Empathy: Why its Facilitation is So Important and How to Foster it in Our Youth

by Grace Sargent, April 22, 2022

Introduction

Humans as a species are empathetic by nature, though modern society seems to hinder its widespread development. Surrounded by technological advancements and automated machines, we have become immersed in a robotic world that fails to illustrate the countless emotions we experience daily. This is quite prevalent among children, who are incredibly susceptible to the mindless behaviors associated with technology. It is extremely common for parents to immediately produce an electronic tablet for their crying child instead of taking more lasting measures. In this digital age, it is increasingly important for children to maintain a healthy relationship with books, as they provide an authentic way to facilitate empathy and to ensure that such important characteristics are nurtured instead of lost or forgotten.

What is empathy?

In order to argue for the value of empathy to individuals and society, a definition of empathy itself must first be understood. American cognitive scientist and author J.D. Trout explains that “empathy is the capacity to accurately understand the other’s position, the feeling that ‘this could happen to me’” (Pohoată 9). As humans, we have a multitude of emotions that we are subject to, not only throughout our lives but fluctuating during our days as well. However, the fascinating thing about these emotions is that we all experience them, whether it be at the same time over the same things, or at different times over different things. It is through these experiences that we can come together and empathize with each other; we know what it feels like to be sad, happy, anxious, or excited, and so we are, consequently, able to gather a general idea of what someone else is currently feeling. Another crucial part of the definition of empathy is the involvement of cognitive comprehension and emotional reactions. To be fully empathetic, both of these characteristics must be developed for long periods of time (Good 1).

Why is empathy important?

Following the comprehension of empathy as a concept, we need to also understand its importance, which has been illustrated through a study conducted by Ph.D. student of Psychology Greg Depow. This study involved questioning 246 participants from the United States seven times a day for one week regarding their levels of happiness, sense of purpose, and overall well-being. The purpose of the study was to track the frequency of participation in situations where empathy could be called upon, whether that meant offering or receiving it. Once the study was completed and the collected data was analyzed, encouraging conclusions were drawn. Firstly, the study found that we empathize often in our everyday lives, as we frequently find ourselves in situations that could benefit from it. On average, over a span of twelve hours, people found nine opportunities to empathize and six opportunities to receive empathy. More notably, the analysis concluded that those who recognized more empathy opportunities and empathized more reported greater happiness and well-being. It is important to remember that empathy does not need to always involve the experience of negative emotions. In fact, according to Depow, we experience positive emotions three times more often than negative ones, which could contribute to why participants reported empathizing more with positive emotions during the study. Relating to the study, Depow reported that at the times when people in the study experienced more empathy, they practiced more kindness towards others (“How Small Moments”). This study demonstrates empathy’s cyclical nature: the more empathetic we are, the better we feel, and the more we want to be empathetic towards others. If we as a society can maintain this healthy cycle, the empathy we share is central to our humanity and can allow us to live in a decent society, characterized by citizens that willingly and voluntarily understand and take care of each other (Pohoată 15).

The development of empathy

One last important note about empathy is that although it is an innate characteristic of humans, it can be improved upon through education about what it is made up of and how those parts relate to one another. Empathy heavily relies on the parts of our brains that deal with an emotional connection with others (“Why the World Needs an Empathy Revolution”). We experience arousal in our pain pathways when witnessing someone else in pain. Psychiatrist Helen Reiss explains that our neurological systems allow us to observe the hurting of others while also giving us a fraction of that pain as motivation to help them out (“Why the World Needs an Empathy Revolution”). However, empathy also involves a level of concern, which complicates its effectiveness in each individual; while we are all “programmed” to empathize with others, not all of us will necessarily empathize to the same extent. Thus, the behavior of people directly correlates with education and self-education (Pohoată 11). It is important to recognize that empathy has multiple parts, and, therefore, it develops over time rather than all at once. Additionally, it is during our adolescent years that our empathy develops the most, given our impressionability. It is understood that children as young as two-years-old can comprehend and talk about specific emotions along with the actions that accompany them (Good 2). This is why attempts at facilitating empathy in children must be made as early as possible and with lots of consideration and thought.

How to effectively cultivate empathy in children

One of the most important parts of teaching children empathy is firstly emphasizing understanding the emotions they and those around them can face, as well as explaining the actions that accompany them. Fortunately, a common thread throughout children’s literature is the discussion of emotions and the ways they are displayed (Berliner). A wonderful way to foster these ideas is to allocate reading time during school, thereby encouraging storytime as a method of enhancing empathy in children. 

Another useful aspect of literature involves the characters that make up the stories. Characters provide a space for emotions to be felt and displayed for children to digest while reading. A useful technique for teachers is to first explicitly explain the events of the story and then circle back to the children themselves. For example, teachers can ask questions in the following format: “This child was angry when his toy was taken away from him. How do you feel when someone takes your toy?” (Berliner). The value of this question lies in how it encompasses multiple important learning points. The child who was asked this question can now understand what anger is, associate it with a certain situation, and even identify that emotion within their own life. This example relates to psychiatrist Helen Reiss’s explanation that better perception of others’ emotions is associated with a strengthened sense of empathy (“Why the World Needs an Empathy Revolution”). They can then take this newfound knowledge and apply it to situations that may arise, ultimately allowing them to be more empathetic. 

These kinds of techniques have proven very effective within a classroom setting, and teachers have shared their approaches and experiences in incorporating them into their curriculums. High school English teacher Jennifer Ansbach discusses how she brought these kinds of methods into her classroom in an attempt to combat bullying and its harmful, long-lasting effects. She called upon the collection of personal essays called “Dear Bully: 70 Authors Tell Their Stories.” The essays come from the perspective of bullies, victims, and even witnesses to bullying. All of them are written in the first person, which is important because first-person writing allows for the explicit expression of specific emotions and feelings during relatable situations. Following the conclusion of these readings, Ansbach asked her students if, before the essays, they would recognize the discussed situations as bullying. Only a handful raised their hands. She then inquired if they now understood those actions as bullying and reported that every student raised their hand. Ansbach continued speaking about this over a few weeks, and by the end, there were positive results seen in the actions of students. After the conclusion of this teaching plan, she explains that it successfully raised awareness on the matter, created empathy in the students, and created “a desire to change their own behavior” (Ansbach 92). Ansbach noticed her students discussing ideas of damage control for bullying victims more often, as well as how they can play a part in ameliorating this ongoing issue. This simple exercise alone demonstrates the empathetic nature of first-person narrative stories and how it can challenge preconceived notions of students.

Emotional transportation and how it relates to empathy

Another idea surrounding the importance of characters in stories deals with empathy facilitation, and it is called emotional transportation. Emotional transportation involves the reader of a story and allows their emotions to truly dive into a story and, therefore, form a more thoughtful connection with the content they are consuming (Bal). When an individual reads a story, their emotions are triggered in a way that can be reflected upon. One of the best ways to relate this reflection to empathy is through emotional transportation, which works most efficiently with relatable characters. When a reader indulges in a story and can identify with a character, they can take it a step further and vicariously experience the events in the story as if they were happening to them in real life. The valuable takeaway of these processes is that the reader practices empathy through reading a story (Bal). The reason emotional transportation carries such importance is because of the individual benefits: the higher the emotional transportation into a story is, the higher the probability of personal change is (Bal). 

As previously mentioned, the best way to encourage emotional transportation is by creating relatable characters. This sense of familiarity allows readers to venture into unfamiliar situations with greater ease and ultimately helps improve their empathetic capabilities. A 2013 study by Matthijs Bal and Martijn Veltkamp was conducted at Erasmus University Rotterdam where students read stories in their free time for a few hours each week and subsequently answered questions about their emotional transportation and empathetic measure. Following the completion of the study, the conclusions supported the idea that emotional transportation plays a valuable role in facilitating empathy. The main verdict of the experiment was that highly transported individuals had increased empathy over the weeks, and those who reported low transportation experienced a decrease in empathy (Bal). This is because low transportation is associated with “defamiliarization,” which is when a reader fails to connect emotionally with a story and its characters, and therefore is unable to relate to the people and situations presented to them. This not only prevents transportation, but it inhibits their ability to empathize (Junker). Thus, children need to have access to books that not only offer situations that pertain to their lives but books that also contain relatable characters.

Conclusion

In closing, empathy and the way it is brought into the lives of children is invaluable. Our society seems to be straying away from the colorful emotions we have to offer and is instead creating a more monotonous lifestyle ridden by the robotic automation of the digital age. It is up to us, however, to ensure that these innate, important characteristics we share don’t disappear. Empathy is central to our humanity and maintains the power to cultivate a healthier, more humane world (Pohoată 10). It is therefore important to instill these ideals into the minds of children and begin intervention as early as possible. Additionally, it is crucial to recognize the most effective method: reading. Through the consumption of novels and narratives, children gain helpful insight into not only what emotions are, but what they look and feel like. Education on these topics early in childhood can be carried into adulthood, and consequently spread throughout our society.


Works Cited

Ansbach, Jennifer. “Long-Term Effects of Bullying: Promoting Empathy with Nonfiction.” The English Journal, vol. 101, no. 6, National Council of Teachers of English, 2012, pp. 87–92, http://www.jstor.org/stable/23269416. 

Bal, Matthijs and Martijn Veltkamp. “How Does Fiction Reading Influence Empathy? An Experimental Investigation on the Role of Emotional Transportation.” PLOS ONE, Public Library of Science, 2013, https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0055341. 

Berliner, Rebecca and Tracy Loye Masterson. “Review of Research: Promoting Empathy Development in the Early Childhood and Elementary Classroom.” Taylor & Francis, 2015, https://www.tandfonline.com/doi/full/10.1080/00094056.2015.1001675. 

Good, Jasmine S., et al. Fostering the Development of Empathy in the Classroom. https://research.avondale.edu.au/cgi/viewcontent.cgi?article=1055&context= teach. 

Junker, Christine R. and Stephen J. Jaquemin. “How Does Literature Affect Empathy in Students?” Taylor & Francis, 2017, https://www.tandfonline.com/doi/full/10.1080/87567555.2016.1255583?scroll=top&needAcces s=true.

Pohoată, Gabriela and Iulia Waniek. “Do We Need Empathy Today?” Euromentor Journal, vol. 8, no. 3, 2017, pp. 7-16, http://proxy.library.stonybrook.edu/login?url=https://www.proquest.com/scholarly-journ als / do-we-need-empathy-today/docview/1986130844/se-2?accountid=14172. 

Suttie, Jill. “How Small Moments of Empathy Affect Your Life.” Greater Good, 2021, https://greatergood.berkeley.edu/article/item/how_small_moments_of_empathy_affect_y o u r_life. 

Suttie, Jill. “Why the World Needs an Empathy Revolution.” Greater Good, 2019, https://greatergood.berkeley.edu/article/%E2%80%8Bitem/why_the_world_needs_an_e mpathy _revolution.

Silly Rabbit, Trix Aren’t for Kids!: How General Mills’ Trix Cereal Targets Young Audience

by Divya Jagnarain, April 5, 2022

It’s 7:15 AM on a Monday morning. Your bus will arrive outside your house in fifteen minutes. Half asleep, you reach into your cabinet and grab a vibrantly colored box of General Mills’ Trix cereal. The nutrition label sticks out, but as usual, you don’t care to read it. It’s colorful, grabs your attention, is easy to prepare and tasty. Many of the cereal boxes advertised on the shelves of grocery stores are designed in such a way to grab the attention of loud, demanding children. While making parents out to be the bad guys, who can say “no” to this brightly colored box of sugar?

What is it about the color of the box and the details of the illustrations that draw children in? According to Leatrice Eiseman, director of Eiseman Center for Color Information and Training and executive director of Pantone Color Institute, “Children are inevitably fascinated by brighter colors from early infancy” (Parpis, 4). Studies have shown that the eyes of growing children will be attracted to the primary colors, red, blue, and yellow (Parpis, 4). Marketing companies, such as those of General Mills’ Trix use this to their advantage. 

Since their eyes are not fully developed yet, from an early age children have a preference for bright colors. These colors are much easier to perceive than faint shades. The bright colors typically used by companies targeting children stand out more in their field of vision (Pancare, 3). On Trix cereal boxes, one can find an abundance of reds, greens, yellows, purples, etc. The combination of these contrasting colors is inviting to a bored child strolling through the aisles of a grocery store. 

Plastered on cereal boxes all over America, the Trix Rabbit, illustrated by Joe Harris has captivated the minds of youths. The Trix Rabbit, commonly referred to as Tricks, has a way of connecting to children. “And, of course, what we feel connected to—which happens when someone, even a cartoon character, makes eyes at us—we’re more likely to buy,” states Alice G. Walton of Forbes Magazine (Walton, para 1). Having a character representing one’s brand that is inviting and entertaining bodes well to grab the attention to young minds. 

