Evidence for blatant dehumanization of mental illness and its relation to stigma

Compassionate nursing in challenging contexts: The importance of judgments

BACKGROUND

Nurses' demonstration of compassion is an ethical and often regulatory expectation. While research has been conducted to examine the barriers and facilitators of compassion in nurses, little is known about how nurses develop and express compassion for patients who may be blamed for their health condition. Unvaccinated COVID-19 patients are an example of such patients.

RESEARCH QUESTIONS

How do nurses provide compassionate care for unvaccinated adults infected with COVID-19? How did the context of COVID-19 vaccination in Canada shape nurses' relationships with unvaccinated patients?

RESEARCH DESIGN

A generic qualitative approach using interviews to gather data was used. Martha Nussbaum's conceptualization of compassion and its cognitive requirements was employed to add depth to the analysis.

PARTICIPANTS AND RESEARCH CONTEXT

Seventeen Registered Nurses, from a range of practice settings, who had cared for unvaccinated patients with COVID-19 participated.

ETHICAL CONSIDERATIONS

Ethics approval was received, and signed informed consent was obtained. Participants who were the current students of the researchers were excluded.

FINDINGS

Three themes were identified:1) Encountering Extreme Workplace Impediments to Compassion.2) Managing Emotions to Provide "Nonjudgmental Care."3) Practicing Narrative Imagination.

DISCUSSION

The difficult working conditions during the pandemic impeded nurses' capacity to be compassionate. Yet, none judged their patients' suffering as trivial, and all provided necessary nursing care. Some initially blamed these patients for the severity of their illness and suppressed their emotions to provide what they called "nonjudgmental care." Upon reflection, participants recognized that these patients' life circumstances may have been barriers to vaccination which, in the end, facilitated the development of compassion.

CONCLUSION

This research has implications that go beyond that of caring for patients with COVID-19. The ideal of "nonjudgmental care" requires critical re-examination because judgments and emotions are required for compassion.

Parenting and family life experiences of mothers diagnosed with schizophrenia within Chinese cultural context

WHAT IS KNOWN ON THE SUBJECT?: Parenting experiences are a great challenge but also a meaningful achievement for mothers diagnosed with schizophrenia (MDWSs). Most previous studies focused on the parenting experiences of Chinese mothers diagnosed with depression rather than those diagnosed with schizophrenia, who usually experience psychiatric symptoms. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Unlike in Western society, Chinese society is characterised by a family-centred culture. This study insightfully explores MDWSs' parenting and family life experiences addressing their intrapersonal mindsets, interpersonal connections with family members across generations and extrapersonal roles such as traditional social expectations as a mother, wife and daughter-in-law. While Western studies have mainly focused on MDWSs' personal resilience, this study insightfully explored MDWSs' resilient dimensions including their personal, familial and cultural issues within the Chinese society. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This study develops a comprehensive and professional understanding of the parenting experiences and family interactions of MDWSs who struggle to achieve their motherly role and re-establish connections with intimate family members. The findings highlight the following important considerations when offering family-based nursing cares: (1) assess power relationships, familial dynamics and cultural influences between MDWSs and their family members; (2) extend family members' involvement, such as parents-in-law, while offering psychoeducation to MDWSs and their family members. ABSTRACT: Introduction In Chinese culture, raising the next generation is recognised as a crucial family matter involving intergenerational participation. Mothers diagnosed with schizophrenia (MDWSs) usually experience high stress due to psychiatric symptoms, different parenting values across generations and traditional expectations associated with motherly roles. MDWSs need urgent professional assistance. Aim To explore MDWSs' parenting experiences and family life in Chinese cultural contexts. Method In-depth interviews were conducted with 20 MDWSs. Data were analysed using interpretative phenomenological analyses. Results The superordinate theme was identified as 'You are not a qualified mother'. Three major themes were elicited: experiencing crises in parenting, family life and self-stability; striving to be a good mother and wife under humiliation; and developing wisdom and courage to move forward. Discussion A dehumanised attitude of family members in a paternalistic culture was found. While Western society focuses on personal resilience and family-based nursing care for nuclear families, Chinese society intensively focuses on MDWSs' relationship with nuclear family members as well as extended family members such as parents-in-law. Implications for Practice The results highlighted the significance of culturally sensitive nursing care for MDWSs and family-centred psychoeducation that clarifies familial dynamics and improves effective communication between MDWSs and their family members.

