Behavior or Diagnosis? Effects of Irritable Patient Behavior and Diagnostic Labels on Mental Illness Stigma

Although research demonstrates significant stigma towards individuals with mental illness, the relative importance of observed behavior and a psychiatric diagnosis in eliciting stigma remains poorly understood. Using video vignettes, three experiments (ns = 195, 749, and 791) examined the effect of irritable (vs. calm) behavior and the presence (vs. absence) of a psychiatric diagnosis (schizophrenia in Studies 1 and 2; schizophrenia and depression in Study 3) on attitudinal, emotional, and behavioral dimensions of stigma towards a fictitious emergency room patient seeking migraine treatment. In line with labeling theory, irritable behavior resulted in greater blameworthy attributions for behavior, greater fear and anger, less caring emotions, and lower perceived warmth. Both a depression and schizophrenia diagnosis elicited stigma by leading to greater endorsements of other stigmatizing attributions (e.g., substance use) as a reason for behavior. Irritable behavior and both psychiatric diagnoses resulted in patients being rated as less predictable and more dangerous, whereas irritable behavior and schizophrenia only resulted in decreased competence. Irritable behavior and psychiatric diagnosis also interacted to predict desire for social distance. When calm, a psychiatric diagnosis predicted greater distance, such that a patient with no label was least stigmatized, one with depression was moderately stigmatized, and one with schizophrenia was most stigmatized. When irritable, the patient elicited a higher desire for distance regardless of psychiatric diagnosis. Mediational analyses show that when controlling for behavior, perceived dangerousness and fear mediate the effect of a diagnosis on desire for distance. In all, results suggest both diagnostic labels and irritable behavior result in stigma via different attitudinal and emotional mechanisms, and that individuals with psychiatric diagnoses face stigma even if behaving calmly. By enriching understanding of the relative importance of irritable behavior and a psychiatric diagnosis on multiple dimensions of mental illness stigma, this work has implications for anti-stigma interventions

A qualitative investigation of the impact of coronavirus disease 2019 (COVID-19) on emergency physicians\u27 emotional experiences and coping strategies

Study objective Throughout the coronavirus disease 2019 (COVID-19) pandemic, emergency physicians in the United States have faced unprecedented challenges, risks, and uncertainty while caring for patients in an already vulnerable healthcare system. As such, the pandemic has exacerbated high levels of negative emotions and burnout among emergency physicians, but little systematic qualitative work has documented these phenomena. The purpose of this qualitative investigation was to study emergency physicians’ emotional experiences in response to COVID-19 and the coping strategies that they employed to navigate the pandemic. Methods From September 2020 to February 2021, we conducted semistructured interviews with 26 emergency physicians recruited from 2 early COVID-19 epicenters: New York City and the Metro Boston region. Interviews, coding, and analyses were conducted using a grounded theory approach. Results Emergency physicians reported heightened anxiety, empathy, sadness, frustration, and anger during the pandemic. Physicians frequently attributed feelings of anxiety to medical uncertainty around the COVID-19 virus, personal risk of contracting the virus and transmitting it to family members, the emergency environment, and resource availability. Emergency physicians also discussed the emotional effects of policies prohibiting patients’ family members from entering the emergency department (ED), both on themselves and patients. Sources of physician anger and frustration included changing policies and rules, hospital leadership and administration, and pay cuts. Some physicians described an evolving, ongoing coping process in response to the pandemic, and most identified collective discussion and processing within the emergency medicine community as an effective coping strategy. Conclusions Our findings underscore the need to investigate the effects of physicians’ pandemic-related emotional stress and burnout on patient care. Evidence-based interventions to support emergency physicians in coping with pandemic-related trauma are needed

Vulnerability to climate change of managed stocks in the California Current large marine ecosystem

