Individual, interpersonal, and organisational factors associated with discrimination in medical decisions affecting people with a migration background with mental health problems: the case of general practice

OBJECTIVES

Although people with a migration background (MB) have more unmet mental health needs than the general population, patients with a MB are still underrepresented in mental health care services. Provider bias towards these patients has been evidenced repeatedly but its driving factors remain elusive. We assessed the moderating effect of the individual (e.g. age and ethnicity), interpersonal (e.g. healthcare provider trust), and organisational (e.g. perceived workload) factors on general practitioners (GPs) differential decision-making regarding diagnosis, treatment, and referral for a depressed patient with or without a MB.

DESIGN

An experimental study was carried out in which GPs were shown one of two video vignettes featuring adult male depressed patients, one with a MB and the other without. Belgian GPs (n = 797, response rate was 13%) had to decide on their diagnosis, treatment, and referral. Analysis of variance and logistic regression were used to analyse the effect of a MB, adding interaction terms for the explanatory variables.

RESULTS

Overall, we found that there were ethnic differences in GPs' decisions regarding diagnosis and treatment recommendations. GPs perceived the symptoms of the patient with a MB as less severe (F = 7.68, p < 0.01) and demonstrated a reduced likelihood to prescribe a combination of medical and non-medical treatments (F = 11.55, p < 0.001). Those differences increased in accordance with the GP's age and perceived workload; at an interpersonal level, we found that differences increased when the GP thought the patient was exaggerating his distress.

CONCLUSION

This paper showed that lower levels of trust among GPs' towards their migrant patients and high GP workloads contribute to an increased ethnic bias in medical decision-making. This may perpetuate ethnic inequalities in mental health care. Future researchers should develop an intervention to decrease the ethnic inequities in mental health care by addressing GPs' trust in their migrant and ethnic minority patients.

Suicidal ideations and self-dehumanization in recently detoxified patients with severe alcohol use disorder: an experimental exploration through joint explicit-implicit measures

BACKGROUND

Metadehumanization (the feeling of being considered as less than human by others) is a pervasive phenomenon in psychiatric states, notably promoting self-dehumanization and suicide antecedents. However, its role in suicidal ideations among patients with addictive disorders remains unexplored. We thus investigated the involvement of metadehumanization/self-dehumanization in suicidal ideations and suicidal thoughts interference in severe alcohol use disorder.

METHODS

We measured metadehumanization, suicidal ideations, and desire for social contact through questionnaires among 35 recently detoxified patients with severe alcohol use disorder (26 males). We measured animalistic/mechanistic self-dehumanization using an Implicit Association Task, and suicidal thoughts interference using a Stroop Task with suicide-related words. We performed regression analyses while controlling for depression/anxiety.

RESULTS

Animalistic self-dehumanization was positively associated with suicidal thoughts interference and with decreased desire for social interactions, such link being absent for metadehumanization or mechanistic self-dehumanization.

CONCLUSIONS

This link between self-dehumanization and suicide-related factors suggests that a reduced sense of belonging to humanity is associated with self-harm antecedents. Results also emphasize the importance of using indirect measures to investigate sensitive variables, such as self-dehumanization and suicidal thoughts.

Unintentional Discrimination Against Patients with a Migration Background by General Practitioners in Mental Health Management: An Experimental Study

Populations with a migration background have a higher prevalence of mental health problems than their native counterparts. They are also more likely to have unmet medical needs and are less frequently referred to mental health services. One potential explanation for this is that physicians, such as general practitioners (GPs), may unintentionally discriminate against migrant patients, particularly when they lack humanization. To date, no experimental study has investigated this hypothesis. This paper assesses the influence of humanization on GPs' discriminatory decisions regarding migrant patients with depression. A balanced 2 × 2 factorial experiment was carried out with Belgian GPs (N = 797) who received video-vignettes depicting either a native patient or a migrant patient with depression. Half of the respondents were exposed to a text that humanized the patient by providing more details about the patient's life story. Decisions related to diagnosis, treatment and referral were collected, as well as the time spent on each video and text, and were analysed using ANOVA. Migrant patients' symptoms were judged to be less severe than those of native patients (F = 7.71, p < 0.05). For almost all treatments, the decision was less favourable for the migrant patient. Humanization had little effect on medical decisions. We observed that GPs spent significantly more time on the vignette with the humanization intervention, especially for the migrant patients. The results indicate that ethnic differences in the management of depression persist in primary care. Humanization, however, does not mitigate those differences in medical decisions.

