Class 22: Stigma (continued)

1. Class 22: Stigma (continued) NOTE Diary Study write-ups dues on Tuesday (April 22).

2. Socially Managing a Handicap How do able-bodied (e.g., “markers”) feel around handicapped? Disturbed, anxious, self-conscious, curious, ambivalent. Do handicapped know what affect they have on able- bodied? Generally, yes. How could they not? What is best tactic for handicapped to take in managing others’ reactions? Should handicapped acknowledge handicap or ignore it?

3. Acknowledging the Handicap Hastorf, Wildfogel, & Cassman, 1979 Question: Do people prefer handicapped person who acknowledges handicap? Method—Study 1: Ss watch video of handicapped student interviewed about starting college. Student acknowledges/doesn’t acknowledge handicap Ss rate how much they like student, how much want to work with him. 71 _____% like acknowledger more than non-acknowledger 79 ____% prefer working with acknowledger over the non-acknowledger

4. Acknowledging the Handicap Hastorf, Wildfogel, & Cassman, 1979 Question: Do people prefer handicapped person who acknowledges handicap? Method—Study 1: Ss watch video of handicapped student interviewed about starting college. Student acknowledges/doesn’t acknowledge handicap Ss rate how much they like student, how much want to work with him. 71 _____% like acknowledger more than non-acknowledger 79 ____% prefer working with acknowledger over the non-acknowledger

5. Acknowledging the Handicap Hastorf, Wildfogel, & Cassman, 1979 ______ _______ Study 1 found: Being open and acknowledging a handicap increases liking. Problem: How many variables are tested here? ______ Method—Study 2: Ss watch video of handicapped person who acknowledges: a. Handicap b. Girlfriend problem (“weird religious trip g-friend’s mom laying on me”) X Which, if any, speaker is liked more?

6. Acknowledging the Handicap: Stressed and Open vs. Cool and Avoidant Hastorf, Wildfogel, & Cassman, 1979 Hastorf et al. predict that the style of disclosing handicap will matter. They expect Ss will not like handicapped person who discloses uncomfortably. Why? Handicapped person’s discomfort will make Ss uncomfortable  dislike. You agree? Why / why not? Ss watch video of handicapped person who: a. Acknowledges but with clear discomfort and awkwardness. b. Does not acknowledge, but is very poised and cool. Ss prefer which handicapped person? Why? X Perhaps courage is attractive.

7. Remainder of Semester: Important Dates Dec. 4 Last Diary Entry, Write-up Instructions Supplied “Stigma” Extra Credit Assignment Due Dec. 11 Last Class Diary Study Write-up Due Dec. 17 Final Exam; 12:00-3:00

8. Quiz 2 Results: Percent Correct • Grades • 11-12 A • B • 9 C+ • 8 C • 7 D • 1-6 F

9. Symbolic Interactionism and the Looking Glass Self * We know who we are based on the way others respond to us. * Others' responses serve as a social mirror. * Let's us know if we're liked/disliked, attractive/unattractive, smart/limited, etc. * Helps us gauge our own emotional reactions to difficult, unusual events. * Provides us feedback about the appropriateness of our own actions. How would stigma affect the social looking glass/mirror?

10. Stigma and the Warped Looking Glass I always felt when I went into some boutique, that all the salesgirls were staring at me.... I always felt that the first thing anyone would notice is that I was fat...and they would know why I was fat. They would know I was neurotic, that I was unsatisfied, that I was a pig, that I had problems. They could tell immediately that I was out of control. I always look around to see if there was anyone as fat as me. I always wondered when I saw a fat woman, "Do I look like that?"

11. How We See Ourselves Shaped By How Others See Us Snyder, Tanke, & Bersheid, 1977 a. Men and women talk on phone, can’t see each other. b. Men led to believe women attractive/not attractive c. Expectations shape responses -- Positive response to “Attractive” -- Negative response to “Unattractive” d. Women respond according to feedback from men e. Women rated by “blind” observer after phone conversation -- “Attractive” condition rated more attractive -- “Unattractive” condition rates less attractive f. Take-home point -- Others’ view of us shapes our view of ourselves -- Our view of ourselves shapes others’ view of us.

