Psychology

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

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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

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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. 

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

Addiction and Brain Disease: Intertwined but Not One and the Same

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by Vignesh Subramanian, October 18, 2021

Today, nearly every major medical organization in the United States defines drug addiction as a primary brain disease – a progressive, relapsing disorder driven not by choice, but rather by neural dysfunction. From patient advocacy organizations like the American Medical Association and the American Society of Addiction Medicine to top research organizations like the National Institutes of Health and the National Institute on Drug Abuse, this characterization of compulsive substance misuse is believed to effectively counter stigmatization of treatment while still accounting for biological and psychological realities. Yet if one is to evaluate other possible classifications and the present state of diagnostic protocols in fair measure, it could be reasonably asserted that a discussion is still to be had about the addict’s role in their own entrapment. The degree to which addiction may be considered a chronic illness is therefore contingent on not just the relativity of its prognosis, but also on what physicians believe to be appropriate recourse. 

The scientific tenets of addiction agreed on by psychologists, neurobiologists, and practitioners alike are key to judging the applicability of the brain disease model. Unwarranted assumptions about either the appositeness of a standard of comparison or a propensity for self-domestication can derail precedents set and determinations previously made by the discipline in question. It is fair to accept the medical discipline’s rhetoric on the need for restrictiveness in exposition, defining “chronic illness” as controllable but hitherto incurable conditions often identifiable by long periods of latency and protracted clinical course [3].

Proponents and opponents of the brain disease model also concur on the neurochemistry behind addiction. It starts with unregulated surges of the neurotransmitter dopamine in response to drug consumption occurring in the basal ganglia, the area of the brain tasked with executive functions that, among other behavior, enable learning from the ‘reward’ of brief ecstasy [5]. An affinity for a substance leading to increased use will cause neural circuits to adapt by restructuring receptors, by scaling back sensitivity to the drug’s effects – requiring more consumption to attain the same euphoric “high” – and by increasing tolerance of the substance as this subconscious demand is satisfied, completing the cycle [8]. The patient eventually develops dependence (inability to function without the substance) and dysphoria (a state of unease in the drug’s absence), fomenting cravings that prioritize reducing pain over experiencing pleasure [11]. The cycle is ultimately difficult to break, for reasons that demonstrate the true interplay of biology and behaviorism: parallel remodeling of the extended amygdala – tasked with controlling responses to stress – and the prefrontal cortex, which manages decision making, drives the user to form associations between increased consumption and decreased stress, causing inhibitory pathways to shut down as short-term reward is favored and sought after [5].

At no point in this slippery slope beyond the first ‘gateway’ use is the chemical compulsion of a drug resistible or reversible; indeed, the same reward circuits that drive addiction account for most human physiological needs, including reproductive activities [2]. In that regard, addiction is not just subconscious, but natural, solely dangerous in excess; patients of more socially sanctioned chronic illnesses – diabetes, heart disease, skin cancer – are victims of similar bet-hedging, whether it be by consumption of processed carbohydrates and meats, lack of exercise, or even sun exposure. Opponents of the brain disease model argue that the problem is initial awareness of risk: addicts must understand that intoxication is a precursor of worse to come, and addiction has a spectrum of severity, making accurate diagnosis difficult if not impossible [4]. With no physical measures of identifying mental health disorders (such as objective lab tests using biomarkers) yet deployed in medical practice, physicians must rely on neuropsychological assessments and dissociated imaging scans to compare a patient’s cognitive impairment with normal executive function and processing abilities. Such measures have found that neural changes associated with addiction matched those of “deep habits, Pavlovian learning, and prefrontal disengagement”, but did not match the “development-learning orientations” of various mental illnesses [1]. In other words, addiction stimulates synaptic pruning and neuroplasticity (the ability of neurons in the brain to change connections and reorganize) just as a conventionally developed brain does, but in atypical patterns poorly reflecting normal maturation and psychological tendencies. This information only sharpens the question of whether addiction is truly an aberration of the mind’s development or simply a collection of varying and even rectifiable effects elicited by the drug itself; to put it metaphorically, would a stabbing through the heart be considered cardiovascular illness? The concept of placing addiction on par with the likes of Alzheimer’s and Parkinson’s disease – surrounded by questions of whether all manipulated neuroplasticity is pathogenic, whether addicts can be responsible for consciously committed actions, and what even constitutes a problem with the brain – is thus far from conclusive. 

Acceptance – or lack thereof – of substance addiction as a brain disease has had and will continue to have wide-ranging implications for patient protections under law and avenues of treatment. Distinguishing between the public perceptions of users’ behavior and the intimate worldviews of addicts as shaped by their battles for recovery help sustain the idea that addiction medicine can be entirely recontextualized into being a centerpiece of public health. For example, even if addiction is not to be considered a disease of the brain, its contribution to the later development of chronic illnesses such as lung disease, stroke and HIV/AIDS makes addiction treatment itself a form of preventative medicine rather than rehabilitation alone [10]. Conversely, if classification of addiction as a brain disease remains the status quo, it might justify dependence as a ‘side effect’ of self-medication started because of lack of access to care, much the way it is for some substances with addictive potential – like selective serotonin reuptake inhibitors (SSRIs) and opiates – that are used and abused as antidepressants and for pain management, respectively [2][7]. As is clearly evident, proponents and opponents of the brain disease model ultimately do not disagree on the facts of addiction, but simply emphasize different contexts that, when taken to their conclusions, have different implications for diagnosis and stigmatization; both camps have proven willing, however, to oversee an explosion of medicalization that address those biological and psychological realities [6]. Today, trained physicians can administer pharmaceutical agonists and antagonists in clinics and other outpatient settings; the importance of psychosocial therapy, monitoring and follow-up in addiction treatment has been amplified; and the establishment of drug courts and diversion and harm reduction programs attests to the idea that drug consumption is not inherently a moral failing and that natural reactions to its effects can be less painfully anticipated and controlled [9]. 

Addiction is a convoluted condition: it has an onset influenced by environmental conditions but no infection agent, has little known pathological prognosis but a tendency to run in families, and displays outward behavioral changes but is not anatomically degenerative. A disease model that assumes partial responsibility on the part of the addict but recognizes the extent to which addiction rewires the brain is perhaps the best road on which to pursue a patient freedom-centric means of battling dependency and decay.

Works Cited

  1. Lewis, Mark. “Addiction and the Brain: Development, Not Disease.” Neuroethics, vol. 10, 2017, pp. 7–18, doi:10.1007/s12152-016-9293-4.
  2. Hammer, Rachel, et al. “Addiction: Current Criticism of the Brain Disease Paradigm.” AJOB Neuroscience Journal, vol. 4, no. 3, 2013, pp. 27–32. doi:10.1080/21507740.2013.796328.
  3. “Is Addiction a Disease?” Partnership to End Addiction, July 2020, drugfree.org/article/is-addiction-a-disease.
  4. Levy, Neil. “Addiction is not a brain disease (and it matters).” Frontiers in Psychiatry, vol. 4, no. 24, 2013. doi:10.3389/fpsyt.2013.00024.
  5. United States, Department of Health and Human Services. “The Neurobiology of Substance Use, Misuse, and Addiction.” The Surgeon General’s Report, 2016. addiction.surgeongeneral.gov/sites/default/files/chapter-2-neurobiology.pdf.
  6. NIDA. “Preventing Drug Misuse and Addiction: The Best Strategy.” National Institute on Drug Abuse, 10 July 2020, http://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/preventing-drug-misuse-addiction-best-strategy.
  7. Satel, Sally, and Scott O. Lilienfeld. “Addiction and the Brain-Disease Fallacy.” Frontiers in Psychiatry, vol. 4, no. 141, 2014. doi:10.3389/fpsyt.2013.00141.
  8. “The Science of Drug Use and Addiction: The Basics.” National Institute of Drug Abuse, 25 June 2020, http://www.drugabuse.gov/publications/media-guide/science-drug-use-addiction-basics.
  9. Smith, David E. “The Evolution of Addiction Medicine as a Medical Specialty.” AMA Journal of Ethics, vol. 13, no. 12, 2011, pp. 900–905. doi:10.1001/virtualmentor.2011.13.12.mhst1-1112.