Introduction to the Special Issue of Group Processes & Intergroup Relations Less than Human: What People who are Dehumanized Think, Feel, and Do

Over recent years, social psychological research has investigated dehumanization (viewing and treating people as less than human) by primarily focusing on those who dehumanize—the perpetrators. Less is known about those who are dehumanized—the targets of dehumanization. This Special Issue aims to address this gap by assembling empirical works on metadehumanization (when targets perceive that they are being dehumanized by others) and self-dehumanization (when targets come to see themselves in dehumanized ways). In this introductory article, we summarize the state of the science and suggest a research agenda for further studying dehumanization from the target’s perspective, by considering: (a) the impact of dehumanizing portrayal used in media; (b) the role of cultural or societal features in shaping our humanness; (c) the individual or situational variables that trigger a dehumanizing versus rehumanizing reaction to dehumanization; (d) the influence of risk- or protective factors on the emerging of metadehumanizing or self-dehumanizing feelings; and (e) the phenomenon of ingroup dehumanization.

Factors influencing general practitioners’ decisions in migrant patients with mental health disorder

Background

Patients with a migration background (MB) have more mental health disorders than those without migration background. Yet, those patients are still underrepresented in mental healthcare services and have more unmet medical needs. Although providers’ bias has been well studied, up to date, little is still known about the factors explaining those biases. We assessed the effect of general practitioners’ (GPs') individual and organizational factors on their decision-making regarding diagnosis, treatment and referral recommendations for patient with MB with symptoms of major depression.

Methods

An experimental study staged a video-vignette of a depressed patient with or without MB. GPs had to make decision about diagnosis, treatment and referral. We then assessed the influence of several factors on their decisions such as age, ethnicity, workload and patient confidence. ANOVA and MANOVA were used for analyses.

Results

Overall, we found more unfavourable decisions in GPs diagnosis and treatment recommendations regarding the patient with a MB (F = 3.56, p &lt; 0.001). In addition, they considered the symptoms of the patient with a MB as less severe (F = 7.68, p &lt; 0.01) and would prescribe less often a medical treatment to these patients (F = 4.09, p &lt; 0.05). Nevertheless, few factors explained these differences, except the age, the workload and the patient trustworthiness.

Conclusions

This paper highlighted GPs biases based on apparent migration background of a patient with major depression that perpetuates ethnic inequalities in mental health care. Further research into the origins of discrimination in primary mental health care are needed to explain how and when those discriminations arise.

Key messages

• This paper shed light on pervasive unintentional discrimination still persist in mental health care among migrants in Europe.

• These findings may help us to further understand the role of general practitioner behaviour in primary mental health care discrimination.

Self-dehumanisation in severe alcohol use disorder: Links with self-stigma and environmental satisfaction

Metadehumanisation (i.e., the perception of being considered as less than human by others) is proposed to be widespread in stigmatised populations, such as people with severe alcohol use disorder (SAUD). However, the relations between metadehumanisation, self-dehumanisation (i.e., the self-perception of being less than human), and stigmatisation (i.e., the negative taint applied to some groups) remain unexplored. The aim of this research is thus to investigate the relations between these processes. Metadehumanisation, self-dehumanisation, self-stigma (and its subdimensions) and environmental satisfaction were assessed in 120 inpatients with SAUD and analysed in a mediational model. Stigma awareness was positively associated with metadehumanisation, whereas environmental satisfaction was negatively associated with metadehumanisation. Stigma's application to the self was associated with increased self-dehumanisation. Self-stigma and self-dehumanisation are closely intertwined phenomena. Self-dehumanisation seems to follow a multi-step process suggesting that some steps, such as dehumanisation awareness, are missing from current models of dehumanisation.

Dual inhibition of factor XIIa and factor XIa as a therapeutic approach for safe thromboprotection

Clinical practice shows that a critical unmet need in the field of medical device-associated thrombosis prevention is the availability of an anticoagulant therapy without hemorrhagic risk. In the quest for new drugs that are at least as effective as those currently available, while avoiding bleeding complications, molecules that target nearly every step of the coagulation pathway have been developed. Among these molecules, inhibitors of factor XII (FXII) or factor XI (FXI) are promising alternatives as deficiencies in these factors protect against thrombosis without causing spontaneous hemorrhage, as revealed by epidemiological and preclinical data. Ixodes ricinus-contact phase inhibitor (Ir-CPI), a new anticoagulant candidate with an innovative mechanism of action could be this ideal anticoagulant agent for safe prevention from clotting on medical devices. This protein, which selectively binds to FXIIa, FXIa, and plasma kallikrein and inhibits the reciprocal activation of FXII, prekallikrein, and FXI in human plasma, was shown to prevent thrombosis in an ovine cardiopulmonary bypass system associated with cardiac surgeries. Furthermore, as opposed to unfractionated heparin, Ir-CPI appears to be devoid of bleeding risk. This review outlines the rationale for targeting upstream coagulation factors in order to prevent medical device-associated thrombosis; examines the novel approaches under development; and focuses on Ir-CPI, which shows promising properties in the field of thrombosis prevention.

