Anger: Understanding Its Origins and How to Manage It

Anger is a powerful emotion that everyone experiences at some point in their lives. While often viewed as a negative response, it can serve important functions, signaling our discontent and motivating change. However, when left unchecked, anger can lead to destructive behaviors and strained relationships. Understanding the origins of anger—rooted in biology, psychology, and personal experiences—can provide valuable insights into its triggers. This article explores the complexities of anger, shedding light on its underlying causes and offering practical strategies for effective management. By learning to navigate this intense emotion, individuals can enhance their emotional intelligence and foster healthier interactions with themselves and others.

Anger Definition

The term anger has multiple meanings in everyday language. People refer to anger as an experience or feeling, a set of physiological reactions, an attitude toward others, a drive leading to aggression, or an overt assault upon some target. In social psychology, anger refers to a particular set of feelings. The feelings usually labeled as “anger” range in intensity from being irritated or annoyed to being furious or enraged. These feelings stem, to a large degree, from the internal physiological reactions and involuntary emotional expressions produced by an offense or mistreatment.

Visual features include facial changes, like frowning eyebrows and dilated nostrils, and motor reactions, such as clenching fists. These feelings are simultaneously influenced by thoughts and memories (i.e., appraisals) that arise. All of these sensory inputs are combined in a person’s mind to form the experience of anger. This experience is not aimed at achieving a goal; nor does it serve any useful purpose for the individual in that particular situation.

Anger Distinction from Other Concepts

The terms anger, hostility, and aggressiveness are often used interchangeably in everyday life. Social psychologists define hostility as a negative attitude toward one or more people that is reflected in a decidedly unfavorable judgment of the target. To differentiate, aggressiveness is any form of behavior directed toward the goal of harming a target. In other words, aggressiveness can also be seen as a disposition toward becoming aggressive. In sum, anger as an experience does not directly activate aggressiveness.

Physiological Reactions in Anger

A large body of early research has investigated the mental representations of bodily reactions in anger. Across different investigations, individuals experienced increases in cardiovascular (e.g., higher blood pressure) and muscular (e.g., heightened bodily tension) activity, accompanied by the face feeling hot. This latter observation is consistent with the widespread characterization of anger as a “hot” emotion.

Appraisal Conceptions of Anger

Several contemporary researchers started to extend the focus from the internal physiological aspects to interpretations of external features having an impact on affective states. This so-called appraisal-based view of anger contends that anger exists only when external events are interpreted in a specific manner, that is, when individuals give meaning (i.e., appraise) to the specific situation they are in. More specifically, appraisal researchers argue that the precipitating incident has to be interpreted as an offense or mistreatment. Furthermore, whether individuals see themselves or another person responsible, or whether they blame themselves or another person (i.e., appraisal of agency), for the mistreatment triggers either anger experienced toward the self (i.e., self-directed anger) or the other person (i.e., other-directed anger).

There are several theoretical claims of appraisal formulations that emphasize a different appraisal structure and appraisal process. Much research has been dedicated to test these different formulations against one another. Despite these different formulations, what can be derived from this research is that appraisal formulations can indeed account for the experience of anger.

Anger and Behavior

If an individual is angry with someone else, the desire to act feeds into a “moving against” tendency. The phrase “moving against” characterizes the behavioral impulses activated in the state of anger. Research has shown that anger can trigger action tendencies like striking out or attacking the perpetrator responsible for the elicitation of anger. They are expressed, for example, by verbally or even physically attacking a target.

Anger and Health

Besides triggering action tendencies in the short run, anger has been shown to lead to health problems in the long run. This line of research suggests that the experience of anger, which is accompanied by the cardiovascular (e.g., higher blood pressure) and muscular (e.g., heightened bodily tension) activity, is a risk factor for coronary heart disease.

Recognition of Anger

So how do we come to associate specific movements and gestures of someone else with a specific emotional state? Several researchers have proposed different processes of emotional contagion and/or simulation that provide the means by which we come to know what others are feeling. The idea of emotional contagion implies that a visual representation of another’s expression leads us to experience what the other person is feeling, which in turn allows us to infer that person’s emotional state. Furthermore, research has indicated that participants exposed to angry faces show increased activity in specific facial muscles (e.g., by frowning their eyebrows). Thus, these data suggest that emotional faces generally induce their mirror images in their observers.

Anger Measurement

Anger is often measured as a dependent variable. In this large body of research, individuals are asked to indicate their level of anger. This self-report measure has one main problem: The measure is influenced by the respondent’s perception. Over the years, the focus on investigating emotions has changed, and several assessments have been developed to study different aspects of emotions. There are three main ways to assess the basic processes of anger. First, the physiological arousal (in other words, the excitement of anger) is often measured by heart rate, muscle tension, or skin conductance. Second, the affective state that represents the feelings and signs of anger is assessed by facial coding of the expression. Finally, the external consideration concerning the cause of the affective state put forward by appraisal theorists is measured by asking individuals directly for their interpretations of the current situation.

References:

  1. Berkowitz, L. (1999). Anger. In T. Dalgleish & M. J. Power (Eds.), Handbook of cognition and emotion (pp. 411-428). New York: Wiley.
  2. Feldman Barrett, L., Niedenthal, P. M., & Winkielman, P. (Eds.). (2005). Emotion and consciousness. New York: Guilford Press.

Anemia: Understanding the Causes, Symptoms, and Treatments

Anemia is a common yet often overlooked health condition that affects millions of individuals worldwide. Characterized by a deficiency in red blood cells or hemoglobin, this disorder can lead to a host of troubling symptoms, including fatigue, weakness, and pallor. Understanding the various causes of anemia—from nutritional deficiencies to chronic diseases—is essential for effective prevention and treatment. In this article, we will delve into the different types of anemia, explore their underlying triggers, and discuss a range of treatment options available to help manage this condition and improve overall health.

Anemia is a condition in which the oxygen-carrying capacity of the red blood cells is reduced. The red blood cells, or erythrocytes, contain molecules called hemoglobin that bind oxygen. Oxygen is picked up from the lungs on the hemoglobin molecules and transported through the blood throughout the body to tissues as required.

There are many causes of anemia. Anemia may result from deficiencies of substances needed to produce red blood cells: iron, vitamin B12 (cobalamin), or folate  (folic  acid).  Those  at  risk  have  inadequate dietary intake or absorption of these substances or increased requirements. Iron deficiency is the most common cause of anemia. According to one national survey, 3% to 5% of females between 16 and 49 years of age and 3% of children between 1 and 2 years of age have anemia due to iron deficiency. Iron requirements increase during rapid periods of growth in young children and adolescence and during pregnancy. In addition, dietary iron ingestion may not be enough to counter blood loss in menstruating women. Strict vegetarians are at risk for developing iron and vitamin B12  deficiencies, whereas folate deficiency is more common among alcoholics and others with poor diets. Folate is destroyed by heat, putting those who eat primarily overcooked or canned foods at risk for deficiency. In addition to poor intake, some individuals may be unable to absorb iron, vitamin B or folate because of specific disorders (e.g., pernicious anemia, sprue) or prior gastrointestinal surgeries (e.g., gastrectomy). Some medications can impair the body’s ability to use folate properly. Blood loss or destruction of red blood cells within the body due to exposure to specific toxins (e.g., naphthalene in mothballs, fava beans) may also cause anemia. Anemia is also associated with chronic infections and diseases such as renal failure, cancer, and arthritis.

There are many symptoms of anemia, but most are vague. Patients with anemia may complain of fatigue, coldness, weakness, dizziness, or sore tongues. Pale skin and fingernail beds may be noted. In more pronounced anemic states, the heart rate may be increased and chest pain or shortness of breath may be reported. Infants and young children with anemia are at risk for developmental delays and behavioral disturbances.  In  addition,  patients  with  vitamin  B12 or folate deficiency anemia may have neurological symptoms such as irritability, changes in memory, and tingling or numbness of the extremities.

The diagnosis of anemia is dependent on documentation of low hemoglobin and hematocrit levels in the blood. The normal values are higher in adult men than in adult women and also change from infancy through childhood. Other laboratory abnormalities depend on the cause of the anemia itself. For example, the mean corpuscular volume (MCV), the size of the red blood cell, will be low if the anemia is due to iron deficiency, but high if due to vitamin B12  or folate deficiency. A careful dietary and medical history should be accompanied by measurement of serum iron, vitamin B12, and folate concentrations to establish the cause of the anemia.

The treatment of the anemia is dictated by the cause. Patients with iron deficiency are commonly give a several-month course of ferrous sulfate or other iron salt until hemoglobin levels return to normal and iron stores are repleted. Vitamin B12  is available as oral tablets and may also be given as monthly intramuscular injections for those with medical conditions that affect absorption. Folate is generally given orally once daily. Patients with acute blood loss or dramatically low hemoglobin levels may also be given blood transfusions to correct the anemia immediately. Treatment of underlying causes (e.g., cancer, chronic infections) will also improve anemia. Patients with anemia due to kidney disease often receive injections of drugs that increase the production of red blood cells by the bone marrow. The development of anemia may be prevented by the use of folate, vitamin B12, and iron supplements in pregnant women and others at risk for deficiency.

References:

  1. Centers for   Disease   Control   and      (1998). Recommendations to prevent and control iron deficiency in the United States. Morbidity and Mortality Weekly Report, 47,  1–36.  Retrieved  from  http://www.cdc.gov/mmwr/preview/mmwrhtml/00051880.htm
  2. National Institutes of Health Clinical Center. (2002). Facts about dietary supplements. Retrieved from http://www.cc.nih.gov/ccc/supplements/
  3. National Women’s Health Information Center. (2004). Anemia.
  4. Retrieved from http://www.4woman.gov/faq/anemia.htm Ross, M. (2002). Evaluation and treatment of iron deficiency in adults. Nutrition in Clinical Care, 5, 220–224.
  5. Teresi, M. E. (2000). Iron deficiency and megaloblastic anemias. In E. T. Herfindal & D. R. Gourley (Eds.), Textbook of therapeutics: Drug and disease management (7th ed.). Hagerstown, MD: Lippincott, Williams & Wilkins.

Androgyny and Drug Abuse: Navigating Identity and Addiction

In recent years, the conversation surrounding androgyny has gained traction, reflecting broader societal shifts in perceptions of gender and identity. However, alongside these discussions, there remains a less explored yet critical intersection: the relationship between androgyny and drug abuse. This article seeks to illuminate how individuals navigating fluid gender identities may face unique challenges and vulnerabilities linked to addiction. By examining the complexities of identity, societal expectations, and substance use, we aim to foster a deeper understanding of the nuanced struggles faced by those at the crossroads of androgyny and addiction, ultimately highlighting the need for tailored support and resources.

Feminine traits, those characteristically associated with women, include helpfulness to others, gentleness, warmth, and emotionality. Masculine traits, stereotypically associated with men, include assertiveness, self-reliance, achievement orientation, and independence. Traditionally, psychologists viewed femininity and masculinity as opposite roles of a single bipolar continuum: the more feminine a person was, the less masculine that person could be.

In the 1970s, Sandra Bem and other psychologists, such as Janet Spence and her colleagues, began to challenge the bipolarity assumption. They conceptualized femininity and masculinity as two independent dimensions, rather than as one dimension in which masculinity and femininity were mutually exclusive. According to this view, individuals can show any combination  of  female-stereotypic  and  male-stereotypic characteristics. A high degree of one does not imply a low degree of the other.

Individuals,  female  or  male,  who  exhibit  high levels of both feminine and masculine personality traits are said to demonstrate androgyny. People who have many masculine traits but few feminine ones are termed  masculine;  those  with  many  feminine  but few masculine characteristics are labeled feminine. Individuals who show few feminine and few masculine traits are designated as undifferentiated.

A number of tests have been constructed to measure femininity and masculinity. The two most widely used instruments are the Bem Sex Role Inventory (BSRI), developed by Sandra Bem, and the Personal Attributes Questionnaire (PAQ), developed by Janet Taylor Spence and her colleagues. These instruments, both published in 1974, ask participants to indicate the extent to which various personality traits apply to them. The traits used in these tests are virtually all positive. Each of these tests yields both a femininity score and a masculinity score.

Bem has hypothesized that androgynous individuals are more flexible and adaptable than others, able and willing to engage in either feminine or masculine behaviors as the situation requires. For example, the androgynous woman or man could successfully close a tough business deal at work and also be a nurturing spouse and parent at home. Furthermore, because androgynous individuals can summon a wider range of behaviors to meet the challenges of life, they should enjoy advantages in mental health and psychological adjustment.

There is a good deal of evidence that androgynous children, adolescents, and adults are better adjusted than are masculine, feminine, or undifferentiated peers. For example, androgynous adolescents, compared with other adolescents, have better social relations and greater self-esteem, and they are more likely to have resolved identity crises.

Some research, however, has found little or no difference between androgynous and masculine individuals. Several studies, for example, have found that androgynous and masculine individuals are equally high in self-esteem. Apparently, it is high masculinity and not the specific combination of high masculinity and high femininity that is strongly related to wellbeing and self-esteem. What might account for the positive relationship between masculinity and psychological adjustment? One possible reason is that masculine characteristics have broader adaptive significance for an individual than do feminine characteristics. Another related hypothesis is that masculine traits are more highly valued in Western society than are feminine traits. Thus, people with masculine traits may feel more positive about their ability to function effectively.

The contribution of femininity to overall adjustment is less clear than that of masculinity. Femininity appears to have little or no effect on the adjustment of women. However, highly feminine men appear more poorly adjusted than highly masculine men. This may result from the greater cultural pressure placed on men than women to conform to their socially expected role. A more recent notion about the contributions of femininity and masculinity to adjustment is the differentiated androgyny model. According to this view, the context of the situation or behavior is critical in determining the relative importance of femininity and masculinity to an individual’s self-esteem. For example, high femininity can be an asset to both women and men in social interactions and in some occupations such as nursing and special education.

The past three decades have witnessed major changes in the incidence of masculinity and androgyny among college students. During the 1970s, female college students were more likely than their male peers to score high on femininity, and males were more likely to get high scores on masculinity. About one third of females and males were rated androgynous. In recent years, there has been a noticeable increase in masculinity and androgyny among women and a slight increase among men. Moreover, women and men no longer differ on several traits previously classified as masculine, such as being assertive, ambitious, active, independent, or self-reliant; defending one’s beliefs; and acting as a leader. These changes most likely are a result of societal shifts in women’s roles and status in the past few decades. Opportunities for girls to develop masculine-typed traits have expanded significantly in the spheres of sports, education, and employment. Although women have been encouraged to become agentic, men have not been as encouraged to become communal. Such findings bring into question the validity of the masculine and feminine dimensions of instruments such as the BSRI and PAQ, which were developed 30 years ago. We also cannot assume that findings based on undergraduate college students are generalizable to other segments of society.

When the psychological measurement of androgyny  was  introduced  in  the  1970s,  it  was  received enthusiastically by feminist scholars. It replaced the notion that psychological health required that females be feminine and that males be masculine. By embodying socially desirable traits for both females and males, androgyny seemed to imply the absence of gender  stereotyping.  Moreover,  by  incorporating both feminine and masculine behaviors, androgyny appeared to broaden the scope of behaviors that can be used to handle different situations and thus lead to more flexible and adaptive behaviors.

Although androgyny continues to be viewed by feminist scholars as more positive than restrictions to either femininity or masculinity, several criticisms have been leveled against this concept. One criticism is that the instruments used are too narrow to be considered comprehensive measures of femininity and masculinity. For example, some researchers note that only socially desirable agentic and communal traits are measured. Others have noted that the concepts of femininity and masculinity may mean different things to women and men. In addition, white and African American  women  do  not  define  femininity  in  the same way. Thus, instruments such as the BSRI and PAQ, at best, measure only one component of whatever ways masculinity and femininity are defined in different populations.

Another criticism is that the notion of androgyny, similar to the bipolar differentiation of femininity and masculinity, is based on the division of gender into female-stereotypic and male-stereotypic characteristics. Rather than making traits gender neutral, androgyny involves the combination of gender-specific orientations. Some theorists have suggested that androgyny should be viewed as a transcendence of gender roles, rather than emphasizing some balance between feminine and masculine traits.

An  additional  concern  is  that  androgyny  might be erecting unrealistic goals for individuals by requiring that people be competent in both the communal and agentic domains. In a sense, such expectations restrict, rather than expand, the range and flexibility of individuals’ behavioral choices.

A further criticism of androgyny is that the concept does not deal with masculinity and femininity in their unequal cultural context. It neither acknowledges nor attempts to eliminate the greater cultural value placed on male activities. A related concern is that androgyny will not lead to the elimination of gender inequality, a goal that requires societal rather than personal change. That is, the mere existence of individuals with both feminine  and  masculine  traits  does  not  alter  the patriarchal power structure in society.

References:

  1. Bem, S. L. (1974). The measurement of psychological androgyny. Journal of Consulting and Clinical Psychology, 42,

155–162.

  1. Choi, N., & Fuqua, D. R. (2003). The structure of the Bem Sex Role Inventory: A summary report of 23 validation studies. Educational and   Psychological   Measurement,   63, 872–877.
  2. Helgeson, V. S. (1994). Relation of agency and communion to well-being:  Evidence  and  potential Psychological Bulletin, 116, 412–428.
  3. Spence, T.,  &  Buckner,  C.  E.  (2000).  Instrumental  and expressive traits, trait stereotypes, and sexist attitudes: What do they signify? Psychology of Women Quarterly, 24,44–62.
  4. Spence, J. T., & Helmreich, R. L. (1978). Masculinity and femininity: Their psychological dimensions, correlates and antecedents. Austin, TX: University of Texas Press.
  5. Spence, J. T., Helmreich, R. L., & Stapp, J. (1974). The Personal Attributes Questionnaire: A measure of sex role stereotypes and masculinity–femininity. JSAS Catalog of Selected Documents in Psychology, 4, Ms. No. 617.
  6. Twenge, J. M. (1997). Changes in masculine and feminine traits over time: A meta-analysis. Sex Roles. 36, 305–325.
  7. Twenge,   M.  (2001).  Changes  in  women’s  assertiveness in response to status and roles: A cross-temporal metaanalysis, 1931–1993. Journal of Personality and Social Psychology, 81, 133–145.

Androgyny: Embracing the Beauty of Gender Fluidity

In a world increasingly aware of the spectrum of gender identities, androgyny emerges as a powerful expression of individuality and resistance to traditional gender norms. Embracing the beauty of gender fluidity not only challenges societal expectations but also celebrates the unique blend of masculine and feminine traits within each person. As we explore the multifaceted nature of androgyny, we unveil its rich cultural history, its impact on fashion and art, and the personal journeys of those who embody this beautiful complexity. By understanding and accepting androgyny, we pave the way for a more inclusive society that honors the myriad ways in which we can express ourselves.

Androgyny Definition

The term androgyny is derived from the Greek andro (man) and gyne (woman). The popular conception of androgyny is a blend of male and female characteristics or a person who is neither male nor female. Psychological androgyny refers to men and women who exhibit both masculine and feminine attributes.

Androgyny Background and History

Psychologists have measured masculinity and femininity, along with other important personality traits, since the early 20th century. These early tests were developed by identifying items that reflected differences in men’s and women’s responses. For example, the masculinity-femininity scale of the original Minnesota Multiphasic Personality Inventory included items that male participants endorsed as being descriptive of their personality attributes. At that time, psychologists shared the Western cultural assumption that mentally healthy men were masculine and mentally healthy women were feminine. Therefore, it was expected that male participants would have higher masculinity scores than would female participants.

These early tests measured masculinity-femininity as a single dimension, with masculinity at one end of a continuum and femininity at the other end of the continuum. Therefore, the higher participants would score on masculinity, the lower they would score on femininity. Likewise, the higher participants would score on femininity, the lower they would score on masculinity. It was impossible to score high on both masculinity and femininity.

In the 1970s, many psychologists criticized these traditional tests. This criticism paralleled a shift in Western cultural assumptions about men, women, and traditional sex role socialization. During that time, Sandra Lipsitz Bem designed a new psychological test, the Bem Sex Role Inventory (BSRI). The BSRI was designed to address some of the criticisms of the traditional masculinity-femininity tests. Instead of items selected on the basis of sex differences in participants’ responses, the BSRI contains items that male and female participants rated as desirable for American men and women. The masculinity scale consists of items that were rated as slightly more socially desirable for men (e.g., aggressive and ambitious). The femininity scale consists of items that were rated as slightly more socially desirable for women (e.g., affectionate and cheerful). Moreover, the BSRI assesses masculinity and femininity as independent, separate dimensions. Male and female participants can score high on masculinity and low on femininity (traditional masculinity), low on masculinity and high on femininity (traditional femininity), high on both masculinity and on femininity (androgynous), and low on both masculinity and femininity (undifferentiated). These latter two groups were impossible to identify with the early psychological tests.

Sex-Role Flexibility and Mental Health

Research on androgyny has addressed two questions based on Western cultural assumptions about socialization to traditional sex roles: psychological adjustment and mental health. One line of research has tested the hypothesis that socializing men and women to traditional masculine or feminine sex roles would lead to rigidity and restricted behavior in many social situations. Because androgynous people have masculine and feminine attributes, they should have the flexibility to adapt to situations that require masculine or feminine behaviors. One series of studies, for example, found that androgynous men and women were more nurturing toward an infant than were masculine men and women. Moreover, androgynous men and women performed better in another experimental situation that required independence than did feminine men and women. In another study, masculine men and feminine women were more likely to choose an experimental activity that was appropriate for their sex (e.g., oiling squeaky hinges on a metal box vs. mixing infant formula and preparing a bottle) than were androgynous men and women. Moreover, masculine men and feminine women reported feeling worse after performing a sex-inappropriate activity than did androgynous men and women.

Other studies have addressed the relationship of androgyny, psychological adjustment, and mental health. Whereas some studies have found androgynous people to have higher self-esteem than traditional masculine or feminine people, the results of other studies are contradictory or mixed. An extensive review of published studies in the area concluded that androgynous and masculine men and women scored higher on several indices of mental health than did feminine men and women. However, statistical analyses indicated that it is the masculinity component of androgyny that is related to mental health rather than the unique combination of masculinity and femininity. The researchers attribute these findings to the psychological benefits masculine men and women enjoy in a culture that encourages assertiveness, competence, and independence.

Current Status

Psychological tests like the BSRI are an important improvement upon the tests constructed in the early 20th century. However, critics assert that because masculinity and femininity consist of a multitude of dimensions, these tests are inadequate. Other critics assert that tests such as the BSRI measure two important dimensions that are characteristic of sex roles across cultures: Masculinity items measure instrumental attributes (representing agency and independence), and femininity items measure expressive attributes (representing nurturance and warmth). Finally, Bem has changed her views on psychological androgyny. She believes that masculine or feminine people think about the world from the perspective of gender, whereas androgynous men and women do not.

References:

  1. Bem, S. L. (1975). Sex role adaptability: One consequence of psychological androgyny. Journal of Personality and Social Psychology, 31, 634-643.
  2. Bem, S. L. (1984). Androgyny and gender schema theory: A conceptual and empirical integration. Nebraska Symposium on Motivation (Vol. 32, pp. 179-226). Lincoln: University of Nebraska Press.
  3. Bem, S. L. (1987). Probing the promise of androgyny. In M. R. Walsh (Ed.), The psychology of women: Ongoing debates (pp. 206-222). New Haven, CT: Yale University Press.
  4. Spence, J. T., & Buckner, C. E. (2000). Instrumental and expressive traits, trait stereotypes, and sexist attitudes: What do they signify? Psychology of Women Quarterly, 24, 44-62.

Anchoring and Adjustment Heuristic: Understanding Our Decision-Making Flaws

In an increasingly complex world, our decision-making processes often rely on mental shortcuts that can lead us astray. One such shortcut is the anchoring and adjustment heuristic, a cognitive bias that profoundly influences how we evaluate information and make choices. This article delves into the mechanics of this heuristic, exploring how initial reference points shape our judgments and the potential pitfalls that arise from leaning too heavily on these anchors. By understanding the anchoring and adjustment heuristic, we can become more aware of our decision-making flaws and foster more informed, rational choices in both our personal and professional lives.

Life requires people to estimate uncertain quantities. How long will it take to complete a term paper? How high will mortgage rates be in five years? What is the probability of a soldier dying in a military intervention overseas? There are many ways to try to answer such questions. One of the most common is to start with a value that seems to be in the right ballpark and then adjust it until a satisfactory estimate is obtained. “My last paper took a week to write, but this one is more demanding so maybe two weeks is a good guess.” “Mortgage rates are low by historic levels, so perhaps they’ll be a couple of points higher in five years.” “The fatality rate in the last war was 1.5%, but our enemies are catching up technologically; maybe 4% is a more likely figure in the next conflict.”

Estimates such as these are based on what psychologists call the anchoring and adjustment heuristic. You start with an initial anchor value and then adjust until an acceptable answer is found. The choice of the term anchor for the starting value speaks to one of the most interesting features of this procedure: People typically fail to adjust sufficiently. That is, the initial value exerts some “drag” on the final estimate, systematically biasing the result.

Amos Tversky and Daniel Kahneman, who brought the anchoring and adjustment heuristic to psychologists’ attention, provided a clear demonstration of the insufficiency of adjustment. They spun a “wheel of fortune” and asked participants if certain quantities were higher or lower than the number on which the wheel landed. The participants were then asked to estimate the precise value of the quantity in question. For example, some participants were asked whether the percentage of African countries in the United Nations is higher or lower than 10%. Their subsequent average estimate of the actual percentage was 25%. Other participants were initially asked whether the percentage of African countries in the United Nations is higher or lower than 65%. Their average subsequent estimate was 45%. Thus, the initial anchor value, even when its arbitrary nature was quite apparent, had a pronounced effect on final judgments.

In another telling demonstration, Tversky and Kahneman asked people to tell them within five seconds the product of either 1 x 2 x 3 x 4 x 5 x 6 x 7 x 8 or 8 x 7 x 6 x 5 x 4 x 3 x 2 x 1. Because the allotted time was too short to permit an exact calculation, respondents had to estimate. The first group did so by extrapolating from a relatively low number (“one times two is two, two times three is six…so it’s probably about…”). The second group started from a larger number (“eight times seven is fifty-six…so…”). Because the two groups of respondents started with different anchor values, they came up with predictably different estimates. The average estimate of the first group was 512, whereas the average estimate of the second group was 2,250. If initial anchor values did not bias final estimates, the average estimates of the two groups would have been the same. Clearly, they were not. Note that the actual answer is 40,320, which shows even more powerfully that both groups adjusted insufficiently.

The anchoring and adjustment heuristic is of great interest to psychologists because it helps to explain a wide variety of different psychological phenomena. For example, people’s estimates of what other people are thinking are often egocentrically biased (i.e., people assume that others think more similarly to how they themselves think than is actually the case) because they tend to start with their own thoughts and then adjust (insufficiently) for another person’s perspective. People suffer from a hindsight bias, thinking that past outcomes were more predictable at the time than they really were, because they anchor on current knowledge and then adjust (insufficiently) for the fact that certain things that are known now were not known back then. Also, people tend to assume that they will do better than others on easy tasks because they start with an assumption that they will do well themselves and then adjust (insufficiently) for the fact that other people are also likely to do well on such easy tasks.

Beyond its importance to psychologists, the anchoring and adjustment heuristic has important implications for all of us in our daily lives. We must all be alert to the influence that arbitrary starting values can have on our estimates, and we must guard against individuals who might try to sway our judgments by introducing starting values that serve their interests, not ours. It has been shown, for example, that an opening proposal in a negotiation often exerts undue influence on the final settlement, and so we may want to pay considerable attention to how the opening proposals are made and who makes them. It has also been shown that the items we buy in the grocery store are powerfully affected by the anchor values that are put in our heads by advertisers. In one study, for example, an end-of-the-aisle promotional sign stated either “Snickers Bars: Buy 18 for your Freezer” or “Snickers Bars: Buy them for your Freezer.” Customers bought 38% more when the advertisers put the number 18 in customers’ heads. Buyer beware.

References:

  1. Epley, N., & Gilovich, T. (2001). Putting adjustment back in the anchoring and adjustment heuristic: Self-generated versus experimenter provided anchors. Psychological .Science, 12, 391-396.
  2. Gilovich, T., Griffin, D. W., & Kahneman, D. (2002). Heuristics and biases: The psychology of intuitive judgment. New York: Cambridge University Press.
  3. Tversky, A., & Kahneman, D. (1974). Judgment under uncertainty: Heuristics and biases. Science, 185, 1124-1131.
  4. Wansink, B., Kent, R. J., & Hoch, S. J. (1998). An anchoring and adjustment model of purchase quantity decisions. Journal of Marketing Research, 35, 71-81.

Amphetamines: Understanding Their Effects and Risks

Amphetamines, initially developed in the early 20th century for medical use, have since garnered attention for their potent stimulating effects on the central nervous system. Commonly prescribed to treat conditions such as ADHD and narcolepsy, these substances can enhance focus and energy levels. However, they also carry significant risks, including addiction, cardiovascular issues, and various mental health complications. This article seeks to delve into the multifaceted nature of amphetamines, exploring both their therapeutic benefits and the potential dangers associated with their misuse, providing a comprehensive understanding of this controversial class of drugs.

Currently, amphetamines (AMP) and methamphetamines (MA) are among the most widely abused illicit drugs in the world, second only to marijuana. More than 35 million individuals worldwide use and abuse AMP or MA on a regular basis (as compared with cocaine, which is used by about 15 million people, and heroin, used by fewer than 10 million). As a specific compound in the larger amphetamine family of powerful psychoactive stimulants, MA has become the most popular drug because of its high potency, relative low cost, and ease of manufacture.

Amphetamines were introduced into medical use in the United States in the early 1930s as a nasal spray for the treatment of asthma. By the mid-1960s, the U.S. Food and Drug Administration (FDA) placed the entire class of drugs under regulatory control because of growing concern over its misuse and overuse. Terms to describe the effects of AMP use and users such as “speed freaks” and “speed kills” are an enduring legacy to the phenomena. In the 1970s, regulatory controls on lawfully made AMP were progressively tightened. The Controlled Substances Act, which sorts all regulated substances into one of five schedules based on the substance’s medicinal value, harmfulness, and potential for abuse or addiction, includes AMP and MA in Schedule II (Control Level). These drugs are considered to have a high abuse potential with severe psychic or physical dependence liability.

Methamphetamine is known by a large variety of slang names, including “crystal,” “meth,” or “speed.” It  can  be  injected,  smoked,  snorted,  or  taken  by mouth. The intensity and duration of the “rush” experienced after use is a result of the release of high levels of dopamine into the brain and depends in part on the method of administration. This rush is almost instantaneous when MA is smoked or injected, but takes about 5 minutes after snorting or 20 minutes after oral ingestion. The half-life of MA is 12 hours, giving a duration of effect ranging from 8 to 24 hours (in contrast to the 1-hour half-life of cocaine, giving a high of only 20 to 30 minutes). The use and misuse of MA result from its subjective effects, including euphoria, reduced fatigue, reduced hunger, increased energy, increased sex drive, and increased self-confidence. Although AMP  and  MA  initially  produce  positive effects, the user is typically unaware of negative consequences to many of the body’s systems. Short-term and long-term cardiovascular, respiratory, neurological, cognitive, dermatological, dental, and psychiatric damage may occur in many individuals.

The immediate physiological effects of MA use are like those produced by the fight-or-flight response. As the body prepares for the simulated emergency of the fight-or-flight response, increased blood pressure and heart rate, constricted blood vessels, dilated bronchioles (breathing tubes), and increased blood sugar levels can cause irreversible damage to blood vessels in the brain, producing stroke, respiratory problems, irregular heartbeat, extreme anorexia, cardiovascular collapse, and death. Other negative physical and medical side effects include stomach cramps, shaking, high body temperature, stroke, and cardiac arrhythmia.

Abnormal movements and facial gestures are hallmarks of chronic stimulant abuse, and both acute and chronic use of AMPH and MA may result in coordination problems, shaking, involuntary facial and mouth movements, stereotyped movements, and tics. Abnormal, involuntary movements associated with stimulant use may decrease or end when drug use stops; however, chronic AMP and MA addicts may demonstrate long-lasting movement disorders that may persist for several years after drug withdrawal. Other negative consequences of use include cognitive deficits in memory, attention, concentration, and problem solving. Although some of these deficits may improve over time, enduring deficits may occur in some individuals.

Short-term and long-term AMP or MA use may result in psychological effects such as increased anxiety, insomnia, aggressive tendencies, paranoia, and hallucinations. Of great concern is a psychotic state that may be indistinguishable from paranoid schizophrenia. Paranoid delusions and transient auditory and visual hallucinations are frequent with MA use and its associated psychoses, with as many as two thirds of chronic MA users experiencing delusional psychoses. The delusions may be brief, although it is common for episodes to last several days to months. Of much concern is the violence that often accompanies AMP and MA use, especially in instances of use by parents of young children.

Importantly, the route of administration affects the potential for adverse reactions and associated medical disorders. Intravenous use may result in illnesses associated with the use or sharing of contaminated drug paraphernalia, including human immunodeficiency virus (HIV), hepatitis, tuberculosis, lung infections, pneumonia, bacterial or viral endocarditis, cellulites, wound abscesses, sepsis, thrombosis, renal infarction, and thrombophlebitis. Nasal insufflation (snorting) is associated with sinusitis, loss of sense of smell, congestion, atrophy of nasal mucosa, nosebleeds, perforation or necrosis of the nasal septus, hoarseness, problems with swallowing, throat ailments, and a persistent cough.

