When the enemy is invisible... Implicit biases against women in hiring

Photo by NASA on Unsplash

We live in a #HeForShe world of #WonderWoman and #girlpower. Today, more women hold positions of leadership and power than ever before in U.S. history and society is the direct recipient of those changes. Yet, there are still industries where women with the same qualifications as their male colleagues are not given the same opportunities. You could support that statement with factoids, such as the fact that more than 825 men have won a Nobel Prize compared to only 47 women. Or, you could support this statement with science. 

In 2013, Dr. Corinne Moss-Racusin and her colleagues at Yale University published a study testing the question: 

Are scientists biased against female applicants to jobs? 

If so, this may explain the imbalance of male and female scientists. To test this question, they recruited  127 professors in Biology, Chemistry, and Physics at 6 research-intensive universities; 3 were public and 3 were private. These professors were asked to provide feedback on the application materials of an undergraduate science student who wanted to pursue a Ph.D. in their field. What's important is that each faculty member believed that they were providing feedback on a real student who wanted to pursue their career path, and that the student would receive this feedback in order to aid them in reaching this goal. 

The professors were then randomly assigned to receive one of two sets of application materials. These two sets of application materials were identical, in that they included the same exact details of a highly competitive student with some ambiguity with regard to their competence to do independent research. This is by far the most common type of application we get as professors, and is also the type of student whose eventual success will depend largely upon whether a professor is willing to mentor and train them. The difference between the two applications was that one of the applicants was named Jennifer, or a presumably female applicant, and the other was named John, a presumably male applicant. 

The professors were asked to rate the applicant's competence, the likelihood that they would be interested in hiring the student, estimate an annual starting salary of the applicant, and report the amount of mentoring they would provide to the applicant. At the end of the study, these professors were debriefed about the study and none of them knew that the application materials they reviewed were not of a real student. 

From this data, they wanted to test several hypotheses, including the following:  

1) That applications with the name John would be rated as more competent and more likely to be mentored and hired, at higher salaries than the applications with the name Jennifer. 

2) That #1 would not depend on whether the professor rating the applicant was male or female. 

They found that applications for John were rated as significantly more competent,and professors indicated that they were more likely to hire and provide more mentoring to John. Professors also indicated that the starting salary for John should be between $29,000 and $31,000 per year whereas Jennifer's should be between $25,500 and $27,500. This pattern did not vary based on whether the professor rating the applications was male or female, whether they were old or young, nor whether the professor already had tenure. 

Photo by Samantha Sophia on Unsplash

The conclusion from the study was that there is an implicit bias against women applying to positions in science that keeps very competent women from getting entry-level positions. In general, this comes down to the question of whether our society cultivates the perception that women are inherently less competent that men, despite having the same experiences and accomplishments. If so, how to we cultivate a different perception? 

In psychology, we like to drill down into problems like this to determine where they come from and how we can fix them. One way to do this is to test whether and to what degree individuals have an automatic, or implicit bias to associate women with positions of subordinance. It's possible that just knowing that you have such a bias is enough to change your behavior enough to make a difference. 

This is important because there are many ways that a social narrative that women are better suited for positions of subordinance can lead women to behave subordinately and men to treat women as subordinants. The ways women perpetuate this review is expertly outlined in books like Sheryl Sandberg's Lean In. 

If you're interested in knowing whether you are implicitly biased in this particular way, spend just a few minutes to take this test. Knowledge is power people!  If you find that you do, there may be some small ways you can combat these types of bias, especially if you ever operate as a gatekeeper to opportunities for training and jobs. The truth is, only we suffer by biases like this. If we want to solve the problems of the universe, we need the best minds to do it. 

Moss-Racusin, C. A., Dovidio, J. F., Brescoll, V. L., Graham, M. J., & Handelsman, J. (2012). Science faculty’s subtle gender biases favor male students. Proceedings of the National Academy of Sciences, 109(41), 16474-16479.

How to be curious.

This week marks the launch of The Positivity Project in 33 schools across 12 different states in the US. Each week, the Positivity Project will introduce 1 of the 24 character strengths that make up the fabric of humanity. The team at The Positivity Project will support teachers, educators, parents, and students in learning how to cultivate each of these strengths with the goal of improving relationships between children and their schools, parents, and local communities. The character strength that will kick off the year is CURIOSITY. 

The first step to cultivating a strength is defining it. Curiosity is a fascinating psychological phenomena to say the least. In preparing this article I found that no one I know has the same definition for curiosity, and depending on the definition you use, the result of cultivating curiosity is very different. 

For example, Drs. Christopher Hsee, University of Chicago, and Bowen Ruan, University of Wisconsin-Madison, recently conducted a study examining the role of curiosity in human behavior. In particular, they conducted 4 experiments to address the question: 

Can curiosity be dangerous?

To answer this question, 54 adults (24 women) who were given a box of 10 ballpoint pens that may or may not deliver an electric shock when clicked. Each participant was randomly assigned to one of two conditions: certain or uncertain. In the certain condition, each pen had a sticker indicating whether the pen would shock them or not shock them if clicked. In the uncertain condition, all pens had the same sticker and the participants were told that the pens may or may not have batteries in them. The research team told the participants that they can click the pens if they wanted to "kill time" while waiting for another part of a different experiment, and then counted how many pens each participant clicked. 

People in the uncertain condition clicked more pens than the participants in the certain condition. The researchers interpreted this as evidence that curiosity might be the human desire to resolve uncertainty, and this desire may lead individuals to expose themselves to danger, or at least pain. 

Then, the research team conducted this same study again with 30 new participants. This time, all participants received the uncertain and certain conditions. To do this, some of the pens had red stickers (shock), some had green stickers (no shock), and some had yellow (uncertain). They counted how many of each type of pen each person clicked. 

Again, they found that people clicked more of the yellow sticker-ed pens than the other two types. And again, the researchers interpreted their results as evidence that curiosity may lead people to expose themselves to danger in order to resolve uncertainty. Indeed, the participants rated their experience of the shocks as negative.  

The research team then conducted 2 more follow-up studies. They changed the potential negative outcome to the sound of nails on a chalkboard in order to show that the effect is not specific to electric shocks. They also included measures of participants' feelings. Participants again were more likely to click on uncertain options even though the uncertain options were likely to expose them to negative sounds, and the more exposure they had to these negative sounds, the worse they felt. Yet, if people were given the option of predicting whether clicking the uncertain button would positively or negatively impact their mood, they were less likely to choose to resolve the uncertainty. 