Sex-based and beauty-based objectification: Metadehumanization and emotional consequences among victims

We investigated how two forms of objectification (i.e., sex- and beauty-based objectification) relate to metadehumanization (i.e., the perception of being dehumanized) and emotional consequences for victims. Capitalizing on previous research, we hypothesized that sex-based objectification would induce animalistic metadehumanization and that beauty-based objectification would induce mechanistic metadehumanization. Our four studies showed that sex-based objectification elicits stronger mechanistic metadehumanization than beauty-based objectification, which also elicits higher mechanistic metadehumanization than non-objectifying control condition. Unexpectedly, animalistic metadehumanization did not vary across conditions. These findings suggest that, consistent with the social metaphor, objectified women feel mechanistically dehumanized, independently of the objectification type faced. Sex- and beauty-based objectifications also elicit more anger but less sadness than the control condition. However, only sex-based objectification increases guilt feelings. The general discussion contrasts perpetrators' vision of objectified women to women's own experience of objectification.

"Whatever you do, just don't let him notice you're a woman!" General beliefs on women's gender ideology as a function of topic in mixed-gender negotiations

How one approaches gender differences in general likely influences the way one handles mixed-gender negotiations. In the present paper, we examine general beliefs on how women negotiators do-as opposed to how they "should"-handle gender in order to increase their chances of success. First, we hypothesised that people's general beliefs would support a sexblindness ideology according to which gender is, and indeed should be, ignored in order to succeed. Second, because negotiation comes across as a stereotypically masculine activity, we predicted that prescriptions regarding what women should do to succeed would commonly favour assimilationism (the belief that women need to assimilate to male norms) over sexawareness (the belief that gender differences should be acknowledged and celebrated). We nevertheless predicted a general belief that women might stay away from these prescriptions and rely more on their gender (i.e. endorse sexawareness over assimilationism) within feminine as compared to masculine and neutral-topic negotiations. Together, our two experiments confirm these predictions. We discuss our results in terms of the consequences on women's gender ideology-based strategies, a potentially relevant aspect to their actual negotiating outcomes.

Metadehumanization in severe alcohol-use disorders: Links with fundamental needs and clinical outcomes

BACKGROUND

Dehumanization, i.e., the denial of one's humanity, has important consequences for social interactions. Earlier works mainly studied the dehumanizer's perspective, neglecting victims and particularly psychiatric populations. This study's goal is thus to investigate if patients with severe alcohol-use disorders (SAUD) feel dehumanized by others and to reveal factors linked to metadehumanization.

METHODS

A cross-sectional study in 120 patients with SAUD as diagnosed by their psychiatrist using DSM-IV criteria.

RESULTS

Participants reported significant levels of metadehumanization, which were directly or indirectly linked to fundamental needs threat (γ = 0.41, p < .001), decreased positive emotions (indirect effect = -0.11, p < .05), reduced self-esteem (indirect effect = -0.16, p < .01), reduced use of functional coping strategies focused on the search of social support (γ = -0.20, p < .05), and increased use of dysfunctional coping strategies (indirect effect = 0.15, p < .01) such as excessive alcohol use (indirect effect = 0.10, p < .05).

CONCLUSIONS

Patients feel dehumanized by others, an experience linked to important deleterious consequences for patients' wellbeing and treatment.

Examining the role of fundamental psychological needs in the development of metadehumanization: A multi-population approach

In the present paper, we investigate dehumanization processes from a victim perspective. We propose that dehumanization experiences, that is metadehumanization, arise from people's feelings that their fundamental human needs are thwarted and that such experiences influence their emotions, self-esteem, and coping strategies. Our model is put at test in three contexts involving different types of dehumanization victims: Women (Study 1a, N = 349), patients with severe alcohol use disorder (Study 1b, N = 120), and employees in organizations (Study 1c, N = 347). Our integrated model of metadehumanization, which considers both its antecedents and consequences, proved stable across contexts and populations and therefore helps building bridges between different psychological disciplines in which dehumanization occurs.

