Dreams,Memories, Reflections by C. G. Jung

Abstract

Group interventions have assumed a growing role in primary prevention and supportive care for cancer and HIV disease. Earlier sections of this Special Report examined empirical findings for these interventions and provided recommendations for future research. The current section offers brief recommendations for service providers, policymakers, and stakeholders.

Group services now occupy an increasingly prominent place in primary prevention programs and medical settings. In previous sections of this Special Report (Sherman, Leszcz et al., 2004; Sherman, Mosier et al., 2004a, 2004b) we examined the efficacy of different group interventions at different phases of cancer or HIV disease, considered characteristics of the intervention and the participants that might influence outcomes, and discussed mechanisms of action. Methodological challenges and priorities for future research were highlighted. In this, the final section, we offer brief recommendations for service providers, policymakers, and other stakeholders. We consider some of the barriers that constrain use of empirically-based group interventions and note how these programs might be implemented more widely and effectively.     

A Test of Competing Cognitive Explanations for the Boomerang Effect in Response to the Deliberate Disruption of Media-Induced Aggression

This study advances research on the boomerang effect in response to anti-aggression media literacy interventions. Previous findings indicate that elementary school children can become more aggressive after exposure to such interventions. We test two competing explanations for the boomerang effect, media priming and psychological reactance, in a 2 × 2 factorial experiment with elementary school children (N = 128). Findings indicate that children may cognitively process antisocial elements of an intervention program in a manner that runs counter to the intended effect of prosocial messages. Specifically, children who were exposed to a media literacy intervention with violent media clips as examples reported an increase in willingness to use aggression, whereas children who were exposed to the same lesson without the clips did not. Therefore, the boomerang effect is best explained by the processing of violent clips (media priming) and is not likely due to resistance to the instructional elements of the lesson (psychological reactance). Implications for researchers and practitioners are discussed.     

Ecology, Community, and AIDS Prevention

I explore the role that may be played by an ecological view of AIDS prevention and AIDS-related social concerns. The study of AIDS risk behavior and interventions designed to prevent AIDS have challenged Health Psychology's typically individualistic perspective. Issues of empowerment, psychological sense of community, interpersonal ties, resources, and culture are central to an understanding of risky sexual behavior and helping people to guard themselves from the threat of AIDS. However, despite Community Psychology's historical expertise in these areas, the field has only recently become involved in AIDS prevention efforts. I outline how resource-based, ecological theories may prove more helpful in addressing the AIDS pandemic than the individual, cognitive theories that have typically been adopted. Sexual behavior and associated risk are tied not simply to people's personal behavior and thoughts but to the likelihood of disease exposure in their ethnic group, the power and choices associated with power in that group, and the alternative means available of meeting their overall sexual, romantic, economic, and social goals. As such, AIDS research and intervention must simultaneously address the individual, social, and cultural spheres if insights that can translate to meaningful change can be expected to occur.     

Meta-analysis of the effects of third-wave behavioural interventions on disordered eating and body image concerns: implications for eating disorder prevention

Third-wave behavioural interventions are increasingly popular for treating and preventing mental health conditions. Recently, researchers have begun testing whether these interventions can effectively targeting eating disorder risk factors (disordered eating, body image concerns). This meta-analysis examined whether third-wave behavioural interventions (acceptance and commitment therapy; dialectical behaviour therapy; mindfulness-based interventions; compassion-focused therapy) show potential for being effective eating disorder prevention programs, by testing their effects on eating disorder risk factors in samples without an eating disorder. Twenty-four studies (13 randomized trials) were included. Most studies delivered selective prevention programs (i.e. participants who reported elevated risk factor). Third-wave interventions led to significant pre–post (g = 0.59; 95% CI = 0.43, 0.75) and follow-up (g = 0.83; 95% CI = 0.38, 1.28) improvements in disordered eating, and significant pre–post improvements in body image (g = 0.35; 95% CI = 0.13, 0.56). DBT-based interventions were associated with the largest effects. Third-wave interventions were also significantly more efficacious than wait-lists (g = 0.39; 95% CI = 0.09, 0.69) in reducing disordered eating, but did not differ to other interventions (g = 0.25; 95% CI = –0.06, 0.57). Preliminary evidence suggests that third-wave interventions may have a beneficial effect in ameliorating eating disorder risk.     

