Deconfounding the effects of dominance and social acceptance on self-esteem.

Three studies examined the independent effects of social acceptance and dominance on self-esteem. In Studies 1 and 2, participants received false feedback regarding their relative acceptance and dominance in a laboratory group, and state self-esteem was assessed. Results indicated that acceptance and dominance feedback had independent effects on self-esteem. Study 2 showed that these effects were not moderated by individual differences in participants' self-reported responsivity to being accepted versus dominant. In Study 3, participants completed multiple measures of perceived dominance, perceived acceptance, and trait self-esteem. Results showed that both perceived dominance and perceived acceptance accounted for unique variance in trait self-esteem, but that perceived acceptance consistently accounted for substantially more variance than perceived dominance. Also, trait self-esteem was related to the degree to which participants felt accepted by specific people in their lives, but not to the degree to which participants thought those individuals perceived them as dominant.

Social coping strategies associated with quality of life decrements among psoriasis patients.

BACKGROUND: Individuals with psoriasis often report significant psychological distress, physical disability, social strain and reduced quality of life. Little is known about how they cope with the illness. OBJECTIVE: The primary aim of this study is to determine whether patients' efforts to cope with psoriasis are associated with better or worse health-related quality of life (HRQL). METHODS: Focus groups identified seven commonly used coping strategies that were subsequently measured, along with HRQL and other variables, in a survey of 318 individuals with psoriasis. RESULTS: Results revealed: (i) that psoriasis is associated with decrements in all quality of life domains that were assessed, and (ii) that commonly used coping strategies such as telling others about psoriasis, covering the lesions and avoiding people were associated with greater decrements in HRQL after controlling for covariates; however, telling others that psoriasis is not contagious was associated with smaller HRQL decreases. CONCLUSIONS: How patients cope with the social aspects of psoriasis is associated with their quality of life.

Role of self-presentation in the health practices of a sample of Irish adolescents.

The association between self-presentational motives and health behaviors were studied in a sample of 183 Irish adolescents. Among girls, dieters and nonexercisers scored higher on measures of trait self-presentational concern than nondieters and exercisers. Self-presentational concerns were positively correlated with boys' and girls' endorsement of self-presentational motives for certain health practices.

Evolutionary origins of stigmatization: the functions of social exclusion.

A reconceptualization of stigma is presented that changes the emphasis from the devaluation of an individual's identity to the process by which individuals who satisfy certain criteria come to be excluded from various kinds of social interactions. The authors propose that phenomena currently placed under the general rubric of stigma involve a set of distinct psychological systems designed by natural selection to solve specific problems associated with sociality. In particular, the authors suggest that human beings possess cognitive adaptations designed to cause them to avoid poor social exchange partners, join cooperative groups (for purposes of between-group competition and exploitation), and avoid contact with those who are differentially likely to carry communicable pathogens. The evolutionary view contributes to the current conceptualization of stigma by providing an account of the ultimate function of stigmatization and helping to explain its consensual nature.

The impostor phenomenon: self-perceptions, reflected appraisals, and interpersonal strategies.

Three studies tested theoretical assumptions regarding the impostor phenomenon. In Study 1, participants completed measures of impostorism, rated themselves, and indicated how they thought other people regarded them. Contrary to standard conceptualizations of impostorism, high impostors were characterized by a combination of low self-appraisals and low reflected appraisals. Study 2 was an experiment designed to determine whether the behaviors associated with the impostor phenomenon are interpersonal strategies. Participants were told that they were expected to perform either better or worse than they had previously predicted on an upcoming test, then expressed their reactions anonymously or publicly. High impostors expressed lower performance expectations than low impostors only when their responses were public. When expectations for performance were low, participants high in impostorism responded differently under public than private conditions. Study 3 examined the possibility that high scores on measures of impostorism may reflect two types of impostors--true impostors (who believe that others perceive them too positively) and strategic impostors (who only claim that they are not as good as other people think). The results did not support this distinction; however, evidence for the strategic nature of impostorism was again obtained. Although people may experience true feelings of impostorism, these studies suggest that the characteristics attributed to so-called impostors are partly interpersonal, self-presentational behaviors designed to minimize the implications of poor performance.

Interpersonal concerns and psychological difficulties of psoriasis patients: effects of disease severity and fear of negative evaluation.

Psoriasis creates interpersonal difficulties for many sufferers, but little research has examined factors that contribute to the degree of social and psychological disability that a particular person experiences. In all, 318 psoriasis patients completed measures of psychological and social well-being, the severity of their psoriasis, and their dispositional level of fear of negative evaluation (FNE). Analyses showed that disease severity and FNE significantly predicted perceptions of being stigmatized, interpersonal discomfort, stress over others' reactions, distress regarding the observable symptoms of the disease, the degree to which psoriasis interfered with the patients' lives, and patients' quality of life. Furthermore, FNE exerted a particularly strong influence for patients who had severe cases of psoriasis.