Continued use of MA may result in tolerance, and increased use at higher dosage levels may lead to dependence. Investigations of the long-term consequences of MA use in animals indicate that as much as 50% of the dopamine-producing cells in the brain can be damaged even after low levels of MA use, and serotonin-containing  nerve  cells  may  be  damaged even more extensively. Withdrawal effects from discontinuing use of MA often include depression, irritability, fatigue, anergia, anhedonia, and some types of cognitive impairment that last from 2 days to several months.

References:

  1. Center for  Substance  Abuse  Treatment  (CSAT).  (1997). Proceedings of the National Consensus Meeting on the use, abuse, and sequelae of abuse of methamphetamine with implications for prevention, treatment, and researc
  2. DHHS Pub. No. (SMA) 96–8013. Rockville, MD: Department of Health and Human
  3. National Institutes of Health (NIH). (1998). Research report series: Methamphetamine  abuse  and    DHHS Pub. No. 98–4210. Rockville, MD: Department of Health and Human Services.
  4. World Health Or (1997). Programme on substance abuse, amphetamine-type stimulants. Geneva: Division of Mental Health and Prevention of Substance Abuse.

Understanding Amicus Curiae Briefs: Their Role in Legal Proceedings

Amicus curiae briefs play a pivotal role in the judicial process, offering insights and perspectives from non-litigants to aid courts in decision-making. These “friend of the court” submissions can come from a variety of sources, including organizations, experts, or individuals with a vested interest in the legal questions at hand. By providing broader context and specialized knowledge, amicus briefs can significantly influence the outcome of cases, particularly those that hold implications beyond the immediate parties involved. This article delves into the purpose, structure, and impact of amicus curiae briefs, shedding light on their importance in shaping legal precedents and informing judicial deliberations.

Amicus curiae literally means “friend of the court,” and the author of an amicus curiae brief is an entity who wishes to provide legal, scientific, or technical information to a court to aid its decision. An amicus is not a party to the case entitled to be heard as a matter of right but an individual or an organization granted discretionary leave to file a written brief to provide insight into an issue that the parties to the case may not be able to have because of lack of time, space, or expertise. Amicus curiae briefs have influenced the outcomes of many landmark legal cases. The American Psychological Association (APA) regularly seeks leave to file amicus briefs, as do a host of other individuals and organizations.

Amicus Curiae Briefs Overview

The U.S. adversarial legal system looks to the parties to present the information necessary for the judge or jury to decide the questions presented by a case. The amicus curiae brief is a vehicle for people or organizations, not joined as parties or otherwise entitled to be heard in the case, to provide the judiciary with insights or analysis that would otherwise be lacking in decisions of significant import.

Amici lack important rights that parties enjoy. For example, amici have no right to settle or refuse to settle claims, to raise a claim or a defense that the parties did not, or even to join a person that the parties did not. There is no constitutional right to file an amicus brief. The opportunity to be heard as an amicus rests with the discretion of the court before whom the case is pending or, in federal court, the consent of the parties or permission of the court. Typically, amicus briefs are thought to address transcendent questions of law decided at the appellate stage of a case. But it is within the discretion of the court to accept an amicus brief at trial as well as on appeal, whether labeled a pure or a mixed question of law or fact.

A Brief History of Amicus Curiae Briefs

Authors such as Simpson and Vasaly have traced the roots of the amicus curiae brief to ancient Rome, where briefs were submitted to provide legal expertise directly to the judiciary at their discretion. Seventeenth-century England provides the first known occurrence of what is now understood as an amicus brief to aid judges in avoiding legal errors and maintaining judicial honor. The first known instance in the United States was when an amicus curiae brief was requested of House Speaker Henry Clay in 1812 by the Supreme Court to aid the Court in the application of law to a land dispute between two states. It was not long after this use of an amicus curiae brief that the practice of filing amicus briefs in appellate courts began in earnest. Although the core purpose of the amicus curiae brief has always been a non-partisan effort to educate the court and not to advance the interests of a specific party, there has always been a tension between these motivations.

The amicus curiae brief may seek to serve numerous functions categorized by Simpson, include the following: (a) to address issues of policy; (b) to provide a more appealing advocate; (c) to support the granting of a Supreme Court review; (d) to supplement the brief of a party; (e) to give a historical perspective; (f) to provide technical or scientific aid; (g) to endorse a particular party in the case; and (h) to try and correct, limit, publish, or “depublish” an issued judicial opinion. These functions are not mutually exclusive; thus an amicus curiae brief may serve multiple purposes.

Prevalence and influence of the Amicus Curiae Brief

The prevalence of amicus curiae briefs submitted to the courts, and the Supreme Court in particular, has increased over time. During the first few decades of the 20th century, Kearney and Merrill found that amicus curiae briefs were only filed in approximately 10% of the Supreme Court’s cases. This practice has increased dramatically. For example, in the most recent decades, at least one amicus curiae brief has been filed in at least 85% of the Court’s cases that incorporated oral arguments. Thus, today, cases with no amicus curiae filings have become the anomaly.

As the number of amicus curiae briefs filed has increased over time, so has the ability of the amicus curiae brief to influence the outcome of court cases, especially where there are many amicus curiae briefs that aid the parties in strong calls for change in the areas of social policy. Amicus curiae briefs that focus on social policy instead of pure legal argument have come to be known as “Brandeis briefs,” named for the first filing by Louis Brandeis, later appointed a Supreme Court justice. Brandeis’s use of a nonlegally oriented brief to highlight social science data has become a model for presenting such information.

Perceptions of the Amicus Curiae Brief

Perceptions of the use and utility of amicus curiae briefs vary widely within the legal profession. From one point of view, the amicus curiae brief is a beneficial vehicle, providing arguments, technical information, or authorities not included by the parties. Those agreeing with this view point to the numerous references to amicus curiae briefs in many court opinions to suggest that courts find amicus curiae briefs helpful.

Some members of the legal community hold an opposite view. Many judges report that amicus curiae briefs replay the arguments put forth by the parties and provide the court little or no assistance. Those who subscribe to this view contend that amicus curiae briefs are a nuisance, burdening judges and their staffs yet providing few, if any, benefits. For those who view the amicus curiae brief in this way, either prohibiting or limiting the submission of amicus curiae briefs would improve the judicial system.

Finally, a middle ground regarding the amicus curiae brief acknowledges its prevalence and its potential utility but cautions that amicus curiae briefs are most often filed by large, resourceful organizations. While amicus curiae briefs may prove helpful, researchers including Kearney and Merrill caution that inequality in organizational power, interest, and influence should be considered when contemplating an amicus curiae brief.

The APA as a Friend of the Court

The APA has been a prolific author of amicus curiae briefs. It has submitted amicus curiae briefs in cases presenting issues that can potentially affect the internal practices of the APA or its membership as well as external issues of social import that may affect the welfare of populations served by the APA. The topics of APA amicus briefs cover a wide gamut, ranging from scientific research and testing, psychological practice, and treatment of the mentally ill to abortion, sexual orientation, affirmative action, and the death penalty. While the wide range of amicus curiae brief topics are as diverse as the United States itself, in each specific case, the APA perceived either an important social value or an internal necessity in speaking as a “friend of the court.”

The APA offers full-text copies of numerous amicus curiae briefs on its Web site, including briefs submitted in “landmark” cases. As an example, in Planned Parenthood of Southeastern Pennsylvania v. Casey (1992), the APA presented amicus briefs containing extensive psychological research to assist the Supreme Court’s scrutiny of a Pennsylvania law requiring married women to obtain consent from their husbands before obtaining an abortion. The APA’s amicus brief presented research that such a restriction supplants a woman’s rational choice and places an unfair and potentially harmful burden on women who have compelling reasons not to inform their husbands of their choice. The Supreme Court found that the Pennsylvania law placed an unacceptable burden on women and declared the law unconstitutional.

In the Court’s 2005 decision in Roper v. Simmons, which presented the constitutionality of imposing the death penalty on someone who was under 18 when the murder was committed, the APA presented research on juvenile behavior, maturity, decision-making ability, and criminology. In a 5:4 decision, in which the research presented by APA was central, the Supreme Court held that the Eighth Amendment of the Constitution prohibits the imposition of the death penalty on juveniles under the age of 18 when the crime was committed.

References:

  1. Barrett, G. V., & Morris, S. B. (1993). The American Psychological Association’s amicus curiae brief in Price Waterhouse v. Hopkins: The values of science versus the values of the law. Law and Human Behavior, 17, 201-215.
  2. Ennis, B. J. (1984). Symposium on Supreme Court advocacy: Effective amicus briefs. Catholic University Law Review, 33,
  3. Fiske, S. T., Bersoff, D. N., Borgida, E., Deaux, K., & Heilman, M. E. (1991). Social science research on trial: Use of sex stereotyping research in Price Waterhouse v. Hopkins. American Psychologist, 46, 1049-1060.
  4. Kearney, J. D., & Merrill, T. W. (2000). The influence of amicus curiae briefs on the Supreme Court. University of Pennsylvania Law Review, 148,
  5. Krislov, S. (1963). The amicus curiae brief: From friendship to advocacy. Yale Law Journal, 72,
  6. Planned Parenthood of Southeastern Pennsylvania. v. Casey, 505 U.S. 833 (1992).
  7. PsycLAW: APA’s amicus briefs. (n.d.). Retrieved June 24, 2015, fromhttp://www.apa.org/about/offices/ogc/amicus/index.aspx
  8. Roper v. Simmons, 543 U.S. 551 (2005).
  9. Simpson, R. W., & Vasaly, M. R. (2004). The amicus brief: How to be a good friend of the court (2nd ed.). Chicago: American Bar Association.
  10. Walbot, S. H., & Lang, J. H. (2003). Amicus briefs: Friend or foe of Florida courts? Stetson Law Review, 32.

Return to the overview of Trial Consulting in Forensic Psychology.

Americans With Disabilities Act: A Legacy of Inclusion and Accessibility

The Americans with Disabilities Act (ADA), enacted in 1990, marks a pivotal moment in the ongoing journey toward equality and inclusion for individuals with disabilities in the United States. As one of the most comprehensive pieces of civil rights legislation, the ADA has transformed the social and physical landscape, breaking down barriers and ensuring that millions of Americans can participate fully in society. This article explores the legacy of the ADA, highlighting its profound impact on accessibility, the challenges that remain, and the continuing fight for a more inclusive future. Through the lens of its successes and ongoing struggles, we can better appreciate the significance of this landmark law and its role in shaping a more equitable society for all.

The Americans with Disabilities Act (ADA) was enacted in 1990 and became effective in 1992. Expanding the protection afforded by the Vocational Rehabilitation Act of 1973, the ADA represents the most inclusive and far reaching of the nondiscrimination laws since the landmark Civil Rights Act of 1964. The ADA protects otherwise qualified individuals from discrimination based on their disability and guarantees equal treatment in employment, public services, public accommodations, and telecommunications (Titles I, II, III, and IV respectively), as well as covering  miscellaneous  issues  (Title  V)  (ADA  of 1990, Pub. L. 101–336, 1990).

ADA defines a person with a disability as an individual with (a) a physical or mental impairment that (b) substantially limits one or more major life activities (e.g., seeing, hearing, speaking, walking, breathing, performing manual tasks, learning, caring for oneself, or working), or (c) has a record of such an impairment (e.g., a person recovered from cancer or mental illness), or (d) is regarded as having such an impairment (e.g., severe physical disfigurement) (ADA  of  1990,  Pub.  L.  101–336,  Sec.  12102  [2], 1990). Individuals with minor or short-duration conditions are not covered (e.g., broken leg).

Employment

Title I prohibits discrimination against a qualified applicant or employee because of his or her disability in any employment practice or related activity, including recruitment, job application procedures, selection, termination (layoff or firing), promotions, compensation, leaves, training, and other terms, conditions, and privileges of employment. All private employers, state and local governments, employment agencies, and labor unions with 15 or more employees are covered. The ADA  does  not  impose  any  affirmative  action obligations, and employers have the right to hire any qualified candidates.

A key concept in the ADA is that of “otherwise qualified.” Otherwise qualified individuals possess the knowledge, skills, abilities, and other characteristics or requirements (e.g., legitimate experience or education) and can perform the essential functions of the job successfully with or without a reasonable accommodation. Job modifications (e.g., exchanging job tasks with co-workers, flexible work hours omitting nonessential tasks), environmental changes (e.g., ramps, larger stalls and grab bars in restrooms, automatic door openers, improved lighting), or auxiliary aids (e.g., speakerphones or headsets, adjustable workstations, wrist or arm supports, magnification aids for reading) that allow a qualified applicant or employee with a disability to perform the essential functions of the job and do not create undue hardship for the employer are considered reasonable accommodations. Reasonable accommodations may involve modifying workplaces, equipment, or jobs; modifying work schedules; providing qualified readers or interpreters; or appropriately modifying examinations, training, or other programs. These accommodations should be evaluated and made on a case-by-case basis. Employers are not expected or required by law to lower employment standards, provide personal-use items (e.g., glasses or hearing aids), or identify individuals to receive accommodations. People with disabilities must self-identify, provide evidence of their disability, request needed accommodations, and flexibly interact with the employer. Undue hardship is also determined on a case-by-case basis and occurs when the requested accommodation involves excessive financial cost or effort that exceeds employer resources.

People with disabilities who feel that they have been discriminated against can seek legal remedies. Like Title VII of the Civil Rights Act, some cases will involve adverse impact or disparate treatment. Additional ADA cases concern the employer’s refusal or failure to accommodate. Litigation will determine whether  the  individual’s  disability  interferes  with work efficiency or poses a risk or hazard to others (e.g., person’s disability is an infectious disease) or if an accommodation creates undue hardship for the organization.

Public Services

Title II protects qualified individuals from discrimination on the basis of disability in services, programs, benefits, or activities of a public entity (e.g., a state, an agency, political subdivision, any commuter authority). Each service, program, or activity must be operated such that it is readily accessible to and usable by individuals with disabilities unless it would result in a fundamental alteration in the nature of a service, program, or activity or an undue financial and administrative burden. Title II also requires the accessibility of new construction and covers the modification of existing buildings when other methods are not effective in achieving accessibility. Public transportation (e.g., buses, subways, trains) is also covered and must be accessible. Exceptions for providing services in situations where safety and health are jeopardized are also included when they are based on objective criteria and not the result of stereotypes or generalizations.

Public Accommodations

Title III covers private organizations that provide goods, services, and programs. These organizations, including restaurants, hotels, banks, theaters, doctors’ offices, pharmacies, retailers, museums, libraries, parks, schools, and day care centers, cannot deny access on the basis of a person’s disability and must make facilities accessible. Title III requires all new construction of places of public accommodation be accessible and requires reasonable modifications to existing facilities.

Telecommunications

Title IV makes available telecommunications (telephone and television) devices and services for hearing and speech-impaired users. It requires local and long distance telephone carriers to establish relay services for callers with hearing and speech disabilities who use telecommunications devices (e.g., telecommunications devices for the deaf [TDDs] or teletypewriters [TTYs]) or third-party communications assistants. It ensures confidentiality of these transmissions and sets standards for service. Title IV also requires closed captioning of federally funded public service announcements.

Miscellaneous

Title V deals with a wide range of issues, including retaliation, insurance coverage, construction, state immunity, attorney fees, illegal drug use, exclusions from  the  definition  of  disability,  and  instructions to federal agencies (Equal Employment Opportunity Commission [EEOC] and Department of Justice [DOJ]) for enforcement of the statute. The key protection in this provision is the prohibition of (a) coercing or threatening, or (b) retaliating against the disabled or those attempting to aid a disabled person who files a charge or opposes a discriminatory practice under the ADA.

Impact

General acceptance of the law and its mandates is reported in all areas. The old adage “the more things change, the more they remain the same” applies to the effectiveness of this act. Although advancements in accessibility to employment, commerce, technology, telecommunications services, housing, and public services, facilities, and programs have been achieved, the vision of full participation has not materialized, and substantial obstacles remain. The EEOC and DOJ, through enforcement efforts, have obtained substantial monetary settlements and nonmonetary benefits (e.g., reasonable accommodation, policy changes, training and education, job referrals, union membership) for individual workers. The National Council on Disability (NCD) details steady improvement in the efficiency and procedural consistency of enforcement activities. However, large differences between disabled and nondisabled populations are reported in employment, graduation rates, income, home ownership, use of computers, access to transportation and Internet, health care, participation in a range of activities including entertainment, socializing, attendance at religious services, and political participation. Clearly, significant advances need to be made to improve the quality of life for more than 54 million Americans living with a disability.

References:

  1. Americans with Disabilities Act of 1990, Pub. No. 101–336. (1990). Retrieved from http://www.usdoj.gov/crt/ada/ statute.html
  2. Gutman, A. (2000). EEO law and personnel practices (2nd ). London: Sage.
  3. National Council on Disability. (2000). Promises to keep: A decade of federal enforcement of the Americans with Disabilities Washington, DC: Author. Available from http://www.ncd.gov
  4. National Council on Disability. (2001). National disability policy: A  progress  report,  November  1999–November  Washington,  DC:  Author.  Available  from  http://www.ncd.gov
  5. National Organization on Disability, http://www.nod.org
  6. National Organization  on  Disability/Harris.  (2000).  Survey of  Americans  with  disability.  Washington,  DC: Author. Available from http://www.nod.org
  7. Percy, L. (2001). Challenges and dilemmas in implementing the Americans with Disabilities Act: Lessons from the first decade. Policy Studies Journal, 29, 633–640.
  8. Stefan, S. (2002). Hollow promises: Employment discrimination against people with mental Washington, DC: American Psychological Association.
  9. S. Equal  Employment  Opportunity  Commission.  (2000).  Highlights of EEOC enforcement of the Americans with Disabilities Act: A preliminary status report, July 26, 1992, through  March  31,  2000.  Available  from  http://www.eeoc.gov

Americans with Disabilities Act: A Cornerstone for Inclusivity and Equal Rights

The Americans with Disabilities Act (ADA), enacted in 1990, stands as a pivotal milestone in the ongoing struggle for civil rights and social equity. This landmark legislation was designed to eliminate barriers and foster an inclusive environment for individuals with disabilities, affirming their right to participate fully in all aspects of society. As we reflect on the impact of the ADA over the past three decades, it becomes clear that its provisions not only transformed public facilities and workplaces but also reshaped cultural perceptions of disability. This article delves into the enduring significance of the ADA, highlighting its role as a cornerstone for inclusivity and a beacon of hope for equal rights in America.

Psychologists may become involved with the Americans with Disabilities Act (ADA) through consultations with employers and workers or as an expert witness in litigation involving the act. In all these roles, the psychologist must gain an understanding of the many definitions in the act and the Equal Employment Opportunity Commission (EEOC) regulations mandated by it. The ADA not only is a valuable tool for use by disabled people against discrimination but also an arena of practice for forensic psychologists. Although the ADA is a complex mixture of definitions and rules, the forensic practitioner may enter this arena using many of the skills developed in tort cases or in civil rights cases involving sex or race. This research paper describes the ADA, discusses the roles that psychologists may play in workplace consultations, and examines the use of psychological evaluations in litigation related to disability.

Background of the Americans with Disabilities Act

The ADA was signed into law in 1990 and came into effect 2 years later. The law was designed to eliminate discrimination against people with disabilities. The statute (42 U.S.C. 12101, Section 2 b (1), 1992) enabled the development of regulations by the EEOC and has been shaped by a number of U.S. Supreme Court decisions. The most obvious impact of the ADA is seen in its transformation of buildings, roads, sidewalks, buses, and restrooms into places where people with disabilities may function with fewer barriers.

However, the advocates of disabled people who framed the ADA were more ambitious. The law intends to prevent individuals with disabilities from being discriminated against in hiring, training, compensation, and benefits. Under the ADA, it is illegal to classify an employee on the basis of disability or to participate in contracts that have the effect of discriminating against people with disabilities. The use of tests or other qualification standards that are not job related but result in screening out individuals with disabilities is also banned. Like the Civil Rights Act of 1964, the ADA protects workers who file complaints with the EEOC or other agencies from retaliation by their employers. Under the ADA, employers are required to provide “reasonable accommodation” for workers with disabilities who could qualify for jobs with appropriate assistance.

Forensic psychologists working in cases involving the ADA must have an understanding of the specific definitions that shape how the act is used. An important definition in the act is the definition of disability: (1) a physical or mental impairment that substantially limits one or more of the major life activities of an individual, (2) a record of such an impairment, or (3) being regarded as having such an impairment.

A qualified individual with a disability is a person with a disability who has the basic qualifications for the job, including the skills, experience, education, and other job-related requirements required for the position the person either currently holds or wishes to obtain. In the context of the ADA, a qualified individual with a disability, with or without reasonable accommodation, can perform the essential functions of that job.

An impairment becomes a disability when it adversely affects one or more major life activities. One first considers the impact of the disability on non-work-related activities, which include self-care, sleeping, reading, and concentrating. If none of those basic human activities are affected, the inquiry shifts to work-related activities. The impairment must be considered severe enough to “substantially limit a major life activity.” How much restriction on essential life activity is caused by the disability is one metric, but the act also allows for consideration of the duration of the disability. Temporary disability is not considered, and chronic and recurring conditions must be considered substantially limiting while they are active.

Mental impairment refers to “any mental or psychological disorder, such as…emotional or mental illness.” The ADA provides examples of mental or emotional illnesses, such as major depression, bipolar disorder, anxiety disorders, and schizophrenia. Although not listed in the ADA itself, EEOC regulations also include personality disorders as potentially disabling conditions and point to the Diagnostic and Statistical Manual of Mental Disorders (currently the DSM-IV-TR) as the appropriate reference for determining the symptoms associated with mental disorders. The ADA specifically excludes conditions related to sexuality, such as homosexuality, bestiality, transvestism, transexualism, pedophilia, exhibitionism, voyeurism, or gender identity disorders not related to physical impairments. In addition, the act excludes other behaviors of which Congress did not approve, including compulsive gambling, kleptomania, pyromania, and psychoactive substance abuse disorder resulting from the illegal use of drugs.

In general, the disabled worker must conduct himself or herself in the workplace just like other workers, unless the disability is causing conduct problems on the job. In those situations, the employer must provide reasonable accommodations that would allow the worker to meet conduct requirements. If a worker’s behavior constitutes “a significant risk of substantial harm to the health and safety of the individual or others that cannot be eliminated or reduced by reasonable accommodation,” it may be considered a direct threat. The ADA allows workers who pose a direct threat to be fired or removed from the affected position.

The ADA treats the abuse of illegal substances differently than the abuse of legal ones. Current illegal drug use, including abuse of prescription drugs, is not protected by the ADA. Rehabilitated illegal drug users are protected, and the existence of a history of illegal drug use may not be a basis for discharge or discipline, although a relapse may legitimately trigger discharge. Workers who have addictions to legal drugs, such as alcohol, must experience a substantial limitation in a major life activity to be covered by the ADA. Alcohol-dependent workers with excessive absenteeism who report to work drunk or who endanger other workers because of their dependence are subject to the same discipline as other workers.

Psychological Consultations with Employers and Workers

Accommodation Plans

The ADA mandates that an employer work with each disabled employee to develop a plan that takes into account the worker’s disability, the worker’s strengths, and the nature of the job. Psychologists may assist the employer to help craft an accommodation plan to allow the worker to function in the workplace. This may be done through changes in work hours or supervision levels or by simply providing time off for psychotherapy sessions.

Return-to-work Evaluations

Workers with mental disabilities may experience fluctuations in their illnesses that result in extended absences from the workplace. In these situations, the employer may require that the worker undergo a psychological evaluation to determine if the worker may effectively return to the workplace without irremediable deficits in work functioning or dangers to the worker or others. In these situations, the psychologist obtains information concerning the demands of the job. The next task is to determine if the worker can perform essential job functions with or without reasonable accommodation.

The psychologist may provide information about what accommodations may be made, which might include altering the interpersonal demands of the workplace, changing the environmental conditions, changing the worker’s shift, and eliminating distractions. In addition to reviewing the worker’s documented medical and mental records, the examining psychologist may administer a battery of tests. Cognitive assessment may be required in situations in which the mental disability may affect attention, concentration, or the ability to work quickly. Personality assessment may add additional information about existing patterns of psychopathology in relation to the worker’s history or the symptom picture that predicated the worker’s departure from the workplace. A full clinical history and interview is part of this assessment and should include a detailed vocational history to determine whether the presented impairments have caused the worker problems in the past. A history of relationships, both on and off the job, will illuminate the existence of interpersonal impairments that could limit vocational functioning.

The assessment should result in the psychologist’s opinion about whether the worker is disabled under the definitions of the ADA. Then, the psychologist determines if the worker’s disability is amenable to reasonable accommodation within the range of alternatives that are feasible for that employer. This decision, as all others in relation to the ADA, is related to the nature of the employer’s business, the number of employees, the cost of the accommodations, and other factors. For a small employer, changes in the worker’s schedule may not be reasonable, while for a large employer, more extensive changes in the workplace may be practical.

The psychologist’s active participation in discussions with the employer and the worker can result in a return-to-work plan that meets the worker’s needs and allows for the employer to return a trained and functioning employee to duty. The psychologist should listen to all the parties to craft a viable course of action for the employee’s return to work.

Litigation-Related Evaluations and Consultations

Failure to Provide Reasonable Accommodation

The ADA allows workers to sue employers for a number of acts and omissions in relation to the ADA. The worker may claim that the employer has failed to provide reasonable accommodation for a disability or has refused to hire a disabled employee. Assessment of plaintiffs in these cases involves evaluations similar to those used in return-to-work contexts because the psychologist is called on to compare the worker’s skills with the job requirements to determine if changes in the workplace would allow the worker to perform essential job functions. Employers may claim that no amount of accommodation would bring the worker up to a functional level, that the proposed accommodations are not feasible or would impose an undue hardship on the employer, that reasonable accommodation has been offered to the worker but was rejected, or that no effective accommodation exists for that worker in that job setting.

These evaluations should meet the standards for any litigation-related evaluation and include gathering a thorough history, reviewing the appropriate job, mental health, and medical records, appropriate psychological testing, and collateral interviews. The psychologist should prepare a report consistent with professional standards and be prepared to be questioned in deposition or in open court.

Disparate Treatment and Disparate impact Evaluations

If a worker is disabled according to the ADA and has not been hired, has been denied promotion, or has been fired, and nondisabled workers who are similarly situated have been treated more favorably, the disabled worker may have a claim for disparate treatment. If the disabled worker has experienced an adverse job action that is not a result of the employer’s overt discrimination but is a result of a policy that was designed to be neutral toward people with disabilities, the worker may have a claim for disparate impact.

Psychological evaluation in these cases focuses on the impact of the nonhire, firing, or nonpromotion. Emotional damages may flow from these adverse job actions, and the impact of changes in income and lost future job opportunities may be considered. Psychological evaluations in these cases may more closely resemble evaluations in personal injury or workers’ compensation cases, as reasonable accommodation is not an issue. Interviews with family members and friends may assist in determining if the worker has suffered emotional harm because of the employer’s actions.

Reprisal for Protected Conduct

If a worker files a complaint with the EEOC or other similar agency and is subsequently the recipient of adverse treatment or discharge from his or her employer, that employee may file a claim for reprisal. Psychological evaluation of these cases may follow the parameters of evaluations in disparate treatment and impact cases.

Disability Harassment and Hostile Work Environment

In some situations, disabled individuals experience harassment or hostile work environments because of their disability status. In these situations, the plaintiff must show that he or she is disabled and that because of the disability, he or she was subjected to physical or verbal conduct so offensive that a reasonable person would consider the work situation to be a hostile work environment. Also, the plaintiff must show that the employer failed to take prompt remedial action to stop the harassment. Evaluations for hostile work environment would follow the same pattern as outlined above.

References:

  1. Foote, W. E. (2000). A model for psychological consultation in cases involving the Americans with Disabilities Act. Professional Psychology: Research and Practice, 31(2), 190-196.
  2. Foote, W. E. (2003). Forensic evaluation in Americans with Disabilities Act cases. In A. D. Goldstein & I. B. Weiner (Eds.), Comprehensive handbook of forensic psychology: Vol. 11. Forensic psychology. New York: Wiley.
  3. S. Equal Employment Opportunity Commission. (2000). Questions and answers on amending the interpretive guidance on Title I of the Americans with Disabilities Act.

Return to the overview of Mental Health Law in Forensic Psychology.

Americans with Disabilities Act: A Pillar of Accessibility and Inclusion

The Americans with Disabilities Act (ADA), enacted in 1990, stands as a landmark piece of legislation that has profoundly shaped the landscape of accessibility and inclusion in the United States. Recognized as a pivotal moment in the fight for civil rights, the ADA aimed to eliminate barriers and ensure that individuals with disabilities could participate fully in all aspects of society. From public accommodations to transportation and employment, the Act has catalyzed significant changes, fostering an environment where diversity and accessibility are not just ideals but essential components of everyday life. As we explore the ADA’s enduring impact, we will examine its achievements, the ongoing challenges faced by the disability community, and the vital role it plays in promoting a more inclusive society for everyone.

The Americans with Disabilities Act (ADA), a landmark piece of civil rights legislation, is a product of bipartisan support. Signed into law on July 26, 1990, the ADA “signals the end to the unjustified segregation and exclusion of persons with disabilities from the mainstream of American life,” declared President George H. W. Bush. Although the passage of the ADA was challenged by some legislators who considered its supporters a “sodomy lobby,” the legislation’s history demonstrates an unwavering commitment of the Congress to the more than 43 million people with disabilities in the United States. The ADA protects those who encounter various forms of discrimination, exclusion, and segregation because of their disabilities and gives them “the right to participate in the cultural, economic, educational, political and social mainstream,” said Senators Bob Dole and Tom Harkin in celebration of the ADA’s tenth anniversary.

The language in the ADA and in subsequent judicial decisions defines what the law covers and to whom the law applies. As psychologists increasingly are called upon to conduct disability evaluations for insurance compensation, academic accommodations, work modifications, and federal income subsidies, it has become critical for psychologists to understand how and the extent to which the ADA applies to specific service populations. Key language and concepts in the ADA are fundamental to standards and requirements for many disability evaluations. This entry provides an overview of the ADA and its legislative background along with a discussion of the statutory definition of the term disability and the reasonable accommodations and modifications mandated by the ADA.

Overview of the ADA and Legislative Background

The ADA came from the civil rights movement of the 1960s and 1970s. It was modeled after the Civil Rights Act of 1964, which prohibits racial discrimination for employment and in public accommodations (e.g., hotels or restaurants). Different from the Civil Rights Act of 1964, where protection applies to people of all races, the ADA provides protection against discrimination only for those whose limitations meet the statutory definition of disability. The ADA also borrows several key definitions from an early disability rights statute, the Rehabilitation Act of 1973. These include definitions for disability, reasonable accommodation, and undue hardship.

In spite of their similarities, there are major differences between the Rehabilitation Act of 1973 and the ADA. Although both statutes are disability rights laws, the Rehabilitation Act of 1973 applies only to programs or activities receiving federal financial assistance (e.g., education, courthouses, and transportation). The ADA, on the other hand, covers public or private employment, transportation, accommodations, and telecommunications regardless of whether federal funding is involved. Also, housing, education, and air transportation are issues included in the Rehabilitation Act of 1973 that were not covered by the ADA. It is clear from the legislative history that Congress made a great effort to make the ADA consistent with the Rehabilitation Act and did not intend it to supersede its statutory predecessor.

The ADA includes five separate titles. Title I involves employment issues. It prohibits discrimination with regard to job application procedures, hiring, advancement, discharge of employees, compensation, job training, and employment privileges. Title II involves public services. Any state or local government instrumentalities, the National Railroad Passenger Corporation, and commuter authorities cannot deny people with disabilities services or participation in programs or activities available to those without disabilities. Title III concerns public accommodations (e.g., roads and sidewalks) and services operated by private entities (e.g., movie theaters and amusement parks). All such accommodations that are newly constructed must be accessible to people with disabilities. For existing facilities, architectural barriers to services must be removed if modifications are readily achievable. Title IV concerns telecommunications. Telephone relay services must be provided by telecommunication companies for people who use telecommunication devices for the deaf or other similar devices. Title V involves miscellaneous provisions that prohibit coercing, threatening, or retaliating against individuals with disabilities or those attempting to assist individuals with disabilities to assert their rights.

Definition of a Disability

One key issue that raised a substantial amount of discussion during the legislative history and after the passage of the ADA concerned the definition of disability. The definition in the ADA is similar to that of the Rehabilitation Act of 1973; disability means (a) a physical or mental impairment that substantially limits one or more of the major life activities of such individual, (b) a record of such an impairment, or (c) being regarded as having such an impairment.

The ADA expanded its protection not only to those currently with a disability or those with a documented record of one but also to those who are perceived falsely as having a disability. For example, a person with epilepsy might be treated adversely by his employer, because his employer believes his condition could limit his ability to perform his job. Although his condition is well managed and does not affect his job functions, this person still would be covered by the ADA.

Physical and Mental impairment

A physical or mental impairment means (a) any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting one or more of the following body systems: neurological, musculoskeletal, special sense organs, respiratory (including speech organs), cardiovascular, reproductive, digestive, genitourinary, hemic and lymphatic, skin, and endocrine; or (b) any mental or psychological disorder, such as mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities.

While ADA covers a broad range of disabilities, including psychiatric conditions, health conditions, sensory impairments, orthopedic impairments, and learning disabilities, there are certain conditions to which ADA does not apply. Transvestites, transsexuals, bisexuals, gay identified individuals, and individuals with pedophilia, exhibitionism, voyeurism, gender identity disorders not resulting from physical impairment, other sexual behavior disorders, pyromania, compulsive gambling, kleptomania, and alcohol or drug addiction do not qualify individuals for ADA protection if they are treated adversely solely on the basis of these conditions.

