as similar to each other as identical twins raised in the same household! In fact, fraternal twins who are raised in the same home are actually more different from each other than identical twins who are raised in completely different

families (Bouchard et al., 1990; Tellegen et al., 1998).

Other studies of adopted children support these findings. On average, the personalities of adoptive parents have no influence on the personality characteristics of their adopted children. Although it may be hard to believe, siblings who are adopted (i.e., not genetically related) and raised in the same

household are no more similar in personality than two people picked randomly off the street (Plomin & Caspi, 1999). The genetic influences on personality are strong indeed (see Module 3.1 for further discussion of the genetic

contributions to behaviour).

Paula Bernstein and Elyse Schein are identical twins who were separated at birth, and upon uniting at age 35 discovered they shared some uncanny similarities. They were editors for their high-school newspapers, chose to study film in university, sucked their fingers but not their thumbs as toddlers, have an odd habit of typing into the air, and share very similar tastes in books, among other similarities. Zak Brian/SIPA/Newscom

It is important to note that this does not mean that parents are incapable of influencing their children’s personality development. Obviously, parents who abuse their children, or on the positive side, parents who put extraordinary efforts into cultivating positive personality traits in their children, are likely to have an impact on their children’s personalities. Knowing that a trait is statistically associated with genetic factors tells you virtually nothing about the extent to which a specific person could be affected by a specific set of environmental conditions. Parents can, of course, have positive or negative influences on their children’s development, and it is important not to deemphasize this when examining biological and genetic studies.

One further challenge of this research is to move beyond estimating the overall

heritability of traits, and begin to uncover which specific genes are linked to personality outcomes. New advances in gene sequencing techniques and molecular genetics methods are allowing scientists to do just that.

Gerald Levey and Mark Newman are identical twins who were reared apart. When they eventually met they had many similarities—for example, both chose

the same profession, loved John Wayne movies and The Three Stooges, and had a fondness for professional wrestling. AP Images

Working the Scientific Literacy Model From Molecules to Personality

It’s pretty mind-blowing to know that who you are was determined to a fair degree before you were even born, by whatever genes you happened to inherit from your parents. Researchers are just beginning to piece together which specific genes influence which traits.

What do we know about specific genes and personality?

Although scientists have not identified a specific gene or genes involved in the expression of specific personality factors, such as neuroticism or agreeableness, they have discovered genes that code for specific brain chemicals that, in turn, are related to personality. For example, one of the genes that codes for serotonin activity has been found on human chromosome 17. Specifically, this gene codes for proteins that transport serotonin molecules within the tiny spaces (synapses) between nerve cells.

Many of our genes are polymorphic (poly = “multiple”; morph = “form”), meaning that there are different versions of the same gene that lead to different physical or behavioural characteristics. Two possible variations of the “serotonin transporter gene” have been identified: a short copy and a long copy.

How do scientists study genes and personality? To study genes and personality, one method is to compare responses on self-report questionnaires of people who have inherited different copies of a specific gene. People who inherit short copies of the serotonin transporter gene from one or both parents seem predisposed to anxiety, shyness, and experiencing negative emotional reactions in interpersonal situations

(Battaglia et al., 2005; Lesch et al., 1996). However, other researchers have suggested that these differences may depend on which of the many different varieties of self-report

questionnaires are used (Schinka et al., 2004).

Another method for studying genes and personality is to conduct experiments and compare the responses of people with different copies of a gene. In one study, participants provided a hair sample so researchers could extract DNA to determine which combination of serotonin transporter genes they had inherited. The participants completed a task that monitored their attentional focus to pictures of positive (e.g., a smiling infant), negative (a black widow spider), or neutral (a kitchen table) stimuli. Previous research has shown that people who have problems with anxiety

focus their attention on threatening stimuli more than non-anxious

people (Bar-Haim et al., 2007). Researchers found that participants who had inherited two long copies of the gene were biased toward looking at positive images more frequently and for longer periods of time. On the other hand, people who inherited one or two short versions of the gene spent more time looking at

negative images (Figure 12.4 ; Fox et al., 2009). It seems that inheriting short copies of this gene increases anxiety levels in general, and seems to steer people toward giving excessive attention to negative and threatening information.

Figure 12.4 Genes, Serotonin, and Personality

People who inherit two copies of the long version of the serotonin transporter gene fixate on positive images and avoid looking at negative images. People who inherit the short version of this gene are not biased toward attending to positive imagery.

Can we critically evaluate this evidence?

It is important to keep in mind that, in most cases, there is no single gene causing a single outcome in a person. Most phenomena are understood to be caused by multiple genes interacting with the environment. At this point the general consensus is that a vast number of genes, each of which has only a very small effect, account for individual differences in

personality (Terracciano et al., 2010). It is also important to note that these are correlational studies, and inferring causality from such data is highly problematic.

Why is this relevant? Knowledge about how genes and personality are related can help psychologists identify risk factors for developing mental disorders. As we will see in other parts of this text, genetic studies of personality help us better understand the biological basis of psychological disorders such as anxiety and depression. This work raises some interesting possibilities, such as the potential to screen individuals to assess their risk of developing a disorder. In turn, at-risk individuals might be better helped with early detection and treatment. Also, knowing about the genetic underpinnings of personality is highly informative to theorists seeking to understand how our personality traits, and the variability of traits across cultures, evolved in the first place.

Module 12.2b Quiz:

How Genes Affect Personality

Know . . . 1. Researchers have found that short copies of the transporter

genes make people predisposed to anxiety, shyness, and experiencing negative emotional reactions in interpersonal situations.

A. serotonin B. dopamine C. norepinephrine D. glutamate

Understand . . . 2. Even when identical twins are reared apart, they still tend to be very

similar in personality. How is this strong evidence that genes contribute to personality?

A. Identical twins who were reared apart were most likely treated in very similar ways.

B. The similarities remain, even though there were probably significant differences in how the siblings were raised.

C. There are fewer similarities when twins are reared together. D. Actually, identical twins who are raised apart show very little

similarity.

3. Which of the following statements best describes what psychologists now know about the genetic basis of personality?

A. Hundreds of genes have been identified that are directly linked to specific personality traits.

B. Technology is not sophisticated enough to link genes and personality characteristics.

C. Some genes have been identified that are related to certain aspects of personality function.

D. Genes do not contribute to personality characteristics.

The Role of Evolution in Personality

Evolutionary psychologists emphasize that our personality structures are built right into our species because they conferred selective advantages to humans possessing certain traits. But the human species is related to other species as well, and so one would expect that we may share at least some aspects of our

personalities with other species.

Animal Behaviour: The Evolutionary Roots of

Personality

One compelling argument for the usefulness of the evolutionary perspective on personality is the presence of personality traits in numerous nonhuman species.

For example, scientists have studied one particular species of bird (Parus major) that lives in Europe and Asia. These birds display two different patterns of behaviour when they encounter new environments, corresponding to a “fast- exploring” or “slow-exploring” personality type. The fast-exploring types are aggressive and bold in their exploration of new environments, and tend to rely more on routine ways of responding to the environment rather than being responsive to external cues. The slow-exploring types are passive, shy when confronted with new environments, and more responsive to the external environment, changing their behaviour more readily to suit changes in the environment. These two personality types are known to have a strong genetic basis. Which of the two personality types is adaptive depends on what kind of year the birds are having. If there are limited resources, aggressive, fast- exploring females, and timid, slow-exploring males have greater reproductive success. In years where resources are plentiful, it is the opposite—slow- exploring females and fast-exploring males have greater success. There are complex reasons why males and females have personality factors that are oppositely adaptive to the environment, but the important point is that the basic personality dimension of aggressiveness vs. passivity is represented in these birds and has been clearly tied to the birds’ adaptive advantage in different

environments (Dingemanse et al., 2004).

The suggestion that animals have personalities may not strike you as all that surprising. Many people who have had close and extended experience with animals, from farmers to pet owners, would say that animals have personalities. For example, dog lovers don’t feel that their pet is a totally incomprehensible beast; instead, they attribute qualities, emotions, and personality quirks that are very “human” to the beloved animal. This may merely illustrate our tendency to

anthropomorphize the living world, seeing other species through our own egocentric lens, but it may also reflect our shared genetic heritage with other species.

Researchers who wish to study animal personalities face a daunting task, particularly considering that nonhuman animals are usually not very adept at filling out personality scales. To overcome this problem, one approach for measuring the Big Five factors in animals was for individuals who are familiar with the animals to rate their behaviours according to the five factors. Typically, observers strongly agree on their ratings of extraversion and neuroticism in

animals (Gosling, 2001). In fact, several of the Big Five personality traits have been found in a rich diversity of species—such as rhinos, primates, hedgehogs,

and even ants (Gosling, 2001)! In one study of chimpanzees, our closest primate relatives, a list of adjectives was taken from the Big Five test and people who were familiar with the chimpanzee subjects rated how well the adjectives applied to each chimp on a scale of 1 to 7. Of the Big Five traits, extraversion,

conscientiousness, and agreeableness were reliably found in the chimps (Weiss et al., 2007).

Psychologists are finding that measures of human personality are applicable to diverse species such as hyenas, octopuses, and chimpanzees, among many others. Poeticpenguin/Shutterstock

Rena Schild/Shutterstock

Michael Nichols/National Geographic/ Getty Images

The presence of basic personality dimensions may be extremely widespread in

the living world; some researchers even argue you do not need a backbone to have a personality. Researchers at the University of Lethbridge, Alberta, have shown that octopuses show stable individual differences in measures of activity,

reactivity, and avoidance (Mather & Anderson, 1993).

Why There are So Many Different Personalities:

The Evolutionary Explanation

David Zuroff of McGill University argues that evolutionary perspectives can make a major contribution to our understanding of personality, helping us to

understand why we acquired the specific traits that we did (Zuroff et al., 2010). This question is left largely unaddressed by most personality theories, which focus on content (e.g., What personality traits are there?), rather than on process (e.g., Why do we have these traits in the first place? What functions do they serve?).

Evolutionary perspectives can help us to understand why humans have evolved the particular personality traits that we have. To the extent that the Big Five traits are built right into our biology, these traits must have been selected for by being adaptive in past evolutionary epochs, helping to promote our survival and reproductive success.

For example, individuals high in extraversion would be more likely to rise in social hierarchies, playing leadership and social networking roles in a community; on the other hand, extraverts tend to be risk takers and sensation seekers, and it would therefore be desirable to offset these qualities with a healthy proportion of introverts in a group.

People high in conscientiousness would be reliable and dependable, and others would learn to count on them to get things done, clearly desirable qualities in a mate. However, the person low in conscientiousness may be an attractive partner to mate with for other reasons, such as their spontaneity and willingness to not always take life too seriously.

People low in neuroticism would be the emotional stalwarts of the community, the people who didn’t crack under pressure but kept a level head and could be counted on in crises. However, being high in neuroticism could pay off at times; for example, groups may benefit from having some highly neurotic people around, because they would be more attuned to danger and act as a voice of caution to keep others from making dangerous decisions.

People high in agreeableness would be the friends who are there for you when you need them, and they would generally help to promote harmony and solidarity as groups work together on larger projects; whereas those low in agreeableness may be useful for providing a critical perspective and ensuring that the group doesn’t make rash decisions.

People high in openness would be imaginative and creative, helping to build bridges between members of different subgroups in the community, and challenging ideas so that the community doesn’t rigidify into dogma and closed- mindedness. On the other hand, those low in openness may be useful for preserving traditions and helping to identify a coherent sense of identity within the community.

As you can see, being either high or low in each Big Five trait could be desirable, depending on the situation. Thus, the complex blends of personality types across society evolved because different traits were desirable in different circumstances. Just as there are different niches to which animal species adapt in an ecosystem, there are different social niches to which people can adapt in society. The extravert and the introvert, the neurotic and the secure, the conscientious and the careless gravitate toward the respective niches they best fill.

Myths in Mind Men Are from Mars, Women

Are from Venus Much is often made about apparent differences in how men and women think and behave. This comparison can sometimes get stretched pretty

far, such as the implication inherent in the title of the 1992 self-help book

Men Are from Mars, Women Are from Venus (Gray, 1992). The notion that men and women may as well be from different planets is strongly reinforced by the popular media.

To what extent does science back up this hypothesis when it comes to personality? On the one hand, there is strong evidence that men and women differ on their Big Five personality ratings. Women generally report higher levels of extraversion, conscientiousness, agreeableness, and neuroticism than men. This finding has been noted in comparisons

made across dozens of cultures (Schmitt et al., 2008). On the other hand, these gender differences are quite small, and are vastly

overwhelmed by the variability within each gender. In other words, there are a lot of men who seem like they’re from Venus, and a lot of women who seem like they’re from Mars. So, even though there is a gender difference in personality, it is so small as to hardly allow the characterization that men and women are fundamentally different from each other.

In an interesting twist, however, this research also found that the gender differences are related to economic factors. Specifically, the countries

showing the largest gender differences in personality also have greater access to resources such as health care, education, and wealth. Men and women in countries with fewer social and economic resources tend to be more similar in their self-reported personality scores. This phenomenon may occur because a lack of resources tends to constrain the behaviours and social roles of individuals, thus making people more similar to each other at the expense of their personal individuation. On the other hand, abundant prosperity opens up more opportunities for

personal expression and allows individual differences to flourish (Schmitt et al., 2008).

The conclusion seems to be that men and women do have different personalities, on average. Nevertheless, the differences are so small that Mars and Venus must be pretty similar places, so to speak. A good title might sell a lot of books, but does little to inform the general public about

what scientific studies truly reveal about human behaviour.

Given that specific traits have certain strengths and weaknesses, it seems likely that the different traits evolved because a mixture of traits with complementary strengths and weaknesses would be advantageous at the group level, if not necessarily at the individual level. In other words, to understand why we evolved the traits that we did, we have to consider traits not operating in isolation but, instead, operating at a more communal level.

Module 12.2c Quiz:

The Role of Evolution in Personality

Apply . . . 1. What is an important piece of evidence supporting an evolutionary basis

of personality?

A. Changes in personality can be seen over generations. B. Personality traits are stable in the sense that they are common

among humans and can be found in nonhuman species.

C. Personality traits are not stable and cannot be found in nonhuman species.

D. No valid evidence supports an evolutionary approach to personality.

Analyze . . . 2. According to evolutionary psychologists, there is great diversity in human

personality because

A. only five personality traits could be useful for our species’ survival.

B. different traits are most adaptive in different situations. C. a person with a diverse personality is best able to adapt to

different situations.

D. some personality traits are most adaptive for mating, whereas others are more adaptive for survival.

3. Which of the following statements best summarizes personality differences between men and women?

A. Averages of some traits such as extraversion and neuroticism tend to differ between men and women, but these differences are very small.

B. Males and females inherit separate sets of genes that cause their differences in personality.

C. Research shows that men and women really do not differ in personality.

D. Males are generally agreeable, whereas women are generally conscientious.

In the final section of this module, we examine biological explanations for our personality traits. Can differences in the volume of brain structures or the activity of brain regions explain, at least in part, why personalities vary?

The Brain and Personality

Modern biological approaches for investigating the brain and behaviour build on many ancient traditions of medicine that connected the mind to the body and sought to understand the person in terms of bodily processes. For much of the

past 2000 years, Western medicine was guided by the theory of humourism , which explained both physical illnesses and disorders of personality as resulting from imbalances in key fluids in the body—the four “humours.” In the late 1700s and into the 1800s, early psychologists promoted phrenology —the theory that personality characteristics could be assessed by carefully measuring the shape of the skull. However, these early biological approaches have long since fallen out of fashion, and the field has made major strides in understanding actual biological systems that are involved in personality processes.

Extraversion and Arousal

A big step forward occurred in the mid-20th century, when researchers began

convincingly linking personality characteristics with specific brain systems. One

of the most influential pioneers in this field, Hans Eysenck (1967), proposed an arousal theory of extraversion , arguing that extraversion is determined by people’s threshold for arousal; according to this theory, people high in extraversion (i.e., extraverts) have a higher threshold for arousal than people low in extraversion (i.e., introverts). As a result, extraverts generally seek greater amounts of stimulation, whereas introverts seek to limit the amount of stimulation they experience so as to not become overwhelmed with excessive arousal. One

brain system, the ascending reticular activating system (ARAS) , plays a central role in controlling this arousal response. Research on Eysenck’s ideas has demonstrated that extraverts do have less reactive ARASs compared to introverts. Put simply, for a given “kick,” introverts have a stronger response, which is why introverts tend to avoid excessive stimulation, whereas extraverts tend to seek it out.

Another influential model of the brain–personality relationship was proposed by

Jeffrey Gray, whose approach/inhibition model of motivation (Gray, 1991) describes two major brain systems for processing rewards and punishments: the behavioural activation system and the behavioural inhibition system.

The behavioural activation system (BAS) is a “GO” system, arousing the person to action in the pursuit of desired goals. This system is responsive to rewards and fairly unresponsive to possible negative consequences; greater BAS activation therefore is associated with greater positive emotional responses

and approach motivation. The other system, the behavioural inhibition system (BIS) , is more of a “danger” system, motivating the person to action in order to avoid punishments or other negative outcomes. The BIS is therefore associated with greater negative emotional responses and avoidance motivation.

Phrenologists believed that different personality traits were housed in different regions of the brain. Classic Image/Alamy Stock Photo

As you might expect, several of the Big Five factors are correlated with activation of the BIS/BAS systems. The most consistent finding is that extraversion is especially related to BAS activation, whereas neuroticism is related to BIS

activation (e.g., Gomez et al., 2000). This evidence is beginning to build at

different levels of analysis, but it takes a long time for such complex studies to accumulate. However, just considering the link between extraversion and BAS activation, we can see data focused on at least three different levels of analysis: behavioural, neurochemical, and emotional. For example, extraverts tend to act impulsively when presented with the possibility of rewards, even ignoring the risk

of punishment (Patterson & Newman, 1993). Extraverts show a stronger dopamine response to rewarding stimuli (Depue & Collins, 1999). And, extraverts tend to experience more positive emotions in a range of situations

(Ashby et al., 1999; Lucas et al., 2000). Thus, a trait measure of extraversion reflects the functioning of many different systems, providing a great example of the integration of science across many different areas of study.

Contemporary Research: Images of Personality in

the Brain

Modern-day researchers use brain-imaging technology to test for relationships between personality and the brain. Neuroscientists have tested whether each of the Big Five personality traits is associated with a different brain region, and whether these regions correspond to the behaviours associated with these traits. The general conclusion has been that indeed, there are many relationships between personality traits and the functioning of specific brain areas, although this research is in its infancy and we have a long way to go before we can confidently discuss “personality in the brain.” However, we can discuss some preliminary findings of this line of inquiry.

Extraversion:

Extraverts have a larger medial orbitofrontal cortex (part of the prefrontal cortex;

DeYoung et al., 2010), and generally show less activation in the amygdala (Canli et al., 2002). The medial orbitofrontal cortex is involved in processing reward, which is consistent with extraverts’ greater reward sensitivity (i.e., strong BAS). The amygdala, on the other hand, is involved in processing novelty, danger, and fear, which extraverts tend to pay less attention to (i.e., weak BIS),

hence their under-active amygdalae (see Figure 12.5 ).

Figure 12.5 Measuring Personality and Brain Anatomy People’s self-ratings of the Big Five traits correspond to their brain volume in specific regions. Here we see two (among several) regions of the brain where size is positively correlated with ratings of conscientiousness and extraversion

(DeYoung et al., 2010). Source: Based loosely on DeYoung, C. G., Hirsh, J. B., Shane, M. S., Papademetris, X., Rajeevan, N., & Gray, J. R. (2010).

Testing predictions from personality neuroscience: Brain structure and the big five. Psychological Science, 21 (6), 820–828.

Neuroticism:

Neuroticism is associated with the size of various brain areas, such as a smaller dorsomedial prefrontal cortex, a smaller hippocampus, and a larger mid-

cingulate gyrus (an area right above the corpus callosum; DeYoung et al., 2010). Each of these areas is involved in abilities that are central to neuroticism. The dorsomedial prefrontal cortex is involved in controlling emotions (Ochsner & Gross, 2005), the hippocampus in controlling obsessive negative thinking (Gray & McNaughton, 2000), and the mid-cingulate gyrus in detecting errors and perceiving pain—whether physical or emotional pain (Carter et al., 1998; Eisenberger & Lieberman, 2004). These are the kinds of processes that define highly neurotic people. They have difficulty controlling their emotions, often fall prey to obsessive negative thinking, and are highly sensitive when they make mistakes or feel pain.

Agreeableness:

People high in agreeableness show less brain volume in an area called the left

superior temporal sulcus (DeYoung et al., 2010), which is activated when one is interpreting another person’s actions or intentions (Pelphrey & Morris, 2006). They also show greater volume in an area called the posterior cingulate cortex,

which is involved in empathy and perspective-taking (DeYoung et al., 2010). These brain areas match the tendency for people high in agreeableness to be more socially attuned and to have more empathy for others.

Conscientiousness:

People high in this trait have larger brain volume in the middle frontal gyrus in the

left prefrontal cortex (DeYoung et al., 2010), which is involved in working memory processes and in carrying out actions that you have planned. These functions are implicated in effective self-control, which is a key strength of the highly conscientious person.

Openness to Experience:

Individuals high in openness to experience have been shown to have greater activation in the dorsolateral prefrontal cortex, which is involved in creativity and intelligence, as well as other brain systems involved in the integration of the self

and the environment (Adelstein et al., 2011). These systems reflect the tendencies for people high in openness to be creative, integrative thinkers.

Although the ability to link brain regions to personality processes at such a refined level has only become possible recently, neuroscientists are beginning to find brain regions that differ reliably between people with different personality

traits. This does not mean that these brain differences cause the personality differences, but it does suggest that these brain regions are involved in serving neurological functions that are related to personality processes at some level. The causal connections might be indirect and highly varied, challenging us with incredible complexity, both of personality itself but also complexity of the neurological architecture of the brain. This complexity reminds us that in most cases, there will be no specific brain area involved uniquely in a personality trait; for example, there is no “centre of extraversion” in the brain. Any trait plays itself

out through many different thoughts, feelings, and behaviours, each of which involves many different brain systems. What ends up manifesting as a stable pattern that we identify as a personality trait therefore represents patterns of activation across many different brain systems.

So we may never be able to point at a single region (or even a few regions) and declare it to be the centre of any single personality trait. That said, we have come a long way from the days when personality was described in terms of the four humours of blood, phlegm, and black and yellow bile.

Module 12.2d Quiz: The Brain and Personality

Know . . . 1. An outdated approach claiming that behaviour and personality were

based on the sizes of various regions of the skull surface was called

A. magnetic resonance imaging. B. alchemy. C. phrenology. D. humourism.

2. Hans Eysenck believed that extraversion was tied most closely to the functioning of the

A. limbic system. B. parasympathetic nervous system. C. ascending reticular activating system. D. amygdala.

Apply . . . 3. You are looking at an fMRI brain scan of a subject in a research study.

The scan shows that the person generally has greater activation in the dorsolateral prefrontal cortex and less activation in the amygdala. Based on this information, what guess would you make about the person’s personality profile?

A. Low on extraversion, high on conscientiousness

B. High on openness to experience, high on extraversion C. Low in neuroticism, high on extraversion D. Low in neuroticism, high on conscientiousness

Module 12.2 Summary

arousal theory of extraversion

ascending reticular activating system (ARAS)

behavioural activation system (BAS)

behavioural inhibition system (BIS)

humourism

phrenology

response styles

Evolutionary psychologists theorize that personality traits evolved because they solved environmental and social problems encountered by our distant ancestors. Although this hypothesis is difficult to test directly, different sources of evidence lend support to it. The widespread occurrence of these personality traits among different species indicates that they are adaptive.

Although extraversion is commonly interpreted to indicate how sociable and friendly people are, it is more fundamentally related to how reactive people are to stimulation. Highly extraverted people have less reactive ascending reticular activating systems (ARAS), which means that they don’t get as big of a “kick” out of a given level of stimulation; this causes them to prefer more stimulating

Know . . . the key terminology associated with cultural and biological approaches to personality.

12.2a

Understand . . . how evolutionary theories explain personality.12.2b

Apply . . . your knowledge to understand how arousal is related to extraversion.

12.2c

environments, relative to introverts, who have more reactive ARASs, and therefore prefer lower levels of stimulation so that they do not feel overwhelmed.

Claims of major sex differences in personality are sometimes made to support popular-book sales. In reality, the general consensus in psychological science is that males and females are more alike than different when it comes to personality. Both, of course, share common personality dimensions. Although females tend to be, on average, more conscientious, agreeable, extraverted, and neurotic than males, these differences are very small, and there is no evidence to support claims that men and women are fundamentally different in personality.

Heritability studies show that personality traits are substantially predicted by genetic variation. Studies of twins and adopted children also back this up, showing that identical twins are far more similar in personality than fraternal twins, and that the home in which people grow up has much less influence over their personalities than the genes they inherited from their biological parents. However, despite this evidence for genetic influences on personality, one cannot conclude that personality is “hard wired” and therefore unchangeable. Personality emerges through the interaction of genes and the environment; thus, a given genetic make-up can express itself differently in different environments.

Analyze . . . claims that males and females have fundamentally different personalities.

12.2d

Analyze . . . the genetic basis of personality.12.2e

Module 12.3 Psychodynamic and Humanistic Approaches to Personality

blas/Fotolia

Learning Objectives

Know . . . the key terminology related to the psychodynamic and humanistic approaches to personality. Understand . . . how people use defence mechanisms to cope with

12.3a

12.3b

Abraham Maslow, who was introduced in Module 11.3 , was fascinated by people who actually live up to their potential. Many of us want to follow today’s pop-culture slogans to “live for the moment,” “be all that you can be,” and “do one thing every day that scares you”—but somehow, most of us never quite get around to it. Perhaps you’ve experienced that nagging feeling that life is passing you by and the epic adventure you thought your life was going to be is somehow more mundane than you’d hoped? Apparently, this doesn’t happen to everybody; some people really do seem to live inspiring and fulfilling lives, and these were the personalities that Maslow wanted to understand.

In striking contrast to much of the cynicism of the 20th century, Maslow believed that although we have the capacity for great evil, at the very foundation of our being we are inherently good. He argued that the more we open ourselves to our inherent goodness, the more we will see reality clearly, rather than through our biases; the more we will be empowered and able to confront life courageously, rather than shrinking from challenges because of our insecurities; and the more we can focus on helping others rather than tending to our own needs and wants. The end result of pursuing personal growth is to become fully, vibrantly alive.

“Laboring under the effects of deficiency motivation is like looking at the world through a clouded lens, and removing those effects is like replacing the clouded lens with a clear one. Self-actualizing persons’ contact with reality is simply more direct. And along with this unfiltered, unmediated directness of their contact with reality comes also a vastly heightened

conflicting thoughts and feelings. Understand . . . the developmental stages Freud used to explain the origins of personality. Apply . . . both psychodynamic and humanistic perspectives to explain personality. Analyze . . . whether projective tests are valid measures of personality. Analyze . . . the strengths and weaknesses of psychodynamic perspectives.

12.3c

12.3d

12.3e 12.3f

ability to appreciate again and again, freshly and naively, the basic goods of life, with awe, pleasure, wonder, and even ecstasy, however stale

those experiences may have become for others.” (Maslow, 1968)

Is it possible to live such a life? Maslow thought so, and personality researchers are still following his call and trying to decipher the magic ingredients that allow some people to truly thrive in life.

Focus Questions

1. How do the psychodynamic and humanistic approaches give you insight into your own personality?

2. How do people use psychological defences to protect themselves from emotionally troubling events?

Maslow hoped that his work would help people learn how to cultivate these qualities within themselves. His optimistic vision of human nature was a major break from the personality psychology of the day, which largely grew out of a Freudian psychodynamic perspective. As we discuss below, to the Freudians, personality was a battleground between opposing forces in the psyche, as people struggled to defend themselves against the negativity that loomed in their unconscious. In contrast, Maslow and the humanists explored a positive, growth- oriented side to personality that we need to fully appreciate in order to have a more complete picture of the human personality.

Although neither Freudian psychoanalysis nor Maslow’s humanistic theories have retained their once-prominent positions in psychology, they remain highly influential approaches in society at large, and have inspired and guided generations of people to live their lives more fully.

The Psychodynamic Perspective

As one of the best known and most influential psychologists of all time, Sigmund Freud often does not get the respect you might think he would deserve. Many of his theories have not stood the test of time and are now largely ignored. Many of his theories are difficult or impossible to integrate with more modern approaches, such as social-cognitive and neuroscience perspectives. Indeed, some of his theories are even regarded as ridiculous by many people (e.g., the Oedipus complex, discussed later in this module). Freud was definitely a colourful character. He was a passionate user and advocate of cocaine before its addictive and destructive properties were known. He was rumoured to have been a tyrant towards his followers, allowing people to express little dissent from his views. Freud has been critiqued as having an obsession with sex, as having created unfalsifiable and therefore unscientific theories, and as using only a limited cross-section of humanity (mostly women seeking counselling in Victorian-era Europe) upon which to base rather grand and sweeping theories about human nature.

However, despite the criticisms, Freud was a pioneer in the study of personality and the treatment of psychological disorders. He laid much of the foundation for our basic understanding of consciousness, which is still with us today, as are many of his key insights. When a drug addict admits to being “in denial” of his addiction, an abuse survivor talks about how she “repressed” her memories and feelings for many years, or someone accuses you of “projecting” your anger onto other people, they are displaying Freud’s ideas.

Interestingly, Freud was not trained in psychology, but was instead a neurologist. The launch of his scientific career was anything but glamorous; he spent many hours peering through microscopes at tissue samples, searching for the elusive testicles of the male eel, which had not yet been discovered. Freud’s extraordinary attention to detail, along with the unwitting cooperation of many hundreds of eels, led him to eventually make the discovery. Which might make you ask, what kind of person exhaustively searches for eel testicles? No doubt, Freudian theorists would have an interesting answer to that question.

After leaving his scientific career to be trained as a physician, Freud began to accept clients who sought his help for psychological difficulties. Initially, Freud

believed that their issues could be resolved through investigating their physiology and isolating the biological factors that contributed to their problems. However, after examining some of his patients, he realized that their emotional struggles often could not be understood at the physiological level; instead, he had to delve into the mysterious depths of the mind. This led him to begin trying to understand the personalities of his patients and the psychological dynamics that led to the problems they were experiencing.

Over time, his observations and ideas coalesced into his psychodynamic theory, which isn’t really a “theory” at all, but rather an evolving family of different theories and ideas that share many key features, which we discuss in this

module (also, see Westen, 1998).

Assumptions of Psychodynamic Theories

A universal assumption of psychodynamic theories is that personality and behaviour are shaped by powerful forces in consciousness, a great deal of which is hidden from our awareness in the mysterious unconscious. By emphasizing the unconscious, Freud threw into doubt many of our common feelings and beliefs. For example, we like to feel like we are in control of ourselves and our behaviour reflects conscious choices that we make. We believe that we know why we do the things we do—that our behaviour makes sense to us. We also like to believe that when we do something embarrassing, immoral, or just plain stupid, that we were somehow “out of control” or that it was a mistake.

From a psychodynamic perspective, however, there are no mistakes, and we have very little control over ourselves and remarkably little insight into the reasons for our own behaviours. Everything we think, feel, and do results from psychological dynamics that are so deeply buried in our unconscious that we have no direct access to them; our mind is a “black box,” even to ourselves.

To understand the implications of Freud’s psychodynamic theory, we will explore its key concepts and how they apply to personality psychology.

Unconscious Processes and Psychodynamics

Freud grounded his theories on a model of consciousness that distinguished between different levels of mental life, most importantly between the conscious

mind and the unconscious. The conscious mind is your current awareness, containing everything you are aware of right now. The unconscious mind is a much more vast and powerful but inaccessible part of your consciousness, operating without your conscious endorsement or will to influence and guide your behaviours. The unconscious mind houses your full lifetime of memories and experiences, including those that you can no longer bring into conscious awareness, such as emotional patterns that were created in early childhood or even infancy. It also contains your preferences and desires, which can influence you in ways that may be obvious, or in ways so subtle that you are not even aware of them. The relationship between these two levels of consciousness is

often described using an iceberg metaphor of consciousness (Figure 12.6 ). With icebergs, the part you can see above the surface is a small fraction of the entire iceberg, while most of its bulk lurks beneath the surface. Similarly, the conscious mind is a small fraction of the entire psyche, most of which lurks beneath the surface of our awareness in the depths of the unconscious.

Figure 12.6 The Freudian Structure of Personality A popular depiction of how Freud viewed personality features an iceberg, with the unconscious mind residing below the surface and conscious awareness at only the tip of the iceberg. The id is completely submerged, whereas the ego and the superego operate at both unconscious and conscious levels. Source: Lilienfeld, Scott O.; Lynn, Steven J; Namy, Laura L.; Woolf, Nancy J., Psychology: From Inquiry to Understanding,

2nd Ed., ©2011, pp.546. Reprinted and Electronically reproduced by permission of Pearson Education, Inc., New York, NY.

The mysterious, vast, inaccessible unconscious is viewed as the primary driver of our behaviours, controlling us in countless ways. Even seemingly trivial behaviours, such as slips of the tongue, were argued to reflect the workings of the unconscious. In fact, these slips, famously called “Freudian slips,” are very useful to the observant person, because they offer a glimpse into the unconscious. When people make a Freudian slip, their conscious mind intends to say something appropriate to the circumstances, but their unconscious mind leads them to say what they were “really thinking.” As the classic psychologist joke goes, “The definition of a Freudian slip: when you mean to say one thing but

you end up saying a-mother.”

Freud believed fervently in the value of these “psychopathologies of everyday life” and developed several techniques that psychoanalysts could employ to use such small clues to gain access into the netherworld of the unconscious. (We revisit this later in this module.) Freud and other psychoanalysts argued that much of what manifests as personality reflects patterns that emerge as people attempt to resolve conflicts between their conscious and unconscious minds.

The Structure of Personality

Have you ever done something you knew at the time was wrong? Like eating that brownie when you knew you shouldn’t? Losing your temper? Hooking up with that attractive person even though they have a boyfriend or girlfriend (or you do)? To explain this type of all-too-common conflict, Freud hypothesized that the human psyche consists of three basic structures, which are often in conflict with

each other: the id, the ego, and the superego (Figure 12.6 ).

The id represents a collection of basic biological drives, including those directed toward sex and aggression. Freud believed the id was fuelled by an energy called libido. Although this term is more commonly used in reference to sexual energy, the libido also controls other biological urges such as hunger. The

id operates according to the pleasure principle, motivating people to seek out experiences that bring pleasure, with little regard for the appropriateness or consequences of their realization. Because the id represents our basic animal desires, it is present right from birth and is the predominant force controlling our actions in the earliest stages of our lives. The id gets us into trouble though, and increasingly so as we get older and society frowns on some of the unrestrained urges of our lusty animal selves. Because society imposes constraints on our behaviour, the id must be restrained from its animal nature; and that is where the ego and superego come into play.

The superego is comprised of our values and moral standards. Our superego tells us what we ought to do, whereas the id tells us what our animal body wants to do. Freud believed that the superego forms over time as we become

socialized into our family and larger community and we are taught the values and norms of our society. The superego represents a process of internalization, through which we adopt the values and standards of others and make them our own, and consequently, we feel good or bad about ourselves based on whether we think we are being “good” or “bad.” When we behave immorally, the superego chastises us, similarly to how our parents may have done, thereby encouraging us to “do the right thing.”

In between the devilish, indulgent id and the angelic, puritanical superego sits

the beleaguered ego , the decision maker, frequently under tension, trying to reconcile the opposing urges of the id and superego. The ego has to be plugged into reality; if it listened to the id all the time, we would be social deviants, instantly gratifying ourselves at every turn, but if it listened to the superego all the time, we would cut ourselves off from much of our raw passion and zest for life. The ego seeks to balance the two forces, operating according to what Freud

called the reality principle. The id, ego, and superego are in constant tension, and it is this tension that gives rise to personality in two key ways.

First, different people’s personalities may reflect differences in the relative strengths of their id, ego, and superego. You can easily imagine a person guided by an extremely strong superego versus a person guided by an extremely strong id. Indeed, these would likely be two completely different types of people. In this deep, structural sense, individuals’ personalities are patterned by their own particular blend of ego, id, and superego. Each person’s unique combination of biology (id), upbringing and sociocultural circumstances (superego), and their uniquely personal awareness and will (ego), ends up developing into their personality.

The second key dynamic that generates much of personality is how one reacts to anxiety. Anxiety plays a huge role in psychodynamic thought, because anxiety is the experiential (what we feel) result of the tension between the id, ego, and superego. When these systems are out of balance, we experience the deprivation of one system as a kind of basic anxiety. This drives negative thoughts and feelings, which ideally would serve as messages to us—signals that “something is wrong; this system is not in harmony.”

Anxiety can be about something huge and overwhelming (e.g., having abuse occur in one’s family) or about something mundane and seemingly trivial (e.g., wearing the wrong thing to a party), but it’s important to note that in either case, the anxiety itself has a kind of life of its own; for example, we can experience truly crushing and debilitating anxiety about something that others would think was silly (e.g., wearing the wrong thing to a party), whereas people can, through psychological defences (as we discuss shortly), defend themselves against even profound anxiety (such as being unwilling to face the reality of abuse occurring in one’s family).

According to Freud, the ego engages in anxiety-defence throughout the day. From worrying about failing, to how we look, to whether someone likes us, to how something we did will be perceived by other people, we feel anxiety. We could wonder whether we made a good decision, feel guilty, wonder if we are losing our looks or our charm as we age, or deal with basically an infinite variety of potential things to worry about and feel badly about. Dealing with this constant drama is the job of the ego. And of course, there is its classic job, which is to figure out what to do when part of us wants to do the bad thing (whatever that may be), and part of us is scared or feels ashamed or otherwise knows we “shouldn’t” do the bad thing.

It’s easy to feel a bit sorry for the ego. Sure, it gets to be in control a lot of the time, but it also never really gets a break, always having to be on the job to keep us from becoming overwhelmed by anxiety. From Freud’s perspective, consciousness is a constant battleground for the ego, negotiating between the id and superego, while also protecting itself from countless sources of anxiety.

Defence Mechanisms

Oftentimes, the ego is unable to resolve the anxieties that plague it. Instead, it focuses merely on protecting itself from excessive anxiety, seeking some way of minimizing or avoiding the negativity it is experiencing. Imagine a young child caught between Mom and Dad screaming at each other. Having no way to resolve their conflict, he plugs his ears and hides in the closet. The child can’t

resolve the negativity, so he tries to escape it. This is what the ego does when it

employs its defence mechanisms , unconscious strategies the ego uses to reduce or avoid anxiety (Freud, 1936; see Table 12.4 ). In fact, the literal acts of plugging one’s ears and running into the closet are examples of denial, which is a very common defence mechanism.

Table 12.4 Examples of Some Major Defence Mechanisms

Defence

Mechanism

Definition Example

Denial Refusing to

acknowledge

unpleasant

information,

particularly

about oneself.

People deny all sorts of things—ways in which

they are to blame for their relationship problems;

bad things that other members of their family

may be doing; dangerous behaviours, such as

drinking while pregnant, that they may be

engaged in; and truly, just about anything.

Simply blocking distressing things from one’s

mind can be a remarkably effective strategy

(until it eventually comes back to haunt you).

Displacement Transforming

an

unacceptable

impulse into a

less

unacceptable or

neutral

behaviour.

After getting criticized by your boss at work, you

go home and yell at your spouse or criticize your

roommate for not doing more housework. One

way or another, you “take out your anger” on a

less dangerous target than your boss.

Identification Unconsciously

assuming the

characteristics

of a more

powerful person

in order to

A child acts like their favourite hero-figure or an

adult copies a trend-setting celebrity. By

associating with a powerful, successful figure,

one feels more powerful and successful too.

reduce feelings

of anxiety or

negative

feelings about

the self.

Projection Perceiving in

other people the

qualities that

you don’t want

to admit to

possessing

yourself.

The classic insecure, tyrannical parent, who

sees hostility and “attitude” in other people, like

his kids or his wife, thinking that other people are

always seeing themselves as superior and are

looking down their noses others. Projection also

allows us to see “evil” and aggression in our

enemies while we invade and bomb them.

Rationalization Attempting to

hide one’s true

motives (even

from oneself!)

by providing

what seems like

a reasonable

explanation for

unacceptable

feelings or

behaviours.

People who are prejudiced against certain types

or groups of other people may not see

themselves as racist, but may instead believe

that the group they are prejudiced against

actually does possess certain negative qualities.

By believing that people from the disliked group

are violent, or lazy, or unintelligent, the person

never has to confront their own prejudice.

Reaction

Formation

Altering an

impulse that

one finds

personally

unacceptable

into its opposite.

People who are judgmental and condemning of

homosexuality, yet have homosexual impulses

themselves. For example, homophobic men tend

to have greater penile arousal, compared to non-

homophobic men, when looking at male-on-male

pornography (Adams et al., 1996).

Repression Keeping

distressing

Many people believe that victims of abuse or

violence are sometimes able to repress their

information out

of conscious

awareness by

burying it in the

unconscious.

traumatic memories, essentially “forgetting” that

the trauma occurred. Nevertheless, the trauma

remains in their unconscious, causing them to

react in ways that are driven by this unconscious

material.

Sublimation Transforming

unacceptable

impulses into

socially

acceptable or

even pro-social

alternatives.

Someone with a great deal of aggression may

become a football player or a boxer. Freud

believed that sublimation was one of the

cornerstones of civilization, the mechanism by

which base human desires were harnessed to

give rise to great works of art, invention, and

scientific advance. Sublimation operates to make

you feel better by finding socially acceptable

outlets for unconscious drives and urges.

Defence mechanisms play key roles in many important social phenomena, such as prejudice and discrimination. For example, imagine a CEO of a company choosing not to hire a member of an ethnic minority; the CEO may protect herself from admitting the possibility that the choice was racially motivated by

engaging in rationalization, reasoning that the applicant didn’t seem as impressive, professional, or “like she will fit into our team.” You can imagine the thought, “It had nothing to do with race, of course! I just want to hire the best person for the job, and I felt that she wasn’t the right fit. After all, I have a lot of experience in this company, and I trust my sense of who is going to work out and who isn’t.” You can see how easily a person’s own reasoning process can be hijacked by the ego in order to protect itself, and the line between what is true and what merely appears to be true can so easily be blurred.

Unfortunately, although defence mechanisms may keep us from feeling anxiety in the moment, they are ultimately dysfunctional for a variety of reasons. One is simply that undesirable tendencies are not confronted and problems are not dealt with; instead, immense energy is devoted to maintaining the defence mechanisms and trying to feel okay. For example, alcoholics (and often their

families) sometimes go to great lengths to avoid having to admit that they have a problem, which only worsens the impact of alcohol on their lives. Freud’s (and others’) work on defence mechanisms remains influential to this day, particularly in the mental health field, where defence mechanisms often play important roles in therapy for psychological disorders.

Personality Development: the Psychosexual

Stages

Freud’s theory of personality also involved a sophisticated understanding of development. Freud believed that the personality developed as the person learned to channel the energy of the libido into appropriate forms of self- expression. Thus, to Freud, development of the infant and child is ruled by the id, involving the young child struggling to contain and channel sexual urges and feelings. The child is a bundle of animal impulses, and development is therefore based on the ego and superego developing properly through appropriate socialization experiences as the child grows up. Freud highlighted specific developmental challenges that children faced at different points of their lives, developing a stage theory of psycho-sexual development that tracked the progression children went through as they matured through the various stages

(see Table 12.5 ).

Table 12.5 Freud’s Stages of Psychosexual Development

Stage Pleasure

Focus

Key Dynamics

Oral (0–18

months)

Actions of

the mouth

—sucking,

chewing,

swallowing

This stage is about the foundation of the ego. Fixation at

this stage represents a basic lack of self-confidence and

“ego-strength,” leaving the person more dependent on,

and therefore vulnerable to, external sources of support.

Anal (18–

36

Bowel

elimination,

This stage is about the development of a sense of control

and competence. Fixation at this stage leads to an “anal

months) control retentive” or “anal expulsive” personality, manifesting

either as an obsession with cleanliness, order, and

control, or as a disorganized person.

Phallic (3–

6 years)

Genitals The key personality challenge is the Oedipus complex,

through which a person further develops the superego

due to the internalization of values from the parents.

Fixation at this stage leads to problems with jealousy and

obsessions with power and sex.

Latency (6

years until

puberty)

External

activities

Ideally, this stage is fairly conflict-free. People focus on

developing themselves, discovering their interests through

sports, arts, and general activities. Fixation at this stage

was not considered to be a big concern.

Genital

(puberty

to

adulthood)

Sexual

activities

with others

Ideally, this stage is also fairly conflict-free. People focus

on fully and authentically engaging in the world, provided

they are not fixated at earlier stages.

Interestingly, most of Freud’s stages happened in the first five years of life, reflecting the central importance of the developmental milestones that occur in the first five years. At each stage, the libido manifests in particular areas of the body, depending on what areas of the body are most salient and important at that particular time of life. For example, as babies, sucking for food and comfort is a central activity, whereas for toddlers, learning to control the bowels and become toilet-trained is a pretty major focus; these physical challenges were reflected by Freud as specific stages (in this case the oral and anal stages). When these bodily areas are relevant to the person, they become a focus for the id, which attempts to derive as much pleasure as possible from gaining gratification in those areas. Thus, each of these important regions becomes a battleground pitting the child’s id against the restrictions of the external world.

If the child was able to release their libidinal energy appropriately through the part of the body that was relevant at that time, this would help them have a healthy relationship with themselves and they would be free to focus on the next stages of development. However, if their need satisfaction was thwarted or

interfered with, they would become fixated at that stage. Fixation involves becoming preoccupied with obtaining the pleasure associated with a particular stage as a result of not being able to adequately regulate themselves and satisfy their needs at that stage. Fixation can occur either because of conflict and excessive parental interference (e.g., criticizing the child for making mistakes during toilet training), or because the child is allowed to overindulge in that form

of pleasure-seeking behaviour (e.g., the Simpsons character Maggie is in serious danger of developing an oral fixation).

The Oral Stage (0–18 months)

For babies, the mouth is where it’s at; all the action that really matters happens through their mouths: feeding, comfort, teething, and even the early experiences of aggression. As a result, the mouth is a major focus for both pleasure and frustration, and the ego has to learn to satisfy the id’s desire for biting and sucking with the superego’s admonishments about what is appropriate in a situation. If this goes well, the infant develops a basic sense of security and empowerment; this is the initial foundation for the ego.

However, if the infant either can’t satisfy its need for security, comfort, or food, or conversely, if it is over-indulged so that it develops an emotional attachment to

using its mouth, then it will develop an oral fixation. Instead of having a healthy ability to self-assert, the infant may develop to be dependent, have an addictive personality, and seek to “consume” the world for its own emotional needs. Fixating at the oral stage means that the person never fully develops their ego, and is therefore more vulnerable to anxiety and less capable at adjusting to social reality.

The Anal Stage (18 months–3 years)

Toddlers begin to become aware of themselves as separate individuals at the

same time that they are gaining control over the bowels. Toilet training thus becomes the focal activity at this stage. Freud believed that if bathroom skills were learned successfully and positively with support and encouragement from caregivers, the result was a sense of competence and confidence that would lead the toddler to develop into a well-adjusted and productive adult. But if parents were too strict and critical of toddlers, making them feel bad about “having accidents” and putting too much pressure on them, they could become fixated at this stage, struggling with issues like shame and control. Eventually, they could become “anal retentive” adults, a rather rigid personality excessively concerned with cleanliness and order with a high need for control and little emotional openness. Or, if parents were too lenient and provided too little support for toilet training, this would produce an “anal expulsive” adult who exhibits opposite qualities of carelessness, disorganization, and general irresponsibility.

The Phallic Stage (3–6 years)

This early childhood stage is a crucially important stage in Freud’s view, although this is where people often find Freud’s theories hard to swallow and many reject his ideas altogether. We believe it is worth considering what insights there may be in Freud’s thinking, even if some of the specific details seem questionable. Also, keep in mind that the full development of Freud’s theories is far more brilliant and detailed than what we are able to capture in a brief overview.

From ages 3 to 6 years, bodily attention shifts to the genitals as children become aware of the differences between boys and girls and start to heavily identify with

one gender. Boys go through the now-infamous Oedipus complex. Freud theorized that in boys, the attachment to the mother that was achieved during infancy (through oral means) now gets expressed in the phallus. He claimed that a boy in this stage become sexually attracted to his mother. The boy also realizes that he is in competition with his father for his mother’s affections; this creates resentment toward the father and, in the wonderful logic of young children, makes the boy want to kill his father. During this stage, boys struggle with highly conflicted feelings toward their fathers, feeling both attached to and hostile toward them. This is a very difficult time emotionally, as boys are torn

between such strong feelings and desires. Freud represents this anguish with

the Greek tragedy of Oedipus Rex (by Sophocles); in this story, the main character, Oedipus, kills his father without knowing he has done so, and ends up marrying his mother. When he eventually learns what he has done, he is so overcome with horror that he stabs his own eyes, blinding himself. (The ancient Greeks were fairly intense.)

Freud used highly sexual language to describe the phallic stage, although it is important to remember that the literal descriptions can also be understood to provide metaphoric insights into personality. According to Freud, little boys are quite distressed to learn that their mothers do not have penises; they reason that something must have happened to cut them off. And if that happened to their mothers, it might happen to them! Furthermore, it stands to reason that it was the powerful father figure who did the nasty deed, thus causing a great deal of

castration anxiety, the fear of castration by one’s father. (Metaphorically, castration anxiety is the fear of emasculation.) Boys resolve this fear, and thus the Oedipus complex, by learning to identify with the father, developing a close bond with him, while repressing sexual feelings for the mother.

For girls, the logic was considerably more complicated and Freud revised his theories somewhat over time. Freud believed that girls also want to sexually possess their mothers and feel competition with their fathers. When girls

discover that they themselves lack a penis, they experience penis envy, which is pretty much exactly what it sounds like. As a result, girls redirect their sexual interest to their fathers, and subsequently men in general, because that’s the way to get a penis. Having a child someday, particularly a boy, is also likely to be highly desired, because having a boy is (according to Freud) another way of obtaining a penis.

As mentioned earlier, Freud’s theories are considered to be very deep and often profound, although it requires a lot of “unpacking” to get to those insights. For example, with regards to penis envy, you can take the penis as more of a symbol of power and masculinity, rather than as a literal penis. You can therefore take the envy of the penis to represent the female child’s desire for empowerment, which she would gain through association with masculine traits and pursuits.

When you think about it this way, you can see some potential merit to Freud’s ideas. But for the most part, this part of Freud’s theory has had little influence on the rest of the field. Also, we assume that the critiques of Freud’s ideas about women are painfully obvious at this point; indeed, these critiques of the phallic stage, as well as its general inaccuracy as a description of the psychological experiences of most people, have been devastating to this part of Freud’s theories.

The importance of the phallic stage is that, at its resolution, the child has formed a healthy relationship with the parents, resulting in the internalization of parental values, which completes the formation of the superego. Successfully transitioning out of this stage leaves the child well prepared as a moral being. On the other hand, becoming fixated at this stage has striking negative consequences. People become plagued with jealousy and preoccupied with sex, seduction, competitiveness, and power.

Freud believed that girls never entirely resolve their Oedipus complexes (the

term Electra complex was coined by Carl Jung but rejected by Freud), leaving women with somewhat less well-developed superegos and thus, a less reliable morality. He theorized that to the extent that Oedipal issues remain, women will seek to control and dominate men through their sexuality or submissiveness because, of course, men have the penises that women envy.

The Latency Stage (6–13 years)

After the lurid sexuality and emotional drama of the phallic stage, the latency stage is downright boring. Between ages 5 and 13, the ego and superego have achieved a degree of general calm. The sexual nature of the libido is deemphasized, and it is instead directed into more productive activities than trying to mate with and murder one’s parents, such as education, hobbies, and hanging out with friends. This is a period of rich personal development for children, during which they gain many of their intellectual, social, artistic, and physical skills. Interestingly, people don’t get fixated at this stage, because personality is largely formed by the end of the phallic stage, and if people are not fixated at an earlier stage, they become relatively free to pursue their interests.

The Genital Stage

The onset of puberty marks the beginning of this stage, which continues throughout adulthood. This is the time during which the person emerges into a mature adult personality, with a fully developed capacity for productive work and satisfying and loving relationships. However, those who remain fixated at previous stages will suffer from underdeveloped personalities, which cause any number of problems in their subsequent adulthoods.

Modern psychodynamic psychologists generally agree that Freud’s stages of psychosexual development are not an accurate view of personality development. However, even this is not entirely clear; clinical psychologists often report observing patterns that are consistent with Freud’s observations of each stage of

psychosexual development (Westen, 1998). For example, one study reported that young children are more likely to show affection to the same-sexed parent

and aggression toward the opposite-sexed parent (Watson & Getz, 1990). This is reminiscent of the Oedipus complex, although the underlying mechanisms are not necessarily the same (i.e., notice there is no reference to sexual attraction or murderous intent).

A huge challenge faced (and never surmounted) by Freudian thinkers was how to empirically measure many of the concepts and processes described in Freud’s theories. For example, how exactly does one measure the contents of the unconscious? How can we measure something that, by definition, people are unaware of?

Exploring the Unconscious with Projective Tests

As discussed earlier in this module, Freud devised a number of techniques for peering into the inner workings of the unconscious, such as analyzing the “psychopathologies of everyday life” for evidence of defence mechanisms and hidden motivations. Freud also refined methods, such as dream analysis and free association, which were believed to reveal unconscious material by side- stepping the conscious mind. For example, dream analysis was based on the

belief that the material in the unconscious, although not accessible to the conscious mind, nevertheless was depicted in our dreams. However, because much of the unconscious operates without language, dreams would not be literal, but symbolic representations of the contents of the unconscious. Thus, the dream analyst had to learn to properly interpret the symbolic meaning of dreams in order to understand what could be learned from the unconscious.

Since Freud’s time, psychodynamic psychologists have attempted to develop more standardized techniques for probing the unconscious. One popular

approach is to use projective tests , personality tests in which ambiguous images are presented to an individual to elicit responses that reflect unconscious desires or conflicts. They are called “projective” because the image can be interpreted in different ways, and the particular interpretation a person chooses is thought to be a projection of her unconscious.

One of the most familiar projective tests is the Rorschach inkblot test , in which people are asked to describe what they see in an inkblot, and psychologists interpret this description using a standardized scoring and interpretation method (Exner, 1991; see Figure 12.7 ). Another projective test is the Thematic Apperception Test (TAT) , which asks respondents to tell stories about ambiguous pictures involving various interpersonal situations (Figure 12.8 ). For example, a picture might show a man and woman looking at each other with blank expressions. Subjects are asked to tell a story about the picture. Who are these people? What emotions are they feeling? Why are they looking at each other that way? The details in the story that a person makes up are thought to be a projection of their personality functioning, and thus, a way of illuminating their unconscious.

Figure 12.7 The Rorschach Inkblot Test Some psychologists attempt to measure personality characteristics by analyzing the verbal responses clients use to describe what they see in an inkblot such as this. Equinox Imagery/Alamy Stock Photo

Figure 12.8 The Thematic Apperception Test In this projective test, the individual is asked to tell a story about what is

happening in the image. The responses to this task are believed by some to give important insights into an individual’s personality. Ken Karp/Pearson Education

Unfortunately for proponents of projective tests, they have not fared well in empirical research, receiving criticism for low reliability and validity. Low reliability indicates that the test will not give the same measurement on subsequent assessments of the same person. Low validity indicates that the test does not actually measure what it purports to measure. For example, although projective tests are supposed to measure personality functioning, in some cases, such as

the figure-drawing test shown in Figure 12.9 , they actually measure a combination of artistic ability and intelligence (see Lilienfeld et al., 2000). Time and again, research has indicated serious limitations regarding the reliability and

validity of projective tests (Garb et al., 2005; Lilienfeld et al., 2000).

Figure 12.9 Figure Drawing as a Projective Test Figure drawing is another projective technique used by many psychologists. The content of the drawings is analyzed and interpreted by the therapist. It turns out that these drawings are somewhat related to artistic ability and intelligence, but

not personality (Lilienfeld et al., 2000).

Despite criticisms from some researchers, many therapists claim that they have experienced significant breakthroughs by using projective tests. A survey in the

mid-1990s estimated that 43% of clinical psychologists and psychiatrists made

frequent use of projective tests (Watkins et al., 1995). More recently, a survey of school psychologists showed that the TAT and Rorschach were used by 30% and 14% of these professionals, respectively, although their popularity appears

to be declining (Hojnoski et al., 2006).

Working the Scientific Literacy Model Perceiving Others as a Projective Test

There are clearly problems with the reliability and validity of some projective tests, but the basic idea of projection remains compelling to many psychologists. Could there be some way to measure projection with greater accuracy? One promising direction is to look at how people make judgments about what other people are like.

What do we know about the way people perceive others? People have a seemingly natural inclination to make assumptions about what others are like, even if only very limited information is available. We may judge people we hardly know as friendly, aggressive, selfish, or trustworthy, for example. But with virtually no information to guide us, how do we make these judgments? One possibility is that we make guesses as to what other people are like by using our own self-concepts as a guide. With no other information to go on, we tend to assume that most people are

kind of like us. The trait of Machiavellianism (see Module 12.1 ) provides a great example. People who exhibit this trait are generally willing and able to manipulate and deceive others to get what they want. Interestingly, they are more likely than the general population to see others as being cynical and selfish

(Christie & Geis, 1970). Thus, psychologists suggest that the degree to which an individual sees people as selfish and cynical

is, to an extent, a projection of his own Machiavellianism (Wood

et al., 2010).

How can scientists study how projection relates to personality? Although projection was initially a psychodynamic idea, contemporary researchers have begun to apply it to other approaches, such as the trait approach. In one study, participants rated both themselves and others in terms of personality traits such as the Big Five, narcissism (i.e., excessive self-importance), and symptoms of depression. Researchers found that the way that participants viewed themselves was related to how they viewed others. For example, people who viewed themselves positively (as agreeable, intelligent, and satisfied with life) were

likely to view others the same way (Wood et al., 2010). This provided evidence that how people perceive others appears to be a projection of how they perceive themselves.

Can we critically evaluate this research? The results of this study indicate that self-ratings and ratings of others are correlated. However, the correlations themselves are

not very large, meaning that psychologists cannot make precise predictions about a rater’s personality based on that individual’s

ratings of others, but rather can make only general statements. Furthermore, this study does not provide evidence that projection is actually occurring (i.e., that people are actually using their own self-concepts to guide their impressions of others). It could be the case that people are simply positive or negative in general, such as being optimistic or pessimistic. The positive, optimistic person would tend to see herself and others positively, and the negative, pessimistic person would do the opposite. Thus, the correlation between ratings of self and other simply reflects a general disposition, not a specific process of projection.

Why is this relevant? Standard projective tests such as the Rorschach inkblot test and

the Thematic Apperception Test are fraught with problems and controversy. It would be unheard of for modern medical doctors to diagnose disorders using procedures that are as unreliable and of as questionable validity as these tests. Thus it is important to search for new and better methods that might reveal meaningful information about the individuals taking them. Psychology need not necessarily abandon projective tests altogether, as the benefits of adding rigour and scrutiny to them has shown that

they can be of value (e.g., Schultheiss & Brunstein, 2001).

Module 12.3a Quiz:

The Psychodynamic Perspective

Know . . . 1. According to Freud, the is the personality component that is

responsible for seeking to immediately satisfy basic biological needs.

A. id B. ego C. superego D. libido

2. According to Freud, in which order do the stages of psychosexual development occur?

A. Oral, anal, phallic, latency, genital B. Oral, anal, genital, phallic, latency C. Anal, oral, phallic, latency, genital D. Latency, oral, anal, genital, phallic

Understand . . . 2. A defence mechanism would be employed

A. by the id to create anxiety.

B. by the superego to reduce or avoid anxiety. C. by the ego to reduce or avoid anxiety. D. by the superego to create anxiety.

Apply . . . 4. Dan lied to avoid getting in trouble with his parents, but now he is

experiencing anxiety caused by extreme guilt. According to Freud, these

negative feelings would arise due to the activity of the . A. Oedipus complex B. ego C. superego D. libido

Analyze . . . 5. Why have some psychologists questioned the reliability of projective

tests?

A. Judges very often agree on how to interpret an individual test. B. Individuals often score quite differently if tested at two different

times.

C. The tests may not measure what they claim to measure. D. These tests often provide disturbing details about a person’s

unconscious.

Alternatives to the Psychodynamic Approach

Freud attracted many followers, but some of his contemporaries took psychodynamic psychology in different directions. They recognized that sex and aggression are not the only motives driving personality development; indeed, other motivational forces, such as the need for belonging, the need for achievement, and the need for integrity or wholeness, are important aspects of personality.

Analytical Psychology

Carl Jung (1875–1961) made a dramatic break from Freud over disagreements about a number of issues, founding the analytical psychology movement. Analytical psychology focuses on the role of unconscious archetypes in personality development. The archetypes were believed to be housed in a region of the unconscious unique to Jung’s theories. In contrast to the Freudian unconscious, Jung believed that there were two main types of the unconscious,

a personal unconscious , which was basically the same as the Freudian unconscious, a vast repository of experiences and patterns absorbed during the person’s life, and a collective unconscious, which is not held within the individual person. The collective unconscious is a separate, non-personal realm of the unconscious that holds the collective memories and mythologies of humankind, stretching deep into our ancestral past. Jung thought of the personal and collective unconscious as entirely different “levels” of consciousness, although they are so different from one another as to be basically completely different things. The personal unconscious is still housed within the person, but the collective unconscious is more like a larger field of forces, which shape the individual personality in certain characteristic ways.

Within analytical psychology, archetypes played a central role; archetypes

are images and symbols that reflect common patterns of experience across all cultures. There are many different archetypes and several particularly important ones, including the Mother, the Child, the Trickster, the Wise Old Man, the Hero, and the Shadow, among others. The Shadow archetype represents unwanted aspects of the self that the person is unwilling to acknowledge; this archetype has been particularly influential among psychologists who emphasize personal

growth, individual empowerment, and healing from trauma (e.g., Ford, 2002). These archetypes were thought to represent major narrative patterns in human experience, part of the universal tapestry of human life. Thus, when archetypal symbols appeared (for example, in a person’s dreams), it was believed that they could be interpreted and would give important insights into the person’s personal growth and well-being. Archetypes are a very popular aspect of Jungian psychology, but they have not had much of an impact on the rest of the field,

again due to their unscientific nature.

The Power of Social Factors

Alfred Adler (1870–1937) initially differentiated himself from Freud by arguing for the importance of social dynamics and conscious thoughts (as opposed to sexual and aggressive drives in the unconscious) as determinants of behaviour. He rejected the centrality of the pleasure principle, instead emphasizing the inferiority complex , the struggle many people have with feelings of inferiority, which stem from experiences of helplessness and powerlessness during childhood. Adler described how people strive to compensate for their feelings of inferiority by trying to appear competent and, in many cases, overcompensate for inferior feelings by trying to be or appear superior to others. Adler’s theories of the importance of the need for power have had a profound influence on the field of psychology and continue to inspire contemporary

research (e.g., Watts, 2000).

Karen Horney (1885–1952) also disagreed with Freud’s heavy emphasis on sex, and especially infantile sexuality. Instead, Horney (disappointingly pronounced “HORN-eye”) focused on the importance of social and cultural factors, arguing that to understand personality one should focus on the functioning of a person’s present self, rather than overwhelmingly focusing on the unconscious, which was largely formed in early childhood. Horney highlighted the role of interpersonal conflict between children and their parents as important to personality development. She also strongly advocated against Freud’s “phallocentrism” (i.e., emphasis on the penis). To counter his theory of the Oedipus complex, Horney argued instead that men suffer from “womb envy,” because men can never experience the miracle of birth and of carrying another human life as part of oneself, or the experiences of breastfeeding and other biological acts of motherhood. She said that men attempted to compensate for their perceived deficiencies by focusing on work and by devaluing and subjugating women. While Freud believed that women suffered from penis envy, Horney argued that any “envy” Freud observed in the female psyche was envy of the patriarchal

power enjoyed by men, not of men’s sexual equipment (Paris, 1994).

As you can see, psychodynamic theorists have separated themselves in a number of important ways. Contemporary psychodynamic psychologists work mostly in the field of clinical and counselling psychology. And, despite some differences, modern psychodynamic psychologists do share many of the core attributes of psychoanalytic thought: an emphasis on the unconscious, internal conflicts between opposing forces within personality, and the influence of early

experiences on adult personality (Westen, 1998).

Humanistic Perspectives

Reacting against the pessimism and disempowerment inherent in Freudian approaches, the humanistic psychologists wanted to explore the potential for humans to become truly free and deeply fulfilled. Thinking outside the boxes of behaviourism and psychodynamic theories, the humanistic psychologists emphasized the individual’s free will to make choices, highlighted positive motivations for personal growth and development, and explored the upper ranges of human experience, such as feelings of transcendence, love, and fulfillment. Proponents of the humanistic approach believed it would become the “third force” in psychology, after psychoanalysis and behaviourism.

Among the many influential humanistic psychologists, Carl Rogers was perhaps uniquely responsible for helping to launch the movement and for cementing certain ideas in the field that remain to this day. Rather than the Freudian depiction of people plagued by complexes and defences, Rogers championed a person-centred perspective , founded on the assumption that people are basically good, and given the right environment their personality will develop fully and normally. Rogers believed that people possess immense inner resources for growth and resilience, and a desire for self-actualization , which is the drive to grow and fulfill one’s potential.

According to Rogers, fully functioning, self-actualized people deeply accept themselves and are highly self-aware; having moved beyond the need to erect defences to ward off negative feelings, they become aware of their inherent goodness. Rogers believed that the more self-actualized a person becomes, the more his inherently good nature will dominate his personality. Other leading

humanistic psychologists, such as Abraham Maslow, also sought to identify the characteristics of fully functioning, self-actualizing people. Research on human strengths and virtues continues to this day, gaining new life in recent years through the positive psychology movement, with renewed interest in topics like personal growth, gratitude, authenticity, and meaning.

Module 12.3b Quiz:

Alternatives to the Psychodynamic Approach

Know . . . 1. The aspect of consciousness proposed by Carl Jung that is a store of

archetypes representing symbols and experiences common to all

cultures is called the . A. preconscious B. subconscious C. analytical conscious D. collective unconscious

2. In contrast to psychodynamic theories, humanistic theories emphasize A. free will. B. how personalities are determined by biology. C. how personality is determined by the environment. D. how defence mechanisms affect behaviour.

Apply . . . 3. Alexandra’s older sister is praised for being good at math, but Alexandra

struggles with the subject. What would the resulting feelings of being “not good enough” be called?

A. Negative reinforcement B. Negative archetype C. Inferiority complex D. Oedipus complex

Analyze . . .

4. Which of the following is not a critique of Freud’s psychodynamic approach to personality?

A. It focuses on situations we cannot control. B. It does not yield many scientifically testable hypotheses. C. It was based on a very limited sample of subjects. D. It has not been found useful or applicable to clinical psychology.

Module 12.3 Summary

analytical psychology

archetypes

collective unconscious

conscious mind

defence mechanisms

ego

fixation

id

inferiority complex

person-centred perspective

personal unconscious

projective tests

Rorschach inkblot test

self-actualization

superego

Thematic Apperception Test (TAT)

Know . . . the key terminology related to the psychodynamic and humanistic approaches to personality.

12.3a

unconscious mind

According to the psychodynamic perspective, defence mechanisms activate whenever we are threatened by feelings of anxiety due to conflicts between different systems within consciousness. These mechanisms include denying and repressing urges, displacing them, or finding more acceptable ways of expressing them.

To explain personality development, Freud began with the concept of libido—the id’s energy source for the drives that originate at different focal points of the body from infancy to adolescence. Each of the stages of psychosexual development— oral, anal, phallic, latent, and genital—is associated with a unique form of conflict as the ego and superego develop. Failure to resolve the corresponding conflict can result in a fixation, in which the person is stuck at a certain phase of development, and this can cause problems later in life.

Apply Activity To apply the psychodynamic approach to understand someone’s personality, you would consider the role that unconscious processes play in determining behaviour, as well as the conflicts that exist between a person’s impulses and his

need to regulate them. Review Freud’s structure of the mind (illustrated in Figure 12.6 ) and the psychosexual stages of development. What might each of the following situations mean from Freud’s perspective?

1. A student cannot concentrate on her homework until every little item on

Understand . . . how people use defence mechanisms to cope with conflicting thoughts and feelings.

12.3b

Understand . . . the developmental stages Freud used to explain the origins of personality.

12.3c

Apply . . . both psychodynamic and humanistic perspectives to explain personality.

12.3d

her desk is in its appropriate place.

2. An individual commits violent acts against others without feeling any remorse.

To apply the humanistic perspective to understand personality, you would look at the person’s motivations for personal growth and fulfillment and consider whether they embody the set of traits described by Maslow as characterizing self-actualized people. In each of the following scenarios, which personality characteristic could the person work on changing in order to move toward becoming self-actualized?

1. Dave is a pragmatic guy, preferring the hard, cold facts of reality to fantasies about how life could be different. He is not afraid to express what he really thinks, and is not very concerned about whether other people accept or reject him. Because he is so comfortable with himself, he has little anxiety and can behave spontaneously and freely in most situations. He feels strongly patriotic toward his country, and thinks that government should focus on issues like taxes and the economy, rather than trying to help people who are disadvantaged due to poverty.

2. Zoe is enthusiastic about life and has a strong spiritual practice, using meditation and prayer to feel closer to the divine. She feels profound empathy for people in all parts of the world and is described by her family as a “bleeding heart,” someone who cares strongly for people who are worse off than her. She regrets some of the choices she made earlier in life, and although she tries to learn from them, finds herself often nostalgically thinking about the past. She has many friends and is very socially active, in part because she is such a people-pleaser that she is good at presenting herself in such a way that she makes other people comfortable.

In this module you learned about projective tests such as the Rorschach inkblot test and the Thematic Apperception Test, which some psychologists believe are

Analyze . . . whether projective tests are valid measures of personality.

12.3e

useful tools that give them insight into unconscious processes. However, projective tests do not appear to be valid ways of assessing characteristics of a person’s personality.

Psychodynamic theories can provide some compelling explanations for human motivation. For example, it is easy to understand how social and moral conflicts arise when couched in terms of a struggle between the id and the ego. At the same time, this approach does not have a lot of scientific support. Its key concepts, such as the id, ego, and superego, are theoretical constructs that cannot be empirically measured. Also, the psychosexual stages of development are no longer believed to be accurate descriptions of stages that children go through while growing up.

Analyze . . . the strengths and weaknesses of psychodynamic perspectives.

