Edita Fino

Objectives: Mental illness stigma is widely examined in healthcare, yet less is known about its intersections with the stigma of chronic physical conditions in shaping distinct forms of disadvantage. Here, we investigate whether patients with concurrent mental and physical health conditions are perceived and treated differently by prospective medical doctors. Methods: Using a mixed‐methods design, preclinical medical students ( N = 463) evaluated clinical vignettes describing patients with single (i.e., mental or physical chronic disease) and multiple health conditions (i.e., concurrent mental and physical conditions). We assessed emotional reactions, attributions of disease aetiology, caregiving attitudes and meta‐beliefs about patients' disclosure behaviour. Participants were also asked to report as accurately as possible on symptoms presented by each patient in the vignette. Results: Findings revealed that stigmatized conditions were associated with higher levels of caregiving discomfort, greater disease disclosure reticence and lower levels of symptom recall accuracy. Compared with patients with single conditions, those with concurrent mental and physical illnesses were less likely to receive care, were attributed a lesser tendency to conceal their conditions and had their symptoms recalled less accurately. Conclusions: Results indicate that when mental and physical illnesses intersect, patients with multiple stigmatized conditions may be differentially perceived in the eyes of medical students and may become (in)visible targets of discrimination in a healthcare setting. We discuss implications for enhancing awareness of social determinants of health and disease for a more representative, responsive and inclusive healthcare curriculum and practice.

Exposure to traumatic events is associated with biases in the perception of emotional facial expressions. By bridging research on trauma exposure and emotion recognition, the present study investigated the impact of war‐related trauma on the recognition of facial expressions of emotions in a sample of war trauma–exposed refugees ( N = 108) from West Asian countries. Through a forced‐choice facial emotion recognition experiment, we assessed how trauma exposure and face gender influenced accuracy and biases in identifying six primary emotions. Participants judged facial expressions of anger, sadness, fear, disgust, surprise, and happiness displayed by a set of 240 faces corresponding to 20 female and 20 male models from the Karolinska Directed Emotional Faces dataset. Expressions consisted of short videos showing each face's transition from neutral to full emotion. The results showed impaired recognition of negative emotions, with fear being the least accurately recognized emotion, suggesting the avoidance of negative affective states as a coping mechanism putatively associated with war‐related trauma. For main effects, partial eta‐squared effect sizes ranged from .159 to .573, and effect sizes for interaction effects ranged from .027 to .189, with most effects being in the medium‐to‐large range. Furthermore, the biases in emotion recognition observed in the present study may reflect gender stereotypes and social norms that shape how individuals perceive and interpret emotional expression in men and women.

Ethnic prejudice in healthcare has been widely examined, yet little is known about its intersection with stigma and prejudice based on one’s health status. The present study investigates the intersections of ethnic prejudice and stigma of chronic disease in a healthcare setting as shaping unique forms of disadvantage. From an intersectional perspective, we examined whether ethnically diverse patients affected by stigmatized health conditions would be differentially perceived and cared for by prospective medical doctors. In a within-subjects, experimental design, preclinical medical students read, and evaluated clinical vignettes describing patients, who were presented as either White Italian or Middle Eastern migrants and were affected by visible and concealable stigmatized chronic conditions. Emotional reactions, attributions about disease-onset, caretaking attitudes, and meta-beliefs about patient disclosure behavior were assessed. Results showed that when reading of patients affected by visible compared to concealable stigmatized conditions medical students experienced stigma-related emotions (e.g., disgust, pity, fear) and attributed patients a higher tendency to be embarrassed, to hide, and to avoid disclosure for fear of others’ negative reactions. However, Middle Eastern migrants when affected by conditions with visible and behavioral manifestations were attributed a lesser tendency to feel embarrassed, to hide, and to avoid illness disclosure for fear of others’ negative reactions compared to White Italian patients with the same conditions. These findings indicate that at the intersection of ethnic prejudice and health-related stigma, multiply stigmatized patients may become invisible and not fully considered in the eyes of medical students. Present results underscore the need to enhance diversity representation in higher medical education for a more inclusive healthcare curriculum and practice.

We examined implicit weight stigma in 320 second-year medical students and in a control group of 173 second-year students in Psychological Sciences. The study consisted of two tasks administered in separate days. On day 1, participants rated faces of several individuals primed by the label “patient with [various conditions]” (e.g. "patient with chest pain") on a series of traits. Faces of higher-weight individuals were preceded by the label “patient with obesity”. One day later, participants performed a memory task (new/old). The tasks for the control group were the same, with the exception that faces were not primed by any label. Lower recognition accuracy was recorded in the memory task for faces preceded by the label 'patient with obesity' in comparison to the control group (no prime). The results suggest that this label might elicit group-based stereotypes leading to a decreased individuation of face appearance and, consequently, a less accurate face recognition. Furthermore, in line with the stereotype content model (SCM), faces primed by the label ‘patients with obesity’ were rated much lower for trustworthiness, and competence, but higher in warmth. Our data highlight the importance of sensitizing medical students to bias-free language in care delivery of higher weight patients.