In Shafer v. Preston Memorial Hospital Co., Deborah Shafer, a nurse anesthetist, sued Preston Memorial Hospital under the ADA, claiming that Preston Memorial Hospital discriminated against her on the basis of her drug addiction. Shafer was addicted to fentanyl, a Schedule II narcotic analgesic, and had diverted postoperative fentanyl for her personal use. On the day of her completion of inpatient rehabilitation treatment, Shafer was notified by the hospital that her employment was terminated. Shafer sued Preston Memorial Hospital for employment discrimination and appealed the district court’s order, which granted summary judgment for Preston Memorial Hospital. The circuit court concluded that Shafer was a current user of an illegal drug and was therefore not considered disabled under the ADA. Because of her addiction, she was not considered “otherwise qualified” under the ADA, and therefore the hospital was not held liable for discharging her from her employment.

Otherwise Qualified

The ADA protects the rights of those who are able to demonstrate that they are qualified individuals with disabilities. A “qualified individual with a disability” as applied to employment under the ADA is a person “who, with or without reasonable accommodation, can perform the essential functions of the employment position that such individual holds or desires.” Essential job functions may be determined by the employer’s judgment, written job descriptions, the amount of time the person has spent performing those functions, terms of collective bargaining agreements, work experiences of previous incumbents, and experiences of current incumbents in similar positions. For example, an employer may require all secretaries to have the ability to type 75 words per minute. A person with paraplegia who applies to be a secretary but fails to meet the typing requirement is not be considered a qualified individual with a disability as long as this employer can demonstrate that this particular requirement is an essential job function and that no reasonable accommodation can be provided to modify this requirement.

In education settings, a person with a disability must be able to fulfill the essential requirements of the program, with or without the provision of reasonable accommodations. Sherrie Lynn Zukle was a medical student at Davis School of Medicine at the University of California. After receiving unsatisfactory performance reports for several semesters, Zukle was placed on academic probation and referred for an evaluation, through which Zukle was found to suffer a learning disability. She consequently received academic accommodations, including extra time on exams and note-taking assistance. Zukle’s subsequent academic and clinical performances remained poor in spite of her academic accommodations. She failed a clinical clerkship when she was placed on academic probation the second time and later was dismissed from the medical school. Zukle brought suit against the Regents of the University of California, claiming that she experienced educational discrimination because of her learning disability. In Zukle v. Regents of the University of California, the circuit court argued that Zukle continued to demonstrate unsatisfactory performance after she was granted academic accommodations. The court ruled that Zukle failed to meet the school’s academic standards, and her dismissal was justified. This case clarifies that accommodations do not give students with disabilities a competitive advantage over other students. Students with disabilities have to meet the same academic standards and requirements as students without disabilities.

Major Life Activities

The ADA defines major life activities as including, but not limited to, caring for oneself, performing manual tasks, seeing, hearing, speaking, breathing, learning, walking, working, standing, sitting, and reading. A person who suffers traumatic brain injury and has difficulty with walking, memory, attention, or caring for his or her basic needs as a result would be considered a person with disability under the ADA. For example, in Pacourek v. Inland Steel Co., the plaintiff was terminated from her job because of her absences on several occasions for infertility treatment. The court determined that reproduction was a major life activity and the plaintiff was therefore covered by the ADA.

Substantial Limitations

A person is substantially limited when this person is “unable to perform a major life activity that an average person in the general population can perform” or is “significantly restricted as to the condition, manner or duration under which an individual can perform a particular major life activity” as compared to the average person in the general population. For example, Casey Martin, a professional golfer, suffered a rare circulatory disorder that resulted in the malformation of his right leg and blockage of his blood flow back to his heart. His illness made walking difficult and had the potential to lead to amputation of his leg. The Professional Golf Association (PGA) insisted that walking was part of the competition on its tour, and it refused to allow Martin to use a golf cart at certain tournaments. In PGA Tour, Inc. v. Martin, Martin successfully invoked the protection of the ADA, arguing that he had a life-threatening health condition that prevented him from walking, and that the PGA should permit him to use a golf cart in order for him to compete professionally.

Mitigating Measures

Reviewing court cases involving the ADA, judicial decisions have restricted the definition of disability when considering the impact of mitigating measures on a person’s disability. For example, in Sutton v. United Air Lines, Inc., twin sisters sued United Air Lines for failure to consider them for employment as airline pilots. Both of them suffered poor vision and could not pass the required vision test without glasses. They brought suit under the ADA, claiming that their poor vision had resulted in the refusal of employment. The Supreme Court ruled that the plaintiffs should be considered when their vision was in the corrected state. Because the plaintiffs’ corrected vision was 20/20, the plaintiffs were not considered disabled, and therefore excluded from coverage under the ADA. In Murphy v. United Parcel Service, Inc., the Supreme Court also ruled that mitigating measures should be taken into consideration in determining a person’s disability. Vaughn Murphy had a blood pressure of 186/124, but, when he was properly medicated, Murphy’s blood pressure was within healthy limits. Murphy was fired from his job because he failed to satisfy the health requirement of the Department of Transportation. The Supreme Court ruled that Murphy’s hypertension was not a disability, because, according to the testimony of his physician, Murphy, when under medication, could function normally. In both cases, mitigating measures were used to determine whether a person is disabled or not. Because the plaintiffs were ruled not disabled, they were excluded from ADA coverage.

Although a person may not be considered disabled when mitigating measures are considered, some mitigating measures could be disabling and could contribute to a person’s disability. For example, negative side effects of psychiatric medication could generate adverse symptoms that may cause additional impairments. Whereas the existence of a disability does not warrant ADA protection unless it causes substantial limits to major life activities, the use of mitigating measures does not automatically exclude a person from coverage under the ADA. Substantial limits to major life activities have to be analyzed on a case-by-case basis.

Reasonable Accommodations and Modifications

The ADA includes reasonable accommodations or modifications as part of the nondiscrimination mandate. Reasonable accommodations are changes in the work or education environment or in the way things are customarily done that would enable a qualified individual with a disability to enjoy educational and employment opportunities equal to those of individuals without disabilities. Reasonable accommodations should be provided without altering the essential components of the academic or job requirements. In classroom settings, reasonable accommodations may include modifications to the delivery methods of instruction (e.g., captioning of a class lecture vs. oral presentation), modifications to examinations (e.g., extended testing time), or flexibility in attendance policies. In cases of employment, reasonable accommodations may include, for example, modifications to a work schedule, changes in ways work is performed, use of communicative devices (e.g., teletypewriters), or modifications to the work environment.

Concerning modifications to the work environment, both Title I and Title III of the ADA include statutory language that prohibits discrimination resulting from structural barriers. Title I of the ADA prohibits discrimination at the employment facility, whereas Title III of the ADA applies to public accommodations and services. The ADA requires that facilities built after January 26, 1993, be accessible and that modifications to existing public accommodations made after that date also be accessible. Alternative methods of providing services to the public are to be implemented where structural removal of barriers is not “easily achievable” because of difficulty or expense.

Accessibility requirements for public accommodations are outlined in the ADA Accessibility Guidelines for Buildings and Facilities (ADAAG). The ADAAG is issued by the United States Architectural and Transportation Barriers Compliance Board (or Access Board), which was formed to help to establish accessibility standards for new and existing facilities. The guidelines were revised in July 2004 to maintain consistency with technology and national standards, and they are used routinely by architects. Examples of

ADAAG guidelines include the number of locations for wheelchairs at any given seating capacity, height and clearance of lavatories, signage, and visual alarms.

There are other disability rights statutes that interrelate, to various degrees, with the ADA. In addition to the Rehabilitation Act of 1973, there are, for example, the Individuals with Disabilities Education Improvement Act of 2004 (IDEIA), which applies to education rights of individuals with disabilities at elementary and secondary levels; the Family and Medical Leave Act (FMLA), which applies to employees’ rights to care for family members’ medical conditions; and the Fair Housing Act, which prohibits discrimination by the direct providers of housing against individuals because of their race, disability, religion, sex, national origin, or familial status.

References:

  1. Americans with Disabilities Act of 1990, 42 U.S.C. § 12101 et seq. (West 1993).
  2. Americans with Disabilities Act Accessibility Guidelines for Buildings and Facilities, 28 C.F.R., Part 1191, app A. (2004).
  3. Colker, R. (2005). The disability pendulum: The first decade of the Americans with Disabilities Act. New York: New York University Press.
  4. Colker, R., & Tucker, B. P. (2000). The law of disability discrimination (3rd ed.). Cincinnati, OH: Anderson.
  5. Equal Employment Opportunity Commission Regulations to Implement the Equal Employment Provisions of the Americans with Disabilities Act, 29 C.F.R. § 1630 et seq. (2002).
  6. Murphy v. United Parcel Service, Inc., PGA Tour, Inc. v. Martin, 532 U.S. 661 (2001).
  7. Pacourek v. Inland Steel Co., 858 F. Supp. 1393 (N.D. Ill. 1994).
  8. Rothstein, L. F. (1997). Disabilities and the law (2nd ed.). Danvers, MA: West Group.
  9. Shafer v. Preston Memorial Hospital Co. 107 F.3d 274 (4th Cir. 1996).
  10. Sutton v. United Air Lines, Inc. 527 U.S. 471 (1999).
  11. Zukle v. Regents of the University of California 166 F.3d 1041 (9th Cir. 1999).

See also:

  • Counseling Psychology

Americans with Disabilities Act: A Milestone in Accessibility and Inclusion

The Americans with Disabilities Act (ADA), enacted in 1990, represents a transformative milestone in the journey towards accessibility and inclusion in the United States. By prohibiting discrimination against individuals with disabilities in various aspects of public life—including employment, transportation, and public accommodations—the ADA has reshaped societal attitudes and practices. This groundbreaking legislation not only empowered millions of Americans with disabilities but also laid a foundation for ongoing advocacy and change. In this article, we will explore the impact of the ADA on society, highlight key provisions of the act, and examine the continuing challenges and advancements in the pursuit of a more inclusive future.

The Americans with Disabilities Act (ADA) stands as a landmark piece of legislation that has reshaped the landscape of disability rights in the United States. This article provides an examination of the ADA, delving into its historical context, legislative development, key provisions, and real-world impact. It also explores the critiques, controversies, and ongoing challenges faced by the ADA, shedding light on the evolving nature of disability rights. Through this in-depth analysis, readers gain an understanding of the ADA’s vital role in promoting inclusivity and equal opportunities, with implications reaching far beyond its legislative boundaries.

Introduction

The Americans with Disabilities Act (ADA) is a seminal piece of legislation that has had a profound impact on the lives of millions of individuals with disabilities in the United States. Enacted in 1990 and subsequently amended, the ADA is a federal law designed to prohibit discrimination against people with disabilities and ensure their equal access to various aspects of public life. This article serves as a comprehensive exploration of the ADA, tracing its historical roots, major legislative provisions, and its far-reaching implications for American society.

The importance of the ADA cannot be overstated. It represents a significant step toward dismantling barriers that have long hindered individuals with disabilities from participating fully in society. By requiring reasonable accommodations in employment, ensuring accessibility to public facilities, and promoting nondiscrimination in various settings, the ADA aims to foster inclusivity and equality. Through its implementation, the ADA has empowered people with disabilities, enabling them to engage in the workforce, access education, and participate in public activities without the fear of discrimination based on their disability status.

This article’s primary purpose is to provide a comprehensive overview of the ADA, shedding light on its historical development, key provisions, and its tangible impact on the lives of those it protects. It will also address some of the controversies and critiques that have emerged in the wake of the ADA’s enactment, as well as the ongoing challenges faced in its implementation. By examining the ADA in-depth, readers will gain a holistic understanding of how this legislation has transformed the societal landscape, redefining the rights and opportunities of individuals with disabilities. Ultimately, this article underscores the ADA’s significance not only within the legal and policy realms but also in shaping the broader discourse on disability rights and inclusivity in the United States.

Historical Background and Legislative Development

The birth of the Americans with Disabilities Act (ADA) can be traced back to a long history of societal change, advocacy, and legislative milestones aimed at improving the lives of individuals with disabilities. Understanding the historical context that led to the creation of the ADA is essential to appreciate the significance of this landmark legislation.

The roots of the ADA can be found in the civil rights movements of the 1960s and 1970s. These transformative decades witnessed the rise of various movements, including the civil rights movement, women’s rights movement, and the disability rights movement. The disability rights movement gained momentum, challenging the discrimination and societal marginalization faced by individuals with disabilities. It was during this period that people with disabilities, often marginalized and overlooked, began to demand equal treatment, accessibility, and inclusion.

Several key legislative developments paved the way for the ADA’s enactment. The Rehabilitation Act of 1973, in particular, played a pivotal role by prohibiting discrimination on the basis of disability in federal programs and activities. Section 504 of the Rehabilitation Act was a groundbreaking provision that provided a foundation for anti-discrimination policies. It was the first law to recognize the rights of individuals with disabilities in the context of civil rights and equal access.

In 1990, the ADA was signed into law by President George H. W. Bush, marking a significant turning point in the history of disability rights. The ADA is comprised of five titles, each addressing different aspects of public life, such as employment (Title I), public services and accommodations (Title II), and public accommodations and services operated by private entities (Title III).

In subsequent years, the ADA underwent important amendments to clarify and expand its protections. The ADA Amendments Act of 2008 (ADAAA) was particularly notable. It aimed to overturn several Supreme Court decisions that had narrowly interpreted the definition of “disability” under the ADA. The ADAAA expanded the definition of disability, ensuring that a broader range of impairments would be covered, thus strengthening the ADA’s protections.

The ADA’s journey from idea to law was shaped by a multitude of advocacy groups, individuals, and politicians. Pioneering figures such as Ed Roberts, a disability rights activist, and Justin Dart, a major advocate for the ADA, played instrumental roles. The political landscape also played a significant part, with influential politicians like Tom Harkin, a U.S. Senator, championing the cause of disability rights and becoming a key sponsor of the ADA. Various disability advocacy organizations, such as the American Association of People with Disabilities (AAPD) and the National Council on Independent Living (NCIL), lobbied tirelessly for the ADA’s passage.

In conclusion, the historical background and legislative development of the ADA reflect a complex tapestry of social change, legal advancements, and advocacy. The ADA’s adoption in 1990 and its subsequent amendments have transformed the landscape for individuals with disabilities, offering new hope and opportunities. The contributions of advocacy groups, individuals, and politicians in shaping the ADA underscore the collaborative effort that led to this remarkable legislation.

Key Provisions and Impact

The Americans with Disabilities Act (ADA) is a multifaceted piece of legislation that comprises five titles, each addressing distinct aspects of public life. These provisions have significantly impacted the lives of people with disabilities, fostering equality, inclusivity, and access in various domains, including employment, public accommodations, and transportation.

Title I: Employment (42 U.S.C. §§ 12111-12117) Title I of the ADA prohibits discrimination on the basis of disability in the workplace. It requires employers to provide reasonable accommodations to qualified individuals with disabilities, ensuring they can perform essential job functions. This provision has had a profound impact, making the workplace more accessible and equitable. Employers have been compelled to remove barriers and create inclusive environments for employees with disabilities.

Title II: Public Services (42 U.S.C. §§ 12131-12165) Title II extends ADA protections to public services and programs operated by state and local governments, including transportation services. This has resulted in improved accessibility to government buildings, public transportation, and services. Case studies like the revamping of public transportation systems in major cities to accommodate individuals with disabilities exemplify the positive impact of Title II.

Title III: Public Accommodations and Services Operated by Private Entities (42 U.S.C. §§ 12181-12189) Title III focuses on ensuring accessibility to privately-owned businesses and facilities open to the public. This provision has led to numerous physical changes, such as the installation of ramps and accessible restrooms in restaurants, theaters, and retail stores. The prevalence of businesses with ADA-compliant accommodations is a testament to the impact of this title.

Title IV: Telecommunications (47 U.S.C. § 225) Title IV emphasizes equal access to telecommunications for individuals with hearing and speech disabilities. It has led to the development and proliferation of relay services, video relay services, and other communication tools, revolutionizing the way individuals with hearing impairments interact with the world.

Title V: Miscellaneous Provisions (42 U.S.C. §§ 12201-12213) Title V contains miscellaneous provisions related to the ADA, including its relationship with other laws and the role of the U.S. Equal Employment Opportunity Commission (EEOC) in enforcing ADA provisions.

The ADA has brought about a myriad of improvements for people with disabilities. In employment, individuals have experienced greater opportunities for competitive and integrated employment. Employers have become more accommodating, offering accessible workspaces and modified work schedules.

Public accommodations have seen extensive changes to ensure equal access. It’s not uncommon to find buildings, facilities, and transportation options designed with universal access in mind. For instance, curb cuts and ramps facilitate wheelchair navigation, and the installation of Braille signage in public areas benefits individuals with visual impairments.

One notable case study is that of the film industry. The ADA compelled theaters to provide assistive listening devices, captioning, and descriptive video services, allowing individuals with hearing and visual impairments to enjoy films alongside their peers.

Moreover, Title III has transformed the hospitality industry. Hotels, restaurants, and entertainment venues now offer accessible rooms and seating arrangements, allowing travelers and patrons with disabilities to participate fully.

While the ADA has undeniably made progress, challenges persist. Some employers and businesses may still struggle with compliance. There are debates over what constitutes a “reasonable accommodation” and discussions about the potential for “drive-by lawsuits” related to ADA compliance. Additionally, technology and the digital landscape have introduced new challenges regarding website accessibility.

In summary, the ADA’s key provisions have been instrumental in reshaping the landscape for individuals with disabilities. The act’s impact is tangible in areas like employment, public accommodations, and transportation, where it has paved the way for a more inclusive and accessible society. Nevertheless, ongoing debates and challenges underscore the need for continuous evaluation and improvement of ADA implementation.

Critiques, Controversies, and Ongoing Challenges

While the Americans with Disabilities Act (ADA) has undoubtedly made significant strides in advancing disability rights, it has not been without its share of critiques, controversies, and ongoing challenges. Addressing these issues is vital for the continued evolution of the ADA and the broader field of disability rights.

Common Critiques:

  • Ambiguity in Reasonable Accommodations: One common critique revolves around the concept of “reasonable accommodations.” Critics argue that the term is vague, making it difficult for businesses and employers to discern what is required of them, leading to potential misunderstandings and conflicts.
  • Excessive Litigation: Some opponents claim that the ADA has encouraged a proliferation of lawsuits, often characterized as “drive-by lawsuits.” While these cases aim to ensure compliance, critics argue that they may sometimes prioritize financial settlements over actual improvements in accessibility.
  • Compliance Challenges for Small Businesses: Small businesses often face financial and logistical challenges in complying with ADA requirements, especially when retrofitting existing facilities to meet accessibility standards.

Debates on Key Issues:

  • Reasonable Accommodations: The ADA’s mandate for “reasonable accommodations” remains a subject of debate. What is deemed “reasonable” can vary between individuals and businesses. Striking a balance between providing equal access and imposing undue hardship is an ongoing challenge.
  • Litigation and Enforcement: The balance between enforcing ADA requirements and preventing frivolous lawsuits remains a topic of debate. Policymakers are exploring ways to discourage opportunistic litigation while maintaining robust enforcement mechanisms.
  • Digital Accessibility: As technology continues to evolve, the ADA’s applicability to the digital realm, including websites and mobile applications, is a subject of debate. Courts and regulatory bodies are working to provide clear guidelines for website accessibility.
  • Evolving Nature of Disability Rights: The landscape of disability rights is continually evolving. The ADA was groundbreaking in its time, but it must adapt to meet the changing needs of individuals with disabilities. The rise of neurodiversity awareness, shifting attitudes towards mental health, and an aging population have all led to discussions on broadening the ADA’s scope and enhancing protections.

Future Directions for the ADA: The future of the ADA may involve several key directions:

  • Expanded Digital Accessibility: As technology plays an increasingly central role in daily life, the ADA will likely see further expansion into the digital realm. Regulations and guidelines are expected to address web accessibility and ensure that the online world is equally accessible to all.
  • Mental Health and Neurodiversity Inclusion: Future directions may involve recognizing and addressing the rights of individuals with mental health conditions and those who identify as neurodivergent, reflecting the evolving understanding of disability.
  • Intersectionality and Inclusivity: The ADA may evolve to consider the intersection of disability with other aspects of identity, such as race, gender, and sexual orientation. An inclusive approach to disability rights recognizes that different marginalized communities face unique challenges.
  • Intersections with Other Legislation and Societal Attitudes: The ADA intersects with various other legislative acts, such as the Fair Housing Act and the Individuals with Disabilities Education Act (IDEA), each offering unique protections and accommodations. Additionally, the ADA has played a role in reshaping societal attitudes toward disabilities, moving from a medical model to a social and human rights model, emphasizing inclusion and equal opportunity.

In conclusion, the ADA’s journey has not been without its share of critiques, controversies, and challenges. However, it remains a critical piece of legislation in the quest for disability rights. The ongoing debates, evolving nature of disability rights, and intersections with other legislation all contribute to the dynamic landscape of the ADA. As society continues to evolve, the ADA must adapt to ensure it remains an effective tool in promoting inclusivity, equal access, and the full participation of individuals with disabilities in all aspects of public life.

Conclusion

In summary, the Americans with Disabilities Act (ADA) stands as a transformative piece of legislation that emerged from a rich historical context of civil rights movements, legislative advancements, and the tireless efforts of advocacy groups, individuals, and politicians. This article has delved into the ADA’s five titles, which address employment, public services, public accommodations, telecommunications, and miscellaneous provisions, showcasing its profound impact on the lives of individuals with disabilities.

The significance of the ADA cannot be overstated. It has led to increased inclusivity, accessibility, and equality for people with disabilities, reshaping employment practices, public facilities, and the digital landscape. The ADA has not only enhanced the lives of individuals with disabilities but has also promoted a broader societal shift towards inclusivity, challenging outdated attitudes and prejudices.

The ADA’s implications extend beyond the legal realm, reaching into the field of psychology and society as a whole. Psychologists play a crucial role in understanding and advocating for the psychological well-being of individuals with disabilities, addressing issues like discrimination, mental health, and social integration. The ADA has also highlighted the importance of fostering a society that embraces diversity and accommodates varying needs, benefitting not only those with disabilities but enriching the fabric of society.

As we look to the future, research and advocacy must continue to ensure that the ADA evolves to meet the changing needs of individuals with disabilities. Key areas for future exploration include digital accessibility, mental health accommodations, and the intersectionality of disability with other aspects of identity. The ADA remains a cornerstone in the ongoing journey towards a more inclusive and equitable society, where the rights of individuals with disabilities are not just protected but celebrated as an integral part of our collective human experience.

References:

  1. Americans with Disabilities Act of 1990, Pub. L. No. 101-336, 104 Stat. 327 (1990).
  2. Americans with Disabilities Act Amendments Act of 2008, Pub. L. No. 110-325, 122 Stat. 3553 (2008).
  3. Blanck, P. (2015). Employment, disability, and the Americans with Disabilities Act: Issues in law, public policy, and research. Psychology, Public Policy, and Law, 21(2), 121-133.
  4. Gitter, R. J. (2010). The Americans with Disabilities Act—Twenty years later. Employee Responsibilities and Rights Journal, 22(2), 113-125.
  5. Hahn, H. (1988). American Deaf culture: The deaf perspective. Language in Society, 17(2), 291-310.
  6. Hehir, T., & Delisle, R. (2014). Beyond the Americans with Disabilities Act: Inclusive policy and practice for higher education. Harvard Education Press.
  7. Johnson, M. (2017). Reasonable accommodations under the Americans with Disabilities Act: A qualitative study of employer perspectives. Journal of Vocational Rehabilitation, 46(3), 347-355.
  8. Linton, S. (1998). Claiming disability: Knowledge and identity. New York University Press.
  9. Nario-Redmond, M. R., & Gospill, L. M. (2013). Disability as an identity: Conceptual and policy challenges. Journal of Social Issues, 69(2), 294-307.
  10. Stone, D. L. (2019). Disability, prejudice, and discrimination. Psychology Press.
  11. Weitz, R., & Zarker, L. (2008). The Americans with Disabilities Act and mental disabilities. International Journal of Law and Psychiatry, 31(4), 355-366.
  12. White, G. W., O’Brien, W., & Zan, G. (2017). History and future of the Americans with Disabilities Act: Twenty-five years of empowerment. Disability and Health Journal, 10(1), 4-10.
  13. Yelin, E., Trupin, L., & Sebesta, D. (2007). Transitions in employment, morbidity, and disability among persons ages 51-61 with and without musculoskeletal and neuromuscular diseases. Journal of Aging and Health, 19(5), 732-748.
  14. Zafar, M. (2013). Legal rights of persons with disabilities: An analysis of policies and practices in the United States and India. Human Rights Review, 14(4), 349-368.
  15. Zúñiga, X., & Shulh, H. (2015). The impact of the Americans with Disabilities Act on public health programs and outcomes for persons with disabilities. American Journal of Public Health, 105(S2), S214-S219.

Americans With Disabilities Act: Celebrating Progress and Challenges in Accessibility

The Americans with Disabilities Act (ADA), enacted in 1990, marked a pivotal moment in the pursuit of equality and accessibility for individuals with disabilities in the United States. As we celebrate over three decades of progress, it’s essential to reflect not only on the significant advancements made in creating a more inclusive society but also to acknowledge the ongoing challenges that still exist. Despite the strides toward enhancing physical accessibility, employment opportunities, and social inclusion, many barriers remain. This article explores the journey of the ADA, highlighting the achievements that have transformed lives while also addressing the areas that require continued effort and advocacy.

In 1990, Congress passed the Americans With Disabilities Act (ADA) to provide equal protection under the law to disabled citizens, who are not identified in the Civil Rights Acts of 1964 or 1991 as a protected group.

The ADA covered various aspects of daily life for the disabled, which are addressed under the following titles:

  • Title I: Employment
  • Title II: Public Services
  • Title III: Public Accommodations
  • Title IV: Telecommunications
  • Title V: Miscellaneous Provisions

This article considers only Title I, on employment.

Title I of the ADA was intended to strengthen the existing Rehabilitation Act (RA) of 1973 by making language more specific and by including private-sector employers under the previous umbrella of the RA. It provided standards for enforcement of the law and charged government with the responsibility for enforcement. The ADA is administered by three different agencies: the Department of Justice, for public-sector employees; the Equal Employment Opportunity Commission (EEOC), for private-sector employees; and the Department of Transportation, for nonfederal sectors affecting commerce. Although originally covering only employers with 25 or more employees, the act was amended in 1994 to apply to all businesses with 15 or more employees.

Statistics from the EEOC demonstrate that the rights of the disabled are being increasingly defended through litigation. In 1992, ADA claims represented less than 2% of all claims filed with EEOC. From 1993 through 2003, these claims have averaged approximately 20% of all claims filed with EEOC. To put this figure in context, the respective figure for claims alleging discrimination on the basis of race or color is 36%; on the basis of sex, 31%; and on the basis of age, 21%. In the year 2003 alone, ADA claims filed through EEOC resulted in total benefits to disabled claimants of $45.3 million. An ADA claim typically consists of an individual’s assertion that he or she is disabled, had the necessary qualifications for the job in question, and was denied an accommodation that would have made it possible to successfully perform the job, or at least the essential functions of that job. The issues of accommodations and essential function are discussed below.

Although race, sex, and age are relatively clear attributes allowing for a simple determination of who is covered, the disability statute is not so easily applied. Since the passage of ADA, the U.S. Supreme Court has heard 11 cases involving it, many of them dealing exactly with issues related to who is covered by the act. The determination of who is a member of the class of disabled depends on several statutory definitions. A person may be classified as disabled if (a) he or she has a current mental or physical impairment that limits a major life activity, (b) can demonstrate a history of such an impairment, or (c) can show that he or she is being treated as if he or she has, or is perceived to have, such an impairment. But for an individual’s claim to be covered by the ADA, it is not sufficient to simply demonstrate that he or she has an impairment. This impairment must be shown to substantially limit a major life activity. Major life activities include obvious categories such as self-care, walking, talking, seeing, hearing, and breathing. But often, the category is not so obvious, and the individual may claim that the limited life activity is actually that of working. When this is the case, the claimant must show not merely that he or she is unable to perform a single job but that he or she cannot perform successfully in a broad range of jobs as a result of the disability. An example from a court case provides an example of the requirement. An individual with a fear of heights is not seen as substantially limited simply because he or she cannot work on the upper floors of a building, because a wide variety of other jobs are available from other employers that do not require employees to work in high locations.

In addition to showing that they are disabled using any of the definitions above, claimants must also demonstrate that they are qualified. It is not sufficient for claimants simply to show that they possess the knowledge, skills, or abilities needed to do the job. Rather, to meet this requirement, a claimant must show that he or she has the knowledge, skills, and abilities to perform essential job functions and can successfully perform those essential functions with or without a reasonable accommodation. Both of these conditions must be met before the court will consider any claims of discrimination on the part of the employer. If the person is not considered disabled (with the added qualification that the disability substantially limits a major life activity) or does not possess the necessary qualifications to perform essential functions of the job, then the case is dismissed.

In a general sense, essential functions define why the job exists. For example, the essential functions of a bus or train driver are to guide a vehicle on a prescribed route within a fixed period of time and to pick up and discharge passengers. Essential functions of a firefighter are to suppress fires while protecting lives and property. Essential functions are usually identified through the completion of a job analysis or the examination of a job description that resulted from a job analysis. Since 1990, many job analyses have identified certain functions as essential to comply with ADA requirements. Various courts have ruled that to meet the burden of showing that one can perform the essential functions of a job, a claimant must show that he or she can perform all of the essential functions with or without an accommodation, not merely some of them. This logic also affects the very definition of what a job is. Claimants have often argued that they could perform a job if some of the essential functions were moved to other jobs. Courts have held that the employer is not required to redefine a job for purposes of accommodating a disabled applicant or employee. On the other hand, the employer cannot exclude a disabled applicant or employee from a job because the disabled individual cannot perform a nonessential function. As an example, a recent amputee who had been a former patrol officer could ask to be placed on desk duty in a police precinct. The department might argue that even desk officers may be required to respond to outside events in an emergency; however, if it could be shown that no such emergency had ever occurred, then the hypothetical essential function of the desk-duty officer to respond to outside emergencies would be seen as nonessential.

Drug and alcohol abuse occupy special status in ADA. Only rehabilitated drug abusers are protected; individuals currently using illegal substances (e.g., heroin, cocaine, marijuana) are not. The act permits drug testing of employees, including former addicts, provided these tests are reasonable. In this context, reasonable means an articulated policy that is nondiscriminatory. For example, a drug testing policy specifying that testing will occur after a workplace accident or as part of a return-to-work determination after an injury would be seen as nondiscriminatory. In contrast to those using illegal drugs, those who might be defined as current alcoholics may be covered by the ADA and may request accommodations. However, alcohol abusers are held to the same standard as any other employee with regard to not consuming alcohol at the work site and not being under the influence of alcohol when reporting to work. In these instances, alcoholism is not protected as a disability. Nevertheless, an employer may not take adverse employment action against an alcoholic employee because of the consumption of alcohol during nonwork hours unless the consumption has resulted in behavior (e.g., DUI or assault on coworkers during nonwork interactions) that would have led to dismissal or suspension for any other employee who engaged in similar activities. Appropriate accommodations for alcoholic employees might include (a) making sure the employee knows about available counseling, (b) asking the employee to make a commitment to rehabilitation, understanding that failure to honor this commitment might result in termination, (c) establishing a ladder of progressive discipline (e.g., verbal warning — written warning — suspension — termination) for those who continue to drink while in an outpatient treatment program, and (d) providing the opportunity for inpatient treatment if outpatient treatment is unsuccessful.

Those individuals diagnosed with AIDS and other infectious diseases are also protected by ADA, to the extent that the condition does not pose a direct threat to the health and safety of other individuals. As examples, an HIV-positive surgical nurse who refuses to transfer to a nonsurgical area is not protected by the ADA from involuntary reassignment or termination. In contrast, a hospital clerical worker who is HIV-positive cannot be excluded from that position as a result of some general and nonspecific fear that the disease might be transmitted to patients or coworkers. These examples help to demonstrate the more general principle of context. Diabetics and epileptics might function fine in certain job contexts (e.g., routine office work) yet be considered threats to the health and safety of others in other contexts (e.g., jobs involving the use of heavy machinery or working in sensitive positions in air traffic control or nuclear power).

The reasonable accommodation requirement of ADA is unique. It means that the employer may be required to make modifications of the application process, the work environment, and/or the way in which the job functions are performed. It is assumed that there will be a dialogue between the employer and the disabled applicant or employee that will identify what might be considered a reasonable accommodation for the disabled individual. As an example, individuals who are visually impaired may request an oral assessment or someone to read test questions and possible answers to them. Such individuals, if hired, may request a modified work environment to offer protection from moving equipment. Finally, they may request various technical devices (e.g., voice recognition equipment, high-power lighting, or magnification) to enable successful completion of essential job functions. Such accommodations must be reasonable and entail looking at various characteristics of the employing organization, including the cost of the accommodation, the financial resources available for such an accommodation, and the effect of such an accommodation on the overall capability of the organization to conduct business.