12.3f

Chapter 13 Social Psychology

13.1 The Power of the Situation: Social Influences on Behaviour The Person and the Situation 533

Module 13.1a Quiz 537

The Asch Experiments: Conformity 537

Working the Scientific Literacy Model: Examining Why People Conform: Seeing Is Believing 538

Module 13.1b Quiz 540

The Bystander Effect: Situational Influences on Helping Behaviour 541

Module 13.1c Quiz 544

Social Roles and Obedience 544

Module 13.1d Quiz 549

Module 13.1 Summary 549

13.2 Social Cognition Person Perception 552

Module 13.2a Quiz 554

The Self in the Social World 554

Module 13.2b Quiz 557

Stereotypes, Prejudice, and Discrimination 557

Working the Scientific Literacy Model: Explicit versus Implicit Measures of Prejudice 559

Module 13.2c Quiz 562

Module 13.2 Summary 563

13.3 Attitudes, Behaviour, and Effective Communication Changing People’s Behaviour 565

Module 13.3a Quiz 566

Using the Central Route Effectively 566

Working the Scientific Literacy Model: The Identifiable Victim Effect 568

Module 13.3b Quiz 571

Using the Peripheral Route Effectively 572

Module 13.3c Quiz 574

The Attitude–Behaviour Feedback Loop 574

Module 13.3d Quiz 576

Module 13.3 Summary 576

Module 13.1 The Power of the Situation: Social Influences on Behaviour

Ted Pink /Alamy Stock Photo

Learning Objectives

Know . . . the key terminology associated with social influence. Understand . . . why individuals conform to others’ behaviours. Understand . . . how individuals and groups can influence behaviours. Apply . . . your knowledge of the bystander effect to ensure that you will

13.1a 13.1b 13.1c 13.1d

In an interview for the British Broadcasting Corporation (BBC), Joe Darby described what it felt like when he started looking at the pictures. They’d been given to him on a CD by a colleague, Charles Graner. They seemed innocent at first, scenes of soldiers at different locations around Baghdad, Iraq. Then he saw a pyramid of naked men, climbing on top of each other. It made him laugh. However, he soon realized these were not people joking around; these were pictures of Iraqi prisoners being tortured and degraded, in the very prison he was working in.

He saw images of his fellow soldier, Charles Graner, physically assaulting a group of handcuffed prisoners. He saw a photo of naked male prisoners with bags over their heads positioned in sexually suggestive poses. And he saw many images of another fellow soldier, Lynndie England, leading prisoners around on a leash, standing behind a pile of naked prisoners while giving a thumbs-up sign, and posing with an Iraqi prisoner who had died.

Then, Joe Darby made the critical decision: He decided to turn the pictures over to the Army’s criminal investigation unit, blowing the whistle on an appalling situation of torture and corruption that implicated the US military and some high-ranking government officials. You may have seen some of these photos yourself, as they were splashed across newspapers and websites around the world. They are chilling, to the extreme, depicting tortures committed by U.S. soldiers against Iraqi citizens in, of all places, Abu Ghraib. Ironically, this prison was renowned for its use of brutal torture under the dictatorship of Saddam Hussein, who was the leader that the U.S. soldiers were “liberating” the Iraqi people from.

When he decided to hand over the pictures, Darby feared that he would be putting himself at serious risk for retaliation from his fellow soldiers. It would be all too easy for any of his fellow soldiers to quietly kill him in his

be helped if you are in an emergency. Analyze . . . whether guards who participate in abuse are inherently bad people, or whether their behaviour is the product of social influences.

13.1e

sleep. However, because he had made his reports anonymously, none of the other soldiers knew that he was the whistle-blower. Astonishingly, it was none other than Donald Rumsfeld, the Secretary of Defense at the time, who blew Darby’s cover. Rumsfeld appeared on TV and personally thanked Joe Darby, by name, for turning in the photos; this unbelievable mistake left Darby unprotected and completely vulnerable to any who would seek revenge.

When his fellow soldiers found out, he was widely congratulated, but back in his home town, Darby was regarded as a traitor. In his words, “You have some people who don’t view it as right and wrong. They view it as: I put American soldiers in prison over Iraqis.” For their own security, Darby, his wife, and children were placed in protective custody. Today, they remain in an undisclosed location, accompanied by a military escort whenever they go out—even for something as simple as a trip to the grocery store.

When we learn about atrocities like Abu Ghraib, we want to understand how people could ever do such things. The hope is that by understanding the social and psychological dynamics that lead to these tragedies, we may be able to prevent more of them in the future, and make it easier for heroes such as Joe Darby to come forward and do the right thing. One thing is certain, people can resist social pressures in any circumstance. And when they do, it pays off in a deep sense of inner conviction and a clear conscience. Joe Darby says that after all he and his family have been through, “I’ve never regretted for one second what I did when I was in Iraq, to turn those pictures in.”

Focus Questions

1. What leads people to engage in horrific acts against others? 2. How much are our behaviours influenced by others?

The Person and the Situation

Most of us grew up with a clear distinction between right and wrong and the belief that the world is comprised of good guys and bad guys. Then we assume that we’re the good guys, and so are people who are “like us.” After all, we don’t go around murdering, torturing, or committing crimes, right? So when terrible things happen, we assume that it’s “other” people who do these things: fundamentally different types of people—bad guys. Although this may be a comforting way to experience the world, it has at least one big downside. When terrible things do occur, we generally look for which bad people to blame, and as a result, we fail to question or challenge the larger system.

Dr. Philip Zimbardo, a highly influential social psychologist of the last half century, is a champion of this alternative view. He says it’s not the bad apples, but the bad barrels. After carefully studying over a thousand pictures of abusive acts occurring in Abu Ghraib, Zimbardo concluded that the tragedy should be seen as an outgrowth of the whole system, and that the blame likely goes very high up the chain of military/political leadership, because a situation was intentionally created that systematically promoted or endorsed the use of violence against Iraqi prison detainees.

REUTERS/Alamy Stock Photo

For example, there was a general lack of supervision over guards’ treatment of detainees, a pervasive and constant fear of terrorism, the presence of many non- military personnel hired from private security companies who didn’t have the same public accountability as military officers, the general danger and stress of living in the area, physical and mental exhaustion, language and cultural barriers

that would make it easier to fall into Us vs. Them ways of thinking (see Module 13.2 ), frequent changes made to the official rules on what were considered acceptable methods for interrogation, the prevalence of social norms condoning prejudice towards outgroups (e.g., Iraqis, Muslims, prisoners) and favouritism towards in-group members (e.g.,. Americans, soldiers, prison guards). Finally, there were contributing factors high up the chain of military and political command. For example, at the prison itself the soldiers who interrogated detainees experienced immense pressure from higher up the chain of command to “get results” when interrogating detainees; they were also frequently, and conveniently, left unsupervised when with detainees, so that when they “worked them over” their superiors would be officially unaware. At the highest level of government, President Bush changed the U.S.’s official policy on torture, even stepping outside of the Geneva Convention prohibiting torture, all in the name of

“fighting terrorism.” One could argue that this created powerful cultural pressures towards, and provided legitimacy to the use of, torture and violence. Zimbardo

believes that all of these situational factors worked together, not strictly to cause a specific act to occur, but to make it more likely that soldiers in those conditions

would commit violent acts (Zimbardo, 2004, 2007).

Courtesy Wikipedia/ZUMA Press/Newscom

It’s disturbing to fully consider the situational explanation for “evil.” Most of us would rather believe in the dispositional, bad apples explanation. Otherwise we

have to face the possibility that we also have the capacity to do terrible things if we fall into the wrong circumstances. On the other hand, if we fail to appreciate the power of the situation, how can we prevent history from repeating itself? How can we learn the lessons taught by Abu Ghraib, or by the Holocaust, if we assume that these things occurred as aberrations, rather than recognizing that certain predictable, situational factors make these types of tragedies more likely to occur?

We must also remember that the situational analysis is never enough to fully explain a behaviour pattern. Individuals retain free will (or so we assume). People are still, in the final analysis, responsible for their behaviour. For example, in Abu Ghraib, most of the soldiers did not behave abusively; they seemed to be able to resist the power of the situation. Joe Darby even had the courage to step forward and report the abuses so that the rest of the world found out what was going on.

To try to fully understand social reality, social psychologists study the interaction between the person and the situation. Kurt Lewin (1936), a key founder (often regarded as the grandfather) of social psychology, expressed this insight as B = f(P,E): Behaviour is a function of the Person and the Environment. This insight challenged the Freudian theories of the early 20th century, which explained a person’s behaviour as being guided by unconscious forces that were rooted in that person’s distant personal past. It also challenged behaviourism, with its emphasis on the person’s history of conditioning. Social psychologists, in contrast, emphasized the role of the individual in choosing how to interpret a situation, and ultimately, how to respond. They also focused on the person’s experience in the present moment. Lewin brought a metaphor from physics into psychology, arguing that a person’s behaviour was the consequence of sets of forces operating on the person, and once an analyst sufficiently understood the forces, then the person’s behaviour could be predicted, just as one could analyze the trajectory of an object by understanding the physical forces (gravity, friction, etc.) operating on the object. This general approach was extremely influential in social psychology and has been widely applied in the business world. Theories of how to create change in organizations often incorporate Lewin’s logic, analyzing the forces operating in the situation and determining which forces to

change.

The past 80 years or so of research in social psychology that has flowed from this insight has pieced together a deep understanding of the situational forces and individual characteristics that determine human behaviour.

Mimicry and Social Norms

Our analysis begins by considering the powerful, and often overlooked, ways in which we are influenced by the people who are immediately around us. For

example, although we are often unaware of it, we tend to engage in mimicry , taking on for ourselves the behaviours, emotional displays, and facial expressions of others.

For example, the chameleon effect (Chartrand & Bargh, 1999) describes how people mimic others non-consciously, automatically copying others’ behaviours even without realizing it. You tend to laugh and smile when others are laughing and smiling. More generally, you make the same emotional expressions on your face as those you see on the faces around you, and then pick up their moods as well. And if someone else is whispering, you will likely whisper, even if it is to ask, “Why are we whispering?” The examples are literally endless; practically every moment of social interaction between people involves mimicry.

This kind of subtly attuned mimicry is highly functional (Lakin et al., 2003), much of the time serving as a “social glue,” helping to coordinate behaviours in social settings, helping people to feel reassured and validated by each other, sending the unconsciously processed message to others that you are kind of like them, and more so, that you are paying attention to them in that moment.

Humans are a social species, and coordinating our behaviour with others is a key part of learning to function in the social world. It is often a good idea to see what other people are doing and “go with the flow.” Learning through observation

is one of our key activities in life (see Module 6.3 ), and probably has been for a long part of our evolutionary past. It’s what we humans do.

The vast bulk of this social processing occurs through implicit, unconscious processes that we can examine at multiple levels of analysis. For example, there are implicit processes of attention, perception, emotions, and behaviour that are

described in social psychology (see also Module 13.2 ). There is emotional synchrony and influence that flows between people and through groups and social networks, and there is even physiological synchrony that ties people together, such as how people’s hormone levels synchronize when they live with each other. The point is, a lot goes on that links us together with other people and we are consciously aware of very little of it.

The social benefits of mimicry can be seen by how they affect social interactions. For example, people mimic others more when they are trying to make a good

impression (Lakin & Chartrand, 2003). It does seem to work: when someone adopts similar bodily movements and gestures to your own (even quite subtly),

you tend to like them more (Chartrand & Bargh, 1999). However, it’s a different story if you try to intentionally mimic people’s behaviour in order to manipulate them. Consciously trying to “steer” this process could lead you into trouble, just like focusing too much on a well-practised movement can cause you to mess it up. Indeed, if someone notices that a person is mimicking them, they like that

person less as a result (Maddux et al., 2008); so, if you are using this power for your own nefarious purposes, at the very least, be subtle about it!

Given that mimicry is so implicit and deeply ingrained, it would make sense to expect that we humans would find it awfully difficult to resist being influenced by

each other. In many different situations, we tend to conform to the social norms that are evident. Social norms are the (usually unwritten) guidelines for how to behave in social contexts. Norms influence everything from our manners (e.g., you probably make different jokes when out with your friends than when you meet your boy/girlfriend’s parents for the first time), to the amount of alcohol we drink, food we eat, clothes we wear, and even the beliefs and attitudes we express. Social norms govern much of our behaviour, even though people often fail to realize this and instead believe that their behaviour is freely

chosen (Nolan et al., 2008). Much social psychological research has shown that people have relatively poor insight into the actual causal factors that influence

their behaviour much of the time; we aren’t in control of ourselves as much as we

would like to believe (Nisbett & Wilson, 1977).

Mimicry and social norms reflect the fact that much of our lives are spent in groups; whether it’s hanging out with friends, doing a work or school project, performing artistically, and so on, small groups are hard to avoid. A key question in social psychology is whether people behave differently in groups than they do as individuals, and how behaviour changes as a result of being in a group.

Group Dynamics: Social Loafing and Social

Facilitation

Let’s start with a question about your own experiences in groups—how do you feel about group assignments? Do you like them because they’re an opportunity to get to know people, or maybe because the group can accomplish something more impressive together than they could alone? Or do you hate group projects because other people waste so much time, or because people don’t have very good ideas, or because some people are slackers whose work doesn’t meet your standards and you end up having to do everything? You probably have some kind of opinion on group projects. But here’s the thing—regardless of your feelings, you are almost certainly going to be working in groups in your future. Whether it’s your job, family and community groups, or the group project your charming professor assigns to your class, it’s pretty tough to avoid working with other people.

Often one of the main purposes of a group is to produce better work than an individual could by working alone. But does this really happen? Do groups produce better work, making the most out of individuals’ ideas and encouraging their best efforts? Or do they produce poorer outcomes, limiting people’s creativity and enabling them to slack off? Oddly enough, the answer to both questions is “yes, sometimes.”

Groups sometimes produce poorer outcomes due to social loafing , which occurs when an individual puts less effort into working on a task with others.

There are various phrases for describing this—coasting, slacking, free-riding. Social loafing can occur in all sorts of tasks, including physical activities (e.g., swimming, rope-pulling), cognitive activities (e.g., problem solving, perceptual tests), and creativity (e.g., song writing), and across all types of groups,

regardless of age, gender, or nationality (Karau & Williams, 2001; Latané et al., 2006). One reason why people loaf is because they think others in the group are also not doing their best, setting up an apparent social norm that “people in this group don’t work very hard.” There are two likely outcomes of social loafing. Either the group performs quite poorly (i.e., crashes and burns), or a small number of people end up saving the group by doing everything themselves.

Given the importance and inescapability of group work, it is important to understand what factors encourage loafing, so we can avoid them.

Low efficacy beliefs. This occurs if tasks are too difficult or complex, so people don’t know where to start. Structure tasks so people know exactly what to do, provide clear deadlines, and give people feedback so they know how well they are doing and how they can improve.

Believing that one’s contributions are not important to the group. This occurs if people can’t see how their own input matters to the group. Overcome this by helping people understand how group members rely on and affect each other, and assigning tasks to people that they feel are significant or they’ve had some say in choosing (if possible).

Not caring about the group’s outcome. This occurs when a person is not personally identified with the group, perhaps feeling socially rejected from the group or perceiving the group as unsuccessful or unimportant. Overcome this by making the group’s goals and values clear and explicit, encouraging friendships to form and group activities to be fun and socially rewarding.

Feeling like others are not trying very hard. As discussed earlier, people loaf if they feel others are loafing (Karau & Williams, 2001). Overcome this by providing feedback about the progress of group members on their individual tasks; strong groups often have regular meetings where people’s progress is discussed and, ideally, celebrated!

In contrast to social loafing, social facilitation occurs when one’s

performance is affected by the presence of others. For example, in probably the first social psychology experiment ever published, Norman Triplett (1898) found that cyclists ride faster when racing against each other than when trying to beat the clock. Many other researchers have found similar effects, even in animals. For example, ants are able to dig more when other ants are working alongside

them (Chen, 1937) and even cockroaches run down a runway more quickly when other cockroaches are around (Zajonc et al., 1969).

The presence of others doesn’t always improve performance, however. We’re all familiar with the athlete who “choked” at the big moment. The presence of others is likely to interfere with our performance when our skills are poor or the task is difficult. Even the cockroaches mentioned earlier did more poorly when other

cockroaches watched them try to navigate a more complex maze (Zajonc et al., 1969).

There are many different mechanisms that explain the social facilitation effect

(Uziel, 2007). One of the most important is that the presence of others is (emotionally) arousing, and arousal tends to strengthen our dominant responses. When the task is simple (e.g., run in a straight line), our dominant responses are the right ones, but when the task is very complex (e.g., juggle three axes), we need to be able to control our responses more carefully, and then arousal decreases performance. Thus, the effects of arousal due to social facilitation depend on one’s skills and the difficulty of the task; the greater the skills and the simpler the tasks, the more likely the presence of others will enhance performance. For true masters of a skill, audiences and competitors generally enhance performance, but novices tend to perform best in practice sessions

when nobody’s watching (Bell & Yee, 1989; MacCracken & Stadulis, 1985).

Groupthink

In the same way that feeling evaluated tends to limit one’s full abilities, the pressures that build within groups also often limit creativity, leading people to

hold back their ideas. Groupthink refers to this stif­ling of diversity that occurs when individuals are not able to express their true perspectives, instead having to focus more on maintaining harmony in the group and on not being

evaluated negatively.

In contrast with our optimistic visions of group “brainstorming” sessions that are wildly creative and inventive, the reality of group performance is quite a bit less impressive. Group members can feel evaluative or competitive pressures within the group, and as a result, the group norm is not as safe or supportive; this makes it feel more risky to put yourself out there and say something really radical and crazy. So, instead of a frenzy of creativity in which group members gleefully pile idea upon idea, group brainstorming often ends up being a kind of polite and restrained process, where a few ideas are aired and then the group quickly moves towards implementing something. In short, group brainstorming often fails.

When group members are more concerned with avoiding disagreements than with generating ideas, three main problems occur. First, group members may minimize or ignore potential problems and risks in the ideas they are considering. The lack of ability to critically question or disagree with ideas means that people will emphasize potential rewards and successes and overlook potentially disastrous things that might go wrong. Second, groups will likely settle too quickly on ideas, because social pressures will make people uncomfortable with prolonging a decision-making process. Instead, they will simply agree with one of the existing ideas. As a result, many potential ideas are never brought to the table for consideration. Third, groups often become overconfident and therefore less likely to carefully examine the consequences of their decisions, leading

them to be less likely to learn from their mistakes (Ahlfinger & Esser, 2001; Janis, 1972). All things considered, groupthink seems like a pretty bad outcome! (Interestingly, the main thing that groupthink is good for is implementing ideas— getting things done. It’s choosing the right things to do that groupthink interferes with.)

Historically, groupthink has been identified in some truly terrible decisions, including the 1986 decision to go ahead with the launch of the space shuttle

Challenger despite safety concerns (the shuttle broke apart 73 seconds into its flight, killing seven astronauts); the escalation of the Vietnam War; and the 1961 Bay of Pigs invasion, when a U.S.-sponsored military invasion attempted to

orchestrate an overthrow of Cuban leader Fidel Castro and was soundly defeated, to the immense embarrassment of the U.S. In each case, leaders committed themselves to a course of action without taking into consideration all the different perspectives and opinions that were available. An example of groupthink in your lifetime was the U.S. war in Iraq. The original official justification for the invasion was that former Iraqi leader Saddam Hussein was manufacturing weapons of massive destruction (WMDs). However, the Bush administration was widely criticized for not giving equal consideration to different types of information before making its decisions. Specifically, information that supported the assertion that Saddam Hussein was manufacturing WMDs was considered valid and given serious weight, whereas information that countered this assertion tended to be rejected as invalid or based on uninformed testimony. In the end, the military action that resulted from this decision involved the deaths of hundreds of thousands of Iraqi citizens and thousands of U.S. soldiers. Now, more than a decade later, no WMDs have been found, and that region remains in turmoil.

Some groups are more susceptible to groupthink than others. Laboratory research revealed that when groupthink occurs, there is often a strong or “directive” leader—specifically, an individual who suppresses dissenters and

encourages the group to consider fewer alternative ideas (Ahlfinger & Esser, 2001). Also, groups in which members are more similar to each other, especially in terms of shared sociopolitical perspectives, are more likely to fall into

groupthink (e.g., Schulz-Hardt et al., 2000).

Module 13.1a Quiz:

The Person and the Situation

Know . . . 1. According to Kurt Lewin, human behaviour is governed by the formula B

= f (P, E). In this formula, E refers to A. environment. B. education. C. ego.

D. extraversion.

Understand . . . 2. The chameleon effect occurs when

A. individuals withdraw from social interactions. B. individuals try to use subtle means of persuasion. C. individuals turn their backs on a group member. D. individuals unintentionally mimic another’s behaviour.

3. Groupthink is least likely to occur when A. group members have very different sociopolitical values. B. group members become excited about their progress. C. a leader emerges who suppresses dissent. D. the group refuses to consider alternatives.

Analyze . . . 4. Which of the following does not explain why social loafing may occur?

A. The individual believes that even if the group succeeds, there will be very little reward in it for each individual group member.

B. The individual believes that the group will fail no matter what his or her contribution is.

C. The individual believes that he or she has little to contribute to a group.

D. The group is engaged in a particularly complicated project.

The Asch Experiments: Conformity

Groupthink can occur easily without a strong leader simply because of conformity pressures that arise spontaneously in groups. Classic experiments on conformity were performed in the 1950s by Solomon Asch. In his now-famous studies, participants were seated at a table along with several other people who

seemed like other participants but who were, in fact, “confederates,” people who were secretly working with the experimenter. Participants and confederates were

asked to look at an image of three lines, and choose which line was the same

length as a “standard line.” The task was designed to be so easy (see Figure 13.1 ) that when people were allowed to give their answers privately, they were correct almost 100% of the time. However, things changed when answers were spoken aloud in front of a group. For the first couple of trials, everybody gave the correct answer, making the participant’s job easy. But then, something weird happened; each of the confederates started giving the same wrong answer, one after another. Then it was the participant’s turn. What would he do? Would he go along with the rest of the group and give the clearly wrong answer? Or would he say what he knew to be the right answer?

Figure 13.1 Perceptual Judgment Task in Asch’s Conformity Studies Which of the comparison lines is the same length as the standard line? In Asch’s experiments, many people conformed to the confederates and gave the wrong answer. Top: Reproduced with permission. Copyright 2015 Scientific American, Inc. All rights reserved.

This is a situation in which unconscious mimicking doesn’t apply, because the

behaviour is very consciously chosen. And, it is not an ambiguous situation at all. However, conformity pressures were strong enough that 75% of people gave the wrong answer on at least one of the 12 trials in which the confederates gave the wrong answer. Each time confederates gave the wrong answer, about one third

of the participants conformed (Asch, 1951, 1955, 1956).

Why would people choose an answer they knew to be wrong? There are two

main types of social influence. Normative influence is the result of social pressure to adopt a group’s perspective in order to be accepted, rather than rejected, by the group. In contrast, informational influence occurs when people feel the group is giving them useful information. Although both types of influence can certainly affect behaviour, there is a big difference between them: informational influence tends to lead to actual belief change (i.e., the person comes to adopt the beliefs of the group), whereas normative influence does not necessarily lead people to privately accept the information that they may, publicly, be demonstrating their agreement with.

In the Asch study, both types of influence seemed to be occurring. For example, some of the conforming participants said afterwards that they thought they had misunderstood something, or that there was some sort of “trick” the others picked up on that they didn’t, because surely the others couldn’t all be wrong if they were all saying the same thing. Other people reported that they didn’t want to stand out or make a scene by being the disagreeable person, so they just went along with the group. In everyday contexts, both types of influence are often at work, making us easily swayed by other people. We will be especially vulnerable to social influence when we are uncertain about the situation, although as Asch showed us, social influence is powerful enough to make us doubt ourselves even when the situation is pretty clear and unambiguous. Many factors work together to determine, in a given situation, the strength of social

influence pressures and whether or not a person ends up conforming (see Table 13.1 ).

Table 13.1 Personal and Situational Factors Contribute to Conformity

People Tend to Be Less Likely to People Tend to Be More Likely to Conform

Conform When . . . When . . .

Only one other person is in the vicinity There is a larger group in the vicinity

There are only male group members There is a high proportion of female group

members

There are only strangers in the room There are friends, family, or acquaintances

in the vicinity

There are extremely clear and simple

tasks

The task is unclear or ambiguous

There is one other nonconformist in the

room

Others conform first

Responses are made anonymously Responses are made publicly

Working the Scientific Literacy Model Examining Why People Conform: Seeing Is Believing

For more than half a century, social psychologists have wondered why subjects in the Asch experiment conformed to the group. Did they consciously choose to conform solely because they didn’t want to incur a social cost by seeming different from everyone else (normative influence), or did the group’s collective opinion actually change the subjects’ own perceptions of the lines (informational influence)? More generally, is it possible that if enough people insist that reality is different from how it appears, then you will actually perceive a different reality?

What do we know about measuring choosing vs. perceiving? The simplest way of assessing why people conform is, of course, to ask them, which Asch did in some of his original studies. However, other research has shown that people often don’t have

accurate insight into their own reasons for doing things (Nisbett & Wilson, 1977). Relying on self-reports only gives insight into the theories people have about their own behaviour, not necessarily the actual reasons why they did what they did.

Recent advances in neuroscience have given researchers the ability to see which areas of the brain are associated with perceptual processes, such as seeing, and processes that more directly involve the self, such as making a choice. If one is consciously making a choice that one knows to be wrong, this should activate parts of the prefrontal cortex that involve executive function abilities, whereas the act of perceiving visual stimuli has its own patterns of activation spread through the frontal, occipital, and parietal cortices. So, in the Asch study, a neurological measurement technique like this might help us to see directly which types of social influence are occurring. One hypothesis could be that informational influence might involve greater activation of visual perception areas of the brain, because subjects are “seeing” the stimulus differently and therefore may be paying special attention to the act of seeing. Conversely, if normative influence is occurring, subjects may activate the executive function areas of the prefrontal cortex, reflecting that they are making intentional choices to override their own knowledge of the right answer, in order to give the socially desirable response. Thus, different patterns of brain activation might shed light on people’s reasons for conforming.

How can science study people’s reasons for conforming, when they may be unaware of the

reasons themselves? In an ingenious study, subjects went through an Asch-like procedure while their brains were being scanned in an fMRI

machine (Berns et al., 2005). Subjects were asked to make judgments about a perceptual task, while also being given information about the perceptions of other people in the experiment, many of which were wrong. The task required subjects to mentally rotate figures in order to determine whether a shape was the same or different from a comparison shape (i.e., like the Asch study, but with shapes instead of lines). Researchers then compared subjects’ brain activation when they conformed to the incorrect judgments of the group vs. when they did not conform but instead stuck to their own independent perceptions.

When subjects conformed, reporting the same judgment as the group, activation occurred in regions of the brain associated with visual perception (i.e., parts of the visual cortex and parietal lobes). This was interpreted to mean that when conforming, these subjects were, in fact, perceiving these stimuli in a different way

—that the difference was in their perceptions. On the other hand, when subjects refused to conform to the group’s incorrect judgments, they activated areas of the amygdala that are

associated with negative emotion (LeDoux, 2000) and with processing social information (Amaral et al., 2003; Singer et al., 2004). This suggests that going against the group’s judgments was an emotionally taxing thing for people to do, involving negative emotion and a heightened social awareness. This may be the brain indicator of the heavy emotional load of standing up for what you believe in.

Can we critically evaluate this evidence? This fascinating study may give us insight into what can happen when people conform to groups, but it leaves wide open the

question of what happens in different situations, including the Asch study. In this study, people were mentally rotating shapes, which is a more challenging task than the line judgments in Asch’s study. Although people’s perceptions on the mental rotation task could be swayed by the group’s judgment, this does not necessarily imply that people’s perceptions on Asch’s much simpler task could also be swayed in the same way. It is important to keep in mind that the different operational details of the experiments, indeed of any experiment, have important implications for how the results should be interpreted.

There are also multiple ways of interpreting the brain-imaging data. For example, in general, people pay more attention to stimuli that are related to emotional responses; so, some of the activity might be related to attention rather than to the emotions associated with conformity (or refusing to conform). In short, it’s not clear from a single study exactly what the activation of specific brain areas means; as with all research, it’s necessary for studies to accumulate and the evidence to converge.

Why is this relevant? This study suggests that when people conform to a group, it can potentially change their basic perceptions about the world at a deep level. This suggests that if enough people say something is true, not only may we go along with the group, we may start to experience the world in the same way. This study also suggests that going against the group, standing up for what you believe, can be a threatening experience, requiring us to experience difficult emotions like fear.

Empowering people to resist the influence of destructive groups or authority figures is a huge puzzle science is still trying to solve. Many forces operate together, some seemingly positive and some seemingly negative, all influencing how empowered a person feels to go against a group. For example, resisting social

influence is likely related to one’s own confidence and self- esteem, expertise, social status, authority, moral conviction, prejudice against the group, the status or desirability of the group, and undoubtedly many other factors that influence how the person feels in that particular moment. Although social psychologists now have a pretty good understanding of how these factors operate, we obviously have a long way to go in our society before we can apply this knowledge fully and effectively.

Follow-up experiments to the Asch study illuminated two additional, very important aspects of conformity situations. First, there is a fascinating relationship between conformity rates and the size of the group. Asch found very low conformity if only one or two people gave a wrong answer. But once there are three or more people, conformity rates shoot up to their maximum level

(Asch, 1951); it only takes a few people to exert “group pressure.”

This finding has deep implications for our understanding of how group norms operate in our everyday lives. Group norms are not just abstract, overarching cultural forces that affect all of us in every situation. Instead, group norms are created spontaneously in each situation. Whenever a few people get together, they establish implicit norms that govern the behaviour of the people in the group. For example, think of the norms that are transmitted as people laugh at a demeaning joke; as co-workers pass along malicious gossip; as a boy is cheered on for eating his seventh slice of pizza while a girl is looked at askance when she loads up her plate a buffet; as kids turn away from a child in the schoolyard who is being bullied or laughed at; as friends laugh at someone’s story about how much alcohol they drank before “somehow” managing to drive home.

Now, think about how these situations can be different when people speak up and say they are offended by racist jokes; when co-workers create cultures of support instead of gossip; when both boys and girls are encouraged to eat healthily and love their bodies; when people stand up together against a bully; and when people make sure their friends are sober before they let them get

behind the wheel. The norms that operate in our everyday lives can make such a big difference.

The second important finding to come out of the Asch studies was that even though groups are powerful, individuals can also be very powerful. In some variations of Asch’s studies, one of the confederates would also give the right answer, going against the rest of the group. This single dissenting voice was enough to shatter the group’s power, reducing the rate of conformity to one

quarter of its original level (Asch, 1955). This shows that groups are most powerful when they are unanimous, but a single person’s courage can burst that bubble and liberate the voices of others who may privately disagree with the group. This is a key reason why it is so important to speak out about what you believe in.

It’s important for people to realize how much power they wield as individuals, because when you are caught in a situation of group pressure, the pressures can indeed feel enormously powerful. For example, with regards to the Abu Ghraib abuses discussed earlier, it is important to understand the normative pressures that were in operation. For example, there is a strong culture in the military of not questioning orders and maintaining solidarity in the ranks; these sorts of pressures create a culture of conformity, maximizing the likelihood of outcomes like groupthink. In such an environment, it can seem awfully hard to go against the group, and as we discussed, Joe Darby was afraid of what would happen if others knew he was the whistleblower. However, once his identity was revealed, his fellow soldiers expressed widespread support and appreciation for his courage. They had also been harbouring their own private disapproval of what was happening, but they were unwilling to be “the only one” to come forward.

Module 13.1b Quiz: The Asch Experiments: Conformity

Know . . .

1. Social pressure to adopt a group’s perspective in order to be accepted,

rather than rejected, by the group is known as . A. normative influence B. social cognitive influence C. informational influence D. sociocultural influence

Apply . . .

2. Which of the following is a reasonable conclusion to draw from the Asch studies?

A. Conformity pressures are so powerful that it is almost impossible to help people stand up against a group’s majority opinion.

B. Conformity always happens because people simply choose to agree with the group just to fit in; conformity can never, however, lead people to privately accept a group’s perspective.

C. People will conform in most situations that involve a great deal of uncertainty; but when people are certain of what is “right,” most will disagree with the group if the group holds a different opinion from them.

D. Even a single individual has a great deal of power in group settings, because by being willing to publicly disagree with the group, conformity pressures are significantly reduced for others.

3. Diane was a member of her university’s student union. The members of the union were debating whether to continue funding the university’s daycare, which was losing money. Diane wanted to continue providing money to the daycare, yet found that other members of the council wanted to close it. If Diane behaved similarly to the participants in Asch’s conformity experiments, which response will she most likely make?

A. Diane will vote to continue funding the daycare, even if she is the only person voting that way.

B. Diane will lose her motivation to be a part of the students’ union. C. If another member of the students’ council also objects to closing

the daycare, Diane will vote to keep it open.

D. Diane will side with the President of the student union in order to

ensure that she is on the same side as the most powerful member of the group.

The Bystander Effect: Situational Influences on Helping Behaviour

One of the most powerful examinations of the ways that social situations influence us has been the study of helping behaviour. Although all of us would like to live in a society in which people will help us when we need it, the truth is often, sadly, quite different.

One tragic example of this, which has become famous in our culture, unfolded in the middle of a cold night, on March 13, 1964. A young woman, Kitty Genovese, was physically assaulted outside an apartment complex in New York City. She screamed and made enough noise that many people (38, it was later revealed) came to their windows to try to see what was going on. One person shouted through his window, which scared the attacker off, and Kitty stumbled around the corner of the building, out of sight of most of the residents. The attacker then returned and attacked her again, stabbing and sexually assaulting her. In total, her ordeal lasted more than half an hour. When the police were finally called, it was too late to save Kitty’s life.

A couple of weeks later, The New York Times published a front-page article, with the headline, “37 Who Saw Murder Didn’t Call the Police. Apathy at Stabbing of Queens Woman Shocks Inspector.” People were shocked and outraged that so many could have allowed a young woman to be assaulted without lifting a finger to help her. How is it possible that not one person intervened? Have we become so selfish and disconnected from each other that we don’t get involved even when someone’s life is on the line?

Kitty Genovese: Her tragic murder in 1964 led to groundbreaking studies on the bystander effect. New York Daily News/Getty Images

Before continuing, we should mention that several decades later, it has been revealed that the murder did not really occur the way it was reported, and the way that most psychology textbooks have repeated ever since. It seemed that only a few of the residents had been able to see anything in the parking lot, and only for a few moments. It was not clear to the residents exactly what was going

on, so their inability to act could have, in many cases, been due to simple uncertainty, not realizing for sure that a crime was occurring. After all, when you live in a highly populated urban area, it is not uncommon to hear noises, including shouting, in the middle of the night, and you can’t be calling the police every time someone shouts and yells on the street for a minute. So, some of the apparent apathy could have been due to confusion and uncertainty, rather than a lack of caring. Also, it was reported later that some of the residents apparently did try to phone the police, so it may have been a mistake to conclude that

“nobody” tried to help (Manning et al., 2007).

Nevertheless, the horrifying belief that so many people could have stood by doing nothing while a woman was murdered launched an important line of

research that found similar effects in many different situations. The bystander effect describes the counterintuitive finding that the presence of other people actually reduces the likelihood of helping behaviour. This is counterintuitive because, usually, one would assume that if there is a certain chance of one person doing something, like helping, then the more people that are around, the

greater the cumulative chance should be that someone will help. However, it seems in many cases that as the number of people in a situation increases, helping rates actually decrease!

There are different explanations for the bystander effect in different situations.

The first was offered by social psychologists Bibb Latané and John Darley (1968) after the Genovese murder. They suggested a rather surprising theory that ran counter to common intuitions. What if the thing that everybody found so surprising was actually the explanation? Instead of being surprised that nobody intervened despite the large number of people at their windows, what if nobody

intervened in the situation because there were so many people involved?

Consider the perspective of each person, standing by their window that night in New York in 1964, looking out at a dark parking lot where they heard shouting. They likely wondered, “What’s going on? Is it serious? Is it two people having a relationship argument? Is it a drunken argument between friends? Or merely people having fun and yelling as some sort of prank? Should I do something, like call the police? Is that maybe a bit excessive? Or does the situation warrant it?

I’m not exactly sure what’s happening . . . maybe I’ll wait a minute and see if I get a better sense of what’s happening. . . . Hey, look at all the other people standing at their windows.” And then, the critical moment happens—they conclude, “Someone else has probably called the police,” or “Someone else probably has a better sense of what’s happening,” or they may even (somewhat selfishly) think, “I don’t really want to get involved . . . but look, someone else will do it.”

The problem is, of course, that if everybody thinks someone else will take on the responsibility of helping, nobody will do anything. Latané and Darley called this diffusion of responsibility , the reduced personal responsibility that a person feels when more people are present in a situation (Figure 13.2 ).

Figure 13.2 Diffusion of Responsibility If one person witnesses an emergency, it is as if 100% of the responsibility for helping falls on that person. If 10 people witness an emergency, that responsibility is diffused, so it is as if each person feels only 10% of the responsibility—which may not be enough to motivate a person to act.

Other studies have explored this effect by simulating emergencies. For example, in one study, subjects believed they were interacting with other people who were in different rooms in the experiment, talking over an intercom system. One of the

other voices on the intercom started to clearly have a seizure and require some help (this was, of course, not real, but subjects didn’t know that). In one condition of the experiment, participants interacted with the other person alone and nobody else was available to help. In other conditions, participants believed there were other participants sitting at other intercom terminals, who were all available to help. Consistent with diffusion of responsibility, people took longer to react to the calls for help, the more people they believed were available to

respond (Latané & Darley, 1968). The take-home message is that the more people there are in a situation, the more likely it is that any one person will assume “someone else will do it.”

The second explanation offered for the bystander effect is that there is often a mismatch between the public behaviour that people display and the private

beliefs or thoughts the people may be having. As a result, the social norms operating in the situation (i.e., the expressions of people’s public behaviour), may be quite different from the actual beliefs held by the people themselves; this is called pluralistic ignorance .

Pluralistic ignorance is one of the most powerful factors invisibly shaping our lives, and indeed our society. It operates in many different situations: racist jokes and comments that people don’t react to; political decisions or corporate policies that others don’t express their disapproval of; a child being bullied and taunted on the playground that nobody stands up for; unjust social practices that the general public passively accepts and allows to continue.

In fact, pluralistic ignorance could potentially be so powerful that it becomes a group norm, which then governs the behaviour of individual people within the group, even though nobody in the group actually agrees with the group norm. Think of how messed up that is! A group could pressure people to do things that each group member, privately, disagrees with. Of course, what likely happens in most real-world situations is that pluralistic ignorance and social influence (e.g., power, authority, etc.) work together so that a few people in a group can impose their values or perspectives onto the group, and then pluralistic ignorance works to keep everyone else from expressing their true thoughts and feelings. As a result, it only takes a few people to “steer” the behaviour of most others, and

once those few people have power, it can be hard for the other group members to make change happen.

The bystander effect, diffusion of responsibility, and pluralistic ignorance can often work together to ensure that people who need help don’t get it.

A key reason why pluralistic ignorance happens is simply that when we are out in the public sphere, the normative adult behaviour is to “play it cool.” Most adults adopt expressions of general neutrality, most of the time, and you only have to walk down the street for two minutes to test this out. Obviously, there are many exceptions, but few adults are as constantly goofy, emotionally volatile, and expressive as, say, your average 3-year-old (which, to be honest, is probably a good thing). As a result, the immediate impression that people give, most of the time, is “I’m cool, and everything is fine,” or as the common meme goes, keep calm and carry on.

One classic study of pluralistic ignorance demonstrated the power of this

tendency for people to remain expressively restrained, even to the point that they would put their lives in potential peril. Imagine being a subject in this study: You are sitting in a room, filling out questionnaires; suddenly you notice a little bit of smoke, wafting into the room from a vent. What do you do?

Your intuition probably tells you that you would get up and check it out, especially if the smoke didn’t stop. You would go over and smell it, perhaps look outside the room, or maybe find the experimenter to report it. Especially if the smoke continued to build, minute after minute, you would take some action. We all learned when we were kids how to get out of burning buildings, right?

If you are sitting in this room all by yourself, then your intuition is probably right. But what if you are sitting in the room with other people? This changes things, doesn’t it? You might not want to embarrass yourself by jumping up right away. After all, maybe the smoke is just mist from a broken air conditioner or something equally benign.

So, in this situation, you pause, considering what to do, looking out of the corner of your eyes at the others in the room. But everyone else isn’t responding either; they are just filling out their questionnaires, perhaps occasionally looking around as well, but “playing it cool.” It’s possible that every single person is privately thinking, “There might be a fire!” but publicly, each person is displaying no evidence of their private concerns, so they all sit there while smoke continues to fill up the room.

Exactly this pattern of behaviour was observed in the rather incredible “smoke-

filled room study” (Latané & Darley, 1968), which had subjects go through the experience just described. Most subjects (75%) who sat in the smoky room by themselves got up to investigate within six minutes, but if the subjects were in a room with two other people who gave no indication of being concerned about the smoke, only 10% of the subjects took action to investigate. In a specific crisis situation in which people would normally help or take action, the mere presence of other people sets up various social forces that can prevent people from doing

so, including embarrassment (Karakashian et al., 2006), pluralistic ignorance (Prentice & Miller, 1993), and diffusion of responsibility (Darley & Latané,

1968).

So if YOU are ever in an emergency situation and need someone’s help, it is important to cut through any confusion, pluralistic ignorance, or diffusion of

responsibility (Schroeder et al., 1995). If possible, clearly ask for help, from a specific person, with a specific command: “Hey you! In the red shirt! I need help! Call 911!” (Or whatever specific behaviour you need.)

Module 13.1c Quiz: The Bystander Effect

Know . . .

1. The reduced personal responsibility that a person feels in a situation when more people are present is known as .

A. diffusion of responsibility B. conformity C. the bystander effect D. pluralistic ignorance

Understand . . .

2. Which of the following is the most plausible explanation for the bystander effect?

A. There are more people who simply do not care enough to help others than originally thought.

B. People fear embarrassment that could come from helping another person.

C. The person in need is likely to be unrelated, and nonrelatives are not worth helping.

D. Bystanders refuse to help because of their own experiences; when they were in need, nobody helped them.

Apply . . .

3. Darcey made a racist joke to a group of people at a party. Although Megan was a member of an anti-racism committee at her school, she

didn’t raise any objection to the joke. This is an example of . A. bystander apathy B. pluralistic ignorance C. the chameleon effect D. groupthink

Social Roles and Obedience

In contrast to social norms, which are general rules that apply to members of a

group, social roles are more specific sets of expectations for how someone in a specific position should behave. The key word here is “specific.” Roles emerge within a specific position in society—such as professor, student, parent, and prison guard—because the rest of society expects the person to behave in accordance with the role. In a sense, the person’s individuality gets subsumed by the role, and what they might freely choose to do takes a back seat to what society expects of someone in that role. Roles can be incredibly powerful, leading people to do things they would never believe themselves capable of.

World War II had a major influence on the field of social psychology, particularly in bringing the concept of social roles to the forefront of study. The Holocaust was extremely troubling; how could seemingly ordinary people condone, and in many cases take part in, the state-sanctioned killing of millions of Jewish people, gypsies, homosexuals, and political dissidents? It seemed like only truly disturbed individuals would be willing to engage in such atrocities. The work of two psychologists changed this view, however, and showed us that social roles can have a powerful effect on our behaviour.

The Stanford Prison Study

In 1971, Philip Zimbardo, a social psychologist at Stanford University, wanted to study the impact that situations could have on people. Would otherwise “good”

people do “bad” things if placed in a bad situation? He placed an ad in the paper asking for volunteers for a prison simulation experiment. After giving the respondents a battery of psychological tests, Zimbardo selected the most psychologically stable people to be participants. He then randomly assigned nine to take on the role of prison guards, and nine to become prisoners.

The study began dramatically, as the police arrested the new “prisoners” outside of their homes, in full view of their neighbours. (Zimbardo enlisted the help of the local police department to help maximize the realism of this part of his study.) These newly arrested men were taken to the police station, where they were fingerprinted and held in a cell, then blindfolded and transferred to the basement of Stanford University’s Psychology Department. Zimbardo had transformed the basement into a simulated prison, complete with cells with barred doors and cots for sleeping. The prisoners were strip-searched and sprayed with de-lousing spray, then given a smock to wear (with no underwear), a nylon stocking for their heads, a chain around their ankles, and an ID number, which was to be their only personal identification while in the study (i.e., they couldn’t use their names anymore). The guards were given uniforms, and were given authority to oversee the daily lives of the prisoners. And thus the study began.

What happened next took everybody by surprise. By the morning of the second day, the situation had started to deteriorate to the point that the prisoners staged a rebellion and refused to cooperate with the guards. The guards responded with force, blasting the prisoners with spray from a fire extinguisher, and physically subduing them. The stress was so intense that within the first 36 hours of the experiment, one of the prisoners completely broke down, exhibiting such severe signs of emotional distress that he was taken out of the study.

The prisoners quickly became absorbed into their roles, following the guards’ orders, trying to avoid punishment, referring to themselves only with ID numbers instead of their names, and generally trying to adapt as well as they could to their situation. The guards also fell into their roles, quickly starting to treat the prisoners with disrespect, engaging in ever-escalating tactics of control and humiliation. Prisoners were made to do push-ups and their sleep was interrupted for “counts” during which they had to line up and say their ID numbers, for up to

a few hours at a time. Guards mocked and verbally harassed the prisoners, forced them to clean toilets with their bare hands, controlled when the prisoners were allowed to use the toilet, and even played humiliating, sexually degrading games. For prisoners who were rebellious or difficult, the guards set up a solitary confinement cell in what had previously been a broom closet.

Volunteers were randomly assigned to play guards or prisoners in the Stanford Prison Study in 1971. Each group took their roles so seriously, and their behaviours degraded so quickly, that the researchers called off the experiment before it was even halfway completed. Philip G. Zimbardo, Inc.

Zimbardo himself, who had assumed the title of Prison Superintendent, also fell into his role. As he freely admits, he quickly lost his more objective perspective as a psychologist running a study, and instead started to view it as “his prison”

containing “prisoners and guards,” not young men from the community who were research participants.

The situation took a serious toll on the prisoners; many exhibited stress-related symptoms including screaming, crying, even becoming ill. Amazingly, although at least 50 outside observers were allowed to see what was going on, nobody questioned the ethics or expressed significant concern for the prisoners, until one graduate student, upon seeing the prisoners being marched down the hall on a “toilet run” with sacks over their heads, confronted Zimbardo with the unethical nature of the study. At that point, Zimbardo realized things had gotten out of hand and called off the study, a mere six days into the planned two-week simulation of prison life.

The Stanford Prison Study could not be repeated today due to the ethical standards that have since come into force. Nevertheless, it remains a stunning example of the power of social roles and how they play out in specific situations. A social role, even one that is randomly assigned, can make otherwise bright, well-adjusted people do things that they would never dream possible for themselves. You can likely see the connection between the Stanford experiment and the tragedies of Abu Ghraib. In both cases, a host of situational factors encouraged brutal behaviour. This is the power of the situation. However, as we discussed earlier, situational forces don’t deserve all the blame; in both Abu Ghraib and Zimbardo’s prison study, not all people were affected equally. In Abu Ghraib, only relatively few soldiers appear to have committed the majority of the documented abuses. In Zimbardo’s study, some people took on their role as guards with far more sadism than others, whereas other guards treated the prisoners more kindly. Understanding precisely what personal factors lead people to be better able to resist destructive situations is a key focus in the field today.

Obedience to Authority: The Milgram Experiment

One additional factor in Abu Ghraib was the military command structure. Prison guards were often given orders to “soften up” the detainees for questioning; softening up implied a variety of tactics, including general harassment and rough

treatment, humiliating prisoners by forcing them to be naked and put in compromising positions, terrorizing prisoners with attack dogs and electrical cables, and committing outright physical torture, including brutal water-boarding and other practices too awful to describe here. The fact that such horrendous things happened is a grim reminder of just how powerful social influence factors can be.

Most of us, however, believe that we would never do such things, no matter how powerful the situation. If we were asked to harm somebody against their will, and we disagreed with it, we would say no. Right? The Milgram obedience

experiments (1963, 1974) thoroughly shattered our ability to legitimately hold this belief. In his now-famous studies, Stanley Milgram showed the world just how powerful authority could be, and how easily otherwise good, normal people could be made to do something horrific, something that probably none of us would believe ourselves willing to do.

Consider what happened in Milgram’s study:

Participants are told the study is about the effects of punishment on memory. They, and the other supposed participant (who is actually a confederate), a friendly middle-aged man, draw slips of paper in order to determine who will be the “teacher” and who will be the “learner.” The draw is secretly rigged so that the participants are always the teacher.

The teacher’s job is to read a series of word pairs to the learner, and then to test him on his memory of the word pairs. The learner will be in a separate room hooked up to an electric shock machine. Each time the learner gets an answer wrong, the teacher is to administer a shock by flipping a switch on a panel in front of him, and increasing the voltage after each wrong answer. The switches go up by 15 volts until reaching a maximum of 450 volts, which is labelled “xxx.” This process is watched by “the experimenter,” a man wearing a lab coat.

As the experiment progresses, the learner starts to make sounds of discomfort in the other room, grunting audibly as he is shocked. By 150 volts he is protesting loudly and saying that he no longer wants to continue in the study. If the subjects continue reading the word pairs and increasing the

shock level, the learner gets to the point of screaming in pain, demanding and pleading, over and over again, to be let out, pleading that he can’t take it anymore, even that his heart condition is bothering him and his heart is acting up. And then, at 330 volts, the learner falls silent and gives no further responses. At this point, subjects are informed by the experimenter that a non-response is to be considered “wrong,” and the punishing shock is to be administered.

If, at any point, subjects express concern for the learner, or say that they don’t want to continue, the experimenter simply says a few stock responses, such as “Please continue” or, “The experiment requires that you continue.”

The “shock generator” that the teacher operated, purportedly to punish the learner. From the film Obedience © 1968 by Stanley Milgram, © renewed 1993 by Alexandra Milgram, and distributed by Penn State

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The “learner” gets set up to participate in the experiment. He is being hooked up to the device that the teacher believes will deliver a shock. From the film Obedience © 1968 by Stanley Milgram, © renewed 1993 by Alexandra Milgram, and distributed by Penn State

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The experimenter explains to the “teacher” what the experimental procedure entails and how to use the shock generator. From the film Obedience © 1968 by Stanley Milgram. © renewed 1993 by Alexandra Milgram, distributed by Penn State

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Although most subjects were highly obedient, some, such as this person, refused to continue complying with the experimenter’s orders. From the film Obedience © 1968 by Stanley Milgram. © renewed 1993 by Alexandra Milgram, distributed by Penn State

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Now, let’s step back for a moment and put the situation in perspective. As part of a psychology experiment, people are asked to shock a person in another room and ignore this person as he expresses increasing discomfort, screams repeatedly, begs and pleads to be let out of the experiment, angrily refuses to continue, indicates that he might be having a heart attack, and eventually falls completely silent. And there is no compelling reason for people to continue, except a man in a lab coat telling them to do so. This seems absurd, when you stop and think about it. Surely almost nobody would actually do such a thing!

What would you do? If you are like most people, you probably feel that you would refuse to continue whenever the “learner” said that he didn’t want to continue (which happened quite early, 150 volts). The moment the other person withdraws consent, you would stop, right?

Careful analyses across many replications of the Milgram study concluded that

this moment of decision making is, in fact, the critical point (Packer, 2008). This is the moment when more subjects disobey the experimenter than any other moment. This is the point at which the true moral conflict becomes clear, between the rights and safety of the learner versus the authority of the experimenter. It is heartening that this is a choice point at which many people choose to follow their morals and disobey the experimenter.

But overall, the story is actually pretty grim. Even though some people rebelled at this point, the large majority of subjects actually continued, despite the protestations of the learner, who would have been, quite literally, a victim of abuse if this were a real situation. It is worth really stopping and thinking about this for a moment, because this finding is truly astonishing—most of the subjects, across all the replications of these experiments, chose to harm another person who had withdrawn consent, simply because an “authority figure” told them to.

It’s important to point out that subjects were not sadistic torturers, gleefully putting the learner through misery. Subjects were deeply distressed themselves, and most of them, many times, over and over, tried to stop the experiment, telling the experimenter they didn’t want to continue, arguing with him, and so on. But the experimenter was implacable, refusing to take no for an answer and just insisting that they continue. The experimenter forced subjects into a situation

where “just saying no” wasn’t enough; they had to insist, even beyond the point of being polite. It is quite telling that many of the participants in Milgram’s study found it difficult to resist the experimenter because they didn’t want to seem rude, and were simply uncomfortable disagreeing with someone so emphatically and taking action. This embarrassment held people back, astonishingly having more power than the man in the other room, literally screaming and begging to be let out of the experiment.

But, surely you wouldn’t go all the way to the end, shocking that poor man, potentially to death . . . would you? This is one of the most unbelievable findings in the history of psychology. Milgram found that two out of every three people (65% to be exact) would do just that—slowly electrocute an innocent, desperately protesting man into oblivion, simply because a psychology experimenter insisted that they do so.

Most people would never expect this outcome, believing “the average person” to be far more ethical and able to do the right thing, when it came to a life or death situation. Indeed, a group of psychiatrists at Yale University were asked to predict ahead of time how many people would obey all the way to the end of the experiment, and they estimated it would be about 1 in 1000—the base rate of

sadistic or psychopathic individuals in the population (Milgram, 1974). Also, the experimental sessions were observed by numerous people through one-way mirrors, who were unequivocally surprised and appalled at the subjects’ failure to effectively rebel.

Subjects in this experiment were clearly distressed by what they were doing to the learner. They became very tense and frequently turned to the experimenter, saying that they didn’t want to continue, expressing concern for the learner, even worrying that they might be killing him. But time and time again, they ended up following the experimenter’s commands, turned back to the shock machine, and increased the voltage.

Milgram wrote,

In a large number of cases, the degree of tension reached extremes that are rarely

seen in sociopsychological laboratory studies. Subjects were observed to sweat,

tremble, stutter, bite their lips, groan, and dig their fingernails into their flesh. These

were characteristic rather than exceptional responses. . . . At one point he (one of the

participants) pushed his fist into his forehead and muttered, “Oh God, let’s stop it.” And

yet he continued to respond to every word of the experimenter, and obeyed to the end. .

. . I observed a mature and initially poised businessman enter the laboratory smiling and

confident. Within 20 minutes he was reduced to a twitching, shuddering wreck, who was

rapidly approaching nervous collapse. . . . (1963, p. 371–378)

Clearly, it was not easy for the subjects to commit harm to another person, but it was even more difficult to break out of the power of the situation and refuse to obey.

Interestingly, Milgram ran other variants of this experiment, trying to see what might change obedience rates. Milgram tried to reduce the situational pressure in several ways, such as having the experimenter deliver his orders from a different location using the telephone, or reducing the stature and reputation of the authority figure by holding the experiment in a private company’s downtown commercial space rather than at prestigious Yale University.

Milgram also tried to increase the personal directness with which subjects would experience the learner’s distress, such as by having subjects and learners in the same room so that subjects had to watch the learner shout and writhe in pain. In one condition, subjects even had to physically force the learner’s hand onto a shock plate while the learner struggled. Astonishingly, although the rates of obedience are somewhat lower, they remain disturbingly high. The fact that 30% of us would physically force a struggling person to receive pain against his will is disturbing, to say the least.

There were two especially interesting and powerful variations. One experiment looked at whether it is easier for a group to resist the experimenter, pitting the power of the group against the power of authority. In this experiment, there were three teachers making decisions collectively. Two of the teachers were confederates, pretending to be real subjects; the other teacher was the actual subject. When the two confederate teachers would make the decision to not continue with the experiment, 90% of subjects also refused. (We would note that it seems surprising that only 90% of them refused, leaving a full 10% of people still obeying the experimenter to the bitter end. Still, 10% obedience is a far cry from the 65% of the original study.) This particular variation is important because it illustrates again the power of dissent. As in the Asch study, if even a couple of people are courageous enough to fight for what is “right,” they make it much easier for others to do the same.

Then there is one final condition, examining a crucial explanation that has been given for the Holocaust, known as the Eichmann factor. Adolf Eichmann was one of the central administrators of the Holocaust of WWII, in charge of overseeing the transportation of Jewish people who were deported to the concentration camps to be executed. In his famous trial for war crimes in 1962, Eichmann’s defence was, essentially, that he was a mere bureaucrat. He didn’t have any real power, but just performed menial tasks, not understanding or being responsible for the larger enterprise. In other words, he was a paper pusher, not a war criminal. He didn’t actually cause harm to people. He merely organized train schedules and such things; he was “just doing his job.” This led sociologist Hannah Arendt to coin the term “the banality of evil,” describing the theory that oftentimes, much of the individual behaviour that allows for great harm to be perpetrated, often is not carried out by evil monsters out of malice and hatred, but instead, by rather ordinary people, doing jobs far removed from their ultimate consequence, who are merely caught up in a much larger system.

This final Milgram experiment quite chillingly examines one part of the “banality of evil,” the removal of the individual’s actions from the ultimate consequences (e.g., Eichmann organizing train schedules, not actually marching people into gas chambers). To simulate this, subjects only had to read the word pairs to the learner; it was another person who actually threw the switches to deliver the electric shocks. This allowed subjects to feel even less responsible. By splitting the process into multiple components, with multiple people involved in different ways, it was easy for each individual to feel not responsible, and not powerful enough to do anything about it. The result was that 92.5% (37/40) of subjects obeyed the experimenter right to the end. Here’s the power of authority combining with “diffusion of responsibility,” and the results are, frankly, horrific.

Milgram himself believed that these studies provided insight into the horrors of the Holocaust, particularly how so many millions of people could be “evil” enough to willingly participate in the Nazi death machine, or to stand passively by while such a brutal genocide took place.

The simple, yet profound, insight from the Milgram study is that it’s not a question of people being good or evil; it’s a question of the power of social

situations. It is, in fact, not difficult to construct situations that are powerful enough to overwhelm even the deep moral convictions and courage of most people. As Milgram noted, “This is, perhaps, the most fundamental lesson of our study: Ordinary people, simply doing their jobs, and without any particular hostility on their part, can become agents in a terrible destructive process. Moreover, even when the destructive effects of their work become patently clear, and they are asked to carry out actions incompatible with fundamental standards of morality, relatively few people have the resources needed to resist authority”

(2009).

In sum, situational forces can exert immense pressure on individuals, making an analysis of personal responsibility very tricky. However, social psychologists would generally agree that, in the final analysis, people are responsible for their behaviours. No matter how powerful the situational forces may be, individuals can always resist them and make a free choice, and history is full of examples of such courageous behaviour. In fact, one of Dr. Zimbardo’s most recent projects,

the Heroic Imagination Project (heroicimagination.org), is focused on understanding the factors that lead people to behave heroically. It is hoped that by unlocking the secrets of heroism, courage, and compassion, we can help society evolve in a healthier direction, and potentially avoid future atrocities.

Module 13.1d Quiz:

Social Roles and Obedience

Know . . . 1. is complying with instructions from an individual who has

authority.

A. Obedience B. Groupthink C. Conformity D. Mimicry

Understand . . . 2. How did the Stanford Prison Study researchers come to the conclusion

that roles, and not individual personalities, were the main influence on the volunteers’ behaviour?

A. The volunteer “prison guards” were specifically instructed to respond brutally.

B. The “prisoners” were actually actors hired by the researchers. C. The prisoners and prison guards were psychologically similar

prior to the start of the experience.

D. The researchers actually believed that personality is more important than social roles.

Apply . . . 3. According to variations of the Milgram experiment,

A. women are much more obedient to authority figures than men are.

B. most of the power of the situation was the general reputation of Yale as an institution; people assumed that the consequences of the shocks couldn’t be too terrible, because it was, after all, happening at Yale.

C. people are much less obedient now than they were shortly after World War II; so, Milgram’s findings are historically important, but are not relevant to modern generations.

D. one of the most effective ways to get people to disobey an authority figure is to make sure they have some companions who will do it too.

Module 13.1 Summary

bystander effect

chameleon effect

diffusion of responsibility

groupthink

Know . . . the key terminology associated with social influence.13.1a

informational influence

mimicry

normative influence

pluralistic ignorance

social facilitation

social loafing

social norms

social roles

At its most basic level, conforming begins with mimicry, in which people simply imitate others’ behaviours. Mimicry seems to help form social bonds and encourages prosocial, helping behaviour. Conformity usually describes the way an individual’s more complex behaviours evolve to become like the behaviours of the group. People may conform because they want to be accepted by the group, or they may conform because the group’s way of perceiving reality actually influences the person’s own perceptions.

In many different situations, other people can change how we behave. In helping situations, the presence of others tends to decrease the likelihood that someone will help another in distress. In other situations, the presence of even a few more people can set up conformity pressures that influence us to behave like the others in the group. Interestingly, these conformity pressures can be largely eliminated in at least some situations if even a single individual is willing to go against the group and break its unanimity. In many situations we are placed into social roles and feel like we have to live up to the responsibilities of that role, even if we would normally behave differently. When authority figures are

Understand . . . why individuals conform to others’ behaviours.13.1b

Understand . . . how individuals and groups can influence behaviours.

13.1c

involved, these social pressures can become even more powerful—so powerful that many people cannot resist complying.

People are least likely to help if they don’t feel personally responsible for taking action, if they are unsure what to do to help, or if they are unsure whether the situation is a genuine emergency. Thus, you can best ensure that others will help you if you make very clear that it’s an emergency and you need help, if you make a specific person responsible for helping, and if you tell that person exactly what he or she needs to do.

Behaviour is a function of the person and the situation. Therefore it is impossible to say in general the extent to which guards who participate in abuse are driven by their own character traits or by situational forces. A full analysis must take both sets of factors into consideration. Clearly though, in situations in which people are pressured to abuse prisoners, peer pressure is exerted through the expectations and behaviours of others, and the authorities in charge condone the abuse, it becomes far more likely that some guards will become abusive. Nevertheless, even the strictest social psychological analysis would never remove the final responsibility from the person; no matter the situation, we can always choose how to respond.

Apply . . . your knowledge of the bystander effect to ensure that you will be helped if you are in an emergency.

13.1d

Analyze . . . whether guards who participate in abuse are inherently bad people, or if their behaviour is the product of social influences.

13.1e

Module 13.2 Social Cognition

w85/ZUMA Press/Newscom

Learning Objectives

One February night in 1999, four New York City plainclothes police

Know . . . the key terminology associated with social cognition. Understand . . . how we form first impressions and how these impressions influence us. Apply . . . your understanding of social cognition to the problem of overcoming prejudice and discrimination. Analyze . . . whether people who commit discriminatory acts are necessarily prejudiced.

13.2a 13.2b

13.2c

13.2d

officers were patrolling a Bronx neighbourhood when they saw a lone man on the street. The officers thought he was behaving suspiciously, so they decided to question him. Upon orders from the police to stop, the man ducked into the vestibule of an apartment building, reaching for the door with one hand and putting the other into his pocket. Officers feared he was reaching for a gun. One officer opened fire on the man, and the other three followed, firing a total of 41 shots, 19 of which hit the man and killed him on the spot.

Tragically, the victim of the shooting was a peaceful and unarmed 24- year-old man named Amadou Diallo. By all accounts, Diallo was a friendly, industrious, and law-abiding man from Guinea, West Africa, who had come to New York in hopes of attaining a college education. He had turned away from the police presumably because he didn’t know they were police (they were not in uniform and were driving an unmarked car); besides, whenever four guys jump out of a car in the middle of the night in the Bronx and start yelling and running toward you, running into the safety of your home is a sensible thing to do. His hand went into his pocket because he was reaching for his wallet.

Much of New York was in an uproar over the shooting, and the turmoil was only heightened after the four police officers were found not guilty of any criminal wrongdoing in court. Half of all New Yorkers disagreed with the verdict, and that figure reached almost 80% among Africans and

African Americans (Connelly, 2000). People of all backgrounds attributed the shooting to hostile prejudice. On the other hand, many other people and most police officers defended the actions of the four officers, blaming the stressful environment in which they work and the need for them to make a snap decision in a potentially life-threatening situation.

Was prejudice an issue in Diallo’s death? If he had been a White man, would the same thing have happened? In recent years, these same questions have played a major role in North American society, with notable movements Idle No More and #BlackLivesMatter creating not only robust and healthy communities, but also a massive increase in public awareness, boots-on-the-streets activism, and meaningful political

dialogue and change.

Central to issues of race, class, gender, sexual orientation, and all other forms of discrimination, is understanding how human beings actually do process information about the social world, and how stereotypes, prejudice and other social processes influence people’s perceptions and behaviours. These are the questions we explore in this module.

Focus Questions

1. How do we make judgments and form impressions about other people?

2. Can stereotypes affect our behaviour in ways that we are unaware of? Could such processes have played a role in the killing of Amadou Diallo?

The field of social-cognitive psychology is a fusion of social psychology’s emphasis on social situations and cognitive psychology’s emphasis on cognitions (perceptions, thoughts, and beliefs). Social-cognitive researchers study the cognitions that people have about social situations, and how situations influence cognitive processes. It is an exciting area to study because it deals directly with the everyday social experiences we encounter in our lives.

One of the central ideas in this field is that there are two major types of processes in our consciousness: explicit processes and implicit processes. Explicit processes , which correspond roughly to “conscious” thought, are deliberative, effortful, relatively slow, and generally under our intentional control. This explicit level of consciousness is our subjective inner awareness, our “mind”

as we know it. Implicit processes comprise our “unconscious” thought; they are intuitive, automatic, effortless, very fast, and operate largely outside of our intentional control. The implicit level of consciousness is the larger set of patterns that govern how our mind generally functions—all the “lower-level” processes

that comprise the vast bulk of what our brains actually do (Chaiken & Trope,

1999; Kahneman, 2003; Todorov et al., 2005).

These two sets of processes work together to regulate our bodies, continually update our perceptions, infuse emotional evaluations and layers of personal meaning to our experiences, and affect how we think, make decisions, and self- reflect. But not only do these two sets of processes carry out their independent functions, they also can influence each other. For example, explicit processes influence implicit processes when our beliefs (e.g., my friend Bob is a kind person!) influence how we process information (e.g., how much attention we pay to Bob’s positive and negative behaviours). On the other hand, implicit processes can influence explicit processes, such as when our automatic tendency to categorize a person into a stereotyped group influences the judgments we make about that person. Explicit and implicit processes are intertwined, each influencing the other as we navigate the social world. In social-cognitive

psychology, models of behaviour that account for both implicit and explicit processes are called dual-process models (Chaiken & Trope, 1999).

One of the major contributions that this understanding has given us is how our conscious acts are conditioned or influenced by a huge amount of unconscious processing. For example, when a person makes a specific choice to do

something, that decision occurs after a whole slew of processes have already occurred—the person paying attention in the first place (choosing some parts of reality to focus on and ignoring many others), interpreting information into an overall understanding, evaluating different pieces of information and forming judgments and beliefs. So, who really made this decision then? And how can you say that it was a conscious act, if the vast bulk of the processing was actually unconscious? The critical insight is that because implicit processes happen so quickly and subtly, our presumably conscious and intentional acts are constantly being influenced and guided by our implicit processes, and we are not generally aware of this at all.

Consider the police officers in the Amadou Diallo shooting. As soon as they saw a Black man on the street late at night in the Bronx, a “Black male stereotype”

may have become implicitly activated (Bargh, 1999); this stereotype then would have guided their explicit thinking, resulting in disaster. Indeed, the Black

stereotype may have influenced their very first moment of interpretation, which was that Diallo was “acting suspiciously.” It would have continued to influence the officers’ interpretations of the rest of Amadou’s behaviours, until the critical moment, forming the perception that he was reaching for a gun.

That’s the double-edged sword of implicit processes; they help us process information efficiently, but they do so through creating biases. And when these biases lead to bad judgments or decisions, it is very difficult to recognize this or fix it, because we are not consciously aware of these implicit processes at work.

Person Perception

The effects of implicit processes are dramatically illustrated by research on person perception , the processes by which individuals categorize and form judgments about other people (Kenny, 2004). Person perception begins the instant we encounter another person, guided by our past experiences with people and the interpersonal knowledge we have absorbed from our culture. When we make a first impression of someone, we rely heavily on implicit processes, using whatever schemas we may have available. Schemas are organized clusters of knowledge, beliefs, and expectations about individuals and groups, which influence our attention and perceptual processes in many ways

(see Module 7.3 ). For example, a person’s visible characteristics (e.g., gender, race, age, style of dress) all activate schemas, and these schemas can bring certain traits to mind automatically.

Thin Slices of Behaviour

One amazing aspect of these implicit processes is just how accurate and practically instantaneous they can be. For example, within the first minute of seeing your professor at the front of the room, you have already evaluated her and made some basic judgments; if you were to fill out your course evaluations after, say, one minute of the first class (which would seem highly unfair!), your ratings would likely be very similar to your course evaluations after an entire

semester’s worth of exposure to that person (Ambady & Rosenthal, 1993; Tom et al., 2010). What happens in these situations is that we make very rapid, implicit judgments based on thin slices of behaviour , very small samples of a person’s behaviour. In even a few seconds, our implicit processes, guiding our perceptions holistically and using well-practised heuristics, are able to perceive very small cues and subtle patterns. This gives us instantaneous, intuitive accuracy, at least in part.

Surprisingly, many of our social judgments are made in this way— instantaneously, based on very little information. Whether it’s judging people

based on tiny snippets of conversations we happen to overhear (Holleran et al., 2009; Mehl et al., 2006), or catching a mere glimpse of their face (e.g., we judge trustworthiness, competence, likability, and aggressiveness after seeing a

photograph for less than one second; Willis & Todorov, 2006). Research by Nicholas Rule from the University of Toronto has shown that we can tell surprising things about people given incredibly little information. For example, people can guess a male’s sexual orientation at rates greater than chance after

viewing his photograph for a mere 1/20th of a second (Rule & Ambady, 2008), and Americans can accurately guess whether other people tend to vote

Republican or Democrat merely by looking at a photograph of their face (Rule & Ambady, 2010). Republicans are viewed as having more powerful faces, but Democrats’ are seen as warmer.

Thin-slice research demonstrates just how quickly impressions are formed, and how surprisingly accurate they often can be. Of course, they are not perfectly accurate, and therein lies the problem.

Self-Fulfilling Prophecies and Other

Consequences of First Impressions

First impressions have a big impact on many of our social behaviours. Even very simple cues, such as facial appearance, guide a wide range of behaviours, from how a jury treats a defendant to how people vote. For example, one study asked participants to act as jurors and evaluate evidence against a defendant. If shown

a photograph of a defendant who simply “looked more trustworthy,” participants

were less likely to come to a guilty verdict (Porter et al., 2010). In another study, the outcome of U.S. elections of congressional candidates could be predicted 70% of the time simply using participants’ judgments of how competent the

candidates appeared in photographs (Todorov et al., 2005).

The fact that our implicit judgments can influence our perceptions and behaviours has countless implications for our social lives, particularly in terms of self-fulfilling prophecies , which occur when a first impression (or an expectation) affects one’s behaviour, and then that affects other people’s behaviour, leading one to “confirm” the initial impression or expectation. For example, if you expect someone you meet to be warm and friendly, you will probably be more at ease with them and will treat them in a warm and friendly manner yourself. This friendly behaviour will make them comfortable and will lead them to behave warm and friendly in return, leaving you with the conclusion that they are—surprise!—warm and friendly. You can easily imagine the opposite process, if your initial expectation is that the person will be cold and unfriendly.

