Substance use treatment programs in the active duty US military: A narrative review

Substance use disorders (SUDs) are a growing problem for the U.S. military. Each branch of the military has its own dedicated substance abuse treatment program. However, there has been limited attention to the research conducted on these programs. The purpose of this narrative review is to describe SUD treatment programs in the U.S. military and to review the extant research published between 2001–2015. Fourteen peer-reviewed articles, 2 official reports, 1 book chapter, 1 thesis, and 1 dissertation were identified. Most SUD treatment programs are nonconfidential, although a confidential program is being piloted by the Army. Recently, the programs have increased their focus on assessment and treatment of comorbid psychological disorders. Further research is required to examine the efficacy, effectiveness, and cost-effectiveness of the treatment programs.     

Patient preference as a predictor of outcomes in a pilot trial of person-centred counselling versus low-intensity cognitive behavioural therapy for persistent sub-threshold and mild depression

The aim of this analysis was to explore whether pre-treatment intervention preferences were related to outcomes for patients with persistent sub-threshold and mild depression who received one of two treatment types. Thirty-six patients took part in a two-arm, parallel group, pilot randomized controlled trial that compared short term (3 month and 6 month) outcomes of person-centred counselling (PCC) compared with low-intensity, CBT-based guided self-help (LICBT). Patient preferences for the two interventions were assessed at baseline assessment, and analysed as two independent linear variables (pro-PCC, pro-LICBT). Eight out of 30 interactions between baseline treatment preferences and treatment type were found to be significant at the p < .05 level. All were in the predicted direction, with patients who showed a stronger preference for a treatment achieving better outcomes in that treatment compared with the alternative. However, pro-LICBT was a stronger predictor of outcomes than pro-PCC. The findings provide preliminary support that treatment preferences should be taken into account when providing interventions for patients with persistent sub-threshold and mild depression. It is recommended that further research analyses preferences for different treatment types as independent variables, and examines preferences for format of treatment (e.g. guided self-help vs. face-to-face).     

The longitudinal association between internalizing symptoms and academic achievement among immigrant and non‐immigrant children in Norway

The aim of this study was to explore the longitudinal relation between internalizing symptoms and academic achievement, as two processes of children and youth development, among children in Norway, and whether having an immigrant background moderated this association. Data collected from 4,458 students in Norway in four waves over three years were analyzed with multi‐group latent growth curve modeling (LGM ). Results showed that internalizing symptoms level remained unchanged over time both for immigrant and non‐immigrant children, while levels of academic achievement increased only for children of immigrants with both parents born outside of Norway. Further analyses supported a reciprocal relation between internalizing symptoms and academic achievement and revealed that the initial level of academic achievement predicted the rate of change in internalizing symptoms over time, but not vice versa. Moreover, immigrant background did not moderate the associations in the model, however, children of immigrants with both parents born abroad initially had lower levels of academic achievement, but showed an increase in academic achievement, compared to their non‐immigrant peers as well as to peers with one native‐born parent after controlling for gender and their grade at the first observation. The implications for policy and practice were discussed.     

Who’s afraid of the big bad wolf? The interweaving of values and science

The role of values in the scientific process is widely debated. But evidence and values cannot be neatly separated. Instead, values infuse the entire scientific process, starting with the choice of research questions. Research avenues are selected based on prior beliefs about the workings of the world. In fact, informally assigned prior probabilities and normalizing constants play an essential role in distinguishing causes from correlations and ignoring irrelevant associations that would otherwise be suggested by raw data. But since these initial probabilities often have a heterogeneous pedigree – often not all that went into their formation is known or knowable – it becomes difficult to cleanly separate evidence from values. At the same time, this reality does not undermine science’s unique status in generating knowledge. This is because it is not the evidence per se generated by science, but rather the method by which science generates it, that justifies science’s privileged role.     

Meta-Analysis of the Effects of Peer-Administered Psychosocial Interventions on Symptoms of Depression

Many community mental health centers have implemented peer treatment models that employ recovered former clients as cost‐efficient adjunct providers. The effectiveness of these and other peer‐administered interventions (PAIs) for treating depression symptoms has not been well‐established. The current study is a meta‐analysis of PAIs’ effects on depression symptoms. Twenty‐three eligible studies were identified. Study characteristics were coded by multiple raters, random‐effects models were used to compare mean effect sizes, and mixed‐effects models were used to test for moderation. PAIs produced significant pre‐post reductions in depression symptoms (d = .5043 [95 % CI .3675–.6412]). In direct comparisons, PAIs performed as well as non‐peer‐administered interventions (.0848 [?.1455–.3151]), and significantly better than no‐treatment conditions (.2011 [.0104–.3918]). PAIs that involved a professional in a secondary treatment role were significantly less effective than those that were purely peer‐administered, and educational/skills‐based PAIs produced better outcomes than those that were mainly supportive. Follow‐up data, when available, indicated that PAIs’ benefits were maintained. PAIs reduce depression symptoms and warrant further study. The clinical significance of PAIs’ benefits, and whether they are better suited as stand‐alone or adjunct treatments, remain to be established. Implications for the roles of mental health professionals are discussed.     

