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The McGill Undergraduate Psychology Journal
ISSUE XI December 2021 (Published April 2022)
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ON THE COVER The cover page was inspired by the article The Freudian Legacy of Modern Personality Theories and Evaluation of Its Real Life Implications by Amina Hammache (pg 110-123). Freud’s understanding of personality was the conflict between three elements: ego, id, and superego. An iceberg is often used to represent these concepts, with ice above water representing the conscious mind and the ice below water representing the unconscious mind. While the id is purely in the unconscious mind, the ego and the superego contain both conscious and unconscious elements. Imagery by Simon Lee via Unsplash
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McGill Undergraduate Psychology Journal
Foreword Dear Reader, On behalf of the McGill Psychology Students’ Association and the PSI Journal Editorial Team, I am proud to present the 2021 edition of the annual PSI Journal. The following 10 articles are a sample of the strong work that is presented by undergraduate students of the McGill Psychology department every day and are the product of years of hard work and perseverance. As you read through, you will get insight into the broad research interests and ongoing projects of psychology students in the fields of behavioural neuroscience, clinical psychology, cognitive neuroscience, health psychology, social psychology, and beyond. This year’s papers explore topics like neural plasticity in deaf individuals, the impact of Freud on modern personality theories, and the impact of COVID-19 from a variety of perspectives. Many of these papers share preliminary findings that will contribute to critical future research projects at McGill. For many of these students, this is just the beginning of a promising career in academia, industry, clinical practice, or whatever path they are inspired to explore. It is encouraging to see such high-level analysis, critical thinking, and communication skills at an undergraduate level. These articles will lead you to self-reflect and ask questions, and you will certainly leave with an even greater curiosity for the field of psychology. Joyce Wu Journal Coordinator and Alumni (’21) Department of Psychology McGill University
Issue XI | December 2021
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Acknowledgements A multitude of individuals were involved in the making of this journal. We would like to express our sincerest appreciation to: The faculty supervisors for their valued mentorship and for supporting undergraduate participation in research. Megane Pepin (alumni ’21), for your design work and countless hours spent formatting the journal to make it not only informative, but also beautiful. The McGill Psychology Students’ Association (MPSA) for supporting the Journal team and providing continuous feedback.
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McGill Undergraduate Psychology Journal
Journal Committee JOURNAL COORDINATOR & EDITOR-IN-CHIEF
Joyce Wu EDITORIAL TEAM
Mathew Apostolatos Matthew Campbell Sofia Hempelmann Perez Bronwen Lathrop Helen Liu DESIGN DIRECTOR
Megane Pepin
2020-2021
Issue XI | December 2021
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Table of Contents ii iii iv 1-14
Influences of Early Changes in Perceived Injustice on Late Changes in Recovery Outcomes Among Individuals with Musculoskeletal Pain [by Ana Nightingale Castillo]
15-23
Framing Information About COVID-19 Can Increase Precautionary Behaviours During The Pandemic [by Stephanie Susinski]
24-35
A Gender-Focused Exploration of Peer Support and Emotional Distress in Victimized Canadian Adolescents [by Yasemin Erdoğan]
36-47
Cognitive Dissonance & COVID-19 Lockdown Measures [by Juno Henderson, Katia Kutlesa, Ben Lawson, Kayla Siksik & Ella Vezina]
48-60
A not so perfect plan: An examination of the differential influence of multidimensional perfectionism on missed and gained events during the COVID-19 pandemic [by Giovanni Andrade]
61-77
Patient and Therapist Perceptions of Autonomy Support in Outpatient Therapy for Eating Disorders [by Emilie Bélanger]
78-89
Neural Plasticity and Working Memory in Deaf Individuals [by Lucy Core]
90-98
Examining Dynamic Norms: A Direct Replication of Sparkman and Walton (2017), With An Extension on the Moderating Effects of Culture [by Qilongyue Chen, Chevieve Heri, Steven Leu & Connie Yun]
99-109 110-123
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Foreword Acknowledgements Journal Committee [2020-2021]
Ecology as a Mean: A Replication of ‘Going Green to Be Seen’ [by Amar Alany, Carly Fraser, Joanna Ma & Lauréanne de Verteuil] The Freudian Legacy of Modern Personality Theories and Evaluation of Its Real Life Implications [by Amina Hammache]
McGill Undergraduate Psychology Journal
Influences of Early Changes in Perceived Injustice on Late Changes in Recovery Outcomes Among Individuals with Musculoskeletal Pain Ana Nightingale Castillo Supervisor: Dr. Michael Sullivan
Ψ PSI Journal
Abstract background.
A growing body of literature has identified perceived injustice as a robust predictor for enduring dis-
ability. However, little is currently known about changes in injustice appraisals through the course of rehabilitation and the impact they might have on the rehabilitation process. The present study explored whether early changes in perceived injustice lead to later changes in recovery outcomes. |
methods.
The study sample consisted of 55
individuals who were absent from work following a musculoskeletal injury. Participants completed measures of
perceived injustice, pain severity, depressive symptoms, and disability once a week for 6 weeks. 24 participants completed the 6-week period. |
results.
Cross-sectional analyses of admission data revealed that perceived in-
justice contributed significant variance to the prediction of pain severity, depressive symptoms, and disability beyond the variance accounted for by age and sex. Prospective analyses indicated that early changes in perceived injustice predicted late changes in pain severity. |
discussion.
Data was collected on a modest sample size of 24
participants. All participants were receiving salary indemnity benefits and, and they were all absent from work as a
result of a musculoskeletal injury arising from a work-related incident. The factors limit the generalizability of findings. | conclusion. The findings suggest that early changes in perceived injustice are a predictor for later changes in pain intensity in individuals with musculoskeletal injury. More considerable attention toward the development of interventions targeting perceptions of injustice specifically may help in the reduction of pain severity.
Keywords: workplace injury, perceived injustice, pain severity, depressive symptoms, disability.
Background
dents and occupational diseases (International
loskeletal pain represents a significant societal
Quebec specifically, both the number of work-
Workplace injury resulting in sustained muscuburden, as it entangles high economic and human costs. In 2011, the absence rate for fulltime employees due to illness or disability was 5.9% (Dabboussy & Uppal, 2012). Discernibly, substantial economic losses are associated with this issue: approximately 4% of the world’s GDP is lost in expenses related to work-related acciIssue XI | December 2021
Labour Organization, 2013; Durand, 2019). In place lesion claims and the amount paid in compensation benefits increased over the past decade. In 2010, the Commission des normes, de l’équité, de la santé et de la sécurité au travail (Commission de la santé et de la sécurité du travail at the time) accepted 92112 workplace lesion claims and paid 1.76$ billion in compensa1
tion benefits. In contrast, in 2017, 96135 claims
PSI Ψ Such appraisals are likely to accompany the ex-
were accepted, and compensation benefits to-
perience of chronic pain arising from an injury.
talled 2.1$ billion (Commission de la santé et de
In fact, accumulating evidence has identified
la sécurité du travail du Québec, 2011, 2018).
perceived injustice as a risk factor for adverse
A shift from biomedical towards more com-
pain outcomes.
prehensive biopsychosocial views characterizes
Numerous studies have linked perceptions
the past decades in physical and mental health
of injustice with adverse outcomes such as
research. Indeed, the dualistic idea of mind and
higher pain intensity, depressive symptoms,
body functioning separately and independently
disability and pain catastrophizing (Carriere
have dominated medicine for the past centuries
et al., 2017; Ioannou et al., 2016; Scott et al.,
(Gatchel, 2004). This view holds that damage to
2015; Sturgeon et al., 2016). A cross-section-
the body stimulates nerves, which would send
al study by DeGood and Kiernan (1996) was
signals to the brain, giving rise to the sensation
conducted among outpatients suffering from
of pain – the latter being assumed to be propor-
pain conditions who participated in an anes-
tional to tissue damage. This perspective hence
thesiology-based pain management program.
failed to account for the experiences of peo-
They were asked to complete questionnaires
ple suffering from clinically painful conditions
assessing variables such as their pain history,
(Keefe & France, 1999). Thereby, a shift toward
job status, and disability status; as well as their
a more comprehensive view of pain began to
beliefs and attitudes with items such as “who do
emerge over the past decades: biopsychosocial
you think is at fault for your pain?” followed by
perspectives emphasize unprecedented inter-
the response options: (a) self, (b) employer, (c)
actions among biological, psychological and
other, and (d) no one. The results indicated that,
social factors that are necessary for a better
in comparison to those who did not blame an
understanding of health and illness (Gatchel,
external source, participants with chronic pain
2004). For instance, the gate control theory of
who did blame an external source reported ex-
pain introduced by Melzack and Wall (1965)
periencing significantly more emotional distress.
brought to light the substantial role of various
They also expected to get less benefit from their
psychosocial factors in pain experience (Melz-
treatment and were more likely to indicate that
ack & Wall, 1965; Gatchel, 2004).
previous treatment had worsened their condition
Perceived injustice has emerged as a robust predictor for enduring disability. The former has been defined as an appraisal characterized by the magnitude and irreparability of loss, as well as a sense of unfairness (Sullivan et al., 2014). 2
(DeGood & Kiernan, 1996). Another cross-sectional study put forward the interpersonal implications of perceived injustice by indicating that ratings of social isolation mediated the relationship between perceived injustice and anger. McGill Undergraduate Psychology Journal
Greater perceived injustice would hence lead to
work disability at a 1-year follow-up, even when
increased anger through feelings of social isola-
controlling for initial pain severity, catastrophiz-
tion (Sturgeon et al., 2016). Expressions of an-
ing, depression, and pain-related fears (Sullivan
ger have been associated with increased pain
et al., 2008).
intensity through the inhibition of endogenous opioid analgesia (Bruehl et al., 2007). Similarly, another study revealed an association between pain severity and depressive symptoms in which higher pain severity lead to higher depressive symptoms, but only in patients who obtained high scores on perceived injustice (Scott & Sullivan, 2012).
As described above, associations between injustice appraisals and adverse recovery outcomes have received significant empirical support in several prospective studies. Research conducted to date implicitly points out to a potential causal relationship between changes in perceived injustice and recovery outcomes. However, little is known about the effects of
Consistent with previous research, Scott et
perceived injustice in the early weeks post-in-
al. (2013) found that perceived injustice predicts
jury since most work on perceived injustice has
adverse outcomes in a prospective study con-
been conducted on samples primarily consist-
ducted among individuals with chronic muscu-
ing of chronic pain patients. The present study
loskeletal pain. Participants were asked to com-
would bring more insight into the prospective
plete self-administered measures of perceived
predictive value of perceived injustice in indi-
injustice, pain intensity, depressive symptoms,
viduals who are in the acute phase of recovery
disability, and anger at multiple times over 3
(< 4 weeks) from their musculoskeletal injury.
months. Analyses of the results identified per-
Demonstrating a prospective relation between
ceived injustice as a significant predictor of pain
changes in perceived injustice and changes in
intensity, depressive symptoms, and disability,
recovery trajectories would assert more con-
also indicating that anger intensity and inhibi-
siderable attention toward the development of
tion differentially mediated these associations
interventions targeting perceptions of injustice
(Scott, Trost, Bernier, et al., 2013). In the same
specifically.
vein, perceived injustice emerged as a unique predictor of the presence of clinically meaningful levels of depressive symptoms at post-treatment among whiplash injury patients with persistent pain who participated in multidisciplinary rehabilitation (Scott et al., 2015). Comparably, another prospective study conducted among individuals with musculoskeletal injuries indicated that high scores on perceived injustice predicted Issue XI | December 2021
Objective
This study seeks to examine the role of perceived injustice as a determinant of symptom severity in individuals with a sustained debilitating musculoskeletal injury from a work-related incident. Participants completed questionnaires measuring perceived injustice and pain-related factors once a week throughout 6 weeks. A 3
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cross-lagged panel design was used to exam-
(i.e., based on self-report), as well as illiteracy
ine the relationship between early (first three
or severe cognitive impairment (determined
weeks) and late changes (last three weeks) in
informally through self-report). All subjects had
perceived injustice and disability. A cross-lagged
completed at least 12 years of schooling. Out
panel design involves comparing the correlation
of the 55 initial participants, 24 completed the
between Variable A at Time 1 and Variable B at
whole 6-week period. Given this reduction in par-
Time 2 with the correlation between Variable B at
ticipants throughout the completion, cross-sec-
Time 1 and Variable A at Time 2. This procedure
tional analyses and cross-lagged analyses were
tests for spuriousness, in other words, whether
conducted on different sample sizes.
the relation between two variables results from
Measures
causal effects rather than from the effects of some other variable (Kenny, 1975). Based on previous findings suggesting a prospective relation between perceived injustice and adverse recovery outcomes, it was hypothesized that early changes in perceived injustice would predict late recovery outcomes (pain severity, disability and depressive symptoms).
Methods Participants The study sample consisted of 55 individuals (25 men, 30 women) who had sustained a debilitating musculoskeletal injury in a work-related incident within 3 weeks before the date of enrolment in the study. All participants were between 29 and 55 years old with a mean of 44 years, absent from work and receiving salary indemnity benefits from the CNESST (Commission des normes, de l’équité, de la santé et de la sécurité au travail). All injuries consisted of either soft-tissue sprain or strain injury arising from a workplace incident. The exclusion criteria included evidence of fracture, neurological disorder, infectious disease, or rheumatoid arthritis 4
Pain severity. A visual scale analog (VAS) was used to measure participants’ levels of pain severity at the time of assessment. This measure consists of a straight line along which respondents are asked to mark their pain level between endpoints “no pain” and “pain as bad as it could be”. Scores are determined by measuring the distance between the “no pain” endpoint and the participant’s mark. A higher score indicates greater pain intensity. The VAS has been shown to be a valid and reliable measure for the severity and unpleasantness of human pain (Price et al., 1983). Perceptions of Injustice. The Injustice Experiences Questionnaire (IEQ) was used to examine pain-related perceptions of injustice. The Questionnaire comprises 12 pain-related thoughts, participants were asked to rate the frequency with which they experience these thoughts in relation to their injury on a 5-point scale, with the endpoints ‘never’ (0) and ‘all the time’ (4). Scores can range from 0 to 48. A study aiming to provide further support for the validity of the IEQ indicated that a cut-score of 19 distinguishMcGill Undergraduate Psychology Journal
es between individuals who recover from mus-
Ratings are made on an 11-point scale with the
culoskeletal injury and those whose recovery
endpoints ‘no disability’ and ‘total disability’.
process will be characterized by persistent pain
Scores can range from 0 to 70. The PDI has been
and disability (Scott, Trost, Milioto, et al., 2013).
shown to be internally reliable and significantly
Participants who obtain a score of 19 or above
correlated with objective indices of disability
are therefore considered to be above the risk
(Tait et al., 1990).
threshold. The IEQ yields two correlated factors:
Demographic and injury information. Partic-
severity/irreparability of loss (e.g. “My life will never be the same”) and blame/unfairness (e.g. “I am suffering because of someone else’s negligence”). The Questionnaire has been shown to have high internal and retest reliability and to be valid for use among English- and French-speaking individuals with musculoskeletal pain (Sullivan et al., 2008). Depressive Symptoms. The Patient Health Questionnaire-9 (PHQ-9) was used to assess symptoms of depression. This measure comprises 9 symptoms of depression for each of which respondents indicate how frequently they experience them. Ratings are made on a 4-point frequency scale with the endpoints (0) ‘not at all’ and (3) ‘everyday’. Scores can range from 0 to 27 with higher scores indicating more severe depressive symptoms. The PHQ-9 has been shown to be internally valid and reliable in several different clinical samples (Gilbody et al., 2007; Kroenke & Spitzer, 2002). Self-Reported Disability. The Pain Disability Index (PDI) was used to measure the degree to which participants perceive themselves as disabled due to their pain in 7 different areas of daily living: home, social, recreational, occupational, sexual, self-care, and life support. Issue XI | December 2021
ipants were asked about their sex, education, marital status, injury type, profession/occupation, annual salary, date of injury, type of injury, history of previous injuries, current compensation status, date of commencement of indemnity benefits, current treatment for injury, and previous treatment for injury.
Procedure This study was funded by the IRSST and was approved by the Institutional Review Board (Research Ethics Office) of McGill University. Participants were recruited through media advertisements soliciting individuals who had been injured in the past 3 weeks in a workplace context and that were currently absent from work. An e-mail address (blessure.psych@mcgill.ca) was provided to potential participants for them to obtain more information about the study and/ or to express their interest in participating. Once enrolled in the study, participants were contacted by telephone and asked several questions regarding demographic and injury information. They were also introduced to the website on which they were invited to set up a secure personal study account, sign a web-based consent form for their participation in the study, and complete online questionnaires (i.e. the measures 5
for perceived injustice, pain severity, depressive symptoms, and self-reported disability listed above) once a week throughout 6 weeks. Participants received $25.00 each week that they completed all study procedures to compensate for any inconvenience associated with their participation.
Data Analysis T-tests were used to compare women and men on study variables. Pearson’s correlations were used to examine concurrent relations among variables at the time of admission. Hierarchical regression analyses were used to assess the unique contribution of perceived injustice to the prediction of pain severity, depressive symptoms, and disability at the time of admission. Regression analyses on cross-lagged correlations were used to examine the sequential relations between early and late changes in perceived injustice and changes in pain-related factors (pain severity, depressive symptoms, and disability). All continuous measures used in statistical analyses showed a normal distribution with values of skewness below 3 and values of kurtosis below 10. Fig. 1 shows the cross-lagged panel design used to examine the sequential relation between early changes in perceived injustice and late changes in pain severity. The same procedure was used for the sequential relation between early changes in perceived injustice and late changes in depressive symptoms; and for the sequential relation between early changes in perceived injustice and late changes in disability. 6
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Results Sample Characteristics
As shown in table 1, initial analyses revealed no significant differences between women and men on perceived injustice, tIEQ (53) = 1.08, p < 0.285, pain severity, tVAS (53) = 1.0, p < 0.32,
pain disability, tPDI (53) = 0.85, p < 0.4, or depressive symptoms, tPHQ (53) = 0.23, p < 0.82.
Distribution of IEQ scores Frequency distribution of perceived injustice scores on the Injustice Experiences Questionnaire (IEQ) at the time of admission is shown in Fig. 2. Out of a maximum possible score of 48, participants scored 22.4 on average with a standard deviation of 12.9. Individuals who obtain a score of 19 or greater are considered to be in the risk range for problematic recovery from musculoskeletal injury (Scott, Trost, Bernier, et al., 2013).
Correlates of Perceived Injustice at the Time of Admission Table 2 shows correlations among study variables at the time of admission. Perceived injustice was significantly correlated with measures of pain intensity (r = .365, p < 0.01) and depressive symptoms (r = .418, p < 0.01); but not with self-reported disability (r = .254, p > 0.05).
Predicting Adverse Pain cross-sectional analyses
Outcomes:
Separate hierarchical regressions were used to assess the value of perceived injustice in the prediction of concurrent pain, depressive symptoms and disability. In each regression, age and sex were entered in the first step. In McGill Undergraduate Psychology Journal
the second step of the analyses, IEQ scores at
both age (beta = -.42, p < .01) and the IEQ (beta
the time of admission were entered. As shown
= .59, p < .01) contributed significant variance to
in Table 3, age and sex were entered in the first
the prediction of disability.
step of the analysis, but the contribution of this step failed to attain statistical significance (p = .19). The IEQ was entered in the second step of the analysis and contributed significantly to the explained variance to the prediction of pain severity beyond the variance accounted for by age and sex. Examination of beta weights from the final regression equation indicated that the IEQ (beta = .32, p < .05) contributed significant unique variance to the prediction of pain severity. As shown in Table 4, age and sex were entered in the first step of the analysis, but the contribution of this step failed to attain statistical significance (p = .39). The IEQ was entered in the second step of the analysis and contributed significant variance to the prediction of disability beyond the variance accounted for by age and sex. Examination of beta weights from the final regression equation indicated that age (beta = -.29, p < .05) as well as the IEQ (beta = .36, p < .05) contributed significant variance to the prediction of depressive symptoms. As shown in Table 5, age and sex were entered in the first step of the analysis, but the contribution of this step failed to attain statistical significance (p = .38). The IEQ was entered in the second step of the analysis and contributed significant variance to the prediction of depressive symptoms beyond the variance accounted for by age and sex. Examination of beta weights from the final regression equation indicated that Issue XI | December 2021
Predicting Adverse Pain Outcomes: cross-lagged regression analyses A hierarchical regression analysis was used to examine the unique contributions of early changes in perceived injustice to the prediction of late changes in pain severity (Table 6). In order to control for the potential R inflation effects of synchronous and autocorrelations, early changes in pain severity and late changes in perceived injustice were entered as covariates in Step 1 of the analysis. Early changes in perceived injustice were entered in Step 2 of the analysis and contributed significant variance to the prediction of late changes in pain severity, R2 change = .18, p < .05. A second hierarchical regression analysis was conducted to examine the unique contributions of early changes in perceived injustice to the prediction of late changes in depressive symptoms (Table 7). In order to control for the potential R inflation effects of synchronous and autocorrelations, early changes in depressive symptoms and late changes in perceived injustice were entered as covariates in Step 1 of the analysis. Early changes in perceived injustice were entered in Step 2 of the analysis but did not contribute significant variance to the prediction of late changes in depressive symptoms, R2 change = .02, p > .05. A third hierarchical regression analysis was conducted to examine the unique contributions 7
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of early changes in perceived injustice to the
cated that early changes in perceived injustice
prediction of late changes in disability (Table 8).
predicted late changes in pain severity, which
In order to control for the potential R inflation
suggests that perceived injustice may take part
effects of synchronous and autocorrelations,
in the persistence of pain. It has previously been
early changes in disability and late changes in
suggested that anger might be a vehicle through
perceived injustice were entered as covariates
which perceived injustice perpetuates pain se-
in Step 1 of the analysis. Early changes in per-
verity. Indeed, expressions of anger have been
ceived injustice were entered in Step 2 of the
linked to increases in pain intensity through
analysis but did not contribute significant vari-
the inhibition of endogenous opioid analgesia
ance to the prediction of late changes in disabil-
(Bruehl et al., 2007). Likewise, acute induction
ity, R2 change = .02, p > .05.
of anger has been shown to increase muscle
Discussion
The primary purpose of the present study was to examine the sequential relation between early changes in perceived injustice and late change in pain-related outcomes, namely pain severity, depressive symptoms and disability. The results of the study were consistent with previous research indicating that scores on a measure of perceived injustice were significantly correlated with measures of pain intensity and depressive symptoms (Scott, Trost, Bernier, et al., 2013; Scott et al., 2015; Sullivan et al., 2008). The findings of the present study extend previous research in showing that early changes in perceived injustice predict late changes in pain severity. A hierarchical regression conducted on variables assessed at admission identified perceived injustice as a significant unique predictor of pain severity, depressive symptoms, and disability at the time of admission even when controlling for age and sex. Cross-lagged analyses indi8
tension and systolic blood pressure, which may intensify pain sensitivity (Burns et al., 2008). A study by Scott et al. conducted among patients with musculoskeletal pain pointed out that anger state mediated the relation between the blame subscale of the IEQ and pain severity (Scott, Trost, Bernier, et al., 2013). The results of the present study did not support early changes in perceived injustice as a predictor for late changes in depressive symptoms nor disability. One possible explanation for the failure to identify perceived injustice as a predictor for depressive symptoms and disability is that the temporal relation between changes in perceived injustice and these two factors might not have been captured by the timeframe used in the study. Measures of perceived injustice, depressive symptoms and disability were collected at 3 different points in time separated by 2 weeks. Changes in perceived injustice might have an influence on
depressive symptoms
and disability over more extended periods than those examined in the present study. It is also McGill Undergraduate Psychology Journal
possible that the relation is contrary to what was
arising from a propensity to interpret various
anticipated: changes in depressive symptoms
negative life experiences in terms of injustice as
and disability may precede changes in per-
opposed to being situational and resulting from
ceived injustice rather than the opposite. This
pain-related suffering and losses. It is relevant
would fit into the conceptualization of perceived
to note that injustice appraisals are not mere
injustice as a set of cognitions comprising ele-
mental constructions, as they often stem from a
ments from, among others, the magnitude and
reality characterized by justice violations.
irreparability of one’s loss, as defined by Sullivan et al. (2014). Similarly, a study by Yakobov et al. (2016) identified reductions in disability as the most reliable predictor for reductions in perceived injustice, which might suggest targeting disability in treatment would help in reducing appraisals of injustice.
There are important clinical implications for the study findings. Interventions targeting perceived injustice might help to prevent the development of chronic pain; for instance, the need to consider prevention strategies in terms of perceived injustice has previously been stressed. Such strategies may require interventions re-
Little is currently known about the factors
garding the structural and social context within
that give rise to perceptions of injustice follow-
which perceptions of injustice arise, such as the
ing a disabling work injury. The distribution of
workplace (Scott et al., 2016). In the same vein,
IEQ scores (Fig. 2) suggests that over half of
Scott et al. (2016) also noted the importance
injured workers obtained elevated scores, even
of providing the injured individual with great-
the first weeks following injury. Some of the
er social validation of their pain and suffering,
factors that contribute to the emergence of per-
which may prevent interpersonal perceptions of
ceived injustice might include situations char-
injustice from developing. Sources of perceived
acterized by violations of fundamental human
injustice often include employers/colleagues,
rights, transgressions of status, or challenges to
insurers, healthcare providers, family, friends,
equity norms and just world beliefs. As such, so-
and significant others for reasons such as con-
cial environments characterized by negligence,
tributing to the injury, inadequately assessing
loss, and unfairness are likely to give rise to
or treating their pain, or responding harshly to
perceived injustice (Darley & Pittman, 2003;
the individual’s pain expression (Scott et al.,
Sullivan et al., 2008). Also, Scott et al. (2016)
2016). Involving various stakeholders in the
suggested that negative social responses (i.e.
rehabilitation interventions as well as compre-
invalidating responses from others, lack of so-
hensively communicating all parties’ recovery
cial support) may contribute to perceptions of
expectations early in the rehabilitation process
injustice A recent study by Yakobov et al. (2019)
have been mentioned as ways of facilitating ear-
denotes the possibility of perceived injustice
ly identification and management of discrepant
Issue XI | December 2021
9
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expectations. This might increase the transpar-
tion strategies may need to address people’s
ency of procedures, in turn making them less
experiences of both past and current injustice,
likely to be later perceived as unjust (Scott et al.,
as patients may attribute blame for the origin of
2016, p. 201; Sullivan et al., 2014).
pain and the ongoing nature of pain separately
It is noticeable that the score distribution on
(McParland & Whyte, 2008; Scott et al., 2015).
the Injustice Experiences Questionnaire (IEQ)
Some limitations need to be discussed. First,
at the time of admission (Fig. 2) follows a bimod-
data was collected on a rather small sample
al curve rather than a normal curve. This could
size of 24 participants. All participants were re-
imply that two different types of individuals are
ceiving salary indemnity benefits and were ab-
represented in the data set, namely those who
sent from work as a result of a musculoskeletal
fall above the cut-score of 19 and those who
injury arising from a work-related incident, which
present lower scores. As mentioned, a study by
limits the possibility of generalization to a larg-
Scott, Trost, Milioto and Sullivan (2013) estab-
er population. Also, the perceptions of injustice
lished a clinical cut-off score of 19 on the IEQ
of the individuals prior to being informed of the
in relation to long-term occupational disability.
study might have influenced their willingness to
Perceived injustice has been shown to be more
participate. These sample characteristics limit
resistant to change than other pain-related
the possibility for the findings to be generalized
psychosocial variables (Sullivan et al., 2008).
to a larger population. The online nature of the
Accordingly, several authors have addressed
data collection also affects the generalizabil-
the need for developing interventions targeting
ity of this study.
perceived injustice specifically. Intervention
reasons, many participants dropped out of the
strategies such as anger management, forgive-
study before completing 6 weeks, which implies
ness-based interventions, acceptance-based
that the studied sample could have belonged to
treatments, and mindfulness meditation have
a subpopulation and have been not well repre-
been suggested (Scott et al., 2016; Sullivan
sentative of the population of interest.
et al., 2012). It was also pointed out that interventions designed to reduce catastrophic thinking might help reduce perceptions of injustice among individuals with a weak belief in a just world (McParland & Knussen, 2016). As mentioned earlier, interventions designed to reduce disability might help to reduce perceived injustice, as the findings of Yakobov et al. (2016) suggested. Scott et al. pointed out that interven10
Additionally, for undeclared
Conclusion
Despite the limitations, the findings of this study provide insight into the sequential relation between perceived injustice and subsequent problematic recovery outcomes, that is, identifying early changes in perceived injustice as a predictor for late changes in pain severity. This main finding highlights the pertinence of designing interventions that target perceptions of injustice McGill Undergraduate Psychology Journal
specifically in order to prevent later increases in pain severity, as we identified the former as a temporal predictor to the latter. Future research is needed to examine in more detail the predictive value of perceived injustice on problematic recovery outcomes over more extended timeframes. Additional work is also needed for further insights into how situational perceptions of injustice might differ from tendencies to experience adverse life events as unjust in terms of recovery. Acknowledgements
I thank the Centre for Research on Disability and Social Integration for the data presented; Dr. Michael Sullivan for his supervision, insightful guidance, and encouragement; and the McGill University Department of Psychology for the opportunity to conduct and disseminate research findings.
References
Bruehl, S., Chung, O. Y., Burns, J. W., & Diedrich, L. (2007). Trait anger expressiveness and pain-induced beta-endorphin release: Support for the opioid dysfunction hypothesis: Pain, 130(3), 208–215. https://doi. org/10.1016/j.pain.2006.11.013 Burns, J. W., Holly, A., Quartana, P., Wolff, B., Gray, E., & Bruehl, S. (2008). Trait Anger Management Style Moderates Effects of Actual (″State″) Anger Regulation on Symptom-Specific Reactivity and Recovery Among Chronic Low Back Pain Patients. Psychosomatic Medicine, 70(8), 898–905. https://doi.org/10.1097/PSY. 0b013e3181835cb7 Carriere, J., Martel, M. O., Kao, M.-C., Sullivan, M., & Darnall, B. (2017). Pain behavior mediates the relationship between perceived injustice and opioid prescription for chronic pain: A Collaborative Health Outcomes Information Registry study. Journal of Pain Research, Volume 10, 557–566. https://doi.org/10.2147/JPR. S128184 Commission de la santé et de la sécurité du travail du Québec. (2011). Rapport annuel de gestion, 2010. CSST. Commission de la santé et de la sécurité du travail du Québec. (2018). Rapport annuel de gestion 2018. 144. Issue XI | December 2021
Dabboussy, M. & Uppal, S. (2012). Work absences in 2011. Statistics Canada. Darley, J. M., & Pittman, T. S. (2003). The Psychology of Compensatory and Retributive Justice. Personality and Social Psychology Review, 7(4), 324–336. https://doi. org/10.1207/S15327957PSPR0704_05 DeGood, D. E., & Kiernan, B. (1996). Perception of fault in patients with chronic pain: Pain, 64(1), 153–159. https://doi.org/10.1016/0304-3959(95)00090-9 Durand, M.-J. (2019). Study of the Psychometric Properties of the Work Disability Diagnosis Interview (WoDDI) for Workers with a Musculoskeletal or Common Mental Disorder. 99. Gatchel, R. J. (2004). Comorbidity of Chronic Pain and Mental Health Disorders: The Biopsychosocial Perspective. American Psychologist, 59(8), 795–805. https://doi.org/10.1037/0003-066X.59.8.795 Gilbody, S., Richards, D., Brealey, S., & Hewitt, C. (2007). Screening for Depression in Medical Settings with the Patient Health Questionnaire (PHQ): A Diagnostic Meta-Analysis. Journal of General Internal Medicine, 22(11), 1596–1602. https://doi.org/10.1007/s11606007-0333-y International Labour Organization (2013). The Prevention of Occupational Diseases: 2 million workers killed every year. World Day for Safety and Health at Work, 28 April 2013. Ioannou, L., Braaf, S., Cameron, P., Gibson, S. J., Ponsford, J., Jennings, P. A., Arnold, C. A., Georgiou-Karistianis, N., & Giummarra, M. J. (2016). Compensation System Experience at 12 Months After Road or Workplace Injury in Victoria, Australia. Psychological Injury and Law, 9(4), 376–389. https://doi.org/10.1007/ s12207-016-9275-1 Keefe, F. J., & France, C. R. (1999). Pain: Biopsychosocial Mechanisms and Management. Current Directions in Psychological Science, 8(5), 137–141. https://doi. org/10.1111/1467-8721.00032 Kenny, D. (1975). Cross-Lagged Panel Correlation: A Test for Spuriousness. Psychological Bulletin, 82(6), 887903. Kroenke, K., & Spitzer, R. L. (2002). The PHQ-9: A New Depression Diagnostic and Severity Measure. Psychiatric Annals, 32(9), 509–515. https://doi.org/10.3928/00485713-20020901-06 Melzack, R. & Wall, P. (1965). Pain Mechanisms: A New Theory. Science, 3699(150), 971-979. McParland, J. L., & Knussen, C. (2016). Catastrophizing Mediates the Relationship Between the Personal Belief in a Just World and Pain Outcomes Among Chronic Pain Support Group Attendees. Psychological Injury
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and Law, 9(1), 23–30. https://doi.org/10.1007/s12207015-9246-y
Psychological Injury and Law, 7(4), 325–334. https:// doi.org/10.1007/s12207-014-9209-8
Price, D. D., McGrath, P. A., Rafii, A., & Buckingham, B. (1983). The validation of visual analogue scales as ratio scale measures for chronic and experimental pain: Pain, 17(1), 45–56. https://doi.org/10.1016/03043959(83)90126-4
Tait, R. C., Chibnall, J. T., & Krause, S. (1990). The Pain Disability Index: Psychometric properties: Pain, 40(2), 171–182. https://doi.org/10.1016/03043959(90)90068-O
Scott, W., McEvoy, A., Garland, R., Bernier, E., Milioto, M., Trost, Z., & Sullivan, M. (2016). Sources of injustice among individuals with persistent pain following musculoskeletal injury. Psychological Injury and Law, 9(1), 6–15. https://doi.org/10.1007/s12207-015-9249-8 Scott, W., & Sullivan, M. (2012). Perceived Injustice Moderates the Relationship between Pain and Depressive Symptoms among Individuals with Persistent Musculoskeletal Pain. Pain Research and Management, 17(5), 335–340. https://doi.org/10.1155/2012/501260
Yakobov, E., Scott, W., Thibault, P., & Sullivan, M. J. (2016). Treatment-Related Reductions in Disability Are Associated with Reductions in Perceived Injustice Following Treatment of Whiplash Injury. Psychological Injury and Law, 9(1), 41–47. https://doi.org/10.1007/ s12207-015-9248-9
Appendices
Scott, W., Trost, Z., Bernier, E., & Sullivan, M. J. L. (2013). Anger differentially mediates the relationship between perceived injustice and chronic pain outcomes: Pain, 154(9), 1691–1698. https://doi.org/10.1016/j. pain.2013.05.015 Scott, W., Trost, Z., Milioto, M., & Sullivan, M. J. L. (2013). Further Validation of a Measure of Injury-Related Injustice Perceptions to Identify Risk for Occupational Disability: A Prospective Study of Individuals with Whiplash Injury. Journal of Occupational Rehabilitation, 23(4), 557–565. https://doi.org/10.1007/s10926-013-9417-1 Scott, W., Trost, Z., Milioto, M., & Sullivan, M. J. L. (2015). Barriers to Change in Depressive Symptoms After Multidisciplinary Rehabilitation for Whiplash: The Role of Perceived Injustice. The Clinical Journal of Pain, 31(2), 145–151. https://doi.org/10.1097/ AJP.0000000000000095 Sturgeon, J. A., Carriere, J. S., Kao, M.-C. J., Rico, T., Darnall, B. D., & Mackey, S. C. (2016). Social Disruption Mediates the Relationship Between Perceived Injustice and Anger in Chronic Pain: A Collaborative Health Outcomes Information Registry Study. Annals of Behavioral Medicine, 50(6), 802–812. https://doi. org/10.1007/s12160-016-9808-6 Sullivan, M. J. L., Adams, H., Horan, S., Maher, D., Boland, D., & Gross, R. (2008). The Role of Perceived Injustice in the Experience of Chronic Pain and Disability: Scale Development and Validation. Journal of Occupational Rehabilitation, 18(3), 249–261. https:// doi.org/10.1007/s10926-008-9140-5 Sullivan, M. J. L., Scott, W., & Trost, Z. (2012). Perceived Injustice: A Risk Factor for Problematic Pain Outcomes. The Clinical Journal of Pain, 28(6), 484–488. https:// doi.org/10.1097/AJP.0b013e3182527d13 Sullivan, M. J. L., Yakobov, E., Scott, W., & Tait, R. (2014). Perceived Injustice and Adverse Recovery Outcomes.
