An Overview of Inoculation Theory

Introduction

Inoculation theory is a social psychological/communication theory that explains how an attitude or belief can be made resistant to persuasion or influence, in analogy to how a body gains resistance to disease. The theory uses medical inoculation as its explanatory analogy but instead of applying it to disease, it is used to discuss attitudes and other positions, like opinions, values, and beliefs. It has applicability to public campaigns targeting misinformation and fake news, but it is not limited to misinformation and fake news.

The theory was developed by social psychologist William J. McGuire in 1961 to explain how attitudes and beliefs change, and more specifically, how to keep existing attitudes and beliefs consistent in the face of attempts to change them. Inoculation theory functions to confer resistance of counter-attitudinal influences from such sources as the media, advertising, interpersonal communication, and peer pressure.

The theory posits that weak counterarguments generate resistance within the receiver, enabling them to maintain their beliefs in the face of a future, stronger challenge. Following exposure to weak counterarguments (e.g. counterarguments that have been paired with refutations), the receiver will then seek out supporting information to further strengthen their threatened position. The held attitude or belief becomes resistant to a stronger “attack,” hence the medical analogy of a vaccine.

Inoculating messages can raise and refute the same counterarguments in the “attack” (refutational same) or different counterarguments on the same or a related issue (refutational different). The effect of the inoculating message can be amplified by making the message of vested and immediate importance to the receiver (based on Jack Brehm’s psychological reactance theory). Post-inoculation talk can further spread inoculation effects to their social network, and the act of talking to others can additionally strengthen resistance to attitude change.

Therapeutic inoculation is a recent extension in which an inoculation message is presented to those without the targeted belief or attitude in place. Applied in this way, an inoculation message can both change an existing position and make that new position more resistant to future attacks.

Brief History

William McGuire set out to conduct research on ways to encourage opposition to persuasion while others created experiments to do the opposite.  McGuire was motivated to study inoculation and persuasion as a result of the aftermath of the Korean War. McGuire was concerned for those who were forced into certain situations which was the main inspiration for this theory. Nine US prisoners of war, when given the opportunity, elected to remain with their captors. Many assumed they were brainwashed, so McGuire and other social scientists turned to ways of conferring resistance to persuasion. This was a change in extant persuasion research, which was almost exclusively concerned with how to make messages more persuasive, and not the other way around.

The theory of inoculation was derived from previous research studying one-sided and two-sided messages. One-sided messages are supportive messages to strengthen existing attitudes, but with no mention of counter-positions. One-sided messages are frequently seen in political campaigns when a candidate denigrates his or her opponent through “mudslinging”. This method is effective in reinforcing extant attitudes of derision toward the opposition and support for the “mudslinging” candidate. If the audience supports the opposition, however, the attack message is ineffective. Two-sided messages present both counterarguments and refutations of those counterarguments. To gain compliance and source credibility, a two-sided message must demonstrate the sender’s position, then the opposition’s position, followed by a refutation of the opposition’s argument, then finally the sender’s position again.

McGuire led a series of experiments assessing inoculation’s efficacy and adding nuance to our understanding for how it works). Early studies limited testing of inoculation theory to cultural truisms, or beliefs accepted without consideration (e.g. people should brush their teeth daily). This meant it was primarily used toward the attitudes that were rarely, if ever attacked by opposing forces. The early tests of inoculation theory were used on non-controversial issues, (e.g. brushing your teeth is good for you). Few refute that brushing one’s teeth is a good habit, therefore external opposing arguments against tooth brushing would not change one’s opinion, but it would strengthen support for brushing one’s teeth. Studies of inoculation theory currently target less popular or common attitudes, such as whether one should buy a Mac or a Windows-based PC computer or if one should support gay marriage.

Implementing inoculation theory in studies of contemporary social issues (from mundane to controversial social issues), and the variety and resurgence of such studies, helps bolster the effectiveness and utility of the theory and provides support that it can be used to strengthen and/or predict attitudes. These later developments of the theory extended inoculation to more controversial and contested topics in the contexts of politics, health, marketing, and contexts in which people have different pre-existing attitudes, such as climate change. The theory has also been applied in education to help prevent substance abuse.

About

Inoculation is a theory that explains how attitudes and beliefs can be made more resistant to future challenges. For an inoculation message to be successful, the recipient experiences threat (a recognition that a held attitude or belief is vulnerable to change) and is exposed to and/or engages in refutational processes (pre-emptive refutation, that is, defences against potential counterarguments). The arguments that are presented in an inoculation message must be strong enough to initiate motivation to maintain current attitudes and beliefs, but weak enough that the receiver will be able to refute the counterargument.

Inoculation theory has been studied and tested through decades of scholarship, including experimental laboratory research and field studies. Inoculation theory is used today as part of the suite of tools by those engaged in shaping or manipulating public opinion. These contexts include: politics, health campaigns marketing, education, and science communication, among others.

The inoculation process is analogous to the medical inoculation process from which it draws its name; the analogy served as the inaugural exemplar for how inoculation confers resistance. As McGuire (1961) initially explained, medical inoculation works by exposing the body to a weakened form of a virus – strong enough to trigger a response (that is, the production of antibodies), but not so strong as to overwhelm the body’s resistance. Attitudinal inoculation works the same way: expose the receiver to weakened counterarguments, triggering refutational processes (like counterarguing) which confers resistance to later, stronger “attack” like persuasive messages. This process works like a metaphorical vaccination: the receiver becomes immune to attacking messages that attempt to change their attitudes or beliefs. Inoculation theory suggests that if one sends out messages with weak counterarguments, an individual can build immunity to stronger messages and strengthen their original attitudes toward an issue.

Most inoculation theory research treats inoculation as a pre-emptive, preventive (prophylactic) messaging strategy—used before exposure to strong challenges. More recently, scholars have begun to test inoculation as a therapeutic inoculation treatment, administered to those who have the “wrong” target attitude/belief. In this application, the treatment messages both persuade and inoculate—much like a flu shot that cures those who already have been infected with the flu and protects them against future threats. More research is needed to better understand therapeutic inoculation treatments – especially field research that takes inoculation outside of the laboratory setting.

Another shift in inoculation research moves from a largely cognitive, intrapersonal (internal) process to a process that is both cognitive and affective, intrapersonal and interpersonal. For example, in contrast to explanations of inoculation that focused nearly entirely on cognitive processes (like internal counterarguing, or refuting persuasive attempts silently, in one’s own mind), more recent research has examined how inoculation messages motivate actual talk (conversation, dialogue) about the target issue. Scholars have confirmed that exposure to an inoculation message motivates more post-inoculation talk (PIT) about the issue. For example, Tweets containing native advertising disclosures – a type of inoculation message – were more likely to include negative commentary which is a sign of resistance to influence consistent with PIT.

