Date

CONTRAST IN JUDGMENTS OF MENTAL HEALTH

By

Laura H. Kushner

Submitted to the

Faculty of the College of Arts and Sciences

of American University

in Partial Fulfillment of

the Requirements for the Degree of

Master of Arts

In

Psychology

Chair:

2008

Scott Parker cr1 . J.-:"-

Kathleen C. Gun

American University

Washington, D.C. 20016

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CONTRAST IN JUDGMENTS OF MENTAL HEALTH

BY

Laura H. Kushner

ABSTRACT

The present study examined contrast in judgments of mental health. Subjects

rated word/definition pairs on a 0 (Low) to 100 (High) mental health scale. We first

established some pairs as exhibiting Low, Moderate, or High mental health. In

Experiment 1, subjects who first saw High words rated Moderate words lower than

subjects who first saw Moderate words. Thus, contrast occurred for Moderate words.

Experiment 2 used Low (rather than High) and Moderate words but found no contrast.

The results echoed previous research on contrast and mental health.

Contrast was induced for the Moderate words in the Moderate/Healthy condition:

Moderate words were moved away from their baseline ratings. Contrast did not occur in

the Moderate/Low condition: Moderate words were not moved away from their baseline

ratings. In neither case did the Moderate words induce changes in the ratings of the

extreme words.

11

ACKNOWLEDGEMENTS

I would like to thank Scott for his unlimited patience, guidance, and support. I

would also like to thank Dr. Haaga and Dr. Gunthert for their valuable feedback and time.

Thanks to my mom and dad for their continued encouragement and willingness to listen.

111

TABLE OF CONTENTS

ABSTRACT ........................................................................................ .ii

ACKNOWLEDGMENTS ...................................................................... .iii

TABLE OF CONTENTS ........................................................................ iv

Chapter

1. INTRODUCTION: Contrast in Judgments of Mental Health .................. 1

Background ......................................................................... 2

Contrast and Perception of Mental Health ...................................... 9

Goals of the Study .............................................................. 26

2. EXPERIMENT 0: CALIBRATION ............................................. 27

Participants ...................................................................... 27

Materials ........................................................................... 27

Procedure .......................................................................... 28

Results ............................................................................ 28

3. EXPERIMENT 1: HIGH MENTAL HEALTH/MODERATE MENTAL

HEALTH ................................................................................................ 30

Participants ...................................................................... 30

Materials ........................................................................... 30

Procedure .......................................................................... 30

Results ............................................................................ 31

IV

4. EXPERIMENT 2: LOW MENTAL HEALTH/MODERATE MENTAL

HEALTH .............................................................................................. 34

Experiment 2A Method .......................................................... 34

Participants ....................................................................... 34

Materials ............................................................................ 34

Procedure ........................................................................... 34

Results ............................................................................. 35

Discussion ......................................................................... 36

Experiment 2B Method .......................................................... 37

Participants ....................................................................... 3 7

Materials ............................................................................ 37

Procedure ........................................................................... 37

Results ............................................................................. 37

Discussion ......................................................................... 38

5. GENERAL DISCUSSION .......................................................... 39

APPENDIX .................................................................................................. 46

A. INSTRUCTIONS ............................................................ 46

B. TABLES ...................................................................... 47

REFERENCES ............................................................................................ 49

v

CHAPTER 1

INTRODUCTION

Contrast in Judgments of Mental Health

The contrast effect is a psychological phenomenon that has been demonstrated in

myriad circumstances. The effect occurs after exposure to a stimulus along a continuum;

the subsequent perception of another stimulus from the same continuum will often be

pushed in the opposite direction, away from that of the initial stimulus. For example, if

one simultaneously places one's right hand in hot water and left hand in cold water for

one minute and then immediately places both hands in a container of lukewarm water, the

right hand will perceive the lukewarm water as cold while the left hand will perceive the

lukewarm water as hot (Locke 1690/1964).

In his seminal book, Outline of Psychology, Wilhelm Wundt included several

sections on the contrast effect. Throughout these sections, it is evident that Wundt

believed contrast was fundamental, widespread, and significant. Wundt went to so far as

to include it as one of three fundamental principles of psychical phenomena (Wundt

1907). Since Wundt, a multitude of studies have investigated and demonstrated the

omnipresence of the contrast effect. Because of contrast's generality, the phenomena

might likely apply to clinical judgments. For example, it is likely that the assessment of

one person may be influenced by judgments previously made of other people. The

present experiment investigates the contrast phenomenon in a context of the perception of

mental health. 1

2

Background

Before examining contrast's role in mental health judgments, it is useful to have

more background on contrast and related phenomena. As described above contrast

occurs when ratings or judgments of a stimulus are pushed in the opposite direction of an

original stimulus. Contrast also has an opposite, known as assimilation. Assimilation

occurs when ratings or judgments of a stimulus are pushed toward the ratings of an

original stimulus (Suls & Wheeler, 2007).

Although a plethora of literature exists on the topic of assimilation and contrast,

an overarching theory does not exist that definitively explains why contrast occurs in

some situations while assimilation occurs in others. Nevertheless, work by Stapel (2007)

has helped clarify the issue.

Historically, contrast and assimilation were generally researched by different

groups of investigators. Contrast was principally examined by psychophysicists while

assimilation was studied predominantly by social psychologists (Suls & Wheeler, 2007).

Each group usually believed that assimilation (if you were a social psychologist) or

contrast (if you were a psychophysicist) was the default mechanism for human

judgments.

Stapel (2007) argues that this division among groups of psychologists continues

today. He emphasizes that research in social cognition tends to focus on issues relating

to categorization and interpretation: thereby leading to assimilation. Other researchers,

(Stapel refers to them as social judgment and comparison researchers) tend to focus

more on comparative issues of social judgments: thereby leading to contrast. As a result

of these different theoretical underpinnings, different kinds of procedures were

developed by each group that tended to lead to assimilation in some instances and to

contrast in others. It will be helpful to explain those kinds of procedures in more detail.

3

To begin, there are several situations that can increase the chance that contrast

will occur. When subjects are presented a series of stimuli that they are asked to

evaluate, this generally produces contrast. In many of these kinds of experiments, a

series of evaluative judgments are initially made of stimuli that come from one region of

a scale (the context stimuli). Next, judgments are made regarding a different series of

stimuli from a different region on the scale (the test stimuli). These kinds of experiments

are common within the sensory psychophysics literature (e.g. Conner, Land & Booth,

1987, taste; Frederiksen, 1975, loudness and brightness; Pol, Hijman, Baare & van Ree,

1998, smell) and generally produce contrast. Similar designs have also found contrast in

other perceptual domains (e.g. Kenrick & Gutierres, 1980, using physical attractiveness

ratings; Samsom & Rachman, 1992, using fear evoking stimuli).

While there is not a consensus as to why these kinds of situations produce

contrast Lockhead (1982) described that contrast will be "Commonly found between the

response to the current stimulus and the average magnitude of several preceding stimuli"

(p. 28). For example, if several loud tones precede a more moderate tone, that moderate

tone will be judged as being quieter than if it had been preceded by several quiet tones.

Just as certain procedures tend to produce contrast, certain other procedures tend

to lead to assimilation. One such procedure is a priming paradigm. In this kind of

design, subjects are first exposed (often implicitly) to traits or behaviors that are

ambiguously related to the property to be judged. Next, subjects are asked to evaluate

the property in question. For example, Higgins, Rholes, and Jones (1977) exposed

4

subjects to a list of either socially desirable traits or socially undesirable traits. Later

subjects were asked to judge a hypothetical person based on an ambiguous verbal

description. Subjects who were previously exposed to the socially desirable traits on

average judged the hypothetical person as more socially desirable than did people who

had been exposed to the undesirable traits. It is thought that this situation is likely to

cause assimilation because the overlap in the context between the prime and the

subsequent evaluation will cause the subject's evaluative response to migrate toward the

prime (Wedell, Hicklin & Smarandescu, 2007).

