Psychological morbidity a year after treatment in intensive care unit

Several studies have linked treatment in the Intensive Care Unit (ICU) with negative psychological outcomes. This study explores the prevalence of negative psychological outcomes in Greek patients (N=29), a year after treatment in ICU. Percentages of participants with anxiety [41%, 95% CI (22%, 60%)] and Post- Traumatic Stress Disorder (PTSD) [34%, 95% CI (16%, 53%)] symptoms were similar to the related literature. Percentages of participants with depressive [17%, 95% CI (3%, 32%)] symptoms were rather low. Only 10% of participants reported absence of quality of live issues. Anxiety symptoms were related to desire to talk about the ICU experience (p=0.010), duration of propofol administration (p=0.018) and loss of employment (p=0.019) and negatively related to duration of stay in the ICU (p=0.025). PTSD symptoms were related to experiencing other stressors during the year after the ICU stay (p=0.001), social constraint (p=0.003), duration of propofol administration (p=0.004), loss of employment (p=0.020), low income (p=0.022) and negative ICU memories (p=0.029). Depressive symptoms were related to loss of employment (p=0.003), low income (p=0.029) and social constraint (p=0.033). Patients experience elevated levels of psychological symptoms long after they are discharged from the hospital. Several psychosocial factors emerged as important factors to consider for predicting levels of distress.

Self-Interest versus Group Interest and “Racialized” Social Constraint

This chapter focuses on racialized social constraint's ability to increase political action in support of the Democratic Party and its candidates. To demonstrate the existence of an in-group norm of active support, the chapter turns once again to data about the race of the interviewer. It then pushes deeper into the causal process of racialized social constraint using a lab-in-the-field experiment that can directly test the effect of racialized social pressure on blacks' willingness to engage in political action. Using the behavior of contributions to the Obama campaign as a black group-norm-consistent behavior, and using personal monetary incentives to defect from this norm to induce a self-interest conflict, the chapter varies whether black study participants must make their choice in front of another person who has made their own political choice clear, as well as whether that person is a racial in-group member. As a result, social pressure from other blacks uniquely reduces self-interested behavior and results in greater group-norm-consistent political behavior. Importantly, the chapter also shows that social pressure from other blacks only works to increase group-norm-consistent behavior. It does not encourage defection.

The Process of Racialized Social Constraint

This chapter digs into the process by which racialized social constraint works to inhibit the defection of black Americans from the norm of Democratic Party support. Empirically, it takes advantage of the social interactions within survey interviews—between black respondents and either black or non-black interviewers—as a window into exactly how racialized social constraint works to inhibit blacks' defection from the Democratic Party. Pooling more than thirty years of face-to-face survey data and twenty years of phone survey data, the chapter shows that the simple presence of a black interviewer exerts considerable pressure on black respondents to conform to the norm of supporting the Democratic Party. It reveals that black respondents express significantly greater identification with the Democratic Party when in the presence of a black interviewer. This chapter further demonstrates that the effect is most pronounced among those blacks who have the greatest incentive to defect from the norm of Democratic Party support: black conservatives.

Norms of Black Political Behavior

This chapter begins with a discussion of the social and political circumstances that have necessitated black political unity, norms of black political behavior, and the emergence of racialized social constraint. Placing its historical origins in slavery, the chapter looks at how racialized social constraint has developed from a tool for navigating the complicated social and political world of forced labor communities into an instrument for facilitating racial group-based collective action politics among black Americans. It connects norms of racial group constraint formed under slavery to mechanisms for mobilizing blacks into the protest activities of the 1960s Civil Rights Movement and tools for facilitating specific forms of engagement in modern electoral politics. From the combined insights provided by a historical review of black Americans' efforts at collective action and the racialized social constraint model, the chapter derives predictions of how racialized norms of political behavior constrain black partisan support in modern electoral politics. Finally, the chapter highlights two basic facts that speak to the explanatory potential of this framework.

Institutional Constraints and the Enforcement of Racialized Social Pressure

This chapter takes up black social institutions as central locations where in-group political norms are defined and propagated. It outlines a basic history of black social institutions, including how their creation was a direct response to the denial of access to white spaces. The importance of these institutions as sites for in-group political discourse and the enforcement of norms are noted. These institutions are places where blacks are reminded of group expectations. Using survey data, the chapter demonstrates the frequency with which blacks Americans interact within black institutions. The analysis shows that black institutions continue to be centers for daily engagement, reinforcing black social ties. The chapter then turns to another lab-in-the-field experiment to directly test the power of black institutions to facilitate racialized social constraint.