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Framing Information About COVID-19 Can Increase Precautionary Behaviours During The Pandemic Stephanie Susinski Supervisor: Dr. Ross Otto
Ψ PSI Journal
Abstract
Our response to global crises is largely influenced by the information we receive from others around us, on social media sites, and by what we read in the news. In the situation of a widely contagious disease like COVID-19, where joint effort is crucial, the way people perceive information can have significant implications. This study focuses on the precautionary behaviours of young adults, who have been an age group that have made up the majority of COVID-19 cases in recent months (Données COVID-19 Par âge et Sexe Au Québec) due to their inclination to engage in risk-taking behaviour during the pandemic. This study investigates the effects of different information types on people’s perceived risk toward COVID-19 and, ultimately, their compliance with COVID-related precautionary behaviours. This study will take place over one month. Participants will report their perceived risk toward the virus throughout the study. Additionally, they will report their engagement in Covid-related precautionary behaviours during the initial and final stages of the study. We will manipulate accurate information about COVID-19 so that it is either framed in terms of losses or gains. We will combine this with information that either adheres to the assumptions of the singularity effect (i.e., presenting identifiable victims of COVID-19), or to the cognitive bias of psychic numbing, (i.e., presenting anonymous and statistical victims of the virus). Participants will be randomly assigned to two conditions: they will either read information about COVID-19 framed as losses combined with information about identified victims or information about COVID-19 framed as gains combined with information about statistical victims. Our predicted results suggest that information framed in terms of loss and information presented in line with the singularity effect could increase perceived risk toward COVID-19, which could also increase engagement in COVID-related precautionary behaviours. Keywords: COVID-19, precautionary behaviours, loss aversion, psychic numbing, singularity effect
Background
all behaviours during the pandemic as having
ingly simple decisions we made in the past are
possible to engage in safe behaviour. For exam-
During the COVID-19 pandemic, many seemnow associated with increased risk. Among the younger population, it is not uncommon to justify risky actions, during the pandemic, with problematic reasoning. Some young adults perceive Issue XI | December 2021
an equal amount of risk, concluding that it is imple, taking a walk can come with the same risk as going to a crowded bar, since the probability of getting infected or spreading the disease depends on random chance, so they might as well 15
PSI Ψ do what they want. This problematic mentality is
or decreasing people’s perceived importance
also sometimes accompanied by a “you only live
in engaging in COVID-related precautionary
once” approach. Some young people believe
behaviours. Additionally, research investigating
that since death is inevitable, they might as well
non-compliance with COVID-19 related public
live their life to the fullest and ignore COVID-19
health measures among young adults found
guidelines (Snell, 2020). This mindset is largely
that factors such as moral disengagement from
supported by the frequent, public message that
COVID-19 rules were strongly correlated with
younger people are significantly less likely to
decreased engagement in COVID-19 related
contract the virus, and if they do, there is a small
public health measures, such as washing one’s
chance that they will develop serious implica-
hands or wearing a mask (Nivette et al., 2020).
tions from COVID-19. These factors can create
On account of these findings, the authors con-
a sense of invulnerability towards the virus that
cluded that public health measure campaigns
many young adults share and endorse (Fraser
should aim to use strategies that foster moral
et al., 2020). This mindset is highly problematic,
obligation when delivering information to in-
as young adults may conclude that it is unnec-
crease compliance with health measures. These
essary to engage in precautionary behaviours,
findings offer an interesting question to investi-
such as social distancing, to prevent the spread
gate: if information, that is deemed personally
of the virus.
and morally meaningful, is delivered amongst
People’s perceived risk toward COVID-19 can be influenced by many factors, such as the
young adults, can this increase COVID-related precautionary behaviours?
behaviour of those around them, the information
A potentially effective way to increase
displayed on news sites, or information on their
engagement in precautionary behaviours is
social media platforms. However, there are many
to increase one’s perceived risk toward the
issues with the information people have access
COVID-19 virus. One way to influence young
to, and the information that is shared. For exam-
individuals’ perceived risk would be through the
ple, research has suggested that misinformation
information they are reading about the virus.
on social media regarding COVID-19 may result
During a global pandemic like COVID-19, it is
from people’s willingness to share false infor-
not uncommon to feel overwhelmed with infor-
mation, as seen in a study where participants
mation, statistics and guidelines regarding the
were willing to share false information even if
novel disease in question. While it is no secret
they believed the information was inaccurate
that COVID-19 can have severe consequences,
(Pennycook et al., 2020). Misinformation can
resulting in millions of deaths worldwide, some
have consequences, such as influencing peo-
young adults are not registering this as something
ple to engage in potentially harmful behaviour,
that is directly affecting them. Often times, most
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McGill Undergraduate Psychology Journal
people see on news and social media sites, are
which can decrease people’s perceived severity
numbers and statistics regarding COVID cases
of the virus. Therefore, this study investigates
and related deaths., The numbers and statistics
the effect of presenting different types of infor-
people see could potentially create an emotion-
mation regarding COVID-related deaths on peo-
al indifference to the many victims of COVID-19.
ple’s perceived risk. This study will compare the
This mental state of emotional indifference is
effects of presenting information about person-
known as “psychic numbing” (Slovic, 2007), and
alized details of COVID-19 victims to presenting
this psychological phenomenon proposes that
information of statistical, anonymous victims on
people have a tendency to show indifference to
people’s perceived risk toward the virus. We
mass suffering, compared to individual suffering.
hypothesize that those who receive informa-
In contrast, “the singularity effect” (Slovic, 2007)
tion about identifiable victims will increase their
refers to the importance people place on saving
perceived risk toward COVID-19, compared to
individual lives. Research has shown that peo-
those who receive statistical information.
ple tend to donate more money to help identifiable victims than anonymous, statistical victims (Jenni & Loewenstein, 1997). Psychic numbing and the singularity effect are also reflected in how we communicate with others about reported suffering and death around the world. For example, emotions such as fear and anger are more likely to occur in texts mentioning smaller rather than larger numbers of deaths. Furthermore, negative emotional words are more likely to occur in conversations surrounding small and moderate amounts of deaths than a larger number of deaths (Bhatia et al., 2020). This research provides evidence for the presence of psychic numbing and suggests that fewer deaths evoke a stronger emotional response amongst people than do a larger number of deaths.
In addition to delivering information in line with the singularity effect, framing COVID-19-related information in terms of loss, as opposed to gains, may increase perceived risk toward the virus. This reasoning is supported by the concept of loss aversion, which refers to people’s tendency to prefer avoiding losses to acquiring gains. Loss aversion is derived from prospect theory, developed by Kahneman and Tversky, which posits that people should be more sensitive to losses than gains. Research investigating formulation effects of gains and losses demonstrates that, when choosing between surgery or radiation therapy, physicians and patients choose surgery far less when the treatment outcomes are described in terms of the probability of dying rather than the probability of living (McNeil
These findings offer an important sugges-
et al., 1982). To apply this to our study, if people
tion for how we can approach the delivery of
are prompted to think about what they would
information to the public. If we only report sta-
lose as a result of not following precautionary
tistics regarding the number of lives lost due to
guidelines, they may be urged to take action to
COVID-19, a numbing effect may take effect,
avoid losing more later. By framing outcomes in
Issue XI | December 2021
17
terms of loss, people may be prompted to think about the threat to one’s health, or even the loss
PSI Ψ
Procedure
One hundred participants will be recruited from
of one’s life, or a loved one’s. Loss aversion
universities in Montreal, Canada. They will be
may create an urgency for people to engage in
compensated with money or course credits
precautionary rather than risky behaviours.
for their participation. Participants will be ran-
In this study, we will investigate whether people’s propensity to engage in precautionary behaviour related to COVID-19 is mediated by their perceived risk of coronavirus. Our goal is to elicit different attitudes and behaviours by framing outcomes in terms of losses or gains, combined with personal or statistical information of COVID-19 victims. We hypothesize that those who receive information in line with the singularity effect, and information framed in terms of losses, will show increased perceived risk toward the coronavirus; therefore, leading to an increased likelihood to engage in COVID-relat-
domly assigned to two groups where they will receive information to read four times a week over a period of a month. Participants will be assessed on their perceived risk toward the virus and their propensity to engage in precautionary behaviours related to COVID-19. These reports will be administered prior to the study and at the end of the four weeks. Additionally, participants will be asked to fill out a questionnaire indicating their perceived risk and perceived fear toward COVID-19 after each reading session. This study will be conducted online, and participants will be sent the information and reports to com-
ed precautionary behaviours. In contrast, those
plete via email.
who receive information framed as gains, and
Materials
information that adheres to the assumptions of
Information manipulation. Participants will be
psychic numbing will not show this increase.
randomly assigned to one of two conditions. In
Methods Participants All participants will be between the ages of 17 and 26. Young adults are the focus of this study due to this age range increasingly making up the majority of COVID-19 cases in Quebec during the time of the study. Additionally, we will target this particular age range due to the research surrounding young adult mentality toward engaging precautionary behaviour.
the loss frame and singularity effect condition, participants will read news and information articles that contain accurate information framed in terms of losses, and information regarding COVID-related deaths portrayed in a way that adheres to the singularity effect (see Appendix A). In the gain frame and psychic numbing condition, participants will read news articles that contain information framed in terms of gains and information regarding COVID-related deaths portrayed in a way that adheres to the psychic numbing effect (See appendix B). To ensure that
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McGill Undergraduate Psychology Journal
participants read the articles, they will be re-
S. Li et al., 2020). The original questionnaire
quired to answer content questions about what
items are based on the government precaution-
they read after each reading.
ary guidelines taken from the countries where
Perceived risk. At the beginning and end of the
the research was conducted, such as China and
month, participants will be asked to fill out a questionnaire indicating their perceived vulnerability and risk to COVID-19. This will involve perceived risk regarding oneself and close others. Administering the questionnaire at the beginning of the study will allow us to establish a baseline perceived risk amongst the participants. Administering it after the four weeks will allow us to investigate the effects of the information phase by comparing the responses on the questionnaire to the baseline responses. Participants will also be required to fill out this questionnaire after each reading session. This 8-item questionnaire was developed for a study investigating predictors of fear of the coronavirus (Mertens et al., 2020). The questionnaire includes items such as “For my personal health I find the virus to be much more dangerous than the seasonal flu”, and “I am worried that friends or family will be infected.” Participants are to rate their level of agreement with each statement on a 5-point Likert scale (1 = “Strongly disagree”, 5 = “Strongly agree”). Higher scores indicate higher perceived vulnerability to the coronavirus. Precautionary behaviour. In order to establish willingness to engage in precautionary behaviours, participants will indicate how often they have engaged in precautionary behaviours since the outbreak of COVID-19 in a 19 item questionnaire (adapted from Li et al., 2020 and Issue XI | December 2021
the United States. Therefore, they were modified to apply to Canadian precautionary guidelines at the time of the study (see Appendix C). Participants will rate their level of engagement in different precautionary behaviours 1 (never) to 5 (almost always). Higher scores indicate more frequent compliance with precautionary behaviours. The questionnaire includes items such as “wear a mask when physical distancing is not possible” and “keep safe social distance with others.” This questionnaire will be administered before and after the information manipulation phase of the study.
Results
In the initial baseline tests of perceived risk and engagement in precautionary behaviour, we predict that those with greater perceived risk toward COVID-19 will show a greater propensity to engage in precautionary behaviours. In line with our hypothesis, during the information manipulation stages, we predict that participants in the loss frame and singularity effect (LFSE) condition will show a significant increase in perceived risk toward COVID-19 in their ratings after reading the articles each week, compared to those in the gain fame and psychic numbing (GFPN) condition. At the end of the month, after the information manipulation, we predict that those in the LFSE 19
PSI Ψ
group will show increased perceived risk toward
terms of loss, combined with providing informa-
the virus, compared to their baseline tests. In
tion about identifiable victims of COVID-19, will
contrast, those in the GFPN condition will not
increase perceived risk in participants, thereby
produce significantly different scores from their
increasing their propensity to engage in precau-
initial baseline tests (fig.1). We also predict that,
tionary behaviours. A key finding of this study
within the LFSE group, those who reported low
would be that those in the loss frame and singu-
perceived risk in their baseline test will show
larity effect condition, who initially reported lower
a far greater increase in their scores after the
perceived risk, showed greater increases in will-
manipulation, compared to those who reported
ingness to engage in precautionary behaviours
high baseline perceived risk (fig. 2).
related to COVID-19, after the manipulation,
Additionally, as hypothesized, we predict that those in the LFSE group will show a significant increase in their willingness to comply with precautionary behaviour guidelines. In fact, within this group, we predict that those who indicated lower scores in their initial baseline test of perceived risk, therefore also indicating low engagement in precautionary behaviours at base-
compared to those with high initial perceived risk. This would be an important finding because targeting those with low perceived risk toward the virus with an intervention, such as one conducted in the study, may significantly increase precautionary behaviour amongst groups who are the most responsible for the spread of the virus.
line, will show a far greater increase in willing-
A limitation of this study involves the self-re-
ness to engage in precautionary behaviour after
port nature of the measures. Subjects’ respons-
manipulation, compared to those who indicated
es about their engagement in precautionary
higher baseline perceived risk scores ( fig. 3).
behaviour may be a reflection of a social desir-
Finally, we predict that, compared to those in the LFSE condition, those in the GFPN group will not show a significant increase in their propensity to engage in precautionary behaviours
ability bias rather than their true frequency of engagement in these behaviours. Furthermore, the results would be suggestive as this study presents correlational data, and further analysis
(fig 4).
would be required to conclude a causal relation-
Discussion and Conclusion
tives for engagement in precautionary behaviour
ship. Further research to investigate other mo-
Our predicted results would suggest that one’s
may be beneficial. Particularly amongst young
propensity to engage in precautionary behaviour
adults, other factors such as peer pressure and
related to COVID-19 may be mediated by their
social media may have a greater influence on
perceived risk toward COVID-19
this age groups’ behaviour during the pandemic.
. We predict
that framing information related to COVID-19 in 20
McGill Undergraduate Psychology Journal
References
Bhatia, S., Walasek, L., Slovic, P., & Kunreuther, H. (2020). The More Who Die, the Less We Care: Evidence from Natural Language Analysis of Online News Articles and Social Media Posts. Risk Analysis. https:// doi.org/10.1111/risa.13582 Données COVID-19 par âge et sexe au Québec. (n.d.). INSPQ. Retrieved November 30, 2020, from https:// www.inspq.qc.ca/covid-19/donnees/age-sexe Fraser, S., Lagacé, M., Bongué, B., Ndeye, N., Guyot, J., Bechard, L., Garcia, L., Taler, V., Adam, S., Beaulieu, M., Bergeron, C. D., Boudjemadi, V., Desmette, D., Donizzetti, A. R., Éthier, S., Garon, S., Gillis, M., Levasseur, M., Lortie-lussier, M., … Tougas, F. (2020). Ageism and COVID-19: What does our society’s response say about us? Age and Ageing. https://doi.org/10.1093/ ageing/afaa097 Jenni, K., & Loewenstein, G. (1997). Explaining the Identifiable Victim Effect. Journal of Risk and Uncertainty, 14(3), 235–257. https://doi.org/10.1023/A:1007740225484 Kahneman, D., & Tversky, A. (1984). Choices, values, and frames. American Psychologist, 39(4), 341–350. https://doi.org/10.1037/0003-066X.39.4.341 Li, J.-B., Yang, A., Dou, K., Wang, L.-X., Zhang, M.-C., & Lin, X.-Q. (2020). Chinese Public’s Knowledge, Perceived Severity, and Perceived Controllability of COVID-19 and Their Associations with Emotional and Behavioural Reactions, Social Participation, and Precautionary Behaviour: A National Survey [Preprint]. In Review. https://doi.org/10.21203/rs.3.rs-16572/v4 Li, S., Feng, B., Liao, W., & Pan, W. (2020). Internet Use, Risk Awareness, and Demographic Characteristics Associated With Engagement in Preventive Behaviors and Testing: Cross-Sectional Survey on COVID-19 in the United States. Journal of Medical Internet Research, 22(6), e19782. https://doi.org/10.2196/19782 McNeil, B. J., Pauker, S. G., Sox, H. C. J., & Tversky, A. (1982, May 27). On the Elicitation of Preferences for Alternative Therapies (world) [Research-article]. Http:// Dx.Doi.Org/10.1056/NEJM198205273062103; Massachusetts Medical Society. https://doi.org/10.1056/ NEJM198205273062103 Mertens, G., Gerritsen, L., Duijndam, S., Salemink, E., & Engelhard, I. M. (2020). Fear of the coronavirus (COVID-19): Predictors in an online study conducted in March 2020. Journal of Anxiety Disorders, 74, 102258. https://doi.org/10.1016/j.janxdis.2020.102258 Nivette, A., Ribeaud, D., Murray, A., Steinhoff, A., Bechtiger, L., Hepp, U., Shanahan, L., & Eisner, M. (2020). Non-compliance with COVID-19-related public health measures among young adults in Switzerland: Insights from a longitudinal cohort study. Social Science Issue XI | December 2021
& Medicine, 268, 113370. https://doi.org/10.1016/j. socscimed.2020.113370 Pennycook, G., McPhetres, J., Zhang, Y., Lu, J. G., & Rand, D. G. (2020). Fighting COVID-19 Misinformation on Social Media: Experimental Evidence for a Scalable Accuracy-Nudge Intervention. Psychological Science, 31(7), 770–780. https://doi.org/10.1177/0956797620939054 Slovic, P. (2007). “If I look at the mass I will never act”: Psychic numbing and genocide. Judgment and Decision Making, 2(2), 79–95. Snell, R. J. (2020, May 25). “Going to Die Anyway”: COVID-19 Deaths of the Elderly are No Laughing Matter. https://cultureoflife.org/2020/05/25/going-to-dieanyway-covid-19-deaths-of-the-elderly-are-no-laughing-matter/
Appendices Appendix A: Loss Frame and Singularity Effect Condition Example - Information framed as losses
“You are at a higher risk of contracting COVID-19 if you engage in more contact with people outside your household. Additionally, if you choose to engage in unnecessary travel, there is a higher chance that you will contract Covid, and an increased chance of putting your families’ and friends’ lives in danger if you see them upon your return.” “After attending house parties and visiting a bar South of Montreal last week, 20 individuals tested positive for COVID-19, and others have been urged to get tested. Additionally, a gathering at a Karaoke bar in Quebec city has led to more than 30 cases of COVID-19. Attending parties and social gatherings has led to an unfortunate, widespread of COVID cases among young adults.” “So far, in Canada, we have lost 12,130 lives from COVID-19 complications. Young people who do not follow precautionary guidelines, attending parties and going to bars, have been responsible for the increased spread of the virus in Quebec.”
Example - Singularity effect
“‘A beloved mother and “abuela,’ Maria Celico Napoli died suddenly at Humber River Hospital in Toronto
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after being diagnosed with COVID-19 just five days earlier.‘It was heart-wrenchingly swift,’ her daughter, Jacqueline Kuehnel, said.”Calls and videos were sorely inadequate and our absence by her bedside made grief abstract and unreal,” her son, Osvaldo Napoli, said. She loved to dance, travel, listen to mariachis, look pretty, see humour in self-deprecation, give gifts, tell stories, watch telenovelas, and to care for her plants and beloved canary birds. She could not stand the suffering of the innocent and vulnerable and hated gossiping and mean-spirited people.”
Appendix B: Gain Frame and Psychic Numbing Condition Example - Information framed in terms of gains
“As long as you keep your distance, you can enjoy seeing friends in outdoor areas. Additionally, it is important to follow precautionary guidelines, as if the government sees a decrease in cases, then we can go back to enjoying our time at bars and restaurants with friends!” “If we act now, we may be able to save Christmas. We will have a chance to gather with family and friends during the Christmas holiday if we can bring the cases down.” “So far, in Canada, we have had 301, 345 recovered
PSI Ψ
= rarely, 3 = sometimes, 4 = often, 5 = almost always) 1. Wear a mask when physical distancing is not possible 2. Change face mask regularly 3. Wash hands regularly for 20 seconds, with soap and water or alcohol-based hand rub 4. Keep safe social distance with others 5. Stay home as much as possible 6. Avoid using public transportation 7. Avoid social gatherings 8. Avoid eating in restaurants 9. Avoid hosting private indoor gatherings 10. Avoid unnecessary travel to other provinces 11. Avoid going to public places if presenting with COVID-19 symptoms 12. Stay home if I feel unwell 13. Avoid touching my eyes, nose or mouth 14. Maintain a safe distance from anyone who is coughing or sneezing 15. Cover my nose with a bent elbow or a tissue when I cough or sneeze 16. Clean and disinfect surfaces and objects 17. Closely monitor personal physical health 18. Encourage people around you to follow the government’s precautionary guidelines 19. Avoid crowded places
cases. When you are recovering from Covid, it is important to drink plenty of fluid and eat nutritious food. If you are attentive to your health, you have a good
Supplemental Figures
chance of recovering from Covid and returning to normal health.”
Example - Psychic numbing
“Quebec reported 808 new cases of COVID-19 and 10 more deaths on Monday, two of which were in the past 24 hours. Since the start of the pandemic, there have been 100,922 confirmed cases, and 6,153 people have died.”
Appendix C: Precautionary Behaviour SelfReport Since the COVID-19 outbreak, how often have you engaged in the behaviours listed below? (1 = never, 2
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Issue XI | December 2021
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A Gender-Focused Exploration of Peer Support and Emotional Distress in Victimized Canadian Adolescents Yasemin Erdoğan
Supervisor: Dr. Frank Elgar Abstract
Ψ PSI Journal
background.
Bullying is a major problem that is recognized as a health and safety risk. The purpose of this study is to identify (1) whether peer support moderates the emotional distress of bullied adolescents, and (2) whether gender has a main effect on this moderation. | methods. Data was collected from 8,232 participants in the 2017-2018 Canadian Health Behaviours in School-Aged Children study. Regression analyses tested the associations between bullying, peer support, and emotional distress, which were then stratified by gender. | results. The Chi2 test showed significant gender differences across bullying and different peer support levels. Emotional distress in victimized females was lower with higher levels of peer support; there was no such trend with males. Victimized males showed high levels of emotional distress with high levels of peer support. There were significant gender differences in bullying’s association with different peer support levels among the youth. The mixed model regression showed that non-victimized males were significantly associated with a -2.02 unit decrease (b = -2.02, CI = -0.86, -0.04) in emotional distress across different peer support levels. Furthermore, peer support’s moderation of emotional distress in victims of bullying was not significant for females, but it was for males. | conclusion. These findings highlight the necessity to develop and implement interventions against bullying. Encouraging friendship formation and providing support is also necessary in order to alleviate some of the emotional distress youth may experience. Keywords: bullying, peer support, emotional distress, adolescents, gender
Introduction Bullying Bullying, now recognized by the Government of Canada as a major and preventable public health problem, is characterized by an unbalanced power dynamic with one side repeatedly inflicting harm on the other side, directly or indirectly. Victimization can be verbal, social, or physical. According to reports found by the National Center for Education Statistics, 20.8% of students in the United States aged 12 to 18 24
said that they were bullied within the 2014-2015 academic year (United States Department of Justice, 2016). Although there has been a decrease in bullying over the years, its prevalence is still a topic of concern due to its implications for the mental health of victims. A meta-analysis covering 80 studies found the mean prevalence of traditional bullying to be 35%, and 15% for cyberbullying (Modecki et al., 2014). According to a study by Troop-Gordon et al. (2017), bullying peaks during early adolescence and espeMcGill Undergraduate Psychology Journal
cially during the school transition period of ninth
costs associated with childhood mental health
grade. In this age group, it is consistently found
problems, as supported by the results of a study
that males engage in more perpetrations of di-
on the socioeconomic impacts of physical and
rect physical, direct verbal, and indirect types of
mental health problems. The study concludes
bullying than females do; and females appear
that there are “large and statistically significant
to be victimized more frequently than males
impacts of childhood psychological problems on
are (citations). Another report found that in the
family income that reach a peak of 28% lower
United States of America in 2017, 24% of fe-
net family income by age 50” (Goodman et al.,
males aged 12 – 18 reported being bullied in the
2011). The prospective economic costs related
school year compared to 17% of males (Musu
to childhood mental disorders are greater than
et al., 2019). Within the Canadian context, the
that of physical illnesses during the childhood
Government of Canada identifies bullying as a
years, largely because the impacts of mental
health and safety risk. They report that Canada
health problems occur early in adulthood
has the ninth highest rate of bullying (among 35
whereas physical health problems usually
countries) within 13-year olds and at least one
have a delayed impact (Goodman et al., 2011).
in three adolescent students in Canada have
Hence, tackling the problem of bullying may
reported being bullied recently (Government
mitigate economic costs among other important
of Canada, Canadian Institutes of Health Re-
psychological consequences.
search & Institute of Gender and Health, 2012).
Mental Health in Victims of Bullying
Furthermore, Canadian findings state that bullying behaviours for boys peaks in ninth grade and for girls it peaks in grades six, eight and nine (Craig et al., 2008). There are both short-term and long-term consequences of being victimized. 27% of victimized students stated that bullying negatively impacted various aspects of their life, such as their self-perception, academics, physical health, and relationships (Musu et al., 2019). Decreased well-being and mental health impacts, which will be expanded on in the following paragraph, are important consequences as well. However, it should be acknowledged that the impacts of being bullied are not limited to consequences for the individual. There are larger-scale Issue XI | December 2021
Being victimized can lead to a vicious self-feeding cycle; as children are bullied, they may socially withdraw and isolate themselves, potentially leading to lower quality friendships and lower levels of acceptance from friends, which may then prompt further bullying. This cycle has been demonstrated in the findings of a meta-analysis investigating whether internalizing problems were caused by victimization or were one of the causes of being victimized. The researchers concluded that internalizing problems were significantly predicted by bullying, and that internalizing problems significantly predicted changes in peer victimization, thus proposing a vicious cycle of interplay between victimization and internalizing problems (Reijntjes et 25
al., 2010). Similarly, findings from a self-report
PSI Ψ cide attempts. Within this risk, there were gender
survey completed by students between grade 9
differences. Victimized girls had an increased
and 12 concluded that frequent exposure to vic-
risk of depression, suicidal ideation, and suicide
timization was related to a seven times increase
attempts regardless of the frequency of their
in risk of depression compared to students who
victimization. Males were only at an increased
were not victims of bullying, as well as serious
risk if they were frequently victimized, with in-
suicidal ideation (SSI) and suicide attempts
frequent victimization being only associated
(Klomek et al., 2007). Naturally, one might won-
with an increased risk of suicide attempts. Other
der whether bullying is the causal source of such
studies have continued to explore gender differ-
difficulties. To answer this, a group of research-
ences in the experience of emotional distress
ers conducted a literature review trying to deter-
in bullying victims and suggested that it is pre-
mine whether bullying victimization is a signifi-
dominantly victimized females who experience
cant risk factor for psychopathology (Arseneault
depressive symptoms (Hankin et al., 1997; Starr
et al., 2009). Their review, which used temporal
et al., 2009). However, literature concerning the
priority to test for causal effects, found that even
role of gender differences in mental health out-
after controlling for demographic factors and so-
comes with peer support as a potential modera-
cial relationships, victims of bullying had more
tor is lacking. Our second research question will
problems in the present than at the start of their
explore this gap in the literature.
school year when they had not been exposed to
Peer Support
bullying. The authors suggested potential mechanisms to explain the occurrence of mental health problems among victims. Their first suggestion was that victims of bullying may become hyper- or hypo-sensitive to stress through their hypothalamic-pituitary-adrenal axis. This physiological response may then explain the victims’ disposition to mental health problems. Other proposed mechanisms involved cognitive distortions and emotion processing. For instance, bullied children may experience distorted ways of interpreting their environment- which can lead to increased risk for psychopathology. In the results of a study by Klomek et al. (2007), both female and male victimized adoles-
Children and adolescents spend most of their time in school interacting with peers. Considering the vast role that peers play in the lives of adolescents, an abundance of research has focused on examining the role of peer support and mental health problems. A prominent researcher in the field of peer support, Dr. Judith Rich Harris,, proposed the theory of group socialization in support of this notion. The theory puts forth the idea that school-aged children are molded more by their friends than their family. Consequently, psychological characteristics - including psychopathological symptoms - are modified by the peer support in their environment (Harris et al., 1995).
cents were at risk for depression, SSI, and sui26
McGill Undergraduate Psychology Journal
It has been established that early adoles-
We hypothesize that gender will have a main ef-
cence is a time where bullying is more prevalent
fect on this moderation; specifically, that females
(Eisenberg et al., 2005). There is also a shift in
will benefit more from the moderating effects of
the importance and impact of peer relationships
peer support on their emotional distress
throughout adolescence. The salience of peers increases as relationships grow more complex and important, and as adolescents begin to identify with distinct groups of peers (Berndt & Murphy, 2002). As expected, positive peer relationships lead to better self-belief, emotional well-being, prosocial behaviour, and academics (Elliot & Dweck, 2017). Indeed, friendships are a protective force and a positive influence on development. Even the perceived availability of interpersonal resources and integration into social networks has been found to buffer stress (Cohen & Wills, 1985). Could the stress-buffering potential of peer support then extend to victimized adolescents? Previous research on peer support emphasizes its power over adolescents’ various outcomes. Expanding on previous research, the current study poses two research questions. The first question asks (1) whether peer support moderates the consequent emotional distress victimized Canadian adolescents experience. We hypothesize that peer support will have a moderating effect on the emotional distress experienced by victimized Canadian adolescents. The second question will attempt to fill in the lacking literature on gender differences in the mental health impact of peer support by asking (2) whether gender differences have a main effect on the moderator - the buffering of emotional distress - in victimized Canadian adolescents. Issue XI | December 2021
Methods Participants The data were derived from the Health Behaviour in School-aged Children’s (HBSC) 2017-2018 cycle. This cross-national survey of children’s health behaviours, well-being and social context is school-based and collects data through anonymously self-completed questionnaires that are administered in classrooms by teachers or trained research assistants. The survey’s protocol was approved by Queen’s University and Public Health Agency of Canada/Health Canada ethics board. Inclusion criteria for this study included being in the ninth or tenth grade, and identifying as either a male or female. Participants who identified as “neither term describes me” and who were in a grade other than nine or ten were excluded. Although sex and gender identification are a contemporary and important topic of discussion, this paper’s goal was to do a preliminary exploration of the differences between school-aged males and females, without delving deeper into the adolescent’s identification. As a result, the sample being used was made up of 8,232 out of the 21,750 total participants. Descriptive statistics of the sample can be seen in Table 1. The inclusion and exclusion criteria were selected based on certain research findings. It has been found that rates of traditional bullying perpetra27
temper
PSI Ψ [irritable],
f: feeling nervous [nervous], g: difficulties in getting to sleep [sleepdifficulty]. The new measure of emotional tion increase for both genders from grade 9 to grade 11 (Hemphill et al., 2012). Further, the transition from middle school to the first years of high school is characterized by major changes of setting, expectations, and relationships. One study found that students’ adjustment improved after a school transition if they had well-adjusted, high-quality, and stable friendships (Berndt et al., 1999). Additionally, gender differences are more nuanced in early adolescence.
Measures Emotional Distress (outcome variable). Emotional distress was the outcome variable measured. In order to measure emotional distress, responses from question 46 of the HBSC survey, asking “In the last 6 months, how often have you had the following?”, were collected. The question asks about symptoms that are psychosomatic in nature as well as psychological. Since the desired outcome variable was emotional and psychological in nature, a new variable that focused on symptoms in line with DSM-V’s diagnostic criteria of Major Depressive Disorder (APA, 2013) was used. The items that were deemed as appropriate were: d: feeling low (depressed) (coded [feellow]), e: irritability or bad [1]
distress was coded [emot_distress]. When computing this variable, the scoring of the items ‘d’ to ‘g’ were reversed so that a rating of five now corresponded with having been bullied “Almost every day”, whereas a rating of one corresponded with “Rarely or never”. Then, the sum of the items was taken as the final step in creating the new variable that ranged from 4 (lowest level) to 20 (highest level) [1]
.
Peer Victimization. For peer victimization, we looked at question 55 from the survey, which asked “How often have you been bullied at school in the past couple of months?”. The answer options were: “1: I have not been bullied at school in the past couple of months”, “2: It has happened once or twice”, “3: 2 or 3 times a month”, “4: About once a week”, “5: Several times a week”. For the purpose of the research question, the question was re-coded to [been_ bullied] with a dichotomous answer. A defining characteristic of bullying is that it is carried out repeatedly over time (Eisenberg and Aalsma, 2005). For that reason, answers that were marked as two to three times per week up to several times a week were considered bullied,
emot_distress = (5 - feellow) + (5 - irritable) + (5 - nervous) + (5 - sleepdificulty).
28
McGill Undergraduate Psychology Journal
whereas answers which marked that they had
for any significant relationships between the cat-
not been bullied at all or that it had happened
egorical variables - being bullied, peer support
once or twice (within the past couple of months)
levels and gender. Mixed-effects linear regres-
were considered not bullied [2].
sion models tested the associations between
Peer Support (variable of interest). The main
bullying, peer support, and emotional distress.
independent variable of interest was the levels of support that the victimized adolescents received. The adolescents responded to question 51 from the survey which was a scale (very strongly agree to very strongly disagree) assessing prevalence of peer support with the following selections: “My friends really try to help me,” “I can count on my friends when things go wrong,”, “I can share both my happy feelings and my sad feelings with my friends,” and “I can talk about my problems with my friends.” A variable for peer support was computed [peersupport] by taking the sum of the four questions in which the answers then ranged from 4 (low) to 28 (high) . [3]
This variable was then divided into tertiles - low, middle, high level of peer support - which was later used in the analysis.
Data Analysis The research question was tested via statistical analysis of the data derived from the Health Behaviours in School Children study. IBM SPSS statistics version 24 was used to conduct all of the data analyses with a significance level of 5% (IBM 2016). Frequencies of categorical variables of interest were reported, while means and standard deviations for the continuous variable were reported. A Chi2 test was used to test
There were various interaction terms used: peer support and gender; gender and victimization; victimization and peer support; peer support, gender, and victimization. The mixed-effects models were then stratified by gender to test for gender differences.
