Week 9 Flashcards

Question

Social groups

Answer 1

Social groups will often develop ways of being that allow identification of other group members The phenomenon is known as habitus: The way they present themselves to others This might include the way they dress They way they talk- accent, language, tone of voice The way they walk or stand This habitus of a group reflects the aesthetic preferences of those who have power within the group

Answer 2

A lot of your credibility as a professional relies on your ability to seem like a doctor Look right, act right, talk right Social identity theory posits that the more doctor-y you seem the easier you will find it to find acceptance, power and influence within the group Traditional doctor habitus in UK: firmly upper middle class, white, male

Answer 3

This poses no problem at all for those who are already from the correct background But other people have to learn to act the right way

Answer 4

It takes time to see oneself as a member of the new group It’s not just about looking the part, sounding the part It’s not even just about being accepted as a member of the group It’s also about successfully internalising the values of the new group

Answer 5

Values and beliefs are about what’s important and how things should be We all hold multiple values across contexts Values are of interest to psychologists and sociologists because they are one of the most important determinants of behaviour

Answer 6

The GMC and other bodies provide us with professional values Honesty, probity, reliability, responsibility Medical schools council list the values expected of applicants: Respect for others, responsibility, integrity, empathy Values of humanistic care: whole person care, respect for peoples intrinsic value, considering others perspectives, suspending judgements, recognising universality, relational focus

Answer 7

Adapted from coulehan and Wilson 2001 Students: explicit professionalism, cognate professionalism, tacit professionalism

Answer 8

When asked many doctors say they espouse professional values They are able to behave accordingly to prescribed professional values when they are thinking about it However when watched the behaviours they display when they are not thinking about it are anchored in a quite different set of values

Answer 9

A position of self interest with values based around objectivity, detachment and wariness Informal and procedural knowledge- how things are done Hafferty 2015 Consequences of hidden curriculum Loss of idealism and acceptance of hierarchy (Sinclair 2020) Neutralisation of emotions (hellman 1991) Detachment and entitlement (coulehan and Wilson 2001)

Answer 10

Conflict between old and new professional values The hidden curriculum as lag in medical culture as medicine shifts from a paternalistic to a patient centred model

Answer 11

Three possible outcome: Narrow to being a technician adopt tacit Non reflective professionalism Internalise professional virtue adopt explicit Values determine behaviour subconsciously Cognate professionalism does not lead to the right behaviours most of the time

Answer 12

The other thing we need to consider here is the system doctors work in High pressure Understaffed and under resourced Punitive when things go wrong Competitive Traumatic Little or nothing in the way of psychological support Loss of sense of community

Answer 13

Difficult to meet the needs of others when own needs aren’t met The vast majority of unprofessional behaviour is seen in highly pressured stressful situations Overworked and overstretched People will experience burnout System must be revised and resources allocated improved to prevent circumstance undermining professional behaviour

Answer 14

Many medical students have role models for their professional behaviour We will often internalise the values of role models easily and without deeper consideration Think about professional behaviour you’re seeing rather than simply accepting it

Answer 15

Social groups to which a person does/does not psychologically identify as being a member Individuals belong to many different in groups and out groups In groups give use a sense of social identity Important source of pride and self esteem Allow us to find out things about ourself Helps us to define socially acceptable behaviour

Answer 16

“ a widely shared assumption about the personality, attitude or behaviour of a person based soley on their group membership” Hogg and Vaughan 1995 Positive or negative Based on accident fallacy (sweeping generalisation) How are stereotypes formed: personal experience, culturally received information, role models/ family members , the media, encoded by language, generalisation, identifying exceptions Explicit or implicit- implicit association test

Answer 17

Social function: allows us to learn from the experience of others Cognitive function: simplify and systemise information about the world, reduces processing time, enables us to respond quicker to situations

Answer 18

People tend to perceive members of an out group as similar to eachother

Answer 19

People perceive many differences between members of their own group

Answer 20

Stereotyping affects our expectations of others and ourselves Stereotypes affects social perceptions and behaviour: conformity/labelling, scapegoating, prejudice/discrimination Stereotype threat, self fulfilling prophecy

Answer 21

An individuals identity and behaviour is influence by the terms used to describe them Labelling theory (Scheff 1966): labels bring attention to specific behaviours that break societal norms, labels become internalised into a persons identity, self fulfilling prophecy Modified labelling theory (Link et al 1989), mental disorders

Answer 22

Person is labelled, social meanings of the label become relevant to the person, response: secrecy, withdrawal, educate , negative consequences for self esteem, earning, relationships etc, vulnerable to further episodes of mental distress Stigma is associated with powerful negative labels

Answer 23

Stereotype threat occurs when a person experiences anxiety/concern that they may confirm a negative stereotype linked to their in-group Negative impact on their performance

Answer 24

Difficult Counter-stereotypes Contact hypothesis: Allport 1954, equal status, common goals, inter group cooperation, support of law/customs, imagined contact/ e-contact Education Media/social media

Answer 25

Sex and sexual identity is biologically determined eg genetic makeup, reproductive anatomy and biological function Gender and gender identity is the social interpretation of sex