The Mental Conundrum

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by Ali Ahmad, October 8, 2021

We all have faced a feeling of regret at some point in our lives. Regret is a human condition that I am sure all of us have faced at least once in our lifetime. The feelings of hopelessness and regret positively reinforce each other as we look back on the past and fixate on the problems we have faced. The more we begin to fixate on these problems, the more we begin to deviate from taking action and instead begin to imagine hypotheticals in our mind. These replays of alternate scenarios in our heads induce  feelings of accomplishment and triumph where there is none to begin with. This fantasy is our mind methodology of expunging negative emotions and mutating it into something bright and positive. This at first does not sound like a problem at first, given that we normally associate feelings of positivity with fulfillment. However, I believe that the motivation that drives us to excel and learn is stifled by feelings of positive emotions that overshadow negative feelings. 

I was once at a house party and a friend of mine from high school was in attendance. They had just accepted an offer of admission from Dartmouth College, a prestigious ivy league university. I was just a junior in High School studying for a retake of the SAT exam hoping to get into a good school. Naturally, I felt that I had fallen behind in my studying and went to bed at night dreaming that I had attained a perfect score through hours of desiccated study. I instantly felt better afterwards and unfortunately I never put in the hours of studying I had initially envisioned myself doing. If I had set up initial negative feelings of having fallen behind or of feeling inferior, I might have had the push I needed to put in the hours of studying and to make a meaningful change in my life.

In a study conducted on cocaine addiction treatment success, the emotional processing of addicts was measured to see if there is any correlation between motivation and goal directed behaviors. The study found that brain areas activated in early treatment for cocaine addiction were also active during  emotional activation. These brain regions included the amygdala, accumbens, and fusiform gyrus (Contreras-Rodriguez et al.). This might sound surprising at first, considering that we all strive to cultivate positive emotions. On the contrary, we all purposefully have a built in “negativity bias,” that we actively use to create adverse scenarios to contrast against to better digest information. This bias is an evolutionary feature unique to humans. In fact the early origin of these negative emotions can be clearly observed in infants, where infants “look at angry faces for a shorter duration due a recognition of aversive stimulus,” (Vasih et al.) All of this suggests that our brains are hardwired from the beginning to attend to negative or threatening stimulus in the environment more so than happy or positive stimulus.

So what are the practical takeaways from this finding? We can first begin by redirecting our negative cognitive energy to moving forward. By grounding ourselves in the present moment we can begin to break through this mental trap and begin to take small steps towards a slightly more positive future.

Works Cited

Contreras-Rodriguez, Oren, et al. “The neural interface between negative emotion regulation and motivation for change in cocaine dependent individuals under treatment.” Drug and Alcohol Dependence, vol. 208, 2020. doi.org/10.1016/j.drugalcdep.2020.107854

Vaish, Amrisha, et al. “Not all emotions are created equal: The negativity bias in social-emotional development.” Psychological Bulletin, vol. 134, no. 3, 2013, pp. 383–403. doi.org/10.1037%2F0033-2909.134.3.383

You’re Never Truly Yours: How Love and Ownership Are Synonymous

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by Marcela Muricy, May 30, 2021

“There is beauty in the idea of freedom, but it is an illusion. Every human heart is chained by love.”

Cassandra Clare

When we are born, we are all empty rooms — white, blank, utterly devoid of all life and personality. Our parents, then, are the only ones who may enter freely: they paint the walls, play their favorite hits on a record player, and maybe hang a cross over the door. They make a storage space of us, piling cardboard boxes in the corner and labeling each as “mannerisms,” “habits,” “beliefs,” or “obsession with the JFK assassination.” From the very beginning of our lives, we belong to them, absorbing their traits and letting them shape and define us. They are the primary decorators of our “room” until we inevitably age, maturing and reclaiming agency of ourselves and our identity, refurbishing this space to our own liking. Yet, as we rearrange it with age, do we truly have as much autonomy in the matter as we would like to believe?

When we are born, our rooms are quite put together, with most interests hand-picked and presented as essential, our parents projecting onto us what they’d always dreamed for themselves. Ballet classes at age 2, ice skating at 4, Catholic school at 5 — all the beauties of the New World, supposedly. When we grow, however, things begin to change. We wear mismatched outfits to school because I like it, even if Mom says we’ll get bullied. We rearrange and redecorate our “room” as we reach the age of puberty and change our sense of self. Our perception of the world becomes completely transformed, that “room” finally opens for us to edit — the space seemingly infinite. 

We can change our clothes, betray our schedules, or shed a religion that once meant everything. We can adopt new hobbies and become part of fictional worlds we wished were within reach, allowing the smell of the worn pages to sink into our memory forever. We can find our true passion, begin reciting knowledge of biology like a prayer, and become intrinsically entangled with the beauty and complexity of it all. We can begin to reconcile with the fact that our parents are flawed humans woven from the same cloth, struggling to grapple with lifelong dilemmas. We can shift our mentalities from theirs, tune our radios to a different station, and make that same inherited room completely unrecognizable.

Yet, while some things we may edit, others are inherently permanent, at least in part. As we age and mature, we can modify the way our parents have previously made us think or act, but some things will always remain regardless of our efforts. We can detach the cross from the wall, yet the mark it made would still remain. We can consciously coat the walls in a new shade, but the other will still shine brightly underneath. If we listen closely, our ears pressed gently against the walls, we will still hear the echo of our parents in the things we say. We will still listen to music that we’re well aware is a result of our dads’ incessant playing of the ’70s hits. We will think with realism and logic, yet still find hints of our mother’s act like a lady perspective in our mind. We still belong to our parents in these small, significant ways because of the remnant traits and interests they’ve left in us. Now, though, we’re also made up of everything else, all the other experiences we’ve had up until this point, and all the people and interests that have affected us during this time — everything else we belong to.

So, then, as we age, do we truly begin to experience sole belonging? In a world of supposed free will, we could say we belong to ourselves, but this declared autonomy doesn’t negate the reality in which we act based on others. These may no longer be our parents, but we mold our lives around new ideas, interests, significant others, friends, etc. — anything and everything we love. This raises the question of whether we truly gain ownership of ourselves, or if we simply pass it onto the hands of someone — or something — else. When we’re younger, our parents hold the master key to our “rooms,” and later on, we simply make copies and hand them out to everything we hold dear. Our friends can tiptoe inside and slip an idea or two while we barely bat an eye. Our occupations can be even more invasive, expanding in the space and barricading the door so that they have unilateral control. Our significant others can have the same effect, moving and rearranging furniture of their own accord, creating a more comfortable space or punching a hole through the wall. We grant ownership to those we love because we want them in our lives, and so we allow them to influence us in this way. Because of our parents, we can be raised as God’s, our school’s, our responsibilities’ — until we become more our music’s, our friends’, books’, intellectual interests’, hobbies’, and everything else we spend our time and thoughts on. Ultimately, we all decide what is best to give pieces of ourselves to, and — as this list inevitably grows over time — the key is to embrace it and balance the effect we let it have on us. The room is ours, after all; it is ours to care for, or be careless with. We must recognize the lack of choice in love, however, and only hope to love what’s best for us — and that the key to it not fall prey to vicious hands.