Results Descriptive Results Table 1 shows the summary statistics for the frequency of the sample across bullying, and peer support levels (low, middle, and high) for the total sample and as stratified by gender. Among the total population of 8,232, 26.3% were bullied, whereas 73.7% were not. The prevalence of bullying was almost equal among the males (25.1%) and the females (27.4%). The spread of peer support levels in the sample was: 32% for low, 40.3% for middle, and 27.1% for high. The Chi2 test showed that there were significant gender differences across bullying (χ2(1) = 5.58, p = 0.02) and different peer support levels (χ2(2) = 57.69, p = 0.00) at p < 0.05. The descriptive statistics for emotional distress among bullied females and males can be seen in Table 2. Overall, females have higher emotional distress than males. Results indicated that the levels of emotional distress for bul-
[2]
bullied no [0] = [1,2] | bullied yes [1] = [3,4,5]
[3]
peersupport = friendhelp + friendcounton + friendshare + friendtalk
Issue XI | December 2021
29
PSI Ψ
the bullied males it was 0.00-14.00.
Further
details about the emotional
distress
levels
across bullying status and different peer support levels, and stratified by gender, can be seen in Figure 1. Bullied females and males have higher emotional distress than their non-bullied counterparts. It is evident that females generally have higher emotional distress levels than males do. Furthermore, the bar chart (Figure 1, in Appendix) shows that females, overall, have lower levels of emotional distress with higher levels of peer support. The same gradient can be seen with non-bullied males. However, bullied males with high levels of peer support show higher emotional distress than those with low and middle levels of peer lied females were lower as peer support levels were higher (x̄ low = 10.22, x̄ middle = 9.48, x̄ high = 8.25). In contrast, levels of emotional distress of bullied males were higher with high levels of peer support (x̄ low = 6.83, x̄ middle = 6.41, x̄ high =7.05). The range of emotional distress in bullied females was 5.00-16.00, while in 30
support.
Regression Results Table 3 shows the regression analysis between bullying, gender and peer support. When assessing the association between the interaction term of gender and victimization in emotional distress, non-victims of bullying were signifiMcGill Undergraduate Psychology Journal
cantly associated with: a -1.59 unit decrease in
females in the sample was similar. As for bul-
emotional distress across genders (b = -1.59,
lying’s association with different peer support
CI = -2.70, -0.49); and a -1.12 unit decrease (b
levels, there were gender differences among
= -1.12, CI = -2.05, -0.19) in emotional distress
the adolescents. When stratified, it was evident
across different peer support levels. There was
that victimized females had higher levels of
also a significant association with a 0.67 unit
emotional distress than victimized males. This
increase (b = 0.67, CI = 0.11, 1.23) in emotional
finding is in line with a multitude of research that
distress across different genders and peer sup-
shows lower levels of psychological well-being
port levels in the non-victimized group. This in-
and higher levels of distress, anxiety (Visani et
dicates that a combination of the three variables
al., 2011), and depressive symptoms in females
causes an increase in emotional distress in
compared to males (Hankin et al., 1997).
non-victims of bullying. This warrants a gender
As expected, the gradient of emotional dis-
stratified analysis of emotional distress, peer
tress for these females was lower with each
support and bullying (Table 4). Table 4 shows
higher level of peer support. A previous study by
the regression analysis between bullying and
Pfeiffer et al. (2011) emphasizes the power of
peer support as stratified by gender. The mixed
peer support with depressed adults. The study
model regression showed that non-victimized
in reference found that there were no significant
males were significantly associated with a -2.02
differences in depression outcomes between
unit decrease (b = -2.02, CI = -0.86, -0.04) in
participants who were assigned to the peer
emotional distress across different peer support
support intervention compared to the cognitive
levels. Non-victimized females were not signifi-
behavioural therapy (CBT) – meaning that the
cantly associated with changes (b = 0.22, CI =
benefits of peer support for depressed adults
-0.15, 0.59) in emotional distress across differ-
was nearly equal to the benefits of CBT. This
ent peer support levels.
study supports the finding of emotional distress
Discussion
This study assessed two questions: (1) if the emotional distress experienced by bullied adolescents is moderated by peer support; and (2) if there are gender differences in the potential moderation. We hypothesized that (1) peer support would moderate the emotional distress of the bullied youth; and (2) females would benefit more from the moderation. Findings revealed that the prevalence of bullying in males and Issue XI | December 2021
being lower for higher levels of peer support among females. The scientific literature provides evidence that females have higher expectations from friendships than males (Hall, 2010). In his research, he showed that females had higher expectations of reciprocity – which he defined as trust, loyalty, commitment, genuineness, and acceptance - than males. According to his meta-analysis, females also had higher expectations of communion – intimacy, empathetic understanding, self-disclosure, and emotional 31
support (Hall, 2010). Geary et al. (2003) argued
PSI Ψ as though they are less in tune with the charac-
that females are less tolerant of non-reciprocal
teristics of the friend group and that their status
friendships, and that they have higher expecta-
in the friend group is jeopardized. Hence, those
tions of trust and loyalty from friends. For this
males with high levels of peer support may per-
reason, reciprocity in friendships would be crit-
ceive more pressure to fit in, therefore exacer-
ical for females. Results from the current study
bating their emotional distress. Another expla-
showing that females had lower emotional dis-
nation for this finding is based on a study by Hall
tress with higher peer support can be explained
(2011). Hall defines agency as the extent that
by these prior research findings.
wealth, status, physical attractiveness, fitness,
In the current study, victimized males showed lower levels of emotional distress with middle levels of peer support than with low levels; however, they showed higher emotional distress with high levels of peer support. In other research, there was a stronger association between victimization and depression for males than for females (Yin et al., 2017). The results from Yin et al’s (2017) study as well as the results from the current study suggest that males may be more vulnerable to emotional consequences when bullied. Previous research exploring the associations between gender, emotional distress, and peer support have suggested that the degree of similarity between friends is a significant factor in defining friendships for adolescents. There have been findings which state that identifying with and being similar to one’s friend group affects an adolescent’s psychological development (Berndt, 1982). Similarly, Geary et al. (2003) stated that male coalitions are competitive, non-reciprocal, and associated with hierarchical differentiation. This implies that maintaining a certain status is critical in males’ friendships. Perhaps victimized males may feel 32
intelligence, and education were expected from friends. In his study, the results showed that males expected more agency than females did (Hall, 2011). This study supports the hypothesis that males may feel that victimization threatens their position in their friend group. Another study found that friendship quality was positively correlated with gossip tendencies in males, but not with females (Watson, 2012). The implication of this is that victimized males with high levels of peer support may have more emotional distress because they are aware of this tendency to gossip within the friend-group. Finally, a study by Kenny et al. (2011) found that high levels of disclosure in best friend relationships were a predictor of distress. They suggested that youth who experience high levels of distress may try to lessen their distress through seeking comfort in their relationships, but because their peers may not have the tools needed to soothe their distress, the support-seeking adolescent may experience more distress given that their need was not met. Thus, seeking high levels of “peer support” may actually be an ineffective way of lessening a victim’s distress in certain situations. Frequently revisiting the trauma of being bullied McGill Undergraduate Psychology Journal
and lingering in the negative feelings with oth-
not value nor receive this level of peer support
ers is known as co-rumination. Co-rumination
and its benefits regularly.
has been found to correlate with higher levels of mental health problems in adolescents and could be an explanation for the current finding (Starr & Davila, 2009). Interestingly, the authors found that a higher number of male friends was related to greater co-rumination. Although unspecified in the survey, the males may have more male friends than female friends, consequently leading to more emotional distress due to co-rumination.
There are several strengths to this study. The current study used the HBSC, a large and nationally representative sample across Canada. This thesis was also unique in that it added to the scarce literature on gender differences in peer support and mental health outcomes. It is not to say that there are no limitations. The HBSC survey relied on self-reported data, thus bringing into question the accuracy of the objective measures by distinguishing perceived
The current study also found that peer sup-
versus enacted peer support. However, findings
port’s moderation of emotional distress in victims
show that perceived peer support correlates
of bullying was not significant for females, but it
with enacted peer support (McCaskill & Lakey,
was for males. This finding is not in line with an
2000). The study did not control for potential
abundance of prior research on peer support and
stressful life events – i.e., health related prob-
females which state that females value and are
lems, socio-economic status, familial problems.
impacted by high quality friendships. Counterin-
As other research indicates, these are factors
tuitively, females highly valuing their friendships
that could have led to some of the emotional
may actually be a potential explanation for this
distress that was attributed to victimization (Yin
finding. Females generally attribute higher qual-
et al. 2017).
ity to their friendships and report higher levels of peer support than males do. In line with prior research, Kenny et al. (2013) found that females reported higher levels of disclosure, support and approval in best friend relationships than males. This finding may be a potential explanation for the insignificance of peer support’s moderation for females; since females already receive and highly value peer support on a day-to-day basis, the benefits of it may not be significant in the context of victimization. On the other hand, it may be significant with males because they do Issue XI | December 2021
Conclusion
This study explored the associations of peer support, bullying, and gender, and found that they have particular implications for the emotional distress of victimized male youth. The results highlight the necessity to implement measures to address bullying. They additionally have important implications for the encouragement of friendship formation, as there was a protective effect of peer support on emotional distress, with gender differences. The finding that victimized males with high peer support have higher 33
emotional distress is very intriguing. Future research can build onto this finding by delving deeper into the reasons behind victimized males’ heightened vulnerability to high levels of peer support. Finally, stemming from the limitations, future research which gathers teacher reports about peer support could assess any differences there may be in perceived versus observed peer support and the role of this in the outcome variable. As stated in the introduction, this study did not delve into sex and gender; therefore, future studies can explore the outcomes variables across the spectrum of identities. To conclude, in addition to developing and implementing anti-bullying programs, it is highly advisable that schools - a context in which bullying, and friendships take place - promote bonding, support and peer engagement. References
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being bullied within a developmental context. Journal of Adolescence, 55, 116–128. doi: 10.1016/j.adolescence.2016.12.012 United States Department of Justice, et al. “National Crime Victimization Survey: School Crime Supplement, 2015.” National Crime Victimization Survey: School Crime Supplement, 2015, Inter-University Consortium for Political and Social Research [Distributor], 20 Dec. 2016, doi.org/10.3886/ICPSR36354.v1. Visani D., Albieri E., Offidani E., Ottolini F., Tomba E., Ruini C. (2011) Gender Differences in Psychological Well-Being and Distress During Adolescence. In: Brdar I. (eds) The Human Pursuit of Well-Being. Springer, Dordrecht. doi: https://doi.org/10.1007/978-94-00713758_6 Watson, D. C. (2012). Gender Differences in Gossip and Friendship. Sex Roles, 67(9-10), 494–502. doi: 10.1007/s11199-012-0160-4 Yin, X.-Q., Wang, L.-H., Zhang, G.-D., Liang, X.-B., Li, J., Zimmerman, M. A., & Wang, J.-L. (2017). The promotive effects of peer support and active coping on the relationship between bullying victimization and depression among Chinese boarding students. Psychiatry Research, 256, 59–65. doi: 10.1016/j.psychres.2017.06.037
Appendix Figure 1. Gender-stratified bar chart of mixed model regression analysis of emotional distress in adolescent sample
Issue XI | December 2021
35
Cognitive Dissonance & COVID-19 Lockdown Measures Juno Henderson, Katia Kutlesa, Ben Lawson, Kayla Siksik & Ella Vezina Supervisor: Dr. Reza Farivar
Ψ PSI Journal
Background
sures at that time was remarkably high. A poll
come ubiquitous in the Western world with
sample of 1,520 Canadians showed that 90 per-
Lockdowns, a set of policies that have bethe COVID-19 pandemic, though argued to be necessary by the relevant authorities, have undoubtedly imposed and continue to impose severe consequences onto the population. The exact measures and policies that comprise a lockdown vary significantly from country to country and even between sub-national jurisdictions, but a general framework remains constant. Lockdown policies are primarily composed of government-mandated restrictions of activities that increase the probability of Coronavirus transmission. This typically entails the closure of non-essential businesses, restrictions on domestic travel and social gatherings, and the suspension of in-person government services, such as schooling, non-essential hospital visits, and daycare. Lockdown policies first saw a phased entrance across Canada beginning in late March of 2020 (Boire-Schwab et al., 2020). Despite these policies imposing severe restrictions on civil liberties, steep economic costs, and, in many cases the cessation of essential government services, support for these mea36
conducted in late March using a representative cent supported keeping the country as locked down as possible to combat the pandemic (DART&maru/BLUE, 2020). This was mirrored by the dramatic increase in the approval ratings for provincial premiers, under whose jurisdiction lockdown policies mostly fell, from the start of the pandemic in March through to the summer, roughly approximating the timeline of the first round of lockdown policies (DART&maru/BLUE, 2020). In Canada’s three largest provinces, Ontario, Quebec, and British Columbia, provincial premiers all saw an estimated increase in approval ratings of over 30 percent from March to June, which roughly corresponds to the timeline of the initiation to the easing of lockdown policies (maru/BLUE, 2020). Given the context, this extremely high level of support is not surprising. At the time, lockdowns were framed as a moral imperative that, for a relatively low cost, would save many lives, as it was feared that the number of new infections and required hospitalizations would overwhelm the healthcare system, which was suffering McGill Undergraduate Psychology Journal
from acute shortages of necessary equipment.
intensive care, and to utilize time spent in lock-
The potential social and psychological costs of
downs to develop plans to coexist with the virus
such a policy were not fully realized at the time,
safely, rather than depend on them to eradicate
possibly because large-scale quarantines had
the virus. This would mitigate the harmful effects
not been implemented within the western world
of confinement and economic recessions on
since the 1919 Spanish Flu, when research on
national and global populations’ food security,
such topics was still in its infancy. However,
domestic abuse, physical health, mental health
research conducted since March has consis-
and suicide, housing, substance abuse, and ac-
tently shown that lockdowns not only impose a
cess to education.
severe psychological toll on all of the hundreds of millions affected but also cause many to cope through means known to have significant deleterious impacts on physical health in the long term. Mental health is a serious concern in Canada at the best of times, with an average of 4,000 dying annually by suicide (Public Health Agency of Canada, 2020). A recent study examining suicidality in Canada has indicated that the economic impact of the pandemic alone predicts the increase in annual suicides for just 2020-21 to be between 418 and 2,114 cases higher than a typical year (McIntyre et al, 2020). There is good reason to expect that this rate will increase further when the deleterious effects of lockdowns on mental health are considered. The World Health Organization itself has
Lockdowns have been shown to predict increases in post-traumatic stress symptoms, depressive symptoms, and anxiety symptoms, which are exacerbated by the longer duration of quarantine, boredom, and post-quarantine stressors such as financial difficulties (Brooks et al, 2020). In a study by Copeland et al. (2021), in which the behavioural and emotional functioning of 675 first-year university students was measured, the virus and its associated educational and governmental measures were found to have a modest but persistent negative impact on mood and wellness. SSimilar reasons (i.e., stress, boredom and a lack of schedule) have also resulted in an increase in alcohol consumption during lockdowns. A study of 1036 Canadians found that
25% of those aged 35-54,
expressed concern over the costs of prolonged
and 21% of those aged 18-34, have increased
and prematurely implemented lockdowns and
alcohol consumption since the implementation
has advised world leaders to use extreme mea-
of lockdown measures (Canadian Centre on
sures as sparingly as possible (World Health
Substance Use and Addiction (CCSA), 2020).
Organization, 2020). Governments have been
Increased consumption of other substances
advised to use lockdowns as a way of flatten-
during the lockdown has also been found. The
ing the curve, that is to say, reducing the rate of
British Columbia Coroners Service reported a
infection such that healthcare systems are not
44% increase in the number of illicit drug toxicity
overwhelmed by the number of cases requiring
deaths in May 2020 compared to April 2020, and
Issue XI | December 2021
37
a staggering 93% increase when compared to
PSI Ψ but who did not necessarily die as a result of
May 2019 (British Columbia Coroners Service,
the disease (Furey, 2020). As such, the fatality
2020).
rate is almost certainly significantly lower than
By restricting people within their homes, lockdowns have also put immeasurable amounts of people in danger. Rates of domestic violence have increased by 20-30% across Canada during COVID-19, coinciding with the shift of the workplace from office to home (Sandovnik et al., 2020). Additionally, a survey of staff and volunteers working at transition houses, shelters, immigration centres and other social agencies throughout Canada found that 82% reported that violence has gotten more frequent and more lethal since the imposition of lockdowns (Trudell & Whitmore, 2020). The Coronavirus was initially thought to be more lethal and more infectious than it is now known to be. Preliminary estimates from March 2020 of COVID-19’s case fatality rate were thought to be approximately 3.4 percent, and more deadly for the elderly and those with pre-existing conditions (World Health Organization, 2020). Presently, 11,776 deaths related to COVID-19 have been reported in Canada, out of a total of 354,498 confirmed cases (Johns Hopkins, 2020). While this suggests a crude case fatality rate of approximately 3 percent, it does not account for those who were infected but who were never tested, either because they were asymptomatic; failed to receive a test; or, at least according to the Ontario provincial definition of how Covid-19 deaths are categorized, those who died having tested positive for Covid-19 38
3% within the general population, and certainly far lower among younger age demographics. At the time of writing, there were 61,140 confirmed cases of Covid-19 in Canadians aged 19 and under, of which just 3 cases resulted in death. This suggests a fatality rate of approximately 0.004% for this demographic (Government of Canada, 2020). For those aged 20-29, the rate is slightly higher, but still very low at 0.019% (Government of Canada, 2020). Even for those between ages 50 and 59, the rate is just .58% of cases (Government of Canada, 2020). None of these account for those with comorbidities or vulnerabilities, indicating these rates could easily be lower for those in good health. COVID-19 certainly poses a potent threat to public health, though this is overwhelmingly directed towards seniors and not other sectors of the population. Over 70% of the deaths in Canada were of those 80 years of age and older, with a further 18.5% of deaths being those aged between 7079 (Government of Canada, 2020). Considering the evidence that has demonstrated the immense costs attributable to lockdowns that have emerged since their initial implementation in Canada, it is reasonable to conclude that the moral calculus underpinning the support of lockdown policies has changed from initially being one of short-term economic and social sacrifice in exchange for widespread harm reduction, to one significantly more complex. Previous research has long supported a McGill Undergraduate Psychology Journal
connection between moral reasoning and politi-
themselves that they lied to somebody for what
cal orientation, indicating that individuals tend to
was at the time a substantial amount of money,
support policies they view as moral and oppose
it was more difficult for participants to reconcile
those they view as immoral (Kivikangas, 2020).
their lying to someone in exchange for a trivial
Previous research has also demonstrated that
amount of money with positive beliefs regarding
individuals are strongly psychologically motivat-
their personal integrity. Therefore, to reduce the
ed to maintain a positive image of themselves,
cognitive dissonance created by these opposing
in which they are morally decent human beings
cognitions, the participants who were paid just
(Kunda, 1990). As such, individuals are subject
one dollar rationalized that the task was signifi-
to experiencing cognitive dissonance, that is,
cantly less boring than it actually was, thereby
when two or more contradicting cognitions are
minimizing their moral transgression from one of
held, if for whatever reason their beliefs or be-
outright lying to perhaps just exaggeration. This
haviour stray into immoral territory. Individuals
resolution allows for the continuation of positive
typically reconcile this dissonance either by
beliefs regarding the self and their behaviour.
modifying one of the cognitions to make it more compatible with another one, by trivializing one of the cognitions to reduce its significance or by adding another cognition to reconcile the initial contradictory cognitions or to deny the contradictory nature of the cognitions in the first place (Festinger, 1962). This phenomenon was first observed by Festinger and Carlsmith (1959). In their experiment, 71 students were asked to perform a deliberately boring task for an hour. Once they were done, the participants were given either one dollar or twenty dollars to tell the next participant (i.e. a confederate in the study) that the task was fun. Lastly, the participants were asked to rate how fun and interesting they personally thought the task was. Individuals who were paid one dollar rated the task as significantly more fun and interesting than those paid twenty dollars. Festinger and Carlsmith (1959) concluded that while individuals could personally justify to Issue XI | December 2021
While previous research has demonstrated that cognitive dissonance can also be created by cognitions regarding one’s moral integrity contradicting those regarding political support, we seek to demonstrate in this study that having previously supported a political policy, specifically lockdowns, may through cognitive dissonance inhibit the integration of negative information regarding said policy. People have a natural aversion to harming others, even in cases where doing so would save many lives, and so it may be difficult for individuals to reconcile their initial support for lockdowns with the harmful consequences of that policy, even if they believe that lockdown policies were ultimately worth the cost they imposed (Mikhail, 2000; Petrinovich, O’Neill, & Jorgensen, 1993). This would yield valuable information regarding factors influencing public opinion on lockdown policies and suggest that continued support for 39
PSI Ψ
lockdowns could in part be attributable to psy-
minimizing the negative information being pre-
chological resistance towards accepting that
sented to them and by asserting their support
previous support of lockdowns created harm,
for continued lockdowns. The control group, by
creating dissonance with positive beliefs re-
having a completely different topic made psy-
garding one’s own moral integrity, which is then
chologically salient, should experience little to
resolved through the minimization of said harm.
no cognitive dissonance and therefore have
To demonstrate this, we used a forced com-
reduced resistance towards integrating the neg-
pliance method where participants are told to write about a subject even if it is against their beliefs (Bem & McConnell, 1970; Cooper & Mackie, 1983). The participants first answered questions establishing that they did in fact initially support lockdowns in March of 2020. Half of the participants were then asked to write an argument justifying the initial series of lockdowns in March (i.e., experimental condition). The other half were asked to write an argument for an unrelated subject (i.e., control condition). Afterwards, the participants were presented with a set of facts about the negative effects of the lockdowns. Lastly, they were asked to answer questions to establish support for future lockdowns. We hypothesized that participants in the experimental condition who were asked to justify their initial support for lockdowns will show greater support for continued lockdowns even after being presented with negative information regarding the consequences of lockdowns. Justifying the initial series of lockdowns will remind participants of their previous support for the policy, and of the moral convictions that are directly contradicted by evidence suggesting these policies created harm. We expect that participants will reconcile this by psychologically 40
ative information and reporting reduced support for lockdowns.
Methods
There are ten randomly assigned participants in this study – six in the experimental condition and four in the control condition. Participants were aged 18-25 and completed the task in their homes on their own computers. The experiment was created using PsychoPy software, version 2020.2.8. The experiment consists of four sections: a set of four statements, a written justification section, slides of factual evidence and another set of four statements. The experimental and control conditions only differ in the prompts of their written justification sections; all other sections are identical. The first set of four statements are presented in sequential order, showing only one statement on the screen at a time. All participants are asked to rate, on a 7-point Likert Scale using their numbered keys, to what extent they agree or disagree. These statements serve to establish the participants’ initial support of lockdowns, in March 2020, as a measure to minimize deaths during the COVID-19 pandemic. In a meta-analysis conducted by Finstad and colleagues in 2010, 7-point Likert scales in a sequential order were found to be McGill Undergraduate Psychology Journal
the most accurate and indicative of participants’
themselves contribute to death in the population,
true evaluation of statements in online formats,
indirectly related to the COVID-19 virus.
therefore this method was used. For an example of a statement shown to participants in the first section, refer to Figure 1.
Lastly, the second set of four statements are presented similarly to the first set, showing only one statement on the screen at a time. All partic-
As mentioned above, the difference between
ipants are asked to rate, on a 7-point Likert scale
the experimental and control conditions are the
using their numbered keys, to what extent they
justification sections: those in the experimental
agree or disagree. These statements serve to
condition are asked to justify the use of lock-
assess the participants’ current support of lock-
downs as a measure to prevent the spread of the
downs as a measure to minimize deaths during
virus regardless of their personal opinion, and
the COVID-19 pandemic – after having read
those in the control condition are asked to jus-
the factual evidence suggesting otherwise. The
tify their favourite pandemic activity. We chose
statements in this section are worded very sim-
to have the control group justify their favourite
ilarly to those in the first section, so as to allow
pandemic activity as we wanted the content of
us to compare participants’ responses before
both written sections to be related to the topic
and after having justified the use of lockdown
of COVID-19 while only having the experimental
measures (or not) and reading factual, contra-
condition write in support of lockdown measures.
dictory evidence. However, to be more subtle,
The content of participants’ written justification
the ordering of the questions was changed.
sections were not statistically analyzed; they
We expect this format - justifying lockdowns
simply served as the experimental manipula-
followed by contradictory factual evidence - to
tion. Following the written justification section,
cause participants in the experimental condition
all participants are asked to read through four
to integrate this new information to a lesser ex-
slides of factual evidence. This evidence sug-
tent than those in the control condition, and thus
gests that lockdowns are not an effective policy
continue to endorse lockdown measures, in an
in terms of minimizing deaths in the population
effort to reduce cognitive dissonance. Converse-
(i.e. all deaths not attributable to old age.) These
ly, we expect those in the control condition to be
slides cover statistics related to: mental health
more receptive to the new information present-
and mortality, substance abuse and overdose,
ed to them and therefore shift their endorsement
domestic abuse and violence, and unemploy-
of future lockdown measures more than those in
ment and suicide - one example from each
the experimental condition. For an example of a
slide can be found in the Appendix. This section
statement shown to participants in this section,
serves to present the participants with evidence
refer to Figure 2.
from reputable sources that lockdown measures Issue XI | December 2021
41
Demographic information such as gender
PSI Ψ perimental and control group respectively. This
and ethnicity were not collected for this present
confirmed that both groups were composed of
study, as it was deemed unnecessary in the
individuals who in theory would be subject to
context of the effects of cognitive dissonance.
experiencing dissonance as a result of the ma-
Results
Raw data were collected directly from the PsychoPy software (version 2020.2.4) and exported for analysis to Excel (version 16.41) and R-Studio (version 1.2.5033). Initial descriptive statistical analyses were performed in Excel (see Table 1). Linear regression analyses were conducted in R-Studio in order to determine the statistical significance of the difference between the control and experimental conditions. Changes in average group responses between pre- and post-sections of the experiment are displayed in Figure 3 which was created using R-studio.
nipulation. Our results were in line with our hypothesis, and while in both groups there was a reduction between the pre-manipulation support for the first round of lockdowns and the post-manipulation support for future lockdowns, this decrease was larger in the control group than in the experimental group. This suggests that the experimental group experienced a degree of cognitive dissonance as a result of having their prior support of lockdowns made mentally salient by the writing task and being exposed to information suggesting harm was caused by said policies. This dissonance produced resistance to the acceptance of this information in or-
Linear model regression analyses were used
der to maintain more positive beliefs regarding
to determine whether or not the experimental
their prior justified opinion, ultimately resulting in
and control groups differed with respect to cog-
increased support for future lockdown policies
nitive resistance in integrating negative infor-
relative to the control group.
mation as measured by the change in support for lockdowns between pre- and post-sections of our experiment (see Table 2). The model suggests that, regarding change in support for lockdowns, experimental differences between groups accounted for 7.53% of the variance (R²= -0.0754, F(1,8)= 0.369, p>0.05).
Discussion
As expected, all participants in both groups reported they strongly supported the initial series of lockdowns as a method of minimizing death, with average scores of 6.5 and 6.75 for the ex42
The implications of this finding, if it is in fact reflective of a psychological reality, are substantial. Regardless of whether or not lockdown policies are or were in fact warranted by the gravity of the pandemic, their implementation undoubtedly carries profound consequences for the lives of millions of people. They represent a severe breach of previously enshrined civil liberties, are clearly detrimental to the physical and mental health of individuals and cause widespread economic devastation. Suffice it to say, it is highly unlikely that support for these policies is given lightly. As such, it is important to McGill Undergraduate Psychology Journal
consider the implications of situations in which
to one group experiencing dissonance and the
individuals who have previously supported a
other not. Rather, it could be a result of the ex-
policy, even one whose seriousness warrants
perimental group simply experiencing increased
increased scrutiny, may be prone to have con-
dissonance relative to the control. This limitation
tinued increased support for the application of
of the sample limits our ability to truly interpret
policies in different contexts, even with access
the size of the effect of dissonance.
to information challenging their previous expectations regarding the efficacy of the policy. This suggests that even for policies that deeply contradict fundamental democratic values, the acquisition of initial public support on a moral premise can facilitate future support. In other words, when a policy receives public support on moral grounds, the burden of proof of validity or efficacy required by individuals for their support may be lowered for either its future application or continuation.
A further limitation is our inability to account for previous exposure to the information presented regarding the harm that results from the implementation of lockdown policies. It is therefore unknown whether or not the level of dissonance experienced could have been moderated by the level of familiarity with said information. Previous research has shown that repeated exposure to information increases its believability, which may impact the degree to which the information influences future support for such policies
While unfortunately none of our findings
(Fazio, 2019). It was also difficult to determine
reached the accepted statistical significance
the extent to which participants engaged in the
of p<.05, this is likely due to the limitations im-
writing task, as due to the remote style of de-
posed by the sample size. Even in Festinger
livery we were unable to effectively enforce the
and Carlsmith’s seminal study from 1959, the
requested length for the task. The study also
observed effect of cognitive dissonance was
suffered from a lack of demographic represen-
only an average difference of .44 on a 5-point
tation, being confined to a narrow age group as
scale between the experimental and the control
a result of consisting exclusively of undergrad-
groups. As such, it was unlikely that we would
uates and not accounting for ethnicity, race, or
obtain results of the magnitude needed to pro-
gender. While it is unlikely that race, ethnicity, or
duce a statistically significant difference. Fur-
gender would significantly impact the effects of
thermore, it should be noted that both groups
cognitive dissonance, age may play a significant
were composed of individuals who had sup-
role in the perception of lockdown policies rela-
ported the initial series of lockdowns, and both
tive to that of the general population, as may the
were reminded of this through reporting their
fact that our sample consisted solely of students
previous degree of support. If the differences
with above-average socioeconomic statuses
between both groups were indeed a result of
and educational attainment.
cognitive dissonance, it was possibly not due Issue XI | December 2021
43
Conclusion
PSI Ψ type, as in these cases the state typically pos-
lockdowns may prevent integration of negative
is available to the public relative to democratic
In this study, we found that previous support of information about the lockdown due to cognitive dissonance. Our findings have illustrated the continued relevance of cognitive dissonance within both political and moral psychology, demonstrating that support lent to policies on moral grounds is subject to encountering dissonance when information regarding these policies conflict with the innate human aversion to causing harm and possessing negative beliefs. This highlights the importance of careful scrutiny regarding the justification for policies that cause negative consequences for society or restrict civil liberties. If indeed prior acceptance of a policy based on a specific factual premise can bias future considerations of the merits of said policy, the implication is that initial information is disproportionately weighted in the consideration of a policy relative to subsequent, even contradictory, information. If true, this would suggest that the psychological desire for internal moral consistency could be manipulated by state actors to increase future political support through the provision of
sesses far greater control of what information regimes. We encourage future research to further investigate the impact of cognitive dissonance on popular support of policies, specifically focusing on the level of prior knowledge regarding the relevant policies. It would also be of interest to examine the impact of cognitive dissonance on policies whose moral framework is not as explicit, such as those regarding economic issues, as it is unclear whether or not this dissonance is reliant on processes maintaining positive beliefs regarding one’s morality or could be generalized to those maintaining positive beliefs regarding one’s competence. Further, rather than a sample that already supports the policy, one might investigate the impact of cognitive dissonance on a group that does not support the policy initially. Finally, in order to better determine the true effect size of the dissonance examined here, a similar experiment could be conducted with a comparison between both a group that has previously supported the policy in question and one that has not, in order to isolate the ef-
an initial affectively-charged moral justification
fects of dissonance.
of a policy that is strong enough to be initially
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Canadian Center on Substance Use and Addiction. (2020, April). 25% of Canadians (aged 35-54) are drinking more while at home due to COVID-19 pandemic; cite lack of regular schedule, stress and boredom as main factors. CCSA. https://www.ccsa.ca/sites/default/ files/2020-04/CCSA-NANOS-Alcohol-ConsumptionDuring-COVID-19-Report-2020-en.pdf Cooper, J., & Mackie, D. (1983). Cognitive dissonance in an intergroup context. Journal of Personality and Social Psychology, 44(3), 536-544. Copeland, W. E., McGinnis, E., Bai, Y., Adams, Z., Nardone, H., Devadanam, V., Rettew, J., & Hudziak, J. J. (2021). Impact of COVID-19 Pandemic on College Student Mental Health and Wellness. Journal of the American Academy of Child & Adolescent Psychiatry, 60(1), 134-141. DART&maru/BLUE. (2020, April 01). Canadians Virtually Unanimous in Fight Against COVID-19. Darticom. https://dartincom.ca/poll/canadians-virtually-unanimous-in-fight-against-covid-19/ Essadek, A., & Rabeyron, T. (2020). Mental health of French students during the Covid-19 pandemic. Journal of affective disorders, 277, 392–393. https://doi. org/10.1016/j.jad.2020.08.042 Fazio. (2019). Repetition increases perceived truth equally for plausible and implausible statements. Psychonomic Bulletin and Review, 26(5), 1705-1710. Festinger, L. (1962). Cognitive Dissonance. Scientific American, 207(4), 93-106. Festinger, L., & Carlsmith, J. (1959). Cognitive consequences of forced compliance. The Journal of Abnormal and Social Psychology, 58, 203-210. Finstad, K. (2010). Response Interpolation and Scale Sensitivity: Evidence Against 5-Point Scales. Journal of Disability Studies, 5(3), pp. 104-110. Furey, A. (2020). Ontario death count includes people who didn’t die of COVID-19, but exactly how many is unknown. TorontoSun. https://torontosun.com/news/pro-
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Johns Hopkins. (2020). COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University. Coronavirus.jhu.edu. https://coronavirus.jhu.edu/map.html Kivikangas, J., Fernández, B., Järvelä, S., Ravaja, N., & Lönnqvist, J. (2020, September 4). Moral Foundations and Political Orientation: Systematic Review and Meta-Analysis. https://doi.org/10.1037/bul0000308 Kneebone, R. (2019). Social Policy Trends. The School of Public Policy, University of Calgary. Kunda, Z. (1990). The case for motivated reasoning. Psychological Bulletin, 108(3), 480-498. doi:10.1037/00332909.108.3.480 Maru/BLUE. (2020). The Quarterly Approval Rating and Rankings of Canada’s Premiers. Statis1.https://static1.squarespace.com/static/5a5d2933a8b2b0f49d244724/t/5f650017344a0e700570 7a44/1600454681275/F+MB+Q3+Premiers+Ranking+2020.pdf McIntyre, R. S., & Lee, Y. (2020). Projected increases in suicide in Canada as a consequence of COVID-19. Psychiatry Research, 290, 113104. doi:https://doi. org/10.1016/j.psychres.2020.113104 Mikhail, J. M. (2000). Rawls’ linguistic analogy: A study of the “generative grammar” model of moral theory described by John Rawls in “A Theory of Justice.” Unpublished doctoral dissertation, Cornell University, Ithaca, NY. Petrinovich, L., O’Neill, P., & Jorgensen, M. (1993). An empirical study of moral intuitions: Toward an evolutionary ethics. Journal of Personality and Social Psychology, 64(3), 467-478. doi:10.1037/0022-3514.64.3.467 Public Health Agency of Canada. (2020). Suicide in Canada: Key statistics (infographic). Canada.https://www. canada.ca/en/public-health/services/publications/ healthy-living/suicide-canada-key-statistics-infographic.html Public Health Ontario. (2020). Rapid review: substance use-related harms and risk factors during periods of disruption. Public Health Ontario. https://www.publicheal-
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PSI Ψ thontario.ca/-/media/documents/ncov/main/2020/08/ substance-use-related-harms-disruption.pdf?la=en Sadovnik, J., Piers, F., Deschamps, J., Erickson, S. (2020). Not turning a blind eye: addressing domestic violence, telework, and pandemic-related employment considerations in Canada. Norton Rose Fulbright. Statistics Canada. (2020, December 18). Labour force characteristics by age group, monthly, seasonally adjusted. Statcan. https://www150.statcan.gc.ca/t1/tbl1/ en/tv.action?pid=1410028702
Trudell, A.L. & Whitmore, E. (2020). Pandemic meets Pandemic: Understanding the Impacts of COVID19 on Gender-Based Violence Services and Survivors in Canada. Ottawa & London, ON: Ending Violence Association of Canada & Anova. World Health Organization. (2020, October 15). Coronavirus disease (COVID-19): Herd immunity, lockdowns and COVID-19. WHO. https://www.who.int/news-room/ q-a-detail/herd-immunity-lockdowns-and-covid-19.
