To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Perceived discrimination is associated with worse mental health. Few studies have assessed whether perceived discrimination (i) is associated with the risk of psychotic disorders and (ii) contributes to an increased risk among minority ethnic groups relative to the ethnic majority.
We used data from the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions Work Package 2, a population-based case−control study of incident psychotic disorders in 17 catchment sites across six countries. We calculated odds ratios (OR) and 95% confidence intervals (95% CI) for the associations between perceived discrimination and psychosis using mixed-effects logistic regression models. We used stratified and mediation analyses to explore differences for minority ethnic groups.
Reporting any perceived experience of major discrimination (e.g. unfair treatment by police, not getting hired) was higher in cases than controls (41.8% v. 34.2%). Pervasive experiences of discrimination (≥3 types) were also higher in cases than controls (11.3% v. 5.5%). In fully adjusted models, the odds of psychosis were 1.20 (95% CI 0.91–1.59) for any discrimination and 1.79 (95% CI 1.19–1.59) for pervasive discrimination compared with no discrimination. In stratified analyses, the magnitude of association for pervasive experiences of discrimination appeared stronger for minority ethnic groups (OR = 1.73, 95% CI 1.12–2.68) than the ethnic majority (OR = 1.42, 95% CI 0.65–3.10). In exploratory mediation analysis, pervasive discrimination minimally explained excess risk among minority ethnic groups (5.1%).
Pervasive experiences of discrimination are associated with slightly increased odds of psychotic disorders and may minimally help explain excess risk for minority ethnic groups.
Psychosis rates are higher among some migrant groups. We hypothesized that psychosis in migrants is associated with cumulative social disadvantage during different phases of migration.
We used data from the EUropean Network of National Schizophrenia Networks studying Gene-Environment Interactions (EU-GEI) case–control study. We defined a set of three indicators of social disadvantage for each phase: pre-migration, migration and post-migration. We examined whether social disadvantage in the pre- and post-migration phases, migration adversities, and mismatch between achievements and expectations differed between first-generation migrants with first-episode psychosis and healthy first-generation migrants, and tested whether this accounted for differences in odds of psychosis in multivariable logistic regression models.
In total, 249 cases and 219 controls were assessed. Pre-migration (OR 1.61, 95% CI 1.06–2.44, p = 0.027) and post-migration social disadvantages (OR 1.89, 95% CI 1.02–3.51, p = 0.044), along with expectations/achievements mismatch (OR 1.14, 95% CI 1.03–1.26, p = 0.014) were all significantly associated with psychosis. Migration adversities (OR 1.18, 95% CI 0.672–2.06, p = 0.568) were not significantly related to the outcome. Finally, we found a dose–response effect between the number of adversities across all phases and odds of psychosis (⩾6: OR 14.09, 95% CI 2.06–96.47, p = 0.007).
The cumulative effect of social disadvantages before, during and after migration was associated with increased odds of psychosis in migrants, independently of ethnicity or length of stay in the country of arrival. Public health initiatives that address the social disadvantages that many migrants face during the whole migration process and post-migration psychological support may reduce the excess of psychosis in migrants.
In 1857, Henry Box Brown starred in Edward Gascoigne Burton's The Fugitive Free and The Nubian Captive, two “slave dramas” based on his life. His performance inevitably infused both with an antislavery message: in a radical departure from conventional black abolitionist strategies of resistance in the British Isles, the plays change our understanding of British anti-slavery, of Brown, and of black British performance in general. Despite his short acting career, Brown should be placed alongside fellow African American actors like Ira Aldridge for his integral role in challenging the white racial schema on the Victorian stage.
Moral injury is the profound psychological distress that can arise following participating in, or witnessing, events that transgress an individual’s morals and include harming, betraying, or failure to help others, or being subjected to such events, e.g. being betrayed by leaders. It has been primarily researched in the military, but it also found in other professionals such as healthcare workers coping with the COVID-19 pandemic and civilians following a wide range of traumas. In this article, we describe how to use cognitive therapy for post-traumatic stress disorder (CT-PTSD) to treat patients presenting with moral injury-related PTSD. We outline the key techniques involved in CT-PTSD and describe their application to treating patients with moral injury-related PTSD. A case study of a healthcare worker is presented to illustrate the treatment interventions.
Key learning aims
(1) To recognise moral injury where it arises alongside PTSD.
