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According to behavioral theory, positive and negative reinforcement, along with stimuli associated with positive or negative incentives, control SUD as well as benign drug use. Cognitive theory adds the influence of the social context and human cognition. Positive reinforcement, often experienced as pleasure, is most effective immediately after a given behavior – such as addictive drug use. Negative reinforcement (relief of an aversive state) also has powerful behavioral control. Addictive drugs temporarily relieve many unpleasant conditions, including the shame and guilt of addiction. Any aversive (punishing) consequences usually appear much later, decreasing their power to suppress behavior. When drugs are easily available and intoxication is tolerated in a society, heavy use is more prevalent, abuse is enabled, and addiction develops in those with fewer risk factors. Eventually, after losses resulting from heavy drug use, further use may be the only available coping tactic and source of reward. Continued drug use brings additional harm, but now has even greater control over behavior because it is the sole source of even temporary relief.
We examined the measurement and mediating role of social support in dietary intake among participants in Texercise Select, an intervention for improving lifestyle behaviours.
Quasi-experimental study. Participants reported their dietary intake, level of social support measured by the new Social Support for Healthy Eating scale, sociodemographics and disease profile. We conducted exploratory factor analysis for scale evaluation and structural equation modelling for mediation analysis to test if changes in dietary-specific social support mediate the relationship between the intervention and changes in dietary intake.
Community-dwelling middle-aged and older adults completed a self-reported survey at baseline and 3-month follow-up (intervention group n 211, comparison group n 175).
The majority of the sample was aged ≥70 years (mean 74·30, sd 8·54), female (82·1 %) and had at least two chronic conditions (63·5 %). The acceptable levels of reliability and validity of the dietary-specific social support scale were confirmed. Compared with the comparison group, the intervention group reported improved intake of fruit/vegetables and water, and improved dietary-specific social support. Improved dietary-specific social support mediated the association between intervention and change in fruit/vegetable intake, controlling for sociodemographics, number of chronic conditions and geographic residence. About 12 % of intervention effect was mediated by social support.
The current study confirms positive intervention effects on healthy eating, and highlights social support relating to dietary behaviours that may be helpful for healthy eating. Future research should investigate additional social support for developing healthy eating behavioural skills.
While exposure and response prevention (ERP) is the most effective treatment for obsessive compulsive disorder (OCD), less is known about the specific mechanisms underlying symptom change after ERP.
We tested the hypothesis that the frequency of self- and therapist-guided ERP related to the extent of symptom reduction and that this link is mediated by increased self-efficacy.
In a sample of 377 in-patients with a primary diagnosis of OCD receiving in-patient CBT, we assessed symptoms (YBOCS-SR) and self-efficacy (General Self-Efficacy Scale), before and after treatment, as well as the frequency of therapist- and self-guided ERP sessions.
Patients with more therapist-guided ERP sessions during treatment showed more symptom reduction and the association of self-guided ERP on outcome was mediated by enhanced self-efficacy.
These findings highlight the importance of both therapist- and self-guided ERP sessions and suggest that therapists should conduct a sufficient number of ERP sessions to optimise treatment.
Texts produced by and about black interpreters and black spiritual intermediaries in seventeenth-century Peru and New Granada indicate the circulation of notions of blackness that demand more critical attention as they offer insight into the adoption and transformation of racial categories by racialized individuals themselves. This Introduction outlines the argument, provides historical context, and defines key terms used throughout the rest of the book.