Two Preregistered Direct Replications of “Objects Don’t Object: Evidence That Self-Objectification Disrupts Women’s Social Activism”

Self-objectification has been claimed to induce numerous detrimental consequences for women at the individual level (e.g., sexual dysfunction, depression, eating disorders). Additionally, at the collective level, it has been proposed that self-objectified women might themselves contribute to the maintenance of the patriarchal status quo, for instance, by participating less in collective action. In 2013, Calogero found a negative link between self-objectification and collective action, which was mediated by the adoption of gender-specific system justification. Here, we report two preregistered direct replications (PDRs) of Calogero’s original study. We conducted these PDRs after three failures to replicate the positive relation between self-objectification and gender-specific system-justification belief in correlational studies. Results of the two PDRs, in which we used a Bayesian approach, supported the null hypothesis. This work has important theoretical implications because it challenges the role attributed to self-objectified women in the maintenance of patriarchy.

Dehumanization of psychiatric patients: Experimental and clinical implications in severe alcohol-use disorders

Dehumanization, defined as the denial of one's membership to humanity, is a process repeatedly reported in extreme contexts (e.g., genocides) but also in everyday life interactions. Some antecedents of dehumanizing experiences (e.g., social exclusion, negative stereotypes) have been reported among patients presenting psychiatric disorders, but dehumanization's experience remains completely unexplored in addictive disorders. We propose a theoretical model and research agenda to overcome this limitation and to improve our understanding of dehumanization's experience in psychiatry, with a special focus on alcohol-related disorders. We also propose much-needed clinical avenues to reduce dehumanization in clinical contexts, centrally by (1) improving dehumanization awareness among medical workers; (2) reducing the need for healthcare workers to use dehumanization to alleviate professional exhaustion; and (3) optimizing medical training to increase empathy toward patients. Finally, some additional improvements are proposed to promote patient's choices, comfort, dignity, and ultimately humanity in hospitals.

Justice reactions to deviant ingroup members: Ingroup identity threat motivates utilitarian punishments

To maintain a positive overall view of their group, people judge likeable ingroup members more favourably and deviant ingroup members more harshly than comparable outgroup members. Research suggests that such derogation of deviant ingroup members aims to restore the image of the group by symbolically excluding so‐called ‘black sheeps’. We hypothesized that information about a harm‐doer's group membership influences observers’ justice‐seeking reactions. Motives for punishment vary based on whether the goal is to punish past harm‐doing (i.e., retributive motives), help harm‐doers recognize the harm inflicted and reintegrate into society (i.e., restorative motives), or control harm‐doer's future behaviour through incapacitating practices and exclusion from society (i.e., utilitarian motives). We hypothesized that immoral behaviours by ingroup rather than outgroup members jeopardize the group's reputation and therefore activate utilitarian (i.e., exclusion‐oriented) motives for punishment. Study 1 (N = 187) confirmed that people displayed more utilitarian motives and less restorative motives when sanctioning an ingroup as opposed to an outgroup harm‐doer. Study 2 (N = 122) manipulated typicality to the ingroup. Participants displayed stronger utilitarian (i.e., exclusion‐oriented) punishment motives when the harm‐doer was presented as a typical ingroup rather than an outgroup member. Study 3 (N = 292) replicated the findings of Studies 1 and 2 and further showed that people displayed stronger utilitarian punishments against an ingroup offender through the experience of increased identity threat. Contrary to our expectations, observers’ ingroup identification did not moderate the effect of group membership or typicality to the ingroup on justice reactions. Yet, ingroup identification influenced both experienced identity threat (i.e., mediator) and utilitarian motives for punishment with high identifiers experiencing higher threat and displaying stronger utilitarian punishment motive. We discuss the results in terms of people's concern for the protection of their group identity.

Perceived Organizational Support and Workplace Conflict: The Mediating Role of Failure-Related Trust

The aim of the present research was twofold. First, we examined the effects of perceived organizational support (POS) on workplace conflict (i.e., relationship conflict and task conflict). Second, we identified one mechanism explaining these relationships, namely failure-related trust. Using a sample of 263 teachers from Belgium, the results of Study 1 indicated that POS is negatively related to relationship conflict and is also, unexpectedly, negatively related to task conflict. Furthermore, using a sample of 477 Belgian employees, Study 2 replicated these results and further demonstrated that failure-related trust mediates the negative relationship between POS and both types of workplace conflict. Theoretical and practical insights of this research are discussed.

The Power of Projection for Powerless and Powerful People

Past social projection research has mainly focused on target characteristics as a moderator of projective effects. The current research considers the power of the perceiver and how it affects projection of competence and warmth. In three studies, participants first rated themselves on a list of traits/preferences, then performed a power manipulation task, and, finally, rated a target person on the same list. Studies 1 and 2 reveal that the effect of power on social projection is moderated by dimension of judgment: high-power/low-power participants project more on competence/warmth than low-power/high-power participants. A meta-analysis conducted on Studies 1, 2, 3, and two additional studies confirmed those results. Study 3 additionally shows that high power increases the salience of competence, whereas low power increases the salience of warmth. Implications for both the power and the social perception literatures are discussed.