Thin slices of behaviour research shows that, in mere seconds, people form impressions that are surprisingly accurate. For example, you could get students to fill out course evaluations in university, evaluating the teaching capability of their professor, in the first minute of the first class, and they would be about the same as ratings taken after an entire semester of being taught by that professor. Monkey Business Images/Shutterstock

Glow Asia RF/Alamy Stock Photo

Self-fulfilling prophecies affect our lives in many different ways. For example, if a person is confident, they are going to behave different than if they assume they are going to fail, nobody is going to like them, and they will continue to be a loser. You already know this; you’ve seen it countless times. It’s the difference between the socially confident person who goes to a party where he doesn’t know anybody and ends up having the best time and talking to all sorts of great people; versus the person who goes to the party and expects that it will be awkward and nobody will like him, so he hangs back, keeps to himself, doesn’t initiate many conversations, and is stiff and uncomfortable, so that he ends up not having a very good time after all. “See, I knew it all along . . . I shouldn’t have gone in the first place. . .” is a self-fulfilling prophecy.

This idea has truly caught fire in North America society because it fits in so well with the “positive thinking” paradigm that so many people believe. And indeed, there is some sense to this. Every coach, athlete, parent, teacher, and anyone who has been a child at some point knows that, in the moment, if a person has no confidence and assumes, “I can’t do it”, then they’re right; they can’t. This is one of the basic lessons of growing up that we all learn at some point; you have to believe in yourself. Because if you don’t, your lack of belief becomes a self- fulfilling prophecy. This is one way that our implicit processes shape our social realities.

Module 13.2a Quiz:

Person Perception

Know . . . 1. are very quick, effortless, and automatic, whereas are

slower, more careful, and effortful.

A. Explicit processes; implicit processes B. Implicit processes; explicit processes C. Internal attributions; external attributions D. External attributions; internal attributions

Understand . . . 2. Which of the following statements about thin slices of behaviour is most

accurate?

A. Thin slices of behaviour lead to inaccurate impressions of others. B. In many instances, lasting and often accurate impressions of

others form in just a few moments.

C. Thin-slice impressions are 100% accurate. D. Thin slices work only when rating the attractiveness of others.

Apply . . . 3. Shania feels sure that her boss doesn’t like her. As a result, every time

her boss is around, Shania acts more restrained and less warm and friendly. This causes her boss to, in fact, find her unfriendly and start to not like her. This is an illustration of

A. a self-fulfilling prophecy. B. thin slices of behaviour. C. implicit processes being stronger than explicit processes. D. explicit processes being stronger than implicit processes.

The Self in the Social World

How do we decide what information to use when we’re trying to understand other people or form impressions of them? What schemas do we activate to guide our judgments? As discussed above, we may use subtle cues in people’s faces or non-verbal behaviours, but what else guides our judgments? Certainly, if the person falls into a group about which there are specific stereotypes, such as categories based on race, class, and gender, then these stereotypes often are

automatically activated and can colour our judgments (Bargh, 1999). But one additional schema that is highly accessible, contains a vast amount of information, and is therefore often used in guiding our social judgments—is ourselves! Much of the time, we look out at the social world through the lens of our own self-concepts.

This has two very important consequences. The first is that we tend to think that

the way we are is the way people should be, and therefore, people who are substantially different from us have something wrong with them. The second is

that we have a strong tendency to split the world into Us and Them, and we are motivated to see Us more positively than how we see Them. Understanding these dynamics gets right to the heart of why there is so much intergroup hostility in the world. It also reveals a tragic irony, which is that in the quest to feel good about ourselves and be happy, we sow the seeds that will grow into distrust, prejudice, and discrimination, thereby causing much suffering and unhappiness. Let’s examine these arguments carefully, because they have major implications for understanding why the world is the way it is.

Projecting the Self Onto Others: False Consensus

and Naive Realism

One way in which our self-concept affects our social perceptions is that we tend

to project our self-concepts onto the social world; this means that the qualities we see in ourselves and the attitudes and opinions that we hold, we tend to assume are similar for society at large. If we are sports fans, we assume that sports is generally important for other people as well. Even qualities we have that we know are not popular are still projected onto society; so, for example, if we are believers in Scientology, we will tend to assume that a larger proportion of the population believes in Scientology than is likely the case, and we will assume there are more Scientology believers out there than a non-believer would

assume. This tendency to project the self-concept onto the social world is known as the false consensus effect (Marks & Miller, 1987). It’s important to understand that this is a pretty sensible way to be, much of the time. After all, if we have to make guesses about people, why not base these guesses on ourselves?

We also generally assume that our perceptions of reality are accurate, that we see things the way they are; this is called naive realism (Ross & Ward, 1996). And it makes sense that we would make this assumption. After all, who wants to assume that they are walking around deluded and wrong all the time?

Imagine being beset by doubts constantly, your life uncertain and stressful because you are never able to trust your own judgments. So instead, we operate under a basic framework of “I make sense,” and then, by extension, “the people that I agree with, who are kind of like me, also make sense.” And then, of course, by one more extension, “the people who I disagree with are deluded, wrong, and quite fundamentally different from me.” You can see the problem here. At the personal level, we just want to feel good about ourselves and function effectively

in the world. But at the group level, we create intergroup biases and an Us vs. Them way of thinking.

Self-Serving Biases and Attributions

This tendency toward naive realism reflects a larger, more general need to want to feel positively about ourselves, to have a positive sense of self-evaluation or

self-esteem (Allport, 1955; Maslow, 1968; Sedikides & Strube, 1995). Undergraduate students clearly enjoy boosts to their self-esteem, reporting preferring to receive such a boost even over eating a favourite food, getting paid,

having sex, or seeing a best friend (Bushman et al., 2011). We strive to maintain our positive self-feelings through a host of self-serving biases , which are biased ways of processing self-relevant information to enhance our positive self-evaluation (Miller & Ross, 1975). For example, we tend to take credit for our successes but blame our failures on other people, circumstances, or bad luck.

One of the sneaky outgrowths of these self-serving biases and motivations is that for many of the qualities and skills that are important to us, we assume that

we are “better” than average. This rather appropriately named better than average effect has been shown in many different domains. We even tend to prefer the letters in our name, especially our initials, over the other letters of the

alphabet (Nuttin, 1985; Pelham et al., 2005); our letters are “better than average.” An extreme example of the better than average effect was shown in one study of almost one million American students; a whopping 85% viewed themselves as “above average” in their ability to get along with other people, and

a full 25% believed they were in the top 1% of this ability (Alicke & Olesya, 2005). If only the laws of math would allow this to be true. . . .

These same self-serving processes also influence the way we explain or interpret people’s behaviour. Much in the same way that first impressions are formed implicitly (which we discussed earlier), our explanations for behaviours tend to start out as automatic and seemingly intuitive. Imagine that you’re driving down the highway and all of a sudden some other driver swerves in front of you, honking; you slam on the brakes and turn the wheel sharply, narrowly avoiding a collision. Quick—what is the first thing that comes to mind about the other driver? Probably, your first thought is not the kindest or gentlest; you assume the other driver is an aggressive jerk, or maybe a bad driver. You yell, “You idiot!” and

shake your fist. This type of explanation is called an internal attribution (also known as a dispositional attribution), whereby the observer (yourself, in the above example) explains the behaviour of the actor (the driver who cut in front of you) in terms of some innate quality of that person (being an aggressive jerk, bad driver, or all-around “idiot”) (see Figure 13.3 ).

Figure 13.3 Internal and External Attributions Internal attributions are based on qualities or actions of the individual, whereas external attributions focus on the context in which the individual is situated.

But of course, there may be other reasons for the driver’s behaviour. Perhaps he is swerving out of the way of a piece of debris on the road, or just blew a tire, or

just received a phone call that his partner is in the hospital and so is distracted, or he’s tired after a long day and didn’t look in his blind spot that one crucial

moment before swerving in front of you. These are external attributions

(also known as situational attributions), whereby the observer explains the actor’s behaviour as the result of the situation (Heider, 1958). Generally, these external attributions are not what first come to mind; rather, we come to them after thinking about it for a bit, and realizing that maybe there were other factors causing the person’s behaviour that we didn’t initially consider.

This tendency to over-emphasize internal (dispositional) attributions and under- emphasize external (situational) factors when explaining other people’s behaviour is known as the fundamental attribution error (FAE) (Ross, 1977). On the other hand, when we explain our own behaviours, we tend to emphasize whichever kind of explanation paints us in the best light. For our negative behaviours, the mistakes we make and embarrassing things we do, our attributions are much more generous. We emphasize the situational factors that cause us to do undesirable things (e.g., we had a headache, we were under a lot of stress, a family member was sick, and so on). This obviously protects us from having to feel incompetent or foolish. However, it also might prevent us from taking responsibility for negative behaviours sometimes.

On the other hand, when our behaviours are desirable, self-serving biases work in the opposite direction; we take as much credit as we can for our successes (e.g., we worked really hard to deserve that promotion, we faced a lot of setbacks but we persevered and didn’t give up).

One rather ironic wrinkle in the story of the FAE is that it doesn’t seem to be quite as “fundamental” as was originally thought. Research on cross-cultural differences has shown that people make the FAE the most in predominantly individualistic cultures such as Canada or the United States, and the least in more collectivistic cultures such as China or Japan. This different approach to explaining others’ behaviour can be seen in how people interpret social events such as news stories. For example, after reading about recent mass murderers in the newspaper, subjects from China are more likely to emphasize situational explanations for the murders (such as recent stressful events in the person’s

life), whereas North American subjects are much more likely to emphasize

dispositional explanations (such as the murderer being an evil person; Morris & Peng, 1994). This greater emphasis on situational factors in collectivistic societies reflects stronger values toward maintaining harmony in interpersonal relationships and fulfilling one’s social roles in the larger community, values

which lead people to be more aware of situational information (Choi et al., 1999; Nisbett, 2003).

Ingroups and Outgroups

Although this desire to feel good about ourselves seems functional and healthy, it often has negative side effects. As we discussed earlier, our self-serving processes also reinforce a tendency to be biased against others. We are motivated to be biased against others because one of the key ways we maintain positive feelings about ourselves is through our identification with larger social

groups (Fein & Spencer, 1997), and we can therefore make ourselves feel good by feeling positively towards these groups. In turn, one way to feel positively about our own group is to focus on how much better we are than other groups

we compare ourselves to. Groups we feel positively toward and identify with are our ingroups , including our family, home team, and co-workers. In contrast, outgroups are those “other” groups that we don’t identify with. In fact, we actively dis-identify with outgroups.

This where our self-serving biases can be so destructive. As positive biases toward the self get extended to include one’s ingroups, people become motivated to see their ingroups as superior to their outgroups—engaging in ingroup bias and potentially, outgroup derogation. All in the service of maintaining our self-esteem, we carve the world into cate ­gories of Us and Them and then we automatically show a preference for Us.

An extremely clever set of studies that began in the 1970s added a crucial insight to the discussion of how we process information about groups. In real- world social interactions between people, there is already a lot of rele ­vant group information available simply based on the physical characteristics of the individuals. Rather than creating groups based on established characteristics

such as ethnicity or gender, researchers using the minimal group paradigm divided participants into new groups based on essentially meaningless criteria. In different studies, people were divided into groups based on whether they

preferred one painting over another (Tajfel, 1970; Tajfel et al., 1971), or whether they flipped heads or tails on a coin toss (Locksley et al., 1980). These newly formed groups had no history, no actual affiliation with each other, and no future together after the experiment was over.

Amazingly, even these completely meaningless ways of forming groups are enough to drive prejudice and discrimination; for example, if people are asked to distribute money between the two groups, they consistently give more to their new ingroup members. These results suggest that the process of categorizing

the world into Us and Them is a fundamental and practically unavoidable part of how we process the social world. It also has some sobering implications. If the people in the group who flipped heads in a coin toss prefer their fellow Heads over those nasty Tails, even though they have no history of animosity, no competition over resources, or any other grounds whatsoever on which to base their preferences, imagine how much more powerful people’s biases will be when faced with real-world distinctions and long histories of conflict and violence. Appreciating the deeply biasing influences of making ingroup–outgroup distinctions in the first place adds an important layer to our understanding of these larger conflicts.

In closing this section, we have to reiterate how important it is to understand that, like them or not, we cannot simply dispense with these psychological processes, despite all the trouble they cause us. All of these processes serve important functions for us. Without the false consensus effect and our tendency to project our self-concept onto others, we would be in a great deal of uncertainty about what other people are like; it would be like living on a planet of mysterious and unpredictable aliens. Without naive realism, we would be plagued by doubts and would constantly second-guess our perceptions of the world. Without a positive sense of self-evaluation, it would be easy to feel useless, helpless, and generally miserable. Without the ability to attach ourselves to desired ingroups and distance ourselves from undesired outgroups it would be hard to feel a sense of belonging, which is indispensable to our well-being and healthy identity

(Cacioppo et al., 2003; Myers & Diener, 1995; Tajfel & Turner, 1986). What we need to do then, is to learn to find a balance between our need to feel good about ourselves and our ingroups, and our more enlightened awareness of our fundamental equality with all people.

Module 13.2b Quiz:

The Self in the Social World

Know . . . 1. The tendency to see your ingroup as superior to outgroups is known as

. A. fundamental attribution error B. outgroup bias C. minimal group bias D. ingroup bias

Apply . . . 2. Which of the following would be an example of the fundamental

attribution error?

A. Assuming that your low grade on a math exam is due to how busy you’ve been, whereas another student’s low grade is due to him being a poor student

B. Assuming that you crashed your car because you’re a poor driver, whereas your brother’s car crash was likely because of the icy roads

C. Assuming that your excellent performance in a 10-km run is due to hard work and consistent training, and that the same explanation fits for all of the other fast runners

D. Assuming that genetics can fundamentally explain all human behaviour

3. Jeanette loves reading—she reads at least one book each week despite having a busy work schedule. When she finds out that none of her coworkers enjoy reading novels, she is absolutely shocked, as she

assumed everyone liked to read. Jeanette’s beliefs are an example of

. A. naive realism B. self-serving bias C. the false consensus effect D. thin slices

4. Donald, once poor, inherited $5 million and decided to donate $1000 to a local charity. Donald believes he took this step because he is a kind and

generous man. Donald might be demonstrating . A. the fundamental attribution error B. hindsight bias C. self-serving bias D. concepts of cognitive dissonance

Stereotypes, Prejudice, and Discrimination

Obviously, the roots of prejudice are planted very deeply in our psyches, stemming ultimately from our deep-rooted attachment to our own selves and our automatic social categorization tendencies. Thus, while at the explicit level we may strive to be egalitarian and not discriminate based on dimensions such as race, class, and gender, our normally functioning implicit processes continually

split the world into Us and Them. In fact, using ERP technology to measure brain activation, research has shown that the perceptual system starts to react differently to people based on race and gender within a mere 200 milliseconds

(Ito & Urland, 2003). When we try to change these implicit tendencies, we are battling our vast and speedy implicit system with our weak and ponderously slow explicit system. Much of the time, our explicit, consciously controlled self is going to lose, and we will fall prey to our implicit biases. These implicit biases lay the foundation for stereotyping, prejudice, and intergroup discrimination.

Myths in Mind Are Only Negative Aspects of

Stereotypes Problematic? The first examples that come to mind when stereotyping a group are usually based on negative characteristics. However, it is certainly not the case that all stereotypic associations are negative; men and women are stereotypically associated with different strengths, for example.

What might be counterintuitive to many people is that even the positive aspects of a stereotype carry a kind of hidden danger, leading to a tendency for people to believe it is okay to emphasize the positive aspects of a stereotype in a “benevolent or well-intentioned way.” This has been examined a great deal with regard to sexism. Researchers

have distinguished between hostile sexism, or stereotypes that have negative views of one or both sexes, and benevolent sexism, which includes positive views of one or both sexes (Glick & Fiske, 1996, 2001). For example, consider the somewhat dated saying that women are “the fairer sex.” A person using this phrase may mean it as a compliment, implying that women are virtuous, nurturing, and empathetic.

However, even stereotypes that a person may defend as being “well- intentioned” can place restrictions on an individual’s behaviour. If we consider women to be “virtuous,” they may be held to different sexual standards than men and, as a result, may be judged more harshly when they violate those standards. Similarly, considering women to be nurturing and empathetic reinforces the notion that women are the primary hubs of family life, and therefore less inclined toward career advancement in our competitive world. The belief in women’s nurturance may feed the belief that their career is never the primary one in a two- gender household, and that when it comes time to raise a family, they will step back from their careers while the man will be the primary breadwinner, thus setting discriminatory practices in motion in the workplace and contributing to making women more dependent on men for financial security. Even when women go toe-to-toe with men in the workplace, they may be hindered in careers that call for assertive or aggressive behaviours (such as being successful in the business world) because the “fairer sex” stereotype is pervasive in the organization

(Glick & Fiske, 1996, 2001). Thus, even seemingly positive aspects of a stereotype can result in negative, unforeseen consequences.

From a social-cognitive perspective, a stereotype is a cognitive structure, a set of beliefs about the characteristics that are held by members of a specific social group; these beliefs function as schemas, serving to guide how we process i nformation about our social world. Based on stereotypic beliefs, prejudice is an affective, emotionally laden response to members of outgroups, including holding negative attitudes and making critical judgments of other groups. Stereotyping and prejudice lead to discrimination , behaviour that disfavours or disadvantages members of a certain social group. Taken together, stereotyping, prejudice, and discrimination underlie many of the destructive “isms” in society—racism, sexism, and classism, among others. One of the central goals of social-cognitive psychology has been to understand how these processes work.

Prejudice in a Politically Correct World

In recent decades, norms have changed greatly in terms of what is appropriate to say about other people. This increased sensitivity to social diversity and equality, such as society’s greater acceptance of LGBTQ expressions of sexuality, or belief in gender and ethnic equality, is sometimes disparagingly referred to as “political correctness.” The label carries the suggestion that the battles for equality are basically over, and now if people in disadvantaged groups raise concerns about how they are treated in our society, they are just looking for excuses, such as when people say someone is “playing the race card” as though they are using their ethnicity merely as a tool to try to take advantage of society. The truth is quite different. Outgroup stereotypes and prejudices are by no means a thing of the past, and neither are the discriminatory practices that go along with them. Just ask Muslims in the post-9/11 world how stigmatized they feel every time there is a “terrorist” attack somewhere in the world. Or, ask a young Black person whether they feel they are treated exactly the same as Whites by their teachers, or the police, or potential employers. Or, look at the outcry after a young girl in Steubenville, Ohio, was sexually assaulted while unconscious at a party and two prominent high school football players in the

community were found criminally responsible; many people felt that she had ruined their lives, and not the other way around. Or, look at the disturbingly common and unabashed expression of negative views against Canada’s Native people in the wake of the Idle No More protests of recent years. Clearly, the full story of stereotypes and prejudice plays out in the lives of millions of people who are placed into the category of “other” by one group or another.

In the United States, despite the victories of the civil rights movement in shifting the racial attitudes of the general North American population, there is still prejudice toward non-White cultural groups. For example, it still seems as though Black men in particular experience the legal system differently from others. Black men in the U.S. are incarcerated far more often than any other groups, and experience substantially more physical and aggressive treatment from police

(Smith, 2004). Records of police encounters over the past 30 years confirm what many minority groups have long claimed—that the police use more aggressive

techniques on minority suspects than White suspects (Inn, Wheeler, & Sparling, 1977; Smith, 2004; Weitzer & Tuch, 2004). This is not a new phenomenon; historically, Black suspects have also been five times more likely

to die in police confrontations than White suspects (U.S. Department of Justice, 2001).

This prejudice has seeped into the basic social-psychological functioning of many people. For example, even though the general public denounces prejudice and discrimination and holds values of universal equality, studies of implicit processes tell a different story. When people (generally, White people) first are exposed to Black faces, this automatically influences a variety of physiological responses, including the activation of facial muscles, cardiovascular responses,

and brain activity related to fear and negative emotions (Cunningham et al., 2004; Eberhardt, 2005).

In fact, measures of brain activity reveal the battle between implicit and explicit processes. Over very short amounts of time, exposure to White or Black faces activates implicit processes such as those described above, indicating a racially biased pattern of processing. However, over longer periods of time, such as 30 seconds, brain activity shifts, showing heightened activity in the prefrontal cortex.

This area relates to the control of emotions and abstract thinking, consistent with a neurological effort to bring values into one’s mind in order to control emotional reactions. This teaches us a powerful lesson: Even if people abhor prejudice at

the explicit level of their awareness, they may implicitly hold negative stereotypes and experience prejudiced emotional reactions.

Clearly, there can be important discrepancies between stereotyping, prejudice, and discrimination at the explicit and implicit levels. This has created huge challenges for researchers attempting to study these processes, because of course simply asking subjects how they feel is only going to reveal their explicit processes, which rarely include overt racism and sexism. This has led to the invention of measurement techniques to try to reveal implicit processes.

Working the Scientific Literacy Model Explicit versus Implicit Measures of Prejudice

If a great deal of modern prejudice has “gone underground” in the sense that people hide it and give politically correct responses at the explicit level, how can researchers accurately measure prejudice in today’s society?

What do we know about measuring prejudice? Psychologists have developed clever ways of measuring the forms of stereotyping and prejudice that are kept silent, either intentionally or because individuals are unaware of their own

prejudices (Greenwald & Banaji, 1995; Nosek, 2007). In order to do so, researchers needed to come up with measurement devices that would reveal people’s implicit processes. This is no easy challenge, because implicit processes can operate so quickly (in less than a second), and so subtly that we are typically not consciously aware of them.

How can science study implicit prejudice?

A major research breakthrough occurred in the 1990s with the

invention of the Implicit Associations Test (IAT ; Greenwald et al., 1998). The IAT measures how fast people can respond to images or words flashed on a computer screen. To complete the test, a person uses two fingers and two computer buttons, and

responds to stimuli, as directed (see Figure 13.4 ). In round 1, subjects are supposed to press one button if they see a White face or a positive word (such as “peace”), and a different button if they see a Black face or a negative word (such as “war”). Thus, in this round, the buttons are associating stereotype-consistent stimuli. With these particular pairings, it takes people around 800 milliseconds (four-fifths of a second) to press the correct button.

Figure 13.4 The IAT Procedure

To complete one condition in the IAT (a), participants must use one button to identify Black faces and negative words and another button to identify White faces and positive words. In the other condition (b), the positive and negative words are switched to be paired with the other race (Black/positive and White/negative). Average response times are faster when Black is paired with negative words and White is paired with positive words (c). Is this a sign of hidden prejudice?

Round 2 rearranges the associations. This time subjects press one button if they see a White face or a negative word, and a different button if they see a Black face or a positive word. Thus, in this round, the buttons are associating the stimuli in stereotype-

inconsistent ways. In this situation, people take an average of 1015 milliseconds to press the correct button, more than one-fifth of a second longer than in round 1. (To control for any possible effects of going first vs. going second, the order in which a person goes through these tasks is usually counterbalanced across subjects, with some going in the order presented here, and others in the reverse order.)

Why does it take longer to respond when there is a Black/positive button than when there is a Black/negative button? The researchers reasoned that racial schemas associate more negativity with Blacks than with Whites. Because schemas guide information processing, they facilitate the processing of information that is schema-consistent; thus, it is easier for a person to make snap judgments to always press one button for either Black or negative stimuli. But schema-inconsistent information is more difficult to process; thus, having two different buttons for Black and for negative means that a person has to override their automatic, implicit association between Black and negative, in order to choose the correct response. The size of the reaction time discrepancy between these two rounds is believed to be a direct measure of the strength of people’s implicitly held negative beliefs or stereotypic associations with Blacks.

The IAT was a major breakthrough, suddenly allowing us to directly measure a person’s implicit biases. Researchers quickly started to develop ways of measuring all sorts of implicit things— implicit attitudes, self-esteem, feelings of connection to nature, and prejudice towards many different groups.

Can we critically evaluate this evidence? Although the data gathered with this instrument show reliable results, some psychologists have questioned the test’s validity: Is the IAT really a measure of prejudice? Or is it possible that the IAT is merely measuring the extent to which people have been

exposed to negative stereotypes, but have not necessarily developed prejudices? After all, simply knowing about a stereotype does not mean an individual believes it, uses it to judge people, or engages in discriminatory behaviour.

Studies by Elizabeth Phelps and her colleagues (2000) suggest that the IAT reflects a person’s emotional reactions to outgroup members. In her studies, White participants were shown pictures of Black and White faces while having their brains scanned using fMRI. The amount of activity detected in the amygdala (a brain area related to fear responses) when looking at Black faces was positively correlated with participants’ IAT

measures of implicit prejudice (see Figure 13.5 ). This suggests that the IAT is measuring something real enough to be reflected in neural activity in areas related to fear and emotional processing.

Figure 13.5 Implicit Associations and the Brain

Researchers displayed photographs of Black and White faces. In White participants, Black faces elicited more activity than White faces in the amygdala, an emotion centre of the brain. This activity was positively correlated with participants’ responses on the IAT. Source: Elizabeth A. Phelps, Kevin J. O’Connor, William A. Cunningham, E. Sumie Funayama, J.

Christopher Gatenby, John C. Gore and Mahzarin R. Banaji, ‘Performance on Indirect Measures of

Race Evaluation Predicts Amygdala Activation’, Journal of Cognitive Neuroscience, 12:5 (September,

2000), pp. 729-738. © 2000 by the Massachusetts Institute of Technology.

Why is this relevant? The development of the IAT has fostered a great deal of research and has been applied to at least a dozen forms of stereotyping,

including stereotypes of social classes (Rudman et al., 2002), sexual orientation (Banse et al., 2001), and even fraternity and sorority members (Wells & Corts, 2008). The results of all these tests illustrate that implicit prejudice seems to be more prevalent

than people are willing to express in explicit tests (Nosek et al., 2002). The IAT is also being applied to clinical settings. For example, one research group developed an IAT that measures attitudes about alcohol use. This instrument can successfully predict how much alcohol someone is likely to consume, even

when explicit measures fail to do so (Ostafin et al., 2008). To the extent that this methodology is valid, it is extremely valuable, giving us a window into people’s private minds.

Psych@ The Law Enforcement Academy Imagine that instead of linking positive or negative terms with Black faces in the IAT, you were asked to make a snap decision whether or not to shoot a potential criminal. A number of researchers have used video- game-like tasks to put participants in these situations. In these video simulations, a figure will suddenly appear, either holding a weapon or a non-weapon (e.g., a wallet or a cell phone). It turns out that when making these split-second decisions, people are a little bit slower to decide whether or not to shoot a Black man holding a non-weapon, and they make the wrong decision more often. When a Black man is holding a gun, however, they make the “shoot” decision more quickly than if the

gun is held by a White man (Correll et al., 2007; Correll et al., 2006). The logic is similar to the IAT discussed above. Because Black and “gun” are stereotypically consistent with each other, people have an easier time processing these stimuli together than when Black and “wallet” are paired with each other. Just like the situation in the Amadou Diallo case then, people are more likely to mistakenly shoot a Black man holding a wallet, believing that he might be holding a gun; at least, they’re more likely to do this in a video game.

Certainly a video game pales in comparison to the adrenaline-fuelled confrontation that occurred that fateful night in the Bronx. It is easy to imagine that the stress of a real confrontation, combined with the complexity of a real-world situation, would lead to an even higher chance

of a mistaken shooting occurring (Saus et al., 2006). To combat any implicit influence of race on an officer’s decision to shoot, most law enforcement agencies in North America have developed extensive training programs, part of which focuses on making shoot–don’t-shoot

decisions (Cordner & Shain, 2011). Programs may simulate a variety of firearms combat situations using a combination of walk-through sets with cardboard figures, and realistic mock-combat against other people armed with foam pellet guns. Research suggests that this training is helpful; even student volunteers in the lab can be trained to reduce shooting

errors through such means (Correll et al., 2007; Plant & Peruche, 2005).

The split-second differences in the IAT may be related to officers’ increased use of deadly force with Black suspects, including cases where

the suspect is unarmed. Here, a police officer undergoes virtual reality training designed to reduce shooting errors. ZUMA Press/Newscom

Improving Intergroup Relations

We are left with an immense practical challenge: How can we overcome the implicit processes we have examined in this module and work toward eliminating harmful stereotypes, prejudices, and discrimination from our society? Unfortunately, there are no easy answers. But there are some promising possibilities.

Keri Kawakami at York University has spent more than a decade researching how to overcome implicit stereotyping and prejudice. Research in her lab has shown that people’s implicit networks can be “reprogrammed” through practice. For example, people can be trained to make situational attributions for negative behaviours by stereotyped group members, thereby overcoming the fundamental attribution error; this helps to prevent people from thinking of others in

stereotypic ways (Stewart et al., 2010). In another study, Kawakami and her colleagues used a computer task to teach people to make different associations with a stereotyped group. Subjects were presented with photographs of Blacks and Whites, coupled with either stereotypic or non-stereotypic traits, and were instructed to respond “NO” to stereotypic pairings, and “YES” to non-stereotypic pairings. After extensive training involving many such trials, subjects no longer

activated negative racial stereotypes, even at the implicit level (Kawakami et al., 2000). This suggests that, over time, as our society continues to evolve in an increasingly egalitarian, non-prejudiced direction, it may be possible for people to

unlearn the stereotypes that history has provided us with. However, there is a huge gap between the kind of intensive training that Kawakami’s participants experienced in the lab and the real-world experience of individuals who are bombarded with both stereotypic and non-stereotypic messages on a daily basis. Nevertheless, these results suggest that it is at least possible for people to

“reprogram” themselves.

One of the most well-supported ideas in all of social psychology is the contact hypothesis , which predicts that social contact between members of different groups is extremely important to overcoming prejudice (Allport, 1954; Pettigrew & Tropp, 2006), especially if that contact occurs in settings in which the groups have equal status and power, and ideally, in which group members are

cooperating on tasks or pursuing common goals (Sherif, 1961). Negative stereotypes and the attendant prejudices thrive under conditions of ignorance, whereas allowing people to get to know members of outgroups, to work together to pursue common goals, to come to appreciate their membership in common groups or as part of the same ingroup (e.g., we’re both Blue Jays fans,

Canadians, or members of the human species; Gaertner & Dovidio, 2000), and to develop friendships with members of outgroups (Pettigrew, 1997, 1998) are all different ways in which contact helps to overcome prejudice. In fact, contact between members of different groups not only helps to combat their own prejudices, but that of their friends as well; simply knowing that someone is friends with an outgroup member serves to decrease the prejudice of that

person’s friends (Wright et al., 1997).

Coming to see our fellow human beings as all part of the same human family is an opportunity that recent advances in technology (the Internet, space exploration), economics (globalization), and ironically, global problems (climate change, nuclear proliferation) have made available to all of us. This global perspective shift may, one hopes, help us to overcome our age-old group prejudices. Astronauts who travel into space and look back on this one little planet that we inhabit often report that the experience profoundly affects them.

“The first day or so we all pointed to our countries. The third or fourth day we were

pointing to our continents. By the fifth day, we were aware of only one Earth.” —I

Congress of the Association of Space Explorers Cernay, France October 2-6, 1985.

Quote of Sultan bin Salman Al-Saud, © 1985 Association of Space Explorers. Used by

permission.

Module 13.2c Quiz:

Stereotypes, Prejudice, and Discrimination

Know . . . 1. prejudice refers to situations in which a person stereotypes a

group of people based on hidden, unacknowledged feelings.

A. Explicit B. Discriminative C. Associative D. Implicit

Understand . . . 2. Unconscious forms of prejudice are believed to be measured with the

implicit associations test. This test is based on

A. people creating lists of words that come to mind when they see a person of a specific race.

B. how long it takes people to respond to positive or negative words along with Black or White faces.

C. changes in heart rate that accompany photos of people from different racial backgrounds.

D. increased activity in the emotional centres of the brain that are associated with specific races.

Apply . . . 3. Jacques believed that everyone from Alberta was a racist “redneck.” He

was therefore quite nervous when he found out that he’d have to work with two Albertans who were visiting from his company’s Edmonton office. After spending some time with the two men, however, he realized that his views about Albertans were incorrect. This is an example of

. A. the Notley effect B. conformity C. the contact hypothesis D. pluralistic ignorance

Analyze . . . 4. Which of the following statements about stereotypes and prejudice is

false? A. Stereotypes can be expressed outwardly and very explicitly. B. All stereotypes are of negative characteristics. C. Stereotypes are often experienced implicitly. D. Prejudice has become increasingly unpopular in both Canada

and the United States.

Module 13.2 Summary

contact hypothesis

discrimination

dual-process models

explicit processes

external (situational) attribution

false consensus effect

fundamental attribution error (FAE)

Implicit Associations Test (IAT)

implicit processes

ingroup bias

ingroups

internal (dispositional) attribution

naive realism

outgroups

Know . . . the key terminology associated with social cognition.13.2a

person perception

prejudice

self-fulfilling prophecy

self-serving bias

stereotype

thin slices of behaviour

We quickly form impressions, even when only thin slices of behaviour are available to us. These impressions can be surprisingly accurate, but they can also affect our behaviour in ways that tend to confirm our initial impressions; this is the phenomenon of self-fulfilling prophecies.

The key to overcoming prejudice and discrimination seems to be to help people create different schemas in their mind for members of outgroups. This can be done by retraining people to make different automatic associations with outgroup members, such as training them to consciously reject pairing of the outgroup with negative or stereotyped traits. Different schemas can also be created through realizing a common identity between oneself and the other person, which can occur from extended contact, cooperation on mutual goals, or adopting more inclusive and abstract categories (e.g., human family) for thinking about people.

It is certainly possible for people to commit discriminatory acts without being prejudiced. Regardless of prejudice, stereotypes are absorbed from the larger

Understand . . . how we form first impressions and how these impressions influence us.

13.2b

Apply . . . your understanding of social cognition to the problem of overcoming prejudice and discrimination.

13.2c

Analyze . . . whether people who commit discriminatory acts are necessarily prejudiced.

13.2d

culture, and these can function as interpersonal schemas that can guide how we see things and how we implicitly process information. This can cause us to behave in a discriminatory fashion without us intending to, such as being more likely to assume an ambiguous object is a gun if held by a Black man, compared to when it is held by a White man.

Module 13.3 Attitudes, Behaviour, and Effective Communication

ZUMA Press, Inc./Alamy Stock Photo

Learning Objectives

Know . . . the key terminology in research on attitudes, behaviour, and effective communication. Understand . . . how behaviours influence attitudes in terms of cognitive

13.3a

13.3b

Bill McKibben is a man on a mission. He wants to save the planet. Actually, to be more accurate, he wants to save the kind of planet that humans can live on. But unlike many people with such ambitious dreams, Bill has a few very important factors on his side.

First, he knows what he is talking about when it comes to saving the planet, having published many books and articles on the topic over the past few decades. Second, he has the full weight of the scientific community behind his cause, which agrees that the human species is heading rapidly for catastrophe as we push global warming higher and

higher. And third, he has a global organization, 350.org, spanning almost every country on Earth, with hundreds of thousands of members. He also has some significant victories under his belt, from organizing the most widespread days of political activism in history to raising unprecedented opposition to key government decisions, such as whether or not to pass the Keystone XL pipeline that would take oil from Alberta’s oilsands and transport it across the United States.

For Bill McKibben, and for the human species more generally, to succeed in the fight against climate change, there are some big barriers to overcome. Psychology provides a great deal of insight into how to rise to such a societal challenge. Any social problem is, at some level, a problem of human behaviour, and finding solutions therefore inevitably involves changing human behaviour.

Focus Questions

1. What is the relationship between attitudes and behaviour?

dissonance theory. Apply . . . your understanding of the central route to describe how a message should be designed. Analyze . . . the difficulties communicators face in trying to convince the public to take action on climate change.

13.3c

13.3d

2. How should communications be structured so as to be as persuasive as possible?

According to the American Psychological Association’s official task force on climate change, “Addressing climate change is arguably one of the most

pressing tasks facing this planet and its inhabitants” (American Psychological Association, 2010, p. 6). The task force was comprised of a carefully chosen group of highly regarded senior scientists, including the University of Victoria’s Robert Gifford. Their overall assessment agrees with the perspective of the United Nations, whose Secretary General Ban Ki-Moon said in 2009 that climate change was the greatest issue of the 21st century. Using the insights of psychology to find solutions to climate change is increasingly becoming a focus for applied psychologists who specialize in communication and behaviour change. Although this module will use climate change as a running example, the principles being discussed can apply to almost any social issue that affects our society. Hopefully this module will help motivate you to change our world for the better.

Changing People’s Behaviour

Four of the most common approaches taken to attempt to change the public’s behaviour on a large scale are technological, legal, economic, and social. The technological approach focuses on making desired behaviours easier and undesired behaviours more difficult; for example, public transit systems make it easier to get to work without driving; having alternative energy technologies (like solar panels) widely available make it easier for people to reduce their carbon footprint; having a public recycling system with separate bins makes it easier for people to recycle, and so on. The idea is to get the technology right so that people will behave in the desired way. The legal approach focuses on policy change, using laws to encourage positive behaviours and discourage negative behaviours. The economic approach focuses on financial incentives and penalties, generally through taxes and pricing. Generally, if the “right” thing to do

is cheaper, and the “wrong” thing to do is more expensive, people will choose the “right” behaviour. The social approach focuses on using information and communication to raise awareness, educate people, and create positive community organizations to encourage the desired behaviours.

Although each of these approaches obviously can have an impact on public behaviour, each one by itself is insufficient for solving or adapting to major global problems like climate change. The biggest problem with the technological, legal, and economic perspectives (aside from the problem that they can’t, realistically, be applied to every behaviour that is relevant to climate change) is that developing and implementing the technological solutions, or passing the laws and setting the price incentives that would be required to sufficiently change behaviour, can only happen if the public at large will support such changes. Any politician who tries to, for example, increase gas taxes in order to encourage the shift to a sustainable energy economy is going to have to overcome some stiff public resistance. Clearly, finding solutions to our environmental challenges requires that the public supports the solutions.

Inevitably, as you consider how to achieve the technological, legal, or economic changes that might change public behaviour, you often end up at the problem of how to get the support of the general public. This takes us to the fourth approach: social. There are a vast number of social mechanisms for changing human behaviour; however, for the purpose of illustrating the application of social psychology to problems like climate change, we focus on one of the most commonly employed social tactics: raising awareness.

The basic assumption behind the raising awareness approach is that people will generally do the right thing if they have the right information. People’s behaviours reflect their attitudes and beliefs (what they think is important, right vs. wrong, etc.), which in turn, reflect the information that they have available. So to change behaviour, you have to give people information that will help change their beliefs and attitudes. Therein lies the logic behind public service announcements, pamphlets, billboards, education campaigns, and the vast majority of the

behaviour change attempts occurring in society (McKenzie- Mohr, 2000). Learning how to communicate effectively in order to influence attitudes and

behaviour has been a major focus of psychology for most of its history, and we have learned a great deal about how to do so.

Persuasion: Changing Attitudes Through

Communication

Social psychologists have discovered many important principles underlying effective communication, giving us a set of tools for influencing all sorts of behaviours, from wearing condoms to eating chocolate bars. These tools are employed for a wide variety of behaviour change purposes, from standard marketing goals like getting us to buy more stuff, to pro-social causes such as getting us to donate blood or to volunteer for a charitable organization.

If you are preparing a persuasive message, understanding what is likely to connect with and have an impact on your audience is extremely important.

These factors are explored by the elaboration likelihood model (ELM) of persuasive communication. The ELM predicts that when audiences are sufficiently motivated to pay attention to a message (i.e., they care about the issue) and they have the opportunity for careful processing (i.e., they have the cognitive resources available to understand the message), they will be persuaded by the facts of the argument, the substance; when either of these two factors (motivation and opportunity) are missing, people will tend to be persuaded by other factors. According to this model of persuasion, information can appeal to people through two general routes: the central route and the peripheral route (Cacioppo et al., 1986).

The central route to persuasion is all about substance. It occurs when people pay close attention to the content of a message, evaluate the evidence presented, and examine the logic of the arguments. If the message is sufficiently compelling, they will be convinced, internalizing the message as something they

believe in (see Figure 13.6 ). As a result, attitude or belief change that occurs through the central route tends to be strong and long-lasting.

Figure 13.6 Central and Peripheral Routes to Persuasion There are two ways that communications can persuade people. In the central route people are persuaded by the content of a message, while in the peripheral

route they are influenced by the way the content is presented, the style over the substance.

However, much of the time, people are not going to pay sufficient attention to the

content of a message, and instead, persuasion will depend upon other features that are not directly related to the message itself, such as the attractiveness of the person delivering the information, or the number of arguments made

(regardless of the quality of those arguments). When taking the peripheral route to persuasion it’s all about style, not substance. Although persuasion is typically not as powerful through the peripheral route, it is nevertheless often a superior route through which to reach people, in part because it’s so much easier. Even though people may not be paying much attention or may not really care about your issue, they can be persuaded if you can skillfully wield peripheral tools. Peripheral tools are quite dangerous, as a result, because they can make even relatively weak arguments potentially have an impact on people, whereas relatively strong and important arguments, if they are packaged in a more boring, less peripherally appealing way, can be overlooked. Anyone who has spent time on the Internet has encountered some form of propaganda, advertising, or scam

that puts information together in a way that sounds extremely appealing, even if it is based on no actual truth at all. But peripheral tools are powerful enough that even the most unlikely of theories or perspectives can gain traction in society if it’s packaged the right way.

Module 13.3a Quiz:

Changing People’s Behaviour

Understand . . . 1. Which of the following is not a common approach used to change the

public’s behaviour?

A. technological B. social C. economic D. conformity

Apply . . . 2. Which of the following is an example of using the central route to

persuasion?

A. An organization having a visually interesting webpage. B. An organization providing factually correct scientific data. C. An organization using a funny and attractive spokesperson. D. An organization having a cool theme song as part of their

commercials.

3. Ahmed’s grandparents immigrated to Canada from Egypt in the 1970s. He wants to raise awareness about the positive effects immigration can have on a society. To do so, he prints out a list of the benefits of immigration and puts copies in people’s mailboxes. How successful will Ahmed’s attempts at persuasion be—and why?

A. Ahmed will have great success because he used the peripheral route to persuasion successfully.

B. Ahmed will be successful because he is using both the central and peripheral routes to persuasion.

C. Ahmed will not be successful because although he used the central route to persuasion well, he did a poor job using the peripheral route.

D. Ahmed will not be successful because he used both the central and peripheral routes to persuasion poorly.

Using the Central Route Effectively

In order to use the central route effectively, you need to be confident that you have the facts on your side. If you feel your perspective makes logical, rational sense, then it makes sense to appeal to the central route. This means getting your audience to pay close attention to your arguments. In order to do that, you have two key factors to work with: motivation and opportunity. People will be more likely to process information through the central route when they are highly motivated and when they have the knowledge or expertise to understand the information. Thus, the central route is most reliable when people are highly motivated about the topic, when they have sufficient time and freedom from distraction, and when the information is not overwhelmingly complex relative to their knowledge (i.e., if the audience is not very knowledgeable, the information has to be simple, but if the audience has more expertise, then obviously the information can be more nuanced and complex). With these factors in mind, this section of the module will examine some key strategies for maximizing the central route.

Make It Personal

Imagine for a moment that your friend has some juicy, scandalous gossip to tell you. There would be a big difference in your desire to hear it if it were about (1) one of her friends whom you do not know; (2) one of your friends; (3) you! Clearly, your desire to get this information is directly related to how personally relevant it is. Making a message self-relevant is crucially important to motivating people to care and pay attention.

It can be surprisingly easy to make information self-relevant. The simple perspective-shift of going from a third-person to a first-person type of description makes a huge difference in how personally relevant something feels. For a moment, look back to the previous paragraph. In that paragraph, our opening sentence could have been, “Making a message self-relevant is very important, blah blah. . . .” Instead, we said “Imagine for a moment that your friend has some juicy, scandalous gossip. . . .” Even subtle nuances, such as appealing to “you,” the reader, can make a message more personally engaging.

Consider one striking study from the early 1980s (Gregory et al., 1982), a time when cable television (CATV) was still making its way into the North American viewing market. Researchers compared two very similar persuasive appeals, which were presented to two samples of homeowners to try to convince them to subscribe to CATV.

In the information-only condition, homeowners were presented with this appeal: CATV

will provide a broader entertainment and information service to its subscribers. Used

properly, a person can plan in advance to enjoy events offered. Instead of spending

money on the babysitter and gas, and putting up with the hassles of going out, more

time can be spent at home with family, alone, or with friends.

In the imagination condition, homeowners received this appeal: Take a moment and

imagine how CATV will provide you with a broader entertainment and information

service. When you use it properly, you will be able to plan in advance which of the

events offered you wish to enjoy. Take a moment and think of how, instead of spending

money on the babysitter and gas, and then having to put up with the hassles of going

out, you will be able to spend your time at home, with your family, alone, or with your

friends.

As you can see, the two appeals are almost identical, providing the exact same arguments; from a purely logical perspective, they should have exactly the same impact. However, their impact differed dramatically: Only 19.5% of the people who received the information-only appeal signed up for CATV, whereas a whopping 47% subscribed when they were simply told to imagine themselves in the scenario! Imagine the profit difference between selling your product to 1 in 5

people or 1 in 2 people. This is the power of making things personal.

This power has been explained by construal-level theory (Trope & Liberman, 2010), which describes how information affects us differently depending on our psychological distance from the information. Information that is specific, personal, and described in terms of concrete details feels more personal, or closer to us; whereas information that is more general, impersonal, and described in more abstract terms feels less personal, or more distant. Importantly, psychological distance depends not only on geography (people or places that are farther away are less personal), but temporal factors (distant future or past times feel less personal), social factors (people or groups that are further removed from one’s identity are less personal), how abstract the information is (abstractions are less personal than things that are specific), and even the level of certainty one feels about an outcome (outcomes that are less certain are less personal).

Communicators should be able to make their messages feel more personally relevant to the audience by working with these factors, bringing the message close to home in time and space, showing how it affects the audience themselves or their social groups, and making consequences or outcomes as certain as possible.

Climate change communicators, unfortunately, have struggled with this. As a result, their communications have often felt “distant” to many people. If the goal is to create psychological closeness and relevance, climate change communications typically involve exactly the wrong types of information. The term “climate change” itself implies something global and abstract; when people do think of specific others who may suffer due to climate change, they tend to

think of others in the distant future or in distant parts of the world (Leiserowitz et al., 2010; Lorenzoni & Pidgeon, 2006). Also, scientists have been honest about communicating the inherent uncertainty of scientific predictions, leading people to emphasize the uncertainty in the science. And finally, communicating about “the climate” inherently involves abstractions, because the climate is an abstraction, as is “global temperature,” “rates of greenhouse gas emissions,” and much of the important information that climate scientists are trying to

communicate. As a result, people often experience climate change as

psychologically distant, rather than personally relevant (Liberman & Trope, 2008; Milfont, 2010). Bringing the consequences of climate change home for a given audience, bringing them close in time and space, and changing the focus of the discussion to the certainty of what scientists do know rather than the uncertainty of what they don’t, should make the message much more powerful

(Spence et al., 2012).

Working the Scientific Literacy Model The Identifiable Victim Effect

An additional challenge for people worried about climate change

is that it is difficult to show how people will be affected by this issue. Issues seem less real when there is no story to accompany them. Contrast climate change with some other very important social issues facing people in North America. The issue of gun control in the United States is influenced by stories such as the horrendous shooting death of 20 children and six adults in Sandy Hook Elementary School in 2012. The crisis facing refugees fleeing war-torn Syria gained international attention when heart- breaking photographs showed the body of three-year-old Alan Kurdi. Racial tensions in the United States, which led to the Black Lives Matter movement, are all-too-often linked with violence, such as the police killing of Michael Brown in Ferguson, Missouri in 2014. These are all upsetting social issues filled with real human tragedy.

Although it is by no means a competition, approximately 400 000 people die every year due to climate-change–related disasters

(DARA, 2012). And this is just at the very beginning of the climate changes that scientists have been warning us about! Researchers at Stanford University concluded that human civilization itself is headed rapidly toward global collapse due to

an escalating mix of environmental problems such as climate

change and the acidification of the oceans (Ehrlich & Ehrlich, 2013); this collapse will likely occur in the next few generations, possibly affecting your children and grandchildren. Given this terrifying possibility, why have climate scientists (and environmental psychologists) been so unsuccessful in persuading people to change their behaviour? The answer might lie in how they tell their story.

What do we know about communicating about tragedy? Many experiments have shown that information about tragedies has much more impact if it focuses on specific details and concrete events than if it relies upon more abstract, statistical

information. For example, the identifiable victim effect

describes how people are more powerfully moved to action by the story of a single suffering person than by information about a whole group of people.

In one study (Small et al., 2007), researchers gave subjects a chance to donate up to $5 of their earnings from participating in the study to an organization, Save the Children, based on information provided in one of three different conditions. In the

identifiable victim condition, participants read about Rokia, a 7- year-old girl from Mali, Africa, who was desperately poor and

facing severe hunger and possibly starvation. In the statistical victims condition, participants read about food shortages and rainfall deficits affecting more than 20 million people in four

countries in Africa. In the third, combined condition, both types of information were provided; participants read about Rokia and then were also given statistical information about mass suffering in African countries.

The identifiable victim effect was clearly demonstrated; people who read about Rokia gave significantly more ($2.38) than people who read general statistical information ($1.14). Clearly,

Rokia tugs on the heart-strings more than abstract numbers do

(see Figure 13.7 ). It is worth pointing out how strictly illogical this is; if we were rational processors of information, we would respond more strongly to statistics, which is essentially many, many Rokia-like stories combined with each other, than to one single story of Rokia which is, after all, “just an anecdote.”

Figure 13.7 The Identifiable Victim Effect

Participants were willing to donate more money after reading about a specific victim of starvation than they were after reading statistics about widespread starvation. Surprisingly, combining

the story of a specific victim and general statistics led to levels of donations similar to the statistics-only condition. Source: Republished with permission of Elsevier Science, Inc., from Sympathy and callousness: The

impact of deliberative thought on donations to identifiable and statistical victims, Organizational

Behavior and Human Decision Processes, 102, 143–153. Fig 3, p.149. Deborah A. Small, George

Loewenstein and Paul Slovic. March 2007. Permission conveyed through Copyright Clearance

Center, Inc.

One interesting twist in this study was that participants who were given information about Rokia combined with the statistics donated only $1.43, which was statistically no different than what participants gave after being presented with the statistics alone, and was certainly much less than participants gave after only hearing Rokia’s story. This study suggests that trying to

simultaneously appeal to the head and the heart might not always work! This has enormous implications for anyone who wants to communicate to others; you have to very carefully consider the balance of your factual information and technical details with your stories, jokes, images and metaphors. Clearly, it’s not as simple as “have solid facts and tell a good story,” because sometimes, combining the two approaches doesn’t work.

How can science explain the identifiable victim effect? Earlier in the module, we mentioned that abstract information is

experienced as more psychologically distant than concrete, specific information. But this doesn’t go far enough to help us understand the findings in this Rokia study. There are two key results to explain. First, why is Rokia’s individual story more impactful than millions of Rokia stories presented in the form of statistical information? Second, why does combining Rokia’s

story with statistics actually make it less likely for people to act?

To understand these findings, psychologists rely upon dual-

process models (see Module 13.2 ) of information processing (Stanovich & West, 2000). The experiential system

(Epstein, 1994), operates more implicitly, quickly, and intuitively and is predominantly emotional; this system responds strongly to personal experiences, images, stories, and other people’s

emotions. In contrast, the analytic system operates more at the explicit level of consciousness, is slower and more methodical, and uses logic and discursive thinking (i.e., reasoning using language) to try to understand reality. The analytic system specializes in understanding, whereas the experiential system

specializes in intuition and feeling. With these systems in mind, you can begin to see why Rokia’s story would be so powerful; Rokia’s story speaks to the experi ­ential system, thereby triggering emotional responses, such as empathy, that would motivate people to give to charity. The abstract statistics, however, speak to the analytic system, the head rather than the heart. Less emotional impact leads to less motivational strength

(Barrett & Salovey, 2002; Forgas, 2000). Without emotions, information about the suffering of millions of people becomes

“just a number,” an abstraction that is difficult to feel.

Although one might expect that the most effective approach would simply be to appeal to both systems, it seems that in some situations at least, involving the analytic system at all can backfire. It is as though the analytic system inhibits or shuts down the experiential system, putting people in more of a cold, analytic frame of mind, so that they have little access to their emotional responses. This may be why the condition that included both Rokia and the statistics was no more motivating than the statistics alone. The cold, analytic way of thinking that was activated by the statistics made Rokia’s emotional story have less

impact than it had on its own (Loewenstein et al., 2001; Slovic et al., 2002). Nobel prize–winning biochemist Albert Szent Gyorgi sums this idea up nicely when he talks about the difficulties trying to wrap your head around the consequences of nuclear war. “I am deeply moved if I see one man suffering and would risk my life for him. Then I talk impersonally about the possible pulverization of our big cities, with a hundred million dead. I am unable to multiply one man’s suffering by a hundred million”

(Slovic, 2007).

Can we critically evaluate this evidence? Taken by itself, this single study cannot tell us whether individual stories are more motivating than statistics; it merely tells us that

this particular story is more motivating than these particular

statistics. Specific stories and specific statistics will have different impacts in specific situations with specific people. Obviously, every particular convergence of circumstances is different. Sometimes, a certain story will be particularly powerful; other times a certain statistic will be. Importantly, we don’t know how the impact of statistical information vs. emotional stories changes over the long term or with repeated exposure. You have surely encountered news stories before that have made you feel very strong emotions in the moment, but within even a few days you largely forgot about them, and you never actually made a contribution to the cause or took any sort of action. This happens all the time. Things “go viral” and then, not too long afterwards, everybody gets over it and moves on to something else.

Obviously, we cannot dispense with talking about statistical, abstract information if we are to communicate with each other about what is happening in the world. It therefore becomes extremely important to understand how the experiential and analytic systems can work together, and how to make the best use of them in crafting effective communication strategies.

Why is this relevant? This research is highly relevant to the challenge of motivating people to take action on major societal issues such as climate

change (e.g., Slovic, 2007). The basic principle for communicating in a way that motivates behaviour change is to personally engage the person to reduce the psychological distance of the information. There are many ways to do this, including framing information in a personal way (see the TEDxUofT talk, “Everything You Love”), describing abstract information as personal experiences, focusing on the near future rather than the distant future, emphasizing specific actions that will make a difference, and using social media strategies so that information comes from friends rather than from strangers.

Nevertheless, despite all the tools that we have to communicate and influence behaviour more effectively, countless questions remain concerning how to make the best use of these tools. These questions will have to be answered over and over again, as we seek (and hopefully find!) solutions to the challenges we face, from our personal lives to issues of global scale like climate change. One of the biggest challenges that must be overcome when communicating about any issue is to understand how to

connect the issue to the values of the people receiving the message.

Value Appeals

As any good marketer knows, audiences are much more likely to listen to a message that is framed in such a way that it seems relevant to their values. Interestingly, pro-environmental behaviours have often been framed in ways that

go against people’s self-interest, involving trade-offs between the economy or the environment, jobs or trees, comfort and convenience or personal sacrifice (Schultz & Zelezny, 2003). And as noble as it might be to sit in the dark, shivering through the winter and eating only locally grown root vegetables while having two-minute showers once a week, these are unlikely to be the next hot behaviour trends.

Researchers have uncovered three major value frames that are relevant in

environmental discussions. Biospheric values emphasize the perspectives and value of other species, ecosystems, and nature itself (e.g., save the polar bears,

save the rainforests, save the Earth!). Social-altruistic values emphasize the perspectives and consequences experienced by other people (e.g., climate change will substantially affect the poor, and will take away the rights and

freedoms of future generations; Stern & Dietz, 1994). However, a major problem that environmentally concerned people run into is that biospheric and social-

altruistic value frames are often not compatible with our egoistic values, which

focus on self-enhancement, personal success, material wealth, and

independence (Schultz & Zelezny, 2003; Schwartz, 1994). Unfortunately, because modern capitalism has so deeply wed material success with personal success and “happiness,” people often find that our individualistic strivings for success and happiness are often at odds with our concern for collective issues like the environment.

It’s possible that environmental messages would be more motivating if they were framed in egoistic terms. For example, messages concerning pro-environmental behaviours could emphasize financial savings (e.g., saving energy = saving money), personal empowerment (e.g., feel like you’re making a difference!), the importance of community (e.g. gardening will bring your community together), economic opportunities (e.g., renewable energy is the fastest-growing sector of the energy economy), and even fun and friendship (e.g., attending environmental protests is actually really fun—you meet the coolest people).

From a strategic point of view, appealing to your audience’s values generally enhances the impact of messages; however, as we’ll discuss at the end of this module, appealing to your audience’s existing values may, in some cases, be detrimental to your cause.

Preaching or Flip-Flopping? One-Sided vs. Two-

Sided Messages

One potential downside to taking a straightforward values approach is that you might sound “preachy.” People may feel like you are shoving your values onto them, and therefore reject your arguments. On the other hand, if you don’t make your own position clear and advocate clearly for your values, people may think you are a “flip flopper” who doesn’t stand for anything in particular, or they may just get confused while you describe all aspects of an argument, and stop paying attention.

In short, is it better to give a one-sided message, arguing for a specific position, or a two-sided appeal that acknowledges different perspectives? You might think

that the one-sided message is strongest, because it’s least likely to raise doubts

in the audience’s mind, but research suggests otherwise (O’Keefe, 1999). It is actually more persuasive if you acknowledge opposing arguments than if you just preach from your own soap-box, unless your audience is unlikely to ever hear information that counters your message.

By giving a two-sided message, you make it more likely that your audience will see you as trustworthy and honest. But you gain in another, sneakier way as well. By bringing up, and shooting down, opposing arguments, you help your

audience resist those arguments in the future. This is called attitude inoculation , a strategy for strengthening attitudes and making them more resistant to change by first exposing people to a weak counter-argument and then refuting that argument (Compton & Pfau, 2005; McGuire, 1961). This strategy operates in a similar way to how the flu shot protects you from the flu. When you get injected with a weakened version of the flu virus, your immune system has a chance to respond, building up the antibodies it will need when the real flu comes along. So, by exposing your audience to counter-arguments and then showing why those counter-arguments are not correct, you give your audience the necessary information they will need to resist those counter- arguments when they hear them later.

Emotions in the Central Route

Taking the central route has been the chief strategy of climate change communicators, and unfortunately, they’ve had a pretty tough go of it. The well- funded “climate change denial” movement has been able to spread enough misinformation through the media that many people have been left confused about what to believe. Negative emotions such as confusion are much more damaging than you might expect, influencing people to process information in a different way. Even very subtle manipulations of confusion can have this effect.

For example, research by Norbert Schwarz and his colleagues has shown that even the font or the colour of the text used in a message can change how skeptical people are of the information. If the font is a little bit more difficult to

read (e.g., font like this, compared to font like this), or if the text doesn’t contrast

as starkly from the background and thus is also more difficult to read, people

tend to be more skeptical of the message (Winkielman et al., 2002).

What seems to happen is that the person experiences a subtle amount of negative emotion, which biases their information processing in a negative manner. As a result, they pay more attention to weaknesses in the information and claims that they disagree with, the net result being that they are less easily

persuaded. Schwarz explains that processing fluency , which is the ease with which information is processed, biases the person’s processing of the information; thus, even insignificant aspects of a communication can, through triggering negative affect, influence the communication’s persuasive impact. Political strategists attempt to influence the public’s emotions for similar reasons

through the use of negative political advertising (attack ads; see Module 6.1 ).

Another key factor that can easily derail communication is the message’s complexity. If your arguments are overly technical, complex, or convoluted, or use specialized language, this can also activate negative emotion for people and bias them against your message. Also, people will simply lose interest in a message they don’t understand and stop paying attention. This is a big challenge for communicating about technical topics like climate change. Strangely, experts are often terrible at communicating their knowledge, tending to forget that their audience may not understand the technical language they use and the subtleties

of what they are saying. Chip and Dan Heath (2007) call this the “curse of knowledge.” Anybody who has ever listened to an expert being interviewed on the news has likely experienced this phenomenon. The expert may find the conversation fascinating and rife with meaning, but to the audience it may sound like a monotonous drone.

The curse of knowledge was shown in an innovative experiment (Newton, 1991) in which subjects were assigned to be “tappers” or “listeners.” The tappers were asked to tap the rhythm to a selection of extremely well-known songs, like “Happy Birthday,” while the listeners tried to guess the songs. To the tappers, the songs were totally obvious; when they tapped out “Happy Birthday,” they would hear the words and the tune in their heads and it seemed pretty likely that the listeners would be able to guess the song; in fact, they estimated that listeners

would guess about 50% of the songs. To the listeners, however, the vague “tap- tap-TAP-tap TAP TAP” didn’t amount to much; they guessed the correct songs a mere 2.5% of the time!

This study illustrates how people with knowledge tend to overestimate the amount of knowledge their audience will have. When you are communicating, remember to keep your audience’s perspective in mind and fight the urge to use impressively long words, acronyms, and technical lingo. Saying less, and saying it in less complex ways, is often saying more.

Module 13.3b Quiz:

Using the Central Route Effectively

Know . . . 1. A strategy for strengthening attitudes and making them more resistant to

change by first exposing people to a weak counter-argument and then

refuting that argument is known as . A. attitude inoculation B. social-altruistic processing C. analytic processing D. value framing

Understand . . . 2. One of the challenges that people have when trying to persuade other

people is that

A. social-altruistic values have a much larger effect on behaviour than other value frames.

B. social-altruistic and biospheric value frames are often inconsistent with egoistic value frames.

C. biospheric and egoistic value frames are often in conflict with social-altruistic value frames.

D. value frames have a very small effect on human behaviour.

Apply . . .

3. Which of the following statements about a (fictitious) anti- anxiety medication—Leafobarbital—should be most persuasive?

A. “Many individuals have found that Leafobarbital reduces their anxiety.”

B. “Think of how Leafobarbital could have changed your anxiety- filled high-school years.”

C. “Over 80% of people in a test group in Thailand found Leafobarbital to effectively reduce their anxiety.”

D. “Imagine what your life would be like if you were anxiety free. Leafobarbital will change the way you feel.”

Analyze . . . 4. Which is the best explanation for the identifiable victim effect?

A. Our experiential and analytic systems of processing information work together to produce a logical response.

B. The analytic system inhibits the experiential systems responses, thus providing a greater identification with the victim.

C. The analytic system responds to the logical content of the identifiable victim’s story.

D. The experiential system responds to the emotional content of the identifiable victim’s story.

Using the Peripheral Route Effectively

To be an effective communicator, you can’t ignore the peripheral route. Half a century of social psychology research has identified several powerful factors of influence. There are more than can be represented here, but we will discuss several of the most important ones. You may recognize many of these, because they have undoubtedly been used against you many times, from corporations trying to sell you products to people trying to get you to do them a favour.

Authority

The use of experts and authority figures to deliver a message can often enhance

the impact of the message (Cialdini, 2001). Even people who look like experts but have no real authority on a subject can be used effectively. For example, an extremely successful ad campaign in the 1970s for decaffeinated coffee used a man who had absolutely no expert knowledge of coffee or its health effects; however, as an actor, he played Marcus Welby, M.D., who was a very popular TV doctor at the time. Dressing the part is important as well; a man wearing a suit who jaywalks across a red light will be followed by 3.5 times as many people

as the same man wearing casual clothes (Lefkowitz et al., 1955).

Liking

We believe people we like. Communicators who connect with their audience get

their message across more effectively (Cialdini, 2001). Liking can be influenced by numerous factors, including attractiveness. For example, in a study performed for the American Heart Association, attractive fundraisers generated almost twice as many donations (42% versus 23%) as their less-attractive counterparts

(Reingen & Kernan, 1993). In the 1972 Canadian federal election, candidates who were rated as physically attractive got three times as many votes as

unattractive ones (Efrain & Patterson, 1974); in fact, politically unpopular parties had substantially less attractive candidates, which may have been a big part of their party’s lack of success at the polls! It is interesting to note that voters themselves insisted that their choices were not influenced by something as superficial as appearance. (In an interesting coincidence, the Prime Minister at that time was Pierre Elliott Trudeau—his son, Justin, has also received some attention for his appearance.)

Thus, there are good reasons to be pleasant and appealing, and to look your best, at least from a persuasion perspective. Highlighting any similarities you may share with your audience, loosening up a little and speaking informally, appropriate use of humour, and even complimenting the audience, can all enhance your likability and increase the effectiveness of your communication.

Social Validation

Because humans are such a social species, we use the behaviour of others as a guide to inform us of what we should do (e.g., conformity and social norms; Module 13.2 ). As an influence tactic, social validation can be incredibly powerful. Social validation is at work whenever you hear that a novel is a bestseller, a piece of music has topped the charts, there’s a long line-up outside a night-club, or “polls indicate” that a political candidate is popular.

One such example of social validation used in climate change communication

occurred in the spring of 2013 when Bill McKibben’s organization, 350.org, and several other organizations submitted a petition with one million signatures, urging President Obama to not allow the Keystone XL pipeline to transport oil from Canada’s oilsands to the United States. Afterward, the fact that a million signatures were gathered became a major part of their organization’s marketing messages. You can see how social validation becomes a major tool for communicators; obviously, proponents of the pipeline would want to downplay these facts, whereas opponents of the pipeline would want to highlight them.

Somewhat ironically, social validation is also often misused by communicators. For example, people may try to highlight the urgency of a behaviour change or

the seriousness of an issue by pointing out how few people are currently doing something desirable (such as wearing condoms during casual sex or reducing one’s carbon footprint), or how many people are currently doing something

undesirable (eating a high sugar diet or leaving the lights on all the time). Although the information may be true and the intentions are good, these communications can easily backfire. In one study, a suicide intervention program in New Jersey told people about the high rates of teenage suicides; as a result,

people who went through the program became more likely to think of suicide as a way out of their problems (Cialdini, 2001).

Reciprocity

You scratch my back, I’ll scratch yours. All cultures have a strong social norm that obligates people to repay to others what they have received. This strong social norm is used by influence specialists all the time, and it can be so sneaky we often don’t realize it. Just think of the “free samples” offered by vendors, the

“free trial workout” offered by health clubs, and even the “free personality assessments” offered by the Church of Scientology. Each makes you feel a debt or obligation. The principle of reciprocity is one reason why corporations donate to politicians’ campaigns, and why pharmaceutical companies spend millions of dollars funding research, organizing conferences, and providing gifts, stationery,

calendars, and even pens to doctors and family health clinics (Cialdini, 2001).

Reciprocity is often used in a two-step manner called the door-in-the-face technique , which involves asking for something relatively big, then following with a request for something relatively small. The logic is that once someone has scaled back their request, you are obligated to meet them part way. Professional negotiators will always start with a proposal they don’t really expect to get; but they know that once they “give up” some of the things they want, the opposing side is obligated to do the same. The door-in-the-face technique can be used to surprising effectiveness.

In one well-known study by Bob Cialdini (Cialdini et al., 1975), people were approached on the street and asked whether they would be willing to volunteer to chaperone inmates from a juvenile detention centre for a day trip to the zoo. When simply asked, 17% said yes. A second set of people were approached and submitted to a door-in-the-face manipulation; they were first asked if they would be willing to volunteer for two hours per week as a counsellor at the juvenile detention centre, and make a commitment for two years. Everybody said no. But when they were subsequently asked whether they would merely agree to volunteer to chaperone inmates from the detention centre on a trip to the zoo for the day, an astonishing 50% said yes. This one-two punch is very effective, both because it makes the person feel obligated to say yes after you have “backed

down,” and because the second request doesn’t seem as onerous when presented after the first, bigger request.

Consistency

One of the most powerful influence techniques, especially for long-term

behaviour change, is an old salesperson’s trick called the foot-in-the-door technique

, which involves making a simple request followed by a more substantial request. To the travelling salesmen of days gone by, literally getting one’s foot in the door meant that a homeowner could not shut you out. In social psychology, the idea is that once you get the person to agree to even a small

request, it’s harder for them to say no to a subsequent request (Burger, 1999; Cialdini, 2000).

The foot-in-the-door technique is also a sneaky strategy, because the initial request can be so small that virtually everyone would say yes to it; nevertheless, it’s powerful, because it makes use of a very strong motivation held by many people—the need for psychological consistency. We’ll describe this in more detail, but just think of how people usually react to being called a hypocrite and you’ll get a sense of the power of the need for consistency. So, the foot-in-the- door technique packs another powerful one-two punch—an initial request that’s hard to refuse locks you in, and then you get cornered into agreeing to a much

larger request (see Figure 13.8 ).

Figure 13.8 Two-Step Persuasion Techniques to Encourage Community Service The foot-in-the-door technique (top) starts with a small request and then moves

on to a larger request. The door-in-the-face technique (bottom) does the reverse. It begins with a highly demanding request and then appears to settle for a much smaller one.

For example, if you are at the beach and you want to go swimming, how can you be sure nobody is going to steal your stuff? Just ask someone to watch your things for you! Simple as that. Although this may seem intuitive, you may be surprised by just how powerful this simple request can be. In one experiment, an experimenter posed as a person sunbathing on the beach, who at one point got up and asked whoever was close them to watch his things; everybody said yes. Then he left, and shortly afterwards, as you might expect, a mock-thief came along and attempted to steal the experimenter’s radio. An astonishing 95% of the people who agreed to watch his things attempted to interfere with the would-be thief, even to the point of chasing the thief down the beach! But in the control condition, when no one was asked, only 20% of people tried to stop the thief

(Cialdini, 2001). Imagine that—an additional 75% of us will become heroic vigilantes just because some stranger casually asks us on a beach to watch his stuff.

Commitments can be extremely subtle, another reason they are sneaky. For example, one restaurant owner was able to reduce the rate of no-shows (people who reserve a table but then don’t show up) from 30% all the way down to 10% by changing two words in the script that his employees used when scheduling reservations over the phone. In the old script, the receptionist would say, “Please call if you have to change your plans.” In the revised script, she said “Would you please call if you have to change your plans?” Then she would wait for a couple

of seconds until the person responded and said yes (Cialdini, 2001). Saying “yes” is an active commitment, and that tiny act was enough to get two-thirds of the no-shows to call first and cancel. Other studies have shown that written commitments (“sign here . . .”) are even more effective than verbal commitments, and commitments that can be made public are the most effective of all.

Module 13.3c Quiz:

Using the Peripheral Route Effectively

Understand . . . 1. Harinder asked Doug to help him carry some boxes from his car into his

backyard. Once that small task was done, Harinder then asked Doug to help him assemble a shed that he had bought. This technique of making a simple request followed by a more substantial request is known as

. A. the door-in-the-face technique B. the foot-in-the-door technique C. social validation D. the nuisance effect

Apply . . . 2. Which attempt at persuasion would be least effective?

A. A bearded man in a leather jacket telling you which type of motorcycle you should buy

B. A well-dressed politician asking you to support her political party C. Someone asking you to be the first person to sign a petition about

an important social issue

D. Someone asking you to sign an online petition that had already been signed by over 100 000 Canadian students

3. Kendra wanted to go to Ottawa for the weekend with her friends, but was afraid that her parents would object. In order to persuade (or manipulate) them, she first asked them if she could travel to Amsterdam with her friends. Her parents said, “No.” The next day she asked if she could at least go to Ottawa. Her parents eventually agreed to this request. This is

an example of . A. the door-in-the-face technique B. the foot-in-the-door technique C. social validation D. the capital effect

The Attitude–Behaviour Feedback Loop

As we mentioned earlier, the reason the foot-in-the-door approach works so well is because people have a general need to be psychologically consistent—for their attitudes, beliefs, and behaviours to match up with each other. Much of the time, we maintain a feeling of consistency by letting our beliefs and attitudes guide our behaviours. We act in the way we think and feel is right. But, the relationship between our actions and beliefs is not always this straightforward.

