Look! A Morsel of Good Vaccination News

It’s been a bad few weeks for vaccination. Whooping cough continues to make a comeback; it was revealed that some New York City schools have third-world vaccination rates; and a study led by Brendan Nyhan found that four different interventions were unable to shift vaccination intentions.

So it may come as a surprise that a new study actually produced some good news. An intervention based on anticipated regret questions (ARQ) and graphical communication managed to successfully shift parental intentions on vaccination.

Our goal in conducting this research was to determine possible interventions that might help parents appreciate the risks of not vaccinating their daughters against HPV infection…We hypothesized that an intervention designed to help mothers visualize the risks of nonvaccination (a graphical depiction of how cervical cancer risk is affected by HPV vaccination) would moderate the effects of ARQ on behavioral intentions…We found that among mothers who saw the graphic message, asking ARQ had a significant positive effect on both message involvement and behavioral intention…the ARQ intervention had no significant effect on vaccination intentions in the text-only condition.

The “graphical” intervention showed filled stadium bleachers to illustrate the number of people who could be saved from cancer, whereas the text-only condition showed only the number. The ARQ procedure involved two questions: 1) If your daughter was not immunized against HPV and developed cervical cancer, how responsible would you feel, and 2) If your daughter was not immunized against HPV and developed cervical cancer, how much regret would you feel?

Additional analyses suggested that rather than changing parental beliefs about the benefits of vaccination, combining ARQ with a graphical message was effective because the ARQ increased emotional involvement with the information contained in the graphics. That is, instead of increasing the perceived downside of nonvaccination, the intervention appeared to have increased the salience of the existing perceived downside.

And now for the caveats. The study involved only 320 mothers, and unlike the Nyhan study, it used random assignment to parse out an effect rather than analyzing how the opinions of individual mothers shifted. Prior research on ARQ also suggests it’s most effective among parents who already have high vaccination-intention levels, so the intervention in the study may ultimately fail to convert stubborn opponents. Finally, the study focused on an HPV vaccine for girls aged 11-16, and not the MMR or whooping cough vaccines for young children that seem to be the basis for the most outlandish fictional side effects.

Clearly, it would be a mistake to rush into building ARQ into the vaccination decision process, but the strategy of targeting potential regret may be promising in ways that purely informational strategies are not (though it should be noted that some of the ineffective interventions in Nyhan’s study — such as presenting a mother’s account of her child’s measles hospitalization — may have featured inducing regret in a more indirect manner.) People on the fence about vaccination are probably already considering the regret they’ll feel if their child develops autism, so inducing them to think about the regret of disease may help level the playing field. Eliminating the small pockets of vaccination opposition is still an uphill climb, but it’s good to see that it’s at least possible for an intervention to have the desired positive effect.
Cox, D., Sturm, L., & Cox, A. (2014). Effectiveness of Asking Anticipated Regret in Increasing HPV Vaccination Intention in Mothers. Health Psychology DOI: 10.1037/hea0000071


The Connection Between Conspiracy Theories and Ambivalence

It’s a good time to be in the conspiracy theory business, and not just because the birthplace of the U.S. President has been verified only 72 times. Thanks to the internet, it’s easier than ever to track down potentially suspicious information and discuss it with like-minded gumshoes.

While certain people may be predisposed to believing in certain kinds of conspiracy theories, there are surely short-term contextual factors that influence whether somebody is likely clear out their living room in order to build a giant cork-board with pieces of yarn connecting various photos and documents. According to a new study by a group of researchers from the University of Amsterdam, one of these factors is the feeling of ambivalence. The reasoning is that feeling conflicted about something is unpleasant. We then attempt to compensate by seeking out order, and that can lead us to find meaning or purpose in ambiguity.

Ambivalence is a presumably unpleasant experience, and coming to terms with it is an intricate part of human existence. It is argued that ambivalent attitude holders cope with their ambivalence through compensatory perceptions of order. We first show that ambivalence leads to an increase in (visual) perceptions of order (Study 1). In Study 2 we conceptually replicate this finding by showing that ambivalence also increases belief in conspiracy theories, a cognitive form of order perception. Furthermore, this effect is mediated by the negative emotions that are elicited by ambivalence. In Study 3 we show that increased need for order is driving these effects: Affirmations of order cancel out the effect of as well as societal implications are discussed.

In the headline-grabbing 2nd experiment participants wrote about a subject they were either ambivalent or univalent about. They were then told to imagine themselves in two ambiguous scenarios. In the first, they hold a job that involves tracking office email use, and the day before unexpectedly getting turned down for a promotion they notice an increase in the number of emails between their boss and the co-worker who sits next to them. In the second scenario, they notice owners of rival businesses leaving a bed and breakfast together. Later, all the businesses increase their prices, leading to higher profits. Participants are told that they own stock in these businesses, and so unlike in the first scenario, the potential collusion benefits them.

