Interview With a Female Fibroids Patient: How One Woman’s Story Speaks Volumes About the US Healthcare System

by Vineeta Abraham, May 6, 2022

Disclaimer: This paper was written for Dr. Marci Lobel’s Psychology of Women’s Health class in Spring 2022. This paper is intended to analyze the real experiences of a woman suffering from health issues. It should be noted that the use of the word “female” in this paper refers to the sex assigned at birth rather than the gender of “women” in general. Name of the interviewee has been changed for confidentiality.

In discussions of menstrual health, we often neglect to pay enough attention to the less apparent changes occurring in our reproductive organs. While one may focus their knowledge of reproductive processes in the female body on the phenomena of menstruation, reproduction, and menopause, there are other symptoms and diagnoses that can impact a female’s menstrual health. 

I was fortunate to have been able to interview Sarah [pseudonym], a 53-year-old registered nurse living on Long Island, about her recent experiences with uterine fibroids, which she identified as noncancerous growths in the uterus. Sarah has been married for 25 years and has three children ages 21, 18, and 16. She is originally from India and moved to the United States in 2003 after receiving her bachelor’s degree in nursing. She follows a Protestant-Christian religious practice and works overnight shifts at Queens Hospital Center. 

Sarah reported finding out about her uterine fibroids at the age of 51, about two years before this interview was conducted. She was lucky enough to have received the diagnosis before experiencing any serious side effects or symptoms. She claimed, “I went in for a regular check-up at my doctor’s office. We had been discussing my anemia for a few visits, so she recommended that I consult with my gynecologist to rule out fibroids.” Unfortunately, the opportunity for a “rule-out” never came. I asked Sarah whether she looked into treatment options upon hearing of her diagnosis of fibroids. She responded grimly, “Yes. The only treatment option is surgery to remove [the fibroids]. That or ablation, which is to block blood supply to the fibroids to shrink them.” Unsurprisingly, Sarah was not eager to undertake such invasive treatment, so after a few weeks of contemplation, she carefully declined. “Temporarily,” she clarified in our discussion. “I won’t be getting any further treatment unless serious complications arise.” She described how having uterine fibroids was not impacting her day-to-day activities any more than other related health concerns that previously existed before this diagnosis. For example, Sarah described how, although 53, she has not yet reached menopause, which is a great cause of concern for her. She also suffers from menorrhagia, which she described as having “severe anemia.” In an afterthought, she added that the fibroids may be adding to this.    

I then asked Sarah about any support or lack thereof she had received from friends and family regarding her diagnosis. She explained that the least support seems to come from her husband: “I asked him to ask around or look into other solutions, if he knows any other doctors, to ask if there are options other than surgery.” He did not follow through with the task, but Sarah did not comment any further on this. On the other hand, she claims better support came from other women, friends or co-workers who had either experienced similar problems or knew of others who had. Sarah described often talking with these women about gynecologist recommendations or side effects in her hunt for more information. When asked if she had felt any financial boundaries inhibiting her from receiving treatment, she said she did not think so, and does not think it would be an issue if she decides to get treatment in the future. 

I also made sure to ask Sarah about how living with this physiological health concern has impacted her mental or psychological health. Fortunately, Sarah replied that she did not experience any psychological differences as a result of her diagnosis. She explained that she is not particularly stressed about having fibroids, as it “doesn’t run in the family, doesn’t give [her] any side effects, and there are no hormonal changes.” She claimed that her lack of distress is one of the reasons she is okay with waiting before jumping into treatment. 

Much of what Sarah discussed with me in our conversation relates to topics discussed in Dr. Marci Lobel’s Psychology of Women’s Health course. For example, Sarah was clear in her explanation of limited options presented to her in terms of treatment for her uterine fibroids. The option of invasive surgery and not much alternative seems drastic and frightening for patients like Sarah. This reminded me of a concept discussed in the “Introduction and Overview” reading excerpted from the Physical Health, Illness, and Healing textbook, in which the authors explained how doctors show “more interest in restricting [women’s] reproductive potential than in treating their illnesses.” Although Sarah has decided she will not be having any more children, she described that she is not comfortable with getting rid of all her reproductive organs, an option presented to her through the discussion of surgery. She mentioned that although she may not want to have kids, she needs those organs to produce hormones for the rest of her life (she also demonstrated a distaste for taking external hormone supplements). The thought of invasive surgery comes with many risks and potential side effects, and is therefore understandably less appealing to women who are caretakers or full-time employees or, like Sarah, both. 