Pre-Bunking

It is much more difficult to eliminate the influence or persuasion of misinformation once individuals have seen it which is why debunking and fact checking have failed in the past. Due to this, a phenomenon known as pre-bunking as introduced. Pre-bunking (or prebunking) is a form of Inoculation theory that aims to combat various kinds of manipulation and misinformation spread around the web. In recent years, misleading information and the permeation of such have become an increasingly prevalent issue. Standard Inoculation theory aims to combat persuasion. Still pre-bunking seeks to target misinformation by providing a harmless example of it. Exposure builds future resistance to similar misinformation.

In 2021, Nanlan Zhang examined inoculation by looking at harsh, preconceived ideas of mental health. Such ideas included the association of mental health with violence. The study consisted of two different experiments, including 593 participants. In the first, subjects were shown misinformation regarding gun violence, only to have the misinformation explained away. These inoculative techniques were concluded to be slightly effective. In the second experiment of the study, subjects were shown false messages that had either high or low credibility. In the first half of the study, the inoculation affected > 50% of the participants. The second half of the study showed increased effectiveness in inoculation, with subjects showing distrust in high and low credibility messages.

A common form of pre-bunking is in the form of short videos, meant to grab a viewer’s attention with a fake message and then inoculate the viewer by explaining the manipulation. In 2022, Jon Roozenbeek (with funding from Google) developed five pre-bunking video to test the viability of short-form inoculation messages. A total of 29,116 subjects were then shown multiple fabricated posts from various social media outlets. The subjects were then tasked with differentiating between benign posts and ones containing manipulation. The videos were effective in improving the viewer’s ability to identify manipulative tactics. Viewers showed about a 5% average increase in identifying such tactics.

Explanation

Inoculation theory explains how attitudes, beliefs, or opinions (sometimes referred to generically as “a position”) can be made more resistant to future challenges. Receivers are made aware of the potential vulnerability of an existing position (e.g. attitude, belief). This establishes threat and initiates defences to future attacks. The idea is that when a weak argument is presented in the inoculation message, processes of refutation or other means of protection will prepare for use of stronger arguments later. It is critical that the attack is strong enough to keep the receiver defensive, but weak enough to not actually change those pre-existing ideas. This will hopefully make the receiver actively defensive and allow them to create arguments in favour of their pre-existing thoughts. The more active receivers become in their defence the more it will strengthen their own attitudes, beliefs, or opinions.

Key Components

There are at least four basic key components to successful inoculation: threat, refutational pre-emption (pre-emptive refutation), delay, and involvement.

  1. Threat. Threat provides motivation to protect one’s attitudes or beliefs. Threat is a product of the presence of counterarguments in an inoculation message and/or an explicit forewarning of an impending challenge to an existing belief. The message receiver must interpret that a message is threatening and recognise that there is a reason to fight to maintain and strengthen their opinion. If the receiver of an opposing message does not recognize that a threat is present, they will not feel the need to start defending their position and therefore will not change their attitude or strengthen their opinion.  Compton and Ivanov (2012) found that participants who had been forewarned of an attack–i.e. threat–but not given the appropriate tools to combat the attack were more resistant than the control group. In this case, the simple act of forewarning of an attack was enough to resist the counter-attitudinal persuasion.
  2. Refutational pre-emption. This component is the cognitive part of the process. It is the ability to activate one’s own argument for future defence and strengthen their existing attitudes through counterarguing. Scholars have also explored whether other resistance processes might be at work, including affect. Refutational preemption provides specific content that receivers can employ to strengthen attitudes against subsequent change. This aids in the inoculation process by giving the message receiver a chance to argue with the opposing message. It shows the message receiver that their attitude is not the only attitude or even the right attitude, creating a threat to their beliefs. This is beneficial because the receiver will get practice in defending their original attitude, therefore strengthening it. This is important in fighting off future threats of opposing messages and helps to ensure that the message will not affect their original stance on the issues.  Refutational preemption acts as the weak strain of the virus in the metaphor. By injecting the weakened virus–the opposing opinion–into a receiver, this prompts the receiver to strengthen their position, enabling them to fight off the opposing threat. By the time the body processes the virus–the counterattack–the receiver will have learned how to eliminate the threat. In the case of messaging, if the threatening message is weak or unconvincing, a person can reject the message and stick with their original stance on the matter. By being able to reject threatening messages a person builds strength of their belief and every successful threatening message that they can encounter their original opinions only get stronger.  Recent research has studied the presence and function of word-of-mouth communication, or post-inoculation talk, following exposure to inoculation messages.
  3. Delay. There has been much debate on whether there is a certain amount of time necessary between inoculation and further attacks on a person’s attitude that will be most effective in strengthening that person’s attitude. McGuire (1961) suggested that delay was necessary to strengthen a person’s attitude and since then many scholars have found evidence to back that idea up. There are also scholars on the other side who suggest that too much of a delay lessens the strengthening effect of inoculation. Nevertheless, the effect of inoculation can still be significant weeks or even months after initial introduction or the treatment showing that it does produce somewhat long-lasting effects. Despite the limited research in this area, meta-analysis suggests that the effect becomes weakened after too long of a delay, specifically after 13 days.
  4. Involvement. Involvement, which is one of the most important concepts for widespread persuasion, can be defined as how important the attitude object is for the receiver (Pfau, et al. (1997)). Involvement is critical because it determines how effective the inoculation process will be, if at all. If an individual does not have a vested interest in the subject, they will not perceive a threat and, consequently, will not feel the need to defend and strengthen their original opinion, rendering the inoculation process ineffective.

Refutational Same and Different Messages

While there are many studies that have been conducted comparing different treatments of inoculation, there is one specific comparison that is mentioned throughout various studies. This is the comparison between what is known as refutational same and refutational different messages. A refutational same message is an inoculation treatment that refutes specific potential counterarguments that will appear in the subsequent persuasion message, while refutational different treatments are refutations that are not the same as those present in the impending persuasive message. Pfau and his colleagues (1990) developed a study during the 1988 United States presidential election. The Republicans were claiming that the Democratic candidate was known to be lenient when it came to the issue of crime. The researchers developed a refutational same message that stated that while the Democratic candidate was in favour of tough sentences, merely tough sentences could not reduce crime. The refutational different message expanded on the candidate’s platform and his immediate goals if he were to be elected. The study showed comparable results between the two different treatments. Importantly, as McGuire and others had found previously, inoculation was able to confer resistance to arguments that were not specifically mentioned in the inoculation message.

Psychological Reactance

Recent inoculation studies have incorporated Jack Brehm’s psychological reactance theory, a theory of freedom and control. The purpose is to enhance or boost resistance outcomes for the two key components of McGuire’s inoculation theory: threat and refutational pre-emption.

