The roles of social norms and leadership in health communication in the context of COVID-19.

The global struggle with the COVID-19 pandemic has lasted for almost three years. Although national and local leaders have often called on the public to comply with preventive measures through health communication, large sections of society sometimes violated precautions and did not adequately follow these calls. We propose that social norms and leaders' identity entrepreneurship characteristics could be essential in effective health communication. In line with this notion, we investigated the effects of social norm types and leadership on complying with preventive measures, the intention to be vaccinated, and prosocial behavioral tendency through a high-powered experiment that focused on three factors: leadership quality (presence/lack of entrepreneurship), descriptive norm (supportive/obstructive), and injunctive norm (supportive/obstructive). Results showed that when support for injunctive and descriptive norms was present, people tended to more readily adhere to preventive measures, get vaccinated, and engage in prosocial behavior. There was also a significant effect of the interaction between descriptive and injunctive norms on compliance with preventive measures. The compliance level was highest when both norm types were supportive and lowest when both were obstructive. The effect decreased in the discrepant norms condition, where one type of norm was supportive and the other obstructive. There is also a significant interaction between leadership and the descriptive norm, indicating that a combination of an entrepreneur leader and a supportive descriptive norm increases compliance with the preventive measure. We discussed the role of leadership and social norms in effective health communication.

Culturally adapted cognitive behavioral therapy for Syrian refugee women in Turkey: A randomized controlled trial.

OBJECTIVE: This study aims to determine for Syrian refugee women in Turkey the effectiveness, feasibility, and acceptability of culturally adapted cognitive behavioral therapy (CA-CBT). METHOD: Participants were randomly allocated to receive either CA-CBT (n = 12) or treatment-as-usual (TAU; n = 11). We used the Harvard Trauma Questionnaire (HTQ) and the Hopkins Symptom Checklist-25 (HSCL) to assess posttraumatic stress symptoms and anxious-depressive distress. CA-CBT was delivered through seven weekly group sessions. RESULTS: CA-CBT had a large effect on PTSD (HTQ d = 1.17) and nearly medium effect sizes for anxious-depressive distress (HSCL d = .40). There were also low drop-out rates and an absence of adverse events. CONCLUSIONS: Because CA-CBT greatly reduced PTSD symptoms as compared with TAU and had a low drop-out rate, no adverse events, and was deliverable in a short treatment frame (seven sessions) and in a group format, we conclude that the treatment is effective, acceptable, and feasible and has the potential for scalability. Clinical Impact Statement: A Syrian version of CA-CBT was effective (large effect sizes for the HTQ), feasible, and potentially scalable (easy application, conducted with trained facilitators, short-term therapy, group format), and acceptable (as evidenced by very low drop out and no adverse events). Thus, the Syrian version of CA-CBT appears to be a valuable psychological intervention for traumatized Syrian refugees, particularly given the lack of effective treatments for this group. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Protocol for a randomized controlled trial: peer-to-peer Group Problem Management Plus (PM+) for adult Syrian refugees in Turkey.

BACKGROUND: A large proportion of Syrians have been exposed to potentially traumatic events, multiple losses, and breakdown of supportive social networks and many of them have sought refuge in host countries where they also face post-migration living difficulties such as discrimination or integration problems or both. These adversities may put Syrian refugees at high risk for common mental disorders. In response to this, the World Health Organization (WHO) developed a trans-diagnostic scalable psychological intervention called Problem Management Plus (PM+) to reduce psychological distress among populations exposed to adversities. PM+ has been adapted for Syrian refugees and can be delivered by non-specialist peer lay persons in the community. METHODS: A randomized controlled trial (RCT) will be conducted with 380 Syrian refugees in Turkey. After providing informed consent, participants with high levels of psychological distress (scoring above 15 on the Kessler-10 Psychological Distress Scale (K10)) and functional impairment (scoring above 16 on the WHO Disability Assessment Schedule 2.0, or WHODAS 2.0) will be randomly assigned to Group PM+/enhanced care as usual (Group PM+/E-CAU) (n = 190) or E-CAU (n = 190). Outcome assessments will take place 1 week after the fifth session (post-assessment), 3 months after the fifth session and 12 months after baseline assessment. The primary outcome is psychological distress as measured by the Hopkins Symptom Checklist (HSCL-25). Secondary outcomes include functional impairment, post-traumatic stress symptoms, self-identified problems, and health system and productivity costs. A process evaluation will be conducted to explore the feasibility, challenges and success of the intervention with 25 participants, including participants, facilitators, policy makers and mental health professionals. DISCUSSION: The treatment manual of the Syrian-Arabic Group PM+ and training materials will be made available through the WHO once the effectiveness and cost-effectiveness of Group PM+ have been established. TRIAL REGISTRATION: Clinical Trial Registration: ClinicalTrials.gov Identifier NCT03960892. Unique protocol ID: 10/2017. Prospectively registered on 21 May 2019.

Evidence for indirect loss of significance effects on violent extremism: The potential mediating role of anomia.

Psychological research suggests that violent extremism (e.g., terrorism) stems partly from existential motives, such as individuals' need to achieve significance in life after experiencing failure, ostracism, or humiliation (Significance Quest Theory; SQT). Parallel investigations from sociology and criminology established similar findings by linking anomia-a syndrome including feelings of meaninglessness, powerlessness, isolation, self-estrangement, and normlessness-with violent behavior. In line with SQT, this contribution tested if anomia could mediate Loss of Significance effects on violent extremism. Accordingly, three studies conducted in France highlight indirect effects of exposure to discrimination on legitimation of political violence (Study 1, cross-sectional, minority population sample, N = 110), violent behavioral intentions (Study 2, experimental, undergraduate sample, N = 249), and support for ISIS fighters (Study 3, experimental, undergraduate sample, N = 221) through anomia. A subsequent study shows this indirect effect to be robust when controlled for Social Dominance Orientation and Political Extremism (Study 4, cross-sectional, undergraduate sample, N = 279). A final investigation re-analyzing data collected in Turkey highlights a reverse effect when the independent variable tapped into social inclusion (rather than exclusion; Study 5, cross-sectional, undergraduate sample, N = 321). This indirect effect was also robust to Political Extremism and Intolerance as control variables. These results support the usefulness of considering anomia as a proximal predictor of violent extremism in a SQT perspective.