This chapter summarizes the current state of the art with respect to school-based drug misuse prevention. The chapter begins by presenting an historical overview of prevention, including summarizing drug use trends based on national surveillance data. The chapter then includes a brief overview outlining the principles of social learning and self-efficacy theories of human motivation, both of which have played a central role in guiding the development of many current prevention models. Several real-world barriers to program implementation are also discussed. In particular, the chapter discusses procedures for ensuring that programs are culturally sound, including discussion of whether deep versus surface structure changes are required to effectively deliver prevention to ethnic or racial subgroups. The various steps required to achieve cultural sensitivity are illustrated using the keepin’ it REAL prevention program. The chapter then explores manipulation checks showcasing how program evaluations use mediation analyses to empirically confirm the active ingredients of drug prevention. The chapter also discusses the need for longitudinal follow-up to establish durable program effects and provides several evidence-based examples drawn from smoking and other drug prevention studies. The chapter closes by summarizing concerns with implementation, the role of teachers in program delivery, and capacity building, all of which influence program outcomes.
Various psychological and biological pathways have been proposed as mediators between childhood adversity (CA) and psychosis. A systematic review of the evidence in this domain is needed. Our aim is to systematically review the evidence on psychological and biological mediators between CA and psychosis across the psychosis spectrum. This review followed PRISMA guidelines. Articles published between 1979 and July 2019 were identified through a literature search in OVID (PsychINFO, Medline and Embase) and Cochrane Libraries. The evidence by each analysis and each study is presented by group of mediator categories found. The percentage of total effect mediated was calculated. Forty-eight studies were included, 21 in clinical samples and 27 in the general population (GP) with a total of 82 352 subjects from GP and 3189 from clinical studies. The quality of studies was judged as ‘fair’. Our results showed (i) solid evidence of mediation between CA and psychosis by negative cognitive schemas about the self, the world and others (NS); by dissociation and other post-traumatic stress disorder symptoms; and through an affective pathway in GP but not in subjects with disorder; (iii) lack of studies exploring biological mediators. We found evidence suggesting that various overlapping and not competing pathways involving post-traumatic and mood symptoms, as well as negative cognitions contribute partially to the link between CA and psychosis. Experiences of CA, along with relevant mediators should be routinely assessed in patients with psychosis. Evidence testing efficacy of interventions targeting such mediators through cognitive behavioural approaches and/or pharmacological means is needed in future.
The aim of the study was to examine the Family and School Psychosocial Environment (FSPE) questionnaire in relation to a possible genotype–environment correlation and genetic mediation between the FSPE variables and personality variables, assessed by the Junior Eysenck Personality Questionnaire. A sample of 506 Swedish children aged 10–20 years from 253 families were recruited via the Swedish state population and address register and SchoolList.Eu. The children were divided into 253 pairs: 46 monozygotic twin pairs, 42 dizygotic twin pairs, 140 pairs of full siblings and 25 pairs of half-siblings. The behavioral genetic analysis showed that both FSPE factors, Warmth and Conflicts, may be partly influenced by genetic factors (suggesting genotype–environment correlation) and that nonadditive genetic factors may mediate the relationship between FSPE factors and psychoticism/antisocial personality (P). An indication of a special shared monozygotic twin environment was found for P and Lie/social desirability, but based on prior research findings this factor may have a minor influence on P and L. P and L were negatively correlated, and the relationship seems to be partly mediated by nonadditive genetic factors. Nonshared environment and measurement errors seem to be the most influential mediating factors, but none of the cross-twin cross-dimension correlations suggest a common shared environmental mediating factor.
Efforts to address the major health, environmental, and social threats that can be found across the globe rely on changes in human behavior. Yet identifying effective and efficient ways to change behavior remains a vexing challenge. To meet this need, investigators need to design and evaluate behavioral intervention strategies in a manner that affords the creation of evidence-based guidelines that specify not only whether interventions work but also how and under what conditions. In this chapter, the design and testing of interventions are situated within the experimental medicine approach. This approach leverages the strength of the experimental method to test how behavior change intervention strategies work and to identify the conditions under which they operate effectively. Moreover, it organizes how investigators specify the questions that underlie the study of behavior change interventions and requires them to articulate precisely what intervention strategy they are using, how they think the strategy operates, and the outcomes it generates. Through the systematic use of this approach, evidence will emerge that addresses practitioners’ prevailing concerns directly – what intervention strategy is the most effective and efficient way to address the problem at hand. This chapter provides an overview of how to implement the experimental medicine approach, describes its key features, and addresses the importance of precision and, finally, considers this approach within a broader set of initiatives that have emerged to support a programmatic approach to the design, evaluation, and implementation of behavior change interventions.