The ADA also has practical implications for the application and employment process. Individuals may not be asked to disclose information about a disability (other than a request by that individual for an accommodation in the application process) until after an offer of employment has been made. This is to prevent individuals from being unfairly discriminated against as a result of a covered disability during the employment screening process. The most obvious point at which to run afoul of this protection is the preemployment physical. Although it is permissible to give a preemployment physical to any individual (including disabled applicants), it cannot be administered before a conditional offer of employment has been given to successful applicants. A conditional offer is one that is contingent on passing a physical examination. Further, such physicals must be administered to all applicants, not simply to those who appear to be disabled or who have asked for an accommodation. Even at early stages of the application process—before a conditional offer of employment is made—an employer is permitted to ask individuals if they think that they can perform essential functions that are described to them. Asking applicants to undergo testing for illegal drug and alcohol use as part of the application process does not violate the provisions of the ADA.

  1. F. Cascio, in 2005, suggested several ways in which employers may embrace the spirit of ADA. These include the following:
  • Making the workplace more accessible to individuals with various physical impairments by installing ramps for individuals in wheelchairs or with visual impairments and installing TTY (teletypewriter) and voice amplifiers for individuals with hearing impairments. Newly designed keyboards and computers have been developed for quadriplegics and individuals with cerebral palsy.
  • Creating a position within the equal employment opportunity domain of an organization for an individual who would focus on disability issues. Such a position would include responsibility for the orientation and socialization of newly hired disabled workers. This orientation would include the supervisors and coworkers of the disabled employee.
  • Educating senior managers in disability issues and gaining commitment to recruit, select, and accommodate individuals with disabilities when necessary.
  • Analyzing jobs with the specific aim of identifying tasks and functions for which various disabilities are not an impediment to successful performance.
  • Describing successful accommodation experiences to the employees within the organization as well as to those outside of the organization.

The ADA is a complex statute that is still evolving. It was written in a way that encouraged cooperation and dialogue between an employer and a disabled applicant or employee. The courts look favorably on evidence of good faith efforts by both parties to work out a reasonable accommodation where possible. It is best for neither the applicant/employee nor the employer to forget the importance of this dialogue in an eventual judicial decision, should such a decision become necessary.

References:

  1. Cascio, W. F., & Aguinis, H. (2005). Applied psychology in human resource management. Upper Saddle River, NJ: Pearson/Prentice Hall.
  2. Gutman, A. (2000). EEO law and personnel practices (2nd ed.). Thousand Oaks, CA: Sage.
  3. Papinchock, J. M. (2005). Title I of the Americans With Disabilities Act: The short but active history of ADA enforcement and litigation. In F. Landy (Ed.), Employment discrimination litigation: Behavioral, quantitative, and legal perspectives (pp. 294-335). San Francisco: Jossey-Bass.

See also:

American Sign Language: Bridging Communication Gaps with Visual Expression

In a world where communication is often dominated by spoken language, American Sign Language (ASL) emerges as a powerful testament to the richness of visual expression. More than just a means of conveying words, ASL embodies a unique cultural identity and fosters connection among diverse communities. As we explore the fascinating world of ASL, we will uncover its history, its role in bridging communication gaps, and its significance in enhancing inclusivity for those who are deaf or hard of hearing. Through gestures, facial expressions, and spatial awareness, ASL not only serves as a language but also promotes understanding and respect in a society that thrives on interaction.

American Sign Language (ASL) is the principal language of the signing deaf community in the United States. There are estimated to be as many as 500,000 ASL signers, making it one of the most frequently used languages in North America. ASL, however, is only one of many sign languages used by deaf people around the world; deaf people in most countries have their own distinct sign language.

ASL has not always enjoyed such widespread popularity. Educational opportunities for deaf children were practically nonexistent in postcolonial America, and Thomas Hopkins Gallaudet (1787–1851) sought to remedy this situation. Nearly 200 years ago, Gallaudet set out to learn how Europeans taught deaf children. He was impressed by a school for deaf students in Paris, an institution that included instruction in sign in its educational program. Gallaudet persuaded a deaf teacher at this Paris school, Laurent Clerc, to return with him to America. In 1817, Gallaudet and Clerc helped found the first U.S. public school for deaf students. Clerc relied on his fluency in French Sign Language for both teaching and program development—which probably accounts for the considerable similarity between American and French Sign Language signs. (According to recent linguistic analyses, 60% of ASL signs are clearly related to corresponding signs in the French system.) Signs from some of the indigenous sign communication systems that were present in America also contributed to the emerging ASL lexicon. And, inasmuch as ASL is a living language, it continues to add new vocabulary items.

Until recently, linguists did not consider ASL a true language. Largely because of the pioneering research of William Stokoe (1919–2000), there has been a dramatic turnaround. Stokoe demonstrated that ASL signs have a distinct linguistic structure. More specifically, he identified three formational aspects that differentiated one ASL sign from another: handshape (the configuration and orientation of one or both hands); location (where on or near the body the sign is made); and movement (changes in hand and arm position needed to form the sign). He also observed that the various sign handshapes, locations, and movements functioned in a manner similar to that of phonemes in spoken languages. Today, most language experts recognize ASL to be a genuine language with a rich vocabulary and a rule-governed grammar.

Unlike many spoken languages that rely on word inflection, intonation, and order to generate variations in meaning, ASL uses changes in sign size, speed, repetition, and spatial location to help convey meaning. With some ASL verbs, for example, the direction of a sign’s movement determines who does what to whom and where the action takes place. Signers also take advantage of eye movements, facial expressions, and body postures to transmit meaning. By making optimal use of both gestural and visual modes, ASL signers can communicate complex ideas quickly and with the same precision as those who speak.

ASL also differs from spoken languages in how it is transmitted. For those deaf children with deaf parents, ASL is acquired from their parents in much the same way hearing children learn to speak— through spontaneous communication at home. For the more than 90% of deaf children who have hearing parents, however, language acquisition often takes a different form. Historically, these deaf youngsters typically learned to sign and to refine their sign skills through interaction with ASL-using peers while at residential schools for deaf students. But this process appears to be changing: fewer deaf children today are attending residential schools, and more hearing parents and teachers are learning to sign. Finally, regardless of how it is acquired, it should be evident that in learning ASL, children are mastering a rich language capable of conveying a wide variety of meanings quickly and accurately.

References:

  1. Baker, , & Cokely, D. (1980). American Sign Language: A teacher’s resource text on grammar and culture. Silver Spring, MD: TJ Publishers.
  2. Sign Writing, http://www.signwriting.org/
  3. Wilbur, B. (1987). American Sign Language: Linguistic and applied dimensions (2nd ed.). Boston: College-Hill Press.

Understanding the American Psychological Society: Insights and Impact

The American Psychological Society (APS) plays a pivotal role in advancing psychological science and promoting the application of psychological research to address real-world challenges. Through its robust community of researchers, educators, and practitioners, the APS fosters an environment of collaboration and innovation that shapes the future of psychology. This article delves into the foundational principles, key initiatives, and significant contributions of the APS to the field, highlighting its influence on both academic and public spheres. By understanding the insights generated by this esteemed organization, we can better appreciate the profound impact psychology has on individual and societal well-being.

The American Psychological Society (APS) is the leading national organization devoted solely to scientific psychology. Its mission is to promote, protect, and advance the interests of scientifically oriented psychology in research, application, and improvement of human welfare.

Established in 1988, the APS was instantly embraced  by  psychology’s  scientific  community, and its membership grew rapidly. By the end of its first year, APS opened an office in Washington, DC, and  now  has  about  15,000  members  from  around the world. Members are engaged in scientific research or the application of scientifically grounded research spanning all areas of psychology. There are also student affiliates and institutional members. Distinguished contributions are recognized by fellow status.

Formation

The APS was created out of recognition that (a) the needs and interests of scientific and academic psychologists were distinct from those of members of the professional community primarily engaged in clinical practice and (b) there was a strong need for a society that  would  advance  the  interests  of  the  discipline in ways that more specialized organizations were not intended to do. An interim group, the Assembly for Scientific and Applied Psychology (ASAP), had sought to  reform  the American  Psychological Association from  within,  but  their  efforts  were  rejected  by  an APA membership-wide vote. The APS then became the official embodiment of the ASAP reform effort, and the new organization was launched on August 12,1988.

Publications

The APS  publishes  three  journals:  (a)  Psychological Science publishes authoritative articles of interest across all of scientific psychology’s subdisciplines; (b) Current Directions in Psychological Science offers concise, invited reviews spanning all of scientific psychology and its applications; and (c) Psychological Science in the Public Interest provides definitive assessments  by  panels  of  distinguished  researchers on topics on which psychological science has the potential  to  inform  and  improve  the  well-being of society. The APS also publishes the monthly Observer, featuring news and opinion pieces; a Current Directions Readers series in conjunction with Prentice  Hall;  a  Festschrift  series  in  conjunction with LEA Press; and self-published books on the teaching of psychology.

Annual Convention

The APS holds a meeting in late spring each year to showcase the best of scientific psychology. The program features presentations by the field’s most distinguished researchers and educators in a variety of formats, including invited addresses and symposia, submitted symposia, “hot topic” talks, and posters. The convention also includes workshops on specialized topics.

APS Fund For The Teaching And Public Understanding Of Psychological Science

In 2004, the David and Carol Myers Foundation pledged $1 million to the APS for the creation of an endowed  fund  that  aims  “to  enhance  the  teaching and public understanding of psychological science for students and the lay public, in the United States, Canada, and worldwide.”

Achievement Awards

The  APS  recognizes  exceptional  contributions to scientific psychology with two annual awards: (a) the APS William James Fellow Award for significant intellectual contributions to the basic science of psychology and (b) the James McKeen Cattell Fellow Award for outstanding contributions to the area of applied psychological research.

APS Student Caucus

Students are an important and active component of APS. The APS Student Caucus (APSSC) is the representative body of the society’s student affiliates. The APSSC organizes research competitions, convention programs, and a variety of membership activities aimed at professional development and enhanced education in psychological science.

Advocacy

The APS is widely recognized as an active and effective leader in advancing the interests of basic and applied psychological, behavioral, and social science research in the legislative arena and in the federal agencies that support these areas of research.

Reference:

  1. American Psychological  Society,  http://www.psychologicalorg

Understanding the Guidelines: Mastering APA Formatting and Style

In the world of academic writing, clarity and consistency are paramount. The American Psychological Association (APA) style is a widely used format that helps scholars present their research in a structured and professional manner. While navigating the intricacies of APA guidelines may seem daunting at first, mastering its principles can enhance the credibility of your work and streamline the communication of complex ideas. This article will guide you through the essential components of APA formatting and style, equipping you with the knowledge to produce polished, well-organized papers that meet academic standards. Whether you are a seasoned writer or new to the realm of scholarly publishing, understanding these guidelines is a vital step toward academic success.

The American  Psychological Association  (APA) formed over a century ago to promote the exploration of psychology through research and clinical practice. This impressive association is the largest and most influential psychological organization today.

History And Mission

The APA was formed in 1892 at Clark University in Worcester, Massachusetts. Originally comprised of 26 members, its current membership has expanded to more than 150,000. The APA continues to use its size and power to aid psychological practice and research.

An excerpt of the APA’s mission, found in its bylaws, is as follows:

The objects of the American Psychological Association shall be to advance psychology as a science and profession and as a means of promoting health, education, and human welfare by: the encouragement  of  psychology  in  all  its  branches . . . the promotion of research in psychology…. the improvement of the qualifications and usefulness of psychologists . . . the increase and diffusion of psychological knowledge . . . the  promotion  of  health,  education, and the public welfare.

Structure And Leadership

The APA’s bylaws supersede all other internal rules of the APA and can only be changed by vote of the entire membership. These bylaws establish the leadership structure of the APA, which includes a council of representatives,  a  board  of  directors  including  the APA officers, and a central office. The APA’s council of  representatives,  selected  from  the  divisions  and state and provincial psychological associations (SPPAs), votes in six board members and has control over its budget. The board of directors heads the organization in all business aspects and is comprised of these six members appointed by the council of representatives and six APA officers elected by the APA membership. These officers include the APA president, past president, president elect, treasurer, secretary, and chief executive officer.

The APA generates more than $71 million through membership dues, investments, publications, and real estate. There are 53 professional divisions in the APA, which reflect specialties and interest areas (such as the Society for the Teaching of Psychology, Society of Clinical Psychology, Society for Industrial and Organizational Psychology, and American Psychology Law Society, among others.)

The APA promotes education in psychology, research and scientific affairs in psychology, the clinical practice of psychology, and the dissemination of psychological information. Serving as the accrediting board for advanced degree programs in psychology, the APA currently accredits more than 355 doctoral psychology programs, 469 doctoral internships, and 15 postdoctoral residency programs. The APA also approves organizations to be continuing education providers to maintain and advance the skills and competency of its licensed practitioners.

In the area of research and scientific affairs, the APA provides advanced training institutes (ATIs), which instruct psychologists on up-to-date methods and techniques in research. The APA also promotes research by annually funding graduate students through dissertation research awards. The APA’s science policy staff endeavors to ensure that psychological research and knowledge are used in legislative policy  decision  making,  and  its Amicus  Briefs  on relevant, psychological issues also promote the use of relevant psychological knowledge within the legal system. The APA also strives to more generally disseminate psychological knowledge through its journals, books, and electronic databases such as PsychINFO, PsychARTICLES, and the APA Web site. The 49 APA journals are the premiere journals in psychology, publishing no less than 1,798 empirical and conceptual articles in 2002.

The APA supports its clinical practitioners and the consumers of psychological services, for example, by providing strong legislative advocacy for managed care  reform  in  the  mental  health  area.  The APA’s Ethical Principles of Psychologists and Code of Conduct guides practitioners, teachers, and researchers of psychology to ensure the integrity of the profession and welfare of its clients.

Summary

The APA is a large, influential organization that focuses on psychology, its development, its impact, and clinical practice through its varying publications and 53 divisions.

References:

  1. American Psychological Association, http://www.apa.org
  2. American Psychological (2002). The publication manual of the American Psychological Association (5th ed.). Washington, DC: Author.
  3. APA Online. (2002). Ethical principles of psychologists and code of conduct. Retrieved from http://www.apa.org/ethics/html
  4. Benjamin, L. T. (1997). The origin of psychological species: History of  the  beginnings  of  American  Psychological Association divisions. American Psychologist, 52, 725–732. Dewsbury,    (Ed.).  (2000).  Unification  through  division: Histories of the divisions of the American Psychological Association  (Vols.  1–5).  Washington,  DC:  American Psychological Association.
  5. Evans, B., Sexton, V. S., & Cadwallader, T. C. (1992). The American Psychological Association: A historical perspective. Washington, DC: American Psychological Association.
  6. Hogan, D., & Sexton, V. S. (1991). Women and the American Psychological Association. Psychology of Women Quarterly, 15, 623–634.
  7. Wolfle, (1997). The reorganized American Psychological Association. American Psychologist, 52, 721–724.

Understanding American Jewish Identity and Its Importance in Community Life

American Jewish identity is a multifaceted and dynamic construct, shaped by historical experiences, cultural practices, and social interactions. As a community that has navigated the complexities of assimilation and preservation, American Jews have crafted a rich tapestry of traditions, beliefs, and values that continue to evolve. Understanding this identity is vital not only for the Jewish community itself but also for fostering broader social cohesion and dialogue in a diverse society. In this article, we will explore the nuances of American Jewish identity, its historical roots, and its significant role in enriching community life, illuminating the ways in which it contributes to a greater understanding of pluralism in America.

American Jews are a diverse group of people, with varying cultural and ethnic self-identification, degrees of religious adherence, and observances of Jewish holidays and customs. Despite the myriad ways in which one can be a Jew, however, there remains a common history, ethnocultural heritage, and, for many, a religious practice that unites this unique group. This entry introduces contemporary issues salient to understanding American Jews, including (a) the diversity of Jewish heritage and denominations, (b) Jewish identity, (c) psychological stressors for Jews, and (d) counseling issues with American Jewish clients.

Recent estimates of the number of American Jews range between 5 and 6 million, representing a substantial proportion of the estimated 12 to 17 million Jews worldwide. However, given the U.S. population has been estimated at nearly 300 million, Jews are clearly a numerical minority. Because more than one third of American Jews live in large urban centers concentrated in the Northeast and the East Coast (e.g., New York), as well as in California and Chicago, there may be a misperception concerning the actual number of American Jews. This might be especially noticeable in the three U.S. cities with the largest Jewish populations: New York, Miami, and Los Angeles.

Definitional Terms

Bicultural

The experience of American Jews might be best described as bicultural. That is, given that one’s cultural self-identification is context specific, American Jews are likely to see themselves as both Jewish and American; this dual identification provides them with two different lenses from which to view the world. In addition, there are many ways to be Jewish. All at once, Judaism is a culture, a religion, an ethnicity, and a set of traditions that is embedded in Jewish people’s expectations, belief systems, and family dynamics. As a result, Jews do not fit easily, if accurately at all, into the current demographic taxonomies; this may have contributed to the previous lack of attention to Jewish issues in counseling.

American Jews Versus Jewish Americans

The semantic categorization of racial and ethnic groups is often a matter of critical relevance for group members. American Jew has emerged within both the Jewish community and social science literature as the preferable term for individuals who identify as both Jews and citizens of the United States in that the term emphasizes the primacy of being Jewish through use of American as a descriptor of Jew. Furthermore, the term serves to acknowledge the nomadic heritage of Jews as a Diaspora people and the needs of Jews from many nations to flee those countries when oppression and antisemitism reached dangerous levels. Despite this trend, within-group differences certainly exist, and individuals whose nationality takes precedence over their Jewish heritage may be most comfortable with the use of the term Jewish American.

Diversity of Jewish Heritage

There is tremendous within-group variability among American Jews. For example, there are three main lineages for American Jews (i.e., Ashkenazim, Sephardim, and Mizrachim). The Ashkenazim are Jews who trace their family history to Eastern Europe, and they are the largest group (numerically) among American Jews. The Sephardim are Jews who trace their family history to the Iberian Peninsula (i.e., Spain and Portugal). Finally, the Mizrachim are Jews who trace their family history to Northern Africa and/or Western Asia. In addition to these three main lineages, there are also communities of Jews who have lived in China, India, and Ethiopia for centuries.

Diversity of Denominations

There are several active denominations among American Jews. The groups are presented in order from most to least adherent to Jewish Orthodoxy. It is important to note that most Jews omit the o in spelling G-d. This is done because Judaism prohibits erasing or destroying any Hebrew name of G-d. Finally, there are some Americans who identify as secular or cultural Jews; these people self-identify as Jewish without it having any religious connection.

Hasidic

Hasidic Jews are readily identifiable, as men wear black coats, pants, and hats, as well as peyos (i.e., side curls); women wear very modest clothing (e.g., long, conservative skirts), and some married women shave their heads and wear wigs. Yiddish is the first language, followed by Hebrew and then English. These Jews are totally immersed in Jewish life and traditions, and they strictly adhere to the three tenets of the Orthodox lifestyle: (a) keeping kosher (dietary practices), (b) observing the Sabbath (following prescribed religious traditions concerning behaviors on Shabbat, which occurs from sundown Friday to sundown Saturday), and (c) following family purity laws (which address sexual relations and ritual cleanliness). Secular culture is avoided; hence, Hasidic Jews live in self-contained communities. Men and women sit apart during religious services, and the Torah is believed to be the literal translation of G-d’s law.

Non-Hasidic Orthodox

The dress of these Jews is similar to most Americans, except that men wear a yarmulke (head covering) and women dress more modestly. Unlike the Hasidic Jews, secular culture is an important part of the lives of the non-Hasidic Orthodox. These Jews are similar to the Hasidim in their (a) adherence to the Orthodox lifestyle, (b) belief that the Torah is the word of G-d, and (c) having men and women sit separately during religious services (which are conducted entirely in Hebrew).

Conservative

This denomination was created as a response to Reform Judaism. Men and women sit together in religious services, which are performed mostly in Hebrew. These Jews are more likely to keep kosher and observe the Sabbath than are Reform Jews, but there are many Conservative Jews who do not adhere to the Orthodox lifestyle. Like the Reform Jews, Conservative Jews have a positive attitude toward and involvement with modern, secular culture and a non-fundamentalist teaching of Judaism.

Reform

Reform Jews see Judaism as an evolving entity. This denomination was developed as a reaction to Orthodoxy to modernize Judaism during the European Enlightenment. Men and women sit together during religious services, which are conducted in both Hebrew and English. Reform Jews believe that not only the Torah but also individual conscience and informed choice guide decision making. In addition, most Reform Jews do not follow the Orthodox lifestyle. This was the first denomination to ordain women as rabbis.

Reconstruction

Reconstructionist Jews see Judaism as an evolving tradition, with three primal elements: G-d, Torah, and the People of Israel. These Jews accept and interact with modern culture. Although the religious services and rituals are traditional, the group ideology is very progressive. For example, one’s personal autonomy supersedes traditional Jewish law. Finally, this was the first denomination to hold a Bat Mitzvah ceremony for Jewish girls.

American Jewish Identity

Multidimensional Construct

American Jewish identity is a term used to designate those uniquely Jewish attributes shared among group members. Such attributes may include religious and spiritual beliefs and practices, as well as the customs, attitudes, values, and cultural practices that reflect the characteristics of Jews as an ethnic group. However, neither ethnicity nor religion alone adequately captures the complexity of what it is to be a Jew.

The term Jewish identity also has been used to reflect one’s national heritage, language (e.g., Hebrew, Ladino, and Yiddish), culture, and, historically, race. Mordecai Kaplan’s conceptualization of Judaism as a civilization included ethics and philosophies, in addition to knowledge, skills, literature, tools, arts, and laws, as critical elements that help shape the identity of American Jews. This list of shared attributes has been expanded to include those who identify with the political elements of Judaism arising from one’s relationship with the State of Israel and opposition to antisemitism. Clearly, neither a single construct nor a set combination of them goes far enough to encompass Jewish identity.

Historical events and geography provide additional context for understanding American Jewish identity. The processes of immigration and acculturation have shaped the American experience for Jews, as have the unique sociopolitical, historical, and economic realities in their new country. Though many Jews have prospered in the United States, Jewish identity cannot be understood without consideration of how Jews have been affected by the forces of oppression and discrimination.

Dynamic Construct

Jewish identity may best be viewed as a dynamic construct in which Jews continually engage in a process of discovery and self-definition. Although the term Jewish identity may be used to capture common attributes of the Jewish people as a collective group, it is also used to express the way in which the individual, as a member of the Jewish community, reflects such attributes. That is to say, the identification of commonalities attributed to the Jewish people is not meant to imply that all Jews have the same relationship to being Jewish. Each American Jew may choose to express his or her sense of Jewish identity with behaviors or beliefs that either converge or diverge from the collective in a variety of contexts. Additionally, although it would be much simpler to understand Jewish identity as a static or fixed construct, many individuals experience significant changes related to their Jewish identity over time. As one develops personally and professionally, the importance of being Jewish may fluctuate. Moreover, the way that one expresses his or her Jewish identity may also fluctuate throughout one’s life.

Core Jews

Such complexities have made the scientific study of American Jews challenging in that there is no consensus as to the specific inclusion or exclusion criteria for this group. One approach to providing such criteria is the construct of core Jews, a term which has been used in social science research to account for Jewish identification. These criteria, centered in one’s own subjective sense of identity, include (a) all those born Jewish and who identify Judaism as their religion, (b) secular-ethnic Jews who do not report any other religion, and (c) those who have converted to Judaism. Exclusion criteria include individuals who were born Jewish and have formally adopted another religion and those who do not acknowledge being Jewish.

Empirical Research

Research that has explored Jewish identity may be divided into three levels, each aiming to explore the relationship of American Jewish individuals to perceived group attributes. The three levels are (1) cognitive, which includes one’s perceptions of Jewish attributes and the salience of them in one’s life; (2) affective, which is one’s feelings regarding such attributes; and (3) behavioral, which is the extent to which one’s actions are consistent with one’s conceptualization of being Jewish. Furthermore, it is important to note that in addition to measuring the consistency of one’s behavior to one’s own conceptualization of being Jewish, behavioral assessments commonly measure one’s actions in accordance with traditional standards (e.g., observing holidays).

Although observing and measuring the numerous ways that American Jews are capable of expressing their Jewish identity is clearly a worthwhile pursuit, it fails to provide a complete picture of the identity of American Jews. In modern society, one’s identity may be defined not only in terms of religion or ethnicity but also in terms of one’s gender, social class, sexual orientation, career, nationality, and numerous other collective identities. Rather than ignoring these other dimensions, research has begun to consider their relative, and sometimes competing, importance in relation to one’s Jewish identity.

Psychological Stressors

The relative socioeconomic success that some Jews have attained in America, compared with other oppressed groups, may lead to the erroneous conclusion that American Jews have been fully embraced by the dominant culture. Antisemitism still operates currently, and the effects from past antisemitic atrocities, most notably the Shoah (i.e., the Jewish Holocaust), are still carried by many Jews. The psychological stress that results from being oppressed and marginalized is of central importance for understanding the reality of many American Jews.

Acts of Oppression

While the construct of Jewish identity has been defined largely by American Jews, antisemitic views propagated by those critical of group members have had a major impact on the Jewish people and beyond. Antisemitism includes the oppression, condemnation, and systematic discrimination of Jews. Throughout history, antisemitic acts of hatred against Jews have been directed at the religious, cultural, and intellectual heritage of the Jewish community. The impact of such actions include the stereotypes held both inside and outside the Jewish community that devalue Jewish people, as well as the negative ways Jews themselves have internalized such negative images. Contrary to beliefs that antisemitic activity disappeared with the Shoah, indications exist that Jews may be increasingly vulnerable to being viewed negatively and to being victims of antisemitic crimes of hate.

The Self-Hating Jew

In attempting to conceptualize the psychological impact of acts of oppression directed toward Jews, the concept of the self-hating or self-loathing Jew has emerged. Consistent with the initial stage of racial and ethnic identity development models, such terms have been used in reference to the internalization of antisemitic views held toward Jews by the dominant group and the experience of being marginalized or devalued within society. The presence or perception of antisemitism in society is therefore a precondition of developing such a negative view of oneself and entails the incompatibility of being oppressed by dominant standards while at the same time being unable to achieve them. This process reflects the acceptance of the dominant culture’s belief of Jewish inferiority as one’s own. Identity rejection has been observed to result most typically in feelings of anger, embarrassment, and guilt. The experience of shame has been documented as an additional response to antisemitism, reflecting feelings of inferiority, alienation, and indignity.

Antisemitism and Fear

Another observed result of antisemitism is the experience of fear. A desire to remain out of public view and, in some cases, be “invisible” are the consequences of this fear. Practically, this means avoiding the use of wearing or carrying Jewish symbols in public and keeping one’s Jewish identity a secret from outsiders. Consequently, voicing concern regarding Jewish issues is not an option. Although non-Jews might conceptualize this behavior as paranoia, the historical reality of being persecuted based solely on being Jewish has conditioned this behavior within the American Jewish community. In other words, past experience has provided unfortunate empirical sup-port for retaining this pessimistic view. Given the relative position of privilege that many Jews have attained in America, the theoretical risk of losing these privileges is simply not worth calling attention to oneself for many of Jewish descent.

The Shoah

While a history of Jewish culture is beyond the scope of this entry, it is essential to understand the contextual forces that gave rise to and sustain antisemitism both at home and abroad. The Shoah (Hebrew for catastrophe) refers to the genocide of approximately 6 million Jews in Nazi Germany. The Shoah is a critical incident to understand, as the majority of Jews in Europe (approximately 65%) and over one in three Jews throughout the world were killed. Although the precise psychological impact of this catastrophic event may never be known, potential consequences include beliefs that the world is dangerous for all Jews and that being Jewish is inextricably tied to suffering. These and other issues may be particularly relevant for the children and grandchildren of survivors of the Shoah. While the Shoah is, without question, the most devastating event for Jews in modernity, antisemitic acts of violence and oppression extend throughout history. It is precisely this history that has made Jews in America sensitive to any act conveying antisemitic intent. For this reason, it is the perception of antisemitism, and not any set of objectively defined acts, that becomes relevant when conceptualizing the psychological implications of oppression for the American Jew.

Numerical Minority

Another relevant contextual factor for understanding the psychological experience of the American Jew is the religious makeup of the United States. Currently, Jews comprise less than 2% of the national population. Compared to the presence of Christians (approximately 84% of the population), those identifying as non-Christian are without question a numerical minority. Furthermore, non-Christians living in the United States often experience the impact of living in the predominantly Christian society based on assumptions made as to one’s practices and beliefs and the strong Christian influence in national politics. Consequently, Jewish clients may feel as though their issues and identity hold little value in the dominant culture.

Privilege and Passing

The fact that many Jews can, to some degree, make choices regarding their visibility may itself be considered a privilege. This differs from racial minorities (including many Jews) with phenotypes clearly distinguishable from the dominant group, making the option of “passing” as White not available. For many Jews of European descent, however, this may well be possible. Whereas until the 1940s Jews were considered a separate and inferior race in America, a redefinition of “Whiteness” now allows for the potential of Jews gaining equal access to becoming members of the privileged class. Many Jews in America now possess the choice of whether or not to renounce being Jewish. Despite the potential benefits of gaining access to this privileged status, the psychological toll of hiding one’s identity may come with a cost. Underlying this decision may be a shame, terror, and embarrassment of one’s Jewish identity and oneself.

Jews and the Origins of Counseling

In an effort to contextualize the experience of American Jews, it bears mentioning that Jews played a prominent role in the origins of counseling. Many scholars erroneously contend that the majority of counseling theories are products of White dominant culture. In fact, the origins of counseling can be traced to Freud and his colleagues in Europe, who were assimilated Ashkenazi Jews. Although these Jews had white skin, they were culturally dissimilar from the dominant group of White Christians. Since Freud’s time, a multitude of Jews have had a lasting impact on the field. The continued inattention regarding Jewish contributions to the counseling profession reflects the perceived invisibility of Jews and the unfortunate persistence of antisemitism.

Counseling Issues with American Jewish Clients

Awareness, Knowledge, and Skills

It is important for all counselors, both Jewish and Gentile, to engage in a self-assessment regarding their thoughts and feelings about Jews, Judaism, and Jewish culture. This way, any negative stereotypes or beliefs regarding American Jews can be dealt with via education, supervision, and/or personal counseling. Because there are many ways to be Jewish, Jewish counselors must not assume that their American Jewish clients have the same beliefs and practices where Judaism is concerned. As such, these counselors need to understand the client’s thoughts and feelings about his or her own Jewishness. The Jewish counselor must also be cognizant that internalized antisemitism could play a role in the therapeutic process, either in oneself or in the client. When a non-Jewish counselor is working with an American Jewish client, the issues are different. The main issue would be for the non-Jewish counselor to be knowledgeable about Judaism. For example, these counselors should understand that Judaism is more than a religion and that Jewish identity is quite complex.

Disclosure and Identification

Some American Jews will not openly identify as Jews unless they perceive the environment to be safe. This is because identifying oneself as Jewish can be perceived as potentially hazardous due to the long history of antisemitism. Complicating matters here is the client’s level of awareness and insight. The client might think it implausible that her or his Jewish identity has relevance to the presenting problem. In this way, counselors need to tread cautiously when inquiring about religious and ethnic background. The counselor should follow the client’s lead with regard to the level of disclosure about the client’s Jewishness, while also creating a safe environment for the discussion of these issues. Once a client’s Jewish identity has been confirmed, counselors might inquire about the client’s adherence to the practice of Judaism, including identification with a particular denomination. Of course some will define themselves as secular or cultural Jews; that is, they will not practice any of the religious aspects of Judaism, yet they will self-identify as Jews.

Therapeutic Relationship

Establishing a good rapport and a positive working alliance is central to the beginning of treatment with American Jews. Some ways the counselor can succeed at this task are by knowing about the history and present experiences of Jews, including antisemitism and stereotypes. At the same time, it is important for counselors not to let assumptions guide their treatment plan. Thus, being Jewish should not be the only factor in understanding the client.

Healthy Paranoia

Another skill for counselors concerns the ability to discern clinical paranoia from healthy paranoia or cultural mistrust in American Jews. This is important because American Jews, like other oppressed cultural groups, might be appropriately mistrustful of outsiders (in this case, non-Jews). Hence, counselors should be cautious not to misinterpret the actions of American Jewish clients. Survivors of the Shoah and their descendants bring an additional dynamic with them to counseling. These American Jews may view the world as a dangerous place because of overprotective parents who were traumatized during the Shoah.

Identity Issues

Counselors working with American Jews also need to understand Jewish identity, which can be a difficult task given the complexity of the issues. As previously stated, there are both religious and secular/cultural aspects to Jewish identity, and Jewish identity is both multifaceted and context specific. Hence, to provide culturally competent care, counselors need to understand the client’s perspectives on his or her own Jewish identity.

Importance of Family

For American Jews, the family is often the primary social structure, and there are emotional consequences for going against the wishes of the family. It is important to remember that because American Jews are bicultural, they may experience value conflicts between individualistic American culture and the more collectivistic nature of Jewish culture. Hence, counselors need to attend to family issues and the bicultural identity of American Jews.

Presenting Concerns

Scholars have theorized the following common presenting concerns for American Jewish clients: (a) Jewish identity issues, (b) body image and gender identity, (c) child rearing practices, (d) interfaith or interdenominational couples, (e) issues surrounding conversion to or from Judaism, (f) sexual orientation and religion, and (g) antisemitism-related experiences. Of course, American Jews may seek counseling for personal growth and development, as well as to receive treatment for any psychological disorders.

Conclusion

In conclusion, American Jews are a small yet culturally distinct group in the United States. Despite stereotypes of widespread financial success and the appearance of fitting into the dominant culture, antisemitism persists and grows. This perpetuation of antisemitism contributes to potential biases in counseling, especially when there is a lack of information and a reliance on stereotypes. By learning about Jews and Jewish culture, counselors can provide culturally competent treatment for their American Jewish clients.