Perhaps this is one of the many reasons Sarah has decided to wait on the decision to treat her fibroids. As she mentioned multiple times in our conversation, Sarah’s fibroids are not an obvious hindrance to her day-to-day routine. In the midst of her hectic work schedule and household responsibilities such as childcare, home maintenance, or cooking, her fibroids are therefore being metaphorically “pushed to the backburner.” This information came as no surprise to me after hearing Dr. Lobel’s lecture on women’s cardiovascular health on February 1, 2022 during which she described how there is often a delay in women seeking healthcare services. Dr. Lobel attributed this delay to factors such as having various other responsibilities or a general lack of knowledge. Sarah’s own testimony relates closely with this concept, as she claimed that her hesitancy to receive treatment came from her desire to learn more information instead of jumping hastily into a decision. This idea of not receiving adequate information was also discussed in the “Introduction and Overview” article, in which the authors described how female patients sometimes receive less information than male patients or report feeling dissatisfied with the communication they had with their healthcare providers. This could come from providers being biased and assuming that male patients are better able to understand their diagnoses or treatment options compared to their female counterparts. However, this lack of strong communication can cause women to feel disrespected or underserved, further discouraging them from seeking healthcare services in the future. True to this idea, when I asked Sarah when the last time was that she went to her provider to check on the status of her fibroids, she responded, “about a year [ago].” Sarah admitted to understanding that the fibroids could grow exponentially in that time frame, and claimed that she will go in for a checkup soon, although she did not clarify when that would be. 

In Sarah’s defense, she has made attempts to remedy her lack of knowledge regarding her diagnosis and treatment options. Sarah described going to her husband primarily to help with the situation. “I asked him to ask doctors that he associates with about other options or if they knew of good places to go for the surgery or ablation.” Sarah’s husband also works in a hospital, and she wished to take advantage of his access to multiple healthcare providers and professional opinions. However, she was disappointed to find that he soon forgot about her situation and never followed through with an inquiry. The lack of support Sarah received from her husband was a theme discussed in Dr. Lobel’s lecture on autoimmune disorders, where she discussed how social support from family and friends can play a large role in the recovery process for female patients. In Sarah’s situation, lack of support from the husband has been a contributor for the delay in her treatment, which may lead to more serious consequences if her fibroids grow.

On the bright side, Sarah claims that she has received better support from her friends and co-workers. Dr. Lobel’s lecture mentioned the benefits of having a support group for patients to connect with individuals who have similar diagnoses or experiences. While Sarah did not attend a formal support group for her diagnosis, she was able to discuss her diagnosis with female friends and co-workers who have experienced reproductive complications. These discussions resulted in sympathy and advice in the form of treatment alternatives or gynecologist recommendations that helped Sarah to feel less alone in her journey. While Sarah, unlike many of the women we learned about in lecture, did not report having serious psychological effects as a result of her diagnosis, she was grateful for the support she received from her friends. This type of support, as we’ve learned, can help women feel less alone in their journey of recovery. 

As seen in our lectures and readings, many of the factors impacting Sarah’s experiences are not unique to her. Female patients are often put in difficult circumstances in which their reproductive organs and menstrual health are endangered, often being placed in situations that male patients and physicians cannot personally relate to. Because of this, it is easy for women to feel isolated or unsure about their treatment options. Women are also disproportionately placed in social frameworks that label them as caretakers or being tasked with other social responsibilities, which adds to the delay in proper treatment. This delay can put them in riskier situations as their conditions may either worsen or become more complicated without proper resources. As in Sarah’s case, there may also be circumstances in which treatment options are available but not ideal, which can also lead to delays and uncertainty in patients. Healthcare services should therefore strive to improve their communication and flexibility in treatment options for females with menstrual and other health related complications. Female patients should feel well supported by both their providers and their social structures throughout their healthcare journeys. 


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

by Vineeta Abraham, December 21, 2021

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

Abstract

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

Introduction

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

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

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

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

Methods

Participants

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

Measures

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

Procedure

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

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

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

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

Results

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

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

Figure 1.

Average Final Exam Scores Across Three Math Classes

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

Discussion

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

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

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

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

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


References

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

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

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

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

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

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

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

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. 

COVID-19: A Different Type of Health Concern

by Vineeta Abraham, September 7, 2020

Unprecedented.

Over the past few months, we’ve heard this word used in almost every conversation or speech, and rightly so; COVID-19, coronavirus, the pandemic — however it is referred to, the mere idea of the event that took the country, and the world, by storm could have never been predicted or prepared for. Everyone was caught off guard, from healthcare providers to politicians, scrambling to provide any sort of assurance to the vast majority of Americans that we would be okay. 

But would we? 

In March 2020, everything seemed to shut down almost immediately. Stores were closing, restaurants were putting up “Closed Indefinitely” signs. Even colleges were forced to tell their residents — students who had started to carve their entire lives into their new homes in their college dorms — that they couldn’t live on campus anymore. 

The change was not taken lightly. 

Aside from the obvious results of the unexpected safety measures put into place — lack of preparedness for education, loss of jobs, a general frenzy for necessities, etc — hidden, deeply rooted problems began to unfold as the days of quarantining turned into weeks, then months, before everyone’s eyes. 