Based on the inductive analysis of the previous chapters of the book, the conclusion provides closing remarks on the historical, political, social, religious and symbolic meanings of the practice of self-coronation among medieval kings, using a long-term approach. From a political point of view, self-coronations are proofs of the activation of individual agency rather than the stability of established structures in the Middle Ages. This ritual demystifies certain anthropological tendencies to constrain the rites to the boundaries of their particular context or to fix them in an essentialist symbolic meaning. From a social perspective, medieval self-coronations pushed for collective innovation and dynamism. These rituals were in a perpetual state of flux, confirming anthropologists’ belief that ritual symbols are not static, absolute objectifications, but social and cultural systems, gathering meaning over time and altering in form. This contextualised approach to the seminal concept of the ‘sacred’ and the ‘secular’ requires us to revise a vision of the past altered by the lens of the modern nation-state and modern rationalism. Some of its qualities may be projected onto the present. The king’s skill in avoiding ecclesiastical mediation may help to explain the frontiers and limits between the temporal and spiritual, between politics and religion, which is essential for the stability of modern societies. In the end, the analysis and interpretation of self-coronations lead us to debunk the myth or grand narrative of the process of secularisation.
The fourth chapter analyses what scholars have called ‘symbolic’ or ‘heavenly’ coronations in Byzantium. With the expansion of Christianity throughout the Mediterranean, self-coronation and the mediation of priests became a point of divergence. Emperors in Christian Byzantium are to be crowned by the patriarchs in ritual practice, but they are frequently crowned by the iconographic representation of the ‘hand of God’. This chapter engages in a comparative analysis of the reality of church intervention in the real performative ceremony of the imperial coronation and the imaginative fiction of the crowning of the emperor directly by Christ and his angels and saints, as established in some iconographic representations. In Byzantium, imperial art was given the task of translating into a visual and symbolic – but not necessarily referential – language the values and ideology that prevailed in each dynasty concerning the source of its power.
The second chapter explores diverse forms of mediation in pre-Christian civilisations, from the Israelite to the Mesopotamian, Egyptian, Persian and Greek monarchies, and the symbolic meanings connected with the idea of ‘consecration without mediation’. Based on textual, epigraphic and iconographical evidence, it privileges the analysis of the royal investiture ceremony in Achaemenid and Sassanid Persia, since the practice of self-coronation decisively influenced subsequent periods, reaching Islamic and even contemporary Persia (including the self-coronations of Shah Reza Pahlavi in 1926 and his son Mohammad Reza Pahlavi in 1967) and expanding beyond its borders, in Byzantium and central Asia.
The objective of this chapter is try to find proof of the growing presence of the investiture and coronation ceremony in the images and narrations that have been preserved from antiquity, such as cave reliefs, coins, murals and historical texts. A natural consequence of the consolidation of this ceremony among the monarchies of the ancient civilisations was the multiplication of the ritual forms in which it appeared, and the consequent images that preserved the ceremony or imagined it. These images necessarily imply, regardless of whether they had a ceremonial reality, the unequivocal message of consecration-without-mediation of the sovereign, a resistance to priestly mediation.
Contemporary studies of conflict have adopted approaches that minimize the importance of negotiation during war or treat it as a constant and mechanical activity. This is strongly related to the lack of systematic data that track and illustrate the complex nature of wartime diplomacy. I address these issues by creating and exploring a new daily-level data set of negotiations in all interstate wars from 1816 to the present. I find strong indications that post-1945 wars feature more frequent negotiations and that these negotiations are far less predictive of war termination. Evidence suggests that increased international pressures for peace and stability after World War II, especially emanating from nuclear weapons and international alliances, account for this trend. These original data and insights establish a dynamic research agenda that enables a more policy-relevant study of conflict management, highlights a historical angle to conflict resolution, and speaks to the utility of viewing diplomacy as an essential dimension to understanding war.