Such a study is the large complex multisite study of Miller et al. (2013). The main focus is to determine how to improve the effectiveness of the inoculation process by evaluating and generating reactance to a threatened freedom by manipulating explicit and implicit language and its intensity. While most inoculation studies focus on avoiding reactance, or at the very least, minimizing the impact of reactance on behaviours, in contrast, Miller, et al. chose to manipulate reactance by designing messages to enhance resistance and counterarguing output. They showed that inoculation coupled with reactance-enhanced messages leads to “stronger resistance effects”. Most importantly, reactance-enhanced inoculations result in lesser attitude change—the ultimate measure of resistance.

The participants in the Miller et al. study were college students, that is emerging adults, who display high reactance to persuasive appeals. This population is in a transitional uncertain stage in life, and are more likely to defend their behavioural freedoms if they feel others are attempting to control their behaviour. Populations in transitional stages rely on source credibility as a major proponent of cognitive processing and message acceptance. If the message is explicit and threatens their perceived freedoms, such populations will most likely derogate (criticise) the source and dismiss the message. Two important needs for reactance to a threatened freedom from an emerging adult population are immediacy and vested interest Miller et al. discuss how emerging adults need to believe their behavioural freedoms, for which they have vestedness, are being threatened, and that the threat exists in real time with almost immediate consequences. Threats that their perceived freedoms will be eliminated or minimised increases motivation to restore that freedom, or possibly engage in the threatened behaviour to reinforce their autonomy and control of their attitudes and actions. In addition, that threat does not necessarily need anger to motivate counter-argumentation, and simply attempting to provoke anger through manipulation is limited as a technique of gauging negative cognitions. Miller et al. also consider refutational pre-emption as motivation for producing initial counterarguments and provocation of dissension when contemplating the attack message.

A unique feature of their study is examining low-controlling versus high-controlling language and its impact on affect and source credibility. They found reactance enhances key resistance outcomes, including: threat, anger at attack message source, negative cognitions, negative affect, anticipated threat to freedom, anticipated attack message source derogation, perceived threat to freedom, perceived attack message source derogation, and counterarguing.

Previously, Miller, et al. (2007) utilises Brehm’s psychological reactance theory[27] to avoid or eliminate source derogation and message rejection. In this study, their focus is instead Brehm’s concept of restoration. Some of their ideas deal with low reactance and whether it can lead to more positive outcomes and if behavioural freedoms can be restored once threatened. As discussed in Miller, et al. (2013), this study ponders whether individuals know they have the behavioural freedom that is being threatened and whether they feel they are worthy of that freedom. This idea also ties into the emerging adult population of the above study and its affirmation that individuals in transitional stages will assert their threatened behaviour freedoms.

Miller et al. (2007) sought to determine how effective explicit and implicit language is at mitigating reactance. Particularly, restoration of freedom is a focus of this study, and gauging how concrete and abstract language informs an individual’s belief that he or she has a choice. Some participants were given a persuasive appeal related to health promotion with a following post-scripted message designed to remind them they have a choice as a method of restoring the participants’ freedom. Using concrete language proved more effective at increasing the possibilities of message acceptance and source credibility. This study is relevant to inoculation research in that it lends credence to Miller, et al. (2013), which transparently incorporates psychological reactance theory in conjunction with inoculation theory to improve the quality of persuasive appeals in the future.

Postinoculation Talk

Following Compton and Pfau’s (2009) research on postinoculation talk, Ivanov, et al. (2012) explore how cognitive processing could lead to talk with others after receiving an inoculation message in which threat exists. The authors found that message processing leads to postinoculation talk which could potentially lead to stronger resistance to attack messages. Further, postinoculation talk acts virally, spreading inoculation through talk with others on issues that involve negative cognitions and affect. In previous research, the assumption that talk was subvocal (existing only intrapersonally) was prevalent, without concern for the impact of vocal talk with other individuals. The authors deem vocal talk important to the incubation process. Their study concluded that individuals who receive an inoculation message that contains threat will talk to others about the message and talk more frequently than individuals who do not receive an inoculation message. Additionally, the act of postinoculation talk bolsters their attitudes and increases resistance to the message as well as increasing the likelihood that talk will generate a potentially viral effect–spreading inoculation to others through the act of vocal talk.

Straw man Fallacy

Due to the nature of attitudinal inoculation as a form of psychological manipulation, the counterarguments used in the process do not necessarily need to be accurately representative of the opposing belief in order to trigger the inoculation effect. This is a form of straw man fallacy, and can be effectively used to reinforce beliefs with less legitimate support.

Real-World Applications

Most research has involved inoculation as applied to interpersonal communication (persuasion), marketing, health and political messaging. More recently, inoculation strategies are starting to show potential as a counter to science denialism and cyber security breaches.

Science Denialism

Science denialism has rapidly increased in recent years. A major factor is the rapid spread of misinformation and fake news via social media (such as Facebook), as well as prominent placing of such misinformation in Google searches. Climate change denialism is a particular problem in that its global nature and lengthy timeframe is uniquely difficult for the individual mind to grasp, as the human brain has evolved to deal with short-term and immediate dangers. However, John Cook and colleagues have shown that inoculation theory shows promise in countering denialism. This involves a two-step process. Firstly, list and deconstruct the 50 or so most common myths about climate change, by identifying the reasoning errors and logical fallacies of each one. Secondly, use the concept of parallel argumentation to explain the flaw in the argument by transplanting the same logic into a parallel situation, often an extreme or absurd one. Adding appropriate humour can be particularly effective.

Cyber Security

Treglia and Delia (2017) apply inoculation theory to cyber security (internet security, cybercrime). People are susceptible to electronic or physical tricks, scams, or misrepresentations that may lead to deviating from security procedures and practices, opening the operator, organisation, or system to exploits, malware, theft of data, or disruption of systems and services. Inoculation in this area improves peoples resistance to such attacks. Psychological manipulation of people into performing actions or divulging confidential information via the internet and social media is one part of the broader construct of social engineering.

Political Campaigning

Compton and Ivanov (2013) offer a comprehensive review of political inoculation scholarship and outline new directions for future work.

In 1990, Pfau and his colleagues examined inoculation through the use of direct mail during the 1988 United States presidential campaign. The researchers were specifically interested in comparing inoculation and post hoc refutation. Post hoc refutation is another form of building resistance to arguments; however, instead of building resistance prior to future arguments, like inoculation, it attempts to restore original beliefs and attitudes after the counterarguments have been made. Results of the research reinforced prior conclusions that refutational same and different treatments both increase resistance to attacks. More importantly, results also indicated inoculation was superior to post hoc refutation when attempting to protect original beliefs and attitudes.

Other examples are studies showing it is possible to inoculate political supporters of a candidate in a campaign against the influence of an opponent’s attack adverts; and inoculate citizens of fledgling democracies against the spiral of silence (fear of isolation) which can thwart the expression of minority views.