Another class of studies in social cognition also produces results that are

assimilative - those that use numerical anchoring. In these studies, the subject first gets

exposed to a number rather than a trait or social context. The subject then gives a

numerical rating of something and that rating is typically moved closer to the number

that was initially presented. For example, Mussweiler and Englich (2005) exposed

subjects to a series ofrandom symbols on a computer screen. After a series of three

symbols were presented for one second each, a number (the anchor) was presented for

thirty three milliseconds. In this experiment, the subject did not report being exposed to

a number. Immediately following the presentation of numbers and symbols, subjects

were asked to consider, "How many Euros does a midsize car cost on average?" When

subjects were not exposed to a numerical value the average estimate of the car was M =

18,312 euros. Subjects exposed to a high anchor value (30,000) gave an average

estimate of the price of a car (M = 21,219 euros) that was significant! y higher than did

subjects who were exposed to a low anchor value (10,000) and then asked to estimate

the price of a car (M = 17,15 0 euros). A number of studies have produced similar results

(e.g Eply & Gilovich, 2001, estimating the freezing point of vodka; Blankenship.,

Wegener, Petty, Detweiler-Bedell, & Macy, 2008, estimating the age of varying famous

men when a significant event occurred in their life.)

5

Interestingly, the results from the Higgins Rholes, and Jones (1977) study violate

Lockhead's theory regarding the importance of the stimuli presented prior to the

response stimuli. According to Lockhead (1982), while contrast is likely to occur if

subjects average several preceding stimuli, assimilation is more likely to occur if one

stimulus is presented and then subjects are asked to evaluate an immediate, subsequent

stimulus. With Higgins, Rholes, and Jones (1977), a series of traits were presented to

each subject, yet assimilation occurred. Of note, in this priming study subjects were not

evaluating the initial personality traits. Instead, they were only evaluating the

hypothetical person's characteristics (after the trait had been presented). The current

research will be set up in such a way that both the initial stimuli and the test stimuli are

evaluated. Historically, this type of paradigm has produced contrast.

Additionally, recent research has demonstrated that when test stimuli are

simultaneously presented (as a group) assimilation is more likely to occur than if the

stimuli are presented sequentially. Zellner and Cobuzzi (2008) asked subjects to

evaluate their liking for pieces of art on a 20 I-point bipolar hedonic scale ( + 100

indicated the most attractive art imaginable, while -100 indicated the most unattractive

art imaginable). Subjects were placed in one of three groups: Grouping, Comparing, and

Control. Grouping subjects observed three paintings by Goya at the same time, the

middle one being the "test" painting. The test painting had been selected based on

previous research that suggested it would have a positive hedonic rating while the two

outer paintings or "context" paintings were selected based on previous research that

suggested they would have negative hedonic ratings (Dolese, Zellner, Vasserman, &

Parker, 2005).

First, subjects were asked based on the paintings how much they liked the artist.

6

Then, they were asked to evaluate their liking for each painting. The Comparing

subjects also saw the three paintings at the same time; however, these subjects were first

asked to rank order the paintings by preference and then to evaluate their liking for each

painting. Finally, the Control group saw only the test painting and rated their liking for

it.

When these paintings had been viewed sequentially (Dolese, Zellner, Vasserman

& Parker, 2005) contrast occurred. But here, the Grouping group rated the test painting

as significantly less hedonically positive than the Control group, exhibiting assimilation.

However, there was no significant difference in ratings of the test painting between the

Comparing groups and the control group. In other words, when viewed simultaneously

and understood to be part of a single group, the two context paintings pulled down the

ratings of the middle "test" painting. Simultaneous viewing can induce assimilation for

stimuli that when viewed sequentially induce contrast.

In addition to design structure leading to assimilation, social influence may also

tend to lead subjects to more assimilative responses. In a famous experiment, Sherif

(1936) exposed subjects to an illusion in which a pinpoint oflight appeared to be moving

(known as the autokinetic effect). Subjects were asked (on an individual basis) to

estimate how much the light moved. In a later phase of the experiment, subjects were

asked to estimate how much the light moved while they were in a group. In this phase,

7

subjects' answers began to converge together. This experiment indicates that a person's

desire to conform to the standards set by others may lead to assimilation. Other examples

of social influence leading to assimilation are abundant (e.g. Asch, 1956, estimating line

length; Yin & Saltzstein, 1968, estimating number of dots).

The importance of the impact of study design in determining contrast or

assimilation was highlighted in a recent study by Zellner, Strickhouser, and Tornow

(2004). In phase one of this study subjects were shown liquid (a tropical fruit drink) in a

cup. They were asked to rate how much they expected to like the drink after simply

looking at, after being told it was a tropical fruit drink, and after being told it was cough

syrup flavoring. Subjects rated their taste expectations on a 201-point hedonic scale

ranging from -100 "most unpleasant taste imaginable" to 100 "most pleasant taste

imaginable". Subjects rated their expectations differently in the three conditions: when

they were told nothing (M= .09), when they were told it was a tropical fruit drink (M=

53.60), and when they were told it was cough syrup (M= -36.00).

In the second phase of the experiment different subjects were given the fruit juice

to drink. Some of the subjects were told that the liquid was a cough syrup, other were

told it was a tropical fruit drink, and finally some were told nothing about the drink. In

this paradigm, subjects who were told the drink was cough syrup rated how much they

liked the juice significantly higher than did the subjects who were told that the drink was

a tropical fruit juice. Contrast occurred, presumably as a result of violation of the

subjects' expectations about how much they would like a cough syrup. As highlighted

above, this paradigm closely matches the kind of design that is likely to produce

contrast.

8

In the final phase of the experiment different subjects were presented with this

same drink. This time, the subjects were told that prior subjects had rated the drink. All

subjects were told a specific numerical rating that had been previously assigned to the

drink. The ratings that were specified were the expectations that were the data of phase

one of the experiment. Thus, some subjects were told the juice was rated .09, some were

told 53.60, and some were told -36.00. In this experiment, subjects who received the

prior negative rating gave the drink a lower taste liking rating than subjects who had

been giving a prior positive rating. Assimilation occurred.

Although the final phase of the experiment does not exactly match the

aforementioned priming procedure, subjects were previously given an exact number to

use as a reference point in this scenario. Another facet that may have led to assimilation

is that subjects were socially influenced, paralleling Sherif (1936). It is possible that

their actual preferences of the stimuli were not affected, but they did not want their

opinions to deviate from the previous raters. In any case, Zellner et al. (2004) were

successful by creating contrast and assimilation using the same stimulus set simply by

slightly altering the instructional procedures of the experiment.

While research has clarified the instances in which contrast and assimilation

occur, there is as yet no theory that can explain which phenomenon occurs under what

circumstances and why. In the current study, judgments relating to mental health are

examined. A series of context stimuli are presented followed by a series of different

stimuli. As discussed above, this kind of paradigm typically leads to contrast.

Therefore, the intent of this research is to expand knowledge of contrast in mental health

assessment.

9

Contrast and Perception of Mental Health

One of the first studies to examine judgments of mental health and illness was

done by Arnhoff (1954). Arnhoffs work is seminal because although contrast was not

observed with mental health and illness ratings, it was the first study to investigate the

topic. Two hundred twenty-two schizophrenic responses to requests for definitions of

various vocabulary items were standardized in order to obtain, "a number of stimuli

whose stimulus values were known" (Arnhoff, 1954, p. 272). In the initial calibration

phase of the study, twenty-two experienced clinicians rated the words and definitions on

"the severity of the disorder in the thinking processes exhibited in the responses"

(Arnhoff, 1954, p.272) using an 11-point scale where 1 indicated little pathology while

11 represented an extremely pathological response. The mean rating for each stimulus

definition was calculated. Only those definition responses that had an average rating

between 4 and 8 were included in next phase of the experiment.

In the next phase, 180 subjects (ranging in education from psychology

undergraduates to experienced clinical psychologists) were recruited and divided into

three groups. Each group was given a set of the 4-8 vocabulary items and definitions

and asked to rate the definitions on the aforementioned 11-point scale. Each of the three

groups was then presented with another series of the 4-8 items and definitions. Before

the second series of definitions were presented, the first group read an example of a

definition at the high end of the scale and its corresponding 11 rating. The second group

read an example of a definition at the low end of the scale and its corresponding 1 rating.

