β-Adrenoceptor blockade modulates fusiform gyrus activity to black versus white faces

Are the current evaluation tools for advanced therapies biased?

PURPOSE OF REVIEW

Despite attention to racial disparities in outcomes for heart failure (HF) and other chronic diseases, progress against these inequities has been gradual at best. The disparities of COVID-19 and police brutality have highlighted the pervasiveness of systemic racism in health outcomes. Whether racial bias impacts patient access to advanced HF therapies is unclear.

RECENT FINDINGS

As documented in other settings, racial bias appears to operate in HF providers' consideration of patients for advanced therapy. Multiple medical and psychosocial elements of the evaluation process are particularly vulnerable to bias.

SUMMARY

Reducing gaps in access to advanced therapies will require commitments at multiple levels to reduce barriers to healthcare access, standardize clinical operations, research the determinants of patient success and increase diversity among providers and researchers. Progress is achievable but likely requires as disruptive and investment of immense resources as in the battle against COVID-19.

The effects of psychosocial stress on intergroup resource allocation

Stress changes our social behavior. Traditionally, stress has been associated with “fight-or-flight” – the tendency to attack an aggressor, or escape the stressor. But stress may also promote the opposite pattern, i.e., “tend-and-befriend” – increased prosociality toward others. It is currently unclear which situational or physiological factors promote one or the other. Here, we hypothesized that stress stimulates both tendencies, but that fight-or-flight is primarily directed against a potentially hostile outgroup, moderated by rapid-acting catecholamines, while tend-and-befriend is mainly shown towards a supportive ingroup, regulated by cortisol. To test this hypothesis, we measured stress-related neurohormonal modulators and sex hormones in male and female participants who were exposed to a psychosocial stressor, and subsequently played an intergroup social dilemma game in which they could reveal prosocial motives towards an ingroup (ingroup-love) and hostility towards an outgroup (outgroup-hate). We found no significant effects of stress on social preferences, but stress-related heart-rate increases predicted outgroup-hostile behavior. Furthermore, when controlling for testosterone, cortisol was associated with increased ingroup-love. Other-regarding behavior was overall higher in male than female participants. Our mixed results are of interest to scholars of the effects of stress on prosocial and aggressive behavior, but call for refinement in future replications.

A meta-analysis of procedures to change implicit measures

Using a novel technique known as network meta-analysis, we synthesized evidence from 492 studies (87,418 participants) to investigate the effectiveness of procedures in changing implicit measures, which we define as response biases on implicit tasks. We also evaluated these procedures' effects on explicit and behavioral measures. We found that implicit measures can be changed, but effects are often relatively weak (|ds| < .30). Most studies focused on producing short-term changes with brief, single-session manipulations. Procedures that associate sets of concepts, invoke goals or motivations, or tax mental resources changed implicit measures the most, whereas procedures that induced threat, affirmation, or specific moods/emotions changed implicit measures the least. Bias tests suggested that implicit effects could be inflated relative to their true population values. Procedures changed explicit measures less consistently and to a smaller degree than implicit measures and generally produced trivial changes in behavior. Finally, changes in implicit measures did not mediate changes in explicit measures or behavior. Our findings suggest that changes in implicit measures are possible, but those changes do not necessarily translate into changes in explicit measures or behavior. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Noradrenaline effects on social behaviour, intergroup relations, and moral decisions

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The involvement of noradrenaline in moral and social judgments is reviewed.

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Noradrenergic transmission is causally involved in implicit racial biases, racial face perception, as well as increasing social harm aversion.

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Fear and anger – mediated by limbic circuit brain activation – might mediate moral and social decisions and acts.

Recent research has begun to elucidate the neural basis of higher order social concepts, such as the mechanisms involved in intergroup relations, and moral judgments. Most theories have concentrated on higher order emotions, such as guilt, shame, or empathy, as core mechanisms. Accordingly, psychopharmacological and neurobiological studies have investigated the effects of manipulating serotonin or oxytocin activity on moral and social decisions and attitudes. However, recently it has been determined that changes in more basic emotions, such as fear and anger, might also have a significant role in social and moral cognition. This article summarizes psychopharmacological and fMRI research on the role of noradrenaline in higher order social cognition suggesting that indeed noradrenergic mediated affective changes might play key – and probably causal – role in certain social attitudes and moral judgments. Social judgments may also be directly influenced by numerous neurotransmitter manipulations but these effects could be mediated by modulation of basic emotions which appear to play an essential role in the formation of social concepts and moral behaviour.