Health

Much of the research conducted in health is attempting to create campaigns that will encourage people to stop unhealthy behaviours (e.g. getting people to stop smoking or prevention of teen alcoholism). Compton, Jackson and Dimmock (2016) reviewed studies where inoculation theory was applied to health-related messaging. There are many inoculation studies with the intent to inoculate children and teenagers to prevent them from smoking, doing drugs or drinking alcohol. Much of the research shows that targeting at a young age can help them resist peer pressure in high school or college. An important example of inoculation theory usage is protecting young adolescents against influences of peer pressure, which can lead to smoking, underage drinking, and other harmful behaviours.

Godbold and Pfau (2000) used sixth graders from two different schools and applied inoculation theory as a defence against peer pressure to drinking alcohol. They hypothesized that a normative message (a message tailored around the current social norms) would be more effective than an informative message. An informative message is a message tailored around giving individuals information pieces. In this case, the information was why drinking alcohol is bad. The second hypothesis was that subjects who receive a threat two weeks later will be more resistant than those receiving an immediate attack. The results supported the first hypothesis partially. The normative message created higher resistance from the attack, but was not necessarily more effective. The second hypothesis was also not supported; therefore, the time lapse did not create further resistance for teenagers against drinking. One major outcome from this study was the resistance created by utilizing a normative message.

In another study conducted by Duryea (1983), the results were far more supportive of the theory. The study also attempted to find the message to use for educational training to help prevent teen drinking and driving. The teen subjects were given resources to combat attempts to persuade them to drink and drive or to get into a vehicle with a drunk driver. The subjects were:

  1. Shown a film;
  2. Participated in question and answer;
  3. Role playing exercises; and
  4. A slide show.

The results showed that a combination of the four methods of training was effective in combating persuasion to drink and drive or get into a vehicle with a drunk driver. The trained group was far more prepared to combat the persuasive arguments.

Additionally, Parker, Ivanov, and Compton (2012) found that inoculation messages can be an effective deterrent against pressures to engage in unprotected sex and binge drinking—even when only one of these issues is mentioned in the health message.

Compton, Jackson and Dimmock (2016) discuss important future research, such as preparing new mothers for overcoming their health concerns (e.g. about breastfeeding, sleep deprivation and post-partum depression).

Inoculation theory applied to prevention of smoking has been heavily studied. These studies have mainly focused on preventing youth smokers–inoculation seems to be most effective in young children. For example, Pfau, et al. (1992) examined the role of inoculation when attempting to prevent adolescents from smoking. One of the main goals of the study was to examine longevity and persistence of inoculation. Elementary school students watched a video warning them of future pressures to smoke. In the first year, resistance was highest among those with low self-esteem. At the end of the second year, students in the group showed more attitudinal resistance to smoking than they did previously (Pfau & Van Bockern 1994). Importantly, the study and its follow-up demonstrate the long-lasting effects of inoculation treatments.

Grover (2011) researched the effectiveness of the “truth” anti-smoking campaign on smokers and non-smokers. The truth adverts aimed to show young people that smoking was unhealthy, and to expose the manipulative tactics of tobacco companies. Grover showed that inoculation works differently for smokers and non-smokers (i.e. potential smokers). For both groups, the truth adverts increased anti-smoking and anti-tobacco-industry attitudes, but the effect was greater for smokers. The strength of this attitude change is partly mediated (controlled) by aversion to branded tobacco industry products. However, counter-intuitively, exposure to pro-smoking adverts increased aversion to branded tobacco industry products (at least in this sample). In general, Grover demonstrated that the initial attitude plays a major role in the ability to inoculate an individual.

Future health-related studies can be extremely beneficial to communities. Some research areas include present-day issues (for example, inoculation-based strategies for addiction intervention to assist sober individuals from relapsing), as well as promoting healthy eating habits, exercising, breastfeeding and creating positive attitude towards mammograms. An area that has been underdeveloped is mental health awareness. Because of the large number of young adults and teens dying of suicide due to bullying, inoculation messages could be effective.

Dimmock et al. (2016) studied how inoculation messages can be used to increase participants’ reported enjoyment and interest in physical exercise. In this study, participants are exposed to inoculating messages and then given an intentionally boring exercise routine. These messages cause the reinforcement of the individual’s positive attitude towards the exercise, and as a result increase their likelihood to continue exercise in the future.

Vaccination Beliefs

Inoculation Theory has been used to combat misinformation regarding vaccine related beliefs. Vaccinations have helped stop the spread of many infections and diseases, but their effectiveness has become a controversial topic in the Western nations. Studies show that misinformation regarding the science has played a major role in the hesitancy for vaccinations. Some of the common misconceptions include the Influenza vaccine giving the flu and a link between the MMR vaccine and autism. Regardless of the many scientific studies debunking these claims, there are people that still cling to these beliefs.

In 2016, a study was conducted to see Inoculation theory combat vaccine misinformation. The participants of this study were a group of 110 young women who had not completed any doses of the human Papillomavirus vaccine (HPV). The study wanted to see the effect of attack messages that questioned the importance and safety of this specific vaccine, and other vaccines. After making arguments against the vaccines and a brief lapse in time, a control group was exposed to inoculation messages, that were in favour of the vaccine. Once the arguments were made, the participants were asked to take part in post-test measurements. The results found that those who received the inoculated messages had more positive behaviours towards the HPV vaccine, and other vaccines.

In 2017, a study was conducted to test Inoculation theory’s role in making vaccine related decisions. A group of 89 British parents were selected, and exposed to one of five potential arguments for a fictitious vaccine. Some groups were exposed to arguments that were completely based in conspiracy, Anti-conspiracy, While the other groups were exposed to both arguments in differing order. After being exposed to these arguments, they were told about a disease that would cause vomiting and a severe fever. The parents were asked if they would get their children the vaccine for this fictitious disease, and the results they gathered displayed Inoculation theory in action. The results showed that those who were exposed to anti-conspiracy arguments were more likely to get the vaccine.

Marketing

It took some time for inoculation theory to be applied to marketing, because of many possible limitations. Lessne and Didow (1987) reviewed publications about inoculation application to marketing campaigns and their limitations. They note that, at the time, the closest to true marketing context was Hunt’s 1973 study on the Chevron campaign. The Federal Trade Commission stated that Chevron had deceived consumers on the effectiveness of their gas additive F-310. The FTC was going to conduct a corrective advertising campaign to disclose the information. In response, Chevron ran a print campaign to combat the anticipated FTC campaign. The double page advertisement read, “If every motorist used Chevron with F-310 for 2000 miles, air pollutants would be reduced by thousands of tons in a single day. The FTC doesn’t think that’s significant.” Hunt used this real-life message as an inoculation treatment in his research. He used the corrective campaign by the FTC as the attack on the positive attitude toward Chevron. The results indicated that a supportive treatment offered less resistance than a refutational treatment. Another finding was that when an inoculative treatment is received, but no attack is followed, there is a drop in attitude. One of the major limitations in this study was that Hunt did not allow a time elapse between the treatment and the attack, which was a major element of McGuire’s original theory.