In review, we are driven to resolve uncertainty at the expense of our mood and the potential for danger. This may be the ugly side of curiosity.  

On the other hand, the VIA Institute on Character defines curiosity as being interested in exploring new ideas, activities, and experiences and having a strong desire to increase their own personal knowledge. In short, they advise that the best way to cultivate curiosity is to "ask questions, and lots of them." 

If we think about both definitions, it seems that both highlight the search for information. What may distinguish curiosity of human nature from curiosity as a character strength is the goal of that search. Are you curious to resolve uncertainty or to add to your personal understanding? If you follow-up your curious urges with "why do I want to know/do this?" and the only answer is "because I just want to know," your curiosity may simply be rooted in human nature. This isn't a bad thing. There are a million reasons that the drive to resolve uncertainty was essential to survival. Think about how we know whether we can fly, which plants are poisonous and tasty, that fire causes pain. The tribe benefits from some people being willing to take these risks. 

Now that we have those basics worked out, it is our job to cultivate curiosity as a character strength. Practice the art of understanding why and how new knowledge will improve your understanding of yourself and the world. Teach children to understand what drives their curiosity. It is this nuanced understanding of how to be curious that will make the difference between practicing curiosity that has negative consequences for mood and safety and practicing curiosity that will lead to the good life filled with strong relationships and purpose. 

To learn more about The Positivity Project, click here.  Many thanks to unsplash for the curious photos. 

Hsee, C. K., & Ruan, B. (2016). The Pandora Effect The Power and Peril of Curiosity. Psychological science, 27(5), 659-666.

Does your personality fit your city? Does it matter?

Where do you live? Why do you live there? For most people, choice of where to live comes down to a few obvious and important factors: family, job, money. Have you ever wondered whether your self-esteem takes a hit when you live in a city that doesn't jive with your personality? Psychologists have. 

Just last month, Dr. Weibke Bleidorn, University of California Davis, and colleagues published a study looking at the whether a person's self esteem varies as a function of the fit between a their personality and the personality of their city  To do this, they used data collected online from the Gosling-Potter Internet Personality Project between December 1998 and December 2009. Participants in this study were between the ages of 16-60 and were included in the study if they lived in a city (based on self-reported zip code) that had at least 199 other respondents. The resulting sample included data from 543,934 individuals living in 860 cities in the United States. 

The online questionnaire included measures of personality and self-esteem. Psychologists typically measure personality across 5 dimensions: openness, conscientiousness, extroversion, agreeableness, and emotional stability (also known as neuroticism). Click here for Wikipedia's definition of each of these domains of personality. Each participant answered 44 questions whose answers placed them on a continuum for each of these domains. If you're interested, you can take the test for free here. To measure self-esteem they asked participants to indicate the degree to which they agreed with the statement, "I see myself as someone who has high self-esteem," on a scale from 1 (strongly disagree) to 5 (strongly agree). As simple as it sounds, self-esteem used to be measured in psychology research using more questions, but this single item tends to be all you need to ask. 

With this data, the research team was able to compute scores for the personality of each participant, as well as scores for each of the 860 cities represented. Using these scores, they were then able to disentangle the contributions of an individual's personality, their city's personality, and person-city personality match as predictors of self-esteem. Not surprisingly, the more emotionally stable (less neurotic), extroverted, open, agreeable, and conscientious a person was, the higher their self-esteem. Interestingly, individuals who lived in cites where the average person was higher in emotional stability, lower in openness, higher in agreeableness, and higher in conscientiousness, the higher their self-esteem. However, these weren't necessarily the question the researchers wanted to answer. The research team was more interested in whether fit between an individual and that of others in their city was important for self-esteem. 

As it turns out, it is, but only for openness, agreeableness, and conscientiousness. They found that individuals higher in openness have higher self-esteem when living in cities filled with open people, people higher in agreeableness report higher self-esteem when they live in cities filled with agreeable people, and people higher in conscientiousness report higher self-esteem when living in cities filled with conscientious people. But also, the other side of that coin may be true; less open people may have higher self-esteem in cities with less open people. 

So what might this mean for all of us wherever we live, by chance or by choice, and/or who may have to decide where to live in the future? Well, it means that there are many contributors to our self-esteem. First is our personality, but also the personalities of those around us. As a clinical psychologist, I can't help but point out that this means there are many pathways to higher self-esteem. One can practice emotional stability, conscientiousness, agreeableness, extroversion, and openness. One can seek out cities that promote emotional stability, agreeableness, and conscientiousness in their potential and current residents. Look to their elected officials, their mascots, their city-sponsored events. And as a result of this study, one can learn to appreciate his/her own personality strengths and seek out cities that are matched in those qualities (particularly openness, agreeableness, and conscientiousness). 

There are limitations to the conclusions we can draw from this study. In particular, there is no way to rule out the possibility that having higher self-esteem influences a person's personality and also the cities they choose to live in. Nevertheless, self-esteem is an important psychological resource that psychologists want to understand how to cultivate in individuals and societies alike. So here it is sensible to try and understand what predicts self-esteem, rather than what self-esteem predicts. Hopefully, the next time you consider moving to a new city, you will think about more than just the practicalities of living there but also the personalities of its residents before you sign on the dotted line. It matters. 

Bleidorn, W., Schönbrodt, F., Gebauer, J. E., Rentfrow, P. J., Potter, J., & Gosling, S. D. (2016). To Live Among Like-Minded Others Exploring the Links Between Person-City Personality Fit and Self-Esteem. Psychological science, 27(3), 419-427.

Our gratitude to unsplash  for the beautiful photos. 

Does Google know about a suicide before it happens?

According to the CDC, suicide is in the top 10 leading causes of death for people in the United States between the ages of 10 and 64. Among individuals in age groups 10-14, 15-24, and 25-34, it is the 2nd leading cause of death. In the year 2014 alone, we lost 42,772 Americans to suicide. Truthfully, this is probably somewhat of an underestimate because suicide is often miscategorized by as "unintentional injury," leading to false records.

If you are a clinical psychologist, you spend a lot of time thinking about ways to detect when a patient is entertaining thoughts that life is no longer worth living. Unfortunately, many completed suicides are unpredictable, and occur in moments where extreme hopelessness intersects with impulse and access to means. As a field there are many brilliant scientists and clinicians working on ways to identify and help individuals at this extreme of human suffering.

