Understanding the Role of Past Health Care Discrimination in Help-Seeking and Shared Decision-Making for Depression Treatment Preferences

As a part of a larger, mixed-methods research study, we conducted semi-structured interviews with 21 adults with depressive symptoms to understand the role that past health care discrimination plays in shaping help-seeking for depression treatment and receiving preferred treatment modalities. We recruited to achieve heterogeneity of racial/ethnic backgrounds and history of health care discrimination in our participant sample. Participants were Hispanic/Latino (n = 4), non-Hispanic/Latino Black (n = 8), or non-Hispanic/Latino White (n = 9). Twelve reported health care discrimination due to race/ethnicity, language, perceived social class, and/or mental health diagnosis. Health care discrimination exacerbated barriers to initiating and continuing depression treatment among patients from diverse backgrounds or with stigmatized mental health conditions. Treatment preferences emerged as fluid and shaped by shared decisions made within a trustworthy patient–provider relationship. However, patients who had experienced health care discrimination faced greater challenges to forming trusting relationships with providers and thus engaging in shared decision-making processes

The Urge to Merge: Ritual Insult and the Evolution of Syntax

Throughout recorded history, sexually mature males have issued humorous insults in public. These ‘verbal duels’ are thought to discharge aggressive dispositions, and to provide a way to compete for status and mating opportunities without risking physical altercations. But, is there evidence that such verbal duels, and sexual selection in general, played any role in the evolution of specific principles of language, syntax in particular? In this paper, concrete linguistic data and analysis will be presented which indeed point to that conclusion. The prospect will be examined that an intermediate form of ‘proto-syntax’, involving ‘proto-Merge’, evolved in a context of ritual insult. This form, referred to as exocentric compound, can be seen as a ‘living fossil’ of this stage of proto-syntax — providing evidence not only of ancient structure (syntax/semantics), but also arguably of sexual selection