Animalistic dehumanization of older people by younger ones: Variations of humanness perceptions as a function of a target's age

The present work investigated associations of older people with humanness. Focusing on complementary approaches (attribute-based, metaphor-based, and target-based), 4 studies tested the hypothesis that older people are the targets of animalistic dehumanization. Using an emotional attribution task, Study 1 (N = 112) explored infrahumanization and shows that young participants attributed more uniquely human emotions to young people than to older ones. No such effect occurred with regards to nonuniquely human emotions. Results of Study 2 (N = 62) replicated this result using a lexical-decision task. Using the metaphor-based approach, Study 3 (N = 99) confirmed that older people's dehumanization is restricted to its animalistic form and does not extend to the mechanistic one. Finally, in Study 4 (N = 167), we used a target-based approach and showed that characteristics initially attributed to older people are perceived as denoting lesser humanness than when these same characteristics are associated with younger people. Results of the 4 studies provide evidence for an animalistic form of dehumanization of older people by younger ones. Limits, implications, and future research are discussed. (PsycINFO Database Record

The Emotional Side of Prejudice: The Attribution of Secondary Emotions to Ingroups and Outgroups

If people favor their ingroup, are especially concerned with their own group, and attribute different essences to different groups, it follows that their essence must be superior to the essence of other groups. Intelligence, language, and certain emotions are all considered to be distinctive elements of human nature or essence. The role of inteligence and language in discrimination, prejudice, and racism has already been largely investigated, and this article focuses on attributed emotions. Specifically, we investigate the idea that secondary emotions are typically human characteristics, and as such, they should be especially associated with and attributed to the ingroup. Seondary emotions may even be denied to outgroups. These differential associations and attributions of specifically human emotions to ingroups versus outgroups should affect intergroup relations. Results from several initial experiments are summarized that support our reasoning. This emotional approach to prejudice and racism is contrasted with more classic, cognitive perspectives.

Differential Association of Uniquely and Non Uniquely Human Emotions with the Ingroup and the Outgroup

According to Leyens et al.’s (2000) theory, intergroup discrimination involves a differential appraisal of the ingroup’s and the outgroup’s uniquely human characteristics. Four experiments investigated how emotions that are considered uniquely (i.e. secondary emotions) and non uniquely (i.e. primary emotions) human (Demoulin et al., 2001a) are differentially associated with the ingroup and the outgroup. Using the Implicit Association Task (IAT) we found a stronger association of ingroup names with uniquely human emotions and of outgroup names with non uniquely human emotions, than the reverse. Whereas Study 2 used negative emotions, all other experiments used positive emotions. In Study 3, two IAT indices were collected: an emotional index and a standard evaluative one. While the outgroup was constituted by North African names in the first three studies, Study 4 staged French-speaking Belgians (i.e. the ingroup) versus Dutch-speaking Belgians (i.e. the outgroup). The results are discussed within the framework of psychological essentialism, according to which uniquely human characteristics form the essence of the ingroup.

HMGB1 secretion during cervical carcinogenesis promotes the acquisition of a tolerogenic functionality by plasmacytoid dendritic cells

Acquisition of an impaired functionality by plasmacytoid dendritic cells (pDCs) contributing to cancer progression has been documented in different types of cancers. In the present study, we postulate that molecules secreted by (pre)neoplastic epithelial cells of the genital tract (cervix/vulva) might attract pDCs but also modify their proper functionality, allowing these cells to initiate a tolerogenic response interfering with antitumor immunity. We demonstrated that pDCs are recruited during the cervical metaplasia-dysplasia-cancer sequence, through the action of their chemoattractant, chemerin. We showed that stimulated-pDCs exposed to cervical/vulvar tumor microenvironment display an altered phenotype. We also demonstrated that cervical/vulvar neoplastic keratinocytes inhibit the proper function of pDCs by decreasing their IFNα secretion in response to CpG oligonucleotides. In parallel, we observed that (pre)neoplastic areas of the cervix are infiltrated by FoxP3(+) Treg cells which colocalize with pDCs. Accordingly, pDCs cocultured with cervical/vulvar neoplastic keratinocytes have the capacity to induce a Treg cell differentiation from naïve CD4(+) T cells, which is in agreement with the development of a tolerogenic response. We identified HMGB1 as a soluble factor produced by neoplastic keratinocytes from the genital tract involved in pDCs functional alteration. Indeed, this molecule inhibited pDC maturation, decreased IFNα secretion following TLR9 stimulation and forced these cells to become tolerogenic. In contrast, inhibition of HMGB1 restored pDC phenotype. Our findings indicate that the use of inhibitory molecules notably directed against HMGB1 in cervical/vulvar (pre)neoplastic lesions might prevent alterations of pDCs functionality and represent an attractive therapeutic strategy to overcome immune tolerance in cancers.