First impressions: Do faces with scars and palsies influence warmth, competence and humanization?

A glance is enough to assign psychological attributes to others. Attractiveness is associated with positive attributes ('beauty-is-good' stereotype). Here, we raise the question of a similar but negative bias. Are people with facial anomalies associated with negative personal characteristics? We hypothesized that biases against faces with anomalies arise because of negative stereotypes (less warmth and competence) and forms of dehumanization (animalistic and mechanistic). We enrolled 1493 mTurk participants (N = 1306 after exclusion) to assess 31 traits of photographed people using 60 pairs of photographs of the same person before and after plastic surgery. Half anomalous faces had a scar and the other half had a palsy. To calculate warmth and competence, we conducted a principal components analysis of the 31 attributes. Animalistic dehumanization was assessed by averaging reverse-scored ratings corresponding to moral sensibility and rationality/logic, and mechanistic dehumanization by averaging across reverse-scored ratings corresponding to emotional responsiveness and interpersonal warmth. We found that both kinds of anomalous faces were seen as less warm, competent and were dehumanized. Our findings suggest that an 'anomalous-is-bad' stereotype generalizes regardless of the aetiology of the anomaly. This effect may be related to a reverse halo effect, that is, the horn effect.

Too different to be equal: Lack of public respect is associated with reduced self-respect for stigmatized individuals

Individuals with physical and mental disabilities can be stigmatized and perceived in terms of their disabilities in the public domain. This is less pervasive in the private domain, because of the presence of individuating information. We argue that disabilities decrease individuals' everyday opportunities to receive basic equality-based respect experiences in the public domain and thus makes it difficult for them to develop a high and secure level of self-respect (i.e., seeing the self as someone who possesses the same rights as others). These hypotheses were tested in a cross-sectional study in Norway with 173 participants (51 males, 117 females, two trans men, and three non-binary persons; Mage  = 28.00; SD = 10.33, age range: 19-77 years), of which 60 participants reported having mental or physical disabilities. In line with our hypotheses, we found higher levels of self-respect for individuals without mental or physical disabilities compared to individuals with mental or physical disabilities. In addition, results showed that respect experiences differed depending on the domain. Whereas individuals with and without disabilities did not significantly differ in the respect experiences they reported in the private domain, they did significantly differ in the respect experiences they reported in the public domain. In addition, respect experiences in the public domain mediated the relationship between disability and self-respect. Implications of the results are discussed in terms of the importance of developing high and secure levels of self-respect and in terms of how respect experiences in the public domain can be ensured for everyone.

Exploring the lived experience of receiving mental health crisis care at emergency departments, crisis phone lines and crisis care alternatives

BACKGROUND

Mental health crisis care includes emergency departments (EDs), crisis phone lines and crisis alternatives. Currently, there is an overreliance on EDs to provide mental health crisis care, with evidence that responses are often inadequate to meet the needs of people experiencing mental health crises. However, the complexities of how individuals experience crisis care across the varying contexts of EDs, crisis phone lines and crisis alternatives remain underresearched.

METHOD

This study used a hermeneutical phenomenological approach to understand the lived experience of accessing care during a mental health crisis. Thirty-one Australian adults who had accessed crisis services at ED, phone lines and/or crisis alternatives participated in in-depth interviews.

RESULTS

The findings are organised across the temporal narratives of participants' experiences from (1) point of contact, (2) positive and negative care experiences and (3) enduring impacts. Several themes were generated during these phases. The findings demonstrate the interrelated nature of care experiences and enduring impacts. With some exceptions, care received within EDs was harmful, resulting in lasting adverse effects. Responses from crisis phone lines were mixed, with participants appreciating the accessibility of after-hour phone support but finding standardised risk assessments unhelpful. Responses from crisis alternatives to ED were promising, aligning with the need for validation and human connection, but were not always accessible or easy to mobilise during a crisis. Notably, across all settings, positive effects were firmly attributed to the quality of the relationship with specific crisis providers.