Works Cited

Clare, Cassandra. Lady Midnight. Simon & Schuster, 2016.

Adolescent Peer Relationships and Mental Health during the COVID-19 Pandemic

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by Sophia Garbarino, Clare Beatty & Brady Nelson, May 25, 2021

See Sophia’s poster for the URECA 2021 Symposium here.

Abstract

In adolescence, females are more likely than males to experience an episode of depression (Hyde et al., 2008). Having a strong social network has been shown to protect against the development of depression and anxiety symptoms (Santini et al., 2015). In the U.S., adolescent social circles were largely disrupted during the initial phases of the COVID-19 pandemic. Although it has been suggested that higher perceived social support protects against poorer mental health (Magson et al., 2021), few studies have examined the potential association between relationship quality and mental health during the COVID-19 pandemic. In a sample of 104 12 to 18 year-old girls, the present study examined peer relationship quality prior to the COVID-19 pandemic and changes in depression and anxiety symptoms during March to April 2020. Relationship quality was measured with the self-report Network of Relationships Inventory – Relationship Qualities Version (NRI-RQV). Depression was measured with the Child’s Depression Inventory (CDI), and anxiety was measured with the Screener for Child Anxiety Related Disorders (SCARED). Across the entire sample, there was an increase in both depression (t = -4.88, p < 0.001) and anxiety (t = -3.07, p = 0.003) symptoms during the COVID-19 pandemic. In addition, pre-COVID-19 perceived closeness of friendships predicted changes in depression and anxiety symptoms during the COVID-19 pandemic. Specifically, greater same-sex (r = -0.29, p = 0.003) and opposite-sex (r = -0.21, p = 0.04) friendship closeness were inversely correlated with generalized anxiety symptoms. Opposite-sex friendship closeness was inversely correlated with depression symptoms (r = -0.26, p = 0.008). Parent-child relationships were also examined but were not associated with changes in mental health. Findings suggest that healthier peer friendships may serve as protective factors against depression and anxiety in adolescents. As vaccine distribution increases and social distancing policies become more relaxed, adolescents may be able to strengthen relationships that were impacted by the COVID-19 pandemic, contributing to improved mental health.

Keywords: COVID-19, adolescents, relationships, friendships, depression, anxiety

Introduction

Background

Adolescence is a critical developmental period for the emergence of sex differences in depression. By ages 13 to 15 girls are approximately twice as likely as boys to experience an episode of depression (Hyde et al., 2008). Prior research has taken a particular interest in the psychological mechanisms responsible for this shift, focusing specifically on girls.

For both sexes, strong social support networks have been shown to protect against the development of depressive and anxiety symptoms (Santini et al., 2015). In early 2020, when the initial phases of the COVID-19 pandemic began, these social networks were largely disrupted, especially for children and teenagers. The daily routine of interacting with classmates and peers at school was abruptly interrupted due to the shift to remote learning. During this time, research suggests that females in particular experienced a notable increase in depressive and anxiety symptoms (Hawes et al., 2021).

While some studies suggest that higher perceived social support protects against poorer mental health (Magson et al., 2021), few studies have examined the potential association between relationship quality and mental health during COVID-19. The present study examined pre-pandemic peer relationship quality and its potential for predicting depressive and anxiety symptoms during the early COVID-19 pandemic.

Hypotheses

The present study tested two hypotheses: 1) Individuals would display an increase in depressive and anxiety symptoms during the initial stages of the COVID-19 pandemic as compared to pre-pandemic symptoms, and 2) Both parent and peer relationships would inversely correlate with depressive and anxiety symptoms during the COVID-19 pandemic. In other words, healthier and closer relationships would be associated with fewer depressive and anxiety symptoms during COVID-19.

Methods

Participants

The sample consisted of 104 girls from an ongoing longitudinal study at Stony Brook University, the Impact of Puberty on Affect and Neural Development across Adolescence (iPANDA) project. This project is currently investigating the relationship between neural reward sensitivity and the development of depression. Eligibility included being assigned female at birth, aged 8 to 14, being literate in English, having no known medical or developmental disabilities, and living within 30 miles of Stony Brook University in Long Island, NY. One of the child’s biological parents also had to be willing to participate. The baseline sample consisted of 317 girls along with one of their biological parents. Baseline data collection was followed by two additional waves, each spaced approximately two years apart. The third wave was still in progress when the COVID-19 pandemic began in late March 2020, therefore not all of the participants had completed the data collection.

Measures

The iPANDA participants (N = 104) were included in the present study if they completed the included measures within the appropriate timeframes. One measure was completed prior to the pandemic (before March 18, 2020), and two measures were completed before and during (March 18, 2020 and after) the pandemic. The average time between the pre-COVID and during-COVID assessments was 55 weeks.

Network of Relationships Inventory – Relationship Quality Version (NRI-RQV)

The NRI-RQV questionnaire is a self-report measure that assesses participants’ relationships with their 1) mother or mother figure, 2) father or father figure, 3) boyfriend or girlfriend, 4) sibling, 5) best same-sex friend, and 6) best opposite-sex friend. The questions had Likert-style responses (1 to 6: 1 = low occurrence, 5 = high occurrence, 6 = not applicable) and were presented in matrix format with each relationship type. Questions were classified into one of ten scales; the five positive scales measured companionship, intimate disclosure, emotional support, approval, and satisfaction, while the five negative scales measured conflict, criticism, pressure, dominance, and exclusion. Each scale contained three items and was scored by averaging the item responses (Furman & Buhrmester, 2010). The present study focused on the Closeness score, which is the mean of the five positive scale scores, for the mother, father, best same-sex friend, and best opposite-sex friend relationships. Participants completed the NRI-RQV assessment pre-COVID.

Children’s Depression Inventory (CDI)

The CDI questionnaire is a self-report measure that assesses participants’ depressive symptoms (Kovacs, 1992). Scores were calculated by summing the item responses, which were Likert style (not often/doesn’t apply to me, sometimes/somewhat applies to me, very often/strongly applies to me). Participants completed the CDI assessment pre-COVID and during COVID.

Screen for Child Related Anxiety Disorders (SCARED)

The SCARED questionnaire is a self-report measure that assesses participants’ anxiety symptoms. Each item had Likert-style responses (0 to 2: 0 = not true, 2 = very true) and was categorized into one of five subscales: panic disorder or significant somatic symptoms, generalized anxiety disorder (GAD), separation anxiety disorder, social anxiety disorder, and significant school avoidance. A total sum score of 25 or above (out of 82) indicated the possible presence of an anxiety disorder (Birmaher et al., 1997). The present study focused only on the GAD subscale, where a sum score over 9 indicated the possible presence of GAD. Participants completed the SCARED assessment pre-COVID and during COVID.

Data Analysis

Using IBM®️ SPSS®️ Statistics (v.27) software, we conducted two paired samples t-tests to examine whether depressive and anxiety symptoms increased during the pandemic as compared to pre-pandemic. Further, we conducted follow-up partial correlations (controlling for pre-pandemic symptoms) to investigate the relationship between relationship quality and depressive/anxiety symptoms during the pandemic.

