THE ANDREA YATES EFFECT

195 Pages·2010·4.83 MB·English

by  Lynette Holman

THE ANDREA YATES EFFECT:
PRIMING OF MENTAL ILLNESS STEREOTYPES THROUGH EXEMPLIFICATION
OF POSTPARTUM DISORDERS

By Lynette Marie Holman

A dissertation submitted to the faculty of the University of North Carolina at
Chapel Hill in partial fulfillment of the requirements for the degree of Doctor of Philosophy
in the School of Journalism and Mass Communication.

Chapel Hill
2010

Committee:

Rhonda Gibson, Ph.D.

Francesca Dillman Carpentier, Ph.D.

Laura Ruel

Tanya Chartrand, Ph.D.

Mary Frances Luce, Ph.D.
©2010
Lynette Marie Holman
ALL RIGHTS RESERVED
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ABSTRACT

LYNETTE MARIE HOLMAN:
The Andrea Yates Effect:
Priming of Mental Illness Stereotypes Through Exemplification
of Postpartum Disorders
(Under the direction of Rhonda Gibson)

Postpartum depression is a common disorder that can occur after a woman has given
birth. Unfortunately, many who suffer from postpartum depression do not seek treatment —
one reason may be because of the stigma perpetuated by media accounts of women with
postpartum psychosis who commit infanticide (Holman, 2009; Chewning, 2008). Although
such incidents are incredibly rare — only 1 in 1,000 new mothers develops postpartum
psychosis, and of these, only 4% commit infanticide (Parry, 1995) — women make the news
when they kill their infants.
This study sought to determine whether an exemplar of extreme maternal mental
illness (i.e., Andrea Yates, the Texas woman who drowned her five children in 2001) is more
likely to trigger, or prime, harsher judgments of a target character who suffered from
postpartum depression than would a non-extreme exemplar. This study used a priming
technique whereby participants — 40 pregnant women, 20 for each condition — were
exposed to online slideshow stories, one about Andrea Yates and one about a woman who
suffered from the milder postpartum depression. Later, their memory was triggered via a
subliminal priming technique consisting of flashes of images from either slideshow. The
participants then watched a video clip of the target character and were asked to evaluate her.
This study sought not only to isolate a media effect, but also to determine how this effect
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may be influencing behavioral intentions such as postponing speaking with their doctors
about depression in order to avoid medication.
The findings of this study suggest that the non-extreme prime triggered harsher
judgments of the target character once that character’s sanity was called into question,
whereas the extreme prime prompted participants to correct their judgments of the target
character and to evaluate her more positively when her sanity was in question. The non-
extreme prime triggered higher perceptions of the risk of developing postpartum disorders
than the extreme prime. However, in spite of harsher judgments and higher perceptions of
risk, those in the non-extreme condition were more likely than those in extreme condition to
engage their health care providers if they thought they were depressed.
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ACKNOWLEDGMENTS
First and foremost, I would like to thank my husband, Philip Holman, and my two
children, Claudia and Liam, for their unyielding love and support through these three long
years. You were my saving grace. I would also like to thank my mother, Linda Seabrook
Huck, who not only supported me emotionally; she literally provided her expertise as a
Registered Nurse. My gratitude also extends to my in-laws, Wilhelmina and Tony Holman,
who helped us hold down the home fort while I pursued my doctoral studies. Others who are
literally a part of my dissertation, either by providing voiceovers for the stimulus website or
by appearing in the Web video, include my brother, Dr. Mark Chewning, Heather Cigeroglu,
Dr. Barbara Friedman, Daniel Siler, Chris Higginbotham, and Samantha Ewing. I am
especially appreciative of Samantha Ewing’s bravery in sharing her personal experience with
postpartum depression. I would also like to acknowledge all of my friends and family
members who have cheered me on through this process.
I am grateful for the guidance and support I have received from my dissertation chair,
Dr. Rhonda Gibson. She stood by me through every hurdle and pushed me to do better. I
would also like to thank my committee. The research I have done with Dr. Francesca
Dillman Carpentier provided me with the groundwork for this dissertation. In addition to
helping me with my stimulus materials for this study, Laura Ruel has been a great support for
me in my personal and professional life. Dr. Tanya Chartrand has been so helpful in focusing
my method, and has helped me see a research stream, or story, beyond this one. Dr. Mary
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Frances Luce has opened my eyes to medical consumer behavior, which gave me the courage
to pursue a study of this population.
Finally, I would like to thank the clinicians who supported me in this effort. I am
grateful to the physicians, nurses and staff of the OB/GYN Health Center, Volusia OB/GYN,
and the Daytona Beach Women’s Center who allowed me to conduct my research with their
patients and in their space. I am most grateful to Dr. John Meyers, without whom this study
would have never moved forward. Not only did he allow me to recruit his patients, he
actively helped me get my proposal through the UNC-Chapel Hill Institutional Review
Board. In addition, I am grateful to Dr. Vagovic and Dr. Tapia-Santiago for opening up their
offices for my study. I would also like to thank Dr. James Moore for lending his expertise as
a mental health practitioner.