CONCLUSION

The findings bring into sharp focus the lived experience of people accessing crisis care and contribute to the shortage of literature on subjective experiences. Providers may better meet the needs of those experiencing mental health crises by understanding the enduring impact of these interactions and the role of human connection beyond a focus on risk assessment, thereby providing opportunities for a joint understanding of risk and meaning-making. Furthermore, understanding the subjective experience of crisis care can guide reforms to ED and develop crisis alternatives to better meet the needs of people in crisis.

PATIENT OR CONSUMER CONTRIBUTION

The first author and the third author are in designated lived experience (Consumer) roles. The first author conducted the interviews and was explicit regarding their lived experience when engaging with participants. Service users were involved as advisors to the study and provided input into the design.

Dehumanization of stigmatized targets of ostracism

The study explored people's reactions to observing the ostracism of stigmatized targets. Participants (n = 198) who observed ostracism experienced need threat regardless of the target's identity. Participants regarded included addicts more positively than ostracized addicts, especially on traits that are considered unique to humans. As for dehumanization, subtle measures demonstrate that ostracized targets are perceived as less human. In contrast, our original measure of blatant dehumanization suggests that targets of ostracism are perceived as more human. The study stresses the inconsistency between dehumanization measurements and the need to specify what each measure taps into and how each contributes to the theory.

A Cross-Cultural Examination of Blatant and Subtle Dehumanization of Autistic People

PURPOSE

This cross-cultural study examined various domains of dehumanization, including both blatant (viewing autistic people as animal-like, child-like, or machine-like) and subtle (denying agency and experience capabilities) dehumanization, of autistic individuals by Koreans and Americans.

METHODS

A total of 404 Koreans and 229 Americans participated in an online survey, assessing blatant and subtle dehumanization, knowledge about autism, stigma toward and contact with autistic people, cultural factors, and demographic information. Robust linear mixed-effects regressions were conducted to examine the impact of the target group (autistic vs. non-autistic) and the country (South Korea vs. the US) on dehumanization. Additionally, correlations and multiple regressions were employed to identify individual variables associated with dehumanization.

RESULTS

Both Koreans and Americans exhibited more dehumanizing attitudes towards autistic individuals than non-autistic individuals across all domains. Koreans showed greater dehumanization of autistic individuals than Americans in all domains except for the machine-like domain. Stigma toward autistic people was associated with all dehumanization domains among Koreans and with some of the domains among Americans. Individual variables associated with dehumanization varied across countries and domains. Positive contact quality frequently predicted lower dehumanization in both cultures.

CONCLUSIONS

Non-autistic individuals consistently rated autistic people as less human than non-autistic people. Future research examining how autistic characteristics or societal perceptions that influence the consideration of an autistic person's humanness vary across cultures is needed. Implementing interventions aimed at enhancing non-autistic people's understanding of autistic individuals' agency and experience capabilities and promoting high-quality contact opportunities with autistic individuals may help reduce dehumanizing attitudes.

The Influence of Using Novel Predictive Technologies on Judgments of Stigma, Empathy, and Compassion among Healthcare Professionals

BACKGROUND

Our objective was to evaluate whether the description of a machine learning (ML) app or brain imaging technology to predict the onset of schizophrenia or alcohol use disorder (AUD) influences healthcare professionals' judgments of stigma, empathy, and compassion.

METHODS

We randomized healthcare professionals (N = 310) to one vignette about a person whose clinician seeks to predict schizophrenia or an AUD, using a ML app, brain imaging, or a psychosocial assessment. Participants used scales to measure their judgments of stigma, empathy, and compassion.

RESULTS

Participants randomized to the ML vignette endorsed less anger and more fear relative to the psychosocial vignette, and the brain imaging vignette elicited higher pity ratings. The brain imaging and ML vignettes evoked lower personal responsibility judgments compared to the psychosocial vignette. Physicians and nurses reported less empathy than clinical psychologists.

CONCLUSIONS

The use of predictive technologies may reinforce essentialist views about mental health and substance use that may increase specific aspects of stigma and reduce others.

