Congruence couple therapy for alcohol use and gambling disorders with comorbidities (part I): Outcomes from a randomized controlled trial

A nonblinded randomized trial was conducted at two Canadian provincial outpatient addiction clinics that tested the effectiveness of a systemic congruence couple therapy (CCT) versus individual-based treatment-as-usual (TAU) on nine clinical outcomes: (1) primary outcomes—alcohol use and gambling, psychiatric symptoms, and couple adjustment; (2) secondary outcomes—emotion regulation, substance use, depression, post-traumatic stress symptoms, and life stress. Data of primary clients and partners (N = 46) were analyzed longitudinally across baseline, posttreatment (5 months), and follow-up (8 months). Alcohol use disorder (95%) and gambling disorder (5%) were in the severe range at baseline, and co-addiction was 27%. Psychiatric comorbidity was 100%, and 18% of couples were jointly addicted. Between-group comparison favored CCT in primary outcomes with medium-to-large effect sizes (Cohen's h = 0.74–1.44). Secondary outcomes were also significantly stronger for CCT (Cohen's h = 0.27–1.53). Within-group, for all primary outcomes, a significant proportion of symptomatic CCT clients and partners improved, converging with ANOVA results of large effect sizes (0.14–0.29). All secondary outcomes improved significantly in CCT with large effect sizes (0.14–0.50). TAU showed significant within-group improvement in alcohol use, other substance use, and life stress with large effect sizes (0.16–0.40). Primary clients and partners made largely equivalent improvement within CCT and within TAU. Results were triangulated with clients' satisfaction ratings and counselors' reports. Overall, significant within-group effects were detected for CCT both clinically and statistically and between-group difference favored CCT. Future trials are required to validate these promising findings.     

The Digitalization of Religion: Smartphone Use and Subjective Well-Being during COVID-19

Previous findings indicate that smartphone use can decrease life satisfaction and can negatively impact religious or spiritual goals. But since the start of the COVID-19 pandemic, smartphones have become significantly more positive and useful. Smartphones have helped people move on with their lives, especially due to the myriad benefits they offer. Users can “virtually” spend time with family and friends (i.e., social) and can order groceries, read the news, attend to religious and spiritual needs, and entertain themselves (i.e., process) without venturing out. In the theoretical framework of uses and gratifications, we explored the impact that smartphone use can have on the subjective well-being of Jews and Christians, respectively, in countries with the highest smartphone penetration: Israel and the United States. Furthermore, we introduced religiosity and spirituality, which have surged during the pandemic, as mediators in the proposed model. In the United States, social and process smartphone use enhanced subjective well-being through religiosity (vs. spirituality). In Israel, the process use enhanced subjective well-being through spirituality (vs. religiosity). Theoretical implications are discussed.     

Examining the Ethics of Clinical Use of Unproven Interventions Outside of Clinical Trials During the Ebola Epidemic

The recent Ebola outbreak in West Africa began in the spring of 2014 and has since caused the deaths of over 6,000 people. Since there are no approved treatments or prevention modalities specifically targeted at Ebola Virus Disease (EVD), debate has focused on whether unproven interventions should be offered to Ebola patients outside of clinical trials. Those engaged in the debate have responded rapidly to a complex and evolving crisis, however, and this debate has not provided much opportunity for in-depth analysis. Additionally, the existing literature on access to unproven therapies has focused on contexts like HIV/AIDS and oncology, which are very different than the Ebola epidemic. In this paper, we examine the ethical issues surrounding access to unproven therapies in the context of the recent Ebola outbreak to yield new insights about this controversial and unsettled issue. We argue first that, in this context, the interests of patients in obtaining access to unproven therapies are not fully aligned with the interests of their providers and drug developers. Second, we focus on the resource constraints facing providers, funders, and patients and conclude that they often counsel against the use of unproven interventions against EVD.     

The Development of Symbolic Uses of Objects in Infants in a Triadic Context: A Pragmatic and Semiotic Perspective

In this study, we address the construction of the first symbolic uses of objects in contexts of triadic interaction (adult–child–object). We assume that symbolic productions are based on public rules of the use of objects previously agreed by the community. The first symbols are not rooted in any literal, evident reality, but in shared rules of uses about the material world. We observed six dyads communicating and interacting together with 10 objects in a semi‐structured situation longitudinally from 9 to 15 months of age. We found that the infants gradually constructed symbolic meanings, and we identified five symbolic levels and sublevels. At 9 months, the infants attended and engaged in the symbolic uses produced by an adult even though they themselves were not yet able to produce them. At 12 months, infants began to use objects symbolically to communicate with adults. The highest percentage of these first symbolic uses was of level 1, that is, with a close relation to the conventional use of the object used to perform the symbol. At 15 months, children increased their symbolic uses and performed symbolic uses at all levels, whereas adults reduced such practices. Adult semiotic mediation and the social meanings of objects can be considered important factors in children's symbolic productions. Copyright © 2014 John Wiley & Sons, Ltd.     