Cognitive Dissonance

Groundbreaking work by Leon Festinger (1957) showed that we can also maintain a feeling of consistency by simply changing our beliefs to be consistent

with our behaviour. Festinger (1957) proposed cognitive dissonance theory , describing that when we hold inconsistent beliefs, this creates a kind of aversive inner tension, or “dissonance”; we are then motivated to reduce this tension in whatever way we can, often by simply changing the beliefs that created the dissonance in the first place.

This sort of belief change was observed in a dramatic way by Festinger and two of his colleagues when they infiltrated a doomsday cult in the 1950s. December 21, 1954, was the date the world was supposed to end, according to the cult’s leader, Marian Keech (not her real name). Keech told her followers that she was receiving messages from aliens who lived on the planet Clarion. The aliens had warned of an impending flood that would destroy life on Earth, but they promised to come in a spaceship and rescue Keech and her followers before the final cataclysm. If the members kept their faith, the aliens were supposed to contact them at midnight. The cult members were so convinced of impending doom that they gave away their possessions, quit their jobs, and prepared for the end.

Festinger and his colleagues, not being big believers in alien messages about the end of the world, wondered what would happen when the prophecy failed to come true. So, on December 20th, the cult members, including Festinger and his colleagues, gathered together and waited for the spaceship to arrive. Midnight

came . . . and went. A few minutes after midnight the group decided the clocks were fast and any minute now, the aliens would be contacting them. Then an hour passed. And another. The group waited all night, increasingly confused, wondering what was going on.

Finally, at 4:45 a.m., it was apparent the Clarions weren’t coming to whisk them away. Keech had been wrong. The cult members had made fools out of themselves and ruined their lives. You might think that they would slink back to their normal lives, beg for their jobs back, and try to recover from the embarrassment. But no, the opposite happened. Keech suddenly got another message from the Clarions! They told her that because her little group had been so faithful, waiting all night for them to come, God had decided not to destroy the Earth after all. They weren’t fools; they were heroes! Convinced that they had saved the world, Keech and most of her followers (some decided this was ridiculous and ditched them at this point) became even more evangelical, contacting newspapers and media outlets, spreading the good word that the

world had been saved (Festinger et al., 1956).

Festinger and Carlsmith (1959) tested cognitive dissonance theory by having subjects come to their lab and spend an hour engaged in a mind-numbing study that required them to perform menial, repetitive tasks. Afterward, the subjects were told that in a different condition of the study, a research assistant meets subjects beforehand and gives them positive expectations of the study, telling them that it’s a fun and interesting study. Unfortunately, the person called in sick that day, and so the subjects were asked if they would play the part of the research assistant for the next, incoming subject. All they had to do was sit in the waiting room, and when the next subject came in, chat with them and tell them the study was fun and interesting. Little did the unsuspecting partici ­pants know that this was what the real study was about, getting them to tell a “little white lie” and then seeing how it affected their attitudes.

The subjects were also offered one of two amounts of payment if they agreed to go along with the deception. Some subjects were paid $1, and others were paid $20. After agreeing to play along and deceiving the person in the waiting room, subjects then filled out a few measures of their perceptions of the study. Lo and

behold, after lying about the study, the subjects actually felt more positively toward it! But not all the subjects felt this way, only those who were paid $1. Why might this be?

The subjects who were paid $20 had more than enough justification for telling a little white lie—“I did it for the money.” But getting paid $1 seems hardly worth it; these subjects were left in a state of uncomfortable dissonance, caught between the beliefs “deceiving people is wrong” and “I just lied to somebody for a measly $1.” However, by changing their attitudes—“I didn’t really lie; this study was actually pretty interesting!”—subjects were able to resolve their dissonance and feel good again.

Cognitive dissonance theory can help to explain many puzzling phenomena of everyday life. For example, why would perfectly sane young people crawl through ice water in their underwear while others stood around shouting at them, throwing snowballs, and even spanking them? In the winter of 2013, exactly such an event happened at Ryerson University, when aspiring frosh leaders went through a “hazing ritual.” When it came to light, university administrators and even Ontario’s premier were shocked and appalled, although no official action was taken except to express disapproval.

Students at Dalhousie University, in the same year, were not so lucky; Dalhousie suspended its entire women’s hockey team in January, except for the rookies, who also lost their season as a result of not having a team to play with. The previous September, the team had held a party at which the rookies were subjected to hazing, and when it came to light, the university administration reacted based on a “zero tolerance” policy.

But why does hazing occur? People have traditionally believed that submitting new group members to rituals that are embarrassing, humiliating, even painful and dangerous helps to bond new members to the organization, deepening their commitment and their feelings of belonging. Cognitive dissonance theory suggests they are right. Being humiliated and embarrassed would be generally dissonant with the belief “I am a reasonable, self-respecting person.” But after you have just publicly degraded yourself, it’s not easy to feel that way. One way

to reduce the dissonance (or discomfort) and reconcile your belief about what you just did with your belief that you are a reasonable, self-respecting person is to change one of your beliefs a little bit. For example, if you suffered in order to join a really exclusive, super-cool, awesome group, then this makes sense; of

course you would suffer in order to join that group! And this is exactly what people seem to do; after initiation rituals, they enhance their perceptions that this is a group worth belonging to.

Interestingly, because cognitive dissonance is based on the need for self- consistency, it does not appear to work in quite the same way across cultures. In more collectivistic societies, for example, the need for self-consistency is not as strong, because it is more widely recognized that one’s “self” is more fluid, manifesting differently in different social situations. This is reflected in collectivists experiencing less dissonance after making choices. However, research conducted at the University of Waterloo has shown that people from collectivist cultures do experience dissonance after making difficult choices for

their friends (Hoshino-Browne et al., 2005). It appears that the need for self- consistency still exists; it’s just that the “self” is more interpersonal than personal.

Attitudes and Actions

If attitudes influence behaviours, and behaviours influence attitudes, then you can see that the two are connected to each other in a circular fashion, with each affecting the other in a self-reinforcing cycle. Because each process affects the other, what happens in these causal loops is that initially small changes can grow into very large changes over time. For example, an initially small behaviour change can feed back to strengthen the person’s attitude toward that behaviour, which leads to greater behaviour changes in the future.

Clearly, sometimes this works, as we saw earlier with the cognitive dissonance examples, the power of commitments, and the foot-in-the-door technique. With regard to climate change and the environmental movement, the hope for many decades has been that this foot-in-the-door approach would build increasingly pro-environmental attitudes in the general public in order to move society toward sustainability. By getting the public to adopt relatively easy behaviours, like

recycling or using compact fluorescent light bulbs, the hope has been that this would strengthen pro-environmental attitudes and spill over, or generalize, to other behaviours and greater support for environmental laws and policies. This

spillover effect has been the basic rationale for the general marketing approach to environmental behaviour change: appeal to whatever values people hold (e.g., the money they’ll save), and encourage the adoption of whatever behaviours seem most likely. For example, you may recall a TV commercial of recent years by the David Suzuki Foundation, in which a man was informed of how much beer money he would save if he got rid of his extra fridge in the basement. Unplugging your fridge today, protesting in the streets tomorrow!

Unfortunately for anybody hoping to use the foot-in-the-door technique to change society in major ways, the strategy seems most effective for encouraging the adoption of similar behaviours (e.g., signing a petition for a cause today will make it more likely that you’ll volunteer for that cause in the future), but it does not reliably spill over to a wider range of behaviours. Spillover is even less likely if there are clear, extrinsically motivating reasons for engaging in the behaviour, such as saving beer money. Just like Festinger’s subjects didn’t need to change their attitudes when they were paid $20 for lying, people whose primary reason for conserving energy is to save money are not likely to strengthen their pro- environmental attitudes more generally. After all, they just did it for the money.

Nevertheless, as we have reviewed, psychologists have provided many insights and tools for communicating more effectively to change people’s behaviour. Hopefully some of the readers of this book will use these tools to make the world

a better—and more environmentally sustainable—place. It’s up to you.

Module 13.3d Quiz:

The Attitude–Behaviour Feedback Loop

Understand . . . 1. Some of the participants in Festinger’s classic study of cognitive

dissonance were only paid $1 to lie to another group of participants. Members of this $1 group ended up viewing the boring experiment as

being more important and interesting than another group of participants who were paid $20 to lie. What is the explanation for this group difference?

A. The members of the $20 group were so happy about receiving that much money that they were unable to generate any emotional response about the experiment itself.

B. The people in the $20 group were already a bunch of liars, so they were unaffected by the study.

C. The members of the $20 group felt guilty about accepting so much money; this made them feel less positive toward the experiment than people who only received $1.

D. The members of the $1 group didn’t want to feel like they lied for only $1, so they altered their beliefs about the experiment so that their beliefs matched their actions.

Apply . . . 2. Athletes at many universities in North America undergo humiliating

hazing rituals when they join a team. How are these rituals related to cognitive dissonance?

A. The intense emotions associated with hazing tap into the experiential processing system and increase the athletes’ approval of the team.

B. Athletes who undergo hazing will increase their positive beliefs about the team in order to justify having suffered through the humiliating rituals.

C. Athletes who view the team more positively are more likely to be willing to undergo hazing rituals.

D. There is no relationship between hazing and cognitive dissonance.

Module 13.3 Summary

Know . . . the key terminology in research on attitudes, behaviour, and effective communication.

13.3a

analytic system

attitude inoculation

central route to persuasion

cognitive dissonance theory

construal-level theory

door-in-the-face technique

elaboration likelihood model (ELM)

experiential system

foot-in-the-door technique

identifiable victim effect

peripheral route to persuasion

processing fluency

When people hold cognitions that conflict with each other, such as when they are aware that they have behaved in a way that runs counter to their beliefs or attitudes, they experience an uncomfortable state of arousal known as cognitive dissonance. In order to reduce this dissonance, they need to change one of their conflicting cognitions, which often results in changing their attitudes in order to reflect the behaviour they just performed. In this way, behaviours and attitudes influence each other.

In order to design an effective message using the central route to persuasion, you must start with solid, convincing facts. Then personalize the message,

Understand . . . how behaviours influence attitudes in terms of cognitive dissonance theory.

13.3b

Apply . . . your understanding of the central route to describe how a message should be designed.

13.3c

making it self-relevant for your audience, such as by directly engaging them in a scenario you describe, by describing how the message is relevant to them personally, or by framing the message in terms of values that your audience members hold. Also, keep your message from being unnecessarily complex, so as to maintain the interest of your audience. If your audience is likely to hear opposing viewpoints, be sure to construct a two-sided message that includes those opposing arguments, and then provide solid reasons for why the opposing arguments are not valid. It also makes sense to use peripheral cues to further strengthen your message, such as appealing to authority, mentioning similarities between yourself and the audience, using humour appropriately, and relying predominantly on specific stories rather than on abstract data and statistics.

Climate change communicators face some key challenges. Traditionally, the environmental movement has framed its messages in ways that run counter to predominant North American values, making many people wary of environmental messages or at least likely to see them as not relevant to themselves. Furthermore, climate change is experienced as psychologically distant from the public, with consequences that people feel are generally going to be experienced by people in other parts of the world and by future generations. Climate change information is also highly technical and complex, and is abstract and statistical in nature, given that climate change is a global phenomenon that doesn’t easily boil down to specific stories about specific people. There is also inherent uncertainty in scientific research, which has made it difficult to express climate change information in a way that would seem “certain” to the public.

Analyze . . . the difficulties communicators face in trying to convince the public to take action on climate change.

13.3d

Chapter 14 Health, Stress, and Coping

14.1 Behaviour and Health Smoking 580

Working the Scientific Literacy Model: Media Exposure and Smoking 580

Module 14.1a Quiz 582

Obesity 582

Module 14.1b Quiz 586

Psychosocial Influences on Health 586

Module 14.1c Quiz 588

Module 14.1 Summary 588

14.2 Stress and Illness What Causes Stress? 591

Module 14.2a Quiz 593

Physiology of Stress 593

Working the Scientific Literacy Model: Hormones, Relationships, and Health 596

Module 14.2b Quiz 597

Stress, Immunity, and Illness 597

Module 14.2c Quiz 600

Module 14.2 Summary 601

14.3 Coping and Well-Being Coping 603

Module 14.3a Quiz 608

Perceived Control 609

Working the Scientific Literacy Model: Compensatory Control and Health 610

Module 14.3b Quiz 612

Module 14.3 Summary 612

Module 14.1 Behaviour and Health

Stock_wales/Alamy Stock Photo

Learning Objectives

Know . . . the key terminology related to health psychology. Understand . . . how genetic and environmental factors influence obesity. Apply . . . your knowledge of persuasion and health to examine the effectiveness of different types of cigarette warnings. Analyze . . . whether media depictions of smoking affect smoking in adolescents.

14.1a 14.1b 14.1c

14.1d

Should we have to pay more for unhealthy or nonessential food items that contribute to obesity and other expensive health conditions? In fact, taxes on these items are becoming increasingly common. In March 2015, the city of Berkeley, California instituted a “sugar tax” on sugary drinks such as colas in an effort to curb the increasing rates of diabetes and obesity. Sugary soft drinks contribute hundreds of calories to our daily diet without providing any nutrition, and do little to leave a person feeling full and satisfied. City officials assumed that taxing these beverages would reduce sugar intake and improve people’s health. Preliminary data suggest that they were correct. Residents surveyed after the tax went into effect reported consuming 21% fewer sugar-sweetened beverages and

26% less cola (Falbe et al., 2016). Based on this initial success, it should come as no surprise that similar taxes were included in political campaigns in a number of municipalities during the November 2016 U.S. election. It seems a foregone conclusion that these taxes will soon appear in Canada as well. On the one hand, these fees may sound like the government interfering with our individual freedom to eat and drink what we like. On the other hand, there is a parallel precedent for sugar tax plans—namely, the massive taxes on cigarettes that serve to discourage smoking and help cover the costs of treating smoking-related illnesses. Plans such as sugar taxes tell us that issues related to health and behaviour are becoming common topics of conversation in many areas of society.

Focus Questions

1. Which factors contribute to weight problems, and how much control over them can people expect to have?

2. To what extent is physical health based on psychological processes such as choice and decision?

To what degree do you believe your behaviour affects your health? Each day we

make choices that shape our physical and mental health. We decide what to eat and what to avoid eating, whether to exercise or to relax on the couch. Some people choose to light up a cigarette whenever the chance arises. Others make a point of avoiding places where people are likely to smoke. The choices people make about their career paths similarly influence their health. Workplace stress levels for air traffic controllers are quite different from those experienced by small-town librarians. The numerous and complex connections between

behaviour and health certainly have created an important niche for health psychologists. These researchers study both the positive and negative effects that humans’ behaviour and decisions have on their health, survival, and well- being.

The need for health psychologists has increased considerably over the last century, as most premature deaths today are attributable to lifestyle factors. In the early 1900s, people in Canada were likely to die from influenza, pneumonia, tuberculosis, measles, and other contagious diseases. Advances in medicine have served to keep these conditions under much better control. Instead, people are now much more likely to die from tobacco use, alcohol use, obesity, and inactivity. In fact, more than half of all deaths in Canada in 2009 were caused by heart disease, cancer, stroke, and diabetes. Although genetics plays a role in these diseases, they have also been linked to unhealthy behaviours such as a

poor diet and smoking (Statistics Canada, 2012a). Clearly, then, our physical and mental well-being are connected to the health decisions that we make.

Smoking

One of the most widely studied health behaviours is tobacco use. Smoking cigarettes causes life-shortening health problems including lung, mouth, and throat cancer; heart disease; and pulmonary diseases such as emphysema. Recent reports indicate that 21% of all deaths in Canada over the past decade

were due to smoking-related illnesses (Jones et al., 2010). The life expectancy of the average smoker is between 7 and 14 years shorter than that of a

nonsmoker (Centers for Disease Control and Prevention [CDC], 2002;

Streppel et al., 2007). This number depends upon how much, and for how long, a person smoked. Quitting by the age of 30 greatly reduces the likelihood that a person will die of smoking-related cancers, a statistic that is quite relevant to

university students (Statistics Canada, 2012b)! The costs in lives and money attributable to smoking are massive, as shown in Table 14.1 . Despite these starkly ominous figures, 19.9% of Canadian adults—22.3% of males and 17.5%

of females—smoke cigarettes (Statistics Canada, 2012b). In other words, 5.8 million Canadians perform a behaviour that is quite likely to harm or even kill them. It should come as no surprise that such a statistic would interest psychologists.

Table 14.1 Health Costs of Tobacco Use

Tobacco use causes an estimated 5 million deaths worldwide each year.

Cigarette smoking is the leading preventable cause of death in North America.

One in five Canadian deaths is due to cigarette smoking.

Close to 1000 Canadians die each year as a result of second-hand smoke.

Sources: Based on CDC, 2009b; Rehm et al., 2006; Statistics Canada, 2012b.

Working the Scientific Literacy Model Media Exposure and Smoking

If smoking is so dangerous, why do people do it? Why don’t they do something safer, like juggle scorpions? This is a perplexing question not only for psychologists, but also for many smokers. One reason may be the exposure young people have to other people who smoke: parents, friends, and even characters on television and in the movies.

What do we know about media influences on smoking? Each day approximately 250 adolescents in Canada try their first cigarette, and many will go on to become full-time smokers

(Health Canada, 2008). There are many possible reasons why adolescents try smoking, including whether family members smoke, whether smoking is common in their culture, personality characteristics, and socioeconomic status. Adolescents may also begin smoking because they associate it with particular traits such as attractiveness, rebelliousness, and individualism. One factor that has received an increasing amount of attention from psychologists and health-care providers is the role of the media. Specifically, does exposure to smoking in movies and entertainment lead teens to begin smoking? Actors in many popular television shows and movies smoke. Additionally, photographs in fashion and entertainment magazines show stars such as Johnny Depp and Kristen Stewart looking cool and smoking cigarettes. Indeed, smokers are often portrayed as sophisticated and self-assured, traits that many adolescents hope to possess. In contrast, very few movies and magazines show someone with emphysema or lung cancer.

How can science help us analyze the effects of smoking in the movies? To what extent do positive images of smoking in movies (and TV and magazines) contribute to adolescent smoking? This question has been addressed using a variety of methods. In one study, researchers conducted a random-digit-dialing survey of 6522 U.S. adolescents from all major geographic regions and

socioeconomic groups (Sargent, 2005). The adolescents reported their age and indicated whether they smoked, and were asked to identify whether they had seen specific popular movies that featured smoking. The more exposure the adolescents had to movies that featured smoking, the more likely they were to

have tried smoking. This relationship persisted even after the researchers controlled for important variables such as socioeconomic status, personality, and parental and peer

influences on smoking (Heatherton & Sargent, 2009).

The effect of smoking scenes on behaviour has also been tested in the laboratory. In one study, 100 cigarette smokers between the ages of 18 and 25 watched either a 10-minute video with smoking scenes or a video that did not reference smoking. In the break that followed the video presentation, participants who saw smoking scenes were significantly more likely to light up a

cigarette (Shmueli et al., 2010). This result is likely due to the fact that smoking cues such as images of smokers or of smoking paraphernalia (packages, lighters, etc.) elicit cravings in smokers

(Balter et al., 2015).

It appears that how people identify with smokers may also influence their decision to smoke. An experimental study showed that adolescents who had positive responses to a protagonist in a movie clip who smoked were much more likely to associate smoking with their own identities. This correlation was observed in both adolescents who already smoked and even those who did

not smoke (Dal Cin et al., 2007).

Can we critically evaluate this evidence? It is very difficult to establish that watching movie stars smoke cigarettes causes adolescents to take up smoking, even though the correlations might suggest that it does. When researchers tracked the amount of smoking featured in popular movies from 1990 to 2007, they found that as the incidence of smoking in movies rose, smoking among adolescents increased after a short period of time. Likewise, when smoking in movies decreased, a

decline in adolescent smoking followed (Heatherton & Sargent, 2009). However, the problem with these correlations is that multiple explanations could be put forth for why they exist.

Although the researchers would like to demonstrate that smoking in movies influences audience members, perhaps the truth is the other way around: People who are already willing to smoke might be more attracted to movies that feature smoking.

Why is this relevant? Smoking by young people raises serious concerns about the health and well-being of those individuals who start smoking at such an early age. In addition, cigarette-related illness imposes a major societal burden in terms of lost work productivity and rising health-care costs. As the research shows, cigarette smoking in movies is just one of many influences on smoking behaviour. Of course, it may be one influence that could be easier to control than, say, peer pressure. With scientific research in hand, advocacy groups such as Smoke Free Movies, the (U.S.) National Association of Attorneys General, and Physicians for a Smoke-Free Canada have a sound basis for arguing against smoking in movies—especially those that adolescents are likely to watch.

It appears that the work of these advocacy groups is paying off. After peaking in the middle of the last decade, the number of films

including smoking is on the decline (Polansky, 2016). However, as you can see in Figure 14.1 , this decline is not a steady one. For example, the number of “tobacco incidents” in PG-13 movies specifically targeted to teens increased from 565 in 2010 to 1155 in 2012; therefore, the curtain hasn’t fallen on this issue.

Figure 14.1 Number of Smoking Images in Popular Movies from 2002 to 2015

This graph depicts the number times tobacco appears in movies from 2002 to 2015. Note that although the overall trend is downward, there are some years in which tobacco incidents are quite prevalent, even in youth-rated movies. Source: 2015 Numbers: After rebound, film smoking falls to near-lows, Centre for Tobacco Control

Research and Education, 2015. Copyright © 2015 by Center for Tobacco Control Research and

Education. Used by permission.

Efforts to Prevent Smoking

Given the health problems (to the smokers and to the people around them) and enormous healthcare costs associated with smoking, both healthcare workers and government officials recognize that more work has to be done to reduce smoking levels. Provincial and municipal laws are reducing the risks posed by second-hand smoke exposure by banning smoking in many public places— especially restaurants and public buildings. As mentioned at the beginning of the module, steep taxes applied to unhealthy products such as tobacco also act as a deterrent against their use. Not only does such a policy tend to reduce the number of smokers, but it also raises funds for healthcare and anti-smoking campaigns.

In the 1990s, several countries added written warnings to cigarette packages (e.g., “Smoking seriously harms you and others around you”) in an attempt to reduce smoking rates. Unfortunately, these labels have had relatively little effect. However, in 2001, Canada became the first country to require companies to include graphic pictorial warnings on cigarette packages. These images included rotting teeth, black lungs, diseased hearts, and sick children; they were also paired with a verbal message. Researchers found that the image-based warnings were much more likely to be noticed by both smokers and non-smokers

than were text-only messages (Fong et al., 2009; Hammond et al., 2003). They were also more useful than text-only messages in educating people about the

risks associated with smoking (Environics Research Group, 2007; Li & Yong, 2009).

Image-based warnings on cigarette packages are now used in over 30 countries

(Hammond, 2011). Numerous studies have shown that these warnings are quite memorable and are having the desired effect. Over 40% of Canadian smokers

indicated that the graphic warnings motivated them to quit (Hammond et al., 2007). And, although it is impossible to accurately state how many people avoided smoking because of the ads, surveys of Canadian adolescents suggest that these warning labels do discourage teens from taking up smoking

(Environics Research Group, 2007). These smoking-prevention programs are therefore a wonderful example of psychologists and government officials working together to improve people’s health.

A new challenge that health officials must face is the issue of e-cigarettes or “vaping.” Vaping is not quite as harmful as traditional smoking, but is still not a healthy habit. Although it is technically illegal to advertise e-cigarettes in Canada, the enforcement of these laws has not been as stringent as for regular

cigarettes. In the U.S., advertising of these products is allowed. A recent study found that most of the exposure that adolescents had to e-cigarettes occurred on

cable television networks (Duke et al., 2014). It remains to be seen whether this form of smoking will lead to an increase in adolescent smoking rates.

Despite this potential challenge, there is some good news related to smoking

rates. The prevalence of smoking in Canada declined steadily over the 1990s

and early 2000s (Statistics Canada, 2012b); in 2001, 28.1% of men and 23.8% of women smoked, 5.8% and 6.3% higher than the current rates. The decrease is even more dramatic among young adults. In 2001, 33.2% of Canadians aged 18–19 smoked; in 2011, this number dropped to 19.8%. These data tell us that anti-smoking efforts are working—but that there is still work to be done.

Module 14.1a Quiz:

Smoking

Know . . . 1. What does a health psychologist study?

A. The positive impacts that our behaviour has on our health B. The negative impacts that our behaviour has on our health C. The chance that we will survive based on our decisions D. Both the positive and the negative impacts that our behaviour and

decisions have on our health and survival

2. In modern times, the leading causes of death in industrialized nations such as Canada are .

A. viral infections B. bacterial infections C. lifestyle factors D. an equal combination of the above factors

Analyze . . . 3. Which of the following statements is the best evidence that viewing

smoking in movies plays a causal (rather than correlational) role in influencing people’s perception of smoking and willingness to try smoking?

A. Long-term trends show that increased or decreased incidence of smoking by adolescents follows increases or decreases in rates of smoking in movies.

B. The more adolescents smoke, the more smoking occurs in

movies.

C. Advertisements for smoking occur more frequently when smoking rates decrease.

D. Adolescent smoking occurs at roughly the same rate regardless of how smoking is depicted in films.

Obesity

Most college and university students are familiar with the term “freshman 15”— the supposed number of pounds students can expect to gain during their first year of school (15 pounds equals 6.8 kg). This term has stuck because weight gain during the first year of university (at least in North America) has become common, if not expected. It is unclear exactly how the term originated, and research has shown that the 15-pound estimate is actually inflated. In reality, male and female students who gain weight during their early university career

put on an average of 6 pounds, or 2.7 kg (Gropper et al., 2009).

What accounts for this phenomenon? Several factors that are probably all too familiar to many readers: increased food intake, decreased physical activity, and, for many students, increased levels of alcohol consumption. The lifestyle changes that students face during university affect physical health. In addition, university in general (and the first year in particular) presents new challenges that bring on a great deal of both positive and negative stress, especially if students move away from home. The freshman 15 (or 6) and other health-related issues are based on lifestyle decisions we make. Six pounds (2.7 kg) is not a lot of weight—but habits formed during any period of time, freshman year or otherwise, can be difficult to break. In this section, we will examine factors that lead us to put on weight as well as ways to use our knowledge of psychology to help us lose it.

Defining Healthy Weights and Obesity

It is important to define your terms when discussing a concept. Doing so ensures

that all researchers are talking about the same thing when they use terms like

overweight or obese. When discussing weight, psychologists and healthcare workers must also factor in a person’s height; being 200 pounds (91 kg) is healthy for someone who is 6’4” (193 cm), but would be quite unhealthy for someone who is 5’2” (157 cm). To account for height differences, people use the body mass index (BMI) , a statistic commonly used for estimating a healthy body weight given an individual’s height. The BMI is calculated by dividing the person’s weight (kg) by the square of the person’s height (in metres). So, if a

person were 180 cm tall and weighed 100 kg, their BMI would be 100 / 1.8 ; the outcome of this equation, 30.9, would be found on a table of BMI scores. In everyday usage, the BMI is used to screen people for weight categories that indicate whether they are considered normal weight, underweight, overweight, or obese. Someone in the healthy weight range would have a BMI between 18.5 and 24.9. People with a BMI that is less than 18.5 are considered to be

underweight and may be at risk of having an eating disorder (see Module 11.1 ). A BMI of 25–29.9 is considered overweight, and a BMI over 30 is considered obese.

Obesity is becoming a growing concern across Canada. It is associated with numerous detrimental health consequences, such as cardiovascular disease, diabetes, osteoarthritis (degeneration of bone and cartilage material), and some

forms of cancer. According to Statistics Canada (2011), 24% of Canadian adults are obese, with almost identical percentages for males and females,

although these rates differ across provinces (see Figure 14.2 ). Although this number is significantly lower than the 34.4% obesity rate in the U.S. (Shields et al., 2011), we cannot afford to become arrogant. With a quarter of our population being obese and another quarter reporting a body-mass index that is overweight, it is clear that body weight is a major health issue in our society. Even more alarming is that obesity rates are on the rise. When examining obesity rates from the mid-1970s until 2004, researchers found that these rates remained constant until the mid-1990s, at which point they spiked upward to the current levels

(Shields & Tjepkema, 2006). This report also noted that Canadians— particularly males—are becoming obese earlier in life, which means that weight- related health problems could occur at an earlier age than they have for previous generations. In fact, some researchers are concerned that these health problems

2

could lead to shorter life expectancies than were enjoyed by previous

generations (Olshansky et al., 2005).

Figure 14.2 Obesity Rates in Canada The rates of obesity differ from province to province. More information about

Canadian obesity rates is available in the 2011–2012 Canadian Community Health Survey. Source: Based on data from Navaneelan, T., & Janz, T. (2014). Adjusting the scales: Obesity in the Canadian population

after correcting for respondent bias. Health at a Glance. Statistics Canada Catalogue no. 82-624-X. Retrieved from

http://www.statcan.gc.ca/pub/82-624-x/2014001/article/11922-eng.htm.

Given that obesity is common and has a number of negative health consequences, researchers are actively trying to understand its causes. As

discussed in Module 11.1 , weight is gained because of a positive energy balance, meaning that too many calories come in and not enough are expended.

Obviously, overeating can lead to obesity. But, several other factors are involved as well, including genetic, lifestyle, and social variables.

Genetics and Body Weight

Twin, family, and adoption studies all suggest that genes account for between

50% and 90% of the variation in body weight (Maes et al., 1997). Genetic factors influence body type, metabolism, and other physiological processes that contribute to body weight and size.

Some researchers have suggested that genes contribute to the development of a set point , a hypothesized mechanism that serves to maintain body weight around a physiologically programmed level. The set point is not an exact number of pounds or kilograms, but rather a relatively small range encompassing 10% to

20% of one’s weight (Garrow & Stalley, 1975; Harris, 1990). Your initial set point is controlled by genetic mechanisms, but your actual weight can be modified by environmental factors—namely, what and how much you eat. According to set point theory, if an individual gains 10% of his body weight (e.g., increasing from 150 to 165 pounds, or 68 to 75 kg) his set point would make a corresponding shift upward—the body acts as though its normal weight is now the larger 165 pounds. Metabolism slows correspondingly, such that this person now requires additional energy expenditure to take the weight off. This process explains why people who gain extra weight may shed a few pounds with relative ease, but find it overwhelmingly difficult to continue losing or even maintaining their weight once they reach an initial goal. Their bodies naturally pull their weight back to the set point.

Set point theory has a long tradition in the field of nutrition, but its validity is challenged by research suggesting that weight gain and difficulty with weight loss are unrelated to a physiological set point. Rather, individual differences in physical activity may be a stronger determinant of who succeeds at losing weight and keeping it off. Specifically, people who gain weight expend less energy in

their normal day-to-day activities (Weinsier et al., 2002). Thus, the difficulty with losing the weight may be related to lower activity levels, rather than to an increase or decrease in a person’s set point.

The Sedentary Lifestyle

How do you spend your time when you’re not at school or at work? Do you watch television? Or do you work out, or curl up with a good book? Research shows us that how you spend your time can have a large effect on your waistline.

Although there are number of activities that could increase the likelihood of someone being obese, data from the 2007 Canadian Community Health Survey

(CCHS) suggest that television is the biggest culprit (see Figure 14.3 ). This survey showed that as the number of hours of television viewing increased, so did obesity rates. Only 13.7% of men who watch five or fewer hours of television per week were obese; compare this to the 25.0% obesity rate for men who watched 21 or more hours of television. Similar patterns were observed for females.

Figure 14.3 Obesity Rates and Television Viewing in Canadian Adults Aged 20–64 For both males and females, obesity rates were positively correlated with the number of hours spent watching television each week.

In contrast, the number of hours spent in front of a computer did not affect obesity rates, at least in males; females who spent more than 11 hours/week in

front of a computer had a slightly higher rate of obesity than those who spent little time using a computer (18.2% vs. 15.3%, respectively). Why was there a strong relationship between television viewing and obesity and a weak relationship between computer use and obesity? Both involve sitting in front of glowing rectangles. One possibility is that computer use—be it video games, social media like Instagram or Twitter, or even typing up an essay for history class—involves a greater degree of engagement than sitting on the couch and passively watching television. It is therefore more likely that people will snack while watching television.

Studies of children’s obesity rates are less ambiguous. In addition to the strong relationship between television viewing and weight, researchers also have found that the amount of time that children spend playing video games is positively

correlated with levels of obesity (Stettler et al., 2004). Although some video game systems such as the Wii involve physical activity, these options claim only a small portion of the overall market. Instead, many games involve sitting in front of a computer or television screen rather than engaging in exercise; this sedentary lifestyle can lead to poor dietary and exercise habits (which may continue into adulthood), and helps to explain the high childhood obesity rates found in many industrialized countries, including Canada.

Social Factors

In addition to genetics and activity levels, obesity rates are also affected by social factors, including influences from one’s family. Similarities in body weight among family members are naturally influenced by what and how much they are eating. What children eat is largely based on what their parents provide and allow them to eat, and eating patterns developed in childhood are generally carried into adulthood.

Sociocultural influences on eating certainly extend beyond the family. Food advertisements trigger eating—after watching a commercial for buttery microwave popcorn, you may have found yourself rummaging around in the

kitchen in search of that last bag you hope is still there. Researchers have found that children who see food commercials while watching a 30-minute cartoon program consume 45% more snack food than do children who view nonfood commercials. The researchers estimated that this difference could lead to an

additional 10 pounds (4.5 kg) of extra weight gained each year (Harris et al., 2009). Of course, corporations selling unhealthy food are aware of the power of advertising and use clever marketing techniques to promote unhealthy foods, often targeting children by linking their food with positive emotions (and toys). Luckily, in some regions of North America, lawmakers are attempting to prevent the corporations from directly targeting children by limiting when commercials can air (e.g., not during Saturday morning cartoons) and preventing them from including toys in kids’ meals. The hope is that these restrictions will reduce unhealthy eating behaviours in children, thus helping them avoid the dangers of obesity.

Psychology and Weight Loss

Given that obesity is quite common and needs to be dealt with, how can people use psychological research to help them lose weight? The first step is to think critically about the weight-loss options that are out there. Some advertisements tell people that they can lose weight without exercising, just by taking a pill. Such options are often gimmicks. Instead, we need to find a way to effectively motivate people to change their behaviours (i.e., to eat healthy foods and exercise). A study from the University of Waterloo suggests that thinking positively about oneself can promote healthy weight loss. In the first part of the study, participants wrote about either self-defining values that made them feel positively about themselves (e.g., friendships, religious beliefs, relationships) or about other values. At a follow-up session two-and-a-half months later, the self-defined value group weighed less, had lower body-mass indices, and had smaller waistlines

(Logel & Cohen, 2012). It is likely that the positive emotion manipulation reduced the participants’ stress regarding dieting. Given that stress leads to an

increase in the number of calories consumed (see Module 11.1 ), reducing stress could lead to a reduction in the amount of food consumed.

Biopsychosocial Perspectives Ethnicity,

Economics, and Obesity Genetics, social influences, and lifestyle factors all play roles in obesity. But what about broader influences, such as socioeconomic status and ethnicity? To address this question, start by classifying the following statements about obesity as either true or false:

1. In Canada, obesity rates are unrelated to ethnicity. 2. Obesity has no effect on a person’s wages. 3. Obesity is related to socioeconomic factors in Canadian adults. 4. Obesity can have a negative, long-term impact on the brain.

Nutritious, nonprocessed foods tend to be more expensive, which may have led you to predict that obesity would be more prevalent in people in lower socioeconomic brackets (e.g., low income or poverty). Also, diet seems to be influenced by sociocultural factors, including the types of foods people grow up eating. What do the data say about these issues?

1. False. Statistics Canada reports that First Nations people who did not live on reserves, Métis, and Inuit people have, on average, a

greater prevalence of obesity than other Canadians (Statistics Canada, 2013a).

2. False. Research on employment statistics indicates that workers who are overweight or obese are paid less than thin colleagues with similar qualifications—a finding that has led economists to suggest that the disparity in wage earnings is about equal to the size of the difference in medical costs incurred by thin versus

overweight and obese people (Bhattacharya & Bundorf, 2005). 3. True. Data from the 2011–2012 Canadian Community Health

Survey show that obesity is more common in people with lower income levels, both for males and females. One factor (of many) influencing this effect is the availability of healthy food options. Fast-food outlets are more numerous in low-income

neighbourhoods than in richer areas (Hemphill et al., 2008).

4. True. Obesity can have a negative, long-term impact on the brain. Researchers have found that people who are obese have, on average, 8% less brain tissue than people who are lean. The average brain of an individual with obesity in his 70s looks approximately 16 years older than a lean person of the same age

(Raji et al., 2010).

Of course, losing weight is only half the battle; we also have to maintain that weight loss. There are a number of challenges involved with this. First, obese

individuals pay more attention to food cues (Polivy et al., 2008) and find them more rewarding than non-obese people (Stice et al., 2008). Additionally, the drive to eat and the perceived value of food increase as more time passes since

the last meal (Raynor & Epstein, 2003); this makes it difficult to remove snacks from one’s routine. Several studies have shown that girls and adolescents who

attempt to diet are heavier later in life (Field et al., 2003; Stice et al., 2005). The restraint involved in dieting—especially avoiding certain highly reinforcing foods —may actually make the foods even more reinforcing in the long run. All of these factors help explain why obesity is such a difficult condition to overcome—it’s not simply a matter of losing a few pounds.

Module 14.1b Quiz:

Obesity

Know . . . 1. is a hypothesized mechanism that serves to maintain body weight

around a physiologically programmed level.

A. BMI B. A set point C. Obesity D. A sedentary lifestyle

2. In Canada, researchers have found that obesity rates are related to ethnicity in what way?

A. Obesity rates are not related to ethnicity. B. Caucasian adults have a greater prevalence of obesity. C. First Nations adults have a greater prevalence of obesity. D. Asian adults have a greater prevalence of obesity.

Understand. . . . 3. Which of the following factors is not related to a person’s weight?

A. Exposure to food advertisements B. Sedentary lifestyle C. Ethnicity D. All of the above are related to weight.

Apply. . . . 4. To avoid gaining weight during the first year of university, a person

should do all of the following except A. increase physical activity. B. decrease caloric intake. C. be aware of the new stressors the individual will face. D. increase alcohol intake.

Psychosocial Influences on Health

The environments where we work, live, and play and the people with whom we interact influence both our physical and mental health. This fact seems fairly obvious, but its importance is sometimes overlooked. Think about the different neighbourhoods in your city. Some are wealthy; others are economically disadvantaged. Some are safe; others have higher crime rates. Consider the experiences that kids would have growing up in each of these neighbourhoods. How would their lives differ? And, how would these experiences affect their well- being?

Poverty and Discrimination

Health and wealth increase together, and it appears that socioeconomic factors have numerous positive and negative effects. People who live in affluent communities not only enjoy better access to healthcare, but also have a greater sense of control over their environments and have the resources needed to maintain a lifestyle of their choosing. Individuals who lack this sense of control live in circumstances that can compromise their health. People who experience poverty, discrimination, and other social stressors have higher incidences of

depression, anxiety, and other mental health problems (Tracy et al., 2008).

Furthermore, health problems are magnified by stress. Heart disease is prevalent in socioeconomically disadvantaged populations, and children who experience adverse socioeconomic circumstances (e.g., less than 12 years of education or living in a low-income household) are at greater risk for developing

heart disease in adulthood (Fiscella et al., 2009; Galobardes et al., 2006). This relationship likely reflects the compound effects of stress, as well as the poorer diet that is often found among individuals residing in communities of low socioeconomic status.

People who are of low socioeconomic status are at increased risk for poor health. Numerous factors, including limited access to healthcare, stress, poor nutrition, and discrimination, collectively place children growing up in these communities at greater risk for developing health problems. Importantly, this

photo is not from a poor developing nation. It is from one of the richest nations in

the world: Canada. Bernard Weil/Toronto Star/Getty Images

Discrimination is another stressor that can compromise both physical and mental health. This kind of stressor is particularly problematic because it is often uncontrollable and unpredictable. Being a target of prejudice and discrimination is linked to increased blood pressure, heart rate, and secretions of stress hormones, which when experienced over long periods of time compromise physical health. For example, when people perceive that they are the targets of racism, their blood pressure remains elevated throughout the day and it recovers

poorly during sleep (Brondolo et al., 2008a, 2008b; Steffen et al., 2003). Discrimination also puts people at greater risk for engaging in unhealthy

behaviours such as smoking and substance abuse (Bennett et al., 2005; Landrine & Klonoff, 1996). Finally, discrimination, or even the perception of discrimination, can put the body on sustained alert against threats. The stress response that this state elicits can have negative, long-term effects on physical

health, as you will read in Module 14.2 .

Family and Social Environment

Our close, interpersonal relationships have a major impact on health and life

satisfaction (Elgar et al., 2011). In fact, chronic social isolation is as great a mortality risk as smoking, obesity, and high blood pressure (Cacioppo & Cacioppo, 2014). Social resilience , the ability to keep positive relationships and to endure and recover from social isolation and life stressors, can protect individuals from negative health consequences of loneliness and social isolation

(Cacioppo et al., 2011).

Marriage is typically the primary social relationship that people establish and has been shown to have long-term health benefits. Married people tend to live longer and have better mental and physical health than do nonmarried adults. Married couples enjoy the benefits of social support and combined resources, and they tend to have better health habits.

This is good news for married couples, but are both members of a heterosexual marriage benefiting equally from their union? It turns out that men enjoy greater health benefits from marriage. Unmarried women are 50% more likely to die from heart disease, several forms of cancer, cirrhosis of the liver, and other preventable diseases than are married women; this effect of marriage is even higher in men, with unmarried men being 250% more likely to die from these

causes (Berkman & Breslow, 1983; Ross et al., 1990). Several possible reasons for this disparity in the health benefits gained from marriage have been suggested. One likely contributor is the greater role that women take in recognizing and supporting healthy behaviours in others.

It should be noted that heterosexual marriages are not the only form of relationship. Currently, there are relatively little data about the health benefits of homosexual marriages. The studies that do exist indicate that legally recognized marriages (like we have in Canada) provide the same benefits as are found for

heterosexual couples (Riggle et al., 2010; Wight et al., 2013). As more countries and U.S. states legalize these marriages, it will be possible to investigate whether both partners benefit equally or if, like heterosexual marriages, one partner appears to gain more health benefits than the other.

Of course, marriage can also be a considerable source of stress. Marital problems are among the most stressful experiences that people can have. Married couples who are experiencing ongoing problems with their relationship tend to experience more depression and greater incidences of physical illness

than happily married couples (Kiecolt-Glaser & Newton, 2001). Marital problems and divorce also affect the emotional and physical health of children, particularly if they are younger during problematic periods of a marriage or during the parents’ actual divorce. Adolescents of divorced parents are at a slightly

higher risk of engaging in delinquent behaviours (Amato, 2001). While divorce can negatively affect the health of children, parents who continue engaging in high-quality parenting during marital discord protect children from many of the

negative effects on health attributable to divorce (Hetherington et al., 1998).

Social Contagion

Families are not the only interpersonal influence on how we think and act. The social group(s) that we belong to can also have a large effect on our health- related behaviours. Social scientists have found that unhealthy behaviours such as smoking or having a poor diet spread throughout one’s social group. You have likely observed this phenomenon in action—if one or two people in a group of friends start to eat a lot of junk food, it is easy for the others in the group to pick up this habit as well. These changes can work in either direction, positive or negative. Just as social-group influence can lead to smoking, it can also lead to training for a half-marathon.

Social contagion in the dorms. Your roommate may influence your GPA more than you know—for better or for worse. At Dartmouth College in the U.S., students are randomly assigned to their dorm rooms rather than matched on various characteristics, as is customary at many schools. This practice makes

Dartmouth’s roommate pairs a diverse mixture. Professor Bruce Sacerdote (2001) found that GPA levels are influenced by one’s roommate. Students with high GPAs elevate the GPAs of their lower-scoring roommates, and vice versa. James Woodson/DigitalVision/Getty Images

These phenomena are examples of social contagion , the often subtle, unintentional spreading of a behaviour as a result of social interactions. Social contagion of body weight, smoking, and other health-related behaviours has

been documented in the Framingham Heart Study. The U.S. National Heart Institute began this ongoing study in 1948 to track 15 000 residents of Framingham, Massachusetts. Participants made regular visits to their doctors, who recorded important health statistics such as heart rate, body weight, and other standard physical measures. Scientists working with the Framingham data noticed that over time, clusters of people from this study group became increasingly similar in certain characteristics—such as body weight increases or decreases, starting or quitting smoking, and even levels of happiness

(Christakis & Fowler, 2007, 2008; Fowler & Christakis, 2008). It turns out that the groups who showed similar patterns in their health statistics were also friends with one another. This work demonstrates just how powerful social factors can be. Of course, this research doesn’t only mean that you should be wary of your friends and their unhealthy behaviours. It also shows that through social contagion, you can be a positive force in the lives of the people around you.

Module 14.1c Quiz:

Psychosocial Influences on Health

Know . . . 1. Which psychological term refers to the often subtle, unintentional

spreading of a behaviour as a result of social interactions?

A. Health psychology B. Social contagion C. Discrimination D. Observational learning

2. Based on the research discussed in this module, which of the following is the lowest risk factor for health problems?

A. Being an unmarried adult B. Experiencing discrimination C. Having an identical twin who is overweight D. Being a married adult

Understand. . . .

3. Which of the following statements about how discrimination influences health is most accurate?

A. Experiencing discrimination stimulates the stress response, which can bring about long-term health problems.

B. People who experience discrimination are likely to compensate for it by making positive health-related choices.

C. An immediate increase in heart rate is the biggest problem associated with experiencing discrimination.

D. Discrimination is unrelated to poor health.

Module 14.1 Summary

body mass index (BMI)

set point

social contagion

social resilience

Some research suggests that genetics influences our set point, a weight (or range of weights) that our body tends to maintain; however, weight is influenced by several other factors as well. Environmental influences on weight gain are abundant. Cultural, family, and socioeconomic factors influence activity levels and diet, even in very subtle ways, such as through social contagion.

14.1a Know . . . the key terminology related to health psychology.

14.1b Understand . . . how genetic and environmental factors influence obesity.

Health Canada

In this module, you read about efforts by different countries to reduce smoking rates. In Canada, cigarette packages contain different types of emotional images depicting the dangers of smoking. But, the audience for these packages is

diverse—some people viewing the images are life-long smokers who should quit whereas others are teenagers who are considering smoking.

Apply Activity Consider the images shown here. Which images target young people and which images target long-time smokers? What differences do you see between the two types of images? What types of imagery do you think would be most effective in

14.1c Apply . . . your knowledge of persuasion and health to examine the effectiveness of different types of cigarette warnings.

influencing the behaviour of the two groups?

Now try using a search engine like Google Images to look at cigarette packages from different countries. How does the packaging differ from Canadian cigarette packages? Why do you think these cultural differences exist?

Correlational trends certainly show that smoking in popular movies is positively correlated with smoking among adolescents (e.g., increased exposure is related to increased incidence of smoking). Controlled laboratory studies suggest a cause-and-effect relationship exists between identification with story protagonists who smoke and smoking behaviour by young viewers.

14.1d Analyze . . . whether media depictions of smoking affect smoking in adolescents.

Module 14.2 Stress and Illness

Imagesource/Glow Images

Learning Objectives

The frustration and embarrassment of choking under pressure is undeniable. Whether the stakes are a championship title or admission to

Know . . . the key terminology associated with stress and illness. Understand . . . the physiological reactions that occur under stress. Understand . . . how the immune system is connected to stress responses. Apply . . . a measure of stressful events to your own experiences. Analyze . . . the claim that ulcers are caused by stress.

14.2a 14.2b 14.2c

14.2d 14.2e

an elite university, a sudden, inexplicable shift to subpar performance can be devastating. According to psychologist Sian Beilock, the culprit in such a case may be the negative effects that stress has on working memory— the short-term capacity to hold and manipulate information. Calculating a 15% tip for a bill of $43.84 at a restaurant, or while the pizza delivery person waits, requires working memory processes. The pressure of your date watching you or the pizza delivery person looking on impatiently may result in your appearing either foolishly generous or just plain cheap.

Beilock has conducted experiments on how stress affects the cognitive resources needed for problem solving. For example, in one study, research volunteers were asked to solve math problems. Some were told that if they solved the problems correctly, they would earn money for themselves as well as for a partner they were paired with; if they did not perform well, both the volunteer and the partner would lose money. Beilock and her colleagues have found that this type of pressure draws resources away from the working memory processes needed for success

(Beilock, 2008, 2010). Stressful thoughts readily occupy working memory space and cause the unfortunate experience of choking under pressure. The fact that the physiological response of stress can be caused by a social situation and can then affect a cognitive ability like working memory demonstrates, once again, the importance of the biopsychosocial model in understanding human behaviour.

Focus Questions

1. How does stress affect the brain and body? 2. How do individuals differ in how they handle stress?

Imagine a student near the end of the semester with several papers due and final exams looming. Now imagine someone who has worked at the same job for 25 years being told that he needs to learn a new computer system or he will be laid off. Or, think about a soccer player in a championship game that will be

decided by penalty kicks; she walks up to place the ball on the penalty spot, knowing that if she misses her team will lose. If you were asked to find one word that connected all of these scenarios, what word would that be? For most

people, that word would be stress. Stress is a psychological and physiological reaction that occurs when perceived demands exceed existing resources to meet those demands. Stress refers to both events (stressors) and experiences in response to these events (the stress response). Stressors can take a wide variety of forms, such as acute events (giving a speech, experiencing an assault, getting in a car accident) and chronic events (illness, marital problems, job-related challenges); the effects these stressors have on performance can be positive or negative.

What Causes Stress?

Have you noticed how some people seem overwhelmed by stressful events while others seem calm and focused? These differences are not a figment of your imagination—people do differ in their responses to stress. To attempt to explain why and how people differ, psychologists Richard Lazarus and Susan

Folkman developed a cognitive appraisal theory of stress (Lazarus & Folkman, 1984). Here, the term appraisal refers to the cognitive act of assessing and evaluating the potential threat and demands of an event. These appraisals occur in two steps (see Figure 14.4 ). First, the individual perceives a potential threat and begins the primary appraisal by asking herself, “Is this a threat?” Threats can be physical (e.g., someone trying to harm you) or psychosocial (e.g., trying to study for two exams on the same day or trying to deal with interpersonal conflicts). If the answer is no, then she will not experience any stress. But, if the answer is yes, she will experience a physiological stress reaction (perhaps a racing heart beat and sweaty palms) as well as an emotional reaction (perhaps

anxiety and fear). As these events unfold, the secondary appraisal begins—she must determine how to cope with the threat. During the secondary appraisal, she may determine that she knows how to cope with the stressor (e.g., studying for the exams over the course of several days); in this case, she will not feel much stress. However, if she believes that the stressor goes beyond her ability to

cope, the physiological and emotional reactions to the stress will continue.

Figure 14.4 The Cognitive Appraisal Theory of Stress The cognitive appraisal theory of stress involves two steps: (1) an evaluation of whether a stimulus or event is a threat and (2) whether you have the resources to cope with that threat.

Imagine that a teenager experiences his first traffic accident. During his primary appraisal of the event, he will probably assess the situation as stressful even though it was a minor collision; his stomach may feel like it is in a knot and he may begin to worry about the consequences. As the stress sets in, his secondary appraisal may help him cope if he remembers that he has insurance to cover the damage, he considers that nobody was injured, and remembers how his parents have always been supportive and understanding. If, instead, he were illegally driving his older sister’s car with no insurance, then his secondary appraisal would lead to a continuation (or an increase) of the initial stress response.

Although the causes of stress can vary from person to person, there are some patterns that tend to emerge. In the workplace, Canadians experience stress due to long hours, high work demands, safety concerns, and interpersonal

relationships (Crompton, 2011). Life changes such as marital difficulties, the birth of a child, or the death of a family member are also a major source of stress. Psychologists have actually ranked stressful events according to their magnitude, as can be seen in the Social Readjustment Rating Scale (SRRS) in Table 14.2 (Holmes & Rahe, 1968). The highest-stress events include death of a spouse and divorce, while holidays and traffic tickets occupy the lower end of the spectrum. According to the psychologists who developed this scale, as the

points in the left column of Table 14.2 accumulate, a person’s risk for becoming ill increases. For example, 300 or more points put people at significant risk for developing heart problems, illnesses, and infections.

Table 14.2 Life Stress Inventories for the General Adult Population and for University Students

Original Social Readjustment Rating Scale (Holmes & Rahe, 1967)

RATING ITEM

100 Death of a spouse

73 Divorce

65 Marital separation

63 Jail term

63 Death of a close family member

53 Personal injury or illness

50 Marriage

47 Fired at work

45 Marital reconciliation

45 Retirement

44 Change in health of family member

40 Pregnancy

39 Sex difficulties

39 Gain of new family member

39 Business readjustment

38 Change in financial state

37 Death of close friend

36 Change to different line of work

35 Change in number of arguments with spouse

31 Mortgage exceeding $10 000 ($69 770 in today’s dollars)

30 Foreclosure of mortgage or loan

29 Change in responsibilities at work

29 Son or daughter leaving home

29 Trouble with in-laws

28 Outstanding personal achievement

26 Wife begins or stops work

26 Begin or end school

25 Change in living conditions

24 Revision of personal habits

23 Trouble with boss

20 Change in work hours or conditions

20 Change in residence

20 Change in schools

19 Change in recreation

19 Change in church activities

18 Change in social activities

17 Mortgage or loan less than $10 000 ($69 770 in today’s dollars)

16 Change in sleeping habits

15 Change in number of family get-togethers

15 Change in eating habits

13 Vacation

12 Christmas

11 Minor violations of the law

Total

Source: Republished with permission of Elsevier Science, Inc. from The social readjustment rating scale by T.H. Holmes,

R.H. Rahe, Volume 11, Issue 2, Pages 213–218, 1967. Permission conveyed through Copyright Clearance Center, Inc.

Of course, the stresses that a young adult experiences are almost certainly different from the stresses that are experienced by their parents or grandparents.

Although students can have all of the stresses listed in the left-hand column of Table 14.2 , it is more likely that students will deal with issues related to school work, a lack of money, and all of the social excitement (and drama) associated with one’s late teens and early 20s. Many Canadian students also deal with the challenges associated with immigration—balancing the family’s

traditions with the desire to embrace Canadian culture (Safdar & Lay, 2003).

Stress and Performance

At this point in the module, it would appear as though stress were always a bad thing. However, some level of stress can actually be helpful—without it, the

motivation to perform can decline. In 1908, Robert Yerkes and John Dodson theorized that too little or too much stress or emotional arousal would both lead to sub-optimal performance. Individuals would be at their best when under a moderate amount of stress. This relationship is depicted in the line graphs in Figure 14.5 .

Figure 14.5 Arousal and Performance Performance is related to at least two critical factors—the difficulty of the task and the level of arousal/stress while it is being performed. For easy tasks, moderately high arousal helps; for difficult tasks, lower levels of arousal are optimal. Source: Ciccarelli, S., & Noland White, J. (2012). Psychology (3rd ed.). Boston: Prentice Hall. p. 39. Copyright © 2012.

Printed and electronically reproduced by permission of Pearson Education, Inc., Upper Saddle River, New Jersey.

Later research found that the link between stress and performance could vary with the task being performed. Researchers noted that stress has positive effects on performance when the tasks being completed are relatively simple (see Figure 14.5 ). In this case, even if the stress consumes the person’s cognitive resources, it will still be possible to complete the task. However, if a task is complex, stress will harm performance. This is because stress uses up many of our cognitive resources; a stressed-out person may find that she does not have the mental resources available to perform at the level she would be capable of if she were not experiencing stress.

Importantly, the stress levels associated with these graphs are not the same for everyone. Some people seem to thrive under intense stress while others do not.

It appears that almost everyone has an individual zone of optimal functioning (IZOF) , a range of emotional intensity in which he or she is most likely to perform at his or her best (Hanin, 2000; Kamata et al., 2002). Sports psychologists have found that if an athlete is too anxious and stressed out—or not stressed out enough—she will not perform at an optimal level. Critically, many elite athletes are able to compare their current emotional state with the level of stress they had experienced prior to good performances; they can then attempt to adjust their current state to more closely match their optimal one

(Jokela & Hanin, 1999).

The data described in this section leads to an obvious question: How does a physiological response—stress—affect our mental life and cognitive abilities? In the next section of this module, we will examine how your brain and body can

produce the feelings and sensations associated with the experience of stress.

Module 14.2a Quiz:

What Causes Stress?

Understand. . . . 1. Some people are at their best when they are under a lot of pressure;

other people reach their best level of performance when they are under relatively little stress. This difference best reflects the concept of

A. primary appraisal of stress. B. secondary appraisal of stress. C. an individual zone of optimal functioning. D. the emotional arousal effect.

Apply. . . . 2. Shea had to move to Montreal as part of his job. He did not speak much

French and didn’t know many people in the city. He was quite concerned. However, he realized that he would quickly meet people through his job and that this social network would help him get settled. According to the cognitive appraisal theory of stress, what would you call Shea’s initial thoughts on moving to Montreal?

A. Primary appraisal of stress B. Secondary appraisal of stress C. Individual zone of optimal functioning D. Emotional arousal effect

3. Claire was usually a little bit nervous before writing exams. However, prior to writing her first Canadian History exam, Claire noticed that she didn’t really feel any stress at all. She ended up getting a C+ on the exam, well below her normal performance. What is the best explanation for her poor mark?

A. Claire’s stress consumed her cognitive resources, thus leading to a poor grade.

B. Claire’s stress level during the exam did not provide her with

enough emotional arousal to perform at her best.

C. The test was so difficult that Claire’s stress levels were not important.

D. The test was too complex for Claire, so her stress impaired her performance.

Physiology of Stress

Think about the last time you experienced stress. How did you feel? Although stress depends upon our mental appraisal of a situation or event, the physiological response to stress occurs throughout most of the body. Indeed, you can literally feel yourself react to acute stressors, such as giving a presentation in class, as well as chronic stressors, such as the cumulative effect of a challenging school year. Walter Cannon, an early researcher into the phenomenon of stress, noted that the physical responses to stressors were somewhat general, despite the fact that stress can come from a variety of sources that may be biological, cognitive, or social in nature. Cannon described

this general reaction as a fight-or-flight response , a set of physiological changes that occur in response to psychological or physical threats. This discovery laid the foundation for the modern study of stress, with several researchers building upon Cannon’s pioneering work.

Hans Selye (1950, 1956) of the Université de Montréal looked beyond the immediate fight-or-flight response and saw the unfolding of a larger pattern

during responses to stress. He named this pattern the general adaptation syndrome (GAS) , a theory of stress responses involving stages of alarm, resistance, and exhaustion (see Figure 14.6 ). As GAS illustrates, a stressful event, such as a mild shock if you are a rat or a pop quiz (or a mild shock) if you

are a university student, first elicits an alarm reaction. Alarm consists of your recognition of the threat and the physiological reactions that accompany it, including increases in blood pressure, muscle tension, heart rate, and adrenaline release. As the stressful event continues, the individual enters the second part of

this adaptive response, known as resistance. Resistance is characterized by an

individual using his or her physical and mental resources to respond to the stressor in an appropriate way (e.g., furiously studying for a quiz or running away from predators). However, an animal (or student) can’t maintain this level of energy use forever. The third and final stage of the GAS is often referred to as

exhaustion; this occurs when the stressful experience depletes your physical resources and your physiological stress response, and thus your ability to cope, declines.

Figure 14.6 The General Adaptation Syndrome This graph depicts the body’s resistance to stress. After the initial shock associated with the stressor (see the dip in resistance early in the Alarm phase), the body recruits resources to allow it to deal with the stressful situation or event. This ability to cope with the stressor peaks in the Resistance phase of the GAS. However, if the individual doesn’t overcome the stressor, eventually he or she will be unable to resist the stress; this final phase is known as the Exhaustion phase. Source: Source: Based on “Stress and the General Adaptation Syndrome” by Hans Selye, British Medical Journal, June 17,

1950.

Since the work of Cannon and Selye, psychologists have further uncovered the highly complex physiological interactions that occur during and after stress.

Modern descriptions of the physiology of stress involve both the autonomic nervous system (ANS) and endocrine (hormone) responses.

The Stress Pathways

Sweaty palms, an increased heart rate, and gastrointestinal sensations (i.e., “butterflies in the stomach”) are part of stress responses to both positive and negative events. Many of these bodily responses are the result of activity in the autonomic pathway, which originates in the brain and extends to the body where

you feel stress the most. Recall from Module 3.3 that the nervous system consists of the central nervous system (brain and spinal cord) and the peripheral nervous system, which includes the ANS. In response to stress, the hypothalamus stimulates part of the ANS known as the sympathetic nervous system, which then causes the inner part of the adrenal glands known as the

adrenal medulla (found on top of the kidneys) to release epinephrine and norepinephrine (also known as adrenaline and noradenaline). These chemicals then trigger the bodily changes associated with the fight-or-flight response (see Figure 14.7 ).

Figure 14.7 Stress Pathways of the Body The stress pathways of the body include the autonomic nervous system and the HPA axis. Both systems converge on the adrenal glands. The autonomic response involves stimulation of the adrenal medulla by the sympathetic nervous system, resulting in the release of epinephrine and norepinephrine—chemicals that stimulate the fight-or-flight response. Activity of the HPA axis results in stimulation of the adrenal cortex, which releases cortisol into the bloodstream.

Another physiological system involved in the stress response is the hypothalamic–pituitary–adrenal (HPA) axis , a neural and endocrine circuit that provides communication between the nervous system (the hypothalamus) and the endocrine system (pituitary and adrenal glands). When you perceive that you are in a stressful situation, the hypothalamus and pituitary gland work

together to stimulate the release of cortisol , a hormone secreted by the adrenal cortex (the outer part of the adrenal gland) that prepares the body to

respond to stressful circumstances. Cortisol may stimulate increased access to energy stores or lead to decreased inflammation. In summary, both the sympathetic nervous system (through the release of epinephrine and norepinephrine) and the HPA axis (through the release of cortisol) function to prepare us to respond to stress.

With rare medical exceptions, humans mount both autonomic and HPA axis responses to stress. These responses are highly adaptive and promote behaviours that help our survival (e.g., being more vigilant or running extra fast). However, as you will see, not everyone responds to these stress responses in the same way.

Oxytocin: To Tend and Befriend

One observation you have likely made is that males and females often respond to stress and threat in different ways. Although many of these differences are a product of societal expectations (e.g., men are typically expected to hide their stress), there are in fact some differences in the HPA axis of males and females. Numerous experiments have found that males have a larger cortisol response to stress than females. This difference occurs for both real-world stressors such as exams and laboratory-based stressors such as having to give a speech

(Kudielka & Kirschbaum, 2005). As a result, males tend to respond to threats with a rapid expenditure of energy (fight or flight).

Shelley Taylor and her colleagues at UCLA have suggested that whereas men are more likely to react to stress or threats with a fight-or-flight response, women

are more likely to have a more social tend-and-befriend response (Taylor et al., 2000; Taylor, 2006). This view makes sense if you think about the history of our species. Over the course of our species’ evolution, females have had to care for dependent and vulnerable children. Running away from a stressful situation would have required abandoning offspring; getting into a fight risked the possibility of death or injury. Both of these responses would have reduced the likelihood that their offspring would have survived. Instead, it made more sense to seek out stable friendship networks for support during times of stress. Doing so provided comfort, but also the potential for additional resources to help with

offspring. This is not to say that women don’t have any instinctive fight-or-flight response or that men have no need to tend and befriend; rather, these researchers are suggesting that there are sex differences in which response is

more likely to occur.

According to the tend-and-befriend theory, females often respond to stress by seeking out social support networks. Although there are physiological explanations for sex differences in stress responses, we should also remember that cognitive and social factors also influence these behaviours. Photographee.eu/Shutterstock

The tend-and-befriend reaction may be promoted by the release of oxytocin , a stress-sensitive hormone that is typically associated with maternal bonding and social relationships. Oxytocin influences a number of behaviours including the contraction of the uterus when a woman is in labour, romantic attachment, social bonding, trust, wound healing, and orgasm (although not all at the same time;

Caldwell & Young III, 2006; Lee et al., 2009). Although oxytocin is clearly involved in a number of behaviours, its role in stress is particularly important. Animal studies have shown that stimulating the release of oxytocin reduces activity in the sympathetic nervous system (one of the parts of the stress

network) and blood pressure (Carter, 1998). In humans, women who are breastfeeding and thus have high levels of oxytocin show lower stress responses

to physical and psychological stress (Light et al., 2000); similar findings were reported in men who were given doses of oxytocin (Heinrichs et al., 2003). And, most relevant to the tend-and-befriend hypothesis, women who receive more frequent hugs from their romantic partners also had higher oxytocin levels and

lower stress responses (Light et al., 2005). That’s something to think about when studying for exams.

Working the Scientific Literacy Model Hormones, Relationships, and Health

Social relationships can be a major source of both positive and negative stress, and they can provide a great deal of support during our most stressful times. Given the links between stress and health, it seems reasonable to ask: How do our personal relationships relate to health?

What do we know about hormones, relationships, and health? Many family events and relationships can be stressful. Almost everyone has argued with their parents or siblings. Holidays and weddings can be fun, but they also involve a lot of planning and, at times, “intense discussion.” Sometimes relationships— particularly with close friends or romantic partners—become very difficult and tense, and may even lead to chronic stress responses that adversely affect a person’s health. However, other relationships can be quite fulfilling, and can lead to strong social bonds that last a lifetime. These positive relationships have been linked to specific hormonal responses in the body.

Two hormones, oxytocin and vasopressin, are involved in social behaviour and bonding. We previously discussed the role of oxytocin in moderating stress responses, particularly in females. Oxytocin has been shown to inhibit activity in the amygdala, a

brain region involved with fear and threat responses (Kirsch et al., 2005). It may also prevent the release of cortisol (Heinrichs et al., 2003). Vasopressin also has stress-reducing functions. Like oxytocin, the release of vasopressin is controlled by the hypothalamus and pituitary gland, and affects the levels of stress

hormones released by the adrenal gland (Goland et al., 1991). People with high vasopressin levels tend to report better

relationship quality with their spouses (Walum et al., 2008). However, oxytocin and vasopressin have health functions that go beyond improving social bonds. Both of these hormones interact with the immune system, specifically to reduce inflammation.

How can science explain connections between hormones, relationships, and health? A common, if not surprising, method for measuring immunity and health is to see how quickly people recover from a minor wound. In one study, the effect of marital stress on wound healing was

tested in a group of 37 married couples (Gouin et al., 2010). Each couple was asked to sit together with no other couples or researchers present and complete a series of marital interaction tasks, including a discussion of the history of their marriage and a task in which both spouses were instructed to discuss something they wished to change about themselves. These interactions were videotaped. The researchers also took blood samples to measure oxytocin and vasopressin levels. Additionally, each participant consented to receiving a suction blister on the forearm, which is a very minor wound created with a medical

vacuum pump. It’s like a hickey—but a hickey for science.

During the marital interaction tasks, those who engaged their partner with positive responses including acceptance, support, and self-disclosure had higher levels of oxytocin and vasopressin. Those who responded with hostility, withdrawal, and distress had

lower levels (Figure 14.8 ). In addition, the suction blister wounds healed more quickly over an eight-day period in

individuals with high oxytocin and vasopressin levels. (Suction wounds heal to 100% within 12 days.)

Figure 14.8 Relationship Quality Is Related to Physiological Responses

Higher oxytocin and vasopressin levels are associated with positive social interactions between married couples. Source: Republished with permission of Elsevier Science, Inc., from Marital behavior, oxytocin,

vasopressin, and wound healing by Jean-Philippe Gouin et. al., Psychoneuroendocrinology,

35(7):1082-90, 2010; permission conveyed through Copyright Clearance Center, Inc.

In another experiment, married couples were given either an intranasal solution of oxytocin or a placebo. They then engaged in discussion about conflict within their marriage. Those who received a boost of oxytocin showed more positive, constructive behaviour during their discussion compared to couples in the placebo group. The researchers also measured cortisol levels from saliva samples obtained from each individual. Those in the oxytocin group had lower levels of this stress hormone compared

to couples in the placebo group (Ditzen et al., 2009).

Can we critically evaluate this evidence? It might be tempting to conclude that a boost of oxytocin or vasopressin could be the key to marital happiness, stress reduction, and physical health. Although the studies you just read

about are related to these important qualities, it is important to avoid oversimplifying what their results mean. Claims that homeopathic oxytocin remedies can make anyone happier and better at love, marriage, sex, and even “mind reading” should be looked at with skepticism. Advertisements for such products are not hard to find. However, scientists are still in the relatively early stages of learning just how oxytocin and vasopressin affect social behaviour in humans, and how they are related to immune

system function (Gouin et al., 2010; Macdonald & Macdonald, 2010).

Why is this relevant? Although these studies were conducted with married couples, the physiological and physical healing benefits of close, positive social relationships extend to romantic relationships, friendships, and family. Procedures for healing physical injury currently focus on repair to damaged areas and preventing infection from setting in. In addition to these critical steps, it appears that managing psychological stress is also important for facilitating recovery from

wounds (Gouin & Kiecolt-Glaser, 2011). As we shall see in the next section of this module, stress can also affect a number of other aspects of our physical health.

Module 14.2b Quiz:

Physiology of Stress

Know . . . 1. Which of the following is not a component of Selye’s general adaptation

syndrome?

A. Resistance B. Alarm

C. Flight D. Exhaustion

2. Which of the following is a major player in the chemical response comprising the autonomic fight-or-flight stress response system?

A. Cortisol B. Epinephrine C. Dopamine D. Oxytocin

Understand. . . . 3. A major difference between the tend-and-befriend stress response and

the responses mediated by the autonomic pathway and the HPA axis is that

A. the tend-and-befriend response involves cortisol activity. B. men are more likely to express the tend-and-befriend response. C. the tend-and-befriend response facilitates care for offspring and

others in a social group.

D. the tend-and-befriend response is a negative stress reaction, whereas the autonomic pathway and HPA axis responses are positive reactions.

4. High levels and low levels are associated with elevated stress.

A. vasopressin; cortisol B. oxytocin; vasopressin C. cortisol; oxytocin D. vasopressin; epinephrine

Stress, Immunity, and Illness

You have likely had the experience of getting sick in the midst of a period of high stress. You are not alone; dozens of experimental and correlational studies have

shown, for example, that stress increases the likelihood that people will succumb

to the cold virus (Cohen et al., 1998). In fact, one study suggests that final exams—an obvious stressor for students—may be bad for you. In this investigation, medical students provided blood samples during the term and again during the final exam period. Analysis of these blood samples showed reduced immune responses during the high-stress period at the end of the term

(Kiecolt-Glaser, 1984). There is a reason this happens: the immune system, which is responsible for protecting the body against infectious disease, has numerous connections with the nervous system, including the stress response

systems just discussed (Maier & Watkins, 1998; Selye, 1955). Psychoneuroimmunology is the study of this relationship between immune system and nervous system functioning.