Television Use,Sexual Behavior,and Relationship Status at Last Oral Sex and Vaginal Intercourse

The current longitudinal study explores the relationship between adolescent television use at time 1 and sexual experience and relationship status (i.e., committed/romantic versus casual) 1 year later. The sample (N = 824) comprised youth aged 14–18. Multinomial logistic regressions predicting group membership from television exposure variables were conducted controlling for socio-demographic characteristics and prior sexual behavior. Results indicate that sexually inexperienced youth watched more television overall than sexually experienced youth, but less adult, premium and music television on cable networks. Premium cable exposure predicted group membership among sexually active youth. Youth who watched more premium cable at time 1 were more likely to be in casual relationship at last intercourse than a committed one. A more complete understanding of media effects on adolescent sexual relationships can help guide policy development, media education/literacy efforts, and contribute to the design of interventions to reduce the negative consequences associated with adolescent sexual behavior.     

An Examination of the Relationships Between Personality,Attitudes, and Cognitions Relevant to Alcohol-Impaired Driving Tendencies1

Previous research has explored the domain of legal and educational prevention in regard to the phenomena of accidents and injuries caused by drinking and driving. Most investigations of psychological factors attempt to distinguish characteristics of drunk drivers relative to the general driving population or controls matched on driving risk variables. In contrast, the present research concentrated on the examination of the process by which empirically derived personality and general attitudinal constructs operate within a cognitive framework to influence the decision to drive. Four conceptual models were proposed that suggested the presence of direct, indirect, and moderated effects of personality and general attitudinal constructs on cognitions relevant to drunk-driving tendencies. Support was observed for a model suggesting the presence of indirect, direct, and moderating effects for the general attitudinal construct driving aggression, and support for an indirect effects model for the personality variable emotional control. The implications of these findings are discussed in the context of utilizing personality and general attitudinal constructs to improve short term cognitive-based interventions.     

The tripartite influence model of body image and eating disturbance: A replication with adolescent girls

The tripartite influence model of body image and eating disturbance is a recent theoretical approach that includes a test of direct (peer, parental, and media factors) and mediational links (internalization of societal appearance standards, appearance comparison processes) as factors potentially leading to body dissatisfaction and eating disturbance. The theory was evaluated in the current study in a sample of 391 adolescent females. A structural equation model that evaluated the tripartite model replicated previous findings reported by Keery, van den Berg and Thompson (2004) [Keery, H., van den Berg, & Thompson, J. K. (2004). A test of the tripartite influence model of body image and eating disturbance in adolescent girls. Body Image: An International Journal of Research, 1, 237–251.]. Additionally, a second model extended these findings, suggesting that peer and media influences are more important than parental influences. The results are discussed in light of the need for prevention programs to incorporate formative influences and mediational processes in the construction of intervention strategies.     

Anxiety,self-discrepancy,and regulatory focus theory: acculturation matters

Previous research has found that Asians (vs. Caucasians) exhibit higher levels of ought and undesired self-discrepancies and prevention focus, all of which have been linked with anxiety. We examined these ethnic differences in the context of acculturation. Participants (N=155) completed two sessions scheduled a week apart. In Session 1, participants completed a computer task to measure self-discrepancy and prevention focus. In Session 2, participants' ought self-discrepancies and closeness to an undesired self were primed. Moderation analyses indicated that Asian participants who were highly assimilated to an Asian culture exhibited higher levels of a prevention focus. Acculturation also had significant moderation effects for affect when self-discrepancies were primed. Our results suggest that interventions based on these systems (i.e., self-system therapy) should consider acculturation when treating diverse individuals.     

An evaluation of the short-term impact of a media-based substance abuse prevention programme

A state-wide substance abuse prevention programme, entitled KidsInTouch, incorporated a multifaceted approach involving: (a) media-based interventions; and (b) parent training workshops. KidsInTouch was targeted at parents and their children, ages five to 12 years. The media-based interventions attempted to increase children's and parents' awareness and knowledge about substance abuse and prevention. In addition, the intervention advertised and solicited audience participation in parent training workshops. Parents participating in the parent training workshops, in comparison to the control parents, evidenced significant improvement in both alcohol and other drug knowledge and parenting skills. The implications of using the media and involving children and their parents in substance abuse prevention programmes are discussed.     

Substance-abuse prevention: Beyond the schoolyard

Substance-abuse prevention in children and youth has had limited success, possibly because the scope of traditional interventions, usually school based, is too narrow. Children who live in poverty and/or whose homes are dysfunctional need environmental changes beyond what traditional school-based programs can offer. Community psychologists need to expand their work in this area. School-based and community-based interventions are addressed. Ideas for broadening interventions to include elements such as family, media, and community collaboration are evaluated and discussed, along with successful examples of such interventions. Suggestions are made for further innovative work in this area.     