Results & Discussion

Figure 1. Pre-COVID-19 vs. COVID-19 SCARED GAD Subscale t-test

t = -4.88, p < .001

Figure 2. Pre-COVID-19 vs. COVID-19 CDI Total t-test

t = -3.07, p < .01

Table 1. Correlations between SCARED GAD (COVID-19), CDI (COVID-19), and peer relationships

COVID-19 SCARED GAD SubscaleCOVID-19 CDI Total
NRI-RQV Best Same-Sex Friend Closeness (pre-COVID)-0.287**-0.080
NRI-RQV Best Opposite-Sex Friend Closeness (pre-COVID)-0.205*-0.259**
Controls: pre-COVID SCARED or pre-COVID CDI
p < .05*   p < .01**  p < .001***

Table 2. Friendship closeness vs. COVID-19 symptoms regressions

COVID-19 SCARED GAD Subscale (β)COVID-19 CDI Total (β)
NRI-RQV Best Same-Sex Friend Closeness (pre-COVID)-.168**.074
NRI-RQV Best Opposite-Sex Friend Closeness (pre-COVID)-.018-.124****
Controls: pre-COVID-19 SCARED and CDI; COVID-19 SCARED or CDI
p < .05*   p < .01**  p < .001*** trending****

Results indicated support for the first hypothesis. Across the sample, participants had greater depressive (t = -4.88, p <.001) and anxiety (t = -3.07, p < .01)symptoms during the COVID-19 pandemic, as compared to pre-pandemic. However, results indicated only partial support for the second hypothesis. Pre-pandemic friendship closeness was associated with changes in anxiety and depressive symptoms; specifically, stronger pre-COVID same-sex friendship closeness uniquely correlated with smaller increases in anxiety symptoms during COVID (r = -.29, p < .01), while stronger pre-COVID opposite-sex friendship closeness uniquely correlated with smaller increases in depressive symptoms during COVID (r = -.26, p < .01). When controlling for pre-pandemic symptoms, pre-COVID same-sex friendship closeness still predicted changes in COVID anxiety symptoms (r = -.17, p < .01). Mother and father relationships were not found to be significantly predictive of changes in mental health during COVID.

Conclusion

Interpretations

It is possible that participants were more comfortable expressing worry to same-sex friends (girls), buffering against increased anxiety symptoms. Perhaps they shared feelings about missing friends or romantic interests at school. Findings also suggest that opposite-sex friends (boys) may have helped improve participants’ moods, buffering against increased depressive symptoms. The girls may have had a crush or two and were happier interacting with them, even if only virtually, while following stay-at-home orders.

Limitations

The sample was predominantly Caucasian and middle class, and from the Long Island, New York area. As such, the sample is certainly not representative of the entire United States, as the U.S. is much more racially and socioeconomically diverse. It is unclear whether or not these results would be similar for individuals of different backgrounds, since a variety of factors, including race, ethnicity, sex, and economic class, impact the degree to which people have been affected, either positively or negatively, by the pandemic (Center for Disease Control and Prevention). For example, Black and Indigenous Americans had the highest COVID-related death rates, while Asians and Whites had much lower rates (APM Research Lab Staff). According to the Pew Research Center, lower-income individuals were also more likely to report lost income and jobs due to the pandemic (Parker et al., 2020). As such, the present study’s sample may not have been affected by COVID-19 as much as other groups.

Further, all measures were self-reported, so participants may have been reluctant to share the full extent of their relationships and COVID-19 experiences. Another important consideration is that there was over a year, on average, between the pre-COVID and during-COVID assessments, meaning we could not account for potential significant life changes, such the death of a parent, losing touch with a friend, moving to a new place, and changes in relationship nature itself. Therefore, the present study’s results regarding pre-pandemic relationship quality may not be fully applicable to pandemic-era relationship health.

Future Directions

Overall, the results were largely what we hypothesized. Increased anxiety and depressive symptoms during the COVID-19 pandemic were evident across the sample and peer relationships predicted changes in mental health. Future studies should investigate these findings further and consider potential gender, race, and socioeconomic class differences that were not found in the present sample. Social factors like gender norms, double sex standards, race/ethnicity, and wealth may further influence the nature of adolescents’ social support networks and how they experienced the COVID-19 pandemic.

References

APM Research Lab Staff. (2021, March 5). The color of coronavirus: COVID-19 deaths by race and ethnicity in the U.S. APM Research Lab. https://www.apmresearchlab.org/covid/deaths-by-race

Birmaher, B., Khetarpal, S., Brent, D., Cully, M., Balach, L., & Kaufman, J. (1997, April). The screen for child anxiety related emotional disorders (SCARED): Scale construction and psychometric characteristics. J Am Acad Child Adolesc Psychiatry 36: 545–553. https://doi.org/10.1097/00004583-199704000-00018

Center for Disease Control and Prevention. (2021, April 19). Health equity considerations and racial and ethnic minority groups. https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html

Furman, W., & Buhrmester, D. (2010). Network of relationships questionnaire manual. Unpublished manuscript, University of Denver, Denver, CO, and the University of Texas at Dallas.

Hawes, M.T., Szenczy, A.K., Klein, D.N., Hajcak, G., & Nelson, B.D. (2021, January 13). Increases in depression and anxiety symptoms in adolescents and young adults during the COVID-19 pandemic. Psychological Medicine, 1–9. https://doi.org/10.1017/s0033291720005358

Hyde, J.H., Mezuklis, A.H., & Abramson, L.Y. (2008). The ABCs of depression: Integrating affective, biological and cognitive models to explain the emergence of the gender difference in depression. Psychological Review, 115, 291-313. https://doi.org/10.1037/0033-295x.115.2.291

Magson, N.R., Freeman, J.Y., Rapee, R.M, Richardson, C.E., Oar, E.L., & Fardouly, J. (2021). Risk and protective factors for prospective changes in adolescent mental health during the COVID-19 pandemic. Journal of Youth and Adolescence, 50, 44-57. https://doi.org/10.1007/s10964-020-01332-9

Kovacs, M. (1992). Children’s depression inventory. Multi-Health Systems, Inc.

Parker, K., Horowitz, J.M., & Brown, A. (2020, April 21). About half of lower-income Americans report household job or wage loss due to COVID-19. Pew Research Center. https://www.pewresearch.org/social-trends/2020/04/21/about-half-of-lower-income-americans-report-household-job-or-wage-loss-due-to-covid-19/

Santini, Z.I., Koyanagi, A., Tyrovolas, S., Mason, C., & Haro, J.M. (2015, April 1). The association between social relationships and depression: A systematic review. Journal of Affective Disorders, 175, 53–65. https://doi.org/10.1016/j.jad.2014.12.049

You Can Sit With Us, But You Shouldn’t Have To: The Hidden Benefits of Social Cliques

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by Vineeta Abraham, May 9, 2021

Many adults with yearbooks filled with high school “horror stories” will claim they  originated from the rigid, harsh social structure they had to adhere to, complete with bullies,  queen bees, and their select array of victims. This myth is the reason behind many administrative efforts to integrate students in middle schools and high schools across the country as an attempt to attack the issue of social circles or “cliques” from multiple angles. When doing this, they often think that tackling the main problem involves eliminating the social hierarchies that exist in the halls of almost every high school. While this seems to be in the students’ best interests, it may be doing more harm than help. What teachers and administrators often fail to recognize is that when students are socially structured, they are able to create identities for themselves and thrive in the niches that the school environment creates for them. While most people assume this means that a sense of privilege will linger among several of these social standings, it should be noted that allowing students to stay comfortably within their social groups might be a better alternative than forcing them to intermingle. Although people have misconceptions about the nature of so-called “cliques,” and are therefore enforcing programs to dismember them, allowing these social circles to thrive, while taking care to encourage healthy cooperation between them, can help students develop psychologically in group settings and avoid the negative effects of not having a social group to call their own.