Calibrating the sociometer: the relationship between interpersonal appraisals and state self-esteem.

Four experiments examined the functional relationship between interpersonal appraisal and subjective feelings about oneself. Participants imagined receiving one of several positive or negative reactions from another person (Experiments 1, 2, and 3) or actually received interpersonal evaluations (Experiment 4), then completed measures relevant to state self-esteem. All 4 studies showed that subjective feelings were a curvilinear, ogival function of others' appraisals. Although trait self-esteem correlated with state reactions as a main effect, it did not moderate participants' reactions to interpersonal feedback.

Appearance Motivation, Obsessive-compulsive Tendencies and Excessive Suntanning in a Community Sample.

Measures of appearance motivation, obsessive-compulsive tendencies and tanning attitudes and behavior were completed by 175 adults, ages 16-65, who were approached while suntanning. Participants who scored high in both appearance motivation and obsessive-compulsive tendencies most strongly endorsed the importance of having a tan, spent the most time in the sun, were least likely to use sunscreen and were more likely to use tanning beds. In contrast, low-appearance motivation combined with high obsession- compulsion was associated with safe-sun practices.

Moving on: autism and movement disturbance.

Many authors have reported on the presence of movement disturbance symptoms in some individuals with autism. Typically, these symptoms have been seen as peripheral to autism or as belonging to a co-occurring syndrome. Some have dismissed these symptoms as having no apparent impact on the presence of behaviors defined as the core characteristics of autism. In this article we considered the relation between symptoms of movement disturbance and symptoms of autism and included our speculative and exploratory analyses of shared symptoms. The analyses point out the difficulties posed by current definitions of autism. We proposed that symptoms of movement disturbance can affect a person's experience of life and how he or she may be perceived by others.

The need to belong: desire for interpersonal attachments as a fundamental human motivation.

A hypothesized need to form and maintain strong, stable interpersonal relationships is evaluated in light of the empirical literature. The need is for frequent, nonaversive interactions within an ongoing relational bond. Consistent with the belongingness hypothesis, people form social attachments readily under most conditions and resist the dissolution of existing bonds. Belongingness appears to have multiple and strong effects on emotional patterns and on cognitive processes. Lack of attachments is linked to a variety of ill effects on health, adjustment, and well-being. Other evidence, such as that concerning satiation, substitution, and behavioral consequences, is likewise consistent with the hypothesized motivation. Several seeming counterexamples turned out not to disconfirm the hypothesis. Existing evidence supports the hypothesis that the need to belong is a powerful, fundamental, and extremely pervasive motivation.

Self-presentation can be hazardous to your health: impression management and health risk.

People's concerns with how others perceive and evaluate them can lead to behaviors that increase the risk of illness and injury. This article reviews evidence that self-presentation motives play a role in several health problems, including HIV infection; skin cancer; malnutrition and eating disorders; alcohol, tobacco, and drug use; injuries and accidental death; failure to exercise; and acne. The implications of a self-presentational perspective for research in health psychology, the promotion of healthful behaviors, and health care delivery are discussed.

Self-presentation in everyday interactions: effects of target familiarity and gender composition.

This study examined people's self-presentation motives in unstructured, everyday social interaction as a function of participants' gender similarity to, and general familiarity with, the targets of their self-presentations. Participants maintained a variant of the Rochester Interaction Record for 1 week. For every interaction that lasted 10 min or more, they rated the degree to which they wanted to make each of 4 impressions (likable, competent, ethical, and attractive), how much they thought about the impressions others in the interaction formed of them, and how nervous they felt in the interaction. In general, participants' self-presentational motives were lower in interactions with highly familiar people of their own sex than they were either in interactions with less familiar people of their sex or in interactions with people of the other sex regardless of familiarity. When participants' interactions with only their 3 most familiar interactants were examined, self-presentational concerns decreased with familiarity in same-sex interactions but increased with familiarity in cross-sex interactions.

Effects of appearance-based admonitions against sun exposure on tanning intentions in young adults.

This experiment compared the effectiveness of health-based versus appearance-based messages on university students' intentions to protect their skin against the sun's damaging rays. One hundred thirty-four Ss completed a measure of appearance motivation, then responded to 1 of 3 essays about tanning and skin cancer. One essay described the health risks of excessive sun exposure, one essay discussed the deleterious effects of tanning on physical appearance, and a control essay described the process by which tanning occurs. Overall, the essay that dealt with the negative effects of the sun on appearance was most effective in promoting intentions to practice safe-sun behaviors. However, the appearance-based essay was effective primarily among Ss who were low rather than high in appearance motivation.