The Trix Rabbit is more than meets the eye, however. In the Journal of Popular Culture, author Thomas Green contends that Trix the Rabbit bears more than a passing resemblance to a “trickster” (Eisenberg, 118). Green writes, “Tricksters are often depicted as participating in some kind of trick, theft, or sacrifice that results in the gift of the useful technology or plant to humanity” (Eisenberg, 118). Similarly, on television commercials, Trix the Rabbit is willing to cheat or deceive to acquire the toothsome cereal from unsuspecting children. That’s where the famous slogan, “Silly rabbit, Trix are for kids,” comes into play. 

From the 1970s to the present day, this harmless rabbit has been trying to get a taste of the eye-catching cereal but has failed to do so due to “selfish children” refusing to share. Trix the Rabbit has to resort to concealing his identity in costumes in order to trick the children. From disguising himself as an astronaut to a breakdancer, Trix the Rabbit takes on the costume of whatever advertisers perceive as popular with children at that time (Eisenberg, 120). In doing so, advertisers succeed in their goal to captivate young audiences. On the contrary, Trix the Rabbit, when he is nearing his goal of acquiring the delicious fruity goodness, his ears always spring free, exposing his true identity (Taylor, para 2). This iconic, well-known television commercial has been planted in the memories of many generations. 

To understand how television companies advertise to specific consumer segments such as children, teenagers, and adults, one must assess the nutritional quality, packaging, and co-branding of the product (Berning et al., para 4). In other words, a cereal’s nutritional profile, package attributes, and co-branding correspond to television advertising targeted at specific audiences. Often, breakfast cereal packaging is “covered in brand characters, promotional opportunities, nutritional claims, and other engaging marketing strategies” (Berning et al., para 13). As mentioned beforehand, Trix the Rabbit is an identifiable character which entices young consumers. In other popular brands, children are drawn to Toucan Sam and Cap’n Crunch in the same light. 

The attractiveness of brand profiles are heightened with the addition of “games on the box, toys in the box, and other forms of brand enhancements” (Berning et al., para 14). On the rear of a General Mills’ Trix™ Cereal box, one can find an abundance of enticing activities. Such activities include “Tumblin’ in Trix,” “Name the Rabbit,” “Hurray for Fruity Shapes,” and so on and so forth. These activities can range from short, adventurous stories to mini puzzle games to full-blown challenges. By putting different activities on these boxes, it begs consumers to buy often to complete the next set. 

Furthermore, breakfast cereal packaging is used to promote product co-branding. For instance, a child walking down the cereal aisle in a grocery store would be drawn to the cereal box with a famous athlete or character from a movie. According to Qu Rao et al, “co-branding can help gain increased access to new markets and can signal reputation and quality” (Berning et al.,  para 15). Television or movie themes, athlete endorsements, or cartoon endorsements are effective ways of targeting new consumers. 

In order for the product to be picked up from the shelves, taken to the register, bagged, taken home, and consumed, advertisers must be able to win over the hearts of both the child and parent. In regards to breakfast cereals, manufacturers are aware that sugar appeals to children. According to statistics, “a third of U.S. consumers buy one box of cereal per trip, 41% buy two and 19% buy three or more” (Sherred, para 3). Chief marketing officer of Shopkick, Kristy Stromberg says “We’ve seen that people are loyal to the brands and tastes they love, and despite a movement towards incorporating healthier options, consumers will always love classic favorites” (Sherred, para 15). At the end of the day, taste is the deciding factor when it comes to choosing breakfast cereals. 

Of the millions of Americans that shop every day, only 18% of consumers look at the nutritional values before purchasing. On the side of a box of General Mills’ Trix is the “Nutrition Facts.” The nutrition facts are clearly visible with the mass and percentage of its ingredients. Many consumers overlook this nutrition label as it is hard to understand. Having it written very plain and simple, one chooses not to question the “healthiness” of the cereal. Additionally, right below the concentrations of cholesterol, sodium, potassium, carbohydrate, and proteins are the percentage of vitamins, irons and calcium listed. It’s general knowledge that these minerals are pivotal to one’s diet. Minerals help our bodies develop and function. For instance, iron is important for cell growth, development, and normal body functions. According to Robert Earl et al, “the prevalence of iron deficiency anemia among young children has been declining, and the decline is attributed to the use of iron-fortified formula and cereal, appropriate supplementation of breastfed infants, and later introduction of cow’s milk to infants’ diets than had been typical in the past” (Earl, 3). Having these minerals listed on the boxes of cereal in clear and readable font further persuades one to purchase said cereal, whether they read it or not. 

As insignificant as it seems, the font displayed on these cereal boxes do make a difference. A brand’s chosen typeface reflects the personality of the brand. Trix™ cereal utilizes fonts such as Franklin Gothic Heavy, Helvetica Regular, Helvetica Black, and other plain fonts. In accordance to UX design student Liz Fu of University of Michigan, “The typefaces were categorized according to their personality traits and typographical features such as x-height proportion, ascender and descender proportion, font weight, stroke design, and counter design, as well as the kerning of the letter pairs. These typographical features give typefaces their personality” (Fu, para 6). These fonts are characterized with the personality traits of directness, gentleness, cheerfulness, and fearfulness. Using fonts of such that have a very familiar, legible, plain, and straightforward personality is agreeable to consumers. 

How can advertisers get this sugary goodness into the household of roughly all Americans? The answer is simple: Box Tops. Popular among cereal boxes are the inclusion of “Box Tops,” which are used for educational purposes. Trix™ cereal is in participation with the “Box Tops for Education” program. Not only on Trix™ cereals, but many popular cereal brands have the words “Every valid Box Tops clip is worth 10¢ for your school” printed on their products as well. In collecting box tops to raise funds for one’s school, children are taught the importance of giving back and how small actions can impact others in a fun way. By doing so, they earn the school’s funds that can be used towards things like school supplies, books, and field trips (Hanawalt, para 2). This characteristic on cereal boxes is appealing to parents along with their children. Many parents want to contribute to their children’s education in one way, shape, or form—whether that is through the donations of box tops or staying up late at the dinner table to complete their child’s science project on time. 

By understanding how the minds of their target audience works, marketing companies are able to play to their advantage. Through the usage of vibrant colors, large fonts, simple words, and enticing games, General Mills’ Trix™ Cereal has stolen the hearts and money of Americans all across the country. Many companies recognize that children are easy targets to sell to. The demanding voices of children bodes well for their products to sell. Where nagging children go, frustrated parents follow.


Works Cited

Berning, Joshua, and Adam N. Rabinowitz. “Targeted Advertising In The Breakfast Cereal Industry.” Journal of Agricultural and Applied Economics, vol. 49, no. 3, 2017, pp. 382–399. doi:10.1017/aae.2017.1. 

Earl, Robert O., et al. Iron Deficiency Anemia Recommended Guidelines for the Prevention, Detection, and Management Among U.S. Children and Women of Childbearing Age. National Academy Press, 1993.

Fu, Liz. “How Typefaces Affect Consumer Perception of Brand Personality.” Medium, 15 Dec. 2017, medium.com/@lizfu/how-typefaces-affect-consumer-perception-of-brand-personality-a8ba928fbad4.

Hanawalt, Zara. “Parents Can Now ‘Clip’ Box Tops Using an App.” Motherly, 30 July 2019, mother.ly/news/box-tops-program-is-going-digital.

Pancare, Rachel. “How Do Bright Colors Appeal to Kids?” Sciencing, 2 Mar. 2019, sciencing.com/do-bright-colors-appeal-kids-5476948.html.

Parpis, Eleftheria. “The Color of Money: The Art, Science and Psychological Appeal of Bright colors.” Brandweek, vol. 51, no. 17, Apr. 2010.

Sherred, Kristine. “Shopkick Survey: 96% of US Consumers Buy Cereal Every Time They Shop, Sweet Brands Still #1.” Bakeryandsnacks.com, 5 Mar. 2019, bakeryandsnacks.com/Article/2019/03/05/96-of-US-consumers-buy-cereal-every-time-they-shop-survey-reveals

Eisenberg, Lee. Shoptimism: Why the American Consumer Will Keep on Buying No Matter What. Free Press, 2009.

Taylor, Heather. “Silly Rabbit! The Trix Rabbit Celebrates His 60th Anniversary.” POPICON, 5 Aug. 2019, popicon.life/silly-rabbit-the-trix-rabbit-celebrates-his-60th-anniversary/.

Walton, Alice G. “The Sticky Methods Of Marketing Cereal To Kids.” Forbes, 4 Apr. 2014, forbes.com/sites/alicegwalton/2014/04/04/the-sticky-world-of-marketing-cereal-to-kids/#18a7bdac7562.

What is (And Isn’t) Positive Psychology?

by Marie Yamamoto, April 1, 2022

Positive psychology is a branch of psychology that focuses on the nurturing of human
virtue and mental strengths as well as the fostering of wellbeing (“Positive Psychology”).
Founded by Martin E. P. Seligman in the late 1990’s, this field aims to combine the core goals of
its predecessor, humanistic psychology, through quantitative methods. Despite common
misconceptions, positive psychology is a multifaceted, empirical field dealing with more than
simple positive emotion.

Part of what made positive psychology so revolutionary was that it steered away from
psychology’s shift towards the examination and treatment of human anguish. Seligman notes that
after World War II, the demand to study mental illnesses and trauma was so pressing and
lucrative that “the other two fundamental missions of psychology— making the lives of all
people better and nurturing genius—were all but forgotten” (“Positive Psychology: An
Introduction”). This heavy emphasis on these aspects of the mind gave psychologists the skillset
to repair mental damage, but without a solid understanding of resilience, it did not necessarily
give them the tools to prevent this pain. Using an empirical lens, positive psychologists presently
conduct research in order to fill this gap. Mihaly Csikszentmihalyi, another influential positive
psychologist, asserts that “[positive psychology] tries to adapt what is best in the scientific
method to the unique problems that human behavior presents to those who wish to understand it
in all its complexity” (“Positive Psychology: An Introduction”).

However, positive psychology is not meant solely for those who wish to protect their
mental state; rather, it studies how one can flourish even when conditions are satisfactory.
Seligman defined this satisfaction as wellbeing or authentic happiness, which goes beyond
simply being in a constant happy mood (Flourish). For example, this field has produced a
plethora of “happiness interventions,” exercises meant to strengthen core values and habits that
make life meaningful and thereby fulfill one’s psychological needs (Walton). Although the
effectiveness of these practices may vary from person to person based on their comfort level and
life circumstances, happiness interventions are backed with empirical evidence and extensive
research that denotes their accessibility and the reasons why they are successful.

It must be noted that the field of positive psychology cannot be conflated with the self-help
community. Those that “decry positive psychology’s commodification and commercial
cheapening by the thousands of coaches, consultants, and therapists who have jumped on the
bandwagon with wild claims for their lucrative products” are criticizing the people that exploit
positive psychology’s name and principles for their own gains (Smith). Likewise, those that
speculate positive psychology’s “replicability, its dependence on unreliable self-reports, and the
sense that it can be used to prescribe one thing and also its opposite” are describing both what
makes positive psychology a science and what makes positive psychology—and perhaps
psychology as a whole—distinctive from other fields (Smith). This field, like other social
sciences, aims to make generalizations about populations or humanity as a whole through the
research procedures and the scientific method. It cannot remain a completely empirical science
as it must account for differences between people and between populations, but the process in
which abstract concepts like gratitude, happiness, and strength are empiricized and the process in
which studies are performed are no different than the natural or applied sciences.

For those interested in exploring this field, the podcast The Science of Happiness, run in
conjunction with UC Berkeley’s Greater Good Science Center, is a great place to start. It can be
found here.


Works Cited

“Positive Psychology.” Psychology Today, psychologytoday.com/us/basics/positive-psychology. Accessed 30 Mar. 2022.

Seligman, Martin E.P. Flourish: A Visionary New Understanding of Happiness and Well-Being. Atria Books, 2012. 

Seligman, Martin E.P. and Mihaly Csikszentmihalyi. “Positive Psychology: An Introduction.” American Psychologist, vol. 55, no. 1, 2000, pp. 5–14. 

Smith, Joseph. “Is Positive Psychology All It’s Cracked up to Be?” Vox, 20 Nov. 2019, vox.com/the-highlight/2019/11/13/20955328/positive-psychology-martin-seligman-happiness-religion-secularism.

Walton, Gregory M., and Alia J. Crum. (2021). Handbook of Wise Interventions: How Social Psychology can help people change. The Guilford Press, 2020.