(2) To understand how Ehlers and Clark’s cognitive model of PTSD can be applied to moral injury.
(3) To be able to apply cognitive therapy for PTSD to patients with moral injury-related PTSD.
Survivor guilt can arise after surviving a trauma in which others die. No studies have systematically investigated psychological treatment for survivor guilt. The present study was a proof-of-concept investigation of treatment of survivor guilt using imagery rescripting. Thirteen participants with post-traumatic stress disorder and self-reported survivor guilt attended two consecutive imagery therapy sessions, to first elaborate and then rescript related imagery. Significant improvements were observed on idiographic process measures of cognitons, emotions and distress related to survivor guilt following the rescripting session. The study provides preliminary evidence that imagery rescripting can be used as an experiential technique to treat survivor guilt.
In Europe, the incidence of psychotic disorder is high in certain migrant and minority ethnic groups (hence: ‘minorities’). However, it is unknown how the incidence pattern for these groups varies within this continent. Our objective was to compare, across sites in France, Italy, Spain, the UK and the Netherlands, the incidence rates for minorities and the incidence rate ratios (IRRs, minorities v. the local reference population).
The European Network of National Schizophrenia Networks Studying Gene–Environment Interactions (EU-GEI) study was conducted between 2010 and 2015. We analyzed data on incident cases of non-organic psychosis (International Classification of Diseases, 10th edition, codes F20–F33) from 13 sites.
The standardized incidence rates for minorities, combined into one category, varied from 12.2 in Valencia to 82.5 per 100 000 in Paris. These rates were generally high at sites with high rates for the reference population, and low at sites with low rates for the reference population. IRRs for minorities (combined into one category) varied from 0.70 (95% CI 0.32–1.53) in Valencia to 2.47 (95% CI 1.66–3.69) in Paris (test for interaction: p = 0.031). At most sites, IRRs were higher for persons from non-Western countries than for those from Western countries, with the highest IRRs for individuals from sub-Saharan Africa (adjusted IRR = 3.23, 95% CI 2.66–3.93).
Incidence rates vary by region of origin, region of destination and their combination. This suggests that they are strongly influenced by the social context.
Chapters 2 and 3 focus on Frederick Douglass’ transatlantic journey to Britain between 1845 and 1847. Douglass epitomized the successful exploitation of adaptive resistance and showed that his employment of each triad’s element simultaneously could court significant fame. He recognized the essential importance of print culture, however, and as a result altered his relationship with that triad to place it center stage. Hence, Chapter 2 discusses Douglass’ performative strategies and his relationship with print culture. He incorporated both favorable and negative reviews of his lectures into his repertoire, and courted endless debate in the press. His invocation of strategic anglophilia was balanced with a chastisement of British policy that championed liberty without actively seeking to help the enslaved in America. Unlike Roper, Douglass was a virtuoso who could balance assimilationist and dissonant language effectively. As a result, Douglass caused a furor toward slavery that was unrivaled by any other African American within a similar time period.
Chapter 5 concentrates solely on Black female transatlantic tours. Due to the gendered nature of adaptive resistance, a separate chapter is necessary to chart the ways they endured a double embodiment on the Victorian stage to campaign against slavery. I argue that Ellen Craft and Julia Jackson used different versions of adaptive resistance that were conditioned by gender as well as race. Craft used silence as a performative tool, an exploitation of antislavery networks, and even created her own communal networks that were based on racial pride. While in public she exploited her reputation as a “white slave,” in private she was outspoken and was tireless in her enthusiasm to promote abolitionist and other reformist causes. In contrast to Craft’s silent public performance, Julia Jackson lectured several times on the British stage alongside her husband, which possibly made her the first Black American woman to speak publicly about her experience as an enslaved individual. African American women were central to the Black protest tradition in Britain and maintained antislavery sentiment throughout the nineteenth century, decades after the British Empire had legally abolished slavery.
Chapter 3 focuses on Douglass’ relationship with abolitionist networks and print culture. He was a shrewd activist and formed friendships with newspaper editors, prominent citizens who had influence over the local press, and sometimes wrote for newspapers specifically to clarify his opinions or to cause further controversy, such as the Cambria in 1847. The constant exchange of letters and newspaper articles that reported on his speeches maintained essential momentum for the antislavery cause and enhanced a connected feeling of solidarity. This network did have its disadvantages however, as white abolitionists were not free from prejudice and Douglass – like other Black activists – struggled against a white racist schema that threatened to control Black bodies. However, Douglass left Britain more independent and determined to seek his antislavery career outside the realm of white control.