Finally, the third group received no example of high- or low-rated items. Examples of

the extreme stimuli prior to the ratings of subsequent words were used to examine

10

whether these "anchors" might influence how the subsequent, moderate words were

rated. Arnhoff found no difference in ratings among the three groups; the "anchors" did

not influence the ratings of subsequent moderate rated words. It is worth noting that this

procedure was more likely to elicit assimilation than contrast. The extreme words were

not evaluated; rather, they were used as an anchoring point. Also, because subjects were

told that the extremes had previously been rated as such, a social influence component

may also have influenced the outcome. However, in 1957 Campbell, Hunt, and Lewis

investigated contrast' s role in influencing perception of mental illness and had different

results.

Campbell, Hunt, and Lewis (1957) designed a study that had a conceptual

foundation similar to that of Arnhoff, and it was the first study to successfully observe

contrast in judgments of mental health and illness. Their study used some

word/definition pairs that were drawn from the Arnhoff study. More words were also

added to the normal and extreme ends of the pathology (thought disturbance) scale.

Forty-nine college sophomores judged the degree of pathology of the Arnhoff

word/definitions and the new word/definitions. An additional 50 items were also added

in the middle range of pathology. These items were preliminarily rated by 26 students

and were sorted into categories using the Thurstone technique of equal-appearing

intervals. These three groups of words: the high pathology, middle pathology and low

pathology words were then pooled together to create a pathology continuum. Finally,

the word/definitions were divided into nine separate groups that spanned a full range of

pathology: these groups were formed by choosing the words that were most consistently

rated by the subjects during the standardization phase. Within this nine-point scale,

group number one words represented no disturbance, while group number nine words

represented extreme disturbance. A sample of a few of the chosen items included: "(1)

Gamble: To take a chance a risk. (5) Brim: Outside diameter with a margin. (9) Stave:

That's before, that's long but not happiness" (Campbell et al., 1957, p. 348).

11

The experimental phase began by placing the standardized stimuli into booklets

that were presented to subjects. Five word/definition pairs were placed on each page (in

counterbalanced orders). In phase one of the experiment, the booklets contained stimuli

from one half of the 1-9 scale (either items ranging 1-5 on thought disturbance or items

ranging 5-9 on thought disturbance). Phase two was the transition phase of the

experiment (containing mid-scale, 2-8, items). Finally, phase three contained stimuli

from the opposite half of the 1-9 scale (again, items ranging from 1-5 on thought

disturbance or 5-9). There were two conditions in the experiment: one group (the low­

high group) first got the low rated items, then the mid-scale items, and finally the high­

rated items; the second group (the high-low group) began with the high rated items and

proceeded to the low-rated items. As before, subjects were asked to rate each item for

degree of thought disturbance on the aforementioned 1-9 scale.

The critical data were the ratings of items that had previously received an

average rating of "5" during the standardization phase of the experiment. After phase

one of the experiment, there was a difference between the low-high group and the high­

low groups' ratings of those mid-scale stimuli. This experiment demonstrated that

subjects who were first exposed to items exhibiting high disturbance rated items in the

medium range of disturbance as less severely disturbed than did subjects who were first

exposed to low disturbance items (Campbell et al. 1957). Although Arnhoff did not find

12

any kind of effect when extreme words were presented prior to moderate words;

Campbell et al.' s paradigm demonstrated that contrast can affect judgments of thought

disturbance. Note that while Campbell et al. successfully demonstrated contrast by

comparing the low-high and high-low groups to each other, they did not test whether

either group's ratings differed from the original value "5" of the standardization stimuli.

Thus their study did not determine whether contrast occurred in both directions or only

mone.

Another important facet of the research done by Campbell et al. (1957) is that

after phase one and phase two, the results from phase three of the study became more

assimilative. Campbell et al. (1957) theorized that in this relatively complex judgment

task, subject variables such as experience and comprehension of the instructions may

influence responses. Specifically, the subjects who had the strongest contrast reactions

in phases one and two of the experiment were the least likely to assimilate in phase

three. Campbell et al. (1957) suggested that the subjects who found the stimuli in phase

one the least ambiguous were the most likely to produce contrast responses throughout

the entirety of the experiment. Finally, it is important to note that by the end of phase

three of the experiment each subject had seen 130 word/definition pairs; some kind of

task fatigue may have interacted with the phenomena under investigation.

Manis and Paskewitz (l 984a) found an additional factor, the degree of similarity

between context and test stimuli, that influence the probability of contrast occurring. In

their series of experiments, subjects were exposed to one of two different kinds of

stimuli. One kind was definitions provided by Arnhoff (1954) that had previously been

rated as exhibiting disordered thinking; the second was handwriting samples. Prior to

the experiment, a "standardization group" (otherwise unspecified) rated these

handwriting samples for psychopathology; average ratings were computed to measure

the amount of psychopathology that each item indicated.

13

Manis and Paskewitz (1984a) varied whether subjects were initially presented

with definitions or with handwriting samples. Both of these stimulus types were

subdivided into two separate subgroups, those that had been previously standardized as

relatively pathological and those that had been previously standardized as being non­

pathological. The pathological definitions ranged between 8.0 to I0.7 on an I I-point

scale of pathology, while the non-pathological definitions ranged from 1.5 to 3.9 on the

same I I-point scale. Also, the pathological handwriting samples ranged from 7.8 to 10.3

on a separate I I-point scale of pathology while the low pathology handwriting samples

ranged from 1.6 to 3.0 on the same I I-point scale. During this initial, induction phase of

the experiment, subjects were presented with one of the four possible combinations of

stimulus type and pathology level: High-pathology definition, low-pathology definition,

high-pathology handwriting, and low-pathology handwriting. All subjects were told that

the samples came from, "a representative cross-section of patients in a state hospital" (p.

222). Each subject was initially shown six moderate pathology stimuli as warm-up,

followed by 20 of the more extreme stimuli described above. Subjects decided whether

the creator of the definition or handwriting sample was schizophrenic or not: a yes/no

decision.

Next, in the experimental phase, subjects were told that the stimuli were,

"derived from another representative sample of patients" (Manis & Paskewitz, I 984a,

p.222). The test items in the experimental phase were both handwriting samples and

14

word/definition pairs. The word/definition test items fell within the moderate range of

pathology; between 4.1 and 7 .8 on the previously mentioned 1 I-point pathology scale.

There were two separate kinds of handwriting stimuli; half of the test stimuli fell

between 1. 7 and 7 .1 on the I I-point psychopathology scale, the other stimuli fell

between 4.1 and 6.6. Some of the subjects rated solely the word/definition pairs, others

rated only the handwriting samples (the 1.7 to 7.1 stimuli), finally some subjects rated a

stimulus set that included both word/definition pairs and handwriting samples (the 4.1 to

6.6 stimuli). Subjects rated the degrees of thought disturbance of the creators of stimuli

on a 7-point scale where 1 represented a person with normal thought, while 7

represented a highly thought-disordered person. Subjects again rated whether the creator

of the stimulus was schizophrenic or not. Finally, subjects rated the confidence of their

diagnosis of schizophrenia (or not) on a separate 7-point scale where I represented a

guess and 7 represented very certain. Because the two 7-point scales ended up being

highly correlated the scales were combined to form one 14-point scale that ranged from

I (very certain the person is not schizophrenic) to 14 (very certain that the person is

schizophrenic). Manis and Paskewitz translated this 14 point scale into a single score,

presumably using a Z-score transformation to equally weight both scales.

For some participants the induction phase stimuli were of the same type as the

experimental phase stimuli (definitions or handwriting samples), while for other

participants the induction and experimental phase stimuli were of different types. So, for

example, subjects who were first presented with definitions could be asked to rate

psychopathology of more definitions or could be asked to rate handwriting samples.