From Criminals to Celebrities: How Women’s Fascination with Serial Killers Reflects Their Perception of Romance

by Ayesha Azeem, March 25, 2022

People have always been interested in learning about influential people’s lives — through both gossip and the media. Whether we’re learning about Jennifer Aniston’s new fling, Kim Kardashian’s pregnancy, or Harry Styles’s secret vacation, we often interest ourselves with other people’s lifestyles, namely celebrities, because we feel as if we personally know them through our powerful admiration and devotion. We see celebrities as heroes; people we aspire to be like. But why are we so drawn to the lives of villains as well?

Recently, women have developed a strong obsession with true crime, a literary and film genre in which the author examines an actual crime and exposes the actions committed by real people; specifically, there has been a sudden fascination with serial killer crimes. This infatuation with evil reveals our desire to uncover the secrets and truth behind those who commit the horrific acts we abhor. Perhaps it fascinates us that these famous perpetrators hold such obvious disregard for morality and societal values; we feel obligated to witness the dramatic scenes unfold as a means of “preparation” for any real-life danger. 

From Ted Bundy to Charles Manson, women often find themselves deluded into romanticizing famous serial killers. We find it hard to accept that attractive people are just as capable of committing grotesque crimes as ordinary people. Recently, the Joker movie played by Joaquin Phoenix, though fictional, has captured the attention of young girls infatuated with his depressing life story and motivation to commit heinous crimes that are similar to real killers. Though women are more likely to be victims of a major crime, for some reason they feel increasingly attracted to the vile and twisted side of history, intrigued to learn about the ways in which they can face danger.

Psychologists conducted a 2010 study at the University of Illinois to investigate the relationship between gender and the true-crime audience. Psychologist R. Chris Fraley and their team discovered that women wrote 70% of the true-crime book reviews on Amazon, while men felt a greater connection to war books, writing  82% of reviews (Yates). The researchers hypothesized why women may feel an increased inclination to read more true crime and suggested that such stories can provide useful information that may help readers avoid or escape potential attacks such as murder or rape. To investigate this claim, the psychologists reviewed the summaries of the books most often reviewed by women. Further study revealed that women were more likely to read a true crime book if the victim used a clever ‘psychological trick’ to deceive and escape from their perpetrator. Unsurprisingly, women also felt attracted to true crime books with female victims. Thus, evidence strongly suggests that women tend to read more true crime books with clever female survivors because they provide a ‘guide’ of instructions as to how to avoid deadly encounters in real life. If women consume as much violence as they can in art, maybe they can escape the true violence that unfortunately lingers in our reality. 

Recently, the producers of All Killa No Filla, a British podcast dedicated to exploring the lives of serial killers, found that roughly 85% of listeners are female (Woman’s Hour). BBC Radio 4’s Woman’s Hour considered why their listeners consisted mostly of women, and invited Dr. Gemma Flynn, a criminologist at Edinburgh University, and Rachel Fairburn, co-host of the famous podcast, to explain their theories. Dr. Flynn believes that a major explanation for female true crime listeners includes women retaining an extensive fear of crime. According to Fairburn, “women love true crime because pretty much from the time that we’re very small, we’re told to be careful, look after ourselves, watch out for bad people, make sure we get home safely” (Woman’s Hour). The host suggests that society constantly attempts to protect women from danger, instilling in their minds that as long as they’re alone, they can be attacked. Thus, women tend to leave their house with a constant target on their back and safety on their minds, attracting them to true crime out of self-preservation. With the stereotype and widely held belief that women cannot walk alone at night because of possible attacks, women feel the need to protect themselves as much as possible, consuming true crime stories at the top of their list. 

The constant fear society holds regarding women as potential victims of brutal crimes stems from the media’s infatuation with blood and murder. According to a 1992 study conducted at SUNY Oswego, mass media “serves as the primary source of information about crime for up to 95% of the general public,” with approximately 50% of news coverage devoted exclusively to crime stories (Mann). With this extensive reporting on crime and violence, Americans fall victim to their availability heuristic, a mental shortcut that relies on immediate examples that come to a person’s mind when thinking of an idea or event. Because of the increased attention presented towards crime on-air, Americans may not believe that the crime rate has actually decreased over the years since all they hear about is murder, rape, and violence when they turn on their televisions. While murder rates decreased by 20% from 1993 to 1996, reporting on murder on television rose by 721%. (Mann). This affects women especially as the constant fear perpetrated by the media regarding crime and murder may be a key reason in females’ attraction towards true crime media. 

Now that we understand why women tend to reach for books labeled with the true crime genre, the compelling question needed to be answered is why women romanticize these vile human beings. After the release of Extreme Wicked, Shockingly Evil and Vile, a film on the life of Ted Bundy based on the perspective of his girlfriend, viewers went to Twitter to express their newfound admiration for the ‘misunderstood’ villain. Ted Bundy was portrayed by attractive and talented Zac Efron, only attracting more fans to the Ted Bundy “fandom,” a group of teenage girls infatuated with the killer (Donaldson). Some tweets include: “Love that conservative masculinity #TedBundy,” and “Ted Bundy is so hot… wish he killed me” (via Twitter). The women who romanticize serial killers like Ted Bundy and Charles Manson can be described as having hybristophilia, or sexual arousal “over someone committing an offensive or violent act,” as described by Dr. Katherine Ramsland, a forensic psychology professor at DeSales University. These women admire the idea of being the ‘exception’ for a damaged person; they feel the need to ‘nurture’ and ‘protect’ their powerful and evil lovers. These women fantasize about “changing” the broken part of serial killers; they want to “fix” them; usually, women who admire such behaviors have trouble with conventional relationships due to insecurities. If she dates a serial killer in jail, at least she’ll know where he is all the time (Psychology Today). Additional research indicates that women feel attracted to masculinity and may interpret serial killers’ unchecked aggression as ‘protective’ or ‘manly.’ Women may feel that these attributes will keep them safe and secure, and thus may prefer more violent mates (Perrett).

Whatever may be the reason behind women’s fascination with serial killers, this infatuation proves fatal. When Charles Manson and Ted Bundy awaited death, thousands of female fans lined up, expecting to marry these vicious men, refusing to believe their crimes simply because of their attractiveness (Sutton). The never-ending fame of attractive serial killers depicts the true danger: our inclination as human beings to automatically trust and like attractive people, simply because of their looks. Many women fell prey to Bundy and Manson’s traps simply because they might’ve misjudged them for being kind, respectable people because of their beautiful smiles or bright eyes. Though Netflix and other entertainment providers may attempt to raise awareness of real tragedies, it is important to also consider the danger of awareness. Today’s generation may be too infatuated with Zac Efron’s looks and appearance in Extreme Wicked, Shockingly Evil and Vile to realize that his charm was what allowed many to overlook his apparent misogyny and objectification of women: “Women are possessions… Beings which are subservient, more often than not, to males. Women are merchandise” (Wyman). The tales of these serial killers should serve as a warning to many women, rather than favorable romantic heroes; we really don’t know what people are like behind closed doors. We need to remind ourselves who these serial killers actually are: vile, immoral men disguised as educated, charismatic professionals; they are not compassionate or need protection – they do not feel. We must not grieve or sympathize with men that never existed.


Works Cited

Donaldson, Kayleigh. “The Sexy Killer Fandom Wars: No, Fancying Ted Bundy Is Not the Same Thing as Fancying Venom.” SYFY WIRE, 11 Feb. 2019, www.syfy.com/syfywire/the-sexy-killer-fandom-wars-no-fancying-ted-bundy-is-not-the-same-thing-as-fancying-venom.

Mann, Stephen, et al. “Crime and the Media in America.” OUPblog, 3 Apr. 2018, blog.oup.com/2018/04/crime-news-media-america/.

Perrett, David I., et al. “Effects of Sexual Dimorphism on Facial Attractiveness.” Nature, vol. 394, no. 6696, 1998, pp. 884–887. doi:10.1038/29772.

Ramsland, Katherine M. Confession of a Serial Killer: the Untold Story of Dennis Rader, the BTK Killer. ForeEdge, 2016. 

Schildkraut, Jaclyn. “Crime News in Newspapers – Oxford Research Encyclopedia of Criminology.” Oxford Research Encyclopedias, 18 Apr. 2018, oxfordre.com/criminology/view/10.1093/acrefore/9780190264079.001.0001/acrefore-9780190264079-e-32#acrefore-9780190264079-e-32-div1-1

Sutton, Candace. “Inside Serial Killer Charles Manson’s Deluded Fan Club.” NewsComAu, News.com.au, 9 Jan. 2017, http://www.news.com.au/world/north-america/inside-the-deluded-world-of-serial-killer-charles-mansons-fan-club-and-the-fiancee-who-says-hes-innocent/news-story/364fe75d235055d38186b3e84347d035.

Tuttle, Kate. “Why Do Women Love True Crime?” The New York Times, 16 July 2019, http://www.nytimes.com/2019/07/16/books/review/kate-tuttle-true-crime-women.html.

“Woman’s Hour – True Crime: Five Reasons Why Women Love It.” BBC Radio 4, BBC, http://www.bbc.co.uk/programmes/articles/5BQCFMQd3mPqj7YT4hlvdCL/true-crime-five-reasons-why-women-love-it.

“Women Who Love Serial Killers.” Psychology Today, Sussex Publishers, www.psychologytoday.com/us/blog/shadow-boxing/201204/women-who-love-serial-killers.

Whyman, Tom. “The Myth of Ted Bundy as a Charming Guy.” The Outline, The Outline, 5 Feb. 2019, theoutline.com/post/7043/ted-bundy-netflix-efron-handsome?zd=1&zi=godwptow.

Yates, Diana. “Women, More than Men, Choose True Crime over Other Violent Nonfiction.” ILLINOIS, 15 Feb. 2010, news.illinois.edu/view/6367/205718.

Islamophobia in the Digital Age: The Rise of a Global Mental Health Crisis

by Farah Hasan, March 22, 2022

My phone lies face down on the table beside me, buzzing sporadically, but insistently. I ignore it, fanning myself against the mid-July heat as I attempt to concentrate on an assignment for my summer class. I drum my fingers against the desktop and whisper the words aloud to myself, trying to make sense of the convoluted sentences of the essay as the buzzing continues. What do they want? I think exasperatedly, assuming my friends are simply spamming me with memes from Instagram and funny Tiktoks. As I finish the reading passage and move on to the multiple choice questions that accompany it, I decide to spare a glance at my phone. Expecting to see Instagram direct messages (DMs) and text messages headed by my friends’ familiar usernames and contact names, I am shocked to instead see hundreds of Instagram comment notifications from unfamiliar usernames, all beginning with the common header “[Instagram user] mentioned you in a comment.” My heart racing in anticipation, I open the Instagram app and quickly scroll through my notifications. I had left a comment criticizing France’s April 2021 ban on hijabs (headscarves worn by women for religious reasons) for Muslim women under the age of 18 on a post advertising travel to the Eiffel tower, and now I see that all these comments are in response to mine. Some of them back me up, but others range from applauding France’s actions, to blatantly calling Islam backwards and incompatible with Western civilization, to attacking me as a young Muslim woman myself. I exit the app without bothering to respond to anyone and close my eyes for a second, my heart still pounding as the hate words flash through my mind repeatedly. Like me, young Muslims everywhere are exposed to Islamophobic rhetoric on the social media sites they use most, and chronic exposure to such hate inevitably takes a toll on their mental health. Online hate is not given the same coverage or attention that street-level hate crimes get, but the effects of the former may be exponentially more profound due to the wide reach of users that are present on online platforms. Actions should be taken to limit such hate speech on public platforms like social media to preserve the mental-wellbeing of users that are targeted by these remarks, even if it means limitations on the First Amendment right to free speech. 

In a case close to home, a Muslim student recently graduated from my high school in the summer of 2021 and was chosen to deliver a speech at the commencement. In her speech, she advocated for the need for understanding and peaceful coexistence during difficult times, and briefly mentioned the ongoing conflict between Israel and Palestine. This part of the speech incited infuriated outcries from the audience, rude remarks shouting at her to “go back to Pakistan” as she walked off the stage, and the creation of a Facebook group as a space for angry parents to vent and express mildly Islamophobic sentiments. Due to the convenience and ease of access, social media is frequently defaulted to as a platform for these polarizing conversations. Certain social media sites, such as Twitter, are “better-designed,” in a sense, to perpetuate hate speech and to facilitate radicalized expression. Dr. Nigel Harriman, professor at the Harvard T.H Chan School of Public Health, and a group of researchers found that 57% of students that actively used the social media sites Youtube, Instagram, and Snapchat had come across hate speech, and 12% had encountered a stranger that tried to convince them of racist beliefs (this was especially common on Youtube). Additionally, exposure to hate messages was significantly correlated to Twitter use and Houseparty use (Harriman et al., 8531). Twitter is a particularly convenient hotbed for such rhetoric, as victims that come forward to tell their stories to Twitter are simply told to block the hating account or delete their own account. In 2014, Twitter issued a statement claiming that it “cannot stop people from saying offensive, hurtful things on the Internet or on Twitter. But we can take action when content is reported to us that breaks our rules or is illegal” (“Updating Our Rules Against Hateful Conduct”). Twitter more recently updated its rules against hateful content in December 2020:

In July 2019, we expanded our rules against hateful conduct to include language that dehumanizes others on the basis of religion or caste. In March 2020, we expanded the rule to include language that dehumanizes on the basis of age, disability, or disease. Today, we are further expanding our hateful conduct policy to prohibit language that dehumanizes people on the basis of race, ethnicity, or national origin.