Psychologists are finding that the stress–illness relationship is a very complex one, involving numerous physiological systems. These investigations are made even more challenging by the fact that the effects of mental stress on physical functioning are diverse. Recall that stress can come in a variety of forms—at the very least, we can divide it into acute and chronic variations. It appears that stress also has dual influences on immunity. Acute stressors tend to activate the immune system, whereas chronic exposure to stress generally causes

suppression of the immune system (Segerstrom & Miller, 2004).

Stress, Personality, and Heart Disease

In addition to making people more prone to catching viruses, high stress levels

appear to put people at greater risk for developing coronary heart disease —a condition in which plaques form in the blood vessels that supply the heart with blood and oxygen, resulting in restricted blood flow. For example, one study followed 12 000 healthy males for a nine-year period and found that men who experienced ongoing stress with their families or at work were 30% more likely to die from coronary heart disease than were men who were not

chronically stressed (Matthews & Gump, 2002). Coronary heart disease begins when injury and infection damage the arteries of the heart. This damage triggers the inflammatory response by the immune system—white blood cells travel to affected areas in an attempt to repair the damaged tissue. These cells gather

cholesterol and form dangerous plaques, which can rupture, break off, and block blood flow. So how does stress fit into this picture? Stress causes an increased release of those molecules that cause the inflammation that leads to heart

complications (Segerstrom & Miller, 2004).

It seems like the link between stress and heart disease should have a simple solution: reduce your stress levels. However, this isn’t as straightforward as one might think. The reason is that our stress responses are affected by our personalities. Interestingly, this relationship wasn’t discovered by psychologists. Rather, it was noticed by two cardiologists—Meyer Friedman and Ray Rosenman—who were conducting an eight-and-a-half year study of cardiovascular health. As you might expect, they found that people who were

prone to stress had poorer physical health (Friedman & Rosenman, 1959). Importantly, a subset of these patients also had a particular group of personality

traits that the researchers labelled as Type A. The Type A personality

describes people who tend to be impatient and worry about time, and are easily angered, competitive, and highly motivated. In contrast, the Type B personality

describes people who are more laid back and characterized by a patient, easygoing, and relaxed disposition (Friedman & Rosenman, 1974). These studies revealed that people who fall in the Type A category are far more likely to have heart attacks than are Type B people.

This initial finding has been replicated many times, though the correlation between levels of Type A characteristics and coronary heart disease is only moderate. This less-than-strong relationship likely reflects the fact that other factors, not just how a person copes with stress, may further elevate the risk of coronary heart disease. People who have a Type A personality also engage in behaviours that compromise physical health, such as drinking large quantities of alcohol, smoking, and sleeping less than people with a Type B personality. Thus, numerous correlated factors may explain the relationship between Type A personality and risk of coronary heart disease. People with Type A personalities are often successful. However, they are also much more likely to experience heart attacks and strokes than are more relaxed, less hostile individuals.

The distinction between Type A and B personalities has not satisfied all

behavioural scientists and physicians. Being quick to anger is a characteristic of Type A individuals, but so is being hyper-motivated to succeed at work. Perhaps there is something more specific about personality that increases one’s risk for developing heart disease. More recent research has shown that people who are prone to hostility and anger are at greater risk for developing coronary heart

disease (Razzini et al., 2008). Other personality characteristics linked to coronary heart disease include anxiety and depression (Barger & Sydeman, 2005; Lett et al., 2004).

Imagine you have a one-hour break between classes, during which you need to get lunch and also visit one of your professors across campus. When you arrive at your professor’s office, you see a line of other students awaiting their turn, and the current occupant is blathering on and on about something completely unrelated to schoolwork. How would you tend to react in this situation? Would you become agitated, angry, resentful, and fidgety? Or would you be more inclined to strike up a conversation with others in line to help pass the time? Your answer will likely depend on various factors—but each of us tends to have a common style of responding to stressful events.

Christopher Futcher/E+/Getty Images

Myths in Mind Stress and Ulcers Many of the presumed links between stress and health are oversimplified or misunderstood. People typically associate ulcers—open sores in the lining of the esophagus, stomach, and small intestine—with people working in high-stress jobs, such as police officers or air traffic controllers. The belief that stress causes people to develop ulcers is widespread. In actuality, most ulcers are caused by a bacterium,

Helicobacter pylori, which can cause inflammation of the lining of various regions of the digestive tract. This bacterium is surprisingly common, and approximately 10% to 15% of people who are exposed to it will develop an ulcer resulting from inflammation. Thus, stress does not cause ulcers, although it can worsen their symptoms. Also, smoking, alcohol, pain relievers, and a poor diet—anything that can irritate the digestive system —increases problems associated with ulcers.

Contrary to popular belief, chronic stress, like that experienced by air traffic controllers, will not cause a stomach ulcer. Photodisc/Getty Images

Stress, Food, and Drugs

Stress influences heart functioning in other, indirect, ways as well. Survey research has consistently shown that people are drawn toward sweet and fatty

foods when they are stressed (Oliver & Wardle, 1999; Steptoe et al., 1998). Laboratory-based studies have shown similar trends. In one experiment, female participants were given stress-inducing tasks to complete including solving a visuospatial puzzle, performing math calculations, and giving a speech in front of what they thought was an audience seated behind a one-way mirror. The women who had the highest levels of the stress hormone cortisol ate more sweet, high-

fat snacks than did the less-stressed women (Epel et al., 2001). The relationship between stress and unhealthy food extends to other species as well. Low-status females in a colony of monkeys are often bullied and harassed by high-status females; researchers have noted that the low-status females ate more banana-

flavoured pellets than their social superiors (Wilson et al., 2008). Interestingly, similar results were found when monkeys had the opportunity to self-administer cocaine; the subordinate monkeys pressed a lever much more often than the

dominant monkeys who presumably had less stress (Morgan et al., 2002).

Obviously, overeating unhealthy food (or doing cocaine) is not a good long-term solution to stress. So, why do some people (and monkeys) use food and drugs to deal with stress? Although it is possible that these substances directly affect the hormones and brain areas associated with stress, most scientists agree that food

(and drugs) influence the brain’s dopamine reward system (see Module 5.3

and 6.2 ). Some research suggests that chronic stress suppresses the reward system (so stressed people would find less joy in things). It is possible that eating rewarding foods increases the activity in this system so that it is closer to

normal levels (Adam & Epel, 2007; Dallman et al., 2003). Additionally, as discussed in Module 11.1 , people who are stressed are mobilizing the body’s resources in case action is required; eating fatty and sugary foods provides the

body with extra calories in anticipation of the person having to use additional energy to deal with a stressor.

Stress, The Brain, and Disease

Although stress is often linked to cardiovascular problems like heart attacks and strokes, its negative effect on the immune system makes stress a factor in other conditions as well. Acquired immune deficiency syndrome (AIDS) is a disease caused by infection with the human immunodeficiency virus (HIV). This disease saps the immune system’s ability to fight off infections to such an extent that even conditions that are relatively harmless to most of the population can be devastating to an individual with AIDS. Patients in industrialized countries with more medical options have a better prognosis than those living in impoverished areas. Retroviral therapies have greatly increased the longevity, health, and overall quality of life of patients. However, people who are HIV-positive need regular vaccination treatments. Unfortunately, stress impedes the body’s ability to respond to vaccinations. In turn, studies have shown that those who experience serious emotional distress are less responsive to HIV treatments. Stress-induced elevation of the neurotransmitter norepinephrine—which is involved in emotional arousal and stress responses—can also worsen the condition of the various illnesses associated with AIDS. Patients who have elevated activity of the autonomic nervous system are slower to respond to antiretroviral therapies, which increases their risks of developing certain types of

cancer such as B-cell lymphoma (Cole et al., 1998).

Researchers are also finding numerous links between psychosocial factors and

cancer progression (Antoni & Lutgendorf, 2007). Several factors, such as the type of cancer and an individual’s age, account for why some people rapidly succumb to cancer while others are able to overcome this disease. But, stress levels also affect the progression of cancer. Why is this? It appears that norepinephrine supports cancer cell growth, and that cortisol magnifies this effect. Hormones from the autonomic nervous system stimulate cells that reside in tumours, which ultimately results in growth and proliferation of these masses

(Antoni et al., 2006). Thus, when someone experiences stress, the autonomic nervous system and HPA axis naturally respond, but their reactions compromise how well the individual can fight the disease.

For many people, stress levels can be changed and the course of a disease such as cancer can be slowed. For example, individuals who have undergone

assertiveness training and learn anger management techniques show reduced

autonomic activity and hormonal activity associated with the HPA axis (Antoni et al., 2007). Also, those who are optimistic, cope by using humour, and have a positive outlook on the disease (and thus less stress) show physiological benefits

such as greater immune responses (Lutgendorf et al., 2007). These studies show us that how we mentally react to the stressors in our lives can dramatically influence how our body responds to serious illness. In the next module, we will discuss how you can draw from psychology research to improve your ability to cope with stress. Doing so will make you happier—and healthier.

Module 14.2c Quiz:

Stress, Immunity, and Illness

Know . . . 1. What is psychoneuroimmunology?

A. A condition in which plaques form in the blood vessels that supply the heart with blood and oxygen, resulting in restricted blood flow.

B. The study of both the positive and negative effects that our behaviour and decisions have on health, survival, and well-being.

C. The study of the relationship between immune system and nervous system functioning.

D. A hormone secreted by the adrenal gland.

2. People with personality are patient and easygoing, and have a relaxed disposition, whereas personality individuals tend to be impatient and are easily angered, competitive, and highly motivated.

A. Type A; Type B B. Type H; relaxed C. Type B; Type A D. relaxed; Type H

Understand. . . . 3. A direct effect of stress on coronary health would be

A. a stress-related increase in inflammation that results in buildup of

cholesterol in the arteries.

B. eating more fattening foods in response to stress. C. engaging in increased risky behaviour due to stress. D. increased moodiness during periods of stress.

4. How does stress affect cancer? A. Stress decreases the number of white blood cells in the body,

which results in cancer progression.

B. Hormones from the autonomic nervous system stimulate cells that reside in tumours, which can in turn stimulate growth and proliferation of the tumours.

C. Stress decreases the growth of cancer cells. D. Stress does not affect cancer.

Analyze . . . 5. Researchers have concluded that the actual cause of ulcers is usually

. A. stress B. bacterial infection C. genetics D. poor diet

Module 14.2 Summary

coronary heart disease

cortisol

fight-or-flight response

general adaptation syndrome (GAS)

hypothalamic–pituitary–adrenal (HPA) axis

individual zone of optimal functioning (IZOF)

14.2a Know . . . the key terminology associated with stress and illness.

oxytocin

psychoneuroimmunology

stress

Type A personality

Type B personality

When a person encounters a stressor, the hypothalamus stimulates the sympathetic nervous system to act, triggering the release of epinephrine and norepinephrine from the adrenal medulla. This reaction is often referred to as the fight-or-flight response. Another part of the stress response system is the HPA axis, in which the hypothalamus stimulates the pituitary gland to release hormones that in turn stimulate the adrenal cortex to release cortisol, which prepares the body to deal with stressful situations.

Cortisol suppresses the immune system, leaving people more vulnerable to illness and slowing recovery time from illness and injury.

Apply Activity To complete this activity, look at Table 14.2 . Using the values next to each stressful event listed, add up the numbers that apply to your experiences and

compute your total stress score. Holmes and Rahe (1967) found that a score of 300 or more puts people at significant risk for illness, while a score of 150–299 puts people at a moderate risk.

14.2b Understand . . . the physiological reactions that occur under stress.

14.2c Understand . . . how the immune system is connected to stress responses.

14.2d Apply . . . a measure of stressful events to your own experiences.

Years later, Renner and Mackin (1998) developed a similar scale for college and university students based on data gathered from a sample of 257 undergraduate students (range: 17–45 years; mean: 19.75 years). Do an Internet search for Renner and Mackin’s College Undergraduate Stress Scale and calculate your own stress score. They reported an average stress score of 1247 (standard deviation: 441), with scores ranging from 182 to 2571. How do you compare with their sample?

Ulcers are damaged areas of the digestive tract often caused by infection with

the bacterium Helicobacter pylori. Stress and other factors, such as diet and alcohol consumption, can worsen the condition of ulcers, but stress alone does not cause them.

14.2e Analyze . . . the claim that ulcers are caused by stress.

Module 14.3 Coping and Well- Being

John Lund/Stephanie Roeser/Glow Images

Learning Objectives

Know . . . the key terminology associated with coping and well-being. Understand . . . how control over the environment influences coping and outlook. Understand . . . positive and negative styles of coping. Apply . . . your knowledge of the beneficial effects of optimism to help you reframe stressful situations as positive opportunities. Analyze . . . whether activities such as relaxation techniques, meditation,

14.3a 14.3b

14.3c 14.3d

14.3e

What is the best way to cope with a personal disaster, such as losing your job? Writing about how the event makes you feel may not seem like a priority, but according to psychologist James Pennebaker, it may be one of the best strategies for coping and regaining the emotional resources needed to move on. Pennebaker, a leading researcher on the psychological benefits of writing, decided to intervene when a local computing and electronics firm laid off 60 professional workers. All he asked the workers to do was to write, but their instructions on how to write were different: Half the volunteers were randomly assigned to write about their “deepest thoughts and feelings surrounding the job loss, and how their lives, both personal and professional, had been affected”

(Spera et al., 1994, p. 725). In contrast, the control group members were told to write about their plans for the day and how they planned to find another job, which is much less personal and emotional. After a month of weekly 20-minute writing sessions, the group members who were writing about their emotions were getting hired much more frequently than the control group members. The participants were randomly assigned to the two groups, so the differences between the groups can be traced to the writing rather than to pre-existing personality differences. Similar methods have been used in Pennebaker’s studies of first-year university students, people grieving the loss of a loved one, and other groups experiencing stressful transitions. The result was the same each time—group members who wrote meaningful narratives of their emotions and thoughts came out ahead, not just in terms of mental health, but physically and in terms of their performance at work or school.

Focus Questions

1. What are the different ways people cope with stress? 2. Which factors make coping especially challenging?

and biofeedback actually help people cope with stress and problems.

This module is designed to help you. In it, you will read about some widely used solutions for coping with stress and behavioural methods that may potentially help in improving health. We will also discuss some topics that might be less familiar, but may prove useful in how you cope with stress and negative events. Finally, we will discuss how stress and successful coping are closely related to your sense of control.

Coping

Although understanding how stress works—both physically and mentally—is important, it is the ability to cope with that stress that will dictate whether or not

you are happy. Coping refers to the processes used to manage demands, stress, and conflict. Coping strategies can include problem-focused coping and emotion-focused coping. Some of us approach a problem or stressor, such as large monetary debt or a setback at work, by taking a problem-solving approach. In other words, we cope by defining the problem and working toward a solution. If you are stressed out by school demands, you could address the problem by setting up a study schedule, dropping a course, or finding a tutor, among many other possible solutions. However, there are times when it is more important to focus on the emotional effects of a stressor than on attempting to find an immediate solution to a problem—in fact, not all stressors are brought about by problems that have identifiable solutions. For example, imagine that your beloved family pet has passed away. In such a situation, you obviously cannot

make a list to deal with your grief; however, you can find ways to reduce the negative effects your emotions are having, both on yourself and on others. Neither of these styles of coping is necessarily superior to the other—their

suitability depends on the nature of the problem (Folkman & Lazarus, 1980). In many instances, both problem-focused coping and emotion-focused coping are used to deal with a stressor.

Of course, not all coping techniques actually help; some may simply replace one problem with another. For example, some people turn to alcohol or drugs to temporarily avoid feelings of stress, and some turn to food. Unfortunately, sitting

in front of the television and eating a litre of Häagen-Dazs ice cream from the container is not a healthy method of coping. In this section, we will examine both the positive and negative methods of coping, and then describe several techniques that can be used to improve one’s well-being.

Positive Coping Strategies

Psychology may have a reputation for focusing on the negative, including how damaging stress can be. In reality, psychologists also study what makes people

thrive, even in the face of extreme stress. This area of study, positive psychology , uses scientific methods to study human strengths and potential. Research in this area has identified numerous adaptive and constructive ways in which people cope with problems. These researchers have found that one of the most powerful tools for coping is also one of the simplest: focusing on positive emotions.

Although it may seem difficult to imagine experiencing positive emotions during times of stress, doing something simple like watching a funny movie can actually help you cope with stress and negative life experiences. Barbara Fredrickson and her colleagues at the University of North Carolina (Chapel Hill) have shown that positive emotions can affect how we perceive and think about the world. For example, these researchers have shown that a negative mood narrows your focus of attention so that you attend to a small part of your environment, whereas

positive moods cause the focus of your attention to expand (Fredrickson & Branigan, 2005). Other scientists have demonstrated that positive moods can also increase a person’s creativity. In one experiment, participants were shown

groups of three words (e.g., falling, actor, dust) and were asked to find a word that related all three items (e.g., star). Individuals in the positive mood condition scored higher than other participants (Isen et al., 1987). This increase in flexible thinking is crucial during coping, as it would help people experiencing negative emotions reframe their stressors into something less upsetting.

Although the effects of positive emotion on our ability to perceive and think are interesting, the most stunning effect of positive emotions is their effect on our autonomic nervous system. When most of us watch a scary movie, our heart

rates increase as we experience fear. Then, after a little while, our heart rates return to normal. But, the speed at which this recovery occurs can be influenced by positive emotions. Researchers have found that when participants watched positive films after seeing a scary movie clip, their heart rate returned to normal

faster than when participants viewed a sad or neutral film (see Figure 14.9 ). The positive emotions seemed to defuse the effects of the negative emotions, thus decreasing the amount of damage that stress and negative emotions can

have on the body (Fredrickson & Levenson, 1998). Because positive emotions allow people to broaden their thought processes and to build new intellectual,

social, and physical resources, these results are now described as the broaden- and-build theory of positive emotions (Fredrickson, 2001, 2003).

Figure 14.9 Positive Moods and Recovery from Negative Emotional Events Research shows that positive moods speed up a person’s recovery from negative events. In this study, viewing a video depicting positive emotions (amusement or contentment) caused heart rates to return to normal levels faster

than a neutral or sad video (Fredrickson & Levenson, 1998). Source: Data from Fredrickson, B. L., & Levenson, R. W. (1998). Positive emotions speed recovery from the cardiovascular

sequelae of negative emotions. Cognition & Emotion, 12, 191–220. Figure 3, p. 205.

Optimism and Pessimism

Closely linked to positive emotions is the concept of optimism , the tendency to have a favourable, constructive view on situations and to expect positive outcomes. People who are optimistic tend to initially perceive situations in a positive way and are also more likely to find positive elements in situations. In

contrast, pessimism is the tendency to have a negative perception of life and expect negative outcomes. These individuals often have what is known as pessimistic explanatory style , which is the tendency to interpret and explain negative events as internally based (i.e., as being due to that person rather than to an external situation) and as a constant, stable quality (Burns & Seligman, 1989). For example, a laid-off employee who struggles to find a job may attribute the problem to his perceived inability to network properly rather than to the fact that it is tough to find jobs in his field. Pessimism is also often linked with negative affectivity , the tendency to respond to problems with a pattern of anxiety, hostility, anger, guilt, or nervousness. These negative emotions make it difficult for these individuals to choose an appropriate coping strategy for a given

problem (DeLongis & Holtzman, 2005; O’Brien & DeLongis, 1996). For instance, someone with high levels of negativity may deal with a difficult breakup by socially withdrawing from others and by becoming angry and resentful. Such responses also make it more difficult for others to provide social support.

As you might expect after reading the previous section, optimism is correlated with better physical health than pessimism. For example, scientists have shown that women who tend toward pessimism and test positive for the HPV virus (a papilloma virus known to cause cervical cancer) have lower counts of white blood cells that fight disease than do optimistic women with the HPV virus. Long- term studies show similar effects of optimism. In the U.S. Veterans Affairs Normative Aging Study involving a large cohort of male participants, optimists had a lower incidence of coronary heart disease than did pessimists

(Kubzansky et al., 2001). Similarly, researchers at the Mayo Clinic administered personality tests assessing optimism and pessimism to patients who came into the clinic for general medical issues during the 1960s. Thirty years later, the data on optimism and pessimism were compared to patient survival. The researchers found a 19% increase in mortality risk in people who were consistently

pessimistic (Maruta et al., 2000). Perhaps a good attitude does more than help individuals cope emotionally with illness; perhaps it actually helps them

overcome it.

Although these studies present a convincing case for optimism, there is an alternative explanation for the results: Optimists and pessimists may simply have had different lifestyles. One of these other lifestyle variables (e.g., diet) could potentially explain the health differences between optimists and pessimists. In order to control for this possibility, a group of U.S. researchers conducted longitudinal (long-term) studies of a group of females with nearly identical lifestyles: nuns. The Nun Study, as it is now known, was exceptional in that it allowed researchers to examine how personality factors such as optimism and pessimism affected people over the course of their lifetime while controlling for variables such as diet, work demands, and stress. As part of this study (which is part of a longitudinal study about factors leading to Alzheimer’s disease), the researchers examined the handwritten autobiographies of 180 nuns; these documents were written by the nuns when they were entering the order in their early-to-mid twenties. The emotional content of the autobiographies was coded by the researchers to see if positive emotions predicted how long the nuns lived. Here are two excerpts from the study:

Sister 1 (low positive emotion): I was born on September 26, 1909, the eldest of seven

children, five girls and two boys. . . . My candidate year was spent in the Motherhouse,

teaching Chemistry and Second Year Latin at Notre Dame Institute. With God’s grace, I

intend to do my best for our Order, for the spread of religion and for my personal

sanctification.

Sister 2 (high positive emotion): God started my life off well by bestowing upon me a

grace of inestimable value. . . . The past year which I have spent as a candidate

studying at Notre Dame College has been a very happy one. Now I look forward with

eager joy to receiving the Holy Habit of Our Lady and to a life of union with Love Divine.

(Danner et al., 2001, p. 806)

The researchers found a strong correlation between positive emotions during young adulthood and the longevity of the nuns—people who were more positive

during their twenties lived longer than less positive people (Danner et al., 2001). Similar results have been found with less-controlled populations (Maruta et al.,

2000; Peterson et al., 1998), suggesting that the results of the Nun Study are due to optimism and positivity, not to an act of divine intervention.

Resilience

Thus far, we have discussed a number of factors that can reduce the effects of stress and promote well-being. However, there are times when negative life events are unavoidable. As you have likely noticed in your own life, individuals differ in their ability to bounce back from events such as disaster, disease, or

major loss. This trait is known as resilience , the ability to effectively recover from illness or adversity. Resilient people tend to have one or more factors stacked in their favour. Financial and social resources, opportunities for rest and relaxation, and other positive life circumstances contribute to resiliency. Even so, amazing stories of resiliency can be found among individuals living with unimaginable stress. Thus, the personality and emotional characteristics discussed earlier are also important contributors to resiliency in the face of adversity.

One amazing example is that of Viktor Frankl, an early- and mid-20th-century Austrian psychiatrist. Frankl was already an influential physician and therapist when he, his wife, and family were forced into concentration camps during World War II. Frankl found himself in the role of helping people adjust to life in the concentration camp, even while he himself struggled to survive each day. He encouraged others to tap into whatever psychological resources they had left to cope with very bleak circumstances. Frankl found that one of the most critical parts of surviving in these camps was finding some sort of meaning in life. For some, this could be the desire to reunite with their family when the war eventually ended. For others, it was a love of poetry (astoundingly, some prisoners were able to write poetry in the concentration camps). But, if a prisoner seemed to lose this sense of meaningfulness in his life, Frankl could tell that this prisoner would soon die. As Frankl later noted, “Despair equals Suffering minus

Meaning” (Gelman et al., 2000, p. 625). A key challenge, then, was to maintain this sense of meaningfulness so that people had a purpose in their lives. Doing so allowed them to cope and remain resilient while witnessing terrifying events. Eventually Frankl’s wife and parents were deported to different concentration

camps, where they were murdered. Despite his own enormous losses, Frankl continued helping others to cope and find solace under the worst of

circumstances (Frankl, 1959).

Psychologists have long focused on the negative outcomes of stress, but stories such as Frankl’s demonstrate that stress and trauma can also lead people to recognize how strong they really are. In fact, psychologists describe the

phenomenon of post-traumatic growth , the capacity to grow and experience long-term positive effects in response to negative events (Tedeschi & Calhoun, 2004). It happens in response to events such as automobile accidents, sexual and physical assault, combat, and severe and chronic illnesses. Individuals who experience post-traumatic growth often report feeling a greater sense of vulnerability, yet over time develop an increased inner strength. They also report finding greater meaning and depth in their relationships, a greater sense of

appreciation for what they have, and an increased sense of spirituality (Tedeschi & Calhoun, 2004).

Post-traumatic growth is not an alternative reaction to post-traumatic stress. Rather, the two conditions occur together. Clinicians recognize that the growth occurs during the process of coping, not because of the event itself. Often a clinical psychologist trained in working with trauma victims helps facilitate the growth process and assists the individual in finding the interpersonal and social resources needed for healing. Some of these resources include medications and some form of counselling. It is also becoming increasingly common for people to use other techniques to reduce responses to stress and negative events, including meditation and yoga.

Biofeedback

As you have been reading this chapter, your circulatory system has been pumping blood and maintaining blood pressure, your lungs have been breathing in air, and your digestive system may have been working on a recent meal, all without the tiniest bit of conscious effort. Certainly you can intentionally hold your breath for a moment, but can you hold your heartbeat or change your blood pressure? If you are like most of us, you cannot control all of these autonomic

functions, but that does not mean it is impossible.

Biofeedback is a therapeutic technique involving the use of physiological recording instruments to provide feedback that increases awareness of bodily responses. The psychologists who developed this technique believed that by seeing or hearing a machine’s representation of bodily processes, people could gain awareness of stress responses and bring them under voluntary control. For example, a patient with chronic stress could use feedback on his blood pressure, heart rate, and tension of his facial muscles to monitor and, possibly, control his stress responses. As you can imagine, this ability would have very useful applications to clinical psychology. However, after some very promising findings, the excitement over biofeedback faded, in part because it was found that simple relaxation techniques were just as useful.

Meditation and Relaxation

Many people report significant benefits by using relaxation and meditation techniques to cope with stress and life’s difficult periods. Both techniques are designed to calm emotional responses as well as physiological reactions to

stress. Meditation is any procedure that involves a shift in consciousness to a state in which an individual is highly focused, aware, and in control of mental processes. However, to say “meditation” is a bit simplistic, as meditation has many different techniques and is practised, in some form, in almost every known culture.

Biofeedback involves the use of physiological monitoring, which allows the patient to see and sometimes hear the output of his or her physiological reactions. Cindy Charles/PhotoEdit, Inc.

In some types of meditation, the individual focuses his or her attention on a chosen object, such as a point on the wall or a physical sensation like the feeling

related to breathing. This technique is known as focused attention (FA) meditation. When distracting or negative thoughts enter into one’s awareness and interfere with meditation, people are taught to accept these thoughts in a nonjudgmental manner, and to then nudge their attention back to its original

focus (Lutz et al., 2008). Although this technique is initially quite difficult, over time people become quite good at maintaining their attention on their chosen object.

A second type of meditation is open monitoring (OM) meditation. This technique also uses focused attention to train the mind and to reduce the influence of distractions. After initial training with FA, people can transition into the use of OM styles of meditating. Here, meditators pay attention to moment-by-moment

sensations without focusing on any particular object (Cahn & Polich, 2006). A key feature of OM is to attempt to experience each sensation intensely, examining its rich sensory properties and emotional characteristics in great

depth; however, these sensations should not become the sole focus of attention, preventing the meditator from responding to other sensations.

The idea that the feelings of happiness and relaxation associated with meditation are due, in part, to us becoming more attentive to the present moment and less attentive to our own “stories” has found some support in research performed at

the University of Toronto. Norm Farb and colleagues (2007) used fMRI to examine brain activity in trained meditators and a control group of non- meditators. Participants were asked to take one of two perspectives while

reading lists of positive (e.g., charming) and negative (e.g., greedy) words. During half of the experiment, participants were asked to use a Narrative Focus, which required them to think about what each word meant and how it related to him or her. During the other half of the experiment, participants were asked to use an Experiential Focus, which required them to pay attention to their thoughts and bodily reactions to the words as they happened, but without any judgment or elaboration. If they found themselves distracted by any memories or thoughts inspired by a word, they were to calmly return their attention to the present moment. The results were intriguing: During the Experiential Focus condition (which is quite similar to a meditative state), trained meditators showed a larger decrease in activity in areas of the frontal lobes related to “the self” (the medial prefrontal cortex) than did novices. They also showed increased activity in areas related to the perception of one’s bodily states. These results suggest that meditation does in fact help us separate ourselves from our own narratives and live in the present moment.

Given that numerous other studies have shown that meditation leads to

decreased levels of anxiety (Chen et al., 2012; Hoffman et al., 2011), it is possible that redirecting attention away from our own self-focused thoughts might improve our ability to be happy. Additionally, meditation has been shown to be very effective in reducing blood pressure, which decreases the likelihood of experiencing long-term problems with hypertension and cardiovascular disease

(Rainforth et al., 2007). Taken together, this research suggests that meditation can be used as a method of coping with stress and negative emotions.

Mindfulness-based stress reduction (MBSR) is a structured relaxation

program based on elements of mindfulness meditation. The primary goal of MBSR is to help people to cope and to relax by increasing the link between one’s body and one’s mind. A common meditative technique used in MBSR is a body scan in which participants pay attention to the sensation of their toes, then their feet, ankles, calves, and so on. By attempting to focus on bodily sensations for 15–20 minutes, the participants engage in a great deal of attentional control; if someone’s mind wanders, she is simply asked to bring it back to the body scan without judging herself for the slip-up. During these relaxation exercises, participants are instructed to recognize and become aware of any emotions they may experience, but to then let it go so that the emotion is not part of their

identity. Studies using MBSR have found that it reduces stress (Baer et al., 2012) and increases a sense of meaningfulness in life (Dobkin, 2008). Not surprisingly, MBSR also leads to increased brain activity in the insula, a brain area related to perceiving bodily sensations; this area is involved with a person’s

ability to focus on the present moment (Farb et al., 2013).

Altered brain activity has also been found after people learned a complex form of

meditation called integrated mind–body training (IMBT). This technique, developed from traditional Chinese medicine, involves a combination of relaxation and posture correction, as well as instructions for heightening one’s

awareness of one’s body (Tang, 2011). Similar to MBSR, this technique has been shown to enhance the control of attention (Tang et al., 2007). IMBT has also been linked to an increased ability to control bodily physiology. In one study, researchers compared participants who had completed either five days of IMBT or five days of a simpler relaxation training program. The IMBT group showed lower heart rates, breathing rates, and skin conductance responses (a measure of stress) than did the relaxation training group. These differences appear to be due to activity in a region of the medial (middle) prefrontal cortex called the anterior cingulate gyrus; this area is involved in controlling attention as well as in some emotional responses. In this study, activity within the anterior cingulate was associated with the participants’ increased control over parasympathetic nervous system responses. The increased parasympathetic activity accounted

for the heightened sense of relaxation experienced while meditating (Tang et al., 2009). Interestingly, later studies showed a strengthening of the white-matter connections between the anterior cingulate and emotional structures in the base

of the brain (Tang et al., 2010), suggesting that IMBT can change how different neural regions interact.

Meditation is practised in many cultures, typically to serve the function of promoting health and stress reduction. Tyler Olson/Shutterstock

Although meditation does appear to have a number of health benefits, training procedures like MBSR and IMBT might not be for everyone. However, there is a relaxation technique that many people in your class likely already perform: yoga. According to various organizations, approximately 1.5 million Canadians regularly practise yoga (in one of its many forms). Yoga involves directed breathing while participants move their bodies into specific poses. This voluntary breathing can influence activity in the parasympathetic nervous system, leading

to a decrease in emotional arousal (Sovik, 2000). Consistent with this view, U.S. college students who performed directed breathing had lower levels of physical

and mental stress than did control participants (Cappo & Holmes, 1984). Yoga may also help your immune system; when compared to people in a simple relaxation condition (nature walks and soft music), people who performed yoga had greater changes in gene expression in the immune cells circulating in the

bloodstream (Qu et al., 2013).

Thus, scientific studies of meditation and relaxation training in all their forms appear to confirm their health benefits, and are also bringing us closer to

understanding precisely how these changes to the brain and body help us cope with stress and negativity.

PSYCH@ Church Stress-reduction techniques like mindfulness are sometimes associated with spiritualism, as many arose as part of different Buddhist traditions; however, a belief in a higher power is not a requirement of these techniques. In contrast, many people use religion as their primary coping mechanism during stressful situations, both large and small. They may use any combination of religious practices, depending on the specific nature of the faith: prayer, meditation, religious counselling, and social support from family and congregations. All of these efforts can provide strength and comfort during difficult times, and they may also be associated with greater overall happiness. Many psychologists have become increasingly curious about the possible health benefits associated with religion and spirituality. Numerous studies have found that people who are very religious and are actively engaged with religious practices do, in fact, live a bit longer than do people who are less

religious or nonreligious (McCullough et al., 2000).

A hasty interpretation of these results might lead one to conclude that religion causes people to live longer—that the experiences of prayer and of attending church lead to the greater longevity. However, the studies in this area actually produce correlational, not experimental, data— psychologists cannot randomly assign people to be religious or not. Consequently, we must consider alternative explanations. For example, lifestyle factors are also at play. Younger and older people of Muslim, Jewish, or Christian faith are more likely to engage in healthy behaviours, including wearing seatbelts, visiting the dentist, and avoiding both the

consumption of alcohol and cigarette smoking (reviewed in McCullough & Willoughby, 2009). Religions also tend to have negative views of criminal activity, drug abuse, and risky sexual activity. Thus, the

increased longevity is probably related to the greater self-control and self-regulation that are characteristic of many religious belief systems.

Generally, people who are religious show greater well-being and lower

levels of depression (Smith et al., 2003). The determination of whether religion protects people from depression depends on the point of view taken, however. People who cope with problems using positive aspects of religion (e.g., treating other people with compassion and kindness, as well as collaborating with others in solving problems) are less prone to depression than religious people who adopt negative appraisals of their problems and concerns, such as viewing problems as a result of a

wrathful God’s punishment (Ano & Vasconcelles, 2005; McCullough & Willoughby, 2009).

Exercise Relaxation training and religious study both require discipline; individuals must follow instructions or teachings in a fairly consistent manner. Staying in good physical condition requires similar devotion, and also produces considerable physical and psychological benefits. However, even short bursts of exercise can be useful. For example, researchers in Germany asked university student participants either to do all-out sprints, to jog, or to do nothing. The students who sprinted were able to learn 20% more items on a vocabulary list than the

students who jogged or were inactive (Winter et al., 2007). Why did this occur? Perhaps the sprinters were more motivated than the others. This explanation sounds plausible, but the researchers randomly assigned healthy participants to the three groups—so there should not be anything inherent to the sprinter group that would lead them to learn more words. It appears that the type of exercise they engaged in led to increased cognitive performance. Which physiological processes might account for the cognitive edge the sprinters gained from their intense physical activity? The researchers discovered that the students who engaged in intense exercise had increased levels of dopamine, epinephrine, and brain-derived neurotrophic factor (BDNF) —a protein in the nervous system that promotes survival, growth, and the formation of new synapses.

Cardiovascular exercise also provides immediate benefits in cognitive

processing speed, again as measured in university-aged students (Hillman et al., 2003). But, these immediate benefits of exercise are not limited to younger people. When sedentary adults between 60 and 85 years of age take up weekly exercise, they show improved brain functioning and cognitive performance

(Hillman et al., 2008; Kramer et al., 1999).

Rigorous exercise has positive effects on the brain and on our cognitive abilities, making it well worth the time and effort. .shock/Fotolia

One important issue to address is whether these short-term effects translate into lifelong cognitive benefits from exercise. Results from long-term studies indicate that a lifestyle that includes regular exercise helps preserve cognitive function

and the brain systems that support it (van Praag, 2009). Researchers have found that older people who are at genetic risk for developing Alzheimer’s disease and who show cognitive impairments can slow the rate of memory

decline by exercising (Lautenschlager et al., 2008). It appears that levels of brain chemicals such as BDNF are boosted by exercise, which helps explain the changes in the brain that account for the cognitive benefits. Furthermore, exercise supports the development of new nerve cells in the hippocampus, a

critical area for memory and cognitive activity (van Praag, 2008). Together,

these studies tell us that the benefits of exercise go far beyond helping you look good.

Module 14.3a Quiz:

Coping

Know . . . 1. is the tendency to respond to problems with a pattern of anxiety,

hostility, anger, guilt, or nervousness.

A. A coping style B. Negative affectivity C. Pessimism D. An aggression complex

2. What is brain-derived neurotrophic factor (BDNF)? A. A protein in the nervous system that promotes survival, growth,

and formation of new synapses

B. A calorie-restricted diet that may involve eating approximately 60% of the normal amount of calories, while continuing to take in the needed nutrients

C. A neurotransmitter that reduces stress and increases overall well- being

D. A hormone that is released in those individuals with a healthy diet

Understand. . . . 3. is a positive coping strategy, while is a negative style of

coping.

A. Meditation; resilience B. Pessimistic explanatory style; negative affectivity C. Meditation; alcohol D. Post-traumatic growth; resilience

Apply. . . . 4. Your partner suddenly broke up with you and did not offer an explanation.

If you attribute the breakup to your not being a very outgoing person, you

are demonstrating . A. negative affectivity B. a pessimistic explanatory style C. resilience D. a coping style

Analyze . . . 5. What is the most accurate conclusion regarding the effects of meditation

on stress and well-being?

A. Meditation is the absolute best way to combat stress and protect your body from disease.

B. Advanced training in meditation will decrease stress in a manner similar to simple relaxation techniques.

C. Meditation helps the practitioner control his or her physiological responses, thereby decreasing stress and preventing health problems such as cardiovascular disease.

D. Meditation is not a commonly used way of managing stress.

Perceived Control

As Dr. Pennebaker’s story from the beginning of this module illustrates, the most stressful of circumstances are the ones that people have little or no control over. For example, children who reside in abusive homes have no control over their circumstances, nor do the victims of natural disasters. Each situation can result in people acquiring a sense that their behaviour has little effect on external events.

Laboratory experiments have demonstrated the negative impact that a lack of control has on health and behaviour. A classic example comes from work on avoidance learning in dogs conducted in the 1960s by Martin Seligman and his

colleagues (Seligman & Maier, 1967). In this study, dogs received electrical shocks while strapped into a harness. Half of the dogs learned to press a panel

in order to escape the shock, thus providing them some control over their stressor. The other half of the dogs received the same number of shocks as the first group, but had no control over when the shocks would occur. After a delay, each dog was placed in a device known as a shuttle box consisting of two small areas separated by a low divider that the animal could easily jump across (see Figure 14.10 ). On each experimental trial, a light in the shuttle box was dimmed before the section of the box that the animal was standing on became electrified, thus providing a shock similar to the one experienced in the earlier part of the study. Through trial and error, animals that were in the controllable stress condition learned that they could jump over the divider to the other side of the shuttle box to get away from the shock; after a few trials, this behaviour occurred immediately after the warning tone was presented, which allowed them to avoid the shock altogether. In contrast, the dogs that had experienced the uncontrollable shocks had difficulties learning to escape. Instead, they would lie down, whine, and appear resigned to receive the shock. This finding was

described as learned helplessness —an acquired suppression of avoidance or escape behaviour in response to unpleasant, uncontrollable circumstances.

Figure 14.10 The Learned Helplessness Procedure

In Seligman and Maier’s study, dogs that could avoid a painful shock would quickly learn to do so. Conversely, dogs that initially learned they could not avoid a shock remained passive when the opportunity to do so was given. The acquired failure to avoid or escape unpleasant circumstances that are perceived as uncontrollable is referred to as learned helplessness.

Later studies provided some interesting insights into learned helplessness, with some potentially important implications for how humans respond to stress. Researchers found that stress responses involve nuclei in the brainstem as well as the ventral (lower) regions of the frontal lobes. When a stressful event is controllable (e.g., being shocked, but having a way to escape), the brainstem produces a stress response such as increased heart rate and blood pressure;

however, this response is then inhibited by the frontal lobes (Amat et al., 2005). When a stressful event is not controllable, the brainstem provides a stress response without being inhibited. This finding suggests that the degree to which

a person perceives a stressor to be controllable will influence whether the stress response will be inhibited, and whether the person will experience an event as being stressful.

The important point about learned helplessness is that the animal, or person,

learns that their actions cannot remove the stress in one situation (e.g., the harness) and then generalizes that helplessness to other situations (e.g., the shuttle box). This is similar to the thought processes of some people with depression. People with depression are prone to hold beliefs that their actions have no influence on external events, and that their environment and circumstances dictate outcomes. Learned helplessness also has similarities to anxiety disorders; namely, increased nervousness and a feeling of being unable

to escape a stressor (Maier & Watkins, 2005). Clearly, both aspects of learned helplessness can negatively affect mental and physical well-being. This phenomenon shows that the perception of control can have a dramatic effect on our ability to cope. Without it, many humans and some nonhuman species will endure pain and stress rather than initiating ways to avoid or escape it.

Working the Scientific Literacy Model Compensatory Control and Health

The idea of a random world in which people lack personal control over events can be discomforting. For example, hurricanes and tornados are often referred to as “acts of God,” rather than the result of an unfortunate confluence of meteorological events and human-populated areas. But does having a sense of control lead to better health?

What do we know about how people cope with seemingly random events? Some people feel as if they are the victims of random events, while others believe themselves to be the beneficiaries of the whims of life. However, the idea that randomness dictates worldly events can create anxiety in people. Even if a person believes randomness is the rule, he or she can become highly motivated to find meaning in the world and, through this search, a sense that the course of events is determined by the will of individuals

or God (Kay et al., 2009). In this way, many people cope with stressful life events through compensatory control —psychological strategies people use to preserve a sense of nonrandom order when personal control is compromised (Kay et al., 2009). For example, people who are skeptical of any divine purpose in the world may change their view in the wake of personal or societal tragedy. These observations are primarily correlational, but researchers have conducted experiments to determine causal relationships between sense of control and beliefs about randomness versus orderliness.

How can science explain compensatory control? To study compensatory control, researchers have developed a laboratory task that manipulates people’s sense of personal

control over a situation (Whitson & Galinsky, 2008). In one study, participants completed a concept identification task in which two symbols were presented on a computer screen and the participant had to guess which symbol correctly represented the concept that the computer had chosen (e.g., the colour of the symbol, its shape). The computer provided feedback on whether the participants chose the correct or incorrect symbol after each trial. Half of the participants received accurate feedback, while the other half received completely random feedback—sometimes their correct answers were recorded as incorrect, and vice versa. Participants receiving random feedback reported feeling a lower sense of control on a self-report measure.

Following the concept identification task, the participants then

viewed multiple pictures, such as those shown in Figure 14.11 . If you look closely, you will see that one of the pictures has a horse-like figure in it, whereas the other image has no discernible pattern. Participants in both conditions reported seeing faintly drawn figures, such as the horse. However, participants who had a diminished sense of control induced by the random feedback they received on the computer task were more likely to report seeing patterns within completely random

images (Whitson & Galinsky, 2008).

Figure 14.11 Seeing Images Where There Are None

Do you see a figure in the image on the left? You may see a figure resembling a horse. What about on the right? There is no

discernible image intended for this image. Psychologists have found that individuals who feel as though they lack control are more likely to detect patterns in the image at right than are people

who feel a greater sense of control (Whitson & Galinsky, 2008). Source: From Whitson, J. A., & Galinsky, A. D. (2008). Lacking control increases illusory pattern

perception. Science, 322, 115–117. Copyright © 2008 by AAAS. Reprinted through Rightslink, by

permission of the AAAS.

It appears that when people feel their sense of control is undermined, they compensate by heightening their search for structure in the world, to the point of calling upon their imagination. This is evident in other domains as well, not just detecting patterns in random, snowy images. People also gain a greater need for structure and become increasingly willing to believe in superstitious rituals and conspiracy theories when their

sense of control is diminished (Figure 14.12 ; Kay et al., 2009; Whitson & Galinsky, 2008).

Figure 14.12 Exercising Compensatory Control

When people feel as though they lack control over the world, their need for structure, perceptual order, and beliefs in superstition and conspiracies increases. Participants who perceived that they

were in control of events were unlikely to see images in snowy pictures (see Figure 14.11 ) and did not hold superstitious beliefs or endorse conspiracy theories. When people perceived that they had lost a sense of control during the experimental procedure, they reported a greater need for structure, perceived images in random arrays, became more superstitious, and

endorsed conspiracy theories (Whitson & Galinsky, 2008). Source: Based on data from Whitson, J. A., & Galinsky, A. D. (2008). Lacking control increases

illusory pattern perception. Science, 322, 115–117.

Can we critically evaluate this evidence? A major advantage of the study described here is that the researchers were able to experimentally induce a perceived lack of control in the participants who received random feedback on their performance on the computerized task. The observation that these participants then perceived images within randomness and showed a heightened belief in superstition and conspiracies may help to explain how people respond to lost control outside of the laboratory. Of course, one limitation is that a real-world lack of control, such as that which occurs in the face of a natural disaster or the loss of a job, has far greater consequences. Thus, as with any laboratory experiment, there is a limit to the degree to which the results generalize.

Why is this relevant? Having a sense of control greatly affects how we think about and interpret the world. In addition, it affects our health. Individuals who believe they can predict and influence present and future events tend to have improved physical and mental well-being compared to people who believe the opposite. For example, patients who are scheduled to undergo medical procedures, such as a colonoscopy, have reduced anxiety for the procedure if they are given clear, informative tutorials about the procedure before it

occurs (Luck et al., 1999).

Researchers have found that when people perceive that they have lost a sense of control during an experimental procedure, they report a greater need for structure, perceive images in random arrays, become more superstitious, and endorse

conspiracy theories (Kay et al., 2009). These researchers have also suggested that religion is sometimes used as a form of

compensatory control (Kay et al., 2010). What do you think?

People may also compensate for their lack of control by

performing superstitious rituals, which can provide a sense of at least partial control over outcomes. This can be seen in everyday examples, such as among athletes who follow the same steps when preparing for a game, as well as in extreme, maladaptive forms, such as in obsessive–compulsive disorder (covered in Module 15.3 ).

Module 14.3b Quiz: Perceived Control

Know . . .

1. is an acquired suppression of avoidance or escape behaviour in response to unpleasant, uncontrollable circumstances.

A. Compensatory control B. Learned helplessness C. Coping D. Resilience

Understand . . .

2. People often turn to religion to explain natural disasters. This behaviour demonstrates the concept of .

A. compensatory control B. learned helplessness C. coping D. resilience

3. A mentally healthy person who is prone to claiming that patterns exist where there are none

A. is showing negative affectivity.

B. is showing signs of post-traumatic growth. C. probably feels a lost sense of control over a problem or situation. D. has a pessimistic explanatory style.

Module 14.3 Summary

biofeedback

brain-derived neurotrophic factor (BDNF)

compensatory control

coping

learned helplessness

meditation

mindfulness-based stress reduction (MBSR)

negative affectivity

optimism

pessimism

pessimistic explanatory style

post-traumatic growth

resilience

Psychologists have discovered that people (and dogs) become more willing to allow unpleasant events to occur if they learn (or believe) that their behaviour brings no change. Having at least some degree of control helps people (and

14.3a Know . . . the key terminology associated with coping and well-being:

14.3b Understand . . . how control over the environment influences coping and outlook.

dogs) cope with these events. When control is threatened, people use compensatory responses, such as detecting order within random images.

Whether someone copes using a positive or negative style is related to personality (e.g., optimism versus pessimism). Positive coping includes the concept of resilience—the ability to recover from adversity, and even benefit from the experience, as is the case with post-traumatic growth. Coping via negative affectivity and pessimism can have both psychological and physiological disadvantages.

Apply Activity

For each of the following four situations, try to think of both a pessimistic and an optimistic way of interpreting the event.

1. You find out that you are one of four people to be scheduled for an interview for a job you really want.

2. Your flight home from Europe is overbooked, so your return home is delayed by a day.

3. Your car has a flat tire and you have to bike 10 km to get to school in time for your 10 a.m. class.

4. Your friend decides to stop attending the kickboxing class that you really enjoy.

How did you feel after each optimistic and pessimistic interpretation? Did you feel better after putting a positive spin on things?

14.3c Understand . . . positive and negative styles of coping.

14.3d Apply . . . your knowledge of the beneficial effects of optimism to help you reframe stressful situations as positive opportunities.

14.3e Analyze . . . whether activities such as relaxation techniques, meditation, and biofeedback actually help people cope with stress and problems.

Meditation and other relaxation methods have been found to be quite effective in reducing stress. While some training and practice may be necessary, these techniques are by no means inaccessible to those who are motivated to pursue them.

Chapter 15 Psychological Disorders

15.1 Defining and Classifying Psychological Disorders Defining Abnormal Behaviour 616

Working the Scientific Literacy Model: Labelling and Mental Disorders 619

Module 15.1a Quiz 621

Applications of Psychological Diagnoses 622

Module 15.1b Quiz 623

Module 15.1 Summary 623

15.2 Personality and Dissociative Disorders Defining and Classifying Personality Disorders 625

Working the Scientific Literacy Model: Antisocial Personality Disorder 626

Module 15.2a Quiz 628

The Biopsychosocial Approach to Personality Disorders 629

Module 15.2b Quiz 629

Dissociative Identity Disorder 630

Module 15.2c Quiz 631

Module 15.2 Summary 631

15.3 Anxiety, Obsessive-Compulsive, and Depressive Disorders Anxiety Disorders 634

Working the Scientific Literacy Model: Specific Phobias 635

Module 15.3a Quiz 638

Mood Disorders 639

Module 15.3b Quiz 643

Module 15.3 Summary 643

15.4 Schizophrenia Symptoms and Types of Schizophrenia 645

Module 15.4a Quiz 647

Explaining Schizophrenia 648

Working the Scientific Literacy Model: The Neurodevelopmental Hypothesis 649

Module 15.4b Quiz 651

Module 15.4 Summary 652

Module 15.1 Defining and Classifying Psychological Disorders

MPI/Archive Photos/Getty Images

Learning Objectives

Know . . . the key terminology associated with defining and classifying15.1a

Over the centuries, our understanding of psychological disorders has come a very, very long way. In the Middle Ages, people who we would now consider “mentally ill” may have experienced a wide range of reactions from society. They may have been viewed as possessed and requiring religious exorcism or even torture. The reason for these extreme responses was that many people in this era believed that that individuals who exhibited unusual behaviours (such as responding to voices that no one else heard or having hallucinations) were under the

sway of evil spirits inhabiting their bodies (Hunter & Macalpine, 1963).

By the 16th century, this belief was part of the witch scares, which for at least two centuries created mass paranoia as the public sought protection from witches, who were believed to gain their power through an allegiance with the devil. Armed with the Malleus Maleficarum (Hammer of the Witches), a 1486 German text filled with detailed instructions for identifying witches, countless people were subjected to “tests,” such as looking for the “Devil’s mark” on the body, a visible spot such as a mole or birthmark that could be interpreted as a sign of allegiance with the Devil.

“Treatments” for mental illness were directly based on this model of illness (i.e., possession by evil). Brutal imprisonment, torture, and demon exorcism were not designed with human psychology in mind. Their goal was not to rehabilitate dysfunctional thoughts, emotions, and behaviours. Rather, the focus was on driving the demon out of the person’s body, or simply executing them, as in the witch-hunting craze that saw the execution of tens of thousands of innocent people (almost all of whom were women).

psychological disorders. Understand . . . advantages and criticisms associated with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Apply . . . your knowledge of the mental disorders defence to decide if defendants are criminally responsible for their actions. Analyze . . . whether the benefits of labelling psychological disorders outweigh the disadvantages.

15.1b

15.1c

15.1d

Thankfully, times have changed.

Focus Questions

1. Are psychological disorders fundamentally different from physical illnesses, or should we view them the same way?

2. Which guidelines or criteria allow psychologists to diagnose a mental disorder such as post-traumatic stress disorder (PTSD)?

One of the defining characteristics of these early responses to psychological disorders was the desire to identify people who were different. In some cases, these differences really were a cause for concern, with some individuals being a danger to themselves or to others. However, as you just read, many of the people identified as being mentally ill were simply different in some, often minor, way. Although these witch hunts tell us more about the psychological state of the “hunters” than the “witches,” they also highlights an issue that still influences psychological care today: What makes a behaviour or characteristic “abnormal?”

Defining Abnormal Behaviour

As the ascension of scientific thought began to displace the religious domination of the Middle Ages, explanations for mental illness shifted from demon

possession to physical illnesses. Asylums , residential facilities for the mentally ill, were set up across Europe, with the general goal of curing the patients’ bodily afflictions that gave rise to their symptoms. Their treatments would certainly not meet modern standards of medical care and were generally ineffective, such as draining up to 40% of a person’s total blood volume! There were even treatments such as throwing the person into a pit of snakes. As unbelievable as that seems (not to mention how difficult it would be for doctors to make house calls. . .), the hope was to shock the person out of their diseased

state (Szasz, 2006).

A fortunate change in society’s approach to treating mental illness came with the courageous activism of two heroic figures, Philippe Pinel, a physician in France,

and Dorothea Dix, a schoolteacher in the United States (see Module 16.1 ). Their tireless advocacy for the mentally ill led to widespread reforms that

ushered in a new approach, called moral treatment, which led to patients being treated with kindness and decency, able to roam the hospital halls and get outside for fresh air. However, there were still virtually no effective treatments, and many people afflicted with mental illness were permanently incarcerated.

By the 1950s, approximately 66 000 people were in psychiatric hospitals in

Canada (Greenland et al., 2001). Things began to change in 1955 when the drug chlorpromazine (also known as Thorazine) was introduced. Suddenly, people with schizophrenia and other disorders involving being “out of touch” with reality were able to function independently, even holding down jobs and living at home with their families. The success of chlorpromazine and other medications

led to widespread deinstitutionalization , the movement of large numbers of psychiatric in-patients from their care facilities back into regular society, which led to a drop in the number of psychiatric inpatients by over 80% over the next

three decades (Torrey, 1997).

The return of hundreds of thousands of people to regular life had its down sides, however. Many former in-patients quit their medications, slipped back into their disorders, and became homeless. Also, although the treatments at this time were

effective in improving many people’s symptoms, they were not cures. Many challenges remained in reintegrating people with schizophrenia and similar disorders into their families and communities.

Unfortunately, helping people reintegrate into regular life was not a central part of the psychiatric approach to treating mental illnesses. Instead, the guiding paradigm for mental health and mental illness is the medical model, which has

held sway since the end of the Middle Ages. The medical model sees psychological conditions through the same lens as Western medicine tends to see physical conditions—as sets of symptoms, causes, and outcomes, with

treatments aimed at changing physiological processes in order to alleviate symptoms. Through this lens, psychological disorders such as depression, anxiety disorders, or autism can be approached in the same manner as conventional medicine would approach diabetes or cancer. What the medical model is generally missing is an appreciation for the whole system of factors that affects the person’s overall functioning.

In recent decades, the medical model has begun to give way to the biopsychosocial model, which includes physiological processes within a holistic

view of the person as a set of multiple interacting systems (Table 15.1 ). For example, depression involves biological factors (e.g., serotonin transmission in the brain), psychological factors (e.g., negative beliefs about the self), and social factors (e.g., relationship rejection and social isolation). Understanding the multiple systems that underlie disorders such as depression gives us greater insight into how to develop more effective treatments; in particular, it becomes easier to see how important it is to use convergent treatment approaches, treating more than one system at a time so as to affect the person’s overall

functioning (see Module 16.2 . and 16.3 ).

Table 15.1 Biological, Psychological, and Sociocultural Factors Influence Both Physical and Mental Disorders

Diabetes Major Depression

Biological Genetic influences on pancreatic

function; excessive refined sugars

Genetic influences on

neurotransmitter production

and function; sleep

disruption; lack of positive

emotional arousal

Psychological Poor food choices; sedentary

lifestyle; alcohol abuse

Negative self-concept;

pessimism; negative life

experiences

Sociocultural Familial and cultural foods and

traditions; limited budget for

Lack of social support; social

withdrawal; lack of

groceries; lack of physical and

nutritional education in schools; lack

of role models

psychological services;

stigma regarding

psychological treatments

What is “Normal” Behaviour?

One of the thorniest problems in the mental health field has always been how to reliably identify who has a mental disorder in the first place (if a disorder is even

a thing that you can have). Given the immense range of apparently normal human behaviour and experience, how can we determine what is abnormal?

You might expect that it would be simple to decide whether or not someone has a disorder—you just have to figure out whether or not they are “normal.” However, one of the main insights we have gained as a global society is just how different “normal” can be from different perspectives. “Normal” can be owning slaves, or it can be speaking in tongues during a religious ceremony; it can be living in fear of being shot by an opposing gang or army, or it can be taking part in village dances where everyone links arms and dances together while mostly naked. Or, it can be sitting quietly in a coffee shop reading a psychology textbook.

It is amazing to pause for a moment and think about this diversity, and how, from the perspective of the people living in a particular culture, their practices seem

perfectly normal and even right (the way things should be); but from outside that cultural framework the same practices may seem strange or even absurd. The

same applies to individuals—what makes sense from your perspective may not make sense to others. “Normal” proves to be very elusive indeed.

This creates a real challenge for the clinical psychologist, who tries to determine whether a person’s behaviour and experience are abnormal enough to warrant treatment, and furthermore, what specifically has gone wrong to make them this way, and how it can be fixed. The clinician has to use some sort of perspective as a framework; she has to judge the person’s behaviour against some sort of

standard. But what should that be? How can this be done without injecting too much bias from the clinician’s own perspective?

The key criterion used by psychologists in deciding whether a person has a disorder is whether the person’s thoughts, feelings, or behaviours are maladaptive , meaning that they causes distress to oneself or others, impairs day-to-day functioning, or increases the risk of injury or harm to oneself or others (American Psychiatric Association, 2013). However, there are many exceptions to this guideline. Some behaviours fulfill these criteria but do not necessarily indicate mental illness. Consider the following:

Heavy drug users and people with psychopathic tendencies may not think they have a problem.

Family members may be concerned about a person’s involvement in a new relationship, or may disapprove of body modifications such as tattoos or piercings.

Mourning the loss of a loved one or having a religious conversion may interfere with one’s day-to-day activities.

Activists may get arrested for protesting government actions and extreme sports enthusiasts may risk death or injury out of passion for their sport.

Obviously, the criteria for determining whether a given behaviour should be viewed as a disorder are not perfect and cannot account for all circumstances. But, generally speaking, when a person’s behaviour and experi ­ence start to become significantly dysfunctional, there may be cause for concern. In order to make more specific diagnoses and determine exactly what type of disorder a person may have, mental health professionals rely on a carefully designed system.

Psychology’s Puzzle: How to Diagnose

Psychological Disorders

The attempt to develop a rigorous system for diagnosing mental illness goes back to at least 1840, when the U.S. government wanted to collect data on

mental illness in the country and included in the official census a single category to denote mental illness: “idiocy/insanity.” (Apparently, sensitivity had not yet been invented.) By 1917, this had evolved into a guide for mental hospitals, called the “Statistical Manual for the Use of Institutions for the Insane.” In World War II, American psychiatrists were hired in large numbers by the U.S. military to aid in the selection of soldiers and to treat mental disturbances resulting from military duty.

Building on the military’s diagnostic system, as well as the sixth edition of the

World Health Organization’s International Statistical Classification of Disease (which included mental disorders), the American Psychiatric Association created

the Diagnostic and Statistical Manual of Mental Disorders (DSM) , a standardized manual to aid in the diagnosis of disorders; this edition described the symptoms of 106 different mental disorders. The purpose for developing the DSM was to provide mental health workers with a reliable method for diagnosing mental illness and to ensure consistency across different institutions and hospitals.

It is worth noting that from the very beginning, the DSM was rooted in a psychobiological view, which argued that mental disorders represented an individual’s specific reactions to psychological, social, and biological processes. However, other emphases changed over the years, from an initial focus on psychodynamic views to a later focus on cognitive and biological perspectives. By the mid-1990s, the DSM had gone through several revisions and was expanded to include over 350 different disorders.

Why are there now almost four times as many disorders than there were half a century ago? The answer to this question may depend on your perspective. Some would argue that improvements in clinical science have enabled us to better diagnose people, and the new disorders are entirely valid categorizations of symptoms. Another more disturbing possibility is that the creation of ever- more cate­gories of disorders has been engineered in part by pharmaceutical companies as a way of increasing the number of disorders people will need to be treated for. This topic has become a battlefield between those who believe science continually improves our understanding of mental illness, and those who

believe that more aspects of human experience are being described as medical “conditions” in order to feed the profits of pharmaceutical companies.

Whatever the ultimate reason, the DSM remains the standard reference manual in the mental health field, particularly in North America. The latest edition, the DSM-5, was published in May 2013. In order to aid in the process of diagnosis, the DSM-5 describes three important pieces of information for each disorder: a set of symptoms and the number of symptoms that must be met in order to have

the disorder; the etiology (origins or causes) of symptoms; and a prognosis or prediction of how these symptoms will persist or change over time.

Critiquing the DSM

The DSM has received its share of criticism over the years. The central issue is, essentially, that there are no perfect ways of measuring psychological disorders. Psychologists and psychiatrists don’t have precise tools, like litmus tests in chemistry that can tell you precisely whether something is an acid or a base. Instead, the diagnostic process is highly subjective, involving human subjects and human clinicians trying to make sense of a messy, ever-changing, set of subjective impressions. In order to try to help clinicians cut through some of this confusion, the DSM offers lists of specific symptoms that are indicative of specific disorders. This is an attempt to make the diagnostic process more objective, which should decrease the likelihood that diagnoses are based on individual clinicians’ biases.

Unfortunately, this doesn’t entirely solve the problem for many reasons. For one, a clinician still has to subjectively decide whether a client displays each symptom

and whether it is severe enough to be considered a symptom or just normal experience. For example, at what precise point does “depressed mood” pass out of the range of normal experiences (we’re all sad sometimes and go through difficult periods in life), and into the pathological range? Another problem is that different disorders often share many common symptoms; as a result, different mental health professionals might make different diagnoses. The DSM was created, in large part, to help making the process of diagnosing a disorder more objective and reliable, but the very nature of human experience is often

subjective, vague, and unreliable.

An additional weakness of the DSM is that there is a fine, and essentially arbitrary, line between whether a person is considered to have a disorder or not. For each disorder, the DSM provides a list of possible symptoms and guidelines as to how many of the symptoms the person must have before being given the diagnosis. If a person seems to have the necessary number (e.g., five out of nine possible symptoms), then he has the disorder, but with one symptom less, he doesn’t. In practice, what this means is that the diagnosis a person receives, and even whether a person receives any diagnosis at all, can depend on a single symptom. This obviously creates a major accuracy problem.

The DSM, by its very existence, also implies that disorders can be objectively defined; the DSM has a lot of authority, and if a set of symptoms is given a diagnostic label, people conclude that there is a real disorder, like a sickness or a disease, that people can “get.” This way of thinking has contributed to the stigmatization of mental illness, and has added to the discomfort and resistance people feel towards the mental health field. It has also led to serious problems when the biases and norms operating in a particular time and place get expressed as scientific fact. For example, in some early versions of the DSM, homosexuality was considered a disorder. Psychologists feel differently now about the diversity of normal sexual experience, and this is reflected in the DSM- 5. However, this example does lead one to wonder whether some patterns of behaviour that are currently considered pathological are defined that way because of biases that we hold.

Critics also express concern that giving mental health workers more labels with which to diagnose clients is not necessarily a good thing and may lead to over- diagnosis. For example, consider attention deficit/hyperactivity disorder (ADHD), which is commonly applied to children who have problems adjusting to elementary school (especially boys, who are at least three times more likely to

be diagnosed with ADHD than girls; Barkley, 1998). Since being included in the DSM, ADHD diagnoses have skyrocketed, although only in North America (in Europe, ADHD only seems to occur 10% as often). Estimates of the prevalence

of ADHD range from the most common rate of 3–5% up to about 20% (Shaywitz

& Shaywitz, 1991).

Critics charge that the handy availability of the ADHD diagnosis makes it too easy to label children as having a “condition” and then medicate them. Studies have shown that between 20% to 70% of children diagnosed with ADHD no

longer met the criteria once they reached adulthood (Weiss & Hechtman, 1993); this raises the possibility that many children are being medicated for what is, essentially, normal development.

Perhaps one solution for improving the diagnostic accuracy of the DSM—both in general and for ADHD specifically—is to develop more objective, biological indicators such as genetic markers, indicators of neurotransmitter dysfunction, or brain abnormalities, that are involved in the symptoms and functional deficits experi ­enced by the individual. These efforts are underway, although the field has a long way to go before such biological markers can be substantially

incorporated into diagnostic criteria (Hyman, 2007).

The Power of a Diagnosis

The long-term effects of receiving a specific diagnosis can be substantial. To continue the example of ADHD, for most children, by the time they get assessed for this condition, they will have experienced an accumulation of problematic behaviours— getting in trouble for being restless or misbehaving in class, forgetting to do homework, interrupting frequently during conversations, not paying attention, and falling behind in school. Imagine how welcome such a diagnosis would be, especially perhaps to the parents or teachers who would appreciate having something (like medication), that can help the child function more effectively, or at the very least, become easier to manage.

However, as you have seen, diagnosing disorders is not always a simple task. Imagine, for example, a person with a considerable amount of anxiety, odd behaviour patterns, and a strong need to control the environment, who is evaluated by a clinician in early adulthood when these patterns are just starting to develop. Depending on exactly what had been happening in that person’s life and recent experiences, coupled with that clinician’s particular biases and ways

of interpreting things, several different diagnoses might be possible ranging from

personality disorders (Module 15.2 ) to anxiety disorders or obsessive- compulsive disorder (Module 15.3 ). Or, the person could be deemed to not have a disorder or to be sub-clinical, meaning that his symptoms do not quite meet the criteria for diagnosis. What happens after this point may differ dramatically, depending on the diagnosis. The person may enter treatment programs or take medications for quite different disorders, or the person may not have sufficiently met the criteria for a disorder and may not get the help she needs. Small differences in initial diagnosis can lead to big differences in long- term treatment and outcomes.

An additional concern is that once a person has been labelled as having a disorder, the label itself may change how that person is viewed by others, and how subsequent behaviours are interpreted.

Working the Scientific Literacy Model Labelling and Mental Disorders

What are the outcomes of diagnosing a person as having a particular disorder? On the positive side, it is hoped that receiving a diagnosis should make people more likely to seek and receive effective treatment. Also, a diagnosis should facilitate communication among mental health professionals: A label indicates a set of symptoms, probable causes, and potential treatments, thus summarizing and highlighting the important pieces of information that will be useful for treating the person. However, these diagnostic labels can also have their drawbacks, such as biasing how people will subsequently interpret the person’s actions or experiences, or changing how people feel about themselves.

What do we know about how labels affect people? It is important to put the following information in the proper

context, which is the recognition that diagnostic labels can be very helpful; they can help people understand their experiences and communicate in a standardized way with whoever they may need to as they manage their symptoms and navigate the mental healthcare system. However, it is also, unfortunately, the case that being labelled with a mental illness can potentially damage a person’s material, social, and psychological well-being in a

variety of ways (Link et al., 1989; Rosenfield, 1997).

For example, seeing oneself as mentally ill can be associated with low self-esteem or feelings of helplessness. In some cases, a diagnosis may lead a person to indulge in even more extreme or destructive behaviour patterns. Because of stigma and negative attitudes towards the mentally ill, people may expect that other people will reject and devalue them. This may lead them to withdraw from social contact and fail to seek the support

that could help them (Kroska & Harkness, 2006; Link, 1987). People may also become demoralized about their capabilities and themselves in general, which then interferes with their motivations and goal-related striving. Sadly, in a classic self- fulfilling prophecy, the long-term effects can be that people end up experiencing the social rejection and stigmatization they

initially feared (Kroska & Harkness, 2006). In short, diagnostic labels are supposed to help; but they have the potential to cause harm as well. This doesn’t necessarily mean we should stop using diagnostic labels; but it does mean that we should be especially concerned about using them accurately.

How can science explain how labels may affect perceptions of another person’s behaviour? One of the most surprising and daring studies ever conducted in psychology occurred in the early 1970s, when eight people, volunteering with David Rosenhan, decided to get themselves committed to psychiatric hospitals. None of the eight were experiencing any symptoms of mental illness, but when they went

to their doctors and complained that they were hearing voices, they received diagnoses for schizophrenia or bipolar disorder (a

mood disorder discussed in Module 15.3 ), and were admitted to a psychiatric hospital for observation and treatment. Once they were in the hospital, the challenge was to convince the doctors that there was, in fact, nothing wrong with them and they could be released back to their regular lives.

Once admitted, the volunteers exhibited no further symptoms and simply tried to behave “normally.” Nevertheless, their behaviours were often interpreted as abnormal in some way by their doctors, so that even normal behaviours such as asking a question to a doctor, or talking about one’s relatively normal childhood, would be interpreted as abnormal by doctors or hospital staff. Despite the volunteers’ best efforts to be released, it took from seven to 59 days for their doctors to be convinced their symptoms were in remission; interestingly, in that time period, they were also given a total of 2100 pills to take (which they merely pretended to take but were able to dispose of when nobody was looking)

(Rosenhan, 1973).

Can we critically evaluate this information? It is tempting to ask whether the labels applied to psychological disorders are beneficial or harmful, but this question may actually oversimplify the situation. For one, the advantages of this system are clear for professionals: Labels are a necessary means of identifying and describing the problems they encounter. There is also evidence to suggest that labels help individuals understand their own situation and offer hope for successful treatment. Some psychologists who are in favour of labels have argued that Rosenhan’s study failed to address the larger issue of labels because the symptoms he used were so marked and severe. Auditory hallucinations are such a hallmark of disorders such as schizophrenia that it would be virtually impossible, perhaps even irresponsible, for a doctor to fail to diagnose an appropriate

disorder and to use this diagnosis in judging the person’s subsequent behaviours. Thus, it seems that labels can be both helpful and harmful in certain instances. In an ideal world, we would be able to keep the labels and get rid of the stigma. This may not be entirely possible, but it is a goal for psychologists and the community to work toward.

Why is this relevant? Many of the potential costs or risks associated with being diagnosed with a psychological disorder stem from the more general problem of stigma toward mental illness. Researchers from a number of academic areas have identified some techniques that work in reducing stigmatization. For example, research shows that personal contact and knowledge of biopsychosocial explanations of mental illness are associated with a more accepting attitude toward people with psychological

disorders (Boyd et al., 2010).

Education seems to matter, too: When individuals are instructed about the first-person experience of mental illness, they show greater acceptance than groups that simply learn the facts about

mental illness (Mann & Himelien, 2008). A student organization known as Active Minds operates on university and college campuses in several countries including Canada and the United States and has had success in reducing the stigma associated

with mental illness (McKinney, 2009). Keep these findings in mind as you read the rest of this chapter. As an informed student, you will be less likely to judge others and more likely to seek help yourself, or to recommend it to others, if it is ever needed.