Much of the skepticism surrounding the existence of social circles in schools comes from  stereotypical assumptions about them. These are often fueled and exaggerated by the media,  through means such as books, television series, and teen-drama movies. The entirety of the  infamous 2004 comedy Mean Girls revolves around a typical new girl trying to outmaneuver the  social ladder that exists at her new school, including the “A-list girl clique” described in the  summary provided on the internet movie database, IMDb. In this movie, many types of cliques  and social circles are represented, as well as a clearly defined ladder that is topped by the so called “mean girls.” The movie highlights the entitled, harmful personalities of those who top these social hierarchies and proposes that cliques tend to remain vicious towards each other and cannot coexist peacefully (IMDb). Media such as this promote a general sense of wariness in the minds of their audiences, which include families, educators, and administrators, through their use of pure exaggeration. One may argue that some schools do in fact have a strong presence of social hierarchies and social ladders, but it must also be noted that this is not very different from how society is structured in a world outside of the school building. Status is not a foreign concept for our communities, and treating it as such in school doesn’t prepare students for what they will face long after graduating from their microcosms of the real world. However, it is possible to attract attention towards eliminating the toxic potentials of social hierarchies while still encouraging the social groups. 

Social circles have existed in schools for generations, and although the way they’re structured has varied through generations, their general formulas remain fairly consistent. Cliques are nothing new, as shown by Jerry Adler, a former senior editor of Newsweek who has written for magazines such as The New Yorker, The Smithsonian, and Scientific American. In a 1999 Newsweek article, he explains that these groups include “athletes and preppies and wanna-be gangsters; pot-smoking skaters and sullen punks; gays and nerds and, yes, morbid, chalk-faced Goths,” and remain “surprisingly similar from coast to coast” (Adler). This consistency further supports the idea that these social structures are not only normal, but even instinctive, especially for adolescents. Shayla Ahamed, a blogger from Penn State University, writes that most people are simply “inclined to become friends with people that are similar to them and share their interests,” claiming that while negative side effects seem to be the focus in the media, forming groups are for the students’ own benefit (Ahamed). Additionally, Daniel A. McFarland, a sociology professor at Stanford University, uses his 2014 study for the American Sociological Review to discuss details of social structures, calling them “supportive and protective” and claiming that this is what leads students to tend to create them more often than not (McFarland). Perhaps the universality in these adolescents’ instincts to self-segregate is an important reason why we should nurture, rather than destroy, this phenomenon that we term “cliques.”  

Although Adler describes that in some places, these hierarchies demand a certain  evaluation of “status” be added to the existing situations, this is not always the case (Adler).  McFarland discusses how “adolescent societies” form when students begin to create groups “with individuals who share similar attributes, behaviors, or attitudes,” continuously  emphasizing the term “homophily” to describe how students constantly look for a sense of  “familiarity” (McFarland). As students begin the extremely trying time in their lives  corresponding to their high school years, their need for connecting to others like them increases immensely, highlighting the importance of having a strong social system to guide them  (McFarland). Although one may believe that social divisions can lead to insensitivity or other  undesirable side effects like bullying, the truth is that proper lessons in respect can, together with  these groups, be advantageous to the student body.  

These avoidable consequences of cliques encourage educators and administrators to overcompensate and actually cause more harm. This anti-clique mentality is inspiration for programs such as “Mix It Up at Lunch,” a social campaign started by the Southern Poverty Law Center’s Learning for Justice project. The “Mix It Up” program aims to encourage students to spend time at lunch with people who are not in their primary friend groups by eating with people outside of those social circles. Learning for Justice has also created multiple other activities to promote integration, including “Mix it Up Dialogue Groups” (“Mix it Up”). Another such example of programs created in an attempt to dismantle these social structures is Abigail N. Kirk’s teacher inquiry for Penn State University called “Kick the Cliques,” in which she promotes classroom activities to encourage girls to cooperate with each other while avoiding the creation of self-made groups (Kirk). These and other similar programs aim to teach students to adapt to other personalities and promote large group settings by straying away from creating smaller groups or self-segregating. While their intentions are pure, programs like these are usually a mix of ineffective and awkward for the students being forced into them, typically without having the choice to opt out. While one may argue that current discomfort will pay off later on, the chances of making most long-lasting friendships from continuously forced collaborations are slim. Furthermore, continuous efforts by the administration to intervene in students’ social decisions can be more harmful than beneficial. 

Rather than trying to eliminate these cliques, schools should embrace the idea of  encouraging kids to thrive within their own social circles. Physician Susan Biali Haas, M.D. argues in her 2013 Psychology Today article, “Stop Trying to Fit In, Aim to Belong Instead,” that people should stop “trying to be something [they’re] not in order to gain acceptance,” which is what integration promotes (Haas). This viewpoint emphasizes the idea that people should embrace their own characteristics and look for those with similarities in order to find their social circles rather than drastically changing their personalities to match those of a preexisting group. The alternative to having to change oneself for the benefit of fitting in would be to allow students to create groups that are naturally suited for their personality types and interests — in other words, allowing them to focus on belonging (Haas). The concept of belonging encourages self-acceptance and self-esteem, thereby providing students with more helpful guidelines for life and helping redirect the goals of administrators. For example, rather than focusing on rearranging students’ social groups, administrative intervention can include teaching students to avoid mean or hateful actions towards those who don’t necessarily fit into their own cliques. Furthermore, author Mark Rowh writes in an article for Current Health 2 that many students claim cliques can be “useful anchors in their social lives,” showing the true benefits they can have on the socioemotional health of students (Rowh). 

Being in small group settings can be psychologically beneficial, and studies of “social  psychology, for example, examine how emotion, cognition, and action are shaped by the social  environment” (McFarland). In an interview with psychologist Dr. Stacey Scott from Stony Brook  University, whose research specializes in emotions and stress in development throughout the lifespan, she described the importance of having “social support” throughout one’s life and  claims that adolescents require that strong support just like adults do (Scott). She explains further by saying that the social segregation that occurs during high school or one’s adolescence is representative of how “adults function in society,” even claiming that “adults aren’t necessarily  friends with everyone, so adolescents shouldn’t be expected to be either” (Scott). She also  suggested that other research has been conducted in the past to explain the normalcy of students  to “view their peers as being nominated under certain groups” and that this is not something we necessarily need to eliminate (Scott). It also encourages students to join small yet fundamental clubs and sports. These clubs and sports follow the same general guidelines that most cliques do — the only difference between most of these clubs and allowing students to create their own social circles is the absence of administrative involvement.  Furthermore, cliques and social groups help students develop and thrive within a self-made “niche in some section of [their] society,” as examined by psychologist Jeffrey Jensen Arnett from the University of Maryland College Park in a 2000 article for the American Psychologist (Arnett). 