The key finding is that participants who wrote about conflicted or ambivalent feelings were more likely to believe that other people’s actions (the co-worker emails and the B&B meeting) were connected to their personal outcomes (not getting a promotion and earning investment profits.) To say that ambivalence therefore increases beliefs in conspiracy theories as they are colloquially defined may overstate things a tad, but it’s fair to conclude that ambivalence at least increases our attribution of outcomes to specific actions and motivations.

More broadly, the study highlights an important point about the necessity of groups and polarization. Having such a nuanced understanding of something that you’re genuinely conflicted about it is great in the abstract. If all of our politicians understood both sides of a policy well enough to feel genuine discomfort we’d probably have much better public policy.

But in practice a nuanced understanding can feel terrible. You see the drawbacks to both sides of the issue. You become marginally more unsure of yourself and your beliefs, and you become driven to find order in places where it might not exist. And so it can feel better to convince yourself that the world exists in black and white. If taxes always hurt economic growth, you don’t have to worry about people without health insurance because raising taxes to expand healthcare has no chance of raising well-being.

The motivation to find order in ambiguity is one striking consequence of ambivalence. But if you examine human beliefs and behavior the need to avoid conflicting feelings may frequently come into play.
van Harreveld, F., Rutjens, B., Schneider, I., Nohlen, H., & Keskinis, K. (2014). In Doubt and Disorderly: Ambivalence Promotes Compensatory Perceptions of Order. Journal of Experimental Psychology: General DOI: 10.1037/a0036099

On Death, Grief, and Regret

There are a number of reasons you should read Derek Thompson’s terrific piece on losing his mother to pancreatic cancer, but one thing that stood out is the way he’s able to describe how the fear of your reaction to losing something can enhance the awful process of actually losing it. In the end, despite being such a self-professed mama’s boy that he “made people with perfectly adequate mother-son bonds think, there is a boy who needs more friends in life,” Thompson got through it.

Then, in the weeks after she died, something strange happened. I did not plunge. Life did not stop. Instead, I felt something so unspeakably strange, so blasphemous, that I wondered if I could talk or write about it, at all. I felt okay.

In fact, his experience was not all that uncommon. Thompson’s story is interspersed with a good roundup of research on grief — research that suggests crippling grief is the exception rather than the rule.

Ten percent of us experience “chronic” and relentless grief that demands counseling. Another third or so plunges into deep sadness and gradually begins recovery. But most of us—”between 50 and 60 percent,” Bonanno said—quickly appear to be fine, despite day-to-day fluctuations. Scientists used to consider these patients tragic actors, shoving their feelings into the core of their bodies, where they would only explode with volcanic violence in dreadful ways later in life. But this, Bonanno says, might be the biggest myth of all. “If you think you’re doing okay,” he said, “then you’re doing okay.”

Something else that struck me about Thompson’s story is that nowhere in the 3,000+ words is there the faintest hint of regret about anything. No second guessing anything he did or the way he spent his time.

I once had a professor who said a better way to think about regret was to view it as a type of desire — specifically, the desire to have done something differently. Thus regret could viewed as the desire to have spent more time with somebody, or the desire to have treated somebody with more kindness. When somebody dies all the regrets regarding your relationship, and thus all these desires, are instantly transformed into desires that can never be fulfilled. It wouldn’t surprise me if the emotional toll of all these unmet desires exacerbates the grieving process.

Perhaps Thompson’s lifelong adoration of his mother left him with no second guessing, no regrets, and no permanently unfulfilled desires. Perhaps that’s what helped him into the fortunate 60% of grievers who are able to move on with their lives. And perhaps the lesson of Thompson’s experience is to provide an addendum to the oft-cited piece of life advice: Don’t just live each day like it’s your last, live each day like it’s somebody else’s last.

There Might Actually Be an Accurate Pro Sports Cliché

When an athlete finally wins a championship after years of falling short they’ll often say that it’s so much sweeter because of all the adversity they had to overcome. I’ve always written that off as one of the 99.7% of sports clichés that have no factual basis, but a new study lead by the University of British Columbia’s Alyssa Croft suggests there’s some truth to it. Adversity might actually make success feel better:

Can experiencing adversity enhance people’s appreciation for life’s small pleasures? To examine this question, we asked nearly 15,000 adults to complete a vignette-based measure of savoring. In addition, we presented participants with a checklist of adverse events (e.g., divorce, death of a loved one) and asked them to indicate whether they had experienced any of these events and, if so, to specify whether they felt they had emotionally dealt with the negative event or were still struggling with it. Although people who were currently struggling with adversity reported a diminished proclivity for savoring positive events, individuals who had dealt with more adversity in the past reported an elevated capacity for savoring. Thus, the worst experiences in life may come with an eventual upside, by promoting the ability to appreciate life’s small pleasures.