The idea of examining behaviour from a biological, psychological (cognitive), and social perspective is a pervading theme in psychology and in this text. This biopsychosocial model is particularly important in clinical psychology. Some

disorders are more common in some cultures than in others. The specific symptoms of these disorders can also vary. Whether these differences are due to genetic differences, cultural biases, or a combination of many factors is an important area of research in psychology.

Biopsychosocial Perspectives Symptoms,

Treatments, and Culture Psychological disorders may not present the same across different cultures, and a lack of appreciation for these cultural differences can

potentially lead to misdiagnoses. For example, post-traumatic stress disorder (PTSD) is a common psychological illness involving recurring thoughts, images, and nightmares associated with a traumatic event; it induces symptoms of tension and anxiety and can seriously interfere with many aspects of a person’s life. PTSD affects almost 10% of the Canadian population at some point in their lives (Van Ameringen et al., 2008). Given that it seems unlikely that the world will stop having disasters, wars, and violence, PTSD will likely be an unfortunate companion for many on the road of life.

Despite the seemingly universal physiological symptoms of PTSD, researchers have found interesting differences in the cognitive and emotional symptoms between different groups. For example, people who experienced trauma in the U.S.-led war in Afghanistan and the 2004 tsunami in the Indian Ocean showed somewhat different symptoms, depending on whether they were Americans or natives to the region (i.e., Afghans during the war, or Sri Lankans during the tsunami). Americans tended to report difficult internal experiences such as flashbacks, whereas Afghans and Sri Lankans were more likely to experience worries about the welfare of their families and communities. Thus, recurring personal flashbacks seem to be more of an individualistic phenomenon, whereas recurring worries about others seem to be more

of a collectivistic phenomenon (Fernando, 2008; Miller et al., 2006). Factoring such cultural differences into diagnostic research and practice

is an ongoing challenge.

Cultural differences play a role in treatments as well. For example, one of the more controversial possible breakthroughs in the treatment of PTSD involves psychological therapy combined with carefully prescribed doses of MDMA (the psychoactive component in the street drug ecstasy). Thus far, MDMA, in combination with psychological therapy, has proven to be an effective treatment for cases of PTSD that resist other forms of

treatment (Mithoefer et al., 2013; Oehen et al., 2013). The effectiveness seems due to multiple mechanisms. For example, the oxytocin release induced by MDMA helps with the emotional bonding and trust that is essential to the therapeutic alliance between therapist and client (see Module 16.1 ), and the effects on serotonin seem beneficial for helping to reduce the anxiety that is key to PTSD. In short, MDMA helps people attain an open and secure state of mind so that they can more effectively face the trauma and begin to address, through therapy, the reactions it provokes.

Of course, there are large cultural and sub-cultural differences in the acceptance of drugs such as MDMA, which is illegal in North America. Therefore, it is unclear whether this treatment option will become available to patients with PTSD.

Survivors of major disasters are at risk for developing PTSD. Cultural factors influence the nature of the anxiety that people experience in the

wake of such disasters. Hou Yu/ZUMAPRESS/Newscom

Module 15.1a Quiz:

Defining Abnormal Behaviour

Know . . . 1. Rosenhan’s classic study “On Being Sane in Insane Places” showed that

A. psychiatric institutions actually make disorders more likely, because they reinforce odd behaviour and they offer ready-made labels that people use to “pathologize” themselves.

B. therapists who come from a Freudian, psychoanalytic background can easily be tricked into believing people have a disorder that they do not in fact have, whereas therapists who are trained in modern cognitive-behavioural therapy do not make this same mistake.

C. once people have been labelled with a specific disorder, this will change how other people interpret their behaviour and behave toward them.

D. the presence of a mentally healthy person in a group of mentally ill patients can dramatically improve the functional scores of the patients.

Understand . . . 2. Which of the following is a problem with the DSM?

A. There is no objectively definable line separating normal from abnormal; thus, determining whether a person has a disorder or not relies upon criteria for distinguishing normal from abnormal, and those criteria are essentially arbitrary.

B. The construction of the DSM may reflect the influence of the pharmaceutical industry.

C. It may lead to over-diagnosis, because it provides diagnostic labels that can be appealing to people for a variety of reasons (such as offering hope that treatment is possible or making a child’s behaviour more manageable).

D. All of the above are potential issues with the DSM.

3. Which of the following is not a psychiatric criterion for mental illness? A. Expression of behaviour that causes distress to self or others B. The condition must be categorical C. Impairment of functioning D. Increased high-risk behaviour (e.g., drug use, speeding)

Apply . . . 4. Which of the following statements about PTSD is true?

A. People of all cultures experience the exact same concerns after trauma.

B. Some cultures are immune to stress reactions. C. Physiological symptoms of PTSD may be common among people

of different cultures, but the specific concerns people have can vary.

D. PTSD occurs only in cultures that use a medical model.

Applications of Psychological Diagnoses

Perhaps one of the most important things to appreciate about psychological disorders is that there is no perfect test for identifying them. Being able to reliably diagnose particular disorders is a central and ongoing challenge to the mental health fields, and has an impact on problems that range from getting individuals the treatment they need to assessing criminal responsibility in the legal system. The fact that our measurements of psychological disorders are not nearly as accurate as we would like makes these issues even more difficult to deal with. In many cases, we cannot even say with confidence whether someone is mentally ill and what psychological illness or disorder they have.

The Mental Disorder Defence (AKA the Insanity

Defence)

This lack of diagnostic accuracy plays a big role in the criminal justice system. You have no doubt heard that in some trials a defendant will plead “not guilty by reason of insanity.” The legal reasoning behind a person being defined as legally

sane (i.e., criminally responsible) or not, is based on the M’Naghten rule, which goes all the way back to 1843 in Great Britain. Daniel M’Naghten assassinated the Prime Minister’s secretary, but the jury was convinced that he was not guilty. They believed that he had been incapable of knowing that what he did was wrong, so M’Naghten was committed to a mental institution, and the plea “not guilty by reason of insanity” entered the legal profession.

In Canada, the insanity defence is now referred to as the mental disorder defence . This defence does not deny that the person committed the offence, but claims that the defendant was in such an extreme, abnormal state of mind when committing the crime that he or she could not discern that the actions were legally or morally wrong. For example, a person could cause a car accident or commit murder when in a severely dissociated state, such as could occur due to schizophrenia. Applying the mental disorder defence is extremely tricky, and indeed, it is rarely used. One study showed that this defence is used in less than 1% of cases in Canadian courts and it has a success rate of less than 25%

(Maxwell, 2015).

Whether or not we can objectively and accurately measure “sanity” is extremely important, as it could be the deciding factor in whether a person becomes a convicted felon or receives psychiatric treatment. However, determining whether or not a person was “sane” when they committed a crime is not an easy thing to do.

Consider two well-known Canadian examples of the mental disorder defence. In 2006, in Barrie, Ontario, Elaine Campione drowned both of her daughters (aged 3 years and 19 months) in a bathtub. At the time, she was involved in a custody battle with her ex-husband. Elaine had been diagnosed with a variety of

psychological disorders and suffered delusions including that others were trying to steal her children. Her lawyer argued that she was not criminally responsible for her actions, but the Crown countered that even though she was mentally ill, her particular disorders did not prevent her from knowing right from wrong. She was convicted of first-degree murder (Supreme Court of Canada, 2011).

In Edmonton, Alberta in 2013, Nerlin Sarmiento drowned her 7-year-old son in a bathtub. Her lawyer argued that she was so deeply overwhelmed by a major depressive episode that was part of her bipolar disorder that she had become convinced that she was actually rescuing her son from a life of poverty and suffering, and believed that killing him was an act of mercy and kindness. In this case, the courts decided that Nerlin was not criminally responsible for her son’s death, and required her to receive psychiatric treatment rather than going to jail

(CBC News, 2013).

The critical issue, legally speaking, is whether the person was, at the time of committing the crime, capable of knowing that what they were doing was wrong. The Courts decided that Elaine Campione knew what she was doing was wrong, whereas Nerlin Sarmiento did not. Cases such as these show both the importance of psychology to the legal system and the difficulties associated with understanding a defendant’s mental state. They also highlight the importance of accurately diagnosing a patient’s condition.

Module 15.1b Quiz:

Applications of Psychological Diagnoses

Know . . . 1. The standard used to judge whether a defendant was capable to knowing

that what he or she did was wrong is known as the

A. McLaughlin rule. B. M’Naghten rule. C. Criminal Responsibility law. D. Law of Effect.

Understand . . . 2. As described in this section, in the legal system the term “insanity”

A. is itself a psychological disorder. B. describes a person with any psychological disorder. C. is not recognized. D. means that an individual could not distinguish between right and

wrong when he or she broke a law.

Module 15.1 Summary

asylums

deinstitutionalization

Diagnostic and Statistical Manual of Mental Disorders (DSM)

etiology

maladaptive

medical model

mental disorder defence

post-traumatic stress disorder (PTSD)

Using the DSM-5 ensures that all psychologists and psychiatrists are using the same criteria to define different psychological disorders; this improves the reliability and consistency of psychological diagnoses. However, the DSM-5 has faced many criticisms. First, psychologists need to decide if a symptom is severe enough to warrant treatment. Second, the number of symptoms that must be present before a disorder is diagnosed seems somewhat arbitrary (e.g., five out of nine possible symptoms). Third, although the large number of possible

15.1a Know . . . the key terminology associated with defining and classifying psychological disorders.

15.1b Understand . . . the advantages and criticisms associated with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

disorders may make it easier for mental health workers to make a diagnosis, it may also lead to unnecessary diagnoses. Finally, there is currently a need for more biological or genetic markers to be added to the diagnostic criteria for many disorders.

The legal consideration of “sanity” hinges on whether a person who commits a crime understands that their actions are wrong in a legal or a moral sense.

Apply Activity Based on what you read about criminal responsibility and the mental disorders defence, how would you judge the following two cases: guilty or not guilty? (Note: we have “toned down” elements from real-world cases to make them much less graphic. However, anyone who is sensitive to descriptions of violence should feel free to skip this section.)

Case 1: Tyson was diagnosed with schizophrenia two years ago. Although his symptoms have generally been under control, he has heard voices and seen things that weren’t really present (hallucinations) on some occasions. During one of these episodes, he thought that someone waiting at the bus stop was a demon walking towards him. Tyson attacked the man, sending him to the hospital overnight.

Case 2: Rick received treatment for depression for several years. Although his symptoms were generally under control, he still had some problems controlling his emotions. While working on a group project at work, Rick became involved in an intense argument with his coworkers who he felt were not working hard enough. Rick attacked one co-worker, sending him to the hospital overnight.

To evaluate the importance of the DSM-5’s labels, it would be helpful to consider

15.1c Apply . . . your knowledge of the mental disorders defence to decide if defendants are criminally responsible for their actions.

15.1d Analyze . . . whether the benefits of labelling psychological disorders outweigh the disadvantages.

their functions. They organize large amounts of information about symptoms, causes, and outcomes into terminology that mental health professionals can work with. From a practical point of view, this system meets the requirements of the insurance companies that pay for psychological services. One downside to this process is that once the label is applied, people have a tendency to misinterpret behaviours that are perfectly normal. Another downside is that if insurance and pharmaceutical companies have influence over how the guidelines are decided, then the whole system could be biased in favour of over- diagnosing and over-medicating people.

Module 15.2 Personality and Dissociative Disorders

AileenWuornos/AP Images

Learning Objectives

Know . . . the key terminology associated with personality and dissociative disorders. Understand . . . the phenomenon of dissociation and how a dissociative disorder might occur. Apply . . . your knowledge of antisocial personality disorder to explain how it could help people succeed in certain professions. Analyze . . . the status of dissociative identity disorder as a legitimate

15.2a

15.2b

15.2c

15.2d

Warning: this story is potentially triggering or upsetting, particularly to people who have experienced abuse. Aileen Wuornos’s life is an unbelievably sad story, so relentlessly tragic that it became the inspiration for the 2003 movie Monster, for which Charlize Theron won an Oscar for her portrayal of Aileen.

Aileen grew up in a complete chaos of abuse and mental illness. Her father was incarcerated and mentally ill, and was thus absent from her life. Her mother abandoned her at age 4, and she was adopted by her grandparents. Wuornos later described a childhood of being sexually abused and beaten by her grandfather, of prostituting herself for money and cigarettes to others, and being raped and impregnated at age 13 by a friend of her grandfather’s. The baby was given up for adoption and by age 15, Aileen had been thrown out of the house and was supporting herself through prostitution.

With no stable home or healthy family relationships, she had very little capacity to trust or emotionally connect with others. When she was 20, she was, suddenly and surprisingly, wed to a wealthy yacht club owner; this might have been her ticket to a better life, but within weeks it devolved into violence and conflict, and the marriage was eventually annulled. Over the next decade, Aileen struggled to keep her life together but was arrested numerous times for offences ranging from forging cheques to armed robbery and car theft, leading her to spend some time in prison.

When she was 33 years old, Aileen Wuornos’s life of pain and trauma came spilling back out of her in a murderous frenzy. Over a one-year period spanning 1989 and 1990, she murdered seven men across the state of Florida. She initially claimed to have killed them in self-defence, in response to each of them attempting to rape her. Although diagnosed with borderline personality disorder and antisocial personality disorder, Wuornos was determined to be sane at the time of her killings and fit to stand trial. She was convicted and sentenced to death in the state of

diagnosis.

Florida (Wuornos v. State of Florida, 1994). In 2002, she was executed by lethal injection.

Focus Questions

1. What are personality disorders and how do they differ from normal personality traits?

2. What are the key characteristics of dissociative disorders? Why does a person develop a dissociative disorder?

Chapter 12 described the psychological approaches to personality— the relatively stable patterns of thinking, behaving, and relating to others that make each person unique and that are bound up with that person’s identity. In certain unusual cases, personality patterns can become deeply entrenched and maladaptive or destructive, which is described as developing a personality disorder (PD).

Defining and Classifying Personality Disorders

Mental health professionals identify personality disorders as particularly unusual patterns of behaviour (relative to one’s cultural context) that are maladaptive, distressing to oneself or others, and resistant to change. For example, some people feel no empathy toward others, even those in great distress. Others have intense needs and high expectations for receiving the attention and admiration of others, and tend to feel severely rejected if their expectations are not met. Other people may become rapidly and obsessively attached to another person, only to reject that individual at a future time. Obviously, many people experience these basic patterns of behaviour in varying degrees; it is important to remember that personality disorders represent

extreme cases. Importantly, personality disorders often persist throughout a person’s life.

The DSM-5 identifies 10 distinct personality disorders, which are categorized into

three different clusters based on shared features (see Table 15.2 ). Cluster A disorders are characterized by odd or eccentric behaviour; Cluster B disorders are indicated by dramatic, emotional, and erratic behaviour; Cluster C disorders are characterized by anxious, fearful, and inhibited behaviour. In addition to these 10 disorders, the DSM-5 also identifies Personality Disorder Not Otherwise Specified, which is a diagnosis given to individuals who exhibit patterns of behaviour consistent with that of a personality disorder, but which does not fit into any of the personality disorder categories described above.

Table 15.2 Types of Personality Disorders When listed in a table, the symptoms of personality disorders seem like characteristics that we all have. In a personality disorder, these symptoms are quite extreme and tend to be stable (if not permanent) traits.

Cluster Description

Cluster A: odd;

eccentric

Paranoid Personality Disorder: See threats where others do

not; difficulty trusting others

Schizoid Personality Disorder: Difficulty forming close

relationships with other people; desire to be left alone, if possible

Schizotypal Personality Disorder: Odd or eccentric way of

thinking and expressing oneself; difficulty forming close

relationships

Cluster B:

dramatic;

emotional;

erratic

Borderline Personality Disorder: Impulsive, manipulative, and

an unstable sense of self; volatile relationships

Narcissistic Personality Disorder: Intense need for attention

and admiration; self-doubt and a fear of abandonment

Histrionic Personality Disorder: Excessive attention seeking;

flamboyant, dramatic behaviour

Antisocial Personality Disorder: Impulsive and prone to risk-

taking; reduced concern for the needs of others

Cluster C:

anxious;

fearful;

inhibited

Avoidant Personality Disorder: Tendency to avoid social

interactions when possible; fear of rejection and embarrassment

Dependent Personality Disorder: Difficulty functioning or

making decisions without the help of others; very low self-

confidence

Obsessive–Compulsive Personality Disorder: A need for

order and high expectations for oneself and for others; very

upset if these needs aren't met

Personality Disorder Not Otherwise Specified: Symptoms do

not clearly fit into one of the above diagnoses

Although each personality disorder deserves to be expanded upon, we will explore the four disorders in Cluster B to get a sense of the overarching commonalities shared by disorders in a given cluster, as well as the specific factors that differentiate them.

Borderline Personality

One of the clearest examples of the emotional dysfunction that lies at the core of

personality disorders is found in borderline personality disorder (BPD)

which is characterized by intense extremes between positive and negative emotions, an unstable sense of self, impulsivity, and difficult social relationships. People with BPD experience a wide range of emotions including extremely positive states such as joy, excitement, and love, but also very powerful destructive emotions such as anger, despair, and shame.

Their relationships are characterized by instability and intensity. A person with BPD may fall in love quickly and passionately, but also be highly fearful of abandonment and thus react intensely to any sign of rejection or criticism, quickly becoming disgusted with and rejecting their partner. They are often highly manipulative in relationships, attempting to keep the person under their control.

In fact, their emotional reactions and ability to be emotionally manipulative in relationships are so strong that therapists typically limit themselves to a very small number of clients with BPD.

It is believed that borderline personality disorder arises out of the person’s attempts to deal with deeply rooted insecurity and severe emotional disturbances that are ultimately rooted in emotionally difficult experiences, such as inconsistent, abusive, or neglectful parenting. To cope with or escape from negative emotions, the person often engages in impulsive, risky, or self- destructive behaviour, including substance abuse, indiscriminate sex, self-injury

such as cutting or burning oneself, and even suicide (American Psychiatric Association, 2013; Linehan, 1993).

Narcissistic Personality

Narcissistic personality disorder (NPD) is characterized by an inflated sense of self-importance and an excessive need for attention and admiration, as well as intense self-doubt and fear of abandonment. The central focus on the narcissistic person’s own feelings and self-importance leaves little room for empathy for others. Instead, they tend to be manipulative and put themselves first, ensuring their own needs are met in their relationships regardless of the toll it takes on others. In many public situations, such as school, people with NPD have a strong sense of entitlement, believing that people should satisfy their demands, and being likely to do whatever it takes, including cheating, in order to

ensure their own success (Brunell et al., 2011).

Histrionic Personality

Emotional dysfunction can also be seen in histrionic personality disorder (HPD) , which is characterized by excessive attention seeking and dramatic behaviour. “Histrionic” comes from a Latin word meaning “like an actor or like a theatrical performance”—an apt label for this disorder. People who have HPD are typically high-functioning because their dramatic nature makes them seem vibrant and attractive in social situations, and they readily use flirtatiousness, sexuality, and flattery to garner the social attention they crave. Similar to the

other personality disorders discussed in this section, the histrionic person often engages in indulgent and risky behaviours, and tends to be highly sensitive to criticism and generally manipulative in relationships. The key difference between HPD and the other personality disorders in this cluster is the flamboyance and exhibitionistic tendencies in histrionic behaviour.

According to Greek mythology, Narcissus discovered his image reflecting on the surface of a pool of water. Unable to tear himself away from the beauty of his own face, Narcissus wasted away and died at the water’s edge. In modern times, narcissism describes a person who has an inflated sense of self-importance. Narcissus, c.1597-99 (oil on canvas), Caravaggio, Michelangelo Merisi da (1571-1610)/Palazzo Barberini, Rome,

Italy/Bridgeman Images

Working the Scientific Literacy Model Antisocial Personality Disorder

In contrast to histrionic personality disorder, which is associated

with dramatic behaviour, the diagnosis of antisocial personality disorder (APD) is given to individuals who have a profound lack of empathy or emotional connection with others, a disregard for others’ rights or preferences, and a tendency toward imposing their own desires, often violently, onto others regardless of the consequences for other people or, often when younger, other animals. APD (often referred to as psychopathy) tends to be highly resistant to treatment, in part because individuals with APD are not alarmed or distressed by their actions (although others frequently are), and they are thus rarely, if ever, motivated to change.

What do we know about antisocial personality disorder? People with APD tend to be physically and verbally abusive, and destructive, and frequently find themselves in trouble with the law. Symptoms of the disorder typically appear during childhood and adolescence, including harming or torturing people or animals, destroying property, stealing, and being deceitful

(Lynam & Gudonis, 2005). The general public might use the term psychopath to describe a person who exhibits these types of behaviour, and indeed, the cold-blooded, remorseless murderer often fits the category of APD.

For some people with severe APD, the antisocial acts they commit are severe, and their lack of guilt or remorse is truly disturbing. This tendency was clearly evident in the words of Aileen Wuornos when she refused to appeal her death sentence:

I killed those men, robbed them as cold as ice. And I’d do it again, too.

. . . There’s no chance in keeping me alive or anything, because I’d kill

again. I have hate crawling through my system. (CNN, 2002)

Keep in mind that serial killers represent only a very small subset of people with antisocial tendencies. In fact, people with APD are sometimes very successful, especially in business, which often rewards the kind of calculating, aggressive disposition of the person with APD; this is particularly true when coupled with the charm and social skills that many people with APD also possess. In fact, business managers often score highly on measures of antisocial personality tendencies, rivalling the scores of people with APD who are in jail. It is interesting to speculate for a moment on the implications for society if we construct our business and economic systems to reward those who are manipulative and lack of empathy.

How can science explain antisocial personality disorder? You may have heard stories of people who have snapped under stress and committed horrific acts—however, this type of extreme stress response does not at all characterize APD. In fact, researchers have discovered that people with antisocial

personality disorder are under-reactive to stress. For example, a flash of light, a loud sound, or the sudden appearance of an angry face will startle most people. In contrast, people with APD show very weak startle responses when exposed to unpleasant stimuli. In one study, researchers recorded the electrical signals of the eyeblink muscles while presenting disturbing images to a group of people with APD and a control group without APD. Figure 15.1 illustrates the results—the strength of the startle response is indicated by the height of the bars. The group of people with APD (the bars on the right side) had much weaker

responses than the group without APD (on the left; Levenston et al., 2000).

Figure 15.1 Emotional Responses of Individuals with Antisocial Personality Disorder

This graph shows the strength of autonomic response to three types of pictures: mutilations, assault, and threat. Responses are much greater among control subjects (those who do not have APD; the three bars on the left) than among the individuals with antisocial personality disorder (the three bars on the right). Source: Adapted from Levenston, G. K., Patrick, C. J., Bradley, M. M., & Lang, P. J. (2000). The

psychopath as observer: Emotion and attention in picture processing. Journal of Abnormal

Psychology, 109 (3), 373–385.

This reduced reactivity to stress is due, in part, to abnormalities in

the amygdala (Blair, 2010; Pemment, 2013). In most people, the amygdala fires in response to aversive stimuli; it is also involved with aversive conditioning, a form of emotional learning (see

Module 6.1 ). However individuals with APD show very little amygdala activity in these situations. Additional impairments occur as a result of problems associated with the frontal lobes. The frontal lobes have connections that allow them to reduce the activity of the amygdala and other emotion-related brain regions

(see Module 11.4 ). Individuals with APD, however, have less grey matter in many frontal lobe regions (Yang et al., 2010). They also have less efficient white-matter pathways connecting

the frontal lobes and amygdala (Craig et al., 2009). As a result, they have trouble regulating their emotional responses (see Figure 15.2 ). Additionally, recent research suggests that these brain abnormalities impair this groups’ ability to integrate emotional information with logical reasoning centres; thus, people with APD are emotionally cut off from the consequences of their

actions, even though they rationally understand them (Baskin- Sommers, 2016).

Figure 15.2 Emotion Regulation in the Brain

In healthy brains, regions of the frontal lobes (highlighted in parts A, B, and D) are able to inhibit the activity emotion-related structures such as the amygdala (C). In APD, less inhibition occurs, thus resulting in problems with the regulation of emotions.

Can we critically evaluate this information? One cautionary note to keep in mind when reading about antisocial personality disorder is that we must be careful not to assume that all people with APD are violent criminals, indiscriminately harming others. Ironically, many of the characteristics of APD may themselves be highly desirable, or at

least useful, in some professions (Dutton, 2012). The ability to emotionally detach from people, to be manipulative and able to deceive or lie without any moral reservations, to be charming and charismatic so as to appear to connect with people even though you can easily see people as tools to be used to satisfy your own desires, may well be rewarded in the worlds of CEOs, lawyers, salespeople, and undoubtedly many other social environments. These personality traits can give people with APD great power over others, because they are able to use others for their own personal gain without being held back by moral constraints

(Lykken, 1995). Thus, the abusive boyfriend, the charming corporate ladder-climber, the intensely focused surgeon, the serial killer, or the socially inhibited hermit may all be outcomes of antisocial personality disorder.

Why is this relevant? Identifying how physiology and brain function differ in people with APD is certainly helpful for psychologists who are trying to understand the underlying mechanisms of these disturbing behavioural patterns. People with APD tend to be highly resistant to psychological therapies, making it even more critical to understand the underlying biological processes. Also, antisocial patterns are often detectable during childhood and adolescence,

which are critical periods of brain development. If a system of early diagnosis and treatment could be instituted, it might be possible to more effectively intervene before the person develops the full manifestation of the disorder, and before they commit any harm.

Module 15.2a Quiz:

Defining and Classifying Personality Disorders

Know . . . 1. Which of the following is not a characteristic of personality disorders?

A. Traits that are inflexible and maladaptive B. Significant functional impairment or subjective distress C. Marked deviation from cultural expectations D. Typically diagnosed with medical tests

Understand . . . 2. refers to a condition marked by a habitual pattern of willingly

violating others’ personal rights, with very little sign of empathy or remorse.

A. Borderline personality disorder B. Narcissistic personality disorder C. Histrionic personality disorder D. Antisocial personality disorder

3. involves intense extremes between positive and negative emotions, an unstable sense of self, impulsivity, and difficult social relationships.

A. Borderline personality disorder B. Narcissistic personality disorder C. Histrionic personality disorder D. Antisocial personality disorder

The Biopsychosocial Approach to Personality Disorders

It is often difficult to identify the causes of personality disorders because they seem to arise from multiple contributing factors over a long period of time. Rather than pinpointing the exact moment a disorder began, psychologists speak in general terms about the types of events that contribute to personality disorders. Adding to the difficulty is the fact that multiple causes are likely at play, and it may be possible for two people to develop the same symptomatic thoughts and behaviours through entirely different routes. The biopsychosocial model provides a comprehensive view, examining personality disorders from three different perspectives.

Psychological Factors

Do people with personality disorders think differently than the rest of the population? Persistent beliefs about the self are a major part of the human personality, and the attempt to compensate for and cope with negative beliefs about oneself is a key part of APD. People with narcissistic (NPD) or histrionic (HPD) personality disorder also tend to have deeply rooted negative beliefs about the self, how they are regarded, and whether they are loved by others. Much of their dysfunctional behaviour patterns stem from attempts to compensate for these negative self-beliefs. For example, the person with NPD may continually seek attention, adoration, and reassurance from others, avoiding negative information about the self at all costs. A similar pattern may be apparent in someone who has a histrionic personality. Attention seeking through engaging in flattery and wearing provocative clothing may help individuals with HPD avoid the negative feelings they associate with being unnoticed.

Adults with APD and children with conduct disorders (often a precursor to APD) have difficulty learning tasks that require decision making and following complex rules. Brain-imaging studies show that children with conduct disorders perform

worse at these tasks and have reduced activity in the frontal lobes compared

with healthy controls and even children with ADHD (Finger et al., 2008). Thus, it appears that cognitive factors and their underlying brain systems are involved in personality disorders.

Sociocultural Factors

Children begin to develop social skills and emotional attachments at home and in their local neighbourhood and community. Not surprisingly, then, troubled homes and communities can contribute to the development of antisocial personality

disorder (Meier et al., 2008). People with APD have often themselves experienced trauma or abuse. A history of being treated as an object rather than as a sensitive human being has consequences. The need to defend the self against intensely negative emotions and experiences may effectively shut down (or impair the development of) the emotional circuitry for empathy. This often results in aggression and cruelty toward others, including animals.

In general, personality disorders often involve extensive emotional damage from childhood experiences, ranging from physical violence and sexual abuse to the profound invalidation and insecurity of being repeatedly abandoned or neglected as a child. For example, even less severe cases of borderline personality disorder may arise from a child having his emotions treated as if they were

unreal or unimportant (Crowell et al., 2009). The resulting deep insecurity and emotional volatility leave adults with BPD unable to control their emotions, and

therefore more vulnerable to everyday life stressors (Glaser et al., 2008).

Biological Factors

Not everyone who experiences extreme stress and abuse develops a personality disorder, of course. So why do some adapt successfully while others do not? The answer may lie in how stress interacts with biological predispositions for personality disorders. A number of specific genes seem to contribute to

emotional instability by affecting serotonin systems in the brain (Crowell et al., 2009). Research also points to unique activity in the limbic system and frontal

lobes—brain regions that are associated with emotional responses and impulse

control, respectively (Brendel et al., 2005).

Thus, the biopsychosocial model of behaviour can help us understand the different characteristics of personality disorders, which are among the most complex and difficult to treat disorders in the DSM-5. As you will see in the next section of this module, this model can also be useful when attempting to understand one of psychology’s most mysterious and controversial conditions: multiple personality disorder.

Module 15.2b Quiz:

The Biopsychosocial Approach to Personality Disorders

Know . . . 1. Some children show a set of symptoms that include difficulty learning

tasks that require decision making and following complex rules. This group of symptoms is sometimes referred to as

A. psychopathy. B. borderline personality disorder. C. disorder of social attachment. D. a conduct disorder.

Apply . . . 2. Which of the following biopsychosocial factors is least likely to be related

to personality disorders?

A. Stress reactivity B. History of abuse C. Decreased activity of the frontal lobes D. Enjoyment of pain

Dissociative Identity Disorder

Have you ever been so engaged in driving, reading a book, or playing a game

that you were totally unaware of what was going on around you? Have you ever had difficulty determining whether an event, perhaps some long-ago story, really happened the way you now remember it, or whether it was a story that happened to someone else, or even a dream? These types of experiences can be thought of as dissociative experiences, because they are characterized by a sense of separation (dissociation) between the person and her surroundings. Dissociative experiences may arise while you are intensely focused on one activity, or when you drift off while not doing anything in particular, such as daydreaming during a long lecture. People differ in their tendencies to dissociate, but such experiences seem completely normal. In contrast, dissociative states caused by brain injury or psychological trauma are far from harmless.

Types of Dissociative Disorders

In a few cases, some people have such extreme dissociative experiences that

they may be diagnosed with a dissociative disorder , a category of mental disorders characterized by a split between a person’s conscious awareness and their feelings, cognitions, memory, and identity (Kihlstrom, 2005). Dissociative disorders include the following conditions:

Dissociative fugue: A period of profound autobiographical memory loss. People in fugue states may go so far as to develop a new identity in a new location with no recollection of their past.

Depersonalization disorder: A strong sense of the surreal, the feeling that one is not connected to one’s body, the feeling of disconnection from one’s regular identity and awareness.

Dissociative amnesia: A severe loss of memory, usually for a specific stressful event, when no biological cause for amnesia is present.

Probably the most familiar member of this category is dissociative identity disorder (DID) , in which a person experiences a split in identity such that they feel different aspects of themselves as though they were separated from each other. This can be severe enough that the person constructs entirely separate personalities, only one of which will generally be in control at a time.

multiple personality disorder

This is also sometimes referred to as .

These distinct personalities, or alters, may be so different from one another as to have different genders, sexual orientations, memories, personalities, and autobiographical senses of self and who they are. The dissociation of alter identities can be so strong that one alter may have no memory of events experienced by other alters. From Dr. Jekyll and Mr. Hyde to Tyler Durden in

Fight Club, we have been both fascinated and frightened by the possibility that a single individual can house radically different personalities within his consciousness.

In most cases, dissociative disorders such as DID are thought to be brought on by extreme stress. Some psychologists have hypothesized that during a traumatic event such as being a victim of violence, individuals may cope with the experience by shifting their consciousness to a different perspective. They may go to another place in their mind, or feel as though they are separate from their physical bodies and are watching events happen to them as though their body was a different person. With repeated experiences, this type of dissociation could become an individual’s habitual way of coping with trauma, as well as other

stressful situations (van der Kolk, 1994). Consistent with this, most cases of DID do include reports of a stressful event or series of events that precipitated the

onset of the condition (Putnam, 1989).

Is Dissociative Identity Disorder “Real?”

DID is a very rare condition, affecting only about 1% of psychiatric patients, and

therefore only a very small fraction of 1% of the general population (Rifkin et al., 1998). There has been longstanding controversy surrounding whether DID is real. Many of the characteristics of different alters could be faked by people who explicitly (i.e., on purpose) adopt different personas, undergo hypnosis, or are simply influenced by the expectations of psychologists. Importantly, in many of

these cases, the different alters begin to feel real to the patient (even if they began as inventions). This makes it quite challenging for researchers attempting to test whether DID really exists. A key problem in this debate is that a condition like DID is very difficult to test for in a rigorous fashion, given how personal and

subjective the experience of identity is.

One approach to testing for DID is to check for memory dissociations between alter identities. For example, in one study, patients viewed words and pictures and were tested for recall of the stimuli either when they were experiencing the same alter as when they learned them, or when they were experiencing a different alter. The results suggested that some types of learning do not transfer

between alter identities (Eich et al., 1997). This finding would suggest that the alters are truly separate identities.

Another approach to examining DID is to record patterns of brain activity. One study using positron emission tomography (PET) actually found differing frontal lobe activity for people with DID while they were experiencing each of their alters

(Reinders et al., 2003). (In case you wondered, the researchers obtained consent to participate in the study from both alters.) Although the results of both of these studies are thought-provoking, they do not provide solid evidence for a biological basis of DID. After all, any different state of mind or emotional experience will involve different patterns of brain activity. The fact that the two alters produced different patterns of brain activation may simply reflect that the person was thinking about and experiencing things differently in the two states of mind, not that the alters were actually distinct personalities.

Another questionable aspect of DID is the huge change in the number of cases reported over time. By 1970, there were only 79 documented cases of DID (then referred to as multiple personality disorder). In 1986, there were around 6000; by

1998, the number had risen to more than 40 000 (Lilienfeld & Lynn, 2003). Also, 80% of patients diagnosed with DID were unaware of having the disorder

before starting therapy (Putnam, 1989). These observations suggest that DID may have its origins in the context of therapy, rather than being a response to trauma. Also of note, the number of alters changed dramatically; in the early decades up to the 1970s, a person would typically have only one alter; but by the 1980s, people were identified as having many different alters, even dozens or hundreds!

Why did the rate of DID skyrocket from 79 cases to more than 40 000 cases in

fewer than three decades? This increased prevalence could simply be a product of awareness: After professionals learned how to identify the disorder, they could begin to diagnose it more effectively. Or, it may be that a small subset of psychologists find the disorder compelling and are more willing to diagnose it, so they interpret symptoms through that framework, and may (even unintentionally)

provoke dissociative symptoms in the context of therapy (Frankel, 1993). The use of highly suggestive techniques such as hypnosis increases the likelihood that this is the case.

Researchers have examined social and therapist effects on DID by observing what happens when the disorder is introduced to other parts of the world. In these cases it appears that DID—whether a disorder or not—has a strong sociocultural component. For example, the disorder was nonexistent in Japan in

1990 (Takahashi, 1990), but Japanese psychologists began diagnosing patients with DID when the disorder was described by North Americans (An et al., 1998). In India, the disorder is recognized, but how the disorder manifests itself is different from in America: Americans with DID switch from alters upon suggestion, whereas people in India who have DID switch alters only upon

awakening (North et al., 1993). These observations point to a predominantly sociocultural disorder in which cultural beliefs and therapists determine how the

symptoms are manifested (Lilienfeld et al., 1999).

Module 15.2c Quiz:

Dissociative Identity Disorder

Know . . . 1. Dissociative identity disorder is best described as

A. a lost grasp on reality. B. a lack of regard for the feelings of others. C. a splitting of identity. D. a problem with memory, attention, and the ability to form coherent

thoughts.

Understand . . .

2. Fugue is a form of dissociative disorder most commonly associated with A. a belief that you no longer exist or are real. B. loss of sensation in an appendage with no physical or

neurological evidence.

C. housing multiple personalities in one body. D. loss of identity and memories of the self.

3. Which of the following is believed to typically bring on dissociative identity disorder?

A. A physical injury to the head B. Extreme stress or trauma C. Old age D. Genetics

Module 15.2 Summary

antisocial personality disorder (APD)

borderline personality disorder (BPD)

dissociative disorder

dissociative identity disorder (DID)

histrionic personality disorder (HPD)

multiple personality disorder

narcissistic personality disorder (NPD)

personality disorders

Dissociation occurs in everyday phenomena such as daydreaming. However, a

15.2a Know . . . the key terminology associated with personality and dissociative disorders

15.2b Understand . . . the phenomenon of dissociation and how a dissociative disorder might occur.

dissociative disorder may occur when perceptions of mind, body, and surroundings are severely and chronically separated, such that the person loses his or her previously stable sense of self and identity.

Some writers have noted that some people with antisocial personality disorder do well in certain competitive professions such as working in a corporate finance office.

Apply Activity 1. List three characteristics associated with APD. 2. For each characteristic listed above, write down how that trait or

behaviour could be useful in the corporate world.

The lack of a physical basis for the disorder and its unusual rate and patterns of diagnosis bring about skepticism as to whether DID is real or is manufactured, perhaps unwittingly, by the person. It is important to find evidence for differences between alternate personalities that cannot be faked by people or created artificially. Recent research in brain imaging is beginning to look for different patterns of neurological activity that could denote distinct personalities, but this work is in its infancy.

15.2c Apply . . . your knowledge of antisocial personality disorder to explain how it could help people succeed in certain professions.

15.2d Analyze . . . the status of dissociative identity disorder as a legitimate diagnosis.

Module 15.3 Anxiety, Obsessive–Compulsive, and Depressive Disorders

Matsunaka Takeya/Aflo/Glow Images

Learning Objectives

Know . . . the key terminology related to anxiety, obsessive–compulsive, and depressive disorders. Understand . . . the different types of anxiety disorders. Understand . . . how anxiety or depressive disorders can be self-

15.3a

15.3b 15.3c

Of all the things to be afraid of in life, surely one of them is not the possibility that you can catch a mental illness, waking up one morning mentally ill because of some bacteria or germ that you were exposed to. This is generally true; we are pretty safe. In most cases, psychological disorders develop over a period of time. There may be some initial signs that everything is “not quite right” with a person, and then there is a gradual unfolding of more noticeable personality, behavioural, or emotional problems.

Unfortunately, there are documented cases of sudden onset obsessive– compulsive disorder (OCD), in which young children suddenly and without prior warning developed symptoms of OCD, including repetitive behaviours and irrational fears and obsessions. Surprisingly, this sudden surge of OCD-like tendencies came after these children were exposed to

bacterial streptococcal infections (Snider & Swedo, 2004). How is it possible that this particular infection seems capable of triggering a sudden-onset psychological disorder in some children?

The answer seems to be that when the immune system mounts its reaction to the bacterial infection, it also damages cells in the caudate, a part of the brain near its centre. As we will see in this module, one theory about OCD is that compulsive, repetitive behaviours (such as hand washing) are ways of dealing with a lost sense of impulse control, the sort

of loss that occurs when the caudate is damaged (Huyser et al., 2009). If this theory is correct, a psychological disorder could be acquired virtually overnight . . . at least in this case.

Focus Questions

perpetuating. Apply . . . your knowledge of anxiety, obsessive-compulsive, and depressive disorders, so as to be alert to people who may benefit from some help. Analyze . . . whether maladaptive aspects of specific phobias might arise from perfectly normal, healthy behaviours.

15.3d

15.3e

1. The experience of anxiety drives many different disorders. What are some of the ways that problems with anxiety can manifest?

2. Depression is another very common disorder. Why do people seem to develop depression?

Anxiety and mood disorders are extremely common. In fact, a recent survey of over 10 000 Ontario students in Grades 7 through 12 found that 46% of females and 23% of males reported suffering from depression and/or an anxiety disorder

(Boak et al., 2015). These staggering statistics show how prevalent these disorders are. Importantly, they also show those suffering from anxiety or

depression that they are not alone—other people truly can understand how they feel.

Anxiety Disorders

Anxiety disorders are a category of disorders involving fear or nervousness that is excessive, irrational, and maladaptive. They also are among the most frequently diagnosed disorders, affecting approximately one in every eight

Canadians (Public Health Agency of Canada, 2002), and often occurring with other disorders, such as depression or obsessive–compulsive disorders, substance abuse, or problematic behaviour patterns such as an excessive need to be in control of situations.

Although occasional experiences of anxiety are normal, even functional responses to life circumstances, when anxiety becomes debilitating and interferes with the person’s daily life, it clearly becomes a problem. People often attempt to cope with anxiety by limiting themselves to environments, activities, and people that make them feel safe and secure, and by developing rigid habits and ways of doing things that keep life predictable and under control. These patterns evolve in order to help the anxious person manage his or her fear, but they also can limit people’s freedom to live their lives as they would like.

In most people’s experience, anxiety occurs as a natural part of the fight-or-flight

response (Nesse & Ellsworth, 2009). We experience this response as a racing, pounding heartbeat with increased respiration, as our autonomic systems prepare our bodies for quick action. Some people may notice a knot in the stomach and sweaty or clammy hands. These physical changes reflect a shift in energy away from non-emergency tasks like digestion and toward fighting or fleeing. This basic fight-or-flight response seems to be common to all mammals, implying that it has long been evolutionarily adaptive to have an easily triggered system that can quickly arouse the body for action. However, living in our modern, stressed-out society, we activate this stress response system repeatedly throughout our days, to the point where it can become harmful to us

(see Module 14.2 ).

Varieties of Anxiety Disorders

What separates anxiety disorders from normal experiences of anxiety is the intensity and long duration of the response. Anxiety disorders are also distinct in that the response may not be directly connected to one’s current circumstances; instead, the anxiety can be free-floating. Either way, anxiety disorders cause a great deal of emotional distress and interfere with people’s daily lives. Of course, not all anxiety disorders are the same. Psychologists have identified distinct patterns of experience that have given rise to several major types of anxiety disorders.

Fight or flight . . . or freeze or faint? In addition to fight-or-flight responses, mammals can also react by freezing—as in the “deer in the headlights” response

—or by fainting, as some will do at the sight of blood (Bracha et al., 2004). Darren Bridges Photography/Alamy Stock Photo

Dlewis33/Getty Images

Generalized anxiety disorder (GAD) involves frequently elevated levels of anxiety, generally from the normal challenges and stresses of everyday life. A person with GAD fears disaster lurking around every corner, and may experience symptoms ranging from difficulty sleeping or breathing to difficulty concentrating because of intrusive thoughts. However, because the anxiety arises out of the ongoing situations and circumstances of life, people often have difficulty understanding their experience and cannot identify specific reasons for which

they are anxious (Turk et al., 2005). It is also difficult to resolve the anxiety, despite trying to control situations and trying to attend to every detail so that nothing goes wrong. Instead, as one detail is dealt with, the anxiety shifts to another source, and the control-oriented person is locked into a never-ending scramble to manage life perfectly so as to keep anxiety at bay.

Not surprisingly, people with GAD often have unstable, irritable moods, experience difficulty concentrating, and have sleep problems. Although there are many different types of factors that increase the probability of developing GAD, ranging from innate, genetic components to current habitual thinking patterns, a convergence of stresses, such as occurs during major life changes, commonly

precede the onset of the disorder (Newman & Llera, 2011).

Panic disorder is an anxiety disorder marked by occasional episodes of sudden, very intense fear. This condition is distinct from GAD because the anxiety occurs in short segments, but can be much more severe. The key feature

of this disorder is panic attacks —brief moments of extreme anxiety that include a rush of physical activity paired with frightening thoughts. A panic attack escalates when the fear causes increased physical arousal, and the increased physical symptoms feed the frightening thoughts. The escalation rarely goes on for more than ten minutes, after which the individual will eventually return to a more relaxed state.

A substantial subset of people with panic disorder develop a recurring fear that the panic will strike again, particularly in an environment in which they would be exposed and unable to escape from people, such as a shopping mall or other

public space. This fear can result in agoraphobia (which is often associated with panic disorder), an intense fear of having a panic attack in public; as a result of this fear, the individual may begin to avoid public settings and increasingly isolate him- or herself. In its most extreme forms, agoraphobia leads an individual to stay inside his home almost all the time.

Working the Scientific Literacy Model Specific Phobias

In contrast to GAD, where an individual’s anxiety can be applied

to just about any situation, a phobia is a severe, irrational fear of a very specific object or situation. Some of the most common phobias are listed in Table 15.3 . Phobias are sometimes divided into two broad categories: specific phobias and social

phobias. A specific phobia involves an intense fear of a specific object, activity, or organism. For example, the person may be afraid of specific animals, heights, thunder, blood, or injections or other medical procedures. Social phobias, which are also very common, are related to interpersonal situations and relationships and are discussed later.

Table 15.3 What Are We So Afraid Of?

Source: Stinson, F. S. et al., (2007). “The epidemiology of DSM-IV specific phobia in the USA:

Results from the National Epidemiologic Survey on Alcohol and Related Conditions,” Psychological

Medicine, 37, 7, pp. 1047–1059. Table 3, p. 1053. Copyright © 2007 Cambridge University Press.

Reprinted with the permission of Cambridge University Press.

Currently

Experiencing

the Phobia

Have Experienced

the Phobia at One

Time

Animals (snakes, birds,

or other animals)

4.7% 50.3%

Natural environment

(e.g., heights, storms,

water)

5.9% 62.7%

Blood or bodily injury

(including injections)

4.0% 42.5%

Situations (e.g., dentists,

hospitals, crowded

places)

5.2% 55.6%

Other specific objects 1.0% 10.6%

What do we know about phobias? Phobias often develop as a result of unpleasant or frightening experiences; there’s nothing like getting bitten by a dog to make a person afraid of dogs. That said, the overwhelming majority of the

triggers for phobias are objects or situations that we may need to fear, or at least be cautious about. For example, people readily develop phobias of spiders, snakes, heights, and drowning— dangers that would have been important over the course of our

species’ evolution ( Öhman & Mineka, 2001; see also Module 6.1 ). This tendency suggests that there may be a genetic component to some of our specific phobias. Of course, this does not mean that other phobias will be impossible to develop, but rather that people are more biologically predisposed to fear evolutionarily relevant objects or situations.

Interestingly, phobias can also develop without direct, personal experience. Why would a person develop an extreme fear about something that they had no personal experience with, especially if it was something that they, realistically, were unlikely to ever have personal experi ­ence with? It doesn’t seem rational, or functional. In some cases, these links form through observational learning, such as seeing vicious sharks in movies. In many of these cases, an initial mental link between an object or situation and an emotion can be retrieved from memory and thought about multiple times. We think about the object and become afraid; this fear can, in turn, become a retrieval cue for the object. The result of these feedback loops is that our brains can create powerful experiences, even though they are not real in the sense that they

are not being triggered by anything actually happening in the external world at that moment; this tendency is known as

parasitic processing (Vervaeke & Ferraro, 2012). Indeed, this is essentially how anxiety disorders, including phobias, work! The self-reinforcing nature of anxiety reactions leads them to grow

and become more extreme over time (Merckelbach et al., 1996).

How can science explain why some people are more likely than others to develop specific phobias? For any given individual, there are many factors that determine whether or not a phobia develops. For example, some of the risk factors for phobias include personality characteristics, like shyness and temperamental inhibition, both of which are,

interestingly enough, partly genetically determined (Biederman et al., 1990; DiLalla et al., 1994).

Scientists have been piecing together the genetic factors that biologically predispose some people to experience more fear than others. One of the first questions to answer is simply whether or not the tendency to learn fear associations can be transmitted genetically. One group of researchers attempted to answer this using selective breeding techniques with mice. The researchers tested a strain of mice for how easily they could learn a fear association (an auditory tone coupled with an electrical shock). The fear response was measured by the length of time the mice held still—mice typically show fear by freezing in place

(Ponder et al., 2007).

By selectively breeding the most fearful mice with each other, and the least fearful mice with each other, researchers could see whether the fear-association response would differ across the

generations of these mice families. As Figure 15.3 shows, across four generations, fear responses became more and more distinct, with the third and fourth generations being very different from each other. These patterns of behaviour diverging so

substantially in different genetic pools suggests that the fear- based learning system is, at least in part, genetically determined.

Figure 15.3 Anxiety Levels Are Inherited in an Animal Model

Over the course of just a few generations, mice from the highly fearful genetic strain show increasingly strong fear responses as indicated by the height of the red bars. Source: From Selection for contextual fear conditioning affects anxiety-like behaviors and gene

expression, Genes, Brain and Behavior, 6: 736–749 by C. A. Ponder, C. L. Kliethermes, M. R. Drew,

J. Muller, K. Das, V. B. Risbrough, J. C. Crabbe, T. Conrad Gilliam, A. A. Palmer. Copyright © 2007

by John Wiley & Sons, Inc. Reproduced by permission of John Wiley & Sons, Inc.

Can we critically evaluate this information? We may question the value of this research because, on the face of it, we don’t seem to have learned much about phobias from studying genetic heritability of fear-responses in mice. However, understanding that genes can influence fear responses in another mammalian species suggests that genes likely underlie our own reactions to threatening stimuli and situations. Therefore, behavioural genomics investigations of phobias could provide us with important information.

A second potential criticism of this research is that it only

examines fear responses from one perspective: genetics. The authors of those research papers would be the first to admit that the full manifestation of a phobia involves many processes and, therefore, would only be partially explained by a genetic understanding. For instance, observational learning likely plays a large role in the development and maintenance of phobias. Seeing another mouse (or human) react with fear to specific objects or animals would teach a young mouse (or human) that

that object or animal is to be feared. The fact that multiple factors are involved in the development of phobias provides further support for the use of the biopsychosocial model when explaining behaviour.

Why is this relevant? In general, understanding causal factors better, targeting causal mechanisms more effectively, and directly manipulating biological systems related to fear and anxiety responses sound like pretty good ideas. A challenge for the future is to understand the interaction between the genetic and other levels of analysis in order to fully develop these tools. Doing so may lead to new treatment for a number of disorders.

Thus far, our discussion of phobias has focused on fearful responses to specific

stimuli such as snakes (or snakes with knives in their mouths). Social anxiety disorder , on the other hand, is a very strong fear of being judged by others or being embarrassed or humiliated in public. People who experience social anxiety deal with going out in public by developing familiar routines and retaining control over their ability to exit circumstances if their anxiety becomes too strong. Social anxiety generally leads people to limit their social activities in favour of not exposing themselves to anxiety, thus making it difficult to succeed and live a normal life in many different ways.

Consider the day of a university student who has social anxiety:

This student always shows up to class just as it begins so he does not have to risk awkward conversation with classmates he does not know, or potentially worse, sitting conspicuously alone and being unable to connect to anyone around him.

Despite being hungry, the student will not go into the cafeteria because his roommate is not around. He cannot face the prospect of sitting with strangers, especially without his roommate. He finds a quiet spot near the library and gets lunch from a vending machine.

Walking across a quiet part of campus, he sees his professor approaching. Not knowing if the professor would recognize him, he wonders if he should say hello. Thinking about this issue makes him so tense, he pretends to stop and read a text message to avoid eye contact.

As you can see, the day is a series of unpleasant, tense moments in situations that most people would find completely ordinary. It is also a series of sacrificed opportunities as the person fails over and over again to take advantage of chances for connection and social contact. The distress the student feels and the degree to which he shapes his life around his social phobia suggest that he has social anxiety disorder. Of course, to make a formal diagnosis of this disorder, a psychologist would need to evaluate the student’s full set of symptoms and their duration.

The Vicious Cycle of Anxiety Disorders

As discussed earlier, anxiety disorders tend to be self- perpetuating (Figure 15.4 ), with anxiety leading to circumstances that provoke further anxiety (Hofmann, 2007). For example, people who are anxious about interacting with others may avoid many social situations because they feel awkward and insecure and don’t want to embarrass themselves. As a result, they become even less confident about their ability to interact with people, making them even more likely to avoid social contact in the future; or, if it is unavoidable, to be so anxious and incapable of functioning effectively that the social opportunity turns into a negative experience, further reinforcing the anxiety.

Figure 15.4 The Vicious Cycle of Panic Attacks

Avoiding or interrupting this vicious cycle is central to the treatment of anxiety disorders. Instead of trying to minimize contact with feared situations, which only serves to reinforce the fear, the person must begin to practise confronting the fear. Only through exposing themselves to fear can people learn how to manage their responses or learn how to effectively manage the feared situation. For example, imagine a young girl who gets scratched by the neighbour’s cat while trying to pet it. The girl may avoid cats in the future and, years later, still feel nervous and unsure of herself around cats. Only by learning to tolerate and eventually interact with cats will the girl be able to reduce her anxiety. The most

important part of psychological therapy for anxiety disorders is exposure , in which the person is repeatedly and in stages exposed to the object of her fear so that she can work past her emotional reactions. For exposure to be most effective, it should be coupled with helping the person to calm themselves down

and to learn to tolerate the aversive feelings they are experiencing (see Module 16.2 ).

Obsessive–Compulsive Disorder (OCD)

Until 2013, obsessive–compulsive disorder (OCD) was categorized as an anxiety disorder. In the DSM-5, OCD was placed into its own category.

Individuals with OCD tend to be plagued by unwanted, inappropriate, and persistent thoughts (obsessions), and to engage in repetitive, often quite

ritualistic behaviours (compulsions). Generally, obsessions and compulsions are linked together, with the compulsive behaviour serving as a means of coping with

the anxiety produced by the obsession (see Table 15.4 ). For example, a common manifestation of OCD is a person who is extremely concerned about germs and cleanliness; he may wash his hands many times each day, insist on only touching other objects through gloves, or become extremely vigilant about the chemicals in food and cleaning products. Alternatively, someone who worries about starting a fire might develop compulsive checking behaviours. Before she can leave her house, she might check that all lamps and appliances are unplugged. She may make the rounds two more times, ensuring that the electrical cords are secured by fasteners at least two feet from the outlet. Finally, she might turn off the light to leave but, to avoid the possibility that the light switch is halfway between on and off, she might count out a series of one to seven in which she turns the light off repeatedly, followed by one last downward swipe to ensure the switch is fully off. Only then can she feel secure in leaving the house.

Table 15.4 Prevalence of Symptoms in a Survey of 293 Individuals with Obsessive–Compulsive Disorder Source: Based on Pinto, A., Mancebo, M., Eisen, J., Pagano, M., & Rasmussen, S. (2006). The Brown longitudinal obsessive

compulsive study: Clinical features and symptoms of the sample at intake. Journal of Clinical Psychiatry, 67, 703–711.

Percentage of Sample Experiencing

Obsession

Specific Types of Obsessions

58% A fear of being contaminated

56% Persistent doubting

48% Need to arrange things in a symmetrical

pattern

45% Aggressive thoughts

Percentage of Sample Experiencing

Compulsion

Specific Types of Obsessions

69% Checking

60% Cleaning

56% Repeating actions

Although everybody has unwanted thoughts that seem to stick in their heads from time to time, obsessions take root and can last for a very long time, even many years. Obviously, these thoughts tend to be distressing.

As these types of intrusive thinking patterns become more extreme and ever- present, they increasingly interfere with the person’s life. Imagine people who obsessively think about cleanliness and germs; everywhere they go in life, they encounter new microbiological terrors, forcing them to adopt elaborate rituals for how to sufficiently clean themselves and how to avoid making contact with germs in many different situations. Many psychologists believe that compulsive behaviours, and the relief they provide, give the person a feeling of control over

their anxiety. They just have to perform a very particular behaviour in order to feel that control.

We introduced this disorder at the beginning of this module by describing how it can occur suddenly in children. This type of onset is exceedingly rare, and not at all representative of the way that OCD usually develops. OCD generally develops over time, ranging from childhood into early adulthood, by which time most cases of OCD will have manifested themselves.

Although the compulsive behaviour patterns associated with OCD can be quite disruptive to the general activities of everyday life, these patterns also tend to be quite responsive to treatment. In fact, anxiety, depressive, and obsessive– compulsive disorders are all generally amenable to treatment. This provides hope for the millions of Canadians who are affected by these emotionally draining psychological disorders.

Module 15.3a Quiz:

Anxiety Disorders

Know . . . 1. The difference between obsessions and compulsions is that

A. obsessions are repetitive behaviours, whereas compulsions are fears about specific events.

B. obsessions are repetitive, unwanted thoughts, whereas compulsions are repetitive behaviours.

C. obsessions are temporary, whereas compulsions are practically permanent.

D. obsessions and compulsions are the same thing.

Understand . . . 2. Allison has an intense fear of flying, so much so that she cannot even

bear to close her eyes and imagine that she is on a plane. From this brief description, Allison may be experiencing

A. a specific phobia. B. a social phobia. C. a generalized phobia. D. normal levels of anxiety.

3. Which condition is marked by a strong feeling of tension and worry, no matter what the situation may be?

A. A specific phobia B. A panic attack C. Generalized anxiety disorder D. Normal feelings of anxiety

4. The idea that anxiety disorders can be self-perpetuating means that A. anxiety in one situation always causes anxiety in another

situation, regardless of what is happening in those situations.

B. the emotions associated with anxiety lead to physiological responses, which in turn lead to more anxious emotions, creating

a vicious cycle.

C. you choose when and what to be anxious about. D. anxiety is always limited to one situation or place.

Analyze . . . 5. If anxiety leads to the onset of so many different disorders, how can it be

a beneficial, adaptive process?

A. It cannot be an adaptive process. B. The physiological response underlying anxiety prepares us to

fight or to flee certain stimuli or situations.

C. Anxiety is a good way to gain sympathy. D. The anxiety response evolved to help attract mates.

Mood Disorders

Mood disorders are very common, affecting almost 10% of adults in Canada and

the U.S. (Health Canada, 2002; Kessler et al., 2005). Due to a combination of biological, cognitive, and sociocultural differences, rates of depression are twice as high among women as among men, and three times as high among people

living in poverty (Hyde et al., 2008). There is also a genetic susceptibility to mood disorders. In this section we discuss the two major types of mood disorders—major depression and bipolar disorder.

Types of Mood Disorders

Feelings of sadness and depression are normal aspects of human experience. By comparison, major depression can be very severe and may occur even when there are no events or circumstances we normally associate with a depressed

mood. Major depression is a disorder marked by prolonged periods of sadness, feelings of worthlessness and hopelessness, social withdrawal, and cognitive and physical sluggishness. With this definition, it should be clear that depression involves more than just feeling sad for a long period of time; cognitive activities such as concentrating and making decisions are affected as well, while

memories shift toward unpleasant and unhappy events. Physiologically, affected individuals may be lethargic and sleepy, yet also experience insomnia. They may experience changes in appetite and the onset of digestive problems such as constipation or stomach aches.

To fully understand depression requires considering the cumulative, daily impact of life’s activities being interfered with by feelings of despair, uselessness, and a lack of energy and motivation. Depression can lead to problems piling up at work and at home, relationships being strained or crumbling, and financial problems starting to interfere with daily life. People deep in depression may find it almost impossible to take care of more than the barest necessities of their lives; their social lives suffer as they stop returning phone calls or emails. Other people may notice and get annoyed or have hurt feelings, which leads the depressed person to feel even worse about himself. These examples provide a glimpse of how depression can become such a monster.

Many people have experienced problems with a mood disorder. Those with depression may experience extended periods of sadness and hopelessness that have no apparent cause. stefanolunardi/Shutterstock

In contrast, bipolar disorder (formerly referred to as manic depression) is characterized by extreme highs and lows in mood, motivation, and energy. It

shares many symptoms with major depression—some distinguish the two by

referring to major depression as unipolar depression—but it occurs only about a third as often (NIMH, 2008). Bipolar disorder involves depression at one end and mania—an extremely energized, positive mood—at the other end. Mania may take several forms: talking excessively fast, racing thoughts, impulsive and spontaneous decisions, or high-risk behaviours. The experience of a manic episode can be exhilarating and parts of it can be highly enjoyable, but the costs of such excessive, indiscriminate, risky behaviour can be very high. Unfortunately, during a manic state, individuals feel little concern about the potential consequences of their actions. Later, as they come into a more normal frame of mind, they may feel a great deal of remorse and embarrassment for their actions, which contributes to their counter-swing into depression.

Bipolar disorder encompasses both ends of an emotional continuum, and individuals with bipolar disorder can move from one end to the other at different rates. Some people with bipolar disorder experience only a few manic episodes in their lives, whereas others go through several episodes each year. A small number of “rapid cyclers” experience very abrupt mood swings, even within a matter of hours.

Cognitive Aspects of Depression

Depression affects cognition as well as emotion. People with depression can become confused and can have difficulty concentrating and making decisions, all of which contribute to growing feelings of helplessness and feeling incapable of doing anything right.

As a depressed person begins to emphasize negative, self-defeating, and self-

critical thoughts, they develop a characteristic depressive or pessimistic explanatory style (Abramson et al., 1978; Sweeney et al., 1986). A person’s explanatory style involves a set of cognitive habits that are important psychological precursors to depression. When faced with the inevitable negative events of life, people with a pessimistic explanatory style tend make the worst of them (instead of making the best of them), so to speak.

For example, when something bad happens, such as the person failing at a task

or a project, she tends to make internal, personal attributions for the event, blaming herself for what happened (“It’s all my fault! I did everything wrong! I

messed the whole thing up!”). Depressed individuals also tend to make stable attributions, assuming that the situation is going to persist (“It’s always going to be like this. There is a fundamental problem, and it’s never going to change.”).

And as they spiral into catastrophic ways of thinking, they make global attributions, expanding the impact of the negative event into other domains or into overall life (“I just can’t do anything right; I’m going to mess up everything”).

The pessimistic explanatory style adds stress and drains energy by constructing a more threatening or hopeless story for the individual. As a result, this explanatory style tends to predict a host of life outcomes from stress and health to success and relationships. To get a sense of how this might work in specific events during a person’s day, imagine an individual with depression who does

something as minor as losing his keys; refer to Figure 15.5 to see the depressive explanatory style at work. Then extrapolate that same set of patterns across many different events throughout one’s life, and you will get a sense of the cumulative burden that this places on the individual.

Figure 15.5 Three Elements of the Depressive Explanatory Style The three elements of the depressive explanatory style are internalizing, stabilizing, and globalizing.

Biological Aspects of Depression

There is a vast and rapidly growing amount of research on the biological aspects of depression. Brain-imaging research has identified two primary regions of interest related to depression: (1) the limbic system, which is active in emotional responses and processing, and (2) the dorsal (back) of the frontal cortex, which generally plays a role in controlling thoughts and concentrating. As is the case with panic disorder, a vicious cycle appears to occur with depression. The overactive limbic system responds strongly to emotions and sends signals that lead to a decrease in frontal lobe activity, and this decrease in frontal lobe functioning reduces the ability to concentrate and control what one thinks about

(Gotlib & Hamilton, 2008).

Various neurotransmitters—especially serotonin, dopamine, and norepinephrine —are involved in depression. Serotonin appears to be particularly important. People with depression typically have lower serotonin levels than non-depressed individuals. Many anti-depressant medications block the reuptake of serotonin, which leaves more serotonin in the synapse, available to stimulate the postsynaptic neurons.

The negative emotions of depression are also linked with stress reactions throughout the body, which tie the neurological aspects of depression (brain regions and neurotransmitters) to physiological systems including the endocrine, digestive, and immune systems. As a result, individuals with depression are at higher risk for a variety of illnesses, as well as for cardiovascular disease. They also have a higher risk of mortality in multiple age ranges; this link to mortality even persists once researchers statistically account for health behaviours and

suicide (Penninx et al., 1999; Roblaes et al., 2005). Clearly, depression has implications for a person’s health.

Research at the genetic level is also uncovering factors that contribute to the likelihood of being diagnosed with depression. Twin studies suggest an

underlying genetic risk for developing major depression (Figure 15.6 ).

Additionally, behavioural genetics researchers have found that people who inherit two copies of the short version of the 5-HTT gene are at greater risk for developing depression, whereas those who inherit two long copies are at a far

lower risk (Caspi et al., 2003). But what is critical here is not just which genes are inherited, but also how much stress people experience. Figure 15.7 shows how this relationship works. As the number of major stressful life events increases, those who inherit two copies of the short version of this gene are far more likely to develop depression, whereas those who inherit two long copies are buffered from depression. People who inherit one copy of each gene (are heterozygous) show intermediate responses to stressful events. Notice that the type of serotonin gene inherited has no effect on depression after only one or two major stressful events. The gene–environment interaction becomes apparent

after an accumulation of events. This interaction between a genetic predisposition for a disorder and life stress is known as the diathesis–stress model of psychological disorders (diathesis is Greek for “disposition” or “vulnerability”). It is just one of many examples of how nature and nurture interact.

Figure 15.6 Genetic Relatedness and Major Depression Identical (monozygotic) twins have a greater chance of both developing major

depression compared to fraternal (dizygotic) twins. Notice that the genetic correlation is highest for female monozygotic twins.

Figure 15.7 Gene and Environment Interactions in Depression Stress interacts with genes and influences whether someone becomes depressed. People who inherit two copies of the short version of a gene that codes for serotonin activity in nerve cells are at an increased risk for becoming depressed in response to major life stressors. Those who inherit two long copies are buffered from becoming depressed as life stressors accumulate. Source: From A Caspi et al., (2003) Influence of Life Stress on Depression: Moderation by a Polymorphism in the 5-HTT

Gene, Science, Vol. 301, Issue 5631, 386–389. Reprinted with permission from AAAS.

Sociocultural and Environmental Influences on

Mood Disorders

Biological and cognitive factors influencing depression interact with sociocultural and environmental factors. For example, the quality of one’s home

neighbourhood can be a risk factor for depression (Cutrona et al., 2006). Poor neighbourhoods are associated with higher daily stress levels due to

substandard housing and facilities, increased crime rates, and other difficulties. Also, people living in these neighbourhoods are more vulnerable to economic stressors such as unemployment because they generally lack the social connections and the educational and professional opportunities that are available to people living in high-income areas. In addition, environmental influences, such as poverty, can interact with social factors. For example, poor neighbourhoods often have weaker and less supportive social networks in the community. Lower rates of home ownership and higher rates of turnover make it less likely that people will get to know their neighbours; this makes long-lasting social relationships (i.e., potential sources of support) much less common.

Suicide

It is difficult to imagine a worse outcome for a mood disorder than suicide. For people who have not experienced a mood disorder, it is equally difficult to imagine how anyone could reach such a low point. Nonetheless, suicide remains a serious public health concern. It is the second leading cause of death (behind

transportation accidents) among Canadian youth (Public Health Agency of Canada, 2013).

There is significant variation in who is most likely to die by suicide. Suicide is four times more likely among males than among females. Many people believe that adolescents are particularly vulnerable to suicide, but the highest suicide rates are actually observed among the elderly population: The suicide rate for people

65 and older is nearly 60% higher than the rate for teens (CDC, 2010). Fortunately, research, treatment, and public awareness have significantly

reduced the suicide rate among youth since the 1980s (Gould et al., 2003). An unfortunate exception to this trend is in Aboriginal communities, where suicide rates remain above the national average.

Suicide often comes as a surprise to the family and friends of the victim,

although in some cases clear warning signs are evident (Table 15.5 ). Among people in their teens and early twenties, the most significant risk factors are mood disorders, recent and extremely stressful life events, a family history of mood disorders (with or without suicide), easy access to a lethal means of

suicide (most significantly, firearms), and the presence of these factors in

conjunction with substance abuse (Gould et al., 2003; Moscicki, 2001). For young people, being the victim of bullying and social ostracism is also a risk

factor (Klomek et al., 2007).

Table 15.5 Warning Signs of Suicide Source: American Psychological Association. (2011). Suicide warning signs. Retrieved from

http://www.apa.org/topics/suicide/signs.aspx

Learn how to recognize the danger signals. Be concerned if someone you know

Talks about committing suicide

Has trouble eating or sleeping

Exhibits drastic changes in behaviour

Withdraws from friends or social activities

Loses interest in school, work, or hobbies

Prepares for death by writing a will and making final arrangements

Gives away prized possessions

Has attempted suicide before

Takes unnecessary risks

Has recently experienced serious losses

Seems preoccupied with death and dying

Loses interest in his or her personal appearance

Increases alcohol or drug use

Certain behavioural signs are often reported by family and friends to have preceded the suicide, giving us behavioural cues to look for in order to identify people at higher risk for committing suicide. For example, an individual may verbally express despair and hopelessness (“I just want to give up; Nothing matters anymore; They’ll be better off when I’m gone”), give away personal possessions, suddenly withdraw from work or school, or have crying spells. For a full description of common behavioural symptoms, consult a proper checklist, or

even better, be assessed by a professional. But for now, Table 15.5 lists common warning signs of suicide that are useful to know and watch out for, particularly for people you know who may be at higher risk of committing suicide.

Recent research has used a novel method of identifying individuals who are thinking about suicide: machine learning. Researchers in the U.S. created machine-learning codes that allowed a computer to sort through the verbal and non-verbal (voice inflection) characteristics of 379 participants recruited at local hospitals. The algorithm sorted people into three groups—suicidal, mentally ill but not suicidal, and controls (i.e., no psychological disorder present)—with an

85% accuracy rate (Pestian et al., 2017)! Although this is just one study, it does suggest that psychologists and psychiatrists will have additional diagnostic tools at their disposal in the near future.

Of course, the most important factor in saving the lives of individuals who are suicidal is the person’s own awareness of his or her condition. There are many options available for those people who make the decision to seek help.

PSYCH@ The Suicide Helpline Suicide hotlines and helplines perform a vital function in today’s society and are used by thousands of people every single day. The first telephone suicide helplines were operated by religious organizations and emphasized empathy and active listening. Although this may certainly be a helpful approach, it may not meet the needs of every caller. Modern suicide helplines are staffed by well-trained volunteers with access to

suicide prevention specialists who can aid in effectively helping the distressed person, assess the level of risk, and get the appropriate medical or psychological help. Telephone crisis responders need to flexibly adapt their way of interacting with the caller, based on the caller’s needs and where they are at that particular moment. For example, first- time callers tend to benefit more from an active listener, who will be nonjudgmental, compassionate, and reflective (akin to the practice of establishing rapport with a client, which is so central in psychological counselling). People who are repeat callers need an ever-changing combination of many needs met, including compassion and acceptance, empathy and understanding, and problem-solving strategies and

activities (Mishara et al., 2007; Mishara & Daigle, 1997).

Almost all Canadian universities have emergency crisis lines. For people aged 20 and under, the Kids Help Phone is also available at 1-800-668-

6868. Additional helpful resources can be found at http:// www.suicidepreventionlifeline.org/ and http://suicideprevention.ca/ need-help/.

Module 15.3b Quiz:

Mood Disorders

Know . . . 1. is characterized by periods of intense depression as well as by

periods with elevated mood and energy levels.

A. Major depression B. Unipolar depression C. Bipolar disorder D. Generalized anxiety disorder

Understand . . . 2. Depression is associated with lower activity in the frontal lobe, which may

result in

A. lack of appetite. B. difficulty concentrating and thinking. C. periods of elevated mood and energy. D. impaired semantic memory.