Stigma Toward Substance Dependence: Causes, Consequences, and Potential Interventions

Substance dependence is a prevalent and urgent public health problem. In 2021, 60 million Americans reported abusing alcohol within the month prior to being surveyed, and nearly 20 million Americans reported using illegal drugs (e.g., heroin) or prescription drugs (e.g., opioids) for nonmedical reasons in the year before. Drug-involved overdose rates have been steadily increasing over the past 20 years. This increase has been primarily driven by opioid and stimulant use. Despite its prevalence, drug dependence is one of the most stigmatized health conditions. Stigma has myriad negative consequences for its targets, including limiting their access to employment and housing, disrupting interpersonal relationships, harming physical and mental health, and reducing help-seeking. However, because research on stigma toward people with substance use disorders (SUDs) is relatively sparse compared with research on stigma toward other mental illnesses, the field lacks a comprehensive understanding of the causes and consequences of SUD stigma. Moreover, it remains unclear how, if at all, these factors differ from other types of mental illness stigma. The goal of this review is to take stock of the literature on SUD stigma, providing a clear set of foundational principles and a blueprint for future research and translational activity.

Self-dehumanisation in voice hearers: the end of a continuum

Background

Meta-dehumanisation and self-dehumanisation have been identified as potentially relevant phenomena for developing a deeper understanding of distress related to voice-hearing, particularly those experiencing voices as part of psychosis. Chadwick has previously argued that those with psychosis, including those who hear distressing voices, typically feel "dehumanised and set apart by their experiences of psychosis and trauma." The present study explores the subjective experience of self-dehumanisation in people who experience distressing voices, which was selected as a useful starting point to inform future research focused on understanding dehumanisation in people with psychosis.

Methods

Qualitative data was obtained through twenty semi-structured interviews with self-identifying voice hearers and analysed using reflexive thematic analysis. This followed the recursive six phase procedure of Braun and Clarke, and this was conducted from a critical realist, contextualist position.

Results

Reflexive thematic analysis of participant's experiences produced a core theme, Dehumanisation as the End of Experiential Continua, and six subthemes: Extent of Distressing Sensory Fragmentation; Sense of Belonging with Other Humans; Integrity of Self as a Private, Coherent Entity; Sense of Worth as a Human Being; Strength of Personal Agency; and Trust in Own Credibility and Reliability. Two further themes, The Push and Pull of Dehumanising Forces and Reclaiming Life through Humanising Forces, were identified. Findings were presented to a panel of five experts by experience, all with lived experience of psychosis and service-use; all five strongly endorsed the themes as fitting with and expressing their own experiences of self-dehumanisation.

Conclusion

Reflexive thematic analysis of voice hearers' accounts identified self-dehumanisation as the endpoint where six experiential continua coalesce. Experiential movement along these continua was affected by a range of interpersonal, intrapersonal, and societal forces over time, including dehumanising attitudes of others and voice malevolence and omnipotence. Future research might examine if and how psychological therapies aimed at those experiencing distressing voices, such as people experiencing psychosis may address feelings of self-dehumanisation.

Little Evidence for the Role of Disgust Sensitivity in Implicit Disgust to Images of White People Engaged in Injecting Drug Use (IDU)

Background: Previous research has shown that People Who Inject Drugs (PWID) are subject to public stigma, which affects access to, and provision and quality of, treatment and support services. Less is known about the socio-cognitive processes that support the development and maintenance of public stigma toward PWID. The present study investigated the role of disgust sensitivity in implicit disgust to injecting drug use. Methods: 126 participants took part in an online Implicit Association Task (IAT) measuring implicit disgust to pictorial stimuli of injecting drug use or medical injecting. Participants also completed The Disgust Scale Revised, Injecting Phobia Scale (Short Form), Attitudes to People Who Use Drugs (PWUD) scale and a substance use inventory. Results: Average IAT score was negative indicating significantly higher implicit disgust to injecting drug use. Hierarchical linear regression found that injecting phobia predicted implicit disgust to injecting drug use. Questionnaire measures of disgust did not predict implicit disgust. While animal reminder disgust and injecting phobia were significantly correlated with each other, animal reminder disgust did not predict implicit disgust scores. Conclusions: On the basis of our findings, stigma toward PWID may not be a result of feelings of disgust toward injecting drug use. We discuss findings in the context of the underlying cortical processes supporting implicit and explicit representations of disgust. Future research should seek to investigate neurophysiological evidence for disgust to and stigmatization of injecting drug use and the potential role of domains of disgust in this.