Inoculation theory can be used with an audience who already has an opinion on a brand, to convince existing customers to continue patronage of a company, or to protect commercial brands against the influence of comparative adverts from a competitor. An example is Apple Computers’ “Get A Mac” campaign. This campaign follows inoculation theory in targeting those who already preferred Mac computers. The series of ads put out in the duration of the campaign had a similar theme; they directly compared Macs and PCs. Inoculation theory applies here as these commercials are likely aimed at Apple users. These ads are effective because Apple users already prefer Mac computers, and they are unlikely to change their minds. This comparison creates refutational pre-emption, showing Macs may not be the only viable options on the market. The TV ads throw in a few of the positive advantages that PCs have over Macs, but by the end of every commercial they reiterate the fact that Macs are ultimately the superior consumer product. This reassures viewers that their opinion is still right and that Macs are in fact better than PCs. The inoculation theory in these ads keep Mac users coming back for Apple products, and may even have them coming back sooner for the new bigger and better products that Apple releases – especially important as technology is continually changing, and something new is always being pushed onto the shelves.

Inoculation theory research in advertising and marketing has mainly focused on promoting healthy lifestyles with the help of a product or for a specific company’s goal. However, shortly after McGuire published his inoculation theory, Szybillo and Heslin (1973) applied the concepts that McGuire used in the health industry to advertising and marketing campaigns. They sought to provide answers for advertisers marketing a controversial product or topic: if an advertiser knew the product or campaign would cause an attack, what would be the best advertising strategy? Would they want to refute the arguments or reaffirm their claims? They chose a then-controversial topic: “Inflatable air bags should be installed as passive safety devices in all new cars.” They tested four advertising strategies:

  1. Defence;
  2. Refutational-same;
  3. Refutational-different; and
  4. Supportive.

The results confirmed that a reaffirmation or refutation approach is better than not addressing the attack. They also confirmed that refuting the counterargument is more effective than a supportive defence (though the refutational-different effect was not much greater than for supportive defence). Szybillo and Heslin also manipulated the time of the counterargument attack, and the credibility of the source, but neither was significant.

In 2006, a jury awarded Martin Dunson and Lisa Jones, the parents of one-year-old Marquis Matthew Dunson, $5 million for the death of their son. Dunson and Jones sued Johnson & Johnson, the makers of Infant’s Tylenol claiming that there were not enough warnings regarding the dosage of acetaminophen What resulted was a Johnson & Johnson campaign that encouraged parents to practice proper dosage procedures. In a review of the campaign by Veil and Kent (2008), they breakdown the message of the campaign utilizing the basic concepts of inoculation theory. They theorise that Johnson & Johnson used inoculation to alter the negative perception of their product. The campaign began running prior to the actual verdict, thus the timing seemed suspicious. A primary contention of Veil and Kent was that the intentions of Johnson & Johnson were not to convey consumer safety guidelines, but to change how consumers might respond to further lawsuits on overdose. The inoculation strategy used by Johnson & Johnson is evident in their campaign script: “Some people think if you have a really bad headache, you should take extra medicine.” The term “some people” is referring to the party suing the company. The commercial also used the Vice President of Sales for Tylenol to deliver a message, who may be considered a credible source.

In 1995, Burgoon and colleagues published empirical findings on issue/advocacy advertising campaigns. Most, if not all, of these types of advertising campaigns utilize inoculation to create the messages. They posited that inoculation strategies should be used for these campaigns to enhance the credibility of the corporation, and to aid in maintain existing consumer attitudes (but not to change consumer attitudes). Based on the analysis of previous research they concluded issue/advocacy advertising is most effective for reinforcing support and avoid potential slippage in the attitudes of supporters. They used Mobil Oil’s issue/advocacy campaign message. They found that issue/advocacy adverts did work to inoculate against counter-attitudinal attacks. They also found that issue/advocacy adverts work to protect the source credibility. The results also indicated that political views play a role in the effectiveness of the campaigns. Thus, conservatives are easier to inoculate than moderates or liberals. They also concluded that females are more likely to be inoculated with these types of campaigns. An additional observation was that the type of content used in these campaigns contributed to the campaigns success. The further the advertisement was from “direct self-benefit” the greater the inoculation effect was on the audience.

Compton and Pfau (2004) extended inoculation theory into the realm of credit card marketing targeting college students. They wondered if inoculation could help protect college students against dangerous levels of credit card debt and/or help convince them to increase their efforts to pay down any existing debt. Inoculation seemed to reinforce students’ wanted attitudes to debt, as well as some of their behavioural intentions. Further, they found some evidence that those who received the inoculation treatment were more likely to talk to their friends and family about issues of credit card debt.

Deception

Inoculation theory plays a role in deception detection research. Deception detection research has largely yielded little predictable support for nonverbal cues, and rather indicates that most liars are revealed through verbal content inconsistencies. These inconsistencies can be revealed through a form of inoculation theory that exposes the subject to a distorted version of the suspected action to observe inconsistencies in their responses.

Journalism

Breen and Matusitz (2009) suggest a method through which inoculation theory can be used to prevent pack journalism, a practice in which a large quantity of journalists and news outlets swarm a person, place, thing, or idea in a way that is distressing and harmful. It also lends itself to plagiarism. Through this framework derived from Pfau and Dillard (2000), journalists are inoculated against news practices of other journalists and instead directed towards uniqueness and originality, thus avoiding pack journalism.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Inoculation_theory >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

What is Self-Perception Theory?

Introduction

Self-perception theory (SPT) is an account of attitude formation developed by psychologist Daryl Bem.

It asserts that people develop their attitudes (when there is no previous attitude due to a lack of experience, etc. – and the emotional response is ambiguous) by observing their own behaviour and concluding what attitudes must have caused it. The theory is counterintuitive in nature, as the conventional wisdom is that attitudes determine behaviours. Furthermore, the theory suggests that people induce attitudes without accessing internal cognition and mood states. The person interprets their own overt behaviours rationally in the same way they attempt to explain others’ behaviours.

Bem’s Original Experiment

In an attempt to decide if individuals induce their attitudes as observers without accessing their internal states, Bem used interpersonal simulations, in which an “observer-participant” is given a detailed description of one condition of a cognitive dissonance experiment. Subjects listened to a tape of a man enthusiastically describing a tedious peg-turning task.