15

Contrast occurred in the experiment. Subjects first exposed to high pathology

induction stimuli rated the subsequent moderate stimuli lower than subjects who were

first exposed to low pathology induction stimuli followed by moderate stimuli. When

the initial, induction stimulus type matched the experimental stimulus type, contrast was

more likely to occur. For example, if a subject was exposed to a non-pathological

definition in the initial phase of the experiment, the subject's rating of a moderate

definition was likely to be rated as more pathological than if the initial stimulus exposure

had been a hand-writing sample. The contrast effect was strongest with the experimental

stimuli that immediately followed the initial stimuli. Results were different for the

subjects who were presented 'mis-matched' stimuli (for example, definitions followed

by handwriting samples). For these groups, the contrast effect was present; however, the

effect size was much smaller. Manis and Paskewitz (1984a) questioned whether the

'mis-match' data results were replicable, and referenced a similar experiment by

Parducci, Knobel and Thomas (1976) in which subjects rated the sizes of geometric

forms (circles and squares) in which contrast did not occur in the 'mis-match' condition.

Manis and Paskewitz (1984a, p.225) concluded that, "the presentation of a biased

induction series ... leads to contrast in estimating the amount of psychopathology implied

by other stimuli of the same type; when, however, stimuli from a different domain are

evaluated with respect to the psychopathology that they imply, the preceding induction

experience does not have a consistent impact". In other words, extreme vocabulary

definitions can create contrast with other vocabulary definitions, and extreme

handwriting samples can create contrast with other handwriting samples. However, if a

degree of similarity does not exist between induction series stimuli and response stimuli,

the magnitude of contrast-like responses significantly decreases. The authors declared,

"The most important finding in these studies is the relative specificity of the contrast

phenomenon" (p.227).

16

Manis and Paskewitz (1984b) published another study that also demonstrated the

specificity of contrast while simultaneously examining the effect of subjects'

expectations. In the experiment, half of the subjects were initially presented with high­

pathology word/definition pairs and the other half were presented with low-pathology

word/definition pairs. Subjects were asked, "Was the definition produced by a

schizophrenic or non-schizophrenic patient?" (p. 367). After this induction phase,

subjects were presented with definitions and handwriting samples and evaluated the

degree of pathology evident in the word or handwriting sample. Some subjects were

asked to state their expectation in connection with the test item. So, before being

presented with the item, some subjects were asked to guess the percentage of

schizophrenic items in the whole list and also asked if the following stimuli would be

from a schizophrenic or non-schizophrenic patient. Subjects' expectations were

congruent with the induction series they were initially assigned; the high-pathology

group believed the test group would include more schizophrenic responses than the low­

pathology group.

In addition to the expectation effect, contrast also occurred. Subjects from the

low-pathology induction group rated the second group of definitions as being more

pathological than did those in the high-pathology conditions. Supporting their previous

studies findings regarding specificity of stimuli, handwriting samples were not affected

17

by contrast. In sum, the work of Manis and Paskewitz (1984b) provides factors that can

both suppress and enhance contrast.

The present study utilizes word/definition pairs as stimuli, following in the

dominant tradition in this field. However, not all research into contrast in judgments of

mental health has used word/definition pairs as the stimuli to be evaluated. For example,

Bieri, Orcutt, and Leman (1963) extended research on contrast and clinical judgment

using a different sort of stimuli and suggesting that the presence of extreme stimuli

presented prior to moderate stimuli creates ratings for those moderate stimuli that are

different from the baseline ratings of moderate stimuli. In the first portion of their

experiment, thirty-three clinical practitioners rated social behaviors of psychological

case reports on a 20-point scale of pathology where 1 represented very mild

maladjustment and 20 represented extreme maladjustment. The behaviors with the

largest amount of inter-rater agreement were placed into one of three categories: low

pathology, middle pathology, or high pathology. Four behavior examples formed one

case.

In the next portion of the experiment, sixty-five social work students were asked

to rate the pathology of the cases on the same 20-point scale. Each student only saw one

category of case (Low, Middle, or High). Cases were also divided according to the

predominant behavior the cases exhibited: aggressive or dependent pathology. This

portion of the experiment provided the non-anchored ratings of the middle cases.

After standardization data had been gathered, 176 more subjects saw two

extreme cases (either high or low pathology) followed by a middle pathology case.

Some of the subjects saw the aggressive cases while others saw the dependent cases.

18

There were eight possible experimental groups based on order of cases presented, kind

of pathology presented, and whether the stimuli behavior was categorized as aggressive

or dependent. The presentation of three cases constituted phase one of the study. There

were three other phases of the experiment that evaluated the impact of time on ratings;

however, the details of the other phases extend beyond the scope of this paper. Results

from phase one echoed several other studies of contrast. The subjects who rated the low

pathology cases first rated the middle cases as having significantly higher pathology than

did the subjects who rated the high pathology cases prior to the middle cases.

Additionally, Bieri et al. (1963) examined the ratings of the middle cases in phase one of

the study compared with the ratings of the non-anchored middle cases. Each of the eight

groups in phase one had moderate ratings that were indicative of contrast; for example,

subjects presented with high pathology cases first rated moderate cases as having less

pathology than the ratings of the non-anchored middle cases. However, only two of the

eight groups had statistically significant differences. Bieri et al. did not specify which of

the two groups provided the significant difference of phase one middle cases from non­

anchored middle cases.

Bieri et al. (1963) provided preliminary evidence to suggest that exposure to low­

pathology stimuli (or to high-pathology stimuli) prior to moderate stimuli creates ratings

for the moderate stimuli that are significantly different from baseline ratings of those

moderate stimuli. However, the conclusions were not definitive; only two of the eight

groups of stimuli yielded significant results and we don't know which ones they were.

Thus the question of just what judgments about mental health are moved by contrast

remains unsettled.

19

In 1971, Perrett found contrast with another kind of mental health/illness stimuli

while investigating whether the professional experience of the subjects would impact

magnitude of the contrast effect. In this study, abbreviated case histories were gathered

from either the closed files of psychiatric inpatients or from the MMPI Atlas. The case

histories reflected a wide range of psychological disturbances. Initially, 80 histories

were rated by five clinical psychologists on a seven-point scale of psychopathology (1

representing "very, very mild" and 7 representing "very, very severe" pathology).

Among the 80 histories, the ones whose ratings had the smallest standard deviations

were selected for use as stimuli in the experiment. The six case histories that received

moderate (3, 4, 5) ratings were selected to be the critical test stimuli that could be

affected by contrast.

In the experiment, subjects were divided into two groups, differing in the context

in which they saw the test stimuli. Each group saw a total of 20 case histories, and rated

their psychopathology on the same seven-point scale that was initially used by the

clinical psychologists. One group saw 14 histories that were previously rated as having

low psychopathology (1, 2, or 3 on the seven-point scale) and immediately afterwards

saw the six test stimuli. The other group saw 14 histories that were previously rated as

having high psychopathology (5, 6, or 7 on the seven-point scale) and immediately after

saw the six test stimuli. Because the six moderate test stimuli were common to both

groups, the differences between their ratings by the two groups were used to evaluate

contrast.

Perett (1971) also divided the subjects according to the kind of background

experiences that they possessed. Some of the subjects worked as therapists in an

20

inpatient setting, some of the subjects worked as therapists in an outpatient setting, and

some of the subjects were undergraduates enrolled in a psychology course. It was

hypothesized that those subjects who worked in an inpatient setting and saw the most

severe kinds of pathology on a regular basis would therefore be the least impacted by

contrast.

The results showed that moderate test cases were rated as more severely

pathological when they appeared following milder case histories than when they

appeared following more severe cases. Thus, the ratings exhibited contrast. Also, the

experienced clinicians and the undergraduates were affected differently by the stimuli.

Contrast was higher for the students than it was for the clinicians. While the variable of

experience did produce statistically significant results, Perett emphasized that the largest

effect size was a result of what level of pathology the subjects saw prior to the test cases.

More recently, Wedell, Parducci and Lane (1990) examined specific factors-- the

number of categories on a rating scale and the kind of anchors on the scale-- that may

influence how contrast affects clinical judgment. They used as stimuli the same thirty­

four case histories of psychiatric inpatients as did Perett (1971); six were the "moderate"

test stimuli, 14 the low psychopathology stimuli and 14 the high psychopathology

stimuli from the Perrett study.