The Pursuit of Hopefulness: Operationalizing Hope in Entertainment Media Narratives

Hope is associated with benefits for psychological and physical wellbeing; consequently, efforts to increase or sustain hopeful feelings are increasingly incorporated into wellness interventions. Although entertainment media provide a wealth of emotionally evocative content, little systematic attention has been given to discrete positive emotions and no investigations to date have identified narratives that generate hope. To address this gap, this research explores underdog narratives, or those depicting characters struggling to meet a goal despite unfavorable odds, as a means to evoke hope, as well as the effect of this emotional experience on subsequent goal-directed motivation. Participants (N = 248) were randomly assigned to one of three media conditions—underdog narrative, comedy, nature scenes—or a no-media control group. Those in the media groups viewed one 5-minute video clip a day for five consecutive days. Consistent with hypotheses, those in the underdog condition felt more hopeful and reported greater motivation to pursue their own goals than those in other conditions. Further, the emotional experience of hope was durable, with hopefulness remaining elevated above baseline levels up to three days after the final media exposure. Implications of these findings for media effects theory and health promotion are discussed.     

Community Violence and Youth: Affect, Behavior, Substance Use, and Academics

Community violence is recognized as a major public health problem (WHO, World Report on Violence and Health, 2002) that Americans increasingly understand has adverse implications beyond inner-cities. However, the majority of research on chronic community violence exposure focuses on ethnic minority, impoverished, and/or crime-ridden communities while treatment and prevention focuses on the perpetrators of the violence, not on the youth who are its direct or indirect victims. School-based treatment and preventive interventions are needed for children at elevated risk for exposure to community violence. In preparation, a longitudinal, community epidemiological study, The Multiple Opportunities to Reach Excellence (MORE) Project, is being fielded to address some of the methodological weaknesses presented in previous studies. This study was designed to better understand the impact of children’s chronic exposure to community violence on their emotional, behavioral, substance use, and academic functioning with an overarching goal to identify malleable risk and protective factors which can be targeted in preventive and intervention programs. This paper describes the MORE Project, its conceptual underpinnings, goals, and methodology, as well as implications for treatment and preventive interventions and future research.     

Methodological issues in prevention research: An introduction to the special issue

In recent years increased attention has been directed to prevention research as a means of solving the multitude of complex social and health problems which confront individuals and their societies. Abuse of substances, behavioral dysfunctions, violence, emotional disorders, educational failures, unwanted pregnancies and sexually transmitted diseases are but a few examples of these most difficult problems. As our recognition of the need for sound prevention strategies has grown, so has our sophistication in designing prevention research studies to evaluate the effectiveness of these new strategies. And that sophistication has brought new challenges, some of which are capable of stifling progress because of their complexity. This problem is certain to grow in importance as interventions with multiple components are used more frequently to meet the challenges of the complex social and health problems we face. This special issue evolved out of the recognition that prevention researchers are confronted by a myriad of difficult methodological issues which have inhibited progress in this area. The articles in the issue present innovative methodological solutions designed to overcome these problems so the field can move forward. Editor's Note: Dr. Edward Seidman edited Methodological Issues in Prevention Research while serving as Associate Editor for Methodology.     

Telling tales in school: extended contact interventions in the classroom

Extended contact has demonstrated its effectiveness in promoting more positive intergroup attitudes among children in previous experimental research. The current project evaluates the use of extended contact interventions involving story‐telling in two novel school settings: the United States (N = 213) and Italy (N = 222) among children aged 5–12 years. Findings indicate support for the effectiveness of the interventions in these two locations among younger minority and majority children but call into question the durability of positive outcomes. Applications and implications are discussed.     

Disorganized infant attachment and preventive interventions: A review and meta‐analysis

Infant disorganized attachment is a major risk factor for problematic stress management and later problem behavior. Can the emergence of attachment disorganization be prevented? The current narrative review and quantitative meta‐analysis involves 15 preventive interventions (N = 842) that included infant disorganized attachment as an outcome measure. The effectiveness of the interventions ranged from negative to positive, with an overall effect size of d = 0.05 (ns). Effective interventions started after 6 months of the infant's age (d = 0.23). Interventions that focused on sensitivity only were significantly more effective in reducing attachment disorganization (d = 0.24) than interventions that (also) focused on support and parent's mental representations (d = ?0.04). Most sample characteristics were not associated with differences in effect sizes, but studies with children at risk were more successful (d = 0.29) than studies with at‐risk parents (d = ?0.10), and studies on samples with higher percentages of disorganized attachment in the control groups were more effective (d = 0.31) than studies with lower percentages of disorganized children in the control group (d = ?0.18). The meta‐analysis shows that disorganized attachments may change as a side effect of sensitivity‐focused interventions, but it also illustrates the need for interventions specifically focusing on the prevention of disorganization.     