It is not clear to what extent associations between schizophrenia, cannabis use and cigarette use are due to a shared genetic etiology. We, therefore, examined whether schizophrenia genetic risk associates with longitudinal patterns of cigarette and cannabis use in adolescence and mediating pathways for any association to inform potential reduction strategies.
Associations between schizophrenia polygenic scores and longitudinal latent classes of cigarette and cannabis use from ages 14 to 19 years were investigated in up to 3925 individuals in the Avon Longitudinal Study of Parents and Children. Mediation models were estimated to assess the potential mediating effects of a range of cognitive, emotional, and behavioral phenotypes.
The schizophrenia polygenic score, based on single nucleotide polymorphisms meeting a training-set p threshold of 0.05, was associated with late-onset cannabis use (OR = 1.23; 95% CI = 1.08,1.41), but not with cigarette or early-onset cannabis use classes. This association was not mediated through lower IQ, victimization, emotional difficulties, antisocial behavior, impulsivity, or poorer social relationships during childhood. Sensitivity analyses adjusting for genetic liability to cannabis or cigarette use, using polygenic scores excluding the CHRNA5-A3-B4 gene cluster, or basing scores on a 0.5 training-set p threshold, provided results consistent with our main analyses.
Our study provides evidence that genetic risk for schizophrenia is associated with patterns of cannabis use during adolescence. Investigation of pathways other than the cognitive, emotional, and behavioral phenotypes examined here is required to identify modifiable targets to reduce the public health burden of cannabis use in the population.
This paper examines the key societal developments underpinning the growth of mediation in Singapore with a view to analysing the evolving conceptualisation of justice within mediation. The introduction of mediation corresponded with a shift from adversarial justice to an indigenous form of conciliatory justice, in which a respected mediator played an adviser role for the disputants and was trusted to ensure the fairness of the process. However, this trajectory was tempered by the need to ensure that Singapore mediation practice conformed with international practices concerning the protection of parties’ autonomy. The ambivalence concerning the mediator's role has resulted in uncertainty about whether the mediator bears primary responsibility for ensuring procedural and substantive fairness. The paper discusses the implications of this ambiguity and proposes ways to resolve it. The current phase of professionalisation in Singapore's mediation movement offers the opportune moment to resolve these existing tensions and to crystallise the mediator's role in facilitating access to justice.
Since 1978, we have observed the steady development of institutions, mechanisms and processes of dispute resolution in China. In the last ten years or so, we then noted frequent issuance of new rules and measures as well as revision of existing laws, the promotion of mediation as the preferred method for resolving disputes and, more recently, the promotion of an integrated dispute-resolution system as a national strategy for comprehensive social control (as well as for resolving disputes), in the name of reforming and strengthening ‘the Mechanism for Pluralist Dispute Resolution’. Careful examination of these latest developments suggests that fundamental changes are taking place that may potentially alter the course of the development of the Chinese dispute-resolution system. These developments are the focus of this paper with an aim to ascertain the nature of the developments and their future direction or directions.
When mediation places decision-making power in the hands of lay disputants it raises troubling issues. Can justice be delivered without judicial assistance? What is the effect on the legal system? And how should outcomes thus achieved be regarded? Critics have tended to answer negatively, pointing to a range of harms including individual oppression and the vanishing trial. Such views, focusing too narrowly on conformity to legal norms, overlook ordinary people's capacity for justice reasoning. A recent Scottish pilot study of small-claims mediation parties illustrates the richness and complexity of their thinking around whether, and for how much, to settle. This suggests that mediation settlements, rather than representing second-class justice, may enhance the legitimacy of the legal system. Implications for theories of justice are considered.