Because Wedell et al. (1990) were testing a number of factors that could

influence contrast, they did two separate experiments. In the first experiment, subjects

judged the mental health of psychiatric patients based on their case histories. In this

phase subjects were assigned to use one of three different category rating scales: a 3-

point, 7-point, or 100- point scale. In each of these scales, a rating of one or zero

represented a case history with a "very, very mild disturbance". The upper limit of the

scale (either 3, 7, or 100) represented a case history with a "very, very severe

disturbance".

21

In addition to the size of the category rating scale, the experimenters also

manipulated what kind of stimuli the subjects saw prior to the moderate test cases. Some

of the subjects saw only mild cases prior to rating moderate cases and some saw only

severe cases prior to rating moderate cases (the "restricted range" groups). Some of the

other subjects saw mostly mild or severe cases prior to the test cases but had three case

examples of the opposite severity included (the "full range" groups).

Like Perett (1971), Wedell et al. (1990) found that the factor that most largely

impacted contrast is the degree of pathology of the words that precedes the test cases.

Additionally, they also found a statistically significant difference between groups as a

function of the range of cases that was presented prior to the test cases. For the full range

groups, who saw a mix of mild and severe cases prior to the moderate cases, the contrast

was smaller than for the groups who were in the restricted range groups. Also, increasing

the number of rating categories from 3 to 7 decreased the magnitude of contrast but there

was no significant difference in contrast between 7- and 101- point scales. Wedell et al.

attribute the heightened contrast in the 3-point scale to response biases rather to

enhanced perceptual changes. The present study is interested in the perceptual aspect of

contrast, shifts in the degrees of apparent mental health, rather than response biases and

hence uses a 100-point scale.

In the second experiment, Wedell et al. (1990) tested whether anchoring the two

opposite ends of the scale might diminish the contrast effect. This experiment used only

22

a 7-point category scale. Subjects were assigned to one of three anchor rating groups. In

the first group, subjects saw an anchor that provided a case history example for each

endpoint of the scale (exemplar anchor). In the second group, subjects saw an anchor

that provided a detailed description for each category that could be selected (DSM

anchor). Subjects in the third group did not see any anchoring information. Again, in

this experiment the same restricted and full range groups of both mild and severe stimuli

were used.

Results were similar to those of the first experiment. Contrast was most affected

by the degree of pathology of the words that preceded the test cases and mirrored the

aforementioned results. Again, there was also a statistically significant difference in

contrast as a function of the range of pathology that was presented prior to the test cases.

In the second experiment, both kinds of anchors equally attenuated the contrast effect in

the restricted range cases, "29% reduction for exemplar anchors and 25% reduction for

DSM anchors" (Wedell et al., 1990, p. 326). There was also a trend for the anchors to

affect the full range group, but not to a statistically significant degree. Overall, the

variables of type of pathology and the range of pathology had more of an impact on

contrast than did whether or not anchors were present.

In sum, Wedell et al. (1990) demonstrated that the strength of the contrast effect

decreased when at least seven rating categories were used or when anchors that spanned

the stimulus range were used; however, contrast was most strongly influenced by the

degree of pathology of the stimuli that the subjects saw prior to the moderate stimuli.

An earlier study by Campbell, Hunt and Lewis (1958) had also examined the

effects of using detailed anchors. In their study, Campbell et al. used vocabulary

23

responses that had been previously rated on a nine-point scale of pathology: a rating of

one indicated "well-organized and normal" thinking, while a rating of nine indicated,

"totally disorganized and eccentric" thinking (p. 213). The methods of the study

replicated their aforementioned 1957 study. However, in this study, some of the subjects

received a detailed explanation/anchor of every value on the 9-point scale. For example,

they were shown that a rating of four meant that, "distinct traces of disorganization and

eccentricity are shown" (p. 215). Like Wedell et al. (1990), Campbell et al. (1958) had

found that contrast occurred both when subjects were presented with the

descriptor/anchor for each scale value and when they were given only the end-point

labels. However, the effect of contrast was larger when the endpoints were labeled than

when a detailed example was given for every value of the scale. The present study uses a

100-point rating scale with anchors only at the endpoints.

While the literature on contrast and mental health has largely examined the effect

of extremely pathological stimuli on moderate stimuli, it has not looked at whether

moderate stimuli have contrast effects on the perception of extreme stimuli.

Furthermore, the research has not determined whether contrast can push mental health

assessments in both directions - toward both more and less pathology. Though

bidirectional contrast occurs in some settings, it does not in others. Parker, Bascom et al.

(in press) demonstrated bidirectional contrast occurring simultaneously when people

listened to various kinds of music. In their study, six different melodies were composed

by the researchers. Three of the melodies were categorized as "bad" because they

violated the norms of popular and classical music. The remaining three melodies were

categorized as "good" because they had similar structure to popular music. Half of the

24

subjects heard the three "good" melodies before the "bad", the remaining half heard the

three "bad" melodies before the "good". Subjects were asked to rate, "how much you

liked listening to it" using a 201-point bipolar hedonic scale (from -100 "hated listening

to it" to 100 "loved listening to it"). Subjects' ratings of the "bad" melodies were higher

if they were rated first, than if they were heard second. The "good" melodies were rated

higher if they were rated second, than if they were rated first. However, loudness

contrast does not seem to be equally powerful in both directions. Parker and Schneider

(1994; see also Parker, Murphy & Schneider, 2002) found that intense sounds affect the

loudnesses of soft sounds, but saw little influence of soft sounds on the perception of

loud ones. The present study will look for bidirectionality of contrast in mental health

judgments and, in addition, will look into whether moderate stimuli influence the

judgments of extreme stimuli.

Word!Definition pairs are used in this experiment, following the largest amount

ofresearch in contrast and mental health judgments. Although several of the

aforementioned studies used case histories, these studies often used psychology students

or clinicians as subjects. The use of words and definitions makes the stimuli more

accessible to a general population.

The present study uses groups of four words followed by a pair of test stimuli,

the ones used to test contrast. Throughout the previously described studies of contrast

and mental health, there was a wide variance in the number of stimuli presented. For

example, Bieri et al. (1963) presented three case histories during a given phase of the

study while Campbell et al. (1957) presented 130 word definition pairs to each subject.

25

A "four plus two" stimuli pattern was used for a number of reasons. First, as confirmed

by previous studies, contrast does not seem to be particularly sensitive to stimulus

number. It is a robust phenomenon and would likely occur with a wide variety of

stimulus number presentations. Secondly, as discussed by Cambell et al. (1957) if

subjects are repeatedly exposed to a larger number of moderate words, contrast may

originally appear but eventually lead to assimilation. Other previous research had used a

variety of context and test stimuli number and contrast occurred (e.g. Parker, Bascom,

Rabinovitz, & Zellner, in press, three context & three test stimuli; Zellner, Allen, Henley

& Parker, 2006, four context & two test stimuli; Dolese, Zellner, Vasserman, & Parker,

2005, five context and two test stimuli; Zellner, Rohm, Bassetti & Parker, 2003, eight

context and two test stimuli). The present study, then, follows the procedure of Zellner,

Allen et al.

In previous studies of contrast and mental pathology, there has been sufficient

evidence to suggest that exposure to stimuli at a well-defined place on a scale can create

contrast for stimuli at a different well-defined place on a scale. However, only one

previous study has suggested that exposure to low-pathology stimuli (or to high­

pathology stimuli) prior to moderate stimuli creates ratings for the moderate stimuli that

are significantly different from baseline ratings of those moderate stimuli. Also, there

have been no investigations in the mental health judgment literature into whether initial

exposures to moderate stimuli can shift ratings of either low or high rated stimuli. These

considerations motivate the present study.

Goals of the Study

1.) Re-examine the contrast effect and its relation to mental health perception.

(i.e. confirm it occurs)

2.) Re-examine whether the presence of the unhealthy stimuli/healthy stimuli

shifts ratings for moderate stimuli away from the baseline ratings of those

moderate stimuli.