Just one of these problems? Mental health. 

The importance and benefits of staying home were extensive. COVID-19 was, and still remains to be, an incredibly dangerous virus with an extremely “wide range of symptoms, ranging from mild to lethal” (Katella). Since no one is “completely immune to the virus,” it’s hard to predict the extent to which this will go until it is no longer a concern (UCI Health). In order to contain the situation, social distancing was, and still is, a must. 

However, people often ignore the very serious downsides of forcing people to stay in homes that they don’t want to be in, and not just because they miss their friends or going out to the mall. 

As shocking as it might seem to some, mental health issues at home are still very prevalent in today’s society, and these were only amplified during the quarantine. Research following past quarantines, such as in Toronto in 2002, shows that people coming out of quarantine felt the effects of “social isolation” and even faced “longer-lasting psychological distress for around a month afterward,” in addition to “almost 29% of participants [displaying] PTSD symptoms, and 31.2% [showing] depressive symptoms” (“How Does Quarantine”). It’s safe to say that these and other effects may be seen when looking at the mental health of people who were expected to quarantine for close to five months. 

In many cases, mental abuse in homes increased as well. The sudden lockdown led to increased tensions as parents began to “respond to their children’s anxious behaviors or demands in aggressive or abusive ways” as a result of increased stress (SAMHSA). Parents were under a lot of stress — stress about the virus, stress about their jobs, and stress coming from the lack of “extended family, child care and schools, religious groups and other community organizations” that they had relied on in the past (SAMHSA). Unfortunately, children and spouses—or other family members—were oftentimes the direct target of their frustration, leading to emotional, mental, and in some cases, physical abuse (SAMHSA). Worst of all, stay at home restrictions left  the victims with nowhere else to go. 

Even though some mental health patients were fortunate enough to have access to therapy through these trying times, it wasn’t nearly the same as what they had expected. In accordance with social distancing rules, “therapists and their patients turned to remote therapy using phones and web cams to continue their sessions,” a shift that presented a whole new array of challenges (Naftulin). While this new method might have been “convenient and accessible,” obstacles such as the “lack of body language reading as one could in an in person session” and general awkwardness for some patients made it difficult for communication to be what the patient or the therapist needed for successful treatment (“The Pros and Cons”). While technology certainly provided a temporary solution the problem, through the use of phone calls and video chatting, virtual therapy simply wasn’t the same as an in-person session. 

It’s now September. Some states are beginning to see better days, like New York, where the rate of infection “has been less than 1% for 30 days — or an entire month” (News). Places are beginning to open up, slowly, and with great caution. People who were stuck at home, stuck inside with some of their worst struggles and thoughts, are slowly beginning to venture out again, filled with hope, or fear, or maybe a mix of both. 

But the problem isn’t over. It’s up to all of us to make sure we don’t return to the state we were in just six months ago. The risks of staying at home are often overlooked in favor of public safety, but we can’t ignore the very real toll another quarantine would have on those suffering from mental health issues. If we’re not careful, we could be forcing people right back into their worst nightmares. 

Stay smart. Wear your masks. Protect yourself, but also protect others. 

Keep each other alive.


Find resources for coping with Mental Health through the pandemic here: 

https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html 
https://www.verywellmind.com/protect-your-mental-health-during-quarantine-4799766


Works Cited

Cherry, Kendra. “How to Cope with Quarantine.” Verywell Mind, 7 Aug. 2020, www.verywellmind.com/protect-your-mental-health-during-quarantine-4799766  

“The Pros and Cons of Online Therapy.” Verywell Mind, 11 May 2020, www.verywellmind.com/advantages-and-disadvantages-of-online-therapy-2795225 

Katella, Kathy. “5 Things Everyone Should Know About the Coronavirus Outbreak.” Yale Medicine, 4 Sept. 2020, www.yalemedicine.org/stories/2019-novel-coronavirus/ 

Naftulin, Julia. “How to Get the Most out of Long-Term Virtual Therapy When You’re Living and Working from Home.” Insider, Insider, 4 May 2020, www.insider.com/how-to-do-longterm-virtual-remote-therapy-2020-4 

News, Eyewitness. “Reopen NY: COVID Infection Rate Stays below 1 Percent for 30 Days.” ABC7 New York, WABC-TV, 6 Sept. 2020, abc7ny.com/reopen-new-york-ny-covid-19-coronavirus/6411561 

SAMHSA. “Intimate Partner Violence and Child Abuse Considerations During COVID-19.” Substance Abuse and Mental Health Services Administration, 2020, www.samhsa.gov/sites/default/files/social-distancing-domestic-violence.pdf UCI Health.

“Why Is COVID-19 So Dangerous?” UCI Health , 29 Apr. 2020, www.ucihealth.org/blog/2020/04/why-is-covid19-so-dangerous