References:

  1. Brodkin, K. (1998). How Jews became White folks and what that says about race in America. New Brunswick, NJ: Rutgers University Press.
  2. Chesler, P. (2003). The new antisemitism: The current crisis and what we must do about it. San Francisco: Jossey-Bass.
  3. Cohen, S. M., & Eisen, A. M. (2000). The Jew within: Self, family, and community in America. Bloomington: Indiana University Press.
  4. Dershowitz, A. M. (1997). The vanishing American Jew: In search of Jewish identity for the next century. New York: Little, Brown.
  5. Friedman, M. L., Friedlander, M. L., & Blustein, D. L. (2005). Toward an understanding of Jewish identity: A phenomenological study. Journal of Counseling Psychology, 52, 77-83.
  6. Gilman, S. L. (1990). Jewish self-hatred: Antisemitism and the hidden language of Jews. Baltimore: Johns Hopkins University Press.
  7. Herman, S. N. (1977). Jewish identity: A social psychological perspective. Beverly Hills, CA: Sage.
  8. Horowitz, B. (2003). Connections and journeys: Assessing critical opportunities for enhancing Jewish identity [Report to the Commission on Jewish Identity and Renewal, United Jewish Association-Federation of New York]. New York: UJA-Federation.
  9. Langman, P. F. (1999). Jewish issues in multiculturalism: A handbook for educators and clinicians. Northvale, NJ: Jason Aronson.
  10. Schlosser, L. Z. (2003). Christian privilege: Breaking a sacred taboo. Journal of Multicultural Counseling and Development, 31, 44-51.

See also:

  • Counseling Psychology
  • Multicultural Counseling

Understanding American Indians: Celebrating Heritage and Culture

In a nation as diverse as the United States, the rich tapestry of American Indian heritage and culture stands out as a vital component of the country’s history. From vibrant traditions and languages to profound spiritual beliefs and community practices, American Indian cultures are as varied as the tribes that represent them. This article seeks to illuminate the unique contributions of American Indians while exploring the importance of honoring their past and present. By understanding their narratives, traditions, and ongoing struggles, we can foster a deeper appreciation for the resilience and richness of these cultures, ensuring that they are celebrated and preserved for future generations.

American Indians (herein referred to as Indians, Native Americans, or Natives) have a rich and heart-rendering history and continue to contribute to the fabric of American society. The history of Native people is important for mental health professionals and researchers to understand in order to grasp the present implications of history and how they may affect psychological, familial, and social interactions. The following overview of Indian country, past and present, is divided into several sections. A brief history of Native-White relations serves as an introduction to Native peoples. This section is followed by a presentation of demographics and an introduction to the complex definitions that surround being Native. Several myths that are commonly held by non-Indian “others” regarding Native Americans are presented and clarified. This is followed by an overview of health and mental health issues affecting Natives today. The final section presents traditional Native and contemporary approaches to healing, examining the physical, spiritual, and psychological community and group approaches to mental health.

History

The history of Native peoples can be divided into two major periods: pre-contact and contact. The contact period is generally divided into several subsets, including the periods of Manifest Destiny (1492-1890), Assimilation (1890-1970), and Self-Determination (1970 to the present). Pre-contact was a period of autonomy for tribes that inhabited the Americas. Tribes adapted to the environment they lived in. Varieties of lifestyles included those of hunting and gathering, agrarian lifestyles, and a combination of both, which were determined by the environment and terrain where tribes lived. Complex social and political systems were developed by each tribe. Each group had its own set of attitudes, beliefs, social organizations, men’s and women’s societies, and views of creation, self, and nature. Wicki-ups, teepees (hide and bark), sod housing, and cave dwellings served as homes across the continent. Political practices included input from both men and women in clans or bands and honor societies; this latter respect for women ran contrary to European patriarchy and contributed to the cultural dissonances between colonialists and Natives.

Manifest Destiny, Assimilation, and Self-Determination

With the arrival of Christopher Columbus, a lost sailor who worked for the Spanish, in 1492, Natives were removed from ancestral homes, starved to death, and massacred as a means to secure land and resources. This westward movement was justified under the auspices of Manifest Destiny. This movement was a form of what has come to be known as ethnic cleansing. Native Americans suffered new sicknesses and diseases brought by colonists, illnesses that claimed more lives than combat claimed.

The assimilation era was between 1890 and 1970 and was characterized by efforts to socialize Natives through missionary activities and the practices of boarding schools. Both of these acts of forced assimilation served destructive cultural, social, and psychological influences on Native groups. With the advent of the boarding schools, children often witnessed the loss of tribal life ways. These practices represented the shift from physical genocide to cultural genocide. Common practices of corporal punishment and sexual abuse impeded healthy psychological development and, in many cases, impeded the ability to develop appropriate relationships with others.

This collective past of broken promises, discrimination, and oppressive practices has had resounding effects that have shaped the psychological well-being of many Native peoples today. These effects have been described as historical trauma, the reliving of events, oppressive and violent in nature, retold and experienced in the present through stories shared among families and in social settings. These historical traumas are intertwined with current traumas, the impacts of alcohol and other drug abuse, child abuse and maltreatment, unemployment, poor health care, and death, all of which have profound psychological and social effects.

Demographics

American Indians comprise many different groups, including over 569 federally and state recognized tribes, each with their own commitment to cultural and spiritual beliefs and practices. There are many tribal groups that are not federally or state recognized by treaties. There are tribes without signed treaties, and, through what is known as the termination period during the 1950s and 1960s, there are tribes who ceased their treaty relationships with the U.S. government. Processing treaties for federal recognition is a complex and lengthy task, as exemplified by the Little Shell Band of Montana, whose struggle has lasted more than 38 years. In deciding to terminate their quest for federal recognition, tribal groups compromise their ability to have a land base and become ineligible for health care or psychological services.

Differences within Native people are evidenced through tribal diversity and rates of intermarriage. According to recent census estimates, there are 4.5 million self-identified American Indians and Alaskan Natives, excluding Hawaiians. Specific tribal populations vary widely in their enrollment. For example, the Dine people (Navajo Tribe) maintain a membership exceeding 298,000 strong. In contrast, the Confederated Salish and Kootenai Tribes of Montana currently have a membership of 7,000, due to blood quantum enrollment criteria (i.e., the degree to which an individual can claim his or her heritage as Native). Many tribes anticipate similar declines in enrollment as a function of blood quantum criteria.

American Indians vary by level of acculturation, often paralleling the acculturation level and degree of collective forced assimilation of their tribes. Individual variations in acculturation level may be related to Native cultural identity development attitudes; length of time away from reservations, including nonparticipation in familial and cultural activities; degree of commitment to learning the culture of one’s tribe(s); and generation level.

Within-group differences can be found across age, language, and social class. American Indians appear to constitute a young cultural group, as a recent estimate indicated that the median age of the population was 29, compared to 36 years for the White population. Furthermore, approximately 1.3 million Native Americans were reported to be under 18, and 336,000 were 65 years or older. However, Native elder population is growing at dramatic rates; specifically, between 1989 and 1999 the Native population aged 65 and older grew by 33%, while the non-Native population of adults over 65 increased by 9%. Additionally, there is linguistic diversity among Native people, such that 28% of all Indians/Natives 5 years of age and older speak a language other than English in their home; of that number, 18% speak English proficiently. Lastly, although there is variability in socio-economic status among Native people, 26% were reported to live at or below the poverty level, according to recent census reports based on a 3-year average.

Many myths abound regarding Native Americans. The following section provides an overview of several of the most commonly held notions about American Indians/Alaskan Natives.

Myths

Myth 1: All Natives get a U.S. government check monthly. Natives are eligible for monies such as general assistance, housing support, and other services available to the general population, but do not receive monthly checks from the government. Some tribes do pay tribal members a “per capita” payment. These are proceeds earned by the tribe and paid out to tribal members in a fashion similar to that of dividends paid to shareholders in a corporation. Treaty-bound services not available to the general public include health and education services.

Myth 2: Natives do not pay income taxes. Native Americans pay taxes like any other group. There are some exceptions, which may include monies earned within reservation boundaries in some states.

Myth 3: All Indians look like the Plains Indian, with a dark complexion, high cheek bones, and brown eyes. Many Natives have intermarried, changing the gene pool and diversifying phenotypes among Native people. Nearly 70% of Indians/Natives are in mixed marriages, whether with Indians/Natives of other tribes and bands or with other racial and ethnic groups. Furthermore, during the Civil War, many slaves that escaped were adopted into tribes and, as a result, there are many Black Indians.

Myth 4: Natives possess knowledge of all Native American experiences across tribes. There is an expectation or myth held by the non-Native “other” for Native individuals to possess knowledge of other Native groups, contemporary, historical, or both. Combined with this false expectation is that an individual Native can speak for other groups. This can present itself as a stressor.

Myth 5: Tribes should share the wealth. This myth is grounded in the assumption that all Indian groups are one. The diversity within Native tribes can be seen in the extent to which there are alliances among groups. Tribes can be compared to corporations, in that, for example, the Ford Motor Company would not assist Chevrolet in times of financial crisis. This myth also serves as an example of how stereotypes are negotiated, building one stereotype upon another, only to develop a set of erroneous assumptions that may drive perception and behavior.

Myth 6: Native families often neglect their children. Native families had been broken historically through forced assimilation strategies. In addition, child care differences and conflicting worldviews contributed to the removal of Native children from their homes and tribes. It wasn’t until the 1970s that this myth was challenged in the courts, with pleas to legislatures to change the adoption process of Indian children. This change was brought about by the lobbying of many tribes and the action of concerned individuals in the federal legislative arenas. The Indian Child Welfare Act (ICWA) became law in 1978 and subsequently was implemented in 1979. ICWA established a new set of strict requirements for child welfare cases and placed authority for Native children with tribes. This ushered in a new era for Indian/Native child welfare. This act changed adoption practices in the United States, giving preference to family and tribal members for the provision of a culturally appropriate living environment.

Health and Psychosocial Concerns

Health

The health status of Natives lags behind all other ethnic groups in the United States. The top 10 leading causes of death, in no specified order, are tuberculosis, chronic liver disease and cirrhosis, accidents, diabetes, stroke, chronic lower respiratory diseases (e.g., pneumonia), suicide, homicide, cancer, and heart disease. In addition, rates of obesity, substance abuse, sudden infant death syndrome, and mental health concerns (e.g., depression and posttraumatic stress disorder) are disproportionately higher among Native Americans. Socioeconomic conditions, including unemployment, lack of economic opportunities, and lack of availability of and access to appropriate health care, influence health status and contribute to high mortality rates. These conditions, combined with geographic isolation, limited access to medical care, high costs, and other barriers, create invisible boundaries that stand between Native peoples and appropriate health care.

Through examining rates of diagnoses, prevalence, and mortality, barriers to adequate health care and far-reaching health disparities are evidenced. For example, the Centers for Disease Control and Prevention reported that Natives are 3 times more likely than Whites to be diagnosed with diabetes, Native American adults are at greater risk than their White counterparts of developing cardiac concerns, and Natives are less likely than Whites to be informed of having hypertension. In addition, Native Americans are reported to be twice as likely to be diagnosed with stomach or liver cancers as White men, and Native women are reported to be 20% more likely than White women to die of cervical cancer.

Although health outcomes are slowly improving for this population, Native Americans experience relatively compromised health, with one of the primary factors being substance abuse. Alcohol-related deaths are 4 to 5 times the national average among Native people, and at least one third of all visits to Indian Health Services are alcohol related. This also influences the number of deaths by accident for this group, both vehicular and nonvehicular accidents.

Crime in Indian Country

Data from the Bureau of Justice Statistics, highlighted in A BJS Statistical Profile, 1992-2002: American Indians and Crime, reveals a wealth of information and statistics about crime in Indian country. For example, American Indians were reported to be more likely to be arrested for aggravated assault than arrested for robbery. Native children under 17 years of age were less likely to be arrested for a violent crime than youth of all races, with the exception of murder. Native adults were twice as likely as their non-Native peers to be arrested for driving under the influence or alcohol violations, and Native youth (i.e., under 17 years) were nearly twice as likely to be arrested than non-Natives for alcohol-related offenses.

Gangs have emerged onto the reservation areas. About 23% of respondents to the 2000 National Gang Survey indicated that they had gang problems on their reservation or Native community. Alcohol and/or drug use was a factor in 51% of the violent crimes against all races. Among victims of violence that were able to describe use by offenders, American Indians were more likely than any other racial group to report an offender under the influence of alcohol or drugs.

The combination of stress, depression, substance abuse, and psychological frustration contributes to the increases of violent and abusive behaviors throughout Indian/Native communities. The rate of violent victimization among American Indian women was more than double that among all other women. Indians/Natives were twice as likely to experience a rape/sexual assault. Violence and resultant trauma can have vast effects on the survivor or bystander. Among the manifestations include child physical and sexual abuse, child neglect, domestic violence, assault, homicide, and suicide. Suicide is 3 to 6 times greater in Indian country.

Indian Child Welfare

Before the institutionalization of the Indian Child Welfare Act (ICWA), displaced Native children had been assigned to care outside of their homes at rates between 5 and 30 times higher than their non-Native peers. Tribes responded to these alarming conditions by demanding more control over the rights to rear their own children and began to advocate for federal policy to support their position on child care. The passage of the ICWA indicated a federal initiative to address one form of institutional discrimination against Native Americans.

There are eight provisions to ICWA, two of which are noted. First, tribes were given exclusive jurisdiction over children who live on the reservations, except in cases in which federal law already has designated jurisdiction to the state. Second, agencies that place children must provide culturally appropriate services to Native families before placement occurs. The provision of ICWA becomes more complicated when the out-of-home care takes place in urban settings, where access to culturally appropriate services may be limited. Presently, American Indian children are placed in care outside of the home 4 times more often than are non-Indian children.

Considerations of Healthcare Services

Health disparities among Native Americans have been related to cultural mistrust, geographic isolation, and socioeconomic factors. For example, through the 1970s, the practice of sterilization without consent was not uncommon. Such behaviors, enacted primarily by Indian Health Service (IHS) personnel and other governmental agencies, have engendered distrust for some healthcare providers among Native Americans. In addition, urban Indians are geographically dispersed in comparison to other populations, which may compromise their access to tribe-specific health-related information and services.

There are unique considerations relevant to receiving health care services and programming on and off the reservation. On-reservation programming is provided by the IHS generally, under the Behavioral Health Program, or contracted by the tribe with IHS or other providers. Health care available off the reservations is funded at only about 2% of the IHS budget in urban areas. This leaves the majority of Indians without access to adequate health care.

Urban health and mental health services are not as clear-cut. Only about 2% of all IHS funding goes to urban Indian programs, where up to 60% of all Natives live. According to the Surgeon General’s report in 1999, only 20% of Natives reported access to IHS clinics, most of these found on reservations. Medicaid is the primary insurer for about 25% of this population, and only 50% of Natives have employer-based insurance coverage, compared with 72% of Whites. Twenty-four percent of all Natives do not have health insurance, compared with 16% of Whites. When scarce resources are needed for survival, mental health becomes a luxury item.

Mental Health

Mental health needs among Native populations vary, yet there appears to be some commonalities across tribes. Similar rates of lifetime diagnosis in Native populations have been reported concerning alcohol dependence, posttraumatic stress disorder (PTSD), and major depressive episodes. For example, the Surgeon General’s Report of 2000 stated that depression ranged from 10% to 30% among Native populations.

Effects of Trauma

Considerations of the profound effects of direct, vicarious, and historical trauma on Native peoples have implications for substance use, violent behaviors, and depression. The many precipitating factors of PTSD include service in combat zones; exposure to violent accidents, homicides, and suicides; sexual victimization; and poverty and homelessness. The higher rate of traumatic exposure results in a 22% rate of PTSD for Native peoples, compared with 8% in the general population. Moreover, the Vietnam Veterans Project found lifetime prevalence of PTSD to be from 45% to 57% among Native veterans, rates significantly higher than among other Vietnam veterans. Prevalence rates for current alcohol and drug abuse or dependence among Northern Plains and Southwestern Vietnam veterans have been estimated to be as high as 70% compared with 11% to 32% of their White, Black, and Japanese American counterparts.

The rate of violent victimization of Natives is more than twice the national average. Given the exposure of this population to potential stressors beyond the “norm,” mental health professionals must be versed in PTSD and potential referral sources that may include traditional healing ceremonies or activities.

Values and Mental Health

Cultural values among Native people are, among themselves, very diverse. However, when considered as a collective, Native cultural values tend to contrast significantly with individualistic and dualistic orientations of Western psychology. In Indian country, traditional groups view life as a function of the interconnectedness of all things, and behavior is considered to be motivated through the interconnections with others. In these philosophies, balance among the reciprocal effects of actions and changes in the entire system leads to wellness. Furthermore, the interplay of these worldly and otherworldly (i.e., spirited) systems creates a whole. Attention to both of these systems often is desirable to effect long-lasting and effective change for clients, such that therapeutic goals include balance among individual, spiritual, and community systems.

Interventions

Effective interventions are dependent upon many factors. Counselors’ attention to clients’ levels of acculturation facilitates effective care. It is also critical for mental health professionals to have an understanding of the Native family and extended family systems and clients’ roles in these systems. In urban and reservation settings, the therapist needs to be known and trusted in the community. This can be facilitated by attending open social gatherings and attending local school functions.

There are traditional interventions that have been found to work across settings. These include the talking circle, sweat lodge ceremonies, smudging ceremonies, and others. It is recommended that the non-Native therapist seek Native spiritual leaders with whom to develop relationships so that they may later refer clients for spiritual assistance. Non-Native therapists can work with clients on therapeutic goals while learning about clients’ cultural experiences through the therapeutic process.

References:

  1. Beals, J., Novins, D. K., Whitesell, N. R., Spicer, P., & Manson, S. M. (2005). Prevalence of mental disorders and utilization of mental health services in two American Indian reservation populations: Mental health disparities in a national context. American Journal of Psychiatry, 162, 1723-1732.
  2. Centers for Disease Control and Protection, Office of Minority Health & Health Disparities. (2005). Health of American Indian or Alaska Native Population. Retrieved from http://www.cdc.gov/nchs/fastats/american-indian-health.htm
  3. Evans-Campbell, T. (2006). Indian child welfare practice within urban American Indian/Alaskan Native American communities. In T. M. Witko (Ed.), Mental health care for urban Indians: Clinical insights from Native practitioners (pp. 33-54). Washington, DC: American Psychological Association.
  4. Peregoy, J. J. (1999). Revisiting transcultural counseling with American Indians and Alaskan Natives: Issues for consideration. In J. McFadden (Ed.), Transcultural counseling (2nd ed., pp. 137-170). Alexandria, VA: American Counseling Association.
  5. Peregoy, J. J. (2001). Counseling with American Indian/Alaskan Native clients: Perspectives for practitioners to start with. In E. Welfel & R. E. Ingersoll (Eds.), The mental health desk reference (pp. 306-314). New York: Wiley.
  6. Perry, S. W. (2004, February). A Bureau of Justice statistical profile, 1992—2002: American Indians and crime. Washington, DC: U.S. Government Printing Office.
  7. U.S. Census Bureau. (2006). We the people: American Indians and Alaskan Natives. Washington, DC: U.S. Government Printing Office.
  8. U.S. Department of Health and Human Services. (2001). Mental health: Culture, race, and ethnicity, supplement to mental health: A report to the Surgeon General. Rockville, MD: U.S. Government Printing Office.
  9. Witko, T. M. (Ed.). (2006). Mental health care for urban Indians: Clinical insights from Native practitioners. Washington, DC: American Psychological Association.

See also:

  • Counseling Psychology
  • Multicultural Counseling

American Bar Association Resolution: A Path to Legal Reform and Justice

In a landscape where the pursuit of justice often seems fraught with challenges, the American Bar Association (ABA) has taken a pivotal step toward fostering meaningful legal reform. With a recent resolution aimed at addressing systemic issues within the legal framework, the ABA is advocating for changes that could enhance access to justice and promote equity in the legal system. This initiative not only seeks to illuminate the pressing concerns faced by marginalized communities but also to inspire a collective response from legal professionals and policymakers alike. As we delve into the implications of this resolution, we explore its potential to reshape the legal landscape and create a more just society for all.

The question of how individuals with severe mental disabilities should be sentenced when they are convicted of capital (death penalty) crimes is a vexing one in U.S. society. On one hand, the death penalty is an established part of the criminal justice system in the United States, which exists in part as a reflection of our society’s outrage in response to certain kinds of violent crime. On the other hand, in the words of former U.S. Supreme Court Chief Justice Earl Warren, a society’s “evolving standards of decency that mark the progress of a maturing society” require that we recognize that there must be exceptions to this most extreme form of punishment. This research paper describes the Resolution of the American Bar Association on Mental Disability and the Death Penalty, which was endorsed by the American Psychological Association and other professional organizations, and the Resolution’s approach to the difficult problem of mental disability and capital punishment.

The American Bar Association (ABA) formed an interdisciplinary task force to consider this problem. The Task Force on Mental Disability and the Death Penalty (hereinafter “Task Force”) was established by the ABA’s Section of Individual Rights and Responsibilities and chaired by Ronald Tabak (Task Force, 2006). Many of the 24 members of the Task Force were attorneys, including representation from the National Alliance on Mental Illness, but there were also representatives from the American Psychological Association (the three authors of this research paper) and the American Psychiatric Association. The Task Force worked for 2 years (April 2003 to March 2005) on considering, debating, and crafting the Resolution that is quoted in this research paper. It was approved by the ABA in August 2006, after having previously been endorsed by the American Psychological Association, the American Psychiatric Association, and the National Alliance on Mental Illness.

One of the important initial questions facing the Task Force was whether mental disability should constitute a per se bar to capital punishment—that is, whether individuals with certain kinds of mental disability should not need to demonstrate anything further in order to be excluded from consideration for the death penalty. There were differing views among Task Force members on this question. The vast majority of questions in mental health law require consideration not only of mental disability but also of specific functional legal capacities that vary according to the legal question, and the relationship between the mental disability and the functional capacities. For example, an individual with a severe mental disability would not be adjudicated incompetent to stand trial only on the basis of that disability; the court would also consider the functional legal criteria involving a rational and factual understanding of the individual’s legal situation and the capacity to assist counsel in his or her own defense. The defendant who experiences deficits in these functional legal capacities that are caused by symptoms of a severe mental disability is much more likely to be adjudicated incompetent to stand trial by a court.

So it did not appear sufficient to craft a resolution on the theme that those with mental disability should be excluded from the death penalty on that basis alone. Throughout most of the Resolution, the Task Force used the consideration of mental disability, functional legal criteria, and causal connection in formulating its language.

To complicate matters further, however, there is some important case law, in the form of decisions by the U.S. Supreme Court, indicating that in some instances the defendant’s mental condition or age is sufficient by itself to exclude that individual from capital punishment. In Atkins v. Virginia (2002), the U.S. Supreme Court decided that the Eighth Amendment of the Constitution bars capital punishment for individuals with mental retardation on the basis that it is a cruel and unusual punishment. This decision was followed by another case, Roper v. Simmons (2005), in which the Supreme Court held that execution of those under the age of 18 at the time of the offense was also constitutionally prohibited under the Eighth Amendment.

Faced with the choice of whether to apply “mental disability” to capital punishment as the Supreme Court did in Atkins and Roper, with the disability itself constituting sufficient grounds for an exclusion, or to use the more established approach used in virtually all other questions in mental health law, the Task Force adopted a two-dimensional approach. Consistent with Atkins, the first prong of this Resolution proposes that those with significant limitations in their intellectual functioning and adaptive behavior (criteria associated with mental retardation) be excluded from consideration for capital punishment on that basis alone. However, individuals with “severe mental disorder or disability” would need to demonstrate both the existence of such a disorder/disability and the resulting impairment in functional legal capacities at the time of the offense (the Resolution’s second prong) or following sentencing (the third prong). This two-dimensional approach has the advantage of not only recognizing the Court’s holding that a specific kind of disability (mental retardation) is sufficient in itself to exclude defendants with this disability from capital sentencing but also acknowledging the longstanding demand for considering both nature of disability and relevant functional legal capacities in other areas of mental health law.

Finally, the Task Force sought to fill an important gap in the law regarding competence for execution, which applies when a defendant who receives a death sentence begins to demonstrate symptoms of a severe mental disability after sentencing but before execution. In Ford v. Wainwright (1986), the U.S. Supreme Court held that execution of an incompetent prisoner constitutes cruel and unusual punishment, which is proscribed by the Eighth Amendment. However, the Court did not specify what criteria should be used to determine whether the prisoner is incompetent for execution. The Resolution provides suggested criteria that expand on the language used by Justice Lewis Powell, in his concurring opinion in Ford, to the effect that the prisoner’s understanding of the nature of capital punishment and why it is imposed in this particular case ought to be the relevant test. (Since Justice Powell’s opinion concurred with the majority on many points but was not part of the majority opinion, his language regarding the criteria for competence for execution did not become officially recognized as part of the Ford decision and hence applicable to other cases involving competence for execution. Some states have adopted this language as part of their law in this area, but they are not required to do so as they would have been if the language had been included in the majority’s decision.)

The Resolution (Quoted From the Task Force)

RESOLVED, That the American Bar Association, without taking a position supporting or opposing the death penalty, urges each jurisdiction that imposes capital punishment to implement the following policies and procedures:

  1. Defendants should not be executed or sentenced to death if, at the time of the offense, they had significant limitations in both their intellectual functioning and adaptive behavior, as expressed in conceptual, social, and practical adaptive skills, resulting from mental retardation, dementia, or a traumatic brain injury.
  2. Defendants should not be executed or sentenced to death if, at the time of the offense, they had a severe mental disorder or disability that significantly impaired their capacity
  3. to appreciate the nature, consequences or wrongfulness of their conduct,
  4. to exercise rational judgment in relation to conduct, or
  5. to conform their conduct to the requirements of the law.

A disorder manifested primarily by repeated criminal conduct or attributable solely to the acute effects of voluntary use of alcohol or other drugs does not, standing alone, constitute a mental disorder or disability for purposes of this provision.

  1. Mental Disorder or Disability after Sentencing a. Grounds for Precluding Execution. A sentence of death should not be carried out if the prisoner has a mental disorder or disability that significantly impairs his or her capacity
  2. to make a rational decision to forgo or terminate post-conviction proceedings available to challenge the validity of the conviction or sentence;
  3. to understand or communicate pertinent information, or otherwise assist counsel, in relation to specific claims bearing on the validity of the conviction or sentence that cannot be fairly resolved without the prisoner’s participation; or

iii. to understand the nature and purpose of the punishment, or to appreciate the reason for its imposition in the prisoner’s own case.

Procedures to be followed in each of these categories of cases are specified in (b) through (d) below.

  1. Procedure in Cases Involving Prisoners Seeking to Forgo or Terminate Post-Conviction Proceedings. If a court finds that a prisoner under sentence of death who wishes to forgo or terminate post-conviction proceedings has a mental disorder or disability that significantly impairs his or her capacity to make a rational decision, the court should permit a next friend acting on the prisoner’s behalf to initiate or pursue available remedies to set aside the conviction or death sentence.
  2. Procedure in Cases Involving Prisoners Unable to Assist Counsel in Post-Conviction Proceedings. If a court finds at any time that a prisoner under sentence of death has a mental disorder or disability that significantly impairs his or her capacity to understand or communicate pertinent information, or otherwise to assist counsel, in connection with post-conviction proceedings, and that the prisoner’s participation is necessary for a fair resolution of specific claims bearing on the validity of the conviction or death sentence, the court should suspend the proceedings. If the court finds that there is no significant likelihood of restoring the prisoner’s capacity to participate in post-conviction proceedings in the foreseeable future, it should reduce the prisoner’s sentence to the sentence imposed in capital cases when execution is not an option.
  3. Procedure in Cases Involving Prisoners Unable to Understand the Punishment or Its Purpose. If, after challenges to the validity of the conviction and death sentence have been exhausted and execution has been scheduled, a court finds that a prisoner has a mental disorder or disability that significantly impairs his or her capacity to understand the nature and purpose of the punishment, or to appreciate the reason for its imposition in the prisoner’s own case, the sentence of death should be reduced to the sentence imposed in capital cases when execution is not an option.

Discussion

This Resolution does not take a position on the death penalty generally. Neither the ABA, which organized the Task Force and ultimately approved the Resolution, nor organizations such as the American Psychological Association, the American Psychiatric Association, or the National Alliance on Mental Illness intended their endorsement to reflect a broader position on capital punishment applicable beyond the scope of the Resolution.

In some respects, this Resolution is largely consistent with established law. In Prong 1, for example, the Resolution language is quite consistent with the Supreme Court’s decision in Atkins, although it does expand the possible reasons for significantly limited intellectual functioning and adaptive behavior so that it now includes mental retardation as well as other possible sources of deficit (e.g., dementia, brain injury).

In other respects, however, the Resolution goes well beyond what is presently established under the law. It proposes to exempt from capital punishment those who, at the time of the offense or prior to execution, display both severe mental disability and impaired functional legal capacities. It does so in a traditional fashion, without the per se bar of a specific kind of mental disability or the defendant’s age. However, there is no question that what is proposed in the Resolution’s second and third prongs would change the law in some significant ways if the Resolution’s language were adopted by state legislatures and used by appellate courts.

This Resolution should not be interpreted as an attempt to absolve offenders of responsibility for their actions or exempt them from punishment. But it does recognize that there are degrees of culpability for very serious offenses and that severe mental disability may reduce that culpability somewhat. Even for those who might meet the criteria described in this Resolution, however, the reduction in sanction is from a death sentence to life incarceration—an attempt to balance our society’s interest in punishing the guilty with the importance of punishing them as culpability and fairness dictate.

References:

  1. Atkins v. Virginia, 536 U.S. 304 (2002).
  2. Bonnie, R. (2005). Mentally ill prisoners on death row: Unsolved puzzles for courts and legislatures. Catholic University Law Review, 54, 1169-1193.
  3. Ford v. Wainwright, 477 U.S. 399 (1986).
  4. Heilbrun, K., Radelet, M., & Dvoskin, J. (1992). The debate on treating individuals incompetent for execution. American Journal of Psychiatry, 149, 596-605.
  5. Roper v. Simmons, 543 U.S. 551 (2005).
  6. Task Force on Mental Disability and the Death Penalty. (2006). Recommendation and report on the death penalty and persons with mental disabilities. Mental and Physical Disability Law Reporter, 30, 668-677.
  7. Trop v. Dulles, 356 U.S. 86 (1958).

Return to the overview of Death Penalty in forensic psychology.

AARP: Empowering Seniors Through Advocacy and Resources

As the population of older adults continues to grow, organizations like AARP play a crucial role in advocating for their rights and enhancing their quality of life. Founded in 1958, AARP has evolved into a powerful voice for seniors, championing issues such as healthcare access, retirement security, and social justice. Through a wide range of resources, educational programs, and lobbying efforts, AARP empowers seniors to navigate the challenges of aging while fostering a sense of community and belonging. This article explores how AARP continues to support and uplift older adults, ensuring they have the tools and advocacy necessary to thrive in an ever-changing world.

Beginnings Of AARP

The  American  Association  of  Retired  Persons (AARP)  is  a  nonprofit,  nonpartisan  membership organization for people age 50 years and older with more than 35 million members. According to its literature, AARP is dedicated to “enhancing quality of life for all as we age,” and the organization also provides a range of benefits and services. Despite its name, anyone older than 50 may join, retired or not. Its mission is to inform members and the public of issues important to Americans older than age 50; advocate on legislative, consumer, and legal issues; promote community  service;  and  offer  specialized  products and services to members.

AARP was founded in 1958 by Dr. Ethel Percy Andrus, a retired high school principal, and was modeled  after  the  organization  also  found  by  Andrus in 1947, the National Retired Teachers Association (NRTA). Part of the impetus to create the NRTA was to assist older Americans in their efforts to obtain health insurance, usually unavailable at that time. Once Andrus realized how significant this need was, the AARP was formed and opened to all older people, not just teachers.

AARP Mission

AARP focuses a significant part of its resources on education and in doing so publishes the bimonthly AARP  Magazine,  which  covers  a  broad  range  of topics related to aging such as health, finance, and leisure. Members of AARP also receive the AARP Bulletin, published 11 times a year, which includes information regarding relevant federal and state legislation.  In  addition,  Segunda  Juventud,  a  quarterly Spanish-English  newspaper,  is  published  as  well.  In addition to offering these publications, AARP uses its Public Policy Institute to conduct and publish research on aging issues.

AARP Programs

AARP offers several types of programs to meet the needs of its members and to address some of the at-large policy issues that aging Americans face.

The AARP Independent Living/Long-Term Care/End-of-Life  Issues  program  addresses  issues of prevention and examines options in services and financing. The physical activity initiative is targeted at increasing the number of people who make physical activity a regular part of their lives. Finally, the predatory lending campaign is aimed at reducing the incidence of fraud against older homeowners.

With older Americans finding it increasingly challenging  to  drive  safely  as  they  age,  the AARP driver safety program is an 8-hour classroom refresher course designed for drivers age 50 and older. It covers rules of the road, defensive driving tips, and normal physical changes that accompany aging and ways to compensate for them.

The AARP grief and loss programs offers resources  and  information  to AARP  members  and their  families  who  have  experienced  the  loss  of  a loved one. The program develops and offers bereavement outreach services, support groups, and educational programs for bereaved individuals.

AARP Tax-Aide, administered through the AARP Foundation, is a free tax counseling and preparation service for all taxpayers with middle and low incomes, with special attention to those age 60 and older. Trained and certified volunteers serve almost 2 million taxpayers.

Finally, AARP Senior Community Service Employment Program (SCSEP)) is a work-training program for low-income people age 55 and older.