26

3.) Investigate whether initial exposures to moderate stimuli can shift ratings of

either low- or high-rated stimuli.

CHAPTER2

EXPERIMENT 0: CALIBRATION

The objective of the calibration experiment was to find a set of words that people

rated reliably and that could be used to investigate contrast.

Method

Participants

Seventy-seven people (31 females, 46 males, ranging from college age to older

adults) participated in this experiment. Participants were randomly selected from the

general population and asked if they would be willing to participate in a psychology

experiment that would take approximately ten minutes. Participants were excluded from

the study if they were not fluent English speakers. Participants were not offered

compensation for their time.

Materials

The creation of the stimuli was inspired by word/definition pairs similar to those

developed by Arnhoff (1954). Sixty words and definitions were created (some) or

adopted (the rest) in order to find responses that would be rated as exhibiting varying

degrees of mental health/mental illness.

27

28

Procedure

Subjects were run individually. Each participant rated the full list of 60

word/definition pairs. In all cases, 10 word/definition pairs were placed on six different

sheets of paper. Subjects were asked to read each word/definition pair aloud and rate

their perceptions of the definitions. Five distinct 6-page sets of the 60 stimuli were

constructed, recombining stimuli into the six groups of 10 in roughly counterbalanced

orders.

Participants rated the definitions in one of two conditions. Half of the

participants evaluated the mental health of the person who created the definitions on a

scale ranging from 0 = no mental health to 100 = perfect mental health, while the other

half evaluated the mental illness of the person who created the definitions on a scale

ranging from 0 = no mental illness to 100 = extreme mental illness. In both conditions

five approximately counter-balanced random stimulus-page orders were used. Subjects'

ratings were made orally, and the experimenter transcribed their responses.

Results

In general, ratings of words in the mental health condition had lower standard

deviations than did ratings of words in the mental illness condition, so the mental illness

ratings were discarded, and mental health ratings are used in the following studies.

Based on the calibration data, four word/definition pairs were selected whose mean

ratings fell into the Low mental health range and were similar to each other (M=37.6,

SD=18.3), four word/definition pairs were similarly selected from the Moderate mental

health range (M=61.4, SD=l 3.6), and four word/definition pairs were selected from the

High mental health range (M=89.9, SD=7.3). (One of the High mental health range

word/definition pairs, "cushion", was used in the Arnhoff [1954] study). These words

are listed in Table 1 and were then used in Experiments 1 and 2.

29

CHAPTER3

EXPERIMENT 1: HIGH MENTAL HEAL THI

MOD ERA TE MENTAL HEALTH

Method

Participants

Sixty people, (sex breakdown unknown), ranging from college aged to older

adults, participated in this experiment. Participants were randomly selected from the

general population and asked if they would be willing to participate in a psychology

experiment that would take approximately five minutes. Participants were excluded

from the study if they were not fluent English speakers. Participants were not offered

compensation for their time.

Materials

The eight word/definition pairs selected on the basis of the calibration

experiment were used as the stimuli: the four High pairs and the four Moderate pairs

shown in Table 1.

Procedures

The procedure was similar to that of the calibration experiment. Subjects were

run individually. Each participant rated six word/definition pairs. Twenty-four subjects

received the four Moderate word/definition pairs followed by two High word/definition

pairs (the Moderate/High group). The remaining 36 subjects received four High 30

31

word/definition pairs followed by two moderate word/definition pairs (the

High/Moderate group). The orders of the word/definition pairs within their category of

Moderate or High mental health were randomized and counterbalanced. For the four

word/definition pairs that were presented first there were two possible stimulus orders

that subjects might have seen: the four word pairs in one order (ABCD) or the reverse

order (DCBA) - see Table 1. After the initial presentation of four word/definition pairs

from one category (Moderate or High), subjects only saw two word/definition pairs from

the other category. Each subject saw one of the following combinations of two: (AB)

(BA) (CD) or (DC). Thus sixteen distinct stimulus orders were used in the experiment.

Each word/definition pair was placed on a different sheet of paper. Subjects were

asked to read each word/ definition pair aloud and rate the mental health of the person

who created the definitions on a scale ranging from 0 = no mental health to 100 = perfect

mental health.

Subjects' ratings were made orally, and the experimenter transcribed their

responses.

Results

Table 2 shows the average ratings for all words in all conditions of Experiment 1.

Each subject's four responses for Moderate words in the Moderate/High group were

averaged; those averages had Mean= 64.9 and SD =10.7. (Table 2 shows the Mean

rating for all words in all conditions of Experiment 1 and Experiment 0). Notice that the

value 64.9 is similar to the calibration data for those words, where their average rating

was 61.4. Each subject's two responses for Moderate words in the High/Moderate group

32

were also averaged; those averages had Mean= 53.9 and SD=19.4. There was a

significant difference between these two groups' average ratings of Moderate words,

t(58) = 2.62,p<.OI l. The estimated value of omega-squared, the proportion of variance

in the two populations attributable to differences in their means (an effect-size measure),

was .09. Moderate words were rated higher by the Moderate/High group (which saw

those words first) than by the High/Moderate group.

Conversely, no difference was seen in the two groups' ratings of the High words.

For each subject we also calculated the average of the ratings for the High words in both

the Moderate/High group (M=85.1, SD=18.4) and the High/Moderate group (M=87.5,

SD=9.9). (Both of those, in words in the High/Moderate group were also averaged; those

averages had Mean= 53.6 and SD particular the value for the High/Moderate group, are

similar to the calibration data where the mean rating for those words was 89.9; see Table

2.) There was no significant difference between the two sets of ratings of the High

words, t(58) = .67,p>.50. The estimated value of omega-squared was 0.

Prior to the completion oft-tests all distributions in the experiment were tested

fo'r normality by assessing skewness and kurtosis. In one of the moderate samples

(Moderate/High group), the kurtosis value indicated that the sample might deviate from

a normal distribution. As a result, a Mann-Whitney test was also performed on this data,

comparing the ratings of the Moderate words in the Moderate/High and High/Moderate

groups. Like the t-test, it found the ratings to be significantly lower in the

High/Moderate group (n = 24, 36; U = 584, 280; z = 2.29; p<.022). Effect size was

measured using Cliff's (1993) d which ranges in value from 0 to 1. For this test, d = .36.

Thus the significant difference found with the t-test was reconfirmed with the Mann­

Whitney test.

Discussion

33

Contrast occurred for the Moderate words: Moderate words were moved

significantly below their baseline ratings when preceded by High words. This is the first

demonstration of a shift from baseline ratings in judgments of mental health.

However, no contrast occurred for the High words. Whether this is a discovery

about contrast or a ceiling effect is not clear. The High words that were selected for the

experiment had a mean rating of nearly 90. It is possible that Moderate words presented

first might have increased the ratings of High words; however the High words were

already at an extreme end on the mental health scale.

CHAPTER4

EXPERIMENT 2: LOW MENTAL HEALTH/

MOD ERA TE MENTAL HEALTH

Experiment 2A: Method

Participants

Forty-eight people, (sex breakdown unknown), ranging from college age to older

adults, participated in this experiment. Participants were randomly selected from the

general population and asked if they would be willing to participate in a psychology

experiment that would take approximately five minutes. Participants were excluded

from the study if they were not fluent English speakers. Participants were not offered

compensation for their time.

Materials

Eight word/definition pairs selected on the basis of the calibration experiment

were used as the stimuli: the four Low pairs and the four Moderate pairs. See Table 1.

Procedures

The procedure was similar to that of Experiment I. Subjects were run

individually. Each participant rated six word/definition pairs. Twenty-four subjects

received the four Moderate word/definition pairs followed by two Low word/definition

pairs (the Moderate/Low group). The remaining 24 subjects received four Low

word/definition pairs followed by two Moderate word/definition pairs (the

34

35

Low/Moderate). The orders of the word/definition pairs within their category of

Moderate or Low mental health were randomized and counterbalanced As in Experiment

1, for the four word/definition pairs that were presented first there were two possible

stimulus orders that subjects might have seen: the four word pairs in one order (ABCD)

or the reverse order (DCBA) - see Table 1. After the initial presentation of four

word/definition pairs from one category (Moderate or Low), subjects only saw two

word/definition pairs from the other category. Each subject saw one of the following

combinations of two: (AB) (BA) (CD) or (DC). Thus sixteen distinct stimulus orders

were used in the experiment.