12. Who Is That Masked Man? Pennebaker Mask Study

13. Being at Once Hyper-visible and Invisible Hypervisible: Everyone notices you because of the mark—the facial disfigurement, the radiation-treatment hair loss, the wheel chair. Invisible: But people still seem to not see you. I am invisible, understand, simply because people refuse to see me. ...it is though I have been surrounded by mirrors of hard, distorting glass. When they approach me they see only my surroundings, themselves, or figments of their imagination—indeed, everything and anything except me. Ralph Ellison, Invisible Man, 1947

14. Stigma Corrodes Self Esteem: The Darkened Looking Glass One of the most direct effects of stigma is threat to self-esteem. -- Defined in terms of stigma -- Avoided, shunned, ostracized -- Non-stigmatized features are overlooked Self-stigmatizing—internalizing other's negative view of oneself. Not just that one is fat or gay or blind or alcoholic, but rather that one is therefore fundamentally flawed as a person—sick, weak, immoral, or evil. In Goffman's terms, one has "a spoiled identity".

15. Paraplegic Many Opportunities Many Opportunities Anxious Busy Busy SELF SELF Dependent Avoided Athletic Athletic Popular Popular Runner Runner Biker Biker How Disability Can Change Self Schema X X X X X X

16. Stigma Deprives Person of Vital Information: The Absent Looking Glass We depend on other's reactions to make sense of things, and of ourselves, when there is no other source of info. Stigmatized don't get this info. Why not? a. Shunned, so don't see how others respond. b. Get a constant reaction to selves, either constantly (and falsely) positive or constantly negative. Stigma becomes a wall that blocks social information.

17. Creating New Reference Groups After acquiring a stigma (cancer, AIDS, paraplegia, etc.) it can help to develop ties to others with similar condition. Why? a. Social comparison b. Recognition of one's own non-stigmatized features. c. Recognizing difference from others who share stigma. BUT, important to not belong ONLY to community of stigmatized. Why? a. Need to re-enter mainstream. b. Need to get feedback from "markers", which may be more realistic

18. In-Between Stigma Status Some people are not fully stigmatized, not fully "normal" * Partially deaf, partially blind * Loss of one limb, but otherwise can walk These people are not fully accepted by mainstream, but also not fully accepted by the stigmatized group. The "unblinded"--and their unexpected social challenges.

19. Ethnicity and Health Care

20. Aversive Racism and MD Interactions with Black Patients Penner, Dovidio, et al., 2010 Aversive Racism: AMBIVALENCE based on A. Believing in social justice, equality, non-biased society PLUS B. Wanting to see self as non-prejudiced, fair BUT C. Having internal, automatic feelings of hostility to minorities

21. “Signature” of Implicit Racist Explicit Racism Measures: Score low Implicit Racism Measures: Score high Black White Pleasant Unpleasant Press E to classify as Black or Pleasant Press I to classify as White or Unpleasant Implicit Association Task (IAT) Reaction time when: Pos paired with out-group Neg paired with out-group Pos paired with in-group Neg paired with in-group Happiness

22. Penner et al. Study Design Subjects 15 MDs: 7 female, 8 male; 12 Indian, Pakistani, Asian 3 White 150 Patients: 112 female, 38 male; all African American Procedure MDs complete explicit measure of prejudice Q 1. It’s really a matter of some people not trying hard enough; if blacks would only try harder they could be just as well off as whites.    Q 8.  Over the past few years, blacks have gotten more economically than they deserve. MDs complete IAT (measure of implicit prejudice) MDs and patients interact in regular consultation. Outcome Measures 1. On same team? 2. Treatment decisions (MD & Pat complete) 3. Was treated warmly 4. Satisfied with treatment (Pat completes)

23. Patient Reaction to MD (Based on all 4 Measures) Due to MD Explicit and Implicit Prejudice Which MDs did Black patients react worst to? High explicit and high implicit prejudice High explicit and low implicit prejudice Low explicit and high implicit prejudice Low explicit and low implicit prejudice X

24. Time Talking During Consultation: MD vs. Patient Hagiwara, Penner, et al. 2013 Question: How much time do non-Black MDs and Black Patients Talk Relative to Each Other? Set up: Same subjects as from Penner et al. study Outcome: Ratio of MD to Patient words spoken. Which MDs dominated conversation the most? High explicit and high implicit prejudice High explicit and low implicit prejudice Low explicit and high implicit prejudice Low explicit and low implicit prejudice

25. On The Same Team: Method to Improve Interactions Between Non-Black MDs and Black Patients Method: MDs and Patients assigned to 1. “Common Identity” orientation 2. Standard Health Info (control) orientation Outcome ( 4 and 16 weeks After Orientation) 1. Greater trust in MD 2. Greater adherence to MD advice