Contemporary Black activists – including those active in the #BlackLivesMatter movement – continue to protest against white supremacy and slavery’s legacies. In the conclusion to this book, I trace how Black Americans who visited Britain as a result of the Ferguson Solidarity Tour in 2015 contributed to this transatlantic tradition of protest and forged their own networks across the country to challenge racism and police brutality. Their methods of organization, protest, and awareness-raising were adapted from their historical precedents and to the contemporary world.
Chapter six explores adaptive resistance in Britain during the American Civil War. Black activists exploited this resistance strategy amongst a climate of growing scientific racism and pro-Confederate sympathy, two factors that were inseparable. Throughout the conflict, Black abolitionists used their testimony to revoke charges of Black inferiority and demanded Britons follow a policy of non-fellowship with slaveholders. Despite abolitionist networks which had dwindled at the start of the war, activists such as William Craft, Sella Martin and William Andrew Jackson lectured on both an abolitionist and non-abolitionist stage with a greater sense of urgency, convinced that the conflict’s outcome would mean either the consolidation or the removal of slavery. Craft and Martin in particular used dissonant language to target scientific racists such as Dr. James Hunt, who lectured and published work on Black inferiority. Hunt avidly supported the South and his friendship with Confederate propagandist Henry Hotze represented the synonymy of a cause that promoted slavery and racism, and as much as possible, Black activists used dissonant language to challenge such theories.
Chapter 7 moves beyond most scholarly accounts of Black abolitionist transatlantic visits to the British Isles and focuses on Josiah Henson in the time period 1876–1877. I analyze his lecturing tour, his visit to Windsor Palace to meet Queen Victoria, and the numerous artistic responses to him, which included a revised performance of Uncle Tom’s Cabin on the stage, a bust in the Royal Academy, and a wax model in Madame Tussaud's. I argue that Henson exploited adaptive resistance in an entirely new age and to do this, he needed to reawaken British interest and lecture about the memory of slavery. He used assimilationist language to capitalize on his association with the character of Uncle Tom from Harriet Beecher Stowe’s Uncle Tom’s Cabin to win fame (and fortune) on the British stage. However, Henson had to negotiate racial stereotypes and work in a climate that whitewashed the nation’s own bloody history of slavery in favor of a romanticized plantation ideal in America. Henson fought against this at every turn and contributed to the Black American protest tradition in Britain a decade after the end of the Civil War.
Chapter 8 focuses on Ida B. Wells’ transatlantic visits to Britain in 1893 and 1894. I argue that Wells, like Henson, exploited adaptive resistance in a new era, but this time redeployed its attention to the legacy of slavery, particularly lynching and racial violence. She sustained the Black protest tradition until the end of the nineteenth century and borrowed from it to create a successful tour in 1894, in particular. Learning from previous activists such as Frederick Douglass, Wells befriended newspaper editors, collected favorable coverage of her lectures, orchestrated interviews in numerous papers, and cultivated reformist networks to raise awareness of lynching. Wells also used a form of visual dissonance within her employment of adaptive resistance: she used photographs of lynched bodies to convince the British people of racial violence, and passed the image around at small meetings as a tool of truth to support her rhetoric. She intervened in traditional white spaces such as Parliament to sustain the Black American protest tradition and remind British audiences they lived and breathed a legacy of slavery.
During their transatlantic journeys to Britain throughout the nineteenth century, African Americans engaged in what I term “adaptive resistance,” a multifaceted interventionist strategy by which they challenged white supremacy and won support for abolition. Alongside my recovery of this mode of self-presentation in sources I have excavated from Victorian newspapers, I use an interdisciplinary methodology to (re)discover black performative strategies on the Victorian stage from the late 1830s to the mid-1890s. Performance was only one strand in the black activist arsenal, however. The successful employment of adaptive resistance relied on a triad of performance, abolitionist networks, and exploitation of print culture, and if an individual ensured an even balance between all three, it was likely their sojourn was successful.
In adopting this resistance strategy, black men and women forged a Black American protest tradition in Britain which was based on their literary, visual, and oratorical testimony. Black men and women sought to make their voices heard in a climate dominated by white supremacy; they refused to capitulate and educated thousands of people on slavery and its legacies through physically and mentally demanding tours organized across Britain.