Appendix Figure 1. Statement shown to participants In March 2020, lockdowns were an effective way to minimize deaths during the pandemic.
Figure 3. Change in Support for Lockdowns
(1) Strongly disagree | (2) Disagree | (3) Somewhat disagree | (4) Neutral | (5) Somewhat agree | (6) Agree | (7) Strongly Agree
Figure 2. Statement shown to participants I currently support lockdowns as a measure to minimize deaths during the COVID-19 pandemic. (1) Strongly disagree | (2) Disagree | (3) Somewhat disagree | (4) Neutral | (5) Somewhat agree | (6) Agree | (7) Strongly Agree
Table 1. Change in Support for Lockdowns
46
McGill Undergraduate Psychology Journal
Table 2. Summary statistics for linear regression analyses
Table 3. Evidence suggesting lockdown measures contribute to premature death
Issue XI | December 2021
47
A not so perfect plan:
An examination of the differential influence of multidimensional perfectionism on missed and gained events during the COVID-19 pandemic Giovanni Andrade
Supervisor: Dr. Richard Koestner
Ψ PSI Journal
Abstract
The pandemic has been an unprecedented time in our modern history and during this time daily life was disrupted. The current study examined the influence of multidimensional perfectionism on perceptions of missed and gained events during the COVID-19 pandemic, and whether perceptions of missed and gained events to be need-frustrating or satisfying partially explained the association between perfectionism and depressive symptoms. University students (N=350) were surveyed in September 2020, assessing perfectionism, depressive symptoms missed and gained events from the summer, feelings towards missed and gained events, and need frustration/ satisfaction related to missed and gained events. The relationship between self-critical perfectionism and depressive symptoms was mediated by perceptions of missed events to be need-frustrating. Personal standards perfectionism predicted perceptions of gained events to be need-satisfying. Results suggest that missed and gained events during the COVID-19 pandemic was an important predictor of mental health among individuals higher in perfectionism because they are less flexible when things do not go according to plan. Keywords: perfectionism, missed and gained events, basic psychological needs, depressive symptoms, COVID-19
Introduction
health. Missed weddings, travel, and time spent
many individuals, and during the pandemic, a
or something to ruminate on. Conversely, peo-
The COVID-19 pandemic disrupted daily life for number of occasions, holidays, vacations and other special events were missed or put on hold. Alternatively, perhaps the pandemic has been a time to engage in new hobbies, or with old friends, or a time when we have gained something that we did not expect. Independent of what happened, it might be that our perception of these events may have impacted our mental 48
with family may have been very disappointing ple may have also had more time to build connections and take up new hobbies, which could have been beneficial. How individuals perceive or feel about these events might be a predictor of mental health during the pandemic. Additionally, there might be individuals who are more sensitive to this chaos or life disruption, like individuals who expect or plan for perfection. McGill Undergraduate Psychology Journal
These events might be especially disruptive for
and whether perceptions of missed and gained
individuals who engage in biases, overvaluation
events to be need-frustrating and satisfying me-
of events, and maladaptive coping, like indi-
diates the association between perfectionism
viduals higher in perfectionism. Indeed, previ-
and depressive symptoms.
ous research has shown that those higher on
Perfectionism and Depressive Symptoms
self-critical perfectionism are more sensitive to perceptions of day-to-day stressors, which are linked to greater depressive symptoms among these individuals (Dunkley & Blankstein, 2000; Dunkley et al., 2000; Dunn et al., 2006). Perceptions of missed and gained events may have also influenced the mental health of individuals higher in perfectionism in these unprecedented times because things did not go according to plan. In line with Self-Determination Theory (SDT), need frustration and satisfaction might be one mechanism through which individuals may have been especially damaged or helped from missed and gained events (Ryan & Deci, 2017). Perhaps, perfectionists’ perceptions of basic psychological need frustration and satisfaction from missed and gained events could have influenced depressive symptoms or coping during this time of uncertainty. There was so much outside of an individual’s control during the COVID-19 pandemic, and perhaps an individual’s perceptions of what has been lost and what has been gained may serve as a risk or protective factor during this time. The present study surveyed students at a large Canadian university in the month of September to determine how perfectionism influences depressive symptoms and perceptions of missed and gained events during the COVID-19 pandemic Issue XI | December 2021
Perfectionism was originally conceptualized as the desire to achieve excessively high standards for oneself (Burns, 1980). Recently, factor analysis has distinguished two higher-order facets, a maladaptive, self-critical dimension and a relatively less maladaptive dimension aimed at achieving personal standards (Dunkley, Blankstein, Zuroff, et al., 2006). Self-critical perfectionism combines the excessive pursuit of high standards with self-criticism as well as negative cognitive distortions. The cognitive distortions that accompany the maladaptive facet of this trait involve a perceived discrepancy in achievement, uncertainty about ability, and concerns about mistakes or failure (Burns, 1980; Frost et al., 1990; Levine et al., 2019). Conversely, personal standards perfectionism involves a relatively less maladaptive pursuit of high standards (Stoeber & Otto, 2006). Self-critical perfectionism has been identified as a vulnerability factor for a wide range of psychopathology, including depressive symptoms, anxiety, and eating pathology (Dunkley, Blankstein, Masheb, et al., 2006). Specifically, with regards to depressive symptoms, clinically depressed patients higher on self-critical perfectionism show elevated levels of depressive symptoms (Clara et al., 2007). Furthermore, longitudinal research in non-clinical samples demonstrates that individ49
PSI Ψ uals higher in self-critical perfectionism experi-
individuals higher in self-critical perfectionism.
ence increases in depressive symptoms over
Dunkley and Blankstein (2000) argued that their
time, suggesting that self-critical perfectionism
distress results from the generation or instiga-
constitutes a vulnerability factor for the devel-
tion of stress in these individuals. Hewitt and
opment of depressive symptoms (Levine et al.,
Flett (1993) attributed their distress to distorted
2019; McGrath et al., 2012; Sherry et al., 2014).
all-or-none thinking and the overgeneralization
In contrast, personal standards perfectionism is
of failures, which lead minor stressful events
often unrelated or inversely related to depres-
to have an exaggerated psychological impact.
sive symptoms (Stoeber & Otto, 2006). The cur-
Therefore, in these novel times, the impact of
rent research aims to determine whether per-
perceptions of missed and gained events might
fectionism is a vulnerability factor for increased
have been an especially important predictor of
depressive symptoms during the COVID-19
mental health, among these individuals higher
pandemic.
on self-critical perfectionism who have been
Perfectionism and Events
identified to be sensitive to perceptions of daily
One theorized difference between personal standards and self-critical perfectionism is the presence of several cognitive distortions that accompany self-critical perfectionism. There is evidence that individuals higher in self-critical perfectionism engage in biases and overvaluation of daily events. They report higher levels of daily hassles, relatively minor day-to-day stressors, which partially explains the relationship between this dimension of perfectionism and depressive symptoms (Dunkley & Blankstein, 2000; Dunkley et al., 2000; Dunn et al., 2006). In contrast, there is no association between daily hassles and personal standards perfectionism (Blankstein & Dunkley, 2002). Hassles consist of various minor annoyances and inconveniences that range in their severity, like missing dinner plans or getting into an argument with a significant other. There are several explanations for the role of hassles in mental health among 50
stressors. In addition to distorted perceptions and overvaluation of daily events, there is also evidence that individuals higher on self-critical perfectionism are more likely to engage in maladaptive coping, and this partially explains their experience of hassles. The relation between self-critical perfectionism and hassles is both direct and mediated by emotion-oriented (e.g., emotional responses, self-blame, fantasizing reactions) and avoidance-oriented (e.g., engaging in a different task instead of the task at hand) coping (Blankstein & Dunkley, 2002; Dunkley & Blankstein, 2000; Dunn et al., 2006). This suggests that their avoidance of dealing with stressful demands and emotional responses when these individuals higher on self-critical perfectionism encounter difficult and upsetting events also contribute to their daily stress. By contrast, personal standards perfectionism is related to probMcGill Undergraduate Psychology Journal
lem-oriented coping, such as confronting the sit-
in personal standards perfectionism are more
uation or problem (Blankstein & Dunkley, 2002;
likely to report need satisfaction and less like-
Dunkley et al., 2000). The impact of missed and
ly to report need frustration (Gillet et al., 2020;
gained events may also be relevant to the mental
Jowett et al., 2016).
health of these individuals higher in self-critical perfectionism. The use of maladaptive coping by these individuals in challenging events exacerbate stress levels, and this might have been even more impactful during an already stressful time, like the COVID-19 pandemic.
Perceptions of basic psychological need frustration and satisfaction from missed and gained events might have influenced the mental health of individuals higher in perfectionism during this time of uncertainty. Gained events might be choices to do something new, such
Perfectionism and Need Frustration and Satisfaction
as to take on a new hobby. These events could
A central component of Self-Determination
times when there were otherwise many restric-
Theory (SDT) is the concept of three basic innate psychological needs, which are essential for growth, integration, and well-being. First, the need for autonomy refers to the need to experience a sense of willingness and volition regarding one’s behaviour. Second, the need for competence refers to the need to experience a sense of effectiveness in interacting with one’s environment. Third, the need for relatedness refers to both the need to experience feeling loved and cared for as well as loving and caring for significant others (Ryan & Deci, 2017). SDT proposes that the satisfaction of these needs is conducive to well-being, whereas the frustration of these same needs is linked to ill-being and psychopathology (Vansteenkiste & Ryan, 2013). Individuals higher in self-critical perfectionism are more likely to report need frustration and less likely to report need satisfaction in daily life (Boone et al., 2014; Gillet et al., 2020; Haraldsen et al., 2020). By contrast, individuals higher Issue XI | December 2021
have been autonomy-satisfying during these tions on what people could do. Missing out on events, like travelling, was often outside of one’s control. These missed events could have been autonomy-frustrating as they limited the choice people had. Moreover, gained events may have also been equated with living up to expectations, like getting good grades, or acquiring a new skill. These events could have been competence-satisfying in these times of increased difficulty and challenge. Missed events may have resulted in perceived failure, such as losing a job opportunity. These events could have been competence-frustrating as they may put one’s abilities into question. Finally, missed events may have involved missing out on time with significant others, for instance, when people were not able to travel back home to visit their family and friends. These missed events could have been relatedness-frustrating, particularly in these times of relatively little social interaction. Gained events may have involved building connections or 51
PSI Ψ spending more time with family at home. These
perfectionism, and explored whether students
events involving significant others could have
had missed or gained events during their sum-
been
Consequently,
mer holiday, how emotionally affected they were
these perceptions of basic psychological needs
by these events, and how need-frustrating or
from missed and gained events might have been
satisfying they perceived these events to be.
relatedness-satisfying.
an important predictor of depressive symptoms or coping for individuals higher in perfectionism.
The Present Study The COVID-19 pandemic disrupted daily life, and during these unprecedented times nearly everyone missed and gained events. The impact of perceptions of these events might be an especially important predictor for the mental health of individuals higher on perfectionism because they might be less flexible as things did not go according to plan (Dunkley & Blankstein, 2000; Dunkley et al., 2000; Dunn et al., 2006). In this study, we examine how individuals higher in perfectionism perceived their missed and gained events, and whether their perceptions of these events be need-frustrating and satisfying partially explains the association between perfectionism and depressive symptoms. We considered three research questions: (1) How does perfectionism influence depressive symptoms during the pandemic? (2) How does perfectionism influence perceptions of missed and gained events during the pandemic? (3) How do perceptions of need frustration/ satisfaction related to missed/ gained events indirectly affect the relation between perfectionism and depressive symptoms during the pandemic? In order to examine these research questions, we surveyed students about their depressive symptoms, trait 52
Method Participants and Procedure The 350 participants for this online study were recruited from a large Canadian public university. Participants were undergraduate university students (Mage = 19.75, SD = 1.41) of which 87.9% were female. Recruitment was done through the university’s psychology participant pool. The study was conducted through Qualtrics in September, 2020. The survey assessed perfectionism, depressive symptoms, missed and gained events from the summer, feelings towards missed and gained events, and need frustration/satisfaction related to missed and gained events. The current study examines the data that was collected during September 2020. Participants were compensated with course credit.
Measures Missed Events. Participants were asked if they had missed any events because of the pandemic. Participants were shown the following prompt: “Life is full of special events, like weddings, trips, family get-togethers, holidays, etc. With the current events of the pandemic, many events you may have been looking forward to may have been cancelled or postponed. Is there a special event or trip you were looking forward McGill Undergraduate Psychology Journal
to that has been cancelled due to the COVID-19
of me.” To measure personal standards perfec-
outbreak? What event or events did you have
tionism, all fifteen items from the self-oriented
to miss because of the pandemic?” Participants
perfectionism dimension of the MPS were used
were given a few lines to share the event they
(Hewitt & Flett, 1991). The scale includes items,
had in mind. Some examples of missed events
such as, “One of my goals is to be perfect in
include, “a family reunion,” “travelling to Eu-
everything I do” and “I strive to be the best at
rope,” and “a festival with my friends.”
everything I do.” The items for self-critical and
Gained Events. Participants were asked if they
personal standards perfectionism were inter-
had gained anything because of the pandemic. Participants were shown the following prompt: “Sometimes during difficult times, unexpected positive events can occur. You may have heard from an old friend or had time to do something
spersed and rated on a 7-point scale, ranging from 1 (strongly disagree) to 7 (strongly agree); higher scores reflect greater levels of perfectionism. The average of each subscale was taken to compute a mean personal standards and
you enjoy or to accomplish something new. Life
self-critical perfectionism score.
can sometimes be full of wonderful things even
Basic Psychological Needs. The Balanced
in the most difficult of times. Has there been
Measure of Psychological Needs scale (BMPN)
a positive event that has happened since the
was adapted to assess psychological need frus-
start of the COVID-19 outbreak? What positive
tration and satisfaction related to missed and
event(s) did you experience because of the pan-
gained events (Sheldon & Hilpert, 2012). This
demic?” Participants were given a few lines to
scale uses three statements to assess need
share the event they had in mind. Some exam-
frustration and three to assess need satisfaction
ples of gained events include, “growing closer
for each basic psychological need (relatedness,
with work friends and/or a romantic partner,”
competence and autonomy). The prompts in-
“being able to focus on hobbies,” and “greater
cluded statements such as “by missing these
academic success.”
event(s) I am missing out on close connections
Perfectionism. Two subscales from the Multi-
with others” to measure relatedness frustration
dimensional Perfectionism Scale (MPS) were used to assess perfectionism (Hewitt & Flett, 1991; Hewitt & Flett, 2004). To assess self-critical perfectionism all twelve items from the socially prescribed perfectionism dimension of the MPS were used. Sample items include “People expect nothing less than perfection from me”
and “these positive event(s) have made me feel more competent in my abilities” to measure competence satisfaction. Participants rated their agreement with these statements on a 7-point Likert scale ranging from 1 (not at all true)” to 7 (very true). These items were averaged to compute a measure of psychological need frus-
and “I find it difficult to meet others’ expectations Issue XI | December 2021
53
PSI Ψ
tration related to missed events and satisfaction
over the summer due to the COVID-19 pandem-
related to gained events.
ic. On average, students reported 1.77 missed
Feelings Towards Missed and Gained Events.
events. The missed events that students re-
A scale of five items was used to assess feeling towards missed and gained events. The scale uses three statements to assess disappointment, rumination, and optimism about missed events. Participants rated their agreement with these statements on a scale of 1 (strongly dis-
ported were travel, time with family and friends, special events or work/ growth opportunities. On average, students reported 1.59 gained events. Gained events that students reported were typically extra time with family and friends, engagement in self-care, or work.
agree) to 7 (strongly agree). Depressive Symptoms. The Centre for Epidemiologic Studies Depression Scale Revised (CESD-R 10) was used to assess symptoms of depression (Andresen et al., 1994). The CESD-R 10 is a validated and reliable self-report measure of depression symptoms that focuses on the affectivity component of depressed mood (Andresen et al., 1994). The scale includes items such as “I could not get going” and “I was bothered by things that usually don’t bother me.” It is measured on a four-point Likert scale ranging from 1 “rarely or none of the time (<1 day)” to 4 “most or all the time (5 - 7 days).” A depressive symptoms score was computed by averaging the ten items.
Results Preliminary Analysis Table 1 contains the means and standard deviations of the variables of interest. 289 (84%) of the students in this study reported missing an event due to the COVID-19 pandemic, and 279 (81%) of students reported gaining an event
54
Regression Analyses Depressive symptoms. To examine the relation between perfectionism and depressive symptoms, a linear regression was run with both types of perfectionism predicting depressive symptoms. Perfectionism was associated with depressive symptoms in September and perfectionism explained 36.1% of the variance in depressive symptoms (R2 =.361, F(2,342)= 96.46, p < .001). Self-critical perfectionism was associated with more depressive symptoms (B = .62, t = 12.80, p < .001). Personal standards perfectionism was not associated with depressive symptoms (B = -.02, t = -.41, p = .682). Missed Events. To examine the association between perfectionism and feelings towards missed events, separate linear regressions McGill Undergraduate Psychology Journal
were completed (Table 2). Perfectionism was
omous. Conversely, individuals higher in per-
associated with reporting missed events to be
sonal standards perfectionism were more likely
disappointing, ruminating over these events,
to report being disappointed about the missed
and being optimistic that these events might
event, and more likely to ruminate over this
occur in the future (R2 =.026, F(2,286)= 3.82,
missed event.
p = .023; R2 =.058, F(2,286)= 8.88, p < .001;
Gained Events. To examine the association
R2 =.039, F(2,286)= 5.77, p = .003). Additionally, perfectionism was associated with reporting miss events to be need-frustrating (R2 =.12, F(2,286)= 19.76, p < .001). Individuals higher in self-critical perfectionism were more likely to ruminate about missed events, and less likely to be optimistic that the missed event would occur in the future. Additionally, individuals higher in self-critical perfectionism were more likely to find these missed events to be need-frustrating, or that by missing out on these events they felt less socially connected, competent, and auton-
between perfectionism and feelings towards gained events, separate linear regressions were completed (Table 3). Perfectionism was associated with reporting gained events to be a positive experience of joy and growth (R2 =.044, F(2,276)= 6.28, p = .002; R2 =.029, F(2,276)= 4.14, p = .017; R2 =.018, F(2,276)= 2.59, p = .002). Additionally, perfectionism was associated with reporting miss events to be need-satisfying (R2 =.03, F(2, 276)= 4.72, p = .010). Individuals higher in personal standards perfectionism were more likely to report unexpected joy and growth from
gained
events
during the pandemic. Additionally,
these
individuals
were
more likely to report these being
events more
as need-
satisfying. Conversely, individuals higher in self-critical perfectionism were less likely to report their gained events as
need-satisfying,
they
derived
less
meaning connection,
competence, and volition from the gained events they experienced during the pandemic. Issue XI | December 2021
55
PSI Ψ
Mediation Analyses
pandemic, and whether perceptions of missed
Next, to determine the mechanism of why
and gained events were need-frustrating and
self-critical perfectionism was detrimental for
satisfying, and how this impacted mental health.
mental health during the pandemic, a mediation
The results indicate that individuals higher
model was done. We proposed that self-critical
in self-critical perfectionism perceived their
perfectionism was associated with more per-
missed events to be more need-frustrating, and
ceived need frustration in relation to missed
this partially explains why individuals higher on
events and more depressive symptoms. A medi-
self-critical perfectionism reported more depres-
ation model was run using SPSS Hayes Process
sive symptoms. Additionally, they were less op-
Macro (2012). For all mediation analyses, 95%
timistic that their missed events would occur in
confidence intervals (CI) of the indirect effect
the future and perceived their gained events to
using bootstrap resampling (k=10,000) proce-
be less need-satisfying. Conversely, individuals
dures were estimated. Standardized coefficients
higher in personal standards perfectionism per-
(betas) are reported for the following models.
ceived their gained events to be more need-sat-
Additionally, baseline personal standards per-
isfying and experienced more unexpected joy
fectionism was controlled for. Figure 1 shows
and growth from these events. They were also
that a partial mediation model was supported.
more disappointed about their missed events.
Perceiving missed events to be need-frustrating
Individuals higher on both of these dimensions
was a factor that partially explained why students
of perfectionism ruminated more about their
higher in self-critical perfectionism experienced
missed events. Taken together, these results
more depressive symptoms.
provide clear evidence that perfectionism is a multidimensional trait that differentially influenced perceptions of missed and gained events in these unprecedented times. Perceptions
of
missed
events to be need-frustrating was identified as one mech-
Discussion
The present study examines how multidimensional perfectionism influenced perceptions of missed and gained events during the COVID-19 56
anism that partially explained the association between self-critical perfectionism and depressive symptoms during the pandemic. These individuals higher on self-critical perfectionism felt less socially connected, comMcGill Undergraduate Psychology Journal
petent, and autonomous in response to missing
need satisfaction (Gillet et al., 2020; Jowett et
out on their events, which, in turn, was asso-
al., 2016). Nonetheless, in spite of the fact that
ciated with depressive symptoms. This finding
they derived more need satisfaction from gained
is consistent with our expectation that missed
events, personal standards perfectionism was
events, including occasions, holidays, and va-
unrelated to depressive symptoms during the
cations might have been especially disruptive
pandemic. This is consistent with previous re-
for these individuals who engage in cognitive bi-
search demonstrating that this dimension of
ases, overvaluation of events, and maladaptive
perfectionism is not associated with depressive
coping (Dunkley & Blankstein, 2000; Dunkley
symptoms (Stoeber & Otto, 2006). Their tenden-
et al., 2000; Dunn et al., 2006). Further, it repli-
cy to perceive gained events as need-satisfying
cates previous research demonstrating that indi-
provides further evidence that this facet might
viduals higher in self-critical perfectionism tend
be a less maladaptive form of perfectionism.
to experience more need frustration in daily life (Boone et al., 2014; Gillet et al., 2020; Haraldsen et al., 2020). The current research provides evidence that perceiving missed events to be need-frustrating was one factor that contributed to depressive symptoms during the COVID-19 pandemic for individuals higher in self-critical perfectionism. This adds to the literature on the cognitive distortions that these individuals engage in which are harmful to their mental health.
An unexpected finding was that personal standards perfectionism was associated with ruminating about missed events. Rumination, along with their greater disappointment, suggests that these individuals higher in personal standards perfectionism were also harmed by missed events during the pandemic. Although other research has focused on rumination as a cognitive mechanism affecting individuals higher in self-critical perfectionism (Di Schiena et al.,
In contrast, personal standards perfection-
2012; Harris et al., 2008; van der Kaap-Deeder
ism was associated with reporting more need
et al., 2016), the current research demonstrates
satisfaction from gained events during the pan-
that individuals higher on both dimensions of
demic. Individuals higher on personal standards
perfectionism ruminated more about what they
perfectionism felt more socially connected,
missed. It may be that rumination by individuals
competent, and autonomous when they gained
higher in personal standards perfectionism was
events, suggesting that they were able to select,
specific to their missed events in the context of
create, or appreciate need-satisfying events to
the pandemic. Further research is required to
cope during the pandemic, like new hobbies or
determine whether personal standards perfec-
opportunities to build connections. This find-
tionism is related to rumination.
ing is in line with past research that suggests that these individuals tend to experience more Issue XI | December 2021
The present research is the first to consider the relationship between perfectionism and 57
PSI Ψ
missed and gained events. At a time when there
gained events may not accurately reflect actual
was so much outside of one’s control, individuals
experiences. These responses, nonetheless,
who expect or plan for perfection were shown to
reflect an individual’s own feelings and percep-
be especially sensitive to perceptions of what
tions of what has been lost and gained based on
was lost and what had been gained. It is also
descriptions of their experiences.
clear from the results that perceptions of missed events influenced the depressive symptoms of individuals higher in self-critical perfectionism. These findings support existing theories on perfectionism and overvaluation of events, such as day-to-day stressors, which contribute to their distress (Dunkley & Blankstein, 2000; Hewitt & Flett, 1993). We can conclude that the impact of perceptions of missed and gained events is also an important predictor of mental health or coping for individuals higher in perfectionism since they are less flexible when things do not go according to plan, like currently during the interruption of daily life as a result of the pandemic. Therefore, the current research extends our understanding of the cognitive distortions of events associated with perfectionism.
Future research may want to use a longitudinal design to infer how missed and gained events contribute to perceptions, feelings, and mental health over time. While it is especially insightful to examine the influence of these events during the pandemic, it would also be interesting to consider whether they are impactful all of the time or after the pandemic. Moreover, current research should be expanded to more diverse populations. For instance, would the effects of missed and gained events be the same for less affluent individuals, or hold among older people, whose experiences might have been very different during the pandemic? Finally, it might also be interesting to examine the pairing of missed and gained events because there may be some meaningful patterns. Perhaps an individual who
There are a few notable limitations of the pres-
has lost a lot of events is less likely to notice a
ent study. To begin with, we cannot determine
positive event, or alternatively, maybe they are
directionality since the study was cross-section-
quick to find a new opportunity.
al. Yet, the questionnaire asked people to recall their missed and gained events, allowing us to understand how their perceptions, feelings, and depressive symptoms preceded these events. In addition, although it is a strength that the participants were university students who have rich and diverse summer experiences, this limits the generalizability of our findings. Another concern is that the self-reported nature of missed and 58
There has been extensive research on the negative impacts that the COVID-19 pandemic has had on mental health. Many studies have focused on the effects of containment measures, concerns about health, and uncertainty about the future, but fewer studies have examined what has been lost because of the pandemic (Fiorillo & Gorwood, 2020; Pfefferbaum & North, 2020; Rossi et al., 2020). The loss of meaningful McGill Undergraduate Psychology Journal
events has been experienced by many people
further investigate how these perceptions of
of the paper with the exception of the results section which was kindly contributed by Shelby. The current project used data collected during the peak of the COVID-19 pandemic in September 2020. The data was sufficient and complete considering the timeline of the project.
missed events may have negatively impacted
References
and as the current research suggests the impact of perceptions of missed events were detrimental for mental health. Future research should
mental health as a result of the pandemic longitudinally.
Conclusion
This study found that perceptions of need frustration of missed events partially explained the relation between self-critical perfectionism and depressive
symptoms.
Personal
standards
perfectionism was associated with perceiving gained events to be need-satisfying and was unrelated to depressive symptoms. These results highlight the differential influence of this multidimensional trait on perceptions of missed and gained events and mental health. Perceptions of missed and gained events was an important predictor of mental health during the pandemic, suggesting that individuals higher in perfectionism are less flexible when things do not go as planned. Statement of Contribution I am very grateful for all the guidance that I received from Dr. Koestner and his graduate student Shelby Levine. They helped me to select a research question in an area that interests me. They also provided me with substantial feedback and suggestions throughout the process of writing this paper and we were able to discuss and analyze the data together. I conducted an extensive literature review and provided a rationale for the findings in the study as well as discussing their implications. I wrote all sections Issue XI | December 2021
Andresen, E. M., Malmgren, J. A., Carter, W. B., & Patrick, D. L. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D. American journal of preventive medicine, 10(2), 77-84. Blankstein, K. R., & Dunkley, D. M. (2002). Evaluative concerns, self-critical, and personal standards perfectionism: A structural equation modeling strategy. Boone, L., Vansteenkiste, M., Soenens, B., der Kaap-Deeder, V., & Verstuyf, J. (2014). Self-critical perfectionism and binge eating symptoms: A longitudinal test of the intervening role of psychological need frustration. Journal of counseling psychology, 61(3), 363. Burns, D. D. (1980). The perfectionist’s script for self-defeat. Psychology Today, 14, 34-52. Clara, I. P., Cox, B. J., & Enns, M. W. (2007). Assessing self-critical perfectionism in clinical depression. Journal of Personality Assessment, 88(3), 309-316. Di Schiena, R., Luminet, O., Philippot, P., & Douilliez, C. (2012). Adaptive and maladaptive perfectionism in depression: Preliminary evidence on the role of adaptive and maladaptive rumination. Personality and individual differences, 53(6), 774-778. Dunkley, D. M., & Blankstein, K. R. (2000). Self-critical perfectionism, coping, hassles, and current distress: A structural equation modeling approach. Cognitive Therapy and Research, 24(6), 713-730. Dunkley, D. M., Blankstein, K. R., Halsall, J., Williams, M., & Winkworth, G. (2000). The relation between perfectionism and distress: Hassles, coping, and perceived social support as mediators and moderators. Journal of counseling psychology, 47(4), 437. Dunkley, D. M., Blankstein, K. R., Masheb, R. M., & Grilo, C. M. (2006). Personal standards and evaluative concerns dimensions of “clinical” perfectionism: A reply to Shafran et al.(2002, 2003) and Hewitt et al.(2003). Behaviour research and therapy, 44(1), 63-84. Dunkley, D. M., Blankstein, K. R., Zuroff, D. C., Lecce, S., & Hui, D. (2006). Self-critical and personal standards factors of perfectionism located within the five-factor model of personality. Personality and individual differences, 40(3), 409-420.
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Dunn, J. C., Whelton, W. J., & Sharpe, D. (2006). Maladaptive perfectionism, hassles, coping, and psychological distress in university professors. Journal of counseling psychology, 53(4), 511. Fiorillo, A., & Gorwood, P. (2020). The consequences of the COVID-19 pandemic on mental health and implications for clinical practice. European Psychiatry, 63(1). Frost, R. O., Marten, P., Lahart, C., & Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14(5), 449-468. Gillet, N., Morin, A. J., Huyghebaert‐Zouagh, T., Alibran, E., Barrault, S., & Vanhove‐Meriaux, C. (2020). Students’ need satisfaction profiles: Similarity and change over the course of a university semester. Applied Psychology, 69(4), 1396-1437.
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Pfefferbaum, B., & North, C. S. (2020). Mental health and the Covid-19 pandemic. New England Journal of Medicine. Rossi, R., Socci, V., Talevi, D., Mensi, S., Niolu, C., Pacitti, F., Di Marco, A., Rossi, A., Siracusano, A., & Di Lorenzo, G. (2020). COVID-19 pandemic and lockdown measures impact on mental health among the general population in Italy. Frontiers in psychiatry, 11, 790. Ryan, R. M., & Deci, E. L. (2017). Self-determination theory: Basic psychological needs in motivation, development, and wellness. Guilford Publications. Sheldon, K. M., & Hilpert, J. C. (2012). The balanced measure of psychological needs (BMPN) scale: An alternative domain general measure of need satisfaction. Motivation and Emotion, 36(4), 439-451.
Haraldsen, H. M., Solstad, B. E., Ivarsson, A., Halvari, H., & Abrahamsen, F. E. (2020). Change in basic need frustration in relation to perfectionism, anxiety, and performance in elite junior performers. Scandinavian Journal of Medicine & Science in Sports, 30(4), 754-765.
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Hewitt, P. L., & Flett, G. L. (2004). Multidimensional Perfectionism Scale (MPS): Technical Manual. MultiHealth Systems. Jowett, G. E., Hill, A. P., Hall, H. K., & Curran, T. (2016). Perfectionism, burnout and engagement in youth sport: The mediating role of basic psychological needs. Psychology of Sport and Exercise, 24, 18-26. Levine, S. L., Green-Demers, I., Werner, K. M., & Milyavskaya, M. (2019). Perfectionism in adolescents: Self-critical perfectionism as a predictor of depressive symptoms across the school year. Journal of Social and Clinical Psychology, 38(1), 70-86. McGrath, D. S., Sherry, S. B., Stewart, S. H., Mushquash, A. R., Allen, S. L., Nealis, L. J., & Sherry, D. L. (2012). Reciprocal relations between self-critical perfectionism and depressive symptoms: Evidence from a shortterm, four-wave longitudinal study. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement, 44(3), 169.
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McGill Undergraduate Psychology Journal
Patient and Therapist Perceptions of Autonomy Support in Outpatient Therapy for Eating Disorders Emilie Bélanger
Supervisor: Dr. Howard Steiger Abstract
Ψ PSI Journal
A strong link has been established between motivation for treatment and treatment outcomes in individuals with eating disorders (EDs). Evidence suggests that motivation can be improved by autonomy support from therapists, which can subsequently impact treatment and health outcomes for those with EDs. This paper examines changes in patient and therapist perceptions of autonomy support in outpatient therapy for eating disorders, as well as potential associations between patient and therapist ratings. The effects of patient baseline characteristics (namely personality and eating disorder symptoms) on patient and therapist perceptions of autonomy support are also assessed. Participants were individuals with heterogeneous ED diagnoses receiving outpatient treatment at the Douglas Mental Health University Institute. Clinical measures assessing eating symptoms, perceived autonomy support, personality, motivation and sociodemographic characteristics were completed throughout the study. Repeated Measures ANOVAs and Mixed Model Analyses were utilized in data analysis. Results indicate improvement in patient eating disorder symptoms throughout the course of therapy. We observed significant changes in therapist ratings of their own autonomy support across timepoints, but no changes were observed across timepoints for patient ratings. We also observed a significant positive association between patient and therapist ratings of autonomy support. Data regarding the effects of patient baseline characteristics on patient and therapist perceptions of autonomy support were either non-significant or did not fit into any reliable models. Findings can help increase therapists’ knowledge of how autonomy support may fluctuate throughout therapy, and which factors to consider when trying to foster autonomy support. Keywords: autonomy support, eating disorders, therapy, motivation, personality
Background
ified Feeding and Eating Disorder (OSFED) are
group of psychiatric disorders that result in the
can Psychiatric Association, 2013, pp.334-53).
