The impact of foregrounding in literary texts on stigma reduction of depression through identification and empathy

:speech_balloon: Speaker: Giulia Scapin

:classical_building: Affiliation:VU Amsterdam, Department of Communication Science, The Netherlands; the University of Haifa, Department of Communication, Israel; Utrecht University, Research Institute for Cultural Inquiry (ICON) of the Faculty of Humanities, The Netherlands; ELIT Network (Marie Skłodowska-Curie grant agreement No 860516)

Title: The impact of foregrounding in literary texts on stigma reduction of depression through identification and empathy.

Abstract (long version below): The present study explores the possibility to influence stigma about depression through exposure to a literary text. Such exposure is expected to foster identification, enhance empathic reactions and increase motivation for prosocial behaviour. In addition, foregrounding is expected to play a pivotal role in the potential effects of literary texts on readers by upsetting readers’ schemata. Therefore, in a correlational research design, the readers’ processing of foregrounding will be assessed for each participant, together with identification and empathy with the story character, prosocial behaviour and stigmatization; expected results will clarify the relationship between these variables in literary texts.


:newspaper: Long abstract

In recent years, the world population has been exposed to a higher risk of suffering from mental disorders, in particular depression (e.g., Arpino & Pasqualini, 2021). Mental health disorders are per se a condition difficult to cope with, and people living with this condition also face stigmatization and social discrimination (e.g., Rössler, 2016; Yokoya et al., 2018). Stigma represents an issue for the whole society since it hinders prevention, early recognition of symptoms and approach to treatment. To reduce the stigmatization of marginalized populations, several researchers explored possible effective strategies. One of the most promising interventions is interpersonal contact with a stigmatized individual (Corrigan et al., 2021). However, direct contact with people belonging to an outgroup is not always possible and requires the stigmatized person to expose her/himself to further potential discrimination. Therefore, it is beneficial to explore alternative ways to access interpersonal contact.

According to previous research (e.g., Oatley, 1999; Mar & Oatley, 2008; Mar, 2018), the fictional world of a novel simulates a social environment where readers can meet characters belonging to potentially all kinds of backgrounds, where they can identify and empathize with them. Since identification and empathy, as one of identification subdimensions (Cohen, 2001), are considered powerful mediators in reducing intergroup stigmatization and improving attitudes towards outgroup members (Pettigrew & Tropp, 2008; Batson et al., 2002; Chung & Slater, 2013), it is reasonable to assume that vicarious contact with a character in the fictional world could affect readers’ stigma (e.g., Johnson, 2013).

However, little is known about which elements in the literary texts trigger such an effect. According to Miall and Kuiken (1999), one element that may distinguish literary texts from other genres is foregrounding. Foregrounding is the use of a disruptive language that “helps to upset the stereotypical schemata through which we usually make sense of the world” (Koopman, 2016, p. 64). However, empirical support for the role of foregrounding possibly reducing stigma is lacking and it is not clear how foregrounding may relate to processes of identification and empathy toward fictional characters. Furthermore, in recent years, the theory of failed foregrounding (Harash, 2019; 2021) even argues that the readers’ processing of foregrounding may fail, which would then not let the assumed effects to occur.

The present study will explore the hypothesis that foregrounding possibly stimulates readers to identify and empathize with the character and thus plays a role in the reduction of stigma, Based on the above, the hypotheses are:

H1. Deeper processing of foregrounding (full foregrounding) will co-occur with higher identification, and its sub-dimension empathy, than shallower processing of foregrounding.

H2. Identification, and its sub-dimension empathy, will correlate with deeper processing of foregrounding (full foregrounding) and prosocial behaviour and reduction of stigma.


In the present study, a literary extract about a character living with depression will be selected. The text will be analysed by an expert team, highlighting the potential foregrounding devices, according to the holistic approach used by Kuzmicova et al. (2017; cf. Van Peer et al., 2021). We will use the findings as a starting point for asking participants to elaborate on these elements in the text, following the retrospective think-aloud technique of Harash (2021).