Among them is Dr. Christine Ma-Kellams, University of La Verne, and colleagues who were interested in understanding whether Google search trends can be used to predict suicide, and whether these trends are more effective in predicting suicide rates than our existing measures.

To answer this question, they pulled together data from several different sources. First, they found data from the CDC National Vital Statistics System on the number of completed suicides in the United States. From the U.S. Census Bureau, she collected demographic data that included information like income, population, home-ownership rates, unemployment, and percent of the population under the poverty line,  age, and racial categories. From the National Survey on Drug Use and Health, they collected nationally representative data on suicide vulnerability as reported on the existing gold-standard, clinical measures for suicide risk. Finally, from Google trends, they recorded the relative frequency of google searches for the terms "suicide," "how to suicide," "how to kill yourself," and "painless suicide" compared to the search term "weather." All of the data used in the study were from the years 2008-2009.

They found that the frequency of these Google search terms was significantly associated with the rate of completed suicides recorded by the CDC. They also found that frequency of these search terms was more predictive of suicide rates than the existing self-report measures we use to estimate suicide risk.

The Google search terms weren't perfect, though. They were less effective at accurately predicting suicide rates in states with lower incomes, higher crime rates, and a larger minority population. Also, it's important to acknowledge the limitations of this study. Even though this data was pulled from many different sources, is nationally representative, and cover two years, there is no way for us to know which direction the effect is going. We think these data mean that people are searching for "how to commit suicide" and then those same people are completing suicide, but it is just as plausible that individuals completed suicide, and then people in their community went online and searched for these terms. It is true that a single suicide in a community can inspire increases in discussions of suicide among the members of that community, but either way the problem to be solved is the same. Find a way to help people who feel like life isn't worth living, and prevent suicide. Google can help us find those people.

So, what does this mean? Google knows where you've been, where you're going, what you want, and how you want it. As it turns out, Google also knows who is thinking of committing suicide. Knowledge is power, and here power is life. Google is already implementing the use of sponsored ads for suicide hotlines that target individuals searching for terms just like the ones in this research study. But we are only at the beginning of understanding how to leverage this type of data in ways that can save lives. For example, can we target specific communities in the wake of a tragedy or disaster when suicide rates increase? Can we create sophisticated programs for online chatting for people going through a moment of hopelessness? Can we use the data to identify communities for whom more mental health resources would prevent these feelings of hopelessness? What ideas do you have about how to harness the power of the internet to reduce suicide rates?

Need Help? Know someone who does? Contact the National Suicide Prevention Lifeline
at 1-800-273-TALK (1-800-273-8255) or use the online Lifeline Crisis Chat.  You’ll be connected to a skilled, trained counselor in your area. Both are free and confidential. For more information, visit National Suicide Prevention Lifeline
Ma-Kellams, C., Or, F., Baek, J. H., & Kawachi, I. (2015). Rethinking Suicide Surveillance Google Search Data and Self-Reported Suicidality Differentially Estimate Completed Suicide Risk. Clinical Psychological Science, 2167702615593475.

Photo credit: Garrett Sears via www.unsplash.com

How Dogs Highjack Your Brain with Love Hormones

A little over 3 years ago, we rescued this puppy and named him Tolstoi. I have had dogs most of my life, so I have always taken for granted that special bond one has with a pet. However, Tolstoi is my husband's first dog, and watching that bond develop so quickly and so deeply was quite a special experience.

Dogs are wonderful in so many ways, and I've written about some of the ways dogs can enhance your health here. This week I thought I would share some recent #justplaincool research on the neuroscience behind the human-dog bond. 

There is a hormone in all mammal brains called oxytocin. Oxytocin is thought to play an important role in relationships. For example, oxytocin surges during cuddling and other intimate activities, in mothers when meeting their new infant for the first time, and while breastfeeding. I won't pretend that we fully understand the ins and out of oxytocin yet, but that's what makes science so exciting. 

Anyway, we have a pretty good understanding that the amount of oxytocin in your system fluctuates in ways that are salient to relationships, but so far those relationships have always been within the same species; human-human, rodent-rodent. Wouldn't it be cool if the neuroscience of how humans bonded with their dogs was dependent on the same processes through which humans bonded with other humans? Well, apparently that's exactly what happens. 

Dr. Miho Nagasawa, Azabu University, and her colleagues were interested in whether oxytocin in the body changes in humans and dogs when interacting with one another. To understand this, they recruited 55 healthy individuals and their dogs. All participants provided a urine sample and then were randomized to one of two conditions. Urine is one place you can measure oxytocin. In the first condition, participants were told to play with their dog for 30 minutes. In the other condition, participants were told not to look directly at their dog for 30 minutes. At the end of the 30 minute experimental condition, participants provided another urine sample. 

They found that the owners and their dogs that interacted during the 30 minutes showed large increases in oxytocin before and after the experiment. They also found that the largest increases in oxytocin occurred in owners who dogs initiated "gazes" with them frequently. This likely means that humans experience a similar neurochemical signal  when bonding with their dogs as with other humans, but that this signalling varies based on how much time owners and their dogs spend looking at eachother. 

My first thought when reading this finding was, well sure. Humans are very bonded with their dogs, and maybe surges of oxytocin just occur with humans interact with anything they are bonded with. Then I wondered whether the dogs experience this same surge in oxytocin. Luckily, Dr. Nagasawa has also conducted that study. 

In the 2nd study, they use the same procedure only this time they included a comparison group of hand-raised wolves and measured oxytocin in the urine of the canines in addition to their owners. They found that the increase in oxytocin after 30 minutes of interacting with their owner occurred in dogs but not wolves, and that the magnitude of oxytocin change was directly related to the length of time the owner and dog gazed at one another. 

Gazing is interesting for several reasons. We tend to take it for granted as a form of communication, but mutual gazing is considered the most fundamental manifestation of social attachment, especially between a mother and infant. Dogs and humans can't communicate verbally, so they rely on engaging socially with humans in other ways that tend to mirror how humans interact with their infant offspring. Another fun fact I learned from these articles was that dogs are apparently more skilled at using human social communicative behaviors than their will counterparts, wolves, but also chimpanzees. This suggests that dogs are uniquely capable of bonding with humans in ways no other species can.  

So basically, the next time Tolstoi stares at me, he communicating with me in a way that send natural "love drugs" throughout my brain to ensure I will keep taking care of him. Sneaky puppy, but man is it powerful. 

Unfortunately, some dogs havent been lucky enough to get rescued yet. If you want your brain highjacked with love hormones, some of these guys are up for the job. 

