Social cognition – the ways social events are interpreted, analyzed and mentally represented – provides an information-processing framework for understanding how construals of self and others affect social discourse and psychological life (Fiske and Taylor, 1991). Social cognition concepts have influenced traditional areas of social psychological theory and research, including attribution processes, person perception, and attitude formation and change. Over time, the information processing emphasis of social cogni-tion has been integrated with concepts of motivation and emotion to create a fuller view of the individual in relation to the social world (Taylor, 1998).
Attribution processes refer to causal explanations generated by an individual to account for why a particular event or set of out-comes has occurred. People use attributions to make sense of their own behavior and that of others, and, therefore, attribution processes influence individual actions, affective experiences and
interpersonal behavior (Weiner and Graham, 1999). Attribution theory (Table 17.2) and research has been a mainstay of social psychology and has led to important clinical mental health ap-plications (Bell-Dolan and Anderson, 1999; Forsterling, 2001; Graham and Folkes, 1990).
Based on the proliferation of research stimulated in the 1970s by social psychological models of causal attribution, three major types of attribution biases in everyday social interactions were illuminated: the fundamental attribution error (Ross, 1977), the actor–observer bias (Jones and Nisbett, 1971) and the self-serving (hedonic) attribution bias (Bradley, 1978) (Table 17.3).
The fundamental attribution error – a bias toward at-tributing behavior to dispositional factors in the actor while underestimating the influence of situational variables – typically occurs in the context of understanding the behavior of others.
The actor–observer bias refers to instances in which individuals attribute their own acts to situational factors and minimize the role of dispositional qualities, attributing the others’ behavior to dispo-sitional factors. Actor–observer differences may be a function of greater self-knowledge than knowledge of others, or related to dif-fering perspectives between actors and observers that lead to dif-ferent causal interpretations. The self-serving (hedonic) attribution bias involves a propensity to attribute one’s successes to disposi-tional factors and one’s failures to situational causes. Specifically, the self-serving bias reflects a wish to present oneself in the best possible light. People tend to extend this attribution bias to impor-tant others in their interpersonal sphere (e.g., spouse). Multiple ex-planations have been offered in the literature regarding the causal underpinnings of these attribution biases (Forsterling, 2001).
Given that attribution processes tend to be activated by negative, unanticipated, or ambiguous events, it is logical to assume that attribution theory would have a useful role in conceptualizing how people come to understand the causes of their illness as well as processes of stress and coping with illness (Amirkhan, 1990; Salovey et al., 1998). Empirical evidence supports this view, as exemplified in a recent meta-analytic study that suggested that attributions influence illness-related coping and adjust-ment (Roesch and Weiner, 2001). Attributions influence one’s self-definitions in relation to the illness, as well as one’s percep-tions of control over illness-related contingencies and outcomes. However, associations between specific attributions and illness should not be interpreted to mean that certain attribution patterns cause illness, but rather that they may be among a complex set of factors affecting responses to illness.
It is clear that causal attributions are important in facilitat-ing health promotion and positive health practices (Rodin and Salovey, 1989; Salovey et al., 1998). To the extent possible, treat-ment interventions with medically ill persons should incorporate a focus upon enhancing the individual perceptions of control over health and treatment regimens with the aim of increasing adher-ence to medical regimens and improving adjustment to medical procedures and conditions. Existing research also underscores the importance of considering locus, stability and controlla-bility dimensions of the attribution process in understanding illness-related attribution processes and their role in predicting patient perceptions of medical treatment (Amirkhan, 1990).
Theoretical models and research have significant implications for mental health treatment (Bell-Dolan and Anderson, 1999; Forsterling, 2001; Weiner and Graham, 1999). Presumably, at-tribution models can be instructive for designing interventions that target causal inferences associated with problematic emo-tion states (e.g., guilt), moods (e.g., depression) and behavioral constellations (e.g., social avoidance) (Bell-Dolan and Anderson, 1999). The application of attribution models to depression is illustrative of this point.
The use of attribution concepts, including the notion of attribu-tional style, in understanding learned helplessness and depression led to the formulation that the presence of a pessimistic attribu-tional style increased the risk that an individual would experi-ence helplessness, hopelessness and depression (Abramson et al., 1978). This attribution dimension was later incorporated as a key component of the hopelessness theory of depression (Abramson et al., 1989; Gotlib and Abramson, 1999). This model predicts that an individual is at risk for hopelessness depression to the extent that negative events are attributed to internal, stable and global causes, and that these causes are perceived as both likely to prompt other negative consequences and to be reflective of deficiencies or shortcomings of self. The model also posits that a given individual’s causal attributions are a function of both situational factors and individual differences in attributional style. Further, cognitive vulnerability to hopelessness depression is conceptualized as a function of individual differences in at-tributional style as well as the propensity to infer negative consequences and negative self-evaluation in response to adverse events (Gotlib and Abramson, 1999).