The fate is much worse for students who don’t belong to a clique at all. While students  may think that most of the so-called “shunning” comes from social classes of higher status  towards those of lower status, the ones who don’t belong to a specific group often get the worst  of the blow. Chris MacLeod, a registered social worker who founded the website Succeed Socially, claims that failing to socially integrate can lead to “slip[ping] through the cracks” of the community (MacLeod). This feeling of not being “right” for a certain group can lead to feelings of loneliness and exclusion. Although it’s true that those who don’t necessarily conform to a certain group may choose to be that way, either because they  “don’t have enough” of whatever that particular group demands of them or simply because they believe those groups are either “on a pedestal” or “below them,” MacLeod suggests that eliminating these mindsets and embracing the idea of joining a group would prove to be beneficial to one’s social state (MacLeod). MacLeod supports the idea that joining such groups even when apprehensive could help improve one’s social skills such as “making conversation, feeling more comfortable around others, [and] being able to open up to people” (MacLeod). Daniel A. McFarland further discusses the importance of this “peer network” in his research by stating that “cliquing increases” during adolescence because of the “attachment shift from parents and family to peers” (McFarland). Allowing these close-knit relationships to form between students would be a better alternative for educators instead of trying to break these social structures down. This, in turn, will eliminate many of the problems associated with adolescent loneliness, as described by researcher Ahmet Gurses in his 2011 article for Procedia Social and Behavioral Sciences as he attempts to connect the problems of loneliness in high school to “academic  unsuccessfulness” (Gurses). Students without groups at all can find themselves falling into a spiral of adolescent loneliness and social awkwardness, as described by MacLeod. The simple alternative is to embrace the benefits cliques can have on the student population (MacLeod).  

Although the use of the words “clique” and “social circle” have negative connotations, it  should be noted that the majority of these assumptions about the implications of creating social  structures come from personal experience. Most phenomena in society have the potential for negative side effects, but it is wiser to eliminate the side effects rather than their causes. Allowing social structures to flourish in a high school setting can actually be beneficial to the students both socially and psychologically. Rather than implementing programs to negate and eliminate the instinct of high schoolers to self-segregate, schools and educators should work to promote healthy segregation. This would encourage students to embrace their differences and connect with others by developing their similarities. Therefore, programs originally intended to eliminate the prospect of social groups should be redirected in order to fuel the creation of healthy divisions among students while promoting sympathy and amiability between these divided groups. The main focus of administrators and  educators should be shifted from reworking preexisting divisions that students make instinctively to teaching students how these divisions can help them flourish as they enter adulthood and the outside society.

Works Cited

Adler, Jerry. “The Truth about High School.” Newsweek, 10 May 1999, www.newsweek.com/truth-about-high-school-166686. 

Ahamed, Shayla. “The Science of Cliques.” SiOWfa15: Science in Our World: Certainty and  Controversy, Penn State University , 8 Sept. 2015, sites.psu.edu/siowfa15/2015/09/08/the-science-of-cliques/. 

Arnett, Jeffrey Jensen. “Emerging Adulthood: a Theory of Development from the Late Teens  through the Twenties.” American Psychologist, vol. 55, no. 5, 2000, pp. 469–480. 

Gurses, Ahmet. “Psychology of Loneliness of High School Students.” Procedia Social and  Behavioral Sciences, vol. 15, 2011, pp. 2578–2581. 

Haas, Susan Biali. “Stop Trying to Fit In, Aim to Belong Instead.” Psychology Today, 17 Oct. 2013, http://www.psychologytoday.com/us/blog/prescriptions-life/201310/stop-trying-fit in-aim-belong-instead.

Kirk, Abigail N. “Kick the Cliques: Activities to Promote Positive Relationships among Girls in the Classroom.” Penn State U, 26 Apr. 2006. Penn State University, www.yumpu.com/en/document/read/51491966/kick-the-cliques-activities-to-promote-positive-relationships-among-. Manuscript. 

MacLeod, Chris. “When You Feel like You Don’t Fully Fit into Any Social Group.” Succeed  Socially, http://www.succeedsocially.com/dontfitintoanygroup. Accessed 20 November 2019.

McFarland, Daniel A. “Network Ecology and Adolescent Social Structure.” American  Sociological Review, vol. 79, no. 6, 2014, pp. 1088–1121. 

“Mean Girls.” IMDb, http://www.imdb.com/title/tt0377092/. Accessed 20 November 2019. 

“Mix it Up.” Learning for Justice, http://www.learningforjustice.org/mix-it-up. Accessed 5 May 2021. 

Rowh, Mark. “The In-Crowd: the Not so Shocking Truth about Cliques.” Current Health 2, a Weekly Reader Publication, vol. 34, no. 2, pp. 11+.

Scott, Stacey B. Personal interview. Oct. 2019. 

The Impact of Gender Discrimination in the Workplace on Women’s Mental Health

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by Farah Hasan, April 3, 2021

Perhaps the most defining moment of the Women’s Rights Movement to date was the passage of the Nineteenth Amendment in 1920 following the valiant efforts of those who spearheaded the project, such as Susan B. Anthony and Elizabeth Cady Stanton, and those who fearlessly backed the movement as a novel mark of progressivism. This momentous occasion is regarded as the single largest extension of democratic enfranchisement in the history of the United States (“The woman suffrage movement”). Despite such enormous strides having been accomplished for the advancement of women in a society where men had always dominated the government, the economy, the workforce, etc., women are far from seeing gender equality in the United States. Although the right to enfranchisement has contributed to the virtual elimination of overt prejudice, implicit bias against women still pervades. Evidence of such implicit bias is seen in numerous places including pop culture, educational institutions, and the workplace. Particularly in the workplace, despite making gains in the labor force participation rate over the last several decades, women working in male-dominated fields have significantly different experiences at work than their counterparts in fields with more female representation (Parker, 2018). Gender discrimination stands as an impediment to many women’s success in their professional and occupational lives, and often deters them from seeking promotions/leadership. Thus, perceived gender discrimination in the workplace has profound negative effects on women’s mental health regarding clinical depression and anxiety, especially in comparison to men’s mental health when faced with the adverse stimuli of gender-based prejudice. 

Gender discrimination in the workforce manifests itself in various forms and is thus perceived in varying extents of severity. One of the most pronounced forms of gender discrimination is the wage gap between men and women, with women earning about 80% of every dollar that a man makes for the same or similar job. Particularly in male-dominated fields, a toxic workplace culture is developed in which job performance and commitment are measured solely by the number of hours dedicated to work, the number of weekend shifts taken, etc. This takes away any hope for having flexible hours, which many women need in order to balance family commitments (as women are often primarily charged with keeping up with familial responsibilities). Consequently, many women are unjustly perceived to be lazy, not dedicated, and not committed to their job role. The lack of female role models in senior roles and leadership positions is also quite disheartening when it comes to female empowerment and promotion. Without figureheads for reference, women are more likely to undervalue themselves, be modest in talking about their accomplishments, and forgo opportunities to seek promotions (Agarwal, 2018). Women with a bachelor’s degree or higher report experiencing higher levels of workplace discrimination than women with lower levels of education. 57% of employed women with postgraduate degrees report experiencing some form of gender discrimination, compared to 40% of working women with a bachelor’s degree and 39% of women who did not complete college (Parker & Funk, 2017). Similar trends are seen when it comes to receiving support from senior leaders, being passed over for promotions, feeling isolated at work, and being paid less than their male counterparts. 30% of women with family incomes of over $100,000 say they’ve been paid less than a man doing comparable work, compared to 21% of women with lower incomes (Parker & Funk, 2017). Regarding the workplace environment, women employed in majority-male workplaces are more likely to see their gender as a limiting factor to their professional advancement, are less likely to report fair treatment in personnel matters, and experience more gender discrimination. 49% of women working in male-majority workplaces report sexual harassment as a problem in their workspace, compared to 32% of women who say the same about female-majority workplaces. Lastly, only 49% of women in male-dominated workplaces report that their workplace is putting enough effort into increasing workplace diversity, compared to 78% of women working in places with an even gender mix and 71% of women working in female-dominated places (Parker, 2018). 