Answer 26

Behaviours, attitudes, values, beliefs which society expects/considers appropriate to males/females

Answer 27

Widely held beliefs about psychological differences between males and females

Answer 28

Process by which children acquire sex/gender identity and learn gender appropriate behaviours

Answer 29

Sex is a multidimensional variable Chromosomal sex Gonadal sex Hormonal sex Sex of the internal reproductive structures Sex of the external genitals Usually correlate

Answer 30

Disorders of sex development DSD Low correlation of categories of biological sex Hermaphrodite True hermaphroditism rare- most cases consist of genital ambiguity (genitals not consistent with chromosomal/gonadal sex) May influence gender identity or gender roles the effect on sexual orientation is more complex

Answer 31

Male develops female external appearance due to insensitivity to androgens

Answer 32

Female develops male external appearance due to prenatal exposure to high levels of androgens

Answer 33

Male develops female external appearance due to deficiency of alpha-reductase

Answer 34

Can lead to abnormal sexual phenotypes and hypogonadism Eg Turner syndrome Xo: Short stature, swollen hands/feet, webbed neck, infertility, amenorrhoea, absent/incomplete pubertal development Eg Klinefelter XXY: gynaecomastia, small testes, less hair, infertility, tall with abnormal body proportions (long legs, short trunk, shoulder equal to hip size

Answer 35

Males and females ‘biologically programmed’ for different roles possibly supported by evidence of structural and functional differences in male and female brains Empathising-systemising theory Baron-Cohen Not supported by some human studies eg Daphne Went: female gender identity and roles, XY chromosomes

Answer 36

Emerged from feminist movements In the late 20th century, feminists began to argue that gender is socially constructed Women felt to be imprisoned by their gender role which has been dictated and manipulated by men and should be liberated

Answer 37

Money and Ehrhardts critical period of gender identity AGS females Males with testicular feminisation

Answer 38

Gender evolved so we can adapt to our environment Parental investment theory: an investment by a parent in an offspring that increases the chance that the offspring will survive; historically maternal investment> paternal Social learning theories: learn behaviour though being treated differently, observational learning and reinforcement

Answer 39

Rooted in the phallic stage of pyschosexual development Resolution of Oedipus or Electra complex

Answer 40

Children’s discovery that they’re male/ female causes them to identify with and imitate same sex models Gender labelling age 3 Gender stability age 4-5 Gender constancy age 6-7

Answer 41

Gender identity alone can provide a child with sufficient motivation to assume sex types behaviour

Answer 42

Gender is socially constructed Enormous cultural diversity of male and female roles More than one gender type in some Native American cultures, social dominance of females in Wodaabe Africans

Answer 43

Transgender is a term for individuals whose identity, behaviour or sense of self does not conform to their assigned sex More common in those born male Recent increase in referrals of young women to gender clinics

Answer 44

Wear clothes of opposite sex but not for sexual enticement nor are transgender Enjoy cross-dressing to gain temporary membership of opposite sex, not necessarily related to sexual orientation

Answer 45

Paraphilias Sexual urges directed to non-human objects suffering/humiliation of oneself or partner towards others incapable of giving consent

Answer 46

Aversive conditioning Reconditioning techniques Cognitive techniques Psychotropic medication SSRIs Hormonal treatments Efficacy of castration and neurosurgery controversial and considered unethical

Answer 47

Lack or loss of desire Common Age, hormones, medical/psychiatric disorders, medications etc Sexual aversion Rare, most have sexual abuse Lack of sexual enjoyment

Answer 48

Results in lack of subjective excitement as well as lack of adequate physiological response It may be due to a number of factors: psychological, pathological, oestrogen deficiency

Answer 49

Erectile dysfunction Lifelong or acquired general or situational Relatively common Increase in age Organic and psychological aetiology Viagra treatment

Answer 50

Women- physical , psychological Men-inhibited orgasm, ejaculatory pain, premature ejaculation

Answer 51

Non-organic vaginismus: involuntary muscular spasm, sexual abuse, relationship difficulties, relaxation techniques, gradual vaginal dilation procedures Non organic dyspareunia: pain during sexual activity

Answer 52

Masters and Johnson Partners treated together Helped to communicate better about their sexual relationship Education about anatomy/physiology of sexual intercourse Graded tasks increasingly intimate exercises concentrating only on sensate focus at first

Answer 53

Be empathic and non judgemental Pre empt the individuals embarrassment Reassure that sexual dysfunction is common Discuss in plain, clear and specific terms Inclusive language Start with open questions Never assume

Answer 54

A mark or spot on the skin A mark of disgrace or infamy Visible sign/characteristic of a disease Goffman 1963: An attribute that is ‘deeply discrediting’ Reduces the bearer ‘from a whole and usual person to a tainted, discounted one’

Answer 55

Impact of what is happening in whole society rather than particular ‘groups’ eg values, fears Social interaction between the stigmatising and the stigmatised Social impact on the individual who is stigmatised