Each word/definition pair was placed on a different sheet of paper. Subjects were

asked to read each word/definition pair aloud and rate the mental health of the person

who created the definitions on a scale ranging from 0 = no mental health to 100 = perfect

mental health.

Subjects' ratings were made orally, and the experimenter transcribed their

responses.

Results

Each subject's four responses for Moderate words in the Moderate/Low group

were averaged; those averages had Mean= 73.6 and SD =11.3. (Table 3 shows the mean

ratings for all words in all conditions of Experiment 2 and Experiment 0. Notice that the

value 73.6 is noticeably higher than the Experiment 0 calibration data for those words,

where their average rating was 61.4). Each subject's two responses for Moderate words

in the Low/Moderate group were also averaged; those averages had Mean= 75.7 and

SD= 13 .3. There was not a significant difference between these two groups' average

ratings of the Moderate words, t(46) = .62,p>.54. The estimated value of omega­

squared was 0.

36

Additionally, no difference was seen in the two groups' ratings of the Low

words. For each subject we also calculated the average of the ratings for the Low words

in both the Moderate/Low group (M=47.9, SD=15.3) and the Low/Moderate group

(M=47.9, SD=18.5). (Both of those are also noticeably higher than the calibration data

where the average rating for those words was 36.7; see Table 3.) There was no

significant difference between the two sets of ratings of the Low words, t( 46) = .106,

p>.99. The estimated value of omega-squared was 0.

Discussion

Contrast did not occur in the Low mental health/Moderate mental health

experiment. The ratings of the Moderate words in both conditions and the Low words in

both conditions were nearly identical. Because the scores for both the Moderate words

and the Low words (when presented first) were much higher than the original calibration

data, the experiment was replicated. Although it is difficult to know why the Moderate

scores and Low scores (when presented first) were so different than the calibration data,

one hypothesis is that these subjects were run during the summer. Fewer college

students were subjects during this time; therefore, most of the subjects came from the

general community as opposed to the American University campus. In order to have a

subject sample that more closely resembled the subject sample of Experiment 1,

Experiment 2B was run.

Experiment 2B: Method

Participants

37

Forty-eight people, (sex breakdown unknown), ranging from college age to older

adults, participated in this experiment. Participants were randomly selected from the

general population and asked if they would be willing to participate in a psychology

experiment that would take approximately five minutes. Participants were excluded

from the study if they were not fluent English speakers. Participants were not offered

compensation for their time. This experiment was run during the fall; thus, more college

students were part of the sample.

Materials

Identical to Experiment 2A

Procedures

Identical to Experiment 2A

Results

As in Experiment 2A, each subject's four responses for Moderate words in the

Moderate/Low group were averaged; those averages had Mean= 65.2 and SD =12.4.

(Table 3 shows the mean ratings for all words in all conditions of Experiment 2B and

experiment 0. Notice that the value 65.2 is more similar to the calibration data for the

Moderate words, 61.45, than to the ratings of the Moderate words presented first in

experiment 2A). Each subject's two responses for Moderate words in the Low/Moderate

group were also averaged; those averages had Mean= 67.2 and SD=18.2. There was not

a significant difference between these two groups' average ratings of the Moderate

words, t(45) = .44,p>.66. The estimated value of omega-squared was 0.

38

Additionally, no difference was seen in the two groups' ratings of the Low

words. Each subject's ratings of the Low words were averaged. Those averages had

Mean= 45.2 and Standard Deviation 18.6 in the Moderate/Low group, and Mean= 40.1

Standard Deviation= 12.8 in the Low/Moderate group. There was no significant

difference between the two sets of ratings for the Low words, t( 45) = 1.1, p> .28. The

estimated value of omega-squared was 0.

Discussion

Again, contrast did not occur with either the Low or Moderate words. The scores

for the Moderate words (presented first) were closer to the original calibration data than

they had been in Experiment 2A; however, this change did not affect contrast.

CHAPTERS

GENERAL DISCUSSION

Contrast occurred for the Moderate words in the Moderate/High condition

(Experiment 1): Moderate words were moved away from their baseline ratings in the

direction of lowered mental health. However, contrast did not occur in the

Moderate/Low condition (Experiment 2A/2B): Moderate words were not moved away

from their baseline ratings. In neither experiment did the Moderate words induce

changes in the ratings of the extreme words.

The results of this study echoed previous research on contrast and mental health.

Similar to the findings of Campbell, Hunt, and Lewis (1957), Perett (1971), Manis and

Paskewitz (1984), and Wedell, Parducci and Lane (1990) this study confirmed that

contrast occurs in judgments of mental health. This study also echoed the preliminary

conclusions of Bieri, Orcutt, and Leman (1963). The presence of the High words shifted

ratings for Moderate words away from the baseline ratings of those Moderate words.

While Bieri et al. demonstrated a general trend towards these results, this study was the

first to confirm overall statistical significance.

This was the also the first study to measure contrast in mental health judgments.

Previous research had focused on scales of thought disturbance or pathology. This

experiment instead used a scale of mental health; where one end of the scale represented

unhealthy and the other represented healthy. In the calibration phase of the study both a

mental health scale and mental illness scale were used to rate the word/definition pairs. 39

40

However, the mental health ratings had less variability than the mental illness ratings,

and that was the reason for choosing to use them to study contrast. Perhaps rating mental

illness was generally more difficult than rating mental health. Anecdotally, more

subjects had trouble assigning judgments in the mental illness condition, and often stated

that without more information it was difficult to make judgments.

A potential concern regarding studies with contrast is that significant findings do

not reflect perceptual differences in actual stimuli, but rather, may simply reflect a

change in the way people are using the rating scale. Manis and Paskewitz (1984a)

allayed this worry and demonstrated that a shift of the perceptual locations of the ratings

on the scale was not the cause of the phenomenon. As described previously, both

handwriting samples and words/definitions were used in their study. Subjects first were

exposed to low pathology words/definitions, then subjects were exposed to either

moderate pathology words/definitions or moderate pathology handwriting samples. The

magnitude of contrast was much greater when the moderate words/definitions were

presented than when the handwriting samples were presented. The use of the

handwriting sample group functioned as a control to ensure that the previous exposure to

the low pathology words/definitions was not simply influencing how subjects used the

rating scale.

Also, because six separate hypothesis tests were performed in this experiment

(and only one produced significant results), it is necessary to consider the possibility that

a type one error might be present. To account for this possibility, a Bonferroni

Correction was used that suggested the critical p-value should be .0083. In the

significant Moderate/High condition the p-value was .011, close enough to suggest that

41

the Moderate words were actually affected by the High words. Also, it is possible to

perform the Bonferroni Correction with an N of two because only two t-tests were done

within the Moderate/High condition. This correction provides a critical p-value of .025,

which this experiment satisfactorily meets.

Consistent with previous experiments of this type, the current experiment

produced contrast. In the experiment, a series of one kind of stimuli were presented to

each subject (4 Healthy words). Next, a series of another kind of stimuli was present to

each subject (2 Moderate words). In reporting results, the average of the Healthy words

and the average of the Moderate words were calculated. As Lockhead (1982) discussed,

this kind of design would likely produce contrast. If the experiment were to have

presented each subject with only one Healthy stimulus followed by one Moderate

stimulus (to be evaluated), results might have been observed to be more assimilative.

Also, as Zellner and Cobuzzi (2008) demonstrated, assimilation is more likely to

occur when presentation of stimuli is simultaneous. In the context of mental health

stimuli, a simultaneous presentation would not have been feasible.