Altered α-defensin 5 expression in cervical squamocolumnar junction: implication in the formation of a viral/tumour-permissive microenvironment

Human papillomavirus (HPV) infection, particularly type 16, is causally associated with cancer of the uterine cervix, which mainly develops at the squamocolumnar (SC) junction. The progression of cervical HPV infections into (pre)neoplastic lesions suggests that viral antigens are not adequately recognized by innate immunity or presented to the adaptive immune system. Members of the defensin family have recently been found to inhibit viral and bacterial pathogens, to stimulate the migration of immune cells and to play a role in anticancer responses. In the present study, we focused on the poorly characterized human α-defensin 5 (HD-5) and its possible role in these processes. We showed that HD-5 was able to prevent HPV virion entry into cervical keratinocytes and to influence adaptive immunity. Indeed, this peptide specifically induced the chemoattraction and proliferation of both activated T lymphocytes and immature dendritic cells in a CCR2/CCR6-dependent manner and stimulated the infiltration of these professional antigen-presenting cells in a (pre)neoplastic epithelium transplanted in vivo in immunodeficient mice. No chemotactic effect was observed with plasmacytoid dendritic cells, macrophages or natural killer cells. Proliferative and angiogenic effects of HD-5 were also assessed in vitro and in vivo. However there was a striking regional disparity in expression of HD-5, being prominent in ectocervical, vaginal and vulvar neoplasia, while absent, or nearly so, in the cervical SC junction. Taken together, these results suggest one possible explanation for why the SC junction is uniquely vulnerable to both high-risk HPV infection (via reduced HD-5 expression and viral entry) and progression of neoplasia (via altered cell-mediated immune responses and altered microenvironment).

[Aging and cancer: coincidence or etiologic relationship?]

In Belgium and in other countries, the Cancer Registry data show an increased incidence of cancers related to age, the majority of tumors being diagnosed beyond 60 years. However, the mechanisms responsible for this increase are not clear. Cancer could be chronologically associated with aging because of the long latency period between the exposition to carcinogenic agents and the appearance of clinical signs. Aging could also predispose directly to cancer by different mechanisms (impaired immune response, increased oxidative stress, shortening of telomeres, accumulation of senescent cells). In this review, we propose to describe different hypotheses which could explain the increased incidence of cancers in the elderly.

Vulvar skin disorders throughout lifetime: about some representative dermatoses

The objective of this paper is to present general considerations which should be kept in mind by clinicians in charge of women with vulvar diseases. Four representative vulvar dermatoses are described. Lichen simplex chronicus is a pathological condition related to chemical and mechanical irritant agents. Detrimental effects of these irritants, in the presence of other dermatoses, have to be considered when therapeutic responses are unsatisfactory. Lichen sclerosus is the most common vulvar dermatosis in elderly. However, it should be kept in mind that it may be diagnosed at any age. Lichen planus, in spite of sharing a similar range of etiological factors with lichen sclerosus, is a very distinct entity. Finally, Paget's disease, although rare, is also described especially because of the challenge it represents both clinically and therapeutically.

Acculturative Stress or Resilience? A Longitudinal Multilevel Analysis of Sojourners’ Stress and Self-Esteem

Intercultural contact may lead to temporary phases of acculturative stress but is also associated with personal growth. While this topic has been well studied, we argue that there has been a lack of systematic investigation in the form of panel data studies. The present article examines the temporal pattern of stress and self-esteem, with measures for sojourners and controls prior to, during, and post intercultural contact. The sojourner sample consisted of a group of Belgian adolescents who took part in a 1 year intercultural exchange program. Sojourners reported lower levels of stress and higher levels of self-esteem during the sojourn compared to pre-departure levels and controls. These findings were explained in terms of personal growth and acculturative resilience. Subsequent analyses also investigated whether stress and self-esteem could be predicted by intrapersonal (i.e., homesickness), interpersonal (i.e., social support), intergroup (i.e., identity, prejudice), and cultural distance measures. Stress was indeed associated with intrapersonal, interpersonal, and intergroup measures, but not with cultural distance. Self-esteem was associated with intrapersonal and intergroup predictors.

To Be or Not to Be Unionized?