Subjects were told that the man had been paid $20 for his testimonial and another group was told that he was paid $1. Those in the latter condition thought that the man must have enjoyed the task more than those in the $20 condition. The results obtained were similar to the original Festinger-Carlsmith experiment. Because the observers, who did not have access to the actors’ internal cognition and mood states, were able to infer the true attitude of the actors, it is possible that the actors themselves also arrive at their attitudes by observing their own behaviour. Specifically, Bem notes how:

“the attitude statements which comprise the major dependent variables in dissonance experiments may be regarded as interpersonal judgments in which the observer and the observed happen to be the same individual.”

Further Evidence

There are numerous studies conducted by psychologists that support the self-perception theory, demonstrating that emotions do follow behaviours. For example, it is found that corresponding emotions (including liking, disliking, happiness, anger, etc.) were reported following from their overt behaviours, which had been manipulated by the experimenters. These behaviours included making different facial expressions, gazes, and postures. In the end of the experiment, subjects inferred and reported their affections and attitudes from their practiced behaviours despite the fact that they were told previously to act that way. These findings are consistent with the James-Lange theory of emotion.

In 1974, James Laird conducted two experiments on how changes in facial expression can trigger changes in emotion. Participants were asked to contract or relax various facial muscles, causing them to smile or frown without awareness of the nature of their expressions. Participants reported feeling more angry when frowning and happier when smiling. They also reported that cartoons viewed while they were smiling were more humorous than cartoons viewed while they were frowning. Furthermore, participants scored higher on aggression during frown trials than during smile trials, and scored higher on elation, surgency, and social affection factors during smile trials than during frown ones. Laird interpreted these results as “indicating that an individual’s expressive behavior mediates the quality of his emotional experience.” In other words, a person’s facial expression can act as a cause of an emotional state, rather than an effect; instead of smiling because they feel happy, a person can make themselves feel happy by smiling.

In 2006, Tiffany Ito and her colleagues conducted two studies to investigate if changes in facial expression can trigger changes in racial bias. The explicit goal of the studies was to determine “whether facial feedback can modulate implicit racial bias as assessed by the Implicit Association Test (IAT).” Participants were surreptitiously induced to smile through holding a pencil in their mouth while viewing photographs of unfamiliar black or white males or performed no somatic configuration while viewing the photographs (Study 1 only). All participants then completed the IAT with no facial manipulation. Results revealed a spreading attitude effect; people made to smile (unconsciously) at pictures of black males showed less implicit prejudice than those made to smile at pictures of white males. Their attitudes change as a result of their behaviour.

Chaiken and Baldwin’s 1981 study on self-perception theory dealt with environmental attitudes. Each participant was identified as having well or poorly defined prior attitudes toward being an environmentalist or conservationist. Participants then completed one of two versions of a questionnaire designed to bring to mind either past pro-ecology behaviours or past anti-ecology behaviours. For example, questions such as “Have you ever recycled?” call to mind the times an individual has recycled, emphasizing their engagement in environmentalist behaviour. On the other hand, questions like “Do you always recycle?” bring to mind all the times an individual did not recycle something, emphasizing a lack of environmentalist behaviour. Afterward, participants’ attitudes toward being an environmentalist/conservationist were re-measured. Those with strong initial/prior attitudes toward the environment were not really affected by the salient manipulation. Those with weak prior attitudes, however, were affected. At the end, those in the pro-ecology condition (“Have you ever recycled?”) reported themselves as being much more pro-environment than those in the anti-ecology condition (“Do you always recycle?”). Bringing to mind certain past behaviours affected what people believed their attitudes to be.

Evidence for the self-perception theory has also been seen in real life situations. After teenagers participated in repeated and sustained volunteering services, their attitudes were demonstrated to have shifted to be more caring and considerate towards others.

Recent Research

Research incorporating self-perception theory has continued in recent years, appearing in conjunction with studies dealing with motivational “crowding out,” terrorism, mindwandering, and the inclusion of others in the self.

Guadagno and her fellow experimenters did a study in 2010 addressing the recruitment of new members by terrorist organisation via the internet. In addition to looking at how such an organisation might influence its targets to support more extreme ideologies (primarily through simple requests gradually increasing to larger commitments – an example of the foot-in-the-door technique), the authors looked at how “the new converts may form increasingly radical attitudes to be consistent with their increasingly radical behavior.” Self-perception theory, then, has strong ties to social identity and social influence in this scenario.

Also in 2010, Clayton Critcher and Thomas Gilovich performed four studies to test a connection between self-perception theory and mindwandering. Self-perception theory posits that people determine their attitudes and preferences by interpreting the meaning of their own behaviour. Critcher and Gilovich looked at whether people also rely on the unobservable behaviour that is their mindwandering when making inferences about their attitudes and preferences. They found that “Having the mind wander to positive events, to concurrent as opposed to past activities, and to many events rather than just one tends to be attributed to boredom and therefore leads to perceived dissatisfaction with an ongoing task.” Participants relied on the content of their wandering minds as a cue to their attitudes unless an alternative cause for their mindwandering was brought to their attention.

Similarly, Goldstein and Cialdini published work related to self-perception theory in 2007. In an extension of self-perception theory, the authors hypothesized that people sometimes infer their own attributes or attitudes by “observing the freely chosen actions of others with whom they feel a sense of merged identity – almost as if they had observed themselves performing the acts.” Participants were made to feel a sense of merged identity with an actor through a perspective-taking task or feedback indicating overlapping brainwave patterns. Participants incorporated attributes relevant to the actor’s behaviour into their own self-concepts, leading participants to then change their own behaviours. The study addresses the self-expansion model: close relationships can lead to an inclusion of another person in an individual’s sense of self.

Applications

One useful application of the self-perception theory is in changing attitude, both therapeutically and in terms of persuasion.

Psychological Therapy

For therapies, self-perception theory holds a different view of psychological problems from the traditional perspectives. Traditionally, psychological problems come from the inner part of the clients. However, self-perception theory perspective suggests that people derive their inner feelings or abilities from their external behaviours. If those behaviours are maladjusted ones, people will attribute those maladjustments to their poor adapting abilities and thus suffer from the corresponding psychological problems. Thus, this concept can be used to treat clients with psychological problems that resulted from maladjustments by guiding them to first change their behaviour and later dealing with the “problems”.

One of the most famous therapies making use of this concept is therapy for “heterosocial anxiety”. In this case, the assumption is that an individual perceives that he or she has poor social skills because he/she has no dates. Experiments showed that males with heterosocial anxiety perceived less anxiety with females after several sessions of therapy in which they engaged in a 12-minute, purposefully biased dyadic social interactions with a separate females. From these apparently successful interactions, the males inferred that their heterosocial anxiety was reduced. This effect is shown to be quite long-lasting as the reduction in perceived heterosocial anxiety resulted in a significantly greater number of dates among subjects 6 months later.