This chapter starts by giving a theoretical definition of gender and its relation to language. It gives the rationale for the focus of the book on women politicians and a critical overview of work in the field of gender and language research investigating language and gender in the professional workplace. It also critically reviews linguistic research into political discourse and the much smaller body of work relating to gender, language and politics. In doing so it highlights the originality of the book’s focus on gender and the interactional details of political discourse in political institutions. The chapter also explains relevant theories and empirical research on women’s representation in politics from the discipline of political science. It describes research into the descriptive and substantive representation; examines current re-evaluations of the ‘critical mass’ theory; and examines the ‘different voice’ ideology relating to expectations about gender and communicative styles. It concludes by citing calls from political scientists for additional methods from a wider range of disciplines with which to measure women’s substantive representation and describes the overall structure of the book.
This chapter examines the interlinked barriers to women’s participation identified by the ethnographic descriptions and analyses of parliamentary interaction in the first half of the book. First it considers the nature of stereotypes about gender and communicative styles and their effects on women politicians, in particular the ‘different voice’ ideology and the problems posed by beliefs in the masculine voice of authority in public contexts. These interactional styles are shown to be ideologically salient to the ways in which politicians evaluate political speeches, including their own. Secondly, it considers sexism and its effects by using examples from the House of Commons. This leads to a discussion of fraternal networks and homosocial bonding and the ways in which this can marginalise and exclude some groups. Finally, the underrepresentation and sexist framing of women politicians by the media is considered by reviewing existing international research literature and examples from the UK House of Commons, using a critical discourse analytic approach.
In this first case study I start by describing Theresa May’s period in office as UK prime minister between 2016 and 2019. Then, an analysis of her performances in Prime Ministers Question Times (PMQs) with Jeremy Corbyn is undertaken, using the adversarial score devised in Chapter 3. The May–Corbyn exchanges are interesting because neither performer is typical in this context – May because she is a woman and Corbyn because he is a man whose stated aim is to make PMQs less adversarial. May’s style in debates is found to be highly evasive with some extremely adversarial elements and Corbyn also uses adversarial language. Next, May’s performances in ‘critical gendered moments’ (where gender or gender relations are explicitly discussed) are scrutinised. May is found to position herself as a feminist, but one who adheres to traditional, conservative gender roles, and she is shown to have some difficulty entering into the homosocial bonding activities of the old boy’s network because of how she is positioned by sexist, collaborative humour. Finally, I consider some gendered media representations of May, particularly in relation to emotion, and identify how she has resisted or exploited them.
Issues concerning the association among attachment anxiety, depression and suicidal ideation among the elderly have rarely been explored. The present study investigated the relationship among attachment anxiety, depression and perceived support concerning suicidal ideation among older people.
Tertiary care settings
The authors recruited 191 elderly patients from 10 tertiary care settings in Thailand
Participants provided data on their suicidal ideation and suicidal attempt using Module C of the Mini-International Neuropsychiatric Interview. Their attachment anxiety was assessed using the revised Experience of Close Relationship questionnaire (ECR-R-18), while their level of depression was investigated using the Geriatric Depression Scale. In addition, their perception of being supported was ascertained using the Multidimensional Scale of Perceived Social Support. We performed two mediation analyses and moderation analyses separately using the product of coefficients approach. First, we created a mediation model to examine the role of attachment anxiety and depression on suicidal ideation. Second, a moderated mediation model was created to explore the relationship of perceived social support as a moderator of depression.
We found that depression significantly mediated the association between attachment anxiety and suicidal ideation. The association between depression and suicidal ideation was moderated by the level of perceived social support.
Findings of this study may broaden our understanding of how suicidal ideation develops among the elderly and further stimulate future research exploring the interaction of positive and negative factors of suicidality among the elderly. Implications of the findings were also discussed.