Answer 56

People distinguish and label human differences; some are seen as undesirable characteristics What is undesirable is decided by society differences between times/cultures Impact of powerful people and institutions as the effect of labelling will spread faster People can experience emotional reactions to labelled people- fear, repulsion, disgust Labelled persons may feel shame, humiliation Labelled persons experience status loss and discrimination as a consequence

Answer 57

Important element in the experience of illness Special care needs for people with visible health condition Potentially delay in seeking help Stigma and prejudice can influence health practitioners and policies

Answer 58

Visible differences Mental health Infectious diseases Feared conditions

Answer 59

Major epidemics where illness causes visible marks or disfigurement (plague, leprosy) Illness seen as coming from outside eg Spanish flu Contagion linked to deprivation and crowded living conditions Linked to negative stereotyping- poor people, gay men with HIV

Answer 60

Incurable disease can lead people to avoid saying the word Unclear causes makes it more frightening Can lead to visible difference eg hair loss Potentially embarrassing outcomes eg impotence Blaming patients might make others feel safer Positive impact of better prognosis for many, awareness raising, charities

Answer 61

‘Abominations of the body’: physical disfigurement/ deviation from social norm ‘Blemishes of character’ : a known record eg of alcoholism, long term unemployment seen as character flaw ‘Tribal identities’: negative evaluation of people due to association with a particular group most often via family eg class, ethnicity, religion

Answer 62

Long history of identifying and classifying physical deformities -fear and disgust but also fascination -living/dead bodies displayed as curiosities Appearance a common focus of teasing in childhood Visible differences can lead to others staring, avoidance eg on public transport, inappropriate questions

Answer 63

Can lead to: Heightened social anxiety Embarrassment Depression Low self esteem Social withdrawal Isolation

Answer 64

Potentially stigmatising attributes are eg -drug or alcohol -time spent in prison -long term unemployment -prostitution -mental illness -‘alternative’ sexualities Traditionally linked to a persons character

Answer 65

Historically the attributes above have been seen as innate/genetic by some and as in control of the individual by others

Answer 66

A person visibly belongs to a particular group: religious groups, racial groups, ethnic groups, chosen tribes Stigma expresses wider social power structures ‘Courtesy stigma’ : stigma rubs off on people close to stigmatised person

Answer 67

Stigma changes the social identity of a person A person becomes discredited when they have a sign of a stigmatising condition which cannot be disguised they are forced to deal with their stigma in almost all interactions ‘Discrediting stigma’ A person becomes ‘discreditable’ when its possible for them to conceal a sign of a stigmatising condition

Answer 68

Enacted stigma:people stare/ avoid/ express disgust Effects on employment and earning potential Isolation; people may avoid contact in anticipation of a negative response: felt stigma

Answer 69

Concealment strategies which may not work Passing as normal Evaluating whether or not to reveal condition

Answer 70

Implies that an individuals social identity is dominated by the stigmatised illness/attribute People may respond to this by: -passing as normal -information control-deciding who to trust -avoiding all social contact -trying to avoid blame -refusing to be ashamed

Answer 71

Both relate to the social phenomenon of people being viewed/treated differently for something that they are rather than their actions Stereotype focuses on group identity Stigma focuses on the stigmatised individual and the effect on them Stigma also includes wider society and power dynamics

Answer 72

Similar to stereotype but more about attitude/negative emotions towards particular groups and individuals Focuses more on the person holding the prejudice who may never be in contact with the person they are prejudiced against Can lead to discrimination/scapegoating Examples: Race/ethnicity and mental health Self harm

Answer 73

In providing services to BME communities (especially black men) prejudice and the fear of violence can influence risk assessments and decisions on treatment which are likely to be dominated by a heavy reliance on medication and restriction This means that service users become reluctant to ask for help or to comply with treatment increasing the likelihood of a personal crisis

Answer 74

When forced to seek emergency care [young people who self harmed] did so weigh feelings of shame and unworthiness These feelings were reinforced when they received what they perceived as punitive treatment from A&E staff, perpetuating a cycle of shame, avoidance and further self harm Positive encounters were those in which they received ‘treatment as usual’ delivered with kindness

Answer 75

Potentially strong impact on how people are treated by health practitioners However, prejudice needs to be seen in its social context rather than only focusing on the prejudiced individual Eg on race: media reports, fear of making wrong decision, focus on risk Eg on self harm: over-stretched service, little time to work with individual, attitudes in workplace

Answer 76

Ongoing debate on whether prejudice in healthcare contributes to inequality in outcomes Disadvantaged groups have worse outcomes Reasons for this are complex (eg environment, behaviour, experiencing discrimination) However the above examples show that negative attitudes discourage people from seeking help)

Answer 77

Social interaction sociology Focuses on the individual who has a visible known difference which causes them to be stigmatised and the effect this has on them The society doing the stigmatising Stigmas are always negative

Answer 78

Social cognition psychology Focuses on the attitudes and emotions that a person holds towards another person or a group of people Prejudices are always negative

Answer 79

Social cognition psychology Focuses on the social expectations that people have about others bases on what group they belong to Stereotypes can be positive, negative, neutral