(“Updating Our Rules Against Hateful Conduct”)

Although Twitter has taken some necessary steps to limit hate speech, this form of harassment nonetheless still exists on this and countless other platforms, and more action must be taken to counter this.

As someone that frequents social media sites like Instagram and Facebook, I understand how detrimental the algorithms themselves can be to one’s self-esteem, but coupled with exposure to hate speech, mental health for those targeted is more likely to plummet. Although I ultimately ignored the hate comments on Instagram under the post about France, the occurrence bothered me for several days afterward, leaving me anxious, unsettled, and dealing with mild sleep difficulties to the point where I deleted Instagram for a few months. Research by Dr. Helena Hansen at NYU Langone found that victims of online hate speech are found to have elevated levels of the stress hormone cortisol, leading them to exhibit a blunted stress response as well as higher rates of anxiety, sleep difficulties, and substance use (Hansen et al. 929). Dr. Brianna Hunt at Wilfrid Laurier University found that exposure to Islamophobic rhetoric is also a predictor of social isolation and loneliness, particularly among Muslim women in Waterloo, Canada. Furthermore, the dehumanizing aspect of hate speech also incites conflicts of identity in Muslim women of color, who feel that neither their religious nor their racial ingroups accept them fully, calling for the need to address mental health for more complex cases of intersectionality as well (Hunt et al.). 

In an effort to mitigate the destructive effects of hate speech on mental health, individuals have advocated for limiting such speech, but opponents of these limitations have expressed their concerns and dissatisfaction with this movement. In the 2017 case Matal v. Tam, the Supreme Court of the United States ruled that hate speech, like regular speech, is protected under the First Amendment under the justification that “giving offense is a viewpoint” (as long as it does not directly incite violence) (Beausoleil 829). Thus, individuals opposing limitation of hate speech on social media argue that doing so would be an infringement on their First Amendment right. There is also the danger that limitations of this sort would be a step in the direction of mass surveillance and abuse of power, ultimately resulting in a power dynamic of large digital companies﹣and potentially the government﹣in stifling any and all dissent (Beausoleil 2124). Other supporting evidence includes the notion that some exposure to counter speech is needed for the development of stable mental health and that various studies have shown that limitation of hate speech does not correlate to improved social equality (Beausoleil 2125). In fact, Dr. Stephen Newman of York University points out that expression of this sort of dialogue may be integral to human personality development, and that exposure to robust forms of speech may actually improve societal dynamics by influencing democratic policy (Newman). Lastly, there is limited existing literature proving that hate speech limitation is beneficial, as regulations of this magnitude have not been implemented anywhere yet. Thus, this argument is largely based on studies that have shown the harmful effects of hate speech. 

In a growing digital age, where social media use is a part of daily life for adolescents, young adults, and even middle aged individuals, chronic exposure to hate speech such as Islamophobic rhetoric cannot be tolerated. The longer online sites and social media platforms delay addressing such sentiments, the more widespread and normalized they will become and the more detrimental the effects will be on affected individuals’ mental health. In regards to opponents’ concerns over First Amendment compromise, the First Amendment cannot be applied perfectly to the digital age, which allows for unprecedented and unanticipated reach of communication across borders, continents, and time, as posts can always be viewed and interpreted so long as they are not deleted (Beausoleil 2127). Restrictions on the right to free speech are warranted in this case, where the mental health of countless targeted individuals on a global scale are at stake. To limit the likelihood that these companies abuse their extended powers of speech limitation, restrictions should be placed on the companies’ extent of power as well (ie. restrictions should be placed on the restrictions). Rather than immediately deleting all posts and comments including hateful rhetoric (which may be impractical), social media platforms should specifically aim to disband or deactivate groups, chat rooms, and accounts specifically devoted to or frequently posting Islamophobic﹣and other hateful﹣rhetoric. On particular posts where the comment section becomes overwhelmingly belligerent and hate-fueled, social media platforms should either delete the post, delete the inflammatory comments, or disable the comment section entirely. Lastly, these social media platforms should issue public statements against hate speech like Twitter did, include them explicitly in their terms and conditions of use, and send automated warnings to users who violate conduct rules multiple times with the intent of suspending their accounts if hateful activity continues. 

Ideally, the extent to which media companies can regulate inflammatory speech should be overseen by the federal government. However, complications may arise due to matters of jurisdiction: for example, the US government may have limited say on regulation of content posted on the social media platform TikTok, as this company was founded in China. Thus, for the time being, regulations should remain on a company-to-company basis. In the short-run, it can be expected that consumer use and feedback will let companies know how effective and acceptable their policies are. 

Though many praise the advent of cyberspaces and the beginning of the digital era as a way of bringing the world closer together with connections never known before, it is difficult to fathom how connected we really are amidst the divisive and discriminatory rhetoric that is often perpetuated on the very same platforms. Hate speech is present in several different forms, including anti-Semitism, racism, homophobia, gender discrimination, and prejudice against disabled individuals. As a Muslim woman, the recent increase in Islamophobic sentiments on social media have made me realize how pervasive their effects on young Muslims’ mental health are. Therefore, I strongly encourage social media platforms to limit hateful speech and promote civil and constructive dialogue instead using the methods outlined above, even if it means a slight compromise on First Amendment rights. By merely limiting and not completely eradicating hate speech, the extent of social media companies’ power is kept in check and the potential societal benefits of exposure to antagonistic speech mentioned previously may still be experienced. Taking actions such as deleting the Instagram post about France with the barrage of inflammatory comments would be steps in the direction of greater coexistence as the Muslim high school graduate’s speech earnestly called for and promoting the benefits of global connection that the digital era originally promised.


Works Cited

Beausoleil, Lauren. “Free, Hateful, and Posted: Rethinking First Amendment Protection of Hate Speech in a Social Media World.” Boston College Law Review, vol. 60, no. 7, 2019, pp. 2101–2144.

Hansen, Helena, et al. “Alleviating the Mental Health Burden of Structural Discrimination and Hate Crimes: The Role of Psychiatrists.” The American Journal of Psychiatry, vol. 175, no. 10, 2018, pp. 929–933, doi:10.1176/appi.ajp.2018.17080891.

Harriman, Nigel, et al. “Youth Exposure to Hate in the Online Space: An Exploratory Analysis.” International Journal of Environmental Research and Public Health, vol. 17, no. 22, 2020, 8531, doi:10.3390/ijerph17228531.

Hunt, Brianna, et al. “The Muslimah Project: A Collaborative Inquiry into Discrimination and Muslim Women’s Mental Health in a Canadian Context.” American Journal of Community Psychology, vol. 66, no. 3-4, 2020, pp. 358–369, doi:10.1002/ajcp.12450.

 Newman, Stephen L. “Finding the Harm in Hate Speech: An Argument Against Censorship.” Canadian Journal of Political Science, vol. 50, no. 3, 2017, pp. 679–697, https://doi.org/10.1017/S0008423916001219.

“Updating Our Rules Against Hateful Conduct.” Twitter.com. N.p., n.d. Web. 26 Sept. 2021.

Parenting and Teaching Styles and Their Interrelated Effect on Students’ Academic Success

by Vineeta Abraham, December 21, 2021

The following is a paper written for Stony Brook University’s Research and Writing in Psychology course (PSY 310) in which students were required to design an experiment and write a research paper based on it. It should be noted that all results and accompanying graphs, tables, and discussions, are imaginative and not based on conducted experimentation.

Abstract

The current study aimed to examine the effects of the congruence of parenting and teaching styles on adolescent students’ academic achievement. Teaching styles mirrored the parenting styles of authoritarian, authoritative and permissive. Sixty eighth grade students were randomly sorted into three different classes, each of which utilized a different style of teaching. It was hypothesized that students who experienced the same teaching style in the classroom as parenting style at home would achieve higher levels of academic success than those students who experienced different parenting and teaching styles. Academic achievement was measured by proctoring identical final exams to all students and analyzing the exam scores. Results showed that students who experienced the same parenting style and teaching style achieved higher final exam scores than students who experienced different parenting and teaching styles. These results support that students’ academic achievement in schools are affected by the similarity and differences that exist between their home and school environments.

Introduction

The many adults present in a child’s environment heavily influence their development and growth. Studies have aimed to look at the ways in which the style of parenting that a child’s guardians choose to follow may impact the child’s mental, emotional, and social development. Such parenting styles were typically identified as either authoritarian, authoritative, or permissive, whereby authoritarian parents show high control and little warmth, authoritative parents show high control and high warmth, and permissive parents show low control and high warmth towards their children (Walker, 2009). Additionally, besides the daily interactions children may have with their parents, their perception of and relationship with teachers while they are students have been shown to play a large role in their academic success (Alvidrez & Weinstein, 1999). It is on this premise that researchers have explored the extent to which parenting styles utilized in children’s home environments have impacted teacher-student relationships (Paschall, 2015). One study explored the effect of parenting styles in home environments on attachment issues and negative versus positive relationships with teachers, especially at a young age (Paschall, 2015). Studies such as this one have suggested that there may be an interconnected effect of different adults’ supervision approaches on children. 

Teaching styles that instructors adopt in the classroom have shown many similar characteristics to the three types of parenting styles (Bassett, 2013). The ability to use the definitions of parenting styles to evaluate teaching styles was shown in one study in which college students were asked to evaluate teachers using the 30-item Parental Authority Questionnaire, also known as PAQ, which was a survey used to assess parenting styles in home environments. A  few changes were made to the original PAQ; although the PAQ was created with the intention of analyzing parenting styles, scores using this survey were extended to teachers (Bassett, 2013). In a similar study, university students from Lander University were asked to read vignettes and describe the teachers in them as authoritative, authoritarian, or permissive, and then describe whether or not they would hire them. The students were also asked to identify the parenting styles they experienced at home, and the results were then analyzed to examine whether students’ preference in hiring teachers with different styles were related to the parenting styles the students experienced in their home environments (Bassett & Snyder, 2013). This study takes a more subjective view by asking the students for their perspective on which teaching style is preferable based on the students’ background. 

When describing parenting styles, an authoritative approach to parenting has often been seen as most effective in regards to yielding positive results such as higher levels of social and emotional maturity (Bassett, 2013). Similarly, an authoritative teaching style was observed to be the most effective at increasing academic success in students (Walker, 2009). A study conducted by Walker in 2009 using fifth grade students and teachers described higher levels of success and even preference for teachers using an “authoritative” style. An important aspect to note is that while authoritative teaching styles were generally seen as more effective, there is not much research that exists analyzing how this effectiveness is impacted by the students’ home environments. The current study aimed to explore the connection between students’ experiences with parenting styles and teaching styles to determine whether or not experiencing the same or different styles at home and at school is most beneficial to the student. 

The purpose of the current study was to determine how the relationship between parenting and teaching styles can influence adolescent students’ academic achievement at the end of an academic year. The teaching styles, categorized as either authoritarian, authoritative, or permissive styles, were designated to each experiment group with guidelines on how to maintain these definitions. Such guidelines included varying levels of leniency in regards to deadlines, supportiveness or consolement during struggles, and acceptance levels of disruptions in the classroom. Student achievement was measured using the final exam score at the end of the academic year. It was hypothesized that students who are instructed by a teacher adopting the same teaching style as the parenting style that student experiences at home will have excellent or high achievement while students who experience different teaching and parenting styles will experience acceptable or low achievement. By examining how similarities and differences in the student’s home and school environment impact their academic achievement through an objective lens, school environments can adapt to be better suited to students’ preferences and can more uniquely and effectively nurture their success.

Methods

Participants

      Sixty students, 30 males and 30 females, entering eighth grade in September 2021 were recruited on a volunteer basis for this study. All participants were in the age range of 12-14 years old and were selected from Nassau County, Long Island, New York. Each participant also came from a household that contains two parents (or similar parental figure or guardian). Three mathematics professors from Stony Brook University’s Mathematics department were recruited to teach the classes. Participants were sorted randomly into three groups consisting of ten males and ten females each. All three classes of students were taught mathematics in accordance with the New York State mathematics curriculum, and all participants had to be able to read, write, and communicate proficiently in English.. All classes were held year-round at Garden City High School located in Nassau County.