I wholeheartedly condone snarkily using this as an excuse the next time you accidentally screw over a friend.

The Dark Side of the Dark Side of Self-Regulation

Elizabeth Weil’s TNR cover story about the perils of teaching self-regulation has generated a lot of pushback. Both Daniel Willingham and Sarah Mead penned responses that you should read in full, but the basic issue is that Weil doesn’t marshall much evidence about the size and scope of the problem she is warning about. She carefully argues for the vague notion that an emphasis on self-regulation could potentially be bad for some kids, but we already know that. The question is how many kids? With what severity?

Here’s Willingham:

There’s a case to be made that American society is going too far in emphasizing self-regulation. But the way to make it is not to suggest that the natural consequence of this emphasis is the crushing of children’s spirits because self-regulation is the same thing as no exuberance. The way to make the case is to show us that we’re overdoing self-regulation. Kids feel burdened, anxious, worried about their behavior.

Weil doesn’t have data that would bear on this point. I don’t either. But my perspective definitely differs from hers. When I visit classrooms or wander the aisles of Target, I do not feel that American kids are over-burdened by self-regulation.

Weil also fails to properly acknowledge that many students are not from stable backgrounds, and in doing so she glosses over a key feature of teaching self-regulation.

Here’s Mead:

Weil’s article also reflects one other feature that drives me up the wall in elite media pieces on education–a heavy focus on the experience of elite, largely white, professionals and their concertedly cultivated children whose experiences are highly unrepresentative of the nation’s families and children–particularly those who are most vulnerable. Maybe Weil knows too many children who are being diagnosed with “sensory processing disorder,” but what about kids in less privileged neighborhoods? Things like the peace tables Weil describes can seem ridiculous, but children from communities where adults don’t usually display strong self regulation or settle problems by “using their words,” may need instruction to help them do so. And so forth.

Weil’s piece is emblematic of a common problem in policy writing, and education policy writing in particular. Almost no policy benefits everybody. Most policies are good ideas if they benefit 60%-70% of people without causing disproportionate harm on the other 30%-40%. But nobody wants to engage with the downsides of their preferred policy because there’s little to gain. Furthermore, in many cases there’s just not enough data to say something definitive about that 30%-40% (such as whether it’s actually 30%-40%.) So everybody pretends their policy is great for every single person, and the result is that people don’t argue by saying, “Here’s why the gains of my policy outweigh the losses,” they argue by saying, “Here are the gains of my policy and oh gosh aren’t they all so awesome.” Both sides tend to embrace this one-sided vagueness because it makes arguing easier. You often see these types of arguments in writing about charter schools, where people talk about the consequences of enrollment patterns or disciplinary models without any attempt at a measured weighing of trade-offs or a specific discussion about the proportion or characteristics of students most likely to be helped or hurt.

Such is the state of affairs in which it’s normal for Weil to spend 3,500 words attacking a policy without making the case that the policy hurts a majority of students or a disproportionate number of the students we should be most concerned about. Granted, Wail doesn’t argue for cutting back that fervently. Her inquiring tone is one that’s commonly found in the “here’s a downside we haven’t thought of…” articles that have become a staple of web journalism. But those tend to be short pieces. Dedicating 3500+ words requires a careful analysis of the pros and cons. Weil doesn’t supply that, and she would have been better off acknowledging this problem (or simply writing a piece that was much less ambitious.)

Finally, Weil should have done more to develop an accurate understanding of what self- or emotional-regulation entails. The word “suppress” appears twice in the article, and I think this is where Weil veers off course. Regulating yourself is not about suppressing desires. It’s about moving beyond your initial impulse, examining the situation, realizing your initial impulse was unwise, and then charting a different course. Take the example of 1st grader who wants to dance instead of listening to a presentation. Rather than suppressing the desire to act out in a creative fashion, regulation would entail understanding that such behavior could distract others and harm her own learning. Ultimately, a new desire to follow classroom rules is formed. Crucially, the child hasn’t learned that the desire to dance is bad or that it should be suppressed.

Perhaps we’d be better off occasionally replacing “regulation” with “re-evaluation” or “reappraisal” (the latter is more common in academic literature.) Doing so would emphasize that there’s no suppression of any kind going on, and it would help curtail the narrative that blossoming bundles of creativity are having their impulses stifled by dry school psychologists.

The Closet Is Real, and It’s Bad

Not that we need science to convince people that concealing key aspects of your identity can be unhealthy, but some important new research led by Harvard’s Alexandra Sedlovskaya helps clarify the psychological consequences of constantly concealing part of who you are.

In the study’s initial set of experiments participants who concealed stigmatized identities (e.g. gay men) were faster than participants without stigmatized identities at categorizing attributes as part of either their “self-at-work” or “self-at-home.”  The faster times suggest that when people conceal their identities it makes the distinction between their public and private selves more accesible. In two follow-up experiments the researchers found that this cognitive distinction between the selves not only led to psychological distress, it did a better job explaining participants’ distress than the broader act of concealment.

