The “doing” or the “being”? Understanding the roles of involvement and social identity in peer-led addiction support groups

While the efficacy of peer-led support groups such as Alcoholics Anonymous (AA) are well established for people recovering from addiction, the “active ingredients” which underpin their efficacy are less understood. Drawing on social identity perspectives, in particular the Social Identity Model of Cessation Maintenance, the current study aimed to explore the relative effects of two possible processes: social identification and involvement with the group's activities. A sample (n = 44) of AA members completed measures pertaining to their social identification with AA, their involvement in the group's activities and their quit efficacy. The findings suggest that AA involvement was significantly related to identity. Mediation analysis revealed a relationship between involvement and efficacy meditated by identity. However, in contrast, the identity-efficacy link was not mediated by involvement. The findings suggest that social identification with AA is as important as, or more important than, simple involvement in the group's activities. This suggests that group planners and facilitators should therefore encourage opportunities to generate a sense of belonging alongside the activities the group revolve around.     

Randomized,placebo-controlled trial of cognitive-behavioral therapy alone or combined with sertraline in the treatment of pediatric obsessive–compulsive disorder

Background

To examine the efficacy of sequential sertraline and cognitive-behavioral therapy (CBT) treatment relative to CBT with pill placebo over 18 weeks in children and adolescents with obsessive–compulsive disorder (OCD).

Methods

Forty-seven children and adolescents with OCD (Range = 7–17 years) were randomized to 18-weeks of treatment in one of three arms: 1) sertraline at standard dosing + CBT (RegSert + CBT); 2) sertraline titrated slowly but achieving at least 8 weeks on the maximally tolerated daily dose + CBT (SloSert + CBT); or 3) pill placebo + CBT (PBO + CBT). Assessments were conducted at screening, baseline, weeks 1–9, 13, and 17, and post-treatment. Raters and clinicians were blinded to sertraline (but not CBT) randomization status. Primary outcomes included the Children's Yale-Brown Obsessive–Compulsive Scale, and response and remission status. Secondary outcomes included the Child Obsessive Compulsive Impact Scale–Parent/Child, Children's Depression Rating Scale-Revised, Multidimensional Anxiety Scale for Children, and Clinical-Global Impressions-Severity.

Results

All groups exhibited large within-group effects across outcomes. There was no group by time interaction across all outcomes suggesting that group changes over time were comparable.

Conclusions

Among youth with OCD, there was no evidence that sequentially provided sertraline with CBT differed from those receiving placebo with CBT.

ClinicalTrials.gov Identifier

NCT00382291.     

Selective attention to threat: A test of two cognitive models of anxiety

Two experiments evaluated differential predictions from two cognitive formulations of anxiety. According to one view, attentional biases for threat reflect vulnerability to anxiety; and as threat inputs increase, high trait anxious individuals should become more vigilant, and low trait individuals more avoidant, of threat (Williams, Watts, MacLeod, & Mathews, 1988, 1997). However, according to a “cognitive-motivational” view, trait anxiety influences the appraisal of stimulus threat value, rather than the direction of attentional bias, and both high and low trait anxious individuals should exhibit greater vigilance for high rather than mild threat stimuli (Mogg & Bradley, 1998). To test these predictions, two experiments examined the effect of manipulating stimulus threat value on the direction of attentional bias. The stimuli included high threat and mild threat pictorial scenes presented in a probe detection task. Results from both studies indicated a significant main effect of stimulus threat value on attentional bias, as there was increased vigilance or reduced avoidance of threat, as threat value increased. This effect was found even within low trait anxious individuals, consistent with the “cognitive-motivational” view. Theoretical and clinical implications are discussed.     

Associations between miscellaneous symptoms and symptom dimensions in adults with obsessive-compulsive disorder

Abstract

Obsessive-compulsive disorder (OCD) is a debilitating psychiatric condition with a heterogeneous array of obsessions and compulsions. Although factor analytic studies have identified symptom dimensions comprising the clinical presentation of OCD, many frequently reported miscellaneous symptoms are not considered in factor analytic studies because they do not fit conceptually within a particular symptom category, despite being functionally related. In the present study, we examined the associations between miscellaneous symptoms and OCD symptom dimensions in a sample of 111 adults with OCD. Overall, most miscellaneous symptoms were associated with one or more symptom dimensions in previously identified four- (14 of the 22 symptoms) and five-factor models (12 of the 22 symptoms). In both models, Contamination/Cleaning was the only dimension not related to any miscellaneous symptom. The present results provide information about which miscellaneous symptoms may be related to particular symptom dimensions, which will assist in clinical evaluations and help planning behavioral psychotherapy (e.g., hierarchy development).     

The Minds of God(s) and Humans: Differences in Mind Perception in Fiji and North America

Previous research suggests that how people conceive of minds depends on the culture in which they live, both in determining how they interact with other human minds and how they infer the unseen minds of gods. We use exploratory factor analysis to compare how people from different societies with distinct models of human minds and different religious traditions perceive the minds of humans and gods. In two North American samples (American adults, N = 186; Canadian students, N = 202), we replicated a previously found two‐factor agency/experience structure for both human and divine minds, but in Fijian samples (Indigenous iTaukei Fijians, N = 77; Fijians of Indian descent, N = 214; total N = 679) we found a three‐factor structure, with the additional containing items related to social relationships. Further, Fijians’ responses revealed a different three‐factor structure for human minds and gods’ minds. We used these factors as dimensions in the conception of minds to predict (a) expectations about human and divine tendencies towards punishment and reward; and (b) conception of gods as more embodied (an extension of experience) or more able to know people's thoughts (an extension of agency). We found variation in how these factors predict conceptions of agents across groups, indicating further theory is needed to explain how culturally generated concepts of mind lead to other sorts of social inferences. We conclude that mind perception is shaped by culturally defined social expectations and recommend further work in different cultural contexts to examine the interplay between culture and social cognition.