Apply . . . 3. First-time callers to suicide prevention lines benefit most from

A. empathy and active listening. B. firm, demanding instructions. C. extensive problem-solving interventions. D. direct referral to the hospital.

Module 15.3 Summary

agoraphobia

anxiety disorders

bipolar disorder

diathesis–stress model

exposure

generalized anxiety disorder (GAD)

major depression

obsessive–compulsive disorder (OCD)

panic attacks

panic disorder

parasitic processing

phobia

15.3a Know . . . the key terminology related to anxiety, obsessive– compulsive, and depressive disorders.

social anxiety disorder

specific phobia

Although anxiety disorders share many similarities in symptoms, they differ in terms of what brings about the symptoms and the intensity of the responses. The cues that trigger anxiety vary widely. In generalized anxiety disorder, just about anything may cause anxiety, whereas in specific phobias, an individual fears only certain objects. Likewise, the frequency and intensity of anxious feelings can range from near-constant worrying to brief periods of highly intense anxiety in phobias and panic disorder.

Both depression and anxiety are characterized by a vicious cycle: With anxiety, anxious or fearful thoughts can lead to physiological arousal; physiological arousal can lead to escape and avoidance to get rid of the immediate fear, which in turn reinforces the anxious thoughts. In depression, a similar pattern can occur with depressed thoughts, self-blame, and social withdrawal.

Apply Activity Write down at least five warning signs for suicide and identify the number of a locally available suicide helpline.

To analyze this issue, we need to examine the specific symptoms that occur in

15.3b Understand . . . the different types of anxiety disorders.

15.3c Understand . . . how anxiety or depressive disorders can be self-perpetuating.

15.3d Apply . . . your knowledge of anxiety, obsessive–compulsive, and depressive disorders, so as to be alert to people who may benefit from some help.

15.3e Analyze . . . whether maladaptive aspects of specific phobias might arise from perfectly normal, healthy behaviours.

someone who has a phobia and is showing an adaptive response (fear, anxiety) but to an inappropriate stimulus or situation. It is perfectly reasonable and healthy to be cautious about heights, for example, in the sense that falls can be dangerous, even life-threatening. This reaction is maladaptive only when the fear response is so intense or out of context that it interferes with daily life. Imagine a house painter who cannot climb a ladder or scaffold; unless he overcomes his fear (or finds very short houses to work on), he will have to make major adjustments to accommodate his fear.

Module 15.4 Schizophrenia

Robert P. Matthews/Princeton University/Getty Images

Learning Objectives

Know . . . the key terminology associated with schizophrenia. Understand . . . how different neurotransmitters affect individuals with schizophrenia. Understand . . . the genetic and environmental contributions to schizophrenia. Apply . . . your knowledge to identify different forms of schizophrenia. Analyze . . . claims that schizophrenia is related to genius or violent

15.4a 15.4b

15.4c

15.4d 15.4e

John Nash is a remarkable story in many ways. He is remarkable for being the inspiration for a movie, A Beautiful Mind. He is remarkable for being a genius, a mathematician, and winner of a Nobel Prize for his work on game theory (Google “Nash equilibrium”), which has become a cornerstone of modern economics and has immense importance in understanding society. He is also remarkable for being an underachiever, you might say, in the sense that Nash undoubtedly did not rise to his full potential, or anything close to it. The world was, at least partially, deprived of one of its most brilliant minds because Nash also had the remarkable characteristic of having schizophrenia.

In 1959, while a professor at MIT, and with his wife expecting their first child, Nash began to experience delusional patterns of thought, developed strange and rigid beliefs, and felt that he was playing some sort of special role as a messenger of some kind, hearing and seeing things that weren’t there, even thinking he was being contacted by aliens who were leaving messages for him in newspapers. His ability to function in daily life fluctuated greatly, as he veered between his lucid, brilliant mind and his confused, schizophrenic mind. His marriage ended shortly thereafter, and Nash eventually spent almost a decade in a psychiatric institution. The voices in his head continued to haunt him for decades. Eventually, he learned how to manage his symptoms and function again in the world. He was able to return to work and even remarried his wife (in 2001). He remained an active mathematician and frequent speaker until his death in 2015, when he and his wife were both killed in a tragic car crash.

John Nash’s case raises some central questions about schizophrenia. What are the underlying neurological and cognitive processes that are affected by the disorder and that produce the symptoms of a person’s experiences? Are there ways of gaining control over symptoms, possibly by strengthening the underlying systems? What factors contribute to better management of schizophrenic symptoms and to slowing or halting its long-term progression?

behaviour.

Nash’s story also challenges some common assumptions about schizophrenia, such as the belief that it is a one-way ticket to insanity and that the person is going to get steadily worse. Or the belief that people with schizophrenia are to be feared, because they are perpetually unstable and likely to do random, unpredictable, even violent or dangerous things. Nash himself managed to live a productive, quiet, peaceful, and generally happy life. Although this isn’t always the case with schizophrenia, it is encouraging to know that such happy endings are possible.

Focus Questions

1. Why do some people develop schizophrenia? What are its causal factors?

2. What brain changes are associated with schizophrenia?

Schizophrenia is often regarded as one of the more devastating psychological illnesses, and indeed, severe cases of schizophrenia involve a shocking loss of basic functioning. Although schizophrenia is not common (affecting only between

approximately 4 to 8 out of every 1000 adults worldwide [Bhugra, 2005; Saha et al., 2005]), it seems to be universal, appearing in cultures all over the world and across history. Some of our earliest writings describe people who seem to have lost touch with reality, who “hear voices,” and who produce bizarre speech and behaviours. At some earlier times in history, a person experiencing such symptoms may have been suspected of demon possession or some form of witchcraft. At other times and places, such people might be revered as shamans or as having special connections to the spirit world, and may well have played important roles in the community. Now, we would likely diagnose schizophrenia.

Symptoms and Types of Schizophrenia

There are many popular but misguided beliefs regarding schizophrenia. For example, people believe that individuals with schizophrenia have more than one personality; however, this is a completely different disorder known as

Dissociative Identity Disorder (DID; see Module 15.2 ). In reality, schizophrenia refers to what many psychologists and psychiatrists believe is a brain disease that causes the person to experience significant breaks from reality, a lack of integration of thoughts and emotions, and problems with attention and memory. Symptoms may begin to occur and escalate very gradually, remaining largely unnoticeable for a long time before family members start to perceive a pattern. In other cases, however, symptoms can begin and escalate very rapidly. There is, therefore, a very wide range of possible trajectories that the disease may follow over time.

Stages of Schizophrenia

In most cases of schizophrenia, there are three distinct phases: prodromal, active, and residual. These tend to occur in sequence, although individuals may

cycle through all three many times. In the prodromal phase , people may become easily confused and have difficulty organizing their thoughts, they may lose interest and begin to withdraw from friends and family, and they may lose their normal motivations, withdraw from life, and spend increasing amounts of time alone, often deeply engrossed in their own thoughts. It is not uncommon for other people to get upset as a result of these behaviours, assuming the person is

lazy or otherwise being irresponsible. In the active phase , people typically experience delusional thoughts, hallucinations, or disorganized patterns of thoughts, emotions, and behaviour. This phase usually transitions into the residual phase , in which people’s predominant symptoms have disappeared or lessened considerably, and they may simply be withdrawn, have trouble concentrating, and generally lack motivation.

There is huge variety in terms of the progression of schizophrenia. Some people cycle through the three stages only a couple of times in their lives, whereas others may cycle repeatedly; typically, the severity of the withdrawal in the residual phase tends to increase with repeated episodes, and their ability to

function normally seems to decrease.

The symptoms of schizophrenia are most pronounced in the active phase of the disease, but one must always remember that the transitions between these phases will not be perfectly clean. There may be times when symptoms do not occur during the active phase; there may also be times when they do occur during the residual phase. Additionally, the person with schizophrenia may experience short-term resurgences of symptoms, often triggered by stressful periods or episodes in their lives.

Symptoms of Schizophrenia

Schizophrenia is associated with a number of different symptoms. A key

distinction is made between positive and negative symptoms (Harvey & Walker, 1987). Positive symptoms refer to the presence of maladaptive behaviours, such as confused and paranoid thinking, and inappropriate emotional reactions. In contrast, negative symptoms involve the absence of adaptive behaviour, such as absent or flat emotional reactions, lack of interacting with others in a social setting, and lack of motivation.

One common positive symptom is the presence of hallucinations , alterations in perception, such that a person hears, sees, smells, feels, or tastes something that does not actually exist, except in that person’s own mind. These experiences are often accompanied by delusions , beliefs that are not based on or well integrated with reality. For example, people may believe that they are someone famous, or that they have a divine purpose; they may believe there is special significance or hidden messages or codes in the media that they encounter; they might believe that everybody despises them, or that they are being constantly followed and that their life is in danger. Or they might believe they can control the wind or communicate telepathically with birds. Many of these

symptoms are examples of delusions of grandeur, a belief that an individual is more important or talented than he or she really is. For example, consider the following personal account of Kurt Snyder, who wrote a book about his experiences with schizophrenia during college:

I thought about fractals and infinity for many years. I always told myself I was on the

verge of discovery, but I simply had to think a little bit harder about it. I just wasn’t

thinking hard enough. The reality is that the problems I was trying to solve were far

beyond my mental abilities, but I didn’t recognize this fact. Even though I had no

evidence to substantiate my self-image, I knew in my heart that I was just like Einstein,

and that someday I would get a flash of inspiration. I didn’t recognize the truth—that I

am not a genius. I kept most of my mathematical ideas to myself and spoke to very few

people about them. I was paranoid that someone else would solve the riddle first if I

provided the right clues. (Snyder, 2006, p. 209)

Source: Snyder, K. (2006). Kurt Snyder’s personal experience with schizophrenia. Schizophrenia Bulletin, 32 (2), 209–

211. Copyright © 2006 Oxford University Press. Reprinted by permission.

In addition to hallucinations and delusions, individuals with schizophrenia often

have disorganized behaviour ; this term describes the considerable difficulty people with schizophrenia may have completing the tasks of everyday life— cooking, taking care of one’s hygiene, socializing. They have great difficulty organizing their behaviour enough to complete tasks before getting distracted by other thoughts or things to do. This makes it difficult to follow a project, or even a train of thought, to completion, as their minds may jump from thought to thought uncontrollably.

Kurt Snyder began experiencing schizophrenia in college. Me, Myself, and Them is his personal account of living with schizophrenia. Provided by Kurt Snyder, author

Individuals with schizophrenia experience several additional problems with cognitive functioning. These range from basic, low-level physiological responses,

such as excessive eye blinking in response to stimulation (Perry et al., 2002), to more complex cognitive skills, such as those required for standardized achievement tests—test scores tend to drop during adolescence as the disorder

begins and progresses (Fuller et al., 2002). Many complex cognitive abilities involve the prefrontal cortex, a brain region that shows significant neurological

decline in individuals with schizophrenia (Wright et al., 2000). This may be the reason for deficits in working memory that connect to symptoms associated with schizophrenia, such as the inability to keep track of a train of thought, organize the sequence of a conversation, and handle multiple tasks at once. Working

memory deficits may partially explain the disorganized thoughts and speech

characteristic of schizophrenia (Park et al., 1999).

Social interaction is often very difficult for people with schizophrenia. These individuals typically have difficulty reasoning about social situations and show

relatively poor social adjustment (Done et al., 1994). In addition, their emotional expressions and ability to react to the emotions of others may be impaired (Penn & Combs, 2000). For example, people with schizophrenia may maintain a neutral mask-like expression on their faces, and show little response to smiles or other expressions from people around them. As a result, the person with schizophrenia generally is not as socially competent and strikes others as a little “odd”; this can set social feedback processes in motion (such as others then avoiding eye contact or extended discussions with the schizophrenic person). This, in turn, may cause the person with schizophrenia to become aware of this negative social feedback, to feel self-conscious and uncomfortable, and to be more likely to socially withdraw in the future.

Social withdrawal and isolation is a very common consequence of schizophrenia and may even be related to the long-term outcomes of the disease. Helping people with schizophrenia deal with their own social behaviours and skills is an important factor in the treatment of this disorder.

Common Sub-Types of Schizophrenia

As you can see, numerous symptoms accompany schizophrenia. For some individuals, the symptoms cluster into different patterns, leading mental health professionals in the past to identify subtypes of the disorder. These subtypes were dropped from official practice in 2013, as they are artificial categorizations of complex behaviour patterns, and are often not reliably measurable; but, they are still commonly used and are therefore worth being aware of:

Paranoid schizophrenia : Symptoms include delusional beliefs that one is being followed, watched, or persecuted, and may also include delusions of grandeur or the belief that one has some secret, insight, power, or some other characteristic that makes one particularly special.

Myths in Mind Schizophrenia Is Not a Sign of

Violence or of Being a “Mad Genius” Although schizophrenia is a widely recognized term, it is also widely misunderstood. As was mentioned in the opening story about John Nash, people may believe that schizophrenia makes people violent or dangerous, or causes people to have different personalities. People also commonly believe that the “madness” of schizophrenia is associated with being a genius. It can be difficult to dispel such myths, especially with high-profile cases that fit so well with these common beliefs; cases like John Nash or Ted Kaczynski (aka the “Unabomber”). Similar to Nash, Kaczynski was a very bright mathematician who seemed to slip into schizophrenic delusions. Contrary to Nash, however, Kaczynski’s delusions led him to take violent actions against what he perceived to be the evil system of our society. This earned him his Unabomber nickname, because he sent bombs through the mail to prominent researchers at various universities.

The truth is that schizophrenia is not associated with genius but, in fact, with cognitive deficits. In contrast to Ted Kaczynski and John Nash, most people with schizophrenia score slightly below average on IQ tests

(Woodberry et al., 2008). Also, people with schizophrenia are only rarely violent. In these cases, other factors such as substance abuse usually play a big role. People with schizophrenia do not have a propensity for violence that is meaningfully different from the rest of the population

(Douglas et al., 2009; Fazel et al., 2009). Rather than being violent, people with schizophrenia are likely to isolate themselves and end up in situations in which they are likely to be harmed. In fact, it’s the people with schizophrenia who should perhaps fear the rest of society; people with mental illnesses are approximately 10 times more likely to be victims

of crime than the rest of the population (Teplin et al., 2005).

Disorganized schizophrenia : Symptoms include thoughts, speech, behaviours, and emotions that are poorly integrated and incoherent. People with disorganized schizophrenia may also show inappropriate, unpredictable mannerisms. Catatonic schizophrenia : Symptoms include episodes in which a person remains mute and immobile—sometimes in bizarre positions—for extended periods. Individuals may also exhibit repetitive, purposeless movements. Undifferentiated schizophrenia : This category includes individuals who show a combination of symptoms from more than one type of schizophrenia. Residual schizophrenia : This category reflects individuals who show some symptoms of schizophrenia but are either in transition to a full-blown episode or in remission.

Increasing our knowledge of the complexity—and variability—of schizophrenia has allowed clinicians to improve treatment methods. This will hopefully help reduce stigma surrounding schizophrenia so that people may not behave as negatively toward individuals with this disorder. Unfortunately, a great deal of stigma does remain, in part because of common misunderstandings that many have about schizophrenia.

People who experience catatonic schizophrenia will remain immobile, even if in a bizarre position, for extended periods of time. Grunnitus Studio/Photo Researchers, Inc./Science Source

Module 15.4a Quiz:

Symptoms and Types of Schizophrenia

Know . . . 1. A person with schizophrenia who experiences delusions that she is

royalty is experiencing a(n) symptom. A. positive B. negative C. catatonic D. undifferentiated

Apply . . . 2. An individual showing poor integration of thinking and emotion visits a

psychiatrist claiming that all of her neighbours are watching her. Into which category of schizophrenia might the psychiatrist classify the individual?

A. Residual B. Undifferentiated C. Disorganized D. Paranoid

Analyze . . . 3. Which of the following statements best summarizes the relationship

between schizophrenia and violence?

A. Generally, people with schizophrenia are no more likely to become violent than non-mentally ill people, and if violence occurs, other factors, such as substance abuse, are likely to contribute to its cause.

B. People with schizophrenia are twice as likely to be violent as non- mentally ill people.

C. People with schizophrenia are far more peaceful than non- mentally ill people.

D. People with schizophrenia cannot differentiate right from wrong, and therefore are prone to violence.

4. There have been several famous cases of people with superior intellectual abilities along with schizophrenia. Does this mean that schizophrenia is the cause or the result of genius?

A. No; in fact, the average IQ of people with schizophrenia may be slightly lower than average.

B. Yes; in fact, the average IQ of people with schizophrenia is approximately 15% higher than average.

C. Yes, because people who are that smart are likely to develop schizophrenia simply because they know too much.

D. No, because schizophrenia is almost always associated with very low IQs.

Explaining Schizophrenia

So far, we have described schizophrenia based on its psychological and physical characteristics. Researchers are also very curious about the underlying sources of these characteristics and have employed a wide range of techniques to discover what causes schizophrenia. Through the application of the biopsychosocial model, a holistic understanding of schizophrenia is emerging.

Genetics

Studies using twin, adoption, and family history methods have shown that as genetic relatedness increases, the chance that a relative of a person with

schizophrenia will also develop the disorder increases (see Figure 15.8 ). For example, if one identical twin has schizophrenia, the other twin has a 25% to 50% chance of developing it. This rate is significantly higher than the 10% to

17% rate found in dizygotic (fraternal) twin pairs (Gottesman, 1991).

Figure 15.8 Genetic Influences for Schizophrenia The more genetic similarity an individual has to a person with schizophrenia, the more likely that he or she will also develop the disorder.

For decades, behavioural genetic scientists have known that genes contribute to schizophrenia, but they have not identified the specific genes that are involved. However, with the benefit of recent technological advances and the data from the Human Genome Project, researchers are beginning to make progress on this question. For example, scientists have discovered a distinct pattern of genetic irregularities that is found in 15% of individuals with schizophrenia, compared

with only 5% of healthy controls (Walsh et al., 2008). On the one hand, this relationship suggests a possible genetic contribution to schizophrenia. On the other hand, the genetic abnormality was not found in 85% of the individuals with schizophrenia.

Additional insights were provided by researchers at the University of Alberta.

Their first breakthrough came by chance, as is often the case. Researcher Diane Cox was looking at samples of genetic material for research that had nothing to do with schizophrenia, but she noticed samples from a mother–daughter pair that showed a remarkable similarity; each sample had a break in one of the genes on

chromosome 14 (Kamnasaran et al., 2003); as it turned out, both of them had schizophrenia. This important clue led to further breakthroughs about genetic contributions to schizophrenia and the mechanisms through which genes affect

the development of the disease (Wong et al., 2013). However, given the complexity of schizophrenia and its symptoms, much more research needs to be performed.

Schizophrenia and the Nervous System

One important neurological characteristic of people with schizophrenia is the size of the brain’s ventricles (the fluid-filled spaces in the core of the brain). People with schizophrenia have ventricles that are 20% to 30% larger than people

without schizophrenia (see Figure 15.9 ; Gottesman & Gould, 2003). The reason for these larger ventricles is a loss of brain matter, which amounts to a reduction of total brain volume by approximately 2% in those individuals with schizophrenia. In particular, the reduced volume can be found in structures such

as the amygdala and hippocampus (Wright et al., 2000).

Figure 15.9 Brain Volume in One Monozygotic Twin with Schizophrenia and Another without Schizophrenia The brains of two genetically identical individuals, one affected with schizophrenia and the other unaffected, are shown here. The arrows point to the spaces created by the ventricles of the brain. Note the significant loss of brain matter in the affected individual. Courtesy of E. Fuller Torrey and Daniel Weinberger

The brains of people with schizophrenia are not just different in size; they also

function differently. People with schizophrenia show lower levels of activity in their frontal lobes, both in resting states and when engaged in cognitive tasks,

suggesting that these brain regions are not functioning at an optimal level (Hill et al., 2004).

Changes in brain chemistry are also evident in schizophrenia. People with schizophrenia have an increased rate of firing in dopamine-releasing cells. Some of this over-activity is in a part of the brain known as the basal ganglia, which is involved in a number of functions including reward responses. As a result of this firing, stimuli that should be meaningless are interpreted as being quite

noteworthy (Heinz & Schlagenhauf, 2010). Excess firing of these dopaminergic cells can produce the types of positive symptoms associated with schizophrenia, such as hallucinations and delusions; however, dopamine cannot be the whole neurochemical story, as it is unrelated to negative symptoms such as flattened

emotion and lack of speech (Andreasen et al., 1995).

Glutamate, another neurotransmitter, appears to be underactive in certain brain regions, including the hippocampus and the frontal cortex. Glutamate is the brain’s primary excitatory neurotransmitter, so a reduction of glutamate in those areas would correspond to a reduction of their functioning. Interestingly, glutamate receptor activity is also inhibited by the drug PCP (angel dust), which in high doses can cause symptoms that mirror those of schizophrenia.

Psychologists have long noted that individuals who are being treated with antipsychotic drugs that block dopamine tend to be heavy smokers. One possible reason is that nicotine helps to stimulate the release of additional dopamine. As a result, heavy nicotine use stimulates the dopamine-rich reward

and cognitive centres of the brain (Winterer, 2010). ImageBroker/Alamy Stock Photo

The fact that schizophrenia has been linked with differences in genes, neurotransmitters, and the volume of brain structures suggests that the mechanisms underlying this disorder are not simple. Indeed, as you will read in the next section, one of the best-known hypotheses about the cause of schizophrenia suggests that it involves an interaction between an external agent (possibly a virus) and the brain at some of its earliest stages of development.

Working the Scientific Literacy Model The Neurodevelopmental Hypothesis

Schizophrenia is obviously a complex disorder, and no single explanation has been able to account for all the variations in its symptoms, severity, and duration. One of the leading perspectives on the causes of schizophrenia is the

neurodevelopmental hypothesis, which approaches schizophrenia from a biopsychosocial perspective, emphasizing the interaction between factors at different levels of analysis.

What do we know about the neurodevelopmental hypothesis? People who develop schizophrenia often exhibit identifiably abnormal patterns of behaviour early on. Indeed, the neurodevelopmental hypothesis suggests that the adult manifestation of what we call “schizophrenia” is the outgrowth of disrupted neurological development early in the person’s life. In fact, schizophrenia may even be set in motion by environmental factors while the person is still in the womb, such as exposure to flu viruses.

One intriguing research finding is that people with schizophrenia

are more likely to have been born during winter months (Tochigi et al., 2004). One hypothesis is that winter births carry this higher risk because the onset of the flu season, in the fall, coincides with the second trimester, in which the fetus’s brain is developing at an enormous rate. Maternal exposure to the influenza virus at such a critical time of neurological development is argued to be one contributing factor to schizophrenia. More generally, environmental factors that cause stress for the mother while pregnant, such as losing her spouse or experiencing trauma such as war or violence, can impact fetal development; the massive release of stress hormones during such difficult events has a variety of neurological and cognitive effects on the developing fetus, which could increase the risk of developing schizophrenia

(Brown & Derkits, 2010; King et al., 2010).

How can science test the neurodevelopmental hypothesis? The neurodevelopmental hypothesis draws from research on genetic and prenatal factors. However, the developmental emphasis of the hypothesis gains strength from behavioural

evidence collected during childhood and adolescence, which shows that people who develop schizophrenia showed warning signs when they were very young. For example, when psychologists viewed home movies of infants and children who subsequently developed schizophrenia, they noted that these children showed some unusual motor (i.e., movement) patterns, primarily on the left side of the body, such as jerky, repeated, and

unnecessary arm movements (Walker et al., 1994). These motor patterns were not present in their siblings, who did not have schizophrenia. This evidence suggests that a precursor of schizophrenia is present very early in life, setting in motion the processes and shaping the patterns of brain activity that lead further into the development of the disorder.

In adolescence, psychologists can detect the schizophrenia prodrome, a collection of characteristics that resemble mild forms of schizophrenic symptoms. For example, a teenager might become increasingly socially withdrawn and have some difficulty with depression and anxiety. But the most telling problems include experiences that resemble somewhat mild hallucinations and delusions. As one example, a teen might say, “I seem to keep hearing my mother calling my name before I fall asleep,

even when I know she isn’t home. It is strange . . .” (Walker et al., 2010, p. 206).

Can we critically evaluate this information? Perhaps the most interesting challenge to this research, and one that has huge implications for our understanding of developmental disorders, is that the precursors to schizophrenia are not unique to that disorder, but in fact are precursors to a variety of neurodevelopmental disorders. Indeed, the traditional view that the neurodevelopmental disorders are separate and discrete categories is being challenged; instead, the developmental disorders of intellectual disability, autism, ADHD, schizophrenia, and bipolar disorder may in fact be part of a larger

syndrome of dysfunction that is rooted in common causes (Owen et al., 2011). The fact that cognitive deficits play such a central role in all these disorders fits with this possibility.

Why is this relevant? By identifying prenatal risk factors and developmental patterns related to schizophrenia, it may be possible to alter the progression of the disorder. As part of this process, researchers will need to improve our understanding of the types of emotional support pregnant women need in order to reduce the effects of stress hormones on the fetus. A long-term goal of these related research programs would be to prevent schizophrenia from

developing, or at least to control its severity (McGlashan et al., 2006; McGorry et al., 2002). To accomplish these goals, researchers will have to rely on all levels of explanation: genetics, prenatal influences, brain structure and function, and psychosocial factors.

It is worth noting that late adolescence and the early twenties is a particularly important time for the proper development of the frontal lobes; this is also the most common time in life for schizophrenia to be diagnosed. Importantly, this is also often one of the more stressful periods in many people’s lives, due to the turmoil of adolescence and the trials of early adulthood. The fact that schizophrenia often appears during a particularly stressful stage of development shows us that processes occurring “outside” of the individual (i.e., in the person’s social environment) may affect the development of this disorder.

Environmental and Social Influences on

Schizophrenia

Long after prenatal development, certain events can increase one’s risk of developing schizophrenia. For example, some research suggests that a very

small proportion of people who use marijuana develop psychotic symptoms, possibly because the drug interacts with the genes involved in schizophrenia

(Caspi et al., 2005). Head injuries occurring prior to age 10 also put people who are genetically vulnerable to schizophrenia at greater risk for developing the

disorder (AbdelMalik et al., 2003). Also, being raised in an environment where psychosocial stressors (e.g., interpersonal conflict, social isolation, poverty) are more abundant, such as modern urban environments, puts individuals at greater

risk for developing schizophrenia (van Os et al., 2004), because schizophrenic episodes are often triggered by acutely stressful circumstances.

Closely related to the impact of stress on the development of schizophrenia is the role of social support. Research has shown that the progression of schizophrenia is strongly related to the way in which family members support

and treat the person with schizophrenia. Families high in emotional expressiveness (EE) tend to be overly critical and controlling, whereas families low in EE tend to be more supportive, accepting, and non-judging. As several teams of researchers have found, there are huge differences between people with schizophrenia who live in high-EE versus low-EE families. People with schizophrenia are three to four times more likely to experience a relapse of their

symptoms within a nine-month period if they live in high-EE families (Brown et al., 1972; King & Dixon, 1999). This trend has led to the creation of therapeutic interventions designed to help families reduce their negative behaviours and to learn to be more supportive.

However, research by Suzanne King of McGill University indicates that the relationship between EE and schizophrenia may be more complicated than previously thought. People with more severe cases of schizophrenia are more difficult to manage, put more stress on the family, and therefore may end up

having more emotionally expressive families (King, 2000). Thus, the full relationship between schizophrenia and emotional expressiveness may involve a two-way causal process, with each factor affecting the other over time.

Culture and Schizophrenia

In Module 15.1 , we introduced the topic of cultural perceptions of mental

illness. Differing cultural perspectives are strongly evident when it comes to schizophrenia. For example, ethnicity influences the types of experiences that individuals report having. A U.S.-based study found that Anglo-Americans tend to focus on the mental experiences of the disorder, such as disorganized thinking and emotions. In contrast, Mexican Americans focus more on how schizophrenia affects the body, such as by producing tension or tiredness. They conceive of the disorder as any other form of illness, rather than viewing mental disorders as a

separate type of condition (Weisman et al., 2000).

Beliefs about mental illness are linked to varying cultural views of the world

(McGruder, 2004). Many people throughout the world, such as the Swahili of Tanzania, believe that what we call schizophrenia is really a sign that spirits have invaded or are communicating with the body. In many cultures, this is actually seen as a good thing, that the person is being gifted with the ability to communicate in some fashion with the spirit world. These individuals are given important status in the community—virtually the opposite to the treatment of schizophrenia in Western culture.

As you think about the different ways that a person with schizophrenia would be treated in these different cultural contexts, and the presumed sophistication of our scientific understanding of what we call schizophrenia, consider one surprising fact—the long-term outcomes for people who have symptoms that

would be diagnosed as schizophrenia are actually better in developing countries and traditional cultures that have been minimally influenced by the Western medical system. This shows us that regardless of the symptoms of a disorder, people benefit from being treated with kindness and compassion.

Module 15.4b Quiz:

Explaining Schizophrenia

Know . . . 1. The neurodevelopmental hypothesis states that

A. neural factors are solely responsible for schizophrenia. B. social factors are solely responsible for schizophrenia.

C. irregular biological and environmental factors interact during early development and are responsible for schizophrenia.

D. prenatal exposure to the influenza virus definitely causes schizophrenia.

Understand . . . 2. Which of the following statements is most accurate concerning the

biochemical basis of schizophrenia?

A. The neurotransmitter dopamine is overly active. B. Dopamine is underactive. C. Serotonin levels are too low. D. There is too much glutamate activity.

3. Evidence for the neurodevelopmental hypothesis includes the fact that young children who eventually develop schizophrenia

A. report hallucinations as early as four years of age. B. show unusual motor patterns such as jerky, repeated

movements.

C. lapse into periods of catatonia. D. had the flu during preschool.

Module 15.4 Summary

active phase

catatonic schizophrenia

delusions

disorganized behaviour

disorganized schizophrenia

hallucinations

negative symptoms

15.4a Know . . . the key terminology associated with schizophrenia.

neurodevelopmental hypothesis

paranoid schizophrenia

positive symptoms

prodromal phase

residual phase

residual schizophrenia

schizophrenia

undifferentiated schizophrenia

Part of how we can explain schizophrenia is by identifying the neurotransmitters that are affected by this disorder. Increased dopamine levels are associated with the positive symptoms of schizophrenia, such as having hallucinations or delusions. Reduced levels of glutamate, an excitatory neurotransmitter, have been linked with the negative symptoms of schizophrenia, such as flat emotional reactions and a lack of motivation.

The neurodevelopmental hypothesis claims that at least some neurological abnormalities are present at birth, although it does not state to what degree these abnormalities are genetic or environmental. Nevertheless, some research suggests that prenatal exposure to the flu or to significant amounts of stress hormones are risk factors for this type of mental illness. Genetics seem to play a role, as twin studies show that if one identical twin has schizophrenia, the other has a 50% chance of developing the disorder—a substantial increase over the 1% occurrence rate in the general population.

15.4b Understand . . . how different neurotransmitters affect individuals with schizophrenia.

15.4c Understand . . . the genetic and environmental contributions to schizophrenia.

Apply Activity Identify whether the following behaviours are positive or negative symptoms of schizophrenia.

1. Rosalita was helped to a chair and she has sat there, virtually motionless, for about two hours.

2. Eyanna refuses to go to the dentist. “Last time I went,” she said, “they put a transmitter in my teeth so that the agents can control my thoughts.”

3. Jeff has begun experiencing extreme dissociations. He even has started acting differently and referring to himself as “Dan.”

4. Jinhai’s language is very difficult to understand. He seems to be talking perfectly well but many of the words he is using are made up and other words are totally out of place.

As you have read, some high-profile cases highlight people with schizophrenia who are intellectually brilliant. In reality, however, research tells us that the average intelligence of people with schizophrenia is similar to, although slightly lower than, the norm. Similarly, the belief that schizophrenia leads to violence derives from a small group of high-profile examples. In truth, there does not seem to be an increased risk of violence associated with schizophrenia alone.

15.4d Apply . . . your knowledge to identify different forms of schizophrenia.

15.4e Analyze . . . claims that schizophrenia is related to genius or violent behaviour.

Chapter 16 Therapies

16.1 Treating Psychological Disorders Barriers to Psychological Treatment 655

Module 16.1a Quiz 657

Mental Health Providers and Settings 657

Module 16.1b Quiz 660

Evaluating Treatments 660

Working the Scientific Literacy Model: Can Self-Help Treatments Be Effective? 661

Module 16.1c Quiz 662

Module 16.1 Summary 663

16.2 Psychological Therapies Insight Therapies 665

Module 16.2a Quiz 668

Behavioural, Cognitive, and Group Therapies 668

Working the Scientific Literacy Model: Virtual Reality Therapies 669

Module 16.2b Quiz 674

Module 16.2 Summary 674

16.3 Biomedical Therapies

Drug Treatments 677

Working the Scientific Literacy Model: Is St. John’s Wort Effective? 679

Module 16.3a Quiz 681

Technological and Surgical Methods 682

Module 16.3b Quiz 684

Module 16.3 Summary 685

Module 16.1 Treating Psychological Disorders

Ambrophoto/Alamy Stock Photo

Learning Objectives

Know . . . the key terminology associated with mental health treatment. Understand . . . the major barriers to seeking help for psychological disorders. Understand . . . the arguments for and against involuntary treatment. Apply . . . your knowledge to suggest what approach to therapy is likely most appropriate for a given situation. Analyze . . . whether self-help options, such as popular books, are a

16.1a 16.1b

16.1c 16.1d

16.1e

“The Power of Vulnerability” has become one of the most popular TED talks ever given. This simple, from the heart talk involves a brilliant, personable, and completely vulnerable woman, talking about how she went to a therapist because she was having a breakdown (although according to her therapist it was a spiritual awakening). Brené Brown’s talk on shame courageously exposed her personal struggle with feelings of shame and “not being good enough” to millions of TED viewers. Her deeply moving story is one that many people can relate to. Brown’s crucial message was that it is normal and indeed healthy for a person to go to a therapist to deal with issues like these. By being so open about her experiences, she sets an example for the rest of us that a key step toward overcoming the stigma surrounding mental illness and therapy is to talk about it.

Western culture’s strong individualistic emphasis and do-it-yourself mentality fosters the attitude that people need to be independent and “strong.” Mental illness is often seen as a sign of weakness, and negative stigma surrounds therapists who are sometimes stereotyped as “quacks” or “shrinks,” lost in psycho-babble and out of touch with reality. Indeed, popular culture has often painted an unflattering portrait of psychologists, from the terrifying Nurse Ratchet in One Flew Over the Cuckoo’s Nest, to the ridiculous Dr. Frasier Crane dispensing psychological wisdom on Frasier.

Thus, it is worth paying attention when an extremely popular cultural event, like Brown’s TED talk, shows the public that therapy is a normal part of many people’s lives. Perhaps the stigma associated with mental illness and therapy is finally being overcome.

Focus Questions

1. What are the major barriers that hold people back from seeking

useful therapy option.

psychological help?

2. What are the settings in which psychological therapy typically occurs?

In Chapter 15 we described some of the psychological disorders that affect people. Disorders touch many people’s lives, either directly (approximately 20% of people are thought to experience a psychological disorder at some point in

their lives; Narrow et al., 2002), or indirectly via friends, family, neighbours, or co-workers who struggle with disorders. Furthermore, if you interpret the term “disorder” more broadly to include experiences like shame, which can markedly reduce or limit a person’s overall functioning, then far more than 20% of us would benefit from getting professional help with the issues that hold us back. Clearly, there is a pervasive need for effective psychological treatments. In this module, we provide an overarching view of the approach our society takes to treating psychological disorders, discussing who tends to seek treatment, who provides it, and how treatment approaches are evaluated.

Over the past several decades, attitudes toward therapy have indeed changed. It is now commonplace for celebrities to be open about their traumatic childhoods, relationship problems, drug abuse, and other psychological struggles. Similarly, bookstores have entire sections devoted to psychology, full of advice and insight for people seeking to help themselves or someone they care about. These changes reflect a general normalization of the idea of psychological disorders and a lessening of the stigma surrounding mental illness. This shift is reflected in the high number of people who seek psychological services; each year in Canada, approximately 10% of the population seeks some form of treatment for

mental health issues (Lesage et al., 2006).

Nevertheless, not all groups of people are equally likely to seek psychological treatment. In general, women participate in therapy more often than men, and people aged 35 through 55 seek treatment more often than younger adults and

the elderly (Addis & Mahalik, 2003; Olfson & Marcus, 2010). People from certain cultural groups are less likely to use psychological services; in Canada, Asian Canadians and people of Native descent are both less likely to seek

mental health treatment than White Canadians (Sue & Lam, 2002). Therapy is also a more popular choice for Canadians and Americans in general relative to people from many other countries such as Israel, Hungary, Japan, and Korea

(Cohen et al., 1998; Masuda et al., 2005; Yoo & Skovholt, 2001). There are many possible reasons for these differences, ranging from the degree of stigma toward mental illness in different cultures to financial and other barriers that make access to treatment more difficult.

Barriers to Psychological Treatment

Despite the optimism with which we opened this chapter, it is still the case that many people with a disorder do not receive help. For example, in one study of 1600 adults who had been diagnosed with depression or an anxiety disorder,

only 30% were receiving some form of therapy (Young et al., 2001). In both Canada and the U.S., surveys show that approximately two-thirds of people with

mental health issues do not seek help from the mental health system (Lesage et al., 2006; NIMH, 2011). Furthermore, even when people do seek therapy, about half of them significantly delay doing so after first becoming aware of their mental

health issues, often for years (DiClemente & Prochaska, 1985; Prochaska & DiClemente, 1984). Why would people choose not to seek help?

There are many barriers that prevent or delay people from seeking psychological treatment. One problem that almost everyone struggles with is that disorders themselves are inherently ambiguous; there is no objective, easily definable line between “mentally healthy” and “mentally ill” and no litmus test that can tell a person with a high degree of certainty that they need to seek help. Thus, a person may believe he is simply “sad,” not depressed, and of course, sadness is a regular part of life, and not everyone who is sad needs to see a therapist. Or, a person may believe she is merely stressed or a bit worried about things, not that she has an anxiety disorder. This inescapable ambiguity makes it unclear exactly when it’s desirable for a person to seek treatment.

Also, people very commonly are motivated to not see themselves as mentally ill,

so much so that they minimize their symptoms, basically tricking themselves and others to think that they are healthier than they really are. To some, having a mental illness would feel like a sign of weakness or a personal failing, and they may not want to see themselves that way, or may not want to feel like a burden to their families and loved ones. Other people may be unwilling to risk the social stigma and fear they might embarrass themselves or their families, or they may not trust the psychological or psychiatric professions and be skeptical of the

efficacy and safety of different treatments (Craske et al., 2005; Mansfield et al., 2005; Vanheusden et al., 2008). Overcoming such skepticism may make a big difference in helping people seek treatment; for example, in one study, 99% of respondents said they would seek mental health treatment if they believed it

would be helpful (Fox et al., 2001). There is an important role to be played by educational programs that help people become aware of how different problems

can be treated, and help to build confidence in the mental health profession (Fox et al., 2001; Sharp et al., 2006).

The cumulative impact of the different barriers to psychological treatment leaves millions of people delaying or simply never receiving the kind of therapy and

support that could seriously improve their lives (P. S. Wang et al., 2005). Understanding these barriers is an important step toward overcoming them.

Stigma About Mental Illness

One common barrier that we alluded to earlier is stigma toward mental illness

and toward the process of therapy itself (Corrigan, 2004; Vogel et al., 2009). You may already understand the effects of stigma—just imagine how different it might be for a business executive to take some time off work to undergo surgery versus taking time off to deal with “emotional issues.” Having surgery or some other physical health issue to deal with would likely be far easier for the person to talk to colleagues about, for others in the workplace to offer support and rally around the person, and for the time off to not impact the person’s success in the company. Unfortunately, in many professions, mental illness carries a strong stigma that can result in people with psychological disorders experiencing discrimination at the workplace. There may also be social costs, such as being treated differently by friends, family, or potential romantic partners. For example,

one out of every two Canadians admits that they would likely not socialize with a friend who had a serious mental illness, and one in four Canadians admits that

they are afraid to be around people with serious mental illnesses (Canadian Medical Association, 2008). Obviously, we still have a long way to go before mental illnesses are viewed in the same way as physical ailments.

Gender Roles

In many countries with strong gender norms, including Canada and the U.S., there are extra pressures on men to avoid treatment because needing help and going to therapy seem incompatible with the idea of being strong and independent, key aspects of the male gender role. This emphasis on strength and independence leads people to deny that they have any problems, or to believe that they need to “just get over it,” as though people can be expected to overcome mental health issues through sheer force of will. This emphasis on individual strength and self-reliance certainly doesn’t promote talking about emotions and acknowledging vulnerabilities, steps that would put people on a

path toward healing (Berger et al., 2005; Mahalik et al., 2003). In fact, getting men to see therapy differently has presented such a challenge that the National Institute of Mental Health (NIMH) has staged public awareness campaigns in the U.S., such as the “Real Men, Real Depression” campaign. Initial evidence indicates that social marketing messages such as this do succeed in increasing the likelihood people will seek help, perhaps partially overcoming resistance

based on traditional gender roles (Bell et al., 2010; Rochlen et al., 2006).

Logistical Barriers: Expense and Availability

Two of the main barriers to mental health treatment are about access—whether

people can afford the cost and the time for treatment (Colonna-Pydyn et al., 2007; Craske et al., 2005). Money has a particularly profound influence on the way that the mental health system functions and the kinds of treatments that are available for many people. For example, psychotherapy can be very expensive, generally costing more than $100 per hour, and often much more than that. Therapy is also associated with numerous indirect costs, such as time away from work, transportation, and possibly childcare.

Unfortunately, government healthcare coverage in Canada generally only includes treatment by psychiatrists, leaving counsellors, psychologists, and many types of therapists less able to reach many people who can’t afford their services. The net result of these sorts of funding decisions is to place substantial emphasis on the medical approaches to treating psychological disorders. In practice, this means that most of the money flows to the pharmaceutical industries, hospitals, and psychiatric treatments, leaving many talk-based counsellors and therapists (as well as emerging movements within the field of therapy that are not yet widely recognized) heavily disadvantaged.

This practice may also mean that many people’s lives spiral into much greater distress and dysfunction than would be necessary if people were able to get therapeutic help for things like learning to effectively manage emotions, improve relationships in the family, or deal with stress or problematic behaviour patterns. Without easy access to counsellors who could help with issues like these, people often try to cope with life as best they can until problems develop into such major issues that they can no longer avoid seeking help. This often results in the treatment process beginning in a hospital emergency room, which places an

extra burden on the public healthcare system (Snowdon, 1999). If an ounce of prevention is worth a pound of cure, as the old saying goes, our current method of funding mental healthcare seems to go in exactly the opposite direction.

To help overcome these barriers, some community organizations provide offices in lower-income areas where private psychotherapists are scarce and needed. Community mental health centres sometimes provide therapy on a sliding scale, which means the cost of a one-hour session varies depending on the patient’s income and whether he has additional health benefits from his employer that would cover some of the therapy costs. Drug treatments can also be made more affordable by using generic products as opposed to brand-name ones, although this tends to be resisted by pharmaceutical companies who spend huge sums of money researching and promoting their drugs. In short, efforts are being made to make therapy more accessible to more people, but the cold reality is that unless policy changes are made to open up funding to a wider diversity of mental health treatments, the problem will persist.

Involuntary Treatment

In some cases, people are required (that is, forced) to enter the mental health system against their will. In Canada and the United States, as well as many other countries, people can be compelled through the courts or on the advice of social service agencies or doctors to be treated for mental illness. The majority of these cases arise due to the person engaging in highly erratic or disturbing behaviour, which results in legal trouble and the perception that the person may be a risk to themselves or others. Involuntary treatment can also be required after the person commits harm to others, as in some cases of domestic violence.

This “outpatient commitment” is a highly contentious issue in the field of mental health and in the legal system, because it strips people of some of their basic rights. Proponents of this practice argue that it improves mental health, reduces the costs of mental illness on society, and increases the effectiveness of treatment by ensuring that people with severe disorders receive treatment that they might otherwise avoid; it also may protect society from people who may otherwise commit harm. People who are opposed are concerned that this practice is unethical because it can restrict the freedom and take away the rights of people who have not done anything harmful to themselves or others, force people to receive medications that may alter brain function and have dangerous side effects, and easily be misapplied to certain ethnic groups and lower

socioeconomic classes (Kisely et al., 2011).

Research has thus far failed to clear up the controversy. For example, some studies show that a significant number of people benefit from mandated treatment, as indicated by their adherence to treatment and reduced encounters

with law enforcement (Hough & O’Brien, 2005; Pollack et al., 2005). On the other hand, many people placed in involuntary treatment programs feel coerced and resentful, and not everyone benefits from the programs. The concern that involuntary treatment decisions can be biased has also been backed up by research. A survey of records in the U.S. indicated that individuals who are lower in socioeconomic status and from African-American or Latino backgrounds are

significantly more likely to receive court-ordered treatment (Takeuchi & Cheung, 1998). To be fair, some of this seeming bias may be due to benevolent reasons; for example, if poorer individuals are unable to afford treatment, then a court- ordered treatment may be relied upon to get people the help that they need. But much of this bias may be due to more undesirable reasons, such as prejudice and the general lack of legal power available to people of lower socioeconomic status and marginalized ethnic groups. Thus, supporters of involuntary treatment continue to point to its apparent benefits for some people, whereas opponents point to its apparent costs for others. The debate continues.

Module 16.1a Quiz:

Barriers to Psychological Treatment

Know . . . 1. Which of the following is not an argument against the practice of

involuntary commitment?

A. Committing people against their will is wrong because it removes people’s basic human rights and freedoms.

B. Imposing treatments, such as drug treatments, onto people is unethical because the side effects and unintended consequences of the treatment itself may further harm the person.

C. The decision to commit people to treatment can be biased due to prejudice and stereotypes that exist in society.

D. Committing people against their will is unnecessary because people can generally get the help they need on their own.

Understand . . . 2. Which of the following is not a barrier for people seeking help for a

psychological disorder?

A. The financial costs associated with therapy B. The fact that it is more culturally accepted for males to enter

therapy

C. Some people’s tendency to minimize their symptoms, making them seem less harmful than they really are

D. Skepticism toward therapy in general

Apply . . . 3. A person’s fear that she may be stigmatized for having a mental illness

A. is unfounded; our society has advanced too far to still be stigmatizing mental illness.

B. is based on fear that they may be exposed to severe treatments against their will.

C. is the sign of delusions, possibly indicating schizophrenia. D. is understandable; unfortunately, there may often be professional

or social costs when others know someone has had a psychological disorder.

Mental Health Providers and Settings

A wide variety of treatment settings are available for people in need of mental health care. The type of treatment people receive depends on several factors, including their age, the type and severity of the disorder, and the existence of any legal issues and concerns that coincide with the need for treatment. Mental health services include inpatient care, outpatient office visits, the use of prescription drugs, attending therapy sessions, and taking part in support groups. Different types of care tend to be delivered by professionals with different training and skill sets.

Mental Health Providers

In popular culture, the terms psychologist and psychiatrist are often (and erroneously) used as if they mean the same thing. In fact, there are some major differences between the two, and even within a category there can be huge differences; certainly not every psychologist nor every psychiatrist takes the same approach as their peers.

Today, some people with severe mental disorders reside in an institution or hospital that specializes in mental health care. These settings are dramatically different than they were just a few decades ago, when they were called “insane asylums” and other unfortunate names. Jerry Cooke/The LIFE Images Collection/Getty Images

Clinical psychologists are perhaps the best-known type of psychologist in the

mental health field. Clinical psychologists have obtained PhDs and are able to formally diagnose and treat mental health issues ranging from the everyday and mild to the chronic and severe. Counselling psychologists are mental health professionals who typically work with people who need help with more common problems such as stress and coping; issues concerning identity, sexuality, and relationships; anxiety and depression; and developmental issues such as childhood trauma. Counselling psychologists may have either a Master’s or PhD degree. Practitioners of clinical and counselling psychology work in many

capacities and settings. They may provide individual or group therapy in an office or institution such as a hospital, or they may conduct psychological testing and research. Other people with different levels of training and background also conduct therapy; for example, clinical social workers and psychiatric nurses conduct therapy to help people cope with psychological problems.

Psychiatrists are medical doctors who specialize in mental health and who are allowed to diagnose and treat mental disorders through prescribing medications. It is important to note that many psychiatrists also work within an integrative biopsychosocial perspective and perform psychological counselling and therapy, or work closely with other professionals who provide such services. Historically, in Canada and most U.S. states, clinical psychologists have not been allowed to prescribe medications, so in many settings psychologists and psychiatrists work together, combining medications with psychological therapies. Like clinical psychologists, psychiatrists work in a variety of settings, but they are most frequently found in hospitals and other institutional settings.

Inpatient Treatment and Deinstitutionalization

Throughout much of human history (although certainly not in all cultural settings), people experiencing severe disorders—such as the profound disturbances associated with schizophrenia or Alzheimer’s disease—were often separated from society. In the 1800s and 1900s, it was common practice to confine people in an asylum. These actions were generally not considered to be “treatments” because there was no hope that the individuals would get better. Instead, the goals were to protect the public and to provide basic care for individuals whose

families could not do so (Wright, 1997).

Sadly, many of the mental institutions of past generations were terrible places for the patients. The creation of large institutions for housing the mentally unwell began in the 14th century due to rapidly growing European populations and mass migration to cities; these trends tended to disrupt the normal family and community traditions that would have provided structure to individuals’ lives and the bonds of collective responsibility that people would have had for the mentally

ill members of their families. As a result, the number of society’s outcasts grew to the point that institutions were built to house them. For the next few centuries, the inmates of these institutions were subjected to brutal confinement, torture, and an almost complete lack of humane conditions. In fact, the modern word

bedlam derives from this time. In 1403, St. Mary of Bethlehem, a hospital in London, England, began admitting patients with mental issues; the hospital’s treatment of these patients was so awful and the hospital was so chaotic that “bedlam” (a mispronunciation of Bethlehem) began to be used to refer to chaos

and madness in general (Foucault, 1975).

By the end of the 19th century, psychology was gaining credibility as a science, and asylums were built both to house the mentally ill and to attempt to treat their conditions. Unfortunately, these asylums quickly became overcrowded, and there were not many effective treatments at the time for most disorders. Thus, despite the good intentions, in practical terms the asylums became little more than giant warehouses that separated the mentally ill from the rest of society, only differentiated from the earlier mental institutions in that the most deplorable of conditions had been improved and there was a more explicit emphasis on finding treatments to help manage patients’ symptoms.

This pattern continued until the 1960s, when people started to take a dim view toward merely housing those with disorders in dismal asylums. One major contribution to the shift in attitudes was that effective treatments began to be developed for some disorders, largely in the form of medications. As patients’ symptoms became more treatable, a society-wide movement toward deinstitutionalization occurred, which involved the movement of large numbers of psychiatric in-patients from their care facilities back into regular society, generally after having their symptoms alleviated through medication. The next three decades saw about an 85% decrease in the number of psychiatric inpatients (Sealy & Whitehead, 2004), both in Canada and many other countries

(Fakhoury & Priebe, 2002). Although a small subset of people remained who required inpatient care, the vast majority of patients who entered the hospital stayed for a relatively short time before they were stabilized, given medication, and sent back (ideally) to the care of their families.

In the decades since this movement began, mental health care providers have amassed many resources and strategies to help people in distress. For example, in as little as three or four days, a patient admitted after a suicide attempt may be fully evaluated, begin medication and therapy, receive education about emergency resources such as suicide hotlines, and then be released. Whereas the goal in the past was to remove the mentally ill from society, now inpatient treatment is geared toward protecting the individual patient from harm while encouraging a quick and successful return to regular society.

Of course, some people still require intensive, long-term care. In place of asylums, many chronic inpatients now live in residential treatment centres. These centres allow inpatients to enjoy much more personal freedom, depending

on the severity of the patients’ symptoms. Low-level residential treatment centres are housing facilities in which residents receive psychological therapy and life skills training, with the explicit goal of helping residents become re- integrated into society. Medium- to high-level centres have the same emphasis as low-level centres, but also place restrictions on individuals’ freedoms for reasons of safety and stability. These centres function like hospitals inside medium-security prisons, with a high staff-to-resident ratio to ensure that residents’ movements and freedom remain under control, with potential escapes prevented by security systems and physical barriers (e.g., locked doors that bar escape). These facilities are intended for individuals with more dangerous histories—such as incidents of physical or sexual assault.

The Importance of Community Psychology

Outpatient therapy and inpatient housing simultaneously grew in popularity through the early 20th century. However, many of the formerly imprisoned patients who were released back into society did not have family or social support structures in place to help them reintegrate successfully. As a result, many mentally ill people faced problems with substance abuse, homelessness, and being victimized or traumatized by people who took advantage of their vulnerable state.

To deal with these issues, some psychologists began to place less emphasis on

individual, one-on-one therapy, in favour of working with the community at large.

This gave rise to a field known as community psychology , which focuses on identifying how individuals’ mental health is influenced by the community in which they live, and emphasizes community-level variables such as social programs, support networks, and community resource centres to help those with mental illness adjust to the challenges of everyday life.

Psych@ The University Mental Health

Counselling Centre In many workplace or education-based communities, mental health services are available to the population through the institution’s own services. A good example is university campuses. The stresses of university life can often bring about temporary struggles with mental well- being. Students must deal with the stresses of managing a heavy workload, beginning a career path, and developing an adult identity, and also often juggle work and family obligations along with school. Some students also face lifelong struggles with mental illness. Approximately 15% of university students exhibit symptoms of depression. One study on first-year students at Acadia University found that 7% of male and 14% of female students experienced a major depressive disorder in their first

year at school alone (Price et al., 2006)! In general, mental health issues seem to be on the rise in university students; over the past two decades, rates of depression have increased more than 50%, with anxiety

disorders and other issues also increasing (American College Health Association, 2007).

University counselling centres typically employ a resident psychologist or psychiatrist, along with a staff of trained counsellors. These centres are in great demand and often have waiting lists. Counsellors are trained to help with the more common student issues, such as stress, anxiety, time management, depression, and relationship issues, but they also often encounter students with more severe disorders than most counselling

centres are designed to accommodate (Gallagher, 2007; Voelker,

2003). In these cases, counsellors can help students find appropriate mental health professionals and, potentially, advocate on their behalf.

Through working at a community level rather than narrowly focusing on individuals, community psychologists hope to prevent or minimize the development of disorders, seeking to enhance the factors (such as healthy family relationships) that strengthen people and make them more resilient to the kinds of stresses that can otherwise undermine mental health. For example, to prevent depression, community psychologists may conduct research into the environmental and neighbourhood factors that contribute to stress, anxiety, and depression, and then work with community groups to resolve these problems. In addition, they may develop programs to counter negative cognitive patterns and bolster positive thinking in schools and afterschool programs.

Module 16.1b Quiz:

Mental Health Providers and Settings

Know . . . 1. Which type of provider is generally permitted to prescribe medications?

A. Psychiatrist B. Clinical psychologist C. Clinical social worker D. Medical psychologist

2. study how individuals’ mental health is influenced by their neighbourhood, economics, social groups, and other community-based variables.

A. Residential treatment centres B. Community psychologists C. Psychiatrists D. Social workers

3. The social movement against keeping the mentally ill in asylums is known as .

A. empirically validated treatments B. social work C. deinstitutionalization D. community psychology

Evaluating Treatments

Given the diversity of treatment approaches and settings that are available, it is important to know which approaches are effective. Aside from the obvious economic logic of society not wasting money on ineffective treatments, it is important for individuals seeking help to get assistance that is effective. In the mid-1990s, the American Psychological Association set up task forces to evaluate different therapy practices and made their findings and

recommendations available online to the general public (APA, 2009). This led to a call for more studies to examine the effectiveness of different therapeutic approaches, so that “evidence-based” treatments could be identified and given further financial support, such as being included in insurance companies’ health insurance plans.

Empirically Supported Treatments

Empirically supported treatments (also called evidence-based therapies) are treatments that have been tested and evaluated (Chambless & Ollendick, 2001; De Los Reyes & Kazdin, 2008). The most rigorous way of testing whether a certain therapy works is through an experiment. An experiment generally involves randomly assigning volunteers to a treatment group (e.g., a type of therapy) and to a control group. Ideally, experiments are also double-blind, which in this case means that neither the patient nor the individual evaluating the patient is aware of which group the patient is in. However, this level of rigour is often close to impossible to attain when evaluating therapies. One common problem is that it is ethically problematic to place people into a control group that receives no treatment of any kind, because it effectively denies them treatment that they need. It is also generally impossible to use double-blind procedures,

given that a therapist, of course, knows which type of treatment she administers, and many clients likely do as well.

Also, it can be very difficult to assess the general effectiveness of a therapeutic approach if therapists themselves differ widely in their own level of relevant skills. Furthermore, each client and therapist is unique, and much of the effectiveness

of therapy comes from the therapeutic alliance —the relationship that emerges in therapy. In fact, the specific type of therapy used is actually less important than the “common factors” of empathy, trust, and the like, which allow the therapist and client to build an appropriately supportive relationship. Establishing a positive relationship therefore depends on various qualities of the therapist and client, as well as the “fit” between the two. Therapists who are more socially skilled (who show warmth, concern, and empathy) tend to be more effective. Similarly, clients who are more open to the process, more willing to trust the therapist, and more willing to recognize and work on their issues are

more likely to benefit from therapy (Prochaska & Norcross, 2002).

Therefore, even though many therapists may provide the same therapy, each therapist will have a slightly different personal approach, and each combination of client and therapist will be unique. As a result, it is very difficult to adequately test the effectiveness of many therapeutic approaches to the rigorous extent

required for empirical support (DeRubeis & Crits-Cristoph, 1998). This is one rather ironic way in which the understandable desire for “evidence-based treatments” may, in fact, create problematic biases that shift the field towards the types of therapies whose efficacy is robust across different therapists and clients, so is easy to measure. What if there are therapeutic approaches that may be highly successful, but depend on subtle elements of the therapeutic situation? For example, therapies that involve deep work on emotional patterns that stem from childhood trauma or attachment insecurity may depend heavily on difficult- to-measure variables such as the empathic connection between the therapist and the client, or the extent to which the therapist is skilled at being emotionally attuned and empathic, and these approaches may thus not fare as well in attempts to identify evidence-based approaches.

This is, admittedly, a confusing and complex issue. On the one hand, of course

we want to have evidence that a particular therapy works, so that clients aren’t subjected to (and paying for) the ineffective treatments, the particular biases of therapists, or outdated practices. On the other hand, the very search for “evidence” may bias the field towards particular forms of therapy whose outcomes are reliable and easy to measure, and as a result, discourage people from practising or exposing themselves to forms of therapy that may be profoundly transformative in ways that are more difficult to rigorously evaluate

(Westen & Bradley, 2005).

The same challenges have held back research on the effectiveness of self-help treatments. Nevertheless, some research has tried to address this issue, given the explosion of self-help literature in the past few decades.

Working the Scientific Literacy Model Can Self- Help Treatments Be Effective?

Many people opt to address their psychological problems by using resources that do not involve visiting an actual therapist, such as self-help books, online information, or community workshops. Are these approaches helpful?

What do we know about the availability of self-help treatments? There is a huge variety of self-help materials available to the public. Just walk down to your local bookstore and check out the psychology section, where you will find books on everything from anxiety and depression to how to raise children, deal with divorce, and optimize your well-being. A quick perusal will reveal that many of these books are written by people with PhDs in the relevant fields (although many are not), but the books also do not always agree with one another on the best approach to whatever issue they are discussing. For example, if you read the popular literature on how to help children deal with emotional struggles,

you could catalogue several approaches that were not only different, but actually would work against each other. Which approach is right? How can we know whether self-help literature is effective in general?

How can science test the effectiveness of self-help treatments? There is some research on this issue, examining whether bibliotherapy , the use of self-help books and other reading materials as a form of therapy, improves people’s symptoms. For example, one study attempted to assess the effectiveness of bibliotherapy over a three-month period in 170 elderly primary- care patients who were experiencing depression. The patients were evenly divided into two groups: both groups received a “standard care” approach, but the self-help group also read a self-help book on depression. After three months, the group who read the self-help book in addition to the standard care showed no signs of reduced depression compared to the control group (Joling et al., 2010). However, as discussed earlier, this is hardly a definitive test of the effectiveness of self-help. It’s possible that particular book wasn’t effective for this population, but a different one could have been. Or, different books may appeal to different people, so testing a single book on a whole group may show no overall improvement, even though a few individuals may have benefited substantially.

A slightly stronger approach to this question is to perform a meta- analysis, combining numerous studies testing a similar hypothesis. One such analysis combined six separate studies

that had tested whether the book Feeling Good reduced depressive symptoms. The researchers found that over four weeks, those who read the book had reduced depression

compared to those who did not (see Figure 16.1 ; Anderson et al., 2005). Thus, there may be reason to believe that bibliotherapy can be helpful.

Figure 16.1 Results of Six Studies Evaluating the Self-Help Book Feeling Good

Research on the book Feeling Good shows successful results in reducing symptoms of depression. Comparisons across six studies (identified by author name and publication date) indicate

statistically significant improvement in each case (Anderson et al., 2005). Source: Based on Anderson, L., Lewis, G., Araya, R., Elgie, R., Harrison, G., Proudfoot, J., Schmidt,

U., Sharp, D., Weightman, A, & Williams, C. (2005). Self-help books for depression: How can

practitioners and patients make the right choice? British Journal of General Practice, 55, 387–392.

Can we critically evaluate this evidence? The biggest strength of the self-help literature is also its biggest weakness: there are so many books available that it is almost impossible to ensure that they are all credible sources of information. The research presented above used a single book,

Feeling Good, as the representative of self-help books. Obviously, this is not sufficient evidence in favour of using self- help books to cope with psychological disorders (an issue that the authors of that research were quick to point out). People planning to use self-help books should ensure that the authors have the

necessary qualifications to advise people about mental-health issues. If possible, they should also see if the coping strategies promoted in the book have been tested by scientists. Although the dense methods and results sections of academic articles may intimidate some readers, most articles also come with an accessible summary (known as an abstract) that provides readers with the take-home message of the study (i.e., did it work?).

The reason that caution is necessary when using self-help books is that many psychological disorders are both complex and emotionally intense. Exploring the different symptoms of a person’s psychological disorder—and examining their causes— can sometimes be a difficult experience. Having a trained therapist aid you in coping with these experiences is often helpful. This is not to say that all self-help books should be avoided. Rather, it is to warn people that these books do not always prepare people for the emotions that can arise as they deal with the symptoms of their psychological disorders.

Why is this relevant? Self-help options have major advantages over traditional approaches to therapy, which means that if they do work, even in part, this is important to know. For example, self-help options are typically low in cost (e.g., compare $150 for an hour of therapy to $20 for a book), are convenient, and can be accessed anonymously, thereby reducing the barriers of stigma, inconvenience, and cost that often prevent people from accessing therapy. Furthermore, self-help options are extremely easy to find in the self-help section in the bookstore or with a quick online search for self-help programs. Indeed, many people consult online resources to get help for depression, anxiety, substance-

abuse problems, and sexual health (Fox, 2005).

That said, research does suggest that self-help approaches,

relative to in-person therapy sessions, are less likely to lead people to actually implement changes in their own lives

(O’Kearney et al., 2006). If you are experiencing psychological distress, it is probably advisable to speak with a mental health professional at least once—especially if symptoms are severe— to find out whether self-help is appropriate for your situation. A professional may also be able to suggest good resources, which can save you a great deal of wasted energy wading through stacks of self-help literature to find quality information.

Module 16.1c Quiz:

Evaluating Treatments

Know . . . 1. is the relationship that emerges in therapy between the therapist

and client, and is an important determinant of the therapy’s effectiveness.

A. Client insight B. Bibliotherapy C. Therapeutic alliance D. Friendship

Understand . . . 2. What does it mean to say that a therapy has “empirical support”?

A. Insurance companies prefer it. B. Therapists prefer to use it. C. Research studies confirm that it is effective compared to no

treatment and possibly compared to other alternatives.

D. Research studies demonstrate that it can do a better job than drugs.

3. Which of the following conclusions best summarizes the effectiveness of

bibliotherapy?

A. It has no benefit whatsoever. B. It is more effective than other forms of therapy. C. It works, but is addictive. D. It may be helpful to many people, but its results are not

consistent.

Module 16.1 Summary

bibliotherapy

clinical psychologist

community psychology

counselling psychologist

deinstitutionalization

empirically supported treatments

psychiatrist

residential treatment centre

therapeutic alliance

These barriers include expense, availability, gender, and attitudes toward therapy, which are often influenced by the stigma against therapy that may be held by a particular group (e.g., males in general).

Know . . . the key terminology associated with mental health treatment.

16.1a

Understand . . . the major barriers to seeking help for psychological disorders.

16.1b

Understand . . . the arguments for and against involuntary treatment.

16.1c

Proponents of involuntary treatment argue that it helps to protect innocent people who may otherwise end up being victims of violence at the hands of a psychologically disturbed individual. Proponents also argue that such treatment improves mental health and ensures that people with severe disorders receive appropriate treatment. Opponents argue that there is no good evidence that involuntary treatment benefits the individual, and instead, receiving involuntary treatment may result in the patient feeling coerced or resentful, suggesting that such treatments are not without cost.

The appropriate kind of therapeutic setting depends on a host of factors, from what is available and within the person’s means to afford, to what sorts of issues the person is experiencing. For common problems such as stress and milder forms of depression and anxiety, seeing a counselling psychologist is likely the best first step; for students, most universities offer counselling services on campus. For more severe and debilitating problems, such as severe anxiety, depression, or schizophrenia, a clinical psychologist or psychiatrist is likely most appropriate. A psychologist will likely engage in a form of psychological therapy, whereas a psychiatrist will likely take a more physiological approach involving prescribing medication.

Self-help books alone are not likely to be life-changing or good stand-alone treatments for serious problems such as major depression, anxiety, and substance abuse. Even so, research on bibliotherapy indicates that in some cases, when used in conjunction with other methods, reading self-help books can bring about modest improvements. It is, of course, always possible that for a specific individual, any specific self-help book may be profoundly helpful and even life-changing; however, on average, reading self-help books has only a small therapeutic benefit.

Apply . . . your knowledge to suggest what approach to therapy is likely most appropriate for a given situation.

16.1d

Analyze . . . whether self-help options, such as popular books, are a useful therapy option.

16.1e

Module 16.2 Psychological Therapies

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Learning Objectives

Know . . . the key terminology related to psychological therapies. Understand . . . the general approaches to conducting major types of psychological therapy. Apply . . . your knowledge to identify major therapeutic techniques. Analyze . . . the pros and cons of the major types of psychological therapy.

16.2a 16.2b

16.2c 16.2d

Medical doctors are generally required to follow the Hippocratic Oath—a pledge that they will cause no harm to their patients. One way of honouring this oath is to use the safest and most effective treatments. Although we do not generally associate the Hippocratic Oath with psychologists, they also follow the basic tenet, seeking to use techniques that are safe and do not cause harm to their clients. If there is a possibility that a specific type of treatment might worsen a condition, this treatment should therefore be avoided, unless there are no better options.

For example, Scared Straight was a program developed in the 1970s that involved exposing at-risk youth to prisons and prisoners. The interventions were based on the premise that shocking or scaring the youths with the harsh realities of prison life would deter criminal activity. These scare tactics involved blunt descriptions of prison violence, along with verbal aggression directed at adolescents attending the sessions. The program may have succeeded in scaring and shocking adolescents, but the youths who attended these sessions did not necessarily go down a straight path. Many were later convicted of crimes and incarcerated. In fact, if anything, the program seemed to backfire; according to some analyses, participants in the program showed an increased chance of

subsequently committing crimes (Petrosino et al., 2003).

Scared Straight and other methods for helping people can,

unintentionally, do more harm than good (Lilienfeld, 2007). Although a rare case, this example reminds us that therapy can be done in many different ways, and we should be cautious in determining which methods are best.

Focus Questions

1. Which options for therapy are available? 2. Are all well-established options equally effective at treating

problems?

In Module 16.1 , we introduced psychological therapy as a set of processes for resolving personal, emotional, behavioural, and social problems and improving well-being. Psychological therapy is a broad term, and mental health providers have a veritable smorgasbord of therapeutic approaches to choose from. In this module, we will study several of these approaches. Although the methods are diverse, they are all types of psychological therapy, rather than biological or medical therapy. In psychological approaches, techniques for resolving problems rely heavily upon communication between client and therapist.

Insight Therapies

Psychologists have long believed that self-knowledge and understanding can

lead to positive changes in behaviour. This is certainly the case for insight therapies , which is a general term referring to therapy that involves dialogue between client and therapist for the purposes of gaining awareness and understanding of psychological problems and conflicts. Historically, the formal beginning of insight therapy came with the development of psychoanalysis by

Sigmund Freud and its evolution into psychodynamic therapies , forms of insight therapy that emphasize the need to discover and resolve unconscious conflicts.

Psychoanalysis: Exploring The Unconscious

Psychoanalysis sprang out of Freud’s understanding of consciousness. As

described in Module 12.3 , Freud hypothesized that much of our consciousness occurs at the unconscious level, outside of our awareness. In particular, many fundamental urges, such as sexuality and aggression, were thought to constantly influence how we think and behave, although we are not explicitly aware of these processes. In fact, because these urges are generally

socially unacceptable, we actively protect ourselves from becoming aware of them through a variety of psychological defences. As a result, the true causes of our behaviour, and thus of our psychological issues, are hidden in the unconscious. This led Freud to emphasize the importance of “making the unconscious conscious,” believing that the process of bringing material from the unconscious into consciousness allowed clients to gain insight into their problems and the past experiences from which they stem. This understanding was believed to liberate clients from the grips of the previously unknown forces that were impacting their lives.

Freud and his followers based their practice on some core ideas summarized in Table 16.1 . These core ideas may sound straightforward, except for one crucial point: Accessing the unconscious mind is tricky business. The client cannot tell you much about it because, of course, they are not aware of it. As a result, Freud and his followers invented several methods they believed would help them access the mysterious unconscious realm.

Four of these techniques have been particularly important in the practice of therapy, historically, and are still in use in many different ways today.

Table 16.1 Core Ideas Forming the Basis of Psychoanalysis

Adults’ psychological conflicts have their origins in early experiences.

These conflicts affect the thoughts and emotions of the individual, and their source

often remains outside of conscious awareness.

The unconscious conflicts and their effects are called neuroses (anxieties).

By accessing the unconscious mind, the analyst and client can gain a better

understanding of the early conflicts that lead to neuroses.

Once the conflicts are brought to the surface, the analyst and the client can work

through them together.

The first technique is free association , during which clients are encouraged to talk or write without censoring their thoughts in any way; instead, the person allows everything that pops into the mind to come spilling out, no matter how odd or meaningless it may seem. Freud believed that this uncensored thought barrage would reveal clues to the unconscious in ways that clients may not normally have access to.