Professionalizing the Practice of Public Policy in the Prevention of Violence

The State of the Science Conference Statement on “Preventing Violence and Related Health-Risking Social Behaviors in Adolescents” accurately summarizes the state of knowledge regarding risk factors for violence and intervention efficacy. The Statement missed an opportunity, however, to move the field of prevention practice and policy forward by advocating for more systematic, central review of preventive interventions through a new federal regulatory body, such as an “FDA for Preventive Interventions.” This body would provide review of evidence-based programs and aid decision-making in funding. As a complement to this body, decision-makers also need guidelines in evidence-based practice in ambiguous circumstances, which characterize much of the reality of public policy. Therefore, this new regulatory body should be accompanied by guidelines for evidence-based practice in intervention and policy. Finally, in order to move forward both of these concepts, a National Academy of Sciences Panel should convene to deliberate how these concepts can be implemented.     

Conducting Ecologically Valid Prevention Research: Recruiting and Retaining a “Whole Village” in Multimethod, Multiagent Studies

Many prevention studies are now designed with complementary interventions in different settings. Evaluations of these interventions require assessing the child's behavior in each of these settings. Conducting these studies, therefore, may involve recruiting school districts, principals, classroom teachers, peers, parents, siblings, and in later years, employers and intimate partners. These participants may be considered natural raters or satellite subjects, depending on their degree of involvement. Issues of recruitment and retention thus are magnified in multimethod, multiagent studies. To illustrate these issues, findings are presented for three studies conducted with risk populations in the past decade at the Oregon Social Learning Center: a passive longitudinal study, a selected prevention study, and an indicated prevention study. Findings indicate that achieving high recruitment and retention rates for at-risk and high-risk subjects in multisetting studies is possible, and that a developmental approach should be taken to recruiting risk populations.     

Trauma, Regression, and the Intensive Group Experience

Ferenczi contributed a theory of trauma and regression that has application in the contemporary practice of group therapy. This article seeks to present an extension of these seminal ideas in the form of interventions based on therapist induced regression. The Intensive Group Experience (I.G.E.), a time extended group format found to be necessary for extensive emotional reliving and working through of trauma is described. A clinical case example is then discussed in detail and concludes this report.     

Alcohol and Drug Use, and Depression Among Hispanic Men in Early Adulthood

Community research and clinical practice have shown that alcohol and drug use and depression are interrelated. Among Hispanics, acculturation may play a role in these relationships. To investigate these relationships as well as alcohol-related problems, we interviewed 288 Puerto Rican, Dominican, and Colombian men in early adulthood. No significant differences emerged in the proportions of abstainers across the three groups. Colombians drank significantly more frequently and had more alcohol-related problems than Dominicans. Dominicans were at least risk for and least likely to have alcohol-related problems. Puerto Ricans were much more likely to use drugs than the other Hispanic men. Drug use was associated with an increased likelihood of heavy drinking which, in turn, increased the risk of drug use and depression. Acculturation decreased the risk of drug use. Results are discussed in terms of implications for community psychology research and interventions.     

Prejudice Against Muslim Australians: The Role of Values,Gender and Consensus

Data from an Australian community survey (n = 189) examining the predictors of prejudice against Muslim Australians were analysed. Using thematic analysis, we investigated the specific values our participants reported regarding their perceptions of Muslim Australians and Islam. We then investigated the relationship between prejudice against Muslim Australians, the most important value priorities given by our participants, and other prejudice‐related variables. After entry into a regression analysis, the participants high in prejudice were found to be significantly more likely to have lower educational levels and more right‐wing views. They were also significantly more likely to report high levels of national attitudes (i.e. stronger identification with Australian identity), concern about gender equality within the Muslim community, less concern about equality generally and report that Muslims were not conforming to Australian values. High prejudiced participants also scored higher in the reporting of negative media‐related beliefs, were more likely to perceive higher support in the community for their views than was the case and were more negative towards Muslim men than Muslim women. The implications for anti‐prejudice interventions are discussed. Copyright © 2011 John Wiley & Sons, Ltd.