The manifestation of gender discrimination and implicit bias against women in different forms and at so many different levels often translates into adverse consequences on women’s mental health. In a study titled “Perceived discrimination and health: A meta-analytic review,” Pascoe and Richman defined gender discrimination as a “behavioral manifestation of a negative attitude, judgment, or unfair treatment toward members of a group” and included studies that discussed poor service and treatment of women in public situations, derogatory comments, and harassment (Pascoe & Richman, 2009). It was found that perceived discrimination plays a role in increasing the incidence of depression, psychological distress, and anxiety. Experiencing discrimination on a regular basis causes more frequent activation of the body’s natural stress response, resulting in a perpetual negative mood state. Chronic stress and discrimination may also diminish one’s level of self-control, leading to increased use of and reliance on smoking, alcohol, and other substances to relieve the negative mood state. This may also decrease engagement in healthy habits, such as cancer screening and diabetes management (Pascoe & Richman, 2009). Risk of depression, in particular, is increased by stressful life events such as the loss of a loved one, a chronic disability/illness, or a business failure. Rejection, social exclusion, and embarrassment/humiliation also contribute to increased risk of depression. Gender discrimination in the workplace increases the odds that women will develop depression, regardless of the type of discrimination faced, whether it be regarding hiring, promotion, assignment of job-related tasks, wages, and firing. Women under 40 years old are particularly susceptible to developing depressive symptoms due to workplace gender discrimination compared to women over 40, adjusting for socio-demographic factors (Kim et al., 2020). 

While gender discrimination often puts women at a disadvantage, it is important to recognize that men could also be subject to such discrimination in the workplace. Due to the salience of historical instances of gender-based discrimination impeding women’s social advancement, most empirical research has focused exclusively on the impact of gender discrimination on women. This may be due to the fact that women have been entering male-majority fields at accelerating rates over the past several decades, but men’s entry into female-dominated fields has been largely stagnant. Regardless, research into gender discrimination may also apply to men entering female-dominated fields. Francesca Manzi of the Department of Psychology at New York University reviewed congruity models of gender discrimination (CMDs) to determine if men in female-majority fields face the same challenges as women in male-majority domains. It is important to note that while it is possible for men to be subject to gender discrimination, they may not be perceived as victims because they do not belong to a group that is commonly discriminated against, and discrimination of an “upper-class group” by a “lower-class group” (in this case, women discriminating against men) is usually not perceived as such. Female-majority occupations are often devalued and perceived to require less skill and intelligence, and thus do not come with significant status or monetary rewards, so exclusion from these occupations on the basis of gender is not seen as socially or economically hindering, and thus is not seen as discrimination. A potential source of stress, however, could be the incongruity of gender identity and occupation. Men may feel increased rates of depression and anxiety after perceiving a conflict between their gender and their job, which may lead to lower job satisfaction, dedication, and commitment. This is largely tied to the stereotype threat that comes from gender norms, where men’s quality of performance in female-dominated jobs is impaired when their gender is made salient (the stereotype threat also affects women in  male-dominated jobs). Conversely, it has previously been reported that men do not face gender discrimination in female-oriented jobs and actually experience facilitated upward mobility on the organizational ladder due to their gender (gender-based male advantage in female-dominated jobs is known as the “glass escalator” phenomenon). Unlike in the case of women being seen as incompetent in a “man’s” field, a man’s gender is seen to be a positive attribute that he brings to an otherwise female-dominated field, and thus the male stereotype works in his favor. Ultimately, this suggests that men have the advantage over women, even in female-dominated professions. Accordingly, men report receiving workplace support and report low levels of workplace inequality and/or mistreatment. Compared to the anti-female sentiment in male-dominated jobs, the anti-male sentiment in female-dominated jobs is insignificant (Manzi, 2019). 

The existing literature shows that both men and women can experience gender discrimination in the workplace. Due to the relative recency of the Women’s Rights Movement, the #Metoo movement, etc. women still have a long way to go in terms of equality and unfortunately bear the brunt of workplace gender discrimination. Women are subject to lower wages, fewer promotional opportunities, workplace isolation, sexual harassment, etc. On the other hand, it is important to recognize the barriers that men may face upon entry to female-majority professions, although further research must be done on this topic. Men face challenges associated with workplace gender discrimination, but on a much smaller scale than women, as they are less likely to report lower wages, be regarded as incompetent due to gender, receive less support from senior leaders, and be passed over for important assignments (Parker & Funk, 2017). Regardless, both men and women may experience some extent of psychological distress, depression, and negative mood state as a result of gender discrimination and/or incongruity between gender and occupation. Most men (67%) and women (68%) report that their gender has not played any role in hindering their professional success, but some workers are still experiencing the challenges of gender-based prejudice (Parker & Funk, 2017). Actions can be taken to counteract implicit bias and gender discrimination by encouraging diversity in workplaces (especially in occupations that are either male- or female-dominated) and normalizing the presence of other gender(s), allowing flexibility in work schedules, promoting female leaders, having strict disciplinary policies against sexual harassment, enforcing equal pay laws, and researching occupational barriers impeding men. Eliminating workplace gender discrimination may be a slow process, but with time, dedication, and sincere activism, it is an immense stride toward achieving true gender equality in America. 

References

Agarwal, P. (2018, August 31). How you can encourage more women into your workforce. Forbes Magazine. Retrieved from https://www.forbes.com/sites/pragyaagarwaleurope/2018/08/31/how-you-can-encourage-more-women-into-your-workforce/

Kim, G., Kim, J., Lee, S.-K., Sim, J., Kim, Y., Yun, B.-Y., & Yoon, J.-H. (2020). Multidimensional gender discrimination in workplace and depressive symptoms. PloS One, 15(7), e0234415.

Manzi, F. (2019). Are the processes underlying discrimination the same for women and men? A critical review of congruity models of gender discrimination. Frontiers in Psychology, 10. doi:10.3389/fpsyg.2019.00469

Parker, K. (2018, March 7). Women in majority-male workplaces report higher rates of gender discrimination. Retrieved August 2, 2020, from Pewresearch.org website: https://www.pewresearch.org/fact-tank/2018/03/07/women-in-majority-male-workplaces-report-higher-rates-of-gender-discrimination/

Parker, K., & Funk, C. (2017, December 14). Gender discrimination comes in many forms for today’s working women. Retrieved August 2, 2020, from Pewresearch.org website: https://www.pewresearch.org/fact-tank/2017/12/14/gender-discrimination-comes-in-many-forms-for-todays-working-women/

Pascoe, E. A., & Smart Richman, L. (2009). Perceived discrimination and health: a meta-analytic review. Psychological Bulletin, 135(4), 531–554.

The woman suffrage movement. (n.d.). Retrieved July 31, 2020, from Womenshistory.org website: https://www.womenshistory.org/resources/general/woman-suffrage-movement

Mental Health is Also Physical

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by Sara Giarnieri, March 12, 2021

When you think about mental health, what comes to mind? 

Are you thinking of emotions, or maybe just general well-being?

Did you know that mental health plays a significant role in your physical health as well? 

Depression, anxiety, and other mental health conditions are often associated with our emotional responses. Yet there are physical characteristics of mental health conditions that aren’t as readily acknowledged such as muscle tension, upset stomach, and chest pain (“Stress symptoms,” 2019).