Measures

Parental Authority Questionnaire (PAQ). All students were provided with a modified version of John R Buri’s Parental Authority Questionnaire (PAQ) from 1991 in order to gauge students’ assessments of the parenting style they experienced at home (Buri, 1991). The 30-item questionnaire asked students to rank statements regarding their parents using a 5 point Likert scale (Buri, 1991). While Buri’s questionnaire aimed to provide results regarding the mother and father’s parenting styles individually, the current study grouped the parents as a single entity and asked all 30 questions as they pertained to both parents or parental figures. For example, “As I was growing up I knew what my mother expected of me in the family and she insisted that I conform to those expectations simply out of respect for her authority” was modified to read “As I was growing up I knew what my parents expected of me in the family and they insisted that I conform to those expectations simply out of respect for their authority” (Buri, 1991).

Procedure

Each of the three groups of students were assigned to one of three teaching styles: authoritarian, authoritative, and permissive. Each of these styles was used by a predetermined teacher who was provided with guidance on how to implement their assigned teaching style as it pertained to leniency, supportiveness, and tolerance. For example, the permissive teacher was instructed to employ high levels of leniency with assignment deadlines, high levels of supportiveness when students expressed having trouble in class, and high levels of tolerance when students created disruptions during class time. The authoritative teacher was instructed to demonstrate low levels of leniency, high levels of supportiveness, and low levels of tolerance. The authoritarian teacher was instructed to display low levels of leniency, low levels of supportiveness, and low tolerance for disruptive behavior. Besides these guidelines, all three teachers were given identical lesson plans and content to teach each class. 

In September 2020, all students were asked to complete the Parental Authority Questionnaire. Results were compiled and each student was then categorized into one of two groups without their knowledge. Group A consisted of students who were about to experience a similar teaching style to the parenting style they experienced in their households, and Group B was composed of students who would be experiencing different teaching and parenting styles in the classroom and at home. 

All three classes of students were taught mathematics using the same lesson plan, co-developed by each of the three teachers. Throughout the school year, monthly observations of the class were conducted, during which the observers would note details regarding leniency, comfort, and tolerance demonstrated by each teacher for a day. 

On June 10, 2021, all sixty students were presented with an originally created, cumulative 50-question multiple choice final exam in mathematics with answer choices A-D. Every test was taken on a Scantron sheet for unbiased grading purposes. All students, regardless of class, were provided with the same exam and took the exam in identical testing conditions at the same time and location. Individual scores from the exam were blindly calculated and measured on a scale in which scores higher than 90% showed excellent achievement, between 75%-90% signified high achievement, between 65-75% indicated acceptable achievement, and below 65% represented low achievement. These results were then analyzed as they related to each student belonging to Group A or Group B.

Results

In assessing students’ academic success it was predicted that students who experienced the same teaching and parenting style would display higher achievement than students who experience different teaching and parenting styles. Students were randomly placed into one of three classes (authoritarian, authoritative, and permissive), and students who reported having a parenting style similar to their teacher’s style were categorized as Group A, and those with parenting styles different than their assigned teacher’s styles were categorized as Group B. Results were compiled in order to support whether or not students who experience the same type of teaching style in the classroom as parenting style at home perform higher academically as shown by final exam scores. 

Figure 1 shows a comparison of Group A and Group B students’ final exam scores in each of the three classes. A two-way ANOVA was used to examine the effect of group assignment in the three differently taught classes on academic achievement in eighth grade mathematics. Results showed a significant main effect of group assignment. Students who experienced the same teaching style in the classroom and parenting styles at home — Group A — achieved significantly higher final exam scores (M = 90.23, SD = 5.55) than students who experienced different styles in the classroom and at home (M = 77.87, SD = 5.73) classified as Group B F (1, 59) = 5.32, p <.05. Furthermore, based on the predetermined scale, a mean of 90.23 showed excellent achievement for Group A (falling between the 90th and 100th percentile), while students in Group B obtained a lower average final exam score of 77.87, signifying high achievement (falling between the 75th and 90th percentile). Additionally, results were calculated to analyze final exam scores for each teaching style classroom. Students in the authoritarian class obtained an average final exam score of M = 79.75, SD = 4.03. Students in the authoritative class obtained an average final exam score of M = 83.95, SD = 2.43. Students in the permissive class obtained an average final exam score of M = 83.5, SD = 4.47. No main effect was found for the style of teaching on academic achievement F (1, 59) = 2.36, p <.05. 

Figure 1.

Average Final Exam Scores Across Three Math Classes

Note. This bar graph displays the comparison of Group A and Group B students’ final exam scores in three differently taught math classes.

Discussion

The present study was conducted in order to examine the effects of similarity or difference of teaching style and parenting style on students’ academic performance. It was hypothesized that students who were placed in a classroom with a similar teaching style as the parenting style they experienced at home would result in higher academic achievement. It was predicted that students with similar teaching and parenting styles, or Group A students, would show excellent (90-100%) or high achievement (75-90%) on the final exam in mathematics, while students who experienced different teaching and parenting styles, Group B, would exhibit acceptable (65-75%) or low (below 65%) achievement. Results showed that students in Group A showed excellent achievement while students in Group B demonstrated high achievement. These findings supported the hypothesis by showing that the level of similarity between teaching styles in the classroom and parenting styles at home (same or different) influenced students’ academic performance. 

The current study used a novel approach to understanding the effect of different adult figures in adolescent students’ lives and how they work together to impact students’ success in education. Previous research has examined the relationship between the two styles, often focusing on the influence of parenting styles on teacher-student relationships, or vice-versa, showing support for the idea that the two are inter-connected (Paschall, 2015). Studies have also highlighted the success of one type of style over the other, often concluding that an authoritative style is seen as being more effective for the classroom and at home (Walker, 2009). While previous research has used a more subjective approach to understanding teaching and parenting styles and how they influence students by asking students to provide insight on preference and evaluation of the different styles, the current study aimed to take a more objective approach (Bassett & Snyder, 2013). The current study showed that students who experienced similar teaching and parenting styles had higher average test scores than those students who experienced different styles at home and in the classroom, providing quantitative support for the idea that both parents and teachers’ methods of supervision can impact students’ achievement together. While less focus was given on highlighting one style as more effective than the others, the study instead examined the relationship between school and home environments. 

One strength of the current study was that it analyzed comprehensive success levels of students by examining average scores of a cumulative final exam rather looking only at final averages or at individual test scores throughout the year, which could be impacted by other factors such as homework completion or class participation, which may not accurately reflect content understanding (as it could be reflective of time constraints or student personality, respectively). Final exams were identical for each student, as was the curriculum, in an aim to make the content of the three classes uniform. Another strength of the study was categorizing students into Group A or Group B — depicting that the students were either going to experience the same or different parenting and teaching styles, respectively — without informing the teachers or students of these placements. This allowed for minimal influence or bias on the teachers’ or students’ parts in regards to academic performance or teaching methods. 

One limitation of the study was the decision to make mathematics the subject to be taught by the three classes. Varying degrees of skill may have been present in each of the three classes, and no additional support classes (extra help, tutoring) were provided, thereby causing there to be a discrepancy between students who were previously skilled at mathematics and students who previously struggled with mathematics. Additionally previous research has shown that authoritative teaching styles were most effective in the classroom (Walker, 2009). This could mean that both Group A and Group B students could have been provided with the most ideal situations in the authoritarian style classroom when compared to permissive and authoritarian classes, indicating that an interaction may exist between the congruence of parenting and teaching styles and the specific parenting or teaching style itself. 

The current study brought to light the importance of examining the many environments children and adolescents find themselves in and how they are connected to each other in impactful ways. This study suggests that students may be more comfortable and successful when they are learning in a familiar environment, and that the continuity that exists between home and school can impact students’ academic performance. Further research is needed to analyze other factors that can impact the students’ success, such as physical setting or other members of the environment (i.e., siblings vs. peers). These further studies can also incorporate the significance and effectiveness of home-schooled students and how the education system can be molded to better suit each individual child’s unique needs.


References

Alvidrez, J & Weinstein, R.S. (1999). Early teacher perceptions and later student academic achievement. Journal of Educational Psychology, 91(4), 731–746. https://doi.org/10.1037/0022-0663.91.4.731

Bassett, J. & Snyder, T.L. (2013). “Parenting” in the classroom: University students’ evaluations of hypothetical instructors as a function of teaching styles and parenting styles. North American Journal of Psychology, 15(3), 447–462. https://www.researchgate.net/publication/286720817_Parenting_in_the_classroom_University_students’_evaluations_of_hypothetical_instructors_as_a_function_of_teaching_styles_parenting_styles

Bassett, J. F., Snyder, T.L., Rogers, D. T., & Collins, C.L. (2013). Permissive, authoritarian, and authoritative instructors: Applying the concept of parenting styles to the college classroom. Individual Differences Research, 11(1), 1–11. https://www.researchgate.net/publication/288606194_Permissive_authoritarian_and_authoritative_instructors_Applying_the_concept_of_parenting_styles_to_the_college_classroom

Buri, J.R. (1991). Parental authority questionnaire. Journal of Personality Assessment, 57(1), 110–119. https://doi.org/10.1207/s15327752jpa5701_13

Paschall, W.P., Gonzalez, H. Mortensen, J.A., Barnett, M.A., & Mastergeorge, A.M. (2015). Children’s negative emotionality moderates influence of parenting styles on preschool classroom adjustment. Journal of Applied Developmental Psychology, 39, 1–13. https://doi.org/10.1016/j.appdev.2015.04.009

Walker, J. M. T. (2009). Authoritative classroom management: How control and nurturance work together. Theory Into Practice. 48, 122–129. https://doi.org/10.1080/00405840902776392

Music Therapy: The Art of Psychological Treatment

by Sanjana Sankaran, December 20, 2021

Nearly 800,000 people die from suicide every year (Suicide Data). Approximately seventy percent of the American youth that struggle with depression requires treatment (The State). People with depression have a daily battle with themselves to prevent those feelings of despair and loneliness from taking over. Those living with mental health disorders may develop effective coping mechanisms to deal with their issues. Music therapy, a method of therapy and a de-stress technique for which the positive effects are not yet highly known, involves “the professional use of music and its elements as an intervention in medical, educational, and everyday environments with individuals” (Wang and Agius 595). Music therapy not only involves listening to music but also consists of thinking, analyzing, and playing it. Many people view music as a means of amusement and frivolity for those involved. Both mental health issues and the fine arts are often stigmatized in our society. In regards to mental health, several people feel the need to downplay their problems since many illnesses do not manifest with obvious physical symptoms. Hence, society issues out old cliches, suggesting that people need to learn how to ‘deal with their problems.’ In actuality, mental health can affect not only one’s mind but also one’s body and, if left untreated, can severely affect one’s quality of life. Over recent years, many have come to view the fine arts as an impractical endeavor since several jobs in this field may not lead to a stable job or income. Historically, humans have always turned to the arts to express their feelings, through music, visual arts, or the written word. Music can have a profound effect on the biochemical as well as the physiological aspects of the brain. More and more researchers today find that psychotherapeutic drugs are not as effective in treating mental health patients as they used to be, partly due to  drug tolerance. As a society, we must alter  our mindset away from  treating psychological problems exclusively through psychotherapy and drugs and must instead leverage the nontraditional method of music therapy for those  who experience daily stressors and mental health disorders.

The standard practices of mental health treatment today involve two significant methods –  psychotherapeutic drugs and psychotherapy –  both of which, given the statistics of how the rate of mental health diagnosis is accelerating, are not enough. People with mental health disorders nowadays have a lot more options as to how to treat themselves: psychotherapy, medication, case management, hospitalization, therapy groups, alternative medicine, electroconvulsive therapy, and peer support (Mental Health Treatments). In the early- to mid-1900s, methods of curing mental health ailments involved lobotomies and shock therapy. Even with all of the progress made today, a recent study shows that approximately 10 million adults in America have suicidal thoughts,  have not been able to seek treatment or have experienced both. In the past six years alone, the population of youth (ages 12-17) with depression has gone up by 4.35%, and two million kids now have major depressive episodes and need to seek treatment (The State). A team of neuroscientists from Naples, Italy found that antidepressant drug treatments are mostly ineffective for major depressive disorders. (Fornaro e. al. 494). Inefficacy can be attributed to tolerance, an anomaly that occurs when depressive symptoms reappear after previous treatment with antidepressants” with the return of depressive symptoms of MDD occurring in 9–33% of patients across published trials” (Fornaro et al. 494). Drug tolerance can build over time as the body requires higher doses of the drug  in order to have the same effect as the initial dose once did, ultimately resulting in other biological side effects. Many antidepressant drug trials tend to last shorter than 52 weeks, contributing to the  lack of understanding as to how effective these drugs will be long-term. The National Institute of Mental Health stated that 25% of 103 patients had depressive episodes. Further these patients were found to have 43 out of 171 following depressive episodes and experienced drug tolerance after a 20 year follow up (Fornaro et al. 496).   