A non-experimental, correlational research design will be chosen. All participants will read the same text. After reading, aesthetic emotions (the Aesthetic Appraisal Scale, Harash, 2021), identification scale (and its sub-dimension empathy, Tal-Or and Cohen, 2010), prosocial behaviour, and stigmatization (Depression Stigma Scale, Griffith et al., 2008) will be assessed. The order of presentation of the questionnaires will be randomized across participants. At the end of the questionnaires, the text will be presented again and the retrospective think-aloud interview will be performed individually. The analysis will control for participants’ need for cognition (i.e., individuals inclination to make a cognitive effort to deeply understand the inner meanings of a text; Lins de Holanda Coelho et al., 2020), literary reading experience, educational background, familiarity with depression, age, gender, and text comprehension. At the end of the session, participants will be debriefed.

Data will be collected between March and June 2022 so that preliminary results will be presented at the conference.

Expected results and Conclusion

This study will clarify the potential relation of foregrounding in literary texts on the reduction of stigmatization through identification and empathy. The results may support the use of literary texts in countering the stigmatization of marginalized populations, making contact between people more accessible through the vicarious experience in the fictional worlds.

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Hi, Gilulia!
Nice job! Great! Wonderful!

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This was a great presentation @Giulia_Scapin I have one question to start this discussion: You were talking about “salient representatives” in literature of, in your study’s case, people suffering from depression. And you emphasized the need for further investigation of this concepts. Have you thought about how you would go about this in future empirical research? How could you determine whether a character in a story is a salient representative of something? And do you think that what makes a character a salient representative of something, differs from one reader to the next?

Really interesting study Giula! Can’t wait to read the final paper. How many participants are you going to include in total?

Hi Lynn! I am looking forward to this IGEL conference too!
To answer your question, we are planning to collect 200 participants in total

Really good question Moniek! Unfortunately, I do not have a clear answer yet. My concern about the salience of the character was born from the Empathy-Attitude-Action Model and underlined by participants’ comments in this preliminary data collection. Some of them had a history of depression and not all of them related to the character. So, I feel that the representativeness of the character differs from one reader to the next, probably accordingly to their previous experiences and/or their prototypical idea of “a depressed person”. Then, I think that a simple way to operationalize this variable is to directly ask the readers what they think about the character. But if you have other suggestions, I am very happy to hear them!
Thank you for the interesting insight!

From the zoom chat during the symposium Q&A:

18:12:46 From Elizabeth Oldfather to Everyone:

I have a question about the valence of these transformative experiences. While it would be terrific if reading should always promote understandings that lead to positive outcomes, have you all considered issues of learning “wrong” lessons, of identificatory processing that leads to catastrophizing thought rather than helpful…? Thinking of e.g. work on narrative self as including not only meaning-making but also narratives of “everything in my life turns good to bad” (can’t remember technical term)

18:14:35 From Willie Van Peer to Everyone:

Completely agree, Elizabeth. There’ll be a piece of research on that by Massimo Salgaro & colleagues in the October issue of the Journal of Literary Semantics.

18:14:51 From Nigel Fabb to Everyone:

I had the same question as Elizabeth about negative transformations and the relation between these notions of transformation to longstanding anxieties about the negative consequences of reading

18:15:12 From Elizabeth Oldfather to Everyone:
Thank you Willie, I will look for it!

18:15:19 From Nigel Fabb to Everyone:
e.g., the ‘Werther’ effect (reading the book made people kill themselves).

18:15:55 From Willie Van Peer to Everyone:
Salgaro et al showed how certain writings may enhance sympathy for Nazi characters….

18:16:08 From dennis kinlaw to Everyone:
Are there studies which consider transformative effects in longer narrative forms (the novel) in comparison to shorter forms (stories, poems)?

And here are the questions the presenters of the symposium came up with themselves to stimulate discussion:

How to pinpoint transformative effects?

How to adapt the transformative reading framework to account for effects not elicited by the text, but rather by reading context (e.g., shared reading, education), by reading habits or other individual differences or life experiences?

How can we take these “extra-textual” factors into account in empirical studies on transformative reading?

When studying transformative reading empirically, how do we determine what a transformative reading experience is (and what it is not)?

When is something “big” enough to be counted as transformative?

How broad should we consider the concept of transformation in the study on transformative reading?