Given the nature of the experiment's design, it is interesting to wonder why

contrast did not occur in the Low/Moderate condition. One possibility is that there was

not a high degree of consistency among the raters on any of the less mentally healthy

items. The Low and Moderate words had standard deviations that were 16.24 and 13.62

respectively (the SD for the High words was a much lower 4.17). This lack of

intersubject agreement in both the Low and Moderate stimuli could explain why it was

difficult to obtain consistent results within the contrast phase. The high variability

among the Moderate words could also explain why the Moderate words did not affect

42

the High words in Experiment 1. For example, it is possible that for some subjects a

word that was classified as having Low Mental Health might have induced more

mentally healthy perceptions than some of the words that were classified as High Mental

Health. If a subject perceived a Low Mental Health word as having similar or even

higher mental health than a word classified as High Mental Health, contrast would surely

be limited. In the future, it would be beneficial to devise Low and Moderate mental

health stimuli that could yield more consistent intersubject agreement.

Another possibility as to why contrast did not occur in the Low/Moderate

condition is that the perceived differences in mental health between Low and Moderate

words are not as great as the perceived differences between Moderate and High words.

Despite the fact that there was a 30 point difference between both Low and Moderate

and 30 point difference between Moderate and High (on the 100 point mental health

scale), maybe the scale was not interval. If the perceived difference between Low and

Moderate words was smaller than the perceived difference between High and Moderate

words, contrast between the Low and Moderate words may have been less likely to

occur. For instance, if two types of words were already perceived to be similar in degree

of pathology the magnitude of the effect of contrast would diminish if not disappear.

Future research might be able to find other Low stimuli that do induce measurable

contrast.

While it is necessary to examine potential procedural reasons why the

experimental paradigm did not produce contrast between Low and Moderate words, it is

possible that the lack of contrast may speak to something more general about the

phenomenon. Maybe the contrast effect is not as general as Wundt suggested. There

43

might be an aspect of the effect that makes it more likely to occur in one direction than

the other with this sort of stimuli.

Finally, Moderate words never induced contrast on either type of extreme word.

It is possible that the extreme stimuli were not changed from their baseline ratings

because of perceptual ceiling and floor effects; both the Low mental health and High

mental health stimuli were already toward the end points of the mental health scale

(M=36.67 and M=89.90, respectively). While the Low mental health stimuli still had

room to migrate to the lower end of the scale, the aforementioned lack of consistency

among the ratings might have impacted those kinds of results. Again, the possibility

exists that, in general, Moderate stimuli do not induce contrast. Alternatively, it could

be that contrast operates only in one direction for mental health judgments as it seems to

in loudness.

The clinical implications of this study mirror many previous studies that

examined contrast and mental health: contrast affects clinicians' judgments. For

example, private practice clinicians tend to rate the same patients as more

psychologically troubled than do state hospital clinicians (Campbell et al., 1957). While

this study did not use clinicians as subjects, the results support the same conclusions. As

much as clinicians desire to assess and treat clients independently from one another,

previous exposure to other clients makes this impossible.

Clinicians should be aware of the effect that previous clients can have on the

judgment of their future clients. While awareness that contrast occurs may not entirely

eliminate the effect, it would likely lessen it. Also, clinicians should use strategies that

have been shown to lessen contrast in terms of rating mental health and illness. As

44

described previously, Wedell et al. (1990) showed that the magnitude of contrast

decreased when subjects were given a detailed description of every point of a particular

scale. If clinicians need to subjectively score clients, it is essential that they have a

detailed exemplar for every particular category. Also, Wedell et al. (1990) found that as

the number of rating categories increased, the degree of contrast decreased. Therefore, if

a clinician has a choice to use a larger scale to rate clients, it would likely increase the

accuracy of actual judgments and limit the effect of contrast. Finally, as Manis et al.

(1984a) demonstrated when two different types or categories of stimuli are presented,

the magnitude of contrast significantly decreases, not having a consistent impact.

Perhaps clinicians could use this categorization effect to their advantage; for example,

diagnose one client with an affective disorder (one category) prior to diagnosing a client

with an anxiety disorder (a distinct category).

The current study may also have some implications that do not mirror previous

research. In these experiments, the pathology in the word/definition stimuli was

disorganization. When the majority of these studies were done in the nineteen fifties and

sixties disorganization may have been the extent of the lay publics' general knowledge

about mental illness. Currently, however, a lay person may have a more complex view

of mental health and illness. For example, information about post traumatic stress

disorder, depression, and anxiety disorders are common in the media. In this

experiment, when subjects were asked to reflect on the mental health of the individual

who created the definition, a modem subject may have a very different conception of

mental health than did a subject fifty years ago. Finally, contrast was never found with

45

the Low mentally healthy words; therefore, the ability to have confidence in all clinical

implications of the study is limited.

This experiment corroborated previous findings on contrast and mental health.

Although Bieri et al. (1963) said they found some instances of movement away from

baseline ratings; this was the first study to definitely show in detail that shift from

baseline ratings occur. Finally, this study was one of the first studies to demonstrate

contrast in terms of mental health, not pathology. To summarize, Moderate words were

moved away from their baseline ratings in the direction of lowered mental health in the

High/Moderate condition of Experiment 1. Future studies should examine whether

changing some variables could reveal contrast with Low and Moderate words.

APPENDIX A

INSTRUCTIONS

I'll have to read these instructions to you or else I'll leave something out.

We are interested in learning about your impressions of people's mental health.

What will happen in this experiment is that you will read out loud some word definitions that come from a wide variety of people. What we would like you to do is to evaluate the mental health of the people who provided the definitions. After you read each word and its definition, you will rate the mental health of the individual who created the definition. There are no right or wrong answers, we are only interested in your impressions.

The ratings will be on a zero to a hundred point scale.

(Hand Scale) Notice that on the scale:

Zero indicates someone with a total lack of mental health, while one hundred indicates someone with perfect mental health. So, for example, a rating of 85 would represent someone you perceive as having very good mental health.

What we need you to do is to read each word and definition and then rate the mental health of the person.

Do not rate definitions according to how intelligent you think the person who made the definition was. Even though a definition may be incorrect, that does not necessarily indicate anything about the mental health of the individual.

Try to be as discriminating as possible.

Any questions?

Hand out definitions After the study, hand out thank you sheet.

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APPENDIXB

TABLES

Table 1: Stimuli List

Contrast Mean Standard Stimuli Definition Rating Deviation Low A. Smoke Rings and poof its magic 37.9 16.7 B. Turban Wraps royally around the clock 33.7 16.0 C. Combat Guns that shoot the noise hurts 37.8 15.9 D. Lipstick Talk too much mouth glued together 37.3 16.4

Moderate

A. King Rules the roost, man of the land 64.6 12.9 B. Philosophy Thoughts fill my vacant mind 62.1 14.3

C. Grass Mow all day, grows at night 59.4 14.6 D. Bride I do answers the popped question 59.7 12.7

High A.Runway Long stretch of road where planes take off and land 90.6 4.3 B. Chaos Confusion, opposite of order 89.6 4.4 C. Cushion A padded device for comfort 89.0 3.6 D. Vase Object used to contain flowers 90.4 4.4

Low Average=36.7, Standard Deviation=16.2 Moderate A verage=61.5, Standard Deviation= 13.6 High Average 89.9, Standard Deviation= 4.2

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Table 2: Words and Ratings-Moderate/High

Moderate Words Mean Rating (SD) Calibration 61.4 (13.6) High/Moderate 53.6 (19.4) Moderate/High 64.9 (10.7)

High Words Mean (SD) Calibration 89.9 ( 7.3) Moderate/High 85.1 (18.4) High/Moderate 87.5 ( 9.9)

Table 3: Words and Ratings-Moderate/Low

Moderate Words Mean Rating (SD) Calibration 61.4 (13.6) Moderate/Low (2A) 73.6 (11.3) Low/Moderate (2A) 75.7 (13.3) Moderate/Low (2B) 65.2 (12.4) Low/Moderate (2B) 67.2 (18.2)

Low Words Mean Rating (SD) Calibration 37.6 (18.3) Moderate/Low (2A) 47.9 (18.5) Low/Moderate (2A) 47.9 (15.3) Moderate/Low (2B) 45.2 (18.6) Low/Moderate (2B) 40.1 (12.8)

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