The present studies are the first to use social psychological theory and methods to test popular claims that the experience of concealing a stigmatized social identity leads to a divided self. Studies 1a and 2 established that public–private schematization occurred among people who have stigmatized concealable social identities relative to people who do not…Using two different measures of distress—perceived social stress (Study 4) and depressive symptoms (Study 5)—among samples of employed gay men, we showed in Studies 4 and 5 that public–private schematization accounted for the association between concealment and heightened distress. Cumulatively, these studies support the hypothesis that for people with stigmatized social identities, routine concealment of these identities in public contexts is associated with a greater influence of public and private social contexts on the architecture of the self-concept, with costs for psychological well-being. 

It’s important to note that this doesn’t merely apply to sexual orientation. Every day people around the world are concealing their immigration status, religious beliefs, and political views, and these potentially necessary concealments will ultimately lead to substandard psychological health.

Another issue to consider is whether the development of new personas via Facebook, Twitter, or other online communities will lead to an overall increase in the stress that results from divided selves. Keeping your active membership in an online gaming community hidden from your classmates isn’t quite the same as concealing a stereotypical stigmatized identity, but it certainly seems like at the margin it could lead to a detrimental strengthening of the distinction between public and private selves (or a public self and a second public self.)
Sedlovskaya, A., Purdie-Vaughns, V., Eibach, R., LaFrance, M., Romero-Canyas, R., & Camp, N. (2013). Internalizing the Closet: Concealment Heightens the Cognitive Distinction Between Public and Private Selves. Journal of Personality and Social Psychology DOI: 10.1037/a0031179

Where Does Culture Shock Come From?

Culture is a powerful thing. It not only affects how much time you spend at work, how you treat others around you, and how much beer you consume before the age of 20, it can also influence the emotions you experience on a day-to-day basis. The simple story of how culture influences emotions is that the same situation can elicit different emotions in different cultures. For example, going out on your own and achieving an important personal goal may elicit more pride in an individualistic culture, but more shame in a collectivist culture (because you’ve abandoned the group.)

According to a new study (journal link, pdf), there is also a more deep-rooted explanation for how culture influences emotions: You’re more likely to encounter situations that elicit culturally condoned emotions and less likely to encounter situations that elicit culturally condemned emotions. In other words, cultures tend to afford situations that are likely to lead to particular emotions.

The core of the study involved American and Japanese students rating the frequency with which certain situations occurred. In prior pilot experiments each of the situations had been shown to elicit either shame — an emotion that tends to be condoned in Japan but condemned in America — or anger, an emotion that is condoned in America but condemned in Japan. The researchers found that Japanese students rated situations eliciting shame as more likely to occur and situations eliciting anger as less likely to occur. American students believed the opposite. In each culture, situations that elicited condoned emotions were perceived to occur more frequently.

The researchers see this as evidence that culture essentially “regulates” situations:

The findings point to a regulatory process at the level of cultures (De Leersnyder, Boiger, & Mesquita, 2013): The cultural selection of everyday situations seems to promote situations that elicit culturally condoned emotions and to suppress those situations that elicit culturally condemned emotions.

In the same way a teacher encourages situations that lead to teacher-condoned behaviors occurring more frequently, a culture encourages situations that lead to culturally condoned emotions occurring more frequently. The question is, how might might this anthropomorphized version of culture “select” certain situations? The authors propose a few explanations:

Antecedent-focused regulation may occur in a number of different ways. Certain cultural practices may generate certain kinds of emotion-eliciting situations and make them occur more frequently (e.g., practice of hansei or critical self-reflection leading to more shame-inducing situations). Social life may be structured in ways that affect the prevalence of certain situations (e.g., politeness rituals and highly structured social interactions reducing friction and keeping social transactions smooth). Finally, institutionalized values may afford the experience of certain kinds of situations (e.g., a strongly endorsed right for free speech increasing situations of dissent).

To get back to my attention-grabbing headline, I think the study hints at a mechanism for culture shock that goes beyond than the standard “you feel discomfort because things are different.” If cultures select for situations that elicit condoned emotions, entering a new culture ought to involve encountering situations built to elicit a less familiar set of emotions. This might mean an increase in situations that elicit emotions your native culture condemns, and a decrease in situations that elicit emotions your native culture condones. That change ought to result in some serious anxiety, and it has nothing to do the fact that restaurants are serving you dishes with strange animals in them.
Boiger, M., Mesquita, B., Uchida, Y., & Feldman Barrett, L. (2013). Condoned or Condemned: The Situational Affordance of Anger and Shame in the United States and Japan Personality and Social Psychology Bulletin DOI: 10.1177/0146167213478201