In the book, Music Therapy in Mental Health for Illness Management and Recovery, written by Michael J. Silverman, the director of the music therapy program at the University of Minnesota, he states that “ even when medications are effective in alleviating the symptoms of mental illness, they do not necessarily facilitate psychiatric recovery as pharmacological treatments do not contribute to the development of knowledge and skills necessary for a successful transition back to the community” (Silverman 55). The state of mental health is worsening – therapies previously used for decades are now proving to be not enough in curbing  the rampant increase in prevalence of depression and other  mental health disorders. Psychiatric treatment needs to implement  a new type of therapy, like music therapy, that includes psychological interventions to analyze how people’s behavioral and thought processes have improved over  time. By seeking new methods of treatments, specifically music therapy, society will move closer towards respecting rather than ostracizing mental health patients. 

Music therapy was developed post World War I and II as a way to ease the minds of many soldiers with PTSD (Craig). Since then, this field has led to a wide range of studies, all seeking to answer the questions of how music therapy works and its purpose. If we have many different types of psychotherapy, why are neuroscientists and psychologists seeking more holistic treatments for their patients that are not guaranteed to work? Let us start with what precisely music therapy is and the basis behind it. Music therapy includes two main facets: psychoacoustics and the appreciation and hearing of music. Psychoacoustics refers to how someone perceives and comprehends music. In contrast, the brain’s mechanisms of appreciation and hearing of music is something that is developed across an entire lifespan and is influenced by many environmental factors (Craig, para. 19-20). 

There are two main methods of music therapy: listening and active playing. When  listening to music, therapists will put on music for the patient, recommended by medical experts who know about the patient’s specific case (Craig, para. 41-42). Some therapists will go down the more analytical route of listening to music. Therapists may ask questions that evoke personal thought analysis and insight. Some may also follow the Bonny method of guided imagery and music. Bonny methods consist of a patient listening to a song and seeing an image. This leads to the therapist asking specific guided questions that lead to the patient talking about their thoughts and emotions (Craig, para. 43-44). Music therapy can change a person’s attention, emotion, memory processing, behavior, and communication. A combination of all of these changes can result in  changes in neural processing that can  effectively change the biochemical state of depressed minds and improve their lives 

  Many studies prove that music therapy has been effective in treating people with mental disorders. In a  study done by Sergio Castillo-Pérez MD and his team, he states that “depression remains a major health problem and, despite using pharmaceutical agents, patients continue to report high levels of unrelieved depression” (Castillo-Perez et al. 390). This group of researchers decided to study a group of low to medium depressed people receiving  psychotherapy treatment compared to music therapy. A group of 79 patients between the ages of 25 to 60 years old were split into the two groups of therapy. The subjects chosen have never taken any psychotherapeutic drugs or have any other neurophysiological problems.  All subjects were asked to self-report their level of depression with a well-known survey known as  the Zung depression scale (Castillo-Perez et al. 387). The subjects self-reported how they were feeling age week for eight weeks. The music therapy itself involved a 50-minute self-administered music session, and once a week the participants would have a group session with doctors and other patients to provide a comfortable environment. The study controlled for stressful environmental variables that may occur such as sudden noises, changes in temperature, any environmental change or trigger (Castillo-Perez et al. 389). 

The psychotherapy administered in this study was standard conductive-behavioral therapy (CBT). At the end of the tests, the researchers quantitatively analyzed the patients’ progress with the Hamilton scale (another type of depression scale) based on their behaviors  and their self-reported scores of the Zung scale. The people with significant improvement meant they had to have a Hamilton scale of 0 to 7. The Hamilton scale was used after the 3rd, 5th, 7th, and 8th weeks. After only three weeks, within the music therapy group,  one person improved; however, none improved within the psychotherapy group.. By the end of the study, 29 subjects improved with music therapy, and only four did not. For psychotherapy, only 12 subjects improved with 16 people showing little to no improvement. These data from the Zung and Hamilton tests were also cross-referenced with the Friedman test, and showed to be statistically significant with a p-value as little as 0.0356 (Castillo-Perez et al. 389).  

As we can see, psychologists and neuroscientists today are doing more and more research regarding music therapy. Castillo-Perez’s study is just one of many examples in which music therapy has proven to improve the quality of life for people with depression more than psychotherapy. The three main methods of treatment for depression today are psychotherapy, antidepressants, and electroconvulsive therapy for severe cases. However, Perez and the rest of his team say, “Pharmaceutical treatments […] make no difference in the odds ratio of suicide attempts” (Castillo-Perez et al. 387). That is what needs to fundamentally change in how we treat and understand therapy for depressed patients. Pharmaceutical drugs will not influence the likelihood of someone committing suicide because there can be many sudden environmental circumstances and triggers. Musical therapy, on the other hand, aims to help depressed patients by trying to invoke the mesolimbic system, which correlates to positive and rewarding thoughts. As people living in  the 21st century, we can understand that there is something special about listening to new music by our favorite artists, or dancing and singing to a high energy song that can affect our minds positively. Songs can reflect how we feel and can heighten our current emotions, and this is something that medicine and therapy at a certain point cannot do as effectively as initially administered. 

As with many people who learn music from an early age, I found that playing a music instrument helped me relax and de-stress, especially after a long day of school and tests. After my piano lessons on Sundays and six-hour days at high school, I would hop on that leather bench and play Emile Pandolfi and feel my heartbeat slow down and my cheek muscles tense from all the grinning. Playing the theme from Harry Potter on the piano was my mode of artistic expression and relaxation. It is easily accessible, then, to imagine how music can help those who have severe emotional or mental disorders. To the parents of kids with mental health disorders, understand that music can be an outlet for kids to release their emotions and can have a tremendous effect on their functioning and behavior; to the kids who never seemed interested in playing music, that is okay. Part of music therapy merely involves passively listening to music in a relaxing setting. Society needs to alter its perspective on music from being misconstrued as a way of wasting time to a way of elevating one’s moods and taking a mental break.  

To truly get an insight on a student’s perspective of music and its effects on mental health, I interviewed a bandmate of mine from high school who has been playing trumpet since the fifth grade. Her lifelong appreciation of music started when she began taking piano lessons in the second grade. She then began taking trumpet lessons and joined the band in the 5th grade and has continued primarily with trumpet since then. When I asked her about her mental health, she said, “As someone who has depression and anxiety, a part of me is always anxious, and the daily fight is not letting it become a 100% of me, and using coping mechanisms to get out of it.” She had to move 350 miles for college and said that it was a difficult transition due to the workload and having to meet new people, making it difficult  to find time to relax. Being a part of the wind ensemble at her college allowed her to ease into the transition of a college student.  When asked how music has helped her with her mental state and journey, she stated, “playing music was definitely a double-edged sword. Although I had stress and anxiety from the responsibilities that came with being on the band e-board, the intrinsic joy I got from getting together with people I cared about and playing amazing music was amazing” (Anonymous). She found that listening to music gave her a sense of solace and tranquility. It allowed her mind to focus on just the music,  and in the process,  she forgot all of her anxieties and elevated her mood. The lyrics, instrumentation, and many other aspects of music therapy can reflect the emotions we feel and can elevate how we feel. Music can alter the state of chemical neurotransmitters in our minds and change our emotions – this is something drugs and psychotherapy cannot do as effectively.  

Due to social media today, music has become much more prevalent in students’ lives and has influenced the way college students handle stressful situations.A significant reason explaining  music therapy’s lack of usage is because there are many misconceptions about the way music therapy works. Music therapy Director of University Minnesota Dr. Silverman, discusses the ill-conceived notions of music therapy, stating that “a common misperception of music therapy is that it is used exclusively to treat musicians” ( 55). Silverman emphasizes that music therapy was always used to help treat people with a broad range of neurological and psychological issues among a variety of adults, children, and seniors. Another common misconception is  that music therapy is not as effective because it is merely the act of passive listening to pre-recorded music. However, music therapy is not just listening to music. Director Silverman says that in a study done comparing two groups of depressed patients who underwent passive music therapy and active music therapy, the active music therapy patients stayed throughout the sessions. Active music therapy involved lyric analysis, recreation music playing, and percussional music therapy (Silverman 55). All of this active participation served as psychological interventions that helped alter the person’s mood, behavior, and mindset.   

In a survey I administered to fellow Stony Brook Students and my fellow high school alumni who have taken part in music since a young age, I discovered their opinions on the use of music in a therapeutic way.  Of the 57 people who responded, 79% played an instrument, 22% of people said they listen to jazz or a variety of orchestral or classical music while studying, 80% of people listen to music when stressed out, and 73% of people found music to be therapeutic overall (“Music As Therapy”). 28% percent of the people I surveyed have mental health disorders such as anxiety, depression, and eating disorders. Even though the  majority of people surveyed did not have disorders, 80% of the people who deal with everyday environmental stressors choose to listen to music to cope. When asked on a scale of one to five (five being complete improvement in mood and one being mood unchanged), 31 people said they felt better after listening to music when they felt anxious, sad, depressed, or other negative emotions. 12 people say their mood completely changed for the better (“Music As Therapy”). Although these results are biased because many of these people have played an instrument, they show that a majority of students understand that music has therapeutic qualities and utilize it as a coping mechanism or a tool when experiencing stress, anxiety, or depressive thoughts. Music is a type of escapism that allows people to avoid focusing  on their current troubles and gives them the ability to focus all of their energy on one thing only – music.  

Having said all of the above, why do people still believe that conventional treatment methods are effective and do not want to change? Discussions of new treatment methods lack because people only know what is largely acknowledged in society. Mental health was and still is stigmatized because it affects one’s  mind and does not often manifest with physical symptoms like cancer. Only in the past few years has the topic of mental health been brought to the forefront. If many Americans do not wish to discuss their mental health problems, then how can new and more productive methods of treatment be used? Therein lies the existing problem that needs to change. Currently, in the time of self-quarantine, anxiety can run high even with people who have not been diagnosed with a  mental health disorder because we live in a time of uncertainty. In a time when the fear of virus spread is high and ‘stay at home’ orders are strict, quarantine serves as an obstacle for people who need weekly in-person therapy sessions. People need to utilize resources at home that are easily accessible to cope with their anxiety, like  music resources. If people are privileged enough to have access to the internet, there are a plethora of resources that can be used for music therapy, such as YouTube, Spotify, or an instrument if one has it. 

Society needs to acknowledge that music therapy is a method that has proven to be successful amongst a wide range of people with varying disorders and varying levels of depression. Well known music therapist Dr. Dany Bouchard eloquently describes how to handle anxiety during the time of COVID: “Music has a connection with memory, brings us emotions, all kinds of stuff. It is how you use it now in order to make it a music prescription” (Rowat, para. 15). Music can help with COVID-related anxiety by serving as a focusing tool that allows our mind to target what is going on now rather than worrying about an uncertain future (Rowat, para. 18). Being open to trying new modes of therapy can  be much more effective for anyone. As time goes on, some people with mental health disorders may have to increase their drug dosage due to drug tolerance that inevitably develops. At times, people who go to therapy may feel that it is not working, and can  revert to unhealthy habits and coping mechanisms. Mental health overall is something that affects people every day through their actions and their emotions. Treatment of mental health disorders is an important aspect of healthcare that needs to be improved;  it is a series of actions and behaviors one takes in order to see an actual result. Music can alter the state of someone’s mood and change someone’s behavior after prolonged daily music sessions. Additionally, the collaborative nature of music therapy allows people with mental disorders to have a massive support system on their path to recovery. Music therapy moves away from the idea persisting in mental health recovery that it is up to the person to improve themselves, and it is a solitary journey. Take 10 or maybe even 20 minutes per day to actively take part in something that involves music, whether it’s through such as playing, writing, singing, or listening.  People with mental health problems are in a daily battle  with their minds to prevent feelings of depression and anxiety from overcoming their thoughts. While psychotherapeutic drugs and therapy are helpful to an extent, music therapy can provide long term positive effects.


Works Cited

Anonymous. Personal interview. 15 April, 2020.

Castillo-Perez, Sergio, et al. “Effects of Music Therapy on Depression Compared with Psychotherapy.” The Arts in Psychotherapy, vol. 37, no. 5, Nov. 2010, pp. 387-90. ScienceDirect, doi:10.1016/j.aip.2010.07.001. Accessed 15 Apr. 2020.

Craig, Heather. “What Is Music Therapy and How Does It Work?” Positive Psychology, 18 Mar. 2020: par 1-101, positivepsychology.com/music-therapy/. Accessed 15 Apr. 2020.

Fornaro, Michele, et al. “The Emergence of Loss of Efficacy during Antidepressant Drug Treatment for Major Depressive Disorder: An Integrative Review of Evidence, Mechanisms, and Clinical Implications.” Pharmacological Research, vol. 139, Jan. 2019, pp. 494-502. ScienceDirect, doi:10.1016/j.phrs.2018.10.025. Accessed 15 Apr. 2020.

