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COURSE NOTES: Social



	Based on the course PSY/SOC 301, taught at The Sage Colleges by Prof. Susan Cloninger. This class uses the following textbook, which provides the chapter organization that you see on the menu on the left side of this page: Myers, D. (2005). Social Psychology (8th ed.) New York: McGraw Hill.

Chapter 14:

Social Psychology in the Clinic

MAKING CLINICAL JUDGMENTS: Sources of Bias

Clinical intuition: less acceptance of scientific method by clinical than by nonclinical psychologists (Myers, 2005, p. 568, Figure 14-1)

consider everyday life...

We don't realize how much we are influenced by various factors (e.g., spilling coffee, stereotypes).
Barnum effect (accepting judgments based on flimsy evidence)
Projective tests and favorable statements about self and friends are especially believed.

Illusory Correlations

example: Draw-a-Person test

Hindsight and Overconfidence

example: suicide
Rosenhan's study of pseudo-patients in a mental hospital

Rosenhan's study: "On being sane in insane places"

8 people posed as "pseudodopatients"

5 men (including Rosenhan himself), 3 women

1 graduate student, 3 psychologists, 1 pediatrician, 1 psychiatrist, 1 painter, 1 homemaker

Presented themselves for admission to 12 psychological hospitals in 5 states

both east and west coasts of US

Called hospital for appointment

on arrival, complained of hearing voices that said "empty," "hollow," and "thud"

No other symptoms! Otherwise acted completely normal and gave truthful responses to interviewer (except changed names and occupations)

All were admitted!

11 of the 12 were diagnosed with "schizophrenia."

Acted normal in the hospital

took notes

flushed medications down toilet

Even hospital staff treat "patients" strangely.

PSEUDOPATIENT: "Pardon me, Dr. _______. Could you tell me when I am eligible for grounds privileges?"

PSYCHIATRIST: "Good morning, Dave. How are you today?" [leaves immediately]

Interpretation : The power of labeling

Self-Confirming Diagnoses

Snyder & Swann's study: Expecting extroversion (or introversion) leads to questions that give confirming evidence.

Fazio's study: In addition, those asked extroverted questions behave that way.
Implications for clinicians' theories of childhood origins of disorders, and for recovered memories.

Clinical Versus Statistical Prediction

Statistics predict better but are less convincing than intuitive prediction.

Implications

questionable "treatments":

facilitated communication for autism
EMDR (eye-movement desensitization and reprocessing) for PTSD
recovered memory therapy

EMDR "therapy"

"eye movement desensitization and reprocessing"
Counselors pass 2 fingers rapidly back and forth in front of the client's face.
Often used to treat post-traumatic stress.
Little scientific support.

How to make a (pseudo)treatment seem effective

begin treatment when patient is worse
improvement attributed to treatment
stability said to "stabilize" disease
getting worse: treatment began too late
when patient improves, reduce treatment
continued improvement: treatment was effective
get worse: reducing treatment was premature

Science might destroy hope for these treatments, right?

RIGHT!
Let's spend our money on real treatments (and the search for them), not on pseudo-treatments.

SOCIAL COGNITION IN PROBLEM BEHAVIORS

Social Cognition and Depression

Depression is the leading psychological disorder on college campuses.
about 25% of college students, at any given time, have symptoms of depression
increases risk of suicide (by 50%)
aggravated by life stress of college life
and, in turn, depressed people often exaggerate the difficulties in their lives

Depressed people are pessimistic.

view bad events as permanent, pervasive, and undermining everything.

Furthermore, nondepressed people with such pessimistic explanatory styles are 4 to 8 times more likely to develop depresion than those with optimistic explanatory styles.

Distortion or Realism?

depressive realism (Alloy & Abramson)

depressive explanatory (attributional) style

failures attributed to stable, global, internal factors

Imagine that your bank has just notified you that your checking account is overdrawn.

Think about the possible reasons for this notification.
Write down what you think is the single most important cause.

Now, answer these questions:

1. Does the cause you wrote down reflect more about YOU or more about OTHER PEOPLE OR CIRCUMSTANCES?
- that is, is it an internal or an external cause
2. Is the cause something that is permanent or temporary; that is, is the cause likely to be present in the future
- that is, is it a stable or an unstable cause?
3. Is the cause something that influences other areas of your life or only your checking account?
- that is, is it a global or a specific cause?

Let's discuss these reasons

internal or external
stable or unstable
global or specific

self-serving illusions

adaptive, though inaccurate

Is Negative Thinking a Cause or a Result of Depression? (both)

Depressed moods cause negative thinking.

Experimental verification.

Depression has negative influences on others.

Negative thinking can also cause depressed moods.

Cognitive therapy:

Change explanatory styles.

This, in turn, will prevent depression.