Nagasawa, M., Kikusui, T., Onaka, T., & Ohta, M. (2009). Dog's gaze at its owner increases owner's urinary oxytocin during social interaction. Hormones and Behavior, 55(3), 434-441.

Nagasawa, M., Mitsui, S., En, S., Ohtani, N., Ohta, M., Sakuma, Y., ... & Kikusui, T. (2015). Oxytocin-gaze positive loop and the coevolution of human-dog bonds. Science, 348(6232), 333-336.

Mama Bear: Ever wonder whether breastfeeding changed your behavior?

This week’s article highlights many of the fun things we do in psychology research. Of course, it started with a question:

Does breastfeeding increase aggression?

Many lactating animals (e.g., mice, rats, prairie voles, hamsters, lions, domestic cats, rabbits, squirrels, and domestic sheep) are more aggressive than their non-lactating peers. In animals, lactation increases aggressive behavior, and reduces physiological responses to stress. This makes sense because for many animal, and even humans until 100 years ago, many infants didn't survive. Lactation is a way for the mother's body to know that there is an infant to still take care of. However, humans have built societies and homes, invented seatbelts, and established food protection standards. So, it remains to be documented whether human women become more aggressive after having a baby, and what physiological processes support this change in behavior.

To answer this question, Dr. Jennifer Hahn-Holbrook, now a professor at Chapman University, and her colleagues conducted a very cool experiment to understand whether breastfeeding women are more aggressive, and whether that aggression is accounted for by reduced physiological responses to stress.

To do this, they recruited three groups of women: 20 women with infants between 3-6 months who were exclusively breast-feeding, 20 women with infants between 3-6 months who were feeding their infant a mix of breast milk and formula, and 20 women who had never had a baby. The women came to the laboratory and met what we call a “confederate.” A confederate is a person introduced to the participants as another participant, but in actuality is part of the experiment. The confederate was trained to be rude. Rude behavior involved ignoring the actual participant, chewing gum, and checking their cell phone during the experiment instructions. This was intended to cause the actual participants to make what psychologists call fundamental attribution error, or the tendency to place an undue emphasis on internal characteristics (personality) to explain someone else’s behavior in a given situation rather than considering the situation’s external factors. For example, when you cut someone off you know it’s because you are late and would otherwise miss your exit. When someone else cuts you off, it’s because they are a jerk.

The participants were then instructed to play a game against the other “participant” that involved reaction time. Fastest person to respond wins. The winner of each round got to push a button that released a loud sound at the loser. The participant controlled the volume (up to 150 decibels) and duration (up to 5 seconds) of the sound with their button push. After 8 rounds of the game, participants fed their babies (breastfed, formula fed) or took a break if they were in the non-mother control group. Then, the participants played the game again for another 8 rounds. The mothers’ blood pressure was monitored and recorded throughout the entire procedure.

They found that breastfeeding mothers delivered longer and louder aversive sounds to their rude competitors, compared to both the mixed-feeding mothers and the non-mothers. They also found that breastfeeding women had smaller increases in blood pressure (a measure of stress) while playing the competitive game than women in either of the other groups.

The research team concluded by saying that women who are breastfeeding, not just new moms, were more likely to be aggressive than women who are not. Supporting this idea, they found that there was a significant positive correlation between aggression during the game and the percent of the infant’s diet that was breastmilk (as a measure of how much the mother is lactating). Therefore, they believe that the physiology that supports lactation in new moms supports aggressive behavior that is protective to the infant. And further, lactating mothers show a reduced response to stress, which likely helps facilitate aggression in times of threat and competition.

So, what can we take away from this? I think on a very basic level, knowledge is power. If you or someone you know is breastfeeding, they are likely to be more aggressive than they are usually, and more aggressive than other people. This is normal and adaptive. Don’t hold it against them or yourself. Aggression has many different dimensions. In this study it was the force with which women delivered aversive sounds to competitors, like a punishment. But what might this behavior look like outside of the laboratory? Potentially, it’s perceiving other people as a threat, competing with other moms for no apparent reason, delivering unusually harsh punishments to your partner or older children for potential threats to the new baby. Just remember, increases in aggression are normal, and being driven by the many, many changes to your physiology that allowed you to have the baby and care for it in the first place.

In these modern times, we take for granted all of the physiological changes that come with being able to sustain a pregnancy, have a baby, and breastfeed that have been promoting human survival for thousands of years. As a result, many women don’t learn about these physiological changes until they are going through it, and society doesn’t do much to support them. Don’t be part of that problem.

Hahn-Holbrook, J., Holt-Lunstad, J., Holbrook, C., Coyne, S.M., & Lawson, E.T. (2011). Maternal defense: Breast feeding increases aggression by reducing stress. Psychological Science. DOI: 10.1177/0956797611420729

Happy tweets, healthy hearts.

Heart disease is the leading cause of death in the United States. The most prominent risk factors for heart disease are smoking, obesity, hypertension, diabetes, low income, and low education. However, psychological science has taught us that living in a social environment that is hostile and un-supportive also contributes to poor health, specifically heart disease.

In the past ten years, the social environments we interact with have grown exponentially with the introduction of social media such as Facebook and Twitter. This introduces an entirely new dimension of social interaction but also a window of opportunity for psychological science researchers. Specifically, a recent study pursued the question:

Does language on Twitter relate to heart disease mortality?

To answer this question, Johannes Eichstaedt and colleagues collected 50,000 words tweeted between 2009 and 2010 from users all across the United States. They systematically review the words for frequency, content, and the location of the user based on their user profile. Then they gathered county specific data on rates of obesity, smoking, marital status, hypertension, income, education, race, and mortality due to Athlerosclerotic Heart Disease from the CDC for the years 2009 and 2010. The data represented in the study represents 148 million county-mapped tweets across 1,347 counties, and CDC data from 88% of the United States.

They found that combining known physical and social risk factors, including income, education, smoking, diabetes, hypertension, obesity, race and marital status, accounted for about 35% of heart disease mortality within a county. However, language used on Twitter alone accounted for about 42% of heart disease mortality within a county. Combining Twitter language and known risk factors accounted for about 43% of heart disease mortality risk. This suggests that language used on Twitter is an important indicator of health outcomes. But what were these people saying on Twitter that predicted heart disease in their county?