“Mental Health Treatments.” Mental Health America National, Mental Health America: par 1-10, http://www.mhanational.org/mental-health-treatments. Accessed 15 Apr. 2020.

Rowat, Robert. “We Asked a Music Therapist How to Relieve Anxiety Caused by Social Distancing.” CBC Music, 20 Mar. 2020, p. 1. CBC: par 1-23, http://www.cbc.ca/music/we-asked-a-music-therapist-how-to-relieve-anxiety-caused-by-social-distancing-1.5504973. Accessed 15 Apr. 2020.

Sankaran, Sanjana. “Music As Therapy.” Survey. 15 April. 2020.

Silverman, Michael J. “An Overview of Music Therapy as a Psychosocial Intervention for Psychiatric Consumers.” Music Therapy in Mental Health for Illness Management and Recovery, Oxford UP, 2015, pp. 60-67. doi:10.1093/acprof:oso/9780198735366.001.0001.

“The State of Mental Health in America.” Mental Health America National, Mental Health America, 2017, http://www.mhanational.org/issues/state-mental-health-america. Accessed 15 Apr. 2020.

“Suicide Data.” World Health Organization, 27 Sept. 2019, http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/. Accessed 15 Apr. 2020.

Wang, Shentong, and Mark Agius. “The Use of Music Therapy in the Treatment of Mental Illness and the Enhancement of Societal Wellbeing.” Psychiatria Danubina, vol. 30, 30 Nov. 2018, pp. 595-600, http://www.psychiatria-danubina.com/UserDocsImages/pdf/dnb_vol30_noSuppl%207/dnb_vol30_noSuppl%207_595.pdf. Accessed 15 Apr. 2020.

The Silent Cruelty of Calorie Counting

by Sara Giarnieri, November 24, 2021

***Content warning: This essay discusses eating disorders***

The first time I was exposed to a calorie counting app was in high school during the start of the COVID-19 pandemic. A gym teacher required us to download the app, My Fitness Pal, in order for us to complete assignments that involved tracking our food intake and exercise. Even after the end of my senior year, I continued to use the app with the mindset of losing weight. The app did as advertised. It certainly helped me to keep track of how many calories I burned versus how many calories I was absorbing… however, I was not happy. Anytime I went out to eat with a friend, I anxiously searched for the lowest calorie options on the menu. I constantly looked at myself in the mirror to bodycheck. I was trapped. Looking back on this time, I realize how much calorie counting made me feel miserable. Rather than being a healthy tool, it was an obsession. My experience made me ponder: Can fitness apps with calorie counting be harmful to some of its users? 

A study conducted by Courtney C. Simpson and Suzanne E. Mazzeo titled “Calorie counting and fitness tracking technology: Associations with eating disorder symptomatology” focused on whether the use of health tracking apps correlated with eating disorder (ED) symptomatology. After conducting the study, it was concluded that their findings “corroborate media reports documenting a relation between calorie tracking technology and ED attitudes, and indicate that monitoring consumption might enhance rigidity and anxiety regarding calorie intake” (Simpson and Mazzeo). This study is showing us that calorie tracking apps have a correlation with behaviors regarding eating disorders (Simpson and Mazzeo). This fact is extremely dangerous because someone who downloads a fitness app with healthy intentions in mind could possibly slip into a harmful situation. It could also be dangerous for those diagnosed with a mental illness like anxiety, since this study has proven that these fitness apps intensify anxiety around calorie counting. This could be potentially triggering.  

On a more personal note, an article titled “Hunger Games” by Alice Gregory highlights the obsession that users with fitness apps can develop over calorie counting. According to the article, a woman named Rebecca Gerson felt herself become more strict with what kind of foods she ate because they all “counted” (Gregory). She felt her social, academic, and personal life decline to the point that she received eating disorder treatment (Gregory). Rebecca’s experience gives us some insight on how an obsession with calorie counting may feel, and more importantly how it leads to negative consequences. Calorie counting forces you to look at every food you eat along with its portion size. It may make an individual afraid to touch certain foods, healthy or not, because of the fear of increasing calorie intake. Unfortunately, the fixation on calorie counting can lead to serious consequences that involve eating disorders, both shown by the study and Rebecca’s experience. 

Keeping this information in mind, how do we approach this situation surrounding calorie counting apps? One of the most important things to do first is to spread awareness of the potential harm of these apps. We need more academic studies, articles, and journals about them. We need fitness influencers who promote these apps to share statements of discretion; share warnings. The most significant thing is for the apps themselves to have clear and concise warnings for users that want to download the app. A discrete message hidden in terms and conditions will not help the problem. For example, some medications have black box warning labels to indicate serious, adverse side effects the medication could cause. Fitness apps should do the same, as they are tools that can deeply change a person’s life. Like medication, it does not work for everyone. 

Another way to approach this issue is to promote body positivity. Users should be encouraged to stay active and nourish themselves with nutrients, but there shouldn’t be a pressure to look a certain way. These apps are for health, not to change our genetic code. We all have different body types, and that is okay. There are many influences outside the app that must be changed in order to encourage body positivity. It will take a long time for such a culturally ingrained thing to change. However, we must start to break the cycle. 

There is certainly a lot to be done in order to prevent the harmful consequences of calorie tracking apps to continue. Becoming more mindful of these consequences can help us as a whole to combat them.

Helpful Resources

Eating Disorder Hotline & Treatment Information: https://www.nationaleatingdisorders.org/help-support/contact-helpline

National Suicide Prevention Lifeline Information: https://suicidepreventionlifeline.org/


Works Cited

Gregory, Alice. “Hunger Games: Is our tech obsession making anorexia worse?” New Republic, vol. 245, no. 1, 18 Dec. 2013, pp. 7–9. Retrieved from newrepublic.com/article/115969/smartphones-and-weight-loss-how-apps-can-make-eating-disorders-worse.

Simpson, Courtney C., and Suzanne E. Mazzeo. “Calorie Counting and Fitness Tracking Technology: Associations with Eating Disorder Symptomatology.” Eating Behaviors, vol. 26, Aug. 2017, pp. 89–92. doi:10.1016/j.eatbeh.2017.02.002.

Social Determinants of Mental Health in First Responders: Paid versus Volunteer Status and Related Implications

by Farah Hasan, November 18, 2021

First responders are celebrated for their selfless devotion to aiding civilians in traumatic events. However, as the first ones to arrive on scene, these responders often face the brunt of the immediate danger. Volunteer first responders may experience their work differently from the way occupational first responders do in regards to workplace culture and environment. As a result of these subtle differences, the mental health implications of responding to emergencies on volunteers differ from the mental health implications on paid responders. The experiences of both paid and volunteer responders must be improved and standardized to ensure that both types of responders are sufficiently prepared for high-stress work and are equipped to deal with common psychological outcomes.

Although career and volunteer first responders perform similar work, they face significant differences in terms of time commitment, recruitment/hiring processes, and training. Paid responders often devote anywhere between 56-72 hours per week to their work, while volunteer responders often dedicate their free time to providing service, resulting in them offering about half the amount of hours that paid responders give. Volunteer first responders are usually recruited on the basis of their completion of basic training (ie. EMT-B training for volunteer EMTs and training through probationary schools for volunteer firefighters), as well as hazardous materials (“Haz-Mat”) awareness training, AED-CPR training, and National Incident Management System (NIMS) training. Career first responders, on the other hand, may go through competitive interview processes and receive extensive training in addition to the basic requirements, including rigorous written and physical tests, as well as close to 200 hours of lectures, labs, and clinical experience (Ventura et al., 2021). Training and on-boarding processes may differ slightly from state to state. It is also important to note that while behavioral health and mental health programs for first responders are available, they are not a standard part of the majority of training processes for both volunteer and career responders. 

Due to the high-stress nature of their work, the prevalence of mental health disorders is significant among these trained heroes. First responders may experience irregular sleeping patterns, autonomic hyperarousal, and hypervigilance as a result of responding to traumatic and/or high-risk emergencies (Stanley et al., 2017; Skogstad et al., 2016). The severity of these symptoms and other aspects of mental health may be influenced by career or volunteer status. Distinctions between career and volunteer first responders arise in terms of cumulative time spent exposed to traumatic events, competing responsibilities (i.e. volunteers may have a separate job), and areas served (Stanley et al., 2017). In a study with a hybrid sample of firefighters (n=204 volunteer, n=321 career), career firefighters reported higher levels of substance use, particularly problematic alcohol use in comparison to volunteer firefighters (Stanley et al., 2017). On the other hand, volunteer firefighters reported elevated levels of posttraumatic stress, depression, and suicidal ideations compared to career firefighters (Stanley et al., 2017). After the 2003 Bam earthquake in Iran, the 2001 World Trade Center terrorist attack, and a 2011 vehicular bus accident in Norway, volunteer first responders were much more likely to exhibit symptoms of posttraumatic stress disorder (PTSD) than career and professional responders (Skogstad et al., 2016). Volunteers are also more likely to report higher perceived personal threat during an emergency situation (Skogstad et al., 2016).

In comparison to career departments, volunteer first responder programs may not provide adequate access to critical incident stress management (CISM), employee assistance programs (EAPs), or general stress reduction therapeutic programs. This may be due to inadequate funding and/or a belief that volunteer first responders do not require extensive resources, as their services may not entail work that is “serious” enough to necessitate them. This serves as a potential structural barrier to treatment for volunteer first responders and may contribute to increased risk of or exacerbated psychiatric symptoms (Skogstad et al., 2016; Stanley et al., 2017). 

Lack of prior training and exposure is another issue that confronts volunteer first responders. Nontraditional responders, such as construction and utility workers, electricians, and transportation workers, who assisted at the terror attack on the World Trade Center (WTC) on September 11, 2001 were in a similar situation in regards to lack of relevant training. Nontraditional responders at the WTC were twice as likely to develop PTSD compared to the police that were present (Bromet et al., 2015). Partial PTSD was also more prevalent among nontraditional responders than among the police (Bromet et al., 2015). This would suggest that lack of training is a contributing factor to the development of PTSD in volunteer first responders, who do not receive as extensive training as paid or professional first responders do. 

Other factors that may contribute to volunteer first responders’ increased risk for psychiatric disorders include lack of role clarity, perceived obstruction of services provided (Skogstad et al., 2016), and education level (DePierro et al., 2021). Role clarity pertains to the idea that volunteers may not fully understand what their task or role(s) are in an emergency, as delegation of roles may not be as efficient and definitively assigned to them as they are to paid professional responders. Perceived obstruction of services provided may arise when volunteers feel that their work is hindered or overshadowed, thereby feeling remorse over perceived inability to provide adequate service in a time of need. Additionally, first responders with a high school diploma are more likely to endorse symptoms of both PTSD and partial PTSD, compared to first responders with graduate or postgraduate degrees (Motreff et al., 2020). Lower education levels can be compared to lack of exposure/training for volunteer first responders, who are also more likely to endorse stigma surrounding psychiatric disorders, thus leading them to attempt to cope with their mental health stressors on their own (DePierro et al., 2021). Despite perceiving a greater stigma around psychiatric disorders and mental health resources, interestingly enough, DePierro et al. also found that nontraditional responders and volunteers were more likely to endorse higher perceived need for mental health resources (DePierro et al., 2021). Lack of education and lack of training both constitute a potential barrier to gaining a deeper understanding of mental health and realizing the importance of seeking professional help when needed.

As both volunteer and paid first responders are typically on the front lines during emergencies, it is important to ensure that the mental health of both types of responders are addressed. Volunteer first responders should be trained to provide the greatest role clarity possible and provided with CISM services as often as possible. For both volunteer and paid first responders, the importance of getting help from mental health professionals when necessary should be emphasized, and the contact information for such services (if they are not already provided by the corps) should be explicitly provided. Research by Jeff Thompson and Jacqueline Drew at Columbia University Irving Medical Center’s Department of Psychiatry show that resilience programs such as warr;or21, which incorporate practices such as controlled breathing and showing gratitude, have potential in alleviating mental health outcomes for first responders (Thompson & Drew, 2020). Additionally, reducing the stigma around mental health using training such as the Road to Mental Readiness (R2MR) program and reforming the workplace culture in this manner will encourage healthy dialogue (Szeto et al., 2019). These steps will pave the way for healthier and better-informed volunteer and paid first responders, which will ultimately enhance the quality of their work and services.


References

Bromet, E. J. et al. (2016). DSM-IV post-traumatic stress disorder among World Trade Center responders 11-13 years after the disaster of 11 September 2001 (9/11). Psychological Medicine, 46(4), pp. 771–783.

DePierro, J. et al. (2021). Mental health stigma and barriers to care in World Trade Center responders: Results from a large, population-based health monitoring cohort. American Journal of Industrial Medicine, 64(3), pp. 208–216.