Person perception, also referred to as social perception, pertains to the ways in which people formulate impressions of others (Leyens and Fiske, 1994). Person perception can be conceptu-alized broadly as involving three sequential processes: 1) the identification of meaningful acts by observation of overt actions based on the actor’s intentions or traits; 2) the formation of attri-butions about the acts; and 3) the integration of attribution infer-ences into a unified impression of an individual (Gilbert, 1998). Social psychologists have long suggested that people formulate implicit personality theories that consist of general beliefs about human characteristics and patterns of covariation among person-ality traits (Schneider, 1973). These knowledge systems facili-tate rapid formation of inferences about the enduring personality qualities of other people in everyday life by using assumptions about interrelationships among dispositional qualities to draw conclusions about observed behavior. More recently, schema concepts in social cognition have been investigated in order to specify cognitive processes through which individuals organize and represent coherent and meaningful impressions of others (Leyens and Fiske, 1994).
Although person perception variables per se have not been explicitly discussed in the context of health issues, one particularly useful application of this literature is in understand-ing relationships between patients and their health care provid-ers. The doctor–patient relationship is influenced in part by the affective and cognitive evaluations that each make regarding the other. These person perception variables affect interaction styles between physicians and their patients which, in turn, may influence the nature and quality of medical care. Patients’ perceptions of their physicians as paternalistic, interested in mutuality in decision-making regarding care, or expecting them (the patient) to have primary responsibility for decision-making will contribute to differential doctor–patient interaction dynam-ics (Shelton, 1998). Similarly, the degree to which the physician’s impression of the patient is that of a passive novice, informed part-ner, or the consumer in charge of care will affect doctor–patient interactions.
Person perception has clinical relevance for the cognitive interpretation of interpersonal situations. Many of the cognitive distortions (e.g., overgeneralization, magnification and minimi-zation) observed in depressed persons (Beck et al., 1979), anxious individuals (Beck et al., 1985), and people with personality disorders (Beck and Freeman, 1990) influence person perception in a maladaptive fashion. Thus, while person perception research has demonstrated a normative tendency to make rapid evalua-tions of others and interpersonal situations based on limited information, this process is apt to become problematic when cognitive distortions are operative. For example, the depressed person with low self-esteem and a pessimistic attributional style who, based on a few experiences of being criticized, perceives others as judgmental in virtually every interpersonal interac-tion is overgeneralizing based upon limited data (i.e., “others are always critical of me”). This is likely to interfere with the development of trusting relationships.
Implicit personality theories and schemas in social cognition are clinically applicable to understanding chronically maladap-tive person perception processes. This may have particular rel-evance for the clinical understanding of personality disorders. For example, the patient with paranoid personality disorder may hold a pervasive view of others as potentially attacking, blaming and controlling (Benjamin, 1996). The patient with borderline personality disorder may perceive others as simultaneously rejecting, abandoning and needing dependent others (Benjamin, 1996). The patient with obsessive–compulsive personality dis-order may believe that others expect perfection regardless of the individual’s own wants and needs (Benjamin, 1996). To address these maladaptive implicit personality theories, schemas and associated interaction patterns, effective psychotherapy helps patients identify dysfunctional person perceptions, develop an affective and cognitive awareness of the etiology of these beliefs and the functions they serve, and form more adaptive schemas of self in relation to others (Benjamin, 1996). Additionally, thera-pists’ awareness of problematic schemas and implicit personality theories early in treatment can assist in assessment and identifi-cation of interpersonal patterns that are likely to be enacted in the therapeutic relationship.
Attitudes refer to evaluations made by people along a contin-uum from positive to negative about specific entities called at-titude objects (e.g., ideas, concrete things, life events, social groups, classes of behavior, persons) (Eagly and Chaiken, 1998). Individual attitudes consist of three elements: cognitive (beliefs about attitude objects), affective (emotions elicited by attitude ob-jects) and behavioral (action intentions or overt behavior directed toward attitude objects). Additionally, individual attitudes may be associatively or logically linked to form broader inter-attitu-dinal structures consisting of two or more attitudes (Eagly and Chaiken, 1998). Attitudes provide a framework for rapid appraisal and evaluative interpretation of one’s world, thereby allowing one to formulate responses to the complexities and ambiguities of daily living in an economical fashion, often without the need for deliberate, conscious processing (Cooper and Aronson, 1992). Fundamentally, attitudes serve an important adaptive function by virtue of their evaluative properties involving distinctions of good stimuli presumed to enhance well-being from bad stimuli that could endanger well-being (Eagly and Chaiken, 1998).
Attitude theory and research has a rich history as one of the great areas of inquiry within social psychology (Eagly and Chaiken, 1998; Petty and Wegener, 1998). However, this voluminous and intricate literature can be encapsulated only briefly here. Theo-retical frameworks developed in the 1950s, 1960s and 1970s that laid the foundation for later social psychological inquiries into attitudes (Table 17.4).