Another view of depression, by Seligman:

The rise in individualism in society has increased depression.
Individual goals can only bring limited satisfaction.
The cure? becoming committed to the common good, and not only our individual well-being.
Seligman's "moral jogging" solution: a little daily self-denial is exchanged for long-term self-enhancement. For example:
Give away 5% of last year's income. Do it personally, not through a charity. Advertise among potential recipients in a charitable field of interest that you are giving, say, $2000 away. Interview applicants, give out the money, and follow its use to a successful conclusion.

Another example:

Give up eating out once a week, shopping for new shoes, watching a rented movie on Tuesday night, and spend the time promoting the well-being of others. Help in a soup kitchen, visit AIDS patients, clean the public park, raise funds for your alma mater.

Social Cognition and Loneliness

We can be alone but not lonely, depending on cognitions.
50-60 million Americans feel extremely lonely at some point each month (25% of us)
18-25 year olds are most lonely
7-11 year olds often report they "feel lonely and wish they had more friends"
older people are (surprisingly) the LEAST lonely

Feeling lonely and excluded (Expectation influences loneliness)

how much contact is expected
how much contact is considered normal

Perceiving others negatively (Behavior influences loneliness)

Shyness, loneliness, and depression are inter-related.
Lonely people are not socially skilled.
They don't get to know new people well during a 15-minute conversation.
They believe new acquaintances don't like them.
But the new acquaintances didn't dislike them. They said "the lonely students did not seem to like themselves."

Cognitive therapy for loneliness

change in self-image
social skills: how to open conversation; how to handle conflict and disappointment

Social Cognition and Anxiety

social anxiety as a temporary state vs. trait

Anxiety comes from wanting to impress others but doubting our ability to do so.
shyness: social anxiety; self-consciousness; worry about what others think
overpersonalizing situations
alcohol reduces self-consciousness
self-handicapping
Attributing physiological symptoms of anxiety to a noise reduces shyness (Brodt & Zimbardo).

Social Cognition and Illness

behavioral medicine (interdisciplinary)

health psychology (within psychology)

stress & disease (Type A, anger-prone coronary risk personality)
controlling and reducing stress
labeling illness; following medical advice
influencing lifestyle behaviors

Reactions to illness

Noticing symptoms
Explaining symptoms: Am I sick?
Socially constructed disorders
Seeking treatment

Emotions and Illness

Optimism and Health

higher subjective well-being during stress (e.g., 1st year college students)
improved physiological change in heart bypass patients
earlier recovery in heart bypass patients (sitting up, walking, exercise, returning to work)
coping by direct action
grow from adversity
stress and illness
explanatory style and illness

Optimism and genetics

heritability about 25% (twin studies)
parental modeling also has an effect

Stress and Illness

learned helplessness
reduced resistance to disease

Stress and Hassles

both influence well-being
daily uplifts counterbalance hassles

HASSLES include such things as:

troubling thoughts about the future
not getting enough sleep
wasting time
inconsiderate smokers
physical appearance
too many things to do
misplacing or losing things
not enough time to do necessary things
concerns about meeting high standards
being lonely

UPLIFTS include such things as:

completing a task
relating well with friends
giving a present
having fun
getting love
giving love
being visited, phoned
laughing
entertainment
music

In some research, hassles are better predictors of health (psychological and physical) than major life events.

more hassles, poorer health

(Maybe major life events, like divorce, are negative because of their effect on hassles, such as forcing a divorced man to make his own meals, or a woman to repair a leaky faucet.

Pessimistic Explanatory Style and Illness

stable, global, internal explanations for bad events
shorter life expectancy
worse health; weaker immune system

SOCIAL-PSYCHOLOGICAL APPROACHES TO TREATMENT

Doctors typically spend 16.5 minutes with each patient.
Not much time for "information giving," which is a high predictor of patient satisfaction.
Patients typically ask questions for only 8 seconds!

More time is given to patients who are

white
female
older
more educated
middle or upper class

Patients often misunderstand what doctors say:

medication instructions and purpose
diagnosis

Some behavioral scientists have been teaching communication skills to doctors. (e.g., having patients restate what they heard, and clarifying misunderstandings)

Result: patients were more satisfied, and recalled 20% more information than control group
Teaching doctors to encourage patients to ask questions:
Patients ask more questions.
Patients felt more in control.
Patients were more satisfied with their visits.
varieties of patient-practitioner relationship models
active practitioner, passive patient (e.g., treating acute trauma or patient in a coma)

guidance-cooperation (still, power is in practitioner's hands)
mutual participation
consumer model (reversed balance of power)

Inducing Internal Change Through External Behavior

writing (self-praising) essays in experiment changes attitudes
choice is important for effective treatment

Breaking Vicious Cycles

3 components to treatment:

behavior

ex: social skills training
environment (situation)

ex: experimental experience conversing with women
thinking

ex: explanatory style therapy (attributions)

Seligman's "psychological immunization"

change explanatory styles to be less pessimistic
college students: small to moderate reduction in depression
children: 50 to 100% reduction in depression in treatment group, compared to controls