Rethinking dehumanization, empathy, and burnout in healthcare context

Dehumanization has been characterized as common in medical settings, despite limited work directly examining this. In this context, everyday dehumanization is believed to be largely unconscious and unintentional, resulting from a variety of factors often related to structural and organizational aspects of healthcare. This article adopts the patients' and the healthcare providers' perspective to explore how dehumanization can have helpful and hurtful effects on patient outcomes and provider well-being. Future directions include more direct assessment of dehumanization in healthcare settings, centering the needs and experiences of people with mental illness and comorbid conditions, and improving our understanding of dehumanization relative to emotion regulation processes.

Role of the media in promoting the dehumanization of people who use drugs

Dehumanization, the perception or treatment of people as subhuman, has been recognized as "endemic" in medicine and contributes to the stigmatization of people who use illegal drugs, in particular. As a result of dehumanization, people who use drugs are subject to systematically biased policies, long-lasting stigma, and suboptimal healthcare. One major contributor to the public opinion of drugs and people who use them is the media, whose coverage of these topics consistently uses negative imagery and language. This narrative review of the literature and American media on the dehumanization of illegal drugs and the people who use them provides a perspective on the components of dehumanization in each case and explores the consequences of dehumanization on health, law, and society. Drawing from language and images from American news outlets, anti-drug campaigns, and academic research, we recommend a shift away from the disingenuous trope of people who use drugs as poor, uneducated, and most likely of color. To this end, positive media portrayals and the humanization of people who use drugs can help form a common identity, engender empathy, and ultimately improve health outcomes.

Self-dehumanization and other-dehumanization toward students with special educational needs: examining their prevalence, consequences and identifying solutions-a study protocol

BACKGROUND

Students with special educational needs (SEN) often face dehumanization, which negatively impacts their mental health, daily functioning, and educational outcomes. This study seeks to address the research gap in dehumanization literature by examining the prevalence, dynamics, and consequences of self-dehumanization and other-dehumanization among SEN students. Moreover, by utilizing psychological experiments, the study aims to identify potential intervention strategies and make recommendations to minimize the negative psychological consequences derived from the dual model of dehumanization.

METHODS

This two-phase, mixed-methods study incorporates cross-sectional surveys and quasi-experimental designs. Phase 1 investigates the self-dehumanization of SEN students and other-dehumanization from non-SEN peers, teachers, parents, and the public. Phase 2 involves four experimental studies to evaluate the effectiveness of interventions emphasizing human nature and uniqueness in reducing self-dehumanization and other-dehumanization of SEN students, as well as their associated negative consequences.

DISCUSSION

The study fills a research gap by examining dehumanization in SEN students, applying dyadic modeling, and identifying potential solutions to ameliorate dehumanization and its negative consequences. The findings will contribute to the advancement of the dual model of dehumanization, increase public awareness and support for SEN students in inclusive education, and promote changes in school practice and family support. The 24-month study in Hong Kong schools is expected to provide significant insights into inclusive education in school and community settings.

The effect of stigmatization education on the social distancing of nursing students toward patients with a diagnosis of schizophrenia

PURPOSE

To assess the effect of a program designed to reduce nursing students' social distancing from individuals diagnosed with schizophrenia.

METHOD

This experimental study was designed using a pretest, a posttest, and a control group. All participants were nursing students, of which 25 were included in the intervention group and 23 were placed in the control group. A 13-week program was offered to the intervention group. The measuring instruments consisted of a personal information form and the Social Distance Scale. Data were analyzed using the two-way repeated measures analysis of variance.

FINDINGS

A significant difference was found between the two groups.

CONCLUSION

The Education Program on Stigmatization in Schizophrenia is an effective intervention that reduces the social distance of nursing students from individuals diagnosed with schizophrenia.

Public Stigma and Personal Networks: Confronting the Limitations of Unidimensional Measures of Social Contact

One of the most promising directions for reducing mental illness stigma lies in Allport's contact theory, which suggests that intergroup interactions reduce stigma. Here, we argue that stigmatizing attitudes are driven by the nature, magnitude, and valence of community-based ties to people with mental illness (PMI), not simply their presence. Using the 2018 General Social Survey (N = 1,113), we compare network-based measures of contact to traditional survey indicators. We find that knowing someone with mental illness, or even number of people known, explains little about desire for social distance, perceptions of dangerousness, or endorsement of treatment coercion. However, having stronger relationships with more PMI, having more friends and family (but not more peripheral ties) with mental illness, and knowing people in treatment are associated with less stigma endorsement. In contrast, we find that exposure to PMI who are perceived as dangerous is associated with greater levels of stigma.