Marketing and Persuasion

Self-perception theory is also an underlying mechanism for the effectiveness of many marketing or persuasive techniques. One typical example is the foot-in-the-door technique, which is a widely used marketing technique for persuading target customers to buy products. The basic premise of this technique is that, once a person complies with a small request (e.g. filling in a short questionnaire), he/she will be more likely to comply with a more substantial request which is related to the original request (e.g. buying the related product). The idea is that the initial commitment on the small request will change one’s self-image, therefore giving reasons for agreeing with the subsequent, larger request. It is because people observe their own behaviours (paying attention to and complying with the initial request) and the context in which they behave (no obvious incentive to do so), and thus infer they must have a preference for those products.

Challenges and Criticisms

Self-perception theory was initially proposed as an alternative to explain the experimental findings of the cognitive dissonance theory, and there were debates as to whether people experience attitude changes as an effort to reduce dissonance or as a result of self-perception processes. Based on the fact that the self-perception theory differs from the cognitive dissonance theory in that it does not hold that people experience a “negative drive state” called “dissonance” which they seek to relieve, the following experiment was carried out to compare the two theories under different conditions.

An early study on cognitive dissonance theory shows that people indeed experience arousal when their behaviour is inconsistent with their previous attitude. Waterman designed an experiment in which 77 male college freshmen were asked to write an essay arguing against the position they actually agreed with. Then they were asked immediately to perform a simple task and a difficult task; their performance in both tasks was assessed. It was found that they performed better in the simple task and worse in the difficult task, compared to those who had just written an essay corresponding to their true attitude. As indicated by social facilitation, enhanced performance in simple tasks and worsened performance in difficult tasks shows that arousal is produced by people when their behaviour is inconsistent with their attitude. Therefore, the cognitive dissonance theory is evident in this case.

Apparent Disproof

Debate ensued over whether dissonance or self-perception was the valid mechanism behind attitude change. The chief difficulty lay in finding an experiment where the two flexible theories would make distinctly different predictions. Some prominent social psychologists such as Anthony Greenwald thought it would be impossible to distinguish between the two theories.

In 1974, Zanna and Cooper conducted an experiment in which individuals were made to write a counter-attitudinal essay. They were divided into either a low choice or a high choice condition. They were also given a placebo; they were told the placebo would induce either tension, relaxation, or exert no effect. Under low choice, all participants exhibited no attitude change, which would be predicted by both cognitive dissonance theory and self-perception theory. Under high choice, participants who were told the placebo would produce tension exhibited no attitude change, and participants who were told the placebo would produce relaxation demonstrated larger attitude change.

These results are not explainable by self-perception theory, as arousal should have nothing to do with the mechanism underlying attitude change. Cognitive dissonance theory, however, was readily able to explain these results: if the participants could attribute their state of unpleasant arousal to the placebo, they would not have to alter their attitude.

Thus, for a period of time, it seemed the debate between the self-perception theory and cognitive dissonance had ended.

Truce Experiment

Fazio, Zanna, and Cooper conducted another experiment in 1977, demonstrating that both cognitive dissonance and self-perception could co-exist.

In an experimental design similar to Zanna and Cooper’s 1974 study, another variable was manipulated: whether or not the stance of the counter-attitudinal essay fell in the latitude of acceptance or the latitude of rejection (refer to social judgement theory). It appeared that when the stance of the essay fell into the latitude of rejection, the results favoured cognitive dissonance. However, when the essay fell in the latitude of acceptance, the results favoured self-perception theory.

Whether cognitive dissonance or self-perception is a more useful theory is a topic of considerable controversy and a large body of literature. There are some circumstances in which a certain theory is preferred, but it is traditional to use the terminology of cognitive dissonance theory by default. The cognitive dissonance theory accounts for attitude changes when people’s behaviours are inconsistent with their original attitudes which are clear and important to them; meanwhile, the self-perception theory is used when those original attitudes are relatively ambiguous and less important. Studies have shown that, in contrast to traditional belief, a large proportion of people’s attitudes are weak and vague. Thus, the self-perception theory is significant in interpreting one’s own attitudes, such as the assessment of one’s own personality traits and whether someone would cheat to achieve a goal.

According to G. Jademyr and Yojiyfus, the perception of different aspect in the interpreting theory can be due to many factors, such as circumstances regarding dissonance and controversy. This can also be because of balance theory as it applies to the attitude towards accountability and dimensions.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Self-perception_theory >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

PLA Navy Personnel in Relation to Attitudes & Barriers to Mental Healthcare

Research Paper Title

Attitudes and perceived barriers to mental healthcare in the People’s Liberation Army Navy: study from a navy base.

Background

The People’s Liberation Army (PLA, China) Navy is increasingly conducting military operations other than war overseas. Factors such as confrontations with pirates, special environments and long sailing times have resulted in mental health problems. However, the navy’s actual utilisation of mental health services is low.

This study examined members’ rate of willingness to seek help and the factors that act as barriers to willingness to seek mental health services in the PLA Navy.

Methods

This cross-sectional study was conducted at the Zhoushan Base, operated by the East Sea Fleet, between March 2019 and April 2019.

The researchers distributed a 12-item questionnaire to examine participants’ attitudes and perceived barriers to mental healthcare. They recruited 676 navy personnel. Participants’ willingness to seek help if they had mental health problems was also assessed.

Results

The response rate was 99%. A total of 88.44% of the sample reported being willing to seek help. Univariate analysis suggested that those not willing to seek help were more likely to agree with the items, ‘Mental healthcare does not work’ and ‘My unit leadership might treat me differently’ and all organisational barriers, and they were more likely to have concerns about ’embarrassment’ and ‘being weak’ than those willing to seek help.

After controlling for demographic characteristics, binary logistic regression analyses confirmed that a lack of knowledge regarding the location of mental health clinics and being perceived as weak were the main factors preventing participants’ willingness from seeking help.

Conclusions

Extensive efforts to decrease organisational barriers and stigma towards mental healthcare should be a priority for researchers and policymakers to improve the usage of mental health services.

Psychoeducation aimed at de-stigmatising mental health problems should be delivered and the accessibility and availability of mental health services should be increased.

Reference

Gu, R-P., Liu, X.R> & Ye, X.F. (2020) Attitudes and perceived barriers to mental healthcare in the People’s Liberation Army Navy: study from a navy base. BMJ Military Health. doi: 10.1136/bmjmilitary-2019-001396. Online ahead of print.

Changing Attitudes & Stigma toward Mental Health in Nursing Students

Research Paper Title

Attitudes and stigma toward mental health in nursing students: A systematic review.

Background

This systematic review seeks to ascertain whether mental health-specific education reduces stigmatising attitudes in nursing students.

Methods

A systematic review of the literature was performed.

Results

Thirteen studies met the inclusion criteria.

Most of the results show an improvement in attitudes toward mental health, both in theory and clinical experience, but a greater improvement toward these stigmatising attitudes was observed in clinical placements than in theory.