The research team identified 3 categories of language use that specifically predicted increased risk for heart disease mortality in their county: aggression & hostility, interpersonal tension, and disengagement. Anger and hostility was a category comprised of frequent use of expletives. Interpersonal tension was a category comprised of frequent use of words such as “hate,” “jealous,” “fake,” and “drama,” not to mention some more expletives. Finally, disengagement was a category comprised of frequent use of words related to boredom and fatigue. Each of these categories was a significant predictor of increased heart disease mortality in a county.

There were also three other categories. These categories were Skilled Occupations, with words referring to attending conferences, learning, and meeting new people; Positive Experiences, using words that refer to friends, weekends, food, company, and things described as wonderful and fantastic; and finally Optimism, which reflects the use of words reflecting possibilities, achievements, father, goals, success, strength, and courage. Frequency of Twitter content in each of these 3 categories was protective against heart disease risk in counties.

But what does this mean? Saying bad words on Twitter causes you to die of heart disease? Posting angry, hostile tweets causes your neighbors to die of heart disease?

Because this research is cross-sectional, these are just correlations, not causes of heart disease. It’s possible that pre-existing heart disease causes people to be more hostile, angry and pessimistic. In that case, language patterns on social media may be an early sign of undiagnosed heart disease that is an area for future preventive science to explore. It’s also possible that engaging with the world with more anger, hostility, and pessimism causes physiological changes to the body that lead to heart disease. Since we know that stress causes heart disease, this pathway is extremely plausible. However, the people who die of heart disease tend to be older, while the people on Twitter tend to be younger. The people in this study that were tweeting expletives were not the ones dying that year, so there’s something much greater reflected in these findings than what predicts heart disease within an individual.

What these findings really suggest to me is that older people living in communities filled with people who are angry, pessimistic, bored, tired, hostile, and curse a lot, are more likely to die of heart disease. The important assumption being made here is that people behave on Twitter the way they behave in the world. In many ways this isn’t really true. But do you think a person that is mean on social media is also the type of person who honks at older drivers when they hesitate to turn right on red, or run a yellow light? I would venture to say yes. The authors suggest that the “combined psychological character of the community” is being represented by Twitter language in this study, and it has robust associations with health. 

We all live in communities, big and small. Other people matter, but more importantly, your behavior matters in the lives of other people.

Eichstaedt, J. C., Schwartz, H. A., Kern, M. L., Park, G., Labarthe, D. R., Merchant, R. M., ... & Seligman, M. E. (2015). Psychological language on twitter predicts county-level heart disease mortality. Psychological science,26(2), 159-169.

We can’t really smell fear, but our brains can.

The brain is such a fascinating organ. Despite having spent a decade studying it, I learn more about the brain, its capabilities, and complexities every day. For example, I recently went to a fascinating talk where I learned that the brain recognizes others’ fear through chemicals in sweat. This post is about how we learned that. 

Dr. Lilliane Mujica-Parodi, a professor at Stony Brook University, is interested in how emotions are communicated between individuals. We have 5 senses: visual (sight), tactile (touch), auditory (sound), gustatory (taste), and olfactory (smell). In particular, Dr. Mujica-Parodi is interested in how emotions are communicated through smell. We know that facial expressions help us visually communicate with one another and language helps us communicate with auditory information, but what communicative purpose does smell have?

To answer this question she collected two different types of sweat: fear-induced sweat and physical exertion induced sweat. The fear-induced sweat was collected from 144 individuals who went tandem skydiving for the first time, including a 1 minute free fall from 13,000 feet.. The physical exertion induced sweat was collected while these individuals ran on a treadmill. Their hypothesis was that the fear-induced sweat would contain different olfactory information

They then recruited a group of 16 individuals (50% female) and had them smell 40 different sweat samples (20 of each type) for 2.5 seconds each. Participants smelled each of these samples from inside an fMRI scanner, while the research team recorded activation of their amygdala, the fear recognition center of the brain. They found that participants had great activation in the amygdala when they were smelling the samples taken from people while sky-diving compared with when smelling the samples taken during exercise.

They then recruited 16 new participants (50% female), and repeated the experiment with 40 new sweat samples, half collected during skydiving and the other half during exercise. They found the same thing: participants demonstrated greater amygdala activation, or recognition of fear, when smelling the sweat collected from people while skydiving.

But were the participants aware that they were exposed to two different types of sweat? It doesn’t appear that way.

To test whether the two types of sweat were noticeably different to the participants, they recruited 16 more participants (50% female), and asked them to smell 16 pairs of sweat samples. After smelling each pair of samples, they were asked to decide whether the samples were both the same or different from one another. The results of this experiment suggest that the participants were unable to accurately report any differences between the two types of sweat.

Finally, they conducted a 4th experiment to test whether exposure to fear sweat influenced perception of emotions in others. Because, after all, what good would it be for our brains to recognize fear in others through chemical signaling, if that different give us any behavioral or perceptual benefits? To do this, they recruited 14 more participants and had them complete a computer task where they saw faces with different expressions ranging from neutral to angry and had to report whether the face was “neutral” or “threatening.” The participants completed half of the trials while smelling the fear-induced sweat and half while smelling the exercise-induced threat. They found that after smelling the fear-induced sweat, participants were more accurate at identifying whether a face was threatening or neutral than when they smelled the exercise induced threat.

I am always impressed by all of the things our brain is constantly doing outside of our awareness, and these findings are no exception. Basically, this study demonstrates that while we aren’t aware of it, we can smell fear in others, the fear circuits in our brain are activated, and that activation leads us to more accurately perceive threat in our environment. 

As a person who would never go skydiving, and who barely rides the kiddie-roller coaster at amusement parks, this makes me wonder about the role of these olfactory signals in amusement parks and haunted houses. Part of our anticipation of the ride could be driven by our brains picking up on sensory information that people have been scared here before. But what about other emotions? Might there be chemical signals for happiness, desire, sadness that communicate our experiences with people who will come after us? Are some people more sensitive to olfactory emotional signals? Is that a strength or a vulnerability? This study controlled for potential differences between men and women, but I would imagine that men and women differ quite meaningfully in how receptive they are to olfactory signals of emotions in others.

As is the case with many studies using brain imaging, there were very few people in each of the experiments I described so the findings warrant replication. As is the case with all cutting edge research, we are left with more questions than answers, but that’s what is so exciting about the field of psychological science. Stay tuned!


Mujica-Parodi, L. R., Strey, H. H., Frederick, B., Savoy, R., Cox, D., Botanov, Y., ... & Weber, J. (2009). Chemosensory cues to conspecific emotional stress activate amygdala in humans. PLoS One, 4(7), e6415.