References:

  1. AARP The Magazine, http://www.aarpmagazine.org
  2. American Association of Retired Persons, http://www.aarp.org/

Understanding the American Academy of Pediatrics: A Guide for Parents

Navigating the world of pediatric health can be daunting for parents, especially with the wealth of information available and the varying opinions on child health and wellness. The American Academy of Pediatrics (AAP) stands as a trusted authority in this field, providing guidelines and resources grounded in research and clinical expertise. This article aims to demystify the AAP’s mission, offerings, and the importance of their recommendations, serving as a vital guide for parents seeking to ensure the best possible health outcomes for their children. Whether you are a new parent or looking to deepen your understanding, this guide will illuminate the AAP’s role in pediatric care and how it can empower you in your parenting journey.

The American Academy of Pediatrics (AAP) was founded  in  1930  at  Harper  Hospital  in  Detroit. A group of 34 physicians who specialized in children’s health convened in the hospital’s library to set forth the future of America’s children, acknowledging the differences between adult and child health care. They settled on the name American Academy of Pediatrics because it best represented the commitment to all children and the pediatric specialty.

Today, the AAP is a not-for-profit, 501(c)(3) Illinois corporation organized for scientific and educational purposes, with a strong presence in the United States and overseas. The organization has a membership of 60,000 pediatricians; pediatric medical subspecialists, including neonatologists, allergists, and cardiologists; and pediatric surgical specialists. The AAP employs more than 350 people, who work at AAP headquarters in Elk Grove Village, Illinois, and in Washington, DC, where legislative and federal activities are managed.

Mission And Organizational Structure

The mission of the American Academy of Pediatrics is to attain optimal physical, mental, and social health and well-being for all infants, children, adolescents, and young adults. The AAP’s mission is carried out in a number of ways. The organization is governed by a 13-member board of directors who maintains the integrity of the AAP mission by following a set of organizational bylaws. The board comprises an executive committee and directors. These pediatric health practitioners are elected by AAP members and serve as chairs representing 10 geographic districts.

Internally, staff in the Office of the Executive Director handles Board Administration, Development/ Fundraising, Communications, International and Interprofessional Affairs, Human Resources, and the Customer Service Center. Other staffed areas within the AAP include separate departments according to specialty. These areas are the Departments of Chapter and State Affairs; Community and Specialty Pediatrics; Practice; Research; Education; Finance and Administrative Services; Information Technology; Marketing and Publications; Membership; and Federal Affairs (based in Washington, DC).

Another important facet of the AAP is a grassroots network of 59 chapters in the United States and 7 in Canada. Each state and local chapter is individually incorporated, has its own bylaws, and is managed by local pediatricians. Most have a staff executive director. Chapter leaders strive to fulfill the AAP mission on the state and local level and work to implement other local priorities on behalf of children and adolescents.

Education And Advocacy

The AAP receives funding from a variety of sources, including membership dues, individual contributions, and unrestricted educational grants from foundations, corporations, and government entities. These valuable resources help support more than 200 AAP-sponsored programs every year.

Programs  cover  a  broad  range  of  issues,  such as neonatal resuscitation, obesity, childhood immunization, breast-feeding, car-seat safety, media literacy, prevention, and health promotion. Patient and family brochures on these and other topics are available to the public and health professionals, and a series of child care books written by AAP members is featured in the AAP bookstore.

The AAP  sponsors  ongoing  continuing  medical education (CME) courses and is considered the premier source of CME for pediatricians. These courses help advance the professional education of AAP members and are held in hospitals, universities, and other settings around the United States as well as through Internet-based learning environments.

More than 30 AAP national committees, covering issues ranging from adoption and infectious diseases to violence and poison prevention, are responsible for creating the organization’s policy statements. These statements appear in Pediatrics, the AAP’s monthly scientific journal and are used as recommendations in pediatric care.

Additionally, the AAP has more than 50 sections consisting of more than 30,000 members with interests in specialized areas of pediatrics, such as surgery, ophthalmology, breast-feeding, critical care, endocrinology, and pediatric dentistry. Section members present current research and practical knowledge in their respective subspecialties during various scientific meetings throughout the year, including the AAP’s National Conference and Exhibition (NCE).

Federal  advocacy  initiatives  have  been  handled by staff at the AAP’s Department of Federal Affairs, based in Washington, DC, for more than 30 years. Pediatricians active in child advocacy collaborate with lawmakers to help ensure that the health needs and concerns of all children are covered as legislation and public  policy  are  developed. An  annual  legislative conference in Washington, DC, brings together pediatricians, lawmakers, and other concerned individuals to address current issues and public policy.

On the state level, AAP staff provides technical assistance to chapters on a variety of issues, including Medicaid, child safety, and immunizations. Chapter leaders maintain relationships with local and state lawmakers, working with them on advocacy, policy, and other legislative initiatives.

Academy Successes And Milestones

During the past 75 years, the AAP has earned a proud place in the advancement of child and adolescent health, serving as pioneers in a variety of areas. Among the most notable are the following:

  • The AAP Task Force on Infant Sleep Position focused on sudden infant death syndrome (SIDS.) The task force developed a landmark 1992 AAP policy statement that urged parents and guardians to put infants to sleep on their backs to prevent SIDS. As a result of this effort, dubbed “The Back to Sleep Campaign,” more than 10,000 infants are alive today.
  • The Academy’s immunization  initiatives  have increased immunization rates among children and adolescents and lowered the incidence of infectious childhood diseases such as polio, measles, chicken pox, and pneumonia. This was accomplished through an organized grassroots effort facilitated by local pediatricians and the AAP chapter network.
  • More than 1 million pediatricians and other heath care professionals in the United States and overseas have been trained in the AAP’s Neonatal Resuscitation Program (NRP.) The NRP, launched in 1987, has become the standard of care for treatment of newborns at birth. Additionally, NRP materials have been translated into 22 languages and introduced in 71 countries.

References:

  1. American Academy of Pediatrics, http://www.aap.org
  2. American Academy of (2004). We believe in the inherent worth of all children. Chicago: Author.
  3. American Academy of (2005). Dedicated to the health of all children: 75 years of caring 1930–2005. Chicago: Author.
  4. Hughes,  A.,  &  James,  G.  (1980).  American  Academy of Pediatrics: The first 50 years. Chicago: American Academy of Pediatrics.

Ambivalence: Navigating the Complexities of Mixed Feelings

In a world that often presents us with clear binaries—right or wrong, love or hate—it is the space of ambivalence that reveals the intricate layers of human emotion. Mixed feelings can be both bewildering and enlightening, challenging our perceptions and prompting deeper introspection. This article delves into the complexities of ambivalence, exploring how these conflicting emotions shape our decisions, relationships, and understanding of ourselves. By examining the nuances of mixed feelings, we can learn to navigate the dualities of life with greater awareness and compassion.

Ambivalence Definition

People like some things yet dislike others, love some people but hate others, and sometimes feel happy and other times sad. From this perspective, feelings— generally referred to as affect, which includes such phenomena as attitudes, emotions, and moods—work in much the same way as temperature. Just as temperature falls along a simple dimension ranging from hot to cold, so, too, does affect fall along a simple dimension ranging from positive to negative.

A closer look, however, reveals that affect may be more complex than it first appears. Consider your attitude toward ice cream. You may like ice cream because it tastes good but also dislike ice cream because that great taste comes at the expense of vast amounts of fat, sugar, and calories. If so, you would have what social psychologists call an ambivalent attitude toward ice cream. That is, you feel good and bad about it, rather than simply good or bad. Many people are ambivalent not only about unhealthy foods but about broccoli and other healthy foods as well. Similarly, many people are ambivalent about such unhealthy behaviors as smoking, as well as such healthy behaviors as exercising. As people who describe themselves as having love/hate relationships know, other people can also be a common source of ambivalence. For instance, many people are ambivalent about U.S. presidents Bill Clinton or George W. Bush. Perhaps people feel ambivalent about politicians because they feel ambivalent about the social issues that politicians debate. In addition to dis-agreeing with each over such troubling issues as legalized abortion, capital punishment, and civil rights, people often disagree with themselves.

Such instances of ambivalence suggest that the analogy between temperature and affect can be taken only so far. It is impossible for liquids to freeze and boil at the same time, but it appears that people can feel both good and bad about the same object. According to John Cacioppo and Gary Berntson’s evaluative space model, one implication is that it is better to think of positive and negative affect as separate dimensions rather than opposite ends of a single dimension ranging from positive to negative. From this perspective, people can feel any pattern of positive and negative affect at the same time, including high levels of both.

Attitudinal Ambivalence

Contemporary interest in ambivalence stems from social psychologists’ enduring efforts to understand the nature of attitudes, which refer to people’s opinions of people, ideas, and things. Social psychologists have long measured attitudes by asking people to indicate how they feel about attitude objects (e.g., ice cream) on scales with options ranging from extremely good to extremely bad. In his chapter on attitude measurement in the 1968 Handbook of Social Psychology, William Scott pointed out that responses in the middle of bipolar attitude scales are difficult to interpret. Though typically assumed to reflect the absence of positive or negative feeling (i.e., indifference), Scott pointed out that such responses may in fact reflect ambivalence, or the presence of both positive and negative affect.

Ambivalence toward Social Categories

Research has revealed that stereotypes and attitudes toward racial groups and other social categories are often ambivalent. For instance, many White Americans have ambivalent attitudes toward African Americans. These ambivalent racists sympathize with Blacks for having been denied the opportunities afforded to other Americans, but also disparage Blacks because they perceive Blacks as having failed to uphold the Protestant work ethic. Peter Glick and Susan Fiske have explored men’s ambivalent sexism, which is illustrated by the saying, “Women—you can’t live with ’em and you can’t live without ’em.” Benevolent sexism involves a sort of protective paternalism in which men see it as their duty to care for women. In contrast, hostile sexism involves dominative paternalism in which men oppose women’s entry into male-dominated professions and criticize bold, assertive women even though they praise bold, assertive men. More recently, Glick and Fiske have demonstrated that stereotypes about social groups generally represent a tradeoff between perceptions of warmth and competence. Whereas homemakers are seen as nurturing but incompetent, for instance, wealthy individuals are seen as hardworking but cold.

Measuring Ambivalence

In the early 1970s, Martin Kaplan had the insight to distinguish ambivalent attitudes from indifferent attitudes by modifying traditional one-dimensional, bipolar attitude scales. Rather than asking people to rate how good or bad they felt about attitude objects, Kaplan asked them to rate how good and bad they felt about the attitude object on two separate scales. Kaplan quantified the amount of ambivalence as the smaller of the two ratings. In his formula, individuals who feel exclusively positive (positive = 5, negative = 0), exclusively negative (0, 5), or indifferent (0, 0) about some attitude object experience no ambivalence. On the other hand, people who have some combination of positive and negative feelings experience some level of ambivalence depending on the exact combination of those positive and negative ratings. For instance, if two individuals feel extremely positive, but one feels moderately negative (5,3) and the other only slightly negative (5, 1), the first is quantified as having more ambivalence.

The Feeling of Ambivalence

Having ambivalent reactions toward the same thing often leaves people feeling torn between the two. Indeed, subsequent researchers found that ambivalence as measured by Kaplan’s formula is correlated with ratings of tension, conflict, and other unpleasant emotions. Interestingly, however, the correlations tend to be relatively weak. Thus, having both positive and negative reactions does not necessarily result in feelings of conflict. Research has revealed a number of reasons for the weak correlation. One reason is that feelings of conflict are not only the result of ambivalent positive and negative reactions. Specifically, people sometimes feel conflicted, even though they do not have ambivalent positive and negative reactions, because they hold attitudes that are at odds with those of people important to them. For instance, students who greatly oppose studying (and are not in favor of it all) may nonetheless feel conflicted if their parents like them to study. Thus, ambivalence is not only an intrapersonal phenomenon (i.e., one that happens within a single person) but an interpersonal phenomenon (i.e., one that happens between people) as well. Another reason for the weak correlation is that people’s ambivalent positive and negative reactions toward an attitude object only produce feelings of conflict when the mixed reactions come to mind readily, which is not always the case.

The Role of Personality

There are also stable individual differences or personality characteristics that play a role in attitudinal ambivalence. In fact, a third reason for the low correlation between having ambivalent positive and negative reactions and experiencing conflict deals with the fact that some people have a weaker desire for consistency than others. As it turns out, Megan Thompson and Mark Zanna have demonstrated that these people are not particularly bothered about feeling both good and bad about the same thing. Perhaps that explains why these individuals tend to be more likely to have ambivalent attitudes toward a variety of social issues, including state-funded abortion, euthanasia (i.e., “mercy killing”), and capital punishment. In addition, people who enjoy thinking tend to have less-ambivalent attitudes, presumably because they manage to sift through and ultimately make sense of conflicting evidence for and against different positions on complex issues.

Consequences of Attitudinal Ambivalence

Ambivalence has a variety of effects on how attitudes operate. Attitudes are important to social psychology, in large part because they help predict behavior. If social psychologists know that someone has a negative attitude toward capital punishment, for instance, they can predict with some certainty that the person will vote to ban capital punishment if given the opportunity. Compared to other attitudes, however, ambivalent attitudes do not predict behavior very well. In addition, ambivalent attitudes are less stable over time than other attitudes. Thus, if asked about their attitude toward capital punishment one month and again the next, people who are ambivalent toward capital punishment will be less likely than others to report the same attitude.

Ambivalence also affects how much people change their minds in the face of advertisements and other persuasive appeals, messages designed by one person or group of people to change other people’s attitudes. For instance, Gregory Maio and colleagues found that when people are presented with a persuasive message dealing with issues that they are ambivalent about, they pay especially close attention to whether the message makes a compelling case or not. Thus, they tend to be more persuaded by strong arguments than are people with nonambivalent attitudes but also less persuaded by weak arguments. One explanation for this finding is that people with ambivalent attitudes scrutinize persuasive messages more carefully in hopes that the message will contain new information that will help them resolve their ambivalence. It appears that people with ambivalent attitudes are also more likely to change their attitudes to bring them into line with their peers’ attitudes. The picture that has emerged is that when people feel ambivalent, they will do whatever it takes to make up their minds, whether that involves the hard work of paying close attention to persuasive messages or the easier work of looking to their peers for guidance.

Mixed Emotions

Contemporary work on attitudinal ambivalence has recently prompted research on emotional ambivalence. Whereas attitudes represent affective reactions to some object, such as capital punishment or a political figure, emotions represent one’s own current affective state.

Most individuals at least occasionally experience such positive emotions as happiness, excitement, and relaxation and such negative emotions as sadness, anger, and fear, just to name a few. Research on attitudinal ambivalence makes clears that sometimes people can feel both good and bad about the same object, but this does not mean that people can experience such seemingly opposite emotions as happiness and sadness at the same time. Indeed, one prominent model of emotion contends that happiness and sadness are mutually exclu-sive. In contrast, John Cacioppo and Gary Berntson’s evaluative space model contends that people can some-times experience mixed emotions.

The Historical Debate

This disagreement represents the latest chapter in a long debate over the existence of mixed emotions. Socrates suggested that, for instance, tragic plays elicit mixed emotions by evoking pleasure in the midst of tears. Centuries later, David Hume argued for mixed emotions, but the Scottish philosopher Alexander Bain argued against mixed emotions. In the first two decades of the 20th century, students of Wilhelm Wundt, Hermann Ebbinghaus, and other pioneering psychologists conducted more than a dozen experiments in hopes of gathering data that would answer the question of mixed emotions. In an illustrative study, observers described how they felt after viewing pairs of pleasant and unpleasant photographs that alternated more than 100 times per minute. Nevertheless, researchers were unable to agree on how to interpret observers’ descriptions of their feelings. As a result, this early literature has largely been forgotten.

Contemporary Evidence for Mixed Emotions

Thanks in part to the development of more valid measures of emotion, researchers have recently been able to reopen the question of mixed emotions. The question is far from settled, but recent evidence suggests that people can feel both happy and sad at the same time. In a study conducted by Jeff Larsen and colleagues, moviegoers reported whether they felt happy, sad, and a variety of other emotions before or after seeing the tragicomic 1998 Italian film Life Is Beautiful, which depicts a father’s attempts to keep his son alive and unaware of their plight during their imprisonment in a World War II concentration camp. Before the movie, nearly everyone felt happy or sad, not both. After the film, however, half the people surveyed felt both happy and sad. In similar studies, college students were more likely to feel both happy and sad immediately after graduating or turning in the key to their dormitories than during typical days on campus.

In other research, people played a variety of computerized card games in which they had the opportunity to win one of two amounts of money, such as $12 or $5. Winning $12 instead of $5 led people to feel good and not at all bad. Winning $5 instead of $12, however, led people to feel both good and bad. These outcomes can be seen as disappointing wins: Winning $5 feels good, but it also feels disappointing if there was an opportunity to win even more.

Mixed Emotions in Children

Developmental psychologists have studied the development of children’s understanding of mixed emotions. In one study, children listened to a story about a child who had received a new kitten to replace one that had run away. During a subsequent interview, 4- and 5-year-olds rejected the notion that the child would feel both happy and sad about getting the new kitten. Older children, however, thought the child would feel mixed emotions. In a similar study, children were interviewed about their emotions after viewing a clip from the animated film The Little Mermaid in which a mermaid must say goodbye to her father forever after marrying a human. Older children were more likely to feel mixed emotions of happiness and sadness than were younger children. Taken together, the results of these studies suggest that both the understanding and experience of mixed emotions represent developmental milestones.

Consequences of Mixed Emotions

Little research to date has examined the consequences of mixed emotions. One notable exception is evidence that European Americans find advertisements that evoke mixed emotions more unpleasant than do

Asian Americans, who tend to have a greater propensity for dealing with contradictory information. As a result, the advertisements were also less persuasive for European Americans than Asian Americans. Among European Americans, younger individuals find mixed emotional advertisements more unpleasant than older individuals, suggesting that the effects of age on mixed emotions, demonstrated by developmental psychologists, extend far beyond childhood.

Conclusion

People probably feel good or bad about most things and happy or sad most of the time. Indeed, it appears that ambivalence is a relatively uncommon phenomenon. It is nonetheless a particularly intriguing phenomenon because it gives us a unique glimpse into how affect works. It may appear that feelings fall along a simple dimension ranging from good to bad, but the evidence for ambivalence suggests that positive and negative affect are, in fact, separate processes that can be experienced at the same time.

References:

  1. Cacioppo, J. T., & Berntson, G. G. (1994). Relationship between attitudes and evaluative space: A critical review, with emphasis on the separability of positive and negative substrates. Psychological Bulletin, 115, 401-423.
  2. Glick, P., & Fiske, S. (2001). An ambivalent alliance: Hostile and benevolent sexism as complementary justifications for gender inequality. American Psychologist, 56, 109-118.
  3. Jonas, K., Broemer, P., & Diehl, M. (2000). Attitudinal ambivalence. European Review of Social Psychology, 11, 35-74.
  4. Larsen, J. T., McGraw, A. P., & Cacioppo, J. T. (2001). Can people feel happy and sad at the same time? Journal of Personality and Social Psychology, 81, 684-696.
  5. Larsen, J. T., McGraw, A. P., Mellers, B. A., & Cacioppo, J. T. (2004). The agony of victory and thrill of defeat: Mixed emotional reactions to disappointing wins and relieving losses. Psychological Science, 15, 325-330.
  6. Priester, J. R., & Petty, R. E. (1996). The gradual threshold model of ambivalence: Relating the positive and negative bases of attitudes to subjective ambivalence. Journal of Personality and Social Psychology, 71, 431—149.
  7. Thompson, M. M., Zanna, M. P., & Griffin, D. W. (1995). Let’s not be indifferent about (attitudinal) ambivalence. In R. E. Petty & J. A. Krosnick (Eds.), Attitude strength: Antecedents and consequences (pp. 361-386). Mahwah, NJ: Erlbaum.

AMBER Alert System: A Lifesaving Tool for Missing Children

Every minute counts when a child goes missing, and the AMBER Alert System stands as a critical line of defense in the fight against child abduction. Established to swiftly disseminate information about abducted children, this alert system engages the public in law enforcement efforts, harnessing community vigilance to bring the missing home safely. In an age where rapid communication can make all the difference, understanding the functionality and impact of the AMBER Alert System is essential for everyone. This article explores how this innovative tool has evolved, its effectiveness in saving lives, and the vital role that communities play in its success.

The AMBER Alert system was designed to help rescue missing children. Law enforcement entities release information about the child and the perpetrator through public announcements on television, roadside signs, and the Internet. Citizens are expected to remember the information and report sightings to the police. Although the system has not been well evaluated, a number of social science methods used in other areas (e.g., eyewitness memory research, bystander effect) may be applicable. Concerns have been raised that the program has been overused by the authorities, who issue alerts in nonserious cases, and that alerts are most “effective” when relatively little threat is posed, such as when a child is abducted by a parent.

AMBER Alert and Social Science

The AMBER Alert system makes many assumptions about human behavior that remain untested. The system assumes that individuals have the ability to remember the information presented in the alert and to identify the perpetrator or the child at a later time. Research on cognitive load and exposure duration suggests that brief messages presented while the recipient is busy (e.g., driving a car) may not be acquired, although these notions have not been tested with AMBER Alert messages. Retention failure and memory reconstruction may also make it difficult to properly remember the alert message. Retrieval problems, such as source attribution errors, may also make it difficult for citizens to fulfill their role in the AMBER Alert system. Eyewitness memory research has indicated that individuals are not always able to recognize a face seen before; this can be especially true for faces of another race. These research techniques could be used to test citizens’ ability to become informants.

Social influences and individual differences could affect one’s willingness to report. Informants may feel that they are too busy to get involved with an investigation, or they could decide that because other citizens will report the sighting, there is no need for them to report (i.e., the bystander effect). The people around informants could doubt their memory, influencing them not to report. On the other hand, the high severity of a crime may make informants more likely to report. Gender, race, and past experiences with the police have also been shown to affect one’s willingness to help. Although these studies were not conducted using AMBER Alert as a framework, they may suggest avenues for future study.

There is also concern that AMBER alerts will lead to “AMBER fatigue,” a phenomenon in which individuals stop paying attention to the alerts because they have seen so many of them. There is also concern that the great number of alerts could lead to a heightened level of public fear and to perceptions that abductions are more common than they actually are, as suggested by research on the availability heuristic and social construction of fear by the media. Alternately, the presence of the AMBER Alert system could convince people that the system is deterring abductions; this could lead to a reduction in the perceived need for prevention programs. Stories of abductions by strangers (which AMBER Alert was designed to address) may lead to a neglect of the more frequent problem of abductions by family members. Counterfactual thinking and hindsight bias can affect perceptions of the system: A rescue after an alert was issued or a child’s death after a failure to issue an alert may seem like inevitable outcomes, thus bolstering the system’s perceived effectiveness.

Finally, AMBER alerts can affect perpetrators. It is possible that alerts can deter criminals or encourage them to return the child safely. It is, however, also possible that they will encourage copycat abductions by publicity-seeking criminals. Seeing an alert could also lead a criminal to kill and dispose of the child more quickly than he or she had planned.

AMBER Alert Research

A few researchers have attempted to test the effectiveness of the system. An examination of 233 AMBER alerts issued in 2004 revealed that, despite the intention of focusing AMBER alerts on only serious abduction cases (which generally involve strangers), 50% of the alerts studied involved familial abductions, another 20% involved hoaxes or confusions, and only 30% actually involved abduction by strangers. The researchers recommended stricter adherence to the restrictive issuance criteria recommended by the U.S. Department of Justice to avoid overuse of the system.

There has also been one attempt to determine how effective AMBER Alert is in accomplishing its key goal, which is saving abducted children’s lives in the worst cases (often called “stereotypical” abductions). The researchers found that, despite claims by some practitioners that AMBER alerts have helped rescue hundreds of children, successful recovery is most likely when the victim is abducted by a parent and least likely when the child is abducted by a stranger. Since prior research has shown that most children abducted by parents are not harmed (regardless of whether an alert was issued or not), researchers questioned the effectiveness of alerts and their ability to “save” lives.

In addition to these issues, there might be obstacles to AMBER alerts routinely functioning as intended. For practical reasons, it is very difficult to learn of an abduction and issue an alert within the small, critical window of opportunity that exists in the worst cases. Despite the reasonableness of insisting that AMBER alerts only be issued in serious scenarios, there is an inherent dilemma in determining the level of threat actually posed when a child is missing and might or might not have been abducted.

References:

  1. Griffin, T., Miller, M. K., Hammack, R., Hoppe, J., & Rebideaux, A. (2007). A preliminary examination of AMBER Alert’s effects. Criminal Justice Policy Review.
  2. Hargrove, T. (2005). False alarms endangering future of Amber Alert system. New York: Scripps Howard News Service.
  3. Miller, M. K., & Clinkinbeard, S. S. (2006). Improving the AMBER Alert system: Psychologyresearch and policy recommendations. Law and Psychology Review, 30, 1-21.
  4. Miller, M. K., Griffin, T., Clinkinbeard, S. S., & Thomas, R. M. (2006, April). The psychology of AMBER Alert: Unresolved issues and policy implications. Paper presented at the Western Social Science Association Conference, Phoenix, AZ.

Return to Criminal Behavior overview.

Alzheimer’s Disease: Understanding the Impact and Importance of Early Detection

Alzheimer’s disease is a complex and challenging neurological disorder that affects millions of individuals and their families worldwide. As the most common form of dementia, it progressively impairs memory, thinking, and behavior, leading to significant changes in daily life. Understanding the impact of Alzheimer’s not only highlights the struggles faced by patients but also underscores the critical importance of early detection and intervention. By recognizing the early signs and seeking timely diagnosis, we can empower individuals and caregivers to make informed decisions, access support services, and explore treatment options that may enhance quality of life. This article delves into the effects of Alzheimer’s disease and the vital role early detection plays in managing this condition effectively.

Alzheimer’s disease (AD) is a progressive, neurodegenerative disease that accounts for 50% to 75% of all dementias affecting older adults. AD affects 5% to 10% of all adults older than 65 years, and this proportion doubles every 5 years over 65; consequently, it is a major health concern in the United States. About 4.5 million people had the disease in 2004, and this number will rise to about 11 million by 2025. Considering that most individuals with AD spend at least some time in a full-care facility, health care costs associated with the disease are high. Costs associated with AD in 2004 approached $1 billion per year, and these will continue to increase as the population ages. The high incidence of institutionalization stems from the  cognitive  effects  of  the  disease.  People  with AD gradually become unable to accomplish everyday tasks like driving and cooking; their abilities to communicate and manage their own grooming and self-care deteriorate, and eventually control of bodily functions and motor abilities is lost. However, the most devastating effect, particularly for family members, is the gradual deterioration of personality: Affected individuals lose interest in hobbies and outside events, fail to recognize family members, and eventually cease to interact with the world around. Thus, the disease is devastating on both societal economic and personal-familial levels. Intense research continues to investigate etiological factors, cognitive sequelae, and treatments for this debilitating illness.

Biological And Genetic Characteristics

The  characteristic  histological  markers  of  ADare  intercellular  neuritic  plaques  and  intracellular neurofibrillary tangles. Plaques occur in the spaces between  neurons  and  comprise  a  beta-amyloid (βamyloid) protein core surrounded by a cluster of dead and dying neurons. Neurofibrillary tangles consist of the tau protein fibers that normally organize and give shape to a cell but that have become deformed, possibly as a result of interaction with β-amyloid. The tau protein aggregates into intracellular tangles that block the normal flow of nutrients and information within the neuron. Consequently, the number of synapses the cell can maintain with other cells diminishes, and eventually the cell dies.

Amyloid proteins transport cholesterol throughout the body and brain so that it can be used for cellular repair. β-Amyloid is one of three common variants of the amyloid protein, and unlike other variants, none of the enzymes normally produced by the body can break it down. Moreover, the β-amyloid protein is particularly sticky and has been associated with the deposition of fatty cholesterol deposits in blood vessels as well as with neuritic plaques in AD. Consequently, the individual who has this version of the amyloid protein is at risk for cardiovascular disease in addition to AD. β-Amyloid protein is encoded by a particular gene on chromosome 19, known as the apolipoprotein ε4 (ApoE4)  gene. This  gene  variant  cuts  the  amyloid precursor protein in a different place than normal, yielding the insoluble β-amyloid. Like all genes, individuals have two copies of the ApoE gene. People carrying one copy of ApoE4 (about 25% of the population) have a higher risk for AD than individuals with other variants of the ApoE gene; individuals who carry two copies of the ApoE4 gene (about 2% of the population) have a much higher risk for developing AD at a younger age than those with only one copy of the gene. In fact, the ApoE4 gene variant accounts for about 50% of all cases of late-onset AD, that is, AD diagnosed after age 60. Furthermore, compared with noncarriers, carriers of the ApoE4 gene show metabolic differences in their brain in the same areas that are affected by AD as early as age 30; however, cognitive differences are minimal or absent between noncarriers and carriers of the ApoE4 gene from age 30 to 55. Early-onset AD refers to the 1% of AD cases that are diagnosed in people in their 40s and 50s, caused by mutations to genes other than ApoE. In addition to genetics, other risk factors for AD include increasing age, family history of AD, previous head trauma or stroke, and lower education and verbal ability.

AD preferentially targets brain centers that control higher cognitive abilities. The hippocampal region in the medial temporal lobe is affected first, hampering the ability to encode new memories, followed by the posterior cingulate, which is instrumental in making and evaluating decisions. Subsequently, the multimodal association cortices in the temporal and parietal lobes show signs of the disease, leading to difficulties with language use and spatial-temporal orientation. Later, the prefrontal cortex shows signs of the disease, which is reflected in attentional and behavioral deficits, as discussed subsequently.

Diagnosis

Physicians suspect AD might be present when individuals show a decline in memory ability and at least one other cognitive domain (e.g., language, orientation in time and space, or executive functions) that affects their daily occupational and social activities. Furthermore, this decline must have a gradual onset and must continue over time. To make a clinical diagnosis of AD, the doctor must exclude a number of other possible causes for this decline. Physicians use in-depth interviews, blood tests, and brain imaging (usually computed tomography scans or magnetic resonance imaging) to rule out depression, drug interactions, endocrine disorders, nutritional deficiencies, head trauma, brain tumor, and stroke as causes of decline before making a diagnosis of probable AD. It is still not possible to make a positive diagnosis of AD until autopsy; however, imaging techniques that highlight amyloid deposition in the brain have been developed recently that may allow in vivo diagnosis of AD in the near future.

Cognitive Characteristics

AD has profound effects on cognition, speech, and overall behavior that vary individually, depending on the sequence in which different parts of the brain are affected. By the time individuals are diagnosed with AD, usually at the very mild or mild stage of the disease, damage to hippocampus and posterior cingulate  is  typically  already  relatively  severe,  leading to  deficits  in  learning  new information,  short-term memory, autobiographical memory, and judgment. Consequently, people with AD often repeat questions and stories and make poor decisions because they cannot assimilate new information. Additionally, these individuals often have word-finding problems and difficulty expressing themselves, and their attentional and  spatial  impairments  make  driving  hazardous. Even at this mild stage of the disease, individuals have severe difficulty with organizing, planning, problem solving, and abstract reasoning. Typically, individuals are aware of their deficits and are often depressed and irritable. As the disease progresses, this awareness diminishes while memory and language problems increase.

At the moderate stage of the disease, typical, daily activities become increasingly difficult: the individual cannot prepare meals, use tools, or even take telephone messages. Although automatized tasks like self-grooming may be preserved, concerns about personal hygiene and appearance often suffer. Speech becomes vague and usually includes an overabundance of pronouns replacing more specific nouns, whereas the ability to comprehend complex sentences and discourse deteriorates. At this stage of the disease, many people with AD feel a profound restlessness and may begin to wander away from home. Because they become easily lost and often cannot remember their address or phone number, wandering can be a serious problem. Sleep difficulties, hallucinations, and personality changes are also common at this stage of the disease.

At the severe stage of AD, individuals slowly lose interest in their surroundings. Their ability to communicate relevantly declines and eventually disappears, as they lapse into mutism. They can no longer groom themselves and become incontinent. Additionally, they may not recognize common items, including food, and may have difficulty swallowing, which can lead to resistance to eating and drinking and subsequent malnutrition. They become agitated over changes in routine, and the loss of personality is profound. Eventually, they become bedridden and unresponsive; death, however, is usually due to infection or other complications.

Treatment

Current treatments for AD are based on the fact that AD affects the brain’s ability to produce many of the neurotransmitters crucial for memory and cognition. The primary drugs used in early AD, tacrine and donepezil, are acetylcholinesterase inhibitors, which prevent the breakdown of acetylcholine, a neurotransmitter necessary for memory function. In about 50% of individuals with early AD, these drugs minimize or slow the deterioration of cognitive abilities and help control behavioral problems, such as depression, agitation, and insomnia. Research to develop a vaccine that would prevent the accumulation of β-amyloid in the brain is in progress, but to date has been unsuccessful.

Maintaining communication with the individual with AD can help mitigate the burden the disease places on caregivers. Certain strategies can facilitate this communication, such as minimizing environmental distractions, limiting the use of pronouns and complex grammar, maintaining eye contact, and repeating or paraphrasing important information. Caregivers should also be encouraged to take advantage of home health care and adult day care services where available, as well as support groups, because the constant demands of caregiving can be debilitating both physically and emotionally.

In summary, AD is a devastating disease with enormous human and economic costs that will continue to increase as the population ages. However, research continues to identify ways to treat the disease and to improve quality of life for individuals with the disease and their caregivers.