Eating disorders (EDs) are a heterogeneous impairment of one’s physical or psychosocial functioning due to disturbances in eating or eating-related behaviour and altered consumption of food (American Psychiatric Association, 2013, p.329). Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Avoidant Restrictive Food Intake Disorder (ARFID) and Other SpecIssue XI | December 2021
among the main diagnostic categories (AmeriAcross diagnoses, treatment dropout and/or readmission to treatment have been frequently observed in individuals with EDs, with common reports from patients of varying amounts of ambivalence surrounding recovery (Geller et al., 2001). As a result, an emphasis has been placed on motivation for treatment for EDs, which has 61
PSI Ψ
led to the pervasive application of motivational
individuals with heterogeneous EDs participat-
interventions in the field (Waller, 2012).
ing in outpatient treatment, those with higher
The importance of motivation within therapy has been established, as engagement and active participation in therapy rely on the sustained motivation of the patient (Ryan & Deci, 2008a). Self-determination theory (SDT) suggests that three main universal psychological needs, competence, relatedness, and autonomy, help foster superior self-motivation (Deci & Ryan, 2008; Ryan & Deci, 2000). Self, or intrinsic, motivation stems from one’s inherent interests and plays an important role as a major component of autonomous motivation (Deci & Ryan, 2008; Ryan & Deci, 2000). Autonomous motivation involves the self-endorsement of one’s actions, and the
levels of pre-treatment autonomous motivation were less likely to drop out of their treatment program (Sansfaçon et al, 2018). Autonomous motivation has also been linked to improvements for individuals with anorexia nervosa attending inpatient treatment, as individuals with higher pre-treatment autonomous motivation displayed a larger reduction in their global eating disorder symptoms post-treatment (Thaler et al., 2016). Another study, which included a heterogeneous ED sample, linked higher levels of autonomous motivation at the completion of therapy to more significant improvements in various ED symptoms (Steiger et al, 2017).
experience of volition when engaging in them,
Therapists can play an important role in the
and has been shown to lead to better physical
enhancement of their patient’s autonomous
and psychological health outcomes (Deci &
motivation, as perceived autonomy support in
Ryan, 2008; Ng et al., 2012, p.334). In regard
one’s social contexts can help to enhance one’s
to participation in therapy, individuals who are
autonomous motivation (Ryan & Deci, 2008b).
autonomously motivated actively choose to en-
Autonomy support involves the validation of an
gage in treatment, identify with their treatment
individual’s perspective, the acknowledgement
goals, and pursue change more volitionally
of their feelings, providing them with choices,
(Ryan & Deci, 2008a). In a meta-analysis of 184
and not pressuring or exerting control over them
independent data sets from healthcare settings,
and their decisions (Ryan and Deci, 2008a; Zu-
the three aforementioned psychological needs
roff et al., 2017). High levels of perceived au-
associated with autonomous motivation predict-
tonomy support in a given therapy session have
ed moderate to strong levels of improved mental
been shown to be associated with high levels
health and increased levels of overall health be-
of patient autonomous motivation in individuals
haviours (Ng et al., 2012).
with depression (Zuroff et al, 2012). Increased
In the context of therapy for EDs, autonomous motivation has been found to have a significant impact on treatment outcomes. In a sample of 62
autonomy support was also found to be helpful with individuals who had experienced a psychotic episode, as those who completed a treatment McGill Undergraduate Psychology Journal
program emphasizing the tenets of autonomy
classification, incorporating all personality traits
support perceived higher levels of autonomy
into five broad categories: openness to experi-
support and saw more immediate increases in
ence, conscientiousness, extraversion, agree-
their quality of life (Browne et al., 2017).
ableness and neuroticism (McAdams, 2013,
Numerous studies have examined the impact of autonomy support on treatment outcomes in individuals with EDs. It has been shown that, in a heterogenous ED sample of individuals undergoing outpatient treatment, autonomy support from mental health professionals, friends, family members, and group therapy peers, led to in-
p.105-6). A recent meta-analysis including 99 studies that used the Big 5 trait taxonomy model found that traits were systematically related to various mental health treatment outcomes and that all of the Big 5 categories act as predictors of various domains of outcomes post-therapy (Bucher et al., 2019).
creased autonomous motivation for the individ-
The relationship between personality and
ual during therapy (Steiger et al. 2017). Similar
EDs has also been extensively studied. A 2006
findings have also been observed in a sample of
meta-analysis examining the relationship be-
individuals with heterogeneous EDs undergoing
tween personality and eating disorders con-
inpatient treatment. It was found that higher au-
cluded that increasing evidence demonstrates
tonomy support from parents and fellow patients
personality characteristics, including negative
led to increased self-endorsed motivation for in-
emotionality, perfectionism, and poor intero-
dividuals and that higher autonomy support from
ceptive awareness, may act as risk factors for
staff led to increased psychological need satis-
the development of eating disorders (Lilenfeld
faction, and a subsequent increase in patient
et al., 2006). One study that specifically exam-
self-endorsed motivation (van der Kaap-Deeder
ined the intersection of personality, EDs, and
et al., 2014).
therapy outcomes found that, when comparing
Although increased autonomous motivation may predict better treatment outcomes, and autonomy supportive actions by therapists may enhance patients’ autonomous motivation, individual differences in the impact of autonomy support on motivation may exist. Patient personality traits could be one measure of such individual differences, as personality has been shown to affect therapy outcomes (Bucher et al., 2019). In the field of personality psychology, The Big 5 trait taxonomy is the most prominent Issue XI | December 2021
individuals with an ED who completed a treatment plan compared to those who did not, the individuals who dropped out had increased levels of impulsivity and anger and lower levels of self-directedness and cooperativeness (Fassino et al., 2003). Other research looking at personality phenotypes of outpatient individuals with EDs replicated pre-established patterns of personality classifications for EDs, namely a under-controlled/dysregulated group (characterized by high levels of openness, ex63
traversion and neuroticism), an over-controlled
PSI Ψ tions of their own levels of autonomy support and
group (characterized by low levels of openness,
how they relate to patient ratings. Furthermore,
conscientiousness, agreeableness, and ex-
data on the impact of patient personality and ED
traversion, and intermediate levels of neuroti-
symptoms on patient perception of therapist au-
cism), and a resilient and high functioning group
tonomy support is lacking. Therefore, this study
(characterized by high levels of conscientious-
aims to examine changes over time and across
ness, extraversion and agreeableness) (Paquin
patients/therapists in autonomy support and ex-
Hodge et al., 2018). In addition, this study found
amine the association between therapist ratings
that completing outpatient treatment led to im-
and patient ratings. The current study also aims
provements in many eating disorder symptoms
to examine the impact of patient baseline vari-
and total eating disorder symptom severity in all
ables, namely personality and ED symptoms,
three personality phenotypes (Paquin Hodge et
on changes in perception of autonomy support
al., 2018).
over time.
Several studies examining the link between the Big 5 traits and EDs using non-clinical samples have also been published. Looking at female undergraduate students, one study that specifically examined the connection between disordered eating and the Big 5 trait taxonomy found that symptomatic participants displayed higher overall levels of neuroticism and lower overall levels of extraversion than the nonsymptomatic participants (MacLaren & Best, 2009). Another study of female undergraduate students concluded that the specific combination of high levels of neuroticism and low levels of extraversion puts individuals at the highest risk for problematic eating symptoms across several different measures of eating disorders (Miller, et al., 2006).
Aims While previous research has examined patient perceptions of therapist autonomy support, no study to date has examined therapist percep64
Hypotheses 1. Perceived therapist autonomy support ratings from patients and therapists will be significantly associated. 2. Patient baseline variables, namely personality traits and ED symptoms, will be significantly associated with patient and therapist perceptions of therapists’ autonomy support. 3. On average, overall ED symptoms will improve for patients throughout the course of therapy.
Methods Participants Patients. Patient participants were recruited from the Eating Disorders Continuum (EDC) of the Douglas Mental Health University Institute, after approval from the institution’s Research Ethics Board. The primary inclusion criterion was a current DSM-5 diagnosis of Anorexia Nervosa, Bulimia Nervosa, ARFID, or OSFED. McGill Undergraduate Psychology Journal
The second criterion was that individuals had
ied, with 12 (66.7%) holding graduate degrees,
to have recently begun participating in the
and 6 (33.3%) holding bachelor’s degrees.
outpatient program at the EDC and had to be
Professional status was also diverse, including
engaging in individual therapy sessions. More
2 (11.1%) psychologists, 9 (50%) psychology
specifically, patients had to have participated in
students interning at the EDC, 4 (22.2%) social
no more than three individual therapy sessions
workers, 1 (5.6%) psychotherapist, 1 (5.6%)
at the EDC in order to be eligible to participate.
psychoeducator, and 1 (5.6%) nurse clinician.
The current sample consisted of 50 (90.9%)
The therapists included in the study were
women and 5 (9.1%) men with a mean age of 31.19 years (± SD = 10.48). Regarding ED diagnosis, 12 (22.3%) were diagnosed with Anorexia Nervosa, 27 (49.1%) with Bulimia Nervosa, 11 (20.40%) with OSFED and 4 (11.4%) with ARFID. Body Mass Index (BMIs) of the participants ranged from 14.19 to 50.33, with an average of 23.11 (± SD = 6.80). Age of ED onset had a mean of 16.93 years old (± SD = 5.80), and a range of 6 to 33 years old. Participants’ total score on the
well-experienced, as they had been practicing psychotherapy for an average of 95.20 months (7.9 years), conducting therapy specific to eating disorders for an average of 79.70 months (6.6 years), and had been working at the EDC for an average of 63.80 months (5.3 years). Therapists each follow individual patients, with an average of 12 patients per therapist. As with patients, variations in available information for different variables reflect missing data at vari-
Eating Disorder Examination-Questionnaire at
ous study timepoints.
baseline had a mean of 4.94 (± SD = 1.01), with
Procedure
a range of 1.53 to 6.14. Regarding ethnic background, 38 (95%) participants self-identified as Caucasian, 1 (2.5%) as Asian, and 1 (2.5%) as African. Variations in available information for different variables reflect missing data at various time points of the study. Therapists. Therapists from the EDC were also recruited to participate, with the sample consisting of 17 (94.4%) women and 1 (5.6%) man. The age range was 25 to 64 years old, with a mean of 36.94 (± SD = 12.18). Regarding ethnic background, 13 (81.3%) self-identified as Caucasian and 3 (18.8%) self-identified as Jewish. The education level of the therapists was varIssue XI | December 2021
Recruitment for this study was done by telephone. A member of the research team would contact eligible EDC patients and provide them with a summary of the study and what their participation would entail. For this to occur, patients had to have signed a form authorizing for them to be contacted by the research team. If a patient expressed interest, their therapist was approached to participate in the study; both patient and therapist were free to refuse to participate. Once informed consent was obtained from both the patient participant and their therapist, both were officially enrolled in the study. Patients were then presented with a form requesting 65
PSI Ψ
consent for the research team to access their
patient questionnaires would never be seen by
medical files. Once a therapist had officially
therapists and that completed therapist ques-
joined the study, any of their future patients who
tionnaires would never be seen by patients. At
consented to participate were automatically en-
the end of a therapy session, the patient and
rolled and the therapist was made aware.
therapist would separately fill out their question-
After joining the study, a research assistant ensured that patients had completed a package of baseline questionnaires, including a sociodemographic questionnaire, the Eating Disorders Examination-Questionnaire 6.0 (EDE-Q), the Big Five Inventory (BFI), and the Autonomous and Controlled Motivation for Treatment Questionnaire (ACMTQ). During the study, patients completed the patient version of the Health Care
naires, place them in an envelope, and leave them in a secure location, which only a research assistant had access to. In order to maintain anonymity, all participants were given an ID number specific to this study, which was used to track their data. Identifying information for both therapists and patients was never included in the study’s main database and was kept in a separate file that only research assistants had
Climate Questionnaire (HCCQ-P), a measure of
access to.
perceived autonomy support from one’s thera-
Treatment
pist, a total of five times, with approximately a month in between each timepoint. The HCCQ-P was always completed at the end of an individual therapy session. Additionally, at timepoints three and five, participants would also complete the EDE-Q 6.0 and the ACMTQ. Therapists also completed a package of baseline questionnaires
Patients at the EDC outpatient clinic participate in treatment for blocks of 10 to 15 weeks, consisting of weekly or bi-weekly individual therapy sessions and weekly group therapy sessions. Patients also have access to nutrition consultations, as well as pharmacotherapy when required. Treatment at the EDC utilizes empirically
after joining the study, consisting of a sociode-
based techniques and treatment manuals.
mographic questionnaire and the BFI. During
Clinical Measures
the study, therapists completed the therapist version of the Health Care Climate Questionnaire (HCCQ-T), a measure assessing their perceptions of the autonomy support they provided in a given therapy session, after the same five therapy sessions as their patients.
Confidentiality of Data During the initial presentation of the study, potential participants were assured that completed 66
Motivation for treatment. The Autonomous and Controlled Motivation for Treatment Questionnaire (ACMTQ), developed by Zuroff and colleagues (2007) is a 12-item questionnaire that is divided into two subscales, one measuring autonomous motivation and the other measuring controlled motivation. Using a range of 1 (strongly disagree) to 7 (strongly agree), individuals must rate how much each statement McGill Undergraduate Psychology Journal
corresponds with their reasoning for engaging
North American samples, the BFI has an aver-
in therapy for their eating disorder. Statements
age reliability of above .80 (John & Srivastava,
include “I don’t want other people to be disap-
1999). In the current study, the reliability of the
pointed in me” (corresponding to controlled mo-
BFI, as measured by Cronbach’s Alpha, was
tivation) and “Getting eating disorder treatment
.579 for patients and .475 for therapists.
is an important choice that I really want to make
Eating symptoms. The Eating Disorder Exam-
to become well” (corresponding to autonomous motivation). The ACMTQ was originally used to measure depression by Zuroff and colleagues (2007), after having been adapted from Williams and colleagues’ Treatment Self-Regulation Questionnaire. It was then further modified by Mansour and colleagues (2012) for specific use with ED samples. In a sample of women diagnosed with an ED, the internal consistency of the ACMTQ was measured as α = 0.85 for the autonomous motivation subscale, and as α = 0.80 for the controlled motivation subscale (Sansfaçon et al, 2019). In the current study, the reliability of the ACMTQ at baseline, as measured by Cronbach’s Alpha, was .704.
ination – Questionnaire (EDE-Q) is a self-report questionnaire that was adapted from the Eating Disorder Examination interview by Fairburn and Beglin (1994). The questions compose four subscales, restraint, eating concern, shape concern, and weight concern, as well as the frequency of various ED behaviours over the past 28 days (Aardoom et al. 2012). The range of possible answers changes throughout the questionnaire, with some questions using a scale ranging from 0 (no days) to 6 (every day), others using a scale of 0 (not at all) to 6 (markedly), and some requiring the participant to write in the number of times a behaviour has occurred. The internal consistency of the global EDE-Q score has
Personality. The Big Five Inventory (BFI) is a
been measured as α = 0.95, with the internal
questionnaire developed by John, Donahue and
consistency of the four subscales ranging from
Kentle, consisting of 44 items that measure the
α = 0.81 to α = 0.91 (Aardoom et al., 2012). In
five dimensions (openness to experience, con-
the current study, the reliability of the EDE-Q at
scientiousness, extraversion, agreeableness,
baseline, as measured by Cronbach’s Alpha,
and neuroticism) that compose the Big 5 model
was .748.
(John & Srivastava, 1999). Using a range of 1
Autonomy Support. The Health Care Climate
(disagree strongly) to 5 (agree strongly), individuals rate how much they agree with certain statements about themselves, such as “Is a reliable worker” and “Tends to be quiet”. The 44 phrases each describe adjectives that are known to be classic components of each of the Big 5 traits. In Issue XI | December 2021
Questionnaire (HCCQ) is a 7-item questionnaire that measures autonomy support, developed by Zuroff and colleagues (2007). Using a range of 1 (strongly disagree) to 7 (strongly agree), individuals rate how much they agree with certain statements regarding their most recent 67
therapy session. In this study, two versions of the HCCQ were used, the HCCQ-P for patients
Statistical Analyses
PSI Ψ
Repeated Measures ANOVAs were conducted
and the HCCQ-T for therapists. Examples of
to examine whether eating disorder symptoms,
HCCQ-P statements include “I felt understood
motivation, and autonomy support perceptions
by my individual therapist” and “My individual
changed across treatment. Mixed Model analy-
therapist conveyed confidence in my ability to
ses were conducted to examine changes in HC-
make changes”. The HCCQ-T, meant to assess
CQ-P and HCCQ-T scores over time and across
how autonomy supportive therapists perceived
patients/therapists, and to examine the associ-
themselves to be in a given therapy session,
ation between therapist ratings and patient rat-
includes statements that mirror those included
ings. Models to examine the effect of personality
in the HCCQ-P, such as “I understand my client”
and ED symptoms on autonomy support were
and “I convey confidence in my client’s ability
also conducted.
to make changes”. The HCCQ-T also includes an open-ended question, specifically “In today’s
Results
session, what factors (either related to you, your
Repeated Measures ANOVAs
client, or the relationship) do you believe led you
Repeated Measures ANOVAs were used to
to be more or less autonomy supportive of your
compare the total scores of both participants
client?”, which allows therapists to provide addi-
and therapists on various questionnaires at mul-
tional detail surrounding their perceived auton-
tiple timepoints (see Appendix Tables 1-5 and
omy supportiveness. The HCCQ was adapted
Figures 1-5.)
by Zuroff and colleagues (2007) for a study examining depression and is based on the original HCCQ created by Williams and colleagues. The reliability of the HCCQ corresponds to α = 0.88 (Zuroff et al., 2007). In the current study, the reliability at baseline, as measured by Cronbach’s Alpha, was .846 for the HCCQ-P and .903 for the HCCQ-T. Sociodemographic information. Before commencing participation in the study, both patients and therapists completed a brief questionnaire that assessed social and personal information, such as age, marital status, education level and professional experience. 68
Patient and Therapist Perceptions of Autonomy Support Changes in reported autonomy support were assessed. Table A1 and Figure B1 present patients’ mean total HCCQ-P scores at all five therapy timepoints. ANOVA indicated that the difference between timepoints (T1 M = 6.04, SD = .73; T2 M = 6.24, SD = 1.04; T3 M = 6.20, SD = .81; T4 M = 6.01, SD = 1.33; T5 M = 6.42, SD = .91) was not significant, F (4,8) = 1.978, p = .191. These results suggest that patients’ perceptions of autonomy support remain stable throughout their participation in therapy. Table A2 and Figure B2 present therapists’ mean total McGill Undergraduate Psychology Journal
HCCQ-T scores at all five therapy timepoints.
time 3 and time 5. ANOVA indicated that differ-
ANOVA indicated that the difference between
ences between timepoints were non-significant,
timepoints (T1 M = 5.77, SD = 1.32; T2 M =
F (2,10) = .238, p = .792, as baseline scores (M
6.15, SD = .52; T3 M = 6, SD = .70; T4 M =
= 5.63, SD =.93), time 3 scores (M = 5.81, SD =
6.01, SD = .66; T5 M = 5.76, SD = .80) was not
1.13) and time 5 scores (M = 5.80, SD = 1.02)
significant, F (4,13) = 1.136, p =.382, except for
were not meaningfully different from each other.
the difference between time 2 and time 5 scores
These results suggest that patient levels of au-
(p = .045). These results suggest that therapists’
tonomous motivation remain stable throughout
perceptions of autonomy support undergo initial
participation in therapy. Table A5 and Figure
increases in earlier sessions, followed by de-
B5 show patients’ controlled motivation scores
creases in later sessions.
on the ACMTQ at baseline, time 3 and time 5.
Patient Eating Disorder Symptoms
ANOVA indicated that differences between time
Changes in participant ED symptoms throughout the study were also examined. Table A3 and Figure B3 present patients’ mean total EDE-Q scores at baseline, time 3 and time 5. ANOVA indicated that differences between timepoints were significant, F (2,13) = 6.847, p= .009, as pairwise comparisons demonstrated that base-
points were non-significant, F (2,9) = .1863, p = .210, as baseline scores (M = 3.41, SD = 1.44), time 3 scores (M = 3.05, SD = 1.33), and time 5 scores (M = 3.27, SD = 1.53) were not meaningfully different from each other. These results suggest that patient levels of controlled motivation remain stable throughout participation in
line scores (M= 4.10, SD = .96) were significant-
therapy.
ly higher than both time 3 scores (M = 3.26, SD
Mixed Model Analyses
= 1.20) (p = .009) and time 5 scores (M = 3.08,
Mixed Model analyses were used to examine
SD = 1.32) (p = .002). The difference between
changes and associations among HCCQ-P
time 3 scores (M = 3.26, SD = 1.20) and time 5
and HCCQ-T scores. Additionally, the effects of
scores (M = 3.08, SD = 1.32) was not significant
patient baseline variables on HCCQ-P and HC-
(p = .479). These results suggest that patient
CQ-T scores were also examined.
ED symptoms are the highest prior to beginning treatment, and significantly decrease during one’s participation in therapy.
Patient Motivation Changes in participant autonomous and controlled motivation were also measured. Table A4 and Figure B4 present patients’ autonomous motivation scores on the ACMTQ at baseline, Issue XI | December 2021
Patient and Therapist Perceptions of Autonomy Support Changes over time in HCCQ-P scores were analyzed. Estimates of fixed effects suggested no linear or quadratic changes over time (estimated linear growth rate = 0.035 points per session, p = .740; estimated quadratic growth rate = -.001 points per session, p =.962) in HC69
CQ-P scores. Analyses also demonstrated that
PSI Ψ shifting in the same way for all of the therapists
the between-individual proportion of variance
involved in the study.
in HCCQ-P scores among patients was 63%. These results suggest that the scores of individual patients remain stable over time and that patients differ from each other in how they perceive autonomy support. Changes over time in HCCQ-T scores were also examined. Estimates of fixed effects suggested no linear change over time (estimated linear growth rate = .212 points per session, p = 0.62). However, analyses did suggest the presence of a quadratic (curvilinear) change over time (estimated quadratic growth rate = -.061 points per session, p = .038). Analyses also demonstrated that the between-individual proportion of variance in HCCQ-T scores between therapists was 26%. These results suggest that the scores of individual therapists do significantly differ over time, with increasing scores in earlier sessions and decreasing scores
Association Between Patient and Therapist Perceptions of Autonomy Support The association between HCCQ-P and HCCQ-T scores was examined. Estimates of fixed effects suggested the presence of a significant, positive association (estimate = .170, SE = .073, t = 2.34, p = .021). These results suggest that patients’ perceived autonomy support corresponds with therapists’ perceptions of their autonomy supportiveness. Analyses also found that the intercepts of HCCQ-P scores did not significantly vary across therapists (p = .644), and that the change over time in HCCQ-P scores for different therapists was not significant (p = .607). These results suggest that the specific therapist a patient received treatment from did not have an impact on their perceptions of autonomy sup-
in later sessions, and that therapists differ from
port.
each other in how they perceive autonomy
Effects of Patient Baseline Characteristics on Perceptions of Autonomy Support Rating
support. Additional tests were then conducted to investigate the presence of individual differences in the slope for the therapists included in the study, done by testing the change over time in the HCCQ-T scores and adding in a random factor. Analyses again suggest the presence of a quadratic (curvilinear) change over time (estimated quadratic growth rate = -.063 points per session, p = .028), but found no significant difference in therapist slopes (p > .150). These results suggest that HCCQ-T scores are all changing, as discussed above, and that they are
70
The effects of patient baseline variables on HCCQ-P and HCCQ-T scores were also examined. When analyzing the effects of EDE-Q baseline scores on both HCCQ-P and HCCQ-T scores, no reliable models fit the data. Models to examine the relationship between subscales on the BFI completed by patients (openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism) and HCCQ-P scores were run, with no significant associations found for any of the subscales [BFI-o (p = .688), BFI-c McGill Undergraduate Psychology Journal
(p = .708), BFI-e (p = .117), BFI-a (p = .162),
each other in regard to their perceived autono-
BFI-n (p = .143)]. Models to examine the rela-
my support from their therapists. However, the
tionship between the aforementioned person-
lack of linear or quadratic change in HCCQ-P
ality subscales of the BFI and HCCQ-T scores
scores indicates that individual patients’ scores
were also run, but no models provided a good fit
do not significantly differ over time and show
for the data for all five subscales.
very little change throughout the course of treat-
Discussion
The primary goals of this study were to assess changes in patient and therapist perceptions of autonomy support throughout therapy and to examine a potential association between them, to assess the effects of patient baseline characteristics on these ratings, and to examine changes in overall ED symptoms throughout the course of treatment. Results indicated that therapist ratings of their own autonomy supportiveness significantly changed over time, whereas no changes were observed for patients’ ratings of perceived autonomy support. A positive, significant association between patient and therapist ratings of autonomy support was also found. The effects of patient baseline characteristics on perceptions of autonomy support from both patients and therapists were either found to be non-significant or did not fit into any reliable model. Results also demonstrated an overall improvement in patient eating disorder symptoms throughout participation in treatment.
Patient Perceptions of Autonomy Support Important results were the observed changes over time in HCCQ-P scores. For patients, the between-individual proportion of variance was 63%, signifying that patients do differ from Issue XI | December 2021
ment. In other words, the patients in the study provided substantially different HCCQ-P ratings from each other on average, but an individual person’s HCCQ-P ratings did not fluctuate significantly throughout the course of treatment. Furthermore, the lack of significant change seen among the intercepts of HCCQ-P scores across therapists and in HCCQ-P scores for different therapists over time indicates that patient scores did not change as a function of the therapist they were receiving treatment from. These findings provide necessary insight into autonomy support within the context of therapy for EDs, how it may fluctuate over time, and the potential impact that individual therapists have.
Therapist Perceptions of Autonomy Support The observed changes over time in HCCQ-T scores are noteworthy. For therapists, the between-individual proportion of variance was 26%, signifying that therapists do differ from each other in regard to their perceived autonomy supportiveness towards their patients. Additionally, the quadratic, curvilinear change observed in HCCQ-T scores indicates that therapist ratings changed over time, with increased levels of perceived autonomy supportiveness in earlier sessions compared to later ones. In other words, the therapists in the study provided dif71
PSI Ψ
ferent HCCQ-T ratings from each other on aver-
therapist autonomy support scores do concord
age, and individual therapist’s HCCQ-T ratings
with each other. Including measures of therapist
significantly changed throughout the different
perceptions of their own autonomy supportive-
timepoints of the study. Further, the difference
ness in future studies will hopefully lead to the
in between-individual proportions of variance for
robust replication of this finding in larger sam-
patients (63%) and therapists (26%) signifies
ples.
that the patients involved in the study differed more in the manner that they perceived autonomy support than the therapists involved did. Further analyses of HCCQ-T scores over time examining the potential for individual differences in slope for therapists demonstrated a quadratic, curvilinear change over time, but a lack of difference in slope, demonstrating that HCCQ-T scores significantly changed over time, but did not differ in their rate of change. In other words, all of the therapists’ scores fluctuated over the course of the study, but virtually all in the same way. These findings help contribute to the lack of research related to therapist perceptions of their own autonomy supportiveness in the context of therapy for eating disorders, and will hopefully be expanded upon in further, more sophisticat-
Effects of Patient Baseline Characteristics on Autonomy Support Ratings Analyses conducted to examine the effects of patient baseline characteristics on ratings of autonomy support drew varied results. Analyses examining the relationship between the personality subscales of the BFI and HCCQ-P scores were run, with no significant associations found for any of the five BFI subscales. In other words, none of The Big 5 personality traits had an effect on a patient’s rating of perceived autonomy support from their therapist. These analyses relate to one of the primary hypotheses of this paper, in which it was anticipated that patient personality would be significantly associated with their perceptions of autonomy support. These results
ed research.
are surprising, as associations between person-
Association Between Patient and Therapist Perceptions of Autonomy Support
an ED receiving outpatient treatment have pre-
ality and treatment outcomes for individuals with viously been found (Fassino et al, 2003; Paquin
Our analyses also demonstrated the presence
Hodge et al., 2018). Further research on the
of a significant positive association between
effects of personality specifically on perceptions
HCCQ-P scores and HCCQ-T scores, signifying
of autonomy support should be undertaken.
that perceived autonomy support from thera-
Our analyses also led to some of our collected
pists by patients was related to therapists’ per-
data not reliably fitting into any models. When
ceived autonomy supportiveness towards their
examining the relationship between the person-
patients. This finding addresses one of the key
ality subscales of the BFI and HCCQ-T scores,
aims of this paper, and confirms that patient and
no model provided a good fit for any of the five
72
McGill Undergraduate Psychology Journal
BFI subscales. Additionally, when examining the
amined. The lack of significance between the
effects of EDE-Q baseline scores on both HC-
various timepoints in patient autonomous and
CQ-P and HCCQ-T scores, no model reliably fit
controlled motivation indicate that the level of
the data. These findings are believed to be due
motivation remained stable from baseline until
to the small sample size included in the study
the end of one’s participation in the study. In
and subsequent limited data that was collected.
other words, undergoing therapy did not directly
Unfortunately, though these data are related to a
impact one’s levels of autonomous or controlled
primary hypothesis of the study, no conclusions
motivation in any way, as individuals remained
can currently be made regarding these areas of
similar to their baseline levels for the entirety of
interest.
the study. This was surprising, as it has been
Patient Eating Disorder Symptoms
previously shown that perceived autonomy sup-
We found significant changes in participant total EDE-Q scores throughout the course of therapy. The differences observed between baseline and time 3 and between baseline and time 5 indicate a meaningful change in EDE-Q scores throughout one’s participation in the study. Specifically, significant decreases in total EDE-Q scores were observed between the above timepoints, indicating the improvement of overall ED outcomes for the patients involved in the study. These improvements in symptoms became sig-
port from one’s therapist increases autonomous motivation in treatment for depression, and specifically throughout the course of outpatient treatment for an eating disorder (Steiger et al., 2017; Zuroff et al. 2012). Considering the high mean HCCQ-P score at each timepoint, indicating that patients perceived high levels of autonomy support from their therapists, it is possible that a ceiling effect occurred, in which patients had no room to improve in their ratings of autonomy support due to the presence of high initial
nificant by the middle of one’s participation in
levels at the beginning of treatment.
therapy and continued to improve only margin-
Limitations and Future Directions
ally between then and the end of one’s treat-
One limitation of the current study is the small
ment. These results were expected, as it has
sample size, which limits the stability and gen-
been shown that completing outpatient treat-
eralizability of the results and the conclusions
ment leads to improvements in ED symptoms
that can be made. Another limitation is the fact
for samples of individuals with heterogeneous
that some of the data did not fit into any mod-
diagnoses (Bégin et al., 2013; Sansfaçon et al.,
els during the conduction of analyses, limiting
2018; Thaler et al., 2014).
the amount of information that can be extracted
Patient Motivation
from the collected data. It must also be noted
Though it was not a primary goal of the study, changes in patient motivation were also exIssue XI | December 2021
that the participating therapists did not all have the same number of patients involved in the study, resulting in some therapists filling out 73
questionnaires for several patients and others only completing questionnaires for one. This discrepancy between the amount of participation from the various therapists may have confounded some results. Future directions for this area of research should include conducting similar studies with larger sample sizes, in order to gain more comprehensive results. Future studies could also include the analysis of elements not directly considered in this study, such as potential differences among therapist ratings of their autonomy supportiveness based on their amount of professional experience or therapist personality, or differences among patient ratings of perceived autonomy support based on additional baseline characteristics, such as ED diagnosis or age of onset of one’s ED.
Conclusion
Given the importance of autonomy support in the context of therapy and its influence on treatment outcomes, research examining factors that may impact both patient and therapist perceptions of autonomy support is extremely valuable. The findings of this paper highlight the significant relationship between patient and therapist perceptions of autonomy support, as well as how these may undergo notable, albeit different, changes over the course of therapy. This information can be directly utilized by therapists engaging in treatment with clients, as increased knowledge about factors that may influence their own perceptions, as well as those of their clients, can help them more effectively foster autonomy support in the therapeutic setting. 74
Acknowledgements
PSI Ψ
I would like to thank Dr. Howard Steiger, who acted as my supervisor, and Dr. Lea Thaler, who provided me with invaluable guidance throughout the completion of my research project and the writing of my paper. Additionally, Ms. Stephanie Oliverio, a research assistant in the Eating Disorders Continuum, also provided me with considerable help, completing various tasks related to data collection.
References
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apy and Psychosomatics, 72(4), 203-210. https://doi. org/10.1159/000070784 Geller, J., Cockell, S. J., & Drab, D. L. (2001). Assessing readiness for change in the eating disorders: The psychometric properties of the readiness and motivation interview. Psychological Assessment, 13(2), 189-198. https://doi.org/10.1037/1040-3590.13.2.189 John, O. P., & Srivastava, S. (1999). The Big Five trait taxonomy: History, measurement, and theoretical perspectives. In L. A. Pervin & O.P. John (Eds.), Handbook of personality: theory and research (pp. 102-138). Guilford Press. Lilenfeld, L. R. R, Wonderlich, S., Riso, L. P., Crosby, R., & Mitchell, J. (2006). Eating disorders and personality: A methodological and empirical review. Clinical Psychology Review, 26(3), 299-320. https://doi.org/10.1016/j. cpr.2005.10.003 MacLaren, V. V., & Best, L. A. (2009). Female students’ disordered eating and the big five personality facets. Eating Behaviours, 10(3), 192-195. https://doi. org/10.1016/j.eatbeh.2009.04.001 Mansour, S., Bruce, K. R., Steiger, H., Zuroff, D. C., Horowitz, S., Anestin, A. S., & Sycz, L. (2012). Autonomous motivation: A predictor of treatment outcome in bulimia-spectrum eating disorders. European Eating Disorders Review, 20(3), e116-e122. https://doi. org/10.1002/erv.2154 McAdams, D. P. (2015). The Art and Science of Personality Development. The Guilford Press. Miller, J. L., Schmidt, L. A, Vaillancourt, T., McDougall, P., & Laliberte, M. (2006). Neuroticism and introversion: A risky combination for disordered eating among a non-clinical sample of undergraduate women. Eating Behaviours, 7(1), 69-78. https://doi.org/10.1016/j.eatbeh.2005.07.003 Ng, J. Y.Y., Ntoumanis, N., Thorgersen-Ntoumani, C., Deci, E. L., Ryan, R. M., Duda, J. L., & Williams, G. C. (2012). Self-determination theory applied to health contexts: A meta-analysis. Perspectives on Psychological Science, 7(4), 325-340. https://doi. org/10.1177/1745691612447309 Paquin Hodge, C., Fletcher, É., Khanizadeh, A., Schmitz, N., & Steiger, H. (2018). Association of empirically determined personality phenotypes with clinical outcomes in people with eating disorders [Manuscript in preparation]. Eating Disorders Continuum, Douglas Mental Health University Institute. Ryan, R.M., & Deci, E. L. (2008a). A self-determination theory approach to psychotherapy: the motivational basis for effective change. Canadian Psychology/ Psychologie canadienne, 49(3), 186-193. https://doi. org/10.1037/a0012753 Issue XI | December 2021
Ryan, R.M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55(1), 68-78. https://doi-org/10.1037/0003-066X.55.1.68 Ryan, R.M., & Deci, E. L. (2008b). Self-determination theory and the role of basic psychological needs in personality and the organization of behavior. In O.P John, R. W. Robins & L. A. Pervin (Eds), Handbook of Personality: Theory and research (pp. 654-678). Guilford Publications. Sansfaçon, J., Fletcher, É., Zuroff, D. C., Schmitz, N., Miller, A., Israël, M., and Steiger, H. (2019). Psychometric properties of the “autonomous and controlled motivation for treatment questionnaire” in women with eating disorders. European Eating Disorders Review, 27(3), 306-314. https://doi.org/10.1002/erv.2656 Sansfaçon, J., Gauvin, L., Fletcher, É., Cottier, D., Rossi, E., Kahan, E., Israël, M., & Steiger, H. (2018). Prognostic value of autonomous and controlled motivation in outpatient eating-disorder treatment. International Journal of Eating Disorders, 51(10), 1194-1200. https:// doi.org/10.1002/eat.22901 Steiger, H., Sansfaçon, J., Thaler, L., Leonard, N., Cottier, D., Kahan, E., Fletcher, E., Rossi, E., Israël, M., & Gauvin, L. (2017). Autonomy support and autonomous motivation in the outpatient treatment of adults with an eating disorder. International Journal of Eating Disorders, 50(9), 1058-1066. https://doi.org/10.1002/ eat.22734 Thaler, L., Israël, M., Antunes, J. M., Sarin, S., Zuroff, D. C., & Steiger, H. (2016) An examination of the role of autonomous versus controlled motivation in predicting inpatient treatment outcome for anorexia nervosa. International Journal of Eating Disorders, 49(6), 626629. https://doi.org/10.1002/eat.22510 Thaler, L., Wilson, S., Coelho, J. S., Antunes, J. M., Israël, M., & Steiger, H. (2014). Mandating Weekly Weight Gain in a Day Treatment Program for Eating Disorders. International Journal of Eating Disorders, 47(5) 500506. https://doi.org/10.1002/eat.22246 Waller, G. (2012). The myths of motivation: Time for a fresh look at some received wisdom in the eating disorders? International Journal of Eating Disorders, 45(1), 1-16. https://doi.org/10.1002/eat.20900 Van der Kaap-Deeder, J., Vansteenkiste, M., Soenens, B., Verstuyf, J., Boone, L. & Smets, J. (2014). Fostering self-endorsed motivation to change in patients with an eating disorder: The role of perceived autonomy support and psychological need satisfaction. International Journal of Eating Disorders, 47(6), 585-600. https://doi. org/10.1002/eat.22266 Zuroff, D.C., McBride, C., Ravitz, P., Koestner, R., Moskowitz, D.S., & Bagby, R. M. (2017). Journal of
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Zuroff, D. C., Koestner, R., Moskowitz, D.S., McBride, C., Marshall, M., & Bagby, R. M. (2007). Autonomous motivation for therapy: A new common factor in brief treatments for depression. Psychotherapy Research, 17(2), 137-147. https://doi.org/10.1080/10503300600919380
Appendix
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Issue XI | December 2021
77
Neural Plasticity and Working Memory in Deaf Individuals Lucy Core
Supervisor: Dr. James MacDougall
Ψ PSI Journal
Abstract
Neural plasticity is the ability of the nervous system, in particular the brain, to reorganize itself both structurally and functionally (von Bernhardi et al., 2017). This phenomenon can occur due to environmental changes such as the absence of auditory input. Studying deaf individuals has provided critical insight into how environmental experience shapes both brain structure and function. The goal of this literature review is to explore the mechanisms that drive neural plasticity in deaf individuals, with a focus on working memory ability. A secondary aim is to examine how the use of cochlear implants and hearing aids affects neural plasticity. In addition, we will provide suggestions for areas of future research. Examining cortical reorganization in deaf individuals will not only advance our knowledge of the capabilities of the nervous system, but may also help inform clinical interventions for deaf individuals. Keywords: deaf, hearing loss, neural plasticity, cortical reorganization, working memory
Neuroscientific studies involving deaf individ-
Introduction
uals have provided evidence for both views. Au-
A Framework of Neural Plasticity Neural plasticity has been observed in many populations including deaf individuals
[1]
. There
are two major theories regarding the function of the cortex following reorganization (Cardin et al., 2020): the functional preservation theory suggests that cortical areas become reorganized to respond to a different sensory modality, but their general function remains the same. The functional change theory posits that cortical areas shift from being responsive to sensory input, to being involved in higher-order cognitive functions. [1]
ditory association areas in the superior temporal cortex (STC) are involved in the processing of other types of sensory input, such as visual information (e.g. Finney et al., 2001; Shiell et al. 2015), therefore supporting the functional preservation theory. Regions of the STC have also been implicated in enhanced working memory performance in deaf, but not hearing individuals (e.g. Cardin et al., 2018; Ding et al. 2015), providing evidence for the functional change theory. In this literature review, we aim to describe and synthesize the findings regarding neural plasticity in deaf individuals and how they align
Using a lowercase d in the word “deaf” refers to individuals with the condition of hearing loss, whereas using a capital
D in “Deaf” refers to individuals who identify culturally as Deaf (Schirmer, 2001). We will use “deaf” in this report, but we acknowledge that there may be individuals included who identify as “Deaf.”