Conclusions

Mental-health-specific training seems to improve perceptions toward mental health.

Clinical placement underpins theory, leading to a decrease in negative attitudes and stigma regarding mental health.

Reference

Palou, R.G., Vigue, G.P. & Tort-Nasarre, G. (2020) Attitudes and stigma toward mental health in nursing students: A systematic review. Perspectives in Psychiatric Care. 56(2), pp.243-255. doi: 10.1111/ppc.12419. Epub 2019 Jul 28.

Is there a Gender Difference in Mental Health Literacy that Affects Mental Health Attitude?

Research Paper Title

Mental Health Literacy Affects Mental Health Attitude: Is There a Gender Difference?

Background

In the current study, the researchers aimed to compare the levels of and factors associated with mental health attitude between males and females. Of particular interest was ascertaining the degree to which mental health literacy was related to mental health attitude and whether this relationship would vary by gender.

Methods

A total of 732 participants aged 18 years or more were recruited from attendees at the 2016 Minnesota State Fair. They used the Mental Health Literacy Scale (MHLS) to measure attitude toward and literacy of mental health.

Results

The multivariate analysis reported that males’ mental health attitude was significantly lower than females. Some factors associated with mental health attitude differed by gender as well. Among men, receiving more social support, experiencing higher levels of depression, and being married predicted greater mental health attitude. Among women, older age was associated with lower mental health attitude levels. However, mental health literacy was the strongest factor regardless of gender. Men and women with greater mental health literacy had a more positive mental health attitude.

Conclusions

Provision of tailored mental health literacy education both for males and females could potentially improve the public’s mental health attitude toward mental illness.

Reference

Lee, H.Y., Hwang, J., Ball, J.G., Lee, J., Yu, Y & Albright, D.L. (2020) Mental Health Literacy Affects Mental Health Attitude: Is There a Gender Difference? American Journal of Health Behaviour. 44(3), pp.282-291. doi: 10.5993/AJHB.44.3.1.

Does Early Maternal Separation Exert a Negative Influence on Student’s Depression & Dysfunctional Attitude?

Research Paper Title

The impacts of maternal separation experience and its pattern on depression and dysfunctional attitude in middle school students in rural China.

Background

In China, because of the growth of economically driven rural-to-urban migration, there are lots of children in rural area who are separating or have separation experience with their parents.

Until now, few studies focused on solely maternal separation and no research studied whether its pattern will affect children’s later psychological status.

The aim of this study was to determine whether early or late maternal separation affects depression and dysfunctional attitude in middle school students and what is the role of cumulative duration and meeting frequency.

Methods

Maternal separation experience was obtained by using questionnaires. The researchers got early maternal separation group first. Then, late maternal separation and control group were obtained with the same number by matching grade, sex and family socioeconomic status.

All the students in the three groups completed the scales of Children’s Depression Inventory (CDI) and Dysfunctional Attitude Scale (DAS).

Results

Both CDI and DAS scores of early separation group are higher than the other two groups.

  • When the researches split the data by sex, only females presented the same results.
  • When cumulative duration is short, there is significant difference in both scores of CDI and DAS among the three groups, which showed the scores of early separation group are higher than the other two groups.
  • When the cumulative duration is long, there is no significant difference among the three groups.
  • When meeting frequency is high, there is no significant difference among the three groups.
  • When it is low, there is significant difference among the three groups, which showed the CDI and DAS scores of early separation group are higher than the other two groups.

Furthermore, the same results are also found in females.

Conclusions

Early maternal separation may exert negative influence on student’s depression and dysfunctional attitude.

The sex, cumulative duration and meeting frequency may also play important roles in the effect.

Reference

Cao, X.J., Huang, Y.X., Zhu, P. & Zhang, Z.G. (2020) The impacts of maternal separation experience and its pattern on depression and dysfunctional attitude in middle school students in rural China. The International Journal of Social Psychiatry. 66(2), pp.188-197. doi: 10.1177/0020764019895795. Epub 2020 Jan 2.

New Channel 4 TV Series on Mental Health – Losing It: Our Mental Health Emergency

Introduction

As attitudes to mental health change during a surge in the number of people asking for help or harming themselves, this series joins the frontline care services in Nottinghamshire

Outline Series 01

Channel 4 begins broadcasting a new series on mental health on Tuesday 21 January 2020 at 10 pm.

Titled Losing It: Our Mental; Health Emergency, the series gains access to Nottinghamshire Healthcare, one of the UK’s largest mental health trusts.

With demand rising and resources stretched like never before, this series explores the unprecedented pressure on mental health services and the seemingly impossible decisions that clinicians have to make every day.

The series places viewers at the heart of the complex decision-making process, giving a unique insight into the pressures and challenges mental health trusts and patients must deal with daily.

Told with a frank first person perspective, this series gives a very personal view of mental illness in 2019; the tragedy, humour and complex challenges.

Outline Series 01, Episode 01

Two weeks after becoming a mum, Laura is sectioned having tried to drive into a brick wall.

And is 11-year-old Briena really suicidal, or is the underlying diagnosis more complicated?

About Nottinghamshire Healthcare NHS Foundation Trust

Nottinghamshire Healthcare provides integrated healthcare services, including mental health, intellectual disability and physical health services.

Over 9000 dedicated staff provide these services in a variety of settings, ranging from the community through to acute wards, as well as secure settings.

The Trust manages two medium secure units, Arnold Lodge in Leicester and Wathwood Hospital in Rotherham, and the high secure Rampton Hospital near Retford.

It also provides healthcare in prisons across the East Midlands.

Its budget for 2019/20 is £465m.

Why Do It?

The Trust made the decision to take part in the series in April 2019 to try and further reduce the stigma associated with mental illness.

The production company, Story Films, has an impressive track record in making sensitive films that deal with difficult topics.

Filming took place across Nottinghamshire during the summer of last year and features patients with a wide variety of diagnoses, including young people, families and people in crisis.

Production & Filming Details

  • Production: Story Films.
  • Distributor: Channel 4.
  • Release Date: 21 January 2020 (UK).
  • Running Time: 50 minutes.

Working with Diversity

People trained in mental health first aid are not expected to have specialist knowledge of different groups’ attitudes and beliefs about mental health.

The most important thing is to avoid making assumptions about the person to whom you are offering support.

For instance, do not assume that the person shares the same attitudes as you hold.

When suggesting that a person seeks further help, it is best to ask who they would feel most comfortable approaching rather than immediately suggesting their general practitioner (GP).

Similarly, it is best to use simple language like ‘low mood’ or ‘sadness’ rather than using terms like depression when talking about a person’s mood or feelings.

These guidelines hold true in any situation. It is always better to avoid making assumptions about another person and to check out that person’s feelings and preferences before offering advice and support.