The Interaction Anxiousness Scale: construct and criterion-related validity.

This article presents data regarding the validity and reliability of the Interaction Anxiousness Scale (IAS; Leary 1983c), a self-report measure of dispositional social anxiety. The IAS demonstrates high test-retest and internal reliability. Correlations with measures relevant to social and general anxiety document its convergent and discriminant validity, and it correlates well with measures of anxiety and interpersonal concern in actual interactions.

Anatomic and physiological bases of social blushing: speculations from neurology and psychology.

Although a common and occasionally troubling reaction, social blushing has received little systematic attention from either medical or behavioral researchers. This article reviews what is known of the physiological and psychological processes that mediate social blushing, and speculates regarding the role of central mechanisms in the phenomenon. Blushing is characterized by the unusual combination of cutaneous vasodilatation of the face, neck, and ears, accompanied by activation of the sympathetic nervous system. Psychologically, blushing appears to occur when people receive undesired social attention from others and may be analogous to the appeasement displays observed in non-human primates. Although poorly understood, the central mechanisms that mediate blushing obviously involve both involuntary autonomic effector systems and higher areas that involve self-reflective thought. Questions for future research are suggested.

Social blushing.

This article reviews theory and research regarding the physiology, situational and dispositional antecedents, behavioral concomitants, and interpersonal consequences of social blushing and offers a new theoretical account of blushing. This model posits that people blush when they experience undesired social attention. Puzzling questions involving blushing in solitude, the phenomenology of blushing, types of blushing, and blushing in dark-skinned people are discussed.

From quality assurance to quality improvement. The Joint Commission on Accreditation of Healthcare Organizations and Emergency Care.

The transition from quality assurance to quality improvement is at an early stage, but it clearly has begun. The progressive anticipated changes in the tone and content of JCAHO standards will place the JCAHO in a different posture in relation to accredited hospitals. Standards are of course a set of requirements that must be met as a condition of accreditation. But the JCAHO's bottom line expectation will be a meaningful and demonstrated improvement in hospital performance. How hospitals reach this objective is their business. This shifts the onus of responsibility to where it belongs and suggests a more facilitative role for the JCAHO. Although the JCAHO is introducing standards requirements that are minimally essential to the achievement of improved performance, full-fledged adoption of CQI concepts will not be mandated. Management structures and styles in health care organizations vary considerably, and CQI is but one means to the desired end of improved performance. We believe, however, that it is the best means and that most organizations will discover this for themselves. Notwithstanding the magnitude of needed internal behavioral change, excellence in performance is what most health care organizations want for themselves and their patients. CQI offers them the opportunity to reach this lofty goal.

Perceived control, drive for thinness, and food consumption: anorexic tendencies as displaced reactance.

Although loss of perceived control has been implicated in the development of eating disorders, previous research has not directly tested the relationship between perceived control and food consumption. This study investigated the hypothesis that individuals with anorexic tendencies react to low perceived control by restricting food intake as a means of regaining a sense of control. Forty female undergraduates who scored either low or high on the Drive for Thinness Scale (Garner & Olmsted, 1984) were led to believe they would be participating in two separate studies. Perceived control was experimentally manipulated such that half of the subjects experienced low control and half experienced high control over a social situation. Under the guise of a second experiment, subjects tasted breakfast cereals and completed measures relevant to eating and body image. Results showed that subjects who were high in drive for thinness (DT) who experienced low control ate less sweetened cereal and planned to eat less at dinner than high DT subjects who experienced high control. Low DT subjects were unaffected by the control manipulation. The results are discussed in terms of displaced reactance.

Subclavian artery false aneurysm associated with brachial plexus palsy: a complication of parenteral drug addiction.

A 35-year-old female drug addict developed a painful left supraclavicular swelling and profound left arm weakness associated with left hand paresthesia and swelling after cocaine injection into the left base of her neck. Arteriogram confirmed a 3.7-cm false aneurysm of the left subclavian artery and a filling defect of the proximal left axillary artery. Emergent intraoperative treatment consisted of false aneurysm resection, embolectomy, and placement of a prosthetic graft. Distal circulation was restored, but the neurological deficit persisted in the left arm and a fever developed in the patient, necessitating rehospitalization 3 weeks after discharge. False aneurysm, a vascular complication of parenteral drug abuse, may lead precipitously to death by exsanguination if not efficiently and effectively diagnosed and treated.