Motreff, Y. et al. (2020) Factors associated with PTSD and partial PTSD among first responders following the Paris terror attacks in November 2015. Journal of Psychiatric Research, 121, pp. 143–150.

Skogstad, L. et al. (2016) Post-traumatic stress among rescue workers after terror attacks inNorway. Occupational Medicine (Oxford, England), 66(7), pp. 528–535.

Stanley, I. H. et al. (2017) Differences in psychiatric symptoms and barriers to mental health care between volunteer and career firefighters. Psychiatry Research, 247, pp. 236–242.

Szeto, A., Dobson, K. S., & Knaak, S. (2019). The Road to mental readiness for first responders: A meta-analysis of program outcomes. Canadian Journal of Psychiatry, 64(1_suppl), 18S–29S. https://doi.org/10.1177/0706743719842562

Thompson, J. & Drew, J. M. (2020). Warr;or21: A 21-day program to enhance first responder resilience and mental health. Frontiers in Psychology, 11, 2078–2078. https://doi.org/10.3389/fpsyg.2020.02078

Ventura, Denton, E., Court, E. V., & Nava-Parada, P. (2021). The emergency medical responder: Training and succeeding as an EMT/EMR. Springer. https://doi.org/10.1007/978-3-030-64396-6

The Pain Before The Birth: Antenatal Anxiety

by Marcela Muricy, November 9, 2021

Pregnancy is an adventurous time— a time of changes in the body that can be welcoming or scary, peaceful or torment, the feeling of finally having everything put together or the stress of slamming your finger between the car door. Any way you twist it, it is a very complicated and unique time for every pregnant person. Most people will fear the aftermath, the risk of experiencing Postpartum Depression, the more intense version of the “baby blues”. Yet, what many pregnant people, their families, and even physicians and researchers overlook, however, is another mental health change that may impact them — and their baby — during the pregnancy itself: antenatal anxiety. “Antenatal”, or “pre-birth”, represents the time period before someone gives birth, therefore encapsulating the symptoms they may begin to encounter, such as mild to intense anxiety. Experienced by about 10% of pregnant people (Falah-Hassani et al., 2017), antenatal anxiety consists of obsessive and excessive worry that begins to impact their daily function, including concerns of maternal/fetal wellbeing, illness in the partner, and the possibility of maternal mortality (Johns Hopkins). These feelings, when experienced chronically and not treated properly, can have lifelong impacts on the child’s development (Misri et al., 2015). It is crucial to consider the prevalence of antenatal anxiety, how much it flies under the radar, and how harmful it is to mothers and their children, particularly during a pandemic in which treatment is very limited.

According to various studies, high antenatal anxiety can cause a decrease in the child’s head circumference, Apgar scores, and body length, as well as an increase in preterm birth rates, maternal eating disorders— and even cognitive and anger issues that can follow the child into adolescence and adulthood (Sarkar et al., 2017; Grigoriadis et al., 2018). For the pregnant person, antenatal anxiety can be a key predictor of postpartum depression (which is experienced by about 15% of pregnant people), so that high levels of antenatal anxiety are strongly correlated with higher likelihood of postpartum depression (Yim and Schetter, 2019; Slomian et al., 2019). Antenatal anxiety, then, although harder to identify, is also crucial in its correlation to PPD, and can help in the prevention of not only antenatal symptoms, but the gruesome symptoms that may follow the long road of PPD.

The main risk factors for developing maternal anxiety have proven to be high maternal preterm BMI, as well as a history of depression and mental issues (Holton et al., 2019; Dachew et al., 2021). Pregnancy ultimately causes a change in social state, hormonal imbalances, and lack of social support, all of which can serve to strain the pregnant person’s mental state and exacerbate past health issues. The listed risk factors, on top of the typical strains of pregnancy, leaves them very vulnerable to developing antenatal anxiety, making regular screenings and checkups even more crucial to preventing these symptoms as early as possible.

The current primary method of prevention includes frequent screenings, however it is proven that there is a strong correlation between pregnant people experiencing antenatal anxiety and choosing to attend less screenings/checkups, and so they are likely to be overlooked. It has been shown that therapy and social support groups tailored to them aids in decreasing antenatal anxiety in vulnerable populations, as well as populations not considered at risk for anxiety, both of which experienced an increase in overall quality of life (Li et al., 2020). The major causes of antenatal anxiety, then, are well treated and relieved by an increase in social interactions and support.

This explains the increase in antenatal anxiety since March 2020; the COVID-19 pandemic has limited the availability of antenatal anxiety prevention and birthed a unique population of vulnerable mothers. Throughout the pandemic, there was a reported decrease in maternal mental health, and an increase in anxiety, depression, and OCD as a result of the fear of infection and social isolation (Hessami et al., 2020; Hinds et al., 2021). This was especially true for mother’s of high risk pregnancies (for instance, being at risk of preterm labor or a diabetic mother at risk of Diabetic Ketoacidosis) and with lower levels of education (Sinaci 2020). Within this sample set, there has also been an increase in PTSD symptoms because of the high stress level associated with the pandemic and the lack of social support (Hocaoglu et al., 2020). The prevention for this population was only possible within the home (self-prevention methods), or with a specialist over a digital platform— both of which are difficult to maintain and ineffective compared to in-person treatment and support (Akgor et al., 2021). This is also a possible challenge for pregnant people in poorer communities that cannot afford to attend regular checkups and screenings, which is particularly risky considering that, in worse financial conditions, they are significantly more likely to experience antenatal anxiety (Bayrampour et al., 2018; Dennis et al., 2018). The COVID-19 pandemic has exacerbated the impact of certain risk factors and exposed a disproportionate lack of resources available in impoverished communities, especially in times of need. 

Antenatal anxiety, then, should be at the forefront of our conversation around the support pregnant people need during pregnancy. Not only should they undergo physical screenings and pelvic exams (as is customary), but they should receive just as many (if not more) regular check-ups regarding their mental health (Kitchen and Jack 2021; Li et al., 2020). Moreover, this check-up should not only be geared towards the most serious aspects of mental health (such as suicidal thoughts), but also towards the more subtle concerns that can accumulate and negatively impact their health over time. Antenatal anxiety and its symptoms may be experienced independently of anything else, making it more difficult to distinguish between normal and abnormal symptoms (Misri et al., 2015). Persistent screenings, intensive education about these possibilities/distinctions, and further treatment studies are crucial to combatting the high prevalence of antenatal anxiety. This is especially true with vulnerable populations that have previous mental or physical health issues, or have limited access to resources due to their financial situation. Pregnant people should know they are well-supported, and their families should know how best to support them— so that none of them may suffer alone.


1 An Apgar score is a postnatal test performed immediately after birth to evaluate the baby’s health. Each category (Appearance, Pulse, Grimace, Activity, and Respiration) gets its own Apgar score ranging from 0-2, 0 being the least healthy and 2 being the most (“What is the Apgar Score?”).


References

Akgor, U., Fadıloglu, E., Soyak, B., Unal, C., Cagan, M., Temiz, B. E., Erzenoglu, B.E., Ak, S., Gultekin, M., & Ozyuncu, O. (2021). Anxiety, depression and concerns of pregnant women during the COVID-19 pandemic. Archives of Gynecology and Obstetrics, 304(1), 125–130. https://doi-org.proxy.library.stonybrook.edu/10.1007/s00404-020-05944-1

Alipour, Z., Lamyian, M., & Hajizadeh, E. (2012). Anxiety and fear of childbirth as predictors of postnatal depression in nulliparous women. Women and Birth: Journal of the Australian College of Midwives, 25(3), e37–e43. https://doi.org/10.1016/j.wombi.2011.09.002

Bayrampour, H., Vinturache, A., Hetherington, E., Lorenzetti, D.L., & Tough, S. (2018). Risk factors for antenatal anxiety: A systematic review of the literature. Journal of Reproductive and Infant Psychology, 36(5), 476–503. https://doi-org.proxy.library.stonybrook.edu/10.1080/02646838.2018.1492097

Coelho, H.F., Murray, L., Royal-Lawson, M., & Cooper, P.J. (2011). Antenatal anxiety disorder as a predictor of postnatal depression: a longitudinal study. Journal of Affective Disorders, 129(1-3), 348–353. https://doi.org/10.1016/j.jad.2010.08.002

Dachew, B.A., Ayano, G., Betts, K., & Alati, R. (2021). The impact of pre-pregnancy BMI on maternal depressive and anxiety symptoms during pregnancy and the postpartum period: A systematic review and meta-analysis. Journal of Affective Disorders, 281, 321–330. https://doi-org.proxy.library.stonybrook.edu/10.1016/j.jad.2020.12.010

Dennis, C.L., Falah-Hassani, K., & Shiri, R. (2017). Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. The British Journal of Psychiatry: The Journal of Mental Science, 210(5), 315–323. https://doi.org/10.1192/bjp.bp.116.187179

Grigoriadis, S., Graves, L., Peer, M., Mamisashvili, L., Tomlinson, G., Vigod, S.N., Dennis, C.L., Steiner, M., Brown, C., Cheung, A., Dawson, H., Rector, N.A., Guenette, M., & Richter, M. (2018). Maternal anxiety during pregnancy and the association with adverse perinatal outcomes: Systematic review and meta-analysis. The Journal of Clinical Psychiatry, 79(5), 17r12011. https://doi.org/10.4088/JCP.17r12011

Hessami, K., Romanelli, C., Chiurazzi, M., & Cozzolino, M. (2020). COVID-19 pandemic and maternal mental health: A systematic review and meta-analysis. The Journal of Maternal-fetal & Neonatal Medicine: The Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 1–8. Advance online publication. https://doi-org.proxy.library.stonybrook.edu/10.1080/14767058.2020.1843155

Hinds, C., Lindow, S.W., Abdelrahman, M., Hehir, M P., & O’Connell, M.P. (2021). Assessment of antenatal anxiety, depression and obsessive-compulsive disorder in pregnant women in the COVID-19 era. Irish Journal of Psychological Medicine, 1–7. Advance online publication. https://doi.org/10.1017/ipm.2021.57

Hocaoglu, M., Ayaz, R., Gunay, T., Akin, E., Turgut, A., & Karateke, A. (2020). Anxiety and post-traumatic stress disorder symptoms in pregnant women during the COVID-19 pandemic’s delay phase. Psychiatria Danubina, 32(3-4), 521–526. https://doi.org/10.24869/psyd.2020.521

Holton, S., Fisher, J., Nguyen, H., Brown, W.J., & Tran, T. (2019). Pre-pregnancy body mass index and the risk of antenatal depression and anxiety. Women and Birth: Journal of the Australian College of Midwives, 32(6), e508–e514. https://doi-org.proxy.library.stonybrook.edu/10.1016/j.wombi.2019.01.007

Kitchen F.L. &, Jack B.W. Prenatal Screening. [Updated 2021 Jul 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470559

Li, C., Sun, X., Li, Q., Sun, Q., Wu, B., & Duan, D. (2020). Role of psychotherapy on antenatal depression, anxiety, and maternal quality of life: A meta-analysis. Medicine, 99(27), e20947. https://doi-org.proxy.library.stonybrook.edu/10.1097/MD.0000000000020947

Misri, S., Abizadeh, J., Sanders, S., & Swift, E. (2015). Perinatal generalized anxiety disorder: Assessment and treatment. Journal of Women’s Health (2002), 24(9), 762–770. https://doi.org/10.1089/jwh.2014.5150

Sarkar, K., Das, G., Chowdhury, R., Shahbabu, B., Sarkar, I., Maiti, S., & Dasgupta, A. (2017). Screening antenatal anxiety: Predicting its effect on fetal growth. Journal of Family Medicine and Primary Care, 6(1), 131–135. https://doi.org/10.4103/2249-4863.214956

Sinaci, S., Ozden Tokalioglu, E., Ocal, D., Atalay, A., Yilmaz, G., Keskin, H. L., Erdinc, S. O., Sahin, D., & Moraloglu Tekin, O. (2020). Does having a high-risk pregnancy influence anxiety level during the COVID-19 pandemic?. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 255, 190–196. https://doi-org.proxy.library.stonybrook.edu/10.1016/j.ejogrb.2020.10.055

What is the Apgar score? Johns Hopkins All Children’s Hospital. (2021). Retrieved November 7, 2021, from https://www.hopkinsallchildrens.org/Patients-Families/Health-Library/HealthDocNew/What-Is-the-Apgar-Score#:~:text=The%20Apgar%20score%20is%20a,at%205%20minutes%20after%20birth.&nbsp;

Yim, I.S., & Dunkel Schetter, C. (2019). Biopsychosocial predictors of perinatal depressive symptoms: Moving toward an integrative approach. Biological Psychology, 147, 107720. https://doi.org/10.1016/j.biopsycho.2019.107720