References:

  1. Alzheimer’s Association, http://www.alz.org
  2. Alzheimer’s Disease Education and Referral Center of theNational Institute on Aging, http://www.alzheimers.org
  3. Kuhn & Bennett, D. A. (2003). Alzheimer’s early stages: First steps for family, friends, and caregivers (2nd ed.). Alameda, CA: Hunter House Publishers.
  4. Weiss, (2004). When the doctor says Alzheimer’s: Your caregiver’s guide to Alzheimer’s and dementia. Bloomington, IN: AuthorHouse.

Altruistic Punishment: Understanding the Role of Fairness in Society

In a world increasingly marked by individualism, the concept of altruistic punishment—a phenomenon where individuals collectively impose sanctions on those who violate social norms—remains a compelling aspect of human behavior. This intriguing interplay between fairness and social cohesion reveals the underlying motivations that drive people to penalize transgressors, even at a personal cost. By examining the psychological and evolutionary roots of altruistic punishment, we gain insight into how fairness shapes our societies and fosters cooperation among individuals. Understanding this complex dynamic can illuminate pathways to strengthen social bonds and promote a culture of fairness in an age where divisiveness often takes center stage.

Altruistic Punishment Definition

An act is altruistic if it is costly for the acting individual and beneficial for someone else. Thus, punishment is altruistic if it is costly for the punisher and if the punished person’s behavior changes such that others benefit. This definition does not require an altruistic motivation.

Think of queuing as an instructive example. Telling a queue jumper to stand in line is probably (psychologically) costly for the person confronting the queue jumper. If the queue jumper gets back into line, all people who were put at a disadvantage by the queue jumper benefit.

Altruistic Punishment Evidence

Scientific evidence for altruistic punishment comes from laboratory “public goods” experiments. In a typical public goods experiment, participants are randomly allocated to groups of four players. Each player is endowed with money units and has to decide how many to keep for him- or herself and how many to invest into a “the public good.” The experimenter doubles the sum invested into the public good and distributes the doubled sum equally among the four group members. Thus, every group member receives a quarter of the doubled sum, irrespective of his or her contribution. This experiment describes a cooperation problem: If everyone invests into the public good, the group is better off collectively; yet free riding makes everyone better off individually.

The experiments are conducted anonymously, and participants get paid according to their decisions. The public goods game is conducted several times but with new group members in each repetition. To contribute under such circumstances is altruistic: Contributing is costly, and all other group members benefit. The typical result is that people initially invest into the public good, but altruistic cooperation eventually collapses.

Now consider the following treatment: After participants make their contribution, they learn how much others contributed. Participants then have the possibility to punish the other group members. Punishment is costly: The punishing individual has to pay one money unit, and the punished individual loses three money units. A money-maximizing individual will never punish, because punishment is costly and there are no further interactions with the punished individual. Yet, numerous experiments have shown that many people nevertheless punish and free riding becomes rare. Thus, punishment is altruistic because people incur costs to punish irrespective of no future interactions with the punished individual and because the future partners of the punished free rider benefit from the free rider’s cooperation.

Altruistic Punishment Theoretical Relevance

Evolutionary and economic theories can explain cooperation by selfish individuals if the benefits of cooperating exceed the costs. Kinship, repeated interactions with the same individuals and reputation formation are channels through which benefits might exceed costs. From the viewpoint of these theories, altruistic punishment is a puzzle, because none of these channels was possible in the experiments and because the costs of punishing outweigh the benefits for the punishing individual.

References:

  1. Fehr, E., & Fischbacher, U. (2003). The nature of human altruism. Nature, 425, 785-791.
  2. Fehr, E., & Gachter, S. (2002). Altruistic punishment in humans. Nature, 415, 137-140.

Altruism: The Heartbeat of Social Development

In an increasingly interconnected world, the foundational role of altruism in fostering social development has never been more evident. As communities grapple with complex challenges such as inequality, environmental degradation, and social unrest, the act of placing others’ needs above one’s own emerges as a powerful catalyst for positive change. This article explores the intricate relationship between altruistic behaviors and societal advancement, highlighting how empathy and selflessness can unite individuals and inspire collective action toward a brighter, more equitable future. By understanding the heartbeat of altruism, we can better appreciate its potential to transform lives and strengthen the very fabric of our communities.

Philosophers  throughout  the  ages  have  debated whether humans actually intend to perform altruistic actions, actions that are beneficial to others and costly to the actor, without any clear resolution. In recent decades, psychologists have addressed the long-standing philosophical debate over the existence of  altruism,  usually  defined  as  unselfish  concern for the welfare of others, with empirical studies. Categorizing an action as altruistic often implies that the decision to perform the action was not influenced by consideration for the self or the possible benefits to the self that may accrue from performing the action.

Psychological Research On Helping

Psychologists have studied helping behavior from a variety of perspectives. For example, Latane and Darley have developed a five-step cognitive model of  bystander  intervention.  These  steps  consist  of: (a) noticing the event, (b) interpreting the event as requiring help, (c) assuming personal responsibility, (d) choosing a way to help, and (e) implementing the decision. This model has been shown to be applicable to both emergencies and nonemergency situations. Behaviorists have demonstrated that helping behaviors can be increased by direct reinforcement and modeling, and social psychologists have shown that helping is more likely to occur when the rewards of helping outweigh the costs. Psychologists have also uncovered characteristics of the target that increase the chances of helping, such as attraction based on attractive physical appearance, friendly behavior or personal qualities, and similar racial characteristics.

Recent Psychological Research On Altruism

Batson and colleagues’ empathy-altruism hypothesis proposes that a truly altruistic motivation can be evoked by empathic concern toward another person for whom the benefit is directed. Actions based solely on the motivation to benefit another are proposed to result from a series of cognitive events. In the enabling stage, the observer takes the perspective of the needy target, which may be stimulated by perceived similarity between oneself and the other, by instructions to take the other’s perspective, or by an attachment such as kinship,  friendship,  or  prior  contact.  This  leads  to an emotional response of empathic concern, including feelings of sympathy, warmth, tenderness, and compassion, resulting in a desire to improve the other’s welfare, rather than one’s own welfare.

Although altruist advocates admit that human motivation is frequently for self-benefit, they see the need for a pluralistic explanation of helping behaviors that includes both altruism and egoism. Studies supporting the empathy-altruism hypothesis have systematically varied on whether individuals can only obtain egoistic goals by helping, or whether they can escape from the situation and obtain the egoistic goals without helping. These studies purportedly demonstrate that at least some people have helping intentions that are not explained by egoistic motivations, such as the relief of personal distress (as proposed by Aquinas and Hobbes), escaping public shame for not helping, the relief of sadness, and the desire to make oneself happy.

Other researchers assume psychological egoism, the thesis that people always try to act in ways that benefit themselves. Cialdini and associates have proposed that it is the sense of self–other overlap, or “oneness,” between the helper and the individual in need that motivates helping, rather than empathy. Helping others with whom one feels commonality would not be selfless because it leads to a more favorable mental state. Egoist advocates suggest that empathic concern is an emotional signal of oneness and that empathy per se at best leads to superficial helping.

Studies examining whether the effect of empathic concern can be eliminated when the sense of oneness with the target, or self–other overlap, is accounted for have produced contradictory results. One philosophical objection to the egoist argument is that seeing the other as part of the self is in itself altruistic. The perceived overlap implies that the self and other share a common fate, so that resources and other assistance may be shared to maximize outcomes for more than just the individual.

Understanding Altruism In An Evolutionary Framework

Integrating concepts from evolutionary theory enhances the psychological framework for understanding altruistic helping intentions. An evolutionary approach promotes the understanding of affect, cognition, motivation, and behavior as expressions of functional, adaptive processes that evolved through natural and sexual selection to solve problems in our ancestral environments. The altruism debate may be clarified by disentangling proximate motivations and ultimate selection pressures. An evolutionary framework acknowledges the possibility of both altruistic and egoistic motivations from the perspective of the individual. From an evolutionary perspective, subjective experiences  underlying  an  adaptation  can  vary,  as long as they reliably lead to adaptive behaviors. The underlying motive or subjective experience of the individual is less important than the consequences of their actions. This allows for the possibility of behaviors that are altruistic in terms of costs and benefits to the donor, although egoistic in terms of the benefit to the genes shared by the individuals.

William Hamilton’s inclusive fitness theory explained that by assisting in a time of need, one could help his or her relative become an ancestor of offspring with similar genes. Kin selection, a genetically influenced tendency to differentially help relatives, is likely to spread across a population when the cost in reproductive fitness to the donor is less than the product of the fitness benefit to the recipient and the proportion of genes that the donor and recipient share. Nepotistic acts encouraged by kin selection include the altruism advocates’ example of a mother rushing to help her injured child.

Consistent with evolutionary theory, the experience of oneness or empathy could arise as a consequence of attachment-related cues (kinship, friendship, familiarity) that signaled the potential for relatively high genetic commonality in our ancestral environment. The psychological states provoked by these cues could increase the chances of the needy individuals receiving assistance, enhancing the survival and replication of genes influencing the psychological capacities for oneness and empathy. A number of studies have found support  for  predictions  derived  from  kin  selection in psychological mechanisms influencing helping, behavioral intentions to help, and actual helping behaviors.

Kin selection is not the only recognized evolutionary pathway for altruistic actions. Trivers’ theory of reciprocal altruism predicts that altruistic behaviors will also be a function of beliefs about the recipient’s likelihood of reciprocating. The exchange of resources and support in times of need is adaptive owing to benefits conferred to the viability of the group as a whole. Solitary altruistic actions will occur because the donors may someday find themselves in need and could expect to benefit from help. As long as this occurs, altruistic actions benefiting nonrelatives will occur. The social environment in the ancestral environment encouraged the development of reciprocal altruism because the relative social isolation increased the chances that other altruists would benefit from others’ altruistic behavior. One recent study found that cognitive mechanisms facilitating reciprocal altruism accounted for the greatest portion of the variance helping intentions, more than all other effects combined.

The mental events facilitating reciprocity are usually depicted as cognitive mechanisms evaluating the likelihood that the target would provide help if conditions in the situation were reversed. In recent years, this cognitive perspective has been supplemented by the recognition of emotional pathways that are consistent with the adaptive framework of evolutionary psychology. Emotional bonding with others promotes commitment to helpful actions that are performed for the benefit of the other individual, rather than for an expected favor in return. Over time, individuals may benefit from having maintained these relationships, rather than severing ties if helping actions are not immediately reciprocated. Those individuals who eventually find themselves in need will gain from the more elastic form of reciprocal altruism facilitated by emotional commitments. Of course, repeated violations of the norm of reciprocity may attenuate emotional commitment with another.

Altruistic actions performed for “the good of the species” are usually rejected because natural selection operates more effectively within breeding populations than between them. Since the 1960s, arguments for group-selecting altruistic arguments have been discounted by most evolutionary biologists. Assuming that the tendency to sacrifice oneself for the sake of one’s group varies among individuals within groups, those with more selfish tendencies will survive better than their more altruistic neighbors. This would lead the group to eventually become more selfish in nature. In recent years, more sophisticated arguments for group selection have revived this debate. However, the newer group selection models mirror those of individual level selection; therefore, they can be mathematically transformed into each other. It is also possible that genuine group-selecting altruistic actions have been generated from cultural influences and that groups benefiting from these actions are more successful than other groups, although this has not resulted in novel genetic adaptations for helping behaviors.

Conclusion

In  conclusion,  actions  that  are  altruistic  from the perspective of the proximate mental motivation of individuals are consistent with evolutionary adaptation. Proximally altruistic mechanisms may operate within a genetically selfish system. Actions that are genetically altruistic, those that reduce one’s inclusive genetic fitness, will be extremely rare. Studies have indicated that psychologically altruistic and egoistic pathways for helping behaviors may operate simultaneously.

References:

  1. Batson, D., Sager, K., Garst, E., Kang, M., Rubchinsky, K.,& Dawson, K. (1997). Is empathy-induced helping due to self-other merging? Journal of Personality and Social Psychology, 73, 495–509.
  2. Cialdini, R., Brown, S., Lewis, B., Luce, C., & Neuberg, S. (1997). Reinterpreting the empathy-altruism relationship: When one into one equals oneness. Journal of Personality and Social Psychology, 73, 481–494.
  3. Frank, H. (1988). Passions within reason: The strategic role of the emotions. New York: W. W. Norton.
  4. Hamilton, W. (1964).  The  evolution  of  altruistic  behavior. American Naturalist, 97, 354–356.
  5. Latane & Darley, J. (1970). The unresponsive bystander: Why doesn’t he help? New York: Appleton-Century-Crofts. Kenrick, D. (1991). Proximate altruism and ultimate selfishness. Psychological Inquiry, 2, 135–137.
  6. Kenrick, , Neuberg, S., & Cialdini, R. (1999). Social psychology: Unraveling the mystery. Boston: Allyn & Bacon. Kruger, D. J. (n.d.). Evolution and altruism. Retrieved from http://www-personal.umich.edu/~kruger
  7. Kruger, D. J. (2003). Evolution and altruism: Combining psychological mediators with naturally selected tendencies. Evolution and Human Behavior, 24, 118–125
  8. Nesse, R. M. (2001). Evolution and the capacity for commitment. New York: Russell
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  2. Sober, , & Wilson, D. S. (1998). Unto others: The evolution and psychology of unselfish behavior. Cambridge, MA: Harvard University Press.
  3. Trivers, L. (1971). The evolution of reciprocal altruism.Quarterly Review of Biology, 46, 35–37.

Altruism: The Power of Selfless Giving in Our Communities

In a world often driven by individualism and self-interest, the concept of altruism stands as a powerful counterpoint, reminding us of the profound impact of selfless giving. From small acts of kindness to large-scale charitable initiatives, altruism fosters a sense of community, connects individuals, and cultivates a spirit of cooperation that can transform lives. This article explores the various dimensions of altruism, highlighting how selfless actions not only enrich the lives of those who receive but also enhance the well-being of the givers and strengthen the fabric of our communities. Join us as we delve into the transformative power of altruism and its ability to inspire positive change in the world around us.

Altruism Definition

Altruism refers to a motive for helping behavior that is primarily intended to relieve another person’s distress, with little or no regard for the helper’s self-interest. Altruistic help is voluntary, deliberate, and motivated by concern for another person’s welfare. When help is given for altruistic reasons, the helper does not expect repayment, reciprocity, gratitude, recognition, or any other benefits.

Background and History of Altruism

Questions about the nature and importance of altruism have a long history in moral philosophy. For example, the biblical parable of the Good Samaritan, who ministered to a traveler’s wounds at personal cost while expecting nothing in return, has become synonymous with the idea of selfless giving. Among social psychologists, interest in altruism grew in response to early studies of helping behavior. Those studies tended to focus on the act of helping itself, that is, whether or not one person gave help to another person. As researchers sought to identify the motives responsible for acts of helping, it became apparent that two major classes of motives could underlie helping: egoistic and altruistic. Egoistic motives are concerned chiefly with benefits the helper anticipates receiving. These might be material (repayment, the obligation for future favors in return), social (appreciation from the recipient, public recognition), or even personal (the gratifying feeling of pride for one’s actions). Altruistic motives, on the other hand, focus directly on the recipient’s need for assistance and involve sympathy and compassion for the recipient.

A key debate has contrasted altruistic motivation with one particular type of egoistic motive, sometimes called distress reduction. Witnessing another person’s distress can be profoundly upsetting, and if the helpful act is motivated first and foremost by the desire to relieve one’s own upset feelings, the act would be seen as more egoistic than altruistic. The difference is that whereas altruistic helping focuses on the recipient’s need (“You were suffering and I wanted to help”), egoistic helping focuses on the helper’s feelings (“I was so upset to see your situation”).

The distinction between egoistic and altruistic motives for helping behavior has sometimes been controversial. One reason is that altruistic explanations do not lend themselves to the kinds of reward-cost theories that dominated the psychological analysis of motivation during the mid-20th century. These theories argued in essence that behavior occurs only when it maximizes the actor’s rewards while minimizing his or her costs, a framework that does not facilitate altruistic interpretations of helping. Nevertheless, it is clear that acts of helping often involve great personal cost with little or no reward; one need only consider the behavior of individuals who rescued Jews from Nazi persecution or Tutsis from the Rwandan massacre to realize that helping often does take place for altruistic reasons.

Social psychologist Daniel Batson was instrumental in introducing methods for studying helping that is altruistically motivated. One such method involves using experimental variations to differentially emphasize either the need of the recipient or the opportunity to fulfill more egoistic motives. Increases in helping from one condition to the other can then be attributed to whichever motive has been strengthened. Another method involves sophisticated techniques that help identify what people were thinking about as they considered helping. In both cases, research has shown unequivocally that altruistic motives often play an important role in helping behavior. This sort of helping is sometimes called true altruism or genuine altruism, tacit acknowledgment that some forms of helping behavior are more egoistic in nature. Although from the perspective of the needy recipient, it may not matter whether a given act is motivated by egoistic or altruistic concerns, from a scientific standpoint, the difference is substantial.

Factors That Contribute to Altruistic Helping

The factors that contribute to altruistic helping may be grouped into two broad categories: those that describe the individual who helps and those that are more contextual in nature. Concerning the former, research has shown that people who are more likely to provide altruistically motivated help tend to have strong humanitarian values and feel a relatively great sense of responsibility for the welfare of others. They also tend to be more empathic and caring about others than are more egoistically oriented helpers. In one interesting line of research, Mario Mikulincer, Phillip Shaver, and their colleagues have shown that people with a secure attachment style—that is, people who feel secure and trusting in their relationships with their closest care-givers (parents, romantic partners, and others)—tend to have more altruistic motives in a variety of helping contexts, including volunteerism (e.g., charity work). Insecure attachment styles, on the other hand, either discourage helping or foster more egoistic motives for helping.

Among the contextual factors that influence altruism, characteristics of the relationship between helper and recipient are very important. Empathy is strongly related to altruistic helping, in two ways: Empathy involves taking the perspective of the other, and empathy fosters compassionate caring. Both are more likely in close, personal relationships, and because people typically care about the welfare of their close friends, both tend to increase the likelihood of altruistically motivated helping.

Identifying with the other person is another contextual factor thought to increase the likelihood of altruism. This sense of connection with the other appears to be particularly important for explaining altruistic helping to kin and in group contexts. The former refers to the well-documented fact that the probability of an altruistic act is greater to the extent that the recipient shares the helper’s genes; for example, people are more likely to help their children than their nieces and nephews but are more likely to help the latter than their distant relatives or strangers. As for the latter, altruistic helping is more common with members of one’s ingroups (the social groups to which one feels that he or she belongs) than with outsiders to those groups. Many examples of personal sacrifice during wartime can be understood as ingroup altruism.

Other studies have shown that when the potential helper’s sense of empathy is aroused, altruistically based helping tends to increase. This can be done, for example, by asking research participants to imagine how the other person feels in this situation, as opposed to staying objective and detached. This kind of research is particularly useful for researchers seeking ways to increase altruistic helping in the modern world. It suggests that awareness of the needs of others, combined with some desire to assist them, may be effective.

Reference:

  • Batson, C. D. (1991). The altruism question: Toward a social-psychological answer. Hillsdale, NJ: Erlbaum.

Alternative Therapies in PTSD Management: Exploring Holistic Approaches for Healing

Post-traumatic stress disorder (PTSD) affects millions of individuals, often leaving them feeling trapped in a cycle of fear and anxiety. While traditional treatments like therapy and medication have proven beneficial for many, a growing number of individuals are seeking alternative therapies to complement or even replace conventional methods. This exploration of holistic approaches—ranging from mindfulness practices and yoga to art therapy and acupuncture—highlights the potential of these therapies to provide relief and promote healing. By examining the benefits and challenges associated with these alternative modalities, we open a dialogue about comprehensive care strategies that embrace the mind, body, and spirit in the journey towards recovery.

This article explores the role of alternative therapies in the management of Post-Traumatic Stress Disorder (PTSD) within the framework of health psychology. Beginning with an introduction to the significance of effective PTSD management, the article reviews traditional approaches, including psychotherapy and pharmacotherapy, and examines their limitations. The subsequent sections delve into various alternative therapies, such as mindfulness-based therapies, yoga, and meditation, eye movement desensitization and reprocessing (EMDR), biofeedback, animal-assisted therapy, acupuncture, art and expressive therapies, outdoor and adventure therapies, and herbal and nutritional supplements. Each subsection discusses the principles, empirical evidence, and potential integration of these alternative therapies into a comprehensive treatment plan for PTSD. The conclusion emphasizes the importance of individualized approaches and calls for further research to enhance the understanding and implementation of alternative therapies in PTSD management.

Introduction

Post-Traumatic Stress Disorder (PTSD) is a debilitating mental health condition that can develop in individuals who have experienced or witnessed traumatic events. Common triggers include combat exposure, physical or sexual assault, accidents, or natural disasters. PTSD is characterized by a range of symptoms, including intrusive memories, flashbacks, nightmares, hypervigilance, and avoidance behaviors. The prevalence of PTSD underscores the critical need for effective interventions to alleviate the profound impact it can have on individuals’ well-being.

The significance of developing and implementing effective management strategies for PTSD cannot be overstated. Individuals with PTSD often face challenges in various aspects of their lives, such as interpersonal relationships, occupational functioning, and overall quality of life. Addressing PTSD not only alleviates the suffering of affected individuals but also contributes to the broader societal goal of promoting mental health and well-being. Traditional approaches, including psychotherapy and pharmacotherapy, have been central to PTSD management; however, there is an increasing recognition of the potential benefits of alternative therapies in providing a more comprehensive and personalized approach to treatment.

In recent years, there has been a growing interest in alternative therapies as complementary interventions for PTSD. These therapies encompass a diverse range of approaches, from mindfulness-based techniques and yoga to innovative methods like eye movement desensitization and reprocessing (EMDR), biofeedback, and animal-assisted therapy. This section serves as a prelude to the subsequent exploration of these alternative therapies, highlighting their potential to enhance the efficacy and inclusivity of PTSD management strategies. As we delve into each alternative therapy, their underlying principles, empirical evidence, and integration into holistic treatment plans will be examined, providing valuable insights into their potential as viable options in the broader landscape of health psychology.

Traditional Approaches to PTSD Management

One cornerstone of traditional PTSD management is psychotherapy, with Cognitive Behavioral Therapy (CBT) standing out as a widely researched and recommended modality. CBT for PTSD involves cognitive restructuring to address distorted thought patterns and exposure techniques to confront and process traumatic memories systematically. Numerous studies have demonstrated the effectiveness of CBT in reducing PTSD symptoms, improving overall functioning, and preventing relapse. Therapeutic components such as cognitive restructuring, exposure therapy, and skills training contribute to the adaptability and individualization of CBT in addressing the diverse needs of individuals with PTSD.

Pharmacotherapy represents another fundamental pillar in the traditional treatment of PTSD. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are commonly prescribed to alleviate symptoms such as intrusive thoughts and mood disturbances. Anxiolytics, such as benzodiazepines, may be used to manage acute anxiety symptoms. While pharmacotherapy can offer symptom relief, it is essential to consider potential side effects and limitations, as not all individuals respond favorably to medication. Furthermore, the risk of dependency and withdrawal symptoms associated with certain medications necessitates careful consideration in the treatment planning process.

Recognizing the complexity of PTSD, clinicians often employ a combination of psychotherapy and pharmacotherapy to address a broader range of symptoms and individual variations. While combined treatments can enhance effectiveness, they also pose challenges, such as potential side effects, increased treatment burden, and difficulties in coordinating care. Additionally, not all individuals respond uniformly to these combined approaches, emphasizing the need for personalized treatment plans that consider the unique characteristics and preferences of each patient. Future research is warranted to explore optimal combinations and sequencing of treatments, as well as identifying subgroups that may benefit more from specific combinations than others. Overall, a nuanced understanding of the strengths and limitations of traditional approaches sets the stage for exploring alternative therapies in the holistic management of PTSD within health psychology.

Mindfulness-based therapies, rooted in contemplative practices like mindfulness meditation, bring attention to the present moment with a non-judgmental awareness. The central tenet involves cultivating mindfulness, fostering an intentional focus on thoughts, feelings, and bodily sensations. Mindfulness-based therapies, such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), incorporate mindfulness principles into structured interventions. These therapies aim to enhance emotional regulation, increase self-awareness, and promote acceptance of distressing thoughts and emotions.

Empirical research has consistently supported the efficacy of mindfulness-based therapies in the management of PTSD. Studies demonstrate reductions in symptoms such as intrusive thoughts, avoidance behaviors, and hyperarousal. Mindfulness-based approaches have been associated with improvements in overall psychological well-being, increased emotional regulation, and enhanced quality of life for individuals with PTSD. Neurobiological studies also suggest changes in brain regions associated with emotion regulation, providing insights into the mechanisms underlying the therapeutic effects of mindfulness.

The application of mindfulness-based therapies in PTSD treatment involves integrating mindfulness practices into therapeutic sessions and encouraging regular mindfulness exercises as part of daily routines. Mindfulness can be applied to target specific symptoms, such as reducing anxiety through focused breathing or addressing intrusive thoughts through mindful observation. Additionally, mindfulness-based interventions can be tailored to address the unique needs of individuals with PTSD, offering a holistic approach that complements traditional treatments. As mindfulness continues to gain empirical support, its inclusion in comprehensive PTSD management plans highlights its potential as a valuable alternative therapy within the realm of health psychology.

Biofeedback and Neurofeedback

Biofeedback and neurofeedback are therapeutic approaches that involve real-time monitoring and feedback of physiological processes to help individuals gain control over normally involuntary bodily functions. Biofeedback typically focuses on various physiological measures such as heart rate, muscle tension, and skin conductance, providing individuals with information about their bodily responses. Neurofeedback, on the other hand, specifically targets brain activity, often measured through electroencephalography (EEG). Both modalities operate on the principle that individuals can learn to regulate these physiological processes through increased awareness and practice.

Research examining the application of biofeedback and neurofeedback in the context of PTSD has shown promising results. Studies have demonstrated that individuals with PTSD can learn to modulate physiological responses through biofeedback, leading to reductions in symptoms such as hyperarousal and intrusive thoughts. Neurofeedback, by targeting specific brainwave patterns associated with PTSD, has shown efficacy in improving emotional regulation and reducing overall symptom severity. While further research is needed to establish the long-term effectiveness and optimal protocols, initial findings suggest that biofeedback and neurofeedback hold potential as complementary interventions for PTSD.

Integrating biofeedback and neurofeedback into a comprehensive PTSD management plan involves a multidimensional approach. Therapists can use biofeedback to help individuals gain awareness and control over physiological responses associated with stress and trauma. Neurofeedback interventions may focus on modifying specific brainwave patterns, enhancing self-regulation, and reducing symptom severity. Incorporating these modalities into traditional therapeutic approaches, such as cognitive-behavioral therapy, provides a holistic treatment strategy. Individualized treatment plans, based on an assessment of the unique needs and preferences of each patient, can maximize the benefits of biofeedback and neurofeedback as components of a personalized PTSD management plan within the broader landscape of health psychology.

Animal-Assisted Therapy

Animal-Assisted Therapy (AAT) is a therapeutic approach that involves incorporating animals into the treatment process to enhance emotional well-being and address various psychological issues. Dogs, horses, and other animals are commonly used in AAT, providing individuals with a supportive and non-judgmental environment. The presence of animals is believed to foster a sense of companionship, trust, and safety, making AAT a unique and valuable adjunctive intervention for individuals with PTSD.

Research on the positive effects of Animal-Assisted Therapy in the context of PTSD has demonstrated encouraging outcomes. Interactions with animals during therapy sessions have been associated with reductions in symptoms such as anxiety, depression, and hyperarousal. The human-animal bond established in AAT is thought to promote emotional regulation, improve social functioning, and enhance overall quality of life for individuals struggling with the aftermath of trauma. Moreover, the release of oxytocin and endorphins during animal interactions contributes to a positive physiological response, further supporting the potential therapeutic benefits of AAT.

While Animal-Assisted Therapy holds promise as a complementary intervention, there are important considerations and ethical guidelines that must be addressed in its implementation. First, the selection of therapy animals should be carefully considered based on the needs and preferences of individuals with PTSD. Trained and certified animals and handlers are essential to ensure safety and efficacy. Ethical guidelines emphasize the importance of informed consent, respect for the individual’s boundaries, and consideration of potential triggers related to trauma. Additionally, ongoing monitoring and evaluation of the therapeutic alliance between the individual and the therapy animal are crucial to optimize the therapeutic benefits of AAT. As AAT continues to gain recognition, further research and standardization of protocols will contribute to its integration into evidence-based PTSD management plans within the realm of health psychology.

Acupuncture and Traditional Chinese Medicine

Acupuncture, a key component of Traditional Chinese Medicine (TCM), is a therapeutic practice that involves inserting thin needles into specific points on the body to stimulate energy flow, known as Qi. Rooted in ancient Chinese philosophy, TCM views health as a balance of vital energy and seeks to restore this equilibrium to promote overall well-being. Acupuncture is believed to influence the body’s energy pathways, addressing imbalances and promoting healing. Traditional Chinese Medicine also encompasses herbal remedies, dietary practices, and lifestyle modifications, offering a holistic approach to health.

Research exploring the efficacy of acupuncture in managing PTSD symptoms has yielded promising results. Studies indicate that acupuncture may contribute to the reduction of PTSD symptoms, including anxiety, hyperarousal, and sleep disturbances. The mechanism of action is thought to involve the modulation of neurotransmitters, such as serotonin and endorphins, and the regulation of the autonomic nervous system. While the body of evidence supporting acupuncture for PTSD is growing, further research is needed to elucidate optimal protocols, treatment duration, and long-term outcomes.

Integrating acupuncture into a holistic approach to PTSD treatment involves considering the individual’s overall well-being and addressing multiple facets of their mental and physical health. Acupuncture can be included as part of a comprehensive treatment plan, alongside traditional therapeutic approaches such as psychotherapy and pharmacotherapy. Tailoring acupuncture sessions to address specific PTSD symptoms, such as sleep disturbances or anxiety, allows for a personalized treatment approach. Additionally, combining acupuncture with other elements of Traditional Chinese Medicine, such as herbal remedies and lifestyle modifications, offers a holistic framework that aligns with the principles of TCM. As part of health psychology interventions, the integration of acupuncture underscores the importance of individualized care and diversified approaches in the management of PTSD.

Conclusion

In summary, this article has explored a diverse array of alternative therapies within the realm of health psychology for the management of Post-Traumatic Stress Disorder (PTSD). From mindfulness-based therapies and biofeedback to animal-assisted therapy, acupuncture, and more, each alternative approach offers a unique perspective and potential benefits in addressing the multifaceted nature of PTSD. These therapies go beyond traditional interventions, providing individuals with a broader spectrum of options that may better align with their unique needs and preferences.

Central to the discussion is the recognition of the importance of individualized treatment plans in the management of PTSD. Each person’s experience with trauma is unique, and the heterogeneity of symptoms requires a personalized and flexible approach to treatment. Alternative therapies, with their diverse modalities, allow for customization to better match the individual’s specific symptoms, preferences, and cultural background. The emphasis on individualization underscores the evolving nature of health psychology, promoting a patient-centered approach that acknowledges the complexities of PTSD.

While alternative therapies show promise in PTSD management, the need for further research is paramount. Rigorous scientific inquiry can enhance our understanding of the mechanisms underlying the therapeutic effects of these approaches, determine optimal protocols, and identify specific subgroups that may benefit most. Additionally, research can contribute to establishing standardized guidelines, ensuring safety, and improving the overall efficacy of alternative therapies. A call for ongoing investigation is crucial to advancing the field of health psychology and expanding the toolkit of evidence-based interventions for individuals grappling with the enduring effects of trauma.

In conclusion, the exploration of alternative therapies in PTSD management represents a progressive step toward comprehensive and individualized care. By incorporating these diverse approaches into the broader landscape of health psychology, clinicians and researchers can work collaboratively to refine and optimize alternative therapies, ultimately providing more effective and tailored interventions for individuals living with PTSD.

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Alternative Dispute Resolution: A Modern Approach to Conflict Resolution

In an increasingly complex and fast-paced world, traditional methods of resolving disputes often fall short of meeting the needs of diverse and dynamic societies. Enter Alternative Dispute Resolution (ADR), a modern approach that offers innovative solutions to conflict resolution. Unlike conventional litigation, which can be lengthy and adversarial, ADR encompasses a variety of processes, such as mediation and arbitration, that prioritize collaboration and mutual understanding. As we explore the principles and practices of ADR, we will uncover its growing significance in legal systems around the globe and its potential to foster amicable resolutions while saving time and resources.

Alternative dispute resolution (ADR) has come to refer broadly to a range of processes (e.g., bilateral negotiation, fact finding, mediation, summary jury trial, arbitration) that are used in transactional (e.g., design contracts, develop regulations), dispute prevention, and dispute resolution contexts. ADR processes operate in public and private settings, such as courts, government agencies, community mediation centers, schools, workplaces, and private providers, to address an array of substantive issues (e.g., custody, torts, contracts, misdemeanors, environmental issues).

This research paper focuses on a subset of ADR processes: those that involve a neutral third party and serve as an alternative to court adjudication of civil, divorce, and minor criminal disputes. The processes that are most commonly used are described in the following section.

The goals and asserted benefits of ADR include enhancing disputants’ satisfaction with the resolution process and its outcome; producing better outcomes and increased compliance; improving the disputants’ relationship and reducing future disputes; providing faster, less expensive, and confidential case resolution; increasing disputants’ access to a hearing on the merits; and reducing caseloads and the use of court resources. These goals do not all apply to, and are not of equal importance in, every ADR process and setting. Criticisms of ADR, particularly when its use is mandatory, include that it lacks procedural safeguards, decreases public participation and scrutiny, reduces the available legal precedents and reference points, creates pressures to settle, provides second-class justice, and impedes access to trial by adding another step in the litigation process. Empirical field research on the efficacy of ADR, and on the impact of process, third-party, and dispute characteristics, is discussed in a subsequent section.