This research aims at analyzing the association between two core variables of the employee-organization relationship (i.e., organizational identification and perceived organizational support) and union membership. Our study shows that perceived organizational support was negatively related to union membership but only for low identifiers. In line with prior research, highly identified employees proved less sensitive to a poor-quality exchange relationship with the organization. These findings suggest that union membership would be one possible response to a lack of support from an organization to which employees do not necessarily identify. However, future research should examine the relative weight of these variables compared to other known determinants of union membership.

The role of in-group identification in infra-humanization

People tend to infra-humanize by attributing more human essence to their in-group than to out-groups. In the present article, we focus on the attribution of primary and secondary emotions to operationalize the human essence. We propose that, in order to infra-humanize, people need to be categorized in meaningful groups. In addition, we argue that what differentiates meaningful from nonmeaningful groups is that the people essentialize, perceiving members of the group as sharing an underlying, common essence. Also, we hypothesize that participants will identify more with their in-group in the case of meaningful groups. Three types of groups were created to manipulate the meaningfulness of the categorization. Participants were either randomly assigned to a group or they chose their group as a function of their preferences for a colour or the type of career they wished to pursue. As expected, infra-humanization occurred only where the categorization's criterion was meaningful. In addition, in-group identification, but not essentialism, mediated the impact of the categorization criteria on the tendency to infra-humanize. Data also showed that infra-humanization is different from classic in-group favouritism. This is because in-group favouritism, but not infra-humanization, was observed in the situation where group membership was based on random assignment. In other words, for infra-humanization to occur mere categorization is not enough; meaningfulness is also needed. For in-group favouritism to arise, the knowledge of being part of a group is a sufficient prerequisite. The discussion focuses on conditions for reducing infra-humanization and on the relationship between in-group favouritism and out-group derogation.

Production of large numbers of plasmacytoid dendritic cells with functional activities from CD34(+) hematopoietic progenitor cells: use of interleukin-3

Plasmacytoid dendritic cells (pDC), a subset of dendritic cells characterized by a rapid and massive type-I interferon secretion through the Toll-like receptor pathway in response to viral infection, play important roles in the pathogenesis of several diseases, such as chronic viral infections (e.g., hepatitis C virus, human immunodeficiency virus), autoimmunity (e.g., psoriasis, systemic lupus erythematosus), and cancer. As pDC represent a rare cell type in the peripheral blood, the goal of this study was to develop a new method to efficiently generate large numbers of cells from a limited number of CD34(+) cord blood progenitors to provide a tool to resolve important questions about how pDC mediate tolerance, autoimmunity, and cancer. Human CD34(+) hematopoietic progenitor cells isolated from cord blood were cultured with a combination of Flt3-ligand (Flt3L), thrombopoietin (TPO), and one of the following cytokine: interleukin (IL)-3, interferon-β(IFN-β), or prostaglandin E2(PGE(2)). Cells obtained in the different culture conditions were analyzed for their phenotype and functional characteristics. The addition of IL-3 cooperates with Flt3L and TPO in the induction of pDC from CD34(+) hematopoietic progenitor cells. Indeed, Flt3L/TPO alone or supplemented with prostaglandin E2 or interferon-β produced smaller amounts of pDC from hematopoietic progenitor cells. In addition, pDC generated in Flt3L/TPO/IL-3 cultures exhibited morphological, immunohistochemical, and functional features of peripheral blood pDC. We showed that IL-3, in association with Flt3L and TPO, provides an advantageous tool for large-scale generation of pDC. This culture condition generated, starting from 2 × 10(5) CD34(+) cells, up to 2.6 × 10(6) pDC presenting features of blood pDC.

Social categorization in interpersonal negotiation: How social structural factors shape negotiations

Social categorization is a powerful determinant of social behavior. As group membership becomes salient, individuals come to behave as group members and, consequently, appraise interactions according to these salient group identities (Turner, 1987). The aim of the present article is to investigate the impact of social categorization on perceptions and appraisals of a distributive negotiation situation. An experiment is presented in which social categorization of the negotiation partner is manipulated. Results revealed that the social structural factors associated with the partner’s group (i.e. social status and group’s competition) influence fixed-pie perceptions as well as participants’ inferences about their counterpart’s target and resistance points. In addition, these effects are mediated by stereotypical evaluations of the counterpart in terms of warmth and competence, respectively.