Learning and reinforcement theories of attitude formation and change, founded on principles of behaviorism, were derived
from basic experimental psychology. Two major examples are conditioning (Staats and Staats, 1958) and associationist (stimulus–response) (Hovland et al., 1953) perspectives. These approaches emphasize the influence of stimulus pairing and stimulus–response patterns in attitude formation (Eagly and Chaiken, 1998).
Social judgment theory emphasizes the interplay of cogni-tive and affective attitudinal components and posits that percep-tions and judgments mediate attitude change (Sherif et al., 1965). According to this approach, attitudes are most likely to be influ-enced by information that is similar to one’s existing attitudinal set (i.e., latitude of acceptance), may be influenced by informa-tion about which one’s attitudinal set is not clearly defined and affectively neutral (i.e., latitude of noncommitment), and least likely to be influenced by information that is inconsistent with one’s attitudinal set (i.e., latitude of rejection).
Consistency theories posit that attitude formation and change are organized by a need to impose structure and order on one’s understanding of the environment. Cognitive dissonance theory (Festinger, 1957) posited that discrepancies between simultaneously held attitudinal cognitions (dissonance) produced psychological tension, requiring attitudinal changes to reestablish consistency (consonance). The degree to which this dissonance causes psychological tension is a function of the per-sonal importance of the cognitions and the number of dissonant cognitions relative to consonant cognitions.
An alternative approach that proposed to account for re-search findings regarding dissonance was self-perception theory (Bem, 1972). According to this perspective, individuals infer their attitudes through observing their own behavioral responses and the conditions under which they occur. From this view, at-titudes are formed on the basis of self-attributions (Cooper and Aronson, 1992).
The final group of attitude theories – functional theories – hold that individuals form and maintain attitudes consistent with their needs and motives (Katz, 1960; Kelman, 1961; Smith et al., 1956). For example, particular attitudes may be adopted for adjustment, instrumental, or utilitarian purposes, as they maximize rewards and minimize punishments. Attitudes also may serve a value expression function. Ego-defensive or ex-ternalizing functions of attitudes allow for maintenance of de-sired views of self and the world, while protecting the individual from acknowledgement of unpleasant realities. Attitudes serving a knowledge function assist people in formulating meaning about events in their world. Functional models suggest a complex interplay among different attitudinal beliefs, necessitating dif-ferent change strategies based upon the function of the attitude being targeted for change (Eagly and Chaiken, 1998).
Interest in enhancing precision in the prediction of behav-ioral responses from attitudinal beliefs prompted efforts to de-velop models of the attitude–behavior relationship (Table 17.5). Two broad types of models include those focusing on attitudes toward targets of behavior and those focusing on attitudes toward behavior (Eagly and Chaiken, 1998).
People’s attitudes affect whether or not they practice adap-tive or maladaptive health behaviors. Accordingly, it has been suggested that information aimed at promoting behaviors that reduce health risk should focus on attitudinal and normative beliefs influencing the behavior in question. The goal of such interventions is to bolster intentions to engage in or abstain from the target behavior.
Although not an attitude theory per se, the health belief model (Rosenstock et al., 1988; Strecher et al., 1997) is a well-known social psychological model explicitly formulated to understand health-related behavior practices. The health be-lief model posits that individuals are motivated to respond to perceived threats of illness, with threat defined in terms of per-ceptions regarding seriousness of and personal susceptibility to an illness. Behavioral responses to health-related threats are influenced by expectations regarding the ability to minimize such a threat, including perceived benefits and problems associated with a given response pattern. Sociocultural and demographic factors as well as personal and environmental cues regarding ap-propriate courses of action also are considered in the model. The model predicts that people are likely to take steps to minimize the risk of contracting a medical problem if the following condi-tions occur: 1) they view themselves as vulnerable to a particular health condition; 2) they deem the condition to be personally con-sequential; 3) they believe that a specific course of action would minimize vulnerability to the condition and that limitations as-sociated with such actions are outweighed by the potential ben-efits to be accrued; and 4) they perceive themselves as capable of performing these actions (i.e., self-efficacy). Researchers have examined the utility of the health belief model in informing pre-vention and intervention approaches for medically ill individuals and those at risk for specific illnesses (Salovey et al., 1998).
Attitudes can have an important impact on psychological outlook and functioning. Whereas individuals who evidence positive mental health possess flexible attitudes that are adaptive to the context, persons with psychological difficulties evidence rigidly held maladaptive attitudes that impair their capacity to cope effectively with life’s challenges. This suggests that helping patients identify and modify maladaptive attitudes about self and others can be an important component of psychotherapeutic intervention (Cooper and Aronson, 1992).