Midi-level measurement of social anxiety in psychiatric and non-psychiatric samples

This paper reports the development and assessment of midi-level behavioral measures of social anxiety in the context of two experiments, one studying an analog student sample, the other a psychiatric sample. Judgments on nine categories of clinically practical midi-level behaviors (e.g. Facial Expression, Orienting, Sense of Timing), based on a review of the literature on human ethology and on pilot research, were compared to global judgments of social anxiety and social skill and to physiological arousal. Intraclass correlations exceeded 0.80 for judgments of the global and midi-level behavioral ratings on both samples. Results of correlational analyses indicated that while there were several significant predictors of global skill and anxiety among the midis, the magnitude of the relationship between midis and globals was stronger for the patient than the student sample. Further analyses based on S's heart rate (HR) reactivity suggested that while global ratings did not significantly predict H R in a high social anxiety situation, one midi-level behavioral rating (self-manipulations) did. The clinical utility of the newly developed measures is discussed with particular attention to their practicality for behavior therapy.     

Centering culture in the treatment of opioid use disorder with American Indian and Alaska Native Communities: Contributions from a National Collaborative Board

American Indian/Alaska Native (AI/AN) communities are disproportionally impacted by the opioid overdose epidemic. There remains a dearth of research evaluating methods for effectively implementing treatments for opioid use disorder (OUD) within these communities. We describe proceedings from a 2-day Collaborative Board (CB) meeting tasked with developing an implementation intervention for AI/AN clinical programs to improve the delivery of medications to treat OUD (MOUD). The CB was comprised of Elders, cultural leaders, providers, individuals with lived experience with OUD, and researchers from over 25 communities, organizations, and academic institutions. Conversations were audio-recorded, transcribed, and coded by two academic researchers with interpretation oversight provided by the CB. These proceedings provided a foundation for ongoing CB work and a frame for developing the program-level implementation intervention using a strength-based and holistic model of OUD recovery and wellbeing. Topics of discussion posed to the CB included engagement and recovery strategies, integration of extended family traditions, and addressing stigma and building trust with providers and clients. Integration of traditional healing practices, ceremonies, and other cultural practices was recommended. The importance of centering AI/AN culture and involving family were highlighted as priorities for the intervention.