Introduction: Negotiation in intergroup conflict

Although conflicts most often occur between groups, research and theory on conflict management and negotiation have largely focused on the interpersonal system and ignored how groups negotiate a solution to their intergroup conflict. Thus we have a thorough understanding of the motivational, cognitive, and affective processes underlying the development of high quality solutions in interpersonal negotiation, but we know little about the extent to which these insights can be comfortably generalized to intergroup settings. Likewise, the large volume of work on intergroup perceptions and intergroup relations has much to say about intergroup negotiation, but these research areas have rarely been connected and produced systematic analysis. The current Special Issue presents research on these topics and aims at promoting cross-talk between negotiation researchers and social psychologists in the intergroup relation domain.

Stereotype content model across cultures: towards universal similarities and some differences

The stereotype content model (SCM) proposes potentially universal principles of societal stereotypes and their relation to social structure. Here, the SCM reveals theoretically grounded, cross-cultural, cross-groups similarities and one difference across 10 non-US nations. Seven European (individualist) and three East Asian (collectivist) nations (N=1,028) support three hypothesized cross-cultural similarities: (a) perceived warmth and competence reliably differentiate societal group stereotypes; (b) many out-groups receive ambivalent stereotypes (high on one dimension; low on the other); and (c) high status groups stereotypically are competent, whereas competitive groups stereotypically lack warmth. Data uncover one consequential cross-cultural difference: (d) the more collectivist cultures do not locate reference groups (in-groups and societal prototype groups) in the most positive cluster (high-competence/high-warmth), unlike individualist cultures. This demonstrates out-group derogation without obvious reference-group favouritism. The SCM can serve as a pancultural tool for predicting group stereotypes from structural relations with other groups in society, and comparing across societies.

Stereotype content model across cultures: towards universal similarities and some differences

The stereotype content model (SCM) proposes potentially universal principles of societal stereotypes and their relation to social structure. Here, the SCM reveals theoretically grounded, cross-cultural, cross-groups similarities and one difference across 10 non-US nations. Seven European (individualist) and three East Asian (collectivist) nations (N=1,028) support three hypothesized cross-cultural similarities: (a) perceived warmth and competence reliably differentiate societal group stereotypes; (b) many out-groups receive ambivalent stereotypes (high on one dimension; low on the other); and (c) high status groups stereotypically are competent, whereas competitive groups stereotypically lack warmth. Data uncover one consequential cross-cultural difference: (d) the more collectivist cultures do not locate reference groups (in-groups and societal prototype groups) in the most positive cluster (high-competence/high-warmth), unlike individualist cultures. This demonstrates out-group derogation without obvious reference-group favouritism. The SCM can serve as a pancultural tool for predicting group stereotypes from structural relations with other groups in society, and comparing across societies.

Incomplete bundle-branch block and ST-segment elevation: syndrome associated with sustained monomorphic ventricular tachycardia in patients with apparently normal heart

This paper reports on three cases of patients with an apparently normal heart admitted for sustained monomorphic ventricular tachycardia. The only abnormal finding showed in the electrocardiogram (ECG) in sinus rhythm that exhibited an entity associated with incomplete right bundle-branch block and persistent ST-segment elevation. The ECG entity was variable and disappeared transiently. Spontaneous ventricular tachycardia in one patient was inducible by programmed stimulation. There was no underlying heart disease. The origin of the ventricular tachycardia in one patient was located by pace mapping in the left ventricle at the left ventricular basal septum. The follow-up (from 6 months up to 6 years) demonstrated a good prognosis. This particular ECG entity associated with monomorphic ventricular tachycardia could have been missed because of the variations in the ECG in sinus rhythm and was associated with a favorable prognosis.

Lay Theories of Essentialism

This article investigates the essentialist perception of social categories and differentiates it from two closely related concepts, namely entitativity and natural kind-ness. We argue that lay perceptions of social categories vary along three dimensions: natural kind-ness, entitativity, and essentialism. Depending on whether membership in social categories is forced or chosen, people develop different theories and associate different types of characteristics. Perceived control upon membership in the categories influences perceptions of entitativity and natural kind-ness but has no direct impact on the attribution of essentialism to the groups.

Infrahumanization or familiarity? Attribution of uniquely human emotions to the self, the ingroup, and the outgroup

People attribute more secondary emotions to their ingroup than to outgroups. This effect is interpreted in terms of infrahumanization theory. Familiarity also could explain this differential attribution because secondary emotions are thought to be less visible and intense than primary ones. This alternative explanation to infrahumanization was tested in three studies. In Study 1, participants attributed, in a between-participants design, primary and secondary emotions to themselves, to their ingroup, or to an outgroup. In Study 2, participants answered for themselves and their ingroup or for themselves and an outgroup. In Study 3, participants made attributions to the ingroup or a series of outgroups varying in terms of familiarity. The data do not support an explanation in terms of familiarity. The discussion centers on conditions not conducting to infrahumanization.