What Don Draper could do with an fMRI…

Humans are terribly inaccurate at predicting their own behavior. Yet, marketing and advertising industries have historically relied upon individuals’ predictions about whether they would use select products, when, and why via focus groups and marketing surveys. 

Luckily, advances in psychological science, in this case with the use of fMRI, we have a window into how the brain responds to the world that is, in some ways, independent from our subjective report. Thus, inquiring minds were eager to test whether brain activity might be a better predictor of our behavior than our reports. For example, in 2011, Dr. Emily Falk and her colleagues published a study showing that neural activation in the medial prefrontal cortex (MPFC), an area involved in self-referential thinking, while watching advertisements for smoking cessation was a better predictor of quitting smoking than self-reports. This is pretty fascinating on the surface, but also very intuitive. People lie. If anyone appreciates that fact, it’s psychologists. We have dedicated years of research to developing ways of patterning the way people lie in order to more accurately measure psychological constructs.

There are a lot of reasons people who want to quit smoking might have inaccurate self-reports on whether they will quit smoking. First and foremost, doctors want their patients to quit smoking, so smokers tell their doctors what they want to hear. However, Dr. Falk and her colleagues conducted a follow-up study where they were interested in whether neural activation to smoking advertisements would predict the behavior of others. In other words, they asked the question:

Can neural responses to advertisements in a few people predict how effective they will be for others? 

To answer this question, the research team recruited 30 individuals (15 males) who were about 44 years old. Each of these individuals were “heavy smokers” with “strong intention to quit” smoking. Each participant then watched 16 smoking cessation advertisements during an fMRI session, where images of activation in their brain were taken. These advertisements were part of 3 different ad campaigns (campaign A, B, C) sponsored by the National Cancer Institute’s Smoking Quitline (1-800-QUIT-NOW). These were real advertisements that were aired locally in a different part of the country, and none of the participants had seen them before. After watching all of the advertisements in the fMRI, participants rated each advertisement’s effectiveness, including whether it motivated them to quit and how persuasive it was. Then, the research team collected data from the Smoking Quitline on how effective each advertisement actually was. To do this, they compared the number of calls they received during the month before each advertisement aired with the number of calls during the month after that advertisement aired.

Based upon the participants’ ratings of advertisement effectiveness, the most effective advertisement campaign was campaign B, followed closely by campaign A, and then campaign C by a larger margin. In contrast, the MPFC demonstrated the greatest activation when watching campaign C, followed closely by campaign B, and then campaign A. So, the brain and self-report are telling us something different, and Dr. Falk’s previous paper suggests that the neural activation in this region would more likely predict who will actually quit smoking. So, which was correct?

Based upon the change in calls to the Quitline before and after each advertisement aired, campaign C was by far the most effective. Campaign C resulted in a 32-fold increase in call volume to the Smoking Quitline, while campaign B resulted in a 12-fold increase, and campaign A only resulted in a 3-fold increase. This effectiveness ranking between campaigns (C > B > A) matches that predicted by neural activation in the MPFC.

Many companies spend millions of dollars creating, filming, and airing advertisements, especially for big events such as the Superbowl (This was my favorite Superbowl XLIX commercial, by the way: #likeagirl). These millions of dollars are intended to be an investment in the even larger revenue generated by the advertisement. Based on this article, the time may be quickly approaching when experimental approaches using fMRI may extend into the private sector, helping advertising agencies determine which campaigns will give them the most bang for their buck.

Obviously, this study was very specific to a target audience where self-reports are perhaps more susceptible to bias than consumer products like which dish soap you buy. It remains to be seen whether neural activity to an advertisement in a group of random individuals in the community, including smokers who have no intention to quit and non-smokers, would return the same results. Given that the brain region with the predictive value (MPFC) is associated with self-referential thinking, I would expect that this finding is limited only to sub-groups of individuals for whom the ad is relevant. However, that’s not too different from marketing focus groups; they use housewives for focus groups on laundry detergent and athletes for focus groups on high-performance running shoes. To truly compare, they would need to conduct this study again comparing the predictions of focus groups on ad effectiveness with the predictions based on neural activity.

Even so, this team of creative researchers still have strong evidence that what a person’s brain is doing in Los Angeles when watching a new advertisement will predict whether a person in Louisiana will call a hotline after seeing the same advertisement. And that, my friends, is very cool.

Falk, E. B., Berkman, E. T., & Lieberman, M. D. (2012). From neural responses to population behavior neural focus group predicts population-level media effects. Psychological science, 23(5), 439-445.

Go hug someone. Here's why.

Having social support is great for your mental and physical health. We have good research showing that people who have supportive relationships live longer, get sick less often, and recover from illness faster than people who don’t. In particular, the immune system is vulnerable during times of stress, and social support buffers the effects of stress on the immune system, thus reducing your body’s vulnerability to illness. However, social support is a pretty ambiguous construct. Does social support mean people remember your birthday, bring you yogurt when you had your wisdom teeth out (instrumental support), come to your grandfather’s funeral (emotional support)? This seems to be an important question because as a clinician, part of my job is to help young people identify reliable sources of social support, ask for help when they need it, and take care of those relationships by showing their support to others. In order to do that, I want to identify actual behaviors that account for why social support benefits health.

One behavior that is a likely candidate is hugging. Hugging is a likely candidate because nonsexual physical contact is a communication of reassurance, care, and empathy. This type of behavior is linked with better immune functioning within both human and non-human primate families and communities. So, the question that emerges is:

Does hugging protect your health? 

To answer this question, an interdisciplinary group of researchers, led by Dr. Sheldon Cohen at Carnegie Mellon University conducted a study on 404 healthy adults (age 33). In this study, each participant completed a questionnaire about their perceived social support and participated in a physical exam that included a blood test for antibodies and measurement of their mucus to assure they were not sick. Each participant then completed an interview every day for 2 weeks where they reported on what they did that day, who they interacted with, whether they experienced any conflicts, and whether they received any hugs from anyone. At the end of the two weeks, they completed another physical exam and blood test to measure the presence of antibodies. Then each participant received nasal drops of the common cold (rhinovirus 39) or the flu (influenza A/Texas/39/91). For up to 6 days following exposure to the cold or flu, participants were assessed for the development of cold and flu symptoms, and then were assessed again 4 weeks after exposure to the illness.