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McGill Undergraduate Psychology Journal
with the framework introduced by Cardin et al.
the anatomical location of A1 and the planum
(2020).
temporale were the same in both groups of participants. The researchers also found inter-
Neural Plasticity
hemispheric asymmetries in these two areas in
Morphometry of Auditory Cortex The auditory cortex is a region in the temporal lobes that is involved in sound processing in hearing individuals. The primary auditory cortex (A1) lies on Heschl’s gyrus and is directly involved in sound perception. It has a tonotopic organization such that different regions of the cortex respond to sounds of different frequencies (Zatorre, 2002). Auditory association areas surround A1 and are responsible for more complex aspects of auditory processing. For example, regions of the STC have been shown to be involved in language comprehension (Binder, 2015) and auditory scene segregation (Ghinst et al., 2016). Hearing loss appears
to result in neural
plasticity in the auditory cortex. For example, Penhune et al. (2003) used magnetic resonance imaging (MRI) to examine the structure of A1 and the planum temporale, an auditory association area, in congenitally deaf and hearing individuals. The results illustrated that the gray and white matter volume in the two regions of both groups was the same. Preservation of cortical volume indicates that neural plasticity occurs in deaf individuals.
both groups, suggesting that auditory cortical symmetry is dependent on genetics, rather than auditory experience. The results from this study provide a first glance of the structure of the auditory cortex in deaf individuals. Interestingly, most research examining the role of the auditory cortex in deaf individuals suggests that A1 does not undergo plasticity, only auditory association areas (e.g. Bola et al., 2017; Lomber et al, 2010; Petitto et al., 2000; Lyness et al., 2013). However, there is some evidence that supports the opposite view (e.g., Finney et al., 2001). The discrepancy in these findings may be due to differences in methodological techniques, as the pre-processing steps and data analysis procedures can impact observed activations in MRI studies (Botvinik-Nezer et al., 2020).
Enhancements in Visual Processing Previous work examining the reorganization of the auditory cortex has found that deaf individuals have enhanced visual abilities compared to hearing subjects, as it is reorganized to support vision. These results support the functional preservation theory because the reorganized region responds to a different sensory modality. An
Alternatively, reduced cortical volume in deaf
early functional MRI (fMRI) study by Finney et
individuals would have suggested a “use or
al. (2001) compared brain activity in the auditory
lose” phenomenon, but this was not observed.
cortex of deaf and hearing subjects while pas-
Penhune et al. (2003) also demonstrated that
sively viewing moving stimuli. They observed in-
Issue XI | December 2021
79
creased activations in posterior superior tempo-
PSI Ψ perception of visual location. Additionally, areas
ral gyrus (pSTG) and in A1. Despite their study
involved in the detection of moving sounds, such
having a small sample size, their findings have
as the dorsal zone of the auditory cortex, were
been replicated by other researchers. For in-
involved in visual motion. The researchers used
stance, Shiell et al. (2015) found that the pSTG
a cooling deactivation technique that effectively
was responsible for visual motion detection in
lesioned areas of the brain. Thus, their findings
deaf individuals. In addition, they observed
provide causal evidence that cortical regions
greater connectivity between pSTG and visual
preserve their original function, but adapt to
areas in the occipital cortex in deaf compared to
receive input from a different sensory modality.
hearing subjects. This provides further evidence
Additionally, the results support evidence in hu-
that the pSTG is recruited for visual motion in
man studies that suggest that cross-modal or-
deaf individuals.
ganization of the auditory cortex occurs due to
A study by Bola et al. (2017) also investigated visual processing in deaf individuals. The researchers used fMRI to examine the brain areas involved in a visual rhythmic task in deaf and
hearing loss. However, it is important to consider that language ability plays a large role in neural plasticity (e.g., MacSweeney et al., 2008), a process that cannot be accounted for using animal
hearing subjects. Hearing participants were also
research.
given an auditory rhythmic task as a control.
Effects of Language
The researchers observed increased activity in the posterior-lateral section of high-level auditory areas in deaf individuals, an area that was activated in hearing subjects when they completed the auditory version of the rhythmic task. Furthermore, Bola et al. (2017) demonstrated strengthened functional connectivity between the auditory cortex and areas V5/MT in the visual cortex, a result similar to that of Shiell et al. (2015). Enhanced visual abilities have also been found in deaf animals. Lomber et al. (2010) demonstrated that the auditory cortex of congenitally deaf cats reorganizes to support vision. The posterior auditory field, a region typically involved in sound localization, was involved in the 80
Deaf individuals vary in their preferred method of communication. Some individuals use sign language exclusively, some rely on speech and residual hearing, others use lipreading or cued speech, and some use a combination of modalities (Schirmer, 2001). These language use differences affect neural plasticity. In particular, many studies have suggested that changes in brain structure and function may occur due to the use of sign language, as it relies on the visual modality, unlike spoken languages. An fMRI study by Cardin et al. (2013) investigated brain activity in deaf signers, deaf individuals who use spoken English, and hearing non-signers. Participants viewed videos of sign-based material that provided linguistic information to the deaf McGill Undergraduate Psychology Journal
signers, but only visual-spatial information to the
Research by Petitto et al. (2000) found ev-
deaf individuals who use spoken English and
idence illustrating that the auditory cortex be-
hearing non-signers. The results demonstrated
comes reorganized to support sign language
that plasticity in the left STC is shaped by sign
in deaf individuals. Using positron emission
language experience, whereas plasticity in the
tomography (PET), the researchers observed
right STC occurs due to loss of auditory input.
greater activity in key language areas that were
These findings shed light on how changes in the
thought to be unimodal sound processing areas
auditory cortex can arise due to sign language
including the bilateral planum temporale. They
use and provide additional evidence supporting
also observed greater activity in the left inferior
the functional preservation theory.
frontal cortex, a region sometimes referred to
Twomey et al. (2017) showed how sign language use influences cortical function. Using fMRI, the researchers examined brain activity in deaf signers and hearing fluent signers when completing a sign language phonological task, semantic task, and visual task. Regions of STC showed increased activity in response to the visual processing tasks in deaf individuals. Twomey et al. (2017) also observed hemispher-
as Broca’s area, that is responsible for speech production in hearing individuals (Petitto et al., 2000). Interestingly, this finding demonstrates that reorganization in deaf individuals does not only occur in the auditory cortex, but also in frontal language production areas. These results further highlight that language use plays a role in cortical reorganization in deaf individuals and illustrate that the reorganization is widely
ic differences in activation patterns within the
distributed throughout the brain.
deaf individuals. The right STC showed consis-
Interim Summary: Neural Plasticity
tent activation regardless of the task, suggesting that this area participates in low-level visual processing. In contrast, the left STC showed increased activation only during the sign language phonological task, demonstrating that the region participates in higher-level visuospatial processing that requires a linguistic component. These interhemispheric differences align with the findings reported by Cardin et al. (2013) and suggest that both basic visual processing and sign language drive functional preservation, and that both of these mechanisms can coexist.
Issue XI | December 2021
The auditory cortex is capable of undergoing many changes. It has been proposed that higher-order auditory association areas, in particular, are subjected to cross-modal reorganization, although some studies have found that the primary auditory cortex can also exhibit neural plasticity. More specifically, many researchers have demonstrated that the auditory cortex reorganizes to become involved in the perception of visual stimuli. It is also important to consider the effects of language, as many researchers propose that neural plasticity arises due to differences in the type of language input received 81
(i.e. signed versus spoken language). These
PSI Ψ An influential model introduced by Baddely
findings support the notion of functional preser-
and Hitch (1974) suggests that there are three
vation. In comparison, some researchers have
main components of working memory: central
found evidence suggesting that cortical areas
executive, visuospatial sketchpad, and phono-
may reorganize to support high-order executive
logical loop. The central executive acts as a
functions. Working memory is one such cogni-
control center, determining the information that
tive process that is explored in the next section.
gets loaded into the other two components and
Working Memory
how long it is maintained there. The visuospatial sketchpad and the phonological loop are two
Working Memory Ability in Deaf Individuals
subsystems that allow us to hold and manipu-
Working memory is an executive function that
sketchpad enables us to hold visual images in
enables us to hold and manipulate information in our minds. Unlike short-term memory, it is an active process (Hitch, 1985) that can be conceptualized as a “mental workbench” that serves other executive functions (Daneman & Merikle, 1996). It is highly related to other processes such as decision-making, planning, and attention (Chai et al., 2018). Working memory ability in deaf individuals is of importance because it has implications for learning and education. For instance, Marschark and Hauser (2008) point to the challenges that deaf children face when placed in a mainstream classroom setting with hearing children. The authors explain that one of the best practices for teaching hearing students is to use a combination of materials (e.g. visual and verbal). However, the working memory capacity of deaf students becomes overloaded when deaf students have to divide their attention between watching a sign language interpreter and viewing the visuals presented by the instructor.
82
late information in our minds. The visuospatial our minds, whereas the phonological loop allows us to remember words, phrases, and other sequences. While working memory is a crucial function for all individuals, the components of Baddely and Hitch’s (1974) model are especially applicable to deaf signers, as sign language requires both subsystems to be utilized concurrently. Deaf signers simultaneously use the visuospatial sketchpad to process hand movements and the phonological loop to hold linguistic aspects of sign language in mind (Marschark & Wauters, 2011). In addition, working memory ability has been examined in deaf individuals in the context of a model proposed by Just and Carpenter (1992). Their model conceptualizes language processing resources as global, modality-free aspects of working memory. Rönnberg (2011) examined behavioral and neuroscientific data that illustrated both modality-free and modality-specific aspects of working memory in deaf individuals. Rönnberg (2011) provides an example of a moMcGill Undergraduate Psychology Journal
dality-free aspect by explaining how speech and
The idea that the auditory cortex reorganiz-
sign aphasias manifest similarly. This demon-
es to support working memory functioning has
strates that there are common, modality-free
been demonstrated by Ding et al. (2015). Deaf
linguistic capacities that can be used for work-
and hearing subjects completed a visuospatial
ing memory, particularly for the phonological
delayed recognition task during an fMRI scan.
loop. Additionally, Rönnberg (2011) asserts that
Ding et al.’s (2015) findings showed that deaf
sensory processing is specific to sign language,
individuals had better working memory perfor-
and the right hemisphere demonstrates modali-
mance, and this elicited greater activation in
ty-specific aspects of working memory.
bilateral superior temporal gyrus (STG). More-
Working Memory as a Mechanism for Functional Change The models of working memory provide us with the background to understand how this cognitive process may be supported by cortical reorganization in deaf individuals, providing evidence for functional change, a theory that suggests that following loss of sensory input, the cortex becomes reorganized to support higher-order processes, such as executive functions (Cardin et al., 2020). Neuroimaging studies have provided evidence that functional change occurs in the cortex of deaf individuals. More specifically, auditory regions have been found to be involved in visual working memory tasks in deaf individuals (e.g. Buchsbaum et al., 2015; Ding et al., 2015; Cardin et al., 2018). Despite the learning challenges deaf children face due to working memory overload (Marschark & Hauser, 2008), working memory performance in deaf adults may be better than that of hearing individuals. This could be an effect of the fact that reorganized auditory cortical regions may be responsible for working memory ability.
over, they found greater connections between frontal eye fields and STG in deaf individuals. The researchers suggested that this result is indicative of a top-down mechanism that underlies crossmodal activation of auditory regions. The findings from Ding et al.’s (2015) study were critiqued by MacSweeney and Cardin (2015). One positive aspect of Ding et al.’s (2015) study was that they recruited a large number of participants. Importantly, however, they did not control for language experience. Therefore, Ding et al.’s (2015) findings could have been a result of language, such as delayed language acquisition, rather than explained by lack of auditory input. Thus, MacSweeney and Cardin (2015) posit that the involvement of STG in visual working memory in deaf individuals, the main finding observed by Ding et al. (2015), could be part of a compensatory mechanism for cognitive processing that occurs due to insecure and late language acquisition. A study by Cardin et al. (2018) found that auditory deprivation results in network-wide cortical reorganization for cognitive processing. More specifically, the researchers found that hearing
Issue XI | December 2021
83
PSI Ψ loss results in the recruitment of the STC during
light both modality-free and modality-specific
working memory. Importantly, unlike Ding et
neural mechanisms underlying working memory
al. (2015), they examined language ability and
performance in deaf individuals. The findings
ruled out the possibility that this finding was a
also support the functional change theory by
result of insecure or delayed language acquisi-
demonstrating how various brain regions shift to
tion. Furthermore, Cardin et al. (2018) observed
be recruited for executive functioning.
that the involvement of the STC was accompa-
Interim Summary: Working Memory
nied by weaker activations in frontoparietal regions typically involved in working memory. The researchers suggest that these findings indicate that the involvement of STC in working memory may be part of a larger network responsible for cognitive control. Finally, Cardin et al. (2018) were able to separate effects based on visuospatial processing versus linguistic processing. They found no effects specific to sign language working memory, thus providing evidence for modality-free aspects of working memory. Buchsbaum et al. (2015) examined working memory for spoken and sign languages. They found that a broad network including temporal, frontal, and parietal lobes underlies this ability, demonstrating modality-free regions that support working memory. In particular, they observed involvement from posterior frontal regions, left temporal-parietal junction regions, and bilateral posterior superior temporal sulcus for both speech and sign. Interestingly, Buschsbaum et al. (2015) also found evidence for brain areas that support modality-specific aspects of working memory. A left temporal-frontal network was more involved in verbal working memory for speech, whereas sign was more reliant on a parieto-frontal circuit. Overall, these results high84
The models of working memory proposed by Baddely and Hitch (1974) as well as Just and Carpenter (1992) help us organize the findings regarding working memory performance in deaf individuals. For example, the findings from Cardin et al. (2018) and Buchsbaum et al. (2015) illustrate modality-free and modality-specific aspects of working memory, which are components of the Just and Carpenter (1992) model. Furthermore, the results in this section support the functional change theory, which posits that following sensory loss, the cortex becomes reorganized to support higher-order cognitive functions. Overall, evidence from deaf individuals has found that auditory association areas of the auditory cortex, particularly regions of STC, are recruited for working memory due to hearing loss (e.g. Cardin et al., 2018; Ding et al., 2015; Buchscbaum et al., 2015).
Effects of Cochlear Implant and Hearing Aid Use
The use of devices such as cochlear implants and hearing aids may also play a role in neural plasticity in deaf individuals. Thus, a secondary goal of this literature review is to briefly examine how these devices may influence cortical reor-
McGill Undergraduate Psychology Journal
ganization. Cochlear implants are small devices
auditory and visual cortex functioning. If visual
that are surgically implanted to electrically stimu-
activation elicited by speech is a side effect of
late the auditory nerve, thereby allowing auditory
lipreading, then cross-modal activation may rep-
signals to travel from the inner ear to the brain.
resent a form of mental imagery. Zatorre (2001)
In contrast, hearing aids do not directly interact
also asserts that age is an important factor to
with the central nervous system. Instead, they
consider when examining cortical reorganiza-
act as amplifiers, enhancing the intensity levels
tion, as the brain is less likely to undergo neural
of incoming sounds (NIDC, 2015). Although the
plasticity as age increases.
mechanisms used by cochlear implants and hearing aids are different, they both aim to provide increased auditory signals to the brain.
More recently, a study by Shiell et al. (2015) examined visual abilities in deaf individuals who use hearing aids. The researchers found that
A PET study by Giraud et al. (2001) demon-
there was a relationship between hearing aid
strated that cochlear implant use was associat-
use and activity in pSTG in response to visual
ed with an increase in both auditory and visual
motion. Additionally, they found a correlation
cortex function. The researchers explain that
between hearing aid use and functional connec-
this finding may appear counterintuitive at first
tivity between the pSTG and visual cortex. More
because it might be expected that increased
specifically, the results indicated that individuals
cochlear implant use would enhance auditory
who had used their hearing aids for longer had
cortex function, but not visual cortex function.
less cross-modal activity in the pSTG and de-
However, Giraud et al. (2001) point out that the
creased functional connectivity between pSTG
visual cortex may show increased activity over
and visual areas. These findings suggest that
time because it participates in speech decoding.
hearing aid use may inhibit neural plasticity in
After all, many deaf cochlear implant users have
deaf individuals, which goes against findings
learned to use lipreading to supplement the au-
from Giraud et al. (2001). This discrepancy may
ditory input to understand speech.
arise due to differences in methodologies (PET
Zatorre (2001) provided a commentary on Giraud et al.’s (2001) study and provided explanations for their findings, as well as men-
versus fMRI) and differences in hearing devices examined (cochlear implants versus hearing aids).
tioned other factors to consider. Zatorre (2001)
Lyness et al. (2013) reviewed how visual
discussed that an interaction between visual
language impacts cochlear implant success in
and auditory information has been established
relation to neural plasticity. Importantly, the re-
which supports Giraud et al’s (2001) finding that
searchers argued that the use of sign language
cochlear implant use was related to increased
is not empirically related to poor cochlear implant
Issue XI | December 2021
85
PSI Ψ outcomes. In other words, choosing to use a vi-
to support visual abilities, as discussed in this
sual language despite having a cochlear implant
review. However, some studies have also ex-
does not impede auditory language skills. The
amined how auditory regions may support other
authors point to findings illustrating that auditory
sensory modalities such as somatosensory in-
association areas can be activated by complex
formation (e.g. Karns et al., 2012). Future work
visual stimuli, regardless of linguistic content,
is needed to uncover the mechanisms underly-
and this cross-modal reorganization is due to
ing this process.
lack of auditory input and not language. Moreover, Lyness et al. (2013) suggest that plasticity does not occur in the primary auditory cortex, but rather only in association areas. Thus, individuals with cochlear implants are still able to process auditory information in a typical manner. Overall, these results do not suggest that visual language causes maladaptive plasticity in auditory areas and thus, visual communication does not affect cochlear implant outcomes.
The research presented in this review is only the beginning of our understanding of the effects of neural plasticity in deaf individuals. There are many areas for study that are yet to be investigated. Providing additional evidence to support the notions of functional preservation and functional change, as well as reconciling the two theories would help improve our understanding of the extent that neural plasticity occurs in the brain. Functional preservation theory suggests that cortical areas become reorganized to support the same function, but in a different modalAn important body of
work investigating this theory has focused on how the auditory cortex becomes reorganized 86
auditory cortex plays a role in other cognitive processes aside from working memory. For instance, working memory is highly related to other executive functions such as attention and decision-making (Chai et al., 2018). Thus, it is plausible that reorganized auditory cortex underlies these cognitive processes too. The findings from a study examining the recruitment of auditory cortex for other executive functions would potentially support the functional change
Future Directions
ity (Cardin et al., 2020).
It is also important to examine whether the
theory, which posits that following cortical reorganization, cortical areas support higher-order executive functions. Additionally, more research is needed at the molecular level to examine how these two theories could be reconciled. For instance, different cortical layers in the same region can support different functions (Rolls & Mills, 2017). Perhaps some cortical layers underlie enhancements in visual abilities, whereas others support working memory. Thus, differences in the cytoarchitecture of the auditory cortex in deaf individuals could explain how functional preservation and functional change could coexist in the same region (Cardin et al., 2020). High spatial resolution
McGill Undergraduate Psychology Journal
laminar fMRI studies would help investigate this
ability. It is important to examine neural plasticity
possibility.
in this context as it advances our knowledge of
The research presented in this review mainly focused on the neural plasticity in the auditory cortex. However, cortical reorganization in deaf individuals has also been demonstrated in the frontal (Petitto et al., 2000) and parietal (MacSweeney et al., 2008) lobes. Further studies could investigate how hearing loss affects neural plasticity in these regions. This would not
the brain’s abilities and may help inform clinical interventions for deaf individuals. Furthermore, we synthesized current findings regarding neural plasticity in deaf individuals and illustrated how they support the functional preservation or functional change theories. We also examined how cochlear implant and hearing aid use may impact cortical reorganization and presented
only improve our understanding of cortical reor-
suggestions for future research.
ganization, but would also illustrate that neural
References
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Conclusion
The study of deaf individuals has contributed to our knowledge of cortical reorganization by illustrating how differential sensory experience can influence brain structure and function. We explored the effects of neural plasticity in deaf individuals with an emphasis on working memory Issue XI | December 2021
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Appendices Appendix A: Author’s Note
When studying a clinical population, it is important to keep in mind that the individuals are real human beings, not merely test subjects. Thus, it is crucial that researchers understand the difficulties the individuals face, as well as other psychological and social dimensions that arise due to their disability. For deaf individuals, in particular, it is important to note that they comprise a very heterogeneous group. As such, learning about Deaf history and culture helps put scientific findings in perspective. Before starting to work on this literature review, several articles, book chapters, and documentaries about deaf individuals were reviewed and consulted in order to obtain the background information needed to carry out this research project. The resources examined are listed in Appendix B.
Appendix B: Background References Brodsky, I. T. (Director). (2007). Hear and Now [Film]. New York, NY: Filmakers Library.
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science, 37(39), 9564–9573. https://doi.org/10.1523/ JNEUROSCI.0846-17.2017 von Bernhardi, R., Bernhardi, L. E., & Eugenín, J. (2017). What Is Neural Plasticity? Advances in Experimental Medicine and Biology, 1015, 1–15. https://doi. org/10.1007/978-3-319-62817-2_1 Zatorre, R. J. (2001). Do You See What I’m Saying? Interactions between Auditory and Visual Cortices in Cochlear Implant Users. Neuron, 31(1), 13–14. https:// doi.org/10.1016/S0896-6273(01)00347-6 Zatorre, R. J. (2002). Auditory Cortex. In V. S. Ramachandran (Ed.), Encyclopedia of the Human Brain (pp. 289–301). Academic Press. https://doi.org/10.1016/ B0-12-227210-2/00046-7
Hott, L. R., Garey, D. (Directors). (2007). Through Deaf Eyes [Film]. WETA Washington, D.C. and Florentine Films/Hott Productions, Inc., Ling, D. (1984). Early intervention for hearing impaired children: oral options. College-Hill Press. MacDougall, J. C. (2005). The psychological impact of childhood hearing impairment and deafness: Implications for clinical management. ENT News. Pinpoint Publications. Edinburgh, Scotland. MacDougall, J. C. (2004). Irreconcilable Differences: The Education of Deaf Children in Canada. Education Canada, Special Edition on Exceptional Children. Canadian Education Association, Winter Issue. Maller, S. J., & Braden, J. P. (2011). Intellectual assessment of deaf people: A critical review of core concepts and issues. In The Oxford handbook of deaf studies, language, and education, Vol. 1, 2nd ed (pp. 473– 485). Oxford University Press. Moores, D. (2001). Educating the Deaf Psychology, Principles, and Practices (5th ed.). Boston, MA Houghton Mifflin Company. Sacks, O. (1986.). Mysteries of the Deaf. Retrieved December 10, 2020, from https://www.nybooks.com/articles/1986/03/27/mysteries-of-the-deaf/ Tranchin, R. (Director). (1993). For a Deaf Son [Film]. KERA-TV, Dallas/Fort Worth
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Examining Dynamic Norms:
A Direct Replication of Sparkman and Walton (2017), With An Extension on the Moderating Effects of Culture Qilongyue Chen, Chevieve Heri, Steven Leu & Connie Yun Supervisor: Dr. Eric Hehman
Ψ PSI Journal
Abstract Can highlighting the change of a norm over time (a dynamic norm) be more influential than presenting a norm at its current state (a static norm) in promoting conformity of sustainable behaviour? We investigated this phenomenon by doing a direct replication of the first experiment of Sparkman & Walton’s (2017) “Dynamic Norms Promote Sustainable Behaviour, Even if It Is Counternormative”. This was an online experiment that examined the interest in reducing meat consumption in the dynamic-norm condition, in comparison to the static-norm condition. In addition to the direct replication, we used a demographic survey to investigate whether identification with the American culture as well as identification with a vegetarian-friendly culture would have an influence on this effect. Although the original experiment found that dynamic norms motivated greater change than static norms, both our replication and additional experiments did not yield significant results. However, we suspect that several limitations to our study may account for these insignificant findings. Keywords: direct replication, dynamic norm, static norm, sustainable behaviour
A significant, extensive research area in social
ple’s behaviour over time, regarding sustainable
psychology has been the investigation of meth-
behaviour. Could dynamic norms, in contrast to
ods inducing prosocial behaviour. Examples of
static norms, have a significant impact on induc-
studies in this field include the watching-eye
ing sustainable prosocial behaviour? The orig-
effect on reducing littering (Ernest-Jones et al,
inal study consisted of five experiments, rang-
2011; Bateson et al, 2013), the effect of inter-
ing from online surveys to field experiments,
group comparison on willingness to perform
investigating the effects of dynamic norms on
sustainable behaviour (Ferguson et al, 2011),
interest in meat consumption reduction, real-life
and the use of social norms in encouraging sus-
food selection in a cafeteria setting, and water
tainable behaviour (Poškus, 2016). In Spark-
conservation in a laundry facility. Our study is a
man and Walton’s 2017 study, they explored the
direct replication of experiment 1, an online sur-
effects of dynamic norm statements, wherein
vey examining the effect of dynamic norms in in-
there is an explicitly stated change of other peo-
creasing interest in reducing meat consumption.
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McGill Undergraduate Psychology Journal
Background Original Study In the original experiment 1, Sparkman and
0.41, 95% confidence interval (CI) for the difference in means = [0.08, 1.49]. A graph of these results is provided in Figure 1.
Walton (2017) hypothesized that a dynamic norm would increase people’s interest in reducing meat consumption relative to a static norm. They explained that reducing meat consumption involves changing personal dietary habits and violating the prevalent norm, which might make change difficult. They expected this change to occur due to two processes: first, it involves pre-conformity, which means that people conform to an emerging norm when they feel a behaviour increases in prevalence for anticipating it to be normative in the future; second, when people see others are changing, they may reconsider the importance and possibility of changing the status quo. Sparkman and Walton found that participants randomly assigned to be exposed to the dynamic-norm statement were more interested in reducing their meat consumption compared to those exposed to the static-norm statement. Although there were significant main effects of gender and political orientation, in that females and liberals reported increased interest in reducing meat consumption than males and conservatives respectively, there was no interaction effect for either of the variables. The original research (N = 118, 43 female, 75 male) yielded statistically significant effects comparing the dynamic-norm condition (M = 3.48, SD = 2.04) to the static-norm condition (M = 2.70, SD = 1.83), t(116) = 2.20, p = 0.03, d = Issue XI | December 2021
In the comparison of political orientation, the difference between liberals and conservatives was significant, t(116) = 2.06, p = .041, b = 0.27. The contrast between male and female were also found to be statistically significant, t(116) = 2.73, p < .01, d = 0.51. After controlling for gender and political orientation using multiple regression and dummy coding approach, the main effect remained significant, t(114) = 2.01, p = 0.047, d = 0.38. Additionally, there was no interaction effect found for either gender or political orientation, ts < 1.20. 91
PSI Ψ
These results suggest that in contrast to
Supplemental Hypothesis. In addition to the
static norms, dynamic norms significantly in-
alternative hypothesis, we had an auxiliary
crease interest in sustainable behaviour (meat
hypothesis to see whether association with a
consumption reduction), even when the norm is
vegetarian-friendly culture would moderate the
considered counter normative.
likelihood of reducing meat-eating in the dynam-
Current Study
ic-norm condition, compared to the static-norm
Main Hypothesis. Our group completed a direct replication of experiment 1 of the original paper. Specifically, we aimed to test whether dynamic-norm statements promote more substantial interest in reducing meat consumption than static-norm statements. Moreover, as tested in the original study, we wanted to figure out whether differences in gender result in a difference of interests in reducing meat consumption. Alternative Hypothesis. The main alternative hypothesis is whether association with the American culture moderates the likelihood of reducing meat-eating in the dynamic-norm condition, compared to the static-norm condition. The original study only had American participants as it was conducted in the United States and targeted the general American population. As our replication was conducted in Canada at McGill University, known for its international student body, participants were more likely to be culturally diverse. Our goal was We wanted to see if the original findings were generalizable and applicable to those in other cultures. To test this, we conducted a demographic survey to collect the participants’ cultural background, along with questions to measure individual association with the American culture.
92
condition. Different cultures have different dietary habits, and, thus, we theorized that people from vegetarian-friendly cultures could have a preexisting inclination to reduce their meat consumption in comparison to those from nonvegetarian-friendly cultures. Therefore, we wanted to see if there would be a significant difference in the reduction of meat consumption between these two groups, regardless of association with the American culture.
Method Participants In exchange for 0.25 extra credits, a total of 130 McGill student participants (120 female, 10 male) took part in the study. All participants were recruited through SONA, an undergraduate participant pool, and completed “Study on Daily Eating Habits 3” through an online Qualtrics questionnaire. The name “Study on Daily Eating Habits” was used to avoid response bias throughout the study. In addition, students were eligible to participate as long as (1) they were 18 years of age or older, and (2) they did not participate in either “Study on Daily Eating Habits 1” or “Study on Daily Eating Habits 2”, which examined the same original hypothesis as this particular study. McGill Undergraduate Psychology Journal
General design
Following this, all participants were asked to rate
The study had two between-subjects conditions:
how interested they were in eating less meat
static-norm and dynamic-norm. The following is
on a scale of 1 to 7 (1 = not at all, 4 = some-
Sparkman & Walton’s description of the stat-
what, 7 = extremely). In addition, researchers
ic-norm and dynamic-norm conditions:
of the original study highlight that if participants
In the static-norm condition, participants read: “Recent research has shown that 30% of Americans make an effort to limit their meat consumption. That means that 3 in 10 people eat less meat than they otherwise would. In the dynamic-norm statement, participants
inferred a higher static-norm in the dynamic-norm condition, this could be an alternative explanation to the results. Thus, to assess the perceptions of the static norm, participants were asked, “What percentage of people do you think
read: “Recent research has shown that, in the last 5 years, 30% of Americans have now started to make an effort to limit their meat consumption. That means that, in recent years, 3 in 10 people have changed their behaviour and begun to eat less meat than they otherwise would.”
make an effort to limit their meat consumption?”
Sparkman and Walton (2017) note in their
were also asked to report their political ideology
study that while the static-norm statement is emphasizing that some people, in general, are trying to eat less meat, the dynamic-norm statement emphasizes that some people are currently changing and are now trying to eat less meat. Following this statement, participants were asked to fill out a 12-item questionnaire, six of which were part of the original survey done by Sparkman and Walton. Out of the twelve items, eight were multiple-choice, while four were text-entry questions. Answers to these text-entry items involved either numerical input or 1-2 worded responses.
Original study procedure Participants read a statement in either the static-norm condition or dynamic-norm condition. Issue XI | December 2021
Furthermore, to ensure that there were no differences in construal of behaviour across conditions, participants were then asked to estimate the number of meatless meals eaten each week by people who limited their meat consumption (Sparkman & Walton, 2017). Finally, participants (1 = very liberal, 7 = very conservative), as well as whether they were practicing vegetarianism or veganism.
Supplemental procedures Following the items of the original study, participants were asked additional demographic questions to investigate the impact of one’s identified culture on the norm statements. Firstly, in addition to Sparkman and Walton’s original demographic questions about gender and political stance, a question asking participants about their age was included; this was incorporated mainly to provide context for the following demographic items. Subsequently, items related to cultural identity were asked. Recalling the original study, the 93
researchers only looked at U.S. adults who read
PSI Ψ all participants identifying with such cultures
either a static-norm or dynamic-norm statement
would be placed under the broad “East Asian’’
about other Americans reducing their meat con-
culture category, which would not be a good
sumption (Sparkman & Walton, 2017). To as-
measurement of our supplemental hypothesis
sess the moderating effect of American culture
nor a representative sample of the culture. To
on the main effect, we asked participants to rate
avoid this, we then asked participants to spe-
how strongly they identified with the American
cifically list and rate their two strongest cultures
culture (1 = not at all, 4 = somewhat, 7 = ex-
(1 = not at all, 4 = somewhat, 7 = extremely).
tremely).
This was done to account for multiculturalism,
Following this, we wanted to see if identification with other cultures, particularly vegetarian-friendly cultures, would moderate the likelihood of reducing meat-eating in the dy-
and for analysis, we chose the higher-rated of the two cultures. Additionally, if participants only identified with one culture, we included the option to select “Not Applicable (N/A)”.
namic-norm condition relative to the static-norm
For this study, vegetarian-friendly cultures
condition, regardless of identification with the
were defined as cultures with the highest rates
American culture. To address this, we provided
of vegetarianism. Thus, vegetarian-friendly cul-
a list of several cultures and asked participants
tures included were those of India, Sri-Lanka,
to select all cultures that applied to them. A vi-
Bangladesh, Nepal, Pakistan, Bhutan, Israel,
sualization of this question is given in Figure 2.