Spontaneous smiles in response to politicians can serve as an implicit barometer for gauging electorate preferences. However, it is unclear whether a subtle Duchenne smile–an authentic expression involving the coactivation of the zygomaticus major (ZM) and orbicularis oculi (OO) muscles–would be elicited while reading about a favored politician smiling, indicating a more positive disposition and political endorsement. From an embodied simulation perspective, we investigated whether written descriptions of a politician’s smile would trigger morphologically different smiles in readers depending on shared or opposing political orientation. In a controlled reading task in the laboratory, participants were presented with subject-verb phrases describing left and right-wing politicians smiling or frowning. Concurrently, their facial muscular reactions were measured via electromyography (EMG) recording at three facial muscles: the ZM and OO, coactive during Duchenne smiles, and the corrugator supercilii (CS) involved in frowning. We found that participants responded with a Duchenne smile detected at the ZM and OO facial muscles when exposed to portrayals of smiling politicians of same political orientation and reported more positive emotions towards these latter. In contrast, when reading about outgroup politicians smiling, there was a weaker activation of the ZM muscle and no activation of the OO muscle, suggesting a weak non-Duchenne smile, while emotions reported towards outgroup politicians were significantly more negative. Also, a more enhanced frown response in the CS was found for ingroup compared to outgroup politicians’ frown expressions. Present findings suggest that a politician’s smile may go a long way to influence electorates through both non-verbal and verbal pathways. They add another layer to our understanding of how language and social information shape embodied effects in a highly nuanced manner. Implications for verbal communication in the political context are discussed.

Background: When exposed to events that transgress one’s moral beliefs, a plethora of negative consequences may follow, which are captured by the concept of moral injury (MI). Despite its relevance to experiences of healthcare workers during a global health emergency, there is lack of validated MI instruments adapted to the healthcare setting.

Capturing political support from spontaneous smile reactions detected in others’ faces can be used to gauge electorate preference. But will a smile elicited in the corner of one’s eye while reading of a favored politician smiling indicate positive disposition and political support for target candidates? From an embodied simulation perspective, we tested whether reading of an ingroup or outgroup politician smiling would trigger morphologically different smiles in faces of readers. In a reading task in the laboratory, participants were presented with subject-verb phrases describing left and right-wing politicians smiling or frowning while their facial muscular reactions were measured via electromyography (EMG) recording from the zygomaticus major (ZM, lip puller muscle), orbicularis oculi (OO, eye corner muscle) and the corrugator supercili (CS, wrinkler of the eyebrows). We expected and found that participants responded with a smile detected at the lip puller (ZM) and eye corner (OO) facial muscles when exposed to portrayals of smiling politicians of same political orientation, and reported more positive emotions towards these latter. When reading about outgroup politicians smiling, there was a weaker activation of the lip corner (ZM) muscle and no activation of the eye corner (OO) muscle, while emotions reported towards outgroup politicians were significantly more negative. Also, a more enhanced frown response (CS) was found for ingroup compared to outgroup politicians’ frown expressions. Present findings suggest that a politician’s smile may go a long way to influence electorates through both non-verbal and verbal pathways. They add another layer to our understanding of how language and social information shape embodied effects in a highly nuanced manner.

(1) Background: Adolescent well-being is a multifaceted construct embedded in family, school, and peer socialization contexts. By adopting a social-psychological perspective we test the association between three sources of support (parents, teachers, peers) and specific components of subjective well-being (cognitive, affective, global-and-domain-specific) to determine whether there is a functional specialization of the role that these crucial socialization agents play for adolescents to attain well-being in specific life domains. (2) Methods: Cross-sectional Albanian data from Wave 3 of the Children’s Worlds International Survey (www.isciweb.org) were used, including 2,339 adolescents (age range 9-13; girls = 49.3%). A structural equation model (SEM) was employed to explore associations between supportive relationships with parents, teachers, and peers and adolescent well-being. (3) Results: Findings support a functional specialization hypothesis as parental support was significantly related to global cognitive and affective well-being; teacher support was significantly related with school satisfaction; and significant relations were found between peer support and almost all well-being variables (context-free, domain-based life satisfaction and affective subjective well-being). (4) Conclusions: Findings contribute to a more nuanced understanding of the role of supportive relationships with adults and peers in adolescents’ proximal socialization contexts (family, school, peer groups) and specific components of subjective well-being.