积极心理学团体辅导对小学生抑郁症状的干预效果

本研究用积极心理学取向团体辅导对小学生抑郁症状进行预防性干预,应用多层线性模型考察了干预效果和中介机制。结果表明:(1)积极心理学干预抑制并逆转了抑郁症状随时间上升的趋势;(2)干预促进了优势使用行为随时间增加的趋势;(3)优势使用在积极心理学干预与抑郁症状之间起部分中介效应。结论:积极心理学干预能预防小学生抑郁症状,优势使用对积极心理学团体辅导干预抑郁症状起到部分中介作用,它是积极心理学干预的特异性有效成分。     

Deregulated semantic cognition contributes to object‐use deficits in Alzheimer's disease: A comparison with semantic aphasia and semantic dementia

Executive control is impaired from the early stages of Alzheimer's Disease (AD) and this produces deregulated semantic cognition (Corbett, Jefferies, Burns, & Lambon Ralph, 2012 ; Perry, Watson, & Hodges, 2000 ). While control deficits should affect semantic retrieval across all modalities, previous studies have typically focused on verbal semantic tasks. Even when non‐verbal semantic tasks have been used, these have typically employed simple picture‐matching tasks, which may be influenced by abnormalities in covert naming. Therefore, in the present study, we examined 10 patients with AD on a battery of object‐use tasks, in order to advance our understanding of the origins of non‐verbal semantic deficits in this population. The AD patients’ deficits were contrasted with previously published performance on the same tasks within two additional groups of patients, displaying either semantic degradation (semantic dementia) or deregulation of semantic retrieval (semantic aphasia; Corbett, Jefferies, Ehsan, & Lambon Ralph, 2009 ). While overall accuracy was comparable to the scores in both other groups, the AD patients’ object‐use impairment most closely resembled that observed in SA; they exhibited poorer performance on comprehension tasks that placed strong demands on executive control. A similar pattern was observed in the expressive domain: the AD and SA groups were relatively good at straightforward object use compared to executively demanding, mechanical puzzles. Error types also differed: while all patients omitted essential actions, the SA and AD groups’ demonstrations also featured unrelated intrusions. An association between AD patients’ object use and their scores on standard executive measures suggested that control deficits contributed to their non‐verbal semantic deficits. Moreover, in a task specifically designed to manipulate executive demand, patients with AD (and SA) exhibited difficulty in thinking flexibly about the non‐canonical uses of everyday objects, especially when distracted by semantically related objects. This study provides converging evidence for the notion that a failure of regulatory control contributes to multimodal semantic impairment in AD and uniquely demonstrates this pattern for the highly non‐verbal domain of object use.     

Smoking on School Property as a Risk Factor for Substance Use Among Adolescent Smokers

The purpose of the current study was to determine if smoking on high-school property was associated with increased risk for other substance use among U.S. adolescents. Secondary analyses were carried out with data from the 2011 Youth Risk Behavior Survey (YRBS, N = 15,503). Only adolescents who reported smoking at least one cigarette in the last 30 days were selected for analyses (n = 2531, 44% female). Alcohol, marijuana, and cocaine use was assessed among participants. Binary logistic regression analysis was carried out to examine the relationship between smoking on school property (yes versus no) with each of the substance use variables. Adolescent smokers who reported smoking on school property were significantly more likely to report substance use across all substances examined compared to smokers who did not smoke on campus. For example, campus smokers were 3.91 times more likely to use marijuana in their lifetime and 3.85 times more likely to have used crack or cocaine in their lifetime compared to smokers who did not smoke on campus. Health care providers who provide services to adolescents should screen for smoking on school property to help identify adolescents at increased risk for substance use.     

Get the Message: Targeting Beliefs to Develop Risk Reduction Intervention Messages for African American Adolescents

Risk reduction interventions that promote condom use, a vital component of most HIV prevention interventions, have been successful in increasing condom use among African American adolescents. Understanding theoretical components that lead to behavior change and selecting relevant risk reduction messages remain important considerations for targeting new interventions and tailoring existing interventions. The present study sought to (1) identify the most important theoretical determinants of condom use intention in African American adolescent males and females, separately, using the integrative model of behavior prediction, and (2) identify underlying beliefs within the determinants that were good candidates for message development in similar interventions. Using 446 African American adolescents, multi‐group SEM indicated that the gender‐specific IM exhibited a better fit than the overall model. Specifically, the IM had a stronger capacity for predicting condom use intention and condom use behavior for adolescent boys. Using a specific criteria for message selection, specific condom use beliefs were discussed as potential candidate messages for both African American males and females.