Leave Me Alone With Your Symptoms! Social Exclusion at the Workplace Mediates the Relationship of Employee's Mental Illness and Sick Leave

Although a substantial part of employees suffers from a mental illness, the work situation of this population still is understudied. Previous research suggests that people with a mental illness experience discrimination in the workplace, which is known to have detrimental effects on health. Building on the stereotype content model and allostatic load theory, the present study investigated whether employees with a mental illness become socially excluded at the workplace and therefore show more days of sick leave. Overall, 86 employees diagnosed with a mental disorder were interviewed and completed online-surveys. Path analyses supported the hypotheses, yielding a serial mediation: The interview-rated severity of the mental disorder had an indirect effect on the days of sick leave, mediated by the symptomatic burden and the social exclusion at the workplace. In the light of the costs associated with absenteeism the present paper highlights the harmfulness of discrimination. Organizations and especially supervisors need to be attentive for signs of exclusion within their teams and try to counteract as early as possible.

Fighting for abortion rights: Strategies aimed at managing stigma in a group of Italian pro-choice activists

Despite societal changes in Western countries, abortion continues to be morally stigmatized. While research on abortion stigma targeted both at people who seek or voluntarily terminate their pregnancy and abortion providers has been conducted, stigma directed at those who advocate abortion rights has remained under-researched. The purpose of this study was to deepen understandings of abortion stigma in relation to Italian cisgender female pro-choice activists. Accordingly, a qualitative study was conducted to examine how participants experienced, perceived, and internalized stigma, as well as the strategies they employed to manage it. The sample included 34 Italian cisgender female pro-choice activists who were actively engaged in movements at the time of the study, including organizations or unions that publicly defend the right to abort. The findings revealed that participants perceive they are targets of negative stereotyping and behaviors. Nevertheless, they do not internalize the stigma and use different strategies to manage it, such as speaking openly about their activism.

Self-Stigma Among People With Mental Health Problems in Terms of Warmth and Competence

Introduction

Self-stigma arising from public stigma is a heavy burden for people suffering from mental health problems. Both public stigma and self-stigma encompass the same three elements: stereotype, prejudice, and discrimination. Public stigma has already been successfully explored by the Stereotype Content Model (SCM) and the Behaviors from Intergroup Affect and Stereotypes (BIAS) map. However, this is not the case for self-stigma. Therefore, this is the first study that applies SCM and the BIAS map to self-stigma by examining whether the effects of self-stereotypes on self-directed discrimination would be mediated by self-directed prejudices in people with mental health problems.

Method

Within a total sample of N = 823 participants, who took part in an online survey, n = 336 people reported mental health problems. Mental health and self-stereotypes (warmth, competence), self-directed prejudice (negative emotions), and self-directed discrimination (active/passive self-harm) were assessed.

Results

Structural equation modeling supported the hypothesis that the stereotype dimensions warmth and competence negatively related to prejudice, while stronger prejudice was associated with more discrimination (active/passive self-harm). Prejudice fully mediated the relationship between stereotypes and discrimination. The indirect effects of warmth and competence on active and passive self-harm were moderated by competence and warmth.

Discussion

Implications for further research on self-stigma and the usage of SCM and BIAS map are discussed.

Less than human: dehumanisation of people who use heroin

Purpose

Stigma reduction is an important public health challenge because of the large morbidity and mortality associated with some forms of substance use. Extreme stigma can lead to dehumanisation of target groups, who are ascribed with lesser humanity. The authors examined whether there was blatant and subtle dehumanisation of people who use heroin, and if these were associated with levels of support for non-discriminatory drug policy.

Design/methodology/approach

A cross-sectional online study using a UK convenience sample (n = 307 [75.2% female, mean age 28.6 ± 12.2 years]) was conducted. Participants completed assessments of blatant (Ascent of Humans [AoH] scale) and subtle (an emotion attribution task) dehumanisation and a bespoke measure assessing support for non-discriminatory drug policies. Other measures controlled for stigma towards people who use drugs (PWUD) and moral disgust.