Taiwan, and Canada (Sawe, 2019).
The listed cultures were very generalized and nonexclusive to specific cultures. This alone would not be useful in testing the supplemental hypothesis. For example, the rates of vegetarianism in Taiwanese and Korean culture are noticeably different at 13% - 14% and 3%, respectively (Ock 2017; Fulco 2019). However,
Results Replication study results 17 participants (13.1%) reported being vegan or vegetarian, and thus were excluded from the analysis of both the replication and the alternative hypotheses; similar to the original study, the purpose of this exclusion was to ensure that participants could potentially be influenced by the norm status and show an interest in reducing meat consumption (N = 113; 105 female, 8 male). Participants in the static-norm condition were compared to participants in the dynamic-norm condition to see if there were differenc-
94
McGill Undergraduate Psychology Journal
es in the interest to eat less meat between the
meat-eating was not statistically significant,
two groups. If the data were to show evidence
t(109) = 1.07, p = 0.29.
of replication, we would find a similar pattern of effects to the original study, specifically, that participants in the dynamic-norm condition were significantly more likely than participants in the static-norm condition to indicate interest in reducing meat consumption. Conversely, if the data were not to show evidence of replication, we would find either an insignificant difference between the dynamic-norm and static-norm conditions in interest in reducing meat-eating, or an opposite significant effect of participants in the static-norm condition indicating higher levels of interest in reducing meat consumption than participants in the dynamic-norm condition. An analysis of the data collected revealed no significant difference between the dynamic-norm condition (M = 4.11, SD = 1.63) and the static-norm condition (M = 3.98, SD = 1.45), t(111) = -0.43, p = 0.67, 95% confidence interval
Supplemental Hypothesis Results. To investi-
for the difference in means [-0.70, 0.45] The
gate the effect of vegetarian-friendly cultures on
visualization of the results is given in Figure 3.
the main results, a simple moderator analysis
In regards to looking at gender, women reported greater interest in reducing meat consumption than men, t(109) = -2.40, p = 0.02.
was performed. The interaction effect of association with a vegetarian-friendly culture on interest in reducing meat-eating was not statistically
However, there was no interaction between
significant, t(14) = -0.67, p = 0.515.
norm condition and gender, p = 0.71.
Interpretation
Alternative Hypothesis Results. To investigate
It is possible that being a non-vegetarian from
the effect of the American culture on the main results, a simple moderator analysis was performed. The interaction effect of association with American culture on interest in reducing
Issue XI | December 2021
a vegetarian-friendly culture might act as a “protective factor” that reduces the likelihood of reducing meat consumption. This is further evidenced by the observation that 85.71% of the 17 participants who were excluded from the main 95
PSI Ψ
study for stating that they were vegetarian or
tial moderators of the relationship between the
vegan were from a vegetarian-friendly culture.
norm conditions and the behavioural measure
The following tables (Table 1 and 2) summarize
also proved to be insignificant. Despite all this,
the results of the study.
there exist limitations in the study design as a consequence of this study being a direct replication that may account for the insignificant results.
Limitations and Future Directions One limitation in the study design is the norm statement and its potentially poor generalizability to populations outside of the US, due to its use of the term “Americans”. Whereas the original study had exclusively American
participants,
our
study’s subject pool consisted primarily ofof primarily Canadian andor international students. Consequently, the term “Americans” in the norm statement may trigger a schema of their own native society for US participants, whereas a foreign soci-
Discussion
In our direct replication of Sparkman and Walton’s 2017 experiment 1 in their study on dynamic norms inducing behavioural change, our results proved to be insignificant, with a minimal difference in the behavioural measure between the dynamic- and static-norm conditions (4.11 and 3.98, respectively). As our population was skewed by gender, due to a significantly greater proportion of females, we also tested for gender; yet, though there was a main effect of gender as in the original study, there was no interaction effect. Our extension hypotheses of identification with American and vegetarian cultures as poten96
ety schema may be triggered for non-US participants; this difference in applied schema may explain the discrepancy in results between the original study and our replication. One of our supplemental hypotheses was that identification with American culture may have been a moderating variable; however, this identification may not be equivalent to American citizenship. For instance, someone who highly identifies with American culture may only be enamoured with the culture, despite not actually being American. In this case, the term “Americans” in the norm statement would still trigger their foreign society schema. McGill Undergraduate Psychology Journal
The use of the term “Americans” in the norm
to clarify whether the term “Americans” in the
statements may also be troublesome in anoth-
norm statement itself is responsible for the in-
er aspect, namely due to the historical effect of
significant findings. For future replications done
the COVID-19 crisis. Recent survey data by the
in the US, researchers may consider controlling
nonpartisan Pew Research centre has shown
for the perception of Americans to account for
that as a result of the United States’ arguably
this historical effect or mayto wait for the Ameri-
suboptimal handling of the pandemic crisis,
can reputation to sufficiently improve (based on,
and their concurrent political strife, the global
for example, national or global polling data). In
perception and reputation of Americans has sig-
regard to the CREP replication meta-analysis,
nificantly lowered (Wike et al, 2020). Wike et al
a suggestion would be to compare replications
(2020)’s survey data, based on responses from
completed in 2020 to future years, in order to
13,273 adults in 13 countries around the world,
control for this potential historical effect.
found that positive views of the US had fallen to a median of 34% across the countries surveyed, and only 15% believed that the US handled the coronavirus well. In many countries, including Canada, Australia, and the UK, the proportion of the public with a favourable view of the U.S. was reported to be at a record low since the research centre began polling on the subject almost twenty years ago. This worsened USU perception of the US may have resulted in the dynamic norm exhibiting a muted effect on the behavioural measure, in that the norm statements regarding “Americans” may have a lesser or even opposite effect on one’s interest in changing their behaviour to align with Americans. A simple solution to account for the effect of the term “Americans” in the norm conditions would be to include additional dynamic and norm statements referring to the study’s native country - in this study’s case, “Canadians”. With this additional set of norm conditions, results can be compared between the condition sets Issue XI | December 2021
In addition to this solution, a potential improvement to the study design would be to increase subject focus on the norm statement conditions when presented, strengthening the effect of the dynamic norm if it does exist. To accomplish this, an open-ended question could be included on the same page of the survey referring to the norm statement, with the idea of allowing the participant to consider the statement to a greater extent. This question should draw attention to the statement while limiting the possibility of being a confound itself, due to, for instance, attitude polarization. As such, the question should be intentionally brief and neutrally worded; Figure 4 is shown on the next page as an example. For future directions in further examining the nature of dynamic norms using this study as a basis, experimental manipulations can be performed on the norm statement; examples include using conditions with differential percentages of people undergoing change, or ma97
PSI Ψ nipulating the time period in which change has
salience of the statement, can serve to eluci-
occurred. This would shed further light on the
date the effect of dynamic norms on behaviour.
boundary conditions in which dynamic norms
Ultimately, despite our results, we believe that
may operate, especially if these investigations
dynamic norms and their potential impact in cat-
are performed using a combination of survey
alyzing significant behavioural change, such as
and field experiments, as done by Sparkman
sustainable behaviour, remains a topic of signif-
and Walton (2017).
icant potential and interest. References
Bateson M, Callow L, Holmes JR, Redmond Roche ML, Nettle D (2013). Do Images of ‘Watching Eyes’ Induce Behaviour That Is More Pro-Social or More Normative? A Field Experiment on Littering. PLoS ONE 8(12): e82055. https:// doi.org/10.1371/journal.pone.0082055
Conclusion
With regards to Sparkman and Walton’s (2017) original hypothesis in experiment 1 on dynamic norms inducing behavioural change, our direct replication results were insignificant. Though our study failed to replicate, this may have been due to limitations regarding the study design as a consequence of being a direct replication rather than the genuine nonexistence of a dynamic-norm effect. As Sparkman & Walton (2017) themselves note in their study, future researchers aiming to study the effects of dynamic norms should “ensure they successfully manipulate or induce the salience of the dynamic norm”. Future conceptual replications using the proposed study modifications regarding the norm statement condition, such as appropriately modifying the term “Americans” and increasing the 98
Ernest-Jones, M., Nettle, D., & Bateson, M. (2011). Effects of eye images on everyday cooperative behaviour: A field experiment. Evolution and Human Behaviour, 32(3), 172-178. https:// doi:10.1016/j.evolhumbehav.2010.10.006 Fulco, M. (2019, January 8). Meatless Dining - for Religion or Lifestyle. Retrieved from https://topics.amcham.com. tw/2019/01/meatless-dining-for-religion-or-lifestyle/ Ock, H. (2017, June 16). [Weekender] Korea turns corner on going meat-free. Retrieved from http://www.koreaherald.com/view.php?ud=20170616000617 Poškus, M. S. (2016). Using social norms to encourage sustainable behaviour: A meta-analysis. Psichologija, 53, 44–58. https://doi.org/10.15388/Psichol.2016.53.10031 Sawe, B. E. (2019, September 20). Countries With The Highest Rates Of Vegetarianism. Retrieved from https:// www.worldatlas.com/articles/countries-with-the-highest-rates-of-vegetarianism.html Sparkman, G., & Walton, G. M. (2017). Dynamic Norms Promote Sustainable Behaviour, Even if It Is Counternormative. Psychological Science, 28(11), 1663-1674. https://doi:10.1177/0956797617719950 Wike, R., Fetterolf, J., & Mordecai, M. (2020, December 10). U.S. Image Plummets Internationally as Most Say Country Has Handled Coronavirus Badly. Retrieved from https://www.pewresearch.org/global/2020/09/15/ us-image-plummets-internationally-as-most-say-country-has-handled-coronavirus-badly/
McGill Undergraduate Psychology Journal
Ecology as a Mean:
A Replication of ‘Going Green to Be Seen’ Amar Alany, Carly Fraser, Joanna Ma & Lauréanne de Verteuil Supervisor: Dr. Eric Hehman
Ψ PSI Journal
Abstract
It is no secret we are living in an environmental crisis that is (at least) partly caused by modern-day consumerism. For this reason, there has been interest among researchers to explore ways to motivate people to buy more environmentally conscious products. Griskevicius et al. (2010) explored the role of priming status motives on the likelihood of selecting the pro-environmental alternatives of equally priced products . They discovered that activating a status motive, through the reading of a status priming story, increases the likelihood of choosing green products over their non-green luxurious counterparts. With the goal of advancing knowledge and helping with the replication crisis in psychology, our team has re-run this study to discover if the effects found by Griskevicius et al. (2010) could be replicated. This replication was completed as part of the Collaborative Replications and Education Project (CREP). An additional hypothesis was added to this replication project investigating the possible moderating role of extraversion. We were not able to replicate the original findings, nor were we able to observe a moderating effect. This study will soon be included in a meta-analysis within the Collaborative Replication Education Project, which will provide more insight on the reliability and validity of Griskevicius et al. (2010) observed effect. Keywords: status, motivation, green, environment, consumerism
Background
did not investigate pro-environmental choices
to find methods to motivate people into making
tive altruism suggested that individuals compete
In today’s environmental crisis, it is important pro-environmental purchasing choices. Published in the New York Times, the CNW Marketing Research of Bandon team explored this goal by investigating what motivates people to buy a ‘green’ Prius car. Their research demonstrated that the principal reason for buying a ‘green’ car was that “it made a statement about me” (Maynard, 2007). Inspired by this article, Griskevicius et al.(2010) decided to investigate a possible link between green products and social status . Previous research supported the relationship between altruistic behavior and status, but it Issue XI | December 2021
specifically. For example, research on competifor status by trying to be seen as relatively more altruistic (Barclay & Willer, 2007; Hawkes, 1993; Roberts, 1998; Van Vugt et al, 2007, as cited in Griskevicius et al., 2010, p. 393). The Costly Signaling theory suggests that altruistic acts are used as a communicative signal to indicate one’s ability and one’s willingness to incur costs (Bird & Smith, 2005, as cited in Griskevicius et al., 2010, p. 394). So, in addition to communicating prosociality, altruism can convey that one has enough valuable resources (e.g.: time, money, etc.) to allow him/her to incur costs without 99
PSI Ψ affecting his/her fitness, thus increasing one’s
that if the effect persists, it would increase the
status (Griskevicius et al., 2010, p.394).Griskev-
original study’s reliability, and show generaliz-
icius and colleagues decided to investigate this
ability of this effect, which is increasingly import-
theory in the context of consumer choices. The
ant within the context of the replication crisis in
authors separated participants into two groups:
psychology.
the experimental condition which was primed
Additional Hypothesis
with a status motives story and a control group which read an non-environmental story or no story at all would increase the likelihood of choosing a prosocial green product (signalling high status) over an equally priced yet more luxurious non-green product (signalling lower status). Results indicated that green choices increased significantly in the status priming condition going from 37.2% to 54.5% for the green car selection, from 25.7% to 41.8% for green household cleaner selection, and from 34.5% to 49.1% for t green dishwasher selection (Griskevicius et al., 2010). A one-way analysis of variance on the product composite showed a significant effect of status;F (1, 166) =8.53, p=.004 - as well as a moderate effect sized=0.47. These results, therefore, supported the primary hypothesis that eliciting status motives increased the likelihood of choosing prosocial green products over nongreen luxurious products. This present study sought to conduct a replication of Griskevicius et al.’s Study (2010). Specifically, it revisited the hypothesis that activating a desire for social status increases the likelihood of choosing a prosocial green product over a more luxurious non-green product of the same price. This study examined if this effect applies in a different sample. It was believed 100
Griskevicius and colleagues did not investigate the mechanisms behind the relationship of their primary hypothesis. It is possible that examining an individual’s level of extraversion might have acted as a driving factor of purchasing choice; in other words, it could have been a moderating variable. Thus we additionally hypothesized that individuals with high extraversion personality traits would be more susceptible to status manipulation and would therefore be more likely to select green pro-environmental products than luxurious products. On the other hand, individuals low in extraversion would have a lower probability of purchasing “green”. Extraversion, as one of the dimensions of the Big Five personality traits, implies an “energetic approach to the social and material world and includes traits such as sociability, activity, assertiveness, and positive emotionality” (John & Srivastava, 1999). Social influence and status are expected to be highly valued by extroverts. This is further supported by previous research, which has found that in a sample composed of undergraduates from either a fraternity, a sorority, or some mixed-sex group, extraversion resulted in the most variance in ratings of status, regardless of the rated physical attractiveness of the evaluated target. (Anderson et al., 2001). McGill Undergraduate Psychology Journal
Hence extraversion has demonstrated a strong
story (see Appendix A). They were instructed to
positive association with pro-environmental at-
‘try to put [themselves] in the shoes of the main
titudes in comparison to other personality traits
character and experience the emotions that
(Tang & Lam, 2017).
they are feeling.” The second control condition
Our current research took a step further and
did not read a story.
investigated if the relationship between status
Next, all participants completed the three-
motive and pro-environmental behavior can be
item questionnaire assessing their green prod-
moderated by one’s extraversion personality
uct preferences. They were instructed to imag-
trait. We expect that an interaction effect would
ine that they are shopping for three products:
emerge when investigating the effects of extra-
a car, a household cleaner, and a dishwasher.
version and status motives. The Eysenck Per-
For each product, displayed in a random order,
sonality Inventory was used to examine whether
they then read a short description for an envi-
such an interaction exists.
ronmentally friendly option and a more efficient
Methods
104 participants were recruited from McGill’s participant pool, consisting of undergraduate psychology students. Participants received extra credit for their completion of a web-based survey on Qualtrics. In order to prevent bias, participants were told this experiment was an assessment of memory recall in university students. This research used a between-subjects design with one experimental and two control conditions. After agreeing to the consent form, participants were randomly assigned to one of three conditions. Those in the experimental condition read a story following a recent graduate’s experience standing out in a new job, which was designed to activate a social status motive (see Appendix A). The control condition read a story about going to a concert with a friend, designed to activate equal positive affect as the other Issue XI | December 2021
and conventional option (see Appendix B). Participants then answered the following two-option question for each product type: “If you were out shopping for a car/dishwasher/household cleaner, which of these two products would you buy?” Participants were told that this was a distraction task to prevent memory rehearsal. Once all questions were answered, participants completed 24 yes/no items from the Eysenck Personality Inventory (see Appendix C). On this questionnaire, higher scores correlate to higher extraversion levels. The subjects were told this was another distraction task. Completion of this task marked the end of the survey and participants were debriefed on the true aims of the study.
Results
We hypothesized that original findings by Griskevicius et al. (2010) would replicate: activating status motives would increase the like101
PSI Ψ
lihood of choosing a prosocial green product
the null hypothesis that activating a status mo-
over an equally priced yet more luxurious non-
tive would not have a significant effect on the
green product. As was the case in Griskevicius
likelihood of choosing a prosocial green product
et al.’s original paper, we first investigated the
over an equally priced more luxurious non-green
differences between the two control conditions
product.
on the product preference task. We found that participants in the no story control group did not significantly differ from participants in the control story group on the selection of the green car (51.3% in the story control vs. 53.3% in the no story control; p = 0.868), green cleaner (59.0% in the story control vs. 56.7% in the no story control; p = 0.850), or the green dishwasher (51.3% in the story control vs. 46.7% in the no story control; p = 0.0.709). Thus, the control groups were combined under “Control” in later analyses.
In addition, we also examined the possible moderating effect of extraversion for this relationship between status activation and product choice. We hypothesized that individuals high in extraversion would be more susceptible to status manipulation and would therefore be more likely to select green products than luxurious products. Even though interactions between variables can still occur when there is no main effect, it is unlikely that the extraversion variable we added moderated the effect of status on product preference, as Nevertheless, we found
We compared the merged control condition
that as the average person increased by 1-point
to the status story condition for each product.
on the extraversion inventory, their likelihood of
As seen in Figure 1 (see Appendix D), there
choosing a green product increased by 0.03%
were no significant differences
in participants’
(t= 0.588, p = 0.5579 ). Figure 2 (see Appendix
preference for e a green car (52.2% in the con-
D) represents each group’s average number of
trol vs. 54.1% in the status manipulation; t(104)
green products selected by level of extraver-
=0.18311, p = 0.855), a green cleaner (58.0%
sion, displaying one standard deviation in both
in the control vs. 56.8% in the status manipula-
directions. Hence, for each group, going one
tion; F(68, 36) = 0.98009, p = 0.921), or a green
standard deviation above or below the mean
dishwasher (49.3% in the control vs. 54.1% in
for extraversion did not significantly affect the
the status manipulation; F(68,36) = 0.99361, p
number of green products selected both in the
= 0.959).
control condition (M=1.61, SD= 0.08) and in the
Further, a one-way ANOVA was carried out for the overall product preference, which looked at the main effect of status across all products and did not indicate significance: F(1,104): 0.059, p = 0.808. We therefore could not reject 102
status condition (M=1.66, SD=0.04)
Conclusion
The present study reexamined the previous research conducted by Griskevicus et al. (2010) Going Green to be Seen on whether eliciting McGill Undergraduate Psychology Journal
status motives will lead people to choose a pro-
the participants . Overall, it is unclear exactly
social green product over an equally priced lux-
why our study failed to replicate Griskevicius et
urious non-green product and to display views
al. (2010) finding. However, we believe that the
of pro-sociability and altruism. Our study addi-
meta-analysis that will be done by CREP will
tionally investigated whether individuals’ level of
provide insight on the reliability and validity of
extraversion personality traits will be a factor
the effects originally observed by Griskevicius
moderating the relationship between status mo-
et al. (2010), as all the replication projects of the
tives and altruistic behavior. Thus higher levels
study conducted by the original researchers will
of extraversion will be more susceptible to sta-
allow a very high power.
tus motives by behaving more altruistically.
As for our second
hypothesis, we failed
Although comparable methods were per-
to find a significant moderating effect of extra-
formed in the present study, it failed to replicate
version. This non-significant result could have
Griskevicus et al. (2010) original findings on
been influenced by a third untested variable
explaining the significant causal relationship of
such as other Big Five personality traits. More
status motive and prosocial behaviors. The ev-
research is needed to help delineate these con-
idence led us to accept the null hypothesis that
flicting results between our replication study and
activating social status motives has no effect on
the original study.
the selection of equally priced green products
Limitations
over more luxurious counterparts. As our direct replication included a similar sample and similar power, it is unlikely that sample and power differences may be possible causes of this failed replication. Perhaps Griskevicius et al.’s subjects already had increased pro-environmental tendencies. However, this tendency would have been present in their control group as well since both groups were matched So, this confounder could not account for the significant effect of their hypothesis. Lastly, it could be that the researchers found this effect because of experimental biases. But, this is also unlikely since participants completed the study online in their study reducing this possible bias significantly as the researcher was not directly in contact with Issue XI | December 2021
Selection bias may be a considerable limitation of this research. Participants were recruited from McGill Psychology Human Participant Pool, which used a convenience sampling approach. The participants in this study were all undergraduate psychology students - same sample population as the original study we replicated - which may not be representative of the target population. Another consideration is the psychographic qualities of our sample being located in Montreal, Quebec. This city is known for following trends and being more environmentally conscious. Thus, this may not only affect participants’ baseline green product preferences, but it may also affect their perception of how green products relate to social status. 103
PSI Ψ It has been shown that undergraduate par-
middle socioeconomic status, thus the results of
ticipant pools are dominated by females, fresh-
studies conducted through these means would
men, and psychology majors (Barlow & Cromer,
not necessarily generalize to people from higher
2006, as cited in Dickinson, Adelson, and Owen,
socioeconomic statuses (Samuel, 2018).
2012). This is far from ideal, as numerous theorists have suggested that women tend to view status less importantly than men, and their status activation tends to be less predictable and less stable in reaching the same level as in men overtime (Anderson et al., 2001). It is important to consider that female participants can be—and are—different from male participants. If this study were to be re-run, it would be wise to inquire about the participants’ gender in order to be able to properly report on gender differences and the representativeness of the sample. Posthoc manipulations could also be employed as a remedy to the potential over-representation of females in the sample. Such an issue could also be resolved by the use of non-undergraduate research participants through participant pools such as Google Surveys or Amazon’s Mechanical Turk (Samuel, 2018). This would allow for a more nuanced sample that is less reliant on undergraduates and potentially less prone to a female overrepresentation. However, the characteristics of such services would bring a similar issue to the generalizability of the study as those who choose to participate in studies on such services (Google Surveys, Amazon’s Mechanical Turk, etc.) in exchange of modest financial compensation would be different than those who don’t participate. In other words, such services would draw people from lower to 104
Upon further consideration of the sample used in our study, we recognize the application of Henrich, Heine, and Norenzayan’s ‘WEIRD’ argument (2010, as cited in Pelham and Blanton, 2019, p.96-7). This states that using undergraduate students in psychology research skews participant demographics to be Western, educated, industrialized, rich, and democratic. Given that we sampled participants from the Psychology Undergraduate Research Pool at McGill University, our sample fits these criteria. This is a significant limitation to the generalizability of our findings as we do not investigate the relationship between prosocial behaviors and pro-environmental behavior for those who are excluded from the ‘WEIRD’ criteria. Some of the ‘WEIRD’ characteristics may be less relevant because of McGill’s prominent international student body; however, this is only an assumption as we did not survey these characteristics in our study. Considering the study design itself, there are two history variables that may have confounded our results. Firstgreen consumerism and pro-environmental attitudes have significantly shifted from 2010 to 2020, which is the gap between the original study and the present replication. There is a recent growing concern for climate change internationally, which makes green consumer trends more popular in the present reMcGill Undergraduate Psychology Journal
search than the original study. Because of this,
with other extraversion batteries, such as the
the threshold for buying green products may
Big Five Traits inventory. Increasing the reliabil-
potentially be lower. Additionally, the perception
ity across various testing inventories at different
of how green consumerism directly relates to
times would increase the validity of the extra-
prosocial behavior may have also shifted. Sec-
version measure. This approach to measuring
ond, this replication was undertaken during the
extraversion is based on a self-report question-
COVID-19 global pandemic. While we are un-
naire, which poses threats such as self-report-
certain exactly how this may affect the results,
ing bias and evaluation apprehension, where
there are current stressors that did not exist in
participants may report their behaviors inaccu-
2010 which may affect participants’ mood, fi-
rately or in a way that makes them look more
nancial situations, and values. Although there is
socially desirable.
no promising approach to control for these con-
Future Directions
founds, it is important to report the threats that these history effects pose to our study’s internal validity. The external validity of the product preference task is limited in both the original and replicated study designs. The measure of product preference was limited to text-only descriptions of the products, in bullet-point form. Real-world presentations of consumer products unavoidably have visual components such as packaging and location that affect consumer decision making. Social factors, marketing tactics, and purchase history also influence purchasing behavior, which are not accounted for in this research. Finally, the measure of extraversion utilized, the Eysenck Personality Inventory, poses a unique threat to internal validity. For the purposes of this study, only the 24 items related to extraversion were tested to prevent subject fatigue. To improve the accuracy of the extraversion measure, the full Eysenck Personality Inventory could have been used in conjunction Issue XI | December 2021
As the current research failed to replicate the original findings of Griskevicius et al. (2010), future research is needed in order to find out more reliably if the effect of eliciting status on pro-environmental choices is real. The meta-analysis by CREP is a crucial step towards this as it will combine many studies from independent research teams and will have greater power. Future studies should measure the baseline measures of subject status and pro-environmental tendencies. The effect of status on pro-environmental choices may be moderated by participants’ initial status level as someone who already has a high status may be less susceptible to status manipulation compared to someone who is at a lower status. Moreover, the effect of status on pro-environmental choices may be moderated by the participant’s initial pro-environmental tendencies. Another avenue for future research is looking at the Big 5 traits as a possible moderating variable. Though our current research did investigate the potential 105
role of extraversion as a moderating variable, research by Pavalache-Illie and Cazan (2018), as well as Quintelier (2014) suggested that agreeableness and openness to experience lead to more political consumer behaviors such as pro-environmental choices. Moreover, the present study only provided text descriptions of the product choices which may not be representative
of real-life set-
PSI Ψ
Quintelier, E. (2014), “The influence of the Big 5 personality traits on young people’s political consumer behavior”, Young Consumers, Vol. 15 No. 4, pp. 342-352. https://doi.org/10.1108/YC-09-2013-00395 Samuel, A. (2018, May 15). Amazon’s Mechanical Turk has Reinvented Research. Retrieved December 17, 2020, from https://daily.jstor.org/amazons-mechanical-turk-has-reinvented-research/ Tang, C. M. F., & Lam, D. (2017). The role of extraversion and agreeableness traits on Gen Y’s attitudes and willingness to pay for green hotels. Journal of Contemporary Hospitality Management, 29(1), 607–623. https:// doi.org/10.1108/IJCHM-02-2016-0048
tings. External confounds such as packaging, shelf-placement, branding may be investigated using real-life simulations for further insight on contributing factors. References
Anderson, C., John, O. P., Keltner, D., & Kring, A. M. (2001). Who attains social status? Effects of personality and physical attractiveness in social groups. Journal of Personality and Social Psychology, 81(1), 116–132. https://doi.org/10.1037/0022-3514.81.1.116 Dickinson, E.R., Adelson, J.L. & Owen, J. Gender Balance, Representativeness, and Statistical Power in Sexuality Research Using Undergraduate Student Samples. Arch Sex Behav 41, 325–327 (2012). https:// doi.org/10.1007/s10508-011-9887-1 Griskevicius, V., Tybur, J. M., & Van den Bergh, B. (2010). Going green to be seen: Status, reputation, and conspicuous conservation. Journal of Personality and Social Psychology, 98(3), 392–404. https://doi. org/10.1037/a0017346 John, O. P., & Srivastava, S. (1999). The Big Five Trait taxonomy: History, measurement, and theoretical perspectives. In Handbook of personality: Theory and research, 2nd ed (pp. 102–138). Guilford Press. Maynard, M. (2007, July 4). Say ‘hybrid’ and many people will hear ‘Prius.’ The New York Times. Retrieved from http://www.nytimes.com Pavalache-Ilie, M., & Cazan, A. M. (2018). Personality correlates of pro-environmental attitudes. International journal of environmental health research, 28(1), 71–78. https://doi.org/10.1080/09603123.2018.1429576 Pelham, B. W., & Blanton, H. (2019). Conducting Research in Psychology: Measuring the Weight of Smoke. Los Angeles: Sage.
106
Appendices Appendix A: Motive Priming and Control Stories MOTIVE PRIMING STORY “Imagine you recently graduated from college. You were offered several jobs and decided to go work for a wellknown and powerful company. Besides paying well, this job offers you the greatest chance of moving up—assuming you can prove that you have what it takes. As you pull into the parking lot on your first day of work, you immediately notice that the lot is full of expensive new cars. Walking to your building, you eye these impressive vehicles and think about the kind of car you should get now that you’ve graduated, perhaps an upscale luxury sedan or a new sports car. You imagine yourself driving through town in a sparkling new car and you feel yourself becoming more motivated. Entering the lobby, you’re impressed by how upscale everything looks—the antique furniture, the artistic decorations, the designer clothing. You’re thrilled to be working at such a prestigious company and you feel that this is exactly the kind of job you deserve. As you wait, another person sits down next to you. A minute later a third person also takes a seat. The two are dressed in brand new business suits, and they’re about the same age as you. Each one briefly looks at you, smiles slightly, and says hello. Both of them look a little nervous and you sense that these are probably your new colleagues. Looking at them out of the corner of your eye, you feel both excited and a little anxious. You imagine how much fun it would be to have colleagues with whom you can talk about the new job. But looking at their facial expressions and their body posture, you feel a sense of competition in the air. You realize this job isn’t a game. You’re not in school in anymore.
McGill Undergraduate Psychology Journal
Your new boss finally comes out and greets everyone. As all three of you walk into the large corner office, everyone sits down. “You’re all very fortunate to be here. The company hires only a few people out of thousands of applicants each year.” Hearing that you beat out thousands of people to get here sends a rush of pride through your body. “In the next few months, all three of you will both work both independently and work together. You’re going to get to know each other pretty well.” As the atmosphere seems to relax a little, you look around the room and everyone smiles. But the boss continues: “Starting today each one of you will get a small cubicle. But we don’t expect you to stay there. After 6 months, one of you will be fired.” Hearing this news sends a shiver down your spine. You quickly scan the room. The other two people are trying to suppress any look of concern and show a confident side to the new boss. You remind yourself that you were hired for a good reason and that you deserve a spot at the top. You sit up straighter and put on a confident expression. “Although one of you will be fired,” the boss goes on, “the person who does the best will not only get a promotion, but they will get a large bonus and will be put on the fast track to the top.” Pointing to the grand window offices down the hall, the boss finishes: “I see a lot of potential in all of you, but only one of you will make it into one of those big offices. You have 6 months to show everyone what you’re made of.” You know there will come a day in 6 months when your boss will again call all three of you into the office. Feeling your heart beating faster, you’re anxious and excited. As your boss finishes up the speech, you’re so eager to get started that you can’t even pay attention anymore. Finally, your boss stops and points at each of you in turn, “Go out there and show us what you’ve got!” Your eyes open wide and a rush of adrenaline pumps through your body. You feel like letting out a yell and running out the door to get started. Seeing your two colleagues in the background, you walk out of the office with a rush of anticipation in hopes of achieving something that few people ever have the chance to do...” CONTROL STORY “Imagine that it’s Friday afternoon during the semester. You’ve been working hard all week and you’ve been looking forward to this weekend for quite a while. You and one of your friends have two tickets for a sold-out concert that’s happening tonight. Both of you have been looking forward to this show for a long time. In fact, you had to bend over backwards to get the tickets. Your friend has been talking about the concert every day for weeks now, so you know she’s excited. And although it’s still several hours away, you can already feel your heart beating a little faster than normal. Issue XI | December 2021
As you’re getting ready for the show at home, your friend calls to tell you that she’s coming over in about an hour. Just so you don’t forget later, you decide to get the tickets from your drawer. You open your top drawer where you remember leaving them, but they’re not there. You search a little deeper in the drawer, but they’re not there either. You stop to take a breath and tell yourself to calm down. You know you put the tickets in a good place, but where? You start searching through your backpack. Books, folders, pens, but no tickets. You turn the bag upside down and shake it. Nothing but junk. Now you start getting worried. What if you lost the tickets? What’s your friend going to think? In a hurry, you look through the laundry. Maybe they’re in a pocket somewhere? You find some pieces of paper, but no tickets. You go into your closet and start throwing things to the floor—no tickets. You’re feeling upset at this point. Your hands start to shake a little. You think back to when you had the tickets and try to retrace your steps. You clearly remember putting them in your top drawer, so you search again. You inspect everything, but there are no tickets in this drawer. You look through your whole room, but they’re nowhere to be found. You run to the kitchen and start looking on the counters. You open all the cupboards and drawers. You have no idea why the tickets would be there, but you need to look somewhere. In fifteen minutes, your kitchen looks like a disaster area. But still no tickets! You run out into the driveway. Maybe the tickets fell out somewhere? You look in the grass, the bushes, underneath cars. But even if they did fall out, they probably wouldn’t even be there by now. As you walk back inside in complete frustration, you feel as though you’re ready to pull your hair out. You lost the tickets. And you obviously can’t go to the show without them. Suddenly, you hear a knock on the door. Your friend is early, probably because she’s eager to get going. You can hear her humming outside. What are you going to tell her? She’ll be crushed. Is there anything you can do? Maybe you should lie? But that probably won’t solve anything. As you walk toward the door, you get ready to fess up, take the blame, and hope that everything will be okay. You open the door, ready for the worst. As you are about to start telling her what happened, she yells “Are you ready?” and pulls out the two tickets from her back pocket. Your eyes get wide. You grab the tickets from her hand and fall to your knees. Your friend has the tickets! She’s had them the whole time. You think back and remember that she wanted to show the tickets to another person, so she took them the other week. You can’t believe you forgot. You don’t think you’ve ever felt so relieved in your life. You sit down, shake your head, and put your hand on your chest. You begin to laugh, wiping the sweat from your forehead. You and your friend will get to go to the show after all. Things are going to be just fine.
107
As you try to forget what happened, you’re actually even more thrilled about the concert than before. Your relief turns into elation. You want to shout to everyone just how great you feel. It’s as though you just found the winning lottery ticket. You can appreciate going to the concert even more now, knowing that you were very close to not going at all. Your friend is dying to get to the show, and her euphoria is contagious. Both of you run out the door, turn up the stereo, and head off to the most thrilling show of your lives.”
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PSI Ψ Appendix C: Motive Priming and Control Stories Each question is answered by selecting “Yes” or “No”. Our use of the inventory only included the extraversion items and did not include the neuroticism items. 1. Do you often long for excitement? 3. Are you usually carefree? 5. Do you stop and think things over before doing anything? 8. Do you generally do and say things quickly without stopping to think? 10. Would you do almost anything for a dare? 13. Do you often do things on the spur of the moment? 15. Generally do you prefer reading to meeting people? 17. Do you like going out a lot? 20. Do you prefer to have few but special friends? 22. When people shout at you do you shout back? 25. Can you usually let yourself go and enjoy yourself a lot at a lively party? 27. Do other people think of you as being very lively? 29. Are you mostly quiet when you are with other people? 32. If there is something you want to know about, would you rather look it up in a book than talk to someone about it?
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34. Do you like the kind of work that you need to pay close attention to?
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37. Do you hate being with a crowd who play jokes on one another?