Introduction: Understanding how abundance, productivity and distribution of individual species may respond to climate change is a critical first step towards anticipating alterations in marine ecosystem structure and function, as well as developing strategies to adapt to the full range of potential changes. Methods: This study applies the NOAA (National Oceanic and Atmospheric Administration) Fisheries Climate Vulnerability Assessment method to 64 federally-managed species in the California Current Large Marine Ecosystem to assess their vulnerability to climate change, where vulnerability is a function of a species’ exposure to environmental change and its biological sensitivity to a set of environmental conditions, which includes components of its resiliency and adaptive capacity to respond to these new conditions. Results: Overall, two-thirds of the species were judged to have Moderate or greater vulnerability to climate change, and only one species was anticipated to have a positive response. Species classified as Highly or Very Highly vulnerable share one or more characteristics including: 1) having complex life histories that utilize a wide range of freshwater and marine habitats; 2) having habitat specialization, particularly for areas that are likely to experience increased hypoxia; 3) having long lifespans and low population growth rates; and/or 4) being of high commercial value combined with impacts from non-climate stressors such as anthropogenic habitat degradation. Species with Low or Moderate vulnerability are either habitat generalists, occupy deep-water habitats or are highly mobile and likely to shift their ranges. Discussion: As climate-related changes intensify, this work provides key information for both scientists and managers as they address the long-term sustainability of fisheries in the region. This information can inform near-term advice for prioritizing species-level data collection and research on climate impacts, help managers to determine when and where a precautionary approach might be warranted, in harvest or other management decisions, and help identify habitats or life history stages that might be especially effective to protect or restore

Assessing Theoretical Conclusions With Blinded Inference to Investigate a Potential Inference Crisis

Scientific advances across a range of disciplines hinge on the ability to make inferences about unobservable theoretical entities on the basis of empirical data patterns. Accurate inferences rely on both discovering valid, replicable data patterns and accurately interpreting those patterns in terms of their implications for theoretical constructs. The replication crisis in science has led to widespread efforts to improve the reliability of research findings, but comparatively little attention has been devoted to the validity of inferences based on those findings. Using an example from cognitive psychology, we demonstrate a blinded-inference paradigm for assessing the quality of theoretical inferences from data. Our results reveal substantial variability in experts’ judgments on the very same data, hinting at a possible inference crisis

Microwave and Computational Study of Methanesulfonic Acid and Its Complex with Water

Spectra of methanesulfonic acid (CH3SO3H, MSA) and its complex with water have been studied by microwave spectroscopy and density functional theory calculations. For the monomer, spectra were obtained for both the parent and −OD isotopologues and, in each case, revealed a pair of tunneling states that are attributed to large amplitude motion of the hydroxyl hydrogen about the S–O(H) bond. Transitions crossing between tunneling states were not found in the parent spectrum and are estimated to be outside the range of the spectrometer, thus precluding the direct determination of the tunneling energy. For the −OD form, however, the tunneling energy was determined to be ΔE = 6471.9274(18) MHz from direct measurement of the cross-state c-type transitions. In its complex with water, the acidic hydrogen of the MSA forms a hydrogen bond with the water oxygen. A secondary hydrogen bond involving the water hydrogen and an SO3 oxygen completes a six-membered ring, forming a cyclic structure typical of hydrated oxyacids. No evidence of internal motion was observed. Rotational spectra of the CH3SO3H···D2O and CH3SO3D···D2O isotopologues were also obtained and analyzed. Comparison with theoretical calculations confirms the cyclic structure, though the orientation of the unbound water hydrogen is ambiguous

The Effect of Early List Manipulations On the DRM Illusion

The Deese–Roediger–McDermott (DRM) paradigm is widely used to study false memory in the laboratory. It tests memory for lists of semantically related words (correct list item memories) and their non-presented associates (false lure memories). Evidence suggests that early items in DRM lists could make an especially significant contribution to false memories of lures, as they may critically influence the underlying associative activation and/or gist extraction processes. The present study tested this suggestion by using two manipulations that were intended to affect processing of early DRM list items. The first was interpolation of a semantically unrelated distractor item among the list items (Experiments 1 and 2). The second was arranging for these items to be either the strongest or weakest associates of the lure (Experiment 2). In Experiment 1, a distractor item reduced both list item and lure recall when presented early in a DRM list, but selectively disrupted list item recall when presented late in the list. In Experiment 2, arranging for the early list items to be the weakest associates of the lure reduced false recall of the lure but had no effect on list item recall. The findings are discussed with respect to theories that explain false memory in the DRM protocol, including fuzzy trace theory (FTT) and activation–monitoring theory (AMT). They are also discussed with respect to general theories of memory and the potential role of category/context information in generating false memories