Findings

There was greater blatant dehumanisation of people who used heroin compared to the general population and other potentially stigmatised reference groups, including people who use cannabis. The authors also found evidence of subtle dehumanisation, and people who used heroin were rated as being less likely to feel uniquely human emotions, less likely to feel positive emotions and more likely to feel negative emotions. Blatant dehumanisation was associated with significantly lower probability of support for non-discriminatory drug policy.

Social implications

Dehumanisation may present significant challenges for stigma reduction initiatives and in fostering public support for drug policy and treatment. Denial of the humanity of this group could be used to justify discriminatory policies or relative deprioritisation of support services in funding decisions. Activities that seek to “rehumanise” PWUD, including social inclusion, and encouraging compassionate media representations that portray the lived experiences of substance use may be useful areas of future work.

Originality/value

This is the first study to investigate blatant and subtle dehumanisation of people who use heroin, and how this relates to public support for drug policy.

Cognitive discrepancies, motivation and subjective well-being in people with schizophrenia

Research indicates that people with schizophrenia often achieve similar levels of subjective well-being (SWB) compared to healthy controls despite prominent symptomatology and significant functional difficulties. Furthermore, compared to healthy controls, young-adult people with schizophrenia differ in the relative importance they place on values, or guiding life principles, associated with educational and occupational success (openness to change), suggesting that changing motivations may contribute to SWB and the apparent motivational deficits commonly reported in this population. The current study sought to better understand these relationships in middle-aged people with schizophrenia or schizoaffective disorder (n=29) versus a relatively healthy group of community controls (n=23). Participants completed measures of SWB and values. They also completed a cognitive battery and interviews concerned with mental and physical health. Patients reported similar levels of SWB compared to controls in the context of significant cognitive, social and vocational difficulties. Moreover, living consistently with values (valued living) predicted SWB in both groups. Lastly, internalized mental illness stigma was negatively associated with openness to change in the patient group. While encouraging from an emotional resiliency perspective, SWB and valued living in people with schizophrenia may hinder motivation towards treatment goals that could otherwise improve functional outcomes in this population.

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Patients with schizophrenia reported similar levels of SWB compared to community controls.

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Living consistently with values (i.e., valued living) predicted SWB in both groups.

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Internalized mental illness stigma was negatively associated with openness to change values in the patient group.

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Changing motivations may contribute to the apparent motivational deficits commonly reported in people with schizophrenia.

Stereotypes of Social Groups in Mainland China in Terms of Warmth and Competence: Evidence from a Large Undergraduate Sample

The Stereotype Content Model (SCM) has been validated in multiple countries and regions. However, previous validation studies in China have been limited by small sample size. The current research increased the sample size (n = 184 in the pilot study; n1 = 1315 and n2 = 268 in the formal study) to validate the SCM in mainland China in study 1. Supporting the SCM, 41 social groups were clustered into four quadrants based on warmth and competence dimensions. 35 of the 41 target groups (85.37%) receive ambivalent stereotype. Perceived warmth and competence were positively correlated (r = 0.585, p < 0.001). Status and competence were positively related (r = 0.81, p < 0.001), and competition and warmth were negatively related (r = -0.77, p < 0.001). In addition, 24 typical social groups were selected and a list of stereotype words for these groups was developed in study 2 (n1 = 48, n2 = 52). The implications of the emerging social groups and the applications of this stereotype word list are discussed.

Social Symptoms of Parkinson's Disease

Parkinson's disease (PD) is typically well recognized by its characteristic motor symptoms (e.g., bradykinesia, rigidity, and tremor). The cognitive symptoms of PD are increasingly being acknowledged by clinicians and researchers alike. However, PD also involves a host of emotional and communicative changes which can cause major disruptions to social functioning. These incude problems producing emotional facial expressions (i.e., facial masking) and emotional speech (i.e., dysarthria), as well as difficulties recognizing the verbal and nonverbal emotional cues of others. These social symptoms of PD can result in severe negative social consequences, including stigma, dehumanization, and loneliness, which might affect quality of life to an even greater extent than more well-recognized motor or cognitive symptoms. It is, therefore, imperative that researchers and clinicans become aware of these potential social symptoms and their negative effects, in order to properly investigate and manage the socioemotional aspects of PD. This narrative review provides an examination of the current research surrounding some of the most common social symptoms of PD and their related social consequences and argues that proactively and adequately addressing these issues might improve disease outcomes.