The second is dream analysis. Freud believed that in the relatively unguarded dreaming mind, the unconscious would be better able to express itself; however, because the unconscious doesn’t communicate through the same language- based way of thinking that the conscious mind uses, it expresses itself through

symbols that need to be properly interpreted. Dream analysis is a method of examining the details of a dream (the manifest content), in order to gain insight into the true meaning of the dream, the emotional, unconscious material that is being communicated symbolically (the latent content). Dreams take the form of imagery (sometimes bizarre and nonsensical imagery) and loose storylines, but within this confusing jumble, symbolic truths are believed to be hidden. The psychoanalyst’s role was to help clients properly understand these symbolic truths in order to gain insight into their unconscious conflicts.

For example, consider one of Freud’s dream analyses: A client dreamed he was riding his bicycle down a street when suddenly a dachshund ran him down and bit his ankle as he attempted to pedal away. Meanwhile, two elderly ladies sat by and laughed at the incident.

The details described are the manifest content, but what might the dream mean —what is the latent content? Freud pointed out that in his waking life the client had repeatedly seen a woman walking a dog and, although he was very attracted to her, he felt great anxiety about approaching her. The man had consciously devised a plan to use the dog as an excuse to strike up a conversation with the woman. Unfortunately, the anxiety caused by fear of rejection manifested itself in an unpleasant dream about being attacked by a

dog, accompanied by the humiliation of being laughed at (Freud, 1920, pp. 165– 166).

The third strategy is to pay attention to signs of resistance . Resistance occurs in therapy when unconscious material surfaces that the client wishes to

avoid. Resistance involves engaging in strategies that keep the information from fully manifesting in conscious awareness. Resistance may be subtle, such as the client using humour to avoid talking about something painful, or it may be obvious, such as the client skipping sessions, becoming angry at the therapist, or becoming cynical about the whole process. This is actually considered a promising signal for the psychoanalyst because it means that they are beginning to access the unconscious motives of clients’ present difficulties. Psychoanalysts then attempt to push through the resistance by making clients aware of how and what they are resisting.

A fourth tool used by psychotherapists involves transference , whereby clients direct certain patterns or emotional experiences toward the therapist, rather than the original person involved in the experiences (e.g., their parents). For example, if a client is addressing a hidden sexual conflict, then transference may occur through her developing sexual feelings for the analyst. Or as another example, if a client’s mother made him feel excessively criticized during childhood, he may tend to see the analyst’s behaviours as being critical in a similar way, and respond defensively as though he’s being attacked or criticized. Thus, the client’s interaction with the analyst becomes a kind of stage on which conflicts with other people are revealed and explored. Transference is a significant milestone in the process of psychotherapy. Once it is reached, the therapist and client can begin to work through specific problems and discuss ways of coping with them.

In sum, there are many different tools that psychotherapists draw upon, including transference, resistance, dream analysis, and free association, that can help to provide direct knowledge of the person’s otherwise inaccessible unconscious. Once this material is brought to the light of the client’s conscious awareness, then these patterns can begin to be examined and, ideally, changed.

Modern Psychodynamic Therapies

Today, Freudian-based psychoanalysis is practised by relatively few therapists. Nevertheless, Freud’s ideas have remained influential and several newer therapies have evolved from traditional psychoanalysis. In contrast to Freudian methods, these new approaches are more concerned with the client’s conscious rather than unconscious experience. They also acknowledge the effect of cultural and interpersonal influences on individual behaviour, and the impact of important needs such as love, power, belonging, and security. Finally, they are more optimistic about people’s ability to reach healthy functioning.

One example is object relations therapy , a variation of psychodynamic therapy that focuses on how early childhood experiences and emotional attachments influence later psychological functioning(see Module 10.2 ). In contrast to psychoanalysis, object relations therapy does not centre on repressed sexual and aggressive conflicts. Instead, the focus is on “objects,” which are the clients’ mental representations of themselves and important others. The basic view is that the quality of the early relationship between the child and these “objects” results in the development of mental models for the child. These mental models act to shape the person’s perceptions and interpretations in relationships, the general consequence being that the person will tend to form and maintain relationships as an adult that are consistent with the mental models that were formed in childhood. The mental models tell the person what is “normal” and provide an interpretive framework within which to make sense of relationships. The therapist’s job is to help the client understand these mental models and the relationship patterns they represent and reinforce. This generally leads to working with relational issues of trust, fear of abandonment, dependence on others, and other relationship factors.

Humanistic–Existential Psychotherapy

An important new movement in psychotherapy arose during the 1950s, when humanistic psychologists broke from psychoanalytic approaches over several deep differences in their assumptions about people and the theoretical foundation upon which they were building. This humanistic– existential approach can be characterized by at least five key differences from the psychodynamic

approaches (listed in Table 16.2 ). Overall, this new orientation emphasized

individual strengths and the potential for growth, and assumed that human nature is fundamentally positive, rather than the essentially negative perspective advanced by psychoanalytic approaches. This shift toward the positive was believed to help individuals access their own sense of personal agency for overcoming their problems.

Table 16.2 Contrasting Psychoanalytic and Humanistic Views of Major Psychological Issues and Debates

Issue Psychoanalysis Humanistic Therapy

Conscious

versus

unconscious

Focuses on unconscious

drives

Focuses on conscious experience

Determinism

versus free

will

Behaviour is determined by

repressed sexual and

aggressive instincts

Behaviour is chosen freely

Weaknesses

versus

strengths

Everyone has neuroses Everyone has strengths

Responsibility

for change

The analyst interprets and

explains to the client what

is wrong

The therapist asks the client what is

wrong and attempts to help clarify

issues

Mechanism

of change

Insight into unconscious

conflicts allows problems to

be worked through

Unconditional positive regard allows a

person to heal and become more

authentically themselves

Humanistic and existential therapies share many similarities: to help people express their authentic selves, to overcome alienation, to become more loving, and to take responsibility for their experiences so that they learn to dwell fully in

the present. The major difference between them is that humanistic therapists focus on removing the obstacles that prevent self-actualization from unfolding naturally, whereas existential therapists emphasize the importance of facing painful experiences such as feelings about isolation, death, and meaninglessness, believing that self-actualization involves transforming by facing one’s fears and negativity. Even though attaining insight is still an important aspect of these therapies, rather than interpreting the hidden meanings of dreams and free associations, the therapist’s role is to listen empathically in order to understand the clients’ internal world. This is referred to as a phenomenological approach , which means that the therapist addresses the clients’ feelings and thoughts as they unfold in the present moment, rather than looking for unconscious motives or dwelling in the past.

American psychologist Carl Rogers (1902–1987) developed a version of

humanistic therapy called client-centred therapy (or person-centred therapy ), which focuses on individuals’ abilities to solve their own problems and reach their full potential with the encouragement of the therapist. As a humanist, Rogers believed that all individuals could develop and reach their full potential. However, people experience psychological problems when others

impose conditions of worth, meaning that they appear to judge or lose affection for a person who does not live up to expectations. Conditions of worth are imposed, for example, by a father who only pays attention or gives praise or encouragement when his child is doing well at something, or who expresses disappointment in the child herself if she does something wrong, focusing more on the child’s character failings or lack of will than on the actual behaviour itself and what caused it. If people give the impression that their respect and love for a person are contingent upon the person behaving in certain ways or meeting certain expectations, then they have imposed conditions of worth. Conditions of worth can impact psychological health over the long term, because they increase insecurities within the individual; as a result, the person is likely to change his behaviour in an attempt to regain affection. If this happens frequently, then the individual’s behaviour starts to be primarily about gaining affection and approval, living in order to please others rather than being able to express his own authentic self. That, to Carl Rogers, is a key aspect of most psychological dysfunction.

Emotion-focused therapy (EFT) is one promising type of person-centred therapy that has evolved from the humanistic–existential tradition; EFT is based on the well-supported belief that it is better to face and accept difficult emotions and

thoughts rather than bottle them inside (Greenberg, 2004; Hayes et al., 2006). Therapists employing this form of therapy aim to help clients overcome their tendency to suppress disturbing thoughts and emotions, so that clients are less defensive overall and have fuller access to their whole range of experiences and emotions.

The most important aspect of all client-centred therapies lies within the dialogue that unfolds between therapist and client. The therapist must show unconditional positive regard through genuine, empathetic, and non-judgmental attention. If the therapist can remove all conditions of worth, clients may begin to express themselves without fear and begin to develop inner strength. Finally, with self- confidence and strength, clients can accept disagreements with others and focus on living their lives to the fullest.

Evaluating Insight Therapies

As discussed in Module 16.1 , from an evidence-based perspective, therapies should be used only if there is empirical support that they actually work (although it is worth remembering that an approach may work for some people, even if it doesn’t work for most).

Psychodynamic therapies meet some of the criteria for empirically supported therapies, though surprisingly few studies in this area have been conducted with proper research design and control conditions. Ultimately, the effectiveness of insight therapies depends on the condition being treated. The best-designed studies have generally shown that psychodynamic therapy is not effective in treating severe depression or schizophrenia, but it has shown promise for treating panic disorder, dependence on opiate drugs (e.g., heroin), and

borderline personality disorder (Gibbons et al., 2008). Psychodynamic therapy may help with major depression, particularly if combined with drug treatment—an

approach we will describe in greater detail in Module 16.3 .

For less severe conditions, such as mild depression and anxiety, behavioural issues such as dysfunctional habits or motivation and goal-striving difficulties, insight-focused therapies can often make a difference, helping individuals gain understanding and awareness of the nature of their psychological problems. Many people with psychological disorders are able to learn to functi Daniel Siegon effectively without digging deeply into possible “root causes,” but instead,

by cultivating new, more adaptive behaviours (Weisz et al., 1995).

Research shows that Carl Rogers was accurate in emphasizing the importance

of the therapeutic relationship for successful therapy (Horvath & Bedi, 2002; Wampold, 2001). In fact, a strong alliance is a good predictor of successful therapy over and above the specific type of therapy delivered (Bohart et al., 2002), and positive regard (Farber & Lane, 2002) and empathy (Bohart et al., 2002) are both related to therapeutic success (Bohart, 2003).

Research is somewhat inconsistent on the effectiveness of person-centred therapy more generally, although this therapy is reliably more effective than no

treatment at all (Greenberg et al., 1994). However, some studies have found it to be no more effective than a placebo treatment (Smith et al., 1980), whereas others have found it to be as effective as cognitive behavioural therapy (Elliott, 2002; Greenberg & Watson, 1998). As discussed earlier, one complicating factor in this research may be the skill of therapists themselves; some therapists may be highly skilled at connecting with clients and establishing good rapport in therapy, whereas others may be less capable in these ways. This difference in therapists’ skill could account for these mixed findings, and make it difficult for research studies to then accurately assess the effectiveness of an approach like Rogers’s.

Module 16.2a Quiz:

Insight Therapies

Know . . . 1. refers to a phenomenon of psychoanalysis in which the client

begins directing emotional responses toward the therapist.

A. Resistance B. Befriending C. Objectifying D. Transference

2. In psychoanalysis, resistance occurs when A. a client develops sexual attraction to the analyst. B. a client begins to divert the analysis by joking, becoming cynical,

or perhaps refusing to answer questions.

C. a therapist begins to have the same feelings as the client. D. the therapist refuses to continue a therapy session.

Understand . . . 3. In psychoanalysis, treatment for psychological problems seems to come

from

A. the client becoming more conscious of the workings of their unconscious.

B. the client receiving unconditional positive regard. C. the therapist understanding and explaining the manifest content

of a dream.

D. the therapist diagnosing the psychological disorder and providing appropriate drug therapy.

Apply . . . 4. A kindergarten teacher (unintentionally) places conditions of worth on her

students. What does this mean?

A. She always lets her students know how much she values them. B. She regularly tries to draw compliments out of her students. C. She acts as if a student no longer matters to her or the school if

he misbehaves.

D. She provides monetary rewards for good behaviour.

Analyze . . . 5. What has research concluded in regard to the effectiveness of insight

therapies?

A. Insight therapies are always very effective. B. Insight therapies are never effective. C. Insight therapies do not help people gain awareness of the nature

of their psychological problems, so they tend to not be effective.

D. The effectiveness of insight therapies depends on the conditions that are being treated.

Behavioural, Cognitive, and Group Therapies

Behavioural therapies attempt to directly address problem behaviours and the environmental factors that trigger them. At the heart of behavioural therapies is the belief that patterns of behaviour are the result of conditioning and learning that have led to the automatization of maladaptive habits. Thus, behavioural approaches seek to recondition clients, training them to adopt different behavioural responses to situations until they develop new, more functional, habits.

Systematic Desensitization

How behavioural therapy works is clearly illustrated by its application to a very common problem: fear of public speaking. Most people experience at least some anxiety about public speaking, but for some, their reaction is so intense that even thinking about making a speech can bring on major anxiety, arousal, and even panic attacks.

To help people learn to handle such an anxiety-inducing situation, therapists will

often employ a behavioural technique known as systematic desensitization , in which gradual exposure to a feared stimulus or situation is coupled with relaxation training (Wolpe, 1990). First, the client is guided towards being able to identify and track their own feelings of anxiety versus relaxation, so that they

gain greater awareness “in the moment” of when they are feelings anxious and, critically, what it feels like when those feelings subside. Once the client has this kind of inner awareness, the therapist will expose them to a very mild version of the fear-inducing situation, such as imagining walking up to the front of the room where he is going to give the speech. As the client engages in this exercise and feels his anxiety starts to rise, he practises relaxing or engaging in behavioural strategies (e.g., pausing in his imagination, practising a breathing exercise in order to calm down) in order to counteract the anxiety he may feel. With practice, the anxious response to that particular trigger will lessen, and the client then progresses to more realistic and concrete manifestations of the situation, each time practising relaxing until he can learn to tolerate his feelings and counteract them with a relaxation response. This escalation of the intensity of the triggering experience continues slowly, step-by-step, until the client can eventually handle

the real thing. This process is described in detail in Table 16.3 .

Table 16.3 Applying Steps of Systematic Desensitization to Fear of Public Speaking

1. Build an anxiety hierarchy. This involves the therapist assisting the client in creating a

list of stimuli that arouse fear responses, starting with the stimulus or situation that

evokes the least amount of anxiety and ending with the stimulus that elicits the most

anxiety.

Think about and visualize:

1. Thinking about the presentation topic

2. Writing down ideas for the presentation

3. Doing library research for a presentation

4. Preparing slides and note cards

5. Practising the presentation alone

6. Practising the presentation with a few friends

7. Travelling to campus to give the presentation

8. Sitting in the classroom waiting to be called for your turn

9. Walking up to the front of the room

10. Standing up at the podium and looking out at the audience

11. Beginning to speak; delivering the first couple of lines

2. Relaxation training. During this phase, the client learns to respond to relaxation

suggestions from the therapist as they begin to work through the hierarchy. This is

typically done using mental imagery while the client is visiting the therapist’s office;

actual props may be used in some cases (e.g., a podium that the person can stand in

front of).

3. Work through the hierarchy. Steps 1 and 2 are combined here as the therapist works

through the entire hierarchy, usually over several sessions, until the client is able to

manage the anxious feelings while continuing to engage in the relevant behaviours.

In some cases, clients may undergo a process called flooding, in which case the client goes straight to the most challenging part of the hierarchy, exposing himself to the scenario that causes the most anxiety and panic. For example, he may elect to give a long speech in front of 100 strangers. By diving right in and (one hopes) discovering that there are no truly negative consequences, the person may find that they have “gotten over it” and lesser forms of the same activity no longer give them anxiety; it should be noted that this is relatively rarely used, as it can easily overwhelm the person instead and simply reinforce their anxious response.

At the opposite end of the spectrum, clients may find it difficult to even begin to expose themselves to the simplest steps of their anxiety hierarchy. Fortunately, consistent with research showing that fear and anxiety responses can be

acquired through observing others (Olsson & Phelps, 2007), and with research on observational learning or “modelling” (see Module 6.3 ; Bandura, 1977), even less threatening steps of an anxiety hierarchy can be established using other people instead of oneself in the anxiety-provoking situation. Watching others engage in the anxiety-provoking situation without suffering negative consequences can help people with severe anxiety reactions, such as phobias, learn to tolerate some mild exposure to the feared stimulus.

Recent advances in virtual reality technology are providing new tools for therapists; for example, it is becoming possible to help clients overcome fear reactions in a virtual setting, an advance that holds exciting new possibilities.

Working the Scientific Literacy Model Virtual Reality Therapies

Systematic desensitization techniques have long been a part of behavioural treatments for fear and anxiety. However, there are some key barriers that can prevent them from being effective. For one, people with fear and anxiety about a specific object or situation usually avoid any contact with it—so even taking the first step toward a therapist’s office can be challenging. Also, although mental imagery is typically the method employed with these therapeutic techniques, it may not transfer well to the actual anxiety-provoking situation because mental imagery may not have the same power as the much more vivid, real situation. Virtual reality technology is offering one potential way around these problems.

What do we know about virtual reality exposure? Virtual reality exposure (VRE) is a treatment that uses graphical displays to create an experience in which the client seems to be immersed in an actual environment. This much more vivid environment feels more like the real thing, and shows

promise for helping people learn to relax in the face of their fears. Also, virtual reality therapy may help to reduce a person’s tendency to use avoidance strategies. Over the past decade, this technology has become increasingly common in helping soldiers returning from military conflicts in Iraq and Afghanistan—many of whom have developed PTSD.

How can scientists study virtual reality exposure? Psychologists at Emory University in Atlanta have been using a simulator called Virtual Iraq, which was developed to deliver two possible scenarios—being in a Middle Eastern city or driving a Humvee through a desert road in simulated war conditions

(Figure 16.2 ). The weather, time of day, background noise, civilians, aerial craft, and ground vehicles can be programmed by the therapist to change as desired during the exposure sessions. There is also the option to provide simulated gunfire and bomb explosions. Smell cues are available using an air compressor that pumps in odours of burning rubber, garbage, diesel fuel, and

gunpowder (Cukor et al., 2009).

Figure 16.2 Virtual Reality Exposure

Combat veterans diagnosed with PTSD have participated in virtual reality therapies involving simulated exposure to traumatic events. Therapists work with clients to help them process and cope with their fears. Erika Schultz/MCT/Newscom

In one set of trials, 20 soldiers who were diagnosed with PTSD following combat activity underwent VRE therapy. Their PTSD symptoms were measured before and after therapists guided them through VRE treatment in the Virtual Iraq simulator. At the conclusion of their therapy, the soldiers’ PTSD symptoms declined by 50%, with 16 of the soldiers no longer meeting the

criteria for the disorder (Rizzo et al., 2010). The results included fewer disturbing thoughts about stressful events that occurred during military service; fewer disturbing dreams; reduced physical reactions such as heart pounding, sweating, and trouble breathing; and less avoidance of activities that triggered memories of military service. VRE using the Virtual Iraq simulator appears to work.

Can we critically evaluate this evidence? From an experimental standpoint, this study should have used a placebo (control) group that received no treatment, or a comparison group that received some other treatment method. In fact, such studies have recently occurred; in one study of U.S. veterans who had served in Iraq or Afghanistan, the effectiveness of VRE sessions was compared to the standard approaches (e.g., prolonged exposure therapy, among other standard treatments), and the VRE approach outperformed the standard

approaches (McLay et al., 2011).

It is not clear from this one study whether VRE therapy would be

beneficial for disorders other than PTSD. However, other research has shown that virtual reality approaches are useful for helping people in many different types of circumstances, including symptom reduction in people with various phobias

(Opriş et al., 2012; Powers & Emmelkamp, 2008), stress management in patients with cancer (Schneider et al., 2011), and body image issues in clients with eating disorders (Riva, 2005).

Why is this relevant? Virtual reality technologies seem to help overcome key barriers to therapeutic effectiveness. As discussed earlier regarding PTSD, clients typically avoid any stimuli associated with the original trauma, and therefore may be resistant to therapy that will expose them to the trauma. VRE approaches can get around this resistance because the therapist has precise control over the way the client will be exposed to the feared situation and can

therefore easily tailor the approach to the client’s needs (Hodges et al., 2001).

Aversive Conditioning

Most people have at least one behaviour they would like to reduce or eliminate, perhaps a nervous habit such as fingernail biting, or an unhealthy behaviour such as smoking. Behavioural principles tell us that these habits are maintained because they bring rewards in some fashion, and thus, changing their rewarding nature can lead to changing the behaviour itself.

Aversive conditioning is a behavioural technique that involves replacing a positive response to a stimulus with a negative response, typically by using punishment. One aversive conditioning treatment involves using the drug Antabuse (disulfiram) to reduce problem alcohol consumption. Antabuse causes

nausea and vomiting when combined with alcohol, so the drug classically conditions an aversion to alcohol. Antabuse works for some individuals, but there

are several reasons why it is not entirely effective (Garbutt, 2009). As you can imagine, the client must have a fairly strong motivation to quit, and must be willing to take the drug knowing that it would make her ill. If she cheats and skips the drug one day, then the treatment will not have much chance of working. Thus, even though aversive conditioning can help people quit, it can require a great deal of willpower to use effectively.

Cognitive–Behavioural Therapies

Behavioural therapies, despite their effectiveness at changing problem behaviours, do not directly address problematic thoughts. This is extremely important because some disorders, such as depression, are caused and maintained, in part, by dysfunctional habits of thinking. Two psychodynamically

trained psychologists, Albert Ellis (1962) and Aaron Beck (1963), found that people with depression tend to interpret and think about their lives in a negative light. As Ellis, Beck, and others learned more about these thought patterns, it became apparent that therapies should be directed at changing negative cognitions into more realistic and rational thought patterns, as well as helping people learn to control the physiological processes (e.g., arousal) that reinforce negative thinking. Over time, this new approach became known as cognitive– behavioural therapy.

Cognitive–behavioural therapy (CBT) is a form of therapy that consists of procedures such as cognitive restructuring, stress inoculation training, and exposing people to experiences they may have a tendency to avoid, as in systematic desensitization (NIMH, 2009). Because avoiding thoughts and stressful situations tends to reinforce the negative feelings that would arise, helping clients to face negativity allows them the opportunity to gain insight into their feelings, to practise a courageous response to negativity, and to learn methods for coping when negativity arises. This type of therapy is far more about the present than about the past. Rather than excavating past traumas or conflicts, CBT therapists help clients become more aware of the thought, emotion, and behaviour patterns that arise in their current lives; through this

heightened self-awareness, clients learn to identify their habitual dysfunctional tendencies, and then work on building more functional cognitive and behavioural habits.

The drug Antabuse is used in aversive conditioning for alcohol consumption. When it is taken and the person subsequently consumes alcohol, Antabuse causes nausea and vomiting. If successful, Antabuse treatment leads to a conditioned aversion to alcohol. Monika Olszewska/Shutterstock

At the behavioural end of CBT, clients are given exercises and guidance in gaining skills they may be lacking. For example, as with systematic desensitization, clients may learn relaxation techniques, enabling them to better tolerate negative feelings when they arise. A person with social anxiety who has difficulty integrating into social situations may learn and practise certain social skills, such as making “small talk” with people at parties or learning to be more responsive to people’s non-verbal cues.

At the cognitive end of CBT, clients are given exercises and strategies to build more functional cognitive habits. Cognitive restructuring involves learning to challenge negative thought patterns, to question self-defeating beliefs, and to view situations in a different light. For example, people with depression or anxiety disorders often hold extreme and irrational beliefs, such as “I can’t do anything right,” “I have nothing worthwhile to say,” “If I fail, it’s going to be a total disaster.” As they become more aware of these negative beliefs, they can question or dispute them, helping themselves appreciate that these beliefs are

far more negative than reality warrants. After all, nobody can do everything wrong; nobody has literally nothing worthwhile to say; and a failure is not “the end of the world,” so to speak, but is also an opportunity to learn and improve. An example of applying CBT strategies to the cognitive symptoms of depression

is shown in Table 16.4 .

Table 16.4 Applying Cognitive–Behavioural Therapy to the Cognitive Symptoms of Depression

Cognitive Symptoms Example of CBT Coping Strategy

Internal Attributions: blaming

oneself excessively for

negative things that happen.

Recognize the role that a person contributed to his

problem, but also examine the role of other

contextual factors (e.g., the situation, the behaviour

of other people).

Stable Attributions: assuming

that situations are permanent

and irreversible.

In order to highlight the temporary nature of a

person’s difficulties, provide examples of how things

that were true in the past are no longer the case.

Global Attributions: assuming

that the results of one negative

event will apply to all aspects

of a person’s life.

Challenge the person to explain exactly how the

effects of one negative event will spill over into other

parts of his life; provide examples of situations when

spillover did not occur.

Of course, it falls to the client to put the behaviours learned in therapy into practice—noting her automatic thought tendencies as they occur, and then actively practising her cognitive strategies. As the client practises interrupting old thought patterns and actively cultivating new, healthier ones, the healthier patterns should become more easily activated, until eventually they become automatic themselves. In contrast, the depressive thought patterns should fade with disuse, becoming less easily activated over time.

The fact that these exercises change people’s functioning has been dramatically demonstrated through neuroimaging studies, which show substantial changes to

neurological function after CBT (Frewen et al., 2008). For example, one study at L’Institut Universitaire de Gériatrie de Montréal showed that, before being treated with CBT, people suffering from spider phobia showed activation in certain brain areas when viewing pictures of spiders: part of the prefrontal cortex involved with controlling emotional responses, and part of the hippocampus involved in contextual fear memories. The activation of these two areas likely reflects the automatic reactivation of fear memories that underlie the phobia, plus the person’s attempt to override the fear response. After receiving CBT, these areas were no longer active when subjects viewed spider pictures. These neuroimaging results provide us with further evidence that CBT can change a

person’s thought processes (Paquette et al., 2003).

Mindfulness-Based Cognitive Therapy

One of the biggest recent advances in therapeutic practice, spearheaded by researchers at the Centre for Addiction and Mental Health in Toronto, is the integration of meditation-based practices, such as mindfulness, with traditional cognitive–behavioural approaches. In this groundbreaking area of research, East

meets West and ancient meets modern, as traditional spiritual practices merge with modern psychological therapies and neuroscientific understanding.

Mindfulness practice and cognitive–behavioural therapy begin in somewhat similar ways—the goal of each is to get the client better acquainted with her thoughts and feelings, in the present moment of experiencing them. But after this emphasis on increased self-awareness, the two approaches differ significantly. In CBT, there is a basic orientation of “fixing oneself.” The purpose of becoming aware of one’s patterns of thoughts, feelings, and behaviours is to gain greater control so that the negative patterns get replaced with more positive ones. In contrast, the practice of mindfulness involves consciously adopting an orientation of “accepting” oneself fully. Strictly speaking, from a mindfulness perspective, you don’t necessarily have to “do” anything about problematic thoughts and feelings; instead, you make the active choice to accept them as they are, to simply observe them without reacting.

It may sound like “just watching yourself” isn’t doing very much. However, it is in fact a highly active and intentional process. In order to be able to watch yourself without reacting to the different thoughts and feelings that arise, you must consciously choose, again and again, to take an attitude of openness and

acceptance toward yourself. Dr. Daniel Siegel (2007) describes this attitude as COAL—curious, open, accepting, and loving. COAL is, essentially, the same attitude that parents take toward children in order to help them develop emotional security.

As people develop emotional security by being involved in loving and accepting relationships, this is reflected in the development of certain brain areas that

Siegel calls the social circuitry. These areas, including parts of the medial prefrontal cortex, are involved in experiencing and managing emotions, feeling empathy and taking the perspective of others, and, generally speaking, reflect an

interpersonal attunement between oneself and other people. The practice of mindfulness is believed to be a kind of intrapersonal attunement, a relationship between oneself and oneself; it seems to involve the same social circuitry, and lead to the same emotional and neurological outcomes as the development of secure attachment. Basically, by practising attending openly and non-reactively

to yourself, you become like your own healthy parent. As Siegel describes it, mindfulness is like re-parenting yourself, actually changing your own biological structures that are involved in emotional security. The key insight here is that security comes from having good relationships, and mindfulness offers a specific

technique for building a healthier relationship with yourself.

A second key way in which mindfulness affects a person is through the

experience of decentring , which occurs when a person is able to “step back” from their normal consciousness and examine themselves more objectively, as an observer. You have no doubt experienced decentring many times, such as when you become aware that you are “talking to yourself” as though there is a private voice in your mind that you can “speak” with, or you may have had the experience of becoming aware of yourself having an experi ­ence while you are having the experience. For example, you may be dancing but then you suddenly

become acutely aware of yourself dancing, as though you are looking at yourself from a third-person perspective.

The ability to decentre is a powerful antidote to difficult thoughts and feelings. By stepping back from your own thoughts and feelings and observing them dispassionately, you detach yourself from the damaging or troubling consequences of your thoughts. This can be similar to watching a young child have a temper tantrum. Because you are not “attached” to the child’s thoughts and feelings (let’s assume), their anger doesn’t affect you in the same way. You have some distance from it, which allows you to think more clearly and decide on the best way to respond to the situation, whereas the child is too caught up in emotion to be able to gain that cognitive control.

Mindfulness-based cognitive therapy (MBCT) involves combining mindfulness meditation with standard cognitive–behavioural therapy tools. The goals are to reap the benefits of mindfulness practice described above, and then to work on changing dysfunctional patterns using CBT. Many carefully controlled trials have shown that MBCT has powerful effects on people who have experienced a major depressive disorder. After the person emerges from a depressive episode, the practice of MBCT substantially reduces the likelihood of experiencing a relapse, lengthens the amount of time that passes between

depressive episodes, and reduces residual depressive symptoms for years after

treatment (Bondolfi et al., 2010; Kuyken et al., 2008, 2010).

MBCT seems to have great promise as a therapy for many different conditions. Initial studies suggest it is beneficial for social anxiety disorder and generalized

anxiety (Evans et al., 2008; Piet et al., 2010), bipolar disorder (Weber et al., 2010; Williams et al., 2007), depression (Kingston et al., 2007; Williams et al., 2006), hypochondriasis (McManus et al., 2012), and suicidal ideation (Crane & Williams, 2010). Mindfulness exercises are excellent tools for encouraging people to become more growth-oriented, and they are adaptable to both individual therapy and therapy in group settings.

Group and Family Therapies

In some situations, clients may benefit by participating in group therapy sessions. Group members share their personal stories and experiences, and the bonding and support that occur in this context can be very powerful. To encourage people to open up to each other, therapists may group people together based on the issue that they are dealing with (e.g., alcohol addiction, divorce), or other similarities (e.g., age, ethnicity, gender, sexual orientation, etc.). A final, logistic advantage to group therapy is the cost, which is usually much cheaper than individual therapy. This makes group therapy accessible to a broad range of people across society.

In other situations, psychologists may conduct family therapy. This may occur if a client’s difficulties stem from or are reinforced by unhealthy dynamics within the family; for example, people with schizophrenia are far less likely to have their symptoms stay in remission if their families exhibit negative patterns of

communication and emotional involvement (Hooley, 2007). Thus, family therapy may be extremely effective for helping people with schizophrenia, generally in conjunction with anti-psychotic drug treatments. Family therapy may also be used to help families deal with specific family members who are highly dysfunctional in some way, such as being addicted or having poor emotional control.

Family therapists generally take a systems approach , an orientation that encourages therapists to see an individual’s symptoms as being influenced by many different interacting systems; one important system is the family system, which can play a big role in the development and maintenance of psychological disorders. For example, imagine a family in which one person is emotionally abusive and controls the other family members by becoming excessively angry. A therapist taking a systems approach would see that behaviour pattern as stemming not only from the individual themselves, but also from the other family members. For example, the other family members may constantly monitor that person and carefully choose their own behaviours so as to avoid making that person angry. Or, the family may stop inviting other people to the house, allowing the angry person to isolate the family within the community. Or, the family members may be too quick to forgive or to apologize themselves and accept the blame whenever the angry person loses his temper, rather than challenging the person and being clear about what the family will and will not tolerate. There are many different ways in which family members contribute to the maintenance of a dysfunctional pattern of behaviour, and a family systems therapist would therefore treat the individual by also working with the other family members to change the larger patterns that reinforce the problematic behaviours.

Evaluating Cognitive–Behavioural Therapies

Behavioural therapies have been shown to be particularly effective at treating symptoms associated with anxiety disorders, such as obsessive-compulsive

disorder and specific phobias (Chambless & Ollendick, 2001). They have also proved useful for increasing behavioural skills (e.g., social skills) and decreasing problematic behaviours (e.g., social withdrawal).

Cognitive–behavioural therapy has been quite effective in treating depression, which is not too surprising given that this method of therapy was specifically

developed for this purpose (Hollon et al., 2002). CBT has also been successful in treating conditions like anxiety, obesity, and eating disorders. In fact, CBT is the most effective treatment currently available for anxiety disorders, particu­larly over the long term, even outperforming anti-anxiety medications for

most adult anxiety disorders (Hofmann & Smits, 2008); furthermore, the effects

last much longer than the effects of drugs, which often are effective only so long

as the person remains on the medication (Hollon et al., 2006). Neuroimaging research on people with obsessive–compulsive disorder showed that both antidepressant drug (SSRI) and CBT treatments effect the same changes in

neural activity (Schwartz et al., 1996), suggesting that these different approaches target similar neural processes. In many cases, rather than taking an either/or approach, the best outcomes have been found by combining drug treatments with cognitive behavioural therapy; this has been found for several

different disorders, including panic disorder with agoraphobia (Starcevic et al., 2004), and depression (McCullough, 2000).

Generally speaking, cognitive and behavioural therapies are the workhorses of psychological treatments; they are quite versatile in their applications and can help to treat a wide variety of disorders. They also take much less time (and are therefore much less expensive) than psychodynamic approaches, and have none of the undesirable side effects of drug treatments. Nevertheless, different treatments work better for different people, and it is worth remembering that for any given person, it is currently impossible to know ahead of time which treatment or combination of treatments may work the best.

Module 16.2b Quiz:

Behavioural, Cognitive, and Group Therapies

Know . . . 1. involves a process in which the client faces feared situations

gradually and under controlled conditions.

A. Client-centred therapy B. Family therapy C. Insight therapy D. Exposure therapy

2. consists of key procedures including exposure, cognitive restructuring, and stress inoculation training.

A. Cognitive–behavioural therapy

B. Family therapy C. Virtual reality exposure therapy D. Exposure therapy

Understand . . . 3. The key difference between mindfulness and cognitive behavioural

therapy is that

A. only CBT involves decentring. B. CBT is supported by empirical research, whereas mindfulness is

just a practice that comes from Buddhism but has little empirical support.

C. in CBT, clients practise replacing their dysfunctional thoughts with more functional thoughts; whereas in mindfulness practice, clients simply watch their thoughts and accept them as they are.

D. CBT can be combined with drug treatments, but mindfulness cannot.

Apply . . . 4. Neil is facing difficulties with anger and depression. His parents are

having trouble managing his behaviours and responding appropriately. To address all of these concerns, the most beneficial treatment in this

situation would likely be . A. cognitive–behavioural therapy B. family therapy C. virtual reality exposure therapy D. exposure therapy

Analyze . . . 5. Cognitive–behavioural therapies seem to be effective because they

A. help individuals restructure their maladaptive thoughts and beliefs.

B. teach individuals to brood over problems effectively. C. systematically desensitize phobias. D. are easier for the therapist to implement.

Module 16.2 Summary

aversive conditioning

behavioural therapy

client-centred therapy (or person-centred therapy)

cognitive-behavioural therapy (CBT)

decentring

dream analysis

free association

insight therapy

mindfulness-based cognitive therapy (MBCT)

object relations therapy

phenomenological approach

psychodynamic therapy

resistance

systematic desensitization

systems approach

transference

virtual reality exposure (VRE)

Psychoanalysis works by uncovering hidden conflicts, whereas humanistic therapy focuses on removing conditions of worth that can hinder a person’s

Know . . . the key terminology related to psychological therapies.16.2a

Understand . . . the general approaches to conducting major types of psychological therapy.

16.2b

growth. Behavioural and cognitive therapies target dysfunctional thought and behaviour patterns, seeking to replace undesirable patterns with more functional ones that clients then practise regularly. Group and family therapies have also been developed and work with social systems that are larger than one individual.

Apply Activity Imagine you are helping someone who has a phobia to find a therapist for treatment. You speak with three professionals about the approach each would take. Match their response with the corresponding school of thought. Note: Not all the schools of therapy will be used.

1. I would ask the individual to describe his train of thought when he encounters the feared object. Then I would ask him to explain why it is irrational to think that way, and we would try to replace his irrational thoughts with more reasonable, less anxiety-provoking beliefs.

2. I would ask the patient to think about his earliest childhood experiences with the object, and then to speak freely about those memories at length. We would try to discover the significance of that object in his early development.

3. We would take an active approach. One important step is to teach the client how to be calm and relaxed while gradually introducing the feared stimulus.

A. Humanistic therapy B. Cognitive–behavioural therapy C. Psychodynamic therapy D. Family therapy E. Behavioural therapy

Table 16.5 summarizes the pros and cons of the major forms of therapy discussed in this module.

Apply . . . your knowledge to identify major therapeutic techniques.16.2c

Analyze . . . the pros and cons of the major types of psychological therapy.

16.2d

Table 16.5 Pros and Cons of the Major Types of Therapy

Pros Cons

Insight

therapies

Can provide deep

understanding of the self

Can facilitate substantial

personal growth and

personal transformation

Often (but not always) involve

long-term therapy, often very

expensive

Can have limited application to

people with serious disorders

Behavioural

and

cognitive

therapies

Typically time- and cost-

efficient

Address immediate

thoughts and behavioural

problems

Address both mild and

severe problems

Do not necessarily offer deeper

understanding of psychological

problems

When used alone, may not be

effective for some severe cases

and certain disorders (e.g.,

schizophrenia)

Group/family

therapies

Allows individuals to

empathize and relate to

others with similar

problems

Gives family members

insight into how each

individual contributes to

both positive and negative

aspects of family life

Can change the larger

social dynamics that

reinforce and maintain the

disorder

Does not fully address individual

issues (although group and

family therapies are often used

in combination with

individualized therapy)

Module 16.3 Biomedical Therapies

Dennis Hallinan/Alamy Stock Photo

Learning Objectives

Know . . . the key terminology associated with biological treatments. Understand . . . how the drugs described in this module affect brain functioning. Understand . . . the other major medical approaches to therapy. Apply . . . your knowledge of drug therapies to different psychological conditions. Analyze . . . whether St. John’s wort, a popular herbal remedy for

16.3a 16.3b

16.3c 16.3d

16.3e

The word “depression” used to be taboo; people didn’t want to admit to being depressed and have others think they were weak-willed or simply needed “to get it together.” Then in 1987 Prozac hit the market, and everything changed. Suddenly there seemed to be a miracle cure for a silent epidemic of depression. Millions of dollars were spent on marketing campaigns that targeted both doctors and the public at large. Rates of depression diagnoses skyrocketed, and sales of Prozac kept pace. Within a decade, Eli Lilly, the company that owned Prozac, was making

$2.5 billion per year from Prozac sales alone (Couzin, 2004).

But then people started to voice concerns about this wonder drug and its “sister” drugs, the selective serotonin reuptake inhibitors (SSRIs) known by brand names like Paxil and Zoloft. People alleged that these drugs caused many different side effects, from relatively “mild” problems such as sexual dysfunction, weight gain, and skin rashes, to very serious problems such as seizures, breathing problems, and even thoughts of committing suicide.

The side effect that really got the public’s attention (and which Eli Lilly denied), was the increased risk of suicidal thoughts. Dr. David Healy, author of the book Let Them Eat Prozac, even went so far as to allege that Eli Lilly’s own research showed that Prozac led to increased risk for suicidal behaviours, but that they had suppressed the findings. In 2005, documents were leaked to CNN purporting to show that Eli Lilly knew, all the way back in the 1980s, that Prozac users were more than 1200% more likely to attempt suicide than people using several other antidepressants.

Around the same time, a meta-analysis called into question the usefulness of SSRIs in general. This study concluded that the effects of

SSRIs were only slightly better than a placebo (Kirsch et al., 2008). Although later meta-analyses found more positive results (Hieronymus et al., 2016), questions about these medications still exist.

Where does this leave you, as a potential consumer of these drugs? We

depression, works.

hope that it leaves you with the awareness that it is important to ask questions and find good research concerning the effectiveness of prescription drugs, as well as their side effects, and to appreciate that there are many different treatment options available for most disorders. The informed “consumer” can, hopefully, make the wisest choice for themselves.

Focus Questions

1. What medical techniques are available for influencing psychological disorders and how do they work?

2. What are the risks and benefits associated with different biomedical approaches?

The biomedical approach to treating disorders involves using drugs, surgery, or other medical procedures in order to alter the functioning of the central nervous system and correct what is believed to be the underlying biological problem. Psychopharmacotherapy —the use of drugs to manage or reduce clients’ symptoms—is by far the most frequently used biomedical option, and is often employed in conjunction with some form of psychological therapy. Other options, such as surgery or electrically stimulating the brain, are typically used only in situations where no other available treatments have succeeded. In this module, we explore and evaluate each of these biomedical treatment options and examine how they may be used in conjunction with other forms of therapy.

Drug Treatments

Psychotropic drugs are medications designed to alter psychological functioning. Drug approaches were first predominantly used in institutional and clinical settings, generally targeting very severe cases. However, in more recent decades, drug treatments have become mainstream practice for many people

experiencing even mild psychological problems and symptoms. This expansion has made certain psychotropic drugs, such as those used to treat depression,

among the most prescribed forms of medicine (Olfson & Marcus, 2009).

Psychotropic drugs have been developed to take many different courses of

action. First, all psychotropic drugs are designed to cross the blood–brain barrier , a network of tightly packed cells that only allow specific types of substances to move from the bloodstream to the brain in order to protect delicate brain cells against harmful infections and other substances (see Figure 16.3 ). After crossing this barrier, psychotropic drugs then affect one or more neurotransmitters. The specific neurotransmitter(s) targeted by a drug will determine which disorders will be responsive to that medication.

Figure 16.3 How Psychotropic Drugs Reach the Brain In order to affect the brain in the desired way, psychotropic drugs must cross the blood–brain barrier, a network of densely packed cells that restrict the flow of substances between the capillaries and brain cells.

Antidepressants

As the name suggests, antidepressant drugs are medications designed to reduce symptoms of depression. In general, antidepressant drugs target areas of the brain that, when functioning normally, are rich in monoamine neurotransmitters—serotonin, norepinephrine, and dopamine. Since multiple neurotransmitters are involved, antidepressants come in several varieties, each

with its own way of altering brain chemistry (Figure 16.4 ).

Figure 16.4 Antidepressant Effects at the Synapse The major antidepressant drugs have different ways of increasing the transmission of neurotransmitters such as serotonin, dopamine, and norepinephrine at the synapses.

Monoamine oxidase inhibitors (MAOIs) were the first type of antidepressant to be developed and widely used. They work by deactivating monoamine oxidase (MAO), an enzyme that breaks down serotonin, dopamine, and norepinephrine at the synaptic clefts of nerve cells (see Figure 16.4 ). When MAO is inhibited, fewer dopamine, serotonin, and norepinephrine neurotransmitters are metabolized, which in turn leaves more of them available for synaptic transmission. Although MAOIs often effectively relieve symptoms of depression, they are used less frequently than other antidepressants, in part because they can cause many side effects, some quite dangerous, especially when they interact with other medications and certain types of foods (e.g., aged cheeses, smoked meats, alcoholic beverages).

Tricyclic antidepressants were among the earliest types of antidepressants

on the market and appear to work by blocking the reuptake of serotonin and norepinephrine (Figure 16.4 ). Unfortunately, they also seem to cause many undesirable side effects, including nausea, weight gain, sexual dysfunction, and even seizures.

Given the severity of the side effects associated with MAOIs and tricyclic antidepressants, it should come as no surprise that both patients and physicians were eager for a new form of antidepressant to become available. In 1987, one

such drug arrived: fluoxetine (also known as Prozac). Prozac is a selective serotonin reuptake inhibitor (SSRI) , a class of antidepressant drugs that block the reuptake of serotonin. These antidepressants alleviate some proportion of the symptoms of depression in some clients, although they also come with certain side effects, as discussed in the opening vignette of this module.

Interestingly, it is not yet clear exactly through which mechanisms SSRIs seem to have their effect. The notion that they work by enhancing mood directly is only a hypothesis; there may be other mechanisms involved. For example, serotonin also causes the brain stem to reduce overall arousal, which could be one way of

reducing the magnitude of negative emotions in general (Maier & Watkins, 2005). SSRIs also lead to decreased activation of parts of the amygdala, which may reduce the person’s negative emotional response to various stimuli

(Sheline et al., 2001). SSRIs have also been shown to lead to neurogenesis— the growth of brand-new neurons—in the hippocampus. Reduced hippocampal volume has been connected to depression, so this may be one route through

which SSRIs affect depression (Jacobs, 2004). It is important to remember that any drug usually has multiple effects on the brain, and it is difficult to determine exactly which effect may be responsible for the overall impact that the drug has on the person.

Myths in Mind Antidepressant Drugs Are

Happiness Pills A common belief is that antidepressants are happiness in pill form—that their chemical magic can not only cause depression to disappear, but

can also bring on optimism and a rush of positive emotion. In reality, antidepressant drugs can alleviate depression (in some individuals), but they do not make people happier than they were before becoming depressed.

The “happiness pill” misconception about antidepressants has led some individuals to believe that taking a high dose of antidepressants will induce a euphoric high, much like cocaine or heroin. This is also a myth. Although some people have attempted to abuse antidepressants by taking high doses (even crushing and snorting them for quicker delivery to the brain), there is no evidence that an intense rush of happiness results. In fact, SSRIs typically take a couple of weeks to work. Taking a high dose, or snorting crushed-up pills, neither magnifies their effects nor reduces the two-week waiting period before effects become evident.

In short, antidepressants are not “happiness pills” and should not be taken by people who are merely looking to boost their mood.

At this point, we have discussed both the mechanisms and the limitations of antidepressants. But, this discussion has been limited to the types of medications that are prescribed by physicians. As you will see in the next section, these are not the only types of remedies available to people trying to cope with depression.

Working the Scientific Literacy Model Is St. John’s Wort Effective?

People often make the assumption that biomedical therapies are limited to prescription drugs or to procedures provided by a physician. In reality, people often self-prescribe and administer treatments for depression. One popular home remedy is the herbal treatment St. John’s wort, found in many health food stores and pharmacies.

What do we know about St. John’s wort? Herbal remedies are often associated with a “hippie” lifestyle or discounted as “unscientific.” It is important to remember that any drug—even so-called natural products—will affect the levels of neurotransmitters in your brain. This is how they affect your

behaviour. St. John’s wort (Hypericum perforatum) appears to influence several of the neurotransmitter systems that are altered by traditional antidepressant medications, including serotonin

(Butterweck, 2003). However, its most prominent effect appears to be on the levels of epinephrine, a chemical associated with emotional arousal and stress responses. Several studies have shown that St. John’s wort causes epinephrine receptors to

down-regulate (move further away from the synapse; De Marchis et al., 2006; Jakobs et al., 2013). This reduces the impact that epinephrine has on the nervous system. St. John’s wort also inhibits the release of glutamate, the brain’s primary excitatory

neurotransmitter (Chang & Wang, 2010). As you can see, this seemingly simple herbal remedy has fairly complicated effects on the brain.

What have scientific studies found about St. John’s wort and depression? The goal of scientists investigating St. John’s wort is to determine if it can be used as an alternative treatment for depression. In order to do this, researchers must demonstrate that St. John’s wort reduces depressive symptoms more than a placebo. Several groups of researchers have examined this research question.

Researchers using animal participants have found that St. John’s wort reduces a number of different behaviours linked with

depression and anxiety (Schmidt & Butterweck, 2015). For example, in the forced swimming test, rodents are placed in an inescapable tank of water. Researchers can measure how long the rodents actively swim versus how long they remain motionless. The amount of time spent immobile is viewed as a

behavioural measure of hopelessness or depression. Researchers have found that antidepressants reduce the amount of time spent motionless; St. John’s wort has similar positive

effects (Bukhari & Dar, 2013).

Tests involving humans use less-aquatic methods to measure depression; most studies use standardized questionnaires. In order to get the “big picture” of these studies, we can examine

meta-analyses that combine the results of the different experiments. A recent meta-analysis of 35 experiments involving 6993 patients found that St. John’s wort led to reduced levels of depression when compared to placebos. Importantly, it was just as effective as traditional antidepressants, but with fewer side

effects (Apaydin et al., 2016).

Can we critically evaluate this evidence? St. John’s wort is not a cure for everyone’s depression. Similar to prescription antidepressants, St. John’s wort will work for some people while having no effect on others. To date, we have little ability to predict and understand who will benefit from this remedy. There is also uncertainty as to the correct dose of this medication.

Research into St. John’s wort is also limited by a lack of human brain-imaging studies. These studies would help identify the specific brain areas affected by this treatment, which would provide researchers with more insight into what cognitive processes are altered when people consume this medication.

Finally, a major limitation of this research is that the quality of the samples of St. John’s wort is not standardized or carefully regulated by government agencies. Thus, different samples of the drug might have quite different levels of active ingredients. This adds a lot of uncertainty to the data and makes it more difficult to

test the drug’s effectiveness (Klaus et al., 2008). Until these

uncertainties are controlled for, physicians will likely be hesitant to recommend St. John’s wort to patients unless other medications have already been ineffective.

Why is this relevant? Knowledge about alternative treatments such as St. John’s wort can help people with depression make informed choices about what treatment is best for them. The results of studies of St. John’s wort appear promising. Indeed, the Canadian Network for Mood and Anxiety Treatments (CANMAT) states that St. John’s wort is an effective treatment for mild to moderate depression

(Ravindran et al., 2016).

However, individuals should still consult with their doctor. St. John’s wort may interact poorly with other medications,

particularly other antidepressants (Borrelli & Izzo, 2009). Therefore, it is important for healthcare providers to know all of the substances that a patient is taking. It is also worth noting that although St. John’s wort is as effective as many antidepressants, research has not thoroughly tested how it compares to psychological therapies such as cognitive–behavioural therapy.

Mood Stabilizers

In contrast to antidepressants, which are primarily used to treat depression

(unipolar disorder), mood stabilizers are drugs used to prevent or reduce the severity of mood swings experienced by people with bipolar disorder. Lithium

was one of the first mood stabilizers to be prescribed regularly in psychiatry, and from the 1950s to the 1980s was the standard drug treatment for depression and bipolar disorder. Lithium, a salt compound, can be quite effective, but it can also be toxic to the kidneys and endocrine system. Today, doctors generally prefer to prescribe other drugs because they seem to be more effective and safer than

lithium (Thase & Denko, 2008). For example, people with bipolar disorder now often take anticonvulsant medications such as valproate or anti-psychotic medications. Although these medicines can be effective in preventing manic episodes, they are also associated with side effects like weight gain, nausea, and fatigue, and in rare cases, very serious side effects occur including brain

damage due to elevated levels of ammonia in the blood (Wadzinski et al., 2007).

Antianxiety Drugs

Sometimes referred to as tranquilizers, antianxiety drugs affect the activity of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter that reduces neural activity. These drugs are prescribed to alleviate nervousness and tension, and to prevent and reduce panic attacks. Widely prescribed examples include Xanax (alprazolam), Valium (diazepam), and Ativan (lorazepam). These drugs appear to temporarily alter the structure of GABA receptors, allowing more GABA molecules to inhibit neural activity. The effects of antianxiety drugs are relatively short-lived. They take effect within minutes of ingestion and may last for only a few hours. Given that these drugs facilitate inhibition of the nervous system, it is not surprising that their side effects include drowsiness, tiredness, and impaired attention, especially when they are taken at high doses. More serious side effects include memory impairments, depression, and decreased sex drive. These drugs also have the potential to induce abuse and withdrawal symptoms.

Antipsychotic Drugs

Antipsychotic drugs are generally used to treat symptoms of psychosis, including delusions, hallucinations, and severely disturbed or disorganized thought. Antipsychotics are the common treatment for schizophrenia and are sometimes prescribed to people with severe mood disorders. There are several classes of antipsychotic drugs.

The first generation of antipsychotic medications (e.g., Thorazine, Halodol) was designed to block dopamine receptors, because symptoms of schizophrenia are

related to dopamine activity in the frontal lobes and basal ganglia. However, these drugs had significant side effects, such as seizures, anxiety, nausea, and

impotence. One of the more severe and often permanent side effects, tardive dyskinesia , is a movement disorder involving involuntary movements and facial tics.

Newer antipsychotic medications are referred to as atypical antipsychotics

or second-generation antipsychotics. These drugs are less likely to produce side effects including movement disorders (like tardive dyskinesia) that commonly occur with first-generation antipsychotics. Different atypical antipsychotics vary in their exact effects, but generally speaking they seem to work by affecting dopamine and serotonin transmission. These medications work for approximately half of the people who take them, reducing the severity of

symptoms but not necessarily eliminating them altogether (Leucht et al., 2009). Unfortunately, their effects tend to weaken over time, and also come with some risk. For example, Clozapine, a very effective antipsychotic drug, compromises the body’s white blood cells. People who take Clozapine must have their blood regularly monitored or the consequences can be extremely severe, potentially even leading to death.

A major challenge for healthcare providers is ensuring that the drugs being provided to patients are safe. Unfortunately, there have been instances in which pharmaceutical companies make some questionable decisions. One of the bigger scandals in the pharmaceutical industry in recent years involved another of the atypical antipsychotic drugs, Zyprexa. Initially, Zyprexa was hailed as a major breakthrough for people with schizophrenia and enjoyed widespread distribution (eventually prescribed to more than 20 million people around the world). Then allegations emerged that Zyprexa caused drastic weight gain and was linked to the onset of diabetes, hyperglycemia, and pancreatitis. Although Eli Lilly officially denied that Zyprexa caused these consequences, as of 2007, the company had paid more than $1.2 billion to settle lawsuits brought against it by

almost 30 000 people (Berenson, 2007).

Much of the testing of drugs, and their promotion and marketing to physicians, occurs behind a curtain of secrecy, making it difficult for the public to always

know whether drugs are being used appropriately. Again, Zyprexa is a good example. In 2009, Eli Lilly pled guilty to charges involving the “off-label marketing” of Zyprexa (i.e., promoting its use for conditions it wasn’t designed to treat). To understand just how much potential harm can occur due to such practices, first consider the possible side effects that were discussed above. Then consider some of the details of this case:

Although Zyprexa was approved in the U.S. by the Food and Drug Administration (FDA)

as a treatment for schizophrenia and bipolar disorder, Eli Lilly admitted that they

marketed the drug illegally, promoting it to doctors as a treatment for other conditions;

this is known as “off-label marketing.”

The U.S. Department of Justice concluded that Eli Lilly concentrated these illegal

marketing efforts to encourage doctors to prescribe Zyprexa for elderly patients for

several conditions, including dementia, Alzheimer’s, agitation, aggression, hostility,

depression, and generalized sleep disorder, all of which are common symptoms in

elderly populations, and none of which were covered under FDA approval. Zyprexa also

carries the common side effect of sedation, which was promoted as a therapeutic

benefit for the elderly that could help to deal with any “behavioural issues.” In fact, using

Zyprexa essentially as a sleep aid was captured by the company’s sales slogan, “5 at

5,” which symbolized how 5 milligrams of Zyprexa given at 5 p.m. would help put elderly

patients to sleep for the night. Then Eli Lilly expanded its marketing efforts to

recommend that doctors prescribe Zyprexa to adults across the age spectrum for a

wide variety of disorders. The company was fined a total of $1.4 billion. It is worth

putting this in perspective though: in only one year (2010), Eli Lilly made more than $5

billion from Zyprexa (Stastna, 2013).

Evaluating Drug Therapies

Many people believe that drugs are designed to target the root physical causes of psychological disorders, and that they should therefore be more effective than psychological approaches to therapy. However, these beliefs are not warranted.

In many cases, drugs are not more effective than psychological therapies. For example, with regard to depression, the use of antidepressants has become

increasingly accepted among the general public, in part due to well-funded marketing campaigns. However, these drugs are not as effective as they are widely believed to be. Approximately 50% to 60% of people who take antidepressants improve within a few months—compared to 30% of people who

improve after taking a placebo (Hollon et al., 2002). Interestingly, about 50% to 60% of people also improve from psychological therapy. Thus, we cannot conclude that drugs are more effective or should replace other approaches to therapy.

In other cases, such as most anxiety disorders, psychological treatments such as

cognitive–behavioural therapy (Module 16.2 ) are generally the most effective treatment (Hofmann & Smits, 2008). A key advantage of CBT is that the effects last long after the treatment is completed (Hollon et al., 2006), whereas antianxiety medications typically are effective only as long as the client maintains the drug regimen (and of course, come with side effects). The superior long-term effect of CBT over drugs has been found for generalized anxiety disorder

(Hofmann & Smits, 2008) and panic disorder (Barlow et al., 2000).

In many situations, a combination of treatment approaches may work best; for example, combining psychological therapy with antidepressants has been shown to be more effective in treating major depression than medication alone

(Burnand et al., 2002; de Jonghe et al., 2001). A similar pattern is found for some anxiety disorders; combining drugs with CBT is more effective for panic

disorder with agoraphobia than either treatment on its own (Starcevic et al., 2004).

Even schizophrenia, which is often viewed to be an organic “brain disease,” is more effectively treated by combined approaches. People with schizophrenia tend to have difficulty in self-reflecting, projecting themselves into the past and

future (D’Argembeau et al., 2008), engaging in basic self-care, and integrating into regular social life. Although drugs may reduce many symptoms, additional therapy using psychological approaches has been shown to have a huge impact on reducing the likelihood of experi ­encing further schizophrenic episodes. Some research has shown that the likelihood of experiencing future schizophrenic episodes is affected even more strongly by social factors, such as

how much negative emotion and hostility are expressed in the family, than even

by whether the person with schizophrenia takes their medication (Hooley & Gotlib, 2000). Clearly, even disorders that are generally viewed as predominantly biological are better understood from a biopsychosocial perspective, because they involve not only straightforward biological mechanisms, but also thoughts, feelings, behaviours, and social relationships.

Module 16.3a Quiz:

Drug Treatments

Know . . . 1. Tardive dyskinesia is

A. a side effect of antipsychotics that involves motion control problems.

B. an antidepressant that breaks down enzymes in the synapse. C. the growth of new neurons in the adult brain. D. a side effect of antidepressant drugs.

Understand . . . 2. affect the nervous system by blocking reuptake of serotonin in

neurons.

A. MAOIs B. Antianxiety medications C. Mood stabilizers D. SSRIs

3. Monoamine oxidase inhibitor drugs work by A. boosting the ability of an enzyme to break down serotonin,

dopamine, and norepinephrine molecules.

B. inhibiting the ability of an enzyme to break down serotonin, dopamine, and norepinephrine molecules.

C. selectively blocking the reuptake of serotonin. D. creating new dopamine molecules.

Analyze . . . 4. Generally speaking, which of the following is the most accurate statement

about psychotropic drugs?

A. They are superior to talking therapy. B. Their effects are rarely evident until weeks after taking them. C. They are usually more effective if combined with some form of

psychological treatment.

D. Although drugs often had bad side effects in the past, modern drugs have largely fixed those problems.

5. Imagine that a friend asks you what you have heard about St. John’s wort because he is considering using it to alleviate his depression. What would you say, based on the research?

A. St. John’s wort is as effective as antidepressant drugs for treating depressive symptoms for many people.

B. St. John’s wort is superior to prescription antidepressant medications.

C. Your friend may as well take a placebo: St. John’s wort has never been proven effective at reducing symptoms of depression.

D. St. John’s wort is superior to cognitive–behavioural therapies.

Technological and Surgical Methods

People working in the mental health field have a variety of biomedical approaches available in addition to drugs, ranging from direct surgical interventions to stimulation of brain areas using magnetic pulses. Today, these types of procedures tend to be quite safe and are carefully tested and scrutinized, although this has not always been the case.

You have likely heard of the frontal lobotomy , surgically severing the connections between different regions of the brain; however you may not know the full, rather chilling, story behind it. Back as far as the 1800s, neurologists experimented with this practice in the hope of “curing” psychological problems. By the 1930s, researchers discovered that by damaging the prefrontal areas of

aggressive chimpanzees, the animals would become calmer and more controllable. When Portuguese surgeon Antonio Moniz heard about this at a conference, he thought it might be useful for helping people with severe

psychoses and other disorders. He helped to develop the leucotomy , the surgical destruction of brain tissues in the prefrontal cortex. Drilling small holes into the skull, Moniz would typically insert a small wire loop, a leucotome, through the holes and into the brain matter; a few flips of the wrist later, the surgery is complete and the patient is left to “recover.”

Moniz himself had some success with the procedure, reporting a general improvement in the symptoms of several severely depressed, anxious, or otherwise disturbed people, and recommended it as a treatment of last resort when all other methods have failed. But then the technique was popularized and turned into a veritable industry by an enterprising American surgeon, Dr. Walter Freeman. Freeman and his collaborator, Dr. James Watts, further refined the “lobotomy” (as he called the procedure) for about a decade, until he learned of a new method, developed in Italy, for getting into the brain without having to drill holes in the skull. The secret entrance was right through the eye sockets.

Based on this insight, Freeman developed the trans-orbital lobotomy, which became known as the “icepick lobotomy.” Freeman would insert a slender metal shaft, like an icepick, in between the eyeball and eyelid, then with a hammer, would tap it through the bony roof of the eye socket and into the brain. Then he would move it around until the frontal lobes were detached from the rest of the

brain (Valenstein, 1973). He was even able to perform this brain-slicing without anesthesia, by first inducing a seizure in the patient through an electroconvulsive shock. Freeman believed the procedure to be miraculously successful. He became a passionate advocate for the lobotomy, and because he was able to perform them so quickly, often more than a dozen in a single day, he travelled around the country in his van, the “lobotomobile,” lobotomizing several thousand people in total. His procedure was always controversial, seen as a miraculous cure by some and as a barbaric practice by others, committing unknown amounts of harm and sometimes even ending in the patient’s death from cerebral hemorrhaging. Nevertheless, Freeman was a medical celebrity for a while, and toured the country teaching his technique to many doctors and

psychiatrists. In total, approximately 40 000 lobotomies are believed to have been performed in the United States and thousands more in western Europe. Freeman was eventually barred from practising, although not until 1967. And despite the protestations of many people, the man who started it all, Antonio Moniz, was awarded the Nobel Prize in Medicine in 1949.

Walter Freeman performing a frontal lobotomy surgery. Bettmann/Getty Images

By the 1950s, the popularity of the frontal lobotomy was dwindling rapidly. The inconsistent and often very negative results of the procedure, and the effectiveness of new psychotropic medications, convinced most of the field to move away from the lobotomy. Nevertheless, the basic practice of therapeutically destroying brain tissue survives to this day, although the techniques are now vastly more refined and precise.

Focal Lesions

One set of techniques involves performing focal lesions , which are small

areas of brain tissue that are surgically destroyed. These brain lesions are only used in some severe cases, when all other treatments have not worked to satisfaction. For example, in some cases of depression and anxiety disorders, lesion surgery has been targeted at a cluster of cells in the anterior cingulate

cortex, an area that is overactive in people with these disorders (Cosgrove & Rauch, 2003; Fitzgerald et al., 2005; Steele et al., 2008). This procedure, which is called an anterior cingulotomy, has no more risks or side effects than do many of the drugs used to treat these disorders, and it can reduce symptoms successfully despite other treatments being ineffective. Focal-lesion techniques have only become possible in recent years due to the surgical precision allowed by the use of brain-imaging technology, which allows surgeons to precisely target desired brain areas.

Electroconvulsive Therapy

Electroconvulsive therapy (ECT) involves passing an electrical current through the brain in order to induce a temporary seizure. This procedure was introduced in the 1930s and has been viewed negatively for much of its history, in part because in its early days it was generally unsafe and easily abused. This

procedure was famously, and chillingly, depicted in the book and movie One Flew Over the Cuckoo’s Nest. Many people believe that ECT causes lasting cognitive impairments, but in fact the majority of research on people who have

been treated with it suggests that this is not true (Rose et al., 2003).

Over the years, ECT techniques have improved dramatically. Patients’ experiences are much less negative; they are now given sedatives and muscle relaxants to reduce the discomfort they may experience and to prevent injury related to the convulsions. ECT has gone from being viewed as a torturous “shock treatment” to a relatively safe procedure, although it is still reserved for the most severe cases of disorders such as depression and bipolar disorder. The side effects are relatively mild, typically consisting of some amnesia for events occurring around the time of the treatment.

People with depression or bipolar disorder may elect to undergo electroconvulsive therapy if other treatments have not been successful. Will & Deni McIntyre/Photo Researchers, Inc./Science Source

Why does ECT work? Neuroimaging research suggests that ECT might alter how different brain areas work together as networks. These changes are most

pronounced in the frontal lobes (Beall et al., 2012; Perrin et al., 2012), particularly in areas along the midline of the brain (Argyelan et al., 2016). One possible interpretation of this emerging literature is that ECT may alter the patient’s tendency to habitually engage in negative thoughts, thereby disrupting the dysfunctional thinking patterns that are characteristic of depression. More research is needed before we will fully understand why ECT works as mysteriously well as it does.

Repetitive Transcranial Magnetic Stimulation

Repetitive transcranial magnetic stimulation (rTMS) is a therapeutic technique in which a focal area of the brain is exposed to a powerful magnetic field across several different treatment sessions. The magnetic field can be used to stimulate or inhibit the activity of particular brain areas. Researchers have found that stimulating the left prefrontal cortex, which is typically associated with positive emotional experiences, improves some symptoms of depression. They

have also found that reducing the activity of the right prefrontal cortex, which is

associated with negative emotional experiences, has the same effect (Berlim et al., 2014). Importantly, rTMS does not have immediate effects. Treatment typically involves between 10 and 25 rTMS sessions, although some accelerated

programs are being tested (George et al., 2014). Patients must also return for follow-up appointments every few months.

rTMS has a number of advantages over other treatments. It does not involve

anesthesia, induce a seizure, or produce cognitive impairments (Serafini et al., 2015). Additionally, rTMS may hold considerable promise for reducing symptoms of other mental disorders, such as schizophrenia (Slotema et al., 2010; Zaman et al., 2008).

Deep Brain Stimulation

Deep brain stimulation (DBS) is a technique that involves electrically stimulating specific regions of the brain. The procedure involves inserting thin electrode-tipped wires into the brain and carefully routing them to the targeted brain regions. A small battery connected to the wires is then inserted just beneath the skin surface. Unlike many of the drugs reviewed previously, DBS produces instantaneous results, and seems to work on even severe cases of depression that have been unresponsive to other treatments. As reported by researchers at the Rotman Research Institute in Toronto, who pioneered the application of DBS on depression, the effects seem almost miraculous; patients who are severely depressed report relief from their symptoms instantaneously,

as soon as the electricity is applied (Mayberg et al., 2005; McNeely et al., 2008). Other researchers have shown DBS to be effective on symptoms of OCD as well (Aouizerate et al., 2009).

Nevertheless, the technique does come with some risk, most obviously the risk of some internal bleeding and infection from the surgical insertion of the wires. DPS can also cause unintended behavioural effects; most are relatively benign and temporary experiences, such as spontaneous laughter and penile erections, but in some cases it may trigger troublesome states of depression or aggression

(Kringelbach et al., 2007).

It is important to note that there are additional therapeutic techniques that are still in development and therefore have not been discussed in this module. Advances in gene therapies, neuroimaging, neurostimulators, and computer science will soon influence how many psychological disorders are treated. These innovations should provide patients with a number of high-quality treatment options. The future of psychology should be exciting.

Delivering brief pulses of a strong magnetic field to specific regions of the cerebral cortex has been shown to help alleviate symptoms of severe depression and possibly other disorders. Bonnie Weller/staff/Newscom

Module 16.3b Quiz:

Technological and Surgical Methods

Understand . . . 1. If a doctor wanted to activate a very specific brain region in the hope of

alleviating symptoms of a mental disorder, she would most likely use which of the following procedures?

A. Focal lesion B. Cingulotomy C. Electroconvulsive therapy D. Deep brain stimulation

2. Which of the following techniques results in intentionally destroying brain cells?

A. Deep brain stimulation B. Electroconvulsive therapy C. Focal lesion D. Repetitive transcranial magnetic stimulation

Apply . . . 3. Amy has been suffering from depression for many years. She has tried a

number of antidepressant medications but suffered so many side effects that her doctor suggested that she stop taking them. Instead, her doctor has recommended that Amy try a new procedure in which a device emitting a magnetic field is placed against Amy’s scalp. This device would affect the activity of Amy’s frontal lobes. Which technique is Amy’s doctor recommending?

A. Deep brain stimulation

B. Repetitive transcranial magnetic stimulation C. Electroconvulsive therapy D. Magnetic resonance imaging

Module 16.3 Summary

antianxiety drugs

antidepressant drugs

antipsychotic drugs

atypical antipsychotics

blood–brain barrier

deep brain stimulation (DBS)

electroconvulsive therapy (ECT)

focal lesions

frontal lobotomy

leucotomy

lithium

monoamine oxidase inhibitors (MAOIs)

mood stabilizers

psychopharmacotherapy

psychotropic drugs

repetitive transcranial magnetic stimulation (rTMS)

selective serotonin reuptake inhibitor (SSRI)

tardive dyskinesia

Know . . . the key terminology associated with biological treatments.16.3a

tricyclic antidepressants

Antidepressant drugs typically target monoamine neurotransmitter activity, with

differing mechanisms of action (review Figure 16.4 ). Many of the antipsychotic drugs on the market reduce dopamine activity in the brain. Antianxiety drugs tend to target GABA receptors and increase activity of this inhibitory neurotransmitter.

Other procedures available for treating mental illness include electroconvulsive therapy, repetitive transcranial magnetic stimulation, deep brain stimulation, and focal lesions. In some cases, particularly ECT, researchers are still unsure what aspect of the treatment produces the therapeutic results. Stimulation techniques increase the brain activity in targeted areas, whereas lesions prevent brain activity. By targeting the areas responsible for specific behaviours, thoughts, or emotions, treatments can have dramatic effects on the experience of someone with a psychological disorder.

Apply Activity Match the drugs listed in the left column with the condition they are typically prescribed to treat on the right.

Drug Condition

1. Lithium a. Anxiety

2. SSRI b. Depression

Understand . . . how the drugs described in this module affect brain functioning.

16.3b

Understand . . . the other major medical approaches to therapy.16.3c

Apply . . . your knowledge of drug therapies to different psychological conditions.

16.3d

3. Xanax c. Schizophrenia

4. Clozapine d. Bipolar disorder

Research into the effects of St. John’s wort suggests it may be an effective treatment for many people. The herb works about as well as prescription antidepressants for at least mild to moderate levels of depression, but its efficacy for severe depression is not well established. Using St. John’s wort carries the significant advantage of not exposing the person to nearly the same range of potential side effects as prescription drugs, although it is also advisable to consult with a mental health professional rather than self-medicating without any professional support.

Analyze . . . whether St. John’s wort, a popular herbal remedy for depression, works.

16.3e

Glossary absolute threshold

the minimum amount of energy or quantity of a stimulus required for it to be reliably detected at least 50% of the time it is presented

accommodation a creative process whereby people modify their belief structures based on experience

acetylcholine one of the most widespread neurotransmitters within the body, found at the junctions between nerve cells and skeletal muscles; it is very important for voluntary movement

achievement motivation the drive to perform at high levels and to accomplish significant goals

acquisition the initial phase of learning in which a response is established