Social Context and the Dynamics of Cooperative Choice

Recent work using decontextualized economic games suggests that cooperation is a dynamic decision‐making process: Automatic responses typically support cooperation on average, while deliberation leads to increased selfishness. Here, we performed two studies examining how these temporal effects generalize to games with richer social context cues. Study 1 found that time pressure increased cooperation to a similar extent in games played with in‐group members and out‐group members. Study 2 found that time pressure increased cooperation to a similar extent in games described as competitions and games described as collaborations. These results show that previous positive effects of time pressure on cooperation are not unique to neutrally framed games devoid of social context and are not driven by implicit assumptions of shared group membership or cooperative norms. In doing so, our findings provide further insight into the cognitive underpinnings of cooperative decision making. Copyright © 2014 John Wiley & Sons, Ltd.     

‘Age-hardened alloy’ based on bulk polycrystalline oxide ceramic

We report here for the first time the development of ‘age-hardened/toughened’ ceramic alloy based on MgO in the bulk polycrystalline form. This route allows for the facile development of a ‘near-ideal’ microstructure characterized by the presence of nanosized and uniformly dispersed second-phase particles (MgFe₂O₄) within the matrix grains, as well as along the matrix grain boundaries, in a controlled manner. Furthermore, the intragranular second-phase particles are rendered coherent with the matrix (MgO). Development of such microstructural features for two-phase bulk polycrystalline ceramics is extremely challenging following the powder metallurgical route usually adopted for the development of bulk ceramic nanocomposites. Furthermore, unlike for the case of ceramic nanocomposites, the route adopted here does not necessitate the usage of nano-powder, pressure/electric field-assisted sintering techniques and inert/reducing atmosphere. The as-developed bulk polycrystalline MgO–MgFe₂O₄ alloys possess considerably improved hardness (by ~52%) and indentation toughness (by ~35%), as compared to phase pure MgO.     

Patterns of psychotherapy development: A mixed-method analysis using assimilation indices

Understanding how assimilation develops is essential in promoting personal change. By attending to signs or indices of assimilation in the speech of clients, therapists can use this process to assess how the therapy is developing and to tailor intervention. The system of assimilation indices was developed to use assimilation to understand the process of change. This system signals five sub-processes of assimilation: external distress, pain, noticing, decentring, and action. This study consisted of a longitudinal mixed-method analysis, following a multiple cases embedded design. The system of assimilation indices was applied to the recordings of nine psychotherapies and contrasted with both the outcome of the therapy and the perspectives of the therapists and clients about their therapy process. The results show that the system of indices is useful in understanding multiple pathways for assimilation. The system of indices is seen as a useful tool for understanding assimilation and as having clinical value in anticipating challenges to the success of the therapy. This study also shows how the indices are sensitive to the nuances in the change process observed in clinical settings.     

The Community Story,Relationality and Process: Bridging Tools for Researching Local Knowledge in a Peri‐urban Township

In intervening in social challenges impacting local communities, Western forms of dispute/conflict resolution have been critiqued for imparting norms, values and practices that marginalise worldviews of indigenous people. From a decolonizing stance, indigenous scholars have emphasised the need for recovery of ‘lost’ values, beliefs and practices to advance indigenous knowledge. We highlight some of the conceptual challenges associated with applying ‘indigenous knowledge’ and culture‐specific ‘indigenous methodologies’ to a marginalised peri‐urban, ethnically plural township community situated on the outskirts of Johannesburg, South Africa. In embracing the mutuality of indigenous and Western knowledge forms, we explore three elements: the community story, relationality and process in relation to initial engagements with our study community. We attempt to transcend the dualism between ‘Western’ epistemologies and ‘indigenous knowledge’ through these ‘bridging concepts’. What is offered is not a formula or model but an orientation that aims to foster mutual learning through collaborative partnerships within and between communities and researchers with a view to inspiring possibilities for creative and meaningful solutions for violence prevention and dispute/conflict resolution. Copyright © 2014 John Wiley & Sons, Ltd.