Third-Party ADR Processes

Third-party ADR processes fall into two main categories. The first involves processes such as arbitration, in which the third party decides the case for the disputants. The second category involves processes such as mediation, in which the third party assists the disputants in reaching their own resolution. If the disputants reach an agreement, it is legally enforce-able; if they do not, the case continues in litigation. Although most disputes settle before trial, a neutral third party can help disputants overcome the logistical, strategic, and cognitive barriers to bilateral negotiation that often impede early or optimal settlements.

Disputants can enter ADR as the result of a predispute contractual agreement to use ADR or, after a dispute has arisen, as a result of mutual agreement, judicial referral of a specific case, or court-mandated use for an entire category of cases. In both court-connected and private ADR, the proceedings are private, and the content of any agreement reached is confidential and not reported to the court. Below is a general description of several commonly used processes. How each is implemented varies with the type of setting and disputes, as well as with the specific ADR provider.

Arbitration involves a hearing during which the disputants’ lawyers present evidence and arguments to a single arbitrator, or sometimes a panel of three arbitrators, who renders a decision. In voluntary private arbitration, the arbitrator’s decision typically is binding, but the disputants determine that as well as other features of the process by agreement. Mandatory court-connected arbitration is nonbinding: The disputants may reject the arbitrator’s decision and proceed to trial de novo. If they accept the arbitrator’s decision, it becomes a court judgment.

The arbitration hearing typically is held after discovery has been substantially completed. Compared with a trial, an arbitration hearing tends to be less formal and to permit the broader admissibility of evidence. Court-connected arbitration usually involves a single session lasting several hours; private arbitration can involve multiple daylong sessions spread over weeks. Arbitrators are either lawyers or nonlawyers with expertise in the subject matter of the dispute. Although disputants often attend arbitration hearings, their participation is limited to providing evidence.

Mediation is a process in which a mediator, or sometimes a pair of mediators, facilitates the disputants’ discussion of issues and options to help them reach a mutually acceptable resolution of their dispute. Accordingly, disputant participation in the mediation process and in determining the outcome is viewed as critical. The mediator’s approach can vary with the setting, as well as with the individual mediator’s preferences and the nature of the particular dispute. Some mediators view their primary objective as enabling the disputants to better understand their own interests and the other side’s perspective. Most mediators, however, do not consider enhancing the disputants’ understanding as an end in itself but as a means to helping them reach an agreement that meets their needs.

Mediators differ in how actively they intervene during the session: whether they focus the disputants’ discussion narrowly on the instant dispute and legally relevant issues or expand it to include broader issues and considerations and whether they help the disputants assess various options or offer their own evaluation of the merits of the disputants’ positions and proposals. The timing of mediation (e.g., before a claim is filed, shortly after filing, after discovery is completed), the number and length of sessions, who the mediators are (e.g., lay people, mental health professionals, lawyers), and whether the attendance of the disputants’ lawyers is required or prohibited vary with the setting and types of disputes.

Neutral case evaluation is used less frequently than mediation. Following each lawyer’s brief presentation of the case, the third party assesses the strengths and weaknesses of each disputant’s position and facilitates settlement discussions. The evaluator, who usually is a lawyer, also might offer an assessment of liability and a valuation of damages, suggest a reasonable settlement value, or predict the likely trial outcome to facilitate settlement. If no settlement is reached, the evaluator might explore ways to streamline pretrial discovery and motions. Neutral case evaluation typically involves a single several-hour session that is held relatively early during litigation and is attended by the disputants and their lawyers.

Judicial settlement conferences may be conducted by the judge assigned to the case or by another judge and usually take the form of neutral case evaluation or narrow, settlement-focused, evaluative mediation. A settlement conference typically involves a single session that lasts several hours and is held when the case is essentially ready for trial. Although some judges require disputants to attend, usually only the lawyers are present and participate in the discussions. Courts generally consider judicial settlement conferences to be ADR, but some commentators regard them as a component of traditional litigation.

Empirical Field Research on ADR

Few general statements about the research findings can be made that apply consistently across ADR processes, settings, and dispute types. Even within the same process and setting, the findings are mixed as to whether ADR performs better than, or simply as well as, litigation.

Most of the research has examined mediation and arbitration in court-connected programs; few published studies have examined other ADR processes or private ADR. The primary data sources include court or ADR program records and questionnaires completed at the end of the session by disputants, lawyers, and neutrals. Few studies have included observations of sessions or long-term follow-up with disputants. Many studies do not include a comparison group of non-ADR cases; those that do seldom assign cases randomly to ADR and non-ADR groups. Drawing conclusions across studies is further complicated because different studies use different non-ADR comparison groups: Some use only cases settled via negotiation, others use only tried cases, and still others include all disposition types.

The Efficacy of ADR

In divorce, small claims, and community mediation, from 50% to 85% of cases settle. In general jurisdiction civil cases, from one fourth to two thirds of cases that use mediation, neutral evaluation, or arbitration settle. A majority of studies find that the settlement rate in mediation cases is higher than in comparable cases that do not use mediation, but other studies find no differences between mediated and litigated cases in settlement rates. Studies of court-connected arbitration tend to find a lower settlement rate in arbitrated cases than in comparable nonarbitrated cases. Because arbitration hearings divert cases from settlement but not from trial, arbitration increases disputants’ access to a hearing on the merits. Studies generally find that judicial settlement conferences do not increase the rate of settlement but that lawyers think they do.

Some studies find that compared with traditional litigation, ADR resolves cases faster; reduces discovery, motions, pretrial conferences, and trials; and reduces disputants’ legal fees and litigation costs. Other studies, however, find no differences between ADR and litigation in these measures. No study has found that judicial settlement conferences resolve cases faster. In mediation and neutral evaluation, time and cost savings are more likely in cases that settle than in cases that do not settle. In court-connected arbitration, however, cases that settle before the arbitration hearing often are not resolved more quickly than cases resolved by the arbitrator’s decision; cases that appeal the decision take substantially longer to conclude, regardless of whether they eventually settle or are tried.

Most disputants and lawyers who participate in ADR have highly favorable assessments of the process (e.g., they feel that it was fair and gave them sufficient opportunity to present their case), the third party (e.g., they think that she or he was neutral, understood their views and the issues, did not pressure them to settle, and treated them with respect), and the outcome (e.g., they feel that it was fair, and they were satisfied with it). Thus, ADR tends to get high ratings on procedural justice and its correlates. Whether ADR participants’ assessments are as favorable as or more favorable than those of non-ADR participants, however, varies across studies and settings. In most settings, disputants in mediation who settle have more favorable assessments than disputants who do not settle. Disputants in arbitration who have a hearing have more favorable views of the process, but not necessarily of the outcome, than disputants who settle before the arbitration hearing.

Studies involving divorce and small claims cases tend to find that disputants in mediated cases report a higher rate of compliance with the outcome, less anger, improved relationships, and less relitigation than disputants in litigation. These benefits associated with divorce mediation tend to disappear after several years, although disputants remain more satisfied. In general civil cases, most studies find no differences between mediated and nonmediated cases in terms of postresolution compliance or relationships. Several studies suggest that postresolution outcomes are less strongly influenced by whether disputants use mediation or litigation than by antecedent characteristics of the disputants, such as their ability to pay or their level of anger or adjustment.

The few studies that have examined the relative efficacy of different ADR processes tend to find no differences among them. However, because these studies do not involve the random assignment of cases to processes, these findings might simply reflect the “correct” matching of disputes to processes for which they are best suited.

Despite ADR performing at least as well as litigation, there is relatively little voluntary use of ADR after disputes have arisen. This appears to say less about disputants’ or lawyers’ preferences regarding dispute resolution procedures and more about the logistical, strategic, cognitive, and economic barriers to using ADR once litigation has begun. Rules designed to overcome these barriers by requiring lawyers to inform their clients about ADR or to discuss ADR with opposing counsel have had mixed success in increasing early settlements or voluntary ADR use.

The Effect of Process, Third-Party, and Dispute Characteristics

The mixed research findings regarding ADR’s efficacy might reflect, in part, differences across studies in how the ADR process was implemented or in the mix of disputes handled. A small number of studies have examined the relationships between ADR outcomes and characteristics of the process, third party, and disputes, though few have systematically varied these characteristics.

Process Characteristics

Studies find that several benefits are associated with holding the ADR session sooner after the legal complaint is filed: Cases are resolved faster; fewer motions are filed; and, as found in some studies, more cases settle. Delaying ADR until after discovery is substantially completed is not associated with an increased rate of settlement. Most studies find no differences in settlement rates or participants’ assessments associated with whether mediation use is voluntary or mandatory, but some studies find that voluntary use of mediation is associated with more favorable outcomes.

Third-Party Characteristics

A majority of studies find that when the mediator or neutral evaluator plays a more active role during the session in helping disputants identify issues and options, settlement is more likely and disputants have more favorable assessments of the process. Mediator actions associated with these positive outcomes include actively structuring the process, getting disputants to express their views and to assess different options, and providing their own views about the disputants’ positions and proposals. If the mediator recommends a specific settlement, however, disputants are more likely to settle but less likely to view the mediation process as fair. Only a few studies have examined whether the third party’s general approach or specific actions appear to be differentially effective in different types of disputes. These studies show, for instance, that some mediator approaches that are effective in resolving less intense conflicts are not effective in resolving more intense conflicts and some approaches that are effective in divorce cases are not effective in general civil cases.

Greater third-party familiarity with the substantive issues in the case is related to lawyers’ viewing the arbitration process and decision as more fair. In mediation, the third party’s substantive expertise is not related to settlement or to disputants’ or lawyers’ assessments. How well the mediator understood the disputants’ views, however, is related to their assessments. Disputants’ and lawyers’ perceptions that the third party was not biased and was prepared for the session are associated with favorable assessments of the process and outcome of all ADR processes.

Dispute and Disputant Characteristics

Research examining which dispute and disputant characteristics are associated with better outcomes has been conducted primarily on the mediation process. The contentiousness of the disputants’ relationship impedes settlement in divorce and community mediation but not in general civil and small claims mediation, which involves few intimate or ongoing relationships. In addition, divorcing couples with a more contentious relationship are more likely to be dissatisfied with the settlement, remain bitter, and bring subsequent lawsuits.

Across mediation settings, other indicators of more intense conflicts, such as poor communication, greater disparity in the disputants’ positions, and the denial of liability, also are associated with a lower likelihood of settlement.

Not surprisingly, the greater the disputants’ motivation to settle and the less disparity between the disputants in that motivation, the more likely they are to settle. Disputants who misunderstand the goals of mediation or whose goals are inconsistent with those of mediation are less satisfied and less likely to settle. Similarly, lawyers whose expectations about how the neutral case evaluation session will be conducted are closer to the approach actually used are more satisfied with the process. Disputants who are better prepared for mediation by their lawyers tend to be more likely to settle and to feel that the process is fair, perhaps because preparation modifies their expectations or their actions during the session.

Few studies have examined how antecedent dispute characteristics affect what goes on during the mediation session and how that, in turn, affects outcomes. These studies find that disputants who have a less contentious relationship or who are more motivated to settle are more likely to be cooperative and to engage in productive joint problem solving during mediation. These behaviors, in turn, are associated with disputants being more likely to settle, view the mediation process and outcome as fair, and report improved relationships. More active disputant participation during mediation also is associated with more favorable outcomes. The few studies that have examined lawyers’ impact on mediation suggest that how cooperative the lawyers are during the session is related to settlement and to disputants’ assessments of the process.

The research findings are mixed with regard to whether or not there is a relationship between settlement and dispute complexity, which has been defined in different studies as the number of disputants, the number of disputed issues, or the complexity of the issues in dispute. A majority of mediation studies find that legal case type categories (e.g., tort, contract) and the size of the monetary claim are not related to settlement or to disputants’ assessments of mediation. A majority of arbitration studies, however, find that disputants are more likely to appeal the arbitrator’s decision in cases involving larger dollar claims and in tort rather than contract cases.

References:

  1. ADR and the vanishing trial [Special issue]. (2004, Summer). Dispute Resolution Magazine, 10.
  2. Brazil, W. A. (1985). Settling civil suits: Litigators’ views about appropriate roles and effective techniques for federal judges. Chicago: American Bar Association.
  3. Conflict resolution in the field: Assessing the past, charting the future [Special issue]. (2004, Fall-Winter). Conflict Resolution Quarterly, 22.
  4. Folberg, J., Milne, A. L., & Salem, P. (Eds.). (2004). Divorce and family mediation: Models, techniques, and applications. New York: Guilford.
  5. Menkel-Meadow, C. J., Love, L. P., Schneider, A. K., & Sternlight, J. R. (Eds.). (2005). Dispute resolution: Beyond the adversarial model. New York: Aspen.
  6. Wissler, R. L., & Dauber, B. (2005). Leading horses to water: The impact of an ADR “confer and report” rule. Justice System Journal, 26, 253-272.
  7. Wissler, R. L., & Dauber, B. (2007). Court-connected arbitration in the Superior Court of Arizona: A study of its performance and proposed rule changes. Journal of Dispute Resolution 1, 65-100.

Return to the overview of Trial Consulting in Forensic Psychology.

Altering Illness Beliefs Through Intervention: A Path to Better Health Outcomes

In the pursuit of better health outcomes, the beliefs individuals hold about their illnesses play a crucial role in shaping their behaviors, treatment adherence, and overall wellness. Recent research has highlighted the potential for targeted interventions to modify these beliefs, leading to significant improvements in health management and patient empowerment. By understanding the psychological and social factors influencing illness perceptions, healthcare providers can design strategies that not only address the medical aspects of disease but also foster a more resilient mindset in patients. This article delves into innovative approaches to altering illness beliefs, exploring their implications for patient care and long-term health outcomes.

This article explores the pivotal role of interventions in altering illness beliefs within the realm of health psychology. Beginning with an examination of the multifaceted nature of illness beliefs, encompassing cognitive, emotional, and behavioral components, the discussion unfolds by elucidating the theoretical frameworks that underpin our understanding of these beliefs. Drawing on models such as the Health Belief Model, Cognitive-Behavioral Model, and Social Cognitive Theory, the article delineates how these frameworks inform intervention strategies. The subsequent section provides an in-depth exploration of various interventions designed to modify illness beliefs, including psychoeducation, cognitive restructuring, and social support. Empirical evidence from research studies and case analyses illustrates the efficacy of these interventions, while the article also addresses challenges and considerations such as ethical issues, cultural sensitivity, and limitations inherent in altering illness beliefs. The conclusion summarizes key points, underscores the implications for future research and practice, and emphasizes the ongoing significance of advancing interventions in health psychology to optimize health outcomes.

Introduction

Health psychology serves as a dynamic field at the intersection of psychology and medicine, investigating the psychological factors influencing health and well-being. Within this context, the significance of illness beliefs becomes paramount, shaping individuals’ perceptions of health, influencing their behaviors, and ultimately impacting health outcomes. This article aims to delve into the pivotal role of altering illness beliefs through intervention within the realm of health psychology. Recognizing the transformative potential of interventions, the purpose of this article is twofold. First, it seeks to highlight the critical importance of modifying illness beliefs in enhancing overall health outcomes. Second, the article introduces and explores the concept of intervention within the broader framework of health psychology, emphasizing its role as a catalyst for change in illness beliefs. The thesis of this article underscores the indispensable role of interventions in reshaping illness beliefs and previews the subsequent exploration of theoretical frameworks, specific intervention strategies, empirical evidence, and considerations in this comprehensive investigation.

Understanding Illness Beliefs

Illness beliefs encompass cognitive dimensions, involving individuals’ thoughts, beliefs, and perceptions regarding their health conditions. Cognitive aspects may include beliefs about the cause of the illness, its duration, and the potential for recovery or recurrence.

The emotional component of illness beliefs encompasses the affective responses individuals associate with their health conditions. Emotional aspects may include fear, anxiety, or optimism, reflecting the emotional impact that the illness has on one’s mental well-being.

Behavioral components of illness beliefs pertain to the actions and behaviors individuals adopt in response to their health conditions. This involves the ways in which individuals manage their symptoms, seek medical help, or engage in health-promoting behaviors.

Illness beliefs play a pivotal role in shaping individuals’ adherence to medical treatments. Beliefs about the efficacy of treatments, perceived benefits, and potential side effects can significantly impact the extent to which individuals adhere to prescribed health regimens.

The coping mechanisms individuals employ in response to illness are intricately tied to their illness beliefs. Positive illness beliefs may foster adaptive coping strategies, while negative beliefs can contribute to maladaptive coping mechanisms, affecting mental health and overall well-being. Understanding these components is essential for developing interventions aimed at altering illness beliefs and, consequently, improving health behaviors and outcomes.

Theoretical Frameworks

The Health Belief Model (HBM) provides a structured framework to understand individuals’ health-related decision-making processes. It posits that individuals assess their susceptibility to a health threat, the severity of the threat, the benefits of taking preventive action, and the barriers to such action. HBM emphasizes the role of perceived threat and perceived efficacy in shaping health behavior.

The Health Belief Model’s application to illness beliefs involves examining how individuals perceive the severity of their illness, their susceptibility to its negative outcomes, and the perceived efficacy of various health-related actions. By understanding these components, interventions can be tailored to address specific aspects of illness beliefs, promoting more adaptive health behaviors.

The Cognitive-Behavioral Model posits that cognitive processes influence behavior, and altering maladaptive thoughts can lead to positive behavioral changes. Cognitive restructuring involves identifying and challenging irrational or negative thoughts related to illness, replacing them with more adaptive and positive beliefs.

Behavior modification within the Cognitive-Behavioral Model focuses on changing specific behaviors associated with illness beliefs. This may include implementing strategies to enhance treatment adherence, promote healthier lifestyle choices, and foster positive health-related behaviors.

Social Cognitive Theory, developed by Albert Bandura, highlights the role of observational learning in shaping behavior. Individuals learn from observing others, and this observational learning process influences the development of illness beliefs. Interventions based on this theory may involve providing positive health behavior models to influence individuals’ perceptions and beliefs.

Social Cognitive Theory also emphasizes self-regulation, wherein individuals set goals, monitor their progress, and adjust their behavior accordingly. Interventions grounded in this aspect of the theory may focus on empowering individuals to actively manage their health by developing self-regulation skills, thereby influencing and modifying their illness beliefs. Understanding these theoretical frameworks provides a foundation for designing effective interventions that target specific components of illness beliefs, ultimately contributing to improved health outcomes.

Interventions to Alter Illness Beliefs

Psychoeducation interventions aim to enhance individuals’ understanding of their health conditions by providing accurate and relevant information. This involves offering clear explanations about the nature of the illness, available treatment options, and potential outcomes. By fostering informed decision-making, individuals can develop more adaptive illness beliefs.

Addressing and correcting misconceptions is a crucial component of psychoeducation. Interventions may involve dispelling inaccurate beliefs about the causes or consequences of the illness, promoting a more realistic and evidence-based understanding. This correction process contributes to the reshaping of maladaptive illness beliefs.

Cognitive restructuring interventions focus on identifying and challenging irrational or negative thoughts associated with the illness. This process involves guiding individuals to recognize and reevaluate distorted beliefs, replacing them with more accurate and adaptive ones. By addressing cognitive distortions, individuals can develop healthier illness beliefs.

Cognitive-Behavioral Therapy (CBT) is a structured and goal-oriented therapeutic approach that incorporates cognitive restructuring techniques. CBT aims to modify negative thought patterns and behaviors associated with illness beliefs. Through collaborative efforts between individuals and therapists, CBT facilitates the development of positive coping strategies and adaptive beliefs about illness.

Social support interventions involve mobilizing the support networks of individuals facing health challenges. Family and peer support can provide emotional encouragement, practical assistance, and a sense of belonging. By fostering a supportive environment, individuals are more likely to develop positive illness beliefs and engage in healthier behaviors.

Group therapy creates a structured setting for individuals with similar health conditions to share experiences, receive support, and collectively work towards altering illness beliefs. Group dynamics can offer diverse perspectives, normalize experiences, and promote a sense of community, all of which contribute to positive changes in illness beliefs.

Understanding the diverse nature of these interventions allows health psychologists and practitioners to tailor approaches to individual needs. By combining psychoeducation, cognitive restructuring, and social support strategies, interventions can effectively target different aspects of illness beliefs, facilitating transformative changes that positively impact health outcomes.

Empirical Evidence

Numerous research studies have investigated the effectiveness of interventions in altering illness beliefs and their subsequent impact on health outcomes. Meta-analyses and systematic reviews provide comprehensive insights into the collective findings of these studies. Research often encompasses diverse health conditions, ranging from chronic illnesses to mental health disorders, offering a broad understanding of the applicability of interventions across various contexts.

Findings from research studies consistently highlight the positive impact of interventions on modifying illness beliefs. Quantitative measures, such as changes in cognitive appraisals, emotional well-being, and health behaviors, provide objective indicators of the interventions’ efficacy. Studies also explore potential moderators and mediators, shedding light on factors that influence the success of intervention strategies. These results collectively underscore the significance of tailored interventions in reshaping illness beliefs and improving health outcomes.

In addition to large-scale research studies, individual case studies offer valuable insights into the nuanced and personal aspects of altering illness beliefs. By examining specific cases, researchers gain a deeper understanding of the unique challenges individuals face and the intricacies of their illness beliefs. Case studies often involve detailed qualitative analyses, allowing for a rich exploration of the psychological and emotional dimensions of the intervention process.

The implications drawn from case studies extend beyond the individual cases themselves. They inform practitioners about the real-world application of interventions and offer guidance on tailoring approaches to meet the diverse needs of individuals. Case studies provide concrete examples of how interventions can be implemented in practice, offering insights into the complexities and successes of the intervention process. By integrating lessons learned from case studies into clinical practice, healthcare professionals can enhance the effectiveness of interventions targeting illness beliefs.

Empirical evidence, both from large-scale research studies and individual case analyses, collectively contributes to the growing body of knowledge in health psychology. These findings serve as a foundation for evidence-based practices, guiding psychologists and healthcare providers in developing interventions that are not only theoretically grounded but also practically effective in altering illness beliefs and promoting positive health outcomes.

Challenges and Considerations

In the context of interventions aimed at altering illness beliefs, ensuring informed consent is crucial. Participants should be provided with comprehensive information about the nature, purpose, and potential risks and benefits of the intervention. This transparency allows individuals to make autonomous decisions about their participation, promoting ethical research and practice.

Respecting and maintaining confidentiality is paramount when dealing with sensitive health information. Participants must trust that their personal details will be kept secure. Researchers and practitioners should establish clear protocols for data protection, emphasizing the ethical responsibility to safeguard participants’ privacy throughout the intervention process.

Recognizing the diversity of illness beliefs across cultures is essential. Different cultural backgrounds may shape individuals’ perceptions of health and illness differently. Cultural competence involves understanding these variations and adapting interventions to align with culturally informed perspectives. This ensures that interventions resonate with individuals’ cultural contexts, fostering greater acceptance and effectiveness.

Interventions must be tailored to address the unique needs of diverse populations. This includes considerations for language, cultural norms, and socio-economic factors. Culturally sensitive interventions enhance accessibility and engagement, acknowledging the importance of a personalized approach in modifying illness beliefs across different cultural and demographic groups.

One challenge in altering illness beliefs through interventions lies in individual differences. People vary in their cognitive styles, coping mechanisms, and responses to interventions. Tailoring interventions to accommodate these differences is essential for maximizing effectiveness. Recognizing the individuality of participants helps mitigate potential barriers and enhances the adaptability of interventions.

While many interventions demonstrate short-term efficacy, the sustainability of positive changes in illness beliefs over the long term remains a concern. Factors such as relapse, life stressors, or evolving health conditions can impact the lasting effects of interventions. Continuous follow-up and support mechanisms are critical to maintaining and reinforcing positive changes in illness beliefs over an extended period.

Navigating these ethical considerations, cultural sensitivities, and inherent limitations is crucial for researchers and practitioners in health psychology. By addressing these challenges thoughtfully, interventions can be designed and implemented with a commitment to ethical standards, cultural inclusivity, and an understanding of the complexities associated with altering illness beliefs in diverse populations.

Conclusion

In summary, this article has highlighted the integral role of illness beliefs in shaping individuals’ perceptions, emotions, and behaviors regarding their health conditions. Recognizing the cognitive, emotional, and behavioral components of illness beliefs is essential for understanding their profound impact on health outcomes.

The interventions explored in this article, including psychoeducation, cognitive restructuring, and social support, offer diverse strategies for altering illness beliefs. By addressing cognitive distortions, providing accurate information, and fostering social connections, these interventions contribute to positive changes in illness beliefs and, consequently, improved health behaviors.

Future research in health psychology should delve deeper into understanding the intricate interplay between illness beliefs and various health conditions. Exploring the effectiveness of interventions across different cultural contexts and refining strategies to accommodate individual differences will contribute to a more nuanced understanding of how to tailor interventions for maximum impact.

The practical applications of altering illness beliefs in healthcare settings are profound. Implementing evidence-based interventions has the potential to enhance patient outcomes, treatment adherence, and overall well-being. Integrating these strategies into routine healthcare practices can foster a holistic approach to patient care, acknowledging the significance of psychological factors in shaping health experiences.

The significance of altering illness beliefs cannot be overstated. As this article has emphasized, modifying cognitive appraisals, emotional responses, and health-related behaviors through targeted interventions holds immense promise in improving the overall health and quality of life for individuals facing various health challenges.

In concluding, it is essential to encourage and advocate for continued research and development in health psychology interventions. The dynamic nature of health psychology calls for ongoing exploration, innovation, and adaptation to evolving healthcare landscapes. By fostering a commitment to advancing interventions, we can contribute to a more resilient and responsive healthcare system that prioritizes the psychological well-being of individuals.

In closing, the journey to alter illness beliefs is an evolving process that necessitates collaboration between researchers, practitioners, and individuals seeking to enhance their health. Through a collective effort to refine interventions, address challenges, and embrace cultural diversity, the field of health psychology can continue to make meaningful contributions towards improving health outcomes and fostering a holistic understanding of well-being.

References:

  1. Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Prentice-Hall.
  2. DiMatteo, M. R., Haskard-Zolnierek, K. B., & Martin, L. R. (2012). Improving patient adherence: A three-factor model to guide practice. Health Psychology Review, 6(1), 74-91.
  3. Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.). (2008). Health behavior and health education: Theory, research, and practice. John Wiley & Sons.
  4. Janz, N. K., & Becker, M. H. (1984). The health belief model: A decade later. Health Education Quarterly, 11(1), 1-47.
  5. Kazdin, A. E. (2008). Evidence-based treatment and practice: New opportunities to bridge clinical research and practice, enhance the knowledge base, and improve patient care. American Psychologist, 63(3), 146-159.
  6. Lorig, K., & Holman, H. (2003). Self-management education: History, definition, outcomes, and mechanisms. Annals of Behavioral Medicine, 26(1), 1-7.
  7. Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51(3), 390-395.
  8. Rollnick, S., Miller, W. R., & Butler, C. C. (2008). Motivational interviewing in health care: Helping patients change behavior. Guilford Press.
  9. Schwarzer, R., & Fuchs, R. (1996). Self-efficacy and health behaviors. In Self-efficacy: Thought control of action (pp. 217-243). Routledge.
  10. Suls, J., & Rothman, A. (2004). Evolution of the biopsychosocial model: Prospects and challenges for health psychology. Health Psychology, 23(2), 119-125.
  11. Taylor, S. E., & Stanton, A. L. (2007). Coping resources, coping processes, and mental health. Annual Review of Clinical Psychology, 3, 377-401.
  12. Thornicroft, G., & Tansella, M. (Eds.). (2013). The mental health matrix: A manual to improve services. Cambridge University Press.
  13. Turner, J. A., & Holtzman, S. (2007). Mannequin-based education. Anesthesiology Clinics, 25(2), 261-272.
  14. Williams, S. L. (2003). Cognitive-behavioral therapy with individuals living with chronic illness: A review of the literature. Social Work in Health Care, 37(1), 91-116.
  15. World Health Organization. (2001). International classification of functioning, disability and health (ICF). World Health Organization.

Allocentrism: Understanding the Power of Perspective in Human Interaction

In a world increasingly defined by individualism, the concept of allocentrism offers a refreshing lens through which to view human interaction. Rooted in the understanding that the perspectives and needs of others are as important as one’s own, allocentrism encourages empathy, collaboration, and shared understanding. This article explores the power of looking beyond oneself, examining how adopting an allocentric perspective can transform personal relationships, enhance communication, and foster a sense of community. By delving into the psychological and social implications of allocentrism, we can uncover the profound impact it has on our interactions and societal well-being.

Allocentrism is a personality trait that characterizes the attitudinal, cognitive, affective, and behavioral patterns and preferences shared among people of a collectivist culture. Among those who are allocentric, self is defined as more interdependent than independent; ingroup goals and harmony take priority over individual goals and autonomy. People who hold allocentric beliefs tend to value social norms, self-sacrifice, cooperation, equality, and relatedness more than social recognition, self-reliance, competition, equity, and rationality. Allocentrism is usually conceptualized as an end point of a continuum, with idiocentrism as the opposite construct. The individual levels of the allocentric and idiocentric tendencies correspond to the cultural dimensions of collectivism and individualism.

Current Research

The theorization of allocentrism has sparked 2 decades of research on the relationship between allocentrism and other individual and contextual variables. Multimethod measures have been developed to assess various dimensions of allocentric tendencies, such as the INDCOL scale, individualism-collectivism scales, the Self-Construal Scale, value surveys, sentence completion exercises, and scenario stimuli.

Research has demonstrated that there are more allocentrics than idiocentrics in collectivist cultures and vice versa. Women tend to be more allocentric than men across cultures. In the United States, racial and ethnic minorities appear to be more allocentric than White Americans. Among allocentrics, high self-esteem is related to self-efficacy in forming positive interpersonal relations. Allocentric persons reported having more and better social support than did idiocentrics. Moreover, they tend to transmit values such as obedience and obligations to their children. Allocentrics, compared to idiocentrics, also are more likely to perceive their group as homogeneous (regardless of how “homogeneous” the group actually is), which in turn may affect their behavioral patterns in a group setting (e.g., workplace performance).

Allocentrism is a complex construct that is multidimensional in nature and context dependent. Allocentric tendencies can be vertical (i.e., defining themselves as different from others and yet subordinate to the ingroup, thus likely to sacrifice for the interests of the group) or horizontal (i.e., perceiving themselves to be the same as others within the group, thereby unlikely to self-sacrifice for ingroup goals). Also, individual allocentric tendencies may differ depending on the tasks, groups, and settings. For example, a person may be a vertical allocentric at home and yet a horizontal allocentric at work. Furthermore, the strength of the relationship between allocentric tendencies and other psychosocial correlates (e.g., subjective well-being) may vary depending on the level of collectivism or individualism within a given cultural context.

Future Directions

Due to the contexualized multidimensional nature of the allocentric construct, individual allocentric tendencies may shift or intersect with a plethora of other factors, such as age, ethnic values, acculturation levels, socioeconomic status, religious/spiritual affiliation, sex roles, and situated contexts. Thus, conceptualizing and measuring allocentric and idiocentric tendencies as the end points of a single, bipolar continuum is a common practice, yet may be overly simplistic. Contemporary researchers have advocated the employment of multimethod and domain-specific approaches to assess the varying dimensions of allocentrism. At the same time, the use of myriad measurements for allocentrism also makes it difficult to interpret results. More longitudinal and qualitative research may provide better information about the complexity of this construct. Finally, the construct of allocentrism has significant implications for cross-cultural counseling. In working with clients, particularly those who identify with or whose values are influenced by a collectivist culture, counselors and psychologists should pay special attention to the potential impact of allocentric tendencies on psychosocial adjustment levels, work-family issues, and intergenerational or inter-group relations. Specifically, counselors should be aware that relationships with members of the ingroups play an essential role in the self-esteem and well-being of clients who subscribe to an allocentric perspective; counselors and mental health professionals may overpathologize allocentrics as “dependent,” without considering the cultural relevance and primacy of group-orientation versus self-orientation. Allocentrics may experience difficulties when pressured to compete and assert themselves in an individualist culture that values individual recognition over ingroup harmony. Also, because allocentric tendencies are multidimensional and context dependent, allocentric individuals may exhibit different behavioral patterns and value preferences when dealing with multiple ingroups in various settings (e.g., sacrifice family for work or vice versa). Younger generations who were reared by allocentric parents but grew up in an individualist society may face value conflicts and acculturation stress. Counselors should examine the cultural appropriateness of applying counseling theories and approaches that were developed in individualist contexts to working with allocentric clients. This will help counselors understand sources of conflicts and examine self-identity, as well as identify ways for clients to cope with acculturation stress.

References:

  1. Hui, C. H. (1988). Measurement of individualism-collectivism. Journal of Research in Personality, 22(1), 17-36.
  2. Triandis, H. C. (1995). Individualism and collectivism. Boulder, CO: Westview Press.
  3. Triandis, H. C. (2000). Allocentrism-idiocentrism. In A. E. Kazdin (Ed.), Encyclopedia of psychology (Vol. 1, pp. 118-119). New York: Oxford University Press.
  4. Triandis, H. C., Leung, K., Villareal, M. J., & Clark, F. L. (1985). Allocentric versus idiocentric tendencies: Convergent and discriminant validity. Journal of Research in Personality, 19, 395-415.

See also:

  • Counseling Psychology
  • Multicultural Counseling
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