Cohen and his team found that 78% of participants in this study contracted the illness they were exposed to (as measured by developing some symptoms), and that 31% developed a clinically significant illness of either the flu or the cold. They also found that people in this study were exposed to hugs 67% of the 14 days, while conflict was only reported on about 7% of the 14 days. The main finding of the study was that participants who reported more conflict during the 14 days preceding exposure to the flu/cold were more likely to develop an infection, however receiving more hugs served as a buffer to that effect. Thus, they found that hugs were an effective, protective experience that prevented the cold/flu.

In particular, their findings suggest that hugs are more helpful in improving immunity to the cold, rather than the flu. This may have to do with the rate that the flu replicates in the body. They also found that hugs were protective in whether or not the participant would get sick, not necessarily how sick they would get. Remember, they drew a distinction between people who developed symptoms (78%) and people who had clinically significant syndromes (31%). Hugs were effective in buffering the link between having conflict and developing symptoms, but were not necessarily effective in preventing the severity of the illness if you do contract the infection. To me, this suggests that, not surprisingly, there is more to immunity than hugs, and there are still individual differences in the ways our bodies respond to exposure to germs and viruses.

Of course, this research doesn’t suggest that we should just go around hugging one another instead of going to the doctor to get a flu shot. Rather, giving hugs to our loved ones frequently, especially if they are going through stress is an effective way to provide social support that may boost immunity.

Despite this important and fascinating potential benefit, there are several questions that emerge from this study about application and potential explanation. For example, do people who give and get hugs frequently simply have more efficient immune systems because they consistently have more exposure to germs and bacteria? I wonder whether we could test that question by comparing immunity across cultures who vary in their typical greetings, for example bowing (no physical contact), shaking hands, kissing on both cheeks. Or, is there something special about a hug that improves immunity through psychological well-being like optimism that people care about you?

Another potential limitation of this study was that conflict was reported fairly infrequently in this sample, only 7% of days (less than 1 day on average). I wonder whether these effects would be stronger or weaker among a sample with more frequent exposure to conflict, such as people exposed to domestic violence, or who deal with conflict as part of their job, such as attorneys.

To conclude, this article is just one more example for me of how we can benefit from taking care of ourselves by showing that we care for one another. I’ve always been a bit reluctant around those enthusiastic groups of people around town squares waving FREE HUGS signs. Now, I have a greater appreciation for the work that they do for public health. More free hugs for everyone!

Cohen, S., Janicki-Deverts, D., Turner, R. B., & Doyle, W. J. (2014). Does Hugging Provide Stress-Buffering Social Support? A Study of Susceptibility to Upper Respiratory Infection and Illness. Psychological science, 0956797614559284.

Photo credit: http://coffeeandwhinelife.com/five-in-less-than-5-minutes-fitness-wellness-tips/

Can we use TV to prevent depression?

I was recently in Miami for the annual meeting for the International Society for Traumatic Stress Studies (www.istss.org) where the theme of the meeting was “Healing Lives and Communities: Addressing the Effects of Childhood Trauma Across the Lifespan.” There was an interdisciplinary panel at the meeting on “Using media to prevent trauma” between scientists and filmmakers. The goal of this panel was to open a dialogue within the scientific community about whether trauma is too prevalent to treat individually, and whether population based “interventions” are a more effective way to prevent the negative psychological consequences of trauma. Are we using a teaspoon to remove water from our punctured lifeboat? During this discussion, they brought up The San Francisco Mood Survey Project, which is uber-cool, so I was inclined to share it with you.

In the late 1970s, mental health awareness was increasing, and epidemiological surveys confirmed that almost 10% of people are depressed*, while 25% of people will be depressed at some point in their life. Even then, it is remarkable to note, there was an understanding among research-oriented clinical psychologists that cognitive-behavioral therapy (CBT) was the most effective way to treat depression. More about that in this past post.

Dr. Ricardo Muñoz of University of California- San Francisco is a psychologist specializing in effective interventions for the treatment of depression. Today, he focuses mostly on interventions using the internet, however in 1978, the best option for community intervention was television. Luckily, the host of a television news program in San Francisco approached him and a group of psychologists at UCSF and UC Berkeley to develop a mini-series on depression. So, the research group compiled active components of effective CBT for depression and compiled them into ten 4-minute segments that were aired during the noon, evening, and nightly news for two weeks. This is considered “primary prevention” because “rather than waiting for people to become depressed enough to seek therapy, preventive educational interventions can be made available to the general public.”

One week before airing the 10 segments, they conducted a phone survey by asking 216 individuals (~ 40 years) about their symptoms of depression and whether they engage in any of the behaviors that would (unbeknownst to them) be recommended on the television segments.

Some examples of the content of these segments are: making a list of 15 pleasant activities, writing out a contract to exercise and eat healthy, showing ways people can reward themselves for following the contract, listing positive thoughts, and showing how to relax.

One week after the 10th segment was aired, they conducted phone interviews with 220 individuals (58 were new). Participants reported on their depression symptoms, how often they engage in the behaviors recommended in the segments, and whether they watched any of the segments on the news in the past 2 weeks.

Unfortunately, only 47 of the participating individuals watched at least one of the segments of the intervention, however the results of the intervention were promising. Individuals whose pre- intervention depression scores were high (clinically significant) who also watched at least one segment, reported a decrease in depression symptoms one week after the intervention. This is an important finding because one of the biggest criticisms of community interventions like these, and more recently on the internet, is the worry that people who are depressed will stop seeking treatment and be at increased risk for persistent illness or suicide. See a past article about depression and suicide risk here. So not only did Muñoz and colleagues find that depression symptoms declined in people who watched the segments, but specifically in those with clinically significant symptoms.

Overall, I find it remarkable that this was done 30 years ago, but disappointing that more programs like this have not “taken off.” Clearly, there are benefits, but apparently the benefits don’t outweigh the costs. This study is no exception given how much time and money it must have taken to compose and produce the 10 segments, to only reach ~20% of a population. But perhaps we should be interested in long term gains, not 2 week gains. In graduate school, I learned about a concept called Gross National Happiness, was proposed by the King of Bhutan, as a way of dedicating national resources to promoting quality of life rather than productivity (GNP) per se.

What is also remarkable to me about this study was whether it was prevention or intervention. Keep in mind, the main finding was that people with clinically significant symptoms showed reductions. This implies that the segments were therapeutic, or served as an intervention. However, for some historical context, the first segment was aired the day after the Guyana mass suicide, not to mention the Mayor of San Francisco Moscone and Supervisor Harvey Milk were shot one week later. Thus, it is possible that the intervention somehow buffered the impact of these major socio-political traumas as evidenced by a lack of increasing symptoms.