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TABLE OF CONTENTS
Chapters
I. INTRODUCTION...............................................................................................1
II. MENTAL HEALTH STIGMA IN A MEDIATED CULTURE.........................14
III. AUTOMATICITY OF STEREOTYPING AND IMPLICIT PREJUDICE......18
Awareness ..........................................................................................21
Intent..................................................................................................22
Efficiency............................................................................................22
Control................................................................................................23
IV. MEDIA PRIMING AND EXEMPLIFICATION..............................................26
The Influence of Knowledge Accessibility
in Social Cognition and Social Judgment...............................................26
Media Priming of Stereotypes.............................................................29
Exemplification Theory.......................................................................31
The Exemplification Effect..................................................................35
V. MEDICAL DECISION-MAKING AND AVOIDANCE....................................44
Attractive Sources: Influence of Medical Professionals.......................46
Strong Logical Arguments: Possible Path
for Persuasive Health Messages ..........................................................47
Non-Conscious Paths to Persuasion and Decision-Making..................49
Avoidance Behavior............................................................................51
VI. HYPOTHESES AND RESEARCH QUESTIONS ...........................................54
VII. METHOD..........................................................................................................58
Overview............................................................................................58
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Participants.........................................................................................59
Experiment Procedure.........................................................................61
Study Administration and Ethical Issues..............................................63
Stimulus Material................................................................................67
Primary Independent Variable.............................................................68
Primary Dependent Variables..............................................................68
Manipulation Checks and Control Variables........................................74
Analysis Used in the Results Section...................................................75
VIII. RESULTS.........................................................................................................77
Priming...............................................................................................77
Exemplification Effect........................................................................86
Behavioral Intentions..........................................................................90
Mediation of Activated Goals on Behavioral Intentions.......................91
Posttest Involvement...........................................................................92
IX. DISCUSSION....................................................................................................93
Limitations........................................................................................104
X. CONCLUSION................................................................................................106
Findings............................................................................................106
Future Studies...................................................................................110
TABLES..................................................................................................................112
FIGURES.................................................................................................................134
APPENDICES.........................................................................................................150
Pretest and Posttest Measures............................................................150
Stimulus Materials............................................................................165
REFERENCES........................................................................................................167

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LIST OF TABLES
Table 1: Descriptive Statistics of Continuous Variables ...........................................112
Table 2: Correlation Matrix and Descriptive Statistics for Key Variables ................113
Table 3: Exploratory Factor Analysis Showing the Total Variance Explained
for the Analysis of the Well-being Traits of the Target Character “Samantha”..........114
Table 4: Exploratory Factor Analysis Showing the Factor Loadings for the
Analysis of Well-being Traits of the Target Character “Samantha”..........................115
Table 5: Principal Components Analysis Showing the Factor Loadings
for the Pretest Perceptions of Risk of Developing Postpartum Disorders..................116
Table 6: Principal Components Analysis Showing the Factor Loadings
for the Pretest Perceptions of Risk of Developing Postpartum Disorders..................117
Table 7: Principal Components Analysis Showing the Factor Loadings
for the Analysis of the Sanity (Prime Addition) of Target Character “Samantha”.....118
Table 8: Regression Analysis for Variables Predicting “Selfish” Trait
of Target Character..................................................................................................119
Table 9: Regression Analysis for Variables Predicting “Drama Queen” Trait
of Target Character..................................................................................................120
Table 10: Regression Analysis for Variables Predicting Depressive Traits
(2-Item Scale) of Target...........................................................................................121
Table 11: Regression Analysis for Variables Predicting Well-being Traits (30)
of Target Character..................................................................................................122
Table 12: Regression Analysis for Variables Predicting Stability Traits (10)
of Target Character..................................................................................................123
Table 13: Regression Analysis for Variables Predicting Calmness Traits (10)
of Target Character..................................................................................................124
Table 14: Regression Analysis for Variables Predicting Well-being Traits (14)
Related to Control....................................................................................................125
Table 15: Regression Analysis for Variables Predicting Well-being Traits (30)
of Target Character (Goal Interaction)......................................................................126
Table 16: Regression Analysis for Variables Predicting Stability Traits (10)
of Target Character (Goal Interaction)......................................................................127
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Table 17: Regression Analysis for Variables Predicting Calmness Traits (10)
of Target Character (Goal Interaction)......................................................................128
Table 18: Regression Analysis for Variables Predicting Well (14) Traits
of Target Related to Control (Goal Interaction)........................................................129
Table 19: Regression Analysis for Variables Predicting Posttest Perceptions
of Risk of Participants..............................................................................................130
Table 20: Regression Analysis for Variables Predicting Posttest Perceptions
of Risk of Participants (Goal Interaction).................................................................131
Table 21: Regression Analysis for Variables Predicting Posttest Perceptions
of Risk of Participants (Depression Interaction)........................................................132
Table 22: Regression Analysis for Variables Predicting Intention of Avoiding
Health Care Provider................................................................................................133

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