TY - JOUR
T1 - Culture, gender and health care stigma
T2 - Practitioners' response to facial masking experienced by people with Parkinson's disease
AU - Tickle-Degnen, Linda
AU - Zebrowitz, Leslie A.
AU - Ma, Hui ing
N1 - Funding Information:
This study was supported in part by Grant Number NS048059 (PI, Tickle-Degnen; Co-I, Ma; Consultant, Zebrowitz) from the National Institute of Neurological Disorders & Stroke of the U.S. National Institutes of Health under the Fogarty International Center’s Stigma and Global Health Research Program. The authors thank, in Taiwan, Dr. Wen-Juh Hwang (Department of Neurology, National Cheng Kung University) and research assistant Pei-Ching Wu, and, in the U.S., Professor Melanie Matthias (Department of Communication Disorders, Sargent College of Health & Rehabilitation Sciences, Boston University) for consultation on sound editing, and many Boston University and Tufts University research associates and assistants, most notably Pai-chuan Huang. We appreciate the help of the research coordinators at the hospitals and clinics where the study sessions were conducted.
PY - 2011/7
Y1 - 2011/7
N2 - Facial masking in Parkinson's disease is the reduction of automatic and controlled expressive movement of facial musculature, creating an appearance of apathy, social disengagement or compromised cognitive status. Research in western cultures demonstrates that practitioners form negatively biased impressions associated with patient masking. Socio-cultural norms about facial expressivity vary according to culture and gender, yet little research has studied the effect of these factors on practitioners' responses toward patients who vary in facial expressivity. This study evaluated the effect of masking, culture and gender on practitioners' impressions of patient psychological attributes. Practitioners (N = 284) in the United States and Taiwan judged 12 Caucasian American and 12 Asian Taiwanese women and men patients in video clips from interviews. Half of each patient group had a moderate degree of facial masking and the other half had near-normal expressivity. Practitioners in both countries judged patients with higher masking to be more depressed and less sociable, less socially supportive, and less cognitively competent than patients with lower masking. Practitioners were more biased by masking when judging the sociability of the American patients, and American practitioners' judgments of patient sociability were more negatively biased in response to masking than were those of Taiwanese practitioners. Practitioners were more biased by masking when judging the cognitive competence and social supportiveness of the Taiwanese patients, and Taiwanese practitioners' judgments of patient cognitive competence were more negatively biased in response to masking than were those of American practitioners. The negative response to higher masking was stronger in practitioner judgments of women than men patients, particularly American patients. The findings suggest local cultural values as well as ethnic and gender stereotypes operate on practitioners' use of facial expressivity in clinical impression formation.
AB - Facial masking in Parkinson's disease is the reduction of automatic and controlled expressive movement of facial musculature, creating an appearance of apathy, social disengagement or compromised cognitive status. Research in western cultures demonstrates that practitioners form negatively biased impressions associated with patient masking. Socio-cultural norms about facial expressivity vary according to culture and gender, yet little research has studied the effect of these factors on practitioners' responses toward patients who vary in facial expressivity. This study evaluated the effect of masking, culture and gender on practitioners' impressions of patient psychological attributes. Practitioners (N = 284) in the United States and Taiwan judged 12 Caucasian American and 12 Asian Taiwanese women and men patients in video clips from interviews. Half of each patient group had a moderate degree of facial masking and the other half had near-normal expressivity. Practitioners in both countries judged patients with higher masking to be more depressed and less sociable, less socially supportive, and less cognitively competent than patients with lower masking. Practitioners were more biased by masking when judging the sociability of the American patients, and American practitioners' judgments of patient sociability were more negatively biased in response to masking than were those of Taiwanese practitioners. Practitioners were more biased by masking when judging the cognitive competence and social supportiveness of the Taiwanese patients, and Taiwanese practitioners' judgments of patient cognitive competence were more negatively biased in response to masking than were those of American practitioners. The negative response to higher masking was stronger in practitioner judgments of women than men patients, particularly American patients. The findings suggest local cultural values as well as ethnic and gender stereotypes operate on practitioners' use of facial expressivity in clinical impression formation.
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U2 - 10.1016/j.socscimed.2011.05.008
DO - 10.1016/j.socscimed.2011.05.008
M3 - Article
C2 - 21664737
AN - SCOPUS:79959594728
SN - 0277-9536
VL - 73
SP - 95
EP - 102
JO - Social Science and Medicine
JF - Social Science and Medicine
IS - 1
ER -