This brings me back to my original topic, which is the question of whether we can prevent the negative impacts of trauma using media. And if we can, what might that look like? I often take my training as a clinical psychologist for granted, and forget that everyone is not trauma-informed. What clinical psychologists know about trauma is that telling your story with others is part of the healing process, as long as those others are “safe.” We know that when someone tells us about a personal experience, either rape or assault or a motor vehicle accident, that is privileged information that was very difficult to share. As receivers of that information, we are responsible for showing gratitude for that information, and validating them by recognizing the overwhelming emotions that must have accompanied their experience. The media does not routinely do that. Only the rarest journalists do that. As a result, we live in a world where emotions are stigmatized, shame is marketed, destitution is disgusting, and victims of trauma are never validated unless they can afford to pay for it. I wonder what the world would look like if instead everyone was “safe.”

*Depression is defined by two weeks of persisting low or negative mood and loss of pleasure in previously enjoyed activities which are then accompanied by several other unpleasant experiences (changes in sleep, appetite, worry, thoughts about death). If you are worried that you might be suffering from depression, you should take an online survey here, or contact your primary care physician for a referral to a therapist.

Muñoz, R. F., Glish, M., Soo-Hoo, T., & Robertson, J. (1982). The San Francisco mood survey project: Preliminary work toward the prevention of depression. American Journal of Community Psychology, 10(3), 317-329.

Is there something in your medicine cabinet for hurt feelings?

If you haven’t noticed, I have a great deal of interest in the relationship between the mind and the body. Luckily, I am living and conducting research during a time when this is of interest to a multitude of disciplines, from molecular biology to politics. Every so often, I come across studies that really get to the heart of the mind-body connection and make me really appreciate how completely integrated all of these systems are. In a conversation with my new mentor recently, one of these studies was brought to my attention.

The study was about pain. Not, “Ouch, I stubbed my toe!” pain, but rather “that wasn’t a very nice thing to say” sort of pain. In psychology, what most people call “hurt feelings” is called social pain. Anecdotally, we use the same language to refer to physical pain as social pain, and only recently have we had the technology to investigate whether the two concepts overlap actually, or just metaphorically.

About 4 years ago, Dr. C. Nathan DeWall of the University of Kentucky and his colleagues published a study on social pain. In this study, he asked the very simple question:

Do existing remedies for treating physical pain help reduce social pain as well?

To answer this question, he conducted 2 experiments. In the first experiment, he recruited 62 undergraduate students. These participants were randomly assigned to receive either 1000 mg of acetaminophen per day (500 mg in the morning, and 500 mg before bed) or a placebo pill. The participants were prescribed their respective pills for 3 weeks. During these 3 weeks, the participants also completed daily reports of their “social pain.” These included items such as, “Today being teased hurt my feelings.”

At the end of the three weeks, they found that participants taking acetaminophen experienced declining reports of “hurt feelings” throughout the study. In comparison, the participants taking the placebo demonstrated no change in their reports of daily hurt feelings. Since the participants were randomly assigned to either receive the acetaminophen or the placebo, the reduction in hurt feelings over the course of the three weeks was likely caused by the effects of acetaminophen on the central nervous system’s recognition of pain.

Dr. DeWall then asked whether the effects of acetaminophen on social pain corresponded to neural networks in the brain. What we know from the past 2 decades of neuroimaging research, is that people who have lesions in the anterior insula and the dorsal anterior cingulate cortex report not being bothered by physical pain, and are less sensitive to social rejection and loss. Thus, Dr. DeWall was interested in whether acetaminophen use would result in differences in neural activity in response to social rejection in these two areas.

To answer this question, he recruited another 25 undergraduate students and randomly assigned them to receive either acetaminophen or a placebo. Participants took their assigned pill every day, morning and night, for 3 weeks. At the end of the 3 weeks, the participants came to the lab to participate in an fMRI, or brain imaging session. While in the scanner they played a ball toss game that, unbeknownst to them, was designed to make them feel socially rejected.

The ball toss game had 2 parts. In the first part, the participant and two other players virtually played catch with each other. In the second part, the two other players stopped throwing the ball to the participant after 3 possessions. This is likely to prime the participant to think and feel socially rejected.

Dr. DeWall and his colleagues found that participants who had been taking acetaminophen for the past three weeks demonstrated less activity in the areas of the brain that are responsible for experiencing pain, anterior insula and the dorsal anterior cingulate cortex, compared with the placebo group. Thus, taking a daily dose of acetaminophen caused their brain to be less sensitive to social rejection.

So, am I telling you to start taking acetaminophen every day to feel less sensitive? NO, absolutely not. These studies were conducted with a very small number of young and healthy people, and taking any medication should be a decision made with the advice of your personal physician. Furthermore, I'm not convinced that not having hurt feelings would be a good thing. Experiencing hurt feelings may be a good thing in the long run, as those experiences will teach you who in your life is a reliable and supportive friend, and who is not. Evidence to support this notion is that Dr. DeWall also collected information on positive emotions throughout the study, and the participants in the acetaminophen group didn't report more positive emotions, even though they had fewer experiences of hurt feelings.

What this study should remind you of is the importance of feelings and their relevance to development and well-being. Given that humans are dependent on adults for a relatively long period of childhood, being able to express “hurt feelings” at separation from a caregiver would have been adaptive. It completely makes sense that physical and social pain would be neurobiologically intertwined. Given that we now have a wealth of information to support that the brain responds similarly to physical and social pain, I would like to challenge the notion that fault can only be placed on people who inflict physical pain on others. Put another way, every time a person says something hurtful to another person, the brain might as well be getting punched. This has implications that we don’t necessarily understand yet. People who are physically abused or live in conditions of chronic pain have long term negative repercussions, but very few people understand the long term consequences of living in an environment filled with hurtful and rejecting social interactions. If these experiences act on the central nervous system in a similar way, ought the long term negative consequences overlap as well? In light of this reminder, I leave you with a quote from my favorite book:

“Shall we make a new rule of life from tonight: always to try to be a little kinder than is necessary?” ~ J.M. Barrie, Peter & Wendy

Dewall, C. N., Macdonald, G., Webster, G. D., Masten, C. L., Baumeister, R. F., Powell, C., ... & Eisenberger, N. I. (2010). Acetaminophen reduces social pain: behavioral and neural evidence. Psychological Science, 21(7), 931-937.