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39. Do you like doing things in which you have to act quickly? 41. Are you slow and unhurried in the way you move? 44. Do you like talking to people so much that you never miss a chance of talking to a stranger? 46. Would you be very unhappy if you could not see lots of people most of the time? 49. Would you say that you were fairly self-confident? 51. Do you find it hard to really enjoy yourself at a lively party? 53. Can you easily get some life into a dull party? 56. Do you like playing pranks on others?
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McGill Undergraduate Psychology Journal
Appendix D: Figures Figure 1. Percentages of Green Product Selection in Control and Status Groups
Figure 2. Average Number of Green Products Selected by Level of Extraversion
Issue XI | December 2021
109
The Freudian Legacy of Modern Personality Theories and Evaluation of Its Real Life Implications Amina Hammache
Supervisor: Dr. Mathieu Roy
Ψ PSI Journal
The use of personality testing, aptitude tests, and
of personality classification on our current sys-
data-driven psychometrics tools is expanding and
tem. To demonstrate the relevance of Freud on
becoming the new norm in the workplace, from
modern personality principles, I will use the trait
big corporations adding organizational psychol-
conscientiousness of the widely used Big 5 scale
ogists to their human resources teams to start-
to establish links between the anal psychosexu-
ups using these assessment methods in their
al stage and obsessive-compulsive personality
wellness workshops. This burgeoning industry is
disorder (OCPD). I will finish the essay with a re-
gaining ground, and the same individuals willing
flection on the future of personality assessment.
to take seemingly unbiased personality tests online frown at the mention of Freud’s personality theories. Often deeming Freud’s radical ideologies as absurd or unscientific, the general public and certain members of the scientific community are often reticent to see the relevancy of Freud’s dogma in modern personality theories. First, I will provide a historical overview of personality psychology will serve as a guide to understand the different trends that have shaped personality psychology through time. In this section, I will explore the different theories of personality and will separate them between type-driven and trait-driven theories of personality. After, I will look at the impact of the categorical classification on personality disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM), followed by a reflection of the Freudian heritage 110
Part I - Historical Overview of Personality Theories Greek Legacy Although modern personality psychology sings the praises of its vast and rich 20th century heritage, personality development has been a subject of interest since early Greek
civiliza-
tions (Bos, 2009 p.30). First, a relevant author of the era, Sophocles, has shaped personality theory through his writing in part by being the inspiration behind one of Freud’s most infamous theories. The Oedipus myth is a story where a young man is struck by a prophecy in which he is destined to murder his father and marry his mother. To describe the root of some forms of neurosis in childhood, Freud refers to Oedipus’s fate but interprets the behaviour as an unconMcGill Undergraduate Psychology Journal
scious desire of the child to take the place of the
work That the Faculties of the Soul Follow the
same-sex parent and have sexual intercourse
Mixtures of the Body explains how one’s physi-
with their parent of the opposite sex (Bos, 2009,
cal and emotional conceptualization was related
p.31). The ideas of fate can be translated into
to the habits and lifestyle of an individual (Bos,
the inevitability of the repressed feelings that
2009, p.35). In his book, Galen discusses the
a child feels in the Oedipus complex theory of
importance of fluids and mixtures of fluids to
Freud. The pre-Socratics have contributed more
relate the constitution of the body and how it
directly to personality theories by providing
related the soul. In the case where there was
some of the first theoretical bases to personality.
too much of a particular fluid, one must free
For instance, Hippocrates, mostly renowned for
himself of the excess to find balance again. The
being the Father of Medicine, is the first to attri-
idea of balance between different elements of
bute differences in character for reasons other
an individual is an example of that we will see
than the divine destiny. He is considered a pre-
again in the Freudian interpretation of the ego,
cursor of personality theory by providing one of
the superego, and the id.
the first categorical theories of personality type,
Another notable Greek philosopher that marks
the theory of bodily humor. Galen of Permagon, a renowned philosopher and physician, then supplemented Hippocrates’ theory of body humors by advancing the idea that the excess or deficit of one particular bodily humor created an imbalance that was said to affect an individual’s appearance and behaviour. In his conception of personality, the bodily humors, the four fluids of the body were linked to types of temperament (Dumont, 2010, p.5). In that way, black bile from the kidneys was linked to melancholy, the yellow bile from the liver was linked to choleric temperament, red blood from the heart was associated with sanguine temperament and phlegm in the lungs was associated with a phlegmatic temperament (Bos, 2009, p.32). For example, an individual who is considered to be choleric will exhibit passionate and bold character, whereas a melancholic individual will be more likely to be pessimistic, anxious and reserved. Galen’s Issue XI | December 2021
the origin of personality is Plato (427–347 BCE). Plato believed that personality emanates from the soul, where the soul is explained as the combination of three basic forces that fuse to guide human behaviour. Plato was also interested in the development of character and reason in childhood,, Plato believed that the beginning was “the most precious and important part of any work” (Dumont, 2010 p.7). He applied this concept to childhood and he believed childhood was a time for character development and that children were in a highly impressionable state. Plato can be considered to be an environmentalist, as he believed that children’s success in life and their character were all pre-determined by the education they received at a young age. He attributed “deformation of character” to a parent’s over-reaction to a child’s spontaneous and immature behaviour. His definition of de111
formation of character is something that can be
PSI Ψ that personality is exhibited at the unconscious
contemporarily conceptualized as deviant be-
level. According to Freud, the conscious mind
havior or mental illness (Dumont, 2010 p.8). For
represents a small part of a larger entity, and it
that reason, Plato believed that in order to make
is through the occasions where one loses
sure that children become good citizens, there
awareness - through slips or through dreams -
should be a balance between an indulgent and
that we get access to the deep and rich reservoir
permissive parenting style and a severe puni-
that represents the unconscious experience.
tive parenting style (Dumont, 2010 p.8). Plato’s
Therefore, Freud puts a lot of emphasis on be-
belief of the importance of childhood in char-
havior and ideas that were not consciously in-
acter development brings us closer to Freudian
tended or caused. He believed that our motiva-
principles of personality, where childhood is a
tions and intentions were mostly unknown by us
critical time for personality development. Like
and that one must look at the unconscious level
Plato and other thinkers of his time, Aristotle
to find answers. In his book, the Ego and the Id
(384–322 BCE), a student of Plato, also be-
(1923/2018), Freud writes: “Psychology of con-
lieved in the concept of Tabula Rasa, which
sciousness is incapable of solving the problems
suggests that children’s minds are blank pages
of dreams and hypnosis” (Freud, 1923/2018,
that require training. This concept will be tak-
p.2). Conscious experience is considered as a
en again through in De Anima, where Aristotle
transitory state by Freud in which ideas may
writes: “Mind is in a sense potentially whatever
come and go easily. In his excerpt, Freud ex-
is thinkable, although actually, it is nothing until
plains that this fleeting state of the conscious
it has thought. What it thinks use be in it, just as
experience is the reason why, to study personal-
the character may be said to be on a writing-tab-
ity, one must look at the deeper level. In the ar-
let on which, a yet, nothing stands written”(Du-
ticle Freud: Id, Ego, and Superego Explained
mont, 2010, p.11). Therefore, Aristotle believes
(2020), Vinney explains how Freud distinguish-
that temperament and personality development
es two types of content:latent ideas, that are
take place in childhood.Temperament and early
considered to be at a preconscious level and
childhood experiences are concepts that will be
can be brought to consciousness at will and (2)
critically relevant to Freudian personality theory
other ideas that are so far repressed that one
development.
must use
Freud Personality Theory
access to the content (dynamically unconscious
Freud used empirical observations to define his theoretical principles of personality and his concepts of psychoanalysis. He bases his theory on the idea that behavior is pre-determined and 112
psychoanalysis techniques to gain
level) . Freud defines the mind as the combination of three different components : the id, the ego and the superego. The personality of an individual is the interaction of the three agencies of the mind and the conflict that occurs between McGill Undergraduate Psychology Journal
these three components. In his book the Ego
way that is socially ostracizing. The ego is plea-
and the Id (1923/2018), Freud explains : “From
sure-seeking and works to to please the id, but
the point of view of instinctual control, of morali-
it does so realistically by compromising with the
ty, it may
be said of the id that it is totally
id or delaying gratification. The ego is responsi-
non-moral, of the ego that it strives to be moral,
ble for secondary thinking processes, which are
and of the super-ego that it can be super-moral
defined by Freud as complex logical thinking
and then become as cruel as only the id can be”
processes that focus on environmental (exter-
(p.54). The components of the mind develop at
nal) variables and consequences that result
different stages of development. They each
from the primary
serve a purpose in personality and they work
the ego would like the id’s desires to be met, but
together to create behaviour. First, the id devel-
makes sure that it is done in a socially accept-
ops the earliest and is present at birth. For this
able way with minimal negative consequences.
reason, Freud explains that newborn children
The ego is the only level of personality that op-
are driven exclusively by the id. It is the most
erates at all levels of consciousness,the con-
primitive part of personality and represents the
scious, preconscious, and unconscious levels,
instincts and needs of an individual. Since it is
as its purpose is to be a mediator between the id
driven by biological forces, if the id’s needs are
and the superego. Consequently, it must be
not met immediately, this results in tension (Vin-
aware of all the variables before making a deci-
ney, 2020). Consequently, newborns will cry
sion (Vinney, 2020). However, the bulk of the
when their needs are not met as they do not yet
ego is located at the preconscious level, making
possess the other components of the mind to
it accessible for the conscious mind to use when
soothe or mend the id. Ideally to the id, all im-
necessary. When the desires of the id are too
pulses and desires must be met right away. This
pressing, the ego attempts to cope with the id by
component of personality is entirely unconscious
using different defence mechanisms at the un-
and has no access to reality. The demands of
conscious level. For example, Baumeister et al.
the id, although extremely tempting, are often
(1998) explains how denial can be used by the
deemed unrealistic by the ego and the super-
ego to dismiss a reality that is too difficult to ac-
ego. This component of the mind remains de-
cept. Finally, the superego is the third part of
mandingly childish throughout life and one must
Freud’s personality theory and is developed be-
develop the ego and the superego to overcome
tween the ages of three and five years old. The
these primary processes and be functional (Vin-
superego represents the moral compass of the
ney, 2020). Second, the ego is the subsequent
triad, making sure that the distinction between
part of personality that is developed from the id.
right and wrong is known and that the individual
This component of personality is set in reality
behaves according to moralistic principles.
and makes sure that the id doesn’t behave in a
These moralistic principles first come from par-
Issue XI | December 2021
thinking processes. Ideally,
113
ents, and later from authority figures that the
PSI Ψ that the superego’s moral agenda is respected.
child holds in high favor (Vinney, 2020). The su-
Since a lot of work is done at the unconscious
perego is composed of two parts: the ideal self
level, we are not always aware of all the dimen-
and the ought self. The ought self is the part of
sions that make up our decisions. Freud consid-
the superego that sets the limitation between
ered a healthy personality to be a balance of
what is deemed acceptable and unacceptable.
the three components (Vinney, 2020). A failure
When an individual acts in line with the super-
to attain this harmony would lead to disruptions
ego, the individual is filled with pride because
in someone’s life. Interestingly, this idea of bal-
the actual self is in line with the ideal self (Vin-
ance was formerly introduced in
ney, 2020). Contrarily, when a limit is trans-
when looking at Hippocrates and Galen’s theory
gressed, guilt is often felt by the individual who
of bodily humor. An excess of a certain fluid
realizes that the action was morally wrong. This
gave an individual certain characteristics such
component of personality operates at both the
as melancholia or anger (choleric). Similarly,
conscious and unconscious level; first, at the
individuals must find ways to manage their dif-
conscious level as it is based on society’s bi-
ferent components of personality (id, ego, and
ased moral view of what is right and wrong and
superego) to have healthy personalities. For
second, at the unconscious level as some of the
example, if one individual has an over-devel-
ideas are not always completely consciously
oped superego, the person might be too rigid,
available. To explain the relationship between
and too anxious about breaking social norms
the ego and the superego and the id, Freud
and rules. An individual with an over-developed
writes in The Ego and The Id (1923/2018) : “The
id may be too impulsive and behave in a way
super-ego is, however, not merely a deposit left
that does not account for society’s norms and
by the earliest object-choice of the id: it also rep-
regulations. In this theory, Freud puts an im-
resents an energetic reaction-formation against
portant emphasis on childhood development, as
those choices. Its relation to the ego is not ex-
the first layer develops at birth and the latest
hausted but the precept: You ought to be such
stage is available as soon as three to five years
and such; it also comprises prohibition.”(p.26).
of age. Freud’s developmental theory on psy-
In this passage, Freud explains how the su-
chosexual development was one of the first at-
per-ego dictates how an individual should be,
tempts to bring psychology under the same
how an individual should not be, and how these
scientific structure and methodology as fields
directives are in reaction to the id’s demands.
like medicine and biology. According to Freud, if
The three different elements act one upon an-
the child’s needs were met, and if the child
other and the ego is left with the daunting task of
passed through the different stages, the children
mediating the operation as smoothly as possi-
would become adults with a healthy personality.
ble, while making sure that the id is satisfied and
In the same way that Aristotle believed that chil-
114
this essay
McGill Undergraduate Psychology Journal
dren were born a tabula rasa, Freud believed
concerned with neatness and organization. The
that children were a blank canvas in which parts
anal explosive personality is the opposite,
of the body they can derive pleasure from. So-
meaning that the child becomes disorganized
cialization of the child helps him develop a
and careless (Lantz & Ray, 2020). The clinical
healthy adult personality. The article Freud De-
importance of these stages of psychosexual de-
velopmental Theory by Lantz & Ray (2020) ex-
velopment becomes significant when we tie in
plains that the different stages of psychosexual
this concept with the formerly explained model
development are divided by age range, stage
of the ego, the id, and the superego. The id and
name, and an erogenous body part and the as-
the
sociated consequence of fixation at the stage of
psychosexual development is the mechanism
development. The two first stages focus mostly
through which a child may experience the dif-
on personality development while the latter fo-
ferent dysfunctions that will have an impact on
cus on interpersonal relationships. In the first
the personality. Later in the essay, we will come
stage (0-1 years old), the mouth is the eroge-
back to this theory to explore the heritage of
nous zone. Oral desire is the most gratifying
Freud’s theory on modern personality theory de-
and pleasurable zone for a newborn baby. Ac-
velopment and personality disorders.
cording to Freud, the earliest attachment was
The work that followed Freud diverged from
provided when oral needs are met. If the child does not receive enough stimulation and that his needs are not met, in terms of personality, this leads to a child who has an immature personality. This immaturity is presented as passiveness, gullibility, and manipulation (Lantz & Ray, 2020). In the second stage of the psychosexual stages (1-3 years old), the associated erogenous zone is the anus. Around this period, toilet training is an important part of the child’s development. There are expectations from parents that their child can go to the toilet at the right time. The child fears a negative reaction from caretakers in case of failure to achieve. This fear leads the child to develop an anal-retentive or expulsive personality (Lantz & Ray, 2020). The anal-retentive personality is a personality in which the child may become overly Issue XI | December 2021
ego will constitute one’s personality and
psychoanalysis and the psychosexual stages and instead examined personality development theory through the traits that make up an individual.There was also a new effort to reduce categories to a minimum to find the essence of personality. Nonetheless, it is important to denote their work to understand the modern categorical system that is used to classify personality types and personality disorders in the DSM. From there, it will be possible to find similarities between the modern conceptualization of personality and Freud’s theories.
Carl Jung Carl Jung worked alongside Sigmund Freud at the beginning of his career and represents a great influence in the domain of personality theory development. He developed his principle of 115
personality types that was published in his book
PSI Ψ 2017). Raymond Cattell was able to reduce All-
Psychological Types. In his article, On The Sub-
port’s list to 16 personality characteristics that
jectivity Of Personality, Atwood (1976) explains
he believed were the most fundamental primary
that Carl Jung was one of the first to distinguish
traits of personality. Similarly, Lewis Goldberg,
the difference between introverts and extroverts,
an American Psychologist of the 1940s, further
where introverts are people who receive stim-
reduced Cattell’s 16 personality traits down to
ulation from within, whereas extroverts receive
the Big 5 traits by using factor analysis (Pea-
their
stimulation from the environment. The
body, 2017). The Big 5 traits are a renowned
author explains that Carl Jung would use four
way of categorizing individuals using the five di-
functions of consciousness (thinking, feeling,
mensional traits of Extroversion, Conscientious-
sensation, and intuition) to divide introverts and
ness, Openness to Experience, Agreeableness,
extroverts depending on their way of perceiving
and Neuroticism. Each of the traits varies on a
the world. According to Jung, behavior is deter-
range between very low to very high. This theory
mined by stable traits which are fundamental
is widely accepted, as many researchers have
units of one’s personality (Atwood, 1976, p. 169).
replicated studies and found that these traits re-
Traits are considered to be discrete categories
main fairly stable across different populations in
that bring consistency in the way one will be-
the world. It is now one of the most widely used
have. His idea of extraversion and introversion
scales of personality in the world.
is still used today, and research has proven that it is a useful differentiator between individuals.
Type-Driven vs Trait-Driven Theories of Personality
Trait Personality : Allport, Cattell and Goldberg
One important separation in schools of thought
Allport was one of the first pioneers of psycholo-
theory and trait theory. While both approaches
gy to try to find links between personality traits
attempt to systematically categorize
and categorize them. By compiling a list of all
they differ in how they approach the categori-
the words in a dictionary that related to person-
zation. Asendorp explains in the article Head-
ality, Allport found that there were three different
to-head Comparison of the Predictive Validity
trait categories, including cardinal traits (core
of Personality Types and Dimensions (2003)
defining personality traits), central traits (com-
that while type theory views people as discrete
mon personality traits), and secondary traits
categories, trait theory sees people as part of
(context-dependent traits). His work inspired
a varying gradient in which they will differ in
other researchers who tried to reduce his list of
terms of intensity of a trait on a normal curve.
characteristics by finding how the traits related
The four temperaments system of Galen and
to one another using factor analysis (Peabody,
Hippocrates are type theories as, according to
116
in the field of personality theory is between type people,
McGill Undergraduate Psychology Journal
their theories of humor, an excessive amount of
especially personality disorders. Right now,
specific humor would disrupt the balance and
the Big 5 traits are not used to define mental
consequently, someone would develop specific
disorders, although some link has been found
character traits. Freud can also be considered
between certain traits and certain disorders
to be a type-driven theorist. A child must pass a
(i.e. neuroticism and depression). In their article
psychosexual stage to move on to the next and
Personality Disorder, Traits and Types (2005),
all stages must be passed to be a healthy adult.
researchers Furnham and Crump (2005) have
A child cannot partially pass a psychosexual
highlighted the limitations of this categorical
stage. Jung is also a type theorist as, according
model and have suggested that a dimensional,
to his dichotomy, one was either extroverted or
trait-based model of personality disorder might
introverted. He divided people categorically and
provide a better alternative to a type-based
an individual could not fall in the middle (an am-
model. The authors found that “ currently, there
bivert). However, some scientists believe that
is a debate on whether or not personality dis-
the type-driven models’ theorists such as Freud,
orders are qualitatively different from ‘normal’
Jung, and others must now be rejected and that
behavior or whether the behaviours associated
the future of psychology is in statistical models
with each specific disorder should be consid-
that are based on the trait theory approach. By
ered simply as an exaggerated or extreme form
using trait continuum models, there is an infinite
of normal behavior” (Furnham & Crump, 2005 p.
number of possibilities on the scale of traits that
168). If mental disorders traits are type-driven,
individuals could fall under (Asendorp, 2003).
then they are a discrete category from mentally
This is the case for the Big 5 theory in which
healthy traits, meaning that an individual with
people will vary on different traits without be-
a mental disorder is qualitatively different from
ing categorized as “purely neurotic” or “purely
a healthy control. If mental disorders are con-
agreeable”. Although there will be extremes for
sidered to be trait-driven, then individuals with
every trait, most of the population will fall in the
mental disorders share the same traits as the
middle of the distribution. What about individu-
healthy controls but fall in the extremes of of cer-
als with mental disorders?
tain traits. Research by Widiger & Gore (2016)
Implications for Personality Disorders in the DSM
indicates that the Big 5 successfully measures
Trait psychologists have put considerable effort
sonality disorders. There are many advantages
into establishing the higher-order super-factors of personality and the mechanics and processes underlying them. This debate becomes especially interesting when looking at the DSM’s approach to categorizing mental Issue XI | December 2021
disorders,
the symptoms and traits of the DSM-IV-5 perto looking at the Big 5 to account for personality disorders symptoms. This type of diagnosis has been proven to have benefits to treatment, research, and also social and clinical decisions. First, rather than trying to make an individual 117
PSI Ψ
fit a specific categorical description, the Big 5
sub-traits of conscientiousness, they were low
allows more flexibility and allows clinicians to
on the overall trait of conscientiousness. These
create a more individualized profile of the pa-
findings lead to the belief that personality disor-
tient. Furthermore, on a social inclusion basis,
ders do represent a maladaptive manifestation
the Big 5 removes the label and normalizes be-
of the Big 5 traits.
havior associated with individuals with person-
These break-throughs in personality disorder
ality disorders by putting everyone on the same scale, rather than creating a separate scale to account for their symptoms. As explained by Widiger and Gore (2016), this removes some of the stigmas that surround mental illness which contributes to the well-being of the individual. As many advantages seem to result from a traitbased conceptualization, such as the Big 5, this encouraged other researchers to look at the feasibility of the alternative to a type-based DSM. It is the case of Furnham and Crump (2005) who looked at the issue of categorization of personality disorders to see if personality disorder traits should be analyzed as type-driven or trait-driven categories. Their results revealed a high correlation between some of the Big 5 traits and personality disorders. For example, they found that sub traits of introversion of the Big 5 were correlated with avoidant and schizoid personality disorders (Furnham & Crump, 2005, p.174). Similarly, another study by Mike et al. (2018) looked at obsessive-compulsive personality disorder and found that the measures of the trait conscientiousness correlated highly with some scales that measured traits of OCPD. They found
that individuals who had OCPD
were found to be neater and achievement-oriented, but less generally conscientious, meaning that although they scored high on specific 118
categorizations are relevant in our analysis of legacy as some of these traits are not unfamiliar to Freud who, in the 20th century, made interesting parallels with certain traits of the Big 5 sub-scales and mental disorders. In the next section, I will compare the case of conscientiousness in Obsessive-Compulsive Personality Disorder and the anal personality described by Freud.
Part II - A case study on Conscientiousness: A Freudian Heritage
Conscientiousness is one of the personality traits of the Big 5 and reflects a tendency to be responsible, organized, goal-oriented, and to follow rules and norms. It is defined by the American Psychological Association (APA) as “the tendency to be organized, responsible, and hardworking” (American Psychological Association, 2020). Although definitions of conscientiousness tend to be similar, there remains disagreement regarding the hierarchical organization of its component traits. Researcher Trull (2013) explains how multiple sub-traits make up these factors of conscientiousness. Some of the characteristics that define an individual who is high on conscientiousness include cautiousness, order, self-discipline, dutifulness, and McGill Undergraduate Psychology Journal
the ability to be self-efficacious (Trull, T. (2013).
to reach their goals and achieve their dreams.
Conscientiousness is often linked to academic
If we link the idea of consciousness and grit to
and professional success, as it pushes individ-
Freud, impulse control is an ability that is very
uals to be performant in their endeavors. It has
important to Freud, as the ego must go against
become the topic of interest for many research-
the pleasure principle, the intrinsic desire of the
ers as its impressive positive impact seems to
id to experience immediate pleasure, for the
determine many outcomes in our society. For
benefit of long-term goals. This ability to push
example, a study by Richardson and Abraham
through to attain goals despite temptations can
(2009) looked at the importance of the Big 5
be described as a well-developed and realistic
traits, motivation, and academic outcomes.he
ego that can follow through with tasks despite
researchers found that individuals who are high
the demands of the id without being overly ob-
on conscientiousness tend to have a higher
sessed with the demands of the superego. This
university GPA than those who were lower on
balance between the demands of the id and the
conscientiousness as they tend to exhibit more
superego, managed by a healthy ego allows
achievement
individuals to succeed in life.
motivation (mediating effect). It
is in part because conscientiousness is highly related to impulse control. Grit is a lower-level personality trait of conscientiousness that is very popular and has gained a lot of attention in recent years. Grit is defined as the ability to persist despite obstacles and it is defined as the ability to remain consistent and committed despite adversity. Duckworth and Quinn (2007) looked at the implication of grit in predicting school success and found that grit was related to various measures of academic achievement. They found that “grit demonstrated incremental predictive validity of success measures over and beyond IQ and conscientiousness” (Duckworth & Quinn 2007). Researchers argue that individuals who demonstrate grit are not necessarily driven by passion or infatuation, but rather by an ability to push through where the effort becomes a skill that leads to success. This type of determination and ambition allows individuals Issue XI | December 2021
Although there is a lot of research that seems to paint a favorable portrait of conscientiousness, in some cases, an over-development of some sub-traits of conscientiousness
can be detri-
mental. For example, in a study looking at the relationship between the Big 5 and personality disorders, the researchers Furnham and Crump (2005) found that individuals who
were high
on the sub-trait diligence of conscientiousness were more likely to exhibit behaviors associated with obsessive-compulsive personality disorder. The researchers define a diligent individual as a “meticulous, precise and perfectionistic, inflexible about rules and procedures; critical of others” (Furnham & Crump, 2005, p. 174). OCPD characteristics include
preoccupation
with orderliness, perfectionism, and mental and interpersonal control (Owens & Beidel, 2012). These individuals are often perfectionists, work119
PSI Ψ
aholics, and can be quite inflexible and rigid
struggles with resisting temptations. Similarly,
about their morals and beliefs. Widiger & Gore
an anal expulsive personality is described as
(2016) explain that there are findings that OCPD
an individual who is disorganized, disorderly,
has its roots in childhood temperament where a
and rebellious to authority. An anal-expulsive
dysregulation of attention occurs. In that way,
personality can also be defined by Freud as
many parallels can be made between conscien-
an individual who struggles with resisting their
tiousness and the anal personality characterized
id and its urges. It may also be a person who
by Freud. Freud described the anal personality
struggles with understanding the demands of
as a neurosis that is based in the anal phase
the superego, or has a weak or disorganized
of the psychosexual stages. According to his
ego that is unable to read and understand the
theory, the anal character would be developed
id and the superego. There is a lot of research
during toilet training, where tension arises be-
that examined the validity of the psychosexual
tween a child and his caregivers’ expectations.
stage of development of Freud. Despite minimal
According to Freud an inability to deliver to the
findings that directly validate Freud’s theories
expectation of parents who are harsh and puni-
(Owens & Beidel (2012), we should not be as
tive at this stage leads to an anal fixation. Freud
quick to dismiss his theory. As demonstrated
describes the anal-retentiveness
personality
by the breakdown of sub-traits of conscientious-
as a tendency to be overly orderly, suspicious,
ness and the similarity to his empirical findings,
rigid, and reserved, and is often paired with an
Freudian theories, such as his anal psychosex-
obsession with cleanliness. Although the field of
ual stage, are congruent to concepts that are
psychology has turned away from this psycho-
widely recognized, only differently explained.
analytic explanation, the traits that characterize
By using
individuals with an anal fixation are very sim-
the sub-traits that make up the Big 5 factor, we
ilar to a maladaptive conscientiousness devel-
find that there are multiple similarities between
opment that we see in individuals with OCPD.
the dysfunctional traits of conscientiousness we
Stubbornness, rigidity, perfectionism, detail-ori-
see in individuals with OCPD and the anal per-
entation, and overly self-reliance are all traits
sonality. In the same way, even when looking
that correspond to both the anal-retentiveness
at grit, which represents conscientiousness at
personality and conscientiousness of the Big 5.
its best,Freudian principles still resonate. Freud
If we push this idea even further, the Freudian
would argue that grit is the result of a healthy
anal expulsive personality would correspond
ego that is able to push away the urges of the id
to the other side of the spectrum of conscien-
and respond to the demands of the superego in
tiousness, an underdeveloped trait of consci-
a normative manner.
conscientiousness and dismantling
entiousness, where an individual is unable to deliver to the expectations is disorganized, and 120
McGill Undergraduate Psychology Journal
In conclusion, many different principles of per-
links between other personality disorders such
sonality theories have shaped our understand-
as schizotypal personality disorder and Freud’s
ing of personality. Some early themes, such as
conceptualization of personality development.
balance within the individual, the importance
His theories also dismiss the effect of culture on
of childhood, and the caregiver’s educational
personality
quality have served as ways to explain normal
the human mind to build his theoretical princi-
and abnormal personality development. Freud,
ple. In the same way, his focus on the patho-
through his conceptualization of the mind and his
logical allow few ways of explaining variations
psychosexual stages, put the emphasis on the
in the normative range. How do we account for
power of the unconscious, the battle between
differences in individuals that vary on the Big
three forces that regulate behaviour, and on key
5 in a normative way? This is a question that
developmental stages that shape a child’s per-
Freud may not be able to provide answers too
sonality. Failure to pass a stage of psychosexual
specifically. Perhaps, the Big 5 could bridge the
development lead to abnormal personality de-
gap between normative behaviour and Freudian
velopment , such as the anal personality. While
personality characteristics, this is a potential
followers of Freud did not fully
area of future research that could be interesting
follow in his
development, focusing mainly on
foot-steps, we looked at the dichotomy between
to explore.
trait-based theories and type-based
So far, the research on personality, whether it
theories
to determine what is the most appropriate way of defining personality conceptualization
and
personality disorders. When looking at factor models, we used the trait conscientiousness of the Big 5 as a case study to assess what it measures and how its subscales relate to Freud’s findings. Some principles of Freud show some congruence with some sub-traits of the Big 5 conscientiousness that we find in OCPD. This allowed us to make certain associations between the anal personality Freud and OCPD. One limitation that is worth acknowledging is the limited scope and the lack of generalizability on the overall Big 5 scale and with the personality disorders. While it may be interesting to explain OCPD through sub-scales of conscientiousness and the anal personality, it is more difficult to find Issue XI | December 2021
is on normative personality traits or on personality disorders, agrees that the Big 5 scale is a great way of assessing personality dimensions. However, despite its popularity and its various advantages, the DSM it has yet to integrate this conceptualization. This decision prevents individuals from receiving a more complete portrayal
of their illness,obtaining individual-
ized treatment, and avoiding stigma related to mental illness labeling (Widiger & Gore, 2016). One of the reasons scientists are reluctant to completely remove the categories is that it allows for better communication across professionals and medical insurance often only covers f treatment costs if an individual receives a diagnosis. To reap the benefits, there should be 121
a complete reconstruction of the way we think about the classification of abnormal personality traits. In the meantime, the Big 5 personality traits have caught the interest of Big Data, and with the growing use of social media, a team of researchers looked at how they could integrate automatic methods to use digital footprints to predict personality traits from social media profiles. Azucar et al. (2018) found that by using different digital footprints, such as the data left by users on different platforms (Facebook, Instagram, Twitter, Reddit) and using comparative demographics, the accuracy of predictions of personality was consistent across all traits of the Big 5. While it is exciting to see new ways that personality theory can be implemented, there are real ethical concerns that will need to be addressed regarding the commercial appeal of companies to have our core personality profiles at their disposition. References
Asendorpf, J. B. (2003). Head to head comparison of the predictive validity of personality types and dimensions. European Journal of Personality, 17(5), 327-346. doi:10.1002/per.492 Azucar, D., Marengo, D., & Settanni, M. (2018). Predicting the Big 5 personality traits from digital footprints on social media: A meta-analysis. Personality and Individual Differences, 124, 150-159. doi:10.1016/j. paid.2017.12.018 Atwood, G. E., & Tomkins, S. S. (1976). On The Subjectivity Of Personality Theory. Journal of the History of the Behavioral Sciences, 12(2), 166-177. doi: 10.1002/1520-6696(197604)12:23.0.co;2-y Baumeister, R. F., Dale, K., & Sommer, K. L. (1998). Freudian Defense Mechanisms and Empirical Findings in Modern Social Psychology: Reaction Formation, Projection, Displacement, Undoing, Isolation, Sublimation, and Denial. Journal of Personality, 66(6), 1081-1124. doi: 10.1111/1467-6494.00043
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Bos, J. (2009). The rise and decline of character: Humoral psychology in ancient and early modern medical theory. History of the Human Sciences, 22(3), 29-50. doi: 10.1177/0952695109104422 Conscientiousness. (2020). In APA Dictionary of Psychology. Retrieved December 30, 2020, from https://dictionary.apa.org/conscientiousness Clark, L. A., & Watson, D. (2008). Temperament: An organizing paradigm for trait psychology. In O. P. John, R. W. Robins, & L. A. Pervin (Eds.), Handbook of personality: Theory and research (p. 265–286). The Guilford Press. Dumont, F. (2010). Historical precursors of personality theory. A History of Personality Psychology, 1-34. doi:10.1017/cbo9780511676093.002 Duckworth, A. L., Peterson, C., Matthews, M. D., & Kelly, D. R. (2007). Grit: Perseverance and passion for long-term goals. Journal of Personality and Social Psychology, 92(6), 1087-1101. doi:10.1037/00223514.92.6.1087 Eisenberg, N., Duckworth, A. L., Spinrad, T. L., & Valiente, C. (2014). Conscientiousness: Origins in childhood? Developmental Psychology, 50(5), 1331-1349. doi:10.1037/ a0030977 Freud, S. (2018). The Ego and The Id. Mineola, New York: Dover Publication. (Original work published in 1923) Furnham, A., & Crump, J. (2005). Personality traits, types, and disorders: An examination of the relationship between three self-report measures. A European Journal of Personality, 19(3), 167-184. doi:10.1002/per.543 Lantz, S., & Ray, S. (2020). Freud Developmental Theory. A StatsPearls. Retrieved December 29, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK557526/ Mike, A., King, H., Oltmanns, T. F., & Jackson, J. J. (2018). Obsessive, compulsive, and conscientious? The relationship between OCPD and personality traits. Journal of Personality, 86(6), 952-972. doi:10.1111/jopy.12368 Owens, M., & Beidel, D. (2012). Obsessive Compulsive Personality Disorder. Encyclopedia of Human Behavior, 746-748. doi:10.1016/b978-0-12-375000-6.002615 Peabody, D. (1987). Selecting representative trait adjectives. Journal of Personality and Social Psychology, 52(1), 59-71. doi:10.1037/0022-3514.52.1.59 Richardson, M., & Abraham, C. (2009). Conscientiousness and achievement motivation predict performance. European Journal of Personality, 23(7), 589605. doi:10.1002/per.732 Roberts, B. W., Chernyshenko, O. S., Stark, S., & Goldberg, L. R. (2005). The Structure Of Conscientiousness: An Empirical Investigation Based On Seven MaMcGill Undergraduate Psychology Journal
jor Personality Questionnaires. Personnel Psychology, 58(1), 103-139. doi:10.1111/ j.1744-6570.2005.00301.x Solms, M. (1997). What Is Consciousness? Journal of the American Psychoanalytic Association, 45(3), 681703. doi:10.1177/00030651970450031201 Trull, T. (2013). Dimensional models of personality: The five-factor model and the DSM-5. Personality Disorders Dialogues in Clinical Neuroscience, 15(2), 135146. doi:10.31887/dcns.2013.15.2/ttrull Vinney, C. (2020, August 28). Freud’s Id, Ego, and Superego Explained. Retrieved December 30, 2020, from https://www.thoughtco.com/id-ego-and-superego-4582342 Widiger, T., & Gore, W. (2016). Personality Disorders. Encyclopedia of Mental Health, 270-277. doi:10.1016/ b978-0-12-397045-9.00092-6
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