Why do mental and physical health go hand in hand?

This is because a disruption in mental health can prevent us from maintaining a healthy lifestyle. As the Office of Disease Prevention and Health Promotion states (2020), “Mental illnesses, such as depression and anxiety, affect people’s ability to participate in health-promoting behaviors.” For someone debilitated by mental health, riding a bike may not be as easy for them compared to someone who may be in a stronger state of mental health. The neglect of our health due to psychological conditions can lead to physical symptoms. 

For instance, some common physical signs of depression are fatigue, changes in appetite, and headaches (“Depression,” 2018). Anxiety can also cause fatigue, rapid heart rate, and a decline in focus (“Anxiety disorders,” 2018). Anyone experiencing physical symptoms like these should recognize that it could be due to mental health, which is an aspect of our lives that is often ignored. Mental health should receive the critical attention needed in order to lessen these physical symptoms and achieve a happier, healthier life. 

Those who are battling psychological conditions may also be at risk for long term physical health conditions.

Studies have shown that people who are struggling with mental health are more likely to have certain health conditions. The New Zealand Journal of Psychology studied the correlation between mental health and physical health and found that those with psychological conditions such as depression and anxiety are more likely to suffer from cardiovascular disease, stroke, arthritis, asthma, and chronic pain (Lockett et al., 2018). The careful treatment of our mental health can help to prevent the development of serious physical conditions. 

How can we take care of our health?

Make sure you are listening to yourself both mentally and physically, as the two coincide with one another. Pay attention to how much sleep you get, provide your body with enough nutrients, and exercise daily. Set aside time to find and indulge in activities that make you feel good. Most importantly, don’t be afraid to reach out! If you feel that you are struggling, don’t hesitate to speak to a friend, family member, counselor, or someone you trust. They are there to help you. 

Think back again: What is mental health to you? Did your answer change, or did it remain the same? Either way, everyone can take more time to learn about mental health and how much it truly influences our lives. 

National Mental Health Resources

National Suicide Prevention Lifeline: +1 (800) 273 – 8255

Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline: +1 (800) 662 – HELP (4357)

National Alliance on Mental Illness (NAMI) Top HelpLine Resources

MentalHealth.gov

Stony Brook University Mental Health Resources

Counseling and Psychological Services (CAPS)

Mental Health Outreach and Suicide Prevention

References 

Anxiety disorders. (2018). Retrieved from https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961

Depression (major depressive disorder). (2018). Retrieved from https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007

Lockett, H., Jury, A., Tuason, C., Lai, J., & Fergusson, D. (2018). Comorbidities between mental and physical health problems: An analysis of the New Zealand Health Survey data. New Zealand Journal of Psychology, 47(3), 5–11.

Office of Disease Prevention and Health Promotion. (2020). Mental Health and Mental Disorders. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/mental-health-and-mental-disorders

Stress symptoms: Effects on your body and behavior. (2019). Retrieved from https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress-symptoms/art-20050987

Mean Girls and Boys That Don’t Cry

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by Ayesha Azeem, February 27, 2021

Whether we want to believe it or not, stereotypes control our conscious and subconscious thoughts, influencing our actions and behaviors towards society. As Leslie Scrivener’s article “The Cult of the Mean Girl” highlights, our perceived ideologies about how women behave toward each other influence our behavior in practice. Because we believe women are supposed to indulge in gossip and jealousy due to social norms, we as a society expect and even participate in this behavior. Ideologies and perceptions of men’s behavior also exist; while society perceives women as emotional and judgmental, we also expect men to remain professional, dominant, and violent. These thoughts and expectations not only affect how we behave towards others but also how we recognize ourselves. 

As soon as we are born, we gain awareness about the accepted and rejected behaviors in our society. One of these expected roles of a woman include “being nasty to each other … one of the rigidly enforced North American standards of what constitutes femininity” (Scrivener 1). Society expects women to treat each other as antagonistic competition, making them their own worst enemies. Little girls are not directly taught about these attitudes from their mothers, yet women around the world understand and engage in hostility towards each other. Girls watch their mothers gossip about neighbors and coworkers and administer this pettiness within themselves as well.

Society expects young women to rely entirely on their husbands and center their appearance, behavior, and mindset around what the men in their life anticipate and desire. As a result, women may prioritize their romantic relationships over friendships with other females since “women receive messages that their primary relationship should be with men, and that they have to compete for those relationships” (Scrivener 3). This often induces unwarranted aggression and possessiveness as part of the rivalry against female peers and thus destroys any connection they once felt. With the heavy emphasis on supporting the patriarchy, the media influences women to yearn for successful romantic relationships as their ultimate goal in life, belittling friendships and enhancing incivility among women. Because of this, when women suffer domestic violence and other relationship-related stress, they find themselves alone with no one to confide in. The stereotypes women comply with cause failures in their connection with peers and foster unnecessary cruelty. However, stereotypes and social norms control not only women, but also men.

We expect men to act dominant, controlling, and violent, and we criticize them when they do not make these traits apparent. From minor reprimanding like “real men don’t cry,” to extreme, life-changing situations such as forced enlistment into the military for men in South Korea, the way in which our society regards and expects men to behave alters the way they recognize and think of themselves. Generally, we expect men to remain nonchalant and unaffected, whereas we portray women as overly emotional. When men find themselves unable to effectively communicate their feelings because they learn at a young age that their tears are forbidden, they tend to internalize their feelings of depression, pain, and hatred, which may transition into radical acts of violence. Studies find that nearly 1 in 4 women experience physical abuse issued by an intimate partner, generally a male (National Domestic Violence Hotline). However, men are also victimized by abuse and rape. 15% of domestic violence victims are males who may not have the support they need to speak up about their struggles for fear of being labeled as an instigator or facing disbelief — or even taunts — rather than the help they desperately need (National Domestic Violence Hotline). Other men may resort to mass violence instead, attempting to get revenge on society for trying to isolate men from their feelings. The recent mass shootings witnessed in the United States have been overwhelmingly committed by male gunmen, from El Paso to Parkland, Florida. The terror and fear only increase as time goes on (Reese). 

Rather than allowing young boys to communicate their feelings and feel heard, society ignores their violence as “boys will be boys” until the resentment transitions into horror.  Additionally, with the emphasis on the patriarchy and the supposed role of a man, young boys are forced to grow up earlier than they are meant to. Society expects every young man to graduate college with a degree, find a career immediately, buy a house and find a suitable woman to make his wife before he grows old. The pressure put on young men without providing an effective and safe outlet causes harm both for themselves and the people surrounding them. 

With this generation’s eagerness to raise awareness about the immoralities around the world, we would benefit from diminishing the unnecessary stereotypes held about gender and how one’s sex and gender should affect the way they convey their emotions. Parents should nurture their children in a way which young boys do not feel obligated to conceal their emotions and vulnerability, and young girls should feel encouraged to create enduring friendships with other females rather than focusing on finding an intimate partner. After all, we have bigger things to worry about than whether our behavior matches that which society expects of us. 

References

  1. Scrivener, Leslie. “The Cult of the Mean Girl.” Toronto Star, 5 Mar. 2006.
  2. “Statistics.” The National Domestic Violence Hotline, https://www.thehotline.org/resources/statistics/.
  3. Reese, Phillip. “When Masculinity Turns ‘Toxic’: A Gender Profile of Mass Shootings.” Los Angeles Times, 7 Oct. 2019, http://www.latimes.com/science/story/2019-10-07/mass-shootings-toxic-masculinity.